At Back On Track we value our time spent with our clients, however we also like to provide them with useful information to help them manage their injuries and more importantly prevent them from coming back.
Click here for information on mechanical low back pain and basic stretches.
Sleep Advice
Sleep is very commonly disrupted for pain patients. Clinicians and patients should have familiarity with principles of sleep hygiene including the following:
Other options: Try making the bedroom a special place for sleep and avoid doing anything else in the bedroom that might interfere with this (except for sex, which can actually help with sleep). Try going to bed really late or getting up really early so that you are really tired when you go to bed the following night. Try to stay awake in bed rather than trying to sleep so you won’t feel frustrated (which means you’ll be more relaxed and may actually fall asleep more easily). Learn to meditate and practice this in the evening. Wear sunglasses for an hour before bedtime so that your brain knows it is night time. Turn the alarm clock around so you can’t see what time it is. Drink decaffeinated coffee just before going to bed—your brain will be expecting a stimulant and so it will naturally try to counter this by becoming more relaxed. Have a short shower 30 minutes before bed or a long bath 2-3 hours before bed.
Timing: Like many things, good sleep is all about good timing
• Keep a regular bedtime and wake time. Don’t sleep in too long on the weekends or go to bed early to ‘catch up’.
• Find the right time for you to sleep. If you are a night owl, don’t go to bed too early. If you are a morning person, don’t try to stay up late or sleep in.
• Don’t spend too long in bed. Your sleep will become shallow and disrupted if it has to fill in a 10-hour block of time.
• Avoid napping in the day as it will make you less sleepy when it comes time to go to bed.
Stress: You can’t get rid of stress, but you can reduce its impact on you at night
• Keep a 30 minute ‘wind down’ period before going to bed when you can do something relaxing.
• Practice relaxation exercises (e.g. diaphragmatic breathing or progressive muscle relaxation) before bed or in bed when you are feeling frustrated or tense.
• Clear your mind before you go to bed. Write down the things that are worrying you and note what you plan to do about them. Write up a plan for the next day so you don’t have to remember it overnight.
• Consider psychological intervention when stress or mental health difficulties are more severe.
Bedroom Environment: You need to have the room ready for sleep
• Temperature. A cool room (~18°C) is better than one that is too warm or too cold. Body temperature drops by about 1 degree during the night.
• Noise. The brain likes peace and quiet when it’s asleep. If your partner snores, or there is other noise in the environment, consider wearing earplugs or introducing ‘white noise’ by running a fan.
• Light. Even a small amount of light can interfere with the brain thinking that it’s night time—people used to live in a world without electricity and a little bit of light meant that the sun was coming up! Consider getting blackout curtains or wearing an eye mask if necessary.
Stimulants: Many things can wake the brain up even when we are wanting to sleep
• Caffeine. Caffeine is a powerful stimulant and its effects last for many hours. It can be found in coffee, black tea, green tea, soft drinks, chocolate, and some pain relievers (e.g. Panadol Plus). Herbal teas or decaffeinated coffee are a good substitute. Avoid any caffeinated drinks from 6pm.
• Nicotine. Nicotine is also a stimulant and can interfere with sleep. Try to minimize this in the evening.
• Alcohol. While alcohol can initially make people sleepy, it has a stimulant effect when it is being processed and tends to wake people up in the middle of the night.
• Bright lights, fast movement, and loud noise all make a person feel more alert. Try to minimize use of television, computers, and less-than-relaxing music before bedtime.
Discomfort and Pain: Feeling physically uncomfortable can make it hard to fall asleep
• Sleep on a comfortable bed and use a good pillow
• Find what position is most comfortable for you. Use pillows to support a comfortable position if necessary.
• Time the use of medication to help with pain relief or sedation at night.
Lifestyle: A balanced life is important for sleep too
• Eat a healthy and balanced diet
• Get some exercise each day – the late afternoon is ideal for helping with sleep.
• Spend some time outside each day to get some exposure to bright light.
• Make sure you get time for work, rest, and play.
Medications:
• Take analgesic medications at an appropriate time. Nortriptyline and amitriptyline are often best taken 3 hours before bed as there is a delay before in ‘kicks in’ and this will also reduce morning grogginess. Pain relief taken before bed can help patients get to sleep easier when pain is distracting them.
• To avoid developing psychological dependence, sleeping pills are best taken on a planned basis rather than ‘as needed’, such as by taking it one night per week on the same day each time.
Other options: Try making the bedroom a special place for sleep and avoid doing anything else in the bedroom that might interfere with this (except for sex, which can actually help with sleep). Try going to bed really late or getting up really early so that you are really tired when you go to bed the following night. Try to stay awake in bed rather than trying to sleep so you won’t feel frustrated (which means you’ll be more relaxed and may actually fall asleep more easily). Learn to meditate and practice this in the evening. Wear sunglasses for an hour before bedtime so that your brain knows it is night time. Turn the alarm clock around so you can’t see what time it is. Drink decaffeinated coffee just before going to bed—your brain will be expecting a stimulant and so it will naturally try to counter this by becoming more relaxed. Have a short shower 30 minutes before bed or a long bath 2-3 hours before bed.
Are you sitting correctly at your desk? Incorrect seated posture can cause a multitude of aches and pains which can have an immense impact on your life, both at and away from work. Sorting out your workstation only takes a few minutes - your body will thank you!
Working in an Office can be hard on the body as you are often in the same position for a long time. Include these exercises to help prevent pain, discomfort or injury from affecting you.
Find out some of our Basic Pregnancy Exercises for you to try. If you require any further advice please don't hesitate to contact us and you can discuss further with an experienced physio.
