There are many definitions of exercise rehabilitation, however they all share the same common goal. This is to help restore optimal function within the shortest time possible with minimal risk of re-injury. Absolute rest may relieve symptoms in the short-term, however this will lead to decreased tolerance to exercise and increased risk of future injury. Benefits of Exercise Rehabilitation post-injury
When injuries occur to muscle, ligament or bone, the body is a great healer by laying down new tissue. However, the new tissue created is not as strong as it once was. This is one of the reasons people may have the same reoccurring injury. Not adequately rehabilitating a muscle strain is bit like putting duct tape over a crack. It will cover the area but it struggle to prevent further damage. The way to plaster over the cracks and actually remodel the injured area is through controlled progressive strengthening rehabilitation.
How does Rehabilitation work?
Exercise rehabilitation follows a logical order and intensity. Starting with simple tasks such as working on flexibility before progressing onto areas such as strength, balance and functional activity. The intensity and dosage of the exercise is progressed to challenge the patient in order to make positive adaptions to their injury. This can only be done through observation and patient to therapist feedback. Every person is unique and will respond differently during the rehabilitation process, even with similar injuries.
Find out more about or book an individual exercise based rehabilitation session by calling us on 023 8025 3317.
This patient’s story relates to a 35-year-old female, who attended goPhysio with calf pain.
When she first came to see Physio Charlotte, she described her pain as a muscular tightness in her calf, spreading up into her hamstring and buttock area.
Her pain had started within 24 hours of a weights session at the gym. She booked and attended her first appointment within 3-4 days of the pain starting.
More about her symptoms
The patient’s pain was intermittent and varied depending on certain activities. It was causing her to wake at night, and she found it difficult to get comfortable. Night-time was the most problematic time, whereas she barely noticed the pain during the day.
What was causing her pain?
At her first appointment, Charlotte carried out a full and detailed assessment and it became clear that the source of the pain into her leg was her lower back, due to an impingement of a nerve in that area. Charlotte started her treatment during that first session and the patient was also given some exercises to do at home.
By the time she came for her second appointment, four days later, she had been sleeping without a problem and had no leg pain. She was acutely aware of her lower back (the source of the problem). With subsequent treatment, we have seen a continued improvement. Treatments during the sessions have included myofascial release techniques, home exercises, soft tissue work, mobilisations, postural advice, and trigger point work.
The patient is counting to work on exercises for her lower back area to help ensure she reduces the risk of the injury returning.
goPhysio provided my treatment in a clean, welcoming environment. My physiotherapist, Charlotte, was excellent. She listened to my description of symptoms and identified the source of my pain after taking a detailed history and conducting an initial examination. During treatment she always explained what she was doing and why, which helped me to better understand my recovery goals. I am delighted with my progress to date and look forward to continuing positive progress.
Achilles tendon injuries or Tendinopathies are typically not related to a specific incident or injury, but instead are a result of overloading or overusing the tendon over a period of time. Your achilles tendon basically is complaining because it can’t cope with the physical demands that are being placed upon it!
Many people suffer from Achilles Tendinopathies. Symptoms can include waking up with stiffness in your achilles tendon accompanied by difficulty walking downstairs. It often eases with light activity or movement, but gets worse again after high level activity, such as a long walk, running or climbing lots of stairs. Often after sitting or resting it stiffens up again and the pain returns.
Like with Plantar Fasciitis, people who suffer with Achilles Tendinopathies experience the ‘yo-yoing’ of pain, rest, pain, rest! Before you know it, you’ve limited your activities and sports to avoid the pain. And just like Plantar Fasciitis, identifying the underlying cause is crucial. It could be flattened arches, poor training habits in running, footwear, lack of flexibility in other muscles, weak areas – many issues (or a combination of issues) can lead to Achilles Tendinopathy.
Mild cases can resolve with rest, but this is rare. Because most people take the ‘wait and see’ approach, Achilles Tendinopathy can be a long standing (chronic) condition, before you seek expert help. If this is the case or if you’ve tried other treatments with no success, SWT can be a very effective treatment to stop your pain and start your recovery.
