3 Reasons You Might Be Feeling The ‘Pinch’ After Training

Ever find yourself getting an odd pinchy feeling in the front of your hip at the bottom of a squat? That ‘can’ be caused by the tensor fascia latae (TFL). This muscle runs from the top of your ASIS hipbone, across the hip joint via the iliotibial band. The TFL is primarily a trunk stabilizer; it tries to prevent your torso from moving as the lower body moves. However, the TFL also flexes and abducts the hip, and internally rotates the femur. This is where our problems lie.

Inability to activate the glutes can cause overactivity through the hip flexors, quadriceps and especially our friend TFL. Inability to activate the gluteal muscles can stem from a number of possible causes:

Inactivity

In terms of muscle, the saying “if you don’t use it you lose it” applies. If we don’t create a demand on or stimulate the muscle, it will become smaller and harder to engage. If you’re sitting on your gluts now, squeeze them together. If you can’t get strong, even activation on both sides, good luck getting activation in the gym.

Asymmetry

Though we are biologically symmetrical, the demands we put on our body are rarely so. Our body’s response to these demands is to make specific adaptions increasing our ability to survive future stressors, thereby making the body asymmetrical. Aysmmetry can be a massive issue when it comes to the demands of training. Whether it be Sport, CrossFit, Powerlifting or Olympic Weightlifting, 90% of injuries both chronic and acute happen on an athlete’s non dominant side. Ie if you’re right handed the issues will mostly happen on your left side. This is because we put the same amount of load and weight during training through both sides, with one side normally lacking the stability, muscle bulk and overall neuro muscular development.

Pain/previous injury

Pain is one of the major inhibitors of our glutes (in particular gluteus maximus). This is primarily a survival mechanism to help prevent further injury, as our glutes are major propulsion muscles.

If you’ve had a previous injury on one side of your body, your body will subconsciously move in a way to unload that area of the body. Unless you physically focus on strengthening the issue. Seeing a Physiotherapist is a great way to get that previous issue addressed and to optimize your performance in the gym.

If you are unable to activate our glutes, more specifically the gluteus medius, the TFL can begin to take over as a primary hip stabilizer. This manifests as pain in the front region of the hip and leads to slow movement throughout the squat or an inability to reach the bottom of the squat.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

5 Tips to Preventing Ski and Snowboarding Injuries

As the temperatures continue to drop outside, winter sports begin to heat up! Activities, such as skiing and snowboarding, are very popular at all age levels and draw thousands of people to the slopes each year. Although, as health care professionals, we advocate for an active, healthy lifestyle for all, we want to ensure that everyone is active in the safest way possible as to prevent injuries.

Winter sport injuries are dominantly traumatic and can be caused by falls, collisions, ski lift accidents and/or dangerous or rough terrain. Some of the most common injuries that are seen are injuries to the knee (ACL and Meniscus tears), injuries to the shoulder (subluxations, dislocations and AC joint sprains), injuries to the head (concussions) and fractures (wrist, hand, finger and ankle). Although some accidents cannot be prevented, below are some tips to minimize your risk of injury.

Ensure Proper Instruction

If you are new to the world of skiing and snowboarding or haven’t hit the slopes in a while, sign up for lessons before heading out on your own. Most, if not all, ski resorts offer free lessons to new and even experienced skiers and snowboarders. Taking lessons will teach you about proper technique, how to fall safely, how to properly use the ski lifts, the “rules of the slopes” and which slopes are geared for your ability level. Let a professional instruct you correctly before you develop you own bad habits, which can place yourself, as well as those around you, in danger!

Utilize Proper Equipment

Speak with a professional at a ski shop or sporting goods store when purchasing or renting ski and snowboard equipment. Although the temperature is cold outside your body temperature will slowly increase as you begin activity. Wearing several layers of light, loose-fitting, water and wind resistant clothing will help your body when adjusting to the temperature changes. Wearing appropriate protective equipment such as goggles and a helmet will aid in minimizing the extent of injury just in case an accident does happen. Before setting sail down the mountain, check the bindings to your skis and snowboard to ensure they are adjusted and set to your height, weight and experience level. Improper set up of you bindings or faulty bindings can lead to a dangerous fall due to lack of control of your equipment. Finally, never use old or outdated equipment without checking with a professional to ensure safety first.

Know your Surroundings

Check with your instructor or read the signage around the resort and abide by all safety rules of the slopes. Learning how to yield, stop and safely fall meanwhile keeping your eyes and ears open for potential hazards when skiing down a busy mountain can prevent numerous injuries from occurring. When choosing a slope to head down, make sure the trail is marked, free of any rocks, trees and large icy patches and that the experience level matches that of your own. Being aware of your surroundings and learning how to navigate the slopes will not only keep you safe, but will also protect those around you.

Warm Up

Beginning an activity without properly preparing the body sends thousands of people to the emergency room or their physician’s office every day. Just like we let our cars heat up on a cold, icy day our bodies need time to prepare for the stressors that we will be placing on it. Research has shown that “cold” muscles are more prone to injury. Warming up, or increasing blood flow to the body’s musculature, by completing a mixture of static and dynamic stretches and slightly elevating the heart rate by completing a short jog will greatly diminish the chances of a soft tissue injury (i.e. strains and sprains).

Hydrate and Fuel Up

Give your body all the tools it needs to withstand a long, tiring day on the slopes. Start your day off with a well –balanced breakfast of healthy proteins and carbohydrates to provide your body with the energy it needs to remain alert throughout the day. Dehydration can occur more quickly in the cold due to the amount of respiratory fluid loss through breathing, sweat quickly evaporating in the cold air and under the multiple layers of clothing and people don’t drink water as often due to not feeling as thirsty as they may feel in the heat. Remember to hydrate before, during and after the day as well as replace the calories lost through healthy snacking throughout the day.

Skiing and snowboarding are great ways to remain active in the winter and are sports that can be enjoyed by all if done properly. Following the tips above and consulting with a professional if you have any questions or concerns, will hopefully lead to an injury free winter sport season!

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

3 Steps To Powerful Hips and A Better Squat

If a few brief hip flexor stretches is your idea of mobility work, you’re cutting yourself short. Make hip mobility a priority, and your reward could be a better squat and less back pain!

The hip flexors are a group of five muscles that connect the femur (or thigh bone) to the pelvis. They move in one of two ways. When the pelvis is stationary, a contraction of the hip flexors will draw the femur upward—think the classic “goose step.” Conversely, if the femur is stationary, a contraction of the hip flexors will tilt the pelvis forward and the butt back.

1. Come Unglued

The first step in building better hip flexors is to spend some painful minutes ungluing tissues that have been frozen from years of sitting at a desk. We recommend rolling, aka “self myofascial release.”

You can roll on just about anything. We’ve used several different types of foam rollers, a Rumble Roller, lacrosse balls, PVC pipe, a number of weird stick-shaped things. We have found that different materials are suitable for different areas on different bodies, so feel free to experiment and find what works best for you.

To work these tissues, start by locating your iliac crest. It’s the top bony part of your hip that sticks out by your beltline. If you’re using a lacrosse ball, simply move into a plank position on the ground and lay on the ball so that it presses into your hip just below the crest. Move side-to-side slowly, so the ball moves back and forth laterally several inches at a time.

Keep adjusting your position until you find a hot spot, then hold that position for at least 30 seconds. Your first impulse will be to tense up when you feel tenderness, but it’s important that you relax and continue to move around the area. Keep it up, and don’t hurry. The more slowly and more often you can do this, the better.

2. Get On The Couch

Now that we smoothed out that old tissue and dislodged a few fossilized nasties, let’s see what we can do about improving extensibility. The couch stretch is one of the most effective movements you can do for opening up your hip to the end range of motion. Adopt a kneeling position in front of something that you can use to hold your foot up (i.e., a couch). Your back knee should be completely flexed, meaning your heel is as close as possible to your butt.

It’s easy to compensate in this position by hyperextending your lower back, but it’s crucial that you don’t. Instead, We want you to focus on squeezing your glutes and hamstrings, which will push your hips forward into a full-on “schwing.” If your right foot is back, you should feel an intense stretch on the right front side of your hip. Hold it for a long time, like a minute or two, and then switch sides.

Like rolling, this is a movement that deserves to be done as often as you can tolerate. We recommend doing it for two minutes on each side every half hour. That may be tough to manage, but the point is this: Frequent, long-duration stretches are the only stretches that will have any significant effect on your tissue length and mobility. If you want to improve, you have to commit.

3. Build Flexible Flexors

The psoas, our primary hip flexor, is usually the weakest of the five flexors, and the other four hip flexors have to work more as a result. To test if this is the case for you, lift one knee well above 90 degrees and hold it there, ensuring that you do not compensate by moving your pelvis or leaning forward. If holding this for more than a few seconds is painful or impossible for you, your psoas suck. You are going to have serious trouble squatting to parallel or lower if these muscles can’t do their job properly.

One way to strengthen the psoas is by performing the type of toe-lifting movement.s We mentioned at the start of the article. However, in this case we prefer to rely on closed-chain movements, where the hands are fixed and can’t move. This small change makes it harder to cheat or compensate, allowing you to focus squarely on the movement.

We recommend doing floor-slide mountain climbers. You will need some furniture moving pads, Valslides, or something similar that will slide smoothly on your floor. Paper plates even work well in a pinch. Put your feet on the sliders and move into a push-up position. To perform the movement, simply pull one knee at a time up toward your chest, going as high as you can while keeping your foot on the slider. You can alternate legs with each rep or do sets of one leg at a time. Don’t expect it to be easy.

Your hips may not lie, but they can really sidetrack your training if they fall out of whack. Implement this three-part plan, and your hips will be more effective in the gym and less prone to injury moving forward!

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

5 Tips for Running in Sub-Zero Temperatures

The key to running in the extreme cold is to protect yourself, wear the proper clothing, and have an exit strategy.

1. Dress in Layers

You’ve heard this one before. Probably from your mother, who advised you take along your jacket — just in case. Well, you should listen to her. A good approach to running in sub-zero temperatures is to wear a breathable synthetic layer, followed by a second insulating layer, topped off by a wind-proof shell. (synthetic layer, half-zip shirt, shell) On the bottom, consider the same approach in two layers (synthetic layer, tights or pants).

2. Grease Up

You’ll be harder to catch than a greased pig in a snowstorm. Smother Vaseline on any exposed skin to offer insulation from the cold and protection from the wind. That means your nose, cheeks, chin, neck, and ear lobes. You’ll be amazed what a layer of this stuff can do.

Tip from the pros: If you’re racing in shorts on a cool day, you can coat your hamstrings and other important muscle groups in Vaseline to keep them warm.

3. Protect Your Bits and Pieces

Okay, guys. This one’s for you. Buy yourself some underwear that is synthetic and offers windproof protection where it’s needed most. You only need to run in the freezing cold once to realize the value of this garment.

4. Head, Hands and Feet

Wear a good hat that covers your ears and keeps you warm without causing sweat to trickle down your neck and freeze. There are several breathable winter hats made for this purpose. Keeping your hands and feet warm will prevent frostbite and make your run more comfortable.

We have found good success wearing wool mittens over synthetic running gloves. The mittens always seem to keep your hands warmer than gloves, and the synthetic gloves keep your hands from getting sweaty inside the mittens. On your feet, you could wear some warm Merino wool running socks.

5. Tell a Friend

It’s always important to tell a friend or family member that you’re going out for a run. However, running in sub-zero temperatures makes it a necessity. You don’t want to get stuck out there. It’s a good idea to bring a phone along as well. Let’s face it, even if you don’t normally run with your phone, you’ll be glad to have it. Be smart and stay safe and you’ll look forward to winter running.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

How to Release the Piriformis Muscle

The piriformis muscle is one of the most irritated spots on a human body. It attaches to the outside of each hip and to your sacrum, the spine’s lowest section. Its job is to turn your leg outward. The major issue for many people is that the sciatic nerve runs through or under the piriformis muscle. If your piriformis is too tight, it can lead to pinching and sciatica-like symptoms in the affected leg. When the piriformis irritates the sciatic nerve, it leads to pain in the buttocks as well as referring pain along the sciatic nerve felt down the back of your thigh or in the lower back.

Step 1

Stretch the piriformis. This is the first step in releasing the muscle. Lie on your back. If you need to release the muscle on your right side, bend your right knee, bring it across your body, and point the knee toward your left shoulder. Move the bent knee back to the starting position. Put your hands under your bent knee and bring it to your chest. You will feel a stretch in your buttock region–stretching the piriformis. Use progressive piriformis stretching. Start with five seconds, and gradually work up to 60 seconds of sustained stretch. Repeat several times throughout the day. If your pain is on the left, utilize the same procedure on the left side of the body.

Step 2

Take a tennis ball, place it under your piriformis and lay on it. This will work out a trigger point, or a knot within the muscle. Lay on the ball for 30 seconds. Relax for one minute. Repeat the process four to five times.

Step 3

Utilize a foam roller. This also can work out a trigger point. If you need to release the piriformis on the left side, start by lying on your left side and placing your left elbow on the mat or floor. This will stabilize your upper body. Place the foam roller beneath the back side of your left hip, under your piriformis. Roll back and forth to release the tension in the muscle. Do the same thing on the right side if that is where you are experiencing pain.

Step 4

Treat other biomechanical problems simultaneously for best results and to prevent future problems. For example, overpronation of the foot can contribute to the problem. Pronation happens as the foot rolls inward and the arch of the foot flattens. Leg-length discrepancies also are commonly associated with piriformis problems, and can be corrected with use of orthotics. Prescription orthotics can be obtained by visiting a chiropractor and undergoing a gait analysis. Stretching may need to be combined with physical therapy for issues like overpronation.

Tips

Keep hydrated and take extra vitamin C, calcium and magnesium to promote tissue healing.

Things You’ll Need

  • Tennis ball
  • Foam roller
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4 Warm Winter Smoothie Recipes

Notice that refreshingly cold smoothies don’t have the same appeal during wintry weather? Give your smoothies a winter makeover by serving them hot and toasty. (It’s not as strange as it sounds—promise!) These ice-free, warm smoothie recipes will warm you up after a chilly morning jog.

Oats and Chocolate Hot Smoothie

It only takes six simple ingredients to whip up an outrageous oats and chocolate smoothie. Safety tip: Don’t fill your blender or smoothie maker with boiling liquid! The steam creates pressure that can cause the lid to blast off, literally. Add the hot ingredients at the end.

Ingredients

  • 15g/0.5oz dark chocolate, chopped (check the brand for gluten free if required)
  • 200ml/6.75floz almond milk
  • 20g/0.7oz rolled oats (check the brand for gluten free if required)
  • ½ a ripe, medium sized banana
  • 6 almonds
  • 5g/0.2oz chia seeds
  • 20ml/0.7floz cold water

Directions

  1. Add the dark chocolate to a jug and pour in the almond milk. Microwave until the mixture is warm and the chocolate has melted (you can do this in a pan if you prefer).
  2. Add the oats, banana, almonds, chia seeds, the water and approx. a fifth of the almond milk to your smoothie maker or blender. Add in an extra splash of cold water if you think the liquid is too warm (see warning above about hot liquids and smoothie makers).
  3. Blend on high for a minute until the oats and chia seeds have been completely incorporated.
  4. Whilst it’s blending, further heat the rest of the almond/chocolate mix until hot, but not boiling.
  5. Pour the blended oat mix into your cup, stir in the almond/chocolate mix and serve.

Warm Apple Pie Smoothie

This warm smoothie has all the taste of an old-fashioned, homemade apple pie—minus the hassle of baking. Plus, at 124 calories and 0 grams of fat per serving, you can slurp with a clear conscience.

Ingredients

  • 1 apple, cored and cut into chunks (peeled if you don’t have a high-powered blender)
  • ½ cup / 120 ml water (for a creamier smoothie you can use yogurt)
  • ¼ teaspoon vanilla extract
  • 1 tablespoon maple syrup (or raw organic honey)
  • ¼ teaspoon ground cinnamon
  • A pinch of nutmeg
  • A pinch of allspice
  • 1 scoop protein powder (optional)

Directions

  1. Combine apple, water, vanilla, maple syrup and spices in a blender. Blend until smooth. Pour into a mug and microwave on high for about 2 minutes.
  2. Sprinkle with cinnamon, and if you’re feeling particularly daring, add a bit of whipped cream on top. Serve!

Wintry Warm Banana Smoothie

The tryptophan and vitamin B6 in bananas helps to boost your body’s production of serotonin, which can improve your mood and increase feelings of satisfaction and relaxation.

Ingredients

  • 1 cup hot water
  • 1 peeled ripe banana
  • ¼ cup chopped raw walnuts
  • 2 or 3 pitted organic dates
  • ¼ teaspoon cinnamon
  • ½ teaspoon pure vanilla extract
  • Optional Anti-Inflammatory Addition: 1/4 inch knob of fresh ginger

Directions

  1. Place all ingredients in a high speed blender (such as a Vitamix) and process until smooth and creamy. Serve warm.

Apple Cider Smoothie

Need a healthy way to detox? This warm cider smoothie packs a ton of fiber, iron, and antioxidants – thanks to ingredients like fresh apples and spinach.

Ingredients

  • 1/2 lemon
  • 2 cup water
  • 3 green apples, roughly diced
  • 2 handfuls of baby spinach
  • 1-inch ginger, peeled
  • 1 Tbsp cinnamon
  • 2 scoops protein powder *optional
  • Supplements – Vitamin C Powder, MSM, Fish Oil, Maca – optional

Directions

  1. Juice 1/2 a lemon and pour the juice into a high-powered blender or food processor.
  2. Add the water, apples, spinach, ginger, cinnamon and protein powder and blend until very smooth.
  3. You can enjoy at this apple cider smoothie at room temperature or cool it down by blending in ice cubes. To enjoy it hot, either heat it by running the Vitamix for 5 minutes or warm it in a pot on the stove.
  4. Finally, whisk or blend in the supplements and enjoy.
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

Exercises While in Bed From a Broken Ankle

Also referred to as an ankle fracture, a broken ankle involves damaged bones and ligaments in the ankle joint. Symptoms include severe pain, swelling, bruising and inability to carry weight on the foot. A broken ankle can take several weeks or months to heal. During recovery, you will need to stay off the ankle to ensure proper healing. Although you should avoid exercising the injured foot, there are a variety of other exercises you can perform while in bed from a broken ankle.

Range-of-Motion Exercises

When you are on bed rest after a serious injury, range-of-motion exercises are vital for maintaining the health and integrity of your joints. When done regularly, ROM exercises keep your joints flexible, maintain muscle strength, increase circulation and prevent blood clots. When doing ROM exercises, begin at your neck and work down to your toes. These exercises simply involve moving the joints in every possible direction. For example, exercising the neck involves pulling your chin to your chest, tilting your head back to look up at the ceiling, looking from side to side and dropping the ears to the shoulders. Along with the neck, ROM exercises should be performed on the shoulders, elbows, forearms, wrists, fingers, hips, knees and ankles. While recovering from a broken ankle, avoid ROM exercises on the injured leg.

Leg Exercises

After a broken ankle, you will likely need to avoid exercising the injured leg. However, these leg exercises can be performed on the healthy leg. While lying flat in bed, bend your knee and press your foot flat against the bed. Slowly slide your heel along the bed toward your buttocks. Then, slowly slide the foot back to starting position. In this same bent-leg position, slowly slide your foot out to the side and then back to center. Extend your leg straight with your foot flexed. As you tighten the muscles in your thigh, bend your knee and draw it toward your waist. Use your arms to hug the knee to your body for up to five seconds before returning to starting position.

Abdominal Exercises

For many people, abdominal exercises can easily be performed from bed. However, if you typically tuck your feet underneath the couch while working your abs, it may be difficult to perform these exercises with a broken ankle. Begin by performing 10 to 20 traditional crunches. Then, modify the crunches to work your oblique muscles. With your hands behind your head, bring your elbow to the opposite knee every time you crunch forward. Slide your hands underneath your buttocks and extend your legs straight on the bed. Use your abdominal muscles to lift your uninjured leg toward the ceiling. Hold for two to three seconds and then slowly lower back to the bed. Repeat 10 times.

Arm and Shoulder Exercises

Lying on your back, extend one arm toward the ceiling with the fingers pointed. Slowly draw 10 small circles in the air in a clockwise direction and then 10 small circles in a counterclockwise direction. Then, draw 10 large circles in a clockwise and counterclockwise direction. Repeat with the other arm. If you are only recovering from a broken ankle, you should be able to perform simple arm exercises with light weights from bed. Exercise ideas include overhead triceps extensions, shoulder presses, chest presses and bicep curls.

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For the next article in the series: click here >>What is Cuboid Syndrome?

4 Things Young, Active Guys Do That Ruin Their Joints

It used to be that joint problems were something only older guys had to worry about.

But today orthopedic surgeons are seeing people in their 40s or younger for joint replacements. In fact, data from the National Center for Health Statistics finds the number of hip replacements has more than doubled in a 10-year span, skyrocketing by 205 percent in people ages 45 to 54.

Surgeons attribute the rise to people wanting to stay active as they age.

Today’s implants also last longer than they once did, so joint replacements are now an option at a younger age, since physicians aren’t as worried about having to replace them.

But while the surgeries are effective, we’d all prefer to skip a trip to the hospital, right?

Here, the top mistakes we all make when it comes to our joints and how to stay out of harm’s way.

You’re Only a Runner

Many patients seeking joint replacement are in good cardiovascular health, but not necessarily good physical health.

If you only run, you might have imbalances when it comes to muscle strength and flexibility. And this, paired with repetitive trauma over time, could lead to arthritis, causing your joints to wear away. It’s important to cross-train.

Giving certain muscle groups (like the ones you use on long, slow jogs) a break once or twice a week while activating new muscles (like the ones you might use sprinting) can fend off injury.

You Let Your Weight Go

When you run, your knee joints carry 7 to 9 times your body weight. While your body can handle this, some research suggests that runners aren’t at an increased risk for issues like osteoarthritis, so it’s important to keep the scale in check.

From a biomechanical standpoint, increased weight is a lot of stress. Overweight people are at a 40 percent or higher increased risk of a knee replacement down the line compared to those at normal weights. The link was even stronger in younger people.

You Skip Stretching

The key to joint health is achieving a good balance between strength and flexibility. As you get older, you need to spend as much time, if not more time, stretching than strengthening. Why? Because the more candles on the birthday cake, the less flexible your muscles become, and flexible muscles help keep joints mobile.

You Push Your Flexibility Too Far

Intense workouts like mud runs aren’t the only way to injure your joints. While exercises like yoga are great ways to boost flexibility and strength, anything extreme when it comes to range of motion—like reaching for that pose your body’s not quite ready for—can put you at risk for a joint injury.

When you create range of motion extremes, you can create bony spurs (projections along a bone’s edges) that may predispose you to arthritis. Your best bet isn’t to skip yoga but rather to stick with the modifications that work for you. And give yourself time before trying anything you might not be ready for.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

7 Things To Do For Stronger Knees

Stretch your IT band. Spending some time stretching and warming up your IT band before diving into a strenuous activity is a good way to keep your knees strong. It is the area of thicker tissue that runs from the outside of the pelvis to the outside of the knee. The IT band helps to stabilize the knee during physical activity.

1. Stand with your left foot crossed over your right and stretch your arms above your head. Lean your upper body as far as you can to the left without bending your knees. Repeat with your right foot crossed over your left, leaning your upper body to the right.
2. Sit on the floor with your legs stretched in front of you. Cross one over the other and pull your knee as close as you can toward your chest, holding it in place for a few seconds. Repeat with your other leg.
3. Ball-squeeze squat: Place a ball between your thighs and squeeze. Slowly squat down until your knees are bent 90 degrees or as low as you can. Do three sets of 10 reps.
4. Large-step lunge: Take a big step forward with one leg and lower your body until your rear knee nearly touches the floor. Bring the rear leg forward to return tot he starting position. Do three sets of eight to 10 reps.
5. Strengthen your hamstrings with step-ups. Stand in front of a raised surface and practice stepping up with one foot, then the other. Repeat on both sides. You can do this holding dumb bells. Do 3 sets of 15 reps.
6. Jumping Rope. Jumping the right way is good. You might want to start in front of a mirror, and make sure that you are landing with your knees slightly bent.  For stronger knees, practice landing in a half-squat position with your knees bent.
7. Do low impact cardio that will, over time, strengthen your knees. Some good activities to try are yoga, swimming, walking and biking. If you’d like to try higher impact activities after this, your knees might be strong enough by then.
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The Great Ice vs. Heat Confusion Debacle

What ice and heat are for:

Ice is for injuries, and heat is for muscles. Roughly.

Ice is for injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen. The inflammatory process is a healthy, normal, natural process that also happens to be incredibly painful and more biologically stubborn than it needs to be. Icing is mostly just a mild, drugless way of dulling the pain of inflammation. Examples: a freshly pulled muscle or a new case of IT band syndrome (which is more likely to respond than the other kind of runner’s knee, patellofemoral pain, because ITBS is superficial and PFPS is often a problem with deeper tissues).

Heat is for muscles, chronic pain, and stress — taking the edge off the pain of whole muscle spasms and trigger points, or conditions that are often dominated by them, like back pain and neck pain), for soothing the nervous system and the mind (stress and fear are major factors in many chronic pain problems, of course).

What ice and heat are not for:

Heat can make inflammation worse, and ice can make muscle tension and spasms worse, so they have the potential to do some mild harm when mixed up.

Both ice and heat are pointless or worse when unwanted: icing when you’re already shivering, or heating when you’re already sweating. The brain may interpret an excess of either one as a threat — and when brains think there’s a threat, they may also amp up the pain.

But heat and inflammation are a particularly bad combination. If you add heat to an fresh injury, watch out: it’s going to get worse! If you heat a freshly injured knee, it can swell up like a balloon, and three times more painful. (That is a rare example of a particularly severe negative reaction to heat. Most cases are not going to be that bad!)

The lesser known threat is from icing at the wrong time, or when it’s unwanted.

If you ice painful muscles, be careful: it might get worse! Ice can aggravate sensations of muscle pain and stiffness, which are often present in low back and neck pain. Trigger points (painfully sensitive spots) can be surprisingly intense and easily mistaken for “iceable” injury and inflammation. But if you ice trigger points, they may burn and ache even more acutely. This mistake is made particularly often with low back pain and neck pain — the very condition people often try to treat with ice.

What about injured muscle?

If you’re supposed to ice injuries, but not muscle pain, what do you with injured muscles (a muscle tear or muscle strain)? That can be a tough call, but ice usually wins — but only for the first few days at most, and only if it really is a true muscle injury. A true muscle injury usually involves obvious trauma during intense effort, causing severe pain suddenly. If the muscle is truly torn, then use ice to take the edge off the inflammation at first. Once the worst is over, switch to heat.

Which is better?

Ice packs and heating pads are not especially powerful medicine: some experiments have shown that both have only mild benefits, and those benefits are roughly equal in treating back pain.

The bottom line

The bottom line is: use whatever feels best to you! Your own preference is the tie-breaker and probably the most important consideration. For instance, heat cannot help if you already feel unpleasantly flushed and don’t want to be heated. And ice is unlikely to be effective if you have a chill and hate the idea of being iced!

If you start to use one and you don’t like the feel of it… just switch to the other.

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.
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