Search Results

Having trouble running or walking without foot pain? Have you been told you have a flat foot? Have you been pitched an orthotic insert for your shoe? BUT… Has anyone told you that you can rehabilitate a flat foot with physiotherapy? That you don’t need to rely on an expensive splint that gets lost, doesn’t fit in our new shoes that wears down and must be replaced? Not to mention that an orthotic doesn’t treat the source of your problem. What does ‘flat feet’ mean? Flat foot can be described simply as dropped arch height and an inward roll of the foot, although it can be a little more complicated than that. Other names that you may have heard of are Pes Planus or Pes Planouvalgus. People with symptomatic flat feet will experience foot pain in the base of the heel or along the fascia that spans the arch of the foot. People may also experience pain in the shins, knees or hips due to the altered mechanics of the foot during walking and running. Most people will experience little to no symptoms of flat feet, however the change in foot posture can have upstream affects at the knee, hip and back. The effects of which may not be obvious until they reach a tipping point and either an injury occurs, or a chronic condition develops (tendonitis or shin splints). Why do Orthotics work? The orthotic acts as a bolster and physically pushes the arch of the foot upwards placing it in a better position. This in the short term will improve foot position and reduce the pain associated with flat feet. That’s it. Take the sole away and the arch drops, and the pain returns. This may help with acute episodes of foot pain and can help people with high workloads manage their pain (labourers, soldiers, athletes) but ultimately the orthotic has no lasting change on the condition itself. In fact, becoming reliant on highly structured shoes with or without insoles deconditions the foots intrinsic muscles and sensory nerves further, meaning when you take the insole away you will probably be in more discomfort! So, how can Physiotherapy build the arch in our foot? Physiotherapy aims to build the arch in your foot by training the soft tissues in your foot and lower limb. This can take some time, but it makes lasting changes. These therapies involve strengthening, stretching, mobilisations and activities that redevelop the neural functions in your foot such as proprioception. Modern footwear deconditions the foot and its structures and graded exposure to flat soled shoes and bare foot walking is also incorporated into the rehabilitation program. Our physiotherapists can assess your feet and develop a personalised evidence-based program that involves activity modification, load management, stretching, strengthening of the tissues that support the arch of your foot. Using orthotics can help with your day-to-day function and reduce pain but in our belief treating the source of the problem is more effective than simply treating symptoms.

Hopefully my discomfort will just go away….. No. The Power of Early Intervention and Consistent Supervision in Musculoskeletal Rehabilitation. Musculoskeletal conditions can have a profound impact on our daily lives, hindering our ability to move, work, and enjoy activities we love. Whether it's back pain, joint stiffness, or sports injuries, finding effective relief is crucial for restoring functionality and improving overall quality of life. In this blog post, we will explore the importance of early intervention and consistent supervised treatment sessions with a physiotherapist. 1. Early Intervention: A swift path to recovery. Timely intervention is key when it comes to managing musculoskeletal conditions. By seeking professional help from a physiotherapist at the earliest signs of discomfort, you can significantly improve outcomes and accelerate the healing process. Early intervention is backed heavily by research, for instance: a) A study published in the Journal of Orthopaedic & Sports Physical Therapy found that early physiotherapy intervention within the first 14 days of low back pain reduced the risk of chronic disability by 50% compared to delayed treatment. b) Research published in the American Journal of Sports Medicine showed that early physiotherapy intervention for acute ankle sprains led to faster recovery, reduced pain, and improved functional outcomes compared to delayed treatment. These importance of early identification and immediate involvement of a skilled physiotherapist to prevent chronicity and promote a faster return to normal activities. 2. The Benefits of Supervised Treatment Sessions: Unsupervised physiotherapy exercises or home-based interventions, which we do recommended, may not always provide the same level of effectiveness as supervised treatment sessions. Here's why consistent supervision matters: a) Correct Technique and Progression: Proper technique and progression are crucial to optimize healing and prevent further injury. A study published in the Journal of Orthopaedic & Sports Physical Therapy (2020) revealed that supervised exercises for rotator cuff tendinopathy resulted in improved outcomes compared to unsupervised home-based exercises. b) Motivation and Compliance: Consistency is key in rehabilitation, and supervised treatment sessions provide a supportive environment that encourages adherence to prescribed exercises. A study published in the Journal of Back and Musculoskeletal Rehabilitation (2018) demonstrated that patients who attended supervised physiotherapy sessions had higher compliance rates and better treatment outcomes compared to those who relied solely on unsupervised exercises. c) Real-Time Monitoring and Feedback: During supervised sessions, physiotherapists can monitor your progress, modify exercises when necessary, and provide immediate feedback. This personalized attention enhances the effectiveness of treatment and minimizes the risk of incorrect execution, preventing further complications or delaying recovery. Early intervention and consistent supervised treatment sessions with one of our physiotherapist’s can significantly improve your rehabilitation outcomes. By seeking our help promptly, and combining effective manual therapy such as dry needling, joint mobilisations and soft tissue release, with physical reconditioning programs you can mitigate the risk of chronic disability and achieve faster recovery. At PhysioK, we understand the importance of early intervention and consistent supervision. Our team of experienced physiotherapists provides personalized care, evidence-based treatments, and ongoing support throughout your rehabilitation journey. Don't wait for your condition to worsen—contact us today and experience the transformative power of early intervention and supervised treatment sessions.

