Lorraine and I are enjoying a busy 2014 with our young family, the busy clinic and Pilates studio as well as our University tutoring and lecturing roles. We are proud to be involved in higher education supporting upcoming students as well as fellow medical professionals and we’d like to share some of the details of what we have been up to.

Lorraine has been regularly lecturing as well as examining on the undergraduate physiotherapy programme as well as the prestigious Masters in Neuromusculoskeletal Physiotherapy at UCD over the last number of months. Given such positive student feedback she has once again been asked to be a clinical tutor for Masters degree students on placement at the Mater hospital over the coming weeks. Lorraine will again this month present a lecture in lower limb biomechanics and injury management to the Irish College of General Practitioners.

Physiotherapists regularly prescribe exercise as a fundamental part of the rehabilitation process, following a muscle or joint injury for example. Running is a very common form of exercise to which many patients will want to progress, when enough function has returned, in order to build up their fitness again. But is running the best exercise for improving fitness?

The short answer is no, in my opinion.

However, possibly a more appropriate answer would likely be that it depends on what your fitness goals are and how you want to define fitness.

Let’s take a look at a local event to help describe what I mean. The Great Ireland Run 10km recently passed earlier in April with the winners achieving some impressive results; men’s first place came in under 30 minutes and the women’s first achieved a 33 minutes and 39 seconds. How do we think the top running athletes prepare for such an event? They will do a lot of running training no doubt but I am certain this is not all they do. Athletes performing at this level need to be in peak physical fitness to sustain the demands they are placing on their bodies and to keep their risk of injury as low as possible.

You may be wondering what do top performing athletes have in common with patient rehabilitation and recreational running. Well, my point is that we can learn from the best in their field and adopt some of the principles used in their training. Naturally our training won’t be nearly as intense or demanding as that of elite athletes so what can we learn from them?

Do you think our early ancestors wore half-length or full-length orthotic shoe inserts? Would their video-recorded gait assessments have revealed more under or over-pronators in the general population?

If we try to imagine how life was back in the day of the caveman we could safely assume that his ability to run both short sprints and long distances was necessary for surviving in a wild environment. Without the ability to track food or flee from dangerous predators the human evolution may not have been possible. What we can also be sure of is the caveman did not run in a pair of Asics trainers with rear-foot gel-cushioning outer soles structured for either a neutral or over-pronating gait . Nope, our early ancestors would have been running barefoot.

Many thousands of years later and despite our advances in footwear design and technology there is a ‘barefoot running’ revolution gaining traction in some circles. The idea is that we as a species have spent more time running barefoot than we have in our fancy high-tech shoes and therefore we are more physiologically suited to running barefoot.

Know your risk level and how best to self-manage pain in pregnancy

Pelvic girdle pain (PGP) is common in pregnancy with some studies[1] indicating as much as 33-50% of pregnant women will experience PGP before 20 weeks of gestation, possibly increasing to 60-70% prevalence in the late pregnancy stages.

Pelvic pain as well as associated low back pain can vary in severity and its degree of debilitation which does not necessarily subside postpartum.

Not all pregnant women develop PGP and some women are more susceptible than others. Women at higher risk may include those with a past history of PGP, lower back pain or any past pelvic trauma. Other contributing factors considered in some studies include high stress levels and psychological variables such as catastrophising and fear-avoidance beliefs[2].

Widespread pain, such as the symptoms associated with Fibromyalgia, is a type of aching pain that affects multiple areas of your body. The unpleasant experience of such symptoms can negatively impact mental health as well as physical functioning. A Physiotherapist experienced in managing the condition of Fibromyalgia can offer effective pain relief and a better ability to cope, but sleep quality is also an important factor the individual can focus on by themselves.

Poor quality sleep can impact all aspects of our health in undesirable ways. When it comes to sleep consistency is as important as quality and that is because we rely on something known as our circadian rhythm. This internal body clock programs our wake and sleep cycles and influences the healthy functioning of our bodies.

Although the precise cause of Fibromyalgia is unknown contributing factors are believed to be such things as infection or injury and more focus is now being placed on sleep quality too. Disturbed sleep may not cause Fibromyalgia but is often associated with the condition and may impact of the severity of the symptoms as well as the ability of the sufferer to remain functional in day to day life.

