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Top Ten Tips For Marathon Recovery

  1. Cool down

You’ll be aching and tired but 15 minutes of walking or gentle cycling after your marathon can make all the difference. Add in some gentle stretching to allow your muscles to gradually relax. Current research supports an active recovery.

  1. Warm up

Your body temperature will drop soon after you finish the race. Be prepared with some warm clothes to prevent cold muscles.

  1. Hydration/nutrition

Drink some sports drink with electrolytes immediately after the race. Be aware of over-hydration though – 13% of runners in the Boston Marathon demonstrated evidence of hyponatraemia. Take a look at www.ssop.com.au/Factsheets/Nutrition/Hyponatraemia.pdf Also, try to avoid caffeine and alcohol during this time…and don’t forget to eat to replace glycogen stores that will aid in recovery.

  1. Compress

Compression garments like Skins provide surface pressure to specific body parts to enhance circulation and deliver more oxygen to active muscles. Improved circulation helps eliminate lactic acid build-up and other metabolic wastes. The compression can work to limit injury caused by overextending muscles.

  1. Easy does it

How long before you can head back to training is very subjective. If you felt good during the marathon you can be back into it after only a few days. Beware however, muscle soreness can actually worsen days after you’ve run, so respect your body and don’t overdo it.

Your body will take some time to recover from the ordeal of a marathon. It’s anecdotal, but as a general rule, allow at least one day for every mile run. During this time you may gradually increase your runs, but keep the intensity easy.

  1. Cross-train

Reduce the risk of injury by modifying your activity for the first 5 – 7 days after your race. Low-impact exercise for 20 – 30 minutes is advisable. Walking, cycling or swimming are good alternatives.

  1. Ice

Although you may feel like a long hot bath, this heat may increase the negative effects of micro-tearing that occurred in your muscles and tendons during the run. While only the most hard-core can handle an ice bath, go easy on the hot tap. Ice can also be applied to the sorest areas, apply for 10 – 20 minutes 24 – 48 hours after the race.

  1. Post-marathon blues

It is not uncommon for runners to feel depressed and un-interested in running after a marathon. Talk about your experiences with family and friends and recognise your achievement in running a marathon. It may also be helpful to try cross-training or join a club to get motivated again

  1. Injury prevention

Injury prevention is key both leading up to and recovering from a marathon. If you experience pain beyond muscle fatigue it’s worth coming in to see us to have it checked out.

  1. Gloat!

Smug smiles, knowing nods, sharing war stories – you have run a marathon! Be proud of a huge achievement.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Top Ten Tips For Marathon Preparation

  1. Plan on it

Make a plan with obtainable goals and stick to it! Variety is the spice of life, and will also keep you in form. Include slow runs, fast runs, hill runs, long runs and interval runs. Vary your tracks and don’t increase your distances too quickly. Remember, resting after training is just as crucial as the run itself.

  1. Feet first!

You’ll be raking up the mileage training for the Blackmores Running Festival. Your foot hits the ground 1500 times every 1.6 kilometers, while absorbing 2.5 to 3 times your body weight. A quality running shop will correctly fit you with the right shoes to take you far.

  1. Slow and steady

You cannot cram for a marathon. Training ultra-hard the week of the race simply will not take you the distance. Consistent training, with a focus on quality over quantity, will get you ready and keep you there for next year’s marathon. Allow at least 12 weeks to get in shape and tackle a marathon.

  1. Warm up and cool down

Don’t forget a dedicated warm up and cool down regime…your body will be grateful.

  1. Listen to your body

Don’t ignore those little niggles. If you have pain beyond your usual muscle-ache do not just soldier on. If, after resting, that little pain continues to cause trouble, come and see us. Toughing it out could only be making any problems worse.

If you’ve had running injuries in the past it may be worth undertaking our digital motion analysis to correct any problems with your gait, such as overstriding.

  1. You are what you eat

Eating right is essential if you want to go the distance. Hydration is also key, so on longer runs try energy drinks or gels. Remember to reward yourself too, you’re burning up all those calories after all! Go to http://www.ssop.com.au/Factsheets/Nutrition_and_Athletic_Performance.27.pdf to read the American College of Sports Medicine Position Statement on nutrition and exercise. Be aware of the possibility of over-hydration, resulting in

hyponatraemia.

