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The impact of fatigue and why optimal recovery is so important.

The impact of fatigue and why optimal recovery is so important.

Mar 24, 2024

Optimal recovery from training and competition is most definitely a subject that we are seeing more frequently discussed and addressed in elite sport and the sports medicine world. Away from sporting competition, we can also inform and educate individuals on how to ensure their recovery is as good as it can be to enable them to be on the top of their game in their day to day life whether that be at home or at work. With useful data collecting tools such as; the Whoop, Oura ring and Apple watch, it is becoming much easier for people to keep an eye on their vital metrics and determine when rest is needed or when is a good time to place their body under higher strain through training, competition or a stressful life event.

Here at Opus, we often have the ‘optimal recovery’ discussion with our patients. It tends to be part of a greater conversation of how we assist in managing that individual’s training load and or managing their current state of physical and mental health. By doing this we can reduce the risk of injury and illness and aid in the patient performing to the best of their ability in whatever task it may be that matters to them.

So what is optimal recovery? The fact is, it is not just any one thing, but instead a combination of a number of components that contribute to restoring a person’s physical, and mental well-being after a period of physical or mental exertion. By ‘optimising’ as many of these components as possible, we can in turn reduce the potential risk of both illness and injury.

Two specific musculoskeletal injuries linked to fatigue which have been researched in depth are hamstring and ACL injuries. One study by Mclean and Samorezov (2009) (2), reported that the inhibitory action of the fatigued muscles in landing activities,  increases the possibility of ineffective perception, decision, and movement execution strategies therefore increasing risk of injury to the ACL. Small et. Al (2009)(3) focused their investigation on the risk of hamstring injury at the ends of each half of a football match. Their findings suggest that due to decreased flexibility of the hamstring muscle group during fatigued sprinting, with a reduced maximum combined hip flexion and knee extension angle observed during the late swing phase of the sprinting cycle, the strain on the hamstring muscle group is increased in this fatigued state and the risk of hamstring injury is amplified.

Jones et. Al (2016)(1) looked more into the impact of training load on the risk of illness due to fatigue. They found that during periods of training load intensification, or where there was a greater accumulation of training load, the risk of acquiring illness increases.

So what are these key components of optimal recovery and how can they impact an individual? Some of those we discuss regularly with our patents at Opus are:

  • Getting sufficient rest and good quality sleep are fundamental for recovery. Sleep is when the body repairs tissues, consolidates memories, and regulates the hormones which are crucial for recovery and overall health.
  • Being hot on your nutrition. A good diet focused around the right food types, supports the body’s recovery processes and replenishes energy stores, repairs tissues, and supports immune function.
  • Maintaining proper hydration levels. Water is crucial for transporting nutrients, regulating body temperature, and facilitating various biochemical processes in the body.
  • Opting for ‘Active Recovery’ when necessary. A pool session, stretch and mobility routine or flush on the watt bike, can enhance circulation, reduce muscle stiffness, and promote recovery by aiding in the removal of metabolic waste products from muscles.
  • Managing stress. Using techniques such as meditation or deep breathing exercises, can help reduce stress levels and promote recovery. Alternatively if that’s not for you, surrounding yourself with friends and family and taking part in activities that you find fun and relaxing can be of great help.

So in short, what we do away from the more strenuous or testing activities in our day to day life, is vital in ensuring our performance is at its best. Optimal recovery leads to reduced risk of injury and illness and in turn, optimal performance.

Reference List

 

  • Jones, C.M., Griffiths, P.C. and Mellalieu, S.D. (2016). Training Load and Fatigue Marker Associations with Injury and Illness: A Systematic Review of Longitudinal Studies. Sports Medicine, 47(5), pp.943–974. doi:https://doi.org/10.1007/s40279-016-0619-5.
  • MCLEAN, S.G. and SAMOREZOV, J.E. (2009). Fatigue-Induced ACL Injury Risk Stems from a Degradation in Central Control. Medicine & Science in Sports & Exercise, 41(8), pp.1661–1672. doi:https://doi.org/10.1249/mss.0b013e31819ca07b.
  • Small, K., McNaughton, L.R., Greig, M., Lohkamp, M. and Lovell, R. (2009). Soccer Fatigue, Sprinting and Hamstring Injury Risk. International Journal of Sports Medicine, 30(08), pp.573–578. doi:https://doi.org/10.1055/s-0029-1202822.

Debunking myths about PRP

Debunking myths about PRP

Mar 20, 2024

Photo by Kindel Media on Pexels
PRP is a minimally invasive outpatient procedure and can reduce pain, improve function and help you return to your normal activities or sporting pursuits. This novel approach, despite its success in clinical studies, is still surrounded by several myths. So, let’s debunk them.

1. PRP therapy requires surgery.

The plasma, the liquid where the platelets reside, is drawn from your body before being placed in a machine that separates the PRP from the rest of the blood. This PRP is then injected into the area of your body being treated. Once the platelets are in the target area, they will break down, releasing growth factors, important proteins that stimulate cell growth, differentiation, survival, inflammation, and tissue repair; collectively triggering your body’s healing process.
As you can see, PRP therapy does not require surgery, solely injections. In most instances, real-time imaging will also be used to guide us and ensure that the PRP is injected directly at the site of your injured tissues.

