Have you ever had knee pain that you do not know what is causing it and it keeps coming back?
This blog will help you to understand what sort of knee pain you have and what is driving your pain. A lot of people develop knee pain while barbell training or playing sport but do not have a clear understanding of what is causing the pain.
The common conditions we will cover today are:
Illiotibial band Sydrome
Patellofemoral Compression Syndrome
Biomechanical Dysfuntion
Patellar Tendinopathy
Iliotibial Band Syndrome: The IT band is a thick band of fascia that starts at the hips and runs the entire length of your upper leg. The pain usually is on the outside of your knee. The reason for the pain is the compression caused by the thick IT band compressing on the bony part of the outside of your knee. Normally you will not get it from a specific incident but will gradually come on overtime. The pain can start as a dull ache and then progress into a sharp pain.
Patellofemoral Compression Syndrome/ Biomechanical Dysfunction: If you have pain on your knee cap or underneath it is most likely down to a compression problem or a biomechanical dysfunction (bad technique when training). Pain normally increases the more you load the knee. So for example, if you are squatting 60kg the pain might be 1/10. But if you increase the weight to 100kg it may increase to a 4/10.
As your knee moves your kneecap/ patella will cause the muscles to tense and surround your knee to stabilise it. But if these muscles are tight then the knee will not move properly and will rub and can cause injury. In the clinic, we assess your squat both in a normal deep squat position and also doing a single leg squat. This allows us to see where you are not moving properly and then work on this with manual therapy techniques and form alternations to help your knee move better and have you perform pain-free again.
Patellar Tendinopathy: If you do sports that involve more explosive movements that are highly repetitive. For example, hurling, rugby and gymnastics. It is common to have patella tendon pain when you do excessive jumping or loading through the knee. It is much more common to get the pain when you are putting force through the knee, for example, jumping. Rather than just running because it is difficult to overload the knee just running on its own.
Mainly the pain is on the patella tendon itself but you can also get pain on the little bump below the knee (called your tibial tuberosity). This is a common place to see swelling too.
In conclusion
Just looking at the knee is rarely enough to fully fix your pain. It can help a great deal to release off tissue and muscle tension around the knee to allow it to move better but the mechanics that have led to the injury in the first place must be fixed in order to stop the pain from coming back.
This is where we can help you in the clinic by both helping your knee move better and lower pain levels but also see where you are moving poorly to help the pain from returning.
If you would like a full functional assessment and find out what is causing your knee pain, then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
In the previous blog, we talked about what causes Plantar Fasciitis and other foot conditions. This blog will cover how to resolve your foot pain. If you have not checked out part one of this blog series then go to our website to read all about it.
A major issue that is a common cause of foot pain is footwear. By changing this we can cause a long term decrease in your symptoms.
Firstly finding a shoe that has a very small heel and that has a wide toe box to allow your toes to sufficiently spread out. The less a shoe does to your foot, the better it is for your foot. Then as you walk during the day the muscles in your foot will strengthen.
There are lots of brands to choose from when picking a barefoot shoe for example Vivobarefoot, Bearfoot Athletics, Lems, Xero and Feelgrounds. Finding brands that blend foot function with fashion will help your transition.
If you do not wear barefoot shoes often then you may not be ready for a complete jump to barefoot shoes. For example, if you could not swim you would not jump in at the deep end straight away. The same applies to your feet. Slowly building your capacity through the foot will help to gradually build your strength and motion in the foot, reducing the chance of injury and discomfort.
Start off at one hour of being barefoot and then gradually increase the time spent each day by 20 minutes to help your transition.
Toe Extensor Stretch
It is common to stretch the plantar fascia. This is based on the idea that the tissues are tight and shortened. But because modern footwear actually lengthens the plantar fascia we should focus on the opposite side of the foot rather than stretching something that is already lengthened.
Start with a stretch to the toe extensors:
Pull one or both feet behind you and position the top of the foot on the ground.
Pull your heel back and towards the ground. This action should allow a good stretch to the top of your foot.
Hold this position for 30 seconds before relaxing. (It is common to get a cramp in the arch of your foot, the more you practice this stretch the better it will get).
Soft Tissue Mobilisation
A common fix for plantar fasciitis is rolling a ball under your foot, this is effective because when deep pressure is put into the plantar fascia, blood flow is stimulated. This can speed up healing and also act as temporary pain relief.
