How 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

Injury Prevention while Summertime Adventuring

Alayne Hamilton

As summer quickly approaches it’s clear lots of us will by spending time holidaying at home this year; so why not get out and make the most of it!

It’s a fantastic time to explore some of Tassie’s wild places without the big crowds. As an added bonus you’ll be supporting local businesses along the way.

Whatever your level of experience or inclination, there’s an adventure out there for you; from short walks in our beautiful parks and reserves to multi-day expeditions on land or water for the wild at heart.

Corkscrew and The Churn, Franklin River

📷 Franklin River Rafting (franklinriverrafting.com.au)

In my pre-osteo life I worked in the outdoor sector and continued expedition work seasonally while I was studying osteopathy. More often than not, customers would book their trip with intentions of hitting the gym or the pavement in preparation for the physical challenge of a multi-day expedition. A few days into the trip, when everyone was feeling comfortable and there was some heavy lifting to be done, the truth would come out; “I got so busy getting ready to go away it totally slipped my mind then it was too late and here I am!”.

If you’ve decided it’s finally time to head out on that adventure that’s been on your bucket list for years, that’s great! Just remember, we were all confined to the couch to some extent this year while COVID restrictions were in place, so give yourself some time to get physically ready for your trip. Lifting and carrying gear, paddling, cycling and walking with a pack all place very different stresses on the body to what we experience everyday.

Pre-trip training:

Combine some aerobic exercise with strength training that focuses on the body area required for the activity you’ll be engaging in.  

• Ankles and knees are common sites of injury when walking on uneven terrain, especially with the extra weight of a loaded hiking pack. 

• Lower back injuries can be aggravated by pack carrying or prolonged sitting on/in a bike, raft or kayak. 

• Shoulders can be especially vulnerable to injury sustained under abnormal load given their open ball and socket anatomy. 

• Changes to sleeping surface and pillow can also be exacerbating factors for neck and back problems. 

This pre-trip training phase would be a great time to pop in and see your osteo to address any issues that might need treatment or specific rehabilitation exercises, particularly if you’re prone to injury in any of the above areas.

Here are some extra tips to look after your body along the way so that you can get the most out of your adventure;

Gear: 

• Pack fitting; Aim for weight on your hips and heavy items low in the pack. If in doubt get help. A comfortable pack is essential to the enjoyment of your trip so sort it out before you go to save your back. If purchasing a new pack ensure that you try it on with some weight in the shop. If you’re hiring gear or bushwalking with a commercial group get some help from the guides to get your pack fitted correctly.

• Bike fitting. Mountain biking has grown exponentially in popularity in Tassie in recent years. Similarly to pack fitting, take some time to make sure your bike is well set up for you before you hit the trails. Bike fittings are available for a fee at some cycling stores. Consider it a worthwhile investment in you.

• Hiking Boots; the change from everyday shoes to a solid sole and ankle support in hiking boots can take some getting used to. Pop your boots on for some short walks and slowly build up towards full day/multi-day trips. Utilise the good ankle support that a boot offers by tying them securely. 

• Walking poles; can be a great addition to your equipment store, especially if you have any existing ankle/knee/hip complaints. Again, give them a go on a day walk to get used to using them. Elbows should sit at around 90 degrees for walking on the flat. Don’t be afraid to lengthen poles for downhill or shorten for uphill walking. Beware the wrist straps! Although very helpful in some scenarios, catching an arm in a strap while falling with the extra weight of a pack on your back can prove dangerous. If nothing else, slip your hands out of the straps on challenging terrain.

• First aid kit; off the shelf first aid kits are great but often people buy the kit, vaguely read the contents and end up carrying unnecessary items. Many kits also don’t have sports tape! Sports tape is great for strapping joints, securing bandages and field gear repair. Tape or Fixumol are great for patching up hot spots/blisters from either boots, packs or paddle shafts. Band aids are pretty useless in the outdoors and generally end up being accidental litter, especially given the potentially wet Tasmanian environment. Use some gauze or non-adhesive dressing and sports tape instead. 

During your trip: 

• Feet/ankles; act on hot spots immediately! The last thing you want is to have your trip ruined by some pesky blisters. Preemptively tape as soon as you even think you feel rubbing. If you’ve sprained your ankles in the past and feel unstable with a heavy pack, tape or brace them before you set off. Make sure your brace fits into your boot without any potential spots for wear on your skin.

• Whatever the activity, you’ll likely discover some muscles you didn’t even know existed. Stretch them out at the end of the day. Google sleeping bag yoga :)

• Your comfort item-  what will make the experience all the more comfortable for you?; a book? clean socks and undies? pack of cards? These items can absolutely be worth carrying the extra few hundred grams of weight to make your trip more comfy. 

• Tech break; there are increasingly few places where you can truly switch off and unplug for a few days. Consider leaving your phone at home or switching it off for the duration of your trip. Make sure that someone in your party has an appropriate means of emergency communication (e.g. PLB, Sat phone).

