Injury-free Skiing – Exercises

How to Improve your Performance and Have an Injury-free Ski!

 

It took just one hailstorm in Sydney to get me itching to ski this season. Most of us ski just a few times each year, and don’t get ourselves conditioned to ski. Try these easy ski-preparation exercises leading up to your ski holiday!

 

Step 1: Check your Alignment76 sit to stand

Start by preparing how you stand. Draw a mark on the centre of each kneecap and stand in front of a mirror. The mark should be directly above your second toe. Adjust your feet and knees until they are. Do a half squat, keeping the marks above your second toes, then stand back up.

Try lunging forward with one leg, keeping the mark above your second toe, then stand back up and repeat with the other leg.112a standing stability work

Repeat each exercise 30 times, squatting lower and lunging a little further forward each time.

Practice will help you align your legs properly to ski, and get you holding an edge like a pro. If you are having difficulty with these exercises, it may mean you need the canting adjusted on your ski boots.

 

Step 2: How’s your Balance?77b hip extension77a standing knee hug into hip extension

Most skiers put too much weight on the back of the ski. Keeping your weight even from front to back will give you more control and a faster ride. It’s great to practice weight-bearing on a balance board, bosu or duradisc.

Try this exercise on solid ground. Stand on one leg, hugging the other leg into your chest with both hands. Make sure that the centre of your kneecap is over your second toe. Get the weight on your toes the same as the weight on your heels. Once you feel steady, extend the leg and your arms behind you, keeping the weight even on toes and heels, then return to your starting position.

Repeat 10 times on each leg.79 advanced pendulum exercise

Progress to the Arabesque position, extending the leg straight behind you, with one arm extended in front. Then return to the starting position.

 

 

Step 3: Strengthening Glutes & Quads

Gluteus Medius

No sport uses Gluteus Medius as much as skiing. Good control of the hips includes having strong glute meds, and this is essential for your turns.04081502

Stand side on to a wall, with your hands on your hips. Lift the knee closest to the wall. Pushing this knee into the wall will make the glutes contract on your standing leg. Maintain your alignment and balance throughout this exercise.

Hold for 10 seconds and repeat 8-10 times each side.

To progress this exercise further, try turning out the foot you are standing on, against the resistance of the floor.

Quadriceps113 quads step strengthening

Your quads are the workhorses of your skiing. You need strength and endurance in these muscles.

Stand with one leg on a step and the step the other down towards the floor in front of you. Stop before your foot actually hits the floor and return to your starting position.

Repeat 10-15 times and do 3 sets on each leg. Maintain your alignment and balance. Move to a higher step and add weights to progress this exercise when you’re ready.

 

 

Step 4: Endurance

The fitter you are, the longer you will enjoy your day on the slopes. That chair ride up only lets you recover so much!

Running, skipping, cycling or using an elliptical trainer as often as you can – at least every second day – is the easiest way to improve your baseline fitness and endurance.

If you have the right space and equipment, in-line skating uses many of the same muscles and techniques as skiing. Jumping exercises get the heart pumpin04081501g and help prepare for those moguls. Find a sturdy, low box that you can stand on, and give yourself lots of room. (Step aerobic steps are great for this.)

Start by standing feet together on the box, and stepping one leg sideways until it touches the ground, then return to both feet together on the box. Step to the other side. Repeat 30 times to each side, and keep your alignment and balance as you go.

Once you’ve mastered this exercise, keep your feet together and jump both feet to the floor on one side, then back onto the box, then both feet to the other side. Repeat 30 times on each side.

Increase the height of the box, and try jumping forward and back when you can.

 

 

Step 5: Improve your Flexibility

Flexibility is particularly important when you are doing tricks or racing, and it is vital that you stretch any muscle that feels tight before andCalf stretch - wedge after your day on the slopes, especially as fatigue and the cold will make your muscles tighten up.

