Golfing

POSTED: May 17, 2012

A game of golf is a healthy activity to help gain and maintain flexibility and range of motion. It is a physical activity that includes walking, lifting and repetitive arm movements, providing the benefits of cardiovascular and strengthening exercise programs.

However, returning to action after being on hiatus for several months puts enthusiasts at high risk of injury. The golf swing is a complex, explosive and physically stressful movement that requires the full rotational capacity of 127 joints and the dynamic activation and co-ordination of 400 pairs of muscles.

To avoid injury, Physiotherapists recommend:

" Walking 20-30 minutes a day, three to four times a week; during the golf season

" Begin practicing your grip on the club;

" Practice your back swing. Keep the club at waist level and slowly increase to a full swing;

" Start with one of the shorter clubs and work up to the longer, heavier irons.

" Stretch as a warm-up, as a break during repetitive movements and as a cool-down after your golf game. It helps you to move easily, keeps muscles flexible and relaxed, joints mobile, and relieves tension and strain.

" Gear - such as your golf shoes, clubs and golf bag - are meant to ease the work, not cause additional strain.

" Carry your golf bag over both shoulders and walk upright. If you have a one-strap system, alternate sides;

" Push rather than pull a wheeled golf cart;

" Hold clubs in a loose, comfortable grip to reduce strain in your hand and forearm;

" When standing for long periods, stand tall and occasionally shift your weight from one foot to the other, or rest one foot on your golf bag or cart.

Reduce strain by fitting the clubs to the golfer,
not the golfer to the clubs - Physiotherapists recommend that golfers choose their golf equipment to match their skill level and body type.

Plantar Fasciitis

POSTED: April 11, 2012

Plantar fasciitis is a painful inflammation of the plantar fascia – a thick, fibrous band of connective tissue in the sole of the foot that supports the arch of the foot. It runs from the ball of the foot to the heel, stretching to its limit when the foot is on
the ground and supporting your full body weight.

When placed under excessive stress, the plantar fascia stretches too far and tears, resulting in inflammation. The effects of the stress can build up gradually or be the result of a sudden occurrence.

The most common causes of plantar fasciitis include:
- Flat feet;
- High arches;
- Sudden increase in activity;
- Increased weight gain, either from obesity or
pregnancy; and
- Poorly fitting footwear.

The pain is commonly felt on the bottom of the foot, where the fascia attaches to the heel.
It is most severe in the mornings when getting out of bed because the fascia is in a shortened position at rest, and when you stand up, the sudden stretch and load of your body weight pulls on the attachment.

Symptoms of plantar fasciitis vary from mild to severe. They can linger for months at a time, with pain increasing and decreasing in an unpredictable pattern. Often, discomfort may nearly disappear for several weeks, only to re-emerge full-blown after a single workout or change in activity. The pain may even temporarily ‘fade’ as you walk.

Plantar fasciitis is a common injury runners experience and along with the causes listed above, it can be triggered by a sudden
increase in your training schedule, or by switching running surfaces – especially from a softer surface to a harder one.



While plantar fasciitis can be treated, it does not resolve quickly. It pays to review each of the factors and try to prevent its onset.

STRETCH – before, during (if needed) and after activity. Tight calf and/or hamstring muscles (back of thigh) limit range of motion and put extra strain on the plantar fascia. Stretching as a warm up and as a cool down will help you move easily, keep
muscles flexible and relaxed, joints mobile and relieve tension and strain.

A physiotherapist can assess your injury and provide appropriate stretching and strengthening exercises that will promote an earlier return to your activity, as well as advice on how to prevent recurrence of injury.

MOVE – For mild cases of plantar fasciitis it may be enough to stretch more frequently, build more rests into your routine, and ensure you have good footwear.

More severe cases may benefit from a heel cup or orthotics. In its most severe form, going barefoot is a poor idea – even in the house. Avoid worn-out shoes and try running on soft surfaces. You don’t have to stop exercising however consider switching to a non-weight bearing sport like swimming or cycling. When you do try running again, begin at a much lower level of intensity and a shorter distance, then you can build up gradually.

