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It’s all in the hips…

The iliopsoas is our most powerful hip flexor and key to lots of tasks from Olympic lifts to every day activities like walking and running. As well as its role as an importance hip flexor it also provide stability to the lower back.

Image result for iliopsoasThe Psoas muscle originates from the lumbar (lower) spine to joints the Iliacus muscle at the pelvis and attaches at the top of the femur (thigh bone).

Weakness in the iliopsoas causes decreased ability to flex the hip joint, as well as difficulty bringing the trunk forward when preparing to rise up from a seated position or walk up an incline. If you are a runner, it decreases your stride pattern.

 

If you are a weightlifting when you are in a deep squat the hips are flexed and the trunk is forward. With weak iliopsoas muscles you will have difficulty getting into this position, which means you lose out on potential power you can create in this area. So, you may not make gains you would like in the lift. Iliopsoas weakness also causes instability at the squat portion of these lifts, which can cause discomfort to the athlete.

How to strengthen your Iliosoas!

The psoas march is a great exercises for people who need to strengthen their hip flexors and improve lumbopelvic control. This exercise can help people recovering from psoas strains or low back pain. As well as those looking to improve squat technique or have a feeling of “tight” hip flexors which is often caused by weak muscles become tense.

 

 

Toe Tap Exercise

This is a great exercise for lumbar-pelvic and eccentric hip flexor control.

Step 1: Lie on your back with your arms alongside your hips. Lift your legs up and bend your knees so they are right over your hips and your shins are parallel to the floor.

Step 2: Contract your belly to pull your navel to your spine. Slowly lower your right foot and leg to “tap” the floor. Keep the 90-degree bend in the knee as you lower. Return the right leg to the start and repeat with the left leg.

Step 3: Alternate for 30 to 60 seconds. One set is sufficient.

Hip flexor Stretch – Deep lunge with side bend

 

Shoulder Impingement

What is it? Why do we get it? And what can we do about it? 

The shoulder joint is a ball and a shallow socket joint. It is formed from a ball on the top of your arm bone and a shallow socket which is part of the shoulder blade. Above the ball and socket joint is a ligament which is attached to a bony prominence ‘acromion’ on your shoulder blade forming an arch. The area between the shoulder joint and the arch is known as the sub-acromial space.

Shoulder-impingement

To move your shoulder and control the position of the ball on the socket, you have a group of muscles known as the rotator cuff. They attach from the shoulder blade onto the top of the arm bone, passing through the sub-acromial space. A small fluid lining cushions the tendon from the roof of the arch. When you move your arm away from your side, the rotator cuff works to keep the ball centred on the socket. When your arm reaches shoulder height, the sub-acromial space is narrowed.

 

What is shoulder impingement? Impingement refers to a trapping of the rotator cuff tendons as they pass through the sub-acromial space. Impingements can be classed as:

  • External
    • Primary: Abnormalities of bony structures i.e the acromion
    • Secondary: Changes in the position of the acromion due to poor muscle stabilisation and co-contractions between the scapula (shoulder blade) and head of the humerus (arm bone). This is the most common presentation.
  • Internal
    • Occurs mainly in throwing sports from the forces placed on the shoulder.

When impingement occurs for a prolonged period or occurs under a heavy load, the tendon can become inflamed and the rotator cuff can become weak, swollen and painful, particularly in overhead activities. Once the tendon becomes affected, it swells, filling more of the space, which increases the likelihood of things getting pinched! This is known as impingement.

What can we do about it? 

If possible, REST the area by not doing activities that aggravate i.e. overhead movement. A common movement that aggravates shoulder impingement is raising your arm with the elbow twisted outwards. Try keeping the elbow in and then raise your arm, palms up to the ceiling (like a waiter carrying a tray), this may help lower your painful symptoms.

Posture Posture Posture… You need to think about your sitting and standing posture. If you have a desk job think about sitting with your feet flat on the ground and hip width apart. Sit tall, with your shoulders back and chin in. When standing make sure your shoulder blades are slightly drawn back and down towards the spine, your standing tall and your chin is in.

Exercises

Do the exercises regularly 1–2 times a day. Don’t do them if it is painful.

Shoulder blade squeeze

Begin this exercise lying on your stomach with your arms by your side. Squeeze your shoulder blades together and slowly lift your arms and chest off the ground, keeping your neck straight. Hold for 2 seconds at the top of the movement then slowly return to the starting position.

Shoulder External rotation with band

Keep your elbow by your side. Your elbow should be bent to a right angle throughout. This exercise will improve the strength of your shoulder muscles. Hold an exercise band with your elbow at a right angle. Pull the band away from your body. Slowly return to the starting position. Keep your elbow by your side.

