Taking part in a cyling endurance event this summer? Read our 10 top tips for staying injury free and making it to the end!

I recently spent the weekend with my brother, Anthony, and his wife who live just outside Salisbury. Anthony has recently given up full time GP practice and now just helps out one day a week at a lovely, little, local practice.

Alongside his long career as a GP my brother has worked as the doctor for many charity bike rides. This has combined his love of cycling, travelling, photography and medicine as well as helping to raise a huge amount for various charities.

He has also learnt a thing or two about how to avoid injury and make it to your final destination in one piece!

Exciting announcement!

I’m proud to announce that Physio on the River is going to be one of the sponsors for the parents of Barnes Primary School who have formed a team of 42 cyclists and will be riding to Amsterdam this June to raise money for the school. We are keen to help them every way we can. So when visiting my brother I asked him for his top tips for doing a long cycling event like the one to Amsterdam. Together with some of our own ideas, here are 10 pieces of good advice.

Our 10 top tips for staying the distance

1. Gears

Get used to your gears – REALLY used to your gears. Otherwise you will simply get exhausted and you won’t make the distance.

2. Speed

You should be pedalling between 60-90 revolutions per minute. If you are going much faster, you will never make it to Amsterdam or wherever your heading.

3. Handlebars

Don’t grip the handlebars tightly. Get used to holding them loosely and let your elbows relax. Otherwise you can end up with Tennis Elbow or Carpal Tunnel syndrome (irritation of the nerve that passes across the front of your wrist and supplies your thumb, index and middle fingers).

You might even consider wrapping more sponge around your handlebars so you can’t grip as tightly. The padding will also provide more cushioning, so you are less likely to develop Carpal Tunnel syndrome.

4. Bums are less important than knees!

If you suffer from knee problems, have your saddle a little higher. If it’s too low your knees won’t make it to Amsterdam, but your bum will and it’s no good if you can’t walk when you arrive!

5. Saddles

Don’t wear a saddle cover because they slip around and can blister your bum. Get yourself a gel saddle but not a gel saddle cover. Don’t get anything with hair on it. Anthony once saw someone with a tiger fur covered saddle and the rider only lasted two hours! It just creates too much friction where you really don’t want friction…..

6. Training tips

When training don’t forget to throw in some swimming, especially backstroke as it’s great for strengthening your back and your back will take a lot of punishment on the ride. You want it to be strong and supple. It’s a great antidote to all that crouching over the handlebars.

In fact, my physio team and I would recommend plenty of variety in your training – not just cycling. Just like any big sporting event, addressing all aspects of fitness will help your performance.

Something like yoga or a stretching regime can help with flexibility. Hip flexors which cross the front of your hips, can get very short and tight in cyclists.  

Pilates exercises are great for improving your core strength. For your legs to power you efficiently you will need a strong core from which your leg muscles can work.

As mentioned earlier swimming is both good for back muscles and good for fitness. Going to the gym to strengthen your leg muscles is essential and whilst there, work on your aerobic fitness with some cardio work like rowing, running and cross trainer. Perhaps not cycling as I’m sure you will be spending plenty of time on that in your training already!

Try and mix up your training so you include a selection of activities through the week. If you need any help both Physios, Richard and Dave, offer personal training at our clinic.

7. Bike fitting assessment

It’s important to make sure your bike is set up absolutely correctly for you. Our cycling ‘guru’ and Physiotherapist, Richard Game, is trained to carry out Bike Fitting assessments in our clinic.

The advantage of having a Physiotherapist carry out your assessment is that they can not only look at how the bike fits you – but also, how you fit the bike.

Very few people are completely symmetrical and most of us have areas of weakness or tightness in our bodies. For example, even though your bike may be set up correctly for you, you may cycle with one knee falling inwards. This may be because your buttock muscles are weak and have nothing to do with the bike set up. This is something that a Physiotherapist will pick up on and can help you address.

8. Working proactively on injury prevention

Bike fitting

Physio Richard can do a Physio screening assessment to identify any weak points in your body that could start to give you problems as you increase your mileage and up your training. Remember that cycling is a very repetitive sport! Once identified he can design a bespoke programme of strength and conditioning and flexibility exercises. You can be working on this programme alongside your normal cycling training. Prevention is so much better than cure.

9. Getting your soft tissues in tip top condition

Many keen cyclists have a very sedentary day job. Spending lots of time in front of your computer can often lead to poor posture and tight hamstring, hip flexors, neck and back muscles. Having some regular sports massages can help to get your muscles and other soft tissues in the best condition.

The Massage Therapist can work on your tight muscle groups and improve your flexibility. Massage is also a useful way to aid recovery following the event. We have a team of three Massage Therapists who are all experienced in pre and post-event massage. In fact, Rachel is a triathlete herself, so knows all about preparation and recovery for big events.

10. Hydration and nutrition

Especially when abroad, use a capped water bottle. You are far less likely to get stomach problems – it’s amazing what the front wheel flicks up!

