Blog | Physio Remedies | Physiotherapy & Sports Massage | London W1, Mayfair, Green Park, Berkeley Square

Nicola Bathe

The Best Forms of Exercise

31013353-close-up-of-man-planting-seedlings-in-ground-on-allotment_500x500-1.jpg

The Best Forms of Exercise To Do

And why!

We are all aware that exercise is good for you but what are the best forms of exercise? Our soft tissue therapist Emily, who is also a triathlon coach, has given us her views on the best forms of exercise that you can do and why:


1) Ones that are incorporated into your life organically

Cycling / running / walking to work / run errands, using a stand up desk, swimming, gardening, taking the stairs etc. This is how we moved before humans made life over-convenient and sedentary, so now we have to set aside time and space to exercise. We’re also more likely do stick at the fun stuff so do things you enjoy.

2) Different types = cross training

Spending all your training time doing one sport can make you good at that sport, but you won’t be challenging your brain / your neuro pathways / your muscles doing the same thing for years and you’ll be more prone to injuries. Branch out, go outside of your comfort zone and try a different genre of sport! I’ve competed in wakeboarding, judo, fencing, lacrosse, triathlon and everything in between. Fundamentally cross training gives you a more well rounded type of fitness.

3) Exercises that involves bilateral movements and ambidexterity

The majority of injuries stem from imbalanced strength in muscles and range of movement. As with no 2, we get lazy just using our dominant side, so why not try brushing your teeth with your other arm, breathing bilaterally (even rotation of the torso) in swimming, kick the ball with your other foot?

If you’d like advice on your current exercise formats or switching up your exercise routine, do get in touch with us for a virtual or face to face appointment.

Words by Emily Chong.

Getting Back To The Gym!

167092857-man-bench-pressed-with-mask-on_500x500-1.jpg

Getting Back To The Gym

Gyms are open! Time to get back in! I was on a roll before, time to pick it up again! All this walking and jogging over lockdown has kept me in shape so I'll be fine!


Just Be Careful

Easy there Tiger, just be careful. Whether it has been 4 months or 13 months since you last stepped through the gym doors, if you've been spending each day walking or jogging to stay in shape then your body will have adapted to that and away from what it was able to do before. You may feel like you'll be able to get back to your previous level of bench press quickly but if you've not done much upper body work in that time, you will have lost a bit of what you had.


Keep On Walking!

There is also no need to stop what you have been doing as well. Don’t lose those gains made by just stopping. Whilst there may be time constraints that could limit how much you are able to devote to some of these activities, if your body has become adapted to 60 minutes of steady lower limb work, it may not have the capacity to comfortably allow compressing that into 30 minutes of higher intensity work. It may require some reorganisation in your day but much of this good work you have been doing can be continued.


Return Steadily

This is not to say don't go back to the gym. There has been a lot of sensible advice around taking things steadily on your return which is worth heeding. It is better to feel a little frustrated that you could have done a little more whilst building your work back up during your first 3 or 4 sessions back than to go back too hard too soon and injure yourself meaning more significant change to your gym program.

And Enjoy It!

As always the key thing is to enjoy your exercise time. Any type of change within an exercise program carries an element of risk, the size of that risk is consistent with the size and volume of change within that program. There is no need to fear that change so long as it is steady and progressive rather than a great leap in one direction or other.


Have fun!


If you have any persistent niggles, aches or pains don't soldier on in silence making them worse. Get in touch with us if you need us.

Words by Paul Martin.




Project Unicorn - The Running Channel’s Quarantine To Qualifier

The-Running-Channel-logo-Red-White-copy_500x500.png

Project Unicorn - The Running Channel’s Quarantine To Qualifier

We’re delighted to be working with Anna from The Running Channel (if you’re a runner and you don’t follow The Running Channel you should!) on her challenge - ‘Project Unicorn’:


Hi everyone, I’m Anna and I’m a runner! I’ve been presenting on The Running Channel on YouTube for a couple of years now and I’m always up for a challenge. So far these have included (but are not limited to) a marathon in my 10m back garden during lockdown, running a mile every hour on the hour for 24 hours, a 260km ultra in the Azores plus a few other marathons along the way.

