Whiplash is a common neck injury caused by a sudden and forceful back-and-forth motion of the head. We often see this in patients who go through a car accident, contact sports injuries (AFL, rugby or even Soccer), or falls. While whiplash is usually not life-threatening, we now know that it can cause persistent pain and discomfort, affecting daily activities. Therefore, it is important to understand its symptoms, causes, and the best exercises for recovery, which can help individuals manage and overcome this condition effectively. Common Causes of Whiplash Whiplash is a term used to describe a fast rocking motion of the cervical area and is most frequently caused by: Car accidents: Rear-end collisions are the leading cause, as the sudden force propels the head forward and backward. Sports injuries: Contact sports like football, boxing, or hockey but even AFL, Rugby or even Soccer increase the risk of whiplash injuries. Falls: Slipping and falling can cause the head to jerk suddenly, leading to whiplash. Physical assaults: Blows to the head or sudden jolts, such as those experienced in shaken baby syndrome, can result in whiplash. What are the consequences of Whiplash for the cervical ligaments? The consequences of whiplash for the cervical ligaments can be significant, leading to long-term instability and chronic pain. When the ligaments are overstretched or torn, they lose their ability to support the cervical spine, resulting in properly: Reduced Stability: Weakened ligaments can no longer provide adequate support to the cervical vertebrae, leading to excessive movement and an increased risk of further injury. That’s why stretching is not recommended either. Chronic Pain and Stiffness: Persistent discomfort may arise as the muscles attempt to compensate for the lack of ligament support. Increased Risk of Degeneration: Ligament damage can accelerate wear and tear on the cervical joints, potentially leading to conditions such as osteoarthritis. Neurological Symptoms: Instability in the cervical spine may irritate or compress nerves, leading to headaches, dizziness, or numbness in the arms. Symptoms of Whiplash Whiplash symptoms can range from mild discomfort to severe pain, and they often appear within hours or days of the injury. Common symptoms include: Neck pain and stiffness: One of the most prevalent symptoms, often worsening with movement. Headaches: Typically originating from the base of the skull and radiating toward the forehead. Shoulder and upper back pain: The impact can cause muscle strain in surrounding areas. Reduced range of motion: Difficulty moving the neck due to stiffness and discomfort. Dizziness and fatigue: A common reaction as the body copes with the injury. Tingling or numbness in the arms: Nerve involvement may lead to sensations of pins and needles. Cognitive issues: Some people experience memory problems, difficulty concentrating, and irritability. Those symptoms may not present all at once, and they can belong to other presentations, while whiplash did or didn’t happen anytime before. That’s why when we go through a clinical history taking, as Myotherapist, we take our time to dig into your past and your body habits, as this can give us important information about your current presentation and what we can do to improve it. Why Can Whiplash Become a Lifelong Issue? In some cases, whiplash can become a chronic condition due to the instability of cervical ligaments. Cervical vertebrae can be divided into two parts, Mobile and Stable joints. C1 to C2 are the mobile ones, whereas C3 to C7 are the stable ones. Now, if along a whiplash incident, the ligaments of either the mobile or, most luckily, the stable side get strained, the muscles surrounding that segment of the joint would have to work harder to maintain stability. This would lead to to ongoing discomfort, reduced mobility due to pain and muscle spasms, and increased vulnerability to future injuries. If left untreated or managed improperly, this is how the condition can become chronic and lead to other injuries along the way. Importance of Thoracic Mobility Thoracic mobility plays a crucial role in preventing the chain effect of mobility and stability issues between the thoracic spine, lower cervical, and upper cervical regions. If the thoracic spine is stiff or restricted, the lower and upper cervical spine must compensate, leading to increased strain and pain. Improving thoracic mobility through targeted exercises can help reduce this compensatory stress, allowing for better neck function and reducing the risk of chronic discomfort. In a case of a previous history of whiplash, maintaining good thoracic mobility would allow the cervical area to focus on its duties, so stability for the lower portion and mobility for the upper. Reducing the risk of overcompensation and muscle fatigue. Effective Exercises for Whiplash Recovery A structured exercise program is essential for whiplash recovery. This program should begin with isometric exercises to restore basic cervical movement, progress to concentric exercises to rebuild strength, and eventually include thoracic mobility drills to enhance overall spinal function. Phase 1: Isometric Exercises for Early Recovery. For the first 2 weeks post-injury, 5 to 7 days a week. Isometric exercises help activate muscles without excessive movement, providing a stable foundation for recovery. This step is essential to start driving more blood to the area irritated by the whiplash and also allow the central nervous system to feel confident in perceiving the cervical structure moving without pain. Isometric Neck Holds: Place your hand on your forehead and gently press against it without moving your head. Push only 25% of your strength, as it has to be a pain-free exercise. Hold for 5-10 seconds and repeat 5 times. These exercises can be done in any cervical movement, such as extension, lateral flexion, or rotation, by using your hand as a resistance and pushing always at 25% of your strength. The strenght of push does not ever progress, what you will progress within isometric exercises are the time fram of push, repetitions and sets. Phase 2: Concentric Strengthening Exercises. From week 3 post-injury onwards,3 to 5 times a week. Once the pain subsides, which we would expect to happen in 2 weeks about it, gradual […]
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Oct
At Melbourne Massage and Treatment in Fitzroy North, we frequently encounter clients dealing with tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis). These conditions can cause significant discomfort and limit your ability to enjoy sports and everyday activities. While they are often associated with repetitive arm and wrist movements, it’s essential to consider how poor shoulder mobility and stability can contribute to these issues. What Are Tennis and Golfer’s Elbow? Tennis Elbow Tennis elbow affects the outer part of the elbow, causing pain and tenderness on the outside. This condition typically arises from overuse of the forearm muscles, especially those responsible for wrist extension. Activities such as painting, or even prolonged computer use, or overstreching of extensor muscles can trigger this condition. Golfer’s Elbow Conversely, a golfer’s elbow affects the inner part of the elbow, leading to pain on the inside. This condition is commonly associated with activities that require gripping, flexing the wrist, or repetitive forearm movements, such as golfing, throwing, or lifting. In this presentation is the common flexor tendon that get’s irritated, and refer with pain. The Connection to Shoulder Mobility and Stability While tennis and golfer’s elbow are localized conditions, they often stem from dysfunctions higher up in the kinetic chain, particularly in the shoulder. Poor shoulder mobility and stability can lead to compensatory patterns that place undue stress on the forearm and elbow joints. Shoulder Mobility Limited shoulder mobility can restrict the natural range of motion for various activities. For instance, if your shoulders lack mobility, you may overcompensate with your forearm muscles during tasks that require reaching, lifting, or throwing. This overcompensation can lead to strain, resulting in conditions like tennis or golfer’s elbow. To maintain proper shoulder mobility, you want to ensure the use of the glenohumeral joint along your exercises and move it with specific drills, as this would stimulate the joint synovial fluid and maintain the joint lubricated. On the other hand, if the joint is hypermobile, we should look into how to stabilize it better. Shoulder Stability Shoulder stability is crucial for maintaining proper alignment during movement. Weakness in the shoulder stabilizers can cause the shoulder joint to become unstable, leading to altered movement patterns. When the shoulder isn’t stable, the body often compensates by engaging the forearm and elbow excessively, increasing the risk of injury. As mentioned in the paragraph above, this is what would occur when someone presents with a hypermobility body. In the hypermobility presentation, the ligaments are more lax and don’t hold back the joint movement as expected. Assessing and Addressing the Issue At Melbourne Massage and Treatment, we recommend a comprehensive approach to address tennis and golfer’s elbow effectively: Assessment of elbow epicondylitis Understanding the root cause of your pain is vital. During an initial consultation, we still mainly focused on your elbow presentation and addressed what movement reproduced the discomfort. But not only that. Throughout a tailored investigation, we will address what could be the root cause of the problem. This way, it would be easier to develop a tailored treatment plan. Treatment for elbow epicondylitis Massage Therapy: Targeted massage can alleviate tension in the forearm and improve blood flow, promoting healing. MDN: Myofascial Dry Needling plays a really effective role in tendinitis management. It focuses on targeting the underactive muscles, restoring the neural connection between the central nervous system and muscle, and desensitizing the painful area. Mobilisation: Mobilisation is an ideal technique to address mobility issue, and improve the range of motion of a joint. For epicondylitis presentations, the mobilisation could focus on wrist, elbow or shoulder. This would be based on the finding along the assessment. Strengthening Exercises: In the exercise program, we will initially focus on exercises that can desitentize the elbow area, such as isometric holds, and then move to eccentric and concentric exercises. In this second step, we would already focus on specific shoulder mobility or stability exercises, as needed. Education Understanding proper biomechanics can empower you to make lifestyle changes that prevent future injuries. Giovanni will guide you through exercises and techniques to maintain shoulder health and prevent elbow pain. Conclusion Tennis and golfer’s elbow can be debilitating, but addressing shoulder mobility and stability is key to recovery and prevention. At Melbourne Massage and Treatment in Fitzroy North, Giovanni is dedicated to helping you achieve optimal function and well-being. If you’re experiencing symptoms of tennis or golfer’s elbow, don’t hesitate to contact Giovanni or Book Now your 15-minute free phone consultation to learn more about a personalized assessment and treatment plan. Together, we can work towards getting you back to the activities you love, pain-free. FAQ Q: What are