Static and Dynamic stretches

Static and Dynamic stretches

In our previous article we discussed the importance of stretching. However, there were few benefits which didn’t complement  each other. The reason is different types of stretching techniques. Stretching in a specific way will provide you slightly different results compared to other stretching techniques. The two most popular techniques are static and dynamic stretches. People often get confused which one to use and when.

Static stretch

Fig.1 Forearm Static stretch

Since decades static stretches have been practiced around the world. It is a great way to stretch those tight muscles. Static stretches, as the name suggests involves holding a stretch for certain amount of time. There are no repetitive movements involved. For example, a static stretch is a simple forearm stretch (fig.1) where you hold the position for around 20 seconds. They have been used in the past and are still being used as part of warm-up routine. However research has shown that Dynamic stretches are more appropriate than static stretches when it comes to warm-ups. Implementations of dynamic stretches have been difficult as many athletes still prefer to stick to satic stretch routine.




Dynamic stretches aim to prepare athletes physically and mentally, to cope with the demands of the subsequent activities. They are sports specific, as it involves similar movements which will occur in the sport or training routine. They are believed to sensitize the neuromuscular system better than static stretches, considering the movements involved. Looking at variety of sports and exercise routines, there are plenty of options for dynamic stretches. Some examples for dynamic Stretches would be butt kicks (fig.2), inch worm, lunges, and kicks.



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Knee Pain – Patello Femoral Pain Syndrome

Knee Pain – Patello Femoral Pain Syndrome

PFPS (Patello Femoral Pain Syndrome) is one of the common knee pain condition affecting active population of all age groups. It is found more in women because of wider pelvis which changes the direction of forces acting on knee joint.

Patella (knee cap) sits in a groove which is present in the lower part of thigh bone (femur). In a normal knee it glides up and down in the groove smoothly, whenever there is knee bending and straightening movement, such as going up and down stairs. However, in an affected knee the patella moves out of the groove causing friction between the two bones which eventually results in pain. Pain can vary from dull ache to sharp pain, which might be accompanied by clicking or momentary weakness in knee joint.




Knee cap is held in position with a good balance between outer and inner structures around the knee cap. Structures which are responsible for movement around the knee are the muscles. The muscle present in front of the thigh is known as quadriceps, as it has four prevailing muscles. Any imbalance between these 4 muscles can change the way the patella moves.

Contributing factors:

  • Poor lower limb mechanics due to
    • Increased foot pronation (foot  flattening)
    • Decrease lumbopelvic (lower-back and hip area) stability due to weak core (abdominal) and gluteal (hip) muscles
    • Decrease VMO (vastus medialis obliques) activity, the inner most muscle of quadriceps




  • Incorrect footwear
  • Muscle tightness; specially increase in Vastus lateralis (outer most muscle of quadriceps) and Illiotibial band (ITB) tightness/activity. ITB is a connective tissue band present on the outer thigh
  • Tight hip flexors and Tensor fascia latae muscle
  • Poor sporting technique/ergonomics
  • Heel strike running pattern increases GRF (ground reaction force)
  • Over-training
  • Sudden increase in training intensity/frequency

Treatment options – Click here



Stretching – Your body needs it!!

Stretching

Stretching has always been an important part of an exercise routine. However, it is also a greatly ignored part of an exercise/lifestyle routine. Reason can wary from it being boring, painful, unfitting, time consuming, worthless and many more. People can give you plenty of reasons to avoid stretching and jump straight to their preferred physical activity or sports. However, there are equal number of reasons or even more to spend quality time in stretching. Stretching is not only limited to an exercise routine or sports, it has an important role in day to day activities as well.

ITB-stretch

 

Our muscles have a tendency to get tighter overtime either from their regular use or from any muscle imbalances. When we train or play sports the dominant muscles tend to get stiffer and tighter from their use. Similarly bad postures will lead to tightness of the shortened and overactive muscles. In order to maintain a good muscle balance and flexibility, stretching plays an important part. Many people will argue that they do nothing except sitting at their work desk, why should they be stretching. These people are at a higher risk of not only contracting general health problems but muscle imbalance and musculoskeletal issues. Reduced movement tends to make the muscle tighter than using it.



