Saturday, 28 May 2016

Getting a Suitable Tennis Racquets

Wrist and elbow injuries are very common in tennis players. One of the main causes for tennis-related elbow pain is incorrect stroking technique, especially the backhand swing. Different type of tennis racquet may increase the risk of injury in the wrist and elbow. The velocity of the swings, the speed of the incoming ball, the qualities of the racquet, the spot where the ball struck the racquet, the string tension and t
he stroke mechanic affect the force that reaches the player’s arm.

Older style wooden racquets are good in absorbing shock on impact as they were heavy and flexible. Modern wide-body racquets are designed to generate more power as they are lighter and stiffer but they are poor in reducing the shock on impact.

If the ball is stuck at the center of percussion or the ‘sweet spot’ of the racquet, the initial shock produced will be minimal. If the ball is hit outside of the sweet spot, the force transmitted to the hand wrist and elbow will be far greater and can cause more damage to the structures.

There are a few modifications can be done in order to reduce the shock at impact and minimize the force transmitted to the player’s arm. For example, lower the string tension, increase the flexibility of the racquet, increase the size of the racquet head, increase the weight of the racquet by adding lead tape, increase the grip size and grip on the higher side of the handle.

The largest comfortable grip size prevents the player from gripping too tightly on the racquet. Optimal grip size should be equal to the distance from the proximal palmar crease to the tip of the ring finger. The grip should only be squeeze firmly during the acceleration phase of the stroke. If not the players should loosen their grip whenever it is possible.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my


Monday, 23 May 2016

Suitable Running Shoes for Athletes


Suitable sports equipment such as running shoes or racquets are important to minimise the risk of sports injuries and maximise the performance. Each runner has a slightly different foot mechanical features and requires a different type of shoe to suit the runner’s need. Choosing the correct shoe that matches the athlete’s mechanical features contributes to optimise the foot function.

The heel counter, the upper rear part of the shoe should be rigid to provide rear foot stability. The rear foot may be injured easily if the heel counter fails to provide adequate support.

The flexibility of the forefoot is needed to allow easy foot motion during toe-off. The calf muscles may be overworked to plantar-flex the foot during propulsion if the sole of the shoe is too rigid. This may lead to early fatigue of the calf muscles and result in tightness and pain. However, athletes with metatarsalgia may want to consider a shoe with less flexibility in the forefoot as this may help to reduce the symptoms.

The midsole contains the more complex shock-absorbing materials. The density of the midsole should be appropriately soft or firm to suit the needs of the runner. A softer midsole allows excessive mobility and a firmer midsole provides a stable base and can be used for extended period of time. Runners who need to limit excessive foot motion should choose a dual density midsole with a firmer density on the inner side of the shoe. Runners who seek for extra shock absorption should go with a shoe with a softer midsole that still provide stability on both sides of the shoe. Flared midsoles that can cause rapid and excessive pronation of the foot should be avoided.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my


Wednesday, 18 May 2016

Muscle Cramps in Adults and Elderlies


Sudden painful involuntary contractions of the muscle in any body part that may be visible or palpable are known as muscle cramps. The legs are the most common body part that suffered from muscle cramps. Muscle cramps can happen any time and they are many cases reported at night time. Each episode can last from a few seconds to several minutes with different severity. The duration and frequency of the attacks varies from person to person. There is no significant underlying causes in most of the cases.

There are two main proposed mechanisms that may contribute to muscle cramps in adults and elderlies. The motor nerve terminals which control the contractions of a muscle are abnormally excitable. The other mechanism suggested that there is an instability in the anterior horn cells due to spinal disinhibition. This may lead to explosive hyperactivity of motor neurons (nerves that control the muscle) and high frequency contractions of several muscle units at the same time.

Risk factors for muscle cramps include motor neuron disease, peripheral neuropathy, radiculopathy, electrolyte disturbances, haemodialysis, uraemia, liver cirrhosis, hypothyroidism, pregnancy and vigorous exercise. There are several medications that may increase the risk of muscle cramps such as diuretics, steroids, nifedipine, morphine and statins.

Most of the cases for muscle cramps are usually self-limiting. It is recommended to exhaust non-pharmacological interventions such as manual therapy, moderate stretching exercise, cryotherapy, thermotherapy, decreasing exercise intensity and electrical stimulation therapy before commencing medications.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my


Friday, 13 May 2016

Causes for Exercise-associated Muscle Cramps


Exercise-associated muscle cramps (EAMC) is a painful contraction of a muscle in a shortened position. The soreness after the cramps can last up to a few days. Acute muscle cramps can be easily alleviated by gentle stretching the affected muscle. There are a few proposed theories for the cause of EAMC. The dehydration-electrolyte imbalance theory and the neuromuscular theory of EAMC are the most commonly known causes.