It is a daily occurrence here at Physio K that a patient will say, my back/neck/shoulder hurts because I have poor posture! Most people believe that by sitting up tall and having a straight back, they have achieved perfect posture. Well, think again… Over recent years research has shown that the ties between developing low back, or neck pain and the shapes and curves of our posture, are non existent! Researchers have also concluded that postures with a reduced lumbar curve and erect upper back (basically sitting upright) requires increased muscular activity and can cause discomfort and fatigue of those muscles, inevitably leading to pain. Below, we have listed 4 myths we want to debunk on posture. Sit Up Straight There are very few people who haven't heard the phrase, “Sit up straight or you’ll hurt your back!”. While keeping your back straight won’t cause you permanent harm, posture is more about how you feel, rather than how you look. Since every person's body is unique, a pose that works for one, may not work for all. In reality, the most important posture is one that is comfortable. This does not mean that you may spend the entire day curled up on your bed or on the couch. It means that you shouldn't feel forced into one particular, fixed position. In the end, the best thing is to avoid slouching or hunching your shoulders and keep moving! Bad posture = PAIN While it is true that slouching and hunching your shoulders will not lead you to a perfect posture, these issues are not the cause of the pain associated with “bad posture”. The aches and pains we feel in the back may be as a result of a different issue entirely. Think of how tense and slumped your shoulders become on a chilly day. Yes, you will feel the pain in your mid/upper back but is your back the root issue here? Another example of things that can contribute to back pain is the feet. Changes in gait can lead to improper loading up through the body and manifest as back pain. This is the key to treating back pain - not to look at where it is, but where is it coming from! Make A Conscious Effort There aren't many things we can do for self-improvement that won't involve making a conscious effort. However, the issue with constantly actively trying to correct your posture is that it simply doesn't work. Unfortunately, no matter how hard you try, as soon as you take your mind off it, you will forget to maintain your position. So it won't work unless you intend to focus solely on your posture with your mind. Good posture is dynamic, just like our minds. So, as long as you prioritize comfort and movement, good posture will follow. Sit Still The changes in good or bad posture happens slowly over time, just like so many other aspects of our physical health. Many of us are under the impression that by actively forcing our bodies to maintain what we believe to be the "perfect posture," it would eventually improve. However, the contrary is actually true. When you don't move enough, a lot of the pain and issues associated with poor posture, such stiffness, will arise. The back is no different from any other part of the body in that it will become more rigid the longer it remains still. Your back needs to move, whether it means occasionally swapping seats or taking a brief stroll. It is recommended to get up from the desk to move approximately every 30 minutes throughout the work day. These common myths we have discussed are spread by well-meaning individuals, and they may not be completely baseless, most of them are creative spins on the truth. The primary message is this, your posture should be comfortable, not effortful. If you catch yourself constantly adjusting your posture and still experience pain, contact us for an appointment or book online today!

We speak a lot about how to fix an injury once it has happened. People are familiar with acute injury management protocols such as RICE or more accurately PEACE & LOVE. What if we were to rewind the clock to before these injuries ever happened? What steps can you take to prevent getting injured at all? In today's blog we will discuss this topic, exploring how small changes in your daily life can aid in injury prevention as well as adaptations to your exercise regimen to also boost your performance! Rehab is the process that all patients go through when they come into any physiotherapy clinic. Usually it will consist of regular sessions over the period of a few weeks-months depending on your injury. In these sessions you will receive a mix of hands on treatment and exercise prescription in order to get you back to your peak physical health. In recent years the word “pre-hab” has been making its way around physio circles. Initially it was reserved for patients who, for example, may be waiting on a hip replacement surgery. Physios would prescribe a set of exercises to a patient pre-op, in order to achieve the max physical health prior to surgery. The thought process behind this is that going into surgery at your best, will allow for optimal results. So…. With this in mind, why can’t it be applicable to everyone? If exercises can increase the likelihood of better outcomes post surgery, can they increase the likelihood of our muscles performing at their best on a normal day? The answer is yes! Targeted and specific exercises to known areas of weakness are one of the most beneficial things you can do to prevent injuries occurring. But… To really make the most out of an injury prevention program, you must take a holistic approach. Looking at all aspects of our lives to see what and how we can do better to maximize our performance. 1. Healthy and balanced diet. Ensuring that we eat a balanced diet is important for all aspects of our lives. In terms of injury prevention, eating enough protein is of utmost importance. Protein synthesis is the way in which our bodies utilize protein to help with muscle growth and repair. 