Sports Therapy | LiveWell Health

The healing power of cupping therapy

Posted on May 27, 2024

Cupping therapy, a form of alternative medicine with roots tracing back to ancient Egyptian, Chinese, and Middle Eastern cultures, has gained considerable popularity in contemporary health and wellness circles. This practice involves placing cups on the skin to create suction, which is believed to enhance blood flow, reduce muscle tension, and promote healing and relaxation. Despite its ancient origins, cupping has found a place in modern therapy, offering a holistic approach to health that complements conventional medical treatments.

The History and Techniques of Cupping Therapy

Cupping therapy dates back thousands of years. Historical records suggest that the ancient Egyptians used it as early as 1550 B.C., as documented in the Ebers Papyrus. The technique also features prominently in traditional Chinese medicine (TCM) and has been practised by various cultures worldwide for centuries.

There are two main types of cupping: dry cupping and wet cupping.

Dry cupping involves placing cups on the skin to create a vacuum. This can be achieved either by heating the air inside the cup and then placing it on the skin, causing the air to cool and form a vacuum, or by using a pump to create the suction.
Wet cupping, also known as hijama, involves a similar process, but after the suction, the therapist makes small incisions on the skin to draw out a small quantity of blood. This is believed to help remove toxins from the body.

Cups can be made from various materials, including glass, bamboo, earthenware, and silicone. The type of material and method used can vary depending on the practitioner’s approach and the specific needs of the patient.

The Mechanisms and Benefits of Cupping Therapy

The primary mechanism behind cupping therapy is the creation of a vacuum that draws blood to the surface of the skin. This process is thought to improve blood circulation, relieve muscle tension, and promote cell repair. By enhancing the flow of blood and lymphatic fluid, cupping may help in removing toxins and reducing inflammation.

Key Benefits of Cupping Therapy:

Pain Relief: One of the most significant benefits of cupping therapy is its ability to alleviate pain. The increased blood flow to the affected area can help reduce muscle soreness, stiffness, and overall pain, making it a popular choice for athletes and individuals with chronic pain conditions.
Improved Blood Circulation: Cupping therapy stimulates blood flow, which can enhance the delivery of oxygen and nutrients to tissues and promote healing. This improved circulation can also help reduce the appearance of cellulite and varicose veins.
Muscle Relaxation: The suction and negative pressure created by cupping can loosen muscles, encourage blood flow, and sedate the nervous system, which makes it an effective treatment for high blood pressure.
Detoxification: Wet cupping, in particular, is believed to draw out toxins from the body, helping to cleanse the blood and boost the immune system.
Stress Reduction: By promoting relaxation and reducing muscle tension, cupping therapy can help alleviate stress and anxiety, contributing to overall mental well-being.
Enhanced Skin Health: The increased blood flow and detoxification effects of cupping can improve skin health, reducing conditions like acne, eczema, and inflammation.

Modern Applications and Considerations

Today, cupping therapy is widely used by healthcare professionals, including medical acupuncturists, massage therapists, sports therapists and physiotherapists. Its integration into modern health practices underscores its efficacy and adaptability.

However, it is essential to approach cupping with caution. While generally safe when performed by trained practitioners, cupping can cause side effects such as skin discoloration, bruising, and, in rare cases, burns or infections. Individuals interested in cupping therapy should consult with a healthcare provider to ensure it is appropriate for their specific health needs.

In conclusion, cupping therapy offers a compelling blend of ancient wisdom and modern application. Its ability to provide pain relief, improve circulation, promote detoxification, and reduce stress makes it a valuable addition to contemporary wellness practices. As more people seek holistic and non-invasive treatments, the popularity of cupping therapy is likely to continue its resurgence, bridging the gap between traditional healing and modern health care.

If you are interested in making a booking with one of our cupping practitioners, then please use our booking system or contact us directly.

Can Meniscus Tears Heal Without Surgery

Posted on May 15, 2024

The meniscus is a crucial structure within the knee joint, consisting of two C-shaped pieces of cartilage located between the femur and tibia bones. Acting as shock absorbers, the menisci play a vital role in distributing weight, reducing friction, and stabilizing the knee during movement. These rubbery, wedge-shaped tissues are prone to injury, with tears being one of the most common knee injuries, particularly among athletes and older adults. A meniscus tear can occur due to sudden twisting or rotation of the knee, or as a result of degenerative changes over time.

Can Meniscus Tears Heal Without Surgery?

Whether a meniscus tear requires surgical intervention depends on various factors, including the severity, location, and type of tear, as well as the individual’s age, activity level, and overall health. In many cases, small tears located in the outer edge of the meniscus, where blood supply is more robust, have the potential to heal on their own without surgery. Conservative treatment options such as rest, ice, compression, and elevation (RICE), along with physical therapy exercises focused on strengthening the surrounding muscles and improving range of motion, may be sufficient to rehabilitate a minor meniscus tear. Additionally, corticosteroid injections or platelet-rich plasma (PRP) therapy may be recommended to reduce inflammation and promote healing.

Recovery Timeline for Meniscus Tears Without Surgery:

The healing timeline for a meniscus tear treated without surgery can vary depending on several factors, including the extent of the injury, the individual’s age and overall health, and adherence to the prescribed treatment plan. In general, minor meniscus tears may take approximately four to eight weeks to heal with conservative management, while larger or more complex tears may require a longer recovery period. Physical therapy plays a crucial role in the rehabilitation process, helping to restore strength, flexibility, and stability to the knee joint. It is essential for individuals recovering from a meniscus tear to follow their healthcare provider’s recommendations closely and to avoid activities that place excessive stress on the knee during the healing process. While some meniscus tears may resolve without the need for surgery, others may require surgical repair or partial meniscectomy to alleviate symptoms and restore function to the knee joint.

Rehabilitation of a Meniscus Tear

A meniscus tear can significantly impact knee function and mobility, requiring a structured rehabilitation program to facilitate healing, restore strength and flexibility, and prevent future injuries.

Here’s a comprehensive rehabilitation plan tailored for a meniscus tear, however we would always advise personally seeing a sports therapist or physiotherapist to design a tailored plan:

Phase 1: Immediate Post-Injury (Weeks 1-2)

Goals:

Reduce pain and inflammation
Protect the injured knee
Restore range of motion

Treatment:

Rest: Avoid activities that aggravate symptoms, and use crutches if necessary to offload weight from the affected knee.
Ice: Apply ice packs to the knee for 15-20 minutes, 3-4 times a day, to reduce swelling and pain.
Compression: Use a compression bandage or knee sleeve to control swelling and provide support.
Elevation: Elevate the injured leg above heart level when resting to reduce swelling.
Pain management: Take over-the-counter pain medications as prescribed by a healthcare professional.

Phase 2: Recovery and Mobility (Weeks 3-6)

Goals:

Improve knee range of motion
Begin gentle strengthening exercises
Enhance proprioception and balance

Treatment:

Physical therapy: Start a supervised rehabilitation program focusing on gentle knee mobilization exercises, such as heel slides, passive and active knee flexion, and extension exercises.
Strengthening exercises: Initiate low-impact exercises to strengthen the quadriceps, hamstrings, and calf muscles, including straight leg raises, hamstring curls, and calf raises.
Proprioception training: Perform balance and stability exercises, such as single-leg stance and mini-squats, to improve joint proprioception and reduce the risk of re-injury.
Cardiovascular exercise: Engage in non-weight-bearing activities like swimming, stationary cycling, or aqua jogging to maintain cardiovascular fitness without stressing the injured knee.

Phase 3: Functional Rehabilitation (Weeks 7-12)

Goals:

Restore normal knee function and strength
Improve flexibility and proprioception
Gradually return to sport-specific activities

Treatment:

Progressive strengthening: Advance to more challenging strengthening exercises, including lunges, step-ups, and resistance training using bands or weights.
Flexibility exercises: Incorporate stretching exercises to improve flexibility and mobility in the knee joint and surrounding muscles.
Plyometric training: Introduce controlled jumping and hopping exercises to enhance lower limb power and agility.
Sport-specific drills: Gradually reintroduce sport-specific movements and activities, focusing on proper technique and biomechanics.
Functional testing: Assess readiness to return to sport or high-impact activities through functional tests, such as single-leg hop tests and agility drills.

Phase 4: Return to Activity (Weeks 13 and beyond)

Goals:

Full recovery and return to previous activity level
Prevent recurrence of injury

Treatment:

Gradual return to sport: Resume full participation in sports or physical activities, starting with low-intensity drills and gradually increasing intensity and duration.
Maintenance program: Continue with a maintenance program of strength, flexibility, and proprioception exercises to prevent future injuries and maintain optimal knee function.
Regular monitoring: Attend follow-up appointments with a physical therapist or healthcare provider for ongoing assessment and monitoring of knee health and function.

