May 20, 2013

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A guide to choosing the right mattress and pillow

March 12, 2013 By Leave a Comment

Do you have sleepless nights due to neck, low back and hip pain? Have you ever considered that your pillow or mattress may be the cause of the problem. Sleep is essential to our everyday functioning, so it is important that we get a good night’s rest. In order to do this you should make sure you are sleeping on a mattress and are using a pillow that are suitable for you.

Which pillow or mattress should I go for? (soft, hard?) This is a question I am commonly asked in clinic. My response is usually, “There is no single type or style of mattress which works for all people as we are all different shapes, sizes, weights etc..” I can give you a guide of what you should be looking for when testing out pillows and mattresses:

When choosing a mattress don’t be scared to have a lie down on it after all, you will spend most of your time lying down on it, not sitting! You should, if you can lie on the mattress for at least 5-10 minutes, in the position you would normally lie in; if you will be sharing you bed with a partner you should both lie on it, to test how it supports your weight.

A bed that is too soft will not be giving your spine enough support so will allow it to go out of alignment and possibly cause muscle stiffness. A mattress which is too hard may put too much pressure on certain parts of the body and result in pain, especially in the hips and shoulders.

When lying on your back the mattress should support you enough so the natural curves of your spine remain.  Get someone to slide there hand behind the small of your back. If there is a gap between your low back and the bed, then the mattress is too hard and not supporting your back. If the person struggles to get their hand underneath your back because your back is rounding, then the mattress is far too soft.  If the persons hand slides through but stays in contact with your back, then this is a good mattress for you. If you lie on your side on the mattress your spine should remain straight. The mattress should be both Supportive and Comfortable.

Like the choice of a mattress, the choice of pillow is also very important.  Your head weighs more than 10 pounds so your pillow needs provide sufficient support, as well as comfort. If support is not appropriate the neck can be put under strain.

A good pillow should keep your head in line with your spine. If sleeping on your back, just run a hand along the back on your neck; the neck should not feel abnormally bent forwards or backwards. If lying on your side your neck should stay in neutral, not bent to either side. For a normal sleeping posture, only the head and neck should be placed on the pillow, not the shoulders.

The amount of support needed from your pillow will be dependent on your sleeping position, as well as your weight and type of mattress. It is important to take in to account the depth of your shoulder in comparison to the distance between you head and bed.

At Avenue Clinic we sell Goldilocks pillows, which involves measuring the patient to provide them with the correct size pillow. For further information on these pillows please see the Goldilocks website:  http://www.goldilockspillows.co.uk/

 

References:

http://becauseilive.hubpages.com/hub/How-to-Choose-the-Best-Mattress-for-your-Body-Type

http://health.howstuffworks.com/mental-health/sleep/basics/how-to-fall-asleep11.htm

http://www.slumberslumber.com/how-to-choose-the-right-pillow/i70

http://sleepforall.com/best-pillow.htm

Filed Under: Uncategorized

The wonders of reflexology for fertility, pregnancy and beyond…

December 13, 2012 By Leave a Comment

The following appeared on the website www.netmums.com. Reflexologist, Jacqui Booth discusses the wonders of reflexology for fertility, pregnancy and beyond…

How is reflexology helpful to women trying for a baby?

Reflexology is a natural, non-invasive healing art that uses pressure points on the feet and hands to balance out other parts of the body. It aims to alleviate tensions and promote relaxation and can be beneficial for pregnancy or indeed, couples trying for a baby.

The Association of Reflexologists gathers feedback from their members, and it indicates that over 50% of clients seeking reflexology in connection with conception find themselves pregnant within six months. Of course, this isn’t a hard and fast rule and very difficult to quantify, but many benefits have been reported and my own experience is good. The advantage of a reflexology treatment is that fertility issues won’t be treated in isolation. Instead, the overall health of the whole person is addressed during the treatment, which allows for hormones to be balanced and stress levels to be tackled too. For maximum effect, a reflexologist might recommend that the dad-to-be receive treatment too – after all, there’s two people involved with making a baby!

Does it have any other particular benefits for women?

