Brighton half marathon recovery tips: how to manage an acute injury

knee-examination-brighton-physioAs a physiotherapist, I get asked how to manage an acute running injury a lot and having just completed training session or race itself you may be asking the yourself the same question.  So in order to help you with your post run recovery here’s a few useful tips to ease you back to fitness and training for your next race.

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often  referred to in the industry as POLICE.  With each letter relating to a useful management strategy this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

Protection:  Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

Optimal Loading:  The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention.runners-start-vitality-brighton-half-marathon-sm

Ice:  Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

Compression:  Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation:  Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the affected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

At this point it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight-bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

James
Sundial’s Physiotherapist

VBHM logoSundial is a partner for the Vitality Brighton Half Marathon on 26th Feb 2017  providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you. Call for a free Runners MOT

How to beat running injuries with strength training

single-leg-squat-strength-exerciseTo avoid common running injuries you should follow the lyrics of Daft Punk – Harder, Better, Faster, Stronger!

As a physiotherapist I get to meet lots of runners with common overuse injuries and I believe most of these problems can be overcome with some simple strength and conditioning principles.

If you’re planning on competing in a running event this year such as the Vitality Brighton Half Marathon it’s likely that at some point during your training you will pick up an injury.  Like most people you’ll probably turn to the internet or a running magazine where you’ll find lots of information on the benefits of warming up and stretching but less likely to find any guidance on strength exercises for running.

In a recent study with 26,610 participants by Lauersen et al (2013), looking at the effectiveness of exercise interventions to prevent sports injuries, found that overuse injuries could be almost halved with strength training alone.

With this research in mind I have put together three basic strength and conditioning programmes for you to work on as part of your running training.  Begin with stage one giving yourself roughly four to six weeks or until you feel confident before moving onto the next programme.

3 strengthening moves for runners from Vitality Brighton Half Marathon on Vimeo.

Remember this is just a rough guide to strength training and your ability to perform these exercises will depend on many factors, so if you have an injury or you don’t feel confident then get it checked out!

Sundial offers a free 20 minute physiotherapy consultation to anyone who is unsure about an injury so please get in touch if you need any further advice.

James
Sundial’s Physiotherapist

VBHM logoSundial is a partner for the Vitality Brighton Half Marathon on 26th Feb 2017  providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Running the Vitality Brighton Half Marathon? Call for a free Runners MOT

Should you stretch as part of your warmup for running?

hamstring-stretch-on-floorShould I Stretch or Should I Go Now?
If I don’t there will be trouble and if I do there could be double,
so come on and let me know…should I stretch or should I go?

The great stretch debate has been going on for several years now with lots of conflicting views leaving the average weekend athlete confused and unsure what to do.  It’s a question I get asked a lot as a physio.

“Should I stretch before or after exercise and what type of stretching should I do”?

This is a quick and simple guide into the benefits of stretching for warming up and cooling down during your half vbhm-sussex-beacon-runner-smmarathon training.  At this point it’s probably worth mentioning that there is no one size fits all plan, every individual is different and because of the conflicting evidence on this subject this post is partly based on research and personal experience as a runner and physio.

A study by Simic et al (2012) concluded that static stretching as a sole activity during a warm up routine should generally be avoided, as it was found to reduce power, strength and explosive performance.  However, the negative effects were only short term and generally returned to normal after 5 to 10 minutes, these negative effects were also unlikely to occur if the stretch was kept under 45 seconds.

Behm et al (2011) documented that dynamic stretching either has no effect on performance or may improve performance especially when the stretching duration is prolonged.  However, the study also went on to say that static stretching used in a separate training session could actually improve range of movement and health.

Confused?  Join the club.

Behm et al concluded that:

“Generally, a warm-up to minimize impairments and enhance performance should be composed of a submaximal intensity aerobic activity followed by large amplitude dynamic stretching and then completed with sport-specific dynamic activities. Sports that necessitate a high degree of static flexibility should use short duration static stretches with lower intensity stretches in a trained population to minimize the possibilities of impairments”.