In conclusion, understanding the nature of meniscus tears and their potential for healing without surgery is essential for individuals navigating treatment options for knee injuries. While conservative management strategies may be effective for some meniscus tears, others may require surgical intervention to achieve optimal outcomes. Consulting with a healthcare provider to determine the most appropriate course of treatment based on the specific characteristics of the injury is crucial for promoting successful recovery and restoring function to the knee joint.

If you would like help and advice on rehabilitation of a meniscus tear, please contact our team for further information.

Understanding the Meniscus: An Essential Component of Knee Health

Posted on May 15, 2024

Understanding the Meniscus: An Essential Component of Knee Health

The meniscus, often referred to as the “shock absorber” of the knee, is a vital structure that plays a crucial role in maintaining knee stability and function. Composed of two C-shaped pieces of cartilage nestled between the femur and tibia bones, the menisci act as cushions, distributing weight evenly across the knee joint and providing stability during movement.

Anatomy and Function

Located within the knee joint, the menisci are tough, rubbery tissues that help to absorb shock and reduce friction between the femur and tibia bones. They also serve to stabilise the knee, preventing excessive movement and providing support during activities such as walking, running, and jumping.

The menisci have a crescent shape, with the larger medial meniscus on the inner side of the knee and the smaller lateral meniscus on the outer side. Each meniscus is attached to the joint capsule and ligaments of the knee, ensuring proper positioning and function.

Common Injuries

Despite their resilience, the menisci are susceptible to injury, particularly during activities that involve twisting, pivoting, or sudden changes in direction. Meniscus tears are among the most common knee injuries, occurring as a result of traumatic injury or degenerative changes associated with ageing or repetitive stress.

Symptoms of a Meniscus Injury

Meniscus injuries can cause a range of symptoms, including:

Pain, especially along the joint line of the knee
Swelling and stiffness
Difficulty fully straightening or bending the knee
Popping or clicking sensations
Feeling of instability or “giving way” in the knee

Diagnosis and Treatment

Diagnosing a meniscus injury typically involves a thorough physical examination, along with imaging tests such as MRI or X-ray to confirm the diagnosis and assess the extent of the injury. Treatment options for meniscus injuries depend on several factors, including the severity and location of the tear, the individual’s age and activity level, and the presence of any underlying knee conditions.

Conservative treatment measures such as rest, ice, compression, and elevation (RICE), along with non-steroidal anti-inflammatory medications (NSAIDs) and physical therapy, may be recommended for minor meniscus tears or for individuals who are not good candidates for surgery.

Surgical options may be considered for larger or complex tears, particularly those that interfere with knee function or cause persistent symptoms. Surgical procedures for meniscus tears may include arthroscopic repair, partial meniscectomy (removal of the torn portion of the meniscus), or meniscus transplant for irreparable tears.

Conclusion

The meniscus plays a crucial role in knee health and function, serving as a vital component of the joint’s stability and shock absorption mechanism. Understanding the anatomy of the meniscus, common injuries, and treatment options is essential for maintaining knee health and preventing long-term complications associated with meniscus injuries. Prompt diagnosis and appropriate treatment can help individuals recover from meniscus injuries and return to their normal activities with improved function and reduced risk of future injury.

If you feel you are struggling with a meniscus issue, our highly qualified sports therapists and physiotherapists can help design a robust rehabilitation plan. Contact us for more information.

Tennis Elbow

Posted on May 3, 2024

Tennis elbow is a condition that causes pain around the outside of the elbow joint, the clinical name for this condition is known as lateral epicondylitis. It usually occurs after strenuous overuse of the muscles and tendons of the forearm. It is a very common musculoskeletal condition with an estimated 1 in 3 people having Tennis Elbow at any one time. The condition is more common in adults and across the age demographic of 30-50 years of age. Both Men and women are equally affected by this condition. Not surprisingly, and as the name suggests, playing tennis or other racquet sports can and is a big factor in the cause of this condition. However, several other sporting activities and non sporting activities can also put you at risk. Tennis elbow can be because of inflammation or, in some cases, small tears of the tendons that join the forearm muscles to the bone (epicondyle of the humerus) on the outside of the elbow.

