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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!
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Reader Question: Swimming for Arthritis ?

I have osteoarthritis throughout my body. My neck, shoulders and right hip are the worst. Which sport can I practice? I would like to swim, is this possible?
– Lida

 

Mark Chen, physiotherapist:

Osteoarthritis means that the quantity and sometimes quality of the cartilage is reduced. We also call it ‘wear-and-tear’. This is a normal phenomenon and sooner or later we will all experience it. It can cause pain symptoms but it doesn’t have to. The cartilage acts as a shock absorb-er. The joints can start to hurt if there is too much pressure on the amount of cartilage.

Swimming is therefore often an obvious choice; in the water you only weigh about 20 percent of your weight ‘on the dry’. So it is a very friendly way of moving for your joints. In addition, you also use almost all muscles while swimming. It provides a good blood circulation and improves the endurance of the strength-supplying muscles. Swimming can also ensures a quick improvement of the cardio-vascular system! Swimmers are among the fittest athletes in the sports world.

There are, however, a number of side notes to make. Posture and technique are important during swimming. Especially the neck can sometimes suffer severely. Take for example the breaststroke, which is popular with many swimmers. Take a good look and you will see many people swimming with an unnatural position of the neck. Almost as if the head is forced to be kept above water. If there is wear and tear at the vertebrae where this “kink” exists, it could cause more complaints instead of less.

The same applies to the shoulder. A considerable amount of movement is needed to make a nice stroke and sometimes osteoarthritis is accompanied by clear limitations in mobility.

Swimming is a nice and friendly sport for the body, but I recommend to look at the above factors. Any physical limitations can be picked up and possibly treated by a physiotherapist possibly in combination with a swimming instructor.

 

Good luck!

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30 Second Posture test

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Episode 1: 30 Second posture test

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5 Questions about Cupping

  1. What is Cupping?

    Cupping involves the usages of glass/wood/silicone cups that are used to create a vacuum on the body. Depending on the chosen method, these will either stay in place for 5-15 minutes (traditional cupping)
    or moved around the area (Gliding). There is also a less well-known version called “Wet Cupping”, with which small cuts are made before the cups are applied. During this version, the cups will be filled with blood from the client. Needless to say proper hygiene and qualification of the therapist are of extra concern with this method.

  2. What are the benefits of Cupping?

    There are multiple benefits from cupping. The most well known reasons to use cupping is to speed up muscle recovery after workouts. This was very commonly seen in the last year’s Olympics, where multiple athletes were seen walking around with the typical marks from a cupping treatment. Because cupping is very non-invasive and doesn’t cause much side effects, it’s a very common choice for athletes after competition or training.Aside from the physical effects, Cupping is very well known for it’s soothing effects on the central nervous system. For this reason, the treatment is often chosen as a pain reliever or to fight stress in general.

  3. How does Cupping feel?

    A lot of my clients describe it as a “reverse massage”. This makes sense since instead of being compressed, the skin and connective tissue is being pulled up and decompressed. Traditional cupping, depending on the amount of vacuum and duration of the treatment can be a bit uncomfortable, whereas gliding is typically experienced as very relaxing. Your therapist is supposed to monitor how you feel during the session and adjust when necessary.

  4. What do the colors mean?

    The skin can show different reactions to Cupping, and each has a meaning as you can see below in the picture. Sometimes Cupping is used as an “assessment”, to get an idea of what’s going on in the area underneath the skin. If area’s display moderate or sever stagnation, these points are often focused on more during follow up treatments. Usually we see these markings become less and less noticeable as the client starts to react to treatment.

  5. Where can I experience Cupping?

    In Asia, Cupping is a very common treatment method and is used to support the body while fighting disease and therefore is very easy to find. When choosing this option, make sure the hygiene standard is good enough since dirty cups can cause infection.
    Also, in most of these establishments there is no underlying physiological knowledge. If you want to get cupping done for specific problems or body parts, it is best to find a Physiotherapist that is also educated in Cupping.

 

Of course, feel free to contact me if you’d like to experience a session!

 

 

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Myths busted: Is your spine “Out of Alignment?”

So many time clients with spine issues tell me the following:

“I’ve had this in the past and my spine was out, so it had to be put back in place”.
Usually, they refer to a manual therapist or chiropractor that did that for them.

I believe this needs to be addressed since it’s simply not true and it can create problems which I’ll explain.

But first let me point out that the spine is a very strong and robust structure. It cannot simply be pushed into and out of alignment by quick thrust. If that would be the case, Rugby players and MMA fighters would be in serious trouble after nearly every match.
Also, in Australia, recently some students tried to take apart an SI joint. It took them more than an hour, 2 students, a hammer and lots of sweat to do it. There’s a small chance that if that’s the case, a microsecond and a quick thrust will provide any structural change.

