The benefits of Cupping in modern massage therapy

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As a Manual Physical Therapist, I am constantly thinking about how to use my body mechanics in the most productive way for the treatment of my clients. This is also to ensure I have longevity in a career I love, and that my body can withstand the often heavy workload that is placed upon it by a physically demanding job. This has driven me to constantly update my techniques and search for tools that alleviate pain and relieve muscle tension in the most effective way.

I’m normally not a sucker (pun intended!) for gimmicks, and have to admit to previously being a little skeptical about the clinical application of suction therapy, or “Cupping” as it is more commonly known. This in turn has driven me to understand the process, benefits, and see why it is quickly becoming a popular therapy method in Singapore, Asia and beyond. Here’s a basic outline of the therapy, and its application in modern massage treatments.


What is Cupping?

Cupping originated thousands of years ago, and is one of the oldest forms of manual therapy (I’m not going to take you through its history - the internet is your library if you’re interested!). By placing a glass or a plastic cup onto the skin, the therapist creates a vacuum in the cup which draws the skin, muscle, and fascia up into the cup. This vacuum can be created with either a hand suction pump or a burning cotton wool ball. The latter is becoming less common in modern therapy due to the relative lack of control on the suction.

In Western medicine, Cupping is used as a direct clinical application. The therapist notes an area of restriction and applies the suction directly onto it to affect change. This is different to traditional Eastern methods which rely on affecting change in the line of meridians or “Qi” throughout the body. Used in conjunction with other massage treatments, Cupping is a useful tool to add into the treatment mix as it provides a different sensation and effectiveness, and thereby improving the overall results.

Cupping is used in the treatment of many types of muscle tensions, including common ailments such as neck pain, shoulder pain, tight trapezius, lower back pain, spinal congestion, and plantar fasciitis.

 Source: WSJ

Source: WSJ


What does Cupping feels like?

Contrary to the commonly-held impression, the suction of the cups does not hurt. In fact, most people find the sensation very pleasant, a sort of a release. The cups can remain in position for several minutes, or the therapist can glide them over the skin similar to the movements of a massage. This negative pressure is the opposite to a deep tissue massage – a pulling versus a pushing effect.


The Benefits of Cupping

  • Relaxation: suction cups provide a negative pressure on the skin, muscles, and fascia. This is in contrast to the positive pressure of the deep tissue massage, and can be a very relaxing and soothing experience.
     
  • Promotes blood circulation speeds up muscle recovery. The negative pressure from the suction allows new blood to flow into that area of tissue with several benefits -
    1. Provides a feeling of relief from physical and emotional tensions
    2. Begins the healing and regeneration process - the exchange of blood allows the removal of toxins and dead cells
    3. Enhances circulation
    4. Warms the skin, and softens tissues to regain elasticity
    5. Reduces inflammation


Useful applications of Cupping in massage therapy

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1. Cupping increases the blood flow and warms the skin, which makes makes it easier for the therapist to get into the ‘knots' in your muscles.

2.  Once the cup is removed, the skin relays information to the therapist about the underlying tissue. A darker patch on skin would indicate an area of restriction or adhesion in the muscles. It can then help the therapist to pinpoint exactly where to massage.

3. As Cupping is a less strenuous (but no less effective) form of therapy, it helps the therapist to prolong their ability to treat clients at a high level for a longer duration.

4. Cupping is used as part of a bespoke suite of massage treatments to improve your body’s condition, which could include deep tissue, stretch therapy, “Gua Sha” (explanation for another time!), and a combination of different techniques depending on what is needed.


Does it leave unsightly dark circles on the skin?

A good therapist will explain the potential effect of Cupping on the skin prior to treatment to get your consent. It is likely that there may be a resulting reddening of the skin directly under the cup, the colour of which depends on the health of the underlying tissue. Healthy tissues do not leave a dark circle.

The technique I use is to slowly move the cup over the soft tissue as I would in a massage, rather than leave it in one spot which is more common in TCM (Traditional Chinese Medicine). This method is less likely to leave dark circles on the skin.

 The Cupping method used in UFIT's massage therapy is part of a comprehensive treatment plan, and is less likely to leave dark marks that look like most of them here!

The Cupping method used in UFIT's massage therapy is part of a comprehensive treatment plan, and is less likely to leave dark marks that look like most of them here!

 

While I wish there is a better name for it, I have had great feedback and results from my clients after using Cupping Therapy, and I am now fully converted to its application!


ABOUT THE AUTHOR

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Lynsey Keyes is a UK trained massage therapist and certified in both ITEC and BTEC level 4 Massage and Anatomy and Physiology. Having spent 15 years working in high-pressure marketing roles, Lynsey embraced her ultimate passion in bodywork and uses her experience to help people overcome the physical and mental stresses of modern life.

She is a passionate believer that massage should be a part of our everyday lives to support our bodies in whatever challenge we put upon them; whether you are a professional sports person, have a sore back from carrying your baby, or simply need to release some tension from a day in the office.

Here’s what to look out for when choosing the right running shoes

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All we need to run, is a good pair of shoes. There is a myriad of factors that may influence your choice of running shoes. Well-meaning friends may advise you to choose shoes based on their own personal preferences and experience, but what works for them may not apply to you. Given that everyone has a slightly different foot structure (and not to mention the exorbitant costs of shoes these days), it is key that you choose the most appropriate shoes for your feet.

