Living with Fibromyalgia

Ed Scully - Soft Tissue Specialist

Fibromyalgia is a painful condition with specific areas of tender points throughout the
body. The condition is also associated with fatigue, morning stiffness, headaches,
restless legs, numbness in hands and legs, irritable bowel and that’s just to mention
a few. There is no solid evidence to the cause of this condition, but research would
suggest that it is a sensory condition that essentially amplifies the processing of
painful stimuli. Fibromyalgia literally means pain in your muscles fibres ( Fibro =fibre,
my = muscle algia = pain).

As a clinician that deals with this condition on regular bases, the first thing I would
say to anyone living with someone who has fibromyalgia is to try and understand the
condition as if it was happening to you! Have you ever had constant burning or sharp
pain? Can you imagine having that pain throughout your body for at least three
months. Not to mention the associated headaches, sleep disorders and other related
symptoms. I can guarantee you, that you too would be tired, worn out and
frustrated. This condition is often misunderstood and can leave the person feeling
down and helpless. The good news is, it can be managed.

There is a mind field of alternative treatments out there, but it has to work for you.
Diet and exercise play a key role in the management of fibromyalgia, but the first and
most important thing is SLEEP. The only way you’re going to be able to motivate
yourself and stick to a plan, is if you can get a good nights sleep. The fibromyalgia
tender points respond well to massage and will give your body the break it needs to
take control of your life. Regular massage by a skilled professional who knows the
areas of tenderness, but more importantly is able to relate to the person and
understand what they are going through is crucial. A lot of the clients I see in the
clinic are relying solely on a concoction of strong painkillers. This can be a big
mistake! I know pain medication has a role to play in fibromyalgia, but in a controlled
manner and as part of a treatment plan, not “the treatment plan”.

A lot of the clients I see with Fibromyalgia have been through or are going through a
lot in their lives. For instance, one particular lady is a mother of two, worked hard all
her life and is caring for a family member who was diagnosed with a severe illness
last year. She has suffered from Fibromyalgia for over six years, but getting by with
medication. Caring for her mother and focusing all her energy on others, she began
to regress. To look after others you have to be able to look after yourself. On her first
appointment, her muscle had become so hypersensitive that the least bit of pressure
was excruciating pain. She was worn down and feeling hopeless. My job was to
reassure her and get her out of pain. To this day, she has her slot with me every
week and I can safely say we haven’t had a week where she has been in as much
pain as that first day.

The key here is pain management, it doesn’t take much to aggravate fibromyalgia
and stress is the biggest instigator. So one of the most powerful things you can do
for fibromyalgia is to make the choice that you are going to take control.

Shoulder Impingement

Andrew O'Neill 

Have you pain IN and AROUND your shoulder or even running down your arm when you raise it up to reach for something in the cupboard. Do you struggle to put on your seat belt? Well, you probably have what clinicians like to call ‘Shoulder Impingement’.

Have you noticed it’s sore to lie on it and it actually gets worse when you aren’t using it or trying to rest it? Chances are there are a few small muscles in the shoulder joint that are really inflamed and angry. These muscles are called the rotator cuff muscles and they act to keep the shoulder bone in its socket like a clamp. All are attached to the humerus (arm bone) and the shoulder blade. Unfortunately, one of these muscles runs under a little hook notch or arch at the top of the shoulder blade and can become pinched on certain movements. If this happens repeatedly the tendon can become sore and aggravated.

What’s the root cause of the problem?

This is a very common complaint and in certain people's cases it may have started with trauma to the shoulder like a fall, but a lot of the time it can just start because of what we do in our daily lives, but also, and most likely because of our posture and more significantly the shape of our rib cage.

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Take a deep breath in. You will notice your rib cage elevates UPWARDS and you will also probably notice it lifting at the front of your chest more so than the back. We notice in the clinic that people that do this are really good at pulling air INTO their lungs but poor at blowing it all out.  So what tends to happen is the shoulders shrug upwards with the chest as they breathe in, but the shoulders never really get a chance to relax back down if the pattern persists. So you end up getting tight muscles around the neck, shoulders and shoulder blade causing less space for that muscle to run under that arch at the top of the shoulder blade and hence more pain.

