Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful and uncomfortable process to repair itself. 

We sat down with Nick Marshall from Surf Life Physio in Miami, QLD earlier this month to get a better understanding of the recovery journey. Nick has over 17 years' experience as a physiotherapist, having practised both privately for his own practice Surf Life Physio and as a senior outpatient physio for Tweed Heads Hospital.

This article continues our injury recovery series. If you missed the first article on the inflammation stage, read it here.

Nick gives his insights on the next two weeks of an injury and provides tips on how best to manage this stage.

Keep an eye out for the next article on what happens after the first 2-3 weeks and for Nick's advice on how to speed up the recovery process, next month as well. 

The proliferation phase occurs following the inflammatory phase.

Just to remind you, in our analogy of a house fire, the inflammatory phase is like our emergency services  who, put out the fire, cordon off areas and stop an area being touched or moved.

The proliferation phase commences after about 3-4 days post injury.

This phase is the beginning of the rebuild. In our analogy, it is the phase where you contact the insurance company and builders to start the process of the rebuild.

The proliferation phase commences around 3-4 days post-injury and then lasts until 21 days after the injury or about 2 weeks.

The biggest difference between this phase and the inflammatory phase is that the injury is no longer sore at rest. It will be sore and restricted with movement and activity. But inflammation is characterised by constant pain without movement.

At this stage the pain should be much less, swelling should have reduced and bruises become darker.

This phase is about stimulating the blood flow to the area so the collagen and elastin forms and matures into its normal shape.

The body’s cells arrange themselves in a way so that they are best designed to resist future load and prevent damage. It’s in this phase that those early building blocks of the ligaments, tendons and muscles can be designed to reduce the risk of re-injury.

You should be aiming for controlled movement.

This would be the most important area to see a physio.

As the injury is no longer sore all the time there is a tendency to get moving too soon. If your movement is not guided properly then a large amount of injuries develop scar tissue which leads to inelastic tissue and a very real cause of future re-injury.

It is also this phase where far too many people grit their teeth and get back to do normal activity. But unfortunately doing that in an inappropriate way during this phase can cause the injury to relapse into the inflammatory phase and stall healing.

If you missed Nick's last article on the Stage 1 of injury recovery, click the link below. It's well worth the read.

Stay tuned next month for Nick's interview on the final stage of the recovery process in February. 

In the meantime, if you have any questions regarding these tips, injury recovery or other health issues please do not hesitate to contact Nick and his team at Surf Life Physio on (07) 5527 7830 or click the button below. 

For this month's contribution from Maximize Health Group, we decided to get some advice on accident recovery. 

We have again enlisted the help of Physiotherapist, Sean McCoola. Sean brings experience to his clients from 20 years as a physiotherapist and has a particular interest in sporting teams and rehabilitation programmes.

Read on to see his insights and get his top tips on accident recovery. 

Return to your normal daily activities as soon as possible including work, exercise and hobbies. Research has shown that if you return to normal movement and daily tasks your recovery will be quicker. Some pain during the recovery process is expected and does not automatically mean that further injury is being caused. Obviously with some injuries you will need to modify how you perform your activities. Planning and advice will be required to address the modifications.

Make sure you are doing everything that you can do to speed your recovery. If you engage in your own management, start normal activities, complete your exercises and follow/seek qualified advice on your injury, I can promise you will get better, sooner.

Be realistic but aim to push your limits. You may need to be adaptable depending on the severity and type of injury, but goals that are a stretch will continue to give you the drive you need to recover to the highest levels that are available to you.

The quicker you can exercise the faster you will recover. Over the years the consistent indicator of better recovery has been clients that have pushed themselves to exercise. It could be as simple as appropriate footwear to walk in, an exercise bike or a gym/pool membership. Make sure to access whatever you need to enable you to participate in general exercise and the more specific exercise for your injury type. It is one of the key factors in your recovery.

Prescribed medication can be useful. You do need to get the appropriate advice and follow it, but medication can be a useful tool in your recovery. I’ve had clients who have refused medication due to fear of the unknown. I believe they would have recovered sooner, and at times, to a better result, if they had understood the role medication could play in their recovery. Get the right advice on medication and comply and you will benefit in your recovery.

