SLAP tears – what are they and what can you do if you have one?

A SLAP tear is an injury to the cartilage of the shoulder joint called the labrum. The labrum is a ring of cartilage surrounding the socket of the shoulder joint. The humerus/arm bone forms the ball aspect of the shoulder joint. Together they form a ball and socket joint.

There are actually many types of labral tears, but the specific type of labral tear we are discussing today is the SLAP tear. SLAP stands for Superior Labrum from Anterior to Posterior, and is a fancy way to say that the cartilage at the top of the shoulder has been injured. The SLAP tear occurs at the point where the bicep tendon inserts onto the labrum, and you can see from the diagram below exactly where the injury occurs.

We do not owns the right to this image. Image retrieved from the American Academy of Orthopaedic Surgeons.

So, what do you do if you have a SLAP tear?

Some SLAP tears does not require surgical intervention and some do. Rehabilitation depends on the severity/size, level of discomfort and, if required, the strength of the repair and surgical protocols.

A typical guideline involves:

Immobilisation
Restore range of motion
Regain Strength
Plyometric/Dynamic Movements

Here are some tips to avoid/minimise a SLAP tear:

Due to shoulder joint having a lot of mobility, it also requires more stability. Here are a few exercises that will help to strengthen the small, stabilizing muscles of the shoulder joint.

Posterior Cuff Strengthening/Face Pulls

Start with your arm straight down at your side and the thumb pointing forwards.
Raise your arm forwards and up/above your head keeping the elbow straight.
Make sure you do not hunch your shoulders as you lift the arm against the resistance.
Control the movement bringing it down by your side, slowly bring it back to the start position and repeat.

Banded Pushups

Start position in a press up position with the band around your wrist, arms directly under the shoulders, fingers facing forwards. The back and trunk level and straight with the toes on the floor.

Lower the body using the arms and shoulders until the chest just touches the floor, keep the trunk straight and arms aligned with the shoulders.
Press up into the start position using the arms and shoulders only, keep the backside in line with the back and shoulders and do not arch the lower back.

Diagonal Y- Raise

Start with your arm straight down at your side and the thumb pointing forwards.
Raise your arm forwards and across, keeping the elbow straight.
Make sure you do not hunch your shoulders as you lift the arm against the resistance.
Control the movement back down to the starting position and repeat.

For more information, email us at hello@bosic.com.au or give us a call at 8599 9811. We would be happy to answer any questions and help you recover!

March 24, 2020November 24, 2020

Working from home during COVID-19? We’ve got your back.

Protect your posture with at-home ergonomics

Working from home is the new normal due to global concerns over COVID-19 (CoronaVirus). How can you look after yourself during this time? Adjust your work – from – home office ergonomics.

The majority of us will be sitting most of the day, if not all day long. You may have heard that sitting is the new smoking. This is because research suggests sitting more than 6 hours a day decreases the lifespan of men by 20% and women by 40%. If we sit more than 10 hours a day, moderate exercise for 30 minutes cannot undo the risk of lifestyle diseases. Therefore, the right ergonomic setup can help offset these risks.

So how do you make your home office more ergonomic?

Simple changes are best!

Desk Height: Desk height should be equal to elbow height (right angles/90 degrees) to equally distribute the load on your wrists, shoulders and neck.
Screen Height: Ideally the top of the screen should be at eye level to limit excessive looking down to protect your neck
Screen Distance: Aiming for one arm’s length away from the screen
Screen Brightness: Adjusted to comfortable brightness, contrast and font size (ensure free from glare, reflection from light sources or shadowing)
Back Rest: Unfortunately replacing your fancy ergonomic chair will be hard. Alternatively, using a lumbar support roll or pillow will provide you with a 10-20 degree recline to minimise the risk of low back and neck pain.
Standing Desk: Converting your kitchen bench top to a standing desk to break up sitting is a good start. How, might you ask? Using books, boxes, mini stools, board games etc. Stack them neatly to form a tower for you to place your laptop on. This will allow you to create and adjust your ideal screen height. The final step would be using a keyboard, wireless keyboard or mouse to adhere to the desk height and keep your body injury free.

