Shoulder impingement during swimming is largely due to dynamic muscle imbalances and biomechanical faults. Dynamic muscle imbalances can be addressed by strengthening exercises for the rotator cuff and scapular stabilisers, together with stretches for the muscles at the back of the shoulder.

One good exercise is to stand facing a wall with your arm raised to shoulder height and elbow straight. Hold a tennis ball to the wall by leaning through your shoulder and pinch your shoulder blades together. Roll the ball in small circles for 15 seconds first clockwise then counter clockwise until you become fatigued or two minutes, whichever comes first.

Biomechanical faults can be addressed by correcting your swim technique. Achieving good symmetrical body rotation through the development of an efficient bilateral breathing pattern helps to avoid shoulder impingement during the catch and pull through phase of the freestyle stroke.

If you already have shoulder pain it may be helpful to shorten your stroke and avoid the use of hand paddles. Hand placement during entry to the water should also be monitored. Instead of entering thumb first change your technique to enter with a flat hand or fingertip first. This is made easier by avoiding reaching across your midline. A thumb first entry works the shoulder internal rotators excessively and when multiplied by approximately 3200 strokes per hour contributes heavily to the muscle imbalance of strong internal rotators and weak external rotators causing shoulder impingement.

Most swimmers pull through with a straight arm or dropped elbow. This loads the shoulder muscles excessively rather than utilising the larger and stronger muscles of the chest and upper back. Making these simple changes can help you achieve many hours of pain free swimming.

For the fitness of you

Linda Reilly

With the weather warming up swimming is an ideal way to get a full body workout.

Overuse injuries in the shoulder and neck are common though, due to the repetitive nature of swimming.

The shoulder is a ball and socket joint with a ring of cartilage around the socket to make the joint more stable. Around this is a loose joint capsule that is reinforced with ligaments and muscles. Because the shoulder is a very mobile joint it relies on the action of these muscles and ligaments to maintain stability. These muscles are called the rotator cuff and consist of four muscles that work together to keep your shoulder centred in its socket.

So, if swimming strengthens the shoulder muscles why do so many swimmers have shoulder problems?

The simple answer is due to the repetitive nature of swimming. The more complex answer lies in the fact that many swimmers don’t have good stroke technique and those that do can still have problems because the swim stroke (in particular freestyle), mainly strengthens the shoulder internal rotators and adductors. This causes muscle imbalance, leaving the scapular stabilisers and external rotators relatively weak and joint laxity increases. The rotator cuff then must work harder to keep the shoulder centred in the socket. When the already relatively weakened external rotators fatigue, the ball of the shoulder joint moves forward and the tendon of the rotator cuff muscles is pinched between the bones as the hand is raised above shoulder height.

Next column I will cover some practical ways to prevent this happening and what to do if you already have impingement problems.

For the fitness of you.

Linda Reilly

Did you know that 90 percent of ageing and wrinkles are caused by sun damage? Sun exposure causes most of the skin changes that we think of as a normal part of ageing.

Over time, the sun’s ultraviolet (UV) light damages the fibres in the skin called elastin. When these fibres break down, the skin begins to sag, stretch and lose its ability to go back into place after stretching.

Australia is the skin cancer capital of the world. More than 11,500 Australian men and women are diagnosed with a melanoma each year, and an estimated 434,000 people are treated for one or more non-melanomaskin cancers. Skin cancer accounts for over 80 percent of all new cases of cancer diagnosed in Australia each year.

If you’d like to know about skin damage to your complexion (face), why not book an appointment at Flannery’s Pharmacy Sun Awareness Clinic. The clinic nurse will conduct a VISIA Complexion Analysis using specialised UV light technology to identify the effects of sun exposure on the face. You will also receive a personalised skin analysis print out.

Our clinic nurse will discuss your analysis and make specific recommendations to help you manage and protect your skin to achieve your best skin possible.

The Sun Awareness Clinic is being held on Wednesday, 5th December and appointments are available between 10am and 3pm.

Talk to our friendly staff today to book an appointment or call Flannery’s Pharmacy on 6852 1111.

The stress fracture is a common overuse injury seen in athletes who participate in endurance and high load bearing activities. Stress fractures in the lower limb account for between 80to 90% of all stress fractures and in runners contributes to almost 16% of all injuries.

During periods of relative inactivity or with osteoporosis or eating disorders, the density of bone decreases. If loads on the bone become repetitive or abnormally high and the bone is not given enough rest to allow for adaptation, the rate of stress-induced microfractures in the bone exceeds the rate at which the bone can repair and stress fractures develop.

The typical complaint with stress fractures is of a gradual onset of pain. Initially there is just pain with activity that subsides with rest but returns when the aggravating activity is resumed. Local tenderness and swelling are often found at the fracture site and pain is easily localised as opposed to shin splints which produce a more diffused pain.

Treatment initially involves rest from the aggravating activity for approximately four to six weeks. It may also require bracing or the use of a cam boot. In some cases, surgery may even be required.

Return to sport should be gradual to allow time for adaptation within the bone and it is important that all biomechanical and nutritional causes be addressed to prevent recurrence. Cross training and participating in a variety of different sporting activities can help minimise the risk of stress fractures.

It is important to remember that if you recognise the symptoms early and treat them appropriately, you can return to sports at your normal playing level.

For the fitness of you.

Linda Reilly

Do you sometimes feel a pain in your hip or the outside of your knee after sitting for a while? Maybe when you stand up or when you run? It could be that you have a tight Iliotibial Band (ITB).

