Posts from June, 2013

How play like Andy Murray but avoid common tennis injuries

Written By davecasey6719@gmail.com, On June 27, 2013

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To become as good a tennis player as Andy Murray take many years of dedicated practice and with years and years of practice increases the risk of accumulated injuries.

With Wimbledon comes an upsurge of interest in tennis, the Market Harborough and Melton Mowbray Chiropractic clinics  offers some invaluable advice on staying injury free this tennis season.

For two weeks at the end of June, a certain ‘fever’ tends to sweep the country, this being ‘tennis fever’. Tennis is the second most played racquet sport in the UK, close to overtaking badminton in popularity, with an estimated 860,000 people playing.

The Chiropractic Clinic in Market Harborough and the Melton Mowbray Chiropractic clinic  will  see an increase in tennis related injuries. Just the same thing happens every year  in the tennis season but with Andy Murray winning even more people will try tennis for the first time.

Playing tennis is a great way to stay physically fit but it requires a variety of physical attributes, including power, endurance, speed, strength, balance, and of course specific playing skills. Compared to other sports, the risk of injury from playing tennis is relatively low, but there are certain factors that increase the risk of an injury that apply to both competitive and social players:

  • Incorrect technique – poor serve and swing technique will increase the chance of injury, particularly to the elbow and wrist. Relying on only the arm to hit the ball, as opposed to the body’s full strength, leads to an incorrect swinging action. A healthy spine able to flex and absorb these heavy twisting loads the discs in the spine can suffer serious injury that can impact everyday life not just sporting ability.
  • Failure to warm up and cool down – warming up / cooling down reduces the risk of muscle and joint injuries, and improves performance.
  • Time spent playing – overexertion is one of the most common causes of injury, and with insufficient rest and recovery time for the body, overuse injuries are more likely to occur.
  • Previous injury – previous injury can lead to similar injuries in the future, especially if you hadn’t taken enough time to fully recover.

When it comes to tennis injuries, they fall into one of two categories; two-thirds of tennis injuries are due to overuse, and the other one-third due to trauma or an acute event such as sudden force or impact. Cumulative, or overuse, injuries most often affect the shoulders, elbows and wrists, with acute injuries affecting the low back, knee or ankle.

Tennis Elbow – the most well-known of all tennis injuries, it is estimated that over 50% of players will suffer with it at some point in their career. It is an overuse injury of the muscles that bend the wrist backwards, from repeated contraction, and can also be caused by improper technique, such as using too much wrist and not enough arm when you hit a backhand shot (faulty backhand follow-through).

Tennis Shoulder – shoulder overuse injuries are usually a result of poor conditioning and strength of the rotator cuff muscles, a group of muscles at the back of the shoulder. These muscles help to position the shoulder correctly in the socket, and a weakness can cause an increase in ‘play’ of the ball in the socket, irritating the tissues. Tennis shoulder injuries often appear after over-loading the rotator cuff when the muscles are contracting, and are usually caused during the follow-through phase of the serve. These injuries cause pain when the ball makes contact with the racquet during the serve, and cause a decrease in serve velocity.

Tennis Ankle – these injuries fall into the traumatic/acute bracket and are caused by a sudden sideways movement, such as pivoting while making a subtle but rapid change in direction, resulting in twisting or turning the ankle inwards. Playing on a slippery wet surface increases the risk of these types of injuries, as does continuing to play, even when fatigue is overwhelming you.

Low back pain – many tennis players will suffer with low back pain at one time or another. It can be caused by the twisting/rotating movement when trying to hit the ball, the sudden deceleration and changes in direction during a game, or over-extending the back during the serve; this repetitive action places considerable stress on the muscles, tendons and ligaments around the spine, and on the spinal joints themselves. Any accumulation of injury to the discs must be avoided at all times as the discs do not have a blood supply and cannot heal very well. All too often this fact is ignored and the damage accumulated becomes too extensive and permanent disability is the result. Just taking painkillers and waiting for such injuries to heal is a recipe for disaster.

