Happy New Years, and good luck to everyone with their new years resolutions to return to the gym after Christmas or getting back to 5-a-side. As you can imagine, we do tend to see an increase in some injuries, due to this surge to increase fitness.
We are all highly motivated when we return to a fitness regime or sport, and tend to throw ourselves into the activity at full steam. We call this going from zero to hero, when people go from doing very little, perhaps over the Christmas period and then return to their fitness activity too quickly. It can be the cause of many of the complaints we see in our Physio clinic. The gradual return to activities cannot be overemphasised.
One of the most commonly overlooked areas are the warm-up and the cool down. We may tend to head straight from the office or the car into our fitness regime or sport without allowing our body to gradually warm up. This increases the risk of injuries. The ideal is to warm up with some activity that will increase your body temperature slowly, so jogging is ideal. Active stretches are encouraged for the warm up stage and not long static stretches. Also some agility work or sports specific exercises and drills, are essential for a thorough warm up. It is important to practise common movement patterns and skills which will be used in your sport or activity. This will help improve performance through ensuring the muscles are prepared for the task in hand, it will also improve co-ordination reaction times and accuracy.
The cool down period can often be replaced by a few pints in the bar after a game. This again is essential to reduce your risk of injury and any delayed onset of muscle soreness (DOMS). The cool down should consist of a gentle jog, decreasing in speed down to a walk followed by light static stretching. Remember to stretch all muscle groups used in the sport. Upper body muscles especially are often forgotten is sports such as football, soccer and rugby.
Thursday, January 5, 2012
Tuesday, November 29, 2011
Back Pain Myths
I hurt my back, so I will probably have bad back pain from now on.
While LBP can be very painful, most people make a very good recovery, with no significant changes to their quality of life. It is common for people with LBP to have occasional episodes of LBP in their lifetime, but these are rarely disabling. Only a very small number of people develop long-standing, disabling problems. Research shows that when you first experience LBP, some simple advice can help reduce it and reduce the risk of it happening again.
I have back pain, so I should stay in bed and rest.
In the first few days after the initial injury, avoiding aggravating activities may help to relieve pain. similar to pain in any other part of the body, such as a sprained ankle. However, there is good evidence that exercise and returning to all usual activities, including work and hobbies, is important in aiding recovery. In contrast, prolonging rest is unhelpful. This increase in exercises and return to activity can be done gradually, and has been shown to reduce the risk of future pain and disability
The more back pain I have, the more my spine is damaged.
More pain does not always mean more damage. People with similar back problems can feel very different levels of pain. The degree of pain felt can vary according to a number of factors, including the situation in which the pain occurs, previous pain experiences, your mood, fears, fitness, stress levels and coping style. If you have LBP it might be that the nerves involved in sending and processing pain are relatively more 'active' compared to other people. This can mean you feel more pain when you move or try to do something, even though you are not damaging your spine. In such cases a number of strategies, including exercises, can be used to help lessen the pain and disability experienced.
I need a scan or X-ray for my back pain.
In most cases of LBP, X-rays and scans are not needed. Every year very large sums of money are spent on unnecessary X-rays and scans for LBP. In addition, many of these scans involve exposure to radiation. Only a small number of these tests actually contribute to better management of the problem. In fact, even adults with no LBP will have evidence of normal 'wear and tear' on these scans. A simple clinical examination is usually enough to identify the minority of people for whom scans are required.
I need an operation to cure my back pain
Only a tiny proportion of people with LBP require surgery. Long -term outcomes after surgery and Physiotherapy are generally similar. Surgery is a higher risk treatment and so is only used if there is no other option. The vast majority of people with LBP can manage their problem by staying active and developing a better understanding of what pain means, what factors are involved in their pain. This should help them continue their usual daily tasks, without having to resort to surgery.
Taken from Move4Health. Challenging Back Pain Myths. ISCP. www.move4health.ie
While LBP can be very painful, most people make a very good recovery, with no significant changes to their quality of life. It is common for people with LBP to have occasional episodes of LBP in their lifetime, but these are rarely disabling. Only a very small number of people develop long-standing, disabling problems. Research shows that when you first experience LBP, some simple advice can help reduce it and reduce the risk of it happening again.