Yes, there’s very little that can’t be addressed in a reflexology treatment, as the aim is to bring about balance and wellness in the whole person. For this reason, practitioners might find that clients report improvements in areas that they didn’t come to be treated for.

Is reflexology advisable for pregnant women in the first trimester?

Reflexology is wonderful in pregnancy, not least because you get a two for one treatment as your growing baby can be felt and even seen on the foot too. You and your practitioner will decide whether you wish to receive treatments in the first three tentative months of pregnancy. At this stage, most women worry about the risk of miscarriage. Even though the aim of reflexology is simply to bring about balance and harmony in the body, it would be all too easy for a mum to feel that the treatment may have contributed in some way should the pregnancy end during this time.

To avoid doubt, many practitioners invite mums-to-be to get back in touch once the pregnancy is established. However, there are reflexologists who are experienced or who specialise in maternity reflexology who may be willing to treat at this time, so do talk to them. After three months, you can confidently enjoy putting your (perhaps swollen) feet up for a wonderful time of relaxation.

Can you really ‘see pregnancy’ by studying the feet?

The therapist may be able to feel the baby growing – first as a little tadpole, and then you yourself may be able to see a growing bulge on the inner side of your foot, just above the heel, maybe larger on one foot than the other. The feet really do reflect what’s going on in the body, and it’s hard to dispute when you get to the nine month mark!

Mums might start asking at this time if reflexology can bring on the labour for them – but in line with the aims of balancing the body, if it’s not time for the baby to budge then it will stay put! However, having received reflexology will make sure that your body is in the best possible state to deal with the labour.

Does it help post-natally?

Continued treatment after the birth will encourage a speedy recovery from the birth and most importantly, some much needed time out for new mums!

Is reflexology suitable for babies?

Yes, they have comparatively short sessions compared to adults, so a few movements will suffice for a baby and can be combined with rhymes to keep their attention. It’s quite a nice thing to do if you have a hand free whilst feeding and it may calm down any gastric problems associated with feeding. Pressing on the solar plexus point is good for calming hiccups and gentle stroking all over the foot is always a good option for calming tears.

And for toddlers and children?

Between the age of two to five they might be quite difficult to keep in one place, so short and sweet is the key here – though you might find that if one sibling has their feet done, you’ll have the next sat beside them waiting for their turn! Reflexology can be done very informally, but you might find that the kids like the whole gathering of lotions, towels and blankets, and getting comfortable on a chair or foot stool before they begin.

Take your lead from your child – as they get older and more private, you might find that they go without a session for a year or more, but then they might change their minds again. If the option is open, then it’s a gentle and non-intrusive way of maintaining contact through the years.

Filed Under: Pregnancy, Reflexology

Should I use ice or heat on an injury?

September 26, 2012 By Leave a Comment

Bot heat and cold are beneficial in reducing pain but they work in different ways. Through my experience some people are still not sure when they should be using cold or when they should be applying heat. I hope you find the following useful.

Ice packs should be used on acute injuries, for example an ankle sprain or a muscle strain (especially in the first 48 hours). Make sure you wrap the cold pack in a towel to avoid a freeze burn and do not apply it for longer than 10 minutes at a time. You can ice an injury several times a day, but you should allow skin temperature to return to normal between each application. The ice pack helps to control/reduce the swelling, therefore will help to control pain. Heat increases blood flow and therefore increases swelling, so should not be put on a recent injury where swelling is involved.

Heat packs are mostly commonly used on chronic injuries/injuries you have had for a while, for example aching in the upper shoulders from deskwork or longstanding low back pain. Heat helps stimulate blood flow to the area and relaxes the tissues. You should again be careful to avoid burns and should only apply heat for 20 minutes at time.

So remember:

-       Never apply heat to an injury when swelling is involved

-       Do not apply heat after exercise or while sleeping

-       Do not apply ice to an injury before exercise

-       Do not apply ice or heat to skin that is in poor condition

If in doubt about the use of ice or heat, please consult a health professional.