What is a Stress Fracture of the Back?

A stress fracture of the back, or lumbar spine, is one of the more common bone injuries in young tennis players. Lower back stress fractures are usually characterised by an ache in the lower back which is exacerbated by sporting activities and eased by rest, although a small percentage of people with a stress fracture can be pain free. Typically it is sore when the patient bends backwards, particularly if standing on one leg. If a lower back stress fracture is suspected, a chiropractor may decide to refer the patient for a MRI scan to confirm the diagnosis.

What can you do to prevent a Stress Fracture?

Serving in tennis requires a combination of spinal hyperextension (bending back) together with rotation and side bending of the trunk. This puts a lot of stress on an area of the vertebra called the Pars Interarticularis and this is where stress fracture develops.

Practising the service should be carefully monitored by the coach to ensure the lower back is not being overloaded. This is particulary important in adolescent players who have just experienced a growth spurt as they are known to be more at risk from this injury.

core stability exercises can help prevent back problems in tennis players.

What should you do if you suffer a Stress Fracture of the Back?

In most cases, complete rest from tennis is the treatment of choice. This would usually be for a period of 6 weeks to allow the bone to heal. In the early stages, a soothing ice pack can reduce back pain and alleviate back pain. During this period, a progressive exercise programme may commence, under the supervision of a qualified chiropractor. This usually starts with exercises to increase the muscular stability in the lower back.

Research has shown that a lack of muscular stability in the lumbar and pelvic regions can lead to low back pain and stress fractures. The principle behind this is that if certain specific muscles can be recruited or contracted, the spine will have much better support. This prevents postural faults which can predispose a person to back pain.

Spine injuries common in young tennis players

Elite tennis players in their teens appear to have a very high rate of lower spine injury, a 2007  study suggests. Although the subjects in this study did not have symptoms, the researchers point out that these injuries will probably progress to more serious conditions if training techniques are not modified. As with common back problems because it doesn’t hurt doesn’t mean that a problem doesn’t exit.

The British researchers found that of 33 elite-level tennis players they examined, 85 percent had some sort of abnormality in the lower spine. Damage to the joints at the back of the spine, stress fractures and herniated discs were among the problems seen on MRI scans.

Tennis players’ careers depend largely on how well they perform at the junior level, the study authors note in their report, published online by the British Journal of Sports Medicine.

This means that during their growth spurt years, young athletes are going through frequent and intense training that can raise their risk of injury.

Tennis involves constant spinal movements — like quick twists and backward arching — that can account for the injuries seen in this study, according to the authors, led by Dr. David Connell of the Royal National Orthopedic Hospital.

The findings are based on 18 male and 15 female athletes training at a UK national tennis center. None complained of any back pain, but using MRI scans, Connell’s team found that only five players had normal exam results.

The most common abnormality was facet joint arthropathy, damage to joints at the back of the spine that are involved in backward arching. A full 70 percent of the players showed this problem; in contrast, studies of middle-aged adults in the general population have found that 8 percent to 21 percent of symptom-free people have facet joint arthropathy, demonstrating that spinal wear and tear is not painful until we then overload already weakened joints.

In addition, the researchers found, more than one quarter of the players had sustained stress fractures in bone structures at the back of the spine, while nearly 40 percent had herniated spinal discs.

It’s important to spot such abnormalities, they conclude, so that training can be modified to prevent the problem from worsening.

SOURCE: British Journal of Sports Medicine, July 19, 2007 online.

When looking at ways to help avoid tennis injuries, we can split it into 5 key areas:

Environment:

  • avoid playing on hard surface courts with no ‘give’, such as cement, asphalt or synthetic courts.
  • inspect the court for holes/cracks that may trip you up.
  • ensure the court is well lit if playing at night.
  • avoid playing in extreme weather conditions.
  • never play on a wet court.
  • clean off leaves, debris, loose balls etc. from the court.

