“Why reading this post is NOT good for you”

You’re probably reading this post inside, sitting on a chair, on a phone or computer screen. Yet spring in Australia is the time when the outdoors beckons. We go to the beach in droves, have picnics and barbecues, paddle and fish and swim. Some hike, others bike, and a few do both (although not at the same time!) But these good times in the outdoors are an exception to the rule, which is that most of us spend the vast majority of our time inside. According to one estimate, the average person spends 90% of his or her life indoors, and as we get older we become even more inclined not to venture out.

When we do, there’s a gantlet of precautions: slather on the sunscreen; take it easy if air pollution is bad; watch out for ticks, mosquitoes, and other creatures that might bite. It’s all very well-meaning but it also reinforces indoor ways. But despite these irritations, the study results are ticking up: spending time outdoors has discernible benefits for physical and mental health. Here are five potential benefits of spending more time outdoors:

  1. Your vitamin D levels will go up

Vitamin D is called the sunshine vitamin because sunlight hitting the skin begins a process that eventually leads to the creation of the biologically active form of the vitamin. Over all, research is showing that many vitamins, while necessary, don’t have such great disease-fighting powers, but vitamin D may prove to be the exception. Epidemiologic studies (i.e. studies on large populations) suggest it may have protective effects against everything from osteoporosis to cancer to depression to heart attacks and stroke. Even by conventional standards, many people don’t have enough vitamin D circulating in their bodies. The good news is that you’ll make all the vitamin D you need if you get outside a few times a week on a sunny day and expose your arms and legs for 10 to 15 minutes.

There are some snags. Vitamin D production is affected by age (people ages 65 and over generate about a fourth as much as people in their 20s) and skin colour. Another problem is that sunscreens are most effective at blocking the ultraviolet B (UVB) light, the part of the spectrum that causes sunburn, but UVB also happens to be the kind of light that kick-starts the generation of vitamin D in the skin.

The either-or of sunscreen and sunshine vitamin has stirred up a lot of controversy and debate between pro-sunscreen dermatologists and the vitamin D camp. But there is plenty of middle ground here: some limited sun exposure on short walks and the like, supplemented with vitamin D pills if necessary, and liberal use of sunscreen when you are out for extended periods, particularly during the middle of the day.

  1. You’ll get more exercise (especially if you’re a child)

You don’t need to be outside to be active: millions of people exercise indoors in gyms or at home on treadmills and elliptical trainers. Nor is being outside a guarantee of activity. At the beach on a summer day most people are in various angles of repose.

Still, there’s no question that indoor living is associated with being sedentary, particularly for children, while being outdoors is associated with activity. According to some surveys, children spend an average of 6 hours a day with electronic media (video games, television, and so on), time that is spent mainly indoors and sitting down. British researchers used Global Positioning System devices and accelerometers, which sense movement, to track the activity of 1,000 children. They found that the children were more than doubly active when they were outside.

Florence has many fun things to do for children of all ages!

Adults can go to the gym. Many prefer the controlled environment there. But if you make getting outside a goal, that should mean less time in front of the television and computer and more time walking, biking, gardening, cleaning up the yard, and doing other things that put the body in motion.

  1. You’ll be happier (especially if your exercise is ‘green’)

Light tends to elevate people’s mood, and unless you live in a glass house, there’s more light available outside than in. Physical activity has been shown to relax and cheer people up, so if being outside replaces inactive pursuits with active ones, it might also mean more smiles and laughter.

Researchers at the University of Essex in England are advancing the notion that exercising in the presence of nature has added benefit, particularly for mental health. Their investigations into “green exercise,” as they are calling it, dovetails with research showing benefits from living in proximity to green, open spaces.

In 2010 the English scientists reported results from a meta-analysis of their own studies that showed just five minutes of green exercise resulted in improvements in self-esteem and mood. It’s hard to imagine how a stroll in a pretty park wouldn’t make us feel better than a walk in a drab setting.

