What Does My Physio Think: will running ruin my knees?

What Does My Physio Think: will running ruin my knees?

Runners are sometimes told by people (who often are non-runners) that running will ruin their knees. We asked our physios and therapists if this is true:

Stuart, our specialist knee and foot & ankle physio says

“Running can actually improve knee health and stimulates cartilage when impacting through the weight bearing phases. Thus it is beneficial to overall joint health so keep on running if you can!”

Our specialist spinal physio Shari says:

“No, not unless you have been advised not to run by your Specialist consultant and/or orthopaedic surgeon. There are certain pathologies that can be worsened by running, but in general when speaking with Specialist Knee Orthopaedic surgeons 5 -10km maximum running distance is ok in moderation.”

Physio Paul, who specialises in sports injuries, says

“There is every chance of ruining your knees if you run very badly, but maintaining good alignment and control through the lower back/abs, hips, knees and ankles can reduce this risk.”

Emily, our massage therapist, triathlon coach, athlete personal trainer, comments: 

“Knee joints are synovial joints which means they produce lubricant to minimise friction. The cartilage in the knee joint is a very smooth surface that aids gliding. Your knees are supposed to bend forwards and backwards over a lifetime. Assuming there is no structural damage and the surrounding muscles are strong and supporting your joints, there are worse things you can do to your knees than running, for example prolonged sitting.”

So - keep on running! And if you’re worried about your knees, give us a call on 02030 12 12 22 to book an appointment with one of our specialist physios.

Bodypart Of The Month: The Shoulder

Bodypart Of The Month: The Shoulder

Next in our Bodypart Of The Month series is the shoulder. We asked our specialist shoulder physiotherapist, Nick Smith, to tell us all about it.

The Shoulder

The shoulder, or Glenohumeral joint (GHJ) is a ball-and-socket joint like the hip joint. The hip joint has a ball that sits in a very deep socket making the joint very stable.  The ball of the shoulder loosely fits in a shallow cup (the glenoid). It is very much like a golf ball on a tee. The GHJ has the greatest mobility of any joint in the body, but is less stable than the hip and more prone to injury.

Soft tissue structures helping to stabilise the GHJ include:

• Joint capsule and ligaments.

• Glenoid labrum - a ring shaped cartilage structure that increases the depth of the glenoid by 50%.

• Rotator cuff (RC) muscles, deltoid and long head of biceps.

In the shoulder there are 6 bursa, sacs filled with fluid found between tissues (bone, skin, tendons and muscle), acting as a cushion to decrease the friction and the irritation between the tissues that move between each other.

When your shoulder works well

When your shoulder is working well the rotator cuff (main function is to keep head of the humerus centred in the glenoid as the shoulder moves, and to lift and rotate the shoulder in the many directions) muscles are working together allowing your shoulder to function without pain and you can participate in your chosen sport or activity.  

When your shoulder doesn’t work well

When your shoulder is not working well this can lead to soft tissue inflammation and possible damage. Injuries include rotator cuff tendonitis and tears, Sub acromial pain (impingement), SLAP (labrum) cartilage tears and bursitis.

Common shoulder injuries

Shoulder dislocation, often due to trauma and falling on an outstretched arm, is a common injury I see in clinic. Most dislocations respond well to physiotherapy and rehabilitation. Occasionally surgical stabilisation may be required if you sustain bone and soft tissue trauma during the dislocation.

Rotator cuff tears are also a common injury and are caused by injury, overuse and degeneration. The treatment of rotator cuff tears depends on the size and location of the tear. Small tears can be managed with physiotherapy and strengthening exercises. Full thickness tears will require surgical repair and then physiotherapy.

Avoiding shoulder injuries

Don’t over load your shoulder too hard too quickly. Build up your strength, resilience and tolerance to load. Ensure you have to correct technique for your chosen sport and activity.

Got shoulder pain or niggles? Call us to make an appointment with Nick on 02030 12 12 22.

Words by Nick Smith.

Running the Virtual London Marathon #40thRace

Image courtesy of Virgin Money London Marathon.

Running the Virtual London Marathon #40thRace

Inevitably, as with pretty much every event ever scheduled for 2020, the London Marathon has been rescheduled and changed format to allow for the safety measures needed to help combat the Covid-19 pandemic. If you hadn’t heard, it is going ahead on its rescheduled date of Sunday October 4th 2020 in various formats.

The elite race will be held in a closely controlled biosphere environment on a closed lapped circuit in St James’s  Park. Those with a place in the mass-participation 2020 event can take part in The 40th Race by running the famous 26.2 mile marathon distance virtually, anywhere they like from 00:00 to 23:59:59 BST on Sunday 4th October. If you don’t have a place yet, there are apparently still charity places available (at time of publishing this blog post). You can search for them with this link.

Ways to run your #40thRace London Marathon

Without the build up on the day, forty thousand fellow runners and the crowds cheering you on, the motivation to start and complete your remote marathon could be difficult to come by. You could just step out of your front door in your standard running kit and run your marathon, but why not mix it up a bit? You don’t even have to run it all in one go.

We’ve found some ideas to make it more fun and help with motivation at the same time.

You could:

• Get a household member  to drop you off somewhere else and you can run the distance home – it’s quite a motivation to know that you’ve got to get home.

• Run to a destination 26.2 miles away, having arranged to meet someone with a medal and a space blanket to collect you at your finish point.

• Set up a route that goes past the houses of some of your friends so they can cheer you on, fill up your waterbottles or have a good chat with you.

• Run a route which takes in local landmarks or tourist attractions for some interest (and good photos?).

• Get your friends to run or walk a few miles or the whole route with you, socially distanced, of course.

• Use the full 24 hours! Run a mile every hour (plus a couple of extra miles in one of the hours) and use the rest of the hour to do all those small jobs you never get around to such as hanging pictures, cleaning your car, weeding your front garden etc – just like Beau Miles did in his 24 hour marathon challenge.

• Run your marathon in fancy dress, even if you hadn’t been planning to this year. Do train in your outfit to check that it’s ok to run in though!

We really shouldn’t need to say this but we will - do remember to stay socially distanced and within Government rules at all times. Stay hydrated and well-fuelled and look after yourself.

Don’t forget to consider your post race recovery as well. Emily, our sports massage therapist and resident triathlon coach, gave us her Top Tips For Marathon Recovery last year.

Have a great #40thRace!

Don’t forget that we’re open for face to face consultations at The Lansdowne Club and virtual consultations from the comfort of your own home via Zoom so if you’ve got any niggles or injuries, call us for an appointment on 02030 12 12 22.

Words by NoviceRunnerNik, image courtesy of Virgin Money London Marathon.

Top bike tips for commuters and road cyclists

Top bike tips for commuters and road cyclists 

Whether you’ve just converted to commuting by bike recently, or are just starting to ride for longer at the weekends, here are some great tips from our massage therapist and resident triathlon coach and bio-mechanist, Emily : 

Skills that you definitely should have (if not, get practising!): 

1. Be able to take one hand off the handlebar to signal or drink from a bottle. Engaging your core by tucking your tail bone in and relax your grip will help. 

2. Be able stand up and sit down while pedalling, this increases air flow for ventilation and helps with bottom numbness / saddle sores as well as giving you more power to go uphill. As you stop at a traffic light, stand up, step off the pedal with your curb side foot on to the ground and take your bottom off the saddle. It is a lot safer than stopping seated, tip toeing to balance, especially in cleats.

Unclip to stop.

Strength and conditioning 

Especially if you are new to cycling, off the bike training will help building the necessary muscles much quicker and help keep injuries at bay. Single legged exercises are far more effective, because, well, we are not bunnies! 

Single legged bridge 

Side plank leg raise

Single leg squats (assisted)

Stretching

If you only have time to do one stretch, this table top pigeon pose will help loosen your glutes and your back. You can hang in this pose for a few minutes, turning your chest both sides to adjust the angle, and have a cup of tea at the same time!

