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Exercises for Back Pain Relief

One in 6 Australians experiences lower back pain at some stage in life.  Symptoms of lower back pain can be debilitating – pain can remain localised in the lower back and in some cases can refer down the legs.  It also restricts movements which then affect work and simple activities of daily living such as putting shoes on, sitting and pulling pants up etc.

Despite pain with movement, exercises are recommended over rest.  Avoid prolonged sitting or standing as remaining in stationery positions tends to disengage muscles that are essential to provide stability to your back.  Keep it moving help relieve pain and assists in the recovery. Here are some gentle exercises that can provide some relief to your back pain:

  Hip flexor stretch

  • Hip flexors are commonly tight for those who sits a lot as it remains in a shortened position when sitting.  Tight hip flexor can contribute to back pain as it attaches to the spine.
  • By performing this stretch as in the picture, you’ll feel tension at the front of the back leg. Push your hips forward to deepen the stretch.
  • Hold for at least 30secs.  Do 3-5 times on each side daily.

Glutes stretch

  • This stretch targets the gluteal muscles and can easily be done when in the office or commuting on the train
  • Sit with one leg crossed, lean forward and gently press the knee of the crossed leg down. You’ll feel a stretch on the side of the hip.

Cat and camel

  • This exercise aims to gently get your back moving
  • Start on your hands and knees.  Make sure your hands are under your shoulders and your knees are directly under your hips.
  • Slowly drop your stomach down and then gently arch your back up.
  • Do 10 times every morning and night

Bridging

  • This exercise strengthens hip muscles that tends to be switched off when sitting for long.
  • Start by lying down with knees bent. Making sure hips, knees and ankles are in line.
  • Lift hips up and lower down with control
  • Do 15-20 per set and 2-3 sets daily.

Pelvic tilt

  • This exercise targets your core muscles which assists in providing stability for your back
  • Prepare by setting up the same as the last exercise.
  • Tuck your tailbone in to flatten the curve on your back, hold for 5-10 secs then relax. You should feel your tummy muscles contracting.
  • Do 5-10 secs hold for 10 times every day

Walking

Although simple, walking is one of the dynamic exercises that is effective in engaging many different muscles. It is also a low impact exercise that can replace running or other high intensity when you have back pain.

If you are suffering from back pain, physios at capital physiotherapy can assess, diagnose and provide you with the right exercises to relieve pain and get your back moving.  Capital physiotherapy is also passionate at injury prevention, so give us a call if you would like more exercises and strategies to prevent recurring lower back pain.

Images from http://www.legacyneuro.com/fitness-friday-maintain-healthy-back/

https://www.bidmc.org/about-bidmc/blogs/wellness-insight-landing/sports-medicine-and-fitness/hip-flexor-stretch

https://www.besthealthmag.ca/best-you/stretching/seated-glute-stretch/

https://goodexerciseguide.com/the-exercises/bridging-exercise/

https://www.gaiam.com/blogs/discover/how-to-be-more-mindful-just-by-breathing-and-walking

Does Physiotherapy Help Osteoarthritis?

Osteoarthritis is a chronic condition caused by the breakdown of cartilage on the contact surface of a bone in the joint. Cartilage is important to provide a smooth surface for movement.  Therefore as the cartilage breakdown deteriorates, inflammation kicks in resulting in swelling and pain. The rough cartilage surface affects the fluidity of movement. The chronic joint pain, joint swelling, joint stiffness hence affects mobility and quality of living.  

Risk factors

There are many risk factors that are unmodifiable1 :

  • Age
  • Genetics
  • Family history
  • Female sex
  • Race

There are also a range of risk factors that are modifiable.  Our physios are trained to identify the modifiable factors and work with you to improve symptoms as well as prevent further decline in functions. These modifiable factors1  include:

  • Previous injury

Physios at capital physiotherapy are trained to assess, diagnose and rehabilitate your injuries to ensure you achieve the best outcome.  In doing so, we are taking a proactive approach to prevent osteoarthritis.

  • Obesity

Sports physios carefully assess your current level of functions and mobility, then prescribe you with exercises of suitable level to assist with weight control.  Capital physiotherapy particularly emphasis on strength and conditioning to encourage you to live a active lifestyle.

  • Occupational overuse

Physio has the knowledge to optimise your occupational health.  We can advise on modifying your work environment or desk setup. This allows your body to efficiently perform tasks at work and hence putting less stress on your body joints.

So make an appointment with our physios at Capital Physiotherapy today to discuss any osteoarthritis related symptoms your have and start to feel stronger and better!

