Lateral epicondylalgia, or tennis elbow as it is often called is a common sports medicine condition. Pain usually felt at the outer side of the elbow and is aggravated by gripping or lifting movements. The pain associated with tennis elbow usually arises gradually 2-3 days after unaccustomed activity involving repeated bending of the wrist or gripping hand movements or activities. Examples include sports (usually racquet-based) and occupational and leisure pursuits (carpentry, bricklaying, sewing and knitting, computer use). This condition can affect any age group but is most common for those between the ages of 40 and 50.
How to Find Ideal Posture?
If you imagine a plumb line dropping from the ceiling by the side of the body. The plumb line should intersect the ear lobe, then run to the shoulder joint, then through the greater trochanter in the hip (the bony bit on the outside of the hip), then just in front of the knee joint and finally slightly in front of the lateral malleolus in the ankle (the bony bit on the outside of the ankle) before it reaches the floor.
If a body part, for example the earlobes is ahead of the line, then the head and neck are not in an ideal position and there is increased tension placed on the muscles in the shoulders such as the upper trapezius - which may lead to neck and shoulder pain. Another example is if the knees are locked back or overextended. In this case the knee joint line is behind the plumb line this can place increased pressure through the knee cap which may lead to knee pain.
A few weeks ago I attended a further education course on shoulder pain & dysfunction and how best to manage this from in a chartered physiotherapy setting. My aim in attending this course was to learn how to better treat shoulders, helping my clients recover more quickly from injury.
Here are ten highlights:
There are 206 bones that make up the skeletal body. Bone is a living tissue that is constantly being removed and replaced. Bones need normal sex hormones, calcium, vitamin D, proteins and weight bearing / strengthening exercise to keep them healthy. Peak bone mass is reached at 25-30 years old. After the mid-forties bone density is lost approximately 0.5-1% a year. As we get older and over 50, more bone is naturally lost than is replaced. This causes bones to become fragile and therefore, they can break easily.
What is Cognitive Functional Therapy in Physiotherapy and how may it help me?
What is CFT?
CFT is a pain management approach that focuses on the patient and targets their beliefs, fears and associated behaviours (both movement and lifestyle). This approach has been devised by Professor Peter O’Sullivan and his research team. Peter is a Specialist Musculoskeletal Physiotherapist (as awarded by the Australian College of Physiotherapists in 2005) and Professor of Musculoskeletal Physiotherapy at Curtin University. Internationally recognised as a leading clinician, researcher and educator in Physiotherapy, he has published more than 100 research papers, been keynote speaker at 60 national and international conferences and taught in 22 countries on the diagnosis and management of persistent pain disorders
Have you ever noticed your pain becoming worse after having a stressful day at work? Have you ever felt your pain to be worse following a bad night’s sleep? Have you ever drawn a link between busy days or busy life periods and an increase in pain? Before we discuss life factors, let’s discuss how the body feels pain.
Nerve fibres in our periphery, i.e. on the outside of the body, allow you to feel pain. For example, if you stub your toe against a door your toe will feel sore. The nerve fibres in your toe will send a message up to your brain to let the body know it is experiencing pain.
Studies have shown that of the patients presenting with headaches to private practice chartered physiotherapy, approximately one third are neck related cervicogenic headaches, one third are muscular tension type headaches and another third are migraine headaches.
Cervicogenic headache is a headache whereby the cause of the headache is a neck disorder, usually felt on one side. In other words the muscles, joints and nerves of the neck may not be functioning correctly resulting in referred pain to the head region. Common causes are sustained faulty postures, certain neck movements resulting in injury to the neck for example while lifting or carrying and sometimes stress.Typically clinical findings with this type of headache include musculoskeletal impairments such as muscular trigger points, restricted neck movements and reduced strength and endurance in the deep neck flexor muscles.
Increasing numbers of ‘older’ people are performing regular physical activity including walking, swimming, lawn bowls, golf, Pilates and cycling. This is great news from a health and social perspective, leading in an improved overall quality of life.
But how do we define ‘older’? It has become more difficult to define by chronology due to the variability in health and functional status among those of similar age. The American College of Sports Medicine (ACSM) define the ‘older’ person as over 65, or between 50 and 64 with clinically significant chronic conditions and/or functional limitations. We must remember there can be a large discrepancy between how old you are and how old you feel and function.
Physical activity and exercise have an important role in successful ageing. Successful ageing involves longevity and survival free of chronic disease, impaired physical and cognitive functioning as well as incident related disability (e.g. following a fall).
What is knee osteoarthritis?
Osteoarthritis (OA) is the most common form of arthritis (Vioreanu, 2014). OA is a degenerative, ‘wear and tear’ type condition while largely effects the protective cartilage in the joint which may affect the the ability of the knee joint to take weight during upright activities like walking and climbing stairs. Symptoms can also include achy pains, sometimes sharp from either the inner or outer knee, sometimes both. You may also feel a stiffness or weakness in the knee which may affect your confidence. Other problems may include intermittent swelling, fully straightening or bending the knee as well as feelings of ‘crepitus’ or grinding (Vioreanu, 2014). The incidence of OA tends to increase with age, with over 50% of the population having OA by the age of 65 (Vioreanu, 2014).
What can be done to help – what do the medical experts suggest?
The National Institute for Clinical Excellence have published updated guidelines in 2014 suggesting:
Why is the warmup and cooldown so important?
The warm-up prepares the body for exercise and should be tailored for the specific exercise that will be undertaken. For football, both general and specific exercises should be performed.
The warm up may involve
- General exercise jogging or cycling for 5-10 minutes to warm the muscles and enhance circulation in preparation for stretching
- Gentle static stretching of key muscle groups such as the hamstrings, calves and hip flexors which are held for 20-30 seconds and repeated 2-3 times. It is also important to stretch/mobilise the spine gently, especially the ‘twisting’ movement.
- Low level resistance exercises to ‘wake up’ important core stabilising muscles which will help support the back, hips and legs during training.
- Once the muscles are well warmed up, more vigorous dynamic stretches can be performed carefully under supervision of the coach so as to avoid injury.
The cool down is important to safely restore the body back to its resting state. This may include: