Ankles, Feet, Physiotherapy, Sports

Ankle Sprains – Putting your Best Foot Forward

 

Musts following any ankle sprain.

Ankle sprains are very common among young and old  alike.  There are many different types and vary depending on the type and severity of the mechanism of injury. Most commonly ankleswollen-ankle sprains occur when we roll our foot inwards, stressing the ligaments that attach from the bone in our leg to the bone in our foot.  They are usually characterised by immediate swelling, pain and reduced range of movement.

After an ankle sprain, it is important to begin on the road to recovery as soon as possible and you can get started by using these simple tips.

RICER Tryptich

Rest – give the structures in your ankle time to heal and minimise the amount that you aggravate the injury.

Ice – place ice, a cold pack or frozen peas over the injured area for 20minutes every 2 hours for the first 72 hours to minimise swelling and reduce pain.

Compression – make use of an elastic bandage or compression sock to apply light compression to the area to reduce swelling.

Elevation – try to keep your ankle elevated with a foot stool when sitting and propping on pillows when lying down or sleeping.

Range of Motion – move your foot and ankle through light and pain-free movements to keep the blood flowing and prevent stiffening of the joint.

Support – if a crutch or stick is required because you cannot weight bear, use it correctly as shown in the video clip below and try to continue your walking pattern as similar to pre-injury as possible.

Always hold the support on the opposite side to the injury, put injured leg forward first accompanied by the support – this will provide you with a wider and more stable base of support.

 


Referral – book in to see your physiotherapist ASAP for treatment, further advice and redirection of care as an X-ray, MRI or specialist appointment may be necessary.

These tips are just some of the steps required immediately after a sprain to allow a return to full functional capacity.  Physiotherapists have a much broader range of tools and strategies at their disposal and their consultation could prevent long-term issues and promote faster recovery.

Post by Mitchell Sandvoss (B. Physiotherapy)

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Achilles, Daily Exercises, Feet, Injuries, Lifestyle, Physiotherapy, Sports, Stretching

The “Achilles Heel” of runners!! 5 tips to help remedy Achilles tendon pain.

Whether you are a professional marathon runner or simply enjoy a recreational jog it is likely that you have experienced pain in the Achilles tendon at some point. The pain will generally be most prominent during warm-up, settle down significantly as you run only to return with a vengeance after you have cooled down after running! If it continues to worsen, it can become very debilitating and prevent from running altogether!

This article will help to arm you with the anatomical information and practical knowledge necessary to help recognise Achilles tendon pain and how to manage it!

Firstly, it is important that you know the anatomy of your Achilles!

Achilles tendonThe Achilles tendon joins the calf muscle to the heel bone. Tendons are a soft tissue structure made up of the elastic material called collagen and always attach muscles to bone. The role of the Achilles tendon is to transfer the power produced by your calf muscles through to the heel bone to move the ankle joint and provide you with forwards thrust as you run.

Pain in this area can be as a result of tendonitis (inflammation of the tendon) or tearing. It can sometimes start very suddenly after a big load through the tendon, such as falling into a pothole as you run. More commonly, pain in the Achilles develops a gradually over time as a result of overuse and worsens unless managed appropriately.

Things that can predispose you to Achilles tendon pain are:

  • Poor foot mechanics (corrective orthotics or well prescribed sports shoes can help enormously)
  • Stiffness of the ankle joints (this can occur after an acute ankle injury such as a rolled ankle)
  • A significant and sudden increase in training load (such as further distance, increased regularity, or extra hills etc.)
  • Weakness of the hip or core muscles

To remedy the situation there are 5 simple things that you can do:

  1. Stretching may aggravate the tendon! Avoid dropping your heel off a step or doing strong calf stretching as this is too aggressive for a sore or damaged tendongastrocnemius-stretch-stairs
  2. Mobilising the sciatic nerve system before rising from bed can help with morning stiffnessHamstringAnim2
  3. Avoid high impact exercises like jumping, skipping, running (especially soft sand running!)Skipping
  4. A small heel raise can help alleviate pain and overstretching in the short term (put one in both shoes!)heel lift illustrated  copy
  5. Get some professional advice from a physiotherapist. There are a number of important exercises that can be done to improve your tendon pain and get you back to running ASAP!!

 

Post by Angus Tadman (B.App.Sc Phty Hons I) and Catherine Stephens (B.App.Sc Phty)

abdominals, back, Core stability, Feet, Gymn Dangers, Physiotherapy, Pilates, Shoulder

What is Core Stability?

Power and Strength are useless without Stability and Control

muscles

Big flashy muscles might be attractive but as any physio will tell you, they are next to useless without core stability.

Thankfully the health and fitness industry has now started to embrace the need for core stability, but still few people really understand the concept and what it means.

Essentially our bodies have hundreds of different muscles that all perform important tasks and the very conspicuous Abs, Glutes, Pecs, Delts and Biceps (amongst others) are there to provide strength but they are supported by a plethora of smaller, less conspicuous muscles that provide stability.

shock absorbersThese are generically referred to as the ‘Core Muscles’ and the best comparison we can think of is with automotive suspension systems.

If the ‘Strength’ muscles are the springs then the ‘Core’ muscles would be the shock absorbers.  They are usually less conspicuous, sometimes even hidden within the springs but without them your car would fall apart in no time.

