Our feet are our main mode of transport, carrying us on a journey of 128,000 kilometres in a lifetime – a distance equivalent to three times around the world!
Ankle joints and feet are the link between your body and the ground. The tips below are to help you move well, stay well and assist in reducing the risk and severity of ankle sprains in the workplace.
With every step, shock is absorbed by the feet, knees, hips and spine to decrease the force of impact. Wearing the correct footwear will help to reduce these forces further whilst not affecting the normal function of the foot.
Wearing the right footwear for the job protects you from stress-related injury to the ankles, knees, hips and spine.
Wear activity-specific, well-fitting shoes, use spots strapping tape or an ankle brace to provide good ankle joint support (see your physiotherapist for advice on the correct support).
Avoid activities on slippery or uneven surfaces and in areas with poor lighting.
Keep your leg muscles strong, especially your calf and ankle muscles to help protect the ligaments
Practice standing on one leg to improve your balance and leg muscle strength.
Simple exercise such as walking or swimming is the best.
Make sure you warm up before and cool down after exercise with gentle stretches.
Article by the Australian Physiotherapy Association as a part of Tradies National Health Month. For more information visit http://www.tradieshealth.com.au/
Core Stability – How It Will Be Even Better In The Future
Following Nicholas’ rehabilitation after his disc prolapse, we have been working hard to determine the best way to incorporate some of the additional core stability training, in particular, Multifidus training, as part of everyone’s Pilates program over the next few months. So why is this important?
What Does Multifidus Do?
The Multifidus are a small group of back muscles which make up some of the deepest layers of the back muscles. In particular, they make up the ‘Local Stabilizing system’ of the lumbar spine, which means their major role is to keep one vertebrae (eg the top vertebrae) ‘stable’ over the other vertebrae (eg the bottom vertebrae), so that the power muscles, such as the erector spinae muscles can move the spine safely. In other words, the multifidus control the amount of glide one vertebrae has over the other. If this is ‘uncontrolled’, it puts pressure on the support structures such as the discs and facet joints, causing injury.
How Does Multifidus Differ From The Abdominal (Transversus Abdominus) Muscles In Core Stability?
These muscles work together, but are not the same thing. The Transversus abdominus muscle wraps around the body and attaches onto the spine indirectly through a thick layer of connective tissue called the thoraco-lumbar fascia. The multifidus muscle attaches directly on the lumbar spine and has a more direct action in maintaining core stability. Multifidus also attaches onto the thoraco-lumbar fascia, so the muscles are linked and enhance each other’s actions
How Do We Train Multifidus?
We can now view multifidus directly on ultrasound. Viewing the activation of this muscle will now become a standard part of your re-assessment and we will work on teaching everyone how to contract this muscle during their Pilates sessions over the next couple of months
• Kneel onto your hands and knees • Make a small arch in the lower back • ‘Squeeze’ the muscle of the lower back ‘in towards each other’. You should feel the muscle in the lower back puff up. Hold for 3 second
Don’t worry, we will be practicing these exercises during your Pilates sessions
Written by Nicholas Charalambous Physiotherapist at MD Health
Although taping is widely regarded as an avenue of injury prevention and treatment, it is important to understand when, how and more importantly why to use it.
In the last couple of years there has been a massive craze in multi-coloured and funky taping patterns seen across athletes, but what exactly do they do? The evidence is quite stretchy when talking about actual changes in electromyography (EMG) muscular activation or proprioception (the bodies ability to recognize where it is in space) or even range of motion of the joint. So why then do it? Apart from the “cool” factor there are some instances where taping a certain part of the body can greatly aid in the reduction of pain or irritation to the area, or even preventing further injury , e.g. ankle taping.
When to Tape:
Prior to taping any body part it is imperative to consult a medical professional on the correct methods of taping, which brand of tape to use as some people may be allergic to them, or of course if it is appropriate for them . A comprehensive exercise plan is recommended prior to considering tape as a method of treatment as studies have shown that taping areas such as the pelvis can actually REDUCE the deep core muscles activation due to the tape taking or mimicking the role of muscles, or in fact lose proprioception in the ankle for those who have been taping for long periods of time.
The Most Common Areas Where Taping May Help:
Ankles: Following acute sprain to help prevent further damage, or for high grade tears or chronic ankle sprains during high level activity
Knees: E.g. for acute Patellofemoral pain syndrome to decrease irritation and friction due to mal-tracking of the patella (knee cap), frequent dislocation or subluxations, or tendinopathies or tendinitis.