Find a small ball, either a golf ball or a sliotar and roll it slowly on the bottom of your foot. When you come to a painful point, hold this pressure for 20 seconds before moving off the area. Do this for 3-5 minutes and see if your symptoms are less than before.
Strengthening The Foot
Improving the strength of your foot should be a major factor in the rehabilitation of your foot injury. As mentioned earlier, just switching to a barefoot shoe can significantly increase the strength of the muscles in your foot.
But you may need to further foot strength can work on the small muscles of the foot.
The Toe Scrunch:
Place a small towel under your foot.
Slowly grasp the towel with your toes and pull it towards your heel.
Do this for 10 reps of 3 sets.
Moonwalks:
Strengthening the tight foot extensors (which are the muscles on the front of your shin) can also be beneficial to your foot pain. Moonwalks are an effective way to do this.
Do this exercise for 20-30 reps at a time.
Then when you have the ability to create a strong foot position you can progress to maintaining it while loading the foot. For example, squats and single-leg RDL’s without any shoes on will help create foot stability in multiple planes of motion as you will be constantly shifting your weight through the foot and forced to adapt.
If you suffer from foot pain or have any questions then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Foot injuries can be frustrating because they affect you constantly in the day. It hurts to run, jump, squat, getting up in the morning and can stop you from doing activities you love.
A common condition people are diagnosed with is plantar fasciitis. The plantar fascia is a thick sheet of connective tissue that lies on the bottom of your feet. It runs from the inner part of your heel and spreads under your foot, attaching to the base of your toes. The function is to act as a shock absorber for the arch of your foot when moving.
Imagine the plantar fascia as a rubber band. When you are not standing up the rubber band is relaxed. But as the foot hits the ground when walking or running, it is pulled taut. This is useful for two reasons.
Maintains your foot arch.
Allows the foot to be more rigid allowing the body to push off the ground propelling itself forward more efficiently.
Imagine you are trying to run through quicksand. It is hard to push off and gather speed because you have not got a firm surface to push off. But the plantar fascia creates an effect in the foot turning this quicksand to a firm surface so you can generate force efficiently and with more power.
For a long time, Plantar Fasciitis was thought to be an inflammation of the plantar fascia and more of a repetitive stress injury. But the true cause of this condition comes down to a problem with blood flow.
When your big toe is pulled inward for example in a narrow shoe or if you have a tight foot, a muscle on the inside bottom of the foot is under tension, this is your Abductor Hallucis. You can test this and see it for yourself. If you pull your big toe inwards and look next to the inside of your heel, you can see the stretching occurring.
This tightening of the muscle leads to pinching of a nearby artery that runs underneath. This restricts blood flow to part of the bottom of your foot.
This leads us to an important point. Poor blood flow limits the body’s ability to recover from stress.
Symptoms:
Most people who are diagnosed with plantar fasciitis have pain on the bottom of their foot (usually near the inside side of the heel) that is especially extremely painful when taking their first few steps in the morning after waking up.
A common description is a knife-like sensation stabbing the bottom of the foot. While these symptoms may get better through the day but are then made worse with loading. For example when you go for a run or stand up for long periods of time.
Mortons Neuroma: A very common condition that causes pain in the foot is Morton’s neuroma. It is a painful enlargement of a small nerve in your foot that runs between your third and fourth toes. But why is the nerve painful in the first place? The answer is often inappropriate footwear and a dysfunctional foot.
The three problem features of shoes contribute to nerve irritation.
Elevated heel: This causes the toes to be in an extended position. This will increase the amount of load on the nerve
Toe spring: Lifting the toes also increases the load on the exposed nerve to an even greater degree.
Narrow toebox: If the toes are pushd together, the nerve can be pinched between the third and fourth toes.
Symptoms:
This extra loading on the nerve and pinching causes symptoms of burning or electrical shock-like pain into the third and fourth toes. It also often gives an uncomfortable sensation in the foot and is often described as a feeling of a pebble in peoples shoes.
Next week we will cover the ways to help manage and fix these issues.
In the meantime, if you suffer from foot pain or have any questions then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Do you sometimes feel a sharp, shooting pain travel down the back of your leg? Or sometimes a dull, ache or tingling and numbness? These symptoms might be down to a condition known as Sciatica. This blog post will help you understand what sciatica is and some ways to help this.