2. Drinking enough water. Water has countless beneficial effects. After all, our bodies are 60% water. Keeping hydrated will help to reduce tension and soreness. It will help to flush out toxins and also carries nutrients around the body which aid in repair. 3. Getting enough sleep. During sleep the muscles release amino acids, the building blocks of protein, into the bloodstream at an increased rate as opposed to while we are awake and active. Over time this helps with the growth of muscles. We also release growth hormones during rapid eye movement (REM) sleep which helps with muscle repair. 4. Different disciplines of exercise. Exercise can be broken into: Strength training - lifting weights, using resistance bands. Cardio/endurance training - running, walking, dancing, swimming. Proprioception - awareness of where you are in space. This aids in balance, preventing future falls. Think of Single leg exercises such as single leg deadlift. Flexibility - stretching, yoga. By ensuring your physical activity programme has elements of all of these types of exercise, you will be in the best position to prevent future injury. 5. Warm up and cool down. Time and time again, we have heard about the importance of warming up and cooling down, but sometimes the urge to throw on your trainers and hit the pavement is too strong. Next time you want to exercise without warming up, think of the following: By warming up, we increase the oxygen supply around the bloodstream. Oxygen prevents lactic acid build up aka, cramp, allowing you to exercise at your highest level with any niggles arising. Cooling down on the other hand helps to regulate blood flow. This enables gradual recovery of pre-exercise heart rate. It also allows for muscles to return to optimal lengths at a safe rate. 6. Listening to your body. Probably the most important of this list. Our bodies are amazing at giving warning signals to us to highlight areas of potential weakness or future injury. If you are intune with your body this allows you to get ahead of the injury and ramp up all of these tips and tricks before it's too late! Actively taking the steps to prevent injuries is a great way not only to keep you on the pitch or in the gym, but also to ensure you are in tune with your body and living a healthy lifestyle. To get further guidance on how you can start preventing injuries, book in today!

These days, everybody is talking about “strengthening their core”. When people say this they are often referring to the uphill battle of toning and defining our abdominals. Did you know that the “core” is actually made up of approximately 35 separate muscles, your abdominals only being a few… So, what is it then? The best way to describe the core is to imagine it as a cylinder. The top of the cylinder is composed of the diaphragm, (aka the breathing muscle) and the bottom is composed of the pelvic floor. Everything in between these muscles is our core, or often referred to as the trunk. The core has numerous functions that allow us to move, twist, turn and jump, but to name a few. The primary function of our core is stabilisation. This local stabilisation works to protect the spine. The protection of our spine is also facilitated by the global stabilisation system - the way in which loads transfer between extremities during functional movements. The system of muscles that lie more locally to the core are deeper than your abs and obliques. Why is the core so important? A strong and healthy core allows you to move your arms and legs freely without causing friction, shearing or excessive strain on your spine. Anticipatory action is the way in which the core can work to protect the spine prior to body movement occurring. If we lose strength in the muscles of the core, anticipatory action is lost, leaving our spine to become more vulnerable to jarring and twisting movements. Lets recap: The body is made up of a local and a global stabilisation system. These systems have the respective roles. The global muscles generate movement, the local stabilisers protect the joint that drives these movements. A good example of this is; when you pick something up off the ground, the muscles of your hip and knee contract to generate force. While this is happening, our “core” engages to protect the joints of the spine and prevent shearing/friction/torque to transfer to those areas. The importance of having a strong core. Our main line of defence against putting undue strain on our joints while moving through regular tasks is the core. That barrier of defence disappears when the core is compromised or not operating properly. If this happens, the joint/capsule/muscles/ligament or nerves of the spine are put at risk from movements and tasks as simple as putting on your shoe. The core is the main support for the spine. If not maintained, it leaves us susceptible to injury. But it's not all injury risk and potential harm! The good news is that the core is easily trained. We can strengthen and ensure coordinated movement with the right exercises. How do I do this? The benefits from core training are endless. Whether suffering low back pain, or being proactive the preventative effects of core training are endless. All core training plans should be individualised, and improve motor control and stabilisation. Other factors showing a good core training program include: systematic, progressive, functional, and emphasise training of the deep local stabilising system, then integrating the coordination and use of global muscle systems for optimal functional movements. As all training, we aim for progression and variation. The use of stabilising or balance devices has proven to increase recruitment and benefits of core training exercises. As the exercises progress to fundamental movement skills, they should be progressed to include sport or activity specific movements. If you want to learn more about core strength and want professional advice & a personalised core training program? Contact us here at Physio K to book your appointment and get stable and strong today!