Stretching helps in

  • Maintaining good flexibility in muscles
  • Reducing fatigue/soreness in muscles
  • Injury prevention
  • Maintaining good muscle imbalance
  • More power generation
  • Improving blood flow
  • Maintaining good posture
  • Improving joint range of motion
  • Relaxation





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Carpal Tunnel Syndrome – Painful Wrist & Hand

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common condition affecting hand and wrist. It occurs most frequently in middle and old age. It is one of the widely known neuropathy (nerve related) condition. The nerve affected in Carpal tunnel syndrome is known as Median nerve. The median nerve is responsible for sensation over the palm side of thumb and three fingers (index, middle and ring)(fig. 1). It also supplies to the small muscles in hand, which controls the function of the thumb and fingers. After running in arm and forearm, median nerve enters the hand through a narrow passage known as carpal tunnel. Carpal tunnel is formed by bones and ligaments. Tendons of the forearm muscles attaching to the fingers and median nerve pass through this tunnel.

median nerve supply

fig. 1

When the space in the canal is compromised, it causes compression and reduced blood flow to median nerve. The reasons for reduced space can range from swelling and other structural changes such as thickening of the tendons. It can be unilateral affecting one side or bilateral (both hands). Usually the symptoms may include pain, pins and needles, numbness, weak grip and burning sensation. Affected area is the area where the nerve supplies – thumb and index, middle and ring finger. Symptoms tend to worsen overtime following a gradual onset.  Carpal tunnel Syndrome is also characterized by its Nocturnal Symptoms (Symptoms occurring/aggravated in the night). Other aggravating factors include, repetitive wrist movements, writing, typing prolonged flexion or extension position of wrist, gripping and driving a car.



Causes

  • Wrist injuries/fracture
  • Jobs involving use of vibrating tools (e.g. Drilling machines)
  • Office jobs involving use of computer
  • Fluid retention from pregnancy or menopause
  • Tendon inflammation
  • Congenital predisposition – born with a smaller carpal tunnel
  • Obesity
  • Rheumatoid Arthritis
  • High blood pressure
  • Thyroid Dysfunction
  • Diabetes
  • Cyst or tumor




Treatment options – Next page




Ankle Mobility – Significance in Injury Prevention

Ankle mobility and its significance in injury prevention

Let it be walking, running, jumping or landing, ankle is the first major joint, from where the forces are transferred up in the body. So it makes the ankle joint a lot more important than what people think of it. Ankle joint is often overlooked while dealing with conditions occurring at knee joint, hip joint or lower back. Primarily ankle joint movements include dorsiflexion (toes coming closer to shin) and plantar flexion (tip toeing) (Fig 1 & 2). Limited dorsiflexion at ankle joint affects shock absorption and many functional movements such as squats and going downstairs.

Every time our foot lands on the ground while walking, running or landing, there is ‘Ground Reaction Force’ produced. To keep the forces acting on the body within limits, it is important for the body’s musculature to absorb the forces.  Under impact activities every joint involved should work in their optimal range. If any joint’s range of motion is affected, it will increase stress on the other joints. This will also influence the muscle function and shock absorption around the affected joint.This is why ankle mobility is important to prevent injuries at foot, knee, hip and Lower back.

dorsiflexion

Fig 1 – Dorsiflexion

plantar-flexion

Fig 2 – Plantarflexion


 



A simple example to better understand it is to do a small jump, landing with stiff joints and another landing while bending at different joints. Landing with stiff joints will feel heavier and impart high forces on the joints. On the other hand, same landing done while allowing ankle knee and hip joints to bend, will feel much lighter. A good range of motion in joints allows the muscle to stretch more and absorb the forces optimally. Therefore limited/restricted joint range at ankle joint will increase the share of Ground reaction force more on knee and hip joint. In addition, a stiff ankle not only lacks in absorbing shock but it also reduces your overall agility and control.


