Good luck to everyone running the grueling Dublin Marathon in a couple of weeks time, including our very own Karen, running her second marathon! The weeks leading up to the marathon will be tough, and not only the actual running of the race, but the recovery can be just as painful! So with that being said, here are our top tips for a fast recovery.
Recovery After the Race:
How fast you recover after a tough race depends on a number of different factors including:
Actual time spent in running preparation
How much rest you got pre-race
How good your nutrition was pre-race to fuel your body
Our top tips to aid recovery:
Rest: In the next 7-10 days try to get as much rest as possible, aiming for 8 hours sleep per night. This will help speed up the recovery process after the marathon.
Ice Baths: If you can withstand the cold, ice baths are a great way to help fight delayed onset muscle soreness (DOMS)
Nutrition: For electrolyte recovery try Nuun or BioSteel performance and recovery drinks. With each meal consume some protein (15-30g), take omega 3 supplements, plenty fruit & vegetables especially pineapple which is high in an anti inflammatory called Bromelain. It is advisable to take in essential mineral salts that will have been lost through sweat during the marathon. We recommend Himalayan Salts to help replenish these salts.
Keep moving: Avoid running for the first days after the marathon, but do take short walks and move as much as possible
Laser: Laser therapy is a great post-race tool to help aid recovery. It helps speed the healing process in the tissues
Kinesiotape: Lymphatic Applications and Cut Outs will help the drainage of the legs and to help reduce DOMS.
Sports Massage/foam rolling: Both are good ways to help your body to recover after the race.
Running Injuries
For some of you, you may have picked up an injury or two during the race. It is important to have these injuries assessed and treated appropriately. Don’t just let it go! Call us today to see if we can help with your marathon recovery!
Yours in Health,
The Lawlor Clinic Portlaoise
Chiropractic | Physiotherapy | Active Release Techniques (ART®)
Plantar Fasciitis (PF) can be quite a debilitating disorder. It is commonly described as having pain under the heel of the foot or along the arch of the foot. It is a progressive disorder, where the first few steps in the morning are painful, along with barefoot walking, or pain wearing flat shoes. Prolonged standing, walking or running can aggravated the pain. Many different treatment options have been proven to be effective in treating PF, such as deep tissue work, stretching and manual therapy. But, are there any additional therapies that are effective at treating PF, for example, if the hands-on approach is not yielding results to your liking?
At the Lawlor Clinic, we utilise Class 4 Laser Therapy for a variety of conditions, including PF. But, is it any good? Are there positive results with this approach? Or is it all a load of nonsense? Let’s see what the evidence says.
Class 4 Laser Therapy
With laser therapy, a light beam is placed on the injured area in an effort to affect cellular metabolism, protein synthesis, wound healing and immune response. The idea is that this will fight the inflammation in the fascia, reduce heel pain, and increase recovery time. 2 papers have evaluated the effectiveness of Class 4 Laser Therapy on chronic PF, and have a strong quality of evidence as they appear on the Cochrane Database of Research.
Macias, 2015
Kiritisi, 2010
Participants
69
25
Laser Treatment
X2/week for 3 weeks
X1/week for 6 weeks
Follow Ups
Before, 1week, 2weeks, 3weeks, 6weeks, 8weeks
Before and at 6weeks
Results – Plantar thickness
DNA
A difference in plantar thickness, but not statistically significant (not meaningful)
Results – Pain
Statistically significant improvement (p<0.001)
Statistically significant improvement (p=0.001)
These two studies demonstrate that after 6 sessions of Laser Therapy, the PF pain had significantly reduced when compared to placebos. This shows that laser is effective in treating PF, but it is important to explain to patients that research suggest that the most effective treatment approach is 6 treatments either x2/week for 3weeks or x1/week for 6weeks and then the patient can make up their mind which they would rather.
