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How is your bed mattress treating you?

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Sleeping postureHow do you know if your bed mattress is contributing to your back pain?

If you are like most people, you will spend 6-8 hours in bed each day. If your mattress is providing insufficient support for your back, it can aggravate or cause you back pain.

Sleeping postureA mattress with poor support allows your spine to rest in an abnormal position and alters stress on the discs, joints and soft tissue in and around the spine. This can cause pain and stiffness. Identifying if the mattress is a contributing factor for a back problem is an important step in overcoming the problem.

So how do you know if your mattress is causing or aggravating you back problem? Here are some simple points to consider:

  1. If you wake up feeling stiff and sore most mornings this can point toward the mattress as a contributor
  2. Sleep in a different bed as a trial, preferably one with more support, and see if you feel less pain and stiffness

A mattress doesn’t last forever. Flipping your mattress regularly can help maintain your mattress but care is required in doing this. Having said this, sooner or later you may need to purchase a new one. If your mattress is contributing to your back pain you should look for a high quality orthopaedic mattress. Most bedding stores or bedding departments can advise you about mattress quality.

If its not the mattress then you need to see your physio and be assessed.

Get moving and keep a balance in your physical life

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It’s busy again on campus and the need to get moving is greater now than ever. Musculoskeletal pain will often occur with trauma and is most common when we spend too long in one posture (sitting or standing). Similarly the amount of time spent looking at a screen (including a phone) increases the chances of neck shoulder and arm pain. The chances then increase considerably if we add stress of any type (even busy stress). You can avoid this type of muscular / soft tissue pain if you subscribe to regular activity … walk, jog, cycle, gym, yoga, Pilates, etc.

Exercise & BalanceBalance your disc with some form of daily activity. 10 mins of activity is a minimum dose, 30 mins is optimal, and 150 mins is a good target per week.

Prescribing running shoes – A guide through the fog of misinformation

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Running shoes are often prescribed based on arch height, degree of pronation they show when running and the latest trends like maximum cushioning and minimalist shoes. So how do you know what advice to follow and which shoes are right for you?

1. Arch Height
It is common practice to prescribe footwear based on the height of your foot arch, such as motion control shoes for people with flat feet and a cushioned shoe for people with high or stiff arches. This has previously been common practice but does not appear to affect the likelihood of sustaining an injury while running.

2. Pronation
Although over-pronation (too much rolling in) of the foot while running is often blamed for many running injuries, there is conflicting evidence to support this. It is unclear what a normal amount of pronation is and the difference between the movement of the shoe and the movement of the foot can be up to 20% while running, which makes measuring the amount of pronation difficult even with video analysis. If you cannot accurately measure pronation then fitting a shoe based on foot type becomes trial and error.

3. Trends
Over the years many trends regarding footwear have come and gone such as minimalist, anti-pronation and extreme cushioning shoes. It is important to consider that even people with the same foot type will respond differently to the same shoe. Therefore it is clear that one type of shoe will not suit everyone and buying shoes based on the latest trends can be erroneous.

So how should you choose what shoes to wear when you run?
1. Experienced Runners
Draw from experience, know what works for you and stick with it. Don’t be tempted by the latest trends and marketing, but if you are, incorporate the new shoe slowly and as an occasional change of pace.

2. New Runners
The most important thing to consider for a new runner is comfort. Try a few pairs on in the store and see how they feel. Initially staying away from extremes such as anti-pronation or extra cushioning shoes is a good place to start.

3. Runner with recurring injuries despite a change in shoes
Remember that shoes play a small role in sustaining most injuries and it is important to consider body mechanics, movement patterns and training habits when attempting to reduce injury risk.

If you are having recurring injuries while running, have a physio assessment to work out what is the best way to get you running pain free.

This blog is a summary of a great educational video from Kevin at Running reform http://www.runningreform.com/

Watch the original video at https://vimeo.com/126720173

Knee pain – what is valgus collapse

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One of the most common joint problems associated with exercise is pain in the front of the knee (patella). It is commonly labelled runners knee or jumper’s knee but often just walking on slopes or stairs can be the source of the pain. If we exclude degeneration of the cartilage under the patella (which is diagnosed with MRI scans), this type of knee pain can be effectively managed.

Knee pain and valgus collapseThe greatest external load on the front of the knee is due to poor movement pattern, where the knee goes inwards towards the other leg rather than straight ahead in line with the middle of the foot. This is termed valgus collapse.