In other words if you’re doing an activity that uses long drawn out movements such as martial arts or ballet then static stretches may be useful.  However, if you’re a runner then short low intensity aerobic exercise, followed by dynamic stretches and finished off with a few running specific dynamic exercises is likely to be more important.

In my opinion stretching is very much a personal thing, I tend to spend 10 to 15 minutes warming up with a combination of light aerobic work followed by dynamic stretches and sports specific exercises.  When it comes to static stretches this is very much dependent on how much time I’ve already had away from the wife and kids, If I can get away with it I might spend 5 minutes doing short duration (under 45 seconds) static stretches on all the major lower limb muscle groups.

So to conclude you can find lots of conflicting views and counter arguments for all types of stretches, if you want my advice do what feels good for you but don’t spend all your non-running time stretching!  In my opinion a good balance between warm up, running, cool downs and strength work is the winning formula.

James
Sundial’s Physiotherapist

VBHM logoSundial is a partner for the Vitality Brighton Half Marathon on 26th Feb 2017  providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. Running the Vitality Brighton Half Marathon? Call for a free Runners MOT

 

Acupuncture and homeopathy to reduce symptoms of perimenopause.

Acupuncture BrightonThough the severity is variable, most women report experiencing some symptoms once they enter the perimenopausal phase of their lives, which may last anything from months to years until their periods cease at menopause. The average age for menopause is 50 with perimenopause generally starting in the mid 40’s although it is not uncommon for women to experience premature menopause and the onset of these symptoms in their late 30’s and early 40’s.

Common symptoms during this time include:

-Changes to the normal pattern of menstrual cycle with heavier or lighter bleed.
-Hot flushes.
-Night sweats.
-Difficulty sleeping.
-Reduced libido.
-Vaginal dryness.
-Headaches,
-Low mood, anxiety.
-Palpitations.
-UTI’s.

Case study:

44-year-old Etta was struggling and came to see me for treatment of her increased anxiety and extremely low moods, erratic menstrual cycle, low backache & hot flushes.
Having taken her case history it was evident that in the terminology of Chinese medicine it would be necessary to rebalance her kidney, heart and liver energy.
A weekly treatment plan of acupuncture was undertaken and homeopathic remedies were prescribed. Dietary changes were also suggested to help support with the inclusion of phytoestrogens such as cabbage, fennel, sage, alfa  & EFA’S.
Improvement was shown after the first treatment with Etta reporting a reduction in anxiety, hot flushes, and backache. After six weekly sessions a 29-day cycle was established and mood lifted. She now comes for monthly sessions to maintain her health and wellbeing addressing any symptoms that may arise.

I practice at Sundial Clinics in Brighton and in London, visit my website www.juliabaker.net for details.

To book an appointment or for further information you can contact me at hellojuliabaker.net or on 07791 345 053.

Sundial visits Sussex Beacon

brighton-chiropractors-matthew-bennett-and-richard-hollis-visit-sussex-beaconRichard and Matthew visited the Sussex Beacon recently. As keen supporters of the Beacon they were wanted to understand more about the amazing work going on there. They were shown around by Jason Warriner, Clinical Services Director, who explained the range of services provided by the Beacon which includes specialist care and support for people living with HIV. The service promotes independence and improve health and wellbeing by providing inpatient and outpatient services. The charity is  funded through donations as well as receiving some local NHS funding .

Richard said “The Sussex Beacon is an impressive organisation providing much needed support for people living with HIV. We love working with the Beacon and helping then achieve their goals by assisting with fundraising.”

Richard and Matthew learned that living with HIV can lead to complex health needs that require timely intervention from several health professionals. The 10-bed inpatient unit is well utilised and the other therapies and services provide a lifeline to many people experiencing the stress of coping with ill health.