Table top pigeon

Nutritions

1. Electrolytes - just water is not enough. As you sweat, a range of salts are lost and your blood becomes diluted. These electrolytes will need to be replenished or the consequences are dire. To make sure you get the correct amount, always follow instructions for the correct ratio of water to electrolyte tablet. Better yet, do a sweat test to be sure:  https://www.precisionhydration.com/pages/why-personalise-your-hydration-strategy

2. Your body takes between 30 minutes to 2 hours to convert food into usable energy. Your glycogen index has between 1 - 2 hours’ worth of energy stored. So fuel before your ride, and, depending on how long your ride is and how hard you are riding, refuel frequently! 

Mechanicals

At a minimum, make sure your brakes are working, your handlebar does turn  and your tyres are inflated to the required pressure. 

Tip 1) Tyre pressure and size are all printed on the side of the tyre for your information.

Tip 2) When taking out a wheel on a bike with hydraulic disc brakes, especially when putting into a car or transporting it, or putting on a turbo, wedge a card between the pistons to prevent them closing together.

Tip 3) Bike pumps usually work like this: lever down to push into valve; lever up to lock in position; pump to appropriate pressure; lever down; use both thumbs to push the pump head away (wriggling it could damage the tyre valve) 

Tip 4) Bike grease is like any grease, you can get rid of it with bike specific degreaser, or just soap and water. 

Happy cycling!

Words and images by Emily Chong.

What does my physio think about foam rolling?

What does my physio think about foam rolling?

What is Foam Rolling?

Foam rolling -  rolling parts of your body over foam rollers, which come in a variety of densities, textures and sizes, using your bodyweight to apply pressure and give a self-massage before and after exercise to help with recovery – is very popular in the fitness world. The idea is that you roll slowly and when you find a tender spot, you focus in on it by rolling back and forth until you feel it soften or release. But does it actually help?

Is foam rolling good for me?

Our spinal specialist Physio Shari says

“As popular as foam rolling is, there isn't actually any research evidence that supports it. I don't routinely recommend it.”

Emily, our soft tissue therapist, triathlon coach, athlete personal trainer, comments: 

“It depends on where you roll and when you roll. There are many conflicting studies and reports. From an athlete’s point of view, it boils down to if it makes you feel better, roll it, if it causes pain more than 7/10, then don’t. Foam rolling can feel like a self-massage which should be done when the muscles are warm and as part of recovery.”

Stuart, our specialist knee and foot & ankle physio says:

“Foam Rolling or any other form of muscle release may help reduce tightness and soft tissue stiffness and thus can assist. It can be beneficial after exercise.”

Our sports injuries specialist Nick comments:

“Whilst there’s no credible evidence to back up claims of the magic of these things, if they help then why not? They won't do any harm.”

If you’re injured, in pain or just need some advice, call us on 02030 12 12 22 to book an appointment with one of our specialist physios.

Getting Back To Normal - Shoulder Related Tips!

Getting Back To Normal - Shoulder Related Tips!

Nick, our shoulder specialist physio, is back for face to face appointments with his shoulder and upper limb clinic on Tuesday 14th July. We asked him for his shoulder-related tips on getting back to ‘normal’ – whatever that looks like for you!

It's more than 100 days since lockdown began - how has this affected you?

How fit do you think you are following 3 months of relative inactivity? 

During lockdown you might have worked on your general fitness, but has this been sport specific fitness? We are now able to play tennis, golf and open water swim.

Tennis related injuries seen in clinic:

• Rotator cuff related shoulder pain (RCRSP): this includes subacromial pain (impingement), bursitis, rotator cuff tendinopathy and symptomatic partial and full thickness rotator cuff tears.

• Tennis elbow and wrist/hand.

• Low back pain, hip and groin, knee and patella tendon, calf muscle and ankle sprains.

Golf injuries:

• Low back and neck pain

• Shoulder, elbow and wrist/hand pain

• Hip, knee and ankle pain

Swimming injuries:

• Shoulder: RCRSP

• Neck

• Knee

Tips for getting back:

1. To avoid tissue overloading and causing injuries don't go back to your chosen sport too hard or too fast. 

2. Always warm up and stretch prior to starting to exercise.

3. Aim for graded exposure and progressive loading, build up your resilience, tolerance and capacity. Increase your effort by approximately 10% per week to achieve your chosen goals.

Home working and ergonomics: 

We've probably all tried to recreate our desks at home, some more successfully than others! Prolonged sitting and working with incorrect postures can have an adverse effect your neck, upper back, shoulders, and thoracic spine. 

If you’re still working from home and are suffering from shoulder / neck pain, it’s likely that your desk set up isn’t ideal. 

Tips for better working from home:

1. Arrange a virtual workstation assessment of your home office to improve your desk set up.

2. Consider the purchase of more ergonomic office equipment such as a monitor, keyboard and mouse for your laptop, a height adjustable ergonomic office chair, a headset for your phone if you spend lots of time on it.

3. Keep active at your desk – move around every 20 minutes. Have a good stretch at lunchtime and the end of the day. Walk around if you can whilst you’re on the phone.

4. Read our blog post How To Work From Home Pain-Free for more tips.

5. Visit your physio to check out pain or niggles that persist.

Keep safe and remember movement is life!

To book an appointment with Nick or any of our other physios or a workstation review, call us on 02030 12 12 22.

Words by Nick Smith.

8 Tips To Master Your Mindset Through Injury

8 Tips To Master Your Mindset Through Injury

I hope you are all safe and well and are hopefully coming out of this period in a good place. Although this time has been challenging for many, it certainly has given us some space to reflect on many things which hopefully will serve you well moving forward. 

Today I wanted to talk about how to manage your mindset through an injury. This is such a crucial part of overcoming an injury, and in fact, can be the difference in the time of recovery and also the success of the recovery. Injuries are difficult to deal with as they stop you doing the things you love doing or even more practically can stop you from being able to manage normal daily activities. There is a huge three way connection between the mind, the brain and the body. As an analogy I like to think of it like this. Imagine an oil refinery, the petrol and a car. The oil refinery is the mind, the petrol is the brain and the car is the body. 

Processing     →     Fuel     →     Performance

Oil refinery     →     Petrol     →     Car

Mind     →     Brain     →     Body

Ultimately what we fuel our body with, physically, mentally, emotionally, spiritually, will determine the performance of the car. I know first hand, both having being injured and also having seen 1000s of injuries, just how a person’s mental attitude can help. When I worked in professional football, what amazed me was the difference in how players coped with similar injuries and how this impacted on their recovery. Although we can’t cheat physiology, healing and anatomy on a grand scale, we can certainly change it by altering our brain physiology which has an impact on our perception of pain and function and can lead to a quicker and more successful return to full health. 

Below are 8 tips for managing the energy that goes into overcoming your injury. No matter how big or small your injury is, there is always a place for improving the overall well being of your mind to help your recovery. 

1. Accept and don’t blame - At times of course, our actions may have been a factor in our injury. If we suddenly did something we were completely unaccustomed to then yes, we could look back and say ‘Oh why did I do that?!’. This is ok, but rather than blame ourselves, we should use it as a lesson for the future. We don’t set out with an intention to injure ourselves! We most often have good intentions, to be healthier, fitter, stronger etc, and this enthusiasm can overlook the fact that our body was perhaps not prepared for that change. Accepting that it has happened and moving on to deal with it as best as possible is key. 

2.  Don’t compare - No two injuries are ever the same and they are certainly not the same in how they present in different people. It is important to stay present to your injury and focus on that and that alone. You can certainly draw on experiences of previous episodes you may have had or people you know who have had similar but use that as a check point rather than a strict comparison. You may judge your progress negatively if you compare it to others who have recovered quickly. Stay in your own reality. 

