Medial tibial stress syndrome-an update with Adriane

February 24, 2020/in Uncategorized /

Shin Pain – an insight into the condition and its rehabilitation.

Medial tibial stress syndrome presents as pain along the shin bone and is often referred to as “shin splints”. It is a relatively common injury and can affect athletes involved in impact sports, and up to 35% of runners.

The cause of shin pain is usually related to a sudden increase in load as one increases training intensity in view of an upcoming running event or game. This means an increase in either kilometer distance achieved, or pace and speed, or type of terrain (concrete vs grass vs soft sand etc), or tackling more hills or inclines. In some situations, it can even be caused by a sudden change in training shoes, which results in different biomechanics and way of loading the lower limb.

It is hypothesised that pathology of medial tibial stress syndrome involves dysfunction in the muscles that attach along the shin bone (tibia), namely posterior tibialis and flexor digitorum longus muscles. It is thought that that increase in load can result in increase in tension within these muscles, causing greater shear forces at the attachment sites of these muscles on the tibia. This in turn may result in symptoms such as pain, swelling and edema. In some severe cases, medial tibial stress syndrome can even lead to micro-fractures along the periosteum of the tibia if left untreated and aggravating triggers are not addressed.

Novice runners who have just picked up running as a new year resolution, for example, are particularly likely to develop this type of injury as their body has not conditioned and adapted to the demands of the new activity yet. Runners with higher body mass index (BMI), decreased hip strength and increased foot pronation were also found to be at higher risks. Females were also more prone to developing this type of injury due to having a larger pelvis and its implications on the biomechanical function of the lower limb.

So, what do I do if I have shin pain? – Does this mean I have to stop running?

Nope. Not necessarily…

Treatment of medial tibial stress syndrome involves an array of different approaches, including reducing load. This does not however mean that you should stop running altogether. It may be essential in some situations to have a temporary break from running until the acuteness and severity of your symptoms diminish to allow you to start a rehabilitation program towards starting to run again. But in most cases, it is a matter of allowing a relative reduction in load – run less distance, run smarter – and start a strengthening and conditioning program to address the biomechanical deficits identified by your physiotherapist.

In the early stages, the physiotherapist may treat the surrounding musculature to reduce any potential tension along the tibia and teach you some useful stretches and management techniques.

The physiotherapist will assess your biomechanics range of motion and strength, review your training volume (kilometers distance achieved per week), help you break down the intensity of your training and assess your running technique.

Overall, you will learn to train smarter, run better and understand how to work the fine line of challenging your body towards improving your performance, and also allowing adequate room for your body to strengthen, condition and adapt accordingly to prevent resurgence of injuries.

So, do not hesitate to see one of our friendly physiotherapists for an assessment and start your journey to fitness and wellness.

 Adriane Kabhlyuk , Physiotherapist and Pilates instructor

References:

Collins, N, Bisset, L, McPoil, T, Vicenzino, B. (2007). Foot orthoses in lower limb overuse conditions: a systematic review and meta-analysis. Foot & Ankle International; 28:396–412.

Geoffrey, J. (2014). Dynamic foot function as a risk factor for lower limb overuse injury: a systematic review. Journal of Foot & Ankle Research: 7: 53.

Janice and Reiman (2017). Lower Extremity Kinematics in Running Athletes with and without a History of Medial Shin Pain. International Journal of Sports Physical Therapy: 7(4): 356-364.

Luedke et al. (2016). Influence of Step Rate on Shin Injury and Anterior Knee Pain in High School Runners. Medicine and Science in Sports and Medicine; 48(7): 1244-50.

Newman, P, Witchalls, J. Waddington, G, Adams, R. (2013). Risk factors associated with medial tibial stress syndrome in runners: a systematic review and meta-analysis. Journal of Sports Medicine; 13(4): 229-241.

Saeki et al. (2017). Ankle and toe muscle strength characteristics in runners with a history of medial tibial stress syndrome. Journal of Foot and Ankle Research; 10: 16

Saeki et al. (2017). Muscle stiffness of posterior lower leg in runners with a history of medial tibial stress syndrome. Scandinavian Journal of Medicine & Science in Sports.