Shoulders: E.g. Effective in acute rehabilitation of Rotator cuff Injuries, Sub Acromial/Coracoid Impingement, or frequent dislocations or subluxations
How to Tape:
There are plenty of instructional videos online which can guide people on how to tape specific body parts however it is recommended that a medical professional’s advice is consulted in order to make it specific as possible.
Taping a body part is not something that should be relied on. It is merely another treatment option available out there IF appropriate. A specific assessment and tailored rehabilitation program, which taping may or may not be a part of, is the best way to address any issues.
Written By Nicholas Charalambous Physiotherapist at MD Health
Summer in Australia is a great time to get outside and enjoy the sunshine whilst increasing your health and fitness. However exercising at this time of year can pose some dangers, particularly with scorching temperatures. So with the hottest part of the year upon us in Melbourne, we thought we would share with you some tips on how to stay safe when exercising in the heat this summer.
1. Slip Slop Slap!
For those of us who have grown up in Australia we have always heard this message since we were kids! But it is always important to be reminded of being sun smart when exercising outdoors, especially during summer. Make sure you wear good quality sunscreen (at least SPF 30+) and if your activity involves water such as swimming or kayaking, make sure you chose a waterproof option. Appropriate clothing is also important to protect against skin damage and overheating. Selecting light, breathable and UV protective clothing which covers large areas of skin is recommended especially when exercising outdoors for long periods such as hiking or cycling.
2. Stay Hydrated
Adequate fluid intake before, during and after exercise is always important, but even more so during the warmer months as we are likely to lose more fluid during exercise due to increased sweating. To avoid dehydration, Sports Medicine Australia recommends drinking 2 cups (500ml) of water in the two hours prior to exercise and for exercise lasting longer than one hour drink 2-3 cups (500-750ml) of water every hour. Fluid intake is also important to keep our core temperature down and prevent overheating in hot conditions.
3. Exercise At Cooler Times Of Day
Exercise involving moderate to high intensities should be performed at the coolest part of the day such as early in the morning or in the evening to avoid some of the risks associated with exercising in extreme heat.
4. Exercise Indoors
When temperatures are extreme, exercising in an alternative environment should be considered where possible. This could include going to a gym and running on a treadmill in an air conditioned environment rather than running outside.
Written By Jack Hickey Exercise Physiologist at MD Health Pilates
The SIJ is the joint between the lower segments of the spine, the sacrum, and the illium bone of the pelvis. The SIJ is given structural support by strong ligaments and muscular support gives the SIJ some degree of dynamic stability. Movements of the SIJ are subtle and can be confusing; however the main movements which occur at this joint are nutation and counter-nutation. Basically speaking, nutation refers to the top end of the sacrum tilting forward relative to the Illium and counter-nutation refers to the top end of the sacrum tilting backwards relative to the Illium.
What is Pelvic Instability?
Pelvic instability refers to uncontrolled counter-nutation of the SIJ. This puts direct stretch on the long dorsal ligament which is highly innervated with nerves and can cause pain often felt in the buttock and down the leg. The combined actions of several muscles are critical to achieve stability of the SIJ, including trasverse abdominus, multifidus, pelvic floor muscles, the gluteal muscles, latissimus dorsi, obliques and erector spinae. Weakness or poor neuromuscular recruitment of these muscles can cause sustained counter-nutation of the sacrum, increasing the risk of SIJ irritation.
Treating Pelvic Instability and SIJ Pain
Assessment to determine which muscles are deficient in stabilising the pelvis is critical for the treatment of SIJ pain. For acute SIJ pain, any exercise or movement which brings the sacrum into nutation should reduce pain. This includes SIJ mobilisations, stretching the hamstrings to inhibit them from pulling the sacrum into counter-nutation, taping across the SIJ or into nutation as well as traction in line of the SIJ to reduce stretch on the long dorsal ligament. Initially to achieve further pelvic stability, exercises to improve the strength and control of transverse abdominus are key. To then achieve dynamic control of the pelvis, strengthening the other muscles which stabilise the pelvis (Most commonly gluteus maximus and latissimus dorsi) is required.
Written By Jack Hickey Exercise Physiologist at MD Health Pilates