Shin Splints: Understanding, Preventing, and Treating the Ache

Medial Tibial Stress Syndrome (MTSS), often referred to as “Shin Splints”, commonly presents as an overuse injury of the lower leg. MTSS is reported as pain on the inside edge of the tibial (shin) bone about a quarter of the way up the tibia from the ankle, with the painful area between 5-12 centimetres in length. It can also present higher on the tibia but is less common. It is not uncommon to see a high incidence of MTSS in preseason sports, including football, netball, soccer, and with high volume training increases in middle and distance runners. It is considered as an early warning sign of a potential stress fracture if the person continues along the current training/exercise path.

Symptoms often include pain on the inside edge of the shin, and swelling can be present but not always. Pain description ranges from a dull ache and throbbing to sharp knife-like pain when the person is running, briskly walking, or during repetitive foot impact activities. It can also continue to be painful at completion of exercise.

Diagnosis typically made by an allied or complementary health practitioner include taking a thorough medical history and physical examination of the client with assessments, including posture, legs, feet and even movement patterns. An X-ray or MRI may also be requested to rule out stress fractures as part of the definitive diagnosis.

Treatment for MTSS to reduce recurrent occurrence includes:

  • Training Load Modification: Swapping high impact activities such as running, to complete rest, or lower impact activities e.g. swimming, or cycling.
  • Manual Therapy: Greatly assists in the treatment and recovery of MTSS targeting the affected inflamed injury site and surrounding tissues.
  • Strength and Conditioning Training: Designed to target the locally affected injury site and general strength fitness to reduce the risk of recurrence.

What can you do to reduce the likelihood of developing MTSS presentations?

  • Wear supportive exercise appropriate shoes when exercising.
  • Starting new exercise with slow progressive increases activity over time. A good guide is to not increase activity levels by greater than 10% on the previous week.
  • Running on soft surfaces can assist with impact reduction too.
  • Cross-training can be a great way to continue exercising while reducing the impact load.
  • If you start to feel shin pain, reduce training load, if it does not start to improve within a few days, seek assistance from a healthcare professional.

5 Reasons to Get Remedial Massage Therapy

Remedial massage therapy is a form of therapeutic massage that aims to address specific musculoskeletal issues and promote healing and recovery. There are many reasons why people might seek remedial massage, but here are 5 common ones:

  1. Pain Relief: Remedial massage is often sought to alleviate pain, whether it’s due to muscle tension, injury, or chronic conditions like back pain, neck pain, or headaches. The therapist uses various techniques and assessments to target the source of discomfort and provide relief.
  2. Injury Rehabilitation: Many people turn to remedial massage as part of their rehabilitation process after injuries, such as sprains, strains, or sports-related injuries. It can help speed up the healing process, reduce scar tissue, and improve mobility.
  3. Stress and Tension Reduction: Stress and tension can manifest in the form of muscle tightness and knots. Remedial massage techniques can help relax muscles, release built-up tension, and improve overall relaxation, contributing to better mental and physical wellbeing.
  4. Postural Issues: Poor posture is a common problem, often leading to chronic pain and discomfort. Remedial massage can help correct postural imbalances by releasing tight muscles and promoting better alignment.
  5. Range of Motion Improvement: Restricted range of motion can be due to various factors, including muscle tightness and joint stiffness. Remedial massage can help improve flexibility and joint mobility, making it easier to perform everyday activities and prevent future injuries.

Keep in mind that remedial massage therapy is a highly individualised treatment, and the specific reasons for seeking it may vary from person to person. Remedial massage therapists aim to assess your unique needs and tailor the treatment accordingly.

 

Ice and Heat for Musculoskeletal Injury Recovery

When should I use heat or ice for an injury?

Navigating at-home care for musculoskeletal injuries can be tricky, deciding when and when not to apply heat or ice can have a big impact – especially during the initial phase of an injury. R.I.C.E and H.A.R.M are useful acronyms for aiding the initial care of musculoskeletal injuries, but how do they work?

The principles of R.I.C.E and H.A.R.M can be applied for 3 days after the onset of an injury. During this period it is important to follow R.I.C.E – this stands for rest, ice, compression and elevation. 

After applying R.I.C.E it is important to do no H.A.R.M – this stands for heat, alcohol, re-injury and massage. These are all things to typically avoid after a musculoskeletal injury.