Our next Pilates course schedule is now published and we are accepting registrations via our Pilates website.

Between the 28th of April and the 2nd of May we have a total of 9 Pilates classes commencing. This term we are running 3x Beginner level classes, 5x Improver and 1x Advanced class.

If you are not sure which level is best suited for your ability please read our level descriptions.

Signing up for one of our courses is very simple. We have a secure online booking system where you can choose your class, register and pay using a debit, laser or credit card to reserve your place immediately. You will receive instant confirmation of the success of your booking.

Do you sit at a desk all-day long?
Are you feeling stiff with rising tension in the shoulders and neck?

Posture related tension in the upper back, shoulders and neck area is a common complaint for desk workers and those who drive a lot due to the prolonged periods of time in the same position. People who work in high-stress jobs will also be familiar with this type of neck tension.

Eventually this ongoing state of tension can lead to headaches and migraines which become more difficult to treat.

This 1-hour 'Neck Tension Release' session will provide you with effective relief at intervals which suit you and your lifestyle in order to prevent more chronic conditions from developing.

Who will benefit?

• Those who feel generally stiff through the upper back as well as tight in the muscles across the shoulders and up into the neck
• May occasionally get headaches which feel they start in the neck and creep up the back of the head, sometimes around to the front
• Desk workers and drivers
• Anyone in stressful working environments who do not get an opportunity to take regular breaks

The idea that the common back pain, specifically lower back pain, can be a result of our modern lifestyles does make some sense. In general people are sitting more for extended periods of time which contributes to lower activity levels. These factors alone can negatively affect posture which often lead to problems in the synovial joints of the spine, nerves and surrounding muscles which all play their role in causing back pain.

The medical history of any back pain sufferer is an important consideration for the Physiotherapist when understanding how best to help relieve the symptoms. There is not a single most effective approach for all conditions of back pain and in fact sometimes the seemingly sensible treatment only makes the symptoms worse. We wrote about such back pain confusion in a previous article.

Over-reacting to back pain can cause both patient and Physiotherapist to take unnecessary measures and potentially over-treat the condition. The most important factor is intervening early before the pain progresses to a more chronic state. An experienced musculoskeletal Chartered Physiotherapist will be able to suitably educate you on your type of pain, potential causes and other important considerations such as the risks of fear-avoidance behaviour.

Anterior knee pain or patellofemoral pain syndrome (PFPS) is a common complaint that we see in the clinic. What we are dealing with here is pain located to the front of the knee, usually over or around the kneecap. It can be vague and difficult to say exactly where it is sore. The pain may be constant and made worse by certain activities, otherwise only painful when doing certain things. The pain often starts gradually for no obvious reason and may be aggravated by walking, running, ascending or descending the stairs or prolonged sitting with the knee flexed. You may have severe difficulties continuing the activity that causes you pain and discomfort.

Who is likely to suffer from this condition?

PFPS is more prevalent in females, they are 1.5 to 3 times more likely to develop the condition than males in the athletic population. It can be a significant and debilitating complaint that can affect as many as 1 in 10 active adolescent girls.

What exactly causes PFPS remains a misunderstood and controversial topic. Knee muscle weakness especially of the vastus medialis obliquus (inner thigh muscles which supports the knee cap), abnormal foot biomechanics - in particular abnormal pronation, weakness of the hip stabilising muscles and poor functional control of the femur during weight bearing tasks can be common causes of the syndrome. So in other words if you have weak thighs and hips, wobbly knees, flat feet and generally poor balance you may be at risk.

Do you suffer from frequent episodes of Low Back Pain?

We offer a 1-hour physiotherapy 'Low Back Pain Maintenance' treatment session specifically designed to help reduce the frequency and severity of your painful episodes.

Who may benefit?

Frequent episodes of low back pain has many causes. These may include generally poor conditioning of the spine, muscle stiffness with ‘trigger points’, low levels of activity, stress and other lifestyle factors. Your low back pain may also be due to a degree of 'wear and tear' of the spine, what is medically referred to as spondylosis or osteoarthrosis of the spine.

Recurrent episodic mechanical low back pain can be well managed with intermittent 'maintenance' physiotherapy sessions.

Our team of Chartered Physiotherapists have designed this 1-hour treatment session to assist you in the management of this type of low back pain with the intention of reducing how often and how severely the episodes occur.