Online Telehealth Appointments

What is telehealth physiotherapy? 

This is the delivery of health care information and services specific to you and your needs via electronic communication. That is management and treatment of your musculoskeletal, pain and pelvic health issues . 

 What are the benefits of telehealth physiotherapy? 

There are numerous benefits it can offer, that is
– Able to receive to expert physiotherapy advice and treatment in the comfort of your home,
– Provides convenience 
– Easy access to specialized services 
– Empower yourself and take control over your recovery  

Will I be covered under my insurance or ACC?

ACC has recently approved funding for patients to access physio via telehealth during the Covid-19 Lockdown to stop the spread. Most insurance companies have followed suit, but it may take just a phone call to clarify they include the service.  

 

Exercise prescription telehealth

Can anyone in the world access these services? 

No, this is only valid for people residing in New Zealand. 

Will my session be recorded?

No. This can be arranged on request. We will be using a secure online platform called physitrack that is encrypted. We ask that you download the app  via this link prior to the session on to your device (smartphone or tablet) or via this link if using a desktop computer.   

What equipment will I need?

All you need is a good internet connection and a webcam and a private quiet space. The physiitrack app will enable us to set up customized exercises with pictures, videos and instructions as well as educational materials and questionnaires as required. 

If you have any further questions contact on 096346469 or ONLINE BOOKING

Physio Auckland

Study: When is bending too much?

This recent study looked at sustained bending and the time it takes before our postural muscles give in and we begin to rely on our passive structures for support.

Alessa 2017

How long is too long, to be in a forward, bent posture? Many of us spend hours doing house chores; weeding, DIY, working on the car etc. Not to mention the time spent leaning over a computer desk or looking down at your phone.

Back pain

Your muscles play an amazing role of suspending us in these positions, but just like with exercise our muscles will reach a point of fatigue. When the postural muscles aren’t able to provide the support we then rely on “passive” structures like ligaments and fascia, which is not their primary role, eventually leading stress and increased risk of injury.

This study looked at 2 angles of the spine leaning forwards and found that within 40 seconds the participants transitioned from the support of postural muscles to the passive structures. While this was found to be a natural transition the prolonged strain on the passive structures has been shown to increase the risk of lower back pain as suggested in another study.

As mentioned in a previous blog, these positions are not “wrong” but it’s better for the overall health of the spine to regularly change position and break from sustained load on an individual structure to provide balance.

Abstract

Static trunk bending is an occupational risk factor for lower back pain (LBP). When assessing relative short duration trunk bending tasks, existing studies mostly assumed unchanged spine biomechanical responses during task performance. The purpose of the current study was to assess the biomechanical changes of lumbar spine during the performance of relatively short duration, sustained trunk bending tasks. Fifteen participants performed 40-s static trunk bending tasks in two different trunk angles (30° or 60°) with two different hand load levels (0 or 6.8 kg). Results of the current study revealed significantly increased lumbar flexion and lumbar passive moment during the 40 s of trunk bending. Significantly reduced lumbar and abdominal muscle activities were also observed in most conditions. These findings suggest that, during the performance of short duration, static trunk bending tasks, a shift of loading from lumbar active tissues to passive tissues occurs naturally. This mechanism is beneficial in reducing the accumulation of lumbar muscle fatigue; however, lumbar passive tissue creep could be introduced due to prolonged or repetitive exposure.

 

Alessaa F. et al (2017) Changes of lumbar posture and tissue loading during static trunk bending. Human Movement Science

Continue reading “Study: When is bending too much?”

Hip Opener for Hinge Shapes

The hip hinge is an important movement in daily activities as well as in sports. Many people are unaware this movement exists and struggle with reaching their potential.

Many lifting injuries result from a lack of movement awareness and weakness of the posterior muscles. The hip hinge is a foundational movement for so many actions like deadlifts, squats, sprinting, jumping. Lacking an effective hip hinge is like racing a formula 1 car on flat tyres.

Developing a good hip hinge will improve the strength of the posterior chain. This includes muscles like the glutes, hamstrings and back extensors. The hinge movement is primarily coming from the hip. The goal is to maintain a neutral spine throughout the movement, the hips start to bend with your butt moving backwards and minimal flexion in the knee. This will increase the tension on the hamstrings and glutes.

The majority of people find this pattern of movement unnatural, as it’s rarely practiced and in most cases, are quad dominant. This quad dominant pattern causes weight to be distributed anteriorly, which is fine with some activities, but most actions we need to be more engaged with our posterior chain.

hip hinge movements.jpg

 

Below are a series of stretches and strengthening exercises to help Improve your hip hinging abilities.

