Stretching
has long played an important role in the world of sport and fitness, with many
athletes stretching religiously before and after exercise in hopes of
preventing injuries.
Lately, this
practice has been called into question with many people wondering if stretching
really makes a difference to athletic performance. The answer, like most
things, is not black and white, as we explore a little in this article.
A brief
introduction to stretching
Stretching
is a type of movement that increases flexibility by lengthening muscle fibres
to the end of their range. Stretching before and after exercise has been
thought to reduce the risk of injury, improve athletic performance and reduce
muscle soreness after exercise.
The two most
common types of stretching are static and dynamic stretching. Static stretching
is when you lengthen your muscle and then hold that position for a period of
time.
Dynamic
stretching uses movement and momentum of the body to stretch muscles to their
end range, without holding the stretch at the end.
What does
the research say?
Some
research has suggested that static stretching before an activity can actually reduce power, strength and performance.
However, these reductions were shown to be minimal and not noticed at all if
the stretches were held for less than 45 seconds. It has also been found that stretching does
improve flexibility but only for a short period of time. A few minutes after
stretching, your joints move further, and with less resistance, so you may have
improved flexibility immediately after stretching.
Why stretch
at all?
One thing
that is undeniable is that stretching feels great, with many people feeling
more relaxed and reporting a rush of endorphins after a good stretching
session. It is also difficult to test the long-term effects of stretching
specific muscles showing abnormal tightness. A long-term static stretching
routine will improve your overall flexibility, and this is thought to help
prevent injuries, although the evidence is inconclusive.
If you’re an
athlete, the decision to stretch or not can be a personal one. A warm-up prior
to intense exercise that includes some form of dynamic stretching is generally
recommended for reducing injury risk, but of course is no guarantee. Strength
and balance training may have a far greater impact on reducing injuries in the
long term.
Your physiotherapist is able to guide you on the best stretching advice for your individual activity and they may be able to identify some areas where improving your flexibility will help to reduce injuries and improve performance.
None of the information in this article is a replacement
for proper medical advice. Always see a medical professional for advice on your
individual injury.
There is no doubt that the human body can be very resilient. Short of regenerating new limbs, our bodies are capable of recovering from large amounts of damage, including broken bones. With this in mind, many people are happy to let nature take it’s course, thinking that seeing a physiotherapist after an injury will only act to speed up already healing tissues.
The
speed of recovery, however, is only one measure of healing and despite our
bodies’ incredible capacity for repair; injury repair can be less than straightforward.
Here are a few things about injury healing you may not have been aware of.
1. Scar Tissue is more likely to
form without treatment.
Scar
tissue can cause ongoing pain and stiffness in skin, muscles and ligaments. Physiotherapy
can prevent excessive scarring from forming through advice regarding movement,
massage and other hands-on treatment.
2. Your ability to sense the
position of your body, known as proprioception, is often damaged after an
injury and can be retrained.
Impaired proprioception is a major factor in re-injury. If
you’ve ever heard someone say “my knee/ankle/shoulder still doesn’t feel 100%”
then this could be why. The good news is that with a specific exercise program,
proprioception can be improved and recovered.
3. Once healing
has finished, your body may not be exactly the same as before.
Following an injury, ligaments may be lax, joints may be
stiffer and muscles are almost always weaker. While the pain may be gone, there
might still be factors that need to be addressed to prevent more complicated
issues in the future.
4. You may have
picked up some bad habits while waiting for the injury to heal.
While in pain, we often change the way we do things, this can
lead to the development of poor movement patterns and muscle imbalances. Even
though the pain has gone, these new patterns can remain and create further
problems down the road.
5.
Injuries don’t always heal completely.
On rare occasions, injuries may not
be able to heal completely on their own. The most serious example of this is a
fracture that cannot heal if the bone is not kept still enough. Other factors
that may prevent an injury from healing include poor circulation, diabetes, insufficient
care of the injury and poor nutrition.
