Tag: sports injury

Fascial blading- how it can help reduce pain and improve function

Fascial blading is a form of gentle, instrument assisted soft tissue mobilisation. The blade itself acts as an extension of the practitioner’s hands and allows the clinician to gently identify and breakdown scar tissue adhesions and fascial restrictions.

Fascia is the cling-film like tissue that connects everything in the body. It runs along and through all our muscles, organs, vessels and nerves and even attaches on to our skeleton, forming a continuous 3D web of connective tissue. Traumas or scars to any area or the body can lead to problems in other areas through disruption of this connective tissue web.

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Stretching won’t make your muscles stretchy

Stretching doesn’t work the way we think it does. At all. If you’ve ever spent your time gritting your teeth, pulling your arms or legs or (eek) neck into weird and wonderful positions to feel that pull, before noticing that a few hours later they’re back to where they were before, you’ll know that stretching doesn’t make your muscles stretchy. To understand why stretching isn’t the key to flexibility, we first have to understand a bit more about how and why our muscles stretch in the first place.

All humans have a reflex in our nervous system called the myotatic reflex. Believe it or not- you’ve probably had this tested without even knowing it. It’s the one we activate when we use a reflex hammer to hit just below your knee which makes your leg jump, or the one just above the elbow which does the same to your arm.

stretch muscle reflex stretchy injury knee pain relief chiropractic chiropractor education blog physiotherapy physiotherapist health rehabilitation painful sports injury training fitness emsworth chichester hampshire sussex
The C6/7 reflex

This reflex is the body’s pre-programmed response to a stretch stimulus in the muscle. When the muscle is stretched (as in when hit by the reflex hammer), an impulse is sent to the spinal cord to contract that muscle (and relax the muscle that works in opposition to it), causing the limb being tested to jump. These reflexes are what are called “monosynaptic” as there is only one junction for any signal to pass through before the body sends a response (the message going in->junction->message coming back happens in the spinal cord, bypassing the brain to make sure the response happens quickly) Think how rapidly your knee jumps when it’s hit by the reflex hammer- it’s usually just 1-2 milliseconds before the body responds.

We use these tests in clinic to check the integrity of your spinal cord and the peripheral nervous system, and they can be vital in helping us identify neuromuscular conditions. But that’s not what we’re talking about today. You might be wondering what purpose these reflexes have? Well, one of their most important functions is to prevent us from tearing our muscles/tendons/ligaments. Let’s look at the patella reflex to demonstrate this:

The patellar tendon is tapped just below the knee, which puts a rapid stretch into the tendon which attaches to your quadriceps muscle (the muscle in the front of your thigh). Muscle spindles (sensory receptors that pick up changes in the length of the muscle) pick up on this rapid increase in the length of the muscle, and very quickly send a message to contract your quadriceps in order to stop the muscle or tendon from over-stretching and causing damage. What happens when your quadricep contracts? Your lower leg comes flying up! If it doesn’t, it could indicate an underlying condition or disease affecting your muscles and nerves (which is why we always test them in clinic!)

What else do reflexes do? Well, they also stop us from falling over all the time. Stand up for a second. Now lean over. As far over to one side as you can go. What happens? The muscles on the opposite side to the lean become stretched, and that reflex is activated again, telling those muscles to contract in order to correct your posture and stop you toppling over. Now, this is a more obvious demonstration of how reflexes maintain our posture, and these postural corrections are generally carried out subconsciously (so we don’t spend all day feeling like we’re going to fall over!) It’s one of those things that we notice more when it stops working.

So what do reflexes have to do with stretching my tight muscles?

When we activate stretch receptors in the muscle, the message the body receives is to contract that muscle to prevent overstretch. So the usual static stretching that we do (for example when we bring our foot up behind us and grab on to it to stretch our quadriceps) puts our conscious and subconscious brain into war against each other. You’re consciously grabbing that foot to pull that muscle into a stretched position, and your stretch reflex (the subconscious brain) is automatically kicking in (as reflexes do) saying “No!” and tries to stop you from over-stretching and causing yourself an injury. What do we tend to do in this situation? Most people say “oooh that’s tight!” and promptly pull harder… Static stretching has actually been shown to decrease strength and athletic performance, while failing to reduce risk of injury to any significant degree.

