By Gemma Percy Children, Exercises, Injury, Sporting

PROMOTING LONGEVITY IN SPORTS!

YOUTH INJURY PREVENTION

Fun facts:

• 81% of girls and 78% of boys aged 15 years or over complete sport or physical activity at least once a week.
• 65% and 59% of girls and boys participate 3 times a week.
• 42% of children under the age 15 are involved in some form of organised sport at least once a week outside of school hours.
• The most common demographic for ACL rupture is 15 year old girls.

With rising participation of kids and adolescents in organised sports it is no surprise that the number of injuries we are seeing in this population is also on the rise. If you’ve ever been involved with children you would know that most kids are far more bendy and flexible than the average adult – This is largely to allow us to grow and develop. Through our youth years we have growth plates all over our body that on average aren’t fully fused until we are about 15 years of age – once these growth plates have fused we are considered skeletally mature and growing ceases.

As little ones grow and develop interests in organised sports they are predisposed to a few common injuries – some of these are related to growth spurts and the non-fusing of growth plates at this age however a large number of injuries can be contributed to factors such as:
• Reduced muscle strength
• Lack of/ poor coordination
• Posture/Reduced trunk control
• Poor balance

Injuries can have long term effects, physically and psychologically, and often lead to drop out of sports – however a well planned and executed prevention program may reduce the chance of injuries such as ACL tears, ankle sprain and lower leg tendinopathies by up to 50% in youth!

Neuromuscular training, which can be defined as general and sport-specific strength and conditioning activities and exercises that aim to enhance health and skill related physical fitness components, has been shown to assist in reducing lower limb injuries – particularly in court based sports such as football, basketball, soccer and netball. Like our skeleton/bones our brains are developing and creating new pathways at a rapid rate when we are young, therefore repeated exposure to skill specific training at a young age can have long-standing and positive effects on prevention of injury.

Neuromuscular training provides best outcomes when completed both pre and during season 3 times weekly – Neuromuscular training can be incorporated into warm up for 15-20 minutes of a training session or pre game.

An example of this for ACL prevention may include:
• 2 x 10-12 each leg alternating lunges
• 2 x 6-8 sets of Nordic hamstring curls
• 2 x 10 – 12 reps of calf/heel raises
• 2 x 5 double leg broad base jumps
• 2 x 5 each leg single leg distance hops
• 2 x 5 each leg zig zag hops

It is important to note that for injury prevention to be effective proper biomechanics and optimal form should be taught and closely monitored during a session.

Start your kids with injury prevention habits today to help keep our young ones healthy and active into their adult lives.

Advice in this blog is general only and for more specific advice you should also consult your health professional and/or coach!

April 8, 2022

By Gemma Percy Chronic, Elbow, Injury, Overuse, Running, Sporting, Tendon pain

Overuse injury – The what, why’s and how’s answered.

What is an overuse injury?

An overuse injury, sometimes referred to as a chronic injury, refers to an injury that is associated with repeated stress or micro-trauma over time. Unlike an acute injury, such as an ankle sprain, over use injuries typically have no specific incident that caused the pain, rather it will typically gradually worsen with activity with a steady increase in pain. Common overuse injuries include tendinopathies, bursitis, stress fractures/bone stress and shin splints.

It is common to see overuse injuries in the athletic population however they can be seen in all population groups – whether your 10 years old starting netball for the first time, 37 and trying to return to a loved past time or 71 and wanting to start walking more, you must know your limits. Overuse injuries are often related to activities that require repetitive stimulus such as long distance running, swimming, occupation demands such as typing and computer mouse use.

What causes an overuse injury?

An overuse injury will occur for a number of reasons and is related to a break down of tissue structure when the load input exceeds the tolerable level for that specific tissue. Common causes of overuse injuries can include:
• A sudden and/or significant increased load; including but not limited to increased intensity of training, increased hours of training, increased frequency of training
• A change to training conditions; including but not limited to addition of hills, change of footwear, change of training surface
• Return to activity after period of inactivity – e.g. start of sporting season return to walking after surgery etc.
• Inadequate rest periods – leads to increased muscle fatigue and therefore increase load/reliance on tendons, bones and other structures.

How to prevent an overuse injury?

Given that the biggest and arguably only cause of an overuse injury is overload it goes without saying that the best chance at preventing an overuse injury is to follow a progressive loading program and avoid going in too hard too soon.