 

Reference:

http://sportsmedicine.about.com/cs/rehab/a/heatorcold.htm

 

 

Filed Under: Injuries, Sport Tagged With: , , , ,

Golf: Injuries and prevention

September 26, 2012 By Leave a Comment

Low back pain, wrist and elbow problems are the most common injuries seen in golfers. Despite being classified as a low-impact sport, approximately 40% of amateur and 60% of professional golfers suffer from injury each season. These injuries majority of the time are due to overuse (such as repetitive bending and twisting), poor conditioning and incorrect swing mechanics (Brandon, 2009., McCarroll, 1996).

The golf swing is often a strong and explosive movement and subjects the lower back (lumbar spine) to quick and intense loads. This can predispose golfers to muscle strains, disc degeneration, osteoarthritis and facet dysfunction in the lower back (Hosea and Gatt, 1996). It is thought that the type of golf swing used contributes to the likelihood of injury. The ‘classic golf swing’ reduces the torque between the pelvis and the shoulders. The front heel is lifted to allow the hip movement, which decreases the torsion/torque through the lumbar spine. The ‘modern swing’ emphasises a large shoulder movement with limited hip turn, as the front foot is kept flat throughout the swing. This swing is thought to allow for more consistent ball striking and an increase in club head speed, however subjects the spine to greater rotational forces and hyperextension on the follow through. If the individual is not properly conditioned and using the ‘modern swing’ they may be at an increased risk of muscular and overuse injuries (Gluck et al, 2008).

A study carried out in 2010 was one of the first to show distinct differences in the swing mechanics between golfers with and without low back pain.  It was found that golfers without low back pain had twice as much flexion velocity on the downswing, which meant their abdominal muscles were being activated more, giving them more strength on their swing (Lindsay and Horton, 2002)

It is important that golfers warm up properly, develop a good swing technique and make sure they have good lower back and abdominal strength. Muscle conditioning and flexibility exercises for the trunk muscles  (especially the multifidi and tranversus abdominus) are vital. Flexibility stretching is especially important for the seniors as it slows the loss of flexibility, which is associated aging and osteoarthritis. (Gluck et al, 2008., Grimshaw, 2002)

Possibly one of the main factors to address is the misconception of the game itself. Many people view golf to be a gentle sport that is not usually associated with injury. As a result people try to learn the game without proper research or coaching and fail to think about warming up, stretching and exercise preparation (Gluck et al, 2008).

 

References:

Brandon, B. (2009). Training to prevent golf injury. Current Sports Medicine Reports, 8 (3), pp. 142-146.

Gluck, G., Bendo, J. and Spivak, J. (2008).The lumbar spine and low back pain in golf: a literature review of swing biomechanics and injury prevention. The Spine Journal, 10, pp. 778-788

Grimshaw, P. (2002). Lower back and elbow injuries in golf. Sports Medicine, 32 (10), pp. 655-666.

Hosea, T.M. and Gatt, C.J. (1996). Back pain in golf. Clinic in Sports Medicine, 15 (1), pp. 37-53.

Lindsay, D. and Horton, J. (2002). Comparison of spine motion in elite golfers with and without low back pain. Journal of Sports Sciences, 20 (8).

McCarroll, J.R. (1996). The frequencies of golf injuries. Clinic in Sports Medicine, 15 (1), pp. 1-7.

Filed Under: Injuries, Sport Tagged With: , , ,

Arthritis and Osteopathy

September 13, 2012 By Leave a Comment

What is arthritis?

Arthritis is a term which is used to describe inflammation of a joint. There are two main categories of arthritis: inflammatory arthritis and degenerative/mechanical arthritis (osteoarthritis). Osteoarthritis (OA) is the most common form of arthritis in the UK.

Each year in the UK 9 million people seek help from their doctor for musculoskeletal problems, 2 million of which will be diagnosed/have Osteoarthritis. OA is a disease which affects the cartilage in the joints.  The cartilage gradually thins and roughens, causing joint surfaces to become irregular. The bone at the edge of the joint may grow outwards forming osteophytes. Over time the capsule and ligaments surrounding the joint thicken and shorten.

Several factors play a role in the development of OA. OA becomes more common with increasing age and is also more prevalent in the obese. It is more commonly found in joints which have been repetitively stressed (such as joints of an elite athlete or a builder) and joints which have been damaged or are deformed.

