PHYSIO & POST SURGICAL REHABILITATION
There are some injuries where conservative (non-surgical) management just won’t cut it (pun intended). On the operating table the surgeon will execute their skill-set and put you back together. The reality is that this is the easy part. The hard part is just about to start. Rehabilitation… which for many musculoskeletal or orthopedic surgeries can last for many months.
Rehabilitation post-surgery is one of the most important parts of your recovery and not engaging in some form of it will more than likely have a longer term impact. Surgery is a traumatic event for your body. Depending on your surgery the trauma extends from the incision through skin, layers of fascia and soft tissues, to cutting & stitching or in some cases the use of screws, metal plates and bone drills. You are left with pain, swelling and reduced functional capacity BUT that’s where post surgery rehabilitation comes in, the process of restoring you back to your strongest self.
Read the FULL BLOG to find out what the post surgical rehab process involves and why its so important.
ROTATOR CUFF TEARS. WHAT CAN YOU DO?
The Rotator Cuff is made up of 4 muscles that work to control the shoulder joint . Despite being relatively small in size they are rather large in significance and most people seem to have heard of the Rotator cuff in come capacity. I think the majority of people may underestimate just how important the Rotator Cuff is when it comes to efficient functioning of the shoulder.
What does the rotator cuff actually do? How do you know when it’s becoming a problem for you?
The Rotator Cuff is made up of 4 muscles – The supraspinatus, infraspinatus, teres minor and subscapularis. Their role very much one of stability.
Read the full post HERE
TRAINING TIPS FOR THE CITY 2 SURF
It’s now just over 10 weeks till the City 2 Surf, the annual footrace that stops Sydney in its tracks. It attracts thousands from the elite athlete to the family of 5; you can walk, run, push a pram, get dressed up as a fairy, or a superhero, you can even run in nothing but budgie smugglers if that’s your thing.
It’s Sydney’s most renowned fitness event boasting 14 gruelling km through the winding hills of the eastern suburbs. It’s by no means a walk in the park and for many the preparations may have already started.
It’s not unusual for us to get an influx of running related injuries in the lead up to an event like this. With that in mind here are some of our training tips to try and help you stay injury free this City 2 Surf season.
- Slowly build up your training: Over the next 6 weeks you want to slowly begin to add distance. Your initial distance and time will depend on not necessarily how fit you are but how ‘running fit’ you are. Where should you start?
INJURY PREVENTION 101
Injuries is what we do. We see them every day. They arise from all different circumstances, in many different patient populations and every individual injury is slightly unique.
However for the purpose of today sblog we are going to try and give you an insight into some common mistakes that people make which brings them knocking on the physio’s door.
Keep clear of these and you might spend less time on the physio table!
- TOO HARD TOO SOON
So you just signed up to run a marathon. That doesn’t mean you have to run 6 times in your first training week. This not an uncommon scenario that we see and the same goes for for the gym or any form of exercise. Build up into it! If you’re new to something you need to slowly expose yourself to it to allow your body to adjust, adapt and most importantly recover.
Read the full blog post here for all out injury prevention tips
Tendinopathy is a common condition that can affect any tendon in the body. The most common which you are likely to have heard of are Achilles, Gluteal (check out our previous blog on this) and Biceps tendinopathy.
We see Achilles tendinopathy regularly in our physio practice.
The Achilles tendon is the thickest in the body – formed by a blend of the gastrocnemius and soleus tendons as they unite to attach into the back of the heel.
Tendinopathy itself occurs when the cell matrix (which is what makes up the tendon) undergoes certain changes. This can result in disruption of the cells organisation & number with associated increases in blood vessels and nerves in the tendon.
Neural pain – what is it?
Have you ever had a shooting pain which feels like you have torn a muscle but strangely enough you still seem to have relatively good strength? You can still get through your basketball game but you’re playing through pain.
Have you ever had pain referring into your leg that feels like it originates up in your back? Starts off dull and annoying but becomes more persistent & harder to ignore?
What about burning? pins and needles? Tingling sensations in your fingers or toes?
