physiolibrary - Tumblr blog

physiolibrary · 4 years ago

Text

Anticipatory Care for Long Term Conditions in Physiotherapy

Introduction

Long term conditions such as non-communicable diseases (NCDs) account for 70% of all deaths each year and the numbers are expected to rise over the next ten years. Global health organizations continue to establish models for prevention and management of these conditions. Physiotherapists have managed to successfully adapt these structural models into their practice and actively contribute to addressing this global burden. In this course, you will explore different interventions that you can utilize in your daily practice to help your patients live a healthier life.

Aims

This course discusses the risk factors and impacts of long term conditions and the role of physiotherapy in promoting their prevention.

Outline

This course is made up of videos, reading, discussions and a final quiz. The course content is split into the following sections:

Video

Reading activity

Quiz

Target audience

This course is aimed at Physiotherapy and Physical Therapy clinicians, students and assistants. Other interested professionals such as athletic trainers, occupational therapists, nurses or medical doctors interested in this subject are also invited to participate.

Practicalities

Hours of Learning - No deadlines are applied to this course and it can be started and completed in your own time according to your personal schedule. We expect the required elements to take around 1 hour depending on your schedule and learning style. Additionally there are many optional resources provided and if you choose to review these the course could take longer to complete. Types of Activities - Reading Physiopedia pages, journal articles, book chapters. Watching videos. Attempting quizzes. Participating in an international discussion forum. Certificates - At the end of the course, when you have completed all of the required elements, you will be able to download a certificate of completion and 0.7 Physioplus points will be added to your personalised learning dashboard.

Requirements to complete this course

In order to complete this course and receive a course completion certificate plus CEUs/CCUs/CPD points you will need to:

Respect the Physioplus Community Culture.

Log all the required learning activities as complete (represented by the orange icons!).

Actively and appropriately participate in the course discussions.

Pass a final quiz with a score of 80% or more.

Complete a course evaluation form.

Learning outcomes

At the end of this course you will be able to:

Define long term conditions and the most common contributing factors to the development of long term conditions

Describe 3 main negative impacts of long term conditions

Identify 6 lifestyle behavioural changes that need to be supported in healthcare practice

Discuss the role of physiotherapy in self management and in the prevention of long term conditions

Accreditations

Australian Physiotherapy Council

Australia

APC Accredited Continuing Professional Development

South African Society of Physiotherapy

South Africa

South African Society of Physiotherapy: PPB007/PT001/2021/139 (3 General CEUs Level 1)

Texas Physical Therapy Association

United States - Texas

The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE.

This activity is provided by the Texas Board of Physical Therapy Examiners Accredited Provider #2312053TX and meets continuing competence requirements for PT and PTA licensure renewal in Texas. This activity will provide 0.78 CCUs.

Keywords: chronic, Long Term Conditions, management, NCDs, non-communicable diseases, prevention

0 notes

physiolibrary · 4 years ago

Text

Assessment of Parkinson’s

Introduction

Parkinson’s, as a condition, has an enormous impact on daily living. People with Parkinson’s will develop difficulties with walking, keeping their balance, and may have experienced, or be at risk of falling. For these individuals changing position is challenging, as is the maintenance of a good posture over the course of the disease process. Physiotherapists play a vital role in supporting people with Parkinson’s. In order to make the appropriate clinical decisions, a thorough assessment of the person's physical limitations should be undertaken. This course includes the primary elements of such an assessment, relevant outcome measures, a model for falls assessment and prediction and also important parts of the European Physiotherapy Guidelines for Parkinson’s Disease.

Aims

In this course, you will learn about the role of physiotherapists in the management of Parkinson’s, and how to conduct a holistic assessment approach.

Outline

This course is made up of videos, reading, forum posts and a final quiz. The course content is split into the following sections:

Video

Reading activity

Quiz

Target audience

Practicalities

Hours of Learning - No deadlines are applied to this course and it can be started and completed in your own time according to your personal schedule. We expect the required elements to take around 1 hour depending on your schedule and learning style. Additionally there are many optional resources provided and if you choose to review these the course could take longer to complete. Types of Activities - Reading Physiopedia pages, journal articles, book chapters. Watching videos. Attempting quizzes. Participating in an international discussion forum. Certificates - At the end of the course, when you have completed all of the required elements, you will be able to download a certificate of completion and 0.8 Physioplus points will be added to your personalised learning dashboard.

Requirements to complete this course

In order to complete this course and receive a course completion certificate plus CEUs/CCUs/CPD points you will need to:

Respect the Physioplus Community Culture.

Log all the required learning activities as complete (represented by the orange icons!).

Actively and appropriately participate in the course discussions.

Pass a final quiz with a score of 80% or more.

Complete a course evaluation form.

Learning outcomes

At the end of this course you will be able to:

define the 3 main roles of physiotherapy in the management of Parkinson’s

independently plan an assessment for people with Parkinson’s based on the 7 common areas of limitations/dysfunctions

contrast the main objectives of physiotherapy in the early and late stages of Parkinson’s

justify the use of outcome measures for people with Parkinson’s

Accreditations

Australian Physiotherapy Council

Australia

APC Accredited Continuing Professional Development

Federation of State Boards of Physical Therapy (ProCert)

Puerto Rico, United States - Alaska, Arizona, Arkansas, California, Colorado, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Wisconsin, Wyoming

ProCert has awarded certification in the amount of 2 Continuing Competence Unit (CCUs) to this course

South African Society of Physiotherapy

South Africa

South African Society of Physiotherapy: PPB007/PT001/2021/006 (3 General CEUs Level 1)

Keywords: ageing, balance, bradykinesia, dyskinesia, dystonia, elderly, falls, festinaton, freezing, gait, neurology, parkinsons, posture

0 notes

physiolibrary · 4 years ago

Text

Benign Joint Hypermobility Syndrome

Introduction

Benign Joint Hypermobility Syndrome (BJHS) is a connective tissue disorder that can cause pain in multiple joints. BJHS often occurs in younger patients and while it is a well-recognised condition, it is often overlooked and not considered as a differential diagnosis. This course will introduce BJHS and explore evidence based physiotherapy management strategies for paediatric populations.

Aims

This course aims to introduce Benign Joint Hypermobility Syndrome and discuss appropriate evidence based physiotherapy management strategies.

Outline

This course is made up of videos, reading, forum posts and a final quiz. The course content is split into the following sections:

Videos

Reading Activities

Quiz

Target audience

Practicalities

Hours of Learning - No deadlines are applied to this course and it can be started and completed in your own time according to your personal schedule. We expect the required elements to take around 1-1.5 hours depending on your schedule and learning style. Additionally there are many optional resources provided and if you choose to review these the course could take longer to complete. Types of Activities - Reading Physiopedia pages, journal articles, book chapters. Watching videos. Attempting quizzes. Participating in an international discussion forum. Certificates - At the end of the course, when you have completed all of the required elements, you will be able to download a certificate of completion and 0.9 Physioplus points will be added to your personalised learning dashboard.

Requirements to complete this course

In order to complete this course and receive a course completion certificate plus CEUs/CCUs/CPD points you will need to:

Respect the Physioplus Community Culture.

Log all the required learning activities as complete (represented by the orange icons!).

Actively and appropriately participate in the course discussions.

Pass a final quiz with a score of 80% or more.

Complete a course evaluation form.