Comparing Laser to Extracorporal Shock Wave Therapy (ESWT)
The idea behind ESWT is similar to LLLT. In ESWT, a probe is placed on injured area and shockwaves are pulsed in through the skin to stimulate angiogenesis (new blood vessels) and neurogenesis (new nerve cells). In theory, these aspects stimulate wound healing mechanisms. Again, 2 high quality papers compared the use of LLLT vs ESWT:
Cinar, 2013
Suleymanoglu, 2014
Participants
55
81
Treatment
X3/week for 3weeks of either ESWT / Laser
X3/week for 3weeks (ESWT)
X3/week for 4weeks (Laser)
Both given stretches for 3 months
Follow Up
Before and at 3 weeks
Before, after 1st session, after 3 months
Results – Plantar Thickness
DNA
Reduction in plantar thickness, more significant reduction in ESWT
Results – Pain
Statistically significant reduction in pain with Laser, not in ESWT
Statistically significant reduction in pain with ESWT, not in Laser
The data above suggests there is no difference between using Laser or ESWT for treating PF. This is because of the conflicting evidence above.
In summary, the evidence demonstrates that Laser (once completed for 6 sessions between 3-6weeks) is very effective in reducing pain levels in those with chronic PF. If you are suffering with PF, or any foot pain, please do not hesitate to contact our medical professionals on 057 8678904.
Over the weekend, the Brownlee brothers, regarded as the best triathletes in the world, demonstrated unbelievable sportsmanship, but also underlined the importance of hydration and fuel with intense exercise. Alistair carried his brother over the finish line, as Jonny had completely burnt himself out.
With the annual Dublin Marathon upcoming, it is important to add in to your training effective hydration and fuelling to prepare your body for the race. Remember also, it’s important to stick to the four building blocks of marathon training. Combining these habits will prepare your body as best as you can for your 26 mile race.
Four Building Blocks of Marathon Training
Build Mileage
Build your weekly mileage over time. Three-to-five runs per week is sufficient. The vast majority of these runs should be done at a relaxed pace. You should run at an easy enough pace to be able to carry on a conversation. When building base mileage, never increase your weekly mileage by more than 10% from week to week.
The Long Run
Do a long run every 7-10 days, so your body can adjust gradually to long distances. You should extend the long run by a mile or two each week. Every 3 weeks, scale it back by a few miles so as not to overtax your body and risk injury. For example, you might run 12 miles one weekend, 13 miles the next, then 14 miles, and then 12 again before moving on to 15 on the fifth weekend.
Doing these runs at a substantially slower pace than usual builds confidence, lets your body adjust to longer distances, and teaches you to burn fat for fuel.
Speed Work
Practice intervals and tempo runs to increase your cardio capacity and make your easy runs feel easy!
Intervals are a set of repetitions of a specific, short distance, run at a substantially faster pace than usual, with recovery jogs in between. For example, you might run 4 X 1-mile repeats at a hard pace, with 5 minutes of slow jogging or even walking between the mile repeats.
Tempo runs are longer than an interval—generally in the range of 4–10 miles, depending on where you are in your training—run at a challenging, but sustainable, pace. This kind of workout teaches your body, as well as your brain, to sustain challenging work over a longer period of time.
Rest, Recovery & Tapering
Rest days mean no running. They let your muscles recover from taxing workouts and help prevent mental burnout. The greatest enemy of any aspiring marathoners is injury, and the best protection against injury is rest.
If you are itching to do something active on your rest days, doing some cross-training is a great option. Cross-training can include walking, hiking, cycling, swimming, yoga, lifting weights, or any other active pursuit that isn’t as high-impact as running.
Tapering: In the two or three weeks leading up to your marathon, scale back significantly on overall mileage and difficulty of your runs to let your body rest up for race day.
How to Maximise Hydration and Fuel to Offset Fatigue
Fuel
Fatigue during the race is, of course, inevitable but it is possible to delay the onset using certain techniques and training adaptations. For endurance sports such as marathon running, the body will use its stores of glycogen to fuel it for energy, which will run out after approx 90 minutes. Therefore, it is essential to keep glucose stores up throughout the race. It is recommended to have 30g-60g of glucose per hour to maintain adequate blood glucose levels. You can use gels or small high carbohydrate snacks if possible. Eating during a long run should be practised in training on not on the day of the marathon.
Eating adequate carbohydrates (5g+/kg bodyweight) and tapering training in the days prior to the race will enhance glycogen stores and metabolic adaptations throughout your training season. This will help direct your body to burn the abundant stores of fat as fuel, thus sparing valued muscle glycogen in the race. Protein will help muscle repair and immune function so is a hugely important part of recovery meals.