Weighted Hip Hinge

This exercises is a great way to warm up and encourage the hip back movement while fighting the resistance to maintain a neutral spine.

Banded Hip Distractions

These two movements are also great for warming up. Both encourage release of the hamstrings but also the band provides a traction force on the hip socket. This should allow the joint to move free’er and help you access more range in the joint.

Dynamic Hamstring stretch

This is a deeper stretch of the hamstrings. Having more flexibility here will help you hinge better at the hip which will off load the knees.

Jefferson Curl

This movement is a great way of developing movement segmentally and will help build strength when maintaining a stable spine. It’s important to note if you have a spinal injury to avoid this movement until you have gone through the appropriate phases of rehab.

Continue reading “Hip Opener for Hinge Shapes”

Do your hips get the green Light?

Functionally the hip has certain positions that create stability and power. We should be looking at accessing its full range to ensure the health of the joint.

Healthy joints make difficult movements easier

Just like the shoulder, the hip has an important role in allowing us to function in various positions. It’s also a ball and socket joint, with both joints acting as catalysts for power, stability and accuracy of its connecting limb.

Unlike the shoulder as you may already know, the hip is held within a deeper socket, but still has a multitude of muscles surrounding the joint, including its own rotator cuff. The hip also has a ligamentous capsule with fibres angling in different directions. Using the capsule the joint can wind up into some very strong and stable positions. Accessing these ranges of tension puts the joint into a safe place to absorb load.

Gray339

These high torque shapes held by the hip are our start and finish points of most movements of the lower limb. Most of the time we can function well within the realms of the inner movement. But if we struggle to start from these positions it becomes difficult to transition and finish in a safe end shape. The goal should be to have full physiological capacity.

In the hip, there are 3 shapes we should all be able to achieve.


  1. The first movement is the squat/hinge a combination of flexion and external rotation at the hip. This movement takes all the glory, it’s all of our squat movements, it’s dead lifting, it’s rowing and the list goes on.
  1. Next is the Lunge/run which is full extension of the hip with internal rotation. This could be the bottom of a split Jerk, in running it would be your trailing leg before leaving the ground.
  1. Pistol is the last movement which alludes a lot of people (including myself), requiring full hip flexion but also full ankle dorsiflexion.

While the squat/hinge position is the most common hip shape used. We should also feel competent at the other 2 positions. Over the next few weeks I’ll go through the 3 movements and provide some ideas to achieve full depths.

Sleep Deprivation and Injury Risk

Acute and chronic sleep deprivation both have negative results with athletic performance. It also poses a greater chance of injury.

Optimal sleep can help minimise athletic injury

Skaggs 2014

For most of us sleep is not taken too seriously. We forgo sleep for other priorities in our busy lives. As I previously posted about the effects of sleep on exercise.  This study demonstrates that a lack of sleep increases the chance of injury. While this studied sleep deprivation of adolescents it can be easily applied to the wider population.

Deprived sleep will lead to higher perceptions of effort and fatigue, impaired strength, endurance and accuracy. Gym go’ers to aspiring athletes should look at this aspect of their life more seriously to protect themselves.

For optimal recovery we should prioritise sleep as much as we do with other remedies like recovery drinks, stretching, ice baths and foam rolling. Tapping into the right amount of sleep will improve performance and recovery from injury.

Original Abstract

Background: Much attention has been given to the relationship between various training factors and athletic injuries, but no study has examined the impact of sleep deprivation on injury rates in young athletes. Information about sleep practices was gathered as part of a study designed to correlate various training practices with the risk of injury in adolescent athletes.

Methods: Informed consent for participation in an online survey of training practices and a review of injury records was obtained from 160 student athletes at a combined middle/high school (grades 7 to 12) and from their parents. Online surveys were completed by 112 adolescent athletes (70% completion rate), including 54 male and 58 female athletes with a mean age of 15 years (SD=1.5; range, 12 to 18 y). The students’ responses were then correlated with data obtained from a retrospective review of injury records maintained by the school’s athletic department.

Results: Multivariate analysis showed that hours of sleep per night and the grade in school were the best independent predictors of injury. Athletes who slept on average <8 hours per night were 1.7 times (95% confidence interval, 1.0-3.0; P=0.04) more likely to have had an injury compared with athletes who slept for ≥8 hours. For each additional grade in school, the athletes were 1.4 times more likely to have had an injury (95% confidence interval, 1.2-1.6; P<0.001).

