Archive for the ‘Injury Prevention’ 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

I’ve just spent three days watching and supporting my wife and a couple of hundred others run or walk their way across 79 miles of Cornish coastal path in three days from Padstow to Lands End as part of the Atlantic Coast Challenge organised by those very fine folk at VOTWO.  http://www.votwo.co.uk/votwo2007/events-and-adventure.php In addition to the aches and pains caused by running 3 marathons across 3 consecutive days, the main injury appeared to be blisters, with the event medic was spending a great deal of time managing these, however there is a simple preventative solution. Most of you who run or walk any distance are aware of where your footwear press against your feet. Generally this does not result in blisters when on regular flat surfaces, however off road terrain and its uneven surfaces cause greater movement of your feet inside your shoes, with these pressure areas at risk of quickly becoming points which develop into blisters. The simple preventative sloution is to put some sort of protective covering on those parts of your feet before you start each day or event. I have found that carefully applied layer of micropore tape across the vulnerable areas will prevent blisters. It is a very quick and easy idea that will reduce risk of blisters and ensuring you fully enjoy your chosen activity.

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.

Like everyone who does any type of sport or endurance event I read every article I can about training for it, listen to advice from those with experience and specialist knowledge, but ultimately I try to find the guidance that best suits me. This is certainly one thing that I feel is really important as a Sports Massage Therapist where I meet many different clients who are looking for a generic solution to their injury, restriction or training plan. As a result I spend a great deal of time reminding them that we cannot always find the ‘one size fits all’ solution. It may sound like I am stating the obvious but we are all different; our bodies have developed and responded to a variety of stresses and strains over the years leaving us with different physiological requirements. This is the case if you are active or not: the work you do affects your body, which is constantly responding to the way in which you use it. So when you’re planning your next training regime or sporting objective - be it for a specific purpose or just to get fit – bear this in mind.  Just because one person does hours and hours of mileage each week, this may not suit you and worse, could lead to an injury. Try and find what suits you and try different things – remember it should be about quality rather than quantity, supplemented with good core stability and conditioning; over training, particularly in one discipline or focus only, is the biggest contributor injury.

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.

Modern lifestyles are busy and often leave us limited opportunity to be selfish and care for our bodies – which we expect to just keep on going, no matter what.

Quick tips:

If you are office-based, set a reminder in your outlook calendar to get up, walk around and stretch out your shoulders and back. Everyone tells me – and I know from experience - that you can get so engrossed in your work you sit for too long, you forget to move so why not use the the computer that is keeping you immobile to remind you to move. It doesn’t have to be a whole exercise routine: just sit back or stand up and walk around for a few minutes. You could so easily set a regular appointment that will pop up on your screen.  Do be careful how you phrase it otherwise it could be a little embarassing if in the middle of that all important presentation up came ‘appointment with my body’ !
If you have an active job, such as a builder, set your mobile phone alarm to make sure you combine the physical pressures of your job with stretching to prevent injury.

Everyone I treat or talk to schedules their sporting events and training around their busy lives but rarely find time to properly stretch.  By this I don’t mean simply warming up/down pre/post exercising; this is about planning in a stretching-only session on a rest day or as part of a lighter training day.

Stretching is a simple yet highly effective activity that will help athletic performance, decrease risk of injury and minimise muscle soreness.  By placing particular parts of the body in certain positions, we can increase muscle length, reduce muscle tension and enhance our range of movement.  In doing this, we increase the distance our limbs can move before damage may occur to the muscles and tendons.

A great example of this is a swimmer who takes time to properly stretch their shoulders.  This will improve the range of movement in the shoulder and therefore facilitate a more streamlined and efficient movement through the water.  In this instance, not only is the risk of injury and fatigue reduced, but moving through the water more efficiently is likely to improve your overall performance and time and therefore a much more enjoyable experience!

I chose my website name ‘Range of Motion’ with great consideration.  A lack of range and flexibility limits our movement and can contribute to muscle and joint problems.  This can lead to injuries which prevent us from carrying out our daily lives or exercise.  Improper muscle action can result in decreased performance and can result in loss of strength and power during physical activity.

Training which does not factor in a regular stretching regime can greatly increase the risk of muscular discomfort, loss of performance and injury. 

Stretching will not necessarily make you run faster, cycle for longer or take that hard hitting tackle.  What it will do is to increase your ability to avoid injury and keep you doing what you really want to do.

What stretching WILL do is release muscle tension, maintain flexibility and reduce post activity muscle soreness and fatigue.  In addition to these benefits, stretching also gives you time to wind down, allow your body to slow down and help you reflect, take stock and relax – something we all need.