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The big movement in health in recent times has been about prevention of injuries. This is particularly a big issue in sports where an injury to a star player can cost the club a lot of money. So how can we prevent injuries from happening?
Well some injuries you probably can't (unless you lock yourself away in a room, although you will likely be at risk of developing other issues) however a large number of conditions that we see on a regular basis are the result of a combination of things that can be seen in a person's history, lifestyle and physical examination. So what are some of the things to look for? The number one biggest factor that increases the likelihood of an injury is a previous injury. Why is that? Well even if a structure, say a ligament in the ankle, has fully healed, the body can still have changes that carry on. These changes in the body likely wont be painful. They are adaptations and changes that allow an individual to continue to function. Unfortunately these changes can lead to future injury. There are a number of tools which we use in combination with a history One of the tools we use in the clinic to identify underlying musculoskeletal issues. One of the most helpful ones being the SFMA. These tests help us to find out if there are any issues with how the body is or isnt able to move and if there are changes to how the body activates its muscles. Lack of normal movement or a change in the normal movement or muscle firing pattern give us a good indication of problems that research has shown to have a strong link to future injuries. So if you have had a previous injury and you feel a sense that something isnt quite right then it may be worth getting that checked from a qualified professional to make sure you wont be dealing with future problems.
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 Like many, my holiday period consisted of eating too much and doing too little. As a result I have come back determined to get back in shape (again).
Each year I get a steady stream of my patients at Activ Therapy asking me for advice on 1) what is the best option for them and 2) whether they should wait until they are pain free to start exercising? In Moorebank and Chipping Norton alone there is an anytime fitness, a plus fitness, crossfit, F45, pilates, curves as well as running clubs, sports teams, boot camps and martial arts academies. No wonder its hard to decide. My answer to 1 is always to go with what will interests you and motivates you and to consider your goals. I always encourage people not to go by price. At the end of the day paying a lot of money to never go is a lot more costly in my mind that paying a little more to actually train and achieve your goals. Ultimately it does come down to what kind of exercise you will enjoy and have the best chance of sticking with (at least long enough to see some actual progress!). Part 2 is a bit more straight forward. Exercise is always appropriate, its just a matter of doing things the right way and at the right intensity. If you have a current injury then it isnt difficult for a therapist to assess you and give you a list of things you shouldn't do which you can then take to your trainer. Your trainer will have a 101 ways to punish you for being overly festive over the holidays so simply eliminating what isnt appropriate wont get in the way of constructing a program that will work for you. Also it should be noted that a good trainer will be able to help you with exercises that will actually help your condition. So it's another reason to get moving sooner. So if you are still procrastinating about getting yourself fit again this year, hopefully reading this means you have one less excuse to make to your personal trainer.
Well a lot depends on what you are used to, as it isn't easy changing your position after several decades. There are a few things that you can do.
If you are a back sleeper then a firmer mattress is preferred as it will better support your spine posture. You also would want a slimmer pillow to support the curvature at your neck. If you sleep on your side then a softer mattress may suit you better as it won't compress your shoulder when lying on it. Your pillow needs to be a bit higher to support the space around your shoulder and the side of your neck. Now many people move a lot from side to side and their back. If you are in that boat then a curved foam pillow with a low and high side of the pillow can do both. If you sleep on your front then it often means that you have your head to one side and arm up over your head which places your spine in a rotated posture and your shoulder in an awkward position. Its not an easy thing to change but one thing you can do is to try sleeping with a pillow underneath one chest when on your front. That way you are a little closer to be a side sleeper! So the answer to sleeping position, pillows and mattress isn't a one size fits all matter. It depends on what you have gotten used to and what pain or discomfort you experience during the night and in the morning. Its about putting in place a strategy to improve your current sleep situation. Who would have thought there was so much to it? I've had a few patients that come in with back and leg pain and the most common self diagnosis (or often the medical/health professional diagnosis) is that it is sciatica. The thing is, not all forms of leg pain that seem to stem from the back is sciatica. In fact as far as what I have seen come through our clinic, the vast majority isn't. The danger is that when diagnosed with true sciatic pain, it can be debilitating and very difficult to treat. Very often it can require corticosteroid or neurosurgery. I find that it is important to ensure that you are dealing with true sciatic pain only before taking those steps. Sciatica refers to lower back pain associated with leg pain due to compression of a spinal nerve root which travels down the leg and becomes the sciatic nerve. This compression usually occurs as a result of degenerative disc changes.  So how can we tell if it is or isnt sciatica?
Well firstly you want to ensure that the assessment is complete. You could be dealing with back pain in conjunction with a lower limb condition such as anterior hip impingement, ilitibial band syndrome, peripheral nerve tension or hamstring strain. I find that in most cases though the leg pain IS directly related to the lower back however not as a sciatica issue. Rather the lumbar spine condition is occuring (or has led to) changes in pelvis orientation causing symptoms radiating from the posterior pelvis. The most common mechanism I come across is a form of piriformis syndrome where either spasming of the piriformis muscle can create pain or the muscle can irritate the nearby sciatic nerve, causing pain that travels down the leg. In all cases of sciatic symptoms short term physiotherapy or chiropractic can be valuable in identifying and differentiating between various lower back injuries. If it isn't scaitica then treatment can significantly reduce symptoms within days. Every day stresses to the body (both physical, emotional and chemical) can cause changes to the way the soft tissues in our body (muscles and fascia) act. In particular all of us would have noticed "tight" muscles or "knots in different areas of the body. Now it would be great to have your favourite physio, chiro or massage therapist in your pocket to pull out and release these each day but for most that isnt possible. One thing we highly encourage (that you can do every day) is use a trigger point ball to self release. Read more about the trigger point balls here. Below are 5 different self release you can do using this simple but easy treatment tool. 1. Tight shoulders (posterior cuff and rear deltoids)
2. Calf muscles (gastrocnemius and soleus)
3. Painful heel (Plantar fascia)
4. Upper back (thoracic spine)
5. Tight hips (Gluteus medius and piriformis)
Let us know how you go with these exercises. If you didnt get the body region that gives you issues, shoot us an email or speak to your physiotherapist or chiropractor.
