the physio place blog

WHAT WOULD YOU DO....IF YOU WERE INJURED AT THE TIME OF A COMPETITION - PLAY ON OR PULL OUT?

2008-04-27T14:18:00.001-07:00

The National Tennis Championships are now over – many congratulations to Edgbaston who beat Bristol today in the final.

It was great to have a chance to see some first class doubles tennis here in Bristol at Next Generation Health Club and also to talk to and do physio on some of the players. One thing I found with almost all those I treated was great determination to play-on despite aches/pains and injuries which would normally bring people to a hobble!

As a rower both in a 'four' and an 'eight', I know how important it is not to let team mates down despite not necessarily being on top form on race day. However I recently spoke with a hurdler who said that he wouldn't consider competing if he wasn't absolutely fit for it on the day....interesting.

So here's the question - Are people in teams more likely to play-on despite injuries than people who are competing on their own and if so, why?

What are your thoughts? Email me at jemma@thephysioplace.com or post a note on this blog and let me know your sport, your level and what you would do. I’ll continue to do my own research amongst patients I treat and feedback my findings.

Thanks

Fun evening with Pat Cash vs Jeremy Bates

2008-04-24T14:24:00.000-07:00

Last night saw the charity tennis match between Pat Cash and Jeremy Bates which was an evening of entertainment and great tennis. Excellent to see the celebs of the tennis world here in Bristol.

The rest of the week at Next Generation is now over to the National Tennis Championship Finals with the final match being played at 1pm on Sunday. If you enjoy tennis and would like to see some high quality tennis being played I recommend you make your way to Next Generation as soon as. Tickets are available from the club.

Celebrity Charity Tennis Event, Next Generation Health Club

2008-04-21T05:28:00.000-07:00

This week Next Generation Health Club, Bristol, where The Physio Place is based, is hosting a Celebrity Charity Tennis Event to raise money for St Peter's Hospice. The first night of this 5 day event will see Pat Cash on court together with other celebrities from TV and sport. It promises to be a great event. I just want to wish everyone playing the best of luck! Don't forget to warm up and stretch out etc - I'm covering the physio so the less injuries the better please! :-)

Anyone interested in attending this great event is advised to call 01845578465 or 07870778490 for tickets.

Look forward to seeing you there.

TENNIS - ADVICE TO REDUCE/ASSIST WITH UPPER LIMB PROBLEMS

2008-04-15T09:10:00.000-07:00

At last the sun's arrived and for many the tennis court beckons. If that's you but you're concerned that old injuries might return, or work related problems may inhibit your game, I recommend you take action and really work to strengthen both your shoulder and arm muscles and also make sure that your core stability muscles are working well.

I regularly treat racquet sports injuries and work related upper limb problems and have found that good posture, core stability and scapular (shoulder blade) control are significant contributors to long term painfree games.

For core muscle activation I recommend looking at my earlier blog on 'running and back pain'. Pilates is also a great way of getting your core muscles working.

Getting your shoulder into a good position is not easy to describe but good posture with well maintained back curves will help to achieve this. Think of a 'piece of string' pulling you up by your hair - don't stick your chest or bottom out but reach up with the imaginary piece of string. This should help to bring your good posture about.

The other thing is strength - once the shoulder and posture and core is good - making sure the muscles around your shoulder blade and arm are strong enough and not too tight. A balance between length and strength of muscles is essential.

Please note that if you're still struggling despite these tips or if you have been experiencing tingling, numbness or pain radiating down your arm and/or into your hand, headaches or other oddities, I recommend that you seek the help of a Chartered Physiotherapist to address the specifics of your problems.

None of the information given on this blog should cause you any problems but if it does stop immediately and seek the advice of a professional.

RESEARCH INTO REFLEXOLOGY BBC PROGRAMME

2008-03-25T05:36:00.000-07:00

Did you see the programme last night about Reflexology? I watched with fascination as a scientist tried to find out and understand the theory behind the practice of reflexology. I have worked alongside reflexologists in the past and have been told by several of the 'freeing up energy pathways' and 'influencing nerves' by massage of the foot but never really understood it from an anatomical view point.

I think the programme served to show that although anecdotal evidence suggests that reflexology can be helpful, from an anatomical point of view it cannot be proven how. However it did prove that touch has an important effect on positively influencing how people feel, which as a physiotherapist who does a lot of hands-on treatment, is good to see proven.

HOW TO LIMIT ACHES AND PAINS AT YOUR WORKSTATION

2008-03-09T07:48:00.000-07:00

After what seems to have been quite a bit of interest last week on my handy back care hints, I thought I'd highlight a couple of key things that might help you if you're suffering from aches and pains whilst sitting at your desk.

I regularly carry out Display Screen Equipment (DSE) workstation assessments and frequently find similar problems.

I'll start with the chair. Does the curve of your low back feel well supported by your chair? If not it may be that the height of the back of the chair may need raising or lowering to achieve this. Another thing to consider is how upright the chair back is - slumping or lying back in your chair is not good!!

