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Are your glutes weak?

One of the largest and most powerful groups of muscles in the human body is located in the buttocks. Consisting of the gluteus maximus, gluteus medius and gluteus minimus — collectively known as “the glutes”. These muscles are important to most of the body’s active movements. If they are weak or underdeveloped, bad posture and numerous health problems can result.

How do “glutes” become weak?

1. Inactivity  as we spend most of our day sitting on them
2. Following an injury (low back, hip, knee or ankle) the glutes can ‘turn off’ to prevent further compression or pain
3. After an episode of pain we will avoid movement because we are scared they will cause pain.  This leads to decreased use of muscle.

Some very common conditions that we see in the clinic that can be directly related to glut weakness include:

1. Trendelenburg sign which can lead to injuries to the lumbar spine, sacroiliac joint (SIJ), greater trochanter bursa, overactivity of piriformis and tensor fascia lata (TFL)
2. “Knocked knees” can lead to injuries to the patellofemoral joint, patella tendon and fat pad.
3. Same-sided shift of trunk (lateral flexion of trunk) can lead to injuries to the lumbar spine due to increased disc and facet joint compression or SIJ due to increased shear forces.

Physiotherapy can improve glut strength

Our physios can conduct a thorough assessment to establish which glut muscles are weak and prescribe an exercise program to improve recruitment, strength and endurance.  This includes specific muscle training to help recruit muscles and improve control and strengthening exercises to assist in strengthening and improve efficiency of the muscle.

Strengthening exercises of the “glutes” can help to reduce any secondary problems associated with the weakness by helping with stability and function of the joints.  The gluteus medius and minimus are important lateral stabilizers of our pelvis.  The major purpose of this is to prevent tilting of the pelvis.  This is important as it allows our swing foot to clear the ground when walking and provide a stable base for our lower back.  The glut max is our power muscle giving us strength to get out of a chair, climb up stairs and sprint up hills.

So get your butt into gear this summer (your body will thank you)!

Are your bones strong enough?

A recent article in the Sydney Morning Herald reported a third of Australians over 65 years are doing no exercise, and many more are not doing enough to improve strength, co-ordination and balance.  The Australian Journal of Science and Medicine in Sport published a study that revealed the older population mostly took part in aerobic activities such as walking, which is beneficial to cardiovascular fitness but does little to protect the exerciser against falls or loss of bone mass.

Osteoporosis is a chronic, progressive disease and is one of the most common metabolic bone diseases in people over 65. It has been most frequently recognized in elderly women, although it does occur in both genders, all races, and age groups. It is characterised by low bone mass and deterioration of bone tissue, with a consequent increase in bone fragility. Unfortunately the disease often does not become apparent until a fracture occurs (usually from a fall).

Another term that is linked with osteoporosis is osteopenia. Osteopenia refers to a bone mineral density (BMD) that is lower than normal but not low enough to be classified as osteoporosis. Bone mineral density is a measurement of the level of minerals in the bones, which shows how dense and strong they are.

Physiotherapy can help to reduce your risk of osteoporosis by improving your strength, flexibility, posture, and balance. Spinal bone mineral density (BMD) is linked with the strength of the back extensors; therefore, maintaining and strengthening the back extensors should be emphasized.

Regular weight-bearing exercises are essential for the maintenance of bone mass  and should be encouraged in all patients, including children and adolescents. Exercise also improves agility and balance, thereby reducing the risk of falls.

Cheer on the Aussies during the London Olympics

With the London games well underway, the athletes are primed and ready to go but the big question is are you?

With 38 sports and with thousands of athletes competing full throttle to win that coveted gold medal we’re sure that you will have an interest in at least one sport. With all sports can come the disappointment of injury; which unfortunately occurs in us amateur athletes as well. Below is a look at a couple of sports that you or your kids may participate in socially that will feature throughout the next 17 days of Olympic competition.

SWIMMING

Our swimmers are regarded as some of the world’s best, but with the many km’s in the pool, injuries can occur with one of the most common shoulder injuries being impingement. This is when the tendons of the rotator cuff become compressed in the space just below the tip of the shoulder. This produces a sharp localised pain which can lead to further tearing and degeneration of the tendons should it be left untreated. As like most injuries it can be brought about by a poor stroke technique, increased training load, or reduced muscle strength around the shoulder girdle to name a few.

