Neck Pain – Wry Neck

Managing sudden neck pain on your own can be difficult. Whether you’ve had an injury or just woke up with it, physio can provide the right type treatment.

Have you ever just woke up with neck pain? Well you’re not alone. Up to 75% of the general population suffer with an episode of neck pain once in their lives.

Usually it comes on suddenly, from some non-traumatic event causing severe pain and stiffness of the neck. Which can be quite debilitating. Often occurring when waking up, if the head has been held in a prolonged position or turning the head quickly in a particular direction.

This can be particularly concerning when not being able function with your neck the normal way. The reassuring news is that it can be treated with physio and resolved using the right type of treatment, in a short period of time.

Wry Neck Symptoms

  • Neck stiffness – Your range of movement becomes severely limited. Usually locked up away from the site of pain.
  • Pain – Extreme pain localised to the centre or side of the affected area. Often radiates into the shoulder.
  • Muscle spasm – The injury usually leads to muscle spasm of the surrounding neck muscles and causes further restriction in neck movement.

Causes of Wry Neck

There are several theories of what causes a wry neck. The most common one being the small facet joints (two on each side of the vertebra) become irritated or injured when held in a prolonged position or moved quickly. This causes the increased pain, movement restrictions and muscle guarding.

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The other cause of a wry neck is an injury to the disc. Whether it be a bulge or strain of the disc wall, it can cause inflammation and place pressure on nerves that branch out of the neck. This may result in pain that radiates down the arm or cause altered sensation. If you experience this altered sensation it is important to seek professional advice. Discogenic neck pain might take longer to recover than a facet, but still responds well to physiotherapy.

Treatment Options

The good news is that a wry neck can be treated conservatively with physiotherapy treatment techniques and exercise. Physiotherapy can offer manual therapy techniques to loosen the stiff joints and soft tissue release for the muscle spasm. Dry needling may also help with reducing the muscle spasm and strapping can help during the acute pain.

Once the pain has gone and movement has returned, it will be important to consider prevention in the future. Strengthening and postural correction exercises for the neck, along with advice on ergonomics for your work environment may be needed.

Ideally seek treatment within the first 24 hours to start with the right advice for dealing with this injury. After a thorough assessment you will receive the best treatment and appropriate exercises to help you recover from your neck pain.

For an appointment, call on 095290990 

Complex movements and a neutral spine

Being aware of what a neutral spine feels like is a good start. But when incorporating it into more difficult movements, it requires patience and consistency.

Let’s start simple before making it complicated

Moving with integrity is essential to getting the best output from your exercise and with that, understanding the principals of neutral spinal position play a primary role. You could be pushing off to sprint or jumping up to block a shot or preparing for an Olympic lift, finding a neutral spine provides your limbs with a stable base to engage.

Maintaining a neutral spine

What is a neutral spine?sPINE

The design spine provides a wide range of movement in different directions, helped by having 25 mobile vertebral segments. This allows you to be highly functional. But not all spinal positions are efficient. It’s a neutral spine that evenly distributes stress through the complex tissue structures of the spine. This reduces the risk of injury when challenged and provides a strong platform for the arms and legs to work from. It also provides the least amount of tension on the nervous system as it branches out from the spinal column.

Looking at the supportive network of the spine, it’s made up of 3 arches. A slight inward cervical arch (neck), an outward thoracic arch (mid back) and inward curve at the Lumbar (lower back). Underneath the lumbar is the sacrum connecting to the pelvis.

Cannons being fired from a battleship have more power, stability and accuracy than once fired from a canoe.

Why do we need a neutral spine?

Physically it’s the most efficient position, but it doesn’t mean we need to be fixed in this shape at all times.

It does however become important when we throw complex movements into the mix. A complex movement is something that requires speed, power and timing from multiple muscle groups across multiple joints. Lacking the coordination of maintaining this posture during difficult movements not only compromises the spine but offers poor performance output.

An easy example of poor spinal position can be the dead lift. Often people race to get a heavier lift while ignoring the potential risks to the tissues of the spine. Finding a neutral position will not only be safe, but will offer better outcomes in developing strength.

Another example I see is the pull up. Coming over the bar there is often excessive chin poke and neck extension to clear the head over the bar. This compromises the neck, shoulders and upper back.