When starting a new exercise routine or looking at increasing your current training regime it is crucial to have a graded and steady increase. This may look like short periods of work in combination with periods of rest when starting running/walking/swimming or other exercise routines. Ensuring you take regular rest days in the early stages of beginning an exercise routine to allow for adequate muscle recovery is another vital key in reducing your risk of overuse and injury.

If you are an avid exercise goer and looking to increase or alter your current regime following the guidelines of progressive overload will limit placing too much demand on your body systems too soon. Progressive overload can be applied by changes to duration/intensity, frequency, exercise technique/execution or external load – in any of these cases an incremental increase of no more than 10% is advised to reduce the risk of overload and injury.

In the case of overuse injuries in day to day life or with work place demands consideration may given to desk ergonomics and/or technique of repeated movements to attempt to reduce strain on specific body parts that may be at risk over overuse.

How to treat an overuse injury?

Unfortunately due to the slow progression and repeated micro trauma of overuse injuries it is often too late for preventative measures by time your pain develops. If you develop pain that you believe may be an overuse injury it is important to seek medical advice to ensure you receive advise specific to your injury and needs.

When visiting your healthcare provider (Osteopath or Myotherpaist etc.) you can expect your practitioner to assess your tolerance to specific loads and determine a management plan to get you back on your way to achieving your goals. Things that may be considered in your long-term management may include:

• Resting without or without the use of a brace or aid if severely intolerant to load.
• Reducing provocative loads and activity – this may look like a 50% decrease in kms walked/run, or reducing frequency of sessions in the gym
• Limiting spring like loads such as jumping that place a large load through injured areas
• Implementing a exercise/rehab regime specific to your goals.

It is important to note that in all cases of overuse injury LOADING with exercise is essential for long-term recovery and prevention of re-injury. An exercise regime tailored to you is likely to include the following:

• Isometric exercises – those that involve holding a sustained position for an allocated time frame e/g. wall sits/planks etc.
• Isotonic exercise – those that involve moving a body part through its range of motions with or without external forces/load
• Plyometric/return to play – If your goals require you to return to sports/high levels of exercise your program will progress to a sports specific return to play plan
that will involve explosive efforts

In all cases you can expect a program to progress through different stages in line with what you are hoping to achieve and usually takes between 6-12 months for adaptations to occur – Rest assured this does not mean your pain will persist for this period of time!

In conjunction with a loading program your practitioner will work with you to reduce and manage your pain. This may be done through the use of braces/taping, manual therapy (such as soft tissue massage), Ice, Dry needling and/or anti-inflammatory medications.

When indicated your practitioner will also work to find underlying bio-mechanical imbalances or deficiencies in surrounding areas and guide you with the steps required to address these also – This may include looking at your hip when dealing with an Achilles (lower leg) tendinopathies.

Please note that this advice is generalised and we encourage you to seek further advice if you think you may have an overuse injury – For more specific advise or to get started on your journey to recovery from an overuse injury book an appointment with one of our qualified practitioners today!
Book an appointment online here today!
Tennis Elbow – in the non-tennis playing individual!
Tame Your Achilles Tendon Pain!

December 23, 2021

By Gemma Percy Exercises, Running, Sporting, Tendon pain

Tame Your Achilles Tendon Pain!

With the warmer weather and a new year in sight it is likely many of you are experiencing a surge in motivation to get your body moving more – however it is important to bear in mind that doing too much too soon or too quickly can wreak havoc on the body if unprepared! In this article we will touch specifically on Achilles tendinopathies unravelling the who, what’s, how’s and why’s behind why your Achilles might be angry.

What is a tendon?

A tendon is a well-organised collagenous tissue designed to bear large loads and act as an imperfect spring as we move our body. Tendons are all over the body connecting our muscles to our bones and work to store and release energy to produce high and fast loads that allow us to walk, run and jump at max efforts!

Who gets Achilles tendinopathy?

Achilles tendinopathies hold no prisoners affecting nearly all population groups – young & old, walkers & runners and those playing multi directional sports. So what causes tendinopathies to develop? The largest risk factor for developing a tendinopathy is a sudden and unprepared change in load – for the Achilles this could include:

• Increased distance of walking/running
• Increased speed
• Introducing hills
• Change of footwear
• Change of surface
• Training for an event

This change in load causes the tendon to become overloaded resulting in a cascade of changes within the cell make up of the tendon resulting in inflammation and often pain.

Symptoms of Achilles tendinopathy:

Those with Achilles tendinopathy will often complain of localised pain over the Achilles insertion, pain that is worse with walking or hills, morning pain/stiffness. Typically pain associated with a tendinopathy will be worse before and after a session and tend to improve throughout the session itself.

