Coming up: Running-the big Debate

Sore Muscle Remedies


We discussed DOMS (delayed onset muscle soreness) in my post entitled Muscle Soreness for the soreness that follows exercise but what about chronic (ongoing) sore muscles?

Here are some of the reasons you might suffer from sore muscles and some of the ways you can remedy it.

DOMS can take 48hrs to come on and can take 48hrs to go away. So let’s say that muscles can remain sore for upto four days following intense activity. Any soreness that lasts longer than this is a concern. Bearing in mind that most of us do train on consecutive days, you may acquire new aches and soreness throughout your training week. In short, if a particular body part or muscle group has remained sore for more than four days and is not alleviated with stretching and light exercise, you need to get it checked.

Providing you have allowed the muscles to recover and haven’t trained the area again in a way that makes them sore all over again the soreness could be due to other factors including:

Quality and quantity of sleep

Nutrition-post exercise and in general

Flexibility training-are you doing any? Do you stretch adequately post training? Do you do any other stretching?

Your training load and schedule-are you being sensible or scientific in how you structure your exercise sessions throughout the week or micro cycle?

Remedies-massage, foam roll self release, static stretching. Heat and ice therapy. Rest. Analyse your training schedule.

All over-use injuries are avoidable

Prevention: Increases in training load Should not exceed 5-10% per week. This will allow your body to respond to training stress through tissue repair and adaptation. Too much too soon and you will be hitting the tissues with more stress before they have had time to fully repair. This is the recipe for overuse injury. All over use injuries are avoidable!


Achilles Tendon-itis-osis-(opathy)

WARNING: this article contains an image of open Achilles tendon surgery

Achilles Tendon-itis-osis-(opathy)

whatever you wanna call it

Symptoms: Achilles Tendon pain usually starts with a little stiffness and tenderness in the morning that eases as you get up and move around. As the problem worsens you may also experience pain at the start of exercise that eases as you continue, you’ll feel increased morning pain too. Soon, you will experience pain that persists following exercise too. Eventually you will experience constant pain that does not warm up or go away at all. At this point you have a very poorly tendon with a very weak scar that is at a very real risk of a catastrophic, complete rupture.

“25% of athletes with this problem resort to surgery”

25% of athletes who suffer long term Achilles tendonopathy resort to surgery.

Many who undergo this surgery fail to regain full strength following surgery which makes it very likely that the problem will return.

Lack of flexibility and lack of calf muscle strength are key factors in the cause of Achilles tendonopathy. Other factors include poor training footwear, abnormal biomechanics and running style and unrealistic increases in training load. It has been recommended that running training should be increased at a rate no greater than 5-10% per week.


Surgery does not guarantee recovery

A strong and long Achilles is less prone to injury and has been proved to make you a more efficient runner. So get strengthen to get strong and stretch to get long for a healthy Achilles.

The truth about the truth about exercise – HIT: High Intensity Training

The truth about the truth about exercise

HIT: High Intensity Training


The recent BBC Horizon programme introduced the public to HIT. A form of exercise involving short bursts of very intense exercise f

or a few seconds at a time a few times a week. Though well intended, the programme seems to have confused a lot of people and raised as many questions as it answered.

The wrong message: on the face of it the message many of us heard was, “you only need to exercise for 3 minutes at a time” and that for a few of us “it doesn’t matter how hard we try, exercise just wont work.”

The right message: if used correctly this type of exercise can offer incredible health benefits. However, proceed with knowledge and caution.


A cure for Borderline Type 2 Diabeties?

Benefits: HIT improves insulin sensitivity showing strong indications for borderline Type 2 Diabetics potentially reversing symptoms and avoiding medication. HIT can reduce blood pressure and improved fuel utilisation helping the body use more fat at rest. For sports people we also see improved endurance performance.

How to do it:

Cycling – 3 x 30 second all out sprints with 4 min recovery 3 x a week for 2 weeks. Or 10 x 6 second sprints with 1 min recovery 3 x a week for 2 weeks

Runing – Hill Sprints 4 x 30 second all out sprints with 4 min on an incline of 1:10 3 x a week for 2 weeks.



Non-responders: this area of the programme was

poorly presented. It does not mean that some people will never respond to exercise. We can all respond toexercise, in fact we all have the potential to be Super Responders, we just need to find the type and intensity of exercise that works for us. For some it’s lifting weights, others it’s slow and steady and others short and sharp. We just have to find what makes us tick!