Learning outcomes

At the end of this course you will be able to:

describe the epidemiology of BJHS

summarise the key signs and symptoms of BJHS

compare BJHS with four other conditions that should be considered as differential diagnoses in patients who present with hypermobility

choose the appropriate assessment measure for BJHS

plan an effective intervention for paediatric patients with BJHS

Accreditations

Australian Physiotherapy Council

Australia

APC Accredited Continuing Professional Development

South African Society of Physiotherapy

South Africa

South African Society of Physiotherapy: PPB007/PT001/2021/172 (3 General CEUs Level 1)

Texas Physical Therapy Association

United States - Texas

The assignment of Texas PT CCUs does not imply endorsement of specific course content, products, or clinical procedures by TPTA or TBPTE.

Keywords: adolescent, assessment, Benign Joint Hypermobility Syndrome, BJHS, child, condition, connective tissue, differential diagnosis, hypermobility, management, paediatrics

0 notes

physiolibrary · 4 years ago

Text

Massage

Introduction

Massage is the place were physiotherapy started. There is also evidence of massage being used in many ancient cultures. Massage is an age old technique uses both stretching and pressure in a rhythmic fashion.

Preparation

Posture

Your ability to administer a good massage will depend largely on your own comfort, therefore maintaining a good posture is beneficial to both you and your client. The following are only basic guidelines and it may be that because of the environment you're in, adjustments may need to be made.

Work with your back as straight as possible. By flexing your hips and knees, you will be able to move more efficiently and with less stress on your back.

Foot position is also important and should be such that you can move in an antero-posterior direction without placing undue strain on your back.

Hand Position

The most useful areas of the hand to use are the ulnar border and base of the thumb.

Other important areas are the palm and the palmar surfaces of the fingers and thumbs. They provide sensory feedback, thus allowing you to adapt your massage with regard to timing and pressure according to the nature of the tissue. It is for this reason that the use of elbows and knuckles should be avoided.

Keep your arms and hands relaxed while massaging, with the hands conforming to the contours of the body.

Always pour the oil onto your own hands, never directly onto the client.

Try to warm the oil (and your hands) before applying to the naked skin. If this is not possible, at least warn the client of what is to come.

Physical Contact

Try to always maintain contact with your client. This allows them to relax, especially if they are lying face down. Removal of the hands may also be interpreted as an indication that the session is over and so cause unwanted movement.

If for some reason you must break contact, for example at a sports meeting where situations are not ideal, then make sure you cover the client and do not leave them exposed.

Massage Techniques

Massage techniques commonly employed include

Effleurage (Stroking)

The hands are passed rhythmically and continuously over a client's skin, in one direction only, with the aim of increasing blood flow in that direction, stretching tissues, relaxing the client and aiding the dispersal of waste products. The word effleurage is derived from French, meaning "to skim". It involves stroking movements of the hands sliding over the skin and is always the first and last technique (as well as being used between other techniques) applied in a massage session. Effleurage may be used with varying tempo and pressure according to the stage of the condition and whatever the desired effect of the massage is.

Performing Effleurage

You should use a wide surface area of the palmar surfaces of the hands and fingers, either with both hands simultaneously or by alternating hands. Pressure is sustained throughout the stroke and is always toward the heart to encourage venous return. On the return stroke, the hands should maintain light contact and avoid the same path taken by the upward stroke. The position, speed and direction of the movements will vary depending on aim of technique and the part of the body being massaged. For example, long, stroking movements may be used on the legs and arms, while a more circular motion may be preferred for the back and neck.

Effleurage should be carried out in a smooth, rhythmical and relaxed manner, beginning with light touch at the start of the session. This should build up to deeper pressure with slower movements for increased circulation and stretching of the tissues at a later stage in the session. The hands should be relaxed and should follow the natural contours of the client's body. The technique should not be rushed, as you need time and quality of movement to determine any tissue abnormalities that require attention. Quick movements will not allow the client to relax and will certainly be more painful if any areas are tender.

When passing your hands over any bony prominences, pressure should be eased, both since there is no therapeutic value of massaging over bone, and to reduce discomfort felt by the client. To complete any massage, use effleurage to relax the client, especially if intense/painful techniques have been used during the session.

Aims of Effleurage

Introduce touch to the client

Put the client at ease

Warm the superficial tissues

Relax the muscles

Allow you to palpate and sense the condition of the tissue

Stimulate the peripheral nerves

Increase blood and lymph flow, thus aiding in the removal of waste products

Stretch tissues

Relax the client before the end of the session[1]

Not all of these aims may necessarily be accomplished in one session. Much depends on what the requirements of the client are. Lighter, brisk movements may be indicated is the client is about to participate in sport and needs to be stimulated and energized. The same techniques applies more slowly will be better employed after exercise to relax the client and aid in the removal of waste products.

It is very important to achieve your aims using effleurage before moving onto other techniques, such as petrissage. If the muscles have not relaxed sufficiently, deep tissue massage may be uncomfortable and painful. The more pliable the superficial tissue is after effleurage, the more beneficial the deeper massage will be.

Petrissage (Kneading)

The skin is lifted up, pressed down and squeezed, pinched and rolled. Alternate squeezing and relaxation of the tissues stimulates the local circulation and may have a pain-relieving effect with some muscular disorders. Petrissage is derived from a French word, meaning "to knead". The basic movement is to compress, pick up and then release the soft tissues. It is generally used when a deeper effect than effleurage is desired, and it's techniques include:

Squeezing

Picking up

Shaking

Rolling

Wringing

Performing Petrissage

As with effleurage, pressure is directed toward the heart to encourage venous return. Your hands remain in almost static contact with the client's skin, while moving them over the underlying muscle. The difference is that with petrissage the overall direction is from proximal to distal, as opposed to effleurage, in which the direction of the overall technique is from distal to proximal. This is achieved by first applying shorter strokes toward the heart, but then moving the hands distally before beginning the stroke again. This is supposed to force blood out of an area by the application of pressure, then releasing the pressure and repeating the technique distally to force fresh blood and nutrients into the area.

Percussion/Tapotement Manipulations

Includes hacking, clapping, beating, pounding or vibrations.

Myofascial Release

Myofascial release is manual technique for stretching the fascia aiming to release fascia restrictions.. Fascia is located between the skin and the underlying structure of muscle and bone, and connects the muscles, organs, and skeletal structures in our body. Fascia can become restricted through injuries, stress, trauma, and poor posture.[4]

Trigger Point Therapy

Trigger point therapy involves the applying of pressure to tender muscle tissue in order to relieve pain and dysfunction in other parts of the body. Trigger points are active centres of muscular hyperactivity, which often cross-over with acupuncture points. The video below shows how a client can do self trigger point massage using a small ball.

Deep Transverse Frictions

Transverse frictions are a transverse connective tissue therapy applied directly by the fingers. Oscillating pressure is applied across the direction of the tissue fibres. Mainly used on tendon or ligament injuries to help break down thickened, pain-producing scar tissue. I

Compression Massage

Rhythmic compression into muscles used to create a deep hyperaemia and softening effect in the tissues. Often used for sports massage as a warm-up for deeper, more specific massage work.

Cross-Fibre Massage

Cross-fibre friction techniques applied in a general manner to create a stretching and broadening effect in large muscle groups; or on site-specific muscle and connective tissue, deep transverse friction applied to reduce adhesions and to help create strong, flexible repair during the healing process.

Swedish Massage

Swedish massage techniques includes long strokes, kneading, friction, tapping, percussion, vibration, effleurage, and shaking motions.