Conclusion: Sleep deprivation and increasing grade in school appear to be associated with injuries in an adolescent athletic population. Encouraging young athletes to get optimal amounts of sleep may help protect them against athletic injuries.

The effect of food on your recovery

When feeling sore or recovering from injury there are other lifestyle factors to consider. Your diet may be slowing down your rate of recovery.

Your nutrition could be what tips the scales on your road to recovery

You’ve come in for treatment of your shoulder. It’s to be expected that it will consist of some manual therapy and education, followed by a home exercise routine to develop strength or improve mobility. But then there are other factors that can impact your recovery. Lifestyle factors such as stress levels, sleep and diet. While carefully rehabbing the injury it’s important to consider what foods your putting into your body.

There are many studies that show the relationship of improved nutrition on overall health outcomes with chronic diseases. More importantly it’s specific role in reducing inflammation.

Making some dietary and lifestyle changes may help with weight loss, feeling emotionally stronger, and reduce pain intensity. Nutrition could be that missing link to recovering from your injury and also help prevent injury.

Many of you may have already found the right nutritional balance in your life. For those that may still need to make changes here are some recommendations based on evidence. Theses are the common problems associated with pain that can be alleviated with diet.

1. Inflammation

Large amounts of inflammatory foods, including refined sugars and vegetable oils, populate the Western diet. Most clinical studies show that a traditional Mediterranean diet, rich in healthy fatty acids, fruits, vegetables and fiber, provides anti-inflammatory benefits. There are other diets with smaller evidence bases that have similar anti-inflam benefits such as paleo and Keto.

Studies have also shown for specific conditions. The Med-diet is rich in polyunsaturated fatty acids and antioxidants that provides anti-inflammatory effects that benefit individuals with rheumatoid arthritis. Evidence shows an optimal diet can reduce inflammation and fight chronic diseases.

2. Obesity

One of the fastest growing problems across the western world. Obesity contributes to numerous chronic pain conditions. Multiple Studies show that weight loss is vital to overall pain rehabilitation.

3. Osteoarthritis

Osteoarthritis (OA) is the gradually degeneration of joint surfaces, one of the main causes of increased OA is obesity. Studies have shown that obesity is the most modifiable risk factor for knee OA. Pain levels of knee OA have been found to half when reducing 10% body weight.

One systematic review found scientific evidence to support some specific nutritional interventions–including omega 3 fatty acids–to relieve symptoms among patients with OA. Studies also show various nutrient deficiencies, including vitamins C and D as well as selenium, contribute to OA.

4. Autoimmune disease

Over 80 autoimmune disorders exist, including Crohn’s disease, rheumatoid arthritis, multiple sclerosis, and type 1 diabetes. Genetic predisposition and environmental factors play major roles in the development of autoimmune diseases. But increasingly, researchers believe adverse dietary changes over the past 50 years. Including gluten intolerance, altered gut bacteria, and vitamin D deficiency contribute to an increased rate of autoimmune diseases.

Those main changes being a high-sugar, high-salt, processed-food heavy diet that paves the pathway for autoimmune diseases. Nutrient depleted diets only worsen this problem with a studies showing vitamin D, vitamin A, selenium, zinc, omega-3 fatty acids, probiotics, and flavanol deficiencies contribute to autoimmune diseases.


Most patients I treat deal with inflammation in one way or another. But if you suffer from any of the other of the above issues, adjusting your nutrition could be the needle-mover to alleviate pains and helps your recovery.

This is only a recommendation for adjusting your diet if you think there could be something exacerbating an inflammatory response. For any major dietary changes seek the advice of a nutritionist.

Foods that fight inflammation

Anterior Knee Pain in CrossFit

Anterior knee pain is common in most sports. In CrossFit there is a lot of repetitive knee flexion, through full range. Look after your knees to prevent this condition.

Anterior knee pain or Patellofemoral pain is quite the common condition within sports. It affects up to 20% of active individuals (1). With CrossFit athletes, there’s no hiding from repetitive knee flexion. Whether you’re squatting, box jumping, running or doing pistols the load on your knee cap is being carefully balanced. If the load is too much it causes pain around the patella.

Symptoms

Patellofemoral pain usually is at its worst when bending the knee, running, jumping, climbing stairs, squatting or kneeling. It can make a noise when the knee bends and sometimes there’s swelling over the knee.