What needs to be done to fix it?

Many people, unfortunately, seek to resolve the pain they are experiencing by getting an injection. Although this may or may not be effective for pain relief there is the danger that the injection may weaken the tendon further which may cause further problems in the future. We always encourage people to use the conservative route when trying to rehab their issue. Conservative treatment starts with finding the root cause of the problem and in this case, we have to look at the diaphragm.

The Diaphragm is a large concave shape muscle within the chest cavity. If this functions effectively (meaning it elevates and depresses with adequate force) we can efficiently pump air in and out of our lungs. A strong, efficient diaphragm allows the shoulder and neck muscles to relax which does wonders for our postures because it will keep the chest/ ribcage from elevating at the front but nice and rounded like a C-shape at the back. Your upper back should be rounded or C- shaped not flat. The only way to achieve a nice rounded upper back is to have an efficiently working diaphragm muscle. Having a nice C-shaped spine means your shoulder blades will be in a good place and hence allowing plenty of room for those rotator cuff muscles to move and work properly. So strengthening and training your diaphragm through specific breathing exercises over a period of time will do the trick. Couple these exercises with direct hands-on treatment to the affected shoulder, and hey presto, you're out of pain. 

TEXT NECK: The Technology Epidemic

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Feeling stiff, achy back, thumb, neck or elbow pain? Maybe you’re a victim of the technology era. Information has never been so readily available, the answer for any questions is “Google it”. The enhancement technology has on business and education cannot be underestimated, but like anything that’s good, there has to be catch! 

Children as young as seven years old use screens three hours a day”. I read this article in the Irish Independent this week. The article was based on a study that suggested that one in twenty Irish children are obese. It was interesting to see the correlation between screen time and child obesity. Well that fact is we all could do with reducing our screen time! 

Ok, the problem lies with overuse. Sitting in front of the screen for hours at work, browsing through your tablet/phone, watching TV, we are spending more and more time in front of the screen.  As a human being we are simply not designed for it. Holding your body in a prolonged position is going to inevitably have profound effects on your joints and muscles. 

Did you ever notice that dull ache in-between your shoulder blades when you are at the computer in work? I bet you will especially notice it on the drive home from work. This is your muscle’s screaming at you because they are hanging on for dear life! Now, you begin to notice the pain moving into your lower back and you can’t get comfortable while trying to get through that important assignment. The problem has now escalated. Neck feels really tired and weak... that’s what I would call ‘text neck’. These are issues we can all relate to at some point. 

What can we do? You can help your children by reducing their screen time and I know how difficult it could be. I have a four-month old baby and he is fascinated with the light from the phone. So I can already see how a parent may allow their child to entertain themselves with technology, sure you would do anything to keep them quiet for a period of time.  But as adults we still have to use technology, go to work and pay the bills that’s life! Time is a major constraint also; we never have enough time to get the work done or look after ourselves. This is the biggest mistake! You have to look after yourself first.   You will be a hell of a lot more efficient if you’re not feeling achy or stiff. Pain is the biggest distraction out there and massage is the quickest and most effective way of getting relief. If you can’t prevent the risk, manage the risk! 

Home Tips:

  • Switch of all screens at least a half an hour before bedtime. The blue light emitted from the screen mimics daylight and will decrease the secretion of a hormone call melatonin which essentially makes you tired and allows for a good night’s sleep. 
  • Understand that your kids are going to be influenced by you! Try and keep computer or phone use to a minimum in the home. 
  • At work take a two-minute break (every 30 minutes) to walk around and stretch the legs. The brain can only focus for 20 minutes at a time so regular breaks in theory should increase productivity. 
  • Position your computer screen at eye level - this is known as Ergonomics.  Google it !!!

 

 

 

Neck pain, Headaches, Migraines 

If you are a sufferer of either one of the above conditions or even all three, I am going to outline my taught process for dealing with someone with these issues.

What do you already know? 