In conclusion

Once again there is nothing better than exercise, especially during this social distancing period. By identifying the risks and implementing early strategies we can reduce the risk of aches and pains in the neck, back and wrists. At BOSIC, we suggest implementing incidental movements to break up sitting and standing times. A simple strategy would be to take regular breaks to exercise or take a walk (including hydration breaks & toilet breaks).

As always please keep up your good hygiene (regularly wash hands, avoid large gatherings and be nice).

If you are getting stiff or sore whilst working from home we can cater to your specific needs and home setup, as we run regular ergonomic setups to clients. For more information and questions at BOSIC we have a video review option via our Telehealth to help you from home, interstate or internationally.

March 20, 2020March 27, 2020

Stretching – Why do we need it?

Stretching for recovery

By Physiotherapist, Vanessa Boon

Why?

Stretching keeps your muscles healthy, flexible and at its optimal length. Flexibility is key in maintaining joint range of motion. Muscles that are tight and short do not perform at their optimal making them weaker which increases our risk of injury. Though there is poor evidence to show that stretching reduces overall injury, it does reduce the risk specific muscle injury.

How much and when?

Ideally daily for at least 5-10 minutes, try to add it into your daily routine. You can try stretching before bed or doing it before and after exercise.

Important: Stretches should remain gentle combined with proper breathing technique, never stretch into pain! Hold a stretch until you feel your muscle relax or hold it for as long as you like.

What are the benefits?

Injury prevention
- Regular stretching allows us to maintain joint mobility and muscle length. Stretching before exercise helps with warming your muscles up and gets it ready for the exercises. Stretching after exercise can reduce DOMS (delayed onset muscle soreness) which is the soreness/ache you feel for a few days after a workout.
Better posture
- Poor sustained posture can cause quite a few issues in the long run. Muscles start to tighten where they should not and cause postural compensations. Stretching can lengthen those muscles that are tight and allow you to reset.
Reduces stress
- Stretching increases blood flow to your muscles while stress reduces it. Reduced blood flow = muscle knots and increased tension. Increased blood flow = decreased tension in muscles and increased blood flow to brain = improvement in mood!

Whether you are looking for a specific stretch routine, warm up, cool down, injury prevention advice or to better your posture, our physiotherapist here at BOSIC can tailor a program that is specific to your needs. Give us a call at 85999811 or visit us @barangarooclinic to find out more today!

March 18, 2020March 27, 2020

COVID-19 (CoronaVirus) Safety Measures

What is Barangaroo Clinic doing in response to Covid-19?

We know and understand that many people are feeling worried about the current world situation. It’s hard not to when you open social media, turn the news on, or tune into someone’s conversation. We’ve never experienced something like this before, so it’s okay to feel a bit anxious about it.

At the present time, the Team at Barangaroo Orthopaedic and Sports Injury Clinic will continue running as normal although we will be taking some extra precautions.

The health and safety of our team, our client community and their families is paramount in the midst of the current COVID-19 outbreak. BOSIC is keeping up to date with the latest information in regard to this matter.

In order to minimise the spread, BOSIC has and will continue to:

Disinfect equipment/surfaces regularly throughout (before and after), and in between clients
Increase daily cleaning procedures in all areas of the clinic
Treating therapists and clients are to wash or sanitise hands before and after treatment
Minimising contact – no high fives, hand shakes etc.
To ensure further safety we will try to minimise back to back consultations to maximise social distancing as your health is priority
TELEHEALTH! It is a 1:1 online video consultation to continue to conquer your goals where we continue communicating from wherever you are (internationally, working from home etc.) Simultaneously we can review, implement or progress your rehabilitation program and management plan. Click HERE to learn more.
Have some of our administrative team work from home / remotely
We are a low volume clinic, we have adjusted our practitioner timetables to reduce the volume of client’s in the clinic at any one time

How can you help?