A good stretch for your calf muscles can be achieved by using a low wedge (an old cutting board against a brick or similar will do the job.) Angle the wedge down towards a wall, and stand with your back against the wall. Hold this position for 1-3 minutes with your legs straight (gastrocnemius), and then repeat with your legs a little bent to reach you61 hip flexor stretchr deeper calf muscles (soleus).

 

Your hip flexors will also need a good stretch after skiing. On your knees, lunge on leg forward with your pelvis tucked under, and then stretch the arm on that side over. Hold for 20 seconds, and repeat on both sides.

A simple quad stretch will also assist your muscle recovery after skiing. You can use a wall or table to support you. Stand up tall on one leg.

107 standing quads stretch

Bend the other leg and reach the foot up behind you. Hold onto your foot and try to keep your knees together. Hold for 20 seconds, and repeat on both sides.

 

 

If you follow these 5 guidelines, your performance will improve on the slopes this season, and you are much less likely to suffer injuries. Prevention is always better than cure! If you have any trouble with these exercises, or would like to improve your performance further, speak to your Physiotherapist.

 

At PPFC, our resident Skiing Physio is Alex Sherborne. Call to make an appointment with him on 02 9399 7399.

Why does my neck STILL hurt??

Why does my neck STILL hurt??

Neck pain can persist for many reasons, but one of the most common is that the relationship between your eye and neck muscles has changed.
Do you feel like your head is crooked when you look straight ahead? This could be a sign that it is influencing your neck pain.

The neck has receptors that tell you where your head is and whether it is straight or crooked. These receptors can be damaged through injury or wear and tear. Studies have found this to be a particular problem after a whiplash injury or if you have arthritis. Balance is an essential part of treating ankle and knee injuries, but is often overlooked in other parts of the body!

 

    

Eyes Closed

Close your eyes

Looking to left

Turn to left

Try this simple test of balance and position of your head:

1. Sit down and focus on a small spot in front of you (eg. a spot on the wall, or a part of the pattern on a curtain.)

2. Close your eyes and turn your head as far as you can to the left.

3. Keeping your eyes closed, turn your head back to where you started.

4. Open your eyes.

 

Looking straight

Open your eyes.

How did you go? Are your eyes focused exactly on the same small spot? Are you a little to the left or right? Are you a little above or below?

Next, try this test on your right side.

Is the result any different?

 

If your head is in balance, you should be able to return to your starting position, open your eyes and be looking exactly at the same spot.
Studies have found that some people are consistently off the spot by an average of 4cm. Often, they are off focus in one specific direction, but perfect in others. Computer work often requires you to quickly turn your head away from the screen, and then return to the part of the screen you were working on. Without realising, you may be constantly correcting your head position. This is often a contributing factor in neck and shoulder pain or stiffness.

The good news is that this can improve and be corrected with practice. By using head-mounted laser equipment, we are able to show you how to correct your head balance, and provide the specific exercises for you to improve your balance and also relieve your neck pain.

 

To find out if this is the reason for your ongoing neck pain, or to discuss what your found when doing this test, book an appointment with Alex Sherborne, or send us an email via our contact page.

Why do I keep rolling my ankle?

Ankle sprains: Why do I keep rolling my ankle? Exercises to stop it happening!

Clare_Alla_balance

There are position receptors, “proprioceptors” located in your joints, ligaments and tendons. They sense where your body is positioned in space, sending this info to your brain.

With any injury, such as a rolled ankle, there is likely to be altered proprioception. Has your ankle ever felt vulnerable on uneven ground or with unexpected movements? Poor proprioception is why its common to suffer recurrent ankle sprains – the ankle stability muscles don’t kick in when your ankle starts to roll.

By using unstable surfaces, we can retrain the stability muscles to function as they did pre-injury – or even better! That’s why it is excellent for you to practice walking on uneven surfaces after an injury.

 

Your challenge to test your stability:

(Caution: stand near a wall for safety when first trying this)

• Can you stand on one leg with your eyes closed? Try keeping your balance there for more than 10 seconds.