If you’re struggling with maintaining this spinal shape when doing complex movements you might want to remove an element of difficulty, such as weight, speed or scaling the movement. Develop better body awareness before making it more more challenging.

How to find your neutral spine

On the floor – 

  • Lying down on your back with your knees bent and feet flat on the floor.
  • Tilt your pelvis up and down to feel the top and bottom of your sacrum, at the back of the pelvis.
  • Then you want to feel the middle of the sacrum, adjusting your pelvis, it will lie between the top and bottom of the tilt.
  • Then tuck your chin in without fully flattening your neck to the floor.Finding neutral spine

Once you’re confident with the shape, get up into standing and attempt to maintain it through movement. The video below, using a stick will provide feedback to keep you well positioned.

… and then once you’re confident with keeping this shape, slowly start incorporating it into heavier, faster movements. This will put you in a safer position and improve the results of your training.

 

Upper Crossed Syndrome – A foundation for failure

Are you aware of upper crossed syndrome? Does this postural shape look familiar to you? If yes, then you take a look at the corrective exercises I’ve included in the blog.

Posture follows movement like a shadow

Are you being double crossed by your posture? There is a chronic condition called Upper Crossed Syndrome (USC) which is expressed by the rounding of shoulders, forward chin poke of the head.  Mostly seen with elderly, but with an accelerated escalation of sedentary lifestyles and work environments, it has become a common sight for all ages.

Upper Crossed Syndrome Anatomy

The position of your head and shoulder is orchestrated by various opposing forces. These muscle balance forces vary depending on the positions we regularly find ourselves in. With UCS there is usually a weakness of the deep neck flexors and overactive/tightness of the upper traps and levator scapulae. This causes a forward head position with a hinge point at the lower cervical spine.

Lower down with weakness of rhomboids and lower traps, matched with overactive/tight pectoralis major and minor causes a rounding of the shoulders.Posture

The muscle imbalance can affect multiple joint levels of the spine, the glenohumeral joint, the acromioclavicular joint and scapulothoracic joint. These might all lead to dysfunctions and result in injury.

How does this impact me?

Well that depends on how you live your life. This is a chronic condition that affects multiple joints and progressively over years they become stiff or weak. This closes the window on living an active lifestyle and increases risk of injury.

With less mobility and stability, comes greater risk to injury. 

This is typical with most office workers, students or driver’s. Their neuromuscular system has adapted to the UCS shape for years. But the injury risk increases when activity and movement levels are pushed higher than normal, for example overhead lifting, throwing sports or freestyle swimming that requires a wider overhead range of movement and ends up putting undue stress on the upper body.

Have you got the following?

  • Chin Poke: Is your head sticking so far out it’s at risk of falling off! Next time you stop at traffic lights take a look at the other drivers posture, it’s common to see the drivers head stuck at least 12 inches from the head rest.
  • Rounding of the Shoulders: Due to a weakness of scapula retractors, the lower traps and rhomboids, the super tight Pec muscles draw the shoulders forwards. Look at overly developed bodybuilders for a great example of rounded shoulders.
  • Winging scapula: When the scapula lifts away from the wall of the rib cage, it’s usually the result of a muscle imbalance. This might take a friend to spot this one for you.
  • Creasing in the neck: It’s the last places you want to see a crease. At the base of the neck and accompanied by the start of a hump in the thoracic spine.

Change starts now – How do I get there?

Expecting to do an overhead squat or chest to bar pull up straight away might be unrealistic if you’ve spent years holding a UCS posture. But there are ways of getting there…

  • Scaling the new movement that your practicing and working within the ranges that your body allows. Giving the joints time to adapt, without risking injury.
  • Working on individual muscles that developed the weakness and tightness over the years. This requires specific strengthening and stretching exercises.
  • Muscle tightness in your neck and chest may benefit from soft tissue work to release the muscle, like massage or dry needling.
  • Correcting form, sometimes we don’t have the body awareness to identify poor technique. Having the coach or physio look at your movement to correct where it’s needed.
  • Change can only be enforced through repetition and habit. The positions you’re in most of the day dictate your posture. At work, in the car, or at home, try to change your posture regularly.

Below are some basic examples of exercises to get you started with organising the shoulder and head. Try following them regularly to give your body the opportunity to change.

Continue reading “Upper Crossed Syndrome – A foundation for failure”

What’s causing my muscle tightness?