Headaches are broken down into a number of different categories, We all have probably had a normal headache that lasts 30 minutes - 1 hour, take two panadol and it's gone. Then there are other types, tension-type headaches, cluster headaches, Migraine headaches they all are somewhat different but can result in the sufferer not being able to function as they would like too.These symptoms can be a throbbing pain, unable to look at bright lights, nausea, the list goes on but I have dealt with a lot of people with migraine symptoms and it's very severe and not to be taken lightly. 

What do you do to help them?

In my experience, people go for the most powerful solution as everything else does not have the same impact. Painkillers and strong painkillers to help the person return to normal function. They are of course very powerful and yes they work. Also, people use ice in the painful area and some people use heat to relax the muscles of the neck. 

What do you do to prevent them? 

That's the interesting thing that always strikes me when it comes to clients, everyone in pain thinks it just happens. But for me its simple when someone presents with a bulging disc and pain going down their left leg, they always ask "How long will it take to fix?" and I always ask myself "Why did the disc bulge on the left and not the right?". Simply put if you can figure out the trigger then you can put in a plan.

Stress? 

If I had a Euro for each time I heard this statement: "It always gets worse when I am stressed", I would be a very rich man 

Do I believe them that pain occurs when stressed? Of course, I do because I understand what stress does to the body. 

What is it? We have all known about stress, the problems that come with it and how it can be very hard to control. Does stress contribute to peoples pain? sometimes yes. Does it contribute to peoples neck pain, headaches, and migraines? Every time YES. Now I don't look at stress like a mystifying thing that attacks me when I am not expecting it and takes over my life for that period of time, I have to look at objectively and the physiological aspects of what actually happens. Number one thing that changes with stress is RESPIRATION (breathing), we go from long deep breaths when relaxed to small shallow breaths when stressed - its a fact. Some people spend a lifetime or start a lifetime BREATHING this way and their posture tells me everything about them. 

A flat back/neck:

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Yes, someone with a flat neck (See pic) is likely to have the symptoms of neck pain, Migraines and headaches. Why? Because firstly you are using your neck muscles to get air into your body and that is not a good thing. You have a huge muscle (Diaphragm) under your ribs designed to pump air in and out of your body and if you have a flat back and neck that muscle is in a bad position and it won't be able to pump. Your upper back should be rounded not flat, your shoulder blades are a C shape so they need to sit on C shape ribs - if they are sticking out we are in trouble. I have never seen a migraine sufferer any other way - They all have flat necks and flat upper backs. Our body was designed with curves to distribute load evenly throughout the spine and if you see a flat spine that means trouble. 

How to fix it? 

If you have a flat neck or spine, you have very weak abs, Specifically Obliques. In studies it has shown that Maximum Oblique contraction happens on a full exhalation, in other words, you need to do an oblique exercise and learn how to exhale. If you ever come to a OnePILATES class you will only hear the instruction to EXHALE, everyone knows how to fill their lungs with air but no one knows how to FULLY empty them. The biggest misconception is that you take a deep breath in to relax, from now on try and get a deep breath out. Here is one of my favorite quotes from one of the greatest minds in health.

"To breathe correctly, you must completely exhale and inhale, always trying very hard to squeeze every atom of impure air from your lungs in much the same manner that you would wring every drop of water from a wet cloth" Joseph Pilates

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Pain in the foot?

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Are you getting sharp pain around your heel as soon as you place your foot on the ground? You are most likely suffering from one of two PAINFUL conditions. Painful yes, but are they something to be worried about? Definitely not. I will 1st explain what they are………...Pain under your heel bone or the arch of your foot is known as plantar fasciitis, pain above the heel bone and on the tendon that attaches from the heel bone to the calf muscle is known as Achilles tendinosis.  

With either of these complaints you might have gone to the doctor and prescribed painkillers or anti-inflammatories, these may help in the short term but unfortunately, it won’t solve the issue in the long term. You really need to find out what is causing the pain in the first place.  

With regards to plantar fasciitis, the most common symptom you will feel is pain first thing in the morning when you get out of bed and place your foot on the floor. This pain then tends to dissipate the more you walk on it as the day goes on until you may have to sit again for a couple of hours at your desk, suddenly you go to get up, place your foot on the floor and OUCH ! that piercing pain returns.