Winkelmann, Z.K. et al. (2016). Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. Journal of Athletic Training. Dec;51(12):1049-1052.

Zachary et al. (2016). Risk Factors for Medial Tibial Stress Syndrome in Active Individuals: An Evidence-Based Review. Journal of Athletic Training; 51(12):1049-1052

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Choosing your running footwear- all you need to know !

Did you know Josh trained as a Podiatrist before becoming a  Physio? 

Here are his expert tips on choosing your running footwear:

As Physiotherapists we are asked for advice on appropriate running footwear several times each day. Footwear companies often make exaggerated and misleading claims about the wondrous properties of their shoes, which can make it difficult to determine what type of running shoe is right for you.

In recent times ‘Barefoot’ or ‘Free’ running has gained popularity. Advocates will argue that because cavemen would have run barefoot this is a more natural way for our body to function when moving, and is more in line evolutionarily with how our foot and ankle are meant to be used.

The reality for present day adults is that a good degree of conditioning and adaptation is necessary for our bodies get used to running without footwear. Cavemen didn’t have to contend with surfaces such as hard bitumen or concrete. The right shoes play a critical role in reducing the shock caused to our bodies by these surfaces.

Numerous studies have demonstrated a marked change in loading patterns (how weight and pressure are distributed) through the feet and legs during running with and without shoes. Rapid change in any exercise training does not allow our bodies enough time to adapt, and adaptation is important for injury prevention. If you wish to trial barefoot running it should be a transition that is quite structured and measured so as to minimise the associated risk of injury. As this is a complicated process, it is best to seek the advice of a trained practitioner with specific knowledge and understanding of the biomechanics of running.

At the other end of the scale to bare feet, is footwear that does not permit normal functioning of the foot. Our feet and ankles are intricate in their design and function very well in normal situations to assist smooth and strain free patterns of movement through the body. Footwear that is rigid and does not accommodate foot motion can have equally detrimental effects to running without shoes.

So what does this all mean?

The long and short of this, if you’ll pardon the pun, is that there is no one-size-fits-all approach to selecting footwear. We each have distinctive running patterns and anatomical variations of the foot and ankle that mean we each need shoes with different features.

It is hard to know where to start with such a vast array of options available. When you walk into your local shoe store, even the staff may have little idea as to the features of each shoe, which is not to denigrate them, but shows how complex the technical components of shoe design and manufacture are.

Reputable brands and stores will have various styles with different features to enable selection of footwear that is appropriate to your own foot type and biomechanics. Remember that cost does not always equate with quality; the most expensive shoe may not work well for you personally. It is much more important that you have a shoe suitable to your foot type and your running regime than it is to spend a lot of money.

There are some common mistakes made when it comes to choosing running shoes.

Always measure shoe size while standing, and allow approximately the width of your thumbnail from your longest toe (which for some people is the second toe, not the big toe) to the end of the shoe. This allows for expansion of the foot during exercise, which is especially important in warmer weather. The width of the shoe is equally important. A good guide is to pinch the top of the shoe over the widest part of your foot. A small amount of the material should bunch between your index finger and thumb. A sign that the shoe is too big is that your whole foot will feel like it slides back and forth in the shoe.

If you wear orthotics, always ensure you wear them when fitting new shoes. You may find you need to go up a full size to accommodate the orthotic device.

Make sure the heel counter, the stiff part at the back of the shoe that covers your heel, is deep enough. If your heel feels like it loses contact with the sole of the shoe when you walk you may need to adjust the arrangement of the lacing of the shoe, or failing that, choose a different style of shoe that offers more depth. This is very important because the position of the back of your foot influences how well the front of your foot functions. Particularly with shoes that have in-built rear-foot control features, such as running shoes, it is essential that the heel sits right on the insole and snugly against the back of the shoe

Lastly, select a shoe that allows your mid-foot and fore-foot to move easily. To check this pick up the shoe with one hand cupping the heel, and the other cupping the toes. Twist the shoe gently between both hands. The first two-thirds of the shoe should twist under pressure and the heel should stay relatively stiff. The flex point of the shoe, where it bends most easily, should be where the ball of your foot would be, ideally around the first third of the shoe. It’s best to avoid shoes that bend in half, as your foot does not bend naturally at this point.

