In the foot, pronation should occur naturally when the foot comes into contact with the ground. Pronation will appear as the foot rolling inward and the arch flattening.
What are the benefits?
Dissipates the force that the foot receives from the ground
Allows the foot to become a stable and mobile adaptor to enhance movement opportunity
Loads the muscles of the extensor chain (calf, quads, glutes) to convert ground reaction forces into forward momentum so we can propel efficiently.
So why have I been told this is bad?
So as you are now aware, pronation is very normal and a critical movement to ensure we move and propel ourselves forward efficiently.
What you may have heard someone say to you is that you ‘overpronate’?
Firstly, overpronation is subjective and not as black and white as it is sometimes made out to be. Overpronation has be defined as: ‘a foot that rolls inward toward the arch excessively’.
What we must understand is that a pronation can only happen when the foot has a stable tripod on the ground. This means that the calcaneus (heel bone), 1st metatarsal (big toe knuckle), 5th metatarsal (little toe knuckle) must all remain in contact when the foot rolls inwards and the arch flattens.
So, If you have been told you are ‘overpronated’ , it is most likely that your whole foot is ‘everting’ NOT ‘overpronating’.
What is Eversion?
Eversion can be defined as: ‘the process of turning inside-out’.
In pronation your heel must naturally ‘evert’ (sole of the heel will move away from the midline of the body) NOT your whole foot.
If your ‘whole foot’ everts (turns out) you will no longer have a stable foot tripod as the 5th metatarsal (little toe) will lose contact with the ground.
The key to ensuring this does not happen is to provide an environment for the bones of the midfoot (middle of the foot) and forefoot (toes) to experience the opposite motion to that of the heel. This will mean that the foot has an opportunity to truly pronate with a tripod on the ground.
So how can you help me do that?
At Physio fusion we can help you to bring your own body into alignment and create an environment in which the healing can begin
Foot strengthening exercises
Footwear advice
Referral to other healthcare specialists for further assistance (e.g. podiatrists)
To find your nearest Physio Fusion clinic and book an appointment call 09 6266186 or visit our websitehttps://physiofusion.co.nz
Low back pain is a common health problem which affects up to 80% of the population at some stage in their life.
In New Zealand ACC spends in excess of $130 million a year treating back pain related injuries.
Most back pain occurs between the ages of 25 and 60, and most typically in the 40s.
In an era of smart devices, posture has never been more important or harder to achieve. As technology continues to grow, sitting at a desk on a computer or on our phones is becoming more prevalent at work. Having a sedentary desk job can result in sitting for around 8 hours a day. This position actually increases the load on your spine more than standing. Spinal pressure “sits” around 140mm pressure. This pressure usually does not hurt the back right away however, builds up over time and can even change the structure structure of your spine. So, if you slouch then spinal pressure increases to 190mm; add some weight and you’ve put 275 pounds of pressure on your spine.
A compromised spine constricts your blood vessels and nerves, causing problems with your muscles, discs, and joints. And all of these problems can lead to headaches, fatigue, and even breathing problems. Your back is a delicate machine. When one part falls out of alignment, it can affect everything setting off a domino effect and wreak havoc throughout your back and body.
Below is a graph showing different postures and the pressure it exerts on the spine;
But, remember: While you may feel comfortable and supported in your chair and find a perfect sitting posture, staying in the same position for long periods is not healthy for your spine. Varying your postures by occasionally standing and moving around for at least a few minutes each half hour will help keep your spinal joints, muscles, tendons, and ligaments loose and pain free.
Stand Up for Your Spine
If you don’t have a sit-stand desk, you can still combat “sitting disease” and protect your spine. Consider these tips:
Do some work standing at a high table or counter.
Use a lumbar roll behind your back when sitting to improve seated posture
Set a timer on your computer for a stand-and-stretch break every 30 minutes.