Dress:

  • wear shoes specifically designed for tennis that support the heel and prevent ankle rolling, choose tennis shoes with skid-resistant soles and high arch supports.
  • consider wearing heel inserts or specially padded tennis socks to absorb the shock when playing on hard services to protect the lower back.

Equipment:

  • see a professional to select a racquet that is the appropriate size and weight, and one that suits your skill level; too light or heavy will increase the risk of shoulder/elbow injuries.
  • a flexible racquet with a larger head is gentler on the arm as the flexion absorbs some of the shock, spreading it over a longer period; this helps to prevent a tennis elbow injury.
  • low string tension is better on the arm as it increases the dwell time of the ball on the strings.
  • thinner strings are more elastic and have better shock-absorbing capacities, making them better for the arm.
  • a grip that is too small or large will increase the risk of an elbow injury as the player has to grip the racquet too tightly to prevent it from twisting.
  • never play with wet tennis balls, especially if you have had a previous shoulder/arm injury.
  • avoid old or low-pressure balls; aim to replace them as soon as they start to lose their bounce.

Preparation:

  • working on stretching and toning your arm muscles off the court will guard against injury; swimming is a good way to achieve this.
  • warm up gently, increase your heart rate with a slow jog or jumping jacks.
  • slowly stretch muscles to improve joint range of motion, and promote elasticity in the ligaments and tendons; hold stretches for 30 seconds.
  • start slowly, hitting a few balls to your opponent; serve several times until the shoulder feels looser.
  • be sure to cool down with stretches after playing to prevent stiff and sore muscles and joints.

Technique:

  • take lessons from a qualified coach to develop skills and technique.
  • when serving/hitting overhead, avoid over-arching the lower back; bend your knees and raise your heels instead, so the upper body weight is evenly balanced.
  • avoid landing on the ball of the foot as this can lead to an Achilles’ tendon injury.
  • hitting the ball in front of the body makes it easier to fully use the shoulder and trunk.
  • forearm muscles are better able to handle the shock if the wrist is held straight when the ball impacts the racquet.
  • use the forearm for control, and the shoulder/trunk for strength.
  • use the other arm for balance with one-handed backhand.
  • in the event of a previous injury or weakness to the elbow, try a two-handed backhand. If you sustain an injury on the tennis court, the best plan of action is to stop playing and seek the appropriate advice and treatment.
  • Chiropractors, whilst best known for treating spinal injuries, are also trained in treating all of the other joints of the body, including the shoulder, elbow and wrist. If you get gripped with tennis fever, and even with following these hints and tips, you still sustain an injury of your muscles, bones or joints, chiropractic may have the answer.

With chiropractic clinics in Market Harborough and Melton Mowbray we are able to offer available treatment in a local setting.

Please call either of our clinics located

Chiropractor in Market Harborough 01858 414841

Chiropractor in Melton Mowbray 01664 561199

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Market Harborough Chiropractor Back Pain Treatment

Written By davecasey6719@gmail.com, On June 20, 2013

Chiropractor in Market Harborough and Chiropractor in Melton Mowbray

Back Pain Clinic in Market Harborough and Back Pain Clinic in Melton Mowbray

Why should we think more about looking after our backs ?

If we look at the cost of back pain to the nation as a whole it may convince us to help reduce this impact on our economy. There has been a lot of research done into this area and the following extracts come a variety of sources.

The NHS spends per year more than £1 billion on back pain related costs, this includes: £512 million on hospital costs for back pain patients.£141 million on GP consultations for back pain.£150.6 million on physiotherapy treatments for back pain. In the private health care sector £565 million is spent on back pain every year.

This brings the health care costs for back pain to a total of £1.6 billion per year.

In addition there are other (indirect) costs. The Health and Safety Executive estimates that musculoskeletal disorders, which includes back pain costs UK employers between £590 million and £624 million per year. These costs are yet still insignificant compared to the cost of informal care and the losses related to it, which reach a staggering total

£10.668 billion. (1)

The total cost of back pain corresponds to between 1% and 2% of gross national product (GP).  Other European countries report similar high costs; back pain related costs in The Netherlands in 1991 were more than 4 billion euro. For Sweden in 1995 this was more than 2 billion euro.