How to manage Achilles tendinopathy?

So what to do if this is all sounding a little too familiar? It is a common misconception that when experiencing pain we should immediately stop all aggravating activities and rest – however when dealing with tendons this is not the case. Due to the nature of tendinopathies it is important that part of the treatment involves loading the tendon to improve its capacity to store and release energy through explosive movements.

Initially to reduce pain you may be required to partially de-load your tendon and stop explosive efforts that require large amounts of stretch & shorten through your muscles. This could include reducing the km’s you walk/run by 50% and resting from all jumping activities while working on slowly loading the Achilles tendon.

In the initial stages of your Achilles tendinopathy your health professional may use therapies such as:
• Manual therapy – soft tissue massage, joint mobility and stretching
• Myofascial dry needling
• Taping to offload the affected area
• Heel wedges or orthotics

Those with Achilles tendinopathy may also find it useful to:

• Limit prolonged standing
• Limit calf stretching
• Limit flat shoes/barefoot

Finally your health professional will work with you to develop a rehab program that will target strength of the Achilles tendon – this will likely include isometric exercises, which require you to hold a certain position for periods, isotonic exercises such as calf raises and in the later stage the introduction of specific hopping, jumping and explosive exercises to ensure a safe and pain free return to walking, running or sport!

For more specific and tailored advice be sure to chat to your Osteopath to work out a plan that works best for you and to address any barriers or fears you may have associated with your Achilles pain. Always consult your healthcare provider before commencing a new exercise program.

December 17, 2021

By Josh Roberts Exercises, Running, Sporting, Strength

How to Overcome Your Hatred of Exercise

Being physically active is an extremely daunting prospect for many people. A lot of us have had very negative experiences with exercise over our lifetime. Social pressures, perceived failures, injuries, pain, and being forced into sports and activities that we genuinely don’t enjoy, has tainted exercise for many of us. Now, into our adult life, there are other responsibilities that soak up so much of our time and energy. It can feel almost impossible to carve out enough time to get a workout in.

Unfortunately, our aversion to exercise is really hurting us. The benefits of physical activity are so broad and encompassing, and so extremely meaningful and powerful. If scientists were able to design a pill that provided the same physical, mental and social benefits as exercise, every person on the planet would be taking it.
Although it’s not as easy as taking a pill, physical activity doesn’t need to be hard and complicated either. Physical activity should be as easy and as painless as possible. It can, and should, fit into your life in a way that becomes second nature.

Exercise can become something that anyone can enjoy, it just needs to be reframed and rethought. These tips are here to help you form a positive habit and build exercise into your lifestyle.

1. Start small

Image: https://www.mentalfloss.com/article/67661/16-little-words-and-phrases-describing-small-amounts

Doing any physical activity is better than doing none. If you’re fairly inactive at the moment, just take the first step. It doesn’t need to be grand. In fact, habits are more likely to stick if they have a low barrier-to-entry and a good chance of immediate success. That means, don’t worry about fancy equipment or expensive gym memberships. What’s the most simple activity that you can think of that involves moving your body? Walk, dance, crawl, roll, sweep, dig, run, jump, swim, ride, play, pilates. Anything. Just move a little bit more than you did yesterday and you’re becoming physically active! Achieving a meaningful goal, no matter how small, will unlock the brain’s neurotransmitters to 1) make you feel good about yourself, and 2) rewire the neural circuitry of the brain to make that habit more permanent.

2. Have fun

Image: https://host-students.com/dance-workouts-you-can-do-at-home/

In what way could you move your body that will provide you with a feeling of happiness and fun? It’s different for everyone, and it can often take a long time to find the activity that lights you up. So be ready to experiment. And think outside of the box, it doesn’t need to be an organised form of exercise – like running, golf, kayaking, rock climbing, frisbee, etc – it can be any random activity that involves movement; kicking a ball around with your dog, dancing in the kitchen, walking to the supermarket, rearranging furniture in your house… Absolutely anything. Don’t restrict yourself to the schoolyard parameters of beep tests and team sports.

3. Team up

Image: https://www.austinfitmagazine.com/March-2015/stay-in-shape-by-walking-with-friends/

More often than not, you’re not the only person in your social circle who is looking to get more active. Be vulnerable and ask a mate if they’ll start going on a morning walk with you once or twice a week. Having an accountability partner makes it easier to get out of bed when the alarm starts ringing. It’s harder to bail on a buddy than it is to bail on yourself. Plus, the benefits of chatting, laughing and spending time with other people compounds the mental and emotional benefits of exercise!