  1. Your concentration will improve

Richard Louv coined the term “nature-deficit disorder” in his 2008 book Last Child in the Woods. It’s a play on attention deficit hyperactivity disorder (ADHD). Researchers have, in fact, reported that children with ADHD seem to focus better after being outdoors. A study published in 2008 found that children with ADHD scored higher on a test of concentration after a walk through a park than after a walk through a residential neighbourhood or downtown area. Other ADHD studies have also suggested that outdoor exercise could have positive effects on the condition. So if you have trouble concentrating — as many do — you might see if some outdoor activity, the greener the better, helps.

  1. You may heal faster

University of Pittsburgh researchers reported in 2005 that spinal surgery patients experienced less pain and stress and took fewer pain medications during their recoveries if they were exposed to natural light. An older study showed that the view out the window (trees vs. a brick wall) had an effect on patient recovery. Of course, windows and views are different than actually being outside, but we’re betting that adding a little fresh air to the equation couldn’t hurt and might help.

So what are you waiting for? Leave your screen, and head outside. Your health, body, mood and mind will thank you for it.

***

Contact us for more information or to make an appointment.

For a complimentary copy of John Perrier’s book “Back pain: How to Get Rid of it Forever” please follow the links below.

In Australia – click here:  http://www.amazon.com.au/Back-Pain-How-Forever-Causes-ebook/dp/B00UV5450U/

Elsewhere – click here: http://www.amazon.com/Back-Pain-How-Forever-Causes-ebook/dp/B00UV5450U/

I acknowledge the work of the Harvard Health School for the sontent of this article. http://www.health.harvard.edu/newsletters/harvard_health_letter/2010/july

“How to get rid of joint pain that is bought on by cold and rainy weather.”

With autumn now approaching and the temperature starting to drop, you may hear a lot of people complain that their bone and joint discomfort worsens. This is a common statement around this time of year. This change can be due to a drop in barometric pressure.

rainy day

How does air pressure relate to joint pain? When there is less pressure on the outside of the joint it allows the swelling inside to increase just a tiny bit. This extra swelling can be the difference between a good day and a bad one.  Air pressure tends to drop even more when it is raining, so cold wet days often feel the worst.  

A hot bath or heat pack married with a good anti-inflammatory cream is often enough to ease the symptoms, but if you find your aches and pains are overstaying their  welcome then your best  treatment is, of course, a few sessions of physiotherapy.

The Role of Physiotherapy

Patients with arthritic or wear-and-tear  disorders may benefit from joint mobilization, electrotherapy,  hydrotherapy and muscle strengthening exercises. Localized, specific massage techniques can also break up the ’rust’ from the joint, greatly reducing the pain.  When done together, these techniques not only reduce the swelling and inflammation in a joint but they loosen it up, giving everything more room to move. This extra space means that the joint does not ache as much, even if the weather outside is cold or rainy.

The Role of Exercise

Moderate, regular exercise has been proven to aid in the prevention of arthritis and joint stiffness, and offers a host of benefits to  sufferers.  Exercise can reduce joint pain and stiffness, builds strong muscles around the joints and increases flexibility and endurance.

What type of exercise should I be doing?

  • Water exercise- such as aqua aerobics or swimming laps—especially if done in a warm pool. This non-weight bearing exercise provides the fitness without the joint pounding associated with land-based activities.
  • Tai chi, yoga, and stretching will help to get you looser if done on a  regular basis
  • Pilates will help to strengthen your core muscles and make sure that you are balanced. When your muscles are balanced your joints will move properly, minimizing the wear and tear.
  • Walking or light jogging, depending on your body’s general condition and specific problems such as knee or hip wear-and-tear.

Please contact us if you have any queries, especially aches that appear as the weather cools.

“Warming up before sport: Why you’re probably doing it all wrong!”

If you want to perform at your best — on the court, on the field or on the pitch– you need to know how to get your body ready for intense activity. Yet most people, even many high level sports people, don’t understand the basics of a good warm up. 

So how do you warm up best? With some slow, sustained general body stretches, right?

