Viewing posts categorised under: Injuries
Tennis Elbow - Why is my elbow hurting?
Lateral epicondylitis (also known as Tennis elbow), is considered an overload injury of the extensor tendons of the forearm where they attach at the lateral epicondyle. It affects up to 3% of the population, and symptoms may persist for up to 1 year in 20% of people. Up to 17% of workers within the highly repetitive hand task industries such as factory workers, admin workers and tradesman, experience lateral epicondylitis.
What does it feel like?
Lateral elbow pain presents as pain and tenderness over the outside of the elbow when doing activities such as:
- Writing or typing on the computer
- Lifting an object (even as light as a sheet of paper)
- Opening the car door or those horrible pasta sauce jars
The pain may build up over a few weeks to become a burning sensation, and cause swelling of the area, stiffness, or weakness in the forearm.
Is it from playing too much tennis?
It can be, but it is categorised as an overload injury. Overload injuries tend to occur after a minor or sometimes unrecognised trauma to the extensor muscles of the forearm. Despite the commonly known title of tennis elbow, tennis is a direct cause in only 5% of people.
How should I manage this injury?
Modify and lower the load going through the extensor tendons.
However, make sure not to completely rest the tendon for prolonged time (e.g., resting completely for 10 weeks, and returning to the activity with pain remaining). Throughout the course of the tendon injury, it is essential to continually modify the load because as the tendon heals, it will gradually be able to handle more load and you will be able to do more things with less pain.
Some “handy” tips on how to reduce the load through your elbow include:
- Doing your best to avoid repetitive tasks
- Use the unaffected hand
- Adjusting your work environment (e.g. height of work chair)
- Wearing a brace to disperse load from tendon]
Exercises that specifically load the tendon gradually have been shown to have improved long-term outcomes. The aim is to progressively increase the load as the tendon heals within pain free limits. These exercises are to be best prescribed to you by your Physiotherapist.
Will cortisone injections give me a quick fix?
Cortisone injections have been proven to reduce pain and improve function in the short term, the quick fix of 6 weeks. However, it does have the highest rate of re-occurrence
and repeated cortisone injections will increase the risk of surgery. With Physiotherapy intervention where patients are educated about their pathology, given advice on medication, braces and how to deload the tendon, people will get out of pain faster and experience less pain over the duration of their recovery.
Other treatment options you can try including Acupuncture, Extra-corporeal Shock Wave Therapy, orthoses/braces, manipulation and exercise and mobilisation.
Take home message!
- Tennis elbow is an OVERLOAD injury.
- Don’t do nothing. Learn how to modify your daily tasks to avoid overloading the wrist extensor muscles
- Cortisone injections may be good for a quick fix, but think long term
If you are suffering from tennis elbow and would like to learn how to manage this injury appropriately, visit your local Physiotherapist. You can also visit our YouTube channel to view a video I have created to provide a few exercises to get you started.
WHY YOUR DOCTOR SHOULD REFER YOU TO AN EXERCISE PHYSIOLOGIST
We all know we should exercise, and the science is clear, exercise is medicine. The following explains what an Exercise Physiologist is and why your doctor might refer you to one.
What IS AN EXERCISE PHYSIOLOGIST?
Accredited Exercise Physiologists
(AEPs) are university-qualified allied health professionals. They specialise in designing and delivering safe and effective exercise interventions for people with chronic medical conditions, injuries or disabilities. Services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia.
WHAT CAN AN EXERCISE PHYSIOLOGIST DO FOR YOU?
EXERCISE TO IMPROVE YOUR MENTAL HEALTH
Mental illness can have an impact on a person’s cognitive, behavioural and social functioning. Those with a mental illness often struggle to engage in their regular work, social and physical activities which can further impact the illness. Mental illness includes anxiety, depression, schizophrenia, bipolar affective disorder and personality disorders. There is mounting evidence that suggests exercise is an effective treatment method for people suffering from acute and chronic mental illness, with some studies suggesting that exercise is just as effective, if not more effective than pharmacological intervention in alleviating depressive symptoms.
