Vinyasa Yoga

This months newsletter will be out in the next few weeks. It is all about yoga and how you can use it help prevent injury by helping with strength and mobility. It is great to help balance the body. Don’t want to miss this article? sign up to our newsletter by clicking on the link at the bottom of the page. It will only take a few minutes. Enter you email and confirm your request by clicking on the link sent to your email account.

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Back pain breaking the myths

Back pain is the most common area of pain I treat in the clinic. Everybody at some point will have an episode of back pain and for those unlucky few ongoing recurrent problems.

The approach to back pain has changed a lot and challenges many widespread beliefs about the condition. Here is what I have found out throughout my 10yrs of experience.

1. Back pain is common and normal.

Most back pain is due to strains and sprains and usually resolves within 6 weeks. Only a very small percentage go on to develop long standing disabling problems and many of these may improve with the right help.

2. Scans are rarely needed. You would think that a picture of the spine would explain why you are in pain but it is not that simple. The scans will often show up things that are poorly linked with pain. Many people who have no pain are shown to have bulging discs, degenerated discs, arthritic changes etc. If you are told you have these problems it can lead to further distress and avoidance of activity.

3. Back pain is not caused by something being out of place. Many people may feel better after manipulations/mobilisations but this is mainly down to short term reduction of pain, muscle tone/tension and fear. As therapists we use these techniques to help get you moving better not to realign you.

4. Bed rest is not helpful. This can create stiffness, muscle de-conditioning and fear. Stiffness itself is painful and treatment and exercises will be painful to get movement back again.

5. Increased back pain does not mean more damage.

6. Surgery is rarely needed. Many people who have back surgery still have pain after because they have not taken a multi factoral approach to getting better. No one treatment will work on its own.

7. There is no perfect sitting posture. It is about moving and altering posture instead of maintaining posture that is important. The body will never like being stuck in one position for any length of time.

8. Lifting and bending are safe. Yes it may cause a strain in the back but should never be avoided as it is good strength work for the back and body. And yes there are bad techniques that can lead to injury, just remember you have a pair of legs to help you. Don’t lift silly amounts of weight, be smart. The length of the activity also has an influence break it up into smaller manageable amounts.

9. Avoiding painful activities is not the way forward. Fear of pain can heighten your senses of back pain and increase stress on the back due to an altered movement pattern.

10. Poor sleep, stress, low mood and worry all influence the back.

11. Exercise is good and safe and persistent back pain CAN get better with it.

Long standing back pain has to have a whole body and psychological approach. Manual therapy can help but exercise is very important as well. So is general health, looking after you weight, healthy diet, good sleeping pattern and knowing how to cope with stress. Everyone is different so what works for one person will not work for the next.

 

 

 

A Healthier You

After some well deserved time off, and over indulgence this Christmas, it’s time to look forward to a new year, and a healthier you!

As we all know exercise is extremely good for your health and well-being. Not only does it improve your muscle tone, and general fitness, it also increases your energy levels and helps stabilise your sleep pattern. Physical activity can boost self-esteem and mood, as well as reducing your risk of stress and depression (especially during these miserable, damp months).

In 2016, make time to take care of you!

To help you get started, here is a list of our top 10 tips

1. Make exercise fun and enjoyable – Find an activity that you enjoy doing, this increases the likelihood that you will stick at it. You do not need to spend hours on a treadmill or sweating in a gym to get fit, if that’s not your thing. There is a whole host of sports/activities out there, why not try a different one each month and find out what you do like.

2. Find an exercise buddy– Having a friend to exercise with helps and is good for keeping you on track. Make a regular plan to exercise together and you will less likely fob it off due to being tired, etc. than if you were exercising alone.

3. Don’t overdo it – It may be tempting, while you have the fitness buzz, to go from 0 to 60 straight away. Resist this urge and ease yourself in gently to begin with. Doing too much too soon, can lead to injuries or burnout, resulting with you discontinuing with exercise altogether. For your first few sessions, it is better to think, I could have done more rather than over doing it and not been able to move for the next 4 days. Gradually increase your effort and volume as you find where your fitness level is. This may mean in a gym class you leave slightly early to begin with or if they say pick up some weights don’t, start with bodyweight.

4. Try something new – If you’re already exercising regularly but is seems to become a bit of a chore, set yourself a challenge to try something new. This is a good way to ensure you don’t get bored, and often you’ll find that embarking on a new activity uses different parts of your body that you aren’t used to, increasing your overall mobility.

5. Set goals – Setting realistic, attainable goals is key to maintaining a healthy lifestyle. It can be a short term goal, such as swimming two lengths of the pool without stopping, or a long term goal such as training for a marathon. Scarborough Athletics Club has a walk-to-run group with the final goal running in the local 5k park run.