People dont often link their elbow pain to the bench press. It is a relatively common comlpaint that we see in our clinics, particularly with some of the big lifters.
What we see as the issue creating elbow problems during the bench press is the shoulder. The two movements that the shoulder needs to be able to perform to get into the deeper part of the bench press position are horizontal abduction (the action the shoulder does to get the elbows moving towards the floor during the bench press) and internal rotation. When the shoulder can't perform these two movements it becomes an issue during the bench press because the hands are fixed by a heavy bar, with only so much room to give and without the shoulder moving correctly the elbow is stuck in the middle. This means that as you try and lift the bar back up out of the bottom-most point of the lift, the elbow is forced to rotate, causing irritation of the wrist flexors/supinators as well as the inside part of the elbow joint. Although it may sound technical your chiropractor or physiotherapist can easily identify this and treat it by regaining the movement in your shoulder and reducing the local irritation at the elbow. Before long you will be pushing new boundaries with the bench press!  Recently we have been lucky enough to work with some elite lifters from PTC Sydney. In that time we have learned a lot in a short time about the very specific needs of their athletes and how to work with their trainers to get the best results. Working with knowledgeable and experienced trainers changes a lot about what we normally do as a lot of the simple stuff we recommend are already being done. Most of our treatments in our clinic gear towards overall health and function but the rules change when the goal is very specific sports performance. The squat, deadlift and bench press are common movements that we have always utilised in the rehab of our clients but zeroing in on getting the most out of these movements while at the same time managing the injuries and pains that come with pushing your body to the limit offer a different set of challenges. Often we need to help our clients work with some degree of pain and depending on competition make decisions on what pain is ok vs the goals of the athlete. Once competition is over we can make long terms plans to get the body right and then build towards the next one.
 We are all told to use our legs to lift but every day we see our patients have trouble performing a good deep squat. This is even in those that exercise regularly. Now there are a bunch of different things that can happen to limit squat range but I wanted to focus on one of the most common one that we see. Before I do that, it's important to understand why it's important. What is the benefit of having a good squat?
Well to start with, those that aren't able to squat still need to perform daily activities like getting in/out of a chair or of a car or picking something off the floor that are similar functional movements. Those that arent able to squat properly are using a different movement pattern to achieve those tasks. Often using more of the lower back extensors (leading to low back pain). Another reason is that the factors needed to squat also relate to other day to day tasks like climbing stairs, walking, mopping or climbing a ladder. If you're squat isn't right then whatever is causing that is probably also affecting other daily movements. So what's holding back your squat? Yes it could be weakness in your thigh muscles but usually its something you might not expect. Stiffness in the upper back, difficulty bracing the core/trunk muscles, weak glute control and internal rotation of the hips are all causes that we see. The one I wanted to focus on and something we see frequently is the lack of ankle range of movement. An inability to dorsiflex (which is the action of bringing your shin forward while standing) can limit how far your knees can come forward which means your centre of gravity cant remain forward as you squat. This usually results in not being able to go too deep with your knees and hips and compensation by bending way too far forward with your back. So what can you look out for? The 5 most common things that might mean a lack of ankle range is holding back your squat are:
Have a look out and if you have any of these and find yourself with aches and pains in your back, knees or hips then a complete assessment by a physiotherapist of chiropractor can help figure it out.  What happens when you sustain an injury? Well in the case of soft tissue (muscle, joint, tendon or ligament) injuries the body undergoes a few stages in order to heal and recover. One of those stages is the inflammatory process. This is the stage (usually the first few days after an injury) where you get all the pain, swelling and heat around an injured area. It is a necessary but painful part of the body's healing process.
Although we dont want to stop the inflammatory process we do want to manage it (and the pain ans swelling that comes with it) and prevent it from getting worse. Certain factors can increase inflammation such as increased activity or weight through an injured area, alcohol or certain foods. On the other side many of you would be familiar with the acronym (R.I.C.E). Referring to rest, ice, compression and elevation. There are also certain foods that can help. An increase in omega 3 foods and reduction in omega 6 foods can assist in managing levels of inflammation. Omega 3 rich foods (that can help reduce infllammation) include:
Also some common herbs that have anti-inflammatory properties include:
Of course everything should be taken in moderation as part of a balanced diet and if you are at all unsure speak to your dietician or nutritionist.
All of these patients came in developing these problems gradually without any specific incident that set it off. They were told that the causes stemmed from repetitive work, bad posture, weak muscles or the classic "wear and tear". As a result the treatments were the fairly standard. Ultrasound and massage the painful area then do some theraband exercises.
Although most of us arent as flexible in one direction compared to the opposite there are some signs that can tell us there may be an issue.
If it is an issue we treat it to regain the movement. Typically you should improve it within one to three sessions. Then move on to the next problematic movement or action. Through this process you can regain pain free function. Whether or not the ultrasound may have the word "bursitis" on it. |
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