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Top 5 Running Injuries & How to Manage Them

Posted on 29th January 2018 by

Injured runners make up a huge proportion of the people we help here at goPhysio. The repetitive nature of the activity inherently makes it a sport where injuries are quite a common occurrence.

In this blog, I will share with you some insider information built up over a lifetime of clinical practice in the sports injury sector, treating 1,000’s of active patient’s with overuse, lower limb injuries.

I’d like to shed some insider light on the 5 most common running injuries and debunk some myths, helping you understand these injuries better, and give you some guidance on how to prevent and manage them if they do occur.

5 Most Common Running Injuries

The 5 most common running injuries we see here at goPhysio are:

  • Plantar Fasciitis
  • Achilles Tendonopathy
  • Calf Tears and trigger points
  • Anterior Knee Pain
  • Gluteal / Piriformis syndrome

Interestingly enough, all these injuries can originate from a similar movement dysfunction.

Starting at the foot with flattened foot arches or over-pronation, there is often a chain of biomechanics events leading up the leg to the trunk. These are nicely illustrated in this diagram. .Biomechanics chain of events

Plantar Fasciitis

Plantar-fasciitis is a fancy, latin word for inflammation of the plantar fascia. The plantar fascia is a thickened sheet of fascia (connective tissue) on the sole of the feet, it’s elasticity gives us a spring in our step when walking or running. The cause of plantar-fasciitis is linked to it being on an excessive stretch for prolonged periods of time, when the arches in your foot are too flat. So on push off when walking or running it’s excessively overloaded and stretched and overtime micotrauma, inflammation, pain and injury can result. Read more about plantar fasciitis here.

Achilles Tendonopathy

Flattened foot arches results in an inwards collapse of the heel bone (calcaneum) into which the achilles inserts. Thus with each step the heel bone excessively moves side to side, in a side-to-side whipping type motion of the achilles resulting in a build of force, overuse, microtrauma, inflammation, pain & injury! Read more about achilles tendon injuries here.

Calf Tears & Recurrent Myofascial Trigger Points

Again a similar mechanism to above. Over time, the calf muscles become tense and tight, they tend top hold a long term dull background contraction in an attempt to control the inward collapse of the heel bone. This increased tone is aggravated by running (we take approx 1,000 steps per km, per foot), resulting in tense, tight, overactive and painful muscles, which worsen with running and can become a long term or chronic issue. It feels especially tight after hill sessions, when the calf or achilles is also on stretch. Read more about calf tears here. 

Read more about the treatment of calf tears here.

Anterior Knee Pain

Anterior knee pain is an umbrella term, used to describe a wide range of injuries causing pain in the front of the knee. Although everyone is unique, in runner’s it is often linked to flattened foot arches and the inward collapse of the heel with it’s knock on effects felt through the whole kinetic chain (as per the diagram above). This inward heel collapse causes the shin bone (tibia) to rotate inwards and the knee will fall inwards, resulting in an asymmetrical build of of forces in structures around the front of the knee and some of the most common running knee injuries, namely; Infra-patellar tendonopathy, Patello-femoral joint map-tracking and Ilio-tibial Band friction syndrome (ITB syndrome). Read more about runners knee here.

Gluteal / Piriformis Syndrome

So, as the heel collapses inwards, we get internal rotation of the legs and hips. Subsequently, the gluteal (buttock) muscles become tense and tight in an attempt to control the inward rotation and movement of the leg and hip. This increased tone over a run (approx 1,000 steps per km, per foot), can result in tense, tight, overactive painful muscles. This often worsens with running and can become long term or chronic, which often results in referred pain travelling down the leg mimicking sciatica. Over my career I’ve even seen patients with this condition that mistakengly have been operated on, (the Surgeon thought it was a disc injury causing the sciatica) when it was merely this “Piriformis syndrome” referring into his leg.

The Solution

With all of these conditions, it’s crucial to understand that……..

the injured structure is actually the victim, the true cause is the uncontrolled movement!

Effective management of such injuries therefore needs to address the following:

From the foot upwards – Fully assessing foot position and biomechanics, looking at incorporating custom orthotics to correct the foot positioning and alignment and control excessive movement and rotation from the foot up the whole lower limb.

From the spine / “core” downwards – This is a crucial and often forgotten element, improving muscle stability and movement control throughout the body. Pilates is great for this.

Reduce inflammation – Ice and non-steroidal anti-inflammatories are an effective way to reduce inflammation in the early stages.

‘Hands-on’ Physio treatments – In the early stages, massage and acupuncture to normalise muscle tone, taping to correct alignment and ultrasound to stimulate natural healing, can all be effective ways to help ease pain and discomfort to help you quickly progress into active recovery.

Selective rest – Means to just rest from the aggravating (pain causing) activities, whilst actively participating in non-aggravating activities such as swimming or cycling to maintain movement and fitness. As we’re designed to move, movement in itself is therapeutic. We can really help guide you on this, as many people think if they have an injury they just need to completely rest.

Running Rehabilitation – Specific exercises, training advice and a return-to-running programme are all crucial to ensure a positive, long term return to running injury free.

