Are you fit to ski?

Ski fitness exercises make a big difference to the way you ski. It is obviously also important about skiing or snow boarding to come back injury free. Yet one in every two hundred skiers returns carrying an injury – some serious. Many skiers do no exercise before the first run on the first day and are much more likely to be injured than a fit skier.

If you are going skiing this season here are some tips from Brighton chiropractor, Matthew Bennett, who was chiropractor to the British Alpine Ski Team. These should keep you skiing at your best and keep you safe.

Top tip: Ski Fitness Exercises

It doesn’t matter how late you have left it to get ski fit – start some exercise. Any exercise, even walking briskly is better than nothing. If you already exercise regularly start doing some specific ski exercises like squats, jumping side to side, trampolining or cycling.

Obviously it is best to start training a couple of months before your trip but even a few days of working out will pay dividends. After all the biggest change in fitness occurs in the first two weeks of starting a new program.

Other sports which can help with skiing fitness are less obvious. Roller-blading is great as it uses the muscles at the side of the hip which are often overlooked in most fitness regimes. Even though it is the wrong time of the year tennis can be good too. It involves agility and lots of side to side movement too which mimics skiing in some respects. It is also anaerobic which is very much like skiing.

The sort of aerobic exercises that will help with skiing are cycling and running obviously but less obviously -swimming. Skiing involves a fair bit of upper body strength too. The upper body must balance over the vigorously moving legs so good core strength and shoulder strength to wave the poles about is crucial. Poling over flat terrain also puts a demand on us. Swimming can help with this very nicely whilst improving heart and lung function at the same time.

Top tip: stop skiing at lunchtime on the third day

Of courses aerobic fitness is very important too. Often we underestimate the effects of altitude on our muscles and lungs. A tired skier is much more likely to be injured. The peak incidence of ski related injuries is the afternoon of the third day. The tiredness is taking hold and skiers are becoming more adventurous and more likely to stay out until the last lift down.

Top tip: build balance into your skiing fitness routine

If you like the idea of cycling consider mountain biking over hilly terrain. The pedaling up hill beefs up the thigh muscles but the down hill sections improve balance and co-ordination.

Another way to improve balance is to stand on one leg with your eyes closed for 1 minute, then do the same on the other side. It is amazing how difficult that is and how well it prepare you for the slopes. If you want to take it a step further then ask to borrow one of our wobble boards but watch out – they are hard core!

An important addition to exercise with an element of balance is working out on a gym ball. The unstable nature of these exercises make the muscles work really hard and improve the speed at which they contract when faced with over balancing. Press-ups, sit-ups, wall squats and back extension exercises are great on the ball.

Top tip: Get a Sundial Skiers MOT

Our chiropractors and physio’s can help if you want to make sure you are in tip top shape before setting foot on the snow. A full biomechanical assessment can pin-point the areas you need to work on and improve the flexibility to help prevent injury. If you want a ski check up then call us for an appointment.

Happy skiing.

Matthew Bennett

Matthew Bennett was chiropractor to British Alpine Ski Team and has worked with top ski shops, boot fitters and ski schools in Europe and the USA.

The hidden dangers of Christmas: Top Tips to avoid back pain

Never mind the feeling of being more stuffed than the Christmas turkey there are other hidden dangers lurking around the Christmas tree. Turkey Lifters Back, Shoppers Shoulder, TV Remote Thumb may not be well known but they stalk the unwary festival reveler just the same.

Ok maybe some of those names are made up but Brighton chiropractor Matthew Bennett says “We do notice a marked increase in patients coming in with aches and pains directly related to the Christmas holidays. Probably the biggest increase is in back pain associated with spending more time doing very little. We sit around watching television, eating and drinking and sometimes even a fair bit of stress.”

Tree Mayhem for Backs

Bending and lifting awkwardly is well known to cause back pain. Lugging the Christmas in and trying to get it straight has its own hazard but also bending, stretching and twisting to put on the fairy lights and baubles start the strain.  Add in traipsing around the shops buying gifts and bending over on the floor wrapping them up pile on the pressure on your back joints and muscles.