At goPhysio, we’d always take an approach where alongside tackling the pain, we’d also analyse and address what’s caused your Achilles Tendinopathy in the first place. Without doing this, you risk getting it again. So, with our expert guidance and holistic care, we give you the best possible chance of long term, recovery.
There are many treatment options when it comes to resolving achilles tendinopathies. These include:
A wait & see approach (can just leave it and hope it will get better in time, which many will do within 8 – 12 months, it just depends whether you can live with it).
Physiotherapy – including strengthening exercises, stretches, manual treatment techniques and taping.
Acupuncture (which many Physio’s will do as part of their treatment).
Activity modification – a crucial part of successful treatment.
Medication, including pain killers and anti-inflammatories.
These forms of treatment can all be very effective for a mild or fairly recent onset of achilles tendinopathies. .
More invasive treatment options for more long standing or severe cases can include:
Shockwave Therapy for Achilles Tendinopathies
However, steroid injections and surgery really are a last resort, there is no guarantee of success with either of these treatment options. A very worthwhile alternative for more severe, long-standing cases that may have failed to get better with other treatments is Shockwave Therapy.
With Shockwave Therapy, ‘shock waves’ are passed through the skin to the affected area using a special device. It’s a non-invasive and relatively pain-free treatment. The medical name for this procedure is ‘extracorporeal shockwave therapy for refractory tennis elbow’. ‘Extracorporeal’ means outside the body and ‘refractory’ means that the condition does not respond to conventional treatments. The ‘shock waves’ are inaudible, high-energy sound waves. How many sessions you will need depends on the severity of your pain and how long you’ve had the problem for. However, 4 – 6 are normally recommend.
The National Institute for Health and Care Excellence (NICE) states that shockwave therapy is safe, although it can cause minor side effects, including bruising and reddening of skin in the area being treated.
Research shows that shockwave therapy can help improve the pain of achilles tendinopathies in some cases. However, it may not work in all cases, and further research is needed.
If you’ve been suffering with achilles tendinopathy and want help, get in touch. You can have a free no obligation phone call to see whether it may help you.
Alternatively, book straight in to see one of our Physiotherapists. They will carry out a full assessment of your elbow and put together a recovery plan for you. If they think shockwave treatment is going to help you, they can get started straight away. Unlike many clinics. we include shockwave therapy in the cost of your appointments, with no additional charges.
Exercise Rehab is such an important part of what we do here at goPhysio.
Rehabilitation, by definition, means “To make fit again” – and that’s exactly what our rehab service helps you with!
From our dedicated Strong Room, our team of graduate Sports & Rehabilitation Therapists, will take you beyond the treatment room and help you recover stronger and more confident.
Many people might be a bit wary of exercise rehab, going into an equipped exercise space, with weights and lot’s of equipment and being pushed a little outside the comfort zone. So, we thought we’d answer a few questions or concerns that might be on your mind!
Why would I need to do exercise rehabilitation?
Gone are the days of lying on a treatment couch and being a passive recipient of ‘treatment’ for weeks on end. Getting active and getting moving is such an important part of recovery from an injury. Yes, the treatment room has a part to play, but to fully recover from most injuries, you need to get stronger, more mobile and more flexible. It takes hard work and investment but it’s not easy. Where do you start? What do you do? That’s where we come in!
Our team of sports and exercise rehab therapists will put together a bespoke exercise program just for you, your injury and your lifestyle. They take into account all the important factors in your life and work with you, making sure we carefully balance the challenge and support we offer. We then guide you through your rehab journey, ‘holding your hand’ as little or as much as you need, giving you the confidence and tools to progress.
I’ve never been in a ‘gym’ before, surely it’s not for me?
Don’t worry – that’s the benefit of what we offer! Whether you’re a regular gym goer or have never even stepped foot inside a gym, because it’s a bespoke and 1-2-1 service, you’ll feel at ease.
It’s almost like ‘Clinical Personal Training’ so you get the results of exercise based training, but with the Clinical expertise, taking into account your injury, the stage of healing and what you realistically need to achieve.
The fact it’s 1-2-1 means you get the some attention of the Therapist.
I don’t think I’d be able to do the exercises!