4. Be forgiving

Image: https://centerforliving.org/blog/5-best-self-care-tips-this-fall/

It’s OK to miss a day, a weekend, a week, a fortnight… Don’t sweat it. We’re all human, fallible and imperfect. Sometimes life gets in the way – you get tired, become distracted, unmotivated or lazy. That doesn’t mean you’re a bad person. Your self-worth doesn’t depend on you being perfect, or exercising every day, or being kind and calm and caring to every person you interact with! You are allowed to stuff up. You’re allowed to be selfish. You’re allowed to sit on the couch eating ice cream and watching telly. You’re enough, regardless of these behaviours. So when you miss a day, wrap a metaphorical arm around your own metaphorical shoulder and forgive yourself – there’s always tomorrow, and every day thereafter, to go out and exercise. Habits aren’t built in a day, so having one off won’t derail the train. In his book Tiny Habits, leading behavioural expert B.J. Fogg says it best; “people change best by feeling good, not feeling bad”.

The Nuts and Bolts

Adult Australians are recommended to do 2.5-5 hours of moderate intensity exercise per week, or you can halve that time and do your exercise at an intense level for 1.25-2.5 hours.

Image: https://www.amhf.org.au/essa_helps_men_move_with_new_male_specific_exercise_resource

So what does that look like in practice? Here’s a couple of suggestions to get you up to the baseline requirement for physical activity without breaking a sweat.

You can briskly walk 15-minutes from your car to your workplace (and vice-versa) 5 days a week, and you’re hitting the low-level guideline. If you haven’t walked much for many months or years, start with a 5-minute walk and build up over a few weeks.
In the morning before work, put some music on while making breakfast, and dance around like a fool for 15 minutes til you get a little breathless. Do the same when you get home that evening, and bingo, there’s your 30-mins of daily moderate intensity activity.
Go for a 5 minute walk in the morning sun. Put on your favourite song and dance for 5 minutes. Do 2 push ups. Quickly vacuum the hallway. Throw a ball to your dog 5 times. Park 500m away from work. Do 5 squats on your lunch break. Get home and go for a 5 minute walk in the afternoon sun. Water the garden. Surely that’s 30 minutes all up?

Take Home Message

Don’t make it complex. Don’t make it hard. Make it fun, make it silly and make it likely to succeed. Once you get a few wins on the board you’ll be even more likely to start adding in more, higher intensity, activities.

September 4, 2021

By Josh Roberts Exercises, Running, Sporting, Strength

5 Must-do Exercises for Beginner Runners

Some people might say I’m crazy but I seriously love running. It sets up my day, drags me out of bed, and gives me a boost of endorphins that allow me to drive all the way to work with very few road rage incidents. I use it as a way to catch up weekly with friends, meet new people, and keep myself relatively healthy. It’s easy, basically free, and accessible to almost anybody.

There are a myriad of benefits to running! It’s a safe and effective way to improve cardiovascular health, bone density, muscular endurance, boost mood, and improve energy. With these few exercises, some smart programming, and a few expert tips you too can enjoy all of these benefits – physical, mental and social.

But beware, all of the exercises in the world won’t make up for doing too much too soon. An estimated 60% of running related injuries are linked to increasing mileage too quickly. Get a running plan in place that is tailored to your needs and slowly increase your weekly load in 10% increments. If you’re new to running altogether, start by increasing your daily walking before beginning to add small bouts of running.

Every individual has their own unique injury history, strengths, weaknesses, and running goals. Therefore it may be helpful to speak to the team at Peninsula Osteopathy + Allied Health, to get screened and assessed on your current capacity, and provided with an individually tailored plan to ensure you hit the ground running! (Pun intended).

Single leg sit-to-stand

Single leg strength, stability, and endurance is a huge component of running efficiency and capacity. The average runner should be aiming to take around 160-180 steps per minute, so for a 25-minute jog, each leg must support the weight of the body approximately 4000+ times! The single leg sit-to-stand is the perfect way to begin loading the muscles of your hip, buttock and leg – in a similar fashion to the way they are required to work during running. Your health practitioner can help ascertain when and how to progress the exercise, by adding weights, increasing the range of motion, and more!

Glute bridge

This exercise focuses on hip extension and increasing the control of your lumbopelvic region (from your low back into your hips and buttock). Our hip extensors, such as the gluteus maximus, are the powerhouse of the running stride. The glute bridge can be altered to become single leg, weighted or with different tempos, all of which may be smart progressions for your practitioner to explore with you.

