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Fascia
By Brianna Delaney
The word fascia might be one you’ve heard before as either the source of your pain or contributing to it. Fascia are dense bands of connective tissue that cover and separate different tissues throughout the body. Wrapping around everything from muscles to bones to organs it is sometimes likened to glad wrap within the body, however it is quite different.
Fascia can be categorised into two main categories;
Superficial fascia is found just deep to the skin surrounding the whole body and containing fat, nerves, blood vessels and other connective tissues.
Deep fascia is a dense fibrous connective tissue that surrounds muscles, bones, nerves and blood vessels. Some muscles will even originate or attach directly onto fascia. There are also areas of sheet-like membranes called Aponeurosis that connect muscles to each other, to bones or other fascia. For example the abdominal aponeurosis.
The role of this connective tissue is to contain soft tissue structures and transmit mechanical tension throughout the body, providing support for tissues and helping to reduce friction as we move. When healthy, fascia is relaxed and malleable but can quickly become tight and painful when trauma or inflammation occurs. This can restrict movement of the underlying tissues and cause pain.
Injury or inflammation of the fascia causes conditions such as fascitis or compartment syndromes. Plantar fasciitis is one of the most common and is the result of repetitive strain typically at the plantar fascias attachment to the heel (calcaneous). It results in pain and inflammation at the sight making simple activities like walking and standing for long periods quite difficult.
However, fascia can play a contributing role in other musculoskeletal presentations. Due to fascia playing a large role in connecting muscles together, a network of connective tissue is created. There are some common patterns that are starting to emerge from this network that are being referred to as myofascial chains or meridians. When injury or pain occurs in one area of the body, tightness or lack of flexibility along other parts of a chain may contribute to the onset or experience of pain. For example, the superficial back line fascial chain connects from the plantar fascia to the gastrocnemius muscle, hamstrings, sacrotuberous ligament to the paraspinal muscles right up to the skull. Tight hamstrings and decreased flexibility has been shown to contribute both to lower back pain as well as plantar fasciitis (Ajimsha, Shenoy & Gampawar, 2020).
Stretching, hydration and staying active can help you to look after your body as a whole and keep your fascia malleable and working to help rather than hinder your daily life.
Resources:
Ajimsha, M.S., Shenoy, P.D., & Gampawar, N., 2020. Role of fascial connectivity in musculoskeletal dysfunction: A narrative review. Journal of Bodywork & Movement Therapies 24, 423-431. https://doi.org/10.1016/j.jbmt.2020.07.020
Gatt A, Agarwal S, Zito PM. Anatomy, Fascia Layers. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526038/
Migraine V Headache: Whats the difference?
By Brianna Delaney
June is Migraine Awareness Month and with 1.1million estimated cases around the world in 2019, knowing about Migraine is important to diagnosing, treating and managing. There are many differences between headaches and migraines and having an understanding can help you and your loved ones understand what to do in each circumstance.
What is a Headache?
Headache is a pain felt in the head or face that has affected around 95% of the population at some point. These can be classified as either primary or secondary, primary headaches include Migraine and Tension-Type headaches, the latter being more prevalent. Aside from presenting symptoms, the duration, severity and frequency of your presentation are important in distinguishing which type of headache you might be experiencing. With tension-type headaches benign the most common, they usually present as an ache or pressure type pain described as a band around the head. Typically tension-type headaches are mild to moderate in severity and have low impact on daily activities.
What is a Migraine?
Migraine Australia explains Migraine as a sensory processing disorder in which a migraine attack occurs when the brain over-reacts when exposed to too much stimulus. There are many different types of migraine with varying triggers as well as differences in severity, frequency and disability, the symptoms and triggers may even change over time. Migraine is typically described as a throbbing, pulsating pain on one side of the head that can last between 4-72hrs. The severity ranges from moderate to severe and can interrupt simple daily tasks and and have varying associated symptoms. Typically, migraine sufferers will prefer dark, quiet rooms until their symptoms subside.
A migraine attack is the experience of symptoms for a period of time. Within the brain, the valves of the ion channels get stuck open unable to regulate the channel. This causes irritation of the pain nerves of the head and neck, blood vessel spasms and inflammation in the affected area. These physiological events cause the experiences of pain, nausea and vomiting and in some cases a sensitivity to light, smells or sounds.
Migraine Australia describe the different phases of Migraine in the image below:
Whether it be migraine or headache, keeping track of when, how long and what symptoms you experience can be useful information in diagnosing and treating your presentation. Keeping a headache/migraine diary can be done with a simple notebook, on your phone or with apps.
For more information on migraine you can head to www.migraine.org.au
Resources: https://www.nkch.org/blog/headaches-vs-migraines-know-the-root-of-your-head-pain
The Travellers 101 to Aches and Pains
By Brianna Delaney
Heading into school holidays and Eastern often means trips away, whether a flight interstate or overseas or maybe a road trip, camping or visiting family. Sleeping in unfamiliar beds, long periods in one position and being a bit more adventurous than usual can often bring about sudden aches and pain that interrupt what should be a relaxing time for making memories. Below we’ll go through some of the common tweaks travellers can experience and some strategies you can put in your emergency kit just in case!