I have back pain, so I should stay in bed and rest.
In the first few days after the initial injury, avoiding aggravating activities may help to relieve pain. similar to pain in any other part of the body, such as a sprained ankle. However, there is good evidence that exercise and returning to all usual activities, including work and hobbies, is important in aiding recovery. In contrast, prolonging rest is unhelpful. This increase in exercises and return to activity can be done gradually, and has been shown to reduce the risk of future pain and disability
The more back pain I have, the more my spine is damaged.
More pain does not always mean more damage. People with similar back problems can feel very different levels of pain. The degree of pain felt can vary according to a number of factors, including the situation in which the pain occurs, previous pain experiences, your mood, fears, fitness, stress levels and coping style. If you have LBP it might be that the nerves involved in sending and processing pain are relatively more 'active' compared to other people. This can mean you feel more pain when you move or try to do something, even though you are not damaging your spine. In such cases a number of strategies, including exercises, can be used to help lessen the pain and disability experienced.
I need a scan or X-ray for my back pain.
In most cases of LBP, X-rays and scans are not needed. Every year very large sums of money are spent on unnecessary X-rays and scans for LBP. In addition, many of these scans involve exposure to radiation. Only a small number of these tests actually contribute to better management of the problem. In fact, even adults with no LBP will have evidence of normal 'wear and tear' on these scans. A simple clinical examination is usually enough to identify the minority of people for whom scans are required.
I need an operation to cure my back pain
Only a tiny proportion of people with LBP require surgery. Long -term outcomes after surgery and Physiotherapy are generally similar. Surgery is a higher risk treatment and so is only used if there is no other option. The vast majority of people with LBP can manage their problem by staying active and developing a better understanding of what pain means, what factors are involved in their pain. This should help them continue their usual daily tasks, without having to resort to surgery.
Taken from Move4Health. Challenging Back Pain Myths. ISCP. www.move4health.ie
Thursday, November 3, 2011
Growing Pains
Firstly ‘growing pains’ are an actual real thing. During growth phases, bone lengthens before muscles and tendons are able to stretch correspondingly and before the muscle and tendon meeting point (musculotendinous complex) develops the necessary strength and coordination to control the newly lengthened bone. This may lead to muscle and tendon injuries. Growth temporarily reduces coordination and this manifests as awkwardness in movement patterns while playing sport.
One of the most commonly presenting children’s’ ‘growing pains’ to our clinic is anterior knee pain which tends to be Osgood-Schlatter’s Disease. This is pain on the front and bottom of the knee cap. It occurs during the time of a growth spurt. It is usually associated with a high level of physical activity, especially in sports involving running and jumping, such as gaelic football, gymnastics or dance. It is usually tender on the tibial tuberosity (this is the prominence of the top of the shin bone, just under the knee cap). There may be also tightness of the surrounding muscles, especially the quadriceps muscle (thigh muscle). The diagnosis of this condition is clinical and x rays are not usually required.
Osgood-Schlatter’s lesion is a self limiting condition that settles as growth finishes. The long term effects may be a bony prominence at the top of the shin bone. Children and parents need to understand the nature of the condition as symptoms may persist for up to two years.
Management of this condition requires activity modification. While there is no research that rest accelerates the healing process, a reduction in activity will reduce the pain. As this condition occurs in children with a high level of activity, it can help to reduce some of the activities they are involved in. There is no need to rest completely. Pain should be the main guide as to the limitation of activity.
Symptomatic management includes applying ice to the region, especially when hot and swollen. Tightness of the quadriceps muscle may predispose to this condition. Therefore a stretching programme and some soft tissue therapy will be helpful. Correction of any biomechanical abnormalities (flat feet) is necessary. Neither injection of corticosteroid or surgery is required.
