Carbohydrate Loading for Endurance Sports

Carbohydrate Loading in preparation for the Dublin Marathon


Darren Macfarlane Sports Injury Clinic, Galway.

What is a Carbohydrate?

Carbohydrate is the body’s prime fuel source when it is physically active. Carbohydrates are a group of complex compounds consisting of carbon, hydrogen and oxygen and include both sugars and starches. When carbohydrate is broken down in the body it is stored as glycogen in the liver and the muscles. Glycogen is the most readily available and efficient source of energy used in any vigorous activity such as running. Inadequate glycogen may limit performance in endurance events lasting more than 90 minutes. Depletion of muscles glycogen is associated with the onset of fatigue. The athlete must then use fat as the primary source of energy with a subsequent reduction in the level of intensity of exercise (you will slow down during race)

'Carbohydrate loading' is probably one of the most misunderstood terms in sports nutrition. People commonly think anyone involved in sport needs to 'carb up' and the way to do this is to eat 'flat out' in the days leading up to an event. Read on to get the facts on carbohydrate loading.

What is carbohydrate loading?

Carbohydrate loading is a strategy involving changes to training and nutrition that can maximize muscle glycogen (carbohydrate) stores prior to endurance competition.

It has been used to since the 1960s as a nutritional strategy to enhance endurance performance lasting more than 90 minutes. Today’s modern day loading has changed since then due to ongoing research and is now more manageable for athletes. Today, 1-4 days of exercise taper while following a high carbohydrate diet (7-12g/kg body weight) is sufficient to elevate muscle glycogen levels. The aim is to boost glycogen stores by optimizing the use of carbohydrate as a fuel source. This is seen to extend endurance by increasing the ability of the body to use carbohydrate as a fuel source.

Does carbohydrate loading improve performance?

With carbohydrate loading it is possible to increase glycogen stores by 20 per cent above normal .This extra supply of carbohydrate has been demonstrated to improve endurance exercise by allowing athletes to exercise at their optimal pace for a longer time. It is estimated that carbohydrate loading can improve performance over a set distance by 2-3%.

Who should carbohydrate load?

Anyone exercising continuously at a moderate to high intensity for 90 minutes or longer is likely to benefit from carbohydrate loading. Typically, sports such as cycling, marathon running, longer distance triathlon will benefit from carbohydrate loading. Shorter-term exercise is unlikely to benefit as the body's usual carbohydrate stores are adequate. Carbohydrate loading is generally not practical to achieve in team sports where games are played every 3-4 days.







What does a high carbohydrate diet look like?

The following diet is suitable for a 70kg athlete aiming to carbohydrate load:

Breakfast 3 cups of low-fibre breakfast cereal with 11/2 cups of reduced fat milk


1 medium banana


250ml orange juice


Snack toasted muffin with honey


500ml sports drink


Lunch 2 sandwiches (4 slices of bread) with filling as desired


200g tub of low-fat fruit yoghurt


375ml can of soft drink


Snack banana smoothie made with low-fat milk, banana and honey


cereal bar


Dinner 1 cup of pasta sauce with 2 cups of cooked pasta


3 slices of garlic bread


2 glasses of cordial


Late Snack toasted muffin and jam


500ml sports drink

This sample plan provides ~ 14,800 kJ, 630 g carbohydrate, 125 g protein and 60 g fat.


What are the common mistakes made when carbohydrate loading?

Research indicates that many athletes who attempt to carbohydrate load, fail to achieve their goal. Common mistakes include:

• Carbohydrate loading requires an exercise taper. Athletes can find it difficult to back off training for 1-4 days before competition. Failing to rest will compromise carbohydrate loading. If you train hard right up to competitions this will deplete glycogen stores and it will be pointless in carbohydrate loading.

• Many athletes fail to eat enough carbohydrate. It seems athletes don't have a good understanding of the amount of food required to carbohydrate load. Working with a sports dietitian or using a carbohydrate counter can be useful.

• In order to consume the necessary amount of carbohydrate, it is necessary to cut back on fibre and make use of compact sources of carbohydrate such as sugar, cordial, soft drink, sports drink, jam, honey, jelly and tinned fruit. Athletes who include too many high fibre foods in their carbohydrate loading menu may suffer stomach upset or find the food too bulky to consume.

• Carbohydrate loading will most likely cause body mass to increase by approximately 2kg. This extra weight is due to extra muscle glycogen and water. For some, a fear of weight gain may prevent them from carbohydrate loading adequately.

• Athletes commonly use carbohydrate loading as an excuse to eat everything and anything in sight. Consuming too many high fat foods will make it difficult to consume sufficient carbohydrate & may result in gain of body fat. Stick to high-carbohydrate; low-fat foods while carbohydrate loading.

A word of caution: always experiment with any new nutritional or training technique in training before trying it in competition.

Good luck with the Marathon Running, don’t forget to have a post-race Sports Massage to relieve those aching muscles. If you have any pre-race niggles don’t ignore them, give our Galway Clinic a call on 086 1957378

http://www.sportsinjurytherapy.ie/

Injury Prevention & Recovery Tips for Galway Bay Half Marathon

Darren Macfarlane Sports injury Therapy Clinic is located at Lower Abbeygate Street, Galway and provides sports injury treatment, sports massage and rehabilitation programmes.