 

R.I.C.E Principles:

Rest

The first component of RICE is rest. It’s essential to allow the injured area to heal by avoiding activities that may exacerbate the injury. Rest does not mean complete immobilisation; it simply involves minimising movement and avoiding activities that strain the injured area.

Ice

Ice therapy is a fundamental element in managing acute injuries. Applying ice helps reduce swelling and numbs the affected area, providing pain relief. The cold constricts blood vessels, limiting the amount of fluid that can accumulate around the injury site. Ice packs or cold compresses should be applied for about 15-20 minutes every 2-3 hours during the initial 72 hours after injury.

Compression

Compression helps control swelling by applying pressure to the injured area. Compression bandages or wraps are commonly used for this purpose. It’s crucial not to wrap the area too tightly, as this may impede blood circulation.

Elevation

Elevating the injured limb or area helps reduce swelling by allowing fluids to drain away from the injury site. Ideally, the injured area should be elevated above the level of the heart when possible.

 

H.A.R.M Principles:

Heat

Heat therapy is beneficial for chronic injuries or injuries that have moved past the initial acute phase. Applying heat increases blood flow, which in the acute phase can lead to more swelling. Heat should be avoided in the first 72 hours after an injury.

Alcohol

Alcohol, specifically excessive consumption, can impair the body’s natural healing process and should be avoided during the recovery period. Alcohol acts as a vasodilator, this means it will contribute to swelling especially during the acute phase. Alcohol can also interfere with medication, increase the risk of bleeding, and hinder the body’s ability to repair damaged tissues.

Re-injury

Avoiding re-injury is crucial for a successful recovery. Gradual reintroduction of activity should be guided by a healthcare professional. Rushing back into activities without proper healing increases the risk of exacerbating the injury.

Massage

Massage can be beneficial in the later stages of recovery. Similarly to heat, one of the main benefits of massage is increasing blood flow to the targeted area. In the initial phase however this can lead to further swelling and should be avoided, unless carried out by a healthcare professional.

Is heat always a bad thing?

Not always! Having explored the H.A.R.M principles, it’s essential to highlight the role of heat in the later stages of musculoskeletal injury recovery.

The first three days (or 72 hours) is known as the acute phase of an injury, after this period swelling should have peaked. As the acute phase subsides, heat becomes a valuable asset in promoting healing. Heat applications, such as heat packs or hot showers promote blood flow, which aids in delivering nutrient rich blood and oxygen to the injured area.

 

 

Navigating the Holidays: Unwrapping the Risks of the festive season

As the festive season descends upon the sun-kissed shores of Australia, it’s time to revel in the warmth of summer and the joy of Christmas. However, amidst the celebrations, it’s crucial to prioritise self-care and ensure a holiday season that is both enjoyable and injury-free. In this blog post, we’ll explore some tips for taking care of yourself and your loved ones during the holiday season.

The Annual Family “Friendly” Competition:
From cricket games in the backyard to hiking trails, the family “friendly” activities that bring everyone together. However, we forget that playing cricket once a year doesn’t mean that we are physically prepared for the fast balls and tackles from our younger, stronger, fitter relatives. It is essential to take certain precautions to ensure that these activities remain safe and injury-free.
Tip: Know your limits, you are not Usain Bolt. Wear appropriate footwear (and padding if you need). Be aware of your surroundings and maybe let the kids take the win.

Tangled Tinsel Tumble:
Whether hosting gatherings or decorating your home, being mindful of potential hazards is crucial. Older members of the family aren’t used to lifting their feet over your rug nor is our dog used to accidentally running into the 6 foot tree in the corner of the living room that wasn’t there before. No one wants their home to be a jenga tower of falling family members during the holiday season. The only reward is new injuries and bruises.
Tip: Secure loose rugs, ensure walkways are well-lit, and be cautious when using ladders or standing on elevated surfaces for decorations. Keep decorations and cords out of high-traffic areas to prevent tripping.

