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
Game On: Avoiding InjuryJust 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.
- ACL Injury
- Hamstring Strains
- Ankle Sprains
- Meniscus Injury
- Groin Strains
- Contusion Injury
Where we’re posting fun and informative tips and tricks to help you stay safe on the soccer pitch.
There are so many variables... ...that can dictate the type of experience and performance you have on race day, and as the day looms closer no matter how many times you’ve rehearsed it in your head, uncertainties still will come bursting to the surface. Nerves start jangling and doubts start popping up in places you never anticipated. View our 14 tips to Marathon Success here:
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.
Patello-femoral Knee PainAching knees affect 25 % of the population and are commonly caused by dysfunction at the patella-femoral joint (under the kneecap). It is typically aggravated by bending movements such as sitting, walking up and down stairs or hills, jumping and running. It is also common during adolescence as the long bones are growing faster than the muscles, tendons and ligaments putting abnormal stress on the joints.
- Unfortunately genetics have a part to play and this can’t be changes
- Faulty bio mechanics due to muscle imbalances
TreatmentTreatment is very successful and we will look at correcting muscle imbalances throughout your lower back, hip, pelvis and leg. This is done by manual techniques to the knee cap, massage, acupuncture, exercise and taping.
RunningIt’s free and mostly anyone can do it but where do you start? Start with a S.M.A.R.T. goal. It needs to be specific, measurable, attainable, relevant and timely. Without a goal your chances of giving up are high! Make sure your goal is realistic – you don’t want to get injured or be deflated when you realise you can’t reach it. Don’t be too ambitious to start. Your goal will give you purpose and motivate you to be consistent with your running. Remember it is what we do most of the time that counts, not what we do occasionally. Running with a group, a friend or even your dog can keep you motivated. Eat well and drink plenty of water to fuel body and lastly be sure to have good supportive footwear.
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.
Why get a functional Screen?Firstly to properly answer this question we must ask ourselves …
…. WHAT IS A FUNCTIONAL SCREEN?A functional Screen is a test (or group of tests) that assesses mobility and stability throughout the body. This will identify areas of the body that may be tight, weak or dysfunctional. It identifies asymmetries within the body. The measures obtained are compared to norms so that you know exactly where you sit in regards to others (certain variables such as height and age are taken into account)
Here at Pottsville and Cabarita Physiotherapy some of the Functional Screening tools we use include;
- FMS (Functional Movement Screen)
- SFMA (Selective Functional Movement Assessment)
- Y balance (Upper limb / lower limb balance and Stability)
- Treadmill Running assessment (With video analysis)
- Posture Assessment (Using the latest app)
This moves us on to the next question…… Why should we get a Functional Screen?
PREVENT an INJURY & PAIN
Prevent an Injury and PainIf we can identify parts of the body that are tight, weak and dysfunctional, then by re-correcting these areas then we can prevent an injury from occurring in the first place. A functional Screen will tell us (and therefore you) what level of risk you have of sustaining an injury. If an injury has already occurred (even if it is subtle) then quite often it will cause us to compensate in some way. This can then increase our risk of having ANOTHER injury occur. All of a sudden we “feel like we are falling apart” and it takes us much longer to recover.
Let massage help you through the winter SeasonFor most of us winter means hot drinks, extra layers of clothing, more hours spent in doors and therefore less physical activity and for some a case of the winter blues as the sun sets earlier and the air gets cooler. The good news is that massage therapy can be a great tool to help you through the season.
The benefits of massage in winter:
It will boost you immune system:The winter months can often bring an influx of colds and flu's, so it’s extra important to have a healthy functioning immune system to fight off these viruses. Being less active in the winter months can also mean poorer lymphatic flow, which means less circulation of the body’s white blood cells. White blood cells are what help your body fight away infections and disease. Studies have shown that massage encourages the flow of your lymphatic system, and therefore white blood cells. The more white blood cells circulating, the stronger your immune system and the less likely you are to get a cold/flu this winter!
It will encourage circulation:In cold weather muscles contract to conserve heat, which constricts blood flow and therefore delivers less oxygen and nutrients to our muscles. This also makes it more difficult for cellular waste and toxin removal. This restriction of blood flow decreases muscle health and function, and at times causes aches and stiffness. Luckily the soft tissue manipulation that is used in massage therapy is a brilliant way to increase circulation and improve your health.
It will keep away those winter blues:For some the colder weather can bring upon stress or feelings of being ‘low’ or ‘under the weather’. One of the beauties about massage is that it releases serotonin and endorphin's, which are hormones that relieve stress/sadness and make you naturally feel happy.
Don’t let the winter blues get you down this season, feel good and get a massage today!
Everyone needs a good stretch .. here are some stretches for Surfing, Skiing, Hockey... any twisting sport!
- Perform each of the stretches shown on the video
- Hold stretches for 20 - 30 seconds.
- Hold stretches only to the point of tension (you should not feel pain).
- Repeat stretches on muscle groups that are especially tight.