  1. The long haul

While long distance runs certainly need to be part of your plan, studies have shown that the number one predicator for running injury is total weekly mileage – the higher the total the higher the risk. Save your long distance runs for peak season training and keep the off-season training more moderate.

  1. Cheerleaders

There is nothing like the sideline cheers of friends and family to help you keep pace. While their cheers will no doubt give you a boost on September 19, remember to thank them for their behind-the-scenes support.

  1. Stick with what you know

Race day is not the time to mix-up your game plan. Have a tried and tested breakfast two hours before, wear your usual clothes and certainly no new shoes! Keep plenty of Vaseline on hand for those sensitive areas. Don’t take a risk with blisters or chafing.

  1. Enjoy it!

You’re running a marathon!

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Real Time Ultrasound

What is Real-time Ultrasound Imaging?

  • Real-Time Ultrasound Imaging (RUSI) is a medical imaging technique that uses the echoes created by high-frequency sound waves to construct an image.
  • A hand-held probe is placed on the skin and transmits 1-5 MHz sound waves into the body. When the sound waves hit a boundary between tissues of different densities (i.e./ between fluid and soft tissue, soft tissue and bone) some of the waves get reflected back to the probe. Other waves will continue on until they too reach a boundary that causes them to be reflected. The reflected waves are transmitted from the probe back to the machine, and a two-dimensional image is constructed using the speed of sound in tissue and the time for each wave’s return.

 

Why choose RUSI?

  • RUSI minimizes exposure to radiation, as it does not emit any potentially hazardous rays
  • RUSI collects images during movement, so muscle activity can be assessed

Why use RUSI?

  • OB/GYNs use RUSI to image unborn babies
  • Sports physicians and radiologists use RUSI to locate muscle tears and to guide cortisone injections into a particular area
  • Physiotherapists use RUSI to view the activity of deep stabilizing muscles

RUSI and Physiotherapy

  • The “core” or deep stabilizing muscles include the pelvic floor, transversus abdominus, multifidus, and diaphragm. Weakness in these muscles can often lead to low back pain, sacro-iliac pain, poor pelvic stability and over use syndromes. Research also shows that after a back injury these muscles often are not functioning properly and need specific exercises to reactivate and strengthen them.
  • RUSI allows the physiotherapist and the patient to view the activity in these muscles in real time. If the muscles are not activating automatically, RUSI can be used as a form of biofeedback to help the patient learn to selectively reactivate and strengthen these muscles. As the patient learns to use these core muscles, activation will eventually become automatic with movement.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Referral Pain

The problem

  • Referred pain is a term that is used to describe pain that is experienced away from the actual site of injury.
  • The most well known example of referred pain is the pain that occurs in the left arm during a heart attack. Although the injury is actually occurring to the heart muscles, pain is felt in the arm.
  • Referred pain can be caused by injury to visceral organs or musculoskeletal structures in the muscles cause referred pain, these areas are known as trigger points.
  • Scientists are not sure of how and why pain is referred.

Hints for self-management

  • Using your thumb, press and hold over the area in the muscle that reproduces your symptoms. Hold the pressure until the referred pain symptoms fade, this should occur within 30-90 seconds.

Management options

  • Massage is one way to treat trigger points in muscle
  • Trigger points usually occur in muscles that are overworking, often due to weakness or poor posture and biomechanics. A physiotherapist can treat the trigger points, as well as provide exercises, stretches, and education to help address the underlying problems.

 More information

  • Pain tends to refer in a set pattern. Somatic mapping of referred pain locations has been helpful in indentifying the location of the injury based on the location to which the pain is referred.  

 

Interesting facts

  • There are many pain receptors in the skin, so the information transmitted to the brain is very precise with regards to where the injury is and whether the source was sharp, dull, hot, or cold. On the other hand, internal organs have fewer pain receptors, so the brain has less information to form an interpretation.
  • Pain may be referred because signals from several areas of the body often travel through the same nerve pathways in the spinal cord and brain. For example, pain from a gallbladder attack may be felt at the back of the shoulder because sensory information from the gallbladder and the shoulder converge on the same nerve pathways in the spinal cord.
  • Trigger points in muscles can cause significant referred pain. Trigger points in the upper back, shoulders, and neck may be the source of referred pain perceived as headaches. A trigger point can be identified if pressing on the “knot” reproduces your pain.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Pilates

The History of Pilates

  • Pilates was developed by Joseph Pilates during the First World War as a means to improve rehabilitation of injured veterans. He believed in a connection between mental and physical health and his approach emphasized maintaining form and control through a series of precise movements.

