An Exercise For Tight Hip Flexors That Works Better Than Stretching

It's 'Global Running Day'... One of my fav exercises for runners, especially those with issues with their hips.

This drill will build capacity in the hip flexors (TFL, rectus femoris and iliopsoas), an important group of muscles for running. 

Like the hamstrings, the hip flexors often end up in constant 'protective mode' due to weakness and lack of strength.  Sitting all day tends to make them tight as hell.

This exercise will help get to the root cause of your tight hip flexors and also help to switch on your glutes.

Stand with theraloop around the middle part of your feet.
Drive one knee up so your thigh is parallel to the ground while also activating your core.

Important ➡️The weight bearing leg drives down⬇️ to the ground, strongly activating the gluteals. ✅This will help improve your running efficiency and gluteal activation on push off.

Happy Running!

#globalrunningday #runnersbody #runnersworld #runnersofinstagram #running #runningcommunity #resilientrunner #runforlife #runningtherapy #runninginspiration

Explain Pain Supercharged

Awesome evening attending the book launch of the new edition of 'Explain Pain: Supercharged' with Pain Educator, Author & Legendary Physiotherapist David Butler.

A few nuggets that I took away:

• Chronic Pain (lasting more than 3 months) is complex - and needs to be considered from a Bio Psycho Social (BPS) perspective 

• Pain is a protector. There is no need for a 'war on pain' & this defensive attitude can create more problems

• There is no such thing as a 'pain receptor'. Your brain only ever receives 'potential damage messages' from the tissues, not 'pain' as such. Depending on the context, the brain then creates the pain experience to get your attention and motivation to change behavior.

• Your thoughts about your pain and injury have real and direct correlations with the immune and nervous system.

• Catastrophization about your experience  can literally turn up the sensitivity dial to the sensations coming from your tissues.

• Innocuous twinges can become amplified, like an overly sensitive car alarm that goes off every time a strong wind blows.

• "RECOVERY is right on the cards "

• The pills aren't working for chronic pain sensitization (33,091 Americans died from opioid overdoses, according to the Centres for Disease Control—almost three times the number who perished in 2002), neither is the surgery. Might work better with pain education combined with gradual return to activity

• Education + reconceptualising out-dated and unhelpful beliefs is the most powerful tool we have !

Do you have an issue with chronic pain?

We'd love to help.

Please click here to see how we can help you...

Is Cycling Good For A Runner?

A new patient from last week prompted this post. He is a 43 year old presenting with persistent calf pain during running. ⠀⠀⠀⠀⠀⠀⠀

He's been a competitive cyclist most of his life. Now, as a father of three young ones he is attempting to make the transition from cycling to running. As his time is limited, he wanted a sport that maximizes his 'bang for buck'. ⠀⠀
⠀⠀⠀⠀⠀⠀⠀
He was frustrated because he generally felt very fit and never had any trouble with injuries as a cyclist.
⠀⠀⠀⠀⠀⠀⠀
On assessment, his calves and hamstrings were weak, hip flexors very tight, and gluteal muscle function poor. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀
Long story short, his strong lung capacity from cycling allowed him to push his body well past what it was prepared for and into the danger zone of overload and injury. ⠀
⠀⠀⠀⠀⠀⠀⠀
Tim Gabbett - "It's not the load that breaks the individual down. It's the load they are not prepared for."
⠀⠀⠀⠀⠀⠀⠀
A really common scenario & and probably explains why triathletes find themselves injured so often. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀

A research study (Rendos et al 2013) confirmed that cyclists develop muscle imbalances (particularly tight hip flexors) that can increase the risk of lower extremity injuries. ⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀
Key Points:
⠀⠀⠀⠀⠀⠀⠀
1. Cycling, while beneficial for cardio health can contribute to muscle balances that can set you up for an injury.
⠀⠀⠀⠀⠀⠀⠀
2. The human body is adaptable to change, but needs plenty of TIME to adapt. The fascia, muscles and tendons can take months/years to build capacity, while the cardio system responds much quicker. ⠀
⠀⠀⠀⠀⠀⠀⠀
3. Running is a high load activity & has the potential to cause long-term problems if you take on too much too soon. ⠀⠀⠀⠀⠀⠀⠀

4. An individualized Movement Assessment and corrective program will help maintain your body and keep it moving optimally. ⠀
⠀⠀⠀⠀⠀⠀⠀
The Resilient Runner Workshop takes the latest evidence-based research and practical strategies to optimize your movement foundation so that you not only avoid injury, but enhance your running performance. 

Saturday June 2nd. 12pm - 3pm.
2 spots left. More details via this link

Tennis Elbow: Fast Track Your Healing

Tennis Elbow: 6 Steps To Fast Track Your Healing

Tennis elbow is a common condition experienced by many people.

It tends to affect people:

• who use their arms a lot for work

• most common between the ages of 35 and 50

• people who have other conditions such as diabetes, high blood pressure, menopause

• people who are very active, especially with a big competition goal coming up tend to push themselves to get fitter

Interestingly, only about 5% of people suffering from tennis elbow actually play tennis!

What is tennis elbow?

Tennis elbow refers to pain coming from the tendons of the forearm that join up to the elbow.

These tendons run from the fingers and wrist right up through the forearm and eventually insert into the elbow.

