All posts in Physiotherapy

Marathon, Half Marathon Race Recovery

Recovery Advice:

Whether you are a first time or seasoned full or half marathon runner, post race you will be on a runners high for finishing your event after many months of running training and preparation. The key to a good post marathon, half marathon or running event recovery is what you do in the first few days after your marathon or running event.

The outcome of not following through on a good recovery include risk of injury, increased fatigue, mood swings and extreme muscle soreness.

At Saanich Physiotherapy and Sports Clinic we advise on the following tips to prepare you for your post race recovery.

 

Drink lots of water

Many of us don’t realise how much fluid can be lost during running. During your running event the wind evaporates a large portion of your sweat – this means that a lot of the fluid you lose is invisible, but can add up to 1-2 litres or water. Some of the signs to watch our for in post running dehydration can be headaches, concentrated urine which appears darker yellow in colour and feelings of being extremely exhausted. A swollen tongue and cracks/indentations in your lips can also be signs of a dehydrated body.

Perform a warm down routine

Warming down will make a huge difference to how your body responds in the first 1-2 days after your running event. This is when DOMS (delayed onset muscle soreness) starts to rear its ugly head. So it’s vitally important to warm down even if you do not feel like it at the time. Stay on your feet and keep moving and walking around the race precinct for about 5-10mins. Do a few light lower limb stretches of your quadriceps, hamstrings and calves immediately after the marathon or running event and keep increasing your light running routine over the next few days.

Book a massage or some hands on physiotherapy

At Saanich Physiotherapy we encourage you to pre-book your post race remedial massage or hands on physiotherapy and dry needling appointment in the first 1-2 days after your event. This will really assist your muscles to re-lengthen and decrease soreness after all the hard work they did getting you over the finishing line.

                                         Wear compression garments

Wear your compression socks, pants or shorts when you get home or even immediately post-race if you can get to them easily. Wearing these can significantly reduce your muscle soreness.

Seven days later have a massage or hands on physiotherapy appointment

It will usually takes 1-2 days for DOMS to kick in. Getting that second massage or hands on physiotherapy appointment a week after a major running event can work wonders. This is quite important if you are looking to continue to run or participate in another event soon (eg the following weekend or fortnight). Our hands on Physiotherapists and registered massage therapists will work over any residual tight knots and bands that developed over the course of your running event.

Legs up the wall

A great way to encourage recovery is to lie with your legs resting up on a wall. This can facilitate blood flow and lymphatic drainage. Adopting this position can improve your mood and energy levels by bringing blood back to the brain. You can stretch in this position for for up to 15mins. Move your gluteals closer to the wall for comfort and to stretch your hamstrings.

More

Knee Pain: Meniscus

Knee Pain: Meniscus

Knee pain can affect a large range of age groups, ranging from ‘growing’ pains experienced by young people to ‘arthritic’ pain in older persons, and everything in-between. In this Blog we will examine knee meniscus injuries, what causes them and how to treat these injuries.

What is the Meniscus of the Knee?

The meniscus are C-shaped structures in your knee joint which sit between your femur (or thigh bone) and your tibia (or shin bone). They are made of a type of cartilage called fibrocartilage, which is a little bit different to other form of cartilage in your knee called articular cartilage. Articular cartilage is often more affected with arthritis. Your knee has two menisci, the medial meniscus and lateral meniscus. The medial meniscus is located on the inside while the lateral meniscus is on the outside of your knee.

The menisci have a limited blood supply which rely on movement of the knee to keep it strong and healthy. The best thing you can do to prevent your meniscus from injury, is to keep active and keep the knee moving.

What does the Meniscus do?

The main role of the menisci is to help with absorbing and distributing forces through the knee joint. They work together with knee and hip muscles to act as a shock absorber when the knee is active. The menisci also increases the surface area of the knee joint, so it adds some extra stability to the knee.

How do you injure your meniscus?

The majority of meniscus injuries occur as people age (over 50 years). As you get older the limited blood supply to the meniscus becomes further reduced. As people age they develop wrinkles and grey hair. The aging process also occurs in the knee, the menisci begin to degenerate, lose some of their strength and become more prone to injury.

As the menisci become more susceptible to injury with age, the range and types of movements which can damage it become more prevalent. The majority of meniscus injuries occur when you twist your knee over a planted foot. – Sometimes it can be as simple, as turning to look over your shoulder or stepping off a ladder and putting weight on your foot and twisting your knee. You might notice the knee to slowly swell up.