The plantar fascia s a tight band of rope like tissue that attaches from your heel to your toes under your foot. So what’s the reason for the pain? it’s usually down to what type of arch you have in your foot. For somebody with a high arch, the plantar fascia is really tight and the foot cannot turn inwards or what we call pronate efficiently. This means the plantar fascia is constantly pulling off the heel bone. So people like this tend to walk on the outside of the heels and feet. These types of people need to stretch the muscles and plantar fascia under the foot.

Other people have a low arch or what some people call flat feet. This is not a bad thing in all cases - look at Usain bolt’s feet for example! But in the general public, a long weak arch means the foot can’t do the opposite of what we mentioned and that is supinated (create an arch). These people need to strengthen the foot muscles under the foot and create a more stable base. So, you need to be able to do both and that is the key. We find in the clinic the people that present with this type of pain cannot do both!  

Similar rules apply to people who have pain in their Achilles. This affects runners a lot but can affect walkers too. They will find the pain is worse when they start to run/walk but it eases off the further as they go. When the tendon is overloaded it gets damaged and you get tiny little micro tears on the tendon, when this tries to heal at rest a lot of scar tissue builds up, then you go out for a run the scar tissue breaks down and the pain eases. So as you can see it becomes a vicious circle. But what you must realize is the tendon is not happy because something elsewhere in the body is not happy. Be that how the foot and heel move as they hit the ground as or a muscle weakness elsewhere.

A key factor in these type of injuries is NOT to stop and rest it fully, you may need to reduce the amount you are doing, but stopping completely might reduce the pain initially but as soon as you resume your activities the pain will come back. You need to strengthen certain muscles gradually

Insoles - Are they the answer?

They can but that depends on your foot type, someone with a high arch will NOT need an insole as it will make a short and tight plantar fascia shorter and tighter. It might give relief for a week or two, why? Because you are changing the position of the foot and avoid stretching the muscle and straining the tendon. If you have a flat arch yes they can be beneficial, but insoles are very powerful and can make changes not only in your feet but all over your body. If you get a pair you should notice a change in the first week, they don't take 3 months to work. Get a good foot assessment first and some physio might get rid of it quicker.


 

‘Why do my joints ache in the cold?’

Ed Scully - Soft Tissue Specialist

The big question in the clinic this week is ‘Why do my joints ache in the cold?’

With the winter sneaking in and the nights getting shorter and colder, you may have heard people complaining of sore and aching joints. When you were out for your evening run this week, you may have noticed that you were a little stiffer than usual. Maybe your knees, ankles or hips are aching when standing in the cold. I have a creek in my neck and I can't look behind my shoulder. These are the common complaints that I have been hearing in the clinic this week and the list goes on…

Achey knees when trying to stand up

Achey knees when trying to stand up

It could be arthritis; as a matter of fact, my father has arthritis and he reckons he can tell when the weather is changing ‘I can feel it in my bones’. It could be a change in the air pressure. It could be an actual injury or something more serious that needs to be checked out by a physiotherapist or by your doctor. 

There is no solid evidence out there to pin-point why your joints are feeling stiff or aching in the cold. It could be any of the above, but one thing we know for sure, is that our muscles are not as efficient in the cold. This is why we warm up before a training session or match. When we are cold, the blood in our muscles is diverted to our organs to keep us warm. This causes our muscles to become stiff and our skin to become ridged. As well as that, our nerves are more sensitive to pain when cold. 

Whatever the cause is, the solution is simple. Keep your muscles in check and get a regular massage as it is crucial for the integrity of your muscles. Massage will reduce painful spasms, help reduce arthritis symptoms, increase athletic performance, reduce pressure on nerves and relaxes muscles. It’s a no brainer guys! Look after number one!

Some tips for you at home!

Wear plenty of layers when going outdoors, try to keep moving when outside to keep the blood flowing, warm up, stretch and foam roll before going for your run in the evening. If you are going to be stationary, bring a hat and scarf. 

Physio, Chiro, Massage - Who should I go to?

