The sciatic nerve is the longest nerve in the human body, so it should be no surprise that sciatica is one of the most common issues seen to by musculoskeletal physiotherapists. Sciatica is the Latin word for “Pain down the back of the leg” but could really be described as more of a pain in the butt, hip, hamstring or lower back. The most common cause of pain in the sciatic nerve distribution (which I shall call sciatica for this article) is compression of the sciatic nerve. It’s a tricky one as sciatica can manifest itself in many ways, none of them painless. Because the sciatic nerve runs through so many major parts of the body, it is common to see sciatica misdiagnosed as other localised ailments, meaning a longer recovery time and no shortage of pain. Sciatica pain can cause a range of pain types from short and sharp, to infrequent and dull to debilitating.
Signs you may have sciatica
- The pain usually only affects one side of the body
- Pain radiates through the lower back to buttocks and down your leg
- The pain is worse when sitting or remaining still
- There is burning, tingling or weakness in the leg on the affected side
- Light exercise (such as walking) may ease the symptoms
The good news is that sciatica is very treatable, and your local musculoskeletal physiotherapist is perfectly positioned to diagnose and treat your pain. While it’s relatively easy to diagnose the sciatica itself, usually there is an underlying cause from a different origin point. The following steps can help to keep some of the pain at bay, and rehabilitate the area so you can stay pain free longer.
- Sit less
Get off your butt! It might seem counterproductive when you have a sharp pain in your buttocks and leg to get up and walk around, but that’s exactly what you should be doing. Sitting for too long, such as at a desk or on the couch watching the cricket can cause your hip flexors to tighten up which is going to cause you even more pain. Set yourself a timer and stand up every 30-60 minutes, go for a walk and make a joke about Monday being a real pain in the butt.
- Take a dip in the pool
Apart from offering a place to escape the scorching heat, the pool is the perfect place to ditch sciatica. Once you’re feeling up to it, swimming slow and relaxed laps is a great way of easing pain, nerve spasms and relaxing the stiff muscles surrounding the painful area.
- Get a massage
Not just any massage, you need a physio skilled in the treatment of the pelvis and lumbar spine to give you a good working over. A titled musculoskeletal physiotherapist will be able to identify the root causes of your nerve pain and give you a massage that stimulates circulation through the affected area and helps to relax any muscle spasms.
- Strengthen your gluts
Strengthening the gluteal muscles (yes – the gluteus maximus is your big butt muscle!) is a great way to help prevent flare ups in the future. Many issues that affect the back and cause constant pain can be relieved by strengthening the hips and the core. Don’t go pumping out thousands of deadlifts, squats and crunches while you’re still in the primary phase of pain though, as that’s only going to hurt you more. Your local Dee Why physio will be able to conduct a full examination of your body and movements to give you the best core exercises for your body type and condition.
While you work with your physio to strengthen your core, increasing flexibility through your hips and lower back will be a key factor in keeping sciatica away. Muscular tension is a key trigger for sciatic pain, and having a daily routine of stretches will help build the resilience of your muscles, release the tension and prevent recurrence. Speak to your physio about the benefits of functional training on your body and the ways it can be used to strengthen the vulnerable areas of your body and protect them from everyday movements that cause pain. Clinical Pilates is also a proven avenue for painful conditions that affect the lower back and body, it’s certainly not just for middle aged mums and Instagram models!
WORD OF WARNING! Don’t sit on your sciatica pain! If left to its own devices, sciatica may go away on its own. Yet on the other hand, if left to it’s own devices the sheath of protective coating around the nerves (think of the plastic coating that is around all power cords) may whither away and die. It is much easier for us physios to fix a problem that has been there for a few weeks than a few months!
Get in contact with your local Fixio Northern Beaches physio and arrange an in depth treatment plan if you are experiencing sciatic pain, don’t let it restrict you from doing the things you love.
