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MS, Multiple Sclerosis, Exercise, Dietary, Physio

Exercise for Multiple Sclerosis…..and a bit more

We started our Exercise and Dietary programme for MS patients back in November 2017. We began with initial assessments whereby we spent time with people living with the condition. Exercise for Multiple Sclerosis is a key component of managing the neurological change. However it is not a stand alone requirement. Maintaining energy levels or combatting fatigue are a daily battle. We heard from contributors living with MS about the many challenges they face – and we also had a laugh…it’s not all misery!

The Challenge for healthcare providers

The challenge for healthcare professionals is to understand the condition in a multi factorial way. It is most important that the medical side communicates with the specialist neurological input. In turn it is imperative that both link in with the therapeutic services available. The golden nugget is that all work in tandem – wishful thinking? I don’t see why not. At Personal Health, we are communicating regularly with our local GPs and a number of innovative Neurologists who see great value in a community based approach.

The Challenge for the MS population

In clinic we have heard from a small section of the MS population about job related stress, family and relationship issues, emotional and physical fatigue. While lifting some dumbbells we have addressed fear, anxiety and resentment. We address fears around deterioration in general health (over a chocolate digestive or two). Generally though we just turn up regularly and allow the crew do their thing. They exercise with determination, question with a healthy scepticism and cut us in two with a sharp wit.

Shared experiences are positive

In Personal Health, our team includes physiotherapy, occupational therapy and a dietitian. We share the workload and our collective experience is working well together. For the participants, they are working pretty well together too. Physical issues from compromised vision to manual dexterity and urinary urgency are on the table – discretely. While nobody is shouting the roof down, there is comfort in shared knowledge and experience. There is comfort in laughter and comfort in the handrails on the wall. There is a strange comfort in Mark’s dulcet tones of instruction or Marion’s dodgy Spotify playlist. Most importantly there is a sense of empowerment about taking on MS for the participants.

Benefits and outcomes

We measure change in clinic based on our initial assessments. There is not always an improvement. Similarly there has been very little decline. With a progressive condition one of the best outcomes can be maintenance of the status quo. In our profession, there is a big emphasis on ‘outcome measures’ whereby data is used to measure clinical changes. This gives people feedback around changes in strength, endurance, fatigue and balance amongst other things. It gives us quantitative feedback too and in general the results have been rewarding for all concerned. We are all on this journey together, and it has been a great learning experience to date.

 

Exercise, fitness, ageing, arthritis, Lifestyle, Dublin 6

Physiotherapy – Motion is Lotion – the benefits of exercise for the over 70’s

Physiotherapy – Motion is Lotion – the benefits of exercise for the over 70’s

 

All the big Consultants we know very regularly use the phrase ‘wear and tear’! It’s a gentle way of talking about the decline of our once glorious body. Arthritis is not curable but it is absolutely manageable. The trick is to exercise correctly while simultaneously not antagonising the inflammatory joint. Movement is key and motion is lotion!

The over 70s lifestyle

A great number of our patients are of a certain age …. but who’s counting right?

What we can confirm apart from dubious birth certificates is that they are a smiling, well oiled vintage. Many of them are golfers, almost all of them are regular walkers. Some join exercise groups dotted around the community. These people are living busy lives, booking concert tickets on the Ipad, gardening and loving the sport on TV. The Grandchildren are beautiful but exhausting, and often that mayhem is followed by a well deserved glass of wine. Lets’s not forget the odd holiday or three … Vitamin D is good for the joints, the skin and the soul.

Motion is Lotion

There is one shared quality among this group who cross our threshold in Personal Health.

They are keeping active. A former P.E teacher from my schooldays had a phrase referring to healthy joints; ‘Motion is Lotion’. This was as relevant for teenage kids as it is now for the ageing population.  It makes perfect physiological sense. Regular activity at any age helps circulation within our joints. An oxygenated blood flow swishing it’s way through our spine, shoulders, hips and knees is all good news. But it is particularly relevant when we are getting older.

Move More or Move Less? ….Move Clever….

