Newsletter June 2015: ASK A PHYSIO

What causes cramps and how do I get rid of them?

— Answered by Greg Lynch

A ‘cramp’ is defined as a painful involuntary muscle contraction that occurs suddenly and can be quite debilitating. Cramps most commonly occur in the leg muscles, particularly the calf muscle or the muscles in the feet. The onset can be quite sudden, but they usually resolve themselves in a few seconds. The muscle can be quite sore for several minutes or even a number of hours. The cause of cramps is often unclear, however there are some theories. Cramps can occur during or after exercise and may be caused by the continued repetitive muscle contraction during exercise – which is why stretching the affected muscle often offers relief. The stretch needs to be sustained for 20–30 seconds and symptoms should improve within this time.

Exercise induced cramps may also be caused by a loss of ‘electrolytes’ (resulting in a chemical imbalance) which happens when we sweat a lot. Ensuring that you take plenty of fluid when exercising may help prevent cramps, if this is the cause. If you suffer from cramps during or after exercise, then a physio can assist you with an appropriate stretching programme, assessing and correcting any muscle imbalances and ensuring that your muscles are conditioned for the activity that you are wanting to participate in. Cramps may also be caused by various medications or disease, if this is the case then I would suggest you seek advice from your GP for management of cramps

Newsletter March 2015: ASK A PHYSIO

I walk every week (around 6-7k per walk)and I get quite sore hips/pelvis from doing this. I’ve been fitted for shoes but it’s still quite sore. Is there anything I can-do to help this?

— Answered by Greg Bell

As a physio looking at the body as a machine, and then as a creative feeling individual, you come up with a few possible questions to bounce back to the individual, which will hopefully provide some answers, or some actions to take to go the step further. Information is key. Location Where is the pain? Hip pain can be felt elsewhere; such as buttock, groin and thigh. Conversely low back pain can be referred into the hip, as can other structures — so a quick investigation of other joints should be done.

General Health

This is an essential part of questioning the walker. Were there any hip problems in the childhood of the walker? Is there any symptom that might suggest arthritis either osteoarthritis (creaking, weakness, stiffness progressing) or rheumatoid (joint pain, many joints involved, fatigue, stiffness of joints)? The physio needs to be aware that many conditions can look perfectly like a muscular or joint problem, but if we ask the right questions, we could avoid missing the rare severe condition.

Newsletter December 2014: ASK A PHYSIO

What’s the fastest way to relieve tension in the muscles without seeing a masseuse or leaving the house?

— Answered by Gill Stotter

There are a number of reasons for people to feel tightness or tension in their muscles. It can be due to over-training, lack of preparation and conditioning or due to muscle imbalances. Muscles work together to perform functional movements; some can be weak and not activating correctly whereas others become tight due to over-activity. It is a fine balance for the body to function optimally, similar to keeping your car tyres balanced. Tension in the muscles can be relieved by heat, self-massage and stretching. You may find a tight trigger point in the muscle or a tight band of tissue. Firstly warm the muscle with a heat pack for a few minutes to promote relaxation and increase blood flow, then gently massage along and across  the muscle fibres with an oil or cream. You can also use a tennis or spikey ball or a foam roller to ease out the tension.

Following the massage gently stretch the muscle using effective breathing techniques to increase relaxation and promote the length in the muscle. Gently work into the stretch, breathing in through your nose and out through your mouth, hold for 30 seconds and repeat 3-4 times, increasing the range of active movement. You may feel slight discomfort as the muscle is lengthening. Always maintain good alignment as you stretch; it is important that the stretch is not painful and it should never feel worse afterwards.

Education, injury prevention and teaching self-management strategies are all important roles of a physio – so if the tension doesn’t disappear then make sure you seek professional advice.

Newsletter August 2014: ASK A PHYSIO

What causes shin splints and how do I prevent them?

Answered by Bharat Sukha – Physiotherapist

Shin splint pain is caused by repetitive loading and can occur with running and sports that involve jumping or rapid acceleration or deceleration. It is classified as an overuse injury.

When you do this type of exercise a lot of force is loaded on your shinbone (tibia) and the surrounding soft tissue. These structures eventually can’t cope with the extra load and the result is the pain and swelling (inflammation) that you feel.

The worst that can happen with shin splints is a high pressure build up in the muscles called Compartment Syndrome or if bony cracks (splints) appear which can result in a stress fracture. These worst-case scenarios are not overly common. Nevertheless, you don’t want to end up with severe pain — which is why it’s a good idea to see a sports physio.

Shin splints are relatively common, but they are not a simple injury and there are a number of factors that can play a role. Here are a few possibilities that a physio can look at:

• poor or incorrect shoes

• running on hard surfaces

• muscle weaknesses

• muscle imbalance or inflexibility

• poor body alignment

• training too much or too quickly

What treatment and management is required? There are a number of ways to treat, and in the long term, help prevent this injury. The best idea is to consult a sports physio who can design a treatment and rehabilitation plan that involves initial rest and local therapy and then addresses ALL the factors that cause you pain.

