Biomechanics, Human, Injury and Rehab, Injury Management

Taping a Sprained ankle for sport

Below is a video on how to tape your ankle when you are returning to play sport after an ankle sprain. The techniques used below helps to limit the amount of inversion at the ankle meaning a player is less likely to roll the ankle during play.

The taping technique should only be applied before a warmup, game or training and remove it after the activity is finished. It’s not like Ktape which can be left on for longer periods of time.

The video demonstrates the stirrup and heel lock techniques but also looks at a figure of 8 if needed. I have demonstrated on myself so that you can see how to do on yourself when you haven’t got a professional to do it for you. I hope this is helpful

If you have any questions regarding ankles or taping please do get in contact with Pollyanna

Anatomy, Biomechanics, Human, Injury Management

Feet the foundation of movement: Part three keeping your feet happy

In the the first blog of this series we looked at anatomy and function of the foot and then proceeded to discuss some common injuries in part two. This part looks into exercises that can help keep your feet supple and strong for everyday life.

Video on exercises to help keep your feet supple and strong

I hope the video was helpful if you have any questions then do please get in touch

Biomechanics, Equine, Horse & Rider, Injury and Rehab, Injury Management

Horse Pilates: Encouraging core engagement through movement

In the run up and during lockdown my clients and friends have increasingly been using the words Horse Pilates to describe part of what I do to help horses move better. To the point that even the Daily Telegraph have used that term in an article published recently. So I thought a blog post about Horse Pilates was needed.

What is Horse Pilates?

Human Pilates was developed by Joseph Pilates. He develop it when in the UK to help injured soldiers from the War to recover. Pilates believed that mental and physical health are closely linked and this is something that can be taken and applied to horses. Pilates is a low impact set of exercises aimed at strengthening muscles while improving postural alignment and flexibility. Any fitness level can benefit and Pilates exercises should be part of any training or rehab plan for a horse.

The focus of Pilates exercises are on the core. However it should also include other areas such as the hips, abdominals, back, inner and outer thigh. The core is the foundation and these other areas are all connected and need to be able to function as a whole.

In regard to horses what we term carrot stretches were a series of movements developed by Hillary Clayton and Narelle Stubbs and can be coined as the first form of Pilates exercises for horses. These exercises help develop the deep core and spinal muscles. They are a combination of stretches, stabilising exercises and lifts which are the first port of call to develop core. However with any exercise caution should be taken that it is the correct exercise for your horse and therefore consulting a professional to help is really important.

Intermediate & Advanced Pilates

Hilary Clayton and Narelle Stubbs exercises could be termed your beginner Pilates for horses as with human Pilates beginner exercise should still be practiced by intermediate and advanced students as it makes sure the deep core muscles are functioning and that the global muscles have not taken over, which often happens in very athletic inviduals. If this happens then the individual is more open to injury and it would be the same in the horse. However a horse can be stretched further so including straight line pole work and walking backwards would be the next step up. The horse can be progressed further by introducing raised poles (cavelletis) and lateral movement such as stepping under. Pole work on circles and in trot would progress things even further, shoulder in from the ground all increase the demand and complexity of the movement.

By working with your horse from the ground you can also develop your partnership with your horse. You don’t want to be doing lots of reps. This isn’t about increasing cardio fitness but about developing finer movements that are controlled. As the horse is able to control their movement through the use of its core muscles then its ability to work under saddle will greatly improve. Their balance will be better and there will be improvement in dealing with a rider on board. This is also a key time to work on yourself and develop your core strength. Your horse will appreciate this hugely.

So every horse can benefit from Pilate type exercise being added to their exercise regime. However professional help should be sort to guide you as the owner as to what would benefit your horse. If you would like to discuss things further do contact Pollyanna.

Anatomy, Biomechanics, Human, Injury and Rehab

Feet the foundation of movement: Part two Injuries

In the last blog we introduced the anatomy and function of the foot (Part one anatomy and function). With this knowledge it can be seen that the foot is quite a complex structure and with so many components you would think quite a lot can go wrong. If you think how often you walk, run or jump and the forces going through your feet it is quite immense, and yet our feet seem to tolerate this on a daily basis. However there are occasions where trauma occurs or our feet just can’t recover as they should. Below are some common injuries your feet might experience.

Plantar fasciitis

Plantar fasciitis is one of the most common forms of foot pain. It is common in runners and older adults. It is often associated with biomechanical issues due to excessive pronation or supination. It is an overuse injury and what we would term a tendinopathy. You may have experienced tennis elbow or Achilles tendinopathy. Which is a similar condition just affecting a different part of your body. Tendinopathy in short is when the tendon is not healing in the normal manner, it can fray, become thickened and be painful.

