Don't Get into Deep Water with Swimming Injuries

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Swimming is one of the most popular sports in the world. We swim in the sea, pools, lakes, streams, rivers, and even ponds. And given 70% of the Earth’s surface is water, we’re not short of opportunities.

While swimming is considered a ‘low-impact’ sport due to the fact that the water supports a large percentage of our body weight, more than 84% of regular swimmers suffer from some type of overuse type injury caused by swimming.

Why? The main reason is the high repetition number and forceful nature of the shoulder revolutions which takes our shoulder joint through its full range of motion (which is one of the greatest of all our joints), against resistance, over and over again.

And as 50-90% of the power generated to propel you forward comes from the shoulders, you can see why they are the most frequently injured joint.

However, swimming also puts stress on your back (to hold you level in the water) on the neck (when raising your head out of the water to breathe), and if you favour the breaststroke, there’s added pressure from the unnatural twisting motion on the knees.

So, despite it seeming to be a low-impact sport, swimming actually carries a surprisingly high risk of injury.

Let’s take a look at those injuries, why they happen, and what you can do about them.

Swimming injuries generally stem from two sources, and often these sources will combine:

1. Muscle imbalances

2. Stroke technique issues

Muscle Imbalances

Our everyday posture, particularly if you spend a lot of time sitting at desk or in a car, or generally not moving around, creates all sorts of muscle imbalances from short hamstrings, tight muscles around the neck, back and shoulders. Unconsciously, we adopt a curved forward upper back, round shoulders and chin poke, which not only add to shoulder problems in swimmers but neck pain, too.

Poor posture is the biggest culprit of short tight trapezius and pectoral muscles and weak anterior (front) neck and upper back muscles. These muscles can be painful and develop trigger points which are hyperactive spots in the muscle, commonly referring pain, and causing headaches. Tight muscles may also limit your neck movements. Good posture ensures good alignment of the joints and ligaments which allows for optimal contraction of your muscles and off-loads underlying structures.

Stroke Technique

This is a big topic to cover because it depends on what stroke you’re swimming mostly with and what kind of injury you may have. Issues may include: a wide, swinging arm recovery which requires excessive internal rotation (causing impingement on the joint); thumb in first with hand entry, which causes excessive internal rotation in the shoulder, and a dropped elbow or straight arm pull-through, which creates a long lever, overloading the shoulder.

In our set of resources which you can download at this link, we’ve put together a Stroke Technique Cheat Sheet for each injury area, which identifies key stroke issues, and suggested solutions.

What does all of this mean to you? You shouldn’t swim? You should reduce your training or change your sport?

The bottom line is that the benefits of swimming - whether it’s for general fitness and physical activity, the desire to win competitions, or just to find your quiet place for stress relief - far outweigh the risk of injury.

And with this in mind, we’ve put together a set of resources to help you manage, or better yet prevent, swimming injuries altogether.

These resources include:

- Stroke Technique and Injury Cheat Sheet

- Common Swimming Injuries Cheat Sheet

- Sink or Swim? Treating and Preventing Swimming Injuries

- Swimmer's Shoulder - Advice and Exercise Rehabilitation Leaflet

- Breaststroker's Knee - Advice and Exercise Rehabilitation Leaflet

- Muscle Cramp in Swimmers - Advice Leaflet

- Back Pain in Swimmers - Advice and Exercise Leaflets

- Neck Pain in Swimmers - Advice and Exercise Leaflet

The resources are packed with practical tips and advice, along with exercise leaflets that combine to help you swimming happily, healthily and injury free into the future.

Managing Chronic Pain

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Pain means different things to different people, in different contexts, and based on different experiences. 

Acute, short-lived pain following a traumatic injury, in many cases heals. The pain that becomes increasingly hard to live with and manage, is the pain that has persisted month after month and often year after year, particularly when the source often can’t be diagnosed. 

Living with chronic pain is almost a disease in itself. It slowly and progressively eats away at you, your confidence, self- worth, and independence. It can consume your life and thoughts, often alienating you from your friends and family even your workplace. 

Living with pain is exhausting, lack of sleep, anxiety and depression often go hand in hand with pain, which in turn can lead to anger and frustration and problems with your relationships at home and with yourself. 

And the physical pain can stop you from doing things you love, like taking walks, playing sports and socialising, which also has an impact on your mental health. 

You know the saying “it takes a village to raise a child”, well we believe it takes an army to survive and thrive with chronic pain. Although it’s important that you are in control and are the driver of your pain management, it would be unrealistic to assume you can do this alone. You need the support of friends and family, work colleges or associates and pain specialists and therapists. 