There are many different ways in which travel can cause aches and niggles that interrupt our holiday, it may be a new pain that you haven’t experienced or a repeat offender you had hoped to avoid! Common problem areas are the neck and lower back pain often from long trips in cars and planes or sleeping in different beds with different pillows. They can also come about from sudden quick movements the body has struggled to catch up with. You may experience a loss of range of motion and difficulty getting comfortable to go along with the pain. As much as the neck and low back are the most common, travel is full of the unknown and that applies to niggles and aches as well.
SO! I have an ache, I’m away from home and my usual health professional, what do I do?
First of all, rest. Letting your body take a minute to assess the situation and figure out what's actually happened can make a huge difference, much like those first few steps after rolling your ankle as you figure out how much weight you can use. Next is ice and heat, ice is commonly used for acute injuries where we want to reduce the amount of swelling and heat is used to reduce muscle guarding aiding in relaxation. However, both ice and heat have an analgesic effect and whichever provides relief is a thumbs up. But I’m traveling! You say, no fear, when your freezer ice packs and wheat bags are out of reach, the local chemist has a handy supply of single use ice packs and heat packs in a pinch (always read the instructions and always have a layer between the pack and your skin).
Sleep is often a struggle on that first night or two as the ache takes its time to settle. Your normal sleeping position might suddenly be aggravating your pain and you can’t get comfortable. Having access to a second pillow can be really useful in gaining comfort and reducing the aggravation experienced overnight. Below we have demonstrated numerous ways to use a pillow as support. If you don’t have access to another pillow, folded or rolled up jumpers/blankets or couch cushions can help as well. These can also be used BEFORE pain occurs to prevent an onset of discomfort.
The magic of a rolled up jumper when traveling is quite amazing, especially for long road trips or plane seats. The photos below show another range of ways these can help change our posture and provide support for the low back, shoulders and hips to reduce discomfort. Changing up our posture regularly is great in avoiding pains from prolonged positions.
After the first day of rest, beginning with light movements and gentle stretching (rule of thumb is nothing over 3/10 in pain) can get you back to the itinerary in no time. Our resources page has a number of videos for different stretches from necks to lower limbs and acute and chronic back pain. [Quick and Easy Stretches - Video Series]
The hope is that these tools allow you to get back to your holiday without pushing through pain or help you to move more comfortably until you can see a health professional.
Bursitis
By Brianna Delaney
Bursa are fluid filled sac like structures found near bony protuberances. They typically rest between the bone and other bones, muscles, tendons or ligaments and prevent friction between these structures that would otherwise move against each other. There are many bursa throughout the body of varying sizes. Bursitis is when these fluid sacs enlarge due to inflammation, this can be a result of injury of the bursa itself or as a response to a painful stimulus.
The most commonly affected bursa in the body include the following:
Pes anserine: sits between the hamstring tendons and the tibia
Trochanteric: is located in the lateral hip and sits between the gluteus maximus tendon and the insertion of the gluteus medius tendon on the femur
Olecranon: at the back of the elbow it protects the tricep tendon as it passes over the ulnar
Prepatellar: over the knee cap just under the skin
Bursa of the Patella
These help to prevent friction between the patella and the quadriceps tendon that runs over the top and attaches onto the Tibia.
Bursitis can be caused by overuse injuries, trauma or inflammatory disorders.The most common cause is prolonged pressure, where the surrounding structures place a continuous stress on the bursa (For example, leaning on your elbow or kneeling for too long on hard surfaces), or through repetitive motions. Alternatively a direct sudden pressure such as trauma can cause the bursa to become inflamed, this incident isn’t always immediately obvious.
Each bursa around the body has certain incidents or activities that are more likely to result in bursitis, for example, the olecranon bursitis (at the back of the elbow) is more likely in those that work in manual labor positions as necessary tasks will require repetitive movements and leaning or may be knocked. While the subcutaneous calcaneal bursa (found at the heel of the foot) can be inflamed from footwear that is too tight or poorly fitting.
When a bursa does get inflamed there is local pain and limited range of motion of the joint and pain on certain movements. However, in more chronic cases there may not be any pain as the structures have had time to accommodate the increase in fluid. In both cases there is often local swelling and musculoskeletal imbalances that may have contributed to the onset of bursitis.
There are a few ways to manage the onset of bursitis, initially, like many acute injuries the PRICE protocol can be used to manage symptoms. Osteopaths can help to educate on adjusting aggravating activities and how to manage symptoms. Treatment and rehab often aim to improve range of motion as well as building strength to support the area and reduce pressure over the bursa.
Williams CH, Jamal Z, Sternard BT. Bursitis. [Updated 2022 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513340/
Foot Mechanics - Pronation and Supination
By Cameron Allshorn
Our feet are critically important to how we move, our balance, motion and function is closely related to the balance and coordination of our foot mechanics
Pronation is typically rotation in a downwards trajectory, it is a common movement in our feet that allows for the transition from ‘heel strike’ to ‘toe off’ in motion. During motion weight shifts across for the foot from the heel towards the big toe as this happens the arch pronates towards the surface.
Excess or over-pronation is when the foot moves past the neutral midline - neutral midline in this case is the expected point where motion should cease - over pronation leads to collapsing or flattening of the arch and inwards or medial leaning of the heel/ankle.
