Category Archives: sports and osteopathy

High Hamstring Tendinopathy

High Hamstring Tendinopathy

It’s also known as proximal hamstring tendinopathy or high hamstring tendinitis and refers to inflammation of the common origin (ischial tuberosity) of the hamstring muscles. The origin is where the muscle attaches to the bone.
Having a quick internet search there seem to be 3 main causes or reasons associated with the onset

  1. Over use. This seems to be the most commonly written about on the internet. Specifically in relation to middle or long distance runners
  2. After back pain. This seems to be due to the pain irritating the sciatic nerve, The cause of the sciatica nerve irritation doesn’t appear to be indicated
  3. Traumatic or sudden onset. Possibly due to a slip or slide and sudden contraction of the biceps femoris pulling and irritating the tendon and where it attaches to the bone. There also seems to be where the fibrosis or sticking of the sciatic nerve to the muscle occurs.

Other causes are given below, but I think these are better thought of as maintaining factors.

  • Adhesions between the sciatic nerve and one of the  hamstring muscles.
  • The fascia covering the hamstrings is scared and bound to other structures and as a result may inhibit sciatic nerve function, and also shorten range of motion.
  • Gluteal weakness can cause overuse of the hamstring muscles. This can cause shortening and tightness in the hamstrings and potentially lead to high hamstring tendonopathy.

Symptoms

High Hamstring Tendinopathy gives you pain in the lower buttock on the part of the pelvic bone you should be sitting on. The pain in the buttock has been described as very sharp or like a tooth ache all the time. There doesn’t seem to be any inflammation in the ischial tuberosity although it’s painful to pressure, most notably sitting. When I had this I wasn’t able to sit comfortably for about 6 months. The pain I had when driving was almost unbearable.

Contraction of the hamstring muscles causes pain in the buttock as does a hamstring stretch . Standing does not cause pain buttock although a slight pull maybe noticed in back of the knee on the outside. Tightness may also be noticed  in the upper hamstrings.

Management

  • 1st stop running/exercising if this is the cause.
  • Next, deal with any active inflammation. Ice around the insertion and tendon. Heat in the muscle belly feels good and may help release any tightness in the muscle itself.
  • In the early stages do not stretch the hamstring muscles, as this will pull on the tendon and further irritate it. I found rollering ineffective.
  • Get it examined so it can be diagnosed and treated as quickly as possible as this may shorten the duration of the condition.

Treatment

Treatment by an osteopath is always based on the needs of each individual patient, because of that it is hard to give a definitive treatment guide.

To manage the potential link between low back pain and sciatica nerve, treatments I have  in the past have included soft tissue techniques to the Iliolumbar Ligament, Lumbar Erector Spinae, and Multifidus. Sometimes manipulation on the lumbar spine may be necessary although articulation can be used instead. Also soft tissue to the gluteal area and the deep hip rotators (piriformis and it’s relationship with the sciatic nerve deserve extra attention), but taking care to avoid the ischial tuberosity and the proximal part of the hamstrings.

When treating the hamstring a variety of soft tissue/massage techniques are used. The techniques chosen depend on the goals for that particular stage of treatment. I normally take care to not stress or tension the upper hamstring tendon until the later stages of treatment.

Conclusion

High hamstring Tendinopathy is a debilitating condition that can affect many aspect of your life. Simple things that we take for granted such as sitting down and eating a meal to leisure activities like running can become excruciating. I don’t want that to happen to you.

Not only have I treated high hamstring tendinopathy, I’ve  suffering from it as well. I understand the frustration that it can give, so aim to get you back to your normal activities as quickly as possible. I have the experience to diagnosis, treat and also advise on a rehabilitation program to try and stop it reoccurring.

Please note. I can’t give a diagnosis online, If you live or work in the Glasgow area it may be an idea to book an appointment.  Click to book an appointment now.

Can you run 100 metres?

45% of the UK population don’t think they can run 100 metres according to a survey from Slimmers world . With our assessment and treatment options pre-conditioning for exercise assessment or pre-hab assessment, we may be able to help you get there.

The 45% of the population breaks down to 65% of women  and 31% of men didn’t think they could 100 metres. The survey also noted that three out of four individuals  or 75 % of the population are never physically competitive active,  whilst over half, i.e. 55% are not physically active at all. Compare that to 6 out of 10 men or 59% who watch sport on TV at least once every week. This  percentage  has increase during the Olympics.

It was hoped that hosting the Olympics in London would encourage the UK to become more active and leave a legacy of exercise and health.

