"Sciatica"... Cleared Up.

Sciatica is a term that gets bounded around for a whole host of signs and symptoms, so we at Chart Clinic would like to offer our knowledge in helping to understand this.

So what is Sciatica?

Sciatica is when the Sciatic nerve (that runs from your low back/ pelvis, all the way down the back of the leg and into the foot) becomes compressed, stretched or inflamed. This leads to pain in the low back and back of the leg and foot, often accompanied by pins and needles, numbness and/ or weakness in the leg. It is important to note that the leg pain is often worse than the low back pain. Another common symptom of Sciatica is the inability to pull your foot up when you walk, giving the appearance of dragging the foot when walking.

The Sciatic nerve is one of the most common nerves to injure in the lower extremity due to the many sites of potential injury. 

What causes it?

The most common reason for Sciatic nerve pain is from trauma or surgery around the hip. It has been documented that 1-3% of all hip replacement surgeries result in Sciatic nerve injury. Hip fracture and dislocation are also reasons for potential Sciatic nerve entrapment.

Piriformis Syndrome, another term you may have heard of, is another area where the Sciatic nerve can become irritated. If the muscle, Piriformis (which is located deep to the buttock muscles), is overly tight then this can lead to buttock tenderness and pain into the back of the thigh. Prolonged sitting, bending forwards and certain hip movements can exacerbate these symptoms, often accompanied by numbness into the back of the thigh. 

The nerve then traverses down in between the hamstrings where a muscle strain here can compress the nerve. The Sciatic nerve then divides behind the knee where one branch wraps around the top of the Fibula bone. A fracture here can then lead to pain into the calf and foot, along with pins and needles, numbness and/ or weakness of the ankle and foot.

What can you do?

This is entirely dependant on the reason why the Sciatic nerve is being compressed. As physical therapists, we are trained to diagnose the reason for a patient’s signs and symptoms through special tests. This is where it is important to differentiate between nerve root irritation (where the nerves come out the spine are inflamed) and peripheral nerve entrapment (where the spinal nerve roots converge) as the signs and symptoms are similar but not the same. 

If the Sciatic nerve is being compressed by muscles or tendons, then physical therapy can be very effective in helping to alleviate these symptoms. Very specific stretches and the use of ice and/or heat can also help.

Due to the vast number of causes for low back pain and leg pain, it is best to speak to a manual therapy specialist to help diagnose and treat the area in question as it is important to identify where the origin of pain lies so it can be treated accordingly.

The above Information is not designed to replace medical advice. Serious Injuries should be managed with assistance from your Physical Therapist or Health Professional. With any symptoms that cause concern or doubt, get them checked out.

 

Chart Clinic is supporting BackCare Awareness Week, 6th- 12th October 2014

Back In The Office

This year our focus in on office workers. About 7.6 million working days were lost due to work-related back pain and other musculoskeletal disorders from 2010 to 2011 according to an NHS study.

Back pain is a major cause of workplace absence, costing the UK 35 million working days each year (source: www.ons.gov.uk). It can have a catastrophic effect on people’s ability to perform their normal, daily activities, and that is why this year’s BackCare Awareness Week is focusing on ‘Back in the Office’.

“Back pain can affect you when driving a car, sitting at your desk, or using a computer mouse; or you may find yourself unable to concentrate on tasks because of sleep deprivation” says James Clapham, the owner and founder of Chart Clinic.

 “Osteopaths are well known for treating back pain, using a wide range of gentle manual treatments depending on the patient’s age, fitness and diagnosis. Treatment is different in every individual and sometimes it might involve treating other areas in the body such as the hips or neck. We might offer advice on lifestyle particularly if we feel something the patient is doing repetitively is part of the reason why they have back pain; or give advice on posture, diet and exercise, or suggest specific exercises”.

To help office workers in Reigate and surrounding areas, who suffer back, neck or aches and pains, Chart Clinic Osteopaths are offering a limited number of discounted consultations at £15 to specifically discuss desk work and posture related problems booked during October.