Muscular tightness is one of the disruptions to normal movement and if not managed well can lead to possible injury. Identifying your tightness and using specific strategies will help relieve tension.

One of the main issues patients struggle with is muscular tightness. They get a feeling of pain or tightness and an inability to relax the muscle.

What is tightness?

When looking at patients I need to find out if they have mechanical stiffness or the “feeling” of tightness or a combination of both, as this would direct my treatment plan.

Is the range of movement limited? does it have a soft or hard end feel? Are movements a struggle at end range, feeling heavy? What’s the rest feeling like, is it a constant tightness?

While we can have mechanical tightness of a joint or muscle, there are also the “feelings” of tightness. You might get your hands to the floor with your legs straight and feel the hamstrings tightening. While another person could do the same, get to their knees and not have tightness.

What causes the feeling of tightness?

Tightness is a sensation like many others, including pain. What we understand from pain is that this is not always brought on physically, but also by the perception of threat.

pathway-of-a-pain-message-via-sensory-nerve-in-injured-muscle,2324600

So like pain, tightness is a protective mechanism from the central nervous system to avoid danger. On a number of levels it detects stressor’s that expose the whole body or specific region to threat.

Examples of this…..

  • Prolonged sitting, without movement we often notice tightness in certain areas, possibly through reduced oxygen supply and increased metabolic toxicity.
  • Stressful situations cause rising cortisol levels and increased activity of the Vagus nerve leading to muscular tightness.
  • Repetitive movement over a period of time causes increased tension.
  • Posture muscle tightnessInjury or pre-existing weakness can cause a guarding response from the nervous system.

Using tightness as a warning sign for these potential threats might allows us to acknowledge the situation and quickly act upon it.

What will help my tightness?

Like all movement patterns, we improve with practice. The same goes for muscle tightness. If we regularly bombard it with neural messages to remain tight we develop trigger points and chronic tightness through a process called central sensitisation. Which makes the tissues more sensitive to pain and tightness.

If we can regularly supply our nervous system with input that is non-threatening we can slowly help desensitise the muscle. But this takes time and regular repetition.

Stretching

Most people with tightness, especially after prolonged rest feel the need to stretch out. But depending on our intended goal there are different types of stretches.

  • Static stretches
  • Active stretches
  • Dynamic stretches
  • PNF (Contract-relax)

While these stretches will help, it might only be temporary without regular repetition and reinforcing the nervous system with good movement.

Strengthening

There is a misconception that resistance training causes our muscles to feel tighter. Mainly due to the effect of DOMS. That feeling of soreness you have the day after a hard workout. But some recent studies have shown that strengthening can be equally, if not more beneficial than stretching.

Improvements in flexibility coming from improved ability to handle higher levels of metabolic stress and lower levels of inflammation. By lowering the threat to the nervous system through increased strength, it allows you to work the muscle through a wider range, without getting a stretch reflex.

Massage and other soft tissue work

Another way to help desensitise these tight muscles is to apply pressure. This could be with the use of a foam roller/lacrosse ball or other manual therapy techniques like deep tissue massage, myofascial release, trigger point release, dry needling.

Relaxation techniques and breathing mechanics

Like in the previous blog, an overactive or dominant sympathetic nervous system can cause muscle tightness. Finding ways of breaking poor postures or shallow breathing using a range of methods like kapalbhati, wim-hof, meditation, yoga etc. Using these methods are just part of the process to lowering overall tightness.

Usually, just following one of these methods individually is not going to be as effective as combining them together. Try to deal with the tightness from all angles.

If guidance is required or manual therapy techniques feel free to call 09 5290990.

Understanding your Nervous System

A healthy nervous system allows us to perform at a high level. Using particular methods we can tap into the subconscious side to improve the running of vital bodily functions.

You can’t control the wind, but you can adjust your sails

Our nervous system has a connection to all structures in the body. Without a healthy working nervous system most bodily functions suffer, our performance in life situations and sport are hindered and recovery from injury is impacted.

The Nervous system

Part of our central nervous system, within our subconscious is a mechanism for handling stressful situations. This is called the Autonomic Nervous system. It branches into two parts; the Sympathetic NS (SNS) and Parasympathetic NS (PNS). The SNS stimulates the bodily functions preparing us for the “fight, flight or freeze” in life threatening situations. The PNS is the other branch that prepares us for “rest, digest and heal”. It’s the PNS that should be the primary driver of our physiology.

B_B6BaNUsAAC6-G

Using the mailman and dog as an example. Most canines are territorial and when unknown visitors arrive they become defensive, will bark and jump at the door. It’s ready to fight. When the postman leaves, the dog quickly forgets what happened and is able to fall asleep within minutes. It recognises the threat has gone and can immediately relax.

Consider yourself in the same situation, feeling threatened of an intruder. You might shout at them to leave or prepare to engage with them. When the person retreats could you relax straight away or will you be on edge for hours or even days?

The SNS is important but only has a purpose for the short term, to allow us to deal with threatening situations. Unfortunately with hectic lives, our brain interprets these physical and mental stresses as life threatening, which frequently triggers the SNS on a daily basis. Constantly stimulating SNS can lead to chronic issues…

  • Anxiety
  • Fatigue
  • Irritability
  • Sleep disorder
  • Non-working muscular tension
  • Hyperventilation
  • Adaptation failure
  • Cognitive dysfunction

The brain struggles to identify physical stress’ and imagined stress’. Anxiety of an electricity bill, job cuts at work or relationship issues will fire up the SNS.

Throughout exercise/sport our PNS and SNS working in balance. Depending on particular stressors like speed, distance, duration, the SNS may start to have a greater influence. It’s important to get into our PNS state for improved decision making, better oxygen delivery and for achieving optimal recovery.

Ways of Activating the Parasympathetic Nervous System

The PNS is the system we should be using most frequently . Therefore finding methods of staying in this state even when put under perceived levels of stress are important.

1. Breathing Mechanics

The way we breath has a deep connection to the autonomic nervous system. Shallow, apical breathing has a direct link to our SNS. But taking Deep diaphragmatic breaths stimulates the PNS. Using breathing exercises daily can help train you into a more relaxed state.  Methods such as….

Wim Hof Method

Apnea Breathing

Kapalbhati Breathing

2. Meditation Practices

Through channeling your thoughts and breathing, meditation can help induce a state of relaxation. Following this 5-10 minutes daily can help improve many different functions. Easy to use apps for this are…

Head Space

Wildflowers

                      SoundCloud – Mindfulness Works

3. Muscle relaxation

Using methods like meditation or yoga are ways of achieving muscle relaxation. Having massages and soaking in a hot bath also offers a way of relaxing muscles. The release of tight muscles indirectly sends signals to the brain to activate the PNS and switch off the SNS.

Continue reading “Understanding your Nervous System”

Iliotibial Band Syndrome

Whether your running, rowing cycling or lifting. Repeated knee flexion may irritate structures on the outer knee. It is important to get on top of this condition to stop it hindering your training.

Setbacks are the perfect opportunity to grow

Iliotibial band syndrome is most commonly experienced with runners. But also in all sports that require repetitive knee flexion under high load. Early signs and symptoms often go unnoticed (or ignored) until it’s blown up into a fully-fledged injury.

What is the Iliotibial Band?

Iliotibial band

The Iliotibial Band (ITB) is a thick fibrous band of strong connective tissue running down the lateral side of the thigh. Its attachment points at the hip are from the Glutes at the back and Tensor Fascia Latae at the front. The bottom connection feeds into the outer border of the knee and patella. It’s at this attachment point that pain and inflammation develops and would be classed as Iliotibial Band Syndrome (ITBS).

The role of the ITB is to provide the knee with stability and to abduct the hip outwards. When we walk, run or squat it’s working hard to keep the knee in the correct position and force is distributed evenly.

What are the symptoms of ITBS?

Problems arise when the lower limb moves in abnormal directions repeatedly, causing the band to flick over bony structures of the knee, leading to irritation. It may also get tighter than normal through shortening or over activity of the Glutes and Tensor Fascia Latae. This results in the ITB becoming a tighter band pulling more at its attachment and compressing other tissue around it.

ITBS usually is a sharp pain or burning sensation in the lateral knee. Generally, felt during exercise when the knee flexes repeatedly through mid-range. This range of 30-40 degrees is when pressure of the ITB against the bone is at its highest. If this movement is repeated enough, it causes friction and irritates the tissue.

What causes ITBS?

There are a number of factors that can cause a stir up of ITBS. Physically there could be a muscle imbalance, with tightness or weakness around the pelvis, hip or knee, reduced balance, and reduced ground reaction time. Mechanically, often due to the physical limitations that cause incorrect movement patterns, poor weight transferring and distribution of load.

On top of this are issues with training error. How quickly a programme is progressed, especially if it involves load or speed. From running to weight lifting, training loads need to be gradually increased to reduce the risk of injury.

Management of ITBS

Initially you may be restricted from doing the activity that caused your pain while your body recovers. An assessment will help you identify what factors are triggering your ITBS. Treatment will be multifaceted providing advice for tissue loading, gait retraining and specific muscle strengthening and stretches. Additionally, soft tissue manipulation, strapping and dry needling.

With the improved running form, increased strength and flexibility you will gradually be introduced back into the activity. This will make you overall better at your sport and reduce the risk of this problem returning.

Evidence shows that ITBS responds well to conservative management with a success rate as high as 92%.

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

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.

Lets stop calling it tennis elbow

This injury affects more than just tennis players. Unlike its name the treatment for lateral elbow pain has advanced.

Lateral elbow pain is a regular complaint from athletes to manual workers, even office workers are exposed to the risks of these injuries. Sometimes this injury can be difficult to shake off without the necessary changes being made.

Why tennis elbow and what should we call it?

The diagnosis of “tennis elbow’ dates back to 1882 described as “lawn tennis arm”. While it effects up to 50% of tennis players throughout their careers there are many other activities other than tennis that cause this problem.

Lateral Elbow Tendinopathy (LET) is a more appropriate and clinical description of the injury. It encapsulates both a tendinitis (inflammation of the tendon) and tendinosis (micro-tears of the tendon).

With repetitive use of the arm, whether you’re doing a swing, cleaning a 60KG barbell, hammering together a fence or typing up endless reports. As the muscles in the forearm are being used continuously without rest the immune and metabolic bi-products cause micro tears in the tendon, leading to scarring, swelling and lateral elbow pain over time.

What can cause LET?

Forearm anatomny.jpg

The most common cause for LET is mentioned above, the small tearing of tendon inserting into the lateral epicondyle (outer elbow). Most commonly the tear occurs with the small muscle Extensor Carpi Radialus Brevis due to its weak insertion into the extensor tendon. But there are several other wrist extensors that can also overload this tendon complex.

For a long time, it was thought the sole problem was with the tendon and its connecting muscle. But the most recent model of LET suggests that as well as inadequate muscle power and endurance, there are also external factors influencing the pain.

These external factors could be…

  • Neck and mid back dysfunctions – Particularly the lower Cervical spine, the nerves that supply the lateral elbow have nerve roots at this level (C5-6). If nerve roots are irritated at these levels it can enhance the feeling of pain in its pathway down the arm, into the elbow. Following the Law of Denervation (This is a whole other blog!).
  • Posterior shoulder trigger points – Following that same C5-6 nerve root into the shoulder, it supplies posterior shoulder muscles. The development of trigger points in these muscles can irritate the nerve branches travelling down the arm causing enhanced pain into the elbow.
  • Thoracic Outlet Syndrome – This is another condition that effects the nerves supplying the arm. The pressure places on these nerves can also cause pain in the elbow.

As you can see all these external factors add a nerve component to the elbow pain and should be cleared in assessment to ensure they’re not involved or treated appropriately.

How long it takes to recover?

Like all injuries, it will vary. Depending on the severity and how irritable you are this could be a few weeks to a few months. Following the guidance and management of the injury from physio you will have greater success than treating it on your own.

If symptoms persist, with no overall improvement over 12 weeks an ultrasound scan may be indicated, followed by an assessment from an orthopaedic specialist.

How do I prevent LET?

LET is a silent assassin, it’s one of these conditions that develops unknowingly (with scarring and tissue inflammation) until it’s too late (when you feel pain).

If you’re involved in sport or work that uses repetitive motion at the elbow, you’re already a candidate for this type of injury. Consider that your warning and take control.

Firstly, those forearm extensors need to be managed. Taking regular breaks to stretch and strengthen the wrists will help. Rolling the lacrosse ball into the forearm and back of the shoulder to reduce tightness. Consider your posture when sat at work or in the car, aim for your head to be over the shoulders.

