From the 3rd to the 7th of September Kate will be practicing 8am until 8pm massage shifts. She will be taking care of the masses of media, support and technical teams that lug heavy cameras and equipment around the stadiums, catching those perfect shots of the athletes that we are all waiting for with eager anticipation. She’s ready for a tough but fantastic week, gaining ever more experience to bring back to patients here at the Longlevens Chiropractic & Sports Injury Clinic.
The Paralympic Torch was lit this morning and I heard someone say on the radio – “it’s a chance to really concentrate on people’s abilities, not their disabilites…” Absolutely. We can’t wait.
Best Wishes and Good Luck to all those participating in any aspect of the event – including Kate!!
In August, Chiropractor Danny Adams and Massage Therapist Kate West from the Longlevens Chiropractic & Sports Injury Clinic proudly attended the first ever UK hosted Hockey Masters World Cup, a great opportunity to meet and treat athletes from all around the world.
Our Therapists’ adventure began with the assistance of the RAC, but once they had safely arrived, they very successfully worked as part of the Hockey event’s Sports Medicine Team with 7 other manual therapists, including Osteopaths, Physios and Chiropractors. The set-up of having a team of professionals in one area at one event worked very well at the Hockey, presenting the international Hockey players with a range of knowledge and experience. Hockey injuries were delegated evenly between the group and the competitors were treated on a first come first serve basis.
Danny and Kate were able to take the time to shadow other treatment techniques and found that they came away having gained an incredible amount through observation and learning as well as experience. The hockey players themselves were extremely enthusiastic about receiving treatment making the event all the more rewarding for Practitioners. What a great success. Well done to all who took part.
“I would estimate that at least 90% of world class athletes use Chiropractic on a regular basis to prevent injuries and to improve their performance” says Sean Atkins PhD Exercise Physiologist.
Here is Usain Bolt receiving treatment from the Jamaican team Chiropractor:
It would appear that Usain Bolt’s Doctor of Chiropractic and the rest of the Jamaican medical team got him firing on all cylinders, given his awesome achievements at this year’s London 2012 Olympics.
The fastest man on a bike, the Multi Olympic gold medal winner and 2012 Tour de France champion Bradley Wiggins from Great Britain, also swears by using Chiropractic treatment:
Here he is speaking about his Doctor of Chiropractic Matt Rabin:
“I first started working with Matt at the end of 2008 following my success at the 2008 Beijing summer Olympics. After years of struggling with minor niggles that I had learned to live with, and having never really found the answer to my problems despite having sought numerous treatment options with no great success, I went to see Matt.
From my first session with him I had great results that were not short lived. That followed up with regular sessions I saw improvements that I had never seen before and that reflected in the way my body held up on a day to day basis which eventually saw me achieve 4th place in the 2009 Tour de France under his supervision.
Matt will undoubtedly remain an integral part of my medical support in the forthcoming seasons and lead up to the London 2012 Olympic Games.“
After just adding the Tour de France and 2012 London Olympic time trial gold to his list of medals and also for becoming the most decorated British athlete ever, I would like to say a huge Congratulations to Bradley Wiggins. It has been incredible year for him, absolutely dominating his sport, us Brits should all be very proud.
…It can be such a pain in the bum… literally! ‘Sciatica’ is the term used to describe any pain that is originating from irritation of the Sciatic Nerve. This pain can be felt anywhere down a leg, from the bottom to the feet.
The Sciatic Nerve is the longest and thickest nerve in the human body, running from your lower back all the way in to your foot, with its thickest part being around 2cm in width! As you can imagine, a lot can happen to that nerve along its route and exactly what can happen is the subject of this post. The Sciatic Nerve originates as individual spinal nerves known as L4,L5,S1,S2 and S3, these nerves exit the spine individually but then converge to create the Sciatic Nerve. Bear this in mind when we discuss problems that can occur to the Sciatic nerve that lead to what we all know as ‘Sciatica’.
