Ankle, Health

Ankle pain, The Best 3 Support Braces

August 2, 2017 • By

Our ankles get little reprieve and time to rest so when we get ankle pain we need a way of looking after them while keeping going. We have outlined the best supports and given a guide so that you can find the perfect support for your ankle pain.

Recent research has proven beyond a doubt what the best thing is for ankle pain and it isn’t what everyone would think. In the past, the need for rehab and strengthening ankles up has been pushed as the most important. But actually, what has been shown to be even more effective in recent research, is wearing an ankle brace.(1

Here is a quick summary of the study from YLM Sports Science

Ankle pain support

Why do braces work so well for ankle pain?

They support you, allowing you to keep moving. That is the key.

Often when we have ankle pain, we aren’t as active, we start walking differently and avoid certain activities. But, with the right support, we avoid the muscle dysfunction and stiffness that comes from this. That is why ankle braces and the most popular item in most physical therapy clinics and that is why you have nothing to lose and everything to gain in getting one for yourself.

We have put together a guide for you below of the different types of ankle support to help you decide on what is best for you:

TypeLevel of supportUsed forLink to example product
Compression sleeveMild support- Ankle pain
- Compression in early stage rehab
- Reduction of swelling
- Mild ankle sprains
- mild instability
Support with strapsModerate support- Ankle pain
- Maintaining warmth
- Moderate support
- Mild instability
- Mild and moderate ankle sprains
Lace-up ankle braceComprehensive ankle support- Moderate and severe (grad 2 and 3) ankle sprains
- Moderate to severe ankle instability
- Dynamic sports

For those of you that don’t have a lot of room in your footwear, there are types of low-cut and low profile ankle braces like THIS Mueller brace that are also a great option.

Further information on ankle pain

For those of you that are information orientated, we have decided to go more in-depth into the many causes of ankle pain, why it can hang around and the many more things that you can do to help it as the more we can do to get rid of ankle pain faster, the better right?

Causes of ankle pain:

  • Tendinopathies: Overload injuries to the tendons around your ankle is common, including peroneal tendons, Achilles tendinopathy and more. Note tendonitis is a common term that is still used a lot but research over the last 10 years has shown that the majority of tendon overuse injuries are not inflammatory after the first 1-2 weeks.
  • Broken ankle: Following ankle fractures and subsequent casting you can be left with stiffness and pain for up to a year. An ankle support can really help with this as well as stretching if you don’t have the full range. You can test your range with an easy test in our past blog post here
  • Arthritis: The top two braces above can help a lot with this as they maintain warmth of the joint
  • Plantar fasciitis

The majority of ankle pain can be helped with decreasing the aggravating activity, supporting the area well and strengthening the ankle back again and there are a lot of great exercises in our past blog posts like THIS one that is great for not just ankle sprains but all sorts of issues down below!

Information on ankle sprains

The most common type of sprained ankle is the lateral ankle sprain (85%), and that is what we are going to discuss and sort out today.

Mechanism of injury: The plain and simple is that a sprained ankle is typically when your foot is forced inward (inversion) and down at the same time (often when changing direction, turning and/or on uneven surfaces). This puts the ligaments under too much stress too fast which causes a tear of one or more of your ankle ligaments.

 

sprained ankle - lateral ligamentsQuick anatomy: The lateral (outer) ankle has 3 ligaments supporting, with the weakest of these (and so most often injured) being the ATFL. The ATFL is the Ligament at the front of the ankle shown here and in most simple sprains, this is the one torn with or without the ligament below it.

Sprained ankle recovery time: The general recovery time is 2-6 weeks (if looked after properly) and keep in mind, even if it feels bad now if you do all the right things you will be one of the 95% who returns to sport and activity within 6 weeks.


Back pain

Slipped Disc: What is it and how to fix it

July 21, 2017 • By

Slipped discs are very common, right? Well, to tell you the truth… they don’t actually happen! Find out what a slipped disc really is and how YOU can sort it out yourself.

