What is it about sport as a teenager that’s so important to your shoulder management as an adult? - Part One

This blog from our Osteopath, Neil, will be the first in a series of short explorations into what can go into the assessment and management of shoulder complaints, with an emphasis on throwing to give some context. Shoulders can be curious and complex conditions to manage with this first blog discussing your shoulders can be quite different from side to side, especially if you’re someone who did a lot of overhead sport as a kid.

When completing a detailed assessment of the shoulder here at the Injury Rehab Centre, one key detail that cannot be overlooked when we are taking your initial history, is your sporting history, particularly in the teenage years.

What is it about sport as a teenager that’s so important to your shoulder management as an adult?

During the early teenage years, prior to your final growth spurt, there is an area of the humerus (upper arm bone) that remains as cartilage and eventually turns into bone.

With enough stress applied to the shoulder from repeated activity from overhead throwing sports or sports dominant to one hand e.g. cricket, baseball, softball. This area of cartilage adapts and creates an additional twist in the bone prior to fusing.

This can be considered to be a positive adaptation and one mechanism that can be the difference between a powerful and weak throw because of the amount of ‘wind-up’ or ‘lay-back’ that can be generated at the shoulder. If you ever watch a baseball pitcher in slow motion from side on, you’ll see the shoulder rotate so far you’ll wonder why it hasn’t snapped!

Once the bone has fused, this can present with an ongoing asymmetry between the shoulders that won’t change with treatment. If you have this sporting history, even when healthy and pain free, you will have greater available movement into external rotation at the expense of less internal rotation when compared to the other shoulder and that of the ‘textbook normal’ reference ranges.

What we then need to consider is that the combination of both movements remain equal - suggesting the total movement available through rotation in your shoulder is the same, just in a different arc due to the bony change.

What some may consider an asymmetrical problem, and restrictions that may need to be addressed, can turn out to just be your normal and nothing to worry about!

This is just one of the pieces that goes into the puzzle of assessing a shoulder here at The Injury Rehab Centre, as part of our comprehensive testing services.

If rotational mobility is not the problem for your shoulder, what else do we need to consider?

Stay tuned for part 2.

Refs:

https://pubs.rsna.org/doi/full/10.1148/rg.2015140254#:~:text=Beginning%20at%20around%2014%20years,2%2C5%2C19

Keller, R. A., De Giacomo, A. F., Neumann, J. A., Limpisvasti, O., & Tibone, J. E. (2018). Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: A Meta-Analysis and Systematic Review. Sports health, 10(2), 125–132. https://doi.org/10.1177/1941738118756577

Nutt, C., Mirkovic, M., Hill, R., Ranson, C., & Cooper, S. M. (2018). REFERENCE VALUES FOR GLENOHUMERAL JOINT ROTATIONAL RANGE OF MOTION IN ELITE TENNIS PLAYERS. International journal of sports physical therapy, 13(3), 501–510.

Tendons – What is it?

Tendon injuries which are commonly referred to as ‘Tendinopathies’ are highly prevalent through society and athletic populations. Within the body any tendon can become painful, with the most common sites being in the lower limb (either Achilles or patella) due to the forces exerted from high impact activities such as running, jumping and landing. We also Tendinopathies through the upper extremity, throwing athletes (cricket, baseball) or racquet sport athletes  suffering from tennis/golfers elbow (forearm muscles) or Rotator cuff Tendinopathies (most likely the supraspinatus). There are a few clear reasons why tendons become injured, they are;

• An excessive amount of load in a short period of time (playing a new sport/ spending a whole day using a hammer).  During this period our body doesn’t have enough recovery time to allow the muscle/tendon to adapt to the load so it breaks down (we see pain and inflammation).

• A period of de-load (rest) then resuming activities (taking a holiday for a few weeks then resuming basketball 4 nights per week). Tendons and muscles love to undergo load, too much and it can lead to injury but also too little means that the tendon doesn’t have enough load so it begins to become stiffer which means it cannot absorb load as well as it once did.

• Repetitive micro-trauma over a long period of time. This is an overuse injury where we don’t give our body adequate time to recover from the stress that it takes on. Seeing as though it is never fully recovering it gradually gets worse and worse over time.

The treatment and management of Tendinopathies is one of the most challenging aspects we face in sports medicine. Every few months there is a new report on what is best for certain Tendinopathies; whether that is surgery, medications, injections or exercise interventions.

The role of a tendon –

The role performed by the tendon is crucial to our musculoskeletal system, the most basic and accurate way to describe what they do is that they transfer force from our muscles to our bone. The force which the tendon controls has 2 components; intrinsic (the individual contracting the muscle – moving) and extrinsic (ground reaction force).

When we get force applied to the tendon we see the first phase where the tendon stretches (this builds elastic energy) the energy created then transfers the force to the attachment site (which in most cases is bone). The stiffness of the tendon determines how much force is transferred; to stiff the tendon transfer the force to the bone (usually results in a stress response), not stiff enough and the force goes into the muscle (which may lead to soft tissue injury.

Risk Factors for Tendinopathies –

We have 2 categories to assess risk factors for these injuries:

Extrinsic -

• Rapid increase in training volume/load/intensity

• Change in footwear

• Occupation

Intrinsic -

• Age - older we see tendon degradation, younger we see issues with the insertion pulling on the bone.

• Body weight - a higher body mass increases stress through tendon.

• Biomechanics - Landing/jumping off forefoot increase load through patella tendon or having a slice serve in tennis compresses the rotator cuff tendons in the shoulder.  

Managing Tendinopathies –

In most cases we often see pain as well as loss of function with these activities, so we need to incorporate multiple strategies to address all the factors that may be causing the issues. We first start with identifying the risk factors and then modifying them accordingly. From the research we know that;

• Increasing muscle size can have a sparring affect on the tendon (achieved through resistance training).

• Heavy load resistance training is recommended to improve tendon function

• Isometric exercises have been shown to improve the structure of the tendon

At the Injury Rehab Centre we evaluate the individual on a case by case basis and work out what will help the individual the most in the short term and long term.  

