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Keep moving with kneecap pain

Keep moving with kneecap pain

Pain in the front of the knee, around the kneecap can be a common issue in people presenting to Physiotherapy. This issue can be caused by an irritation of the patellofemoral joint, the joint between your kneecap and the base of your thigh bone. Often pain can occur in this joint when running, walking up or down stairs or during other exercise such as squatting. Pain in this area often relates to pressure on the kneecap as it articulates with the bottom of your thigh bone – your femur. The force on this joint is mainly influenced by two things: the amount of force being produced by the quadriceps muscles on the top of your thigh, and the amount of knee bend or flexion that occurs when the joint is under load.

Here are a few strategies you could implement to reduce your patellofemoral pain whilst continuing to exercise:

  1. Choose exercise activities that gradually expose the knee to greater stresses.
  There is a systematic review by Hart et al. (2022) that has looked at the average reaction force that different activities place on the patellofemoral joint in healthy individuals. Walking: 0.9x body weight Descending stairs: 2.8x body weight Ascending stairs: 3.8x body weight Running: 5.2x body weight Squatting: 1 – 18x body Looking at these averages, a good way to try and reduce the load on the patellofemoral joint could be to target start with a low loading exercise such as walking and gradually progress to stairs and then running. As you can see, there is a very large variability in the loads that are placed on the knee during squatting movements. Therefore, if you can minimise the amount of knee bend during your squats, you may be able to reduce your knee pain.
  1. Modify your current exercise program to reduce the stress on the knee joint.
  We know that the joint reaction force will increase with greater knee bend. Choosing squat variations that limit your knee from bending more than 90 degrees could allow you to maintain lower body strength whilst reducing your pain. Choosing exercises that are double-legged rather than single-legged may reduce the tendency of your knee to track inwards, which may help to settle your patellofemoral pain. If you are a runner, increasing your step rate may help you to settle your knee pain and keep you running. If you keep the same running pace, an increased step rate will reduce your stride length, which reduces the amount of knee bend through the weight-bearing portion of the running cycle. This can then reduce the reaction force in the patellofemoral joint, and it will be easier to maintain better alignment through your hips to avoid a scissoring pattern. Then once symptoms have settled you can begin gradually re-expose the knee to more loads over time so that it can get used to it. As with many areas of the body, this advice is generalised and may not be affective for individuals with varied anatomy and movement patterns. Try a few of these strategies, and if you’re still having issues with your knee pain, we’d be happy to help you here at the clinic. Reference: Hart, H. F., Patterson, B. E., Crossley, K. M., Culvenor, A. G., Khan, M. C. M., King, M. G., & Sritharan, P. (2022). May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis. British Journal of Sports Medicine, 56(9), 521–530. https://doi.org/10.1136/bjsports-2021-104686

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Don’t Get into Deep Water with Swimming Injuries

Don’t Get into Deep Water with Swimming Injuries

Swimming is one of the most popular sports in the world. We swim in the sea, pools, lakes, streams, rivers and even ponds. And given 70% of the Earth’s surface is water, we’re not short of opportunities. And while swimming is considered a ‘low-impact’ sport due to the fact that the water supports a large percentage of, more than 84% of regular swimmers suffer from some type of overuse type injury caused by swimming. Why? The main reason is the high repetition number and forceful nature of the shoulder revolutions which takes our shoulder joint through its full range of motion (which is one of the greatest of all our joints), against resistance, over and over again. And as 50-90% of the power generated to propel you forward comes from the shoulders, you can see why they are the most frequently injured joint. However, swimming also puts stress on your back, to hold you level in the water; on the neck when raising your head out of the water to breathe and if you favour breaststroke as a stroke, there’s added pressure from the unnatural twisting motion on the knees. So, despite it seeming to be a low-impact sport, swimming actually carries a surprisingly high risk of injury. Let’s take a look at those injuries, why they happen and what you can do about them. Swimming injuries generally stem from two sources, and often these sources will combine:
  1. Muscle imbalances
  2. Stroke technique issues
Muscle Imbalances Our everyday posture, particularly if you spend a lot of time sitting at desk or in a car, or generally not moving around, creates all sorts of muscle imbalances from short hamstrings, tight muscles around the neck, back and shoulders. We unconsciously adopt a curved forward upper back, round shoulders and chin poke, which not only add to shoulder problems in swimmers but neck pain too. Poor posture is the biggest culprit of short tight trapezius and pectoral muscles and weak anterior (front) neck and upper back muscles. These muscles can be painful and develop trigger points which are hyperactive spots in the muscle, commonly referring pain and causing headaches. Tight muscles may also limit your neck movements. Good posture ensures good alignment of the joints and ligaments which allows for optimal contraction of your muscles and off-loads underlying structures. Stroke Technique This a big topic to cover because it depends what stroke you’re swimming mostly with and what kind of injury you may have but issues include: a wide, swinging arm recovery which requires excessive internal rotation, causing impingement on the joint; thumb in first with hand entry, which again causes excessive internal rotation in the shoulder and a dropped elbow or straight arm pull through which creates a long lever and overloads the shoulder. What does all of this mean to you? You shouldn’t swim? You should reduce your training or change your sport? The bottom line is that the benefits of swimming - whether it’s for general fitness and physical activity, the desire to win competitions, or just to find your quiet place for stress relief - far outweigh the risk of injury.