For those in the gym, look at your wrist position. Most movements other than front rack and press positions, you want to maintain a neutral wrist. Look at your kettle bell swing or pull up, keeping the wrist close to neutral will reduce the force through the muscles of the forearm.

How can physio help?

Depending your presentation when assessed there are a range of treatments that could include…

  • Soft tissue manipulation of the wrist extensors, neck and shoulder
  • Joint mobilisations to the elbow, cervical and thoracic spine
  • Dry needling of forearm wrist flexors/extensors, deep neck extensors, posterior rotator cuff.
  • Mobilisations with movement for the elbow, neck and shoulder
  • Strapping of rigid or kinesio tape
  • Prescription of elbow brace/clasp
  • Specific exercises to strength and stretching exercises for the wrist, shoulder and cervical spine
  • Mobility exercises for thoracic and cervical spine

There are many treatment options available but to help with a quick recovery it’s important to provide a tailored treatment plan to meet your individual needs.

For an appointment, call on 095290990

Recovering from DOMS

Delayed muscle soreness after intense exercise is expected. There are proven ways of reducing these pains quickly to get back into your normal level of training

Your future is created by what you do today, not tomorrow

So we’ve discussed the specific differences of muscle soreness after a workout and soreness from an injury. When you get Delayed Onset Muscle Soreness (DOMS) it is quite annoying trying to continue with training. Knowing that with DOMS we get the following problems.

  • Strength can be reduced by up to 50%
  • Range of movement will be limited
  • Pain will last between 48-72 hours

Understanding these limitations, its important to scale the weight, the depths and distances to accommodate for these temporary draw backs. But there are ways of accelerating the recovery or at least making it more tolerable.

Protein BCAA glutamine1Proteins 

Amino acids are the building blocks of proteins. As muscle damage is the precursor to DOMS, supplying it with a good source of Amino acids has been show to assist in recovery. While having a well balanced diet, additional supplements of glutamine and BCAA’s can reduce the inevitable weakness post workout. It may even help with soreness. (1,2,3,4)

Vitamin D

vitamin-d-en-fb.jpgGetting a little bit of sunshine might not be enough. The latest NZ Ministry of Health stats showed 32% of the population had lower than normal Vit-D levels. There is a link between people low in vitamin D and increased pain sensitivities (5). Taking supplements of Vitamin D3 may help additional soreness.

1023029.jpgHeat

Jumping in the spa pool or a using the hot water bottle. Heat is always soothing but it has longer lasting benefits to use heat with DOMS for the overall recovery (6,7).

Tart Cherry Juice

Tart cherry Juice muscle.jpgThis one is an unusual remedy but the benefits have been shown in this study (8). Following Exercise there was a 22% less weakness from the cherry drinking group, but no effect on pain. There are many natural anti inflammatory agents in cherries that is thought to help.

CoffeeCoffee Muscle soreness

I for one am pleased this is on the list, it gives me more reason to drink it! Studies have shown that caffeine helps lower pain levels and improve weakness during DOMS (9,10). Also helping increase number of reps compared to control groups.

Compression sleeveCompression Garments

Not necessarily for training, but post workout studies show that wearing compression tights or tops can reduce weakness and pain levels (11,12).

backsquat technqueTraining with DOMS

Even following the above strategies you will still have soreness and weakness. Consider this when training. You want to ensure your training for quality not quantity. Studies show training with soreness is acceptable and will temporarily reduce pain levels (13,14).

Myofascial Rolling (Foam Roller/Lacrosse ball)

Using foam rollers and lacrosse balls into tight tissues is a good way of preparing tissue for working through full ranges of movement. Through changes to mechanorecptors and nociceptors. There are studies showing benefit post workout and regular intervals during 48-72hours of DOMS (15,16).