Why don’t people think they can run? Maybe they don’t believe they can, or have enough confidence because they’ve had an injury in the past, but with our new appointment options we may be able help you start exercising again.

We have 3 options to help you get exercising and keep you exercising.  We’ve termed them an MOT, a Service and a Repair. Go and have a look  at our sports injury treatment options and start allowing your inspiration to be your achievement.

When to have an Osteopathic Sports Massage

Sports massage and sports therapy, When is the best time to be treated by your osteopath? Is it preventative, for maintenance or just if you’re injured with an ache or pains .

 

Sports massage and sports therapy, When is the best time to be treated by your osteopath? Here we look at a couple of scenarios.

http://storify.com/GlasgowOsteo/when-to-have-treatment

I suppose in conclusion the answer “to when is the best time in a training cycle to get sports massage treatment” is anytime. It just depends on what your looking for or what the aim is to your treatment.

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Annoucing Our First Sponsored Athlete.

Sponsoring an athlete

Glasgow Osteopath is really happy to announce that we are now sponsoring* one of Scotland’s top Ultra-runners – Paul Giblin (twitter @pyllon)

Paul trusted me to treat him over his first season of Ultra events including the 96 mile West Highland Way Race and his results speak for themself. Paul completed 7 Ultra marathons in 2011, and finished 3rd overall in the Scottish Ultra Marathon Series. Highlights include a win at the 55 mile Cateran Ultra and a top 5 finish at the infamous West Highland Way race.

Paul’s training and competition schedule is gruelling and my treatment is tailored to meet the demands of a packed 9-month plan. This involves race preparation treatments, techniques to speed up recovery, general maintenance and dealing with issues as they arise – such as ‘emergency’ muscle treatment that on one occasion would have meant he couldn’t compete.

If Paul trusts me to maintain his body throughout the season it means he can focus on training and racing – helping him achieve his ambitions for the year. No matter what the distance, from 5K to marathon (and beyond), I believe I can help to keep you training so that you get the most out of your running.

If you’d like to know more about how I could support your training plan send me an email Osteopath Glasgow or call me to discuss – I love to talk running!

We’ll keep you updated on Paul’s progress through the year including links to his ultra-running blog.

Stretching to stop injury?

Does Stretching Stop Injuries?

stretching to stop injuryWe’re often told to stretch,that it will reduce pain or that stretching will benefit our sport or that it may reduce the incidence of sports injuries. A quick google search suggested other benefits. In this post I’m going to take a look at some of the suggested benefits of stretching. I’ve grouped some of them together,  as in my opinion some of the suggested benefits overlap.

  • Increases flexibility; One of  stretchings main benefits is to increase length of a  muscle or the range of motion across a joint. This appears to be true, if the stretch is performed correctly. Although in my opinion most stretches aren’t specific enough to work on trigger points, or through scar tissue.  Care also needs to be taken as some research has shown that injury can happen from being too flexible, the same is true from being too inflexible.
  • Reduces muscle imbalance;  This should be taken in tandem with increasing flexibility and as part of an overall balancing and flexibility program.
  • Improves circulation; This is an interesting one.  I normally like to think of, and describe muscles as a sponge. Imagine taking a sponge and squeezing it in to a ball and lowering it into a bucket of water. Now take it out. No water runs out, because no water has soaked in. Now exchange the squeezed sponge for a tight muscle. Blood would have greater trouble flowing in, and through the muscle possibly resulting in increased blood pressure. When you compare that to a non squeezed sponge and how easily the water flows in and out it would seem to make sense to stretch a muscle to aid blood flow. This may also help increase recovery rates.
  • Decreases anxiety and stress, relaxes muscles, can give you an overall feeling of well-being; This I believe is as part of a relaxation or meditation routine. There may be some endorphin release associated with stretching, or it could be the time-out taken from your life while stretching helps you relax and releases tension.
  • Reduces risk of injury; There is actually very little evidence for this. particularly for stretching prior to exercise. Although Stretching can help improve flexibility, and better flexibility may improve your performance in physical activities or decrease your risk of injuries by helping your joints move through their full range of motion. For instance, imagine the muscles in your calf attaching to your Achilles tendon are tight and lack flexibility. If you do a lot of hill walking, your foot may not move through its full range of motion. Over time, this can increase your risk of tendonitis or tendonopathy in your Achilles tendon. Stretching the muscles that attach to your achilles tendon,  may improve the range of motion in your ankle. This, in turn, may decrease the risk of microtrauma to your tendon that can lead to overload and injury.

So here we have 5 benefits of stretching. Will they help you reduce injury, make you faster or feel better? Try it and find out. I’d be interested to hear your experiences so leave a comment. Next post will be on the muscles you can’t stretch.

 

 

Osteopath Daniel Gerber Keeps Top ultra runner Paul Giblin at his best.

Getting Faster As You Get Older. The conclusion

Osteopath Daniel Gerber Keeps Top ultra runner Paul Giblin at his best.As this series of posts have progressed it may appear that it has been concentrating on older athletes, but what is in here is just as appropriate to all athletes. In preventing sports injuries I wrote about how we could build strong foundations to start your athletic endeavour and remain injury free. Here I’m going to write about time scale of osteopathic treatment  intervention.

When I treat people I get asked 2 questions;

  1. How many treatments will I need?
  2. How frequently will I  need to be treated?

The answer to how many treatment is, “It depends”. What does it depend on?

  • Distances covered; The distance you cover is proportional to the trauma your muscles receive. Think of it like weight training. The heavier the weight or the more repetitions done the more effect on the muscles. The same is true of training distances. Add hills, or a lower gear if cycling  and the intensity increases (which take us to the next point).
  • How often you exercise; How often, type of exercise and intensity of that exercise are important, but probably more important is the rest and recovery. Here I will be thinking about where do you fit your rest and recovery phase into your exercise routine. Do you cross-train? This again factors into the abuse or maybe overuse your body receives
  • Your age; I explained in the last post about your body being the mirror of your life. Well the older you are, or the more you’ve “done” with your body the more potential problems that may need addressing
  • Existing problems; Is your body adapting because an existing problem. Do I have to treat this first? Most of the time I will treat the problem you’ve asked to me to treat first (I have to try to keep you to your training or competition schedule if you have one)

So the answer is it really depends on you. I treat each patient as an individual with individual expectations and treatment needs. What you want to achieve from your osteopathic treatments may vary making your treatment plan very different from anyone elses.

How frequently do you need treatment? I normally treat weekly to start with then move to fortnightly appointments . Some patients elect to have scheduled maintenance treatments to keep their competitive edge and to try to reduce the likelihood on injury.

If you’re not sure if an osteopath can help you why not book in for a free 15 minute assessment. It will give me a chance to find out about you and what you need. It will also allow me to tell you what I think could help you.

 

Getting Faster as you get older (pt2) The Even Better News

Back to Part 1

What an osteopath would do to make you faster

In part one I wrote about muscle cell efficiency and  decreases in muscle economy. Now I’m going to write about how me as an osteopath can help improve muscle economy through efficient movement by increasing flexibility.

An osteopathic principle believes that your muscles are a mirror of your life. What does this mean to you and why should it make you faster? Every thing you have done is “trapped” within your muscles. Every strain, pull and  injury. All the times you overused, abused, mis-used your body. The hours you’ve spent sitting at a desk, on a sofa or stuck in a car in traffic. It’s all held in the muscles, making them stiffer, tighter and  feeling older. These are inefficient muscles. It takes a greater effort to move them.

To move a joint the muscle on one side has to contract to pull it, at the same time the muscle on the other side has to relax to allow the movement. If the relaxing muscle is tight and inflexible it will require greater effort from the contracting muscle to allow the movement. Your economy of movement will be decreased requiring greater effort or power and decreases to your stamina.

Stretching can play a part in decreasing the inflexibility, but only a part if we consider muscle tightness in terms of structural and functional changes.

A muscle spasm could be thought of as a functional change. The muscle contracts to protect the area from further injury or insult. It’s normally short-lived and the muscle returns to its normal length.

A structural change is when the muscles form changes more permanently. There are studies showing the cellular structural changes associated with tennis elbow. It is  also thought that shin splints can in part be caused by trauma and scar tissue formation in the shin muscles. Trigger points are another example of what I would call structural changes to muscles. All these examples leave the muscle either shortened or with shortened areas that don’t respond well to stretching. I also believe that training without stretching can lead to structurally shortened muscle.

This is where an osteopath can help. Working through your muscles may help return your muscles to more norm state, breaking down any restrictions to movement helping you move more efficiently.

One of my patients demonstrated that possible effects of this. He came in with left-sided low back, buttock, groin and leg pain. I treated the problems on that side and while training on a turbo trainer he noted

“Did 15mins singe leg spins this morning. Left side has more power and comfort with 10% more rpm.”

While I know this isn’t conclusive it does give me a way to start to measure improvements.