 

Adduction (toward the body’s midline) with band

To help will improving overhead movement patterning, and increasing functional range into abduction (away from the body’s midline) of the shoulder joint. Uses the shoulder adductors and extensors to assist in the movement, thus reducing the work rate of the abductors and flexors (if they are weak / injures ) as well as reducing impingement and pain.

 

 

An effective rehabilitation program should focus on regaining full shoulder range of motion, reestablish shoulder stability, and restore strength and local muscular endurance in the rotator cuff and shoulder stabilising muscles. You should always complete your rehabilitation under guidance of a rehab specialist, email info@rehab360.co.uk to book an appointment or visit www.rehab360.co.uk/bookings

Heal Pain…. Plantar fasciitis

Plantar fasciitis is a condition that effects lots of people involved in sport. Most commonly where force is being absorbed by the foot i.e. running or tennis. In fact it accounts for as 8% of all running-related injuries. It is also prevalent in the general population 3.6% to 7%.
So what is plantar fasciitis?  It involves inflammation of a thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes (plantar fascia). Plantar fasciitis commonly causes stabbing pain that usually occurs with your first steps in the morning.Unfortunately plantar fasciitis is a injury which can be frustratingly hard to get rid of. However the good news is there now a growing body of literature which is changing the way we treat the problem. Rather than strictly stretching the plantar fascia we now add good old high loaded strength training.
Plantar Fascia stretch – performed 10 times for 10 seconds three times per day. Cross the affected foot over you leg, pull your toe back towards your shin till you feel a stretch across the bottom of your foot.IMG_7316

High-load strength training: These exercises should be performed every second day for three months. Every heel-rise consisted of a three second concentric phase (going up) and a three second eccentric phase (coming down) with a 2 second isometric phase (pause at the top of the exercise).

Alongside the exercise here are some top tips on how to manage the injury:

  1. Make sure you do your rehab!
  2. You should not run before your heel is pain free for 4 weeks and you can walk 10km pain free.
  3. Where support trainers whenever possible.
  4. If you have to wear dress shoes wear them with your gel insoles.
  5. Its ok to feel some discomfort when completing your exercises but the pain should not suddenly increase following the exercises or 24 hrs after.
  6. Avoid activities that flare up your symptoms. When you want to start these activities again, start slow be cautious and build slowly.

This is not a miracle cure! The programme should be overseen by a Rehab Specialist.

Rest, Recovery and Injury Prevention

Injuries are often the biggest hindrance to continuous progression. Returning from injury can be a long and arduous process. It’s better to reduce your potential of picking up an injury in the first place. 

Previous injuries associated with inadequate rehabilitation predisposes you to recurrence of further injuries.

Why do people get injured? Primarily it’s over training, poor biomechanics, poor neuromuscular control and untreated previous injuries. 

What can I do about it?

A combination of mobility and stability in equal measure is a necessary foundation for efficient athletic movement. – Steve Wright physiotherapist English Premier League  

Take the long view with physical preparation, lay the foundations before you start building the house. 

Do not train ‘around’ pre-existing niggles. Assess and improve your weaknesses. 

Movement quality – Corrective exercises that reinforces correct posture and positioning of the body to allow effective athletic movements.

Recovery and Regeneration – Systematically implementing strategies to help you recover from training and day to day stresses.

Flexibility and Mobility

Limits in functional flexibility can significantly impair the ability to move efficiently. – Gambetta

Working on flexibility and mobility is time well spent, it will allow you to move easily through unrestricted, pain free range of motion and will improve training and competition performance. 

Better to be STRONG and BENDY than WEAK and STIFF! 

Strength…

Lower limb – We spend a lot of time on one leg (85% when running). Therefore single leg strength is key for injury prevention. 

Upper limb – You are looking to balance muscles you see in the mirror but also the ones you don’t! … Your back muscles are as equally important.

Recovery and Regeneration

In order for our bodies to adapt to training it must have a sufficient period of recovery. 

Your body needs physiological stress (training) to bring about physiological adaptation which leads to improved performance. 

Recovery allows training induced adaptation to take effect.

Without rest, the body can’t recover and adapt for training demand as it will become exhausted. 

Recovery Strategies fall into two main camps

Things you can do before (Prophylactic):

Nutrition – eat regularly, drink a lot of water – 2.5 liters, eat lots of fruit and veg

Supplements, compression garments.

Things you can do after (Therapeutic):

Sports massage therapy – enhance oxygen and nutrients delivery to fatigued muscles, increase removal of lactic acid, warming and stretching soft tissue etc….

 SLEEP, ice bath, anti-inflammatory drugs, cool down

Conclusion

Everyone is different! What is right for one person is not right for all. Factors such as age, sex, genetics, and size all play a part. 

However, there are simple things you can do now to reduce risk of injury, recover faster, and perform better. These are: 

1 Listen to your body and seek advice sooner rather than later

2 Prioritise flexibility / mobility and quality of movements 

3 Implement recovery strategies