Have you heard of dry-needling? Perhaps you’ve even experienced it for yourself! We have discussed dry-needling on the website before, (catch up here if you missed it!) but given we get asked a lot about the specifics, we wanted to go into a little more detail! In this post we’ll be discussing the important differences between dry-needling and its arguably better-known cousin; acupuncture. Whilst the needles used for acupuncture are quite similar to the ones used for dry needling, there are distinct differences between the two modalities. Let’s sum up the 5 biggest differences between the two: 1. Positioning Acupuncturists position needles in anatomical spots which aim to alter the energy flow or ‘chi’. These spots are the same in every human body and have to be memorised. With dry needling, we will search for a trigger point (points in the muscle that can cause local or referred pain). These are different with everyone and depend on your pain pattern. Dry needling will be tailored to the specific needs of each patient. We focus on the clinical reasoning and will do needling in muscles that cause your pain, not necessarily in the muscles that are giving you symptoms. 2. Depth In acupuncture, the needles will only just puncture through the skin, generally quite superficially. With dry needling, we will search for the trigger point. This can either be superficial or deep in the muscle, depending on your individual issue. We use needles produced by GEMt; a Melbourne-based business which conducts professional training in dry-needling world-wide. The design of the needle itself has been refined and perfected after repeated clinical testing, and these are the best available on the market at present. Our fully qualified physiotherapists have completed certified GEMt training courses, ensuring they have the most up-to-date training and experience. Of course, safety and hygiene are of the utmost importance in any treatment of this nature. To ensure this, our therapists also disinfect their gloves before starting each procedure, and needles are safely disposed of following treatment; NEVER re-used. 3. Duration Where an acupuncture treatment can take 20 or 30 mins with the needles inserted, whereas with dry needling at Physio K, we use efficient and effective techniques for stimulating the neuromuscular system that takes only about 10 seconds per targeted area. This means we’ll be with you the entire time, rather than leaving you for longer, as is often the case with acupuncture. 4. Reaction With acupuncture, you normally don’t feel much of what’s happening. In dry needling, we will search for a twitch response, which will feel like a short spasm of the muscle. This is a quick contraction followed by a release of the muscle fibres, which will have a beneficial effect on the tissue and will normalise the tone of the muscle. Some ‘dormant’ muscles can get activated by this process, other ‘overactive’ muscles will relax. The end result will be a better functioning muscle. 5. Results Contrary to acupuncture, you’ll feel or see immediate results with dry needling. It is very easy to assess and reassess the effectiveness of the treatment. It’s very common to have an immediate increase in range of motion in the joint or a release of tension in the muscle. We often use dry needling as a treatment modality in combination with other techniques and we do not charge extra for it! Let us know if you’re interested in this very effective method in order to get you moving pain free again! To book online: click here

What the HEEL is going on??? Do you ever experience pain on the bottom of your foot, around your heel or arch while walking or running? You may be experiencing Plantar fasciitis. Most of us who have experienced plantar fasciitis know first-hand how debilitating and frustrating it can be. Every morning resembles being forced to walk on glass and you quickly become annoyed and dissatisfied. The prevalence in the general population is estimated to range from 3.6% to 7% and may account for as much as 8% of all running-related injuries. What is Plantar fasciitis? …. Plantar fasciitis is an inflammation of the fibrous tissue (plantar fascia) along the bottom of your foot that connects your heel bone to your toes. Plantar fasciitis can cause intense heel pain. Ok so, I understand what it is but how did I get it? …. Well, it is not always clear why this happens. You may be more likely to get plantar fasciitis if you: recently started exercising on hard surfaces exercise with a tight calf or heel overstretch the sole of your foot during exercise recently started doing a lot more walking, running, or standing up wear shoes with poor cushioning or support are very overweight While there isn’t just one specific cause of inflammation, it can be difficult to discern the exact cause as there are many reasons that can lead to it. The one thing that all these causes have in common is that they cause a lot of pressure on the plantar fascia tissue, leading to excess stretching or overuse. My GP has told me I have Plantar fasciitis. What should I do next? …. Book in for a session at Physio K! As physiotherapists we can help you to manage your pain, symptoms and mitigate flare ups through a variety of different treatments. Treatment is always individualised to each client we see. We will carry out an assessment so that we can provide the most appropriate treatment based on your level of pain and what stage of rehab you are at. What should I expect from physiotherapy for this? …. We will be able to help guide you through the rehabilitation process; help you understand signs of plantar fasciitis healing and get you back to doing what you love! Some of the treatments you can expect to receive, but are not exclusive to are: Massage or soft tissue work Home exercise programmes for stretching and strengthening Advice and education Dry Needling What should I do while waiting to see my Physiotherapist? …. There are many home practices you can adopt to aid in your recovery from plantar fasciitis. It is always recommended to see a professional.

Bone is changeable tissue that responds to variables in mechanical loads by altering its mass, structure and/or strength. Today's blog will explore some of the key principles behind exercise for bone health. Principle of Specificity: The way bones change in relation to loading is site-specific and not systemic in nature. In other words, when your physiotherapist prescribes exercises, they must include targeted activities that are known to directly or indirectly load the bones giving trouble. The most common sites of fractures are the hips, the spine and the wrists. Principle of Progressive Overload: The load put on bone, either directly or indirectly, must push a little bit further than what we are used to during everyday activities. Bone is adaptable. If you lift at the same weight session after session, you will be unlikely to see any improvements. If you lift a little bit heavier each time, you will notice changes in lifting capacity and muscle definition. The same happens with bones, if you don’t progressively overload them - nothing will change! Principle of Reversibility: any positive bone adaptations resulting from exercise training will be progressively lost once the exercise is stopped.The findings from a 16-year non-randomized study involving a “multimodal exercise program in early postmenopausal women with osteopenia found that at least two sessions per week was the minimum effective dose to positively influence bone over the long-term”. So… Now you know the importance of exercise for healthy bones, but what can you do? Take a look at our suggestions below of exercises for bone health! Exercises for bone health: It is recommended to have a mix between weight-bearing and resistance based exercises for best bone health. Weight-bearing exercises ● Walking ● Hiking ● Jogging ● Climbing stairs ● Playing tennis ● Dancing. Resistance based exercises: ● Lunges ● Deadlifts ● Squats ● Rows ● Flys ● Overhead pres If you have a bone density deficiency or want to prevent it, check in with a member of our team here at Physio K to see how you put the steps in place to lead a stronger, healthier and happier life!

