2014 ‘Injury of the year’

Yep I’m calling it… a little early maybe but it’s hard to imagine anything knocking this injury out of its top spot. Lachie  is one of those people that always manages to outdo himself when it comes to injury. It’s never simple or straight forward, and this one was no different. I wasn’t there to witness the actual injury but the photos speak for themselves…. it really is the most unbelievable injury I have EVER seen so much so that it even had high profile sports surgeons running for the hills. (if you don’t like gory stuff I suggest you don’t look at the photo).lachie

We see a whole range of acute knee injuries that require surgery. Usually people tear one, maybe 2 ligaments or injure the cartilage in the knee. Not this guy though, he actually managed to tear the big 4. Yep that’s all 4 major ligaments that are basically responsible for holding the knee together.  ACL… gone. PCL… rutured… MCL.. split… LCL…torn.

Take a moment to process that. I didn’t believe it until I had the MRI report in my hands and could read for myself.

How? well its kind of funny you asked. It was ‘rugby related’.. but not exactly on the footy field but rather in the ‘tram tracks’. Tram Tracks is a one-on-one tackling battle that continues until someone taps out. Its probably the dumbest game in the world but rugby boys seem to love it (especially after one or two beers). Must be something to do with testosterone and a little ‘healthy’ competition.

So amidst a Saturday session in the ‘tram tracks’ Lachie managed to dislocate his knee, not his kneecap his knee.

He required a full open knee reconstruction where the surgeon used two donor ligaments to pretty much design him a new knee. Usually a knee reconstruction uses a ligament created using a tendon graft from your own hamstring, however  in this case donor tissue was used because the surgeon wouldn’t have wanted to compromise the stabilitylachie 2 of the knee any further. Taking a graft weakens the hamstring tendon in the short term and potentially could slow the recovery & rehabilitation.

Lachie is now 10 weeks post surgery and I’ll admit I’m very surprised with how well he is recovering. He’s back in the gym doing a full legs program (with light weights). The focus is primarily on developing good hamstring & quadriceps control. His rehab also includes proprioceptive training and balance exercises on a wobble board.

This week he will progress to jumping and hopping to prepare him for a return to running program. His surgeon is very happy with his progress and expects him to make a good recovery.

The bit I still don’t get…. I asked Lachie the other day if he wanted to play rugby again next year, he did hesitate a little but not as much as I would have expected, before saying ‘yeah probably’. I guess it’s one of the things I love about my job, these guys go through so much just to get themselves back on the field. For many it’s a play at all costs attitude. Is that just a guy thing? Or is rugby really that good of a game? Maybe that’s why they say rugby is the game they play in heaven, because these boys literally can’t get enough.

Lachie works for Adwords Management Australia and is available for interviews upon request…. or he can just help you with website marketing & design stuff, he’s pretty good at that too!

Hope this has helped you through the Wednesday afternoon slump!

Have a great day

Em 🙂

Are you running into problems?

Iliotibial band (ITB) Friction syndrome is one of the most common causes of lateral (outside) knee pain that we see, especially in runners. It’s also probably one of the most frustrating problems both for myself and for the patient. It is largely an overuse injury due to the repetitive nature of activities such as running. It often starts out as a little ‘niggle’ however gradually worsens & worsens until it quite literally will stop you in your tracks.index

The ITB is a band of connective tissue that spans the length of the outer thigh. It originates up at the hip from another structure called the TFL (tensor fascia lata) and inserts onto the tibia just below the knee. It plays a crucial role in stabilizing the outside of the knee during activity. ITB friction occurs when the ITB gets tight & inflamed (as a result of overuse) and begins to rub over the lateral femoral condyle on the outside of the knee joint producing acute, often sharp pain in this area.

Many of my patients ask WHY? There are some factors such as pronated feel, tight calves, poor pelvic stability, anterior hip inflexibility and poor lower limb control that can increase the likelihood of developing this problem. Other extrinsic factors such as footwear & training loads also need to be addressed and considered when looking into the management of this issue.

SYMPTOMS

  • Pain felt on the outside of the knee
  • Tenderness over the outside of the knee
  • Pain generally worsens with activities such as running, particularly downhills and downstairs
  • In more severe cases there may be swelling and or crepitus (creaking) over the side of the knee
  • Pain can extend up into the thigh along the length of the ITB

Often people suffering from ITB friction may be able to run a few hundred metres before the pain will kick in. It is not advisable to try and run through this pain, you will aggravate the tendon which can then take several days to settle down.

