Strain vs Sprain: Understanding the Differences

Physical activity and sport is an integral part of numerous people’s lives and many have suffered an injury which has set them back in their function and/or their ability to play and participate in daily activities. So how do we best equip ourselves to minimise our chance of injury? Ideally we would look at why the injuries are occurring, however to spare you reading an essay we will define injuries in one of two ways: Contact injury Non-contact injury Contact injury: A direct injury which is caused by an external force e.g. tackling or being struck by an object. Indirect injury: this can be due to a physical mechanism such as falling. Or can be due to internal factors which can lead to strains or sprains for example. Here we will focus on strategies to implement to prevent indirect injuries. Rehabilitation from past injuries A large indicator of risk of injury is if you have had a particular injury previously. This is highly attributed to the incomplete recovery due to early cessation of rehabilitation exercises. This could be due to pain levels decreasing, however we also need to look at function! We love seeing pain levels reduce, but rehabilitation exercises also have a large role to play in enabling your levels of function and activity return to pre-injury levels. If you stick to them and check in with your physiotherapist your rehabilitation exercises can also be progressed to potentially get you functioning to levels even better than your pre-injury levels. This all depends on your dedication and appropriateness of your exercises. Seeking input from a physiotherapist will allow you to have many aspects assessed such as, range, strength, control, balance, functional activities and/or more to allow exercises or manual therapy to be tailored to your ability with room to progress along the rehabilitation journey that will also be adapted to your ability with re-assessments of the above mentioned aspects. Adequate warm up Preparing your body prior to your activity increases blood flow and oxygen, increases your range of motion and flexibility, and can improve your performance. Having trouble as to what you should include in your warm-up? Head over to our static vs dynamic stretching’ blog post, instagram reels, or book in with one of our physiotherapists who can assist you. Managing load Sometimes we get excited and increase either the intensity, frequency, and/or weight too quickly when our body, in particular our tendons, are not ready to take that much load. Our bodies take time to adjust to the stresses we put it through. This is where we want to implement the principle of progressive overload. This gives your body the chance to gradually adjust to the stress and slowly build up as necessary. In your sport you may see this through your pre-season training into your season training to ensure that your body is able to withstand the higher weight or intensity in training/games. Load management will be a key strategy used by our physiotherapists to reduce pain levels and increase your participation levels. Strength and functional training Increasing your strength and your ability to protect your joints is imperative to decrease your risk of injury. This can be training specific muscles that you may have found to have strength deficits or can be overall strength levels to optimise your performance levels. Functional training can incorporate similar movement patterns that you may complete in your training or sport. Similarly, it can include balance, proprioception, stability, and agility exercises. Many researchers have found a correlation between balance and proprioception levels and ankle sprains. If you would like some guidance on what this may look like for you feel free to book in with one of our physiotherapists or exercise physiologist who would love to help. Additionally, you can book in for a VALD assessment to get real data on your strength levels and compare it to normative data. Adequate recovery Recovery strategies such as sufficient sleep, hydration, and nutrition are imperative. To aid your recovery efforts post training/games and between sessions compression garments such as NormaTec boots or infrared saunas can also be of benefit, with their ability to increase circulation of blood, possibly reducing the onset of muscle soreness Our recovery room has 2x infrared saunas and 3x NormaTec boots ready for you and your friends! Call us or book online for a casual session or $20 weekly subscription for unlimited access!

