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Reach New Heights This Summer With Young Rehab

Posted on 27th July 2018 by

The extra free time over the summer holidays creates a perfect window of time to get you child Young Rehab Summer goPhysiostarted in our Young Rehabilitation sessions in our Strong Room at goPhysio.

These sessions are a great way to get the kids away from screens and to develop their strength and durability to take them into next their next season of sport.  This can help to reduce the risk of future injuries as well as recovery from existing injuries and niggles.  As well as this, it can generally increase their confidence in movement and teach them another form of exercise that they continue with.

The young rehab classes start with a 45 mins session with one of our Sports and Rehab Therapists where participants are set a bespoke programme tailored to their specific goals and sport.  The remaining 4 sessions are run in groups of up to 3 people under direct supervision.

Sessions are booked as blocks of 5 sessions lasting 45 minutes which includes the initial 1-2-1 session.  Each block costs £150. These could be taken as one per week taking them up to the end of the summer holidays or could also be taken more regularly to gain some momentum and maximise what they get from the sessions.

We understand that you may be going away at some point over Summer and that other plans will come up.  For that reason we are flexible and classes can be booked in at various times each week or moved forward to another week to work around your plans.* Sessions can be booked throughout the week, including Saturday mornings and right up until 8pm during the week.

Who might benefit from Young Rehab?

Kids and teens often go through some big changes between the ages of 10 – 14 as they experience a high rate of growth. Combined with lot’s of sports and physical activities, the growing body can sometimes struggle and pain and injury rears it’s head. This can be highly frustrating, as G.P.s will often advise these youngsters to just rest – but try telling that to a competitive teenager who loves sport! Young Rehab provides a great way to support these kids in staying active and getting back to their sport as quick as possible.

We’ve had many kids experience the benefit of of Young Rehab here at goPhysio.

We’ve seen a large number of young gymnasts and dancers. These athletes often have wonderful flexibility but can lack stability, strength and movement control in key areas. This in turn can lead to some common injuries such as knee pain.

Kids who participate in sports with lots of repeated movements also frequently seek our help. Kicking a football, swimming and tennis are great examples. These youngsters are often training or competing many times a week and sometimes their growing bodies just can’t cope.

It’s not only for the very sporty kids – growing children by the very nature of growing can experience aches and pains that can be effectively managed by learning some key exercises.

If you are interested in booking your child in, or you have any questions then please do not hesitate to contact the clinic on 023 8025 3317.  We can get started immediately!

*A 24 hour cancellation policy applies. All sessions must be used within 3 months of the 1st appointment.

Read More 

Young Rehab – All you need to know

Growing Pains – Knee pain in kids and teens

Sever’s Disease

Why youngsters should play multiple sports

 

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Why youngsters should play multiple sports

Posted on 9th May 2018 by

With the end of season finally upon us for many of our most popular kids sports, we’re seeing a huge spike in the number of youngsters we’re seeing in the clinic with injuries. Unfortunately, many of the most common growth related injuries (Severs, Osgoods Schlatters, Sinding Larson etc.) affect the most active and sporty children at a time they are experiencing growth spurts. Although there is a part of this that we can’t control (growth!), what we are seeing increasingly contribute to the injuries these kids are presenting with is very frequent, intense participation in single sports. We also see this across a huge spectrum of sports, so football, swimming, gymnastics, tennis, dance & more!

Our sporting culture here in the UK (and many other countries too) is to ‘pigeon hole’ children into a single sport from a very early age. Before they know it, children are training / playing / competing / performing in a single sport 5 – 7 days a week! Unfortunately, much of this early specialisation in single sports is driven by the coaches and/or teams. Parents and children fear that if they don’t specialise and fully commit to a single sport they are risking their chance and future success.

The intentions of most parents, coaches and teams is well meaning – the more they train or practice for the sport, surely the better they’ll get and the higher the chances of ‘success’ (defining what success is is a whole other topic that won’t be covered here!).

However, all the evidence points towards the opposite being true – there are many benefits to playing multiple sports and risks to early specialisation in a single sport. The title image of this blog was recently published in the Sports Business Journal, why kids shouldn’t specialise in one sport is discussed here.

The benefits of playing multiple sports

  • Improved sporting performance – studies suggest playing multiple sports at a young age will actually enhance sporting performance in the long run
  • Between the crucial development ages of 6 – 12, playing multiple sports will enhance development of fundamental movement skills
  • Increased athleticism, strength and conditioning – playing a single sport can improve skill for that particular sport, but can limit overall athletic ability
  • Increase chance of developing a lifelong love of playing sport / exercising – if enjoyment, fun and variety are the focus, children are less likely to burnout
  • Develops a more creative athlete by exposure to many skills, situations and environments

The risks to early specialisation in sport

  • Injuries – repeated movement and demands placed upon developing bodies can increase risk of injury. The more movement variety youngsters have, the less risk they have go picking up an injury.
  • Burnout (see the great infographic below on how to prevent this).
  • Social isolation – commitment in hours to training, travel and competing can have an impact on a youngsters social life.
  • Early over-professionalisation – sport is seen in an adult, commercial context with winning being the main focus.

