Wozniack's Secret Weapon

Australian Open Reflections 🇦🇺🎾 & Wozniacki's secret weapon!

The Australian Open Tennis Women's final was one of the best ever in terms of athletic ability, competitiveness and skill.

Caroline Wozniacki's game is build around running & her superior endurance set her up perfectly for a championship win.

It is good lesson for all of us - whether you play tennis, golf, footy or just trying to get through 'life' looking after the kids....in an ideal world, you want your physical capacity to meet (or ideally outstrip) the demands on your body.

There is no better way to 'solidify' your movement capacity than by running a half / full marathon, depending on your goals.

Let's look at the numbers more closely. In late 2014, Caroline ran the NYC marathon in a time of 3hr26.

The 2018 Australian Open women's final went for 2hr49 (and especially considering the heat), her superior aerobic endurance and capacity was a huge advantage for her.

We know that when you become fatigued, 2 things happen

• (1).  your form / skill level drops and
• (2). your chance of injury increases

If you can create a solid buffer of fitness supporting your game, the chances of you successfully going the distance increase dramatically.

In the words of sports scientist Tim Gabbett, "Train hard AND train smart".

Gradually building a decent aerobic foundation is PROTECTIVE against injuries, builds robustness and gives you a better chance of reaching your athletic potential.

Congratulations 🍾🎉 @carowozniacki #wozniacki #tennis #australianopen #resilientrunner #robustness #goingthedistance #capacity #endurance #enduro

TOP 10 STRETCHES FOR RUNNERS

Foam Roller Exercises For Swimmers

Swimming is without doubt one of the best things you can do for your body.  Water has a natural buoyancy that decompresses the joints and enables smooth, pain-free movement.  Swimming also improves core strength and is one of the safest ways to maintain your cardiovascular fitness.

However, that doesn’t mean it’s perfect.  

Like any other physical activity, repeated movement patterns over time can lead to muscle imbalances.  As a Physiotherapist working with swimmers, the most common area I see problems are in the neck, shoulders and upper back.  

In the clinic, I find myself repeating the same set of exercises to my patients, so I thought I’d write this blog post to share with you in the hope you can avoid future issues.  

The majority of swimming injuries are from overuse, relating to a gradual tightness that builds up over the years.  Once the muscles have developed significant restrictions in flexibility, pressure starts to build in the spine and shoulder joint.  

If you are consistent with your stretches and a few simple exercises, you can counter-act the typical muscle imbalances and stay pain-free in the water.  

The foam roller is without doubt the best way to maintain your tissue quality, improve flexibility and maintain your muscle balance.  Consistency is the key and the best time to do these exercises is straight after you swim.  

I'd love to get your feedback in the comments section & please let me know if you have any questions :-)

Thoracic Roll

Lift your hips up and keep your head supported with your hands. Roll the upper part of your back from the shoulder blades down to the lower ribs.  
Keep breathing and relax your jaw.  You should feel some nice releases in the joints here.  Avoid the neck and the lower back.  

Thoracic Arch

Drop your hips to the mat and arch the middle of the back over the roller.
Breathe in through the nose as you expand the diaphragm for three breaths.  Repeat at a few different levels, depending on where you feel tight.

Lats Trigger Point Release

Lie on your side and roll up and down along the outer part of your shoulder blade.  If you feel a sensitive spot, breathe and hold the pressure for around 30-60 seconds until the trigger point releases. 

While resting your shoulder on the roller, gently rotate your body forwards and backwards, searching for any tender trigger points.  Take care not compress any nerves around the shoulder - you shouldn’t feel any pins and needles or significant pain. 

Thoracic rotation stretch

Place the roller parallel to your left side.  Place the right arm on the roller and reach through to the left, aiming to feel a gentle stretch between the should blades.  Rest your head gently on the mat.  As you exhale, reach a little further to the left.  Aim for 30 seconds and then switch sides.

Childs Pose / Lats stretch

Sit your hips back towards your ankles with your arms on the roller.  Breathe in through the nose and expand the lower ribs.  As you breathe out, gently sit the hips back further and lengthen the arms away.  You should feel a nice stretch though the back of the shoulders and lower back.

Try 30 seconds straight ahead and then 30 seconds on each side.  To stretch the left side. push the hips back to the left with the arms on the right side of the foam roller.

Plank

Lift into a plank with your forearms on the roller.
Breathe through your diaphragm and hold for 30 seconds.
Advanced:  gently move roller up and down using the arms, for more intensity.

Pecs stretch with breathing

Bring your awareness to your neutral spine.  You should have a slight arch in your lower back (about 1 fingers width).  Maintain this position while you breath in and slowly bring your arms out to the side and up over your head, feeling a gentle stretch in the front of the shoulders.

