Are you aware of your ability to balance? Do you incorporate balance practices into your daily or exercise routine? Do you know why is balance important?

 

⭐ Have you ever wondered why the Physio-Led Pilates Classes include exercises in standing, challenging your balance (which everyone just loves😆)? We'll you're about to find out! ⭐

 

What exactly does "balance" mean?

Balance is defined as the maintenance of an even distribution of weight which enables someone to remain upright and steady.

 

When do we need to rely on our ability to balance?

Our ability to balance is continually challenged - even with simple everyday tasks!

 

⚠️ Did you know:⚠️ we rely on our balance to keep us upright when sitting! Most of this comes from our core muscles and trunk control.

 

As we walk, each time we take a step we are balancing on one foot for a short period of time. When we run the time spent on one leg increases dramatically! As you can imagine, if you struggle with balancing on one leg, your body has to work a lot harder when you walk or run and this can make you more susceptible to an injury, particularly from the low back down.

 

 

Your balance is challenged even further when changing levels, e.g. going up or down a step, stepping off a curb or out of the shower/bath. If that’s not already enough, the even greater challenge to balance is standing/walking/running on an unstable surface. These unstable surfaces can be something as simple as a soft surface (e.g. a thick carpet, grass, sand) or an unpaved or cobbled road.

 

So how hard is it really to balance?

How hard does YOUR body have to work when doing a simple balancing task?

Well why don’t you give it a go to find out...try stand on one leg for 30 seconds. You might be thinking pfft that’s easy(!) but give it a go.... you may be quite surprised at the challenge!

If it is relatively simple for you...can you stand on one leg with your eyes closed? This not only assesses your balance but also your proprioception (your joints’ awareness of where they are in space). This is particularly important in preventing ankle injuries when it comes to stepping off a curb or playing sport.

 

⚠️ Did you know:⚠️ for adults over the age of 65, balance exercises are advised at least twice per week to reduce the incidence of falls and injuries.

 

Do balance exercises reduce injuries?

YES! The inclusion of balance exercises into a daily or exercise routine have been shown to reduce falls and injuries occurring.

⭐TIP: If you have osteoporosis it is particularly important to important to work on your balance to reduce the risk of a broken bone occurring from a fall.

Amongst the sporting population, including balance exercises in your regular training have been shown to:

• Reduce risk of ACL tears
• Reduce the risk of overuse knee and ankle injuries
• Reduce the risk of lower limb (hip,knee & ankle) sports injuries
• Reduce the risk of re-injury to the ankle

 

⚠️ Did you know:⚠️ balance exercises are included in professional sports training programmes, including the FIFA-11+ injury prevention programme for footballers!

 

So now you know why balance exercises are included in the Physio-Led Pilates Classes....p.s. I enjoy those exercises just as much as you do 😂

 

⭐TIP: There are simple ways to incorporate balance exercises into everyday life - next time you are brushing your teeth or waiting for the kettle to boil try standing on one leg!

 

 

Based on information from:

Hrysomallis, C. Relationship Between Balance Ability, Training and Sports Injury Risk. Sports Med 37, 547–556 (2007). https://doi.org/10.2165/00007256-200737060-00007.

Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008 Dec;56(12):2234-43. doi: 10.1111/j.1532-5415.2008.02014.x. PMID: 19093923.

 

Have you injured your knee? Is your knee now swollen or tender? Is the movement of your knee restricted? Can you walk?....Should you get an x-ray??

 

As clinicians we often use a screening test (the Ottawa Knee Rule) to help guide our decision making in whether or not to refer for an x-ray after a knee injury.

 

A knee x-ray is required in the following scenarios:

 

• You are unable to put weight through the leg for 4 steps after the injury occurs (limping is allowed).

 

OR

 

• You are aged 55 or over.

 

OR

 

• You have tenderness over the bony bump on the outside of your leg, just below your knee (head of fibula).

 

OR

 

• You have tenderness of your kneecap only (i.e. nowhere else around the knee is tender).

 

OR

 

• You cannot bend your knee more than 90 degrees.

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*It is important to note that this screening test is only valid for up to 7 days after the injury has occured.*

 

These guidelines are for clinicians to combine with their own assessment and clinical reasoning skills. They should not replace an assessment by a medical professional nor medical advice. These guidelines purely act as a screening test to help us rule out the possibility of a bony injury to the knee.

 

Did you know: x-rays are also often used to assess for arthritic change in the knee BUT they are not necessarily needed for a diagnosis of arthritis to be made (read more here).

