Hawkes Physiotherapy Blog

　 The pregnacy year: First Trimester 1-12 weeks Formation of baby’s major body organs Second Trimester 13-27 weeks Increasing growth, Uterus near the rib cage Third Trimester 28-40 weeks Continued growth and maturation of body systems Postnatal 0-3 months 6 weeks for uterus to normalise Changes and Challenges Hormonal Cardiovascular Posture Musculoskeletal and Biomechanical Hormonal Progesterone increases Breast development Reduction in smooth muscle tone - leads to constipation/haemorrhoids Hyperventilation Increased storage of fat 　 Oestrogen Increases Increase growth of uterus and breast ducts Prepares breasts for lactation Increases water retention Relaxin Increases Decreases intrinsic strength of connective tissue (Mantle et al , 2004) Cardiovascular Blood volumes increase by 40% Haemoglobin levels drops by 20% Heart size increases by 30-50% to cope with increased blood volume Enlarged uterus li

What is a Leg length Discrepancy? Structural: A true bony difference in length of the lower extremities Functional: A difference in leg length attributable to asymemetry in joint position What amount is significant? Difference            Problem                                                Source 3 mm                     Running injury risk                                  Subotnick 5 mm                     Spinal compensation                               Friberg 6 mm                     Running injury risk                                  Brody 7 mm                     No problem < 7 mm                               Corrigan, Maitland 9 mm                     Lumbar facet angle changes                    Giles 10 mm                   Low back pain                                       Cyriax 15 mm                   Compensatory scoliosis                          Gibson 20 mm                   LE compensation                                 

I work in private practice and as you may imagine I see my fair share of whiplash injuries. So I thought that I would write a blog article on the subject:   Definition: "Acceleration - deceleration mechanisms of energy transfer to the neck" "From motor vehicle collisions, but can also occur during other mishaps" "Result in bony or soft tissue injuries, which may in turn lead to a variety of clinical manifestations called whiplash associated disorders (WAD). Grading: n Grade 0: no neck complaints or signs n I: pain, stiffness or tenderness, no physical signs n II: as I + musculoskeletal signs (MSK) n III: as I + neurological signs +/- MSK n IV: fracture or dislocation n Late whiplash: symptoms 6 months+ Mechanism of injury: n Bannister et al (2009) – rear-end collisions account for half of cases, associated with more severe symptoms n Elliott et al (2009) – 0-50 milliseconds: cervical and thoracic spine straighte

It is estimated that at some point 70% of all swimmers get a shoulder problem. It's no wonder when you consider what the shoulder goes through! The average competitive swimmer performs over 1 million arm strokes per year. Sounds a lot doesn't it. But think about it. When I was swimming at my peak I trained 9 times per week and averaged 7000 metres per session, which is 280 lengths of a 25metre pool! Times this by 9 and this gives 2520 lengths per week! We trained nearly all year, so say 45 weeks per year. That's 113,400 lengths per year! Now when you consider a stroke count of 12 strokes per length this is 1,360,800 strokes And we haven't even counted the strokes done in competition every weekend! Sorry to go all maths teacher! The issue however isn't just the amount of strokes: The way your shoulder should move in elevation is to externally rotate, however in front crawl you actually internally rotate the joint and this causes the supraspinatus

‘ The hip is designed to operate under loads exceeding 3x the body weight and to be controlled by muscles of enormous power and incomprehensibly accurate coordination. Anything that disturbs this intricate balance will cause the hip to work under abnormal conditions.’    (Strange 1965) Prevalence of hip injuries: 10% of all clinic visits are hip related. (McCrory and Bell 1999)   Arthroscopic Diagnosis of Pathologies (Villars 2003)   N=1170, Age 6-80 years:     • 38% OA (arthritis)  • 19% Labral • 16% Osteochondral lesions • 5% Ligamentum Teres Injuries • 4% Synovitis • 4% Loose bodies • 14% Other   — Hip Loading:   Weight bear through roof of acetabulum — Walking   3-4x body weight. — Running 5 x body weight — Turning (skiing) 7x body weight — Stumble - single impact load 8 x body weight (Bergmann et al 1993) — Repetitive Loading-chondral damage (Krebs et al 1998; Pauwells 1976;Radin et al 1991)   Where do you