Turkey Lifters Back

Who would have thought that a turkey could be so menacing. The benign bird becomes 25lbs of sizzling danger when bending over to get it out of a hot oven. The other option of several manageable pre-sliced fillets somehow doesn’t conjure up the same feelings of festive cheer though.

No-one wants to be a killjoy but alcohol is a factor in many of the injuries we see. There is the obvious “PFO” (Pissed and Fell Over) to the more insidious pro-inflammatory effects of booze over several days. On the plus side there is a muscle relaxation effect of moderate alcohol intake but after 2 or 3 drinks this doesn’t work anymore.

Adrenal Stress and Back Pain

Loads of sugar can affect your back too amazingly. Sugar stimulates your adrenal glands amongst other things and this combined with alcohol, caffeine and stress can over-work your adrenal glands leading to adrenal fatigue. Not only can this leave you feeling very tired but your adrenal glands produce anti-inflammatory corticosteroids. Without this chemical any injury is likely to be more painful.

You made it into the afternoon on Christmas Day uninjured. You may have been working in the kitchen on your feet for hours and your back or shoulders may be tightening up but now it is time to relax. You slump down into the sofa and watch a bit of TV. It seems like you stay there until the end of Boxing Day and by the time it is all over you feel like your back is shouting.

Top Tips to Avoid Back Pain this Christmas

  1. Take regular breaks when doing housework or cooking
  2. Use a table rather than standing up for some food preparation like peeling spuds
  3. Get help lifting awkward items
  4. Bend over by going down on one knee when pick up light stuff
  5. Bend your knees and stick your bottom out when lifting heavy stuff
  6. Use a step ladder rather than stretching when putting up decorations
  7. Get out for a regular walk over the holidays
  8. If you don’t go for a walk, do some squats
  9. If you don’t do squats or go for a walk vary the seat you seat in, possibly putting a cushion in the small of your back
  10. Take it easy on the alcohol and sugar

We hope you don’t have need of us but be assured that if you do, we are here between Christmas and New Year.

Happy Christmas from us all at Sundial.

College of Chiropractors awarded a Royal Charter


Matthew Bennett and the Royal Charter

The College of Chiropractors has been awarded a Royal Charter. We found out last week the fantastic news that the Her Majesty the Queen had granted this prestigious award though the Privy Council. One of our chiropractors, Matthew Bennett, is on the board of the College of Chiropractors. “This is the first time that an emerging profession has been granted a Royal Charter. It recognises the marvellous work the College does in promoting patient safety, research and quality of care. We all very proud” says Matthew.

The College of Chiropractors was formed in 1999 to promote excellence in practice. It has over 1200 members in the UK and links with several other bodies around the world. It has headquarters in Reading but runs post-graduate courses all over the country. Matthew is the Director of Graduate Training responsible for 200 trainers and their trainees. He also teaches on the graduate programme as well as mentoring new graduates locally.

A Royal Charter is rarely granted and signals permanence and stability and, in the College of Chiropractors’ case, recognition of the innovative approach the College brings to the development of the chiropractic profession. The Royal Charter essentially formalises the College’s position as a unique, apolitical, consultative body, recognising its role in promoting high practice standards and certifying quality and thus securing public confidence.

Matthew adds “This new award for the College of Chiropractors puts it on a similar footing to the other Royal Colleges in medicine and dentistry. Our team has worked for a decade to achieve this.” Whilst the new College has a long way to go to match the prestige of its bigger brothers it is a big step towards recognising the value that the chiropractic profession can bring to healthcare in the UK. This can only be a good thing for the millions of people who are still suffering from back pain, neck pain and other spinal health problems. As chiropractic care becomes more widely available in the NHS the College of Chiropractors will play massive role in ensuring quality of care and high standards of practise.

