Stay on top of your ride this summer

Surfing involves dynamic movement on an unstable surface. So to be able to surf well out in the ocean, it is important to be able to move well on land. As surfing is such a demanding sport, it requires flexibility and strength to perform. Muscular imbalance and restricted movement are key problems that can keep surfers out of the water.

Unfortunately, due to the unpredictability of the ocean some injuries can also be caused by trauma. However, a lot of surf injuries can be avoided with early intervention. Here are some of the key issues to be aware of, and some tips to avoid them restricting your ability to surf.

Surfers Neck

A common cause of neck injuries in the surf is overuse. You spend a lot of time in a prone lying position with your neck extended. Prolonged extension on the cervical joints in closed position (packed position) whilst paddling, can cause increased demand on the neck structures. The pain will reduce your ability to look ahead for the next set or look over your shoulder when paddling for the next wave. Stiffness and pain through the neck can develop poor biomechanics in your shoulder resulting in further injury.

# TIP:  Daily range-of-motion neck stretches and chin tucks can help slowly improve the mobility in your neck.

Shoulder Injuries

Shoulder pain is one of the most common injuries that occurs for surfers. Pain and weakness can affect your strength when paddling, duck diving and popping up. Overuse and weakness with the repetitive paddling stroke can lead to injuries on tendons, or pinching of bursa structures. Paddling strengthens the large muscles in the shoulder (Levator scapular, Latissimus dorsi, Upper Trapezius, Deltoids, Pec Major). Unfortunately, it does not work the smaller rotator cuff muscles as much. Having that imbalance can result in impingement through the shoulder, making shoulder movement painful.

# TIP:  In the gym it is important to target your smaller (rotator cuff) muscle groups with light free weight exercises.

Back Pain

After a big day of fighting the current and paddling endlessly to get back out into the line up it can quite often feel like your back is starting to seize and go into spasm. A strong back is critical for keeping any surfer in the water. Paddling on your board basically involves long periods of back extension. If the strength and endurance is not there to hold that position, you are likely to end up with a sore back and the potential for further injury.

# TIP:  In the gym incorporate back extensor exercises, along with core and functional rotational movements.

Hip Injuries

Popping up, a few pumps down the line, a round house cut back and a few more pumps, all require great mobility and flexibility – especially in the hips. Due to our lives becoming more sedentary (or spending 50 mins in a car following a cautious drive out to Piha). Our hips become shorter and tighter due to prolonged contracted positions. Tight hips can cause not only pain and limitation in your surfing manoeuvres, but also can contribute to pain in the lower back and knees.

# TIP:  Regular stretching of hip flexors, hamstrings, glutes and adductors are important for maintaining hip mobility.

Knee Injuries

Knees can take a beating out in the surf. The medial collateral ligament (MCL) is one of the most common structures to injure on the knee while surfing. The MCL is the large ligament that supports the inside of everyone’s knee. When you’re in a crouched position about to be barrelled, your back knee position is often bent and twisted inwards. If the wave were to close out or dump heavy on you, the MCL would be under a lot of stress and this can lead to a sprained or torn ligament.

# TIP:  Make sure the muscles around your knee are strong to support your knee structures. Strengthening quads, glutes and incorporating balance exercises are key.

Ankle Injuries

The ankle is important in surfing as it gives the surfer the first lot of information as to where they are positioned on the board. A lot more ankle injuries are happening for surfers as aerial manoeuvres are becoming more common resulting in an increase in awkward landings. A rolled ankle or stiff ankle can both be limiting for surfers. Pain and lack of mobility can cause difficulty popping up, crouching low or limit power when carving that big turn.

# TIP:  In the gym focus on balance and mobility, as well as calf strength for push off.

If you are aware of any injuries that may be affecting your surfing performance, or would like to go over your technique and strengthening exercises, get in contact with our team at Ponsonby Physiotherapy. We’re happy to help you with the right functional advice and support to keep you on the water this summer.

Photo credit: Tim Marshall

Our physiotherapists see a lot of different injuries across age groups but the age group that we tend to see most of is the 35-50 year old group. There are several reasons why this particular age group might be susceptible to a few more injuries than others. But for the most part the higher injury rate can be preventable – so long as when we exercise in our 40s we stop thinking like we did when we were 20!

As we start to reach middle age, our bodies experience changes in our muscles, ligaments, tendons and joint structures. Typically we take much longer to recover from injuries. At the same time, it is more important than ever that we add exercise into our lifestyles.

What’s going on?

There are a number of contributing factors which help to cause a spike in injuries for this age group. Perhaps not having the time to prepare for sports games or complete pre-training, warm-ups and warm downs. Sometimes we’ve done too much, too soon or we have not achieved the needed frequency of exercise stimulus. As an example, I hear people say that they are training for a half marathon, and then find they are only running perhaps twice a week. One long run and one short run. Where in reality, it would be better to have another 1-2 runs a week with some resistance training thrown in there.