Symptoms of OA include joint tenderness/pain, joint swelling, reduced range of movement/stiffness. In some cases the joint may appear red and/or hot. Instability and crepitus of the joint may also be reported. Pain tends to increase when exercising the joint and at the end of the day. The affected joint is often stiff first thing in the morning (and takes approximately 30 minutes to loosen up) and after long periods of rest. Symptoms fluctuate, with bad or good spells lasting for a few weeks or months. People have reported that their symptoms are affected by changes in the weather (usually made worse by the cold and damp) and how much physical activity they are doing.

There is no cure for OA, however several things can be done to ease the symptoms.

How can Osteopathy help with osteoarthritis?

Your Osteopath will use techniques to: loosen the tissues around the affected joints, help increase ROM, help to increase fluid circulation within the joint and aid drainage to decrease swelling/inflammation. The practitioner will do a head to toe check to make sure the rest of your body is moving well and there is no other factor/s contributing to your symptoms. If your Osteopath feels further intervention maybe necessary they will liaise with your doctor.

Your Osteopath will be able to give you advice on exercises that will help strengthen the muscles around the affected joint and maintain/increase mobility.  They can also advise you on how to keep active and fit. They may feel it is necessary to tape/strap the affected joint to provide it with extra support or to help with drainage. Your practitioner may suggest special insoles. Insoles can be very beneficial, as they help distribute your weight more evenly through the feet, preventing uneven forces being transferred up through the lower limb and into the lower back.

How can you help yourself?

The correct diet can certainly help some people with arthritis or rheumatism. If you are overweight and suffer with arthritis, one of the most beneficial things you can do to help yourself is to change the type and amount of food you eat. Being overweight means there is greater forces going through your back, hips, knees, ankles and feet. It is also important to make sure your diet is supplying you with the necessary nutrients including minerals such as iron and calcium.  Cut down on sugary and fatty foods and try and eat more wholemeal starchy foods (such as wholemeal bread and brown rice), vegetables and fresh fruit.

Take regular exercise. Exercise helps to strengthen the muscles around the joints and maintain a good range of movement. Non-weight bearing exercise, such as swimming is the most beneficial, but any form of exercise is better than none. Find a form exercise which is suitable for you and does not aggravate your symptoms. It is also important to rest your joints if they are inflamed. Applying ice to the joint can help reduce inflammation. Make sure you wrap the cold pack in a towel to avoid a freeze burn and do not apply it for longer than 10 minutes at a time. You can ice an injury several times a day, but you should allow skin temperature to return to normal between each application. The joints should be used little and often. Long periods of rest can have an adverse affect as the joints have time to stiffen.

There are several nutritional supplements available which have been shown to help with the symptoms of OA. Common ones include: calcium, vitamin D, omega-3, MSM, glucosamine and chondroitin. Tumeric has been found to be effective in reducing osteoarthritic pain according to a study published in the ‘Medical News Today’ in 2010. You should discuss with your dietician/nutritionist or doctor before taking any supplements as you can take too much and they can also interfere with other medication.

 

References:

www.arc.org.uk

http://www.patient.co.uk

http://www.nhs.uk/Conditions/Osteoarthritis

http://www.medicalnewstoday.com/releases/201305.php

Filed Under: Arthritis Tagged With: ,

Is your child’s school bag and shoes causing them pain and possibly problems in the future.

September 13, 2012 By 1 Comment

The Back Health Charity BackCare have highlighted that approximately 60% of children are carrying over weight school bags. Some primary school children are routinely carrying bags which weigh over 15% of their body weight (NHS, 2012). Not only are the bags too heavy, most children are wearing them in the most detrimental way, on one shoulder. These heavy school bags are often carried between lessons, as well as to and from school. Experts have voiced that carrying anything that weighs more than 15 per cent of the child’s body weight will be causing spinal damage, whatever bag you use.