Brighton Chiropractor and physiotherapist working together

Chiropractors and physiotherapists work together surprisingly often. One of the great advantages of having a team of practitioners at Brighton’s Sundial Clinics who can treat back or neck problems and sports injuries is that the best combination of treatments can be given. Sometimes this will mean deciding which type of practitioner is best suited eg Low back problems are typically seen by our chiropractor and calf strains by our physiotherapist. There are times when seeing both a chiropractor and a physiotherapist is the best solution, an approach called “co-management” writes Sundial chiropractor, Richard Hollis.

Here are a couple of case studies of recent clients at Sundial Clinics here in Brighton, who have benefitted from seeing both a chiropractor (in these cases me!) and our physiotherapist, Quentin.

Case 1

Mr A had 3 weeks of right Achilles tendon pain which had begun after overstretching playing football. It was recommended that physiotherapy would be the best option and Quentin diagnosed a right Achilles strain and began treatment with laser, massage, taping and exercises. After 10 days progress was a little slower than anticipated, so after discussion with Mr A, it was agreed that the injury may benefit from some dry needling (also known as Western Medical Acupuncture) to help decrease inflammation, decrease pain and help stimulate healing. This is a treatment that I am qualified in and was able to apply some needles the next time Mr A had an appointment with Quentin by booking a little time out in my diary. We followed up the next week and Mr A reported a 60% improvement and treatment was repeated. Improvement continued and Mr A has now returned to playing football.

Case 2

Mrs B was seeing me for right sided leg pain which after a short course of treatment was 90% improved. She mentioned at an appointment that she had unfortunately slipped on some leaves a few days before, landed on an outstretched right arm and now had right shoulder pain, with limited shoulder movement. I examined her shoulder and concluded she had strained a muscle called supraspinatus, part of the “rotator cuff”. I recommended that she should see Quentin for some physiotherapy advice and that I would see her again as planned in 2 weeks and could discuss the progress physiotherapy had made with her shoulder. At the next appointment her sciatic pain was resolved and her shoulder had improved by 80% with physiotherapy and that Quentin expected it to be completely resolved by the following week.

If you are unsure who you should see first, a chiropractor or physiotherapist, then book in for a free check and we will suggest who would be the ideal practitioner to sort out your problem.

Marathon Training Tips: take the simple, natural approach

Marathon training tips are easy to come by.  There are many many articles written about running and, of all the sports, this is where many so called experts seem to know it all. Especially when it comes to marathon distances. Guest contributor PT Pete shares his experience of natural marathon training.

If you flick through any of the running magazines you will read lots of different articles and written with many differing opinions. Some will suggest you run two long runs a week, others will say one long one and 3 shorter ones while others will suggest something completely different. They will often look very complicated, enough to put you off training in the first place!

Having run the Brighton Marathon and the London Marathon I get asked a lot about my training routines and you know what, I genuinely didn’t have a set routine.

I knew I had to run 26 miles. I hadn’t run more than 12 miles in one go so that was clearly the main goal, to run further that this. I decided I would run ONE long run a week, slowly increasing as felt right, and one or two short runs.

BUT…sometimes I did two long runs and that was it. I went with how I felt and still do. Trust your body to let you know what sort of shape you are in and how hard to train.

Marathon Training Tips

  1. Note some distances in your car, get to know your area in mileage and plan some routes and get out and start running.
  2. Allow enough time to train ( as in months ); know your fitness level and your starting point.
  3. Get some comfortable trainers (not the most expensive).
  4. Get a check up from a good physio. Sundial do a Runner’s MOT with Quentin. He’s great. See my story about how he helped me here.

Running is as natural an exercise as it gets, we’ve done it for thousands of years and it shouldn’t be complicated. There are some great routes around Brighton. Get out there and enjoy running around seeing the world from a different perspective!

PT Pete

Brighton based trainer PT Pete is one of the UK’s top trainers. He has worked all over the world as well as in some of the most exclusive London clubs. He has run marathons both here in Brighton and is now training for the Marathon des Sables – the toughest foot race in the world.