   

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RUN: Better, Faster, Longer, Stronger

RUN: Better, Faster, Longer, Stronger

Do 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  

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Game On: Avoiding Injury

 

Game On: Avoiding Injury

Just like the Olympic games, soccer transcends race, religion, culture, and nationality to unite us in a singular interest. It has become an international language with a staggering 270 million people playing in games across the globe. It’s a sport that inspires the kind of collective joy that can only come from sharing a truly remarkable experience. And that alone is worth celebrating. Alas, the game we love does not come without consequence. Unfortunately, soccer injuries are all too common. Muscle injuries are a frequent occurrence among soccer players. This type of injury is associated with a burst of acceleration or sprinting, sudden stopping, lunging, sliding or a high kick. Ankle and knee injuries are also very common. This injury occurs when ligaments are strained, during cutting, twisting, jumping, changing direction or contact/tackling. Groin pain, in particular, is a widespread occurrence, with 1 in 5 players experiencing an injury in a season. Surprisingly, nearly half of all soccer injuries can be avoided. It’s true, preventing injury is possible. In most cases, injuries are caused by an underlying weakness or imbalance in the muscles of the leg, core, and pelvis. Specialized exercises and training programmes designed to address the areas that are most vulnerable to injury during a game can dramatically reduce your risk of getting injured. Your physical fitness is the single most important factor in preventing soccer injuries. For instance, studies have found that:
  • Strength training can reduce the incidence of injury by nearly half (47%) compared to players who did no specific strength training.
  • 51% of hamstring injuries can be avoided with good proprioceptive programmes.
  • Among players who participated in pre-season proprioceptive training 3x a week, there were 7x fewer ACL injuries and an 87% decrease in the risk of ankle sprain.
  • Neuromuscular training for the knee can reduce the incidents of serious knee injury by 3.5x.
Whether you are an avid player or prefer to play part-time as a pastime, injuries can be bad news. But a little knowledge and preparation can go a long way. That’s why we’ve put together printable/downloadable fact sheets on the 6 most common soccer injuries, and how to both prevent and treat them. Our free fact sheets include prevention and treatment techniques for:
  • ACL Injury
  • Hamstring Strains
  • Ankle Sprains
  • Meniscus Injury
  • Groin Strains
  • Contusion Injury
  Our informative fact sheets are perfect for anyone who is interested in preventing injuries, treating injuries, and minimizing the risk of reinjury. You can download them here If you want to understand more about any of these aspects, get in touch with us. A good preventative programme incorporating both strength and neuromuscular/proprioceptive training can help keep you in the game. If you’ve already suffered from a soccer injury or your kids, family or friends have suffered from one, download our informative fact sheets for treatment techniques Click here And be sure to check out our Facebook page https://www.facebook.com/pottsvillephysiotherapy

Where we’re posting fun and informative tips and tricks to help you stay safe on the soccer pitch.

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Massage Therapy

Fact: It is estimated that 37% of the population of developed countries and 41% of developing countries, suffer from chronic pain.

It is one of the most common reasons why people visit Rosie at Pottsville and Cabarita Physio (up to 40% of visits).

Other common reasons include rehabbing sports injuries, relief of pain from accidents or muscle strains, relief of stress and as a form of preventative health care.

And also, just that good old relaxation that can only come from human touch.

What is massage therapy, exactly?

People with specific massage therapy training are highly knowledgeable about anatomy and physiology and are skilled diagnosticians with regards to chronic pain and how to treat it.

