The Psoas: is It Killing Your Back? 

People from all ages, occupations, and sport disciplines complain of low back pain. A tight Psoas often contributes to your back pain. Good News? You can avoid it… you can even fix it.

Where and What is My Psoas?

The Psoas is one of the largest and thickest muscles in the body. It attaches to the vertebrae of your lower back, and the head of your femur (thigh bone). The Psoas is primarily responsible for hip and thigh flexion and has a lot of influence over your lumbar posture and the way your hips are positioned.

When you’re sitting for a prolonged period of time, your Psoas is in a shortened position. Leave it for long enough, and it will start to think this is normal. Your tissues want to move into that resting position. Leaving you tight & contracted.

Incorrect posture during standing and walking (which is often caused by a tight Psoas) will leave it even tighter and harder to loosen.

Why Does It Cause Back Pain?

A tight Psoas is a killer for your back for various reasons.

If it is tight and in a contracted state, your Psoas will want to bring your lower back forward, moving you into an anterior tilt: lordotic posture.

The pressure exerted by the Psoas whilst in a contracted state can compress the joints and discs of the lumbar vertebrae. This pressure causes degeneration and will make them more susceptible to injury.

A shortened Psoas on one side will pull the spine or pelvis to that side, leading to many painful problems, including scoliosis.

A tight Psoas will stop your Glutes firing and activating normally. This is Reciprocal Inhibition: the Psoas and the Glutes are opposing muscles.

Lack of Glute activity plus horrific posture can lead to overcompensation in other muscles of the back, leaving them tight and overworked. Couple this with the referring pain from the trigger points in your Psoas and you will be hurting.

Tips to Avoid A Tight Psoas.

There are several ways to stop your Psoas turning into a hazardous plank of wood. All of which are easy to implement and should be even if you don’t suffer from back pain yet. Here goes…

Postural Corrections. If we stay in a certain position all day, our tissues will want to move into that resting position, in this case, your Psoas. The best sitting posture is one that always changes.

Sit Back in Your Chair. This will stop you leaning forward as much, and thus your Psoas won’t be in as shortened position in comparison to when you sit on the edge of your seat.

Stop Hooking Your Feet under Your Chair. You put yourself in more hip flexion and therefore, more Psoas activation. Set your feet flat on the floor, or a raised platform if you are a shortie.

Stand Up When Performing Exercises. You sit all day at work and keep your Psoas shortened. Do the opposite in the gym. Instead of the bike, get on the treadmill. Sub in Overhead Press instead of Seated Press.

Stop Sleeping on Your Stomach. When you are on your stomach, your back goes into hyperextension. This is exacerbating what a tight Psoas already does to your back (anterior tilt). Change it up.

Move More. Not staying in a seated position all day will go a long way to stopping you developing a tight Psoas. Get up more frequently, stretch more often, change positions… just keep moving!

Tips To Loosen A Tight Psoas.

If you do suffer from low back pain and you suspect a tight Psoas, relax (maybe your Psoas will follow the lead), read the next few tips, and get cracking.Stretch. Add Psoas and Hip Flexor stretches after your workouts. Get out of your chair at work occasionally and do some stretches. Do some at night before you go to bed. You can do this one:

PSOAS STRETCH ATTEMPT

The most effective way to loosen your Psoas is through a therapist.For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

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Empowered You: Why Injury Prevention is Crucial

   New year, empowered YOU!  This year embodies not only getting fit and nourishing our bodies properly, it’s also about preventing injury from occurring so we can continue on our fitness journey!
I like many of you LOVE working out!  It has taken me however many years to workout SMART.  Being a Physiotherapist and avid athlete I learned to combine both loves, stop abusing my body and fighting through “bad” pain.  What’s “bad” pain?  Its not the burning sensation you get in your muscles from pushing through one more rep, its the pain that brings you to a 7-10/10 on a pain scale, the pain that is disabling and lingers forcing you to stop doing what you love doing.

Throughout my athletic career I suffered many season ending injuries, including 3 ACL reconstructions, concussions, and a dislocated shoulder.  I quickly realized that in a matter of seconds injury can occur, even if you believe you are “fit”.  At the time I felt a little defeated, why were all these injuries happening to me.  My belief in the phrase “everything happens for a reason” and passion for living an active life, allowed me to focus on the positives of these injuries, they lead me to my profession and truly understanding the importance of rehabilitation and more importantly preventing injury from occurring.  A key focus in my career and life is sharing my knowledge with active individuals alike and preventing them from going through months of therapy!