Your physiotherapist can assess your injury and develop a treatment plan that will both restore you to the best possible function and prevent further injuries. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Remove the skin and seed of the mangoes and place in a blender. Add mint, blueberries, honey, coconut and yoghurt and blend all ingredients together for 60 seconds.
Check consistency of the smoothie and add either ice to thicken or milk to thin the mixture to your preference.
Being active is one the most important aspects of a healthy lifestyle and there are many different ways to get your heart rate up. No matter what your choice of activity is, there is always some risk of injury. In this article, we have listed some tips from physiotherapists to help you prevent accidents and injuries while exercising.
Choose the right footwear
The correct footwear can go a long way in protecting your feet and ankles from injury and can even prevent serious accidents such as falls. Every activity places different demands on your body and tailoring your footwear to suit these stressors is a great strategy for preventing injuries. For example, basketball players often wear shoes with support that extends above the ankles to help protect against ankle sprains, while hikers require thick and supportive soles to cushion and protect their feet. Wearing shoes that are too large or have poor grip can lead to slips and falls, particularly when exercising in the outdoors. Your physiotherapist can guide you with the correct choice of footwear for your chosen activity.
Pace yourself
When you start to see improvements in your fitness and strength, it can be tempting to push your limits to see just how far you can go. The danger in this is that often your tissues are still adapting to the increased demands of your new exercise regime. Increasing your weights, training time or running distances by too much too soon can lead to major setbacks. Give your body time to adjust and progress in a slow and steady manner.
Check your form and posture
Checking your posture in the middle of a workout is probably the last thing on your mind, however poor form is a leading cause of injury in athletes. Lifting heavy weights when your spine is not in its optimal position causes many low back injuries. Taking a second to check your posture before starting a lift is highly recommended.
Seek professional advice
Coaches and trainers are able to help you spot vulnerabilities and share their knowledge, helping you get the most out of your chosen activity. Often it is easier to prevent bad habits from forming than it is to break them once they are already in place. Invest in the advice of an expert, they can help you to avoid injuries as well as reach your peak performance.
Your physiotherapist can identify weakness in your training technique, bio-mechanical vulnerabilities, tight and/or weak muscles and can help guide you through your recovery if an injury does occur. However, prevention of injuries is always preferable to treatment, whenever possible.
None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
Low back pain is one of the most common conditions treated by physiotherapists. If you are unlucky enough to have been a sufferer, you know that severe pain in the back can take over your life. With improved understanding, health professionals have come to identify some common myths about back pain that are inaccurate, misleading or even counterproductive.
Myth #1 – Discs can ‘slip’ out of place
Sitting between the vertebrae of the spine are soft discs that provide flexibility and shock absorption to the spine. In the past, many health professionals including doctors and physiotherapists told patients that these discs had ‘slipped’ as a way of explaining their pain to them. While this was helpful to some extent, it is not entirely accurate. These discs are actually very secure and rarely, if ever ‘slip’ out of place. Discs may bulge slightly or in some cases tear. However, more often than not these injuries will heal without any permanent damage and exist in many people without causing any pain at all. Thinking that a part of your spine has permanently ‘slipped’ out of place can cause you to move differently. This can create even more pain and dysfunction.
Myth #2 – If you have low back pain, you should stay in bed
When back pain strikes, our natural instinct is to rest, avoid movement and wait for the pain to pass. However, studies have shown that being active and performing targeted and gentle exercises can help improve low back pain. In fact, our impulse to stop moving and protect our spines can actually cause abnormal movement patterns and stress. This can then lead to ongoing pain after the original injury has healed. If you are unsure of what kind of exercises you should be doing, your physiotherapist can help guide you with a targeted exercise programme.