Contact:

01737 248 023

info@chartclinic.co.uk

www.chartclinic.co.uk

Aches, pains & niggles – Should runners rest or run?

Runners are often faced with something of a dilemma if they are suffering a aches, pain or have a niggle and this is whether they can run through it or will that put them at risk of developing a more serious problem. Possibly you are suffering with an injury and you are trying to decide whether to run, rest up and recuperate or even seek professional sports injury advice.

The following guidelines will help you to assess your situation and make a better informed decision regarding your complaint.

Are there any signs of significant injury?

First of all it’s important to eliminate some of the more serious signs and symptoms that may require you to seek medical attention. These are as follows:

• Swelling
• Joint locking or giving way
• Severe pain
• Loss of sensation or numbness
• Pins and needles or tingling
• Pain upon pressing a bone
• Limitation of movement in a joint (i.e. not just feeling stiff, actual physical restriction of movement)
• Pain on impact or landing
• Painful weight-bearing

If you have any of these signs and symptoms it may be advisable to seek medical opinion. A little swelling or tingling may just require caution and not necessarily a GP visit, but if the problem persists then it is wise to get it checked out.

How often are you getting these symptoms?

If you have only experienced these symptoms on one occasion and have been running fine since then the chances are it was just a freak one-off. It is recurring symptoms that will be worth investigating.

Should you run through it or rest?

For the more severe injuries your body will tell you what to do, most significant pain and injury will stop you from running. Pain, with time will worsen and almost always mean you have to stop. However with the adrenaline coursing through your veins the pain can sometimes be disguised. Certain minor niggles may actually get better as you warm up and improve with each step, in these instances you are probably not at risk by carrying on. It is important to remember that you should not grin and bear pain and push yourself with tears welling in your eyes! With any uncertainty, don’t push it, stop running, see if it eases or get it checked out.

What if your pain is fine when you stop running?

This is usually a good sign, pain with running is certainly more of a problem than being pain free at rest. If however, pain continues to interfere with your regular day to day activities, then this is probably going to require attention.

Can you alter your running to reduce your pain?

Decreasing your speed, increasing your cadence, reducing stride length, running on a softer surface or stopping and stretching out, are all factors in running that can be manipulated. Making these adjustments may well ease your pain and if it stops, then that is very positive. Maintain what you have changed for a short while and you may find it eases sufficiently to resume your regular running style without pain.  For a number of running related injuries, the repetitive nature of running, causing recurring stress at a vulnerable area is to blame, but this can occasionally be resolved by making some small adaptations.

What is your mileage?

Large increases in mileage, for instance following a marathon training programme over a period of a few months, especially if you are a beginner will of course leave you feeling achy, you are not necessarily injured though. Stiff heavy legs can be a sign of fatigue and this will normally be resolved with a 1-3 rest days.

How much time do you have?

An injury shortly before an event, perhaps or week or two prior to a race is almost always going to mean you will have to pull out. The volume of training and time invested to get the level of fitness required for a half or full marathon, only to risk greater injury by running through it, is probably not worth it – there will be other races you can run. If you get a problem in the early days of training then you will have adequate recovery time and this poses less of a problem.

What other types of training will be more valuable?

With injured runners or those looking to reduce injury risk, the addition of a cross- training session to their weekly training regime will add great value. Strength and conditioning, core stability training or working on flexibility may well be of more benefit than running through a niggle. If you focus on stabilising and building strength around the problematic area and giving yourself time for a decent stretch, this will be better than heading out for a half decent run.

Are you training too much?

Overtraining is a big one in the running injury world; some of the signs to watch for are as follows:

• Low energy
• Abnormally Stiff muscles
• Weary after training
• Taking longer to recover
• Sleep loss
• Decreased appetite
• Poor immunity
• Training is more of an effort
• Poor performance

When is rest the absolute best thing to do?

To start with, if your training schedule does not include any rest days then seriously consider adding them in. Your body needs rest to strengthen and adapt to the training that you are doing, failure to do so will inhibit your body’s natural cycle when training, the careful balance of breaking down and building back up again. No runner likes to rest, but it really is an important consideration when planning your training.

