The second most commonly asked question by patients is… “Do you do knees?”

The first is of course, “What’s the difference between an Osteopath, Physio & a Chiropractor?” I wouldn’t insult you by explaining the difference, because of course you know the difference & that’s why you continue to come to our clinic.

So let’s go back to the knee question. The answer is YES! We do “do” knees.

Osteos not only treat knees but also treat ankle, elbows, hips & wrists. If the problem involves a muscle, joint, tendon, ligament or cartilage we can help.

In this article we’re going to have a look at:

• How do cartilage injuries happen?
• Why do cartilage tears happen?
• When can conservative treatment help & when is surgery indicated?
• What can an Osteo do to help you recover?

Sports Injury Bulletin

By Chris Mallac

I was in my back yard a few weeks ago running through the routine spring clean of collecting deadwood and leaves to be burnt off in a rather impressive bonfire. There was a substantial 2m log that I had to move which I have done on previous occasions with no ill effects. I ensured I had a straight (neutral) spine, activated the pelvic floor and inner abdominals and then lifted the log on its end in a manner similar to how one would perform a deadlift. And to my dismay I felt a slight twinge in my back, which I reasoned to be a slight twinge of a lumbar spine disc.

In the end I was not overly surprised as I have noticed in the past if I spend an lengthy period of time away from the gym I tend to be more ‘injury prone’ especially when it comes to my 40 year old lumbar spine. And in the 5 weeks prior to this incident I had done next to nothing in terms of gym loading.

So this brings me to my point of this article. Is lifting in the conventional gym sense of the word actually protecting us from injury? In my case it is a resounding yes.

“In my case, 5 weeks away from deadlifts had weakened my lumbar spine discs and made them more susceptible to a ‘twinge.’

Applying load to the body in the gym, in the form of conventional squats, deadlifts, bench presses etc. does create an adaptive process in the body. Muscles change their morphological structure to not only become stronger but also they are able to generate more stiffness that protects our joints from unwanted stress. Bones become more dense and thus stronger – hence the reason why doctors advocate resistance training for osteoporotic women. Nerves become more efficient at firing the muscles and also recruiting muscles in the right sequence. And finally joint structures become stronger by hardening the articular cartilage that covers the end of bones.

But these adaptive effects can also be lost when one stops applying the load – the detraining principle. In my case, 5 weeks away from deadlifts had weakened my lumbar spine discs and made them more susceptible to a ‘twinge’. The lack of load on the muscle had created a detraining effect where I could not generate the necessary stiffness to support the spine, and the lack of formal lifting had deconditioned the nerves so I probably was not actually using the right muscles to lift.

So therefore what are the correct exercises to be doing in the gym to avoid unwanted injuries? Below are listed a few points that one should consider when training themselves or planning a training regime for someone else. In must be pointed out that gyms and training have come a long way since the bodybuilding fuelled days on the 70’s and 80’s. Gyms now house unconventional pieces of equipment such as multidirectional cables, Kettle bells, Viper’s, TrX etc, which did not exist 20 years ago. So the gyms are now a much better place to be in terms of developing an injury free and resilient body.

Everyone should learn how to deadlift. Both the conventional kind that we see powerlifters do as well as Romanian Deadlifts (if you don’t know what these are then Google them). Slight rule on the deadlifts – do them from just below the knees on a rack. Most of us don’t have the flexibility in our hips to maintain a neutral spine when lifting from the floor. Another rule, if you like to lift heavy, do so only once every 2 weeks. Lifting heavy on deadlifts every week seems to drain the nervous system and make you feel flat (unless of course you are chemically enhanced).

For every push exercise, perform 2 pull exercises. Neck and shoulder injuries are much more common in push based exercises and also much more common in trainers who emphasise too many push exercises (bench press, dips, shoulder press etc..). The pull based exercises (rows, pulldowns, reverse flyes etc..) tend to use the scapular and shoulder stabilisers better, and thus give us some protection from shoulder injuries.