 



Factors leading to reduce ankle mobility – Click here


 


Piriformis Syndrome – Pain in the butt

Piriformis Syndrome

Pain in the butt is a commonly used idiom, but it actually can be a real pain to many as piriformis syndrome. It is commonly seen in people who spend long hours sitting, such as desk bound jobs, long distance driving or riding a motor bike. Many long distance runners, cyclists, and skiers are at a high risk of getting Piriformis Syndrome as well. Symptoms are usually unilateral and are present as pain in the buttock or hamstring area. Affected side may experience neurogenic (nerve related) symptoms such as pins and needles, loss of sensation and weakness down the limb. Symptoms generally get worse with sitting or activities involving running. Many patients also report a feeling of a pebble under the affected buttock while sitting.piriformis-syndrome




Piriformis muscle is found deep under the big gluteal muscles. It runs across the pelvis area outwards and attaches to the femur (thigh bone). It serves as a rotator of the hip joint. It is an external rotator when the hip is extended and an internal rotator when the hip is flexed. Piriformis is very closely related to the sciatic nerve which runs down the leg from the lower back area. Piriformis muscle sits across and over sciatic nerve. In certain people, the sciatic nerve actually passes through the piriformis muscle itself. Any injury, irritation or tightness to the muscle may irritate the sciatic nerve and lead to neurogenic symptoms down the limb.

 

Causes

  • Injury to the muscle – from a fall
  • Limb length discrepancy
  • Jobs involving prolonged sitting
  • Poor sporting technique
  • Muscle imbalance around Lumbopelvic area (lower back and pelvis)
  • Piriformis compensating for weak gluteal muscles
  • Tight hip flexors and adductors
  • Overpronation(flattening) of foot  – causing internal rotation at hip
  • Altered gait biomechanics
  • Any pyogenic infection





Treatment options – Next Page



Improve Hip Mobility To Prevent Low Back Pain

Hip Mobility and low back pain

Hip mobility is a major factor in deciding how your low back will behave overtime. Hip joint movement restriction has been found to be one of the major factors in developing low back pain. These two areas are so closely related that they work in conjunction at times. Change in the appropriate proportion of hip and low back (lumbar spine) movement can lead to movement dysfunction and injury. Considering a movement such as a squat (Fig. 1), where low back should be kept neutral throughout, with full movement occurring at hip. If hip range is limited due to joint stiffness or muscular tightness, it can force the lumbar spine to flex and lead to injury.



shiv 2+3

Fig. 1

It is also noteworthy that this disproportion in ROM(range of motion) has been increasing day by day. Following this, the low back problems are at a high. We can relate reduce hip mobility to ever increasing sitting habits, inability to do a full squat and lack of Stretching and cool down in sports. So, why or what leads to this kind of movement dysfunction?




Factors leading affecting Hip mobility – Next Page



ITB Tightness – A runner’s nightmare

ITB tightness – A runner’s nightmare

ITB (Illiotibial Band) related conditions are commonly seen in endurance sports. Running, cycling, hiking are some such sports where an individual is highly prone to ITB related injuries. ITB tightness cannot be ignored, as it can lead to many injuries which can affect one’s performance. Quite often it’s not the tightness itself but increased loading or strain on the ITB because of other biomechanical factors.  These injuries are usually overuse type and if they develop, they can keep an athlete off sports for weeks or more. So, it is very important to keep a check on its tightness in order to prevent injuries.

Illiotibial band is a thick band of fascia found on the outer side of the thigh. It runs from the pelvic bone, crosses hip and knee joints and gets attached to the tibia (lower leg bone). At the hip joint, gluteus maximus and TFL (tensor fascia lata) muscle merge into ITB. It also attaches to the fascia of vastus lateralis muscle (outer thigh muscle), which is a part of your quadriceps muscle. Illiotiabial band is an essential structure as it helps in stabilizing the knee joint.