The underlying idea behind massage therapy is that a relaxed and loose muscular structure promotes the flow of energy through the body, which enables the body to maintain health and heal itself, without resorting to drugs or surgery.

Here are some common massage therapy modalities that you may encounter, ranging from simple relaxation to treatment of complex pain issues and connective tissue realignment.

Swedish Massage

This is your standard relaxation massage. Swedish massage is very popular in spa settings.

As one of the most popular types of bodywork performed today, the overarching goal of Swedish massage is the ultimate relaxation of the entire body. It is exceptional at achieving this, easing tension while promoting the release of environmental toxins stored in the body’s fat and epidermis layers while simultaneously increasing the oxygen levels in the blood.

Swedish massage has also been shown to produce significant reductions in the stress hormone, cortisol.

Trigger Point Therapy and Myofascial Release

A trigger point is a small area of tightly bound and ‘knotted’ muscle that will produce referred pain into another part of the body when pressed upon. For example, a trigger point in the rhomboid muscle in the upper back can produce headache-like pain at the base of the skull.

Trigger points such as these are often misdiagnosed as migraines.

Trigger points range in severity from mildly annoying to completely debilitative. The affected muscle fibres are in a permanently shortened and tense state, and can even pinch nearby nerves, producing even more related symptoms, sometimes spiraling into full-blown fibromyalgia, a disorder of the connective tissues.

This is one area where massage therapy has a distinct advantage over every other form of treatment. Conventional medicine’s answer to trigger points is usually an injection of a local anesthetic or a corticosteroid injection. Both of which are temporary, unnatural treatments and in the case of the corticosteroid, actually damaging to the tissues.

Massage therapy treats these by the application of pressure directly to the trigger point, going over time from light to very deep, (usually within the same session) whereupon the trigger point will begin to release and relax.

Follow-up treatment is nearly always needed to retrain the muscle fibers to lengthen and “smooth” back out. A good massage therapist can often boast a near 100% success rate with trigger point therapy, even when other treatments have failed.

Myofascial release is a broader application of this type of therapy that seeks to restore mobility and function to the body’s underlying network of connective tissue that is present in every muscle in the body. It improves lymph circulation (keeping the blood clean) and enhances the muscle’s natural stretch reflex, keeping the body supple and strong.

It should be noted that these types of massage therapy are not the same as a relaxing Swedish massage and can sometimes be quite painful as the body relaxes, releases, and returns to normal homeostasis. It’s important to communicate to us during your treatment if you are uncomfortable at any time.

Sports Massage

As the name implies, sports massage is focused on the athlete. From the highest level of competition, to the casual weekend warrior, sports massage therapists can be found everywhere from weekend 5ks to professional locker rooms and Olympic fields.

Sports massage focuses on both pre- and post- event training and recovery.

Pre- event for example, may involve stimulating a stretch reflex in the quadriceps muscle of a runner to help lengthen her stride, with repeated treatments resulting in a faster runner who is less prone to injury.

Post-event can take the form of a light, relaxing massage to stimulate healing blood flow to an overused muscle group, enabling the athlete to recover safer and faster, and enable them to perform at the top of their game sooner than otherwise would be the case. Rather than a specific technique as in trigger point or myofascial therapies, sport massage focuses on the dual goals of athletic performance and recovery and may borrow heavily on other modalities to achieve these ends.   Rosie is our skilled masseuse and is looking forward to helping you, to book in phone 0266764000 / 0266764577 For more information click http://bit.ly/2S96ETT https://www.facebook.com/pottsvillephysiotherapy

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Tennis Elbow (Lateral Epicondyalgia)

Tennis Elbow (Lateral Epicondyalgia)

  If you have tennis elbow you can experience pain when performing gripping tasks or resisted wrist/finger extension. Pain can also be present when your forearm muscles are stretched. There is probably tenderness directly over the lateral epicondyle, the bony bump on the outside of the elbow, and tender points (trigger points) in the forearm muscles. In some cases, you may also experience neck stiffness and tenderness, and possibly also signs of nerve irritation like numbness and tingling. Most elbow movements are pain-free despite the surrounding area being painful.

WHO IS AFFECTED?

