“I must have slept funny” – Morning neck pain

If you wake to neck pain in the morning

Just as the day is a dawning

Your neck will lock tight

You’ll look quite a sight

From something that struck with no warning  

 

“I must’ve slept funny…” 

I hear this a lot as an explanation for a pain that appears for no obvious reason when waking.  It seems strange, doesn’t it, that something can go wrong with just your normal bed and pillow? But maybe this is just a convenient scapegoat.  After all, as humans we always want to be able to blame something.  And if you wake to a pain that wasn’t there before, it’s natural to suspect the last thing you were doing before the pain – sleeping! 

I hear this so often that I think there must be some truth in sudden movements first thing before the neck is warmed up and ‘ready’ for action.  But it’snot necessarily correct just because the sleeping came before the pain.  So did a lot of other things – like brushing your teeth, but you wouldn’t think to blame that, would you?

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Posted in Adults, Arm, Shoulder and Neck

Older people need to exercise smarter!

Most of us steaming slowly but inevitably into middle age and beyond will have noticed how niggles and pains seem to come about randomly and for little or no apparent reason.  Worse still is how they appear to hang around for much longer than before or that seems reasonable!  

So why is this?  Well, three things spring to mind: Firstly, there’s the decline in muscle mass and quality as we age.  Unless we make a special effort – and it does take more effort just to keep what you’ve got as grow older – our muscles tend to diminish in size.  This means they tire & come under strain more readily.

Another thing is that  the quality of the muscle fibres changes.  They become less elastic and aren’t capable of generating the same force as younger muscle fibres.  They also need longer recovery time, not only between intense physical activity, but also to injury.  That twisted ankle that you shrug off after a couple of weeks in your twenties is going to hang around for a lot longer in your fifties.  So you’ll need to learn to be patient!

The third thing is that ‘white-stuff ‘ injuries become more common as you age.  White stuff refers to the glistening cartilage and muscle tendons you see when you’re boning a chicken or leg of lamb.  The injuries to these increase because on the cellular level there are changes that happen which make the tendon less elastic and less strong – and less able to recover from repetitive strains.

So you may be doing something which doesn’t seem to require that much effort & which you’ve done loads of times before, but the fact of doing it repeatedly leads to a niggle appearing from nowhere.  

 

What does all this mean for the over forties?

First, we need to work on maintaining our strength as we age, or improving it if you’ve been inactive for a long time.  Just going for your daily walk is not going to cut it in terms of improving strength in other parts of the body not used much in walking.  But just be careful to increase the intensity of your exercise regime slowly to give those muscles and tendons extra time to adapt.  

Second, and very importantly, vary the exercise to avoid too much repetitive strain on those tendons.  Try to avoid just returning to the same exercises week after week.  Try rotation.  Two that are often affected are the achilles tendon  and the tendons around the outside of the elbow involved in wrist movements.  The shoulder is another commonly affected area.  

Third, since recovery slows with age, allow more time for recovery and rest for muscles that have been worked hard or strained.

And finally, warming up & easing into physical activity gradually rather than jumping in may help to prepare less elastic muscles for activity and avoid cramp or pulled muscles.  Warming down and stretching just after should help too instead of just coming to a sudden halt before going to shower.

Posted in Adults, Older People

Do your knees swing in towards each other when you bend them ?

Many people notice their knees doing this instead of staying in line with the lower leg and foot.  This can be a problem.

Why?  Well as the knee swings inwards it puts more pressure on the inside edge of the knee, including the medial collateral ligament there, which has to try to resist and control that pressure.  There could also be consequences for the meniscus or disc, which will have uneven pressure on it.  Both can be painful, with knock-on effects on the foot, which will tend to roll inwards increasing the pressure on the inner side of it.

Imagine a leg with this knee problem like bending a stick.  On the outside of the stick’s curve the wood is stretching – this is the side of the ligament I mentioned above.  On the inside of the curve the wood is being compressed – this is the side of one of the discs, the one being compressed.

Problems may only surface after many years as the abnormal forces slowly take their toll.  But the effect can be more sudden in the case of someone using their knees to control large repetitive forces as in sports such as skiing or cycling.

So what can you do about it?  Here are 3 ideas:  

Strengthen your abductors – the muscles that move your leg out to the side. This can be done lying on one side and slowly lifting your upper leg, holding it up for 5 – 10 secs, and slowly lowering it.  Repeat 10 times.  Then try another set.  If you use a gym, you might be able to use a machine to help.  

Strengthen your adductors – the muscles on the inside of your knee. Read more ›

Posted in Adults, Legs and Knee

“So what is the difference between an Osteo and a…?”

“… chiropractor and physio?” Such a common question which could be answered by talking about differences in philosophy, but that probably wouldn’t shed much light on the actual differences in treatment.

I see a lot of patients who’ve had first hand experience of different kinds of therapy, so my answer comes from what they’ve told me.  But before I get started, please remember that these are broad generalizations and I’ve certainly heard of  therapists of one variety working very differently from the descriptions below.

Physios on the whole, seem to do a certain amount of soft tissue work, (not a lot), and usually include a lot of homework for the patient to do in the form of stretches or strengthening exercises.  Strapping and taping are common with visits to the physio as are the use of devices like ultrasound.  Some are licensed to provide manipulation, but many aren’t and don’t.

I’ve often heard that a typical chiropractic session is short, often no more than 10 minutes. Chiropractic seems to focus on manipulation (clicking of joints) as the main tool of choice and not much, (if any), soft tissue work. Read more ›

Posted in Adults

Back Pain – “Could it be my kidney?”

It’s only natural  in the search for a self diagnosis that we point the finger at any organ in the painful area.  So if it’s at the front of the chest you think heart, and just the worry might be enough to give you palpitations!

I’ll just say right up front that I’ve only seen relatively few people with back pain which didn’t come from a joint, nerve or muscles.  And that’s a good thing as it has meant that treatment and recovery was a relatively simple matter. But cases of kidney related back pain are out there.  

 

What you’d be looking for with kidney issues

Basically, if any of your internal organs is playing up and in trouble you’re going to have noticed other symptoms associated with the function & purpose of that organ.  With the kidney we’re talking about issues with peeing.  For example, changes in how often you go, discoloured or cloudy urine or pain peeing.

Read more ›

Posted in Adults, Back and Hip

Trampers & Hill Walkers – Knees Aching?

I made a discovery very late in the trip after many days out int the Nelson Lakes area in late December and early January last year.  It’s one I wish I’d cottoned onto much earlier, as it probably would have resulted in better tramping performance for less discomfort in the knees after each day.

The pain, an ache, wasn’t so much inside the knee or deep down, but below the patella, or knee cap. I’m not sure exactly how or why I suddenly came to this realization, but it was this:

Going uphill I was constantly relying on and overusing my quadriceps muscles for each upward step.  Those are the front of thigh muscles which are used to straighten the knee when it is bent.  So, I’d put my foot forward and up for the next step, and just straighten the knee on that side to power myself up. What I was not using enough were my gluteal muscles, especially the gluteus maximus.  

Now that sounds awfully like the name of a Roman Emperor or commander of a Roman legion, but it is in fact, the muscle which pulls your thigh backwards, or downwards and backwards if you use it to help you go uphill! And then Read more ›

Posted in Adults, Legs and Knee

The best exercise for Achilles tendinosis?

Well, l I’ve got a question mark there in the title of this subject for three good reasons. The first is that the research and reports about this are not conclusive – how often is health related research cast-iron??  The second is that no one exercise is good for all sufferers of tendon related issues.  What works for one person, will be ineffective for someone else!  And the third is that your Achilles pain may not actually be from the tendon itself.  Other structures near the heel could be to blame, so you need a correct diagnosis to begin with.

Having said that, if you’ve had a nagging Achilles tendon problem for weeks (and probably months), which is worse when running or jumping, there’s a good chance you’ve got Achilles tendinosis.  Chances are that you’ve already seen someone about it if it’s that bad, in which case you might already know what’s to come…  

 

What is tendinosis?

Basically, a condition in which the fibres of the tendon become rather disorganized and less able to cope with the huge forces through it when your calf muscles are being used.  So further aggravation of the tendon is more likely, and for reasons that are still not quite understood, the repair process seems to get disrupted so that it takes forever to come right in some people.

An Achilles problem Read more ›

Posted in Adults

4 easy exercises for a stiff upper back

Gyms, running or walking are great for working out our lower bodies, legs or specific muscles,  but our upper backs often get forgotten or are under challenged.  It’s an important area, not least because of its connection to  healthy neck and rib movements. So why not try these exercises in between all that sitting or whilst you watch t.v?  

The snake wriggle

Sit with feet flat on the floor, preferably on something with a bit of spring like a mattress or sofa, cross your arms & hold onto your shoulders. Now try to produce a continuous & rhythmic side to side motion through your upper back – so it does a snake-like movement.  The bounce in the sofa or mattress will help produce some recoil & spring that helps with the movement. As a variation, try taking in and holding a deep breath whilst doing this.

 

Freestyle no-arms “air swimming”  (like air guitar!)

sidebending Sit like before, but this time imagine doing the free style swimming movement with your shoulders. This is similar to the snake wiggle above, but it adds an extra dimension of rotation with each shoulder describing circles in a forwards-backwards direction.            

 

 

 

 

 

 

Painting  overhead circles with straight arms

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Posted in Adults, Back and Hip

Carpal tunnel from waterblasting!

rafisprayingAnd in both hands at the same time! As anyone who’s come to our Torbay clinic knows, we have a lot of rough textured concrete out front – perfect for the mud and dirt to settle in & turn  a drab dark grey colour, and lots of paths round the house too.   So when I saw $100 off a powerful water blaster  recently, I couldn’t resist. I got started and went at it hard for perhaps around two hours solid, just swopping hands now and then as they tired.

Folks, this was me not following my own advice to patients to break up activities with different ones rather that go hard at it for hours on end doing one thing!

Read more ›

Posted in Adults

A slouched upper back can reduce your neck & shoulder movements.

If you’re one of those whose upper back slumps & sags forward and down, try this little experiment.

Sit in your normal slumped position, & turn your head as far as it will go to one side.  Notice how it feels.  Stop right there – don’t move your neck.

Now lift your chest a little & try to make your neck longer – without tipping your chin up.  Notice how your head will turn a bit more without that same level of discomfort.

I’ve had patients complaining of low neck pain turning their heads to reverse the car, and this one simple adjustment to posture is sometimes almost all that’s needed to eliminate or greatly reduce the pinching feeling.

In the next blog:  some ways to improve your shoulder and thoracic mobility

So what about shoulder mobility?  What’s the connection with a slouched upper back?  Well the problem is related more to upper backs that are both curved forward (‘kyphotic’, to use the technical term) AND stiff.

Shoulder flexion – i.e. moving your arms forwards and straight up all the way above your body is only possible if the upper back also bends back slightly for the last part of the arm raise.

So if your back is too stiff that’s going to be harder to do. You’ll feel a tightness at the front of your shoulders as they struggle to do all the movement without your back’s help, or you’ll ‘cheat’ by arching your lower back more – not the best if you suffer from low back pain too!

But hey, what’s the problem?  After all, unless you’re a basketball or netball player, how many of us actually need to raise our arms straight up high on a daily basis?

Actually, over the long term the effects can be more insidious and give a pinching pain just raising our arms up to lift, put on a jacket or brush teeth and hair.  That’s called impingement syndrome and is another story in itself…

Posted in Adults, Arm, Shoulder and Neck