A tight illiotibial band or increased loading/strain on it due to biomechanical factors, can lead to anterior knee pain, external hip snapping and ITB Friction Syndrome. In external hip snapping, an audible click occurs from ITB moving over greater trochanter (bony protuberance) of thigh bone. Pain might also be present along with an audible click when an individual flexes and extends the hip.ITB-fs

While in ITB Friction Syndrome, pain is present on the outer side of the knee. This pain usually sets in during activity and increases gradually, which can further force an athlete to discontinue. You might notice tenderness on palpation and swelling may as well be present. This condition develops due to increase in friction and compression between the ITB and lateral femoral condyle (outer bony protuberance of thigh bone near knee joint).




Next page – Factors leading to excessive loading on Illiotibial Band



Sitting Posture – Are you practicing it right??

What is the right sitting posture?

In the previous article on posture, we discussed basics of a right sitting posture. This article will focus on the neutral joint position while sitting and cues to correct them. Now days, majority of people spend their time at work or home, sitting in front of a computer. We tend to ignore the fact that human being was evolved to be active, to walk, to run and not sit for 8+hours at a desk. A plethora of problems arises from prolonged sitting and also the way we sit. Health conditions can range from chronic neck and low back pain, fatigue, increased risk of cardiovascular, metabolic disorders and many more.

Interestingly many people are aware of these facts but they find it hard to do anything about it. It’s surely not that feasible or practical to just change your line/type of work. However, there are ways to reduce the impact of sitting on the body. The most common sitting posture mistakes we encounter at work are slouched posture, forward head, resting to one side and bad work station ergonomics. There are more if we look down further at the position of feet which can lead to poor blood flow and knee joint pain.




Common Sitting posture mistakes

incorrect-sitting-postures

  • Forward head posture
  • Neck rotated (commonly seen in people working on two screens and also if the screen is kept on the side)
  • Hunched back
  • Protracted shoulders
  • Arms kept too far from the body
  • Forearms not resting on the table
  • Side bending or listing at back (tends to happen when people rest to one side – specially on the opposite side of hand using mouse)
  • Posterior pelvic tilt ( which forces the spine to hunch)
  • Sitting forward (buttocks not close to back rest)
  • Crossing of legs
  • Knees excessively bend and feet kept under the chair either straight or crossed
  • Feet kept far from the body
  • Sitting for prolonged hours without regular breaks and enough movementincorrect-foot-postures





Continue reading – Page 2 of 3



Understanding Correct Posture Part – 1

Understanding Correct Posture

For years we have been told to sit and stand straight maintaining a good posture. In spite all said, poor posture has become an epidemic among humans, thanks to the urban lifestyle. Life has become nothing but long hours of sitting at work and living in the new world of mobile phones and tablets. This digital world has surely made things easy, fast and accessible but at the cost of your movement, physical work and health. These are the side effects of urbanization, which we have already discussed in detail in one of our articles. Please click here to read it if you have missed.




posture 4

Correct posture is when the whole musculoskeletal system is working at its optimum. Right alignment of joints and a good balance between the muscles, ensuring no excessive strain is placed on any structure. A correct posture not only engages the right muscles, it also reduces your effort in carrying out activities. Now the million dollar question is what a correct posture is and how one can avoid excessive strain on the joints and muscles.  The most common answer would be standing and sitting straight. However, “straight” is not the right word when it comes to many joints of the body. The right word here should be neutral. Being straight somewhat corrects your posture but if you are not aware of the neutral position, compensation is meant to happen to achieve a straight posture. Many a times the word “straight” can be misleading.



posture-3

Next important thing to consider while correcting posture is to include each and every joint. However, we often only concentrate at one particular area of body or joint. For example, when people try to correct their sitting posture they seem more focused on straightening their spine, ignoring the pelvis shoulders, feet and arm position. Our whole skeletal system is a chain. If you change something at one end it will affect the whole chain. This makes it important to understand the neutral position of every joint in our skeletal system.



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