One of the most commonly presenting children’s’ ‘growing pains’ to our clinic is anterior knee pain which tends to be Osgood-Schlatter’s Disease. This is pain on the front and bottom of the knee cap. It occurs during the time of a growth spurt. It is usually associated with a high level of physical activity, especially in sports involving running and jumping, such as gaelic football, gymnastics or dance. It is usually tender on the tibial tuberosity (this is the prominence of the top of the shin bone, just under the knee cap). There may be also tightness of the surrounding muscles, especially the quadriceps muscle (thigh muscle). The diagnosis of this condition is clinical and x rays are not usually required.
Osgood-Schlatter’s lesion is a self limiting condition that settles as growth finishes. The long term effects may be a bony prominence at the top of the shin bone. Children and parents need to understand the nature of the condition as symptoms may persist for up to two years.
Management of this condition requires activity modification. While there is no research that rest accelerates the healing process, a reduction in activity will reduce the pain. As this condition occurs in children with a high level of activity, it can help to reduce some of the activities they are involved in. There is no need to rest completely. Pain should be the main guide as to the limitation of activity.
Symptomatic management includes applying ice to the region, especially when hot and swollen. Tightness of the quadriceps muscle may predispose to this condition. Therefore a stretching programme and some soft tissue therapy will be helpful. Correction of any biomechanical abnormalities (flat feet) is necessary. Neither injection of corticosteroid or surgery is required.
Wednesday, November 2, 2011
Post marathon advice
After the race (which most people haven't thought about!):
1.Stretch well this week- this will help your recovery no end.
2. Recovery bath- some people swear by a lukewarm bath with epsom salts. Avoid a hot bath.
3. Take adequate recovery time- I often see injuries months after a marathon, as people didn't take a break. The jury is out on how long is needed, and of course it varies per person, but guidelines would state not to return to intense training until 26-40 days after the race.
4. Cross-training is a great way of assisting your recovery- a gently cycle/swim/walk in the days after the race can get the blood flowing and ease the leg stiffness.
5. Avoid too much alcohol the week after the race! This is obviously going to affect your recovery.
6. Having a rub-down in the week after the race can help to alleviate muscle soreness.
Let us know if you want a rub-down prior to or after the race (discount voucher still valid!)
1.Stretch well this week- this will help your recovery no end.
2. Recovery bath- some people swear by a lukewarm bath with epsom salts. Avoid a hot bath.
3. Take adequate recovery time- I often see injuries months after a marathon, as people didn't take a break. The jury is out on how long is needed, and of course it varies per person, but guidelines would state not to return to intense training until 26-40 days after the race.
4. Cross-training is a great way of assisting your recovery- a gently cycle/swim/walk in the days after the race can get the blood flowing and ease the leg stiffness.
5. Avoid too much alcohol the week after the race! This is obviously going to affect your recovery.
6. Having a rub-down in the week after the race can help to alleviate muscle soreness.
Let us know if you want a rub-down prior to or after the race (discount voucher still valid!)
Monday, October 17, 2011
Running the Marathon Injury Free
October 31st is fast approaching! At this stage you have probably started your taper and just completed your last long run at the weekend. This is often the time that injuries can rear their head, the combination of the final long run at peak weekly mileage, followed by the change in training with the taper.
This is also a time when you will progressively have more time on your hands as the mileage reduces, which can cause panic to set in.
My advice for this final phase:
1. Don't panic- as I say time and again, your training is essentially done, so its a bad idea to try to make-up lost mileage- you need a fresh body at that start line, that is the reason for the taper.
2. Don't make any unplanned changes to your training/clothing/footwear/diet etc.- with extra time on your hands and extra time to think, people can end up doing daft things before a marathon- my advice is not to try anything new, or make any changes to your training plan- the plan is designed for your body to peak for race day, and messing around with this is risky.
3. If you are having any niggles, best get them seen to now- the later you leave it, the less time there is for it to get sorted for the big day.
4. Having a rub-down in the week prior to the marathon (but not within 3 days) can help to keep the muscles feeling loose and fresh.
5. Keep well hydrated.
6. Distract yourself with other activities if you feel the panic setting in!
And after the race (which most people haven't thought about!):
1. Have something warm to wear.
2. Eat something salty (eg crackers) within 15 mins of finishing, and...
3. Stretch well afterwards- this will help your recovery no end.
4. Recovery bath- some people swear by the ice bath (science is undecided), or a lukewarm bath with epsom salts may be more pleasant. Avoid a hot bath.