Wrong!

Most studies show little or no benefit in a generalised, non-specific stretching program to prevent injury.

Scientific evidence indicates that active warm-up, as opposed to slow passive stretching, is the best injury preventative.  In other words, get moving!  So the puppy in the photograph could probably be doing things a little better!

dog stretching

You will also need to do some core muscle activation, and some sports-specific drills.

An example of an active warm-up that focuses on the leg muscles might include the following activities:

  • A slow 400 metre jog to start the process
  • Next, do a few minutes of light movements.  These should concentrate on (a) relaxed gentle movement (b) all the way to the end of range (c)  in each direction (d) for all your joints. Make sure that you move your spine and neck  as well as your limbs.  If you have any specific muscle imbalances or physio-prescribed exercises/stretches, now is an ideal time to work on them.
  • Now perform some exercises to activate your core muscles (if you know how … if you’re unsure than please contact us directly). This is an important step to awaken them for the task ahead, which is unfortunately often omitted.
  • Now move to an active phase. Start with half a dozen 40-60m runs at 50% pace, walking back in between. Slowly increase your stride length with each repetition.  Activate your core muscles as you run.
  • Add another half a dozen “run through” sprints of 40-60 metres, beginning at 50% pace, and increasing by 10% each repetition.
  • Perform 3-5 backwards jogs over 20 metres, and then a similar set of sideways runs.
  • Finally, add sports-specific skills (e.g. kicking: start at 20m, then increase to full strength over 20 kicks.)

By the time you have completed  this warm up, your muscles and joints will be loose, your core muscles activated and ready to protect your joints, and your cardiovascular system will be ready to go.  You’ll hit the playing field in peak condition, and not only will you help to prevent injuries – both short and long term – but you’ll be ready to fire from the first whistle.

 

What has a Mythical War Hero got to do with Heel Pain?

In Greek mythology, Achilles was a Greek hero of the Trojan War. Achilles was the greatest warrior of Homer’s Iliad. Legend states that Achilles was invulnerable in all of his body except for his heel. He even died because of a wound on his heel. The term Achilles’ heel has come to mean a point of weakness.

However, most runners and athletes who need to run or jump will know that Achilles heel is better known as Achilles Tendinitis and it is both painful and effects your sporting performance.
Achilles Tendonitis
What is Achilles Tendinitis?

Achilles Tendinitis is a term that commonly refers to an inflammation of the Achilles tendon.  It is an overuse injury that is common in sports that require running or jumping. Most experts now use the term Achilles tendinopathy to include both inflammation and micro-tears. But many doctors may still use the term tendonitis, tendinitis or tendinosis out of habit.

What are Tendons?
Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

What Causes Achilles Tendonitis?

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

Sometimes a tendon injury can happen suddenly. You are more likely to have a sudden injury if the tendon has been weakened over time.

Common Causes of Achilles Tendonitis

  • Over-training or unaccustomed use – “too much too soon”
  • Sudden change in training surface – e.g. grass to bitumen. Soft sand works your calves and achilles very hard
  • Flat (over-pronated) feet
  • High foot arch with tight Achilles tendon
  • Tight hamstring (back of thigh) and calf muscles
  • Toe walking (or constantly wearing high heels)
  • Poorly supportive footwear, or changing from shoes with a high heel cup to a lower one, which puts more stretch and strain on the achilles.
  • Hill running.
  • Poor eccentric strength

What are the Symptoms of Achilles Tendonitis?

  • Achilles tendonitis may be felt as a burning pain at the beginning of activity, which gets less during activity and then worsens following activity. The tendon may feel stiff first thing in the morning or at the beginning of exercise.
  • Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.
How is Achilles Tendonitis Diagnosed?
Your physiotherapist can usually confirm the diagnosis of Achilles tendonitis in the clinic. They will base their diagnosis on your history, symptom behaviour and clinical tests.
Achilles tendons will often have a painful and prominent lump within the tendon.
Achilles tendinitis Further investigations include US scan or MRI. X-rays are of no use in the diagnosis.