Maintaining mobility is essential to recovery after injury due to an accident. Of course, this will be modified and adapted in relation to your injury and your stage of recovery. Move it or lose it applies. Mobility aides, medication and some extra thought may be required to continue your progress, but the results will be worth the effort.

Prioritise mobility for getting around and moving your body as quickly as is reasonable post injury. The sooner you move the sooner you improve your level of independence and the sooner your recovery will progress.

From the use of crutches to getting out of bed to learning how to use a wheelchair to move that injured joint, there are always “best practice” ways to be most efficient in maintaining mobility in getting around and moving your body. Talk to the professionals who regularly advise on this topic such as a physiotherapist and you will reach your mobility goals sooner.

As in all things, persistence will win the war for your mobility requirements. Many will take years to get to their best levels of mobility post injury.

Stay tuned next month for another article from Maximize Health Group.

In the meantime, if you have any questions regarding these tips, prevention of cramps or other health issues please do not hesitate to contact Sean on +61 7 3343 5494 or [email protected].

You’re damn right it can, in a big way. And not in a hippy woo woo sort of way. I'm talking a scientific and biologically measurable kinda way. Now it’s going to get a little technical/nerdy, but hang in there. A book by Joyce and Lewindon (1) gives an excellent summary, ‘In the 1970s, Robert Ader, a psychologist and immunologist, showed that the mind and body communicate with each other in a bidirectional flow of hormones, neurotransmitters and cytokines. The brain and immune system represent a single, interactive system of defence. Thoughts, beliefs and emotions have neurochemical consequences on both the immune system and individual cells. Emotions and health interact. The immune system does not only fight sickness, it has a major role in tissue regeneration and injury recovery. Marucha et al. showed healing of mouth ulcers in dental students took 40% longer during exams than holidays.’

The interaction between all of these is governed by a little part of the brain, the hypothalamus. This little guy is super important as it organises everyday functions that we don’t even think about; body temperature, hunger, thirst, sleep, libido (wink wink). It also governs the body’s response to stress, acute and chronic. Acute stress response is very important. We’ve all heard of the flight/fight response, which is generally a good thing. Step onto road, oncoming car, jump back to avoid tackling a Ford Focus travelling 30km/h above the speed limit, give driver the finger, proceed to sweat profusely, feel heart palpitations, ponder the meaning of life, quit job and start painting like you always wanted to.

But chronic stress can be a bastard. It’s associated with overproduction of cortisol, and regarding injury recovery and rehabilitation, there is an increase in pro-inflammatory cytokines and decrease in anti-inflammatory counterparts. To sum up in one sentence, stress delays injury recovery significantly.

Lots of things and the rate at which it will slow recovery cannot be measured, but these factors can be mitigated. Sleep deprivation is big. You need at least the magic 7-8hrs/night. A study by Milewski et al. showed adolescents that go less than 8hrs sleep/night were 1.7x more likely to develop an injury. Same thing rings true with injury recovery. Sleep is the body’s time to recover and repair. Make sure you get enough.

Mood, emotions, anxiety and depression levels are all massive factors for injury recovery let alone holistic health, refer back to question 1 for the detailed answer as to how and why.

1. Mindfulness. Now this might be leaning a little toward the hippy side for some, but don’t worry you won’t have to identify your spirit animal just yet (cough...grizzly bear). Numerous studies have shown how a regular practice of mindfulness, in whatever form that may take for you, has a huge impact on your mental health. I’m a big fan of people like Tony Robbins, Tim Ferris, Gary Vaynerchuk etc. These guys have interviewed the top 1% of pretty much every industry out there, and about 80% of these high achieving individuals do some sort of mindfulness. A lot meditate, others do activities where time becomes irrelevant and they get lost in something they enjoy, and others have gratitude journals. The key is the disconnection from the stressful stimuli we are bombarded with and to give the mind a break. Good things happen here.

2. Set boundaries. Learn when to say no. Setting healthy boundaries allows you to do your job properly without getting too stressed out. There are a ton of analogies that work here. You can’t pour from an empty cup, you need to put your own oxygen mask on before attending to children etc. But seriously it’s true. Yeah, we know sometimes it’s difficult/impossible to say no to certain things at work and life. Learn how to set those healthy boundaries. You’ll thank yourself.