ADD IT UP – Add up all of your symptoms. If there is tenderness on the inside bottom of your heel, especially when you first wake up in the morning, you may have plantar fasciitis.

Bicycling

POSTED: March 19, 2012


For an injury free ride Physiotherapists recommend:

FRAME SIZE - Stand over your bicycle's top tube (between the saddle and the handlebar). The general rule-of-thumb for road biking is to have roughly one inch of clearance between your buttocks and the frame. For mountain biking on trails, you should have two to six inches depending on the terrain and the slope on which you are riding so that you are compact and can put your feet down quickly.

SADDLE POSITION AND HEIGHT –The saddle should be level for endurance and recreational riding. If you are sliding forward from a forward-tilting saddle, your arms and back will be taking too much weight. If the seat is tilted backwards, you may place undue strain on your low back and may experience discomfort or pain in the saddle area.

Saddle height should be set so your legs are not quite fully extended at the bottom of each pedal stroke. The straight leg should have a slight bend in the knee, roughly 30-degrees. If you have to shift your seat with each stroke, your saddle is too high and needs to be lowered. A bicycle seat too low will create stress on your knees; and too high will increase stress on your lower spine.

HANDLEBAR POSITION –The handlebar position can make a difference to the comfort of your back and upper body while riding. Handlebars that are too low or too far forward force you to stretch and bend down too far, placing undue stress on your back and neck. Higher handlebars will have you put more

weight through the saddle. Generally, taller riders should have lower handlebars in relation to the height of the saddle. Also ensure you have the correct distance between the seat and handlebars. If it is inadequate, your neck muscles may become strained.

SHOE/CLEAT ALIGNMENT – If you ride your bike with clipless pedals, the position of the cleats on your cycling shoes determines the comfort of your feet, ankles, knees, hips and back. Misaligned cleats can put stress through all joints from your foot to your low back with every pedal stroke. Your feet should point straight ahead when clipped into the pedals and you should have a little bit of ‘float’ or sideways movement between the pedal and the cleat to allow your joints to follow a natural pedal stroke. The rule-of-thumb is to continue adjusting the cleats until you feel no torsional, or twisting, stress in your leg as you pedal.

If you are injured from cycling consult your physiotherapist

Running

POSTED: February 14, 2012

Running is an activity that many enjoy and can be extremely beneficial to one’s health. A 30 to 40 minute run, three or four times a week can help to maintain flexibility, increase mobility and build strength and endurance.

Proper posture and body mechanics will help lessen the strain on your body.

Physiotherapists recommend:

- Stretch before and after your run. Concentrate on stretching the calf, hamstring, quadriceps, iliotibial band, groin, buttocks, outside of the knee and back. With each exercise, hold the stretch for at least 15 seconds, until you feel tension but not pain, and do not bounce.

- Before starting your run, relax and take a deep breath. This allows the lungs to move into an efficient position and the hips to pull forward, for an easier run. After exhaling, try to maintain your chest in this alignment.

-Look straight ahead and run in a straight line. Swing your arms naturally.

-Good running posture will allow your feet to run almost automatically, with a quick, gentle push. The push off should always be forward and not upwards.

-A smooth stride will reduce effort and therefore increase efficiency. Increasing the frequency of your stride and keeping the feet lower to the ground will allow your muscles to stay relaxed.

- Increases in mileage and speed should be by 10%. An unrelenting increase in mileage from one week to the next will ultimately result in injury.

- Pace for interspersing of hard days and easy days and also hard and easy weeks.

- One or two days a week, at least, should be devoted to rest or non-running activities.

Because of the repetitive nature and impact running has on your body, runners tend to be more susceptible to injuries.

- Avoid running on hard surfaces. Dirt paths are better than asphalt and asphalt is better than concrete. Grassy areas may look inviting but they may hide holes, rocks, and other potential hazards;

- Rotate your activities (running, cycling, swimming, etc.) to reduce strain and keep it interesting;

- Don’t overdo it – proper rest is essential; listen to your body and watch for recurring or persist

Shoveling Snow

POSTED: January 26, 2012

FORECAST PREDICTS 50% SNOW, 70 % BACK INJURIES

Back injuries and pulled muscles are among the most common health threats from using poor technique when shoveling snow. While most people recognize that shovelling snow is very hard work, that can put severe stress on your heart, fewer people recognize the stress and strain that it places on the low back.

Take time to stretch and prepare your body for activity with a simple warm up of marching on the spot and a few shoulder circles to help tackle the snow.

Tips to help get a handle on safe shovelling:

1. Choose a shovel that’s right for you – A shovel with an appropriate length handle is correct when you can slightly bend your knees, bend forward 10 degrees or less, and hold the shovel comfortably in your hands at the start of the shovel stroke. A plastic shovel blade is lighter than a metal one, putting less strain on your spine; and sometimes, a smaller blade is better than a larger one. This avoids the risk of trying to pick up a pile of snow that is too heavy for your body to carry. Ergonomic shovels with a bent shaft require less bending and your heart doesn’t need to work as hard;                              


2. When you grip the shovel, make sure your hands are at least 12 inches apart. This will increase your leverage and reduce strain on your body. Always keep one hand close to the base of the shovel to balance weight of the lift and lessen the lower back strain;


3. Lift the snow properly – Squat with your legs apart, knees bent and back straight. Lift with your legs. Do not bend at the waist. Scoop small amounts of snow into the shovel and walk to where you want to dump it. Holding a shovel of snow with your arms outstretched puts too much weight on your spine.


4. Spray your shovel with a lubricant or silicon spray so the snow does not cling;


5. Step in the direction in which you are throwing the snow – This will help prevent the low back from twisting and “next-day back fatigue” experienced by many shovellers;



6. Tackle heavy snow in two stages – Begin by skimming off the snow from the top and then remove the bottom layer. Avoid overloading the shovel. You are working too hard if you cannot say a long sentence in one breath. If this is the case, take a short rest or decrease the intensity of effort slightly;


7. Take frequent breaks when shoveling – Stand up straight and walk around periodically to extend the low back.  Do standing extension exercises by placing your hands on the back of your hips and bend backwards slightly for several seconds. Because you bend forward so much when shovelling, you need to reverse this by straightening up and bending backwards slightly;


8. Wear proper footwear with good tread to help avoid slipping or falling;

Shovelling snow is a rigorous physical activity.  If you don’t exercise regularly or if you have a medical condition consult a Physiotherapist.

Brought to you by PABC Physio Tips

Seniors Fall Prevention

POSTED: January 4, 2012

Physiotherapists tips for reducing the risk of falling:

• Plant both feet securely on the ground before getting out of the car;


• Wear a good pair of lace-up walking shoes that will support your feet and provide necessary cushioning for your joints; this will make walking safer and more comfortable. Avoid high heels, slippers, and open-toed sandals, which can cause you to trip; 


• Make sure the tips on canes and crutches are large and spiked for icy conditions;


• Sit rather than stand while dressing;


• Before you get up out of a chair or up from bed, wait 10 seconds before rising to your feet to prevent dizziness;


• Install handrails and grab-bars in the bathrooms and stairways;


• Concentrate on what you’re doing while you’re doing it, and move at a speed that feels comfortable;


• Avoid taking unnecessary balance risks like standing on furniture. Instead, use a sturdy stepladder.


• Avoid hyper extending the neck. Extending the neck backwards can cut off circulation to the brain, causing a black-out or even stroke.


