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HAMSTRING STRAINS – HOW TO REDUCE YOUR RISK THIS SPORTING SEASON

22.03.19

 

HAMSTRING STRAINS – HOW TO REDUCE YOUR RISK THIS SPORTING SEASON

  Hamstring strains are an annoying part of life that a lot of sports people will have at some point throughout their time playing competitive or recreational sports. They are the most common muscular injury in AFL, soccer, American football and Track & field, and account for a large amount of time spent on the side-lines. Because of this there has been a lot of research into ways to reduce the risk of hamstring strain injuries from occurring in the first place. To understand how to reduce the risk, we first need to understand the risk factors.   Some of the major risk factors will make a lot of sense;
  • previous hamstring injury
  • poor strength in the hamstrings
  • fatigue
  • sporting moments where there is large load through a hamstring that is already on stretch (ie heel strike of the foot in a full sprint or landing from a jump with a relatively straight knee and bent hip).
  Some of the other risk factors may not make a lot of sense without explanation, these being;
  • Imbalance in muscular strength from leg to leg of >20% puts you at 3.4x the risk of having a hamstring strain within the next season.
  • Having short biceps femoris fascicle length puts you at a 4x increased risk.
  To understand what this means, you need a little bit of background information about the anatomy of the hamstrings and the architecture of a muscle. The Hamstrings are a group of three muscles in the back of your leg which are called your semimembranosis & semitendinosis (the two towards the middle of your leg), and the biceps femoris (outer one). A muscle is made up of a whole heap of different layers of fibres, that are arranged like the picture below. The fascicle is the functional bundle of individual fibres that all contract together, and to gain the most power out of our muscles the fascicles all need to contract together. Now as I said above, having a short fascicle length is something that has been proven to put you at an increased risk of hamstring injuries, and luckily enough the researchers have found ways that we can address this change and thus reduce our risk.     The overall mantra of avoiding hamstring strain injuries and creating sports proof hamstring muscles is LONG & STRONG. This means equally strong muscles in each leg, and long fascicles in our muscles. With this mantra in mind, we can address the majority of the risk factors for having a hamstring strain in the first place.   STRONG – as you see in the risk factors above, poor strength & strength asymmetry from side to side are two big modifiable risk factors for hamstring injuries. So obviously then we need to be doing hamstring strength training to reduce our risk. The less obvious thing then is what type of strengthening. Research has shown that by doing concentric hamstring training (muscle shortening while it contracts) we are definitely able to increase our peak force output from the hamstring muscles (strength) however this has also been shown to reduce the length of our biceps femoris fascicles, which is working against our LONG & STRONG mantra.   LONG – our fascicle length is actually something that we are able to change. The way that we do this is via repeated eccentric muscle contractions (contracting and lengthening at the same time). Research has shown that we are able to lengthen our fascicles with loaded eccentric exercise, and luckily enough for us this is also addressing the strength part of our mantra. The only catch here is that positive changes in fascicle length can be made in a four-week eccentric training program, but with a further four weeks deload, where we don’t continue with our eccentric strength training our fascicle length is back to where it started. The frequency of eccentric training needs to be at least weekly to maintain the changes in fascicle length.

So, the obvious question now is – HOW DO I DO IT?

There are plenty of different eccentric focused hamstring exercises that are at different levels of difficulty. Some of these include;
  • Glute bridge hamstring sliders
  • Stiff leg deadlifts/ Romanian deadlifts
  • Single leg Romanian deadlifts
  • Nordic Hamstring curls (very difficult)
The exact exercises used doesn’t seem to play a big factor in the outcomes of the training, as long as the individual is putting a load through their hamstrings that is close to their upper limit of muscular capacity. This means that someone weaker can achieve similar results from including glute bridge hamstring sliders as someone stronger can achieve from including Nordic Hamstring curls. As long as you are working on moving towards more load in the exercises, you are doing your best to reduce risk of hamstring strains.   MAJOR TAKE HOME MESSAGES
  • Remember the mantra LONG & STRONG
  • Train your hamstrings eccentrically to address risk factors
  • Continue to eccentrically train your hamstrings once per week to maintain the changes in muscle architecture.
  Good luck with building those sports proof hamstrings!

