Why everyone needs a foam roller! What is Fascia?
- Fascia is a layer of connective tissue that surrounds the outer surface of muscles , individual muscle fibres, vessels, nerves and organs binding them together
- Fascia connects our skin to our muscles and our muscles to each other forming chains that help to redistribute stress throughout the body
- The connection between the muscles and fascia is the myofascial system
- For various reasons including inactivity, repetitive motion, injuries and poor posture the fascia and underlying muscles can become stuck together of bind causing ‘knots’ or trigger points. This restricts movement, decreases flexibility, causes muscles to fire improperly during exercise and causes pain.
- It increases range of motion and decreases pain by sending information to the brain to enhance muscle activation and relaxation via the nerves and therefore breaking down adhesions. The elastic fibres are also directly manipulated from a knotted position into a straight position which is the correct orientation for the fibres
- Tension is released via stimulation of the golgi tendon organ(GTO) (the nerve receptor where the muscle and tendon meet). When excited the GTO causes the muscle to relax
- Increased blood flow / circulation and therefore improved vitality
- Allows muscle relax and to fire efficiently
- Reduces pain
- Assists injury prevention
- Acts as an indicator of when muscles are tightening even though you may not feel pain with activity
- Alternative to a massage
- Reduce cellulite
- Identify the problem area
- Hold on the tender spot for 30-60 sec or until the discomfort decreases by 50-75%
- Roll over the whole muscle looking for other tender spots
- Roll the entire length of the muscle to stimulate the GTO
- Remember muscles are 3 dimensional so you may need to roll in multiple directions
- Do not roll on 1 area for longer than 1-2 minutes.
- If there are no tender spots you can you long sweeping rolls over the long muscles such as the hamstrings
- Start with gentle pressure and gradually increase as your tolerance allows
- Stay on soft tissue and avoid bones, joints and tendons
- Also roll the areas above and below the problem area
- You should expect mild to moderate discomfort when rolling but NOT pain especially sharp pain
- While rolling focus on your breath: in through the nose for 4 sec and out through the nose for 6 sec. The longer exhalation helps to activate the para-sympathetic nervous system which allows the body to relax. You must not hold your breath
- It is good idea to do some core exercises prior to rolling
- Pre workout: roll quickly for 15 sec to
- Increase blood flow
- Optimise length / tension relationship of a muscle
- Improve movement efficiency
- Psychological ramp up for activity
- Post workout: roll slowly for 30 sec to
- Flush the tissue,
- Create elasticity of the tissue,
- Begin recovery process
- Any time for the benefits already discussed, primarily getting rid of any niggles and bringing tight muscles back toward a normal state
- High blood pressure
- Varicose veins
- Taking anti-coagulant therapy
Feeling The Pinch?
The Stubborn Shoulder Impingement SyndromeDo 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 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.
Have you been diagnosed with Parkinson’s disease and worried about what the future holds?Do you want to optimise your quality of life now and in the future? Parkinson’s disease is a debilitating disorder, where nerve cells in a part of the brain that produce dopamine are affected. The nerve damage affects the brain’s control of the muscles, which causes shaking (tremor), increased muscle stiffness, slowed movements and balance problems. Parkinson’s disease also affects your thinking abilities, especially the ability to control and regulate behaviour, and may cause anxiety and depression. Drugs can control the symptoms in most patients, but unfortunately only for a limited time.
How can exercise help?Exercise benefits the health and wellbeing of people with Parkinson’s disease in many ways. By increasing fitness, exercise protects against many complications of the disease. For example, better mobility may improve quality of life and prolong independent living. Exercise may also have positive effects on mood and improve brain function and make drug therapy more effective. It also provides a means by which individuals can actively participate in the management of their disease. Walking speed in people with Parkinson’s disease is related to muscle strength in the legs, so exercise programs focuses on increasing leg strength are beneficial. Programs using resistance training like Clinical Pilates, increase muscle mass and strength, and also improve step length, walking speed and walking distance. Rhythmic stimulation of the brain via the eyes or ears while walking can help, and balance training combined with resistance training (like Clinical Pilates) can improve balance and stability. ‘Cueing exercises’ involve walking while listening or seeing cues that mimic the rhythm of walking. These exercises can help improve your walking movements and overcome difficulty with gait initiation and freezing. ‘Dance’ provides exercise to music that can facilitate functional and expressive movement. It also provides important social interaction and can lead to improvements in perceived quality of life. ‘Dual tasking’ exercises, where a secondary task (like counting backwards) while walking can help. These exercises usually try to improve one aspect of walking at a time.