DIAGNOSIS: A skilled physiotherapist will be able to diagnose ITB friction from your clinical history and a thorough examination. There is usually no need for further investigation unless you do not improve with appropriate management.

TREATMENT & MANAGEMENT

Physiotherapy is a vital tool to manage ITB friction syndrome. In the initial stages rest from aggravating activities will be required to allow inflammation and pain to settle.

Physiotherapy treatment should involve a variety of the following:

  • Soft tissue releases to tight structures such as the ITB, TFL, gluteus medius, lateral quadriceps and lateral hamstring. This should then be complemented with use of a foam roller at home on a daily basis
  • Addressing bio-mechanical factors such as poor pelvic stability and anterior hip inflexibility
  • Advice regarding exercise modification, footwear & training loads. Some elements within training sessions should also be looked at such as the direction of running if using a track, if you are repeatedly running the same bend you will be overloading one side more than the other which can result in overuse injuries such as this.
  • Dry needling is an awesome way of releasing tight bands of muscle. Often with this problem I find these all around the outside of the hip and down the length of the thigh.
  • Electrophysical therapy such as TENS to help with pain & inflammation.
  • Icing & use of anti-inflammatory medication

With the correct treatment most people with ITB friction syndrome will make a full recovery, however rehabilitation can be a lengthy process in those patients who have had the condition for a while. In saying that it is so important that this problem is caught early. If you get on top of ITB issues in the first 48-72 hours you will drastically reduce the amount of time off running.

Can it be prevented? There are some exercises that I would advise runners do on a regular basis in an attempt to prevent excessive tightness of structures such as the ITB. Use of a foam roller is a great form of self massage, it’s a bit of a love / hate relationship but it is extremely effective. Hip flexor stretches, general pelvic stability exercises and bilateral calf strengthening are essential in the long term management plan. Chat to your physio if you want someone to go over such exercises more thoroughly.

Have a great week!

Ems

Have you injured your meniscus?

The knee is of the most commonly injured areas in the body. Generally we see a pretty even spread between acute knee injuries sustained from a traumatic event such as during sport or from a trip or fall; on the other hand we have the overuse knee problems…. the runners that pump out a huge amount of km per week resulting to overload or inflammation of some of the structures in and around the knee.

The meniscus or menisci (we have two in each knee) and one of the internal cartilages within the knee joint that can be prone to injury both acutely and as a result of overuse.

The menisci are moon shaped cartilages that are located in the knee. They are the ‘shock absorbers’ which permit us to undertake such high intensity and high impact activities. We have one located on the inside and one on the outside of the knee.index

The signs & symptoms of a meniscal injury will vary significantly depending on the severity of the damage:

  • An inflamed or irritated meniscus will present with joint line tenderness, discomfort at end of range extension (straightening the knee) and a reproduction of pain at end of range flexion (bending). There may be a small amount of swelling present.
  • A meniscus that is torn will have swelling, joint line tenderness and potentially an inability to move the knee through full range of motion due to pain. In cases where the tear is large you may experience locking of the knee in certain positions.
  • A Baker’s cyst which is a pocket of swelling directly behind the knee may be present & can be an indication of a tear in the meniscus

A diagnosis can be made by a skilled physiotherapist based on your history & from a proper examination. There are special tests that assess the integrity of the meniscus. Further investigation, usually an MRI, may be warranted to confirm the diagnosis & make decisions regarding future management of your injury.

Management

Treatment of a meniscal injury will again depend on the severity. Being cartilage in nature these structures don’t receive a very good blood supply, making the healing process slightly slower.

An inflamed meniscus can take up to 6 weeks to settle down. A torn meniscus can be managed conservatively in some cases, however in others surgical intervention may be required. This will depend on the size & position of the tear and the degree to which it is affecting your function.

Physiotherapy treatment can include the following:

  • Soft tissue massage to tight, overactive muscles
  • Electrophysical therapy to assist with management of swelling & pain
  • Dry needling – targeted towards overactive tight muscles or to assist with management of swelling, pain & inflammation
  • Exercise prescription: stretching & strengthening exercises to target tight & weak muscles around the knee
  • Advice regarding activity modification

If surgical intervention is required your physiotherapist will prepare you for surgery and also be able to assist you with the post surgery rehabilitation.

