Case Study: Frontal Knee Pain (Part 3)

Single leg exercises should be incorporated in strength and conditioning sessions as it is the best way to mimic the single leg work required in running with landing and push-off. It is also a good way to identify any imbalances from one side to the other. In the final part of this series, Jonny’s pain had largely settled and his rehab focused on single leg control. He also practiced a more efficient running technique to minimise loads placed on the knee.

Case Study: Frontal Knee Pain (Part 2)

During the initial stages of rehab, the primary focus was to maintain muscle function which can be inhibited by pain. During assessment, it was also established that Jonny was weaker on one side of his outer hip muscles (glutes) when looking at the way he balanced on one leg. The video below looks at a couple of simple exercises he worked on to improve this.

Case Study: Frontal Knee Pain (Part 1)

Knee pain is a common issue in runners. It can start off as a niggle and can easily be ignored until the point where running is no longer tolerable. This is frustrating particularly when training for a race or event. In part 1 of this month’s case study, we will look at some common physiotherapy techniques we use for pain relief in the treatment of anterior (pain in the front of) knee pain.

Jonny hurt his knee during a 42-mile Ultra Marathon which was on trail and had plenty of up and down hill sections. This caused an acute overload of the structures around his knee cap, causing pain and swelling.

Case Study: Ankle Sprain Rehab - Part 3

This concludes our 3-part series following Mariam’s ankle rehab programme after a bad sprain two weeks before her first trail marathon and then her first trail ultra-marathon five weeks after that.

Phase 1 (first 2-3 days after injury):

• Ice, Elevation, Compression

• Crutches

• Avoidance of non-steroidal anti-inflammatories (i.e. ibuprofen)

Phase 2:

• Non-weight-bearing exercises

• Training modification

• Progression to weight-bearing and single leg exercises

Phase 3:

• Training modification

• Running technique modification

• Progression to plyometrics and impact loading

Case Study: Ankle Sprain Rehab - Part 2

Part 2 of our ankle rehab case-study following Mariam's injury two weeks before a trail marathon. This is a sports physiotherapy approach to the treatment and management of an injury leading up to a specific event. In this episode, we looked at progressing her exercises and training modification leading up to the run.

New Mummy Struggles: Exercise after Pregnancy

After giving birth to my first baby five months ago, life had changed as I knew it. Sleep deprivation… endless feeds… nappy changes… How does exercise fit into the picture?

I had always been a fit and active person, exercising 4-5x a week and continued to exercise right up until four days before my daughter was born. Before I knew it, I had this tiny human completely dependent on me. I felt like there was no time for anything else. Not long after I gave birth, we attended a family wedding. A family member commented that I had put on weight since having a baby and decided it was appropriate to tell me to stop eating junkfood. It was at this point I knew I had two choices: 1. Wallow in self-pity and never leave the house again 2. Find the motivation to do the things I enjoyed before having my baby. I chose the latter.

Since giving birth, I knew my body was no longer the same. I realised this after I came home from hospital and a 10-minute walk around the park felt like a marathon. As a physiotherapist who works with a lot of ante- and postnatal women, I am lucky to have the background knowledge on the human body after birth. I knew I couldn’t just jump back into what I was previously doing pre-baby. It was going to take time and patience. For the first six weeks, my exercise consisted of pelvic floor and abdominal exercises shown to me in hospital. This was all well and good when you are advised to do them every few hours, but when you’re dealing with a brand new baby; it’s the last thing on your mind! I therefore incorporated these exercises with a task I was doing constantly throughout the day - and that was feeding my baby (which was every 2-3 hours!) Every time I sat down to feed her, I made myself do them. I also went on daily walks with the buggy, which helped my mental wellbeing just to get outside the house.

After my 6-week check-up, I saw a physiotherapist who assessed my pelvic floor function and measured my belly for a diastasis recti; a condition that happens during pregnancy when the abdominal wall separates. This causes a small gap above or below the belly button. To address this, I attended mother and baby Pilates classes. Pilates focuses on the working relationships of the muscles around your trunk. These include your abdominals, diaphragm, pelvic floor and back muscles – ideal after having a baby! Being able to bring my baby along to the classes also made it easier for me not having to worry about a babysitter.

At 12-weeks, I felt I was ready to begin higher intensity exercise. After we put the baby to bed at night, I would go for a light jog for 15-20 minutes and gradually increased this as I felt comfortable. Thankfully having a baby in the spring meant long daylight hours for me to head out. I also joined a mother and baby bootcamp-style class, which incorporated strength and resistance exercises as well as high intensity interval training.