Physical therapists are experts in handling pain, finding the source of the pain and treating your body holistically. Physical therapy can be very beneficial in managing chronic pain by promoting joint movement, using exercises to reduce stiffness and improve muscle strength – all of which can reduce your pain and improve your mobility which may help with daily activities. Specific nerve mobility treatments can help reduce sensitivity to pain and massage has always been a trusty stalwart as it reduces stress and anxiety as well as pain. 

This month we’ve put together a range of resources that can help you learn to manage this pain, whatever pain level you’re at.

We have leaflets on the following topics:

  • The Strain of Pain: Dispelling the myths behind chronic pain with strategies for managing your pain

  • Understanding Chronic Pain

  • Skills to Cope with Chronic Pain

  • How Physical Therapy Can Help You if You Suffer from Chronic Pain

  • How Pain Affects Your Life (infographic)

  • Relaxation for Chronic Pain (exercise handout)

  • Building Activity into Your Everyday Life If You Suffer from Musculoskeletal Pain

  • Chronic Pain: Tips for Managing Activity Levels

These resources are packed with practical tips and advice, along with worksheets, exercise leaflets and infographics that combine to help you master your chronic pain.

You can download the resources here.

If you’re living with pain on a regular basis, there are many ways we can help so if you need advice, please don’t hesitate to contact us.

And if you know anyone who could benefit from any of these resources, please feel free to share this blog post with them.

Healthy Workplace = Happy Workplace Or, Thinking on Your Feet

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You might not find it surprising, but it turns out that a lack of exercise is a silent killer. The World Health Organisation lists physical inactivity as the fourth biggest risk factor for death in adults across the world. 

The latest research shows when it comes to heart disease, leading a sedentary life is as great a risk factor as smoking and obesity. In fact, inactivity in terms of disease risk, is more dangerous than being overweight. 

If you spend long periods of time sitting, this is particularly bad news, as it increases your risk of heart disease, obesity, diabetes, and cancer. The most current research has shown that even normal weight individuals that are inactive, are at risk of developing disease. There is a molecular pathway that is essential to burning fats, that shuts down with inactivity, which subsequently increases your risk of developing heart disease. 

And sadly, you can’t bank the benefits of exercise from your youth, hoping it will help you 40 years down the line. The ideal scenario is to have been active throughout your life.  However, research has shown that your health can benefit from physical activity at any age, meaning it doesn’t matter when you start, as long as you start! 

Physical activity performed regularly, can help to prevent and manage over 20 chronic medical conditions. These include coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems, and musculoskeletal conditions. 

So the good news is that we can combat the negative effects of prolonged sitting (total of 8 hours or more) with just 60-75 minutes of moderate intensity physical activity a day. 

The reality is that hectic schedules can make it seem impossible to fit workouts into your busy week. The prospect of packing a gym bag, trudging to your local gym, working out, showering, changing, and trudging back to where you came from, can feel like a lot of effort. 

But when we neglect exercise, we not only put both our physical and mental health at risk, but this also has a negative impact our productivity and effectiveness at work. 

And you would be surprised at the number of opportunities there are in a working day, to increase your activity levels. This doesn’t have to mean running or cycling to work (although that’s great if you can) but you can in fact accumulate activity that is beneficial to health, in lots of different ways during the day. 

Which is why we’ve put together a collection of resources to help you achieve this. 

At the following link you can download leaflets, exercise handouts and infographics on the following topics.

17 Ways to Be More Active at Work

  • Thinking on your Feet - Why it Pays to Be Physically Active at Work Client

  • Newsletter

  • Stretching Exercises for the Workplace

  • Strengthening Exercises for the Workplace

  • Why Posture Matters

  • Optimal Desk Posture Infographic

  • Carpal Tunnel Infographic

  • Preventing and Treating Carpal Tunnel Syndrome

  • Carpal Tunnel Rehabilitation Exercise Sheet 

Click here to download the resources here.

As physical therapists we can help with a wide range of issues caused by long periods of sitting at a desk, including back and neck pains, tingling in your hands, carpal tunnel syndrome, even regular headaches experienced at work. Please get in touch if you need advice and I hope you find these resources useful.

The Power of Massage Therapy

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Fact: It is estimated that between 35-43% of the UK population is estimated to suffer from chronic pain, that’s 28 million people. It accounts for 40% of time off work and costs the NHS over £10 billion pounds a year.

