Today, our in-house chiropodist & podiatrist, Sarah Kerrane SCPI, talks us through Plantar Fasciitis Home Tips 

• Rest: it is very important to take a period of rest from weight bearing activity to allow the inflammation within the plantar fascia band to reduce. Therefore, avoid long periods of walking, running and standing.
• Footwear: Wear shoes that cushion the heel and support the arch and avoid wearing shoes that are too flat
• Avoid walking barefoot: this can cause sudden stretching of the sole which can cause further inflammation of the ligament
• Heel pads: You can purchase soft heel pads to place on the heel of all footwear to raise the heel and provide cushioning. You can also purchase simple insoles over the counter with cushioning for the heel and support for the arch.
• Medication: anti inflammatories, for example Ibuprofen, can be taken to help reduce inflammation and provide temporary pain relief. Also, the use of anti inflammatory gels and creams like Voltoral can be applied to the heel for the same effect.
• Massage: place a bottle of water into the freezer and let it turn to ice. Remove shoe and sock, and roll the bottle of iced water along the sole of your foot for 15 mins. This can work well to reduce inflammation and provide relief. Alternatively, you can use a tennis ball or a golf ball.

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Neck pain is very common. Today,  Chartered Physiotherapist, Rob Hanley, takes us through his top 3 stretches to help relieve neck pain.

 

Our Poor Necks

Our necks have it tough. We spend our lives in positions that our necks don’t really like; crouched sitting in front of computers, watching TV, driving, bent over browsing on our phones.

 Neck Pain is Common

It’s no surprise then that neck pain affects a lot of us, 70% of us, at some point in our lives. The real problem with it though is that up to 85% of us can get some degree of ongoing pain for many years after our first bout of it

 Top 3 Neck Stretches

So much neck pain can be prevented however. There are lots of exercises that can really help to keep our necks flexible and free. Here are my 3 of my favourites.

Note: Stretches must be pain free and never  provoke symptoms

Upper Traps Stretch

Great For:

• Tight trapezius muscles
• Pain when you look left and right

For this stretch, gently bring your ear towards your shoulder. Hold for 30 seconds.

 Upper Back Stretch

Great For:

• Loosing up a tight mid back
• Taking the pressure off the neck

 

For this stretch, a foam roller is really helpful, or a rolled up bath towel if you don’t have a foam roller. To do the stretch, place the roller between your shoulder blades and bend backwards gently to loosen out your upper back.

If you have medical conditions that cause you to bruise easily or have brittle bones, it is best to seek professional advice before doing this exercise

Front of Neck Stretch

Great For:

• Loosening out the muscles on the front of the neck

For this stretch, please see the excellent youtube video from rehabmypatient.com here:

 

We love these exercises.

If you would like to chat to our expert physiotherapists on your neck  problem you can contact us below. We’re happy to answer any questions you have.

 

 

 

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Today, our in-house chiropodist & podiatrist, Sarah Kerrane SCPI, Talks us through her top tips on how to recognise a verruca and how to get rid of it.

What is a Verucca?

A verruca is another name for a plantar wart, caused by the human papilloma virus (HPV).  Verrucas are a type of wart that affect the bottom of the feet. To view images of many different Veruccas you can Click Here.

How Do I Know if I Have a Verucca?

Verrucae present as one circular lump or a cluster of small lumps with overlying hard skin or callus and may sometimes contain small black dots.

• develop on the soles of the feet
• are white, often with a black dot in the centre
• tend to be flat rather than raised
• can be painful if they’re on a weight-bearing part of the foot

How Do I Get Veruccas?

Verrucae are very contagious and can be spread through direct or/ and indirect contact.

The most common areas to contract a verruca are swimming pools, gyms, locker rooms, communal showers (direct contact) and also sharing socks, shoes or towels’ with a person who already has the virus (indirect contact).

Verrucae can persist for years if left untreated and can sometimes cause pain.

