Anyone who is physically active should be able to appreciate the importance of ankle stability. Whether your running, changing direction quickly, jumping or lunging you require strength and control around the ankle to ensure correct posture. If this is lacking then you are at a greater risk of injury. Furthermore conditions like shin splints and plantar fasciitis become more common.
Our ankles support our bodies. As such, this joint carries an incredible amount of weight and has to be quite mobile to allow for an array of movements. It is no surprise then that ankle sprains are very common. The problem with this type of injury is that it is often shrugged off and quickly forgotten. Even with a minor sprain the ankle joint becomes fragile and more likely to give way during movement. This will have an impact on how you control your entire body during movement and can lead to compensations and conditions in other parts of your body.
If you have sprained your ankle, recently or in the past, then it is important to talk to your physiotherapist. If it is a recent injury your physiotherapist will offer guidance on how to reduce swelling and pain within the joint. Taping and supportive footwear will help provide support whilst the ligaments heal. Once the swelling and pain reduces then your physiotherapist may use gentle joint mobilsations to treat any resulting stiffness and you will be guided on the appropriate way to regain stability within the joint through appropriate exercises.
The exercises are specifically designed to help strengthen the ankle. Ankle stability exercises are also a good idea if you are usually active or if you have sprained your ankle in the past. See your physiotherapist and they can do a biomechanical screen to pick up if your current condition is as a result of deficits around the ankle or if you are at a greater risk of ankle injury.
Some simple ankle stability exercises that you could try include:
-Drawing the alphabet with your foot in lying and then trying it whilst standing and balancing on one leg
-Practicing balancing on one leg with eyes open then trying this with eyes closed.
-Using a trampoline, piece of foam or bosu ball to practice your proprioception and balance in a range of different movements.
-Compare the control between the two ankles and you might notice some differences
To find out more on how to improve ankle stability or if your condition is related to your ankle then come in and see one of our physiotherapists who will be able to guide you through the correct exercises for this.
WHAT IS AN ANKLE SPRAIN?An ankle sprain is a stretch or tear in one or more of the lateral (outside) ligaments of the ankle. Ankle ligaments are slightly elastic bands of tissue that keep the ankle bones in place. Because the ankle is responsible for both weight-bearing and mobility, it is particularly susceptible to injury. The relatively small joint has to withstand large forces exerted when walking, running and jumping, especially if the surface is uneven. Most ankle sprains happen when the ankle twists or rolls suddenly, usually a rapid and uncontrolled movement. The most common injuries happen when the foot rolls onto the outside of the ankle, straining the outside ligaments of the ankle joint. Symptoms of a sprained ankle include; pain, tenderness and swelling, bruising, trouble moving the ankle, and sometimes an inability to put your full weight on the ankle.
HOW LONG DOES IT TAKE TO HEAL?Most people recover completely from mild sprains within two to six weeks. More severe sprains can take up to six months before you can return to full activity, or sport. Once a significant sprain occurs, without good rehabilitation the joint may never be as strong as it was before the injury. It is not surprising therefore that many people have a history of repeated ankle sprains. With the correct rehabilitation however, you can help your ankle become even stronger than it was before the injury.
