This is a very topical subject at the moment and one that patient’s with lower back pain frequently comment on when they have a consultation. It is often a negative belief that their posture is poor or bad and is probably the reason why they have back pain. Other common beliefs are that their back is too arched (increased lumber spine lordosis), they are mis-aligned, they have tight muscles, the pelvis is too tilted and they have a leg length ...Continue Reading →
Have you had back pain for a while? Is it worse after lifting? Are you under the impression that you should keep your back straight and brace your ”core” when you lift”?
Well, you might want to think again.
It’s almost part of our culture that you should “keep your back straight” when you lift. However, it’s important to update culture and ask: what’s the evidence for this advice? Well, you may find it surprising, but the evidence for this advice is ...Continue Reading →
It seems logical, you break a bone and the best management is to repair it with an operation. However, the human body has an amazing ability to repair itself and many fractures are best managed by letting nature take its course.
Recent research published in the BMJ (Fractured heel: Surgery or physiotherapy?) compared surgery with conservative management in 142 with heel fractures. The conservative group had the best outcome with good healing and less complications.
Some fractures may need an operation, but ...
A recent slide was produced based on sound research evidence (Brinjikji et al 2014).. It showed that many of the ‘problems’ seen of MRI scans of the lumbar spine were also seen in people who never had back pain.
We spend a long time reassuring patients with low back pain that many ...Continue Reading →
This post discusses the most common cycling injuries. The most frequent areas of the body that cyclists report having pain are at the knee and lower back. The latter being the most common and both are well documented from collected data over the last twenty years. Unfortunately, the research into causes of these problems are sparse and often anecdotal.
The very nature of cycling (in particular road cycling) and the pedalling action is repetitive with often long hours in the saddle. Minor discomforts ...Continue Reading →
The term ‘core stability’ has been a term that we as physiotherapists have endured for the last 20 years. Back in the 1990’s a small number of medical articles reported that people with chronic low back pain (CLBP) demonstrated changes in onset timing of certain abdominal muscles. Unfortunately, these findings along with anecdotal beliefs about abdominal muscles led to a revolution and a worldwide industry in promoting core stability type exercises. The fundamental assumption was that weak abdominals lead to ...Continue Reading →
Cycling has become increasingly popular in the UK over the last 10 years due in part to the success of the British Cycling team in major competitions as well as British cyclists such as Bradley Wiggins and Chris Froome winning the Tour de France. This year Yorkshire is holding the Tour de France Grand Depart and this will inevitably create interest and a surge in people taking up cycling.
If you are new to cycling then choosing a bike is ...
We often get patients that have been told by Consultants, G.P’s, osteopaths, Chiropractors and fellow Physiotherapists that they should be careful or even stop certain activities or sports following an injury. These words are very powerful and patients will more often than not stop their sport of choice and become more sedentary.
Commonly, I often find that this advice is given to runners who have had or are recovering from acute lower back pain, whatever the explanation given as to ...Continue Reading →
We have just started a series of presentations discussing common cycling injuries; how to prevent these occurring through a thorough bike fit, as well as introducing the benefits of using a Wattbike for ongoing training or occasional specific fitness testing.
The repetitive nature of cycling has the potential to cause problems. When observing the statistics, competitive cyclists average up to 5,000 pedalling revolutions an hour, between 10-150 miles each session and up to 20,000 miles a year. It is therefore easy ...Continue Reading →
A few weeks ago I assessed a runner who had pain on the outside of their knee following a marathon. He wanted a second opinion as treatment so far had not helped.
He ran regularly and had completed several marathons over the years. His pain was worse with running or sitting.
A diagnosis of ilio tibial band syndrome (ITB syndrome) was made. Orthotics, stretching and local treatment was given. A suggestion that one leg was shorter probably caused the problem.
Why did he ...Continue Reading →
As a Physiotherapist I commonly come across patients that have been told that they have a leg length discrepancy from fellow health professionals including Physiotherapists. In some instances these supposed leg length discrepancies are corrected by specifically made insoles or shoe raises or inserts. The issue I have is that it is common to have up to a 2cm difference in leg length differences and this is normal. I would argue that the apparent leg length is more related to ...Continue Reading →
“Brain knows movement… Not muscles..” (Beevor 1903)
This insight from over 100 years ago highlights the problem of squeezing muscles and bracing cores. We don’t learn this way and it only engenders fear and is not functional. Low back pain does not improve with this approach. http://www.ncbi.nlm.nih.gov/pubmed/22135712Continue Reading →