Category Archives for "sports"

Whole-Body Partner Workout

Looking to try something new for your next workout? Try these fun and challenging exercises with a partner at the gym or at home. 

1) Medicine Ball Pass: 

Lie on your back with a mat with your feet planted next to each others. Begin with one person holding the medicine ball, then both sit up by engaging the core, and pass the ball to the other person. Repeat back-and-forth passes by performing simultaneous sit-ups for 20 to 30 repetitions. 
                                                                                                                                  credit: Kami Price

2) Squat Seesaw:

Grab a resistance band with a handle on each end and stand face to face. Begin with one person performing a squat to bring the resistance band downwards, while the other person stands tall and brings the resistance band overhead by extending their arms. Remember to keep an upright body position through out the movement and engage the core. Repeat for 20 repetitions. 
                                                                                                                              credit: Travis McCoy

3) Push-up to Bent-over Row:

Partner #1 will begin in a push-up position by placing both hands on the floor shoulder-width apart while the partner #2 holds the ankles. Partner #1 will perform a push-up by engaging the core and glutes to lower their body towards the floor as Partner #2 holds their ankles by keeping their arms extended and back neutral. After Partner #1 has brought their body back up by pushing up, Partner #2 will then pull their partner’s ankles upwards to chest level to perform a row. Repeat 10 times before switching roles. 

                                                                                             credit: Kami Price

4) Single-Leg Core Rotation:

Stand tall side to side with your partner and hold a medicine ball. Raising the outer leg to a 90 degree angle for each person, engage the core, and rotate to pass the ball back and forth between your partner and yourself. Complete 10-15 passes before switching positions to raise the other leg and complete another set. 
                                                                                                                              credit: Travis McCoy

5) Plank High-Fives

Begin in a plank position facing each other by placing hands directly below your shoulders and body positioned in a straight line. Engage the core and keep the spine neutral, raise one hand while the other partner raises the opposite hand to high-five in the space between you and your partner. 

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

What is Cuboid Syndrome?

Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.

The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome may also occur in sports such basketball, football, or soccer. Weight-bearing, uneven pavement, or quick changes in direction that occur in sports may aggravate symptoms. A third cause of this syndrome may be an individual’s altered foot biomechanics. Athletes who have over-pronated feet, also known as flat feet, may be more prone to cuboid subluxation.

Imaging such as x-rays, MRIs, and CT scans can be used to rule out other causes of pain. However, a cuboid subluxation can be difficult to diagnose and therefore, must be carefully assessed by a general physician or other health care professional.

STRENGTHENING

Daily strengthening and mobility exercises should be performed on a pain-free basis to prevent the foot and ankle from becoming weak or stiff. Watch the videos below on how to properly perform strengthening exercises:

Use a resistance band tied to a stable anchor and wrap it around the unaffected leg. With the affected ankle, stand either in front of the band or inside while keeping your posture tall and inner core engaged. Hike the foot with the band wrapped around the leg up off of the ground and slowly push the leg out to the side and then slowly return it back to the middle while keeping the foot off of the ground the entire time. Resist the movement with the standing leg by squeezing the butt muscles. Repeat this 10 times for 3 sets daily.
Start by putting your weight on the side of the affected ankle and hike the opposite foot up off of the ground. Remember to keep your inner core tight below the belly button. Then with the foot that’s off of the ground touch the first point in front of the ground, then to the side and then behind you, and then cross over to the other side of the body. Repeat the 4 points of contact (front, left side, back and right side) for 30 seconds 4 sets 4 times per day. As you get stronger increase it to 60 seconds 4 sets 4 times per day. If you have a fracture as a result of your injury or you are unsure if this is the right exercise for you to do, consult your physiotherapist before starting this exercise.
Starting with tall posture, engage your core muscles below the belly button by drawing the lower abs inwards toward the spine. Avoid arching the low back. With arms in a ready position do a one-legged squat with your body weight distributed equally over the foot. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heel as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of ten repetitions daily. 

TREATMENT

Other treatment options include foot support such as padding, taping, or orthotics to help stabilize the bones of the midfoot or correct for over-pronation. Rest from repetitive, weight-bearing actions such as jumping or running may help alleviate pain. Ice affected area for 10 minutes at a time to reduce swelling and inflammation. Consult your family physician, physical therapist, or podiatrist to perform a manipulation if the cuboid bone is suspected to be dislocated.