As a matter of fact :

“No supportive evidence is found for the chiropractic subluxation being associated with any disease process or of creating suboptimal health conditions requiring intervention. Regardless of popular appeal, this leaves the subluxation construct in the realm of unsupported speculation. This lack of supportive evidence suggests the subluxation construct has no valid clinical applicability.” 

Why is this misconception a problem?

Saying that a client’s spine “is out” creates two problems in my opinion:

  1. dependency on the practitioner or technique used to “correct” the problem.  It’s the practitioners duty to inform the client correctly and in my opinion, and provide information and/tools to empower the client to take manage or restore their own bodies’ function. We as health professionals can and should help this process but dependency on us should be avoided.
  2. False beliefs about a structural “dysfunction” of the spine. Saying something is “out of place” and “needs to be adjusted” creates the idea that there is something wrong with the spine. The next time a client deals with pain, a logical consequence would be to think “my spine is out again”, which will result in thinking that manipulation is needed to fix the problem.

Both of these issues can be avoided simply by not using these terms anymore. Spinal manipulations definitely have clinical value but we should aim to provide information that is accurate and beneficial to the clients beliefs, aside from just treating them.

The Epidemiology of low back pain. (Hoy D1Brooks PBlyth FBuchbinder R.)

 

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Mindset: Positive Feedback Loops

During my session with Cheryl, she mentions right at the beginning that she might not be able to workout well.
She’s tired, her sleep quality hasn’t been good and she pulled a muscle in her during gardening work.
I make a note of it, smile at her and say “let’s just see what we can do”. During the workout session, she’s breaking records all over the place.
First, she did full sets with what her 1 rm was 4 weeks ago.
Then she completed double the work of an exercise she struggled with last week.
Last but not least, suddenly she realized that her back wasn’t hurting.

“Actually, I feel a lot better than when I came in”.

I don’t know if this will be the case at the start of the session, but clinical experience shows us that in most cases, it does.
It’s important because this realization creates a positive feedback loop which is the following:

  • I don’t feel good, might not perform well
  • Perform well, or better than expectation
  • Feel good about performance
  • Positive reference for next time when not feeling good
  • Better decision making

As opposed to a negative feedback loop like this:

  • I don’t feel good, might not perform well
  • Decide not to workout
  • Feel bad about not meeting expectations/ Lose progress
  • Lose motivation

Feedback loops

 

Mine, and Cheryl’s takeaway from this:

Especially when in the first 12 weeks of training, it’s important not to give in to expected outcomes that only give you short-term instant gratification. Make decisions based on planning, not on the emotion of the day.
Of course, if you find out that you’re actually hurting or not feeling good during the workout, you can still decide to rest. But at least at that moment you’ve made a decision based on actual feedback of your body and not a projected outcome of the brain.

I’ve been applying this mindset experiment over the last year -not just for fitness purposes- and it has given me great results. Hope it can do the same for you.

Mark



 

 

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Back pain: What type are you?

Okay, we can not put labels on people.

After all, we are all different and move differently. But the truth is that people mainly move in 3 directions, which are the following:

rug pijn hulp stap 1, bepaal welk type je bent

I will not make it too technical but the planes mean the following:

Sagittal (Blue): Move forward / backward, bend forward to pick up something
Frontal (Red): Sideways movements, such as when we raise our hands to wave to someone
Transverse (Green): Rotatory movements, such as when we reach to open a door.

The vast majority of our movements take place in the so-called Sagittal plane. Or often, actually to be more precise …

… the vast majority of our non-movements.

Een slechte houding plaatst 40% meer druk op de wervelkolom

 

Fact: A bad posture places 40% more pressure on the spinal column

When we move much in the same directions, the body adjusts to it. In practice, we see that this often results in 2 different archetypes: extension type and flexion type.

As you can see in the picture, there are a number of things that belong to these types.

Not everybody has all the features, but they often influence each-other . As a result, they are often seen together. The more features you have, the more you belong to this pattern.

Extension Type

The features or this type are:

-An enlarged arch in the lower back
-“Flaring out” the rib cage
-The pelvis tilts forward (“Water spills out on the front”)
-The knees are fully extended

Possible Issues:

Extension types often come with compression problems, or complaints related to pressure when joint surfaces are close to each other. -and thereby imposing excessive pressure on the connective tissue.

