Many factors determine how to treat a torn (partial tear ) or ruptured (complete tear) of the ACL. The severity of the tear and the degree of movement or impact that the client may be likely undertake in the future is a major concern. Is the client likely to undertake impact sports in the future or are they at the tail end of their career? This is a very real concern for those facing ACL surgical repair.
The labrum is the articular surface (the area where the ball of the arm bone or humerus connects to the actual joint surface or glenoid cavity *the socket of the shoulder). Its like looking at the Universal Joint on a car crankshaft. The surface on the inside of the socket is where the labrum forms a secure ‘cuff’ for the bony humerus to insert into. Like a ring of fibre that makes the articulation more secure, it helps to create a deeper rim. Like the rubber ring on a preserving jar.
The hangover is over, the parties are done and now it is the time to move into the reasonably slow return to form and work that is January. Now is the time that resolutions are adhered to with religious zeal. Its easy to get up in the mornings and don the workout gear, the running shoes and jog off into the early morning glare. With warm mornings and some people still away on break, there's so much less distraction. Make use of that and set the habits now so you don't get distracted later on when its March.
However, there is a very real threat of throwing yourself into the fray with just a little bit too much 'exercise' abandon. Its great to harness the excitement of 'going for it' and utilising all that freshly cultivated motivation, throwing on the running shoes that you got from Aunty Beryl for Christmas and setting out your weekly timetable of 6am spin classes with an added lunchtime run around the Botanical Gardens and yoga at 8:30pm. But the danger is that you got 'too hard', 'too quickly'.
Understanding and embracing the fact that this is when everything goes out the window is a positive outlook to the frantic rush that is pre-Christmas. You can have all the best intentions of 'doing it strongly' and committing to gruelling summer training schedules and restricted eating plans so that come January 1, you are able to strut your stuff on the boardwalks of Bondi and not feel intimidated.
People who suffer from chronic pain know how debilitating it can be. Pain can take the joy out of simple, everyday activities and make life difficult and overwhelming. Pain can be all-consuming, exhausting, depleting. Often an underlying cause for pain can’t even be found, leaving a patient with very few treatment options other than pain killers or other strong medications.
One of the best things you can do to ensure your good health is to learn how to read food labels and to understand what you're eating and where it comes from. There's a lot of jargon on the labels that can confuse, befuddle and make digesting the information more difficult than digesting the product! But there are a few tricks in there that are utilised by food producers to get away with non-legitimate claims. Knowing what you are looking for and identifying what is true for you is a little bit of education that is important for making the right choices.
Its hardly the time to start thinking about starting new goals and new ideas about what to do with yourself for next year. But it's not a bad time to start taking stock of where you are at with the whole work/life balance of this year and how you might want to change that in the future.
As we are so close to the season of indulgence, many of us start to fall off the bandwagon with motivation to exercise, eating correctly and maintaining dignity at social events whilst dressed inappropriately as a pirate!
But it may be a good time to just start to think about how you managed yourself this year and how you might like to do things differently in the dates to come. Most of us make it to Christmas with a frazzled look on our faces and a wide eyed expression of "are we there yet" fixed firmly on our faces. The week between Christmas and New Years is often when we start to madly spend time focussing on the dates to come. After the headiness of the days of eating and presents, all of a sudden we find ourselves faced with new years resolutions and pressure to come up with the 3 individual goals for the 7 sectors of our 'life wheel' in a mere 3 days. ARGGHHH!
So now is actually the perfect time to schedule in some time to sit, be, forget about deadlines and focus on what the goals for next year may be. What may you want to improve? What areas are the areas that you didn't spend time on enough this year? Did you get that holiday in? Did you maintain your fitness regime? Did you spend enough time with the kids this year? These are the questions to sit under a tree with and ponder and the time is NOW.
Scheduling in time to reflect is important. Putting it in the diary makes it a task. Which you want to do if you are serious about maintaining that balance between work/life/relationships etc. Brainstorming and ideas don't flow freely when we are frantic and stressed and trying to 'fit' something into the daily work planner. Like a garden, it needs time and space to grow.
So allot 30 min to 'plant some seeds' this week. You don't have to have the solutions til next year, but planting the ideas or even just identifying which areas need more attention may help to clarify that sector of life that you need to address for the future. Putting it in the subconscious means your brain may already start to be formulating solutions for you - so when you do come to sitting down in front of the blank piece of paper entitled 2015, you won't be stuck for ideas.
A little quote came to me this week which I rather like and think is kind of appropriate for keeping perspective for this time. I hope you enjoy it as it certainly resonated with me.
Leunig Curly Flat Letters
MOVE IT OR LOSE IT. It's a simple process of using what you have so you can keep it active and toned. If you want your brain to remain active and not suffer from dementia - exercise it. If you want your knees to stop aching in the winter - get them moving, get them active and they will respond. Sitting down is not going to give anyone a better, healthier outlook on life.
