Pain

Pain on Inside of Knee? Get To Know Your VMO

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If you’ve ever had a nagging pain on the inside of your knee or a knee that seems to buckle or give way, there is a fair chance you’ve had some dysfunction in the VMO muscle.

VMO dysfunction is very common in runners, hikers, cyclists, athletes involved in jumping sports and after any knee injury.

In this short blog, we’ll find out more about how issues develop in the VMO and what you can do to help.

WHAT IS THE VMO MUSCLE?

VMO stands for Vastus Medialis Oblique and this is part of the quads, running along the inside of the thigh, with the bulk of the muscle sitting directly above the inside of the knee.

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FUNCTION:

The role of the VMO is to assist with extending your knee and arguably the most responsible muscle for knee stability, as it helps control the alignment of the knee-cap.

When the VMO isn’t functionally optimally, the knee cap tends to shift slightly out of place during movements such as squats and lunges, causing pain and inflammation behind the knee-cap.

SYMPTOMS:

When the quads get overloaded (suddenly or over time), tightness in the muscle fibres (called trigger points) can refer a toothache-like pain deep in the knee joint (see Figure 1 below).

This pain from the overloaded VMO muscle can often be confused with joint pain such osteo-arthritis or a meniscus tear, as the location and type of pain are often similar.

Figure 1

Figure 1

The initial knee pain then may disappear after a few weeks, only to be replaced by a sudden weakness in the knee (a condition called “buckling knee”) that causes a person to unexpectedly fall while walking.

HOW THE VMO BECOMES OVERLOADED:

The VMO can be activated as a protective response to knee injury such as to the ligaments, meniscus or post-surgery.

The VMO is also commonly overloaded with repeated use in the following situations:

  • suddenly increasing your volume of running or cycling (running places around 6 x body weight through the quads)

  • a new (or sudden increase) in an exercise program involving repetitive squats, lunges, leg extensions or wall sits

  • jumping sports e.g. basketball

  • cycling - poor bike fit

  • walking downhill or stairs

  • being over-zealous in rehabbing the VMO - too much strengthening too soon

TREATMENT:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your VMO issue.

“Short term treatment such as soft tissue massage and dry needling is very helpful, while long term building capacity in the quads, glutes and core is critical to prevent a relapse.

 

TRIGGER POINT DRY NEEDLING:

Tightness and contraction of the VMO responds very well to dry needling, which can de-activate the trigger points (knots in the muscle).

The benefit of dry needling is that it can reach the deep fibers of the muscle and lead to a quicker resolution of symptoms. 

Treatment of the VMO is generally very responsive to treatment, provided the contributing factors are addressed.

SELF-CARE TIPS:

  • apply heat to the VMO muscle 10 minutes each day to increase blood flow and reduce tension

  • if you’re a runner or hiker, avoid the hills (in the short-term)

  • ensure your shoes are not overly worn

  • when running - avoid over-striding, ensure proper warm up and cool down and take walking breaks frequently to avoid overloading the VMO

  • avoid prolonged kneeling on the floor e.g. gardening, washing floors - use a low bench or stool to sit on instead

  • foam roll the VMO daily for a few minutes (see below). It’s also a good idea to roll out the adductors which are also commonly tight

Foam Roller for the VMO:

Foam rolling the inner quad and adductor - fun times!

Foam rolling the inner quad and adductor - fun times!

Questions or concerns about your knee pain?

If you are curious about how we can help with our knee pain, I’d love to help you out.

Please leave a comment below or send an email direct to dan@kinfolkwellness.com.au

If you’d like to get your knee on the fast track straight away, please use the button below to schedule an appointment online:


The Obstacle Is The Way

This blog post was inspired by Ryan Holiday’s book, The Obstacle Is The Way, which describes how employing the philosophy of Stoicism can turn our ‘trials into triumphs’.

This book got me thinking about how we approach issues such as sporting injuries, chronic pain and loss of function that we see in the clinic.

Obstacles such as chronic pain are becoming more prevalent in Australia, with one in five adults reporting they suffer with moderate to severe pain everyday.