For example, you may need the correct shoes for your foot type and a programme that initially reduces your activity level and then addresses cross training, stretching and strengthening. Fixing just one factor won’t resolve your problem so you need to have them all covered! It is important to see your sports physio as EARLY as you can as this type of injury does progress relatively quickly and just resting and medication alone will not help you in the long term.

Newsletter August 2014: Irene van Dyk – how physiotherapy kept me in the game

Newsletter July 2014: Muscle Cramps

* What are muscle cramps?

A muscle cramp is a strong, painful contraction or tightening of a muscle that comes on suddenly and lasts from a few seconds to several minutes.  It often occurs in the legs.  A muscle cramp is also called a charley horse.

Night-time leg cramps are usually sudden spasms, or tightening, of muscles in the calf.  The muscle cramps can sometimes happen in the thigh or the foot.  They often occur just as you are falling asleep or waking up.

* What causes muscle cramps?

The cause of muscle cramps isn’t always known.  Muscle cramps may be brought on by many conditions or activities, such as:

  1. exercising: injury, or overuse of muscles;
  2. pregnancy: cramps may occur because of decreased amounts of minerals, such as calcium and magnesium, especially the later months of pregnancy;
  3. exposure to cold temperatures, especially to cold water;
  4. other medical conditions, such as blood flow problems (peripheral arterial disease), kidney disease, thyroid disease, and multiple sclerosis;
  5. standing on a hard surface for a long time, sitting for a long time, or putting your legs in awkward positions while you sleep;
  6. not having enough potassium, calcium, and other minerals in your blood;
  7. being dehydrated, which means that your body has lost too much fluid;
  8. taking certain medicines such as anti-psychotics, birth control pills, diuretics, statins, and steroids.

* How to prevent them

The best prevention involves stretching regularly, adequate fluid intake (note: tea and coffee do not count as caffeine acts on the kidneys to increase fluid loss), appropriate calcium and vitamin D intake, supplemental vitamin E, and possibly (check with your Doctor) supplemental magnesium intake.

* How can you stop a muscle cramp when it happens?

  1. Stretch and massage the muscle
  2. Take a warm shower or bath to relax the muscle.  A heating pad placed on the muscle can also help Try using an ice or cold pack.
  3. Always keep a cloth between your skin and the ice packDrink plenty of fluids

*   NB: Vitamin D deficiency will cause poor calcium absorption.

Newsletter June 2014

Do you suffer from stiff and sore joints? Arthritis?

You can reverse some effects of arthritis and eliminate aches from joints entirely with new techniques involving micro-mobilisation and movement.

We take a multidisciplinary approach and provide tips and techniques that will help you long after you finish your treatment, because helping you gain optimal function and resolution of pain and the prevention of re-injury is our goal.

Observations such as, “it must be age”, “I fell apart after having my children” “my job is so physical” and “all the wear and tear of from sports” were common themes. For some it was the hips or knees, shoulders, some necks and most reported experiencing low back pain. Some in the group had lost time from work, others reported costs of time and money in seeking treatment and some mentioned the psychological stresses.  Reports of low back pain, with a location typically defined in the literature as “pain localized below the line of the twelfth rib and above the fold of the buttock with or without leg pain” (1) are widespread and reported to affect between 4-33% of the population at any one time (1). A 2006 study (2) reported that in a Canadian telephone survey, there was a 84% lifetime prevalence of low back pain and a 34% one week prevalence of low back pain in those surveyed.

Headache: 70 to 80% of all headaches are posture induced

“Sitting at my desk feels like an occupational hazard”

A little slouching while using the computer or watching TV seems harmless, but repeat it enough times and it turns into posture habits that not only alter our appearance but might even lead to recurring pains and aches down the road. Want to tell if someone has bad posture habits? Look out for these tell-tale signs:

  1. Rounded shoulders.  Instead of the shoulder aligning with the ear when observed from the side, it hunches forward.
  2. A forward head.  Characterized by a neck and chin that jut out, a forward head is one of the most common causes of head, neck and shoulder tension and pain.

Newsletter December 2013 

Do you suffer from headaches?

What causes the head pain?

How do I get rid of it?

Pain in the head can have many causes.  Most common cause is mechanical, that is, due to a stiff and painful neck joint or muscle.

This occurs due to either:

  1. An active injury such as whiplash, a fall or lifting strain or awkward unguarded neck movement or
  2. A passive injury from a prolonged or repetitive strain to the joint and/or muscle.  For example, poor posture while sitting at your desk, driving or watching TV.

There are many other causes of head pain such as sinus problems, eye problems, jaw or teeth problems, high blood pressure, migraines or on a more serious note, brain lesions.

Physiotherapy assessment will diagnose the cause and if it is mechanical in origin treatment may be as simple as correction of posture, stretching of tight structures and strengthening of weak muscles.

Try this simple posture exercise.

Sit or stand as tall as you can (Imagine a string pulling you up tall from the centre of your head).  Then while looking straight ahead glide your head horizontally backwards as far as you can (without any neck forward (flexion) or backward (extension) bending).  Hold this position of head and chin retraction for a few seconds, relax and then repeat up to 10 times.

(These exercises may need to be repeated several times a day.)

Acupuncture

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