Exercise to assist in improving body weight to lessen additional load on the spine
Strengthen the core to provide additional support
The focus is simple: Reduce your sitting throughout the day. But, remember that varying postures is best for your back and neck, so do not go the opposite extreme and never sit. Alternating sitting, standing and movement throughout your day is the best way you can keep your spine safe and body healthy—at work and beyond
Still having back pain?
Schedule an initial assessment with one of our Physiotherapists so they can determine the root of the problem. During this assessment your physiotherapist will be able to decide whether your pain is a source of nerve root irritation, discogenic, postural related, or musculoskeletal. After arriving with the consensus of the problem, we will be able to use many techniques to relieve the back pain. These include: manual therapy, therapeutic exercise, and postural recommendations.
To find your nearest Physio Fusion clinic and book an appointment call 09 6266186 or visit our websitehttps://physiofusion.co.nz
I know how hard it can be when it comes to working out and its really easy to find an excuse to avoid lockdown workouts but it’s not just about staying in shape its also about keeping active to feel mentally strong. We know that exercise does wonders for mental health and at a time where its all uncertainty, anxiety, and a daily dose of doom and gloom, we all need to work out that frustration somewhere!
If you’re struggling with a lack of motivation or negative mindsets there’s only one way to turn it all around: Take ACTION
How much exercise is enough?
You’ve heard the saying something is always better than nothing and that’s the case when it comes to exercise. The current recommendation for adults according to Best Exercises for Health and Weight Loss.org is to aim for 150 minutes of moderate intensity activity every week (or 75 minutes of vigorous intensity) with two sessions of strength building activities per week. That’s about 30 minutes of movement, five times per week.
This is a quick full body routine:
Bodyweight Squats
Stand with your feet shoulder-width apart. Engage your core muscles and gently squat down. As you squat, bend from your hips. Keep your back straight as you push your hips back and counterbalance by leaning your torso forwards. Keep your knees aligned with your toes. Your weight should be evenly on your heels and the balls of your feet, not your toes. It might help to image your are trying to sit down in a chair that is too far away from you. Tense your bottom muscles at the bottom of the squat and keep them tense as you straighten back up to the start position.
Arm dips
Start in a seated position. Place your hands on the seat of the chair and use your arms to move yourself forwards towards the front of the chair. You will need to move your feet further forwards to help your stability. From this position, use the strength of your arms to slowly lower your body directly down towards the floor and then raise yourself back up. Do not actually sit on the floor and keep your hands close in beside you. Relax and repeat.
Lunges
Stand straight with your arms to the side or on your hips. Take a large step forwards on your affected leg, then drop your hips directly down between both feet, bending your hips and knees to a 90 degrees. Push back up to the starting position, and repeat. Make sure you take a large enough step that your front knee does not travel over your foot, and ensure your knee travels directly forwards. Keep your body up straight throughout the movement.
Mountain Climbers
Adopt a plank position insuring your hands are directly beneath your shoulders.
Fully flex one hip and hold.
Extend the bent leg to the rear and repeat the movement pattern on the opposite side
The restrictions and change brought by the outbreak of COVID-19 has resulted in a great deal of control being taken from our hands; this has been anxiety provoking for many of us. Nevertheless, it’s important to re-evaluate, acknowledge and place focus upon the matters that we DO have control over so that we can gain our personal power back!
Lockdown Productivity Tips
Check in with yourself: how is your body and mind feeling. Embrace your emotions and give yourself permission to feel the way toy do.
Stay connected: Social connection is inevitably limited at the moment but catching up with people via text or facetime will help prevent feelings of isolation.
Maintain some form of routine: Maintaining a routine helps provide some structure do days which often all seem to merge into one.
Get fresh air where possible: Daily fresh air can provide an easy change of scenery when we are stuck at home most of the day.
Gentle exercise is a MUST!
Stay Hydrated: Drinking enough water is important to keep your body hydrated and makes sure your body functions properly.
Eat well- You’d be surprised how your diet can affect how you feel. Gut health in particular is linked to mental health.