Anthony recommends that nibbling long-burn carbs/protein (nuts and fruit) is more fun than putting additives into your water bottle. The latter is only necessary on rides over 100k. Anthony advises to avoid meat at lunchtime as it ruins afternoon performance and isn’t needed.

He stressed the importance of ensuring you are pre-loaded with water at the start of your day. If you have not peed by 11 o’clock you should be worried. If you haven’t peed by 12.30, stop riding as dehydration lurks.

We hope you find these tips useful and we wish charity teams all the best for their endeavours over the summer months!

Next steps…..

If you would like to book a Bike Fitting Assessment or a Cycle Screening Physio Assessment with Richard, or you are interested in a sports massage, personal training or our Yoga and Pilates classes, just:

Call us on 020 8876 5690

Email us here

Or simply pop in for a chat – we are always happy to chat things through first.

Hear how Physio Dave helped a keen runner with persistent Achilles Tendinopathy

I recently caught up with one of our keen running clients, Patrick, who came to the clinic complaining of chronic Achilles Tendinopathy. Read on to find out how Physio, Dave Burnett, helped Patrick recover so that he could return to distance running again.

Hi Patrick- tell us a bit about yourself and what sport and exercise you do?

As a retired rugby player and triathlete my body has taken a bit of a battering over the years. Nowadays I cycle as my main sport but still enjoy running and swimming.

How and when did you develop your running Injury?

Achilles tendinopathyIt was probably a combination of not warming up properly, pushing too hard and the uneven surface that must have aggravated my Achilles tendon problem. When you are only a short distance out the tendency is to keep going to the end which probably just aggravated the situation even further.

What did your physiotherapy involve and how did you find it useful?

Dave at Physio on the River was great! Things were made easier as I was being treated by him for a shoulder injury at the time and he saw me hobble in and immediately diagnosed the issue – which was a Chronic Achilles Tendinopathy. So, after a couple of sessions of manual therapy treatment and stretching exercises for the calf, hamstrings and glutes (buttocks) we started the Shockwave treatment.

Describe your experience of shockwave therapy?

Shockwave for the achilles tendonI had 4 sessions of Shockwave which involved getting hammered by metal pads 100 times a second! It hurts the first time, although I think this was psychological and then after that it became quite therapeutic!

Whilst you mustn’t run immediately after the treatment, you can stretch and it’s important to do loaded strengthening exercises.

Every week I felt some progress. Once we had finished the Shockwave sessions we were able to progress to more explosive “plyometric” exercises. Apart from a blip when I may have done too much too soon, I was able to gradually build up the time and distance I was running and eventually the pace.

I am making great progress now. The important thing is to listen to your body and take your time. When you get injured after 50, it’s about managing the condition. The shoulder injury also helped as it forced me to go swimming and I was able to do more rigorous plyometrics in the pool. The positive benefits of swimming are extensive!

How are you getting on now and have you achieved your goals?

I’m in a good place now and am hopeful of continuing Park Run regularly and getting to that all important 22-minute milestone. My ultimate aim is to get back to half marathons.

What’s your brief understanding of how to manage your Achilles tendon problem in the long-term?

Should it return I should first  reduce the load, gradually re-load, add plyometric exercises and load even more -with marginal increments and take my time! Thanks very much Dave!

Thanks, Patrick, for sharing your story and illustrating so nicely how we treat and help people manage chronic tendon problems like yours.

Next steps….

If this has struck a chord with you and you’re suffering with a tendon problem, to make an appointment with Dave just:

Book online

Call 020 8876 5690

Email us here

Or pop in for a chat!

Is cadence important for running? Read Dave’s steps to success!

And why cadence may be something to consider……

If you have ever wondered what the Cadence measurement on your Garmin running data actually means, you should hopefully find the following advice useful!

Cadence (the total number of steps you make per minute) is dictated by your running style and can have a big impact on your running economy (i.e. your energy expended). It is also a risk factor for many running injuries.

What does the research tell us?

A 10% increase in step rate may reduce knee joint loading by up to 34% (Heiderscheit et al 2011).

Low cadence (<166 steps per minute) is linked with a 6-fold increase in shin pain versus a cadence less than 178 steps per minute (Luedke et al 2016).

Low cadence is typically seen with:

  • an “over-stride” pattern – see below left, versus good foot placement right. When over-striding the foot contact is made significantly ahead of the knee and the runner’s centre of mass. This is a common running style fault and injury risk factor.

  • similarly, increased ‘bounce’ or excessive vertical oscillation expends excessive energy and also poses a risk to injury.

So what is the ideal cadence for running?

The ideal cadence for running is thought to be approximately 172-190 steps per minute.

How do I go about making changes?

Changing your cadence can take some practice and it’s sensible to only increase by 5-7.5% at a time. Allow  2-3 weeks to accommodate this amount of change before you increase any further.

There are several mobile Apps available to help set and monitor your cadence and many running and sports watches will record cadence as part of their standard data. Additionally there are running coaching strategies and drills that can be learnt to aid the correction of over-striding or excessive bounce patterns.

How can we help you?