Sometimes such presentations aren’t as simple as a muscle or joint injury, but rather you may have an issue with your system of nerves.
Want to know more? READ FULL BLOG
What is Plantar Fasciitis?
The plantar fascia is a thick fibrous band of connective tissue that spans across the sole of the foot from base of the heel bone (calcaneus) to the under surface of each of your toes.
The plantar fascia has a few important roles; It serves to support the bones and joints in the foot; works as a passive limitation to collapsing of the arch on the inside of the foot and enables us to push off from the ground.
When your plantar fascia develops microtears or gets inflamed this is known as PLANTAR FASCIITIS.
Plantar facsciitis can be one of those problems that seems to come from no-where, however there are several risk factors that can play a role in the development of this painful and often debilitating condition.
Find out the cause, symptoms and most importantly what you can do to alleviate it in the full BLOG
Do I use Ice or Heat?
Ice or heat therapy can be some of the most effective, simple and safe self treatment options for many painful problems, however when used poorly they can potentially do more harm in the short term than good.
While there are always exceptions we are going to give you some basic guidelines that should help you make a bit of an educated decision.
Ice is definitely your best option for most ‘fresh’ acute injuries where there is a specific incident or trauma such as a rolled ankle or twisted knee. The aim of the ice is to reduce the swelling & inflammation which is the body’s natural response to tissue damage.
Read the complete blog post HERE
“Can I still train?”
Given that we are located inside a gym this is probably the most common question we get from our clients. 99 times out of a 100 the answer will be yes BUT your training will most likely need to be modified!
We want to keep you training as we firmly believe that movement is a vital part of your rehabilitation. There will be individual injuries that vary so it’s always good to get it checked out but we are going to give you some pointers of when you can and can’t push through the pain.
Check out the full blog HERE for a few of our simple guidelines to follow which may help you decide how far you can really push yourself
Osgood Schlatters – A common cause of knee pain in adolescents
Osgood Schlatters is the term given to knee pain in adolescents that is caused by inflammation at the attachment site of the patella tendon onto the tibial tuberosity.
It is one of the few common ‘growing pains’ that we see in kids, especially in those that are more active or who are undergoing a growth spurt.
When a child grows the bones grow quickly and the soft tissues including the muscles and tendons can’t keep up which can cause them to become short and tight. In the case of Osgood Schlatters the quadriceps gets tight. It blends into the patella tendon, so as the quad contracts during running & jumping activities it pulls on its attachment on the tibial tuberosity creating pain and inflammation
Click HERE everything you need to know about Osgood Schlatters
Magnesium, Calcium & Vitamin D – Could a balance of these be the key to optimal health?
A while back we posted a blog about what we like to call the Master Mineral, Magnesium.
Magnesium is imperative to the functioning of the body but it certainly doesn’t act alone. Adequate magnesium levels don’t mean much if you are deficient in other important minerals such as Calcium, Potassium and Vitamin D. The body needs balance, and for the body to function at its most efficient level this balance is rather delicate!
Most people think that the most important factor for strong bones is calcium. Well you also need Vitamin D. What if I told you that you need Magnesium to convert Vitamin D into its active form which is required to absorb the calcium which we need for strong bones? Magnesium is what kick starts the whole process. One without the other, too little of one, too much of another; all result in an imbalance with potential health consequences.
Keep reading… HERE
What is your body awareness like?
The human body is a wonderfully intelligent design.
However like anything, without care and upkeep, it can and eventually will break down.
We tend to see most people when they are beginning to feel broken; they have pain, dysfunction, stiffness that is starting to impact on their day to day work, life or play routine.
I propose a question to you all. Do you think you are in tune with what’s going on inside your body?
Something we have started to notice is that many musculoskeletal problems are largely contributed to by lack of total body awareness or proprioception. Jill Miller defines proprioception as “your body’s sense of itself; your inner GPS system. The ability to sense position, location, orientation and movement of your body and its parts”
What role does this play in our health and how can we work to improve it? Check the full BLOG
CRAMPS. What? Why? Can they be prevented?