Nearly 5 million working days were lost as a result of back pain in 2003-04. This means that on any one day 1% of the working population are on sickness leave due to a back problem. (5)

Back pain is the number 2 reason for long term sickness in much of the UK.

In manual labour job, back pain is the number one reason.

So if you are in a manual job, especially if you are self employed, your number one reason for time off work and reduced earnings is back pain. If steps are taken to reduce the risks of back pain developing in the first place ie: with regular visits to a chiropractor, you would have less time off work.

Benefits of early intervention not only include the likelihood of employees making a sooner recovery, but also makes it cost effective to the employer as absenteeism will drop. Indeed the costs to companies are huge, and can be due to legal fees, compensation, loss of customer satisfaction resulting from poorer service due to absenteeism and much more. 

All the current research available strongly advocates that prevention is the key to the management and reduce the long term suffering and disability associated with low back pain. Waiting until the damage has become irriversible is simply madness.

If you do nothing, nothing will change

Take action today and call, dont wait until its too late.

For more information on how we can benefit your business call us now on

Chiropractor in Market Harborough on 01858 414841

Chiropractor in Melton Mowbray on 01664 561199

 
References
1. Maniadakis A, Gray A. The economic burden of back pain in the UK. Pain 2000;84:95-103
2. The cost of accidents at work, HS(G)96 2nd Edition, HMSO 1997.
3. Norlund Al & Waddell G. Cost of back pain in some OECD countries. In: Nachemson AL, Jonsson E(eds). Neck and back pain: The scientific evidence of causes, diagnosis and treatment.
Philadelphia: Lippencott, Williams & Wilkins, 2000.
4. Van Tulder M. Chapter 1:Introduction. Eur Spine J 2006; 15(suppl 2):S134-S135.
5. Back Health st work. HSE 2005
6. Department for work and Pensions, 2002

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Spinal Manipulation

Written By davecasey6719@gmail.com, On June 18, 2013

Chiropractic Clinic in Market Harborough and Chiropractor in Melton Mowbray

Many practitioners use manipulation as a mainstay of treatment for back pain, be that the chiropractic profession or osteopaths and physios have even come over to art as well in recent years. Many general practitioners have attended training over the years but the majority leave manipulation to the experts now as it requires years of daily practice to become proficient.

Decades of research have shown again and again the value of manipulation, especially when it is combined with a programme of rehabilitation.

So why use manipulation in the first place. To understand that you need to understand why we get back pain in the first place.

First and foremost the bones of the spine, the vertebra, do not get misaligned and manipulation does not put bones back into place. The next big myth about back pain regards the “slipped disc”, there is no such thing as a slipped disc. It is physically impossible for an intervertebral disc to slip out of place and pinch a nerve. Discs can after decades of miss use and abuse end up being torn, split and ruptured, resulting in disc bulges or prolapse, which can affect the nerves but they can never just slip out of place that is nonsense.

The majority of back pain is the results of ligament injuries and that includes the intervertebral discs themselves. Back pain is not the result of muscle spasms, the muscles spasms are the result of pain in spinal ligament injury.

Simply put all the ligaments in our bodies have limited blood supplies and as a result they all have limited healing abilities. Whereas muscles and bones have very good blood supplies and heal very well, even from major trauma. So if you have back pain that has lasted for more than six weeks you can be sure its not because of a “pulled muscle”.

Manipulation is performed to take tight, stiff, fibrous ligaments and stretch them again and again until they loosen off enough to restore normal movement.

To arrange an appointment to see a chiropractor skilled in the art of manipulation call

Chiropractor in Market Harborough on 01858 414841

Chiropractor in Melton Mowbray on 01664 561199

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Rehabilitation verses surgery for low back pain

Written By davecasey6719@gmail.com, On June 14, 2013

Chiropractor in Market Harborough Chiropractor Melton Mowbray

Interdisciplinary Chronic Pain Management vs. Back Surgery:

Which is Right for You?