Festive Fatigue
While the holidays can be a time of joy, they can also bring about stress and anxiety. When you are in charge of the pavlova, picking up mum from the nursing home, setting the table all whilst needing to be in two places at once, it is hard not to be put together. Balancing social commitments, family expectations, and personal well-being is key to a healthy and happy festive season.
Tip: Prioritise self-care activities such as mindfulness, meditation, or a leisurely walk to manage stress and maintain mental well-being. Set boundaries to protect your mental health. Take time out for yourself, do not cancel your pilates session or your osteopathy appointment, your body will thank you later.

Don’t Forget Old Mate H20!
The summer heat can be relentless, and dehydration is a common concern during the festive holidays (especially when the egg nog is the go to). Whether you’re enjoying a beach day, a barbecue, or a festive gathering, it’s essential to stay hydrated to prevent fatigue and heat-related issues.
Tip: Carry a reusable (or emotional support) water bottle and make a conscious effort to drink water regularly, especially if “the grinch” is your new favourite cocktail.

By incorporating these injury prevention tips into your holiday plans, you can ensure a safe and enjoyable festive season for yourself, your family, and friends. Prioritising safety allows everyone to fully embrace the festive spirit without starting off the new year in the ED.

Overcoming Overuse Injuries: A Guide to Prevention and Healing

In today’s fast-paced world, many of us lead active lives and engage in various physical activities. While being active provides numerous health benefits, it can also lead to overuse injuries. Overuse injuries occur when repetitive movements put excessive stress on specific parts of the body, resulting in pain and discomfort. Fortunately, our team at Peninsula Osteopathy & Allied Health put together some information on common causes and types of overuse injuries, how we can assist you to address these injuries and how you can help yourself!

Overuse injuries typically develop gradually and can affect anyone engaged in repetitive activities. Some common causes include:

  • Repetitive Motion: Repeatedly performing the same movements, such as running, jumping, or throwing, can strain the involved muscles, tendons, and joints.
  • Training Errors: Increasing exercise intensity, duration, or frequency too rapidly without allowing adequate time for recovery can overload the body, leading to injuries.
  • Poor Technique: Incorrect posture, improper form, or flawed biomechanics during physical activities can place undue stress on certain body parts, making them susceptible to overuse injuries.
  • Inadequate Rest and Recovery: Failing to incorporate rest days into your exercise routine can prevent your body from healing and repairing itself, increasing the risk of overuse injuries.

Common types of overuse injuries include:

  • Tennis/Golfer’s Elbow: Characterised by pain and inflammation/irritation in the tendons of the elbow, typically caused by repetitive wrist and forearm movements.
  • Runner’s Knee (Patellofemoral Pain Syndrome): A common knee condition resulting from excessive stress on the kneecap, causing pain during running or activities involving knee bending.
  • Shin Splints: Pain along the shinbone (tibia) caused by inflammation of the muscles, tendons, and bone tissue due to repetitive impact activities like running or jumping.
  • Achilles Tendinitis: An inflammation of the Achilles tendon, the large tendon at the back of the ankle, caused by repetitive strain or overuse.

Here at POAH, our osteopaths can play crucial roles in the diagnosis, treatment, and rehabilitation of overuse injuries. We are able to assist you with:

  • Accurate Diagnosis: We will conduct a thorough assessment to identify the specific cause of your overuse injury and determine the best course of treatment.
  • Individualised Treatment Plans: Based on your diagnosis, we will develop personalised treatment plans incorporating a range of techniques such as manual therapy, exercise prescription, stretching, and strengthening exercises.
  • Rehabilitation and Exercise Programs: We can guide you through progressive exercise programs aimed at restoring strength, flexibility, and function, while ensuring you regain optimal movement patterns.
  • Education and Prevention: Finally we can provide valuable guidance on proper technique, training modifications, and injury prevention strategies to reduce the likelihood of recurring overuse injuries.

While professional guidance is crucial, self-management also plays an important role in the recovery process. Here are some practical tips for managing overuse injuries:

  • Rest and Recovery: Allow your body sufficient time to rest and heal. Modify or temporarily halt activities that exacerbate your symptoms.
  • Pain Management: Ice and heat pack strategies can be effective pain relievers, often personal preference dictates whether hot or cold will benefit you more. Over-the-counter pain relievers or anti-inflammatory medications, used under medical guidance, can also help manage pain and inflammation. Please ensure you consult with your medical practitioner to determine what is the most appropriate for you.
  • Proper Technique and Form: Pay attention to your body mechanics and ensure you are using correct posture and technique during activities to reduce unnecessary strain on vulnerable areas.
  • Gradual Return to Activity: When your symptoms improve, gradually reintroduce activities, starting with low impact and gradually increasing intensity and duration.
  • Cross-training: Engage in alternative activities that work different muscle groups, reducing the repetitive strain on the injured area while maintaining overall fitness.
  • Stretching and Strengthening: Perform specific stretches and exercises recommended by our team to enhance flexibility and strengthen the affected area.