• Was this too easy? Stand on a rolled up towel to challenge your balance. Eventually you can add multitasking like throwing and catching a ball to this exercise.

 

In our gym, we use exercises on foam balance beams and the Bosu to retrain proprioception. A real challenge is walking on the beam with your eyes closed. Most of us are heavily reliant on vision for body awareness, and taking this away really works your other positional senses! The goal is to retrain your balance and co-ordination, as this will reduce your risk of re-injury.

 

For more tips on how to stop injury recurring, call 93997399 and request a consultation with Alla.

 

By Alla Melman, Physiotherapist

Challenge your balance!

Core stability exercises: poor balance is often an indicator of poor core stability

Your posture muscles are meant to kick in to keep you upright when your balance is challenged. They are the ones that you can feel switch on when keeping your balance on a moving bus. But you don’t just need your core when the bus driver slams on the brakes!

 

Even when you are sitting or standing ‘still’, muscles are switching on and off all the time to keep you balanced. Even having tight and sore neck and shoulders can be enough for your core muscles to be a bit ‘sleepy’. When the core muscles are slow to turn on, or don’t turn on at all, there is increased risk of back pain and other injuries.

 

If you do have back pain, you need to retrain smooth coordinated movement of the core, a balance between stability and mobility. It is incorrect to rigidly brace the spine; you should be able to breathe freely.

 

Helpful tips: How to stop your posture and core muscles fatiguing when sitting

  • Sit tall, and initiate movement as though you were about to stand up
  • Flutter: relax your arm down by your side palm facing forward. Imagine you are shaking drops of water off your hand, feel the movement all the way up into your shoulder. Do each hand separately. Do you feel any difference side to side? If one side feels harder to engage your core, this is usually your weaker side.

Do this exercise every few hours to remind you to engage your stability muscles when seated.

 

d4

 

 

 

You can also try sitting on a gym ball and lift one foot off the floor. Can you keep your balance? Can you add a flutter with your arm and still maintain your balance?

 

 

 

 

 

 

 In our physio gym we use a variety of equipment to challenge your balance and make core stability exercises fun! Allas blog

  • soft balance beams
  • Bosu
  • gym balls
  • dura discs
  • wobble boards

Anything that challenges your balance is a great way to wake up your ‘core stability’ muscles.

 

 

 

For more information on how you can improve your balance and core stability, call 93997399 and request a consultation with Alla.

 

 

By Alla Melman, Physiotherapist

Francine St George on Tony Delroy’s Nightlife

Francine St George on Tony Delroy’s Nightlife

Physiotherapy has come a long way in the last 20 years, and its getting better all the time.

 

What are some of the advances we’ve made in treating sore necks and backs – and what might be yet to come?

 

Join Francine for the last time with Tony Delroy’s Nightlife on ABC Radio, for a look back, and a look forward to the future of physio.

 

For recent Podcasts and MP3 downloads:

Nightlife_Logohttp://www.abc.net.au/nightlife/listen.htm

To find Francine’s most recent interview on the site, you may need to scroll down the topics by date of appearance (see below).

Does incontinence go away by itself?

‘One in Three Women who ever had a baby wet themselves’

Don’t become the ‘One’ in three – This International Women’s Day – Do something about strengthening your pelvic floor!

 

 

Why can having a baby make you wet yourself?

PPFC_incontinence_WH_pic (2)

The weight of your baby during pregnancy and birth can stretch your pelvic floor muscles, your pelvic connective tissues and the nerves suppling your pelvic floor. This can leave the pelvic floor and connective tissues weak so they are not able to keep the bladder from leaking, especially when you cough, sneeze and exercise. Leakage can start after having a baby or as you get older or following menopause.Weakened pelvic floor muscles and connective tissue can also cause a prolapse (dropping down) of the pelvic organs.

 

 Will this leaking or prolapse go away by itself?