Case study -

An example of this a patient of mine that had Achilles tendinopathy; the individual had recently increased his running from 10km per week to 35km (preparing for a marathon) and had recently bought new footwear. Straight up we can see there is a dramatic increase in workload being performed but also he had bought a new pair of shoes that didn’t suit his feet (which affected biomechanics). Once we decreased the risk factors causing the painful state and we saw a return to function, we conducted a Super-Session at the clinic which identified that the individual had reduced ankle range of motion on the injured side (risk factor for lower limb injuries) but also found that they had a decreased strength (could only manage to perform 3 reps at 1.2 x Body weight) and with runners we see roughly 1.5 x body weight going through each leg with each foot strike, so if they don’t have the strength something else needs to take up the slack (which can be the tendon at times).  

We manage the individual by reducing the risk factors (as much as possible – some cannot be avoided i.e genetics), but then provide them with enough load so that the tendon can regenerate and get stronger, but also so that they can get stronger so that the tendon doesn’t break down again.  

Why the Injury Rehab Centre can help?

At the Injury Rehab Centre we specialise in assessment and collecting actionable data using the latest technology previously only found in elite sporting institutions particularly in understanding how and why injuries occur. This includes:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify the risk factors of injuries.

• Traditional Physiotherapy and Osteopathy examinations to the lower back as well as hips as well as other regions of the body.

• Strength Testing to identify any strength discrepancies that may be causing your injury or pain.

Next our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques. This may include the use of the True Stretch system as well as Dry Needling and Taping techniques.

Finally your management plan will involve an individualised training plan to build your strength and capacity (muscle and tendon strength, stamina, specific flexibility) often to improve discrepancies from side to side that could be the true cause of your injury.

For any help in regards to any injuries you may be suffering from yourself or you have any questions relating to any other injuries feel free to call The Injury Rehab Centre on (03)9553 7024 or email [email protected]

References –

1. Magnussen, R. A., Dunn, W. R., & Thomson, A. B. (2009). Nonoperative Treatment of Midportion Achilles Tendinopathy: A Systematic Review. Clinical Journal of Sport Medicine,19(1), 54-64.

2. Kjær, M. (2004). Role of Extracellular Matrix in Adaptation of Tendon and Skeletal Muscle to Mechanical Loading. Physiological Reviews, 84(2), 649-698.

3. Frye, A. C. (2009). Bone density, geometry, strength, and muscle size in male runners with and without a history of stress fracture.

Why Runners Think They Get Injured?

If you have ever been told the reason for your running injury was due to insufficient stretching, shoes or flat feet, you may be surprised.

 The literature explains that there is not enough evidence to point the finger at these reasons. (Saragiotto, 2014)

 When tracking load, injuries do not peak until at least 3 to 6 weeks after training has commenced. In other words, appropriate LOADING is critical in the early stages to prevent these injuries from occurring!

-

Mechanotherapy is the loading of your bone, muscle, tendon, ligaments and structures. Decreased pain sensitisation occurs with this loading.

Physiotherapists understand the fine balance between underloading and overloading, as well as the demands of endurance runs. 

If you’d like to feel better, move better and perform better visit buff.ly/2MDGH0P

Get yourself a REHAB PLAN to ensure optimal performance and a pain free finish.

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilties#runner #endurance

Reference:

Saragiotto, B.T., Yamato, T.P., Hespanhol Junior, L.C. et al, What are the main risk factors for running-related injuries?. Sports Med. 2014;44:1153–1163.

Should I Lift Heavy Before My Big Run?

Has anyone ever told you not to lift heavy because you should not “get big” before that big run coming ahead? Think twice. 

The evidence is emerging. 

 It has been shown that SLOW and HEAVY low repetition resistance training, as well as EXPLOSIVE resistance training at least 2-3 times a week only enhances running efficiency, speed and strength. Systematic reviews have shown improved running economy by 8% in the resistance trained group compared to the untrained control group, without putting on additional muscle.

 Did you also know that your calves take up to 8 TIMES the load of your body weight when running? The stiffness of your achilles tendons will also not change enough with running alone. This highlights the importance of strength training even further, not only for performance but also injury prevention. 

If you’d like to feel better, move better and perform better visit buff.ly/2MDGH0P

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilities#runner #endurance #speedy #strong #power 

References:

The Effects of Resistance Training on Endurance Distance Running Performance Among Highly Trained Runners: A Systematic Review in The Journal of Strength and Conditioning Research 22(6):2036-44 · November 2008

Effects of Strength Training on the Physiological Determinants of Middle- and Long-Distance Running Performance: A Systematic Review Blagrove, R.C., Howatson, G. & Hayes, P.R. Sports Med (2018) 48: 1117.

They Say Running is Bad for the Knees

Let me tell you a secret.

‍ The secret to a healthy, functional and pain free knee.

You may have heard the phrase “movement is medicine”.

And you’re probably wondering: But not running, surely?

You may have countlessly been told not to run in fear that you damage your knee. Unless you have already had a serious injury to your knee, seek a healthcare professional for expert advice. The truth is, the evidence debates otherwise.

Did you know recreational runners had the LOWEST rate of developing knee osteoarthritis of 3.5%? Non-runners on the other hand, increased their chances of developing knee osteoarthritis with a rate of 10.2%. That’s a staggering DOUBLE to TRIPLE the difference!

With different medical presentations, lifestyle factors and personal preferences, we understand that everyone is different.

If you’d like to feel better, move better and perform better visit http://buff.ly/2MDGH0P

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilties#runner #knee

References:

https://buff.ly/2NZ24Gu

Not a Runner. Where Do I Start?

We know that taking up a new activity can be pretty overwhelming. Exciting too.

If you are new to the running scene, here are some top tips to get you dashing - based on the evidence.

Did you know 50% of runners will feel some disruption to their running?

Highest risk are

1) Novice runners

2) + Have a BMI greater than 30

3) + Totaling at least 3km within their first week of training

The great news is that these are preventable and best managed with appropriate loading and a smashing plan depending on your individual goals.

.

If you’d like to feel better, move better and perform better visit http://buff.ly/2MDGH0P

.

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

.