If you are unsure if your running style is a cause of any niggling injuries or are wondering if your running style is efficient, it’s best to have a Biomechanical Treadmill Assessment which we offer here at Physio on the River.

Physio Dave Burnett is our running guru and runs our running clinic. He can give your running style an MOT and coach you through any changes necessary. He can also help you resolve any old injuries you may be carrying.

Next steps……. (no pun intended!)

To book a Biomechanical Treadmill Running Assessment with Dave just:

Call 0203 916 0286

Email us here

Or simply pop in for a chat – we’d love to see you!

Keen cyclist? Read about our new Bike Fit service!

With Richmond Park and the Surrey Hills almost on our doorstep it’s not surprising that cycling has become such a popular sport in this area.

Cycling places unique demands on the body and, here at Physio on the River, we frequently assess and manage people with problems related to cycling. These include aches and pains caused by cycling and the way the bike fits the person, as well as movement issues and physical problems with their body that impedes their cycling – and often both at the same time!

Therefore, it is entirely appropriate that we are now able to offer a comprehensive ‘Bike Fit Assessment‘ by a Physiotherapist to ensure optimal performance, manage any individual musculoskeletal imbalances in the body, minimise injury risk and keep you pedalling joyously!

One of our team of Physios, Richard Game, is a keen cyclist and loves treating cycling injuries. He is also trained in carrying out Bike Fit Assessments. Read more about how Richard can help and the value of having a thorough Bike Fit.

10 most common cycling aches and pains

  1. Neck pain – whether you are on a road bike, mountain bike or a hybrid, your neck has to be unnaturally extended for long period of time in order to see the road ahead. This commonly causes neck pain and sometimes neck related headaches
  2. Hand pain – too much pressure on your hands (usually because of incorrect bike set up) can cause hand pain. Also pressure on the nerve can lead to finger tingling and weakness (a temporary nerve palsy)
  3. Forearm pain – this can be from over gripping the handlebars or incorrect set up causing too much load on the forearms
  4. Lower back pain – it’s not hard to see how flexing the back in an unnatural position for hours at a time can cause lower back pain! Correct bike set up can help to alleviate this.
  5. Hip pain – cycling involves an awful lot of repetition in a very static posture. Tightness across the front of the hips can pose a risk to developing hip pain
  6. Knee pain – incorrect alignment of the knee when cycling (allowing it to drift inwards or outwards) can provoke knee pain
  7. Ankle pain – the position of the foot on the pedal and the cleats can alter the alignment and loading through the ankle
  8. Foot numbness – pressure through the foot and toes can lead to numbness of the foot
  9. Saddle soreness – we’ve all experienced that I’m sure – but the position of the saddle in relation to handlebars and pedals can contribute more or less to this soreness
  10. AC joint soreness – the AC joint is a small joint that sits just above the main shoulder joint. It takes a lot of load transferred up from the arms and into the upper body. It too can get sore and lessening the load with correct bike set up can help to lessen the pain

So you can see that there are quite a few aches and pains that can develop and getting your bike fitted to you correctly can go a long way to alleviating the stresses through the various parts of your body.

What is the advantage of a Physiotherapist carrying out your bike fit assessment?

As Physios we can not only assess how the bike is set up correctly for you but we can also look at how well your physical make-up works on the bike! Not everyone is totally symmetrical and cyclists often carry old injuries and imbalances in their body. We have the background knowledge of the human body to assess what needs to be fixed in your skeleton and movement system for a more comfortable ride. So Physios can look at how well the bike fits you and how you fit the bike!

What is a bike fit assessment?

Bike fitting aims to maximise rider comfort. A well fitted rider should be able to sustain a relaxed position on the bike with minimal effort, without causing strain and overloading tissues.

Bike Seat position IS NOT a normal sitting position but on a bike! It’s an entirely different posture.

The key to a successful bike fitting is that the rider is relaxed, their posture is optimal, weight is distributed evenly and comfortably, the joints are extended optimally to produce power and the foot is stable.

What can you expect from your bike fit assessment?

Bike Turbo Trainer

A bike fitting will take approximately 75 minutes. You should attend wearing cycling clothing, the footwear you cycle in (cycle shoes with cleats if used) and of course, bring your bike!

You will have your bike connected to a turbo machine and expect to be riding for up to 25-30 minutes on and off whilst we carry out the assessment.

We may occasionally make recommendations on changes to components such as saddles, stems and handlebars and, as necessary, can help you to source them (though for most this shouldn’t be necessary).

We charge £180 for our new bike fit service.

Next steps…….

If you would like more information and a chat with our cycling physio guru Richard Game just:

  • call 0203 916 0286
  • contact us by email here

Need to exercise but short on time? Let us help you with some top tips!

I used to find exercising really easy as I had a lovely, lively, young Springer Spaniel who had bags of energy and was a struggle to keep up with! But sadly she is now 12 years old and, except on really good days or when she sees a unsuspecting squirrel, she is trailing several feet behind me! I realise that my old workout is no longer the aerobic fix I need….

I wonder if any of you watched the ‘Trust me I’m a doctor‘ programme on BBC 1 on Thursday 13th September? I love watching it when I’m around and that episode was particularly interesting.

