Search

Emma James Physio Blog

Chartered Physiotherapy and Clinical Pilates

Category

Hints and Tips

Top 10 lower back pain Myths!

Lower back pain and the unhelpful beliefs that could negatively impact your behaviours

 

Most of us will have inevitably suffered from some form of lower back pain in our lives, to varying degrees of severity and volumes; but it’s almost certain to have affected us somewhere along the way! That opening statement in its itself is a perfect example of how beliefs and experiences around back pain can negatively impact our behaviours, fortunately I am going to now expand on it and point you in the direction of some fantastic editorial research that has recently been published for the benefit of the general public.

back-painLower back pain (LBP) is the leading cause of disability worldwide, but the way we as health care professionals and you as patients understand the pathology may differ. In an ever-progressing world of research; there are even gaps of knowledge within sub-groups of practitioners that negatively impact the way LBP is perceived and treated. We hear about it through all media channels and we have an understanding of the ways pain management is prescribed and how we are instructed as patients to manage LBP. Common beliefs and understanding on these factors can influence the way individuals perceive and understand LBP and ultimately the affect it can have on the way you live your life.

In this blog I will review the aforementioned article and address the fact’s from my own point of view and experience;

Ten unhelpful LBP beliefs;

Unhelpful LBP beliefs are common, culturally endorsed and not supported by evidence.

Myth 1:  LBP is usually a serious medical condition

You can feel debilitated or in an amount of pain that indicates a serious pathology; but the facts are the vast majority of LBP cases are not life-threatening pathologies that cause permanent disability.

Myth 2: LBP will become persistent and deteriorate in later life

There is no strong research to support an association with age and deterioration in LBP; age is not a risk factor – we are all subject to the same level of risk; of which there are very well supported methods of managing LBP.

Myth 3: Persistent LBP is always related to tissue damage

Having a reoccurrence of the same type of LBP doesn’t mean the same structures are being damaged to an increasing degree each time – it may feel that way because the pain can get worse but the soft tissue structure that are involved in LBP will heal within a normal time frame. There are a multitude or internal and external factors that relate to pain replication which can be managed and overcome.

Myth 4: Scans are always needed to detect the cause of LBP.

Scans are unlikely to tell us anything different to what we already know. There can be the same scan presentation in a person with and without LBP; again, it’s the multi-faceted level of factors contributing to our pain which are more important than scan results.

Myth 5: Pain related to exercise and movement is always a warning that harm is being done to the spine and a signal to stop or modify activity

There are really clear and accurate ways to monitor painful responses during exercise; most of the time – pain is acceptable during exercise/rehab and is more likely to be beneficial than harmful. Increasing your exposure to painful movement/tasks is one of the more effective way to reduce your sensitivity to these painful triggers.

sitting-at-desk-pain

Myth 6: LBP is caused by poor posture when sitting, standing and lifting

A really common one; posture does not cause pain, plain and simple. Stress, anxiety, sleep deprivation, periods of persistent working/inactivity are more likely to be the cause of posture related pain rather than the position its self. Get up, move, meditate, talk to your peers and share experiences; it will make a difference.

Myth 7: LBP is caused by weak ‘core’ muscles and and having a strong core protects against future LBP

Our ‘core muscles’ control spinal movement; so, it makes sense that weakness increases our injury risk, right? Wrong. Varying the degree and quality of movement in our lower back; along with the able to transfer weight through our trunk gives us more dynamic movements; but weak muscles do not cause pain.

heavy-lifting

Myth 8: Repeated spinal loading results in ‘wear and tear’ and tissue damage

Heavy lifting and forward bending do not wear out the spinal discs, it actually lubricates them and some studies have found evidence to support increasing strength of discs with increased loads, just make sure these movements are familiar and build them up.

Myth 9: Pain flare-ups are a sign of tissue damage and require rest

Similar to Myth 5; there are a number of factors that can cause pain replication, sensitivity related to previous movements, tasks, scenarios and intrinsic factors are most likely to be the causes of pain; and your practitioner should talk you through understanding this and how to manage it before you refer back for re-assessment (if needed at all).

Myth 10: Treatments such as strong medications, injections and surgery are effective, and necessary, to treat LBP

These interventions are invasion, have varying success rates, complication risks and secondary symptoms; the long-term benefits are not guaranteed. Of course, there are pathologies and examples where these treatments are more likely to be necessary; but for the majority of LBP patients; they just aren’t needed.