Commonly people attribute any pain in the leg to being Sciatica but this is only when it affects one of the specific nerves that runs directly down the back of your leg called the Sciatic nerve.
Symptoms of Sciatica
Symptoms are radiating pain that travels from the low back, through the buttock, and down the back of the leg. This is normally down one leg rather than two. Sometimes Sciatica can give other symptoms other than just leg pain, this can include:
● Numbness of the buttock, leg, or foot
● Tingling that radiates down the leg
● A burning sensation in the low back, buttock, or leg
● Lower body weakness
So how can we help your pain?
With Sciatica we do a number of tests in the clinic to rule in and out certain conditions and make the best plan of management moving forwards to help.
Methods we use in the clinic to help:
Soft tissue massage
Active release techniques
Chiropractic adjustments
Instrument assisted soft tissue massage
Laser therapy
Home rehabiliation exercises
Most cases of Sciatica are best managed with conservative care but is also important to keep active and moving while avoiding bed rest where possible. This will help with your recovery.
A Useful Exercise
Important exercises to do for Sciatica are nerve gliding exercises. The goal is to use these techniques to increase blood circulation, reduce the swelling that is around the nerve and get the nerve back to its natural movement. This will decrease symptoms once these areas are restored. Below is a link to an exercise for the Sciatic nerve. Start with 10 repetitions, gradually increase the stretch on the neck and the leg, don’t force the motion, it will gradually increase with each repetition. If this exercise increases your symptoms, then stop the exercise.
If you suffer from Sciatica and would like an examination and treatment to help relieve your symptoms then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Lots of people come into the clinic complaining of elbow pain. Commonly people have pain on the inside of the elbow and say it is down to overuse of the elbow after a long week or overtraining and the elbow has flared up because of it. But with pain on the inside of the elbow, it is not always down to overuse but down to misuse.
With elbow injuries, if you just look at the site of pain and blame the elbow for the cause of the problem you might be missing the root cause of the issue. This is because the muscles which are around your forearm attach onto you humerus which is the upper arm bone and this starts at the shoulder.
People spend a lot of time in a hunched over position with the arms turned inwards and therefore when you have to turn your arms out for example when you hold the bar squatting or doing barbell curls, if the movement is not coming from the shoulder then the movement has to come from the elbow. This creates stress at the elbow as it is not designed to overly rotate.
A lot of the time with elbow pain the thought process is to stretch out forearms. But this is treating the symptoms, not the cause. The root cause is often from being restricted in shoulder movement.
So, if you are having elbow pain or even if you are not you can try this quick test. Hold your hands out in front of you with your arms straight and turn your palms upwards. A lot of the time the you will see a difference from side to side with how much you can turn your palms upwards. You may also find you are compensating to get this movement from the wrists or feel stress through the elbow. If this is the case then helping your shoulder mobility will prevent pain from occurring or if you are in pain, be the resolving factor in your pain.
If you want to know more about potential causes of injuries or get your pain sorted, then contact the clinic for a full functional assessment to see where your imbalances are. To do this contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Elbow injuries are a common injury in desk workers and athletes. In people who lift weights they are one of the most common injuries to have.
Although the elbow may appear to be a simple hinge joint that simply has two movements (bending or straightening the elbow), the reality is far from it. The elbow is a more complicated joint than it seems because the movement occurs between three bones and surrounding this are 16 small muscles. These help to not only straighten and bend your elbow but also rotate it as your palm is either up or down.
Although many elbow issues are due to overuse of the muscles causing a repetitive strain injury, it is common for people to cause an injury to one of the several nerves in the arm. This can cause tingling, numbness, a burning sensation and possible weakness in the hand.
A type of exercise that is used to help nerve pain is nerve gliding. This aims to either stretch the nerve or glide the nerve.
Gliding techniques will stretch the nerve and have the aim of increasing the tension and pressure through the nerve. This sometimes makes symptoms worse in people.
Sliding techniques will move the nerve with a lot less tension and pressure and therefore don’t increase symptoms.
The goal is to use these techniques to increase blood circulation, reduce the swelling that is around the nerve and get the nerve back to its natural movement. This will decrease symptoms once these areas are restored.