3. Goal setting - This is a really crucial area and it is up to you and your therapist to come up with short, medium and long term goals. The most important of these are the short term goals as they will keep you present. At the start of your rehab your therapist should know what your ultimate goal is as this differs for everyone. Short term goals however are the key to keeping momentum going. You should establish a set of what we call process goals and then little tests you have to pass before you can move onto the next stage of rehab. This really is more for your therapist to do and then give you the exercises to reach those milestones but it’s really important to understand how these process goals will move you closer to your long term outcome. In the back of your mind, have that long term goal in sight, but each day focus on the tasks right in front of you. This is what will cause the mini shifts day in day out and before you know it you’ll be closer to your dream destination!

4. Clean language - The way we describe our injury and how we visualise what is going on in our body is really important. Unfortunately, it is not just patients who use inappropriate language when describing injuries. Therapists can also fall into habits which aren’t beneficial to an a understanding of the pathology of the problem. There is a lot of fear which can creep into a patient’s mind when they are spoken to in language which serves to, at times, catastrophize the problem. Depending on the injury of course, examples of such words are ‘unstable, broken, inflamed, tight, flared up, out of place’. Now in some instances, it may be appropriate to use some of those terms but a lot of the time it just isn’t scientifically right. The two most common misconceptions I hear are “My ITB is tight’ and “My back is out of place”, both of which aren’t really true! Speak to your therapist to gain a good understanding of what’s going on and use better language yourself in describing it. It can be a real game changer in moving forward with your rehab and altering your mindset. 

5. Visualisation - The power of visualisation is very real. You may have seen the images of F1 drivers mentally practising the circuit prior to getting in the car, tennis players getting into the zone during breaks, dancers working through routines in their heads etc. This constant mental imagery closes the gap between the thought and the action and allows the two to be more whole. This can work in rehab too. There are studies which show that adding visualisation can help the recovery from injuries. Sitting there and visualising healing taking place, picturing a healthy joint, muscle of whatever is injured, and looking positively at the recovery can aid both pain and also function. It is almost like a mini hypnosis which can be so powerful. It may sound odd, but talking to your injury verbally for a few minutes a day can help with recovery. 

6. Breathing - Similar to number 5 this is a really simple technique that we can use. The reason breathing properly and mindfully is so important is the effect it can have on the physiology of our body. Although you won’t notice the immediate effect of, say, breathing for 5 minutes a day on your rehab, over time the change is real. Breathing helps to regulate cortisol levels, the hormone which is released during times of stress. Regardless of where the stress is coming from, cortisol will be elevated in this state. During injury, stress may go up. Exercise has the effect of releasing your happy hormones: endorphins which can counteract the stress hormone. So, if your exercises routine has been disrupted and this balance of hormones has been affected, taking just 5 minutes twice a day to focus on some breathing techniques can really help regulate stress. You can try diaphragmatic breathing, box breathing, alternate nostril breathing - there are many forms of breathing out there. Please make sure that you are in good health, have no associated heart or respiratory conditions, are not pregnant and do not have other health issues that could be a contraindication to doing some of these techniques. 

7. Be adaptable - In some instances we have to accept that an injury may force us to reconsider what we can do going forward. I personally know how this feels.  After having had several ankle injures, I have now accepted that I can’t do the things I did 10 years ago which is ok and I have since found new things to help and also keep my enthusiasm up for exercising despite not being able to do exactly the same things. Re assess your current exercise routine, be open to trying things you haven’t tried before, understand that our bodies do change with age - what may have previously worked for us may not be serving us as well now. I am a big believer in having variety in your exercise, unless of course you have a very, very specific sport or event which requires you to train very specially. For example, it would be counterproductive for a 100m sprinter to suddenly take up lots of yoga as they actually rely on an element of stiffness to produce power over a short space of time. Train your body in different ways to ensure good balance of strength, flexibility, power and fitness. 

8. Make sacrifices - Ultimately it comes down to how important an outcome is to you. Your ultimate goal and your lifestyle have to be aligned if you want to see the best and quickest results. Not only can our brain not comprehend conflicting thoughts, nor too can our body. What do I mean by this? Well, if you want to lead a healthier lifestyle and yet keep telling yourself that you love fast food, your brain will become confused and so too will your actions. Similarly, if your goal is to ski after a knee injury and your physio has set you a programme of going to the gym 3 - 4 times a week, choosing to go out socialising on two of those days instead is not going to produce the results you need. It may sounds common sense but it is often not common practice. Your daily habits will, over time, produce the results you want. It’s that simple. Be prepared to sacrifice some things, perhaps only for a while mind you, to focus on what matters most at the time. 

I hope that these points have been useful in identifying some areas you could work in to optimise your rehab. I am a huge believer in mindset and how it affects the body and paying attention to the above can really help shift you in the right direction. 

If you would like to find out more about any on the above then please feel free to contact me at alex@physioremedies.com.

I wish you well in your rehab and I appreciate you for taking the time to read this article.  

Stay healthy, stay strong!

Best wishes 

Alex. 

Words by Alex Manos.

COVID-19 The Road To Recovery

COVID-19 The Road To Recovery -

Advice From The Chartered Society Of Physiotherapy

Have you had Covid-19 or know someone who has had it?

The Chartered Society of Physiotherapy (CSP) has developed a brand new animation to help patients who are recovering from Covid-19 to self-manage their symptoms with physiotherapy guidance. This is a great resource for you to share with your friends and families to help ease some of their anxiety about recovering from the virus and getting back to normal life. The animation is titled COVID-19 The Road To Recovery and you can watch it below:

This short, 90 second animation illustrates what people can expect when recovering from Covid-19; reassuring them that it may take time to get their energy and fitness back. It also provides advice on simple measures that anyone can take to ensure the best recovery possible; like keeping active and partaking in low-intensity exercise.

If you or anyone you know have concerns about your recovery from COVID-19 we encourage you to seek the advice of a Chartered Physiotherapist, GP or other Health Professional, who can provide bespoke advice and support. You can also see more information about Covid-19 recovery from the CSP by visiting this link - Covid-19: the Road to Recovery.

If you’d like an appointment with one of our physios, please call us on 02030 12 12 22 to book an appointment.

Looking After our Mental Health In Challenging Times

Looking After our Mental Health In Challenging Times

Managing purpose and productivity during the coronavirus pandemic

Our mental health has a huge effect on our physical health and it’s important we take notice and care of both, particularly during challenging times such as these. As physiotherapists, we talk a lot about physical health so we asked our specialist physio Alex, who is also a Life Coach and Yoga instructor, to talk about looking after your mental health:

I hope that you are all keeping well and have been safe and healthy during this unusual time. It’s encouraging to see that the green shoots are hopefully appearing and slowly but surely we will be returning to a more normal way of living. It has been a challenging time for everyone no doubt in many ways. Not only has the financial implication taken its toll on many, the major shift in balance of work, life,  family and  social time has made it a challenge to re adjust. 

I wanted to briefly share some of the insights I have had and how I have managed to keep momentum going despite a huge reduction in my day to day work which has given me time and space to explore other things. I do this to see if I can hopefully help guide you into a mindset which focuses on the positive which has come from this. 

I wanted to write about two concepts which have perhaps been a challenge for many to find results in: they are productivity and purpose. So much of our value in terms of productivity and purpose comes from our time spent at work and for many of us who have not been able to continue working in the same way, this dramatic shift could have been met with a lot of resistance and a sense of feeling lost. A lot of our work is based around a problem and then solution type scenario. Whatever line of work we are in there is usually a starting point and an end task to to our duties and with that comes a sense of accomplishment, recognition and validation for our efforts. We gain purpose from being productive in the work we have been given to do, that's completely natural.

So what happens when our external source of productivity gets taken away? How do we generate that internal fuel to drive our feeling of purpose? What happens when our daily focus suddenly shifts and we have a blank canvas as to what we can attend to? 

