Injury to soft tissues/muscles account for something like 10-30% of all injuries in sport and hamstring tears are the most common of these. The hamstring acts as both a knee flexor and a hip extensor as well as contributing, to a lesser extent, to external rotation of both the hip and knee. Most common injury to the hamstrings, approximately 70% of all injuries, occur to the biceps femoris, the lateral of the 3 hamstrings, and usually during high speed running where the muscle is required to lengthen and contract at the same time to slow down the leg. The tear is normally in the long head of biceps femoris around the tendinous junction where the muscle is at it weakest. Continue reading “Hamstring tears”
Back pain is often spoken about in structural and biomechanical manner where you can get the impression that you may have to give up doing what you love to do be it golf, crossfit, rugby or gardening because you have issue X. The big issue with this is that it on the one hand over simplifies the problem and catastrophises it all in one go so that you are left thinking that your wonky leg is the cause of all your pain and trying to run on it is a recipe for disaster. Continue reading “Is spinal alignment or other structural issues the cause of back pain?”
It’s a common question to be asked what is the best exercise for lower back pain, the answer often seeming to be pilates or other “core” exercise. The idea being that a weak core means that you are over stressing weak back and core muscles and pilates addresses these issues.
It’s a common question to be asked which exercises reduce back pain, the answer often seeming to be pilates or other “core” exercise. The idea being that a weak core means that you are over stressing weak back and core muscles and pilates addresses these issues.
I often find when clients develop nonspecific aches and pains they start, almost randomly, introducing low load rehab work into their program in an attempt to solve the problem. This is usually done after a quick google search which makes various reasonable suggestions as to what might be wrong and the exercises to do to help the problem. This though really doesn’t tackle the problem well, if at all, given it misses out looking at why the aches and pains developed to begin with.
The term Trigger Points (TrPs) is often used by therapists to describe localised tender spots that may refer pain to other areas when stimulated. Whilst there seems to be less argument about whether they exist or not there is more about what they might be and there are major issues with being able to find them, perhaps 50/50 at best, and the reproducibility of actually being able to find them, 18%. In fact in 1992 a, admittedly small, blind study was carried out on them using using both those with Myofascial TrP’s and fibromyalgia. Yet the best of the best of Trigger Point specialists including Simons, of Travell and Simons writers of the Trigger Point bible, and 3 others couldn’t find or agree on any where they were given as much time as required to find them.
For myself they were never a good fit in any treatment I was trying to carry out as the treatment of them seemed to be the polar opposite of what I was trying to do otherwise, that is relieve pain not cause more pain. The treatment of TrP’s for most manual therapists seems to revolve around pressing hard on something that is already sore and use the symptoms to help understand what the underlying problem may be and treat that not the symptoms, I’ve always felt that they were symptoms of an issue elsewhere rather than a problem in and of themselves.
There is certainly more evidence to suggest that TrP’s may be a sensitization of the nervous system, possibly centrally. This carries even more weight when you consider that the areas that the referred pain cover are very similar to the path of the peripheral nerves. There is a great short piece over at the HumanAntiGravitySuit giving a couple of lovely diagrams of how the idea of TrP’s may be more about nerves. Continue reading “Trigger points and reasons why I don’t bother.”