6. Eat a well balanced diet– Studies have shown around 80% of any fitness goal depends on your diet. This applies whether you are trying to lose weight, or train for an event. Food is fuel for your body and it is important that you put the right things in it, to maximise results.

7. Water – Keep hydrated! Aim for at least 1.5 litres a day. Water washes out salts, toxins and helps the body to recover from exercise.

8. Sleep – When you relax, the body is able to repair itself post exercise. Sleeping, also relaxes your mind, and enables you to be more focused when awake. Go to bed a little earlier and see if it helps.

9. Preventative Sports Therapy – Regular visits to an expert therapist will enable you to achieve the most out of your life and avoid unnecessary aches and pains. Pro-Am Health Scheme gives you an affordable solution to investing in your health and well being. Sign up today

10. Keep trying, don’t give up – If you have a bad experience at a gym or your sick of getting injured then remember the first 4 points above. You never know you may find a activity where you become a volunteer or coach and inspire many more people to stay active.

Core Exercises for Cyclists

Participation in cycling is on the increase due to the success of our GB squad but also many local clubs having the funding to setup beginner groups and host relaxed fun events. Its a great exercise for fitness and for many it is easier to build up fitness levels compared to running due to its low impact. It is an exercise we give to many athletes when injured to help keep fitness. As with any sport there are injury risks and cycling is no different.

Bike setup and on bike posture are essential to avoid injury.

Here at Pro-Am we recommend you get a proper bike fit especially when spending alot of money on the bike. Next is making sure your posture is good on the bike. The on bike posture is a vital aspect of efficient cycling and it is the strength of our core which can help you maintain good posture. When our central stability is poor it makes it increasingly hard to dissociate the hips from the back and this can lead to you dragging rather than driving through the revolution cycle. It also creates increased postural fatigue through the thoracic spine (mid back).

Here at Pro-Am we can help prevent injuries occcurring from the result of poor core control with advice on some simple mobility and strength exercises which could also increase your performance too. Combine this with regular sports massage to reduce the effects of the repetitive motion that cycling incurs and you can become injury proof.

 

 

Osteopath, Chiropractor or Sports Therapist?

Previously Pro-Am has explained the difference between a Physiotherapist and a Sports Therapist. I did this because for some reason Physiotherapy is seen as a more recognised profession because of its use within the NHS but in private practice there are many more choices available.

This article is about the difference between Osteopaths, Chiropractors and Sports Therapists.

This is actually quite hard to explain as many of our skills and practices overlap.  I was going to give a definition for all 3 but they all sounded the same.

All 3 professions can assess, treat and rehabilitate musculoskeletal injuries. All 3 use manual therapy to manipulate soft tissues and joints. And all 3 use exercise to help treat and rehabilitate clients. What makes it so confusing is we all use different methods and terms to assess, treat and rehabilitate, its like we are each in our own tribe with our own languages but in reality we have the same knowledge and end goal: Getting people pain free and healthy.

What are the differences?

You will find the manual therapies used will be slightly different. It can be said that all 3 are classed as complementary medicine but Osteopaths follow a more holistic approach, Chiropractors say they are ‘evidence based’ and Sports Therapists share both approaches.

Osteopaths and Sports Therapists take a full body approach, Chiropractors are seen to be more specialised in the spine but can treat any joint or muscle.

Out of all of them Sports Therapists are much more specialised in their degree training towards musculoskeletal and sports but what makes a sports injury, a sports injury? Many of the injuries sports people get, so do non sporting people. A Sports Therapists most common injuries seen in the clinic will be general neck and back pain from people who have non sporting backgrounds. A lot of the techniques learnt can help many with chronic pain conditions like fibromyalgia and arthritis.

Osteopaths and Chiropractors have a choice to specialise in many other areas and treat a wider variety of other health problems like vertigo, tinnitus, asthma, IBS ect. They can also specialise in working with athletes. Osteopaths and Chiropractors are a protected profession by the health council so all are guaranteed to have completed a degree, sadly Sports Therapy is still battling for this recognition and until then please check that the Sports Therapist you see has the letters BSc after their name and are registered with The Society of Sports Therapists.

You will find many Osteopaths or Chiropractors will also train in Sports Therapy or Physio and vice versa. Sadly you do get some arrogant therapists who will say ‘Osteopaths are the best’ or ‘Chiropractors can only deal with your injury’.

‘No one profession is better than the other, they have different approaches towards the same outcome’

For each therapist no matter what profession, it’s all about building a good solid reputation and offering a great service to help people in pain, improve their life and enable them to get back into what ever activity they enjoy.