Flat feet or high arches can increase the risk of plantar fasciitis. Tightness in the calf muscle, hamstrings and gluteals can also increase the risk. Plantar fasciitis has a gradual onset of pain which is often located on the medial aspect of the heel and experienced after activity. However when it becomes more severe pain can be experienced when weight bearing and on activity. Periods of inactivity during the day can also increase the pain when commencing activity again. Stretching the foot and fascia also can cause pain.

Stress fractures

The common bones in the foot that can suffer stress fractures are the calcanous, navicular and metatarsals. Calcaneal stress fractures are common in runners, military personnel, ballet dancers and sports that involve jumping. Having poor heel cushioning, overstriding and a heavy load can all increase the risk. The onset of pain is insidious in nature and aggravated by weight bearing. There is localised tenderness to the medial or lateral border of the heel.

Navicular stress fractures are the most common stress fracture in the foot. It can occur in sprinters, jumping sports and hurdling. It is an overuse injury and is thought to be due to training errors and impingement of the bone between other tarsal bones. Decreased dorsiflexion in the ankle is thought to perhaps bring about an increase in compensatory dorsiflexion in the foot increasing the stress placed on the navicular. Individuals often experience a midfoot localised ache, radiating along the medial aspect of the medial longitudinal arch. It often gets better with rest.

Metatarsal stress fractures occur with excessive loading of the forefoot and muscle fatigue. Forefoot pain is experienced and aggravated by activity. Pain gradually worsens with activity and tenderness over the metatarsal is present. Stress fractures don’t always present themselves on x-ray straight away so can be harder to diagnose than a complete fracture. However if one is suspected then management strategies can be implemented until diagnosis is confirmed

Metatarsalgia

Metatarsalgia is an inflammatory condition of the metatarsal phalangeal joints. It is caused by excessive pressure over prolonged periods of time. It is associated with high arches, excessive pronation of the foot, clawing/hammer toe, tight extensor tendons of the toes, prominent metatarsal heads and Morton’s foot. Pain is aggravated by forefoot weight bearing and affects the mid stance and propulsive phase of walking. Pain is gradual in onset and local tenderness over joints is present. Passive flexion of the toe causes pain and a v shape between toes can also be an early sign.

Bunion (Hallucis valgus)

This is when the big toe deviates laterally, it is more common in women and older people. There are a number of factors that can lead to the development of a bunion constricting footwear like high heels, excessive pronation of the foot, long first metatarsal (big toe), trauma to the medial and plantar ligaments and trauma to the medial sesamoid bone. As the deformity develops so does the pain over the medial border of the big toe this can be relieved by removing footwear or wearing wider shoes.

Toe Clawing

Toe clawing is not necessarily a painful condition but suggests that the long flexor tendons are tight. During the propulsion phase of gait the long flexors contract to stabilise the toes, if the foot is unstable the long flexor tendons excessively contract causing the toes to claw at the ground to maintain stability. If this continues then it could affect other areas of the foot or body as they compensate.

The above are just a few examples of injuries that can develop with feet. There are many others. The majority of the above injuries can be avoided by performing exercises and taking other everyday precautions. Part three of this series will address these solutions to help you maintain happy feet.

If you have concerns about your feet then either consult your doctor or Pollyanna would be happy to answer any queries you might have where she can

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Biomechanics, Equine, Injury and Rehab, Injury Management

Case Study Part Two: Road to Recovery

Willow Road to Recovery

In part two we discussed Willows history and issues that were causing her complex lameness, which you can find more detail in Case study Part One: Complex lameness. In this part we are going to discuss what treatments were used and Willows progress.

Treatment

Willow’s treatment was started very gently. In this case less is more. Willow is also a very receptive and expressive horse, which as a therapists is brilliant as she leads her own treatments. It is so important to listen and respond to a horses reaction. In this case Willow directs me on duration and areas she needs working on. Willow is also very responsive to acupressure points.

Her treatment began with Bladder 25 to help strengthen her lower back, address any stiffness or pain in this area. Willow responded by lowering her head almost to the ground and softening her eye to the point that she almost went to sleep. This allowed me to massage through her hind quarters to release further tension and relieve pain. Willows neck and poll muscles were also released through a number of soft tissue techniques. As well as her adductors on her inner thigh. This caused increase tone and activation through the TFL and quadriceps.