 

adamSo that’s it, also check out this useful infographic about Back Facts
Keep your eyes peeled for more on this subject!
Adam 😊

Blog post by Adam
Senior Physiotherapist at Emma James Physio

 

Sleeping Posture and Lower back pain

How you sleep plays an important role in managing back pain, as certain positions place more strain on the back than others. Generally, back sleeping and supported side sleeping are regarded as most ergonomic, while stomach sleeping tends to be most associated with pain.

Whichever position you prefer, here are some tips for staying comfortable.

good-and-bad-sleeping-positions

 

  • Reclining may be beneficial for your back because it creates an angle between your thighs and trunk. This angle helps to reduce the pressuer on your spine.
  • Disc herniation happens when part of a disc pushes out of its normal space.
    Curling your torso into a fetal position opens the space between vertebrae.
  • Sleep on your side with a pillow between your knees.
    The pillow will keep your hips, pelvis and spine in better allignment.

Alignment is key

Be careful while turning in bed. You can get out of alignment during twisting and turning motions as well. Always move your entire body together, keeping your core tight and pulled in. You may even find it helpful to bring your knees toward your chest as you roll over.

Tips to reduce lower back pain

back-pain

  1. Dont twist your back or make rapid jerking motions
  2. Get in bed by sitting on the edge of the matress. Supporting yourself with your hands, bend your knees and lay on your side. Then adjust your position as needed.
  3. Get out of bed by rolling on your side (facing the edge of the matress) and bend in your knees. Supporting yourself with your hands, carefully swing your legs to the floor and stand up straight. Get up from the seated position.

Special Offer

and-so-to-bed-logo-ejphysio-offerOur friends at And So To Bed are offering a special discount code for Emma James Physio customers which is an additional 10% off all And So To Bed products when purchasing online.

Use online code: ASTB10 at shopping basket. Offer available until 31st December 2020.

 

india-wayland

Bye for now 😉
India
x

Blog Post by India
Sports Therapist at Emma James Physio

Treat your Pelvic Floor to more!

Pelvipower_bio-feedback_training_EJPhysioThere is a new Swiss technology-driven treatment for increasingly common issues such as incontinence, pelvic girdle pain, sexual health/dysfunction, and back pain.

The treatment (called PelviPower) is conducted in the form of a customised therapy chair, where specific impulses (Magnetic Field Therapy, PFT) and high-accuracy sensors (Biofeedback Training, BFT) can target an individual’s particular issues whilst producing results that are measurable and can be replicated.

Conventional Approach

Until very recently, both clinicians and patients have been limited to abstract descriptions and poorly located/defined areas of symptoms, relying heavily on vague and subjective instructions to address various pelvic girdle complications; while most of these issues are often sensitive topics to discuss, and the physical assessment itself being quite intimidating as well. Understandably this has led to a general reluctance for both men and women discuss/seek treatment for their pelvic issues. The PelviPower system addresses these obstacles by providing precise real-time data to the clinician without any invasive procedures, and it also gives the patient a much better information and direction throughout the treatment process.

Incontinence

At least 30% of woman experience some degree of urinary leakage in their lifetime especially during and after pregnancy and soon after menopause as oestrogen levels decline. 1 in 4 women will avoid activities such as sports, going to the gym or daily social activities as a result. There is common misunderstanding that it is a normal or inevitable consequence of childbirth or ageing, when in fact it is an issue that needs to be addressed. Common forms of Incontinence include:

  • Stress incontinence: This is urinary leakage due to weakened pelvic floor muscles and tissues. It generally occurs when pressure on your bladder increases — such as when you exercise, laugh, sneeze, or cough.
  • Urge incontinence: You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
  • Bowel Incontinence: Bowel (or faecal) incontinence is the inability to control bowel movements. Severity can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control. Some people have recurring or chronic faecal incontinence.

Mens Health

A healthy pelvic floor muscle(s) can prevent incontinence, erectile dysfunction/premature ejaculation, complex pelvic girdle pain, and lower the incidence of back pain. Amongst men who require a prostatectomy, it is also imperative to optimise the pelvic floor muscle before and after the surgery to prevent these unwanted leakage and/or incontinence.

PelviPower Treatment

Pelvipower_magnetic_field_training_EJPhysioThe PelviPower treatment chair is currently utilised globally, and receiving excellent feedback from expert pelvic floor clinicians in leading-research areas such as Ireland, Australia, and New Zealand.