• Be mindful around pets. Feet can get caught in leashes, dogs can knock you down or you can trip over the sleeping or wandering pet;


• Slow down. Be conscious of risky situations and hazardous areas;


• Be physically active every day to improve posture, muscle strength and balance. Enroll in Tai Chi or an exercise program to improve flexibility;

The risk of falling in older adults can be reduced dramatically when specific exercises, activities and interventions are prescribed by a physiotherapist. A targeted physiotherapy treatment program can help maintain or regain strength, flexibility and endurance in a way that still feels safe and secure.

 
For example, a physiotherapist will assess a senior’s physical status and provide appropriate recommendations or treatment. As part of the assessment, the physiotherapist will review medical history and determine general physical condition, strength, flexibility, balance and gait (the way each person walks). After determining the primary limitation, a program of exercises and activities will be prescribed that focus on that area but with an overall goal of improving physical function and mobility.

Healthy New Year

POSTED: December 31, 2011

All of the staff at Therapeutic Edge Physiotherapy, Victoria BC wish you a happy and 'healthy' New Year.

All the best in 2012!

Safe Skiing And Snowboarding

POSTED: November 25, 2011

Winter enthusiasts look forward to this time of year when there’s an abundance of winter activities to enjoy, like skiing and snowboarding.

Before heading out to the slopes, you need to remember that winter activities often pose a higher risk of injury if time isn’t taken in advance for proper body conditioning.

Physiotherapists see an increase in “impact” injuries in winter. They recommend good conditioning program prior to hitting the slopes. Workouts to stretch and strengthen thighs, hamstrings, buttock muscles and abdominal muscles can also help.

The “ABC’s of Winter Conditioning”
A is for Alignment – People spend a lot of time in seated or contorted postures, which can affect postural alignment. This may limit the body’s ability to achieve and maintain peak capacity and may lead to pain or injury.

A Physiotherapist can tailor a program of stretching and strengthening exercises to promote optimal postural alignment.

B is for Balance – Balance is a fundamental component of any sport, especially skiing. If you have a sedentary lifestyle, you may need to “train” your balance reactions for sport related activity. Most gym’s have balance equipment available. Use them to improve balance and ultimately enjoyment on the slopes.

C is for Core Training –Skiers and boarders need a strong core or torso as an “anchor” for the legs. These are the muscle groups that work together to stabilize the trunk. Exercises that have a rotational component and work the core areas in three dimensions are best.

While many sports such as cycling, or weight training are one-dimensional, life and sports, like skiing, are 3-D so you must train for them.

D is for Deceleration Control – Skiing and boarding are all about controlling the gravitational pull on frozen water. A typical ski turn usually lasts 2-3 seconds. Skiers must be able to control their deceleration speed to slow the forces of gravity and finish their run safely.

Exercises that work the quadriceps in a slow controlled manner such as step ups, split squats and lunges are excellent ways to train
for this. They mimic the forces of skiing and allow you to improve strength in a hip-extended position - the functional position for all sports.

Using Your Laptop

POSTED: October 26, 2011

Physiotherapists offer advice to prevent injury from mobile technology. We now work anywhere, using wireless technology like laptops and Physiotherapists are seeing more and more clients suffering from pain that results from working directly at their laptops.

The long periods people spend working without taking breaks, sitting with their heads bent forward and shoulders hunched often triggers pain from the serious effects of the neck and shoulders to the wrists and hands.

Musculoskeletal disorders are one of the most common causes of severe long-term pain and physical disability, and are considered one of the biggest health problems facing mobile workers today. Statistics show that an increasing number of laptop users experience ongoing aches and pains. Many of these injuries can be prevented with improved work habits and posture.

Physiotherapists are concerned with the increase of repetitive strain injuries (RSI) and other soft tissue injuries as people spend more and more time slouching over their laptop. Many individuals discount the discomfort that they feel until they are experiencing full blown symptoms of RSI by then the problem is much more difficult to resolve.
Many of these injuries can be prevented with improved work habits and posture.