Probably the most common question we get from clients is if and when can they go back to sport, whether it be running, soccer, netball. The time frame unfortunately isn’t that clear cut as it comes down to the severity of the injury. Generally speaking its at least 6 weeks before people get back into higher intensity exercise BUT that is very ball park. Those that end up in surgery take a little longer as many surgeons are in no rush to have you placing heavy loads through the knee.

I recently was working with a professional snowboarder who injured his knee. He ended up in surgery & its been about 9 weeks now and he is just beginning to become confident with jumping, running & high intensity exercise that puts alot of load through his knee. The good news this is just in time for him to hit the slopes for the Australian Ski Season…. that is if we actually get any snow this year!

If knee pain is holding you back from exercise or its just there irritating you throughout your day to day life I would suggest getting it checked out by your physiotherapist.

Shoulder ‘impingement’ syndrome

It’s got many names…. rotator cuff tendinitis, swimmers shoulder, throwers shoulder, subacromial impingement or subacromial bursitis. These are all smart, intelligent sounding names for pain that occurs deep in the anterolateral shoulder (anterior meaning front & lateral meaning side… so to the front and side)

Lets do a little anatomy recap: The shoulder is a ball and socket joint; likened to a golf ball on a golf tee. The humerus or upper arm bone sits against a small socket called the glenoid. It’s an inherently unstable joint which is why we are able to perform all the weird & wacky movements with our arms.

The rotator cuff are a group of 4 muscles: supraspinatus, infraspinatus, subscapularis and teres minor. Their role? to depress the head of the humerus essentially assisting the joint capsule and shoulder ligaments to hold it snug in its socket.shoulder

The supraspinatus tendon is usually the one of interest when it comes to rotator cuff ‘impingement’. It passes between the acromion and head of the humerus in the ‘subacromial space’. This space is perfectly designed for the tendon with not a hell of a lot of ‘breathing space’. So when the tendon gets inflamed, irritated and swollen a pinching occurs as this space becomes a little too narrow!

This can be an overuse injury due to repetitive or prolonged strain on the rotator cuff tendons such as with overhead activities, pulling/pushing, lifting or repetitive reaching. It can also be the result of a direct blow or fall onto the point of the shoulder forcing the head of the humerus upwards into the subacromial space creating a pinching effect on the rotator cuff tendon.

Both outcomes result in a painful arc of movement of the arm that can begin to impact on simple activities of daily living such as reaching behind for your seat belt, doing up your bra (ladies) and overhead reaching tasks.

Patients will generally report feeling a deep ache deep inside their shoulder that they can’t quite pinpoint. The severity can vary enormously from a small niggle that is quite hard to replicate with testing to those that can barely lift their shoulder above shoulder height due to pain.

A few key symptoms that indicate ‘impingement’ syndrome include the inability to sleep to the affected shoulder; associated neck stiffness as a result of compensatory movement patterns and pain on repetitive overhead movements… often people will struggle with hanging out the clothes or unpacking the dishwasher.

How is it diagnosed?

A skilled physio need only listen to your history and do a few key clinical tests to know diagnose an impingement syndrome.

Further investigation such as ultrasound or MRI can be organised to confirm this diagnosis if required.

Is physio necessary?

The short answer is yes. Why?

In both presentations of impingement whether it is an overuse problem or as the result of acute trauma physiotherapy is a pretty important management tool.

Treatment can include:

Soft tissue massage: to tight overactive muscles particularly at the back of the shoulder. The upper trapezius found at the top of the shoulder is also tight.

Advice regarding activity modification in terms of training & exercise but also avoiding day to day tasks that may be aggravating their condition.

Dry needling & acupuncture: this is a really useful way to release tight muscles whilst also encouraging blood flow to the region. Fresh blood is packed full of oxygen and essential nutrients to assist with the healing process.

Rehabilitation: once the inflammation is under control most people need to undertake a rotator cuff strengthening program to restore correct shoulder biomechanics, improve posture and prevent ongoing pain and dysfunction. Some common exercises include internal and external rotation as well as lots & lots of upper back strengthening. Think seated row, high row, and prone row! Muscly backs are incredibly attractive boys….

What happens if ‘conservative’ management fails?