The brain and mind is a wonderful thing and one of the beautiful contradictions is that when we get the things we often yearn for, we miss, we wish we had more of, we are often not prepared and actually struggle to manage them. It’s the reason why so many lottery winners actually end up losing all their money or run into emotional and social problems because they suddenly step into a new way of life which they themselves have not created, so they actually are unaccustomed to it, it’s alien to them.

So what can we do to manage this so we come through it with purpose, productivity and a sense of value? 

Here are 5 ways we can look at what has happened and happening with a fresh and positive mindset, a mindset which will make us appreciate things. 

1. Ask yourself this simple question. Prior to the change, what were the things I really wanted more of? Of those things, which ones were in my control to make use of and appreciate. 

2. What areas in my life needed more attention? Perhaps it was health and fitness, your relationship with a significant other, your relationship with your children, your intellectual life, your emotional and spiritual well being, your career (perhaps a career change), your time spent communicating with family and friends. Looking at those areas, what steps have you taken to elevate them to a new level? Where can you find areas of personal growth to work on? 

3. What can you be truly grateful for? The simplest way to do this is to start a gratitude journal or practice. A nice way to do this is the ’10 finger gratitude practice’. Each day, sit quietly somewhere for 5 minutes where you know you won’t be distracted (the start to the day is usually best if possible) and open your hands. Close your eyes, visualise and internally repeat 10 things you are grateful for and each time you do, close one finger until you have done 10. Then take your hands openly and place them over your heart and breathe deeply 5 times inhaling the things you have just show gratitude for. Literally fill your body with a sense of appreciation for what you have. 

4. Understand that rest is a necessary thing. Taking a pause from usual life, if you are fortunate to be able to come out of it unscathed, is a blessing. If, we say live to an average age of 80, 5 months off equates to 0.5 percent of your life. Think about it, 0.5 percent of your life to recharge, re group, re evaluate what matters and spend time doing some of the things you really really want to do.

5. I personally came from a place of thinking that we are just merely passengers on this planet. As much as we have created some wonderful things we have also done some extremely damaging things to the planet. I take solace in thinking that perhaps the planet needed a break from us to recharge, regroup, find it’s beauty again, breathe and restore some of it’s natural existence so that us humans can live in more peace and harmony with our surroundings and the other creatures and living beings which we share this world with. Think about the dolphins in Venice, the flamingos in Mumbai, the pandas in Hong King zoo mating. Theses amazing pictures and stories which have come out of the earth having some time to itself. 

Another wonderful tool we have at our disposal in this modern era is the availability of free information. At the touch of a button we can watch a TedTalk, a you tube video, listen to a podcast, download free programs, access free exercise routines. So many wonderful ways we can keep exploring self development and personal growth, for FREE! 

When we come from a mindset that things happened for us and not to us we can hopefully begin to accept the challenges and appreciate the new opportunities that may arise in this time. 

• There is purpose in reading a book 

• There is purpose in spending uninterrupted play with your children 

• There is purpose in having the chance to sit as a family to share a meal more often 

• There is purpose in taking a walk in the woods and saw during the amazing weather we have had

• There is purpose in listening to podcast

• There is purpose in watching that Netflix series you have been wanting to 

• There is purpose in starting to learn a new language 

• There is purpose in learning to cook 

• There is purpose in just slowing down

There is purpose all around us. Once you can detach from needing an end result to something, needing that goal crossed off, one can find purpose in the journey and the existence of just being present and appreciating the things right in front of our eyes.

In perhaps one of the greatest movie speeches of all time and a personal favourite of mine, Al Pacino playing Tony D'Amato in the film Any Given Sunday, says ‘That’s what living is, the six inches in front of your face’. It’s a wonderful philosophy as it can keep us grounded and in the moment. 

I hope that you have enjoyed reading this message. This kind of work is a passion of mine and I have been fortunate to learn from some of the very best and I am grateful to have a platform to share and serve people in a way which I too have been served by others. 

Words by Alex Manos.

Body Part Of The Month: The Spine

Body Part Of The Month: The Spine

For the next blog piece in our Body Part Of The Month series, our spinal specialist physio Shari tells us about the spine.

The Lumbar Spine And Lower Back Pain

At some point in our lifetime 80% of the population will suffer from lower back pain. There are a number of different causes of lower back pain and if your pain is persisting it is always recommended to seek the opinion of your health care professional.

Causes of Lower Back Pain

Sometimes the cause of back pain can be a muscular strain from being in an awkward posture after gardening or a long flight, and other times the cause may be from a structural problem.

Below are listed some of the common things I see in practice:

• Non-specific lower back pain

• Discogenic lower back pain

• Radicular pain-caused by neural impingement and often experienced as symptoms in your thigh or leg, be it pain, numbness, pins and needles or weakness

• Facet joint pain

• Spondylolisthesis: forward slip of the vertebrae

• Fractures

• Osteoarthritis

• Stenosis: narrowing of the space in your spine where the nerves are present, and associated with arthritis

• Rheumatological conditions - auto-immune conditions

• Sacro-iliac joint pain

• Pregnancy related pain

• Hypermobility associated pain

Assessing Lower Back Pain

When treating my patients initially I will take a thorough history of your condition, and ask about your past medical history, your current symptoms, medications, activity levels, stress levels, occupational requirements and goals. Then a physical assessment will be undertaken to determine your diagnosis. Occasionally scans and investigations are needed, and you may be referred to a specialist consultant doctor.

Following this we will formulate a treatment that will best address your issues whether it be improving the mobility of your spine, your pain or strength deficits.

 Treating Lower Back Pain

Exercises that address the flexibility of your spine and the surrounding joints such as your upper back, as well as your hips and pelvis can also be beneficial, as can exercises that address the activation and strength of your stabilising muscles, to help get you back to the activities that you enjoy.

Sometimes taping and belts can be helpful in the acute stages of pain or where stabilisation is needed such as in pregnancy. Occasionally medication may also be necessary to reduce the inflammatory pain in your spine so that you can undertake the prescribed exercises.

In severe cases of pain spinal injections by a specialist doctor are needed to reduce inflammation, which then can enable patients to be able to undertake their exercise rehabilitation.

In most cases it is best to maintain your mobility and activity levels as long as this isn’t aggravating your symptoms.

Words by our specialist spinal physiotherapist Shari Randall.

How To Work From Home Pain Free

We don’t recommend working from home like this…

How To Work From Home Pain Free

Many of you are now working at home due to the coronavirus pandemic restrictions. Some of you will have home offices and others of you will be sitting at your kitchen / dining room tables.

Sarah has written up some tips on how you can make your home office set up more ergonomic and try to prevent unnecessary aches and pains.

1.      Sitting position:

• Always sit your bottom to the back of any chair.

• Knees and hips should be at a 90 degree angle and feet flat on the floor. If your feet are dangling, put something underneath to support them (big books / solid box).

• You should sit 3 - 6 inches away from your desk. Clear any clutter from under the table so you can get in close.

• Elbows bent to 90 degrees and close to the body.

• Wrists should rest in neutral.

• If you don’t have an ergonomic chair, you can roll up a small towel (not a cushion), put some tape around it to maintain the roll shape and place this into the small of your back to help maintain an upright posture. Or buy a lumbar support – see links below.

• Your head should be straight, shoulders relaxed, and your line of vision should be at the top third of your screen.          

2.      Laptops:

• If you are working off a laptop for long hours and you can afford a laptop stand, buy one now. Laptops were not designed for long periods of work and using one will cause pain long term as you have to look down. They can be as cheap as £15 and go up to £150 – see links below.

• Place your screen on the stand and make sure your line of vision is in the top third of the screen.

• If you have a lap top stand you will need a separate keyboard and mouse.

• If you do not have any of the above and continue to work on laptop, take even more breaks - every 20 mins - and do some stretches.

3. Desktop Screen:

• Your screen should be placed central to your body.

• Screen height should be in the top third of your vision – if not stick some books underneath it.

