Late last year Jacinta attended a course on ‘Greater trochanteric pain syndrome’. This syndrome covers many dysfunctions and injuries around the hip. Greater trochanteric syndrome is caused by irritation of the bursa (fat pad) which is a shock absorber as well as a lubricant for the muscles around the hip that lie adjacent to it. The bursa cannot be irritated on its own, there are many injuries that pre-exist that eventually cause the bursa to become inflamed. Once the bursa is inflamed it can be hard to treat as it can become irritated easily. Exercise can help however it needs to be assessed appropriately and only then can a closely watched exercise program commence.
Completing a hip assessment is not an easy process, if you have had your hip assessed by us you may remember there are many objectives that we need to measure and test before we can derive exactly what is causing your hip pain. This is how we can prescribe the correct type of program. One exercise that Jacinta has introduced to MD Health is a seated hip abduction hold with a belt. This is a great way to strengthen the gluteal muscles without causing irritation to the bursa! Once the pain has relieved we can progress to isometric holds with added resistance. You may have seen some of these exercises around the clinic!
Eccentric Based Strengthening – proven to increase flexibility and reduce lower limb injury according to recent studies!
Stretching may be a thing of the past according to a recent review that looks at the effects of eccentric (lengthening the muscle under load) training for increased strength, flexibility and overall reduced risk of lower limb injuries.
There are many factors that contribute to lower limb injuries some of which are poor neuromuscular control, reduced strength, poor joint range of motion and reduced flexibility.
In the past stretching was believed to be an important part of injury rehabilitation and that it could reduce the time until return to sport and it has been an encouraged activity during a warm up and cool down for many sports for years.
Most current studies suggest that stretching is ineffective at reducing injury risk, post exercise muscle soreness and improving performance. In actual fact, stretching has been shown to be a cause of injury if done during a warm up. Stretching reduces the contractile ability of the muscle and therefore decreases the stability of the joint.
So… If poor flexibility and range of motion are risk factors of lower limb injuries how can we improve this without stretching?
According to a review of 6 studies of the lower limb it showed consistent evidence that eccentric training increases range of motion with joint stability.
What is eccentric training?
All movements that we do with our body have a concentric (muscle shortening) phase and eccentric (muscle lengthening) phase. For example when completing a bicep curl the concentric phase is lifting the weight towards to shoulder (muscle is shortening whilst contracting) and the eccentric phase is straightening the elbow again (muscle is lengthening whilst contracting).
Sarcomerogenesis is the most likely reason why a muscle can improve in flexibility after eccentric training. It is where there is a prolonged shift in the muscle length-tension curve and the muscle adapts to the mild damage that is caused by eccentric training. This then improves the generation of torque a muscle can provide as well as reduce the chance of injury in an extended joint position.
Next time you decide to push yourself into a painful stretch think about whether this could be detrimental to your muscles and joints. Ask how we can help you complete some eccentrically loaded exercises to improve your flexibility.
Written by Beth Chiuchiarelli – Exercise Physiologist