It is clear, as a rehab community, we are collectively not doing a great job at helping.

The longer I work as a physio, the more I see how the right mindset and beliefs are a key factor in recovery.

Reading more about the Stoic philosophy, I could see how my values as a health care practitioner aligned closely with with this approach.

The average person has about 50,000 thoughts per day, and for someone who is in chronic pain, you could imagine a large percentage of those thoughts could be centered around these three questions:

  • what is going on?

  • how is this going to get better?

  • when is this going to get better?

When they experience injuries, it’s common for athlete’s (even weekend warriors) to feel anxious and depressed.

One study of 343 male college athletes found that 51 percent had some symptoms of depression after being injured.

Addressing beliefs and attitudes early on can provide the foundation to a successful return to full function.

Downward Spiral Of Injury

We know that a previous injury is the biggest risk factor for another injury.

And that means as a rehab community, we have some work to go in terms of educating and providing injured people a comprehensive rehabilitation program in order to prevent compensations and further issues.

Without inadequate rehab, a downward spiral of pain and injury can develop, eventually leading to burnout.

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Stoicism - a little background

Getting back on topic!

Stoic philosophy was founded in Athens in the early 3rd century BC, and was practiced by the likes of Epictetus, Seneca and Marcus Aurelius.

Ryan Holiday writes specifically of being inspired by Marcus Aurelius, whose quote inspired the book:

“The impediment to action advances action.

What stands in the way becomes the way.”


Marcus Aurelius, as well as being one of the most successful Roman Emperors, had his own private struggles with chronic pain in the chest and stomach.

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His personal notes practicing Stoic philosophy, The Meditations, refers many times to psychological strategies for coping with pain and illness.

His physical resilience and endurance was remarkable, despite not having ideal physical health he was to become one of the most respected emperors in Roman history.



Mindset Shift

One of the biggest lessons taught by the Stoics was to re-conceptualise your obstacles from something to avoid to something to welcome, as a means of growing stronger and more resilient.

Obstacles give you important clues as to where you may have some ‘weak links’ and provides an opportunity to turn them into strengths.

Following a Stoic philosophy involves re-wiring your thinking, shifting from negative emotions such as from worry, anger and frustration to calmness, gratitude and hope.

To be clear, negative emotions can be healthy and natural.

But at some point, they become more of a hindrance to your forward progress.

With the right plan in place, and plenty of patience, grit and perseverance according to leading sports scientist Tim Gabbett, you can turn yourself into an unbreakable athlete. 

“It is a rough road that leads to the heights of greatness” - Seneca

“It is a rough road that leads to the heights of greatness” - Seneca

Short Term Pain Coping Strategies

Of course if your only goal is to avoid pain, there are some strategies that can bring about some fast relief.

Using pain-relieving medication has it’s time and place.

But unfortunately we’ve seen the long term consequences of opioid medications (e.g. tramadol, oxycontin and codeine) that can sometimes lead to addiction and other serious side effects.

And we now know from the research that these drugs create a long-term increased pain sensitivity, making your pain levels greater than before you started taking them.

The other problem is once you come off the medications, you haven’t any had an opportunity to learn from your pain and injuries, so you essentially need to start all over again.


Instead of relying on pain medications, here’s eight practical strategies, inspired by the Stoic Philosophers, over 2000 years ago, to help you overcome your pain and live the best life you possibly can:

  1. Accept Pain And Injuries 100%

The Stoic philosophers were big on understanding the rhythms of nature.

Just like stormy weather, it would unwise and naive to believe you would never have a pain or flare-up in your body.

No one gets out of life without serious challenges along the way and no one is immune to experiencing pain.

However, the difference lies in how we perceive and respond to it.

A real life example world would be to consider how a sailing boat gets from point A to point B if there is a direct headwind blowing in their direction?

Would the sailor just give up and think it’s not worth the hassle?

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The experienced sailor would no doubt accept that unfavourable winds are going to happen some of the time - that is a normal part of life, and they wouldn’t get overly emotional when it occurs.