Slipped disc, Herniated disc, disc bulge and sciatica are all interchangeable and often used to explain the same thing. Now I need to say first of all that intervertebral discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments – Slipped disc is just a colloquial term which has bred a lot of fear over the years but really there is nothing to fear!

The two common sites for herniated discs are the lumbar spine (low back) and the Cervical spine (neck). Today we are going to cover the low back as this is the most common, but stay tuned for self-treatment of herniated discs in the neck!

Discs cannot actually “slip” as they are firmly attached to the vertebrae above and below vertebrae by very strong ligaments

Basic anatomy:

lumbar anatomy - slipped discs and herniation

The spine is made up of vertebrae stacked on top of each other, held together by ligament and muscle. in between each vertebra is an intervertebral disc. Now in the lumbar spine, there are 5 vertebrae and the most common level for disc herniations are L5/S1 – this is the Disc between your lowest lumbar vertebrae and your Sacrum. roughly 80% occur here with the second most at L4/5 above it.

The Lumbar discs are made up of a harder outer layer, holding in a gooey middle.

How does a Disc herniation occur?

When too much force is repeatedly put through the front of the disc (such as bending forward, slouching and lifting heavy objects) the gooey center of the disc is forced forward and eventually (after thousands of bends)it forces through the outer layer.

A lot of Discs are injured doing very simple things light, changing a light bulb or picking up a baby but it is not that action that does it, it is a build up over time and it can take any little thing to tip it over the edge!

Now there is different levels of disc damage as you can see in the picture below:

disc bulge levels herniation - how to fix slipped disc

 

Now, sequestrations are serious and often need surgery but the remaining levels can be and should be treated conservatively (non-surgically) first.

Depending on the level of disc herniation, they can cause symptoms in different places down the leg due to the nerve roots that get annoyed. Keep in mind though that Disc herniations often do not have pain or change on sensation into the legs – there is a very wide range of presentations.

 

Herniated disc symptoms: You can have some or all of these.

  • Pain worse in the morning and cold/bad weather
  • Sciatica – Common back and leg pain caused by irritation to one of the 5 Lumbar spinal nerves. The nerves are irritated by the disc compressing on it or inflammation from the disc herniation. This usually only occurs down one leg.
  • Back spasm – often people are given this as a diagnosis but muscle spasm DOES NOT HAPPEN FOR NO REASON – there is always something behind it. Muscles around your back tighten up and go into spasm to protect your back and try to stabilize it so that no more damage is done.This is called muscle guarding and is a natural mechanism initially but in the following days, it can lead to a lot of discomfort, pain, and limitation.
  • disc bulge, slipped disc, herniation - self treatment physiotherapyAggravated by sitting, prolonged standing, bending and twisting.

Recovery and healing time

Recovery: Up to 80 percent recover within 6 weeks

Healing time: 12-18 months due to poor blood flow into the discs.

 

 

When to go to the hospital or see your Doctor

  • Weakness in your legs
  • Change in bladder or bowel (toileting) function.
  • Constant unremitting pain or pain not improving

If in doubt see your local health professional as this information is not meant to replace the assessment and advice of a health professional.

 

“Slipped disc” Self-treatment

1. keep active: back in the day bed rest was the first port of call, now it is the opposite. keeping relatively active is the best thing for your back and you need to remember that the chances are your back will get better and that over 80% of the population get back pain just like yours!

2. Exercises: to get the right muscles firing again to stabilize your spine and to loosen off the tight muscles (so that you dont feel hunched over and shuffling!) follow this link: Must know exercises for acute low back pain

3. Stiffness in your upper spine puts a huge amount more stress though your low spine and gets worse when in back pain! Here is a great way to mobilise your own spine

4. The greatest exercise for Disc Herniations: this exercise was developed by a top Physiotherapist Robin McKenzie. Repeated Extensions In Lying (REIL) act to centralise the disc and gradually reduce the disc Herniation.

