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What is the role of a Sports Therapist & Rehabilitator?

We not only treat injured athletes, we also deal with many common muscular complaints such as back pain, joint pain, muscle strains, ligament sprains, postural problems and work related conditions. 

 

In sport, a Sports Therapist helps injured athletes return to full performance after injury. In the general public, Sports Therapists help diminish aches and pains and allow continue activity of daily living. The treatment varies dependent on the injury, degree, activity or sport involved.  A qualified Sports Therapist advises on prevention of injuries and can examine, assess and treat those that do occur, as well as helping with the rehabilitation process.

At the moment in the UK, Sports Therapy is unregulated. Anyone can call themselves a Sports Therapist, or Sports Masseur, without even having a qualification. Some sports therapists have a diploma and others have a degree. A Sports Therapist differs to a sports massage therapist who generally, are not trained in rehabilitation exercises or electrotherapy and may only have attended a short course.

Trochanteric Hip Bursitis

This an overuse injury which is common in runners. “Bursitis” basically means inflammation of a bursa, which are sacs of fluid found between bones and overlying soft tissues. They can become inflamed from protecting soft tissue from repetitive friction. The Trochanteric bursa sits over a body lump known as the greater trochanter. It reduces friction from the Iliotibial band (ITB) and the bone.

 

Symptoms of trochanteric hip bursitis

 

Usually, you will experience pain in this area, on the outside of the hip. This is worse after activity such as running. The pain can last for a few days after activity, depending on the severity. Pain may travel down the outside of the thigh and into the gluteal area. Palpation can reveal tenderness in this area. Other than running, climbing stairs and laying on that side may cause a problem.

 

Causes

Overuse and repeated friction are the main concerns for this condition. Studies suggest that this can be a result of faulty biomechanics in the body. Other causes include falling onto this area due to impact e.g. Skiing. 

 

Woman are at a higher risk for this injury due to having wider hips. In running, this can cause altered biomechanics causing woman to have a knock-kneed appearance known as hip adduction. As a result, woman need stronger abductors to balance this out. Weakness in this area can cause increased tension in the ITB. As noted earlier, this lies on top of the Trochanteric bursa. Increased pressure can add additional friction to the bursa, pre disposing bursitis. 

 

Factors that can contribute to the development of this condition include; overpronation, leg length differences, uneven surface running and doing too much too soon. 

 

Treatment

Rest and ice is key to reduce the inflammation. Correcting the cause of the inflammation is also essential to prevent the pain returning. Seek medical advice from a specialist to determine this. Common advice given includes:

  • Stretching and foam rollering the ITB 
  • Self soft tissue work on the gluteal area 
  • Hip abduction exercises 
  • Return to activity guidance 

 

It is important that you are pain free before you try and return to activity. Strength improvements should also be seen in hip abduction exercises. Adequate rest periods should be given to not overload the injured area. If you feel any pain, stop and go back to the rehab phase!

Think you have a Sports Hernia?

Pain, bruising and restricted movement are all warning signs of a sports hernia, but could also indicate other conditions. A sports hernia however will not go away on its own, so it’s critical to pay attention to the warning signs and seek treatment early. Early diagnosis and treatment can mean the difference between a quick return and a season spent on the sidelines.

 

Warning Signs

 

  1. Sharp pain. As a result of a tear in the lower abdominal muscles. Twisting or quick movements can worsen the pain.
  2. Chronic pain. With rest and the pain goes away, only to return to activity and pain. This can start a cycle that will only worsen until the sports hernia is surgically repaired.
  3. Lumps and bumps. Due to this being an internal injury, usually their are no visible signs. Men can sometimes develop a small bulge in the area, which can be painful to touch.
  4. Pulling or stretching feeling. One of the more common symptoms of a sports hernia is a pulling or twisting feeling with activity.
  5. Bruising. Uncommon.
  6. Difficulty with everyday activities. You might find it difficult or painful to do common tasks, like reaching, bending and lifting.

Watch out for these warning signs of a sports hernia when exercising or playing sports.

SLAP tear of hip overview

The hip or acetabular labrum is a ridge of cartilage that runs around the rim of your hip joint socket. Its purpose is to make the hip socket deeper and more stable. The labrum can be torn from its attachment and cause pain, clicking or catching.

