Sports Injury Prevention for Baby Boomers
While there may be no single fountain of youth, you can slow down the aging process by staying physically active. Regular exercise enhances muscle and joint function, keeps bones strong, and decreases your risk of heart attack and stroke.
Here are some tips developed by the American Orthopaedic Society for Sports Medicine and American Academy of Orthopaedic Surgeons that can help you exercise safely.
Always take time to warm up and stretch before physical activity. Research studies have shown that cold muscles are more prone to injury. Warm up with jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes. Then slowly and gently stretch, holding each stretch for 30 seconds. Do not stretch cold muscles.
Just like warming up, it is important to cool down. Gentle stretching after physical activity is very important to prepare your body for the next time you exercise. It will make recovery from exercise easier.
Consistent Exercise Program
Avoid the “weekend warrior” syndrome. Compressing your exercise into 2 days sets you up for trouble and does not increase your fitness level. Try to get at least 30 minutes of moderate physical activity every day. If you are truly pressed for time, you can break it up into 10-minute chunks. Remember that moderate physical activity can include walking the dog, working in the garden, playing with the kids and taking the stairs instead of an elevator. Parking on the far end of a parking lot will increase the distance you have to walk between your car and your destination.
Take sports lessons. Whether you are a beginner or have been playing a sport for a long time, lessons are a worthwhile investment. Proper form and instruction reduce the chance of developing an “overuse” injury like tendinitis or a stress fracture.
Lessons at varying levels of play for many sports are offered by local park districts and athletic clubs.
Invest in good equipment. Select the proper shoes for your sport and use them only for that sport. When the treads start to look worn or the shoes are no longer as supportive, it is time to replace them.
Listen to Your Body
As you age, you may find that you are not as flexible as you once were or that you cannot tolerate the same types of activities that you did years ago. While no one is happy about getting older, you will be able to prevent injury by modifying your activity to accommodate your body’s needs.
Use the Ten Percent Rule
When changing your activity level, increase it in increments of no more than 10% per week. If you normally walk 2 miles a day and want to increase your fitness level, do not try to suddenly walk 4 miles. Slowly build up to more miles each week until you reach your higher goal. When strength training, use the 10% rule as your guide and increase your weights gradually.
Develop a balanced fitness program that incorporates cardiovascular exercise, strength training, and flexibility. In addition to providing a total body workout, a balanced program will keep you from getting bored and lessen your chances of injury.
Add activities and new exercises cautiously. Whether you have been sedentary or are in good physical shape, do not try to take on too many activities at one time. It is best to add no more than one or two new activities per workout.
If you have or have had a sports or orthopaedic injury like tendinitis, arthritis, a stress fracture, or low back pain, consult your Physiotherapist who can help design a fitness routine to promote wellness and minimize the chance of injury.
Our spinal columns are made of twenty four vertebrae stacked one above another on the pelvis. They are joined together at the front by discs and at the back by facet joints. When we bend forward, the vertebra above tilts and slides forward, compressing the disc and stretching the facet joints at the back of the vertebrae. When we bend backward, the disc compression is reduced at the front and the facet joints are compressed at the back. In the upper neck and thoracic areas we tend to have more facet joint strains and in the lower cervical spine and lumbar spine areas, disc injuries are more frequent. This is because our upper spine joints allow us to turn our heads to see, hear and smell, so they need mobility but do not support much weight. Our lumbar spine bears around half our body weight and as we move and sit, there are huge, sustained, compressive loads on our discs.
CAUSES OF BACK PAIN
Disc injuries are the most common cause of low back pain and can range in severity from a mild intermittent ache, to a severe pain where people cannot move. Disc injuries occur mainly during sudden loading such as when lifting, or during repetitive or prolonged bending forces such as when slouching, rowing, hockey and while cycling. They are often aggravated by coughing and running. A flexed posture during slouching, bending or lifting is a frequent cause of disc damage because of the huge leverage and compression forces caused by gravity pulling down on the mass of the upper body.
It is important to understand that damage from small disc injuries is cumulative if discs are damaged at a faster rate than they can heal and the damage will eventually increase until it becomes painful. Pain sensing nerves are only on the outside of the disc, so by the time there is even small pain of disc origin, the disc is already significantly damaged internally where there are no nerve endings to feel pain with.