Potential causes of Anterior Knee Pain

Unfortunately for the knee cap, it’s stuck in a tug of war from forces in different directions. This suspends the knee cap as it tracks within the grooves of the knee.


  • Muscle imbalances: The Vastus Lateralus (outer quad) and Vastus Medialus Oblique (inner quad) are the forces from either side. This is one of the most common issues where your VL is overly tight, sometimes with trigger points. This causes a shift of the knee cap away from midline resulting in more pressure on surface of the patella.

A tightness of the quads muscle, particularly Rectus Femorus causes an upwards force on the patella. When the knee is bent under load this puts extra pressure on the surface of the knee cap.

  • Biomechanics: Our body moves as a functional unit and often the knee pain is a result of something more global. The knee sits between two other mobile joints, the hip and ankle. The ankle may be rolling in or weak Glutes are causing too much internal rotation of the leg. This changes the direction of force through the knee and patella.
  • Overuse: Repeated movements especially with a new movement pattern can put higher demands on tissue. If you’ve only just started doing CrossFit or doing high reps of pistols or box jumps you may feel some anterior knee pain.

Prevention and Self treatment

This word strikes fear into most Crossfitters – REST.

While it’s understandable you still want to train, there needs to be a compromise. We want to reduce the number of days training the initial few weeks to allow symptoms to subside. We also need to restrict the some of the deeper knee flexion movements and high impact activities.

We want to offload the force reaction on the patella when bending the knee. The more knee flexion the more force reaction. Deep squats might not be a good idea to start with when feeling anterior knee pain (see the table).

force.jpg

Activity Force % Body Weight
Walking 334 N 1/2 x BW
Bike 905 N 1.3 x BW
Stair Ascend 1760 N 2.5 x BW
Stair Descend 4000 N 5.7 x BW
Jogging 7.7 x BW
Squatting 6375 N 7.6 x BW
Jumping 20 x BW
Schindler (2011) (2)

If you’re feeling anterior knee pain you want to stick within a comfortable pain-free range. Try to understand that this condition needs to be managed carefully and with patience to ensure a smooth recovery.

Stretching and mobilising is important, especially the quads. If you’re unable to lie on your stomach and pull your heel to your bottom it’s a sign that your quads are in a poor condition. Regular foam rolling and stretches of the quads, glutes and along the ITB will help prepare you for training and prevent the onset of a patella dysfunction.

Practice the movements you’re struggling with. Ask your coach to look at the movement for correction or to be scaled in the interim until you’ve developed the strength. Also, practice soft landings, if everyone in the gym can hear you land, that’s a lot of force being passed through the knees.

What to Expect from Fundamental Physio

If you’re struggling to recover on your own don’t wait too long. The longer you wait the more chronic it becomes and harder to recover from. Putting up with patellofemoral pain has been shown to accelerate the process of patella osteoarthritis (3). 

Firstly, assessing your knee to test the mechanics of the joint with a series of orthopaedic tests to clear for any other pathologies. Then looking at how your knee and leg moves with different functional tests. This will help identify where you’re struggling and where you may be compensating.

Once we’ve identified the problem areas treatment will be more specific to your problems. This may consist of manual therapy such as massage, joint mobilisation trigger point release and dry needling. Depending on the stage of your recovery, strapping techniques with rigid or kinesio tape.

First we must break you down and then rebuild you…

While the aim is to get you back to functional movements, there may be some individual muscles that might have weakened. You’ll likely start off with some isolated exercises to build strength and control. Then putting it all back together in a compound movement. Correcting your on position, weight distribution and depth. You’ll have a lot more body awareness, rather than just doing the movement and it’ll help prevent an injury like this happening again.

If you’re struggling with recovering on your own contact me on 09 5290990

  1. Lack et al (2015), Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis. 
  2. Schindler (2011) Basic kinematics and biomechanics of the patello-femoral joint. Part 1: The native patella. Acta Orthop Belg.
  3. Crossley, (2014) Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? 

The Holiday Workout

Most of us when on Holiday completely switch off from exercise. If you don’t want to miss out on training try some of these workouts.

This blog follows on from The Office Workout I published a few months ago. There are times we neglect exercise, most commonly in the Office and when taking time off, going on holiday.

The usual story is you’ve been training hard all year and then go on vacation. At home you’re a finely tuned machine with a strict routine. In holiday mode, that routine usually goes out the window. Now try not to fear, a week away from the gym will not cause significant losses in muscle mass or fitness.