The affects of ageing on our muscles

The programme explained how over the age of 50 we start to lose muscle mass at a rate of about 1% per year and muscle power at a rate of about 2% per year. This in part explains why older people become more ‘frail’ and are more susceptible to falls.

1% or 2% per year may not sound much but if you think about it that adds up to 30% loss of power by the time you are 80. This can have a significant effect on your ability to walk distances, climb stairs and even such simple things as getting up out of a chair. Muscle weakness can also affect your balance and increase your chances of having a fall.

So keeping up our exercise when we are over 50 is absolutely essential if we want to maintain our muscle mass and independence.

The shocking statistic is that 40% of middle aged adults take less than 10 minutes continuous brisk walking per month!

So what can you do to reverse this affect?

weight liftingThe programme also explains how important it is to do resistance exercise such as weight lifting at the gym, to combat this effect. They recommend you do this twice a week. They also demonstrated some simple body weight exercises (ones that we frequently prescribe to clients) that can be done without the need to go to the gym.

Common excuses for not exercising!

The most common excuse for not exercising is a lack of time. So some scientists at Bath university carried out an experiment looking at blood sugar levels and blood fat levels at intervals after a block of 30 minutes brisk walking and compared this to 6 x 5 mins of simple exercises and taking no exercise at all. The simple exercises included sitting to standing, going up on your toes in standing, squats and marching on the spot.

They chose blood sugar and blood fat levels as these can be harmful in the extremes. If not kept under control they can lead to Diabetes and heart disease.

The team of doctors were all surprised to find that both exercise groups benefited equally with a 40% drop in both blood sugar and fat levels following the experiment. Not surprisingly the control group who took no exercise had no drop in blood sugar or fat levels at all.

This is a really useful finding as it means that those who are time poor but can squeeze in 5 mins here and there into their daily schedule can still do something really worthwhile for their health!

Top tips for sticking to an exercise regime!

  • Exercise snacking! Remember that 5 mins brisk walking performed 6 times a day is just as good as 30 minutes of continuous brisk walking. So move regularly and take lots of mini breaks of exercise if you don’t have time to take it all in one go.
  • Find a gym buddy! Remember that weight training for the over 50’s has lots of benefits to health including preventing that decline in muscle power and helping bone density. A good way to increase your chances of sticking to it is to find a gym buddy. This extra bit of commitment and the thought you might be letting someone else down is a great way to motivate yourself. My gym buddy (my son, Sam) has been away in New Zealand for the last 5 years so I’m looking forward to his return a week today and his help in motivating me to go to the gym more often!
  • Joining a class can be a really helpful way to stick to exercise. The social aspect helps to make it fun and more than just exercise. We run 34 classes of Pilates, Yoga  and Dance,Tone and Stretch classes each week so there’s something here for everyone!
  • Diarising your exercise – simply popping a regular time in your diary can help to prevent other things taking over that time.
  • Get it done early! Its so easy to put things off as the day progresses so try and get your exercise done early in the day before you get too busy and distracted by other things.
  • Work exercise into your daily life – personally I walk to work (15 minutes) and on the way home I take a circuitous route for 50 minutes. It’s a great opportunity to listen to a book on audible or a podcast and I get home feeling refreshed and no longer thinking about the clinic! I know other people who cycle to work or walk their children to school and work exercise into their day that way.
  • Personal training – some people just like the one to one attention and motivation of a personal trainer to keep them on track. The advantage to this is that the trainer can tailor the exercises specially to you and your physical needs. We have two physios (Richard and Dave) who both have a background of sports science degrees before training as physiotherapists and they offer personal training in our studio at the clinic. Using a doubly qualified Physio for your training means their in depth knowledge of the body will keep you exercising safely!
  • Sign up for a charity event. There’s nothing like a good cause to spur you on! And it’s nice to share the experience with others.
  • Share your exercise resolutions with friends. Telling people your intentions makes it much more likely you will stick to it. They say it can take 21 days of doing something regularly to form a habit so persevere!

Here at Physio on the River we aim to support you by getting you better and more healthy and keeping you that way through appropriate exercise.

Next steps…..

If you’d like to join one of our classes or arrange for a personal training session with Richard or Dave just:

  • call us on 0203 916 0286 and speak to one of our receptionists
  • email us here
  • or pop in for a chat! We are always happy to talk things through first

If you have a physical health issue that is stopping you from exercising then one of our team of physios may be able to help you back to fitness. Or if you have an elderly relative who is becoming frail and is at risk of falling – find out more about our falls prevention programme.

Read how Physio helps experienced runners improve performance and manage injury risk

If you are an experienced runner, it’s highly likely you’ve trained and competed whilst injured.

Indeed, research shows that runners often carry old “niggles” that have never been properly sorted out.

If you are a seasonal runner, or tend to aim for certain events, you may find that you are susceptible to injuries at certain times of the year, or points in your annual training cycle.

