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Developed hip pain during your covid isolation? Avoid these 3 exercises!

Developed hip pain during your covid isolation? Avoid these 3 exercises!

Have you developed some new aches and pains or aggravated some old ones after following free online exercise classes? Or perhaps you have increased your normal activity level by doing more walking, running, stair or hill climbing to try and stay fit and healthy during the COVID-19 restrictions. At Physiotec, we have seen an increasing number of people who have developed or aggravated their hip pain during the covid-crisis. In fact, pain over the outer side of the hip is one of the most common problems we see. This is usually related to a condition called gluteal tendinopathy, also sometimes referred to as trochanteric bursitis.

There are some challenges with going it alone with a new exercise program. If you do have a pre-existing or new injury, how do you know:

  • which exercises or programs are the best options for you?
  • what are the correct techniques to use?
  • how do you make the exercise harder or easier if you need to?
  • how do you alter your program if you develop pain?

If you are struggling with any of these challenges, a physiotherapist can assist with either a telehealth or face-to-face consultation. For many painful conditions, good education and advice will help you stay active while minimising the risk of pain or injury.

For specific hip conditions such as gluteal tendinopathy or trochanteric bursitis, many factors influence the health of the tendons and bursae at the side of the hip. Either too much or too little stimulus may result in changes in tendon health and consequently, your ability to perform normal activities without pain. Too little load may be associated with a sedentary lifestyle where the muscles and tendons aren’t working enough. Too much load may be associated with a quick increase in activity (either a new or existing activity). Particular sustained positions or repetitive movements may also contribute to reduced tendon health or the development of pain over time.

3 Exercises to avoid when you have gluteal tendinopathy

 

So, who is most affected with this condition and why? 18% of the population aged over 50 suffers with this type of hip pain, and women are 3 times more likely to develop the condition than men. While the causes are often multifactorial, a change in hormones is thought to contribute to the development of tendon changes. A common story we hear from our patients is that there was an onset of pain associated with a combination of the following:
• Peri or post menopause and the associated hormonal changes
• Weight gain during this time, and
• A sudden increase in activity levels to counteract the weight gain

It should be said that changes in the health of tendons and bursae are not necessarily painful. Pain may develop if weakened tendons are unable to cope with their workload. Pain is often triggered by sudden increases in activity levels, where the tendons have not been given adequate time to adapt to the new loads. Examples include taking up a new sport or activity, or returning to activity after illness, injury or pregnancy. Going on holidays and walking lots of hills or stairs or for long distances along the beach may cause a problem. Sudden loads on the tendon during a slip or fall can also result in pain and injury, or a gain in weight may add more load to these tendons that support your bodyweight when standing on one leg.

How do you know if you have a gluteal tendinopathy or trochanteric bursitis?

Pain over the side of the hip due to gluteal tendinopathy or trochanteric bursitis

Do you have pain over the side of the hip with any of the following?
• Lying on your side
• Walking up hills or stairs
• Standing on one leg
• Sitting in low chairs especially with crossed legs
• Getting up from chairs and during the first steps

If you answered yes to most of these, you may have gluteal tendinopathy or trochanteric bursitis. The good news? Education and exercise provided by a physiotherapist provides an 80% success rate, with significantly better outcomes than a corticosteroid (cortisone) injection or a wait and see approach (i.e. basic advice and monitoring the condition)*. The even better news? Dr Alison Grimaldi was instrumental in the development of this successful program and all physiotherapists at Physiotec have been trained in the protocol.

We are now back in clinic for face to face consultations – if you have flared or developed hip pain (or any other pain), give us a call to book in! We are also still offering Telehealth consultations for those who are continuing to isolate or those who find it more convenient to attend an appointment ‘virtually’. You can read more about our Telehealth service here.

 

*Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, Wajswelner H, Vicenzino B., 2018. Education plus exercise versus cortico- steroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. May 2;361:k1662. doi: 10.1136/bmj.k1662.

4 tips for pain relief when you’re stuck at home

4 tips for pain relief when you’re stuck at home

1. Manage your stress

The effect of the COVID-19 pandemic has been devastating worldwide. We are lucky in Australia that the spread of illness is now being well contained. However, the social distancing measures have not come without a significant cost for many businesses, their employees and our way of life. Higher levels of stress are common and in the coming weeks, parents will also be juggling home schooling and many people will experience pain working at home.