My passion and drive to prevent injuries in active individuals, led me to creating an Injury Prevention Program thats main purpose is to prevent injuries, decrease the amount of time spent away from sport/activity, optimize and enhance athletic performance, and target functional imbalances.  The program design is very individualized, as we all have led different lives that have contributed to these imbalances, such as sport, having children, and poor posture to name a few. Imbalances show up in our bodies as tight muscles vs elongated ones, knots or adhesions in our muscles or fascia (band/sheet of connective tissue), postural changes, and/or pain. The active part of the program starts by building foundational strength and balance in our CORE muscles and stabilizers, so we are then able to build and strength train our larger prime mover muscles.

core-muscles-diagram

What are some tips for getting started with an Injury Prevention Program:

  1. Seek out a Physiotherapist who is familiar with Injury Prevention and the activity you do. They will be able to assess your body and give you an individualized program based on their findings. Some may recommend you receive additional manual Physiotherapy sessions to help with alignment and breaking down some of your adhesions.
  2. Get involved with programs that ensure you master the CORE muscles first before starting any other fitness program/plan.  Programs that explain the CORE, its importance and how to properly train it.  Your CORE is the center point of functional movement. When engaged and trained properly it prevents injury to your back and pelvis as well as allowing you use the rest of your body more efficiently.
  3. Lastly, train SMART! Listen to your bodies cues.  Your intuition is always right.  If something feels off, and/or in 7-10/10 pain, stop!

Know how to listen to our bodies signs of pain or imbalances. Lets make 2016 about building the foundations in our bodies to prevent injury from occurring so we can live our most powerful life, without having to live with pain.

 

Christina Drew, MPT, BSc.Kin
Owner of Kinetic Physiotherapy
Registered Physiotherapist, Yoga & Pilates Instructor

PLANTAR FASCIITIS.

Plantar Fascia

The plantar fascia is connective tissue that originates at the heel bone and fans out to attach to the base of each toe. There are many muscles, tendons, nerves and bones that lay beneath the plantar fascia. The plantar fascia also helps support the arch of your foot and act as a shock absorber.

Plantar Fasciitis occurs when there is strain to this connective tissue. Repetitive strain causes micro tearing of the tissue, which then leads to swelling, irritation, pain, and dysfunction.

Common Causes:

  • Excessive pronation (inward rolling of your feet)
  • Very low arch (pes planus) or very high arch (pes cavus)
  • Tight calf muscles or achilles tendon
  • Prolonged standing on hard surfaces
  • Improper shoes or shoes that are worn
  • Obesity

Common Symptoms:

  • Stabbing pain in your heel with your first few steps after you have been sitting for a prolonged period of time or when you get out of bed
  • Pain after prolonged stand, walk, or run
  • Ache on the bottom of your foot at the end of the day

Things That May Help:

  • New, supportive footwear
  • Stretching your calves and hamstrings
  • Rolling a frozen bottle of water or an Acuball under your foot
  • Manual treatment to help decrease adhesions in your plantar fascia, and to help correct mechanical dysfunction in your lower leg.

BACK TO SCHOOL!

It’s that time of year again: the last weekend of summer has come to an end, the kids are going back to school, and the daily routine of the work week has returned.

The return to school is often accompanied by the return of…the heavy backpack. Given this, there are a number of points to consider when filling those backpacks (and purses) to avoid unnecessary stresses and strains placed on your child’s body. This year you can be proactive and prevent potential aches, pains, and injuries due to over weighted and unbalanced backpacks. Read on to find out how!

images

There are a number of items that children bring to school each day that can make the weight of their backpacks really heavy. There are several consequences that an over weighted backpack can have on your child’s body, so it is important to note that a child’s backpack should not weigh more than 10% of their body weight (i.e. a 60lb child should carry no more than a 6lb backpack).

An oversized or over weighted backpack can cause excessive stress and strain on structures in the neck, shoulders, and low back. Strained neck and shoulder muscles can cause pain and headaches that can significantly impact school work, and impact your child’s overall posture and body positioning. Poor posture in turn can further exacerbate neck and shoulder pain creating an ongoing cycle of pain and dysfunction. If not managed properly, activities that recruit neck and shoulder muscles such as computer work, school work, throwing, and/or stick handling can cause extreme neck and shoulder pain.