Patients who suffer from chronic back pain understandably want to find a
solution – and many hope for a ‘silver bullet’ that relieves most if not all of
their pain.

For many patients, the hope is that surgery is the best answer to
relieve their pain quickly. While back surgery has proven successful in
addressing a wide range of painful back conditions, several recent studies
demonstrate that there exists a viable, effective alternative to back surgery –
the interdisciplinary chronic pain management program, which can offer a better alternative for certain types of patients.

When physicians make an effort to inform patients about the potential risks of spine surgery and benefits of chronic pain management programs, many patients come to accept a rehabilitation model over surgery.

Investigations are being undertaken to answer why general practitioners in particular do not inform back pain patients of this situation.

The foundation of the interdisciplinary chronic pain management
approach is to help patients view chronic pain outside the traditional medical
model, i.e., the physician is responsible for finding a ‘fix’.

Instead, interdisciplinary chronic pain management teaches patients to manage and cope with pain and its impacts through a combination of the following:

  Physical conditioning

  Education about risks and alternatives

  Psychological treatment, including relaxation training

  Vocational counseling to facilitate return to work

Several recent studies have shown that the chronic pain management approach can be as effective in treating spine pain as spine surgery.

  Educating Back Surgery Candidates About Chronic Pain Management
 
Chronic Pain Management Outcomes Comparable to Back Surgery
The results of a 2003 study of 64 Swedish chronic pain patients with evidence of severe disc degeneration compared surgical to chronic pain management outcomes after a year of intervention.1 These patients were randomly assigned to undergo either a lumbar fusion with posterior transpedicular screws and post-operative physical therapy; or a modified chronic pain management program involving cognitive-behavioral intervention with three daily physical exercise sessions for three weeks. The results showed that chronic pain management delivered as well or better than back surgery against the following patient satisfaction criteria:

 At one-year follow up, both groups had significant improvements in function,
  as measured by the Oswestry Disability Index (ODI), although the back surgery group had to contend with an early complication rate of 18%.
 

There were no significant differences between the two groups in terms of pain,
use of painkillers, emotional distress or ability to return to work.

Fear-avoidance beliefs (those catastrophic thoughts that can actually
exacerbate pain or maintain pain) were reduced significantly more in the
chronic pain management group over the back surgery group. (Another study was conducted by an extended research team in 2006 with similar results.2)

Additional support for the use of interdisciplinary chronic pain management was confirmed in a larger trial that included 349 patients who were uncertain if they should undergo back surgery.

These patients were randomly assigned to have either spine stabilization surgery (spinal fusion) or “intensive rehabilitation” (a chronic pain management program). Study participants were followed for 24 months, with the following findings:

  The patients treated with back surgery showed a slightly greater improvement  in function as measured by the Oswestry Disability Index, but no other  differences between the two groups were significant.

Intra-operative complications occurred in 19 patients who underwent back surgery.

 A follow-up study of these same patients found that the cost of chronic pain
 management was far less than that for back surgery (by about 45%)4 , making
 chronic pain management more cost-effective than spinal fusion, a finding that was confirmed in later studies.

The percentage of patients returning to work two years after the start of the
treatment was equivalent.

Chronic Pain Management May be Preferable for Certain Types of Patients
Based on the above study results, chronic pain management is a viable
alternative to back surgery for chronic pain patients, especially for those
patients who have one or a combination of the following characteristics: Have a high level of fear, anxiety or other identified psychosocial risk. Back surgery does not address these issues, whereas one of the goals of an  interdisciplinary chronic pain management program is to help build a patient’s coping skills.

Are uncertain about whether back surgery is the best strategy

 Expect poor outcomes from back surgery, either because of fear or a previously  problematic procedure or failed back surgery.

For patients with a history of failed back surgery, the success rate for repeat back surgery is quite low.