Ed Scully - Soft Tissue Specialist

Thats me on the right side and yes he is enjoying it - Pic taken at Tullamore Half Marathon

Thats me on the right side and yes he is enjoying it - Pic taken at Tullamore Half Marathon

So should you go to the physio, chiro or do you need a Massage?

I know, I know it can be very confusing but also so simple. You don't need to know everything about your body to know what you need. A simple way to look at it is like this:

If you are someone that suffers from constant tightness in their neck (Having a heavy head)It doesn't get worse or better - Get a massage

If you are someone that has constant, nagging pain running down your shoulder blades (whatever you do you can't stretch it) Get a massage

Pain in your elbow and you can’t grip a pen or lift the kettle - here's a simple tip Get a massage.

You started exercising and now you have stiffness in your legs and hips because it's getting near Christmas and you want to lose some weight, put it back on and then do it all again in January - I can make your life easier Get a massage

If you are someone that struggles to get from a sit to a stand without stiffness in your back (Takes you 30 seconds to straighten) Get a massage

Love to run, exercises, gym but feel you're slowing down, NO you do not have a major condition maybe you have a build up of muscle soreness - Get a massage

If you have being diagnosed with arthritis (Sore joints always achy) Get a massage

If you can't get your foot to the ground in the morning (Takes you a few minutes to be able to walk on your heel) - Get a massage, most people love when you massage their feet.

The thing about massage is that it's everywhere and easily accessible BUT it's very important to massage the right person at the right time. I have extensive Knowledge of soft tissue techniques and I am also a trained Sports rehabilitator. I work as a soft tissue specialists at TC Physiotherapy and in that environment where there are 3 chartered physiotherapists who will give me clients and say “work your magic” as they know that all this person needs is a massage, Not exercises, and they know I am the best at doing it. Yes, massage is cheaper but a good massage therapist should know when to move you on not hold you back. A good soft tissue specialist should know when not to give you a massage.

 

Shoulder and neck pain

Andrew O'Neill 

Pain in between your shoulder blades? Pain in the neck?

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This week I decided to tackle what is invariably the most complex joint in the human body, the shoulder. Why is it complicated? Well, for a start it is the only joint that can rotate through full 360 degrees of motion meaning there are many muscles to contend with. Secondly, chronic shoulder and neck pain (meaning pain that did not originate from an acute injury)  are commonly related dysfunctions somewhere else in the body. When assessing for these dysfunctions we need to look at the following:

 

  1. The opposite shoulder.

  2. The rib cage positioning.

  3. The diaphragm’s efficiency.

  4. The position of the neck.

  5. The position of the pelvis.

  6. Scapular (shoulder blade) movement and position.

  7. The position of the jaw.

  8. Fascial and skin irregularities.

  9. Your daily activities of life.

 

This is just the start ! and unfortunately, we do not have the space to delve into and discuss every one of these potential dysfunctions. But in general, if any one of these, or more than likely a combination of these are not functional and doing what they should be doing we can end up getting nasty shoulder and neck pain. I have decided to focus firstly on what we see in the clinic on a day to day basis most often and address the rest of in future articles.

 

So let’s first address your daily activities of life. What I mean by these are the things we do in our day to day life and specifically our jobs. For those of us that sit at a desk all day or drive a lot of you may relate to this even more than others. Unfortunately, sitting for long periods of time means your posture can become restricted in certain areas, for example, your upper back and buttocks get very little movement and can result in a flat looking spine. So why is this an issue? Well, it means your shoulder blade will not sit and slide effectively on the rib cage and we find when the shoulder blade doesn’t function properly we get shoulder pain. We often see this presented as shoulder blade winging where one or both shoulder blade stick out from the rib cage and don’t move in sync as we lift our arms up and down repeatedly. We also see the shoulder loses its ability to internally and externally rotate. What tends to happen then is other muscles around the shoulder and neck become overworked and cause pain. We tend to see people complaining of pain at the side of the shoulder and down the arm. Specific exercises and treatment are then required to released these overworked muscles and re-establish the shoulder blade control on the rib cage

Shoulder Blade - image on the right shows how the shoulder blade is rounded (C shape) and should sit on a rounded spine 

Shoulder Blade - image on the right shows how the shoulder blade is rounded (C shape) and should sit on a rounded spine 

This also requires working on the ribcage itself to achieve this, just solely working on particular muscles will not suffice. We do this by training our diaphragms. An inefficiently working diaphragm generally means our ribcage becomes elevated at the front and flat and extended at the back. Breathing exercises that encourage the ribcage to depress at the front and expand around the T-spine are very effective in getting the scapula to move efficiently, hence off-loading those overworked muscles and getting the ones that need to work, working.

