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

 

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

Runners MOT – Brighton Half Marathon

physio or chiropractic for PFS in BrightonRunning injuries often start with a niggle. Knee pain, muscle strain, tendon pulls, bursitis, ligament sprains and all sorts of other aches and pains are a constant reminder that marathon training and actually running it can be a hazardous business. Many people who enter for the Vitality Brighton Half Marathon will not complete it because of injury. We aim make sure you are not one of them.

For the next few weeks we are offering a free Runners MOT especially aimed at runners in the Vitality Brighton Marathon. We want you to be fit, strong and ready to run in support of the Sussex Beacon.

Our physios will check you out top to bottom concentrating on your footwear and leg and foot movements. We will check all the usual things like over-pronation but also things that often over-looked like jamming of the hinge joint of the ankle which changes stride length. We will look at knees, hips and backs too. At the end of our Runners MOT you will have an in depth risk profile of the likelihood of future running injuries and a plan for prevention. If you are having problems currently then we will give you a plan for the best recovery.

So don’t let a niggle turn into a pain, call to make an appointment.

VBHM logo

 

 

 

 

Bupa and Axa PPP cover our chiropractors and physio’s in Brighton

Bupa accpetedHere at Sundial Clinics, Brighton we often get asked if patients can claim their fees back from their health insurance companies. Most of the time, you can.

At Sundial we have chiropractors and physiotherapists who are recognised by both Bupa and Axa PPP.   Both these private health insurers have a restricted list of recognised practitioners in each speciality.  To become recognised, there are a number of requirements, including being in practice for more than 5 years  and having references from medical consultants. We also have to adhere to strict guidelines on quality assurance, patient satisfaction and probity.

If you are thinking of making a claim on your health insurance for chiropractic or physiotherapy then it’s worth checking your policy to see if there is an excess and to check the limit of the cover. You will then need to call your insurer to get a claim number which you can pass on to us. We can claim your fees back from your insurer directly or you can pay us and can claim back the fees yourself. You may also need to be referred by a GP in order to make a claim. This is usually straightforward and GPs are generally happy to do this.

If you need an MRI scan or an x-ray, this will often be covered as well. Things that aren’t covered include extra services such as massage and products such as nutritional supplements and orthotics.

Pre-existing conditions

Most health insurance companies will not accept a claim for pre-existing conditions. If you have back pain that comes and goes, it can be difficult for an insurer to assess whether or not this is a pre-existing condition or whether the back problem completely resolves and each presentation is in fact a new episode. If you have any doubts as to which sort of back pain you have then please get in touch as we may be able to help in providing the insurer with accurate information.

Sometimes an insurer will suggest another practitioner in your area. If, however, a practitioner is on your insurers approved list, you can choose to see who you like. If you have any queries, please give us a call.

 

Axa PPP

Simply Health WPA

How to treat Shin Splints

Shin splinPhysiotherapy leg examts or Medial Tibial Stress Syndrome (MTSS) is easy to treat if the problem is caught early. If symptoms of pain along the inner border of the shin bone (tibia) goes on for too long then significant damage can occur to the muscle and bone bone coverings and the condition becomes chronic. Brighton physio, here at Sundial, James Masterson explains.

What can I do to help myself?

Rest and ice – Ice can be an extremely effective pain relief for shin splints as it acts as a local anesthetic by numbing sore muscle tissue. It also helps to slow down the inflammation and swelling process which occurs with injury.

Take down inflammation – Anti inflammatory medication may help to reduce any swelling and speed up your recovery time. Please consult your doctor before taking any medication.

Wear appropriate footwear!! – It may be beneficial to visit a specialist running shop where you can be advised about what might suit your needs. On average running shoes should be replaced when worn for between 300 and 600 miles, depending on factors such as body weight, running style and training surface. In some cases orthotics (inner soles) may be used to help abnormal loading throughout your lower limb and correct issues such as over-pronation and supination. More information on orthotics here.

 

What can the physio’s at Sundial do to help?

The first stages of rehabilitation may include advice to rest from aggravating activity for a while. We can give you ice packs to use of the first 2 day after the pain starts or is aggravated by the offending activity. We will help you switch to low impact exercise such as swimming and cycling and advise on how best to incorporate changes to maintain strength and fitness. Only in extreme cases is protected weight bearing necessary.