Next your screen height - is the top of your screen level with your eyes? If you currently spend most of your time using a laptop it really is worth having either a separate screen or keyboard which will improve posture and reduce neck bend.

Another important fact about the screen is that you shouldn't rotate either your head or body to look at it - if you are, try to move it to a place on your desk that means that you can sit directly in front of it without rotating.

Next, the keyboard and mouse - can you reach them both whilst keeping your elbows by your side? Are your elbows at a 90 degree angle? If not, bring both the keyboard and mouse closer towards you to achieve this angle. This is often helpful in reducing aches and pains in shoulders and arms.

Finally, take regular breaks from prolonged actvities such as sitting and wherever possible try and vary your tasks throughout the day.

Please note that these pointers do not make up a full workstation assessment they are just a couple of things to look at. If, despite these suggestions you are still suffering, you may need some physiotherapy treatment. If however, you don't suffer with problems until you come to sit at your desk - perhaps it would be more appropriate to get someone to look at the specifics of your workstation.

If you are interested in finding out more about workstation assessments in general have a look at this and if you have a question about your own that you'd like advice about do email me .

BACK PAIN - HANDY HINTS TO HELP REDUCE/MANAGE IT

2008-03-05T05:02:00.000-08:00

This week I have been asked to do a number of workstation assessments and also given a back care talk so it seemed a good time to share some of the things I've found and a couple of handy hints to help reduce/limit back ache. Please remember however that this advice is very general and may not be specific to your problem - for specific advice and exercises I would strong suggest you see a physiotherapist.

Working through the day's activities....
1. remember to roll out of bed don't just pull up on your 'washboard' - think of a car starting in the morning - it takes a bit of time to warm up and this is a good way to prepare you body for the day
2. think about how you're sitting in the car - is your back well supported? how far back have you positioned your car seat - if you're practically horizontal this is not a great position!! trying bringing the seat more upright - closer to a 90-100 degree angle at your hips
3. if you do a lot of lifting/carrying keep the load close to your body and bend your knee to pick it up if it's low. If you're carrying shopping - split the load into two bags and distribute the weight evenly or even better put everything into a back pack and use both shoulder straps to carry
4. daily activities about the home such as hoovering, ironing, washing up, etc can bring about pain - try to break regularly from a static posture and do something else - varying tasks and trying to maintain your low back curve can really help to reduce this kind of ache. When washing up - try opening cupboard door of the unit the sink is is and rest one foot up on the low shelf - it can just help to bring you into a less flexed posture
5. if you go to the gym or play a sport - consider how you are using the equipment - make sure your core is working well and you have enough length and strength in your upper and lower limbs to allow for the movement you require. If you're not sure how strong or flexible your muscles are - ask a gym member of staff or email me and I'll be happy to answer any questions link
6. thinking about footwear is also key - if you wear high heels a lot - remember to stretch out your calves regularly, if you tend to wear shoes that don't offer much support into the arch of your foot they may not be helping your back either - a pair with more support could be the answer
Having been good all day at your desk with your sitting posture etc - don't go home and slump in front of the tv! Try keeping your low back curve as much as possible - perhaps use a pillow to support the curve - keep your feet on the floor and don't sit for hours at a time!
Getting up from sitting and moving regularly whether at work, in the car or sitting at home can really help to reduce problems with our backs.
The next thing to think about is your bed - making sure it is the most supportive and comfortable for you is essential - don't assume that because it is 'orthopaedic' for example that it must be the right one for you - it may be - but try lying on a number of different mattresses and compare the different levels of support and comfort - you may be surprised. Key things to look for are that your back curves should not disappear into a dip in the mattress nor should you feel like you're resting on the top as if lying on the floor.
Hope these suggestions are helpful.

DOES YOUR BACK ACHE WHEN YOU RUN?

2008-02-22T11:47:00.000-08:00

Running analysis is something I really enjoy doing, as it is a great way to see how runners are moving, helping to identify which muscles are working and show potential areas of problems which can contribution to back ache.

Back ache, which can be due to a number of different reasons, is often seen as too little or too much mobility of the spine which can significantly affect performance.

However it cannot be assumed that the problem rests solely with the back itself as tightness and weakness of muscles and/or altered foot, knee and hip mechanics can all have an impact on our spine.

If you are suffering with back pain which is stopping you from running I advise that you contact a qualified chartered physio to address the specifics of your presentation/problems.

If, for example, you find that you occasionally feel back ache at the end of run, I would advise you to have your running analysed by a physio who specialises in this to identify the likely contributing factors.

If you would like some simple pointers on how you might be able to get your back and core muscles into action - which may help with your running performance the following may be helpful. However again, if you struggle with any of the exercises or any of them aggravate anything I really would encourage you to see a physio for specific advice about your needs.

Ok here goes. First of all - a good posture is essential. I know physios go on and on about posture but it really is very important. As many of the muscles that keep us upright and mobile are attached to our spine and pelvis, getting our back curves and pelvis into the right position helps to get the best control/length/strength from our muscles.

One suggestion you can try to help get a good posture is to imagine there is a piece of string attached to the top of your head pulling you upright - please note though - this is not about sticking your chest out!

