Every year, around February, we start to see people who made a new years resolution to get in shape and start running trickle in the physio doors. Most of the time they have simply done too much running, leading to overuse and injury. However, quite often they have little idea about the only piece of equipment you need for running – the shoes on your feet. So here are some basic tips to help you pick a running shoe that will help keep you and your feet happy.

1. Not too tight!
Your feet/toes ‘splay’ out when they hit the ground, and need room in your shoe to do so. You should have about a thumbs width between the end of your big toe and the end of the shoe, and you should be able to wiggle your toes and see them wiggle through the fabric of the shoe.

2. Correct size
Make sure your whole foot fits on the sole of the shoe, and you don’t have the ball of your foot or pinky toe squished in/hanging off. If you have a wider foot, you may have to look into brands that provide wider options (such as ASICS who provide normal, 2E and 4E widths in some shoes).

3. Find the right support
If you have a flatter arch or are a heavier runner, you will probably be better served with a stiffer arch support. You can test the stiffness of the arch support by poking into it with your thumbnail.

Hopefully this goes without saying, but base your decision on the practical aspects of the running shoe, not how they look. Running shoes are a piece of equipment designed for a purpose, and while there is nothing wrong with choosing shoes that you think look awesome, that is not the most important factor when deciding which shoe is right for you. The right shoe will keep you comfortable and help prevent injuries for many kilometres to come!

Lower leg injuries (hamstring and groin strains, ankle sprains and calf strains) are the most frequently occurring injuries in AFL and can keep you off the field for weeks, reducing your game time, fitness and strength while awaiting recovery. The nature of AFL with the sprinting, leaping, weaving and tackling requires a great deal of power, agility and proprioception and as a footy player myself having experienced 2 quad strains in the past year I can personally vouch for the frustration of time off play.

But these injuries are mostly preventable, and lucky for us the world of research has put together a lower limb injury prevention program called Footy First to do the hard work for you. This program, endorsed by AFL medical, physio and sports science associations, has 5 levels of graded exercises over an 18-week period, targeted to challenge balance and control, plyometrics and strength of key muscles. It reduces acute knee injuries by 54%, lower limb injuries by 39% and ankle sprain injuries by 50% in not only AFL but other sports including soccer and basketball.

The program takes around 25mins and is designed to replace a regular warm up before a training session, and only needs some cones, footies and some enthusiasm to implement.

Bring it up with your coach or download a free copy and do it by yourself; reduce your time off the field so you can perform on the field and get the best out of your season!

Jess

1. Slow and steady
If you are starting up a new activity, whether it be the gym, running or competitive ironing, ease into things. Your body needs time to adapt to new stimulus, which means you need to temper your enthusiasm a little. Instead of running every day, for example, give yourself two or three days and stick to those until you have acclimated to this new exercise.

2. Recovery is just as important as exercise
Give yourself a few days off hard exercise each week. Going for a walk, an easy swim or even a simple stretch session and allowing your body a day to recover and repair is just as important as hitting it hard and putting in the effort.

Our physio Chris has recently started running, after doing basically no cardio for the past 10 years. Sitting at a svelte 105kg, it is important for him to manage the amount of running he does to prevent injury.

Currently, he runs twice a week – once for a longer distance (3-5km, walking when a break is needed) and once at a faster pace (4x500m with walking for recovery in-between).

Now, this is not a whole lot of running. But it allows for adequate recovery, and allows room for progression as Chris gets fitter. It is always easier to start easy and ramp up, than start too hard and wind up at the physio.

Most of the time when I aim to teach people to ‘belly breathe’ they say “I want to avoid looking fat so I have learnt to suck my gut in – and now you want me to start pushing my belly out when I breathe?!” Trying to look thinner is one reason why many of us have adopted an altered way of breathing but what other reasons are there?