tennis elbow and golfer’s elbow? A: Lateral epicondylitis, affects the outer part of the elbow, causing pain due to overuse of the forearm muscles, particularly those responsible for wrist extension. Common activities that can trigger it include painting and prolonged computer use. Medial epicondylitis, impacts the inner part of the elbow, leading to pain often associated with gripping, flexing the wrist, or repetitive movements like golfing or throwing. Q: How are shoulder mobility and stability related to these conditions? A: Poor shoulder mobility can lead to overcompensation by the forearm muscles during activities requiring reaching, lifting, or throwing. Similarly, weak shoulder stabilizers can cause the shoulder joint to become unstable, forcing the forearm and elbow to work harder, which increases the risk of injury. Both factors contribute to the development of tennis and golfer’s elbow. Q: What are the signs of limited shoulder mobility? A: Signs include restricted movement during overhead activities, difficulty reaching behind your back, and discomfort during routine tasks that involve lifting or throwing. These limitations can lead to compensatory movements that stress the elbow. Q: How do you assess tennis or golfer’s elbow at Melbourne Massage and Treatment? A: We conduct a thorough assessment that focuses on your elbow presentation, identifying movements that reproduce discomfort. This investigation also explores potential underlying issues related to shoulder mobility and stability, helping us understand the root […]
Oct
Mobility is the degree to which a joint can move before being restricted by surrounding tissues. Not all the joints taught are considered mobility joints. The Mobility and Motility Joints Theory Starting from the big toes joint and moving up the body to the upper cervical joints, we can count one by one a mobility joint alternating with a stability joint. So this would be like this: Big toes – M. Metatarsal – S Ankle -M Knee – S Hip – M Lumbar -S Toracic – M Lower Cervical – S Upper Cervical – M Shoulder – M Elbow – S Wrist – M Tarsal – S Fingers – M The major differences are: A Muscular structure surrounds mobility joints Stability joints are surrounded by ligaments and tendons Mobility joints move in more planes than stable ones. The stability joints, indeed are essential to the body mechanics to ensure that gravity and force applied to the body by its own weight are well distributed. First thing first. Now, if we plan to strengthen our body, like by going to the gym, running or doing any sports activity, ideally we would like to ensure that the mobile joints can deliver the minimum required of ROM. Why? Well, if the mobility joints are stiff or not mobile enough, the priority of moving would not diminish and the stability joints, are going to do their best to compensate. But let’s see this with an example. Mark (name of fantasy) who is an office worker, spends about 40 hours a week at his desk, and to reduce the work and life stress decided to start a routine run 3 to 4 times a week for 1 hour per time. Mark thinks that to go for a run, you don’t need training and has no clue about the mobility, stability and strengthening chain. After a few weeks that is enjoying his new routine, Mark start experiencing knee pain. Mark also didn’t realise that due to the long hours of sitting at the office, his hips joint are tight, and his external rotators, such as the gluteus max and piriformis, are tight. As per consequence, when Mark stands up, the angle of the gate (AOG), which refers to the rotation of the foot in a standing position, is up to 4 toes per side. (3 toes is the max AOG we expect in the foot). Now, what happens next is that when Mark goes running, his ankle mobility and hip mobility are visibly restricted. So, he will lean forward with the upper body, by having tight hips, and strike the floor with the feet externally rotated, so all the body weight will be loaded in the middle of the foot. As a result, the Stability Joint that sits between the ankle and hip, so the knee, will compensate for the other two joint dysfunctions. In this case, the knees would take extra pressure medially and stretch out laterally. So, what should Mark do?! Well, initially, to stop the pain from happening, stopping running would be a good idea. Said so, that would not fix the problem. What Mark should do, is: Massage to boost the change within the tight joints and reduce the knee pain Start a mobility program to improve the Hip and Ankle functionality Exercises that aim to reduce tension in the external rotator reinforce the internal rotator (Gluteus Med and Min) Train on how to run These are the basic steps to implement a model of Mobility, Stability, and Strengthening. Does this model apply to other sports activities? Of course, it does. Visualise your body as a giant mechanical machine made of rope and hinges. The mechanical result will not be ideal if the hinges are stiff and the ropes are tight. To improve the result, each component needs to be looked after. So what message would be the most recommended? Along with Melbourne Massage and Treatment services, Thai Massage, Remedial Massage, and Myotherapy are soon the most recommended services Giovanni offers to improve the body’s mobility. Regarding mobility training, Thai Yoga is also an effective way to improve joint mobility, as these exercises focus primarily on improving joint mobility. What there is to consider is the patient’s presentation, medical history and pre-existent injuries. If there are no significant concerns, I suggest Thai Massage as the best approach. For people who have presentations such as Diabetes n1 or hypertension, Myotherapy treatment or Remedial Massage is mainly recommended.