Hamstring bridge

Weakness in the single leg hamstring bridge test has been shown to predict hamstring related injuries in AFL players and military personnel. While we may not be reaching the pace of an AFL player, hamstring strains, tendinopathies, and niggles are still very common amongst casual runners. Start double leg and work towards a single leg variation.

Copenhagen adduction

Hip and groin pain is another common running niggle. This exercise increases the strength and control of your adductors (groin) while also providing a side plank core control exercise – bang for buck! Begin with a short lever (knee on the chair) and progress to long lever when ready (ankle on the chair).

Calf raises

The calf complex is made up of the gastrocnemius (the big two headed muscle you can see) and the soleus (underneath and severely under-appreciated). The soleus actually produces the majority of force in the ankle during running. To strengthen the soleus do calf raises with a bent knee and to strengthen the gastrocnemius do them with your knee straight. Did anyone notice that I snuck in 6 exercises?

Bent Knee Variation | Straight Leg Variation

September 3, 2020

By Belinda Kelly Exercises, Sporting, Strength

STRENGTH! WHAT IS IT GOOD FOR?

Training for strength

Strength training uses the most weight with the least amount of repetitions with long rest periods in-between. Aiming for the ability to lift large amounts of weight for less time. Following the process of task-specific training, this is most effective for people who are trying to increase their overall load to be moved.

Training for Muscle Hypertrophy (growth)

Hypertrophy refers to muscle size as well as strength, you may see this in body-building where they utilise lighter weights, more repetitions and less time resting for particular muscle groups. Muscles require metabolic stress to increase in size, thus as a result of lactate acid build up and micro tears, the muscle then uses its repair process to rebuild and grow larger. This principle is best used for those beginning any exercise program as this utilises the aims of both muscle strength and movement, combining components of strength and endurance principles.

Training for Power

Power training involves using reasonably lighter weights and longer rest periods whilst the aim of the movement is to encourage speed. Power generally refers to the ability to move at high speeds. Power also includes the use of physics where force equals mass times acceleration and power training aims to practicing the acceleration part of the lift. Power principles are usually seen in athletes or powerlifting where weight is increased but require a high speed to move a certain weight. Power based exercises can also be found in HIIT workouts where explosive movements are completed with reduced rest.

Training for Muscular endurance

Endurance training requires more repetitions to ensure muscle functioning can last longer, usually with lighter weights. Rest is usually less for this principle as endurance is suggestive for long durations with little recovery. Endurance based programs for created for marathon runners, or for the everyday person to be able to withstand loading for an extended amount of time.

Which one is for you?

Consider your goal – what do you want to achieve out of your exercise program?
Consider your day-to-day activities – what do you do each day that requires a specific exercise program relative to your daily routine?
Consider what you have done previously – exercise, work and medical history can all have an impact on the physiological systems used within each of the above principles.
A training program is a variety of structured exercises using the principle FITT will guide you towards achieving your goals better.
• Frequency
• How many times a week for an activity?
• For sedentary individuals, start with 2-3 days/week of aerobic exercise and build up to 5 days/week. Build an exercise regime suited to your lifestyle.
• Intensity
• How hard to exert?
• Someone new to exercise should start at a low intensity, but health changes occur at a moderate exercise intensity
• Type
• Which type of activity should you do?
• Should be enjoyable, affordable, and achievable
• Time
• How long in minutes
• This does not include the warm up or cool down.
• 10 min bouts of exercise can be accumulated throughout the day
• If walking is the exercise – first increase the time before increasing the intensity (walking uphill/at a quicker pace)

Training or exercise programs are always most efficient when tailored specifically for individuals and their goals.

Medical Clearance and assessment is always advised prior to beginning any new exercise regime
Individuals unsure of the correct technique, exercise programming or structuring of a resistance program individual to their goals should consider receiving information and education from a qualified health/fitness professional, or Exercise Physiologist.

Any questions or concerns or if you would like to book in for an appointment to discuss your exercise goals, please contact the clinic on 5253 2345. You can also book online on our website!

Written by Tiarna Preer, Exercise Physiologist

References:

American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Philadelphia :Lippincott Williams & Wilkins, 2000.

