Olympians and Disc Herniations

Evgeni-Plushenko-back-injury-russia-withdraw-02132014The 2014 Winter Olympics have been a wonderful display of determination, speed, strength, agility and athletic performance. As the athletes pushed their bodies to the limits, injuries inevitably occurred. Disc herniations were one common injury that plagued athletes. Craig Pickering (Great Britain, bobsled), Evgeni Plushenko (Russia, figure skating), Henrik Zetterberg ( Sweden, ice hockey), and Brendan Green (Canada, biathlon) all experienced disc herniations, which in most cases prevented them from competing in the games.

Back pain PID 1The spine is composed of 24 bones (vertebrae) that are stacked on top of one another. A small disc is located between each vertebra and acts as a cushion and shock absorber.  These discs have a tough outer layer called the annulus that surrounds a jelly-like substance called the nucleus.

A disc herniation begins when wear and tear or a sudden injury causes the jelly substance to push against the tough outer layer. If severely injured, the nucleus can break or herniate through the outer layer. Since there is limited space in the spinal column, the herniated disc can press on the spinal nerve causing pain.Bulging-Disc

Causes
1) Sudden unexpected load: traumatic situations such as a motor vehicle accident, lifting and twisting, or a fall. Any sudden event that cause an unexpected load to the disc may result in disc herniation.

2) Accumulated micro trauma: repeated micro injury to the disc over a period of time can result in disc herniation. For example, poor posture when sitting, standing and working can cause over stretching and weakness of the outer layer of the disc. Over time this weakens the disc and increases the risk of the nucleus herniating. 

Symptoms
Symptoms of disc herniation can include one or all of the following:
-back pain
-leg and/or foot pain
-weakness in leg or foot
-numbness or tingling sensation in leg or foot
-loss of bowl or bladder control: this is very rare but may indicate a more serious condition called caudal equine syndrome. Immediate medical attention is required.

Diagnosis
Your doctor or physiotherapist will suspect a disc herniation based on your symptoms and the history of your injury. A physiotherapist can perform clinical tests to determine if there is disc injury and nerve compression. MRI and CT scans are the most accurate diagnostic tests to confirm disc herniation.

Treatment
Conservative treatment is appropriate for minor and moderate disc herniations. Physiotherapy treatment can include a variety of methods such as ice therapy, traction, electrotherapy, taping techniques, soft tissue massage, acupuncture, joint mobilization, postural advice and home exercise program. More serious cases may require surgical intervention.

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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Bronze with a Broken Rib

1297523994615_ORIGINALThe Sochi 2014 Olympics are now underway and it has been a great day for team Canada. The day started with a bronze medal finish by our very own, Mark McMorris, in Men’s Slopestyle Snowboard. Winning Canada’s first medal is quite an accomplishment, especially given the athlete’s injury.  McMorris fractured one of his ribs 2 weeks before the Olympics, which posed a big concern for the medal hopeful. However, with determination and intensive therapy, McMorris persevered  in order to fulfil his Olympic dream.  This is an incredible feat as most would be unable to compete with such an injury.

What is a rib fracture?
A rib fracture is a break of any of the 12 rib bones. The ribs form a cage around the torso, attaching to the spine at the back and traveling around to the front of the chest. Ribs 1-7 attach to the sternum, ribs 8-10 attach to the rib above via cartilage, and ribs 11-12 are considered ‘floating ribs’ because they do not attach to the chest.

Fractures are typically the result of trauma to the chest caused by a fall, direct impact to the chest, or motor vehicle accident. In serious cases, the rib can be become displaced, which may result in organ damage to the lungs, liver, kidney, spleen or blood vessels.

nucleus-medical-art-illustration-of-the-thoracic-chest-and-back-skeletal-anatomy-featuring-the-ribs-sternum

Signs and symptoms of a rib fracture can include:
-chest, midback, side pain that may radiate into the shoulder, neck or back
-pain with breathing
-pain in the chest with coughing and sneezing
-pain with movement, especially bending and twisting (McMorris was doing a lot of this)
-visible bruising on the chest
-tender to touch the area of the fracture

Rib fracture treatment:
Depending on the severity and presentation of symptoms, physiotherapists utilize a number of techniques to treat rib fractures. These include: advice on activity limitations/restriction, taping, postural correction, protective padding, soft tissue work, joint mobilization (post fracture healing), graduated return to sport/activity plan, electrotherapy, fall prevention programs and exercises to improve range of motion, strength and flexibility.

It is amazing the Mark McMorris fought through this injury today to bring home the bronze. We are so proud of all of our Canadian athletes and look forward to more inspiring stories to come. GO CANADA GO!

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.

Connect With Your Core

What is my core?

core-muscles-diagramThe core can be divided in to two groups of muscles, the “inner core” and the “outer core”.

The “inner core” is composed of 4 deep stabilizing muscles: the transversus abdominus, multifidus, diaphragm and pelvic floor muscles.  These muscles do not create any specific movement. Instead, when correctly working together, these muscles turn on before you move your body to provide stability to the spine and pelvis. Therefore, having a strong inner core helps to prevent back injury. It also provides a strong base of support for leg and arm movement which can help to prevent and rehabilitate neck, shoulder, elbow, hip, knee and ankle injuries.

Conversely, when these muscles don’t work correctly, the body must resort to less efficient movement strategies to perform various tasks. This increases your risk for injury, dysfunction and recurrent pain. Research shows that following a back injury, the anticipatory co-contraction of the inner core muscles is impaired. This can create a cycle of: injury, pain, impaired “inner core” muscles and increased risk of injury. This cycle can be broken through targeted “inner core” strengthening.

manage_abs5The “outer core” is composed of the rectus abdominis (“six-pack” muscle), inner and outer obliques and the back extensor muscles known as the erector spinae. These are the muscles that are normally targeted during abdominal exercise programs and “core” exercise classes. The problem with this is that the “inner core” muscles remain untrained and weak while the “outer core” muscles get stronger. During injury, the outer core muscles can tighten up in an attempt to compensate for “inner core” muscle weakness. This can actually contribute to and exacerbate back pain.

Strengthening Your Core
It is very important to add inner core strengthening to your daily routine. We normally do not think consciously about engaging these muscles and you may not even know how to isolate them. A physiotherapist can assess your current inner core strength and co-contraction, teach you how to contract these muscles and provide progressive exercises to strengthen these deep stabilizing muscles. You can also check out this video by Shawna, who takes your through an inner core workout.