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Physiotherapy For Cycling Injuries

Posted on 10th June 2018 by

Bike Week 2018 This week is Bike Week, which aims to inspire more people to take to 2 wheels.

Cycling is a wonderful way to exercise, whatever your level or age. It’s great for cardiovascular fitness, muscle strength, flexibility and has a host of health benefits.

It’s a safe form of exercise and is often a great way to start fit if you need to maintain your fitness with a lower impact activity. It’s also a fab way to incorporate exercise into a mode of travel!

However, like many forms of exercise, cycling can become a source of injuries. Cycling injuries tend to fall into 2 camps, either a traumatic injury or an overuse injury.

Traumatic Injuries

These are caused by some sort of trauma. This is normally a fall or collision and can be very minor to severe. Traumatic injuries are often accidents that can’t be avoided, but you can take precautions. These include:

  • Wearing appropriate protective clothing such as a helmet
  • Being up to date with bike maintenance to make sure you bike is in top working order
  • Knowing and reading the weather conditions and environment to make sure they fit with your plans
  • Understanding your personal limitations and being realistic with your ability. Many accidents occur when people are pushing themselves unrealistically.

Common traumatic cycling injuries include:

  • Fractures – often the clavicle (collar bone) or scaphoid (wrist) as you put your arm out to protect you as you fall.
  • Bruising – to the muscle and/or bone. This is as a result of falling directly onto the area, often a prominent bony area such as the outside of the hip.

Overuse Injuries

As the name implies, are caused when a part of the body is being ‘overused’ and can’t cope with the physical demands being placed upon it. Cycling is a very repetitive activity, an average cyclist might perform well over 5,000 revolutions an hour. The human body has a threshold of what it will tolerate and sometimes it just can’t cope with prolonged repetitive demands being placed on it. This is when an overuse injury rears it’s head.

The problem with overuse injuries is that they often start gradually as a tiny niggle that you ignore. Before you know it that niggle is a regular occurrence but you think it will just go away just as it appeared. Then it eventually becomes really annoying and can actually becomes so severe it stops you doing the things you love and that may have caused it in the first place, which is even more of a pain!

You can take steps to avoid or minimise the impact of cycling overuse injuries. These include:

  • Make sure your bike is set up correctly. This is crucial given the repetitive nature of cycling. Very small adjustments such as saddle and handlebar height can make a huge difference.
  • Increase your cycling gradually. Whether its speed, distance or hills – don’t do too much all at once. You need to give your body time to adapt and adjust to the demands being placed upon it.
  • Listen to your body. If you feel a little niggle, hold back a bit until it eases off to give your body chance to recover.
  • Seek advice at the right time. If a niggle is becoming more than that, it’s better to come and see us sooner rather than later. Overuse injuries that are ignored can often become long term problems and then they’re much harder to resolve and take longer to recover.

Common cycling overuse injuries include:

  • Back pain – which is often related to your posture on the bike and easily resolved by changing your bike set up.
  • Neck pain – again, this is often posture related and being more aware of your posture and position on the bike can be really helpful.
  • Knee pain – including tendonopathies, patellofemoral pain (front of knee) or ITB problems (side of knee).
  • Foot or ankle problems – such as achilles tendonopathy or forefoot pain from the pressure of peddling.

As Physio’s we’re highly skilled at identifying and resolving all the injury issues that may arise from cycling. Many of our team are keen cyclists themselves, so can truly identify with what you’re experiencing. If you are suffering with an injury as a result of cycling, give us a call to see how we can help you and get you back on your bike! #BikeWeekUK


Read more about Physiotherapy for Cycling Injuries on the Chartered Society of Physiotherapists website.


 

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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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How might orthotics help me?

Posted on 10th March 2018 by

Orthotics are prescribed and worn for a variety of reasons. They are also known as insoles, shoe inserts or orthoses.