I hope this has provided some food for thought when it comes to running and footwear. Remember there can be a large degree of trial and error when choosing footwear, but a good retailer will have a more in-depth understanding of appropriate shoe types for you, so don’t be afraid to ask questions and do your homework.

 

Josh Neeft

M Physiotherapy (GE), B. Podiatry

Inner North Physiotherapy
734 High Street
Thornbury VIC 3071
P: (03) 9089 6666
F: (03) 9089 6644
E: josh@innernorthphysiotherapy.com.au
W: innernorthphysiotherapy.com.au

Clifton Hill Physiotherapy
111 Queens Pde
Clifton Hill VIC 3068
P: (03) 9486 1918
F: (03) 9486 5650
E: josh@innernorthphysiotherapy.com.au
W: cliftonhillphysiotherapy.com.au

Your feet and diabetes

The Australian Bureau of Statistics stated in 2018, that 5% of Australians have type 2 Diabetes mellitus. That is equal to one million Australians. Diabetes in fact, is the fastest growing disease in Australia. Currently two hundred and eighty Australians are diagnosed every day. How does this relate to Podiatry, you may well ask?

Type two Diabetes mellitus is a progressive disease. As the pancreas fails to produce sufficient amounts of insulin, blood glucose rises. It also causes a lowering of the good cholesterol (HDL) and a rise in the bad cholesterol (LDL) and triglycerides. This leads to a hardening and narrowing of blood vessels in the legs, compromising blood supply to your feet. Both high blood glucose and high levels of bad cholesterol plus the toxic effects of their metabolic by-products they generate, damages nerves in your feet.

The combined effect can result in numbness, tingling and painful feet.
Also, an increased risk of bacterial infections, delayed healing and ulceration. In fact, Diabetes Australia quotes four thousand four hundred foot amputations occur every year due to diabetes. There are ten thousand Hospital admissions annually due to diabetes and foot ulcerations.

There is no denying the seriousness of this disease adversely affecting your feet. It is not just a touch of sugar.

Prevention is always better than cure.
So, if you are over fifty five years of age, have diabetes in your family, are of Chinese, Indian, Aboriginal or Pacific Island background or if you had gestational diabetes, you are at a high level of risk in developing type two Diabetes mellitus.

If you smoke cigarettes, have high blood pressure, if your waist circumference is greater than one hundred and two Cm if you are male or greater than eighty eight Cm for a female or if your Body Mass Index is greater than twenty five, you too are at a high risk of diagnosis.

If you are always tired, always hungry, put on weight easily especially around your waist, are slow to heal, have blurred vision and are thirsty, these are the symptoms of type two Diabetes mellitus.

So, see your GP for a test. Eat well, exercise and lose weight. See your Podiatrist, Erica Michaelson at

CHP + R, to assess your foot health or provide a comprehensive diabetic assessment.

Erica Michaelson

Podiatrist

 

Erica consults on all aspects of foot care and lower limb biomechanics, including advice on footwear, running shoes, the assessment of foot posture and orthotic prescription and treatment of foot and lower limb pain. Erica has a special interest in children’s feet, diabetic foot care, skin and nail conditions of the feet and sports and dance injuries.

Erica is very experienced with difficult foot problems and is one of the very few podiatrists endorsed by the Australian Health Practitioners Registration Agency to prescribe medications such as anti-inflammatories, anti-fungals and anti-biotics and to perform pain-relieving foot injections.

 

BOOK CLUB WITH A DIFFERENCE

In an endeavour to mix up our education and share knowledge, this morning our enthusiastic Team Pelvis met up over breakfast for Book Club. Each of us presented on a different book

  • A Headache in the Pelvis (Issy)
  • Ending Female Pain (Adriane)
  • Mindfulness (Rosie and special guest the beautiful Emilia)
  • The Gut (Kiera)
  • The Body Keeps a Score (Trauma) (Jen)

It was super fun with a delicious breakfast and got our brains working hard early on a Monday morning. Well done girls, I have learnt plenty and look forward to our next breakfast for Podcast Blitz!