As you breathe out, lower the arms down, whilst maintaining neutral spine.

Cat-Cow

Arch your upper back and look down towards your hips while contracting your abdominals.  Then reverse the motion by lifting your head and hips.  
Repeat 10 times.  Note:  Take care not to overstrain your neck or your lower back with this exercise.  Do not force into the end of its range.

Tricep Dips

Use the foam roller to bring some more intensity to the tricep dip.  This exercise will help develop resilience in the shoulder stabilisers.  Take care not to do too much too soon.

 Side-plank

Lie on your side and push into a side-plank, either through your knees or feet.
Keep breathing while holding for 15-30 seconds.  Then repeat on the other side.  Keep the shoulders, hips and knees in the same alignment.  This exercise will help strengthen the small stabiliser muscles in the shoulders.

The Best Defence Is A Good Offence

If you've had a few niggles or been in pain recently, you might find yourself feeling a little overwhelmed. Sometimes the pain forces us into a defensive or protective mode.

Defensive strategies could include:

• ignoring the pain & hoping it will go away
• regularly taking pain killers / anti-inflammatory to numb the pain
• reducing or eliminating any sort of exercise for fear of causing a flare up

You may also find yourself bracing your body rigidly, every time you move or you may hold your breath (subconsciously) the majority of the time.

Defence IS an important short-term strategy for a new injury, don't get me wrong.

But, after a few months, you're tissues have generally healed the best they can.

Then you've got to take a leap of faith and breakout out of defence and start to re-build proactively...step by step.

When planning your offensive play...success comes from having multiple strategies.

Just like in sport, if you're repeating the same offensive strategy all the time, your body will quickly see it coming and the positive adaptations become limited (and the risk of overuse injuries increases).

The best offence to build resilience in your body would include a good variety of types of movement.

Forming the foundation would be doing a form of Cardio aerobic exercise (whatever you enjoy), Pilates, Yoga, strengthening with a PT, and weight bearing exercise to stimulate bone growth.

Challenge for 2018:

Try x 5 NEW types of exercise or movement approaches that you haven't tried before.

TIP: try something that is the opposite of what you currently do. If you tend towards high intensity exercise than try something easier. If you tend to do easy stuff try something more intense.

Some movement options you could try:
- hiking, stand up paddle boarding, rock climbing, triathlon, cross fit, F45, orange theory fitness, Feldenkrais, karate, surfing, dancing, Parkour, BOUNCE, acroyoga, foam rolling, restorative Yoga, sprinting, 7 min workout, mountain biking, tennis, Aussie rules (especially for women!)

Keep challenging yourself.

Your body and mind will thank-you :-)

Runner's Knee

Patelleo-Femoral Pain Syndrome / Runner's Knee Treatment in Adelaide

The Resilient Knee Project is an innovative solution for people with chronic knee pain that empowers individuals to self-manage their pain and most importantly, get them back to enjoy the physical and mental benefits of running.

Founded by Daniel O’Grady, dedicated professional with first hand experience of overcoming knee pain and running the NYC Marathon, the project aims to be a world leader in restoring people’s confidence in their knees and get back to doing what they love.

Is The Resilient Knee Program right for you?

Start a conversation with our new Chat Bot HERE

What is Runners Knee (Patellofemoral Pain PFP)?

Patellofemoral pain (PFP) is a common condition where pain is felt on the front of the knee, either around or behind the patella.

It occurs in up to 20% of the population (1).

The patellofemoral joint is made of the kneecap (patella) sitting on the front of the thigh bone.

The patellofemoral joint functions as a pulley system to help the quadriceps muscles straighten the knee most efficiently.

There are around 20 muscles that hold the patella centred and aligned.

Pain often results when there is excessive compression on the patella or a muscle imbalance around the patella causes misalignment of the patella.

Over time, this causes rubbing of the joint surfaces, creating inflammation and pain.

What are the most common symptoms of PFP?

• general ache/pain in the front of the knee

• pain aggravated activity involving a bent knee and body weight on the leg (e.g. walking up and down stairs, squatting, kneeling, jumping or hopping)

• pain aggravated by sitting for prolonged periods e.g. driving or sitting in a movie theatre.

• some people also hear and feel a grinding / clicking around the knee with mild swelling

An x-ray or MRI is not usually necessary to diagnose PFP.

Patello-femoral pain is often mis-diagnosed as knee osteo-arthritis in young people, due to the deep ache that is often felt. 

An assessment by a Physiotherapist will help to clarify your diagnosis.

Who is most likely to be affected by PFP?

The main risk factor for developing PFP is recent spike in training load. 

