Helping you back to work, to play, to life!

Masterton clinic on the move Labour weekend!

The Chilton Building in King St Masterton is in a state of metamorphosis and we’re excited to be a part of it!


img_1079Dave Borman is developing the building and, in keeping with his previous local developments, looking at a high end restoration of this beautiful art-deco building. We’ve enjoyed the process of designing the kind of space that fits our model of what an ideal service would look like, and designing spaces around how we think health services will need to be delivered moving through the next decade or two (a mix of 1:1, whanau or small group spaces, and larger spaces, with multiple functions built into them). Then we’ve looked at various building options and locations before settling on the Chilton building. At this stage of the development we’ll be moving into 430m2 of space that has been fully fitted out from bare masonry back to the finished product.

As a health service we’re obviously highly aware of health and safety considerations, so designing and purpose building has enabled us

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Dancers – are you forcing flexibility?

dancer 1
Picture: http://havilahdancecompany.com/

Dancers, like all athletes, are known as a determined bunch, with an impressive capacity for tunnel vision. Sometimes this determination can backfire, with dancers training through injuries, or pushing the limits of their bodies in unsafe ways. Particularly in the young dancer, there is a huge capacity for injury when striving to reach the flexibility seen by dancers on TV, twitter or instagram.

Every dancer knows the familiar pain of a pulled muscle from pushing too far into a stretch, but most dancers don’t know the bigger more serious consequences of forcing flexibility. As Lisa Howell (Dance Physiotherapist, www.theballetblog.com) once said, pushing into a stretch is often the slowest and most painful way of achieving flexibility. Its also the way in which you are most likely to injure yourself. Dancers need to look after their bodies, as they are the instrument of their craft, and you can’t replace it if it becomes damaged. With young dancers this is even more important, as the average recreational dancer stops dancing after leaving school around 18, but they have more than 60 years left with which to live in their body.

When performing static stretches (the type where you sit in a stretch and hold it) there is a principle known as the path of least resistance. This means that between all the muscles, tendons and ligaments that support the joints in your body, the part that is already the most mobile, will stretch the most, while the stiffer tissues are stretched the least. This often leads to instability in joints that are already lax, while the stiff joints that need increased mobility, stay stiff. This is often a contributing factor responsible for dancers finding they aren’t getting any benefit from traditional stretching and is where an individualised programme can be beneficial.

dancer2
Picture: @pointeproblems

When stretching is successful and greater flexibility is achieved, that is only half of the equation. In order to execute the perfect arabesque or développe á la secondé you need to be able to utilize that range against gravity. This is where strength is important, and ensuring you are recruiting the correct muscles for the job at hand. Using the wrong muscles often leads to muscles strains, while a lack of strength and control can lead to injury.

 

Stretching should be a part of your warm up and cool down surrounding your dance class. However, how you do this is extremely important. Dynamic stretching, such as grande battements and those with movement through full range can and should be an important part of your warm up, however static stretching should be avoided before class. When you perform a static stretch, you cause your muscle to temporarily lose power for around 30 mins afterwards, meaning you will not be able to perform at your peak during class. Static stretching should be reserved for the end of class, as part of a cool down process. Saving static stretching for the end of class also reduces your likelihood of a muscle strain resulting from stretching.

dancer 3
Picture: http://liveyourinnerdance.tumblr.com/

And I haven’t even touched on the issue of oversplits, which my students can all tell you I am pretty passionate about NOT doing. For further explanation of why, head on over to The Ballet Blog.

These exact same principles apply to gymnasts, aerialists and acrobats. There are many different ways to achieve flexibility and contrary to popular belief, long, sustained, painful stretches are not the best way. Pain does not equal gain. I would much rather see you in the clinic, setting you up to achieve your goals, rather than working with you to regain what you had after an injury. So if you’ve hurt yourself in the pursuit of the perfect split leap, or if you feel like you’re just not getting anywhere, come on in, I would love to help you out.

 

 

Game Day Nutrition

gatroadeSo the All blacks are telling you to drink PowerAde, and just about to start telling you to drink Gatorade, Betty White’s saying you aren’t you unless you have a snickers in your hand, and we have the Highlanders making a bucket of chicken look like the most fun you have ever had with your mates. On the other hand George Foreman is knocking out the fat, everyone is telling you sugar is the worst thing in the world, and that all you are allowed to eat is what you have grown in your own garden. I’m not going to get into your day to day nutrition, but what I would like to do is talk a bit about nutrition for game day, and some basics around GI and the role nutrition has on injury prevention. So if you want to give your body that extra few percent, keep your energy up and your mind sharp when you are out there competing, have a read.

Keeping your blood glucose (sugar) levels up is important, especially due to the way that energy systems in muscles work. The energy that goes into muscles, occurs in the lengthening portion of muscle movement, the eccentric phase it is called. It is like pulling a spring long ways, getting it ready to release for when your brain sends a signal down to the muscle. Essentially, energy goes in, the muscle lengthens, and it’s ready for the next message your brain sends to shorten (contract) again. Running out of energy is partly why muscles get tighter as the game or sport goes, so we can break this down to tired muscle = tight muscle = that strained calf. For anyone that has ever had a strain of the hamstrings or calf, I would ask, did it happen early or late in the game, did you eat well before the game, and did you warm up well. Hamstrings in particular are required to rapidly lengthen when you see that gap that you are suddenly trying to go for, when you are off balance and have to bring your foot all the way forward to catch yourself, or where you have been set up perfectly for that volley and all you need to do is belt that ball into the top right corner, in the last minute, of the final, in your social soccer game, to set yourself up for a lifetime of stories of your heroics.

In my own experience game day can often be a nerve racking time, whether that’s from excitement, fear, or the pressure of needing to perform, pushing your appetite down your priority list. However, in order to perform at your best, and also help prevent injury, ideally, 2-3 hours out from sport, you want to be getting a good amount of energy in whatever form you can. Some people like a hearty breakfast, a bowl of porridge, others a few bananas, and some struggle to get anything in at all. For those people in particular, a great way to get in something in is a smoothie. A few bananas, some berry’s, a bit of yogurt,  throw in some honey while you’re at it, I often put in a sachet of quick oats too, attack that with your nutribullet/ninja, whiz stick, blender, chuck it in a bottle, and work away at it in that 2-3 hour pre-match period.

Now I don’t want to sound like an advertisement, unless Coca-Cola want to send me some sponsorship money, but sports drinks like your Powerade’s, Gatorade’s, etc. can be great as part of your pre-match warm up and also for half time, when the legs are starting to lose their zip. These types of drinks contain sugar for energy but also electrolytes, mainly sodium and potassium, which help to keep the fluid in your body in the right balance. As you sweat in a game, you are losing both water and electrolytes, hence why sweat is salty, this is why replacing this with drinks that contain electrolytes keep you better hydrated than just drinking water.

I know sugar has been taking a hammering as of late, and rightly so, but there are times where if used right can be effective in ensuring a good performance. Similarly white bread has been put on the naughty list, as essentially when it breaks down in your stomach, it pretty much turns straight into sugar. Foods which are high in sugar, or are very refined or processed are very easily broken, hence you get a very quick blast of energy from them, but that energy is soon gone. The speed in which different foods are broken down are quantified in the glycaemic index, or GI which is often found on the packaging, and gives an indication of how quickly something is broken down in the body and converted into the glucose that enters your blood, and provides energy to your muscles. High GI foods, quickly convert to sugar in the bloodstream, Low GI foods take longer to deliver sugar to the blood stream. It is comparable to filling your log burner up with small bits of pine. Your fireplace is going to throw out a huge amount of heat, but very soon need more, where putting in a large piece of something dense, like kanuka, will just sit there and burn at a lower intensity, but for longer. Fats are similar in the slow burning way of energy delivery. With this in mind, as we are trying to get that burst of energy, something higher in GI can be useful. I myself am partial to the odd snickers as part of my pregame intake, or a bumper bar, but that’s maybe just me being a sweet tooth.

The end of a game is also a time where nutrition is important in how your body pulls up. I was once told by a dietitian I had worked with that chocolate milk is ideal. It contains sugar to replace what has just been used up, protein for muscle repair, and fat also, which is an important slow burning energy source, so I am often seen with a chocolate milk mustache at the end of each rugby game.

Anyone with a condition which may be affected by a sudden increase in sugar, or a dip, should seek medical advice in the management of their blood sugar levels and nutrition. For any specific requirements you may have, you may need to seek specialist input from a dietitian, or a medical professional.

I hope that helps people out there with refining their pre-match ritual, and by all means, get out there and do your own research as well.

Good Luck out there this weekend, evening, afternoon in your physical endeavours!

Your local physio

Nick 

(Physiotherapist – Masterton)

Winter sport tips with Nick Hohepa

We are well into the middle of season for many of the winter sports around the Wairarapa, and for some, getting into the business end of the season. After getting through the initial pre-season and return to sports stage of the year which is often the cause of a few sprains and strains, all of you finely tuned athletes will be entering the second phase of season injuries, where weeks of playing and training week in week out, carrying a niggle here or there with you, and general fatigue may be starting to have an effect on your game. So at this time I thought it may be handy to go through a few tips for getting through the remainder of the season in good shape, so that come crunch time, you will be feeling ready to give it everything.

What I thought I may do over the next few weeks is write up a bit of info around a few different aspects of management in and around your sport or leisure activities. We will go through some basics on managing aches and strains, touch on nutrition, things to recognize regarding concussion, and some basics on return to sport.

Those Niggles and Strains

Whether you are playing soccer, hockey, rugby, netball, walking the dog, or jumping on the trampoline, we can all end up with bumps and bruises, niggles and strains. The two main area’s these will occur, are in muscles, and in connective tissues, ie, your ligaments and tendons. For both types of injuries they can occur to different degrees, from a contusion, partial, or a full tear. Many slight niggles can be taken care of with applying R.I.C.E (Rest, Ice, Compression, Elevation) management, which are aimed at reduction of inflammation. It is not uncommon to notice a few aches and pains the following day also. For those minor niggles, movement is your friend, go for a walk, get in the pool, maybe the spa if you can get to the pools, or are lucky enough to have one at home. Heat opens up the blood vessels, and cold closes them down, so it can be useful to use these back to back, so that you can flush the area, using the two modalities effectively like a pump.
calvesFoam rollers are a great way to get into those sore and tight muscles, and are great for the calves, hamstrings, quads, the side of the thigh, the lower and middle of your back, but you are probably best to seek some advice from a physio, may I recommend Back In Action!!! Conveniently located in both Carterton and Masterton.

 

For the coaches out there, it’s important to be taking fatigue into account in this part of the season, where fitness should be coming along well but niggles may be starting to add up. Training management will be important to reduce the strain on some potentially tired bodies. The first training of the week, if 2 or more are involved could involve a good warm up, time to stretch, as well as allowing players time for their own stretches, and perhaps working more on skills, than full intensity training, and as bodies are warmed up, some more high intensity work towards the end of training for a short period.

For the injuries that force you from the field, affect your walking, movement of your arms, neck and back for the following day or two, are not improving, or getting worse, that’s when it is going to benefit you to seek treatment from health professionals. Severe pain or injury should be addressed immediately, whether it be an ambulance, a trip to ED, or if not as severe a visit to your doctor, who will often refer to a physio, or seek physio advice, who if on assessment see the need for medical input, will refer to your GP, or a specialist.

I hope some of that may help out, keep your eyes peeled for the next piece on the role of nutrition on game day.

Any questions or queries, fire away at nick@getbackinaction.co.nz

Your friendly neighbourhood physio

Nick

(For appointments with Nick Ph: 06 377-4422)