Why exercise when you have Type 2 Diabetes

05.11.17

 

Exercise can reduce progression and side effects of type 2 diabetes by:

• Improving glycaemic (blood glucose) control • Increasing insulin sensitivity for up to 72 hours post exercise • Resistance exercise increases muscle mass which becomes glucose storage space • Weight loss • Decreasing blood pressure • Improving self confidence • Improving cardiac function • Decreasing depression • Improving muscle strength, flexibility and balance Type of exercise • Incidental exercise: walking to work, taking the stairs etc • Low to moderate intensity: walking, exercise bike, swimming, water aerobics etc How much exercise • 30 min to 1 hour of low to moderate intensity exercise daily (i.e.- you are still able to hold a conversation but may be a little breathless). Minimum amount of exercise should be 150 min / week (3x30) at 50-70% of maximum heart rate. • Avoid resting for more than 2 days in a row • 8-10 resistance exercises exercising all the major muscle groups should be performed twice a week. Your Physiotherapist will recommend a personalized program for you to start with and progress every month or as needed. Do not exercise if you are unwell, PLEASE SEEK THE ADVICE OF YOUR GP BEFORE COMMENCING EXERCISE

Remedial massage and its effect on Low back pain

01.09.17

Remedial massage and its effect on Low back pain

Lower back pain   Low back pain is an extremely common symptom for many people, affecting up to 85% of the population at some point in their lives. Low back pain (LBP) can be a complicated issue, yet it can also be a rather simple biomechanical fault of imbalances in the hips.  

Muscle Imbalances:

A frequent cause of LBP is due to muscle imbalances. Remedial massage therapists can treat these imbalances between muscles of the hips, legs and back, which play a major role in LBP. For example weakness/under activity of the muscles at the back or side of the hip, like Gluteus Maximus or the hip abductor muscles, can cause muscles in the front of the hip like Psoas Major, to over activate and potentially pull the lumbar vertebrae and sacrum out of alignment. This misalignment can soon cause twinges or pain in the lower back and put the lumbar area at greater risk of more serious injuries if not treated.

Myofascial trigger Points:

Another cause of LBP are the presence of Myofascial trigger points. These can arise in muscles for a variety of reasons; muscle overactivity, underactivity or as mentioned above can be caused by muscle imbalances.  Common active Myofascial trigger points found to be associated to LBP are in muscles like Quadratus Lumborum, Psoas Major, Multifidi and the Gluteal muscles. Trigger points prevent nutrient flow and inhibit muscle function, which can lead to faulty movement patterns and pain. Remedial massage therapists can treat trigger points, bringing health back into muscles, relieving pain.   Remedial massage therapy has been shown through studies to be extremely beneficial for patients with low back pain, especially when treatment is combined with exercises and education. Remedial massage can be used as part of a multi-disciplinary approach accompanied with modalities such as physiotherapy, yoga or osteopathy, or as an effective stand-alone therapy.   No one wants to live with low back pain. Let your closest remedial massage therapist help you today so you can enjoy the activities you love!

How to look after your body at your work station

27.02.17

  Guidelines for healthy computer use • Move and stretch every hour to promote blood flow • Respond to any feeling of discomfort by changing position • Add variety to your tasks • Make sure you are sitting correctly and have your workstation set up to avoid strain   Postureimages (3) • Relax shoulders • Elbows at 90 degrees • Forearms level • Head upright and looking forward • Neck lengthened • Back supported by chair • Use a lumbar support • Feet fully supported on floor or footrest   Work space • Place items close to your position based on how often you use them. Regularly used items should be placed within easy reach • If you are using the phone a lot look into a head set or speaker phone. Never cradle the phone between the side of your head and your shoulder.   Chair • Adjust seat height so that feet or flat on floor or foot rest with your knees at or slightly below the level of your hips • With your bottom pushed into the back of the seat, adjust the back rest height so that the lumbar support is in the lumbar or curved area of your spine • Recline the back rest angle between 95-110 degrees so that both the upper and lower part of the back is supported • Adjust the armrest height so that your shoulders are not elevated   Computer • The top of the monitor should be positioned at eye level • Torso must not be twisted • Keyboard and mouse should be just below elbow level • Keyboard should be centred in front of you • Adjust the keyboard tit so that your wrist is in neutral (straight) • Monitor should be about arms length away • Lighting should be even and glare free