 

Reference:

1 March, L. M., & Bagga, H. (2004). Epidemiology of osteoarthritis in Australia. Medical journal of Australia, 180(5), S6.

 

Sports Physiotherapy: Pros and Cons of Bracing and Taping

Professional athletes and everyday recreational sportsmen are often out of action when injuries happen.  Bracing and taping are great tools to assist recovery of the damaged structures, or to support movement in certain positions so we can continue to exercise.  Some also use them as an injury prevention measure. There is an extensive variety of braces and many different taping techniques sports physios use. Let’s have a look at the pros and cons you know when to use either of these tools.

Bracing

Bracing is an external device applied to a joint by restricting movement and hence stabilising the joint.  It comes in different sizes. A well-fitted brace can reduce pain by keeping the injured structures out of the painful range of motion. There are also different materials of braces available depending on the stability required: the fabric ones are softer, permitting more movement while the other ones are more rigid.   

Pros

  • Easy application and removal
  • Re-usable and cost effective
  • Provides significant support for return to play/ assist recovery/ pain relief

Cons

  • Requires regular cleaning especially when being worn for long hours
  • Bulky when compared to taping, especially for larger joints
  • Long term application can result in muscle weakness when injured structures rely on braces for stability

 

Taping

There are broadly two types of tape that are widely used by sports physio: rigid and kinesio tape.  Rigid tape, as the name suggests, enhances rigidity of joints. It stabilises joints by being applied to weakened injured structures such as a sprained ligament.  Kinesiotape is stretchy and it facilitates muscle movement to rehabilitate for injuries.

Pros

  • Not as bulky as braces and is easier to move around/ play sports with
  • Cheaper than braces
  • No sizing required and gives very customised fit to provide optimal support when applied appropriately
  • Kinesiotape tape can facilitate muscle activation

Cons

  • Material and glue may irritate skin
  • Needs frequent re-application if long term support is required
  • Non-reusable therefore if required for long term can be costly
  • Requires someone else (e.g. a sports physio) to apply for you (unless you have practised a dozen times although will still be awkward)
  • Can be painful to remove and may leave glue marks (and hairless patches for the hairy ones)

If you suffer from any acute or old injuries and would like to explore the options of taping or bracing to get yourself active and moving, feel free to contact our friendly team at Capital Physiotherapy.

 

When To Ice And Heat

When to use Ice vs Heat

Are you suffering from an injury and wonder if ice or heat can help?  When used properly, ice and heat can be therapeutic modalities that are easily accessible by all of us. A general rule is that ICE is for any injuries that are fresh, red, swollen and hot whilst HEAT is for anything chronic, stiff and achy.

Ice

Acute injuries such as a contusion (or more commonly known as a corky), a rolled ankle or a fracture generally elicits a cascade of inflammatory response.  Inflammation is our body’s natural mechanism to protect and repair, by bringing extra blood flow (hence the swelling) and sensitising the pain to stop you from using that injured structure.  Excessive inflammation, however, increases pain and reduces mobility. Ice calms down the inflammatory response by controlling the swelling and numbing the pain. Sports physios also use ice for muscle soreness post-exercises/ post-sports for pain relief.

Heat

As you may be able to picture, if heat is applied to a freshly rolled ankle, it will only bring more blood flow and make a balloon out of an already swollen ankle.  The therapeutic properties of heat to encourage circulation and relax muscles make it useful for chronic pain. Athletes with tight muscles, or any structures with tension in it find it improves elasticity of soft tissue.  It also has good pain-relieving effect on arthritic joints which is beneficial in the more senior population.

In short, use ice on anything that looks fresh and angry but heat for more long term painful structure,

If you need to see a sports physio for any advice regarding your injury or sports performance.  Feel free to contact Capital Physiotherapy, our friendly physios are more than happy to help!

Sports Physio – When do I Stretch, Before or After Exercising?

Stretches improves flexibility, which is an essential component of movement and exercises. But should we stretch before or after a workout? The short answer is to do stretch before AND after activities. Meanwhile, we shall think a little more about WHAT stretches to do and WHY.

Our bodies require flexibility for movement to occur efficiently.  Imagine wearing super tight jeans when you have to chase after a bus.  The jeans are limiting your range of motion and hence no matter how hard you try to take big strides you won’t go too far too fast.  Having flexibility means that your muscles can work more efficiently during sports or exercises.

Amongst the many different ways to stretch, static and dynamic ones are the most commonly used. Take our hamstring muscles as an example. To perform a dynamic stretch, we swing the leg back and forth across the entire available range of motion.

