Why Women Get It

Yes you did read correctly, women really do get it. Get what you ask, get neck pain that is. Women competing in sports are at a higher risk of getting neck pain compared to men.

Consider the results in a study done to compare gender difference to control the head-neck segment when an external force was applied to it. The women's head's and necks accelerated faster and moved more even though they recruited earlier and greater muscle activity than the men. Also found in the women- poor isometric (keeping the head-neck stationary) strength (49% of men's strength on average). Women also generally have smaller heads and necks and hence, a lesser ability to resist force. Women may be at a higher risk of concussion from sports with greater loads being applied to the head such as football, martial arts of rugby.
Have a look at the video of your neck muscles in action. Please come and see us if you are suffering from neck pain, our staff can help you.

Reference

Gender Difference in Head-Neck Segment Dynamic Stabilization during Head Stabilization. Medicine and Science in Sports and Exercise. 2005 37(2): 272-279

Sorry Y'all

A few of our readers and patients have asked about why we haven't posted in a while. While there seems to be some problems with the blogspot server, so we haven't been able upload our pictures. Will put them up as soon as this is resolved.

Our 2nd Year Anniversary!

On 18 June 2009, Physio Solutions turned 2. I am lucky to have a great team alongside me throughout this journey. A special thanks goes out to Jane who has been my right hand lady from the start :) Thank you to my wonderful team for a job well done. You guys are the best!

Aized

"Gino, You Just Got On My Nerves!"

This was exactly what my patient said to me. Let me elaborate more. 

Got a really interesting patient recently. Have asked the patient's permission so I can write about it, won't mention the person's name of course.

My patient presented with tingling sensations, and some general numbness and pain down the left arm all the way to the 4th and 5th fingers on the palm side. In addition, there was also pain in the neck and shoulders all on the left side.

My patient who usually trains to race triathlons had gone away over the weekend to do cable skiing in Batam. There was a lot of force transmitted to the arms of course and the discomfort started soon after the session ended. My patient also has to maintain sustained postures with a fairly heavy weight as well at work so obviously there was some "problem spots" present in addition to the new pain.

After a detailed assessment, I found the cause. It was actually the patient's ulna nerve causing all the tinging sensations, numbness etc. I treated the patient's neck, and mobilized the ulna nerve as well of course and here's when I got the inspiration for this particular post. My patient said "Gino, you just got on my nerves!" The patient was much better after that and I was able to discharge my patient after 2 sessions.

Most people know about muscles and joints, in fact you often see and touch them. Often there are pictures of them in clinic walls as well. Nerves, however are often forgotten. Our nerves connect the brain and spinal cord to our muscles, joints etc and are really important. Peripheral nerve problems are far more common than most people think. All around the body, nerves slide as we move and sometimes they can be sensitive to pressure or stretch.

Actually there was an article featuring Aized in the Straits Times on nerves called 'Nerves of Steel'. Here is the article if you want to have a look at it  (http://www.physiosolutions.com.sg/pdf/the_straits_times_jan_03_2008.pdf).

If you have any sensations of numbness, pins and needles, itchiness or pain and sometimes even hot/ cold sensations, then it can be your nerves acting up. Let us know if you need any help with your nerves.

Why Men Don't Get It

Yes, now that I've gotten your attention. Here is the next follow up post for our current trends in anterior cruciate ligament (ACL) reconstruction management which started on Mar19 (http://physiosolutions.blogspot.com/2009/03/current-trends-in-anterior-cruciate.html ).

Why don't men get it, well, not as often as women anyway when it comes to getting an ACL tear. Are women more prone to ACL injuries? Yes, there seems to be a substantial body of research that now suggests that women are more prone to ACL injury than are men (e.g. Arendt & Dick, 1995; Bjordal, Arnoy, Hannestad 1997; Ferretti, Papandrea, Conteduca, 1992; Gwinn, Wilcken, McDevitt, 2000 and Messina, Farney, DeLee, 1999).

Many studies have attempted to explain the disproportionate incidence of ACL injuries among female athletes. Research implicates hormonal, anatomic, environmental, and neuromuscular factors that may predispose athletes, particularly women, to ACL injuries. Let's discuss each of these factors.