4. Mouse and keyboards:

• Keyboard should be placed central to the body, and at a height where the wrists remain in neutral and elbows at 90 degrees.

• Mouse should sit close to the keyboard on whichever side is best.

• You can use mouse and wrist rest if they help achieve this position.

• Make sure your keyboard and mouse stay within the circle, as shown above.

Other top tips:

• Take micro-breaks every 20 minutes: you should take a break and complete 20 seconds of micro movements. This could be shrugging the shoulders back, rotating your upper back from side to side, turning your neck side to side etc.

• Documents should be placed at the same height as your computer screen - try using a document holder.

• Allow your eyes to take a break from your screen by exercising them! Do this by focusing on objects in the distance regularly when you take a break from staring at your computer screen.

• Use a head set instead of a handheld phone. Handheld devices should be used only for short durations with the upper limb supported, which will reduce the strain through the neck.

• Handheld devices (phones, iPads, Kindles etc) should be held at eye level so to prevent strain on your neck from looking down for long periods.

• Your office should be well lit and well ventilated, with no glare from lights or windows on your screens.

• Stand hourly at a minimum.

• If you stand for prolonged periods, this also causes fatigue and your arms are not supported, so standing desks are not necessarily better than sitting desks in general which is evidence based supported. The key is taking regular breaks from static postures.

Remote workstation assessments:

If your office set up is a pain in the neck (literally!), get in touch with us! We can do remote ergonomic assessments of your workstation set up to see how we can help you. We are currently offering these at £55 for a 30 minute session.

And of course, if you’re in need of a physio appointment, we’re also offering those remotely too, via online video or phone.

Buying links:

Lumbar / McKensie rolls – by on Amazon and how to use them – McKensie roll position.

Laptop stands –  ebay – laptop stand  or Posturite Stand – which doubles up as document holder.

We have worked with Posturite for over 15 years and they have very kindly offered all our patients a 25% discount on any products bought from them. If you are a patient of ours, please contact Chris at chrishollely@posturite.co.uk, quoting PHYSIOREMEDIES, to get a quotation.

Words by Sarah Lawson.

Patient News: Alex Flynn - Certainly Uncertain

Patient News: Alex Flynn - Certainly Uncertain

Last year we announced that our patient, Alex Flynn, would take on the 4 Deserts Grand Slam Plus this year – racing 1,250km / 780 miles unsupported on foot across some of the most inhospitable landscapes in the world in the Namib Desert, Gobi Desert, the Great Caucasus of Georgia, the Atacama Desert and Antarctica - and that we’ll be supporting him in the lead up to this epic challenge.

Alex was diagnosed with Parkinson’s disease in 2008 at the age of 36. His diagnosis became the catalyst in his life for showing people the possibility of creating positive change in the face of adversity.

We asked Alex to write us an update on how things, including his training, are going, given the most recent turn of events.

Alex says:

I haven’t written for a while. Truth is I’ve been training for a race that may not happen.

Coronavirus has thrown everything in the air so to speak. Not only has it panicked many people and caused uncertainty across the world, it’s also made travel, insurance and racing in close proximity to others a game of Russian roulette.

I like things to be relatively certain. That’s why I like to train five times a week and take two days off. In typical Flynn style, my training graph would normally resemble the topography of K2; steep and unforgiving. I made this mistake in my past. Stress fractures and hotspots on my lower legs became frequent friends. Discussing this with Paul, I’ve managed to soften the curve of the graph by incorporating more cycling and cross-training into my regime. This is not just to obviate the risk of stress fractures but also cope with a changing physique that comes with being almost 50 years old.

So, training over the last few months has been a mixture of functional training with Gareth Batson at Cynergy PT, muddy trail and long road runs and cycling. In addition, I’ve spent time at the Park Club and have been working on my strength training with Quentin at the Engine House.

The result is that I’m stronger and fitter as well as benefiting me with fewer Parkinson’s symptoms. However, it’s not been without its aches and pains. Paul Martin has been amazing at managing my anxiety where I feel pain in my knee or ankle. He knows exactly the right thing to do. Paul helped me achieve my 10 millionmetres challenge and made it possible for me to #KeepMoving.  

I guess I will go with who I trust and know. After all, we are all looking for certainty.

Words by Alex Flynn. Images by 10MillionMetres.

How To Stay Injury Free Whilst (London) Marathon Training

How To Stay Injury Free Whilst (London*) Marathon Training

With the London Marathon* coming up at a rate of knots, we asked Stuart, our lower limb and sports injury specialist physio, to give us his advice on how to stay injury free whilst training for a marathon:

Runners, joggers and walkers view the marathon as the ultimate fitness test and challenge with a record number of people now participating globally. Many will have never completed this kind of run before and are also not seasoned runners. However, this does not stop many of us trying to complete this challenging and arduous task and getting that medal for the 26.2. 

Training for a marathon can be a daunting task as many people are worried about being injured and how they will react if this is the first time they have ventured into the higher mileage brackets. It has been viewed in the evidence that most people who do participate in the marathon will suffer from some injury during their training or the race. For example, it has been seen that novice runners sustained 30-38 repetitive strain injuries per 1000 hours of running while marathoners running more than 200 minutes per week sustained less than 10 RRIs per 1000 hours of running.

There are many ways to help reduce the likelihood of injury such as good preparation/warm up, having a good base level of strength and stability monitoring your build up gradually and of course having rest days:

Warm up:

The purpose of a warm up is to increase core body temperature, muscle activation, joint mobility and prepare the body for activity. The ability of the muscle to contract efficiently can benefit greatly as the quadriceps can help reduce up to 60% of the load through the knee joint when landing during a run thus being warmed up appropriately can prevent any knee injuries.

For the ideal warm up we should incorporate a high number of dynamic tasks such as lunges, calf raises, toe walks, leg swings. The evidence has been shown that a Dynamic Warm Ups performed pre training can also enhance and improve performance.

Strength and Stability Exercising:

A base level of strength and stability is required to undergo any exercise or physical task. For example if we are running and have a cadence speed of 140 then we are impacting 70 times on each leg every minute that requires the ability of the body to absorb force and propel us forward while trying to maintain good kinetic chain control and stability.

Resistance training has shown improvements of up to 8% following a period of resistance- or strength-based training during a normal running training plan. This can be attributed to improving running economy and improved neuromuscular control. When we consider that any small improvement can impact running economy the benefits may have a larger impact on long distances such as a marathon. 

Training plan: 

It is a advised that you don't increase your mileage by more than 10%. The 10% rule is one of the most important principles to adhere to help prevent injuries. As most running injuries are overuse in nature the 10% rule can help prevent this. It may be a long and slow process by only increasing the 10% but it will help keep you running safe and for longer.

Rest Days: 

Having rest days helps not just your body to recover but reduces the likelihood of injury. It has been seen that less than two days rest in endurance runners had an increase of 5.2 fold of overuse injuries. Every day that we exercise causes microdamage to muscles and without adequate rest we don’t repair. Build in a few rest days each week to help recharge, reduce injury and then improve your training and performance.

If you experience any prolonged niggles or pain during your marathon training period, don’t ignore it. Get expert advice and help. Call us on 02030 12 12 22 to book an appointment with one of our specialist physios.

* Other marathons are available.

Words by Stuart Mailer.

NEW: One To One Physio / Rehab / Yoga Sessions

NEW: One To One Physio / Rehab / Yoga Sessions

Our specialist physiotherapist, Alex, is now offering one to one physio rehab sessions which include the use of yoga to help strengthen your body. Of these sessions Alex says:

“These sessions are perfect for anyone who is curious about introducing yoga to their exercise routine. I often meet a lot of resistance from people who have thought about starting yoga but are overwhelmed at the thought of a class filled with super bendy people standing on their heads!

This is not what yoga is about and I'm here to help you find your way into your yoga journey in a safe and personalised way. I’ve been a Physio for almost 20 years now and this gives me a deep understanding of the body, its movements and limitations, and also how to work with any injuries you may have.