WHAT CAN BE DONE?Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury. This bleeding leads to inflammation, part of the natural healing process. However, the body tends to overreact to sudden traumatic injury and as a result excess inflammatory fluid accumulates which can result in ‘scar’ tissue production. Too much scar tissue may prevent normal function with reduced flexibility and increased risk of re-injury. It is important to get medical advice to gain a positive diagnosis and
ADVICE HANDOUTFollow the PRICE guidelines immediately after injury and for at least 3 days afterwards before doing anything else. Your local physio therapist as well as most massage therapists can assist you with this: PROTECT - Protect the injured tissue from undue stress and avoid ALL movements in the same direction as when the injury occurred. REST – Unload the joint (take the weight off it) as much as you can in the first 72 hours after injury. Try and avoid walking on the joint as much as possible. ICE – Ice is an amazing natural healer and a great short-term pain reducer. It is also believed to have a beneficial effect in reducing swelling and promoting healing. The optimal amount of time to apply ice is around 10-15 minutes in bony areas such as the ankle. It can be applied as often as desired to achieve pain relief, ideally every 1-2 hours. COMPRESSION - This is advised for the first 72 hours, but only while your foot isn’t elevated. The compression can be firm if it doesn’t cause pins and needles or any loss of feeling around the joint. ELEVATION - Reduces the flow of blood to the area which helps reduce swelling. Elevation is recommended in the first 72 hours after injury. However, remove any compression while your foot is elevated unless you are wearing just a light compression bandage. When following PRICE it is also important to avoid HARM, hence the saying: ‘Give PRICE and avoid HARM’. HARM is an acronym for Heat, Alcohol, Running, Massage. Following this acute management phase, your physical therapist will start some ‘hands-on’ treatment to mobilise and strengthen the joint. This phase of treatment is crucial to ensure you return to full function and prevent future injury. Adequate preparation for activity is key and weight-bearing should progress gently. Drastic changes in activity level and performing unpractised skills expose your ankle to re-injury. Gradually build up your fitness level. Your ankle, and the rest of your body, will thank you for it! WHY IMMEDIATE TREATMENT IS IMPORTANT The success of injury healing can be boosted by appropriate, effective and timely action particularly in the early stages of an injury (ie. the first 72 hours). Any ‘soft-tissue’ is subject to injury including ligaments (which join bones to bones), tendons (which join muscles to bones) and to muscles themselves. The immediate reaction of the body to injury is similar irrespective of the soft tissue structure and is known as an inflammatory reaction. Injuries can be caused by overstretching, bruising or crushing. A strain describes overstretching of a muscle, while a sprain describes overstretching of a ligament or tendon. THE INFLAMMATORY REACTION Tissue injury usually involves damage to small blood vessels that results in bleeding at the site of injury. This bleeding leads to the four main signs of inflammation:
- Heat – chemicals released from the damaged tissue causes dilation of surrounding blood vessels to bring healing agents to the area. The result is more blood and therefore heat
- Redness – is due to the increase in blood to the area
- Pain – is caused by the chemicals released from the injured tissues as well as the increased tissue pressure from the fluid acting on nearby nerve endings
- Swelling – is the result of this accumulation of extra fluid.
RUN: Better, Faster, Longer, StrongerDo you dream of being that runner where every step of every mile is 100% pain free? No aches, no twinges or niggles, no lingering soreness from yesterday’s session. You are not alone; research shows that as many as 79% of runners get injured at least once during the year. Stop. Think about that number for a moment; nearly 8 out of every 10 runners you see at your next race have been or will be injured sometime that year. Think of running pains in terms of a spectrum. At one end you have severe, full-blown injuries, we’ll name that the red zone, which includes stress fractures that require time off. The other end, where you're in top form, is the green zone. Mild, transient aches that bug you one day and disappear the next sit closer to the green end. Unfortunately, many runners get stuck in the middle, in the not-quite-injured but not-quite-healthy yellow zone. Your ability to stay in the green zone depends largely on how you react to that first stab of pain. Often a little rest now, or reduction in training mileage and intensity, with some treatment, can prevent a lot of time off later. Developing a proactive long-term injury-prevention strategy, such as strength training, stretching, regular massage and foam-rolling can help keep you in the ‘green.’ Physical therapy is a lot like homework, not all of us like having to do it, but if you don't do it, you’re sure to get in trouble at some stage!