We asked Dave Burnett, who heads up our Running Clinic, to explain the common causes of injury and how we can help you reduce your risk and manage ongoing issues whilst at the same time improve your performance!

What caused my injury?

This is a commonly asked question at the clinic!

In the absence of an acute trauma or a specific isolated event, “overuse” is a common cause of injury.

To be more specific overuse usually means “training load errors”.  Simply put, if your training load (i.e. the frequency, intensity, time & type of training) is higher than what your tissues (e.g Achilles Tendon or Knee-cap Joint) can tolerate, you’ll get injured.

And why hasn’t my injury resolved yet?

Tissue tolerance is related to to several different factors and all of these can affect your ability to get over an injury:

  • your age – we all recognise that we become less elastic and quick to recover as we get older
  • our genetics – some people just have good genes
  • our general health and level of fitness
  • previous injuries we have suffered
  • our strength & flexibility
  • our biomechanics – the way we are built or the way we move
  • and finally our recovery, sleep, nutrition & lifestyle!

Runners that are at a higher risk of injury

Certain sub-groups of runners are at higher-risk of injury including

  • Beginners with less than 1 year’s experience
  • Runners with previous injuries (particularly in the first 3 months following the injury)
  • Marathon runners who run more than 40 miles/ 65km per week
  • Runners who rapidly increase their  speed or distance
  • Women with a low BMI or reduced bone density (Osteopenia or Osteoporosis)

(JAMA, 2014)

How can training load affect injury?

Various factors influence training load including:

  • The nature of your weekly running programme  – i.e. the frequency, intensity, time and duration)
  • Any other exercise or strength and conditioning you may do on top of your running
  • The nature of your running training is also a factor and some injuries are more commonly “volume-related” versus “pace-related”.

 

How can I improve my tissue tolerance?

Improving your tissue tolerance will reduce injury risk and can be achieved in several ways:

  • Cross-Training – using a variety of types of exercise in your training e.g. using swimming/cycling/cross-trainer
  • Optimising or adapting your running style– your running style will change the forces placed on your joints and muscles- small adaptations are often effective to help solve ongoing niggles and can help improve your economy and performance.
  • Optimising your footwear for your specific running biomechanics– this will help reduce load on the system
  • Taping can help offload your tissues so they have more tolerance to exercise
  • Running Specific Strength and Conditioning – it is now widely accepted that running performance can be improved by combining endurance training with explosive strength training. Adapting common gym-style strength work to make your programme specific to your running demands will help you improve your tissue tolerance more quickly
  • Maximise nutrition, hydration and sleep– these will undoubtedly help performance, recovery and tissue repair.

How Physio can help

At Physio on the River, we can help you both:

  • recover from injuries which are stopping you from running
  • help those ongoing niggles you are carrying whist continuing to run and
  • help reduce the risk of re-injury

Our physios are specialists at assessing the way you move and identifying the causes of injury. Combining our clinical skills and video gait analysis we can give you a really thorough screening and a baseline of information to create a tailor-made plan of action.

Our Standard 60 minute Running Assessment includes:

  • Establishing the specific details of your running history by exploring your training programme, coaching advice and goals for up and coming competitions
  • A physical screening to identify important biomechanical factors related to running (e.g joint and muscle flexibility tests and lower limb strength and muscle control measurements)
  • Treadmill analysis of your running with Hi-Speed video
  • A report of your video analysis findings
  • An exercise programme to help facilitate your rehabilitation

NB- if your Screening Assessment and/or running analysis identifies a specific injury requiring treatment then a course of physiotherapy can be provided.

How to book a Running Assessment with Dave or one of our team of Physios:

Call 0203 916 0286

Book online here

Email the clinic here

Or just pop in and speak to one of our Receptionists

If you found this useful and would like to read our other running related blogs just click here.

Are you a first time marathon runner or new to distance running? Read our top tips for avoiding the injury pitfalls!

 

If you have just got your first place in the London Marathon for 2018 – congratulations! Or perhaps you are new to distance running? Either way you’re no doubt excited but perhaps equally anxious about the challenges ahead.

Training for, and then running a marathon is a great achievement but there are lots of potential pitfalls along the way to overcome. Read on to find out our Running specialist, Dave Burnett’s top tips to help you glide along the road to success! Dave heads up our Running Clinic team of Physiotherapists.

 

1. Training programmes

“What do you mean? – I don’t just start running?!”

Whether you are just looking to get round or have a timed goal in mind, a marathon training programme is vital to success.

The programme you choose will depend on lots of factors including: your previous running experiences, the time you have available to train, your general health, your level of fitness and any injuries you may have or have had in the past.

If you are new to exercise, have any significant cardiovascular or bone health problems or are overweight, it’s a good idea to see your GP before you start training.

If you are new to running and don’t exercise regularly, it’s best to start with a Beginner’s Training Programme such as:

http://www.nhs.uk/LiveWell/c25k/Pages/couch-to-5k.aspx

https://www.runnersworld.com/training/the-8-week-beginners-guide

If you have some running experience or you are generally fit and exercise regularly the below link offers Marathon Programmes from beginner to advanced.

https://www.virginmoneylondonmarathon.com/en-gb/trainingplans/

You will notice that your plan includes lots of activities that aren’t running. This is because we know that working on all the different aspects of fitness – flexibility, cardiovascular, core strength, muscle power and running pattern can help your all round performance and lower risks of injury.