Meniscus injuries in the younger ager group (under 30) are not as prevalent. Simple twisting movements to the knee are unlikely to cause menisci injury in younger persons. You are more likely to see menisci injuries occur with other knee injuries such as ligament damage caused through sport.

What should I do if I damage my meniscus?

So you have injured your knee and you are thinking, what to do next? Alternatively, you have had a scan on your knee and been diagnosed with a meniscus tear and wanting to know what is the best way to treat it?

A 2002 study involving people who had ‘degenerative’ menisci tears, compared the rehabilitation recovery rates of three groups. The first group had meniscus removal surgery (i.e. arthroscopic meniscectomy), the second experienced joint ‘wash-out’ (lavage) and third underwent ‘placebo’ surgery where the surgeon made skin incisions only. All groups undertook the same rehabilitation program. Amazingly they found no difference in between the 3 groups. All groups had the same levels of pain and function, and all improved at the same rate.

Since the initial 2002 study, further published studies have compared meniscus surgery with placebo surgery and physiotherapy treatment. These studies continue to confirm the same result, that is, there is no differences between all of the groups in terms of rehabilitation other than the surgery group having a higher cost of treatment!

The treatment for meniscus tears in the active, younger population (under 30) is more complex with some individuals needing surgery as soon as possible, while others can manage with physiotherapy and exercise.

What does this all mean?

Degenerative meniscus tears are more common as people age. In some cases people who not have any knee pain may have degenerative menisci and not be in any pain. In other words having a degenerative meniscus correlates poorly pain. The good news is, you might not need to have surgery at all if you are able to undertake a comprehensive physiotherapy rehabilitation program.

Will surgery provide you any benefits? Yes it will in the short term. However, arthroscopic meniscus surgery is associated with a ten-fold increase the risk of knee osteoarthritis.

Although most degenerative meniscus tears don’t need surgery, there are always some cases where surgery is going to be more effective than physiotherapy. Some menisci tears can either ‘stick-up’ into the joint or ‘break-off.’ In cases like these the tear can cause the knee to lock when trying to bend or straighten, and surgery is recommended to remove the tear.

What will my physiotherapist work on during my rehabilitation?

The first thing your physiotherapist will undertake is a full assessment of not only your knee, but your legs and even your back to see if you pain is coming from your meniscus or from somewhere else.

If you have hurt your meniscus recently your physiotherapist will start treatment aiming to reduce the swelling and begin to return it to its full range of movement.
If you have full range of movement and no swelling in your knee joint your physiotherapist will begin an exercise program focused on strengthening the muscles around your knee, and from around your hip. Weak quadriceps muscle has been found to place a greater load on your knee joint and your meniscus. Strengthening these muscle groups can reduce the pressure on the meniscus during movement. Weakness in your bottom (gluteal) muscles can also affect your knee function. Weakness in the gluteal muscles is known to place more load through the inside of the knee, which is where the majority of medial injuries occur. Strengthening the quadriceps and gluteal muscles will contribute to reducing the pressure on the knee.

To Summarize:

Degenerative meniscus tears areas common as wrinkles and grey hair as you grow older. Although surgery is sometimes required for some knee injuries it often is not the only or best option in most cases. For most knee injuries involving the menisci the best anti-aging medicine is physical activity and exercise.

More

Neck Pain Victoria – Text Neck?

Neck Pain Victoria – Text Neck?

Are our devices giving us neck pain?

There are millions of people right now looking down at their smartphone or tablet. Do you ever stop to think about what this might be doing to your neck and upper back?

At Saanich Physiotherapy and Sports Clinic, we are seeing a huge increase in the amount of neck, upper back, shoulder and arm pain which is all related to posture when using devices. From texting on the smartphone to watching TV on the tablet in bed, we are all guilty in some way. And sadly, we are seeing more and more children coming in with these issues too.

Consider how much your head actually weighs. On average, it weighs 4.5-5kg. When sitting or standing upright, this weight is supported by the lower neck vertebrae, intervertebral discs, muscles and ligaments. When you then lean your head forward when looking at your smartphone, the relative weight of your head on your neck muscles can increase up to 27kg! Just by looking down at your phone, you can increase the force on your lower neck by 5 times!

When maintaining this position for a period of time, the muscles will fatigue and stop working, meaning that the force of your head is now being held up by small ligaments, the neck joints and the discs in the neck. It is no wonder people are having more and more neck pain.

