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Overuse Injuries

Posted on 12th February 2018 by

What is an overuse injury?

An overuse injury is normally a chronic injury that gradually occurs over a period of time, rather than a sudden acute traumatic injury. Repetitive trauma to a muscle, joint, ligament or tendon such as a tendinopathy or stress fracture are just a couple of examples of overuse injuries.

What causes overuse injuries?

Overuse injuries are often linked to training overload in athletes, or sudden changes in activities that put stress through the body which they are not used to and therefore overload the soft tissue or bone. When we take up a new hobby, sport or activity or increase training levels/load this will put increased stress onto our body, this will lead the body having to adapt. However, if the body is not given time to adapt and the body is overloaded then this can, in some cases, lead to repetitive ‘microtrauma’ to the tissues. This can be unnoticed for a long time, or thought to be just a muscle ache. Some causes of this include:

  • Poor Technique
  • Muscle imbalances
  • Training overload/level
  • Biomechanics of your foot

What might it feel like?

Depending on the affected tissue or body part will depend on how it will feel. Common symptoms include:

  • Pain that starts initially during a warm up that then eases of and returns at the end of your sport or activity
  • Consistent pinching or sharp pain on specific movements
  • Constant dull ache

How do the symptoms progress?

Overuse injuries can be slow in developing and last a long time. The longer the problem is ignored the worse or more frequent the symptoms can become. This may lead to pain every time you engage in your sport or activity and may also lead to pain/swelling afterwards.

How is it diagnosed?

If you think you may be suffering with an overuse injury, it is important to get an assessment by a physiotherapist or sports therapist. The key to effective management of an overuse injury is accurately identifying exactly what’s causing it and addressing this. This will help to prevent any of those niggles turning into a bigger problem and possibly preventing you doing the sport of activity that you love.

What is the best treatment for overuse injuries?

There are lots of treatments that can be used to help, depending on the injury. Treatment will often start with easing the symptoms of the injury, such as pain and inflammation. In parallel to this, addressing the underlying cause and working on strength and stability to prevent reoccurence is key. Treatments may include:

Outlook

When the underlying issue is addressed and appropriate changes are made, overuse injuries can be solved. They can often be a very frustrating injury, as they inevitably need a bit of rest and trial and error to work out exactly what’s causing the issue. That’s where we come in, seeing an expert can guide you through the puzzle of injury and help get you back doing what you love as quickly and painlessly as possible.

Read More 

Achilles Injuries

Running injuries – The basic principles

Treatment of calf pain in runners

Runners knee (patellofemoral pain)

What’s physiotherapy got to do with a dripping tap?


 


Top 5 Running Injuries & How to Manage Them

Posted on 29th January 2018 by

The top 5 running injuries. 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

The Injured Runner Project
We are trying to find out more about what injured runners do to get back to pain-free running, and would love to hear from you! If you’re interested in helping us out, please take a few moments to answer a couple of questions by clicking on this image. Many thanks.

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Why Pilates is great for runners

Posted on 25th January 2018 by

Pilates is a mainly mat based, body-conditioning routine designed to increase physical endurance, flexibility, posture, co-ordination, and core strength. It involves focused, controlled movements that can be modified to create different levels of difficulty.

Pilates was developed by a German, Joseph Pilates, in the early 1900’s as a form of exercise for soldiers recovering from injuries in WW1. He then adapted it for use by gymnasts and dancers. This form of Pilates is known as ‘traditional’. There are a host of other types of Pilates too, including Reformer Pilates, which utilises equipment and resistance techniques.

At goPhysio, we teach the APPI method, which is a form of clinical Pilates. The APPI Method is a research based, clinical application of improving the way a person moves and functions in their everyday life. The traditional Pilates exercises have been broken down into clearly defined levels to ensure a standard, gradual progression towards normal, functional movement. This also helps to build a strong foundation to build and progress your core strength on. The core cylinder, the focus of all Pilates movements, consists of the four abdominal groups (external oblique, internal oblique, rectus abdominis, transversus abdominis), the three lower back groups (psoas major, quadratus lumborum, spinalis) as well as the muscles of the buttocks, hips and pelvis.

The core

The ‘core’ plays a key part for any sport – in running, the main purpose is to stabilise and support the spine and trunk, providing a strong centre for the transfer of forces. It helps to make the dynamic leg movements as efficient as possible. Strong core muscles also help to maintain good posture to maximise performance and minimise injury. Reduced core stability can cause excess movement in the trunk, through over rotation. This can lead to a poor running form, which in turn leads to increased fatigue and reduced performance potential. This is due to energy being wasted in the form of excess movement and poor control.

