Sin categoría archivos - Osteofisio Marbella

Golf, neck pain and osteopathy

Golf, Osteopathy, Physiotherapy / By osteofisio marbella

In the last week I have seen a patient, a golf player, who had been suffering from neck pain on his left side for more than three weeks. The cause of the pain and its resolution motivated me to write this post relating golf, neck pain and osteopathy.

This patient, in addition to the pain, had restriction of some neck movements. The symptomatic treatment of this patient would have been aimed at relaxing the painful musculature with some manual techniques and stretching, which would have led to an improvement in symptoms lasting a few days.

Symptom treatment versus osteopathy

I always keep in mind the importance of treating the body as a unit, and that in many cases the place where our patients have pain does not match with the origin of the problem.

This way of thinking, typical of osteopathy, and the search for the cause of my patients’ discomfort has helped me to solve the vast majority of the problems that afflict them.

In order to achieve a lasting solution, I evaluated the structures related to neck pain and golf practice. And logically, the cause of the persistent neck pain became apparent.

My patient had a big retraction of the teres minor muscle due to overuse, apparently caused by poor swing technique.

This muscle retraction caused a decrease in the internal rotation of the shoulder, and at the same time conditioned the normal movement of the scapula.

This altered scapular mobility generated an exaggerated traction of the levator scapulae muscle on the cervical spine, causing neck pain that did not go away.

The left picture shows the teres minor muscle in orange; the right picture shows the levator scapulae muscle. In the centre, the directions of the forces of these muscles.

Treatment

Appropriate treatment of this muscle (teres minor) resulted in an immediate improvement of the neck symptoms, which continued to improve in the days following treatment thanks to the indicated stretches that the patient continued to perform.

At the same time I recommended to contact a golf instructor to improve the sporting gesture that initiated the muscular imbalance.

To summarise, we had a golf player patient who came to osteopathy with neck pain caused by muscle retraction away from the cervical area that did not improve over the days. Appropriate treatment produced an immediate and lasting improvement.

There are many other possibilities for golf-related neck pain, it is only necessary to assess each patient thoroughly to determine the cause and choose the appropriate treatment.

At Osteofisio Marbella we will be happy to assess your individual case and apply the necessary treatment to resolve the pain that is bothering you and at the same time improve your golfing performance.

“Relieving your pain is just the beginning, improving your quality of life is the goal”.

Leonel Díaz Coria

Physiotherapist ICPFA-certified – Osteopath

Muscle contractures: how to solve them.

Sin categoría / By osteofisio marbella

If you suffer from frequent muscle contractures, you are tired of them and would probably like to get rid of them for good, or at least for a long time. We will see how the osteopathic approach can help you.

We will be talking about muscular contractures not generated by a recent physical activity. We will talk about those contractures that appear without knowing why, until now.

Many patients come to my osteopathic practice because they suffer from certain muscular contractures for long periods of time, having not found effective solutions in previous treatments.

¿Qué tienes que saber de las contracturas musculares?

The first thing I explain to my patients is that muscles are not intelligent structures; they only carry out orders. Just as you hear it, they obey the nervous system, which regulates their activity.

When the nervous system sends the order to a muscle to contract, it will contract, and when it is ordered to relax it will also relax.

“A muscle is not intelligent, a contracture is”.

“A contracture is the body’s response to compensate for various problems”.

Why do muscle contractions appear and remain?

When a muscular contracture appears, and is maintained over time, it is due to several reasons:

it tries to protect a structure (organs, nerves, vessels, intervertebral discs, etc.).
it compensates for a postural alteration.
it avoids movements in an area where moving or moving too much could be detrimental.

Some examples: if someone has an intervertebral disc injury with a lot of pain and finds relief by leaning their trunk to the right, they will probably maintain that position. In order to do so, they need to keep certain muscles contracted and after a while they will start to ache. If someone tries to relieve the pain of these over-activated muscles by doing a local treatment, he will only get a momentary relief. When they start moving again, these muscles will be activated again to maintain the position that protects them from the pain caused by the damaged discs.

Another example: if someone has an unstable shoulder, their muscles will maintain an almost permanent contraction during movement in an attempt to protect that joint from excessive movement and further damage. If someone is trying to relieve the discomfort caused by this sustained muscle contraction, they will only succeed until the patient moves again. At that point their nervous system will tell those muscles to contract again to protect that joint. And the muscles will obviously do so.

Knowing that muscle contracture is the body’s response to compensate for a problem, it is easy to realise that if the treatment approach is only to treat that contracture, the problem will not be solved, and that the muscle contracture will quickly return.

By doing so, you will only feel temporary relief until the nervous system realises that the muscle or muscle group is not performing its assigned task and sends the order again to contract to meet its target.

What is the solution?

From an osteopathic point of view, the objective is always to look for and treat the cause of the symptoms. This is the only way to resolve the presence of a symptom without it recurring again and again.

From the initial assessment we can determine what the problem is that generates the symptoms for which each patient consults, and thus propose the appropriate treatment to resolve it.

As I always explain, treating a symptom without addressing its cause is like having a hole in a boat and taking care of getting the water out instead of fixing the hole….

“The solution is always to solve the cause”.

Physiotherapy and osteopathy in sports performance.

Sin categoría / By osteofisio marbella

For many years the work of the physiotherapist and also of the osteopath has been recognized in the sports field. But it is not always clear which is the main contribution of physiotherapy and osteopathy to sports performance.

In my opinion, there are five components that must work together with the same common objective in order to achieve an optimal athletic performance.