Stress has a direct and marked impact on pain levels, so if you experience pain working at home and your normal achy neck or back is worse than usual, stress may be playing a substantial role. Often one of the first things you notice when stressed, is muscle tension developing around the neck and shoulder region. You may also feel tension developing in the lower back, particularly if you are sitting rigidly on the edge of your chair. Be sure to sit back in your chair and relax, allowing the chairback to support you.

When you are feeling overwhelmed or feeling tension and pain build in your neck or back, try some relaxed deep breathing. It can work wonders!

 

2. Optimise your home working environment

Many workers have had no choice but to make a rapid transition to a home-office, with less than ideal ergonomic set up. Pain working at home can result.

Good Desk Set Up

Problem: Using a laptop or tablet for prolonged periods will mean a poor neck angle and substantial increases in loads on the joints and muscles of the neck and upper back.

Solution: Organise an external monitor and/or keyboard, to ensure you can look straight ahead at your screen. These were in very short supply but are available again now.

Problem: Your desk and/or seat height may not be suitable.

Solution: Most people won’t want to invest in a new home set up for this temporary situation. But you can improve the situation usually with pillows, back supports, footrests and even bricks to alter the height of a low desk!

Aim to avoid situations where:
a. your knees are higher than your hips
b. your elbows are bent more than 90degrees

If you need a wedge cushion, decompression cushion or a back support, you can drop by the clinic to pick one up or we can organise delivery.

One of our physiotherapists can also check out your home working environment via a Telehealth video consultation.

 

3. Continue (or start) your Physiotherapy Rehabilitation Program

Don’t let this golden opportunity pass you by! Often our patient’s lives are so busy with all the events they must attend for work or family, that their home exercise program goes by the wayside. This makes it difficult to fully overcome a persistent pain issue.

Now is the time to attend studiously to your home program and get on top of those problems once and for all. This will help control pain working at home and it’s also very important for athletes to use this time to maintain or improve conditioning to avoid injuries when returning to sport.

Our physiotherapists are now transitioning back into the clinic after a short break with COVID-19 social distancing, so you can:

  • organise a check up on your program,
  • address a problem you have been meaning to attend to for ages or
  • put a plan in place to maintain your conditioning to prevent injury when returning to sport or your regular physical activity

PhysioTec Physitrack

We can provide assistance either in the clinic or with our telehealth service.

Telehealth is a video consultation. It allows us to assess your movement, check exercise technique, and tailor an exercise program for home. If you do not have an existing diagnosis for your painful condition, we’ll take a thorough history and step you through a variety of tests. This will help us determine what the main problem is.

The telehealth consultation also includes a free app with an individualised program. These exercises have video, audio and text descriptions available. On top of this, the in-app features also include tracking so you can check off your exercises daily and a messaging system to keep in touch with your physiotherapist.

Read more about Telehealth here.

 

4. Engage in regular exercise

We already know the important benefits of exercise, some of which include:

  • Positive effects for mental health
  • Weight control
  • Improved sleep quality
  • Prevention and management of a variety of health problems
  • Physiological benefits for the body, such as improving strength and mobility, which in turn help us to maintain independence.

Additionally, and perhaps most importantly right now, we know that regular physical activity decreases the risk of a person contracting a communicable disease (such as viral and bacterial infections). It enhances the ability of a person’s immune system to control itself. (Campbell & Turner 2018, Dominski & Dominski, 2020). Therefore continuing, maintaining or starting an exercise program is encouraged.

While the gyms and Pilates studies are closed, your options are to exercise outside or at home. There are many free exercise classes available online, but for those with previous injuries, be cautious. Some of these low-quality programs will not be suitable and may aggravate your condition or produce a new one.

Our physiotherapists can check your home exercise technique easily with telehealth , helping you control pain working at home. If you have gym equipment at home, Eric Huang, our strength and conditioning physiotherapist is very happy to check your lift technique and provide some ideas to vary or progress your program.

Eric Huang Telehealth Physiotec

Did you know?

Our Pilates instructors are also providing a high-quality Online Pilates service. Each class is run by one of our qualified Pilates Instructors and lasts approximately 40minutes. The classes focus on strength and conditioning exercises with the aim of keeping you moving and helping you maintain good functionality.

Physiotec Online Pilates_2020

Those who have already started these classes with Alice or Lisa have been loving them! Each class is limited to 4 people, and exercises are adapted for every client’s condition or physical fitness. The small class sizes also allow the instructor to monitor your form and posture, thus maximising your performance and safety.