Myth #3 – Severe pain means severe damage
Pain that is severe, strikes suddenly and without warning can be a very scary experience. If this happens to you, you could be forgiven for assuming you must have sustained a very serious injury. The fact is however that the spine, being surrounded by nerves is a particularly sensitive area of the body. This means pain in this area can be very strong without significant damage. A small ligament sprain or muscle tear can actually cause a large amount of pain. It is common however for intense symptoms to settle down quickly, even disappearing within a few days. In many cases, symptoms that last for longer than 2-3 weeks are caused by changes to your movement patterns in response to this pain, and not the original injury itself.
If you are suffering from back pain, the best person to see is your physiotherapist. They can help you to recover without any complications or side effects. This will help you safely return to your usual activities while also ruling out any serious damage that might need further investigation.
None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
The Four Biggest Mistakes You Can Make After A Muscle Tear
Our muscles play an important role in the movement of our body. Without our muscles, we wouldn’t be able to bend our elbow or straighten our leg. As our muscles are soft and designed for flexibility, they are also prone to injury.
In the period following a muscle tear, there are a few common mistakes people make. These can actually make their injury worse and delay healing times. Here are a few of the most common mistakes we see.
Stretching
After a muscle tear, the damaged fibres slowly begin to heal and reattach to each other. This process can be quite fragile and during the early stages, aggressive stretching of recovering tissue can impair healing or even lead to more tearing. While gentle stretching a few days after the injury can have a positive effect, you should check with your physiotherapist to ensure you’re not stretching too far and causing further damage.
Applying H.A.R.M.
Most of us are aware of the acronym R.I.C.E (rest, apply ice, compress the area and elevate) as the recommended treatment in the early stages of an acute injury. The acronym H.A.R.M is less well known and is used to remember the things you shouldn’t do after an injury. This stands for applying heat, drinking alcohol, running or massage. All of these activities can increase swelling, pain and increase the damage of the injury in the first 48-72 hours.
Failing to see a physiotherapist
The diagnosis of a muscle tear might seem straightforward, however, there might be more going on than you realize. Many conditions can mimic a muscle tear, or you may have suffered a tear due to an underlying weakness or pathology. Having a physiotherapist confirm your muscle tear or identify another condition is vital to ensuring you recover fully.
Your physiotherapist is also able to identify any factors that could lead to further injury and is able to help restore your tissue to its previous level.
Returning to sport too early
One of the most confusing things about muscle tears is that often they become less painful while the tissues are still not completely healed. Many people suffer another tear simply because they return to sport too early. While you may feel as though your tissues are back to full strength, the muscle fibres can still be healing and vulnerable to a tear. It is important to test your injury gradually, starting with gentle exercise and building up to high-intensity activities.
Your physiotherapist is able to guide you with a full rehabilitation programme. This can help to restore strength, flexibility and control to your damaged muscle, keeping you injury free for the future.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Patellar tendinopathy, also known as jumper’s knee, is known as an overuse disorder. It is characterised by pain at the base of the patella (kneecap). Common activities include squatting, sitting or going up and down stairs. The condition is known as jumpers’ knee because it commonly affects athletes involved in sports that require jumping and repetitive loading of the patella tendon. This can include basketball, volleyball, football and tennis.
Landing and jumping activities put a great amount of stress on the patella tendon. This tendon is responsible for transmitting the full force of the quadriceps muscles to the lower leg. It is most often used during activities such as jumping and landing. Interestingly, this force can actually be many times more than your body weight.
What are the symptoms?
The hallmark sign of patellar tendinopathy is sharp, localised pain in the patellar tendon. (This is just below the base of the kneecap). The pain is usually aggravated by activities that increase load through the quadriceps muscles such as squatting and jumping. Pain associated with patellar tendinopathy usually occurs gradually. It can often occur when a person has been very active for a long period of time, or if they have recently increased their training schedule. The pain will commonly start as a small niggle, gradually becoming more noticeable. There may also be a feeling of stiffness with movements of the knee or first thing in the morning.
How does it happen?