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilties#runner #endurance

Running Releases More Than Just Sweat

We could go on all day about all the benefits of running.

Those who run will be aware that they will often feel better, healthier and happier after a run. This occurs through its release of natural endorphins and the benefits of adding years to your lifespan with its effects on our cardiovascular system. Therefore, reducing our chances of illness- mentally and physically!

If that’s not enough, adding some cardiovascular fitness into our exercise regime will help you chase that bus you just missed AND ALSO make your way up those stairs without puffing yourself out for 10 minutes after. Now doesn’t that sound like a dream come true?!

If you’d like to feel better, move better and perform better visit http://buff.ly/2MDGH0P

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilties#runner #endurance #cardiovascular #fitness

How Important Are Your Running Shoes, Really?

Everyone loves a fresh pair of kicks. But what are the KEY things to look for when purchasing a running shoe? And more importantly, does it even matter?

There has been hot debate between minimalist vs maximal support shoes. There is actually not enough evidence to point to a perfect, one size fits all shoe. This all really does depend on you, your needs and pre-existing injuries and niggles.

Minimalist shoes mimic our “natural” running pattern, and the limited evidence showed that it produces higher impact in our novice runners. Minimalist shoes are therefore not recommended for our heavier runners in reducing injury.

Minimalist shoes will also load different joints to our maximal support shoes. We also know that conditioning our bodies to external load will help combat aches and pains. That being said, do our shoes really matter? IT DEPENDS!

What we DO know is that comfort takes priority and that regularly rotating our shoes can reduce our risk of injury by 39% in runners.

If you’d like to feel better, move better and perform better visit http://buff.ly/2MDGH0P

Book yourself an appointment with one of our runnings physiotherapists and marathon to help you DASH past that finish line!

#tirc #injuryrehab #themat #injury #cheltenham#physio #osteo

#rehab #pain #injuryrehabcentre #exercise #training#marathon #running #awayfromresponsibilties #shoes #footwear

Top 5 exercises to cut your risk of ACL injury in HALF this pre-season

Banish your risk of ACL injury this summer and smash your sporting goals

It’s a fact: no one wants to spend the summer pre-season laid up on the couch binge watching re-runs of Friends when you should be out training and performing better for the upcoming football, netball or another sporting season. Did you know that ACL injury is the NUMBER ONE cause of time spent on the sporting side-line? And that’s across ALL sports. That’s a pretty significant reason to spend some time bullet-proofing your ACLs. The great news is that you can cut your risk of suffering through extended couch-time by 50% with these 5 exercises.

At the Injury Rehab Centre our Physiotherapists and Osteopaths regularly work with those from the Cheltenham, Moorabbin, Mentone, Highett, Hampton, Black Rock, Beaumaris and Heatherton suburbs to not only rehabilitate athletes after knee injury, but also ensure any future injuries are minimised.

Which 5 exercises should you be doing right now?

The best ACL prevention programs are based on 3 key areas:

1. Plyometrics – how well your body moves and deals with the forces from running, jumping, landing, and quickly changing direction.

2. Neuromuscular training – teaching your body to optimally send nervous system signals to improve the force and speed of muscle contractions, to improve your balance, and develop correct movement patterns for the most efficient performance possible.

3. Strength training – improving your ability to produce and handle increased loads, leading to greater injury prevention and athletic development.

Drumroll…. Here they are!

1. Reach and tap

• 3 rounds, taping in all directions

2. Single leg deadlift

• Keep balancing knee fixed

• Back flat

3. Box drop with counter-movement jump

• 3 repetitions

• Absorb the landing

4. Drop and cut

• Stick the landings

• Bend through the hips, knees, ankles

5. Trap bar squat

• Drive through legs

• Keep back tight

• Slide shoulder blades down (as if into back pockets), and hold there

With these 5 exercises, each of the 3 key areas is addressed, ensuring your risk of ACL injury is drastically reduced, keeping you on track to smash the 2018 season.

Why the Injury Rehab Centre is the place for ACL rehabilitation

At the Injury Rehab Centre our Physiotherapists and Osteopaths focus on the assessment and collection of actionable data using the latest technology to determine and reduce your risk of ACL injury previously only found in elite sporting institutions.

This includes:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on potential discrepancies or deficiencies of flexibility, balance and movement control that may predispose to ACL injury.

• Slow Motion Video Analysis of how you move, land, and change direction TO FIND BAD HABITS that may predispose to knee injury.

• Strength Testing to identify any strength discrepancies that have a huge effect on how well your muscles can protect your knee ligaments.

• Force Plate Technology to put a number on the differences between each leg in the power you can generate for sporting performance and protection from injury.

• Traditional Physiotherapy and Osteopathy examinations to identify any potential factors that may increase your risk of ACL injury

Next, our treatment process achieves pain relief in the shortest amount of time by using hands-on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques. This may include the use of the True Stretch system as well as Dry Needling and Taping techniques. Finally, your management plan will involve an individualised training plan to build your strength and capacity (muscle and tendon strength, stamina, specific flexibility) often to improve discrepancies from side to side that could be the true cause of potential knee injury.

For a limited time only, the Injury Rehab Centre is running a FREE initial consultation – no cost, no obligation – with one of our Physiotherapists or Osteopaths.

We know it’s risky if you have suffered a knee injury in making sure that you choose the right practitioner to look after your recovery. You don’t want to waste time, money and you want to get back to a full recovery as soon as possible. Our FREE initial consultation lets you decide if we are the right clinic for you and also lets us decide if we think we can help.

So don’t wait, get back to feeling better, moving better and performing better give us a call on 9553 7024 or book online at www.injuryrehab.com.au/bookings.

The 6 tick boxes to return to sport from ACL rehabilitation

Anterior Cruciate Ligament (ACL) injuries can be distressing for patients and its rehabilitation is one that needs to be taken seriously. We understand that it is a timely rehabilitation, but also understand that time is not the only factor that needs to be accounted for when dealing with an ACL injury. It has been reported that 81% of individuals with an ACL injury will return to any kind of sport. Only 65% will return to their pre-injury level and merely 55% return to competitive sport.

