When asked recently to write an article on knee pain and injury prevention and give my top three tips or exercises to treat or prevent knee pain - my response was typical as an expert in any field - how can I distill down a massive topic to three exercises? The truth is you cannot. So I came up with six of the best.
I frequently call the knee - the naughty middle child! Why?
The knee is a modified hinge! The knee is capable of flexion and extension and some small amounts of internal and external rotation only. However - the joint above (the hip) and the joint below (the ankle) have many directions of movement available - especially the hip - and therefore require lots of stabilisation. Indeed one could almost solely focus on the hip to treat the knee.
Top Six Exercises for Knee Injury Prevention
Here is my pick for strengthening exercises to prevent knee injury: Exercises shown here should always be demonstrated and supervised before they are performed to ensure correct technique and therefore optimal outcomes. Consult your local strength and conditioning expert, chiropractor or physical therapist for further instruction.
Always remember - every exercise has a regression to something easier, and a progression to something more difficult. If you need further help here please feel free to leave us a message and we can post an option to demonstrate. And again I can't reiterate enough - seek professional guidance before beginning any exercise program.
Chair Squat / Single leg sit to stand
A superb exercise almost every body can do to improve leg and hip strength. Place feet in a wide comfortable position hands in front of you like a genie, spine neutral position and sit back to touch your buttock on the chair. Stay leaning forward and rise from the chair (nose over toes) to stand up tall.
If this movement is to easy - it can be performed with a weight - or changed to a single leg option as demonstrated
A simple exercise to build strength below the knee. Start with two legs and simply raise up and down avoiding rolling ankles - keeping the knee slightly bent and the feet nice and straight. Once you are able to perform 30 easily - progress to single leg calf raises - supported - and then progress to single leg unsupported. Once you can perform 30 single leg calf raises unsupported you get a high five from me - but then you can add weight with a dumbell or kettlebell etc.
Bridge - Hamstring Bias
Performed laying on your back like a normal bridge - but with your feet further away from your buttock than normal. Work up to 30 second holds. Once this becomes too easy progress to single leg lifts alternating sides. Progressions can be achieved by moving the feet further away from the buttock or lifting up and down from the ground repeatedly.
A brilliant exercise for targeting the gluteals and the buttocks. Place the rear foot on a chair and lower down within your limits towards the ground over three seconds. Drive back up to the start keeping the knee in alignment with the foot minimising any deviation or twisting. Work up to 20 each side. Progressions.
Aimed at the muscles in the lower back and the lateral hip. Perform with the bottom knee bent at first and then progress to feet stacked, legs straight, knees in alignment, hips stacked, shoulders stacked all directly above each other. Please be careful if you have a history of shoulder problems and seek supervision first.
A tough exercise and should be progressed from the easiest version first. Provides strength for hip and knee stability in your adductor and groin muscles.
Progression (a) knee on chair with knee bent, bottom leg straight, lift and hold.
Progression (b) both legs straight thigh on chair
Progression (c) foot on chair bottom foot on floor
Progression (d) foot on chair with lower leg raised to chair
Perform 30 second holds before progressing to the next option
Chiropractic is a practice that treats problems with the musculoskeletal system with specialised focus on spinal care.
The musculoskeletal system is made up of a person's muscles, bones, joints, cartilage, and tendons. It supports a person's body, allows them to move, and protects their organs.
Traditionally, chiropractic was based on the belief that problems with the musculoskeletal system caused disease through the central nervous system. This belief is no longer officially part of the practice.
Chiropractors apply hands-on therapy for musculoskeletal conditions.
The word chiropractic comes from the Greek words cheir (hands) and praxis (practice). As the name suggests, it is a hands-on therapy.
Chiropractic manipulation is the application of pressure to a person's spine or other parts of their body by a qualified chiropractic doctor, or chiropractor. This pressure allows a chiropractor to adjust and correct alignment.
Chiropractic manipulation aims to reduce pain and improve mechanical function, or the way a person moves.
Modern chiropractic is based on a spinal care model. But chiropractic manipulation has its roots in less scientific theories.
Historically, chiropractors believed that a misaligned spinal column could cause disease. This was thought to happen via the central nervous system and something called "innate knowledge".
The theory was called "vertebral subluxation complex". Early practitioners believed 95 percent of diseases were caused this way. They believed that chiropractic manipulation would correct problems in the musculoskeletal system and, in turn, cure disease.
Skeptics and scientists found this belief to be lacking in scientific basis. Early chiropractors also rejected the germ theory of disease and immunization. As a result, chiropractic lacked legitimacy in the eyes of the scientific community.