DON’T panic most cases don’t get to this stage but sometimes conservative management of impingement syndromes can fail. In these circumstances there are more aggressive forms of treatment that can be explored such as cortisone injections, platelet injections and in very severe non responsive cases surgical intervention maybe required.

Impingement syndrome can be a very very debilitating problem. When it’s chronic it’s a frustrating condition to suffer but also to treat. It’s stubborn and slow. If you’re noticing a niggle don’t ignore it, the sooner you get treatment & appropriate management strategies are employed the sooner you will be back in the surf, on the tennis court or in the pool.

Stubborn hip pain? Maybe its trochanteric bursitis.

What is it? Trochanteric bursitis is one of the common causes of pain on the lateral (outside) of the hip and is the result of inflammation of the superficial (& deep in severe cases) trochanteric bursa.

In some cases inflammation of these two bursae can be accompanied by local tendonitis or inflammation of the gluteal tendons & hip rotator muscles.

What is a bursa? Bursa are small sacs or ‘cushions’ of fluid found throughout the body. They sit between tendons & bones  to allow tendons to slide without friction over bony surfaces. When these sacs get inflamed or irritated they can cause pain

Why? Trochanteric bursitis can occur as an overuse injury due repetitive friction of the gluteal tendons as they pass over the greater trochanter during activities such as running and cycling. In these castroch_bursaes there is usually biomechanical deficiencies that need addressing. It can also be of acute onset from a direct blow or fall onto the lateral side of the hip

What are the signs & symptoms?

  • Pain & swelling on the side of the hip
  • Pain may travel down the outside of the thigh
  • Pain aggravated by lying on affected side
  • Pain made worse by activities such as climbing stairs, crossing & uncrossing legs, rising from a low seated position, running & cycling.
  • Tenderness directly over the greater trochanter.

How is it diagnosed?

A skilled physiotherapist will be able to diagnose trochanteric bursitis from your clinical history & examination. Diagnosis can be confirmed via ultrasound or MRI investigation should this be required.

What can be done?

Immediate diagnosis & correct management of this condition will assist with a speedy recovery. Physiotherapy treatment can involve:

  • Soft tissue massage to tight surrounding muscles
  •  Dry needling / acupuncture to assist with pain relief & relaxation of surrounding muscle spasm
  • Advice regarding activity modification, appropriate stretching & strengthening exercises.
  • Electrotherapy such as TENS to assist with pain relief & controlling inflammation
  • Correction of underlying biomechanical insufficiencies such as weak gluteals, pelvic stability & pronated feet
  • Use of ice to control inflammation
  • Medication such as non steroidal anti-inflammatories (discuss this with your pharmacist)

In cases where the patient does not respond to the conservative management discussed above a cortisone injection may be warranted. This is done under ultrasound guidance. Your physiotherapist will discuss these options with you should they feel it necessary.

If you are struggling with hip pain and think you would benefit from an assessment with Ross or Em feel free to give us a call on 9328 3822. You do not need a referral to see our physiotherapists!

Happy Monday! 🙂

Tibialis Posterior Tendonitis

Tibialis posterior dysfunction is one of the most common overuse injuries found in the foot & ankle.

The tibialis posterior muscle originates high in the shin from the back surfaces of the tibia and fibula. It tracks down along the inside border of the tibia, passes around the inside of the ankle and terminates via two attachments in the foot.  The main insertion (and that of interest to this particular injury) is into the tuberosittib posty of the navicular.

The tibialis posterior is an extremely important stabiliser of the foot & ankle. It functions to produce inversion at the ankle and also plays a major role in maintaining and supporting the medial arch.

Tibialis posterior tendonitis occurs when there is excessive strain put upon the tendon as it inserts into the navicular.

Why?

  • As an overuse injury through years of wear and tear associated with high impact activities such as running
  • Acutely as a result of sudden increase in training volume or intensity OR the use of inappropriate footwear

Athletes with poor foot biomechanics such as flat or pronated feet, tight calves and poor pelvic stability are at more risk of developing tibialis posterior dysfunction.

Signs & Symptoms:

  • Pain: felt along the inside of the foot
  • In acute cases there can be visible swelling on inside of the foot
  • Pain aggravated by high impact activities such as running & jumping
  • Crepitus may be felt along the length of the tendon.

A thorough physical examination by a physiotherapist will usually be sufficient to diagnose tibialis posterior tendonitis. In cases where diagnosis is in doubt an MRI may be required to rule out other potential pathologies.

