Sunday, October 22, 2017

SS Turns 8!

Our clinic celebrated our 8th anniversary yesterday. A big thank you to all our families, staff, friends and patients for all your support all this while. We wouldn't have done it without all of you.

Our goal has remained the same all this while. To make our patients better quicker. "As long as we're happy and enjoy treating our patients, it's not really work."

Here's to many more years to come!

Monday, October 16, 2017

Hamstring/ Calf Pain? Treat Your Back

Now here's a nasty hamstring injury
I was looking through some of our past articles in our Physio Solutions blog and came across this article on how treating the lower back helps with hamstring injuries.

Here's a good reason why this is so. This article written way back in 2004 addressed the issue of hamstring and calf strains in older footballers in particular (but can also be in runners, triathletes etc).

I came across many of Dr John Orchard's articles back when I was doing my post graduate physiotherapy studies in 2003. This particular article suggested that a possible mechanism of higher occurrences of hamstring/ calf strains in older athletes may be due to your lumbar spine (or lower back) issues.
See where L5 nerve root is, (disc is next to it in white)
He suggested that the L5/ S1 neve root segment may be more prone to irritation and compression under the lumbosacral ligament due to disc degenerative changes. Dr Orchard notes that the L5 nerve root has the "most tortured path through the lumbosacral canal" before going over the sacrum to join the sacral plexus (or nerve roots).
The lumbosacral ligament further lessens the L5 space 

He suggested that it is likely that the location of a larger lumbosacral ligament is clinically more significant in older athletes due to degenerative disc changes (or slipped discs).

Due to possible L5 nerve root entrapment, some older athletes may have regular hamstring/ calf  and nerve muscle and tendon injuries. This happens when the L5/ S1 segment loses disc height (due to a slipped disc).

Space for the L5 nerve root is thus reduced (under the lumbosacral ligament) and may cause back pain and/ or hamstring and calf muscle/ tendon injuries.

So now you know why we treat your lower back when you have a hamstring or calf injury, especially when treating just the hamstring or calf doesn't improve your condition.

This is especially so when you saw from last week's post on how the hamstrings are closely related to the thoracolumbar fascia.


Orchard JW, Farhart P et al (2004). Lumbar Spine Region Pathology And Hamstring And Calf Injuries In Athletes: Is There A Connection? BJSM. 38(4): 502-504.

Sunday, October 8, 2017

How Your Hips Are Connected To Your Shoulders

Yes, our shoulders are connected to our hips! Definitely if you refer to work done by Tom Myers in his Anatomy Trains book.

If you look at the picture above, you can see that the right hamstrings through its fascial attachments are linked to the buttocks then through the thoracolumbar fascia across to the opposite (left) rib cage, shoulder and arm.

If I say it simply, it means your hamstrings actually attach to your arms! Or if I put it in a different way, your arms don't end at your arms. They end at your legs.

Another look at the connection
So supposing you have a rotated/ and or unstable pelvis (or hip), this can affect your shoulder and change the biomechanics in your shoulders and cause pain.

So in order to treat your shoulder pain, I'm not really crazy if I assess your hips before I look at your shoulder.

Just ask Bertrand, without really assessing his shoulder pain, I made his shoulder better just by taping his hip. 

Now when you come and see us in our clinics, you know why we look at your hips first if you have shoulder pain.