 

Cartilage damage can become a serious injury since it does not heal easily. Hip labral tears can lead to joint instability and further orthopedic issues in the future

 

The labrum can tear for many reasons. Some people tear their labrum from falls or sporting injuries when your hip is forced into extreme positions. It can also be damaged by repetitive trauma in sports that require regular rotation of the hip e.g. golf, football, hockey, and ballet

 

You can also tear a hip labrum with a sudden injury. Hip dislocations are usually accompanied by labral tears of the hip.

 

Symptoms 

 

  • Stiffness in your hip
  • Pain in the front of your hip or groin region
  • Pain that may radiate down through the buttocks
  • Pain gets worse with standing, walking or other activity
  • Locking or catching in your hip joint as you move
  • Feeling of instability or weakness on that side of your body

Hip labral tear may predispose you to develop osteoarthritis in that joint in the future. Hip labral tears left untreated are a chronic problem. They may alter your gait, which can lead to other knee, back, and neck issues. It will also make the joint more unstable which will accelerate the onset of osteoarthritis.

 

Phase I – Reduce Pain & Protect Your Labrum

Rest the hip and avoid aggravating activities.  

Avoid sitting:

  • with knees lower than your hips.
  • with legs crossed or sitting on you legs so that the hip is rotated.
  • on the edge of the seat and contracting the muscles that flex your hips.

You should also avoid extending your hip excessively.

 

Phase II – Restore Flexibility & Strength

  • Restore any limited joint range-of-motion.
  • Improve your soft tissue muscle length and resting tension.
  • Activate your deep stability muscles.
  • Progressively strengthen your intermediate and superficial muscles.
  • Enhance your proprioception and joint position sense.

Phase III – Return to Activity or Sport

  • Aim to improve your functional activities of daily living
  • Graduate through a return to sport program that is specific to your needs.
  • Some labral tears can be treated conservatively but some will need hip surgery.

 

PREVENTION

Try to avoid loading your hip with your full body weight when your legs are in positions at the extreme ends of your hip’s normal range of motion.

Poor Posture & It’s effects

Do you remember when your parents used to tell you not to slouch all the time? They were right to do so as poor posture can have detrimental effects. The issue of ‘poor ‘posture’ has become increasingly talked about within healthcare circles and ergonomic assessments are more common in office life. But why is posture so important?

Postural dysfunction or “Poor” posture is defined as when our spine is positioned in unnatural positions, in which the curves are emphasised and this results in the joints, muscles and vertebrae being in stressful positions. This prolonged poor positioning results in a build up of pressure on these tissues.

The result of this is muscle imbalances where opposing muscles on opposite sides of a joint provide differing amounts of tension, due to muscle weakness or tightness. Transferring abnormal stresses to the joints.

Muscle imbalances can lead to a musculoskeletal pain syndrome know as upper cross syndrome.

Upper cross syndrome is characterized by forward head posture, increased thoracic kyphosis (rounded back), excessive mid-upper cervical spine extension, and scapular protraction (forward shoulders).

This results in tight upper cervical extensors and anterior thoracic muscles, as well as weakened (elongated) deep neck flexors and scapular muscles.

Tight muscles can affect joint motions due to their increased pull on their attachments. Conversely, elongated muscles become weak when they are lengthened past their optimal length. This is because it is harder for the muscle to produce an active muscle force. Overtime, these muscle imbalances of tight and weak muscles can lead to abnormal movement patterns, movement dysfunctions, and ultimately predispose your body to a host of other potential issues. Some conditions which can potentially arise due to poor posture include cervicogenic headaches, generalized cervical neck pain, limited shoulder range of motion, and shoulder impingement.

While poor posture might not directly be a source of pain, it represents a ‘mis-alignment’ of the body and can thus be a contributor to a host of neuromusculoskeletal conditions. Obtaining correct posture is easy. A physical therapist will be able to help you strengthen elongated muscles and stretch shortened muscles; however, once you have the adequate strength and muscle length, it’s up to you to remember to maintain this ideal posture throughout the day. Try to constantly remind yourself, if you’re sitting, standing, or walking around, to “stand tall, keep that chest out, shoulders back, and head relaxed!”

Piriformis Blog

The Piriformis Muscle is a located underneath the Gluteal muscles. It’s function is to externally rotate your hip. It’s frequently a source of ‘pain in the butt’. 

 

Piriformis Syndrome is cause by the muscle becoming overly tight resulting in compression of the Sciatic Nerve. Biomechanical faults can contribute to this such as foot arches, knee position and leg length. Aggravating factors include bending, lifting, running and especially sitting. The condition is extremely common and usually seen more in women. 