5. Take adequate recovery time- I often see injuries months after a marathon, as people didn't take a break. The jury is out on how long is needed, and of course it varies per person, but guidelines would state not to return to intense training until 26-40 days after the race.
6. Cross-training is a great way of assisting your recovery- a gently cycle/swim/walk in the days after the race can get the blood flowing and ease the leg stiffness.
7. Avoid alcohol after the race! This is obviously going to affect your recovery. If you do decide to go for that pint of Guinness, just make sure its acccompanied by some water.
8. Having a rub-down in the week after the race can help to alleviate muscle soreness.
Let us know if you want a rub-down prior to or after the race (discount voucher still valid!)
Best of Luck
This is also a time when you will progressively have more time on your hands as the mileage reduces, which can cause panic to set in.
My advice for this final phase:
1. Don't panic- as I say time and again, your training is essentially done, so its a bad idea to try to make-up lost mileage- you need a fresh body at that start line, that is the reason for the taper.
2. Don't make any unplanned changes to your training/clothing/footwear/diet etc.- with extra time on your hands and extra time to think, people can end up doing daft things before a marathon- my advice is not to try anything new, or make any changes to your training plan- the plan is designed for your body to peak for race day, and messing around with this is risky.
3. If you are having any niggles, best get them seen to now- the later you leave it, the less time there is for it to get sorted for the big day.
4. Having a rub-down in the week prior to the marathon (but not within 3 days) can help to keep the muscles feeling loose and fresh.
5. Keep well hydrated.
6. Distract yourself with other activities if you feel the panic setting in!
And after the race (which most people haven't thought about!):
1. Have something warm to wear.
2. Eat something salty (eg crackers) within 15 mins of finishing, and...
3. Stretch well afterwards- this will help your recovery no end.
4. Recovery bath- some people swear by the ice bath (science is undecided), or a lukewarm bath with epsom salts may be more pleasant. Avoid a hot bath.
5. Take adequate recovery time- I often see injuries months after a marathon, as people didn't take a break. The jury is out on how long is needed, and of course it varies per person, but guidelines would state not to return to intense training until 26-40 days after the race.
6. Cross-training is a great way of assisting your recovery- a gently cycle/swim/walk in the days after the race can get the blood flowing and ease the leg stiffness.
7. Avoid alcohol after the race! This is obviously going to affect your recovery. If you do decide to go for that pint of Guinness, just make sure its acccompanied by some water.
8. Having a rub-down in the week after the race can help to alleviate muscle soreness.
Let us know if you want a rub-down prior to or after the race (discount voucher still valid!)
Best of Luck
Tuesday, August 30, 2011
European Junior Championships, Tallin, Estonia, July 2011
It’s always great to go away with a team to a championship. The athlete’s whole season is geared towards making the qualification standard for a major, and once this is achieved, then planning their training so that they peak at the right time. You can feel this energy and excited nerves when you work at these competitions and it makes for some real emotional roller coasters.
I travelled as team physio with the Irish junior track and field team to Tallinn, Estonia, my first time at a junior championship. A team of 16 athletes (they must be 18 or 19 this year to qualify as a Junior), 4 coaches, team manager and team doctor travelled for the championships that took place over 4 days, with the whole trip lasting a week.
In one sense it was a busy week, heading down to the track usually on the 7am bus, and coming back on the last bus around 9pm to work back at the hotel until about 11pm. Thankfully no-one was carrying any major injuries and so the workload itself wasn’t too great. Temperatures soared into the 30’s for the first few days, and so it was a priority to keep the athletes cool. This weather suited the sprinters more than the endurance athletes. In particular Liam Brady competed in 32 degree heat to make his international debut by coming 7th in the 10km, and the 10km race walkers Maeve Curley (10th) and Emma Prendiville (15th) had to endure similar conditions.
Stand-out performances included Thomas Barr, who, also making his international debut, smashed the Irish National Junior record twice, and also recording the 2nd fastest time run by any Irish man ever (Junior or Senior) over the 400m hurdles. Thomas was ranked 5th in his round 1 heat, only to win it, then come second in his semi-final, and ultimately finished 5th in the final. Since then he has knocked another chunk off his personal best by running 50.06s at the National Senior Championships. Keep an eye on Thomas for the future.