Physiotherapists have the knowledge and skills to advise on modifications to the work environment as well as giving guidance on improving work habits and postures. Specific strengthening and stretching exercises, combined with aerobic conditioning, may be part of the prescription to prevent recurrence of RSI.
Prevention and early intervention are the preferred approaches to managing RSI. Simple changes such as adding an external keyboard or mouse, and raising the monitor screen, will allow you to adopt a healthier working posture.

Laptops defy the ergonomic principle of allowing for optimal posture for musculoskeletal health, and laptop users who spend hours on end typing text will have likely suffered the consequential sore shoulders and tight neck.

For example, if you’re working with elbows at the recommended 90-degree angle, the laptop’s screen position will require that you bend your neck forward to view it, which puts excessive loading through the joint of your neck. But if you raise the laptop to eye level, then you are typing an awkward angle that can put strain through wrists and elbow joints. While extended computer usage of any kind can be hard on your body, prolonged laptop use can be especially hard on the user.

Physiotherapists recommend using key commands and shortcuts whenever possible, buying laptops equipped with adjustable height screens, and using an external keyboard when typing for extended periods.

- Make frequent postural changes and take breaks;
- Remove unnecessary supplies from carrying case such as drivers, batteries, and cables;
- Select a carrying case with wheels or backpack style.
- If these options do not work for you try periodically alternate carrying on the left and right shoulders or hands;
- Use a docking station, external keyboard, and pointing device whenever possible;
- Be creative – try using items around you to optimize your setup. For example, use your portable computer on top of the carrying case to raise the monitor to eye level or use a three-ring notebook to incline/decline to a better angle. This is especially effective when using an external keyboard;
- Alternate from your lap to a desk every 30 minutes.

Raking Leaves

POSTED: September 30, 2011

While raking can be a good way to enjoy moderate exercise, too much twisting, reaching, bending, lifting and carrying bags of leaves can place excessive loading on the spine, resulting in back strain or more serious injuries.

Before starting, Physiotherapists recommend:
Warm-up exercises for the larger muscle groups such as the shoulders, back and the legs before (and after) all yard work.
Well-fitting shoes with good soles will prevent slipping and give your back better support.

RAKING TIPS
Hold the rake handle close to your body to help maintain good posture while raking. Keep one hand near the top for better leverage and use your arms and legs more than your spine. Ergonomic rakes, sold in garden centres across the country, have bent or side handles or handles that are padded for less strain on the hands and wrists. This design ensures that the elbows are bent slightly and also encourages good posture;
Change sides frequently and avoid twisting from the waist. When raking, the tendency is to plant the feet in a fixed position and rake in several directions from that position. Instead, place one foot ahead of the other which allows you to shift forward and backward easily as you rake;
Take frequent breaks and/or change to a different activity.

BAGGING TIPS
When bagging leaves, lift manageable loads. Keep your back straight and use your legs to do the lifting. If you have to stoop, face the pile of leaves and don’t twist as you lift;
Don’t try to overreach to get those last few leaves;
When lifting the bag of leaves, tense your stomach muscles to give your back additional support and keep the bag close to the body.

Keep your back straight while lifting with the legs;
Don’t pile too many leaves into one bag, especially if they are wet. It will be heavy and awkward to lift;
When finished for the day, take a few moments to cool down by doing the same exercises performed prior to raking.

Back To School : Choosing The Right Backpack

POSTED: September 12, 2011

Choosing a Backpack for Back to School

It’s time to head back to school and everyone is busy buying pencils, geometry sets and what seems like the 15th pocket sized dictionary in the last 10 years. (Where do they all go anyway? ) We here at Therapeutic Edge Physiotherapy in Victoria would like to share another Edge Tip with you regarding that ever so essential back to school item: The Backpack.

Backpacks are the workhorse of the student population. They get dragged around, sat on, used as goal posts and carried back and forth every day. Over the course of the year, the bottom can become a never emptied, rummage around till you find it layer that may serve only to add weight, not functionality.

Here are a few simple guidelines to think about when choosing a backpack.