Female Fighters 05 Oct – 18 Nov. A photography exhibition by Amelia Shepherd at Sundial

Come and join us for a private of viewing of the extraordinary images from Brighton photographer Amelia Shepherd.  Amelia will be presenting her portfolio of Female Fighters at Sundial Queens Road.

Here she will be available to talk about her work, her motivation and her sport.

http://www.youtube.com/watch?v=RlKoWXe0K1Q

Amelia has worked as a documentary photographer focused on self-defined projects for the past six years. In 2010 she graduated from London College of Communication with an MA in Documentary Photography and Photojournalism.

Female Fighters is a year-long project combining Amelia’s passion for story telling with her interest in engaging communities.  Amelia has created a citywide exhibition with a street presence where the interface between artist, participant and audience is intermingled. Utilising the streets to present one part of this work offers opportunities to passers-by to connect with the subjects. These unexpected encounters in unusual locations create a poignant layer of audience engagement.

A compelling set of portraits of female kick-boxers is presented along with multimedia installations that challenge common representations of women, offering insights into their multi-layered lives. The concept developed through Shepherd’s own practice in kick boxing – She says “Generally reactions focus on ‘aggression’ or ‘violence’. These ill-placed misconceptions motivated me. I’m interested in how such labels affect us as females.”

Arthritis Pain Compared to Other Joint Pain

Arthritis pain is sometimes confused with other sorts of joint pain. When a joint that is not arthritic is causing discomfort, often it is because the joint is too stiff or is moving too much. This is called mechanical joint pain. “Choosing what sort of pain you have is important so that you can get the right treatment as soon as possible” says Brighton chiropractor, Matthew Bennett.

Mechanical Joint Pain

Mechanical joint problems are caused by the bangs and knocks of everyday life or by an accident leading to injury. If the injured joint is stiff and moving to little then it is called hypomobility. If the joint has become lax and is moving too much it is called hypermobility. In both of these cases the joint can become inflamed and painful. If this goes on long enough the nerve endings in and around the joint can become sensitised to pain leading to yet more agony. If this occurs in the spine it can cause Facet Joint Syndrome.

When the nerve endings get irritated in this way the body’s movement sensors send alter the messages to the brain. The technical name for this body awareness is proprioception.

Mechanical joint ache is often worse with certain positions like standing for long time but it tends to be eased with rest. Although you might be stiff initially after arrest generally mechanical joint problems are better with gentle activity.

Inflammatory Joint Pain

Inflammatory joint pain is due to one of the many sorts of arthritis like rheumatoid arthritis. In this sort of inflammatory arthritis often the joint itself is attacked by the body’s autoimmune response. The joint cartilage is attacked and the joint becomes inflamed and painful. In this sort of arthritis the discomfort is often worse with activity and the more you do the worse it gets.

Diagnosing the difference between mechanical joint pain and inflammatory arthritis can often be quite tricky. Indeed, sometimes you can have both going on at the same time. Inflammatory arthritis often shows up on blood tests, whereas mechanical joint pain does not. X-rays and MRI imaging often don’t help much, especially in the early stages.

People with inflammatory arthritis tend to have other symptoms as well like general muscle aches and pains all over the body and the symptoms tend to affect both arms as well as legs symmetrically. Mechanical joint pain on the other hand, will often only affect one or two joints, often on one limb. You can of course have both types of joint problems.

Treatment of Inflammatory Versus Mechanical Joint Pain

Inflammatory joint problems tends to be treated with strong drugs like steroids or specific anti-arthritis drugs. Mechanical joint pain on the other hand, can be helped with a combination of non-steroidal anti-inflammatory drugs as well as physical treatments like chiropractic, physiotherapy and exercises.

In mechanical joint pain, it is important to get prompt treatment. If the symptoms last longer than a couple of weeks. Most mechanical joint problems will get better within a week or two. So if it isn’t it may be starting to become chronic and long-lasting. Indeed 4/5 people who have an episode of back pain and don’t get proper treatment still have grumbling back ache a year later.