Get to that “thing” you’ve been delaying for months
Pick up a good book
Learn new habits or rediscover old ones
These may seem like simple strategies but sometimes it’s the simple things that are most effective
“One day this will all be over and we will be grateful for life in ways we never felt possible”
The gratitude we will have for the things we once took for granted will be unmeasurable- getting on a plane, an impromptu visit to the cinema, a shopping spree, going to the gym, even meeting a friend for lunch at a café. Keep going, nothing lasts forever and we have so much to look forward to. In the mean time take each day as it comes, be kind, support those who are struggling and keep going! You are stronger and more resilient than you know!
One common belief about lifting is that rounding your back when lifting an object is considered dangerous while lifting with a straight back is considered safe…
However, there is a lot of misinformation circulating around lifting mechanics and what is deemed “good technique” versus “bad technique.”
Here are some key myths and misinformation that you may have heard:
A ROUNDED BACK WHILE LIFTING OVER STRESSES THE BACK MUSCLES AND LIGAMENTS
Research has shown that regardless of lifting position, whether you’re stooped, squatting or weightlifting, your back has to produce the same amount of force. Statistically speaking, it’s not significantly different.
FLEXING THE SPINE WHILE LIFTING INCREASES THE LOAD ON THE LUMBAR DISCS
Under heavy loads, discs are unlikely to fail unless >95% flexion is achieved (which is near impossible)
With low loads, the disc is unlikely to fail unless you do thousands of repetitions continuously
Your body is an amazing adapter, this includes discs! Your discs can adapt and become more and more able to handle loads when stressed appropriately
THESE COMPOUND TO CAUSE INJURIES AND PAIN TO THE BACK MUSCLES AND DISCS
Resistance training has demonstrated through countless studies the ability to increase bone mineral density (BMD) of the lumbar spine. BMD is actually positively associated with the strength of the spinal discs and ligaments at that level. With appropriate loading and training, disc, ligament, bone and muscles are going to adapt favourably
A NEUTRAL SPINE IS SAFER, STRONGER, MORE EFFICIENT AND BETTER TO LIFT WITH
There is no significant difference between activities that encourage more spinal flexion and one’s that do not in the long term
Lifting with lumbar flexion is not a risk factor for low back pain
Research has shown lifting with a bent back is more metabolically and neuromuscularly efficient
When the spine is in extension during bent over activities, the hip is actually flexed to a greater degree – decreasing the ability for the glutes and hamstrings to create as much internal torque. Flexing the spine reduces this effect and reduces the moment arm for the hip extensors
STOP BACK PAIN & INJURIES BY LIFTING WITH A NEUTRAL SPINE
Your lumbar spine flexes every time your hip flexes! It is impossible to isolate one versus the other. It is also impossible to not flex while doing common movements
Extreme flexion however (>/=100%), may pose an increased risk under heavy loads, but not at light loads
You may still be wondering why you have back pain (stay tuned for our next blog!). Your pain may not be directly related to your lifting strategy.
Could you have pain with forward bending? Absolutely.
Is bending at the lumbar spine an increased risk for pain or injury? In the vast majority of situations, no.
If I have pain with forward bending, is it bad to temporarily limit doing so? Not at all.
Should I fear bending at the spine with or without pain or injury? No. Being fearful of flexing/moving your spine is actually a stronger predictor of disability and back pain.
Work on moving through your spine, after all it’s what it is designed to do! Choose comfortable movements and gain confidence over time, then build up your strength gradually with resistance training – try and not to push too fast, we want nice, healthy adaptation! Give your body time to adapt, back pain is not quick fix sometimes but you are resilient and with healthy, normal movements and some patience, you will be okay.
The Achilles tendon is the largest tendon in the human-body. It is a band of tissue that connects your calf muscles to your heel bone (calcaneus). This tendon primarily facilitates general mobility such as walking, running, climbing stairs, jumping, and standing on your tip toes, by helping to raise the heel off the ground.
Common Achilles Pathology
Achilles tendinitis and tendinosis are two common disorders and are typically classified as overuse injuries.
