Chart Clinic Reigate Osteopathy and Sports Massage

For Immediate Treatment Of A Sports Injury, Think R.I.C.E.

2012-02-22T08:15:00.000-08:00

This may be obvious to the seasoned athlete but it is worth discussing the significance and reasons behind following the RICE protocol after injury, later on you will appreciate the benefits of this simple form of first aid.

The first 24 hours – Remember this is the most critical time for treatment, immediately after an acute soft tissue injury. When you injure a soft tissue such as a muscle, ligament, or tendon there is a very likely chance of injuring blood vessels too. As a result blood gathers around damaged tissues causing compression within the neighbouring tissues, which causes a secondary ‘Hypoxic’ injury that deprives the tissues of oxygen, causing more harm. As a result, every attempt should be made to decrease the bleeding at the injured area. This is where RICE comes in, a simple mnemonic to summarise 4 actions to take after injury:

Rest

Ice

Compression

Elevation

So why follow RICE and what does it do?

Rest

Where possible following injury, you should try and stop activity to reduce the bleeding and swelling. If you injured say, the muscles in the back of your lower leg (calf) bleeding will increase as you exercise these muscles whilst running. If your injury is so severe that you cannot walk without limping, then a rest from weight bearing can be achieved by using crutches for a lower body injury or a sling for an upper body injury.

Ice

Straight after injury ice is mainly used to slow down the rate at which the soft tissues work and respire. Later on after the acute phase of injury, ice may be used as therapeutic treatment for its pain-relieving affect. There are numerous ways to apply ice, this could be crushed ice wrapped in a damp cloth or tea-towel, reusable frozen gel packs or immersing injured area in a bucket of icy water. Cold water and cooling sprays are often used but these rarely penetrate enough to affect the deeper tissues. Opinions vary for how long and how often to apply ice, but a useful guide is to generally apply ice for 15 minutes every 1-2 hours, steadily reducing the time of applications over the next 24 hours. Care should be taken to protect the skin with a towel or similar barrier to avoid the ice burning the skin or causing nerve damage. People with cold allergy or peripheral vascular disorders such as Raynaud’s phenomenon should not apply ice to treat an injury.

Compression

Compression of the injured area with a firm bandage reduces bleeding and, as a result decreases swelling. It is important to apply compression during and after the application of ice, so make sure a bandage is applied throughout. The size of the bandage is dependent on the size of the injured area and should be cut accordingly. Tubigrip type bandages come in a variety of sizes and widths. The bandage should feel firm but not so tight that it aggravates painful symptoms. If bandaging from a roll, the application should start at the furthest point away, wrapping each layer so it overlaps the layer below by half and should continue to extend upwards to at least one hands width higher above the margin of the injury.

Elevation

Elevating the injured area can be accomplished by using a sling for upper limb injuries and by resting the lower limb on a chair, cushions or bucket. For this to be effective the lower limb must be elevated higher than your hips/pelvis, this enables gravity to draw away fluid accumulation at the injured area and therefore decrease pressure within the fluids that bathe all the surrounding tissues around the injury.

Remember this advice is for a soft tissue injury, If you are in any way concerned that your injury is more severe in nature, it is vital that you seek medical advice immediately.

Once you feel more comfortable and the initial swelling and inflammation is more bearable it is then time to seek the advice from a musculo-skeletal specialist such as an Osteopath, Physiotherapist, or Sports Therapist.

Follow the advice of an injury professional, in addition to therapy, you may need to do exercises and follow a rehab programme.

Finally, whatever you do avoid the temptation to return to your sport too soon. Be guided by your therapist and rest for as long as is required, or you could end up doing more damage and need even longer away from activity.

At Chart Clinic, we are happy to discuss your individual situation and advise you the best course of action for your injury, so do feel free to get in contact.

Reference:

Brukner and Khan, Clinical Sports Medicine 3e, McGraw-Hill Professional (2007)

Back Pain? Osteopathy can help...

2012-02-01T12:29:00.000-08:00

Back problems are extremely common. Research has shown that back pain and related problems may affect in excess of 60% of people in the UK at some point in their lives. This is largely due to the fact that the lower back supports most of your body’s weight.

It is possible to suffer with a variety of symptoms. This may be a tingling or burning sensation, dull ache or sharp pain.

Back trouble does not necessarily make just your back hurt, you may get symptoms in more distant areas like your hip, buttocks, groin or legs (commonly referred to as sciatica).

Problems with your spine and neck can also cause symptoms, for example dizziness, headaches, pain in the arm or shoulder, pins and needle and much more!

It is not always the case that one sudden event causes your back pain. This can be a result of strain over a longer period of time. If you are doing things improperly, for example, standing or sitting for a long time with bad posture. It is then that unexpectedly one straightforward movement like reaching or bending for something that triggers your pain.