Burnout in young athletes

The crux of it is, for the majority of youngsters, taking part in sport is a way for children to develop well physically, have fun, enjoy activity with friends and importantly install lifelong love of being physically active to help them live a healthy life!

Unfortunately for many sports, naivety from the top won’t change things, it’s very shortsighted and their well-meaning intentions don’t actually have the health and wellbeing of children as a priority. However, sports such as Hockey, do give a glimmer of hope. Their Player Pathway is an excellent example of a great framework for specialisation.

  • They don’t identify ‘talent’ until players reach 12/13
  • Their over riding aim is to “provide fun, enjoyable, learning for every player”
  • They develop close links with local clubs and schools
  • They provide an extra 6-10 hours training a season for ‘talented’ players which then leads to a very structured pathway of progression
  • Children can continue playing for their local and/or school team

So, what’s the takeaways from this:

  • Evidence suggests that children should take part in multiple sports and avoid specialisation until they reach adolescence (around 13, The American Association of Paediatrics says 15)
  • Offer lot’s of opportunities to they different sports and activities whenever you can
  • The focus should be on fun and enjoyment
  • If they do get an injury, seek professional advice. That may need specific guidance on an exercise programme, training programme and activity modification to help them

You can read another great article on the subject here.

benefits of playing multiple sports for children

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Sever’s Disease

Posted on 13th August 2017 by

What is Sever’s Disease?

Sever’s isn’t really a ‘disease’ as such. Sever’s is an inflammation of the growth plate at the back of the heel, which occurs in growing, adolescent children.

What causes Sever’s?

As children go through their ‘growth spurts’, bones will grow faster than muscles and tendons. Because of this, in Sever’s, the tendon at the back of the heel (Achilles tendon) pulls at the heel bone. Thus, due to repetitive stress, it is particularly common in active children.

Sever's Disease How is Sever’s diagnosed?

Sever’s is pretty easy to diagnose through a thorough assessment. The history, your symptoms and the pattern of the problem will paint a picture that leads to the diagnosis. A thorough assessment involves matching the symptoms reported to a physical examination of the heels, alongside discussing activity level and participation in sports.

What might Sever’s feel like?

Sever’s presents as pain in the back of the heel, often present in day to day activities such as walking, and made worse during or after physical activity – especially sports involving running and jumping.

How do the symptoms of Sever’s progress?

The pain caused by Sever’s tends to be directly linked to activity levels. What’s most frustrating about this is that it’s often the most active kids that suffer with it, so limiting their activity can be quite distressing.

The condition may get worse and may be more difficult to treat if you ignore the symptoms and carry on high levels of activity through it. Therefore, without the correct management, the symptoms of Severs can persist until growth stops. Whilst there is no direct treatment that can stop the pathology of Severs, there are many things physiotherapy can do to help relieve and manage the symptoms.

What is the best treatment for Sever’s?

One we have a diagnosis of Severs, we will really focus on helping your child manage the condition.

This can include:

  • Advice on pain relief and managing the symptoms
  • Guidance on sport and activity modification, a term we call ‘relative rest’
  • Exercises to stretch and strengthen muscles in the lower limb, foam rolling can be great
  • Shoe modifications, such as heel pads that cushion the heel as it strikes the ground, heel lifts that reduce strain on the Achilles tendon by raising the heel, or arch supports that hold the heel in an ideal position

The outlook for Sever’s 

The sooner Sever’s is managed, the quicker recovery can be, and with correct management, the condition usually goes away within a few months. The problem does not cause problems later in life.

Related injuries

Severs in very similar in nature to Osgood Schlatter’s of the knee. However, other conditions we consider when children present with heel pain include:

Severs Case Study 

11 year old Joe came to see us complaining of a 3 month history or worsening heel pain. Joe was an extremely enthusiastic grass roots football player, training and playing 4 times a week. He’d recently started trampolining, which he loved! However, his heel pain was starting to get so severe, it was limiting his ability to play football, with him often limping off the pitch after 30 minutes.

When he came to see us, we found he had:

  • A significant tender spot on both heels
  • Naturally flattened arches in his feet
  • Very tight, painful and tense calf muscles

Joe’s Management 

The first steps we took, were to educate and reassure Joe about his condition. Sometimes this reassurance and understanding can be a turning point in recovery – it isn’t anything serious and it will get better!

We taught Joe’s parents a treatment protocol, called The Strickland Protocol. This is a set and timed programme of rest, muscle release and re-introducing activity and stretching.

Joe was advised a short period of complete rest from any impact activity (with the reassurance of the long term gains of this) with a gradual re-introduction. In Joe’s case, he was advised to stop trampolining and football completely for a few weeks, to try and help settle his symptoms as they were so severe. He started a daily treatment programme at home that his parents could help with – the aim of this was to reduce tension of calf muscles and start to reduce the pull on his heel bone. He also used ice on his heels and painkillers when necessary to ease the pain.