Size
-not oversized to carry more!
-pack should sit evenly in the middle of the back (no sag towards the "rear")

Weight
-find a lightweight backpack that won't contribute to the overall weight significantly when loaded.
-a loaded backpack should not weight more than 10-15% of your child's body weight

Padded Back and Straps
-to help reduce pressure on the chest/shoulders and prevents items from digging to your child's back

Backpack Tips:
Loading your Backpack: Teach your child to load heavier items (text books) closer to the back keeping the load closer to their centre of gravity. This prevents strain on the back and improves efficiency of core tummy muscles.

Posture: STAND TALL! with your head and neck in line with your shoulders, keep tummy muscles engaged and use both shoulder straps to help evenly distribute the weight of the pack.

Things to Watch Out For:
- Red marks on the shoulders
- Tingling in arms and hands
- Pain in low back

**Encourage your child to tell you if they have aches and pains. Physiotherapists can help your child before it becomes a more serious injury and to teach then how to engage tummy and back muscles for proper posture.

Victoria Physiotherapy Tips – Getting The Most Out Of Gardening – Part 2

POSTED: August 9, 2011

August in Victoria is a bountiful pleasure in our garden city. There is nothing like fresh produce from the garden. Not only does a garden provide fresh fruits and vegetables but thirty minutes of yard work, planting or raking gives great general health benefits such as preserving flexibility, increasing mobility and building strength and endurance. However, many people overdo it in the garden. This week we continue to share the advice of the Physiotherapy Association of BC with more physiotherapy tips for the garden.

5. Raking or hoeing – keep your tools close to your body and your back straight to reduce strain. Use your arms and avoid twisting your trunk. Use long-handled tools suited to your height.

6. Weeding or planting – do not bend from the waist. Squat or kneel on a kneeling pad or use tools with long handle.

7. Digging or shovelling – insert the head of the shovel vertically into the ground and step on the blade. Lift small amounts at a time and bend at the knees, using your legs not your back to lift the load. Avoid twisting. Use a wheelbarrow to move big or heavy loads.

8. Lifting or carrying – know your limits and lift properly: bend your knees, not your back. Keep the load close to your body. Don’t lift items that are too heavy for you to handle – get help! Use a wagon or wheelbarrow to transport supplies and / or to move or carry heavy items.

9. Pruning or trimming – get as close to your work as possible. Don’t stretch beyond your reach or past your stable footing. Rehearse the movement as a stretch first to test your ability and positioning.

10. Remember to take a moment to site back and enjoy your hard work.

Victoria Physiotherapy Tips – Getting The Most Out Of Gardening

POSTED: July 18, 2011

Summer is upon us and so are those weeds. In this post we will share some tips from the Physiotherapy Association of BC on best practices while in the garden. These tips are recommended to provide you with all of the joy and health benefits of gardening without the aches and strains associated from over doing it.

To be injury free season, Physiotherapists recommend:

1. Begin with a warm up – Start with easy raking, or go for a five-minute walk to warm up your muscles. Follow this with stretching all major muscle groups to help prevent injury. Give your back, neck, hands and fingers some extra time when stretching.

2. Be aware of your posture and body mechanics – Move your feet instead of twisting at your waist when sweeping, raking, mulching or potting. If you can’t avoid twisting, tighten your stomach muscles in order to protect your back.

Use your legs rather than your back when lifting or unloading heavy bags or pots. Bend your knees, keep your back straight, and hold the object close to your body to prevent unnecessary strain on your back.

3. Use ergonomically correct tools – Buy tools with long handles to help with weeding. Build or buy a potting bench that is high enough to prevent unnecessary bending. Sit on the ground to trowel without bending over. When kneeling use a knee pad to avoid putting too much pressure on your knees.

4. Pace Yourself – Don’t try to do everything all at once. Take breaks throughout your work and do some gentle stretching to keep limber. Vary tasks to make sure different muscles get used and one particular muscle group is not overworked. Repeated actions that use a specific muscle or muscle group can cause pain or injury.