Chiropractic theory has since evolved. It is becoming more accepted as a treatment for musculoskeletal pain.
In 2009, a study published in the journal Chiropractic & Osteopathy explored the theory behind vertebral subluxation complex. It concluded that there was a lack of evidence to fulfil the basic criteria of causation. This meant it was unscientific for chiropractors to claim disease was caused this way.
In 2014, The International Chiropractic Education Collaboration put out a position statement making it clear that the profession no longer supported the vertebral subluxation complex theory:
"The teaching of vertebral subluxation complex as a vitalistic construct that claims that it is the cause of disease is unsupported by evidence. Its inclusion in a modern chiropractic curriculum in anything other than an historical context is therefore inappropriate and unnecessary."
The statement also clarified that a number of chiropractic education institutions do now support the World Health Organization's (WHO) immunization mission.
In 2016, an article in Chiropractic & Manual Therapies advocated for a new approach to chiropractic that would leave behind its "bad" unscientific elements. Aspects of the profession to be left behind included:
· adherence to a flawed chiropractic ideology focusing on innate intelligence and vitalism
· claims of cures for visceral and other non-musculoskeletal conditions
· anti-vaccination propaganda
· anti-drug and anti-medicine propaganda
· an unhealthy disregard of clinical research, evidence-based practice, and non-specific treatment effects including natural history and the placebo effect
The article went on to lay out a ten-point plan for modernizing the profession. This notably included the need for chiropractors to become "solely musculoskeletal practitioners with a special emphasis on spinal pain".
Modern chiropractors have, for the most part, left behind the belief systems that claimed spinal therapy could cure unrelated illnesses.
Although the chiropractic profession has evolved, there are still some chiropractors that believe in unscientific theories.
Chiropractors who hold on to beliefs that the rest of the profession has left behind are referred to as "straights".
Before making an appointment with them, it is a good idea to find out whether a chiropractor takes a modern or straight approach. This way, a person can make an informed decision about the sort of treatment they are due to receive.
Treatment from a chiropractor will often focus on the spine and use massage, heat/cold, and relaxation techniques.
When a person first visits a chiropractor, they may ask questions about musculoskeletal pain. The chiropractor will then examine the person physically, focusing on their spine. The chiropractor may also perform other tests, such as X-rays, to determine the necessary treatment.
If treatment is needed, the chiropractor will develop a treatment plan. Treatment normally involves using the hands or a device to quickly apply controlled force to a joint. The aim of this is to improve the quality and range of physical movement.
Other treatments the chiropractor may offer include:
· heat and ice
· electrical stimulation
· relaxation techniques
· counselling around lifestyle factors that affect musculoskeletal health
· dietary supplements
There is growing evidence to suggest that chiropractic manipulation may be an effective treatment for:
Neck pain: According to a 2017 literature review, chiropractic workplace interventions may reduce self-reported mechanical neck pain among office workers.
Lower-back pain: A 2016 study found moderate evidence that chiropractic care may be as effective for lower-back pain as physical therapy. A 2017 systematic review found that spinal manipulative therapy was associated with modest improvements in pain and function for those with lower-back pain.
Chest pain: A 2016 study found chiropractic care to be more cost-effective than self-management for chest pain. It can be seen as a good primary care approach for those with non-specific chest pain.
As the profession has evolved, chiropractic has gained legitimacy as a complementary medical practice. In some countries, it is now considered to be part of mainstream medicine.
In Switzerland, chiropractic is now considered a primary medical profession. According to a 2016 article, the training programme chiropractors go through in Switzerland sets them up to become experts in primary spine care.
There is no evidence that chiropractic works as a treatment for health conditions that do not relate to the musculoskeletal system.
Chiropractic adjustment involves manipulating the spine. This may cause mild side effects such as:
· increased pain
· muscle stiffness
A 2007 study looked at the safety of chiropractic care for neck pain. It found that although side effects were common, they were rarely severe or long-lasting.
The study concluded that the benefits of chiropractic care for neck pain outweigh the potential risks.
Research also suggests chiropractic manipulation is safe for those with lower back pain. A 2016 study found no serious side effects of chiropractic care for lower back pain.
Name: Hayden Smith
Goals & aspirations: Compete in the 2018 Winter Olympics in Pyeongchang, South Korea
Training requirements: Training consists of 8 training sessions (2 x pushing, 2 x sprints and 4 x weight lifting) and 2 recovery sessions per week. Generally a total of 15-16 hours/week.
