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.

 

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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

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.

Nerve Release

Nerve Mobility (and why it’s so important!)

Nerves

 

Your nervous system goes from the top of your head right down to your finger tips and toes. The nervous system allows us to feel both pain and sensation (sensory nerve) and allows us to contract muscles, creating movement (motor nerve).  All nerves have a definite length and this is why injury anywhere in our body can cause problems in other parts of our body. For example, a disc bulge in our lumbar spine can create tension in one or both legs – which in turn can cause pain, pins and needles, numbness or weakness.

 

The below exercise will help keep our nervous system mobile through a process called “neural flossing”.  Imagine each nerve as a piece of dental floss that glides through our muscle tissues as we move. Following injury, surgery or periods of poor or repetitive postures –  the nerve can be restricted somewhere along its path and this is where pain or nerve symptoms can start.

 

The exercise below will help you to maintain a healthy nervous system, and is of particular help if you are experiencing any of these issues:

  1. Low back pain (with or without leg symptoms)
  2. Sacro Iliac Joint (SIJ) or pelvic pain
  3. Glute (buttock) pain or spasm
  4. Recurrent hamstring or calf muscle strains
  5. Achilles or plantarfascial (sole of the foot) pain

 

Lower Limb Nerve Release

Lie on your side with both knees bent up and a towel between them.

 

Place one hand around and feel the muscles on either side of your spine. Check they are relaxed. If they are not, take your legs backwards a little until you can feel that your back muscles are totally relaxed. There must be absolutely no back pain or referred pain into the buttocks or legs in this starting position. If there is, place a small rolled up towel under your waistline until you feel your back is totally relaxed. Now flex your foot and extend the top leg at the knee, and stop as soon as you feel tightness. You may feel the back start to tighten or you may experience this as tightness in the calf or hamstring muscles. As soon as you feel this tightness, back off this tension by bending the knee, that is backing off a fully extended position. The tension wherever you are feeling it should decrease.

 

Now flex and point the foot from the ankle to loosen the nerve. Do this ankle movement five times, then rest the foot back onto the other foot in the starting position. Repeat this exercise with the foot, keeping the hips in this same position three times. Once you feel it getting a little easier then bring both your knees a little closer to your chest (a little more into flexion). Again extend the knee, and flex and point the foot.

 

Do not do the foot flexing with the nerve on full tension as this can aggravate your pain. If you experience latent pain, namely an ache that starts approximately 30 minutes after doing this exercise, then you are either doing the exercise incorrectly or it is not appropriate for you. I would recommend you consult a physiotherapist to learn how to do this exercise correctly.

58a Lower Limb Nerve Mobility_1              3b Lower Limb NM_2

 

Exercises extract from New Bodyworks, Copyright PPFC 2013