Injury of the month: Headaches

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Is Your Headache Really a Neck Ache?

Headaches are often caused by disorders of the neck or physical and emotional tension. For many people, headaches start as pain or tension at the top of the neck. As the pain worsens, it may spread to the back of the head, the temples, forehead or behind the eyes. This happens because the nerves in the upper part of your neck are connected to the nerves in your head and face. A disorder of the upper neck or muscles can cause referred pain to your head. 

 

Does this sound like you?

  • Pain radiates from the back to the front of your head?
  • Headache with dizziness or light-headedness?
  • Headache brought on or worsened by neck movement of staying in the same position for a long time?
  • Headache which always feels worse on the same side of your head?
  • Headache eased by pressure to the back of your skull?
  • Headache which persists after your doctor has checked for other causes?

 

How We Can Help:

Postural neck ache can usually easily be treated with some gentle mobilisations by a   physiotherapist and a stretching programme to prevent recurrence.

Physiotherapists can successfully treat headaches originating from the neck or soft tissues and show you how to prevent the pain from occurring. Even if you think your headache doesn’t come from your neck we can often help to reduce the intensity.

  1. Mobilisation                                            
  2. Manipulation                                     
  3. Massage                                             
  4. Relaxation therapy
  5. Functional and rehabilitative exercise
  6. Encouraging normal activity
  7. Postural assessment, correction and advice
  8. Muscle activation and re-education

Your physiotherapist can also offer you self-help advice on ways to correct the cause of headaches, such as practical ergonomic tips for work and in the home; adjusting furniture, relaxation, sleeping positions, posture and exercise.

 

If you'd like an appointment with either of our Spinal Specialists, Kara Mulvein and Caroline Ephgrave, please call us on 02030 12 12 22 or send an email to info@physioremedies.com .

 

Words by Kara Mulvein.

 

 

Fraser Cartmell: How Does Racing as a Professional Athlete Work?

Somebody racing as a full time professional triathlete is quite clearly not common amongst the general population, and so from time to time I am asked by those who are curious enough, to explain "how does that work?" when I mention what it is that I do with my time.

Ultimately there are a number of different pathways towards professional triathlon racing - nothing is set in stone, which makes for exciting opportunities at different points in life for people, depending on their own circumstances and lifestyle choices.

 

The Traditional Route

For me, I suppose it was a more traditional route - at least here in the UK anyway - which began as a junior athlete who was finishing school and embarking on my university studies. Representation for GBR at championships events across the world came my way through the National Federation 'system', which in turn supported me to simultaneously combine my University degree with many hours of swim, bike and run training. Ultimately I wasn't good enough at this format of 'draft - legal' or Olympic distance ITU racing to reach major events as a senior athlete and the Federation support (financial / medical / logistical) fell away.

 

The Non-Drafting Route

However, I still loved the sport and was keen to explore the concept of 'non drafting' or Ironman racing. This would mean braving the world of racing without the outside the 'support bubble' I had been fortunate to receive, but equally it would give me the freedom to choose whatever type of race I might want to do, rather than what I "had" to do as previously determined by the Federation and their qualifying criteria.

 

National Lottery Funding

These are two different pathways to racing, but both allow triathletes to race professionally and earn a living. In the UK athletes are very fortunate to access the much lauded National Lottery Funding and the associated support structures. However you have to be exceptionally good to reach this level, and of course to stay there year on year is no easy task either. When this funding disappears athletes can understandably struggle with how to move on and can at times be lost to sport at an elite/professional level because they simply can't continue to make ends meet.

 

Sponsorship

Nonetheless, racing the 'non drafting' Ironman circuit of events - as I have done for many years now - can provide all sorts of new opportunities to work with a host of different potential sponsors. These could either be brands from within the industry providing equipment sponsorship, or indeed non-endemic companies you have some association with (perhaps locally) who in turn can hopefully provide the financial support that was lost from the aforementioned Federation.