Parents are warned that excessive load bearing on immature spines, such as carrying a heavy, poorly designed bag to and from school, could increase a child risk of suffering with back problems in the future (Amal H. Ibrahim., 2012). At a young age, a children’s spine is still developing, so having a heavy bag thrown over one shoulder can exert harmful forces on the spine and muscles and can actually affect the natural curve of the spine, possibly leading to scoliosis. Research has shown that if you experience back pain as a child, you are four times as likely to experience back pain in your adult life.

It is recommended childrens’ backpacks:

  • Should weigh no more than 10 per cent of the child’s body weight (Olubusola Esther Johnson et al., 2011)
  • Should be worn on both shoulders so the weight is evenly distributed.
  • Should have a padded back panel and wide padded straps for increased comfort.
  • The heaviest items should be packed so they are closest to the spine, to reduce strain.
  • The straps should be adjusted so the backpack sits high up on the back and a waist strap can be used so the pelvis can hold some of the load.
  • Should only contain the necessities (i.e. books needed that day).

The charity has also highlighted that other factors may contribute to children’s back problems, such as poorly designed chairs and unsupportive footwear (Mohd Azuan  et al., 2010). Teenagers are particular vulnerable when wearing unsupportive shoes as the foot bones continue to grow through adolescence. Abnormal loading of pressure through the feet can cause the structure of the bones to change. This can lead to a change in their gait and this may cause knee, hip and low back problems.

It seems to be teenage girls which are most effected as many are wearing ballet type pumps, which are far too flat and provide no support. Without the correct support the arches, muscles and ligaments become stressed and strained. The typical pattern is that the foot/arches flatten and the lower leg turns inwards, causing the knees to work in an abnormal position and can contribute to knee or hip pain. If the shoes are too flat they are not providing any shock absorption and the teenager/child may also experience heel pain. If your child/teen insists on wearing a certain type of shoe that is not supportive enough, then you can insert a simple orthotic into the shoe, which will provide extra support.

It is recommended that school shoes:

  • Should have a strap, velcro or laces to hold them on.
  • Should be made out of natural or breathable fabric.
  • Should have the necessary support and a small heel.
  • Should have a deep toe box, so the toes have room to move and are not scrunched up.

The BackCare charity have stated that up to 80 per cent of the population experience back pain at some point in their life and interestingly many of the adults back problems can be traced to childhood. This highlights the importance of making changes now, as they will possibly lead to a decrease in back problems in adulthood.

 

References:

Amal H. Ibrahim. (2012). Incidence of back pain in Egyptian school girls: Effect of school bag weight and carrying way. World Applied Sciences Journal, 17 (11).

Mohd Azuan, M. et al. (2010). Neck, Upper Back and Lower Back Pain and Associated Risk Factors among Primary School Children. Journal of Applied Sciences, 10 (5), pp. 431-425.

Olubusola Esther Johnson et al., (2011). Percent of Body Weight carried by secondary school students in their bags in a Nigerian school. Journal of Musculoskeletal Research, 14 (2).

http://www.nhs.uk/news/2012/03march/Pages/rucksack-bags-back-pain-children.aspx

http://www.backcare.org.uk/blog/?p=186

http://www.dailymail.co.uk/health/article. Search: School children back pain.

Filed Under: Children's Health Tagged With: , , ,

Horse riding: the influence between rider and horse

August 21, 2012 By 3 Comments

As an Osteopath and horse rider myself, I have treated many horse riders and
have seen how injuries or imbalances in the rider can have an effect on the
horse.

 

If a rider if suffering with back or hip pain etc, he or she will undoubtedly be
compensating for this in their riding position and therefore will be transferring
the problem down through the horse, particularly if the injury results in altered
weight bearing. Low back pain may cause a rider to lean forward in order to
achieve comfort and this transfers more weight through the horse’s withers
and this can restrict the horses shoulder movement. Consequently, the rider
influences the musculoskeletal system of the horse, so can be the cause of a
horses back problem, heaviness/stiffness of a rein/s, head tilt or lameness. It is
vital that the rider has a good body alignment, balance and flexibility, in order to
achieve efficient riding. Osteopathy does not only target the symptoms a rider
presents with, but also detects unrecognised areas of restricted movement.
Osteopaths believe the whole body will work well only if your body is free from
restriction and in good structural balance.