What are the Aims of Achilles Tendonitis Treatment?

Achilles tendonitis is one of the most common problems that we see at PhysioWorks and it is unfortunately an injury that often recurs if you return to sport too quickly – especially if your rehabilitation program is not completed.
Your calf muscle is a large powerful group of muscles that can produce sufficient force to run, jump and hop. Your achilles tendon attaches your calf muscle to your heel bone. It is a tendon or non-contractile soft tissue structure, which does have a different level of blood supply and function, which does alter the rehabilitation from a calf tear.
Researchers have concluded that there are essentially 7 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence.

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

As with most soft tissue injuries the initial treatment is RICE – Rest, Ice, Compression and Elevation.
In the early phase you may be unable to walk without a limp, so your Achilles tendon needs some active rest from weight-bearing loads. You may need to be partial-weight-bearing, and use crutches, a wedged achilles walking boot or heel wedges to temporarily relieve some of the pressure on the Achilles tendon. Your physiotherapist will advise you on what they feel is best for you.
Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot. Anti-inflammatory medication (if tolerated) may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.
As you improve a kinesio (stetchy) style supportive taping will help to support the injured soft tissue.

Phase 2: Regain Full Range of Motion

If you protect your injured Achilles tendon appropriately the torn tendon fibre will successfully reattach. Mature scar formation takes at least six weeks. During this time period you should be aiming to optimally remould your scar tissue to prevent a poorly formed scar that will re-tear in the future.
It is important to lengthen and orientate your healing scar tissue via massage, muscle stretches, neurodynamic mobilisations and eccentric exercises. Signs that your have full soft tissue extensibility includes being able to walk without a limp and able to perform Achilles tendon stretches with a similar end of range stretch feeling.

Phase 3: Restore Eccentric Muscle Strength

Calf muscles work in two directions. They push you up (concentric) and control you down (eccentric). Most Achilles injuries occur during the controlled lengthening (eccentric) phase. Your physiotherapist will guide you on an eccentric calf strengthening program when your injury healing allows.

Phase 4: Restore Concentric Muscle Strength

Calf strength and power should be gradually progressed from non-weight bear to partial and then full weight bear and resistance loaded exercises. You may also require strengthening for other leg, gluteal and lower core muscles depending on your assessment findings. Your physiotherapist will guide you.

Phase 5: Normalise Foot Biomechanics

Achilles tendon injuries can occur from poor foot biomechanics eg flat foot. In order to prevent a recurrence, your foot will be assessed. In some instances you may require a foot orthotic (shoe insert)  Your physiotherapist will happily discuss the pros and cons with you.

Phase 6: Restore High Speed, Power, Proprioception & Agility

Most Achilles tendon injuries occur during high speed activities, which place enormous forces on your body (contractile and non-contractile). In order to prevent a recurrence as you return to sport, your physiotherapist will guide you with exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance.
Depending on what your sport or lifestyle entails, a speed, agility, proprioception and power program will be customised to prepares you for light sport-specific training.

Phase 7: Return to Sport

Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.
Your PhysioWorks physiotherapist will discuss your goals, time frames and training schedules with you to optimise you for a complete return to sport. The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.

What Results Should You Expect?

There is no specific time frame for when to progress from each stage to the next. Your Achilles tendonitis rehabilitation status will be determined by many factors during your physiotherapist’s clinical assessment.
You’ll find that in most cases, your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improves.
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.
The severity of your tendon injury, your compliance with treatment and the workload that you need to return to will ultimately determine how long your injury takes to successfully rehabilitate.

Can Your Achilles Tendon Rupture?

The worst case scenario is a total rupture of your Achilles tendon. Treatment in this case usually requires surgery, plaster or a walking boot for at least six weeks. Most of these injuries take six months or more to adequately rehabilitate.
Achilles tendon rupture

The best advice is to seek early advice from your physiotherapist to do all you can to avoid this nasty rupture happening in the first place.