The sequence of used is generally

Effleurage: Gliding strokes with the palms, thumbs and/or fingertips

Petrissage: Kneading movements with the hands, thumbs and/or fingers

Friction: Circular pressures with the palms of hands, thumbs and/or fingers

Vibration: Oscillatory movements that shake or vibrate the body

Percussion: Brisk hacking or tapping

Passive and active movements: Bending and stretching

Contraindications

Include: Any type of skin infection; Open wounds; Circulatory problems such as thrombosis, bleeding disorders; Less than 48 hours after injury; during acute inflammation; Tumours if in the area being massaged.

Is Massage Effective?

While often preliminary or conflicting, there is scientific evidence that massage may help with pain and may improve quality of life for people with depression, cancer, and HIV/AIDS.

Pain- A 2008 research review and 2011 NCCIH-funded clinical trial concluded that massage may be useful for chronic low-back pain. Similarly a 2009 clinical trial reported massage may help with chronic neck pain. A 2013 sytematic review of sytematic reviews found that there is an emerging body of evidence supporting the effectiveness of massage therapy for the treatment of non-specific low back pain in the short term. They also cautioned that this should be interpreted with caution as there were methodological flaws in the primary research. Massage may help with pain due to osteoarthritis of the knee, according to a 2012 NCCIH-funded study

Depression- A 2010 meta-analysis of 17 clinical trials concluded that massage therapy may help to reduce depression and a 2010 review concluded that massage may help older people relax.

Cancer- For cancer patients research reviews and clinical studies have suggested that at least for the short term, massage therapy may reduce pain, promote relaxation, and boost mood. However specific precautions with cancer patients are needed Avoid massaging: open wounds, tumour site, blood clot in vein, sensitised areas post radiotherapy.

0 notes

physiolibrary · 5 years ago

Text

Copenhagen Hip Adduction Exercise: The Science and Unique Variations

Why Use Hip Adductor Exercises?

A 2015 systematic review (a study of studies) published in the British Journal of Sports Medicine found that hip adductor strength was one of the most common risk factors for groin injury in sport (1).

One study of note on professional ice hockey players found that they were 17 times more likely to sustain an adductor muscle strain (i.e., groin injury) if their adductor strength was less than 80% of his abductor strength (2).

What Are The Most Effective Hip Adductor Exercises?

With the above in mind, it’s not uncommon for personal trainers and strength coaches to claim that you don’t need to do specific exercises to target your adductors, as compound exercises like squats and lunges do the job effectively. However, the research in this arena shows this common belief/claim to be false.

A review investigating the barbell squat found that a greater hip external rotation position (feet turned out) along a wide stance of the feet, as well as an increased load will increase hip adduction activation during this exercise (3). However, the highest values in muscle activity for the wide-stance squat (4), along with those found during a single-leg squat and a lunge, are relatively low compared to exercises that focus primarily on the hip adduction movement (5). So, with respect to reaching greater levels of muscle activation in the adductors, exercises targeted at training the hip adductors are superior to exercises like wide-stance squats, single-leg squats and lunges.

How To Do the Copenhagen Hip Adduction Exercise – Performance U Style!

Since most people are already familiar with the conventional exercises for targeting the hip adductors, like standing hip adductions with a band or cable and the seated hip adduction machine, below I’m highlighting the Copenhagen hip adduction exercise.

Put simply, the Copenhagen hip adduction exercise has been shown to be a very effective movement for training hip adductors (6,7), and it’s certainly one of my favorite exercises for targeting the hip adductors.

Check out this video (filmed at Gravity & Oxygen Fitness in Boca Raton, FL) to see how I perform the Copenhagen hip adduction exercise, which is a bit different than it’s commonly done.

Also, check out these two-part versions I also like to use of the Copenhagen hip adduction exercise, which are both highlighted in this video.

0 notes

physiolibrary · 5 years ago

Text

Heel Spur

Are you experiencing intermittent or chronic pain at the base of your heel, especially while walking, jogging, or running? You might have a heel spur.

Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Risk factors for heel spurs include walking gait abnormalities, which place excessive stress on the heel bone, ligaments, and nerves near the heel, running or jogging, especially on hard surfaces, poorly fitted or badly worn shoes, especially those lacking appropriate arch support, excess weight and obesity. Research shows that shockwave therapy is very effective for treatment of heel spurs.

0 notes

physiolibrary · 5 years ago

Text

Colles’ Fracture

One of the most common forms of upper limb fracture is a Colles’ fracture. This occurs at the wrist and is very common after a fall on an outstretched hand.

At your wrist joint you have two bones from your forearm and multiple small bones in your hand. When you fall onto an outstretched hand very commonly the distal end of your radius bone is fractured.

As a result of this your wrist can look a little like a dinner fork due to the displaced bone at the wrist joint. This is the main presentation that can indicate a fracture over a mild sprain or contusion. An X-Ray is required to confirm a fracture and then whether the fracture is displaced or not. If displaced, an open reduction and internal fixation surgery is required to place the bone in the correct position to allow it to heal properly.

You are then normally placed in a cast and sling for around six weeks to allow the fracture to heal appropriately. Once past this phase, physiotherapy becomes important to regain range of motion and strength, not only at your wrist but also your elbow and shoulder.

This is due to the prolonged period of inactivity. It is very important to complete a course of rehabilitation so that you are not left with residual weakness or limitations in movement at any of these joints, especially your wrist.

0 notes

physiolibrary · 5 years ago

Text

MUSCLES & POSTURE DURING LOCKDOWN

Muscle imbalance account for 80% of the pain you will experience in your life.

Poor posture is a telltale sign of muscle imbalances.

Muscle imbalances are caused by overusing certain muscles and underusing others.

Muscles that are too long usually feel much tighter than muscles that are too short. Until you can identify the muscles as too short and tight or too long and tight, you will not know what pose to select to correct the imbalance.

Muscle imbalances can either be developed or exacerbated by doing the wrong yoga pose, Pilates, or strength training exercise for your current musculoskeletal condition.

In general, muscles on the backside of the body are too long, except for the calves. Muscles on the front side of the body are too short.

Stretching muscles that are already too long is a common mistake in yoga, gym and other fitness classes.

There are five major muscle imbalances you need to identify.

Right exercise regimen or right yoga can correct these muscle imbalances in a relatively short time once you learn how to choose correct exercises or poses for your symptoms.

Correcting muscle imbalances will give you better posture, more energy and reduce or eliminate many painful conditions.

0 notes

physiolibrary · 5 years ago

Text

Disc prolapses

“Bending based back pain?”

Lower back pain is the leading cause of lost work productivity each year in Western society. Over a lifetime the incidence of lower back pain is estimated at well over 50%, with a yearly incidence estimated at around 5%. Of new presenting patients to medical professionals, around 15% are reported to be for lower back pain. The intervertebral disc is reported to be a more frequent cause of lower back pain that muscular of ligamentous strain/sprain.

In your lumbar spine there are five intervertebral discs. These function as a load bearer during functional activities and interestingly provide around a third of your spines height. The central nucleus consists of 70-90% water in a healthy adult, allowing optimal function. This is surrounded by an outer sheath of annulus fibrosis, which maintains the nucleus centrally. The annulus only has a nerve supply and therefore injuries to the nucleus only do not usually cause symptoms in the population. Only when the lesion spreads to the annulus do symptoms become clear.

Increased forces are exerted through your disc during flexion based motions of your lumbar spine. This places a primarily anterior directed force to the disc as the anterior aspects of the adjacent vertebrae move closer together. Over a prolonged period, such forces can reduce the load bearing capacity of the disc and reduce the water content of the nucleus. This can result in the nucleus buckling under the load which it can no longer tolerate and push into or completely through the annulus fibrosis into the spinal space.

