Heat or Ice??

The question of whether to heat or ice is one we get frequently. And the answer for the most part is actually quite simple.

Despite much discussion about the theory of both heat and ice either increasing or decreasing inflammation, bloodflow etc., there is not much scientific evidence that either will help your healing in the long run. Therefore, my most common answer is "Whatever alleviates your pain."


There are, however, a few situations where I do have specific recommendations:

1. Many continue to recommend ice for the first 24-48 hours after injury to reduce inflammation (see my previous blog on this topic). This also up for discussion, but it is a situation that I continue to recommend ice rather than heat as there is no downside to icing in this situation.
2. I also never recommend heat to an already hot or swollen joint. This might be a result of osteoarthritis, or a recent surgery. If a joint is already hot, there is no need or benefit and it may even be deleterious to add heat to it (although many arthritis sufferers prefer heat - and if after years of suffering this is what makes you feel better - you know your body best!).
3. You have been icing a tendon for ages to no avail. Try heat! There is evidence that with chronic tendinopathy, there is actually no inflammation present (hence the name change from tendinitis to tendinopathy). That combined with the fact that tendons have very poor blood supply lends to the idea that chronic tendon injuries may respond better to heat (which increases blood flow to the area).

As always, thanks for reading!
Rebecca

Images courtesy of google images.

Most Common Golf Injuries and Tips to Minimize Them

The sun is shining (finally!) and it feels like Golf Season!

At this time of year (and after golf trips, lets be honest) there are always a couple of people who come in, having played too much golf without any preparation, with various injuries. Golf injuries can run the gambit but the following are a couple of the most common injuries:

1. Low Back Injuries: Golf exposes the back to tremendous forces. Combine this with the fact that the repetitive torsion is always in one direction and you are doing most of it in the bent over position, golf is the perfect storm to produce a back injury. See my previous blog for easy tips to reduce the strain on your back. A pre-season core strengthening and hip mobility program will also help reduce low back issues.

2. Elbow Tendinopathy: 'Golfers Elbow" is the obvious issue; but 'Tennis Elbow" (the same insertional tendinopathy only on the opposite side of the elbow) is equally prevalent amongst golfers. These issues are usually a result of either training errors (too much too soon, weakness in the forearm etc) as well as impact issues. Try not to overdo the golfing on the first day out - especially hitting from a rubber mat at the driving range! Pre-season grip and forearm stretching and strengthening will also help minimize these injuries.

3. Rotator Cuff Injuries: Rotator cuff injuries result from much the same reasons as listed above for elbow injuries; too much too soon, weakness and/or impact with the ground. A pre-season rotator cuff strengthening program and easy stretches can help minimize these issues.

Here is a link for some stretches that will not only be important at the first tee; but for the two weeks prior to the season starting. don't forget the strengthening too!

As always, thanks for reading. If you have any furthur questions (or end up with a golf injury) please contact us. I am a 'Fit Fore Golf" Level 3 qualified Physiotherapist!

Rebecca

Image courtesy of Google Images

Why Lie About Doing Your Home Exercise Program??!?

Ya, SUUURE You Did Your Home Exercises!

Here are a few reasons why NOT to lie to your physiotherapist about not doing your home exercise program:

1. Your physiotherapist is not your school teacher. There is no grade. We won't judge. OK maybe just a little, but honestly we have seen PLENTY of people who haven't done their home exercises before, you aren't that different.
2. We might start taking up more time looking for other causes: Maybe you have some neural tension... When really you just haven't bothered to drop that leg over the edge of the couch to stretch your hamstring!
3. Your physiotherapist usually has an arsenal of exercises: we can change and tailor your routine if you are finding it hard to fit into your daily life. Make it shorter, or change the positions so it is easy to do at your desk, etc.
4. The only person you are hurting is yourself! We are not giving a physiotherapy exercise program for OUR health!
5. Last but not least: Your physiotherapist usually knows anyway.

OK, so here it is from my perspective. Your physio exercises are important. They may seem either far too easy or at the other end of the spectrum seem too overwhelming to do. But humour us... you might just see a faster improvement!

As always, thanks for reading, Rebecca

Photo courtesy of google image.