Next, core stability. I've just had a look at some of the websites that show core stability exercises and they tend to go straight to doing exercises like the 'plank' and 'oblique strengthening'. I strongly recommend that these exercises are NOT the first ones you undertake. I suggest the first muscle that should be addressed is 'transverse abdominus' - which acts as our abdominal 'corset'. This muscle is the deepest abdominal muscle and goes all around our trunk. There are a number of ways to try to activate this muscle one way is to try tightening your pelvic floor muscle - not your 'washboard' - and remember to keep breathing!

The next key muscle is 'multifidus' which runs either side of the lower spine. Try taking a light weight in one hand and raising a straight arm forward - this will work the opposite back muscle - repeat on the other side - remember to keep your good posture throughout!

Assuming you are not in pain and that the muscles mentioned above are working well, why not have a go at the more challenging exercises on this link

Earlier I mentioned the contribution to back problems that altered foot, knee and hip mechanics can have. One key way to help address some of these problems is with making sure you have the right trainers. I keep coming back to the importance of trainers but it really is vital to get this bit of kit right and also remember that trainers don't last forever! Most will be good for between 400-500 miles then will need replacing. Make sure you go to a good shop which looks at you running. Try on a few pairs to make sure you've chosen the most comfortable one for you which also offers enough support.

Hope that helps.

STRETCHES FOR RUNNERS

2008-02-21T02:39:00.000-08:00

Over the last couple of days I have had several enquiries from runners about which stretches they should be doing for their legs. I found this website that I think is particularly helpful link - have a look at stretches 1-4. These are good for the legs and won't put any unnecessary stress through your low back when doing them - always a good thing!

MARATHON RUNNING AND HOW TO AVOID KNEE PAIN

2008-02-18T04:31:00.000-08:00

Thankfully the number of skiing injuries coming into the clinic at the moment is small, however running is a different story!

With what seems to be an interesting interest in people having a go at running anything from a 5k to a marathon, the number of knee and ankle problems is high.

I've listed here a couple of handy hints that I have found to be the main contributors to problems. First of all trainers!! It's essential that the "green flash" from school are NOT use for running!! Make sure that you visit a good running shop and have your running looked at. Try on a few different pairs to see how they compare. Shops in Bristol include Easy Runner and The Sweatshop, Next Generation Health Club.

Another key problem seems to be the length and strength of leg muscles. By stretching regularly - front and back thigh muscles (quads and hamstrings) and calf muscles, you will help to maintain flexibility and by making sure that muscles are also strong enough. Quick tests to try - hopping 30 times - does one leg tire before the other? If you have access to a leg press - what weight are you able to push on each leg - is there a difference between the two? Whilst lying on your front can you hold a static knee bend against a reasonably firm resistance between the angles of 90 degrees and an almost straight leg? If there are differences they ought to be addressed.

Next, how is your balance? Are you relatively stable when standing on one leg on an uneven surface - does running across uneven ground create problems? Practice standing on one leg on an uneven surface like a trampette/wobble board or perhaps a cushion (if at home)- if quite challenging - you may need either more practice or perhaps some strengthening exercises/support for your feet/ankles.

I know it's hard to know how we look when we run but running at a speed that is right for our form can also help reduce problems. Too much speed without good muscle balance and core muscles can contribute to lower limb problems but also can affect our backs and shoulders too.

To get the most out of your training and enjoy the journey - cos it should be fun!! - the key points are get the right kit, follow a good training programme including healthy eating and if you're at all concerned about an ache or pain - that isn't improving despite my handy hints! - have a chat with a physio and find out what the best plan of action is.

Info on Knee Injury

2008-02-13T06:09:00.000-08:00

Seeing a lot of knee injuries at the moment and discovered this site which has some useful material.

Get ski fit

2008-02-12T06:45:00.000-08:00

Ok, so you’re heading to the slopes. Planning on an injury-free time and hoping to get the most out of every day.

Well before you go have why not consider some useful exercises to help minimise injury, strengthen your legs and give you the stamina to keep going.

In my experience knee pain is a major problem for both skiers and boarders. We all know that accidents happen but fatigue and muscle weakness not offering enough joint stability leading to injury could be avoided.

For knee strengthening in a gym I would suggest using the leg press and hamstring curl machine. With or without access to a gym – try squats, lunges, step ups (on a box/stair). For improvement in balance – try standing on one leg and drawing a semi-circle in the air with the one that’s off the ground – to make this more difficult why not stand on an uneven surface like a wobble board or cushion. Finally for those inner thigh muscles try lying on one side and lifting the leg of the side you’re lying on – make the lifts both small and large in range. Warming up and really stretching well is also key – especially calves and making sure that you do stretches regularly while your on holiday will certainly help to reduce the risk of strains.

For some general guidelines towards getting fit for skiing this article is helpful:
http://www.sportandme.com/docs/sports/skiing/guide/ski_exercises.html

Here are some more handy hints on how to minimise damage for the beginner skier http://jointhealing.com/pages/sports/skiing.htm