Caring for your feet

Summer can be a trying time for your feet but with a few simple steps your summer may be more enjoyable. Sweaty Feet – can be controlled by swabbing your feet regularly with surgical spirit, making sure the spirit gets in between the toes. Surgical spirit evaporates rapidly from your skin leaving your feet cool & dry. Used every day it should help your sweaty feet.

Try not to use lots of talcum powder on your feet if there very sweaty, the powder absorbs a small amount of perspiration then forms clumps of soaked powder which can make your feet smell!

Blisters – are common in the summer, with rising temperatures causing the feet to swell, with extra perspiration the feet rub on the insides of your shoes causing blisters.

Try to wear at least a pop sock or trainer sock, these act in 2 ways:

• Firstly the sock absorbs a small amount of perspiration.
• Secondly the sock itself forms a nice soft barrier between your feet & the hard shoe.

Corns & Callous – are caused by friction or pressure. Corns usually form on the top of the toe and can be very painful. Callous form on the ball of the foot. Corns can be difficult to remove, so attempts at home using cream or liquid should be avoided. Callous on the ball of the foot can usually be reduced using a pumice stone or foot file. Creams containing Urea are sometimes effective at reducing the hard scaly skin around the heels. I recommend “heel balm” available from Boots or Superdrug. If your corns or callous are painful a visit to a State Registered Chiropodist is advisable.

By Andrew Gladstone – Podiatrist.

Playing and exercising safely in hot weather

Come the warmer months and longer days most of us start exercising more outside in a wide range of activities from walking and cycling, to tennis, triathlon and 5/side football. Most people don't consider that the climate of the southern UK is hot enough to worry about heat exhaustion, however our summers are mostly quite humid and conditions could become a high risk for heat injury at temperatures only in the mid 20s °C (low-mid 70s Fahrenheit).

How do you tell if someone is suffering from Heat Exhaustion?

Dehydration can lead to heat exhaustion. Symptoms may include:

• High heart rate
• Dizziness
• Loss of endurance/skill
• Confusion
• Nausea
• Cool skin, but paler than normal
• Little urine passed, but highly concentrated
• Cramps (assoc. with dehydration)

• Remove from field/court/exercise area
• Lay the victim down in a cool place
• Give plenty of cool water
• If the person is confused or unable to drink water, seek medical help immediately

1. Hydration – Drink up! The more you sweat, the more fluid you must consume to avoid dehydration. To diminish the risk of heat illness fluids should be consumed before, during and after activity.

Thirst should not be relied upon as an indicator of fluid needs! It is recommended that at least 7-8ml of water per kg of body mass (that's about a pint for a 70kg/11stone person!) be drunk no more than 2 hours before exercising to promote adequate hydration.

During exercise it is recommended to drink water at regular intervals – at least 3ml per kg of body mass (about 1 cup for a 70kg/11stone person) every 15 to 20 minutes. Water should be cooler than air temperature, and should be swallowed NOT swilled in the mouth and spat out. For activities lasting more than one hour, research indicates that sports drinks such as Powerade or Gatorade are more beneficial than water for replacing fluids, energy and electrolytes lost during exercise.

2. Rest and Rotation

In conditions of moderate to high risk, participants should rest/substitute 10-25% of normal playing time, or the total time of activity should be shortened by the same amount. For example, if an activity is normally one hour long, in high risk conditions a player should be able to rest for up to 15 minutes in that period. Alternatively the activity could be shortened to only 45 minutes total.

3. Clothing

Recommended are light coloured, loose fitting clothes of natural fibres or, even better, composite fabrics with high wicking (absorption) properties (as sold in the running section of good sports stores), that provide for adequate ventilation.

For further information visit Sports Medicine Australia at www.sma.org.au

By Peter Bell – Physiotherapist

Tennis Elbow
  Lateral epicondylitis, a painful often chronic condition, felt over the outside of the elbow often extending down the forearm, aggravated by actions involving the wrist and elbow, such as backhand stroke in tennis. It is caused by overuse or misuse of the muscles of the forearm.

With regards to tennis, it usually occurs as a result of poor backhand technique or incorrect grip of the racket. It can also occur as a result of long periods of mouse and keyboard work at the computer, due to poor positioning of the arm when using the mouse. The forearm should be resting, comfortably, on the desk.

Healing is quicker with early appropriate intervention. Rest will obviously help the acute phase, but frequently the pain returns when the arm is used again in the same way. Physiotherapy will help in preventing this reoccurrence.

Treatment is directed at reduction of inflammation and restoration of painfree function:

• Rest
• Corticosteroid injections can be used to reduce inflammation but should be followed by physiotherapy:

Acupuncture and/or ultrasound to reduce inflammation Exercises to restore muscle strength and function of the elbow and wrist Awareness of the cause, action taken to remove or change the cause, eg, check grip on tennis racket, or alter position of the mouse so that it is close, thereby relaxing the forearm.

Tennis Tips

• Check racket grip size – there should be a thumb's width between the thumb and the tips of the fingers.
• Do not grip the racket hard.
• Good backhand grip and swing will prevent jabbing and therefore less impact at the elbow.
• Stretch before playing – elbow straight and flex wrist backwards and forwards.

Ready to swing?

Many of our clients are exposed to golf at different levels, from the serious weekly player to the annual work function. Though not obviously a risky sport, the repetitive and explosive nature of the golf swing can expose those who are less than prepared to unnecessary harm. Attitudes to warming up for golf are generally very poor. A 2003 survey found just 3% of people had warmed up adequately despite believing it could enhance performance (75%) and help prevent injury (27%). The most vulnerable areas for golfers are the lower back, elbow, wrist and shoulder, with over 80% of injuries the result of repetitive strain. During acceleration into the ball very high forces of compression, shear, torsion and lateral bending occur about the lower back. Due to poor swing mechanics these loads are much greater in amateurs than professional golfers, despite less power being delivered to the ball. An adequate warm up consists of cardiovascular exercise to increase blood flow to the peripheral muscles, followed by stretching and then sport specific activities to help activate the learned motor control pathways for the game at hand. Exercise sheet available from the Josephine Lawson Physiotherapy Clinic. By Ryan Clark Physiotherapist