3. Exercise. It’s easily the best thing you can do for your body; physically, mentally and emotionally. A cascade of endorphins, dopamine etc. is released from the brain as a result of exercise and you feel pretty awesome. Have you ever noticed how good you feel during the day and how much you can accomplish when you set the alarm, get out of bed early and do some exercise before you get to work? It’s outrageous! Not to mention all the metabolic diseases you are fighting off one burpee at a time. 10/10 highly recommend.

If you missed last month's article from Queen Street Physiotherapy on whether exercise and movement is bad for back pain, check it out below.

Stay tuned for another article from the Queen Street Physiotherapy team in January. 

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Donovan and the rest of the team by visiting the Queen Street Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.

A nutritionist generally works more one on one with clients in a clinical setting. 

Most nutritionists adopt a holistic approach to case taking and treatment.  This means that they will look at the functioning of all your body systems including areas such as digestion, metabolism, hormones, energy levels and sleep to name just a few.  

Nutritionists will also look at diet, lifestyle and levels of stress to assess the nutritional requirements for their clients.  This individualised assessment and treatment stems from the concept of bio-individuality - that there is no ‘one-size-fits-all’ approach when it comes to achieving optimal health.  Every client is viewed as a unique individual with highly individualised nutritional and energy requirements, body compositions, metabolism, backgrounds and lifestyles that all influence their overall health and the foods that make them feel at their best. 

It is important to note however that these are general guidelines and there will be dietitians who adopt more of a holistic approach as well as nutritionists that tend to adopt more of a dietetics approach.  

When looking for the appropriate practitioner for you it is important to ensure that the dietitian or nutritionist has a professional membership with an appropriate association.  This will ensure that they have the necessary qualifications, are held to specific legal and ethical standards and have ongoing Continuing Professional Education requirements.  

Some people may call themselves a nutritionist or nutrition consultant when they have in fact only undertaken a few nutrition subjects.  This is why it is imperative to ensure your practitioner is appropriately qualified so that you can be sure that you are dealing with someone who can provide you with the most accurate and up to date nutritional information. 

Stay tuned for Kate's next article in January. 

In the meantime, if you wish to get in touch with Kate phone  0423 493 330 or click the button below. 

In most cases, however, it is rarely recommended that they undergo rehabilitation, and will often be passed off as just a “sore” back, knee, or shoulder etc, in the hope that it will just get better with time. This is a frequent occurrence, and prolonging the intervention will in most cases eventuate into something more serious. Often people are unable to continue working, lose mobility and have to reduce their level of recreational activity for example sport, exercise, fishing, gardening.

With all injuries minor or severe, rehabilitation is needed for recovery. Missing early rehabilitation time frames for any type of injury can drastically decrease the likelihood of complete recovery. It can also drastically decrease the full return to all active daily livings, recreational activities, and life as they know it.

Early Allied Health interventions such as Physiotherapy, Exercise Physiology, Occupational Therapy and Podiatry after an accident, have been shown to produce greater recovery rates and significantly decrease the risk of long-term health issues arising from accidents. These interventions are not solely utilised for major injuries causing hospitalisation, but also seemingly non-sinister injuries including but not limited to strains, fractures, whiplash etc. Things such as a stiff neck and even a sore back can cause movement issues as well as wear and tear, and these relatively small issues can lead to major concerns in the long run. ^1,2

Rehabilitation treatments provided, do not have to be manual therapy “hands-on” treatment. Working on basic building block movements and providing education about injuries can be just as effective. Re-educating personal injury sufferers, on how to move correctly is vital when returning to normal daily activities pain-free. It is imperative that Mental stressors caused by injuries, can also play a vital role in recovery, and this needs to be addressed once again, as soon as possible. ^{3, 4}

In today’s society, 1 in 3 adults are not achieving the recommended physical activity, as well as 1 in 3 being overweight or obese. These statistics also represent significant negative impacts on quality of life and general overall health. If you combine these statistics with people not seeking help after an accident, then this is a recipe for disaster. ⁵

In general, people need to be physically active to help with quality of life, and this should be no different after a motor vehicle accident. Prescribed rehabilitation and physical movements can be all the difference between returning to work, regular pain free living and a long term healthy life. Don’t increase your stress levels after an accident by not looking after yourself. Early Allied Health has proven to be effective for everyone, and should be sought after as soon as possible!