Here are 4 essential factors you should consider when getting your next pair of running kicks.


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1. SHOE WIDTH
Standing in a neutral position with your shoes on and your toes spread apart, your foot should fit squarely within the foot bed of the shoe. If your toes feel cramped against the sides of the shoe, the shoe fit is too tight. Some shoe brands such as New Balance and Asics manufacture shoes that are available in wider than usual sizes, known as 2E (wide) and 4E (extra wide). Shoes in these sizes will provide you with roomier insoles for extra comfort.

2. SHOE LENGTH
Your feet will normally swell up slightly after a run or at the end of the day, so it is advisable to go shoe shopping in the evening to maximise your chances of getting the correct shoe size. The general rule of the thumb (literally) is that there should also be a thumb’s width of space between your longest toe (usually the first toe, or second for some) and the tip of the shoe.  When you run, sweat that is produced may cause your foot to move more than usual in your shoe. Having that little space between your toes and the tip of the shoe prevents any unnecessary abrasions to the foot.

3. FLEXIBILITY
The shoe should bend along the same line as your big toe when it bends at the ball of your foot. In other words, the bending point of the shoe should be close to the bending point of your toes. You can determine the bending point of the shoe by holding on to the heel of the shoe and press the front part of the shoe onto the ground. If the bending point of the shoe is too far forward or backward from the bending point of your toes, this may cause you pain along the arch or at the big toe.

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A lack of flexibility in the shoe can also lead to increased tightness in the calf muscles when you run, as the foot is unable to move freely. Having said that, a shoe which is too flexible may also cause a strain on the muscles and ligaments in the foot due to repeated over-stretching.

4. COMFORT
Current research findings are moving towards the notion that so long as a shoe feels good when worn, it should work. For most people, this is identified as the subjective feeling of having support under the arch. Some shoes retailer allow you to test out shoes on an in-store treadmill. Test run the shoes first - if the arch of your foot starts to feel tight and sore after a short while, it probably means that the shoe is providing too much support. Instead, change to a shoe with less stability and more cushioning, and try it out again on the treadmill.

The key is to find a pair of shoes that allows your feet to feel comfortable in while running. Ultimately, the correct shoe for you should complement your natural stride, rather than change the way you run.


 The author Mok Ying Rong has represented Singapore in multiple international run meets. 

The author Mok Ying Rong has represented Singapore in multiple international run meets. 

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If you are suffering from a pre-existing injury from running, or even if you just want to improve your running efficiency, this is where physiotherapy can help you. A trained physiotherapist can assess your gait, and check for any strength imbalances which could be the root cause of your issues. With an appropriate treatment and rehabilitation programme under the guidance of a physiotherapist, you will be equipped with the skills and knowledge to choose the correct footwear  and optimize your running gait.

Choosing your shoes, though, is only the prologue. Your running journey only really begins when you step your foot out of the door!


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ABOUT THE AUTHOR

Mok Ying Rong is a physiotherapist with an intense passion in the musculoskeletal field. She utilises a holistic manual approach alongside an energetic desire to get people back to a pain-free status. Ying's niche is in analysing and treating issues related to the running biomechanics. 

Ying is also an avid sportswoman. She started off as a competitive swimmer before transiting towards triathlons, and finally establishing herself in the run scene. Her more memorable achievements include breaking the Singapore National Half-Marathon record in the 2016 Gyeongju Half Marathon, and representing the nation in the 2015 World Cross Country.

Ying's first hand sporting experiences allows her to relate better to people who are passionate about sports.

How to manage pain and stay injury-free

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It's so annoying to be injured. It stops you from doing what you want to do and brings a lot of discomfort with it. That niggling pain that bothers you every time you exercise, or the discomfort you have when sitting at your desk for hours on end. A lot of us will try to ignore the pain, hoping that it will go away with time or rest. Sometimes this works. You listened to your body telling you to take some time out to recover and HOORAY, you're back in the game. But sometimes this approach just won't kick it.

Understanding why you feel pain is the most important thing to do if you want to get rid of it effectively. One thing that's important to know is that PAINFUL doesn't necessarily mean HARMFUL. This doesn't mean to say that you should keep pushing yourself through the pain hoping it will just go away. What it means is that there may not be anything structurally damaged, but there is something happening biomechanically that your body just does not like. Injury can occur when there is altered stress on the body's tissues. The pain you feel in the body is your brain's way of telling you that something isn't right, like an early warning system.

How can we overcome pain? Rehabilitation is usually multi-faceted but to put it simply; we need to get the stiff bits moving and the bendy bits more stable.

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The thoracic spine is just one part of the body that we frequently see as being 'stiff' - this is likely to be due to the modern day lifestyle of sitting too much and spending too much time in poor postures. Doing regular thoracic mobility exercises and foam rolling the upper back will help to increase range and free your upper back up so that the lower back doesn't have to do all the work.

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Hips and ankles are two other common 'stiff bits', below are a few ideas of how to get them moving.

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Increasing stability and control in the relatively 'bendy' bits is equally important. This may involve increasing core and gluteal activation, strength and endurance of the deep postural muscles in order to create a strong and stable foundation from which to move. Combining the two approaches is a recipe for success, as long as you do your homework.

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This is just a little snapshot into what your rehabilitation may involve. So if you've got a niggling pain that just won't go away, or you think you could get a little more out of your training if only you could move a little better, book in a session with one of our physiotherapists for a full body check-up.  

