Upper back pain

Thoracic spine (upper back) pain

The main cause of this problem is injury to the small joints either side of the spine.

Risk factors for the development of this problem include:

Poor seated posture – or spending too long sitting
Limited thoracic extension – due to slouching posture
Reduced mid back rotation – again due to prolonged sitting and not enough movement of these joints.
Muscle imbalance between the chest muscles and the back muscles.
Treatment for this injury includes mobilization of the stiff and injured joints, massage, dry needling or acupuncture and stretching to help settle the affected area. A rehabilitation program is then devised to treat the risk factors and causes of the injury.

To help prevent this happening follow these simple exercises:

Lie over a rolled up towel on the floor placed horizontally across your back. Stretch your arms up over your head and feel the gentle stretch as your encourage your upper back to extend. Hold each position for 30 seconds and try to do 3 levels of your back.

Lie on your back on a Swiss Ball – then relax the arms out to the side at 90 degrees and keep them there for 30 seconds – rest for 30 seconds and repeat three times.

Advertisements

How a Warm-Up Routine Can Save Your Knee

As football, rugby, and netball season draws nearer we thought it would be a good time to talk about sporting knee injuries. The most debilitating of all that will promptly put a stop to your season and more than likely have you visiting the surgeon is a injury to your anterior cruciate ligament (ACL).

Recent research suggests that changing how individuals land and how sports teams warm up before practices and games could substantially lower the risk that athletes will hurt a knee.

Injuries to the A.C.L, which connects the tibia and femur and stabilises the knee joint, are soaring. The ligament is prone to tearing if the knee shears sideways during hard, awkward landings or abrupt shifts in direction – the kind of movements that are especially common in sports like rugby, netball, basketball, football, volleyball and skiing.

Motivated by the growing occurrence of these knee injuries, many researchers have been working in recent years to develop training programs to reduce their number. These programs, formally known as neuro-muscular training, use a series of exercises to teach athletes how to land, cut, shift directions, plant their legs, and otherwise move during play so that they are less likely to injure themselves. Studies have found that the programs can reduce the number of A.C.L. tears per season by 50 percent or more, particularly among girls , who tear their A.C.L’s at a higher rate than boys do (girls are 4-6x more at risk than boys, although, numerically, far more boys are affected).

To date, few clubs, schools or teams across the New Zealand have instituted neuro-muscular training, the most easiest of all are the PEP (Prevent Injury, Enhance Performance) program, which was developed by the Santa Monica Sports Medicine Foundation, and the FIFA 11 program, created by the international governing body of soccer. Both programs are free, and take about 15-20mins of exercises useful at ‘priming’ the body for sport which jumping, squatting and side-to-side shuffling movement.

The programs also emphasize landing with knees bent and in the proper alignment, which is where the team at Bureta Physiotherapy can help. When a player lands with the knee in the knock knee position (dynamic valgus in medical terms) their risk of knee injury is hugely increased.

how to warm up before a run

Dynamic valgus can come about from a number of factors – biomechanics, habitual, core/hip strength, foot posture and balance. The physiotherapists at Bureta will be able to teach you how to land properly and if required give you the appropriate exercises to be strong enough to land in this preferred position.

ACL reconstruction is long and involved and we would like the opportunity to protect you, your daughter or son from this injury.

Come in and see us at the clinic to take you through the PEP program or assess your jumping technique.

Running into pain? What are Shin splints

Kate Niederer – Physiotherapist at Bureta Physio explains

As the days get longer, lighter and warmer, many of us shift our attention to the great outdoors and getting moving in time for summer. Often we go gung ho in a running regime, which is great for cardio fitness but our body tissues which have been in hibernation over winter, aren’t quite ready for the increase in load and this can set us up for a number of over load issues. Shin splints being one of them.

Shin splints is a generic term for any pain at the front of shin. The most common is medial pain (inside shin). This pain is caused by bone stress, inflammation at the insertion of the muscle into the shin bone and/or an increase in muscle compartment pressure.