Matthew said “The Beacon has a huge range of people with different skills working here. The dedicated staff make a massive impact on the lives of those with HIV. On top of that, they work with a cheery attitude that makes the Beacon a wonderful place to be.”

Sundial supports the Beacon by providing massage therapy at the Vitality Half Marathon here in Brighton. Last year Sundial carried out over 200 massages in three hours using 45 volunteers from Brighton Medical School physio course. During the day Sundial raised over £2000 to support the event. David Hill who organises the race also accompanied Matthew and Richard.

As preferred provider, Sundial also offers physiotherapy and chiropractic to Sussex Beacon runners at preferential rates. Sundial physio, James Masterson, also offers training and recovery tips for runners.

The next Vitality Brighton Half Marathon 2017 is on Sunday 26 February and entries are open now.

From left to right in photo above: Jason Warriner, Richard Hollis, Matthew Bennett, David Hill.

 

Matthew meets Minister at House of Commons

Matthew meets Minister Justin Tomlinson
Matthew meets Minister Justin Tomlinson

Sundial Principal, Matthew Bennett, recently attended a reception at the House of Commons and met a minister and several MPs as well as representatives from the MSK community. He was invited as President of the British Chiropractic Association to the launch of the new Arthritis Research UK report – Working with Arthritis. This report laid out the extent of conditions including back pain, osteoarthritis and other inflammatory conditions such as rheumatoid arthritis and the impact this has on work.

Matthew met Justin Tomlinson MP, Minister for Disabled People who said “Supporting disabled people into work is a priority for this government which is why our Access to Work grants are available throughout people’s careers.

“I strongly encourage employers and employees to take up this support so that we can reduce the disability employment gap and make sure everyone benefits from being in work.”

The Minister went on to say that the government was providing a further 25,000 places this year in addition to the 37,000 places currently available on the Access to Work scheme. This scheme helps especially small and medium-sized businesses provide support and to make adjustments to the working environment to get disabled people back to work and to keep them in work.

At a national level, the need to address MSK conditions in a work context is clear. Only two thirds of working age people with a musculoskeletal condition are in work and these conditions are now leading the cause of sickness absence, resulting in a fifth of all absence-around 3.6 million working days lost each year. Back pain alone cost the economy an estimated £10 billion each year. The burden of MSK conditions is likely to worsen as the population ages and people are expected to lead longer working lives.

The report highlighted that people with MSK conditions often make adaptations so that they can keep working. Some choose to change the type of work they do, reduce their hours, or become self-employed changing duties, flexible arrangements which allow people to work in comfortable settings and pace activity, and the ability to take emergency leave can help people with arthritis to stay in work.

Matthew Bennett said “The reception was a wonderful opportunity to meet the Minister and MPs and hear their views on the importance of MSK conditions. It is clear that the government is taking this problem very seriously

“Chiropractors have a key role in treating not only spine related MSK conditions but also advising and supporting people with other inflammatory conditions and osteoporosis. The BCA is committed to working with all stakeholders in the MSK community. Indeed, our vision is to become the leader in spine care and to work collaboratively to achieve this.”

Arthritis research UK is the charity dedicated to stopping the impact that arthritis has on people’s lives. Their focus is on reducing the pain and keeping people active. Their remit covers all conditions which affect the joints bones and muscles including back pain osteoarthritis, rheumatoid arthritis and osteoporosis. They fund research into the cause, treatment and cure of arthritis and they provide information on how to maintain healthy joints and bones and how to live well with arthritis. Along with BCA they are members of ARMA.

 

 

Knee arthroscopy not all it’s cracked up to be

physio or chiropractic for PFS in BrightonMany people with recurrent knee pain have keyhole surgery to trim the cartilage in the knee. Recent research suggests that this operation – an arthroscopy, is no better than doing exercises. This surgery is one of the most common in the UK. About 150,000 people, mainly middle aged and older adults undergo this procedure every year so you would think there is good evidence to show that it works.

