Ankle sprains are one of the most common sporting injuries and most people have experienced one at least once in their lifetime. While they are common, this doesn’t lessen their negative impacts. Surprisingly, having poor balance might be increasing your risk of ankle sprains. Here we discuss a few facts about balance and what you can do to reduce your risk of ankle injuries.

What Are They? Muscular trigger points are better known to most of us as muscle knots and can feel like painful, hard lumps located inside muscles. These knots can both be painful to touch and refer pain in surrounding areas. It is thought that trigger points form when a portion of muscle contracts abnormally, compressing the blood supply to this area, which, in turn, causes this part of the muscle to become extra sensitive. Trigger points are a common source of pain around the neck, shoulders, hips and lower back.

When injury strikes, the first thing that most of us want to know is ‘how long will this take to heal?’ Unfortunately, the answer to this can be complicated and requires at least a little understanding of how the different tissues of the body heal. Each of the tissues of the body, including muscles, tendons, ligaments and bone, heal at different speeds and each individual will have some variation on those times as a result of their individual health history and circumstances.

Golfer’s Elbow (Medial Epicondyle Tendinopathy) Golfer’s elbow is tendinous overload injury of the tendon on the inside of the elbow, usually due to overuse. As its name implies, it is a condition common in golfers. However, as with all sporting injuries, this condition can affect anyone. Golfer’s elbow is similar to Tennis elbow, occurring on the inside of the elbow rather than the outside. What are the symptoms? Typically, someone suffering from this condition will experience pain on the inside of the elbow, forearm and possibly extending down to the hand. The pain will be worst with activities that require gripping of the hand and movements of the wrist. Less common is the experience of pins and needles in the hand. How does it happen? The exact cause of this condition is unknown; however, it is generally thought to occur when the forces transmitted through the tendon become too great. This can be due to increased demands on the tendon or reduced quality of the tendon tissues. As the tendon is attached to muscles that bend the wrist and provide grip strength, activities such as golf, rock climbing or manual work that involve gripping objects can easily create forces that damage the tendon. Conversely, factors such as poor blood supply or simply the normal processes of aging can reduce the quality of the tendon. If the tissue is not functioning well, then even simple but repetitive movements in an office job can cause Golfer’s elbow. There are a few other known contributing factors for Golfer’s elbow, such as poor posture, neck dysfunction, a recent change in activity and a history of trauma, such as a fall onto an outstretched hand. What is the treatment? Golfer’s elbow usually develops slowly, and healing can be a long process. The first step to effective treatment is accurate diagnosis, as many other conditions have similar symptoms and need to be excluded first by a medical professional. Once a diagnosis of golfer’s elbow has been confirmed, treatment is aimed at allowing tissues to heal and regenerate. This will require a certain level of rest, and changes to the forces affecting the tissues, sometimes through bracing or taping. Specific exercises have been shown to assist tissues in coping with and responding to load; these are called “eccentric” exercises. Other treatments include increasing blood flow to the area to promote healing. In chronic and severe cases, injections of corticosteroids are used, and in severe cases surgery may be undertaken. The information in this newsletter is not a replacement for proper medical advice. Always see a medical professional for assessment of your condition.

Strengthen to Lengthen, Does It Work? Improving flexibility by stretching is a core tenant of most exercise programs. We have all heard the adage to stretch and warm-up before exercise to help prevent injuries and there is no doubt that stretching can just feel amazing! It can be surprising to learn that sometimes, the answer to improving flexibility can actually come from strengthening muscles, not just stretching them. Why is this? The muscles of the body are primarily responsible for its movement. By contracting and shortening they move their attachments closer together or by relaxing they allow their attachment to move apart in a controlled manner. The stronger and more coordinated muscles are, the more efficiently muscles are able to move the body more precisely and against more resistance. This likely comes as no surprise, however what you may not realise is that muscles also play a large role in providing stability to the body, particularly around the more flexible joints such as the hip and shoulder. If needed, they will often prioritise their role as stabilisers over that of movers. What does that mean? If muscles are too weak to allow safe and controlled movement when needed, they might ‘tighten up’ to provide the stability necessary to keep your body upright. The less movement through range, the less blood flow muscles will be receiving, which can also lead to reduced muscle health and greater risk of injury. Increasing the strength of muscles can allow them to relax and move more freely, improving flexibility. One of the reasons why strengthening to improve flexibility may seem counter intuitive is because many of have experienced muscle pain and stiffness after a strength workout, which can add to the perception that strengthening muscles shortens them. This pain and stiffness is usually short lived, reducing over 48 hours as muscle tissues return back to normal. Do any strengthening exercises work? While improving strength and coordination may allow muscles to ‘relax’, there is one type of strengthening exercise that will actually physically lengthen muscles by creating new muscle cells. Eccentric exercises, or ‘controlled lengthening’ have been shown to have a very beneficial effects on muscle health, length and even improve tendon health. Having a targeted eccentric training program to strengthen muscles has been shown to improve flexibility and reduce injuries overall. Ask your physiotherapist for tips on training muscles to their optimal health to promote flexibility. Your physiotherapist is able to assess any muscles for weakness and reduced length, giving you a targeted program to improve function and reduce injuries.

How do you stretch properly?  While there are many benefits to be gained from effective stretching, employing an improper technique can actually result in injury. Here are some tips and guidelines for you to follow when stretching: Warm up first with an activity such as walking (at least 5 -10 minutes). Stretches should be pain-free. You should only feel tension or a tight feeling when stretching. If you feel a sharp pain, this means you're stretching too far and should relax a little. Don't hold your breath while stretching; keep breathing to ensure the muscle tissues remain oxygenated during the stretch. Stretch both sides. But, if one muscle is tighter than the other, focus on it more until they're both in the same range. Avoid bouncing at the end of the stretch because it may lead to injury. Hold stretches for 20-30 seconds, if not longer. A 10 second stretch is not always enough to achieve a lasting effect. Repeat the stretch 3-5 times with intermittent rest periods in between. Make sure your body is aligned properly and observe good posture.

There is no doubt that the human body can be very resilient. Short of regenerating new limbs, our bodies are capable of recovering from large amounts of damage, including broken bones. With this in mind, many people are happy to let nature take it’s course following an injury, thinking that seeing a physiotherapist will only act to speed up already healing tissues. The speed of recovery, however, is only one measure of healing and despite our bodies’ incredible capacity for repair; injury repair can be less than straightforward. Here are a few things about injury healing you may not have been aware of. 1. Scar Tissue is more likely to form without treatment. Scar tissue can cause ongoing pain and stiffness in skin, muscles and ligaments. Physiotherapy can prevent excessive scarring from forming through advice regarding movement, massage and other hands-on treatment. 2. Your ability to sense the position of your body, known as proprioception, is often damaged after an injury and can be retrained. Impaired proprioception is a major factor in re-injury. If you’ve ever heard someone say “my knee/ankle/shoulder still doesn’t feel 100%” then this could be why. The good news is that with a specific exercise program, proprioception can be improved and recovered. 3. Once healing has finished, your body may not be exactly the same as before. Following an injury, ligaments may be lax, joints may be stiffer and muscles are almost always weaker. While the pain may be gone, there might still be factors that need to be addressed to prevent more complicated issues in the future. 4. You may have picked up some bad habits while waiting for the injury to heal. While in pain, we often change the way we do things, this can lead to the development of poor movement patterns and muscle imbalances. Even though the pain has gone, these new patterns can remain and create further problems down the road. 5. Injuries don’t always heal completely. On rare occasions, injuries may not be able to heal completely on their own. The most serious example of this is a fracture that cannot heal if the bone is not kept still enough. Other factors that may prevent an injury from healing include poor circulation, diabetes, insufficient care of the injury and poor nutrition. Your physiotherapist can assess your injury and develop a treatment plan that will both restore you to the best possible function and prevent further injuries. None of the information in this article is a replacement for proper medical advice. Always see a medical professional for advice on your individual injury.

Focus on Calf Tears  What are they? The calf muscles refer to a group of muscles at the back of the lower leg that act to point the foot away from the body and play an important role in walking and running. A tear or strain of these muscles occurs when some or all of the muscle fibres are torn or stretched. This is a common injury that can affect anyone from athletes to those with a more relaxed lifestyle.