Archive for the ‘Injury Advice’ Category

A colleague recently directed me to a fascinating article and detailed research on barefoot running/forefoot running from Harvard University. If this is a subject that interests you then I strongly recommend that you take the time to read it.  If you prefer, take a look at a short 5-minute video clip, the following video from their site. http://www.youtube.com/watch?v=7jrnj-7YKZE
Personally I believe there is something in this research that all runners could benefit from – even if it is just to think about your style of running. When you watch the video or look at the images of runners on this particular page –   http://www.barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html The graphs clearly show that midfoot and forefoot striking must be a more energy efficient way of running; the heel strike creates a ’stop’ so you must lose some forward motion.  This is in addition to the jolting forces going through your foot and transferring to your shin, knees and beyond. Whereas a mid foot/forefoot strike maintains more forward momentum, requiring less energy to maintain a smooth forward propulsion. There is of course a health warning that goes with this – If you are a heel striker, your body is already used to this style so you cannot just change it. You could risk injuries including calf strain or achilles pain. Before considering such a change, you are advised read the following advice from the Harvard Research –  http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html

I’ve seen a couple of clients recently and I thought it may be worth just highlighting the need to look after the small intrinsic muscles that support the joints and initiate movement. We all see and recognise the obvious muscles of the body but these are just a small part of the picture.

Underlying these are the small supporting muscles – the muscles that start and control movement. An example is the shoulder: many people exercise and do activities that involve large, expansive movements.  However they do not always benefit the smaller muscles and this can occasionally lead to deep shoulder pain as those muscles become fatigued and the tendons attaching the muscle to the bone become strained.  This can easily be prevented with specific conditioning exercises that improve the strength of those deep muscles.

This applies just as much to your back and many of those aches and pains we all feel. The deep muscles of the spine that stabilise the joints become fatigued due to a lack of conditioning; abdominal workouts without specific exercises to strengthen the muscles of the back are only half the solution.

I do not intend to try and describe an endless list of exercises here in this blog, my suggestion would be that whatever your lifestyle choices you will enjoy them much more if you don’t have these annoying little aches and pains deep in your joints. You can avoid these with properly directed exercises.

Speak to a conditioning coach http://www.uksca.org.uk/uksca/Common/practitionerSearch.asp, try Pilate’s http://www.pilatesfoundation.com/newsite/index.php or get the personal trainer at the gym to show you specific exercises. Finally if none of that appeals look up a local sports injury therapist, physiotherapist or other equally qualified injury rehabilitation advisor on the web and they will give you very good advice.

Just don’t ignore it because many little aches and pains can be avoided if you look after the bodies basic infrastructure.

I saw a regular client very recently who I treat bi-weekly for general preventative massage following the birth of her first child last year. Normally treatment is focused on easing the strains caused by lifting and carrying her little one each day. This time she asked me to look at her neck and shoulders which have caused her trouble in the past when spending long periods on her laptop.We discussed what had changed in her routines recently and was just about to remind her of the need for good posture and to remember to use laptop stands and remote keyboards when she said ‘I wonder if it is because I have been spending time on my iPad’ . I asked her to show me how she was using it and she appeared to be slightly hunched over – very similar to another client that I had seen just a few days previously. It got me thinking about how we use the wide variety of modern technology such as desktops, laptops, Blackberries, iphones etc. We all enjoy – and rely on – using these and will spend many uninterrupted hours focused on what we are doing without realising what we might be doing to our bodies. If you are using any of these gadgets then you need to take regular breaks, change your position and occasionally look up. Most people typically slump when using such equipment, thus our shoulders become rounded, putting greater strain on the joints and muscles in your neck and back, and shortening the muscles in  your chest – not ideal!

Remember – take a break, sit back, straighten up, hold your shoulders back push the chest out a bit. If you have a habit of forgetting, build this into your day by using calender reminders and make an appointment with your body.

This is the time of the year when many of you will be setting out on your marathon training and it is does not matter if this is the first one you will do or you are an experienced long distance runner. The risk of injuries are high, the volume of running  will potentially pre-dispose you to picking up those aches and pains that could hinder your carefully worked out training plan. They are all preventable if you include within that programme regular maintenance sessions with a manual therapist who can iron out any difficulties before they hit you. You will take the time to consider what you eat, what you wear, your running shoes; but will you think about your body and what you will demand of that? Running has an impact through the whole of your body not just the legs and feet; it will effect your back, your shoulders and your neck. Good quality sports massage and joint mobilisation can minimise those impacts and make your whole marathon experience more enjoyable.  Your massage therapist can give you excellent injury prevention advice and most of them have experience with training and sports activities so will know what you are experiencing at first hand. You can also find some excellent online advice at the following website and link that I saw today, http://www.sportsinjuryclinic.net/sports/marathon_tips.php

There is a great deal of information on the web about the science of these tights, shorts, shirts and calf supports and it is not my intention to go into finite detail. I am keen to share two very recent examples of direct experience of the effectiveness of these for post event recovery. A friend purchased a pair of compression tights prior to doing the New Forest Middle distance triathlon http://www.racenewforest.co.uk/ with the intention of using them the day before the event to minimise pre race fatigue and as a recovery aid afterwards. He was very impressed with the effects after the race claiming that usually, following a half ironman distance event he would be very stiff for at least a week. However, using the compression tights he was clearly able to move about easily and his overall recovery time was significantly reduced.