Essentially the long term goals of reaching the pinnacle of your event will remain. Previously that may have been the World ITU championships or even the Olympic Games, and now it has become Ironman Hawaii, for example. The only real difference is who you are representing when you get there. It will either be a national federation or likewise a group of personal sponsors who share your goals and agree to support your journey in whatever way they can.

If you're interested in sponsoring Fraser, just pop an email to us at info@physioremedies.com and we'll put you in touch with him.

 

 

Client News: Toby Swims The Channel

Physio Remedies client Toby Davis planned to swim The English Channel at the end of July in aid of The Cystic Fibrosis Trust but the weather wasn't playing ball during his window. However, he did eventually get the call to swim and his Channel Swim Report follows.


Finally, I'm off!

After a frustrating two week wait for the weather, at 11pm on Monday 7th August I finally lowered myself off the boat and walked up Shakespeare Beach (just around the corner from Dover Harbour) to clear the water feeling calm and relaxed, reminding myself to enjoy what might well be a once in a lifetime experience. Then the klaxon sounded to signal the start of my 21 mile channel swim from England to France and we were off - I dived in and swam out to my boat SUVA's spotlight in the water, which I would use as a marker over the next 6 hours of darkness.

Ready for the off!

The first few hours

That first few minutes were exhilarating but I managed to control the adrenaline and settle into a decent rhythm fairly quickly. I fed every hour and my first feed was very quick - a quick roll onto my back, down the carb drink and confirm to my crew that I felt good, then off again. About 15 seconds, which was the plan. Over the whole swim it turned out my longest feed was 40 seconds and average time about 20 secs which I was very pleased with. 

After the first feed the next 2.5 hours flew by and I knew it was going well. Swimming in the dark was fun, it gave me the opportunity to solely focus on getting my stroke right and making sure I was enjoying the swim as planned. 

Hour 4

Around hour 4 it started to feel a bit more of an effort and, when I stopped for a feed I realised why - suddenly where before I had been floating on my back next to the boat, now when I did that I had to kick furiously just to stay alongside. That brought home just how strong the tide I was swimming in was, and ended any over optimistic thoughts in my head about the possibility of making it across in a super quick time.

Around this time I also got some jellyfish stings to my back, legs, shoulder and most interestingly across my mouth and nose - I didn't really mind these actually, they were a bit like an extra strong stinging nettle and helped jolt me out of any autopilot swimming. 

Sunrise

Around 5:30am we were treated to the most amazing sunrise which brought the darkness section of my swim to a dramatic end. To witness that from sea level in the middle of the channel was truly spectacular.

I am a very dark shadow in the foreground in this one but quite rightly the sunrise takes centre stage!

Hour 11

I swam steadily and pretty comfortably until the 11th hour when my crew told me they needed a big push in terms of effort. So I sprinted at 100% for an hour, which felt like forever. The fascinating thing was that, despite having swum for 10 hours already, every time my brain told me I needed to slow down I could override it and just kick harder.

Unfortunately the spring tide turned out to be too strong for me to fight across it and hit land at Cap Gris Nez, which tends to be the fastest place to end a crossing. So I found myself being swept up the coast by a strong turned tide, which meant the sprinting had to continue as I tried to fight far enough through it to hit land.

Hour 13

Around hour 13 I got frustrated as France had seemingly disappeared from view (it was actually hiding behind the boat on my right as I got swept north past the Cap) and I asked for a marker to give me an idea of how close I was. Neil my pilot told me I was deep into French inshore waters, and shortly after that the coast came into view again seemingly within touching distance.

Despite being no more than a couple of kilometres out, I spent another 2 hours pushing across the tide to get in - that time actually went quite quickly as I knew that I would get in eventually and that it was just a matter of time. I had to stop myself celebrating in my head though as I knew lots of swimmers still failed to hit the shore from that close. But finally I got close enough to see the houses and beach on the shoreline and knew I was swimming into Wissant. 

Me sprinting against the ferry

The final 20 minutes!