No, probably not… but it is never too late to take steps to strengthen your pelvic floor, protect your connective tissue and prevent future damage.
A helpful Tip: A good place to start is to squeeze and lift your pelvic floor just before you cough, sneeze or lift something. This will provide better support for your pelvic organs, and will help to strengthen your pelvic floor muscles. This can reduce the chance of urinary incontinence.

 

If you have continence concerns, a Women’s Health Physiotherapist can help.

 

Please contact us for further information and individual advice. We offer total confidentiality and privacy with all our physiotherapy consultations. Simply call us on 02 9399 7399, and request a Women’s Health Consultation with Clare.
By: Clare Dingle, Physiotherapist

 

Reference- Continence Foundation of Australia

Acute Sports Injury Management

Acute Sports Injury Management

The right treatment from the onset of an acute injury may help decrease the healing time by days or even weeks, so start treating your injuries the right way and help yourself to get better faster. Try to start during the first two hours of injury and maintain the PRICE and no HARM routine for the first 48-72 hours.

 

 

PRICE

Protection: Protect the area from further injury. Don’t try to run it out. Stop the game and crutch, stretcher, sling or brace the area, until you have assessed the extent of the injury.

Rest: Decrease activity to a level that is allowing recovery and not making the injury worse. That may mean wrapping yourself up in cotton wool for a few days or only running 20 kilometres because your knee starts to hurt when you run 22 kilometres.

Ice: Apply an ice pack to the area for 15 minutes with a layer of wet material between the ice and your skin to stop ice burns. The ice decreases swelling, pain, metabolic rate and nerve conduction, but a reaction called the Hunting Response may cause an increase in blood flow and swelling after 15 minutes of icing, particularly in hands and feet. You may apply ice packs for longer periods on larger areas of the body. Allow the area to recover from icing for double the icing time to prevent frostbite (usually 30 minutes) and repeat.

Compression: Wrapping an elasticated bandage or tubing over the injured area will reduce swelling and support the area. This may be a towel wrapped around an injured neck or a wide belt around a painful back. Make sure you compression is firm, but not painful and extends both below and above the injured area.

Elevation: Holding the injured area above the heart will decrease bleeding and swelling. This may require putting a hand up in a sling or an ankle up on a pillow. Maintaining this routine for the first 48-72 hours of any injury is vital for prompt recovery.

 

 

Now for the things that you should not be doing for the first 48-72 hours:

 

HARM

Heat: Heat causes the blood vessels to dilate and will increase bleeding, swelling, pain and tissue damage. It will make your injury last longer no matter how good it feels. Wait until the swelling has subsided and the area is no longer warm to touch compared to the same area on the uninjured side- around 72 hours.

Alcohol: Alcohol is a vasodilator. It increases bleeding and swelling. It can affect your balance and mask the pain and severity of the injury.

Running: Running, or any form of active exercise may increase bleeding and swelling. Exercising too early risks worsening the injury and prolonging your healing time.

Massage: Massage, particularly using heated creams, will increase bleeding and swelling. It will prolong your injury. Many products, containing very effective well-proven active ingredients, provide little proof that they get through the skin barrier to the injury. Generally, medication is more reliably effective if taken orally.

 

So, the next time you sprain you ankle, don’t finish the game, rub on some Dencorub or sit down to a beer. PRICE it. Don’t HARM it. And if pain persists, see your PPFC professional.

 

 

shutterstock_127129352

 

By Alex Sherborne

Is your Smartphone giving you the Hump?

Is your Smartphone giving you the Hump?

 

This is the first in a series of short articles on my ongoing obsession- the cause and treatment of neck pain.

 

Dowager’s Hump is the term commonly used for a bump at the base of the neck. It is usually associated with the elderly, but I’m finding it increasingly in younger and younger people.

 

The proliferation of smartphones and tablets has encouraged forward head posture, and in many people the spine adapts to holding the head in this position. The neck muscles have to work harder and harder as the head is held forward.

 

 

spines_1024-300x199

Assessment of Stresses in the Cervical Spine Caused by Posture and Position of the Head, HANSRAJ K, Surgical Technology International. 2014

 

 

There are simple things you can do improve your posture, your potential hump and all those unwanted aches and pains. Being aware of your posture is the first step and will find you feel more confident and more in charge of your body.