We all have the potential to be Super Responders

Drawback: HIT alone typically only expends 250kcal per week. It doesn’t matter how good HIT is at improving insulin sensitivity, glycemic control or how convenient it is compared to hours at the gym if you eat more than you use you will put on weight.

Disclaimer: I must insist you consult your GP before trying HIT to ensure you are safe to do so.

Shin Splints Medial Tibial Stress Syndrome (MTSS)

This is one of the most common complaints seen in runners and running based sports people, but it is avoidable if you are prepared and take care of your body.

Just like Achilles Tendonopathy that we reviewed last month, it can start as minor discomfort that if left untreated can progress to debilitating pain and advanced muscle and bone injury. For this reason we must be aware of it and keep an eye out for the signs and symptoms.

An over-use injury? Or an under-prepared injury!

Your calf muscles are one of the most powerful muscle groups in your body. They originate on the end of your thigh bone above the knee joint and attach to the heel via the Achilles tendon. What is less well known is that the muscles have a long attachment to the bone that runs along most of it’s length. This is where MTSS occurs. Repetitive overload from the muscles onto the bone causes damage to the top layer of bone. The tissues attempt to repair but are re-injured every time you exercise leading to damage on top of damage.

The factors contributing to this injury can be intrinsic (from inside the body) or extrinsic (from outside the body).

Intrinsic Causes (inside the body)

-Insufficient muscular strength

-Poor flexibility

-Muscle Imbalance

-Abnormal biomechanics

-Poor nutrition

Extrinsic Causes (outside the body)

-Unrealistic increases in training load

-Sudden change in training/playing surface

-Improper footwear

-Too much too soon

These factors usually occur in combination and can take time to cause pain, by which time damage has been done and must be treated immediately by a Sport Rehabilitator.

However, now that you know the causes you can assess your training behaviour and physical preparedness to identify which factors you need to eliminate.

Symptoms include deep tightness and tenderness to the general calf, this can be felt after running, during running and eventually for prolonged periods even at rest. The medial or inside area of your shin bone may be sore to touch.

MTSS is often refereed to as an over-use injury, but it could just as accurately be defined as an under-prepared injury.



Hot or Cold Therapy? -coming soon

Anatomy of your Favourite Muscles-coming soon

Gym Training Makes You a Better Runner

…it’s true!

It is a myth that the only way to get better at running is to run more.

There are many factors involved in making you a better runner, including cardiovascular endurance, power, stride length, efficiency and muscular endurance.

Cardiovascular endurance is the main area that you will improve with your running training. The other factors however can be dramatically improved through a careful, progressive gym based strength routine.

Myths/Fears Dispelled: “I’ll bulk up and that’ll make me slow.” Do not fear bulking up or that weight training will make you slow. The truth is, increased muscle strength, strength-endurance and power output increases your running speed and can knock minutes off your times. Unlike excess body-fat, active tissue carries itself.

“Any spare time I have should be spent on the road.” Your body needs time to recover from a run and the gym is a fantastic place to aid recovery and work on the more subtle aspects of training.

The Advantages:

  • Adds variety offering a break from the norm.
  • Allows you to work in the mirror so giving visual feedback on previously unseen problems/bad habits.
  • Injury prevention. Gives you a chance to address and prevent muscle imbalance that could lead to injury if undiscovered.
  • Allows you to train your balance and coordination. This is crucial in increasing your efficiency of movement by encouraging good quality movements and improving your motor control.
  • Utilises different energy systems to help you manage your body composition including body fat percentage.
  • Good environment in which to stretch and put into practice the flexibility work that all runners can improve on.
  • Good environment in which to implement a Core Stability element. This increases your running efficiency and offers a strong guard against injury.
  • Good opportunity to experience the benefit of classes such as Pilates, Yoga and many others that will improve you running and add further variety.
  • Gives you a chance to meet other runners and exercise professionals and ask questions or share ideas.

Key Tips:

Get an induction from a gym instructor.

Start with large, multi joint movements (squat or leg press instead of seated leg curl, upright row instead of bicep curls and lateral raises).

Once you are comfortable in the gym, aim to progress not just in the weight you lift, but, also in the complexity of your exercises and movements.

Keep running and keep looking for new and exciting ways to enjoy your training.

Stretching & Flexibility


We all know that we should.

Sometimes we do, sometimes we don’t.

Plenty is written and professed on the subject of stretching with some outstanding work and some less than convincing work. For the purpose of this post I will offer my view on the application of Static Stretching.