Common post-pregnancy myths that need to be debunked:

It’s normal to wee myself a little bit sometimes because I’ve had a baby

False: Incontinence post-birth is a sign of pelvic floor dysfunction and could indicate a prolapse. It is important to get this assessed by a women’s health physiotherapist to avoid long-term problems.

It’s normal to have back or pelvic pain because I’ve just had a baby

False: You may be in pain because of muscle imbalances and weaknesses. Seek advice from your physiotherapist for treatment and exercises to address any issues.

I’ve had a C-section so I don’t need to strengthen my pelvic floor

False: Your pelvic floor, regardless of how you gave birth, has been through a lot! It has carried the weight of your baby, the placenta and a 50% increase in blood volume for 9 months. This will greatly affect its ability to do its job properly compared to pre-pregnancy function.

Doing lots of ab-crunches and “planks” will help me get a flat tummy

False: These types of exercises should not be performed early on after birth as they cause excessive force on the abdominal wall, which may actually increase separation. It is best to strengthen the deeper abdominal muscles first with Pilates-type exercises.

It is important to remember that every woman is different. Exercise timescales are determined by your previous level of fitness, the type of birth you experienced and take into account any complications thereafter. Seek advice from your physiotherapist before commencing an exercise regime.

At Physio Effect we provide physiotherapy throughout your pregnancy journey and beyond. This includes ante- and postnatal assessment, treatment and physio-led Pilates classes. Our partners at Everyday Athlete Gym also run special mother and baby exercise classes.

Click here to see more about our ante- and postnatal services here at Physio Effect

One of our physios Mariam Kilpatrick with wonder-baby Aria

The Tool of our Trade

IASTM - What is it?

A revolutionary treatment technique used in physiotherapy is the use of an instrument or a tool, which enables the physiotherapist to locate and treat an area of soft tissue dysfunction.

The official term is called Instrument Assisted Soft Tissue Mobilisation or IASTM. The technique itself is said to have evolved from the traditional Chinese Medicine technique called Gua Sha. However, Gua Sha uses the principle of Meridians to move the bad “Qi” out of the body. You could perhaps say that IASTM is a modernised version of Gua Sha using anatomical reasoning. IASTM is growing rapidly in popularity due to its effectiveness and efficiency in treating musculoskeletal conditions while remaining non-invasive compared to other treatment techniques such as Trigger Point Dry-Needling or Acupuncture. 

IASTM is performed using an ergonomically designed tool most commonly made of stainless steel. The tool is used to detect and treat fascial restrictions, effectively treat scar tissue, chronic inflammation and/or degeneration.  As with any physiotherapy treatment, the use of IASTM is also supplemented with exercise prescription and additional methods such as joint mobilisation designed to correct any biomechanical issues by addressing musculoskeletal strength and muscle imbalances or weaknesses. 

IASTM Tooling around the knee at Physio Effect

How Does IASTM Work?

Soft tissue injury involves damage to muscles, ligaments, tendons and fascia (connective tissue) somewhere in the body. Common soft tissue injuries usually happen after a sprain, strain or a blow to the body resulting in ruptured blood vessels or overuse of a particular body part. Soft tissue injuries can result in pain, swelling, bruising and loss of function. Adhesions within the tissue may develop as a result of repetitive strain/overuse, surgery, or immobilisation. 

Often, people with soft-tissue injuries do not seek out treatment until the injuries have become chronic (weeks/months after injury). By this point, the body has completed most of its self-healing process. Scar tissue and adhesions are formed during this healing process, which limits motion and often causes pain. Scar tissue and adhesions essentially act like super glue in your body. When scar tissue is created after injury, new cells are laid down excessively and in a disorganised manner. Scar tissue/adhesions prevent the muscle or other tissues from lengthening appropriately. It is often necessary to restart the healing process in order to remodel the soft tissues in the affected area. By introducing controlled micro-trauma to affected soft tissue using IASTM, a local inflammatory response is stimulated. This micro-trauma initiates reabsorption of inappropriate or excessive scar tissue and facilitates a remodelling of the affected soft-tissue structures. After IASTM treatment, scar tissue can be remodelled so that the cells become organised in a direction that better promotes movement.

The ergonomic design of the tool used for IASTM provides the physiotherapist with the ability to locate these soft tissue restrictions and allows them to treat the affected area with the appropriate amount of pressure.  

What should I expect after an IASTM treatment? 

It is important to note that IASTM’s ability to reinitiate healing comes from the fact that it is essentially re-injuring the body (although to a lesser degree and in a controlled manner). This may cause mild discomfort during the procedure. There may be soreness in the treatment area for a day or two following treatment and occasionally bruising may occur.

What are common conditions treated with IASTM?

• Tennis or Golfer’s Elbow

• Neck or Back Pain

• Plantar Fascitis

• Rotator Cuff , Achilles or Patella Tendinopathy

• DeQuervain’s Tensosynovitis

• Post-Surgical Scars

• Ligament Sprains

• Muscle Strains

• IT Band Syndrome

• Shin Splints

• Chronic Ankle Sprains/Stiff Ankle

• Arthritic Pain

What are the benefits following IASTM?

• Improved range of motion

• Improved muscle strength and function

• Altered pain perception and reduction of pain

IASTM is a common treatment technique utilised by the therapists at Physio Effect. The dedicated team at Physio Effect provides a full package of services that will ensure you’re supported through injury prevention, assessment, recovery and helping you achieve your ultimate performance goals. 
 

Dry Needling: The most effective pain treatment you may never have heard of!

Dry needling is a type of acupuncture that has become very popular with physiotherapists in recent years in our treatment of injury and pain. Also known as Western Medical Acupuncture, Dry Needling differentiates itself from traditional acupuncture by being administered to soft tissue structures such as muscles and fascia (connective tissue) in order to stimulate the central and peripheral nervous systems. This results in the release of pain relieving substances within the body, which can desensitise painful structures as well as the loosening of excessively tight muscles, therefore restoring movement and function and facilitating a healing response. Dry needling is often used in conjunction with other treatment techniques as part of a treatment plan. This is different from traditional Chinese Medicine type Acupuncture which places needles along meridian lines and is based on a model of treating and restoring energy flow within the body.

Why is it called Dry Needling and how does it work?

This was to differentiate it from the more traditional western medicine approach to treating painful muscles and joints that involved the use of a hypodermic needle to inject a medication such as a steroid solution.

Dry needling uses only a thin acupuncture-type needle to stimulate and deactivate myofascial trigger points, muscles and connective tissues. This can also have both diagnostic and treatment benefits whenever a practitioner is attempting to address problems in deeper muscles and structures that massage techniques cannot be effective at reaching.

Myofascial Trigger Points can be found to be causing pain in nearly every musculoskeletal pain problem. (Myo=Muscle; Fascia=Connective tissue - the term ‘myofascia’ describes that area). These trigger points present as hypersensitive localised muscle tenderness that can also cause prolonged ache in a more widespread area. They can arise from overloading and overuse of muscles and structures such as in sport or after trauma, or even while sitting with a poor posture with the example being pain to the neck or back. As well as pain, myofascial trigger points can cause weakness of the affected muscles and restrict range of movement, both which can contribute to other problems and compensations developing.

Generally as the needles used are so thin, a patient can often not even feel the needle being inserted. When dry needling is administered effectively to a myofascial trigger point the patient may experience a local twitch response from the muscle. This instantaneous involuntary contraction confirms the presence of a myofascial trigger point and the practitioner may stimulate this twitch response a number more times manually using the needle or via an electrical current from a TENS machine to successfully deactivate.

Results can often be instantaneous when assessing restricted ranges of movement in muscles and joints and your practitioner will often demonstrate this with before and after treatment testing.

After a dry needling treatment a patient may instantly experience improvement in their pain and dysfunction being treated however it is quite common to experience muscle soreness around the needle site for between 24-48 hours. This post treatment soreness, however, is comparable to what can be expected from most hands-on therapies such as deep tissue massage.

As dry needling is administered in a clinical environment by highly trained and regulated physiotherapists, it should be considered to be a very safe treatment option and your clinician will have taken every precaution to minimise risk of injury or infection from the needle. It would however not be advisable to try for anyone who suffers from a significant phobia of needles.

Injuries and conditions to consider dry needling with:

• Postural and work-related pain

• Sports injuries affecting all muscles and joints

• Muscle and Joint Tightness

• Disc injuries

• Migraines and Tension-Type Headaches

• Tendon Injuries

• Fibromyalgia and Complex Regional Pain Syndrome

Are you taking a HIIT in Training?

In the last number of years we’ve seen a huge shift in the exercise industry towards high intensity interval training (HIIT) as a means of providing time efficient and intense workouts.

There is no doubt that HIIT training can rapidly increase fitness and provide the numerous health benefits associated with exercise but there are also a number of pitfalls to training exclusively like this that should be considered in order to ensure this works for you.

As Sports Physiotherapists we have seen numerous patients fall into repetitive cycles of injury while training in the gym. It becomes all too easy to just suggest this is because that person does Crossfit or trains at a boot camp and attribute the blame to this.

We work closely with a number of Crossfit and Functional Fitness style gyms and, in our experience, they are providing great instruction of movement form/techniques and offer a good variety of training ranging from strength and gymnastic to HIIT training.

We feel that the problem with injury usually arises because of the individual participating in this training not fully appreciating what is involved in it and where they fit into it at any point in time. Often, intense, sweaty workouts are favoured over the more strength or technique based sessions as there is a greater association with feeling fit or losing weight.

The problem with this is that in these HIIT type session exercises are being performed quickly in order to set a time or score. This requires pushing into fatigue using weights or load that can often be disproportionately high for your current strength levels and abilities. This can cause soft tissues and joints to become overloaded and injured. To train like this at a maximal or “competition” intensity 5-6 days per week is unsustainable and unproductive on so many levels and will nearly always lead to burn-out, disappointing performances and injury.

No professional athletes would ever train at full intensity on every session; instead they will do this in limited amounts and work on the various components of their sport in order to peak for short periods only a few times per year. This ensures continual improvement and decreases their likelihood of injury.

We appreciate most people have no aspirations with their exercise to compete in anything, however in order to train consistently, safely and effectively over a number of years, the principles need to be much the same whether recreational or competitive. Class-based exercise instructors will teach technique and oversee safe performance to the best of their abilities in a large group but they cannot be expected to know each individual or monitor everyone to the same degree as a personal trainer or coach. This is why it is essential to take more of an individualised approach and responsibility within these environments in order to lessen injuries, frustration and lack of improvement.

Things to consider with your HIIT sessions:

Have you been training regularly to have built up a sufficient base of fitness and strength to attack a workout at maximum intensity?
If not, you can always modify the workout slightly by going lighter, slower or changing the exercises to something that is more appropriate for you. There’s no shame in it, the shame would be to continually miss sessions due to injury

Do you warm up appropriately for intense exercise sessions?
Most people will exercise early in the morning or after work and at both these times the body is stiff from being sedentary for long periods. It’s unrealistic to expect to move well or safely during intense bouts of exercise without preparing the joints and muscles for this.

The Coach (and mini-coach!) at our Partner Gym EveryDay Athlete leads a structured warm up appropriate to the programmed HIIT workout

What are your individual needs when warming up? Eg. do you require extra stretching for your shoulders because that day you’ve been hunched over a desk all day? 
This may not be covered in a class-based environment and you should make sure to cover this yourself before the class starts.

What are your expectations?
If you plan on moving quickly and repetitively with a weight or movement, do you have the strength and skill to perform this same movement in a much more controlled manner?
If you want to get a sweat on in every session that’s okay too but this can also be achieved by training at 80% instead of 100% on some sessions.

Long Term Goals

Year in and year out exercise and training requires consistency and dedication. Similar to more extreme diets, we shouldn’t be looking for a quick fix as it is often unsustainable and doesn’t provide long term results, as this approach can be tortuously difficult and we will lose motivation quickly or get injured.

Have you discussed with your coach, instructor or physio what your individual needs and expectations are with training?
This will reduce that feeling that you’re expected to perform at full intensity on every session. They can help identify things that you may do in your own time or out with class times in the gym that should help you progress to where you want to.

Image from one of the HIIT Classes at one of our partner gyms EveryDay Athlete at our Northside Clinic and Studio in Port Dundas

Back Strengthening Exercises for Desk-Based Workers

At Physio Effect we routinely treat the general population for injuries and pain which can be attributed to a sedentary lifestyle. We have previously discussed the risks posed by excessive hours of sitting and how this is reaching almost epidemic levels in the Western world. Today's article provides some general exercise recommendations that can go some way to reducing this risk and counteracting the negative effects of sitting.

In an ideal world, those of us who have sedentary or sitting based occupations should aim to move, stretch, and be active for at least 1-2 minutes of every hour. While some of the exercises shown here may not be suitable for your particular work environment, any effort to perform a routine of this nature for 5-10 minutes before or after work or during a lunch break would go a long way to reducing the risk of pain and injury. General exercise and safe varied movement of any kind is also highly recommended.

Exercise 1 - Thoracic Rotation

Thoracic Rotation Start

• Start on all fours with one hand placed behind your head.

• Slowly turn the elbow towards the ceiling allowing your trunk to rotate and stretch

• Hold at top position for 3-5 seconds. Repeat x 10 with each arm

Thoracic Rotation Finish

Exercise 2 - Dart

Dart - Start Position

• Lay face down with thin pillow or folded towel for head support

• Arms by your side, gently stretch your fingertips away from your shoulders allowing your shoulder blades to glide downward and slightly inward

• Palms facing your hips, have your arms floating just off your side and not touching the floor

• Keeping the back of your neck long and eyes looking to the floor, gently lift your head and upper body just off the floor - imagine lifting from your breast bone

• Hold the finish position 3-5 seconds. Repeat 10 times 1-2 sets

Dart - Finish Position

Dart - Finish - Detail

Exercise 3 - Hip Flexor Stretch

Hip Flexor Stretch Start Position

• Take a kneeling / lunge position as shown - use support of wall or furniture for balance if required

• On the kneeling side gently engage your buttock and lower abdominal muscles - imagine you are tucking your tailbone in between your legs

• You should feel a stretch at the front of your hip/ thigh. If balance allows gently raise the arm on the same side as the kneeling knee.

• Hold the stretch for 30 seconds minimum and repeat 2-3 times each side.

Hip Flexor Stretch Finish Position

Exercise 4 - Cobra

Cobra Start Position

• Lay face down with hands palms down about shoulder height

• Using your arms slowly press out peeling your upper body slowly off the floor

• Remain heavy in your hips trying to keep them in contact with the floor - relax your buttock muscles

• Hold the finish position for 5-10 seconds, return to the start and repeat 5-10 times

Cobra Finish Position

Exercise 5 - Shoulder Bridge

Shoulder Bridge Start Position

• Lay flat on your back with feet shoulder width apart and knees bent

• Using your lower abdominals gently tilt your pelvis to press your lower back flat to the floor

• Pressing through your heels, using your buttock and abdominal muscles gently peel your spine up from the floor starting with your tail bone.

• Finish with your weight resting across your shoulder blades and your shoulders, hips and knees in a diagonal line

• Hold finish position for 3-5 seconds, return to start and repeat 10 times for 2-3 sets.

Shoulder Bridge Finish Position

Exercise 6 - Superman

Superman Start Position

• Start in all fours position with knees under hips, hands under shoulders and spine relaxed

• Slowly extend out opposite arm and leg pointing the toes behind and the fingertips to the front

• Keep gentle tension in your lower abdominals - think about drawing your bellybutton in towards your spine

• Try to maintain spinal position throughout the movement, return slowly to start position

• Repeat with opposite arm and leg, try 10-12 repetitions for 2-3 sets.

Superman Finish Position

Exercise 7 - Thoracic Extension with Foam Roller

Thoracic Extension with Foam Roller Start Position

• Lying on your back with knees bent and feet flat, place a foam roller under your mid-upper back as shown

• Take a deep breath in and then, as you exhale, slowly extend back over the roller to stretch your back. Try to keep your lower abdominals engaged to avoid over-arching your lower back

• Support your head with your hands and be careful to stay relaxed in your neck. If you find this too intense or uncomfortable, try using a pillow or pillows to rest back onto

• Hold the finish position for 2-3 breath cycles, return to start position and repeat 5 times

• Move the roller to another position in your mid-upper back and repeat the process, aim to work on 3-5 positions along your spine

Thoracic Extension with Foam Roller Finish Position

Thoracic Extension with Foam Roller Alternate Finish Position

Exercise 8 - Pec Stretch

Pec Stretch Start Position

• Stand as shown with arm at approximately shoulder height and palm to forearm placed against the doorframe

• Slowly turn your body away by stepping your feet around to open and stretch the front of your chest and shoulder

• Lean gently into the stretch, keeping your neck relaxed, hold for 30 seconds+, repeat x 2 on each side

• Alternatively, use a doorway to position both arms in the stretch position, step forward to feel the chest and shoulder open and stretch. Hold 30 seconds+, repeat x 2.

Double Pec Stretch Position

While these are general exercise recommendations suitable for the majority of the population they are not prescriptive for any specific pain or injury. These exercises should be performed slowly and gently in a range of movement suited to your own level of ability and flexibility. The exercises should not cause any pain and we recommend that if you are in any doubt or if you are suffering from spinal or joint pain issues you should consult a healthcare professional for advice.

At Physio Effect we provide a wide range of services allowing us to not only treat your pain or injury but ensure that you are given the best advice specific to your individual needs to prevent your problem from recurring. 

We got a new piece of kit in our Studio!

We are very excited to get a reformer for our studio here at our Northside Clinic in Port Dundas - read more about the reformer here and see Nicki, one of our Massage Therapists demoing it below!

Running injury prevention; do you need a musculoskeletal screening?

Sports-specific screening available!

Musculoskelatal screenings are available from our team of experienced and expert Sports Physiotherapists – but what is it? Imagine, someone could look you over and help flag issues before they become injuries!

Here's what Jonny says:

“A 60-minute assessment which will include a full body assessment of flexibility, strength, balance and body control to highlight potential for injury or problem shoot issues experienced by a runner. This may also include treatment if needed as well as education on issues flagged up with suggestions of how to fix these.”

We have a broad spectrum of sports expertise here at Physio Effect – everything from running, martial arts and football to rugby, mountain biking and roller derby! Whatever your sport or activity, whatever your level, we’ll be able to assess and treat you!

What is the difference between ‘Regular’ and ‘Clinical’ Pilates?

Regular Pilates is conducted by a Pilates instructor, whereas Clinical Pilates is prescribed and supervised by a Physiotherapist. The difference is very important because a physiotherapist has an in-depth knowledge of injury, pathology, body function and movement patterns. The physiotherapist will assess each person and determine which exercises will be the most effective for each individual. This becomes especially important if you have a history of injury such as low back pain, whiplash, hypermobility or an athlete coming back from an injury. There will be certain exercises which need to be adapted specifically for you.

For more information on our Clinical Pilates classes here at Physio Effect, have a look on our Clinical Pilates page

#KnowledgeShare – Shoulders Month – Rotator Cuff

23rd February 2017

We see a lot of clients coming to us with shoulder injuries – sometimes it’s not what they think! In this new video, Danny gives us a the basics (and a bit more!) on the rotator cuff!

#KnowledgeShare – Shoulders Month – Mobility Exercises

Here's Jonny from a few years ago demonstrating some exercises to improve overhead range of movement using small equipment you'll find in your gym

#KnowledgeShare – Back Mobility

17th March 2017

It’s Back Month here at Physio Effect! Here’s Jonny (and Ash) showing us how to use the foam roller for a bit of mobilisation!

Foam Rolling: What is it? What’s the Evidence? How to apply it!

Foam Rolling

What is it?

Self-myofascial release is a name given to the use of equipment or tools to perform self-massage and stretching with the aim of increasing joint range of motion and improving muscle recovery and performance. One of the most commonly used tools is a foam roller. You will often see people in gyms attempting to manoeuvre their bodies in various positions over one of these rollers.

Most commonly rollers will be used in a way that the body is positioned with the roller in contact with a specific muscle or muscle group. The user then uses gentle motion to stretch and massage the area while controlling the pressure exerted by adjusting their position and the weight going through the area.

The theory is that using foam rollers used to massage and stretch our muscles, joints and soft tissues can make them more pliable thereby increasing range of motion. It is also theorised that pressure applied to soft tissues can stimulate change through the central nervous system by sending signals which alter the tissue activity and reduce tension levels.

What’s the evidence?

In general terms, self-myofascial release using a foam roller appears to have short-term effects of increasing joint range of motion without exhibiting any negative effects on muscle or joint performance. There is also some evidence to suggest that post exercise muscle soreness can be reduced while muscle recovery is enhanced when foam rolling is used after strenuous or intense exercise.

The overall summary of the evidence to date suggests that foam rolling is a safe tool to use prior to or after exercise to assist with warm up and/or recovery. However, the research is limited and fails to come to a consensus on what the optimal methods, techniques or frequency of foam rolling should be. There is not yet enough research or evidence to define the best way to roll specific muscles or how many sets or repetitions is appropriate.

How can I apply it?

The general consensus is that foam rolling is safe and can be a welcome addition to assist in warm up and recovery. While we do not have enough evidence to create exact protocols there is room here for individual preference and some experimentation to see what works best for you. From personal experience and from reviewing the literature we would suggest trying:

• 3-5 sets of 30+ second repetitions on each targeted muscle or muscle group

• Apply gradual pressure in various planes and directions.

• For larger or longer muscle groups consider dividing the application into 2-3 areas

• Consistent application aiming for a minimum of 3 times per week

• Slight discomfort during application is acceptable but strong or intense pain is not

• Position yourself carefully to avoid unnecessary strain on other muscles or joints

Below are a few examples of positions used to foam roll various muscles

Foam rolling outer thigh    

Foam rolling upper back

Foam rolling calf muscle

A word of caution

Foam rolling can be a useful adjunct to any exercise or training routine and may also be used by more sedentary individuals to reduce muscle and joint stiffness. Foam rolling, however, is not an appropriate tool for treating damaged or injured tissues and we would warn that it should not be used as such. Always seek advice from a qualified professional if you are in any doubt.

Foam rolling does not replace or negate the need for adequate warm up and the use of correct techniques when exercising. We would suggest using foam rolling to compliment your existing training or exercising routine but not to replace any aspect.

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Article written by Daniel Wray – Senior Physiotherapist and Director at Physio Effect

The dedicated team at Physio Effect provide a full package of services that will ensure you’re supported through your pain management, injury prevention, assessment, recovery and helping you achieve your ultimate performance goals. We offer a range of services including Physiotherapy, Sports Massage, Craniosacral Therapy, Clinical Pilates and Yoga.

Kinesio-Taping

Article written by Daniel Wray – Senior Physiotherapist and Director at Physio Effect

6th November 2017

What is Kinesio-taping?

Kinesio-taping is a commonly used form of support taping applied to the muscles and joints of the body. There’s a good chance you will have seen this brightly coloured tape on a friend or colleague or through its wide use across many sports including football, tennis and swimming. Tape is normally applied by a trained health and fitness professional and can stay in place anything from 24 hours up to one week. The tape can stay in place after bathing or swimming and its breathable elastic properties mean it is generally well tolerated by the skin.

The theory behind kinesio-taping suggests that it works via its unique elastic properties lifting the skin to improve fluid movement and alleviate pain. A suggested mechanism of how this works is the alleviation of pressure on pain receptors interrupting the normal transmission of pain signals to the spinal cord. Other popular notions suggest that application of kinesio-tape can help stimulate and strengthen a weakened muscle or relax and release a stiff or tightened muscle depending on the level of tension applied to the tape. It may also offer support and restriction of movement when this is required as part of treating injured tissues or joints.

Kinesio taping application for shoulder support

Kinesio-taping application for shoulder support

What’s the evidence?

As Physiotherapists and health professionals it is central to good practice that we seek out solid evidence to support the use of any therapy or treatment. Kinesio taping falls almost entirely into a category of little to no hard scientific evidence supporting its use. There have been numerous studies and systematic reviews of the evidence that conclude that kinesio-taping offers little to no clinically significant benefit. It appears most of the evidence and positive reviews from patients and health professionals to support kinesio-taping are anecdotal or based on single case reports or small samples.

Should I use kinesio-taping?

Despite the clear lack of evidence for its use the spread of kinesio-taping throughout health and sport practices does not appear to be waning. As a Physiotherapist with more than 10 years in clinical practice I have been officially trained and certified as a kinesio-tape practitioner and while I recognise the lack of hard clinical evidence I do still have a place for using kinesio-taping in my practice.

There is no clear evidence that proves any clinical risk in using kinesio-taping and anecdotally within practice I have had many patients report a sense of support or relief associated with the tape application. There may well be an element of placebo effect here but as long as that effect is positive and the potential benefits or lack thereof have been openly and realistically explained to patients then I see no issue with kinesio-tape use as part of a bigger clinical picture.

The use of kinesio-taping should not be considered as a complete treatment for any injury or condition and patients should understand it has limited evidence. Kinesio-taping should be considered as one aspect of treatment and any practitioner using it should be able to provide a rationale for doing so even if this comes down to personal clinical experience over specific evidence. Kinesio-taping should not be considered the mean to the end and should be an adjunct to support a full treatment and rehabilitation plan based on careful evidence based clinical assessment.

Article written by Daniel Wray – Senior Physiotherapist and Director at Physio Effect

The dedicated team at Physio Effect provide a full package of services that will ensure you’re supported through your pain management, injury prevention, assessment, recovery and helping you achieve your ultimate performance goals.