Do I need orthotics for running?

Orthtoics for Runners KneeWhy would I need orthotics?

Although running shoe design and technology has progressed leaps and bounds over recent years, there are certain foot types that will require more support, explains James Masterson, physio here at Sundial, Brighton.  However not everyone will benefit from orthotics and it’s important to gain professional advice before deciding on whether an orthotic is right for you.  A full biomechanical assessment from a physiotherapist or chiropractor can help determine whether the underlying root of the problem stems from your feet and whether or not an orthotic is appropriate for your foot type.

Orthotics can help running and are designed to optimize the alignment of the lower limb, which can improve shock absorption in the lower extremity and realign joints from the foot all the way through the kinetic chain to the spine, preventing problems foot, knee or hip.  The main role of an orthotic is to restore a neutral alignment which will in turn reduce the stress carried throughout the body during weight bearing activities.  This is particularly important during running as (hopefully!) the feet are the only part of your body in constant contact with the ground.

An orthotic can either be an off the peg prefabricated orthotic, with a selection made to fit most general foot types, or a custom made orthotic, normally constructed by a podiatrist which is made specifically for the individual. The off the peg orthotics work well for most people and are considerably cheaper. We sell Superfeet orthotics at Sundial.

Another important factor worth considering with orthotics is that most people change their shoes several times throughout the day.  Although your running shoe will provide you with support whilst you’re wearing them, it’s likely that you will spend more time out of these shoes than in them.  This can potentially lead to overuse injuries during regular every day activities, especially if your profession requires you to spend large amounts of time on your feet.  This is another way in which an orthotic can be useful as it can often be taken from one shoe and placed in another.  However orthotics aren’t your only option and if possible should only be used as a short term solution, please see my future posts on physiotherapy exercises to improve overpronation.

The three basic foot types:

Firstly, it should be noted that pronation is a natural movement of the foot’s mechanics.  It occurs at the joint below the ankle called the subtalar joint and this movement allows the foot to roll in slightly during the stance phase of gait and helps the lower limb deal with shock.  Although this process is not necessarily detrimental to your body it can affect your running style and possibly lead to injury.

 Neutral foot:Over pronation, Brighton physio

This means that you’re a neutral pronator, meaning your foot rolls in slightly and you push off evenly through the front of the foot.  Sometimes you can tell if someone is a neutral runner by looking at the sole of their shoe, running from the heel to the big toe along the outer surface there will often be signs of S-shaped wear and tear.


Underpronation, or supination as it is often referred to, is when the outer surface of your foot hits the ground at an increased angle causing minimal or no natural pronation.  Again this leads to access shock throughout the lower limb and can be potentially damaging to your body when running.


There is significantly more inward rolling of the foot meaning more weight is transferred to the inner surface of the foot late in the stance phase.  This causes instability and leads to compensatory movement patterns throughout the kinetic chain, potentially leading to injury throughout the lower limb and within the spine.

If you have any queries or want more help then book in for a free Runner’s MOT


Happy running.

Running shoes – top tips for the marathon season from Brighton physio

Choosing running shoe, Brighton physioIf like me you’re considering starting your preparation for the up and coming marathon season then take a look at my top tips for staying injury free and completing the 26.2 miles with a smile on your face says James Masterson,  a physiotherapist here at Sundial, Brighton.

Which running shoe shall I buy?

Inappropriate footwear is the root of all evil when it comes to running.  Before embarking on the long and tedious road to the finish line every runner should start with their feet.  Visiting your local running shop for a gait analysis is a good place to begin. As well as being advised on the most appropriate running shoe for your foot type it’s also an opportunity to view yourself in action.  Video analysis taken during these consultations will allow you to look at your lower limb alignment whilst you’re walking and running, giving you a good idea of movement patterns which could potentially lead to overuse injury.

 Top 5 running injuries caused by over use and inappropriate footwear:

1. Plantar fasciitis

2. Achilles tendinitis

3. Medial tibial stress syndrome (aka shin splints)

4. Patellofemoral pain syndrome (aka Runners knee)

5. Iliotibial band syndrome

When it comes to purchasing your shoe it’s likely that you will come across the below terms. Remember it’s not all about what foot type you are!  Take the time to get a feel for the shoe, being able to stand, jump, walk and run before handing over your cash is a great way to find out if the shoe works for you and reduce the risk of injury later in your training.