Make sure you only do a few sliders at a time because overstressing the nerve even with a less aggressive technique will potentially increase your symptoms. It is not always the case that a little bit of something is good so let’s do lots of it in a more is better approach. So do this little and often throughout the day rather than all at once.
If you suffer from any elbow issues or capal tunnel then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Chances are you know someone with a hamstring injury or have had one yourself. If you have had a hamstring injury you will know first hand they can be very difficult to get rid of. Also, you are faced with the problem that if you have a hamstring strain you have a very high chance of re-injuring the hamstring again.
But what are hamstring tears?
Class I: There are only a few muscle or tendon fibers are torn. You will usually have pain during or after activity which would be worse when sprinting. There may be a small amount of swelling and discomfort. Usually associated with minimal strength loss. You will likely be able to walk directly after the injury.
Class II: A partial tear of the fibers. You will usually have pain during activity which stops activity. There will be a significant loss of strength and a significant amount of pain. You will likely have some pain when walking.
Class III: This is when there is extensive tears to the muscle, you will usually have felt pain immediately and may have fallen to the ground. Your range of movement at 24 hours is usually significantly reduced with pain on walking. There is usually weakness in contraction.
Class IV: A complete rupture of the muscle/tendon. This will be associated with a huge loss of muscle function, often an inability to walk due to pain and massive bruising on the back of the thigh. This class can often be less painful than class III.
How to help
If you have suffered a low-grade strain of your hamstring, here are some explanations of exercises that you might find useful. If you have sustained what you think may be a grade 2 or above injury, it is recommended that you go see a medical practitioner for some hands on help and to effectively rehab the muscle.
A good exercise to start for a low grade hamstring strain is a bridge. Start by lying on your back with your knees bent. Drive your heels into the ground and imagine you’re about to get punched in the stomach (this will make sure your core is braced). Then drive your hips upwards and squeeze your butt muscles. You should then hold this postition for 5 seconds and then lower yourself to the starting position. If this is painful then STOP, you don’t want to over strain the tissues that are healing. 2-3 sets of 15 reps.
Also it is important to work on your balance. To do this, stand on one leg, then do a small hip hinge and attempt to hold this position for 10-20 seconds. Start with your eyes open and then once you are comfortable with this you can try doing it with your eyes shut which will make it much more challenging. Also, try to do this exercise barefoot. 2 sets of 5 holds.
If would suffer from recurrent hamstring issues, then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Hip pain is very common in people who exercise regularly. But how can you help your hip pain and tight hips?
To prepare the body to be able to squat or lift weights pain-free, you should improve your sense of balance and general control single-legged.
Think about it, when was the last time you trained single leg exercises? I mean, really trained it? But it’s never too late to start incorporating it into your workout routine.
The hip airplane which was designed by Dr. Stuart McGill with the aim of being an active flexibilty exercise deals with both balance and general control head-on so will seriously challenge you to perform it equally side to side.
Therefore, the hip airplane will test and improve the stability of the muscles in and around your hip.
Even people who can squat huge amounts of weight can struggle with this and it will lead to injury. This is because of progressively causing micro-trauma to your tissues because you don’t have the functional stability around your hip. So, people of all athletic ability can benefit from training single movements.
So why is the hip airplane so important for the squatting movement pattern?
When you squat you femur’s are in an abducted position (so they’re pointing out) with your feet also out in relation to your pelvis. Your pelvis is the stable point around which your femurs will move and rotate in their socket.
So to recreate this movement but to work on stability rather than strength you can use the hip airplane. This is because instead of having your foot out to the side and your pelvis in neutral, the foot is now directly underneath your body and you will deviate the pelvis.
How to do the hip airplane
Firstly do the exercise barefoot to activate the small muscles in your foot which will help create a stable structure from the ground up.
Starting position: Then go onto one leg and bring your front leg upwards to 90 degrees.
Then bend your torso forward so it is over your leg in contact with the ground, do this while kicking your back leg behind you.
Keep your trail leg straight.
(If you know common weightlifting movements then this is very similar to the single leg roman deadlift or RDL).
Then slowly bring your belly button towards your leg in contact with the ground and then out to the side. Then return back to the starting position.
Aim: Practice quality of the movement with good form. But as a rough guide aim for 1-2 sets of 10-20 repetitions. But this exercise is all about control so even if you can only do 3 to start. Slowly build up from there.