Biggest challenges: Unfortunately I had a training injury in September 2015 where I broke my fibula and tore all of the ligaments in my ankle. The injury has been a big challenge with consistent treatment and follow up surgeries. I'm confident I am now back close to 100% with the help of a great team of health professionals and still consider myself somewhat lucky to still be competing.
How do you stay focused? I stay focused by keeping my eyes on the end goal of the games next year. I cascade overall goals down to daily training goals each day which allow me to focus on doing the right things now.
What do you love most about your sport? I love the speed and the adrenaline but also the camaraderie that you get from a close knit team that lives and trains together all season.
Personal highlights? A couple of podium finishes (top 6 for bobsleigh) in Park City on the North American Cup Circuit last season would have to be my highlight so far. We had a great crew down there that worked together really well and that showed in our results. Hopefully this is a sign of good things to come next season!
Advice for young athletes? Definitely to stick with it and keep working hard, with the right attitude and commitment to training you can reach your goals. Too often athletes with buckets of talent throw it all away with the wrong attitude.
How did you get into Bobsleigh?
I come from a rugby and sprinting background. After competing in a 100m race back in 2014 another coach told me that I was probably on the "too heavy" side of being a successful sprinter and recommended that I give bobsleigh a try.
What were your first thoughts about the sport?
I just remember getting to the bottom of the track after my first run and thinking "oh no, I just quit my job to do this". The only way I can describe that first run would be like being in a frozen washing machine on spin cycle going >100kph. I ended up going back to the top of the track for another run and liked it a whole lot more the second time round. It isn't a comfortable ride in the back, there are a lot of bumps and unfamiliar pressures; nothing can really prepare you for your first run.
Who do you compete with?
I first started the sport pushing Heath Spence but moved over to push Lucas Mata last season as Heath took on a coaching position with the Chinese team. We currently have 3 other brakemen in the team; David Mari, Lachlan Reidy and Gareth Nichols.
What does the road to the Winter Olympics look like for you?
We leave for Calgary in August and complete a training block using the Ice House. We will start sliding on the tracks once there is ice in October and will have races from November to January.
How do you qualify etc.?
To qualify as a team we will have 8 races from November to January where we accumulate points which add to our IBSF ranking. If our ranking is high enough we will be given the quota to nominate a sled (hopefully in both the 2-man and 4-man formats). Once we have the quota spot it's a matter of selecting the best team of 4 to go and compete.
Have you been to Korea? Seen the track?
I didn't get to travel to Korea last season for the test event. Unfortunately I had to have surgery on my ankle In February so I was still recovering from that. I watched the team race from back home and it looks to be a great facility with a pretty challenging track.
What's your goal for the Olympics?
Our goal is to start times that are in the top half of the field. Obviously we are challenged with the equipment we use compared to other well-funded nations but it's not really an excuse. Hopefully we can get a good start then have our pilot weave some magic.
What do you do off the ice?
Off the ice I work as a Risk Assurance Analyst for Lion (a dairy and drinks company) here in Sydney. They are extremely accommodating to my schedule and always flexible with my training requirements. It's a rarity to be able to compete overseas for a few months each year and keep a job that continues my career development, so I can't thank them enough for that!
Can you tell me a little bit about your swimwear company?
The swimwear company is a bit of a side project. I really don't believe in asking for handouts from people without giving anything in return so it's a good way to help me fund my sporting endeavours.
Favourite Quote? No quit, all hustle!
Barbs experience is nothing less than inspiring. Not only did she complete the C25K successfully, she went on to finish a life long goal of hers to run the Sutherland to Surf!
Take the next step and sign up for the Health Associates Couch 2 5km! What are you waiting for!
Often the simple things are overlooked. Health is advertised and marketed as products or services that are outside of our control. Pills, potions, lotions and programs all created to improve your quality of life. There are places for these in ones overall health, but often coming back ourselves, looking at our lifestyle, habits and behaviour is where we will experience the greatest benefits.
According to the Sleep Health Foundation Australia is on the grip of a sleep deprivation epidemic which has a staggering impact on our nations productivity, risk safety and mental health. Research conducted by the Sleep Health Foundation revealed that 33 to 45 percent of adults sleep either poorly or not long enough most nights, facing each day with fatigue, irritability and other negative side effects of sleep deprivation.
If you are suffering side effects from poor sleep, the Sleep Health Foundation recommend these tips:
Stick to a routine
Try to go to bed at the same time every evening and get up at the same time every morning.