Preventing these Injuries

We are our own normal

I want to reassure you that we are all different. We all have biomechanical differences that our bodies cope just fine with, we are our own ‘normal’. So, if you have ‘flattened arches’ but are able to run a marathon with no issues, nothing needs to change! You don’t need to address this ‘just in case’. Pain or injuries, such as those above, often arise when we are demanding too much of our body too soon, without giving it time to adapt to the demands – so in running, increasing distance or speed too quickly, changing the terrain etc. So much of the skill in preventing these injuries comes down to our training technique and running habits, combined with our body’s own ability to adapt.

However, what we often see is that a small biomechanical issue such as those explained above, combined with demanding too much of our body too soon, results in the body complaining with one of these injuries. Runners then get stuck in an injury cycle, where they can’t run without getting pain. By fully understanding and addressing the combination of biomechanical issues and training, this is the most effective way to overcome the injury and continue to enjoy a lifelong love of running!

By Paul Baker MCSP, goPhysio Clinical Director


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Should I run through pain?

Posted on 22nd January 2018 by

In my experience, I’ve found many runner’s to have a high pain threshold, which can be a help when you’re a runner. However, deciding whether to run through pain is a dark art and filled with many pitfalls!

So, in this blog, I’d like to help you avoid unnecessary injuries and share with you some insider information built up over a lifetime of clinical practice treating runners, offering you some clarity and debunking these myths related to running through pain:

Pain is weakness leaving the body!

Pain is a sensation and all sensations are pleasurable, so enjoy the pain!

No pain no gain!

So, “should I run through pain?” Well, in a nutshell it depends on what type of pain you’re experiencing. Broadly speaking there are 2 types of pain related to running and it’s crucial to be able to distinguish between the main 2 types.

1. Delayed onset of muscle soreness, also known as DOMS for short, which is a normal part of any successful exercise training programme. It’s often described as “heavy legs” and in runners is mostly felt as a broad, dull, heavy, ache in the large propulsion muscles of the leg i.e. gluteals, quadriceps or claves.

DOMS is often experienced the day after a run, when you’ve increased the mileage or done a hard hill or speed session, when you are doing day-to-day tasks that work those muscles, such as getting out of a chair or walking downstairs. It’s entirely normal and desired for the training effect.

Physiologically, one way to describe what’s happening within the muscle in DOMS is that during the harder exercise session, you get microscopic tears within the exercised muscle. The body is then in a phase where it’s laying down new muscle fibres, increasing muscle cross sectional area (getting larger) and increasing strength and endurance, hence the desired “training effect”. It normally peaks day two after the exercise session and then subsides. Read more about DOMS here.

2. Pain as a result of injury This type of pain is undesirable as any part of a training programme. Unless there is a definite memorable traumatic incident whilst out running either a slip, trip or fall (which you would be able to remember), all other running injuries can be classified as overuse injuries.

By their very nature, overuse injuries, will start gradually and mostly occur when there is a perfect storm of intrinsic and extrinsic factors.

Intrinsic (Internal) Injury Factors

These are factor internal to your body, namely:

  • A recent increase in body weight
  • Your running technique
  • Poor or altered foot & lower limb biomechanics
  • Long term muscle imbalance
  • Muscle strength & control
  • Muscle flexibility

Extrinsic (External) Injury Factors

These are factors that are external to your body and focus generally around your training parameters, namely:

  • Running volume – frequency, duration or distance
  • Running intensity and speed
  • Running terrain – hilly or flat, road or off-road
  • Inadequate warm-up
  • Running footwear

When we assess runners at goPhysio we will often find a unique mix of these factors. When combined together, they lower their body’s loading capacity or ability to cope with the demands that are being placed on their body. This results in the body complaining, often with a sharper, more niggling pain, where injury has occurred. An important part of our job as physiotherapist’s is to prioritise which factors, if addressed, will give the quickest, best outcome i.e. return to running symptom free long term.

However, if you continue to mindlessly run on this type of sharper pain without addressing the predisposing factors, it will likely worsen in severity and frequency, being felt earlier into a run and to a greater severity, eventually limiting your ability to run.

At this stage, what is usually happening physiologically, is the DOMS described above has developed into pain from injury. The micro-trauma, if left unaddressed, becomes inflammation, pain and eventually an injury.

So, if you think you’re experiencing these worsening, sharper symptoms over 2-3 runs in a week to 10 day period, stop and seek an expert physiotherapy assessment to identify, modify and remove all the predisposing factors getting you back to painfree running quickly!

Happy Running and don’t enjoy the pain!

By Paul Baker, Clinical Director of goPhysio


Sleep: The Magic Elixir for Runners

Posted on 19th January 2018 by

I’ve just recently read a great book, titled Why We Sleep, by the neuroscientist, Matthew Waker. Why we sleep

I wanted to share a summary of the relevant sections, which I thought would be enlightening and useful for you keen, active, health conscious runners. If it sparks your interest, I would thoroughly recommend getting hold of a copy to read it in full. It really is fascinating!