Useful tips for purchasing your running shoe:

  • Try having a foot analysis in the late afternoon/evening as your feet swell as the day goes on and may give you a false feel when purchasing your running shoes in the morning.
  • Pick a shoe that matches the contour of your arch, you won’t be able to feel this by just standing in them so always make sure you take them for a spin before handing over your cash.
  • Try and have your feet measured before trying on your shoe, this will give the running shoe assistant an idea of the size and width of your foot.  Different brands suit different foot types and not all shoes will equal in size, for example, Nike shoes tend to be good for wider feet and Adidas tend to be better for a narrow foot type.
  • Don’t buy your shoes too small, the fabric will loosen as time goes on but generally if a shoe has hot spots that aggravate your feet whilst trying them out in the shop then it’s likely this will occur during your training.  Remember! Tight shoes equal blisters and potential toenail damage, this will limit the amount you’ll be able to train and will also look horrendous in a pair of flip flops.
  • Lace your shoe up from the bottom up, not just at the top two eyelets!  This allows you to support the shoe around your foot equally and avoids excess movement.  Your heel should fit snug within the shoe and your toes need to have some wriggle room at the front.  A good test for this is to see if you can still scrunch up your toes whilst the shoe is fully laced up.
  • Change your shoes according to your individual usage, most manufactures will recommend that you change your shoe roughly every 300 – 500 miles but this is dependent on so many factors, for example a person’s weight, gait mechanics and running terrain will all play a massive factor in your choice to change your shoes.  Let’s be honest running shoes are expensive, so my advice is look for signs of wear and tear and as soon as the natural cushioning of the shoe starts to depreciate this is probably a good time to start looking for your new runners.

If you have any queries or want more help then book in for a free Runner’s MOT.

Happy running.

Next: Do I need orthotics?



Sleeping and sitting named as top triggers for back pain

Choosing a mattressWhat are the commonest causes of back and neck pain? Surprisingly most people don’t mention strenuous exercise but sleeping and sitting as their commonest causes of neck and back pain.

A new survey asked people throughout the South East about their neck and back pain. 76% said they were currently experiencing pain in the neck or back or had done so in the past. 43% said that sleeping caused their problem whereas 44% said sitting was also a trigger.

With 4 out 5 people spending 6 hours or more in front of a computer screen and 19% spending 4 or more hours in front the the television it could be that modern lifestyle is to blame for these high figures for neck and back pain.

As part of Back Pain Awareness Week (6-12th Oct) we are raising awareness about this issue and encouraging everyone not to take it sitting down. By being more active you can drastically reduce neck and back pain. Understanding how to sit properly and keeping active will help improve posture, strengthen muscles and therefore reduce neck and back pain

TOP TIPS for maintaining a healthy back and neck:

  • Sit up straight – keep arms relaxed and close to the body and place arms on the desk when typing. Make sure the top of the screen is level with the eyebrows and the chair is titled slightly forward, allowing for the knees to be lower than the hips and the feet to be flat on the floor. Workstation help.
  • Keep moving – if sitting in the same position all day take regular breaks – ideally every 30 minutes. It’s good to stretch your arms, shrug your shoulders and move your fingers around – this helps to keep the muscles more relaxed. RSI treatment and prevention.
  • Switch off – try to limit the time you spend leaning over you mobile devices or with your laptop on your knees especially after a day spent in front of a screen, to help improve your posture and relieve neck strain.
  • Sleep easy – test out your mattress before you buy it to find the perfect one and lie on your side rather than lying on your front with your neck twisted to one side. Mattress help.

For more information on how to maintain a healthy posture, here is a simple, three minute exercise programme for all ages, designed to help strengthen the spine and improve posture and help joints. To watch a video of the exercises you can do, please visit:

If you have a neck or back problem you might like to see one of our Brighton chiropractors or physio’s then call 01273 774114.