There may be a previous history of pain coming and going as the damaged area has become inflamed, perhaps was rested or treated, settled for a while but as the underlying problem was not fixed, the pain has flared up repeatedly since. This type of disc injury responds very well to Physiotherapy treatment.
A marked disc injury causes the outer disc to bulge, stretching the outer disc nerves. In a more serious injury, the central disc gel known as the nucleus, can break through the outer disc and is known as a disc bulge, prolapse or extrusion.
Spinal muscles are often blamed as the cause of spinal pain but this is rarely the cause of the pain. Muscle pain may develop as the muscles contract to prevent further damage as they protect the primary underlying painful structures. This muscle pain is secondary to the underlying pathology and when the muscles are massaged, given acupuncture etc, there is temporary relief but the pain will often come back, as the muscles resume their protective bracing. Treatment must improve the structure and function in the tissues which the muscles are trying to protect. The most common sources of primary pain are the discs, facet joints and their ligaments.
There are four facet joints at the back of each vertebra, two attaching to the vertebra above and two attaching to the vertebra below. A facet joint strain is much like an ankle sprain and the joints can be strained by excessive stretching or compressive forces. The joint ligaments, joint lining and even the joint surfaces can be damaged and will then produce pain.
Facet joint sprains can occur during excessive bending but typically occur with backward, lifting or twisting movements. Trauma such as during a car accident or during repetitive or prolonged forces such as when slouching or bowling at cricket.
There are many other sources of back pain including arthritis, crush fractures and various disease processes. Your Physiotherapist will examine your back and advise you should further investigation be necessary.
SYMPTOMS OF BACK PAIN
Symptoms of structural back pain are always affected by movement. This is important to understand. Symptoms, usually pain but perhaps tingling and pins and needles, are often intense and may be sudden in onset but also may be mild and of gradual onset. There are other conditions which can produce back pain such as abdominal problems, ovarian cysts and intestinal issues. If you have symptoms in these areas which are not affected by movement, you must consult with your doctor. If you have chest, jaw or upper limb pain which is unaffected by movement, you must attend your doctor or hospital immediately.
Facet joints, discs, muscles and other structures are affected by our positions and movements. More minor problems produce central low back pain. With more damage, the pain may spread to both sides and with nerve irritation, the pain may spread down into the thigh or leg. As a general rule, disc pain is worse with bending, lifting and slouching and facet joint strains are worse twisting and bending backward or sideways. A severe disc problem is often worse with coughing or sneezing and on waking in the morning.
DIAGNOSIS OF BACK PAIN
Diagnosis of back injuries is complex and requires a full understanding of the onset history and a comprehensive physical examination. It is important for your Physiotherapist to establish a specific and accurate diagnosis to direct the choice of treatment. In some cases, the pain may arise from several tissues known as co-existing pathologies and each of these are treated as they are identified. Where the Physiotherapist requires further information or the management may require injections or surgery, the appropriate x-rays, scans and a referral will be arranged.
UPPER BACK AND LOWER BACK PAIN RELIEF
Eighty percent of adults will experience severe spinal pain at some time in their life. Much of this pain is called non-specific low back pain and is treated with generic non-specific treatment. This type of treatment often fails to provide lasting relief. However, Musculoskeletal Physiotherapists have developed specific diagnostic skills and specific treatment techniques, targeted to specific structures. We identify the structure and cause of the pain producing damage and develop specific advice and strategies to prevent further damage and promote healing.
Specific techniques are chosen to correct the structural and mechanical problems. Among many choices, treatment may include joint mobilisation, stretching, ice, strengthening and education. As normal tissue structure and function returns, there is a reduction in the inflammation and the pain will subside.
When normal movement has been achieved, the inflammation has settled and the structures have healed, your new strategies will reduce the possibility of the problem recurring. We use this specific approach to reduce or stop chronic pain.
While we have the choice to manipulate, adjust or click joints, patients with ongoing pain will seldom benefit from repeating these techniques. This is because our tissues are elastic and the benefit of the quick stretch of manipulation is lost, as the elastic tissues tighten and shorten again. Adjustments of this type have little long term benefit and often lead to an unhealthy dependence on the provider. Your Physiotherapist will choose a safer and more appropriate treatment for you.
PROGNOSIS OF BACK PAIN
Physiotherapy for back pain can provide outstanding results but it is a process, not magic. The damage which produces pain in a back takes time to develop and also time to repair and heal. You will understand there are often several interacting factors to deal with and patient compliance is necessary.