2. Distance runners get injured frequently – so lower your injury risk!

Since the 1980’s the yearly risk for regular runners to get injured has remained as high as 70-80% despite advances in training methods and footwear technology.

As a ‘running beginner’ (i.e. less than a year’s experience), or if you have had any previous running injuries, you are at a higher risk of getting injured.

‘Overuse’ or ‘training load errors’ are common pitfalls in distance running. Beginners are often susceptible to injuries caused by ‘too much, too soon, too fast!’.

Simply put – if your training load (frequency, intensity, time and type) is higher than what your tissues can tolerate, you’ll get injured.

Our tissue tolerance is multi-factorial and related to: our age, our genetics, our general health, any previous injuries, our strength and mobility, our biomechanics, ability to recover, sleep, nutrition and lifestyle!

How we can help: At Physio on the River we offer a Physiotherapy Running Screening Assessment. Our physios can give you expert advice to reduce your injury risk and help you to progress through your training programme. The running assessment includes:

  • Health screening to help flag up any important health or disease factors that could affect your running
  • Physical screening tests specifically tailored to running which will highlight movement restrictions or imbalances in muscle strength or control
  • Treadmill video analysis of your running to identify any technical issues with your running pattern
  • Advice on running based strength and conditioning exercises to complement your training schedule

3. Do you need an injury MOT?

Research shows that runners often carry old injuries that have never been properly sorted out. An old niggle can place you at higher risk of developing a further injury so it’s really essential to get these assessed and treated properly before you start out on your running journey.

Common problem injuries may include calf muscle or Achilles tendon injuries, kneecap or knee tendon problems, buttock, hamstring and groin injuries or lower back pain.

Our physios are specialists at assessing the way you move and identifying the causes of injury. They can help you resolve ongoing issues.

4. Treat your feet!

It may sound obvious but a decent pair of running shoes will help reduce risk of injuries and make those longer runs much more bearable down the line.

The type of shoe you choose will depend on several important factors including:

  • your foot posture and shape of your feet (narrow or wide, high arch or flatter arch etc)
  • your running style – whether you are a heel striker or a forefoot striker
  • your running biomechanics – i.e. how all your joints from the lower spine to the toes move in a chain. Running can be affected by seemingly remote things like a stiff big toe or a stiff upper back!

It is therefore good to consider buying some shoes from somewhere that has the knowledge and skills to identify these factors properly. Locally we recommend Sporting Feet in Putney or Up and Running in Sheen.

5. Food for thought – literally!

A late and a croissant on the train to work simply won’t cut it in the world of marathon training! Your training schedule isn’t a license to eat just what you fancy!

  • So base your diet around mainly fresh, unprocessed foods – vegetables, fruit, wholegrains, meat, fish, eggs, dairy products, beans and lentils, nuts and seeds.
  • Don’t forget to include some healthy fats like olive oil, avocado and oily fish to support your immune system, which may be compromised by heavy training. These healthy fats can help your joints recover from pounding the pavements.
  • Eat more on your long run days and less on your rest days, particularly starchy and sugary foods.
  • Keeping alcohol to less than 14 units per week is also advisable.

To read more about nutrition and hydration for your marathon training and the race day itself read our blog here.

So to summarise: start by sorting out any old unresolved niggles, get yourself a proper training plan suitable to your particular level of experience, come and have a Running Assessment Screening session or Injury MOT with Dave, get yourself a decent pair of running shoes and don’t forget to fuel yourself properly!

If you would like to book a session with Dave or one of the team of physios, just call 0203 916 0286, email us here , book online by clicking the book online button on the right here or drop in for a chat.

If you have found this blog useful and would like to read our other running and marathon blogs just click here.

Do you want to hit the ski slopes in peak fitness this year?

Skiing is for some a serious sport, for others an adrenaline rush, and for most of us a much needed winter break from the routine.

Skiing is a demanding activity and places high demands on our bodies, especially the legs.

Injuries can occur for many reasons, but what we know for sure is that when you are more conditioned for an activity, you are able to significantly reduce the level of risk you are exposed to.

With this in mind, we are running a 6 week program of strength and conditioning in preparation for your ski trip. In this blog we will be explaining the various knee injuries that can occur and offering some useful preventative advice.

40% of skiing injuries are to the knee. The binding release mechanism on skis has caused a successful reduction in broken bones, but there is no protection for the knee ligaments or cartilages. The 3 most frequently injured structures are the medial collateral ligament – at risk in the snow plough position, the anterior cruciate ligament and the meniscus or cartilage usually injured when bending and twisting. When you injure all three this is called the ‘unhappy triad’!

People particularly at risk are unfit recreational skiers taking their annual ski holiday and fatigue is one of the biggest factors. Does this sound familiar?