The same goes for humans.  Good strength muscles alone won’t keep you running smoothly. Without good core stability you’ll be in for lube and servicing (physio) all too often and eventually you’ll be off to the scrap yard before your time!

inner_core_musclesWhen it comes to spinal stability, the most important muscles are the multifidus, pelvic floor and transversus abdominis. As shown in the image to the right, these muscles form a supportive cylinder around the spine. The transversus abdominis is like a corset around your abdomen and it sits deep underneath all the “six-pack” muscles.  It attaches the lower ribs, diaphragm and lumbar spine to the pelvis.

This ‘core’ stabilises the spine and allows the load of movement to be evenly distributed between all the intricate joints of the spine. Just like a car suspension system, it reduces the shock through the joints and thus reduces wear and tear which would, over time, lead to conditions such as arthritis or bulging discs.

personaltrainerDoing exercises like sit ups is useful to strengthen the big “six-pack” muscles, but doing this exercise without good core stability will lead to excessive load through the joints of the spine and can lead to injury of the spine.

So in that respect it is important to activate and strengthen the core before you start on a regime of strength building.

 

Muscles of the posterior shoulderAnother example is the shoulder. The “delts”, “lats”, “pecs” and “biceps” look fabulous but they are not the stabilisers of the shoulder.

Over training of these without attention to the deeper, core stabilisers of the shoulder can result in injury as a result of an increased load being put through the system without the appropriate “suspension”, so to speak.

See our blog on ‘Shoulder Stability’ for a series of simple exercises to build core shoulder stability.

Each area of the body  has a “core” component.

Feet have intrinsic muscles that operate in balancing.

Ankles rely on hip and foot stabilisers for control.

Knees similarly need good hips and feet to be protected.

and even Necks have a deep system of muscles that control movement.

In essence, the core muscles play a crucial a role in overall well being and strength. Without the stability and control provided by the deeper core muscles, the power and strength gained from training is useless!!

Stay tuned as our series of CORE STABILITY blogs will introduce the specifics of core training for different parts of the body and the common areas of overloading we see in fitness regimes!

Post by Catherine Stephens (B.App.Sc Physio) and Angus Tadman (B.App.Sc Physio Hons I)

Feet, Lifestyle, Physiotherapy

High Heels – The Pain for the Gain

High-heeled modelLove them or loathe them high heels have a marked effect on how a woman stands and moves and most men will know that these effects can often be quite alluring.

High heels:-

  • Increase the curvature of the calf improving muscle definition and in doing so enhance the slimness of the ankle
  • By lifting the heel the buttock muscles have to work harder and in doing so appear more pert.
  • The shift in weight means the chest is pushed forwards thereby enhancing breast lines.
  • The general awkwardness of the revised gait means that swings, sways and jiggles are introduced that tend to attract extra attention.

Xray of High HeelsHOWEVER!!  . . .

as can be seen in the X-ray of a foot in high heels, there are other factors to consider that not only cause pain during and after wearing, but can also cause long term damage.

  • Metatarsel pressureThe pressure on the Metatarsals  (the long bones just behind the toes or balls of the feet) is increased enormously. This increased pressure increases the risk of the development of a ‘Morton’s Neuroma’, (nerve aggravation between the metatarsals) which develops into a nerve growth.
  • Toe Squash in high heelsIf you compare the ultimate healthy state of barefeet it is easy to see how the toes are  pushed together to fit into the ‘glamorous’ narrow shoe, increasing the likelihood of Bunion formation ( Hallus valgus) and an overall cramping and deformation of the foot results.
  • Achilles tendonThe Achilles Tendon is shortened and prolonged wearing will cause permanent change which in turn changes the foot ankle dynamics and increase risk of ankle sprain and tendon damage.
  • The increased arch often affects the lower spine, increasing joint pressure that can cause episodes of back pain and instability.

So…. a physio’s advice (who has been known to wear high heels herself from time to time)  is to keep the really high heels for very special occasions!   Choose lower heels when you can. Keep this in mind when shopping girls!!

After a night in heels spend a few days in flats – or even barefeet if you can.

If heels are part  of the work attire, wear flats to and from work and slip on the glam’ professional look only when necessary.

Girls… remember it was a man who designed high heels and back in the times when men did wear heels they were not 15cm high and definitely not stilettos but wedges which are a more stable option!!!

Post by Catherine Stephens B. App Sc (Physio) MAPA.

Feet, Physiotherapy, Stability

The foot – an amazing piece of machinery !

Happy feetWe stand, run, jump, hop & dance, all on our feet and rarely give them any thought until we feel pain or feel unsteady!

Our feet are the basis of our posture and give us most of the feedback we need to balance!

Bones of the footSo as upright animals we rely totally upon our feet, yet there they are, down there, out of sight, out of mind while many, many small muscles do their stabilising jobs.

But have you ever thought what’s involved in simply standing on your feet?

Here’s a simple exercise to highlight just one of the stabilising muscles.  Give this a try.

Stand with feet hip width apart.

Two feetTry to stretch you toes out straight and lean slightly forward so the tips of your toes have a small amount of weight on them but you haven’t lifted the heel.

Can you feel the muscles in the sole working? These are the muscles designed to support our arches and I bet this is the first time you’ve been aware of them !

But then our world is mostly flat and safe and we have no need to be in a position of preparation for change and as a result our feet get really lazy.

I like to think of our feet having a TRIPOD OF STABILITY.

  • The tip of the big toe
  • The base of the little toe and
  • The heel

Try standing with weight evenly distributed between these three points and you will unwittingly turn on a whole range of muscles in your foot, thigh, buttock and back.

Bare feet in grassStrong feet – the basis of good posture – a basis of good health.

Post by Catherine Stephens B. App Sc (Physio) MAPA.