5 Tips for Maintaining Good Posture

Good posture doesn't just look good; it is crucial in maintaining physical health and is very often than a key part of physiotherapy treatment. Think about it: when you are spending ALL of your time in a poor position, sooner or later something will breakdown! It is part of why we as physiotherapists spend time just looking at your positioning and why we have coined phrases like "forward head posture" "anterior pelvic tilt" or "anterior humeral shift" to be used when diagnosing and treating orthopaedic conditions. Without doing a specific postural assessment, here are some easy tips for maintaining good posture:

1. Desk Stretches. One way to get frequent breaks and to stop poor posture is to do desk stretches on a regular basis. Squeezing your shoulder blades together and moving your ear to your shoulder and holding for 30 seconds are two examples of good neck stretches.
2. Frequent Breaks. Prolonged sitting is often a cause of poor posture. We are just not meant to sit for 8 hours a day so frequent breaks are a must!
3. Core and Upper Back Strengthening. These muscles help hold you in proper posture, so keeping them strong is a must.
4. Stretches. Over time some muscles can become tightened and hold you in a poor posture. Two common muscles that become tightened are the pectoral muscles and hip flexors, so give them a daily stretch.
5. Fitness Maintenance. Overall fitness will help your sense of well being, work your rib cage and improve overall posture
6. Relaxation Techniques. Posture can be worsened during stress - shoulders start to rise and bodies start to slump! Throw a yoga class or some simple breathing exercises into your routine and you will help alleviate some of that stress.

Physiotherapists are trained to assess and work towards correcting poor posture. If you have a painful condition that you think might be related to poor posture contact us!

As always thanks for reading. Rebecca 

Photos courtesy of google images.

A Running Program:

Part 3: The Stretching Program

This is no longer a "pre-season" program, so I will rename it simply a running stretching program. I always recommend a stretching program for any runner. This allows you to at least partially counteract the muscle imbalances and tightness that come from being a runner. These imbalances can be even more pronounced if you are a runner who sits at a desk all day (see my previous blog on this topic). The following stretches are pretty basic and aim to stretch the main muscle groups of the lower body: calf, quads, hamstrings, gluts and hip flexors. They include stretches that are given at our clinic on almost a daily basis.



1. Calf Stretches: the important thing about doing calf stretches is that you do them both with the knee bent as well as straight to be sure you get the two main muscle groups of the calf. If you are doing both these positions, it really doesn't matter whether you do them with your foot against the wall (targeting plantar fascia a bit more), over a step or in a lunge against the wall (as shown).

2. Hamstring Stretches: We prefer these hamstring stretches since they allow you to target different portions of the hamstring (medial and lateral) and give your knee a bit of protection since it is supported, but again whatever stretches work the best for you are fine. Sitting on a supportive structure (bench, couch or bed will do) first lean forward with a straight back (left image). Second, turn your shoulders away from the leg you are stretching and lean the same shoulder toward your knee still keeping your back as straight as possible (right image).




3: Quadriceps Stretches: We give this quad stretch out very regularly since the traditional quad stretch doesn't target the rectus femorus (also a hip flexor).When the rectus femorus is tight it can effect your hips and back as well as your knee. 
Standing with one knee on a chair behind you, and holding onto someting stand up as straight as you can until you feel the stretch in the front of the quad. Back of a couch or arm of a chair can also be used to prop the foot up.

4. Hip flexor Stretch: A favourite of Richard, this stretch targets
the hip flexor without putting too much strain on the back. Putting one foot on a higher structure like a table or railing, lunge forward until you feel the stretch at the hip of the standing leg.

5: Gluteus Maximus Stretch: Holding on to your leg in the crossed over position hig the knee in to your opposite shoulder and hold.








6: Gluteus Minimus (and other small, deep hip external rotators) Stretch. this is my favorite stretch! Since starting Fascial Stretch Therapy, I have given this stretch out a lot as it is the closest I can get to mimicking the deep hip stretch that I give. Sitting in this position and keeping both hip bones on the floor let your knees fall to both sides to target specific muscles.


To actually increase muscle length, stretches are best done when the core temperature is slightly raised (after activity) and should be held for a minimum of 30 seconds (as opposed to dynamic stretches which are done as pre-activity preparation), but any time is better than none. I find myself cutting them out after a run to save time, but will do them before bed as a relaxation technique... Do whatever works for you!

Remember, stretches alone might help reduce injury but will rarely help you recover on their own. See my previous blogs on running injuries, running strengthening, and eccentrics to give you more clues!
As always, thanks for reading!