Initially treatment would involve avoiding aggravating activities .i.e. freestyle stroke and apply ice for pain relief to the area. Following this period we would start to address any contributing issues that may exist such as muscle tightness, reduced strength & finally correct any poor biomechanical or technique issues.

A majority of shoulder injuries from swimming can be prevented with correction of stroke technique and altering your training load in the short term.

GYMNASTICS

Gymnastics produces spectacular jumps, flips and spins but injuries can occur if you’re not careful while performing these routines.

Ankle sprains often occur following tumbling or landing from jumps and leaps that sometimes require aerial movements. Ankle sprains tend to only involve a ligament but can occasionally cause a fracture. Our initial management usually includes active rest, ice, compression & elevation. Ankle strengthening exercises are also recommended and upon return to training strapping may help prevent these injuries recurring.

Wrist pain in gymnastics is brought about by repetitive high impact weight bearing particularly with tumbling, cart-wheeling and flips. Wrist pain can either be acute where there has been an incident (which a fracture may need to be excluded) or gradual due to repetitive movements such as hand-standing. Depending on the nature of the injury we would recommend that you do a lot of strengthening work around your wrists and consider the use of braces or taping to support the wrist and prevent any further injury.

CYCLING

Just off the back of the tour de France, the men’s and women’s road race will showcase London to the world. For all those budding cyclists either riding competitively or socially you need to not only look out for the traffic on the road to prevent any injury but also look after yourself. Whatever type of cycling you do be it on or off road, mountain biking or BMX racing you can fracture bones, strain muscles, and even dislocate joints if you aren’t careful.
Some common injuries to joints include:

Knee:

–        Anterior knee pain

–        Ligament damage

–        Patellar tendinopathy.

Hip and low back:

–        Low back pain

–        Groin strains

Ankles and feet:

–        Achilles Tendinopathy

–        Calf tears or strains

–        Ankle sprains

Most of these injuries may be due to overuse of certain structures but some can be a result of an accident. The prevalence of these and many other injuries can be reduced with a good posturing and a combination of core and strength exercises.

RUNNING

Running demands the athlete to deal with high impact forces through the knee, shins and feet. These forces can overload the muscles, ligaments and tendons supporting our body due to a variety of reasons but commonly through increased training loads, running on hard surfaces & poor foot biomechanics.
Shin splints are a very common condition that we see which is when the muscles at the front of your leg become overloaded. We recommend an initial rest period including icing and NSAID’s. Soft tissue treatment can also be commenced to reduce any tightness that exists.
Long-term management is important because if this becomes chronic in nature it may lead to extended periods off running, which we all don’t want.

We recommend a management program which includes a combination of lower limb strength and stretching exercises, dry needling and correcting any biomechanical abnormalities.

So, enjoy cheering on the Aussie’s during the Olympics and should you have any concerns or questions about any injures acquired during you chosen sport during this Olympic period please don’t hesitate to call us on (02)8065 6902

Tips for a Healthier Spine

12 TIPS FOR A HEALTHIER SPINE

1. Exercise Regularly
Regular exercise and strengthening activities will promote a healthier, stronger and more stable spine. Aim for a minimum 30 minutes of exercise daily. Exercise does not have to be overly strenuous to achieve significant benefits. An activity such as a walking can make a huge difference. Start any new exercise slowly to give your body a chance to build the strength and fitness.

2. Maintain Optimum Body Weight.
Excessive bodyweight exerts more stress and pressure on the spine, thereby increasing risk for abnormal and accelerated “wear and tear”. Excessive body weight also makes it harder to maintain the optimal body alignment, which can cause stiffness and pain in the spine.

Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2). It is a rough guide only and does not account for age / build etc.

The WHO (World Health Organisation) definition is:
a BMI greater than or equal to 25 is overweight
a BMI greater than or equal to 30 is obesity.

3. Maintain Good Posture
It is very important to maintain optimal posture in sitting, standing, walking etc. Poor postures such as slouching cause uneven pressure through the spine, increase stiffness and can accelerate degeneration of the spine. Poor postures are also commonly associated with soft tissue strains and nerve irritation such as sciatica in the spine.

4. Improve Core Strength
The deep abdominal muscles, pelvic floor and diaphragm help support the low back and pelvis. These muscles make up what is called your “core”. Strengthening the core will increase spinal stability and reduce the risk of injury. Taking this one step further, exercise such as pilates, which focuses on strengthening the postural muscles as well as the core will benefit your spine.

