Rapidly growing bones, combined with great love of high impact, reaching sports such as AFL, basketball and netball, can often lead to inflammation of the tibial attachment of the patella tendon, known as Osgood-Schlatter’s Disease. Ongoing repetitive stress on the tendon can result in micro tears to the tendon and damage to the bone itself.
Left unchecked and untreated, it leads to a bony protuberance on the tibia, disintegration of the bone causing intense pain for the athlete.
Localised pain at the attachment point on the bone during and after sport
Oedema (swelling) and tenderness below the knee both in the tendon and in the capsule that contains the patella.
Pain that can be triggered by contacting the quadriceps against resistance.
Pain made worse by the application of ice.
Generally, athletes between 10 and 18 years are most likely to develop the condition, and it is usually more common in boys.
A visible increase in size of the tibial attachment in either one or both legs.
There are a range of options which are beneficial depending on the severity of symptoms.
Active rest and heat, the use of topical pain relief creams, and a heat retainer in initial stages are helpful. Cessation of the activity provoking pain until symptoms subside and the use of Kinesiotape to support the knee and reduce pressure on tissue can also be helpful.
Shockwave and low level laser are also effective in reducing injury time, as is manual lymphatic drainage in reducing the impact of the condition.
Osgood-Schlatters disease rarely requires medical intervention, and frequently heals once the athlete reaches physical maturity. Problems in adulthood occur most commonly from loose bodies in the bursae that surround the knee.
However, an athlete who has Osgood-Schlatters Disease, may have several bouts of the condition prior to muscular-skeletal maturation.
Sports Injuries, their prevention and Treatment, Renstrom and Petersen
Since 1940, Lipoedema has been recognised as a valid medical condition in women (Mayo Clinic), and yet still women with this condition are stigmatised and told to increase exercise, and lose weight.
Sadly, this advice comes, not only from friends and families, but often from medical professionals, personal trainers and gym staff. Little wonder then, that depression and eating disorders are commonly experienced by women with Lipoedema.
What is Lipoedema?
An inherited adipose ( fatty tissue ) disorder, mainly experienced by women, which usually manifests at puberty. It has metabolic, inflammatory and hormonal elements and is often associated with chronic venous and lymphatic insufficiency. Men are very rarely affected by Lipoedema.
It is often the case that these symptoms are initially treated as the primary issue, and only much later is the Lipoedema recognised as the primary disorder.
How is it diagnosed?
Most commonly, Lipoedema is diagnosed by its visual characteristics. It is often first noticed following significant hormonal changes such as the onset of puberty, pregnancy and menopause.
Signs and symptoms
Waist is small compared to much larger bottom, hips and thighs. In initial stages, the legs are only affected as far as the knees, but as the condition progresses, it impacts the lower half of the legs.
Symmetrical increase in fatty deposits usually from the waist to ankles. Feet are not affected, and the condition is typified by “fat rings” around the ankles ( and if arms are affected, the wrists) known as the bracelet effect.
Lipoedemic fat pads accumulate on the upper thighs, and around the knees, resulting in abnormal gait, and knee and hip pain.
Legs are often very sensitive to touch and pressure and exercise is painful both during and after participation.
Non pitting oedema occurs, especially after long periods of sitting or standing. Skin is soft to the touch, as is the underlying fatty tissue.
Skin temperature is often lower on affected limbs, and can have an orange peel like appearance.
Affected areas bruise more readily than surrounding areas.
Generally diets and intense exercise have little effect on Lipoedema, though a healthy diet and moderate exercise is important in Lipoedema management.
Frequently Lipoedema is identified within families, ie, My Grandmother, mother, Aunts, had “heavy legs”, “childbearing hips” etc. Whilst these people might never have been identified as having had Lipoedema, it is more likely that this history implicates the current symptoms in a Lipoedema inheritance.
Remember not all women suffer all of these symptoms, each person will have a different array of these symptoms, and some will vary, daily and seasonally, but as the we age, more symptoms become an issue.
