A Planet specially for Physios....

As physiotherapists we spend ALOT of time working with people who have stiff joints, tight muscles, reduced movement….. All of these things present as a lack of mobility, which is, in most cases, resulting in pain (hence why they are sitting in my waiting room).

BUT sometimes we forget about the other side of the coin….. The hypermobile ones, those that have TOO much movement, their joints have more range than required, their muscles are too flexible.

This is actually a problem that exists far more commonly than one may think, often it is asymptomatic & people won’t even be aware that their body is a little more like an elastic band than their best friends, BUT in some cases joint hypermobility syndrome can cause pain.

Joint hypermobility is usually inherited; if your mum is super super flexible, chances you will be too. There is nothing you can do to change it or prevent it, unfortunately its due to a gene representation in the connective tissue (the glue that holds our bodies together) causing it to become more pliable& more stretchy allowing for excessive movement at certain joints.

People with hypermobile joints have a higher incidence of dislocation and sprains of involved joints. The hypermobility tends to decrease with age as we naturally become less flexible.

When it comes to being hypermobility some people just live with it, other people may suffer from certain related medical conditions such as Ehlers-Danlos Syndrome (EDS), Marfan Syndrome and Osteogenesis Imperfecta BUT the purpose of this blog isn’t to overload you with information related to these issues but rather to give you a little insight into a more common presentation which is ‘hypermobility syndrome’ or HMS and when you may need to seek a little professional advice.

Do you have HMS?

There is a great little series of tests that you can do right no on your living room floor. Give yourself a score of 1 for each of the following that you CAN DO.

Touch the floor with your palms flat without bending your knees
Can you bend your left elbow back past straight
The same for your right elbow
When lying flat on floor with your left leg straight out in front of you can you lift your left heel off the floor approx 1-2 inches without lifting your knee or upper leg
The same for your right leg
Can you bend your left thumb under so that it touches your forearm
The same for your right thumb
Can you bend your left little finger back past 90 degrees
The same for your left little finger

For each one you are able to achieve give yourself a point.

What was your score out of 9? If you were able to do any of the above you have are classed as hypermobile BUT you don’t necessarily have HMS.

In a clinical setting your score along with the prevalence of certain symptoms would categories you into either minor or major hypermobility syndrome. Some symptoms include joint pain, history of subluxation or dislocation of joints, being particularly tall & slim.

If your hypermobility is causing you joint pain make an appointment with a sports physiotherapist. They will be able to assess you and answer all your questions about what you can, can’t, should and shouldn’t be doing. There are exercises that can be done to help with the pain and also allow you to partake in all the activities you wish to. It’s also nice to be educated about the risks that certain sports may present to you as a ‘hypermobile’ individual; for example if you are desperate to play high intensity collision sports such as rugby you should be aware that the risk of you dislocating your shoulder is slightly higher than your team mates who are not hypermobile.

So you have HMS? DON’T PANIC. This doesn’t mean you need to start doing things differently. Yes you can exercise, in fact it’s recommended that you do; yes you can play sport (some may be advisable to avoid); yes you can go trampolining; yes you can ski; yes you can LIVE a normal life.

via- http://yoursportsphysioblog.com/2014/05/30/are-you-hypermobile/

Why post exercise soreness is a good thing sometimes...

DOMS or delayed onset muscle soreness is the term given to sore stiff muscles following unaccustomed strenuous exercise. DOMS usually begins 24 hours after exercise and can linger for anywhere between 2-4 days.

When we talk of DOMS we’re not talking the heavy feeling in your legs when you cross the line of your first marathon, more so the pain you get the next morning when you descend the stairs for your morning coffee and your quads shake like crazy!

I personally love the feeling of DOMS… Sometimes.. It’s a sign that I’ve actually worked hard in the gym for once in my life!!

Everyone is susceptible to DOMS so don’t think if you train 7 days a week that you’ll avoid it, if you change up your exercise regime DOMS might come looking for you. When we exercise we program our muscles to deal with certain stresses and certain loads. Notice when you do your first session of squats / lunges your quads burn for days but after the 3rd or 4th time you do a similar session there is minimal post exercise soreness. This is all due to the ability of our muscles to adapt.