Dynamic stretch has been shown to improve muscle power, sprints and jumps when performed prior to exercises. It is therefore a good idea to include dynamic stretches in your warm up to prime for sports performance.

On the other hand, a static stretch is to hold the muscle in a lengthened position for 30seconds.

Static stretch is great as part of the cool down post sports or workout in order to maintain or increase flexibility.

 

For more ideas of stretching, have a look at this sports physio video (https://youtu.be/HNeTehBImAs) on Capital physiotherapy YouTube channel. Or if you have any questions, feel free to ask our team at Capital physiotherapy, South Yarra.

The Proper Lunge Technique

Lunges, like squats are one of the best exercises you can do in the gym too. It’s another exercise that can effectively work on more than one area of your body. An effective exercise means your body will gain the most out of it, so you can reach your goal quicker! However, just like an improperly done squat, the wrong technique will cause you injury and future issues in the knees. It is important that you scrutinise your technique and concentrate on the quality of your lunge.

Not only are lunges great for your body, but they are easily done anywhere you’d like to exercise. You may see lunges done out in the park during boot camps (*shivers*). You may also see them done in the gym; you can be creative and use the different weights and bars to increase the intensity of your lunge routine. I personally like to do the lunge at the comfort of your own home. It’s an easy exercise that your body will thank you for!

The most important factor while doing lunges are to make sure your knees are positioned correctly throughout the movement. This means:

  1. Your knees do not move past your toes at the front
  2. Your knees do not move rotate inwards
  3. You keep your body nice and upright

By making sure you follow the above rules, you reduce the chance of any wear and tear around your knee caps as well as reducing any issues that arise due to improper technique. By having your knees moving in the correct way, your knee caps are able to distribute the force much more evenly around its surface area; this reduces stress building up on only one area of the knee cap.

In addition, by doing the exercise correctly, you will gain the most out of your lunge. Correct technique allows your muscles to function at its most effective; which means you can progress yourself and get stronger quicker!

Make sure you have a chat with one of our physios to get the most out of your routine!

De quervain’s Tenosynovitis

De Qeuervain’s Tenosynovitis is a painful condition that affects the tendons on the side of your thumb and wrist. This condition affects two tendons (Abductor Pollicis Longus and the Extensor Pollicis brevis) that arises from your forearm. These two tendons are very close together and they pass through a structure called the synovium before inserting at the base of the thumb.

This type of injury usually occurs due to several factors, one of which is repetitive movement. This can be seen when you use a mouse or a pen for a prolonged period of time, as well as the use of a screwdriver or hammering. Another common time this occurs is during and after pregnancies in women. This could be related to the lifting technique of the new born, as well as the usually quick gains in weight. This increase in pressure puts stress along the tendons, causing the pains.

Pain is generally quite general and achy in nature at the start. However, ongoing physical activity will result in the pain becoming sharper and localised on the side of your wrist (thumb side). Some swelling may also be observed.

It is imperative that you get your wrist looked after if you suspect a De Quervain’s Tenosynovitis. Prolonged use of the injured area will result in further aggravation and potentially may require surgical intervention. When caught early, conservative treatment would usually suffice. There are multiple ways that our physios at Capital Physiotherapy can look after you.

Depending on the person, treatment may include a combination of friction massage, electrotherapy, taping as well as exercises. Dry needling may also be done. The specific advice will differ per person, and at Capital Physiotherapy, we are well equipped to fully assess your specific situation to give you a tailored treatment program.

So don’t wait any longer, give Capital Physiotherapy a call and we will get you back to your best again!

Osgood-Schlatter Syndrome

Osgood-Schlatter Syndrome usually occurs in children and would normally affects both knees. This can be classified as ‘growing pains’. The pain is usually located at the tibia tuberosity (the bump in the tibia) and can be very sensitive to touch. These tend to occur when the child is undergoing a growth spurt, as well as an intense period of exercise; specifically: soccer, basketball and ballet. Traditionally speaking, there are more boys being affected by this syndrome; however the gender gap is narrowing as more girls participates in sports.

Ongoing activity, without appropriate management by a physio, may result in an avulsion fracture, whereby a piece of bone is torn away from the main bone. In this case, a splint may be ordered to allow the fracture to union.

Osgood-Schlatter is normally treated conservatively when caught quite early. Physiotherapy is usually recommended to help guide rehabilitation. Treatment would involve reducing tight muscles in the quadriceps, hamstrings and gastrocnemius muscles; as well as some strengthening exercises. Taping may also help.