Develop a squat and maintain it. Getting very strong at squats is not only unnecessary but also potentially injury producing. The knees and lower back are more susceptible to injury in heavy squatting. So unless you are a footballer, powerlifter or weightlifter, heavy squats serve no real purpose. Squat for the movement and the benefits that you reap from the moderate loads but avoid the heavy stuff.

Incorporate a ‘functional’ session each week. If the bodybuilders who died in the 80’s could step into a gym now and look at the new age gyms, they would wonder in amazement at what these things do and the benefit they have. Equipment such as the multidirectional cables, TrX, Vipers and Kettle bells challenge the body in ways that conventional lifting cannot. The key point of difference is that most of these require that the body either has to move or stabilise in a rotational direction. This brings into play a new area of body function that transfers to everyday life much better.

The final point is that the sessions to need to be regular to generate the stress to create and adaptive process. Going once every 2 weeks will not do this. Furthermore, avoid lengthy periods of time away from the gym. Even on holidays, some load can be applied to the body in the form of bodyweight exercises that will at least maintain these adaptive processes.

As one of our patients you’ll have experienced our approach when you come in for treatment. If you want to recommend anyone who’s tried everything before but they’re still in pain, why not take advantage of our $40 New Patient appointments and our holistic Osteopathic approach. Call the clinic to find out more or just send them this article.

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

Andrew has a passion for sport and exercise after competing in APS first grade Water Polo, Rowing and University Representative Football along with having experience playing Golf, Soccer, Tennis, Rugby and Cycling.

Over the last few weeks I’ve been treating a lot of patients in preparation for this year’s Melbourne Marathon trying to get them ready for the race. It’s a goal that has taken a lot of time and planning to get ready for, in some cases an entire year. So if you’re thinking about starting to put the kilometres into the legs to get ready for next year’s event here are some important Dos and Don’ts that will make sure you can finish on top.

Running too much too soon

One of the most common problems I see in all patients who take up any type of exercise, not just running is that they do too much too soon. This can lead to many overuse injuries such as Patellar Tracking Disorders and ITB Syndrome. I appreciate that in the beginning it’s easy to be overly enthusiastic and want to make big gains quickly, but remember if you break down with injury…well you won’t be going anywhere.

If you’ve never run before, start by walking. If you’re coming back from a break from running, start slow a build yourself up. It takes a long time for your body to strengthen and adapt to the stresses you put it through so be patient and give yourself time. As a general rule I recommend never increasing the distance of a run by more than 10% a week. 

Rest!

You’re body doesn’t get stronger when you’re running, it gets stronger when you’re not. This means you need rest. Always give yourself at least a day off to recover between training runs. If you can’t possibly bear the thought of having a day of complete rest then try cross-training with other methods. Cycling, swimming, resistance weights are all great low impact alternatives that will spare some of the muscles you’ve already worked running.

Run with good form

Like everything good form in exercise is what will give you the most biomechanically efficient movement to complete an action. It will also put less strain on your muscles, joints and tendons. Running with good form involves the following points:

• Feet strike the ground flat slightly toward the forefoot, NOT on the heel.
• The foot should kick toward the butt on the recovery phase of the stride.
• Knees are nice and high, 90 degrees of hip flexion.

Good running form though doesn’t just involve the lower half of your body, what you do on top is just as important. By maintaining good upper body form you minimize any movements that are not involved in propelling yourself forward. Good upper body form involves the following:

• Keep the head and back upright with shoulders back and relaxed. Not only will this give you a good base to run from it will also allow you to breathe easier.
• Elbows should be at 90 degrees with hands nice and relaxed to avoid tension through the arms.
• Shoulders swing naturally back and forth with no sideways movement. The elbows should almost touch the sides of the body during this movement

Your body is a machine, keep in tuned

If you’re going to treat your body like a racing car or bike then it’s going to need to be looked after in the same way. That means regular maintenance treatment to keep working parts moving well and efficiently to avoid a break down.