Your clinician will conduct a thorough non-invasive examination with you, noting the subjective history, symptoms, and your particular goals/expectations from the treatment. You will then be asked to sit in the PelviPower chair so that your pelvic floor contractions can be assessed, and your clinician being provided with specific data about your contraction patterns. From there the clinician will be able to tailor an individualised treatment plan for your needs, which would typically involve 2-5 sessions per week of no more than 20 minutes in the chair per chair (depending on your situation). The entire process is conducted whilst fully-clothed, and is complete non-invasive.

My Conclusion

  • Convention/past diagnosis and treatment of pelvic floor issues can be inaccurate, lacing specific focus
  • Can be a daunting and embarrassing process for the patient
  • A lack of awareness and support
  • PelviPower is non-invasive, relatively easy to use
  • The treatment is measured and can be replicated
  • Noticeable improvement within a short space of time
  • Guided by a trained clinician throughout the entire process

Exciting News!

You will have the opportunity to try PelviPower for yourself as this service will be available at our Hemel Hempstead practice from December 2019.

For more information please visit our PelviPower page, visit the PelviPower website or contact us for more information and how to book.

kelvin

Kelvin
x

Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

 

Tendon Pain Treatment and Management

The best part about tendon rehab is you need to facilitate your load to optimal levels, so it doesn’t mean complete cessation of exercise! Tendon rehab is fundamentally based around loading the affected musculotendon unit, so strengthening exercises are key. Research shows best outcomes are associated with a long term (average 12 weeks), progressive and individualised loading programme. So as long as you put the hard graft into your rehab; you’ll go the extra mile!

There are other significant factors that will contribute to your management; such as foot and ankle biomechanics, BMI, psychosocial factors as well as other co-morbidities. As Kelvin stated in our previous blog post, each case of tendon pain is unique and is tailored to you as the individual.

So, what is the norm for Tendon Pain?

Due to the makeup of the tendon fibres and what their role is, it takes either a dramatic change in your load or a build up in load that exceeds your capacity over time to elicit a painful response. This may cause an inflammatory response for an acute change and/or structural change in a more chronic period of excessive loading. Either way, there will be an element of pain that is overriding in either your day-day activities or exercise-based activities.

So, What do we do?

You stop doing what hurts, dur? Well, with tendon pain it isn’t as straight forward, and that’s good news for you! Why? Because it doesn’t mean you have to completely stop all forms of activity. Our aim is to keep the healthy or injured part of the tendon active within our desirable limits and with suitable progressions in activity and exercise; our tolerance will improve over time!

So now we come onto the million-dollar question, what is the right amount of pain?

The criteria for tendon related acceptable pain is really straight forward, we take a subjective interpretation of your pain and provide scores of optimal, acceptable and undesirable intensities of pain. The presence and/or duration of symptoms after a reaction are also monitored and fall into the same categories. Remember, your pain is unique to you, as well as your exercise tolerance – this is all considered when your therapist constructs your rehabilitation programme.

adamSo don’t panic, tendon pain isn’t as debilitating as it seems. With patience and commitment, we will get you back to your goals, and back even stronger than before!

Adam

Blog post by Adam
Senior Physiotherapist at Emma James Physio

The upward surge in sports injuries around this time of the year

As the winter months slowly start to take over our skies, the balmy holidays in July and August already feel like a distant memory; what that also means for a lot of us is that we’re back in full swing with our gym routines, running trails, contact sport training and games – casual and professional athletes alike – and perhaps preparing for our next marathon/half-marathon.

Interestingly, we as Sports Physios tend to see an upward surge in sports injuries around this time of the year. And sometimes, as a figure of speech, we can even predict certain months being more “hip/knee/ankle injury dominant”, depending on whether there is a prominent sports events coming up e.g. London Marathon, or a finals series. In those months, we are bound to see and treat a few people with sore ankle tendons or painful knee tendons.

…but why is that?

Today I’m hoping to provide you with a little insight to how we as physios answer that question.

Tendons mostly are the thick, fibrous connective tissue that links a particular muscle to a bone, and is the main structure that converts a muscle contraction into an actual body movement. It is primarily made up of collagen tissue, and this tissue can be an incredibly robust, “workhorse” structure – being able to absorb impact, withstand multi-directional forces, convert muscle energy into movement, and generate power + velocity pertaining to our chosen sport.