For the sailor who is committed to reaching point B, the solution, is to change tack.

If the boat turns onto a 45 degree angle, then the sails are able to pick up the wind and use it to the boats advantage.

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Progress is no doubt slow and frustrating, but it is still forward momentum and getting you closer towards your goal.

When the winds eventually turn favourably, you would have built up a decent reserve of resilience and capacity.

Bottom line: there is a season for pain and it is a normal and inevitable part of life.

Keep breathing, batten down the hatches if necessary.

The storm will pass.

2. Let Go Of Your Fight Against Pain

Following on from the first point, counter-intuitively, to overcome your pain, you must be at peace with your pain and fully accept it.

The struggle, the fight and the mental battle against your pain only ends up wasting precious energy and resources, that could otherwise be better spent.

Being trapped in a state of resistance and anxiety leads to your body into a fight or flight mode where your muscles are held in a constant state of tension.

This can lead to even more problems than your initial injury.

Common muscles that are involved in the fight / flight response are:

  • neck / trapezius

  • hip flexors

  • lower back

  • TMJ jaw

  • shoulders

Once you can find acceptance, a significant burden is literally lifted from your shoulders.

With the guidance of a health care professional, it’s important to let go of your anxiety and find a place inside that is relaxed.

“Sometimes, your only way out of the pain is through the pain”


3. Imagine The Worst Case Scenario

The Stoics proposed, rather than avoiding the pain, we must accept it and then confront it.

Once you are feeling more relaxed and in control of your emotions, Stoicism actually encourages you to imagine the worst case scenario in terms of your pain experience.

If you could courageously come to terms with the worst case scenario - and see how, while it would be difficult, you would definitely still be able to cope.

Practicing this exercise mindfully can help reduce the fear around pain, injury and loss of function, knowing that you will be able to manage, no matter how bad things get.

4. Good vs Bad?

Injuries can often be thought of as ‘bad’.

But are they really?

This reminds me a of a story about a farmer.

One day his horse runs away. And his neighbor comes over and says, to commiserate, “I’m so sorry about your horse.” And the farmer says “Who Knows What’s Good or Bad?”. The neighbor is confused because this is clearly terrible. The horse is the most valuable thing he owns.

But the horse comes back the next day and he brings with him 12 feral horses. The neighbor comes back over to celebrate, “Congratulations on your great fortune!” And the farmer replies again: “Who Knows What’s Good or Bad?”

And the next day the farmer’s son is taming one of the wild horses and he’s thrown and breaks his leg. The neighbor comes back over, “I’m so sorry about your son.” The farmer repeats: “Who Knows What’s Good or Bad?”

Sure enough, the next day the army comes through their village and is conscripting able-bodied young men to go and fight in war, but the son is spared because of his broken leg.

And this story can go on and on like that. Good. Bad. Who knows?

Be at peace with your path and have faith that everything happens for a reason.

There is no good or bad to the practicing Stoic, there is only perception.


5. Switch From Goal Oriented To Process Oriented

While you can learn the principles of Stoicism, the philosophy is actually one of action.

A Stoic needs to focus his attention on action in the present moment of time because neither the past nor the future can be changed.

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Being process orientated, you start to focus on all of the small daily things you need to do that all add up to produce the end result.

Come back to the present moment.

That is where the power is to change your life for the better.

Take the focus off being pain-free and instead put your focus on the process.

What are the small daily tasks you need to do to become pain free?

“Luck is what happens when preparation meets opportunity.” ― Seneca


6. Understand Your Pain

“We are more often frightened than hurt; and we suffer more in imagination than in reality.” Seneca

There is no doubt that ongoing pain that is unexplained can be frightening.

With the help of your Physio and Doctor, if you can understand that some degree of pain is a normal part of the healing process, you can relax in that knowledge.

It’s important to realise that whatever pain you experience should be related to a certain physiological process.