What Can I Do To Get Verrucae Treated?

There are a number of treatment options available out there for verrucae, though no one treatment can guarantee a cure.

One very good option is salicylic acid which is a cream that is applied to the foot. We use a very strong version of this in clinic so it is excellent  for getting at the verruca.

Pharmacies also stock salicylic acid for you to put on at home. This can also be helpful but this is a much weaker form of the salicylic acid than we can use in clinic.

A third option is to see your GP. They can burn the verucca  over a number of session using liquid nitrogen cryotherapy.

Verruca Etiquette

 Do

√  Wash your hands after touching a wart or verruca

√  Change your socks daily if you have a verruca

√  Cover warts and verrucas with a plaster when swimming

√  Take care not to cut warts or Verrucas with nippers or scissors.

Don’t

X  Share towels, flannels, socks or shoes if you have a wart or verruca

X  Scratch or pick at warts or verrucas

X  Walk barefoot in public places with a verruca

 

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Today, our inhouse chiropodist & podiatrist, Sarah Kerrane SCPI, talks us through her top tips on how to recognise a fungal nail infection and how to get rid of it.

What is a Fungal Nail Infection?

A fungal nail infection, also called onychomycosis, in an infection of the nail.

It causes the nail to become discoloured and thickened. The nail may appear white, yellow, brown or black and may be easily lifted from its nail bed.

 

 

What Causes Fungal Nail Infections?

The main causes of fungal nails are sweaty feet, walking barefoot in swimming pools and communal showers, wearing occlusive footwear and sharing items with someone who already has the infection.

How Do I Get Rid of It?

Treatment of fungal nails can be difficult as the infection is in the nail bed, under the nail plate itself so it can be difficult to reach yourself

There are also a number of other nail conditions that can closely resemble a fungal nail infection; therefore it is important to be evaluated professionally by a qualified podiatrist

In clinic, we carefully file, bur and pair back the thickened toe nails.

There are also a countless number of over the counter products to help the paired back nail so we will advise you on the best compound for your foot.

 

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The Do’s & Don’t of Foam Rolling

Foam rolling is simply a phenomenal way to massage out your tight muscles at home. Chartered Physiotherapist, Rob Hanley MISCP, takes us through his do’s and don’t of foam rolling.

Foam rolling has been around for quite a while now and it has lots of great benefits. It can do so much for us including:

• Breaks down adhesions in muscles
• Increases circulation
• Helps muscle relaxation
• Improves joint flexibility

Those of you that have tried it before know just how good it can be but how uncomfortable it can be too. The benefits far outweigh the aches however, and here are my Do’s and Don’t of how to get the best out of your foam roller

The Do’s: 

• To begin with, keep it really simple
• Start with a soft foam roller and progress to a firmer one once you get used to it
• Be careful and go slowly, working into is slowly
• Remember to breathe and relax
• There are some great spots to foam roll from the arms to the mid back and legs. Here are a couple of great examples!

• • Glutes/ IT band

 

 

• • Quads

 

The Dont’s

Now that we have looked at the Do’s lets look at where we need to be careful when foam rolling.

• Foam rolling is often uncomfortable  but should never ever be painful
• Never roll over bruises, broken skin or swollen areas
• Be super cautious around body parts such as the
  • Lower back
  • Neck
• It’s not always good to foam roll for if you have certain medical conditions.
  • Get medical advice before you foam roll  it you have conditions such as osteoporosis, rheumatoid arthritis, blood thinning disorders or if you are pregnant.

Foam rollers are great.  If you would like to chat to our expert physiotherapists on how to use your foam roller contact us below. We’d love to answer any questions you have!

 

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In today’s blog Kevin Hartigan BSc. Physio, MISCP discusses the benefits of stretching and why it is vital to add a solid warm up to your workout.   Included below is a recommended video and a PDF from (Clinical sports medicine Brukner and Khan 2012 for added explanation).