Sciatica is the term given to describe symptoms caused by irritation of the sciatic nerve. Contrary to popular belief, it is NOT a medical diagnosis. The sciatic nerve is formed from spinal nerves exiting the lower back, and runs through the buttock and down the back of both legs. Any pain or symptom experienced along this nerve is referred to as ‘sciatica’.
Common symptoms include:
One sided pain that may be felt in the lower back, buttock, hip and leg. It may also radiate to the foot and/or toes
Pain that can be described as severe, burning, sharp, tingling, searing
Weakness and or numbness in the leg, foot and toes
The problem causing sciatica is actually the correct diagnosis. Common causes include:
Lumbar disc herniation
Degenerative disc disease, osteoarthritis
Spinal stenosis (narrowing of the spine)
Nerve entrapment e.g. from tight musculature surround the lumbosacral area
Most sciatic pain is treated and managed with conservative treatment. As sciatica can be caused by a range of different issues as described above, it is important that an appropriate assessment is performed to provide specific treatment. Not all sciatic pain is the same!
Our physiotherapists will provide a range of treatment which may include:
Advice and education about the condition and how to manage the symptoms, generally exercise and staying active rather than bed rest
Strengthening exercises for supporting muscles e.g. lower back, core, hip
Stretching exercises for tight muscles
Hands on treatment for stiff joints and/or tight muscles
An individualised exercises program for self-management and future prevention.
Most cases of sciatica resolve by themselves within six weeks to three months. Sciatica can also be caused by narrowing of the nerve tunnel between discs due to osteoarthritis. Elderly people who suffer from disk degeneration as a consequence of ageing tend to be troubled the most by sciatica.
If sciatic pain is bothering you, make an appointment with one of our physiotherapists to aid in a correct diagnosis for optimal management.
There is a common belief that there is not much you can do for osteoarthritis because the joint damage has already occurred and can’t be reversed. However it is often the inflammation of the tissue surrounding the joint and instability from the weakened tissues that lead to pain from an arthritic joint.
Our physiotherapists may be able to help you decrease the inflammation and pain around the joint and get you moving again. Here is some information about osteoarthritis and how we can help.
What is osteoarthritis?
Arthritis is a name for a group of conditions that cause damage to the joints in our body, usually causing pain and stiffness
Osteoarthritis is one of these conditions and it affects the whole joint, including bone, cartilage, ligaments and muscles
It is most prevalent in the joints of the hips, knees, neck, lower back, fingers and big toe, but can occur in any joint
It is degeneration of the joint structures, namely the cartilage (protective cushioning on the bony surfaces) and its underlying bone surfaces
Bony growths or spurs commonly known as osteophytes are common in osteoarthritis
Ligaments and muscles around the joint also deteriorate in osteoarthritis
It normally affects a joint on one side of the body i.e. it doesn’t normally occur bilaterally like other arthritic conditions
There are other arthritic conditions you may have heard of such as rheumatoid arthritis, juvenile arthritis, and ankylosing spondylitis.
Signs and symptoms
Swelling of the joints
Symptoms usually develop and worsen gradually over months or years
Affecting ability to carry out normal daily activities
Clicking/grinding in the joint
Loss of flexibility in a joint
What causes osteoarthritis?
Previous joint trauma/injury
Being overweight greatly increases your risk
High joint stress/repetitive use/heavy loads
There is an increase risk as you age and there is more ‘wear and tear’ on the joints
Arthritis can be diagnosed by taking a thorough history and physical examination
X-ray can help confirm a diagnosis – you may need to see your doctor to get a referral
Our physiotherapists can help you with:
Strength and exercise programme
Joint mobilisation/soft tissue techniques
Aids or braces
Weight loss programme
Medication and joint supplements – your doctor can guide you on the best options
Surgical options such as joint replacement
Pre-operative rehabilitation has been shown to improve outcomes post-operatively, so if you are requiring surgery come and find out how you can help speed up your recovery with pre-hab
Some hints for the colder months
Cold weather can exacerbate joint pain and joint stiffness. Remembering a few common sense tips can help people with osteoarthritis survive cold weather:
Dress warmly and layer up
Exercise indoors to stay motivated and warmer
Use a heated pool for exercise – talk to your physiotherapist for local options and classes
Ensure your vitamin D levels are adequate
You don’t have to wait for the warmer months to reduce pain associated with osteoarthritis! Book an appointment with a physiotherapist online 24/7,