To make the all-important decision of whether or not you are going to carry on running, again be guided by your body and make your decision based on how you feel. A feeling of lethargy and heavy legs, often just take a bit of a mental ‘get up and go’ and will in fact feel better for a run. But if you are overcome with pain then don’t be disheartened and substitute your usual running session for some valuable cross-training instead. It’s useful to allow yourself some training flexibility, avoid a rigid unforgiving programme and mix things up a bit. If you are too tired, inject some pace with a good speed work session or take an easier recovery run.

Most importantly with injuries, if you have any degree of uncertainty, it is better to act and get some professional help to find a resolution, sooner rather than later.

Last minute preparation... Tips for the Virgin Money London Matathon 2014

It’s been a long, gruelling journey to get to this point, but it is finally hear. Some of our runners have already pounded the streets home successfully after completing to Brighton marathon last weekend, now for the biggie the Virgin Money London Marathon!

Runner’s, this week you should relax, you have been tapering for the past few weeks, now just enjoy this final week and look forward to the big day, the adrenaline and the uplifting support from the crowds, the experience alone will be amazing!

If you want to keep an eye on the weather visit the MET office website, this will help you prepare for what clothing you will need on the day, http://www.metoffice.gov.uk/events/london-marathon

In the next few days it’s worth doing a few things in final preparation:

• Rest and relax, you have done your training, now enjoy the rest and wait for race day.
• Consider a Sports Massage to help you physcially and mentally prepare.

• Eat sensibly this week; add an extra carb to your meals, such as jacket potato, rice or pasta.
• Trim your toenails before race day – to avoid any discomfort in your shoes.
• Pick your clothing for the appropriate weather.
• Check your running shoes – Remove any twigs, stones etc. from soles and check the laces are not fraying.
• Drink plenty of fluid the day before race day – your urine should be a pale straw colour.
• On race morning apply some petroleum jelly or similar lubricant to sensitive areas such as nipples, thighs and between arms and chest to avoid chafing.
• Eat something light on race morning bagel, toast, cereal or a banana are all good choices. Avoid eating too heavy a meal the evening before.

Good luck to all our marathon runners :-) - we will see you Monday for a well earned sports massage

Half Marathon & Marathon Training Tips

 

 

These are our top tips to help you when training for your half or marathon.

Avoid training error

As many as 85% of all running related injuries are caused by training error, as are the majority of running injuries we see at Chart Clinic. By following a few easy steps you can avoid these errors. Increase your amount of training gradually. It is generally advised to keep this to a 10% increase per week. Train using a mixture of intensities, an 80:20 split is sensible, 80% low intensity running to 20% of high intensity running (i.e. hill/speed work). Keep your long slow runs at an easy and steady pace, this type of run is about developing your endurance and putting miles into your legs, not the speed at which you run. Employ an incremental increase in your training then decrease a little, put into practice by running increasing distances for three weeks and then in the fourth week decrease your mileage by 10%.  

Plan your training

Plan your training week, identify what you want to achieve in each run and stick to it, this adds variety and you won’t over do it. For example, avoid finishing your long run with some sprints; these should be completed on separate days. It also pays to  have a little flexibility, if you are running a planned 10 miles but after 7 miles you develop a niggle in your knee, stop running. It is ok to listen to what your body wants to do rather than running through discomfort to keep to a regimented plan. Allow yourself to aim to run 8-10 miles rather than a straight 10. 

Use a combination of training methods

Consider swapping one of your weekly runs for strength and conditioning session. Strength, balance and flexibility all play an important role in decreasing running injuries and can even boost your running performance. Research has shown as many as half of all injuries in runners can decrease by following a simple strength and conditioning programme.

Running shoes and gear

There has been a lot of discussion about the recent trend in minimalist footwear and forefoot running, suggesting that this is the way forward. In general, most people naturally heel strike as opposed to land on their forefoot. We see it with injuries that present at Chart Clinic, there is a higher injury risk by adopting a drastically different running style. To learn the forefoot technique safely takes months of practice, and training guidance or coaching is advisable. The most important thing to remember with regard to running shoe advice is buy the pair of running shoes that is the most comfortable for you to run in. Check with your local running shoe shop if you can have a go running in them (perhaps on a treadmill) before you buy.