Achilles tendonitis involves inflammation of the Achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation. This inflammation is typically short-lived. Over time, if this is left resolved, the condition may progress to degeneration of the tendon- Achilles tendinosis, in which case, the tendon loses its organized structure and is likely to develop microscopic tears.
There are two types of Achilles tendonitis and it is based on which part of the tendon is inflamed:
Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to your heel bone.
Non-insertional Achilles tendonitis involves fibres in the middle portion of the tendon and tends to affect younger people who are active.
In both non-insertional and insertional Achilles tendinitis, damaged tendon fibres may also calcify (harden) and often bone spurs (extra bone growth) develop with insertional Achilles tendinitis. Achilles tendonitis may also increase your risk of sustaining an Achilles tendon rupture (tear).
Causes
Typically referred to as “overuse” conditions, Achilles tendonitis and tendinosis are often caused by the sudden increase in repetitive activity involving the Achilles tendon. This can put too much stress on the tendon too quickly, that can then lead to micro-injury of the tendon fibres. Because of this ongoing stress on the Achilles, the body is not able to repair the injured tissue. The structure of this tendon is then modified, resulting in continued pain and other symptoms. The Achilles tendon also has poor blood supply that makes it more susceptible to injury and may make recovery from injury slow.
Common factors that may lead to the development of disorders of the Achilles tendon include:
Weak and/or tight calf muscles
Rapidly increasing the amount or intensity of exercise within a short span of time
Hill climbing or stair climbing exercises
Presence of bony spurs in the back of your heel
Changes in footwear – especially changing from wearing high-heeled shoes to flat shoes
Wearing poor fitting, inappropriate, or worn out shoes during sporting activities
Exercising without adequate warm-ups and stretching
A sudden sharp movement which causes the calf muscles to contract and the stress on the Achilles tendon to be increased. This can cause the tendon fibres to tear.
Excessive mobility
Poor feet positioning and biomechanics (excessive pronation and flattening of the arches of the foot)
Symptoms
Common symptoms include:
Pain and stiffness along the Achilles tendon especially first thing in the morning
Pain along the tendon or back of the heel that worsens with activity
Severe pain the day after exercising
Visible thickening of the tendon
Tenderness to touch
Bone spur
Swelling that is present all the time and gets worse throughout the day with activity
If you have experienced a sudden “pop” in the back of your calf or heel, you may have torn your Achilles tendon. Please seek urgent medical attention if you think you may have torn your tendon.
Diagnosis
If Achilles tendonitis or tendinosis is suspected, please deter from any activity or exercise which causes the pain. It is advisable to see your doctor or physiotherapist as soon as possible so that an accurate diagnosis may be made and appropriate treatment recommended.
You will be asked about the nature and duration of your symptoms and the medical professional assessing you will have a look at your foot and ankle. Ultrasound scanning may be used to evaluate the damage to the tendon and/or surrounding structures.
An MRI may be recommended if symptoms persist. X-rays may also be taken to rule out other disorders which may cause symptoms like Achilles tendonitis and tendinosis.
Treatment
Treatment will depend on the nature, severity, and length of the injury. Generally speaking, the longer the symptoms are present before treatment commences, the longer the timeframe until full recovery is attained. Full recovery may take between three and nine months.
Initial treatment options in the early stages may include:
Rest – to avoid further injury to the area
Ice – to reduce inflammation
Elevation – to reduce swelling
Non-steroidal anti-inflammatory drugs to reduce pain and inflammation.
How physiotherapy can help:
Physiotherapy typically focuses on two main areas: treatment and rehabilitation. Treatment may entail massage, shockwave therapy, acupuncture, gait re-education, and gentle stretching, whereas, rehabilitation predominantly entails strengthening of the Achilles and surrounding musculature.
Strengthening of the muscles surrounding the Achilles tendon facilitates healing in the tendon itself. Strengthening is attained through the utilization of specific exercises, that will be taught by your physiotherapist. It is common for the rehabilitation programme to take up to three months.