Re-injury rates for ACL vary between 6% to 25% thus making the decision for when it is appropriate to return to sport a decision that ultimately must be made with clearance from the orthopaedic surgeons, physiotherapists and osteopaths such as those at the Injury Rehab Centre in Cheltenham.

What are the criteria to return from ACL injury safely?

One study set out to explore an objective return to sport/discharge criteria and evaluate whether strength or functional tests were risk factors for ACL graft rupture. They examined 158 professional male athletes in Qatar and followed up with the individuals 6 months after their return to sport.

The discharge criteria examined were:

• Isokinetic Testing – Quadriceps Strength Deficit <10% at 60 Degrees/Second between legs

• Single Hop – Limb Symmetry Index (a measure to standardise test results with lower limb length) >90%

• Triple Hop – Limb Symmetry Index >90%

• Triple Crossover Hop – Limb Symmetry Index >90%

• On-Field Sports Specific Rehab

• Running Agility T – Test (ability to run and change direction over a set of cones in a T shape set 10 metres apart) – <11 seconds

Of the 158 athletes that participated:

• 116 (73%) fully discharged

• 42 (27%) did not achieve

Injury Occurrence

• 26 (16.5%) sustained graft rupture

  • 17 occurred within the first 6 months of return to sport

• 11 (7%) sustained opposite side rupture

Was there a difference in those that were fully discharged versus not?

YES!

• 12 out of 116 (10.3%) that were fully discharge sustained an ACL graft rupture

• 14 out of 42 (33.3%) that did not meet the 6 criteria sustained an ACL graft rupture

Take home messages:

• ACL re-rupture rates range from 6-25% and a high amount of individuals return to sport (81%)

• Not meeting all 6 variables examined by the study places you at a 4x greater risk of rupture

• For strength examined, every 10% decrease in hamstring to quad strength ratio there was a 10.6x greater risk of ACL rupture

  • DON’T NEGLECT THE HAMSTRINGS!!

At the Injury Rehab Centre we utilize a functional and objective measures to help mitigate your risk of injury before you return to sport. We utilize a variety of tools and combine some of the tests above with force plate technology to increase our understanding of your capability. If you’ve had an ACL injury recently or had a previous ACL injury, ensure that you are ready for your next upcoming season with the Injury Rehab Centre and book with a physiotherapist or osteopath now!

What we do at the Injury Rehab Centre

At the Injury Rehab Centre in Cheltenham we go above and beyond traditional Physiotherapy and Osteopathy clinics by using the latest assessment technology to perform tests as previously described to collect data on how you move to assess your risk of ACL injury or how your rehabilitation is progressing.

We utilise:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.

• Slow Motion Jumping and Running Video Analysis to IDENTIFY YOUR BAD LANDING AND CHANGING DIRECTION HABITS that maintain a risk of injury.

• Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.

• Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries and prevent return to full performance.

•  Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.

Individual management plans can then be created using baseline data to track progression of a program to address movement deficiencies and discrepancies (muscle and tendon strength, stamina, specific flexibility) as well as increasing your movement skill to make you more efficient out on the road, track or trail to bullet proof your body from injury and increase performance.

The Injury Rehab Centre is currently seeking participants for research we will be conducting into the effectiveness of treatment and rehabilitation for ACL reconstruction patients.

As part of this research participants at the Injury Rehab Centre will receive a FREE M.A.T assessment in which detailed lower limb testing will be performed to identify deficiencies and discrepancies in lower limb function to calculate risk of injury.

If this sounds like you or someone you know go click here to register your interest in being part of this study and getting a FREE assessment today.

Reference:

Kyritsis P, Bahr R, Landreau P, et al Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture Br J Sports Med 2016;50:946-951.

How strength training will reduce pain and injury by 50%

At the Injury Rehab Centre our Physiotherapists and Osteopaths who service the Cheltenham, Moorabbin, Mentone, Highett, Hampton, Black Rock, Beaumaris and Heatherton suburbs have the philosophy that stronger people are harder to kill injure. That’s why a big part of our management for dealings with patient pain and injury often involves an active approach teaching our patients to become stronger and move more efficiently.

Exercise is good for us!

jogging

Most patients that our Physiotherapists and Osteopaths see understand that physical activity is beneficial for many common diseases and pathologies. It’s now commonly known through research that exercise helps with:

• Cardiovascular disease

• Diabetes

• Cancer

• Hypertension

• Obesity

• Depression

• Osteoporosis

How does injury occur?

So exercise is good for our body but what about pain and injury? Many of us engage in a variety of different activities and sports that all inherently put our body through stress and strain. We accept the risk of injury because we simply enjoy activity and the benefits outweigh the cons. But what happens when our body doesn’t have the capacity to tolerate the stress and strain that we put it through? Well, injury of course. Whether it be an acute over stretching of a muscle or ligament or repetitive strain over time often the story is simply that we don’t have the strength to care for this amount of stress.

What does the research say?

One study conducted a systematic review (high level evidence) to examine what the effects of strength training, balance/proprioception, stretching, and a combination of these techniques on injury rates.

Main Findings:

• Combination, strength, and balance/proprioception all displayed a tendency to decrease risk of injury!!!

• Stretching alone had no effect

• Strength training had highest preventative effect among all techniques

• Both acute and overuse injuries could be significantly reduced

• Overuse injuries could be reduced by nearly 50%

The take home message:

• Stretching along before and after your workouts is NOT enough to help you reduce your risk of injury

• A strength-training program integrated as a part of your sport/activities should almost be essential to help you reduce your risk!

What do the Physiotherapists and Osteopaths at the Injury Rehab Centre in Cheltenham do?

At the Injury Rehab Centre We specialise in assessment and collecting actionable data using the latest technology previously only found in elite sporting institutions particularly in understanding our patients strength and capacity. This includes:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify the risk factors of low back pain.

• Slow Motion Video Analysis of fundamental lifting techniques such as squats, deadlifts and presses TO FIND BAD HABITS that can cause injury to areas such as the lower back.

• Strength Testing to identify any strength discrepancies that have a huge role in injury risk.

• Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries such as those activities that contribute to back pain.

• Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.

Next our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques. This may include the use of the True Stretch system as well as Dry Needling and Taping techniques.

Finally your management plan will involve an individualised training plan to build your strength and capacity (muscle and tendon strength, stamina, specific flexibility) often to improve discrepancies from side to side that could be the true cause of your low back pain and build confidence in your body.

If you suffer from low back pain and want to get off the treatment merry-go-round and back to feeling better, moving better and performing better contact the Injury Rehab Centre today on 95537024 or book online using the link at the top of the page.

Reference:

Lauersen, J.B., Bertelsen, D.M., Andersen, L.B. The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomized controlled trials. Br J Sports Med, 2014, 48: 871-877.

Run less, improve your running results?

One of the biggest hurdles the Physiotherapists and Osteopaths encounter at the Injury Rehab Centre in Cheltenham is convincing our patients with running injuries such as plantar fasciitis, achilles tendinopathy, knee pain or ITB syndrome is that the way for them to reduce their rate of injury AND improve their performance is to run less and do more weights in the gym.

A lot of runners have difficulty making time for the weight room or even hear the misconception that lifting weights will only hurt their performance with running. This however is proven to be untrue and there are plenty of options and routes for strength training programs such as traditional weight lifting, HIIT, and plyometric programs however it can be confusing to know which style of training is most suitable for you.

Mo Farah one of the greatest runners of all time didn’t get there by only running. He also adopts a consistent strength program

Let’s convince you why strength training is important for runners by informing you with a few studies findings:

• Decreased strength/control around the hip that controls hip drop, adduction, and internal rotation are associated with increased incidence of anterior knee pain (Patellofemoral pain syndrome).

• Individuals with decreased hip abduction, knee extension, knee flexion strength over a cross country season had increase in anterior knee pain and achilles tendinopathy.

• Systematic review has found that hip abduction strength had correlation with ITB pathology (limited evidence for knee/lower leg injuries)

Running injuries such asplantar fasciitis, achilles tendinopathy, knee pain or ITB syndrome are pretty complex and there are MULTIPLE factors that have been associated with increased risk of running injuries. There does seem to be a general agreement that runners with decreased strength are predisposed to some injuries!

But… I’m an avid runner, and go to the gym 2-3x a week and still have pain?

One study looked at a hip strength-training program in pain-free individuals and the effects that it had on their running mechanics. The program lasted 6 weeks, 3x a week, and incorporated movement education with weight bearing exercises.  They analysed their running mechanics before and after the program.

OUTCOMES:

• Hip Abduction strength: INCREASED 42%

• Hip External rotation strength: INCREASED 20%

• NO SIGNIFICANT CHANGE IN RUNNING FORM

• Improved single leg squat mechanics

Running is a very complex movement! This study demonstrated the notion that with pain-free individuals: Strength-training program won’t significantly change running mechanics. The runner that is in pain only while running may benefit from running retraining on top of a strength training program to get optimal benefits from your rehab!

Check out some of the top strength exercises for runners below. 

The Solution!

Until you are assessed by one of the therapists at the Injury Rehab Centre using the latest technology to put a number on your flexibility, strength, balance and running technique you won’t know exactly why your running injury has occurred nor the best course of treatment to get you running pain free faster!

Take Home Messages:

• Decreased strength may predispose individuals for running injuries

• Solely strength training won’t change form

• Runners in pain may benefit from component of retraining running

If you are a runner increasing their mileage and base for training or having pain while running then you should seek consultation from one of our Physiotherapists/Osteopaths at the Injury Rehab Centre in Cheltenham.

We will perform a comprehensive running analysis covering all components of movement to help you identify what needs to be addressed as part of your rehab program. This includes:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.

• Slow Motion Running Gait Video Analysis to IDENTIFY YOUR BAD RUNNING HABITS that stop you from progressing that next step in your running.

• Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.

• Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries.

•  Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.

We then tailor and individualised rehab program based on your presentation to get the best possible outcome and achieve our goals.

To learn more about the Injury Rehab Centre’s Return To Running program click here or contact our friendly reception on 95537024 to learn more.

References:

Mucha, MD, Caldwell, W, Schlueter, El, Walters, C, & Hassen, A. Hip abductor strength and lower extremity running related injury in distance runners: a systematic review. J Sci Med Sport. 2016, pii: S1440-2440.

Luedke, LE, Heiderscheit, BC, Blaise Williams, DS, & Rauh, MJ. Association of isometric strength of hip and knee muscles with injury risk in high school cross country runners. Int J Sports Phys Ther. 2015, (106): 868-876

Willy, RW, Davis, IS. Effect of a hip-strengthening program on mechanics during running and during a single-leg squat. JOSPT. 2011, 41(9): 625-632.

Why does your heel hurt? 2 factors that cause Plantar Fasciitis.

Plantar Fasciitis is one of the most common causes of symptoms for heel pain in runners and is usually categorised by a sharp pain particularly in the morning that warms up or reduces with walking or running. At the Injury Rehab Centre our Physiotherapists and Osteopaths in Cheltenham see many presentations of Plantar Fasciitis every week. About 10% of Plantar Fasciitis cases are linked with running and incidence peaks for individuals between 40-60 years of age.

Why is it happening to me?

Plantar Fasciitis like many other repetitive stress injuries occurs when there is too much load for what the body can tolerate. This repetitive stress causes micro trauma in the Plantar Fascia that is constantly irritated from time spent walking or running in activities of daily living. The foot faces repetitive strain from deformation of the arch during running with landing forces up to three times body weight with every step and this may lead to the development of Plantar Fasciitis.

Am I at risk?

The following factors have been identified in the research as being major risk factors for Plantar Fasciitis.

• Reduced ankle dorsiflexion range of motion

• Obesity (BMI > 30 kg/m2)

• On feet majority of workday

Amongst Runners:

• Use of racing spikes

• High Foot Arch/Varus Hindfoot

• High frequency of running days per week

• Increased running volume km’s/week

• Years of running activity

• Inefficiencies in running form

 What are the common symptoms that I might get with plantar fasciitis?