Our team at goPhysio work closely together. It’s often the case that treatment with your Physio or Sports Therapist will reach a point when it’s really important to focus more on exercise based therapy. If that’s the direction you’d like to take, your Physio or Sports Therapist will complete a comprehensive referral into the rehab service, so your injury and where you are in your recovery path is established. This provides a great starting point for your rehab.
Your program will be fully bespoke and can be adjusted at any time.
I’ve got an injury, won’t it make it worse?
The latest scientific evidence supports and advocates the use of exercise as one of the best ways to manage and recover from most injuries. It really is magic! But you need to do the right exercises at the right time, too much, too soon can make an injury worse, too little or targeting the wrong areas won’t help your recovery. That’s where our expertise comes in.
Can’t I just do the exercises myself?
As part of all our Physio and Sports Therapy appointments, we’ll always provide a bespoke exercise programme for you to do in between appointments. This will be emailed to you with pictures and videos and full instructions, so you can carry on progress in your own time. Many people struggle with doing exercises themselves. It may be you don’t have time, don’t feel confident or are wary of what to do.
Having that 1-2-1 support and a session scheduled, this is a great way to build your confidence and make progress. We also have lot’s of equipment to hand so we can do a wider range of exercises and push you with your recovery a little more.
How much does rehab cost and how do I book in?
Sessions can be booked at any time. Each 1-2-1 session lasts 45 minutes and costs £59. You can purchase a block of 6 for a reduced cost of £295, so you get 1 session free. To book your session, just call us on 023 8025 3317 or speak to your Physio or Sports Therapist.
The aim of wearing orthotics is to allow your lower limbs to function in a more natural and efficient manner. This can result in improved biomechanics, improving any symptoms you may have, helping to prevent injuries and allowing you to enjoy your daily activities in comfort.
They work by giving your body information, through the receptors in your feet, facilitating your muscles & joints to work optimally, essentially training them.
It’s important to keep in mind that people will adapt at different rates and experience different effects based on a multitude of factors; namely age, fitness, body weight, specific foot mechanics, individual issues & history of injuries.
Ultimately, orthotics can only correct your foot position, biomechanics & control whilst you wear them, so please follow your physio’s advice & your specific weaning plan to maximise your results!
General day-to-day Wearing Instructions
When you initially wear your orthotics they may feel different or uncomfortable. This feeling is quite normal. Keep in mind that orthotics are designed to change the way you walk & feel. As time passes, your orthotics should feel comfortable and a pleasure to wear. The instructions below provide you with guidelines to help you become accustomed to wearing your new orthotics.
Try to wear your orthotics for one hour on the first day. Increase that time by 1 hour each day, until at the end of 2 weeks, you are wearing them all day i.e.
Day 1 – wear for 1 hour
Day 2 – wear for 2 hours
Day 3 – wear for 3 hours
Day 14 – wear for 14 hours
If your orthotics become intensely uncomfortable before the prescribed time, remove them from your shoes and stop wearing them that day. Return to wearing them the next day. Some people adjust more quickly than others to wearing orthotics. If your pain or discomfort persists over a few days, please contact us at the clinic for a free consultation review appointment.
Some people report a little discomfort when first wearing their orthotics. This discomfort can occur in the legs, knees, hips and/or lower back. This is an indication that your orthotics are working. Small changes are occurring throughout your musculoskeletal structure and it may take time to adjust to these changes. These aches are usually transitory and will disappear in time.
If the orthotics you were prescribed have a full-length top cover and the extension is too long (extends too far beyond your toes or bunches up at the end of your shoes), simply trim back a little bit of the cover until they fit your shoes properly. Your physiotherapist can do this at your fitting. Just bring a selection of shoes so s/he can get it right for all pairs. However, If your shoe has an insole that can be removed, use the length of this insole as a guide for sizing.
It is not unusual for the orthotics to slip, particularly if they have been placed in slip-on shoes. In most cases this will disappear as your foot function improves. If slipping persists, try to purchase shoes that have higher heel cup/support that will accommodate your orthotics.
Before placing your orthotics in either new or old shoes, it is important to take out all the removable manufacturer’s arch supports, rubber or felt additions or other inserts from the inside of your shoes.