DOMS is thought to be the result of micro tearing of the muscle fibres; the amount of soreness will depends on what exercise you performed and for how long. Eccentric movements (where you’re loading the muscle as its lengthening) i.e. going down stairs or down hills; all seem to result in greater soreness.

The prevention or treatment of DOMS has been a much debated topic for several years, purely because no single treatment has been found to be 100% effective.

Some simple tips include:

Warm down and stretch properly: active recovery is best, it may be the last thing you feel like but a slow jog warm down with gentle stretching can help reduce post exercise soreness.
Ice baths: not really the weather for it but a lot of elite athletes swear by this method. (hot/cold shower may be more tolerable in winter months!)
Sports massage has been shown to have some effect
Rest: if you have just completed your first half marathon no need to engage in a strenuous training run the next day, your muscles need time to recover so take a few days off. However if your desperate to get out and about walking is a good way to get your legs moving!
Try taking Magnesium; The Great Muscle Relaxer (consult your health practitioner for more information)

Don’t be afraid of DOMS it’s often a sign that you have worked hard and pushed your body to its limits!

via- http://yoursportsphysioblog.com/2012/05/31/why-post-exercise-soreness-is-a-good-thing-sometimes/

Back Pain Myths

Back pain is one of the most common presenting problems that I see on a day to day basis… At some point in our lives 8/10 of us will suffer from an episode of back pain. Despite this statistic we arent exactly well educated when it comes to our backs!!! Here are some common “myths” about how to save our backs…

1.    “I shouldn’t lift heavy objects” : there is slight truth to this comment, repetitive lifting can put undue stress on our lower back and predispose to injury. However this can be avoided if the correct lifting technique is used. Lifting should come from the legs, bend the knees and keep the back straight….. Use your quads and buttocks; they are after all two of the biggest muscles in our bodies!!

2.    ” I always sit with good posture so I shouldn’t get back pain” while having good posture is important, even a perfect ergonomic setup won’t reverse the negative effects that 6-8 hours of sitting can have in our spine. Sitting places stress through our intervertebral discs which are the shock absorbers of the spine. The seated position also puts our hip flexors in the shortened position and encourages our deep abdominals to be lazy, particularly when you slouch ( that’s 80% of us by 3pm)

3.    “I do 100 situps a day so my back should be nice and strong”....unfortunately it takes a lot more than 100 situps a day to achieve a strong spine. Ideally you need a good core stability program. Our core stabilisers are the deepest layer of abdominals consisting of the tranverse abdominus, lumbar multifidus, pelvic floor and diaphragm. These muscles help to provide a corset and give support to the discs and joints of our spine.

4.    ” When I have back pain I should lie flat on my back in bed till it goes away”....there is no doubt that in an acute episode of back pain that rest is essential. However exercise is the best thing for speeding up your recovery. You should consult your physiotherapist for appropriate exercises that will be safe for you in the acute phase and as your pain resides these exercises can be progressed and become a long term maintenance program for your back

5.    “Sleeping position doesn’t really impact our backs” for all the tummy sleepers our there it’s time to ditch this bad habit… The best way to sleep is on your side with a pillow between your knees (the lazy S). This position maintains the natural curves of your spine

6.    “Other health factors don’t affect my chance of developing back pain” incorrect there are several health factors that actually increase our chances of suffering from back pain.

Smoking: the chemicals in cigarettes actually dehydrate our intervertebral discs and speeds up the process of degeneration. Research indicates that smokers will take 6 months longer to fully recover from disc related back pain.

Extra pounds: carrying extra kilos will place excessive on the shock absorbers in our spine and also increase the load through the weight bearing joints causing them to wear out faster

Hydration: our intevetebral discs are made up of around 70% water. The amount of water will depend on the amount of load applied through the disc ( this will differ at night – discs tend to rehydrate over night as we sleep) when a disc is dehydrated its mechanical properties are altered significantly and can no longer absorb stress as efficiently.

via- http://yoursportsphysioblog.com/2012/05/07/back-pain-myths-busted-3/