It is one of the most common reasons why people visit sports massage or soft tissue therapists accounting for up to 40% of visits.

Other common reasons include rehabbing sports injuries, relief of pain from accidents or muscle strains, relief of stress and as a form of preventative health care. 

And also, just that good old relaxation that can only come from human touch. 

What is massage therapy, exactly?

People with specific massage therapy training will have gone to school for a minimum of 100 hours and received skilled instruction in the manual manipulation of the body’s soft tissues, including muscles, connective tissues, tendons, and ligaments. 

They are highly knowledgeable about anatomy and physiology and are skilled diagnosticians with regards to chronic pain and how to treat it. 

The underlying idea behind massage therapy is that a relaxed and loose muscular structure promotes the flow of energy through the body, which enables the body to maintain health and heal itself, without resorting to drugs or surgery.

Here are some common massage therapy modalities that you may encounter, ranging from simple relaxation to treatment of complex pain issues and connective tissue realignment. 

Swedish Massage

This is your standard relaxation massage. Swedish massage is very popular in spa settings. 

As one of the most popular types of bodywork performed today, the overarching goal of Swedish massage is the ultimate relaxation of the entire body. It is exceptional at achieving this, easing tension while promoting the release of environmental toxins stored in the body’s fat and epidermis layers while simultaneously increasing the oxygen levels in the blood.

Swedish massage has also been shown to produce significant reductions in the stress hormone, cortisol. 

Trigger Point Therapy and Myofascial Release

A trigger point is a small area of tightly bound and ‘knotted’ muscle that will produce referred pain into another part of the body when pressed upon. For example, a trigger point in the rhomboid muscle in the upper back can produce headache-like pain at the base of the skull. 

Trigger points such as these are often misdiagnosed as migraines.

Trigger points range in severity from mildly annoying to completely debilitative. The affected muscle fibres are in a permanently shortened and tense state, and can even pinch nearby nerves, producing even more related symptoms, sometimes spiraling into full-blown fibromyalgia, a disorder of the connective tissues. 

This is one area where massage therapy has a distinct advantage over every other form of treatment. Conventional medicine’s answer to trigger points is usually an injection of a local anesthetic or a corticosteroid injection. Both of which are temporary, unnatural treatments and in the case of the corticosteroid, actually damaging to the tissues. 

Massage therapy treats these by the application of pressure directly to the trigger point, going over time from light to very deep, (usually within the same session) whereupon the trigger point will begin to release and relax. 

Follow-up treatment is nearly always needed to retrain the muscle fibres to lengthen and “smooth” back out. A good massage therapist can often boast a near 100% success rate with trigger point therapy, even when other treatments have failed. 

Myofascial release is a broader application of this type of therapy that seeks to restore mobility and function to the body’s underlying network of connective tissue that is present in every muscle in the body. It improves lymph circulation (keeping the blood clean) and enhances the muscle’s natural stretch reflex, keeping the body supple and strong. 

It should be noted that these types of massage therapy are not the same as a relaxing Swedish massage and can sometimes be quite painful as the body relaxes, releases, and returns to normal homeostasis. It’s important to communicate to us during your treatment if you are uncomfortable at any time.

Sports Massage

As the name implies, sports massage is focused on the athlete. From the highest level of competition, to the casual weekend warrior, sports massage therapists can be found everywhere from weekend 5ks to professional locker rooms and Olympic fields.

Sports massage focuses on both pre- and post- event training and recovery. 

Pre- event for example, may involve stimulating a stretch reflex in the quadriceps muscle of a runner to help lengthen her stride, with repeated treatments resulting in a faster runner who is less prone to injury. 

Post-event can take the form of a light, relaxing massage to stimulate healing blood flow to an overused muscle group, enabling the athlete to recover safer and faster, and enable them to perform at the top of their game sooner than otherwise would be the case. 

Rather than a specific technique as in trigger point or myofascial therapies, sport massage focuses on the dual goals of athletic performance and recovery and may borrow heavily on other modalities to achieve these ends. 

The tip of the proverbial iceberg…

The above is by no means a comprehensive list of massage therapy modalities. There are literally dozens of different types of massage, used in everything from lymphatic drainage, body realignment, even neuromuscular therapy that seeks to balance the nervous system.

If you’d like to go into greater detail on these and other modalities, and to get the latest, most cutting-edge information on the art and science of massage therapy, pain relief and injury prevention, then please click this link to sign up for our clinic newsletter.

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