Category Archives: lower limb

Circulation II

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Just as water stagnates when it stops flowing, your blood which is mostly made out of water starts to decompose when it stops flowing. When the circulation in your tissues (flesh and muscle) significantly slows  you have problems because the tissues have a diminished function and are not as good at repairing themselves.

Heart attacks and strokes are about as scary (and common) as circulatory problems get. If you know someone well who has suffered a stroke or a heart attack you may have noticed that even if the incident was relatively minor it really shakes people up and affects their confidence, it can really make people question their own sense of self identity and worth and make them suddenly feel very old.

One can adopt a fatalistic attitude about if your time is up there is nothing you can do about it so you may as well die doing something that you love, the only flaw in this logic is if a heart attack or a stroke does not kill you it may leave you feeling like you wish it had because there is a good chance that you will never be the same again afterwards.

Taking a bigger interest in your health is no guarantee that you won’t meet such a fate, you might be unlucky enough to have poor circulatory DNA but all that any of us can do is to minimise the risks, you wouldn’t knowingly drive on bald tyres now would you?

Heart attack and stroke rate amongst the top four killers of Australians each year, (cancer and medical malpractise make up the other two) but at the other end of circulatory disease spectrum are less life threatening but still concerning problems like how you look for instance.

A persons’ skin usually shows the effect of years of sun baking, smoking and eating fatty food but even if you don’t do any of these things if your circulation isn’t good because you don’t exercise regularly (for instance) you may not have a very good colour or lustre about your skin. The whole cosmetic industry is about how your skin looks and all the cosmetic products under the sun are a poor substitute for good circulation in the blood vessels just under your skin.

Your eye sight is very much subject to your circulatory health too, glaucoma, the number one cause of blindness in this country is most often caused by by capillary damage in your retina. Having diabetes is the number one reason why people get glaucoma, and it is not the only circulatory problem that diabetics get, capillary damage can give you diabetic ulcers on your extremities and can even cause impotence in men.

Even though diabetes is an endocrine disorder it can have big circulatory consequences, with diabetes growing faster than all other diseases more and more people will be forced into taking greater care in their circulation as well as their diet.

Your circulation really is a big deal and effects your whole body, it is yet another reason why we must exercise, eat and hydrate well and pay close attention to our posture.

Lifting and Carrying

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Lifting even moderately heavy objects the wrong way can injure you, this is a well known fact. You may perform the lift well but then you may trip or twist when you are carrying your load and the result will be the same- pain, inconvenience and the fear that you might have done yourself serious damage.

Work place safety is taken seriously by responsible employers because they have a stake in you not hurting yourself, lost productivity and increased compensation insurance premiums are costs they like to avoid. So think about how you lift things when you are not at work and  how much it might end up costing you.

Sometimes a weight that you have easily lifted a thousand times before (that isn’t that heavy at all), can give you a sudden shock of pain one day. Momentarily you stop you in your tracks and wonder what just happened. This is usually due to poor lifting (and carrying) technique but may also be a repetitive strain injury too. Some small loads can be very hard to hang onto to like a squirmy toddler or a dog trying to avoid his bath. Lifting and carrying injuries can be very unpredictable.

Then there are lighter things that we lift and carry everyday like  laptops, handbags and brief cases. How we carry these things can have an undesirable effect on our spines too but in a more gradual less noticeable way. The constant carrying of even light objects over a long period of time, always on the same side of your body can change it’s balance and distort the shape of your spine. The shape of our bones over a long period of time can change because of uneven posture.

I wish I had a backpack when I was a school kid, they are so much better for your back than our hand carried cases and even better if you use the chest strap. If you wear a pack always the carry the load as high as you can and evenly.

If a backpack makes your business suit look too casual or it doesn’t match your beautiful dress please be conscious of frequently and evenly swapping your purse or case from hand to hand to share the load. Handbags can make women’s shoulder suffer just as surely as her high heels can cause her back pain, fashion has it’s price.

You don’t have to carry anything at all to be lop sided, poor general posture can do it to you too.

We are very lucky to have so many labour saving devices available to us it is ridiculous to risk our spinal health by not using them. The next time you see an African woman carrying a big water jug on her head it is because posturally it is the safest and most efficient way of carrying it over a medium to long distance without the aid of a vehicle or a trolley.

In a way we have become a little spoiled by our labour saving devices, when we do not have them at our finger tips we can be a liitle useless at lifting and carrying.

 

 

 

 

work out your workout

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If like most people you do not have a huge amount of spare time on your hands making the most of the time you do have is important, this applies to working out too. All the exercises you do should have a clear purpose and part of that purpose should be about minimising harm.

We are all a bit different, the work we do, new and old injuries, joint conditions, congenital deformities and the way stress affects us can make exercises that are easy for others hard for you to do. Sharp pain is a definite warning to back off any particular exercise.

The look you want to achieve and what we specifically need or want to do well is an important consideration, as is your muscle type. Some people get bigger muscles than others using the same exercises and this applies to stretching and cardio too. 

Squats for instance can give you increased thigh strength, if you lift or are naturally a bit week in your thighs squats become more important to your needs. Squats generally help you lift things better, even if is just your own backside getting on or off  chairs which becomes increasingly harder for many as they age or put on weight. Squatting down too far (past 90 degree knee flexion), can damage your knees, the greatest value of squats is supporting postural strength. Squatting with your knees bent more acutely than 90 degrees is a common exercise hazard many fall into.

The pressure inside your knees increases greatly when you fully flex your knees under your own body weight and much more so under extra load (pushing against a weight). Squats are safer if your knees are good.

If you have had a knee replacement full squats simply are not possible. It is fine to do full knee bends when you are not weight bearing as with leg stretches but under load it is a different story.

Another exercise that has a high risk factor is the shoulder press, if you are a footballer needing to reinforce your collarbones for front on tackling, shoulder press (and other exercises with similar actions) can help protect your upper body.

The trouble with shoulder press type exercises is that a)- any history of neck trauma like from a whiplash injury from a road accident can create a weakspot that might give way under stress. b) shoulders do not work efficiently when your hands are supporting weight above the height of your shoulders or behind the centre line of your body and c) Some of the muscles in shoulder press such as your upper trapezius and supraspinatus are always working against gravity anyway and are more likely to need stretching.

It is ok to workout hard but workout smart too.

Feet and Footwear

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Your feet do a lot of hard work and they need all the help they can get if you want them to still be serving you well when you are old and grey. Shoes that look good such as women’s high heels or shoes that have a high convenience factor such as thongs (flip flops) can be injurous to our feet. In the case of high heels the balls of your feet get over-worked, you can get achilles tendon shortening and lower back pain too because the pelvis gets tipped forward too far in order to stand straight in them.

In thongs (and high heels) you have no arch support, this applies to most sandals too. You can also get hammer toes and plantar fasceitis from shoes with no heel support.

In footwear with insufficient arch support the arches are more likely to collapse (pronate) which is hard on your knees and will even adversely affect your spine, if your main arch has already collapsed it is even more important.

Orthotic inserts tailor made for you by an Orthotist can be of great benefit to you, so long as you renew them when they wear out and they are used in shoes they are suited to they can be of  assistance for not only your feet but for the overall  structure of your whole body. A flat foot can give you knee pain on the other leg.

Bare foot running on grass can help you run faster but more importantly you can change direction quicker without twisting your ankle. There is actually an association of bare foot running enthusiasts. Thick soled runners may look comfortable and absorb shock well but the soft edges of the soles make your ankles more susceptible to rolling.

Walking on dry sand helps stretch and strengthen your toes and bush walking can strengthen the muscles in your soles and help your balance. Even the fittest amongst us can have weak foot muscles because we are accustomed to walking on flat level surfaces all the time, walking over twigs and rocks helps strengthen the muscles that correct your foots position.

Above everything please regularly massage your feet, even 5 minutes will help. Your feet work very hard, if you allow them to stiffen your foot won’t roll and spread as you step, this affects your stride and balance, this is a safety issue as well as a fitness one.

As we age the circulation in our feet deteriorates which can cause swelling at the day’s end, this is worsened by socks that have tight top bands. Raise your feet when you are relaxing and lie down, it will help relieve any pooling of fluid.

The act of massaging your own feet can in itself be a good stretching exercise for your legs and hips, when you lean forward to reach them.

If you have any issues with ingrown toenails, act early and learn how to trim your nails properly, do not trim the corners back of your big toe nail, trim straight across or the nail will dig into the skin at the side of the nail as it grows through. If your toe joints get stiff stretch the joint and move it around, if you allow your toes to stiffen it diminishes your ability to enjoy a good walk. This simple action can save you from having a painful nail removal later on and make walking and running generally much easier. 

 

Knee Pain II

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Just as knee  pain can be caused by uneven muscular tension near the knee, so too can it be caused by muscular tensions in the hip, lower back and feet. This can be particularly deceiving when the feet, hip or lower back are not actually in any pain.

This occurs via the compensation effect, unconsciously your body in it’s attempt to maintain balance and avoid pain changes it’s posture as a reaction to other things going on in your body.

This can happen in a variety of ways, perhaps a past ankle injury that is no longer  painful causes you to develop a change to your stride when you walk, creating added pressure on the soft tissue in your knee. This compensation may occur on either side of your body, from your hip to your toe.

Changes in your work and home activities can change your posture in subtle ways that you may not notice immediately. You may not think you are moving differently to how you always have, but the body seems to remember what happens to it even if “you” cannot. This may result from a change in how you move, sit, stand and even react to stress.

I have known people over the years who have actually had such persistent knee pain and stiffness. Then they have had exploratory arthroscopic surgery that has revealed no likely cause for the discomfort at all. Their knee pain turned out to be of a muscular cause which an arthroscopy is unlike to detect.

A collapsed left foot arch for instance can make your right knee sore because of changed weight displacement.

Golf places unnatural sideway stresses on the knee joint that can progressively damage cartilage and ligaments, good playing techniques help but if you want to keep playing regular therapy and exercise are necessary.

Swimming and aquarobics are good ways to supplement a lack of walking, running or cycling. Doing extra upper body work with weights can burn off some of those spare callories too. If normal weight bearing exercise hurts your knee your whole body will suffer if you give up on exercise.

If your knee cartilage is worn down and you have been informed that you have osteoartritis (OA) nothing will restore the lost cartilage but it will not necessarily become a cause of constant knee pain. Cartilage wears down slowly, from day to day it does not change much.

If your OA affected knee was sore last week but not sore this week it is not because you have grown more cartilage this week, it means there were other factors at work. Stiff muscles can be just the sort of transient factor that can account for intermittent knee pain because muscular tensions change much faster.

Too often people give up on a knee that they are told is incurable, by definition OA has no cure that can make it like new again. Your knee’s symptoms can be managed though and by keeping the muscles supple in your legs. Self Massage and stretching can help your knees stay better for longer.