Causes of overpronation can be weakness in foot and leg muscles or past injury to the foot/ankle leading to excess movement of the foot. It is important to note too, that extra forces can be placed through the feet during pregnancy as a result of weight and hormonal changes.
Ongoing overpronation can cause pain in the foot and ankle but can also play a key role in issues such as knee, hip and lower back pain. It can lead to increased wearing of footwear soles that mean we move through shoes quicker than expected. Mostly, overpronation has a direct impact on motion and gait, if left unmanaged it can create considerable compensatory change that can have a big impact over time.
Strengthening of the intrinsic foot muscles, the smaller muscle group within our foot, can help with maintaining the structure of the arch and to support structures higher up. This can be particularly important during adolescence as teens are growing rapidly!
Never forgetting that muscles of the leg such as gastrocnemius, soleus, peroneals (these make up the ‘calf’ muscle group), hamstrings and glutes also play a key role in providing stability and strength through gait
Pronation of the Left Foot
Supination is the opposite motion, defined as rotation in an upward trajectory; it functions to limit excessive pronation and support the hind foot in motion.
Excessive supination is when the arch of the foot lifts and restricts normal pronation. This can lead to increased weight on the lateral (outside) of the foot in motion. It is often the result of stiffness in the mid foot (tarsals and metatarsals) or hypertonicity (tightness) of the calf or tibialis muscles. Also known as under pronation, it is less common than over pronation.
Longer periods of excess supination can lead to pain in the foot (particularly around the heel) or injuries such as shin splints or patellofemoral (knee) pain. As with over pronation, compensatory changes to gait and motion are common if excessive supination is left unmanaged and can become a contributing factor to presenting pain and injuries in other areas.
Supination of the Left Foot
If you’d like some more information on how this might apply to you, ask us at your next appointment!
Setting Goals and Finding Bench Marks to Stay Motivated
By Brianna Delaney
There are different times of the year where different priorities take center stage and we find ourselves motivated towards a new goal. It’s exciting and thrilling to think of ourselves as reaching that goal, in whatever time frame we’ve set ourselves, using that boost in adrenaline and endorphins to jump in head first to start reaching it. So how can we set better goals, achieve them and avoid the disappointment that can come so quickly after that initial drive starts to wear off?
First of all, it’s a great time to reflect on past goals and what you’ve achieved regardless of the goals you set. Considering the last 12months, reflect on special moments and memories and people you are grateful for. Then consider the goals you might have been focused on in that time, did you achieve them? If not, what stood in the way? Determining what held you back from meeting those goals means that we can better remove the obstacles before the next one.
Secondly, write down exactly what your goals are, be as specific as you can about what it is you are aiming for, when you want to achieve it by, and how you’ll know when you have reached your goals. This way you can plan all the steps to get there in more detail, either working backward from your goal or determining your start point and planning accordingly. Having a plan with detailed steps helps walk before we run.
Now that you have reflected on past goals and determined a few barriers and you’ve set your new goals with specificity and intention, it’s equally important to determine where you are right now in relation to that goal. Benchmarks are a way for us to know our starting point, helping to refine the stepping stone on the way to that final goal but also help us appreciate how far we’ve come as we move through those steps. For example, if your goal is to run 5km and your benchmark is 500m, your first step won't be to run 2km after a week. Your specificity may come in deciding that you’ll run three times a week and the first week you’ll only do 500m each time. Now you’ve taken an achievable step towards the goal and away from your benchmark without risking going too hard too fast.
Often with goals, we might get frustrated mid-way through the journey that we aren’t where we think we should be, this is the exact time to remind yourself of your benchmark. If six weeks into your running you aren’t only running three times a week consistently but you’re now running 2km a time, you’ve made huge strides from your starting point. This helps to battle some of the mental blockades and setbacks that we can experience along the way, switching our perspective from ‘why aren’t i there yet?’ to ‘look at what I’ve already done’.
Creating a balance between motivating ourselves towards our end goal but always appreciating what we have already achieved is a bit of a juggling act, below are some tips on how to better set yourself goals and determine your benchmarks.
Using seasons or important dates such as your birthday, summer, or ‘after easter’ as your launch date for your goals may not be the right time. Rather, pick times where you are settled into your routine and you aren’t too busy with projects, holidays and social events, to give yourself a better chance of integrating your steps.
Introduce your changes gradually, whatever your steps may be, don’t overwhelm yourself with change that’s hard to implement after a tough day or de-motivating when you’re tired. Sometimes the best initial step is to form the right habits, if your goal is getting fit, then regardless of whether you spend 5 minutes or 60 when you get there, try just making sure you go to the gym four times a week. Build the habit of going first. Look at your schedule and decide when those 2, 3 or 4 times a week are going to be and once it feels normal, move onto the time spent there.
Starting all your goals at once relates back to that sense of overwhelming change. Prioritize them in some way, either what's important to you or when you want to achieve them.
Most importantly, determine why these goals are important to you and have some way of reminding yourself of this regularly. Having a meaningful reason to put in the work and make those changes is key to keeping the fire stocked and motivation levels constant.
Remember that all progress is something to celebrate, ‘keep your eyes on the prize’ is a great mentality but when you’re feeling stuck or progress is slow, take a minute to look back and appreciate where you started, to acknowledge that benchmark and all the steps you’ve completed so far.