EXERCISE TO MANAGE CHRONIC PAIN AND ILLNESS
Chronic pain is pain that persists beyond the expected healing time of an injury. Unlike acute pain which is caused by tissue damage, chronic pain is less about the structural or tissue damage and more about the sensitivity of the nervous system and ‘non tissue related factors’. Significant research has shown that exercise is an essential component in the treatment of chronic pain. Studies have shown that it can be an effective way to reverse this downward cycle of deconditioning and worsening pain, and gradually over time help those with chronic pain engage more in activities of enjoyment and essential activities of daily living with greater ease.
EXERCISE TO REDUCE YOUR RISK OF FALL AND IMPROVE YOUR BALANCE
Falls can result in permanent disability, restriction of activity, loss of confidence and fear of falling, all of which reduce quality of life and independence. There is now good evidence that exercise can prevent falls in older people by decreasing a number of key risk factors. For example, exercise can improve muscular strength, balance, balance confidence and walking speed, as well as psychological factors such as mental ability and mood.
EXERCISE TO INCREASE YOUR MUSCLE MASS AND BONE STRENGTH
Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone density). Any bone can be affected by osteoporosis, but the most common sites are the hip, spine, wrist, upper arm, forearm or ribs. Exercise can help bones modify their shape and size so they become stronger and this can prevent injuries. Exercise also increases muscle strength and improves balance which can help reduce the risk of falls.
EXERCISE TO CONTROL YOUR DIABETES OR PREDIABETES
Diabetes mellitus is a metabolic disease indicated by an elevated fasting blood glucose level due to deficiencies in insulin secretion or inability to use insulin. Everybody benefits from regular exercise but for people with diabetes mellitus (Type 1 or 2) exercise can play a vital role in the management of their condition. Exercise cannot reverse the damage to the cells in the pancreas that leads to the decreased production of insulin. Exercise can improve the way the muscles respond to insulin, which, in turn, helps regulate the blood glucose level for some hours after the exercise. Exercise also increases glucose uptake by the muscles and can lower the dose of insulin required by improving the body’s response to insulin.
EXERCISE TO IMPROVE OUTCOMES DURING CANCER TREATMENT AND BEYOND
Cancer is developed when abnormal cell function occurs. can develop within all parts of the body and can invade surrounding and distant sites by spreading through the blood vessels and lymphatic systems. If diagnosis and treatment are not administered in the early stages of the disease, cancer can be life-threatening. The potential benefits of exercise during and after treatment are significant and research has proved its effectiveness. Exercising during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments.
Our Accredited Exercise Physiologist at Pottsville and Cabarita Physiotherapy will take you through a full screening to assist in prescribing you the appropriate program to achieve your goals in a safe manner. You can book an appointment with our Exercise Physiologist Sammy here or call 6676 4000
Feeling The Pinch?
The Stubborn Shoulder Impingement Syndrome
Do you get a sharp, debilitating pain in your shoulder when you are performing tasks like brushing your hair, putting on certain clothes or showering? During these movements, where you raise your arm out to the side and then upwards over your head, do you alternate between no pain and pain? For example, during the first part of the moment you don’t feel any pain, and then suddenly your shoulder “catches” and there is sharp pain, followed by no pain again as you continue to move your arm upwards.
These are all signs of a condition called Shoulder Impingement Syndrome (SIS), where the tendons of the rotator cuff muscles that stabilise your shoulder get trapped as they pass through the shoulder joint in a narrow bony space called the sub-acromial space. Impingement means to impact or encroach on bone, and repeated pinching and irritation of these tendons and the bursa (the padding under the shoulder bone) can lead to injury and pain.
Shoulder complaints are the third most common musculoskeletal problem after back and neck disorders. The highest incidence is in women and people aged 45–64 years. Of all shoulder disorders, shoulder impingement syndrome (SIS) accounts for 36%, making it the most common shoulder injury.
You shouldn’t experience impingement with normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis. Likewise, if the bursa becomes inflamed, you could develop shoulder bursitis. You can experience these conditions either on their own, or at the same time.