How to Stand with Good Posture

22.02.17

• Hold your head up straight with your chin in. • Ensure that your earlobes are in line with the middle of your shoulders. • Keep your shoulders back. • Push your chest out, slightly. • Keep your knees straight, but not locked. • Stretch the top of your head toward the ceiling. • Engage your abdominals, but don’t suck in or tilt your pelvis. • Carry your weight equally between the balls and heels of your feet. • Breathe naturally. Ways to Improve Posture 1. Exercise Focus on stretching tightened muscles in the chest, front of the shoulders, and hip flexors (front of the hips) as well as strengthening back, abdominal, and glute muscles. 2. Foam Roll Foam rolling, or myofascial release, is becoming much more popular, and for good reason. It is essentially like a deep tissue massage for your muscles. This is important because it allows tight muscles and fascia to loosen up so that stretching those muscles becomes easier. If you have formed bad posture of years and years of bad habit, it may be very challenging to correct it without release those over worked and tight muscles. 3. Ergonomics Ergonomics involves changing your environment to support and encourage good posture. Adding lumbar support to your chair is a good example, or even invest in a standing desk. You could also modify a tool, work station, counter height, or task to improve its ergonomics. 4. Eliminate Bad Habits You must first be conscious of these bad habits, but things such as slouching in a chair or reading while lying down are some places to start. Working under dim light is also one, it results is craning your head forward to see your work better as well as slouching. Even driving your car in a bad position can help contribute to poor posture. Did you know posture affects many areas of your life: Mood Memory Confidence Digestion Bones & Muscles Content adapted from http://blog.paleohacks.com/how-to-improve-your-posture/# Vintage posture

Why Pilates should be part of your exercise routine

06.02.17

Why you should be doing Pilates! Mindfulness and Stress relief: Pilates requires total focus and breath control –this activates your para-sympathetic nervous system (your rest and repair system) allowing relaxation throughout the body Core activation: The core is the foundation for every exercise in the Pilates method Pain relief: building a strong core and strong muscles will support your musculo-skeletal system and provides significant pain relief particularly to lower back pain but all joint and muscle pain Recovery from an injury with Pilates to rebuild the muscles that have been weakened through pain, injury, rest or adaptive postures Improved flexibility: Pilates incorporates a variety of stretching, flowing movements to mobilise your spine and lengthen your muscles. Improved posture: Pilates targets the deep postural muscles, and promotes elongation through the spine, allowing you to stand taller. Full-body workout: Pilates focuses on core control while training the entire body as an integrated system. Your whole body will become toned with regular Pilates. Safe and gentle: Pilates is gentle and safe for everyone from the young to the pregnant and elderly. Balance: Pilates exercises help to improve your balance which is great at all ages but especially for falls prevention in the elderly Performance Enhancement: Pilates is a great way to build strength and reinforce correct movement patterns allowing more efficient movement. This will show up as better results with your chosen sport.