Yoga for me is about being 'flexible' (not the bendy type!) in how you practice and what suits you ,and having one to one sessions really is the best way to achieve the best outcomes. These sessions are also great if you are looking to enhance your overall strength, flexibility and wellbeing by training your body and mind in a very different way to before.

I meet many clients who are regular yogis and then come in with an injury which may or may not be related to their yoga practice. When we have looked at some of the postures together we can identify small areas and modifications which can make a huge difference in two main ways: one is by not stressing certain areas in a unhealthy way and the other is to gain more connection and balance on the mat, deepening your awareness of the pose you are in. The adjustment might be very small, but unless it's pointed out you won't feel the benefit of it.”

So if you've been thinking about it and want to find out more then please contact us to book in a session with Alex.

Getting Back To Exercise In The New Year

Getting Back To Exercise In The New Year

Noticed the number of gym adverts increase recently? Noticed a bit of an upturn in attendance at the gym in the past couple of weeks? A combination of the New Year's Resolution market and December excesses mean this is peak gym membership season. So what are we trying to work against?

Christmas Calories

Some sources estimate that during Christmas Lunch, an 'average' person may consume up to 5,200 calories through starter main course, dessert and drinks. These figures were sourced from a supplements firm, so there is a vested interest here, however the same article suggests this would take jogging 52 miles (i.e. 2 marathons) to burn it all off. Whilst this may not be everyone's preferred option to address the balance, come early January, with the December splurge behind us, it is a good time to start a new regime so that next Christmas we are ready for it!

However the initial push to get the ball rolling can end up with disillusionment, pain and injury or frustration at a lack of progress and subsequent withdrawal from the process. Here are a few easy steps to try to stay on target so that the monthly membership costs aren't going to waste:

Pace yourself

Don't try to burn 5200 calories in one go. It won't work (unless you are going to row the Atlantic in which case that's about a daily energy requirement and a little extreme). Ease into it, consistency is most important and in the early stages you may be better coming out of the gym or finishing your exercise thinking you could have done more. Build it up over a few weeks until you can hit it harder when your body will be better conditioned to the work.

You are where you are

Remember when you used to go to the gym twice a week 6 years ago? Regularly bench pressing 90kg, squatting 60kg and managing an hour on the treadmill? Easy there tiger, that was a little while back. If you are returning to the scene of previous triumphs, take those weights and reps right down. You will get much more getting your technique right on a light weight that you can increase over a few sessions than by jumping back in where you were. You might get away with it for a couple of sessions but your body's powers of recovery will take some honing as well.

Recovery is important

If it's been a while, build up from a couple of sessions per week. Most gains are made when the body is recovering and in the early stages there may be a lot to recover from. If every session feels like torture, give yourself a chance - do your exercise, but drop the weight or reps a little. Focus on technique or something different to what you might normally do. Preparation (warm up, the right food and hydration levels for you, making sure you are doing the best session for you) is important, but recovery (light refuelling, stretching, resting afterwards) is just as vital.

Enjoy it!

It is supposed to be fun! Exercise doesn't have to be about slamming away on the treadmill almost doubled over with exhaustion in a gym full of seemingly uberfit obsessives wondering how on earth Mo Farah does it.

It can be a cycle to the station, restarting some team sport, going for a longer walk with some friends, anything that gets your heart rate up for a prolonged period of time. It is often easier to exercise with someone as you are both doing the same thing and if you aren't feeling it one day, there is the perception you are letting someone else down if you pull out of what you were going to do together. Stick with it, long term it will be worth it!

Forming a habit

Our NoviceRunnerNik has written a blog post about forming a gym habit with some helpful tips which can be applied to other exercise too.

Injured?

If you do pick up an injury, get expert advice - call us for an appointment on 02030 12 12 22. Don’t give up on your hard earned fitness. Read our what to do if you get injured blog post for ways to keep up your morale and keep moving.

Words by Paul Martin.

What Does My Physio Think About: RED January

What do you think about RED (Run Every Day) January and other sign up type exercise initiatives?

What is RED (Run Every Day) January?

RED (Run Every Day) January and other sign up type exercise initiatives are becoming very popular, possibly because of the exposure they have on Social Media. People pledge to run or do another form of exercise every day for a month to raise awareness of or sponsorship money for a charity. They’re encouraged to post about their daily achievements on Social Media.

Are RED January and similar initiatives a bad idea?

Our spinal specialist Physio Shari says:

“Unfortunately this will very often lead to overuse injuries, which may range from strains, to tendinopathies, stress reactions in the bone to stress fractures. I wouldn't recommend suddenly running every day after a long period of inactivity or if your body isn't conditioned to it. I do have patients who run 6-7 days per week and love it and have been doing so for years, however there is obviously a reason that they are seeing me and it is for overuse/overload injuries and/or biomechanical problems! A balanced exercise regime is best with a gradual increase in loading and recovery days, particularly if starting exercising from a zero or low background level."

Physio Paul, who specialises in sports injuries, says:

“Be sensible! Initially you might be able to get away with a couple of bigger runs in short succession but at some point you'll need to slow down or plug in some recovery runs. Vary distance, volume and intensity through the period of time you are committing to.”

If you are intending to run every day this month or any month, do be very careful about overloading your body, particularly if you’re normally not particularly active. You could consider Moving Every Day - varying the forms of exercise that you take to reduce the risk of overuse injuries. Try cycling, walking, gym classes or weight lifting too.

Capitalise on your new found fitness too. At the end of the month continue Move Every Day sensibly to make it part of your ongoing routine to help you towards a more active life.

Are you a Gym Newbie? How to form a gym habit and enjoy it

Are you a Gym Newbie? How to form a gym habit and enjoy it

Thinking about making ‘going to the gym’ a new year’s resolution (again!)? Are you a bit of a gym newbie? Our NoviceRunnerNik was too this time last year but now she’s a committed gym goer. Here’s her story on how to form a gym habit and enjoy it.

Januaries are good months for gym owners

The owner of my gym told me last week that my gym’s February to December monthly membership income is typically half that of January’s. Lots of people sign up in the new year, the gym gets busy and then so many fade away. So if you’re going to decide to go the gym, how can you turn it into a long term habit, particularly if you’ve never really been a gym-goer?

I too was a gym newbie

Until November 2018 I could count the number of times I’d been in a gym on two fingers. The first time was definitely not in this century. So I nervously approached my local gym for a chat about how it works and what I could do there. I was keen to complement my running training (my first love) by doing some things that didn’t involve running. I’d signed up for a tough 32 mile ultramarathon in August this year and as I’m a bit prone to overtraining injuries, training in not running (or cross training as it’s apparently called) seemed like a good idea. I liked the look of lifting weights. So I signed up for a month of membership and a personal training session (in for a penny, in for a pound) and turned up the next week for my induction and first ever personal training session.

No one is watching you, they’re all watching themselves

I couldn’t really articulate why I was nervous about going to the gym. I think I was worried about looking like someone who didn’t know what they were doing. I think that somewhere inside of me, the old 14 stone, size 18 couch potato that I was until seven years ago, still lurks, wondering what on earth someone like me was doing in a gym.

The first thing I learned is that, just like real life, gym members come in all shapes, sizes, ages and fitness levels. The members at my gym range from older teenagers, through Junior Powerlifters competing at national level, to 70 something retirees (with impressive deadlifts!), each with their own reasons for training at the gym.

The second thing I learned was no one is watching you. They’re all watching themselves. And no one cares what you’re wearing, what you’re doing, how you’re doing it. That’s not to say they don’t care about you – all the gym goers I have met are lovely, friendly, chatty, polite and helpful.