What Causes Running Injuries?There are a lot of theories as to what causes running injury but it seems the answer is fairly obvious: running! Research has stated that “running practice is a necessary cause for RRI (Running Related Injury) and, in fact, the only necessary cause.” With running being the key risk factor for running injuries what other factors influence risk? Historically a lot of emphasis was placed on intrinsic factors like leg length discrepancy, pronation (flat foot), high arches, genu valgus/varum (knock knee or bow legged) and extrinsic factors like ‘special’ running shoes being stability shoes or anti-pronation shoes, lack of stretching. However, recent studies have shown there is no one specific risk factor that has a direct cause-effect relationship with injury rate or injury prevention. Whilst warming up, compression garments, acupuncture and massage have some evidence in reducing injury rates it is all a little grey. Leaving you with a multifactorial buffet of probable contributing causes to running injuries. There is however one specific factor that has been proven, and that is training error. Estimates suggest that anywhere from 60 to as much as 80% of running injuries are due to training errors. Runners become injured when they exceed their tissues capacity to tolerate load. A combination of overloading with inadequate recovery time. Poorly perfused tissues, such as ligaments, tendons and cartilage, are particularly at risk because they adapt more slowly than muscles to increased mechanical load. Factors that affect how much training load a runner can tolerate before injury will also have a role. There are 2 key factors that appear to play a part in this – Body Mass Index (BMI > 25) and history of previous injury, especially in the last 12 months. While high BMI and previous injury may reduce the amount of running your body can manage, strength and conditioning is likely to increase it. There is a growing body of evidence supporting the use of strength training to reduce injury risk and improve performance. Training error and injury risk share a complex relationship - it may not be that total running mileage on its own is key but how quickly this increases, hill and speed training. The old saying of “too much, too soon” is probably quite accurate. Injury prevention is really a ‘mirror image’ of the causes of an injury. So, if you understand the primary reasons for getting injured then you are heading in the right direction to staying healthy this running season. What are The Most Common Injuries to be Aware of? Body tissues such as muscles and tendons are continuously stressed and repaired on a daily basis, as a result of both 'normal' functional activities and sport. An overuse injury often occurs when a specific tissue fails to repair in the time available, begins to breakdown initially at microscopic level and then over time develops into a true injury. So, the first time you feel a soreness, a stiffness or a pain is not necessarily when it all began. The most common injury is ‘runners knee’ or patellofemoral pain syndrome and accounts for over 40% of running injuries. This is followed closely by plantar fasciitis, achilles tendinopathy and then ITB (iliotibial band syndrome), shin splints and hamstring strain. These injuries generally need complete rest or at least a reduction in training volume and intensity. Followed by physical therapy to promote tissue healing and mobility. Although these are overuse injuries there is frequently an underlying muscle weakness and/or flexibility issue that needs to be addressed with specific rehabilitation exercises. If you do pick up an injury (including 'tightness' 'irritation' or 'niggle') that you’re worried about then we can help, the sooner it’s treated the better. And don’t forget to check out our Facebook page https://www.facebook.com/pottsvillephysiotherapy
Don’t Let Yourself Be Sidelined by Tennis InjuriesTennis is one of the most popular sports throughout the world, with approximately 75 million participants worldwide. It is a sport that you can play at every age and at every level. Children can start playing from the age of 4, using softer, slower balls and smaller rackets on modified courts to make the game easier and more fun, gradually progressing to regular rackets, balls and courts. Older players can start the sport at any age and can continue playing all their life. Whether you are looking for the competitive club league tennis or a more social game amongst friends, tennis is an excellent sport with loads of health benefits. Tennis is a fun and social (as well as competitive) way to add to your weekly activity goals.
Here are some amazing benefits of participating in regular activities like tennis:1. Increased brain power From alertness to tactical thinking, tennis enhances the neural connections in your brain. Kids who play tennis regularly get better grades at school. 2. Better hand–eye coordination Playing tennis involves regular skills that all contribute to good hand–eye coordination. You can improve your agility, balance, coordination, reaction time and more. This can benefit you in injury prevention where improved balance and agility can help protect against rolling an ankle or tripping and falling often resulting in sprains or Colles fracture of the wrist or worse a hip fracture in older age. 3. Reduced stress Tennis involves physical, mental, social and emotional challenges, which increase your capacity to deal with stress. Or simply running around smashing some balls may help you to blow off some stress too! 4. Strong heart Compared with other sports, tennis players have the lowest incidence of cardiovascular disease. Playing just 3 hours a week will reduce your risk of heart disease by 56%. 5. Higher fitness levels Playing tennis on a regular basis (2–3 times/week), either singles or doubles, meets the global exercise recommendations and leads to increased fitness levels. Tennis is an excellent interval training technique - running, stopping, burst of activity then rest between points or games (which elevates and then lowers heart rate repeatedly through a match) which is proven to be hugely beneficial in improving fitness levels and in cardiovascular conditioning too. The effect is not only seen in elite players but with recreational tennis too. 6. Leaner body Tennis is an excellent and fun way to burn calories and lose weight. An hour of singles play can burn 580–870 calories. A lower body weight has immense benefits in preventing and managing cardiovascular diseases including diabetes, and a lighter frame will reduce loading on your back and joints reducing joint pain and possible arthritis in older age. 7. Strong bones Playing tennis on a regular basis leads to stronger, healthier bones. This effect is strongest in those who play tennis from an early age, but even if you start playing tennis later in life you can benefit from the positive effect on your bones. This is applicable to both women and men combating the development of osteoporosis a.k.a. brittle bones with ageing. 8. Strong leg muscles Playing tennis strengthens your leg muscles, which helps maintain your mobility and independence in old age.