Professional athletes who train regularly have an entire pit crew of professionals looking after their bodies but amateur athletes all too often neglect this part of their training. Here at the Sports and Spinal group an Osteopath will look at your whole body to identify any musculoskeletal dysfunction that could predispose you to injury or slow you down. Treatment of those dysfunctions may involve soft tissue massage, joint adjustment and stretching techniques to correct the problem. We can also provide you with a personalized rehabilitation exercise routine just for you, to make sure injury doesn’t stop you achieving your goal & to keep you running at your best.

If you’re suffering from pain while running or you want to avoid an unscheduled pit stop due to injury, give us a call at the clinic.

Dr Andrew Lemon

Sports & Spinal Group

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

Do you suffer from a burning feeling in your chest? Do you have pain in your upper abdomen? Are you constantly taking antacid medication? You may be suffering from heartburn or reflux.

Heartburn is a very common condition, which is the feeling of discomfort in the area behind the breast bone or upper abdominal area and is often described as a burning sensation. Patients may describe regurgitation of acid and food into the oesophagus or throat. Because the stomach contents are acidic they irritate the lining of the oesophagus and throat, causing a feeling of burning.

This is a common complaint I hear from many of my patients, however, not many of them realise that this may be related to their back pain they have come to see me about. One thing that is often present in these patients is mid back pain. Many people use medications such as antacids to relieve their pain and symptoms related to reflux but there is a place for Osteopathy in the management of heartburn also.

The nerves that come out of your spine supply different abdominal organs. It is through the thorough knowledge of the body’s anatomy that, as Osteopaths, we know which spinal segments to look at in your back that relate to your reflux.  It is not just your back that can be involved in organ (otherwise known as visceral) conditions. The neck, ribs and associated muscles are also important parts of the body to examine in relation to reflux.

Restricted movement, increased heat, tenderness and change in tissue textures are held to be the hallmarks of visceral problems in the gut. Osteopathic visceral treatment involves gentle mobilisation and stretching techniques directed towards an organ, which in this case is the stomach and oesophagus, and treatment of the associated muscles and spinal joints.

Visceral treatment is a gentle yet effective technique. Patients often say that they feel like I am doing very little when my hands are on their abdomen, yet are impressed with the results can be achieved.

Heartburn is one of many abdominal conditions that I see in the clinic. If you have any questions regarding your abdominal pain or would like to book an appointment to see if we can help, call me at the clinic now on 95893777. Don’t wait, your digestive health is way too important.

Dr Eliza Gleadell

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

To win a World Cup, exceptional skill, form and luck are needed to progress through to the finals. Almost every World Cup has thrown up an upset of some magnitude that is totally unexpected.

In 2007, eventual losing finalistsEnglandsuffered a heavy defeat against eventual winnersSouth Africain the pool stages. They unexpectedly picked themselves up to narrowly beat Australia in the quarter final and then eventually progress through to the final.

Rugby fans and the bookmakers will have their eyes on who has the fittest and most intact teams at the business end of the tournament. New Zealand are still the outstanding favourites for the tournament, however history shows that most of the top teams will succumb to injuries in key players at some stage during the tournament. It is how the teams overcome these injuries that will determine who holds up the trophy at the end of October.

In 2003, the eventual winnersEnglandhad to deal with the loss of their talismanic flanker Richard Hill for a large part of the pool stages and quarter final. During the pool stages and in the quarter final, England looked a far different side that eventually won the final a few weeks later. In was no coincidence that their improvement in the semi and eventual final, was due to the return of Richard Hill.

Also in 2003, New Zealand along with Englandwere the outstanding favourites. Everyone expected a New Zealand vs England final. However a traumatic knee injury to their captain Tana Umuga in the pool stages stalled their progress and they eventually lost to Australian an exciting semifinal.

The World Cup presents an entirely different challenge to the medical staff that does not occur in a regular English premiership season or a Super 15 tournament. In regular competition, the team squads are quite large and players can be rotated from week to week to overcome fatigue and to deal with injuries. However at the World Cup, if a player suffers a serious injury he can either be kept in the squad, treated and hopefully recover in time for the important part of the tournament or he can be replaced and sent home. If he is replaced in the squad, he cannot return to join the squad at a later stage. So it is a big call to make.