The most common reasons orthotics are recommended are:

  • Arch and heel pain (Plantar Fasciitis)
  • Lower leg tendonitis (Achilles tendonitis and posterior tibial tendon dysfunction)
  • Shin splints
  • Knee pain, such as chondromalacia patellae, iliotibial band syndrome (Runners knee)
  • Leg length discrepancy
  • Low back pain

Orthotics work by improving foot efficiency, lower limb alignment, therefore reducing stress on the problem area resulting in pain relief.

Although some people adapt to orthotics very quickly, you should gradually adjust to them by wearing them for a few hours more each day. You should avoid using them for extended activity, including sports, until you feel fully comfortable.

They should be comfortable and used whenever you are doing the activity that would normally aggravate your condition. If you need orthotics, they can improve your overall comfort in your lower limbs and feet.

We are able tosses whether you’d benefit from orthotics by combining our knowledge & expertise of injury and how the foot and ankle works with a dynamic computerised foot scan. Following this we can make appropriate recommendations based on your individual case and circumstances.

Read More

What are orthotics?

Overuse injuries

Top 5 Running Injuries and How To Manage Them

 

 


goPhysio Joint Focus: Knee Pain in Adults

Posted on 8th February 2017 by

knee pain in adultsThe knee is the largest joint in the body. It is extremely mobile yet highly stable, allowing us to walk, jump and run.

It relies on both the stability of the pelvis above and the foot below for peak performance. If these become impaired, it’s ability to be stable yet mobile is compromised and injury often occurs. The knee is often injured during sporting activities, is prone to ‘wear & tear’ and a common problem in adolescents during or after growth spurts.


 

Common Knee Injuries

Many common injuries affect the knee, these include:

If you’re suffering with knee pain and it’s stopping you doing what you love or being as active as you need to be, our team can help you. We offer a range of services from our clinic in Chandlers Ford, which can help identify & resolve your knee problems and also address the prevention of knee injuries.

If you want any advice, please do give us a call on 023 8025 3317 or you can book an appointment online.


Yoga & Physiotherapy – A Success Story

Posted on 22nd November 2016 by

Physio Gemma, recently attended a specialist course to train in using yoga techniques as part of physiotherapy treatment. She has started integrating some yoga principles into some of her treatment programmes and her patients are benefitting greatly. Mrs A kindly agreed for Gemma to share her success story with you.

Mrs A came to see us one year after arthroscopic knee surgery – she no longer had any pain from the knee and was exercising regularly in a gym with a personal trainer. She felt the knee was strong, however she was concerned by her lack of flexibility; both the knee and hip on the same side had stiffened up considerably since her operation and didn’t seem to be improving.

When she first came to us she couldn’t fully straighten her knee, nor bend it much past 90 degrees, and her hip was similarly stiff, especially in rotational movements.

On her first session we discussed her goals – she was keen to get back to running but mostly wanted to be fit for ski season! We started with lots of hands on mobilisations to loosen up both the hip and knee joints but we wanted to find a fun way to progress her flexibility at home as, lets face it, a series of static stretches can feel like a bit of a chore……

We took her into our studio and chunk by chunk taught her a short routine of yoga poses specifically designed to improve her hip and knee flexibility, with the added bonus of being good strength and balance poses too.

We added to this over several sessions, combining hands on treatment with 1-2-1 yoga in her physio sessions until she was confident in a 10-15 minute routine that she could practice daily at home.

Mrs A said that doing yoga rather than static stretches helped her to relax, clear her mind and focus on the poses to improve her flexibility so that it has now become an enjoyable part of her daily routine.

6 weeks later she has regained full flexibility of both the knee and hip, is back to running and confidently looking forward to ski season!

A great success story! If you think you’d benefit from an integrated approach of yoga with physiotherapy, give us a call and book an appointment to see Gemma.


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.

 


Runner’s Knee (Patellofemoral Pain Syndrome)

Posted on 19th August 2016 by

Knee pain is one of the most common running injuries we see here at goPhysio. A regular injury is ‘runner’s knee’ or more technically Patellofemoral Pain Syndrome (PFPS).

