Sun, Sand and Soreness…
5 common Holiday Injuries and what to do about them.
Whether you were lounging on the beach in Hartenbos or having a Bosveld Christmas, sometimes an unwanted visitor climbs out of your suitcase when you get home: pain. Now what to do with your unwanted guest? Here follows an explanation of some of the common holiday injuries and how Physiotherapy can help you manage your pain.
1. Plantar Fasciitis (also known as Plantar Fasciopathy or Plantar Fasciosis)
While on holiday we often find ourselves wearing more casual clothes, walking barefoot on the beach or even jumping on the trampoline with the kids. The change in activity and foot support can often cause irritation and inflammation in your foot causing plantar fasciitis. This is very common in holiday injuries, and if it is identified quickly – very easy to sort out!
1.1 What is plantar fasciitis and why is it painful?
Plantar Fascia is the tissue at the bottom of your foot connecting your heel-bone to your toes. Pain is due to Overuse of the plantar fascia at the place where it attaches to the calcaneus (the “heel-bone”). This “overuse” (or loading the structures more than usual) leads to microtears in the plantar fascia, leading to inflammation and pain.
1.2 What are the symptoms of plantar fasciitis?
- Pain of gradual onset, usually at the bottom and to the back of the foot.
- The Pain worse in the mornings when getting out of the bed, decreases with activity during the day, but as the condition progresses the pain increases as fatigue sets in closer to the end of the day.
- Standing may increase your pain.
1.3 What can I do at home to relieve my pain?
- Decrease your training load / avoid activities causing pain – remember to take it slow. New Year’s resolutions don’t have to be met all in a single day.
- Consider wearing a soft silicone pad under your heel in your shoe.
- When starting activities again; progress slowly and listen to your body.
- Wear comfortable shoes and avoid wearing high-heels.
1.4 How can physiotherapy help my plantar fasciitis?
- Address the risk factors associated with plantar fasciitis: increase ankle joint flexibility, relieve tightness in the appropriate muscles and prescribe exercises to improve toe, foot and leg strength and flexibility.
- Help you to adjust the load on your foot, while still maintaining an active lifestyle.
- Taping / Strapping to support the plantar fascia.
- Assess your biomechanics to make sure that the whole chain of movement is working in an optimal manner – to allow function without pain.
2. Neck pain
Going on holiday is not always relaxing: chasing your last deadline, getting the house ready to go away and family conflict are all stressors that contribute to neck pain. In addition to these stress-producing events, sleeping on a different pillow or mattress or falling asleep in the car can all aggarvate your neck pain.
2.1 What is “neck pain” and why does it hurt?
A painful sensation at the back or the side of the neck that usually has a multifactorial origin.
Some of the contributing factors could be:
- Poor posture
- Sustained unnatural positions (like falling asleep in a car)
- Muscular factors
- Neural factors
- Pain originating from the vertebrae (bones) in your neck or thoracic area are some of the causes of neck pain
- Stress, depression, anxiety and your beliefs regarding your pain also plays an important role.
Click here to read more about your spine.
Why is this part of common holiday injuries? Because any of the above factors can cause pain, especially after a stressful year.
Usually we manage these factors and stay relatively pain free. However, when the factors contributing to pain outweighs a person’s coping strategies, pain surfaces. Physiotherapy can relieve pain by addressing pain-contributors.
2.2 What are the symptoms associated with neck pain?
- Discomfort with movements of the neck (for example looking in your blindspot, doing desk work)
- Headaches or jaw pain
- Pain in your neck (front or back part) more towards the end of the day, or when you wake up
- Pain or pins and needles in your arms or hands
- Perceived weakness in your hands or arms
- A tender spot when touching your cervical spine area
2.3 What can I do at home to relieve my pain?
- Apply heat to the painful area
- Stay active (if it is pain-free) by doing relieving stretches
- Consider adapting your pillow, car seat or desk set-up (a physiotherapist can assist you).
2.4 How can physiotherapy help my neck pain?
An multimodal approach might be considered, including:
- Pain relief (manual techniques, exercise, dry needling, etc.)
- Neural tissue mobilisation (stretching your nerves, and allowing the nerves to move in the areas that they need to move in)
- Addressing unhelpful and adaptive movement patterns
- Ergonomic and postural advice (desk, car, sleeping positions)
- Education and stretches/exercises to avoid stagnant postures, stiff and weak muscles and to allow optimal function.
3. Back pain
Your bad posture while driving too much, boogie boarding or picking up your wife’s heavy suitcase are some of the activities that could have aggravated the pain you experience in your back. Or even just the thought of returning to your sedentary desk job can bring about a jolt of back pain. So these are not just common holiday injuries, but rather very common general injuries.