A disc bulge essentially only affects the nerve at which level the bulge is occurring, this therefore would affect the path of the Sciatic Nerve but particularly at the points at which the original nerve supplies the body. For example, a backwards and to the side (postero-lateral) Disc Bulge at L5/S1 usually causes pain/tingling/numbness/pins and needles at the sole and outside edge of the foot on the same side as the bulge. This is because the nerve exiting between the spinal segments of L5 and S1 is what is known as the S1 nerve root (like a tree a nerve has a root, another word for where it starts). The S1 nerve supplies both muscles (a Myotome) and skin sensation (a Dermatome). So as you can see the S1 nerve supplies sensation to the sole and outer edge of the foot which is why pain is felt here. This applies to all nerves exiting the spine. If one level has a bulge then the skin it supplies may have a change in sensation. The muscles that each affected nerve innervates may also not work correctly or may even begin to decrease in size and become flaccid, seen in severe cases. For example, The S1 nerve supplies lots of muscles in the lower leg and foot so it would be quite clear if there was something affecting its innervation severely as all these signs would be present. Chiropractors treat disc bulges all the time, worst case scenario is surgery for a disc but your Chiropractor or manual therapist will let you know if this is necessary.
Foraminal Stenosis
The word ‘Foramen’ basically means ‘a hole’, where the L4, L5, S1, S2, S3 nerves leave the spine between each vertebral segment is a hole called the ‘Intervertebral Foramen’. If anything decreases space at this Foramen then Sciatica can occur, problems such as bony spurs, inflammation, a Spondylolisthesis or a Tumor can all cause a decrease in space here and irritate the nerve as it exits. This can therefore be one of the causes that lead to irritation of the Sciatic nerve and the symptoms associated to it.
Piriformis Syndrome
In a nutshell ‘Piriformis Syndrome’ occurs as a result of the Sciatic nerve being irritated by the Piriformis Muscle. Though it’s not always simple to treat for the following reasons:
The Sciatic nerve’s relationship with the Piriformis Muscle in the general population differs from person to person. As you can see, most commonly it passes beneath the Piriformis Muscle, however in the minority of the population the Sciatic Nerve can actually pass through the Piriformis Muscle entirely, or even stay split around it and connect after.
The Piriformis is an external rotator of the the leg, if it gets too tight (common in a lot of people) it can become irritated, this leads to inflammation at the muscle and surrounding tissues, which in some cases includes the Sciatic Nerve. This irritation can cause symptoms down the leg that are often misdiagnosed as disc bulges due to their similar presentation.
If you have further questions or would like to know more about this topic please ring us on 01452309372 or email contact@longlevenschiro.com
Chiropractor Danny Adams and Massage Therapist Kate West had a great day yesterday treating international hockey players at the first ever UK hosted World Hockey Masters Tournament.
Well done both, fantastic day, great job done.
*We love taking part in days and events like this. Please get in touch with us if you are hosting or taking part in an event that we could help with, however big or small!!*
Registered patients this is for you! We can proudly state that most of our new patients are referred to us by existing patients, so this month we are offering you 50 % off your next treatment if you are already registered with us and you refer someone to us who registers during the month of August (by the way, that still counts if you yourself are a new patient to us in August!).
You can take us up on our half price offer on either massage therapy or chiropractic treatment, depending on which is more appropriate to you. All that we ask is that you do this before the end of 2012. And, you get 50% off your next treatment for each person that you refer during August, so if you refer two people then that’s two half price treatments in a row!
As is the norm, Terms and Conditions Apply. If you would like to book in or if you have any queries then give us a call on 01452309372 or email contact@longlevenschiro.com
It’s rare to that you find someone with the ‘perfect’ posture, but the idea is that it is aspired to. Below is a diagram of what we should all be aiming for.
There tends to be 3 types of ‘bad’ posture that practitioners see most often:
Sway back posture:
• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage The Upper chest collapses, flattening out the chest wall. Chest also moves back and in.
• Upper Back has an increased bend forward (Kyphosis).
• Lower Back flattens out
• Pelvis tilting under (Posterior tilt) and pushing forward.
• Knees locked
Flat back posture:
• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage falling forward
• Upper Back Straightening out as you move down the spine
• Lower Back flattens out
• Pelvis tilting or tucking under (Posterior tilt)
• Knees locked
Hollow back posture:
• Head is too far forward
• Neck has an increased curve
• Shoulders are falling forward and down
• Chest and Rib Cage collapsing
• Upper Back is rounding (Kyphosis)
• Lower Back has an increased curve (Lordosis)
• Pelvis tilting forward (anterior tilt)
Knees locked
Poor posture can effect the body massively. It can mean some muscles shorten and so cannot perform normally and therefore others lengthen which decreases strength. It can also effect blood flow through muscles which can lead to pain spasms.
Poor posture can be the cause of much discomfort and injuries due to the short/tight muscles or the lengthened muscles that allow too much movement possibly leading to injury.
Posture is something that everyone should be very aware of and be trying to correct every minute of every day.