Symptoms of tennis elbow

• Comes on gradually, related to a recent change in loading

• Sore during warm up but feels better during activity 

• Often worst 24-48 hours after activity

• Tendons can become inflamed when severe limiting movement

6 Steps To Fast Track Your Healing

Step 1. Get the right diagnosis first

You will need to have a thorough examination by a physiotherapist to determine if you have any referred pain from your neck and shoulder or if your elbow pain is isolated.

This will assist in a more direct approach to your problem and a speedier recovery.

Elbow pain can be coming from various sources such as:

• Referred pain from your neck and shoulder can cause tennis elbow

Once you have been diagnosed with tennis elbow, it’s important to have realistic expectations of recovery.

Patience is definitely required as the healing process of tendons is longer than any other tissue in the body and take anywhere from 2 months to 2 years to full recover from tennis elbow.

You may need to continue with an exercise regime in the longer term - even after you stop seeing your physiotherapist.

This will ensure that your pain stays away for good.

Learning to listen to your body and know how much your arms can handle is a very important skill to learn as you recover.

Step 2. Calm things down

Generally we use two stage process for helping tennis elbow:

1. Calm things down

2. Build things back up

Calm things down:

• Avoid aggravating activities and other things such as aggressive stretching

• Stay calm and know that it will get better - your body is a powerful self healing machine

• Write a list of all the activities that aggravate it (see below) and then prioritise the activities with the most important at the top. Try and cut out or delegate 80% of the activities that aren’t important for you to keep going

• Cut the remaining load by 50% for 2 weeks and if you haven’t noticed a difference, you may need to cut the load more

• Load = duration + intensity of an activity.  If you can’t modify duration, you can modify intensity 

• Learn to listen to your body during an activity and the 24 hours after when the tendon will communicate with you

Common activities that increase the load on the elbow tendons are:

• computer use - typing, using mouse e.t.c.

• texting on your phone

• gardening / weeding

• Lifting heavy weights - bicep curls, overhead, swings, pullups

• lifting groceries all in one go

• carrying a heavy bag around

• knitting

• lifting small / big children

• racquet sports or rowing

• Push-ups / yoga / body weight exercise on arms

• Massaging / manual therapy

• playing musical instruments

• ironing

• doing dishes

• peeling vegetables

• gripping a bicycle handle or car steering wheel

Step 3. Ice/ Heat and TENS

Apply ice to the elbow regularly to reduce the pain and inflammation, particularly at the early onset of pain.

Some people find heat in the form of a wheat pack works better, as this can reduce the tension in the muscles and increase blood flow.

Another option is using a TENS machine that can stimulate blood flow to the muscles and tendons (this gives only short term relief and must be used in conjunction with other methods listed).

Step 4. Massage and dry needling

Techniques such as massage and dry needling can be used to release tension around the arms, shoulders and upper back.

Muscles that have been overused over a long period of time often form knots or trigger points that can be palpated easily.

When tight, they can become a source of referred pain, with each muscle having a different area of referral (see below).

Dry needling has the ability to get achieve a quicker and more effective deep release of the muscles. As tendons have quite poor blood supply, dry needling can also stimulate the deep blood flow and increase the healing process.

The effects of Dry Needling were studied in this new study that took 110 people with tennis elbow and evaluated two treatments. 

One group received dry needling and other group received anti-inflammatory medication (Ibuprofen 100mg x 2 day) and a brace. 

The patients were evaluated after three weeks and six months.

Results:

Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the medication and brace group at six months.

Conclusion:

Because of the low complication rate, dry needling is a safe method, and it might be a more effective treatment option for tennis elbow.

At Kinfolk Physio & Wellness, in addition to specialising in dry needling, we also take a holistic view of your movement and set you up with a personliased home exercise program that maintains flexibility and builds strength and capacity, to give the best long term solution.

If you would like to get your elbow pain on the fast track to healing, please click below to book an Initial Assessment (or call us 1300 657 813).

Step 5. Graduated loading program

At the end of the day, we want to gradually build the capacity of your forearm muscles so they can withstand the demands from your daily life.

This involves a graduated, progressive program of specific strengthening under the supervision of a Physiotherapist.

We follow a 12 weeks program to rebuild strength in the muscles of the forearm, shoulder and even through the neck and core muscles.

You would be doing exercises 2-3 x per week for about 15 minutes.

Tendons require gradual load in order to heal properly, so it’s very important to continue to strengthen your muscles even if your pain has improved.

To find out more about our loading program for tennis elbow and start your journey, please use our easy online booking system by clicking below.

Step 6. Create the optimal healing environment

With tendon problems, it’s really important to know that your body is always trying to heal itself.

So it’s important to try and create the optimal environment for that healing to take place.

This would include:

• Get a good 7-8 hours of good quality sleep per night

• Eat a high energy diet with sufficient protein and carbohydrates

• Get enough rest during the week

• Decrease stress in your life as much as possible

• Ensuring your ergonomics at work are suitable

Do I need a cortisone injection?

If first-line treatments aren’t working a more invasive approach could be considered that includes a corticosteroid injection.

Corticosteroid injections, while giving effective short term relief, tend to wear off after 6-12 months, and the pain can return, (often worse than before). 

The problem also with cortisone injections is they tend to weaken the tendons in the elbow, greatly increasing the risk of future overload.

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

How To Return To Running (Without Doing Another Injury)

The research is pretty clear that the biggest risk factor for an injury is a past injury.

Pain and injury can trigger off protective mechanisms that can sometimes be tricky to identify and overcome.

For many runners returning from an injury, a common theme is to run within yourself, intuitively trying to protect the body from further injury.

Blog Post continues HERE