Over the last 10 years several studies have looked at the effectiveness of knee arthroscopy. This includes studies that group together all these results in a so called meta-analysis. In science terms, this is a good as it gets – gold standard evidence one way or the other. It showed no benefit for keyhole surgery for the knee. Keen to sew this up once and for all this new study compared two groups.

A Norwegian team looked at people with knee pain with a tear of the cartilage (meniscus) which had been verified on MRI. The patients did not have any evidence of osteoarthritis. They divided these 140 patients into two groups – one group had the surgery and the other a 12 week course of exercises. The exercise group did a series of knee exercises two or three times a week.

The patients in the exercise group had improved muscle strength in the thighs and reported less pain, swelling and restricted joint movement. This is not surprising as surgery can cause these symptoms. Both groups reported similar improvements to the surgery group patients when asked about daily activities. Nearly a quarter from both groups went on to have further knee symptoms of pain, swelling and dysfunction.

If you have knee pain and have a suspected tear to the meniscus this study suggests that a course of supervised exercises would be well worth a go. The surgery for this condition is no better and may well be worse – especially in the short term. Given that surgery  carries a risk it merely highlights the benefits and safety of exercises.

If you have knee pain and want to have the best evidence based care then book an appointment with our physio.

Reference: BMJ 2016;354:i3934

How to manage an acute injury yourself

Runners knee pain“As a physiotherapist this is a question I get asked a lot and having just completed the Brighton Half Marathon you may be asking the yourself the same question.” says Sundial physio James Masterson.  He goes on to say “So in order to help you with your post run recovery here’s a few useful tips to ease you back to fitness and potentially your next race.”

Physiotherapists love an acronym and what used to be known as RICE or PRICE is now often  referred to in the industry as POLICE.  With each letter relating to a useful management strategy this acronym can be a helpful tool in guiding anyone suffering from an acute injury.

 Protection

Depending on the severity of your injury you may want to use a brace, tapping or in more extreme circumstances casts and crutches, this will help to prevent excessive movement and protect the site of injury.

 Optimal Loading

The key part to remember here is OPTIMAL, the right amount of loading will help stimulate the healing process of a muscle, tendon, ligament and bone. This could be any type of activity such as standing, walking or swimming, however in more serious injuries such as fractures or full tendon ruptures the OPTIMAL load might be no loading and may require casting, crutches or surgical intervention

 Ice

Applying ice during the initial stages of an acute injury can be beneficial for reducing both pain and swelling.  Although medical professionals have been recommending ice for several years the evidence is far from conclusive.  I usually advise my patients to wrap an ice pack in a flannel or thin towel and apply directly on the site of pain for 15 minutes 3 to 4 times daily within the first 72 hours of injury.

 Compression

Similar to ice compression can be used for managing swelling, applying a simple tubigrip or neoprene strap can help to compress the injury site.  The applied compression should be tight but comfortable with good circulation above and below the strapping, I often ask patients to remove the compression for short periods throughout the day and take the strapping of at night to allow the skin time to breath.

Elevation

Can also be very useful in reducing swelling.  For example, if you’ve acutely sprained your ankle lying on your back with your leg raised and supported can reduce the amount of blood rushing to the effected area.  With this specific injury you may wish to do a few ankle pumps to improve the blood flow and help with the healing process.

 At this point it is probably worth mentioning that I recommend anyone to seek medical advice if you are unsure about an injury.  Although the POLICE protocol is a useful tool for managing an acute injury it is not a one size fits all strategy!!  If you are having difficulty weight bearing or have symptoms such as bony tenderness, considerable swelling, loss of range of movement or the feeling of instability in a joint then I recommend seeing a medical professional ASAP.