But if you’re feeling fidgety and can’t just lie in the sun, I’ve put together some options. Also try making some up yourself, get creative with the movements you use in the gym.

Take a rope…

One of the easiest pieces of equipment you can take away. It’s small and light to carry. Work on singles or doubles. Develop your technique and surprise your training buddies when you get back.

75DU’s – 50 air squats – 25 burpees – 20 push ups – 25 burpees – 50 air squats – 75DU’s

Other DU options….

30 HSPU/Push ups – 40 Mountain limbers – 50 Sit ups – 60 Squats – 70DU’s

3 rounds: 20 DU’s – 30 Walking Lunges – 40 Push ups – 30 Squats – 20 V-sit ups – 10 Burpees

Use the ocean…

Unless you’re a CrossFit Games athlete, how often are you doing interval training with swimming?  Find a quite section of beach and jump in the water.

8 Rounds: 100m swim – 10 Push ups – 15 Sit ups

Other swimming options…

30 mins AMRAP 50m Swim – 10 Push ups – 15 Air squats

15 mins AMRAP 50m Swim – 30 seconds treading – 50m Swim 

Use the Beach…

The sand creates another challenge of instability that you don’t have in the gym. Train in the sand to make the workout harder.

5 Rounds: 10 Push ups – 15 Air squats – 50 Walking lunges – 10 Burpees

21 – 15 – 9 Push ups and Air squats – 400m run each round

15m Bear Crawl – 20 Push ups – 15m Crab Walk – 20 Squats – 15m Burpees broad jumps – 20 Mountain Climbers

Get Creative

Think of other possible ways of training on holiday. They might not always work but it’s worth trying.

What’s in a warm up?

There’s a misconception with the warm up, that it’s mainly used to raise the heart rate and body temperature. But there’s much more to this part of your workout. If applied appropriately it can enhance your overall performance.

Warming up before sport or any strenuous activity it’s important to reduce the risk of injury (1-3). For the typical adult most of the day is sedentary (sitting or standing). Would you expect to jump straight into your fastest 100m sprint or complete a heavy dead lift? No is hopefully your answer.

What structures am I warming up?

Vascular System

When you move, changes happen to your circulatory system. There is increased blood flow to muscles, resulting in increased oxygen supply, along with delayed lactate buildup. 

Myofascial System

During the warm up the muscle and fascia (the connective tissue between muscles) begin to increase in temperature. Muscle fibers are prepped for a smoother contraction. A warm up allows fascia to slide easier.

Nervous System

This is the most important part of a warm up. Your nervous system is connected to every other system in your body. A warm up causes increased neural activity, increased sensitivity of nerve receptors and increased speed of nerve impulses. This provides improved balance, faster reaction times, increased speed, strength and flexibility. 


Warming Up Excites Neural Pathways

The nervous system is constantly responding to a multitude of sensory information to adjust muscle tension, movement patterns and balance. If a light jog was your standard “warm up”, but you’re training for heavy dead lifts. Will you have channeled the right neural pathways for this activity?

There’s a study showing improvements in vertical jump performance following sets of squat repetitions (4). It also demonstrated increased EMG neural activity following the squats.

A baseball study showed improvements in batting speed following warm ups with a weighted bat (5). This enhanced the neural motor pattern of this movement providing more speed and strength.


What’s in a warm up?

Really a lot depends on what you’re preparing for. Consider what muscle groups and movement patterns need to be primed. You need to be firing up your neuromuscular system and increasing your heart rate to enhance the vascular system.

Mobility – If you’re not doing this in your spare time, then check-in 10 minutes earlier to do foam rolling or some static stretches for those notorious tight areas.

Cardio – The best way of increasing your heart rate is a light jog or cycle, jump on the rower or practice some skipping.

Dynamic movements – This is where our nervous system gets kick started. Working on these movements will fire up movement patterns used when performing. These movements should engage our core stabilisors of the spine.

Plyometrics – Implementing this into your warm up will help fine tune your motor skills and ensure precision when training.

Explosive strength – Once going through the above warm ups. It helps to use extra resistance to improve those neural connections. Back squats before box jumps. Chest passing medicine ball for passing speed. Weighted overhead throw for spiking or serving.

Take the warm up seriously. By incorporating these actions to your warm up you will see great results and minimise injury.