There are generally two types of back pain, acute (short-term) and chronic (long-term, continuous, ongoing). Acute low back pain is more common and it usually last for 1 month and can occur any number of times, whereas long-term back pain tends to last for longer than 3 months. Acute back pain can be resolved quite quickly especially with manual therapies and exercise, with good advice from a health professional you can take action to prevent a recurrence.

Osteopathy and Back Pain

Osteopaths are professionally trained individuals who are skilled in diagnosing problems, as well as those that may need further investigation if required.

Around 30,000 people currently consult osteopaths every working day with more than 7 million consultations carried out every year (General Osteopathic Council). NICE (the National Institute of Clinical Excellence) guidelines recommend manipulative therapies including osteopathy for the treatment of low back pain.

Treatment with an Osteopath

Osteopaths use a wide variety of gentle manipulations, depending on your age, health and diagnosis. Treatment is different for each patient but typically includes techniques such as different soft tissue massage and joint articulation to release tension, stretch muscles, help ease pain and mobilise your joints. Occasionally, when we move joints you may hear a ‘click’. This is just like the click people get when they crack their knuckles.

Keeping a healthy spine and joints

When we are young our body is a little more forgiving, easily adapting to the stress and strains it is subjected to. As we grow older the body begins to lose some of the suppleness which gives the body flexibility to get by and adapt. This especially applies to the discs between the vertebra and cartilage. Frequent movement is vital for these structures to allow maximum motion to increase local circulation and nutrition to the nearby fluids and tissues.

The British Osteopathic association suggest the following tips to keep a healthy back:

10 top tips for back care

1. Keep moving and stretching
2. Take regular exercise
3. Take frequent breaks between repetitive tasks and vary the rhythm
4. Change position – avoid ‘computer hump’
5. Pace yourself when the work is heavy e.g. gardening
6. Adjust car seats, and on long journeys, have breaks and stretch
7. Watch children’s posture – don’t let them carry bags on one shoulder
8. Avoid strain when lifting especially when shopping and with small children
9. Is your bed the right bed or is it getting old?
10. Seek osteopathic advice earlier rather than later

Source: osteopathy.org/back-pain 1/2/2012

If you or someone you know is suffering with back pain, why not get in contact with Chart Clinic to see how we can help, we will be happy to answer any questions or concerns you may have.

Getting fit in 2012? Kick-start January with our new year’s resolution fitness tips!

2012-01-01T03:30:00.000-08:00

The end of the festive season sees around 34 million Brit’s pledge to make a New Year’s resolution; did yours make the top ten? Unfortunately about 40% of these good intentions will be abandoned by the end of January.

TOP 10 NEW YEAR’S RESOLUTIONS FOR 2012

1. Become more physically fit

2. Improve financial condition

3. Improve health

4. Lose weight

5. Read more

6. Change overall attitude: be more positive

7. Improve family relationships

8. Travel more

9. Do more volunteer work

10. Improve other relationships (friends, co-workers, neighbours)

A December of office parties, entertaining and overindulging through the Christmas holiday are a great reason to make us want to kick-start 2012 with a healthy diet and some exercise.

Exercise related injuries are a regular occurrence in the New Year, something that we see all too frequently at our Reigate clinic.

If getting fit is on the top of your list, here are a few tips to keep you motivated and avoid injury - the two leading causes of quitting an exercise program.

Pick a type of exercise you will enjoy– you are more likely to keep at it.

Perform a warm up routine and stretch before and after you exercise, also do a warm down afterwards. Doing this before and after exercise decreases the chance of hurting yourself, as muscles are less likely to get injured if they are warm and relaxed.

Build up slowly, if you haven’t exercised in a while ease yourself back in gently, a beginner to running won’t be able to run a marathon right away, mix brisk walking with some light jogging and increase distances gradually.

Even if you are not a beginner to a sport, think about taking some coaching or a lesson. Improving your technique will decrease your chances of picking up an injury.

Avoid being a ‘weekend warrior’ by spreading exercise throughout the week. Overdoing it at the weekend will put you more at risk of injury.

Listen to your body. Pain, swelling and stiffness are your body’s way of telling you to ease back on an exercise routine. If you find that these symptoms do not resolve themselves, or are beyond what you consider normal, it may be time to seek medical attention.

Prevent injury, and boredom, by balancing cardiovascular exercise, weight training and stretching in your exercise routine.

If in doubt ask, seek advice from a professional, sports injury specialists can offer advice on taking up an exercise regime and injury care.

Wishing you a Happy New Year and a New You, Good luck!

To find out more how an Osteopath or Sports Massage can help you, or for more information visit our website www.chartclinic.co.uk.

Poor posture at work causes back and neck pain, are you sitting comfortably?