Jen

GLA:D (Good Life with Arthritis from Denmark) Program at Clifton Hill Physiotherapy

An exercise and education program for people with hip or knee osteoarthritis (OA) symptoms.

 

The GLA:D program is an exercise and education program developed by researchers in Denmark for people with hip or knee osteoarthritis symptoms.

Results from the GLA:D program in Denmark have shown:

  • Symptom progression reduction of 32%
  • Less pain
  • Reduced use of joint related pain killers
  • Less people on sick leave
  • High levels of satisfaction with the program
  • Increased levels of physical activity 12 months after starting the program

 On the success of the GLA:D program in Denmark, this program has been implemented in other countries, and most recently it has been launched in Australia.

The GLA:D Australia program consists of:

  • Two education session which teach you about OA, how the GLA:D Australia exercises improve joint stability, and how to retain this improved joint stability outside of the program
  • Collection data on your current functional ability
  • Group neuromuscular training sessions twice a week for six weeks to improve muscle control of the joint which leads to a reduction in symptoms and improved quality of life

OA is the most common lifestyle disease in individuals 65 years of age and older, but can also affect individuals as young as 30 years of age. Current national and international clinical guidelines recommend patient education, exercise and weight loss as the first line of treatment for OA. In Australia, treatment usually focuses on surgery. The GLA:D Australia program offers a better and safer alternative. The GLA:D program is unique in that the education and exercises provided can be applied to everyday activities. By strengthening and correcting daily movement patterns, participants will train their bodies to move more effectively, prevent symptom progression and reduce pain.

At Clifton Hill Physiotherapy and Pilates and Rehab we were one of the first practices in the country to implement this program which reflects the latest evidence in OA research. We have now been offering the program for more than two years and have had more than 30 participants complete the program. Our graduates have consistently achieved good gains in their physical functioning, high levels of satisfaction with the program. Preliminary analysis of the outcome measures collected from our cohort doing the program at Clifton Hill Physiotherapy have shown the following improvements 3 months after starting the program:

  • A reduction in pain levels
  • Mean improvement of 7% in walking speed
  • Mean improvement of 20% in sit to stand functional test performance
  • Significant improvements in quality of life measures

We have also been very pleased to see that our graduates have made active steps towards maintaining their gains and setting new goals either by continuing with the GLA:D sessions as an ongoing program, or by adherence to a progressive home exercise program of both specific neuromuscular control exercises as well as general exercise.

We have also had a few participants complete the GLA:D program at our center as a result of being referred via the trial currently being conducted by La Trobe University on the delivery of the GLA:D program. This trial is still actively recruiting participants, and if you are interested be sure to check out the following link:

http://semrc.blogs.latrobe.edu.au/knee-pain-clinical-trial/

At Clifton Hill Pilates we are currently running the exercise sessions for this program at the following times:

  • Mondays at 10.30am
  • Tuesdays at 3pm
  • Thursdays at 10.30am
  • Fridays at 11am

All GLA:D sessions at Clifton Hill Physiotherapy are currently run by Physiotherapists who have officially trained in the GLA:D program including Cathy Derham, Billy Williams, and Adriane Khablyuk.

Be sure to get in touch with our team at Clifton Hill Physiotherapy to find out more about the program if you experience any hip and/ or knee osteoarthritis symptoms, regardless of severity.

 

Cathy Derham

 

 

Built for walking – Made to walk! Low back pain and exercise

Wondering about low back pain?

Why does it hurt?

Why do so many people in Melbourne have low back pain?

Human beings are designed to move! It may sound simple, but think back to your high school science classes. Apart from making all sorts of misuses of the Bunsen burner, do you remember learning about all those muscles attached to the bones of the human body? They’re everywhere! Unfortunately in the smartphone age, the most commonly used muscle is our adductor pollicis (ie. scrolling up with your thumb). But do you know what the main intended uses of your muscles is for? That’s right, you guessed it: walking! Plain and simple walking.