Breathing and the Diaphragm
By Brianna Delaney
Diaphragmatic breathing is something many of us have heard about or been asked to do in relation to yoga, singing, meditation, pilates, strength training and even injury recovery. However, understanding where the diaphragm is and what some of the benefits of this type of breathing are, can help us practice better.
The diaphragm is a dome shaped muscle that sits below the lungs at the base of the rib cage. Unlike most muscles, the diaphragm has one central tendon that rests under the heart, and attaches to the base of the sternum, lower ribs and lumbar spine. This unique attachment means that rather than acting to provide joint movement, the contraction of the diaphragm raises and lowers its central tendon, creating inhalation and exhalation.
It is not the only muscle that plays a part in respiration, but it is what we call a primary muscle of respiration alongside the intercostals (muscles between our ribs). These muscles create changes in pressure gradients to help move air in and out of our lungs. Air always seeks to create equal pressure between two places. To breathe in, some of the intercostal muscles contract to pull our ribs up and out while the diaphragm draws its central tendon and the lungs downwards. This increases the space in our rib cage and creates a lower pressure inside our lungs than the air pressure around us, drawing air in to fill the lungs; causing you to inhale. To breathe out, some of the intercostal muscles will pull the ribs back down as the diaphragm relaxes. Suddenly there is less space than needed which creates a higher pressure inside the lungs than in the air around us and pushes air out; causing us to exhale.
For the large part, the diaphragm contracts and relaxes without our conscious input and adjusts its rate and depth of contraction as we move, rest, sleep and go about our day. Diaphragmatic breathing not only helps to strengthen the diaphragm, slows our rate of breathing and uses less energy to breath. But can also help us relax, reduce heart rate and blood pressure, improve muscle function during exercise as well as make breathing easier.
How to do diaphragmatic breathing:
Lay on your back on a flat surface with your knees bent
Place one hand on your chest and the other on the bottom of your rib cage
Breathing in slowly through your nose, letting the air travel deep into your lungs. The hand on your chest should stay still as you feel the hand on your lower ribs rise
Exhale and repeat
Want to see a diaphragm in action?! Learn how to create your own on our resources page here!
Preparing for a Change of Season
By Cameron Allshorn
Trees are getting greener, the grass getting longer, Spring is here and summer is on the way! Woo Hoo! After a long winter this is not the only change of season occurring. At this time of year we transition from our winter sports and hobbies to the summer seasons options.
Longer days and warmer weather can give us extra time to exercise and get into the things we love to do at this time of the year.
HOWEVER!
After a few months off, have you taken time to see if your body is as ready as the mind for the new season that is upcoming?
Some sports and hobbies are more taxing or dynamic than others; in most cases will use different regions of the body or movement patterns to what you have been refining over the winter season. Now is a great time to check in on what the body needs to be ready to hit the season running and ready to have the best one yet.
Here are a few pointers to keep in mind for some of the peak spring and summer seasons on their way. Many of these are interchangeable across sports and hobbies.
Cricket: Shoulder mobility, lower back stability (very important for the fast bowlers), Hips and hamstrings.
Gardening; The garden can be a big job after winter. Lifting, bending, twisting and kneeling are important and our bodies thank us when we give them the best TLC prior and after getting out into the garden.
Hiking: Pectorals, Quads, Feet are just as integral for a good (and comfortable) multi day hike, have you neglected these areas over winter. These muscles can often be tight during periods where we have been more sedentary.
Ocean Sports: We’re talking swimming, surfing, paddle boarding and more. Commonly these involve upper and lower body connection, functional core stability, lower back and legs.
Rowing: Spinal rotation, upper body control, power and connection between various regions, like many sports, rowing requires a variety of movements falling into place in the right order for the best output.
Running: Hobart has an array of running events over this time of year, are you training for Point to Pinnacle on November 20th or Bruny Island Ultra on Dec 3rd, or maybe you have just completed the Hobart Marathon last weekend.
Sailing: Core stability, hips, arms, It takes a lot to keep a boat upright in the spring wind! Keeping this in check can help avoid shoulder, lower back and other injuries.
Tennis: Elbows and forearms, lateral mobility, calves, foot and ankle function. This goes for all the other racquet sports too.
And don't forget the evergreen and all year round hobbies and sports like Golf, Basketball, Hockey and Soccer many of these transition from season to tournament and interstate play over this period, this can mean a lot of action across a smaller time period like a weekend or fortnight.
If you’re a sporty teen, a returning adult or a weekend warrior make sure you take a moment to check on what your body might need leading into the next part of your year so that you can be ready to go when it’s here.
Thanks for reading.
Coping with the Ups and Downs of Running. . . Literally!
By Brianna Delaney
PART II
Much like running uphill there is a technique to running downhill. Those ‘race the wind’ moments from cross country were either a really nice speedy way to catch up or a barely controlled downhill fall. Easing in and out of decline sections can help our overall performance on runs, especially race days, by providing more consistency from start to finish.
Downhill
Now you’ve made it up the hill, maintained your rhythm and you’re approaching the downhill. Is it time to race the wind?! ‘A break’ he cries! Not quite! As much as we have to exercise restraint and focus on the rhythm going up hills we have to do the same going downhill.