As you do this exercise more and more you will get better at balance and your steering ability in rotation. As you improve you can start leaning further forward to make the exercise harder.
If would like a full functional assessment and to get some tips and feedback on your exercises, then contact the clinic today on 0578678904, direct message us on Facebook or book now.
Yours in Health
The Lawlor Clinic: Spine & Sport, Portlaoise, Laois
Firstly, cycling in comparison to other sports has a low rate of injury, apart from crashes or collisions from, for example, someone jumping into the cycle lane on your morning commute and your morning coffee failed to wake you up in time.
However, cyclists do need to take care of their backs because in general, the most common thing cyclists complain of, is their back.
Being hunched over on a road bike will take an effect over time. Low back pain is reported by more than 50% of cyclists and in overuse injuries lower back pain causes the highest rates of functional impairment and medical attention amongst cyclists.
Why do cyclists get low back pain?
There are many potential reasons why cyclists can get back pain but the following are the most likely:
Poor bike fit: This can be from an incorrect saddle height or and uneven saddle
Knee has a less than 25% bend at the end of the stroke. This will force you to rock your pelvis from side to side to get enough power at bottom of the stroke.
Your handlebars are too far forward causing you to overstretch which will increase tension in your lower back.
Flexing the lower back and causing core abdominal muscles to be in a poor position and so won’t work effectively. This means you won’t be in a stable position when you’re cycling.
You can also hurt your neck and upper back by bending your neck too far upwards. This will increase the strain in your neck and you could also hurt it going over unexpected bumps.
Using BIG gears. You should aim for a cadence of around 90 RPM. If you are getting lower than this then it will put extra stress on your back.
Tight hamstrings. If you have a reduced range of motion in your hamstrings then this will pull on your pelvis and rotate your spine into a more rounded position.
Poor core muscle strength.
If you are riding on bumpy terrain. This increases jarring and compression to the spine while you ride and can cause pain in your back.
Length of cycling done weekly. Cyclists who ride an average of 160 km or more per week are significantly more likely to report back pain than those who rode less km per week.
Things to check if you have back pain while cycling:
Ultimately there are 3 main things to do:
Check your bike fit. There is an association between bike fitting and your comfort while cycling. This can increase pain if your bike is not fitted properly.
Check your cadence and see if it needs to be increased. A low cadence puts more strain on your back.
Strengthen your core and back muscles. The low back is not designed to take much hard work when cycling. Your core should protect it and provide support.
If you suffer from back pain when cycling and would like a full functional assessment feel free to contact the clinic today on 0578678904 or book now.
💥Have you had overly tight calves for a long time? Hip extension may have something to do with this.
🏃🏻 Your hip and ankle are key components in your gait/running cycle. Normal range of motion is 10 degrees for hip extension and 40 degrees for ankle dorsiflexion.
💥If you are restricted in these movements then there may be long term effects of your running performance and you could incur injuries or overly tight muscles along the way.
💪🏽There are 2 main muscles in your calf. The Gastrocnemius and the Soleus. The main firing of these muscles is when your heel lifts. The gluteus maximus at the back of your hip stops firing just before your calf muscles, this acts as a one two punch that propels you forwards.
💥Normally ankle dorsiflexion should be equal to hip extension. So if your ankle is restricted in movement, then you will not be able to access your full hip extension and therefore affect performance and increase your susceptibility to injury. This is termed the Z angle.
✍🏻 It has been shown if you can not get into full hip extension then your calf has to fire early to still help you move forward while running. So, your calf is being loaded for a greater amount of time so runners can be symptomatic of calf pain for days after a run because of this.
💥Also, if you can’t get into full hip extension, when the calf contracts it will drive your weight upwards creating a vertical phenomenon, meaning your calves have to work harder.
How can we help at the Lawlor Clinic?
During an assessment we can see if your hips ankles or other parts of the body aren’t moving properly or to see if you are compensating in other areas.
Once we have found the problem areas , we can mobilise and manipulate them. This should increase the range of motion in the area.
Then we will give exercises in the clinic and for you to do at home that will help get the muscles surrounding the joint to work well functionally while you move.
👌This will mean you can get into the previously not possible range of motion and keep it there so you will be out of pain for longer and performing better.
If you would like to book in for an assessment then contact the clinic today on 0578678904 or book now.