Each year thousands of Australians suffer a work related injury that either causes them to miss time at work or diminishes their ability to carry out their role effectively. Safe Work Australia estimates that these injuries cost roughly $60 billion to the Australian economy. Now that’s a lot of sick days (not to mention the sickies you chuck when the surf is up…) Not only that, but the way you carry out your job could be causing ongoing damage to your body that will eventually become painful, without you even knowing it. When most people think of workplace injuries, they think of one off accidents or injuries caused by repetition at physically demanding jobs. This couldn’t be further from the truth. With more people than ever working physically inactive jobs, many workplace injuries and illnesses are a result of poor posture, repetitive awkward movements and failing to identify aches and pains correctly to begin with.
With these tips you will be able to identify common workplace injuries and overuse problems, put in place proactive structures to avoid them and know when to see your local physio for further treatment.
Redesign your desk space
You’ve probably heard the term ‘ergonomic’ thrown around a lot in the last few years. There’s ergonomic keyboards, mouse pads, chairs, desks, pens, pencils, cups, water bottles, scissors and I bet somewhere somebody is trying to market ergonomic toilet paper to someone. Australians spend millions of dollars a year on ergonomically designed products that have no scientific facts behind them. Yep, you read that right. Most products are baloney. At its core, ergonomics is the study of how humans fit into their work environment. No fancy ergonomic pencils required. In fact, the most effective and proven ergonomic changes to your workspace don’t involve any new products at all. While people tend to focus on the type of chair they have, they tend to overlook how they hold their bodies while performing their work. For example, correcting your trunk position (or the position you end up in within that fancy chair), sitting with your body closer to your desk, having relaxed and symmetrical shoulders and feet flat on the ground can make a positive difference to your workspace. Try a few different positions for your most used items focusing on those principles and you’ll find that sore neck may just disappear.
Lift with your head (not literally)
About 30% of all workplace injuries are caused by manual handling tasks. Manual handling includes anything that involves lifting, pushing, pulling, holding, restraining, throwing and carrying. Manual handling related injuries can be minimised by a thorough and effective assessment of the risks. I know it’s easy to ‘just do it’ when it comes to the work, but that is often a sure-fire way to end up injured. Ensure you fully evaluate the layout of the workspace, the location of the item, the weight of the item, the duration and frequency of the tasks and try to streamline as much of the process as you can. Ask yourself ‘does it have to be done this way?’ Just because heavy boxes have always been delivered onto a high counter top for distribution does not mean that’s the best way to do it. Using mechanical aides such as forklifts, conveyor belts and wheelbarrows may be a better alternative. The importance of training how to do the task properly can’t be overstated. Inexperienced workers are much more likely to suffer a manual handling injury than well trained workers.
Recreate the work tasks for your physio to observe
It can be difficult for your local physio to get an accurate idea of exactly how a movement is being performed and under what conditions. As a musculoskeletal physiotherapist I regularly observe, evaluate and recommend alterations to the techniques of sportspeople who carry out a range of repetitive and awkward movements. Why should work tasks be any different? If you can’t start ‘a bring your physio to work day’, take some photos of your work area, or have someone take photos or video of you performing your regular duties in a work environment. This will allow your physiotherapist to evaluate your body movements, work area and advise of any possible changes that could be made. Plus, you’ll be able to feel like a professional sportsperson having your movements evaluated and corrected for optimal health and wellbeing. But seriously, if you work in a pub and want to bring your physio to work… I’m down!
Work doesn’t have to be one of the biggest causes of injury to Australians. Many injuries can be reduced or removed through simple alterations to your environment and being more aware of how you hold your body. A musculoskeletal therapist is perfectly trained to make these observations and give you the personalised tips to be able to go home every day happy and healthy. Without any of the gimmicks.
In just over two weeks time, the Sydney Morning Herald Sun Run & Cole Classic kicks off again just across the road from your friendly neighbourhood Dee Why Physio. Let’s hope the Northern Beaches has a little less in common with the surface of the sun by then. Started in 1983 at Bondi Beach by the keen ocean swimmer, Graham Cole after returning from competing in Hawaii at the Waikiki Roughwater, the event has grown into a weekend starting with a 10km run. With its roots heavily invested in the belief that anyone could train and challenge themselves with dedication to swim a reasonable distance through the surf, the Cole Classic swim rewards each finisher with a memento of their achievement.
Today the event is also a huge contributor to fundraising for a host of charitable causes such as, Kids Cancer Project, Cure Brain Cancer Foundation and Beyond Blue. As of today they have raised $65,000 of their target of $200,000 for 1100 different charities! Congrats guys and gals!!