As his symptoms eased, stretching and foam rolling of his calf muscles was started and activity was carefully re-introduced.

It was concluded that trampolining was likely to have been one of the main triggers of his problem. Given that returning to football was his upmost priority, it was decided in conjunction with his parents that returning to trampolining was not advisable. Instead, Joe started swimming regularly. The benefits of this were that swimming would help maintain and improve his fitness, whilst being low impact and not irritating his heel pain. He gradually increased his football playing time, using pain levels as a guide and building on time gradually.

We also guided him on his choice of footwear – to wear supportive and cushioned trainers and school shoes and a really good, supportive football boot. Many of the football shoes that are now on the market look great but offer absolutely no cushioning or support. Particularly astro boots, which are like running around on a piece of cardboard! Joe opted for a traditional leather boot, which offered much more support. He was advised to minimise playing in astro boots as much as possible.

It has taken almost a year of guided management for Joe to return fully to normal activity free from pain. What has reassured Joe and his parents is that they understand what’s going on, have made the right informed choices to help recovery and enabled Joe to get back to doing what he loves, playing football! Much of this management was advice and education and Joe doing a regular programme of exercises himself at home.

Had he not had the right advice, Joe could have gone down a route of spiralling inactivity and developed secondary issues – not only physical but also psychological, if he couldn’t play football.

If you’d like some advice on managing Sever’s or any other growing pains, give us a call on 023 8025 3317. 


 

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Growing Pains? Knee Pain in Kids and Teens

Posted on 27th September 2016 by

Growing pains?

Many children experience aches and pains as they grow which are typically written off as ‘growing pains’, told there is nothing that can be done and that they will ‘grow out of it’.

There is some truth to this; during a growth spurt the bones will lengthen first and then the muscles adapt and lengthen to keep up and there can be a period of discomfort around the joints whilst this happens.

However in young sporty children these ‘growing pains’ may well indicate a traction apophysistis (growth plate injury) that needs to be carefully managed to avoid long-term problems and ensure a quick return to sport.

What is a traction apophysitis?

This happens when the muscles are pulling on the growing part of the bone that hasn’t fully fused yet Osgoods Schlatters – like a rope pulling on cement that hasn’t hardened. If this area is overloaded by repeated, forceful muscle contractions, inflammation, pain and microtrauma to the growth plate will result.

This usually happens in very active sporty children who typically play 10+ hours of sport a week – especially kicking, sprinting and jumping activities like football, basketball and gymnastics. It always occurs during a growth spurt and is thought to affect around 20% of 9-16 year olds.

The main areas affected are the knee (Osgood-Schlatters disease) giving pain below the knee cap, or the ankle (Severs disease) giving pain above the back of the heel. Both conditions are associated with tightness of the muscles surrounding these joints pulling on their respective growth plates.

What can be done about it?

Rest, ice and anti-inflammatories can be helpful but most kids won’t want to wait months and months for their bones to stop growing before they return to sport, particularly if they are a budding athlete.

Will stretching help?

If the muscles are tight why don’t we just stretch them?

Well this actually pulls on the area where the muscle attaches to bone, potentially making it worse, not better!

So in response to this dilemma the Strickland protocol has been developed by a Physiotherapist to address the cause of the pain (tight muscles pulling on the growth plate) and to help guide return to sport and activity.

What is the Strickland Protocol?

The Strickland Protocol involves:

  • Applying a specific type of massage towards the insertion of the muscle to improve a muscle’s length and reduce its tightness, which reduces the pull on the tendon attachment – this needs to be done for a minimum of 2 minutes a day.
  • Once underlying tension is taken out of the muscle, helping it to catch up in length with the bone, the attachment site seems to repair in double quick time.
  • Once the child feels no pain in stretch position, we replace massage with stretches, safe in the knowledge that it should be able to cope with the loading of stretches.
  • Massage is continued in parallel with stretches to speed up process of elongation.
  • Rest from aggravating activities is essential – for a minimum of 3 weeks we recommend nothing more strenuous than walking, otherwise this delays healing substantially!
  • An important aspect is the involvement of the parent / guardian as the protocol cannot be done without their help & cooperation, as it will be them that performs massage on daily basis.
  • This is followed by sport-specific rehab and addressing a biomechanical or technique issues as we guide you back to sport.

Does it work?

YES! It has a 95% success rate in 3 weeks when correctly adhered to!

How can goPhysio help?

If your son or daughter is suffering with knee pain (or pain at their heel), you may have been to see your GP who has advised you that there is nothing that can be done, your child just needs to rest. However, we have found that by using this treatment protocol we can effectively help children get back to what they should be – running round, doing sports and having fun!

What we can do to help you and your child is assess the problem thoroughly to make sure we’re confident with the diagnosis. We will then advise you on the best course of action. The great part is that the treatment is pretty simple, with our guidance you can carry out the programme at home – we’re here to provide extra support and advise on progress as and when you need it.

We also offer a specialist Young Rehab service, which provides guided specific rehab programmes for kids, you can read more about this here.