• Pain with first steps in morning or after inactivity

• Throbbing, searing, or piercing pain located on arch / inferior heel

• Walking on toes, barefoot, or upstairs may make you worse

• Pain will often ease up after period, but may get worse with continued activity

Is there anything that I can do?

Therapeutic intervention should consist of consulting a Physiotherapist or Osteopath to assess, treat and train any underlying dysfunctions or discrepancies causing the Plantar Fasciitis.

Studies examining the foot’s musculature in individuals with Plantar Fasciitis tend to display a decrease in:

• Toe Flexor Strength

• Foot Intrinsic muscle strength

  • These muscles are important as they provide DYNAMIC arch support of the foot during propulsion of gait in running.

Exercises to help Plantar Fasciitis should focus on evening up the ledger between how much stress and strain is being put through the body whilst increasing the tolerance of the Plantar Fascia and the body as a whole to these stresses.

A simple exercise that you may want to try to increase the local capacity of the muscles of the foot is the Foot Shortening Exercise or “Arch Doming” exercise: (See figure)

Keep toes in neutral position and attempt to not bend or extend the toes of your foot while contracting the arch.  This exercise will take PRACTICE in order to get good at and you may experience some cramping in your arch, which is a good sign that you are activating these intrinsic muscles.

Perform this exercise multiple times a day with sets of 10 repetitions.

What’s my prognosis if I already have it?

The odds are in your favor! 80% of individuals who have Plantar Fasciitis had resolution of their symptoms in 12 months. However to get the best possible outcomes with your recovery a strategic approach to addressing causative and maintaining factors needs to be implemented. Patients should expect a recovery time of 6-12 months to make full resolution with Physiotherapy and Osteopathy management.

What should I do if I start noticing heel pain sticking around after a week or two?

Don’t delay. The earlier you can begin management to address Plantar Fasciitis with a Physiotherapist or Osteopath the better your outcomes in treatment with be.

The reasoning for this is likely the repetitive nature of the sport where little issues can then cause more stress and strain becoming painful over time.

Particularly if you are a runner our Return To Running Program has a comprehensive history taking and assessment process going above and beyond what other clinics do, so we can identify the root cause of your running related injury. This process is equally applicable to non runners with Plantar Fasciitis and utilises the latest technology including:

• M.A.T Assessment created by the therapists of the Injury Rehab Centre to laser focus on areas of flexibility, balance and movement that identify whether your are at risk to sustain an injury.

• Slow Motion Running Gait Video Analysis to IDENTIFY YOUR BAD RUNNING HABITS that stop you from progressing that next step in your running.

• Strength Testing to identify any strength discrepancies that have a huge role in increasing your injury risk.

• Force Plate Technology to put a number on differences in the power you can generate through each leg that can lead to compensations and can cause repetitive stress injuries.

•  Traditional Physiotherapy and Osteopathy examinations to identify dysfunction.

Next our treatment process achieves pain relief in the shortest amount of time by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques including the use of the True Stretch system.

Finally your management plan will involve an individualised training plan to build your running/walking movement capacity (muscle and tendon strength, stamina, specific flexibility) as well as increasing your movement skill to make you more efficient out on the road, track or trail to bullet proof your body from injury and increase performance.

Don’t delay. Contact the Injury Rehab Centre to get back on track to resolving your heel pain today. Call our friendly reception on 95537024 or book your appointment online by clicking the link below!

References:

Buchbinder, R. Plantar Fasciitis. New England j med; 2004, 350;21: 2159-2166.

Cole, CC, Seto, CS, Gazewood, J. Plantar Fasciitis: Evidence-Based Review of Diagnosis and Therapy. American Family Physician; 2005, 72 (11): 2237-2242.

Di Caprio, F, Buda, R, Mosca, M, Calabro, A., Giannini, S. Foot and lower limb diseases in runners: assessment of risk factors. Journal of Sports Science and Medicine (2010) 9, 587-596.

McKeon PO, Hertel J, Bramble D, et al. The foot core system: a new paradigm for understanding intrinsic foot muscle function. Br J Sports Med 2015;49:290.

Riddle, DL, Pulisic, M, Pidcoe, P, Johnson, RE. Factors for plantar fasciitis: matched case-control study. The Journal of Bone and Joint Surgery; 2003, 85(5):872-877.

4 Habits of Injury Free Triathletes

As Physiotherapists and Osteopaths in Cheltenham and Bayside we see many triathletes coming through the doors of the Injury Rehab Centre. Much like other endurance sports, a high proportion of triathlete injuries can be linked to overuse (80-85% in fact!). Triathletes do fairly better than pure endurance runners in injury rate, but are more prone to injury than swimmers and cyclers. As you can imagine, running has the most commonly cited association with injury followed by cycling and then swimming.

Common injuries triathletes present with include:

• Runner’s knee. Experiencing a tender pain around or behind the kneecap is usually a sure sign of patellofemoral pain syndrome, a fancy term for runner’s knee

• Achilles tendinitis

• Plantar fasciitis

• Shin splints

• Iliotibial band syndrome

• Stress fracture

• Patellar tendinitis

• Ankle sprains

Why is it happening?

• Lack of stretching

• Poor warm up

• Intensive training

• Insufficient care of muscles

• High impact running style

Consider: The T2 transition (cycling to running transition):

Once of the most unique parts of Triathlon is the transition between the swim, bike and running components of the race. Of particular importance is the transition from the bike to running, as this seems to be an area of the race where individual are most predisposed to injury. This could be due to many reasons but most likely are.

• The change in muscle actions and from an unloaded state (cycling) to a loaded one (running) during this transition provides a high-risk zone for injury to occur.

• There is also a period of time for running technique to become optimal after cycling that may increase the stress in the low back and knee as there may not be optimal ability to dissipate load.

Things that injury free Triathletes do:

1. A lot of self treatment/maintenance: Triathletes with cycling and running backgrounds tend to have increased tightness of the hip flexors, tensor fascia latae muscle, and iliotibial band (ITB). Use a foam roller with daily training to help maintain your range of motion for 5-10 minutes a day!