Athletes at all levels of participation typically perform warm-up and/or stretching exercises prior to any physical training or competition. The warm-up routine may vary significantly from athlete to athlete, but the primary aims are always the same;to reduce the risk of injury and to improve performance. Stretching is overwhelmingly recommended by Sport Rehabilitators and trainers and is so practised by the vast majority of athletes in almost every sport and discipline.

However, there is constant debate, and strongly conflicting views exist of the best way to warm-up and stretch. As a result many sports people remain confused as to how they should best prepare for strenuous activity. Is warm-up necessary? Should I stretch before exercise, and will it improve or impede my performance? How long should the stretch be held and how many times should a muscle be stretched? These are some of the most common questions asked by athletes and they remain unanswered.

Static stretching is probably the most commonly practised form of muscle stretching techniques. And is the form of stretching referred to in this post.

Let me first make the distinction between Stretching and Warm-up. They are two very different things, but not entirely separate. Warm-up should precede any physical activity or stretching and should thus be regarded as Preparatory Exercise.

Preparatory exercise aims to prepare the body by increasing muscle temperature and elasticity and increasing blood and oxygen delivery to the working muscles. The primary benefits of Preparatory Exercise are two-fold: Improve Performance and Reduce Injury Risk. These benefits are well documented.

Static stretching involves placing a muscle in a lengthened position and holding it there for a period of time. The primary benefit is Increased Muscle Length.

In a person of desirable, neutral flexibility Preparatory Exercise is adequate for readying the body for Training and Reducing Risk of Injury. Stretching is not well documented as a method of reducing injury risk in a person of neutral flexibility. In which case I recommend that an athlete performs 5 minutes of moderate intensity cardiovascular activity prior to training.

For anyone who cannot claim to have neutral or perfect flexibility the rules must be altered slightly to accommodate their lack of flexibility. Get your flexibility assessed accurately and start addressing any muscle tightness immediately.

Aim to achieve neutral or perfect flexibility suitable for your sport or sports or choice. Only then can you truly rely on your warm-up to help reduce injury risk.

If you have a tight muscle, it is already at an increased Risk of Injury. Take action to stay injury free.

Part I:

Stretching before and after exercise is important for preparation and cool-down purposes. However, if you are aiming to improve your flexibility it is imperative that you put time aside for stretching sessions in addition to your current routine. Start with one a week, aim for three.

Muscles are thermo-elastic, meaning they become more elastic when heated. For both safety and increased effectiveness, perform either 5 minutes of moderate cardio vascular exercise to the point of mild sweat, or take a 10 minute hot bath prior to your flexibility work-out.

There are various stretching techniques, each with its advantages and disadvantages. In this piece Static Stretching has been chosen in order to provide safe and convenient methods for use in the home or wherever you are. The static stretching method involves passively lengthening a target muscle by placing it in a maximal position of stretch and holding it there for an extended period of time.

There are certain rules to achieving the safest and most effective static stretch:

1) Warm up first (as described above).

2) Apply a stretch to the target muscle until you feel 8 out of 10 on the pain scale (“0”=no stretch at all, “10”=very painful stretch)


3) Hold this position for 30 seconds

4) Do Not bounce (otherwise it would be called “Bouncy Stretching!”)

5) Repeat steps 2-4 until you have stretched the muscle 3 times.

Hip Flexor: this muscle group runs down the front of the thigh from just above the pelvis to just below the knee. Tightness is very common. The picture shows an aggressive stretch, you may wish to place your back knee a further forward.

Keep it simple, do it well.

Hamstring: a well known and poorly looked after muscle group. This is my favourite stretch for the area. Keep your front knee nice and straight and point your foot away. Keep your back neutral or “flat.” It’s not easy to reach the floor so use a chair or Swiss Ball to aid balance.

Be patient and take your time. Have fun and enjoy your new-found flexibility.

Part 2: Building on the Basics

Now that you have had some time to practice your warm-up, remember the key principles and the two techniques, let’s apply what we’ve learned to two more vital stretches.

Quadriceps: this muscle group comprises four muscles that run from approximately the front of the hip joint down the front of the thigh. They cross the knee joint via the knee-cap and join the shin at the bump just below your knee-cap. Tightness is common and many injuries are preventable if you can maintain good “Quads” flexibility.

To stretch, keep your knees together and try to get your foot tight to your bum. Tense your bum to gesture hips forward as in the top arrow. Keep the knee back as in the bottom arrow. If you can, place the foot by your buttock onto a sturdy surface behind you, a slight bend in the standing leg will intensify the stretch.