Five components involved in sports performance:

1. Athlete: is the main component, which contributes with his talent, effort and dedication to raise his level to the maximum of his possibilities.

2. Trainer: he is the one who administers and doses training loads.

3. Physiotherapist and osteopath: is in charge of making sure that the athlete is in optimal physical condition to face training and competitions without physical restrictions.

4. Nutritionist: is in charge of planning the necessary energy contribution for the individual needs, both for the daily feeding and for the food and liquid intake before, during and after the competition.

5. Rest: this must be restorative and of good quality and quantity.

Functions of the physiotherapist and osteopath:

Among the most well-known functions of the physiotherapist and osteopath are those of being part of the rehabilitation process after an injury, also is who ensures that the athlete returns to activity in optimal conditions and in the shortest possible time.

Other known functions of the physiotherapist and osteopath are both pre-competition preparation and post-competition therapeutic measures to ensure a rapid recovery in order to back to train as soon as possible.

Injuries prevention and performance optimization: less known but more valuable functions.

There are also other functions of the physiotherapist and osteopath that are closely related to the optimization of sports performance and injury prevention.

Currently, working with an athlete is not limited to waiting for an injury to occur and then working in recovery. On the contrary, the necessary measures are taken to act in a preventive way.

There are a number of functional sports assessments aimed at detecting risk factors in order to avoid injuries and optimize sports performance. It consists of making a detailed study of each athlete.

When I attend an athlete I make an exhaustive evaluation that includes: a postural evaluation, analytical and global mobility, flexibility, strength evaluation and force asymmetries between agonist and antagonist groups and also in terms of concentric and eccentric contraction, evaluate the stability of the CORE, a series of basic movement patterns, and finally the proprioception of lower limbs.

At the end of the evaluation I look for to determine in which system is the cause of the deficits. It is possible that the origin is osteoarticular, muscular, fascial, visceral, craniosacral, alterations of the motor control, propioceptive deficits, and so on.

Once the causes have been detected, all that remains is to decide and apply the appropriate treatment through manual techniques and the implementation of an exercise plan that aims to correct the causes of the alterations.

Physiotherapy and osteopathy can work in advance to enhance sporting performance. Excellent results are achieved with regard to injury prevention and also in terms of improving performance, since any factor that interferes with the execution of movements will be limiting the possibilities of development and sporting success.

Micro-traumas. Why are they so important?

Sin categoría / By osteofisio marbella

Most of the patients who visit our offices are due to the presence of some type of pain; from different parts of the body, acute or chronic, of greater or lesser intensity, and caused by different circumstances.

When I talk about the causes that led to the presence of pain or other symptoms, many are surprised to hear that most patients come for micro-trauma rather than trauma.

What is a trauma?

Empecemos por lo más fácil y conocido; un trauma es un golpe, caída o impacto de manera directa o indirecta que genera una lesión de distinta gravedad en la zona afectada. En la foto del levantador de pesas, es fácil reconocer el trauma en ese accidente, sufriendo un grave impacto en su columna cervical; y que lógicamente, no habrá sido la única parte de su cuerpo que sufrió ante ese accidente. Cuando ese deportista acudió a la consulta por su trauma, no cabe duda que habrá podido describir lo que sucedió y por qué presentaba dolor cervical, entre otras cosas. Aquel paciente que sufrió un trauma lo sabe, (salvo que haya perdido el conocimiento) y lo puede describir en la consulta. Tienen la suficiente intensidad como para que el paciente lo sienta en el mismo momento que se produce y que lo recuerde al llegar a la consulta.

What is a microtrauma?

On the other hand, those patients exposed to microtraumas, generally do not know it. Microtraumas are those inadequate positions, badly executed movements (they can be sports, work or daily life) or movements performed correctly and repeated an excessive amount of times. Then, in the example in the photo, it is very possible that that patient comes to the consultation for cervical pain or headaches, and that he does not know that it is due to the bad habit of talking on the phone holding it with his shoulder so that he can have both hands free and thus continue working while answering a call.

Micro-traumas are extremely aggressive to our body precisely because we do not identify them; and we do not identify them because they are not aggressive enough in terms of intensity to generate symptoms at the very moment they occur. They have a cumulative effect and will certainly produce symptoms at some point if they are repeated enough.

That is why in the first consultation I asked about what they do at work, how many hours they sit every day, what position they sit in at work, what position they sleep in, what sport or physical activity they do. All these activities have the possibility of being done incorrectly and of gradually generating postural alterations or injuries that in the day to day almost nobody perceives.

Personally I insist with my patients about adopting proper positions when working and performing repetitive movements. It would be useless to make treatments to solve symptoms without identifying and treating the cause that generated them, because that way the problem will reappear in a short time.

In other words, microtraumas are an invisible enemy (for most) that generate lesions little by little until symptoms appear, most commonly pain. To such an extent that they go unnoticed by many patients, that several times I have had to explain to a patient that his symptoms were due to inadequate sitting positions for so many hours a day (for months and years) and that they tell me: “it can’t be, I have always sat like this And that’s why it hurts now! It is a microtrauma, it will not generate symptoms immediately.

We have an advantage over micro-traumas

The advantage we have with microtraumas is that by knowing about them, we can prevent them from ending up with the appearance of symptoms. It is possible to improve positions in the workplace, make the necessary breaks to not end the working day in pain or correct the movements that are made improperly. With traumas, we often do not have the possibility of preventing them.

Mi recomendación es cuidarse en aquellas posiciones que se mantienen durante muchas horas todos los días y en las actividades que se repiten con mucha frecuencia. Ambas deben realizarse de manera correcta para evitar problemas futuros.