Research was commissioned in January 2014 on a sample of 2006 UK adults.

*Sample of 408 adults from the South East responded to the question ‘have you ever suffered from neck or back pain’ and 312 adults from the South East responded to the question ‘how often do you suffer from neck or back pain’.

Never too old to exercise

Older runnersWe often think that as we get older we will inevitably have to accept that we will be limited by ill health, aches and pains. Whilst it is true that our bodies change we are often more able than we think. More and more people are taking up sport and exercise at a later age and are surprising themselves with what they can achieve.

In a recent study of 3500 people one in ten people, aged 64 on average, took up regular exercise. The effects on health and disability were amazing. People who started doing even moderate activity at least once a week were three times less likely to have developed a nasty illness or disability over the eight year study. Those that had always been active and stayed that way were seven times less likely to be ill.

Interestingly the study found that not only the expected illnesses were less likely in the active group but mental health was too. So heart disease, stroke and diabetes were less likely but also Alzheimer’s disease, depression and cognitive function overall was better. Although this study did not look at back pain or other bone and joint problems specifically other research has noted benefits here too.

So the message is clear – if you are active already – stay active. If you are inactive – get active.

The British Chiropractic Association has produced some simple exercises to improve strength and flexibility. The Straighten Up campaign is a series of easy exercises you can do at home in a few minutes. If you do these three to four times a week or ideally every day you will notice differences in you abilities in two weeks.

If you fancy something a bit more vigorous then running, tennis and cycling and swimming might be more your thing. These sports are wonderful for endurance and improving cardiovascular health. In fact anything that gets you heart pumping and gets you a bit out of breath is good. Golf is great but you might want to consider something more vigorous.

Karate recommended for older adults by Brighton chiropractorIf you want to try something a bit different then consider a martial art. Something like tai chi which you learn in small classes as well as doing at home can be fun. This works on balance and strength as well as flexibility. Even more vigorous martial arts like karate can be done until well into old age. It is all about being young of heart rather than limiting your options.

Go on – give something new a try. I took up karate a year ago and love it. It is marvelous for balance, strength and flexibility as well learning new things I never thought I could do. To learn more about a great local karate club in Brighton go here.

There are more tips here for staying active when you are older.

M. Hamer, K. L. Lavoie, S. L. Bacon. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. British Journal of Sports Medicine, 2013; DOI: 10.1136/bjsports-2013-092993



Neck pain treatment – what works?

Chiropractors BrightonNeck pain is remarkably common with nearly half of us suffering at one time or another. Worst of all it keeps coming back.  Many different types of treatment are currently used so which ones should you choose if you have neck pain? A recent review into the best ways to treat neck pain has just been published and it makes interesting reading.

Manipulation or mobilisation are good treatment options for neck pain especially when combined with laser therapy and advice, stretching and specific exercises. Massage can be helpful in combination with other forms of treatment but not on its own. This package of care is what our chiropractors and physio’s do here at Sundial.

The treatments that don’t have evidence of working for neck pain include TENS machines (is anyone still using these?); traction and trigger point therapy (a form of deep pressure on tender tight points in a muscle).

These findings are broadly similar to the Bone and Joint Decade (BJD) Task Force report on neck pain in 2008.  In this report they go further by recommending acupuncture and pain killer medication. The list of treatments unlikely to help for neck pain are the same but go on to advise against surgery, collars, ultrasound, most types of injection into the neck and radio-frequency denervation.

The BJD report offers some helpful advice about choosing the right sort of treatment for a bad neck. Don’t expect to find a single “cause” for your neck pain. Stay as active as you can, reduce mental stress and try over-the- counter pain relievers first. If pain persists then seek treatment form a practitioner with the right sort of expertise. The authors conclude that no one treatment is likely to help everyone and you may need to mix and match approaches to find what works for you. Any treatment should show some improvement in your symptoms within two to four weeks. If not try something else. This advice also applies if you have mild whiplash from a road traffic collision for instance.