Washing hands often with soap and water for at least 20 seconds
Avoid touching eyes, nose and mouth as this is how the virus can enter your body
Stay at home if you are sick or feeling unwell
Speaking to friends and family about hygiene, hand washing and minimising unnecessary contact
Cough or sneeze into a flexed elbow or tissue, dispose of the tissue and wash your hands

If you have further questions or concerns, please view the previous email about our updates in regards to COVID 19.

Enough about the sad news, let’s finish with how you can stay active and healthy. As we have learnt previously your immune system is the body’s mechanism to fight invasions and stop you getting sick, So we suggest:

Continue to eat healthy foods via a nutritious and balanced diet (vegetables)
Reduce the consumption of junk/fast foods
Stop smoking and reduce your alcohol consumption
Regular EXERCISE (with social distancing), as we all know this helps boost your immune system

The above we consider daily common sense, but the media fails to tell us how to try to live healthier.

Unfortunately things are going to get worse before they get better, but here at BOSIC we believe “The comeback is always better than the setback.” As long as we continue to practice active, healthy living and good hygiene it will not only boost your immune system but minimise the spreading of this virus.

We appreciate your cooperation on this matter and will keep you informed if we receive any further information from the Government and Department of Health as this is a fluid situation. If you have further questions, please feel free to call us at 8599 9811.

March 18, 2020September 29, 2023

ONLINE/VIRTUAL PHYSIO

VIRTUAL PHYSIO CONSULTATIONS via PHYSITRACK

CLICK HERE TO BOOK NOW

Many of you will be familiar with Physitrack for your rehab programs. We also use it a lot to communicate with our clients internationally and who are travelling with work as well as those who just want an individually designed program just for them.

What is a telehealth consultation?

A tele-health consult is a video face to face consultation with your treating practitioner. They are not a replacement of treatment or assessment in house but can be used well when people are unable to get to their on site appointment. They are very helpful for those working remotely, on the go, or frequent travelers.

How is it different to an on-site consultation?

As therapists, we are very reliant on our hands to assess and feel what we think maybe going on which we cannot do over the phone. However, these consults are great if people have questions about certain exercises they’re doing, while others may want to discuss their injury process, certain postural or movement problems and need help finding a solution.

We are also able to show and tell, demonstrating exercise progressions, correct technique and testing certain movement and strength parameters.

How do I book in?

Just book in for your usual scheduled appointment, either online or give our team a call on 8599 9811. Please mention “Telehealth” so our team can send you our information document with how to prepare and set up!

BOOK HERE

What are the inclusions & fees?

You will get 1:1 video consultation with the practitioner of your choice. The therapist will assess via video, taking a progress report and ask you to perform movements as required.

Review, implementation or progression of your rehabilitation program and management plan

Consultations are offered with a fee reduction of $25 on our on site fees. If you have additional questions, feel free to call us at 8599 9811.

March 6, 2020March 6, 2020

What do we REALLY know about recovery?

By Physiotherapist, Paulina Backiel

The Oxford Dictionary defines recovery as:

“a return to a normal state of health, mind, or strength.”

All these things are so important in our daily lives, and they mean something a little different to each of us. In the paragraphs below, I will take you through the 3 main topics of recovery.

1. Normal State of Health

First of all, you have to think about what health means to you. This does not necessarily mean that you should go on an aggressive diet or start fasting. It is important to create health goals that are achievable. This could be: an appointment with a dietitian to get your diet on track, an appointment with a personal trainer to guide you through an exercise program, a massage to help decrease stress, or simply giving yourself an extra 30 minutes of sleep every night.

2. Normal State of Mind

This can be challenging for anyone. It’s so hard in this day and age to get a piece of mind when your phone is going off every minute or when you are staring at a computer screen for hours without a break to get some fresh air. To recover your mind, it’s important to try and remove all of the stressors crowding your mind for at least one hour every day. Some people do yoga, some meditate, but for me it is my running and my gym time. It’s the time that I intentionally set aside for myself and my form of meditation.

