Articles in Category: General Health

Why do I keep getting this pain?

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 30 October 2019. Posted in Newsletters, General Health

A large number of patients that we see suffer from chronic pain syndrome, problems that won’t go away and that continue to haunt them on a daily basis. These presentations are often variable in intensity, going from really severe down to minimal or even no pain. Often when these patients present the history is very unclear - they will often remember when they started to suffer from the pain but not how it started or whether there was a cause or event.

Unfortunately, for many patients, they’ve gotten to the point where they feel overwhelmed and out of control of the presentation before they show up to see us.

For the vast majority of these cases, they have retracted away from many of their daily activities and feel that simple things like housework or going to work will make them worse. When treating these sorts of cases, our first goal is to identify where they are breaking down, what are their weaknesses, what are their imbalances?

By doing a systematic analysis of these people, we can identify the key issues and develop targets for our treatment and exercise interventions. In the vast majority of these cases, the clients are not doing any regular exercise. As a result, initial exercise programs may seem trivial and start as something as simple as 2 minutes of walking, 2 or 3 times a day.

hamstring mid belly stretch 2

Pictured: Don Williams demonstrates the hamstring stretch exercise

The prime goal with managing these cases is to be systematic – we need to understand what makes people worse, what makes them better and how do we develop a routine that will get them back to where they want to be. Formulating hard targets of what they want to achieve in specific time frames, as well as getting a diarised understanding of what makes them worse and what makes them better is a good start for us to put together their treatment plan.

These cases require comprehensive assessment. Many of these clients have had multiple X-rays, often of the same area. The question you need to ask yourself is, if you have already had four sets of X-rays done of the lower back and nothing has changed, why would a new X-ray show anything different? And if it did, why would that mean that was the reason for the pain? Because, remember, you have had these scans done before, and that problem wasn’t present, but you already had the pain. Clearing up these myths is one of our prime goals, and then giving people hope, clarity and direction will normally move them down the path of getting a result.

When planning these sorts of cases, we would normally be looking a 6-12 months to recover. Unfortunately, if a problem has been there for ten years, the likelihood of a resolution in days or weeks is highly unlikely. It takes some dedication and structure to re-train the system. If you have a chronic complex case that you would like us to review and assess, please call us and we can look at developing a treatment plan to help you achieve your result.

What's in a Shoe?

on Monday, 28 October 2019. Posted in Newsletters, General Health, Ergonomics, Training and Performance

Article by Elizabeth Evans
B. Sc., M. Pthy.. M. SPSc., AEP, AES
Memb: APA, ESSA


Most people buy shoes based on fashion. Here, at the Institute of Sports and Spines we take shoes seriously, we even have a confiscation box!

This quick shoe anatomy lesson will help you choose the right pair of shoes on your next shopping trip.

The UPPER: This is everything above the sole of the shoe. Usually made with several layers of fabrics and mesh that are sewn and or glued together.
What to look for: An upper that is shaped like your foot, is smooth and doesn't cause rubbing.

The Ankle Collar: This is the top of the shoe opening that holds the heel down in place snuggly.
What to look for: Avoid shoes that allow the heel to slip out and those that cause excess rubbing or pressure near the Achilles tendon.

The Saddle: This is the area around the arch between the ball of the foot and the ankle.
What to look for: The arch of your foot should feel comfortable, not being pushed, slipping and falling down. Your foot should feel snug and secure without pressure.

The Toebox: This is the front of the shoe upper that encloses the forefoot and toes
What to look for: A toebox that fits the width of your toes/forefoot. Your foot should bend and spread naturally without pressure or rubbing on the toes, pins and needles is often a sign the toebox is too narrow.

The Heel-Toe Drop: This is the difference in height between your heel and the ball of your foot. Changing the foot drop drastically can contribute to injuries and alter your stride in walking and running.
What to look for: A shoe that feels right when walking or jogging.

Other tips include:

You may think you know your size, but it’s best to get your feet measured each time you buy new shoes.

When you go shopping, take along the socks you intend to use to find a great fit.

Are your Feet Flat, Neutral, or Rigid? 

on Monday, 28 October 2019. Posted in Newsletters, General Health, Ergonomics, Training and Performance

Article by Emily Holzberger
Accredited Exercise Physiologist B.ExSSci (ClinExPhys). Memb: ESSA, ASCA Level 1 Strength and Conditioning coach, Level 1 Volleyball Australia coach

 

Different foot types impact the way we move and perform exercise. There are three primary foot types these are:

1. Flat feet: lacks medial arch, generally wide feet, very mobile, pronation.
2. Rigid feet: very high arches, immobile, make a loud thud when walking on hard surfaces, supination.
3. Neutral feet: medial arches present, good mobility through the foot.

The type of foot type you have impacts how your body distributes load. Here we can see the how the ankle joint is impacted by our foot type:

Foot pic 2

Our body works like a chain, so if I have very flat feet may knees are likely to be knock kneed. For some people this may impact them only when doing exercise. For example, if when I'm performing a squat my medial arched collapses my knees will move together. This puts pressure on the medial aspect of our knee joint and increases risk of knee pain. This can happen for people with pronated or neutral feet. See bellow the difference between squatting with no arches vs. arches.

foottypes


If you're looking at that squat and thinking “Hey! That's what I look like!” do not fear, we have an exercise that can help build up the strength in your arches. This exercise is called short foot, the goal is to keep equal pressure between the ball of your foot and your heel. Imagine “gripping the ground” with your foot. By doing this your foot will shorten due to the lifting of the arch through the muscle contracting. This is great to practice whenever you're doing exercise as it allows our body to get into a better position for loading.

relaxedfoot


For those with rigid feet it is very important to cushion your foot well. Ensuring that the shoes you are wearing are providing you with a comfortable base is good for reducing risk of pain through the feet, ankles, knees, lower back and even your upper body. If when you are walking around at home you sound like a baby elephant that's a sign that you should be wearing shoes, especially if you're spending a lot of time on your feet. Even some cushioned thongs or crocs could do the trick!

If you're not too sure what foot type you have, it can be helpful to have a look at a few pairs of your shoes, they may hold the answer! You can see exactly where you wear down your shoes and this tells us your foot type. Here we can see what your foot type can do to your footwear:

Arches

If you're still not sure about exactly how your foot type is impacting your walking or running gait, come into Institute of Sports and Spines for a gait analysis. From this, we are able to create an exercise program tailored to your foot type and the rest of your body. Get in contact if this sounds like something you're in need of!

 

Images sourced from:
https://dr-abbie.com/factsheets/squatting-with-orthotics/
https://www.solescience.ca/kinetic-chain-movements-feet-affect-body/
https://www.healthline.com/health/beginners-guide-to-pronation
https://denverfitnessjournal.com/the-short-foot-exercise-for-stronger-feet/