For example:

Ankle sprain —> inflammation around the ligament, you can expect some soreness for 4-6 weeks

Lower Back pain —> occasional flare-ups, especially if sitting too long. Disc injury takes around 3 months to heal

Tendon degeneration —> worst in the morning and with sudden changes in training volume, hills or speed work

Knee - patello-femoral syndrome —> (pain in front of the knee cap) take on average 3 months to get better and pain relates to irritation behind the knee cap and gets worse with squats, kneeling and stairs

Nerve related irritation or damage —> could be many months or years of altered sensation in the affected area

Muscle pain —> the most common source of musculo-skeletal pain - lack of oxygen to the muscle from poor posture, excess muscle tightness or injury.

Chronic pain (more than 6 months) —> relates to increased sensitivity in the nervous system which magnifies minor tissue problems. It may come down to the fact, that we all have wear and tear and issues in our body, for whatever reason, the body and nervous system has decided to heavily focus on that particular area.

If there is ongoing pain and you are not sure why, then you may need to talk to your health care provider in more detail.

7. Develop A Growth Mindset

Stoic philosophy has a lot in common with the Growth Mindset approach, developed by Carol Dweck.

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According to this approach, the most important word in the dictionary is ‘yet’.

Re-frame your challenges…

“I haven’t completed the marathon…yet”

“I haven’t felt strong and pain-free in my lower back…yet”

“I’m not sure what it feels like to walk without pain…yet”


8. Train Your Mind To Endure Pain And Discomfort

It takes practice to exhibit self-control with our perceptions of life’s obstacles.

You can practice - the next time your stub your toe or get a paper cut.

Pause for a moment and see if you can absorb the sensation of discomfort - without reacting to it.

One of the great things about exercise is that it is a form of discipline where you willingly put yourself in a position of discomfort for a period of time, with the hope that you will come out the other side better off physically or more importantly mentally afterwards.

As you practice pushing yourself to the threshold, you will build a reserve of willpower to draw from as necessary, creating a “Inner Citadel” of strength and resilience.

For me personally, that is one of the reasons I enjoy the process of running so much.

Every time I go for a run, I know I will confront the pain of a body wanting to stop.

To achieve any sort of reasonable time, you need to learn to listen to your bodies pain, but constantly re-directing your attention and keep pushing to achieve your goal.

“Faced with pain, you will discover the power of endurance” - Epictetus


Conclusion

Pain and injuries are never easy.

But with the right attitude, they can be an valuable internal guide to making you better and stronger than before.

What seem like insurmountable obstacles become once in a lifetime opportunities.

If you’d like to find out more about Stoic philosophy, I’d highly recommend you check out the book, The Obstacle Is The Way.

Now it’s over to you,

What’s the biggest obstacle you’ve faced? What benefits were you able to derive from it?

I’d love to hear your thoughts in the comments section below.

Increasing Motivation For Exercise

Completing a personalised exercise program is a critical part of getting the best outcome from your Physiotherapy treatment program.

At your Initial Assessment, we perform a thorough movement screening, and thoughtfully design a program to help you re-build your foundation and address the underlying root cause of your symptoms.

Ideally, you’ll find the exercises fun, interesting, challenging (and possibly even enjoyable).

The best results will involve us collaborating together to add / modify the exercises as we go.

With your feedback, we'll be able to fine-tune them so you are getting the most positive impact and making real progress towards your goal.

Realistically, it's natural to have trouble finding the motivation or time to get the exercises done (especially as you start to feel better), so here's:

3 tips to help improve your exercise adherence:

1. Keep in mind your purpose and your 'why'

Think about the types of activities that you want to be able to do again, pain-free.

Tell yourself, every set of exercises you do are getting you one step closer to reaching your goal.

'The journey of a thousand miles begins with one step'.

2. Set aside a regular time and place to do the exercises

Perhaps you could tie the exercises onto an already established daily routine such as after brushing your teeth, or straight after a walk/run).

Using the in-built reminder in the app can also really help.

3. Aim for 'progress not perfection'

We don't expect you to be 100% compliant with these exercises every day, (but we'll be incredibly impressed if you do!).