Walker explains that:

“Sleep is one of the most important aspects of life, health and longevity and yet it is increasingly neglected in 21st century society”

For the active runner, adequate sleep is crucial to help in learning new motor skills, improving athletic performance and mitigating injury risk!

In the book, Walker explains that the term ‘muscle memory’ is a misnomer, muscles have no such memory, and that in fact ‘muscle memory’ is really ‘brain memory’. As humans, we learn new motor skills and movement routines through practice. For a runner it could be working on running technique, training or strengthening muscles in the gym, which can help us better execute a skilled memory routine (running). But the routine itself – the memory programme resides firmly and exclusively within the brain.

Research over the past 20 years has unequivocally demonstrated that after practicing any motor skill, your brain will continue to improve skill memories in the absence of further practice after a full night sleep. Walker concludes that in fact

“Practice does not make perfect, it is practice followed by a nights sleep that leads to perfection”

Sleep helps the brain automate the movement routines – helping them become second nature and effortless – precisely the goal of many sports coaches when perfecting the skills of their athletes.

The 100-metre sprinter superstar Usain Bolt has, on many occasions taken naps in the hours before breaking the world record and before Olympic finals in which he won gold. The author’s studies support this wisdom: day time naps that contain sufficient numbers of sleep spindles also offer significant motor skill memory improvement, together with a restoring benefit on perceived energy and reduced muscle fatigue.

“Sleep is one of the most sophisticated, potent and powerful – not to mention legal – performance enhancer’s everyone should be using fully”

The book’s findings are backed up with more than 750 scientific studies that have investigated the relationship between sleep and human performance. Anything less than 8 hours of sleep a night and especially less than 6 hours a night and the following can be experienced:

  • Time to physical exhaustion drops by 10 to 30%
  • Aerobic output is significantly reduced
  • Similar impairments are observed in power output, measured by limb extension force & vertical jump height
  • Decrease in peak and sustained muscle strength.
  • Marked impairments in cardio-vascular, metabolic and respiratory capabilities linked to a decrease in the amount of air the lungs can expire
  • The ability of the body to cool itself during physical exertion through sweating, a critical part of peak performance, is impaired

Injury Risk 

There is also a significant increase in the risk of injury with a lack of sleep.

“There is no better insurance policy to mitigate the risk of injury than sleep!”

Described in a research study of competitive young athlete’s in 2014, Walker explains that a chronic lack of sleep across a season predicted a massively higher risk of injury, as illustrated on the graph below.

Sleep and injury risk
Sleep after sporting performance is just as crucial for recovery. The book states that

“Post performance sleep accelerates physical recovery from common inflammation, stimulates muscle repair, and helps restock cellular energy in the form of glucose and glycogen”

What does all this mean for the local fun runner?

Regardless of running ability, sleep is equally important for anyone who is physically active. Until recently the experts thought that adequate sleep, good nutrition and exercise were the 3 fundamentals on which to live a healthy life.

However, through a large body of research over the last 20 years, Walker has highlighted that adequate sleep is the foundation on which being healthy and exercising effectively is built upon.

In other words….without adequate sleep you will not gain the full potential benefits of a healthy diet and regular exercise. So, you should be aiming for between 7-8 hours of sleep each night, especially in the midst of a running training programme, to allow your body to recover and achieve the full benefits of training.

For further information, please read Why We Sleep, by Mathew Walker


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Running injury? When to get help and who to see!

Posted on 18th January 2018 by

Injuries are part and parcel of sport, exercise and running. But when is it OK to manage the injury yourself and when do you need to get help?

Firstly, our bodies are designed to heal naturally from injury over a period of a few weeks, depending on the severity of the injury and nature of the condition.

However, being sensible is the key. If we fall and suddenly we have a swollen, painful, red/bruised limb, then we should seek immediate attention in A&E or a walk in centre. If you’re unsure which to use, calling 111 to get a healthcare professional to help you with all your enquiries.

However, if you’re suffering with a less severe or ongoing overuse injury in your soft tissues (muscle, tendon, ligaments) or joints, which is taking a long time to settle i.e. lower back pain, knee pain, or a sports injury,  then seeing your G.P. or a Physiotherapist, is your best option.

Unfortunately, the reality waiting to see your GP if you’ve got an injury only serves to delay your recovery. Most will advise rest in the first instance and maybe painkillers, and ask you to come back in 6 weeks if it isn’t better (sound familiar?). Have a look at a previous blog post we wrote ‘The magic 6 weeks‘.

Eventually they may refer you to an NHS physio, and there’ll be more waiting for an appointment, which can be up to 18 weeks or more locally! That’s 6 months plus of potential pain, suffering and not doing some of the things you enjoy.

However, most private Physio’s accept direct referrals, minimising any hold ups in your treatment, giving you peace of mind and a positive action plan, without any delays. Clinically, physiotherapy is justified from day 1 of an injury – competitive and elite sports men and women will have immediate physio.

However, for the general population, the ideal time to see a physiotherapist will depend on the severity and nature of your condition and your aims and goals.

If you have a severe painful injury that stops you from running (or exercising) and you’re due to run a marathon event in 4 weeks – immediate Physio is crucial.