Sundial Clinics offers a free 20 minute physiotherapy assessment to anyone who would like advice about an injury, this session is a great way to get some useful tips on how best to manage your injury and to see if physiotherapy is right for you.  Why not call the clinic today to arrange a free informal consultation and stop that niggle turning into a pain!

Sundial ready for Brighton Half Marathon

VBHM RunnerWe are making the final preparations for the Vitality Brighton Half Marathon on Sunday 28th February. In three days time we are proud to have a team from Sundial running the race as well as a team offering pre- and post-race massages, all in support of the Sussex Beacon.

The runners are in their final stages of preparation after months of training. They have endured windswept downs and blustery seafront training runs as they gradually clock up the miles to harden their muscles for the task ahead.  Their gaunt stares and smelly gym bags at work give away who is doing the race and who is not. Injury and illness have taken their toll and the full complement is down by two. Hopefully the rest of the Sundial team will remain healthy until they cross the half marathon finishing line on Sunday. The race starts at 9:00 on Madeira Drive so do please come along and support the team who will be running in Sundial colours.

We are also pleased to be part of the support team for the race itself. We have over 40 physiotherapy students from Brighton Medical School helping us out on the day. We will be providing pre- race massages to warm up those stiff muscles and get the blood flowing so the runners can fly round the course. Hopefully a few personal bests will be forthcoming too.

After the race we will help soothe tired and aching muscles and aiding recovery with wonderful massages. Massage also aids recovery so the muscle stiffness over the following days will be reduced. The Massage Tent on Madeira Drive by the Yellow Wave cafe will be a blur of activity as the massage therapists and physio’ students go to work. We expect the first runners will be back about 10:05 with the bulk of runners coming in at around the 10:30-10:45 mark.  We have over 200 massages booked and priority will be given to those that have pre-booked. If you want to  arrange a massage then book here.

Sundial are also the partners providing clinical care and advice for sports injuries for the runners. If you have any niggles then give us a call and our physio’s, chiropractors and massage therapists can see you quickly. All the money raised from the pre-and post race massages will be for the Sussex Beacon and we will be supporting their wonderful work by donating £10 from each new consultation to them too.

VBHM logo

Great stretches for running

Stretching may help reduce injury and improve flexibility in runners. Most runners include stretches in their routine. It is important to prepare your muscles for a run by gently warming up and keep flexible by doing these stretches. These exercises put together by our physio can help stretch the main running muscles.

These stretches should be held for over 30 seconds – don’t rush. Aim to do these exercises once a day although doing them twice a day is three times as beneficial. Stay relaxed and breathe out as you develop the stretch. Develop the stretches gently to avoid overstretching and injuring yourself.

The 3 stretches we recommend for running are: hamstring, hip flexor and calf and here is how to do these.

You can download the stretches for running for free here VBHM stretches

Hamstring stretch

Dynamic hamstring stretch

Sets three each side

Hold 30 to 60 seconds

  • straighten one leg, grabbed the back of your thigh and target your leg towards your chest until you feel a gentle stretch.
  • Bend your leg at the knee slightly coming off the stretch
  • repeat by pushing your heel towards the ceiling
  • alternate your legs

Note: avoid kicking violently or arching your lower back

If it’s shaking your doing it well!

Hip flexor stretch

Hip flexor stretch

Sets three each side

Hold 30 to 60 seconds

  • hands on hips, tuck your tailbone under to flat on your back
  • lean forwards while maintaining a straight posture and keeping your head up
  • avoid arching your low back or letting your hips roll forwards

Note: do it next to a wall if you feel out of balance

Calf stretch

Sets three each sideCalf stretch

Hold 30 to 60 seconds

  • have front toes and knee touching the wall
  • move your foot back a little until you can just about keep your knee against the wall and heel on the floor
  • hold
  • Move the back foot away from the wall to feel a stretch
  • keep back heel on the ground and knee straight as possible
  • hold
  • swap legs

In partnership with the Vitality Brighton Half Marathon

VBHM logo