Prone extensions in lying McKenzie exercise for disc low back pain

 

Position: Lying on your Front with your hands in front of you like you are going to do a push up.

Action: Keeping your hips and back relaxed, push your shoulders up. Do not push into pain, so stop when and if you feel pain and hold it for 10 seconds then relax down and repeat 10 times.

 

Initially start on you elbows as shown, then progress to straight arms.

Prone extensions in lying McKenzie exercise for disc low back pain physiotherapy

Reps and sets: 10 x 10 second holds 3 x daily


Remember: if pain worsens with this exercise do not push as far or as hard. If pain continues to worsen then consult a health professional.

 

These easy steps will help you so much, just remember that you WILL have good days and bad days but if you stick to the above 4 things, your Disc pain will get a lot better. Try and persevere with these exercises for 6 weeks at least!

Let me know how you get on and don’t forget to like, share and follow and remember, a slipped disc doesn’t exist!

Also see: progressed exercises for keeping back pain away

 


Back pain, Core strengthening, Health, physical therapy, physiotherapy

Beating Low Back Pain – Must know Physiotherapy Exercises

July 20, 2017 • By

Don’t put up with low back pain and Sciatica. Below are the best and safest exercises to treat your low back pain yourself.

With 80% of the population experiencing low back pain in their lifetimes, and 84% of those having a recurrence within the same year, this is a huge problem, but a problem that can be helped… alot! As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five exercises for you

As with most other pain and injury, treatment and exercises combined lead to optimal results, so below are five of the best exercises for you to rehabilitate your low back pain at home.

1. Bridge, level one:

Start by lying on your back on the floor or bed with your knees bent. Squeeze your buttocks together and lift buttocks off the floor until your body is aligned. Hold for 5 seconds, then lower down. Repeat 10 times twice.

Brideg - up

Bridge level 2:

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

For the next level up if the above is too easy, keep one leg straight out in the air and perform with one leg. 10 reps each side, 2 sets.

SL bridge 1SL bridge 2

2. Glute sling stretch:

Our favorite stretch!

glut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibilityglut and Lat stretch - Hip flexibility

 

Start on your hands and knees then bring one knee between your hands. stretch the other leg out behind you and across to the other side. Now slowly walk out over your knee with your hands until you feel a good stretch.

Hold for 1 minute each side.

Tip – If that is too much of a stretch then go down onto your elbows first.

3. Bird-dog: 

Instructions: In four point kneeling slowly raise one arm and leg on opposite sides, making sure to keep your back straight (imagine your dinner is sitting on your hips – it is all about control). Lower down in a controlled manner and repeat, 10 times each side twice.

Beginners: Start by raising one leg only.

birddog 2birddog 1

4: Hip flexor stretch: This is important to unload the Low back and pelvis:

hip flex 1hip flex 2

Tip: to get a good stretch “tuck your bum in” or draw the bones at the front of your pelvis up towards the roof. You should feel it in the front of your hip or top of your thigh.

Hold for 1minute.

5: McGill Curlup

Place your hands down on the floor underneath the natural arch in your lower back (Don’t flatten your back.) Only lift your head and shoulders off the ground – unlike crunches, there should be no movement of your lumbar spine. Your hands are there to make sure your back is not curling off your hands or crushing them.

Once you have good spine control then you can take your hands onto your thighs and slide them to the top of your knees to do the curl-up. It doesn’t feel like you are going far but with repetition, it can get your abs firing well.

Begin with 20 at a time, and build up.

mcgill curl up

The key to all of these exercises is to maintain control and don’t rush them.  Do these exercises twice daily for 6weeks and notice the difference (but don’t stop there!)

Also see Slipped disc: what is it and how to fix it.

And if you want more and harder exercises to strengthen up your low back: Get into some QL strengthening!