In the run up to the Galway Bay Half Marathon Darren shares his tips on how to prevent injury during the lead up to the big day and recovery tips following the event.

One of the most important aspects of training for any Marathon is to slowly build up endurance for the long distances while staying injury free. The last thing you want to happen is that after signing up you become unable to compete on the day due to injury.

Warm up

A proper warm up is a key component to preparing the body for the demands of any training session or competition. Developing a pre-race warm up is unique to each individual. Performing a warm up will elevate heart rate, VO2, and increase blood flow to the connective tissue and local muscles to be trained. This in turn will raise muscle temperature and help decrease joint and muscle stiffness, therefore improving range of motion. Warm-up periods of five to 15 minutes are recommended. Warm muscles are less susceptible to injuries and a proper warm up is essential for injury prevention. As part of the warm up you should incorporate some dynamic stretching.

Cool Down

Incorporating a proper cool down will help clear lactic acid from muscles and prevent muscle soreness. This should be a low intensity light jog. Just like the exercise began with a stretching routine it should end with one. Warm down stretch’s should be static stretch’s. Stretching is key to preventing nagging soreness. Stretching thoroughly before a training session is important, but stretching afterwards is key to helping muscles recover from the strain and stress.

Incorporate Recovery Techniques:

There are a number of ways to incorporate recovery into your routine. Bio foam rollers and massage sticks help sore, achy or stiff muscles recover from exercise. The most important piece of stretching equipment you can own is a foam roller. Foam rolling helps sore achy or stiff muscles recover from exercise. You can roll out knots in muscles and serves as a sort of deep tissue massage that you can do on yourself. Be sure to hit IT bands, your lower back and your calf’s. Foam rolling should be done after stretching.

Because of the pounding that your joints can take over the course of a long run, icing your sore spots – particularly knees or hips – can prevent inflammation and next-day soreness. After a long run, you can simply jump into the sea or a cold river or take an ice bath or wrap your legs with cold wraps. Ice naturally reduces swelling and aids muscles in healing. Having an ice pack in the freezer is handy to treat any strains or aches.


Have Regular Sports Massage

Sports massages are critical to muscle recovery. Most people find scheduling appointments on the lighter training days more beneficial. This is mainly because it enables the therapist to treat any specific muscular tightness allowing a couple of day’s recovery before the long training session on Sundays.

Alternatively some athletes enjoy having the massage following their longer training session to allow them to maximize their training performances throughout the week.

It is suggested that whilst people are training for a half marathon they receive weekly mas-sages. It is especially important to have massage towards the build up to the longer training weeks prior to the race. It is also wise to have a massage a few days before an event to loosen up the muscles and relax the athlete as part of the final week preparations for the race .It is also as valuable to receive massage as soon as possible following the race, as this helps to improve the recovery rate and reduces the intensity of delayed muscle soreness (DOMS) experienced 1-3 days post event.

Stick to a Healthy Diet

Pay attention to your diet. Not fuelling yourself correctly or overeating can lead to real problems. You need to be sure that you are getting enough protein and iron to allow your body to recover. Food is the fuel that helps you compete. Bad fuel can lead to bad results. Taking in protein following long workouts is also crucial to helping muscles recover. The goal of post-exercise nutrition is to restore muscle and liver glycogen stores, improve hydration and help those sore legs get the nutrients they need to recover and get stronger and more importantly to repair muscle tissue. You should eat 15 to 30 minutes after a long workout, preferably as soon as possible, when the muscles are most receptive to fuel. Muscle replenishment and tissue repair can be accelerated if you combine carbohydrates and protein together in a ratio of 4 to 1. You will also need Increase your consumption of carbohydrate during periods of heavy training

Footwear

Good footwear provides protection from impact and supports the foot and ankle. Make sure your footwear fits well and has enough Cushing for absorbing impacts. Make sure it has a good sole for traction on the surface and that it is suitable for Running. The wrong type of shoe can increase the risk of various injuries including blisters and Shin Splints .Don‘t wear regular runners when running. Professionally fitted shoes designed for running will support your feet and reduce your risk of injury. Take your old runners with you when purchasing new ones so the salesperson can identify where your shoes wear the most and choose the right footwear to suit your feet. Replace your running shoes frequently. Shock absorbing capability will diminish gradually and may be inadequate after 350 to 550 miles. The upper of the shoe may not show much wear, but the shock absorption may still be gone. If you are running 20 miles per week, you should be replacing your shoes between 4 and 8 months depending upon your shock absorption needs. It is always cheaper to replace shoes than having months of treatment for a running injury. Properly fitting running shoes can help prevent injuries. Look for light-weight shoes that breathe well and offer good arch and ankle support also with good shock absorbing capacity to help in injury prevention.

Listen to Your Body

Finally, listen to your body. Over the many miles of half marathon training, your ability to tell the difference between soreness and the beginnings of a possible injury will become more finely tuned. If there is nagging pain in a joint or muscle, vary your workout schedule or take a day or two of rest. Swimming is obviously low impact and is a good way to keep fitness up while giving your tired legs a break. If you are hurt, you won’t be able to stick to your training schedule. So, focus on staying healthy and then work on keeping up with the training. If you have sore shins when you run or back pain, don't ignore those symptoms. Treat even seemingly minor injuries very carefully to prevent them becoming a big problem for you.