Why does stretching feel so good then?

There are a few reasons why stretching might make you feel like you’re getting somewhere.

One: If you continually statically stretch your muscles, you can cause that stretch reflex to become less active. This can mean the muscles do lengthen, but only for a little while. Give it an hour or two for that reflex to go back to normal and the muscles will tighten back up again. This can cause problems for athletes- static stretching means the muscle is unable to contract properly because those muscle spindles aren’t functioning right. There’s plenty of research out there to show that static stretching before exercise can reduce your muscle strength, power, performance and joint stability.

Two: The more we stretch, the better we’re able to tolerate the sensation of “pulling” in our muscles. Yep, we’ve all said it “Ooooh, that’s a good stretch!” That temporary lengthening and release does feel good, but not for long.

Three: Pull a muscle or tendon enough, and you’ll begin to stretch your ligaments. Ligaments can, over time, then become stretched out to the point where they’re unable to function properly, resulting in joints that move too much, and are unstable. When ligaments get to this point, they might never regain their original length and strength.

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Someone tell him to stop…

Stretching- Will it get you out of pain?

In a nutshell, no. The nervous system rules the road. It’s totally in charge of everything that we do. If you’ve had treatment with me, you’ve probably heard me talk about the reasons why the brain can cause our joints to stiffen and feel like they’re “locked up”. It’s your brain’s way of stabilising an area that it perceives to be at risk of injury (whether that perception is founded in fact or fiction!) So on a very fundamental level, if your brain still perceives there’s an issue in that area, no amount of pulling on your muscles is going to change that. Equally,if the muscle is tight and sore because there’s a joint somewhere that’s misbehaving and preventing the muscle from functioning as it should, then stretching isn’t going to do much for that problem.

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The process that tells us how tense our muscles should be at rest (known as “resting muscle tone”) is called the alpha-gamma feedback loop and it’s a lot more intelligent than we give it credit for when we’re yanking on our body to get it to stretch. In order to reset an over-enthusiastic resting muscle tone, we need slow, controlled movement which provides vital sensory feedback, allowing this system to reset itself. This makes it fairly clear that pulling our muscles into, or beyond, their stretch capacity does little other than provide a temporary increase in muscle length which then rebounds when those muscle spindles reset, giving you little more than temporary relief from pain and probably serving to prolong your discomfort by making your muscles tighter overall.

So how do we make muscles stretchy without stretching?

First we have to look at what’s causing the muscle tension in the first place. Let’s look at the hip joint as an example. It’s got anywhere between 170 to 200 degrees of flexion and 40-60 degrees of extension, so is well over the 180 degrees needed to do the splits. So aside from structural changes in the hip joint, is mainly restriction in the soft tissues that stops most of us from being able to pop the splits whenever we fancy. No amount of stretching or “bouncing” into the splits is going to get you there- for whatever reason, the muscles you need to do the splits are activating way before their supposed maximum load and your brain is telling those muscle spindles to stop before you hurt yourself.

We have to stop thinking that we can teach our muscles anything. Our muscles don’t call the shots- our brain does. If a muscle gets tight, it’s because the brain is telling it to contract. So if stretching isn’t the answer, what is?

  1. Chiropractic care to correct the cause of the problem- We find, assess, diagnose and treat the underlying reason for the muscle tension. If you don’t know why they’re tight, how can you possibly get them better?
  2. Foam rolling. It’s not just rolling about on the floor (although that helps!) Foam rolling activates a different receptor in the muscle (called the Golgi Tendon Organs) which sit at the junction between your muscles and tendons. When we foam roller correctly, we stimulate these GTO’s which encourage the muscle spindle activity to calm down, helping to decrease muscle tension, reduce pain and improve function.
  3. Functional movement. Simply put, warm up based on movements you actually do in real life. How often do you actually grab your neck and pull it into a weird angle in real life? Not often. If you’re a runner, instead of doing straddle-stretches or the good old foot-behind-your-bum-and-pull stretch for the quads, try lunges, high knees and skipping instead to replicate the movement you’re going to do.