However, tendons do have a major character flaw: they are very, very sensitive to change. Which means any drastic changes to one’s training routine – simply termed as Load in Sports Science – can have an irritating effect on the tendon structure, eventually leading to pain. Load, as we know, can be measured in a few ways:

  • Frequency: How often the training takes place e.g. How many runs per week?
  • Intensity: How hard the training session(s) is, e.g. How fast you’re running
  • Volume: How much the person is doing in a particular session, e.g. How far you’re running

When there is a sudden, drastic increase in load – or an “upward spike” – the collagen structure of the tendon is unable to cope with these changes, and can often begin an inflammatory process, leading to collagen/tendon breakdown, and in severe cases, loss of structural integrity. Broadly speaking, this is when the person begins to feel a persistent pain during and/or after the training, and the performance/output is no longer as well as before. Conversely, tendons also adapt to a decrease in load – or we refer to as “deloading” – whereby the collagen structure adapts to a lesser training load/regime, and in time is no longer at the capacity of its previous training intensity. So if we were to put two and two together: a deloading phase during our summer holidays/off-season followed by an upward spike around this time of the year…it’s not hard to see why some of us are getting aches and pains!

Luckily, most of the time these changes are not permanent, and tendons generally do respond well to treatment and rehabilitation. This is where the expertise of your physio comes in – we can determine the extent/severity of your presenting tendon injury, provide any immediate treatment that is necessary, but more importantly go through the details of your training routine and carefully making adjustments to it. This ensures that we are gradually rebuilding your tendon strength properly, as well as preventing it from further irritation and breakdown. Such is the nature of tendon injuries, there is no one-size-fits-all, and each case is treated in accordance to its specific needs.

All the physios at Emma James have had the privilege to work with (and currently so) athletes at various levels, and therefore are very experienced in dealing with tendon injuries.

kelvinShould you have any doubts about your training, be sure to contact us as we would love to help. Just imagine: us making your marathon training (actually) enjoyable!

Kelvin
x

Blog post by Kelvin
Senior Physiotherapist at Emma James Physio

Growing Pains in young footballers

Growing pains (Traction Apophysitis) can occur in children following a period of rapid growth and/ or increase in sporting activity. During periods of rapid skeletal growth (think teenagers suddenly almost growing overnight) the cartilage within long bones of the body is weaker and becomes more susceptible to injury.

Growing pains most commonly affect tendon attachments at these sites: the heel (Sever’s disease), below the knee cap (Osgood-Schlatter’s) and at the base of the knee cap (Sindig-Larsen-Johansson). Often these children participate in football as well as other running and jumping sports.

Onset is usually gradual with pain over the areas mentioned above. Unfortunately, often growing pains mean the child ends up resting from their sport. However, rest alone often does not solve the issue, with pain returning when the child attempts to return to activity.  Bone often grows quicker than the muscle has time to stretch and adapt causing increased tension at the tendon attachment which can cause pain to develop. We cannot control this!

However, we can have some control over other contributing factors such as;

  • Training load- how frequently/ intense training is, is it varied and balanced with good emphasis on technique and rest?
  • Poor biomechanics
  • Poor capacity of muscles to deal with rapid skeletal growth

Obtaining an early diagnosis and appropriate management plan should reduce the impact on a child’s participation in sport.  An individualised rehabilitation program should be devised with the help of your physiotherapist to address the factors outlined above. A physio will also advise on which activities to temporarily limit and which to continue with and future training strategies.

lisa

Lisa
x

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Exercises you can do at your desk!

Following my post about the benefits of Pilates, heres some useful exercises you can do at your desk!

Note: With all sitting exercises you must be sitting up tall on your sit bones. Keep your core engaged (almost feel like you are pulling your belly button in towards your spine) and shoulders relaxed and down.

desk-exercises-1

Dumb waiter

Sit with your elbows bent at 90 degrees. Keep them tucked into your waist while you open out your forearms and keep your back straight. Keep pressing your shoulders down while you repeatedly open and close your forearms.

Spine twist

Hold your hands on the back of your head. Keep elbows out to the side. Hips facing forward. Inhale through the nose and as you exhale through the mouth twist though the mid-point in your back to one side. Inhale and on exhale come back to center repeat on the other side. Do as many as you want but make sure you keep an even count.

desk-exercises-2

Spine stretch forward

Sitting nice and tall, resting your hands on your lap. Breath in through your nose as you exhale tuck your chin to your chest and start rolling down through from the top of you back, only to half way down your back. Breath in and then on the exhale use your abdominals to pull your torso back up to sitting tall. Rolling through your spine bone by bone.