Now, many of us use our bodies in ways that it is not made to be used (think: sitting at computer nine hours a day then spending the evening scrolling through overwhelming Netflix options). What this does is put abnormal stresses on our body, in particular your lower back, which can result in low back pain. So actually, in most cases of low back pain, there’s not a lot of mystery involved in why it hurts. Backs just simply are not made for the sustained stresses that we put them through.

So if walking is the most basic movement that our bodies are designed for, then it’s no surprise that walking is an excellent remedy for low back pain. Research shows that a simple walking program can be the most effective way of reducing low back pain.

Of course there are limits to abide by, and low back pain is different for everyone, so guidance from your physio in starting a walking program is essential. If you are having trouble, our Physiotherapists  can guide your exercises and address work with you on your low back pain issues.

When it comes to low back pain, most people are looking for a quick fix. Well, this is it! Strap on those Nikes, and take to one of the many lovely tracks Melbourne has to offer.

You won’t regret it!

Daniel Zeunert

Physiotherapist

Daniel is passionate about achieving the best outcomes for his patients by keeping up with the latest evidence-based research in physiotherapy. He uses a combination of exercise and manual therapy, operating under a biopsychosocial approach to patient care.

Masterchef 2019 has kicked off to a delicious start!

Continuing with the successful format from last year, our in-house Masterchef comp has a “lucky dip” for the budding chef to pick the feature ingredient. Each dish is judged on taste, presentation, and how well they showcased the feature ingredient.

For an additional twist this year, some new ingredients have been added to spice things up- anchovies, olives, and lemongrass (yummm!)

As the reigning winner from Masterchef 2018, I kicked off the season with the ingredient almond, and made a ‘Chinese almond jelly with goji berries and lychee’. Unfortunately, this did not turn out to be as delicious as I hoped, so it looks like the Masterchef title is up for grabs!

We have had delicious savoury dishes such as Billy’s ‘Mini Baked Potatoes with Mushroom Topping’ and Adriane’s “Cheese Sable Biscuits’.

Some current front-runners are Debbie’s ‘Passion Fruit Slice’, which was the perfect balance of sweet and tart. Ali’s ‘Lemon Sensation Tart’ (pictured) let lemon be the star. Brendan E also dished up a ‘Salted Caramel Brownie Slice’, which was demolished within seconds. Amanda’s ingredient mint was creatively used in a ‘Mint Slice Cheesecake’, which was presented as a giant replica of a Mint Slice! A mint and chocolate lover’s dream come true!

Strong contenders so far, everyone’s waistlines are looking suspicious and we are looking forward to the upcoming delicious creations!

 

Sonja Tun 

Physiotherapist

Pilates instructor

Masterchef CHP/CHPR/INP Champion 2018

Persistent buttock pain- its probably not sciatica.

A PAIN IN THE BUTT

The most common cause of persisting deep buttock pain or lateral (on the outside) hip pain is not sciatica, but caused by tendinopathy of the gluteal tendons: usually Gluteus Medius and Gluteus Minimus tendons. It’s also often misdiagnosed as bursitis, and treated (ineffectively) with cortisone or other injections.

This very common condition, also called greater trochanteric pain syndrome, is irritated by lying on either side at night. This puts pressure on those tendons between the greater trochanter ( ateral hip bone) and the bed surface when lying on the painful side, or pressure from the position of the top thigh as it crosses the midline when lying on the good side. It’s also made worse by sitting too low and getting up from sitting, crossing the legs, walking up hills and when climbing stairs. Lunges and Clam exercises can aggravate it. It can get so bad as to disturb sleep, create a painful limp and prevent walking & exercise altogether!

Affecting women much more than men, one study from Scandinavia (1) showed one in four women have got underlying Gluteal Tendinopathy, often becoming symptomatic with a spike in load. An event like overseas travel, extra walking or new impact exercise can trigger it, especially if the gluteal muscles (the buttocks) have weakened. This is so common, can last for years and its a pain in the butt !! However unlike sciatica, the pain will usually not refer below the knee or cause any nerve symptoms like tingling or numbness.