So what are the main points from these two reports? Two groups looking at neck pain independently have come up with very similar recommendations. These recommendations are also similar, as you might expect, for other spine related problems like back pain. Conservative treatment is best, you have to help too by doing the home exercises and keep going to find what works for you.

These messages are a big relief to the thousands of people who endure regular neck pain.



Evidence-based guidelines for the chiropractic treatment of adults with neck pain. Bryans R, Decina P, Descarreaux M, et al. Journal of Manipulative & Physiological Therapeutics 2014; 37: 42-63.

The Bone and Joint Decade 2000- 2010 Task Force on Neck Pain and Its Associated Disorders; Executive Summary,  (2008), Haldeman S, Carroll L et al. Spine 33(4S):S5-S7

Matthew attends WHO Health Assembly

Brighton Chiropractor Matthew Bennett at WHO Geneva
Matthew at the WHO

Matthew is attending the the WHO Health Assembly in Geneva as part of a delegation from the World Federation of Chiropractic (WFC). The Assembly meets every year to discuss pressing health issues around the world and to formulate strategies for dealing with them. The UK government is represented by a strong delegation including Health Secretary Jeremy Hunt and Chief Medical Officer Dame Sally Davies. The UK is pushing for better dementia care and more sensible use of antibiotics to prevent bug resistance.

At the keynote address, WHO Director-General Margaret Chan galloped through the tide of health issues facing not just the developing world but also wealthier nations. She touched on everything from the resurgence of polio to the the obesity epidemic in children. Unfortunately no mention was made of musculo-skeletal (MSK) disorders like back pain. That is why the WFC delegation is here; to raise awareness about the leading cause of disability throughout the world.

The recent report on the Global Burden of Disease concluded

“Low back pain causes more global disability than any other condition. With the ageing population, there is an urgent need for further research to better understand low back pain across different settings.”

Matthew talked with one of the co-authors of the report and a member of the WFC delegation, Professor Anthony Woolf, a UK based consultant rheumatologist about how musculo-skeletal problems are a public health issue. They are the leading cause of disability in all parts of the world and have a huge economic and social impact but are overshadowed by the big killers like heart disease and cancer. They agreed that all professional groups need to work together to address this growing problem.

The World Health Assembly meetings take place at the vast United Nations buildings here in Geneva. Outside there are views of the lake, flags fluttering and black limousines everywhere. Inside the huge assembly hall is hard to miss but trying to find one of the multitude of meeting rooms can mean a long trek from one side of the complex to the other and from the basement up eight floors to the top.

The WFC delegation consists of chiropractors, academics, researchers and doctors all with the goal of improving the provision of MSK care worldwide. The WFC itself was formed in 1988 and was admitted into official relations with the WHO in 1997 as a non-governmental organisation (NGO). The WFC represents the national chiropractic associations in 90 countries including the UK.

Health Secretary, Jeremy Hunt, and Director General of WHO Margaret Chan (2nd from left) at meeting on dementia



Sundial wins award

PPQM award for Sundial Chiropractors Brighton 2014Sundial has been awarded the Patient Partnership Quality Mark (PPQM) by The Royal College of Chiropractors.

The PPQM is awarded to chiropractic clinics that demonstrate excellence in meeting patient expectations in a range of areas including accessibility, cleanliness and safety and patient communication. The decision to award the PPQM is made by a panel of patients and public who form the Royal College of Chiropractor’s Lay Partnership Group.

The award was presented to clinic principal, Matthew, at a ceremony in London on 29th January by Lay Partnership Group member Mr Paul Shorten.

About The Royal  College of Chiropractors

Granted a Royal Charter in 2012 and the Royal prefix in 2013, The Royal College of Chiropractors  is an academic membership organisation with over 2800 members and the following objectives:

  • to promote the art, science and practice of chiropractic;
  • to improve and maintain standards in the practice of chiropractic for the benefit of the public;
  • to promote awareness and understanding of chiropractic amongst medical practitioners and other healthcare professionals and the public;
  • to educate and train practitioners in the art, science and practice of chiropractic;
  • to advance the study of and research in chiropractic.