 

Let’s now address how an elevated rib cage can cause neck pain. In simplest terms, if the ribcage is elevated this can shorten the muscles at the front of your neck, pulling your neck and head forward, this, in turn, lengthens all the muscles in the back of your neck. Muscles that are in a constant lengthened position will feel like you can barely keep your head up “heavy head”. Like any other muscle in the body, they have to be able to contract and lengthen, muscles that are stuck in either a ‘lengthened’ or ‘shortened’ position will eventually cause pain. These muscles that are lengthened in the back of your neck are also attached to your shoulder, if these don’t function properly you may see a shoulder that is up on one side and down on the other. For example, you may feel pain running down your neck to the top of the shoulder blade or the trap muscle that runs from the side of the neck to the top of the shoulder. Simply stretching these muscles may help in the short term but unless the root cause is addressed you will end up back in the same place you started.

 

So, in conclusion, you can have a number of different symptoms and a number of different causes. The key point is you are the environment you live in, think about when your pain starts? how long it lasts? And can you relieve it?. If you can answer these questions then it can make my job a lot easier to fix. Don't forget that pain that comes and goes’s is MUSCULAR not a bone and not a disc.

 

Broken Leg: A four week break.

Broken Leg: A four-week break.

I have heard this question a lot this week “How did you get Dan Currams back in Four weeks?”.

The answer is with a lot of hard work and a lot of help which I am going to outline in a case study type article.

3rd September: Hurling a challenge match on Sunday morning and Dan received a direct blow to the lower 3rd of his fibula. So where and what is the fibula? Below the knee, you have two major bones, 1: Tibia (shin bone) which lies on the inside, 2. Fibula smaller than the tibia and lies on the outside of the leg. Both bones travel the length of the lower leg and attach into the ankle.

This resulted in a lot of bleeding and Eddie Scully (Soft tissue specialist) in my clinic sent Dan straight into A&E. I got a call from the manager Stephen (The Bluebird) Byrne saying that the leg was broken. I text Dan that I needed to see the X-Ray as it's very important to see the extent of damage and also what break to understand where to start Rehab. He couldn't send me on an image so we were at deadlock what to do next.

Next, I heard Dan was sent home and put in a boot, I was delighted as that meant no operation was needed, we had a small chance but again I needed an image to understand the damage.

7th September: First visit in the clinic:

A boot and two crutches and a very depressed Dan is what I was greeted with. No problem let's have a look at the damage. The leg looked ok, the bones were very tender to touch and there was a huge amount of bruising and swelling. Our first job is to get rid of the swelling as this will restrict movement. How we do this is by strapping the ankle every day. Next job was to start trying to clear the dead blood (Bruising) and get fresh blood in to start the healing process.

I handed over to Eddie (steady Eddie) who started treating Dan daily, massaging the leg and using an abrasion tool to clear out any scar tissue. Eddie's role in this can not be understated he would have seen Dan over 20 times in the four weeks leading up to the match. A great character who got more info out of Dan in 2 weeks than half the KK team have in 5 years. The importance of keeping a player in good form cannot be understated, who would do exercises and keep showing up to treatment if they do not have the belief or desire to get back. A Lot of the desire came from Dan but Eddie added a lot of laughter to the equation.

 

7th - 14th September: Holidays

I missed the county semi-final, you can blame my two brothers for that a 30th birthday present. Anyways Dan obviously didn't play but we scraped through. I still needed to get an image and Dan tried every avenue to get one but to no avail. Eddie kept plugging away and we also started Dan in the OnePILATES studio.

As Dan was still in a boot he couldn't weight bear on the leg, but with the reformer bed(Of which we have ten) it allows you to train the major muscle groups of the body. With the bed, we were able to keep muscle mass in Dan’s quads, hamstring glutes, and core. Without the reformer, I honestly wouldn't know what to have given him to do. A brilliant piece of equipment and studio that we just opened in the nick of time. Amy and Natalie again were involved here as I only done one session with Dan in the studio, so they also deserve a lot of praise. So the plan was to get Dan to do 3 One PILATES sessions a week until the final.

Did I believe he would get back?, honestly no Did Dan believe he would get back?, no doubt yes.

19th September: Xray

The break

The break

So at last we got an Image or three that we could analyse,there was an image taken originally at the time of the break but we couldn't find it. So when I received the image I sent it to 4 people 1: Andy (physio in TC clinic) 2: Eddie 3: The bluebird 4: Dave O’Sullivan (Former physio munster, leeds rhinos, huddersfield giants). My initial thoughts were that the bone looked healthy but Dan text me and said the doctor said it would be another 4 weeks. Andy also said it didn't look good but was very hard to tell. Eddie has a cousin that is a radiologist and he sent it to him who got back and said the bone looks good but could be a big risk.

We stayed doing the same thing massage by Eddie and reformer pilates by Natalie and Amy.

26th September: second last training

Bad news I made the call, I told bluebird there was no hope and I told Dan too. I just couldn't take the risk of him doing more damage and all the info I had received was that it was too much of a risk. I was a bit more deflated than Dan which surprised me, but looking back that's what makes a good leader, understanding that their impact is still felt in the dressing room. So Dan stayed positive throughout.

27th September: Whatsapp

7.45 pm - Text from Dave O’ Sullivan: “Sorry I didn't get back to you but that bone is good to go”. I replied instantly “Can you take a call?”. We talked for twenty minutes, Dave explained he showed it to a few docs and also was of the opinion if he can hop, jog, jump, pain-free he will be ok. I text dan and met him in the clinic at 9.30 pm and we got him hopping sprinting on the spot etc.

28th September: Running

7.30 am we went for a run in O'Brien Park. I just needed to see how he was moving, We did about twenty minutes of straight line running and some twisting and turning. I got into my car at 8 am and text Stephen “He is good to go”.

With regards his running I made a few slow-mo videos and analyzed them after which showed me where we needed to go rehab wise to clean up his running. The key point here is that he was not allowing his left arm to swing forward which would affect his left calf strength.

12 pm: I and Ed had a look and decided we needed to concentrate on getting the fibula moving again as it was stuck in the boot for 3 weeks. We did a lot of exercises in standing and found a few areas to work on. Knowing Dan we knew he would work and work hard.

29th September: Chasing

Another early morning session with Ed and then I met dan later on in Mountbolus for some chasing drills.

5 pm - 8 pm: I wanted to get Dan's lungs moving again but also check his ability to twist and turn on that leg. One simple exercise was to get him to chase me around the field and yes I am deceivingly fast. It all went well and Dan trained for about 3 hours that night.

No pain or swelling after so we were good to go. Two more massages on Saturday and Sunday and the rest is history.

Key point: We wouldn't be able to get this done without the people I have mentioned but big praise has to go to Dan himself. One thing he has above a lot of players and athletes I deal with is he trusts. He trusts that I will get him back from injury, he trusts that sean Sweeney will get him very fit and he trusts management will make the right decisions. In this case study, I have shown that I as well trust and use different people to help achieve my goals. Trust is not an easy thing to give but once you do then that's one less thing to worry about.

 

Dan celebrates the win

Dan celebrates the win

2 Mistakes You Make When You’re Pregnant with Back Pain

2 Mistakes You Make When You’re Pregnant with Back Pain

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1st Mistake:

You think it is OK to have lower back pain when you’re pregnant.