Overuse injuries may try to slow you down, but they won’t stop you! Your passion for the activities you love is worth preserving, and your well-being matters. That’s why the team at Peninsula Osteopathy & Allied Health is here, ready to be your allies in recovery and vitality.

Don’t let pain hold you back. With our expert care and your commitment to self-management, we’ll help you reclaim your active, pain-free lifestyle. Remember, the sooner you act, the faster you’ll thrive. Reach out to us today and let’s conquer those overuse injuries together. Your journey to a healthier, happier you starts now!

Navigating Injury: The Art of Pacing and Progression

At Peninsula Osteopathy, we understand that injuries can be both physically and emotionally challenging. Whether you’re recovering from a strain, sprain, or a more serious injury, the journey to healing requires a thoughtful and strategic approach. In this blog, we delve into the importance of pacing activities and effectively progressing or regressing rehabilitation exercises, offering insights that can significantly enhance your recovery process.

Pacing: A Key to Successful Recovery

Pacing, often referred to as finding your “activity threshold,” is a fundamental principle in injury rehabilitation. It involves striking the right balance between engaging in activity and allowing your body the necessary rest it needs to heal. Here’s how to implement pacing:

  1. Listen to Your Body: The first step in effective pacing is tuning in to your body’s signals. If an activity causes pain, discomfort, or fatigue, it’s crucial to acknowledge these signals and adjust accordingly.
  2. Gradual Progress: The journey to recovery is not a sprint but a marathon. Start with gentle activities that don’t strain the injured area and gradually increase the duration and intensity as your body responds positively.
  3. Prevent Overexertion: Pushing yourself too hard too soon can lead to setbacks and potentially delay your healing process. Pacing helps prevent overexertion and promotes a gradual return to your usual activities.
  4. Build Confidence: Pacing allows you to build confidence in your body’s ability to heal and adapt. It also reduces the anxiety that can arise from the fear of re-injury.

Progressing and Regressing Exercises: Your Customised Approach

Progressing and regressing rehabilitation exercises play a pivotal role in your recovery journey. These strategies involve tailoring exercises to your current abilities while ensuring that you challenge your body within its limits. Here’s how to effectively utilise them:

Progression: As your body heals and gains strength, progression becomes essential:

  1. Increase Intensity: Gradually add resistance or weights to your exercises. This stimulates muscle growth and strengthens the injured area.
  2. Expand Reps and Sets: Slowly increase the number of repetitions and sets to improve endurance and muscle conditioning.
  3. Embrace Complexity: Integrate more complex variations of exercises. This engages multiple muscle groups, enhancing overall strength.

Regression: There might be times when you need to take a step back to support your recovery:

  1. Reduce Intensity: Lower the resistance or weight to prevent strain, especially if you experience discomfort.
  2. Limit Range of Motion: If a movement causes pain, reduce the range of motion or opt for a modified version.
  3. Utilise Support: Incorporate assistive tools like bands or stability aids to provide support during exercises.

Musculoskeletal injury recovery is a process that demands patience, resilience, and expert guidance. At Peninsula Osteopathy, our expert practitioners are here to guide you through every step of your recovery journey. Pacing activities and skilfully adjusting exercise intensity are two powerful tools that can expedite your journey to healing. At Peninsula Osteopathy, we’re dedicated to providing you with the support and knowledge you need to make informed choices about your recovery. Remember, every step you take towards progress, no matter how small, is a step towards regaining your strength, mobility, and overall well-being.

5 Ways Your Rehab is Helping

Rehabilitation exercises are a staple of injury recovery, however we’re all guilty of letting them fall by the wayside from time to time. This blog will show you the many interesting ways in which your exercises are effective, hopefully inspiring you to persevere with them! (And spoiler alert, its not all about strengthening weak muscles!).