Birthday Blog – Matt Bracken

25.01.17

Matt Bracken

Why do you love pilates? In my opinion, Pilates is the gold standard in preventing and managing musculoskeletal health issues. As humans we start to develop bad habits and movement patterns and these patterns aren’t necessarily correct. We do what is easiest in regards to performing a task and over time these movement patterns are reinforced. Pilates slows everything down and breaks apart all the bad habits we have developed. It incorporates and analyses every key movement pattern and ensures that we can do them correctly. From the very basics it allows us to re-learn how to move correctly in a controlled environment and then build on it, gradually changing our poor movement habits that occur on a daily basis and reinforcing the correct ways of moving. We improve our core stability, balance, strength and flexibility. We become functionally stronger and more flexible, which allows us to be more proficient at doing things in a bio mechanically ideal manner and this helps us be injury free. What is the best thing about being a physiotherapist? Very simply;
  • To be able to help others.
  • To spread knowledge and address an issue, one step at a time.
  • To meet several hundred faces each year and work through each issue, each injury, one at a time.
  • To self-empower people with knowledge and understanding that they can have for the rest of their lives.
The physical component of treatment is obviously an integral part of physiotherapy but it is the knowledge base that I believe is indispensable. Obviously it is a huge bonus to be able to watch people improve and observe them going from a painful state to pain-free. It can be an extremely draining job but I can honestly say I wouldn’t want to be doing anything else – I have never enjoyed it so much. Why work at Pottsville and Cabarita physio? After graduating in 2007 I have spent several years travelling, working in a dozen different practices. When I made the move to Byron Bay four years ago I certainly didn’t expect to be where I am, still working in the same practice. I have never worked at such a professional, well-run practice with such amazing dedicated owners. I enjoy going to work, to engage and interact with a variety of faces. I feel like I am constantly improving and expanding my knowledge base. I feel I am a part of all advances in technology, up to date with the latest clinical evidence and knowledge base without having to live in a city. I work 4 days per week and am lucky enough to be able to travel several times per year. This gives me the perfect lifestyle balance and keeps me recharged and enthusiastic about going to work. Best relaxation tip It’s not necessarily easy but spending a few moments with our eyes closed in a peaceful environment (preferably outdoors) can be a game-changer. We all get stressed, anxious and over-whelmed and it goes against our instinct in these moments to slow down. In fact, these are our most vulnerable and important times. Whether it is in the morning or another time through the day, taking a few seconds or minutes to close our eyes and focus on nothing more than our own breathing is one of the most powerful ways to recharge. Meditation is several times more powerful and recharging than sleep. Best lifestyle tip Exercise should be one of the most important things in our lives. It isn’t regulated, we can do what we want, but whatever form we choose will result in a release of endorphin that makes us feel happy. It puts a smile on our faces and will give us a much higher quality of life. Favourite activity Jumping into the ocean. In particular to be surfing in a beautiful, isolated, possibly unfamiliar environment with just a couple of mates is very hard to beat. Favourite recipe I can’t go past Mexican. There are a thousand different recipes out there. I wouldn’t say I follow any specific recipe – it more comes down to what I have at home. Generally speaking, it would be kidney beans, onion, red capsicum, garlic with guacamole and grated lettuce and a spicy salsa (crushed tomatoes, paprika, cumin and fresh chili) laid down on a home-made tortilla under the grill, with a little coriander on top. A typical Sunday A typical Sunday for me involves doing something that is not typical. As much as routine gives us stability in our lives, my weekend are always spontaneous, never the same. I could be hanging out surfing with friends in the bay or down the coast in unfamiliar surroundings exploring and writing in solitude. I think variety really is the spice of life so I try to keep things unique, and I feel like this helps spark new thought processes and even inspiration.

Most Common Types of Headaches

12.10.16

The most common types of headache are:

1) Cervicogenic headache 2) Tension headache 3) Migraine 4) Sinus headache 5) Cluster headache.

rear headache

Cervicogenic Headache:

These are headaches originating from the cervical spine or other anatomical structures in the neck, such as nerves or muscle. SYMPTOMS can include neck pain and cervical muscle tenderness. CAUSES Although the syndrome can be characterised by chronic pain on one side of the head, it is often referred from either joints or muscles of the upper neck. Often these headaches can happen following a whiplash, neck injury or muscle trauma due to poor prolonged posture or severe stress Often people hold poor positions and sustain them for long periods of time, this can result in a 'poked neck' posture with an increased thoracic curve. This posture typically results in upper neck joint stiffness and related thoracic spine stiffness, contributing directly to neck dysfunction and as a result, a cervicogenic headache. Trauma to the neck as occurs with whiplash is also a very common cause of neck pain and headache. Whiplash is usually associated with car accidents, but it can happen during skiing accidents or falls from significant heights. Physiotherapy TREATMENT includes:
  • Postural assessment
  • Mobilisation and/or manipulation of cervical spine
  • Soft tissue massage and trigger point release of the muscles and the soft tissues around the neck.
  • Exercise programs, lifestyle advice and self management techniques to improve the postural control,           position and strength of the neck, upper spine, lumbo-pelvic core and scapular muscles.
  • Acupuncture if indicated
You will learn inhibition (or “switching off”) of the over active superficial neck muscles and to engage (or “switch on”) the deep stabilising neck muscles. An individualised specific exercise program can be prescribed which can target re-activation of deep neck muscles and relaxation of the superficial muscles to restore balance in the neck and spine. This is usually required to fully improve the headaches and stop them recurring due to poor posture or incorrect fitness and strength training techniques.   Man temple headache

Tension headache

Tension headaches are caused by muscle spasm over the head and neck. This can be due to stress, worry or anxiety. They tend to be afternoon headaches and feel like a tight band across the head.