For now though, consider these three steps to help you stay injury-free:

1. Progress gradually

Don’t ramp up your training too quickly, it’s just not worth it. Our bodies take time to change and adapt so be consistent and avoid loading spikes. For example, if you've had a week of rest from exercise, don’t expect to do more than you previously did, as large fluctuations increase the load on our joints and soft tissues. Follow the 10 percent rule: add mileage OR intensity by 10 percent or less a week, and do not increase both at the same time. Monitor yourself with a training App to show what you have done each week. Also remember overload can be brought about by a combination of lifestyle and training. If you have been overloaded at work, this will affect your training too.

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2. Recover well

Listen to your body. It needs time to recover, both mentally and physically. The micro trauma that occurs to the muscles and tendons stimulates further healing and growth, and this can only happen if they’re given a chance to rest and recover. If you start to feel a niggling pain, give yourself time to recover. Do not be afraid to adapt your training schedule to your needs. You won't lose fitness from taking one day off. Ensure your training programme includes recovery sessions - this can be swimming, pilates, yoga, or foam rolling sessions.

3. Strength and conditioning

We all have areas of weaknesses. An important component of any training plan is to make sure we have good flexibility, core stability, and strength. A dynamic strength and conditioning programme will target specific areas to help stabilise joints, promote postural balance, and improve muscle performance and efficiency. It helps the body tissues to become used to higher levels of loading, enabling them to deal with the increased demands of training and competing, therefore minimising the risk of injury. In essence - get the stiff bits moving and control the bendy bits!

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When you have an injury that just won't seem to go away, see a physiotherapist who can assess different predisposing factors such as your biomechanics, alignment, muscle strength, muscle length, and motion control. Get this – often the source of your pain may not be where you feel it. At UFIT Clinic we don't just prod and poke the bit that hurts in the hope that the pain will go away. Our physiotherapists are highly skilled in assessing body biomechanics in order to fully understand how your body moves and why certain activities or postures are causing you pain. Book an assessment with us to find out more!


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ABOUT THE AUTHOR

Lucy Warren is a Physiotherapist and Pilates specialist from the UK. She has a first-class honours degree in Physiotherapy from Cardiff University, and is also an APPI-trained matwork instructor. Lucy has extensive sports experience with professional and semi-professional teams and athletes, having provided pitch-side physiotherapy for multiple elite sport teams in the UK. She has also worked for the British Army for two years, assessing and treating infantry soldiers and helping them to rehabilitate to peak fitness. 

Lucy taught matwork Pilates for several years before making the transition across to Reformer Pilates. Lucy loves using the Reformer and other Pilates equipment with her clients in order to achieve their specific rehabilitation goals. She believes that it is an incredibly versatile tool which can lead to daily life improvements like better posture and more efficient movement, as well as relief from pain associated with physical imbalances.

In her own time Lucy is a keen netballer, skier, and loves to travel new places.

Effective ways to relieve a Migraine

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If you suffer from terrible migraines, you are not alone. Migraine is the third most prevalent illness in the world affecting an incredible 1 billion people worldwide!

Migraine is a neurological condition that can be episodic or chronic. It usually starts with a severe throbbing in the neck or at the side of the head, a searing pain that can shoot straight up into your skull. Often it is accompanied by nausea, vomiting, dizziness, visual disturbances, tingling in the extremities, and hypersensitivity of the senses. Attacks can last between 4 to 72 hours.

What does a migraine feel like?

I am lucky enough to never have to suffer from a migraine. And unless you have, you will never know exactly how debilitating, disorientating and downright vomit-inducing it can be. Descriptions such as these can give you an idea:

“Like a vice around my head, with stabbing behind my ears and pressure behind my eyes. Pull the shades, lie down, don’t move.”

“It’s like having your head compressed by a two-ton brick while someone hits your temple with a hammer at random intervals.”

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During an attack, you most likely do not want anyone to touch you or even come near you. You just want to take a prescribed painkiller, and ride it out in a dark room. Are you tired of this routine, and looking for a more effective pain-relief solution?

Relieve migraine with massage therapy

When you’re coming out of an attack, getting a massage can help to relieve the pain immensely. Massage has been proven to help reduce muscle spasms, improve circulation, relieve tension and vascular headache pain, and promote relaxation. In fact, a twice-weekly 30-minute massage has proven to be effective against migraine attacks in a study conducted over 5 weeks.

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Deep tissue massage can help to ease through any areas of muscle or fascia that have become tight and restricted as a result of the migraine pain. These are the spots that a well-trained and experience massage therapist will focus on:

1. Neck and Shoulders

The neck and shoulders are the most common areas of tension. Migraines can cause these areas to become tight and rigid, and as such would benefit from deep, slow strokes. Even by simply lifting the weight of the head for a few minutes, the muscles in the neck are given enormous relief.

2. Head and Skull

Tension is also often felt in the jaw and temples. A face massage should never be underestimated for the relaxation it can bring. The 43 muscles in the face can become extremely tense and contorted during an attack, and the numerous pressure points in the skull mean that a gentle ‘hair wash’ approach on the skull can feel like heaven.

3. Hands and Feet

As they are less directly related to areas where migraines are felt, massaging hands and feet can be an extremely effective and accessible area to treat when a sufferer is feeling unwell.