For females entering their forties, there is also the added complication of perimenopause and menopause where our hormones start to go somewhat haywire, along with oestrogen disappearing, which can have a detrimental effect on our tendon and muscle strength.

So, what can we do to help ourselves?

It’s time to adjust how we approach our exercise and training, even if we are time poor.

Firstly, that means considering our load response. This has a direct impact on our tendons and joints. If we are introducing new exercise or adding more intensity, frequency or volume to our exercise of choice, then we need to do this gradually so that our bodies can adjust to the load and start to respond in a positive way. For example, if you are gearing up for the touch season, then you will need to do some cardiovascular (CV) fitness training, but also add sports-specific movements into training sessions; such as change of direction, running backwards, and change of pace.

Secondly, the importance of resistance training as we get older has been widely documented. We want to be able to maintain our muscle strength. In order to do this we should be lifting weights or using some form of resistance. This could be free weights or the use of power bands. Dr Stacy Sims leads the field with regards to women and training with her mantra being ‘women are not small men’ and on the several occasions I have heard her speak she is a vocal advocate for women lifting heavy stuff! Obviously, we need to build slowly into lifting if we are new to this concept, but if done right and frequently then gains can be quite quickly made.

In addition, consider the frequency of the stimulus with resistance work, the need to incorporate some variety in exercise, the use of different repetitions and sets, and the tempo of the exercise. Always bear in mind the quality of the movement rather than the quantity, and of course adding warm-ups, mobilisation movements and stretches.

In terms of training your CV fitness as we reach that 40+ age group, don’t ignore your previous exercise experience. Someone starting out with a low cardiovascular fitness level will be quite different to someone who has been exercising for most of their life. Their CV systems are going to respond differently. We need to consider the intensity of our exercise as well as allowing enough recovery time at lower intensities.

I guess a basic concept to think about when exercising is “use it or lose it”. So if you are just doing the same thing all the time, then you will continue to maintain that level of fitness, which might be fine but you then can’t expect to be able to maintain your ability to sprint, or run up several flights of stairs when you have only been walking on the flat.

What do we want to add to our cardiovascular fitness goals?

• Mix elements of higher intensity work alongside moderate work
• Add some strength focus into our aerobic exercise choice – such as stairs/hills or increase resistance on the bike
• Shorter rather than longer is often better (dependent on what you might be training for)
• Recovery is important and this includes sleep and nutrition. Nutrition needs do change as we get older and often the type of food we eat and the time we eat can have a positive impact on the benefits of your exercise and recovery.

Make the time to exercise

Making time to exercise as we get older is clearly important. Its benefits are far reaching in terms of our health, not only from a physical perspective but also mental health as well. Even small bursts of exercise will have a positive impact on your overall health.

The key to sticking with it is to find an exercise, activity or sport you enjoy and then start a habit to exercise regularly with others or on your own. Some people enjoy listening to music or the latest podcast while out and about, others just enjoy being in nature.

Remember that resistance work is your friend! It will help you be active for longer and hopefully help prevent some of those niggly injuries.

Our physiotherapists can help both in your rehabilitation program as well as helping you move towards those lifestyle goals, developing an exercise program to suit you. We can also provide advice around load and how to prevent training errors. We look forward to helping you achieve your goals.

If you know what deadlifts are, there is a good chance you will have heard a few scary things said about them. There has historically been a stigma regarding the exercise, with some people thinking they are dangerous, or that if you do deadlifts you will damage or injure your back.  However, we can debunk this negative myth and show you that deadlifts, if done correctly, can be your friend and ally.

Understanding the Deadlift

There is an increasing body of evidence in the strength and conditioning world that the deadlift might be one of the best, if not the best, strength exercise you can do. The deadlift is a simple free weight exercise. It involves lifting a stationary weight from the floor in a continuous motion. The ‘dead’ refers to the fact that the weight is still at rest, so no momentum is used during the exercise.

The deadlift is classed as a compound exercise, which means that it works multiple muscle groups at the same time rather than working a specific muscle in isolation. This makes the deadlift a very efficient and functional exercise. The muscles worked during a deadlift include your glutes, hamstrings, quadriceps, abdominal and lower back muscles (including your trunk and core muscles), mid back, upper back, neck and shoulders. It also works your forearms so it will increase your grip strength as well.

The deadlift is excellent for developing whole body strength, endurance, stability and power. Deadlifts particularly target the posterior chain, which are the muscles on the posterior aspect of the body. These muscles are involved in hip, knee and back extension (straightening).