Stay tuned for another article from the Doveston Health Team in January. 

In the meantime, if you wish to get in touch with Nathan regarding this article, physiotherapy after an accident or any other health-related issues, please visit the Doveston Health website or click the button below. 

Long-term outcomes of individuals injured in motor vehicle crashes: A population-based study. Alghnam S, Wegener ST, Bhalla K, Colantuoni E, Castillo R., 2015

Outcomes of motor vehicle crashes with fracture: a pilot study of early rehabilitation interventions. Brooke KJ1, Faux SG, Wilson SF, Liauw W, Bowman M, Klein L., 2014

Predictors of non-return to work 2 years post-injury in road traffic crash survivors: Results from the UQ SuPPORT study., Heron-Delaney M, Warren J, Kenardy JA, 2017

Delayed recovery in patients with whiplash-associated disorders.Dufton JA1, Bruni SG, Kopec JA, Cassidy JD, Quon J., 2012

The Lancet, Volume 384, Issue 9945 react-text: 64, Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013: 65 30 August–5 September 2014 /react-text react-text: 66, Pages 766-781

I can do one better and show you. Watch the video below where Dr Matthew Platz demonstrates what a typical back examination involves.

Chiropractors look for different movement patterns in the back which may show how a patient has been guarding their painful back and set up stiff joints and imbalanced muscle in an attempt to keep working with their problem. They may have been putting up with a problem for weeks and only come to the chiro when their medication stops working, their sleep is affected, or their partner is worried that they are not improving.

Chiros assess the neck, back and pelvis for joint stiffness and compare the patient’s current movement patterns in comparison to normal movements that a young person should be able to do and decide on the actual underlying cause for a patient’s pain or dysfunction or reduced sporting performance.

Chiros often see patients with back pain AS A RESULT OF guarding or adapting for a longer term hip or knee issue. The muscles that attach to the hip and knee often begin up at the pelvic area and begin to create stiffness and pain in the back when overworking to accommodate for a knee or hip issue.

Chiros work with hip, leg and knee problems as well to assist in settling the back issue.

Assuming that the problem is identified as restrictions or mechanical locking of key spinal joints, the treatment usually involves precise spinal manipulation and self-stretching at home to retrain spinal muscles and joints to move in efficient patterns. 

As symptoms improve and activities of daily living return to normal, increasingly challenging exercises are prescribed to help stabilise the spine and improve its capacity to do all that the patient wants to do. This differs from some other approaches that may give exercises earlier and may not allow the body to deal with the joint dysfunction part of the problem. Workplace advice such as desk set up and moving and exercise customisation completes the management plan.

Stay tuned for another article from Andrew in January. 

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Andrew and the rest of the team by visiting the Andrew Vincent Chiropractic website.

Andrew Vincent Chiropractic offer massage and nutritional support alongside their chiropractic services to ensure a whole lifestyle change is possible. 

Whether you have rolled your ankle, broken a rib or torn a ligament, your body goes through the same painful and uncomfortable process to repair itself. 

We sat down with Nick Marshall from Surf Life Physio in Miami, QLD earlier this month to get a better understanding of the recovery journey. Nick has over 17 years' experience as a physiotherapist, having practised both privately for his own practice Surf Life Physio and as a senior outpatient physio for Tweed Heads Hospital.

This article starts the first of three interviews on injury recovery. Nick gives his insights on the first 72 hours of an injury and provides tips on how best to manage this stage.

Keep an eye out for the next two articles on what happens after this initial phase and for Nick's advice on how to speed up the recovery process. 

Immediately following hurting yourself you enter the inflammatory stage.

You've injured yourself and now it's time for your body to fix itself by finding the damage, reducing further risk of injury and laying the first foundations for repair.

This is the period of time when the injury is sore all the time no matter what you do or how you try to carry the injured area. It’s the body's pathological protective response. 

Trying to describe the recovery process is confusing, jargon-filled and to be frank, a little boring. So, I let's look at the process through a real-world example. 