An osteopath won’t just look at your legs. They may also  look at your back and pelvis to get that working properly. This would allow it to integrate with your improved leg movements making your whole running gait more efficient.

Why stop there? An osteopath can also look at your ribs and diaphragm. Loosening your diaphragm, which is your main breathing muscle, could give you a fuller breath. Working through the muscles between the ribs and the rib attachments may also allow your chest to expand more again allowing more air in.

So the other suggestion in the experiment’s conclusion, is to do some weights to improve your breathing. I’d like to suggest hold off on the weights. Get what’s there working properly and watch those efficiency gains. Then decide if you really need to do the weights. After all you’re going to be carrying the weight gain on inefficient legs.

The list is almost endless of what an osteopath could improve. The next post is going to be on what to expect when you visit an osteopath and a likely time frame for treatment.  Part 3 out now

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enjoying running as you get older

Getting Faster as you get older? The good news

Research shows that you can run faster.

enjoying running as you get olderDoes age automatically mean that there’s a decline in our athletic endeavors?  A commonly held belief is the older we get the poorer our sporting performance gets, but this isn’t necessarily true and I believe that osteopathy can  help all runners and other athletes whatever their age maintain their speed and possibly reduce the impact of injury.

A recent post in the NY Times reported on some good news for older runners. The results from the experiment on aging factors and running economy suggest that ‘age-related declines in running performance are associated with declines in maximal and submaximal cardiorespiratory variables and declines in strength and power, not because of declines in running economy.’

What may be confusing to a lay person is that they’re confusing economy and efficiency and muscle with muscle cells.

What they meant by this is your muscles cells  don’t lose efficiency. ie older muscles cells use oxygen as well as younger muscles.

In fact muscles that have been trained for endurance events use oxygen more efficiently. The Genetics and Molecular Biology of Muscle Adaptation (Advances in Sport and Exercise Science) highlights research that shows that mitochondria, the powerhouse of a cell, do their job better the more the muscle is used, or to put it another way, the older the muscles and the person using the muscle is, the greater the potential for speed and endurance.

So according to the experiment, the decline doesn’t come from decreases in the efficiency of the muscle cells, it comes from the decline of your heart and lungs and the decline in strength and power of your muscles. Or to put it my way the decline comes from decreases in the economy of effort used during movement.

The experiment noted that older runners had decreased upper body strength compared to younger runners and that while they both had similar leg power, the older runners had decreased leg flexibility.

While using your arms does help pump your lungs, there doesn’t appear to be any correlation between upper body muscle mass or power and respiratory efficiency. The movement of the rib cage and the diaphragm (the main respiratory muscle) were not assessed in this study, but age can and does tighten these leading to decreased flexibility there as well.

Correcting these decreases in flexibility is where an osteopath could play a crucial role in maintaining your athletic performance. How is what I’m going to talk about in Part 2 >

 

Preventing Sports Injuries

Injuries In Sport

Osteopathy and sports injury preventionWhen I started running I posted on facebook that “with my knowledge I intended to avoid all running injuries”.  Obviously (hopefully) this doesn’t include accidental injuries like falls, trips or twisted ankles.

What I mean by this is the preventable sports injuries. Continue reading Preventing Sports Injuries

Osteopathy for Pain Relief

Treatment for pain

Pain relief is one of the main reasons people come to osteopaths for osteopathic treatment. Osteopathy helps people of all ages who suffer from pain, tackling complaints ranging from sports and work-related injuries to arthritis and sciatica. The osteopaths role is to alleviate pain and improve the patient’s mobility in order to make life more comfortable.

What is pain?

Pain is your bodies way of telling you that something is wrong. It is often caused by swelling of tissue, which creates pressure on nerves and leads to discomfort. Pain is a useful mechanism to alert you to a problem, and stops you from damaging your body further.

It should always be taken seriously.

Pain can affect many areas of the body, but particularly the lower back, head, neck, joints and legs. It can result from injuries and arthritis, and can also manifest itself in the form of rheumatic pain and period pain.

Osteopaths diagnose the causes of pain and help to ease it by increasing movement, decreasing muscle spasm and reducing tissue inflammation.

Treatment methods range from massage and soft tissue techniques to muscles and connective tissues to manipulation and stretching of joints. This helps to reduce muscle spasm, increase mobility and to create a healthier state in which damaged tissues can heal.

The skilled techniques of an osteopath can often allow you a speedy return to normal activity. If you have had a pain for a long time, and other forms of treatment have not helped, osteopathic treatment could be beneficial.

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