Anatomy

Your elbow joint is a joint consisting of 3 bones. The first is in your upper arm and known as the Humerus. The other 2 bones are in your forearm and known as the Radius and Ulna bones. At the bottom of the humerus there are small bony prominences called epicondyles, where muscles within the forearm attach. The bony prominence located on the later side of the elbow (outside) is called the lateral epicondyle.

Muscles, ligaments, and tendons play a huge role in holding the elbow joint in position with strength but also flexibility to move.

Lateral epicondylitis, or tennis elbow, is a condition that affects the muscles and tendons of your forearm however extensive research has shown one particular muscle can play a large part in Tennis Elbow which is the Extensor Carpi Radialis Brevis (ECRB) muscle. The muscles associated with Tennis Elbow are responsible for the extension of your wrist and fingers.

Symptoms

The symptoms of tennis elbow usually develop over a long period of time. In the vast majority of tennis elbow cases the pain can just be minor and more of a side note but can worsen over time. In most cases there is no specific injury associated with the condition, it is usually a repetitive overuse injury but not in all cases.

Common signs and symptoms of tennis elbow include:

Pain or burning on the outer part of your elbow
Pain when lifting, twisting or bending your arm (with or without objects)
Weak grip strength
Sometimes, pain at night on the outside of your upper forearm, just below the elbow.
You may also find it difficult to fully extend your arm.
The symptoms are often worse when the forearm is being used in activities that can be as simple as pouring water into a cup, using a screw driver even shaking hands.

Causes

Overuse – Recent studies have show that a particular muscle, when damaged can play a large part in the cause of Tennis Elbow. This muscle, located in the forearm, is known as the extensor carpi radialis brevis (ECRB). It is a muscle that helps in stabilizing the wrist when the elbow is straight.

When the ECRB is injured / weakened from overuse or a specific incident, small tears appear in the tendon where it attaches to the lateral epicondyle (bony prominence). This of course then leads to inflammation and the resulting pain.

Studies also show, the ECRB could be at a greater risk of damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities – Activities play a large part in the cause of Tennis Elbow (Lateral epicondylitis). As you would expect Tennis and other racket sports are a factor in the case of Tennis Elbow (hence the name) however anyone can get it and it could even be down to work related overuse. Professionals such as Plumbers, Electricians, Carpenters, Factory Workers, Cooks and Butchers can get this condition based on how they are using their arm such as the use of screw drivers with the twisting actions etc

Age – Anyone can get Tennis Elbow at any stage in their life depending on the activities they are doing and how they are using their arm. That said, the majority of cases we see can range between the ages of 30 and 50.

Unknown – Tennis Elbow (Lateral epicondylitis) has been known to occur even without any particular reason such as repetitive over use etc. If this happens, it is called “idiopathic” or in layman’s terms, of an unknown cause.

Pain that occurs on the inner side of the elbow is often known as golfer’s elbow

Diagnosis

When discussing this issue with your doctor, they will take into consideration a number if factors before making a diagnosis. These will include how your symptoms developed, your work and your hobbies etc.

The Doctor will discuss how and when the symptoms occur and are more severe and where on the arm the pain / symptoms are materialising. You will need to make sure you inform your doctor of any underlying health issues such as Arthritis (RA or Osteo), you you have injured your elbow in the past or any other medical issues that has a baring on your elbow.

There are a number of tests the doctors can and should perform during your examination such as asking you to try straighten your wrist and fingers with the doctor providing resistance with your arm straight.

Your doctor may recommend additional tests such as X-rays, Magnetic resonance imaging (MRI) scan or an Electromyography (EMG) – this will be to rule out nerve compression.

Treatment

Tennis elbow is a condition that will eventually get better over time, the length of time will be determined by how much you are using the arm in the way in which it was damaged in the first place. This may mean you will need to stay off certain activities indefinitely for a period of around 6-8 weeks. This could be shorter or longer depending on what state the injury is in.

However, there are treatments that can be used to speed up your recovery and ultimately help alleviate symptoms while you recover.

The first stage in any recover is REST. It is important you rest your injured arm and stop doing the activity that’s caused the problem in the first instance.

ICE – Apply a cold compress to the injured arm, such as a bag of frozen peas or a sports ice pack / gel pack for a few minutes several times a day, this will reduce inflammation and ease the pain. Some people have great success with contrast bathing the area so for example, icing the joint itself (the bony / tendinous areas) and using heat on the muscular areas such as Forearm to relax the muscles and speed up recover.