Movement, Hips, Arthritis, exercise, Fitness, Dublin, ageing

The magic of Jimenez…..aaaaaaannnd Stretch !!

With regular movement our joints begin to move more freely – regardless of previous injury or medical diagnosis. Let’s take the hip as an example. It is a joint that regularly succumbs to arthritic change as we get older. The natural tendency is to move less with arthritis present in the joint. This is often due to pain while weight bearing. It is a perfectly natural reaction to move less. Unfortunately this is the completely wrong thing to do and means the joint will only deteriorate quicker. We need to start moving clever without impacting the damaged part of the joint.

Non Impact Movement

One of the best remedies for joint pain is to move the joint in a non weight bearing way. Cycling (indoor exercise bikes or outdoors in the park) allows the hip joint to move without compressing the ‘wear and tear’ we referred to previously. Most importantly, it strengthens and lengthens the muscles that surround the joint. It is a positive cycle whereby the blood flow helps lubricate the joint. This in turn eases inflammation. As soon as we have facilitated greater movement, the joint has greater range. This means the muscles protecting the joint automatically get stronger while stretching and contracting with greater activity.

The Solution

Get active!! If you would like to choose Personal Health as your option, we will be waiting with open arms. There are comfy seats and tea on tap (post exercise) to recover and recuperate. We always have time for a few chats too. Hopefully see you soon!

Wellbeing, Health, Corporate, Fitness, Dublin 6

Wellbeing Weeks and Fruit Friday’s don’t work!

Too often, we have seen the corporate wellbeing world be a storm in a teacup. ‘Wellbeing Weeks’ or ‘Fruit Friday’s don’t work! If your employees don’t feel valued, a guest speaker once a year and a free basket of fruit here and there, won’t change their productivity or happiness.

Stress is an enigma. we all know it’s there but we can’t always identify it. What does it look like ? Or how is it measured? We are in a data driven age and non measurables tend to be under valued.

In our experience dealing with the corporate wellbeing world, we have noticed that some issues repeatedly become a stumbling block. The ultimate goal is for wellbeing initiatives to actually improve wellbeing ! At the very least there ought to be a reduction in stress levels.

The problem for HR

In our experience, the difficulty for innovative and enthusiastic HR managers is implementation. That’s why initiatives like ‘Fruit Friday’ exists. It’s a gesture that can be achieved. It’s also coming from a very well meaning place.

But in a target driven environment, punctuated by End -of -Quarter stress avalanches, the wellbeing philosophy becomes a distant ideal. The idea that the Sales team might take a 30 minute break for a mindfulness session during the avalanche is outlandish.

Ironically, it might be the perfect time to do it, but let’s face it, it is highly unlikely.

Can Lifestyle change actually reduce stress?

Well in terms of exercise the World Health Organisation (WHO) recommend 150 minutes of light exercise per week. This is a non specific recommendation, and indeed slightly less than 150 minutes can suffice if done at a moderate to vigorous intensity. Let’s not focus on the content for now. Let’s simply look at the duration;

  • 2 x 30 minute sessions in a week amounts to 1/168th of our week
  • A whopping 0.006% of our week !!

Time Management and Lifestyle Change

Can we spare 0.006% of our week to help reduce stress levels ? We all know we can. But we still regularly don’t. Perhaps we are not truly framing the benefits in a relevant way.

It can specifically improve our performance in work.

Neurological benefits are rarely highlighted, but the scientific community have proven that exercise can improve concentration, memory and decision making under pressure! How good is that ?!

Due to the vascular (blood vessels) change that occurs during/post exercise there is an associated change in blood flow inside the brain. Why not tap into this ?

Behavioural Change and Wellbeing

For the HR managers out there it is important to manage your own expectations and the barriers facing your implementation of wellbeing.

0.006% of the week doing exercise is of course achievable for your employees. However It may be time better spent to have a regular check in / reminder to simply encourage employees to adopt new behaviours. Ultimately they have to do the exercise themselves. So, raising awareness about lifestyle benefits can be a powerful message if done in a strategic way. It gently lets your most important resource (your people) know that you value their lives outside of the job, and you value their time while on the job. You don’t have to provide the actual activity for lifestyle change, you just have to constantly encourage the change in behaviour.