More info about Achilles tendon rupture.
Contact our clinic directly

How do I treat a muscle tear?

What happens when I tear a muscle?

Muscle pain can be caused by any strain, injury or tear. The most commonly injured areas are the high speed/load muscles such as your hamstrings, thigh (quadriceps), calf and biceps. Muscle tears can range from a mild strain, in which the fibres are stretched but not torn (grade one), a moderate strain (grade two), to a complete rupture (grade three). Funnily enough, grade three strains are often the least painful. Why? Because the rupture is complete, there is simply nothing left to hurt!

What’s the Best Treatment for a Muscle Strain?

Treatment options vary depending on the severity of your strain or tear. Until you’ve been accurately diag-nosed, use the following guidelines:

  • Ice and a compression bandage.
  • Elevate the region if it is swollen.
  • If it’s painful to walk you should be using crutches.
  • Reduce your training to a level where you feel no pain.
  • Seek the advice of your Physio.

hamstring tear

What Should You Do Next?

Returning to sport can be easy or complicated depend-ing on the muscle affected. Some muscle tears, such as hamstrings, are notoriously difficult to get right. Ideally you should undertake:

  • an assessment of your muscle function, core stability and biomechanics to avoid injury recurrence.
  • deep massage to ensure that any scar tissue doesn’t clump.
  • a muscle rehabilitation program that incorporates components of strength, endurance, flexibility and speed that is specific to your chosen sport.
  • a neural tissue dynamics assessment to ensure that no nerve tissue has become entrapped in the scar tissue.
  • application of a heat retainer to the area when you return to sport.
  • application of ice therapy after any training sessions.

If you suffer a muscle tear which fails to respond after a few days, or continues to niggle, please contact PhysioWorks for more specific advice.

To read more about muscle tears, see http://www.physioworks.com.au/regions/muscle-pain-amp-injury or contact us directly via http://www.physioworks.com.au/Bulimba/bulimba.htm or http://www.physioworks.com.au/Mansfield/mansfield.htm

 

Back injury to Australia’s cricket captain Micheal Clarke

Today’s Australian newspaper ran an article on Michael Clarke’s lower disc injury. In the article, they discuss the opinion of  a physiotherapist on Clarke’s treatment. I feel that he raises some good points, particularly the one about over-reliance on CT scans and x-rays to diagnose the pain. (One study showed that 2499 out of every 2500 back x-rays are a waste of time.) He also mentions that much pain is caused by precipitated by poor muscle control – another well-accepted principle of treatment by most physios.  The full text of the article is below.

cricketby:Adam Shand

AT the end of a disastrous tour of India, Australia’s skipper Michael Clarke literally carries the burden of the nation’s expectations on his dodgy back.

While this weekend’s fourth Test in Delhi is the first match Clarke has missed through injury, the timing is ominous with back-to-back Ashes series looming.

Clarke’s “degenerative” back condition, a “bulging disc” first diagnosed when he was 17, has become an ever-present concern for the 31-year-old.

Leading Melbourne physiotherapist Geoff Fisher believes Cricket Australia must re-examine its protocols about managing injuries if Australia’s most valuable asset is to pay his way.

Fisher questions whether the team doctor should be in charge of diagnosing and overseeing treatment regimes for conditions like Clarke’s. “In sporting teams, doctors have become the front line of diagnosis for such pain but they are hopelessly out of their depth in dealing with musculoskeletal problems,” says Fisher.

“If the Australian team’s frontline response is medical then it will almost certainly fail.”

Fisher claims there is an over-reliance by sports doctors on CT scans and X-rays to diagnose pain. Scans often reveal abnormalities in the structure of a joint or limb, like Clarke’s bulging disc, he says.

“The doctor will say, ‘we see there is change in the structure of the joint. There’s evidence of wear and tear or abnormality. We can’t explain why it’s happening but we know it is happening because of the pain’.”