The term “Text Neck” is becoming more commonly accepted as a diagnosis for neck pain caused by prolonged use of smartphones and tablets. If left untreated, this massive increase in force in the lower neck and lead to headaches, increased arching of the spine, general pain and tightness and arm pain from irritating nerves in the neck. It can also cause weakening of the muscles in the neck which can lead to ongoing pain, stiffness, headaches or arm pain in the future.

With the increase in children having smartphones and even the use of tablets in school, there are becoming more and more postural issues arising which is definitely a concern for ongoing and long term neck and upper back problems later in life.

Text Neck can be treated. Your Physiotherapist may use joint mobilizations, soft tissue massage, taping or even dry needling to help restore normal movement within the joints and muscles.

However, it is imperative that you strengthen the muscles in the neck and upper back to prevent long term issues. Your Physiotherapist will tailor a program for you to complete at home or might even recommend core conditioning or yoga classes for a supervised strengthening program.

If you, your children or another family member or friend are guilty of using their smartphone or tablet too much and are noticing pain or discomfort in their neck, upper back or arm make sure you book an assessment with your Physiotherapist sooner rather than later!

More

Gym Injury Prevention

Gym Injury Prevention

WEIGHT TRAINING INJURIES

Improper weight-training techniques can lead to weight training injuries. The most common areas to be injured are the back, shoulders, and knees.

Back Injuries

Back sprains and strains most commonly result from improper lifting technique when performing exercises such as bench presses, deadlifts, and rows. Sprains involve stretching of ligaments while strains involve stretching of muscles or tendons. Initial treatment involves the R.I.C.E. method (i.e. Rest, Ice, Compression, and Elevation). Assessment and treatment by your physiotherapist are also valuable. At Saanich Physio your Physiotherapist can help you minimise the risk of obtaining weight training injuries.

Training Tip: The risk of back injuries can be reduced by maintaining a neutral spine and avoiding flexing or extending the lower back under heavy load.

Shoulder injuries

Lifting weights overhead incorrectly can lead to injuries such as shoulder impingement syndrome and rotator cuff damage. Shoulder impingement syndrome is when swelling and inflammation of structures in, and around the shoulder results in pain in the front and side of the shoulder/upper arm. Rotator cuff damage causes pain and weakness of shoulder movement. Treatment for these conditions may include physiotherapy and anti-inflammatory medication in minor cases; and cortisone injections and potentially surgery in more serious cases.

Training Tip: The risk of shoulder injuries increases with excessive repetitions. Ensure you also train other body parts to give your shoulders adequate recovery time between training sessions.

Knee Injuries

Repetitive knee exercises such as squats, lunges, deep knee bends, jumps, knee extension and leg lifts can cause pain at the front of the knee. Injury to the patellar tendon (the tendon that connects the kneecap to the shin bone) can occur with overuse. Small tears develop in the tendon leading to pain just below the kneecap. Treatment in the form of physiotherapy and a patellar tendon strap often helps to reduce symptoms and your doctor may also recommend anti-inflammatory medications.

Training Tip: Ensure that your kneecap tracks correctly (i.e. over the outside of the foot) during squat and lunge exercises.

If you feel pain from weight lifting in the gym seek treatment and corrective strategies from us at Saanich Physio. The longer you keep training with an injury or small niggles that can turn into bigger injuries, the longer your recovery time will be. Seek help early and keep yourself in the gym – there is no need to suffer from weight training injuries.

REFERENCES:
Aasa U, Svartholm I, Andersson F, et al. Injuries among weightlifters and powerlifters: a systematic review. Br J Sports Med 2017; 51:211-220.

Kerr ZY, Collins CL, Comstock RD. Epidemiology of weight training-related injuries presenting to United States emergency departments, 1990 to 2007. Am J Sports Med 2010; 38(4): 765-71.

Mazur LJ, Yetman RJ, Risser WL. Weight-training injuries. Common injuries and preventative methods. Sports Med 1993; 16(1): 57-63.

Siewe J et al. Injuries and Overuse Syndromes in Competitive and Elite Bodybuilding. Int J Sports Med 2014; 35: 943-948.

Siewe J et al. Injuries and Overuse Syndromes in Powerlifting. Int J Sports Med 2011; 32: 703-711.

Weisenthal BM, Beck CA et al. Injury Rate and Patterns Among CrossFit Athletes. The Orthopaedic Journal of Sports Medicine 2014; 2(4): 1-7.

More