Migraine

Migraine is a severe throbbing headache that is often associated with nausea and vomiting, often the pain is one sided. Migraine can be caused by triggers e.g.- food, emotions, light and noise, exercise.

Sinus headache

Sinus headaches

Sinus headaches are caused by increased production of mucous within the sinus, or blockage of the drainage system of the sinus. Pain is mostly frontal and often worse with bending forward or lying down.  

Cluster Headaches

Cluster Headaches occur in bouts, often they are short lasting, but may occur several times within a 24hr period. Severe pain occurs behind one eye or one half of the head. These can often be helped by exercise.  

Take a moment to "feel" your headache;

  • Is your headache caused by your neck ?
  • Does your pain starts at the top of your neck and then spread around to the front of your head?
  • Does moving your neck make the pain worse?
  • Does prolonged sitting make your headache worse?
  • Do you have light headedness or dizziness?
  • Is your headache eased by pressure to the base of the skull?
  • If the answer is YES to any of these questions Physiotherapy treatment will help you.

How to prevent your headaches:

  • Check your posture, think tall. Your shoulders should be relaxed, your chin tucked in and your head           level. Your neck should feel straight and relaxed.
Bad posture is one of the main contributors of neck pain and sometimes headaches. The rule is to keep the head in a neutral position. Many of us tend to hunch or bend the neck forward while reading or working at the computer. In some offices the computer may be at a much higher level than the head, causing the individual to look up for extended periods. Sleeping with your neck too high or too low can cause neck pain and headaches, as well as a mattress that does not support the natural curve of the back.
  • Check your sitting position, especially if you are in a sustained position for long periods. You may           need to stretch frequently throughout the day.
  • Check your pillow. A memory foam pillow is best for most people. Do not use more than one pillow.
  • Relax: watch that you are not clenching your teeth, or hunching your shoulders. Learn to recognise           when you are tense and learn how to relax. Taking deep breaths or applying a heat pack to the tense           muscles may help.
  • Exercise: You need to keep your muscles and joints flexible and strong. You will be prescribed an           exercise program that is appropriate for you.

Headache Triggers

  • Increased stress levels – causes increase muscle tension and increased blood flow
  • Decreased immunity
  • Dietary factors – particularly important in migraine and cluster headaches:
o Caffeine o MSG (soy sauce, chips, tomato paste) o Preserved meats (e.g. Hot dogs) o Food colouring's o Citrus, red skinned fruit, honey, licorice, almonds, wine o Cheese, Chocolates, Bananas, Tomatoes, Vegemite, Wine, Mushrooms

Here at Pottsville Physiotherapy we can successfully treat headaches and show you how to prevent the pain recurring.

Melissa Macdonald has done extensive training in the management of headache and migraine and specialises in this area. Greater then 80% of all headaches (including migraine) have a cervical component and can be helped and even alleviated with skilled treatment. jumping for joy

Tips For Better Sleep

 

Regular sleep is essential.

Sleep is just as important as food and water but unfortunately most of us don’t get enough sleep. Sleep is when our body rests and revitalizes. It is when healing and growth occur. Many important bodily functions occur when you are asleep: regulating hormones, stimulating the immune system, detoxification, tissue repair, reducing inflammation. Aim for 7-10 hours / night Chronic sleep deprivation, even just losing 1 hour per night can wreak havoc on your body. Not only that we often struggle to wake up, have an afternoon slump and then sometimes we are wide awake when we need to be going to sleep. Some of us have the misfortune of suffering insomnia.

The stress of modern life is often the cause, not enough hours in the day to get everything done, our cortisol levels are continuously high affecting our bodies adrenal glands and making the problem worse. It is a vicious cycle that you need to break A.S.A.P.

What happens when you don’t get enough sleep?