Studies have shown that up to 40 per cent of people have abnormalities in their spines that don’t automatically cause pain. Clarke’s pain, often described as his back “locking up”, may have nothing to do with discs or vertebrae. It may in fact be a protective response from the muscles of his back, not an injury at all.

It’s a problem that blights the lives of millions of people who spend too much time chair-bound or sitting in motor vehicles with knees elevated higher than hips. This places excessive strain on the postural muscles that keep the spine stable. Spinal muscles will attempt to control movement by an increase in tightness and tone.

“By reducing the range of movement, threats to the spine, are reduced. These responses are hard-wired and self-increasing, built into the neurology of the brain and spinal anatomy.”

The giveaway clue is that Clarke often suffers tightness in his hamstrings, Fisher says.

If Clarke’s problem is related to his spinal muscles, it is a treatable condition, using safe non-invasive manual therapies, says Fisher.

Working with triathletes, Fisher uses a variation of an Australian-devised therapy known as “continuous mobilisation” which might provide an alternative for Clarke.

Fisher’s method of manual therapy is designed to “turn off” the protective behaviour in the spine and the referred pain is often immediately relieved.

Fisher says that 95 per cent of his patients with chronic pain in their head, legs, knees, arms, feet or hands, are in fact suffering from “referred pain”. If, like Clarke, they haven’t suffered a trauma or arthritis, the source of the problem is invariably found in the lower back or neck where muscles have engaged in a protective response to guard the spine.

To learn more about back pain, please visit http://www.physioworks.com.au/store-1/books/back-pain-how-to-get-rid-of-it-forever

 

“How to avoid and treat running injuries”

Although one of the most popular and convenient ways to stay fit, running is also one of the easiest ways for you to develop an injury. The impact and stress of running can be hard on your muscles and joints, commonly resulting in injuries to your hips, knees, ankles, and feet.

How to Avoid Running Injuries?

There are several simple techniques to help you avoid running injuries.

  • Perform a Warm Up & Cool Down. You may have specific stretches that have been prescribed by your physio—your warm up/down is an ideal time to per-form them. However, general static stretching is not as effective as once thought. A better method of warming up is to start very gently—perhaps with a walk—and gradually increase your pace.
  • Wear appropriate footwear suitable to your foot structure. Recent research indicates that softer, pad-ded footwear may actually be worse for your joint than a harder sole. Keep this in mind when buying your next pair of shoes.
  • If your foot has biomechanical problems, you would probably benefit from orthotics, which can be fitted on-the-spot at either of our PhysioWorks clinics.
  • Avoid over training – ask us for advice. As a general rule, do not increase your training by more than 10% each week. Do not try to beat your previous times every day! Take it easy, enjoy yourself, and gradually get into the habit of running.
    running injuries
    Common running injuries

Early Warning Signs of Impending Injury

If an ache or pain develops, do not ignore the early warning signs. While some injuries can be immediately evident, others slowly and progressively get worse, making it even more important to act early before chronic problems develop. So what are the early warning signs you should look for?

  • Joint pain: Pain that lasts longer than 48 hours needs physiotherapy diagnosis.
  • Tenderness: If pressing your finger into a specific point causes pain, and the same pain is not produced on the opposite side of the body, please ask for advice.
  • Swelling: Usually obvious, swelling often co-exists with pain and heat. The area will feel “full”.
  • Reduced Range of Motion: Compare with opposite side of body.
  • Weakness: Perform tasks on both sides of body to identify weakness.

Other warning signs that you have overtrained include

  1. Pain that does not go away when you warm up
  2. Aching that persists for more than 30 minutes after you have cooled down, or
  3. Stiffness and pain the following morning.

If you experience any of these signs or symptoms, please give us a call. We will save you months of pain and frustration. We’ll have you back jogging pain free again in no time!

For more information on running injuries, please see http://www.physioworks.com.au/Injuries-Conditions/Activities/running-injuries or visit us directly at http://www.physioworks.com.au/Bulimba/bulimba.htm or http://www.physioworks.com.au/Mansfield/mansfield.htm