Whether you're a seasoned marathoner, a weekend jogger, or just starting out on your running journey, an important decision you'll make is selecting the right pair of running shoes. The sheer variety of options can be overwhelming, with each brand boasting its own technology and features. But fear not! In this guide, we'll navigate the maze of running shoe options to help you find the perfect fit for your feet and running style. Before diving into the world of running shoes, it's essential to understand your feet. Are you flat-footed or do you have high arches? Do you overpronate, supinate, or have a neutral gait? Knowing your foot type and biomechanics will guide you towards shoes that provide the right support and cushioning. Types of Running Shoes: There are several types of running shoes designed to cater to different needs and preferences: 1. Cushioned Shoes: Better for runners with high arches or those who prefer a plush feel, cushioned shoes provide ample padding to absorb impact and enhance comfort. 2. Stability Shoes: Designed for runners who overpronate, stability shoes offer additional support to prevent excessive rolling in of the foot. 3. Motion Control Shoes: Suited for severe overpronators, motion control shoes feature firmer support to limit excessive foot movement. 4. Minimalist Shoes: Minimalist shoes promote a more natural running experience by providing minimal cushioning and support. They're best suited for experienced runners with strong foot muscles. 5. Trail Shoes: If you enjoy off-road running, trail shoes offer enhanced traction and durability to tackle rugged terrain. 6. Racing Flats: Lightweight and streamlined, racing flats are designed for speed and performance during races or speed workouts. Key Features to Consider: When deciding on running shoes, keep an eye out for the following features: 1. Fit: The most important aspect of a running shoe is how it fits your foot. Ensure there's enough room in the toe box to wiggle your toes, and that the shoe securely hugs your midfoot without feeling too tight. 2. Cushioning: Choose the right level of cushioning based on your preferences and running surface. More cushioning isn't always better; it's about finding the balance between comfort and responsiveness. 3. Support: Look for shoes that offer the right amount of support for your foot type. This might include features like medial posts, arch support, or stability technology. 4. Durability: Consider the durability of the shoe, especially if you're a high-mileage runner. Look for durable materials and reinforced areas in high-wear areas like the outsole and upper. 5. Flexibility: A good running shoe should flex at the forefoot to accommodate the natural movement of your foot during the running gait cycle. Conclusion: Finding the perfect pair of running shoes may require some trial and error, but understanding your feet, running style, and the key features of running shoes will help narrow down your options. Remember to prioritise comfort, support, and durability, and don't hesitate to seek advice from knowledgeable staff at specialty running stores. With the right pair of shoes, you'll be well-equipped to hit the road or trail with confidence and comfort. Happy running!

Blood Flow Restriction (BFR) Training BFR has been used in bodybuilding circles for many years for muscle hypertrophy, however, recently we’ve seen it makes its way into the rehab & general strength & conditioning arena. It involves the use of an inflatable tourniquet, such as an elastic band or cuff, around the top of the arm and/or leg to restrict blood flow during exercise. The goal of BFR training is to increase strength gains while lifting lighter loads which reduces the overall stress on the limb and avoids muscle breakdown.

Both squats require ankle knee and hip mobility, but front squat demands more ankle mobility and less hip mobility due to the upright torso positioning.

Can I see a physio if I’m not injured or in pain? Definitely! There’s actually some great reasons to see a physio when you’re feeling ok and even have a regular check in schedule. 1. Injury prevention: We can assess range of movement, strength, balance and coordination to assess injury risk and put a plan in place to help prevent issues from arising. 2. Sports performance optimisation: Regular check ins and treatments with your physio can help keep problem areas under control and avoid getting as sore and tight. By having someone who knows your baseline measures and your body, we can help keep you on track and be able to notice if changes are needed in terms of training schedule, rehab exercises and treatment plan. 3. Advice and education: we can help guide your training loads, work place set up, rehab/prehab exercises and activities to avoid when needed. 4. Improved healing and recovery if injuries do occur: As much as we’d like to, we can’t 100% prevent injury. Things happen in the sporting arena and in everyday life that are sometime unavoidable, and can cause pain, inflammation and dysfunction. The good news is that if you do regularly check in with your physio and get regular treatments, it can lead to improved injury recovery and reduced time on the side-lines. 5. Reduced falls and related injuries: One of the most common reasons that older adults are admitted to hospital is due to injuries sustained in a fall. We can help older adults who may be at risk of falling by working on strength, balance and general fitness, as well as managing any pain that may be causing in increased risk of falling. Regular sessions with guidance from our physios can help reduce the likelihood of falling in the first place, and if falls do occur, can help reduce the likelihood of serious injury. In summary Physiotherapy isn’t just for athletes or injured people. By regularly checking in with your physio, you can reduced the likelihood of injury, improve your healing when injuries do occur, optimise sports performance, and just feel better in general! At Active Balance, we want to get your feeling great not just now, but in the long term. What that means for you will be different to the next person, as will the frequency and type of treatments that are recommended. Your physio will work with you and take into account your lifestyle, current functional abilities and goals to work out the best treatment plan for you.

The plantar fascia is designed to absorb the stress and strain we place on our feet when walking/running and doing other activities such as playing sports.