Running, Prehab, Physiotherapy, Hip, Knee

Top 10 tips for Runners

Main Photo Credit: Jonathan Colon, www.skatesphere.com/

Get Started Today to Enjoy a Summer on the Move

Have a Plan:

Whether your aim is to run your local park run every Saturday or to make the Olympics in two year’s time you need to have a plan. There are two options: You can go online to get a generic plan based on achieving a set distance in a target time. Many runners have used them to good effect. The only problem is they might be too advanced or too easy for your running ability. The second option is to get a qualified coach who will tailor a programme to your needs and ability. It is important to have goals with these plans and they range from weekly goals (running 3 times a week) to yearly goals (running  5K in under 20 minutes).

Running gear:

Fail to prepare, prepare to fail. This is where so many new runners fall down. The most important piece of equipment is the shoes and it should be first on your list to buy. Nowadays if you go into any sports shop in the country they will do a gait analysis on you to see which shoes would suit you. They video you while running on a treadmill for a few minutes and then the footage is played back in a Freeze by Freeze frame if necessary to assess your foot plant, stride and running pattern. This information can then be used to find the best shoe for you. Also to consider when buying shoes is the terrain you will be running on (Grass, Road, Trails or track).

While hitting the road you will need heavier shoes with more support. While on the track you would be looking for light shoes with little support. The socks are just as crucial as the shoes as you need running specific socks due to the extra padding across the ball of the foot, the toes and heel area. There’s also usually padding or a tighter area through the arch to allow the shoe to fit more closely and add better arch support. Now on to the shorts and T-shirts which is the uniform of all runners around the world. These need to be lightweight, breathable and sweat-wicking. As we live in Ireland it rains or is extremely windy most of the time. So running jackets, base layers and running tights can be your friends in the constant battle against the weather.

Start where your fitness level is:

If you haven’t ran in years or done any cardiovascular exercises you cannot expect to go out and run 30 minutes straight without needing a rest. To get around this start off by alternating running with walking throughout the run (a minute of walking followed by a minute of running). Another way is to just take short breaks when you need it on the run. So if you are starting off, start with the run/walk method – go slowly and don’t run more than 3 times a week. This way you’ll gradually build your pace and distance and prevent injury.

Always warm up, cool down and stretch:

Before every run you should do some dynamic stretches such as rolling your shoulders back, hip circles, lunges and squats. The dynamic stretch should be followed by five minutes of a slow jog. The warm up and dynamic stretches are done to get every muscle in the body ready for the run and to prevent injury. After you run jog slowly for 5 minutes and finish with some static stretching which you hold for 30 seconds (Quad, Hamstring and Calf stretch).

Running, Stretching, Physio, Physiotherapy

10 percent rule:

As you start progressing on with your running and feeling good, it is important not to over do it. That is why there is a 10 percent rule where you are not meant to increase your weekly training mileage by more than 10 percent per week. People who increase their weekly mileage too quickly get injured. The only exception to the 10 percent rule is if you are starting at a single-digit weekly mileage after a layoff, you can add more than 10 percent per week until you’re close to your normal training load.

The Conversation Rule:

Running is not all about going as fast as you can all the time. Especially on easy runs you should be able to have a full conversation with the person you are running with. People whose heart rate and breathing rates were within their target aerobic zones were found to be able to hold full conversations. Those who couldn’t were running faster than their target aerobic zone. The exceptions to the conversation rule are during hard runs, speedwork or races.

The Hard / Easy day rule:

It states to take one easy day after every hard day of training. An easy day is defined as a short run, slow run, a cross training day or no exercise at all. A hard day is defined as a long run, tempo run or speed workout. Apply The hard/easy day rule to your monthly and yearly training plans by treating yourself to one easy week each month and one easy month each year. The exception to this rule is after the most tiring long runs or speed workouts especially if you are older. You should wait for two or three days before your next hard workout.