Cramps can be one of the most painful, uncomfortable experiences ever.
By definition a cramp is a ‘sudden, involuntary, painful contraction of a muscle’. They can last from seconds to minutes, and often leave behind a palpable tight knot within the affected muscle.
Cramps can occur for no particular reason, however the most common presentation is during an extended period of vigorous, intense exercise.
There are many proposed theories for why muscle cramps come about. I’m sure many of you would have heard things such as tight & inflexible muscles, heavy sweating, dehydration, poor diet, and general poor physical condition as possible contributing factors. While I don’t disagree with the potential for all of the above to play a role, the theory that most scientists are beginning to agree on is that cramps are due to altered neuro-muscular function of a muscle.
Find the full blog on Cramps HERE
Movement is Medicine
“Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death” – Dr James Levine (Mayo Clinic)
If I was to ask you what one of the most dangerous things you do each day was, would you ever imagine that sitting may be one of your answers?
I wouldn’t be surprised if many of you, as you sit reading this, are thinking that’s a slight exaggeration. Unfortunately I’m here to tell you that it’s absolutely not.
Let’s think about this. You probably sat down for breakfast, before sitting in the car or bus to get to work, you’ll sit to have a coffee, then move to your workstation, sit in the cafeteria for lunch, back to work, into the car and finally onto the couch for an episode of two of Netflix. Aside from transitioning between different seated positions how much movement are you really doing in a day?
Humans are not designed to sit. We are a machine of motion, designed to move, and in turn its movement that keeps us healthy both physically and mentally.
But wait there’s MORE
Tennis elbow.. that diagnosis that everyone seems to have heard of.
Despite the name this injury often has very little to do with tennis, in fact many of the clients we see with ‘tennis elbow’ don’t even own a tennis racquet!!!
Also known as lateral epicondylitis which is the smart name for irritation/inflammation and/or degeneration of the common extensor tendon of the elbow. The common extensor tendon is formed by all tendons of the muscles which work to extend the wrist and hand.
Repetitive use of these muscles via many day to day activities can lead to overload of the tendon and result in pain and dysfunction.
Want to know more? Read the full post HERE
Trigger Ball’ing – are you doing it right?
Trigger ball’ing & foam rolling have become a bit of a trend in the last 5 years as more and more people begin to realise the importance of flexibility and mobility.
We have recently started holding weekly mobility classes at the gym. These classes incorporate a variety of trigger ball techniques along with some active movements, stretching and deep breathing exercises. We frequently get asked questions during these classes about what trigger ball’ing does, how often should we do it, why does it work, how painful should it be?
It’s time to clear the confusion. Find answers to all your trigger ball questions HERE
Are you hypermobile?
As physios we spend a heap of time working with people who are fundamentally stiff. Whether it’s stiff joints, tight muscles or reduced mobility, all can create dysfunction in the body which more often than not will eventually result in pain.
What about the other side of the coin? The hypermobile people. The people with joints that move too much. Those who have ligaments and muscles that are too lax?
Generalised joint hypermobility is usually inherited and is more common in females than males. Quite often it’s asymptomatic & people either don’t realise or just accept that they are super flexible and very bendy.
How do you know if you are hypermobile? And what if you are?
Find everything you need to know HERE
Firstly a little anatomical education.
What is a meniscus? We have two menisci in each knee. These moon shaped cartilages sit on the upper surface of the tibia (shin bone). They serve as the ‘shock absorbers’ which essentially absorb most of the daily impact that we place through our knees from general activities such as walking up stairs or bending to tie your shoelace to higher intensity forces such as running or jumping.
These structures, like most in the human body, can be vulnerable to injury. The most common mechanism of injury is a twisting injury when the foot is planted, often seen in sports such as basketball or rugby. In the older population, degenerative tears can occur without significant trauma.
How will you know if you have a meniscus injury? How are they treated?
Find all the information you need HERE
Clinically known as Medial Tibial Stress Syndrome or Medial Tibial Periostitis, ‘Shin Splints’ is a colloquial term used to describe pain along the front and inside of the shin.