Pilates also has many other benefits for runners

  • Helps to identify any weaknesses that inhibit your gait. It will provide you with muscular cues to help you fire and strengthen muscles that help you maintain a better running posture, which in turn will reduce the risk of injury and overuse.
  • A strong, balanced body helps you maintain proper form as you fatigue. Pilates helps you loosen your hips, legs and back, all helping you keep a fluid, long stride.
  • Pilates can decrease your recovery time after injury or a strenuous workout by increasing joint mobility, improving flexibility and body awareness.
  • Pilates breathing encourages you to use the diaphragm and control your inhalation/exhalations to assist with movement – this translates into better control during running.
  • Pilates helps to improve hip, pelvic and lumbar spine mobility & flexibility, through the movements and stretches.

We run over 20 classes a week at the clinic and even though they are aren’t targeted specifically at runners, it would be a great addition to your training regime to help with core strength, balance and improved mobility & flexibility.

Pilates Exercises for runners

Read More 

Read more about Clinical Pilates

Take a look at our latest Pilates timetable

Our top 6 Pilates exercises for runners

The Injured Runner Project
We are trying to find out more about what injured runners do to get back to pain-free running, and would love to hear from you! If you’re interested in helping us out, please take a few moments to answer a couple of questions by clicking on this image. Many thanks.

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Transitioning from Parkrun to 10k

Posted on 1st January 2018 by

Parkrun started back in 2004 when 13 runners got together on a blustery day in Bushy Park, Teddington, UK. It is now an international family of over half a million runners (and Parkruncounting). The Saturday morning 5km is a regular event in many diaries. With the Hendy Eastleigh 10k and many other longer distance running events round the corner, having nailed a 5k, you may have your sights set on more of a challenge!

So, how do you make the leap from 5k?

When you first started running you probably followed a plan and gradually increased the distance and your body adapted to allow you to run 5km quite happily. Now you want to be able to run even further, this may seem daunting at the beginning. So why not go back to basics and follow the same principle you had when training for 5km.

  1. Set yourself a goal for when you want to be able to achieve 10km, maybe book yourself onto a 10km race, like the Hendy Eastleigh 10k, so you have a goal in mind.
  2. Once you have your goal, follow a training plan that gradually increase your distance each week. There are lots of apps that enable you to enter a date and a distance goal and work backwards and formulate a training plan for you. Just make sure it’s realistic, too much too quickly can overload your body and not give it time to adjust, which is a risk for picking up an injury.
  3. Why not join a running club or seek help from a running coach for advice, tips, and tricks to help your transition from 5km to 10km.
  4. Ensure you have varied distance and speed runs within your training. Use hills and interval training too to add different dimensions to your training.
  5. Listen to your body, if increasing the distance is too hard one week, don’t beat yourself up. Do what you can, the training plan is just a guide.
  6. Allow your body to recover, have rest days. If we don’t allow ourselves rest days, the body does not have time to repair and recover from your last run.
  7. Add in some cross training, try Pilates to improve your movement control, strength and stability, giving you a great stretch and recovery session. Why not go for a swim for some cardiovascular training without the stresses and pressures on you body.
  8. If you start to get a reoccurring niggle or injury get it assessed as soon as possible to prevent it from getting worse.
  9. Listen to some music, an audio book or podcast whilst you run or run with friends to keep the training fun.
  10. Ensure you cool down, stretch, or foam roll. Try using a trigger point MB5 or MB1 ball, which is a great way to release those tight muscles before and after your runs.

Most important of all is to enjoy your training, monitor your progress and don’t panic if you are slightly behind your training schedule remember that is only a guide to help you progress.

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Official Health Partners of the Hendy Eastleigh 10k

Posted on 5th December 2017 by

We are excited to announce a fantastic new partnership with the Hendy Eastleigh 10k, as we become theEastleigh 10k goPhysio official Health Partner of the race.

One of the largest 10k road races in the country, the Hendy Eastleigh 10k is to be held on Sunday 18th March 2018. It is set to attract around 2,800 runners  and will celebrate it’s 34th anniversary next year.

Clinical Director of goPhysio Paul Baker said he is delighted to be part of such a fantastic event.

Hendy Eastleigh 10k“We help so many runners here at goPhysio and see first hand how important running is to people. To be involved in this great, local event, and have the opportunity to support so many runners is really exciting!”