 

D.I.Y. Massage for Migraine Relief

If you are feeling the onset of a migraine, a D.I.Y. massage on these 4 pressure points will help to relieve the pressure in your head. Press a finger down firmly on each of these points for a few seconds, and release slowly:

2. Between your eyebrows

1. Base of your skull

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4. Between your big toe and second toe (at the top of your foot)

3. Between your thumb and index finger

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The right massage therapist will be able to work out the what, where, and how to massage in order to relieve your migraine symptoms. One person’s migraine symptoms might differ from another, so there is more than one prescribed pattern for treatment. I recommend having a massage soon after your attack has subsided, and also schedule regular inter-migraine massages to prevent further attacks. Don’t wait until the next horror!


About the author

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Lynsey Keyes is a UK trained massage therapist and certified in both ITEC and BTEC level 4 Massage and Anatomy and Physiology. Having spent 15 years working in high-pressure marketing roles, Lynsey embraced her ultimate passion in bodywork and uses her experience to help people overcome the physical and mental stresses of modern life.

She is a passionate believer that massage should be a part of our everyday lives to support our bodies in whatever challenge we put upon them; whether you are a professional sports person, have a sore back from carrying your baby, or simply need to release some tension from a day in the office.

Are you a “Weekend Warrior”? 8 tips to avoid common exercise injuries

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Let’s set the scene – it’s the weekend! It’s been a long week at work with lots of disruptions and sleepless nights. You had a couple of drinks the night before and had less than 6 hours of sleep. But no problem! You just want to get outdoors and smash an intense workout to get those positive endorphins running.

Warm up? That’s boring. Foam-roll? Nah, haven’t got time for that! Take an electrolyte drink? Hmm, I’m fresh out of my supply. But it’s okay, just get into it. What’s the worst that can happen, right?

Ten minutes into your run, you are starting to feel a little ‘niggle’ in the muscle. But it’s okay, just keep going. Two minutes later, you sprint round a bend…and BAM! A sharp pain in your ankle. Or you’re on your last heavy deadlift…and AGH! Your back!

These are what we at UFIT Clinic like to call the “weekend warrior” injuries – afflictions caused by poor preparation, fatigue, or overload.  Here’s the top 5 most commonly seen injuries at the clinic on a Monday morning, and the steps you can take to avoid them.

 UFIT Clinic's team of physiotherapy, osteopathy, and sports massage therapists.

UFIT Clinic's team of physiotherapy, osteopathy, and sports massage therapists.


1. Ankle sprain

This is usually caused by rolling the foot inwards during some form of impact. This inward motion can cause one or multiple ligament sprains of varying degrees, with a lot of swelling, bruising and surrounding tissue damage.

Estimated recovery time: 2 - 6 weeks

2. Hamstring strain

This occurs most frequently in sports with explosive movements such as sprinting, soccer, and weightlifting. We also see injuries due to gradual overload, usually in runners or cyclists. Pain, visible swelling and bruising usually behind or around the back of the knee is commonly experienced.

Estimated recovery time: 6 - 12 weeks

3. Shoulder tendon injuries

Your shoulder tendons are the end parts of the muscles that is attached to the bone, and these guys are very sensitive to load and compression. Shoulder tendon injuries can be caused by poor seating posture at work, or wrong technique during exercise, leading to inflammation, sharp pain and reduced range of motion.

Estimated recovery time: 6-12 weeks, and sometimes even up to 6 months

4. Sharp lower back pain

Sudden onset of lower back pain is a very frequent injury is one of the most common injuries we see every day in the clinic. Your spine is a very strong structure made up of lots of tissue including bones, joints, muscles, tendons, ligaments, nerves and fascia. When any one of these structures are injured due to incorrect posture, poor technique, or weight overload, you get lower back pain.

Estimated recovery time: Usually 6 weeks, unless something more serious is involved such as an intervertebral disc or nerve injury, which may take longer.

5. Tennis or golfer’s elbow

You don't need to play either sport to be afflicted with this condition. The most common cause of elbow pain is a weakness at the wrist, leading to an overloading of the forearm muscles and the elbow tendon. Incorrect shoulder and wrist movements in sports such as tennis, golf, and weightlifting can also cause elbow pain.

Estimated recovery time: 6-12 weeks depending on how aggravated the elbow tendon is


8 ways to stay injury-free

 

1. Build your training up slowly

 Don't rush through your workout, listen to your body and go at your own pace.

Don't rush through your workout, listen to your body and go at your own pace.

If you’ve just returned from a break, holiday or rest period, then you need to consider gradually increasing you training appropriately. For example, if you just started to train for a marathon after a long period of inactivity, don’t begin by running 5 days in a row.

2. Warm-up properly

 Take the time to warm up properly before any exercise.

Take the time to warm up properly before any exercise.

Before jumping straight into your workout, make sure you do a dynamic warm up where you actively move your muscles to wake up your nervous system. Even a 5 minutes warm up routine can drastically reduce the chances of an injury.

3. Follow an appropriate training program

 Join an exercise group led by a certified instructor to get the most out of your workout.

Join an exercise group led by a certified instructor to get the most out of your workout.

When training for a particular event or race, it’s a good idea to follow a training program or join an exercise group to help you stay on track of your progress.

4. Focus on correct technique

 Improve your running foam and performance with a  Running Gait Analysis  at UFIT Clinic.

Improve your running foam and performance with a Running Gait Analysis at UFIT Clinic.