Getting the right advice is important. Getting the right diagnosis is paramount. Having contrary opinions is all very valid, but if a practitioner isn't listening to what you are saying and not taking into account 'your' experience and what you 'feel' is the issue, then perhaps it is time to find another therapist. You are the person who can give the information about exactly what is being experienced and that information is often a great insight for anyone wanting to investigate symptoms or conditions. It is a therapist's job to LISTEN. Despite having qualifications and degrees and years of being a professional, no-one knows your body better than you do. Only you know what you are experiencing. Being able to illustrate or dictate that is sometimes a challenge but never believe that you don't know better or that what you think isn't valuable!
Often a transition from couch potato to active individual is brought about by an upheaval. Again, a sufficient lever to promote you into action as opposed to sitting back and being 'reactionary'. This can be a threat of ill health (such as a doctor's dressing down of your lifestyle), a failed attempt at a 20km hike or a sudden realisation that you are under and below a level of health/fitness that you thought you were. Seizing on these 'opportunities' are a great way to propel you forward into your new habit forming action. Seizing that moment and beginning 'now' rather than later creates urgency which results in you being more likely to follow the momentum you are creating.
There is so much evidence that is available that supports the integration of physical activity to keep cognitive function at optimum levels. In other words, getting up and doing stuff with your body is vital to maintaining your brain capacity.
The idea and concept of the self induced reward is ingrained in theorems as an aid to short term motivation and instilling a sense of achievement in the workforce are well documented. We work for a reward. There is always a carrot dangling at the end of achain somewhere in our psychological headspace.
Friends and clients wane lyrically about the 'zone' and the sheer delight of finding that rhythm and cadence of metronome precision. The mere thought of running or 'jogging' has me thinking of sweaty eyes, flushed face and ankle shattering kms of tarmac. Sometimes necessity indicates a challenge to your persona. The need to conquer no matter how ambivalent you are towards the task - so to the challenge I go, with fixed determination to try and conquer my fear and my resistance. And every now and then you end up surprising yourself.
Clean Living is life without toxins. Ingesting foodstuffs that hasn't had a whole heap of processing done to it before it reaches your mouth. Receiving food in its raw state is the best way to indulge in a clean lifestyle. Additives such as preservatives, sugars, flavourings and the like, all have toxic elements contained within them. Some of these are processed within the body and some stay around in fat deposits after the body has dealt with them. Now you aren't going to have a toxic system by eating a bowl of factory produced microwaved french fries. But consistent ingesting of this type of food is going to build up levels of toxins in your system which is going to raise issues over a sustained period.
I am always telling people, GET AWAY FROM THE DESK, despite you thinking that you possibly can't - you really CAN. When I am doing admin, I always try to ensure that at least 5min out of every hour, I get away from the desk, stand up and do something else, even if it is just walking to the kitchen and preparing a cup of tea. Or going to visit the boys at Mecca Espresso! it was instilled in me from the days of High School study. Set the alarm clock for 55min. That 5 min break saves you time and prevents you from making the mistakes that you have to go back and fix later.
With any injury, there is associated compensation. The body is very good at adapting. What this means is that the body will 'find a solution' if it cannot perform a movement utilising the known or 'normal' means of activation/contraction. (biomechanics) If a hamstring is not firing properly or is compromised, the body will utilise the power of adductors to complete a movement. If a shoulder stabiliser goes 'down', the body will recruit from another muscle in the chain to stabilise the shoulder for movement.
Noting the anterior and posterior chains means that you have to be conscious of both sides of the equation when addressing motion and movement with training. If we don't ensure that BOTH sides of the equation are in balance then we will have issues with overdominant muscles. So no matter how much stretching and maintenance you do, if you aren't being active on BOTH anterior and posterior, you cannot really achieve a productive alignment. The pelvis is possibly the most simplistic example, but the understanding rings true for all major joint spaces.
Chronic pain is classified as pain that has gone beyond the length of 3- 6 months. Perhaps a better description is 'pain that has gone beyond the expected period of healing'. When you sprain an ankle, the recovery is 4-6 weeks. When you break a bone the expected healing is 2-3 months. Acute pain is pain that hurts when you move. It makes you wince when you extend beyond what the body is capable of tolerating. Its identifiable and explicable. Chronic pain is pain that sustains and is constantly present. It doesn't decrease with time, it doesn't get better with immobilising joints, it just 'keeps on keeping on'.
A client this week was faced with the uneviable prognosis of disc bulges in the lower cervical spine, possibly brought about through excessive overhead lifting with her weekly training regimen. Another client this week is faced with a degenerative and debilitating knee injury (or in his case – injuries) that may be brought about by overuse and ‘training through pain’. Without jumping on the negative implications of CrossFit, Strongman or Powerlifting regimes, (as I am quite fond of them) there is no doubt that this style of intense exercise regime can hold many dangers when the smallest of compensations and deviations occurs due to fatigue, over-training or poor instruction.