Let's take a house fire and call that our injury. The moment the fire is detected, the emergency services are dispatched. These being Fire, Police and Ambulance.

The body’s general response to this inflammatory stage is 72 hours. But largely what you do and how you behave during those initial minutes following the injury will dictate whether it is more or less than 72 hours.

This phase is generally represented by three symptoms:

1. Heat and redness: blood is rushed to the injured area to bring resources needed to repair the injury. This pools around the injury causing redness and heat. 
2. Swelling: this is often a result of fluid seeping through damaged blood vessels into the damaged tissues. These vessels are typically damaged by the initial trauma. In some cases, this will present as bruising. 
3. Pain: this is the big one. When you first sustain the injury, pain is caused initially by a chemical reaction that interacts with local pain receptors to warn your body you have sustained an injury. This is the pain we were talking about during the 'police' activities in this recovery stage. As you recover, the increased inflammation in the area may place pressure on nerve endings in the area, causing further pain. This pain will inevitably limit function, movement and activity.

There are a number of acronyms that can be used for treatment in this early inflammatory stage. But probably the best message is first and foremost ‘do no harm’.

To achieve this most health practitioners will advise the injured person to commence R.I.C.E.

It might sound strange given we talk about our immediate treatment being to reduce swelling with the R.I.C.E. method but we actually want to avoid anti-inflammatory medication in the first 72 hours.

Despite what so many people think, we actually need the body's inflammatory response and inflammation to start a healing effect. It’s this inflammation that brings all the building blocks of repair and without inflammation, an injury will not heal properly.

We want to reduce the inflammatory response to make it more comfortable but not remove it completely. 

Absolutely, you see it in elite sport when you are watching TV. The first person to an injured player on the field is the physiotherapist. If for no other reason than determine the level and extent of injury and then to make an educated assessment of the ability of the player to continue to play. It’s no different off the field. 

Quick and early identification, assessment and diagnosis of a person’s injury can better frame the rehab process as well as fast track a rehabilitation plan and return to work.

Check out the other parts in this series below.

Stay tuned next month for Nick's interview on stage 2 of the recovery process.

In the meantime, if you have any questions regarding these tips, injury recovery or other health issues please do not hesitate to contact Nick and his team at Surf Life Physio on (07) 5527 7830 or click the button below.

This is a very in depth question but I will do my best to keep it short and simple.

To understand that pain doesn’t equal damage you need to wrap your noggin around pain itself. Pain is, 100% of the time, an output of the brain. It does not come from the tissues but from the brain interpreting data and evaluating whether said data is harmful to you. Pain acts a protective mechanism. It is there to stop you doing dumb things and hurting yourself. The brains takes into account not only the signals from tissues, but also draws on past experiences, emotional state, current stress levels, thoughts, beliefs, attitudes…the list goes on. The brain and central nervous system (CNS) does an incredible job in processing all this data in an instant, but occasionally it makes mistakes and can give you the sensation of pain when really there isn’t any damage happening.

Tissue damage commonly goes hand in hand with acute pain, but not always. You sprained your ankle, it hurts like a b#$%* but typically heals up in a few weeks and you’re encouraged to stay active. On the flip side you can bend over one morning to tie your shoes and your back seizes up, again hurts like a b#$%* but it doesn’t necessarily mean tissue damage. You haven’t slipped a disc, there’s no nerve root compression it’s just painful and stiff, and takes a little time and TLC to get back to doing the things you love. The brain, for whatever reason, doesn’t like that bending move even though you’ve done it a thousand times before, and it locks up the low back. Tight muscles, stiff joints and super wired nerves can give you a great deal of misery.

There’s a really interesting case about a construction worker that ended up with a metal pole sticking straight through his boot. The guy was in agony, screaming the house down. They got him to hospital and cut the boot off. Turns out the pole had gone between his toes. Didn’t break any bones, didn’t even pierce the skin. Once he saw it he calmed down and very soon wasn’t feeling a thing. But because he thought he would have a gaping hole in his foot, his brain had conjured up the pain! Now ask him at the time and he would have sworn on dear old Nana’s life the pain was real, not in his head. This is a case of the brain misprocessing data, and creating the output of pain.