In both inflammatory and mechanical joint problems laser treatment can be helpful. It is painless and completely safe. In fact NICE, the clinical guidelines watchdog, have recommended it for osteoarthritis of, for example, the knee.

In back problems NICErecommend manipulation as done by chiropractors alongside conventional treatment. Similar guidelines exist the neck problems.

If you have a problem and would would like to know exactly what is causing it then call us for a free check with our physio’s or chiropractors. We’ll give you a brief examination and we should be able to tell you what you have and what you can do about it.

Does back pain increase as you get older?

Brighton chiropractor, back painBack pain is one of the areas that we think gets worse as we get older but is this true? We often think that as we get older we will get more aches and pains.  To find out researchers scoured all the research on the topic to see if a trend could be found. Brighton chiropractor, Matthew Bennett, sums up the latest research.

It is reasonable to assume that back pain, or lumbago as it sometimes called, will worse as we get older because of the accumulation of wear and tear, arthritis and general use and abuse. As we get older we tend to exercise less, pick up more injuries in falls and generally recover more slowly from trauma, especially in the back. In spite of this the studies over the last 10 years don’t show an increase in back ache beyond the age of 60. In fact, in some studies, back pain actually seemed to be less frequent over the age of 60 compared to the years leading up to 60.

Why doesn’t back pain get worse as we get older?

There are several theories why back pain does not get worse as we get older. It could be that the people in the research just happened to be born at a time when they were very fit and robust naturally. Computer games, television and dishwashers were not around 60 years ago so people were growing up then were less sedentary. This may be the answer. Only a study that follows a large number of people for the whole of their lives would tell and this has not been done yet.

Another theory is that we get more tolerant to pain as we get older; our pain threshold goes up perhaps. The most likely explanation seems to be, however, that we do less physically demanding activities in old age so we don’t injure our backs so much. There are not many rugby players, mountain bike riders or kick boxers over the age of 60! Also we tend to stop work around this time. So if work posture or activity, or even work stress is the factor that brings the back ache on then stopping work might help prevent future occurrences.

Here at Sundial the average age of our patients is 38. Central Brighton has a younger demographic than other parts of the country where the average age of patients with back pain is around 45. That is not to say we don’t get people in their 60’s and 70’s coming in – we do, but the peak age to get back pain is in the younger, early middle aged groups. We also treat a few teenages with back pain which brings the average down.

If you are getting back pain and want to see if chiropractic or physio treatment can help you then pop in for a free check. We can also advise on a few simple exercises that you can do at home to keep your back healthy and pain free.

Reference

Does back and neck pain become more common as you get older? A systematic literature review. Chiropractic & Manual Therapies 2012, 20:24

Update:

Further research on the prevalence of bone and joint problems in older people show all sorts of aches and pains do continue into old age. Women tend to get more pain than men.

What is the prevalence of musculoskeletal problems in the elderly population in developed countries?A systematic critical literature review Chiropractic & Manual Therapies 2012, 20:31

Achilles tendonitis, Brighton physio explains treatment at home

Achilles tendonitis is a broad term that is used to describe a recurrent pain below the calf muscles of your leg and coming from the tendon. Sometimes more accurately called Achilles tendinopathy it is a very common injury and most sports people are curious about, whether you are an experienced athlete or someone returning to sports.

For the least experienced of us, the Achilles tendon is a band of tissue linking your calf muscles to the base of your heel. It is very strong and thick to allow you to push through your forefoot when walking, jogging, climbing stairs and doing many more activities.

Achilles tendonitis – how does it get injured and can you prevent it?

A question I am often asked is ” How do I know I have this problem and how did it come on in the first place ?” Well, in the case of Achilles tendonitis the pain slowly increases at the back of the leg and it’s often brought on by specific activities such as climbing stairs or running. If you touch the painful area you might feel thicker tissue compared to the other side. It may be warm when painful and slightly “crunchy” when you are resting.

