september 2019
It never hurts to get a little more thoracic spine mobility
Do you suffer with neck, shoulder or lower back pain, if so, then you may want to work at improving your thoracic mobility.
Along with hip mobility the thoracic spine is probably the most important area that you want moving, and moving well. However, it is often overlooked when treating the aforementioned problematic areas. That’s not to say that if someone comes in with neck pain and you treat the neck, that they wont experience a decrease in symptoms, but in order to promote a longer lasting effect working into the thoracic spine may hold the key to eliminating repeated episodes.
Despite popular belief the thoracic spine is BIG on movement, and if mobility is lacking then surrounding areas compensate by taking on additional demand. Unfortunately the surrounding areas such as the lumbar spine do not take kindly to this increase in demand; this is because the lumbar spine is built for stability rather than mobility, so when it is asked to do both, this is when injury commonly occurs.
With that said, how do you keep your thoracic spine mobile? Due to the orientation of the facet joints the movement available is primarily rotation as well as flexion and extension in the lower segments, therefore exercises should look to incorporate all three of these movements.
I have put together a few simple exercises that can be performed daily to help increase the mobility of the thoracic spine as well as help to promote neck, shoulder and lower back health.
October 2019
What’s the problem with this process?
The number one indicator for injury is previous injury, so if you have sprained your ankle once, chances are you will sprain it again, and probably in the not to distance future. So why is this such a predictor, even if you have followed the above process!?
That’s because the aim of treatment/rehabilitation is often to get you back to normal function prior to the injury, which might be adequate if it is a freak injury, but injuries occur when the load placed through a tissue exceeds that tissues maximum capacity, which can actually occur in daily life or sporting activities on a regular basis. So in relation to the above example of an ankle sprain, the reason the sprain has occurred is because the force placed through the ankle exceeds the ankles ability to effectively manage that load, with that in mind the ultimate goal of rehabilitation should therefore be to ensure the ankle becomes stronger and continues to to get stronger over time in order to limit the risk of re-injury.
Obviously no therapist can completely eliminate the risk of injury, but the aim of treatment should always be to mitigate that risk as much as possible by way of ensuring the tissues are able to withstand greater loads moving forward. This process is explained in the equations below:
Load > Capacity = INJURY
Load ≥ Capacity = REHAB
Capacity >> Load = PREVENTION
March 2020
Understanding Tendons
Following on from my previous post, one of the more common conditions I find myself treating or have patients present with is that of tendon pain, whether it be in the ankle, knee or elbow to name a few.
Tendon pain is often linked to an overload or overuse injury, which means the force put through the tendon exceeds the tendons capacity at managing that force. This results in cellular change within the tendon matrix - which basically means instead of cells being placed in an organised manner they are placed in a disorganised and haphazard manner which affects their ability to function correctly, resulting in localised pain.
As well as being the piece of connective tissue that attaches muscles to bones, tendons are also designed to act as a spring, they do this by storing and releasing energy, particularly during explosive movements. This is an important function as it allows us to athletically perform whilst being metabolically efficient.
Tendon pain was almost always referred to as tendinitis, and it is still a term that is often used today, but tendonitis by name (‘itis’ = inflammation) indicates that inflammation markers are present within the tendon, but this has now been somewhat disproven, as there is little evidence to suggest that inflammation is present unless in an acutely injured tendon, but even that inflammation is still only thought to be present for a few days. The more accepted term nowadays for ongoing tendon pain is tendinopathy as this refers to a more generalised disorder within the tissue. Recent research suggests that tendonopathies should now be considered as more of a continuum, and can be classified under three stages.
Stage 1. Reactive Tendinopathy
Stage 2. Tendon Dysrepair
Stage 3. Degenerative Tendinopathy
For the purpose of this post it is not necessary to dissect each stage of this process, but what is important is to state that wherever you may be on this continuum no intervention is going to reverse the pathological changes in the tissue, but what can be done is improve the tolerance of the tendon in order to stop ongoing pain. However, like most things the earlier you are along the continuum the better the prognosis is likely to be.
There are a few symptoms that likely indicate tendon pathology:
- Pain after exercise, normally the next day
- Pain free at rest but initially more painful when you start exercise
- You can often train through the discomfort once warmed up
- Local tenderness/thickening at site of the tendon
So if you are suffering with any of the above symptoms get yourself assessed by a qualified therapist 🤙.