Generally an overload issue caused by:

footwear
training surfaces
increase volume/load of training
biomechanics
running technique

The muscle involved (tibialis posterior) attaches into the bone along the length of the shin. When this muscle is overloaded or works to hard, it pulls on the bone causing an inflammatory reaction. With continued loading, the outer layer of the bone can pull away and if the load continues, can develop into a stress fracture – this is why it is so important to get it treated as soon as symptoms present!

The goal of treatment is too reduce pain/inflammation/compartment pressure by limiting the amount the muscle pulls on the bone. We look above and below the injury site to find WHY the muscle is pulling on the bone.

Causes:

rigid foot – decreased shock absorption
over pronation -> medial muscles work harder and longer from lengthened position -> muscle fatigues ->decreased shock absorption -> chronic traction of muscle on bone -> inflammation -> stress #/compartment syndrome
tight calf muscles
ankle instability from previous sprains
poor glut and core control

Specific investigation is required to determine the exact cause of pain and therefore the treatment required. There are many treatment options available but which is most effective for you will be dependent on the CAUSE of muscle stress.

Treatment options that we can help with include:

Ice massage
Rest
Managing training load, talking to coach/physio, pain-free cross-training
calf stretching/rolling (plantarfascia and calf)
massage/trigger point/acupuncture/Dry needling
Footwear/orthotics/strapping
Running analysis, running drills
Strengthening programme – usually targeting gluts/core to improve control lower down chain. A Muscle Balance Assessment can be useful to determine muscle imbalances

If you get onto it quickly, this issue can resolve quickly, otherwise, if a stress fracture develops, it can take much longer (up to months of rest (no running)) to settle.

If you do have any of these symptoms, try some of these remedies, otherwise come and see one of the excellent physios here at Bureta (we specialise in biomechanical analysis and treatment of overload issues) so we can work together to get it settled sooner rather than later! And remember, if you are starting an exercise programme coming into summer, build in to it to allow your muscles time to adapt or have a chat to us about the safest way to start your fitness regime.

Think Optimistically About Injury

We regularly get clients in the clinic frustrated or disappointed with injury, which is an entirely natural and understandable response. However if we think of it optimistically then the majority of the time the injury has come about from being active. In a population that is constantly being told that obesity, heart disease, diabetes etc is rising – then being active is a great thing. I always tell clients that if we were never meant to get injured, then we wouldn’t be good at healing. Our bodies are dynamic and will adapt to stimulus under the right load – Physiotherapist are excellent at telling you when to load and what to do to give you the optimal environment to get better.

(recent news article from New Zealand Society of Physiotherapists President in response to ACC article discussing the increase in costs of injuries from dancing and skateboarding in the Sunday Star Times)

Focus on the fun of physical activity and the positive effects to your health, not the risks say physiotherapists. “Let’s celebrate our active population,” suggests Jonathan Warren, President of the New Zealand Society of Physiotherapists. “Isn’t it wonderful that so many more New Zealanders are getting into dancing, skateboarding, jogging, fitness training, weightlifting and tennis? We’re missing the point altogether if we highlight only the risks and costs of injuries and not the importance of fitness and the potential health dollar savings related to this.

“The truly unsustainable costs – to individual health and to the health system – arise from inactivity,” Mr Warren commented in response to reported increases in injury claims resulting from these activities. “I can’t emphasise enough how important it is for all New Zealanders to be active. We should all take sensible precautions to reduce injuries, but we should not let the fear or cost of injuries put us off being active. In New Zealand we have a highly competent physiotherapy workforce to promote and support active lifestyles.

“I agree with the Dancing With The Stars contestant who said it’s awesome so many people are giving it a go instead of just watching.”

Physiotherapists advise people to take some basic precautions when starting a new activity:

Go to a teacher or trainer qualified in your activity. Ask about experience and credentials.
Start slowly and learn the basics. Extend the scope of your activity gradually.
Warm up first – cold muscles, tendons and ligaments are more vulnerable to injury.
Avoid putting pressure on areas of your body you know cause you problems. If you’re unsure, ask a health professional such as a physiotherapist.
If you have a serious medical condition, consult an appropriate health professional about how best to start your chosen activity.
“It’s ironic that in the same month that stomach stapling is promoted as a saving to the health dollar, an increase in participation in dancing is viewed negatively. Keep active and have fun, for your health’s sake,” Mr Warren says.Heath