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

Diana in Europe!

Diana, who works front desk at both the Burnaby and Cambie InSync Physio clinics, recently returned from her trip to Europe! Diana and her dragon boat team, Dragon Zone Premier, had the opportunity to compete at the 2018 Club Crew World Championships in Szeged, Hungary as one of the five Premier teams representing Canada. Her team placed 6th overall in the world with 48.803s in the 200m Mixed Premier Standard Boat Grand Final, 5th overall in the world in 500m Mixed Premier Standard Boat Grand Final, and 4th overall in the world in the 2km Premier Mixed Standard Boat Final. 

Following her competition, Diana got to see the beautiful emerald waters of Plitvice National Park, hidden blue caves near the island of Hvar, and the historical city walls of Dubrovnik, Croatia. 

Diana also got to explore the ruins of Pompeii as well as the Roman Forum and Colosseum in Rome, Italy.

One of her highlights was seeing the rows of colourful houses on the island of Burano and watching a talented glassmaker create a horse made of glass on the island of Murano, Italy. 

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

How to Avoid High-Altitude Illnesses

Altitude training involves spending several weeks at a higher altitude (preferably over 2000 m or 8000 ft above sea level) to adapt the body physiologically. At elevations greater than 1200 m or 3950 ft, there is a decrease in atmospheric pressure which reduces the partial pressure of oxygen in inspired air. This causes decreased arterial oxygen levels and leads to increased ventilation and cardiac output, along with an elevation in heart rate. Performance will decrease for individuals that have not acclimatized to the change in pressure and are consequently exposed to a risk of high-altitude illnesses.

Acclimatization

Acclimatization is the process of adapting to the decrease in oxygen concentration at a specific altitude. With acclimatization, there will be an increase in heart rate, blood pressure, bicarbonate excretion, respiratory frequency and volume along with a reduction in plasma volume. To compensate for the decreased arterial oxygen levels, erythropoietin (EPO), a hormone in the body, will trigger more red blood cell production to aid in oxygen delivery to the muscles. Training at high altitudes allow athletes to produce additional red blood cells that will provide a greater cardiovascular effect on performance at competitions held at lower elevations.

Acclimatization requires an altitude exposure of more than 1 week. Staged ascents promote gradual and partial acclimatization when an individual resides at a moderate elevation before ascending to a higher elevation to reduce the adverse consequences of rapid ascent. The first stage of ascending should be greater than 3 days at a moderate altitude. Remaining at a moderate altitude for 3 to 7 days will reduce the symptoms and risk of altitude sickness. However, a time period of 6 to 12 days will improve athletic performance.

High-Altitude Illnesses

High-altitude illnesses can occur at elevations above 2500 m. Mild altitude illness can occur between 2000 and 2500 m.

Acute mountain sickness ( is commonly experienced by individuals 6 to 12 hours after ascending to elevations above 2500 m with the prevalence and severity increasing with higher altitudes. Symptoms include: headaches, nausea, dizziness, and sleep disturbance. Some risk factors may be a lack of previous acclimatization, history of migraines, age of 46 and above, or being a female. Symptoms typically resolve within 1 to 2 days with rest or with non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin. If symptoms become severe, descend immediately or use supplemental oxygen.

High-altitude cerebral edema (HACE) is a more severe form of altitude illness. Symptoms include: truncal ataxia (loss of body control), decreased consciousness, mild fever, and coma. If a headache is poorly responding to NSAIDs, then this is an indication of acute mountain sickness progressing to (HACE).

High-altitude pulmonary edema (HAPE) presents with a loss of stamina, dyspnea, dry cough, cyanosis (bluish skin), or pink, frothy sputum (phlegm). The risk of HAPE increases with increased altitude and faster ascents. HAPE occurs when fluid accumulates in the lungs due to rapid altitude ascent or ascent accompanied by strenuous exercise. Untreated HAPE may result in death approximately 50% of the time.

PREVENTION & TREATMENT

Prevention of high-altitude illnesses involve acclimatization before exposure, slow ascent, and appropriate pharmaceuticals for the corresponding illness. For mild AMS, take a rest day or descend 500 to 1000 m if there is no improvement in symptoms. For severe AMS, descend immediately and use supplemental oxygen at 2 to 4 L per minute. A hyperbaric may also be used for severe AMS. AMS may be treated with NSAIDs or acetazolamine. For severe AMS, use an appropriate dosage of dexamethasone.