The second example of feedback was from my wife using a combination of gear over the three days of the votwo-organised Atlantic Coast Challenge http://www.votwo.co.uk/votwo2007/community/news-item.php?start=&offset=&item=172. At the end of each day’s run she put on compression tights immediately after finishing. I particulalry noticed the increased ease she had in moving around, climbing up stairs, getting in/out of transport; in the past, it had been very obvious she was stiff and finding all movement difficult. During the night she chose to sleep in compression shorts and calf supports, which she put on immediately after post-event massage and stretching each day. She told me she felt so much better than she had last year at the same event. This combined compression clothing and massage strategy certainly aided her recovery each day enabling her to feel less muscle soreness and fatigue and also getting into her running much more quickly on each subsequent day.

Both examples demonstrate compression tights as a great aid to recover and I would certainly recommend these following any event or training session.  Note that my personal view is that these should not be used in isolation but to compliment good quality stretching and regular massage.

Excellent piece in the magazine as a whole especially the comment about ‘old injuries’. This ties in with an earlier post on our differences; how over the years all the things we do take a toll on our bodies and many of the niggles we ignored - and still do - leave a legacy. Everyone is different: your physiology has responded to what you have asked of it over the years; your body has an awesome capacity for adaptation and many of those times when the injury sorted itself was just your body learning to live with it. The likely outcome was that another part has had to take on a greater load or change its natural way of moving. Eventually though, it will stop finding those changes more difficult to achieve and something will give. Try and respond to them at the time; good manual therapy to correct the original injury will pay huge dividends in the long term along with regular maintenance to reduce risk of injury in the first place.

This is one that I find affects a wide group of people, many of whom do not regularly engage in any particular sport or attend a gym. Recently, I have had conversations with individuals who have seen their GP and been prescribed anti-inflammtory tablets but there is much more you can do. This can be treated with a good deep tissue massage on the affected area along with work on the joints of the foot, ankle and into the calf muscles. You can help yourself with some simple home remedies: use a tennis ball, golf ball or even a rolling pin and sit comfortably with it under your foot and use it for self massage by rolling it across the underside of your foot as you press down on it.

Another option – and one that will help cool any inflammtion – is to fill a small plastic drinks bottle with water and put it in the freezer. When frozen, use this as a roller under your affected foot. This way you have the massage effects of the roller along with the soothing and cooling affect of the ice. I would still recommend seeing a manual therapist who will make sure of the diagnosis and work with you towards recovery.

Runners World magazine carried a very interesting article in the August publication about the susceptibility of people to certain types of injury; this was taken from research published in the British Journal of Sports Medicine. http://bjsm.bmj.com/They have listed the six injuries that runners suffer from and have suggested groups of people that may suffer from these more than others. http://www.runners.world.magazine.co.uk It is well worth reading and taking note of the possible causes and suggested prevention options. I would imagine that like me the most important thing to those of you who exercise is to do it pain free. There are many reasons why we all get injuries; more often than not overtraining is the biggest cause. The advice in this article along with regular massage maintenance is definitely the best way to avoid those injuries. It does not matter if you only train occasionally for recreation or more seriously top compete there are many things you should consider if you want to enjoy it every time.

The treatment I can provide is not just for the recreational or serious athlete, it can be beneficial to everyone no matter what lifestyle you have. Those long hours at work can ‘jam up’ the muscles and create tightness throughout the body. A wide range of treatment modalities can release that tension that can develop not just in your neck and shoulders but equally through the legs and lower back.

It may be your opportunities to exercise are limited, perhaps due to illness or pregnancy; these are often the very situations that benefit the most from deep tissue massage and assisted stretching or joint mobilisation. Remember to look after yourself by treating your body from time to time, as a pregnant client of mine realised through a bi-weekly massage programme.

There are guidelines regarding treatment of people with illnesses and pregnant ladies which can be discussed at a consultation so that the treatments can be tailored to your specific needs.

I have recently worked with a client who is pregnant and recently have had some great sucess in relieving her aches and pains as part of a regular massage programme.  As the female body changes and responds to increased demands of pregnancy, lower back pain is often a common complaint, as you may expect, which can lead to some symptons of scaitica; this can be reduced or erradicated with carefully applied massage and articulatory techniques, as has been the case with my client.

I have had success over the last couple of months with clients who have felt tight and aching sensation in the lower calf muscles when running, along with some achilles tendon soreness. In addition to the usual treatment of massage and with stretching the muscles and tendon, I have found that conducting an assessment and treatment of the bones of the foot can have a significant impact on relieving the stiffness and soreness. 

Keeping this simple, the foot is made up of several individual bones; when these work together, they act as an additional shock absorber by moving against one another and taking the strain off each foot strike. When they become stiff, the impact of each step transfers further up the leg and can cause the soreness associated with Achilles Tendinitis or a feeling of aching fatigue in the lower calf muscles.

Using a technique that works on each joint in the foot and by moving those joints, I have had very good results with clients who were struggling with running and simply walking.