Standing Quad Stretch

Glutes: the buttock muscles are often tight and, if they are not working properly, can contribute to back pain and lower limb problems. They are a group of more than four muscles and can be stretched in many ways. Get to grips with this technique to start getting your glutes flexible again. Using the diagram above, lie down and place one foot on the wall. Aim for 90° at hip and knee of the leg that’s on the wall. Place the other foot onto the knee. Feel the stretch into the buttock/hip of the other leg. Push your bottom into the floor to intensify.

Tip from the Top: Last issue we learned that muscles are Thermo-elastic (become bendy when heated). After your warm-up and completed stretch session, apply ice to your muscles to freeze-in the new length that you have achieved. Apply an ice pack for 10 minutes. Alternatively, if you’re feeling brave, you can relax in a bath of cold water for 3-5 minutes immediately after stretching.

I hope you have found this Stretching Special helpful and look forward to fielding any queries that you may have in the near future. Enjoy stretching safely!

An Ankle Problem that Won’t Go Away?

In my clinic I often go through periods of similar injuries presenting all at once. The recent trend has been ankle sprains and related ankle problems with the same question being asked of me, “will I always have weak ankles?”

The most commonly injured ankle ligaments are the ones on the outside or lateral aspect, comprising Anterior (green) Mid (red) and Posterior (yellow) Ankle Ligaments.

The ankle is a complex series of joints essentially joining the lower leg to the foot. Where the two bones of the shin end we have the prominent “ankle bones” sticking out on either side. These bony prominences are where the ankle ligaments originate. Take a look at fig.1 below. The ligaments branch approximately down onto the nearby bones of the foot to give support and also send vital information to the brain and spinal cord about what the ankle is doing and where it is in space.

A typical “inversion sprain” of the ankle. The foot twists excessively inwards, under weight bearing, causing lateral ligament injury.

An ankle sprain almost always occurs when you take your weight on the foot and it twists under you, most commonly with the foot turned in, but can occur with the foot turned out causing injury to the inside (medial) ligaments. When this occurs the ankle or foot is taken through a range of movement too great for the ligaments to resist (fig. 2). The result is excessive stretching, tearing or complete rupture or snapping of one or more ligaments.

The role of ankle ligaments and the effect of a sprain are easy to understand and help us to appreciate the role of Sport Rehabilitation. As previously mentioned, the ligaments give key sensory feedback about where our foot and ankle are in space. Indeed if we are twenty five or seventy five years old our ligaments have spent that time learning the many movement patterns and working in partnership with the foot and ankle. When a ligament is sprained fibres of the ligament are damaged or lost and must be repaired and replaced. The new fibres do not know the many movement patterns and must be given time to grow, become strong and learn before we can say we are 100% fit. If we return to sport too soon however, or fail to rehabilitate fully how can we expect our ankles to be 100% fit? Injured ankles need Rehabilitation.

I don’t believe in weak ankles. I do believe in strong Rehab.

Occupational Rehabilitation – take care of yourself

In the Work-Place

Ever tried sitting in the same position for eight hours in a row? Sounds like a long time doesn’t it. You can imagine getting a numb bum, stiff back, tight neck and shoulders, stiff legs maybe. Well that’s precisely what you’re doing for 8+ hours a day and for 46+ weeks a year. Is it any wonder that the average office worker has back, neck, shoulder and various other complaints?

Just because everybody does it doesn’t make it okay.

Follow these tips to combat these problems and liberate you from your sedentary desk posture that at times makes you feel twenty years older than you are.

At Work:

Organise your Tasks: to allow variety and give you a reason to change position and move around.

Get Up! Take a wonder but make it constructive, instead of emailing a colleague in the same office or building go and speak to them, people like to talk to your face. Go to the water cooler, most don’t drink 3 litres a day so it’s doubly good for you.

Get your Workstation Properly Assessed.

In Most Offices it’s the Law

Mobilise your Back: sit smartly and rotate your trunk 12 times each side to look behind you. Do this with your hands over your navel and with arms crossed.

Stretch your neck: sit as above and flex to one side to move your ear towards your shoulder as pictured. Use just a little help from the hand to apply a stretch to the uppermost side of your neck.

Out of Work

Take regular exercise: 30 mins a day Monday-Friday

(No time? Pah!!) stop a tube stop or two early and walk to work. Take a walk after dinner, it’s a lovely way to catch up with your partner rather than just sitting near each other watching the TV. Exercise like this will get you moving your body after a day of sitting in one position at your desk or driving up and down the motorway.