Descend immediately if symptoms of HACE or HAPE are experienced. Use supplemental oxygen at 2 to 4 L per minute or a hyperbaric bag. Consider dexamethasone for HACE and nifedipine for HAPE. Consult a physician for more information on which drugs to use.

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

How to Prepare for a Competition Abroad

Preparing for a competition in another country takes weeks in advance to properly adapt the body to new environmental conditions. There are a number of aspects to consider when travelling abroad such as the climate, elevation, pollution, accommodations, food, water, vaccinations, and emergency plans.

Jet Lag

Jet lag is when the body cannot adapt rapidly enough to a time zone change. This results in fatigue, poor sleep and performance. There are a multiple factors affecting jet lag such as the number and direction of time zones crossed, age, individual health, dehydration, stress, alcohol, and excessive food intake. It is estimated to take approximately one day per time zone crossed to re-synchronize the body. It is recommended to spend time outdoors once you arrive at destination to help adjust the sleep/wake schedule. To prevent jet lag, slowly adjust your sleep schedule a few days before travel and maintain adequate levels of hydration and nutrition.

Nutrition

Travelling in another country entails eating a wide variety of exotic foods. Avoid risk of food contamination by avoiding tap water with ice, peeled fruits, shellfish, and buffet style meals. Bring a water filter or water purification tablets. It is recommended to eat foods that are similar to the foods you would eat at home. Scout potential restaurants nearby and determine what to items to pack if necessary.

Avoid high-fiber foods before competition and limit fat as well as protein intake prior to activity. Consume carbohydrates such as bread, rice, or pasta prior to competition. Eat a large meal at least 3 to 4 hours before the competition to allow for adequate digestion. A small snack will take approximately 1 hour to be properly digested.

Emergency Plan

Ensure the coaching staff, medical aids, and/or you yourself are familiar with the medical personnel at the facilities as well as the ambulance and emergency procedures. Apply for the appropriate travel insurance. Remember to pack any required medications and a small first-aid kit. For any acute sprains, immediately rest, apply ice, compress, and elevate the injured part. This is known as the R.I.C.E. method.

Climate

For colder environments, wear layers of clothing with the innermost layer being made out of lightweight polyester or polypropylene, the middle layer made out of polyester fleece or wool, and the outer layer as protection from the wind or rain. Use clothing vents and adjust insulation to reduce sweat accumulation. Only wear the outer layer if it is windy or rainy.

For warmer environments, wear breathable, lightweight materials and protect yourself from the sun with proper coverage by wearing a hat, sunglasses, long sleeves or a thin jacket. Bring sunscreen and proper footwear.

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

Which is Better for an Injury: Ice or Heat?

Ever wondered whether to use ice or heat for your sore muscles, your healing fracture, or any injury? Both ice and heat have been commonly used to treat an array of injuries, but when to use either one is critical in preventing further damage and promoting faster recovery.

Acute irritation or inflammation of a muscle, ligament, or tendon is typically treated with ice. The cold application reduces inflammation and numbs the pain, especially when the superficial tissues are red, hot, and swollen. The inflammatory response associated with damage to tissues is a defence mechanism in the human body that lasts for the first several days to protect against infection. The response involves immediate changes to blood flow, increased permeability of blood vessels, and flow of white blood cells to the affected site.

ICE APPLICATION

Ice can be used for gout flare-ups, headaches, sprains, and strains. It is crucial to apply ice to the site of injury during the first 48 hours post-injury to minimize swelling. For soft tissue injuries such as muscle strains or ligament sprains, an ice massage involving elevation of the injured body part above the heart and circular movement of an ice pack around the affected area may promote faster recovery of these acute injuries. Apply for 10 minutes at a time, then take a break from icing for another 10 minutes. Repeat this process 3 to 5 times a day. Remember to wrap the ice pack in a dry cloth or towel.

HEAT APPLICATION

Heat can also be used for headaches, sprains, and strains as well as arthritis or tendinosis. Heat causes blood vessels to dilate which increases blood flow and relaxes tight or stiff muscles and joints. Do not use heat during the initial inflammatory response as this will further aggravate the site of injury. For minor injuries, applying heat for 15 to 20 minutes at a time may be sufficient to relieve tension. However, longer periods of heat application such as 30 minutes to an hour may be required for major chronic injuries. Hot baths, steamed towels, or moist heating packs can be used as different heat options.