Foot alignment

An important part of the recovery process is assessment of foot alignment and walking/running analysis to highlight any potential problems. Advice on appropriate footwear and the
In more severe cases our physio care involves laser therapy which improves healing, reduces pain and takes down inflammation. Soft tissue techniques such as massage may also help to ease tight muscles associated with shin splints or MTSS. application of inner soles may also be of benefit. We are experts in this sort of advice and work with local running shops to get the best footwear for you.

We will also advise on a home exercise plan consisting of stretching, balance and strength exercises to help too. This is an important part of your recovery along with a graded return to activity with symptom free progression.

 

Causes of Shin Splints -more here

Marathon Training Tips: take the simple, natural approach

Marathon training tips are easy to come by.  There are many many articles written about running and, of all the sports, this is where many so called experts seem to know it all. Especially when it comes to marathon distances. Guest contributor PT Pete shares his experience of natural marathon training.

If you flick through any of the running magazines you will read lots of different articles and written with many differing opinions. Some will suggest you run two long runs a week, others will say one long one and 3 shorter ones while others will suggest something completely different. They will often look very complicated, enough to put you off training in the first place!

Having run the Brighton Marathon and the London Marathon I get asked a lot about my training routines and you know what, I genuinely didn’t have a set routine.

I knew I had to run 26 miles. I hadn’t run more than 12 miles in one go so that was clearly the main goal, to run further that this. I decided I would run ONE long run a week, slowly increasing as felt right, and one or two short runs.

BUT…sometimes I did two long runs and that was it. I went with how I felt and still do. Trust your body to let you know what sort of shape you are in and how hard to train.

Marathon Training Tips

  1. Note some distances in your car, get to know your area in mileage and plan some routes and get out and start running.
  2. Allow enough time to train ( as in months ); know your fitness level and your starting point.
  3. Get some comfortable trainers (not the most expensive).
  4. Get a check up from a good physio. Sundial do a Runner’s MOT with Quentin. He’s great. See my story about how he helped me here.

Running is as natural an exercise as it gets, we’ve done it for thousands of years and it shouldn’t be complicated. There are some great routes around Brighton. Get out there and enjoy running around seeing the world from a different perspective!

PT Pete

Brighton based trainer PT Pete is one of the UK’s top trainers. He has worked all over the world as well as in some of the most exclusive London clubs. He has run marathons both here in Brighton and is now training for the Marathon des Sables – the toughest foot race in the world.

Chiropractic on the NHS

Do you think chiropractic should be available on the NHS? A new study shows how effective chiropractic on the NHS can be. The research into a pilot scheme in Essex has just been published and it shows that more than 99% of patients referred were satisfied with their care. Interestingly chiropractors worked alongside osteopaths and physios to get these favourable results.

When a patient went their GP with back or neck pain they were assessed and could be referred into the manual therapy program. They were sent to their choice of chiropractor, osteopath or physio and were seen within 2 weeks. Gone were the long waiting lists for referral to other NHS services.  Gone was sole reliance on a fistfull of drugs and a photocopied leaflet of exercises. Patients had a series of about six sessions of manual therapy, guided exercises exercises and advice.

Two out of three of these patients showed good improvements in their pain levels and daily activities. Importantly, nearly half had had pain for a year or more with very little relief. Finally they found something to help them.

Of the 696 people who went along to these therapists most reduced their medication as well.

Brighton Chiropractors and Physio’s Working Together

Here at Sundial we have chiropractors and physio’s working alongside each other too. Although we are wholly in the private sector at the moment we support getting NHS cover for our patients. For this reason we support the Health Care Bill which is attracting so much controversy at the moment.

If you want chiropractic more widely available on the NHS ask your GP to consider it.

References

Evaluation of a general practitioner referral service for manual treatment of back and neck pain

Mark Gurdenet al

Primary Health Care Research & Development Primary Health Care Research & Development, FirstView Article : pp 1-7

Can regular chiropractic care prevent back pain here in Brighton?

If you are one of the four out of five people will go on to develop regular bouts of back pain after an initial attack, this is an important question to answer. For over 100 years chiropractors have claimed that regular treatment can prevent recurrences of back pain. Are we right?

For most of the 20th century, medical treatment, including here in Brighton, consisted of bed rest and painkillers for back pain. Unfortunately, this contributed to an increase in the cases of recurrent back pain. From 1980 until 2000 the number of days off work in the UK due to back pain doubled every decade.

Eventually, GPs stopped treating back pain this way and accepted what chiropractors and others had been saying that active treatment is best. It is also true that chiropractors accepted that painkillers and anti-inflammatory medication are also helpful, whereas up until then old school chiro’s often shunned drugs.