Recovery days reduce injury rates by giving muscles and connective tissues an opportunity to repair between training. Plan a day of rest once a week into your training schedule. It will not hurt your performance, but will actually help it and is critical in muscle recovery. Athletes with high consecutive days of training, have more injuries. While many athletes think the more they train, the better they'll play, this is a misconception. Rest is a critical component of proper training. Rest can make you stronger and prevent injuries of overuse, fatigue and poor judge-ment. Avoid training when you are tired if you experience pain when training STOP your training session immediately.



Contact Darren at our Galway Clinic on 086 1957378 for a pre Galway Bay Half Marathon sports massage and post-Race recovery massage.

http://www.sportsinjurytherapy.ie/

Injury Prevention & Recovery Tips For Ironman 70.3 Galway

Injury Prevention & Recovery Tips for the Ironman 70.3 Galway


Darren Macfarlane Sports injury Therapy Clinic is located at Lower Abbeygate Street, Galway and provides sports injury treatment, sports massage and rehabilitation programmes.

In the run up to the Ironman 70.3 Galway Darren shares his tips on how to prevent injury during the lead up to the big day and recovery tips following the event.

One of the most important aspects of training for any ironman is to slowly build up endurance for the long distances while staying injury free. The last thing you want to happen is that after signing up you are unable to compete on the day due to injury.

Warm up

A proper warm up is a key component to preparing the body for the demands of any training session or competition. Developing a pre-race warm up is unique to each individual. Performing a warm up will elevate heart rate, VO2, and increase blood flow to the connective tissue and local muscles to be trained. This in turn will raise muscle temperature and help decrease joint and muscle stiffness, therefore improving range of motion. Warm-up periods of five to 15 minutes are recommended. Warm muscles are less susceptible to injuries and proper warm up is essential for injury prevention. As part of the warm up incorporate with proper dynamic stretching.

Cool Down

Incorporating a proper cool down will help clear lactic acid from muscles and prevent muscle soreness. This could be a low intensity light jog or cycle. Just like the exercise began with a stretching routine it should end with one. Warm down stretch’s should be static stretch’s. Stretching is key to preventing nagging soreness. Stretching thoroughly before a training session is important, but stretching afterwards is key to helping muscles recover from the strain and stress.

Incorporate Recovery Techniques:

There are a number of ways to incorporate recovery into your routine. Bio foam rollers and massage sticks help sore, achy or stiff muscles recover from exercise. The most important piece of stretching equipment you can own is a foam roller. Foam rolling helps sore achy or stiff muscles recover from exercise. You can roll out knots in muscles and serves as a sort of deep tissue massage that you can do on yourself. Be sure to hit IT bands, your lower back and your calf’s. Foam rolling should be done after stretching.

Because of the pounding that your joints can take over the course of a long run or even bike ride, icing your sore spots – particularly knees or hips – can prevent inflammation and next-day soreness. After a long run, you can simply jump into the sea or a cold river or take an ice bath or wrap your legs with cold wraps. Ice naturally reduces swelling and aids muscles in healing. Having an ice pack in the freezer is handy to treat any strains or aches.







Have Regular Sports Massage

Sports massages are critical to muscle recovery. Most people find scheduling appointments on the lighter training days more beneficial. This is mainly because it enables the therapist to treat any specific muscular tightness allowing a couple of day’s recovery before the long training session on Sundays.

Alternatively some athletes enjoy having the massage following their longer training session to allow them to maximize their training performances throughout the week.

It is suggested that whilst people are training for the Ironman they receive weekly massages. It is especially important to have massage towards the build up to the longer training weeks prior to the Ironman event. It is wise also a few days before the event to have a massage to loosen up the muscles and relax the athlete as part of the final week preparations for the event .It is also valuable to receive massage as soon as possible following the event. As this helps to improve the recovery rate and reduces the intensity of delayed muscle soreness (DOMS) experienced 1-3 days post event.



Stick to a Healthy Diet

Pay attention to your diet. Not fuelling yourself correctly or overeating can lead to real prob-lems. You need to be sure that you are getting enough protein and iron to allow your body to recover. Food is the fuel that helps you compete. Bad fuel can lead to bad results. Taking in protein following long workouts is also crucial to helping muscles recover. The goal of post-exercise nutrition is to restore muscle and liver glycogen stores, improve hydration and help those sore legs get the nutrients they need to recover and get stronger and more importantly to repair muscle tissue. You should eat 15 to 30 minutes after a long workout, preferably as soon as possible, when the muscles are most receptive to fuel. Muscle replenishment and tissue repair can be accelerated if you combine carbohydrates and protein together in a ratio of 4 to 1. You will also need Increase your consumption of carbohydrate during periods of heavy training

Listen to Your Body

Finally, listen to your body. Over the many miles of Ironman training, your ability to tell the difference between soreness and the beginnings of a possible injury will become more finely tuned. If there is nagging pain in a joint or muscle, vary your workout schedule or take a day or two of rest. Swimming is obviously low impact and is a good way to keep working on one of the triathlon disciplines while giving your tired legs a break. If you are hurt, you won’t be able to stick to your training schedule. So, focus on staying healthy and then work on keeping up with the training. If you have sore shins when you run or a stiff neck when you bike, don't ignore those symptoms. Treat even seemingly minor injuries very carefully to prevent them becoming a big problem.

