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Tewkesbury’s local experts in clinical chiropractic & remedial massage.

Call today on 01684 291 261 to arrange a free chat with Aidan (our chiropractor).
We'll let you know if we can help you, and if we can't, who can.

NB: This is a blog of our personal opinions, and is provided as a brief overview of things we think you might find interesting.

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  • Runner's Knee 01 February 2020 | Comments (0)

    Exercises for PFPS / Runner's KneeLet’s take a look at patellofemoral pain syndrome (PFPS).
    AKA runners’ knee.

    PFPS is pain that originates between the kneecap and thighbone. The pain is felt at the front of the knee, either under or around the edges of the kneecap; it is typically more noticeable going up stairs or walking or jogging uphill. The root of patellofemoral pain can vary and may be difficult to identify.

    Potential causes include a sudden increase in training, or simple overuse for a period of time. Forces affecting the patellaMuscle imbalance that can cause the patella to aberrant gliding within its groove (patella tracking); injury elsewhere in the kinematic chain; so a sprained ankle, or a lower back problem, left for too long, may develop into knee problems. Simple body weight, especially if matched with an increase in training load, such as taking up jogging in an attempt to reduce weight. Women are more prone to PFPS than men, especially as related to patella tracking, probably due to wider hips, and consequent knee alignment, especially if coupled with a narrower stride width.Kinesiology taping for PFPS / Runner's Knee

    #PFPS #RunnersKnee #KneePain #Massage #Tewkesbury

    You can find out more here:
    www.physio-pedia.com/Patellofemoral_Pain_Syndrome
    www.webmd.com/pain-management/knee-pain/runners-knee#1

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    SpondylarthritisLet’s take a look at Axial Spondyloarthritis (AxSpAr)

    Axial Spondyloarthritis is a progressive form of inflammatory arthritis, which involves the spine. It affects up to 1 in 200 people in the general population, and may account for as much as 15% of cases of chronic low back pain in younger adults. Classically, it starts for no identifiable reason in the late teens or twenties, and likes affecting the sacroiliac joints at the base of the spine, usually one at a time. It can also affect any other joint in the spine and rib cage; but also the tendon attachments elsewhere in the body, especially at the heel, knee, fingers and toes. There can also be a history of inflammation in parts of the eye (uveitis), bowel (IBD) and/or skin (psoriasis).

    MRI of Axial SpondylarthritisSpinal pain will typically present in a cyclical nature, often with no identifiable reasons for periods of exacerbation; and can be combined with extreme stiffness of the lower back, and with night pain. Pain is often worse with rest, but relieved by activity / exercise, and anti-inflammatory medications such as Ibuprofen or Naproxen.

    To diagnose AxSpAr, your GP will ask you about the above common factors, and take a blood test, for genetic and inflammatory markers and refer you to a rheumatologist; who can arrange a specific type (STIR sequence) of MRI scan to make the actual diagnosis. Further imaging may be necessary to confirm which joints are affected.

    Undiagnosed and untreated, AxSpAr can result in fusion of spinal segments, bone weakening, and even fracture. Consequently, spinal manipulation as often provided by chiropractors, osteopaths and physiotherapists should not be performed, What is axial spondylarthritisthough other forms of physical therapy targeting exercise, mobility and pain relief can be appropriate for symptom relief, but only a rheumatologist can treat the underlying condition.

     

    You can find out more here:
    ww.nass.co.uk
    www.physio-pedia.com/Spondyloarthritis

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Ehlers-Danlos is a chronic pain syndromeLet’s take a look at Ehlers-Danlos Syndrome (EDS).

    Ehlers-Danlos Syndrome is a group of inherited connective tissue disorders, caused by faulty collagen. Connective tissue helps support the skin, muscles, ligaments, and organs of the body. People who have the defect in their connective tissue associated with Ehlers-Danlos Syndrome may have symptoms which include joint hypermobility, skin which is easily stretched and bruised, and fragile tissues. There are 3 common types of EDS; and 3 extremely rare, so we’ll just talk about the first 3 here. As it is genetic, this is not a condition with any cure, but it can be managed, and symptoms can be treated – typically under the management of a rheumatologist. The earlier in life a diagnosis is made, the better it can be managed.

    Hypermobility (about 1 in 10,000 people)Joint Hypermobility in Ehlers-Danlos Syndrome
    The primary symptom is generalized joint hypermobility which affects large and small joints. Joint subluxations and dislocations are a commonly recurring problem. Skin involvement (stretchiness, fragility, and bruising) is present but to varying degrees of severity, according to the Ehlers-Danlos Foundation. Musculoskeletal pain is present and can be debilitating.

    Classical (about 1 in 20,000 people)
    The primary symptom is distinctive hyperextensibility (stretchiness) of the skin along with scars, calcified hematomas, and fat-containing cysts commonly found over pressure points. Joint hypermobility is also a clinical manifestation of the Classical Type.

    Vascular (about 1 in 250,000 people)
    The vascular type is considered the most serious or severe form of Ehlers-Danlos Syndrome. Ehlers-Danlos SyndromesSkin is extremely thin (veins can be seen easily through the skin) and there are distinctive facial characteristics (large eyes, thin nose, lobeless ears, short stature, and thin scalp hair). This form can be lethal, as the artery walls can be severely weakened.

    There are only about 100 cases of the other 3 types of EDS combined - worldwide.

    You can find out more here:
    www.nhs.uk/conditions/ehlers-danlos-syndromes
    www.ehlers-danlos.com/what-is-eds
    www.rcgp.org.uk/clinical-and-research/resources/toolkits/ehlers-danlos-syndromes-toolkit.aspx

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    Frozen ShoulderLet’s take a look at frozen shoulder.
    AKA adhesive capsulitis.

    Frozen shoulder is a chronic shoulder condition typically lasting 1.5 - 2 years; but can be triple that. It is characterised by both pain and restricted movement. The cause is often unknown, though it is related to immobility of the shoulder (eg after keeping your arm in a sling), previous injury to the shoulder, and to diabetes. The process is one of inflammation and contraction of the shoulder capsule, often with some scar formation within the joint itself.

    Classically, frozen shoulder goes through three phases
    Frozen Shoulder ArthroscopyFreezing/painful phase: Gradual onset of shoulder pain at rest with sharp pain at extremes of motion, and pain at night with sleep interruption which may last anywhere from 3-9 months.
    Frozen/stiffening phase: Pain starts to subside, progressive loss of glenohumeral motion in capsular pattern. Pain is apparent only at extremes of movement. This phase may occur at around 4-6 months and can last for about 12 months.
    Thawing/resolving phase: Spontaneous, progressive improvement in functional range of motion which can last anywhere from 1 to 4 years.

    Conservative management of frozen shoulder does not really offer a cure, or reduce the duration; but attempts to reduce the severity of the symptoms – both pain and freezing; and is based around mobilisation, massage, stretching and strengthening. NB: because the goal of conservative management is for symptom reduction, not cure – it is impossible to know for sure if it is working or not.Phases of healing for Frozen Shoulder
    Medical management of frozen shoulder is based around steroid injection to reduce inflammation, or manipulation under anaesthetic to break down scar tissue.

     

    You can find out more here:
    www.physioadvisor.com.au/injuries/shoulder/frozen-shoulder
    www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/chronic-shoulder-injuries/frozen-shoulder

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Lower Core 17 January 2020 | Comments (0)

    Deep Intrinsic lumbar muscle groupLet’s take a look at core strength and stability for the pelvic girdle and low back.

    First of all – what is meant by your Core Musculature? Well, this largely depends on who you ask. As physical therapists, we mean the deep muscles that stabilise your body, and allow other, larger muscles to create movement from a firm base – the foundations if you like. The 2 most important areas for this core stability are for the shoulder girdle and neck; and for the pelvic girdle and lower back (the subject of this post).

    As humans, we stand upright, using our spine as a pillar, which needs to be supported to stay that way; that support largely comes from the deep intrinsic lumbar muscle group (especially multifidus) which tether each vertebra onto the one below, alongside the transverse abdominus muscle which acts more like a weight-lifter’s belt… Core Endurancethat’s active, in the right place, and with you 100% of the time; these are “backed up” by the diaphragm and pelvic floor musculature.

    Unfortunately, the deep intrinsic muscles are directly inhibited by pain in the lumbar or pelvic areas, and waste away quite quickly; it is also a muscle group for which you have limited to no conscious control. Despite lacking control over these muscles, they will contract alongside the transverse abdominus muscle; which is how you can go about strengthening and stabilising your spine. Once you have that stability your lumbopelvis will move more efficiently, with less chance of injury, and if/when injured, may recover more quickly.Core Strength

     

    You can find out more here:

    www.physioadvisor.com.au/exercises/popular-programs/core-exercises

    www.chiro-trust.org/back-pain/tried-back-pain

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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    Ice or Heat 11 January 2020 | Comments (0)

    Apply ice as soon as possible after injuryLet’s take a look at the therapeutic use of ice and heat.

    As a rule of thumb, you should apply an ice pack as soon as possible after an injury; applying it for 10-15 minutes, and repeating after 60-90 minutes. Make sure that the ice pack is dry, and covered in a layer of material. The closer you can stick to this regime the better.

    After the 3rd or 4th day, then it becomes a little less clear as to which you should use. Generally after this time, muscles will respond better to heat, whilst joints will respond better to ice. If you’re unsure, try alternating between the two. Apply ice for 10 minutes, then 45 minutes later, heat for 10 minutes; repeating this cycle.

    Heat: Directly stimulates sensory nerve fibres, altering your perception of pain, by overloading the sensory pathways. Heat also increases the metabolic rate of the tissue, increasing the efficiency of what they’re doing at the time - namely, trying to heal the injury. Heat can also directly increase flexibility of tissue, resulting in relief from muscle spasm, and increased range of motion.

    Ice for pain reliefHeat may exacerbate bleeding &/ oedema locally. Possible side-effects include burning if too hot.

    Cold: Applied for up to 5 minutes, narrows the blood vessels, which will help to reduce bleeding and oedema in the early stages of healing. If applied for more than 5 minutes (but less than 20 minutes), cold has the opposite effect, improving the local blood flow; but then, by removing the ice, the body's own regulation systems will rapidly warm the area, exciting the cells, who can then use the extra blood supply provided.

    Ice can also have an analgaesic effect through stimulation of some of the sensory nerves (similar to heat), combined with reducing the conductivity of the pain sensory fibres allowing some pain relief.

    If overused then the use of cold therapy will slow down the healing process. Possible side-effects include an ice-burn if used inappropriately (ice-pack not wrapped in dry tea-towel).

     

    Heat for pain reliefUltimately, both can have a beneficial effect, and "using the wrong one" won't do any damage. Equally, something hot and something cold work better than chemical mimics (such as deep heat or ice spray) though the chemical mimics can often be more convenient.

     

    You can find out more here:

    www.physioadvisor.com.au/health/injury-rehabilitation/ice-or-heat

    www.sportsinjuryclinic.net/treatments-therapies/cold-therapy-cryotherapy

     

    At Back In Action we also offer free chats. This will take about 10-15 minutes where we can talk in general terms about your condition, and see if we can point you in the right direction for treatment. Whether that is with ourselves, someone else, or on your own at home. Call today to schedule your no obligation free chat.

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