Take care with food and drinks
Avoid all stimulants like caffeine and alcohol for at least an hour before bed and finish eating at least two hours before bed.
Wind down and relax before bedtime
Have a buffer zone before bedtime to, review the day's activities and work out a plan of action for the next day.
Lower the lights
Your body clock is affected by light, so turn off bright overhead lights and lamps and put aside your smart phone, computer or iPad at least an hour before bed.
Make sure your bedroom is comfortable
Keep your bedroom quiet and dark with comfortable bedding suitable for the season. No TV in the bedroom!
Don't lie awake watching the clock
Staring at the clock when you can't sleep actually increases the stress hormone known as cortisol in your body, making it more difficult to fall asleep. Try turning your clock away from you.
Of course, there can be many reasons why you may be having poor sleep and seeking help from a professional is always recommended.
Start with the simple things and get back to basics. Eat well, sleep well and live well.
Congratulations to our Couch 2 5km runners!
You did it!
Twice a year Health Associates organises a Couch to 5km program. A low cost, high quality learn to run program to encourage our community to not only move more, but to move well. As experienced runners and running coaches, Chris and Alana have built a strong program and strong team to deliver what we believe to be one of the most comprehensive running programs for beginners in the shire at affordable prices.
This month we had over 20 runners complete the Menai Park Run, completely redefining what they thought they we capable of. Some have never run, some never visioned themselves as endurance runners and most are juggling the millions of commitments that comes with working age and parenthood.
We are so proud of all our runners and the effort you put into the program. It has been a hard season with so much illness that set many of our runners back. But they persevered and have achieved outstanding results.
Thank you to all our participants for taking part in the program and allowing us to support and guide you. We really love to be able to encourage an active and healthy community and we are really grateful for your belief in us.
See you at the next C25K in 2018
Chris and Alana
Lower back pain can originate from many causes. It is very common in people of all ages and can feel like an ache, tension or stiffness. Common causes of back pain are sudden movements and falls, injury, or a medical condition. Many things are considered when determining how and why you are experiencing pain and as a physician I would examine what is happening with your bones, tendons, ligaments and muscles among many other things.
Considering that 1 in 6 Australians experience lower back pain each year, most Australians experience lower back pain in their life time. Most sufferers are of working age, equally among men and women. But back pain can start in youth as young as 8 years of age.
As an experienced practitioner in the diagnosis and treatment of back pain I would like to share with you my most helpful tips that can help ease your recovery or fast track you to the most appropriate care in a timely manner.
As a general statement - lower back pain can be categorised in three ways;
If you just have simple lower back pain here are some basic things to do...
If bending forward aggravates your lower back then try stretching in the opposite direction. Lying flat on your tummy, propping yourself up on your elbows and letting your lower back arch and sink down on the ground. Aim to be completely relaxed and try not to contract any muscles. It should be just a very gentle stretch into extension.
If your lower back is aggravated by extending and going backwards we would be thinking it may be a sacroiliac joint problem or a facet joint problem. Indeed you would stretch in the exact opposite direction. The easiest and safest way to do this is to lie flat on your back and bring both your knees up to your chest. Gently bringing your knees to your chest you should feel a little bit of a stretch through your lower back.
In most cases please avoid the following movements if you are experiencing lower back pain:
Please consider this advice as general in nature. You should always consult with a professional in order to achieve a diagnosis. If your symptoms worsen you are advised to see a physician.
Chris Bowles is an experienced chiropractor with one mission; to help you be 'Free to Move.'
If you are experiencing aches, pains, headaches, migraines or sports injuries then he can help you.
Chris is available Monday - Saturday from 8am - 7pm ( 8am - 12pm on Saturday)
Call 9542 3330 or book online today.
Foam rolling has been around for a long time. It seems to be a household item. Great for the kids to play on, ornamental in the living room and often collecting dust. You see them in gyms, they are used for warms ups and cool downs and often recommended by health care professionals. I want to help you claim back your foam roller and give you 3 simple tips to get rolling again and help you feel great.
1) Thoracic Spine Extension
The thoracic spine is one of the five segments of the spinal column, encompassing the shoulder and chest area.
It's essential that you maintain thoracic mobility to avoid poor posture, and unsightly rounded shoulders which can eventually lead to back pain or acute injury.
Thankfully, thoracic mobility can be easily maintained and improved using a foam roller and the thoracic spine extension exercise, as described below.
This exercise will help stretch out the chest and back muscles, relieve muscular tension and maintain thoracic mobility.
The quadriceps are responsible for leg and hip extension and are an easy muscle group to keep in good shape using a foam roller.