PAINKILLERS – Taking Paracetamol to ease the pain and Non-Steroidal Anti-Inflammatory’s such as Ibuprofen to reduce the inflammation can help greatly whilst in recovery.

MASSAGE – Asking your personal Sports Therapist / Massage Therapist to perform a sports massage on the arm offering STR (Soft Tissue Release) as well as general massage to relax the area and stimulate blood flow can really help to speed up recovery and make you feel better.

PHYSIOTHERAPY – Physiotherapy should be considered with other conservative treatment options especially for more severe and persistent cases.

A good rehabilitation plan with those elements mentioned above has seen great results and improved recovery time as well as reduced inflammation, reduced pain and improvement to the range of movement in your arm.

SURGERY may be an option if the issue persists and you have gone through a considered and tailored physiotherapy and massage program as a last resort to remove the damaged part of the tendon.

Depending on the severity of your Tennis Elbow, recovery can take anything from a couple of months through to 2 years in the most extreme cases. Getting over such an injury should not be considered quick or with a magic treatment, recovery and repair takes time, getting the rehabilitation right is also a very important thing to consider to stop this reoccurring.

Exercises

There are a number of exercises you can perform to help in the recovery of Tennis Elbow but also to help strengthen the area to help in the preventing moving forward. We have put together a video of some of the popular and most effective exercises / rehabilitation programs for this condition. Alternatively you can consult one of our personal trainers or strength & conditioning coaches.

Prevention

It’s not easy to avoid getting tennis elbow as it can be very minor issues that cause it. However a dynamic and considered training program with a qualified strength and conditioning coach can really help. Further to this if your injury was caused through overuse then looking at reducing that particular activity until you have strengthen the area or looking at other ways to do the task in question will help.

Should you need any further information or help, please contact a member of our team. Alternatively you can book one of our Sports Therapists or Physiotherapists through our online booking system.

Tennis Elbow Main Image for article

Shin Splints

Posted on April 5, 2024

Shin splints is a generic term used to describe several conditions of the lower leg such as:
– Medial tibial stress syndrome (MTSS)
– Stress Fractures
– Compartment Syndrome

Throughout this article will we discuss the signs & symptoms for each condition.

Anatomy

The function of the tibialis anterior muscle is to dorsiflex the foot (bringing your toes towards the shin). Not a lot of strength is required to perform this movement and as a result the TA tends to be quite small. As the muscle contracts to perform dorsiflexion, the plantarflexors relax to allow the foot to raise. Plantarflexors are muscles that create the opposing movement of the foot, meaning they bring your toes down towards the ground. If the plantarflexors fail to relax, then the TA needs to overcome both the weight of the foot and the intrinsic resistance of these antagonistic muscles. This extra effort causes overload on the TA, resulting pain and discomfort.

Medial tibial stress syndrome (MTSS)

MTSS is inflammation of the periosteum, usually occurring on the posterior and medial surfaces of the tibia. The inflammation results in scar tissue which can stick or ‘splint’ the affected muscles (gastrocnemius and soleus) to the bone, making it difficult for them to lengthen, which would allow the tibialis anterior (TA) muscle to function.

Symptoms

– Pain and discomfort in the front and medial side of the shin, especially when walking or running uphill since the ROM required increases.
– inflammation along tibia
– persistent discomfort during activity, increases with walking or uphill running
– limited dorsiflexion (tight calf musculature)
– pain on palpation of medial tibial border
– pain on full contraction or stretch
– foot in a pronated position

Causes

– Muscle imbalance
– Impact
– Change of stress (e.g: shoes, surfaces, intensity)
– Over pronation of the foot

Stress Fractures

Continued microtrauma caused by repetitive impact can lead to small cracks developing in the tibia. The fractures often occur on the anterior tibia where the impact force is focussed.

Symptoms

– Pain felt on anterior and posterior tibia
– Increased pain with activity (particularly impact)
– Pain on palpation on anterior tibia
– Nodules along anterior tibia may be felt in more chronic stages

Causes

– Muscle imbalance
– Poor posture
– Over pronation during walking, jogging or running gait
– Overuse and excessive repetition
– Too much too soon

Compartment Syndrome

Compartment syndrome results in an increase in pressure in any of the four compartments of the lower leg

Symptoms

Symptoms are similar to those of deep vein thrombosis (DVT), so the healthcare professional should be confident that DVT is not a possibility before progressing with any treatment.