If an injury stops you from going to work and you’re self employed – immediate physio is highly cost effective! We see so many people that can’t work because of an injury and if they aren’t getting paid, the cost of private treatment to get them back to work quicker is actually very cost effective.

If you have minor injury that is improving steadily, you can avoid the aggravating factors and don’t mind not being so active for a while, then you could attempt to self treat your injury. However, with this comes the potential risk of re-injury when you return to the causative activities.

If your injury isn’t improving and you want to get back to a high level of activity, i.e. golf x 2 weekly or gardening, then Physio is important to help you return to your activities and prevent re-injury.

There’s an old, well known saying “time is the best healer”, but where injury is concerned, this is a myth!

Essentially, if your injury is not improving within 5-7 days, you need to see an adequately qualified and experienced physiotherapist. The longer you delay seeing someone, taking the ‘wait & see approach’, the longer it will take you to get better and the more it will cost you in pain, effort, time, money and frustration at not doing the things you enjoy.

Who to see?

We understand there’s an overwhelming choice of healthcare providers and it can be a stressful experience choosing which therapy or clinic is best for you. The lines between different therapies are merging, making your choice of therapy and clinic more complex as Chiropractor’s give exercises, Physio’s do manipulations and Personal Trainers do rehabilitation.

From your perspective we’re all the same – you just want to see someone who can get you better! A good clue when deciding which profession to see, is to consider who the professionals use to look after their bodies? In professional sports, from cycling to football, rugby to the Olympics, it’s a Chartered Physiotherapist that is trusted to sort out injuries, they’re the ones you’ll see run out onto the pitch. There’s obviously a good reason for this. Physiotherapy is also the 3rd largest health profession in the UK after Doctors and Nurses.

Physiotherapy is a proven strategy for in the first instance, easing the worries and concerns of people suffering from aches, pain and stiffness. And then helping that person move freely again, bending further, stretching easier, feeling healthier and stronger and living an active, fulfilled lifestyle into their 40’s, 50’s, 60’s, 70’s and beyond.

Here at goPhysio we will offer you an appointment within 24 hours of you getting in touch. It’s YOU that matters and for that reason our care is focused on listening to you, solving your injury problems and achieving your goals.

The sooner you take the time and effort to invest in your health and wellbeing with physiotherapy, you’ll be back doing all the things you enjoy.

If you need a solution to your running injury, don’t delay – you can book your appointment online here now.


 


Hot OR cold?

Posted on 16th January 2018 by

It’s a common dilemma, you’ve picked up an injury but aren’t sure whether to put ice on it or use heat? Both can be great at relieving pain from an injury, but in some instances it’s better to use heat and in others cold.

So, take a look at our quick reference to guide you!

Hot or cold for injury

This article provides general advice and does not replace individual medical advice. Before you treat an injury yourself, if you are concerned about your symptoms or have specific questions, please seek appropriate medical attention.

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Runners – The Importance of Footwear and getting it right!

Posted on 15th January 2018 by

For a runner, running footwear is the most important piece of kit you will have in your running career (well – joint-most important next to a good Sports Bra for you ladies!). You will fight together through tarmac and forest paths, from quick mid-week runs to the long, slow Sunday ones. Training and racing side by side – so, with the Hendy Eastleigh 10km around the corner, you need to a pair of shoes you’re going to get on with!

Running Footwear has evolved so much in the last decade, it would be naïve to attempt to choose your perfect shoe alone. There are so many variables such as cushioning, stability, heel offsets and durability across well over 20 brands, who have up 30 shoes each on the market. That’s a lot of shoes!!

So, as your Official Health Partner of the Hendy Eastleigh 10km 2019, we thought to give you 5 points to find your match made in heaven:

  1. Support your local shop. Don’t buy online – you can’t get fitted properly over a computer – not yet at least! Go in and talk to someone one-to-one and get a gait analysis done. A gait analysis helps identify any potential issues with your running style and whether it can be corrected with a particular set of shoes. The main movement they will look out for is the term ‘pronation’ and other elements such as heel striking and lateral/medial rotation of the hip. From this information, they will be able to suggest the best solution for you.
  2. Be open minded – don’t judge a shoe by its colour or brand. Always try what the shop recommends and get the shoe which feels most comfortable. Not the one which matches your new sports top! A pretty pair of shoes won’t hide the pain on your face half way round 10km!!
  3. Be transparent! Talk to them openly about your current aches and pains, and also what you like/don’t like about each of the shoes they suggest. That kind of feedback maybe the different between getting a good shoe and the perfect shoe for you!
  4. Don’t be too limited on price. For a good pair of running shoes, you’ll be looking at spending around £110 for a decent pair. It’s an investment for sure, but the shoes will last you long time and can offset a lot injuries and pain in the long run – no pun intended! They will last ~450 miles for the higher mileage shoes before you need to consider replacing them. So for someone doing 10 miles a week, that’s about a year!
  5. Don’t leave it too late! Give it at least three weeks before the race. Trust me from experience – it will make you re-evaluate everything you thought you knew about blisters otherwise! Break the shoe in properly with about 5 x 5km runs. And then, if you have any issues, just talk to them. It does happen and they will usually be keen to rectify the problem. But be wary, most guarantees only last a month!

Good luck to all who are doing the Hendy Eastleigh 10km! Fingers crossed for good weather and we will see you there as your Official Health Partner for the day!

Cameron Knapp

goPhysio – Sports Massage Therapist

Read More 

How to warn up for running

Top tips for injured runners

Runners – how to maximise your training time


Blue Monday

Posted on 14th January 2018 by

Blue MondayBlue Monday is a name given to a day in January (typically the third Monday of the month) claimed to be the most depressing day of the year. This year it’s Monday 15th January 2018.

However, knowing it’s coming up, you could make a conscious effort to set out and enjoy it – in different ways perhaps, but just as much as you would enjoy a warm summer’s day. How can that be possible?

Well, it’s really is up to you whether you exist in a prison on Blue Monday, or you enjoy yourself. If you prefer the latter, our suggestion is simple: exercise.

Aerobic exercise, any steady movement you enjoy—walking, jogging, swimming, cycling—boosts endorphins, and will leave you feeling calmer and happier.

To stay healthy, adults should do 150 minutes of moderate-intensity activity every week. If you haven’t exercised for a while, gradually introduce physical activity into your daily routine. Any exercise is better than none. Even a 15-minute walk can clear your mind and relax.

And after that, who wouldn’t like a massage? Treat yourself and add a therapeutic massage to your routine. You’ll feel, look and simply be healthier far into the future. It’ll promote a faster healing of strained muscles and sprained ligaments; reducing pain and swelling as well as formation of excessive scar tissue

Make your Blue Monday the best Monday of the year!


How to Foam Roll – The Art of Self-Myofascial Release

Posted on 12th January 2018 by

Here’s a quick, no nonsense guide for runners to help improve your warm-up, performance and prevent injury with some simple foam rolling! It’s all about the fascia!

What is fascia?

Firstly, fascia is a dense connective tissue that surrounds every muscle, joint and organ in the body.

There are 3 types of fascia; superficial, deep and visceral.

  • Superficial fascia lies just beneath the skin.
  • Deep fascia penetrates and surrounds muscle tissue.
  • Visceral fascia helps keep vital organs in place.

Everything in the body is connected through fascia, but some areas are more connected than others, forming thickened sheaths and bands of fascia. These are bundled together, inseparable from the muscle tissue (myo) and it’s accompanying web of connective tissue (fascia), forming a 3D myo-fascial web throughout the body. Think of a 3D spider’s web in the shape of your body & you’re getting close!

When working optimally, this myo-fascial web helps provide support, stability, movement dynamics, force transmission and optimises sporting performance.

Why should runners foam roll?

Trigger Point Grid Foam Roller Foam rolling
We like the Grid Rollers from Trigger Point Therapy
  • For warm-up pre running, as it’s far more effective that static stretching (5)
  • To increase nutrient-rich blood flow to muscles that need it.
  • To improve the mobility and flexibility of muscles and joints (4,6,7).
  • To increase athletic performance (8,9).
  • To recover from exercise faster (1,2,3).
  • To reduce inflammation and remove toxins/chemical waste products.
  • Longer term, to break down adhesions in muscle and connective tissue.
  • You can also successfully self-treat minor injuries such as muscle strains and trigger points.

When should runners foam roll? 

  •  MB1 MB5 Trigger Point Roller Ball
    A great alternative to a foam roller is the MB1 or MB5 ball

    Before exercise: when paired with a dynamic warm up to increase blood flow to areas that may be lacking it.

  • After exercise: used within a cool-down procedure to flush out blood that has pooled in working muscles and to allow fresh nutrients and oxygen in to kick start the recovery process.

Rolling for only a few minutes can have a dramatic impact on the quality of your training session. So, if you’re stuck for time, pre-exercise rolling would provide most benefit.

How to foam roll

Remember this easy guide and apply it to each muscle group that you’re working on.

  • 4 linear rolls (to search the muscle for areas of tightness, we call these ‘hot spots’).
  • 30 second holds on each hot spot.
  • 4 joint movements (to move the muscle underneath the roller).
  1. Underside of the foot (plantar fascia)