With the recent spike in lockdown restrictions most people have been advised to return to working from home. As a result, I’m sure the dust has been blown off many home set-ups that were installed during the peak of the pandemic in 2020. For most of us this ‘temporary’ setup consisted of a four-legged chair, kitchen bench and our laptops, or even worse…our beds! But is this really the best idea? What did the home office change? For a majority of the workforce, the COVID 19 health emergency introduced us to remote working for the first time. With the primary goal being to minimize physical contact and potential contamination of the workplace, it was a feat of technological brilliance that allowed most companies to continue to operate despite these restrictions. Yet with this in mind, the shift to a home set up has resulted in a considerable change to the environment in which we work. Among the advantages of this we see reduced time spent commuting to and from work, possible increases in productivity and motivation as well as a better work-life balance. However, not everything has changed for the better. Common struggles such as a lack of separation between work and rest, no personal human interactions or communication problems are the obvious disadvantages that most of us would identify when talking about the harm of working from home. But what if I told you that working from home was also affecting your physical health? Is your home environment detrimental to your health? A study conducted in 2020 (Moretti et al., 2020), targeted the changes in working life that most of the population has experienced since the COVID-19 health emergency. In this it analyses the physical health issues related to remote working. The two major factors identified were the increased periods of inactivity and the adoption of poor posture due to lack of environmental support. It suggested that our home environment is inferior to the workplace, particularly due to the “absence of ergonomic office furniture which may impede the adoption of a healthy posture and promote the onset of musculoskeletal disorders.” SO... WHAT DOES THIS MEAN IN ENGLISH? In simple terms our use of a four-leg dining chair, kitchen bench and laptop are a poor substitute for an office desk with an adjustable chair and height adjustable monitor. In fact, this shows that it can lead to the development or worsening of physical disorders notably lower back and neck pain. It reported that 70.5% of participants had musculoskeletal pain with the lower back being responsible for 41.2% of complaints and the neck accounting for 23.5%. Now given that lower back pain itself is quite complex it would be wrong to suggest that the poor remote working station is the only reason for this spike in pain. However, if we frame the entire working from home lifestyle and take the big picture into consideration, it is quite easy to see how these factors can play together. If we combine the reduced activity levels, with poor body positioning whilst sitting, poor psychosocial factors from time in isolation and the continued stress of repetitive work, it starts to paint quite an ugly picture for our overall spine health. Furthermore, it is well documented that working in the same position for an extended period significantly increases your risk of injury. Considering that the most frequent health problems presented within the working population are spine related, this finding is not too surprising. What can you do to prevent this? Whilst we are going to give you some tips below on how to adapt your workstation, to maintain good health and wellbeing throughout this period of remote working change should not stop there. It is essential that you continue to maintain boundaries with work. If possible, schedule time away from your desk. Try to maintain physical activity throughout this period aiming for at least 30 minutes of moderate physical activity every day. Furthermore, maintaining social relationships during this period will also help alleviate stress and other psychosocial factors that may influence your pain. If you can adjust your home set up it should include the following changes: 1. Adjust your screen height. The ideal screen sits in line with your shoulders so adjust your desktop to this height and if you have a laptop elevate it with a platform or some sturdy books. This will prevent excessive craning of the neck or other less ideal positions. Working with one screen is also preferable as it prevents you rotating your neck repeatedly to one side which can contribute to imbalance. 2. Lumbar support. If you do not have an office chair at home, a rolled up towel positioned at the small of the back can act as a substitute helping to assist you into an ideal position. 3. Keep your keyboard and mouse close to the edge of your desk. This will prevent excessive forward leaning. 4. Keep your feet flat on the floor. If you have a height adjustable chair this would be ideal. If not, using a footstool beneath the feet can offer the same support. 5. Keep moving. Try to avoid being stuck in the same position for long periods of time. Remember, your next position is your best position! Moretti, A., Menna, F., Aulicino, M., Paoletta, M., Liguori, S. and Iolascon, G., 2020. Characterization of Home Working Population during COVID-19 Emergency: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health, 17(17), p.6284.