In the same way we tend to lean too far forward going up, a common mistake going downhill is to lean too far back. Shifting weight backwards causes us to land further onto our heels and increases the breaking forces. Increased ground reaction forces also put a lot of pressure on our joints and muscles. Leaning back is a natural way to slow down and stop, however, if we are able to maintain the rhythm the added speed is an advantage.
Contrary to the natural feeling, try to stay upright and ‘lean into’ the hill while maintaining that natural ankle lean. To continue to maintain that rhythm, start to lengthen out your stride as the downhill gets steeper. As your speed increases you will need to also increase your step turnover or cadence, this helps keep your feet under you and will help those with a tendency to overstride or who suffer from shin-splints.
As we approach the downhill, start to lengthen your strides and let your speed build, then slowly adjust your step turnover rather than overstriding. Continue to land on the mid or forefoot but try to bend the knee just slightly to reduce the impact on joints and muscles. Allow your arms to drift a little wider than usual and more rotation through your torso to balance, maintaining your upright posture and ankle lean. At any point where you feel as though you’re going too fast or losing control, rather than leaning back to slow down, try shortening your strides a little at a time. Once you are back in the driver's seat, enjoy!
Equal Effort
Unless you have a running program that includes sprints, intervals or other changing parameters, a steady state run should focus on the single goal of maintaining effort. Over Part I and II we have covered the techniques that will best help you approach any change in incline across a run, but the true aim is to even out the effort required from start to finish. Ultimately, running should only require slightly more effort going uphill than running on even surfaces and slightly less when running downhill.
As you may have picked up, a key way to manage this is rhythm or cadence. Cadence is the amount of steps taken in a minute and important to a lot of high level runners or those experiencing overuse injuries. You can measure yours by counting the amount of steps taken in a minute in a straight line (flat surface!) or many sport watches track this. Keeping it as even as possible can be as simple as altering your stride to the needs of the incline or decline, much like shifting up and down gears on a bike. If you need a cue to help, counting your steps or some run playlists are designed around a number of beats-per-minute, run to the beat!
Varying our terrain and being able to feel confident in running unfamiliar routes is a great benefit to the overall experience of running. Hills particularly have their own benefits in improving speed, strength and coordination and while you don’t have to be doing hill sprints every week, feeling confident in tackling them will aid your running journey!
Happy Running!
Coping with the Ups and Downs of Running. . . Literally!
By Brianna Delaney
Part I
Just about everyone remembers school cross country, the winding up and down courses through local trails, forests, beaches or paddocks. While the downhill sections felt like racing the winds, going uphill was a battle of wills and leg power against inclines that seemed to grow just for cross country day! Learning to adjust to variable terrains can make a run overall smoother and encourage it as a means of exploring our cities and trails.
Uphill
Running uphill provides a number of benefits not just to our running performance but to our overall strength and fitness too. Requiring more muscle recruitment to overcome the added gravitational forces, it's a natural form of resistance training. This builds strength and power through the calves and ankle to improve the rebound or push off when running, but also works our cardiovascular system harder. Uphill running forces us to land further forward on our foot and helps us learn to engage the natural spring of the calf muscles to push us along.
Despite the benefits of including some inclines into your running, there are a few common mistakes to watch out for; the tendency to lean forward is a big one! Most runners will lean forward from their hips and this causes a number of obstacles:
Reduces hip flexion and the amount of knee drive they can muster
The glute muscles aren’t able to extend behind us properly, lowering the effectiveness of our toe-off and using less of the stored energy in our calf muscles
There is also an increase in difficulty now that your center of gravity is in front of you, giving you more to work against to make it to the top
So then how do we attack the hill and make it feel easy or at least easier? As much as we say don’t lean forward, there is a small amount of natural forward lean your running posture should have. But don’t think ‘from the hips’ rather, think about leaning forward from your ankles. This helps our foot to land more directly under our hip and creates less reaction force with each step.
As we run up the hill try thinking of these cues:
Stand tall and ‘drive your hips’, use your hip muscles to get your knee high and extend out behind you
Create shorter strides as the incline gets steeper
Increase the power in your arm drive
Stay tall and relaxed
Look towards the top of the hill, not your feet!
If this sounds like a lot all at once, here is a simple systematic approach to any hill. As you start to go up, shorten your stride and don’t try to maintain pace, just maintain your rhythm. Check in with your posture, think head up shoulders back and keep your feet low to the ground. Use a light ankle flick to push off, not an explosive push, and as you reach the top of the hill run through the crest without slowing or pulling back.
Focusing on maintaining the rhythm or cadence of our run over pace when we face hills is to even out the amount of effort. It's about equal effort going up, flat or down, not pace. If your breathing is increasing then it's likely you are going too fast, over striding or bounding too far off the ground. Steady breathing = steady effort.
And just like that, those mountains you saw on cross country day now look like mole hills! Look out for Part II where we chase the wind! . . .with control.
What is Pain?
By Brianna Delaney
Everyone experiences pain, rolled ankles or paper cuts are universally understood. However, some pain can be hard to describe and impacts people in different ways. It is hard for others to grasp not just what it feels like or the severity, but also the impact it can have on daily life. This may be because pain is often associated with the idea of injury or illness, rather than as the sensory and emotional experience it is defined as. Understanding how our bodies identify and register pain and how this relates to injury and illness, can empower us to better identify, process and manage it.