2. Intensive training: Be patient, and don’t do too much, too soon. Be considerate of your training and don’t increase the mileage of your running/swimming by greater than 10% between training weeks. If you have trouble with training regimens, seek a coach!

3. Don’t have a high impact running style: The different disciplines in triathlon can often mean athletes are not as technically proficient as they should be. Injury free triathletes are also very competent runners and transition well. A comprehensive running assessment may be of benefit.

4. Regular consults with their Physiotherapist or Osteopath: If you are training and competing close to your physical limit it’s naive to assume there won’t be aches and pains. Regular consultations with your Physiotherapist or Osteopath should be part of your routine to reduce the risk of injury and keep you training consistently.

The Injury Rehab Centre are experts in providing comprehensive running assessments to break down your biomechanics and identify regions that may be at risk of injury. Utilising the M.A.T (Movement Assessment Tool) and Strength Testing we can then help develop a plan to improve your form and minimise your risk of injury. Contact us today at the clinic on 95537024 or click here to book online!

References

Migliorini, S. Risk factors and injury mechanism in Triathlon. Journal of Human Sport & Exercise. 2011,  6(2): i-vi

Why you really need a Crossfit Physio/Osteo

CrossFit Injuries

As Physiotherapists and Osteopaths in Cheltenham and the Bayside region of Victoria we see many patients at our clinic who are participants in Crossfit.

CrossFit is a conditioning program that continues to grow in popularity, so much so it even has an annual Crossfit Games that are broadcast through ESPN. This form of high intensity training with limited rest intervals has gained literary support as an effective form of exercise with minimal time investment and personal accounts for improvements in fitness levels. While there is no doubt Crossfit has done a lot for the world of health and fitness in getting people moving, performing compound resistance exercise with great intensity it also has the potential to cause problems. In 2011, the American College of Sports Medicine (ACSM) and Consortium for Health and Military Performance also recognised the benefits of the programs, but demonstrated concern for injury rates.

What are the problems?

A study examined 386 individuals involved in a CrossFit program for the previous 6 months and found:

75 individuals were injured and occurred most in:

• Shoulder

• Low Back

• Knee

Gymnastic and power lifting movements were responsible for most injuries. Gymnastic movements were associated with a higher frequency of shoulder injuries and power lifting had an association with low back injuries.

Anecdotally our Physiotherapists and Osteopaths also see Crossfit participants and other gym goers around Cheltenham suffer from:

• Neck strains

• Rotator cuff strains

• Wrist pain with certain power clean movements

• Hip impingement

• Patellar tracking and patellar tendinopathy

Are there any patterns?

• Males more frequently injured

• Injury rate decreased with increasing levels of coaching supervision

• No significant difference in injury rate across age

Individuals should be aware of their risks for injury and seek coaching supervision for safe form with their exercises. It appears safe for all ages to participate in supervised CrossFit programs, but we still recommend follow up with a medical practitioner before beginning any exercise program to rule out any health concerns. Often the biggest problem is an untrained individual undertaking the complicated movements involved in Crossfit and putting their bodies through more stress than they can tolerate.

How will the Injury Rehab Centre help you?

At the Injury Rehab Centre our Physiotherapists and Osteopaths utilize tools like the Functional Movement Group’s M.A.T (Movement Assessment Tool), Slow Motion Video Analysis of the lifting form, Force Plate Technology and Strength Testing in their purpose built rehab gym to not only determine your risk of injury during a Crossfit program but also help rehab, address the cause of your pain and improve performance!

If you’re a Crossfit participant and you are looking for a Physiotherapist and Osteopath who can assess you in the gym environment you train in and bullet proof your body from Crossfit related injury contact us at the Injury Rehab Centre on 95537024 or click here to book online.

References:

Weisenthal, B.M., Beck, C.A., Maloney, M.D., DeHaven, K.E., Giordano, B.D. Injury rate and patterns among CrossFit athletes. Journal of Orthopaedic Sports Medicine, Arthroscopy, and Knee Athroplasty, 2014, 2(4): 1-7.

Are YOU or DO YOU KNOW an injured RUNNER?

Unfortunately it’s a more common problem than not with recent statistics from Sports Medicine Australia finding that up to 70% of recreational and competitive runners sustain overuse injuries during any 12-month period.

The reason for this is often due to the repetitive stress the sport can cause when there are imbalances in the way we move, over thousands of steps these can start to add up.

At the Injury Rehab Centre our unique approach to assessment goes above and beyond other clinics. Utilising the latest technology in slow motion capture, force plate analysis, strength testing, our M.A.T (Movement Assessment Tool) and traditional Physiotherapy and Osteopathic assessment techniques we get to the CAUSE of your issue and tailor a unique treatment and training management plan to get you to where YOU want to be.

If you suffer from a running injury don’t let pain slow you down. Contact us at the Injury Rehab Centre and book your appointment today.

The Number 1 Factor to Avoid Injury that Every Runner Forgets.

Running Injuries – The 10% Rule

Running is one of the world’s most common and accessible sports to participate in. Unfortunately, research tells us that between 26 – 92% of runners will sustain an injury and according to the Australian Sports Commission’s 2006 survey, 70% of runners sustain overuse injuries during any 12-month training period. Unfortunately this keeps Physiotherapists and Osteopaths like the team at the Injury Rehab Centre in Cheltenham very busy particularly in the lead up to the Melbourne Marathon.

Most common overuse injuries that Physiotherapists and Osteopaths treat are:

• Patellofemoral Pain Syndrome

• Iliotibial Band Friction Syndrome

• Plantar Fascitis

• Meniscal Injuries

• Tibial Stress Syndrome (Shin Splints)

• Patellar Tendinopathy (Jumper’s Knee)

How do we stop this? Reduce too much, too soon.

What about the 10% Rule?

