Prevention is better than cure!
Now you must of heard this saying before and of course it is absolutely bang on!
So hands up who went to their Physio injury free with the intention of trying to prevent injury?
What, nobody?
Exactly!
...but what about the phrase? Don't you agree that prevention is better than cure?
Oh you do!
So practice what you preach.
Here is why:
Let's take an example such as Plantar Fasciitis or CPHP (Pain under your heel). What causes this problem is different in each individual and so the person needs to be assessed for these issues to get rid of the problem. However getting rid of the causes before you get a problem means that the chances are that you don't get it in the first place.Wouldn't that be great!
So what are examples of causes of Plantar Fasciitis:
Running?
4.5 to 10% of all running athletes will develop it and this is mostly in distance runners, hence why it is sometimes called jogger’s heel (Lopes AD et al 2012), (Singh et al 2008). It is also a running pace not just distance related injury according Nielsen et al (2013).
Not all runners get the problem though so why some and not others?
So what other factors are there that can potentially cause it?
Underloading of the structure causing weakness of the tissue, which exposes the structure making it easier to overload.
Vascular and metabolic disturbances (e.g: Diabetes, Peripheral vascular disease)
Genetics: As with all things some people have a genetic predisposition to chronic connective tissue disorders.
Age: The enthesis (the part of the plantar fascia that is usually injured) is brittle and therefore susceptible to damage. CPHP is common after 50 years old and this can be in part, attributed to the degeneration of the fat pad.
Shortened calf muscles: 12% of individuals examined in a study by Kim et al (2010), revealed a continuation of the Achilles tendon and the plantar fascia. So this means that excessive tensile forces in the calf under dorsiflexion would transmit the force into the plantar fascia. In fact it has been found that the chance of developing CPHP actually triples if passive ankle joint dorsiflexion is less than 10 degrees! (Sahin et al, 2010).
Overweight: Lutter (1997) reports that 65% of the non-sports demographic are overweight and a BMI of 25-30 doubles the chances of getting CPHP.
Spending a lot of time on your feet especially on hard surfaces: The chance increases by 3.6 times in weight bearing occupations (Sahin et al, 2010).
Poor footwear and abnormal biomechanics: Commonly it was considered that the cause relates to your foot arch mechanics but the evidence for this is hit and miss.
For example:
Abnormal shape or movement of the arch is not associated with chronic plantar fasciitis, but they found that arch mechanics may influence the severity of plantar fasciitis once the condition is present (Wearing et al 2004).
However there are other potential biomechanical factors other than the arch:
Irving et al (2006) found that decreased first metatarsophalangeal joint extension increased the likelihood of developing the condition.
And…
Excessive Supination causes impaired shock absorption = increased force ‘spikes’ to damage tissues directly.
So with this condition alone there are lots of potential causes, some of which can be screened for to then correct and minimise the risk of getting it.
Obviously this is just one condition but many others can be prevented too!
E.g. 50% of primary Anterior Cruciate Ligament (ACL) injuries can be prevented (Kahn 2010).
Talking generally:
Are you strong enough?
Strength training reduced sports injuries to less than 1/3
& overuse injuries could be almost halved (Lauersen et al 2014)
Are you flexible enough for your activities?
Decreased ankle dorsiflexion movement is a risk factor for developing Patella Tendinopathy in basketball players (Backman & Danielson 2011).
Worrell et al (1991) reported that the hamstring-injured group's injured extremity was significantly less flexible than the non injured one.
Decreased ankle dorsiflexion movement is a risk factor for developing Patella Tendinopathy in basketball players (Backman & Danielson 2011).
Worrell et al (1991) reported that the hamstring-injured group's injured extremity was significantly less flexible than the non injured one.
Are you too flexible?
Yes you heard correctly!
Hypermobile individuals often have a long history of soft tissue injuries (Acasuso-Diaz et al 1993).
Dislocations & subluxations are more common in individuals with hypermobility syndrome (Finsterbush & Pogrund 1982).
It is known that proprioceptive acuity is diminished in individuals with hypermobility syndrome (Hall et al 1995).
There is an increased healing time in the hypermobile individual (Russek 2000).
What things prevent common problems?
Regular resistance training should be considered as a strategy to prevent osteoporosis in middle-aged & older men (Bolam et al 2013).To prevent injuries in novice runners, work on trunk performance & hip neuromuscular control, rather than strength (Schmitz et al 2014).
Multimodal programs including jumping/plyometric exercises are best for injury prevention in children & adolescents (Rossler et al 2014).
Acupuncture is clearly effective in relieving pain & preventing migraine relapse or aggravation (Li et al 2009).
An arm support together with an alternative mouse may prevent work-related musculoskeletal disorders of the neck & shoulder (Hoe et al 2012).
Post-treatment exercise programmes can prevent recurrences of back pain (Choi et al 2010).
Evidence suggests that exercise alone or in combination with education is effective for preventing Low back pain (Steffens et al 2016).
Increasing step width in running may be beneficial in the treatment & prevention of running-related ITB syndrome (Meardon et al 2012).
Patellofemoral pain syndrome injury prevention should consider modification of cadence & Vastus Medialis strengthening (Lenhart et al 2015).
Evidence suggests that foot orthoses (insoles) can prevent or slow the progression of hallux valgus deformity in RA (Budiman-Mak et a 1995).
Eccentric strengthening, with good compliance, appears to be successful in prevention of hamstring injury (Goode et al 2014).
Things to Know About ACL Tear & Reconstruction.
ReplyDeleteThe ACL stabilizes the knee and connects the thigh bone to the shin bone. The ACL may get injured due to sudden twisting. An ACL injury may also be accompanies with meniscus tear. A popping sound at the time of injury with swelling, pain and instability in the knee generally indicates an ACL injury. ACL injuries need surgical reconstruction since they do not heal on their own. Using the latest cutting edge techniques Surgeon performs ACLTear & reconstruction using allograft and autograft methods.
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