Valgus collapse is a strength and movement problem which can be corrected with specific exercises targeting the right muscles. A thorough physiotherapy assessment should consider:
• Muscle length (especially the outer thigh)
• Muscle strength (particularly at the hip)
• Foot mechanics / posture
• And the way you move (muscle control or coordination)

The treatment is a series of pain free exercises that address the cause of the problem. Taping the knee is a short term option for reducing pain. Sometimes changes in footwear and / or orthotics can also assist with pain reduction, but neither replaces getting stronger and moving better. If you have persistent pain in the front of the knee, have it assessed and get a prescribed exercise plan.

Looking after your physical health as a uni staff member

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NU Moves massage

Did you know that there is a physiotherapy clinic on campus? NU Moves Physiotherapy offers discounts to all uni staff members. It is important to us to help keep UoN staff healthy and active. If you are in pain see a physio today.

Our physios at NU Moves have post-graduate qualifications in manual therapy; exercise prescription; expert clinical problem solving; and clinical research. We undertake a thorough assessment to determine the cause of your pain and an appropriate treatment plan to suit your goals. All of our treatments sessions are one-on-one. Whether you wish to be pain free while sitting at work, or staying active through exercise – NU Moves can help.

NU Moves are familiar with the workplace demands that at times are associated with prolonged sitting, increased stress and not enough time to exercise. All of these factors contribute to pain. A good start is to make time for your daily dose of physical activity every day. Another method of relieving pain associated with stress or muscle tension is massage. Manual therapy from a physio involves massage of varying types; joint mobilisation (gentle form of manipulation) and stretches. You may also be helped via advice around posture or your computer and work station ergonomic set-up.

NU Moves Physiotherapy also performs dry needling, orthotic prescription, bracing / splinting, exercise and gym programming, and work specific functional rehabilitation.
To book an appointment with NU Moves call 4921 6879.

Stay strong – feel better

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NU Moves Pilates

Christmas is just around the corner! Now is a great time to come along to NU Moves Pilates to get some quality movement in the bank and blast those abs before getting some well-deserved R & R over the holiday season. NU Moves Pilates continues to focus on providing small group classes run by a qualified physiotherapist. Our average class has between 3 and 4 participants which allows for optimal supervision and individual exercise advice. The mat based classes can be tailored to suit participants from the beginner to advanced levels.

Our classes are held at a variety of times to provide you with some options. You can start your day on a positive note with our morning classes, get away from the desk for our lunch-time classes or finish the day strong with our evening classes. All of our classes are held in the NU Moves Physiotherapy clinic.

Monday 7am with Jess
Monday 6:30pm with Nikki
Tuesday 6:30pm with Nikki
Wednesday 7am with Jess
Thursday 12:15pm with Ben
Friday 12:15pm with Ben

You can save money by claiming on your Private Health Insurance. Most Private Health Funds with Physiotherapy extras will provide cover for NU Moves Pilates classes.
If you have any questions about the classes or wish to book in, give us a call on 4921 6879 or email via admin@numovesphysio.com.au

Common training mistakes – how to avoid injury

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running and physiotherapy

Exercise and sports related injuries are common. Some sports such as rugby come with higher risks and frequency of injury. General exercise often has low risk of injury but that depends on how hard we push ourselves and the type of exercise we do. It doesn’t matter whether it is a team sport, an exercise class, a personal training session or an individual session, an injury will limit your participation for a period of time.

One common source of injury is ‘training error’. This is usually doing too much, too soon but can also be related to technique (e.g. squat, running) or equipment. Technique is the way you move relative to the load or complexity of the movement.

There is a fine balance between being challenged sufficiently to enjoy exercise and avoiding ‘training error’. A simple message is the more you know your body at each stage of life the less likely injury will occur. This means train at a level of load suited to your body; gradually increase the level of exercise over several weeks; listen and adjust to pain especially if it is in a joint or the spine; and use mirrors to watch how you perform a gym exercise to ensure the technique is correct. It’s simple advice but it works if you want to reduce the chance of injury.

Stress fractures in runners – 3 minutes of what, why & when

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female runner

 

What is a stress fracture: Normal bone responses to repetitive stress can be divided into: normal response, stress reaction, and stress fracture.

Normal response: Osteoclasts are bone cells that remove bone tissue known as ‘bone resorption’. Whilst osteoblasts are cells that create ‘bone formation’. Bone is a dynamic tissue that is constantly being reshaped by osteoblasts and osteoclasts working in balance.

Stress Reaction: Repeated bone stress without appropriate rest causes osteoclastic activity to outstrip osteoblastic activity.  This osteoclast / osteoblast imbalance initially results in microfractures which when investigated shows bone marrow oedema.
 
Stress fracture: A stress fracture is when the repeated stress and imbalance continues and the microfracture progresses into a true break in the cortical bone.
 
