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Readers Question: “Spinning class bad for Knees?”

I have arthrosis in my knee and a little bit in the hips, can I still do spinning? I’ve been doing it for years.

– Din

Mark Chen, Physiotherapist

The advantage of spinning is that it is not a weight-bearing activity (except the standing parts, of course). That makes it a ‘safer’ option than, for example, running, where your knees and hips have to endure huge impact for miles. So if you look at it purely from a mechanical-stressn perspective, it should be no problem at all.

You indicate that you have been doing spinning for years. Could it be that the number of years and intensity have contributed to the current condition of the knee? Ultimately, it is, of course, a one-sided and repetitive form of sport. For example, do you clearly have more pain immediately after spinning, or the morning after? In that case, you should question how good spinning is for your body.

I am personally a fan of variety, not only because I like to do different things but also not to burden my body too much with one element. I also recommend this to the majority of my clients. Ask yourself the above questions and if spinning does indeed cause problems for you, then consider reducing or varying with a different sport.

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Injured? Here are the estimated recovery times

Muscle Sprain/ Tear:

Grade I: 0-2 Weeks
Grade II: 2-12 Weeks
Grade III: 3-24 Weeks

Ligament Sprain / Tear:

Grade I: 0-3 Days
Grade II: 3-24 Weeks
Grade III: 5-52 Weeks

Tendon:

Tendonitis: 3-7 Weeks
Tendinosis: 12-28 Weeks
Laceration: 5-28 Weeks

Bone Contusion/Fracture:

5-12 Weeks

Cartilage Irritation/Damage:

12-100 Weeks

Ligament Graft:

12-100 Weeks

 

All of these are depending on health and level of activity of the individual, alongside with illness beliefs, perception, nutrition, sleep and stress levels. Therefore these are to be used as a guideline and always is the help of a professional recommended for an efficient rehabilitation process.

Source: Dr. Caleb Burgess DPT, OCS, CSCS

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Do this before you start running

If you’ve read the previous articles on running, you now know that your bodies’ own shock absorbers are of crucial importance.

Whenever I work with clients that want to either get into or- improve their running performance, I test them on multiple abilities.
One of those is their ability to jump. or actually, to land. 

By practicing and optimizing your jumping mechanics, you create can learn how to use your ankles, knees, and hips to decelerate impact. It teaches the central nervous system how to make all the different muscles and joints to work together in an efficient way.

These are the conditions for a healthy jump and landing.

  • Knees track the first 2 toes during the jump and the landing
  • There is a smooth transition between ankle, knee and hip flexion during the land
  • There is a smooth transition between ankle, knee and hip extension during the jump
  • No noticeable impact may be heard during the landing “or Ninja-style landing”
  • Has to be performed barefoot

This is how to test it for yourself, though I strongly advise getting a set of trained eyes to accompany you for a good assessment.

  • Put your phone on camera mode and select the “Slow-Motion” option.
  • Make the jump at least three times while taking separate videos for it.
  • Rate the technique on the points above. Sound usually doesn’t transfer well to slow-mo videos so you’ll have to rate that yourself.

Here’s a video of my athletes doing box jumps in slow-mo, what do you think?

 

 

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Readers Question: A muscle tear, now what?

“Can you be treated for a muscle tear by a physiotherapist? What relieves the pain and how long does the recovery take?”

-Wilma

 

Mark Chen, physiotherapist:

 

I would like to start with the following: everyone can use physiotherapy!

That said, the answer to your question depends on a number of factors. The location of the tear and the size, for example, are very decisive for the duration of the recovery. Someone who walks a lot in his daily life will need more recovery time for a tear in his calf muscle than someone who is sitting behind a desk.

Recovery

The recovery of soft tissue proceeds in phases. There is a fixed time for the recovery. This cannot be accelerated but it can be optimized and certainly also be delayed. Give your body the time and opportunity to do its job.

The first phase of recovery is called the inflammatory phase. Think of an ankle that becomes thick and stiff when you have rolled it. Thickness, redness, heat, pain and stiffness characterize this phase, in which the body tries to create a safe environment for recovery.
This phase often takes three to five days.

In the phases that follow, the ‘proliferative phase’ and the ‘organization phase’, a new network of tissue is created. This can be compared with a wound on the skin. It must first be bridged. If there is a scab the body can repair the skin underneath. Then the crust falls off and you see new tissue.

That’s how it works with muscles too. As soon as the crack is bridged, the new tissue has to be stressed and adapted to the demands. The muscle will be ‘repaired’ again within three to five weeks, but the time to make the tissue completely stressable can take several months to a year!

Support
I advise people to support the affected muscle with medical tape in the period that it can be less stressed. If the requirements you place on the tissue do not go beyond the general daily life, then, most likely you do not need physical therapy.

If you are an athlete or do a heavy job, that is a different story. It can make a huge difference if you hire a therapist or trainer to help you build your load capacity. My experience is that most clients become stronger than they were before.

Do not underestimate the capacity of your body, it is amazing if treated properly! Drink enough, rest enough and success with your recovery!

 

Best,

 

Mark

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Readers Question: Cracked rib, can I tape it?

I fell three weeks ago. I thought it was okay, but the next day it turned out that I damaged my ribs. Thanks to paracetamol, I have no problems with exercise. In addition, an elastic bandage gives relief during walking, but that is not really comfortable. My question is whether I would be helped extra with taping while walking? If it is possible to tape the ribs at all?

-Miek

 

Mark Chen, Physiotherapist

Yes, Athletic tape can certainly support your ribs. Thanks to the tape, there will be fewer shocks on the ribs during walking. And that can help a lot! And if the Tape is placed right on the site of the bruise, this can have a good pain-decreasing effect. Some techniques can even speed up the recovery of the bruise.

There are different techniques and you will have to find the one that works best for you. Probably, a technique that imitates the function of your bandage will be a good option to start with. That is why I advise you to do this with a certified therapist. Taping ribs is quite tricky to do yourself. He/she can show you how to do it and apply the first one for you. It should be able to stay on for 4-7 days so sometimes you only need it once!

PS.

Here are the 5 most commonly asked questions about Athletic Tape

 

Best of luck,

 

Mark

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Readers Question: Noisy knees

When I squat, my left knee makes all kinds of noise. And not once, but really a series in a row. It does not really hurt, but I’m worried. And it’s just not a nice sound. Do you have any idea what this can be?

– Menno

Mark Chen, Physiotherapist

Sounds in joints are very common and exist in various forms, for example, there’s “snaps”,”pops” and “cracks”. Sometimes they are a one-time thing but they can also be constant, as you describe in your question. I can immediately reassure you; 90% of all knees crack, and as long as there is no pain, there is no clinical value. This rule of thumb applies to all sounds joints make.

The knee is a bit special when it comes to sound-making and that is mainly due to the kneecap. Visualise the kneecap as a kind of boat, which lies in the bony groove of the upper leg. There’s cartilage between the kneecap and the femur for smooth movement.

If both surfaces are smooth, there would probably never be any sounds. But that’s not how it works for most people. There are countless factors that determine how our knee is loaded and how the cartilage is stressed as a result. Think of sports, work (for example road workers) and footwear. These factors allow the structure to adjust. A “rippled” structure of your cartilage is very normal, but it does provide a bit more friction when there is a lot of pressure on the kneecap. For example, in squatting.

If you still worry after this explanation, there are ways to change the direction of your kneecap. As long as you do not experience pain, however, you do not need to take any action as far as I am concerned. Ask around in your own environment who else has noisy knees and you will be surprised. And in Dutch, we have a saying that would translate to something like this:

“creaky cars go the longest” , let’s hope that applies to your knees as well!

 

 

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Readers Question: Groin Pain

I play soccer and fitness, but during training I often suffer from pain in the groin. Two years ago, my left groin was strained and I started exercising a little bit too soon. Now I have a lot of problems with my right groin during and after training. I find it very annoying during exercise, but also in daily life. Do you have tips?

-Stephan

 

Mark Chen, physiotherapist

You’re partly answering your question yourself. You started training too early. We are all bound to certain laws of nature when it comes to repairing damage in the movement system. This recovery takes place in a number of phases and is time-bound. There are a number of things you can do to speed up the recovery, but speeding it up is not possible. But slowing down is!

It seems that this happened to you. If you have suffered damage to your muscle fibers, they must fully recover before they are able to be stressed at the same level again. Especially in sports like football, where the entire lower body is heavily loaded. Starting your training too early can ensure that your injuries are maintained or worsened. Time to reduce the load and practice patience.

Visit a physiotherapist and have your groin checked. This way you can exclude that damage is still present and make an estimate for how much you can stress the area at this time. Often there are also ways to take pressure off parts of your body during activity. Think of athletic tape for example. These are the brightly colored pieces of tape that you see often nowadays, with football players, runners and even swimmers to support peak effort. Sometimes this can help you to train without your groin being constantly overloaded.

Good luck!

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5 Questions about Athletic Tape

The sports enthusiast is probably already familiar with it: the colored tape that decorates the calves, thighs or arms of (top) athletes. This so-called medical tape is also being used more and more by non-athletes. Why?