3. Normal State of Strength

This does not mean that you have to be like Arnold Schwarzenegger or the world’s strongest male or female. This can be a fitness goal that you set for yourself that involves strengthening the body. Whether you go see a physiotherapist because you want to train for a swim, or you want to be able to run 5km for the first time, any goal can be adapted to work best for you. The stronger our bodies are through exercise, the better we feel! Plus, exercise decreases the chance of developing certain diseases, depression, and lowers our risk of cancer.

Recovery in Sports

This is the recovery that everyone is so familiar with, however as athletes (anyone who plays a sport) we tend to ignore this crucial part.

When we play a sport or exercise, we apply stress to the body’s tissues. This is how we are able to stimulate growth in our muscles. I bet most of you can really feel a hard workout the next day. That feeling is called DOMs, meaning “Delayed Onset Muscle Soreness.” This is when the muscles have been worked to their limits and are now in recovery phase which could last 24-72 hours post exercise.

Recovery for athletes can mean you work on a different set of muscles the next day to give your sore, healing muscles a rest. It can mean treating yourself to a massage or going to the beach for a relaxing day in the sun. Whatever recovery you choose, don’t forget that sleep is critical for the body to be able to recover and is one of the hardest things to accomplish in our busy schedules. So make sure you get at least 8 hours of sleep if you are an athlete that trains consistently. This will drastically decrease your risk of injury, and can increase your performance.

Want to learn more about my self-care and recovery routines? Feel free to shoot me an email at paulina@bosic.com.au. I am happy to chat and would love to meet you!

February 14, 2020February 13, 2020

Put your best foot forward! The difference between stability and neutral footwear

What is a stability shoe? What is a neutral shoe?

By Physiotherapist, Paulina Backiel

A common question people ask is, “do i need a stability or neutral shoe?” Today, I am here to help you figure out what do those words even mean and to give you some guidance on how to choose the right shoe.

Neutral

I would recommend this shoe for 80-90% of my patients. A neutral shoe means that the same foam carbon plate, or other sole technology, is placed throughout the shoe. They have no motion control, allowing the foot to move freely, using more muscles in the foot. This can increase strength in the foot, instead of allowing it to become lazy and weak.

Stability

This has been a great marketing scheme for years. Just because you need a shoe that is stable does not mean you need a stability shoe. Neutral shoes can be stable due to their rigidity and a better fit for most people.

A true stability shoe contains a post in the middle of the shoe, under the arch of your foot. This post is generally made of a stiff, rigid sole material in order to hold the arch of your foot up. I would only recommend this to 5-10% of my patients, so unless you have a chronic condition, anatomical deformity, or a surgeon has specifically recommended a medial post in your shoe, I would not recommend a stability shoe.

The post inside of this shoe controls the motion of the foot, which ultimately makes your foot do less work. Over time, the foot will become dependant on the motion control properties, and if you run on the lateral side of your foot (the outside of your foot) this can over correct your foot, putting you at risk of ankle sprain and muscle strains on the lateral side of the foot and shin.

In conclusion

If you are looking to get new running/walking shoes and you do not have any major problems or pains in your feet, a comfortable neutral shoe would be advised. If you are unsure, go see a running physio such as myself, a podiatrist or a professional shoe fitting shop. Feel free to ring us up at 8599 9811 and book in an appointment for an assessment.

February 6, 2020February 6, 2020

ACL – from Injury to Recovery (through the eyes of a physio!)

By Principal Physiotherapist, Sam Davison

ACL from Injury to Recovery Through the Eyes of a Physio

That’s me in the bottom right – see, just a normal human having fun with friends!

Most of you believe physios to be super resilient gym lovers who are totally bullet proof…. Truth is we are just normal human beings who have always had a passion for keeping active.