Members and Fellows of the College have always embraced postgraduate training and Continuing Professional Development (CPD) in the public interest, pre-empting any statutory requirement. The College actively fosters patient and public involvement through its Lay Partnership Group. For more information, visit

PPQM logo 2014_2016

Is your spine slowing down your running?

photoIf back or hip pain is hindering your running performance and fitness goals then here are some facts to help put a spring back in your step writes Brighton chiropractor Amy Pease. Staying fit helps to prevent aches and pains, however various factors come in to play when pounding the pavements that could put you more at risk of injury. Pain in the low back or hips can arise from inflamed muscles, ligaments, nerves, discs or spinal joints. Injuries can range from mild muscle strains to more serious conditions such as a disc herniation; a chiropractor will be able to tell you the cause of any discomfort with an examination.

Injuries occur because of underlying dysfunction

When you run, 2-3 times your own body weight is transferred from your feet into your ankles, knees, hips, pelvis and spine every time your feet strike the ground. This process should not be painful when repeated regularly providing you have a good running posture and healthy function in your joints and muscles. However underlying muscle imbalances and stiff or unstable joints could eventually cause problems; this may not be noticeable until you increase your mileage or training frequency. For more information on two common muscle imbalances below.

3 Top Running Tips…

  1. Build up your mileage slowly – this gives your muscles, ligaments and joints time to adapt and build endurance to the increased workload, reducing your chances of injury.
  2. Strengthen your hips and core – weakness in these areas are often associated with a poor running posture and back pain. Strengthening these areas will help to stabilise your back and pelvis protecting your spine. The chiropractors and physiotherapists at our clinic can give personal advice on what exercises you should be doing. Alternatively Pilates or yoga may be useful.
  3. Get your shoes fitted by a professional – unstable arches or over-pronation when running often need rebalancing with a suitable trainer and/or a foot orthotic (a specialised insole). Trained staff at a running store should be able to advise you on choosing the right shoe. Additionally at Sundial we fit Superfeet orthotics.

If you think the topics raised in this article may apply to you, give us a call to make an appointment.

Weak hip abductors, unstable pelvis
Weak hip abductors, unstable pelvis


When you think about it, running is simply an uninterrupted series of jumps from one leg to the other. The hip abductors are an important group of muscles that stabilise the pelvis when standing on one leg.  So when one or more of the hip abductors are weak (usually the Gluteus Medius) the pelvis will drop on one side. This drop places increased forces through your low back and pelvis often causing stiffness or discomfort.  A recent study on 300 people found that people with low back pain had significantly weaker hip abductor muscles than those without. It is also common for the hip abductors to weaken after an ankle sprain on that side.



Weak abdominals, tight hip flexors
Weak abdominals, tight hip flexors


Weak abdominal muscles allow the pelvis to tilt forward; this overloads the joints in your low back often causing stiffness or discomfort. To compensate for this weakness your hip flexors will work harder. Interestingly the main hip flexor (Iliopsoas) connects to your spine and pelvis, and can be the root cause of low back pain when aggravated. Your deep abdominals (obliques and transverse abdominus) along with your back muscles work together like a brace to protect your spine when performing bending or twisting movements, learning how to control these muscles is essential to a healthy back.

Amy Pease

Free Spine Check for Kids on Friday 21st February 2014

Kids get back pain tooSundial Clinics, Brighton are supporting Rockinghorse with a new free spine check for children. On Friday 21st February 2014 Sundial will be carrying out free spinal check ups to check for poor posture and other causes of back pain as well as joint and muscle problems. Parents will be invited to make a donation to support the Rockinghorse Children’s Charity, which aims to improve the lives of sick children throughout Sussex.

Kids spine check includes:-

-Posture check
-Spine check
-Exercises to improve posture

Sundial chiropractor Matthew Bennett says

”Sundial Clinics have been a long term supporter of Rockinghorse and we look forward to raising money to support their excellent work for children in Sussex. Many children suffer from back pain and other aches and pains sometimes put down to growing pains. We can identify and help these problems.”