The dehydration-electrolyte imbalance theory proposes that EAMC is a result of fluid and electrolyte depletion due to inadequate fluid ingestion and replacement. This leads to sensitisation of select nerve terminals and results in EAMC. Exercise in hot and humid conditions may facilitate muscle cramps by increasing the rate and amount of fluid and electrolytes lost. Miners are more prone to develop muscle cramps due to the hot and humid working environment. There are more cases of muscle cramps during the period of high risk for heat illness. However, there are reported cases where marathon runners developed EAMC in cool, temperature-controlled environments around 10 to 12 degree Celsius.

The neuromuscular theory suggests that EAMC is a result of an imbalance between excitatory impulses from muscle spindles and inhibitory impulses from Golgi tendon organs due to muscle overload and neuromuscular fatigue. A decrease in the inhibition from the GTO and an increase in the excitatory stimuli from muscle spindles may present during neuromuscular fatigue. This will lead to a heightened excitatory state at the spinal level. Therefore, EAMC often occurs when the muscle contracts in a shortened state, especially at the end of competitions and physical work.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my


Sunday, 8 May 2016

Exercise-associated Muscle Cramps


Exercise-associated muscle cramps commonly occur during or shortly after exercise. Athletes are more susceptible to muscle cramps up to 8 hours following exercise in a cramp prone state. Isolated exercise-associated muscle cramps involved continuous contraction and shortening of a single multi joint muscle such as calf muscles, quadriceps and hamstrings. Generalised exercise-associated muscle cramps may involve multiple and bilateral muscles. Typical symptoms of exercise-associated muscle cramps include acute pain, stiffness, visible bulging or knotting of the muscle and possible muscle soreness that can last up to several days. Other causes to skeletal muscle cramps may be due to metabolic, neurologic or endocrine pathology.

There are two theories for the cause of exercise-associated muscle cramps, the dehydration-electrolyte theory and the neuromuscular theory. Maintaining hydration and adequate electrolyte levels is beneficial to alleviate the symptoms of exercise-associated muscle cramps. There are recommendations that adding 0.3-0.7 g/L of salt or higher amounts of sodium (3.0-6.0 g/L) to their drinks based on the frequency of muscle cramps. A volume of fluid loss which is less than 2% of body weight reduction is recommended to maintain proper hydration in athletes. Monitoring the body weight of the athlete helps to ensure sufficient fluid replacement.

Stretching, quinine and beta-blockers are shown to be effective in alleviating muscle cramps. Moderate stretching of the affected muscle is most commonly used to relax the muscle. Exercises that improve the neuromuscular system such as plyometric exercise and endurance training may be beneficial to prevent exercise-associated muscle cramps by delaying neuromuscular fatigue.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my


Tuesday, 3 May 2016

Leg Length Difference in Scoliosis


Scoliosis is a complicated three-dimensional deviation of the spine which includes the lateral bending of the spine, increased lordosis or kyphosis and rotation and torsion of the vertebrae. Spinal buckling of scoliosis causes distortion of the spine in all direction. There are several types of scoliosis and each of them has a slightly different etiology. Scoliosis can be found as part of a recognisable disorder. It can be due to neurologic, muscular, congenital bone anomalies or developmental disorders. Spinal deformity is commonly seen in neurofibromatosis or poliomyelitis. Painful muscle spasm can result in scoliosis. Non-painful scoliosis can result from a muscle imbalance due to compensation for biomechanical asymmetry. However, the majority of the scoliosis are idiopathic. There is no single causative factor identified in idiopathic scoliosis.


Pelvic unleveling due to a difference in leg length contributes to scoliosis. Unequal leg length can be measured by physical examinations and postural radiography. The distance between the umbilicus and the medial malleolus can be measured and compared to look for leg length discrepancy. The distance between the anterior superior iliac spine and the medial malleolus can be measured. X-rays of the pelvic in a standing position can be taken to look for unleveling of the humeral heads or the iliac crests. These three measurements can be taken and compared to obtain an accurate leg length difference. Correction of the leg length discrepancy can be done by a heel lift on the side of the short leg.

For more information or enquiries, please contact us at 03-2093 1000 or visit our website at www.mychiro.com.my