We've heard every excuse in the book about why you couldn't complete your exercises, so no need to aim for perfection, we all have days where other priorities must take precedence.

But remember that your health is important.

'Those who think they have no time for exercise will sooner or later have to find time for illness'.

Please let us know if you have any questions or concerns to help make your journey a good one.


The Power Of Plasticity - Helping You Move Better - Part 1

"We are all sculptors and painters.  Our material is our own flesh, blood and bones." - Henry David Thoreau

This post takes a look at why we move the way we do, and how we can tap into the 'Power Of Plasticity' to start moving (and feeling) well again.

Warning: This post is long.

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As the New Year ticks over, many of us find ourselves reflecting on our health and making some goals for the year ahead.

I can understand you may be reluctant to set a new years resolution.

But from the body’s view point, it desperately needs a goal to work towards.

It needs direction, positive growth, a challenge and a reason to get out of bed in the morning.

Your goal might be a run a marathon. Or it could be taking a challenging hike. Or spending the day in the garden.

Whatever it is, it should be something you enjoy and something that will motivate you to get you moving more often.

As soon as you become complacent about your body and your health, it can lead to a downward spiral of pain, injury and de-conditioning.

In modern day life with our attention being drawn into our devices, internet and netflix we can find ourselves completely out of touch with our bodies.

Months or years can easily slip by and all of a sudden we can find ourselves in a ‘movement rut’.

“Change is the only constant in life” - Heraclitus

Whether we are conscious of it or not, the body is always changing and adapting to the stresses we put it under.

From our bodies perspective you are either growing or stagnating.

There’s not much middle ground.

Plasticity: the adaptability of an organism to changes in its environment

That continual growth or stagnation that takes place is also known as plasticity.

As humans, we are highly adaptable and this can be a very positive thing.

The entire body is capable of plasticity

Professor Lorimer Mosely, from the University of South Australia, writes:

All our body systems respond to demand – in obvious ways such as:

  • growing muscle cells when we lift weights – myoplasticity

  • sweating more when we acclimatise – endoplasticity

  • learning to recognise a pathogen and eliminating it on next contact – immunoplasticity

  • increasing our heart-rate earlier on a hill after running up it a few times – cardioplasticity

  • adjusting the aperture of our pupil to improve our underwater vision – obiculoplasticity

  • the toughening of skin on well trodden heels – dermoplasticity.

In fact the body that you have today, is different is quite a bit different to the body you had a few days/weeks/years ago.

Regeneration Speeds Of The Human Body:

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“The body is a powerful healing machine” - Kelly Starrett

These info-graphs refer to how our body parts are under a constant state of repair and regeneration (plasticity).

I’m not sure about you, but I find this knowledge really empowering and inspiring.

If you are in a difficult place right now, keep the faith and stick it out.

“Everything will be okay in the end. If it's not okay, it's not the end”. - John Lennon

With the right guidance and plan in place, good times are ahead for you.

If you can harness the power of positive plasticity you can get stronger, more resilient and eventually become pain-free.

Movement and Neuro-plasticity

This blog post is mainly focused on the neurological and muscular plasticity that happens in the body in response to movement.

We will take a look at how the healthy brain-body system operates when it’s fully “connected,” and conversely, what happens when things become dysfunctional.

Body Maps In The Brain

In many ways, our understanding of the brain has only just begun.

One of the most exciting developments in the 20th century was the identification of ‘body-maps’ in the brain.

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The body maps refer to two of the principal areas in the brain involved in movement.

These include:


1. The Somato-Sensory Cortex - Encodes the representation of the entire body (i.e. body maps). Representational space correlates with how much a body part is used (i.e. use it or lose it)

2. The Motor Cortex - Generates conscious movement and stores subconscious movement patterns (i.e. muscle memory).

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Our Body Maps Are Plastic

Neuroscience research suggests our brains are ‘plastic’ meaning that areas change depending on the amount and quality of use. 

The more time and attention moving a certain body part, will result in a bigger representation of that area in the brain.