We see many patients who have the habit of cracking their own neck or lower back. In most cases, people experience stiffness after prolonged sitting or looking at a computer screen. Many crave the feeling of relief that comes from a crack or pop in the neck, but is it actually good for you? The short answer is no, and it could actually contribute to your problem or maintain your long term stiffness. WHAT IS THAT CRACKING OR POPPING SOUND? The first cause of a crack or pop when doing a movement is either a ligament or tendon that moves over a bony part or one another. A ligament connects bone to bone; it restricts movement. A tendon connects your muscle with your bone. Sometimes these ligaments or tendons are tight and will roll or rub over your bones and a clicking sound will appear. This is the case when the click keeps happening with every movement you do. The second cause of a cracking sound is called cavitation. Our joints contain gases, such as nitrogen, oxygen and carbon dioxide; together with fluid they cushion and lubricate the joints. Specific movements or pressure in the joint will create gas bubbles that make a cracking or popping sound. Getting that cavitation can give you relief and can ease the discomfort in a tight area. Getting the crack or pop in your spine (neck, mid back or lower back) can give you endorphins and will feel good initially, but it’s not necessarily what you need and can cause you more harm in the long run! WHY IS CRACKING YOUR OWN SPINE BAD? Leave the adjustments to a specialist health practitioner, who has extensive knowledge and experience. There are many arteries and veins that can be damaged by cracking your neck if you’re not sure what you’re doing. These vessels carry blood to and from the brain, so forceful movements could increase the risk of a stroke. Another danger of repeatedly doing these movements is damaging or stretching your ligaments. This can cause hyper-mobility and/or instability, which could cause muscle tightness. This will then give you the urge to crack your spine again, and so on. It’s a negative spiral that you need to stop as soon as possible. HOW DIFFICULT CAN IT BE TO STOP DOING THAT? Many people find it hard to stop cracking their own spine; it’s a habit and changing behaviour is not easy. The first step is being made aware of it and realising that it can be causing or contributing your problem, rather than solving it. Many people don’t even think about it or do it consciously. When you stop for a few weeks, in most cases your soft tissue will normalise and the urge to crack will reduce or ideally disappear. Strengthening your core muscles can be helpful to help support and improve your spine mechanics. WHICH CRACKS ARE OK AND WHICH ONES SHOULD I AVOID DOING? Generally speaking, the clicks or pops that give you an instant relief when you search for it are the ones you should avoid. When something repetitively pops with normal movements, but it doesn't give you that relief that you're after, that's usually ok. E.G. When you roll your shoulders backwards or forwards, you might hear a popping sound every time you do that movement. This is most likely not a cavitation, but muscle fibres flicking over your ribs. That's ok and is not dangerous. CAN I CRACK MY KNUCKLES AND WILL IT GIVE ME ARTHRITIS? The story of arthritis that’s caused by cracking your knuckles is an urban legend. It was probably invented by someone who didn’t like the sound and your mom used it to scare you. There is no evidence or research showing direct links between arthritis and cracking joints. The fingers or toes are simple joints and will not be impacted by these actions. If you can’t resist cracking something, go ahead and pop your knuckles. Oh, and tell your mom that it won’t hurt, refer her to this article :-)

In a previous interview with Alison McGregor from Chainsmith Bikes (which you can read here), physiotherapist Kenny from Physio K talks about how tightness in the body and repetitive movements can result in overuse and injuries. Aches and pain when cycling should not be ignored. At Physio K, we often deal with injuries or pain as a result from cycling. We know how your body acts and reacts to repetitive movements. Spending hours in the saddle in a similar position can accumulate into a series of problems. We are used to assess the body, search for different movement patterns, educate our clients and address their problems. But sometimes the body isn’t the problem, discomfort can also be caused by the positioning on the bike. Alison McGregor has a passion for women’s cycling and her aim is to encourage all new riders. She is co-owner of Chainsmith, a custom road bike specialist shop in Surry Hills. One of their services besides building custom bikes is specialised bike fitting, which can be key in injury prevention. Let’s delve into the world of a bike fitter who can make your comfort on the bike a whole lot different! THE INTERVIEW: Kenny Merlevede: You're specialised in custom built bikes. How much can you customise on a bike and how (much) could this impact the performance of the athlete? Alison McGregor: Years ago my business partner David Piacenti and I recognised common problems in the workshop. All these road bikes were turning up for services with all sorts of set-up issues. The stems were really short, saddles were pushed forward or the shifters and bars were arched back. Basically the riders were adjusting their bikes to relieve pain or discomfort. Numb hands, sore shoulders, saddle sores were the main problems they were trying to stop. When you're uncomfortable on the saddle, you deny yourself your best performance. It makes sense to think the problem is solved by adjusting parts here and there. But it often makes things worse. The fact is sometimes you just bought the wrong bike. Making too many changes negatively impacts your bike handling, your position and balance over the bike is changed. In extreme cases it can cause dreaded vibrations or speed wobbles, which is obviously dangerous and impedes both confidence and performance. The bottom line is that many riders buy a bike based on what their mates ride, or what the Pros ride. It can be an expensive mistake to follow others rather than look at yourself and celebrate what makes you unique. So we devised a very different approach to finding and building the right bike to achieve personal riding goals. Our clients already came to Chainsmith for consults, to choose high-end factory frames and components. Then we