“The Pilates Principles” include:

Alignment – maintaining correct postural alignment throughout exercise

Breathing – maintaining even breathing throughout exercise using a technique that engages the deep stabilizing muscles

Centering – engaging the core prior to movement of the extremities

Concentration – using the mind to control muscles and movements

Control – no uncontrolled movements

Precision – every movement has a purpose

Flow/Efficiency of Movement – once efficiency has been achieved, exercises are intended to flow together

Originally, Pilates consisted of 34 exercises performed on a padded mat on the floor. Joseph Pilates later invented many pieces of equipment, such as the Reformer and Trapeze Table, which utilize springs and pulleys to either add resistance or assist movement

What are the goals of Pilates?

  • Pilates emphasizes motor control, and teaches how to maintain neutral postural alignment throughout movement
  • In Pilates, “the core” refers to deep stabilizing muscles that attach to the pelvis and the spine, including pelvic floor, transversus abdominus, and multifidus. Pilates focuses on isolating, activating, and strengthening the core. When combined with motor control, this will help protect the spine.

What should I expect from a Pilates class?

  • Pilates classes may be advertised as “mat” or “equipment” classes. In mat classes, exercises are performed on foam mats on the floor, primarily using body weight resistance. Equipment classes utilize some of the equipment originally developed by Joseph Pilates to add resistance or assistance to exercises.
  • Each class usually lasts around 45 minutes
  • Ideally, a Pilates class won’t be too large, allowing the instructor a chance to assess each individual for correct execution of the exercise. In Pilates it is possible to “cheat” using larger muscles, rather than the deep core muscles, to perform a movement. In some cases “cheating” can only be identified when the instructor physically checks to see what muscles are active. This level of attention is precluded when class size is too large.  

Who may benefit from Pilates?

  • Individuals who have back pain, neck pain, or headaches
  • Individuals who have difficulty with motor control or poor posture
  • Pre-, peri- and post-natal women. Women who are pregnant should check with their physician before initiating an exercise regime
  • Athletes looking to improve stability, balance, and motor control

 

 At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Osteoarthritis

The problem

  • Is also known as OA or degenerative arthritis and is a group of diseases involving degradation of joints, articular cartilage and bone
  • Cartilage is a tissue which lubricates and cushions joints
  • OA can have a number of predisposing factors, including: hereditary, mechanical, metabolic and developmental
  • OA often results in pain which decreases movement and function, leading to wasting of muscles and weakening of structures. 

Interesting facts

  • OA affects around 3 million people in Australia, representing about 15% of the population
  • OA commonly affects hands, feet, the spine and the large weight bearing joints such as hips and knees.
  • Muscle weakness around an osteoarthritic joint is a common finding
  • Diabetes, obesity, injury and inflammatory diseases such as gout can promote the development of OA in joints
  • OA is the leading cause of pain and disability in the elderly
  • 90% of total hip replacements and 95% of total knee replacements are performed for OA in Australia

What you can expect/look out for

  • Acute pain
  • Decrease in function of affected joints
  • Stiffness and swelling
  • Crepitus or creaking of joints 

Hints for self-management

  • Activity modification to reduce irritation of affected joints
  • A graduated exercise program to increase strength of the surrounding muscles
  • Weight management with diet and exercise
  • Anti-inflammatory medication

Management options

  • Research has shown that exercise is one of the most important treatments for OA of the hip and knee.
  • Low impact exercises (where there is less impact going through your hips and knees) include water exercise, cycling, walking and strengthening exercises
  • Strengthening exercises can be prescribed by a physiotherapist or exercise physiologist
  • Braces/supportive devices for affected areas eg knee brace
  • Arthroscopy and in the most severe cases joint replacement surgery

More information

  • Among the 100 different types of arthritis, OA is the most common
  • OA is more common as we age
  • Most cases of OA have no known cause and are referred to as primary OA. When the cause is known, the condition is referred to as secondary OA
  • Repetitive use of worn joints over time can lead to loss of cartilage
  • Inflammation of cartilage can stimulate new bone growth (spurs and osteophytes) which form around the joint (see below)

http://www.innvista.com/health/ailments/arthritis/osteoart.htm

 At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

 

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Ergonomics

What is Ergonomics?