5. Take Breaks from Sustained Postures
Avoid sustained postures, your body is not designed to stay in the one position for long periods of time. During episodes of prolonged sitting or standing, such as at an office desk, periodically take a break. Aim to take a break every 30 minutes to stretch your arms, legs and back. It only needs to be for a few minutes and then resume your activity. Periodic stretching will help to keep you from feeling stiff and sore at the end of the day.

6. Maintain Flexibility
Regular activity and stretching helps maintain flexibility of the spine; flexibility enables you to maintain an optimal posture and even pressure through the spine. It also allows for normal, full range of movement of the spine.

7. Use Proper Lifting Techniques
Proper lifting technique will reduce the risk for spine injury. Keep the back straight and bend the knees and hips when lifting; this reduces stress on the back. Avoid lifting objects higher than your waist whenever possible. Face the object you wish to lift. When lifting hold the objects close to the body. Do not twist through you spine while lifting. When possible push rather than pull an object which is less stress on the back. Seek help lifting when necessary.

8. Invest in a Good Pillow and Mattress
The average individual spends approximately one third of life sleeping, therefore proper support of the spine and head during this period is important. There are different types of pillows and what feels the most comfortable to you is the best. A good mattress will support the spine and facilitate a better quality of sleep.

9. Invest in Good Chairs
We spend the majority of our lives in a sitting position. Chair design greatly influences sitting posture. Poor chairs contribute to chronic back problems; well- designed chairs promote better back health. Regardless of design it is very important that you aim to take breaks while sitting every 30 minutes.

10. Take Care with Strenuous Activities
When undertaking strenuous activities take care not to over do it. In particular take care with activities that you do not partake in regularly as your body is not conditioned for them. Common activities that cause injuries to the spine are gardening, moving house, shifting furniture etc.

11. Listen to Your Back
Avoid positions and activities which cause increased back pain including referred symptoms down your arms or legs. If back symptoms should persist or progress, see a physiotherapist. If you are performing an activity that causes back pain, think about what you can change to alleviate the pain. Your body will usually tell you what it needs if you take time to listen to it.

12. Learn to Relax
Learn to manage stress both on and off the job. This will help to reduce muscle tension and pain from those muscles. I think we can all relate to stress causing tension in our neck and shoulders.

IF BACK OR NECK SYMPTOMS PERSIST, SEE YOUR PHYSIOTHERAPIST OR DOCTOR.

Prevent a Knee Injury this Ski Season

With winter well & truly set in, it can only mean one thing…. NSW ski season begins.

Skiing allows us to let loose down the slopes at high speeds, enjoy the sights but most important of all leave the hussel and bussel of the city and have fun. But in saying that accidents can happen while you’re down there and unfortunately it may lead to an injury. As the winter rolls on we begin to see more and more skiing-related injuries & although some of these can be prevented through undergoing training in the summer months, whether it be Pilates or gym work for most of you; some injuries can be accidental and just plain unlucky.

Knee injuries to the ligaments that surround the knee account for a large proportion of the ski-related injuries that we see in the clinic; with an anterior cruciate ligament (ACL) rupture being a common sight. Ski-related injuries can also include bone, muscle or cartilage damage. The repetitive twisting and turning of the knee while skiing as well as for some; the variety of ways to fall over and land on the knee could lead you to stress or strain the structures in and around the knee.

A recent visit to a prominent knee surgeon in Sydney who specialises in ACL’s, mentioned that a simple on-field warm-up program can reduce non-contact ACL injuries. Primarily it should be targeted at people who have undergone an ACL reconstruction in the past or those who compete in sports which are known to lead to significant knee injuries. He advocated for the “PEP Program” which stood for; Prevent injury Enhance Performance.

This program was developed in the USA through assessing and treating 1435 female NCAA student-athletes who had ruptured their ACL. The program has 5 principals involving a warm up, stretching, strengthening, plyometrics and agility drills. It was found that this program reduces non-contact ACL injuries by upwards of 70% and for those with a prior ACL injury; it reduces the risk of a recurrent non-contact injury by 5 times (Gilchrist 2008).

Before you head down to the slopes take a quick moment to look at the video, it runs for 4 minutes demonstrating each component of the program. It is a useful injury prevention tool for all those people young and old who will be venturing down to the snow this winter and with fingers crossed don’t come back into see us with a knee injury.

Happy Skiing!