Treatment:

Initial treatment must focus on unloading the tendon and allowing it to rest. In severe cases where simple weight bearing activities are painful a short period in a walking boot may be warranted. Icing and anti-inflammatory medications may also be suggested by your health care provider.

Physiotherapy management can involve:

  • Soft tissue massage to tight surrounding muscles, particularly the calf.
  • Electrophysical therapy to reduce inflammation & assist with pain relief.
  • Dry needling to reduce inflammation
  • Taping of the foot to unload the tendon
  • Advice regarding orthoses, shoe inserts & appropriate footwear
  • Activity modification
  • Exercise prescription of appropriate strengthening exercises

In chronic cases or those that have not responded to conservative therapy further intervention may be required. Options can include corticosteroid injections and surgery.

Have a wonderful week! 🙂

Reflexology: Are you walking on the solution to your health problems?

As a physiotherapist massage makes up a pretty significant portion of my days work, and a lot of people may find it odd but I find giving massages strangely therapeutic… most of the time; the 100kg footballer wanting a deep tissue massage maybe not so much. The worst part about it is that I get insanely jealous of the person on the table thoroughly enjoying an hour of zen time while I am lost in thought about what I would do to trade places with them.

In light of this I have been promising myself that I will treat myself to a massage for several months now. You wouldn’t think it would be hard to put aside an hour on a weekend to achieve this but somehow Saturday and Sunday roll by and on Monday I find myself in the familiar daydream about when and how I can get myself a massage over the coming week.

I finally did it. Thursday night late night shopping of all places, in search of an outfit for the races, next minute I was dozing off in a reclining chair enjoying a 40 minute reflexology foot massage. Best $45 I ever spent. (and no I didn’t find a dress for the races that day). While in my sleep like state I did manage to notice that there were certain points on my feet that were incredibly painful compared to the rest and I couldn’t help but be curious about what these particular points meant in the world of Chinese medicine. Unfortunately I didn’t get any groundbreaking information from it:

  • Base of both my heels: This zone represents the lower back and legs. Makes total sense I am always stiff and sore in these areas because I am on my feet all day and do a fair bit in the way of running / weights training
  • My left arch: This area represents the stomach and adrenal glands.
  • The top and side of both my big toes: This represents the head and neck region. I am often stiff and sore through my neck and shoulders given that I do a lot of massage and work with my arms.

My very western orientated medical brain doesn’t really believe that releasing pressure points in the hands and feet can treat the range of medical conditions it says it can BUT I am trying the whole be ‘open minded’ and the more I read about it the more it interests me.

What is reflexology?

Reflexology is a form of massage that involves releases pressure points in the hands and feet which coincide with certain areas of the body. Basically our feet and hands are maps which correspond to parts of the body including our organs and vital systems such as the nervous and circulatory system.

reflexology

By releasing these ‘reflex points’ you can help to stimulate circulation and muscular function to the corresponding area which can assist with relaxation and reducing stress on that particular organ or gland. The deeply relaxing nature of this form of massage can alleviate stress that builds up through everyday life and we all know how much stress can negatively affect our body’s ability to function at its optimal level!

Reflexology is not a stand-alone therapy but when used in conjunction with proper medical treatment it can help to alleviate stress which in turn improves our ability to heal both mentally and physically.

Sessions should last between 30 minutes and an hour and should not cause pain. For the best response consistency with treatment is important. A treatment cycle is once a day for 6 days in two week intervals and you are expected to note changes in your condition throughout this period. Immediately following a treatment you can experience nausea, tiredness or a worsening of your condition; this is normal and only temporary.

Reflexology can also be used purely as a one off at the end of the day it’s just a deep trigger point massage for your hands and feet and what a bonus if you de-stress your organs and vital bodily systems in the process.

The Verdict:

Personally: I’m on the fence: I’m certainly not advocating you book a reflexology session to treat your chronic medical condition BUT I’m most definitely getting another foot treatment in the next week!

Scientifically: Medical evidence is limited, clinical trials have produced mixed results.

Are we walking on the solution to many of our health problems? It’s an interesting thought to ponder on a Monday.

ref

Why stress can be a real pain in the neck.

Sydney can, at times, be a very overwhelming place to live. Don’t get me wrong I LOVE this city and quite frankly I probably would choose it over any other place in the world especially to live my current lifestyle… I will eventually retire to Byron Bay, wear flowers in my hair every day and practise yoga on the beach BUT that’s a whole separate story!