2011-11-29T09:01:00.000-08:00

For a vast majority of people today, work involves long hours at a desk in an office. Sitting in one place for lengthy and stressful days, it is no wonder that work-related muscular and joint problems or Musculoskeletal Disorders (MSDs), account for an estimated 11.6 million working days lost each year.*

For most people, we are aware that our posture is probably not that great. Perhaps you are reading this now slumped in your office chair? Have I caught you?!

Do you find that you get an achy back sitting at the desk or a stiff neck looking at the computer screen? These are two of the most common problems that patients present to us at our Osteopathic clinic in Reigate.

Yes, treatments such as Osteopathy or Massage can help to provide excellent relief for these symptoms. But it’s not just about what treatment we can offer for aches and pain, it’s also about what you can do to help yourself...

So why does your neck or back ache when you are working at the computer or laptop? The answer usually lies with your posture and the way your desk arrangement is setup. If you spend hours slouched over a desk and computer, with your head not in the optimum centre of gravity, you will start to run into trouble.

Typically an adult head weighs around 5kg. We can compare the weight of your head to that of a bowling ball, now if you hold that bowling ball with your arms outstretched in front of you, they will tire out pretty quickly. Now, hold it close to your body and you can support it much more easily. The same applies to your head, sitting up straight balances the weight of your head nicely on top of your spinal column. However, if you are hunched over your desk, the muscles and joints in your neck desperately hang on, supporting the weight of your head.

As your head pulls down and forward your neck gets totally overloaded causing strain to those muscles and joints.

So what can be done? Well in almost all cases of work related back, neck pain and various other forms of RSI we come across, the patient has paid little or no attention to desk setup or what is commonly referred to as ‘office ergonomics’.

Why not get a colleague to secretly take a photo using their phone, of you busy at work? It has to be when you do not notice, and then we can see your bad habits at their worst!

How is your posture? Just some of the key checks to make are as follows:

§ Your Chair, is it too low or too far back from your desk?

If it is, this encourages slouching and your back will not be supported, the head tilts forward, your shoulders hunch. You may even hook your feet into your chair base, restricting blood flow in the legs.

Shorter people may need the chair to be low enough so their feet are planted on the floor. But take care, if it is too low this may cause you to overstretch your arms or shrug your shoulders. You may require a foot rest to overcome this.

§ Your monitor, is it too low?

That will cause your head to tip forward and downwards. As a result your whole body leans further forward, moving your back away from the ‘back rest’ of the chair and encouraging you to slouch.

Remember the back rest, it does exactly what it says – rests your back! So be sure to make use of it.

Well I have been typing for far too long; it’s time for a break! Be sure to every so often, look away from your screen and focus on something in the distance this rest your eyes and get up at least once an hour and have a walk around your desk.

For any other work related problems get in touch with us, but we can only deal with musculoskeletal disorders, sorry we cannot do anything about your boss!

*(http://www.hse.gov.uk/msd/msds.htm)

Does cracking knuckles cause Arthritis? Fact or fiction...

2011-05-19T01:17:00.000-07:00

When somebody ‘cracks’ their own knuckles using their hands, an audible popping or crunching sound is often heard, that may make some peoples skin crawl! But does this mean something is broken or damaged and does it lead to Arthritis?

A joint is mobile part of the skeleton any place where the end of two bones come together and meet. The end of the bones where they are in union is covered by a layer of articular cartilage. This is surrounded by a capsule which engulfs the joint and its synovial fluid. This synovial fluid lubricates the joint and nourishes the joint surfaces including the cartilage.

The synovial fluid contains dissolved gases such as Oxygen, Carbon dioxide and Nitrogen. When a quick, precise force is applied to a joint, the space within the joint capsule increases in volume. On the other hand, the increase is restricted by how much synovial fluid is enclosed in the joint itself. The Synovial fluid cannot expand unless the pressure within the joint capsule decreases and the dissolved gases can be set free from the fluid. The audible ‘cracking’ noise is caused by a reaction to this pressure changing within the joint and the gases quickly escaping from the synovial fluid.

A number of clinical trials and research have been undertaken to determine if cracking knuckles causes arthritis. So far there has been no evidence to suggest that there was an increased incidence of arthritis among habitual joint crackers, however, a connection was revealed between knuckle-cracking, hand swollenness, poorer grip strength, injury to ligaments adjoining the joints and dislodgment of muscular tendons.

All in all, the research points towards that even though knuckle-cracking is not linked with arthritis, people who do it too often may cause some damage to other important structures of their joints.

Tips on starting back in the garden this spring!

2011-03-22T08:24:00.000-07:00

Gardening is a very pleasurable activity enjoyed by many, but it doesn’t have to be torturous for your back. With a little care and planning, the eagerly anticipated return to the garden after the long winter can be a more enjoyable experience even if you have a bad back!