Don’t delay refuelling after runs:

Making sure you refuel properly after a run is probably more important than the run itself.  Especially if you have done a fast run. Your post run meal is very important because it will aid recovery.  It is recommended that the post run meal contains carbohydrates for energy replacement and a good source of protein for muscle repair as soon as possible. After a run it is important to have that post run meal within the hour of running. For quick energy before having the post run meal have a banana while cooling down and doing your stretches. As it is quick and easy to eat.

Listen to your body:

If something hurts for two days in a row take days off. Two days of pain may be signalling the beginning of an injury. If the pain continues for over a week even with rest days it is probably time to go see your doctor. It’s the same if your body is feeling tired, there is nothing wrong with taking a day or two off to let the body recover from the exertions of exercise. Even if you have to take a week off from running it is not going to have a big impact on your fitness level.

Track every run so you can see your progress and make notes about your workouts:

Apps like Strava and MapMyRun use GPS to automatically store your route, distance, calories burned and your pace so you’ll watch yourself run further and faster over time. These apps also allow you to enter notes about each run so you can see patterns like that the first mile I always feel terrible (going too fast at the start) or you run faster when go first thing in the morning or that you get a pain in your right leg after 3 miles. The apps are also good because you can set up groups with your friends and challenge each other to see who has the most miles in a week .So this adds some healthy competition.

Exercise, Health, Brain, Fitness, Rathmines, Physio

Exercise to keep your Brain calm

Exercise can help your brain slow down….Which is a really good thing!

The quality of blood flowing to and through the brain is affected by exercise. Is your head in a tizzy?? Exercise can actually slow down the speed with which neurons fire in the brain.

This is a good thing! We all need to slow down a bit. Most people reluctantly enjoyed the recent ‘snow holiday’ as we were forced to switch off and relax for a couple of days. Exercise can have a similarly calming effect. When we unplug devices, meditate or walk by the sea, our brain naturally produces good ingredients. Exercise similarly produces a fertile soil for the brain.

Exercise. Brain

Benefits for the Brain

Exercise will stimulate your memory, situated in the hippocampus area. Your capacity to concentrate will improve. It will reduce your mental stress levels due to effective management of the stress hormone – cortisol. In the same way exercise helps reduce the risk of cardiovascular disease, it also reduces the risk of any cognitive decline – such as dementia or Alzheimer’s.

How?

Everybody talks about the physical benefits of exercise. The word cardiovascular is synonymous with fitness and heart health. Neurovascular is far less commonly used but is equal in importance when we consider exercise.

Neurovascular applies specifically to the blood flow in the brain. When we exercise we oxygenate the brain’s blood vessels with healthy red blood cells. With greater oxygen to the brain we are calmer, more alert, less impulsive and generally better decision makers. This is so valuable in the modern day pressures of work/life/family demands.

Toothpaste for ‘Brain Plaque’

When I wash my teeth in the mornings I put toothpaste on the brush and fire away. The brushing motion along with the toothpaste itself combats the buildup of plaque on our teeth. The brain produces plaque as we get older too. One of the best ways to replicate the toothpaste analogy for our brain is to exercise. The healthy blood flow derived from exercise can help combat the growth of brain plaque. One of the other most important ways to reduce growth of plaque in the brain is to be sociable! And laughter produces feel good hormones too!

So, get out and meet some new people, or connect with an old friend! Go for a walk and have some fun. You are doing yourself and your brain a big favour.

Getting Back to Exercise After Having a Baby – Women’s Health Physiotherapy

 Tips for getting back to exercise After Having a Baby – Women’s Health Physiotherapy

  • After pregnancy and labour women can neglect themselves as they can become consumed by the amazing yet chaotic word of a newborn baby. 
  • Juggling it all can be tough, most of the time something has to give and this tends to be time for yourself that is sacrificed.
  • Firstly don’t be too tough on your self, give your body time to heal. A woman’s body is amazing and you should be proud if it.  Growing and nurturing a baby is no easy feat!
  • My advice would be getting strong and mobile the right way, from inside out!
  • Remember that
    many of the physiological and morphological changes of pregnancy persist for four to six weeks after having your baby.
  • Thus, exercise routines should be resumed only gradually after pregnancy and should be individualized.  Physical activity can thus be resumed as soon as physically and medically safe.
  • This will certainly vary from one woman to another, with some being capable of engaging in an exercise routine earlier than others.