This fact alone places enormous pressure on the medical staff to make the right call from the outset. If they make the wrong call and the player does not recover, it places enormous pressure on the team. If they rule out a key player but he eventually recovers in time but is no longer able to be to be part of the squad, then this may lead to some serious questioning from the coaching and playing staff.

With this in mind, the medical team needs to be extremely well prepared and have every base covered. Most teams will travel with at least one doctor, some may have two. They will also have at least two physiotherapists, one or two massage therapists and some may include specialty therapists such as osteopaths and chiropractors. So they will be well stocked from a human resource point of view to deal with 30 players. But they will also have contingency plans in place to allow them to make the right decisions from the outset. The big teams will have already sourced specialist services such as radiology and orthopaedic surgeons in the cities they will be accommodated in. The medical staff will be in constant contact with players who have been left at home and the medical people responsible for them to ensure that if a squad player does suffer a serious tournament ending injury, then the player at home will be able to step up and fly over to be part of the squad. To do that he needs to be fit and injury free.

For the medical staff, the tournament is far from 5 star hotels and silver service dining with days of sightseeing involved. They tend to see the inside of a hotel room most of the time with the occasional trip out to training or games. The demands of the team and the players are first and foremost and they work extremely hard to ensure that injured players are receiving the best treatment as often as is needed and the needs of the players are met at all times.

So whichever captain eventually holds up the William Webb Ellis Cup in late October, he will be thanking a host of people, medical staff included.

Courtesy of SIB- Chris Mallac 

Dr Wayne

Group Director

 Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

]]> http://sportsandspinalgroup.com.au/back-pain/what-it-takes-to-win-a-world-cup%e2%80%a6/feed/ 0 http://sportsandspinalgroup.com.au/back-pain/don%e2%80%99t-end-up-looking-quasimodo%e2%80%a6/ http://sportsandspinalgroup.com.au/back-pain/don%e2%80%99t-end-up-looking-quasimodo%e2%80%a6/#comments Tue, 27 Sep 2011 16:49:49 +0000 badbak http://sportsandspinalgroup.com.au/?p=1943 If you sit at a desk all day, if you’re a student at school or you’ve just got bad posture, you might end up looking like this by the time you’re in your 60’s. It’s not a good look.  With more & more of us sitting at work or school in front of computer screens, it’s easy to see why we can develop bad posture. We’re simply not designed to sit at desks all day. In the early 90’s some bright spark thought we could all use a “Swiss Ball” or “Fit Ball” to sit on at work to fix [...]]]>

If you sit at a desk all day, if you’re a student at school or you’ve just got bad posture, you might end up looking like this by the time you’re in your 60’s. It’s not a good look. 

With more & more of us sitting at work or school in front of computer screens, it’s easy to see why we can develop bad posture. We’re simply not designed to sit at desks all day.

In the early 90’s some bright spark thought we could all use a “Swiss Ball” or “Fit Ball” to sit on at work to fix bad posture forever. What a load of rubbish that was. Sitting on a Ball is not the solution, believe me, I’ve tried it. If you can sit on a ball with good posture, you can sit on a chair with good posture.

The problem with sitting at your desk is that it requires a number of key muscle groups to remain active in order for you to retain good posture. Very often these muscle groups become either tense or weak. Tense or weak muscles can’t provide you with enough support for good posture, so we slump & in turn make those muscles more tense & weaker. So the cycle continues.

What happens next is where we as therapists come in. Your tense & weak muscles lead to pain & discomfort. Here’s a list of common complaints from patients we see every day with bad posture:

• Neck Pain & Shoulder tension
• Headaches
• Fatigue
• Stiff joints
• Pain behind the eyes
• Lower back Pain
• Sciatica
• Pain over the coccyx
• Pain between your shoulder blades

This list is only a few of the many problems that poor posture causes.

So what’s the solution?

The solution is’nt to tell you that you should sit at your desk for less or that you should sit up straight. That’s obvious. We all know that but it’s not possible to retain good posture for long periods. So we need to manage the effects of sitting badly.