Hydration
Hydration and electrolyte replacement will also play a role in offsetting fatigue. Replacing lost electrolytes with a sports drink with carbohydrate will ensure you are refueling lost water, salts and glucose.
It is critical during your training and especially in the days before the marathon that you are resting adequately. In training, always have a rest day and replenish your body with nutrients such as fruits, vegetables, carbohydrates and protein to aid repair and recovery.
When you run, you will produce heat, which must be dealt with to avoid overheating. Your body deals with this by producing sweat, which cools the body down. Sweat rates vary from person to person and day-to-day depending on the weather conditions, intensity and exercise duration.
When we sweat, we not only lose water but electrolytes as well, in particular sodium, potassium and magnesium, which play a critical role in controlling the balance of fluid in your cells, tissue and blood. You will need to ensure you keep your water levels topped up and it is advisable to also top up with electrolytes so that you can restore fluid balance correctly.
Keeping hydrated will result in a better performance and reduction in early fatigue. During your training, it is advisable to estimate your sweat rates and therefore your need for re-hydration. This is simply done by weighing yourself before your training and afterwards. Please note that this is only a best guess and take into consideration the intensity and duration of the training session as well as the ambient temperature and compare this to your race day conditions.
As always, don’t forget to warm up and cool down!
We will have another blog closer to race day about the ideal preparation in your final week and what to do for race day. If you are experiencing any annoying niggles with your training, please do not hesitate to contact our experienced medical professionals on 057 86 78904.
Yours in Health,
Lawlor Clinic, Portlaoise
Chiropractic | Physiotherapy | Active Release Techniques (ART®)
A common condition we see in the clinic, that is often misdiagnosed is adhesive capsulitis or frozen shoulder. It is a debilitating and very painful shoulder condition, but what are some of the warning signs of this condition?
Gradual onset of shoulder pain from no apparent reason: Most of the time frozen shoulder comes on without having had any trauma. Pain is usually the first sign, and in some people if can be so severe that it radiates down the arm.
Gradual loss of shoulder movement: In the first stages of it, the pain can cause people to overlook that their range of motion has slowly started to decrease, most times this will become very apparent upon examination.
Pain at night: not necessarily worse pain at night, but noticeable pain during the nights
Cannot lay on that shoulder: Usually apparent at night as well, the person is not able to put any body weight on that shoulder.
Cannot make sudden movements: Moving the arm is a big challenge, especially with sudden movements, the pain becomes dramatically worse.
Frozen shoulder is very tricky, especially in the early stages, and it often gets misdiagnosed. It can be complicated further by diabetes and thyroid issues. The recovery time can be long, but there are things that can help. Think you may have frozen shoulder? Contact us today to get a thorough examination and see what options are available for you.
With the middle of July now here, summer is in full swing, (with or without the cooperation from the weather!). And with summer comes travel and holidays. We get many patients that end up injuring themselves on holidays, and what should have been a good time, ends up being a painful week or two. So what are some ways that you can keep yourself injury free while traveling??
Smart travel posture- Weather you are flying or driving or taking the train, one of the easiest ways that you can safeguard your back health is by remembering to maintain good seated posture. That can be difficult depending on the type of seat. Most general airline seats for example are not made with good spinal posture in mind. The easiest way to help combat this? Sit all the way back in the seat with bum and back hitting the back rest. Then get an extra pillow, towel, blanket, or sweatshirt, and roll it up and place it behind your lower back. This will help you maintain the normal lumbar lordosis. Sitting back in the seat also helps keep the upper back in a better posture. And don’t forget about the neck, make sure not to keep the head in a bent forward posture for extended periods, be that for reading or texting. Keeping the head back on the headrest will ensure a neutral posture for your neck as well.
Proper lifting of luggage- Utilize the rolling capabilities of your luggage if it has it. If you end up in a hotel with no elevator and are stuck carrying your bag up three flights of stairs, here are a few tips for you. Keep the abdominal muscles contracted. Keeping these muscles active helps them to act as a natural weight belt for the lower back and prevent injuries. Bend from the hips instead of from the back. Always try to aim for keeping the back flat when bending over to lift something up, this will also help to protect the lower back from injuries.
Hydration- Especially true if you are somewhere warm, but drinking plenty of water is not just for times when the sun is shining. Keep your water bottle close by at all times. Water help to hydrate the joints and the muscles and can ease tension and pain. Dehydration leads to headaches and more aches and pains.