 

Please Share, like and comment to let me know how you go.


foot pain, Health, running

How to Run Better, The Basics

July 19, 2017 • By

There are a few easy things that everyone can apply to their running to decrease injury, pain and simply make running easier and faster! Today we are simply going to show you how to run better

This is perfect for those of you that have regular niggles or if you have plateaued with your running and need a way to step it up. So here is your easy guide on to how to run better and improve your run!

running cadence 1801: Cadence:

This is basically the number of steps that you take per minute and for best efficiency, this should be 90 steps per minute on each foot (180 total per minute). To achieve this, first of all, you need to measure what your current cadence is. You can do this by counting the amount of steps your right foot takes in one minute.

Try then increasing your rate (if needed) and time again in another 5 minutes. The trick is to think like you are running on an icy or slippery surface and your heels are coming up behind you. This could well feel awkward to do at first and can take weeks to get used to, but once you get used to it, running will feel much easier.

Tip: A great way to improve your running cadence and run better is to use a metronome (some examples here)

how to stop overstriding2: Don’t stride out:

When striding out the foot lands on the heel and with the leg relatively straight out. This creates a braking force up through the leg and acts to slow you down, meaning YOU have to work harder.

Run better by kicking your heels up more – don’t run with straight legs!

 

3: Think smooth, light and easy:

If you look at the best medium to long distance runners you will see they have very little upward head movement (less bobbing up and down). This means less wasted energy! So to run better, we need to lean our body weight forward more and imagine projecting yourself forward and slightly up. Practice standing 1 meter in front of a wall and leaning forward through bending at your ankles until you are about to fall forward and then come back again in order to get a feeling of shifting your body weight forward.

Exercise: Practice standing 1 meter in front of a wall and leaning forward through bending at your ankles until you are about to fall forward and then come back again in order to get a feeling of shifting your body weight forward.

Remember – Perseverance is key with this! You will feel like you can just keep running and running when this becomes second nature – and then you tell others how to run properly – I still find it amazing that no one gets taught how to run!

Lastly, check out the video below of what I think is some close to perfect (no one is perfect) running:

 


Back pain, Health, Hip pain, Knee pain

The Wall Sit – Beat knee pain

July 5, 2017 • By

The Wall sit is one of the most do-able exercises and is a brilliant strengthening exercise for anyone with back, hip or knee pain.

Who would benefit from would wall sits, otherwise known as wall squats?

  • Those wanting to avoid or prepare for knee or hip surgery
  • Most with hip or knee arthritis will get massive benefit
  • Those of you that struggle to get up from chairs
  • Anyone at all who wants to strengthen their back and legs from home

wall sit exercise for knee pain arthritisSo what is a wall sit?

It is simple a squat hold with your back leaning against the wall as shown in the video below. the key  things to remember are:

  • Your knees should no go out past your toes. Aim to keep your knees over your ankles or feet
  • Keep your chest up and back straight
  • Do not push into pain
  • Expect some burning in your thigh muscles (this is a good pain and shows your muscles are working hard)

Top tip: Lean into the wall with a Swiss Ball, foam roller, basketball or anything that rolls to minimize friction – this makes the exercise far more effective and comfortable.


The idea for the wall sit is not to repetitively go up and down but squat down and hold for a period of time.

Aim to hold until your muscles start fatiguing and then come back up again and repeat 10 times – over time your hold time will get longer and longer and your back and legs will get stronger! (1)

Tip: Only go down as far as is comfortable for YOU and don’t go past horizontal thighs.

Progression

The one-leg wall squat is often used as a test of lower limb endurance(2,3) and also makes for an excellent exercise when you want to push your leg strength further while still looking after your knees.

All you need to do differently for the one leg hold is lower yourself down, keeping your feet shoulder width apart and then carefully lift one foot just off the ground – hold as long as you can (without losing form).

Below is a table giving average times to gauge where you are at:

wall sit values

The wall squat is a great exercise and well worth persevering with whether you can just hold a double leg wall sit for 20 seconds or a one leg squat for 100! Make it a challenge every night for one month and notice the difference.

References: