Category Archives for "sports medicine"

Building a Stronger Core to Prevent Low Back Pain

Up to 80% of individuals will experience some lower back pain at least once in their lifetime. Lower back pain (LBP) results in high costs and places a burden on society. These costs include diagnostic, treatment, and indirect costs associated with work disability. A number of conditions can lead to low back pain such as infections, tumours, fractures or dislocations of the spine. However, lifting heavy loads is generally thought to be a key predictor of LBP. An important element in prevention of LBP is to correctly stabilize the trunk during lifting by pre-activating the abdominal wall muscles. By doing so, the spine will increase in stiffness to reduce the effect of undesired spinal perturbations. Exercises aimed at bracing the abdominal muscles may reduce the risk of LBP.

There are two ways of stabilizing the abdominal muscles: an abdominal hollow or abdominal brace. An abdominal hollow begins by drawing in the lower abdomen (transversus abdominus) while maintaining relaxation of the other surrounding abdominal muscles such as the obliques. At the same time, small muscles of the lower back (close to the spine) such as the multifidus are contracted while the larger back muscles are relaxed. With contraction of the lower abdomen and small back muscles, intra-abdominal pressure is increased and the fascia surrounding the spine increases in tension. Combined, these contribute to provide intersegmental stability.

An abdominal brace is performed by activating all of the abdominal and lower back muscles, rather than specific muscle recruitment. By tensing the entire trunk without drawing the muscles in or pushing them out, global activation of the ab and back muscles may provide increased stability in all directions in various movement patterns.

Both the abdominal hollow and brace can help increase the stiffness of the spine to minimize lower back pain. The use of either one will depend on the desired movement pattern and the goals of the individuals in stabilizing their core. Strengthening the core muscles is also essential in reducing the amount of loading on the lower back muscles. Watch these videos below:

Back Pain, Lower Back Treatment “Building Core Strength”:

Back, Sacro-Iliac-Joint Pain & Dysfunction: Core Stability Foam Roller:

Strengthening Hips, Pelvis and Low Back For Ultimate Frisbee: “Psoas March”:

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

Strain vs Sprain? How To Recover Optimally

Acute sprains and strains may impede performance and delay return to a sport. Proper management, treatment, and prevention is essential to recovering effectively. An athlete must first understand the definition and recognize the differences between a “sprain” and a “strain.” A sprain is defined as a violent overstretching of one or more ligaments in a joint. A sprain can result in pain, tenderness, swelling or bruising at the joint. A strain is defined as a stress or direct injury to the muscle or tendon. A strain may also cause pain when moving or stretching the injured muscle, but can also cause muscle spasms.

Grades of Strain:

1) Grade I – Mild Strain: slightly pulled muscle with no muscle or tendon tears and no loss of strength and low levels of pain
2) Grade II – Moderate Strain: partial tearing of the muscle or tendon at the bone attachment with reduced strength, moderate pain levels
3) Grade III – Severe Strain: complete rupture of muscle-tendon-bone attachment with separation, substantial loss in strength and high levels of pain

Grades of Sprain:

1) Grade I – Mild Sprain: minor tearing of some ligament, no loss of function
2) Grade II – Moderate Sprain: partial rupture of portion of ligament, moderate loss of function
3) Grade III – Severe Sprain: complete rupture of ligament or separation of ligament from bone, substantial loss of function

Proper RICE Treatment:

1) REST: Do not continue to use the affected muscle or ligament immediately after injury. Use crutches for the lower extremities (i.e. leg or ankle) and splints for the upper extremities (i.e. arm or hand)

2) ICE: Sudden cold may help constrict capillaries and blood vessels to slow or restrict internal bleeding. Place an ice pack between a towel or dry cloth. Apply ice every hour for 10 to 20 minutes at a time.

3) COMPRESS: Compression can help reduce swelling post-injury. Wrap the injured part firmly with an elasticized bandage, compression sleeve, or a cloth. Do NOT wrap the cloth too tightly as it may cut off blood circulation and lead to more swelling.

4) ELEVATE: Elevate the injured part about level of the heart to reduce swelling and pain. Place a soft object such as a pillow or piece of clothing to use as a prop below the body part.

Continued Recovery:

Continue to follow the above RICE method for two to three days post-injury. Daily stretching may help loosen the muscle. Key to prevention is to stretch the tight muscles and strengthen the weak muscles.

Watch the videos below on how to recover from a common ankle sprain or shoulder strain:

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

Responding to a Cervical Spinal Cord Injury


A catastrophic cervical spinal cord injury occurs with structural distortion of the cervical spinal column due to actual or potential damage to the spinal cord. Damage above the C5 vertebrae in the spinal column results in the greatest risk of immediate sudden death for an athlete. Above this level, damage may impair the spinal cord’s ability to transmit respiratory or circulatory control from the brain. Effective acute care is critical in preventing permanent dysfunction or death in an athlete as a biochemical cascade of events can occur during the initial 24 to 72 hours post-injury.

Any of the following symptoms warrants the initiation of a spinal cord injury management protocol:

– unconsciousness or altered level of consciousness

– bilateral neurologic complaints

– significant midline spine pain

– obvious spinal column deformity

Treatment:

When treating a cervical spinal injury, stabilize the spine in a neutral position immediately. Avoid applying traction to the cervical spine to create as little motion as possible. After manual stabilization of the spine, immobilizers such as foam blocks or straps may be used. If rescue breathing becomes necessary, the person with the most training and experience should establish an airway using the safest technique. 

If the athlete is in a position that prevents treatment of the airway, slowly realign the cervical spine. However, stop movement if the athlete experiences increased pain, neurologic symptoms, or muscle spasms. Prepare for transport to the nearest hospital.  The team physician or athletic trainer should accompany the athlete to help guide equipment removal.
If possible, remove equipment to clear access to the airway. Remove helmet and shoulder pads if necessary.

Prevention:

1) Use appropriate technique when tackling or engaging in contact (keep your head up)
2) Medical personnel should be able to recognize and respond promptly to cervical spinal injuries
3) Ensure equipment hardware is not rusted and is repeatedly inspected for maintenance
Athlete may return to play only after full tissue healing, neurologic recovery, and medical clearance from a physician.

Watch Iyad, physiotherapist at InSync, demonstrate how to mobilize a stiff neck with a quick and easy exercise:

Casa, Douglas J., et al. “National Athletic Trainers’ Association Position Statement: Preventing Sudden Death in Sports.” Journal of Athletic Training, vol. 47, no. 1, 2012, pp. 96–118., doi:10.4085/1062-6050-47.1.96.
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.