The important thing to do is to have plans in place to reduce the severity, to self manage, and to provide the best support for your body you are able to.
Implications of Lipoedema
In recent research, respondents to a lifestyle survey indicated the profound impact on how women with Lipoedema lived their lives.
95% reported difficulty buying clothes
87% a significant reduction on quality of life,
86% low self esteem
83% avoided having photos taken
60% restricted social lives
60% feelings of hopelessness
47% self blame
45% eating disorders
Other issues included, ridicule, financial pressures from discrimination, lack of exercise due to harassment, marriage breakdown, the hazards of yo-yo dieting.
In general a lack of freely available information, about treatments, self help, and management strategies among the general population, has lead to isolation and embarrassment for many.
However this is changing and awareness is growing.
The first step is to secure a diagnosis. This sounds simple, but as previously alluded to, it may be the most complicated step you have to take!
No one likes it, right? The idea of plunging a tortured, ageing body into icy waters post game, is enough to send us into cardiac arrest. Yet, it is considered to be a rite of passage in many sports. The greatest test of sporting achievement is often perceived as being time spent in an ice bath.
But what if there was a better way, which provided all the perceived benefits, but without the profound discomfort?
In fact, there is little evidence that ice bathing, or Cryotherapy, has the benefits ascribed to it.
If we believe that the body functions optimally at 37 degrees Celsius, then it makes sense to maintain the core temperature at that level throughout the recovery process. Minimal increases in core temperature during exertion are expected, and, provided adequate hydration and nutrition are maintained, our body systems adjust accordingly. It follows then, that reducing the core temperature with cooling, will quickly return the body to homeostasis, but does that mean exposing the body to temperatures more than 20 degrees below core temperature?
Having been involved in Masters sport for almost two decades, as a therapist, it is my experience that Ice baths do the opposite of what is expected, and in fact, slow down the recovery process. In competition where more than one game is played per day, ice bathing has resulted in decreased performance, increased muscle stiffness and joint pain or discomfort and appears to have no benefit to the players beyond the adrenalin rush of removing a stressor from the body.
We also know from research, that heat, and alternating hot cold plunges are ineffective in reducing recovery time. So, it would appear that extreme ranges provide little value beyond team building benefits – the misery loves company, approach.
What is the ideal recovery plan?
Current thinking is that key ingredients are hydration, nutrition and rest. Of course there is the issue of the niggles or injuries requiring attention.
I will discuss the hydration and nutritional aspects elsewhere, but clearly there remains the need to deal with muscle soreness and how to freshen tired bodies post game. Proving optimal nutrition and hydration has many demonstrable benefits and coupled with warm up and cool down programmes is critical in competition.
Evidence in favour of pool work is strong. We know that water based exercise provides compressive support of around 20 mcg Mercury to muscles, so the equivalent of most commercially available compression garments… without the need to shoe horn yourself into one! This is widely regarded as being the most beneficial level of compression to reduce delayed onset muscle soreness ( or DOMS).
If we subscribe to the benefits of cooling, rather than shocking the body, assisting vasodilation by cooling the surface area slightly provides benefit by immersing in water below core temperature. Tepid, or cool water, at around 27 degrees, is comfortable for players. It provides compression, reduces the core temperature gently, supporting the innate recovery of body systems, without the systemic shock of ice bathing.
Adding warm down stretching, and movements such as walking, and resistance work appears to assist blood flow to large muscle groups, and assisting with recovery.Masters athletes report reduced stress, improved range of movement, and demonstrably less swelling in injured or arthritic regions.
We have found 10 -15 minutes to be effective, whilst longer is enjoyable. In competition this can easily be accomplished between games in most cases.
Does Pool based Recovery reduce Injuries?
The evidence at this stage is anecdotal. As a Sports Trainer/therapist, working at all levels, Nationally and internationally, over almost 25 years, I endorse a no ice policy. A concenus among the cohort I care for is strongly in favour of the cool water approach. It is invariably the case, in cricket, soccer and wheelchair sport that I have worked with, that the players carry fewer injuries, recover more quickly, demonstrate a greater range of motion, and enjoy the pool work.