It is important to look for a backpack with thick padded straps because a complex system of arteries and nerves run down the neck, underneath where the backpack straps run, and into the shoulders and arms. A heavy backpack with thin straps can put extreme pressure on these structures and compromise circulation to the arms and/or cause the nerves to be stretched. This can cause pins and needles in the arms and hands, and lead to feelings of heaviness and pain. Thick padded straps will help distribute the weight of the backpack more easily and reduce the pressure on these structures.

In addition to thick padded straps, ensure that the backpack straps are tightened so that the backpack fits snuggly against the child’s spine above the lower curve of the back and waistline. If the backpack is fitted snuggly against the back, the whole body is able to accommodate the added weight. However if the straps are too loose and the backpack hangs to low, an abnormal amount of strain is placed on the low back. This can lead to complaints of low back pain and/or aching which in turn can impact school activities like sitting at a desk and various activities in gym class. This can also be caused if heavier items are packed further from the child’s back and off center, so try to pack heavier items close to the child’s back and in the center of the backpack.

Lastly, ensure that your child wears their backpack with both straps to help distribute the weight evenly throughout the body. If only one strap is worn, the body will shift in an attempt to compensate for the uneven weight and result in significant muscle imbalances throughout the trunk and spine. These muscle imbalances can cause abnormal curvatures of the spine and disrupt normal spinal alignment, which can lead to other complications further down the road.

Refer to the summary points below to prevent theses and other potential injuries from occurring due to a heavy backpack!

How to wear a backpack properly:

  • ensure the backpack weighs no more than 10% of the child’s body weight
  • wear both straps
  • above the waist line
  • center the weight close to child’s back
  • use another bag to carry items will cause the backpack to be too heavyIt is important to remember that these same points also apply when wearing a heavy purse on one shoulder!

Use these same considerations and look for a purse that has a thicker flatter shoulder strap. If you tend to wear your purse on only one shoulder, be mindful of this and try to switch shoulders every 10 minutes. Alternatively, carry your purse in your hand and use your core muscles to keep your spinal alignment and continue to switch hands every 10 minutes. Lastly, try to limit the amount of weight you are carrying in your purse by only having items that are necessary for the day!

 

References:
Kids Health: Backpack safety http://kidshealth.org/parent/positive/learning/backpack.html#
American Occupational Therapy Association: Backpack strategies for parents and students
American Academy of Pediatrics: Back to school tips. http://www.aap.org/en-us/about-the-aap/aap-press-room/news-features-and-safety-tips/Pages/Back-to-School-Tips.aspx
5 Backpack Safety Tips: http://www.parenting.com/article/backpack-safety-tips

Why You Need to Warm Up

untitledHere at Kinetic Physiotherapy, we are passionate about preventing injuries before they occur. That is why we have spent time over the past 2 weeks at our local soccer club talking to teams and parents about injury prevention and the importance of a proper warm up. Here is a taste of what we talked about.

 

Injury Prevention

Playing soccer is an excellent way to promote an active lifestyle and can have many health benefits. However, soccer is a high-intensity, high-impact sport with frequent changes in speed, movement and direction, which increase risk of injury.  Most injuries (60-90%) occur at the ankle, knee and thigh. Between 60 and 90% of all soccer injuries are classified as traumatic and 10-40% are classified as overuse injuries. These injuries can have long-term health impacts such as increasing the risk of early osteoarthritis. Overall, soccer injury poses potential negative outcomes to the player, impacts the healthcare system and may discourage children from playing. Therefore, it is very important to implement preventative strategies to reduce the risk of injury and support the health benefits associated with playing soccer.

A comprehensive, well-designed warm up is a valuable solution to reduce risk of injury. FIFA 11+ is a complete warm-up program developed to reduce injury among male and female soccer players. This comprehensive warm up program includes exercises that focus on strength, body awareness and neuromuscular control during static and dynamic movement. Several promising studies on this program have been completed. One study found consistent adherence to the FIFA 11+ program reduces risk of injury by 1/3 and reduces the risk of severe injuries by as much as 1/2 in soccer players. Another study found in addition to reduced injury risk, adherence to FIFA 11+ results in significant improvement in functional balance. Yet another study concluded that soccer teams who implemented the warm up had an 11.5% lower incidence of injuries during games and 25.3% lower incidence of injuries during practice compared to teams not performing the warm up.

Given this evidence, implementation of a warm up program such as FIFA 11+ can be an effective way to prevent injury in soccer players.