build the bike to suit their exact needs. This is one type of custom. It allows the client a proper position over the bike, enabling them more control in riding all sorts of terrain. With the feedback we received we knew when clients are well balanced on a purpose chosen bike they use muscles correctly, fatigue less, ride longer and faster. The second type of custom aligns the client with their bike even further. When a bike is made to measure, in true custom fashion, our experienced builders engineer a frame to perfectly balance the individual rider. The geometry and the tube measurements are developed in relation to a rider's bone lengths and flexibility. This means better comfort and better handling. When it comes to performance, the evidence shows that being aero is not the be all and end all. With good fitting practices there should be synergy created between your body, the machine, and the terrain. That's what full custom bikes afford you. Kenny Merlevede: You're working with the ID match bikefit lab. How (much) does that differ with other, classic bike fit systems? Why or how is it better? Alison McGregor: We were so relieved when IdMatch Bike Fit Lab arrived from Italy because we knew it would give our clients certainty. It saves them money and time, and ultimately helps them find their best bike. Chainsmith is the only one to have the system in Australia and it took a lot of Italian conversations to understand the incredible accuracy it would give. Now we've had time to use the Lab, we realise the efficiencies and capabilities are beyond other fit systems. There's so much technology! Measuring is done with 3d scanning. When you're seated on the smart bike it automatically adjusts as you're pedalling. It simulates a riders position on their current bike in seconds and then makes incremental changes to better the riders position and performance. The smart bike is different because it's effective for clients who own bikes, but also for clients wanting new bikes. There are thousands of bike models and components in the IdMatch program. So a client's frame size and components can be determined before they buy. Of course, you need to read the data and you need to understand geometry in the first place. So humans are never replaceable. But we are trained, and with this system being so efficient it's a powerful tool. Importantly, our custom clients have the opportunity to seamlessly assume their ideal position before a frame has even been created. That's a security our custom clients appreciate. Kenny Merlevede: You've had a few injuries and niggles yourself. Some got fixed with treatment but I'm sure your bike fit system has helped a lot as well. How did you experience the difference after making the bike changes? Alison McGregor: About 10 years ago I stopped running due to excruciating pain. I was diagnosed with stenosis. I was never competitive nor much good at it, but I was gutted because I loved it. But there wasn't much hope. Luckily being on the bike helped open up my back. So I took it up pretty aggressively. When I met you, I'd suffered three straight days of unrelated neck pain. You immediately relieved the pain with some incredible needle work. That day you taught me a valuable lesson. Being in the ride position for hours on end, several times a week, comes at a cost if you fail to support yourself with stretching or strength training. And even with the world's best bike fit, or custom bike, you can benefit from medical recommendations. When we received the IdMatch Bike Fit Lab we obviously tested ourselves. I'm a macro adjuster and I tend to have a high pain threshold, but when you're on the fit system and it's manually moving you as you pedal you can feel each incremental change to your position. Even though my fit was close with small adjustments I could literally feel my shoulders opening up and the access to air getting better. In another instance, if you look at my stance you'll notice my right toe naturally points outwards. It's no coincidence my older frames have marks on the chainstays and crank. I literally stripped the paint off my CX frame and started scraping through the carbon! Since my fit, I've adjusted all my cleats with slight changes to my saddle position. The float is no longer destructive but more importantly my stroke is smoother and with more power. Bike Fit starts at the cleat, so there are noticeable changes in comfort from that one change. At the same time I added strength training with shoulder, core and hip focus. Off road there's been obvious benefits - my improved position combined with strength work allows me to hold the front wheel down and avoid slipping out on really rocky climbs. My change in stability and balance is really noticeable. Kenny Merlevede: Have you had huge successes with a bike fit on athletes' aches and pains? Alison McGregor: Absolutely. For clients who own a bike and visit the lab to increase performance or comfort, the feedback reports show how we've helped. Since February we've done so many fits. Probably the most dramatic has been for several petite women who struggle to find a bike for their riding aspirations. One in particular suffered quite drastic injuries due to her position and saddle. She'd lacerated particularly sensitive areas. Obviously this is something that can stop your riding altogether. A change of ride position and saddle using the IdMatch Saddle Test has eliminated the problem and, in the meantime, she ordered a custom frame to cater for her size and race ambitions. Aching hands, neck and back aches and knee pain are usual issues we see. Burning feet or saddle pain are also common. Actually, a client recently came to us while working through piriformis syndrome. The bike fit adjusting his bars and saddle helped with notable improvements in his riding comfort. That means he can ride more, and ride endurance. Of course he's also working with a medical practitioner, which we always subscribe to. But the reduction of pain due to the bike fit has been a fantastic motivator considering his lengthy battle with injury. Kenny Merlevede: How can your bike fit system help riders with injury prevention? Alison McGregor: The IdMatch Bike Fit Lab is a fantastic tool for fit, but also programmed to provide the most ideal bike options. By introducing the Lab the idea was to offer pre purchase bike fit. It's the best way to select the right frame model, in the right size, with the correct components. The other day we'd a client wanting to purchase a brand