As with all sports, just playing that sport is not really enough to optimise performance or manage the risk of injury well. Participating in conditioning exercises that incorporate many different areas of fitness – aerobic, strength, balance, co-ordination and flexibility for example, will give you the necessary all round skills to ski well and stay injury free.

After all PREVENTION IS ALWAYS BETTER THAN CURE!

How can I prevent these injuries?

We strongly recommend attending a Get Fit to Ski program and we have designed a six week course to help you prepare in time for the coming season.

Here are some other hints and tips we have put together:

  • Pre-season quadriceps strengthening:  we recommend building up the thigh muscles using the stepper or bike and weights machines. To improve endurance keep the number of reps per set quite high (about 20).
  • image from www.fitnowtraining.com

    Core stability and balance exercises:  it’s essential to have good control of your trunk, pelvis and hip muscles and Pilates exercises are excellent for this – we run Pilates classes in our studio here. Having quick reactions and good balance will help you cope with that unsuspecting mogul! Swiss ball exercises are a great way of improving balance.

  • Recognising dangerous situations: don’t try to get up until you have stopped sliding. Don’t jump unless you know how to land! Keep knees soft when you fall to cushion the impact.
  • Preventing fatigue: pacing yourself during the day’s skiing will help prevent fatigue. For example, warm up on an easy slope and take short regular breaks for refreshments. Remember, injuries are most likely to happen first thing in the morning when you’re cold and in the afternoon when you’re tired.
  • Après ski: no, not the drink at the end of the day! We recommend carrying out a thorough stretching routine to help the muscles relax and recover. Important muscles to stretch are quadriceps, calves, hamstrings, gluteals, lower back and hip flexors.
  • Equipment: it is very important not to ‘make do’ with loose or ill fitting bindings or the wrong type of ski for your experience and skill level. A bit of time spent hiring or buying the right equipment is a must.

Should the worst occur – how do I quickly access treatment?

Accurate diagnosis and treatment is essential in ensuring that any injury recovers as quickly and successfully as possible.

sourced from milfordphysio.co.nz

Many injuries are not severe enough to require surgery and will get better with Physiotherapy. We can help reduce the swelling, restore the normal movement of the knee and strengthen the surrounding muscles so that some stability is restored. However, some injuries will require surgery and, here at Physio on the River, we have excellent links to specialist ski Consultants for fast referral.

If you need any help with this or you’d be interested in booking yourself onto our Fit to Ski class before the season starts,  please contact us here. Our Physios are always happy to chat about a problem on the phone before booking an appointment and you can reach us on 0203 916 0286 or pop by in person.

If you enjoyed this blog then take a look at our other skiing blogs.

Need to improve your golf swing performance and banish back pain? Physiotherapy could be the answer!

We know that lower back injuries are the most common amongst golfers. In fact, in professionals they account for up to 63% of all injuries.

Wouldn’t it be nice to be free of pain and improve the effectiveness of your swing?

Follow these 5 top tips to banish pain, prevent injury and maximise your golf swing…

 

  1. Have you warmed up?

picture of warm up exercises sourced from www.dalehavesgolf.com

image sourced from www.dalehavesgolf.com

That first tee drive demands a complex series of full body movements which can place up to 8 times your body weight through the spine!

Learning a series of simple on-course stretches and warm-up movements helps prepare your body for the high demands of your golf swing and reduces strain on your spine.

 

  1. How is your flexibility?

stretching from www.mikepedersengolf.com

image sourced from www.mikepedersengolf.com

Your golf swing requires a lot of both side-bending and shearing forces forwards and backwards in your lower back.

If this area hasn’t got good freedom of movement you can put excessive strain on the discs, ligaments, muscles, nerves and joints of the spine.

Having an assessment of your spine and the way you move will help tailor a programme to reduce pain and prevent injuries.

A course of Sports massages can also be a useful way to address muscular tightness.

 

  1. Don’t forget stability!

picture of strengthening exercise for golf

image sourced from www.golfdigest.com

We know that people who experience low back pain, particularly if it has persisted for more than 3 months, have reduced deep (core) abdominal and lower spinal muscle strength and control.

This has a significant effect on the spine’s ability to control the force of your golf swing and how well you are able to generate power to strike the ball.

Working on your deep trunk muscles is essential if you want more distance and less pain! Sports Physiotherapy and our Pilates classes are a great way to achieve this!

 

  1. Power up!

strengthening for golf

image sourced from www.fitnessbyandrew.com

Preventing back injuries and reducing low back pain is not just about focusing on the spine.

Research has shown that the major muscle groups of the leg (buttocks/thighs), shoulder (rotator cuff muscles) and forearm are placed under high loads during the different complex phases of your golf swing.

Weakness and/or past injuries to other areas of your body may have an impact on both potential for back injury and the quality and power of your swing.

 

  1. Get specific!

Most golfers also enjoy other sports and may use the local gym to help keep fit.

However Sports Physiotherapy can offer a bespoke assessment of the way you move, as an individual. This is then used to tailor a programme to make you “golf-fit”. Specific muscle tightness, joint stiffness, poor movement control and muscle weakness can be quickly identified, treated and rehabilitated.