Employees: make it the norm in your office and everyone will benefit. It’s good for your physical and mental health to move about and it will help prevent injury. The best employee isn’t the one glued to their desk with the most back ache, in fact this is the employee most likely to be forced to take prolonged leave due to occupational injury.

Absenteeism Costs Industry Billions £££

Employers: absenteeism through occupational injury such as back pain costs industries billions. Occupational pain and work related injury also reduces productivity and increases negativity among employees. A pain free workforce is a happier more productive one and when employees feel cared for their loyalty and quality of work increase significantly. Support your employees’ interest in and pursuit of exercise. Consider the value

Muscle Soreness

We are talking about Delayed Onset Muscle Soreness or DOMS. 

This soreness can take 24 to 48 hours to appear and another 24 to 48 hours to go away. Symptoms include tenderness to touch, stiffness and loss of flexibility and aching when using these muscles.

It is part and parcel of sport and fitness so I have put together some tips and tricks to help you deal with it. Many of these you may already know, but I wonder how many you actually do each time you exercise.

Always do a 5 Minute Cool Down

When we exercise we are intentionally putting stress on our bodies and this stress can cause DOMS. This is soreness within the muscles caused by microscopic tears in the tiny fibres that make up the muscles. With the right cool-down, refuelling and rest the soreness can be dramatically reduced, allowing your tissues to repair so you can get back out there and train and perform at your best.

Rehydrate & Refuel: take on small amounts of fluid during exercise and ensure adequate hydration over the hour following. The first 45 mins after exercise are the best time to get protein and simple carbohydrates into your body to provide the building blocks for tissue repair. This will greatly decrease the amount of soreness you experience and allow you to experience the full benefit of all your hard work.

Stress + Repair = Fitness

Stretch: as soon as you finish training, perform 5 minutes of light cardio to flush out the waste products of exercise such as “lactic acid.” Then perform three thirty-second static stretches to all of the major muscles you have been using. Put 15 minutes aside especially for this.

Rest: make sure you have a day or two in the week where you either train light or just do a stretching session. Ensure that you are getting your 8hrs’ sleep per night to allow your body to repair muscles and replenish fuel stores.

Get  a Massage

Sports Massage: is an effective aid to muscle soreness. Immediate Post Exercise Massage helps the removal of waste and “lactic acid” as part of your recovery and sports massage between exercise and competition forms an effective aid to Repair.

Aching is a sign of hard work, but if you find that you are having persistent muscle pains or you have lost your enthusiasm for training due to fatigue, you may be suffering from an over-training condition. If this is the case you should talk to a Sport Rehab practitioner right away.

Exercise on the Beach-in Secret…

Instant Tan and Tone!

So you’re packing to go on holiday and you wish you’d done a bit more fitness work before departure? So what! Everyone knows you feel most confident, most positive and most toned immediately after exercise.

Now you can have that post exercise confidence on holiday, whilst you top up your tan and without anyone even realising you are working out.

You don’t want to be doing burpees and down-face dogs on the beach pointing your derrière at every Tom, Dick and Javier. So let’s keep it discreet and dignified. From your sun lounger or towel position you can perform some great toning exercises. We are going to avoid any real movement because let’s face it, doing full on press ups is either going to look showey-offey or just plain rude. And you can get arrested for that.

Here are four crackers:

The man appears to be gazing out into the big blue, he’s actually putting as little weight on his arms as he can so his abs are doing all the work to hold this position. See how long you can hold it for. Do it 3 times and try to beat your time.

Straight Leg Raises:
can be done on your front for your bum and rear thigh. Do them on your back for your front thigh and a bit of abs. If your back hurts on the latter, bend one knee like the man pictured above. Do it 3 times and try to beat your time.

no more flabby arms. Push up to raise your chest and tummy off the ground and hold it for as long as you can. Keep your pelvis on the floor and try not to use your back. Do it 3 times and try to beat your time.

Total Abs:
carry on reading Cosmo or Clarkson whilst working all of your abs. Normal plank on your elbows and toes, hold for as long as you can. Side plank as pictured, hold for as long as you can on both sides. Do each one 3 times, try to beat your time.

Keep watered and slap on the sun protection, there’s no use in having a beautiful body if you have to hide it ‘cos you Lobstered yourself!

The Isometric Workout

What would you say to a workout based on staying still?