Are addicted to or dependent upon pain killers. Since substance abuse or
 overuse is associated with worse spine surgery outcomes.

Patients with such problems would likely be better served by participation in a chronic pain management program than by having back surgery.

Have unrealistically high expectations of the degree of pain relief achievable
through back surgery. Some researchers have found that such expectations by  patients who underwent surgery for spinal stenosis were associated with more pain and less satisfaction six months after surgery than those who had lower expectations of pain relief. In cases where a potential surgical patient has any or a combination of the above noted situations or psychological characteristics, a chronic pain management program ought to be at least considered as an alternative to back surgery to avoid further patient disappointment, additional cost, and the possibility of continued pain even after surgery.

References:
  Brox, Sorenson, Friis, Nygaard, Indahl, Keer, Ingebrigtsen et al. (2003)
  studied 64 Swedish patients with evidence of severe disc degeneration lasting
  more than one year.

  See, Brox, Reikeras, Nygaard, Sorenson, Indahl, Holm, Keller, Ingebrigtsen,
  Gurndes, Lange and Fris, 2006

  Obtained by Fairbank, Frost, Wilson-MacDonald, Yu, Barker and Collins (2005)
  Rivero-Atlas, Campbell, Gray, Fairbank, Frost and Wilson-MacDonald, 2005)

  Turk and Burwinkle (2005) in a separate review of the literature, confirm and extend such findings. They found that the chronic pain management approach is approximately 26 times more cost-effective in returning patients to work than  is spine surgery.

 If you would like another option outside of surgery call

Chiropractor in Market Harborough on 01858 414841

Chiropractor in Melton Mowbray on 01664 561199

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Spinal stenosis

Written By davecasey6719@gmail.com, On June 13, 2013

Chiropractor in Market Harborough and Chiropractor in Melton Mowbray

Spinal stenosis is an aquired condition most commonly seen as a result of long standing arthritis of the spine. As the discs degenerate reducing the spacing between the spinal bones the bone begins to remodel and form boney projections, known as osteophytes. As the ostephytes continue to grow larger and larger they begin to reduce the space where the spinal cord and various nerves are situated. The spinal cord and nerves become progressively compressed until the nerves become damaged.

Once the nerves have become damaged there is little hope that they will recover even with surgery to the affected area.

By maintaining a healthy spine and limiting the extent of arthritic changes the disability associated with this condition could be avoided before its too late.

To arrange an appointment for a spinal health check call to speak to a specialist today.

Remember

If you do nothing, nothing will change”

Call

Chiropractic Clinic in Market Harborough on 01858 414841

Chiropractic Clinic in Melton Mowbray on 01664 561199

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Improving back pain services

Written By davecasey6719@gmail.com, On June 11, 2013

Chiropractor in Market Harborough Chiropractor in Melton Mowbray 

East Leicestershire and Rutland Clinical Commissioning Group is beginning to put plans in place to improve how patients with low back pain access services.

Currently low back pain patients access services through making multiple visits to General Practitioners. This often leads to complicated arrangements with prolonged waiting times and multiple visits to see various specialists in an attempt to manage their back pain.

This has been shown to be a very ineffective and time consuming procedure that ultimately delays treatment.

Living with back pain can have a major impact on patients quality of life. If these conditions are allowed to develop into chronic pain syndromes they can become difficult to manage.

At this stage any attempt to treat and resolve back pain can often be too late.

The way General Practitioners advise patients needs to be investigated to improve the way their patients are referred to other services to change the current weakness in patient care.

 This can be improved by taking advantage of a multidisciplinary team so that patients get the right care for their specific condition.

Chiropractors are ideally qualified to participate in this programme.

If you would like a instant access to specialist treatment with a chiropractor in Market Harborough or a chiropractor in Melton Mowbray or the surrounding regions call

The Chiropractic Clinic in Market Harborough 01858 414841

Chiropractic Clinic in Melton Mowbray 01664 561199

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