We have two Senior Physiotherapists with a specific interest in golf – Dave Burnett and Sophie Cannon. Both keen golfers themselves – they know what is required to improve your game and keep you free of back pain.

To benefit from a golf assessment with one of our Sports Physiotherapists then give us a call on 0203 916 0286 or click here to contact us.

10 top tips to help tennis players remain injury free!

Are you feeling inspired by the Wimbledon Tennis Championships?

At this time of year tennis courts will be buzzing with enthusiastic players. The repetitive nature of tennis means that without proper care injuries can result.

Sophie Cannon, one of our Physiotherapy Team and a keen tennis player herself, has given her 10 top tips to stay injury free! Read on!

1. The neck or ‘cervical spine’

sourced from www.cervical-spondylosis.com

sourced from www.cervical-spondylosis.com

During a game a player will serve many times. This will be multiplied if you need to re toss the ball. Of course ball placement is extremely important for the successful serve.

As you look up at the ball you extend your neck and this can stress the ‘facet joints’ at the back of the neck. This would also be exacerbated by a high ball toss.

To counteract this strain the following stretch can be helpful.

2. The shoulder

sourced from pbmassagetherapy.com

sourced from pbmassagetherapy.com

The shoulder is one of the main joints a tennis player might struggle with. Serving can be the main cause of pain.

The key here is warming the serve up, slowly building pace and making sure you practice first and second serves. Again, it is good ball placement that will help prevent overstraining the shoulder.

We recommend doing stretches to maintain a good range of shoulder movement. The muscles at the front of the chest (your pectorals), particularly, can become tight. Here is a useful exercise to stretch those muscles.

3. ‘Tennis Elbow’ – we have all heard of this!

sourced from www.teachpe.com

sourced from www.teachpe.com

The muscles that extend the wrist all converge on a small point at the elbow. Slowly over time the repetitive stress placed on this point of insertion can cause pain and weakness.

Tips here would be to check that your grip size and racquet weight are correct. Ensure that your arm is relaxed as you play. There is also a stretch that can help release the tension in these muscles.

4. The wrist

For the wrist it is extremely important to warm up and not be tempted to hit a powerful shot as soon as you step on the court! Start your warm up on the service line, keeping your shots gentle until your muscles have warmed up. Then start extending yourself from the baseline. The tennis elbow stretch above also helps the wrist.

 5. The ‘core’

man tennis player silhouette

Pilates exercises are a great way to strengthen the deep muscles of your stomach and back (your core) and is essential in helping to prevent back pain. Our Pilates classes would be perfect

Much of the power in your shots should come from your core muscles working to drive your body through rotation.

Core control will also help improve balance, agility, accuracy, power and your game overall.

6. Range of movement in your spine

image sourced from www.drprem.com

image sourced from www.drprem.com

Maintaining good range of movement in your spine is also important.

You need good upper back (thoracic) rotation and backward bend.

This exercise is a good starting point.

7. Good hip flexibility

image sourced from www.training.fitness.com

image sourced from www.training.fitness.com

Tennis involves repeated side stepping, lunging and stretching.

If you don’t have good hip flexibility, a groin strain might be the result.

This exercise maintains length in the muscles of the inner thigh (your hip adductors) and it’s easy to do on court!

 

8. Strong leg muscles

image from www.inmotionlife.com

image from www.inmotionlife.com

Knees have to cope with lots of twisting and lunging movements.

Gluteal (buttock) and quadriceps (thigh) strength are important so that this load does not result in injury to the cartilage (meniscus) and ligaments or pain behind the knee cap (patellofemoral joint).

A couple of sessions a week in the gym working on leg strength will pay dividends. Alternatively squats, lunges and single leg dips are good to include.

9. Balance and Agility

image from www.fitnowtraining.com

image from www.fitnowtraining.com

Balance and agility training is essential to keep you firmly on your feet but reaching every ball!

The ankle joints will cause problems if they are weak.

Simple exercises like standing on one leg on an unstable surface such as a cushion is a good starting point.

This can be challenged further by introducing arm and leg movements to test your balance.

10. Get a tailored programme for you!At the end of the day we are all individuals with different body shapes, weaknesses and imbalances.

Our best recommendation is to come and see one of our Physio team who are all trained to analyse movement in sport. They can give you a thorough Sports Rehab Assessment and quickly identify any areas of potential weakness that could lead to injury. They can make you an individually tailored exercise programme to help you work on those weaknesses and reduce the chance of injury.

To book an appointment with one of our Physio team just call 0203 916 0286 or click here to contact us by email.

 

 

 

  • Physio on the River

    The Old Ticket Office
    Barnes Bridge
    Barnes
    SW13 0NP
  • 020 8876 6152

  • Opening Hours

    Mon: 7am – 9pm
    Tues: 8am – 9pm
    Wed: 7am – 9pm
    Thurs: 8am – 9pm
    Fri: 7.30am – 7pm
    Sat: 8am – 2.30pm
    Sun: Closed

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