Daylight hours may be getting shorter but the beautiful days are in good supply.

This recent good weather may have prompted you to resume exercising which has lead to some aches and pains. Never fear, one of our physiotherapists, Michael Tew, has some timely advice.

If on the other hand you like to take a more leisurely approach to a sunny day, Simon Gellie explains how exercise can be beneficial not just for your health but for the treatment of neck and back pain.

Should you have any questions regarding the content of this newsletter please feel free to ask a Backfocus therapist, they are more than happy to offer advice.

RUNNING INTO AN OVERUSE INJURY?

You may have been inspired recently by the summer weather to take up jogging or some other sport where running plays a major part. Its often a month or two after commencing this activity that some of us begin to experience various pains, such as;

• - Shin splints
• - Heel or arch pain
• - Achilles pain
• - Knee pain

These problems are described as ‘overuse injuries’, because they typically occur following a change in a person’s routine - for example running after many months off. Other reasons include a significant change in a person’s training program, running surface or footwear.

Whenever you begin to experience any of these pains, a person should apply the same simple steps:

Rest from the aggravating activity.

Where running is your aggravating factor, you should stop immediately; if walking is enough to set off your pain, make sure you moderate your activity levels, and wear appropriate footwear whenever walking for more than a few minutes (this means wearing trainers to work and changing shoes when you get there!).

Ice:

Applying ice for approximately 20 minutes every hour over the injured area should help relieve pain and the associated inflammation caused by your injury. AVOID applying heat packs, vigorous massage or rubbing at this stage.

Look at your footwear:

In many instances your running or walking shoes will be contributing to this problem. Questions to ask include:

• - How old are your shoes?
• - Are they appropriate for the sport or activity you are participating in?
• - Do they provide enough support for your feet specifically?

See a Physiotherapist:

It is difficult for an individual to identify all the problems that may contribute to their pain. Your Physiotherapist will be able to help in the following ways:

• - Providing immediate pain relief when your condition is particularly severe.
• - Apply various treatment techniques to improve the range of motion and muscle length where this is a problem.
• - Identify the biomechanical issues that contribute to your problem.
• - Identify changes in your routine/ training that may have contributed to the problem.
• - Provide recommendations regarding appropriate footwear, including the provision of basic orthotics to improve the way your foot moves.
• - Suggest changes in your exercise/ training program that may help to improve your symptoms.
• - Tailor a program of exercises to correct any biomechanical problems that may be contributing to your problem.

Once the above steps are taken, you will typically see significant improvements within a few weeks. In some cases, basic overuse injuries can develop into significant problems, such as stress fractures. For this reason it is important to ‘get on the front foot’, and address the causes of your problem early.

Author: Michael Tew

Associate Physiotherapist at Backfocus’

Diamond Creek and Collins Street Clinics.

EXERCISE PHYSIOLOGY AND BACK PAIN

Back and neck pain can be very debilitating. Figures suggest that around 80% of people experience back pain at some time in their lives.  Back pain can be localised in and around the spine, but can also be experienced as sciatic pain. Headaches and migraines are also commonly caused by neck issues.

Exercise is gaining recognition as playing a vital role in the long term recovery and in preventing many musculoskeletal injuries, including back and neck pain. Although exercise is commonly prescribed by many different practitioners, coaches and personal trainers, Exercise Physiologists are  university qualified and have practical knowledge in exercise rehabilitation to compliment the existing or previous management of other health care practitioners.  As an exercise physiologist, I believe that to achieve long term results when trying to prevent and rehabilitate pain and injury you must correct the underlying causes, not just seek to stop the pain.

What are the underlying biomechanical causes of back and neck pain?

Most back pain is caused by excessive loading placed on muscles, joints, ligaments, spinal discs, etc. due to poor core stability. Core stability is traditionally defined as “an individual’s strength and control of their lower back, pelvic and abdominal muscles in order to maintain optimal postural alignment of the lower back and pelvis”. However, I believe that it is important to also include the shoulder girdle and rib cage, as the lower back and pelvis do not operate in isolation, and muscles throughout the torso must act in a coordinated manner in order to maintain optimal postural alignment and also to initiate biomechanically efficient upper and lower limb movements.

A good analogy to help understand core stability is to consider how a tent is supported. A tent is held upright by a rigid tent pole. The bones of your spine act like a tent pole, however your spine is not rigid, so it relies on the support of ligaments and deep stabilising muscles to hold adjacent vertebrae and to help maintain optimal postural alignment i.e. stabilise the spine. If the muscles that stabilise the spine, pelvis, rib cage and shoulder are weak or are poorly controlled then your spine will tend to collapse, just like  a tent pole made from a piece of spaghetti. There are many muscles that attach directly onto the spine, pelvis, rib cage and shoulders. These muscles move our torso and limbs and also assist with stabilising the core, acting in a similar way that guide ropes help to keep the tent pole upright. If a tent had guide ropes that pulled more on one side than on the opposite side then the tent would lean, so too, if the muscles on one side pulled more than the other due to imbalances in strength and/ or flexibility, or these muscles compensate for weak stabiliser muscles then they will pull your body into a poor postural alignment. One very important difference to note is that a tent only requires “static stability” i.e. support to maintain a single stationary position, whereas, the human body must have “dynamic stability” to provide support and maintain optimal alignment of their core and limbs whilst moving in many different ways to participate in sport, work and daily living activities.

So how do Exercise Physiologists correct these biomechanical faults?

Exercise physiologists conduct a comprehensive physical assessment and then use this information to design a personalised exercise program to improve posture/ biomechanics, core stability, flexibility, functional strength, cardiovascular fitness, balance and coordination. Programs focus on achieving long term results by correcting the underlying biomechanical causes of your pain, improving the strength of muscles that support your back and neck and teaching efficient movement for your specific sport, work or daily living activities.  Expert supervision by an exercise physiologist ensures that each client completes the exercises with good technique to prevent further injury, to ensure that the exercises are effective, and also to ensure that progressions are made at safe and appropriate times.

If you suffer from back or neck pain then a Back Focus Exercise Physiology program could be the solution that you are looking for. For further enquiries or to book in for a program please call Back Focus Physiotherapy at the clinics listed below

Author: Simon Gellie - B.Sc., Grad. Dip. (Exercise & Sports Science), Dip. Remedial Massage

Exercise Physiologist and Massage Therapist at the Epping, Hurstbridge and Mill Park Clinics.

We hope this provides you with some useful tips for your exercise routine - whether that be energetic or leisurely.  Don’t forget you can always contact one of the Backfocus physiotherapists if you think you need more information or advice concerning exercise related issues.

Until the next issue of Infocus, may the sunny days be plentiful.