The last 20 mins were pretty special, just making the most of the experience and thinking about all of the people who had supported me through the months and months of training. It got slightly emotional. I could walk up the last 50 metres and had a great time running and jumping through the waves to stand clear of the water for the klaxon to sound the end of the swim after a total of 15 hours 04 minutes! 

Channel Swimmer!

It felt incredible to have finished the swim and even better that physically I still felt pretty good. I could easily lift my arms above my head and hold up my 4 month old in celebration once we got back to Dover, which I think is a good result!

The team - Neil the pilot, Toby the co-pilot, Kate, me, Alice and Tony the official observer

I was back in the water (with pain free shoulders) within 2 days which was a huge bonus and a ringing endorsement for Ray Gibbs' coaching and the technique work he has done with me, as well as the excellent physio I had received in advance of the swim from Sarah Lawson at Physio Remedies.

Now to relax a bit and work on my future swim bucket list with a cold drink in hand!


Toby's Channel Swim has raised over £10,000 to date. If you're as impressed as we are at Toby's feat, you can donate to The Cystic Fibrosis Trust via his Just Giving page.

 

Words and images by Toby Davis.

Injury of the month: hip & groin pain

‘It’s jungle country down there, mate.’ These were the words of a hip surgeon relative of a physio friend of mine when referring to an area of the body known as the femoral triangle. The rationale for this comment was variabilities in local anatomy from person to person can make it very difficult to consistently predict the location of sensitive structures between individuals. The challenge with a lot of hip and groin pain is that there are a lot of structures that can refer symptoms to the area which can lead to subsequent overload of inhibited structures.

Image source - Health Appointments

Image source - Health Appointments

Within any injury or pain system, whilst there may be a single causative factor or structure it is often the case that there will be an element of affect across muscle and tendons, joints, the nervous system and some connective tissue. Within the groin, there are many muscles, both big and small that affect the hip joint and many nerves and blood vessels that pass through the area to supply the lower limb. Keeping these muscles in balance is part of the approach, however it is often not as straightforward as that.

Tight Hip Flexors?

An often-reported problem for people with groin pain is that they have tight hip flexors. This is all well and good, however it doesn’t explain either why they are tight or what to do about it beyond stretching. Whilst tightness in the front of the hip can be common in groin pain, there might be good reason why this is an overriding finding in that they are often overloaded. One of the major hip flexors (psoas major) originates from the front of the lumbar spine.

Image source: Health Appointments

 

Weak Hip Flexors?

With poor abdominal control, they are in a good place to offer some stability to the front of the lumbar spine. Often addressing abdominal muscle control and timing is enough to offload these muscles. However, during my time working with elite athletes, we found many of the sprinters would complain of groin pain which we attributed to these mystical tight hip flexors, so we worked on the gluteals and hamstrings which we found were often inhibited. Our problems didn’t get any better until someone suggested that perhaps the hip flexors were weak and needed some strength work alongside appropriate abdominal work. After starting this approach our groin pain reports dropped significantly.

Solution: Restore Control

Much like the shoulder (another interface between limb and torso), the hip and groin areas are complex areas that are links between areas requiring controlled stability and movement. Restoring control of the trunk and effective timing of abdominal musculature can allow pain related to overloaded structures to settle and start to regain balance within this area.

Paul is our hip & groin specialist - if you'd like to book an appointment with him please call us on 02030 12 12 22 or email us on info@physioremedies.com.

Words by Paul Martin.

Fraser Cartmell: Kit for getting started in triathlon

This month, our pro triathlete, Fraser Cartmell, writes about the basic kit that you need to get started in triathlon and his favourite bits of kit for each discipline.

Looking in from the 'outside', triathlon by its very nature can be viewed as a complicated sport, given the combination of three separate sports (or disciplines) within a sport! Indeed, when I began racing triathlon as a young junior in the north east of Scotland, nearly twenty years ago it appeared a daunting task to begin with, but as with most things in life, baby steps (and plenty of borrowed items) got me started on the journey. It's safe to say I've been hooked ever since.