1. Rest

It is very important to rest to help with your recovery.

Rest on your back or side to

  • Minimize discomfort,
  • Reduce swelling
  • Take extra weight off your pelvic floor and lower abdominal muscles.

2. Pelvic Floor Exercises

  • Pelvic Floor Exercises can be safely started 1-2 days following the delivery of your baby, provided there is no increase in your pain.
  • Deep Abdominal and Pelvic Floor exercises help you return to your pre-pregnancy shape and will help with healing of stitches

Exercises to strengthen your Pelvic Floor

It is important for all women before and after birth whether they have a vaginal or cesarean delivery to strengthen their pelvic floor muscles.

1. Long Hold:

  • Lie on your back with your knees bent and your feet supported but apart.
  • Squeeze and lift around all 3 openings in your pelvic
    floor. These being your back passage vagina and bladder. Like you are
    trying to stop yourself passing wind and urine.
  • Hold for 6-10 seconds, keep your abdominal, buttock and
    thigh muscles relaxed and continue to breathe
    normally.
  • Relax for 3 seconds.
  • Repeat this exercise another 5 times
  • Repeat 3 times a day.
  • As your pelvic floor muscles get stronger, practice in
    sitting and standing.
  • Gradually increase the hold time and number of repetitions until you can do a 10 second hold 10 times.

Remember…Always stop exercising when the muscle fatigues.

2. Quick holds

  • Tighten the pelvic floor muscles as above but only hold for a second before letting go fully.
  • Repeat 5 times in a row.
  • Repeat 3 times a day.
  • Gradually increase your repetitions until you can do 20
    quick squeezes in a row, it may take a few months to be able to do this.

3. Deep Abdominal Muscle Exercise

During pregnancy, as your baby grows, your abdominal muscles stretch and become weakened.

Abdominal muscles are important for back support and in maintaining good posture.

Deep Abdominal Activation

  • Lie on your back with your knees bent and feet supported and hip distance apart.
  • Breathe in, let your tummy rise.  Breathe out; gently tighten your lower abdominal
    muscles (by 20%) by pulling your lower belly in towards your
    spine (as if getting into tight trousers).
  • Keep your upper abdominal muscles relaxed
    throughout the exercise and breathe normally
  • Hold the position for 3 seconds. Repeat 5 times, 3
    times a day.
  • As you get stronger do the exercise in sitting, all fours
    and standing and gradually increase the hold time up to 60 seconds.
  • Women who have undergone a caesarian section should follow all the above advice. However, because you have had an abdominal operation you may be more tired; do not expect too much too soon. You need to wait longer before engaging in more challenging exercises, always seek advice from your medical practitioner. There are several layers of stitches in your lower abdomen that will take time to heal so increase your activities gradually as you feel able.

4. Return to Exercise

At 6 weeks postnatal start gentle exercises:

  • Walking as pain/discomfort allows, gradually increase your distance then your speed.

  

  • Swimming when you have had 7 days in a row free from vaginal bleeding or discharge.
  • Join a Post Natal Pilates or Yoga class and progress the strengthening of your deep muscle system in a supervised, safe and guided environment. 

5. High Impact Exercise (e. g weights, jumping, running)

  • At 3-4 months post natal you should check your pelvic floor strength by; coughing with a full bladder or jumping with a full bladder before attempting high impact exercises.
  • Only begin if there is no urine leakage.
  • If you have leakage, Book an Appointment with a Women’s Health Physiotherapist for an Assessment and individualised Exercise programme.

6. Lastly Exercise should be enjoyed and help relieve stress not add to it! So choose exercise that you like and always listen to your body.