The injury can vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness tendon tears, which may require surgery. Over time the tendons can thicken due to repeated irritation, perpetuating the problem as the thicker tendons battle to glide through the narrow bony sub-acromial space. The tendons can even degenerate and change in microscopic structure, with decreased circulation within the tendon resulting in a chronic tendonosis.
What Causes Shoulder Impingement?
Generally, SIS is caused by repeated, overhead movement of your arm into the “impingement zone,” causing the rotator cuff to contact the outer tip of the shoulder blade (acromion). When this repeatedly occurs, the swollen tendon is trapped and pinched under the acromion. The condition is frequently called Swimmer’s Shoulder or Thrower’s Shoulder, since the injury occurs from repetitive overhead activities. Injury could also stem from simple home chores, like hanging washing on the line or a repetitive activity at work. In other cases, it can be caused by traumatic injury, like a fall.
Shoulder impingement has primary (structural) and secondary (posture & movement related) causes:
Primary Rotator Cuff Impingement
is due to a structural narrowing in the space where the tendons glide. Osteoarthritis, for example, can cause the growth of bony spurs, which narrow the space. With a smaller space, you are more likely to squash and irritate the underlying soft tissues (tendons and bursa).
Secondary Rotator Cuff Impingement
is due to an instability in the shoulder girdle. This means that there is a combination of excessive joint movement, ligament laxity and muscle weakness around the shoulder joint. Poor stabilisation of the shoulder blade by the surrounding muscles changes the physical position of the bones in the shoulder, which in turn increases the risk of tendon impingement. Other causes can include weakening of the rotator cuff tendons due to overuse, for example in throwing and swimming, or muscle imbalances between the shoulder muscles.
In summary, impingement usually occurs over time due to repetitive overhead activity, trauma, previous injury, poor posture or inactivity.
When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (upper arm) from riding up into the shoulder space, causing the bursa or tendons to be squashed. Failure to properly treat this instability causes the injury to recur. Poor technique or bad training habits such as training too hard is also a common cause of overuse injuries.
Over time pain can cause further dysfunction by altering your shoulder movement patterns which may lead to a frozen shoulder. For this reason, it is vitally important that shoulder impingement syndrome is rested and treated as soon as possible to avoid longer term damage and joint deterioration.
What are the Symptoms of Shoulder Impingement?
Commonly rotator cuff impingement has the following symptoms:
- An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead
- Shoulder pain that can extend from the top of the shoulder down the arm to the elbow
- Pain when lying on the sore shoulder, night pain and disturbed sleep
- Shoulder pain at rest as your condition worsens
- Muscle weakness or pain when attempting to reach or lift
- Pain when putting your hand behind your back or head
- Pain reaching for the seat-belt, or out of the car window for a parking ticket
Who Suffers Shoulder Impingement?
Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that require repeated overhead lifting or work at or above shoulder height also increase the risk of rotator cuff impingement.
How is Shoulder Impingement Diagnosed?
Shoulder impingement can be diagnosed by your physical therapist using some specific manual tests. An ultrasound scan may be useful to detect any associated injuries such as shoulder bursitis, rotator cuff tears, calcific tendonitis or shoulder tendinopathies. An x-ray can be used to see any bony spurs that may have formed and narrowed the sub-acromial space.
What does the Treatment Involve?
There are many structures that can be injured in shoulder impingement syndrome. How the impingement occurred is the most important question to answer. This is especially important if the onset was gradual, since your static and dynamic posture, muscle strength, and flexibility all have important roles to play. Your rotator cuff is an important group of muscles that control and stabilise the shoulder joint. It is essential the muscles around the thoracic spine and shoulder blade are also assessed and treated as these too work together with the entire shoulder girdle.
To effectively rehabilitate this injury and prevent recurrence, you need to work through specific stages with your therapist.