The sport is littered with different bits and pieces of equipment that you can appear to *need* in order to toe the start line - triathlon is undoubtedly a marketing dream! However, stripped back to the bare essentials it can hopefully resemble a far more attainable event for the everyday person who might want to give it a go, just to see how they find it. The *need* for the shiny and sparkling equipment can come later!

Swim

To begin your triathlon journey the pool triathlon is a great starting point. As long as you have a trusty swimming costume and goggles, you're all set. Fancy, once piece triathlon suits, and expensive wetsuits for open swimming can come later if you decide you're keen. One thing I will advise against is using a regular surf wetsuit with the belief that "it'll work fine"... I used a friends' windsurf version for my very first open water event and it was a miracle I ever made it ashore! But you learn quickly, and these days my tri specific wetsuit, complete with far thinner and more flexible neoprene is certainly one of my key pieces of race equipment.

Bike

As a youngster who explored the countryside after school on his trusty mountain bike, I was familiar with riding off road, rather than on a road bike. And so, conveniently my first taste of racing a triathlon was an off road event, which I loved. Once the inevitable triathlon seed had been sown, we (my parents) were able to borrow a road bike from (another!) friend for the remainder of that summer until Christmas came around for my very own set of speedier wheels. My point here is that the *need* for expensive, aero tri-specific bicycles isn't necessarily justified until you've really sunk your teeth into a number of local level events, to test your appetite. Perhaps inevitably however, my time trial bike resplendent with electronic gears and carbon wheels has become a firm favourite piece of kit that I spend extra care looking after.

Run

I always believe that shoes and footwear are as exciting to me as they are everyone else, but I'm not so sure? Personally, I love the smell of a new pair of trainers when they appear from the shoebox, and so over the years of racing professionally I have become spoilt with the deliveries of new shoes that sponsors have kindly sent.  Whether it be for training or racing, I'm a total sucker for a fresh set of trainers and I think after my bike these rank as 'next best favourite' items on my list, and I'll do my best to keep them in good condition. I might even have been known to machine wash shoes (which you are not supposed to... it's bad for both the washing machine AND the shoes apparently!) to keep them clean. It works a treat!

Accessories

As technology has rapidly progressed there are now all sorts of other 'extra' things that we *need* to train and race for triathlon, including (but not limited to) GPS running watches and cycling computers, electrolyte energy drinks and carbohydrate specific bars, racing helmets with visors and bike shoes with ratchets and straps. There are even special pedals that measure your power output (that the aforementioned cycle computer will tell you about) and many more I have limited time to write about!

Too many items to choose your favourite from I'd say ;)

 

Words by Fraser Cartmell.

Helpful Hints for the Holidays

Back and neck pain are common problems experienced when travelling or staying away from home - so here are some ideas to help you enjoy a more comfortable summer break.

In the car:

  • Make sure you sit with good posture - if your car doesn’t have enough low back support use a rolled up towel (pick the right size!) or buy a purpose-designed lumbar roll.
  • Don’t allow your chin to poke forwards as you peer out the windscreen - especially at night! This is a very common habit and can result in a stiff and sore neck. The back of your head should be just touching the headrest support and your chin should be tucked towards your Adam’s apple.
  • Take breaks – get out and walk about every hour or so even if just for a few minutes.

On the plane:

  • Don’t fall asleep in an awkward position - try and keep your back in its normal alignment (again a small lumbar roll can help with this) and use a horse shoe shaped neck support to help stop your neck kinking into the wrong position.
  • Remember sustained positioning when your joints are not in neutral alignment can cause damage and pain – so avoid it.
  • If you're on a long flight, get up and walk every two hours. This will also help your circulation.