So there you have it. Stretching tight muscle tissue will only make it tighter. Find and correct the reason for the tension and enjoy super-supple muscles instead!

Kinesiology taping for pain- how does it work?

Kinesiology tape has become massively popular over the past few years, gracing the torsos of Olympic athletes and sportspeople around the world- and whilst there are conflicting messages coming from the research around it, the tape appears to show promise for a range of issues.  A recent review showed that there was moderate evidence to support the use of tape to reduce pain, so let’s look at how tape can help.

Properties of kinesiology tape

    • 100% cotton, latex free tape
    • Medical grade acrylic adhesive which is heat sensitive allowing the tape to stick to the skin
    • The thickness, weight and elasticity of the tape is approximately that of skin, so most people can tolerate the tape without issue
    • Allows for free movement and does not restrict movement like other tapes may
    • The elastic properties provide support and reduce muscle fatigue

Where some tapes are stretched out to maximum capacity before being applied, kinesiology tape is less effective when fully stretched out- in fact, mastering the art of how much stretch to apply is one of the main skills to learn when using tape.

The risks of using tape are minimal, and whilst the research surrounding tape is still in its infancy, we can use it safely in clinic knowing that we’re not causing any harm and are instead likely to see great results which will help contribute further to the use of kinesiology taping.

How taping works to reduce pain

kinesiology taping pregnancy pain lymphatic fluid kinesiotape rocktape sporttape fitness health exercise training running injury sports fit health runner run sprint gym Emsworth Hampshire chiropractic chiropractor Philippa Oakley Acorn Health
More space = happy structures!

When taping for pain, inflammation, swelling or oedema, we use a technique called “space correction”. This does what it says on the tin- creates more space directly above an area of pain, inflammation, swelling or fluid build up, which helps decrease pressure by lifting the skin away from the fascia.

This has a number of effects:

  1. Decreased pressure alleviates the irritation on chemical receptors in the underlying structures, thus decreasing pain
  2. Increased circulation may occur in the area, allowing for increased removal of cells or fluids that can build up during the inflammatory process
  3. Stimulating mechanoreceptors (sensory receptors in our skin that pick up pressure or distortion) can help decrease pain

The initial benefits are reducing inflammation and pain, but there are thought to be neurological benefits

too- when the tape is placed over tight muscles, it appears to reduce their response to being stretched, helping to make them feel less sore and painful. When applied over weak or injured tissues, the feedback these tissues send to the brain is altered and improved, which can help the body to stabilise the area.  This is how we can then move on to use the tape for fascial correction.

In some cases, as with ankle inversion injuries (rolling over on the ankle), there is an imminent risk of further injury as the ligaments in the muscle have been stretched out and therefore aren’t able to stabilise the joint as effectively as usual. In this case, the patient’s initial injury was over 7 days ago so we have used a fan application to encourage lymphatic flow but also applied a light-stretch support around the lateral part of the foot to help stablise the injured ligaments.

Lymphatic fan taping helps to reduce fluid build-up by directing lymph fluid towards a less-congested lymphatic pathway and lymph nodes. We use the anchor of the tape to indicate where we want the lymph to flow, much like directing traffic! Whilst this is an advanced taping technique and one that would be applied by your practitioner, it demonstrates the myriad uses of kinesiology taping perfectly and shows how effective it can be in helping reduce inflammation and aid recovery at a cellular level.

Take home notes:

There isn’t a barrage of research to support the use of kinesiology tape, the papers that are available show positive and encouraging results. Every new treatment modality has to start somewhere, after all!

kinesiology taping pregnancy pain lymphatic fluid kinesiotape rocktape sporttape fitness health exercise training running injury sports fit health runner run sprint gym Emsworth Hampshire chiropractic chiropractor Philippa Oakley Acorn Health(Think of Louis Pasteur testing out his Rabies vaccine on a 9 year old. Sounds nuts now, but that’s where most great ideas starts from- somebody going “I wonder if….?”) 