How can PH help?

Book appointment with our women’s health physiotherapist Mary-Kate to get a thorough pelvic floor assessment and specifically tailored exercise programme.

Pre and postnatal Pilates and yoga

Dietitian, Dublin 6, Caoimhe McDonald

Take control of your IBS don’t let it control you – By Caoimhe Mc Donald

Dietitian, Dublin 6, Caoimhe McDonald

“Take control of your IBS don’t let it control you”   

Irritable bowel syndrome (IBS) is a chronic and relapsing bowel disorder. It affects up to 20% of adults and adolescents as well as children. It is 1.5 times more common in women than in men.  Symptoms include:

Dietitian, Dublin 6, Caoimhe McDonald

  • abdominal pain
  • bloating
  • constipation
  • diarrhoea
  • flatulence
  • poor appetite
  • indigestion

It is important to note that many conditions have symptoms that can mimic IBS. Inflammatory bowel disease, coeliac disease and microscopic colitis are a few. It is important that the diagnosis of IBS has been carried out, coeliac disease has been ruled-out and alarm features are absent.

Many people have had symptoms of IBS all their lives and done nothing about it. It is so often put down to having “a sensitive tummy”. As a Dietitian, I would estimate 60 – 70% of my patients suffer with IBS. It is very common for people to come to a dietitian for a different reason and drop it into conversation when discussing their diet. People wonder how it has become so much more common these days. However, when asked about their family history many report one or both of their parents have avoided a food for years as it “doesn’t agree with them”. 

Irritable Bowel, Dietitian, Rathmines

The truth is, more people feel comfortable discussing their digestive health and doing something about it. People live busy lives that can often be stressful and many are now more conscious of their diet and looking after their health. I have seen patients with such severe symptoms it has a huge impact on their quality of life. They are unable to attend work, they fear getting public transport, avoid social activities or not sleeping at night as a result. Why live with something like this when symptoms can be managed effectively?

Multifactorial

The exact cause of IBS is not known and it is thought to be multifactorial. Suggested causes may be; a previous gastrointestinal infection, prolonged antibiotic use, stress, medication, alcohol, poor diet and lifestyle factors. Two thirds of IBS patients perceive their symptoms are related to food. Symptoms can come and go and may be exacerbated in stressful situations which can make it difficult to identify the exact triggers.

So how do people go about managing their symptoms of IBS?

Dietitian, Dublin 6, Caoimhe McDonald

  • Medical management using anti-diarrhoeals, anti-spasmodics, laxatives or low dose antidepressants
  • Self-help – 7% treat themselves with no medical supervision
  • Herbal remedies
  • Psychological guidance
  • Probiotics
  • Lifestyle changes
  • Dietary guidance

Diet assessment and adjustment by a qualified dietitian is so important in the management of IBS. Many patients prefer dietary management rather than a reliance on medication. As a dietitian specialising in digestive health, it is very rewarding to see a patients’ symptoms improve. With guidance on diet, meal pattern, lifestyle factors and stress management, people will notice improvements. Some may immediately feel better after increasing fibre in the diet, increasing fluid and introducing exercise. Others may find eliminating certain foods beneficial or the use of a probiotic.

FODMAP Diet

There is a growing interest in restriction of short chain fermentable carbohydrates called FODMAPs (fermentable, oligosaccharides, disaccharides, mono-saccharides and polyols….a mouthful I know!) for IBS management. The low FODMAP diet is an exclusion diet specifically for patients with IBS which has been supported by 30 clinical studies. Research has shown that limiting these foods (high in FODMAPS) can alleviate the symptoms associated with IBS.  The low FODMAP diet should be done under the supervision of a dietitian as exclusion diets are at risk of nutritional inadequacy.

If you feel you could benefit from seeing a dietitian in relation to digestive health or any other dietary issue contact Caoimhe McDonald at Personal Health. Caoimhe has worked with patients with IBS for years and can help you identify the triggers for your IBS. Caoimhe will provide meal suggestions, recipes and shopping lists to make sure your diet is still balanced and you are getting all the nutrients you need.