  • Ergonomics is the study of a persons biomechanical abilities/limitations and how they interact within the environment they work/live in.
  • This information is applied to workplaces and products to arrange and design systems/workstations that are tailored to fit the people who use them. 

Why is Ergonomics important?

  • A well designed workplace which suits your unique body type will help to promote good posture and movement patterns and help to optimize function
  • Poor posture and/or repetitive movement patterns can cause a number of aches and pains in the low back, upper and lower limb and even bring on headaches.  

What are some basic ergonomic tips?

  • Make sure your chair is correctly set up; have your shoulders relaxed with your elbows an inch above your desk and your knees and hips bent to about 90 degrees.
  • A foot stool can be used to achieve correct leg position and reduce pressure on the back of your thighs
  • Your backrest should be adjusted to maintain your back in a neutral spine
  • Always practice good posture, sit back and have your chair pushed in under the table to avoid poking the head forward and putting undue strain on your neck
  • Muscles were made to move, so try to get up and stretch at least once an hour
  • Avoid over reaching; keep your work close with your mouse and keyboard being no further than the length of your forearm away from your body

 At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

 

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Beginning Exercise

Weekly Exercise Goals

Experts recommend the following as a minimum level of weekly activity:

  • Do moderately intense aerobic activity for 30 minutes at least 5 days a week
  • Or, do vigorously intense aerobic activity for 20 minutes at least 3 days a week
  • Additionally, do 8-10 strength training exercises, 10-15 repetitions of each, 2-3 times a week

Those who are at risk for falling should also perform balance training exercises

  • An exercise is considered to be of “moderate intensity” if it is rated a 5 or 6 level of difficulty on a 0 (resting) to 10 (all-out effort) scale and produces a noticeable increase in heart rate and respiration rate.
  • An exercise is considered to be of “vigorous intensity” if it is rated at a 7 or 8 level of difficulty on a 0 to 10 scale and produces a significant increase in heart rate and respiration rate.
  • Flexibility is also an important component to fitness, and at least 10 minutes of flexibility activity is recommended on each day that aerobic or strength exercises are performed.

If you are able to exceed these minimum exercise goals, do so for additional health benefits. 

Starting an Exercise Program

  • If you have been out of the habit of exercising for a while, gradually build up the intensity of your workout to meet the recommendations
  • Before beginning a workout routine, have your health cleared for exercise by your physician

If you are over the age of 65, or if you have a chronic condition (i.e. arthritis), you may want to develop an activity plan with a healthcare professional that takes into account individualized risks and therapeutic needs

Top Tips for Achieving your Goals

  • Choose activities you enjoy participating in. If you don’t like to run but enjoy swimming, choose swimming to be your primary form of aerobic exercise.
  • If you’re not sure how to perform a particular exercise, ask for help. It is important to use good technique when exercising to reduce the risk of injury.
  • Research shows that 3, 10-minute bouts of moderate intensity exercise throughout the day are just as effective as 30 minutes straight.
  • Combinations of moderate and vigorous intensity exercise can be used to meet the guidelines.
  • Set aside a specific time during the day that you will use for exercise.
  • Beginning an exercise program with a family member or friend can make things fun and help with accountability. 

Resources

 

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Pregnancy Exercise

Is exercise during Pregnancy safe?

  • Yes, for a normal, healthy pregnancy, exercise is not only safe, but has many potential benefits for both mother and child.
  • A healthy woman with a normal pregnancy may continue in an already established exercise routine; however, it is recommended that she not increase the intensity of the exercise above pre-pregnancy levels.
  • If a woman has not been exercising on a regular basis prior to pregnancy, she should consult her physician before beginning a new exercise routine. 

What are the benefits of exercise during pregnancy?

  • Reduces the risk of preeclampsia
  • Helps prevent gestational diabetes
  • Helps reduce and manage musculoskeletal pain
  • After delivery, exercise helps boost the mood and reduce symptoms of post-partum depression

What types of exercises should be done during pregnancy?