Injuries to the pelvis are typically associated with high energy traumas such as a
horse rider hitting the pommel of the saddle, which forces the back of the pelvis
apart or a fall which can cause a direct compression, a shearing force or an
abrupt rotation through the pelvis. These type of injuries can cause a functional
leg length discrepancy.

In clinic we often see patients with a leg length discrepancy; this is simply
defined as a condition where one leg appears shorter than the other. Leg length
discrepancy has been split into two categories:
(1) Structural: which is a true shortening of limb caused by congenital,
traumatic (e.g. a broken leg) or pathological origins (e.g. wear and tear in
one hip)
(2) Functional: this is the most common and develops as result of altered
mechanics in the lower body, such as foot over pronation or supination,
muscle or joint imbalances and incorrect pelvic positioning.

Leg length discrepancies can still remain even when you’re sat in the saddle.
They may be evident when one stirrup is required to be longer than the other
for comfort. The difference in stirrup lengths may also alter how the weight
distribution is transferred to the horse and this may aggravate any existing
problems the horse has or contribute to new ones. The difference in leg lengths
also results in larger forces being transferred through some of the joints,
these could include ankle, knees, hips and sacro-iliac (SI) joints. Prolonged
compression through a joint will eventually lead to irritation and inflammation
in that area. In my clinical experience I have found that either muscle tension or
restriction in the pelvis to be the main cause of leg length discrepancy.

You may not be aware that you have a leg length discrepancy or significant
restriction within the body, because they are not always a problem in the

short term. If these imbalances remain they will eventually cause pain locally
or elsewhere. An Osteopath can help to improve any pelvic or leg length
discrepancy or muscle imbalances/strain/pain due to trauma by improving
muscle tone and joint function. If you have any questions then feel free to
contact me at Avenue Clinic on 728798 or at admin@avenueclinic.co.uk.

References:

Chila, A. (2011). Foundations of Osteopathic Medicine, 3rd Ed. Lippincott
Williams & Wilkins, China.
Dalton, E. (2007). Short Leg Syndrome, Part One. Massage Today, 7 (8)
Dalton, E. (2007). Short Leg Syndrome, Part Two. Massage Today, 7 (11)
Mulhall, K., Khan, Y., Ahmed, A., O’Farrell, D., Burke, T. and Moloney, M. (2002).
Diastasis of the pubic symphysis peculiat to horse riders: modern aspects of
pelvic pommel injuries. British Journal of Sports Medicine, 36, pp. 74-75.
http://www.osteopathy.org/MXENQ85VAJ

Filed Under: Injuries, Sport Tagged With: , ,

Exercise during Pregnancy and Post-Birth

August 16, 2012 By 1 Comment

Healthcare providers are encouraging women to exercise moderately during their pregnancy, unless they have any complications or have been advised not to. Exercise before and during pregnancy has been associated with reduced preeclampsia risk, prevention of gestational diabetes and has also been linked to a decrease in caesarean section rates and infants with higher Apgar scores. Generally, women who exercise regularly before pregnancy, should continue to be active and modify their routine as medically indicated. Women who have not been active before should consult a health professional for advice before commencing exercise. (Borg-Stein et al, 2005)

Physical changes during pregnancy have the potential to affect the musculoskeletal system at both rest and during activity, the main change being weight gain. The increase in weight will mean there are greater forces across the joints such as the hips and knees. This is one of the reasons why the frequency, duration and type of exercise may need to be modified during pregnancy. Ligament laxity is another well-known physiological change during pregnancy. This increase in ligament laxity happens in the first and second trimester of the pregnancy and remains for weeks to up to many months afterwards.  Although there is a lack of clear evidence that musculoskeletal injuries are more prevalent in pregnancy due to this ligament laxity, it still needs be considered when prescribing exercise regimes. (Artal and Toole, 2012)

Many of the physiological changes of pregnancy remain for at least four to six weeks post-birth, this is why exercise regimes should be resumed gradually after pregnancy. Generally it is recommended that most women should wait six weeks after birth to start most types of exercise and eight to ten weeks after a c-section but exercise should only begin when physically and medically safe. This will vary from one woman to another, dependant on how the labour was, whether a C-section was carried out and how physically fit the mother was previously (Artal and Toole, 2012). Gentle exercise such as pelvic floor exercises can be started within a few days of an uncomplicated delivery however those with a c-section should wait until they have stopped bleeding and have medical approval to begin.

Fifty per cent of women suffer with a pelvic organ prolapse and 1 in 3 women will have urinary incontinence post-birth. If high impact exercise is introduced too early, urinary leakage may increase. A prolapse is often described as a  “heaviness down below or something coming down.” The symptoms of a prolapse are often worse at the end of the day or after high impact exercise. Most women perform pelvic floor exercises, however approximately 30% of women are performing the exercise incorrectly and are actually bearing down rather than squeezing inwards and drawing upwards. Pelvic floor strength and endurance should be improved with regular pelvic floor exercises and then the intensity of the exercise programme can be gradually increased to match this. Pelvic floor exercises can be repeated four-six times a day in sets of ten. They can be done either sitting or standing and anywhere, anytime. The best way to find the muscles is to try stopping and starting (or slowing down) the flow of urine while you’re on the toilet. (Yates)

Low impact exercises such as swimming and cycling and gentle core exercises are recommended initially with a gradual return to higher impact exercise. Higher impact can be defined as taking both feet of the floor at the same time and it is a good idea to wait three to five months after delivery (depending on your level of fitness before and during pregnancy) before starting high impact exercise. It is important not to work through any form of pain. Pain is a warning signal that should never be ignored so it is important to make adaptations or stop altogether.

Exercise should not interfere with a mother’s ability to breast-feed. It has been shown that lactic acid is increased in the breast milk of mothers that are exercising at maximal intensity, but not in those that are exercising at moderate intensity. It is not clear whether this short-term increase in lactic acid makes the breast milk less palatable for the baby. For this reason mothers may consider breast-feeding their infant before they exercise, which will also help make the breasts more comfortable during exercise or to postpone the feed until one hour after a workout (Gregory et al, 2003). It’s also important to drink plenty of fluids, before, during and after exercise.

Exercise during and after pregnancy is important but it is also important that too much isn’t undertaken too soon. It’s essential to listen to your body and take it from there.  If you have any questions about exercise, before, during or after pregnancy then speak to your GP, healthvisitor, midwife or give us a call at Avenue Clinic on 728 798. Avenue Clinic is a multidisciplinary clinic with a variety of therapists with a special interest in treating women before, during and after pregnancy including Osteopaths (Gemma Piercey and Dimi Argyros,  who also treats babies and children), an acupuncturist (Jo Vessey, with a special interest in acupuncture aimed at improving fertility) and  massage therapist (Nicky Jenkins) who is trained in pregnancy massage and also does pregnancy yoga.  Tai Chi/QiGong  (with Rajan Chaudhary) is also a good low impact exercise option.

 

References

Artal, R. and Toole, M. (2012). Guidelines of the American College of Obstetricians and Gynaecologists for exercise during pregnancy and the postpartum period. British journal of Sports Medicine, 37, pp. 6-12.

Borg-Stein, J., Dugan, S. and Gruber. J. (2005). Musculoskeletal Aspects of pregnancy. American Journal of Physical and Medical Rehabilitation, 84 (30, pp. 180-192.

Gregory, A., Wolfe, L., Mottola, M. and MacKinnon, C. (2003). Exercise in pregnancy and the postpartum period. Journal of Obstetrics and Gynaecology Canada, 25 (6), pp. 516-22.

Yates, L. Web: http://www.cef.co.nz/articles/61?fwcc=1&fwcl=1&fwl

http://www.nhs.uk/conditions/pregnancy-and-baby/pages/your-body-after-childbirth.aspx#close

Filed Under: Pregnancy Tagged With: ,

Shin Splints

July 2, 2012 By Leave a Comment

Shin splints 

Shin splints is a general term used to describe pain at the front of the lower leg. However true shin splints cause pain on the inside of the shin and this can arise from a number of causes.