How are they diagnosed: A clinical examination of factors such as training loads, biomechanics, location of pain, and bony tenderness, will indicate whether a bony stress reaction / fracture is a possibility. Following this various imaging options are MRI (which can show bone marrow oedema in stress reaction stages and microfractures once stress fracture develops); CT scans (not as sensitive as MRI and have associated radiation as per an XRay); Xray (which frequently doesn’t show up stress fractures in the early stages – up to 3 weeks); and bone scans (very good at detecting stress fractures but are time consuming, nonspecific and are a poor choice to monitor recovery).
 
Who is most at risk: The female athlete triad is a combination of low bone density, nutritional issues, and menstrual irregularities. Together these represent the highest risk of developing stress fractures in the female runner. However any one of these alone can also lead to a stress fracture when combined with running.
 
What else increases your risk:

  • Rapid increase in running distances
  • Lack of rest / recovery time during a period of running training
  • Inappropriate footwear relative to the foot type of the individual
  • Nicotine smoking

What to look out for:

  • Pain during or after running / exercise
  • Bony tenderness
  • Nutrition – how balanced is your diet
  • Training – running distances per week and speed of increases
  • Bone density – do you know yours? (especially if you are female and run a lot)
  • Shoes – despite the debates surrounding ‘support’ vs ‘free’ shoes, the right type of footwear is important for a lot of people!

Management: If you have pain with running organise an assessment as soon as possible. The best management is prevention but if they occur the treatment depends on which bone it is. Some stress fractures have greater risks associated and need orthopaedic specialists involved, whilst others are lower risk and can be managed conservatively. The most common strategy is to immobilise the area and often to remove any weight bearing stress through the bone.

McCormick et al (2012), Stress fractures in runners. Clin Sports Med, 31.

Finding Balance in your Life

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balanceAs physiotherapists and exercise physiologists, we help people address the neuro-musculoskeletal system (nerves, muscles, bones and joints) of the body with physical exercise strategies. This is reliant on a person getting involved with our recommended strategies and advice. The biggest barrier to not getting involved is time available and prioritising. Even when it actually makes us feel better to go for a walk or do a stretch, the time available often gets in the road.

Physical balance is similar to nutrition advice. We know a balanced diet will make you feel better – so will finding a balance in exercise and movement. This balance changes throughout each week, month and year of our life but keeping a routine amount of the right type of activity for you will increase your feeling of well-being and reduce the risk of many health conditions such as diabetes and heart disease.

Most commonly it is too much sitting and not enough out of the chair activity that creates problems. Other times it is too much running and not enough recovery.

The message we commonly convey to our clients is:

Why do you exercise, why don’t you exercise, how much activity do you do, how does the activity levels weigh up against the amount you sit? The body will respond to the loads you put on it; similarly it will respond to what you eat and how much stress you are under.

Find the balance:

Consider what activity makes you feel good and write down a plan to achieve it. There is no better time to do it than today! Remember, it’s not always about doing more – some of you will be overdoing exercise for your own reasons – in this case finding the balance might be going for a swim or a walk instead of a run.

Do you know how to correct your posture?

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correct postureMaster the simple things and you will get the best outcomes!
We all have our own unique postures – some with increased curves, others with reduced curves, and sometimes with sideways curves (scoliosis). Posture should also be considered relative to whether you are sitting, standing or dynamically moving. Achieving a biomechanically correct spinal posture is important for several reasons.

Firstly, in helping our clients we often find that achieving the correct posture can reduce pain and discomfort associated with sustained standing and sitting postures. For those who have to stand for long periods in retail or hospitality, an increased curve in the lower back can lead to pain. A simple correction is to lean up against the wall slide down to bend the knees slightly and flatten the lower back to the wall. If this eases the discomfort we need to focus on what creates this posture type – tight hip flexors, poor tone or weakness in the lower abdominals and gluteal (buttock) muscles.

Alternatively those who get discomfort in the lower back, mid back or neck with sitting at the computer, it often is associated with the ‘lazy, slouched posture’ where the curve in your lower back (normally known as a lordosis) is reversed and there is one arched curve (instead of two) from base of the spine to base of the neck. The head then protrudes forwards and the shoulders become rounded. Again a simple correction is pelvic tilting – rolling the pelvis forwards over your hip bones. Getting that lordosis curve back in the lower back will often reduce pain and allows for the mid back (thoracic spine) and neck posture to be corrected. You have to get a stable base to work from and slouched is not a stable base.

Secondly correct posture increases the efficiency and safety of how we move, for example with lifting. The squat lift (knees fully bent) or semi-squat lift (knees bent to 90 degrees) are both acceptable methods of lifting. If you keep your lower back straight and bend at the hips and knees it will engage the gluteal muscles and provide stability to the pelvis and lower back.

The big message, it is OK to relax your posture at times so long as it isn’t occasions such as when you are lifting loads or sitting for prolonged periods.