 

 

Information based on:

Stiell IG, Greenberg GH, Wells GA, McDowell I, Cwinn AA, Smith NA, Cacciotti TF, Sivilotti ML. Prospective validation of a decision rule for the use of radiography in acute knee injuries. JAMA. 1996 Feb 28;275(8):611-5.

Bachmann LM, Haberzeth S, Steurer J, ter Riet G. The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review. Ann Intern Med. 2004 Jan 20;140(2):121-4.

 

Have you rolled over on your ankle or injured your foot? It’s more than likely sore, swollen and a combination of glorious colours!

How do you know if it’s just a sprain (soft tissue injury) or if there may be a fracture (bone break) involved?

 

As clinicians there are a set of guidelines which we use as a screening test to help guide our decision making in whether or not to refer for an x-ray after an ankle/foot injury. These are called the Ottawa Ankle Rules.

 

Going by these these rules:

 

An ankle x-ray is required if there is pain around the ankle area AND:

 

• You are unable to put weight through the leg for 4 steps after the injury occurs (walking with a limp is okay).

 

OR

 

• You are tender on either of the sticky-out bony bumps located either side of the ankle (particularly towards the rear of these bone bumps) or any bony tenderness above or below these bumps.

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A foot x-ray is required if there is pain around the middle of the foot AND:

 

• You have tenderness over the sticky-out bony bump on the outside of your foot (located about halfway between the outside of your heel and your little toe).

 

OR

 

• You are unable to put weight through the leg for 4 steps after the injury occurs (a limp is okay)..

 

OR

 

• You have tenderness over the bony bump on the inside of your foot (a few centimetres in front of the bony bump on the inside of your ankle).

---

 

It is important to note that these guidelines are for clinicians to combine with their own assessment and clinical reasoning skills. They should not replace an assessment by a medical professional nor medical advice. These guidelines purely act as screening test to help us rule out the possibility of an ankle/foot fracture.

 

 

Information based on:

http://www.theottawarules.ca/ankle_rules

 

 

Have you ever injured yourself? Did you know what to do?

 

My guess is you’re probably familiar with the age-old acronym of RICE or PRICE - Protect, Rest, Ice, Compression, Elevation. What you may not be so familiar with is the fact that this advice has now COMPLETELY CHANGED!

 

So what should you do now if you suffer a soft tissue injury?

Not to sound too hippy but PEACE & LOVE...yep I’m serious this is the most recent evidence-based advice!

 

For the first 72 hours after sustaining an injury, the following is recommended:

 

This has not changed from previous advice and guidelines. It is important to protect the injured area by giving it relative rest in the early days, by not engaging in activities or movements that evoke pain.

 

2. Elevate

Again, this is not new information and remains from previous advice. Elevation means keeping the injured area higher than your heart (if possible!). This should be done as often as is feasible for the first three days after injury.

 

3. Avoid Anti-Inflammatory Modalities

Inflammation after an injury is a good thing! Inflammation is a normal part of the recovery process and a necessary step towards healing. It is recommended to avoid taking anti-inflammatory medications, using anti-inflammatory rubs or lotions and using ice as they will all slow down the healing process.

 

4. Compression

Applying compression to the area - through the use of tape or elastic bandage - helps to reduce swelling in the first few days after injury.

 

5. Education

This one is really targeted towards healthcare professionals to educate patients that an active recovery is the best approach to dealing with an injury. Passive treatment like electrotherapy (ultrasound, laser, TENS etc), manual therapy (hands-on treatments) and acupuncture are not recommended in the early stages of healing.

 

 

After the first three days of healing the following is recommended:

 

 

1. Load

To promote recovery you will need to gradually load the injured area as you resume normal activities and exercise. Listen to your body and let pain be your guide.

 

2. Optimism

Be optimistic about your ability to recover! Your mind plays a strong role in the healing process - positive expectations are highly correlated with better outcomes.

 

3. Vascularisation

Pain-free cardiovascular exercise should be started from day 3 post-injury. Examples include: swimming, cycling, walking, running, using a crosstrainer etc. This will help to promote blood flow to the injured tissues to facilitate optimal recovery.

 

4. Exercise

There is strong evidence that exercise improves mobility, strength, balance and proprioception (an awareness of a joint in space) after injury. Pain can be used as a guide when progressing exercises. Maintaining activity levels and taking an active approach to recovery is key!

 

 

Did you know?

Treating a soft-tissue injury optimally in the early stages reduces the likelihood that it will persist and become chronic. If you do have a chronic injury or persistent pain this blog post may be of interest to you. 

 

 

Information based on: 

Dubois, B., Esculier , J. (2020). Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine; 54, pp. 72-73.