References:
Kendall, 1993
NLSSM – North London School of Sports Massage
The term ‘Shin Splints’ (also known as “runner’s leg”) is in fact a general umbrella term used to describe quite a few different lower leg injuries. Each of the injuries can be grouped in to one of four different categories depending on where the area of pain is felt. I will mention each individual injury but not cover each one in depth. I will, however, give an example of one of the injuries from each of the 4 shin splint group types so as you have an idea of how each of the 4 types presents. I will however not be covering how to treat these areas as that is a whole different kettle of fish and I would recommend seeing a specialist if you feel you have any of the following to receive a personal treatment plan.
A summary of the four types: 1. muscular (various lower limb muscle strains) – tibialis posterior and anterior syndromes, soleus syndrome 2. periosteal (most outer layer of a bone) – periostitis of tibia 3. fascial (Fascia) – exertional compartment syndrome 4. osseous (bone) – tibial and fibular stress fractures
1. Muscular
Example: Tibialis posterior Syndrome
This type of shin splints essentially is as a result of a strain or incomplete tear of Tibialis Posterior:
caused by biomechanical dysfunction (esp. overpronation) of the foot and ankle.
pain usually appears at the beginning of a workout and later disappears, only to reappear afterwards.
palpable tenderness along the medial side of the lower leg.
tenderness is also elicited by resisting plantar flexion and inversion of the foot radiography helps to rule out stress fracture of tibia/ tibial periostitis.
additional treatment – lower leg strap (like elbow strap) for redistribution of muscle tension.
This type of shin splints involves painful inflammation of the outermost layer of bone called the periosteum specifically along the central border of the shin, usually the distal 1/3 .
Originally thought to be related to stress along the posterior tibialis muscles and tendons causing myositis, fasciitis and periostitis, it is now believed to be related to periostitis of the soleus insertion along the posterior medial tibial border. As a result of excessive pulling of the muscle. Excessive pronation or prolonged pronation of the foot causes an eccentric contraction of the soleus, resulting in periostitis.
May be as a result of a change in running distances, speed, form, stretching, footwear, or running surfaces.
Tenderness along the anterior side of the tibia and sometimes slight swelling and thickening above the bone can be noticed.
Additional treatment – ice and NSAID, soft running surface, cushioning of the heel.
3. Fascial
Exertional Compartment Syndrome (ECS)
This type of shin splints involves thick sheaths of Fascia divide the muscles of the leg into four compartments each with their own muscles, blood and nerve supply. The four compartments are the ‘Anterior compartment’, ‘Lateral Compartment’, ‘Posterior Deep compartment’ and the ‘Posterior Superficial Compartment’. The mechanism involved is as a result of fascia that is too tight along with an increase in muscle volume within the compartment as a result of increased activity which can lead to a decrease in compartment space around the muscles. This therefore increases the pressure within the compartment and diminishes the compartment’s veins ability to return blood therefore increasing the pressure further. If really severe the arterial blood supply in this compartment can also be cut off.
ECS is usually exercise induced aching leg pain and a sense of fullness, both over the involved compartment. These symptoms are almost always relieved by rest, usually within 20 minutes, only to recur if exercise is resumed.
Both legs is common
Activity related pain begins at a predictable time after starting exercise or after reaching a certain level of intensity
Many individuals with anterior ECS describe mild foot drop or paraesthesia (or both) which are amplified by physical exertion.
The most common compartment involved is the Anterior 50-60% then the Deep Posterior 20-30% and the remaining 10-20% is between the Lateral and Superficial Posterior compartments.
Home advice involves Ice and reducing the level of strain, though for an active individual fasciotomy provides a quicker and long-term solution (surgery to release the tight fascia and therefore decrease the pressure in the involved compartment.
This particular condition is notoriously difficult to manage conservatively, if there are any practitioners out there with suggestions then I would love to hear their experiences.
Do not confuse with an acute compartment syndrome which is in fact a medical emergency.
4. Bone
This type of shin splints involves stress fractures of the Tibia (shin bone)
as a result of repeated sub-maximal loading.
dull pain, swelling and palpable tenderness is confined within 2-3 cm in diameter.
Insidious onset.
Increased pain with activity/ decrease with rest.
Pain usually limited to fracture site.
Pain on percussion and vibration.
If you are still unsure as to which of these problems you are experiencing or you wish to get more advice then feel free to message me for more advice. Otherwise I would recommend an experienced manual therapist such as a sports Chiropractor.