This pronouncement was written for the American College of Sports Medicine by: William J. Kraemer, Ph.D., FACSM (Chairperson); Kent Adams, Ph.D.; Enzo Cafarelli, Ph.D., FACSM; Gary A. Dudley, Ph.D., FACSM; Cathryn Dooly, Ph.D., FACSM; Matthew S. Feigenbaum, Ph.D., FACSM; Steven J. Fleck, Ph.D., FACSM; Barry Franklin, Ph.D., FACSM; Andrew C. Fry, Ph.D.; Jay R. Hoffman, Ph.D., FACSM; Robert U. Newton, Ph.D.; Jeffrey Potteiger, Ph.D., FACSM; Michael H. Stone, Ph.D.; Nicholas A. Ratamess, M.S.; and Travis Triplett-McBride, Ph.D. Progression Models in Resistance Training for Healthy Adults, Medicine and Science in Sports and Exercise: February 2002 – Volume 34 – Issue 2 – p 364-380

August 5, 2020

By Gemma Percy Elbow, Exercises, Sporting, Tendon pain, Uncategorised, Work Injury

Tennis Elbow – in the non-tennis playing individual!

What is tennis elbow?

Are you someone suffering from pain on the outside of your elbow and Dr Google is telling you that you have tennis elbow, despite never touching a tennis racquet in your life? Tennis elbow, otherwise known as lateral epicondylalgia, is an overuse injury affecting the outside of your elbow resulting in pain, tenderness and substantial limitations in functionality of the upper extremity.

Clinically tennis elbow presents as pain that is aggravated with repeated movements of the elbow or wrist, pain with lifting and decreased or painful grip strength.

Lateral epicondylalgia commonly affects those in office jobs, construction/repair, cleaners and healthcare workers and is associated with repetitive bending and straightening of the elbow joint for more than 1 hour per day.

In greater depth lateral epicondylalgia is both a load related and systemic based condition that ch

aracteristically has an acute inflammatory stage and a chronic degenerative stage. Lateral epicondylalgia affects the extensor carpi radialis brevis tendon and occurs when there is weakness and decreased capacity of the tendon to manage loads resulting in micro tearing within the tendon. This micro tearing further reduces the tendons capacity and elicits a pain response with in our body such that activities of daily living such as picking up a coffee cup can be sufficient enough to trigger pain.

Lateral epicondylalgia often goes hand in hand with a mild degree of shoulder girdle weakness. When using our arms for day to day activity we require a transfer of energy along the chain from shoulder to elbow to wrist – in tennis elbow a weakness in the shoulder leads to an increased demand on the elbow and wrist and hence an overload as discussed above.

The good news is that tennis elbow is generally self limiting meaning that within 6-12 weeks you are like

ly to experience significantly less pain, improved functionality and healing of the underlying tissues.

So how can treatment help?

Treatment of tennis elbow may involve soft tissue massage, joint mobilisation/articulation and mild or gentle stretching in combination with strengthening exercises to prevent reoccurrence. The goal of treatment is to reduce the duration of symptoms and associated disability. Treatment is thought to stimulate mechanoreceptors, which in return inhibits or blocks pain signals from nociceptors reaching the brain.

Your practitioner may also suggest a brace or assist you with taping techniques of the elbow to increase your function. Taping/bracing plays a role by placing tension at point on the muscle distally to irritated/damaged tendon site promoting healing of the damaged area.

In some cases injection of cortisone may be indicated however there is research to suggest that injection may lead to poorer long term outcomes in function and movement.

Getting started – What can I do from home?

The best thing you can do to help yourself is to rest from aggravating loads – this may include avoiding repeated wrist, forearm or elbow movements. It is important not to avoid all upper limb movement as this may further decrease the ability of your tendon to load! When completing movement or exercise it is important to take note of your pain levels – if what you are doing is increasing your pain rating by more than 1/10 it is advisable to stop that activity/exercise where feasible.

Caution should be taken with stretching, as overstretching may further increase tension/load on tendon and influence the pain response – when stretching the extensor muscle group you should complete this with your elbow bent at 90 degrees and stop if pain persists. The use of ice (cryotherapy) may be of benefit in reducing the inflammatory response and assist in reducing the acutely painful elbow.

Exercises that may be beneficial in reducing pain and improving the overall function are outline below:

1. Isometric wrist extension

• Start in a seated position with your forearm resting on a table and your palm facing down.• Place your other hand on the back of your affected hand.
• Attempt to lift your affected wrist up, whilst resisting the movement with your good hand (Ensure you keep your forearm in contact with the table.)
• Hold this position for 10 seconds
• Repeat 10 times, 3 times through with a 60 second rest between sets.

2. Scapular retraction

• Start in a standing position with your arms by your side and palms facing backwards.
• Gently push your hands backwards and feel a gentle squeeze between your shoulder blades (Ensure you keep your shoulders away from your ears)
• Hold this position for 2 seconds and slowly return to starting position
• Repeat 10 times, 3 times through with a 60 second rest between sets.