Interestingly, deadlifts are also good for teaching optimal hip function. Hip function can be reduced due to our increasing use of stationary seated positions in work and leisure. Improving the strength of the posterior chain muscles and learning how to synchronise the movement of the ankles, knees, hips and back into one pattern, helps to optimise hip function and encourages these joints to form good functional movement patterns. With this we can minimise the strain on, and increase the resilience of these key structures in the body and therefore reduce the risk of developing injuries and pain in these areas.

If you already have low back pain (particularly, mechanical low back pain), deadlifts may actually form an important part of a strengthening programme guided by your physiotherapist. They can be very effective in helping to reduce pain and disability, and increase both your activity and physical performance. Deadlifts have also been shown to be effective at improving pain related fear of movement in patients with low back pain.

And of course, with postural-based issues being relevant for many, deadlifts can also help improve your posture. By strengthening the posterior chain and core muscles, deadlifts increase the strength and endurance of your posture muscles, helping you sit and stand with a more optimal posture.

Highly Functional and Adaptable

The deadlift is a very functional exercise and its benefits transfer well into sports and normal daily activities. When you are stronger and more resilient your ability to do everyday tasks such as picking heavy objects off the ground e.g. groceries, children or suitcases etc. is enhanced. Deadlifts can also help develop a level of strength that can be used for a number of other exercises and improve performance in activities requiring significant levels of hip and core strength e.g. running and jumping.

The deadlift can be performed in a number of different ways with a variety of equipment. Different types of deadlifts will target the body in slightly different ways. The right type of deadlift for you will depend on your performance goal. Remember you can be resourceful with your equipment as well. When dedicated equipment isn’t available, deadlifts can easily be performed at home with a suitable object around the house e.g. a bag of groceries or a backpack with weights inside.

If done correctly, the deadlift is considered one of the safest weightlifting exercises to perform. You can’t get stuck under the weight and it can’t pull you over. If you get into trouble you can just drop the weight on the floor. If people do get injured while doing deadlifts it is typically linked to poor exercise technique, lifting too much weight for their capabilities, or progressing the load too quickly. It is therefore very important that if you want to start adding deadlifts to your exercise regime, you see a professional who can teach you the correct exercise technique and guide your progression safely.

If you have technique questions or would like further support, get in contact with us here at Ponsonby Physiotherapy.

Pain located at the front of the knee – anterior knee pain – can have multiple causes, especially if the pain has been brought on suddenly by an accident or injury. However, whether the pain started slowly, or due to a specific incident, the two most common causes of anterior knee pain are Patellofemoral pain and Patellar tendinopathy.

Patellofemoral pain may be caused by a variety of structures in the knee joint. Because of this, the pain is usually quite vague in its location. It may be felt on either side of or below the knee cap. It is mostly felt with weight-bearing activities that also include bending the knee such as running or using stairs, and is especially aggravated by downhill activities.

The patellar tendon or ligament is a fibrous tissue that connects the kneecap to the top of the shin bone. In patellar tendinopathy the fibres become disorganised and weakened. The pain is usually felt below the knee cap and can be sensitive to finger pressure. Activities that involve jumping or sudden changes in direction and / or deceleration often aggravate the pain. The pain may also be felt at the beginning of a squat, or on climbing stairs.

Pain at the front of the knee is often associated with a sudden increase in load on the structures supporting our knee joint. If the load on the knee is greater than what it is able to handle, pain or injury can result. More obvious factors that can have an effect on this are, for example, the frequency and type of our activity, speed, surfaces, shoes, or how often we rest. Other factors can be harder to identify such as the correct alignment and biomechanics of our hip, knee and ankle joints. Correct alignment and biomechanics of the knee, in part, depends on the strength, length and control of the muscles in our glutes, thigh and calf. 

How can physiotherapy help with these conditions – in person or remotely?

Because pain at the front of the knee is mostly associated with our daily activity and exercise, if you can’t visit your physiotherapist in person, knee pain like this can successfully be treated without hands-on treatment. The trick is to strengthen the knee and improve its mobility so that it is able to handle more load. From there, the load placed on the knee can be slowly increased.

Depending on the situation it may be important to first decrease and better understand the pain. In addition to being uncomfortable, pain also changes the way our muscles function and the way we move. During this time, it may be necessary to temporarily decrease or avoid certain activities.

Once the pain is under control, we can look at managing and slowly progressing the load placed on the knee joint with daily activity. Working with you, your physiotherapist may alter some of your daily habits or activities, or change your training program to accomplish this.

Throughout the treatment period, your physiotherapist may incorporate certain exercises or stretches to improve body alignment with the movement of the knee during daily activities.

If you are currently struggling with knee pain, get in touch with a physiotherapist here at Ponsonby Physiotherapy to get the right support for your specific situation.