3.1 What is “back pain” and why does it hurt?
An unpleasant sensation in or alongside the spine, in your hips or sometimes even in your shoulders or legs.
Like neck pain, there are many contributing factors that can include:
- Rapidly increased activity load
- Rapidly decreased activity load
- Muscle guarding – to protect the lower back
- Soft tissue, neural or vertebral components
- Motor control deficits
- Muscle weakness or imbalance
- Sleep deficits
- Increased alcohol use or smoking
- Cognitive factors: beliefs regarding back pain
- Emotional factors: stress, anxiety, depression, anger, frustration
- Social stressors: significant life changes, support system etc.
When your capacity changes to cope with these factors, or more factors get added to your unique situation and your capacity to cope with it does not increase, your body lets you know by producing the sensation of pain in your back.
3.2 What are the symptoms of back pain?
- After sitting for a period of time (especially getting out of the car or chair) you have pain in your back
- Pain when bending down to fasten your shoelaces or pain bending backwards
- Standing causes pain
- Pain that starts in the morning and eases with movement during the day, or vice versa
- Pain that gradually increases in intensity as the day progresses
- Unpleasant sensations in the legs (pain and pins and needles are common) or feet.
- Pain every time you move
Your symptoms will largely be determined by the structure taking strain. A physiotherapist will differentiate which structure is causing your pain by doing an assessment. The common culprits generating low back pain are:
- Discs between the vertebrae
- Facet joints (articulating areas of adjacent vertebrae)
- Ligaments
- Muscles
- Nerves
- A combination of the above. Read all about your spine here.
3.3 What can I do at home to relieve my pain?
- Gradually start moving your whole body by walking and gently moving your pelvis and back. It is best to let a physiotherapist assess you first and give you specific exercises to target the right area.
- Heat and ice are modalities that can alleviate the pain.
- Consider adapting the postures that you spend a lot of time in: driving, sleeping and working.
3.4 How can physiotherapy help my back pain?
The findings in the evaluation will determine which treatment modalities will be used. It will include:
- Education and exercise prescription
- Manual techniques and Pain control: soft tissue techniques, movements that decrease pain, taping, dry needling, mobilisation of the spine
- Desk and posture adaptations
- Advice on lifestyle changes
- Referral to the appropriate professional if the symptoms do not improve.
4. Elbow pain
This might have been lingering even before your holiday (brought on by working on a keyboard) and could have been aggravated by activities like playing beach bats, golf, mixing the batter for your Christmas cake, sewing or playing catch with your dog. Your pain might have been mild, but after your long drive home you realized that there is another culprit for common holiday injuries.
4.1. What is “elbow pain” and why does it hurt?
Common types of elbow pain are lateral and medial elbow pain.
- Lateral elbow pain (on your thumb’s side of your elbow)
- Medial elbow pain (on your pinky’s side of your elbow)
The most common reason for lateral elbow pain is when the tendons of your extensors in your wrist and forearm get overloaded and tendinopathy develops. This is then called lateral elbow tendinopathy or tennis elbow. The pain arises due to continued use of an already irritated tendon causing microscopic tears and scarring.
Although not as common as lateral elbow pain, medial elbow pain accounts for around 9-20% of all epicondyle (one of the bones in your elbow) related pain. The pain mechanism can be similar to lateral elbow tendinopathy, with the flexor rather than the extensor tendons mainly being the culprit. Alternatively, pain in the medial elbow can arise due to excessive throwing activities. Pain arises due to stress being placed on the medial collateral ligament, creating instability.
Your physiotherapist will also consider the following causes of elbow pain:
- Pain originating from the cervical (neck) or upper thoracic (trunk) spine, referring to the elbow
- Inflammation of the bones or bursa in the elbow joint (radius and humerus)
- Elbow instability due to ligament injury or fracture
- A combination of above mentioned problems
4.2 What are the symptoms of elbow pain?
Lateral elbow tendinopathy can present like:
- Elbow pain on your thumb’s side of your elbow while gripping objects.
- Pain starting 24 – 72 hours after unaccustomed activity involving wrist extension.
- Sudden onset of elbow pain after a single event of exertion.
Medial elbow tendinopathy can present like:
- Pain with bending the wrist towards the arm
- Pain with squeezing a small rubber ball
Other symptoms of elbow pain with the cause other than a tendinopathy:
- Burning sensation in the neck, arm, elbow or wrist
- Pain with overhead activities
- Pain with typing on a keyboard
4.3 What can I do at home to relieve my pain?
- Modify how you do the activity that cause your pain (a physiotherapist can help you to adapt a new technique)
- Modify the frequency and intensity that you perform the activity causing your pain
- Consider using a brace to support your elbow (a physiotherapist can suggest one or apply strapping to assist)
4.4 How can physiotherapy help my elbow pain?
- Pain relief strategies: manual and soft tissue techniques, strapping, dry needling etc.