If you have such symptoms then maybe a simple change in your routine can help you. Think about those things. Do you wear appropriate footwear on a daily basis? Did you change your exercise program or take on a new sport? Are you climbing stairs several times a day? Did you change the surface on which you do your jogging? All those can be factors which could bring on an injury.

Achilles tendonitis treatment at home?

To start with, nothing replaces the diagnosis of a healthcare professional. The following is for information only and you should still seek appropriate advice.

The main thing you should remember is that tendons like movement and activity but don’t heal if left inactive. An injury to a tendon, if not dealt with appropriately, can become a long lasting problem.

These exercises, if performed with NO PAIN, are a good start as self treatment for Achilles tendinopathy.

1. Go up on tip toes, slowly lower heels 2. Roll foot arch firmly on tennis ball 3. Back knee locked, heel on ground, lean forward

http://www.youtube.com/watch?v=OUpcFZM-V68

How can we help Achilles tendonitis?

By making sure that Achilles tendonitis is the right diagnosis. The internet does not carry out a physical examination where as musculoskeletal specialist does. Our physio’s will be able to differentiate between several types of potential injuries affecting similar area and carry out the appropriate treatment.

After 2 weeks it is starting to get chronic. If your pain does not subside within 2 weeks then give us a call.  It is often easier to get rid of an ache or pain when it just started!

Further treatments we use for Achilles tendonitis here at Sundial in Brighton may include:-

– Deep tissue friction to the Achilles tendon will activate the renewal of the fibres.
Laser therapy will reduced any inflammation provoked by the deep tissue friction and encourage tissue healing.
Dry needling with acupuncture needles around the site of injury to activate the renewal of fibres. This can be an alternative to deep tissue friction.
– Athletics taping (rigid tape) or kinesio taping (stretchy tape) can help to off-load the Achilles tendon during its repair phase.

Quentin Guichard BSc MCSP

Physiotherapist at Sundial Clinics

Addendum:

Recent research underlines the importance of laser therapy and exercises in Achilles tendonitis

Physical therapies for Achilles tendinopathy: systematic review and meta-analysis.

Sussmilch-Leitch SP, Collins NJ, Bialocerkowski AE, Warden SJ, Crossley KM.

Benefits of Rock Tape kinesiotaping, Brighton physio Quentin Guichard explains

Rock Tape kinesiotaping has become very popular with good reason at the Olympics. If you, like us, watched the Olympics in every spare moment whilst it was on, you will have noticed athletes wearing different coloured tape.  Usain Bolt wore some on his thigh to help him speed to his historic triple gold medals.  Novak Djokavic had some on his elbow and Serena Williams wore some too.  So what’s the difference between the coloured Rock Tape and normal taping?

How does Rock Tape kinesiology taping work?

The tape is called “kinesiotape” and the theory is that this taping raises the layer of skin and attached tissue covering a muscle, so that blood and other fluids can move more freely in and around that muscle, delaying fatigue. This keeps the athlete performing for a longer period of time. The tape is also used to promote proper form; the tape is applied so that when the muscles become fatigued, the tape helps to keep them in proper form, for longer periods.

What does Rock Tape help?

We use it to encourage proper form in running, swimming, cycling, diving in fact, just about any sports that depends on accurate and specific movement.  This also helps prevent overuse and “tracking” injuries when muscles have become imbalanced, such as Runners Knee.  Anything from back pain and posture problems to tennis elbow can also benefit from kinesiotaping.

This shows video shows Rock Tape being applied

Is there any proof that Rock Tape Works?

The research into this type if taping is in its early days, but there are some encouraging early studies showing performance improvement (1). Judging by the Olympics, the medical teams and their athletes certainly seem to think it helps them achieve their goals!  I am seeing some great results using this tape. We use Rock Tape because we find it is better than other sorts of tape. Here is how Rock Tape explain the difference. If you are getting any joint or muscle problems in your sport, then give me call to book an appointment to see if I can help.
Physiotherapist
References