For example:

  • people who use braille have a larger finger representation in the brain than the average person

  • similarly guitar players will have a bigger hand representation in the brain

Body maps (and movement) comes to down to habits

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Imagine you’re heading down to Aldinga for a day trip, (which is a beautiful beach an hours drive south of Adelaide, that allows cars onto the sand).

You arrive at the beach and follow the ramp down, driving your car onto the beach.

As you drive along the sand, your car makes tracks in the sand.

You find a nice spot to park the car and get yourself set-up. After you’ve had a swim, you’re feeling refreshed…but then you realise you’ve forgotten to buy some snacks.

So you jump back in the car and as you start driving, you can see the tracks you’ve made earlier.

As the sand is harder under the tracks, it’s easier for your car to move along the same tracks and reduce the likelihood of you getting bogged.

Each time you make a trip along the beach, the tracks get a little deeper and it gets a little easier to drive because the sand gets a little firmer and the track is becoming more worn.

You automatically keep using the same track without even thinking about it.

Using the same track is very similar to what happens with our bodies - the car represents our bodies movement and the tracks represent the neural pathways in our brain.

As our brains begin to use this pathway more, it becomes second nature.

This process of re-wiring the brain and forming new connections is plasticity in action.

Essentially using the same habitual movement patterns over and over again without ever thinking about it.

To create new movement patterns is like carving out a new road.

If you’ve had pain for some time, your body goes into protective mode. Movement expression becomes limited and breaking out of this stereo-typed response is going to take considerable energy, effort and some serious intent.

In an ideal world…

In an ideal world, the brain has a perfectly sharp representation of the body and the brain/body have a variety of quality movement patterns (muscle memory) to handle the demands placed on it.

The body and mind are perfectly synchronised.

An example of this might be watching Roger Federer playing tennis or Eddy Betts playing AFL.

They make highly complex skills look easy and effortless.

Body maps change when you’re in pain

Initially, when you’ve injured yourself or are in pain, the body map representation of the involved area actually gets bigger.

This explains why you may feel an increase in pain sensitivity and mild pains can become magnified.

This is especially true if the body part is very important to you e.g. if you injured your finger if you’re a concert pianist or your knee if you’re a runner.

The Negative Side Of Plasticity - Smudging

Smudging refers to the reduced accuracy of the body maps in the brain that happens when you don’t use a particular area for a period of time.

Smudging can be caused by things like:

  • poor posture

  • ongoing pain

  • injury

  • inactivity

More about brain smudging with David Butler:

Smudging of the brain maps, otherwise known as the Homunculus, latin for ‘little person’ in your brain   Credit: Explain Pain (Butler & Mosely)

Smudging of the brain maps, otherwise known as the Homunculus, latin for ‘little person’ in your brain

Credit: Explain Pain (Butler & Mosely)

“Pain and body image are closely related” – Norman Doidge

Studies have shown now that smudging of the body maps is related to the severity of lower back pain.

For example if you have injured your spine and you feel intense pain and muscle spasms for a few weeks, naturally, you may limit the amount of movement you will do for your spine.

Over time, there is less sensory input from the spine to the brain.

With limited input, the brain hasn’t got an accurate sense of what’s happening in the body (smudging of the body maps) and starts to perceives this as a threatening situation.

This is an important point because the pain you feel may not be related exclusively to a structural issue.

The fact is many people have degeneration / wear and tear and have absolutely no pain at all (see the chart below).

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Pain, especially as it becomes more chronic, may be more related to changes in the nervous system (specifically the body maps in the brain).

The key point is that physical pain doesn’t necessarily have (only) physical causes.

Credit: Explain Pain (Butler & Mosely)

Credit: Explain Pain (Butler & Mosely)

Key Point: A very large part of the way we move, comes to down the accuracy of our body maps

A large body of evidence shows that pain and injury causes a change in activity in the regions of our brains that control movement.

This is true for things like:

Everyone has their own unique response to pain and injury and I can’t emphasize enough the importance of getting a personalised movement assessment to find our your own individual patterning.