Specific hormonal factors may include rising estrogen levels which can relax soft tissue and predispose women to ACL tears. It has been suggested that during the midcycle of the menstrual period where ostrogen level rises, tensile strength in the ACL may decrease. 3 studies actually reported the risk of sustaining a non contact ACL injury during the ovulatory phase of the menstrual cycle (Beynnon et al, 2005)

Anatomic factors includes the shape of the intercondylar notch as a potential factor. Some studies have shown that women (who have smaller intercondylar notches compared to men) are at a greater risk for ACL injury, likewise for ACL volume. Those with smaller notches also had smaller ACL's and are more prone to tears. Other anatomical differences that may also play a role include women's wider pelvis and joint laxity.

Even your playing style can result in injury. Women tend to play sports in a more upright posture compared to men. Being more upright increases loading forces on the knee and causes higher shearing forces thus increasing susceptibility of an ACL tear.

Men usually have more developed thigh muscles and better control in muscle activation of the quadriceps and hamstring muscles compared to women. Our hamstrings act to "protect" the ACL when the quadriceps are activated. Studies show that women relied more on their quadriceps and took significantly longer time (compared to men) to activate their hamstrings in weight bearing.

Incidently, most of the ACL injuries that occur in females during sports are from non-contact situations, meaning it usually does not happen in a tackle or when someone nudges you say when you both are jumping for the same ball. Studies show three main non-contact mechanisms that can cause the injury. They are: planting and cutting, straight-knee landing, and one-step stop landing on a hyperextended (straightened) knee. Other common mechanisms of ACL non-contact injury are pivoting and sudden deceleration. What sports have some og these movements? Majority of female patients with ACL injuries that I have seen play netball, rugby, basketball and soccer.

Where do we go from here? What do we do with this knowledge? Based on our experience in working with athletes, as a preventative strategy, we've found that it is important for us to identify risks factors by looking at patterns of incidence and prevalence of ACL injuries and educating athletes, patients (such as you), parents, coaches, teachers etc. Research is currently pointing towards gender and sport specific training and rehabilitation programs. Please contact us if you are keen as we have the rationale and clinically researched techniques to help prevent ACL injuries.

References

Beynnon, BD et al (2005). Treatment of Anterior Cruciate Ligament Injuries, Part 2. Am J Sports Medicine 33(11) pp 1751-67

Park, SY et al (2009). Alterations in Knee Joint During the Menstrual Cycle in Healthy Women Leads to Increases in Joint Loads During Selected Athletic Movements. Am J Sports Medicine 37(6) pp 1169-77

Moller, JL and Lamb, MM (1997). Anterior Cruciate Ligament Injuries in Female Athletes: Are Women More Susceptible? The Physician and Sports Medicine 25(4) pp 1272-83

How Would You Know If You Need Physiotherapy?

1. Do you work more than 4 hours daily at a computer?
2. Do you work at a laptop?
3. Do you constantly need to massage your neck and back while you're at work?
4. Do you exercise less than twice a week?
5. Do you get less than 6 hours of sleep every night?
6. Are you a working mother/father and have at least 1 child below 1.5 years?
7. Do you have a Blackberry?
8. Do you live with pain/numbness on a daily basis?
9. Is your pain stopping you from doing what you want?
10. Would you like to find out why you're having pain?

If you've answered YES to at least 5 of the above questions, you NEED PHYSIO SOLUTIONS.

Stretching Session @ Fort Canning Park

Come join us for a stretching session on Thursday 14 May, 630pm at Fort Canning Park. Our patients constantly ask us about good stretches to do after a training or exercise session, so we're going to teach you :)

We'll lead in a 1 hour stretching session for the main muscle groups used in sporting activities. You'll need these stretches as one of your plans to prevent injury.

Meet at the Physio Solutions clinic at 620pm. We'll lock all our belongings in the clinic and head to Fort Canning Park together.

What to bring: A Bath Towel & Exercise Attire

We'll provide insect repellent! Email admin@physiosolutions.com.sg to let us know you're coming :)

Photo courtesy of Maginashun