At Masters level particularly, trainer/therapists are often dealing with chronic, long term issues, with resultant biomechanical or compensatory patterns entrenched in nature. Our role is clearly restricted to dealing with what we can influence in the time available. Teaching pool work allows players a take home approach. This is clearly an easy form of management with high compliance.
Ice bath is counter intuitive to all players at Masters level and beyond, compliance is difficult as a consequence. Tepid pool work however, has demonstrable benefits, and high compliance levels. It can be used multiple times a day, is inexpensive and simple to facilitate. It can be as simple as walking in chest deep water, or as complex as a full warm down routine.
Players report feeling fresher, and particularly, lighter in the legs, post session. Invigorated, recharged and relaxed bodies perform better in competition, and the teams that consistently employ this approach are definitely less injury prone.
Masters athletes, generally require more therapy, are more body aware, but also less likely to request treatment, toughing through their aches and pains, so pool work helps those players and adds a self-administered therapy to their tournaments.
Are the benefits sufficient to change the culture of your team?
For almost twenty years, I have suffered debilitating cramps. Generally, they strike at night, after a long day of being on my feet, treating clients, or at sports tournaments. Frequently episodes have lasted two or three hours. The pain has been excruciating, with muscle spasms and micro-trauma, causing discomfort for several days.
My GP told me that, aside from magnesium, not much helps, and that I would just have to live with this situation. He neglected to tell me that anti hypertensive medication would make the situation much worse! He didn’t know that a diet with moderate to high sugar levels would also make things worse, and the cruel irony was, his recommendation that I try a commercial sports drink would expose me to even more sugar thus worsening the situation.
At this point, with the cramps becoming a nightly occurrence, and long periods spent in hot showers trying to bring the muscles into a relaxed state, I was exhausted and distressed.
I tried all kinds of remedies, both allopathic, and natural, to no avail. Nothing made more than a transient difference. Then I began the detox process and noticed on the nights that I had severe cramp, I had also eaten chocolate with my coffee. So I reduced my sugar intake. No sweetened foods after lunch. There was an improvement!
Then, in November two years ago, I was at a Sports Medicine conference and during the break, I encountered Crampade for the first time. I was impressed with the passion of the inventor. I was impressed by the science and research we discussed, and came home with a generous amount of product to try for myself.
Of course, the theory was great, that wasn’t unique! The formulation is. But the proof of any product lies in its usefulness.
From the first time I took it, Crampade was spectacularly different! For me, the cramps stopped within five minutes of me taking it. This has been consistent over the last eighteen months. Every time I have taken Crampade, I have experienced relief, usually within three to five minutes. To have a product such as this has been a game changer for me.
But, Crampade isn’t just good for cramp. It also provides electrolytes lost through dehydration.
It helps sportspeople perform better for longer. This is particularly true for Masters level sports people. It also aids recovery in tournament situations, and helps with decision making.
Because Crampade is a powder, in a sachet, it is really convenient to use. It is a measured dose, unlike many other products on the market. A sachet or two in your sports bag, or wallet, and you have it with you for every situation.
Crampade is convenient to use, because on sachet taken prior to competition provides enough electrolytes for the day. There is no need for alternating water and a sports drink, the focus simply becomes drinking water during the game time.
Crampade requires only a small amount of water to deliver electrolytes, reducing the bloated feeling, and meaning it can be taken immediately before play. This is also a major advantage for those who suffer night cramps, reducing the need to wake a short while after taking it.
It is an occasional use product – you only take it when you need it.
The formulation is alkaline, helping reduce lactic acid.
The inclusion of pyridoxine is especially valuable for pregnancy. Because it is an electrolyte formulation, it is beneficial for those suffering morning sickness. Clients using the product report feeling better sooner.
Really, there is a reason for everyone to consider Crampade as their preferred choice, for hydration, cramps, sports performance, and post celebration recovery.