I like the hustle and bustle, the chaos, the crowds; but there are a lot of people I know who just don’t cope with the fast paced society many of us thrive on. interestingly it’s these same people who seem to suffer ALOT with stress related problems.

You may be wondering why own earth a sports physiotherapist is writing about stress but you would be surprised at how many people we treat for injuries driven by stress. Stress at work – long hours, deadlines. Stress with kids and juggling this drop off and that pick up and that child’s sport practise. Stress with family pressures. Stress from overtraining – doing too much, not letting your body recover.

headacheStress has many forms and no matter which way you suffer from it it has a HUGE impact on your life. It can make you anxious and agitated, prevent or stall weight loss attempts, mess with your hormones, play havoc with your immune system and all in all make you a bit of a grumpy bitch.

The most common presentation that we get that’s driven by stress is neck / upper back pain quite often associated with headaches. So called ‘tension’ headaches are a combination of physical and emotional stress resulting in tight overactive muscles through the neck and shoulder region. This dull ache precipitates behind the eyes and feels like a tight band around the forehead can turn what you were hoping to be a productive days work into a nightmare where you literally can’t sit still and have concentration levels of a 5 year old.

In a nutshell stress triggers a part of the brain called the hypothalamus. The hypothalamus then sends a message to the pituitary gland which sets your adrenal glands to work producing stress hormones, namely cortisol. Small amounts of cortisol is required to maintain homeostasis in the body however chronically high levels can disrupt this sensitive balance.

On the surface we see this manifest as you begin to stress about something and typically a lot of us hold your stress up in your shoulders. Suddenly your upper trapezius muscles (that muscle bulk between your neck and the point of your shoulder) are now working overtime to support the weight of your head as it creeps closer and closer to the computer screen. They become tight and full of little trigger points which can be tender to the touch. The upper trapezius has several attachment points along either side of the neck and up high at the base of the skull, as it tightens over time due to sustained stress it pulls on these attachments causing the facet joints to become stiff. Lack of adequate mobility combined with chronic muscle spasm creates discomfort in the neck and can refer pain around to the front of the head resulting in a headache.

 

What can be done?

Typically these headaches come on gradually over the course of the day. Patients often describe a ache in behind the eyes with tightness through their neck and upper back.

I have often had patients who have gotten a massage which offered short term relief only to have the headache return the next day. In most caseshead 1 treatment to the cervical joints themselves is required to restore full mobility in combination with myofascial releases of tight over active muscles. Long term management requires postural retraining and specific deep neck flexor strengthening.

That deals with the ‘physical’ side of the problem but in order to beat tension related headaches for good you have to fix the emotional side…. In order words CHILL out a little.

Sure there will always be little factors that its inhumane not to worry and stress a little over and good stress is healthy but too much of it isn’t doing your health and wellbeing any favours!

 

Happy Hump Day

** Not all headaches are stress related. Headaches come in many forms including migraines, vascular headaches, headaches as a result of trauma. If you are a regular sufferer I would recommend getting a professional opinion!

5 ways to give your sore, aching muscles some TLC

Were you one of the 85,000 Sydney siders that took to the streets yesterday to participate in one of our nation’s most famous foot races?

A windey, up and down 14km track from leafy green Hyde Park to picturesque Bondi Beach. We were blessed with a delightfully sunny winters day.. From the pro’s to the novice runner; there were superhero’s; fairies; mums and bubs; and an unusual abundance of the latest it garment the ‘onsie’! It’s one of those days where just about anything goes, and most defiantly the only day of the year topless smurfs are allowed to run a muck in Bondi’s best pub the Beach Road Hotel!

So you finished the race and of course immediately, in true City 2 Surf tradition, headed straight for the nearest watering hole… and no I’m not referring to the sandy shorelines but rather the closest pub serving ice cold beer! Re-hydration is the key to recovery right?

city 2 surf

A lot of the time muscle soreness following exercise that you are not usually accustomed too simply requires time. Unfortunately boy and girls this post exercise soreness tends to be worst 48 hours post exercise so if you are struggling today, don’t expect too feel much better tomorrow…BUT it’s all downhill from there I promise.

Despite feeling a little worse for wear today there are a few little things you can do to give those sore aching limbs some TLC.