– Pain and swelling of lower limb
– Pain and discomfort increasing with activity
– Symptoms relieved shortly after activity stops
– Pain on palpation of affected compartment
– Pain on contraction of affected muscles
– Reduced ROM relating to movements of the muscles in the affected compartment
– Neurological symptoms distal to the compartment (numbness, tingling)
– Reduced pulse quality of the affected foot

Causes

– Post-impact bleeding
– Rapid hypertrophy of compartment muscles
– Inflammation of tendons from repetitive movement or impact
– Reduced flexibility in an adjacent compartment

Diagnosis of Shin Splints

Shin splints are usually diagnosed from the patients’ medical history and a physical exam. In some cases, an X-ray or other imaging studies can help identify stress fractures.

Treatment

Rest – Avoid activities that cause pain or discomfort but don’t give up all physical activity. While you’re healing, perform low-impact exercises, such as swimming, bicycling or water running.

Ice – Apply ice packs to the affected shin for 15 to 20 minutes at a time, every 2-3 hours for several days. To protect your skin, wrap the ice packs in a thin towel.

Take an over-the-counter pain reliever. Try ibuprofen to reduce pain.

Resume usual activities gradually after your pain is gone.

Alternative therapies

As soft tissue specialists in some cases Shin Splints can be confused with a tightness in the Tibialis Anterior muscle and as such a sports massage or deep tissue massage can relieve the issue. That said even if you have shine splints, maintaining good blood flow to the area and keeping your muscles relaxed and the lymphatic fluid drained can also be achieved through hands on soft tissue massage and lymphatic drainage techniques. Other therapies like medical acupuncture has also shown to be effective in the management of pain and symptoms.

Exercises

Standing Gastrocnemius Stretch

Primary muscles stretched: Gastrocnemius (calf muscle)

Starting Position: Stand facing a wall or sturdy object, about arm’s length away. Place your hands flat against the wall at shoulder height for support. Keep your feet hip-width apart and both feet flat on the ground.
Step Back: Take a step back with one foot, keeping it flat on the ground and extending it behind you. Your back leg should be straight, with your heel firmly planted on the ground and your toes pointing directly forward.
Bend Front Knee: Bend your front knee, shifting your weight slightly forward while keeping your back leg straight. You should feel a gentle stretch in the calf muscle of your back leg.
Adjust Position: If you don’t feel a stretch, you can adjust your stance by stepping farther back or bending your front knee slightly more. Ensure that your back heel remains in contact with the ground throughout the stretch.
Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your calf muscle to gradually release.
Switch Sides: After holding the stretch on one side, release and switch legs, stepping back with the opposite foot. Repeat the stretch on the other side, following the same steps.
Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Soleus Stretch

Primary muscles stretched: Soleus (calf muscle)

Starting Position: Sit on the floor with your legs extended in front of you. Keep your back straight and your feet flexed, pointing towards the ceiling.
Bend Knee: Bend one knee and cross it over the opposite leg, placing your foot flat on the floor on the outside of your opposite knee. Your bent knee should be pointing towards the ceiling.
Foot Positioning: Keep your foot on the floor relaxed, with your toes pointing slightly outward and the sole of your foot in contact with the ground.
Lean Back: Slowly lean back, using your hands for support behind you. Keep your back straight and your chest lifted as you lower your upper body towards the floor.
Feel the Stretch: You should feel a gentle stretch in the calf muscle of your extended leg. This stretch primarily targets the soleus muscle, located deeper within the calf.
Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your calf muscle to gradually release.
Switch Sides: Release the stretch and switch legs, crossing the opposite knee over the other leg and repeating the stretch on the opposite side.
Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Tibialis Anterior Stretch

Primary muscles stretched: Tibialis anterior (front of shin)

Starting Position: Sit on the floor with your legs extended in front of you. Keep your back straight and your feet flexed, pointing towards the ceiling.
Cross Ankle: Cross one ankle over the opposite knee, placing your foot flat on the floor beside your opposite knee. Your crossed leg should form a figure-four shape.
Lean Back: Slowly lean back, using your hands for support behind you. Keep your back straight and your chest lifted as you lower your upper body towards the floor.
Point Toes: Point your toes of the crossed leg towards the ceiling. This movement will target the tibialis anterior muscle, located on the front of your shin.
Feel the Stretch: You should feel a gentle stretch along the front of your shin and ankle of the crossed leg.
Hold and Breathe: Hold the stretch for 20-30 seconds, focusing on deep, steady breaths. Relax into the stretch, allowing the tension in your tibialis anterior muscle to gradually release.
Switch Sides: Release the stretch and switch legs, crossing the opposite ankle over the other knee and repeating the stretch on the opposite side.
Repeat: Perform the stretch 2-3 times on each leg, aiming to deepen the stretch slightly with each repetition. Listen to your body and avoid pushing into pain or discomfort.