  You don’t have to be a tennis player to suffer from tennis elbow. It is caused by the repetitive movements and the gripping actions common in tennis hence the term ‘tennis’ elbow. However, it may also occur in other activities requiring repetitive gripping actions. Tennis elbow can therefore stem from daily activities such as using scissors, cutting meat, carrying grocery bags, gardening, manual work that involves repetitive turning or lifting of the wrist, such as plumbing, or bricklaying, and typing.

ACUTE VS CHRONIC

  Acute tennis elbow, also known as lateral epicondylitis, is an injury to structures involved in extending (straightening) the wrist and fingers at the site where the forearm muscles attach to the bone via the extensor tendon. It occurs when more force is applied to that area than the normal healthy tissue can handle. For example:
  • Unaccustomed hand use such as starting the tennis season,or increasing the frequency or amount of time playing tennis too quickly. Sometimes just a weekend of home DIY may trigger it
  • Excessive gripping or wringing activities, possibly a new racket or different grip size
  • Poor forearm muscle strength or tight muscles
  • Poor technique (this may be a poor tennis shot).
  Chronic (ie. longer term) tennis elbow is associated with degenerative changes in the tendon. While a sudden acute flare up of tennis elbow may have some inflammation or swelling, chronic tennis elbow generally doesn’t involve inflammation and is instead associated with changes in the nerves and blood supply to the tendon.   Unfortunately, rest as a treatment is rarely helpful. If left untreated, tennis elbow can last anywhere from 6 months to 2 years and can have a serious effect on your sport, daily activities and work. Physiotherapy is effective both in acute and chronic tennis elbow, and there are several things you can do to help in recovery and prevention.  

TREATMENT

  Tennis elbow should be diagnosed by a physiotherapist or doctor. A history is taken, and tests performed. Referred pain from the neck and reduced nerve mobility can mimic tennis elbow. The physical therapist must check your neck and clear it from any involvement in your elbow pain. An ultrasound scan or MRI are the best tests to identify tendon damage,but are often not necessary.   Physical or manual therapy treatments than can help include:
  • Massage therapy to relieve pain and stretch tight muscles and structures
  • Manual therapy can mobilise joints in the elbow and around the neck to ensure normal function
  • Taping and braces are beneficial in reducing pain in the elbow and supporting the muscles when you return to sport n Ice and ultrasound therapy may be used to reduce inflammation.
  • Dry needling can also be effective for pain relief, releasing trigger points in the muscle and promoting tissue healing
  • Exercise therapy should be prescribed to strengthen and balance the muscles of the forearm. While stretches help to lengthen tight muscles.
  Other treatment options may include injections, which should only be considered if the exercises have not helped. Surgery can be carried out under local injection (subcutaneous tenotomy) with a 95% success rate and no reduction in grip strength.   You need to try and prevent tennis elbow from occurring or recurring, which unfortunately it has a tendency to do, which means finding out what caused the injury and addressing these issues with the help of your therapist.

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Don’t Let Yourself Be Sidelined by Tennis Injuries

Don’t Let Yourself Be Sidelined by Tennis Injuries

  Tennis 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 Free

But 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!

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10 top tips for Cyclists

10 top tips for Cyclists

 

Common injuries in Cyclists include knee, lower back, neck and shoulder

 

  1. Make sure your bike is suitable for the type of riding you are doing

  2. Make sure your body fits the bike

  3. Have a great pedalling technique

  4. Vary your riding from day to day

  5. Stretch and activate, slow build your effort as you start your ride

  6. Target sleep, stress, diet and alcohol

  7. Eat well especially during and after a ride of 2 hours or more

  8. Have a strong and consistent recovery routine

  9. The recovery ride – An easy one our ride at high cadence and low power is essential to good recovery after a hard day.

  10. Massage

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Remedial Massage and its effects on Fascia