The vast majority of disc prolapses will be in a posterior direction, due to the mechanism stated above. In this case, the bulge can place to one side or both if large enough, and irritate nerve endings where they exit the spinal cord at the foramina of corresponding vertebrae bilaterally. This irritation causes common symptoms related to lower back pain; lower limb paraesthesia. In a large disc prolapse, the bulge can irritate both nerve endings at a single level causing these symptoms down both lower limbs. Alongside bowel & bladder, saddle anaesthesia and sexual dysfunction, these are red flag symptoms which require immediate examination by a doctor and likely MRI/CT scan.

Primary symptoms therefore for this condition include flexion based symptoms, lower limb paraesthesia and pain with prolonged sitting. Standing will usually be more comfortable than sitting. A medical practitioner will examine you for these symptoms via a neural examination and range of motion tests. Initial treatment for an acute disc prolapse will consist of rest, avoidance of aggravating factors and exercises that promote placing the disc back into its original position. In severe cases where conservative therapy is not enough to improve a person’s symptoms, surgery can be indicated to remove a herniated part of a disc of to replace a severely damaged disc.

Prognosis for small to moderate disc bulges is generally good, taking 6-8 weeks for a full recovery. Beyond this point, rehabilitation exercises to strengthen your core are crucial to prevent reoccurrence of the same injury. Severe disc bulges can in rare cases cause chronic debilitation and in rarer cases still are a medical emergency if the spinal cord is compressed. If you think these symptoms are similar to what you are experiencing, it is important to be examined by a medical practitioner immediately.

0 notes

physiolibrary · 5 years ago

Text

Dupuytren’s Contracture

Have you noticed 1 or more of your fingers have become bent and you are unable to straighten it? You may have a Dupuytren contracture.

A nodule may have developed over the past months or years, and is now causing your finger to bend. If it is now affecting daily life when gripping or trying to use your hand, a physiotherapist can help to maintain range of motion, strength and function of your hand.

Dupuytren contracture typically progresses over the course months or years. This condition most commonly begins with thickening of the skin on the palm, resulting in a puckering or dimpled appearance. As the condition progresses, bands of fibrotic tissue form in the palmar area and may travel toward the fingers. This tightening and shortening eventually leads to the affected fingers being pulled into flexion.

The main treatment for this is by injection or surgical intervention. Physiotherapy is important post intervention in the form of splinting, exercises, oedema and scar interventions to maintain the range of motion that was obtained through the injection or surgical removal of the fibrotic tissue. Functional range of motion of the fingers is imperative to many activities of daily living, making its preservation key.

0 notes

physiolibrary · 5 years ago

Text

Is Your Pain Caused By Stress, Anxiety Or Worry?

Were you taught that pain is just a symptom of damage to some part of your body? Most people were and it certainly can be the case in the early stages of injury, like when we sprain an ankle. But what about pain that carries on longer than we expect and doesn’t get any easier, perhaps even sometimes getting worse as time goes on?

Do you find that your pain can get worse:

After long stressful days?

When you’re sleeping less?

If you’re anxious or worried?

Even when you’re doing less?

Pain Is Weird

It doesn’t really make sense how pain can start in your lower back, move into your hip, travel a bit down your leg and then also give you a headache? Or a feeling your arm or shoulder just feels a bit out of sync? Or your pain increases for no real reason when you’d been doing pretty well this previous week?

So, yes, that makes no sense at all if pain is just about damage. But remember that is not how pain works. We now know that pain is poorly related to damage to a specific structure in your body.

Pain Is Protective

Imagine if we didn’t feel any pain? We’d all be burning hands and breaking all sorts of bones! Pain is protective, a bit like an alarm system. So, like that sprained ankle, pain tells us it’s sore - so we limp around a bit for a few days to protect the ankle. And over time that pain eases off and we return to walking normally again.

But what if our alarm system gets a bit too over protective? Like the annoying car alarm that goes off for no reason at 5am in the morning? Or the super sensitive fire alarm that starts beeping at full volume when it senses a bit of smoke? No cars are being stolen, no buildings are burning but ultimately those alarms are designed to protect. Our body’s own alarm system can get over protective as well.

Pain Is A Recipe Of Many Ingredients

So when pain hangs around longer than usual, it becomes less about physical damage and more about other things. With persistent pain, our body is getting better at producing pain and our body reacts more easily, much like those over sensitive alarm systems.

So what in your life can make you more sensitive? We need to consider things like stress, poor sleep, avoiding meaningful activities, fearing the worst, negative beliefs about pain, emotional health... almost everything really.

This video is a nice quick (less than the 5 minutes!) visual way of explaining this.

Pain Is Changeable

Start by thinking of your body as a cup. If your cup gets full of all the things going on in your life, and then starts to overflow, that’s when you can start becoming more sensitive to pain and your alarm system is easily set off.

You can either decrease the effect of those things in your cup or build up your capacity to tolerate those stressors by making your cup bigger. Or ideally do both. And the good news is we have a lot of possibilities to help with your pain and your sensitivity; it is rarely about one specific thing that has to be “fixed”.

And understanding that pain is not always equal to damage helps us tolerate and adapt.

How Your Chartered Physiotherapist Can Help Your Pain

Build a bigger cup - we can guide you about the best way to get moving and finding the right balance of activity for you. Usually it’s best to begin by just poking into some mild discomfort with some gentle movements for a few minutes a day and then gradually building up into doing things that are meaningful to you.

Look at the contents of your cup - we can talk through all the things in your life and come up with ways to help manage and reduce them. We will know when you may benefit from the support of other health professionals too.

Pain doesn’t mean you have to stop doing all the things in your life. Remember pain means your alarm system is overactive; it’s not so much about any damage, more about the need for protection. But the issue is our body can overdo the protection. You don’t need “fixing” before you can start moving and doing!

What we work on doing to keep you healthy and pain free is to treat the conditions that make you more sensitive. You can’t actually change things like that arthritis or degenerative changes but you can change the things in your life that sensitise them. If you remember one thing from reading this, remember “pain is more about sensitivity than damage”.

What would you be doing if your pain was less of a problem for you?

References

Specific gratitude to Dr Greg Lehman for his work in the field. Particular references referred to throughout are:

Lehman, G. (2017). ‘Tissue changes and pain: explaining their relevance’, The New Yorker, 6 March. Available at: http://www.greglehman.ca/blog/2017/3/6/tissue-changes-and-pain-explaining-their-relevance (Accessed: 23 April 2020).

Lehman, G. (2017). Recovery Strategies - pain guidebook.

http://www.greglehman.ca/pain-science-workbooks (Accessed: 23 April 2020).

0 notes

physiolibrary · 5 years ago

Text

10 Tips To Help You Run Faster

Chasing down the clock on race day is the ultimate motivation for many runners. Every runner aspires to shatter their personal best and be able to effortlessly run faster and harder for longer.

So many of us get caught up each day with various stresses such as work, family, team commitments etc., and we often feel that there aren't enough hours in the week for us to train. Or, even when we do train, we feel lethargic, exhausted and even unmotivated.

Ultimately we struggle to find time to adequately prepare ourselves to achieve our performance goals. However, what if you could train smarter, not harder, and still achieve or maybe even surpass your performance goals? Here are 10 top tips that you can implement in your training to help you maximise your potential and achieve faster finishing times.

Run More Often

This might sound fairly obvious, but running more frequently will help you increase your speed and endurance capacity over time. To monitor this, you should devise a training plan and set an achievable weekly mileage goal.