Some recreational runners may be familiar with a rule that they shouldn’t increase their mileage by more than 10% between training weeks. There is more research needed to understand how this rule may help runners to avoid training errors, but there is beneficial research to support this rule. One study found:

>30% increase in weekly mileage led to higher risk of some of the most common running injuries:

• Patellofemoral Pain

• Iliotibial Band Syndrome

• Medial Tibial Stress Syndrome (Shin Splints)

• Patellar Tendinopathy (Jumper’s Knee)

• Greater Trochanteric Bursitis

• Injury to Gluteus Medius or Tensor Fascia Latae muscles

Other factors a long with sudden increases in training load may also contribute to:

• Plantar fasciitis

• Achilles Tendinopathy

• Calf Injuries

• Hamstring Injuries

• Tibial Stress Fractures

• Hip Flexor Strains

The Injury Rehab Centre is offering 3 more weeks of FREE running assessments to help treat runners in pain and those looking to prevent injury prior to beginning running programs. Book with us today to reserve your FREE assessment with running Physio Alex Kimp to get on the path of decreasing your injury risk an increasing performance!

References:

Nielsen et al,“Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries: An Association Which Varies According to Type of Injury,” J Orthop Sports Phys Ther 2014;44(10):739–747.

“Running: How to safely increase your mileage” J Orthop Sports Phys Ther. 2014 Oct;44(10):748

Golf Health – Reducing injury and improving your game can be the same thing.

From the outside golf can look like a gentle sport and we are very lucky to have so many great sand belt courses around the Cheltenham, Moorabin and Bayside areas. However, when we start to look at the complex interaction of muscle forces, and joint biomechanics required to play the perfect shot we can appreciate that injuries can occur like low back pain or golfer’s elbow pain any sport.

Did you know that 53% of male and 45% of female golfers suffer lower back pain and 30% of touring professionals are playing injured at any given time?

The professional tour players have recently adopted many strength and flexibility strategies to improve their game and reduce the risk of injury. They consult and see Physiotherapists, Osteopaths and Strength and Conditioning coaches everyday to make sure they are finely tuned. This started with the likes of Tiger Woods and has become a common trend with athletes like Rory Mcilroy, Adam Scott, Jason Day and Jordan Spieth.  Many amateur golfers don’t put the time into the preparation side of their game and even though they don’t get paid the same doesn’t mean it doesn’t effect their body much less.

You would never play a game of football without training adequately leading up to the game and preparing with a comprehensive warm up routine before the first bounce, so why do so many golfers neglect this side of things?

The truth is often those little nuances in the way your body works that might be causing lower back pain or golfer’s elbows symptoms out on course might also be the same limitations that are reducing the distances of your drives, or causing inconsistency in your approach play.

At the Injury Rehab Centre our Physiotherapists and Osteopaths take a holistic approach to maximizing the movement efficiency of the body in the golf swing through our Golf Health program. This program doesn’t try to change your swing technique and only focuses on getting the most out of your body. Key components of the program include:

• A full physical analysis of the way your body moves in relation to your golf swing complete with Slow Motion Video Capture and force measurement using our Force Plate Technology.

• Hands on treatment to increase movement in key areas related to an efficient golf swing such as the foot and ankle complex, hips and thoracic spine.

• Individualized mobility program to maintain flexibility in areas of limitation.

• Individualized strength and conditioning program building actionable power and stamina to increase efficiency in transitional elements of the backswing and follow through of your swing.

• Individualized warm up program to make sure you are physically prepared to get the most out of every round you play.

As mentioned previously this program is about maximising the efficiency of the way you move so you can better express your golf swing, not change your swing itself.

If physically your body is restricted or you suffer from some type of dysfunction that inhibits the complex sequencing that goes into the golf swing, no amount of money spent of clubs or lessons will improve your swing or reduce your lower back pain or golfer’s elbow symptoms. Only when you improve the function of your body will you get your game back on course.

If you are interested in increasing shot power and consistency in your shot play on course then contact our Physios and Osteos on 95537024 or book your appointment online.

Return to Running – How to beat running injuries with long term results.

Running is one of Australia’s favourite recreational activities due to convenience/affordability and we are lucky to have many great running tracks around the Cheltenham, Moorabin and Bayside areas. Unfortunately, the repetitive nature of the sport means that it is has one of the highest rates of injuries causing interruptions in training and leading to loss of conditioning.

According to Sports Medicine Australia:

• Up to 70% of recreational and competitive runners sustain overuse injuries during any 12-month period.

• 42% of all running injuries are to the knee, followed by 17% to the foot/ankle, 13% to the lower leg and 11% to the hip/pelvis.

• Overuse injuries can occur from training errors (running frequency, duration, distance, speed and lack of leg strength and flexibility) and inappropriate surfaces, terrain and footwear.

• Overuse injuries, as a result of training errors, are more common than acute injuries such as ligament and muscle sprains and strains.

• The most common overuse injuries are patellofemoral pain syndrome (runner’s knee), iliotibial band friction syndrome, plantar fasciitis, meniscal injuries, tibial stress syndrome and patellar tendinopathy.

At the Injury Rehab Centre we take a holistic approach to the treatment of running injuries such as plantar fasciitis etc in a way that not only aims to get symptomatic relief but also to create long standing change to reduce the risk of re-occurrence.

Fundamentally most overuse injuries occur because something is wrong with the way we run, causing too much stress and strain to an area resulting in pathology.

Our comprehensive history taking and assessment process means that we get to the bottom of what the issue might be. This process utilises slow motion running gait analysis, our very own Movement Assessment Tool (M.A.T) for measuring muscle and jint flexibility and control, as well as muscle strength testing using Force Plate technology and traditional Physiotherapy and Osteopathy examinations.

Next our treatment process aims to achieve symptomatic relief by using hands on Physiotherapy and Osteopathy techniques such as soft tissue massage, joint manipulation, articulation and stretching techniques including the use of the True Stretch system.

Finally your management plan will involve an individualised training plan to build your running movement capacity (muscle strength, stamina, specific flexibility) as well the competency in other directions of movement.

One of the biggest problems many runners face is that the sport is so repetitive in one direction of movement. This lack of variability can be a big factor in the origin of many overuse injuries such as patellofemoral pain syndrome, iliotibial band friction syndrome, plantar fasciitis. By creating competency in moving in other directions we give runners more movement options to utilise to offload these areas when running for extended periods of time.

If you or someone you know suffers from a running related injury book your appointment online to start your Return to Running journey today.