TrP Foot roller Foam rolling

  • Place the roller under the sole of the foot.
  • Apply pressure and roll slowly towards the heel and back to the sole of the foot, 4 times.
  • Hold pressure on any hot spots you may find.
  • Once this hot spot starts to reduce, maintain pressure and add in movement of the toes by flexing and extending them all 4 times.
  • Repeat the process 3-4 times.
  1. Calves (gastrocnemius and soleus)TrP Calf Roller
  • Zone A = achilles to mid-calf.
  • Zone B = mid-calf to just below the knee.
  • Roll zone A, followed by zone B.
  • Begin by sitting on the floor with the roller on your Achilles tendon.
  • Place your hands behind you and the other leg on top to add pressure.
  • Roll up and down searching for hot spots. If any are found, hold this pressure for 30 seconds.
  • You can also ‘span’ the muscle by turning your foot inwards and outwards whilst maintaining pressure on a hot spot.
  • Repeat this process 3-4 times before moving on to zone B.
  1. Thighs (quadriceps)
  • Zone A = front of the hip to mid-thigh.
  • Zone B = mid-thigh to just above the knee. TrP Quads
  • Roll zone A, followed by zone B.
  • Begin by lying on your front with the roller at the front of your hip just below the bone.
  • Support yourself with your elbows out in front and the other leg bent up to the side.
  • Roll up and down in search of hot spots. If any are found, hold this pressure for 30 seconds.
  • You can also ‘span’ the muscle by turning your foot inwards and outwards whilst maintaining pressure on a hot spot.
  • Now, once on a hot spot, bend and straighten the knee 4 times.
  • Repeat this process 3-4 times before moving on to zone B.
  1. Buttock (gluteals and piriformis)
  • Begin by sitting on the roller with your hands behind you for support.
  • Shift your weight onto one side as you bring that leg up and cross it over the other.
  • Aim to have the roller ‘in your back pocket’.TrP Glutes Foam Rolling
  • Roll along the length of your glute in search of hot spots. If any are found, hold this pressure for 30 seconds.
  • Repeat the process 3-4 times.
  1. Upper back (paraspinals, rhomboids, trapezius)
  • Lay on your back with the roller just below the shoulder blades.
  • Place your arms behind your head or cross them in front of your chest.TrP Upper Back Foam Rolling
  • Lift your hips off the floor and use your legs to roll up and down the spine.
  • Carefully extend your back over the roller.
  • Add in side bends to target various muscle groups.
  • Again, if any hot spots are identified, hold this pressure for 30 seconds before moving on.
  1. Chest (pectoralis major/minor)
  • Lay on your front and place the roller (or trigger point ball) just inside the shoulder joint, on the pectoralis tendon. Pec TrP
  • With the arm above the head roll up and down in search of hot spots.
  • If any are found, hold this pressure for 30 seconds.
  • Add in arm movements to manipulate the soft tissue underneath the roller. 4 straight-arm scoops should do it.
  • Repeat this process 3-4 times.
  1. Latissimus Dorsi
  • Lay on your side with one arm above your head for support.
  • Place the roller at a 45° angle just underneath your armpit.Lat Dorsi TrP
  • Shift your weight to roll up and down in search of hot spots.
  • If any are found, hold this pressure for 30 seconds.
  • Add in straight arm movements to release the tissues further, 4 movements followed by 4 rolls.
  • Repeat this process 3-4 times.

References

  1. Pearcey GP, Bradbury-Squires DJ, Kawamoto J, Drinkwater EJ, Behm DG, Button DC. Foam rolling for delayed-onset muscle soreness and recovery of dynamic performance measures. J Athl Train. 2015;50:5–13.
  2. Macdonald et al. (2014) Macdonald GZ, Button DC, Drinkwater EJ, Behm DG. Foam rolling as a recovery tool after an intense bout of physical activity. Medicine and Science in Sports and Exercise. 2014;46(1):131–142.
  3. Rey E, Padron-Cabo A, Costa PB, Barcala-Furelos R. The effects of foam rolling as a recovery tool in professional soccer players. J Strength Cond Res. 2017;
  4. Bushell JE, Dawson SM, Webster MM. Clinical relevance of foam rolling on hip extension angle in a functional lunge position. J Strength Cond Res. 2015;29:2397–403.
  5. Su H, Chang NJ, Wu WL, Guo LY, Chu IH. Acute effects of foam rolling, static stretching, and dynamic stretching during warm-ups on muscular flexibility and strength in young adults. J Sport Rehabil. 2016; 1-24.
  6. Kelly S., Beardsley C. (2016) Specific and cross-over effects of foam rolling on ankle dorsiflexion range of motion. International Journal of Sports Physical Therapy 11(4), 544-551.
  7. Macdonald GZ, Penney M, Mullaley ME, Cuconato AL, Drake CD, Behm DG, Button DC. An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force. J Strength Cond Res. 2013;27:812–821.
  8. Peacock CA, Krein DD, Silver TA, Sanders GJ, von Carlowitz KPA. An acute bout of self-myofascial release in the form of foam rolling improves performance testing. Int J Exerc Sci. 2014;7:202-211
  9. Monteiro et al. Acute effects of different self-massage volumes on the FMS overhead deep squat performance. Int J Sports Phys Ther. 2017; 12(1): 94-104.
  10. Monteiro ER Correa Neto VG. Effect of different foam rolling volumes on knee extension fatigue. Int J Sports Phys Ther. 2016;11(7):1076‐1081.

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Productive healthy ageing and MSK health

Posted on 9th January 2018 by

Last month, Public Health England published new guidance, entitled Productive healthy ageing and musculoskeletal (MSK) health.

Over the last few decades, life expectancy has been steadily increasing, with the ONS estimating that by 2041, there will be an 3.2 million people aged 85 years and older in the UK.