These stages may include:
- Early Injury: Protection, Pain Relief & Anti-inflammatory Treatment
- Regain Full Shoulder Range of Motion
- Restore Scapular Control and Scapulohumeral Rhythm
- Restore Normal Neck-Scapulo-Thoracic-Shoulder Function, including posture correction
- Restore Rotator Cuff Strength
- Restore High Speed, Power, Proprioception and Agility Exercises
- Return to Sport or Work
The early stages of treatment will involve manual therapy, including massage to relieve pain and release tight structures as well as mobilisation techniques to restore normal shoulder movement. Strapping/taping has been shown to be helpful in reducing pain as well as ultrasound and laser therapy. As you move through the other stages of treatment your therapist will prescribe rehabilitation exercises specific to your shoulder, posture, sport and/or work demands.
Corticosteroid injections can be useful in the initial pain relieving stage if conservative (non-surgical) methods fail to reduce the pain and inflammation. It is important to note that once your pain settles, it is important to assess your strength, flexibility, neck and thoracic spine involvement to ensure that your shoulder impingement does not return once your injection has worn off.
Some shoulder impingements will respond positively and quickly to treatment; however many others can be incredibly stubborn and frustrating, taking between 3-6 months to resolve. There is no specific time frame for when to progress from each stage to the next. It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration. For more specific advice about your shoulder impingement, contact Pottsville and Cabarita Physio on 6676 4000 or 6676 4577
The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case.
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:
- Muscle imbalances
- Stroke technique issues
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.
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.
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.
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.
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
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!
Research shows that over 70% of us treat ourselves to chocolate at least once a week.
Good quality dark, raw chocolate (at least 70% cocoa) has impressive health benefits:
· Boosts energy levels
· Improves blood flow which is great for your cardiovascular health
· Releases endorphins which helps with pain relief
· Relaxes muscles due to the magnesium content
· Tryptophan (the precursor of serotonin) boosts happiness
· May improve cognitive performance
· Anti-oxidants work to fight cellular and oxidative damage resulting in clearer, firmer skin
Winter Ski Slopes Strategies
There’s no doubt about it, snow sports are fun. Whether you’re hurtling down the side of a mountain at 40 mph, or exploring backcountry terrain; snow sports always involve excitement, adventure and exhilaration. But snow sports are much more fun when you’re physically fit. There is nothing worse than having to limp in early from the slopes because you’re tired or sore (or even worse, injured). Snow sports are major workouts and if you’re not fully prepared physically for your holiday, not only will you be exhausted for most of it, but you’re also at a much higher risk of injury, let’s face it, nobody wants to come home in a plaster cast. So, the goal of this guide is to get you as fit as possible, in the shortest time possible, and give you the best chance to have an awesome, injury-free holiday. Snow sports demand a combination of both technique as well as muscle strength and flexibility to keep stay safe on the slopes, run after run. Decent stamina (aerobic fitness) is key if you’re going to have enough energy to last the day, and anaerobic fitness is needed for the downhill bursts of activity. So, if you’re spending your hard-earned cash on a trip to the mountains, it’s just a waste if you don’t prepare. Any preparation you can do in the weeks leading up to your holiday will improve your performance and enjoyment, as well as reduce your chance of suffering an injury. Here are our top six strategies for reducing the risk of injury while on the slopes.
Strategy 1 - Health
Anything that gets you out of breath will be strengthening your heart, and improving your lung capacity. Walking, running, stair climber, rowing, cycling and swimming are all great ways to work your cardiovascular system. Because snow sports involve stamina as well as short-burst aerobics, the most effective preparation is a combination of high-intensity training and longer, more sustained efforts called interval training. Interval training is the best way to build cardiovascular endurance; the key to the training is to maintain a high heart rate, concentrating on short sprints. Aim for two to three, 20-30 minute interval training sessions a week, working harder to increase the heart rate for one or two minutes, then working less hard to
drop it right down for 2 – 4 minutes before repeating the same sequence, throughout the session. This routine can be incorporated into any of your favourite cardio workouts from running to swimming. Remember to build up the exercise slowly and incrementally. So, if you’re starting from a relatively low fitness level, have longer rest periods in between the sprints, and shorter sprint periods, and slowly build these up. If you’re not sure where to start, a physical therapist or personal trainer will be able to help you find a training schedule that will suit you. The other reason that good fitness is a major advantage is because ski resorts are usually found at higher altitudes than where you would normally live. This means there’s less oxygen in the air, meaning you need to breathe harder to get the same oxygen levels as you would at sea level and it can take a few days to acclimatise. Being physically fit can help combat side effects of a high altitude.