Flexion Type

The Flexion type has the following characteristics:

-The shoulders often “roll” forward
-The head is on the front and the neck is extended
-Upper back is rounded
-Lower back is flattened, or even rounded
– There is “no ass!”
– Knees are bent

Possible Issues:

The Flexion types are often the people with an office job. Working behind a desk easily pulls your body to this archetype . Mostly if you are not aware of your posture while sitting. This habit is then taken to the car and home where the “working posture” is continued to the “couch posture”.

This often passive posture can adversely affect the connective issue that hold the vertebra together. The inter-vertebral discs may also suffer greatly. Because there is little active support of the muscles, almost all of the strength ends up directly to the so-called “passive structures” such as the joints, ligaments and cartilage.

Herniated discs and instability problems are often seen complaints in this pattern.

 

Which back type do you have?

Which pattern is most like you? Once you know this, you can start balancing your posture through targeted exercises.

Under this article, please let me know what kind of type you are and what complaints you may experience!

I’ll be able to help you out from there on.

 

 

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5 Questions: Dry Needling

If I tell somebody “I think you may be a good candidate for Dry Needling, often their eyes open wide accompanied with a painful facial expression. The word “needling” doesn’t seem to trigger the best of responses even though “acupuncture” seems to have a more benign effect.

That’s a bit strange because by definition they’re the same thing:
Acu = Needle
Puncture = The act of piercing through 
As a Physiotherapist and Dry needling therapist, I’ve come to understand it’s mostly about understanding what’s going on during a dry needling treatment and what the differences/similarities are with acupuncture.
1. What is dry needling?
Dry needling is a so-called intramuscular- treatment performed by a specially trained physical therapist. This treatment method is often used for muscular complaints that have existed for a long time and is part of a total treatment. Examples can include chronic headaches, low back pain, RSI, neck problems, tennis elbow and other long-standing muscle problems . The physiotherapist uses thin acupuncture needles, which can help to quickly and easily fix “knots” in muscles.
2. Is it similar to acupuncture?
“There are similarities between acupuncture and dry needling.  For example, the same needles are used and the needle placement technique matches. However, there are also obvious differences.
The biggest difference is the approach. Chinese traditional Acupuncture is mainly used from an energetic concept. The idea is that the body has a wide map of “meridians”, which function as energy channels between different body charts. Blockages in these energy pathways can lead to problems and acupuncture needles are inserted to unblock the problematic areas.

A map of the meridians used in Traditional Chinese Medicine

Dry needling works from a physiological and bio-mechanical concept. There are many muscles that work together as a team through the body. Since all these muscles are connected, they strongly influence each-other. Sometimes some of the muscles in the team can hold “triggerpoints”, which are commonly known as “knots”. These points can cause pain, stiffness and dysfunction in the muscle and the joint it works for. But it can also affect the entire line it belongs to. With dry needling, the aim is to insert a thin acupuncture needle in the triggerpoint to release it from the muscle.

The Myofascial “arm line” muscle connection (From the book “Anatomy Trains”)

Another difference is that classical acupuncture often uses multiple needles, which remain in the body for some time. Dry needling uses one or a low amount of needles and they usually are in and out in a matter of seconds. 
3. When is dry needling applied?
“For long-term muscular complaints, dry needling is effective, especially if myofascial (muscle tissue and fascia = connective tissue) trigger points are present. These trigger points can be explained as a painful hardening or muscle node. Often these trigger points cause not only pressure pain , But also pain in other parts of the body.
The physical therapist is looking for these places because they can be the main cause of your complaints. In addition to pain, a triggerpoint can also provide movement limitation, stiffness and reduced activity of the particular muscle. Sometimes even reactions like sweating, dizziness, headache, blurred vision, tingling or cold hands can occur from an active Triggerpoint.

Low back muscles and their referred pain patterns

Most patients with muscle problems can be treated with DN, but in some cases dry needling is less suitable. Pregnancy is a reason not to treat, just as fear of needles. Acute injury due to an accident, for example a muscle tear, is also excluded from treatment.
4. How does it feel?
“In order to release trigger points, the physiotherapist will cause them to “twitch”, which will force the muscle to relax. The insertion of the needle will not or hardly be felt. The treatment of the muscle is often accompanied by a Sudden short tightening of the muscle. This “cramping” can be a bit painful but is usually short-lived,  and a positive effect of relief follows immediately after. The muscle may be more flexible, the mobility in the joint improves and pain decreases.
5. What is the effect of a treatment?
“After treatment, the treated muscles usually feel quite tired and heavy.” Strong muscle soreness” is a common phenomenon, which is quite normal and often disappears within a day. Sometimes, some general fatigue occurs after treatment. Regularly, patients experience a deep sleep on the night after treatment.
During a first treatment , the therapist usually only treats a small number of points. This way he/she can see how you react to the treatment before the intensity is built up.