Structure is key to long term success and adherence; we are creatures of habit after all. So, start with a weekly goal around your current training level, and then increase it progressively as your body adapts and the training load gradually feels less stressful. This will ultimately leave you able to run harder for longer.

Run For The Hills And Improve Your Acceleration

Hill training helps to improve your running economy and efficiency, which will translate into faster running. Hill repeats are a great way to help you move up the gears and develop lightning acceleration. You should only incorporate hill training into your running program once you've built a strong endurance base.

All you need to do is find a hill with a moderate incline that's roughly 100–200 meters long. Run up the hill at a hard effort, ensuring the effort is consistent and without letting your running form fall apart. Turn around and recover by walking or jogging down the hill at a steady pace.

You can repeat this for reps and sets and you can perform and progress on a weekly basis.

Train For Speed

If you don’t run fast, you won’t get faster. Tempo runs, interval runs and fartlek runs are all common variations to traditional steady state running sessions that can be used to develop speed and endurance qualities.

Tempo runs (long intervals) help you develop your anaerobic threshold, which is critical for running faster.

Short interval runs help you to get comfortable shifting your pace and maintaining a faster speed.

Fartleks or speed play are simple quick bursts of speed that vary in distance (unstructured intervals). These speed "pick-ups" are great preparation for mentally being able to handle a pace that is not comfortable for longer periods of time.

Fine Tune Your Running Mechanics

Proper running form can shave valuable seconds or even minutes off your pace or finish time at races. The key to efficient running at any speed is to practice proper technique.

This means keeping your upper body tall yet relaxed, striking the ground with your mid-foot landing under your hip, and swinging your arms forward and back at low 90-degree angles.

Running mechanics drills like high knees, bum kicks, A-skips, B-skips, bounding, straight leg bounding, ankling and cariocas can usually be performed after a warm-up, but before the bulk of the training session roughly twice weekly.

Get Stronger And Build Resilience

Strength training is an often overlooked yet crucial component of any runner’s training preparations and only needs to be performed twice weekly.

Having a strong core, strong glutes, mobile joints and overall body strength will improve your overall athleticism and lead to faster running.

Core strengthening exercises such as crunches, reverse crunches, V-ups, Pallof presses and planks will help you improve your form and posture, which will assist in opening up your lungs for more efficient breathing and faster running.

Moreover, your glutes drive your stride and maintain the power required for speed. So by performing exercises like squats, step ups, bridges, single leg Romainian deadlifts and side lying hip abduction, we can target our glutes and work on making them stronger. This will result in reduced risk of injuries, and you should feel more efficient and powerful when running.

Put A Spring In Your Step

Add plyometric exercises such as squat jumps, broad jumps and pogo jumps (with a skipping rope) into your training - this is a sure fire way to light up your fast twitch muscle fibres responsible for fast and explosive movements.

Exercises like these enhance our bodies ability to store and release elastic energy (we act like a spring), allowing for shorter ground contact times, longer strides and reduced bobbing up and down. This correlates to less energy leakages and allows for more efficient movement and energy expenditure, which will ultimately lead to faster finish times.

Eat, Sleep, Run, Repeat

Don't be under the illusion that running hard every day will make you faster. Rest is critical to your recovery and injury prevention efforts. Our bodies rebuild and repair themselves during these rest days, and it’s essential that runners sufficiently fuel their body on these days (and every other day) to optimise their performance.

Good nutritional habits, such as ensuring adequate protein intake for muscle recovery, carbohydrate intake to fuel workouts, fat intake for joint health and water intake to prevent dehydration, will allow runners to reap the rewards from their training.

Sleep is also a crucial long term recovery strategy, as when we sleep a lot of important things are happening to aid in the recovery process. Studies have even shown that runners who get more shut eye (between 8-10 hours) have quicker reaction times, stronger immune systems and faster finish times.

Cross Train For Performance Gain

Cross training is a powerful tool in your training toolbox and if used wisely, can dramatically improve your running speed and endurance. Runners can strategically cross-train as supplemental exercise on top of their normal workload to boost their fitness level or use it as an active recovery tool to speed up the healing process.

Activities such as pool running or cycling, are as specific to running as you can get without actually running and they’re also impact free (meaning injury rates are drastically lower).

Stretching

Studies have shown that stretching prior to running does not prevent injury or improve performance. Although, warm up activities do prevent injury and improve performance, so time is best spent warming up the muscles rather than stretching before activity.

Stretching before activity actually decreases power, force output, jump performance, and speed. Whilst dynamic warm up activities, utilising the muscles you want to challenge in your work out or competition, will improve your performance.

Try to stretch after your workouts or on your rest and recovery days to improve flexibility and reduce your risk of injury.

Watch Your Step

Lightweight or minimalist running shoes that have greater cushioning, greater longitudinal stiffness and greater comfort were associated with improved running economy. It’s also recommended to replace your running shoes every 300-500 training miles, as they lose their ability to shock absorb which can lead to impaired running mechanics, slower finish times and, worse again, injury!

So there you have it, 10 top tips to guide you on your way to running faster. My advice is to implement each tip one at a time into your training plan, to avoid any risk of injury and overtraining.

Be mindful that it’s also easy to be overwhelmed when initially trying to implement numerous things at once. So take it one step at a time (excuse the pun) and gradually add these into your weekly routine. This will ensure greater longer term adherence, enhanced quality of training and ultimately faster finish times.

Resources

https://runnersconnect.net/how-long-before-you-have-to-change-running-shoes/

https://strengthrunning.com/2013/07/cross-train-for-speed-health-recovery/

https://trailrunnermag.com/training/trail-tips/increasing-your-mileage.html

https://www.verywellfit.com/how-to-run-faster-and-improve-race-times-2911291#citation-2

https://www.active.com/fitness/articles/why-all-endurance-athletes-should-strength-train

https://www.runnersworld.com/training/a20630818/hill-running-workouts-for-speed/

https://therunexperience.com/how-to-run-faster/

https://strengthrunning.com/2015/09/running-drills-to-improve-speed-form-efficiency/

https://www.runnersworld.com/training/a20845443/improving-speed-and-endurance/

https://therunexperience.com/how-to-run-faster/

https://greatist.com/fitness/25-ways-run-faster-now

https://www.runnersworld.com/health-injuries/a20790822/should-i-stretch-before-my-runs/

0 notes

physiolibrary · 5 years ago

Text

8 Ways To Improve Your Golf Swing And Reduce Your Handicap

Have you recently started playing golf? Are you an experienced player tired of taking longer than your golf friends to get around the course? Everyone is competitive, it’s in our nature. No matter what task is at hand, we always strive to do our best. It’s no different when it comes to playing golf.

So, maybe it is time to take action into your own hands and improve your golf handicap. Not only will you feel more confident on the course, with better results when you get to the clubhouse, improving your game will give your physical health and wellbeing a boost too.

1. Warm Up

Studies have shown up to 62.5% of golfers never perform a warm-up routine prior to their golf practice, despite the positive physiological and performance benefits associated with implementing this into their pregame routine. Such benefits include: reduced risk of injury, improved muscle strength and power, improved rate of force development and reaction time, improved coordination. Moreover, each of the movements performed in the warm up should be dynamic. Dynamic movements have greater performance benefits than static stretching which has been shown to reduce muscle power output prior to exercise. The ‘RAMP’ approach has shown performance enhancement qualities and is as follows:

Raise – body temperature, heart rate, respiration rate, blood flow and joint fluid viscosity

Activate – key muscle groups

Mobilise – key joints and range of motion specific to the sport

Potentiate – high intensity dynamic exercis-es to mimic performance

2. Mobility - Motion Is Lotion

Golfers require adequate flexibility for a long flowing swing. The main areas a golfer requires mobility are their hips, shoulders and middle part of their back (thoracic spine). Good flexibility through all of these joints allows the body to rotate further on the axis that the club travels around. Greater rotation means a longer arc for the club to follow through which has numerous performance benefits including hitting the ball further and potentially adopting a better swing rhythm.

