Thursday, 5 July 2012
The forces march is a demanding five-day
event where athletes complete at least a marathon distance a day! This is an
event that Revolution Sports Injuries Clinic supports every year and provides
graduate sports therapists to offer injury diagnosis and treatment as well as
sports massage. This year the event was made even more difficult by the heat wave
that Britain experienced at the end of May. Never the less the event was yet
again, a great success!
What
is the Veterans Charity?
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| The Sports Therapy team for the forces march 2012 |
The Veterans Charity
focuses on providing direct support in the form of
what we call 'modest provisions', anything from a wheelchair, mattress or
bath-lift to everyday items like TVs, microwaves, clothing and food
and even bicycles.
We have helped many Veterans to get
the things that we often take for granted but, when provided quickly, can
make a real difference to how they live. For many former service personnel, it
can be difficult to make ends meet and to cope with the pressures of life. The
Veterans Charity has helped to make life better for those who have served our
country and now need our help. We have also provided advice to Veterans who
simply don’t know which way to turn next and need some guidance.
We at Revolution Sports Injuries
Clinic are looking forward to The Forces March 2013!
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| A well deserved beer and an ice bath for some of the runners after completing the whole five day event! |
For information about Revolution Sports Injuries Clinic go to:
If you are interested in entering the Forces March 2013 go to:
Thursday, 14 June 2012
The past month has very busy at our clinic as well as summer events that we are involved with. Not only are our staff now trained to use Dry Needling in our clinic, which involved some intensive training with a great training provider called Club Physio but we have been out in the field working with athletes at events such as The Forces March which is 5 marathon distances over 5 days. We also have a ex patient and athlete who's charity is supported by Revolution Sports Injuries Clinic currently cycling across the USA for a charity called Sea2Sea. More on these great events and athletes in my later blogs. This month's article is going to look at the major
muscles of the core, the principals of how the core works and the forces that
are exerted on the structures around it.
The Muscles:
The local stabilizing muscles:
- Transverse abdominis (TVA)
- Multifidis
- Diaphragm
- Muscles of the pelvic floor
We will be focusing on the TVA and Multifidus muscles as they are
specifically related to posture and the imbalances can be easily be detected.
This is the deepest abdominal muscle. Its origins are the iliac crest, inguinal
ligament, lumbar fascia and cartilages of the inferior 6 ribs. It inserts on to
the xiphoid process, linea alba and pubis.
This muscle is the bodies natural weight belt and is responsible for
drawing in the abdominal wall. This muscle is key to the stabilization of the
core. Richardson et al. (1999) found people without back pain TVA fired
30milliseconds prior to shoulder movement and 110 milliseconds prior to leg
movement. This shows that the TVA has a feed-forward role and activates prior
to limb movement stopping the spine from being exposed to vulnerable forces.
Multifidus
This is the largest and most medial of all the lumbar muscles. It
fibers are centered on each of the spinous processes, from here fibers radiate
inferiorly to the transverse processes of the vertebra 2,3,4 or 5 levels below.
Multifidus is key in the production of extension forces, which are
essential in the stabilization of the lumbar spine during flexion as well as combating
shear forces that maybe applied.
Richards et al. (1999) identified that the TVA and Multifidus muscles
are vital stabilizers to the lumbar spine and dysfunction can lead to injury.
This is due to the fact that both attach with the thoracolumbar fascia to
create a cradle to protect the back from injury.
The Global stabilizing muscles:
- Rectus abdominis
- Internal and external oblique’s
- Quadratus Lumborum
These muscles are responsible for the movement of the core.
If you can imagine, when the core works in harmony your local
stabilizing muscles fire prior to limb movement and stabilize the spine then
the global stabilizers fire to provide movement of the whole torso.
It is due to this system that athletes and coaches talk about the
importance of the core. All movements whether it be kicking, running, throwing,
tackling, skiing or skating utilizes the core to develop power as well as to
provide balance.
I hope this has provided you with an overview of the core muscles and
their purposes. Next month I will discuss the injuries and pain associated with
imbalances and muscles firing correctly. In the meantime if you have any
questions please feel free to drop me an email or catch up with me when you see
me around the gym.
Have a great month,
Thursday, 8 March 2012
I am going to do a series of articles covering the pelvis and sacroiliac joint (SIJ), this will be followed by an article on the causes of injury. The final article will look at the effect that core strength and correct muscular balance has on the stability of the pelvis and the lower back. This first article will look at the pelvis as well as the sacroiliac joint.Anatomy
The pelvis is made up of two Ilium bones posteriorly and the pubic bones anteriorly, as well as a triangular bone called the sacrum. The sacrum sits at the base of the lumbar spine with the Ilium bones inserting at each side. The pubic bones are joined anteriorly at a cartilaginous joint called the Pubic Symphysis.Sacroiliac joint functions
The SIJ is designed to transfer large loads and its shape has adapted to this task. The sacrum is essentially the ‘keystone’ between the wings of the pelvis (Gibbons, 2011). There are two ways that the SIJ maintains its integrity, these are form closure and force closure.
Form ClosureThis is due to the anatomical alignment of the bones of the Ilium and the sacrum. The anterior surfaces of the joint are relatively smooth to aid the transfer of compression forces and bending movements. This can cause weakness so the SIJ uses the wedge shape of the sacrum to help stabilize along with their irregular shaped surfaces that interlock to aid stabilization.
Force Closure
This is the effect that the ligaments and muscles have on the joint. The main ligaments that stabilize the joint are the sacrotuberous ligament, (this connects the sacrum to the ischium) as well as the long dorsal sacroiliac ligament that secures the sacrum to the posterior superior iliac spine.
The role of the core
The ligaments cannot stabilize the SIJ without the support of the number of groups of muscles. The two most important groups of muscles that contribute to the stability of the lower back and the pelvis are the inner system, called ‘the core’ or the local stabilizers. These are made up of transverse abdominis, multifidus, the diaphram and the pelvic floor. The outer system is called ‘the sling’ or the global stabilizers.
All of this results in something called a force couple. This is “a situation where two forces of equal magnitude, but opposite direction are applied to an object” (Abernethy et al., 2004). Force couples cause the joint to maintain integrity, but still be able to move. It is when this force couple fails and one force is stronger than another that an injury will result.
Thursday, 5 January 2012
This month I am going to talk about hamstring stains. This injury has made the news recently when Leicester Tigers RFC of the Aviva Premiership lost two of their stars – Manu Tuilagi and Louis Deacon both with hamstring strains during their win over Worcester on December 27th.
There have been many studies looking at the frequency of hamstring strains in sport. Studies have found that as a percentage hamstring injuries peak at 33% of lower limb injuries in 16-25 year olds and they most often occur in sports where the hamstrings can be stretched eccentrically at high speed (1, 2). A study into injury rates found that out of 1614 individuals in Australia who suffered hamstring injuries it made up 54% of rugby injuries, 10% of football injuries and 14% of athletics injuries. But less than 2% of tennis, squash, ballet and gymnastics injuries (2).
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| Muscles of the posterior thigh |
What is a Hamstring Strain?
It is actually a tear in one, or multiple hamstring muscles. The hamstring in made up 3 main muscles: Semitendinosis, Semimembranosis and Biceps Femoris. The role of the hamstring is to flex the knee and extend the hip.
Symptoms of a Hamstring injury
- Sudden, sharp pain at the back of the leg, during activity.
- Pain when stretching the muscle
- Pain when contracting against resistance
- Possible swelling and bruising
- If severe, a gap maybe present in the muscle which can be felt
- Bruising after a hamstring tear
Hamstring injuries are graded in severity, based on the damage. A Grade 1 tear would consist of a minor tear within the muscle. Grade 2 is a partial tear of the muscle and a grade 3 tear is a complete rupture of the muscle.
Treatment
At the time of injury:
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| Injured hamstring 2-3 days post injury |
It is important to stop activity and apply the R.I.C.E principle of Rest, Ice, Compression and Elevation.
After 24-48 hours, it is important to see an injury specialist such as Sports Therapist or Physiotherapist who can correctly diagnose the injured muscles and begin a rehabilitation program. The treatment would include the use of Ultrasound, sports massage, progressive loading and stretching of the muscle as well as promoting early mobilisation of the limb.
References:
Clark RA. Hamstring injuries: risk assessment and injury prevention. Ann Acad Med Singapore. Apr 2008;37(4):341-6
Kujala UM, Orava S, Jarvinen M. Hamstring Injuries. Current trends in treatment and prevention. Sports Med. Jun 1997; 23(6): 397-404
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