To finish of the session 5 gentle dock pulls were included on both sides to help strengthen and activate the TFL and quadriceps. A number of belly lifts were also performed to help activate the core muscles and stretch through the back.

Initial Outcome

Just from the above treatment and exercise Willow showed immediate improvement. Firstly her TFL (tensor latae fascia) and quadriceps started to activate. Had increased tone and secondly she was far less sensitive through her back and hindquarters. Her movement seemed eased but was still showing signs that were present on initial assessment. However the goal of making Willow more comfortable was achieved.

Continued Treatment

The original plan was to come and treat Willow little but often to allow her body to make small adjustments and to not overload her system with change. So visits were made twice a week for about two weeks. During this time I was fully aware that the country might go into lockdown and that I wouldn’t be able to come up to physically treat Willow. So Willow’s owner was taught how to do some of the key techniques that were helping Willow the most and given equipment to allow progress if I couldn’t be there. Willows owner was also doing some of acupressure points on a daily basis in between my treatments.

So in the second treatment acupressure point Bl 25 continued to be used along with the introduction of Bl 21 which helps with atrophy, gastrointestinal issues, edema , back pain and general weakness. Each session I added a new point Bl 11 (helps strengthen bones and joints, nourishes and facilitates blood flow, benefits joint problems and also helps neck and spinal pain), Bl 19 (helps with hip pain and gastrointestinal issues) and lastly Bl 23 (helps with general weakness, lower back pain and estrous cycle). The owner was also taught these points as treatment progressed. Willow responded well to all these points

Massage through Willows back, hindquarters, neck and poll were also carried out to help activate muscles and release tension that has developed due to compensatory mechanisms. Again Willow responded well over the two weeks

Exercises

Initially dock pulls and belly lifts were introduced. Gradually the number of repetitions were increased and this was something Willows owner performed between sessions. In the second treatment weight shift directed through the shoulder was introduced this along with dock pulls were to encourage Willow to use her stabilising muscles. To start the main aim was to develop Willows core to give her a stronger foundation to develop more global muscle strength.

Willow was introduced to some foot pads. Just one placed under a fore foot to start and then moved to a hind foot. The foot pad was placed under for as long as Willow would stay. This was often a couple of minutes. This was again to encourage Willow to use the finer muscles to stabilise herself.

Before I got to progress Willow further lockdown occurred. However with guidance Willows owner was able to progress her exercises gradually. Walking over a pole in straight lines was introduced then progressed over a week to a figure of out over a pole. These progressions occurred over a 3 week period from initial treatment.

Willows owner continued with all the above acupressure points, exercises and pole work by week 4 she was walking over 2 poles in a row with several repetitions. By week 5 Willow was introduced to slightly raised poles done in hand exercises. Willow is also on a track for the summer months so poles and obstacles to step over were introduced to encourage her to use her hind quarters more throughout her daily life. By week 6 straight line trotting in hand was introduced. By week 7 3 poles on a circle at walk was performed with no ill effect.

Progress

Walk up 3 months after initial assessment

Willow showed great improvements in her walk and confidence by week 2 of initial treatment. She was also getting increased turnout time. By week 3 she was back out on full turnout and her Bute had been gradually decreased as well. Within a month Willow was out 24/7. Willows feed was also changed to help increase weight and muscle mass by phasing in Copra and Speedi beet into her seaweed, brewers yeast, lucerne and chaff. Gradually the lucerne was phased out and replaced with Agrobs Leichengrass. There were two aims with these changes one was to reduce any feed stuffs that might cause increase in inflammation (hoof friendly) and to help increase condition.

The above photographs show a vast improvement in muscle mass and posture. The video further up also shows huge improvement in movement patterns. Willow will always have some sacroiliac issues but with careful management she should be able to lead a happy and comfortable life.

If you have any concerns about your own horse and lameness then do consult a vet or contact Pollyanna with any queries and she will try and help the best she can.

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Anatomy, Biomechanics, Human

Feet the foundation of movement: Part one anatomy and function

Feet are an important part of our lives. They continuously absorb a lot of force to allow us to move and balance in a number of ways. When feet are doing their job life is great but if there is something wrong then daily life can be affected hugely. Do you take care of your feet, understand how they work or want to know more about these incredible structures then continue reading?

Today we are going to discuss the anatomy and function of the foot. Part two will look into problems that may arise with feet and how they can affect the rest of the body. In part three and to conclude the series then ways to keep your feet healthy for pain free movement will be discussed.

Anatomy of the foot

The foot is quite a complex structure compared to the rest of a human body. It is made up of 26 bones, 30 joints and over a 100 muscles, tendons and ligaments all working together to create an apparatus that allows movement, and stability while bearing the weight of the whole body.