The report highlights that older people have an abundance of skills, knowledge and experiences that benefits the wider community greatly, however, the opportunity to utilise these resources is dependent on good health as we age.

Challenge the view that retirement is about sitting more and moving less.

As life expectancy rises, we must promote the concept of productive healthy ageing. This involves many pillars including; financial security, resilience, social activities and physical health.

Productive healthy ageing

Physical Health 

MSK conditions are problems of the bones, joints, muscles and spine, and are a common cause of severe long term pain and physical disability. There are 3 groups of MSK conditions:

  • inflammatory conditions, for example rheumatoid arthritis
  • conditions of MSK pain, for example osteoarthritis, back pain
  • osteoporosis and fragility fractures, for example fracture after fall from standing height

The older a person is, the more likely they are to experience chronic diseases and disabilities such as poor MSK health.

MSK conditions have a massive impact on society.

  • Lower back and neck pain were the leading causes of disability in England from 1990 to 2016.
  • Estimated levels of MSK conditions in England for 2012 also found that 18% and 11% of people aged 45 years and above have knee and hip osteoarthritis, respectively.
  • An estimated 17% of all ages have back pain.
  • Fractures, which are often a consequence of falls, are one of the most serious MSK problems seen in the older population.

There are many risk factors that can increase people’s susceptibility to MSK problems, including age, being overweight or obese, lack of physical activity, and poor health habits such as smoking.

The two risk factors that often coincide are increasing age and reduced physical activity. As people age, they take part in less physical activity

In the 19 to 24 year age group 76.6% of people are physically active compared to 24.7% in individuals aged over 85 years.

Living for longer does not mean a lifetime of pain and ill-health. There are steps that we can take throughout our lives to maintain healthy productive lives, reduce the risk of developing MSK conditions and better manage our health.

Our Top Tips

As a physiotherapy, health & well being clinic, a significant number of the people we see are in the older age range. We see people with MSK conditions such as osteoarthritis, back pain and osteoporosis. We see people concerned about their reducing mobility or with balance problems that mean they are starting to loose their independence. More frequently, we are now seeing people who are really investing in their physical health – listening to the messages the Government are putting out and taking action to reduce the risk and impact of MSK conditions.

Physical activity in adults

So, what are the best ways of tackling physical health as we age?

  1. Stay as active as possible. Simply walking is fantastic, you can make it social or build it into functional tasks such as shopping. Set yourself some walking goals, to increase your distance gradually. Find a variety of physical activities that you enjoy – swimming, specialist classes, yoga or Pilates are all great ideas. It doesn’t matter what you do, the most important thing is that it’s fun and enjoyable, then you’re more likely to make it part of your routine!
  2. Sit less. Don’t be tempted to sit more. Activities such as gardening, going out shopping, looking after grandchildren and cleaning are all wonderful ways to stay active.
  3. Be health conscious. If you’re invited to check up’s at your G.P., don’t put them off. Keeping on top of your general health and managing any conditions you may have, will help with your physical health. You can also have check up’s or health MOT’s through schemes such as Health Works locally. Try and eat well, sleep well and have time for relaxation too!
  4. Keep on top of aches and pains. If you do pick up an injury or an MSK condition such as arthritis is giving you pain or limiting you, seek help. Seeing someone sooner rather than later will help make sure you can stay physically active and recover quickly, so you can continue enjoying life. “Use it or loose it” is a very apt saying as we age. If you can’t keep active due to pain or an injury, you can very quickly loose muscle strength, balance, fitness and flexibility. So it’s really important to be pro-active.

How we help 

We run a range of specialist services for the older residents of Chandlers Ford and surrounding areas of Hampshire. Our core service of physiotherapy is there for you if you want help and relief from pain or an injury. It’s also valuable if you have a diagnosis of an MSK condition such as arthritis or osteoporosis, and want to know more about the condition and be pro-active about managing it.

We also run weekly Positive Steps classes, which are specifically designed exercise classes for older people. They are a relaxed, sociable and fun way to exercise in a supportive environment, led by Clinicians who understand your exact needs and goals. You can try your first class for free, so why not get together with a friend or partner and give it a try!

We also have an extensive Pilates timetable. Our mat classes are ‘Clinical Pilates’, so adapted specifically to work on optimising physical health and run by Clinicians who understand the ageing process and the best way to exercise.

Wherever you find yourself, we’re here to help and support you. Not sure if and how we can help? Just pop in or give us a call and we can have a chat!

 

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The Benefit Of Pilates For Winter Sports

Posted on 8th January 2018 by

Winter is upon us and with that, ski and boarding seasons are in fill swing!

We get lots of enquiries at the clinic about how best to prepare for skiing holidays and how to prevent the worst from happening with injuries.

In today’s blog, we’ll look at why preparing for your ski or snow boarding holiday is important and what Pilates is – if you haven’t come across it before

Ski holidays are a big commitment, both physically and financially. They are also time limited, so most people ski around 6-8 hours a day for 5-7 days in a row. This can be a huge increase in demands on your body if you normally sit in an office all day!