400m runner Joanna Mills also defied her ranking by qualifying through 2 rounds for the final where she was placed 4th. Another great fighting performance.
Medal hopeful Ciara Mageean went into a straight final, the qualifying heats being cancelled. It’s never easy leading a 1500m from the start, which is what Ciara unfortunately ended up doing. Despite a valiant effort to hold off the Serbian, Ciara’s gold medal hopes got dashed in the last 40m. A great performance and she brought home Ireland’s only silver medal to add to her silver from last year’s World Juniors.
European Juniors wrapped up my athletic season for this year. Within the past year I have been fortunate enough to have worked at the European Cross Country Championships in Portugal, European Team Championships in Turkey, European Junior Championships in Estonia, and worked with junior and senior athletes at 2 training camps in Portugal. I was privileged enough to work with teams that took home gold (U-23’s men’s cross country) and silver medals (Ciara Mageean). Who knows what 2012 will bring.
I travelled as team physio with the Irish junior track and field team to Tallinn, Estonia, my first time at a junior championship. A team of 16 athletes (they must be 18 or 19 this year to qualify as a Junior), 4 coaches, team manager and team doctor travelled for the championships that took place over 4 days, with the whole trip lasting a week.
In one sense it was a busy week, heading down to the track usually on the 7am bus, and coming back on the last bus around 9pm to work back at the hotel until about 11pm. Thankfully no-one was carrying any major injuries and so the workload itself wasn’t too great. Temperatures soared into the 30’s for the first few days, and so it was a priority to keep the athletes cool. This weather suited the sprinters more than the endurance athletes. In particular Liam Brady competed in 32 degree heat to make his international debut by coming 7th in the 10km, and the 10km race walkers Maeve Curley (10th) and Emma Prendiville (15th) had to endure similar conditions.
Stand-out performances included Thomas Barr, who, also making his international debut, smashed the Irish National Junior record twice, and also recording the 2nd fastest time run by any Irish man ever (Junior or Senior) over the 400m hurdles. Thomas was ranked 5th in his round 1 heat, only to win it, then come second in his semi-final, and ultimately finished 5th in the final. Since then he has knocked another chunk off his personal best by running 50.06s at the National Senior Championships. Keep an eye on Thomas for the future.
400m runner Joanna Mills also defied her ranking by qualifying through 2 rounds for the final where she was placed 4th. Another great fighting performance.
Medal hopeful Ciara Mageean went into a straight final, the qualifying heats being cancelled. It’s never easy leading a 1500m from the start, which is what Ciara unfortunately ended up doing. Despite a valiant effort to hold off the Serbian, Ciara’s gold medal hopes got dashed in the last 40m. A great performance and she brought home Ireland’s only silver medal to add to her silver from last year’s World Juniors.
European Juniors wrapped up my athletic season for this year. Within the past year I have been fortunate enough to have worked at the European Cross Country Championships in Portugal, European Team Championships in Turkey, European Junior Championships in Estonia, and worked with junior and senior athletes at 2 training camps in Portugal. I was privileged enough to work with teams that took home gold (U-23’s men’s cross country) and silver medals (Ciara Mageean). Who knows what 2012 will bring.
Thursday, June 30, 2011
Athletics Ireland Season Update
Since April the outdoor track and field season has been underway, with a busy few months for me as I travelled with both the juniors and the seniors for warm weather training camps in Portugal, and the European Team Championships in Turkey.
The junior camp was in Alfa Mar in Portugal, and consisted of 14 youths, training for the youth Olympics and World Youth championships, and 16 juniors hoping to qualify for the European Junior Champsionships. The juniors were my remit as I will be travelling with them to these championships in Tallin in July.