Much like any treatment, there will be an element of placebo involved, but studies like this and this have shown that the effects of kinesiology tape can’t be reproduced by placebo taping.

Simply put, the mechanisms and understanding behind how and why kinesiology tape works are grounded in scientific thinking and understanding. It’s a safe, low risk, effective way to help your body towards recovery, and whilst it’s no replacement for treatment, rehabilitation and injury management, it helps to put some of the power of recovery back into your hands.

NB: Whilst tape can be applied by anyone, it is important to have the issue diagnosed by an appropriately qualified healthcare or medical professional prior to using kinesiotape or allowing someone else to apply it. As with any form of treatment, you want to ensure the treatment is appropriate for the issue and eliminate any other underlying issues which may mean taping is inappropriate.

We are moving to Palmers Road early 2017!

The Acorn Team are excited to announce the imminent launch of our new clinic! We have been working hard to create a multidisciplinary ‘health hub’ for you in the heart of Emsworth and are delighted to let you know we’ll be moving to our new premises at 2 Palmer’s Road in early 2017! We are going to be able to offer a range of healthcare therapies to cover all your and your family’s healthcare needs under one roof.

Emsworth Chiropractic Acorn Health Palmers Road Chiropractor Health Hub Clinic Evidence Treatment Physiotherapy Osteopathy

Not only that, we will also be extending our opening hours to offer even more appointments at times convenient to you and will be offering workshops, open days to meet our practitioners, and we’ll be inviting health care specialists and interesting speakers for educational events and seminars so you can get the right information and best care possible.

We hope you’re as excited by this news as we are! We know you will love it, and will benefit from even more once we move to the new clinic in Palmers Road. To stay up-to-date with the latest news and developments on this exciting new project, please follow our Facebook page or sign up to our newsletter to be the first in the know. Let’s get moving!

Want to find out more about Acorn Health?

Read our frequently asked questions here.

Download our free resource on preventing posture and pain here.

Find out more about Philippa Oakley (Nee McKernan) here.

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New Year’s Resolution: Injury free for 2016

Here it is, the oh-so-predictable New Year’s Resolution post about a “New Year, New You.” We’re going to bypass that this year in favour of something far more important. Whilst New Year’s Resolutions which centre around going to the gym, getting fitter or putting more of an emphasis on our health are fantastic, we want you to spare a thought for your joints before you start a new exercise regime.  Search online for “getting fit quotes” and the words that pop up most frequently are “pain”, “hurt”, “sore”, “skinny” or “burn”.  Whilst some pain is normal and to be expected, this has given rise to a worrying influx in the number of sport-related injuries we’ve seen from athletes “training through the pain”.
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Most sporting injuries occur from what we call the Terrible Toos- doing too much, too soon. After not working out for months or years, people come in and try to run 5 miles or lift 200 lbs at their first session.  Their deconditioned, unprepared muscles can’t cope with the action and so injury occurs. We then have to recover from the injury by which point our motivation for our New Year’s resolution is gone.  You won’t become Batman (or Catwoman) in one workout session, so please please please train properly and spare a thought for injury prevention this year.

So how does injury occur?

Injury, particularly sports injury, occurs through direct or indirect trauma to muscles, ligaments, and joint capsules.  Injury takes two forms- direct and indirect. Direct trauma or injury occurs through blunt trauma or a sudden overload- so dropping a weight on your foot would be a direct trauma (HINT: Don’t do it!)

Indirect trauma or injury occurs from repeated submaximal loading.  (When we refer to joint loading, what we mean is the force that is put on a load-bearing or weight-bearing joint during exercise.) This could be therefore be repetitive injury to your elbows when lifting, or your knee when running. Indirect trauma can therefore occur through repetitive lifting of weights, running, or any activity that “loads” a joint.