Patellar tendinopathy is not a particularly traumatic condition. Rather, it usually develops gradually over time due to prolonged overloading of the tendon. Like other tissues in the body, tendons are dynamic and can adapt to be able to withstand more force with training. However, if a tendon is unable to adapt to increased load quickly enough, it can develop micro tears. This leads to pain and dysfunction, known as tendinopathy. The risk of developing this condition can be increased by external factors. These include the type of sports chosen, training volume and the hardness of the training surface.
Intrinsic factors such as bone structure, muscle length, diet, age, muscle strength and overall health can also affect the ability of a tendon to adapt to forces. Anything that impairs the tendon’s ability to absorb force can lead to the development of tendinopathy. In general, men are affected by this condition more often than women.
How can physiotherapy help?
As with all conditions, the first step to effective treatment is an accurate diagnosis. Your physiotherapist will be able to correctly identify this condition and any factors that have led to its development. Treatment for any tendinopathy will involve a degree of rest and reevaluation of your training schedule. Treatment of the tendon itself has shown most effective with a targeted exercise program involving isometric and eccentric muscle contractions. These types of movements have been shown to help stimulate healthy tendon tissue to increase strength. They also help to support the damaged tissue, ultimately reducing pain. Tendinopathies can be notoriously difficult to resolve without patience and commitment to a rehabilitation program guided by a physiotherapist.
Note: None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
Preheat an oven to 180 degrees Celsius and line a baking tray with baking paper. Peel carrots and cut into large sticks. Crush one clove of garlic and add to baking tray along with carrots. Drizzle with olive oil and sprinkle with salt and pepper.
Place the baking tray into the oven and cook for 20 minutes, in the meantime, cut dates into quarters and add to the baking tray. Cook for a further 20 minutes before adding sliced almonds to the baking tray.
Continue baking for 10 minutes more and remove from oven. Mix ingredients together gently in a large bowl and set aside to cool.
Lower back pain (LBP) is thought to affect around 60-80% of the Western population throughout the course of their life. Many people don’t have any preceding events to cause lower back pain, although specific injuries can also initiate their symptoms. Low back pain constitutes almost half of all chronic pain. This has a huge effect on quality of life, as people with lower back pain tend to have more time off work and higher of medical costs than those who do not have symptoms.
What causes lower back pain
Sedentary lifestyles, increased body weight, reduced physical activity and poor postures are all contributing factors to LBP. For example, obesity rates in the western world have never been higher. Unfortunately this is known to cause greater rates of musculoskeletal pain than ever before. LBP can strike suddenly or build up slowly over a period of time. Many people report sudden and severe onset of low back pain from a seemingly innocent movement. Others find that their back aches towards the end of the workday and follows a regular pattern. Thankfully, more and more workplaces are advocating for better ergonomic set-ups in order to pre-emptively reduce the incidence of LBP amongst employees.
Dealing with lower back pain
Dealing with LBP is complicated as there are many treatments to choose from. Unfortunately, there is rarely a miracle cure that works for everyone. What research tells us is that effective and timely advice, thorough professional assessment and a tailored exercise program shows the best outcomes in the long term.
There are some cases where your physiotherapist or doctor will suggest that you have imaging such as an x-ray or MRI. While imaging can be helpful in ruling out serious injuries it is important to realise that if everyone was to have an MRI of their spine, it is reasonable to expect that most people would have changes in the appearance of their spines, even if they don’t have any pain or other symptoms. The take-home message is that scans do not always paint an accurate picture of what is happening within someone’s back.
The back is actually made up of a number of different structures. These together to achieve the required movements needed to perform daily activities. With such a complex combination of tissues and joints, aches and pains can be caused by any number of structures. Keeping the muscles and joints of the spine strong and healthy can have a remarkable impact on pain levels regardless of the specific structure causing symptoms.