Pilates can help to prepare you for the slopes in many ways:

  • Helps to prepare the body for intense period of exercise
  • Reduces the risk of injuries
  • Improves fitness
  • Addresses muscle imbalances
  • Helps you make the most of your holiday!

Pilates is a low impact form of exercise, usually mat based, that centres around the idea of maintaining a strong ‘core’ during dynamic movement patterns. It works on improving balance, flexibility, muscle strength and posture. It incorporates elements of yoga, martial arts and Western forms of exercise.

So how does having a well trained ‘core’ help me on the slopes? 

There are 4 key elements that will help you during your time on the slopes – Posture, Alignment, Control & Muscle Balance.

I’m sure you’ve seen it before, some people struggle to even stay upright! During this struggle their muscles are so tense and working so hard to keep them upright, thinking about posture goes out of the window!

Posture

A crucial part of winter sports is how you stand on your skis or board.

Incorrect posture will force your body to work much harder than it needs to, which is really inefficient. So, you’ll find that some of your muscles will tire much more quickly and your body will generally fatigue.

When you’re on your skis or board, your posture needs to be stable, yet easily adaptable to the dynamic nature of snow sports.

Pilates helps posture by educating the right postural muscles for you. It teaches postural muscles to work effectively and efficiently.

Alignment

This follows on from posture. Alignment is the relationship in your body between key areas like your head, shoulders, pelvis, hips, knees & ankles. So, if you were drawing a line between these key points like a dot to dot – there will be good and not so good patterns of alignment.

Learning to align your body in its optimal position, will reduce the strain on joints and muscles. Correct alignment will improve your control and balance.

We take it for granted, thinking our body will naturally do this, but a lifetime of postural stresses, injuries, sitting at desks, driving etc. will effect our optimal alignment. We may have tight weak muscles or even some that don’t ‘switch on’ when they’re needed.

Pilates really works to optimise your alignment, teaching all those bits of your body to work efficiently in relationship to each other. Being conscious of your alignment will carry over to your time on the slopes and you will reap the benefits in efficiency, endurance and preventing injury.

Control

Being able to control your body effectively allows you to make small changes without over or under compensating. This skill is vital in skiing and boarding. Reduced control results in working harder than you need to, overstraining the body.

All the moves and exercises in Pilates will challenge and educate body control. Practising control off the slopes will help it become second nature when you’re on the slopes! Let’s face it, when you’re hurtling down a slippery mountain with an equally slippery piece of equipment attached to your feet, a bit of control is a nice thing to have!

Muscle Balance

Muscle imbalances are common throughout the body and don’t always result in a problem. But if your body is being put under greater prolonged physical stress (like a week skiing!), imbalances can become problematic. Weak muscles can be forced to use increased tone or tension to help support them, which increases their work load. Other muscles can work overtime to try and compensate. As skiing/boarding is a whole body exercise, it’s important to address any imbalances you may have.

Pilates is a great form of exercise to do this, that really works the whole body. When practising Pilates exercises you can quickly find out which areas are weak or tight!! It will really teach those ares to work and address any compensations your body is making.

So, how exactly can Pilates can help prevent injuries and keep me safe during my trip!

All of the points above are vital injury prevention tips – correct posture and alignment, better control and well balanced muscles will all reduce the risk of injury.

Any area of the body can be injured when skiing, as it’s a whole body sport. This includes joints, bones, ligaments, muscles and tendons. An injury can vary from a minor muscle strain to a major bone/joint injury such as fracture or dislocation.

Pilates specifically can help you:

  • Maintain control
  • Improve balance – reducing the risk of falling
  • Distribute the load evenly throughout your body – reducing the risk of overworked muscles
  • Increase your flexibility – helping you maintain the correct posture and stance
  • Improve your dynamic movement control – allowing you to adapt to your terrain

Pilates will give you the skills needed to have a safe and enjoyable time away – plus it’s a great form of exercise all year round! The benefits are transferrable to everyday life and exercise too, not just extreme winter sports.

If you’re interested in experiencing for yourself how Pilates can benefit you, come and join one of our classes. We run an extensive timetable of classes, including daytime, evening and Saturday mornings – with a range of levels to suit all.

The goPhysio Team also have some top tips to help reduce the risk of injury on the slopes

Fiona – Listen to your body! Don’t keep going if you feel like you need a break.

Kim – Get any pre-exisiting injuries treated BEFORE you go – don’t leave it until the last minute! You really wouldn’t believe the number of people we see at the clinic a few days before they’re due to go skiing, who’ve had an injury for ages and call us in desperation (normally looking for a knee brace to solve their problem!). Think ahead!!

Paul – Pace yourself throughout the day and have regular breaks to top up energy levels with a hot chocolate!

Francesca – Just in case……make sure you have some insurance to cover any injuries or illnesses while you’re away.

We hope you have a safe & happy holiday!

p.s. Obviously, some injuries are totally unavoidable. So if you do find yourself heading home not quite in one piece, we’re here to help you recover too. You can book an appointment online or give us a call. We aim to offer you an appointment within 24 hours, if not the same day so you can get sorted without delay. All our team are keen skiers or boarders, so know exactly what you’re talking about.