Wearing Orthotics During Sports Activities
Start wearing your orthotics in your sports shoes for walking only. Wear them for a period of two to four hours, for two consecutive days. If they are reasonably comfortable, wear your orthotics for your sports activities using the following example as a guide:
For the first two days, wear your orthotics for 1/4 of your total activity time i.e. if you run for 1 hour wear them for 15 mins.
If you are comfortable, add another 15mins of wearing time every 3 days.
After a week and a half you should aim to be wearing your orthotics for the entire duration of your sporting activity.
This information only suggests general guidelines. Your specific situation may well be different based on a wide range of factors. Your Physio will discuss your specific weaning plan with you during your fitting appointment.
Over the following 6-8 weeks, your custom orthotics will be gently correcting your foot position, easing pressure, aches & pains, helping you return to activities you enjoy.
You should book your free follow up consultation for 6-8 weeks after your initial fitting. This is to check how you are getting on with your new orthotics and a chance for you to ask any questions. Please bring your orthotics along with you to this appointment.
Caring for your Orthotics
Cleaning Instructions: To clean your orthotics, take a damp cloth with mild soap and water and gently wipe them down. Let the orthotics dry naturally. Do not use direct heat such as a hair dryer as it can damage the adhesive.
If your orthotics are exposed to wet environments, remove them from your shoes and allow them to air dry naturally.
Placing a small amount of Talcum Powder on your orthotics can control odour.
Refund and Exchange Policy
Your Orthotics are individually manufactured based upon your prescription. In the event that you are not completely satisfied with the fit, comfort or quality of your orthotic device, we will work with you to make adjustments and modifications until you are entirely satisfied.
Orthotic Shell – The 3/4 length orthotic hard shell comes with a lifetime warranty against factory defects, breakage or cracking. This is the crucial part of the orthotic, that corrects your foot position. Top Cover – The original top cover in which the working orthotic shell is sandwiched, comes with a 6-month warranty on delamination, tearing and abnormal breakdown. New top covers requested within 6 months of the original order due to delamination, tearing and abnormal breakdown will be free of charge. New top covers requested after the 6 month warranty period, will incur a £45 charge. If the top cover needs replacing, please return to goPhysio & we will send your orthotic to Gaitscan for it to be replaced.
If you have any further questions, regarding the use or care of your orthotic please do not hesitate to give us a call on 023 8025 3317 The goPhysio team!
In the light of the uncertainty, ongoing changes and turbulent times we are living with. We are committed to helping as many people as possible benefit from Pilates, so have a range of ways for you to take part in Pilates.
Pilates is such a popular form of exercise and activity. For some, it’s such an important part of life, helping maintain mobility, freedom of movement, flexibility, and warding off injuries, aches and pains.
We are delighted to have now launched a full timetable of live Online Pilates classes. This means you can enjoy the benefits of Pilates from the comfort of your home, perfect if: you want to do a regular, live Pilates class but don’t feel confident coming into the studio.
Unlimited access to the full online timetable is £29/month. You can enjoy as many classes a week as you like! Alternatively, you can choose to pay £5 per class on a PAYG basis.
The online classes also offer another option if you are one of our face to face Pilates mat or Reformer members, but can’t make your regular class as you are having to isolate, look after a child home from school, can’t get into the studio, aren’t feeling up to coming to the studio (or any other reason!). As part of your studio class membership, you will now get unlimited free access to all the online classes.
The new online classes are part of our new ‘Hybrid’ model of Pilates, where we are live streaming our face to face studio classes. During the live stream, there will be some interaction with the people in the studio class. Those joining us at home will not have 1-2-1 guidance or interaction, but as an integral part of the class you will have full instructions, prompts and guidance throughout.
Hi, I’m Roz, Physio & APPI Pilates Instructor at goPhysio. Luckily I am an introvert so the isolation of lockdown wasn’t too much of a challenge – however I discovered the demands of being a single parent in isolation has a whole world of challenges that come with it! All of us need a support network around us and the best thing about being part of the goPhysio team is that we can provide some of that support for our patients.
As well as helping people individually within my role as a physiotherapist it has been really exciting seeing so many familiar faces come back to Pilates. The real bonus for me coming back to work after lockdown has been the opportunity to develop our Pilates Reformer service, starting classes as well as continuing with individual sessions. Being able to pass on my knowledge and love of reformer training to others is really exciting.