Recovery days reduce injury rates by giving muscles and connective tissues an opportunity to repair between training. Plan a day of rest once a week into your training schedule. It will not hurt your performance, but will actually help it and is critical in muscle recovery. Athletes with high consecutive days of training, have more injuries. While many athletes think the more they train, the better they'll play, this is a misconception. Rest is a critical component of proper training. Rest can make you stronger and prevent injuries of overuse, fatigue and poor judge-ment. Avoid training when you are tired if you experience pain when training STOP your training session immediately.



Contact our Galway Clinic on 086 1957378 for a pre event sports massage and post event recovery massage
http://www.sportsinjurytherapy.ie/

Herniated Disc / Slipped Disc / Bulging Disc

Herniated Disc / Bulging disc

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist

The spine is made up of 33 bones know as vertebrae which are separated by discs called intervertebral discs. Their function is to act as shock absorbers and cushion the spine and to allow movement in spine. The intervertebral discs are filled with a gelatinous substance in the middle called nucleus pulposus. Excess stress on the spine can damage the discs or as a disc degenerates it can herniate. This is when the inner core to leaks out. The weak spot in the outer core of the disc is directly under the spinal root, so the herniation in this area puts direct pressure on the sciatica nerve. Depending on where the sciatic nerve is pinched will determine where you feel the pain which can radiate to the front of knee or right down the back of leg to calf or foot.

Approximately 90% of disc herniations will occur toward the bottom of the spine at L4-L5 or L5-S1. The majority of disc herniations are of posterior protrusion, which means that the disc is bulging towards your back side. Most posterior disc bulges cause pain when bending forward. This causes the disc to move posteriorly, thus compressing on the sciatica nerve.

Symptoms

• Acute low back pain.
• Constant sharp pain which radiates down leg sometimes as far as the calf or foot.
• Pain may be worse by sitting for long periods, coughing or sneezing, lifting heavy objects or moving your back will increase pain.
• Pins and needles may be felt in the back of the leg.
• Numbness in the buttock leg or foot.
• Pain can be better in morning after a nights rest.
• Muscle spasms in lower back.
• Weakness in big toe or ankle.

Treatment Options for a Herniated Disc.

• Visit your doctor for diagnoses and treatment options.

• Treatment options will depend on the length of time the patient has had his or her symptoms and the severity of the back pain. Is there any weakness or numbness present and the age of patient will be considered. Patients will be advised to start with 6 to 12 weeks of non surgical treatment, such as physical Therapy, epidural injections or non-steroidal anti inflammatory drugs.

• Physical therapy treatment can help reduce back, leg pain and discomfort caused by the herniated disc. The physical therapist will also advise on rehabilitation corrective exercise programme and lifestyle changes to help reduce pain.

• Surgery may be recommended such as a microdiscectomy to alleviate the pain from a herniated disc if after 12 weeks of non surgical and the pain is still severe.

• For most patients symptoms from lumbar herniated disc will resolve with no surgical treatment such as physical therapy but it may take a prolonged period of time.

Tips

• Stay off your feet, this will keep the pressure off your spine and you will heal a lot faster. Walking and sitting are the 2 worst things you can do besides sleeping on your back or stomach.

• Sleep on your side with a cushion between your knees, a cushion behind your back and in front of your chest. This will help keep the pressure of the hips and the lower spine and will prevent you from rolling over.
• Avoid bending over, this will make condition worse.

If you have been diagnosed with a herniated disc physical therapy will help reduce your pain. Contact our Galway clinic on 086 1957378

www.sportsinjurytherapy.ie 

Sciatica

Sciatica

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist

Sciatica is quite a common complaint which is caused by pressure on the sciatic nerve which runs down the leg. This pressure causes pain in the lower back also with pain which can radiate down one or both legs.

Causes of pressure

·  Herniated or bulging disc

·  Disc degeneration

·  Muscle Tension in gluts and piriformis muscles

·  Bony growths

·  Tumors

·  Infections

The most common cause is from a herniated/ bulging disc or a tight piriformis muscle. Five sciatic nerves run from the lower back down the leg. When excessive stress is put on the spine this can damage the discs. These discs are filled with a gelatinous substance and when the disc is damaged the jelly-like centre squeezes out and puts pressure on the spinal cord compressing the sciatica nerves causing pain to run down leg and sometimes as far as the calf and foot.

The piriformis muscle is located adjacent to the sciatic nerve and if tight can impinge the nerve also causing pain.

Symptoms

·  Acute low back pain.

·  Constant sharp pain which radiates down leg sometimes as far as the calf or foot.

·  Pain may be worse by sitting for long periods, coughing or sneezing, lifting heavy objects or moving your back will increase pain.

·  Pins and needles may be felt in the back of the leg.

·  Numbness in the buttock leg or foot.

·  Pain can be better in morning after a nights rest.

·  Muscle spasms in lower back.

·  Weakness in big toe or ankle.

Sciatica Treatment:

·  Rest and avoid bending or lifting heavy objects.

·  Apply heat packs or a hot bath may help relax muscles and relieve muscle spasm.

·  Lying on the floor in the psoas position may relax muscles.

·  See a sports injury specialist or doctor for a diagnose and treatment.

·  Begin a rehabilitation programme under the guidance of your sports injury specialists.

For diagnose and treatment of sciatica .Give me a call at our Galway Clinic for an Appointment on 086 1957378 

www.sportsinjurytherapy.ie

Lower Back Pain Case Study

Case Study for Lower Back Pain

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist

This case study is for a rugby player who came to me with lower back pain which he has been suffering with for the last year. With a reoccurring injury my client needed a full biomechanical functional screening assessment to get to the underlining cause of the problem. I will discuss relevant information he gave me, the assessments I carried out and their results and the treatment and individual corrective exercise programme that I designed for him.

Relevant Information:

• My client broke his left ankle 2yrs ago. Had surgery and had metal pins put in place. Sometimes during training sessions he can experience pain in left ankle.
• He has been suffering from pain in lower back for the last year especially while driving on long journeys or sitting at his desk in work all day.
• Reports after a heavy training session involving squatting or lunging that he experience pain on left side of lower back.
• While running or sprinting he feels his left leg straining out to side.
• Currently trains four times a week and just lives with the chronic pain in the lower back.

Biomechanical Functional Screening Assessment:

I carried out a postural assessment which included measuring the spinal curves and pelvic tilt. I then assessed the local system (core) for any weakness or to see if it was working properly. I carried out a comparative range of motion assessment on the lower leg muscles. I then recorded the client doing a lung and squat to assess his movement.

Assessment results:

Postural Assessment:

• Left lateral view shows an increased curve in Lower Spine. This indicates Lordosis and is consistent with the back pain client is experiencing

• Knees are anterior and that would suggest tight Quads

• Spinal Curve: L5 to S1 is 24, this is very curved which again indicates Lordosis

• Pelvic Tilt: Left is 16 degrees Anterior and Right is 15 degrees Anterior, Normal is 0 degrees. This indicates an anterior Tilted Pelvis which will increase the Curve in the Lower Spine. I suspect this is tiled because of tight Quads, Psoas, Erector Spinae and weak Hamstrings & Lower Obliques

Local System (Core):

• Lower Ab Coordination: This is Poor and confirms weak lower Obliques

Comparative Range of Motion (flexibility & joint movement):

• Measurements showed both Quads to be tight with Left tighter than the right – this backs up the postural assessment findings

• Both Psoas are tight which was also identified in the postural assessment

• Both Calf’s are tight with the left a bit tighter

• Left QL is tight

• Right Piriformis is tight

Assessment of Movement:

• Lunge

• Plane of motion stability: Fell left during lunge due to Left Ankle instability

• Squat

•  Initial movement coordination: chunky movement evident on initiation of decent, knee flexing prior to hip flexion. This means that movement is faulty

•  Plane of motion stability: Saggital instability in the forward position &; frontal instability to the left side. The muscles that stabilise the body during movement are not firing to stop him falling forward and to the left side

•  Full Range of Motion: Client only got ¾ of way and that would indicate tight Calf’s, Quads &Psoas

My Findings:

1. Hyperlordosis in lower back would suspect is leading to is lower back pain. This is caused by his overly tight quadriceps, psoas and erector spinae and by having weak hamstrings and lower Obliques.

2. When you run, sprint or walk, the psoas muscle (hip flexor) fires and tilts the pelvis forward and the lower Obliques fire at the same time to counteract the forward movement to control the movement. The clients lower Obliques are weak, this means the pelvis is tiling forward rapidly shaking it causing a lot of stresses on the lower back which can lead to pain.

3. All the clients muscles in his left leg are tight this was probably a result after the operation. During the lunge he fell to left side this is because muscles are tight on this side and client had some left ankle instability.

4.During the squat I observed faulty movement and instability, he also had hip and ankle mobility restrictions, and this will affect him during his training and during games which can lead to muscles imbalances and injury.

Corrective Exercise programme:

I designed an individual corrective exercise programme from the assessement results to correct any dysfunction the my client had. I went through the exercises to ensure correct form while doing them. My client will follow the programme for the next month and come a for some soft tissues treatment also on his tight muscles.

I will keep you posted on the progress, check out Darren Macfarlane Sports Injury Therapy on FACEBOOK & my blog darrenmacfarlanesportsinjurytherapy.blogspot.com

www.sportsinjurytherapy.ie 

Neck and Shoulder Pain

Neck and Shoulder Pain

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist

Common Causes

·  Poor Posture

·  Stress

·  Chronic Overuse Condition

Poor posture, stress and force of habit we tend to lift our shoulders up, hold yourself in this position for long periods of time over the day and this leads to shoulder and neck tension.

 As a result, blood flow through the area is limited with a result of a build up of lactic acid. This causes the muscles to stiffen, become tight and sore. To limit tenderness we lift the shoulders even more, which in turn increases muscle tension and further limits blood flow to area and the circle continues. Common areas to find large amounts of tension and knots is the upper trapezius (top of shoulders).

Poor posture when driving, sitting at desk or working on a computer for long periods can have the complete opposite effect on some muscles which become weak. The shoulder blades are moved further away from each other with poor posture .This results in the muscles becoming slightly stretched and lengthened. As a result the muscle fibers become glued together to gain strength to prevent themselves from being over stretched and torn.

Standing with are arms held in front of the body for long periods of time causes the pectorals muscles to become tight and short.

When muscles become tight and some weak in the upper body it leads to a condition called upper crossed syndrome. This syndrome produces lifted and forward shoulders, winging of scapula, and forward head posture. This posture produces stress on the cervical region (neck) and the shoulders due to the altered motion of the glenohumeral joint due to the incorrect positioning of the shoulder girdle.

Stress causes hormone adrenalin to be produced, this is known as the fight or flight syndrome. This causes us to hold or bodies ridged and crunch up, and in turn (like poor posture) prevents blood flow to or muscles causing muscle tension in the upper neck and shoulder muscles.

Tips to prevent neck & shoulder Tension

·  Feet flat on floor or use foot rest

·  Arms parallel to the floor & level with keyboard

·  Always sit with spine in alignment don’t lean to one side. Lumber support can help with this.

·  As soon as your mind goes onto your work the muscles are like springs and will pull you back to a poor posture position. So regularly remind yourself to straighten up.

·  Regular massage can help you relax & prevent stress.

·  Visit a sports injury specialist for Injury Treatment, who will work on any tight muscles and break down any knots and provide a corrective rehabilitation programme to strengthen any weak muscles & stretch out any tight muscles.

Don’t Suffer with Neck and Shoulder Pain!  Have it treated .Give me a call at the Galway Clinic for an Appointment on 086 1957378

www.sportsinjurytherapy.ie 

Runners Knee

Iliotibial Band Syndrome (IT Band Syndrome / Runners Knee)

By Darren Macfarlane, Sports Injury and Rehabilitation Specialist

Iliotibial band syndrome is very common among runners so much so, that it is known as, runner’s knee. It affects up to 10% of all runners at some stage. Iliotibial band syndrome is a painful overuse knee injury that affects the outer part of the knee.
The Iliotibial band is a sheath of thick, fibrous connective tissue which attaches to the tensor fascia latae muscle. It then runs down the outside of the thigh and inserts into the outer surface of the Tibia (shin bone) just below the knee joint. The IT band acts as a stabilizer of the pelvis and to extend the knee joint (straighten it) as well as to abduct the hip (move it out sideways).

As the ITB passes over the lateral epicondyle of the femur (bony part on the outside of the knee) it is prone to friction. At an angle of approximately 20-30 degrees the IT band flicks across the lateral epicondyle. When the knee is being straightened it flicks in front of the epicondyle and when it is bent, it flicks back behind.
Iliotibial band syndrome is common in runners as 20-30 degrees is the approximate angle at the knee when the foot strikes the ground during running. IT band syndrome is an overuse condition that is aggravated by excessive training which causes the band to tighten which then rubs off the knee bone causing pain and inflammation on the outside aspect of the knee and is often more intense when descending stairs, or getting up from a seated position.

Signs and Symptoms of Iliotibial Band Syndrome:

• Sharp or stabbing pain located on the outer side of the knee joint.

• Pain aggravated by running, especially running downhill or climbing stairs.
• Pain will usually worsen as activity continues
Causes of Iliotibial band Syndrome:
• Athletes who fail to perform adequate stretching exercises to quadriceps and lateral thigh.
• Overtraining and overuse
• Running on a cambered road surface. Because most roads slope off to sides, running in the same direction leads to the outside foot being lower than the inside foot. This in turn causes the pelvis to tilt to one side and stress the it band.
• Biomechanical abnormalities that can lead to it band include, excessive pronation of the foot, leg length discrepancy, lateral pelvic tilt and bowed legs.
• Weak hip muscles i.e. gluteus medius.
• Naturally wide and tight it band.

Prevention and Treatment of Iliotibial band Syndrome:

• Rest from any activity that causes pain and inflammation. No one likes to be told to rest but movements like running will aggravate the pain. Rest will allow inflammation to decrease and area to heal. Start with at least five days of complete rest from training.
• Apply ice. This will reduce inflammation. Apply ice at least three times a day. Wrap ice in cloth to prevent burns.
• Try swimming or cycling if pain free or work on upper body strength during recovery period. Rest and low impact cross training can lead to a faster recovery.
• Stretch the Iliotibial band, quadriceps and piriformis muscles if tight after training.
• Avoid overtraining
• Make sure running shoes are in good condition. Many it band injuries are as a result of worn out shoes.
• Foam rollers are useful way to self massage the it band and help stretch out tight and painful areas.
• Strengthening the gluteus medius, if weak it overloads the it band and it has to do all the work and tightens up.
• Increase weekly mileage and training time gradually.
• Get regular sports massage; this will eliminate any tightness or adhesions that cause the IT band to tighten up and turning into pain and leading to time off training.
• Attend a physical therapist to get a full biomechanical assessment to determine the underlining cause of the IT band pain. They will assess your posture and lower limb alignment and correct any dysfunction with a corrective exercise rehabilitation programme and with soft tissue techniques.

Don’t Suffer with IT Band Pain! For a Sports Massage Treatment or to Have a Biomechanical Functional Assessment .Give me a call at the Galway Clinic for an Appointment on 086 1957378

www.sportsinjurytherapy.ie 

How can Functional Rehabilitation help my pain

HOW CAN FUNCTIONAL REHABILITATION HELP YOU WITH CHRONIC INJURY?

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist

If you are suffering from a reoccurring injury, there is usually an underlying problem where something is not functioning correctly in your body and over time this has lead to causing your injury. This is known as a chronic injury .Instead of focusing on the injury alone, you have to look at the bigger picture to see what is causing it and time and thought must to be taken to rehabilitate this injury properly.

This is where Functional Rehabilitation can help you.

In functional rehabilitation there are four different assessments which are: Postural, Core Function, Range of Motion & Movement. When all of the assessments are carried out and the data is put together, you are given a functional corrective exercise programme. This will prevent future injury and help with your chronic injury.

If your posture is incorrect while standing still then it will be incorrect when you move, this will result in restricting your movement and will make your body unstable through your joints, which will lead to injury and muscle imbalances.

Your body’s Core is designed to work automatically without us knowing, its function is to stabilise the joints of the spine and pelvic girdle therefore if this is not functioning properly it will lead to injury and especially injury of the Lower Back.

The range of motion assessment allows you to assess the flexibility of your muscles and the health of your joints, it also lets you know where there is a presence of pain and inflammation. In everyday life we move, that is why movement needs to be assessed so that we can see if the muscles that move us, and the muscles that stabilise us during movement are working efficiently.

Why Rehabilitate using Functional Exercises?

As upright human beings we have to combat gravity daily, we do this through all of the movements we make. We climb mountains; take part in all kinds of sports, walk, and run, everything we do involves movement. There is no point in training or rehabilitating your muscles in isolation because we do not use our muscles in isolation – we train with a view to excelling in our chosen sport. Functional exercises tailored to your body will increase your ability to move efficiently and reduce your chronic injury.

A strong foundation of muscular balance and core stability is essential for any athlete. In many athletes their core is not fully developed, weakness and lack of coordination in your core can lead to compensatory movement and strains, overuse and injury. A functional corrective exercise program will prevent future injury as well as improving efficiency & performance.

For more information and advice on Functional Rehabilitation contact our Galway clinic on 086 1957378 
www.sportsinjurytherapy.ie 

What is a Functional Assessment and why do i need one

What is a Functional Assessment and Why Do I Need One?

By Darren Macfarlane, Sports Injury and Rehabilitation Specialist

An athlete needs to have his body optimal to perform at the highest level; any deviation from this can lead to poor performance or even injury. Functional assessments are very important to athletes because it can let them know what strengths or weakness they have in there body. Any weakness or dysfunction in the body i.e. lack of mobility, weak core which are left undressed can severely impact upon your performance and increase risk of injury. Staying injury free is a key to success in sport. By understanding what’s dysfunctional in your body you then know what is needs to be corrected.

The tests I perform at Darren Macfarlane Sports Injury Therapy are:

• Posture

• Core Strength (using a pressure biofeedback monitor)

• Comparative Range Of Motion

• Movement (Lunge and Squat)

Why have these tests done?

Posture

The posture test can give me a good visual feedback of any deviation from optimal posture. It can highlight can excessive curves in the spine i.e. Hyperlordosis in lumber spine which can lead to lower back pain or Kyphosis in the thoracic region which can lead to shoulder and neck injuries. If your posture is incorrect while standing still then it will be incorrect when you move, this will result in restricting your movement and will make your body unstable through your joints, which will lead to injury and muscle imbalances .As part of the posture test I measure your spinal curves and pelvic tilt. Any tilt in your pelvis can lead to back pain or this can also highlight that there is any muscle imbalances. Any visual signs of fallen arches from posture test will then also be confirmed by gait analysis. Fallen arches can lead to shin splints, knee problems, quadriceps strains and hip pain.

Core Strength

Your body’s Core is designed to work automatically without us knowing, its function is to stabilise the joints of the spine and pelvic girdle therefore if this is not functioning properly it will lead to injury and especially injury of the Lower back. By assessing the core you determine where the weaker portion of it are and more importantly that it is working properly, this is important to provide spinal and pelvic stability needed to protect you from damaging forces as a result of gross movement during your particular sport or daily activities.

Comparative Range of motion

I use goiniometers and an inclinometer to measure range of motion in athletes. The range of motion assessment allows you to assess the flexibility of your muscles and the health of your joints, it also lets you know where there is a presence of pain and inflammation. It assesses the asymmetries which occur between the right and left hand side of body and lets me know what’s happening throughout the kinetic chain. This assessment can be made specific to your sport. Tight and inflexible muscles can lead to muscle strains which will frustrate athletes because they will need to rest for weeks which can hamper there training and fitness levels.

Movement

Movement is assessed by recording clients doing a lung and squat. This shows whether the athlete has stability and movement competency in order to train or compete without getting injured. In everyday life we move, that is why movement needs to be assessed so that we can see if the muscles that move us, and the muscles that stabilise us during movement are working efficiently.

Once the postural, core strength, flexibility, mobility and stability dysfunctions have been analysed a therapeutic corrective exercise program is designed specific to your individual needs.This program will get you to a level of function that you require which will allow you to do your sport properly without the risk of injury, staying injury free is one of keys in any sport, it will also improve your efficiency and performance level.

The assessments are done at your initial consultation which takes about an hour and then you return one week later to receive your individual corrective exercise program, where I address your dysfunction. I then take you through the exercises so that you do them properly with good form and understand them. Five weeks later the you return for re-assessment to monitor your progress.

You cannot determine a proper course of training and strengthening without a proper

Clinical assessment. You need to determine the correct course of action to correct any imbalances and apply the right training methods.

Have a functional Assessment today. Or for any information on functional assessments Call Darren at our Galway Clinic on 086 1957379
www.sportsinjurytherapy.ie 

Have I strained my muscle

HAVE I STRAINED MY MUSCLE AND IF SO WHAT SHOULD I DO?

By Darren Macfarlane, Sports Injury & Rehabilitation Specialist-Galway

Muscle injuries are among the most common injuries and they account for 30% of all injuries in sport.

If you’ve ever been involved in a sport you’ve most likely heard your manger tell you not to pull a muscle. A muscle tear is more properly described as a muscle strain, which means the fibers of a muscle in the body have been overstretched resulting in a severe injury. Strains are caused by overstretching or eccentric overload and are located in the muscle-tendon junction.

Strains frequently occur in sports that require explosive muscular effort over a short period of time e.g. sprinting, jumping, soccer, gaa football and hurling. The rupture occurs when the demand is greater than the strength or elasticity of the muscles fibers. The muscle becomes torn as the force exceeds the contractile strength of the muscle. Examples in sport are sudden stopping, slowing down or a combination of slowing down and acceleration when turning cutting jumping and when a change in direction is involved.

Strains mainly occur in muscles that move two joints, i.e. the hamstring muscle which flexes the knee and extends the hip. Other examples of muscles susceptible to the distraction ruptures are the quadriceps, gastrocnemius (calf) and the bicep muscle in the upper arm.

Muscle strains are caused from extreme physical activates, improper warm up prior to these activities or simply a lack of flexibility and conditioning needed for the sport or fitness regimen.

TYPES OF STRAINS

Strains are classified by the degree of rupture.

·                    First and Second degree strains: this is a partial rupture

·                    Third degree strains: this is a complete rupture   

SIGNS AND SYMPTOMS OF A MUSCLE STRAIN

• A sharp and stabbing pain felt at the moment of injury and when muscle is contracted later. Usually there is little pain at rest.
• Partial rupture, pain will inhibit muscle contraction.
• Complete rupture, muscle unable to contracted
• There is often localized tenderness and swelling over damaged area.
• After 24hrs bruising and discoloration may be seen. Often below site of injury there are signs of bleeding within the damaged muscle.
• In some very serious cases you may also hear a popping noise at the same time you feel the sting of the tear.

TREATMENT OF AN ACUTE MUSCLE STRAIN INJURY
THE PRICE PRINCIPLE (WHEN INJURY FIRST HAPPENS) USE IN THE ACUTE PHASE FIRST 48-72 HRS. DO PRICE TO PROMOTE HEALTY HEALING OF TISSUE.

• PROTECTION-Protect area from further damage. Take player of pitch or stop activity you are doing.

• REST-Rest the injured area from exercise and other day to day activities. Any movement will continue to open and aggravate the tear and cause more bleeding .Rest enables fibers to begin to knit together quickly before any more damage is done.

• ICE-Ice should be applied as soon as possible as this reduces the amount of bleeding and swelling in the tissues, less bleeding reduces the amount of scar tissue developed. It also has an analgesic effect which reduces pain and also reduces the protective spasm around the area of the injury and makes it more relaxed .Ice for the first 3 days only every 3hrs.Never apply the ice directly to the skin, place the ice in a plastic bag and wrap within a towel .Leave the cold pack on the torn muscle for no longer than 15mins or it could exacerbate the injury. Always check contraindications to using ice.

• COMPRESSION-Immediately apply to restrict blood flow to injured area and to limit swelling .Do not apply around whole limbs it will starve other areas of blood.

• ELEVATION- Done as much as possible, a leg or arm should or arm should be comfortably supported so that it is raised higher than torso .This elevation slows the arterial blood flow to the area and therefore helps in restricting the amount of bleeding gravity also helps in the removal of swelling from the area and so aids recovery.

NOTE: All acute injuries should be seen by a medical practitioner as soon as possible. Majority of strains and sprains are minor and the inflammation soon stops and patient may choose not to seek medical help .IF Swelling, pain and inflammation remains after 48hrs of good price, this suggests that it could be more than a minor soft tissue injury and you must be medically assessed.

CONSIDERATIONS

To safeguard from a muscle tear make sure to properly train and condition the body for the specific sport or activity. This will not only increase your flexibility and strength for your chosen sport but also make your muscles more resilient and adaptable to the exercise.

·                    Sports massage is a great way of preventing muscle strain injuries.

·                    Muscles have a great capacity to regenerate but the new muscle fibers will be shorter and incorporate inelastic scar tissue. If the scar tissue covers a large area, function will be impaired because contraction is restricted. Areas of different elasticity may be formed in the muscle which increases the risk of recurrence of the rupture. It is therefore important to have all muscle strains treated and rehabilitated properly

.

If you have a Muscle Strain you need Treatment. Call Darren at our Galway Clinic for Appointment on 086-1957378

www.sportsinjurytherapy.ie