Making the most of your gym sessions

I realised that I needed to make the most of each gym session, to make it worthwhile taking the time out to go three times a week. So to stop me aimlessly using the machines with no real idea of what helps, I asked my new personal trainer for a training plan to work to, in particular to help improve my core and arm strength. I have, like most runners, stronger legs and weedy arms – a t-rex body shape! He gave me a two week, push day (arms), leg day and pull day (arms), plan.

And then I just needed to learn the lingo: the different types of sets, tempos, names of the equipment and exercises and how to do them. I started recording what I was achieving for each exercise, weights and reps wise, in a spreadsheet on my phone as I trained so that I knew where to start the next time I was doing that day. It’s highly motivating when you smash your PBs each week when you first begin!

Personal training and diaries

I decided to have a personal training session once a week for a few months, partly to ensure I was doing it right and partly as he pushes me so much more than I push myself on my own. I changed the days I trained with him so that we went through all of the exercise sessions. I’ve also started doing 30 mins on the static bike or 5k on the rowing machine after each session, to make it even more worthwhile going. This is also great ‘brain occupation’ training for long distance running!

I put all my gym sessions in my diary so that they are appointments I will attend and I avoid booking anything else that clashes with them. This means I have no excuses to not go to the gym and the gym has become part of my daily routine. I also discovered my next door neighbour was toying with joining the gym to increase her strength which would make caring for her very frail husband slightly easier, so I encouraged her to start and now we encourage each other to turn up and train at the same time. We usually have a good chat on the crosstrainers as we warm up!

Learning to enjoy the gym

And after a few weeks, once I’d learnt the ropes and chatted to a few people, I started to look forward to, and enjoy, going to the gym, which amazed me! I even began to feel sad when my gym session was over.

Smashing gym PBs is a great feeling but it does happen less and less as you get stronger. I did have one leg training day a few months ago where I smashed every single PB on every single set. Whilst it left me wondering for a while why I’d not upped my weights much more previously, the fact that I could barely walk the next morning made me reconsider!

Benefits of gym training

I’ve experienced some great side effects from my gym training. I started smashing my running PBs without increasing my volume of running training, including parkrun times and I knocked 16 minutes off my first ever half marathon time when I ran the same half again this year. My knees in particular are less cranky when I run and I’m generally experiencing fewer niggles. I feel stronger when I run and I recover more quickly from big exertion running such as a 19.5 mile run around North Wales which included the summit of Snowdon, managing to leap out of bed the next day when I expected to be hobbling.

The 32 mile ultra in August, although hard and quite tiring, went like a dream. Recovery was quick. Thank you gym work!

My top 10 tips for forming a gym habit – make it hard to make excuses not to go

1. Find a gym that suits you and what you want to do – that its opening hours suit you, it’s easy to get to and park at, it has the equipment or classes you want. Ask friends or the internet for recommendations. Try several if the first one doesn’t work for you.

2. Pay automatically for monthly membership: if your chosen gym is for you, put your monthly membership payment on a standing order or direct debit. Then it gets paid without you having to think about it and you might feel you should go to the gym to make use of it.

3. Book your gym sessions in your diary, just like any other appointment and treat it as such. Be realistic about how many sessions a week you can manage.

4. Go to the gym at a time that works for you: if you prefer it when it’s quiet, find out when is off peak attendance time. Lunchtimes are usually, but not always, quieter in my gym.

5. Make the most of your gym sessions, part 1: have a training program written specifically for you, tailored to your goals and your likes, by a personal trainer, or find something that works online. Record your stats each session using Google docs on your phone or in a notebook so that you can see your improvement.

6. Make the most of your gym sessions, part 2: treat yourself to a personal training session every so often. You’ll learn a lot and will be pushed to work harder.

7. Vary your training regularly to keep you interested in going. If you only use the machines, try some free weights or some functional strength work like tyre flips, battle ropes, kettle bells. Change your program every few months.

8. Warm up, cool down and stretch to reduce the chance of injury. If you don’t know how to, ask a personal trainer at the gym.

9. Train with someone else for some accountability: you don’t need to actually train with them but if you agree that you’ll see them at the gym at a certain time and day, you’re more likely to turn up.

10. Remember that gym goers are all shapes, sizes, ages and fitness levels and everyone is watching themselves. Don’t be afraid to ask anyone for help or advice. You belong too.

Most importantly: when you start, or start back if you’re a seasoned gym-goer, at the gym in the new year, take it easy. Don’t leap in where you left off in the summer or start off with the really big weights as they look the part. Ease yourself in gently, up your weights gradually, move with control and reduce your risk of injury. Much as we love to see you, we’d prefer you didn’t hurt yourself in the first week of the new year!

If you do pick up an injury or would just like some advice about getting (back) to the gym, please call us on 02030 12 12 22 to book an appointment.

Words by NoviceRunnerNik AKA Nik Bathe.

Patient News: Wayne Collins' Ride To Rome Part 2

Patient News: Wayne Collins' Ride To Rome Part 2

Wayne Collins, one of our physio patients, recently cycled from London to Rome with his friends Alessandro, Dot and Aileen to raise money for two charities close to their hearts. The first is The Royal British Legion, specifically for their projects supporting Admiral Nurses who work with people (and their families who are often more affected) with Alzheimers, a disease that took Wayne’s father at an early age, and the courses that they run at the Battle Back Centre. The second charity is Demelza House, which is a hospice that provides respite care and end of life care for children with severe illnesses and life limiting conditions.

Wayne has very kindly blogged his experience for us in two parts – this is the second part - the actual ride. You can read the first part: the run up to the big event, here.

Our Ride To Rome!

And we were off!

We set off from the Coliseum Theatre in London early one Friday morning in late July.

Our first delay was the raising of Tower Bridge which in all my years of living and working in London I have never witnessed!

Our route out via Greenwich effectively ran alongside the A2 along some very rough sections of cycle paths to our first stop at Demelza House in Sittingbourne. Demelza is one of the two wonderful charities that we were raising money for. We received a very warm welcome and were fed with sandwiches and some lovely homemade cake to send us on our way to Dover.

First stop - at one of our charities, Demelza House.

The weather was kinder to us in the afternoon as we picked up the Via Francigena Pilgrimage route from Canterbury to Rome. We would crisscross this route many times over our 19 day adventure.

Unfortunately upon our arrival at Dover we soon realised that we would not be departing anytime soon! We loaded the bikes into the van ready to board the ferry and then spent the next 4.5 hours waiting to do so!

Through France

We arrived at our hotel in Paris at 1am in the morning and had to unload the contents of the support van into our rooms for security.

We were up again at 6am ready for Day 2, waking up to torrential rain that stayed with us for the whole day! Thankfully that was the only any like that which was a relief as it took the next two days for my shoes to dry out.

Luxurious accommodation in France - a stack of shipping containers as rooms

Over the next days we proceeded south through France largely following routes that we had driven during two recces in January and March. We encountered some road closures and subsequent diversions along the way just to keep us on our toes.

We cycled through some amazing scenery with the vineyards south of Reims being particularly impressive and memorable. We did our best to support the local farmers and agricultural economy along the way which meant we had to sample the local wines with dinner each night. It would have been very rude not to have done so!

Psychologically we had one of our hardest challenges ahead of us....the Alps!

Tackling The Alps!

Due to snow earlier in the year we had not been able to drive the Alpine passes so we really had no idea what laid ahead.

Please remember we are not club cyclists, purely amateur leisure cyclists with an average age the wrong side of 60.

As we approached the Alps we cycled down the entire Eastern side of Lake Annecy to Albertville, once the home of the Winter Olympics and not normally a place you would be cycling. Thankfully these days it’s the home of a state of the art cycle shop/repair centre and some very friendly generous staff.

We had now been cycling for 9 days averaging around 76 miles a day.

Day 10 was the “rest” day before we tackled the Alps. On this day we cycled the relatively short distance from Albertville to Beaufort to find ourselves sitting at the most amazing patisserie for breakfast whilst looking at the Ski Map across the road....are we insane? Should we really be in a ski resort on our bikes?