The good news is that clinical research (2) proves the right exercise program and advice on sitting and sleeping posture can resolve the pain and prevent it becoming chronic. Clifton Hill Physiotherapy / CHPR Physios Dr Henry Wajswelner and Dr Sallie Cowan were involved as treating physiotherapists in a landmark study called the LEAP trial, published in the British Medical Journal in 2018, that proved a physiotherapy program was the most effective form of management both in the short and long term. Education on the right ways to sit, stand, lie at night and move to minimise tendon compression is a key early component of the physiotherapy treatment program. Then a very gradual build-up of the right type of exercises to restore the gluteal, thigh and trunk muscles is the main form of longer-term management.

If you have persisting buttock/ lateral hip pain that is not responding: you probably have gluteal tendinopathy !!! Make an appointment with one of our physios to be assessed and get the right advice and exercises so you can get rid of this annoying pain in the butt!!

 

Dr Henry Wajswelner FACP* APA Specialist Physiotherapist (As awarded by the Australian College of Physiotherapy 2007)

Henry is one of the first Specialist Sports Physiotherapists in Australia, passing his College exam and gaining his Fellowship in 2007. He has over 35 years clinical experience at the highest levels including the Australian Olympic Rowing Team and the Australian Institute of Sport in Canberra.

Henry specializes in using Physiotherapy and Clinical Pilates for persistent spinal and joint problems. His experience comes from using Pilates in managing athletes’ injuries & through his doctoral research studies into Pilates for Chronic Low Back Pain. Henry also works closely with Orthopaedic Surgeons and Rheumatologists for all types of clients to develop specific Pilates programs to optimize recovery from surgery, pain and injury. Henry often works with other physiotherapists to co-manage difficult problems to achieve outstanding results.

Henry is also a researcher involved in studies investigating the best way to manage hip pain caused by Gluteal Tendinopathy. He is a Senior Lecturer and Course Co-ordinator at Latrobe University, where he leads the Master of Sports Physiotherapy Course for Graduate Physiotherapists from all over Australia.

 

 

Clinical Research Studies mentioned in this blog :

  1. Segal NA, et al (2007) Greater trochanteric pain syndrome: Epidemiology and associated factors. Archives of Physical Medicine and Rehabilitation 88:988-992.
  2. Mellor R, Bennell K Grimaldi A, Hodges P, Kaszka J, Nicolson P, Wajswelner H, Vicenzino B (2018) Effects of education plus exercise versus corticosteroid injection versus no treatment on patient rated global outcome and pain among patients with gluteal tendinopathy: a randomized clinical trial ( LEAP trial ). British Medical Journal; 361:k1662

 

Osteitis Pubis- Where did it go? Billy Williams Clifton Hill Pilates & Rehab

Passionate supporters in the AFL community will more than likely be familiar with the once frequently used diagnostic term, ‘osteitis pubis’. In the early 2000s, it seemed every second player was reported to be suffering from this troublesome injury of the hip/groin which was responsible for significant amounts of missed game time and a complex, challenging recovery period.

However, in recent times you may have noticed that it is very rarely being reported in the media by elite sports clubs. But why is this? Are therapists better at managing groin pain in sport? Is the term extinct? The answer might surprise you…..

Leading into 2014, there was a large amount of disagreement and uncertainty regarding the use of diagnostic terms for hip and groin pathology within the sports medicine and physiotherapy industry. Osteitis pubis, or OP, was often used as an umbrella term to describe a number of injuries which were potentially co-existing, and as such became easily recognisable by the public. It was widely accepted that an athlete with OP would require a lengthy rest period and a graded rehabilitation back into training and sport.

In November 2014, 24 experts in groin pain from a number of backgrounds and countries (including surgeons, sports physicians and physiotherapists) attended Qatar for a meeting to discuss the inconsistencies in hip and groin diagnostics. Prior to the meeting, each expert was given the same two case study examples. These included descriptions of relevant clinical symptoms, results of clinical tests and imaging findings for an athlete who was experiencing groin pain. They were then asked to independently provide their expert diagnosis.