Shoulders

Some golfers may be unable to lift one/or both arms up high enough above their head, these asymmetries can affect both their backswing and follow through. These restrictions may be a result of muscular tightness (pectorals, lats, posterior rotator cuff), joint tightness (glenohumeral joint capsule) or even a lack of strength in key muscle groups (scapular retractors, rotator cuff muscles, serratus anterior).

Thoracic Spine

Many golfers lack flexibility through their thoracic spine. As we get older we tend to stiffen up in this area. Without sufficient rotation in the thoracic spine the entire swing relies on only hip and shoulder movement, Consequently reducing the arc size the club head has to work within. Reduced mobility may also increase shearing forces on the lumbar spine which may lead to different movement patterns, muscular imbalances and potentially pain further down the line.

Hips

The hip joints are a major contributor to rotating the body in a golf swing. Particularly the front of the hip as it has to turn inwards during the follow through of a golf swing. It can be very difficult to improve internal rotation mobility for some individuals as hip joint architecture or bony abnormalities can restrict movement in this direction. However many golfers just have tight hip joint muscles (hip flexors, glutes), joint capsules or ligaments restricting their movement.

3. Strength - Build Strength And Resiliency

Resistance training should be performed a minimum of twice a week in order to improve strength or power. The main areas that we need to look at strengthening for golfers are the upper leg muscles and core musculature.

Even though a lot of the swinging happens with the arms, most of the power generated in a golf swing actually comes from the hips and core. Imagine in the backswing that the body is being wound up like a rubber band. The unwinding should start at the hips and pelvis then culminate in the arms and hands generating clubhead speed.

Hip Strengthening

Strong hip muscles benefit golfers in two ways. One is the generation of power, the other is surviving the 5-6 km roundtrip on the course .There are a bunch of small muscles that surround the hip providing stability and support, but we are more interested in the bigger ones known as the glutes. They serve 2 major functions, that is to rotate the hip which is very useful for a powerful golf swing, and the other is to pull the leg through when walking or running (propulsion).

Core Strengthening

Core muscles is a fairly broad term that applies to most of the muscles in the abdomen and spine region. We don’t need rock hard abs to have a good golf swing. However, what we do need is good back extensors and obliques strength endurance. The back extensors help maintain a good posture during stance and throughout the swing. Whereas, the main function of the obliques involves rotating the thorax which is crucial for generating a powerful golf swing.

If you can build up strength in these muscle groups you will be less likely to develop fatigue in your swing towards the end of a round and will comfortably hit the fairway from start to finish.

4. Technique - Practice Your Swing!

Pretty straightforward but golfers must practice their golf swing and form to achieve a better swing and ultimately reduce their handicap. Practice makes perfect after all, it’s just the law of specificity.

The golf swing is an art that involves multiple moving segments (your arms, legs and the golf club) around one stable link (your core). A breakdown in any one of those segments can ruin your day and even your season.

Additionally, swinging a golf club requires moving at a very high speed in a short amount of time, increasing the risk of injury. So going to the driving range, practising your pitch and putt or even taking lessons; it’s important to get into the swing of things (excuse the pun!) sooner rather than later to reduce your handicap.

5. Aerobic Fitness - Improve Your Stamina

The average length of a golf course is just over 6km. So, with that being said, after carrying clubs over your shoulders or pulling/pushing a golf cart for that distance, some golfers might feel exhausted approaching the 18th hole. Therefore, it’s vital that golfers have an adequate baseline fitness to cover the distances required on the golf course to prevent fatigue setting in and affecting their performance.

The national guidelines for physical activity in Ireland suggests individuals should carry out a minimum of 150-300 minutes of moderate aerobic activity a week (able to hold a conversation) e.g. brisk walk, cycling or 75-150 mins of vigorous aerobic activity a week (unable to hold a conversation) e.g. fast tempo jogging, swimming for additional cardiovascular health benefits.

6. Equipment

Reduce strain by using the right equipment. Golfing gear such as your shoes, clubs and bag are meant to ease the work, not cause additional strain. Therefore reduce strain by fitting the clubs to the golfer, not the golfer to the clubs. Also here’s a few tip on how to effortlessly move around the course to reduce the likelihood of developing golf related aches and pains:

Always carry your golf bag over both shoulders and walk upright. If you have a one-strap system, alternate sides often

Push rather than pull wheeled golf carts

Hold your clubs clubs with a loose, comfortable grip to reduce straining your hands and forearms

When standing for long periods, stand tall, not slouched and occasionally shift your weight from one foot to the other, or rest one foot on your golf bag or cart.

7. Sleep Supplementation

Does dreaming about playing golf make you a better player? Not necessarily, however our ability to perform on the golf course is directly impacted by the quality of your sleep. In fact, poor quality or lack of sleep directly impacts your fitness both physically and mentally which is detrimental to your performance.

Golfers need quality sleep for their body to repair and recover from exercise and especially from playing a round of golf. It’s also required to enable golfer’s to think well and use the mental skills they’ve developed to full effect on the golf course. Research suggests anywhere between 8-10 hours of shut-eye is the desired amount of rest golfers should aim to achieve every night to maximise their performance capabilities.

8. Cool Down

Following your game, and before heading home it’s advised to stretch again in order to reduce the severity of subsequent muscular aches and pain known as DOMS (delayed onset muscle soreness), as well as to work on any flexibility issues you may individually have.

To cool-down it is better to use static stretches, rather than the dynamic stretches performed in the warm up. All you have to do is slowly take your muscles to the end of their range of motion and hold it there for 20-30 seconds. You should feel slight resistance in the muscle as you stretch it, but you should never feel pain during a stretch.

An adequate warm-up and cool-down routine for golf can mean the difference between a good game and a great game, so next time you are heading out to the green don’t forget to factor in enough extra time for you to both prepare and cool-down your body; your muscles, joints and score card will thank you for it in the long run!

So there you have it, 8 sure fire ways to improve your golf swing and reduce your handicap. Be sure to try and implement these suggestions into your schedule and practise them consistently. Before you know it you’ll be walking down the fairway in Augusta with your green jacket on!

It’s important that if, on your way to success, you become aware or concerned regarding any aches or pains to contact your local Chartered Physiotherapist and book an assessment in order to prevent any long-term issues developing that may affect your performance down the line.

Resources

https://www.physiotherapyinleeds.co.uk/articles/tips-for-enjoying-golf#

https://physiocanhelp.ca/blog/fit-to-a-tee/

https://sportandspinalphysio.com.au/4-simple-strength-exercises-for-golfers/

https://sportandspinalphysio.com.au/how-to-improve-your-golf-swing-without-hitting-a-ball/

https://www.golfpsych.com/golf-fitness-and-sleep/

https://blogs.bmj.com/bjsm/2016/08/12/physiotherapy-and-treating-golfers-practical-tips-and-experience-based-principles/

https://www.hss.edu/playbook/fitness-friday-proper-golf-swing-mechanics-to-avoid-injury/

0 notes

physiolibrary · 5 years ago

Text

Managing Acute Soft Tissue Injuries With PEACE & LOVE

The rehabilitation of soft tissue injuries can be complex, to say the least. Over the years there has been much debate in determining best practice in the acute management of soft tissue injuries.