We too can get injured. During my 11 year physio career, I’ve spent the bulk of my time working within the outpatient department. Over the years I’ve developed a particular passion for the lower limb and more specifically treating soft tissue injuries of the knee. I now work closely with a number of orthopaedic surgeons developing evidence led protocols whilst continuing to ensure the comeback for my patients is better than their initial set back. On reflection, I’ve helped hundreds of patients rehab their knee injuries, with and without surgery, over the past decade in the UK and in Australia.

“Unfortunately, now I have become one of my own statistics.”

When I thought about taking a fun helicopter ride through the Alps, this wasn’t exactly what I had in mind….

Two weeks ago whilst enjoying the beautiful snow in the Alps, I took a bit of a tumble on a black run (nothing particularly spectacular or dramatic) and straight away I just knew, despite not hearing the infamous pop or noticing the swelling within the first ten minutes as the textbook always said. Whilst trying to locate my skis and get back up, I realised the binding was totally cracked. A lot of energy went through my knee to break the ski. No amount of bum shuffling would have gotten me to the bottom. I wasn’t in a position to ski anywhere. I was scooped into the “ski-doo of shame” and swiftly airlifted back across the Swiss border into France into an ambulance and onto a medical centre.

As usual, the XRs were normal and I was told it was just a mild sprain and to crack on with it. And so, in typical British style, I headed to the pub to meet my comrades for the apres ski. Funnily enough I was on holiday with 4 doctors. As physios, we know that doctors examinations of the joints aren’t always as good as our own (ha ha) but aside from having the knee the size of an elephant, I didn’t have a lot of pain, and all the ligament tests felt normal. I’m not sure what day would have been the best day to hurt myself but day 1, and only 3 hours of mountain air, seemed awfully unfair. Whilst everyone else minced on the mountain, I took myself to the aqua centre for a daily 2 hour spa session, which was bliss. Fast forward 5 days, eating large amounts of bread and cheese and enjoying our french wine collection, I somehow managed the long 22 hour journey back to Sydney. Unfortunately, my worst fears were confirmed and my MRI showed a significant amount of bone bruising, a ruptured ACL and a torn meniscus 🙁

There are simply no words to describe my devastation at the time – I knew what was coming and exactly what I was facing. See the MRI below:

So, here is my plan of action before my reconstruction:
    ⁃    PREHAB – getting my knee in as a good a shape as possible before going under the knife
    ⁃    But specifically:
    ⁃    Getting my knee moving better and reducing the swelling that’s left
    ⁃    Weaning from the brace
    ⁃    Pool work (walking / lunges / squats / calf raises and gentle free style)
    ⁃    Gym work – Nothing wrong with the abs or arms
    ⁃    Quads, quads and more quads

I’ll give you a post op update once I’m through the other side! Thank you all so much for your words of encouragement and support. I’m so fortunate to be surrounded by the best Multidisciplinary team in Sydney, and together we will show you how BOSIC rehabs an ACL.

Bring it on!

January 22, 2020February 6, 2020

Nervous to start exercising? Start with the basics

By Physiotherapist, Vanessa Boon

How do I get started?

Start small – you can start with 10mins. daily. Any activity is better than no activity!
Make it a habit – make it a habit to set aside time, to prioritise exercise and your health!
Work up to it – get started and see what works for you, if you find that you can dedicate more time in a day, do it. But remember to make sure it is manageable and is something that you can be consistent with. You will never see changes overnight, consistency is key.
Listen to your body – If you are ill, if you are in pain or just really run down, it is ok to take a break. In fact, it is good practice to take a break when you need it. The goal is to get back into your routine as soon as possible. If you are in pain, consider doing alternative exercises that will not flare you up. If you are finding it difficult to think of alternatives, give us a call and one of our physios or exercise physiologist can help you out with that!
Manage your expectations – Set achievable goals for yourself and reward yourself when you achieve them. Do not expect it to be easy or to get fit overnight. Fitness and health is not a quick overnight fix, consistency is key.