I love that Crampade was created from the benefit of scientific research, but I love that it is fundamentally a supplement. There are no negative side effects, and that is highly unusual.
Cost wise, Crampade is less than half the cost of other products on the market.
Where can I get it?
Available in our Clinic or from our online store for $13/box of 10. Buy and try today, you will be amazed!
The average adult heart beats 72 times a minute; 100,000 times a day; 3,600,000 times a year; and 2.5 billion times during a lifetime.
Though weighing only 11 ounces on average, a healthy heart pumps 2,000 gallons of blood through 60,000 miles of blood vessels each day.
A kitchen faucet would need to be turned on all the way for at least 45 years to equal the amount of blood pumped by the heart in an average lifetime.
The volume of blood pumped by the heart can vary over a wide range, from five to 30 litres per minute.
Every day, the heart creates enough energy to drive a truck 20 miles. In a lifetime, that is equivalent to driving to the moon and back.
Because the heart has its own electrical impulse, it can continue to beat even when separated from the body, as long as it has an adequate supply of oxygen.
French physician Rene Laennec (1781-1826) invented the stethoscope when he felt it was inappropriate to place his ear on his large-bosomed female patients’ chests.
The foetal heart rate is approximately twice as fast as an adult’s, at about 150 beats per minute. By the time a foetus is 12 weeks old, its heart pumps an amazing 60 pints of blood a day.
The heart pumps blood to almost all of the body’s 75 trillion cells. Only the corneas receive no blood supply.
During an average lifetime, the heart will pump nearly 1.5 million barrels of blood—enough to fill 200 train tank cars.
Five percent of blood supplies the heart, 15-20% goes to the brain and central nervous system, and 22% goes to the kidneys.
The “thump-thump” of a heartbeat is the sound made by the four valves of the heart closing.
The heart does the most physical work of any muscle during a lifetime. The power output of the heart ranges from 1-5 watts. While the quadriceps can produce 100 watts for a few minutes, an output of one watt for 80 years is equal to 2.5 gigajoules.
The heart begins beating at four weeks after conception and does not stop until death.
“Atrium” is Latin for “entrance hall,” and “ventricle” is Latin for “little belly.”
A newborn baby has about one cup of blood in circulation. An adult human has about four to five quarts which the heart pumps to all the tissues and to and from the lungs in about one minute while beating 75 times.
The heart pumps oxygenated blood through the aorta (the largest artery) at about 1 mile (1.6 km) per hour. By the time blood reaches the capillaries, it is moving at around 43 inches (109 cm) per hour.
Early Egyptians believed that the heart and other major organs had wills of their own and would move around inside the body.
An anonymous contributor to the Hippocratic Collection (or Canon) believed vessel valves kept impurities out of the heart, since the intelligence of man was believed to lie in the left cavity.
Plato theorised that reasoning originated with the brain, but that passions originated in the “fiery” heart.
The term “heartfelt” originated from Aristotle’s philosophy that the heart collected sensory input from the peripheral organs through the blood vessels. It was from those perceptions that thought and emotions arose.
Prolonged lack of sleep can cause irregular jumping heartbeats called premature ventricular contractions (PVCs).
Cocaine affects the heart’s electrical activity and causes spasm of the arteries, which can lead to a heart attack or stroke, even in healthy people.
Galen of Pergamum, a prominent surgeon to Roman gladiators, demonstrated that blood, not air, filled arteries, as Hippocrates had concluded. However, he also believed that the heart acted as a low-temperature oven to keep the blood warm and that blood trickled from one side of the heart to the other through tiny holes in the heart.
Galen agreed with Aristotle that the heart was the body’s source of heat, a type of “lamp” fuelled by blood from the liver and fanned into spirituous flame by air from the lungs. The brain merely served to cool the blood.
In 1929, German surgeon Werner Forssmann (1904-1979) examined the inside of his own heart by threading a catheter into his arm vein and pushing it 20 inches and into his heart, inventing cardiac catheterisation, a now common procedure.