Kids posture smBack pain in children is more widespread than first thought. Researchers at Swansea University report a large increase in the number of children receiving treatment for back and neck pain. Research done by the British Chiropractic Association has found similar trends. Indeed as far back as 2005, 45% of children had suffered some kind of back pain by the time they were aged 11.

Richard Hollis, of Sundial Kemp Town is all too aware of this problem.

“As a chiropractor, I talk to a lot of parents who are concerned about their children’s posture and the health of their backs. Kids seem to need to carry so much more to school, do less physical exercise during the school week and then sit at home in the evening.” says Richard

As well as a posture check and spinal examination the Sundial chiropractors and physiotherapists will be giving exercises and helpful tips to keep children’s spines fit and healthy. Getting more active and tackling poor posture can help prevent back, neck and shoulder problems.
Straighten Up UK for kids is a simple, three minute posture care programme from the British Chiropractic Association, designed to help children feel and look their best. Straighten Up consists of just three simple exercises which are intended to be completed on a daily basis to become a part of a daily routine, just like brushing our teeth. Easy to learn and do, the sequence of exercises consists of precise, slow stretches, each with a specific purpose.

Analiese Doctrove at Rockinghorse Children’s Charity, added:

“This is an opportunity for parents to get their child’s spine and posture checked and to support Rockinghorse at the same time. The experts at Sundial can give plenty of tips and advice to help prevent aches and pains starting in the first place. By promoting an active lifestyle as well as balance, strength and flexibility in the spine, the risk of back problems in children can be reduced.”

To book an appointment call Sundial Queens Road or Sundial Kemp Town.

Here are some photos of the day.

Rockinghorse Kids Check 1

Rockinghorse Kids Check003 Rockinghorse Kids Check 2

The 7 R’s – Brighton Marathon Training Tips

Jewel runs Brighton Marathon
Jewel runs Brighton Marathon

The Brighton Marathon is the highlight of our sporting calendar. We have supported Brighton runners and their charities for many years but we have noticed that many people are not getting the support and advice they need to complete the marathon injury free. One in five people who enter the marathon will not complete it because of injury. We aim to make sure you are not one of them!

Pre-Training/Training Tips

Before you begin marathon training, you should be able to run for at least 30 minutes without stopping. Distance is not important right now. You just need to get your body used to running.
Combinations of runs/walks are great to use during pre-training because they ease your body into the exercise and minimize the chance of experiencing a running injury. Follow a set schedule or rota of training leading up to the event, so that you can set yourself small goals to work towards on a weekly basis.

Recovery Tips

Take recovery days equally as serious as your running days.
You should not run every day as your body needs to rest between runs, so it can recover from one run to the next, getting stronger between each run.
Use your non-running days to rehabilitate and to refuel with the right foods.  Ice any soreness, particularly in your knees or shins, four times per day for 15-20 minutes.  Stretch all the muscle groups in your legs, spine and upper body as you use them all!

Injury prevention

Never run through an injury, get it checked out by a professional!  Most of us are aware to use the RICE (rest, ice, compression and elevation) principle if we sustain an acute injury such as an ankle sprain or shin splints but there are other, less acute pains to be aware of, that may turn from a niggle into a strain.
Wear the correct footwear.  Your trainers should be no more than 6 months old or have been subjected to 500 miles of running.  Older shoes lose shock absorbing ability and increase the risk of injury. Check the soles of your trainers for abnormal wear as this could indicate a biomechanical problem elsewhere.  When choosing new running shoes go to a running shop staffed by experienced runners who can advise you on the correct shoes for your foot and running style.

The 7 R’s for marathon training

Run for 30 minutes before starting specific training
Rota – set up a schedule of training with goals
Rest is important because your body builds muscle, strength and stamina in this recovery phase
Refuel – improve your diet with our video program to get the right building blocks for recovery
Rehabilitate – stretch all over and ice any injury
Replace worn out running shoes
Runners MOT – this free check up is available to all Brighton Marathon runners – don’t let a niggle turn into a pain
Our physios and chiropractors support Brighton marathon runners with the offer of our Runners MOT at either of our Brighton clinics.  So if you have an injury or just a niggle, call and get it checked out!