Calf Raises

Muscles targeted: Gastrocnemius (calf muscle), Soleus

Starting Position: Stand tall with your feet hip-width apart, ensuring your weight is evenly distributed between both feet. Keep your shoulders relaxed and your abdominal muscles engaged for stability.
Lift: Slowly rise up onto the balls of your feet by lifting your heels off the ground. Focus on using your calf muscles to initiate the movement. Keep your core tight to maintain balance.
Peak Contraction: Once you’ve reached the highest point of the movement where you feel a strong contraction in your calf muscles, pause briefly. Ensure that you maintain control throughout the exercise to prevent any jerky movements.
Lowering Phase: Slowly lower your heels back down to the starting position, allowing your heels to gently touch the ground. Resist the urge to drop your heels quickly, as this reduces the effectiveness of the exercise.
Repeat: Perform the desired number of repetitions, aiming for 10-15 repetitions to start with. As you become more comfortable with the exercise, you can gradually increase the number of repetitions or add additional resistance by holding onto dumbbells or using a calf raise machine.

Resisted Dorsiflexion

Muscles targeted: Tibialis anterior

Starting Position: Sit on a chair or bench with your feet flat on the floor, hip-width apart. Place a resistance band around the top of your foot, securing the other end to a stable object in front of you, such as a table leg or heavy piece of furniture.
Ankle Positioning: Sit up straight with your shoulders relaxed and your abdominal muscles engaged. Your knees should be bent at a 90-degree angle, with your thighs parallel to the ground. Ensure that the resistance band is positioned securely around the top of your foot, just below your toes.
Dorsiflexion: Keeping your heel planted firmly on the ground, slowly pull your toes towards your shins against the resistance of the band. Focus on contracting the muscles on the front of your shin (tibialis anterior) to lift your foot upwards, bringing your toes closer to your body.
Peak Contraction: Hold the top position for a moment, feeling the muscles on the front of your shin working hard. Maintain control throughout the movement to maximize muscle engagement and prevent any jerky motions.
Lowering Phase: Slowly release the tension on the resistance band as you lower your foot back down to the starting position, allowing your toes to point away from your body. Avoid letting the resistance band snap back quickly, as this can strain your ankle joint.
Repeat: Perform the desired number of repetitions, aiming for 10-15 repetitions to start with. As you become more familiar with the exercise and your strength improves, you can gradually increase the number of repetitions or adjust the resistance level of the band.

If you believe you have shin splints and would like to have an evaluation done and possibly some treatment by some of our physiotherapists or sports therapists, then please contact us or alternatively make a booking online.

General Muscle Strains

Posted on March 5, 2024

Muscle strains, also known as pulled muscle, usually arise from an indirect insult from application of excessive tensile forces. Most muscle strain injuries occur from a powerful eccentric contraction or overstretching of the muscle, while more severe injuries may involve partial or complete tears in tissues. Muscle strains are one of the most common injuries, particularly in sport where 90% of all sports-related skeletal muscle injuries account as muscle strains. For most with grade I muscle strains, healing takes about 2-4 weeks, and typically 2 months for those with a grade II strain. In rare and severe instances, grade III strains could take at least 6 months, or longer, depending on the type of surgery received. Muscle strains are predisposed by older age, previous muscle injury, less flexibility, lack of strength, and fatigue. Minor muscle strains typically heal on their own with rest, however therapeutic massages could speed a strained muscle injury, by helping to loosen the tight muscle and increase blood flow to help heal damaged tissues.

Anatomy

These kind of injuries mostly occurs at the musculotendinous junction (primary site of force transmission between the two tissues), where the tendon emerges from the muscle belly and myo-tendinous junction. During eccentric muscle actions, or when muscle tension increases suddenly, the damage may occur in the area beneath the epimysium and the site of muscle attachment to the periosteum. The region adjacent to the MTJ is more susceptible to injury than any other component of the muscle unit, respectively, from type and direction of applied forces and muscle architecture. Haemorrhage occurs in the affected area, up to 24 hours after injury, with an inflammatory reaction occurring after. Laying down of fibrous tissue and scar tissue starts after 7 days, being visible after 2 weeks.