 

5.1 Posture check
Figure 1.1

 

 

 

 

 

 

 

Check your posture by standing with your feet 6-10 centimetres from a wall. You should be able to comfortably place the back of your head, your shoulders and your bottom against the wall without markedly changing your posture (Figure 1.1).

 

 

 

 

 

 

 

 

 

 

 

8 Wall exercise
Figure 1.1b

 

 

 

 

 

 

 

As an exercise, rest the back of your hands and forearms on the wall and gently slide them up and down the wall without increasing the arch of your back (Figure 1.1b). Repeat slowly, but painlessly 8-10 times. As your back muscles get stronger and your chest muscles get longer, you will be able to take your arms higher and higher up the wall.

 

 

 

 

 

 

 

 

 

 

 

 

 

By: Alex Sherborne, Physiotherapist

 

Exercises extract from New Bodyworks book by Francine St.George.

Understanding Persistent Pain & What You Can Do To Recover

Understanding Persistent Pain & What You Can Do To Recover!neck pain

 

The first thing to understand about persistent pain is that the amount of pain you experience does not necessarily relate to tissue damage. There are people who have severe joint degeneration on x-ray and don’t have pain, and others that have clear x-rays and lots of pain. Pain is a normal response to your brain perceiving something as a threat, this is the body’s way of protecting itself, and in the short term it works well.

 

The body initially responds to an injury with inflammation, which promotes healing. When pain persists despite tissue healing, it is because the nervous system – nerves, spinal cord and brain have become sensitised.

 

It works like this: there are nociceptors, lets call them ‘danger sensors’ all over the body. With enough stimulation, they send signals up to the spinal cord. When stimulation reaches a critical level, the message is sent on to the brain. The role of the brain is to assess these messages, and if the brain concludes that you are in danger and need to take action, it will produce the experience of pain. So while the pain is very much real, it is an output of the brain, not just a sensation in the body tissues.

 

With persistent pain, your nervous system changes. You develop more of some types of danger sensors in the nerves and spinal cord, and their alarm threshold is lowered. It is kind of like a car alarm that goes off when a leaf blows over it; the nervous system is in a state of hyper-vigilance, always on the lookout for threat. The brain becomes really good at producing the experience of pain, through repeated experience. So over time, it takes less and less to trigger your pain, even thinking about bending or lifting can be enough to feel pain. This sets you up in a downward spiral, the less activity you do to avoid pain, the more deconditioned and hypersensitive your tissues get, and the more pain you have.

 

There is a strong link between feeling depressed, stressed or angry and persistent pain. Stress affects your physiology and further sensitises the nervous system. Your attitudes and beliefs make a huge contribution to your experience of pain. We consistently see that people with overly negative or unhelpful thoughts have much more difficulty recovering from their injuries. However, learning positive ways of coping, such as pacing yourself effectively can significantly reduce your disability. Upgrading your activity in a slow and steady manner can begin to desensitise the nervous system, and hence reduce or even eliminate your experience of pain.

 

One of the ways we facilitate this here at Physio Posture Fitness, is through Physiotherapy Gym Sessions (PGS), allowing a supervised, graded return to activity in a focussed individualised manner. Whilst the exercises precisely target weak or tight muscles, they are also designed to reduce the sensitivity of your nervous system to allow you to get back to doing what you love to do.

 

Tips for tackling persistent pain:

Your brain is amazing, capable of rewiring itself to recover from persistent pain. Try these ‘brain’ exercises to change neural connections in your brain straight away.

  • Virtual Reality: Close your eyes and imagine yourself doing an activity that you love pain free: running, wrestling with the kids, gardening. Play the positive video in your head over and over.
  •  Remember to keep exercise fun – laughter really is the best medicine! Put on your favourite music & let yourself dance. Move without fear.