In Conclusion, diet is not always the cause. It can be just one contributing factor to IBS. For many, stress management may be the best solution. Contact the Personal Health team to make an appointment with Consultant Dietitian Caoimhe McDonald or Psychotherapist Susan Duffy on 01 4964002.

Football, Physio, sport, Physiotherapy, Fitness

Will Jonathan Walters be fit for Saturday ? by Ronan Fallon

Well is he going to be fit to continue?

Last night’s match in Paris saw the boys in green put in a great performance on the European stage. It’s fair to say that we could have easily taken all three points. Unfortunately, this result did have an impact on Jonathan Walters.

It is well known that he has been struggling with an Achilles tendon problem for the last few weeks. The Achilles tendon is the common tendon from the calf muscles into the heel bone.
It is a notoriously tricky problem for anyone from an international footballer to a mid-week 5-a-side social footballer or tag rugby player. As such, it was not a good sign that Jonathan Walters reported last night that he was struggling with this issue from the very first minute!

Achilles tendon
As you can see from the image, pretty much all activity on the football pitch requires load to go from the calf muscle and through your Achilles tendon. This allows the athlete to propel forward to run & jump.

 

MANAGEMENT

Chartered Physiotherapy Dublin 6

Decisions Decisions…..

There is no doubt that the Irish medical team are using all of the resources at their disposal in an effort to get Jonathan fit for Saturday. This is a very quick turnaround for an injured achilles such as this one.
I suspect that they will be using a battery of treatments including anti-inflammatories, Icing, Soft tissue for the calf muscles and most importantly rest.
The crucial component in this management strategy is controlling loading. Thai is the weight that he takes through that inflamed tendon. He should be on crutches for 48 hours. This would allow the Achilles to recover without the stress of his bodyweight on every step.

Medical Team

This is a tricky conundrum for the medical team today. How long can they afford to rest Jonathan from team training in preparation for the Belgium match? Martin O’Neill and his team will have  already discussed this and may have even made a decision on ruling him out.
It’s very difficult to see how Jonathan Walters will be fit for Saturday. An MRI scan will show the true extent of the damage. As a result all we can work off are the soundbites from Management and player alike.

In conclusion, we’re all hoping for a speedy recovery and that his removal from the game early might just give him a chance for the big game on Saturday.

COYBIG !

Ronan

Mobility, Flexibility, fitness, movement, health

The Pursuit of Flexibility

As the years go by, the pursuit of flexibility can be a wistful bygone goal. In reality we stiffen up a fair bit as time flies. So, what seemed to be regular flexible movement at one stage, now seems difficult to attain. Why do I groan all of a sudden when I’m standing up from a chair ???

Let’s be kind to ourselves here – mobility and flexibility are often impossible due to our lifestyle demands. Similarly, if we do find some free time, is stretching a priority? It seems so boring… Perhaps not?

Well, there is a lot more to flexibility than static muscle stretching…. A lot more!

And best of all, it can genuinely provide relief, positively affecting your mood.

 

Be kind to each other

Many components affect our flexibility including:

Joint Capsule
Muscle
Ligaments
Tendons
Nerves

I am going to focus on joint stiffness in the thoracic (mid) spine as this is a common presentation across office workers. It is also equally common in multiple sports including cycling, rowing, boxing, wrestling and hockey.  Here is why…

The thoracic spine is the area of our spine located between your neck and low back. Thoracic mobility is important for optimal movement. The mobility of spinal joints and their surrounding capsules adapt depending on the activities performed. Multiple sports require the athlete to move with their arms positioned in front of their body, this positional demands often result in the shoulders sitting forward and a round upper back consequently increasing the risk of developing stiffness in this area.

As the mobility of the thoracic spine affects the function of the shoulders, neck and low back, it is strongly recommended to spend time ensuring your thoracic mobility is being maintained. It is all about balance.