we don't sell. The IdMatch program allowed us to look at all the options in an appropriate model and size, this includes the handlebar, stem, saddle and crank length. What quickly became apparent was his lack of flexibility. With our recommendations he realised his choice wasn't suitable. A handful of spacers could have helped his comfort, but it would have drastically and negatively affected his balance in the front end. We came up with a much better solution that aligned his body and cycling goals. Pain or injury prevention doesn't only come in the form of good position, but also in how a bike handles in relation to the rider's balance. Many cyclists don't realise that when you're not balanced correctly over the bike you can experience instability on corners and descents. Good performance isn't just about being fast, it's about riding confidently and trusting your equipment 100%. At the end of the day, with the right bike and ideal position you should feel synergy between yourself, the machine, and the terrain. It's exactly that unity that allows you to really commit to your best performance. You can learn more about the comprehensive bike fit system here ​​ To read the article about cycling performance and injury prevention with Kenny Merlevede, click here

Subacromial impingement syndrome. It’s quite a mouthful and a diagnosis that will make you fearful of ever using your shoulder and arm again. But what is it and what does it mean? Subacromial impingement is considered to be the most common musculoskeletal condition affecting the shoulder and is estimated to affect at least one in four people at some point in their lifetime. It is based upon the idea of tissues within the shoulder joint undergoing compression during certain functional movements, especially ones that involve the arm being raised above shoulder height. In essence this theory suggests that one of the muscles that contributes to the rotator cuff (supraspinatus) gets pinched underneath the bony roof of your shoulder blade (acromion process) resulting in pain and inflammation of the tendon and its surrounding tissues such as the bursa (a sac of fluid that protects the tendon from abrasion). But is this really the cause of your shoulder pain? After all, up until this point in your life you’ve never had an issue with this bone or this tendon so what’s changed? To answer this, we first must understand what tendons are and how they operate. Tendons are the connective tissues that help connect a muscle to a bone. It is made up of collagen fibres which are closely packed to give a tendon the strength it needs to transmit the forces produced by our muscles into the bones they attach to. In fact, tendons are so robust that gram for gram these tightly packed fibres are stronger than steel! If that’s the case, then you may be wondering how do they get damaged? Well, there are several lifestyle factors that contribute to tendon health and regeneration. Avoiding modifiable factors such as smoking, obesity, high intakes of fatty or processed foods and high cholesterol levels all contribute to maintaining healthy tendons. However, by far the most notable risk factor for tendon injury is SUDDEN CHANGES IN ACTIVTY LEVELS! Tendons do not like a sudden change in activity. If they go through a period of unaccustomed loading, especially above shoulder height, they will end up getting irritated and unhappy. When we work a tendon to fatigue (which happens quite easily when we first start moving after a period of inactivity) it induces swelling within that tendon. This is especially true in the case of the supraspinatus tendon, which is the main tissue implicated in this diagnosis. As a result of this fatigue and swelling there is a decrease in activation of the supraspinatus muscle which plays an important roll in stabilising the shoulder joint and preventing the unwanted rise of the humeral head (top of the arm bone). Therefore, the issue is not actually subacromial impingement but rather tilting more towards an irritation of the tendon due to overuse, also referred to as overuse tendinopathy or as rotator cuff related shoulder pain. So, what can you expect from physiotherapy management? Well typically when dealing with rotator cuff related shoulder pain there should be physiotherapy rehabilitation for the first 12 weeks, followed by self-management or independent rehabilitation from week 12 to 24. After week 24 you can then return to normal activity. Physiotherapy management may often include some manual therapy techniques in addition to a targeted home exercise program or work-related activity program. It is important to note that some of the exercises you will be asked to complete may bring on some discomfort or result in you working through pain. This is completely normal, but it should be tolerable and settle quickly upon completion of the exercise. The reality of the situation is that this theory of shoulder impingement is now considered outdated. The evidence now shows us that decompression surgery, which was and still is the surgical procedure for this injury to date, does not outperform either placebo surgery or physiotherapy treatment in the short-, medium- or long-term outcomes. So, we have to ask, why risk taking the surgical route if in 6-12 months-time the result will be the same with physiotherapy treatment. References Cuff, A., & Littlewood, C. (2018). Subacromial impingement syndrome – What does this mean to and for the patient? A qualitative study. Musculoskeletal Science And Practice, 33, 24-28. doi: 10.1016/j.msksp.2017.10.008 Lewis, J. (2009). Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment?. British Journal Of Sports Medicine, 43(4), 259-264. doi: 10.1136/bjsm.2008.052183 Lewis, J. (2011). Subacromial impingement syndrome: a musculoskeletal condition or a clinical illusion?. Physical Therapy Reviews, 16(5), 388-398. doi: 10.1179/1743288x11y.0000000027 Lewis, J. (2016). Rotator cuff related shoulder pain: Assessment, management and uncertainties. Manual Therapy, 23, 57-68. doi: 10.1016/j.math.2016.03.009 Lewis, J., McCreesh, K., Roy, J., & Ginn, K. (2015). Rotator Cuff Tendinopathy: Navigating the Diagnosis-Management Conundrum. Journal Of Orthopaedic & Sports Physical Therapy, 45(11), 923-937. doi: 10.2519/jospt.2015.5941 Löscher, S. (2018). 2013 Neer Award: Prädiktoren für das Versagen von nicht operativer Therapie bei chronischen, symptomatischen Rupturen der Rotatorenmanschette. Manuelletherapie, 22(04), 157-159. doi: 10.1055/a-0658-8975