This is a very complex topic but there are some great Youtube videos that break it down nicely. Check out ‘Understanding Pain in less than 5 minutes, and what to do about it!’ and also ‘TEDxAdelaide - Lorimer Moseley - Why Things Hurt’.

In terms of severe low back pain, an almost countless number of things, but there are a few main ones we see at Queen Street Physiotherapy.

Here are the main nasties/red flags we look out for in low back pain.

There are other red flags which physio’s look for, but the above are the more serious ones that need urgent attention.

There are a lot of great products out there that can help ease back pain.

I personally love a hot pack and my trusty trigger point ball.

Heat can help locally at the site of pain, makes it feel warm and snug. But also can decrease the ‘pain signals’ getting to the brain by giving the nerves something else to report to the brain…in this case, heat.

My trigger ball also gets a good workout. Triggering tight musculature around the low back can help a lot. I go for my glutes and ITB, but also the bigger muscles in the back, QL and erector spinae. If you don’t know these you’ll need to be shown by your physio. And if the trigger ball is too intense you can use a foam roller instead.

If you missed last month's article from Queen Street Physiotherapy on whether exercise and movement is bad for back pain, check it out below.

Stay tuned for another article from the Queen Street Physiotherapy team in January. 

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Donovan and the rest of the team by visiting the Queen Street Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, podiatry, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.

Absolutely not. The right exercise has been shown hands down to be the best rehabilitation for just about any injury or niggle. The real question should be, ‘What is the RIGHT exercise?’ This is where things can get a little complicated and it’s like asking, ‘How deep’s a hole? Or how long is a piece of string?’ It really depends on you, your injury and your personal circumstances. At Queen Street Physiotherapy we can advise and guide you on the right types and amount of exercise.

But for a very basic baseline you want to exercise within a tolerable pain limit (i.e. it’s a bit sore but I can do the exercise without it getting worse) and you want to reach small milestones along the way. Typically that will reduce the swelling/inflammation, achieve pain free range of motion, gentle return to activity, then a full return to performance. And your activity or performance is very dependent on you. It might be rep level sport, or gasping for air in a PT circuit wishing it was time for that post workout cappuccino. 

For most acute injuries, typically 48hrs, but the consensus is evolving.

The old acronym RICE (say it with me…rest, ice, compression, elevation) has now been given a shiny new upgrade to POLICE (protect, optimal loading, ice, compression, elevation). And it’s the optimal loading part that’s key.

Early movement, early rehab, early exercise equals faster and better recoveries. The best example of this is a knee replacement. The morning after you’ve been cut open, bones and joint removed replaced with titanium then stitched back together again, you’ll have a nasty physio like me getting you to stand up and walk around…while you’re still drugged up, in your flattering surgical nightie and connected to a bunch of drips and beeping machines.

Why? Because we know it’ll be that much better later down the track.

In regards to getting back into exercise, whether you have been absent due to injury or you have just had a large break due to the hectic nature of life, the key is to take it slowly but keep it on a daily basis.

Generally we have all done some form of exercise at some point in our life, whether it was in a sporting team, a PE class at school, or a group fitness session.

The first place to start is by simply walking.  Increase your endurance and your physical capacities to handle 30 mins of brisk walking.  Stretches to your lower limbs should be performed prior & post walking that include stretches to your calves, hamstrings, quadriceps and gluteals.

If you are still unsure, the professional staff at Queen Street Physiotherapy can advise you on all your stretches or exercise program.

Not all lower back injuries have a singular diagnosis and a sequential rehabilitation program. Lower back pain management strategies need to be designed specifically for your particular injury and lifestyle. First and foremost, a physiotherapist can reduce your immediate pain with treatment including manual therapy, massage therapy and strapping. Alleviation of pain will be your paramount concern and is an important first step in your rehabilitation.  Physiotherapists can advise you on the duration of your rehabilitation and treatment needs, which will vary for each individual and injury. It is also important to be aware of the correct techniques for activities and daily living to support your injury throughout the rehabilitation phase. A physiotherapist can advise you:

Stay tuned for Phill's next interview in December. 

In the meantime, if you have any questions regarding this interview, treatment of back pain or other health issues please do not hesitate to contact Phill and his team by visiting the Queen St Physiotherapy website.