If you are new to an exercise, it is advisable to consult a coach, or a physiotherapist to learn the correct technique, proper form, and movement pattern in order to avoid injury.

5. Self-maintenance

 A sports massage session after a workout can work wonders on those knots.

A sports massage session after a workout can work wonders on those knots.

Don’t like foam-rolling and stretching? Then we would highly recommend you to book yourself in for regularly massages or body work sessions with a physiotherapist to keep all the muscles limber and the joints mobile so that you can continue to exercise injury-free.

6. Stay hydrated

 Make sure you drink enough water, especially when you're working out under the sun.

Make sure you drink enough water, especially when you're working out under the sun.

Our muscles, fascia and connective tissue are mostly made up of water, so when the body is dehydrated we are at a higher risk of sustaining a soft tissue injury. Making sure that you drink between 3-4 litres of fluids daily, and take a electrolyte supplements to combat what we lose through sweat, especially if you love exercising outdoors. A simple tip is to have a glass of water before bed, one glass in the morning, and continue to sip water or electrolytes throughout the your exercise.

7. Get adequate sleep

 Put your phone away from your bedside - the blue light from mobile devices can affect your ability to get enough sleep.

Put your phone away from your bedside - the blue light from mobile devices can affect your ability to get enough sleep.

Research has shown that inadequate sleep can leave you susceptible to increased exercise injuries. So having a late night on Friday ahead of a rugby match on a Saturday morning might not be the best plan. Plan your social and exercise calendar in advance to ensure you are getting at least 7-8 hours of sleep a night.

8. If you are experiencing pain, stop!

 Learn to tell the difference between a muscle ache and pain from overexertion.

Learn to tell the difference between a muscle ache and pain from overexertion.

Mild muscle aches during a hard workout session is to be expected. But if you are experiencing a different type of pain that you’ve never felt before, then stop immediately. Do not push through pain, as doing so might complicate and add on to the original injury. If in doubt, consult you physiotherapist. They can help to assess, diagnose and treat the injury appropriately.

Practice these 8 tips to stay injury-free and become an “everyday warrior”!


About the author

Máire is a senior physiotherapist at UFIT Clinic specializing in sports injuries and rehabilitation. She has a Masters in Physiotherapy in Queen Margaret University, Edinburgh, and has worked with a number of amateur and professional sports teams, including the Irish national basketball team.

Máire is also an avid runner and competes regularly in Singapore, often placing on the podium. As an APPI (Australian Physiotherapy and Pilates institute) and Balanced Body trained pilates instructor, Máire uses the principles of pilates clinically when treating runners as well as in her own recovery, and believes that it has contributed to her injury-free running career.

 

QUALIFICATIONS 

  • BSc (Hons) Athletic Therapy and Training (Dublin, Irl)
  • Sc Physiotherapy (Edinburgh, UK)
  • Kinesio® Tape Application Certified
  • Australian Physiotherapy & Pilates Institute Mat Certified
  • Balanced Body Reformer and Equipment based Pilates Trained
  • OMT Dry Needling Practitioner 

Frozen shoulder – How to let it go

A chilly explanation

So what exactly is frozen shoulder? Current research suggests it is characterized by a change in the joint capsule and certain ligaments within the shoulder causing them to lose their elasticity and become very stiff hence the term ‘frozen’. The pain may be a result of the inflammatory process and the chemicals released while this is happening. But it could also be attributed to a host of other causes.

  (Source: MMG, Inc. 1996)

(Source: MMG, Inc. 1996)

Diagnosis - the cold facts

  • Did the pain came on gradually in the shoulder or upper arm with no significant trauma?
  • Is the range of movement reduced - notably into flexion (straight up in front) and external rotation (with the elbow bent at the side, rotating outwards) even with someone assisting you with those movements?
  • Are you unable to lie on the side of your affected shoulder?
  • Did the pain run in a pattern from “pain-predominant” - where it is more painful than stiff, to "stiffness-predominant” where it is more stiff than painful?
  • Have you had an X-ray that cleared the pain of other possible diagnoses?
 UFIT Senior Physiotherapist Daniel working on restoring shoulder mobility with a client.

UFIT Senior Physiotherapist Daniel working on restoring shoulder mobility with a client.

Frozen shoulder is technically a diagnosis of elimination. If you are showing the signs and symptoms, our investigation must eliminate all other likely reasons for the frozen shoulder diagnosis to be accurate. For example, Elsa is experiencing terrible shoulder pain, and is unable to lift up her arm, rotate it out to the side, or lie on it.  But after getting an X-ray, she discovered that the pain is actually caused by a joint fracture and rotator cuff tear, with the same symptoms of a frozen shoulder.

Osteoarthritis, joint fractures, rotator cuff tears, and shoulder dislocations all produce similar signs and symptoms. So if you suspect your shoulder pain might be due to a frozen shoulder, make sure you see your doctor to rule out other possible causes.

Don’t be a snowflake, get expert advice

If you suspect you have frozen shoulder, get down to see your doctor or a physiotherapist and get it checked out. It is uncommon to require a surgical intervention, as studies have shown that conservative measures such as a graded exercise program produce the best results. However, there may be other things the doctor can recommend to ease the pain.

If you've already been diagnosed with a frozen shoulder, the best advice would be to see a physiotherapist, who will recommend an individualized rehabilitation program to guide you through the stages of your condition.

 Don't self diagnose - see an expert if you are experiencing pain!