Over the last 6 months, healthcare has experienced a HUGE shift. As a result of the global pandemic we are all still living with, face to face health care experienced an absolute drastic decline. For obvious reasons. The NHS has had to prioritise managing Coronavirus care, health issues that were not deemed urgent became a very low priority and potential risk of transmission meant that many healthcare interactions shifted from face to face (in person) to virtual (aka online, video, phone consultations etc.).
This shift, in the earlier stages of the pandemic was absolutely necessary. As a local healthcare provider, we quickly set up an online service in order to continue to help people with their pain, injuries and recovery, with ‘virtual physiotherapy’ and a video Pilates service. There is no doubt this was needed and we helped many people.
Longer term, there is definitely scope for online and virtual healthcare services to continue. There are many opportunities and indisputable benefits of virtual healthcare:
It can be cost effective, particularly for the NHS and larger organisations. Delivering services online is potentially much more cost effective, and the COVID situation has enabled this huge shift (that was already in the pipeline) to happen quicker. It can also be a more affordable way for patients to access healthcare.
Access to specialist care is no longer geographically dependent. You don’t have to live in the same city or county as that specialist who may be best place to help you, access is now available more easily to anyone in the world.
It can be more time efficient, not only for the Clinical team, but also for those accessing the service. You aren’t taking out the time needed for travel, parking, time off work etc. and can get the support you need from the comfort of your home.
You may feel more relaxed and confident being in your own surroundings. Particularly when going out and about carries some risks, remaining in your own surroundings to access care can be preferable.
However, for all it’s potential benefits, there are so many reasons why it is so important for face to face care to continue.
Here’s a few of our thoughts on the huge value of face to face care.
Personal connection – yes, you can connect online or on the phone, but let’s be honest, it really is second best. It’s wonderful if there’s no alternative and for some there isn’t – in the face of Coronavirus, if the risk of contracting the virus outweighs the need for face to face healthcare, access to virtual healthcare is essential and has huge benefits. But you really can’t beat having that personal, face to face connection with someone.
All the non-verbal cues are crucial. How people stand, talk, move, sit, breath……..these cues are all such important aspects of an assessment and getting to the bottom of someones problem. Yes you can get some sense of these elements on video, but so much can be missed.
Online fatigue – Anyone who’s been involved in endless Zoom meetings, Microsoft Teams lessons, online quizzes and live Facebook streams, will inevitably be feeling the fatigue of thee online platforms setting in. Yes, technology is wonderful. Yes, it’s presented unimaginable opportunities, enrichment, information and connections, but the fatigue does set in and it’s so important that our lives don’t become focused purely around a screen and technology.
Technology woes – Technology is great, but reliant on so many factors that don’t make it an equal experience for all. Your device (camera, sound, screen size for example) own understanding and technological ability, internet connection, physical space and lighting will all impact on how positive your experience is. For some it just ins’t accessible, whether that be access to the actual equipment or skills needed to make it work effectively.
Privacy can be a serious consideration. You may not have the time or space at home or in the office to carry out a confidential appointment and have an open and honest discussion like you would in a private, clinical space.
A more accurate diagnosis can be made in person, when you can actually feel, touch, move and interact fully with someone. It is a much more effective way of really getting to know someone, their aims, goals and story and what you need to do to help them.
Engagement and interaction is much more effective – using skilled ‘hands’ to guide and support someone, whether that be in actual ‘hands on’ treatments or to assist and guide exercises, stretches, positions of rest or to ease pain, just can’t be replicated virtually in the same way. Engagement is crucial to get positive outcomes.
Benefits from virtual support can plateau quickly – any support is generally limited to advice and exercise, which works well for many people but not everyone! Some people need more than this.
If you wanted to catch up with a friend, what would your preference be? Meeting up for a coffee in person or a phone call? Yes, a chat on the phone or a FaceTime can be great and meets a need, but if you had a choice, what would you rather? Just think about what additional joy you get from actually meeting your friend face to face!
Since we re-opened for face to face care, we have heard so many really sad and worrying stories. Stories of people being isolated for months, without any contact – coming to see us in a very safe, clean and relatively protected environment has been a lifeline, not only for their physical health but also psychologically. Their appointments have been their only physical contact.
