Top tips for preventing sports injuries

In part 1, I introduced the topic of period pain.  In this blog post, I want to explore the topic from the perspective of functional medicine practitioners who believe that period pains are caused by certain nutritional deficiencies particularly vitamin B, magnesium and essential fatty acids. There is evidence that magnesium can reduce the sensitivity to pain.  In one study 21 out of 25 women treated with magnesium for six months saw a reduction in the period pain. In one scientific study over 500 women aged between 12 to 21 with moderate to severe period pain took vitamin B1.  87% were completely cured after 3 months.  Just 5% saw no effect at all, while 8% saw their pain reduced.  There is also scientific evidence that vitamin B6 may be useful too. Finally, there is scientific evidence that Acupuncture can be a safe and effective treatment for period pain. References Magnesium reference see >> https://www.ncbi.nlm.nih.gov/pubmed/27978803,  https://www.ncbi.nlm.nih.gov/pubmed/11687013, Vitamin B reference see >> https://www.ncbi.nlm.nih.gov/pubmed/8935744, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459624/ Acupuncture references see >> https://www.ncbi.nlm.nih.gov/pubmed/29879061 and https://www.hindawi.com/journals/ecam/2017/1791258/abs/  

If you remember last week, I shared some tips on how to prevent lower back pain.  These tips were inspired by me straining one of my lower back muscles while on holiday in Bulgaria.  I stated last week that it was sorted out by a combination of massage, stretches and back exercises. So this week I want to share the three simple stretches I used to ease my back. 1. Knees to Chest For the first day this is the only stretch I did. You lie on your back, with your knees bent and your feet flat on the floor. Put your hands behind your knees and gently bring your knees towards your chest.  I held this stretch for about 2 minutes and did it 3 - 4 times a day. 2. Two - knee - twist Lying on your back, bend your knees into your chest and bring your arms out at a T. As you exhale lower your knees to ground on the right. Keep both shoulders pressing down firmly. If the left shoulder lifts, lower your knees further away from the right arm. Hold for 1-2 minutes each side.  Again I repeated this stretch 3 - 4 times a day. 3. Thread the Needle Lying on your back, bend both knees with the feet flat on the ground. Bend the right knee like a figure four, with the outer left ankle to the right thigh. Lift the left foot into the air, bringing the left calf parallel to the ground. Thread your right hand between the opening of the legs and interlace your hands behind your left thigh. Hold 2-3 minutes and then repeat on the other side. Again I repeated this stretch 3 - 4 times a day.

Chair sitting is unique in that Gluteus maximi are totally relaxed at the same time as having an upright torso, and they are therefore not able to contribute to lumbar extension and back stabilization as they usually do. Without the help of the Gluteal muscles, the Erector Spinae muscles above become tired and painful in a very short time, and give up fighting to maintain the correct "hollow" in the lumbar spine. The diagram on the left indicates what happens to three key muscles when you spend long periods of time sitting. The Hamstrings (H) are shortened by sitting.  Also, during sitting, the Gluteus Maximus (GM) is relaxed and unable to tension the lumbosacral fascia.  This means the Errector Spinae (ES) muscle group must therefore perform the entire lumber extension workload. This article discusses the link between lower back pain and the following muscle problems:-

1. Shortening of the hamstring muscle.
2. Overworking of the Erector Spinae muscle group and the development of trigger points.
3. Overworking of the Iliopsoas muscle group and the development of trigger points.

• Diffuse achy - type pain radiating out from the groin area to the lower back, and possibly around to the side of the hip and the butt area. If the trigger points in the groin are not pressed, the pain is not sharp or stabbing.
• Relief of pain is often experienced by sitting down.
• Worse upon lengthening the iliopsoas, i.e. when one stands up, or straightens the hip joint.
• Worse for doing situps.
• Worsened by externally rotating the hip (i.e. making the knee cap look outward) when the hip joint is fully extended.
• In patients with sciatic nerve pain, lying flat on one's back with the legs out straight causes the trigger point tightened iliopsoas to compress the lumbar vertebrae together, with the result that the nerve roots of the sciatic nerve are compressed too.
• When lying flat on one's back, doing a straight leg raise reveals weakness on the affected side.
• In patients with sciatic nerve pain due to nerve root compression, lying flat on one's back with legs out straight stretches that trigger point tightened iliopsoas. The result is that the iliopsoas compresses the lumbar vertebrae together, and the the nerve roots of the sciatic nerve are compressed at the same time.