Pain is often made worse by exercise and is accompanied by tenderness along the inside of the tibia.
Shin Splints is one of the common overuse injuries that we see, particularly in the running population.
What is it? Inflammation of the tibial periosteum (lining of the bone). The culprit? The Tibialis posterior muscle, although there are several layers of fascia and connective tissue around here that can also contribute.
Why? biomechanics, training loads, footwear. There are a while bunch of factors to consider.
Read the full BLOG for why and what to do if you are suffering from shin pain.
Common Back Pain Myths
They say over 80% of people will experience back pain at some stage in their lifetime. This can range in severity from a dull niggle to sharp shooting pain that can be incredibly debilitating. One thing is for sure it’s one of the most talked about injuries going around and as a result there is a heap of information out there about back pain. Some good, some bad.
So we thought we would try and clear up some common ‘myths’ that are floating around whilst also giving a few bits of advice about the best way to manage your back pain.
MYTH #1 – DON’T MOVE??? The old approach of lying down and not moving as the treatment of choice for back pain couldn’t be further from what your body needs. Sure ‘relative rest’ plays a role, but movement plays an equally important one.
Read the whole blog post HERE
Sand Running – Is it good for you? Better than road running? Is it bad for your knees? Bad for your joints?
These are all questions we regularly get asked. Especially in the summer months when people start to to Sydney beaches for sunrise soft sand sessions.
Like all forms of exercise a little moderation goes a long way. The first session will hurt, not necessarily at the time (although your ticker may think otherwise) but the next day, especially your calves. The motion of sand running is slightly different to firmer surfaces so certain muscles such as your calf and peroneals (on the side of your ankle) need to work harder to propel you out of the sand.
Is there a downside? Not really. However there are a few things to consider if you’re starting sand running for the first time.
Read all about them in this article we put together for the BONDI BAREFOOT, one of the beaches hottest footraces that’s only 8 weeks away!!
Common Foot / Ankle Injuries – Part 2
Ankle sprains, calf tears, Achilles ruptures, fractured toes.
These injuries usually happen in one traumatic incident. You trip off the kerb and go over on your ankle, it hurts immediately. It may swell and become bruised, you may find it hard to bear weight on it, and you will probably yell a few profanities at the time.
These acute injuries benefit significantly from treatment ASAP. The first 48 hours of management are really important to control swelling, inflammation and reduce pain.
Read Full Blog HERE
Common Foot / Ankle Injuries – Part 1
Feet. Totally the most neglected, and probably underappreciated part of the body.
Imagine being a foot; shoved into smelly, tight shoes all day. No ventilation. Minimal support. Sucks even more to be a women’s foot, strapped into those way too high heels.
Our feet get put through hell on a daily basis, and for many without a second thought; yet we rely on them for just about everything in life.
The foot is made up of 26 bones that form many small interconnected joints. There are a multitude of ligaments, tendons, muscles and cartilages as well as nerves and blood vessels all of which can be injured as a result of overuse or trauma.
There are a handful of more common foot / ankle related injuries that we tend to see on a regular basis. Most of these problems are due to a combination of overuse from repetitive loading, biomechanical inefficiencies and poor footwear choices.
Read all about them HERE
Hip Impingement – Part 2. The Exercises
If you missed Part 1 to this two part piece on Hip Impingement it’s probably worth a read. Scroll down a little to find the link. This goes through the what is and the why.
Now for the exercises. We have broken this into 4 sections; Hip capsule stretching, mobility & massage techniques to target tight areas around the hip, glute strength/activation, and technique. A well rounded management for Hip Impingement should consider all of the above elements with a focus on the individuals restrictions and weaknesses.
Find all the exercises HERE
Hip Impingement – Part 1
Have you ever felt a pinching deep in the front of your hip?
It may be more noticeable in specific positions, like when you get into your car or at the bottom of a squat. Sometimes you might feel it refer into your groin or upper thigh?
What you might be experiencing is what we call hip impingement. It’s more fancy complicated name is femoroacetabular impingement, shortened to FAI.