So what is pain? It’s a neurological response to stimuli and part of the body's protective system. Within the different tissues that make up our body, there are receptors called nociceptors. These respond to what is called noxious stimuli, that is stimuli that is or has the potential to be harmful. These receptors send this information as neural messages to the brain to decide whether or not to respond. If the stimuli is registered as being noxious, then we register this as pain. What’s important to remember is that these stimuli have registered as being painful, but whether or not actual harm has occurred has not yet been determined.
There are a number of thresholds that need to be reached for the brain to register a stimuli as noxious and for tissue damage to occur. In many cases we register pain before actual tissue damage has occurred. This is so the system does its job of ‘protecting’, as our natural response is to try to remove the stimuli that has caused or is causing us pain.
For example, when you hit an uneven surface and roll your ankle, you will register some pain. However, with most mild sprains we may take our weight off our ankle, take a few light steps and give it a minute or two of rest (removing the stimulus) but will be able to return to activity very soon after or the next day. This is because, while the event was painful, the protective system has done exactly as intended, acknowledged that the movement at the ankle had the potential to be harmful, and used pain as a warning in order to tell us to be more careful of our steps before injury occurred.
This process of nociception is more complex when considering the different biological, psychological, environmental and social factors that play a part. The experience of pain becomes more personal and individual as these factors and others are considered in each occurrence of pain, even more so when past experience and beliefs are applied to the situation. All of these factors can influence whether our bodies raise or lower the threshold for what is considered painful in different scenarios, if significant enough, a painful experience can lower our threshold for registering an activity or circumstance as painful. For example, if a person registers that sitting for too long causes their back pain to become worse, the threshold for how long that person can sit for a single period of time may become lower and lower the longer the back pain is around.
Some of the many ways we help those reduce their pain and improve these thresholds is not only through treatment but also in helping guide through strengthening, reintroducing aggravating movements as well as education on simple changes to daily activity and routine.
Exercise for the Right Reasons - Exercise Right Week May 23rd - 29th
By Cameron Allshorn
Exercise should be fun and enjoyable. It should leave you with a sense of success and completion. Sometimes we board up our exercise as an afterthought or as a must-do rather than something to look forward to and it is important that we drive ourselves to do the kind of exercise that we enjoy!
Each of us is different and it is important to accept that not all forms of exercise are going to entice you (or everyone) to come back for more. There are endless options available to trial and find enjoyment in, from gyms (of different styles), class based exercise like HIIT, Pilates or Yoga, team sports, swimming, running, cycling, bushwalking and water based activities. Additionally there are many options for those who prefer to exercise in their own space at home.
Not all facets of exercise are physical!
Exercising for your mental health is just as important. Doing a form of activity that is mentally stimulating and rewarding can have as many benefits as the physical ones you see. The same thing over and over again exclusively can lead to decreased yields both in performance, endurance and enjoyment. If you find that you often run the same route, or use the same equipment at the gym try mixing it up and see if you can notice the difference. Think about the ‘why’ of your exercise plan as you may find you are better connected and motivated when including others, joining a team or class or maybe its best for you to crank the music up and work out on your own.
our little team of osteopaths is a good example of how varied an approach to exercise can be and the reasons that we commit to it.
An osteopath can help get you going towards your exercise goals so if you do have any questions come and ask us!
https://exerciseright.com.au/exercise-right-week-campaign/
RUNNING: Over-ground, Treadmill or Elliptical?
By Brianna Delaney
What to know about when and how different surfaces can aid your running journey.
Running is one of the most accessible and versatile forms of exercise available. It doesn’t matter how little time you have, where you live or whether you like to stay indoors or explore the outside, running is always an option. But choosing if your run should be on the pavement, treadmill or elliptical and knowing which one suits best, when or how to use them can be a little bit tricky and confusing. Each option has its own merit and can be used by beginners and experts alike. Here we talk about what makes each of them different to help you decide whether they are part of your run training or not.
Running itself is a great cardio workout and can provide variety into your week in a number of ways. One of the main reasons people choose to lace up is to head outside and enjoy some fresh air. Running outside provides huge benefits for mental health, increasing levels of endorphins and serotonin in your body improving mood and energy levels. However, taking it to the footpath over a machine requires a higher amount of energy usage and muscle activation to propel our bodies forward but also to account for the uncertainty of corners, uneven grounds, hills and curbs. It’s also really great for our bone health, as bones strengthen in response to load demands. The more we take up or increase our running, we are increasing the demand for a stable, strong foundation our muscles can act on. All types of run training can be done outside with some consideration to the weather conditions and surfaces, anyone can go as far as they like, as fast as they like and whenever it suits their schedule the best.
Getting into running however can be a challenge for a lot of people and treadmills can help to combat some of the pacing issues and many of the common injuries and hurdles that are faced. While running is great for our bone health, for some, the hard surfaces of tracks, trails and pavements can be too much load too quickly. Treadmills reduce the amount of ground reaction force experienced and reduce the chances of overuse injuries. They also have a lower wind resistance and the addition of a moving belt means a lower amount of energy is needed to propel our bodies. The controlled environments that treadmills provide are a great training tool for runners of all levels, controlling speed, incline and intervals. This can help learn pacing, improve speed and add tempo and threshold runs into a running program. With the added benefit of being inside, some are more likely to hold a more consistent routine when they don’t have to worry about rain or wind resistance. Be sure to get someone to run you through how to use the treadmill and all it’s functions on your first try, be safe and take it easy till you’re used to the feeling and function.