1. Motor recruitment & coordination

Rehab exercises can rewire the brain maps responsible for controlling and recruiting certain muscles and patterns, improving the technique and efficiency of your movement. In early stage rehab, the use of external constraints can decrease the number of potential movement solutions – helping to offload painful areas and teach the body how to utilise pain-free movement patterns.

As you progress, the rehab should gradually increase the degrees of available motion to move from rigid movement to fluid and variable movement – more closely mimicking the requirements of a full and active life.

2. Cognitive restructuring

We often fear certain activities and movements as we believe they can make our injury worse. Frequent low load exercise can help to restructure our relationship with movement. By repeating safe movements we can change the way we think about exercise and physical activity, which allows us to do more of our necessary daily tasks and get back to our loved recreational activities.

3. Nociceptive desensitisation

Nociception is the process of nerves sending messages to the brain from a particular body part that something is harmful. The brain then processes and codes the nerve signal and can create a sensation of pain.

During injury these nociceptive nerves can become more sensitive, due to many factors including inflammation at the injured body part. Exercising the sore body part causes the brain to respond to this demand by acclimating to the sensation, thereby decreasing the body’s pain response to the particular stimuli. The body gets used to the stimulus and it therefore becomes tolerable, no longer eliciting the pain response.

4. Descending pain inhibition

This phenomena is similar to taking medications that are designed to decrease pain, like panadol. Exercise causes nerves and chemicals to be stimulated that have a hypoalgesic effect – meaning they directly dampen the sensation of pain.

5. Progressive strength

Although early rehabilitation isn’t focused on building strength, it sets the foundation for further exercise progression. A good rehabilitation program should always be progressing towards a higher goal. As the aforementioned characteristics are achieved, the exercise prescription should increase its intensity – either by increasing load/weight, increasing volume, decreasing rest periods, or progressing to a more challenging movement.

Conclusion

Rehabilitation exercises are not just mundane routines, but powerful tools that facilitate a holistic recovery journey. They serve as more than just a means to strengthen weak muscles; they actively engage the brain, reshape our perceptions, and recalibrate our pain responses. Through consistent practice, we not only rehabilitate our bodies but also transform our relationship with movement and pain. Embracing these exercises not only aids in physical recovery but empowers us mentally, allowing us to reclaim our lives, one pain-free step at a time. So, let these insights inspire you to persevere with your exercises, for they are not just a path to recovery, but a gateway to a stronger, more resilient you.

Pins and Needles?

Why do I have tingling in my hands?

Hand numbness can be caused by damage, irritation, or compression of one of the nerves or a branch of one of the nerves in your arm and wrist.

Diseases affecting the peripheral nerves, such as diabetes, also can cause numbness, although with diabetes, similar symptoms usually occur first in your feet.

Uncommonly, numbness may be caused by problems in your brain or spinal cord, although in such cases arm or hand weakness or loss of function also occurs.

‘Pins and needles’ (paresthesia) is a sensation of uncomfortable tingling, prickling, itching or skin crawling, usually felt in the hands or feet. The affected area is sometimes said to have ‘fallen asleep’.

A common cause of pins and needles is leaning or lying awkwardly on an arm or leg, which either presses against the nerves or reduces the blood supply to the local area. Changing position usually quickly restores normal feeling as the nerves start sending messages to the brain and spinal cord again.

Symptoms of pins and needles

Common features of pins and needles include:

  • prickling and tingling sensation
  • numbness
  • return of normal feeling a few minutes after changing position.

Hands, arms, legs and feet are the parts of the body most commonly affected.

Pressure-related pins and needles
The nerves of the body send information back to the brain and spinal cord. When a sensory nerve is pressed by being in a cramped or awkward position the messages are interrupted, which can cause pins and needles.

Once pressure is taken off the nerve, functioning resumes. An uncomfortable prickling sensation is caused by the restarting of pain messages from nerves to the brain. This usually resolves within minutes. An example of this is when you hit your elbow and feel a tingling sensation in your little finger.

Pinched nerves and pins and needles

Nerves can be compressed or ‘pinched’ by bones and other tissue. Some examples include:

Carpal tunnel syndrome – the main nerve that services the hand runs through a ring of wrist bones. Inflamed and swollen tendon membranes reduce the amount of room inside the wrist and irritate or compress the nerve. Symptoms include pins and needles, pain and weakness in the hand.