Nutrition

It has been scientifically proven that fuelling your body (muscles and digestive organs) before you train or run in an event is very important. Aim to consume around 250-300 calories about 1-1.5 hours before you run. Eating any closer may cause cramp and not eating enough may lead to you lacking in energy. During longer runs try to get 100 calories onboard after the first hour and around another 100 calories every 45 minutes subsequent to that.

Staying Hydrated

Taking on enough fluid is vital, 2 hours before you run try to drink about 500ml water, and then immediately before you set off another 150ml. During your run aim to drink 150-200ml, every 20 minutes or so. By avoiding big gulps you minimise the fluid in your stomach, a full stomach can be awful whilst running, so drink little and often.

Skiing & Snow Boarding – Tips for training

If you are heading away skiing this year, some training for your holiday will go a long way, by that we mean some physical conditioning in preparation for the demands of the slopes. Several hours daily skiing takes a substantial effort and this drains your body physically, leaving you feeling fatigued. To prepare your body for optimum performance and minimise your chances of picking up an injury, here are a few tips for ski and snowboard fitness:

Get your heart pumping – work on some cardio

Fatigue is a big risk factor in skiing injuries, as most people will report getting injured later in to their day, when tiredness sets in. By working on your cardiovascular fitness before you go, you will not only increase your threshold for fatigue, you will also lower your injury risk. Dedicate 35-45 minutes, 3 times per week to jogging, cycling, swimming or playing football, tennis, other racquet sports etc. This will significantly help your cardiovascular fitness.

Strengthen up those legs

By working on some strength training you will give your legs a better chance at handling the demands of skiing or snowboarding all day. Performing exercises like squats, lunges, side lunges, dead lifts, single leg calf raises and step-ups are all helpful. As you build on this strength you can add in some additional activities including more explosive movements, Plyometric exercises such as hopping, bounding, squat thrusts, box jumps, side to side lunges are useful.

Build a strong core

Having a strong, stable centre of core muscles will help you to get the most out of your skiing. Plan to do some core strength exercises such as the plank, gluteal bridge, birddog, side plank, abdominal and oblique crunches. Swiss balls are another very versatile bit of kit to help you work on this.

How is your balance?

Standing on one leg for a minute is a good guide to how well you are able to balance, now apply that to balancing on a thin ski or snowboard whilst charging down a mountain and you can see how important balance is! Working on this before you go can really make a big difference, try and balance on each leg and when that gets too easy try balancing on one leg on top of a pillow. Not challenging enough? Try that with your eyes closed or by having someone throw a ball for you to catch or bouncing a ball against a wall yourself (with your eyes open of course!). There are other tools out there for those who are more advanced and want to really test their balance, bosu balls, wobble boards or wobble cushions make balancing very tricky indeed.

Thinking about starting running in January? Looking for some motivation to help you get started?

Get motivated with Jantastic. The running challenge that’ll get you running, keep you running and transform your running.

Check out Jantasctic 2014  

 

 

Jantastic is a free running challenge that encourages participation by all. It’s created by Marathon Talk and supported by England Athletics and Adidas that is intended to give your running and fitness a boost in the early part on the New Year right into the Spring. Jantastic is suitable for all running abilities and open to everybody.

This is a great way to set yourself personal running targets during January, February and March to help you stick to your New Year’s health and fitness goals. Whether you are a beginner taking up jogging for the first time, running to improve your own personal fitness, or training for your first Half or Full Marathon to the seasoned runner completing another marathon. Jantastic will help you along the way and keep you motivated. Its all about your personal aims, your goals and accomplished in your own time.

The Challenge starts on Monday January 6^th 2014, but you can join in at anytime.

Start running, stay running and transform your running. #JANTASTIC2014

www.jantastic.me