The ITB is a thick band of fascia that runs down the outside thigh. It starts at the top of your pelvis, runs over the hip and attaches to the outside of the knee. It also attaches to some of the buttock and hip muscles allowing it to co-ordinate how these muscles work to stabilise the hip and knee. Fluid sacs, called bursae, located at the hip and knee, provide cushioning between the ITB and the bones beneath. If the ITB is tight it can irritate the bursae causing inflammation and pain.

An inflamed bursa at the hip is called a Greater Trochanteric Bursitis and at the knee it is known as ITB Friction syndrome or runner’s knee.

The ITB shortens when sitting for prolonged periods. It can also tighten if the muscle is overworked. This occurs with sudden increases in exercise load or volume, or if pelvic control is poor due to weak hip and glute muscles.

Because the ITB is a thick, fibrous band rather than an elastic muscle it requires a longer lighter stretch than most muscles.

The use of a foam roller can also be quite helpful in increasing the flexibility in the ITB. A youtube search of “foam roller + ITB” will yield videos of how this can be done.

For the fitness of you

Linda Reilly

Bose® noise-masking sleepbuds™ are designed for sleep. They don’t stream music but instead use pre-loaded, soothing masking sounds to cover up unwanted nighttime noises so you can get to sleep and stay asleep.

With three eartip size options, Bose sleepbuds™ give you an extremely comfortable fit and stay in place – even if you sleep on your side. The rechargeable batteries provide up to 16 hours of use. Plus, the convenient charging/storage case lets you recharge at any time and protects your sleepbuds™ when they’re not in use.

With the Bose Sleep app, you can customize your experience with personal settings.

Choose which soothing sound you want to hear, how long it plays, and its volume. You can even set wake-up alarms that won’t disturb anyone else.

Talk to the friendly staff at Flannery’s Pharmacy today about the new Bose® noisemasking sleepbuds™.

Injuries to the lower back are one of the most common golf related problems. The incidence of lower back pain in the male golfer is between 25% to 36% and 22% to 27 % in the female golfer. It has been reported to account for up to 52% of all injuries in recreational golfers and 24% of injuries in professional golfers. The injury mechanism of nearly half of all lower back injuries in golf is due to the swing.

The modern golf swing has been shown to produce large forces on the lower back which change directions rapidly during the swing. Because golf is played in a slightly forward flexed position, along with the asymmetrical, rotational nature of the swing the forces the joints in the lower back are subject to are quite high. The compression force on the spine during the swing has been shown to be up to 8 times body weight.

So what can you do to prevent getting back pain when you play? Maintenance of good mobility in the hips and thoracic and lumbar spine is important.

This may require a regular exercise programme at home along with a good warm up before you play whilst using proper technique when lifting your bag and bending through the knees when retrieving the ball.

If you already have lower back pain consider slowing your back swing down. Make sure your weight properly shifts to your back foot and your hips rotate during the back swing. Also, avoid placing your feet too far apart during the address phase as this limits hip rotation later in the swing and increases stresses on the lower back.

The calf muscles are commonly injured in sports that involve quick acceleration, deceleration or sudden changes in direction.

Many people describe a sudden sensation of being struck on the back of the leg. A calf muscle tear is often referred to as a strain or a “pulled muscle”.

The calf comprises of two large muscles, gastrocnemius and soleus. They both join to form the Achilles tendon which inserts into the heel bone. The gastrocnemius also helps to bend the knee and together they contract to point the toes.

Tears to the calf muscle can range from a small partial tear with little pain and minimal loss of function to a complete rupture which may require surgery. Recovery time and return to sport depends upon the severity of the injury.

The immediate treatment for all calf injuries consists of the RICE protocol – rest, ice compression and elevation. The No HARM protocol should also be applied – no heat, no alcohol, no running and no massage.

This is aimed at reducing bleeding and secondary tissue damage within the muscle. If you are unable to walk without a limp the use of a heel raise or wearing shoes with a small heel will decrease pain without further stressing the muscle. A compression bandage or wearing SKINS over the injured area helps limit bleeding and swelling.

As pain decreases, gentle exercise and stretching can begin in addition to treatment recommended by your friendly Sports Physio. It is important not to ignore a calf strain as return to activity too soon could make the injury worse.

For the fitness of you.

Linda Reilly

If you are over 35, it’s time to think about your lungs. When it comes to COPD (Chronic Obstructive Pulmonary Disease), identifying it early is one of the most important factors to maintaining lung function. This is no cure but it is preventable, so putting the proper steps in place for people at risk can make a big difference.

COPD affects one in seven Australians over the age of 40 and is the second leading cause of avoidable hospital admissions in Australia. Cigarette smoke causes about 80 to 90 percent of all COPD cases.

If you are over 35 and relate to any of the following points, talk to our pharmacists or registered nurse. We can do a simple COPD screening to check your risk.

• Are you a smoker or ex-smoker?

• Do you or have you worked in a job that exposed you to dust, gas or fumes?

• Do you cough up phlegm or mucus most days?

• Do you cough several times most days?

• Do you feel you are out of breath more easily than others your age?

• Do you experience frequent chest infections?

If you are a smoker, the most important thing you can do to stop COPD from developing or progressing is to quit! Nicotine Replacement Therapy (NRT) products work by releasing a smaller, more slowly-absorbed amount of nicotine (compared with smoking), which can help to reduce withdrawal symptoms as you quit.

If you would like to quit smoking or find out more about your lung health, call in to Flannery’s or Life Pharmacies for a free COPD screening, information and advice.