In bed:

  • Lots of people suffer as a result of sleeping in a strange bed. Whilst there’s not a lot you can do about the bed itself you can alter the pillows (or take your own).
  • The pillow’s purpose is to fill the space between the head and neck and the mattress.  If you sleep on your back your pillow should be fairly flat.  If you’re on your side that pillow should fill the space between your shoulder and head to ensure your neck is held straight and doesn’t drop down toward the mattress (too flat pillows)  or is pushed away (too many pillows) - it should be ‘just right’.

And remember we are open throughout the summer holidays to help ease any aches and pains. Just call us on 02030 12 12 22 or send an email to info@physioremedies.com to make an appointment.

Words by Kara Mulvein.


Injury of the month: Tennis Elbow

Injury of the month: Tennis Elbow

With working for many years in the professional tennis environment and also seeing the recreational club players, the summer always brings to the fore an increase in injury occurrence. Tennis injuries are not uncommon in the recreational player and at this time of the year these injuries become more frequent as we increase our hours on court. Tennis players suffer from injuries such as low back pain, shoulder pain, knee pain and also trauma injuries such as ligament sprains and muscle tears. One injury commonly known is Tennis Elbow that is prevalent in the recreational player.

Fraser Cartmell: IRONMAN 70.3 Staffordshire Race Recap

Fraser Cartmell: IRONMAN 70.3 Staffordshire Race Recap

Sunday saw the third edition of the Ironman 70.3 Staffordshire, set in the beautiful surroundings of Shugborough Estate grounds. In addition to the scenic views the 1800 or so athletes were also ‘treated’ to a hot summers day of racing, which certainly created an extra layer of difficulty to the task of collecting the finishers medal at the finish chute. Indeed, playing to stereotypes – this particular Scotsman noticed the temperatures too, given they reached upwards of 30C!

FRASER CARTMELL: IRONMAN 70.3 STAFFORDSHIRE PRE RACE POINTERS

FRASER CARTMELL: IRONMAN 70.3 STAFFORDSHIRE PRE RACE POINTERS

For those of us racing Ironman 70.3 Staffordshire (and that includes me too) it is now Race Week! Hopefully the previous few weeks and perhaps months of preparations have gone fairly smoothly (we all have bumps in the road, that’s just life!) and you are now looking forward to enjoying all of your efforts on race day.

Fraser Cartmell: Starting your Tri season in open water

Fraser Cartmell: Starting your Tri season in open water

Now that the winter is well and truly behind us the triathlon season is once again upon us and is bedding in for the long haul all the way through to September and the falling leaves of early Autumn – if we allow ourselves to think that far ahead? – so let’s talk about getting back to it!

Physio Remedies: Our Specialisms

Physio Remedies: Our Specialisms

Physio Remedies is a Centre of Excellence for Physiotherapy, providing a Consultant-level service with direct links to surgeons and consultants.

Just like surgeons and consultants, our physiotherapists are specialists in their own areas and they work to mirror, consolidate and support the work carried out by orthopaedic surgeons to help you get back on your feet as quickly as possible.

Compex Muscle Stimulation for Rehab and Training

Compex Muscle Stimulation for Rehab and Training

Neuro muscular electric stimulation (NMES), also known as electric muscle stimulation (EMS), electrotherapy, muscle stim or e-stim, is delivered through a small device, the Compex, that sends electronic pulses to your nerve fibres in order to create involuntary muscle contractions. It can be used to aid rehabilitation following injury or surgery and to enhance training sessions and workouts.

Fraser Cartmell: 'Warm Weather' Tri Training Camps

Fraser Cartmell: 'Warm Weather' Tri Training Camps

Living as we do in the 'frigid' north of Europe (I live in Scotland, perhaps I'm a little biased!) the winter months really tend to drag endlessly on. The notion that the clocks are going to 'spring forward' seems an impossibly distant glimmer of hope on the far horizon and trying to maintain a modicum of regular outdoor exercise can become far from easy and much less enjoyable. Certainly, we make do, and find a way to 'wrap up' / 'rug up' and keep warm but it's often not much fun for the most part. Or perhaps I am just being far too 'glass half empty' in my analysis of this time of year? Maybe...