The foot is separated into three regions the hindfoot, midfoot and forefoot. The hindfoot is made up of the talus and calcanus. The talus articulates with the fibula and tibia to form the ankle joint (talocrural joint) and the calcanous is your heel. The midfoot has five tarsal bones, which are wedge shaped and help form the arch of your foot. The forefoot contains the metatarsals and phalanges which form your toes.

Function of the foot

As noted earlier the foot bears the weight of our bodies. When walking the pressure on the feet increases twofold and then fourfold when running. This is a huge amount of pressure in such a small structure. As a result the foot needs to be able to absorb and distribute weight. It also needs to be able to help with propelling the body forward in our chosen gait. The foot has three arches the medial longitudinal, lateral longitudinal and transverse arch. These arches allow weight to be distributed throughout the foot as well as allowing the foot to make adjustments to uneven terrain. The medial longitudinal arch is the primary load bearing and shock absorbing structure of the foot. It forms the instep of the foot.

The plantar fascia makes up the primary passive component (along with the bony structures) of the medial longitudinal arch. It covers the sole and side of the foot. Active toe extension stretches the fascia which adds tension to the medial longitudinal arch. It helps stabilise the foot especially in the push of phase of movement. Other structures such as muscles help stop the arch from lowering to much when weight bearing and likely protects against stress related injuries.

The foots ability to repeatedly transform from a flexible and shock absorbing structure to a rigid lever type structure is really important in our ability to move and weight bear. If there is a problem in the foots structure then our ability to weigh bear and move is compromised and our everyday living is profoundly affected. In the next post injuries that can arise with feet will be discussed.

If you have any queries about injuries to your feet then don’t hesitate to get in touch to discuss your concerns or book an appointment

Biomechanics, Equine, Injury and Rehab, Injury Management

Case Study Part One: Complex Lameness

Willow the complex case of lameness

This case follows the assessment and treatment of a 19 year old horse, Willow. It shows the complexity of a case that has multiple factors interacting together and that by viewing the horse as a whole all these factors can be addressed in an efficient and effective way. This first part introduces Willow’s history and the problems that were being experienced by her. The second part will discuss treatment used and the outcome.

History

Willow is an Irish cross (possibly thoroughbred with some Arad), she is 19 yrs old, 15.1hh in height and of a slight build. Willow has had hock surgery and been owned by the current owner for 9 years.

I have been giving Willow bodywork session for the last year and she also receives McTimoney chiropractic treatment from a very good practitioner. Willow has exhibited an unlevel pelvis on a number of occasions. This is potentially linked to an underlying issue within her sacroiliac joint, which could be a result of previous activities or injury. Willow had been ridden western style and potentially barrel raced in the past. With her current owner she is hacked and schooled at a low level. Willow has been barefoot for the last year.

Willows issues

Over the winter Willow lost a bit of condition and then the mud came. Willow seemed to find the mud particularly difficult to deal with. Willow developed some heat in her right fore and lameness. After a vets visit an abscess was ruled out. However it was noted that her gait was abnormal. Not just in her right fore but the hind legs as well. The vet placed Willow on restricted turnout on a firm flat surface for 4 weeks with Bute and then review her progress.

Willow’s owner asked me to come and help make Willow more comfortable. On initial assessment Willow showed a complicated lameness, by this I mean there were a number of potential issues going on. Firstly you had the forelimb lameness which was likely to be secondary refered lameness. There was also axial lameness going on, which can be harder to identify. Willow also showed left non weight bearing lameness in her hind due to the flight pattern and placing it along her midline when stepping through, this also affected her cornering to the left. She was also hesitant to place her left hind hoof down. Willow also walks on 3 tracks and has a slight head bob down suggesting a hind limb lameness. Lastly Willow’s right hind has a slight wobble when transferring weight onto it.

Willow on initial assessment

Closer look

On palpating, Willow showed a decreased tone and atrophy in her hind quarters specifically the quadriceps and gluteals bilaterally. Willow also showed decreased activation through her tensor fasciae latea and quadriceps on her right hind, this would explain the shaking through this leg when starting to weight bear. Willow was particularly uncomfortable through the lumbar and sacral area when palpated. Her neck showed tightness bilaterally but more so on the left.

The above introduces the issues that Willow has experienced. In part two we will discuss treatments and how Willow progressed. If your horse presents as lame always consult your vet before getting hold of a bodyworker. If you have any questions or concerns then please do get in contact with Pollyanna.

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