Don't self diagnose - see an expert if you are experiencing pain!

In the meantime don’t freeze, do something about it

Learn how to manage the pain. Pain is a very complicated and multi-faceted phenomenon. Understanding how and why we feel pain will help you to deal with it.

Modify your activities. This can be as simple as switching the hand you use to reach for the seat-belt. List down all the activities that causes discomfort to your shoulder, and try to think of different ways you can modify the activity. This will save you  from a world of discomfort.

Get more pillows for the bed. If it is uncomfortable to sleep at night, prop your upper back and arm up with pillows so that you can get a better quality of rest.

Exercise. Gentle exercises such as "hanging shoulder rolls" and the "pendulum arm swing" can help to relieve the discomfort, and is also a good way to kickstart your journey to regain full range of movement.

Be patient, and pace yourself. If you try to rush and overdo the rehabilitative work, it may negatively affect your condition tomorrow. So be conscious of your abilities to avoid aggravating the pain.

About the author

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Daniel Arthur is a Senior Physiotherapist from the UK currently working at UFIT Clinic in One North. He brings over 8 years of experience working with the UK National Health Service, private health clinics and premiership sports clubs.

Instagram – Thefightingphysio

 

Beat lower back pain: an expert opinion

Lower back pain is common. Over 80% of us will suffer from it. Unfortunately, there is a long-held view that lower back pain is usually caused by something mechanical, and can only be resolved with surgery. In most cases this is not true. There are many things that you can do on your own to alleviate the pain, without having to go under the knife. Our body is a remarkable instrument that is capable of recovering on its own, given sufficient time.

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Physiotherapy and rehabilitation can help you manage and recover from lower back pain, through a mixture of mobility and strengthening exercises.

If you have been experiencing intense lower back pain regularly, manual therapy and soft tissue release can help to reduce pain and facilitate movement. It will not be an easy journey. There will be sweat (lots of it), there may be tears (I can’t promise they won't be mine!), and there will likely be setbacks. These are normal, recovery is usually not linear and pain is not predictable. But at the end of that journey, you can be satisfied that you have earned your recovery. Not only that, you will become fitter, stronger,  and better equipped with practical and effective knowledge to avert pain in future.

An MRI scan is not always necessary

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An MRI scan is useful if you are planning a surgery, as it gives the doctor a good overview of your anatomy. It is also useful if you are displaying certain neurological symptoms, such as progressive leg weakness or a loss of bowel control. Your doctor and physiotherapist will screen for these conditions, which may indicate certain pathologies. In the absence of these, your MRI is just a very expensive “selfie”. It gives little to no value in helping the doctor come up with a treatment plan, or predict how you will respond to conservative treatment.

A good physiotherapist will base your treatment on your symptoms, thoughts, feelings, response to movement, and tests results. There are also numerous studies comparing the MRI results of people who have back pain, with those who doesn't have pain. In both groups, there is a remarkable similarity in the number of people with disc bulges and other degeneration symptoms. If these conditions are present in people who are not experiencing back pain, maybe they are not the main issues that are causing the pain.

Tips for Beating the Pain

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  • Stay active. People who remain active recover more quickly. It can be as simple as including a 20-minute walk each morning and evening.
  • Change postures regularly. Your back becomes sensitised by prolonged stationary posture & awkward movements - your best posture is your next posture.
  • Do regular spine-strengthening exercises. Don’t be afraid of any particular movements, even if they don't feel comfortable right now.
  • Practice, practice, practice. The exercises may leave you feeling sore at first, but you will get better with regular practice.
  • Be patient. Sometimes the pain can get worse for no reason at all. Be proactive and optimistic about treating it, but don’t blame yourself for making it worse.
  • Stay optimistic. The more you worry about your pain, the worse it might become - your brain acts like an amplifier.
  • Make sure you are getting a good night's sleep. This might mean making adjustments to the pillows you use, or your sleep posture.
  • Get strong. Strong supporting muscles can help to alleviate back pain, and also provide a whole host of other benefits.
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About the author

Kyle Wild completed his physiotherapy training in Leeds, UK and worked briefly in the NHS before combining roles between private practice and sport. He has extensive experience in contact sports, from initial injury management to post-injury rehabilitation . His passions lie in preparing people to perform within their chosen sports, with an emphasis on performance throughout the rehab process. You have to prepare your body for the stress and strains of what you enjoy doing, especially if you don't want to end up in the clinic because of it!

Overtraining Your Kids: Too Much, Too Soon?

Over the years, school sports in Singapore are becoming more and more challenging and demanding. No longer just a social event, the competitions are now extremely competitive. Either this is because schools are putting more focus on competitive sports as a way of raising their profile, or parents are seduced by the notion of nurturing the next Olympic champion, the reality is that school kids in Singapore are training harder than ever, for longer, more intense sessions. 

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Overtraining is an issue for two reasons:

1) Burnout:

Paediatric burnout, or ‘overtraining syndrome’ is more than just being tired. It is the body's physiological and psychological response to chronic stress. This can happen when excessive demand is placed on the young athletes – either in volume (too many sessions in a week) or intensity (too much pressure to perform).

What are the signs of burnout from overtraining?

  • Fatigue: Does your child wakes up in the morning and still complains about being tired? Or do their teachers comment about them being sleepy at school?

  • Low self-esteem: Is your kid suddenly telling you that they are ‘not good’ at a particular sport, or want to drop out of the competition because it's not fun anymore?

  • Low immune system: Has your child been falling sick easily and frequently?

  • Irritability: Has your once-happy child suddenly become withdrawn and snappy with you and his coaches? This is a natural response to chronic stress.

  • Depression: In extreme cases, athletic burnout can trigger bouts of depression in kids as young as 12 if they are pressured by high expectations to perform.

2) Overuse Injuries:

At the UFIT Clinic here in Singapore, we are seeing more and more ‘overuse injuries’ in young kids. What are we referring to? Inflammation of tendons and ligaments, issues such as Osgood-Schlatters, or Sever’s syndrome, and even stress fractures in developing bones. These are most commonly seen in young athletes who participate in two or more sports. Coaches are usually aware of not overworking their athletes. However, when your child goes from session to session, and coach to coach, the cumulative effect of all that physical work can lead to a burnout, constant muscle fatigue, or worse, forcing your child to sit out of the sport due to injuries.

The Good News? Both Burnout and Overuse Injuries are entirely preventable!

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Review your child's weekly schedule for sports training, including all school-based activities (PE classes, etc). You might be surprised by the amount of time your child spends on physical activities! Ask your child if they are happy with the amount of physical training they are participating in - do they feel pressured to train? You can also consider speaking to your child’s coaches if you feel that their training schedule is too demanding. Show them your child’s physical activity schedule – they might also be surprised!

We recommend that your child should have at least one full day of rest in a week, and no more than two days a week with two scheduled training sessions. This will certainly prevent the possibility of burnout and overuse injuries. With your child happier and more relaxed, that will actually lead to better sporting performance!

About the Author

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Declan has always maintained a strong interest in sports, and has previously worked as an Academy Physiotherapist for Crystal Palace Football Club (a professional football club in London, England), He was also the Rehabilitation Coach for the Western Province Stormers Academy (a professional rugby club in Cape Town, South Africa). Within Asia, he consults for the Indonesian Athletics Association as a Performance coach and physiotherapist for their Olympic athletes and Elite Development Squad.

How to get rid of Plantar Fasciitis, the foot of all evil

Plantar Fasciitis is often a dreaded foot disease - but with persistent and consistent treatment it can be overcome! Mok Ying Rong - UFIT Clinic physiotherapist,  Nike Sponsored elite athlete, Singapore’s Half-Marathon record holder and winner of the 2017 Great Eastern Womens' Half Marathon - shares her advice on overcoming Plantar Fasciitis right here ... 

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What is plantar fasciitis?

It is a clinical condition characterised by sharp pain in the middle of the heel and along the arch area. Pain is often worse with the initial few steps after prolonged inactivity such as the first step you take in the morning. Pain gets better with some movement but increases with further loading. Pain is often worse at the end of the day.

Who gets it?

Athletes who engage in repetitive weight-bearing sports such as distance running, basketball. Weekend warriors who engage in a sudden increase in sports coming from a level of sedentary desk work throughout the week. There is also some evidence linking ageing with plantar fasciitis. People with occupations requiring prolonged standing and walking.

What contributes to the development of plantar fasciitis?

Intrinsic and extrinsic factors both play a contributing role. Intrinsic factors include arch height, hypomobility of the ankle, tight calf muscles etc. Extrinsic factors consist of factors such as inappropriate footwear, uneven ground surfaces, increased in weight-bearing activities, sudden increased in mileage and increased Body Mass Index. Alteration of ankle-foot biomechanics resulting from previous injuries and soft tissue or joint limitation can contribute to the development of PF. For example, tight calves can limit the mobility of the ankle which can subsequently result in excessive compensatory pronation, leading to a strain at the plantar fascia.

How does physiotherapy help plantar fasciitis?

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Your physiotherapist will help to manage and reduce your symptoms by utilising a variety of techniques according to your specific needs. Techniques include joint mobilisation, soft tissue releases, gait and footwear analysis. If you engage in sports such as distance running, your physiotherapist may also discuss with you on appropriate progressing of training loads. The physio will also assess for other factors that can put you at risk of symptom recurrence. Throughout the whole process, you will also need to play a part by doing the exercises that your physiotherapist will teach you.

If necessary, you will be prescribed orthotics and night splints. Orthotics can help to minimise excessive pronation which causes additional strain to the plantar fascia. Wearing a night splint at night allows the fascia to be placed in a more optimal and relaxed position.

Running and plantar fasciitis

Plantar fasciitis can be very persisting which gets increasingly difficult to treat the longer it is present. The best way to go about it is to prevent it. Try running on soft surfaces, increase your running mileage by no more than 10% per week, perform regular stretches for your calves after each run and wear the proper shoes for your foot type and gait.

Here are 3 activities to try out :

1. Assess the flexibility of your big toe

Can your big toe be raised up to an angle of 50 degrees when your knee is positioned above your foot (as in the diagram)? The flexibility of the big toe allows the ‘windlass mechanism’ to occur. This windlass mechanism is the winding of the plantar fascia to elevate the medial longitudinal arch. Without this mechanism, the foot loses its stability and the foot’s stability muscles cannot function well. The plantar fascia is then subjected to great amounts of strain.