Treadmills can help us to learn pacing, improve speed and add tempo and threshold runs into a program
Ellipticals are much the same, providing a controlled environment that is especially great for recovery runs, due to the little to no impact forces applied to the body. They require even less energy than the treadmill as there is no eccentric muscle activation or push off phase of the stride. Ellipticals are great in helping with cross training and maintaining running fitness when managing and returning from injury. Specifically, ellipticals help to improve the strength of smaller stabilising muscles around the ankle and by utilising the upper body to provide resistance, better preparing a runner for the resistance experienced outside. Ellipticals can be great for those beginning their running journey, building up their cardio fitness or those looking to include a more active rest into their existing run program. Active recovery runs can help to speed the recovery phase by increasing blood flow with a low amount of physical load stress. Again much like the treadmill, ask questions and get an introduction on how to use the machine before jumping on for the first time.
How Do You Move - Fundamental Human Movements.
Human movement can be divided to 7 classes and each are integral to our day to day functions, balance and control of all 7 movements can reduce risk of injury and help you get the most out of your body at the gym, at work on on the field.
Read MoreHow Do You Move - Foundational Human Movement
By Cameron Allshorn
Movement is a skill as much as any other. We spend a lot of time focusing on the outcome of movement rather than having much observation on how it happens in the process.
Movement involves a range of mechanics - some simple, others more complex - that connect and refer to each other to allow us to move in the multiplanar ways that we do. It is a key part of why, as Osteopaths, we will assess many regions of the body to manage a specific presenting complaint.
Our modern lifestyle means that we haven't the need for certain types of movement and for others there is an increased need. (i.e chairs, couches, benches and the like mean we spend more time in elevated sitting and less time squatting or at ground level)
Movement is a skill that we excel at during childhood, though it needs to be developed during childhood and refined as we age. Patterns of movement arise and the body will naturally adapt to what we do most often. There are 3 core groups of movement that move us - these are …
Locomotor
Movements that move us! such as walking, running, leaping, hopping, crawling.
Non-Locomotor
These movements we do mostly stationary usually while sitting or standing. Such as reaching, twisting, flexing, bending.
Object Control
throwing, catching, kicking or swinging which often combines both locomotor and non locomotor motion as other sensory components like vision and hearing.
Implementation of movement training can make a difference in the overall effectiveness of a training program and particularly when engaging in a new sport or activity. Moving well is a great way to reduce the risk of injuries and keep you doing whatever it is you want to be doing
Stretching: Different Ways for Different Times!
By Brianna Delaney
We’ve all been told to stretch before and after exercise or to help relieve stress and tension but are you picking the right types of stretches for you? Dynamic and Static are the two main types of stretching that help us prepare and recover from movement.
Dynamic stretches help prepare our body's tissues (muscles, ligaments, tendons) for movement and activity by repeatedly taking our joints through their full range of motion. This helps to reduce the stiffness in muscles and increase the muscle temperature to perform better. Typically, dynamic stretches make up a large part of our warm-up routine by improving mobility in the required movements, but under lower loads and speeds. For example, soccer players will use side steps, leg swings and step jumps as dynamic stretches, as these are common movements they make while playing. However, you can also take an everyday static stretch and turn it into a dynamic one, by moving in and out of the stretch rather than holding it. In Dynamic stretching you should only hold the position for up to 5 seconds before resetting and repeating a few times.
Static stretching on the other hand helps us to improve our flexibility, by moving to the end of our range and holding that position for a number of seconds. A great option for cooling down, static stretches help prevent injury, reduce tension and aid in recovery. These are better saved for post-activity as they require our body to move slower and don’t prepare us for fast movements. Static stretches are also a great way to help manage stress and tension, by helping us break up the work day and tune into our body. Consider taking 5 minutes once or twice in your work day to run through some simple stretches, this may help you transition better between work and activity across the week. These stretches are typically held for 20-30seconds and performed only once or twice on each side of the body.
Finding the right warm up and cool down tools for you can really change how you feel during and after your exercise. It even helps us to reap more of the benefits of doing the activities we love! Coming up with your own warm up and cool down routine doesn’t have to be difficult. Pick a few key movements from your exercise, and do them slower, but repeatedly as you engage with the full range you have available, such as arm rotations for throwing sports, leg swings for running or threading the needle to help trunk rotation.
Cool downs are as simple as identifying the major muscle groups you’ve worked and picking a stretch or two for each. Child's pose is great for the lower back, the Figure 4 stretch targets the glutes and can be done seated or standing, whereas the World's Greatest Stretch targets a number of areas all at once! There are many ways to help a single muscle from different positions, no matter your flexibility level, thus making it easy to find a comfortable cool down routine for you. Don’t forget you can find some great videos and materials in the Resources section of our website to help get you started.
Let's talk about sleep - Part 2
By Tegan Hailey
Part 2 -
Struggling to Sleep?