  1. Emery et al, (2010) The effectiveness of a neuromuscular prevention strategy to reduce injuries in youth soccer: a cluster-randomised controlled trial. 
  2. McCrary et al, (2015) A systematic review of the effects of upper body warm-up on performance and injury. 
  3. Al Attar et al, (2016) How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis. Sports Med
  4. Sotiropoulos et al, (2010) Effects of Warm-Up on Vertical Jump Performance and Muscle Electrical Activity Using Half-Squats at Low and Moderate Intensity. J Sports Sci and Med
  5. McCrary et al, (2015) A systematic review of the effects of upper body warm-up on performance and injury. Br J Sports Med

Understanding shin splints

There is no satisfaction without a struggle first

Those that have experienced shin splints know how frustrating it can be to train. Whether it’s running, skipping or box jumping. Pain can be so intense that we stop doing these movements for a short period or permanently out of fear. With shin pain, there are many different factors that cause it. This is why having it assessed and treated appropriately can help you ease back into these activities with more control over symptoms.

  • Shin splints is a vague term used to describe overuse or repetitive strain of structures in the lower leg.
  • In athletics and military, “shin splints” can affect up to 35% and is more prominent with females. (1)

Take a look at the several muscles in the shaft of the lower leg, and the layers we have in our bone.

It’s very easy to label the condition as “shin splints”. But looking at the different structures involved with shin pain a more accurate diagnosis would help direct treatment and management of the problem. Shin pain can also be produced by other conditions.  Another reason to get assessed.

Shin splints (other conditions)

Bony shin splints

The outer layer of bone called the periosteum has a great blood and nerve supply. This makes it a common area for feeling shin pain. When training under normal stresses with adequate rest the density of bone increases which allows us to tolerate running for longer. If stress forces increase with little rest time in between, inflammation and pain develops. Pain ignored for long enough could result in a stress fracture.

Rest period of stress fracture: Depending on the severity and nature of the fracture it may take 4-12 weeks. Having it assessed and possibly X-rayed will help guide the timeframe.

Rest period for inflammation of the bone: This requires a shorter rest time but should be closely monitored to ensure we identify the cause of extra stress to the bone. Usual rest periods will be 4-6 weeks.

Muscular shin splints

Compartments of lower leg.gif

Muscles of the lower leg are held within compartments wrapped up by fascia. During running for example these compartments build up in pressure. As the pressure rises, oxygen levels lower, toxicity builds and then results in pain. A condition known as Exertional Compartment Syndrome (ECS). If ignored this could lead to chronic exertional compartment syndrome which often requires surgery . 

Rest period for ECS: Similar to the inflammation of bone, it may require between 2-6 weeks of rest. In this time, it is about identifying the issues causing the problem and building up a tolerance to the activity.

Tendon shin splints

Tendons are the pulleys of muscles, they connect to specific bony points to cause a movement. Inflammation of the tendon can be cause by excessively loading the tendon . Three tendons that lead to shin related pain are the Achilles, tibialis posterior and the peronei. Most common being tibialis posterior.

Shin splints tendinopathy

The Tibialis posterior muscle supports the arch and if it fails can result in many changes to the foot and ankle. Catching this fault early will allow you to correct the problem easier.

Rest period for a tendinopathy: This really depends on the length of time you’ve suffered, the severity and foot mechanics. Recovery time can take up to 12 weeks. Giving time to offload the tendon and building up stress’ again.

Managing shin splints

As mentioned above, it’s important to make a clear diagnosis to provide adequate rest and adjust back into your activity. Along with normal hands-on therapy and exercise prescription, physio can help shin pain specifically through adjustments made to the following:

  • Training error – over training, excessive distances, change in running surface.
  • Poor foot mechanics – A foot with a high arch or that rolls in poses a higher risk for stress fractures and tendon pathologies when running.
  • Footwear – Shoes lacking adequate arch support for an unstable foot causes muscles/tendons to work harder.
  • Running form – Analysing running form will help identify weak structures and correct poor patterns.
  • Movement and balance control – Good balance at the ankle, knee, hip and a strong “core” of your trunk muscles play vital roles in evenly distributing the force.
  • Muscle flexibility – Tightness of muscles can put excessive load on the tibia while running.
  • Ankle mobility – Increased ankle range of movement with joint mobilisations and stretches can reduce stresses on the lower leg.
  • Muscle strength and endurance – The strength of a muscle helps maintain a good position while running or jumping. But it also requires stamina to repeatedly hold position.

Returning to running

Returning to normal running with shin splints is always an uphill battle and is never a smooth transition. It’s a learning experience, understanding what your body can withstand and tailoring your rehab appropriately. It can be frustrating, but having patience with the process will get you back into your activity.