2.    Stretch your calves

Here are two variations of calf stretches. For both variations, you can alternate between doing it with a straight knee and a bent knee. The former focuses on stretching of the gastrocnemius while the latter focuses on the soleus (the deeper of the two calf muscles).

a. Wall stretches

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b. Hang off an edge

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c. Self-mobilisation of the plantar fascia

With one hand, pull the toes of the foot back to place the fascia on a stretch. With the other hand, massage the fascia by applying gentle but firm pressure across the fascia along the arch. Do this for 5-10minutes, 2 times a day.

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About The Author

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Ying is a physiotherapist with an intense passion in the musculoskeletal field. She utilises a holistic manual approach alongside an energetic desire to get people back to a pain-free status. Ying started off her career as a physiotherapist in the private sector. During her period here, she found her niche in analysing and treating issues related to the running biomechanics. 

Ying is also an avid sportswoman. Ying started off as a competitive swimmer before transiting towards triathlons and finally establishing herself in the running domain. Her more memorable achievements include breaking the Singapore National Half-Marathon record in the 2016 Gyeongju Half Marathon and representing the nation in the 2015 World Cross Country. Ying's first hand sporting experiences allows her to relate better to people who are passionate about sports.

QUALIFICATIONS

  • BsC Physiotherapy (Queen Margaret University)
  • Dip Physiotherapy (Nanyang Polytechnic)
  • National Coaching Accreditation Programme (NCAP) theory level 1

Five reasons why you need an Osteopath

Hear it from Sebastien Bodet, Osteopath at the UFIT Clinic.  As a fully qualified Osteopath and former Olympic swimmer (he competed in the 2008 Beijing Olympic Games in the 4x200m freestyle relay and represented France for eight years in international competitions), Seb understands the personal needs and requirements of returning to training, competition and full function following an injury.

Osteopathy is a form of manual healthcare which recognises the important link between the structure of the body and the way it functions. Osteopaths focus on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a holistic unit.

And what does Osteopathy do?

1.     It cures pain

The most obvious benefit is the ability of Osteopaths to treat pain in a way that considers you as a person and your body as a whole. Osteopathic treatment can be used to effectively reduce and cure pain that you experience in a number of different areas of your body. You might walk into your Osteopathic clinic with a sore back and skip back out!

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Osteopathy can:

-       Remove the underlying cause of pain

-       Reduce pain and stiffness in muscles and joints

-       Increase the range of motions in the joints

-       Treat spinal problems from poor posture or spinal disk injuries

-       Relieve chronic pain through non-invasive treatment

-       Decrease the stress on the joints

-       Reduce tension in the body

-       Relieve tension headaches and migraine headaches.

2.     Reduces discomfort from chronic illness

Another obvious benefit of osteopathic treatment will be seen if you suffer from a chronic illness (such as asthma, arthritis, irritable bowel syndrome etc). Your Osteopath will be able to treat you in a way that alleviates your symptoms (even if they are unable to cure the disease itself).

This is a massive benefit if your illness causes you to have numerous symptoms that prevent you from carrying out your hobbies or reduce your quality of life.

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3.     Injury prevention

If you have just recovered from an injury or acute condition then Osteopathy can be used to reduce the likelihood of your problem reoccurring. For example, if you have just recovered from a period of knee pain, your Osteopath will be able to work to strengthen the structures that support your knee and retain the mobility in your joints. This will prevent you from injuring your knee in a similar way.

If you've never had an injury, but have a hobby or lifestyle that puts you at risk, then Osteopathic treatment could benefit you by preventing an injury. A common example of this is if you drive for long periods of time then your Osteopath will be able to treat your body in a way that prevents you from developing pain in your back (which is a common complaint of people who drive for their living).

Osteopathy can:

-       Reduce scars and adhesions

-       Treat trauma resulting from accidents (Sport injuries, Motor vehicle injuries)

-       Encourage the body to heal itself.

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4.     Pregnancy

During pregnancy your body undergoes a great amount of change and development to accommodate a growing fetus. The postural changes and increase in weight are obvious, but other changes may be more subtle like the effects of hormonal softening of ligaments and the position of the growing baby. A combination of these things can put additional pressure on your joints and muscles of your spine and pelvis.

The most common complaints that Osteopaths csn help with during pregnancy are:

-       Lower back pain

-       Sciatica

-       Pelvic girdle pain

-       Shortness of breath

-       Neck, shoulder and upper back pain

-       Insomnia

-       Swelling

-       High blood pressure

-       Fatigue.

5.     Relaxation

Osteopathic treatment will bring you added benefits as it will give you time just to think about yourself and your body. You will probably find your consultations extremely relaxing and Osteopathy is known to reduce your stress levels by increasing the efficiency of your bodies systems (such as your blood flow, nerve supply and immune system).

Osteopathy can:

-       Increase circulation

-       Reduce blood pressure.


About the author

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Sebastien Bodet is a qualified Osteopath from France and graduated with a MSc in Osteopathy from Ecole d’Osteopathie Paris. Prior to this, he obtained a BSc in Sport & Exercise Science from the University of Rouen. He is also a certified Personal Trainer and Swimming Coach.

Before relocating to Singapore, Sebastien worked as a Sports and Health Manager for a luxury Parisian spa and launched his own Osteopathy clinic in 2014.

Sebastien has a strong sports background. He is a former Olympic swimmer who competed in the 2008 Beijing Olympic Games in the 4x200m freestyle relay and represented France from 2001 to 2009 in major international competitions. He was a member of the University of Michigan Elite swimming team and to this day remains an Olympic Sports Ambassador in France.