2. PRP is only good for pain relief.

Although PRP is generally used in patients with chronic pain conditions, there are so many additional benefits that this treatment will present beyond pain relief. This includes reduced inflammation, the recruitment of stem cells to the area triggering new tissue production, stimulation of blood vessel growth, and the degeneration prevention of healthy tissues. These benefits combine to speed up tissue regeneration and healing, relieving your pain. This is especially beneficial for athletes who are looking to get back on their feet as soon as possible.

3. PRP is a highly risky procedure.

Given that PRP therapy relies solely on injections, the procedure itself is deemed exceptionally safe. For starters, the plasma injected is autologous, meaning that it is made for your own blood, and you do not need to worry about potential negative reactions or side effects. What’s more, PRP therapy has been used for several years now, with no major complications being reported.

One study, in particular, investigated the clinical application and safety of PRP therapy for patients with patellar tendinopathy, a condition that causes chronic back pain. One of the key points the researchers noted, besides the remarkable improvement in back pain, was the safety of PRP and that no complications or side effects were seen across all 15 clinical studies included.

Considering PRP therapy but don’t know where to start? Or have more questions that you need answering? Get in touch with our team to discuss your options and how we can help relieve your pain.

Common shoulder injuries amongst athletes and how we treat them

Common shoulder injuries amongst athletes and how we treat them

Mar 12, 2024

Photo by Quino Al on Unsplash

Acromioclavicular joint injury

The acromioclavicular (AC) joint is the point at which two bones, the collarbone (clavicle) and part of the shoulder blade (scapula), meet. An injury to this joint is characterised by shoulder separation and can be defined as one of six types. The severity of the injury also impacts the treatment approach.
1. Type I. The AC ligament is slightly torn; however, there is no significant damage to the coracoclavicular ligaments. Treatment often centres around rest and recovery, with the joint being iced and protected, often with an arm swing. Following this, range-of-motion exercises are recommended as soon as they can be tolerated. 2. Type II. The AC ligament is completely torn; however, there is little to no tear to the coracoclavicular ligaments. Initial treatment involves rest, ice, pain medication, and up to a week of shoulder immobilisation in a sling. Range-of-motion exercises are recommended alongside strengthening exercises.
3. Type III. The AC and coracoclavicular ligaments are completely torn, resulting in the collarbone separating from the scapula. Although treatment for this injury can be conducted non-surgically, as with type I and II injuries, the duration of recovery is significantly longer, with a sling being required for up to a month. 4. Type IV, V, VI. Treatment of these injuries almost exclusively involves surgical interventions, with specialists required to reduce the risk of long-term complications. In these cases, regenerative medicine may also be considered.

Rotator cuff tendonitis

Rotator cuff tendonitis is characterised by pain and swelling of the cuff tendons and the surrounding bursa (a soft fluid filled sack that cushions the joint). This injury, unlike an injury to the AC joint, does not occur all at once. Usually, rotator cuff tendonitis transpires over a substantial period of time following repeated irritation to the area. Although it can affect anyone, this injury most commonly presents in people with loose joints, abnormal bone anatomy in the shoulder, and those who do repetitive heavy lifting, such as weightlifters and powerlifters.
Treatment of rotator cuff tendonitis is predominantly non-surgical and involves plenty of ice, NSAIDS for pain management, including ibuprofen, and steroids. In the instance that surgery is required, the most common procedure is an acromioplasty. However, recent advances in regenerative medicine have permitted the accelerated and enhanced recovery of these injuries using mesenchymal stem cell therapy.

Beyond these individual conditions described, there are also activity-specific injuries, including thrower’s shoulder, swimmer’s shoulder, and rugby shoulder. At Opus, we ensure that your injury is fully assessed so that you receive the best possible treatment that is tailored to your needs. Get in touch to discuss your recovery with one of our world renowned specialists.

Can regenerative medicine help with back pain?

Can regenerative medicine help with back pain?

Mar 4, 2024

Photo by Gordon Cowie on Unsplash

Back pain is a silent problem amongst the general population, with figures suggesting that approximately 1 in 6 people are experiencing back pain at any given time in England. What’s more, back pain is deemed the largest single cause of disability across the UK. But why is this? And why are the numerous treatments available not bringing these numbers down?

Most cases of back pain are caused by muscle and ligament strains and, in the vast majority of cases, cannot be avoided. However, there are several other causes of back pain, including sciatica, a slipped disc, and ankylosing spondylitis, that can often occur spontaneously and without trauma. Then, we move to treatments. For the most part, treatments of back pain focus on rehabilitation and pain management, which, although great in getting you back on your feet, does not always treat the underlying cause and prevent further injury. Sports medicine is a great option to educate you on preventative measures; however, regenerative medicine offers more long-term symptom relief.