Lateral/side bend

Sitting up nice and tall, arms by your side as you breath out reach your right arm down one side of your chair with out leaning forward or backwards. Repeat on the other side.

desk-exercises-3

Hip opener/Hip flexors

Cross one leg over the other (ankle on the knee) and bend forward over your legs with a flat back.

Single Leg raises

Sitting nice and tall with feet flat on the floor, extend one leg at a time focusing on activating the quadricep muscles and then slowly lower down. Alternate each leg.

Why not try a Pilates Class?

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

pippaPippa
x

Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Pilates – gain a balanced body and mind

Pilates practice can help you gain a balanced body and mind. … A balanced body is one in which each part of the body works with one another to create and maintain a stable person. A balanced body is one that is mentally, emotionally, and physically stable.
The beauty of Pilates is that anyone, at any age can get started. Through the controlled and progressive movements, you can totally reshape your body.

Improved posture

By strengthening your core and improving your alignment of your spine.
Desk jobs encourage bad posture which can lead to kyphosis (rounding of the upper back) by working on muscular imbalances this can be reversed. Most Pilate moves help with scapula, shoulder and spine stability.

Improve flexibility

flexibilityWith longer hours of sitting we get tight hip flexors and generally stiff. Pilates encourages you to lengthen and expand your muscles.

Strengthen core

All Pilate moves require you to hold your core. Core muscles are not just your abdominals but the deep muscles running from the bottom of your head to your pelvis. They help support the trunk. Having a strong core will help support your back, which will help with pain and injury prevention.

Improve your balance

As you get older your balance becomes worse over time, this can then cause falls and injury. Pilates exercises require a more holistic approach and require activation and coordination of several muscle groups at the same time, which in turn improves your balance reducing the risk of falls.

Mental Health

pilates-classes

In Pilates you are told to regulate your breathing. Breathing is one of Joseph Pilates key principals. Pilates breathing directs your focus inward for the duration of the class, focusing on the present, feeling the muscles work and reconnecting with your body.

Exercising even if low impact helps produce endorphins in the body, which are also known as the happy hormones. It is natural drug to help boost your mood.

 

Pilates Classes

We offer a wide range of Pilates and Yoga Classes at our Hemel Hempstead Clinic, with our experienced and qualified instructors.

Look out for my next pilates post coming soon!
pippaPippa
x

Blog Post by Pippa
FCO Gym Manager & Personal Trainer
Emma James Physio

 

Football injuries in kids

Playing football has many benefits, however, as with all sports there is some risk of injury. According to research (Faude et al, 2013) this risk tends to increase with age throughout the age groups.

Research suggests Between 60 and 90 % of all football injuries were traumatic and about 10-40 % were overuse injuries. Most injuries (60-90 %) were located in the lower extremities with the ankle, knee and thigh being most affected.

The most common injury types were strains, sprains, and contusions (bruises).

The injuries we see the most in clinic among young footballers include:

  • Ankle sprains
  • Hamstring strains
  • Groin strains
  • Knee injuries (from bruises to cartilage and ligament injuries)
  • Quadricep (thigh) bruises and strains
  • ‘Growing pains’

Research suggests about half of all football incurred injuries led to an absence from sport of less than 1 week, one third resulted in an absence between 1 and 4 weeks, and 10 to 15 % of all injuries were severe (including, at the extreme, an anterior cruciate ligament tear which can lead to over 9 months out of football).

football-injuriesIt is important to see an experienced and Chartered Sports Physio as soon as possible after an injury to ensure:

  1. Correct diagnosis, treatment and management
  2. That the injury correctly repairs and does not return when the child resumes playing football and/ or give long term issues

 

Treatment for most acute injuries sustained during playing football includes:

  • PRICE – protect, rest, ice, compression, elevation
  • Rehabilitation – range of movement exercises and strengthening
  • Advice on gradual return to play
  • Analysis of training amount and type, addition of regular strength training if needed, modifying training amount to ensure full recovery and limit risk of future issues.

The timing and exact nature of these interventions depends on the injury sustained and the individual player and, as such, we would recommend you always consult a Sports Physio.

Treatment of overuse injuries (often referred to as ‘growing pains’) is similar but may also include more analysis of the child’s biomechanics, strength and training routine to try to identify why the issue has occurred and what can be done to resolve things and get the child back to playing football.

More Information:

lisa

Lisa
x

Blog post by Lisa
Senior Physiotherapist
MSc MACP MHCPC MCSP 

Emma James Physio

Create a free website or blog at WordPress.com.

Up ↑

%d bloggers like this: