Blog

Many patients come to my practice having heard something about inner core stability, but the majority have a very skewed perception of the core muscles and how to exercise these.

As an example, I asked a patient of mine (a provincial rugby player) if he does core exercises. “Yes”, he replied, “I do 100 crunches every day!”

You may think that this is the ideal response, but in fact he had very poor core stability when tested, and by the end of this article you should realise that he was in fact not training his core muscles.

To understand the concept of the “core”, one first needs a basic understanding of the muscles that make it up. The core can be related to a cylindrical can.

• The lid of the can is the diaphragm
• The bottom is the pelvic floor
• The front and  sides are made up of a deep stomach muscle (you’ve probably never heard of it) called Transversus abdominis
• Lastly the back is a muscle called Multifidus

These muscles all act together to increase the pressure inside the stomach cavity, and in so doing increase stability around the mid-section. A good way of visualising this is to try imagine squeezing a new tube of toothpaste with the cap on. The tube keeps its basic shape and is quite difficult to compress. Now remove the cap or make a hole in the side of the tube and suddenly the tube collapses.

The deep stomach muscle and Multifidus also have connections to the spine itself and when contracting, prevent excessive movement at the spine during activity.

So why was the rugby player not training his core you ask?

Well, most people only train the top three layers of stomach muscles during regular stomach exercises. Crunches, sit-ups and similar exercises all involve movement of the torso and so you tend to only train the “mobilising” muscles. These may look good when your shirt is off, but do very little for your back.  The deep stomach muscle is a “stabilising” muscle, so in order to train it, you need to challenge your bodies’ stability.

This is where Physio-balls, Bozu-balls (half a physio-ball) and Pilates come in. Using this equipment under the supervision of a trained Physio or other health professional will help you train your core correctly by challenging your balance and stability. Most of the exercises that use this equipment will be static exercises (i.e. holding a certain position with as little movement as possible) and then at a more advanced stage, movement can be added. Ever seen a person doing a full squat whilst standing on a Physio-ball? These people have phenomenal core stability and its quite amazing to watch.

One last thing worth mentioning is that if you do go to Pilates, PLEASE make sure your instructor shows you how to isolate Transversus Abdominis before you commence any exercises. If you have not been shown how to do this, you could do more harm than good. For this reason, Pilates classes at the gym down the road is probably not the best place to start this form of exercise unless you can get individual attention.

There is so much more to be said about core stability and its importance, but I hope this short explanation will help you to better understand your body.

If you need more info or would like to check and train your core, give us a call and let us bulletproof your back.

Ric@PhysioPRO

Having recently tested just how far back the human fingers can bend…with expected results, I thought I would write a post on hand injuries in Sports.

Hand and wrist injuries account for approximately 15% of injuries that present to sports clinics. This is not surprising once you break down just how many components make up the human hand.

For starters, there are 27 major bones, 17 joints, at least 123 named ligaments, 34 muscles which move the fingers and thumb, 48 named nerves and 30 named arteries. In other words, there is a lot that can go wrong here…

There are just too many specific hand and wrist conditions (Carpal tunnel syndrome, De Quervain’s Tenosynovitis, Scaphoid fractures etc.) to cover in one post, however I would like to discuss a bit more on finger injuries.

In sports we commonly see injuries to the fingers that involve either forced flexion (such as a ball hitting the point of the finger-Mallet finger), or forced extension (such as the finger being bent backwards further than normal-Jersey Finger). Both these injuries could cause damage to either the ligaments, tendons or even the bones of the hand.

“Jammed finger” occur when the finger is twisted sideways, disrupting the collateral ligament (on either side of the joint). When this occurs in the thumb, it is referred to as “Goalkeepers Thumb”.

So what should you do if you injure your finger playing sport?

Immediately following the injury, try applying the PRICER regime (see our post on Acute Injury Management-6 Oct 2010). Application of compression bandages (from the tip of the finger downwards) and ice should help reduce/minimise the extent of swelling. Where possible, “buddy-strap” your injured finger to the finger next to it thus reducing movement of the injured finger.

If you have dislocated your finger, seek immediate medical attention as trying to put it back yourself may cause more harm than good.

It is advisable to go see your Physiotherapist or Sports Physician within 24-48hrs after injury, as some injuries require urgent attention. They will assess the extent of your injury and will probably send you for x-rays to rule out fractures.

Lastly, make sure you follow through on your rehabilitation! Finger injuries that are not treated correctly can become chronically painful and stiff. You will only appreciate how important your fingers are once you can’t use them…trust me, I know…

This month we welcome Riccardo Vacccaro, co-owner of PhysioPRO, to the world of blogging.

Riccardo Vaccaro received a BscPhysiotherapy (with Honours) from Wits University in 2007. He has always had a keen interest in sports medicine and rehabilitation.

Riccardo is a Fully Accredited Sports Physiotherapist registered with the South African Sports Medicine Association (SASMA). He is also a member of the Sports interest group of The South African Society of Physiotherapy (SASP).

Hi everyone,

Recently there has been a lot of interest shown in Elastic Adhesive Taping (EAT) as this multi-coloured tape has become a common sight in the sporting population. You only have to look as far as our National Rugby team to see how this tape has changed the taping world.

At our practice, patients are often amazed with the results they achieve using this tape. It is used to reduce pain, decrease inflammation and allow improved function.

It was created with the intention of “getting therapy between therapy sessions”. So let’s look at how and why it works.

There are currently many brands of this tape on the market and according to the brand, it may be referred to by different names, for example Kinesio tape, Kinesiology tape or K-tape etc.

Whatever the brand, they all work on the same basic principles, however not all tapes were created equally and there are differences in the adhesive properties of the different brands.  What about the different colours you ask? Well apparently this was done as colour therapy for patients, so for example blue should be used to try “calm down” tense patients. In my opinion, that’s about as usefull as wearing a hologram around your wrist to improve balance…but let’s leave that topic for another day.

So why does it work? Well, think of when you bump your head/knee/elbow or any other body part. What is your first instinctive reaction? After shouting ouch, you will most likely rub the area with your hand to help relieve the pain. This is because you are stimulating the skins mechano-receptors (which respond to touch) to send signals to the brain and in so doing, you close the “gate” on pain signals being sent.

This effect is known as The Pain Gate Mechanism and by applying tape over the skin, we are able to stimulate these mechano-receptors over a prolonged period thus reducing the body’s’ perception of pain.

Through this sensory stimulation, we are also able to effectively “switch” a muscle “on or off” depending on the direction of pull applied to the tape, and because the tape is applied over a prolonged time (3-5 days), this pull can be used loosen scar tissue.

It doesn’t end there though, because one of the other most valuable effects of this tape is the increase in lymph drainage, which is achieved through the tape microscopically lifting the skin, allowing fluid to flow easier and thus reducing inflammation.

I never get tired of seeing the expression on my patients’ faces when they see how a massive bruise is almost completely gone in 3-5 days after application of this tape.

As great as this tape may sound, it is really only as effective as the practitioner applying it. To get the best out of the tape, the practitioner has to assess each patient’s condition and then apply the appropriate taping technique, specific to the symptoms and cause thereof.

As with all great products, many companies are jumping on the band wagon, so please be wary of “do-it-yourself” taping, as you will probably be disappointed with the results and shocked at the price!

At PhysioPRO, our Physiotherapists are trained in the Kinesio Taping® Method and for more information on this subject please visit www.kinesiotapingafrica.co.za and click on the FAQ’s section.

“The new age sportsman or woman deserves a dynamic physiotherapist. Gone are the days of sticking someone on a machine for thirty minutes and massaging them for ten minutes. At PhysioPRO we pride ourselves on keeping up-to-date with current trends in Sports Medicine, to give you the patient, the best results possible.”

Riccardo