What are the recommendations for exercise?

For strength/resistance training: aim to target major muscle groups 2/week. If you want some exercise ideas, head on over to our Instagram to watch all sorts of videos with tips and tricks to help you on your fitness journey. Make it more challenging by adding weights or using resistance bands!

For aerobic activity: aim to get more than 150 minutes of moderate activity/week or 75 minutes of vigorous activity/week.

An easy way to measure activity intensity:

Low = you can belt out your favourite song
Moderate = you can hold a proper conversation
Vigorous = you are trying to catch your breath

How do I work up to the recommendations?

The simple answer is to make it work for you.

Exercise is not one size fits all. Not everyone likes the same sort or style of exercise. Choose one that you enjoy and have fun with it! Pick activities that fit your lifestyle and stick to it!

If you know you do not like to exercise alone such as resistance training, join a class or a group. Make it social! When where you workout with friends it makes the experience more fun, and it will keep you motivated.

If you want to try a group exercise class with our team, send us an email or give us a call at 8599 9811 to find out when we are doing our next F45 class. Or, if running is more your thing, check out our Run the Streets (Barangaroo) run club, who go for group runs every Monday at 12:15.

January 17, 2020January 15, 2020

Is your goal to run a race in 2020? The perspective of racing through the eyes of a runner.

By Physiotherapist, Paulina Backiel

I always scan through insta, looking at runners and their smiling, perfect race photos, looking like they are having a blast. Well let me tell you, this is what I look like (yep, that’s me right there – not a stock photo). Not really pretty right? Reality usually isn’t, its messy and all over the place. So here is a sneak peak into my mind when fighting for that messy 1st place.

I’m at the start line, everyone is staring me down since I’m a female lining up with the men at the front of the line. I’m wearing a singlet, and I see females in sports bras, six pack abs showing, and I’m thinking to myself, “I’ve already lost” (with my one pack). The announcer says 3 more minutes until “Start.” I take my gel and caffeine strip to wake me up (I’m not a morning runner). The countdown begins.. 3..2..1…GO! My heart beat sky rockets, I can feel it travel up my body and into my throat. One guy passes me, then another, then some female runners. I don’t let this falter me, I just have to stay on their tail. I try to convince myself that they are starting too fast so they will fade eventually (right)? Breathing is getting harder. I start to hyperventilate and have to close my eyes while running, reminding myself to take slower, even breaths. After 4km I finally start getting into the groove and all the sudden I pass a female runner, then another. I read a sign someone is holding saying “you are our inspiration,” and it almost brings tears to my eyes, but I have to keep running. My legs are starting to get heavy as 7km approaches; holding a sub 4min/km pace is starting to get harder. Then someone from the side cheers saying “first female, keep running!”

The adrenaline rush that hits me is unreal. I start thinking “I can actually do this,” and I can feel the warmth spread through my body like electricity straight to my fingertips and my toes. At this point the world does not exist, I can do anything I put my mind to. Nothing is impossible anymore! One kilometer to go – I’m on fire. At this point it feels like everyone I love is pushing me forward. My uncle who, rest his soul, is telling me not to give up like he did, while my dad is telling me I’m running too slow and can go faster (typical dad). Everyone that ever doubted me can no longer bring me down. I sprint the last 600m, and i’m stumbling over the line. I come to a harsh stop almost crashing into another runner. The crowds are cheering, I have to sit down with my head between my knees to try to regain my regular breathing pattern.

The announcer calls my name over the mic, “…and first female, Paulina Backiel, has just crossed the line!”

Distance running is not about how good you look in your running photo or how big your six pack abs are. Distance running takes training and, most of all, mental strength. Trust your body’s abilities. If you believe you can do something, do it. That belief, along with the time you put in your training, can get you farther than the person next to you at the next race. So train hard and believe in yourself. If you want something, you have to be willing to reach for it, even if it feels like reaching for the stars at the moment.