Friday, 12 August 2016

Snapping Hip Syndrome

In my previous blog, I wrote about bursitis at the hip. Snapping hip syndrome can occur as a result of chronic bursitis at the hip. This condition is commonly found in dancers, runners and cheerleaders. The cause of this condition can either be from within the joint itself, or from structures just outside of the joint capsule.

I will not go into anatomical details here, but basically, various ligaments and muscles can be affected, resulting in three different types of snapping hip syndrome that may occur. A ligament or muscle snaps over a bony structure, thus the name ‘snapping hip syndrome’. The muscle or ligament involved will determine the type of snapping hip syndrome present. Iliotibial band friction syndrome, which I have written about previously, can also cause snapping hip syndrome.

Signs and Symptoms
A snapping sensation is heard or felt when performing certain movements of the hip. The most common movement is bending the hip and turning the leg outwards while standing on one leg. Snapping may also be experienced in the inner groin. Pain is not usually associated with this condition.

Non-streroidal anti-inflammatory medications may be used to treat the initial inflammation caused by the bursitis. Thereafter, an appropriate exercise rehabilitation programme should be prescribed by a biokineticist to correct muscle tightness and weakness surrounding the joint. Poor training techniques and biomechanics will also be assessed by the biokineticist and corrected.

Foundations of Athletic Training: Prevention, Assessment and Management

Friday, 24 June 2016

Bursitis at the Hip

Hip bursitis is an inflammatory condition, whereby a bursa of the hip becomes  inflamed, either due to chronic rubbing, causing friction and therefore inflammation; or inflammation as a result of a traumatic injury to the area. There are three bursae of the hip that can be affected, namely the greater trochanteric bursa, the iliopsoas bursa and the ischial bursa. Hip bursitis is a common running injury.

Greater trochanteric bursitis
This bursitis is commonly seen in female runners (because females have anatomically wider hips), road runners (the camber of the road affects running angles), cross-country skiers and ballet dancers. A burning or aching sensation is experienced deep in the hip joint and is exacerbated by walking and exercise. Pain may also refer down the outside of the thigh.

Iliopsoas bursitis
Repeated compression of the iliopsoas bursa causes this type of bursitis. It can also occur when there is osteoarthritis present at the hip. Pain is also experienced deep in the hip joint, slightly inside and to the front of the joint itself.

Ischial bursitis
This less common type of bursitis is caused either by a direct blow to the hip, such as a fall, or from prolonged sitting on hard surfaces. Pain is felt at the back of the hip and is exacerbated by prolonged sitting, uphill running, and any pressure applied to the back of the hip joint.

Management of hip bursitis
Initial treatment includes rest, ice, deep massage and anti-inflammatory drugs. Stretching exercises are given for the involved muscles. In more severe cases, a cortisone injection into the site may be necessary. Once the initial pain has been treated, running technique, posture and walking pattern should be assessed by a biokineticist to assess whether there are biomechanical factors contributing to the condition. From this assessment, appropriate exercises are then prescribed by the biokineticist to stretch and/or strengthen the involved muscles and improve running or walking abnormalities to prevent the condition from recurring.

Foundations of Athletic Training: Prevention, Assessment and Management

Thursday, 17 March 2016

Post-Pregnancy Exercise

Having recently had a baby myself, I thought I would give some insight into what types of exercise, as well as when one can start exercising following giving birth. Of course, post-pregnancy exercise depends on whether you have had a natural birth or a Caesarean section, and also the level of fitness you managed to maintain during your pregnancy. These are only guidelines – always check with your doctor before starting any exercise programme following giving birth, especially if you had any complications during pregnancy or birth.

Regardless of whether you had a natural birth or a Caesar, the body takes about six weeks to heal from the labour and/or surgery and so one must use this time to rest and recover and focus on your new born baby. Your body has undergone many changes over a period of nine months, so it will take time to get back to what it was before. However, one can start very gentle pelvic floor exercises the day after delivery, and light walking within your pain limits can begin one week later and is good for both your body and mind. Use pain as a guide – if you experience any discomfort, stop whatever you are doing immediately.

About six weeks post-delivery, your body should start to feel a little more normal again. You can increase your pelvic floor exercises and walking as you feel comfortable. Provided your surgical wound has healed without any complications and your doctor gives you the go-ahead, you can start swimming. After 12 weeks, gentle cardio, as well as light resistance exercises can be started, again provided your doctor has cleared you for this. Again, use pain as your guide and stop immediately if you experience any discomfort. Start slowly with whatever it is you are doing and increase gradually within your pain-free limits. Remember: even if you kept fit during pregnancy, your body has undergone a huge amount of trauma, whether it be from labour or surgery or both. If you laboured and still had a Caesar, the trauma to the body is even greater and so you will take a little longer to recover. Always listen to your body!

If you feel like you need some company or a little guidance, consider joining group classes, such as a Pilates class, or consult a biokineticist who will provide you with an appropriate exercise programme.

Exercise is like medicine for your body and mind and will help you to feel like yourself again after a long process of many changes. Embrace your new body and work within its limits. Take your baby for walks with you and enjoy the special time together.

The Pregnancy and Baby Book; DK Publishers

Tuesday, 15 December 2015

A Joyous, Healthy and Active Festive Season

Once again I would like to thank all my loyal readers for your continued support throughout the year. I hope you have gained some useful insight from the topics covered during the past year.

I wish you a joyous festive season and a prosperous new year. May 2016 be a happy and healthy year for you all.

Remember to keep active during the festive season! Play and laughter can be the best exercise! J

Monday, 2 November 2015

Plantar Fasciitis

Plantar fasciitis is one of the most common foot injuries, affecting approximately 10% of runners. It is an inflammatory condition, in which the connective tissue on the underside of the foot becomes inflamed. Intrinsic factors contributing to this condition include biomechanical factors related to the foot and ankles, as well as muscle imbalances in strength and flexibility of the lower leg and foot muscles. Extrinsic factors include incorrect footwear, poor training and excessive running on hard or uneven surfaces.

Signs and Symptoms
Pain is experienced on the underside of the foot, near the heel, and is usually worse after rest and will be particularly severe first thing in the morning when weight is placed on the foot. This pain tends to improve within a few minutes of walking. In more severe cases, where there is neural involvement as well, pain is more severe and widespread. Pain often improves with activity, but will recur after rest.

Ice and non-steroidal anti-inflammatory drugs are used to manage the acute pain and inflammation. Massage is used to reduce inflammation in the fascia. Strapping and heel lifts may be used to take the pressure off the arch of the foot. Achilles tendon stretches should be performed, as well as various other exercises to improve range of motion in the ankle and foot, within pain-free ranges. Gentle strengthening exercises can be done to improve muscle strength around the foot and ankle, again within pain-free ranges. A biokineticist can then assess factors contributing to the condition and provide appropriate stretching and strengthening exercises to improve muscle imbalances, thereby preventing the condition form recurring.

Foundations of Athletic Training: Prevention, Assessment and Management