Sports Injuries

Sports Injuries

Pain around the knee cap (Patellofemoral Joint Syndrome (PFJS) – Dr Jed Pullen – Associate Osteopath @ MOVE Osteopathy

In my experience the main cause of patella femoral joint syndrome is due to muscles that have become very tight combComments 0ined with a lack of adequate stretching, foam rolling or treatment. A change in shoes, type of training and surface you train on may also be the culprit. Tight muscles pull the patella, also known as the knee cap, so that it no longer slides and glides smoothly up and down when you bend and twist. Equally, weak glute muscles and a muscle located on the inside of your knee may be attributed to poor motion at the knee.
Osteopathy can help to loosen off musculature around the knee and hip which contribute to pulling and poor movement patterns of the patella. Short exercises to help retrain muscles that, based on our assessment, are in need of more strength will also help to prevent further pain and recurrence of pain. If patellofemoral joint syndrome doesn’t get treated it is likely to persist for a long time as the causative factor hasn’t been address. If quickly addressed with treatment this pain may be resolved in 2-3 weeks. Cases that have been on and off for a long period of time often take longer.
There are a number of things that you can do to help. Foam rolling through the ITB , the outside of the thigh, as well as the quadriceps and glutes are all going to help with releasing muscular tension. In the short term sports taping/ rocktape can help to ease the pain during activity. Applying ice after exercise is also important to help reduce inflammation in and around the knee. A short stint of consistent osteopathic treatment over 2-3 weeks, and then follow up treatments to help reduce likelihood of recurrence should see a significant improvement in the pain level experienced during exercise.
 

Shin Splints – Dr Kieran Schulz – Associate Osteopath @ MOVE Osteopathy

Shin splints occur when the muscles sitting either side of your shin (tibialis anterior and tibialis posterior) are being overused.  This most often occurs when you rely on one of these muscles too heavily, usually from factors like running on hard or angled surfaces; increasing the distance, intensity or duration of your runs too soon; wearing unsuitable footwear; or poor biomechanics in the foot, ankle or knee which changes the loading patterns of the leg.  If left untreated, this steady tightening can result in the tight muscle pulling so hard on its tendonous attachment to the tibia (shin) that the muscle starts tearing the outer soft-tissue layer of bone away from the bone itself.  This is what we call shin splints.
If you don’t remove the causative factor, the irritation will continue and usually the situation progressively worsens till running and walking induce severe pain in the lower leg. With rest alone, it may take many months to ease, but with appropriate care, that recovery time may be reduced to just a few weeks in mild cases.  Self management like rest, ice, taping, self massage and stretching usually help, and when you couple these at-home strategies with patient specific advice and osteopathic techniques which will help to loosen the tight tibialis muscles, calm and stretch the irritated area, and correct the biomechanical imbalances in the surrounding joints, you’ll be back into training again in no time!
 

Hamstring Strains – Dr Ashleigh Maggary – Associate Osteopath @ MOVE Osteopathy

A hamstring strain is where the muscle tears, this can occur in varying degrees from a few muscle fibers to a complete tear. Excessive pressure on this muscle can cause the strain or it can occur when performing unaccustomed or repetitive activities. It is most generally a non-contact injury and is common among runners, or with sports involving kicking or jumping. Other causative factors include inadequate flexibility or strength of the hamstring, muscle fatigue, and insufficient warm up time.
Depending of the severity of your muscle injury, healing time can take up to 18 weeks. Treatment for minor hamstring strains may resolve within 2-3 weeks if addressed promptly. Osteopathic treatment will speed recovery time and help to prevent recurrence of the injury.
For recent injuries, ice for the first 24-48 hours to help reduce swelling to the area. Elevate the leg that is injured (if possible). Avoid any sudden or strenuous movements of the hamstring to protect it from further injury. Osteopathic treatment will focus on reducing inflammation to the area and maintaining range of motion. For a resolving muscle strain, heat can be applied now that there is no swelling. This will help the muscle start the healing process. You can do some self-massage to the area at home, this will encourage blood to the area to help recovery. Stretching daily, once injury resolved and pain free, is very important to avoid re-injuring this area, especially after exercising. Treatment will focus on regaining stability, strength and improving range of motion. In most cases muscle strains respond well to osteopathic treatment, for more complicated muscle injuries we can discuss referral to a GP for further investigation.

Ankle sprains – Dr Vincent Cahill – Senior Associate Osteopath @ MOVE Osteopathy

The most common ankle sprain is an inversion sprain where the ankle rolls out. This normally occurs when you step on something or fall over. There is three main ligament on the outside of the ankle that are affected when you roll your ankle. The damage done is categorised into the different grades:

  • Grade 1 strain: when there is some slight stretching and damage of the fibres of the ligament.
  • Grade 2 strain: is when there is a partial tear of the ligament which leads to some hypermobility of the ankle joint
  • Grade 3 strain is Complete tear or rupture of the ligament.