Before you start:

It’s important that you are in practical but comfortable clothing as to not restrict your movement. If it’s cold, wear plenty of layers so your muscles keep warm. Well fitting flat shoes that are strong and supportive with non slip sole are also essential.

It may not be obvious but gardening should be treated as strenuous exercise where injury is a real possibility. The importance of a physical warm up should not be underestimated as to avoid hurting yourself.

A basic suggested warm up:

Walk on the spot, gradually increasing the height of your knees.
After a couple of minutes build up this walk to a marching pace.
Roll you shoulders in a circle forwards and then backwards for 1-2 minutes in each direction.
With your arms relaxed swing them forwards and then backwards.
Standing straight circle you hips around, be careful not to arch you back too much.

Start these gradually and then build up a routine that feels right for you.

Gardening tips, a general guide:

If you have been away from gardening for some time or returning after an injury, it is vital that you tackle it at a steady pace and build up gradually.

It is more often than not that you become very eager to get out in the garden, do too much and suffer the consequences with aches and pain the day after!

Any movement that involves bending, twisting and this combination together with lifting something puts your body at risk, in particular a strain on your back.

These simple guidelines can help you to protect your back whilst working in the garden:

· Avoid over reaching or straining by working close to you, don’t over stretch to reach something

· Don’t just bend your back, bend your knees to get down to pick or lift something up

· Move your feet; don’t just twist your spine

· Rather than overloading bags, wheel barrows or spades, use lighter loads

· Be careful not to spend more than 10-20 minutes stuck in one position doing something

· Push or roll heavy loads along the ground rather than carry it

· If lifting look out for obstacles that may be in your way.

· Divide heavy loads and make several trips if you are moving, rocks, stones or compost.

· Keep your feet hip width apart so you have a stable base.

· Carry heavy loads as close to you as possible

· Test heavy loads to see if you can manage by attempting to lift one corner. If in doubt get some help.

· Bend your knees rather than your back.

· Use the whole of your hand to grasp a load, not just your fingertips.

· Try to remember the importance of maintaining good posture when lifting, even when lowering a load; be sure to bend your knees and not your back.

If all fails and you do manage to hurt yourself, give me a call or email to discuss your problem.

James Clapham, Reigate Osteopathy and Sports Massage at Chart Clinic. Tel: 01737 248 023 or email: info@chartclinic.co.uk

Running the marathon and sports massage

2011-03-11T05:09:00.000-08:00

“The factor that probably boosted Paula Radcliffe’s performance more than any other is her ability to regenerate. Her regular massages were to give extra maintenance to the whole body. Above all it’s to give Paula’s muscles and tendons the best chance to recover from the heavy workloads she puts them through” The training secrets of Paula Radcliffe article written by Orlando Pizzolato in TN40 July 2003.

If you or someone you know is getting ready for the marathon, no doubt you are aware of the hard work and dedication that goes into running the distance. There is a fine line between training hard and over doing it, it is all too often the case that this leads to injury.

Regular sports massage is by far the best way to make sure that those muscle tissues get stretched and gain ample blood flow delivering the right nutrients, keeping the body in top physical and mental condition.

Sports massage has some key benefits as follows:

A regular session of sports massage promotes healthy muscles and encourages the circulation of blood. Basically what happens is, a deep massage reorganises the fibres in your muscles, permitting new oxygen and nutrients to flow and therefore allows a more speedy recovery.

The other important system is the lymphatic system; there is no pump behind this, so the lymphatic system is reliant on movement in order to function whereas the blood is pumped by the heart throughout the human body. When muscles tighten they contract and this holds back the flow of blood. The flowing movements of a massage not only relaxes tension but encourages the flow of blood and lymphatic fluid, removing toxin build up from your body and introducing fresh blood into your muscles aiding their healing and repair.

A history of injury may also affect a runner; there could be scar tissue at the site of the injury. However some of the scar tissue can be broken down with regular massage, energetically affecting performance of your muscles, ligaments and tendons. That is not to say that massage can totally get rid of scar tissue, but it will certainly help to increase its flexibility to smooth the progress of training with less drawbacks.

There is a huge psychological benefit of massage; this is due to the release of ‘feel good’ chemicals - endorphins, natural pain killers. Not only does this aid mental preparation for activity but will help maintain a positive mental frame of mind. Half the battle with increasing mileage with training is the ability to get motivated and then keep going on longer runs. Massage reduces any anxiety, helping you to reach a state of calm.

Taking a regular weekly massage will without doubt help to keep your body in top form as you prepare for your event. It is not advised to have a sports massage before a heavy training session. The muscles will have relaxed and will not be ready for high impact exercise and could cause injury. For the greatest results schedule your massage at least 2-3 days prior to your big event.