Regardless of direct or indirect trauma, the end result is still the same- tissue dysfunction that is characterised through pain, inflammation, and internal tissue stress.  This can lead to what is known as “functional disability”, where you’re able to go about your day-to-day life largely without issue, but your training or exercise regime is impaired. Not what you want when you’re motivated to get to the gym!

Why does injury occur?

Whilst some sports injury occurs through direct trauma- such as a rugby tackle, overuse injuries are more common in sports than acute injuries. These are subtle and occur over time, hence why early detection and diagnosis is key. Faulty movement patterns, joint restriction or muscle dysfunction can be detected by your chiropractor which can help to identify those who are at risk of an overuse injury and provide advice on injury prevention, modification of exercises, adaptations to technique or treatment if appropriate.
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Researchers have reported that impact forces of up to 550% the normal force load are transmitted to our joints when running, with impact forces between 4 to 8 times higher than those during normal walking.  Much as you wouldn’t lift a heavy weight without putting some thought into it first (if you even decided to lift it at all!) we need to put some thought into how well equipped our bodies are to cope with these additional stresses and strains before we hit the gym. This is why launching into a fitness regime without putting some thought into how you’re going to do it and how you’re going to protect yourself whilst doing it can be crucial.

Coping with this degree of stress can be challenging enough even for joints that are well-adapted to this degree of stress, but if you are starting a new exercise regime or perhaps picking up a new activity, your joints need some time to adapt to the new activity. They also need to be ready and able to cope with this degree of stress. This is where chiropractic comes in.

How does chiropractic help?

Chiropractors are primary healthcare professionals who are trained to diagnose, treat, manage and prevent disorders of the musculoskeletal system (bones, joints and muscles), as well as the effects these can have on the nervous system and general health.

<a href="http://acornhealth.org.uk/?attachment_id=1174" rel="attachment wp-att-1174"><img class="aligncenter size-full wp-image-1174" src="http://acornhealth.org.uk/wp-content/uploads/iStock_000047834800Large-1.jpg" alt="Sports injury running health fitness exercise gym chiropractic Hampshire Havant Fareham Emsworth Sussex Chiropractic Chiropractor Physiotherapy physiotherapist" width="2547" height="1930" /></a>
Philippa explaining Achilles tendonitis at a recent “Running without Pain” workshop at The Run Company, Chichester.

Chiropractors are often thought to only “crack backs” and only treat back pain.  Much like your GP wouldn’t prescribe the same pill for an ear infection as they would for high blood pressure, so a chiropractor doesn’t just perform spinal manipulation for a bad back.  It entirely depends on the nature of the injury, the level of pain, and most importantly, your personal preferences (it all comes down to teamwork!) Chiropractors have a vast array of treatment options they can offer and chiropractic care can be crucial in injury prevention because chiropractic emphasises the correct functioning of all joints, muscles, tendons and ligaments in your body to ensure you are performing at your very best. Whether you are an elite athlete, a gym newbie, or perhaps a keen sportsperson returning from injury, chiropractic can be crucial in identifying dysfunction prior to an injury occurring.

A crucial part of treatment at Acorn Health is helping you to develop a firm understanding of how your body works, how pain and problems can occur and how to prevent it.  We work with you to develop a new fitness routine and training programme with appropriate exercises that will enable you to strengthen and stabilise your joints whilst reducing your risk of picking up an injury.

So whilst you’re dusting off your trainers and wrangling your way into your sports kit, spare a thought for your joints, and spare a thought for injury prevention.

If you would like to receive our “Injury for Runners” resource, detailing the most common types of running injuries, the mechanism of injury, preventative measures and more useful information, please complete your details below.

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References:

Kessler MA, et al.: Volume Changes in the Menisci and Articular Cartilage of Runners An In Vivo Investigation Based on 3-D Magnetic Resonance Imaging. Am J Sports Med May 2006 34:832-836.

Kessler MA, et al.: Recovery of the Menisci and Articular Cartilage of Runners After Cessation of Exercise Additional Aspects of In Vivo Investigation Based on 3-Dimensional Magnetic Resonance Imaging. Am J Sports Med May 2008 36:966-970.

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