  My anecdotal observation from working in the outdoors was that people often adapted surprisingly well to long days of unaccustomed activity on expedition based trips. However, niggly old injuries would rear their heads when the going got tough. Even just a little preparation a few weeks out can make a trip much more enjoyable and reduce the risk of sustaining an injury in the field. 

Above all; be safe, push your limits, have fun and we’re here for you when you get back!

Foot Health Week

By Alayne Hamilton

Feet.

Some people love them, some people hate them. Most of us don’t pay much attention to them unless they give us grief.

But our feet are so important!

They carry us around all day long and often play a vital role in our leisure activities too; whether you chill out by playing sport, doing yoga, hiking, or kicking your toes up on the couch while you indulge in a bit of screen time. 

The foot is a complex piece of anatomy with 28 bones and more than 100 tendons, muscles, and ligaments that all work together to keep us upright and moving. A longitudinal and transverse arch are maintained only when all of these elements are in balance, allowing the foot to function properly.

It can feel great to have your feet treated by a manual therapist. You will sometimes feel a change higher up the body just by having an osteopath treat your feet. Not convinced?

Here’s a test for you. 

Here’s how to try it yourself!

You’ll need a spiky ball/golf ball/small firm ball and yourself:

1. Stand up and try to touch your toes. How far can you reach? Make a mental note of how far you can reach and what it feels like.

2. Roll the arch of your foot around on the ball for 1 minute on each side. You might like to sit down for this step. Give extra attention to any spots that feel sore or tight against the ball. 

3. Once you’re finished, (stand up and) try to touch your toes again. Notice that it’s easier this time? Or that you can reach further. 

Plantar Fasciitis

A common musculoskeletal complaint in the foot, and the most common cause of heel pain in adults is plantar fasciitis. The plantar fascia is a band of connective tissue that runs along the sole of the foot from the heel to the ball (or in anatomical terms, from the calcaneus to the heads of the metatarsals). Plantar fasciitis involves the repetitive strain of this tissue, often at the calcaneal (heel) attachment resulting in local inflammation and pain. High or dropped arches, running, prolonged standing, obesity and pregnancy can all increase the risk of developing plantar fasciitis by contributing to an increased level of tension on the plantar fascia. Plantar fasciitis is what we call a ‘self limiting condition’, meaning that it often spontaneously resolves after approximately 12 months. However, manual therapy and rehab exercises can improve function, reduce pain and reduce the risk of recurrence. Wearing good quality, well fitted footwear and avoiding running on hard surfaces can act as preventive measures against plantar fasciitis. 

Plantar fasciitis is just one of many musculoskeletal complaints of the foot. If you suffer from foot pain of any description get it checked out before you’re stopped in your tracks!

August is Tradies National Health Month!

By Alayne Hamilton

The term ‘Tradies’ refers to technicians and trades workers, labourers, machinery operators and machinery drivers.

We can’t go through this month without first addressing a stereotype; 

TRADIE (ˈtreɪdɪ) noun: The pie eating, iced coffee drinking trades worker who never exercises, gets up early and stays up late and drinks too much beer. The tradie breezes through their 20’s then as time goes on suffers from all those aches and pains that used to just “go away on their own in a couple of days’’. 

Fortunately; 2019 data from the APA shows that 70% of today’s tradies’ report that they are trying to eat a healthy diet and only 20% reported that they never engage in exercise. This is great news!

Although it’s time to rethink the stereotype, there’s no denying that by the nature of their occupation and workplace environment, tradespeople are at an increased risk of suffering a workplace injury. 

This has significant ramifications for the individual, business and client as people are removed from the workplace during their recovery, sometimes for a long period of time. This can also have the flow on effect of high stress and declining mental health. The juxtaposition of when to return to work financially and professionally vs. physical recovery can be a difficult one to balance, especially for the self employed.

So, how can we make sure our tradies are safe at work? 

Prevention!

Prevention of musculoskeletal injury is the best approach. An osteopathic preventative approach includes manual treatment as well as targeted exercise and rehabilitation activities to ensure that the body is biomechanically functioning optimally and activities are being carried out in a safe way; not unlike training for sport. Making sure that the body is capable of withstanding the physical stresses it encounters throughout the work day is vital. 

Again, focussing on parallels with sport, we all see professional athletes warming up before a game and generally accept that when we exercise, warm ups are a good idea. However, only 24% of tradies reported that they warmed up before work in the 2019 APA Australian Tradies Health Research report. Workplace attitude/culture was largely blamed for this low number. 

If you’re interested in learning more about what conditions you (or the tradie in your life) is at risk of developing, have a look at this interactive tool from WorkSafe Victoria;

http://injuryhotspots.com.au/#/.

Injury hotspots allows you to browse the conditions that are frequently reported in different occupations and even gives suggestions on how to minimise risk with “Safety Solutions”.

For example, the 3 most common areas of injury for a labourer are; 

Axial: low back pain/injury

Lower limb: Knee injury

Upper limb: Hand/finger injury

Whatever your role and whatever the occupational environment, prevention is the key to success in looking after yourself and your team at work!