Beaufort the day before the Alps ascent

Time for some bike cleaning and maintenance before I, Alessandro and our driver Glyn headed up the Alpine climb to see what the next day would have I store for us. Last time Alessandro and I were there it was closed due to the snow.

It took us around 5 hours for me to drive the route and return.... not quite the rest day we had planned, however I am so pleased that we did drive the route. The ladies on the other hand enjoyed a lazy girlie day in the sun in Beaufort.

Alessandro spent many days planning the routes and then modifying them following our visits earlier in the year. We, the novice cyclists, clearly had not paid enough attention to his notes though! In order to cross the Alps by the “easiest” route it was not what we had imagined it would be, i.e. a long climb up and tricky steep decent down to Italy.

Oh No! It was a long 22km climb up to Cormet de Roseland which was part of this year’s Tour de France, albeit probably a little faster than us. This was followed by a steep decent down to Bourg St Maurice before a further 35km climb up to the Italian Border. We were definitely running on adrenaline on this day!

Part way up first climb over the Alps

This climb took us up over the Col du Petit Saint Bernard through the middle of La Rosiere Ski Resort. It felt very strange cycling under ski chair lifts and seeing signage relevant to being in a pair of skis, not on a bike!

Top of first alpine climb!

The steep difficult hairpin bend decent down into La Thuile in Italy at the end of that day was very tough as we were all so tired, however, we had made it over the Alps...what a relief!

And Then Italy

The next couple of days were down through Northern Italy where our choices of road through the steep sided valley were limited and the ride got even tougher in many ways with very, very bad road surfaces and heavy traffic including lots of trucks which were not that happy to see us.

Cycling through Italy was more challenging than our route through France with steeper climbs and more and more tired legs. The adrenaline rush of the Alps had left us and at times we really struggled. Tempers got a little frayed at times too, but we all stuck together and pushed each other to keep going.

The messages from home via our Facebook page from not only friends and family, but also from others who we did not know that had started following our challenge were very important to us and certainly kept us going.

1,000 miles in

Day 15 saw us reach the 1,000 mile mark! We were all very tired and whilst relieved to have made it that far, I don’t think it really started to sink in until we posted the pictures that evening and the messages from our supporters started to arrive.

Italy and 1,000 miles covered!

Day 15 saw us enter the beautiful region of Tuscany through which we carried on the next day. How different it looked in the blazing sun some 5 months after our drive along the route back in March. Still stunning, but so very different.

Energy levels were now very low, and even though Day 19 would see us reach Rome, we all struggled to remain in good spirits and to keep going at times. We had been blessed with overcast conditions through much of France, however we were paying the price now with temperatures in the upper 30s.

Day 19 and our final approach to Rome had a brief stop at the lake north of the City where the Pope has his Summer Residence.

And Finally, Rome!

Thankfully Rome itself was very quiet in August as it’s very hot and the residents and businesses were on holiday. There was a tiny amount of traffic compared with what had greeted us in March so we needn’t have worried so much.

Emotions were running high as we cycled first to the Vatican and then onto our final destination, the Colosseum.

At The Vatican

At The Colliseum

We Made It!

We had made it! 1,388 miles, averaging 76 miles a day, excluding the rest day at a mere 12 miles and we made it over the Alps without having to get off and walk!!

We did it!

What an adventure! One we will never forget and, thanks to our amazing sponsors, nearly £12,000 was raised for the Royal British Legion and Demelza House.

Words and images courtesy of Wayne Collins.

JUST AMAZING Wayne and team - well done!

Are you going on your own adventure and would like to share it with us? Send an email to us at info@physioremedies.com.

Body Part Of The Month: The Hip

Body Part Of The Month: The Hip

This month our body part of the month is the hip and so we’ve asked our hip and groin specialist, Paul Martin, to tell us about to tell us a little more about the hip:

One of the more important muscles around the hip is gluteus medius - shown in red in the image above. It’s not the biggest muscle in and around the hip and pelvis but its effects are wide ranging and having it function well is important for healthy functioning in many areas, the hip, lower back and knee to name but three.

When it’s all going well

What happens when it all works well for the lower back? When it works well (i.e. it is strong enough to bear the load and operative at the correct time to absorb the work), it is able to stabilise the pelvis on the hip. When we stand on one leg, gluteus medius works to keep the pelvis level providing a level base for the lower back to sit upon.

What happens when it works well for the hip? Gluteus medius plays a large role in keeping the ball of the hip squarely in the socket. It plays a key role in moving the leg away from the midline of the body but it also contributes to both internal and external rotation of the hip (i.e. rolling inwards and outwards) so will control excesses of these movements as well

What happens when it works well for the knee? Due to the control of rotation around the hip, when functioning well it can limit shear and rotation of the femur (long thigh bone) on the tibia (shin bone) which reduces risk of overload in other muscles to control this movement.

When it’s not going well

So what happens when it’s not working well? The opposite of the above. The pelvis will provide a less level base for the spine to support itself from, single leg standing (e.g. during gait) will likely be accompanied by some form of hip or pelvis on hip rotation depending on which parts of the muscle aren’t playing ball which means that a number of rotational forces will resolve themselves around the knee.

Sounds catastrophic! How can we possibly survive without gluteus medius functioning? The body has a phenomenal ability to create compensatory movements or actions that mean that we can still function if a few muscles aren’t doing what they should when they should. However if these things get out of control it can lead to tight muscles on the outside of the leg and Runner’s Knee, or tightness in the back muscles or even back pain.

How to get it going well

Keeping on top of this little muscle won’t cure all your ills, but it can certainly help keep some nasty aches and pains away.

The video in this link gives five good gluteus medius exercises and also shows progressions too. They are:

1. Side-lying abductions

2. The pelvic drop

3. Single leg deadlift

4. Single leg squat

5. Side bridge (or side plank).

Are your hips causing you concern? Call us on 02030 12 12 22 to book an appointment with one of our hip and groin specialist physios.

Words by Paul Martin.

If Office Christmas Parties Were Sporting Events...

If Office Christmas Parties Were Sporting Events...

It's that time of year that some people love and others dread.  For some it's a party every day and others it's one big blow out. 

Here are our specialist shoulder & elbow and sports injury physio (and man about town) Nick's top tips for:

Surviving the office Christmas party (or parties)!

1. Remember it's a marathon not a sprint! The booze will not run out within the 1st hour, so pace yourself.

2. Think like a triathlete! Drink, Eat and Dance, but not at the same time.

3. It's like a game of chess and tactics are essential! Don't get cornered by the office bore or the lustful one who's just eaten a packet of mints!

4. It's all in the preparation! Line that stomach before you start the race of units.

5. Hydration! Have a soft drink/water whilst drinking alcohol, this will make you feel better the next day.

6. If physical activities are part of the party, stay off the alcohol until its safe to drink!

7. It’s not an excuse for Cage Fighting and sorting out those grudges that have been building up all year! Avoid confrontation. Stay calm and give peace a chance!

8. Dancing on tables is not yet considered an Olympic Sport!

9. Dance floors can be dangerous. The majority of injuries happen from people slipping on liquid on the floor, or falling onto broken glass. And watch out for the over enthusiastic Whirling Dervish who might knock you over like a 10 pin bowling ball!

And Nick’s tips for hangover cures:

1. Don't rely on the hair of the dog. This will only delay your hangover. Alcohol is a diuretic making you urinate more and will dehydrate you further. Drink plenty of water.

2. Don't drink too much coffee. Caffeine is also diuretic. Try juice or water.

3. Go and do some exercise! The endorphins will kick start your recovery! Make sure you warm up and are sufficiently hydrated before pushing yourself too hard.

4. That fry up might sound appealing, however a banana or kiwi fruit will help replenish those lost nutrients, especially potassium.

We hope you manage to stay safe and upright at your Christmas parties but if you do sustain an injury by showing off on the ice rink, you know where we are.

Words by Nick Smith.