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

How to Prevent Elbow Injuries in Young Throwers

Recent research has shown that nearly 40% of 7 to 18 year old baseball players endure elbow and shoulder pain during their baseball season. Nearly half of these injured players report their ongoing participation despite having pain. A recent epidemiological study of ulnar collateral ligament (UCL) injuries in athletes 17 to 20 years old reported the number of UCL reconstructions has increased dramatically for this age group. Early education and detection of elbow injuries in throwing sports may help reduce the number of overuse injuries from developing.

Symptoms

“Little league elbow,” or known as medial epicondyle apophysitis, is most commonly found in young throwers. Sports such as baseball, softball, tennis, or golf, can result in this overuse injury to the growth plate on the inside of the elbow. Repeated stress to the growth plates may cause inflammation and lead to pain or swelling. Serious injury may even result in separation of the growth plate from the rest of the bone. Players may also experience a reduced range of motion and a decreased ability to throw hard or far. A child experiencing any symptoms involving their arm should cease activity and see a pediatric specialist or their family physician. X-rays may be required to determine the extent of damage.

Prevention

Prevention begins with identifying causative factors early in the season and adhering to strict guidelines such as the pitch count for young players and the duration of participation in a given year. Total body conditioning that involves strengthening the hip, back, and legs may help reduce the strain on the athlete’s arms. See below for exercises on how to stretch and strengthen the forearm.

Playing in a variety of sports rather than engaging in one particular sport, known as early sports specialization, may promote athletic dexterity and minimize risk of overuse injury.

Treatment

Partial UCL ruptures can be successfully treated with nonsurgical treatment. However, with or without surgery, players must cease any throwing activity prior to undergoing an organized throwing rehabilitation protocol to reduce the risk of further progressing the injury. Promoting mental health is also important in the young athlete’s recovery period. Preventing the athlete from participating in their sport may result in significant psychosocial trauma. Therefore, special attention to the athlete and feelings of sadness or depression should be addressed with coping strategies.
Watch the video below on how to perform “nerve flossing” for chronic neck, shoulder, elbow pain or stiffness:

Watch the video below on how to warm up properly before games or training to prevent injuries and perform better:


References:
https://www.breakthroughpt.com/wp-content/uploads/2018/05/Reducing-Elbow-Injuries_jospt.2018.0607.pdf

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.

Traumatic Brain Injuries

Catastrophic traumatic brain injuries, including hematomas and cerebral edema, are the second most common cause of fatalities in football players and can occur in many other contact sports. When there is severe contact with the head, the brain swells and blood pools to increase the intracranial pressure. If treatment is delayed, displacement of the brainstem, known as a herniation, or respiratory arrest can occur. 

Types of Brain Injuries:

Diffuse cerebral edema, or second impact syndrome, primarily occurs in children when the athlete suffering post-concussive symptoms following a head injury returns to play and sustains a second head injury.
Skull fractures, although not always visible, can arise from a head impact. Skull fractures can cause swelling and tenderness, bruising around the face, and bleeding from the nose or ears. All skull fractures should be treated by a physician.
Intracranial hemorrhage is a pathological accumulation of blood within the skull activity and occur in different regions of the brain. An epidural hematoma occurs when the middle meningeal artery, located by the ear, ruptures due to a direct blow to the head. Blood then pools between the skull and the dura mater, a protective membrane that envelops the brain. The onset of symptoms are rapid and emerge within a few hours. The athlete may initially have a period of lucidity, but a decline in functioning is seen 2-3 hours later. 

Another type of hematoma known as a subdural hematoma is more commonly seen in adults over 45 years old and is associated with a tear in the bridging veins of the brain due to serious head trauma. Symptoms may include nausea, headache, or vomiting.  

Common Symptoms:

Common symptoms include: visible wounds, fractures, swelling, facial bruising, altered state of consciousness,  bleeding, stiff neck

Treatment and Prevention:

If any traumatic brain injury is suspected, then treat as a medical emergency and call 911. Refer the athlete for a CT or MRI scan to confirm bleeding.

Helmets are key in preventing catastrophic head injuries and reducing the severity of concussions. Athletes and coaching staff should be educated on the risks and symptoms of concussions or the head injuries discussed above. Proper technique in contact sports may significantly reduce the occurrence of head injuries.

Watch the video below on how to mobilize a stiff neck:

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