On December 3, 1967, Dr. Christiaan Barnard (1922-2001) of South Africa transplanted a human heart into the body of Louis Washansky. Although the recipient lived only 18 days, it is considered the first successful heart transplant.
A woman’s heart typically beats faster than a man’s. The heart of an average man beats approximately 70 times a minute, whereas the average woman has a heart rate of 78 beats per minute.
Blood is actually a tissue. When the body is at rest, it takes only six seconds for the blood to go from the heart to the lungs and back, only eight seconds for it to go the brain and back, and only 16 seconds for it to reach the toes and travel all the way back to the heart.
Physician Erasistratus of Chios (304-250 B.C.) was the first to discover that the heart functioned as a natural pump.
In his text De Humani Corporis Fabrica Libri Septem, the father of modern anatomy, Andreas Vesalius (1514-1564), argued that the blood seeped from one ventricle to another through mysterious pores.
Galen argued that the heart constantly produced blood. However, William Harvey’s (1578-1657) discovery of the circulation system in 1616 revealed that there was a finite amount of blood in the body and that it circulated in one direction.
Some heavy snorers may have a condition called obtrusive sleep apnoea (OSA), which can negatively affect the heart.
The right atrium holds about 3.5 tablespoons of blood. The right ventricle holds slightly more than a quarter cup of blood. The left atrium holds the same amount of blood as the right, but its walls are three times thicker.
Grab a tennis ball and squeeze it tightly: that’s how hard the beating heart works to pump blood.
In 1903, physiologist Willem Einthoven (1860-1927) invented the electrocardiograph, which measures electric current in the heart.
List by Tayja Kuligowski, published November 28, 2016
1 Avraham, Regina. The Circulatory System. Philadelphia, PA: Chelsea House Publishers, 2000.
2 Chilnick, Lawrence. Heart Disease: An Essential Guide for the Newly Diagnosed. Philadelphia, PA: Perseus Books Group, 2008.
3 Daniels, Patricia, et. al. Body: The Complete Human. Washington, D.C.: National Geographic Society, 2007.
4 Davis, Goode P., et. al. The Heart: The Living Pump. Washington D.C.: U.S. News Books,1981.
5 Parramon’s Editorial Team. Essential Atlas of Physiology. Hauppauge, NY: Barron’s Educational Series, Inc, 2005.
6 The Heart and Circulatory System. Pleasantville, NY: The Reader’s Digest Association, Inc., 2000.
7 Tsiaras, Alexander. The InVision Guide to a Healthy Heart. New York, NY: HarperCollins Publishers, 2005.
With our largest population reaching retirement age and discussion on the stress to health care facilities, thoughts have turned very much towards the idea of providing services to fall prevention, and early intervention strategies.
It has recently become popular to run classes for seniors with a view to reduce the risk of accidental fall. Statistics suggest that as many as 33% of Australians over the age of 65 will fall at least once a year.
Falls result in hospital stays, rehab costs and reduction of options for Seniors, with many pressured into moving from independent living to some form of assisted care as a consequence of concerns voiced by family members.
Many of those who fall, but are not hospitalised, manifest lack of confidence in movement, aversion to activity, long term pain, muscle wasting and fear of the future. Some experience depression and anxiety, and others loneliness due to self-imposed restrictions.
Tired of exercises that don’t work well, because you’re not sure about how effective they are? Need to cross your legs when you laugh or sneeze? Does the prospect of wearing plasticised undies make you depressed?
Surgery has been the only viable option for women suffering fron long term urinary stress incontinence, though recently Physiotherapy has offered specialist pelvic floor stimulation in clinics.
However, given the embarrassment and expense these visits often cause, many women still suffer in silence.
But, help is at hand…
A small, discrete device, designed especially for women to use at home, is now available. SensaTone pelvic floor stimulator uses mild electrical pulses in the vagina, to strengthen and tone muscles, ensuring you are engaging the correct muscles, delivering help where it is needed most, eliminating guesswork.
The unit has 4 settings, to treat mixed, urge, and urinary stress issues.