We encourage you to consult a health care practitioner if your pain persists or for more personal advice and advanced care of tennis elbow.

July 30, 2020

By Belinda Kelly Exercises, Hips, Sporting

3 Tips to Get You Started on Your Running Journey

The coronavirus pandemic of 2020 has changed our lives dramatically. It has stopped us from seeing friends and family, made us change our hygiene habits (maybe for the better?) and significantly changed our routines and day-to-day existence.

With gyms closed and outdoor activities limited, I wanted a easy, quick and affordable way to fit exercise into my day.

And so like that, I took up running!

Now I am no expert, that is one thing I am sure of, but I can definitely impart some tips and tricks that I have put in place to keep me motivated and committed to the cause, because to be honest, running in itself is pretty boring.

What keeps me coming back is the post-run endorphin hit that you get with any exercise, what a great way to start the day!

For all the beginner runners out there, this is what I have incorporated to keep me going.

Set Goals

Probably the easiest and most effective tip towards achieving your goals is to create them in the first place! Too many times I have seen clients and patients (and of course me personally!) start exercise classes or rehabilitation programs with vague and ambiguous end points.

“Get fit”, “get stronger”, “improve flexibility”, “increase my core strength” are some common ones that get bandied around. The problem with these is that they aren’t specific enough.

One great way to create clarity with goal setting is to use the S.M.A.R.T acronym. SMART goals are specific, measurable, achievable, relevant and time-orientated. If we take running as our example to create a SMART goal, it might look something like this:

I want to run 21kms continuously, by the start of next year (6months time).

This goal is specific (21kms continuously), it is measurable (we can track progress via measuring Km’s ran), it is achievable (yours may be different based off your level of fitness/experience), it is relevant and has a date attached to it. From this we can work backwards and put a plan in place to reach this goal.

Track your progress

There is now an abundance of ways that we can do this with modern technology – from phone apps all the way up to top of the range wearable watches. If you are a beginner like me, using a phone app would be the best place to start. I have been using the RunKeeper app from Asics. It’s free and has all the features needed to give you the right amount of information and feedback.

Measuring and tracking your progress over time creates buy-in, tells you how you are tracking towards your goals and can create that little extra bit of incentive to stay with the process when the last thing you feel like doing is going out and exercising.

On the flip side, try not to get too bogged down on the day-to-day progress and running times/splits/Km’s ran. Being sick, tired, fatigued from work, dehydrated, stressed etc. are all factors that can influence your run. As long as the overall trend is a positive one, it’s ok to feel crappy from time to time.

Injury Prevention – Warm-up, work on your weaknesses & manage loads

Avoiding any significant disruptions or prolonged time-off from running is going give you the best chance at reaching your goals. As an Osteopath, I could write a whole blog post on this topic alone! (Maybe I will?).

Injury prevention doesn’t mean spending every other day in the gym or getting weekly massages – as nice as that may be!

There are a few simple strategies that you can do to limit your chance of getting hurt:

Warm-up

A 5-10minute warm-up prior to going for your run may help to limit the chance of an injury occurring in the first place or speed-up your recovery post-run. Your warm-up should consist of some flexibility-based and strength-based movements that target all the parts of the body that you will be using during the run. Common stretches and exercises in a warm include dynamic stretching (think leg swings, trunk twists etc.), strength-based exercises (squats, lunges, single leg exercises) and neuromuscular exercises (high knees, butt flicks, grapevines etc.).

Make your legs and trunk resilient and adaptable

Another way to prevent injuries from slowing you down is to build your bodies capacity to be resilient against running, this can be done by increasing the strength in your leg and trunk muscles. Going through a systematic and thorough musculoskeletal assessment with your trusted health professional will help identify areas of weakness and then will allow you to put in place strategies to adjust accordingly. At Peninsula Osteopathy & Allied Health, a common running assessment may include things like testing the range-of-motion and strength in your ankles, knees, hips and spine. From this we can then give you exercises and hands-on treatment to improve these deficits.

Manage your loads

I.e don’t do too much but don’t do too little. Maybe the biggest cause of injuries in any training program is increasing your loads too quickly. This is because your body doesn’t have the capacity to deal with the loads and stresses you are putting it under. Again, another topic that we could dive deeply into with various guidelines and protocols, but for beginner runners (like me) splitting your running program into 2 week blocks and not increasing your overall running load by more than approximately 10% each block can limit the chance of any flare-ups. A multitude of factors can contribute to overall ‘load’; running distance, speed, elevation and amount of rest can all be altered to make runs easier or more difficult. Tracking your progress via an app or watch gives you more data to make informed decisions and prevent any excessive fluctuations in load.