Symptoms of the pathology

• Pain, tenderness, redness, or bruising
• Limited range of motion
• Muscle spasms
• Swelling
• Localised pain and general muscle weakness
The inflammatory phase- occurs within a few hours however peaks 1 to 3 days after the injury. Redness, swelling, heat, pain, decreased range of motion.
The Proliferation phase- 24 to 48 hours after the injury. If a muscle is partially torn, this phase will repair the tear by laying down new fibres to repair that gap (scar tissue).
The Remodelling Phase- up to 1-2 years. Formation of the muscle where re-injury is more susceptible.

Causes

Muscle strains usually occur from an indirect insult, from application of excessive tensile forces. The most commonly injured muscles are the bicep femoris, rectus femoris, and the medial head of the gastrocnemius, all with a greater percentage of type II fibres, a pennate architecture, cross two joints. Strains typically occur during the eccentric phase of a muscle action or during excessive loading, where the muscle can become overstretched beyond its limit. Laboratory studies show that partial and complete injuries exhibit disruption of muscle fibres near the muscle-tendon junction, where tissues tear when forces across the musculotendinous unit contract too strongly.
Risk factors: Muscle imbalances, poor conditioning (e.g., weaker muscles), fatigue in the muscles.

Diagnosis

Manual Testing – observation, palpation, strength testing, and evaluation of motion.
Most muscle strains can be diagnosed through manual testing, where pain is typically felt by the patient with resisted muscle activation, passive stretching, and direct palpation over the muscle strain. Assessing tenderness, any palpable defect, and strength at the onset of muscle injury will determine grading of the injury and provide direction for further diagnostic testing and treatment.
Often, diagnosis is uncertain and further detail is needed to locate the muscle strain. Radiographs, ultrasound (US), and magnetic resonance imagine (MRI) are common imaging tools. Radiographs would return normal in acute muscle strains, however, may be useful in differentiating between bony and muscular aetiologies of pain.

Clinical grading system

Grade I- localised pain worsening with movement, mild swelling, tenderness, and minimal haemorrhage. (< 10° RoM deficit) Grade II- localised pain worsening with movement, substantial pain to palpation, considerable pain on contraction with greatly disturbed gait. (10-25° RoM deficit) Grade III- (muscle or tendon rupture) severe pain, swelling, and haematoma present. Palpable defect and loss of muscle function. (> 25° RoM deficit).

Treatment

Treatment for muscle strain injuries has remained the same over the years, with little scientific basis for most treatment protocols. Instead, it provides a basis for the currently accepted methods of treatment.
Initial treatment consists of rest, ice, compression, and nonsteroidal anti-inflammatory drug therapy. As pain and swelling subside, physical therapy should be initiated to restore flexibility and strength. Strengthening, range of motion, proprioceptive exercises, and functional training are subsequently followed, that should progress gradually. Stretching exercises should be done carefully without pain, and only to the point of discomfort. Strengthening exercises should progress sequentially through isometric, isotonic, isokinetic, and functional exercises, through a pain free range of motion. Massage therapy may also help to relax injured muscles and improve range of motion, and immobilisation therapy can be used to remain the injured area in a neutral position.

Exercises

The type and intensity of exercises will depend on the injured area and should be performed through a pain-free range of motion and only to a point of discomfort.
For the most common muscle strain injuries, examples include:
Hamstrings (add resistance in absence of pain):
– Hamstring curl– Lie on stomach, lift foot of affected leg by bending the knee
– Hip extension– Face a wall with hands at about chest level. Kick the affected leg behind you, remaining in control
Quadriceps (can add ankle weight to increase difficulty)
– Straight leg raise (laterally rotated)– raise leg parallel to the bent leg without arching the back.
– Wall squat– slowly lower body down and hold, maintaining pelvis, back, and head against the wall.
Gastrocnemius
– Plantar flexion with resistance– point the foot away while sitting down, holding a loop of resistance band to apply resistance
– Calf raises– seated in the early stages or standing in later stages. Raise up onto toes and lower the heels back down.

If you are suffering from any of the things listed above, you can contact us through an email info@livewellhealth.co.uk or give us a call on 0330 043 2501.

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