 

Why Bother?

Doing a warm up prior to exercise, training or games can greatly reduce the risk of an injury, prepare you mentally and physically,  while also improving performance and enjoyment levels.

What Are The Key Benefits?

Some of the key benefits of a good warm up include:

• • increasing blood flow to muscles
  • increasing oxygen and energy release in muscles
  • increasing nerve speeds to muscles
  • decreased stiffness of joints & connective tissues
  • increased relaxation and concentration
  • all leading to……….reduced risk of injuries!!!

Components Of A Good Warm

So, how do you complete an effective warm up? A good warm-up up routine should follow the RAMP framework:

• Raise
• Activate and Mobilise
• Performance

Phase 1 – Raise

The aim of the ‘raise’ section is to:

• Raise/ Increase Body temperature
• Raise/ Increase Heart rate
• Raise/ Increase Breathing rate
• Raise/ Increase Blood flow to muscles
• Increase Joint flexibility

You can do this in any way you want to, with your goal being to break into a sweat after about 10 minutes. Start slow and gradually build up the intensity. Example exercises are:

• Jogging, cycling, skipping, etc

Phase 2 – Activate and Mobilise

The aim of this phase of the warm-up is to:

• Wake up the major joints used in the sport / activity
• Wake up the key muscle groups

Example activation and mobilisation movements include:

• Squats
• Lunges
• Balance work
• Planks
• Running drills
• Mini band routines

Phase 3 –Performance

The aim of this phase is to ‘prime’ you for the movements /activities involved in your session or sport. This part of the warm up should be focused on exercises which directly mimic your activity or sport, serving two primary objectives:

• Increase the intensity to a comparable level to which you are about to compete in.
• Improve subsequent performance

Therefore, the content of the performance phase depends very much on the sport activity you are preparing for.

So, for some examples:

Example 1:  Technical Rugby Session

• Plyometric exercises
• Short-moderate distance accelerations and sprints and (0-20m)
• Involvement of tackling pads and general contact work
• Game specific reaction drills – decision making, evasion in dynamic environment including contact work

If you want more information “Boksmart” for Rugby is excellent  Click Here

Example 2: From “GAA 15” for Gaelic games : Click Here

Example 3: From “FIFA 11+” for soccer

 

 

References:

Jeffreys, I. (2007). Warm-up revisited: The ramp method of optimizing warm-ups. Professional Strength and Conditioning. (6) 12-18. [PubMed]

Clinical sports medicine Brukner and Khan 2012

https://www.scienceforsport.com/warm-ups/#toggle-id-1

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Our feet support the weight of our body, so problems can lead to foot pain and affect the way we walk, and can even cause knee, hip and back pain. Therefore, it is important to seek help immediately for your foot pain by a chiropodist or podiatrist.

This month, our inhouse Chiropodist and Podiatrist, Sarah Kerrane talks to us about the most common causes of big toe pain.

Top 3  Causes of Big Toe Pain

Common causes of pain in the big toe are bunions, turf toe and sesamoiditis.

 

 

Bunion

A bunion is a bony growth on the base of the big toe joint. It is usually caused by tight footwear, high heels, flat feet or fallen arches and they can also be inherited from parents/grandparents. Treatment involves:

–       Wider footwear- this gives more space for the sore area so help relieve

–       Orthotics or custom arches- these can lift up your arch and give support to the bunion

–       Gel cushions to offload painful joint

–       Night splint

–       Toe exercises

–       In some cases, surgical removal of the bony growth

 

 Turf Toe

This is pain on the bottom of the big toe joint, where the ligaments of the big toe become sprained. This can occur due to overuse, stubbing the toe, bending the toe excessively, wearing soft shoes and playing on astro turf.

Treatment involves

–       Rest

–       Ice

–       Compression bandage

–       Elevate the foot

–       Taping the toe to take pressure off the joint

Sesamoiditis

The sesamoids are two small pea-sized bones embedded in the tendon on the bottom of the big toe joint. Sesamoiditis is when the tendons surrounding these bones become injured or inflamed. It occurs from impact like running, jumping or ballet or from flat feet.