Physical therapist Mark Chen explains it.

1. What is medical taping?

“Medical taping is the collective name for taping with the characteristic, brightly colored, elastic tape. There are many different brands (Curetape, Kinesiotape, X-tape) that are all similar in appearance and function.

The founder of medical taping is the Japanese Kenzo Kase. In the seventies, Kase was already a well-known name in chiropractic and acupuncture. His main point is that physical exercise and muscle activity are necessary to prevent or cure physical problems.

The stiff tape that was available at that time and was used mostly to restrict the freedom of movement of a muscle or joint did not have this effect. Kase, therefore, looked for a tape was more like human skin. In this way, you can improve the physical functions and support injured muscles and joints, without restricting the body’s movement possibilities.

Thus, after years, Medical tape was put on the market. In the last ten years, Medical tape has also gained a lot of popularity in Europe and more and more physiotherapists are becoming skilled in medical taping. ”

2. What kind of injuries medical taping suitable for?

“Medical tape can be used for many different types of injuries.bApplications of the tape are nowadays mainly seen in the sports world. In case of problems in the musculoskeletal system, the tape is often used to support joints or to influence muscles to increase or decrease the load on that structure.

The tape can also be used for posture correction, swelling reduction, pain reduction and improving skin condition for example with scar tissue. Medical taping is extremely versatile. Not all therapists are trained to apply all aspects of the tape, so ask your practitioner for the possibilities. ”

3. What kind of tape is used?

“With medical taping, the tape is used that has the same elasticity as the skin, is very thin and sticks well, it is ventilating, skin-friendly, moisture-resistant and anti-allergic, but it is advisable to apply the tape to a dry, clean, hair-free surfaces.

There are several brands of tape and the type used will differ per therapist. I myself have experience with one type of tape (Cure Tape), so it is difficult to give an objective opinion about which is best. It is ultimately a matter of which tape works best for you.

4. Can you do everything ‘while taped’?

“Depending on the technique and the skin of the client, the tape can last between four and ten days, during which time you can do everything with it: exercise, showering and even swimming! The tape breathes and transports moisture, so it causes no mushy skin under the tape. Of course, intensive use shortens the lifespan of the tape. ”

5. Can you also apply medical taping yourself?

“Yes, it is certainly possible to tape yourself.” Depending on the problem, location and technique, it is sometimes useful to tape yourself (learn with a physiotherapist), which gives you more freedom, especially if you have to be taped regularly. this reduces the number of treatments that you need with a physiotherapist as well.

Nowadays there are even pre-packaged, custom-cut packages for sale at some sports stores. They provide enough tape for self-taping once with an explanation in text and illustration. However, I would advise you to buy a roll of tape and find a certified therapist to teach you how to do it. It guarantees a professional approach and is cost-efficient.

Help me with this

Readers Questions: Preventative Physiotherapy

“I regularly suffer from back pain. Does it make sense to visit a physiotherapist every month just for maintenance? Can I prevent problems this way?”

-Francine

Mark Chen, Physiotherapist

Maintenance based treatment is certainly a possibility. Your physical therapist can ensure that your muscle tension remains under control, the joints maintain a good mobility and he/she can prescribe exercises.

Still, it is better in my opinion to take a good look at why you regularly suffer from your back. The spine is perhaps the most complex part of our mechanical system and almost everyone gets to deal with back problems sometime in their life. Often a lot can be explained from your lifestyle. Sitting a lot, for example, is a factor that is often overlooked, but has a major influence on the functioning and health of the spine.

Changes in pulling forces

The constant shortening of the hip-flexors changes the strength-length ratio of the muscles around the hips and the pelvis. These have a direct influence on how you move. This “strength-length ratio” acts as a tug of war between the muscles. Constantly, both teams work equally hard to keep everything balanced. Sitting a lot, lifting it incorrectly, a one-sided load during hobby or sport (tennis, darts, golf) can ensure that one of the “teams” gets an extra player, which destabilizes the balance.

“Weak Spine”

Of course there can be many other causes. For example, I get to see clients with a “weak back” a lot. I myself am rather concerned about that term because it suggests that it is something that can not be fixed. Time and time again I’m struck by how little control we have over our spine. And we have use it for so many things!

To return to your question: It is worthwhile to visit a physiotherapist for maintenance , but don’t go just for a massage or a manipulation. Look further. Dig deeper. Exercise and aim to get stronger.

Try to put together the pieces of the puzzle that cause your back problems and look for a long-term solution together with the physical therapist and/or personal trainer.

 

Help me out!