Common Soccer Injuries:

Sprains are stretched or torn ligaments. Ligaments are tissues that attach one bone to another bone at a joint. Ankle ligament and knee ligament sprains are the most common sprains in soccer. Typically ankle sprains occur when the ankle is rolled under, damaging the ligaments on the outside of the ankle. Knee ligament sprains occur through direct (blow or tackled) or indirect (pivoting or twisting) impact to the knee. Popping or snapping sound may occur at the time of injury. Other symptoms include pain, swelling, inability to weight bear and feeling unstable at the affected joint.

Strains are stretched or torn muscle or tendon. Tendons are tissues that attach muscle to bone. The most common muscle strains in soccer players are hamstring (muscle at the back of the thigh), groin and quadriceps (muscle at the front of the thigh). Symptoms vary depending on the severity of the injury but may include pain, swelling and bruising, difficulty walking and moving the hip and/or knee.

Osgood-Schlatter’s disease is an overuse injury characterized by inflammation of the tendon below the kneecap (patellar tendon). It is caused by constant pulling of the patellar tendon where it attaches to the shin bone. This injury is common in growing children and adolescents who are involved in athletics. Symptoms include pain, warmth and swelling around the knee and tenderness below the kneecap.

Achilles tendonitis is repetitive stress injury causing inflammation of the Achilles tendon which attaches the calf muscle to the heel. This injury can be caused by sudden increase in exercise frequency or intensity, tight calf muscle , growth spurt or bone spur.Common symptoms include pain and stiffness along the Achilles tendon and heel, swelling, pain with exercise, and thickening of the tendon.

Patellofemoral pain syndrome is one of the most common complains of young athletes. The kneecap (patella) is a small bone in the front of your knee. This bone glides up and down a groove at the end of the thighbone when the knee bends. Patellofemoral pain syndrome occurs when the patella is not aligned properly and travels more to one side of the groove making it rub against the thighbone. Common symptoms include a dull ache underneath the kneecap when squatting, getting up after sitting for prolonged period and walking down the stairs. A painful creaking or grating sensation may also be felt when bending.

Importance of a Warm Up

Whether you a play soccer or not, a  warm up is a necessary component before engaging in any physical activity for the following reasons:

Muscles:

  • During exercise, muscles require increased blood flow, which provides energy and oxygen and helps to remove waste products. If an individual goes straight from rest to high intensity exercise, the body has a difficult time coping with the increased blood flow demand. This results in poor oxygen supply and a build up of waste products in the muscles causing them to fatigue faster. A warm up will help to increase muscle temperature so that they can gradually adapt to the demands being placed on the body.

Heart:

  • The heart controls blood flow to the body. During exercise, increased demands are placed on the heart to increase heart rate and blood flow. A warm up helps to gradually increase heart rate so that the heart is not unnecessarily stressed when maximal physical exertion is required.

Flexibility:

  • Warm ups that include stretching help to increase flexibility of the muscles. Think of your muscle like a rubber band. When the rubber band is warm, it stretches easily. If you freeze the rubber band, it becomes harder to stretch and is more likely snap. Similarly, if your muscles go from being cold to fully stretched, tears in the muscle fibers are more likely to occur. Gradually warming up the muscle will reduce the risk of straining or tearing them.

Nerves:

  • The proper warm up can increase the speed at which the brain and nerves communicate. This in turn can improve the your reaction time and speed of movement.

Mental:

  • Warm ups are important for both your physical and mental state. As you warm up, your level of alertness, motivation and concentration increases. This enables you to better focus on the task at hand and to forget about all of the other things that have happened or will happen throughout your day.

For more information please contact us at via e-mail: info@kineticphysiotherapy.ca or call us at 905-637-1414.

 

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a common cause of knee pain in both adolescents and adults.  It is especially prevalent in runners and is sometimes called “Runner’s knee”. PFPS is typically characterized by pain at the front of the knee.

Anatomy:
b.pfsmlThe patellofemoral joint is comprised of the patella (knee cap) and the femur (thigh bone). The patella sits in a groove on the femur. When the knee bends, the patella moves along this groove. This is referred to as “patellar tracking”. A combination of dynamic (quadricep muscles and ITB)  and static (articular capsule, medial and lateral retinacula, bony structure and ligaments) stabilizers control patellar tracking.

 

Symptoms:

  • Pain around or under the patella
  • Aggravated by activities such as squatting, going down stairs, kneeling, lunging, running and prolonged periods of sitting
  • Knee may feel stiff
  • May notice clicking or grinding with knee movement
  • Minimal swelling

Causes:
There are 3 primary contributing factors that increase the risk of PFPS.