Foam roller exercises for the quads will alleviate muscular tension, limber the muscle, and work out any knots or trigger points for improved soft-tissue quality.
Tight calves can be the result of many things, not the least of which is a lack of flexibility training. Foam rolling can help break up tight fascia — the connective tissue surrounding your calf muscles — and work out the kinks and knots.
1. Place the foam roller underneath your calf muscles.
2. Place your hands on either side of your hips and if you can lift your bodyweight up off the floor.
3. Using your arms as a fulcrum, roll your calf slowly from top to bottom and back again, turning you leg inward and outward to hit all areas of the muscle.
So you have an MRI. Now we have THE answer!
If you have ever visited me or heard me speak on imaging - then you will have heard my rants on the use and abuse of imaging in medical diagnosis. There is even a term for it. VOMIT - victims of medical imaging technology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126156/
The allure is powerful - "a picture tells a thousand words" we are told. Well sometimes a thousand words is too much!
Here we have a small but informative study which demonstrates the subjectivity of image interpretation. All clinical investigations have elements of subjectivity in their interpretation.
An area of practice that I am particularly passionate about is communication of imaging results. Its absolutely amazing how powerful what is communicated to a patient (and how) - especially in regards to diagnostic imaging results. The patient that walks in armed with scans or xrays from 10 years ago exclaiming "I HAVE A DISC BULGE!" In my head I think how can I possibly undo this belief system...? People literally carry these pathology labels around with them for life. So strong is our desire to know, see and label pain in our body.
Other studies have demonstrated the very high degree of false positives. https://www.ncbi.nlm.nih.gov/pubmed/25584950 - Nakashima et al. demonstrated this in their cervical spine study
"Most subjects presented with disc bulging (87.6%), which significantly increased with age in terms of frequency, severity, and number of levels. Even most subjects in their 20s had bulging discs, with 73.3% and 78.0% of males and females, respectively. In contrast, few asymptomatic subjects were diagnosed with SCC (5.3%) or increased signal intensity (2.3%). These numbers increased with age, particularly after age 50 years. SCC mainly involved 1 level (58%) or 2 levels (38%), and predominantly occurred at C5-C6 (41%) and C6-C7"
Get that! 73% of 20 year olds with no neck pain had disc bulges on MRI and 87.6% of the 1200 participants had disc bulges and no neck pain.
What does all of this mean? Just because you have xyz pain and an MRI or xray with "wear and tear, disc bulges, degeneration etc etc" - please consider obtaining a clinical diagnosis (also very subjective) from a provider that is going to move your focus from pain and imaging results to movement and function based outcomes.
There is definitely an art, a skill, involved in unpacking, counselling and educating people about their bodies and the lack of support for the use of imaging in the vast degree of spinal problems. Sure imaging has its place but as I like to say though - there is no image that says - here is your pain!
Introducing The Parnells - Gregg and Kim. We love these two little pocket rockets. They have an unstoppable spirit to keep going and to never give up. They signed up for the Health Associates Couch 2 5km in the summer and achieved extraordinary results. What really stood out was there support and encouragement for each other. Kim was first thinking about participating in the program and Gregg quickly jumped in and said "lets do it together!"
Although their health and fitness journey hasn't been without a few speed bumps, their dedication to understanding their injuries and respecting the process of recovering and healing has helped them recover with optimism and confidence.
Stores officer/Purchasing TAFE
What does health mean to you?
Being active in body and mind
How do you keep healthy
Run, walk, soccer
How you stay motivated?
Train and exercise with a friend or group.
I feel accountable to them if I don't turn up!!!
Facebook page to feel encouraged.
Why do you like coming to Health Associates?
Friendly faces with help and guidance and a wealth of knowledge
Advice for others wanting to improve their health?
Start off with small goals
Find a friend to exercise with
Listen to your body
Customer support manager
What does health mean to you?
Keeping fit and healthy means a lot to me. I have a busy life and staying fit helps to meet the day to day demands.
How do you keep healthy
Football, mountain biking and running
How you stay motivated?
Kim and I support each other, but being part of a wonderful group really helps you along
Why do you like coming to Health Associates?
Chris and I play in the same football team and he has been able to help me with many sports injuries I’ve had over the past few years.
Advice for others wanting to improve their health?
Get out and just do it ! The C25K is a great way to start and meet others starting out
Be free to move with Health Associates. We are dedicated to helping you do the things you love by helping you with pain or injuries. Our practitioners are highly regarded in the field and it is our goal to fast track you to being and feeling your best!