The anterior cruciate ligament (ACL) is one of the many structures in the knee joint that aids in the stability of the knee joint throughout movement. Mainly preventing excessive anterior (forward) translation of the tibia (lower leg bone) on the femur (thigh bone), as well as rotational forces. The ACL is commonly torn in athletes with the mechanism of injury occurring being non-contact with your foot planted and a sudden change in direction or rapid stopping, or contact with a direct below to the side of your knee. You may experience hearing or feeling a “pop” in addition to the sensation of lack of stability or “giving way.” It is of popular opinion that if an ACL is ruptured the only option is surgery, due to the belief that the ACL cannot heal naturally. However, there has been a big shift with new evidence surfacing concluding that ACL full thickness tears can in fact heal with conservative management, with no adverse effect on return to play*, and improved patient outcomes. Filbay and colleagues (2022) analysed the data from The Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) randomised control trial where participants either had rehabilitation alone or an optional delayed ACL reconstruction (ACLR). All measures were taken at baseline, three and six months, and one, two, and five years. At the 2-year follow-up, 16 out of 54 (30%) of rehabilitation plus optional delayed ACLR participants displayed evidence of ACL healing on MRI. Compared to MRI showing evidence of ACL healing of 53% of rehabilitation alone participants at the 2 year follow-up and 58% at the 5-year follow-up for the same group. Better sport/recreational function and knee-related quality of life was reported 2 years after injury by participants with evidence of ACL healing compared with the non-healed, delayed ACLR, and early ACLR groups. Another reason for the pathway of surgery was due to the theory that an ACLR prevented the development of osteoarthritis (OA), however it is now being suggested that ACLR could increase the risk of OA. A 20 year follow-up study found that there was no difference in knee OA between operative versus nonoperative groups. This study found that the operative group demonstrated greater knee stability however subjective and objective functional outcomes were poorer despite this (Yperen et al. 2018). It is important to note that in this post we are talking strictly on ACL ruptures alone. Everyone’s experiences and circumstances differ in what additional structures may or may not be implicated and a holistic approach is necessary for you and your allied health team to collectively choose what option may be best for you. If you would like more information feel free to get in contact with one of our physiotherapists or exercise physiologists. Alternatively, book in for your rehab journey that we would be delighted to be a part of! *It is important to know that electing to have surgery is not a necessity for return to sport and does not necessarily prevent further knee damage when returning to sport. References: Filbay, S, Roemer, F-W, Lohmander, S, Turkiewicz, A, Roos, E-M, Frobell, R & Englund, M, 2022, ‘Evidence of ACL healing on MRI following ACL rupture treated with rehabilitation alone may be associated with better patient-reported outcomes: a secondary analysis from the KANON trial,’ BMJ Journals, vol. 57, no. 2, pp 91-99. Yperen, D, Reijman, M, Es, E, Bierma-Zeinstra, S & Meuffels, D-E, 2018, ‘Twenty-year follow up study comparing operative versus nonoperative treatment of anterior cruciate ligament ruptures in high-level athletes’, The American Journal of Sports Medicine, vol. 46, no. 5, pp. 1129-1136.

Anatomy On the side of your wrist underneath your thumb is two tendons called the abductor pollicis longus (APL) and the extensor pollicis brevis (EBP). They help the thumb to abduct (move away from the wrist/other fingers) and extend (bring the thumb back or up). These tendons are cord like structures which attach the muscles to the bone. Signs & Symptoms Pain near the base of the thumb that develops suddenly or over time and gradually gets worse. Swelling near the base of the thumb Difficulty moving the thumb and wrist when doing something that involves grasping or pinching/gripping Pain with turning the wrist Pain with lifting something with thumbs pointed upwards (i.e. lifting a child) A “sticking” sensation in the thumb when moving it Pain that can occasionally radiate up the forearm. Feeling of weakness in the thumb Occasionally tingling or pins and needles in the hand Causes Dequervian’s Tenosynovitis refers to inflammation to these two tendons. While a direct cause can be unclear, it is strongly associated with overuse of these two muscles. Any activities that lead to chronic overuse of the thumb can lead to the development of this issue There are several instances where It can often occur, particularly: In new mum’s or child care workers, picking up babies is common and frequent. Typing or scrolling phone hammering /sawing Gardening Repetitive grasping Treatment of Dequervian’s Tenosynovitis During your physio consult after accurately diagnosing the condition, some treatments we can provide include: Soft tissue massage through the thumb and forearm. We may occasionally treat from the neck down the arm Mobilisation of the joints – again working from the neck all the way down Stretching/strengthening exercises – any weakness or tightness may be addressed by stretching and strengthening exercises Give activity modification advice – educate you to complete the activities that cause the main concern with simple modifications Taping/splinting of the forearm, wrist and thumb to decrease pain and improve function of the hand. At Home treatments Some things you can do at home to be proactive include: Ice or heat packs to increase blood flow through the region to aid with recovery and decrease pain Exercise to help strengthen and stretch weak and tight muscles Other treatment practices can include splinting, NSAIDs, steroid injection and surgery. We believe that physiotherapy is a less invasive or disabling treatment style than the aforementioned and should be given a try first, and to try these treatments if there is little response to physiotherapy guided treatments. Conclusion If you think that you’re suffering from De Quervain’s Tenosynovitis or are suffering from wrist or thumb pain and still aren’t quite sure, give us a call on 0450 877 731 or book online so we can get you in the right direction and move without pain.