If you are suffering from low back pain, speak to your physiotherapist for advice on how to best manage your symptoms. While nobody can prevent back pain with 100% certainty, it’s good to keep active and take care with heavy labour. This can reduce your chances of having lower back pain.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.
The biceps brachii muscle, commonly known as the biceps, sits between the shoulder and elbow. It has two parts: the long head and short heads. These come together to form the main muscle bulk, which is the “Popeye” part of your upper arm. The biceps brachii muscle runs from the top and front of the shoulder all the way down to the upper forearm. The biceps tendon is the part that attaches the muscle to the bone, both at the shoulder and the elbow.
The muscle functions to bend the elbow and turn the hand to face palm-up. The term “tendinopathy” is used to describe injury and pain of a tendon. This is most commonly due to overuse. Biceps tendinitis tends to affect the long head of the biceps more commonly. Both the tendon itself and the tendon sheath can be the source of pain.
How does it happen?
This condition occurs most commonly due to repeated use of the biceps over a long period of time. People with this condition often present in the later stages of tendon damage, when they begin to experience pain. This means that biceps tendinopathy is a slow-developing condition, without any symptoms until it reaches the point that the tissues become injured and painful. This is the body’s way of self-defence; it is telling you that it doesn’t like the activity you are asking it to do.
While specific tasks such as throwing sports, tennis or golf can increase the risk of developing a biceps tendinopathy, often it is simply caused by usual daily activities throughout the course of an adult’s life. With aging comes a decrease in the collagen and elastin components of tendons. This contributes to a reduced ability to sustain a high load, which can cause degeneration or inflammation over a longer period of time.
What are the symptoms?
Biceps tendinitis is painful; often aching at night and increasing in intensity when performing overhead tasks such as reaching and lifting. The pain is usually at the front of the shoulder, and can radiate downwards along the front of the arm.
People with this condition often have developed adaptations to their usual movement patterns in order to avoid aggravating this pain. This in itself can lead to other issues such as strained or overworked muscles. An example of this is hitching up the shoulder to the ear when going to use the affected side, as this will help to offload the affected muscle, allowing the biceps to be under less stress. Unfortunately, eventually this will increase the stress on the muscles of the upper neck and shoulder, leading to secondary aches and pains.
How can physiotherapy help?
Your physiotherapist will assess and diagnose this condition, which will in turn allow for a comprehensive management plan to be put in place. A combination of strengthening, stretching and muscle release is often beneficial to assist in management of this condition.
If you have developed secondary complications with changes to your normal movement patterns, your physiotherapist can assist you in addressing these and training your body to avoid causing further damage.
If further imaging or onward referral is needed, your physiotherapist can help in guiding you through this process.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
16 Small Fresh Prawns, peeled, deveined and pan-fried
Sweet Chilli Sauce for dipping
Bring a saucepan of water to the boil. Add rice noodles and cook for 3-5 minutes until soft. Drain noodles, rinse and set aside to cool.
Cut carrots into thin sticks, chop mint and coriander leaves and mix these leaves with the carrot sticks together in a small bowl and squeeze lime juice over them.
Fill a large shallow bowl with warm water. Dip one rice paper into the water for one second to soften. Lay the wrapper on a clean bench and place two prawns, a small handful of noodles, some carrot, mint and coriander in a row across the center, leaving a few centimeters of the rice paper uncovered on each side.
Gently wrap the sides of the wrapper over each other to create rolls.
Sufferers of knee pain know that nothing can kill your optimism for a recovery faster than a diagnosis of Osteoarthritis (OA). Osteoarthritis is often seen as a kind of death sentence for joints. Many people believe that if you have OA your pain will never improve and will only get worse until a joint replacement can be performed. In fact, joint replacements for hip and knee OA are some of the most common and indeed successful operations performed by orthopaedic surgeons.
At least, this has been conventional wisdom for decades. Many of us see our bodies like cars, when a part ‘wears out’ it needs replacing with a new one. The truth is much more complicated, mainly due to our bodies’ incredible ability to adapt and change.