Cervical nerve root irritation – nerves in the neck exit the spinal cord via small holes between the vertebrae. These small holes can be narrowed by inflammation, injury or outgrowths of bone tissue (bone spurs). The nerves are irritated or compressed, causing pins and needles and, sometimes, referred pain into the arms

Sciatica – the legs and feet are serviced by the sciatic nerve, which starts between the vertebrae of the lower back. This nerve can be irritated or compressed due to problems in the lower back or pelvic or buttock area causing pins and needles, and sometimes pain, down the legs.

When to seek medical advice for pins and needles

The occasional bout of pins and needles is a harmless event. However, chronic pins and needles can be a warning of some other underlying disorder.

Always see your doctor if you experience frequent or persistent bouts of pins and needles.

Treatment for pins and needles

Treatment depends on the cause. For example, carpal tunnel syndrome may be treated with rest, splinting and medications such as anti-inflammatory and diuretic medications.

A compressed or irritated nerve may require treatment such as osteopathy, medication or (in some cases) surgery to ease the pressure and allow full nerve functioning to resume.

Lower Back Pain

Low back pain is pain felt in your lower back or lumbar spine. Most people have lower back pain at some point in their life. For most people back pain comes on quickly (acute back pain), but then improves or goes away within three to six weeks. However, it is common for it to come back, with some people going on to develop more persistent pain (that lasts for more than three months).

What causes lower back pain?

The causes of back pain are not fully understood. Most people with back pain don’t have any significant damage to their spine. The pain comes from the muscles, ligaments and joints.

Common contributors to back pain include:

  • repetitive or heavy lifting (manual handling)
  • sudden awkward movement
  • not getting enough regular physical activity (being sedentary)
  • poor posture
  • stress – muscle tension.

What to do if you have back pain?

  • Stay as active as possible – talk to your Osteopath or doctor if you need specific advice for your situation
  • Manage your stress
  • Relaxing – learn some relaxation techniques to reduce stress levels, try some heat packs or gentle exercise to calm your nervous system
  • Learn more about your particular injury – what makes it better, what makes it worse?
  • Lift and carry safely – ask for help if something is too heavy to lift alone.

Exercise and low back pain:

Exercise is great medicine for lower back pain, with no specific type being the best. Just stay as active as you can, allowing for the restrictions in movement that may come with pain. If you enjoy gardening, then staying active may mean pottering in your garden, even if heavy jobs such as digging or pruning are too much for you. If you run regularly, staying active may mean continuing training but reducing the distances you run each week. This will all depend on the severity and presentation of your pain. Speak to your Osteopath or GP for specific advice for your situation.

If you are having persistent low back pain, a strengthening program may be necessary to help you overcome or manage your presentation. This should be relevant to the way you prefer to exercise.For example if you stayed active by walking, to gain further health benefits you now need to walk further or faster, walk up hills, or carry extra weights. It is important to seek guidance in this as each presentation of back pain is different and should be tailored to you.

Jaw Pain? Look no further!

The letters TMJ stand for temporo-mandibular joint, the joint attaching your jaw to your head. You can feel it moving in front of your ears when you open and close your mouth.

Your jaw region contains muscles, bones, joints, ligaments and membranes which all play an important role in jaw function. Dysfunction or irritation to these structures can cause pain. Pain in the jaw can also be from distant structures, for example upper neck pain can refer to the face or even pain originating from the heart can be experienced as facial pain.

Problems with your TMJ can present as:

– Clicking or popping with jaw movement
– Locking with opening or closing of your mouth
– Pain with chewing, talking or yawning
– Tender points on muscles around the jaw
– Clenching of teeth throughout day or night

Treatment for TMJ dysfunction depends on the cause. If it is due to postural or muscular problems, osteopathic treatment can help to reduce your symptoms and relax any jaw muscle spasms you may be experiencing. Your osteopath may teach you some exercises or stretches to do after treatment, which will aim to help further reduce your discomfort. Jaw pain can be complex and may require a multi faceted approach. If symptoms persist you may require a referral to an orthodontist, or if problems are related to stress, implementation of stress management techniques may be required.

If you feel like any of the above symptoms are describing what you may be feeling, give us a call and we will do all we can to help!