Forget running, cycling, swimming and forget speed and agility. Here’s a calorie burning, muscle toning, core strengthening workout that you can do any time, anywhere with nothing but your own body weight (plus Spandex and sweat-band).

Make sure you can see a clock or stopwatch. The plan is to hold a sequence of challenging exercise positions in a circuit style, rest and repeat.

Start with a 10 second hold in each position

Squat: (feet and knees hip width apart) aim for horizontal thighs. Your head should always be higher than your hips as pictured.

Too hard? Hold on for support or perform ½ or ¾ depth.

Too easy? Hold your arms straight above your head.

Press-Up Position: Toes & Hands, tense bottom, straight line from top to toe as pictured.

Too hard? Put your knees on the floor.

Too easy? Do straight arm side plank as pictured, do 10 sec right arm then change without resting the knees do 10 sec on the left. Or hold mid press-up with your arms bent ½ way.

: Elbows & Toes. Tense your bottom and keep a flat low profile as pictured.

Too hard? Place elbows on a chair.

Too easy? Do 10 sec with one foot slightly lifted, do 10 sec on each side. Or do 10 sec with one arm slightly lifted, do 10 sec each side.

: Ankles and Knees together. Lift to form a straight line through shoulder-hip-knees. Bottom Tense.

Too hard? Only raise up ½ way.

To easy? Place your hands on opposite shoulders.

Perform one legged; time 10 sec on each leg.

Perform 10 seconds of each position and rest for 2 minutes. Aim to do this 3 or four times through. If it’s too hard, use the regressions in Blue or hold for shorter time. If it’s too easy hold for 20, 30, 45 or 60 seconds and check out the progressions in Red.

Remember to do a cardio vascular warm-up for 5-10 mins before to achieve a mild sweat and 15 minutes of static stretching to arms, legs and abs to finish.

Have fun and let me know how you get on.

Joint Dislocations

When you think of a joint you might imagine a knee, a shoulder or the knuckles of your fingers. Three primary structures keep these joints in place; the shape of the joint surfaces, the surrounding ligaments and the muscles that cross the joint.

A dislocation occurs when the surfaces of a joint are forced away from one another, resulting in pain, visible deformity and an inability to use the joint.

take all injuries of this nature seriously

When a joint suffers a dislocation there can be joint surface damage, muscle damage and weakness and almost always ligament damage. Your recovery is dependent on the extent of this damage, the medical treatment you receive following injury and how vigilantly you follow your Rehabilitation Programme.

First Aid


Apply Ice

Immobilise the area

Seek immediate Hospital attention

Particularly in cases of childhood dislocation and congenital instability, a joint may pop out and back in with or without excruciating pain, often leaving the injured person confused as to what has actually happened to them. These cases should be treated like any other dislocation with immediate Hospital attention and full assessment by a trusted Rehab professional. Following First Aid and Hospital attention there will be a period of strict rest before Rehab exercises can commence, but be patient and get ready to put all of your energy into your recovery.

be patient and get ready to put all your energy into recovery

Once a dislocation has occurred there is an increased likelihood of recurrence so take all injuries of this nature seriously and take steps to promote as comprehensive a recovery as possible. If you have suffered repeated dislocations you will undoubtedly be apprehensive of particular activities and live in fear of your next dislocation. There is a reason that you have had a number of incidents with the same joint and it is advisable to seek a full assessment of your current condition.

You may have developed a major muscle imbalance or certain postural or behavioural patterns that increase the likelihood of your injury happening again. There is nothing worse than going through that pain and the lengthy recovery process only to suffer another dislocation and have to start all over again.

In some cases there are surgical options that may be appropriate and in all cases a comprehensive physical and functional assessment is the best starting point to get you on the road to your fullest recovery whilst answering your questions and dispelling your fears.

Two exercises, Twenty minutes, Every Major Muscle

Two Unbeatable Exercises for a Total Body Workout


The sun is shining and what could be better than getting brown and fit at the same time? You can exercise from the comfort of your garden or hit the park or green for a 20 minute session and know you are healthier and browner than you were 20 minutes before. Please remember to wear sun protection and take a bottle of water with you.

These two exercises are all you need to top up your tan and your tone this time of year. You’ll work your thighs front and back, your buttocks and inner thighs along with your sides and stomach with no fancy equipment required. Get stuck-in!