While lower back pain is common in pregnancy it is not normal and you should not think that you have to put up with this pain for your entire pregnancy. You might think that many women complain of back pain, that it is a normal occurrence and that you should just continue on with life. Your own mother may have suffered from low back pain when she was pregnant and she just put up with it. Your friends had back pain and they just continued on with their pregnancies. You may have mentioned it to your GP and they may have told you that it is normal in pregnancy. You might feel that as long as my baby is ok I can just put up with the pain. When I was a Midwife in Dublin, I myself thought it was normal part of pregnancy as so many women suffered with this issue, until I learned from a women’s health physiotherapist that while it is common in pregnancy it is not normal for women to have to put up with this pain for the entire 40 weeks! It is not ok!


2nd mistake:

There is nothing that can be done to help get rid of low back pain in pregnancy.

Wrong there are loads you can and should do to help your pain when pregnant. Why suffer for nine months and make the pregnancy process a non-enjoyable one. Why listen to the horror stories of back pain, unable to walk without crutches, sciatica etc. Why not try and find a solution, and enjoy the process.

 

We can do lots of things to prevent these such as pregnancy reformer pilates. And also if we are the unfortunate one to get back pain I can do lots of things to help you.

 

All the time I hear “once the baby arrives it will all be fine again” but it's not. There is a lot that we can do to help you get rid of low back pain in pregnancy during and after and it's not complicated. Yes you will hear that when your pregnant hormones relax ligaments and muscles, This is true they relax the ligaments and muscles at the front of your body but they tighten the ones at the back of your body. If you know which muscles to treat and what exercises to give it can make the vital difference.

 

If you are pregnant and suffering from low back pain, contact the clinic and we can help you!

5 Tips for Exercise in Pregnancy

There are many benefits of exercise in pregnancy. These include boosting endorphins (making us feel good), improving cardio-respiratory and muscular fitness, reduction/management of back pain, reduced stress, prevention of excess weight gain, prevention and management of gestational diabetes, improvement in mild to moderate high blood pressure anda reduction in the risk of pre-eclampsia.  

The Curse of Shin Splints.

People often ask me what causes shin splints and how do I fix them. The truth is, the injury is actually quite a complex one so I never have a quick answer or cure. I decided to address the issue this week and have been discussing the subject on our Facebook page all last week with a few tips and tricks to help you along and improve your pain.

10 Questions For Tommy..

10 Questions For Tommy..

1, Describe your background

I studied Physiology and Health Science in Carlow IT and then I went onto Salford in Manchester to study Physiotherapy. I have had numerous jobs before and during my college years. I worked as a labourer for all trades, Dunnes  Stores, Xtra Vision and also I worked in Bord na Mona. Recently I added them up and I have had over 12 jobs and I have learned a lot from them all. I feel I am lucky to do my job as a physiotherapist because it's my passion, but the other jobs taught me different aspects of business. It doesn't matter what you are doing or where you're working, as the saying goes “every day is a school day.”

Total Knee Replacement Surgery Before & After.

A few weeks ago I wrote an article on Osteoarthritis. We got loads of feedback and questions from people who had been diagnosed with the condition in relation to where to go and what to do from there. Thankfully many have started individualised and bespoke treatment and are seeing a reduction in pain and an increase in strength and improvement in overall health. Since then, many people have also contacted us that are on a waiting list to get a total knee replacement or have recently had one.

A Case Study

This week I am going to do a case study, a step by step guide of how to get someone out of pain. I obviously can't use my client's real name so Kathryn my front of house, is posing for the photographs but this is how my client evolved over the last three months.

So Sally is a 37 year old woman with three kids, ages from one year to five year old. She works as a primary school teacher and has lower back pain for the last ten years. Sally’s pain has got worse since having her first child and now she is unable to get out of bed without severe stiffness, she can't put on her shoes, it’s sore brushing her teeth and she is unable to do any activity without seizing up. The pain is all in her right hip and sometimes down her right leg.

3 Simple Ways To Fix Your Posture

A lot of lower back pain sufferers are told to sit up straight. This is a huge error as most people I see in the clinic are already too straight. The spine is meant to have curves to allow load to be distributed evenly.

 

The area where most people are restricted is the mid back. This area becomes very flat and a lot of people have what we call in clinic ‘a flat mid back”.

 

Here is an exercise that will help you open up that ‘a flat mid back”.