Remedial Massage and its effects on Fascia

What is fascia? Fascia is a type of connective tissue that essentially holds us together. It is composed of mostly collagen and elastin.  The fibres of collagen are the longest and strongest form of protein molecules found within body, they can hold up to ten thousand times their weight.  Collagen provides the tensile strength and structural integrity of the connective tissue. Whereas the elastin fibres allows the connective tissue to stretch, providing flexibility and the capability to absorb shock. These fascial fibres sit in an extremely receptive transparent fluid base that is interwoven in many directions all over the body.     Types of Fascia:
  1. Compartment fascia – surrounds individual muscle fibres, muscles, and muscle groups.
  2. Superficial Fascia – the fascia that lies just under the surface of the skin.
  3. Fascial sheaths – Superficial fascia that covers joints providing support and stability.
  4. Visceral fascia – surrounds each organ.
  5. Myofascial meridians/slings – bilateral systems of receptive connective tissue. These fascial slings relate to how we sense ourselves and how we move through life.
  Fascia and the systems of the body: Fascia incorporates all of the systems, with blood, lymph, nerves and meridians all passing through the fascial network. Fascia has particular connection to the muscular, nervous and endocrine systems. It is continuously reacting to these systems, responding to our emotions, movement and awareness.   Fascial Imbalances: Just like how muscles in the body can become imbalanced, fascial slings can get out of balance too. These imbalances are usually from lifestyle activities such as your job, sport and emotional/mental state. A good example of imbalance within the Fascial slings is between the Anterior Functional Line - which is a functional fascial sling that runs along the fibres of the Pectoralis Major, along the abs like rectus abdominis and the external oblique, down to the pubis, then continuing along the Adductor Longus muscle to the femur/thigh bone. And the Posterior Functional Line - a functional Fascial sling travelling along Latissimus Dorsi and the sacrolumbar fascia, and then connecting to the fibres of Gluteus Maximus on the opposite side, then along the ITB and Vastus Lateralis, ending at the sub patella tendon. A common scenario of fascial imbalance is when the Anterior Functional Line becomes short and tight and therefore medially rotates the shoulder drawing it forward. This shortening results in the Posterior Functional Line activating and lengthening. This is an intelligent response between the fascial slings as they adapt to change and try to maintain centre of gravity. However if these slings stay imbalanced for long periods of time it can have a negative affect on other structures within the body and cause pain e.g. to the spine and shoulder joint, as well as associated muscles. Fascial imbalances affect overall strength, flexibility and stability.   How Massage can help: Remedial massage therapist can help with these fascial imbalances by using Myofascial release techniques (MFR) to lengthen and open the tight/stuck fascial sling, in turn allowing the opposing sling to return back to its healthy functional length. As well as muscular and structural imbalances, it is important for Remedial therapists to look into fascial imbalances when treating pain and postural dysfunctions. At times muscles won’t release properly or structural corrections won’t hold if the associated fascia has not been treated. When MFR is performed on tight fascia, clients notice great freedom and openness; it is a very effective technique.   Talk to your Remedial massage therapist today, and see if fascial work could benefit you!     Rosie Rayner Dip. RMT Ad. Dip. STT

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Patellofemoral pain

Experiencing knee pain while walking, running, squatting, kneeling, going up or down stairs or slopes?

You may have a condition known as Patellofemoral pain syndrome.

Patellofemoral pain syndrome is one of the most common knee complaints of both the young active sportsperson and the elderly. Patellofemoral pain syndrome is the medical term for pain felt behind your kneecap, where your patella (kneecap) articulates with your thigh bone (femur). This joint is known as your patellofemoral joint Patellofemoral pain syndrome, is mainly due to excessive patellofemoral joint pressure from poor kneecap alignment, which in time, affects the joint surface behind the kneecap (retropatellar joint). Physiotherapy inventions help strengthen one’s quadriceps and hips, which subsequently aids in restoring the biomechanics of the patellofemoral joint. Physiotherapists are able to advise and design customised exercise programs to improve the strength of your knee and leg muscles and help you maintain good general fitness. If you are experiencing patellofemoral pain, or any pain in your knee and joints, it is important to have your condition assessed by a physiotherapist. Patellofemoral pain typically develops because of 1 of 3 different reasons 1. Excessive pronation of the foot (flattening of the arch). It doesn't matter if you have high arches or flat feet, it depends on how much your arch flattens from non-weight baring to weight baring. This can be addressed in the short term with the use of orthotics but a strengthening program of the muscles that support your arch is recommended. 2. Weak quadriceps (weak thigh muscles). The quads are the largest muscle group in the body that we use to extend our knee. Important for walking, running, squatting, and climbing stairs. We can test your maximum isometric contraction and compare it to your unaffected side to see if this is a contributing factor and address any deficit with an appropriate strengthening program. 3. Weak hip abductors (gluteal muscles). Gluteus medius and minimus help to keep our pelvis level while walking and running. If your opposite hip dips then the knee you are standing on will drift inwards causing poor alignment of the patellofemoral joint. This deficit can be picked up with good observation skills and strength testing.    

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