Over to you. Hopefully you’re putting the final touches on your training regime and preparing yourself for the races, physically and mentally. But, I won’t judge if you’ve left your prep a little late… Being a Northern Beaches physio, I’ve seen it all when it comes to preparations and mis-preparations for runs, swims and everything in between. Don’t get caught out by failing to prepare, especially when extreme heat is involved. Follow these tips below to help prepare, and make sure your Sun Run is a fun run without any sink in your swim.
10 kilometres isn’t that far when you think about it
Ideally you want 12 weeks to prepare for a 10km run, but if you’ve only got 2 weeks… well damn, that’ll do! I know what you’re thinking: “how can I pack 12 weeks’ worth of training into two”? The answer is… don’t. No seriously, ask my cousin who decided to run a marathon without any prep. He was cactus for months afterwards. Going hell for leather is a quick way to end up with all kinds of overtraining injuries that you’d be on your way to your musculoskeletal physiotherapist to sort out. To avoid being fatigued and sore on the day of the run, don’t do any more than a handful of full length runs at race pace. Ease into your longer runs and focus on your breathing, technique and intervals of race pace running without overdoing it.
Undergo a biomechanical assessment with your physio
This is doubly important if you are starting from relative scratch. Having a musculoskeletal physiotherapist go through your body’s movements in depth will pick up on any areas of weakness that may indicate an injury is more likely. A further benefit of undergoing an assessment with your physio is that they will be able to assess your running and swimming style to help you get the most efficiency out of each movement.
Time to taper
If you’re not part of the “how can I prepare for a 10km race in 2 weeks” crew, it’s time to taper off from all that awesome training you’ve been doing. As a general rule runners should look to decrease their workload by 30-50% in the last 7 days before a race. Avoid throwing in any crazy new exercises to your routine too. If you haven’t been taking jazzercise classes and doing Romanian deadlifts daily, now is not the time to start. Don’t stop moving altogether though, keep up the light runs and stretching to keep your body active and moving.
Break up your training swim distances
You don’t need to swim 5km every training session. In fact, swimming this distance a few times in the safe environment of a pool will likely be all the confidence you will need to know in yourself that you can swim that distance on the day. Swimming 5km can be boring and repetitive, not to mention a great way to cause yourself a rotator cuff injury if you’re not used to it. Break up your training swims into more manageable pieces; a 1km swim session can be completed in 10x100m, 5x200m, 500m+200m+200m+100m… you get my drift.
Use the RICER method if you are feeling some soreness post race
Rest properly, but please resist the temptation to down too many celebratory alcoholic beverages. If you must go out, keep hydrating, don’t party too hard because you need to let your body recover.
Ice – this will help constrict the blood flow to sore areas and help to reduce inflammation and soreness. If you feel up to it, you can always take an ice bath.
Compression of the legs and arms will help flush out the lactic acid that has accumulated. Wearing compression gear will work great for this. Pairing compression and icing will ensure they work symbiotically and will shorten your recovery period.
Elevate your legs as you lie in bed thinking about how accomplished you feel.
Referral to your local sports injury expert if the soreness is over 5/10 or if the pain last more than 3 days (hint: you are on their website 😉)
The main thing is to make sure that you are comfortable, confident and prepared for whichever race you are participating in. Seeking the advice of a Dee Why physio with expert knowledge in preparation and recovery for these types of events is the best way to make sure you’re going in full armed with everything you need to crush your goals on race day.
Going by name alone, you wouldn’t expect to see Tennis Elbow too far from centre court. But the reality is that lateral epicondylitis is currently causing thousands of painters, plumbers, carpenters and computer programmers alike plenty of pain and discomfort around the country. In fact, only 5% of tennis elbow cases are actually linked directly to tennis, most new cases are due to heavy computer use. Talk about false advertising! Maybe it should be renamed for the 21st Century – Computer Elbow. Tennis elbow is one of the most common overuse injuries seen by musculoskeletal and sports physiotherapists. With many cases leading to joint compression, nerve inflammation, increased stress on the arm and pain when gripping and lifting things … due only to not getting it treated earlier!