Exercise- Most people don’t associate holidays with exercise! But being on holiday can be a great opportunity to do exercises that you may not be able to do while at home. Hiking, walking, swimming, are all great lower impact activities to do to help keep your body strong and healthy. Forget about that lounge chair at the beach, get yourself out and moving.
Smart shoes- Speaking of all that walking you will be doing. Now is not the time to wear a brand new pair of shoes. Make sure you wear in the shoes before you go to avoid pain. And if you know you will be doing a lot of walking, make sure to bring proper shoes with the support you need, even if they might not fit in with the local fashion trends. It’s better to be pain free, than to be stylish and in agony!
Keep our tips in mind as you enjoy your summer travel, to help keep back pain at bay!
To date, Fibromyalgia is still a misunderstood condition. There are many theories as to what causes it, what can trigger it, and what can help with the pain. But we don’t know for sure. As you can imagine, that can be very frustrating for someone who has been diagnosed with this condition, not knowing what to do about it. Lets learn a little more about this common condition.
1. Fibromyalgia is a condition that causes wide spread muscular pain, it is more common in women than in men, and can run in families. Fibro= fibrous tissue, myo= muscle and algia= pain.
2. The newest theories on the causes of it are leaning towards a dysfunction in the nervous system. Something triggers the nervous system and the persons pain response is altered. Or how the brain is interpreting the pain is altered.
3. There are many other symptoms associated with this condition besides muscle pain, some of these include: fatigue, muscle weakness, poor concentration, brain fog, headaches, and anxiety, just to name a few.
4. There is no specific test for fibromyalgia. It cannot be detected in a blood test or scan. The best way to diagnose it is from the persons specific history. Guidelines from the American College of Rheumatology state that the person must have : ” widespread pain lasting more than 3 months, and other general physical symptoms including fatigue, waking unrefreshed, and cognitive (memory or thought) problems.”
5. There is also no specific treatment for fibromyalgia. Common is for patients to be put on pain killers, or anti-inflammatories, and sometimes anti-depressants.
You may be feeling quite grim right now, because we don’t know what causes it, and it can be hard to treat. So what can we do?
Exercise – regular exercises seems to be one of the biggest things that helps to keep fibromyalgia manageable. Not only is this shown in the research about the condition, but in our experiences here in the clinic.
Chiropractic treatments – chiropractic care can help relieve muscle tension and pain that comes along with fibromyalgia.
Laser – our class 4 laser is also a great tool at helping ease the pain of those tender points associated with this condition.
Dry needling/acupuncture- another one that our fibromyalgia patients feel the benefits from.
Nutritional supplementation- more research needs to be done, but there is some evidence to support certain supplements and their role in helping this condition, including vitamin D, co-enzyme Q10, probiotics, and trace minerals magnesium and zinc.
So you can see, there are things that you can do to actively work on taking control of this condition. Our best advice, find a provider who will work with you, looking at the whole picture and incorporating some of the things above, and help you to stay consistent.
Have fibromyalgia? Book an appointment today and let us help you get on the road to managing this condition and getting back to your life!
Aimee had a great time last night at the Portlaoise Leisure center last night, May 12th, 2016, sharing their presentation “Sitting Is The New Smoking”.
For those of you who couldn’t attend, here is a little recap of the evening.
-Sitting is the new Smoking is a phrase coined by Dr. James Levine, an American endocrinologist. He says, ” Sitting is more dangerous than smoking, kills more people than HIV, and is more treacherous than parachuting. We are sitting ourselves to death.”
– One hour of sitting watching TV = 28 minutes of life lost. One cigarette = 11 minutes of life lost.
– Our tips for reducing your risk: Get routines for getting moving, Get your co-workers/friends involved, Get proper equipment, Get moving while you are seated, Reconsider your transportation
– Having a 1-2 hour workout does not offset the negative effects of sitting for 8+ hours a day.
– Lots of small movements throughout the day and being sedentary less than 6 hours a day are what we should aim towards to reduce our risks.
Have you been diagnosed with a disc herniation? It is one of the most common conditions that we see in the clinic. Today we want to show you one effective exercise that can help reduce your pain: The McKenzie Extension exercise.