  • Ideal non-weight bearing activities include swimming and cycling. After the first trimester, stationary cycling should be substituted for road cycling, as the mother’s center of gravity changes and the risk of falls increases.
  • Weight bearing exercises may include walking, jogging, low-impact aerobics, or Pilates.
  • Heavy weightlifting and other activities that require straining are not recommended.

Pelvic floor and Pregnancy

  • Pelvic floor exercises can be particularly important for women during pregnancy. The pelvic floor refers to the group of muscles that stretch from the pubic bone to the base of the spine. They help hold the bladder, uterus, and bowel in place. These muscles also help control when you empty your bladder or move your bowels. During pregnancy these muscles can be stretched and become weaker
  • Performing 3 sets of 10 pelvic floor exercises daily can help support the extra weight of pregnancy, shorten the second stage of labor when the baby is being pushed out, and speed recovery following delivery.
  • To perform a pelvic floor contraction, imagine that you are trying to stop yourself from passing wind and trying to stop your flow of urine mid-stream at the same time. You should feel a drawing-in sensation. Try to work up to holding the contraction for the length of time it takes you to breathe in and out 3 times.

Tips for ensuring safety during exercise

  • As changes in weight distribution occur, balance and coordination may be decreased. It is important to choose exercises that do not take you beyond the limits of stability.
  • Avoid large changes in internal temperature. Fluid intake before, during, and after exercise can help ensure adequate hydration. Wear loose-fitting clothing and avoid exercising in high heat and humidity.
  • Avoid exercising in extreme changes of atmospheric pressure, as in SCUBA diving and high altitude exercise.
  • After the first trimester, avoid exercises that require you to lay flat on your back.
  • Adjust daily caloric intake in order to ensure proper nutrition and adequate weight gain.
  •  If pregnancy is not progressing normally or if vaginal bleeding, membrane rupture, persistent pain, chronic fatigue, or regular contractions more than 30 minutes after exercise occur, medical attention should be sought.

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries. 

Contact us today – 9252 5770

 

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.

Women’s Health – The Pelvic Floor

Fixing Below the Belt

Physiotherapy, combined with medical management is beneficial in treating:

  1. Incontinence
  2. Prolapse
  3. Chronic Pelvic Pain
  4. Low Back Pain
  5. Pregnancy- Related Pain

Physiotherapy Treatment

A Pelvic Floor Physiotherapist will:

  • Work as a team with other health practitioners
  • Assess symptoms via thorough specific questioning
  • Assess all aspects of PF muscle function per vaginum
  • Assess posture and lumbopelvic muscle function
  • Establish a clinical diagnosis
  • Educate and explain using models and illustrations
  • Set individual treatment goals in collaboration with the patient
  • Initiate use of appropriate, reliable and valid outcome measurement tools
  • Provide effective treatment based on individual assessment findings, with progression on exercises likely to resolve the symptoms without surgery or medications
  • Continue treatment with supervision, motivation, feedback (verbal and/or EMG biofeedback) and adherence strategies
  • Provide successful treatment to women of any age

  • Regularly communicate with the referring GP or specialist regarding assessment findings, progress and outcomes.

What are the symptoms?

Bladder Symptoms include:

  • Leak urine with coughs, sneezes, exercise or on the way to the toilet
  • Pass urine frequently
  • Rush to the toilet – urgency
  • Get up twice or more at night to pass urine
  • Wet the bed when asleep
  • Feel their bladder is not completely empty
  • Poor urine flow
  • Strain to get bladder to empty
  • Frequent urinary tract infections

Bowel Symptoms Include:

  • Leakage from the bowel with the urge to open their bowels
  • Urgency with the urge to open their bowels
  • Leakage from the bowel on passing wind
  • Unable to control wind
  • Straining to empty their bowels

At Sydney Sports and Orthopaedic Physiotherapy our highly qualified physiotherapists specialise in the assessment, treatment and prevention of neuromusculoskeletal injuries.

Contact us today – 9252 5770

This handout was prepared by Sydney Sports and Orthopaedic Physiotherapy and is intended as a general information service. Please note that the information provided is not intended as a substitute for advice from a registered physician or healthcare professional. If symptoms persist, please consult your doctor.