Manual Handing and Musculoskeletal Health in the Workplace

By Alayne Hamilton

Ergonomics: non-desk based work

We’ve talked a lot about desk based work of late with many people taking time away from the office to work from home.

But…

For a lot of industries sitting at a desk all day is just not a reality!

As COVID restrictions continue to ease and people return to a level of normality in the workplace, here are some considerations for those whose jobs require either an increased level of activity or a wider variety of activities.

There are very few workplaces where manual handling is not required on some level; and we’re not just talking about lifting and carrying heavy objects. A wide variety of tasks from waiting tables to driving a forklift to landscaping have the potential to lead to musculoskeletal injury through maintaining sustained postures, repetitive strain, exposure to vibration or use of significant physical force.

Safe work Australia reports that in the 2014-2015 financial year 107,355 serious claims were lodged and 90% of these claims were made due to injuries and musculoskeletal disorders. 43.8% of these serious claims were in relation to trauma sustained to a musculoskeletal structure; bone, ligament, tendon or muscle.

If you do need to regularly lift loads around the workplace, either great or small; keep the following tips from Corporate Work Health Australia in mind to protect yourself from injury.

Corporate Work Health Australia: Manual Handling Poster

(Link above to higher quality image)

Image Source: https://corporateworkhealth.com.au/ergonomic-assessment/manual-handling-ergonomic-stretching-posters/

Some further considerations for varied workplaces…

Driving:

People whose jobs demand regular hours of driving should ensure that their driving position is optimised, especially when using shared company vehicles, Take the time to adjust seat positioning (height, low back support, seat base, backrest and distance from pedals), mirrors and steering wheel whenever you enter the vehicle. Take regular breaks throughout the day and avoid working from the vehicle where possible to avoid neck strain(i.e. working on a laptop seated in the car).

Footwear:

Whether you’re on your feet all day in retail or stomping around a construction site, don’t underestimate the importance of good quality footwear! Work boots/shoes should be comfortable and supportive as well as functional to avoid foot, lower limb or back pain.

Occupational health and safety factors that should be taken into account when assessing the appropriateness of footwear for work include; protection from dropped items through a steel or composite toe, non-slip soles, adequate cushioning for prolonged standing or standing on hard surfaces, adequate contact area with the ground (i.e. small pointed heels provide little contact), secure fastenings, work boot compliance with Australian standards.

Flat, enclosed shoes that meet the specific requirements of your work environment and are comfortable are universally the best option.

Even if you have an active or physically demanding job it’s important to still follow the Australian Physical Activity Guidelines in order to reap the mental and physical benefits of regular activity. See our last blog about safely returning to sport post-COVID. 

If you’re returning to work and are already implementing new systems or procedures due to COVID-19, what better time to reassess hazards around the workplace and consider how these can be minimised? For tips on how to reduce the risk of developing musculoskeletal disorders in your workplace have a look at; Safe Work Australia: Home and WorkSafe Tasmania: Home.

What is Dry Needling? By Osteopath Cameron Allshorn

Here is a quick explainer post all about Dry Needling and why I find it useful as a complementary part of my osteopathic treatment.

Dry needling is a method of treatment I here at Rockhopper, it is a common technique that is used by many osteopaths and other allied health modalities. It is a safe and minimally invasive technique that has seen great results for many musculoskeletal injuries and ailments (1)

Most people find Dry Needling to be a relatively pain free technique, with only a small instance of pain as the needle is inserted or removed, feeling like a pinch. While the needles are in place you may feel a twitching sensation within the muscle fibres.

Here are a few points of information that may answer some of those questions you had.

Dry Needling is performed using a sterile single use fine acupuncture needle inserted into a muscle to decrease pain and increase mobility. The needles have a range of sizes and gauges (width), predominantly I use a 30-45mm length 0.22-0.30mm gauge needles to provide this treatment, though some larger muscle areas may require a larger needle.

Dry needling was developed on the principles of muscle bound myofascial trigger points that can cause pain and restrict movement. Myofascial trigger points or knots as they are known colloquially form after a muscle fibres are shortened during a contraction and are unable to relax. Overtime this trigger point can become sensitive causing increased pain and discomfort.  

The presence of the needle draws blood supply which carries oxygen and other nutrients to the area involved and allows for the muscle to relax over a short period of time allowing for increased mobility and reduced sensitivity once the needles have been removed.

Needles are located within the muscle tissue for a short period of time usually around 5 minutes and 10 minutes. The size of the treatment area will dictate how many needles are used with larger muscles requiring more needles.

Despite sharing equipment dry needling differs from acupuncture via the treatment approach. Dry needling is very specific to a particular muscle or muscle group as opposed to the approach of Acupuncture that uses the meridian points to guide the technique with the aim to treat various regions of the body.  

Dry needling is a great way to manage acute muscular symptoms and can be a great management option for many other ongoing conditions such as plantar fasciitis, lateral epicondylitis (tennis elbow) and patellofemoral pain plus many more.