- Restoration of grip and other strength deficits through exercise and stretches
- Improvement of decreased flexibility
- Aid in return to normal activity
- Relieve any associated neural pain
5. Hip bursitis
Running around on the beach, sustained positions of watching series or long periods of standing can cause the bursa in your hip to become inflamed leading to a condition known as hip bursitis.
5.1 What is hip bursitis and why does it cause pain?
A bursa is a small, fluid filled sac that eases movement between structures (mostly bones and tendons) in the body. The bursae covering the bone at the side of your hip (greater trochanter) are more often involved in bursitis than the bursa in the front of your hip at your psoas muscle. When you engage in an activity that involves the muscles in your hip excessively contracting and gliding over your bursa, it can cause inflammation and pain. This is usually a slow process but can be aggravated by trauma to the hip or an acute episode where there was pressure on or trauma to the hip.
5.2 What are the symptoms of hip bursitis?
- Pain in the posterior side of the hip that may radiate down the leg.
- A snapping feeling around the hip when moving the leg.
- An inability to lie down on your affected hip.
5.3 What can I do at home to relieve my pain?
- Decrease the aggravating activity temporarily.
- Apply ice on the painful area.
- Attempt movements of the spine and legs that are not painful in order to maintain range of movement.
5.4 How can physiotherapy help my hip bursitis?
Physiotherapy firstly aims to decrease your pain. This is done by aiding the body out of the inflammatory state. Then exercises and treatment techniques will be used to restore any loss of range and strength. Finally, a relapse is prevented by addressing any muscle imbalances and other predisposing factors that could have caused your hip bursitis.
6. Sciatica
This debilitating pain often surfaces after the holidays due to prolonged periods spent sitting in the car (or on the couch). Compression on the structures surrounding the sciatic nerve can be caused by sitting. Therefore sciatica can also present itself when returning to work and long periods of sitting commences. Nerve pain is quite severe, and it may feel as if your whole leg is on fire.
6.1 What is sciatica and why does it cause pain?
The sciatic nerve is a nerve that originates in your lower back, runs along the back of your buttock and ends behind your knee. Being the largest nerve in your body it can be a great source of pain. Pain arises from the sciatic nerve if it is being compressed or irritated by a structure in close proximity to it. This can be due to any of the following:
- Muscle spasm in your back, buttock or the back of your leg. A muscle often producing sciatic symptoms is the piriformis muscle in your buttock. See the picture for the anatomical position of the piriformis.
- A herniated disc.
- Impingement of the nerve root (where the root exits the spinal canal).
This is not an extensive list: always consult a medical professional in order to get an accurate diagnosis.
6.2 What are the symptoms of sciatica?
- Pain in the lower back or buttock.
- A burning, deep sensation along the back of the leg of the same side as the buttock or back pain.
- The leg may feel heavy or slightly numb.
- Pain when getting up after sitting for a long period of time.
- Tingling sensation at the back of the leg.
6.3 What can I do at home to relieve my pain?
- Use hot or cold packs to alleviate pain.
- Maintain proper posture.
- Avoid long periods of driving or sitting.
- Engage in gentle stretching and core activation exercises (ask a physiotherapist to help you with this).
6.4 How can physiotherapy help my sciatica?
By diagnosing the cause of your sciatica a physiotherapist can initiate a treatment plan to not only alleviate immediate pain, but also prevent future episodes by identifying underlying factors contributing to your sciatica. You can expect some of the following treatment modalities:
- Massage, spinal mobilisation or dry needling to relieve any associated muscle spasm and stiffness.
- Range of motion exercises to improve blood flow to the affected area.
- Neural exercises to improve the movement of the sciatic nerve in the sheath.
- Strengthening exercises to activate the appropriate muscles.
- Education on the correct posture in sitting, sleeping, driving and picking up heavy objects.
During the year it is easy to ignore your pain because you get too busy. Or one usually manages contributing factors to pain, or suppress uncomfortable sensations in the body. When on holiday, you often reconnect with some of these symptoms and become aware of pain or discomfort. It might even happen that you feel so relaxed after a holiday, and once you return to work the pain resurfaces. At Mariska Odendaal Physiotherapy the aim is to address the immediate pain. Then treat the pain, and to prevent any recurrent incidents so that our patients can have a productive and pain-free 2022.
Make your appointment now at any of our capable Physiotherapists to make sure we can help these unwanted common holiday injuries to go away!