For case study one;

NINE different diagnostic terms for primary diagnosis were used!

For case study two;

ELEVEN different diagnostic terms were used!!!

Across the two case studies, 22 different clinical terms were used to describe primary, secondary or tertiary injuries of the same two case studies! This clearly highlighted the need for an agreement on what should be considered accurate terminology when describing hip and groin pain. This would be critical in understanding the anatomical details of each athlete presentation and facilitating clear cross-referral between practitioners.

This meeting is known as the ‘Doha Agreement’. It advocated that long standing groin pain be classified under the following clinical entities;

  • Adductor-related groin pain
  • Iliopsoas-related groin pain
  • Inguinal-related groin pain
  • Pubic-related groin pain
  • Hip-related groin pain
  • Other conditions (including non-musculoskeletal diagnosis)

These clinical entities are often broken down with further more anatomically descriptive terminologies for deeper accuracy. However, many terms, including osteitis pubis, were not recommended for clinical use by the group of experts.

Since the Doha agreement clinicians are gradually becoming less comfortable with using the term osteitis pubis, and as such the public are hearing it less often. It is still occasionally used as it is easily recognisable by many sports fans, and this helps with honest translation of information from clubs to their fans.

Next time you hear OP mentioned in the media, understand that it is likely an injury related to one or more of the many tissues around the hip and groin such as the adductor muscles, the pubic bone, the hip joint or other physiological structures. An accurate and correctly descriptive diagnosis of a hip or groin injury can be obtained by collaborating information from reported symptoms, high quality clinical assessment and then complemented by diagnostic imaging findings. Once an accurate diagnosis is achieved, an appropriate rehabilitation and return to activity plan can be prescribed.

This accurate diagnosis is relevant if you are an athlete, if you enjoy non-competitive exercising or even to improve your ability to complete common daily tasks such as walking or shopping. The fantastic physiotherapists at CHP/CHPR/INP are experienced in working with sporting and non-sporting patients, and are your perfect first stop to work towards getting the answers to your troublesome hip or groin…. Hint; It’s not osteitis pubis.

Billy Williams, APAM

Bachelor of Physiotherapy

Graduate Certificate of Sports Physiotherapy

REFERENCE:

Weir. A., Brukner. P., Delahunt. E., et al. (2015). Doha agreement meeting on terminology and definitions in groin pain in athletes. British Journal of Sports Medicine. 49(12). 768-774.

SLEEP FOR GOOD HEALTH-Rosie Purdue

Are you getting enough sleep?

More and more research is coming out about the importance of sleep, yet almost a third of us get less than 7 hours quality sleep each night. Sleep takes place in three stages and deep sleep actually allows your brain to clean itself. Put scientifically, during deep sleep, the spaces between our brain cells expand by up to 60% allowing cerebral-spinal fluid to remove toxins such as beta-amyloid (a protein that can negatively affect memory). Also, research shows links between poor sleep and increased pain, as well as a correlation between lack of sleep and diseases like stroke, diabetes and depression.

The following tips may help improve your sleeping:

  • Set a nightly routine.
  • Dark, cool room.
  • Warm bed.
  • Relax and prepare for sleep before getting into bed; read a book, listen to calming music, do a puzzle.
  • No smoking and alcohol close to bed time (both can cause waking during the night).
  • No screen time 1-2 hours before bed; this will help your natural body clock.
  • If your partner snores, try different ear plugs.
  • Avoid a heavy dinner/dessert, but a light snack may help if you are hungry.
  • Avoid stimulants in the afternoon and evening.
  • Keep the bedroom for the two S’s.
  • Try practising mindfulness; it can decrease the effort of sleep.
  • If you are having trouble, don’t stay in bed worrying about it, get up but stay in a low-lit room.

If you’d like more help finding ways to improve your sleep quality, I recommend the 21 Day Sleep Programby Smiling Mind. Go to the App store, download the free App, create a login, go to ‘All Programs’ and it will be at the top of the page. Good luck and sleep tight.