When an ankle is sprained it normally swells and a lot and is very painful for the first 24-48 hours. In this time it is really important to incorporate R.I.C.E (Rest: keeping off it as much as possible; Ice: 20 minutes on 20 minutes off, Compression: through a bandage, Elevation: Having the foot/leg raised onto something).
Healing of ankles is in three stages:

  • Stage 1: includes resting, protecting the ankle and reducing the swelling of the ankle. This normally takes one week and will be greatly improved by Osteo treatment. Taping and bandaging can help to really protect the ankle in this stage.
  • Stage 2: Includes restoring range of motion, flexibility and strengthen. (1-2 weeks). Gentle non-weight bearing circles of the ankle and kicking in the pool can help in this stage.
  • Stage 3: Gradually increasing weight bearing activity to restore function. (weeks to months). Slow progression of weight bearing exercises.

Osteopaths can greatly increase the rate of healing of an ankle sprain and also correctly diagnose any issues that needed follow up scans or referral. Osteo’s would help decrease the inflammation around the joint in stage one of the healing and increase movement if any restrictions have occurred in stage two. It is also important for us to check the hips, pelvis and lower back to make sure that there isn’t any imbalances present form the injury or from the limping after the incident.
Stage three is very important to make sure that this doesn’t become a chronic problem. An Osteopath would guide you with some strengthening and proprioceptive exercises to stop this happening. Including standing on the injured ankle with your eyes closed and heel raises on an uneven surface.

Weight training injuries – Dr Bridget Vinning – Associate Osteopath @ MOVE Osteopathy

The main cause of weight training injuries that I see walking through the door are those attributed to poor technique and weakness in gluteal and middle back muscles. For example, not activating your gluteal muscles effectively during a squat or dead lift can lead to overloading your lower back muscles and joints and/or having bad shoulder posture during any upper body exercise will often lead to overuse of the trapezius muscle causing neck pain and headaches.
Osteopathy can help with weight training related injuries by identifying areas of weakness in your movement patterns and give you simply advice on how you might go about changing your current routine. Osteopathic treatment can help by releasing tension in muscles which are tight and being overused and ultimately restore full range of motion in your joints which may be restricted due to particular movement patterns your body has fallen in to.
When it comes to time frame for recovery it is very dependant on what area of the body is injured and your ability to rest or at least alter what you are doing in the gym to avoid re-aggravation. I often advice my clients to seek advice from a personal trainer for a few sessions when they are starting something new and if they don’t follow this up on a regular basis at least check in every 4-6 weeks to see if your technique is as best as it can be. Your osteopath is also able to screen your shoulders/back/hips and provide information on areas that require stretching and those which need strengthening. Communication between your training professional and osteopath is very beneficial to all parties involved.

Elbow pain / Tennis & Golfer’s elbow – Dr Grant Sinclair – Associate Osteopathy @ MOVE Osteopathy

Elbow pain is a very common site of pain in the upper limb; your osteopath can help to differentiate where the pain is coming from and why it has occurred. Areas that are associated with lateral elbow pain can refer from other sites including the neck shoulder and wrist. Lateral epicondylitis (tennis elbow) and Medial epicondylitis (golfer elbow) occurs when the muscles in that elbow region become irritated and inflamed generally preceding repetitive strain during a certain action like repeated wrist extension against resistance, contrary to what the name suggests you do not necessarily need to play golf or tennis to develop epicondylitis’s.
Osteopathy can be useful treatment option, by settling down the inflamed area by encouraging adequate circulation and lymphatic drainage of the area allowing the inflammatory process to take place for optimal healing of the irritated tissues. Your osteopath may use a variety of varying techniques ranging from stretching and soft tissue mobilization to dry needling, in combination with lifestyle advice to reduce causative factors along with specifically target exercise rehabilitation.
Nobody wants to be out of action or in pain for any extended period of time longer then need be, generally epicondylitis is a self-limiting condition that without treatment can last anywhere from 6months to 2 years to recover, with osteopathic treatment you will tend to find that the initial painful episode can settle within 6-9 weeks if acted upon quickly, but will usually require ongoing care to prevent flair ups.
In conjunction with osteopathic management supportive aids such as braces or taping maybe useful to reduce strain on inflamed tissues as well as avoiding aggravating factors such as heat or massage to the affected area as well as exercise that may stretch or irritate the area.

How can Acupuncture help with Sports injuries?

Nicholas Smith – acupuncturist @ MOVE Osteopathy
Acupuncture is a useful tool in the management of many sports injuries. Whether it is an acute injury or a long-term condition which won’t go away, Acupuncture can help.
One of the ways acupuncture helps, is by increasing blood flow to the area.   Acupuncture can increase the flow of nutrients to the area, giving the body what it needs to heal itself.  It also flushes out inflammatory mediators, the chemicals which sustain an inflammatory response long after it has outgrown its usefulness.  This means Acupuncture can be useful in treating any condition where inflammation is a part of the cause, which is often the case with chronic conditions such as Plantar Fasciitis, Arthritis and Bursitis.
Increased blood flow can also help with acute conditions like with sprains and strains.  Inflammation can be reduced, and the increase in nutrients allows the tissues to heal themselves faster.  This can lead to significantly reduced recovery time after injury.

Susan Maughan – Acupuncturist @ MOVE Osteopathy

Acupuncture assists the healing of acute and chronic sports related injuries by helping the body heal. Needles are placed right at the site of the problem and supporting points are put in other areas of the body to stimulate the body to release its own natural pain killers, natural anti-inflammatory and anti-stress hormones. This in turn will move the blood and qi in the affected area to:

  • Reduce pain, swelling and inflammation
  • Increase range of movement
  • Decrease muscle spasm and relax muscles
  • Decrease bruising
  • Help disperse oedema or swelling
  • Improve healing to reduce recovery time
  • Improve blood supply to deliver nutrients and remove toxins at the site of the injury.
MOVE Osteopath’s tips on posture for you

MOVE Osteopath’s tips on posture for you

Dr Giulian Di Venuto – Osteopath

My number one tip is to maintain your body through exercise, stretches and an osteopathic tune-up or maintenance treatment.
Changes in posture are of concern to Osteopaths because postural deviation can produce excessive stress on the musculoskeletal system.
I often describe optimal posture as the position, arrangement or alignment of the skeleton that requires the least amount of muscular energy to hold it upright and to account for the constant downward pull of gravity.
Deviations of the skeleton, of only millimeters, changes all the angles. It’s like the leaning tower of Pisa…everyone knows as soon a they see it that it does not look right and that at any moment gravity will win!
I have always said, Osteopathy is like Engineering for the human body. We assess the body like an engineer would address a damaged building and figure out why the injured area is failing and causing pain. We address the foundations and fix the cracks. This is often why we will recommend that people get regular maintenance care and treatment and advice specific to them, their body and their lifestyle.
 

Dr Ashleigh Maggary – Osteopath

ash stretch

My number 1 posture tip is the – Rolled towel thoracic spine stretch
This stretch is great for correcting forward head carriage and rounded shoulder posture, and encourages relaxation after slumping at the computer desk for prolonged periods of time.
Roll up a medium sized towel, and lie over the towel as it’s placed from the base of your neck to the mid back. Keep a flat pillow under your head (to avoid over extending your neck) and your knees bent (if necessary, to avoid low back strain). This stretch encourages stretch to the muscles which shorten during prolonged desk posture (pectoral and anterior neck muscles) and provides slack to those normally strained (trapezius and rhomboid muscles).
Spend 15 minutes in this position, focusing on deep breathing and allowing the body to relax into position. To increase stretch lie with arms outstretched. You should notice the stretch will ease and become more comfortable. Discontinue if any pain occurs.
 

Dr Grant Sinclair – Osteopath

I see tight or stiff upper back and neck and shoulder area as a large contributor to poor posture.
I find this stretch to be my ‘go to’ stretch for anyone with upper back or tightness across the neck or shoulders.
Most people can do it at the desk driving car (at stop lights of course) or in between activities.

The Eagle Arms stretch
How to do itgrants tip

1)    Cross your left elbow under your right and twist your forearms so your palms come together in the centre of your body
2)    Bring your forearms away from your face
3)    Try to lift your elbow to your shoulder height
4)    Hold for 30-60 seconds right and left

 

Dr Hilton Blauensteiner – Osteopath

A lot of people because of sedentary work posture can experience lower back pain.
Here is an exercise to decompress lower back that I use myself, it’s great for easing the muscle tension caused by sedentary work and can be done easily in bed at night before going to sleep.
Instructions: Lie comfortably on back with legs straight and try to stretch by pointing one leg away from the head (towards the foot). Start by doing the stretch lightly a few times alternating between left and right legs. Next try holding the stretch quite firmly for a few seconds. [A variation to this position is to have the hips and knees bent with the feet flat on the bed/floor and then pushing the pelvis towards the foot on the same side.] If done correctly, this will have the effect of stretching the region right at the base of the lumbar spine, which is where the stretch should be felt. It is also where most low back pain originates. Compare left and right sides and try to stretch until both sides feel like they can stretch the same amount. As with all stretches, starting slowly and gently is a good idea to minimise causing further strain or aggravation.