A SESSION MIGHT LOOK SOMETHING LIKE THIS:
5 MINUTE WARM UP 1-2 MINUTES SPRINT (high heart rate)
2-4 MINUTES INTERVAL (lower heart rate)
1-2 MINUTES SPRINT (high heart rate)
2-4 MINUTES INTERVAL (lower heart rate)
1-2 MINUTES SPRINT (high heart rate)
2-4 MINUTES INTERVAL (lower heart rate)
5 MINUTE WARM DOWN
Strategy 2 - Strength
Skiing and snowboarding require a strong abdomen, and powerful legs, and in the case of snowboarding, good upper body strength too. The stronger you are, the less likely you are to get tired. If fatigue creeps in, your form can start to deteriorate, making it difficult to last the day as well as increasing your risk of a fall. Stronger muscles better support your joints, and absorb the forces from impacts and vibrations, and this can also help prevent injury.
The quadriceps muscles (front of thigh) work in two ways on the slopes, helping as you both bend and straighten the knees. The controlled lengthening of the quadriceps from straight to bent is called eccentric training and is fundamental to snow sports. Squats, lunges, deadlifts and plyometric jumps are all good exercises to specifically strengthen your quadriceps and hamstrings (back of thighs) and glute (buttocks) muscles essential for snow sports.
Good core strength (your deep abdominal muscles) is required to sustain postures for prolonged periods, maintain balance and control and support your back from injury. Planking exercises, bridging, using a Swiss ball, mountain climber and Pilates are all excellent exercises to improve core strength. Your physical therapist can give you specific skiing or snowboarding exercises to strengthen your legs and core
Strategy 3 - Balance
Balance is important in all aspects of snowboarding and skiing. Good balance will ensure better technique and efficiency when on the slopes but also help prevent falls and possible injury. Yoga and Pilates are two great forms of exercise for developing balance. Simple balancing home drills include: Stand on one leg with eyes closed for two minutes twice a day. When this gets easy, add some small movements, such as little knee bends or brushing your teeth. You can advance this by standing on something wobbly or uneven (a Bosu ball at gym or a soft pillow at home). Stand on one leg whilst swinging the other leg around with your eyes closed; or practice picking up small objects off the floor whilst balancing on one leg.
Strategy 4 - Warm up
Warming up increases blood flow through your muscles, preparing them to respond to the demands of snow sports, and reducing your risk of injury. Stretching as part of warm up also helps improve flexibility in your joints and muscles. Walking briskly, a jog, swinging your legs doing some walking lunges will all help. Warm up again following a lunch break or long wait at a ski lift when you’re out on the slopes. A cool down and light stretch helps remove lactic acid from your muscles and keeps them subtle, which will make getting out of bed the next day easier! Once you come off the slopes, before sitting at your favourite après ski spot, walk around for 5-15 minutes, and do some stretches.
Strategy 5 - Equipment
Apart from physically preparing your body to cope with the demands of snow sports, some equipment can help protect it from injury. Helmets are designed to resist impact and absorb energy to minimize damage to the brain. Helmets have been shown to decrease head injury risk and severity by 2260%. Wearing a helmet really is a no brainer (pun intended!). Badly fitting bindings and rented
equipment have been associated with increased injury risk. Make sure you have your bindings fitted and adjusted (even if you own your own equipment) by a certified technician. Ensure you also rent skis according to your skill level. Be realistic and don’t over estimate your ability as this may increase your risk of injury. The use of hip pads and wrist guards whilst snowboarding have been shown to be beneficial in lowering overall injury risk too.