Rebecca Chambers, MSc in Exercise Science and BSc(PT)

Photos courtesy of google images

A Pre Running Season Program: Part 2

Part 2: Strengthening Program

This running strengthening program is a compilation of the top 5 of our favourite exercises to prepare you for your running season. They are simple, quick and require no equipment. They also assume that at the moment you are injury free! Below our Top 5 are a few more of our favourite exercises that require some simple equipment.

Top 5 Running Preparation Exercises.

Lunges. Targets: gluts, squads and a bit of hamstring. Has the added benefit of a functional hip flexor stretch. I like reverse lunges, regular and walking lunges for different reasons. Reverse lunges will work both glut max as well as glut min in a stabilizing capacity, but will give you less hip flexor stretch. Reverse lunges are less common so I will give you their description and pictures, but feel free to replace or rotate with regular or walking lunges. Description: Standing with feet shoulder widths, take a step backwards about 2-3 feet (.75m-1m) depending on your ability and bend both legs keeping the majority of your weight on your front leg. From the bent position step back onto the front leg and drive the back leg forward. Without putting that foot back down, repeat by placing it back behind you again.

Side Lunges. Targets: quads, hip adductors and abductors (small gluteus muscles). Description: starting with your feet shoulder width apart, step out to the side 3 or more feet bending that leg and keeping the standing leg straight and step back in a fluid motion. Repeat on the opposite side

 

Chair Bridge Marching. Targets: hamstrings, glut max and low back. Description: laying on the floor with your heels on a chair and knees bent, lift your bottom off the floor. Maintaining your position and trying to keep your hips even lift one leg and then the other.

Plank with Knee to Elbow. Targets: abdominals and hip flexors. Description: Holding a straight arm plank with back flat, bring your right knee to your right elbow. Repeat with left knee to left elbow. For the next repetition, attempt to bring your right knee to your left elbow. Alternating elbows works all hip flexors.

Dead Bug Marching. Targets: abdominal muscles and hip flexors as well as core control. Description. Start lying on your back with your hands under your bottom with your hips and knees bent at 90 degrees (and your shins parallel to the floor). Without letting your back lift off the floor and keeping your knee bent at 90 degrees attempt to bring your heel to the ground. Only go as far as you can keeping your back flat. If this becomes easy try without your hands under your bottom.

Start by repeating 10 of each of these exercises. As they become easier, add a second then a third set of 10. Try to do some sort of strengthening 3x/week for maximal gains, 2x/week for maintenance. This list is by no means exclusive, and will be augmented by mixing it with some of your favourite exercises or some of our "Also Ran" exercises to break up the boredom!

"Also Ran" Exercises: These exercises require some equipment but are worth adding in!

Squats. Targets: body weight squats increase muscular endurance of quads and glut max. Start with 20-40!
Side Walks. Targets: small gluteus group. With a theraband wrapped around your ankles - in a half squat take 10 steps to the side in one direction then repeat in the other direction.
Single Leg Anything. Targets: small gluteus muscles as well as core stabilizers. Do arm curls, arm raises, overhead presses all standing on one leg. To make them work your stabilizers even harder, do one arm at a time on one leg!
Dead Lifts. Targets gluteus maximus, hamstring and low back strength and no program would be complete without adding these in! Description: standing with legs shoulder width apart and slightly bent, lower light weights (5-10lb to start) down the front of your legs keeping your back straight. Allow your knees to bend as needed to keep your back straight!

Stay tuned for part 3: Pre Season Stretching Program

Please proceed with caution for all of these exercises. If you are experiencing any injuries or have any medical conditions, consult your physiotherapist or physician before starting this program. For more information on our team and services, please consult our website.

As always, thanks for reading, Rebecca

A Pre Running Season Program: A Three Part Series

 

Part 1: Why do a Preseason Strengthening and Stretching Program??



If, like me, you are a fair weather runner, it's time to get ready for your next outdoor running season! It's time to strap on the runners and just go right? Not so fast. If you want to avoid injuries, as well as following my previous tips, you might want to add a pre-season primer to prepare your body for the upcoming season. The following are a few reasons why you might want to incorporate this program into your season's plan:

1. You need to address the muscular imbalances that have built up after a winter of couch lying (or working too many hours at a desk) and might contribute to your next running injury.
2. Strengthen stabilizers to withstand the repetitive impact they are about to incur throughout the upcoming season
3. Improve muscular endurance to improve running performance

In the upcoming blogs MacLean Sport Physiotherapy will give you an overview of a few of our basic, favourite strengthening and stretching exercises to prepare your body for the upcoming running season! Stay tuned!

Image courtesy of google images.