The Secret is Staying Injury FreeBut these health benefits won’t be very fruitful is you are sitting side-lined because of injuries and while some injuries are quick to repair, others can take a couple of weeks and others may be more stubborn, taking 6 weeks or more. What’s more frustrating, and unfortunately very common, is the risk of re-injury. One of the greatest risk factors for an ankle sprain or a muscle strain (tear) is having suffered from a previous sprain or strain. Nearly 2/3rds of tennis injuries are chronic overuse injuries, many of which are caused by poor technique, incorrect equipment use and lack of physical conditioning
Acute injuries, like an ankle sprain or calf strain, although sudden and unpredictable can also be prevented with adequate preparation and appropriate conditioning. Chat to one of our friendly staff for more information on how to prevent common tennis injuries and stay in the game longer!
10 top tips for Cyclists
Common injuries in Cyclists include knee, lower back, neck and shoulder
Make sure your bike is suitable for the type of riding you are doing
Make sure your body fits the bike
Have a great pedalling technique
Vary your riding from day to day
Stretch and activate, slow build your effort as you start your ride
Target sleep, stress, diet and alcohol
Eat well especially during and after a ride of 2 hours or more
Have a strong and consistent recovery routine
The recovery ride – An easy one our ride at high cadence and low power is essential to good recovery after a hard day.
Achilles Tendon InjuryA tendon is a band of tissue that connects muscle to bone. The Achilles tendon, connects leg muscles to the heel bone, allowing you to walk and run. Achilles tendonopathy is a common injury among runners, but may also occur in people with pronated feet, high arches, tight calf muscles and those who wear inflexible running shoes. Overuse of the Achilles tendon at the back of the heel occurs in the case of dancers, runners and walkers who exert a lot of stress on the tendon during their activities. It is a very painful condition and if one continues to put pressure on the tendon, it may snap, often with a loud popping sound. The primary symptom of an Achilles tendon injury is pain to the back of the heel, which increases with exercise and lessens when exercise stops. Achilles tendonopathy also manifests itself with warmth, swelling and tenderness at the site. Range of motion may be limited. Achilles tendonopathy can lead to small tears in the tendon, making it susceptible to rupture, however rupture may also take place without any previous Achilles tendon problems. If any of these symptoms occur, it is best to rest and elevate the leg while icing it and of course, see us or doctor as early as possible. Achilles tendon ruptures are most often seen among middle-aged people who play a sport on weekends or in their spare time.
Symptoms of Achilles tendon rupture are:
Sudden pain in the back of the ankle which feels like a kick or a stab. It may turn into a dull ache. Swelling between the heel and the calf. Difficulty walking or rising up on the toes.
A rupture may be treated surgically or non-surgically, depending on the extent of the damage and your condition.Until you can get professional help, the RICE formula should be applied: Rest. This is important as walking may cause further problems. Ice. Use an ice pack wrapped in a towel. Never apply directly to the skin and leave on for twenty minutes. Compression. Bandage the foot to prevent further swelling. Elevate the leg at or above the level of the heart to decrease swelling. For non-surgical intervention, we (or a doctor) will recommend a brace or special insoles for your shoes, as well as physiotherapy. We will work with you to manage your pain with ice and instruct you in stretching exercises for the calf muscles. We will also help you modify your training schedule to match your recovery and advise you on wearing proper shoes to prevent further injury.