To understand impingement you need to know some basic anatomy. The hip is a ball and socket joint. Normally the ball (head of the femur) smoothly slides & moves around the socket (acetabulum). With hip impingement this relationship gets disrupted, and for a medley of reasons, there is abnormal contact between the ball and socket.
To find our more about Hip Impingement check out the full post HERE
Stretching – Why, When, How?
Remember when stretching was a simple task? As a kid I remember rocking up to sport 10 minutes before kick off & your coach would get you to touch your toes for 15 seconds, then move onto one or two more and you were ready to go. Now there’s dynamic, static, PNF, ballistic and that’s just to name a few. It can be a little confusing so here is a brief overview into what each type of stretching encompasses so you can start to work out which works best for you.
STATIC STRETCHING – This is the typical form of stretching that most people tend to use. It involves putting the muscle on stretch (lengthening the muscle) & holding it for a period of time. This form has gotten a bit of a bad rap in the last 10 years, having minimal evidence to suggest that it actually helps to decrease your risk of injury, however I feel that it still has it’s place when used for the right reasons.
Read more about the when, why and how of stretching HERE
Shoulder ‘Impingement’ – What you need to know.
Shoulder ‘impingement’, rotator cuff tendonitis, subacromial bursitis, subacromial impingement. Regardless of what you decide to call it the underlying anatomy and biomechanics of this injury is relatively similar.
Let’s revisit the anatomy of the shoulder, a ball & socket joint that’s been likened to a golf ball sitting on a golf tee which indicates the inherent instability in this joint. A joint that needs to be able to move freely to allow us to reach overhead, behind our backs and across our bodies, whilst also being strong & stable at the same time.
Efficient shoulder mechanics requires a balance of stability & mobility between the humerus (arm bone), scapula (shoulder blade) and thoracic spine (rib cage). Stiffness, weakness, tight muscles or trauma can disrupt the unique movement pattern resulting in dysfunction and pain in the shoulder.
Read the full blog HERE about what shoulder ‘impingement’ actually means and what you need to do to treat it properly!
RECOVERY 101: Feel Better. Train Better
“There is no such thing as over-training, just under-recovering”
This is one of our all time favorite quotes! RECOVERY should be an integral part of anyone’s training program, however unfortunately it tends to be a bit of a forgotten aspect. If you want to push your body to its physical & mental limits each day then you need to ensure that you are effectively recovering.
What does proper recovery encompass? Gone are the days of a 5 minute stretch at the end of your workout being sufficient, recovery is about getting your body primed for your next athletic endeavor. When done well you will not only improve your performance but also reduce the chance of suffering an injury.
Recovery isn’t limited to rest days, down time and de-loading weeks. There are many aspects to this all important process.
Read the FULL BLOG to discover some our favourite ways to give back to our bodies a little.
MAGNESIUM – The Master Mineral
If I asked a group of athletes to name some key elements or minerals for human health & performance, common responses would probably include calcium, iron, fish oil, or even probiotics. A not so common answer would be magnesium. I’m hoping that after reading this post your response would have magnesium close to the top of the list!
I started taking magnesium a few years ago to help with constant night cramps in my calves. It’s worked wonders on the front but I also began to notice that I was sleeping better, my body wasn’t as sore & tight as it usually was and I had more energy. This sparked my investigation into Magnesium, The Master Mineral that I now find myself encouraging many of my clients to start taking on a daily basis.
Why is magnesium so important?
READ THE FULL POST HERE
How to strengthen your ‘core’
What does ‘core strength’ actually mean? I don’t think there is a specific definition that I feel is totally adequate. The ‘core’ refers to the deep and superficial musculature, joints, diaphragm and connective tissue within our trunk, hips & pelvis and how they all work together. I won’t bore you with technical names but when we talk about ‘CORE STRENGTH’ we are referring to the ability of this musculature to stabilise the spine throughout every type of movement.
So how exactly does one go about strengthening the core and why do we need to? Gone are the days of just planking for as long as you can… you need to think far beyond planks, crunches & sit-ups; instead you need to challenge your body in different ranges & different planes of movement
Read the full blog for some of our go to core strength exercises HERE
Pain in the Neck?