Excersise
Physiotherapists have always known that the pain and disability that comes with arthritis can be improved with a closely targeted exercise program. In some cases, the pain that is attributed to OA is actually due to another, entirely treatable cause. In other cases, strengthening the musculature around the painful joint can have a significant effect by providing the joint with extra support.
The way we move is often affected negatively by pain and this in itself can create a downward spiral. This is not to say that in some cases, surgery is the best and most effective option to improve your quality of life. Rather that there is a strong case to see a physiotherapists to seek treatment for your knee pain first.
Physiotherapists are highly skilled at identifying exactly what is causing your pain and helping you reach the highest level of function. In fact, a recent study has shown that with targeted exercises, directed by physiotherapists – many patients who were scheduled to have surgery were able to improve their quality of life dramatically, avoiding surgery and getting back to their favourite activities.
While exercise is a very powerful treatment, it’s not that any exercise will take away any pain. To be effective, you will need to have a full assessment, with a personalised treatment programme from your physiotherapist. This can involve identifying weak muscles, limitations in flexibility, finding painful trigger points, restoring movement to stiff joints and providing bio-mechanical assessment to make a combination of changes that can make a large difference to your pain and activity levels.
Your physiotherapist can also identify any external factors that may be contributing to your pain. This could be something as simple as unsupportive footwear or workplace set up etc. Talk to us to see how we can help you manage your osteoarthritis.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
The hamstrings are a large group of muscles found at the back of the thigh. The primary role of these muscles is to bend the knee and collectively, these muscles are some of the strongest in the body. Despite their strength, the hamstrings are very prone to injury especially when overworked or undertrained. Hamstring strains and tears are quite common in sports that involving sprinting, jumping and sudden changes in speed. Football and soccer players are some of the athletes most commonly affected by hamstring tears.
Hamstring strains are categorized into three grades, these are:
Grade 1 (mild) – A few muscle fibers are either damaged or ruptured; there may be pain a day after the injury but no loss of movement.
Grade 2 (moderate) – Roughly half of the muscle fibres are torn; there may be acute pain and mild loss of function; walking may be affected. Grade 3 (severe) – More than half of the muscle fibres are ruptured and there is immense pain and swelling; definite muscle weakness and loss of function.
Grade 3 (severe) – More than half of the muscle fibres are ruptured and there is immense pain and swelling; definite muscle weakness and loss of function.
What are the symptoms?
The symptoms of a hamstring tear depend on the severity of the injury. Common symptoms include pain at the back of the thigh – which could range from mild to severe, swelling, bruising, loss of knee motion, tenderness at the back of the thigh, reduced length and muscle weakness of the hamstring. In some cases, tingling, numbness and weakness of the structures below the knee are seen. However, these are rare.
What are the causes?
A single cause of hamstring tears can be difficult to determine however, it is thought that a lack of coordination between the hamstrings and quadriceps muscles during sudden changes of speed or when kicking can cause the hamstrings to contract excessively or become overstretched, causing a tear.
There are also recognised risk factors, that increase the possibility of hamstring tears including increased age, fatigue, strength imbalance, previous injury of the hamstrings, poor core stability, poor hamstrings flexibility and tight hip flexors.
How can they be prevented?
Understandably, trying to prevent hamstring tears is important business. Research has consistently shown that the most important factor in preventing hamstring tears is having high eccentric strength in the hamstrings. Eccentric muscle contractions occur when a muscle is contracting while also lengthening. For example, when you lower your straightened leg slowly to the ground, your quadriceps muscle will be working eccentrically.
Your physiotherapists is able to show you some exercises that can target eccentric muscle strength specifically as well as identifying any risk factors that may be contributing to you individual risk.
None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.
If you require professional advice or treatment, please see our range of treatment options, or book an appointment online. Physio Direct has many clinics located throughout New Zealand, with no GP referral required to make an appointment.