The role of regenerative medicine

Let’s first consider platelet rich plasma (PRP) injections. For those experiencing repetitive and debilitating back pain, surgery is usually the last option you want to take; however, PRP offers an effective alternative that could treat the pain of your injury as well as prevent further strains. Depending on the root of your back pain, PRP can be injected into the discs, facet joints, and paraspinal muscle, with previous patients seeing an improvement in their symptoms within six weeks of their first treatment. In clinical studies, PRP injections have been used to treat patients with degenerative disc disease, join-related pain, and pain or functional decline caused by facet joint arthropathy.

Mesenchymal stem cell therapy, on the other hand, has shown great success in patients with chronic discogenic low back pain. This type of pain is caused by chemically or mechanically damaged discs in the back and is often caused by trauma. However, this pain also arises due to deterioration as a result of ageing. Stem cell therapy is deemed a valid alternative treatment for back pain caused by disc disease, with one study demonstrating treatment success in over 90% of patients. This success is down to the regenerative impact of stem cells and their ability to differentiate into cartilage at the site of injury.

The key distinction between Opus and other private clinics in the UK is that we are the only institution that offers a regulated and licenced mesenchymal stem cell treatment. Get in touch with our team to discuss how we can support you in your treatment journey using either our world renowned sports medicine specialists or regenerative medicine.

The impact of fatigue and why optimal recovery is so important.

The Different Approaches to Treating Scoliosis through Physiotherapy

Feb 22, 2024

Physiotherapy Scoliosis Specific Exercise (PSSE) is the umbrella term and model that encompasses specific education, physiotherapy exercises, psychological support and bracing for scoliosis (Berdishevsky et. al, 2016). PSSE approach has become a more accepted form of conservative treatment due research showing an improvement in cobb angle, posture and breathing function (Seleviciene et. al, 2022). The PSSE model incorporates a multidisciplinary approach and can be used as an adjunct to medical treatment (Berdishevsky et. al, 2016). There are currently 8 scoliosis schools which use PSSE, however the Schroth method, Scientific Exercise Approach to Scoliosis (SEAS) and Barcelona Scoliosis Physical Therapy School approach (BSPTS) are the most researched and shown to be the most effective in reducing Cobb angle and quality of life (Seleviciene et. al, 2022)

Schorth method

The Schorth method is the most studied approach with research demonstrating reduced prevalence of surgery, improved self-image and quality of life. This method uses ‘body blocks’ to help explain the scoliosis and therefore determine the most appropriate treatment. For example, the spine is split into hips, lumbar, thoracic and shoulder blocks to help assess the curvature and rotation of the spine. This provides a clear exercise programme and prioritises the manual therapy techniques. Education is used throughout the various exercises to help teach the patient to elongate the concave areas in order to improve posture. The four most common exercises include:

  • 50 X pezziball – The ’50 X pezziball’ involves the patient sitting on a swiss ball in front of a mirror and using a wall bar to self-correct the spine alignment. The patient uses the mind body connection and cues to aid spine elongation and core engagement.

  • Prone exercise- This exercise uses shoulder traction and counter traction to aid the thoracic curve while activating the iliopsoas for the lumbar curve.

  • Sail exercise- Sail involves stretching and elongating the thoracic cavity.

  • Muscle cylinder- This involves side lying on the convex side to engage QL and correct the lumbar curve against gravity. (Berdishevsky et. al, 2016)

SEAS

The SEAS approach focuses on increasing spine stability and is often used alongside wearing corrective braces to maintain range of motion and muscle tone. This approach is more functional by encouraging postural correction in different activities of daily living. Equipment such as balance boards are regularly used to aid muscle endurance and neuromotor function. (Berdishevsky et. al, 2016)

BSPTS

The BSPTS approach is based on the Schroth method and focuses on challenging the trunk with or against gravity. This includes supine exercises which remove gravity and allows the patient to focus more easily on posture corrections, as well as side lying exercises which concentrate on lumbar concavity by working against gravity. The various exercises use corrective pads and cueing to promote elongation, traction/counter traction and muscle activation to improve posture. (Berdishevsky et. al, 2016)

Despite the various research conducted on these approaches, there is still a lack of research (Seleviciene et. al, 2022); therefore, it is important to incorporate each method into clinical practice to aid posture and quality of life (Berdishevsky et. al, 2016).

Reference List

Berdishevsky, H., Lebel, V.A., Bettany-Saltikov, J., Rigo, M., Lebel, A., Hennes, A., Romano, M., Białek, M., M’hango, A., Betts, T., de Mauroy, J.C. and Durmala, J. (2016). Physiotherapy scoliosis-specific exercises – a comprehensive review of seven major schools. Scoliosis and Spinal Disorders, 11(1). doi:https://doi.org/10.1186/s13013-016-0076-9.

Seleviciene, V., Cesnaviciute, A., Strukcinskiene, B., Marcinowicz, L., Strazdiene, N. and Genowska, A. (2022). Physiotherapeutic Scoliosis-Specific Exercise Methodologies Used for Conservative Treatment of Adolescent Idiopathic Scoliosis, and Their Effectiveness: An Extended Literature Review of Current Research and Practice. International Journal of Environmental Research and Public Health, 19(15), p.9240. doi:https://doi.org/10.3390/ijerph19159240.