 

 

 

Now try these stretches:

1)      Neural Glides are an effective way of mobilising the nervous system and encouraging freedom of movement. They are a way of desensitising neural pathways throughout the day. A mobile nervous system is a healthy nervous system.

 

 

1 Nerve Mobility Palm Upward_1

 

Stop sign: put your hand out in front of you as if directing traffic to a stop, only straighten your elbow to a comfortable range. Try this progressively further out to the side until you can do it comfortably side on to your trunk.

 

 

 

 

 

 

 

 

2)      Try approaching a movement in a novel way to get under the radar of a sensitised nervous system:

–  Instead of turning your head, keep it still and swivel your trunk around in an office chair.

–  Try moving your eyes side to side whilst sitting tall and holding the head still to wake up your postural muscles and give your eyes a break from the screen

 

 

By: Alla Melman, Physiotherapist

 

Exercises extract from New Bodyworks book by Francine St.George.

Upper Body Nerves & Posture

Needing some fun exercises to ease unwanted neck and shoulder aches and pains?

Crazy elbow stretch

by Francine St George, 28/11/13

Our body does not like being in a sedentary postion for hours on end! Postural muscles fatigue and muscles that should be used for movement take over and tighten up.  This in turn can cause tension on the nerves that run from our neck to our arms.  Try to take regular breaks every hour or so and have fun with the following exercises!

 

How to do nerve exercises correctly

We talk about gently winding up or tensioning up a nerve as the starting point for doing a nerve exercise. This means we position the body so the nerve is being slightly tensioned as it emerges from the spine and runs into a more distal area. We can then move either the limb, the back or the neck and this will begin to loosen the nerve. It is critical that you do not overstretch or force a nerve mobility exercise as this will cause pain. It is also important that if you feel pins and needles, or latent pain,  then you need to ease back, as you are definitely overdoing it.  In this case, consult your physiotherapist to find out how to do your nerve mobility work correctly.

 

4 Relaxing the neck and shoulder_1

1. First lets relax the upper neck and shoulders…

Place your left hand onto your right shoulder. Tighten your right shoulder muscle by shrugging your shoulder. Now relax this muscle by altering the position of your right shoulder joint so that you can feel with your left hand that your right shoulder muscle is as relaxed as it can be. Try positioning your shoulder back and downwards, and then relaxing and softening your posture without slumping and this will usually help this muscle relax. Once you have learnt how to do this with your hand on your shoulder you can then do this whenever you feel yourself getting a little tense. Be sure to repeat this exercise on the opposite side – using the right hand on the left shoulder.

1 Nerve Mobility Palm Upward_1
2. Nerve mobility; palm facing away and fingers up

While sitting in a chair, take your hand out to the side of your body with your fingers facing upwards. Imagine there is a wall there and you are gently bending your elbow and almost straightening it while moving your hand towards and away from this imaginary wall. Keep your hand at about waistline level and then start to move your arm backwards slightly behind your body. If you feel tightness in your hand, this means you have tension in the nerves running from your neck into your forearms.

 

 

 

 

2 Nerve Mobility Fingers Down_1
3. Nerve mobility; fingers facing down

Now, turn your fingers downwards facing the ground with your palm still facing away from your body. Start with the elbow bent and then try to straighten it. Do this very gently with small oscillating movements. Be sure you expand the chest and pull the shoulders back and downwards for the exercise to be more effective.

 

 

56 crazy elbow stretch_1

4. Crazy elbow stretching

This exercise is for tensioning the ulnar nerve which traverses the medial side of the elbow. Have fun with it! Make a circle with the tips of the thumbs and index fingers. Raise the arms and roll the other fingers towards you. Place the circles formed by the thumb and index fingers around the eyes and spread the fingers lengthways down the side of the face. Gently depress the shoulders and pull the shoulder blades together to achieve an effective stretch. Hold for 10–15 seconds. Great stretch if you are working at a computer and don’t mind your colleagues’ comments!

 

 

Extract New Bodyworks, Francine St George 2013