Many people will be familiar with various acronyms or protocols they may have encountered over the years such as “PRICE - Protection, Rest, Ice, Compression, Elevation”, the outdated and all too often go-to advice or treatment after “pulling your hamstring” or “going over on your ankle”. This is a passive approach focused on unloading the affected area and avoiding movement to prevent further subsequent damage.

Another one you might recognise is “POLICE - Protection, Optimal Loading, Ice, Compression, Elevation”, an updated and more proactive approach, whereby rest is replaced with a balanced and incremental rehabilitation programme with the premise that early activity accelerates tissue healing and promotes early recovery.

It’s clear that there’s still much debate and conflicting views regarding clinical best practice. This more often than not leads to confusion amongst patients and clinicians alike, when deciding which protocol to implement for the desired treatment outcomes. Moreover, it’s important to note that both protocols alluded to above have one common flaw, they’re solely focused on acute management.

Unfortunately, both fail to recognise the subacute and chronic stages of tissue healing. Nonetheless, recent researchers have developed a more contemporary acronym that encompasses the entire rehabilitation continuum from immediate care (PEACE) to subsequent management (LOVE). This protocol also assumes a more holistic strategy which outlines the importance of educating patients and addressing a variety of factors during treatment to enhance recovery. So what exactly is PEACE & LOVE?

“Immediately after injury, do no harm and let peace guide your approach”

Protect

Avoid any aggravating activities/movements and deload the affected area for 1–3 days to minimise bleeding, reduce swelling and mitigate the risk of aggravating the injury.

However it’s advised to keep rest to a minimum, as prolonged rest can compromise tissue strength and quality. Pain should be used to guide the cessation of the protection phase.

Elevate

Elevate the limb higher than the level of the heart to promote fluid to flow out of tissues and reduce swelling.

Avoid Anti-Inflammatory Modalities

The various phases of inflammation actually help repair damaged soft tissues. Thus, inhibiting inflammation using medications may negatively affect long-term tissue healing, especially when higher dosages are used. Therefore, the use of anti-inflammatory medications should be avoided.

Surprisingly, cryotherapy (ice therapy), even if used mostly as an analgesic, should be avoided. This is because ice could potentially disrupt the inflammatory process, impair tissue repair and promote premature scar tissue formation.

Compression

External mechanical pressure using taping or bandages helps limit intra-articular oedema and tissue haemorrhage (reduces swelling and bleeding).

Educate

Patients should be educated on the benefits of an active approach to recovery and establish realistic expectations about recovery timeframes instead of chasing the ‘magic cure’ approach. Passive modalities, such as electrotherapy, manual therapy or acupuncture, early after injury have insignificant effects on pain and function compared with an active approach and may even be counterproductive in the long term.

“After the first days have passed, soft tissues need love”

Load

An active approach with movement and exercise benefits most patients with musculoskeletal disorders. Mechanical stress should be added early and normal activities resumed as soon as symptoms allow.

Optimal loading without exacerbating pain promotes repair, remodelling and builds tissue tolerance and the capacity of tendons, muscles and ligaments through a process known as mechanotransduction.

Optimism

Optimistic patient beliefs and expectations are associated with better treatment outcomes and prognosis. Psychological factors such as catastrophization, depression and fear can represent barriers to recovery.

Vascularisation

Pain-free aerobic exercise should be started a few days after injury to boost motivation and increase blood flow to the injured structures. Early mobilisation and aerobic exercise improve physical function, supporting return to work and reduce the need for pain medication in individuals with musculoskeletal conditions

Exercise

Exercises help to restore mobility, strength and proprioception early after injury and reduces the risk of re-injury. Pain should be avoided to ensure optimal repair during the subacute phase of recovery, and should be used as a guide for exercise progressions.

From what has been highlighted in this blog, it’s safe to conclude that the management of soft-tissue injuries involves more than just short-term damage control as once prioritised by the ‘PRICE’ and ‘POLICE’ protocols. However, treatment paradigms must be continually updated based on contemporary research evidence. Therefore, whilst anti-inflammatory modalities (Medications/Ice) show benefits on pain and function, the innovative ‘PEACE & LOVE’ acronym flags their potential harmful effects on optimal tissue repair.

Consequently, clinicians and patients alike should seek to achieve more favourable long-term outcomes by incorporating this holistic and novel approach to treatment. This all encompassing approach to the management of soft tissue injuries focuses on treating the person at hand, not just the injury.

For that reason, in future practice whether it be dealing with an acute ankle sprain or a hamstring strain it’s helpful to encourage PEACE, because all that soft-tissue injuries require is some LOVE.

Resources

Dubois, B. and Esculier, J., 2019. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine, 54(2), pp.72-73.

Bleakley, C., Glasgow, P. and MacAuley, D., 2011. PRICE needs updating, should we call the POLICE?. British Journal of Sports Medicine, 46(4), pp.220-221.

0 notes

physiolibrary · 5 years ago

Text

Is Foam Rolling Worth The Pain?

Myofascial release focuses on reducing and easing the tension in trigger points located in muscle. Foam rolling is a myofascial release technique you can do yourself, which can help relieve muscle tightness, soreness and improve range of motion.

Foam rolling is also believed to enhance recovery post-exercise and enhance performance during exercise. The results are similar to getting a massage, however foam rolling is now a common practice to achieve something similar at home. With foam rolling you use your bodyweight to apply pressure to the soft tissues during the rolling motion.

Foam rolling is a type of deep tissue massage where someone is trying to work out knots in tight or sore muscles, so you will experience discomfort or pain. It should be uncomfortable and sometimes it can be painful but not unbearable, and when you are done it should feel better. But does the evidence behind foam rolling indicate that it is worth the pain?

What Do The Research Papers Say?

Research studies on foam rolling are still quite limited, however research is continuing. See what the current research says below.

Does foam rolling improve range of motion? Foam rolling may offer short-term benefits in increasing hip, knee and ankle range of motion without affecting muscle performance. This suggests that using a foam roller may be beneficial to improve joint flexibility as a pre-exercise warm up and cool down due to it’s short term benefits.

Does foam rolling enhance post exercise recovery and reduce delayed onset muscle soreness? Research suggests foam rolling does reduce muscle pain when completed following an intense bout of exercise. Foam rolling increases blood flow to the muscles, which supplies muscles with more oxygen, helping recovery and reducing delayed onset muscle soreness.

Does foam rolling before exercise affect muscle performance? Foam rolling does not improve muscle performance during exercise. However it does not have a negative effect on muscle performance. This means that there is nothing contradicting the use of a foam roller.

So Is Foam Rolling Worth The Pain?

The answer to this is that it is completely your decision. Foam rolling may give you short-term benefits of improved muscle flexibility before exercise, which may help reduce your chance of injury when it is included in a good warm up technique. Foam rolling may also reduce muscle pain when completed after exercise, however it should be used after every exercise routine to see continued benefits. Research on the benefits of foam rolling is continuing and right now a concrete answer cannot be provided.

So if you like it, keep doing it. If you haven’t tried it, it may well be worth seeing if it’s for you.