Have you you have ever woken up with a sore, stiff neck? You can’t turn to one side making reversing the car close to impossible? Too scared to move in case it spasms again?
This is the classic presentation of a WRY NECK or if I’m being clinically correct a ‘torticollis’.
This condition is usually of rapid onset whether it be upon waking or following sudden jerky movements of the head and neck. I’ve seen many ladies suffer a case of this after vigorously towel drying
their hair! The result is pain and obviously restricted neck movement. A wry neck can range in severity with some of the worst cases having little to no neck rotation due to acute pain to those who maintain close to full movement with tolerable discomfort.
Gluteal Tendinopathy – What you need to know
Ladies I’m directing this blog predominantly towards you… it seems we are slightly more pre-disposed to developing this particular problem. Something to do with beautiful child bearing hips and for those with bubs, the changes that your body and pelvis undergo during pregnancy and childbirth. Boys don’t stop reading just yet, you aren’t completely immune to gluteal issues so what’s to follow may still apply.
Gluteal Tendinopathy: the technical name for what you may feel as pain on the outside of your hip. We tend to see it more often in women, in their late 30’s or 40’s, who live an active lifestyle. It’s most common in runners, and even more common in runners who love to run hills and stairs. Yes men can get it, so can younger athletes we just tend to see more of it in the above mentioned patient population.
Like most injuries there are anatomical and bio-mechanical considerations that must be addressed when treating & managing this problem.
Mobility is not always the answer
Despite the title, this blog isn’t intended to suggest mobility isn’t important. In fact Active RX believe mobility is an integral component of exercise and looking after your body. The problem however is mobility, to some, has become the be all and end all as a cause of pain, injuries and niggles.
Whilst it might be the case for some it certainly isn’t the answer for all. If you’re feeling tight and have some mobility restrictions work away on them and if you’re finding it is improving your chosen activity even better, keep doing what you’re doing.
The people I’m looking to get through too today are the ones who have gone through all the mobility exercises they could find and their pain/injury/niggle hasn’t changed at all. Sounds like a lot of effort for no reward.
There are some other factors that should be considered such as muscle strength, endurance, motor patterns/activation and of course technique.
What is Dry Needling?
For anyone who knows me, or has been treated my be will be well aware that I am a serious advocate for dry needling.
Dry needling can work wonders with many conditions that walk through my door, from headaches to tight calves, chronic tendon problems and acute swollen joints. It’s by no means the answer to everything as a stand-alone treatment but when used in conjunction with other therapies such as corrective exercise & mobility work it can be a very useful technique.
Dry Needling utilizes an extremely fine needle, exactly the same as those used in traditional Chinese acupuncture. The main difference between these two techniques comes down to the theory behind where and why.
Fire up those Glutes.. with these 4 exercises.
The glutes… No other muscle gets as much attention in the rehab world as the glutes. It isn’t without merit as they are an important player in our body, not only does this powerhouse link our upper and lower half but the glutes also help us with things like balance, pelvic stability and obviously strength & power.
We have found that sometimes (and we stress sometimes) ‘glute weakness’ can be a little over diagnosed being often labeled the culprits for back, hip, knee and ankle pain. Whilst this can definitely be the case or at least a contributing factor to pain and dysfunction – motor control, a mobility issue and activation could also be the underlying driver.
With that being said… if strengthening is what you need here are some of our favourite glute exercises that have come from a mix of personal and clinical experience.
Who is Active Rx?
Who are we and where did we come from? For those of you that are interested…. read on. For those not so interested… we reckon you should read on anyway. Everyone has a story. Whether its luck, opportunity, chance or choice there is always a reason why people end up where they are, doing what they are doing.
Active RX is the product of a bit of all 4 of these. We have always had a real love for sport and fitness, which is lucky because you won’t find a shred of anything that even closely resembles musical or artistic talent in either of us! We have both competed at an elite level, Em in hockey and Nick in rugby union. I guess you could say this fostered our interest in the human body, how to train, how to perform and most importantly how to recover.