Treatment involves

–       Rest

–       Ice

–       Padding/cushions to offload painful area

–       Taping

–       Wide low heeled shoes

–       Orthotics

 

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Rob Hanley, Chartered Physiotherapist at Total Care Physio loves learning from the best in the world. Today,  he reflects on working with some of world’s best runners and triathletes at Iten High Altitude Training Centre in Kenya.

High Altitude Training

As a Kerryman, I’m well versed in mountains but  Iten is a different story altogether. Located in Western Kenya at an altitude of 2400m, it is  well over twice the height of Carrauntoohil before you even lace up the runners.

It an ideal location for a world class training centre. 2400m is in the Goldilocks zone-  an altitude where regular training suddenly become much more difficult and where the body is forced to adapt.

Founded by 4 time world champion Lorna Kiplagat, it has that blend of expertise combined with great facilities, miles and miles of running trails and, almost as importantly, no distractions. Athletes come here to train and train hard. The view from the corridor outside the bedrooms says it all.

Good Technique is Vital

As a runner, I was interested to see what effect the altitude would have on me. I found that exercise was instantly more difficult, but over the days my body did get used to it. I quickly felt fitter and stronger.

As physiotherapist, I was keen to see some of the best runners in the world train. These guys and girls move, at a ferocious rate, but it is the grace and technique that really stood out for  me. A great reminder of just why great technique is so important, both to perform at the highest level and help prevent injury.

The Benefits of High Altitude Training

When we look at the research, studies disagree on how effective high altitude training is yet. Athletes come from all over Africa and Europe come to train at Iten, however,  and the list of world champions  that have passed through it’s doors is a long one: from Lorna herself to more recently David Rudisha and Mo Farrah. The athletes we met certainly had loads of first hand experience of just how beneficial this training can be, but I, for one, was exhausted!

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Chartered Physiotherapist, Rob Hanley, uses both acupuncture and dry needling in his daily practice. Here he takes us through the most common questions he gets on these two types of treatment.

 

20 years ago, dry needling was not a common service offered in Ireland. In recent years, the pool of research behind it has grown considerably and it can be very helpful in treating a whole host of problems. These are the top 5 questions I get asked each day on dry needling.

What is Dry Needling?
The history of dry needling began with the ground breaking work of Dr. Janet Travell and Dr. David Simmons. They discovered that trigger points or “knots” can exist all over the body and can be a crucial factor in many types of pain. They mapped these points and found they pressed on them with their hands, as a stronger technique, placed a very fine needle into the knot, they could release the tension and help relieve pain.

What is a Trigger Point?
A trigger point is a super tender point in a muscle, commonly called a “knot”. This area can become painful and can also send referred pain to other body parts in very predictable patterns. Good examples are trigger points in your neck can cause headaches or points in your back can cause pain in your legs.

Will it Hurt?
Generally, nothing is felt on inserting the needle. It’s just too thin. When the needle touches the trigger point or knot, many people describe it as an ache or cramping sensation but this is good.

Is it Different to Acupuncture?
It’s quite similar. The same, sterile needles are used as in acupuncture. Many of the points we treat are the same too but the technique of how the needle is used differs. Acupuncture tends to be a bit more gentle and there are some treatment points that are unique to acupuncture alone. For this reason, I like to incorporate both techniques.

What Problems Can it Help With?
Dry needling can benefit a whole host of conditions from:

• Muscle tightness
• Muscle pain & spasms
• Tendinitis
• Joint pain
• Low back & neck pain
• Sciatica
• Acute & chronic pain
• Headaches

Our Chartered Physiotherapists are experts in dry needling so we’d love to answer any questions you have. You can contact us by phone, email, or by dropping in to us in clinic.

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