Tennis Elbow pain is commonly focused where the forearm meets the elbow joint on the outside of the arm (not to be confused with Golfer’s Elbow which normally affects the inside of the arm). Excessive use of wrist extensors (those muscles that work all day when you have your hand on your mouse or raised keyboard) and forearm supinators can cause small tears to develop on the elbow end of the extensor carpi radialis brevis (ECRB) muscle. When this pain first starts to occur is when your local physio should hear about it, but the reality is that many people just grin and bear the pain, only causing more problems in the long run. With these tips you will be able to help stave off tennis elbow or cut down the length and intensity of your pain considerably.
Stop and recover
If you are currently experiencing pain, holding an ice pack (please wrap it in a chux or a towel… ice burns are awkward to explain!) against your sore elbow for a few minutes several times a day can help ease it. Tendons calm down slowly. Tennis elbow can last from anywhere between weeks and years, depending on how you manage it. The simplest way to recover from tennis elbow is to cut back on the movement/s causing it. This can be hard for those of you who perform this movement every day for work. You may need to modify your movements, focusing on using other muscle groups effectively. Tennis elbow CAN (though rarely) get better without treatment. Rarely! If you are at the point where your elbow has been experiencing ongoing pain, in the long term you statistically have a longer recovery period and more chance of recurrence than someone who undergoes a physiotherapy rehabilitation program. A musculoskeletal physiotherapist has expert knowledge on recovery and prevention methods.
Have a coach or physio check out your form
For the 5% who do get their tennis elbow on the court, having your coach or a local sports physiotherapist with a tennis background observe and critique your technique and movements could help reduce the strain on your tendons. Incorrect technique can unequally distribute the power in the swing of a racquet to rotate through and around your wrist; creating a movement through the wrist instead of the elbow joint or shoulder. This can increase pressure on the tendon and cause irritation and inflammation, leading to tennis elbow. A sports physio will be able to observe these movements and offer advice on how to make adjustments to minimise this strain. Another simple thing to check is the size of your grip. Those playing with a fat overgrip are at a higher likelihood of developing elbow pain!
Make ergonomic adjustments to your workspace
If you are a heavy computer user, making some adjustments to your computer workstation may be all you need to kick the dreaded “computer elbow”. Keyboards are a large contributor to these issues, with many people raising the back of the keyboard so that it slopes downwards. Doing so cocks your wrists into an extension; causing the extensor muscles of your forearm to contract, extra pressure on your wrists and fast-tracking your way to pain. A gel pad is a good defender against this problem for both the keyboard and mouse, as is a comfortable chair with an ergonomic design.
Stretching and strengthening exercises
Musculoskeletal physiotherapists recommend and will take you through a number of stretches and strengthening exercises designed to help prevent a recurrence of pain. An effective stretch involves simply extending the painful arm with your palm down, bending your wrist so your fingers point toward the floor, with the other hand pull your fingers back toward your body. You will feel the stretch along the outside of your forearm. 30 seconds on. Rinse and repeat. Strengthening the wrist with a simple home exercise known as the ‘towel twist’ is also an effective preventative measure. Hold a loosely rolled-up towel with one hand at each end, twist the towel by moving your hands in opposite directions like you’re wringing out water. Give it 10 good twists holding for a few seconds in one direction and then 10 in the other.
Your Dee Why physio will ask you a number of questions on your first visit, try to note:
- When your symptoms began
- If any motion or activity makes the pain better or worse
- Any recent direct injuries
- What medications or supplements you take
This allows us to help build a profile of the injury and lets us get stuck into creating your personalised recovery program. If any of the above sounded like you, click the buttons above to book an appointment or just give us a call!
 Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Nynke Smidt, Daniëlle A W M van der Windt, Willem J J Assendelft, Walter L J M Devillé, Ingeborg B C Korthals-de Bos, Lex M Bouter – “At longterm follow-up, our findings suggest that physiotherapy becomes the best option, followed by a wait-and-see policy.”
The festive season is well and truly in full swing. The holidays have arrived, the decorations are hung, roasts are being roasted, backyard cricket pitches are receiving final preparations and Santa is double checking his naughty or nice list. But around Australia Physiotherapists and other health professionals are holding their collective breaths; for the Christmas break is a time when Aussies like to push their bodies to the limit. We’re not just talking about a tummy ache from too much Christmas pudding, or stepping on some brand new Lego either. Statistics show that hospital admissions increase by at least 10% during the Christmas period as more people engage in biking, swimming, surfing and trampolining with the old grog consumption related injuries skyrocketing too. My favourite medical acronym gets written on every second xray at this time of year: PAFO – “pissed and fell-over”! Preventing injuries and accidents is essential to getting the most enjoyment out of this holiday season and avoiding a nasty trip to the hospital or limping into your physiotherapist’s office in the New Year.
Rule number 1: DON’T GET SLACK WITH YOUR INJURY MANAGEMENT ROUTINE
We know it’s been a long year and you deserve some rest and relaxation, but if you have a regular routine of exercises or stretches to manage an ongoing condition, continue over the holiday period. Every January Northern Beaches physiotherapists see an increase in people with injury “flare-ups” due to taking a rest from their injury management routine.
Rule 2: Ease into your New Year resolutions
If you went to the gym twice in 2018, please don’t start 2019 with a 20km beach run unless you keep running directly into the waiting room of your Dee Why physio clinic! Some of the most common injuries physios see in January are New Year resolution related. There’s no reason to jump right into the deep end and risk yourself an injury. Physios recommend preparing your body with daily walks progressing in difficulty, ocean swimming and bodyweight exercises if you are just getting started.
On the flipside, if you regularly play sports and stop training over the Christmas holidays, it is natural for your body to lose some strength and physical conditioning. This can lead to a higher risk of sports related injuries if you return with full gusto straight away. Us musculoskeletal physiotherapists recommend easing your way back in after the break and focus on warming up effectively and stretching before returning to full work in order to avoid the sprains, strains and tears associated with too much too soon.
Rule 3: Be aware of your alcohol consumption
Not only is alcohol one of the leading causes of Boxing Day regret syndrome, it is also the prime reason many people suffer physical injury during the Christmas holidays. A 2018 study by Monash University analysed a number of Emergency rooms in Australia and New Zealand and identified that 9.5% of admissions to the ER came as a result of alcohol related shenanigans. It’s important to keep up water consumption with alcohol to avoid headaches and excessively painful hangovers. Alcohol, dehydration and excessive Aussie sun exposure is a quick trip to a very unpleasant couple of days. Cue the Australia Day memories from 2018. Many injuries are caused by accidents from people being overconfident on shiny new Xmas toys (not always their own). We know the trampoline looks fun, but if you haven’t backflipped in 20 years, it probably isn’t best to try after a few frothies.
Rule 4: Beware the holiday sports injuries
Don’t be afraid to run through a few stretches before bowling your first over of backyard cricket or kicking the first footy in the annual family football derby. The summer holidays are a great time for water and racquet based sports, but activities like swimming, surfing, tennis, and beach volleyball rely on the strength of the shoulder and are highly injurable without proper warming up or conditioning.
A common injury musculoskeletal physiotherapists see is ‘subacromial bursitis’ – causing severe pain when lifting or moving the arm, loss of strength which always takes a few weeks to return to painless function with the right guidance. Not the best start to the New Year. If your shoulder starts to hurt playing tennis or volleyball, try to stop overhead serving and keep your shots below parallel to the ground. Ice it up and restrict movement for the next few days if things get sore. If it’s still sore 3 days later you need to go and see someone.
….And the injuries due to inactivity
Believe it or not, musculoskeletal physiotherapists see an increase in lower back pain this time of year. People stop their gym routines and settle in for long movie marathons or sports binges on the couch for days on end in an attempt to decompress from the stress of a long year. Sitting in a slumped position for long periods of time puts increased pressure on our lower backs, putting you at increased risk of low back pain. Our bodies aren’t made to be sitting for too long! Get up and move about for at least two minutes every 20-30 minutes, if you’re driving long distances make sure to stop every two hours and walk around. Changing your posture regularly has been shown improve comfort and reduce the risk of musculoskeletal injuries.
Merry Christmas and Happy New Year from the Beaches Sports Physio team and remember that the best Christmas present you can get yourself and family is your health.