Love running? A good warm up and cool down is essential to help prevent discomfort and injury.
In order to help prevent injuries a thorough warm up is beneficial for a great days biking.
Training for climbing guidelines – Train smart to get strong
Here are some general guidelines to help you make the most of isolation – what better time to get some climbing training in.
- Easier said than done. We’ve all made this mistake.
Climbers like to try hard and progress – it’s rewarding and fun. However, as a result, we usually try too hard, too frequently. We also see the top climbers in the world punishing themselves with hardcore workouts but we need to recognize two things – firstly, they’ve worked over a long period of time to get their ligaments and tendons to a capacity that tolerates extreme loads frequently; secondly, they likely have a genetic advantage to high load tolerance in their tendons/ligaments (research is starting to indicate the genetic role in tendon health).
Here are some general rules for balancing load vs frequency:
A) If you have climbed intensively (2-3d/wk) for less than 2 years, you should generally stay away from hangboards and moon boards. However, these are unprecedented times where you’re not on rock or in the gym - hangboards are all we have. So, if you’re new to climbing, check out the below link for a conservative program:
https://www.99boulders.com/beginner-hangboard-training
B) Only train at your max 2d/wk
ie. Climbing problems/routes or hangboarding to your limit or even failing (never work to failure on a hangboard)
48-72hrs recovery between sessions (varies for each person and for strength vs power vs power endurance)
If you’re training boulder problems, the moon board or hangboard to your max 2d/wk, don’t expect to be climbing at your peak outside on your project in that same week – your nervous system will be too fatigued. It is ok to be fatigued on your project but for best results, plan periods when you want to prioritize training versus periods when you want to prioritize projecting
Examples:
Isolation from a global pandemic…
Or, winter versus summer
Or, in climbing season a 4wk rotation can work well – 4wks hard training then 2-4wks projecting before going into another 4wks hard training.
C) How your fingers feel is NOT a good guide for when you’re ready for another max session
After a max training session, even if your fingers feel good the next day, you’re not ready to train – your tendons/ligaments need recovery and your nervous system is fatigued.
This can be incorporated into a warm-up, end of a session, or as a workout on days between max training session
- Posterior rotator cuff (infraspinatus, teres minor) – in various shoulder positions
- Triceps – dips, push-ups and overhead press – a combination of these works a good range of shoulder positions
- Wrist extensors
Check out the warmup booklet of 8 exercises I’ve put together for this purpose.
This is where a physio that knows climbing can be valuable
I find people can generally be one of, or a combination of these three categories:
1) Reduced mobility – most importantly shoulder and hips
2) Reduced strength and stability – scapula, shoulder joint (glenohumeral joint), core, hips
3) Reduced control and body awareness – Generally evident in newer climbers but poor scapula control can persist in experienced climbers too
Please feel free to contact me if you have any more questions or want some more info on what hangboard programs are best for you:
nick@backontrackphysio.co.nz
Keep healthy,
Nick Black
Climber, Physiotherapist
It is getting into golfing season and with that golfing injuries. We've put together a few exercises to help you avoid injury on the green.
When the snow is here, be sure to check out these skiing warm up exercises to prepare your body for the slopes.
Snowboarders, check out these exercises to get you ready to hit the slopes
Ski season is not too far away. Now is the time to get in shape! Check out some pre season skiing exercises to get you sorted!
If you love getting away from the main trails and into the back country, be sure to warm up correctly with these exercises.
We have some basic pilates exercises to get you started. Remember that we have many classes running throughout the week if more supervised sessions are more your thing.
Ankle sprains are a very common lower limb injury. We have further information on ankle sprain management, prevention and some exercises to help get you going.
Back pain is one of the most common grievances that can hold you back from getting on with your daily life. We have included a resource from Physiotherapy NZ about how to care for your back.
Working in the construction industry is tough and physically demanding. The industry has some of the highest rates of work place injuries in New Zealand (1). The prevalence of low back injuries among construction workers is as high as 54% (2). Back injury may result in disability or time away from work, which has detrimental effects on the employer, the employee and their colleagues.
We have good info on preventing injuries on site as well as a warm up and stretch programme for Builders.
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First level |
Deeper level |
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Decrease heart rate |
Helps body realign itself |
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Decrease stress |
Helps break old holding patterns |
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Increase circulation |
Improves postural distortion |
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Stimulate parasympathetic system |
Frees muscles from fascia |
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Break up scar tissue |
Re-establish pliability of fascia |
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Enhance sense of wellbeing |
Lengthens chronically shortened muscles |
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Decrease overall tension |
Creates space for fluid exchange |
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Client feels whole, connected, balanced, grounded |
Resets muscles spindles and changes muscle memory |
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Reduce fascial restrictions |
Allow rehydration of tissues |
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Decrease pain |
Decrease fascia and muscle imbalances |
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Increase range of movement |
Relieves stress and compression on joints |
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Increase energy |
Release memory stored in tissues |
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Increase lymphatic drainage |
Facilitates mind- body connection |
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Enhance nerve conduction |
Promotes physical and emotional healing |
Myofascial release uses no oils or cream and is done slowly to allow the fascia to release and the body to go into a relaxed state. The therapist listens to the client’s body with their hands and does long stretching strokes over the skin. Sessions start with more superficial strokes which get firmer depending on whether deeper therapy is needed. The client will be aware of a stretching sensation in addition to feeling the tissue releasing, space being created and calmness in the body.
Nicola has completed her Fundamental and Advanced lower limb Myofasical Training and is having some great success with her clients. If you are interested book in to see her or she is happy to discuss whether myofascial release may be beneficial for you.