Big congratulations to Bradley Wiggins for winning the Tour De France, supported by a medical team that includes Matt Rabin, BCA Sports Chiropractor. His testimonial for Matt, and for Sports Chiropractic, can be found on Matt’s website http://theperformancechiropractor.com/says-who/bradley-wiggins/ and reads as follows:
” I first started working with Matt at the end of 2008 following my success at the 2008 Beijing summer Olympics. After years of struggling with minor niggles that I had learned to live with, and having never really found the answer to my problems despite having sought numerous treatment options with no great success, I went to see Matt.
From my first session with him I had great results that were not short lived. That followed up with regular sessions I saw improvements that I had never seen before and that reflected in the way my body held up on a day to day basis which eventually saw me achieve 4th place in the 2009 Tour de France under his supervision.
Matt will undoubtedly remain an integral part of my medical support in the forthcoming seasons and lead up to the London 2012 Olympic Games.”
Whiplash – you hear the term used all the time but do you really know what it is and why it occurs? Here it is for you, put simply by Danny Adams, Chiropractor at Longlevens Chiropractic & Sports Injury Clinic:
Studies show that a rear-end collision of as slow as 5 Mph can result in what is known as a “Whiplash Associated Disorder” (WAD). (This is the correct term for whiplash used by medical professionals). Classically, most people will tell you that a rear end car collision is what leads to Whiplash. However, this is not the case, as you can see from the term ‘Whiplash Associated Disorder’ Whiplash can occur in many different ways. If you follow the definition you would be forgiven for thinking that Whiplash can only be as a result of hyper flexion and hyper extension. However, what is more common is that when a person experiences whiplash it is as a result of the person’s neck not being prepared correctly for the rapid change in movement. Whether the impact to the persons body came from behind or the sides. This is because the muscles of the neck are not prepared correctly to brace the neck bones and tissue (usually because the person was not expecting to injure themselves). Then by the time they have braced it is too late and the damage has been done. Also, mistakes are made in treating, where it is commonly thought that the ligaments surrounding the facet joints (little joints that connect each segment of the spine) get sprained due to hyperflexion (too much flexion) and subsequent hyperextension (too much extension) whereas, in fact, a large amount of joint compression occurs as the neck gets taken through and ‘S’ shape curve just after impact seen in the middle picture below.
Here is the classification of WAD injuries just to show you how different each Whiplash injury can be. There are a few different classifications though this one is most common at the moment, designed by ‘The Quebec Task force”. If you have suffered Whiplash then you would have fallen in to one of these graded categories.
Now, another very common mistake to make with Whiplash is that the injury only occurs within the bony part of the neck and local tissues. In fact a large part, if not the majority of your pain will be coming from the surrounding musculature that braced the neck too late. What happens is that the muscles that failed to respond quickly enough at the time of impact are kept in a state of neurologically controlled hypertension (too tight!) as they form their own protective brace around the bones and tissue of the neck. Don’t get me wrong, there may have been bone, joint and tissue damage but it is usually the muscles that are responsible for the long term effects of Whiplash. Often the segments of the spine, their joints and local tissue have often healed while the muscles can stay in a state of unnecessary tightness for years after.
A simple but frustrating mistake I hear time and time again when advice is given for Whiplash is “use heat to relieve the pain and symptoms”. For the life of me I do not know why this is suggested, if you get a bruise or you tear/strain a muscle why would you want to encourage the inflammation with heat in the early stages? Heat feeds inflammation, if you read the physiology behind inflammation you will see that inflammation is a genius evolutionary process but essentially quite crude. The body does a great job with inflammation breaking down and clearing out dead and diseased tissue, though it often goes too far and can in fact damage it’s own healthy cells, thus prolonging the recovery of an injury. By applying heat you will get relief at the time of application due to the over riding of the ‘pain gate’ at the damaged region. However, a few hours later the pain often will return and sometimes it can be worse. I’d suggest using ICE 10-15 minutes every 2 hours and observe the difference.
If you would like further information on whiplash please contact us on 01452309372 or email contact@longlevenschiro.com. See more of Danny’s articles here.
From the 3rd to the 7th of September Kate will be practicing 8am until 8pm massage shifts. She will be taking care of the masses of media, support and technical teams that lug heavy cameras and equipment around the stadiums, catching those perfect shots of the athletes that we are all waiting for with eager anticipation. She’s ready for a tough but fantastic week, gaining ever more experience to bring back to patients here at the Longlevens Chiropractic & Sports Injury Clinic.