Medical Treatment for Back Pain

Even now, however, back pain treatment from the doctor consists of a brief course of physio or medication which stops as soon as the symptoms stop. If you have had recurrent back pain you will be all too familiar with the trips to the doctor, prescriptions for strong drugs, referral to the physio (after a wait of many weeks) then being given a few exercises. You are probably fed up with your back feeling vulnerable and about to go at any time. You may even find that you’re limiting your activities to avoid the things that bring it on. If so, what can be done to prevent the dreaded back pain from returning?

Well, new medical research, published in 2011, suggests that an initial intensive course of manipulation such as our chiropractors in Brighton do here at Sundial, followed by periodic checkups and treatment may help prevent long-term back pain from re-occurring. Interestingly, those that did not receive the continuing course of care lost their earlier improvements.

Preventative Chiropractic Treatment Works

So the evidence seems to point to an initial course of treatment over a few weeks to get rid of the initial pain and improve function followed by a course of care over the next few months to make sure that those improvements are maintained. Here at Sundial we use the best available evidence to guide our treatment and we generally stick to this sort of plan in helping you get better.

If you would like to know if preventative chiropractic care can help you then give us a call for an initial chat, at no charge.

Reference:

How a Brighton Physiotherapist Can Help With Shoulder Pain

If you are looking for a physio in Brighton to help with shoulder pain then we can help.  Shoulder pain can affect up to 1 in 3 people at some time. But how does physio help with shoulder pain? What does a physio do and how successful is it?

Shoulder Pain

The shoulder is one of the most complex joints in the body. Unlike the hip joint which has a deep socket for the ball of the thigh bone to sit in the upper arm bone, the humerus, sits in a shallow cup. Ligaments tie the bones together. The cup is deepened by a rim of cartilage but this itself can tear and cause pain. The shoulder and chest muscles wrap around the shoulder joint to hold the bones in place as well as move the bones themselves. It is this complexity and the competing goals of flexibility and stability that make the shoulder joint a target for injury.

Physiotherapy Examination

With so many possible structures to go wrong in the shoulder, the first thing our physios do is examine and probe the tissues, testing ranges of movement and looking for restrictions  and weaknesses. Simple tests often show up where the problem is but sometimes x-rays are needed which are carried out at Sundial or we refer for MRI or ultrasound scans.

Brighton Physiotherapists

Our physios are some of the best in Brighton and are experts at diagnosing shoulder problems. Once a firm diagnosis is made then treatment can start. The treatment for shoulder problems is a partnership between you and the your physio. You may be given exercises to gently mobilise stiff joints as well the physio carrying out precise mobilisation procedures here. You may also be given muscle strengthening exercises which can work wonders at getting to the root cause of the problem as well reducing the pain signals from the injury.

Brighton Physiotherapists Secret Weapon

Our secret weapon in the treatment of shoulder injuries is our Thor laser. It is one of the few units in the whole of Sussex. Laser is remarkably effective in reducing pain and inflammation and also at  improving  healing. Studies have shown laser to be more effective than many other treatments for shoulder pain including ultrasound.

Our physios work with other practitioners where needed to bring about the quickest benefits. Sometimes bringing one of our chiropractors to work alongside can improve the outcome of treatment especially where spinal joint problems are playing a part in the shoulder dysfunction and pain.

So if you have pain in the shoulder and would like to get rid of it make an appointment to see one of the physiotherapists at our Brighton clinics. To download a free physiotherapy check certificate go here.

References

Comparison of the effects of low energy laser and ultrasound in treatment of shoulder myofascial pain syndrome: a randomized single-blinded clinical trial.

Rayegani S, Bahrami M, Samadi B, Sedighipour L, Mokhtarirad M, Eliaspoor D.

Eur J Phys Rehabil Med. 2011 Sep;47(3):381-9.

Runners MOT – New

Most runners know that a good warm-up and warm down routine, including stretches, is likely to minimise the risk of injury whilst running. In spite of this, the injury rate in runners is still too high, especially knee injuries. Runners are increasingly us to help prevent injuries as well as treating them once they have occurred.

We are helping out with the Rockinghorse runners again this year. Antony our physio has already been giving training tips and we have all been helping runners get over niggling training injuries. If you are running, whether for Rockinghorse or not, you might like to book an appointment for our Runners MOT. Bring your running shoes along and we will check them out along with your back, hips knees and feet for running problems. Some problems will not cause pain until they build up to a critical point so don’t wait for symptoms to tell you if there is an issue.

The fee for this service is £5 which we will donate to the Rockinghorse charity.