The Burpee: there’s no escaping the toughness of this feared drill, it’s hard because it’s seriously good for you.

i) Begin standing straight, feet together. Bend down to place your hands down in front of your feet (knees inside your arms). ii-iii) Take your weight on your hands and either thrust both feet back to the rear or step one at a time into the full press-up position (middle picture). iv) Now thrust or step your feet forwards to where they were, bringing your knees close to your chest and your weight back onto your hands. vi) Finally, from this squat position, jump high in the air, landing softly. Repeat. Perform 3 in a row then rest for 2 minutes. If that’s comfortable add a couple, aim to be able to perform 12 in a row. Perform 3 sets of 3-12

Turkish-Get-Up: slower and more controlled than the Burpee with just as many muscle groups.

i) Start in standing with your right arm above your head (keep it there). ii-iii) step back with your left foot into a full lunge, resting the knee. iv) Put your left hand on the ground adjacent to your hip, take your weight on this hand and your right foot so you can bring your left foot through to the front. v) Sit down. vi) Lie down. Now perform the sequence in reverse. Sit up, lift up and swing your left foot back and rest the left knee. Take your left hand off the floor so your trunk is upright. Step back out of the lunge. Perform without any hand weights initially. Perform 2 with the right hand up then 2 with the left hand up then rest for 90s. As you improve just repeat the sequence again before resting as often as you like.

20 minutes of these three times a week and you’ll feel fit and toned in no time, remember to do 5 minutes’ light jogging or running first to warm up and perform 15 minutes’ static stretching afterwards.

New Winter Sport Injuries

I’m already seeing an influx of Winter Sport related injuries in the Clinic, most of whom will rehabilitate to full fitness with just a little patience and a touch of hard work on their Rehab programme. My concern however is for those of you who may have suffered an injury already this season, or may be one of the unfortunate ones who by the end of the season will have sprained, strained, fractured or dislocated something and will fail to make a full recovery. With fitness resolutions and health goals set for 2011 the last thing we all want is to be put out of action, especially if a treatable injury is allowed to develop into a long term nagging and painful problem.

“Untreated injuries can turn into long term problems.”

The 3 P’s of Personal First Aid: the aim of First Aid is to Prevent the condition from worsening, Protect the injured area and Promote recovery. So if you suffer an injury, major or minor, do everything you can to prevent it from worsening, protect it and get on the road to recovery. This starts with the PRICE principle: Protection, Rest, Ice, Compression & Elevation. Do this for 48hrs and be sure to seek professional advice in order to Promote recovery and ensure your return to exercise is appropriate.

Return to Exercise: if you return too soon or at an inappropriate level you risk re-injury. On the other hand, if you avoid exercise for too long or fail to progress appropriately you risk weakness and failure to make a full and active recovery.

“All injuries should be taken seriously.”

Common Winter Sports Injuries include knee ligament and cartilage tears, shoulder muscle strains or dislocations and wrist & thumb ligament sprains or even fractures. All of which should be taken seriously in order to limit the extent of the damage, find out what tissues are injured and put the right treatment intervention and rehab programme in place. The first 48 hours are crucial. Look after yourselves this winter sports season whether you are Skiing, Snowboarding, Skating, Luging or one of many local sports people in the middle of your competitive season and to all you runners, cyclists and triathletes out there.

If you have any questions relating to Sport Rehab, injuries, health and fitness you know where to find me. See you soon.


Your body, like any tool or machine, needs to be taken care of, maintained, checked and repaired. Exercise burns fuel that needs to be replenished and the rigours of exercise cause fatigue that needs to be alleviated.

You have a 45 minute window after exercise in which you must cool-down, stretch, refuel and rehydrate.

Why Cool Down? During exercise your body expends large amounts of chemical energy that leaves behind large amounts of chemical waste in your body. This waste must be removed from your muscles and tissues in order for recovery and adaptation to take place. If left to settle and stagnate you will feel prolonged stiffness and your muscles will remain short and tight.

You have 45 minutes to cool-down, stretch, refuel and rehydrate

The Cool Down: Don’t stop dead and rush through your stretches like you’ve got something more important to do, or worse still, hit the showers and leave without kick-starting your recovery. You need to slow the body processes down gradually over about 5 mins through gentle jogging, light rowing, low resistance cycling, fast walking or easy swimming. This will allow you to settle your breathing, heart rate and blood pressure. This active part of cooling down also keeps the muscles gently contracting and relaxing acting like pumps to help remove lactic acid and the other waste products. If these waste products are allowed to settle in the muscles and tissues they will cause increased muscle soreness, tightness and dramatically increase the risk of future injury to these tissues.