The answers to poor posture are many but let’s just stick to one simple solution that I’ve found to be one of the most powerful. The Foam Roller.

The Foam Roller is a must for every home. I say that because everyone in our home sits, whether at school, work or just to watch the TV.

What the Foam Roller does is open up your chest & stretch those compressed and jammed up muscles & joints between your shoulder blades. This reduces stress on your shoulders, neck & back.

It’s one of the only exercises that I give that doesn’t even get you out of breath.

There are many ways to use the Foam Roller. You can use it vertically along or horizontally across your spine as in this picture or you can even roll it under you, acting like a massager.

You can also use the Foam Roller to help you with other problems like:

• Tight Hamstrings
• Tight ITB’s
• Tight Calf Muscles
• Poor Balance
• Poor core stability

If you’d like to know more about how to improve your posture & how to use the Foam Roller call the clinic and make an appointment with one of our practitioners.

We sell the Foam Roller at the clinic & can give you a set of customized exercises to suit your body type & symptoms.

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

Dr Eliza Gleadell is one of our very experienced Osteopaths who might be able to answer this question.

You see Eliza’s special interest is in the treatment of “visceral” conditions using her Osteo skills & as you’re about to find out, many common conditions like back  & shoulder pain can be related to dysfunction in organs like your liver, gall bladder, uterus or even your diaphragm.

Eliza has been interested in the treatment of conditions like Asthma, Reflux, Inflammation of the Gall Bladder, Constipation & Period Pain using her Osteo skills since graduating from Victoria University.

If you’d like to know more about how Eliza might be able to help you, a family member or a friend using Visceral Osteopathy, please watch the video.

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

Imagine Sam Stosur’s Osteo telling her that she can’t play tennis.

She’d be a little unhappy. Right?

Well that’s exactly what we would be saying to Sam if she were suffering from Tennis elbow. This poorly named condition that affects the tendons on the outer aspect of the elbow joint is actually very common in people who play all sorts of different racquet sports, not just tennis.

In my experience there’s actually just as many people who suffer from tennis elbow who play golf, squash, do upper body weight training & renovations at home using hand tools or paintbrushes.

The worst case of tennis elbow I’ve seen is that of a middle age man who decided to build a huge decking area onto the back of his house using a nail gun to fix the slats on to the frame. All in one weekend!

This is a recipe for disaster. Once again, because this patient doesn’t actually use a nail gun in the weekdays, he’s risking serious injury because he’s unaccustomed to the strains and shear forces that a powerful nail gun will exert on his elbow. If he were a builder, nothing would have happened.

Tennis elbow or Lateral Epicondylitis as it’s called affects the tendons of the muscle that attaches to the lateral or outermost side of the elbow. The tendon of this muscle becomes inflamed and then becomes degenerative or starts to wear.

Tennis elbow problems take a long time to heal because tissue that it affects, the tendon, has a poor blood supply.

So what can you do to speed up your recovery if you have tennis elbow?

• You must seek treatment early. The later you leave your painful elbow, the longer it will take to get better.
• You must to make sure that you have true Tennis Elbow & that your elbow pain is not coming from your neck. Our Osteos will be able to diagnose where your pain is coming from.
• You must perform the correct “eccentric” exercises to strengthen and rehabilitate your injured tendon. See my last newsletter about DOMS to find out more about eccentric loading.

Here’s a great exercise for tennis elbow:

WARNING. Please do not practice these exercises before consulting our Osteos.

Hold a 3 – 5 kg weight or in the early stage a full bottle of wine in the inured hand. You lift the weight up with two hands and then lower it down with the  one that’s injured. Do this for 3 sets of 15 repetitions. This is a great exercise as it strengthens the weak muscles and spares the stronger ones.

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

DOMS is the acronym for Delayed Onset Muscle Soreness. It’s caused by exercise-induced muscle damage, the pain and stiffness that peaks a day or two after starting a new fitness program.