• Lowered immunity

• Cognitive performance declines with fewer than eight hours of sleep.

• Adverse affect on affect brain function.

• Sleep deprivation disrupts hormones that regulate glucose metabolism and appetite. The association     between sleep deprivation and obesity appears to be strongest in young and middle-age adults.

Tips for a Good Night's Sleep

1. Set your body clock by maintaining a regular bedtime schedule, including weekends: go to sleep and      wake at the same time everyday no matter what. 10pm – 6am is a good starting point to aim for.

2. Establish a regular, relaxing bedtime routine (warm bath, reading (not a backlit screen), meditation,      candle, aromatherapy or soothing music).

3. Keep your bedroom dark, quiet and cool.

4. Avoid over stimulating your senses prior to bed. Turn off electronics, better still have a ‘no gadgets in      the bedroom’ rule for you and the kids, avoid watching TV especially violent, stressful shows prior to      bed. Avoid loud music with a fast beat. Dim the lights whilst getting ready for bed: bright lights interfere      with melatonin the sleep hormone.

5. Sleep on a comfortable mattress at a comfortable temperature, the optimal temperature is 22 degrees      Celsius.

6. Use only 1 pillow so your neck is not overly flexed, a memory foam contour pillow is best.

7. Use your bedroom as a bedroom only, not an office.

8. Finish eating at least 2-3 hours before your regular bedtime. This means no food after 7pm

9. Exercise regularly, but not within 2-3 hours of bedtime. Include as much incidental movement and      dynamic activity as well as scheduled exercise in your day.

10. Avoid caffeine (e.g. coffee, tea, soft drinks, chocolate) close to bedtime. Caffeine can take up to 8 hours         to get out of your system so avoid all caffeine after 2pm. Drink calming caffeine free herbal teas like         chamomile tea.

11. Avoid alcohol close to bedtime or best to avoid it altogether

12. Slow your breathing and practice meditation before bedtime. This will help slow your heart beat, slow         down your brain and help you to unwind before sleep. Start simple with taking 5 deep breaths in         through the nose, out through the mouth and focusing on making the expiration as long as possible.         There are some fantastic apps you can download if you have trouble doing this on your own.

13. In the morning when you wake, get straight up, no snoozing, snuggling or lingering. Have a large glass         of filtered water and get moving preferably outside to enjoy some sunlight exposure.

14. Avoid naps as they can put your body clock out of synch

15. Avoid sleeping pills as they can be highly addictive and don’t solve the problem. Magnesium is a natural         muscle relaxant and has been shown to help.

16. Still having trouble you need to look at the STRESS LEVELS in your life, it is also worth speaking to         your G.P.

MAGNESIUM – An Essential Nutrient

MAGNESIUM Magnesium is an essential mineral required by the body for maintaining normal muscle and nerve function, keeping a healthy immune system, maintaining heart rhythm, and building strong bones. Magnesium is also involved in at least 300 biochemical reactions in the body. One of the roles of magnesium is a calcium channel blocker which means it helps muscles to relax. A deficiency in magnesium can lead to many problems but what concerns us as Physiotherapists is it can lead to muscle spasms, muscle pain, muscle fatigue, cramps, restless legs and trigger points as well as migraines and osteoporosis. Signs of deficiency include (but are not limited to) headache, dizziness, muscle cramps, muscle weakness and fatigue. Other symptoms may include shortness of breath, PMS, heart palpitations, frequent constipation, anxiety and depression, numb/tingling skin, teeth grinding, and difficulty falling asleep. Conversely, consuming too much magnesium typically causes diarrhoea as the body attempts to excrete the excess. What can I eat to boost my magnesium levels

  • Green leafy vegetables (silver beet, spinach and broccoli), nuts and seeds (including brazil nuts,           cashews, almonds, hazelnuts and sunflower and sesame seeds) it is also found in grains like brown           rice, rye and wheat and fruits such as figs and apricots.
If you feel you are still not getting enough magnesium in your diet you can take supplements, use an organic magnesium spray or take a bath with Epsom salts: – 360mg daily or 5mg per kilogram of body weight, if you feel you are deficient and need to take a therapeutic dose 10mg per kilogram of body weight for 3 days. Please speak to your doctor or pharmacist for further information.