My advice, ask around, word of mouth is all 3 professions main way of advertising, recommendations are everything to us. What ever injury or illness, seek out a professional who specialises in that area. If you are still not sure then find a local therapist in your area and give them a ring and ask, we are all here to help and give advice. This may be you booking an appointment there and then or it may be information of another therapist who is best suited to your needs. If your not happy with one therapist DO NOT let it put you off, its like anything in life we are all different and respond to things and personalities  in different ways.

Should you exercise through pain?

As a Sports Therapist this is a common question I get asked.

‘Should I exercise through pain?’

First of all if you have persistent pain whilst exercising, please get it checked out.

My response  to this question is usually ‘it depends, pain is complex’ clients are left frustrated by me leaving the answer open ended. It is important for the client to understand pain but it can take time to explain. I tend to stick to 3 short rules.

  • During your session use a pain scale 1-10 (1 no pain 10 pain as bad as it could be) do not go into or beyond 6/10.

0-2 Safe 2-5 Acceptable 5-10 high risk

  • Recovery, if you have 3/10 pain the next morning that is okay you can do your next session, if you have 3/10 pain in 1-2 days you can do your next session with caution reduce intensity or volume, if you still have pain above 3/10 3-5 days after, then you have done too much, rest, and cross train. Your next session should involve less volume or less intensity when pain has reduced to an acceptable level.
  • If you have to miss 2 weeks of exercise or pain is not reducing in fact is getting worse: rest, cross train and seek out an injury expert.

The above maybe all you want to know but here is some more in depth information:

Pain is a complex thing, I have done a lot of reading on it and here are my conclusions. It can really stop us in our tracks or it can just let us know we had a good training session. Peoples perception of pain varies greatly, what is sharp for one person may just be dull for another. Our bodies response to a pain stimulus is also not very accurate, using an example of making toast, it can not tell whether you have burnt the toast or burnt the whole house down. It just sends the signal and sometimes, over reacts. We can say pain and tissue damage are very poorly correlated. Just because you feel pain does not necessarily mean you have damaged something. An example would be a single episode of cramp.

Can you change your pain?

See if slowing down, reducing intensity, and/or changing type of exercise (high impact to low impact) eases your pain. Are there certain movements which ease your pain, performing these regularly but staying away from painful actions can off load the injury site and help it recover. Sometimes a change of footwear is needed. If trainers are getting old or have started to lose their support due to getting soaked through it can trigger many lower limb injuries. Check for technical errors or if you have implemented some changes intensity/volume/technique/equipment have these triggered the pain?

Sometimes when you can modify your pain it is good to test your limits. I have seen many clients where actual fear of injury recurrence can increase perception of pain. Test it out gradually on your next sessions, do not go straight back into the same volume or intensity, build it back up. Your injury site has to get back to a level of been able to cope with the impact, fitness and stress of your exercise. Exercise in itself can help stimulate healing. An injury specialist can help guide you, to help get you back fully into your chosen exercise.

Physiologically what signs can we see of a serious injury?

Look for swelling, redness, heat, severe pain, giving way or locking of a joint and bony tenderness. You should not exercise through pins and needles or numbness, which are your typical symptoms of referred pain from a disc/nerve been compromised. All of the above are symptoms you should not exercise through. These are symptoms to get checked out.

When should I definitely NOT exercise?

If there is any suggestion of a stress fracture, then exercise especially impact exercise (running, zumba, gymnastics ect.) should be avoided until advised it is safe to do so. You may be able to use swimming or cycling for very light exercise but only if they give the go ahead. Acute injuries or the acute stage of an injury (1-2 wks) active rest is recommended. If a tendon has become swollen and very painful (reactive) exercise will likely aggravate it further. If a tendon injury has been around for a while and you mainly get pain after or the next day but it goes away in a few days, exercise is okay. If you have been training really hard, you may have over trained and rest can be the best option for both recovery and injury. Do not push through chest pain or abdominal pain.

Try to follow the above information if you are having pain exercising and if ever in doubt get it checked out. Never put up with pain thinking it will go away, it may just get worse.

 The text above is for guidance purposes only. If you are in pain whilst exercising then seek out a specialist in this area.

Neck and Shoulders Feeling Tight?

Neck and shoulder pain? tight or painful chest? stressed at work or home? does your pain keep returning or getting worse? Breathing patterns can contribute to or even be the cause of your chronic muscular pain. Here is some information you will find helpful to start finding relief.

Breathing is intertwined with our bodies emotional responses and stress levels, how? the diaphragm’s connection to the brain. We have to breath to survive, we do not have to think about breathing it just happens but it can also be controlled.

How does breathing relate to painful shoulders? when we are stressed our brain sends an alarm signal that alerts us to danger. however this works like a fire alarm. It does not know whether you have burnt your toast or if the house is on fire. It simply sends an alarm.