0 notes

physiolibrary · 5 years ago

Text

Copenhagen Hip Adduction Exercise: The Science and Unique Variations

It’s common for personal trainers, strength coaches, athletes and exercises enthusiasts alike to regularly use exercises that focus on training the hip abductors (i.e., the glutes), like lateral band walks (with a mini-band around their knees and/or ankles). However, I find it’s a lot less common to see them doing exercises that are targeted at training the hip adductors.

In this post I’m providing you a brief overview of the scientific evidence that explains why I regularly include hip adductor exercises into comprehensive fitness and conditioning programs, and I’m also showing you a few ways that I perform the Copenhagen Hip Adduction exercise, which is one of my top hip adduction exercises.

Why Use Hip Adductor Exercises?

What Are The Most Effective Hip Adductor Exercises?

How To Do the Copenhagen Hip Adduction Exercise – Performance U Style!

Check out this video (filmed at Gravity & Oxygen Fitness in Boca Raton, FL) to see how I perform the Copenhagen hip adduction exercise, which is a bit different than it’s commonly done.

youtube

Also, check out these two-part versions I also like to use of the Copenhagen hip adduction exercise, which are both highlighted in this video.

youtube

0 notes

physiolibrary · 5 years ago

Text

Burpees Aren’t a Bad Exercise! The Practical & Scientific Reasons Why

Many personal trainers and strength coaches argue that the Burpees exercise is bad or inherently dangerous. I’m not one of them.

In this post I’m sharing how I perform the burpee exercise differently than it’s traditionally done, and also explain my rationale for doing so while addressing some of the common concerns I’ve heard about the burpees exercise from other trainers and coaches.

Plus, below the video I provide some cool research findings on the burpees exercises, and also show why the debates trainers and coaches get into about things like burpees aren’t nearly as trivial as they may seem. This is because these debates aren’t actually about the burpee exercise, but about something much deeper and more important.

Burpees Exercise: A Better Way to Do Them, Why They’re Not Bad

Watch this video below to:

See how to perform what I call “Gorilla Buprees”

Learn a unique a challenging advanced variation to Gorilla Burpees

Understand my rationale for using the (Gorilla) Burpees exercise

Hear my direct responses to some of the common concerns and criticisms about the burpees exercise

youtube

How to Do Gorilla Buprees

As you see in the video above, I don’t perform the Burpees exercise in the traditional manner. Instead I do what I call Gorilla Buprees, which are an exercise I’ve included in all three of my books: Building Muscle and Performance, Strength Training for Fat Loss and (my newest book) Your Workout PERFECTED.

To give you more detail on how and why to perform the Gorilla Burpees exercise, here’s the section on them from my book, Your Workout PERFECTED:

Setup

With your feet slightly farther than shoulder-width apart, hold your arms straight in front of your body (see figure a).

Action and Coaching Tips

Bend your knees and hinge forward at your hips so that your torso leans forward. Place your hands on the ground, with your wrists directly below your shoulders (see figure b), and jump backward to move into a push-up position (see figure c). Make sure that your body forms a straight line and that you do not allow your hips to sag toward the floor in the push-up position. Jump back up so your feet are outside your hands (see figure d), then return to a tall standing position to complete the rep (see figure e).

WHY IT’S BETTER

You start with your feet slightly farther than shoulder-width apart, instead of the way the burpee is commonly done, which has them closer together. Then, in this version, you’re lowering and raising your torso by mainly bending and extending from your knees and your hips, which places more emphasis on the lower body. Burpees are commonly performed by bending over mostly from your lower back and placing your hands on the floor in front of your feet, involving less contribution from the lower body and placing more stress on the lower back.

Benefits

More involvement from the lower body

Less unwanted stress on the lower body

Science on the Burpees Exercise

A 2014 study published in the Journal of Strength & Conditioning Research did a comparison of responses to sprint interval cycling and the burpees exercise. The study was done on U.S. Army Reserve members who had at least 1 year of preplanned, supervised exercise a minimum of 3 days per week for a duration of approximately 1 hour per before the start of the study,

The sprint interval cycling group did “all-out” bursts against resistance for 30 seconds. And, during the 4-minute active recovery period after each sprint, participants cycled against no resistance. The burpee exercise group performed as many burpees as possible for 30 seconds, followed by 4 minutes of active recovery involving stepping in place at a self-selected pace. Both groups repeated this cycle 3 times for a total of 4 sets.

The results of this study suggest that “the cardiovascular strain elicited by a single session of low-volume, high-intensity intermittent burpees may be sufficient to confer cardiorespiratory and metabolic adaptations equivalent to those reported in studies using sprint interval cycling.“ (1)

Another important finding of this study was that participant perceptions of exertion were significantly different. Although the self reports ranged from “hard” to “very hard,” and the reported rating of perceived exertion during both sessions characterizes the exercise intensity as vigorous; the subjects perceived the burpees exercise to be easier. (1)

The researchers stated that this may be because sprint-interval cycling primarily involves the leg flexor and extensor muscles, whereas a greater amount of whole-body musculature is active in performing the burpees exercise. (1)

The researchers went on to state that these findings should be of specific interest to strength and conditioning professionals who want to provide athletes and other clients with a vigorous whole-body aerobic and anaerobic conditioning alternative to traditionally programmed running, cycling, or swimming. Unlike sprint interval cycling that requires specialized equipment or a running protocol that requires access to at least a minimum amount of terrain or to a treadmill, the burpees exercise is cost-free, accessible to all, and may be completed in small space. (1)

In short, this research demonstrates that not only are burpees an effective metabolic exercise that requires no special equipment and very little space to perform; it also may be a more tolerable conditioning option (which can increase adherence) based on perception of fatigue over other traditional conditioning options such a bike sprints.

What Exercise Debates Are Really About

Put simply, it’s a myth that the debates about the efficacy of exercises like crunches, hip thrusts and burpees are actually about the particular exercise in question.

Many trainers and coaches will say it’s very important that one be able to justify what they’re doing in their training. This is because they know that what separates good trainers and coaches from those who don’t know any better goes beyond the use of any particular exercise. It’s about how well one can justify the use of a given exercise in they way they’re utilizing it. Therefore, they feel it’s very worthwhile to discuss the reasons why one is using a particular exercise in the way they are because, if one is presenting bad reasons as justification for what they’re doing, those reasons can be discussed and modified for the better.

Well, that’s exactly what’s going on with debates about crunches, hip thrusts, and burpees. It’s far less about the use of the exercise in question, and far more about how good or bad the justifications are that people are providing for the claims they’ve made about a given exercise. Yet, many of the same trainers and coaches who proudly say how important it is that one be able to properly justify what they’re saying and doing in their programming, will turn around and label such debates as being about nothing more than a trivial exercise. And, therefore they’re quick to write off such debates as being petty and unimportant. That’s the very definition of a logical contradiction.

In short, these debates are not about what you think about a give exercise such as burpees, but rather about how you think in general. More specifically, the reliability and validity of how you think. And, how you think is crucial because if someone is presenting poorly reasoned, logically flawed arguments in attempt to support their own positions on something like burpees, it reveals a deeper reality about the (sloppy) thinking processes they use that drive their training decisions. It also shows they’re less able to identify poorly reasoned arguments and unjustified claims when they’re made by others who struggle with critical thinking.

You see, it’s not simply whether someone can explain their perspectives that drive their decisions on exercise programming; it’s whether or not the explanations they’re providing are valid and reliable. We tend to want to focus on the conclusions people hold about a given topic when we should be focusing on the thinking processes they used to reach the conclusion they’ve come to. This is because claims and beliefs are only as good as the evidence and rationale that’s given to support them. Hence, why not all (conflicting) information/opinions are equally valid.

0 notes