Static Stretching: this involves placing the target muscle in a lengthened position and holing it there for an extended time. You should hold your stretches for 30 seconds at a level of moderate but bearable discomfort and repeat twice for each muscle. Learn which muscles you have been using and prioritise your functional stretches for that session.

Put your enthusiasm into every aspect of your health and fitness

Eat and Drink: next you need to start replacing the fluids lost and energy expended and also deliver the building blocks for muscle repair. Aim to start taking on water and fruit juices gradually at this time, best served close to body temperature. Eat and drink a good mixture of simple carbohydrates (natural sugars) and complex carbohydrates (starchy foods) for energy. Vitally, eat or drink a light meal or supplement that offers up to 30g of healthy, lean protein for repair within these 45 minutes. For meat eaters, 30g of protein can be found in a tin of tuna steak or a medium chicken breast. Many protein supplements such as shakes and bars may proclaim to deliver more than 30g per serving, but this is purely to catch the eye of the unwitting consumer. If you consume more than 30g of protein you will simply excrete the excess.

Thirst is not an accurate measure of hydration. Look when you pee because when hydrated your urine will be just lightly coloured. If it is darker and has a strong odour, you are already approaching dehydration. Water is vitally important to hydration and is best absorbed at a temperature close to your body temperature (37°C). For best absorption and rehydration aim to drink slowly and steadily rather than gulping down pints at a time.

Warm-up, work hard and start your recovery straight away. Put your enthusiasm into every aspect of your health and fitness.


The Healing Power of the Pool

When injury strikes, rest is advisable. Total rest however can do as much harm as good. “Modified Activity” describes it better.

Modified Activity: eliminate aggravating activities as much as possible, but keep fit via other forms of both cardiovascular and strength training.

The pool is an ideal environment in which to reduce aggravation and maximise strength and fitness whilst injured. Through buoyancy, hydrostatic pressure and heat, the healing power of the pool can get you on the road to recovery.

Buoyancy: particularly with lower limb and back injuries the “weightless” effect of water can take the weight off the area enough to allow early return to activities such as walking, sidestepping and squatting. In all cases, buoyancy will help you to lift submerged limbs and body parts, especially when holding or attaching a float.

Reduces Swelling: Getting rid of swelling is key to reducing pain and regaining normal movement. A submerged object is subjected to Hydrostatic Pressure. This is like a compression bandage but will not restrict your movement. The compression helps in the body’s absorption and removal of the fluid that is causing swelling and pain.

Reduces Pain: the body can only deal with so many sensations at once. The billions of water molecules brushing against the skin of the injured area can cause hyperstimulation of the pain sensing nerves. This causes the body to be temporarily distracted from the pain to give you both relief and more natural movement.

Warmth: as the body senses the heat of the water, pain is further reduced by the same mechanism described above. The warm water also increases flexibility and mobility by reducing muscle spasm and warming the stiff scar tissue that is associated with injury.

Keeping up your aerobic exercise through modified swimming will help in maintaining your cardiovascular fitness, which is key to your return to sport. Particularly with lower limb injuries; running, cycling and other training activities can be difficult and limited in their intensity. Placing a floatation device between your knees will allow you to swim using arm strokes alone, which can really challenge your fitness and upper body endurance. Continuous swimming for 20 minutes will give you a really good workout.

Whenever you pick up an injury that requires rest before returning to sport or activity, always consult an injury professional to fully understand your problem.

Running is a Single Leg Activity

From the moment you start running you will not have both feet firmly back on the ground until the moment you stop.

Single Leg Stability is the foundation of efficient and injury free running.

Watch this space for isolated, integrated and functional training drills to improve your running & reduce your injuries.

With many of us in the thick of Marathon Preparation, could this be the key?

In the Mirror:

Stand on one leg!

Sounds easy?

Do it again with hands on hips without letting your hip rise or fall on one side.

Are you leaning away from the lifted leg? Stand straight!

Is your lifted leg hiding behind your standing leg? Don’t let it!

Don’t let the legs touch eachother!

Your standing knee should be looking straight back at you, not moving left or right.

I trust you are keeping your standing big toe down. This will stabilise your arch to help balance.

Getting all of these things right sets the foundation for better running.

Have a go!


Time to make it a little harder…

Perform shallow Single Leg Squats

Sit back into your hips and knee as if sitting on a chair that’s a little too far away.

Touch your standing knee with both hands, pause then return to stand tall on one leg.