 

Pain is located in the buttock area that is also accompanied by sciatica-like pain, numbness, and weakness that runs down your leg. Treatment includes heat, ice, soft tissue work and exercise. Specific exercises include stretching and vital gluteal strengthening. 

Lower Back Pain

With school starting next weeks here’s some information about kids and backpacks:

 

Is your child’s backpack too heavy? Will they tell you if it is? Children have other stresses to worry about whilst attending school, make sure back pain isn’t one of them. 

 

Have you every heard that backpacks can causes spinal deformities in kids? 

Hopefully not as this is a myth! 

Scoliosis is sometimes associated with heavy backpacks as it’s usually diagnosed around the same time kids start carrying heavier books for school. In reality, there is no correlation as there is no research to support this. 

However, that’s not to say a heavy backpack can affect a child’s back. Muscles, ligaments, discs and joints can all be overloaded due to a prolonged external stress. In the long term, it could lead to postural changes due to muscle imbalances and leaning forward too much.

 

Will your kids let you know is their backpack is too heavy? 

Maybe your child doesn’t realise that his pain is coming from his backpack. The pain may be mild to start with so they may not see the backpack as a concern. Research suggests that a child should only carry a backpack which weighs, at most, 10-20% of their body weight. See this as prehabilitation for your child and make sure they are not overloaded. 

 

Should kids even wear backpacks? 

Yes, our backs were made for movement and activity. Staying active and giving our backs light work is healthy.

The key to a healthy spine is to wears both straps, don’t buy a big backpack and observe your child throughout the term.

KTape – The Facts

What is it? 

An elastic therapeutic tape that is used for treatment, singling or combined with other manual therapy techniques. It helps to relieve pain, reduce swelling, provide support to muscles and joints and enhance performance. 

 

Key points 

  • 24hr wear for many days prolongs benefits 
  • Cheap and effective 
  • Water resistant 
  • Can be worn exercising, showering or swimming
  • No side effects 
  • Self application 

 

How does it work? 

When the tape is applied correctly, it achieves the last of these effects by lifting the skin to create a small space between the muscle and dermis layers. That space takes the pressure off swelling or injured muscles, allows smooth muscle movement and makes space for drainage and blood flow.

 

Kinesiology benefits

  • Pain relief 
  • Reduce swelling and inflammation 
  • Accelerate recovery from bruises 
  • Helps with muscle spasms 
  • Speedier muscle recover 
  • Supports joints without restricting movement 
  • Enhances muscle function 

 

It may help…

Muscle strains; ligament sprains; bruising; muscle weakness; joint alignment; joint instability; poor posture; shin splints; growing pains; tendinitis; plantar fasciitis; osteoarthritis; joint swelling. 

Knee Blog

Knee pain when bending is a common problem. There are a number of different causation factors which can affect how the knee moves. The pain may start suddenly after an injury, or gradually come on over time.

Around the knee there are many structure including: muscles, bones, cartilage and ligaments. These structures all need to work together properly to allow for smooth, pain-free movement. Problems in any of these areas can lead to knee pain when bending. For example, if there is muscle weakness or ligament instability, the bones may move slightly out of position causing them to catch or grind on other structures in the knee.

Some of the most common causes of knee pain when bending include: Runners knee, bursitis, knee sprain, meniscus tear, arthritis, patella tendinitis, Iliotibial band syndrome and Osgoods Schlatters.

Treatment Options

The best treatment will depend on the underlying cause of your knee pain when bending. Signs and symptoms need to be examined, as well as taking a detailed history of the present condition. A tailored exercise programme can then be developed to suit you. 

Ever wondered what the difference between a Sports Therapist and Sports Masseuse is?

Sports therapist specialise in musculoskeletal conditions – I.e. Where it hurts. However, they are well adapt at neurological conditions and orthopaedic cases. 
Sports massage is one of many techniques to help you recover from your condition. 
Sports therapists are certified in more techniques to help such as; joint mobilisation, muscle activation and exercise prescription. 

What’s the difference in qualifications? 
A Sports Therapist is a degree level qualification, usually alongside a certain amount of placement hours. 
Sports massage is usually a diploma level, therefore entry levels may not be the same as a Sports Therapist. However, that’s not to say there are not some great sports masseuses out there. 

Sports massage transfer scientific knowledge and manual therapy skills relating to soft tissue structures to treat damaged tissues. 
Sports therapy includes a wider set of skills and supporting knowledge. Core areas include:
Anatomy and physiology 
Biomechanics 
Advances manual therapy skills 
Gait analysis 
Rehabilitation from injury