Stress/anxiety/sedentary lifestyles/poor posture typically causes ‘upper chest’ breathing whereby our upper chest rises and we get a sharp inhale of air that only reaches the tops of our lungs. This is good for times of high stress when we need a sharp increase of oxygen like in a flight or fight response. But, this type of breathing over a long period of time can cause many issues like neck/shoulder pain and pelvic floor weakness. Neck pain patients almost always show some degree of upper chest breathing due to the notion of ‘accessory muscles’ helping to get the air in quicker. These accessory muscles are situated around the front of our neck and will always be quite tender to palpate on upper chest breathers.

So start thinking about adding some diaphragm breathing into your daily routine. Whether that’s in the car, before bed or even at work – take some time out to think about how you’re breathing and you will most likely reduce some anxiety at the same time! Remember: inhale deep/ slow/low and watch your belly push outwards slightly (Not inwards!)

Now, depending on the sport, many individuals will have a coach. Kids playing soccer – coach is there. Tennis? Coach is there. This is great, as hopefully these coaches are experienced and have an eye for technical faults, and how to improve them, as well as a reasonable knowledge of how to properly prepare their athletes for the rigours of their sport.

Often, however, we get individuals presenting to the clinic who have no coach or who have sought no technical guidance. Some examples might be a runner who trains alone, or a retired golfer who has being playing most of their adult life. This has always been a little bit of a mystery to me.

When I do my taxes, I seek professional help. Why? Because they are complex enough that I would do them wrong, and get a hefty smack from the ATO. So for a once a year occurrence, I will happily pay someone who knows what they are doing to help me avoid a penalty (and hopefully get a few dollars back!).

So I wonder, why do people not elect to seek out professional guidance for an activity they do multiple times per week? Many people take their training / sport of choice very seriously, and dedicate a significant number of hours to their ‘craft’. A session with a running coach once a month would make an astronomical difference to your training, and your injury risk. Ditto for a golf swing coach, or a strength coach, or a swimming coach.

I’m not saying this will prevent any and all injuries – that would be absurd. However, it will help you identify many issues before they have a chance to injure you and take valuable time away from what you want to be doing – being active!

One of the ways we can correct our sitting posture is by using a back support or lumbar roll. These supports aim to encourage the correct alignment of the spine. Most commonly we tend to slouch through our lower back causing the natural curve in the lower back to flatten. The picture below gives a good visual of that (and I bet it’s all too familiar!).

The picture below shows how a lumbar support for your office chair or car seat can really help maintain the natural lumbar curve and prevent you from slouching. This can not only help alleviate lower back pain but also mid/upper back pain.

There are quite a few different options of lumbar rolls/back supports out there. We have some different options in the clinic for you to try, so why not give us a call or make an appointment to get yourself assessed and work out which type is best for you.

That’s a lot of sitting!

Our bodies are designed to move, and are very good at adapting to what you ask them to do. Just look at a sprinter verses a marathon runner – it’s easy to see that their bodies have adapted to what they do. The sprinter holds more muscle mass, because for the most part they will be running for around 10-15 seconds at an all out effort. The marathon runner is much more slender, because all that extra muscle is a handicap when you need to run for hours at a time.

Just like our Olympic examples, your body adapts to its daily tasks. If we are sitting all the time, guess what? Your body is going to structure itself to sit!

Your hamstrings will get tight / short (if your knee is always bent, they don’t need to be that long).
Your glutes will get weaker, and in some cases not activate at all (you don’t spend much time on your feet, they aren’t needed).
Your pecs will get tighter and pull on your shoulders due to long stretches at the computer desk.
Your upper back muscles will get weak and tight because when you slouch, they are put in a poor position to do their job.
Your lower back will get sore because your core and glutes no longer have the strength to properly support your spine.

At some point, these adaptations will usually lead to some pain. It might be neck pain, shoulder pain, back pain… it’s different for everyone. But it’s important to realise that the problem is one of movement and posture, not necessarily injury. This is why a big part of physiotherapy is providing homework – exercises to get you moving, and strengthen these weak areas.

So with Spring having sprung, get out there and move! Dust off the bicycle, get out for some walks/runs, hit the gym or the pool or the hiking trails. A teaspoon of prevention is better than a pound of cure

Prevention:  We all know that prevention is better than cure. And because osteoporosis cannot be cured, it’s imperative that we all aim to prevent its onset. The best way to do this is through a diet rich in calcium and Vit D and strength exercise during childhood and adolescent years.  This will help to prevent bone loss later in life.

What type of exercise:

1. Weight-bearing exercise – This simply means exercise in which you are putting load through your bones by standing. Examples of this can be ball sports, brisk walking, skipping, aerobics, dancing, gymnastics, tennis etc.

2. Progressive strength training – This is exercise done with weights and means that over time you will build upon your muscle strength, thus creating a healthy force through to your bones. The weights can be dumbbells, barbells, ankle strap weights, kettlebells, medicine balls – the list goes on! The key here is that the weight being lifted should be progressive, meaning don’t keep lifting the same weight for years.  As your strength improves, gradually increase the weight being lifted.

How often: Research currently states that some form of strength or weight-bearing exercise should be done at least 3 days a week in order to get the benefit for your bone health.

So if you need help with devising a strength or weight-bearing exercise program, call us to make an appointment today!

Sara

Firstly, let’s bust the myth that bunions are hereditary. Contrary to popular belief, bunions are not related to genetics. They are not attributed to inheriting poor bone structure and should not be treated with surgery (most of the time!).

In most cases there is an external reason for the production of a bunion, and it is most likely what you are wearing on your feet! So let’s talk about footwear and bunion prevention.

Human feet are naturally widest at the ends of the toes – not at the balls of the feet. Look at the feet of a baby, their toe region is always wider than the rest of the foot. BUT most modern footwear is manufactured to be widest at the balls of the feet, which causes the toes to be pushed inwards. This is why if you look down at your feet now perhaps your toes look squashed inwards and cramped? Your toes are not designed to be that way however footwear has caused this to happen over time. Most commonly the big toe is the one to suffer and can look like the picture below on the right. For our patients who are dancers – have a think about how your pointe shoes may be causing this to happen as well.

So what are some things you can do to manage and prevent bunions forming?

1. Only wear shoes that are wider at the toe box (and not just the balls of the feet). If you are finding it difficult to locate shoes like this talk to your physio about some options.
2. Use tape or orthosis to help correct the big toe alignment. My current favourite is the “Correct Toes” orthosis which can help correct alignment, strengthen the foot and restore function.  We can also use K tape or Rocktape to correct the alignment.

One of the questions we ask when taking a patients history is about what they do for exercise. Personally, I will ask for a typical week – do you go to the gym 3x and run 2x? Play soccer on the weekend? We do this for a few reasons, some of which include:

1. Find out if your injury is potentially related to these activities
2. Find out if your injury is potentially related to not doing anything

Number two seems a little confusing, yes? Well, your body is very good at adapting to what you ask of it. If you have an office job, you aren’t asking very much. Most of the time you’re sitting down (probably with average posture), and the majority of the movement required will be at the neck (to look at your screen/coworkers) and your wrists (to type/use a mouse).

If you’re work week is 50 hours, you commute an hour or two each day, and your only exercise is walking – you simply aren’t going to challenge your body in any significant way. This leads to weakness – your core muscles and glutes will weaken, increasing the risk of back pain and injury. Your upper back will adapt to slouching, leading to neck pain, headaches and shoulder pain.

Walking can’t fix those things. It does not ask enough of your physical capabilities to cause positive adaptions. Put another way – there are plenty of unfit, weak individuals who are perfectly capable of walking.

So what will? Strength training, rock climbing, kayaking, pilates, gymnastics… the list is endless. Find something that legitimately challenges you, that you enjoy or can at least tolerate, and commit to doing it a few times a week. You could do rock climbing Wednesday, and hit the gym Monday/Friday – there are no rules to this.

Three months later, your body will thank you. You may still be sore – but it will be sore from using muscles you haven’t used in a while, not from sitting at a desk all day!