  1. Treat myself to a massage: This is not something I get to indulge in very often but it really does work wonders. It assists with relaxing tight, overworked muscles whilst also helping to flush toxins and waste out of our muscles via improved circulation and lymphatic flow. A little bit of ‘me’ time goes a long way on days like today!
  2. Have a sauna: I recently wrote about the benefits of the sauna and how good they are for your mind, body and soul. I love doing a little 10 minute stretch session in the sauna when I am a little sore, the heat improves muscle flexibility, assists with blood flow and promotes relaxation. If you don’t have access to a sauna try one of second favourite past times…. A radox or Epsom salts bath!
  3. Take magnesium: The MASTER nutrient when it comes to recovery. Often called the great relaxer magnesium is essential to muscle repair and recovery. In my opinion best taken before bed so it can work its magic through the night!
  4. Have a day off! If you can’t possibly fathom a rest day head to a bikram yoga or pilates class. If neither of these tickle your fancy grab a foam roller and spend a good half an hour ironing out some of those trigger points.
  5. Re-fuel and rehydrate: Intense exercise depletes our glycogen stores and also causes breakdown of muscle tissue. Usually in the first hour following a bout of high intensity exercise one should consume a recovery meal rich in protein and carbohydrates which should be coupled with fluid replacement to restore electrolyte balance lost through sweat. Those of you that spent the afternoon celebrating in style may have missed the ‘optimal’ window to best achieve these two things BUT regardless of the decisions you made yesterday today’s nutrition is still important! Make sure you are well hydrated…. and maybe opt for a big bowl of veggies and some lean protein for dinner tonight!

Have a fabulous Monday everyone! You should CONGRATULATE yourselves, 14km is pretty damn impressive if you ask me!!!

Do ‘special physio creams’ work?

We are constantly sent samples and sachets of the latest special ‘healing’ creams. Most of them promise a natural solution to relieve muscle and joint aches and pains.. but do these often overpriced creams actually work?  and is there any science behind them whatsoever?

I’m going to use Fisciocrem as a bit of an example, we got a couple of tubes in the mail recently and have tried it out on a few select patients… to our suprise they loved it and several have come back requesting the ‘special cream’

What is Fisciocrem?

Fisciocrem has a similar make up to many ‘pain creams’ such as pain away, pain go etc etc. Pretty much they are all made up of a combination of natural plant extracts each chosen specifically for their beneficial effects on muscle, joint and tissue trauma. The extracts are gently removed from the flowering plant, reduced into micro particles and bound together in a gel with purified water.

When the cream is applied to the skin the solution rapidly releases these active plant ingredients which are absorbed across the skin membrane providing you with ‘pain relief in a matter of minutes’.

These creams are particularly appealing to patients who are wary of or don’t want to tcreamake oral anti-inflammatory medication to assist with their recovery from certain conditions.

What are the active ingredients?

  • Arnica montana: one of the most common extracts used in herbal medicine. Used readily for recovery from bruising.
  • Calendula Officinalis: Important role as an anti-inflammatory agent to help with swelling within tissues and to help calm aggravated soft tissues
  • Hypericum perforatum or “st Johns Wart’ : Another well known plant remedy used historically for relief from soft tissue trauma.
  • Malaleuca Alternifolia (Australian Tea Tree Oil) is well known for its use as topical pain relief and as an anti-inflammatory agent.

All the active ingredients in Fisciocrem are suitable for use in pregnant women and children.

How do you use it?

Apply a small amount to your sore spots and massage gently into the skin. The longer you run the greater the effect. For best results use several times daily.

But do they actually work?

I thought long and hard about how exactly I wanted to answer this question… and really it comes down to whether your asking scientifically or as a means of patient satisfaction.

Scientifically no there isn’t a clinical trial or study which proves in black and white that creams such as Fisciocrem actually work. At the end of the day the results are immeasurable anyway.

Patient satisfcation… Yes there is something strangely therapeutic about a scented cream that warms your skin,whether it’s the action of the rubbing itself which stimulates circulaton and heat to the tissues or its the tingling and warmth that the cream itself generates. It may well be a giant case of the placebo effect BUT the fact of the matter for some conditions it feels considerably nicer than having plain sorbolene rubbed into your sore spots!

Remember read the label and use only as directed and be careful not to rub your eyes or face after applying it to your skin, I made that mistake a few times at work… it’s not pleasant!