1) Muscular imbalance

  • Quadricep muscle weakness can impair patellar tracking. When the inner quadricep muscle is weak and the outer quadricep muscles and ITB are tight, the patella is pulled towards the outside, impairing its tracking. Tight hamstrings and calves can also contribute to PFPS. Furthermore, weak gluteus muscles decreases pelvic stability and increase the force placed on the knee which increases risk of PFPS.

2) Malalignment

  • Large Q-angle (wide hips), knock knees and asymmetrical kneecaps can contribute to PFPS. Additionally, over pronation (excessive rolling-in) of the feet can cause the lower leg to rotate inwards, increasing stress on the knee joint.

3) Overactivity

  • Increasing your running/training mileage, speed, intensity and hill work  too quickly without enough rest are common training errors that can cause PFPS.

Treatment:

Physiotherapy can effectively treat PFPS. The first step of treatment is identifying the cause of the problem. A treatment plan will then be created to deal with the cause and prevent injury recurrence. Initially, resting and icing the knee will be important to decrease pain and inflammation. A variety of soft tissue techniques, andjoint mobilization, as well stretching and strengthening exercises will be used to further rehabilitate the knee and surrounding structures. If necessary taping techniques, knee bracing and foot orthotics may recommended to deal with malalignment issues. It is important to note that addressing this issue early will promote faster recovery.

For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.

Muscle cramps: Why you get them and what you can do

calf-crampMuscle cramps are involuntary muscle contractions of one or more muscles. These spasms can be quite painful lasting a couple seconds to 15 minutes or longer. A muscle cramp can recur several times before it resolves.  Muscles of the feet, calves, thighs, hands, arms and abdomen are  prone to spasm. Whether you are out for a run, in the car or  going to sleep, muscle cramps come without warning.  A common question we get at our clinic is what causes these cramps and how can you relieve them?

Potential Causes of Muscle Cramps
Injury: Following an injury, muscle cramps can occur as a protective mechanism. Muscle spasms help to minimize movement, stabilizing the injured area.

Vigorous activity: Exercise related cramps are likely caused by muscle fatigue. In normal functioning muscles, inhibitory messages are sent to the muscle to prevent it from contracting too strongly. When the muscle fatigue, this inhibitory message is decreased causing overstimulation to the muscle. This results in a muscle cramp.

Dehydration: Dehydration can occur through excessive fluid loss when sweating and/or inadequate fluid intake. Dehydration increases the likelihood of muscle cramps.

Muscle cramps can also be caused by an underlying factor:
Mineral deficiency: Low levels of calcium or magnesium in the blood causes increased excitability of the nerves and the muscles that they stimulate. Increased muscle stimulation can result in muscle cramping.

Nerve compression: Spinal nerve irritation or compression can cause cramp-like pain.
This may be accompanied by weakness or sensory changes.

Poor circulation: If blood vessels become narrow due to arteriosclerosis, blood supply to the extremities become decreased. This can result in muscle cramps that are more likely to occur when you are walking or exercising but stops with rest.

Kidney, thyroid, hormone and liver disorders: Muscle cramps can be complications of an organ disorder. For example, hypoglycemia and anemia can cause muscle cramps.

Drug side effect: Various drugs such as those used for blood pressure, Alzheimer’s disease, high cholesterol and others can cause muscle cramps.

What can you do?

Stretch: Most muscle cramps will relax if the muscle is stretched. This can sometimes be accomplished by standing up and walking around or changing positions. Stretching the specific muscle group in spasm may also be required. For instance, if your calf is in spasm, stretch is by performing these 2 stretches. CalfStretches

Massage: Gently massaging the muscle in spasm may help to relax the muscle.

Heat: Applying a heat pack to the muscle cramp or having a warm bath may also help to get the muscle to relax.

Prevent the cramp: There are a number of things you can do to prevent muscle cramps from happening in the first place:
a) Stay well hydrated
b) Ensure adequate dietary intake of nutrients and minerals
c) Stretch before and after physical activity
d) Rest: get enough sleep and allow sufficient time for muscles to rest and recover after exercise

Physical therapy: If your muscle cramp is the result of an injury, physical therapy can help to decrease muscle tone and spasm and rehabilitate underlying injuries.

Note: Cramps that are a result of organ disorders, nerve compression, poor circulation or drug complications may need further medical investigation for appropriate treatment.

For more information about Kinetic Physiotherapy, visit our website:http://www.kineticphysiotherapy.ca  Contact Kinetic Physiotherapy via e-mail:info@kineticphysiotherapy.ca or phone: 905-637-1414 to set up an appointment.