What is Clinical Pilates and why has it made such an Impact?Clinical Pilates has been shown to reduce the onset, persistence and recurrence of pain by addressing the neuromuscular dysfunction it is associated with. Clinical Pilates is largely concerned with training local spinal and pelvic stabilising muscles to work efficiently throughout functional activity. It is particularly important in the rehabilitation of spinal pain amongst other motor control problems and is associated to what researcher’s term “specific stabilisation exercises” or “motor control exercise”. With the latest research emerging, evidence-based Physiotherapists have re-evaluated their management of low back pain with a shift towards this type of exercise rather than focus on strength and endurance, which is perhaps more appropriate in the advanced stages of rehabilitation. CLINICAL PILATES involves the following components which are particularly helpful to aid in the rehabilitation of low back pain:
- Teaches co-activation of Transversus Abdominis (TA), Pelvic Floor (PF) and Multifidus (MF) muscles
- Teaches correct muscle activation patterns
- Trains local and global stability systems
- Trains neutral stability before end range stability
- Progresses static stability to dynamic
- Direction specific
Osteoarthritis and supplementsOsteoarthritis is a common inflammatory condition characterised by joint pain. See below example. Osteoarthritis affects 2.1 million Australians. The prevalence is higher in women and joint symptoms are experienced by more than 25% of people aged 65 years or older. Osteoarthritis is particularly burdensome, on individuals and on the healthcare system and is the main reason for knee replacement surgery. This is of great concern considering the projected rise in the aging population. In recent years, omega 3 fatty acids (from fish oil), glucosamine and chondroiten have increased in popularity. Research into these and osteoarthritis is showing some promising results, however more research is still needed. Should you take these supplements if you have Osteoarthritis?? You can as there is some worthwhile evidence but it should form only a small part of your management plan. Score your pain on a scale of 1-10 before taking the supplement, then after 3-6 months score your pain again to see if there has been any change. If you are taking chondroitin it is recommended that you take a supplement containing 800mg such as BioOrganics glucosamine 750g and chondroitin 400mg. There is much stronger evidence to show that dietary induced weight loss (>10% of body weight) and physical exercise such as strength training and aerobic exercise can have a moderate to large improvement in pain, function and quality of life. In addition, learning effective pain – coping skills have been shown to have positive outcomes not only for pain but also for function, stiffness and disability.
What is World Osteoporosis Day?World Osteoporosis Day takes place every year on October 20th, launching a year-long campaign dedicated to raising global awareness of the prevention, diagnosis and treatment of osteoporosis and metabolic bone disease.
In Australia an estimated 1.2 million people have osteoporosis and a further 6.3 million have low bone density.The disease is most common on the older population with 66% of adults over 50 suffering Poor bone health can lead to minimal trauma fractures such as a minor bump or fall The most common fracture sites include: hip, wrist, spine arms and ribs Physiotherapists understand the impact of a fracture on a patient, seeing how disruptive they can be for day to day tasks and quality of life, slowing the road to recovery. Fracture prevention is complicated but studies have shown we can reduce re-fracture rates by up to 80%. We can devise strength and balance programs specific to you type of fracture, age and level of function which result in improved mobility strength and physical performance A new online tool will assist you and your Physio. Visit http://www.knowyourbones.org.au/ Australia’s first bone health self assessment. The assessment provides a general risk summary report.
Why do you love Pilates? I love Pilates because it is a form of exercise that can be modified to suit ANYONE. The layers of challenge you can add are endless. I also love that age is no barrier, it's the practice that counts! What's the best thing about being a physio? Being able to help people reach the goals that are most important to them. No matter how big or small, it's really rewarding to be a part of that journey. I also love that physio can take you in so many directions. From the clinic to the sports field, the possibilities are endless! Why work at Pottsville and Cabarita Physiotherapy ? I grew up in Cabarita, so it's nice to be able to come back to my roots. It's an amazing community with a great coastal vibe and being so close to the beach is always a plus. But, most importantly, the team is amazing! Best relaxation tip? A nice long walk along the beach followed by some guided meditation. There is nothing better. Best lifestyle tip? Find something you love and do it consistently. Challenge yourself in some way each and every day. Favourite activity? Doing some high intensity interval training or boxing. It gets the heart racing and the sweat pouring. It's even better when you have some amazing people to work out with. Favourite recipe? Tacos. Need I say more? A special mention to Kai's choc chip oatmeal cookies. If you haven't tried them, you should! A typical Sunday... A nice long sleep in followed by a Pilates workout. I then like to go to one of my favourite cafes on the Coast and enjoy multiple coffees and a delicious brunch. You might catch me running around the rugby league scene in the afternoon. That's my other passion!