Dr Jed Pullen – Osteopath

 

My postural tip:
The mouse often causes many problems affecting your wrist to your neck. Make sure your mouse is as close to the front of the desk, sitting directly next to your keyboard, with your shoulder relaxed and elbow by your side. This minimises stresses place on muscles and joints of the arm, shoulder and neck. The mouse often starts to move forward over the day, along with your posture, so take note to readadjust every half an hour.

Dr Bridget Vinning – Osteopath

I have listed a few different stretches/exercises because I find them really beneficial and addressing the posture problems I see most commonly.

  1. Foam roller chest stretch. Lying with a foam roller or rolled up towel vertically down the spine, place arms out by side on the ground. You should feel a stretch in the front of your chest, your pectoral (chest) muscles. Hold this position for 3-5 mins daily.
  2. Cat/camel stretch. On all 4’s with hands underneath shoulders and knees underneath hips, arch your back into the air, tucking your chin and tail bone under. Then lower your back towards the ground, looking up towards the wall in-front of you and with your bottom in the air. Hold each position for 3-5 seconds, repeat 10 times each day.
  3. Chin tucks/ posterior cervical muscle stretch. This can be done, lying down, sitting or standing. Nod your head forward whilst tucking your chin in towards the back of your neck. You should feel a stretch at the base of your skull and down the back of your neck. Hold this position for 20-30 seconds and repeat 3-4 times during the day.

Dr Vincent Cahill – Osteopath

There is two hints or things I get people to focus on
1.       Shoulders don’t look good as earrings. I think when people are stressed or anxious or even really absorbed in things they tend to walk around or sit with elevated shoulders loading the traps and neck.
2.       Concentrate on lifting your sternum at the computer. By lifting your sternum your shoulders will drop and your head will come back form the screen as well.
 

Dr Kellie Rawlings – Osteopath

My tips are regular exercise, stretching and tune-ups and being aware of the little things that can make a really big difference such as
–       limiting screen time (phones/ipads etc) especially on weekends.
–       being aware of your posture when lifting and bending and doing everyday tasks like lifting kids, groceries washing etc
–       good footwear if you intend to be standing or walking for a while – high heels can look great but they are a nightmare for your posture.
–       Don’t think it won’t catch up with you and you can get away with no exercise or wearing high heels every day, bending and lifting badly or simply not looking after yourself…… you will definitely pay the price!!

Dr Kieran Schulz – Osteopath

Would have something very inspired to say if he was not doing his posture the world of good by taking a well eared holiday, resting and relaxing……. Which we all should do more often!
 
 
 

To sit or stand, which is the answer? The Standing desk movement:

The Standing desk movement:
To sit or stand, which is the answer? 
With us undertaking more hours at the computer/desk people are looking for ways to make themselves as comfortable and pain free as possible. The truth is the human body is not made to sit for extended periods of time. Thinking about our spine as a spring, when we sit this spring is constantly loaded and it means that eventually it gets sore and painful. What our body needs and craves is movement.
Swiss balls where very popular from the early 2000’s, but the truth is you can slump on a Swiss ball just like you can in a chair. What they did provide though was movement, that slight movement from side to side or up and down was enough to keep that spring moving. Following the same fundamentals more companies are providing standing work stations for their workers. The thought of standing for 8 hours in a day makes my legs hurt already, but when you stand you rock side to side and sway and that again is enough to unload that spring. Also by standing you are distributing that force and load that would have just been on your spine through your hips and legs. So having an adjustable desk in which you can stand for a while and sit for a while it the ideal set up.
More research is coming out of America that is looking into the benefits of moving more at work. Things like walking meetings are being held. It has been shown that walking meetings will be on average 10 minutes shorter than sitting ones and also have a higher information retention rate (also no one falls asleep in a walking meeting). Certain companies are even looking at having a treadmill desk set-up to break up your day. A lot of the time this obviously would not be practical but you are getting the idea.
So what is the take home message? Move (pun intended) more at work, whether it be a walk at lunch time, getting up to get a cup of water or having your offices first walking meeting. By doing this you will let the body do more of what it wants to and minimize the aches and pains that come with long hours at the desk.
References:

  • Thompson WG, Levine JA Productivity of transcriptionists using a treadmill desk. Work 2011;40(4):473-7
  • Levine JA et al. Non-exercise physical activity in agricultural and urban people. Urban Stud. 2011;48(11):2417-427
  • http://www.abc.net.au/radionational/programs/healthreport/past-programs/index=2012?page=5