The Parkinson’s Program we run at Pottsville and Cabarita Physio caters for individual abilities and incorporate all the above factors.
- Aim to exercise 4–5 times per week for 40 minutes
- Engage in a variety of lower intensity exercises designed to optimise balance, muscle strength and endurance to prevent falls
- Clinical Pilates based programme's that include back muscle strengthening and balance activities like standing on one leg, heel-to-toe walking along a line, stepping sideways over objects and walking on tip toe are ideal
Smile: you are less likely to catch a cold if you are happy and relaxedLet it go: anger creates a stress response that affects your hormones, neurotransmitters and gut flora (where 80% of your immune cells live)
Walk in the park, bush or beach: spending time in a green space boosts immunity by switching on the para sympathetic nervous system (rest and repair state)
Yoga or Pilates: bending and twisting is a natural immunity booster
Bounce: get on the trampoline or rebounded to flush the lymphatic system
Massage: even a self massage 5 minutes per day prior
Breathe: slowly and gently. Your breathing should be silent and invisible.
Spend some time in the sunshine
Move: don’t sit for more than 1-2 hours at a time
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.
What is Clinical Pilates and why has it made such an Impact?Clinical Pilates has been shown to reduce the onset, persistence and recurrence of pain by addressing the neuromuscular dysfunction it is associated with. Clinical Pilates is largely concerned with training local spinal and pelvic stabilising muscles to work efficiently throughout functional activity. It is particularly important in the rehabilitation of spinal pain amongst other motor control problems and is associated to what researcher’s term “specific stabilisation exercises” or “motor control exercise”. With the latest research emerging, evidence-based Physiotherapists have re-evaluated their management of low back pain with a shift towards this type of exercise rather than focus on strength and endurance, which is perhaps more appropriate in the advanced stages of rehabilitation. CLINICAL PILATES involves the following components which are particularly helpful to aid in the rehabilitation of low back pain:
- Teaches co-activation of Transversus Abdominis (TA), Pelvic Floor (PF) and Multifidus (MF) muscles
- Teaches correct muscle activation patterns
- Trains local and global stability systems
- Trains neutral stability before end range stability
- Progresses static stability to dynamic
- Direction specific
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 do you love Pilates? I enjoy being able to strengthen and stretch out my body..... any chance to take off shoes is welcome! I have had first hand experience with immediate relief. What is the best thing about being a physiotherapist? I enjoy the mental Challenge of problem solving with clients in a vulnerable situation, helping them understand whats going on ans what we can do to assist. De – escalating someone who has thought the worst of their situation, Instilling in them optimism and confidence is a great outcome and good feeling. Why work at Pottsville and Cabarita physio? I have grow up in a small coastal village - I enjoy the friendly village feel. The vibe around town and in the clinic is fantastic. Over the past 4 years I have watched the growth of the town with this and the advancements in technology, The Clinic at Cabarita has come into its own. Best relaxation tip To relax I enjoy Surfing and gardening. I also enjoy spending time with my wife and Chocolate Labrador Raz. Our Fruit trees are pumping out the good stuff at the moment, when I get home I wander outside (after taking off my shoes!) and pick the fruit and enjoy. Its a great way to slow down and switch off after a full day. Best lifestyle tip Many people will know that I have been studying for my Masters in Physiotherapy, I have been practising during this time to take time out and have a surf or do something I love. If you are going to do post graduate study, my advice is to do it slowly, take your time. Favourite activity To go for a sunrise surf with friends. Favourite recipe My Nachos and Tacos .. I cook - however I'm the only one who likes it! A typical Sunday An early morning surf, followed by a bike ride with my wife to go and have Mexican!.. I do this every day... except for the Mexican... So wonderful living and working in paradise!