The most rewarding thing as a physio working with juniors is the fact that they are on such a steep learning curve about their training and how their bodies move. The fact that they are so young (juniors need to be 19 or under), their bodies also respond really quickly to rehab and treatment. The main aim of my week was to screen everyone in relation to their strength and movement, pinpoint any injury risk factors, and address these with a rehab programme. The group had disciplines of track and field events, including race walker and recent European Cup junior bronze medallist Kate Veale. Unfortunately the warm element to the training did not work out very well on this trip!
Senior camp is a totally different ball-game. Athletes are much more tuned in to how their particular body moves and performs, particularly in terms of how it responds at different times of the season. Track and field athletics, unlike team sports, has athletes based all over Ireland, in addition to England, Germany and the USA. They congregate at training camps and competitions mainly so there is often a nice “catch-up” atmosphere. I have done this camp a number of times over the years, and I have to say this one was the most relaxed I have worked on. Everyone was in good spirits, with familiar names such as Derval O’Rourke, Paul Hession, Olive Loughnane and Ailis McSweeney at the Competition, among others. The main aim for most of these athletes this year, apart from this being pre-Olympic year, is attaining the qualification standard for the World Championships in Korea in August.
The European Team Championships takes place every year. Ireland got promoted to league 1 two years ago (there are 4 leagues- the super league, with countries such as GB, France, Germany, and leagues 1-3). Ireland spent a long time working to get promoted to league 1, and was determined to hold their place, especially since we hope to host the next European Team Championships in 2013 (there is none next year due to the Olympics and European Championships). So it was important for the older athletes to leave their legacy, and for the younger ones to make their stamp. Thankfully Ireland avoided relegation (by one place!), and had some stand-out performances, including our highest placing individual, Wicklow’s Fionnuala Britton, who came 2nd in the 5,000m, and who has already made her World Championships and Olympic standards. Fionnuala is definitely an athlete to watch.
Next up is European Juniors in Estonia in July, with 14 athletes having made the standard to date, including medal hopefuls Ciara Mageean and Mark English.
The junior camp was in Alfa Mar in Portugal, and consisted of 14 youths, training for the youth Olympics and World Youth championships, and 16 juniors hoping to qualify for the European Junior Champsionships. The juniors were my remit as I will be travelling with them to these championships in Tallin in July.
The most rewarding thing as a physio working with juniors is the fact that they are on such a steep learning curve about their training and how their bodies move. The fact that they are so young (juniors need to be 19 or under), their bodies also respond really quickly to rehab and treatment. The main aim of my week was to screen everyone in relation to their strength and movement, pinpoint any injury risk factors, and address these with a rehab programme. The group had disciplines of track and field events, including race walker and recent European Cup junior bronze medallist Kate Veale. Unfortunately the warm element to the training did not work out very well on this trip!
Senior camp is a totally different ball-game. Athletes are much more tuned in to how their particular body moves and performs, particularly in terms of how it responds at different times of the season. Track and field athletics, unlike team sports, has athletes based all over Ireland, in addition to England, Germany and the USA. They congregate at training camps and competitions mainly so there is often a nice “catch-up” atmosphere. I have done this camp a number of times over the years, and I have to say this one was the most relaxed I have worked on. Everyone was in good spirits, with familiar names such as Derval O’Rourke, Paul Hession, Olive Loughnane and Ailis McSweeney at the Competition, among others. The main aim for most of these athletes this year, apart from this being pre-Olympic year, is attaining the qualification standard for the World Championships in Korea in August.
The European Team Championships takes place every year. Ireland got promoted to league 1 two years ago (there are 4 leagues- the super league, with countries such as GB, France, Germany, and leagues 1-3). Ireland spent a long time working to get promoted to league 1, and was determined to hold their place, especially since we hope to host the next European Team Championships in 2013 (there is none next year due to the Olympics and European Championships). So it was important for the older athletes to leave their legacy, and for the younger ones to make their stamp. Thankfully Ireland avoided relegation (by one place!), and had some stand-out performances, including our highest placing individual, Wicklow’s Fionnuala Britton, who came 2nd in the 5,000m, and who has already made her World Championships and Olympic standards. Fionnuala is definitely an athlete to watch.
Next up is European Juniors in Estonia in July, with 14 athletes having made the standard to date, including medal hopefuls Ciara Mageean and Mark English.
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