Should you have any questions or wish to know more about a warm-up or how to reduce your chance of injury during running, give the clinic a call to speak to one of our experienced Osteopaths, Myotherapists or Exercise Physiologists on 5253 2345.

October 3, 2019

By Belinda Kelly Sporting

Gearing up for summer sport!

It’s that time of year again! People all around our community are dusting off cricket bags and tennis racquets, ready for the long hot summer of sport!

Injuries in sports such as tennis and cricket are extremely common. So we thought we would give you some tips to help avoid injury this summer.

Warm Up!

This is perhaps the most over-looked aspect of sport over summer. Just because the weather is warm outside, does not mean that your muscles are warm and ready to play. Make sure you spend some time before the game to actively stretch and prepare yourself. This can go a long way to reducing soft-tissue injuries, and allows you to perform at your best!!

Stay hydrated!

At trainings and game day, it is vitally important that you are consuming enough water so that you can function to the best of your ability. In the heat, your body produces a large amount of sweat to cool you as you exercise. By making sure you consume plenty of water, you can help yourself in the prevention of soft tissue injuries, cramps and heat exhaustion.

Recovery!

Summer sports can be very taxing on your musculoskeletal system. It is vitally important that after a game or training session, you are taking all the necessary steps to ensure that you are ready to go next time you play. Be sure to perform some static stretching, use a foam roller, go for a walk in the pool or at the beach, and hydrate, hydrate, hydrate!!

Keep training specific!

Sports such as tennis, golf and cricket include specific movements of the upper and lower extremities. Be sure that you are training for the movements that you will be performing on game day. For example, cricketers should be focusing on shoulder strength and flexibility, as well as rotation through the trunk as these make up a lot of the movements performed whilst playing. Tennis players should focus on knee and ankle stability, as well as forearm and grip strength training.

Remember, if you have any questions or queries, please don’t hesitate to give PO+AH a call on 5253 2345 to see what an Osteopath, Myotherapist or Exercise Physiologist can do for you! We have appointments available 6 days a week at two convenient locations; Drysdale and Leopold.

August 17, 2019

By Belinda Kelly Acute, Chronic, Exercises, Sporting

Is your low back holding you back? Here’s how to manage it!

Managing your low back pain

Most of us have had some sort of low back pain before. From a minor ache and tightness that resolves in a couple of days to more intense, sharp pain that can take a little bit longer and be much more intimidating and frightening!

Regardless of the severity and the duration, there are a few things you can do to make sure that the pain doesn’t linger and affect your life anymore than it has to.

These are some tips we end up saying to the majority of people who present to us with various types of low back pain.

But of course, if there are more serious symptoms like pins and needles, numbness and weakness in your legs then it is important you seek a healthcare professionals opinion.

Keep moving and stay at work

This is probably the most important thing that you can do. Movement is the best medicine for any episode of low back pain. Go for gentle walks and do some gentle stretches. Keep that back moving. Also returning to work and if needed, returning with modified duties improves your chance of recovery and decreases how long your low back pain will hang around for. Some activities may need to be modified to make them easier for you to do and your healthcare professional can help you with this.

Use heat, not ice

A lot of confusion about whether to use heat or ice exists in the community. Of course it depends on the type of your back injury, but generally in acute back injuries or in back injuries that have lasted a long time there is unlikely to be much inflammation, so icing the affected area is unlikely to help. Using heat instead can help relax and decrease the tension in those tight back muscles and help you feel and move better.

Hands-on treatment can help

Your healthcare professional (osteopath etc.) can give you information on what is happening, why you are in pain, recognise if something more sinister is going on and educate you on what you should and shouldn’t do. They can also help relieve some of those aches and pains and give you stretches and exercises to help keep you moving.

Some medications may help, but try conservative treatment first

A great adjunct to movement and hands-on treatment is the addition of certain medications. Speak to your doctor or pharmacist about what may be suitable for you, dependent on your past medical history and complaints. This may not be a long-term option so it is important that medication is used in conjunction with some of the other strategies we have mentioned above.

Stay positive

Above all else, stay positive. Most episodes of more acute low back pain settle within a few weeks and rarely have a longer lasting impact on your quality of life. Keep moving, modify a few things and let the body do its job. Our bodies are amazing at healing themselves and some things just take time.

For personalised advice regarding your low back pain come in and see one of the PO+AH team to help you on your recovery.

Category: Sporting