The first step is becoming aware, and then you can go about re-wiring your neural pathways and re-building your movement foundation.

If you aren’t consciously creating your movement patterns, you are in default mode - where your environment creates and dictates your movement.

Re-building Movement Patterns

“The more richer, the more varied the possibilities of your movement landscapes, the powerful you are” - Michael Merzencich

Back to our person with lower back pain example mentioned earlier.

Through pain and fear of doing more damage, their movement repertoire has become limited.

This results in:

  1. A reduced ability to adapt to changes in their environment, leading to a higher chance of re-injury

  2. Overload of tissues in the movement patterns that the person feels safe in e.g. they may have been told to always ‘sit up straight’ and the posterior back muscles are in a constant state of tension and activity

The original injury most likely has healed and the person now is dealing with the consequences of the changed movement patterns.

For optimal long term health, gradually adding variability to your movement and posture is a critical skill to learn.

In the world or ergonomics, having a variety of movements trumps locking into a narrow and restricted definition of ‘good posture’.

Creating the right conditions and environment to learn new movement patterns and strategies is what we’ll spend more time discussing this in Part 2 of this blog.



Key Take Home Messages:

  • The key to tapping into your bodies potential is neuro-plasticity, the process of creating new neural pathways

  • Understanding neuro-plasticity is the most revolutionary discovery of neuroscience in the past century.

  • There is great hope for people with chronic pain if you can access the power of movement neuro-plasticity

  • “The relationship between pain and the state of the tissues becomes weaker as pain persists” - D Lorimer Mosely

  • Widening our treatment approach to integrate the research on neuro-plasticity may be the missing link in helping people with chronic pain conditions

In Part 2 of the blog, we’ll go into depth about how to optimise your lifestyle to enhance and encourage the benefits of movement neuro-plasticity.


5 Tips To Fast Track Your Heel Pain Recovery

Heel pain can be highly debilitating, not to mention extremely frustrating.

One of the main issues is that heel pain has many contributing factors.

Sometimes people only address one or two at a time and start to feel better, but the problem never really goes away completely.

To get your heel pain better you need to follow as many of the recovery guidelines (shown below) as possible for at least a month.

This may mean some changes to your lifestyle and you may need to make some room in your life to allow proper healing to take place.

5 Tips To Fast Track Your Heel Pain Recovery:

1. Update your footwear, including your running/exercise shoes and your work shoes immediately. Find the most comfortable and supportive shoe that suits your feet.

100% AVOID thongs, high heels and bare feet for a minimum of 3 months.

2. Stretch your calf muscles daily. Hold a gentle stretch for 1 min x 3 per day (dropping your heel over a step is a good option).

3. Reduce inflammation by using ice on your heel for 15 mins x 2 per day.

Either an ice pack with a velcro compression sleeve or you could also roll a frozen water bottle under your foot.

4. Tape your foot.

Use a simple rigid tape to pull from the outside of your foot, under the arch and up to the inside of the foot. Try a few pieces so at least half your foot is supported.

5. Gradually increase the walking you are doing each day.

Start with 10 mins and gradually build up to 30 mins everyday.

Monitor your time, distance and pain levels (during and the day after) by keeping a journal.

Maintaining a healthy weight is a key to getting better.

Bonus Tip:

Keep in mind the only evidenced based treatment to get both plantar fascia and achilles tendonitis issues better is a graded strengthening program. Start with these two:

- Strengthen the foot by doing daily foot 'scrunches'. Imagine you are picking up a towel with your foot - hold the position for 30 secs and repeat x 5. Aim to do this x 3 per day. A small amount of pain < 3/10 is OK.

- Strengthen your calves. After your daily walk, do 3 x 15 heel raises, lifting your body up onto your toes.

If you would like some more personalised advice on how to overcome your heel pain, we'd love to help you. It is a condition we see in the clinic everyday...and you don't have to put up with it!

After a thorough assessment, if you are a viable candidate for our program, we will map out a personalised plan to get you feeling (and staying!) better as soon as possible.

If you have any other questions…please contact us.