Physiotherapists can also liaise with your child’s coaches so that they can continue to train, but minimizing any activities that may aggravate the syndrome. This is important as stopping their training will stunt their skills growth. Stopping training will also result in muscle atrophy and tightness developing as you ‘wait’ until the pain goes away. This may then create a domino effect and result in other issues in the near future.

Our physiotherapists at Capital Physiotherapy are well experienced dealing with Osgood-Schlatter Syndrome. Not only are they qualified to assess the functioning of your child’s knee joint; but they also have experience working with different sports clubs. This means they are well placed to not just treat your child, but communicate with other stakeholders to ensure your child gets the best care they deserve. This holistic care is important for your child’s wellbeing and Capital Physiotherapy will deliver.

So don’t hesitate to contact us at Capital Physiotherapy and we will get your child back to their best!

Muscular Imbalance Causing Knee Pains

I have seen many people reporting of knee pains. Some who had a sporting incident, resulting in a traumatic damage to the knee; while others have been a gradual progression of knee pain. Initially the pain is described as mild, an annoying ache. With ongoing aggravation, the pain progresses in a sharper type, where it can eventually stop people from doing their daily activities. With these gradual progression type of pain, it is important that the knee is looked after quickly so that further aggravation and worsening of symptoms can be avoided.

The quadriceps muscles are made up of 3 main group of muscles. The first in the Vastus Lateralis; the second is the Vastus Intermedialis and the third is the Vastus Medialis Oblique. Each of these muscles attaches onto the patella and has its own direction of pull. The VL pulls the knee cap laterally (to the outside), while the VI pulls the knee cap directly upwards. The VMO, meanwhile, pulls the patella medially (to the inside).

Each of these muscles will interact in such a way that the knee cap is pulled directly up along the patellar groove. By keeping the knee cap moving smoothly along this groove, you can minimise the pressure around the knee cap.

As you can imagine, any issues with the quadriceps, will result in this finely tuned movement of the knee cap to be disturbed, causing issues in the future.

Improper training, could potentially result in the VL being overworked and getting much stronger than the VMO. You can see this when someone does a squat or a lunge and their knees are moving sideways. This results in an imbalance of the patella as it move up and down along the patella groove. The result of this would be increased friction along one side of the patella which will gradually become increasingly worsening knee pain.

Injuries to the knee will also affect the movement of the patella. The more significant and frequent injuries you have in the knee, the more your VMO becomes less activated. This will have the same impact as the above scenario over time; mainly a gradual worsening of pain; as well as wear and tear along your knee cap.

It is therefore imperative that you get your knee pain looked at as soon as you can. Further postponement as well as ongoing aggravation will result in worsening of your symptoms and finally preventing you from doing your exercises.

Come to our physios at Capital Physiotherapy. Our appointments are strictly 1-on-1 and we provide longer than industry standard appointments to truly understand, not just your body, but your exercise routine as well as a multitude of other factors that can affect you. It is only with a great understanding of your situation will you achieve the outcome you deserve.

So don’t wait any longer and call us now!

MCL and LCL injury

Other important ligaments in your knees are your Medical Collateral Ligament and the Lateral Collateral Ligament. These, along with the rest of the ligaments, work together to provide stability in the knee joint. The MCL, originates from the inside part of your femur (thigh) and attaches to the inside part of your tibia (leg). The LCL, on the other hand, originates from the outside part of your femur and attaches to the outside part of your tibia.

 

The MCL is important in providing stability in your knee, so that it does not bend inwards. Injuries to this ligament could be due to a prolonged stress on the MCL, such as during skiing. It can also be injured due to a traumatic incident, whereby you are tackled from the outside.

 

The LCL, meanwhile, is important in providing stability in your knee, so that it does not bend outwards. Injuries to this ligament are usually due to a traumatic incident, whereby you are tackled from the inside.

 

 

There are 3 grades of ligament tears:

  1. Grade 1=a small tear resulting in some pain but still allowing almost full function
  2. Grade 2=a moderate-significant amount of tear, causing significant pain and reduction in function
  3. Grade 3=a complete tear of the ligament, resulting in pain, instability as well as minimal function. A grade 3 tear may also involve damages on other structures as well.

It is important that after a knee injury and if you suspect an MCL or LCL tear, that you seek physiotherapy help as soon as you can. Our physios at Capital Physiotherapy are well trained to diagnose as well as clear other structures in the knee of any involvement in the injury. Your appointment is spent 1-on-1 for the duration of the session to ensure you get the most out of your physio. A treatment plan will be provided to you so that you have a clear understanding of what needs to be done to get you back doing what you do best!

Don’t hesitate to contact us at Capital Physiotherapy!