IMG_2129
The more time you spend sitting at your desk, or training, then the more time you need to invest in maintaining your mobility and flexibility. To prevent long-term changes the idea is to position your body in the opposite positions from what you train or work in. For most people this will involve mobilising your upper back in extension and in combined extension and rotation. In other words, straightening your spine.

Over the past years I have found the following thoracic mobility exercises to be highly effective in maintaining and restoring thoracic movement:

1.Thoracic extension on foam roller:

Stretches the pectoral muscles and forces extension in the upper back. Ensure your low back is flattened on the roller for most efficiency. Hold for 30 seconds. Repeat 2-3 times. You can alter the position of your arms between 90 degrees and 120 degrees to bias different areas of your upper back. See image below.

IMG_3255 (1)

 

2. Segmental flexion and extension over the foam roller:

Place fingers on temples to promote thoracic extension. Position the foam roller horizontally and roll along your upper back. Stop at the segments which feel more uncomfortable and stiff. To bias the mobility at these segments, slowly extend over the roller towards the ground. Support your lower back whilst doing this by tucking your bum in. See pictures below as the athlete moves from thoracic flexion into segmental extension.

IMG_3256 IMG_3257

 

 

 

 

3. Bows and Arrows:

Position yourself in side-lying so that shoulders and hips are in line. Bend your knees so that your hips and knees are in line (this offloads your low back ensuring the movement is coming form your upper back). Outstretch both arms. Reach the top hand past the bottom hand and then pull backwards as though drawing the arrow on a bow. In this drawing back motion, aim to have the top shoulder facing up towards the ceiling. This is a slow and controlled movement and aim for 10 repetitions 2-3 times on each side. See the images below.

IMG_3258

IMG_3259

4. Shaking it all out:

Finally, if all else fails….Try loosely and gently relaxing your stomach, if you have ‘a belly’ (everybody does by the way) let it real and hang over your belt. Then gently allow some light  shaking through all the main joints, neck, shoulder, spine, hips, knees, ankles and feet. Just like the way Diego Maradona used to warm up for football games…..

 

 

Tag a friend if you feel this article is relevant to them, or that co-worker who constantly complain of upper back stiffness! If you have any further questions or queries regarding thoracic mobility or wish to purchase a foam roller contact us at Personal Health on 01 4964002 or email info@personalhealth.ie.

Physio, Golf, Tennis, Physiotherapy, Fitness, Exercise

Tennis Elbow, Golfers Elbow or both – the dreaded Country club!!

Tennis Elbow, Golfers Elbow or both – the dreaded Country club!! 

country club

 

I’m regularly asked about both Golfers & Tennis elbow in the clinic. Generally they are a large portion of the non-contact elbow injuries that patients develop. Commonly, it’s a term that people have heard of but are not quite sure what it actually is! Golf or tennis may not be on your list of hobbies to be struck down!

A tennis elbow is an irritation of the tendon on the outside or lateral part of the elbow whilst a golfer’s elbow is an irritation of the tendon on the inside or medial part of the elbow.

If you are unlucky enough to develop both, you become a member of the “Country Club!”

 

Golfers-vs-Tennis-Elbow

 

Basically, the majority of the muscles in our forearms anchor to either the inside or outside of the elbow via a shared tendon. When we overload these tendons from things such as hitting 200 golf balls off a rubber mat or deciding to tackle painting the house in one swoop, we can cause a painful episode in these tendons.

It’s a very common problem. I always like to take people through the anatomy of the issue. Understanding is the key to settling this problem down. We are fortunate to have some state  of the art anatomy tools to facilitate this in the Personal Health clinic.

 

image_Blue_elbow-pain

 

Acute or Long-Standing Issue

The next question is whether it is an acute flare up or a long standing grumbling issue? This largely dictates the management and treatment. Conservative management with appropriate exercise, soft tissue work and de-loading of the tendon resolve this issue in the majority of cases. Surgery and injections are thankfully relatively rare.

 

 

 

Call us to find out more.

Phone: 01 496 4002

Email: info@personalhealth.ie

Website: www.persoanlhealth.ie