Strategy 6 - Saftey
Experience and education are key. People with low skill levels are more likely to be injured but don’t assume that experience and skill level go hand in hand. If you’re inexperienced, lack confidence or feel a bit rusty – it’s worth taking the time to attend ski/snowboarding school or get some private instruction for the first few days of your holiday. Take time to re-familarise yourself with the snow, easing onto the green and blue runs before heading off to anything more challenging. A higher proportion of people are injured in the afternoon. This may be due to a wide range of factors, including fatigue, business on the slopes, heavy lunches, or alcohol intake, as well as changes in snow conditions. Take regular breaks through the day or carry snacks to keep your energy levels up. Ensure you stay hydrated. Just because its cold doesn’t mean you aren’t sweating from physical exertion. Dehydration can result in mental and physical fatigue. Staying hydrated can help combat the effects of high altitude. Finally, it’s your responsibility and behavior that can keep you safe on the
Applying these six strategies will significantly increase your chances of returning from your snow sports holiday uninjured and intact. Keep an eye on our Facebook page for more snow sports fun and advice. And have a great holiday!
slopes. Most injuries can be prevented, know the snow responsibility code and follow it:
the snow responsibility code and follow it:
1.STAY IN CONTROL AT ALL TIMES
2.PEOPLE BELOW YOU HAVE RIGHT OF WAY
3.OBEY THE SIGNS LOOK BEFORE YOU LEAP
4.STOP WHERE ITS SAFE (ON THE SIDE OF THE PISTE),AND WHERE YOU CAN BE SEEN
5.STAY ON THE SCENE AFTER AN ACCIDENT
Credit - Co -Kinetic Journal
Achilles Tendon Injury
A 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.
Pain is NORMAL
. It is the body’s way of alerting us to what it thinks is DANGER
. The interesting thing about pain is that we don’t actually experience pain until our brain interprets a signal from the body as being pain. It is important to accept that YOUR PAIN IS REAL – IT IS NOT IN YOUR HEAD!!
There are many things that contribute toward the brain signalling pain:
Family issues; My mother has cancer could this be what is happening to me?, Who will look after the family?
Work issues; Will I have to have time off? , How much money will I lose?
Anxiety/stress can increase the sensitivity of the nervous system
Exercise can help turn down pain signals by releasing chemicals that help to quieten the nervous system.
All of these things make a difference as to whether or not your brain will interpret the signals from the body as pain.
The important thing to understand is that the brain can still signal pain long after the original injury in the tissues has healed.
When you initially have an injury, signals are sent to the brain to alert it to danger. The brain then interprets the signal, remember factors mentioned above will play a role in the brain interpreting the signal, and this is where the pain experience starts. This is all necessary so that you don’t go and do anything which may injure you further. However these messages can persist and lead to chronic pain.
Chronic pain is when you continue to experience pain long after the original injury has healed
This is due to central sensitisation. This is when the brain sends chemicals to the spinal cord to meet the signals coming from the tissues. These chemicals can be excitatory, which means they multiply the signals coming from the tissues and therefore send a much stronger signal to the brain then the original signal from the tissues. The brain can also send messages to the tissues to release more inflammatory substances – the body thinks it can heals faster this way, but doesn’t know when to turn off this inflammatory process. This type of inflammation is not helped by medication and explains why there can still be inflammation present many months later. This causes the nerves to become hypersensitive and send earlier and more signals to the brain, again this is an over sensitivity of the nervous system.
Over time, the cycle continues which results in increasing sensitivity of the brain and therefore more and more pain.
Pain can become a habit – your body anticipates and remembers it and it takes very little to trigger it, sometimes when things are really bad even thinking about moving can trigger the pain. The brain has lost its ability to differentiate between painful and non painful input, so just to be safe it triggers everything as pain. The brain has also lost its ability to distinguish between body parts so you may find your pain spreading or moving.
The good news
here is there is no damage in the tissues causing the pain
, it is just that the brain is so used to feeling the pain that it continues to signal even though the damage has healed. It is the sensitivity of the nervous system that is causing this. The important things to understand is that PAIN DOES NOT EQUAL DAMAGE!!
The solution is to make the brain understand that there is no longer any damage in the tissues and it is time to desensitise. We can do this through a graduated return to normal activity.
1. Any new injury or disease requires a prompt medical examination.
2. Understand any prescribed help. Ask for appropriate scientific evidence supporting what is offered to you.
3. Make goals that both you and your clinician understand.
Aim for physical, social and work goals, which allow your progress to be measured.