Queen St Physiotherapy offers ergonomic advice, custom made orthotics, running assessment, hydrotherapy, dry needling, remedial massage, exercise and stretching programs.

Cramps. They are the death of every cyclist. 

We have enlisted the help of Physiotherapist, Sean McCoola from Maximize Health Group to give us some tips on how to better manage cramps.

Sean brings experience to his clients from 18 years as a physiotherapist and has a particular interest in sporting teams and rehabilitation programmes.

Sean sat down with us earlier this month to give us his top 4 tips on stopping cramps. 

Take it away Sean.

At Maximize Health we are often asked by the cyclists we treat about cramps and how to stop them.

Below is a discussion and guide to what we have seen work over the years. The simple reminders below will enhance performance and aid general well-being and if you fit the pieces of the puzzles together for you, it may even stop cramps for your cycling endeavours.

Studies have shown that cramps are associated with high intensity activity and muscle fatigue. Yes, no proverbial Sherlock!

This directs you in the first instance to get your training and race plans suited to you and your current sustainable exertion level.  And then address other factors below including hydration, stretching, electrolyte balance and nutrition which are often quoted as areas to address to avoid the possibly devastating effects of cramping while out on the bike (e.g poor race performance, pushing the bike home), or after the event/training (jack knifing in the car when driving home from the charity ride).

My advice is to increase your awareness of when the cramps occur for you and then experiment with the factors leading up to the occurrence.

Sorry guys and gals there are often no quick and easy answers for the road warriors.

Hydration continues to be a major topic in the discussion of cramps. I take a wide gauge view at this and recommend that appropriate hydration needs to be an everyday activity especially if training loads are high and frequent and when coming into summer months and/or humid conditions. Some cyclists are heavy sweaters, and this loss in fluid is often associated as a major contributing factor to cramps. 

Hydration levels are imperative for optimal performance and getting this part of the puzzle to fit for you may also reduce cramps.

Another risk factor for cramping demonstrated in studies is low or irregular rates of stretching.

Don’t get too hung up on the bio-physiology but go by the rule that if muscles are tight (shorter than optimal resting position) and/or if they have trigger points (localised areas of increased muscle firing that resets and increases the resting tone of the whole muscle), this seems to increase the chance of cramping.

Optimal muscle length will also reduce discomfort and improve performance. Winning all round! Unfortunately some riders will just have to stretch and address trigger points more than others.

We all need electrolytes to maintain correct muscle function to help maintain life as we know it.

There is little scientific evidence stating that electrolyte levels play a significant role cramping.

Optimal electrolyte balance may assist in cramp prevention, but how much is enough?

Once again this will come down to experimentation for individuals. Test the various input options (Drinks, gels, salt tabs or food) for brand, concentration levels, timing etc.

There are now companies doing sweat tests for the salt/sodium levels in your sweat. But a general guide is if you have the white ring or streaks around your neck on your jersey after you ride you are possibly sweating out electrolytes, including, sodium/salt in higher than optimal levels, and this may need to be addressed.

What we put into our bodies leading up to and on race/training days may affect cramping incidence.

A balanced diet must help performance and general health and well-being. “Balanced” will mean different things to the individual and depend on physical and even mental load.

I believe the overall and longstanding aim is for you to give yourself the right amount of energy to fuel your body for tasks you are giving It, in acceptable input formats to promote continued health to train at your desired increased intensities for longer.

As always folks, tips like these may not be fully comprehensive for your situation and seeking out a health professional is a worthwhile exercise if cramping persists and is affecting your ability to bring your 'A' game.

This discussion is by no means exhaustive and there are many other cramp prevention strategies that may work for you (my Mum swears by camphor in a sock by your feet under your bottom sheet in bed overnight to prevent calf cramps).

What we have found over the years is that if you address the above factors and fit the pieces of the puzzle to your situation it will at the very least improve your performance and enhance your health and well-being.

Now on your bikes and enjoy.

Thanks Sean. Stay tuned next month for another article from Maximize Health Group.

In the meantime, if you have any questions regarding these tips, prevention of cramps or other health issues please do not hesitate to contact Sean on +61 7 3343 5494 or [email protected].