Almost any exercise can cause DOMS. However, the main type of exercise that causes this common condition is what’s called eccentric exercise.

Eccentric exercise is when muscle fibres become longer while under tension. A good example of this is when you lift something that’s too heavy for you. Let’s say you’re at the gym doing biceps curls or you’re just lifting a box using both arms.

In both cases, you’re lifting the weight using your biceps muscles to bring the object closer to your body. If the weight you’re pulling towards you is heavier than your biceps can handle, your biceps muscle fibres will be elongated while trying to contract. The heavy weight will force your biceps muscle fibres to stretch rather than doing what they are supposed to do, which is contract. This can lead to DOMS.

Other common causes of DOMS are walking or running backwards & running down hill. These types of exercise require some muscles fibres to lengthen to slow the body down as others contract & move the body forwards.

Symptoms of DOMS

• Dull nagging ache in the affected muscle group
• Muscle tenderness
• Increased pain on muscle contraction
• Symptoms come on 24-48 hours post exercise
• Relief after 5-7 days

So what can you do to avoid DOMS?

Avoid prolonged sessions of unfamiliar exercise. Work to gradually increase a new exercise or training session.

Drink plenty of water before & after any exercise.

Take Magnesium pre & post exercise. I recommend ½ a tsp before & after 1 hour of exercise. Magnesium is available as UltraMuscleze from the clinic.

Warm up using a dynamic warm up and cool down using static stretches post exercise.

This advice applies to any type of exercise, not just ones at the gym or park. I believe that you should be doing exactly the same preparation before doing work in your garden, cleaning your home, washing the car or playing with the kids.

We see a lot of patients who become injured after doing activities that are different to what they usually do. If you sit in an office all day and then decide to have a spring clean or hire a skip for the weekend to get rid of the jungle in your backyard, you’re a candidate for a back injury.

If you’re suffering from DOMS or want to know more about how to prevent injury please call the clinic to make an appointment with one of our Osteopaths or Massage therapists. Tel: 9589 3777

Osteo & Massage are great ways of getting rid of muscle soreness & flushing out those tired and painful muscles after exercise. So if you want to get rid of DOMS call us and make an appointment.

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.

Hi, my name is David Wang I’m a Chinese Medicine Practitioner & I believe that Chinese Medicine & Acupuncture can help you to lose weight.

I’ve been practising Acupuncture & Chinese Herbal Medicine for over 25 years & I love seeing how powerful & effective my treatments can be in helping people every day.

As one of the oldest forms of treatment, Traditional Chinese Medicine has over 3000 years of recorded history & has not only served the health needs of 1.3 billion Chinese people, but it has also gained popularity in the Western World with people looking for the same health benefits.

Among the many significant contributions, Chinese medicine has established a holistic concept in its health care system: viewing the universe, the world, the nations, the societies, the family, the human beings and the body-mind-spirit as a united whole.

When Chinese medicine looks at obesity issues, it focuses not only on reducing fat, but also more importantly on HOW to avoid producing unwanted weight gain.

“Teach the hungry man how to fish rather than just give him a fish”

 With my weight loss program I’ll assist you with 2 important approaches to achieve your weight loss goals & keep the weight off.

1. Using a combination of Acupuncture, Cupping, Meridian Massage & Traditional Chinese Herbs I’ll help you to lose weight. I conservatively estimate that you could lose 6kgs in 12 weeks, without doing exercise.
2.  I’ll give you a list of foods to take out of your diet as well as foods to include. The foods that I’ll recommend will be carefully chosen for your particular constitution or make up in your custom made dietary program. They’ll include special Asian vegetables & foods that have been used for centuries to assist people in maintaining a healthy and balanced diet.

 I’m looking forward to sharing 3,000 years of Chinese medical wisdom & history with you to serve your health and weight loss goals. Please call 9589 3777 today to book your appointment. Thank you and see you soon.

- David Wang

Statements and opinions expressed in articles, reviews and other materials herein are those of the authors; the editors and publishers of these articles and do not necessarily represent the views of the Sports & Spinal Group, it’s employees or associates.