Whilst we all know, getting enough sleep each night is vital for our health and well being, It is common to see sleep disturbances with pain. Whether that be in initially getting to sleep or staying asleep throughout the night, pain can interrupt our normal rhythms. Sometimes even if you manage to get enough sleep, the quality of sleep can be quite poor, meaning we still don't feel well rested in the morning.
Is there anything we can do to help improve our quality and amount of sleep? Regardless of whether pain is limiting us or not, we can start with good sleep habits.
Let’s start with the basics…
1. Develop a regular sleep schedule
Going to bed and waking up at the same time will help maintain your body’s internal clock. This helps you to fall asleep and wake up more easily.
2. Create the right sleeping environment for you
Try to create the same sleeping environment every night, once again this will vary from person to person. Whether that be a very dark room, sleeping with the door open just a little bit etc.
3. Avoid all screens at least 30 minutes before bed
VERY IMPORTANT, and one in which many of us are guilty of! Electronic devices emit short-wavelength light, known as blue light, which has been shown to reduce/delay the natural production of melatonin in the evening. Melatonin is the hormone responsible for creating the feelings of sleepiness. There has also been some investigation into blue light affecting the quality of REM sleep (1).
4. Try to avoid stimulants such as caffeine before bed
As caffeine is a stimulant, it inhibits the chemicals in the brain that promote sleep. Caffeine reaches peak levels in the bloodstream within 30-70 minutes, with its effects last between 3-7 hours, taking up to 24 hours before it is fully eliminated from the body (2).
5. Practice mindfulness
Being in the right mindset before bed can be tricky. It is often easier to focus on relaxation than trying to fall asleep. Whether you practice mindfulness, meditation, breathing exercises, or any other relaxation techniques that work for you.
6. Limit napping during the day
If you do, try to keep it under 20 minutes! Napping can be good for relieving stress and increasing alertness, however for adults, napping for too long can interrupt our regular sleep cycles. This may be in getting to sleep that night or getting the right amount of hours in.
7. Make sleep a priority!
Most importantly we should prioritise sleep where possible. Most adults need 8-10 hours of uninterrupted sleep per night, with younger children needing more.
For more information about sleep recommendations for you age group check out Australia’s 24-Hour Movement Guidelines.
If you are looking to make changes in your sleep habits, it is a good idea to make gradual adjustments, as it can take a while for your body to recognise a new routine.
References:
How Does Blue Light Affect Children's Sleep? | Sleep Foundation. Sleepfoundation.org. (2021). Retrieved 23 September 2021, from https://www.sleepfoundation.org/children-and-sleep/how-blue-light-affects-kids-sleep.
Sleep, C. (2021). Caffeine and Sleep. The Sleep Health Foundation. Retrieved 23 September 2021, from https://www.sleephealthfoundation.org.au/caffeine-and-sleep.html
Let's talk about sleep - Part 1
By Tegan Hailey
Part 1 -
Struggling to sleep due to pain?
Most of us would have experienced a time when pain had limited us from being able to fall or stay asleep, and thus know how frustrating it can be. Whether you are in acute or chronic pain, sleep plays an important role in our body’s recovery.
As osteopaths, it is common for our clients to want to address sleep as part of their pain management. So is there anything we can do to help improve our sleep when pain is limiting us?
The answer is YES! Whilst we cannot guarantee that your sleep will be entirely pain free, the aim is to make you feel supported and comfortable as much as we possibly can.
Below you will find some images and explanations on how PILLOWS are used to help improve our quality of sleep. Depending on our sleeping position, area of pain and ability to provide appropriate support and stability.
Pillows for Lower Limb:
Example: Lower back pain
Option 1
Back Sleeper: Place a pillow underneath your knees.
Option 2
Side Sleeper: Place a pillow in between your knees, with the pillow support down your leg.
*Note: Sleeping on the non-affected side is recommended where possible.
Pillows for Upper Limb:
Example: Right shoulder pain
Option 1
Back Sleeper: Place a pillow high up into your armpit.
Option 2
Side Sleeper: Affected Side
Place a pillow underneath your waist so that you create a gap for your affected limb to sit nicely.
Option 3
Side Sleeper: Non-affected Side
Place one pillow in front of your torso to prevent you from rolling forward. Place a second pillow high into you armpit, and drape your affected side over the pillow for support.
Please note that tummy sleeping is not recommended.
For more information on how to help improve your quality of sleep when dealing with pain please talk to your osteopath.
Let’s talk core and what does ‘activate your core’ actually mean?
By Tegan Hailey
There are a lot of misconceptions about ‘activating your core’; most people believe that your core is simply made up of the abdominal muscles, such as that 6-pack we have all dreamed of having. However your core is much more than that!
Your core is actually made up by a group of diverse muscles that are designed to work together to provide stability and support with all of our day to day activities.
Let’s start with the basics - what muscles make up your core?
So why is it so important to maintain good core strength?
Whether you are an athlete, desk worker or manual labourer, having good core strength is not just about making sure you engage it properly during exercise. You may hear us go on and on about the importance of engaging your core with many daily activities. As the purpose of your core is not only to make sure that we are functioning to the best of our ability, but also to prevent us from acquiring, for example, that unwanted lower back pain by …
Working together to transfer force evenly throughout the body
Preventing excessive load from going through the spine