We’ve seen people who didn’t know they could or had no way of accessing online or virtual support, so suffered for months unnecessarily. Sadly, we’ve also seen people who were misdiagnosed or have had serious illnesses missed
In the 20+ years since we’ve been working in the healthcare sector, we’ve never experienced such a change and shift and the physio profession is at risk of starting to become a little divided and fragmented in it’s approach. Face to face care doesn’t now look or feel quite the same (PPE, social distancing where possible and stripped back surroundings) – but our team are the same, our level of commitment and care is the same and our goal remains to help you, so even behind the mask, that’s what we’re doing.
We are always open to embracing progress and change and virtual and remote services are a very valuable way of helping people, but what is becoming very clear is that there is a clear need for more training and guidance in this area to ensure it is an effective way to delver what’s needed.
We are entering week 8 of lockdown, meaning week 8 of home schooling, kids not getting out with their friends, no formal social or sporting activities or hobbies.
How are you coping? Are the kids running you ragged? Has healthy eating and exercise gone out the window completely?
Fear not, we have a few handy ideas to kick start motivations once again!
It can be hard for our bodies and routines to adjust to such a change like the current global pandemic. It’s important, especially for younger members of the family, to introduce a new routine into daily life to keep stress levels low and energy levels high. You may be facing an increased number of stressors and tensions may be riding particularly high. In spite of this, it’s helpful for family units to come together to work through their problems. Try to be mindful of how others are feeling and to be more forgiving if they need to explode, cry or simply hide away.
When we’re feeling down, we often turn to sugary foods to help give us an energy boost. However, this can have a negative effect as the sugar rush may not last long and could potentially crash lower than we were before. Its good to look for energy in carbohydrates, especially complex carbs, such as sweet potato, wholegrain breads, lentils, parsnips or butternut squash. They have a slower release to help keep energy levels higher for longer.
One way to get younger family members eating the right foods is to include them in meal planning and preparation. They’ll have a sense of achievement and is a nice break from any home schooling also. Or, you could class it as a Food Tech class… two birds with one stone.
London Sport has an exhaustive list of ways to get kids up and active at home. Current Government advice is daily exercise to help the public get fresh air during lockdown, but we don’t always want to exercise. Their list gives you extensive areas of other ways to keep fit and healthy from the comfort of your own home; whether its alongside The Nations PE teacher, Joe Wicks, or Sport Englands campaign with Disney to create fun dance routines.
We’re often bombarded by negative messages or thoughts from tabloids and social media, so its important to look for ways to keep spirits high from all the technology we have at our disposal. Zoom quizzes have been very popular in recent weeks, and are a great way to catch up with friends of family. You can also find a whole host of online games and entertainment which loved ones can participate in with you across the internet. They’ll introduce enjoyment and pleasure back to this ‘new normal’ and give younger people another element to a daily routine.
But, lockdown isn’t always about looking after others before yourself. You still need to make time for you. Listen to a podcast, read a book, enjoy the sun; make time for yourself to relax and reflect on the current situation. Self care is so important in order to look after others. Some of the our favourite podcasts are:
When thinking about your current situation it’s helpful to:
Acknowledge and accept that this is how things are at the moment (this is your new ‘normal’ and you can’t push it away or make it disappear). Think about what’s in your control and what is outside of your control.
Find a way to allow yourself to feel all the things that this new normal brings up (it’s OK to feel cross, frustrated, sad, angry and any other associated emotion).
Find ways to do your best within the situation (are there any positives for example, are you getting to do anything which you wouldn’t normally be able to do?).
Stay in the moment rather than regretting the past or worrying about the future. We will be thinking more about this process in the next Step.
Hopefully, we’ll be able to find a sense of normality soon be connect with loved ones properly. There are of course, further online guides on how to cope during lockdown. Support wesbites such as Mind, Family Lives and Young Minds are charities that offer support, knowledge and advice so if you are struggling, please speak to someone.
We’ve pulled together a carefully selected list of products that can help you with your rehab, recovery, Pilates and exercises at home. Take a look at the items and click on the links to be taken through to the individual products that your Clinician has recommended.