The pain from shin splints tends to be dull at first, but if ignored can become very painful. Commonly the pain is felt when you first begin your bout of exercise and then often eases as your exercise session continues. Following exercise the pain may return as the inflammation takes place and you may find the pain is at its worse the following morning.  The shin bones often feel bumpy and tender to touch and some people may have redness or swelling a long the shin bone. The pain can be exacerbated when the foot is pointed downwards. The most common cause of shin splints is due to the traction forces applied to the bone from the surrounding muscles and this leads to inflammation of bone lining.

The most common causes of shin splints include:

  • Overuse or a sudden increase in exercise
  • Inadequate footwear
  • Muscle tightness (possibly caused by a lack of a warm-up or cool-down)
  • Oversupination (rolling out) or overpronation (rolling in) of the feet.
  • Running on uneven or hard surfaces
  • Restricted range of movement at the ankle joints

The treatment for shin splints involves reducing the pain and inflammation and finding the cause of the problem. You need to allow the muscles to return to their original condition and then introduce exercise gradually.

Treatment includes:

  • Rest to allow the muscles to heal
  • The application of ice to reduce inflammation
  • Exercises to stretch the muscles in the lower limb.
  • Manual therapy – to include soft tissue techniques, taping techniques and articulation/manipulation to correct any mechanical imbalances. Orthotics may be issued to correct overpronation or oversupination.

 

References

http://www.sportsinjuryclinic.net/sport-injuries/ankle-achilles-shin-pain/shin-splints

http://www.nhs.uk/conditions/shin-splints/Pages/Introduction.aspx

Filed Under: Injuries Tagged With: , ,

Heel pain – About Plantar Fasciitis, Prevention and Treatment

June 14, 2012 By Leave a Comment

Plantar Fasciitis: how to prevent and treat it

What is plantar fasciitis?

Plantar fasciitis is inflammation of you plantar fascia, which is found on the sole of your foot, attaching from your heel bone to your toes. The plantar fascia is a strong band of tissue and its main job is to support the arch of your foot and it also acts as a shock absorber.

Plantar fasciitis causes pain on the sole of the foot mainly felt at the heel, but it can span the length of your sole. The pain can be described as sharp, throbbing or a dull ache. It is commonly worse first thing in the morning or after a period of rest, which means your first few steps are very painful.

What causes plantar fasciitis?

  •  Poorly fitting footwear or shoes with no arch support
  • If you are on your feet all the time
  • If you are over weight , this can put more strain on the plantar fascia
  • Tightness in your calf muscles and Achilles tendon
  • Overuse or sudden stretching of your sole, e.g. a sudden increase in exercise intensity.

How to prevent plantar fasciitis

  • Wearing shoes with good arch support and with heel cushioning
  • Trainers worn for running and walking should be changed regularly
  • Be sure to stretch your lower limb muscles thoroughly before and after exercise, especially your calf muscles and the plantar fascia.
  • Weight loss maybe beneficial if you are overweight.

Treating plantar fasciitis

  • Manual therapy – A practitioner (Osteo, physio etc..) will examine and explain to what they think is causing the problem. They will treat you using soft tissue techniques, articulation and stretching.
  • Stretching – See the video link for some basic stretches. These can be done in sets of 3, held for 30 seconds each time, up to 3 times a day.
  • Insoles and heel supports – you can buy heel cushioning supports specifically for heel pain and insoles that will help to support the whole of your foot. These should be worn at all times.
  • Rest – Rest you foot as much as possible, avoid activities that will cause excessive stretching to the sole of your foot, such as running and prolonged standing.
  • Pain relief – Apply ice to the affected area. Wrap a cold pack in a towel and apply for 15-20 minutes, 3-5 times a day. Painkillers such as ibuprofen may help reduce inflammation and pain or some people find rubbing pain relieving gel/cream into the sole of the foot beneficial.

http://www.patient.co.uk/health/Plantar-Fasciitis.htm

If any of the above sounds familiar and you are currently suffering with heel pain, then please contact us at Avenue clinic and we will be happy to help.

 

 

 

Filed Under: Injuries Tagged With: , , , ,
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