PFP is common in:

• runners

• cyclists

• triathletes

• cross fitters

• football, basketball, jumping sports

• hikers (especially going downhill)

Biomechanical issues that can predispose to PFP include:

• weakness in glutes, quads (VMO), core, calves

• tight ITB, TFL, quads (outer), hamstrings, calves

• stiffness in ankles (e.g. post ankle sprain)

• stiffness in the hip joints / hip flexors

• runners with who predominantly heel strike

 White et al (2009) showed that patients with patellofemoral pain had shorter hamstring muscles than asymptomatic controls.

What is the most effective treatment?

There is strong evidence to support a tailored physiotherapy (including exercise, education, taping), compared to placebo in the short (six weeks) and long-term (one year).

Evidence shows a personalised exercise program (combination of stretching and strengthening) gives the best long term outcomes. 

Ideally this exercise program is set up by a Physiotherapist after a comprehensive assessment. 

How long until I feel better?

As our understanding has grown, it has become clear that PFP is not necessarily something that will disappear on its own, and some people can have episodes on and off for many years.

As such, in order to have the best chance of recovering from your PFP and reducing the likelihood of it recurring, it is important to understand your condition, your individual contributing factors and what you can do.

For many people, a program of ongoing and progressive exercise (as prescribed by your physiotherapist) is necessary to build and maintain muscle strength, and good movement coordination.

Additionally, there is evidence suggesting that people with PFP may have an increased risk of going on to develop patellofemoral osteoarthritis (OA). Therefore, seeing an experienced physiotherapist for a management program will help you keep your patellofemoral joints functioning as well as possible, and keep you as active as you’d like to be now and into the future.

What can I do?

• avoid aggravating activities

• ice your knee to eliminate the inflammation (15 mins x 2 day for 2 weeks)

• home exercises - foam rolling (see below) and strengthening

For Runners:

• avoid hills

• cut back on your running mileage

• increase your cadence by 5-10%

• check your shoes - time for a new pair?

• focus on cross training - swimming, pilates, yoga e.t.c.

Some of the common foam roller exercises we prescribe:

Calf

Hamstring

ITB

Quads

How can a Physiotherapist assist with recovery?

1.  Assessment and Diagnosis

A Physio Assessment early on  in your journey pays big dividends in terms of identifying relevant contributing factors and helping you get on the fast track to healing. 

We spend a lot of time in the beginning educating you so you know what to expect in terms of recovery and what you need to do, to manage your recovery successfully.

2.  Dry Needling / Massage and Taping

Generally a short burst of targeted hands manual therapy over 3-4 sessions will help re-set your tissues, balance the muscles around the knee and get you into a position where you can confidently self-manage. 

Muscles that are commonly tight and affecting your knee include:

• ITB

• TFL

• hamstrings

• quads and calves

Foam rolling and spiky ball massage are effective at maintaining flexibility, but dry needling has the ability to get to the deeper part of the muscle and get a more effective release. 

Find out more about dry needling here.

We can also show you how to tape your knee to provide relief in the short-term.

3.  Guidance on load management

We will give you advice on how to gradually re-load your tissues to safely protect your knee from future flare-ups.  We work with your coach or trainer to manage your return to doing what you love. 

4.  Building a personalised home exercise program

You are the most important part of the healing process and what you do is the most important part getting you better. 

We use the convenient Physitrack App to build your personalised home program with videos delivered to your smart phone.

5.  Movement Re-Training

Once your pain is under control we then watch how you move and optimise your movement patterning to decrease the chances of the knee pain returning.

People with patello-femoral pain are often hip flexor and quadricep dominant and need to learn how to activate the glutes and hamstrings.

We have some specific exercises to show you to help you fast track this process.

Is Knee Pain or Injury keeping you from being as active and healthy as you want?

Don't delay your treatment...

The occasional ache or pain may be nothing to worry about, but failing to pay attention to strong pain may end up causing you a lot of problems in the future. If knee pain is reducing your ability to take part in the activities your normally do, then it is time to get it looked at. In general, chronic knee pain or clicking that is affecting your life is a sign that something is wrong.

A serious problem will not correct itself, and left untreated, can result in more pain and irreversible damage. 

Bookings:

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

References:

1.  Boling M, Padua D, Marshall S, et al. Gender differ- ences in the incidence and prevalence of patellofe- moral pain syndrome. Scand J Med Sci Sports 2010;20(5):725–30.

2. 

Wood L, Muller S, Peat G. The epidemiology of patellofemoral disorders in adulthood: A review of routine general practice morbidity recording. Prim Health Care Res Dev 2011;12(2):157–64.

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Dan O'Grady is a results driven qualified Physiotherapist and member of the Australian Physiotherapy Association.  Dan has a special interest in treating knee pain.  He has been working in private practice for 15 years with (over 20,000 patient consults). He is passionate about helping people to move better, feel better and get back to doing what they love.

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