References

  1. Song-Gyu, (2013), Combined effect of branched-chain amino acids and taurine supplementation on delayed onset muscle soreness and muscle damage in high-intensity eccentric exercise. J Int Soc Sports Nutri
  2. Volek et al, (2013), BCAAs reduce muscle soreness (DOMS) J Int Soc Sports Nutr.
  3. Tajari et al, (2010), Assessment of the effect of L-glutamine supplementation on DOMS Brit J Sports Med
  4. Glyn et al, (2012), Exercise-induced muscle damage is reduced in resistance-trained males by branched chain amino acids: a randomized, double-blind, placebo controlled study. J Int Soc of Sports Nutri
  5. Plotnikoff et al, (2003), Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc
  6. Mayer et al. (2006), Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial. Arch Phys Med Rehab
  7. Petrofsky et al, (2017), The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness. Cl J of Sport Med
  8. Connolly et al, (2006), Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damageBr J Sports Med.
  9. Maridakis et al, (2007), Caffeine attenuates delayed-onset muscle pain and force loss following eccentric exercise. J Pain
  10. Hurley et al, (2013),  The Effect of Caffeine Ingestion on Delayed Onset Muscle Soreness. J Strength Cond Res
  11. Hill et al, (2014), Compression garments and recovery from exercise-induced muscle damage: a meta-analysis. Brit J of Sports Med
  12. Armstrong et al (2015), Compression socks and functional recovery following marathon running: a randomized controlled trial. J Strength and Con Res
  13. Zainuddin et al, (2006), Light concentric exercise has a temporarily analgesic effect on delayed-onset muscle soreness, but no effect on recovery from eccentric exercise. Appl Physiol Nutr Metab
  14. Trevor et al, (2008), Effects of a 30-min running performed daily after downhill running on recovery of muscle function and running economy. J Sci and Med Sport,
  15. Pearcey et al, (2015), Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Ath Training
  16. MacDonald et al, (2014). Foam rolling as a recovery tool after an intense bout of physical activity. Med Sci Sports & Exs

CrossFit – How can Physio help?

CrossFit has its share of injuries like any sport. An experienced physio with knowledge of the training can get an athlete functioning pain free quickly and performing back to their best.

To perform at your best you need a strong mindset, great coaching staff that are strict with your technique and an experienced physio to prevent aches and pains

Most Kiwi’s are pretty tough, with a ‘she’ll be right” mentality when it comes to injury. You’d think that would be a perfect combination with the image CrossFit portrays. But when you’ve been carrying that niggle for so long and it starts getting worse, it could shut you down completely from training.

Physio and CrossFit work well together

Physio’s are specialists in movement analysis and CrossFit itself is a training regime that goes through gross fundamental movement patterns. So putting yourself through these movements and identifying your weakness’ gives me a lot more insight into where your problem could be coming from.

What are the common complaints?

There have been interesting studies done over the last few years into injuries within CrossFit. Interestingly the studies correlated similar with the same common areas being involved:

  • Shoulder
  • Lower back
  • Knee

Some injuries being severe enough to stop some from working, training and competing. These are the most common areas of injury I see come into the clinic from CrossFit, but I also see others suffering from:

  • Neck and thoracic strains
  • Ankle sprains and hypomobility
  • Hip impingement
  • Patella dysfunction from quad heavy squats
  • Wrist strains

How can Physiotherapy help?

As a physio it’s my job to get you functioning pain free as quickly as possible. Being a Crossfitter myself, who performs daily and understands the training styles, philosophy and terminology I can relate to the frustrations that you may face with limitations in training. Also working on site I can take you into the gym, look at techniques of different movements and provide you with additional drills to perform before your WOD.

What do I offer a CrossFit athlete?

  • An assessment of your movement patterns looking for weakness, asymmetry and any underlying mobility issues.
  • Hands on therapy for immediate pain relief, this may involve soft tissue massage, joint mobilisations and dry needling.
  • Localised taping of problem areas to assist you during your next training session
  • Diagnosis and ongoing management for acute or severe injuries, including referrals for further tests such as x-rays/ultrasounds, scans or to a specialist.
  • Educating you on what caused your injury or pain and steps to prevent further problems.
  • A personalised rehabilitation program – listing corrective, strengthening and stretching exercises to assist your recovery.
  • Liaising with and providing regular updates of your progress directly to your coach or trainer to ensure you get a coordinated approach to your rehabilitation. This also ensures that you are scaling or modifying WOD’s as required.

For an appointment, call on 095290990 

Montalvo et al (2017) Retrospective Injury Epidemiology and Risk Factors for Injury in CrossFit. Journal of Sports Science and Medicine

Keogh et al (2016) The Epidemiology of Injuries Across the Weight-Training Sports. Sports Medicine

Weisenthal et al (2014) Injury rate and patterns among CrossFit athletes. Journal of Orthopaedic Sports Medicine, Arthroscopy, and Knee Athroplasty