In the last blog, you learned what happens to your discs. We guided you through the stages of disc herniations, and how they can protrude outwards into the spinal canal, which can cause irritation around the nerves and pain. With this exercise we are trying to get a decompression of the discs, encouraging them away from the spinal canal and the nerves, which will be evident by an improvement in your pain.
If you are experiencing pain down one leg, what we would expect with the Mckenzie extension exercise, is that the pain starts to become more central. Meaning that instead of feeling it all the way down to the ankle, you start feeling it only at the knee, or down to the bum.
If your pain does not improve with this, that means you may need a different type of exercise for your lower back pain. As always, its important to get a proper assessment and diagnosis to get the best treatment plan for you!
Disc herniations are one of the most common conditions we see at the clinic. Did you know that many people, around 50%, have a disc bulge and don’t even know it?? We say that not to panic you, but to reassure you that if you do have been diagnosed with a disc herniation, it doesn’t mean you will have to live in pain the rest of your life. Let’s learn a little more about this common condition.
What is a disc and what does it do?
To understand this condition better, the first thing that we need to do is learn what a disc is actually supposed to do.
In between our spinal bones (vertebrae), we have our discs. Made up of thick collagen on the outside with a gel like center. They act as shock absorbers, helping us to distribute loads through through the spine.
Discs are happy and healthy when they are well hydrated. So how do you hydrate a disc?? Our discs are the most hydrated first thing in the morning after a good night of sleep. But proper healthy movement is another way to keep your discs hydrated. We should all move through our full spinal range of motion every day to keep our spines and discs healthy. Hydration, we can’t mention disc hydration without referring to what it is that actually keeps us hydrated. Water. Getting plenty of water every day is another thing that will keep you discs healthy over time.
Improper lifting, moving, poor posture or prolonged sitting, will decrease disc hydration and health, leading to injuries and pain over time.
Stages of disc herniation
One of the easiest ways to think about a disc bulge is to think about a jelly donut. Take that donut and put it on the floor, then put your foot on top of it. Slowly start to push your foot down onto the donut, we know that at this point the jelly on the inside is starting to move around due to the pressure. If you keep pushing downwards with enough pressure over time, what will happen?? That jelly will come squirting all the way out of the donut. So now that you have that image in your mind, lets go back to the spine.
Four stages of disc herniation:
Degeneration- this is when the discs start to weaken and dehydrate, but the disc is still in tact.
Prolapse- when the inner gel of the disc starts to bulge outwards, but hasn’t broken through the disc.
Extrusion- when the gel bulges outward with enough pressure to break the outer part of the disc, but still remains inside.
Sequestration- when the gel comes completely outside of the disc and into the spinal canal
Now you have a better understanding of what actually happens to your discs when they start to degenerate. Having a disc bulge can be a very serious condition, and with proper treatment and monitoring it can be resolved. It’s important to go to an expert to make sure you get the correct diagnosis and care you need!
Shoulder pain and stiffness is one of the top conditions we see in the clinic. One of the most frustrating shoulder injuries, is frozen shoulder. A stubborn condition that can be difficult to treat, causes loss of motion in the shoulder, and can be quite painful. Typically affects 40- 60 year olds, women are more affected than men, and smoking, diabetes, and thyroid disease can contribute to it.
What you need to know is this:
Treatment of frozen shoulder will not be successful if it focuses only on the surrounding musculature.
With this condition, the capsule of the joint causes the problem, and due to that fact, work must be done on the capsule to get the improvements that you want.
So how can we work on the capsule?
Laser Therapy. Our laser is great for helping to speed up the healing process. It helps frozen shoulder specifically because it can penetrate deeper below the skin surface to get to the capsular level.
Active Release Techniques. (ART®) is great for frozen shoulder because we have specific protocols to work not only on the muscles around the area, but to work on the capsule itself.
Dry Needling. If we are talking about getting down to the capsule, there is not much better than dry needling. We can put the needles directly into the capsule to help stimulate healing in the area.
And how long will it take for this stubborn condition to resolve? With work done on the right structures you can anticipate results in 6-8 visits. If you have frozen shoulder, don’t let just anyone work on it, get in to see someone who knows how to get to the root of the problem and get the results you want.
Yours in Health,
Lawlor Clinic
Chiropractic | Active Release Techniques (ART®)| Sports Injuries