Classes are priced at $20 per session, sold in packs of 5.

Call us on (07) 3342 4284 or contact us today to book in your free class trial!

 

 

References

Campbell, J. P., & Turner, J. E. (2018). Debunking the myth of exercise-induced immune suppression: redefining the impact of exercise on immunological health across the lifespan. Frontiers in immunology, 9, 648.

Dominski, F., Dominski, B. (2020). Exercise and Infectious Diseases – Covid-19. British Journal of Sports Medicine Blog, March 17, 2020.

Saturday Acute Injury Service

Saturday Acute Injury Service

Ever hurt yourself on a Friday night or Saturday and wished you could have your injury seen to? Did you know Physiotec now offers Injury Clinic every Saturday from 11:30am-1:30pm. One of our skilled Sports Injury & Performance Physiotherapists will be on staff every Saturday to cater for the acute injuries sustained during Friday night/Saturday. The right advice and early management makes all the difference. Get treatment/advice now. Don’t wait!!!

We also have a normal clinical service and pilates on Saturday morning, but reserve places with one of Sports Injury & Performance team specifically for acute injuries that require urgent assistance.

Why should I exercise during and after Pregnancy

Why should I exercise during and after Pregnancy

For Mums and Mums to be…

Have you ever experienced some pain in the pelvis  or in the hips during or after pregnacy?

Poor pelvic control or instability is a condition more common in women and is most likely to occur during or post –pregnancy.  During pregnancy, a hormone called relaxin is released in the body to allow the ligaments to stretch to accommodate the fast growing baby. With another human being growing rapidly, the pelvis does undergo an increase in loading, which some women cope with a little better than others – this can be due to genetic factors such as natural pelvic and ligamentous structure, or the background muscle conditioning you had prior to the pregnancy.

DON’T WORRY THOUGH…. remember that “instability” does not mean your pelvis is physically out of place but rather your muscles around the pelvis are not providing adequate’ force closure’ or mechanical compression or support around the pelvis while the ligaments are lax.

Who is more at risk of developing Pelvic pain due to pelvic instability?

Research has shown that  women who are involved in strenous work, or have a previous history of low back pain and a history of lumbo-pelvic (lower back and pelvis) pain during previous pregnancies are at risk. Although, direct trauma to the pelvis such as a fall can also result in pelvic instability.

How can Physiotherapy Help?

Use of Physical Aids

Physiotherapy can help by identifying the cause of the pain around the pelvis, whether it is originating from the lumbar spine or from pelvic instability. Off loading the pelvis may be important in reducing the symptoms such as using crutches or walking sticks. Tape or pelvic/abdominal belts  can also provide some compression around the pelvis, assisting with stability in the shorter term.

Postural and Movement Education

Being aware of movements or postures that may overload the pelvis, and optimising muscles support around the lumbar spine and pelvis are the most  important factors in managing this condition. Some specific advice on what movements or positions you may need to avoid or adjust can make a big difference in avoiding pain aggravation.

Specific and Appropriate Strengthening Exercises

Improving activation of the deep supporting muscles around the pelvis is also extremely important for providing dynamic control, so

despite laxity in the ligaments, your muscles can assist in compensating for the reduced support that ligaments can give during your pregnancy. Using real time ultrasound to train deep abdominals and pelvic floor muscles, and some of the deep hip/pelvic muscles are beneficial to someone who has pelvic instability. This is followed by a progressive strengthening program matched to the needs of the individual. Your physiotherapist can recommend appropriate Pilates and Pilates-based exercises as well as monitor your progress throughout your pregnancy and even after your pregnancy.

Transversus Abdominis Ultrasound At Rest
Ultrasound retraining of the abdominal wall – Transversus abdominis

If you are suffering from pelvic pain due to instability, see a Women’s Health Physiotherapist and get some good advice on pain management, training in deep muscle activation and an appropriate exercise program.

Image Courtesy of keerati of freedigitalphotos.net

References:

Vleeming et al. (1992). An integrated therapy for peripartum pelvic instability. A study of the Biomechanical effects of Pelvic Belts. American Journal  of Obstetrics. 166 (4): 1243-1247

Wu et al. (2004). Pregnancy-Related Pelvic Girdle Pain (PPP)I: Terminology, Clinical Presentation and Prevalence. European Spine Journal. 13:575-589