With just 3 months to go until the Hendy Eastleigh 10k it is never to late to get your running shoes on and get going!

Still need convincing? Here’s a few reasons from our team why running is such a great form of exercise.

Why it’s great to run!

Running is one of the best forms of aerobic exercise for physical conditioning of the heart and
lungs. Studies have shown that running has huge health benefits and it can help you experience more energy, patience, humour and creativity. It can even make you happier! So, grab your trainers and head out to explore the world of running.

Running improves your health Running is a fantastic way to increase your overall health. Research shows that running can raise your levels of good cholesterol, increase lung function, boost your immune system & lower your risk of cardiovascular diseases. running can even fortify your immune system by accelerating the circulation of protective cells.

Running is great for your heart It’s the king of cardio. Running, even 30 minutes or so a few days a week, can help prevent or reduce high blood pressure. According to a landmark study in the Journal of the American College of Cardiology, running is associated with a drastically reduced risk of cardiovascular disease.

Running makes you happier The rush of chemicals (endorphins) your body experiences after a run can give you a ‘runners high’. Running can reduce stress, anxiety and depression. A recent study even found that just 30 minutes of running a week, for three weeks, can boost sleep quality, mood and concentration during the day.

It’s easy and convenient Whatever your schedule, you can always squeeze in a run. Just put on your trainer’s and off you go! You can even run whilst your kids cycle or with a baby in a pushchair, take your dog or run your commute!

It’s a cheap way to exercise No gym membership, joining fees or sneaky add-ons. Just the occasional pair of trainers every 500 miles or so, means running is a cost effective way to exercise regularly.

Running seriously torches calories Running is a great calorie burn. It’s one of the best forms of exercise for losing or maintaining consistent weight. The bonus is that the calorie burn continues after you stop running and regular running boosts this “after-burn”, amplifying the effects even more.

It’s a killer leg workout Your body’s biggest muscles are all in your legs and running benefits them all, it’s a great workout to strengthen these important muscles.

You can do it right now Running is such a natural motion, you don’t need to invest in special In the early stage, depending on your targets, you don’t need lessons like many other sports, as running is such a natural motion, just pop on your trainer’s and away you go.

Running strengthens your joints and bones It’s long been known that running helps increases bone mass, and even helps stem age-related bone loss or osteoporosis. It’s also great news for your knees, as a recent study found runners were half as likely to suffer with knee arthritis compared with walkers.

Running can add years to your life It’s recommended that we do at least 30 minutes of exercise, 5 times a week. Making sure you meet these recommendations will help you live a long and healthy life!

Running works your core A surprise to some, but running actually works your core too. The rotation in your spine as you run, challenges your core muscles, helping strengthen your spine. Running on uneven surfaces provides an extra challenge.

Running helps mental health We all live in a busy, stressful time. Running provides the opportunity to take some time purely for yourself, away from your phone, emails, colleagues and kids. You can get primitive with running, giving your brain space to recharge. It can help you to unwind and relax. It’s difficult to come back after a run stressed!

Running improves your sleep Feeling tired from exercise improves your ability to fall and stay asleep. Improving the quality of your sleep is now thought to be a fundamental part of your health and wellbeing. It is even thought that running can help cure insomnia!

Running boosts your confidence Running can boost your confidence and self-esteem. By setting and achieving goals, you can help give yourself a greater sense of empowerment that can leave you much happier and improve your overall feeling of wellbeing and mental health.

It’s a world of discovery Explore new parks, hidden tracks, forests, beaches, river paths, the list goes on. You can run anywhere, any time and enjoy the change of seasons and all the elements as you do.

Running boosts your memory Running can stimulate brain growth as it helps stimulate an increase in the production of brain-derived neurotrophic factor, which encourages neural growth.

Running is a great way to socialise Runners, love nothing more than talking to runners about running. There are so many social aspects to running, whether it’s joining a running club, taking part in a Parkrun or training for an event, there’s a lot of support and camaraderie found amongst runners.

There you have it! Many ways in which running can help you become healthier and happier. Every time you run, you’ll improve your resting heart rate, your body will release endorphins, your legs will get stronger and you’ll burn a whole lot of calories. In the end you’ll be happier, fitter and stronger! Remember the key to better health is right under your toes……

So, grab your trainers and head out to explore the world of running. You’ll thank yourself for it!

Eastleigh 10k health partner goPhysio

Enter the Hendy Eastleigh 10k here.


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