What is ‘Runner’s Knee’?

As you bend and straighten your knee, the knee cap (or patella) naturally moves up and down in a Runners knee groove in your thigh bone (or femur) . The knee cap is held in place by various muscles and tendons, helping it to move well. If any part of this isn’t quite working right it can affect the knee cap, particularly if you’re doing a repetitive movement such as running. Such problems around the knee cap can cause damage to cartilage, ligaments or fatty tissues near the knee cap and as a result cause pain and inflammation.

Pain often originates from the contact between the back of the knee cap and the thigh bone.

What does it feel like?

Pain is often felt during a run behind the knee cap or infant of the knee. It can be a dull achey pain or may be quite sharp and severe. Other symptoms include:

  • Pain during other activities, sports or even walking
  • Pain when squatting or going up or down stairs, down especially
  • Stiffness and swelling around the knee cap (‘puffy’ knees)
  • Loss of muscle bulk in your quadriceps (front thigh muscles)

What causes it?

A number of issues can cause runner’s knee. It’s often something that comes on gradually and people endure for some time before seeking help, so often, by the time a runner comes to see us there are a few things going on and compensations have developed. Problems that can contribute to runners knee include:

  • Overworking the patellofemoral joint (joint between knee cap and thigh bone)
  • Stiff hip joints
  • Over pronation at the foot (flattened arches
  • Tight hamstrings, calf and quadriceps muscles
  • Lack of strength in quadriceps  muscles
  • Issues around the glutes and pelvis

What can Physio do to help? 

To settle the pain and discomfort of your knee pain, you can rest and use ice and painkillers. Rest is crucial, as the problems is often a result of  overuse, so reducing activity will help this. However, if you’re like most runners, you aren’t going to be keen on resting for long.

As with any overuse injury (read a previous blog about overuse injuries here), it is crucial to identify the cause of the problem. This is where physio comes in, as we’ll be able to identify exactly where the cause of the problem lies and address it. This may be through a tailored exercise programme to strengthen, stabilise and stretch particular areas around your knee, hips or pelvis. It could be that you’d benefit from orthotics and if so we can assess your need and advise accordingly. Or it may be an issue with your running technique, training programme, running shoes or other activity you’re doing.

In combination with addressing the underlying issue, we provide relief of your symptoms to make you feel more comfortable. This could be through hands on physio techniques to release soft tissues, acupuncture, electrotherapy or taping. We have a huge range of techniques and tools that can help you.

Most importantly, we’ll guide you back to doing what you love to do and that’s run! We make sure you know when to start running again without re-injuring yourself, it’s a difficult balance. We advise on distance, timing, rest, speed and making sure you are progressing your specific exercises to support your recovery.


Knee Arthroscopies – Too many, too soon?

Posted on 23rd July 2015 by

On yesterday’s Radio 4 programme, Inside Health, Dr Potter discussed whether surgeons are maybe too eager and/or too quick to carry out knee arthroscopies.

An arthroscopy (key hole surgery) can be the only or best solution for a number of knee issues. However, research has found that conservative management or physiotherapy, can be a better alternative, with the same outcomes as surgery. In other cases, physiotherapy can help significantly delay the need for surgery.

This is really encouraging for those that suffer with knee pain. No one wants to undergo surgery unnecessarily.

What was mentioned though was that access to physiotherapy is needed to meet these recommendations. Research has indicated that 1-2 hours of physio is required for 2-3 months, yet with pressures in the NHS this is rarely achievable. Even private insurance companies now are limiting the number of physiotherapy sessions that are covered by their policies in an aim to keep their costs down and stay profitable.

The alternative is coming to a clinic such as ours, where physio is self funded. Your treatment plan is tailored to your individual presentation and life-style. This can be a small price to pay to avoid surgery.

If you’d like to listen to the full programme, click on this link and you’ll find the arthroscopy segment 6m 50 s in.Knee