Your reaction to this alarm has 3 reactions Fight, Flight or Freeze. Within the work environment you can not start a fight or run a way from it unless you want to lose your job. You just hope that the deadlines and work volume will somehow go away without devouring you? This is the freeze response and is usually accompanied with breath holding. Breath holding is a natural primitive survival instinct and is an automatic response to stress and pain.  It is something we do not usually notice ourselves doing unless we are extremely body aware.

When we freeze our breathing becomes shallow, our ribs move less and our muscles become tense. If we were in a real life threatening situation we would be playing dead. With this response repeated day after day it can lead to our muscles feeling stiff and hard, leading to chronic pain and dysfunction.

If not acknowledged and dealt with stress can cause many health problems, sore muscles are just the first step. It can lead to you feeling tired and run down, frequently getting ill and headaches. All warning signs that your body needs some kindly attention.

So what can you do?

You begin your journey by having awareness of your breath. It is advised that you do seek out a therapist to make sure you do not have any underlying mechanical reasons for your neck and shoulder pain. Breath holding maybe in response to protecting an injury site.

Muscular pain caused by work related stress is very treatable. With the assistance of a therapist you can become more aware of your breathing pattern and put ‘you’ in driving seat to combating your pain.

Here at Pro-Am we can help you to understand the mechanisms of the stress response and help improve your breathing pattern which will help keep your shoulders, ribs and chest mobilised.

 

 

 

Sciatica Causing You Problems?

Is Sciatica causing you pain? How can we help ease your sciatic pain?

What is Sciatica?

Sciatica describes a set of symptoms that can include lower back pain, pain in the glutes (buttocks), pain shooting down the leg and numbness and tingling in parts of the leg and foot. It is often just experienced down one side of the body and can interfere with activities of daily living and sleep.

What Causes Sciatica?

Sciatica is an irritation of the sciatic nerve, there are many causes and in order for treatment to be successful the right cause needs to be found. Common causes are tight muscles in the lower back or glutes, and disc or facet joint irritation .

Less common sciatic symptoms can be caused by spinal stenosis (a narrowing of the spinal canal) or a growth or infection.

What is piriformis syndrome?

Piriformis syndrome describes a case where the muscle known as the piriformis compresses the sciatic nerve due to its position deep in the glutes. This can be caused by poor posture when lifting, poor prolonged postures (office based, driving) or physical activity  overuse. If referral pain is present is usually stays above the knee sometimes into the calf but rarely, if referral pain travels into the ankle or foot is is most likely related to the disc. Sometimes piriformis syndrome can mimic a hamstring strain.

Piriformis_Sciatic

Can Sports Therapy provide effective Sciatica treatment?

In cases where muscle tightness and stiffness is causing impingement of the sciatic nerve, then yes. If your injury is caused by the disc becoming irritated or facet joint irritation without  damage, then yes. You have to remember that muscles control joint position and when tight can alter posture and create compression on the sciatic nerve. Even with a herniated disc we can advice you on exercises to help get you back to full fitness and how to prevent flare ups.

Early treatment intervention can prevent chronic muscle tightness from establishing itself. However even in cases where chronic tightness is already presenting itself sports therapy can still be an effective treatment intervention.

Often sciatica creates a pain cycle, once the nerve has been irritated by tight muscles, the body further contracts around the sensation of pain to protect itself. This exacerbates the original tightness. A Sports Therapist can manually locate, ease and soften tight muscles and provide relief of pressure and relief of pain. We educate about good movement patterns and use muscle energy techniques to change the bodies pain cycle allowing movements to become pain free.

If there are any underlying issues that created the primary irritation of the sciatic nerve sports therapy can work in support of other treatment modalities. Just inform the therapist if you already have a diagnosis of sciatica so they have the full details and can design a treatment plan to suit your needs.

How else  might we support you through your sciatica care?

We can show you how to do exercises to ease and mobilise stiff muscles and joints. At Pro-Am we believe starting with a good breathing pattern and good body awareness enhances the efficacy of the exercises given. We like to make you involved in improving on and maintaining the benefits our treatments provide.

Please note that this blog post is for information purposes only.If you think you may be suffering with sciatica please seek out an injury professional or see your doctor.

Quick Updates

I don’t know about you but I have been glued the tv watching the Winter Olympics, its just what I needed to keep me motivated for my own training when the weather is awful.

Last week our Hull York Medical students finished their sports massage module, and as they finished Scarborough Sixth Form students started their sports massage course. This is a new venture for me, the students are studying BTEC Sports Science and the course I’m running for them is to introduce sports massage. I will also be running a shorter course later this month for A level students who are interested in going into Physiotherapy, Sports Therapy, Sports Rehab.

Hopefully we will have another group of Hull York medical students in April so keep an eye out for free massages around that time, as they will need practice models.