Anna Harding from The Running Channel, about to take on Project Unicorn.

Anna Harding from The Running Channel, about to take on Project Unicorn.

Project Unicorn

My next challenge will be a little longer in the making. It’s a challenge we are affectionately calling ‘Project Unicorn’. My next challenge is to qualify for the Boston Marathon.

I’ll be training for the next few months up until Autumn 2021, when I’ll take on a marathon to get that time. For me, it’s 3 hours 30 mins. Well, it’ll be a few minutes under that actually to guarantee qualification. To give you an idea of what that means for me, my marathon PB, set at Amsterdam Marathon 2019 is 3:53:06. So just a casual 25ish minutes to shave off.

The BIG difference this time though, is that we’re treating this as a bit of an experiment. We’re building ‘Team Anna’ to get me to that finish line. We’ve put together the best of the best when it comes to a coach, sports psychologist and, of course, physiotherapist. Paul Martin is going to be an integral part of Team Anna - he’s already helped me with my first hurdle of injuring my calf on a rather overzealous speed session!

Training

The real training will start 16 weeks out from race day, which hasn’t been 100% set in stone yet because of the uncertainty with coronavirus, but it’ll be around May that I need to step it up a notch. Until then, it’s cross training on the bike for me, calf raises, Paul’s infamous glute circuit and a bit of core work to get me in top shape ready for the mileage to increase.

Watch this space over on YouTube for Paul’s first appearance in the Quarantine To Qualifier series in episode 2. You can find out more about the challenge in episode 1 now:

We are superchuffed to be part of Team Anna and we’re looking forward to following her journey to Boston!


Words by Anna Harding from The Running Channel.

Top Tips On Starting Or Getting Back To Cycling

woman on bike

Top Tips On Starting Or Getting Back To Cycling

If you’re thinking about starting cycling or getting back to cycling, give it a go! It’s low impact and a fantastic cardiovascular cross training option which complements running and other sports very well. You can travel far and wide, local coronavirus restrictions permitting, under your own steam which is very satisfying.

Our NoviceRunnerNik, who appears to have acquired a cycling addiction over the last few years to add to her running addiction, has drawn on her own recent experiences of getting back to cycling and written up her top 10 tips:

Like many people I’ve ridden a bike from a young age (with stabilisers) on and off for years (without the stabilisers) and I’m into cycling in a big way at the moment so I thought I’d share my top tips for getting into it or back to it:

 

Getting back to it or getting started:

1.      If you didn’t do a Cycling Proficiency course or similar at school and / or are nervous of how to cycle, you can take online cycling Bikeability courses and watch videos, which may help with your knowledge and confidence.

2.      Read the current Highway Code so that you know your responsibilities as a cyclist and those of the vehicles sharing the road with you.

3.      Check your bike’s tyres are in good condition and inflated to the pressure shown on the tyre, that its gears are working correctly and that the saddle and handlebars are adjusted to suit your body geometry. If it doubt have it serviced.

4.      Start slowly with shorter distances and build up your mileage gradually.

5.      Be safe and visible. Wear a cycling helmet for all your rides and wear a high vis top and use bike lights, front and back, even in daylight. I’ve found that drivers are generally better behaved when I have lights switched on, on my bike.

6.      Ride with confidence – you have just as much right to be on the road as the other vehicles do – and look ahead for hazards such as potholes and slow traffic so you can avoid sudden changes of direction.

7.      Don’t let hills put you off. Walk them if you need to.  No one cares! And they are good for you!

8.      If you like using a sports tracker such as Strava, use one to record your rides. You can also check out other people’s routes and see how your fitness improves over time.

9.      Follow any local Covid-19 local restrictions when you ride your bike (it goes without saying really) and remember to give pedestrians next to or in the road a wide berth.

10.  Make it fun so that you keep doing it. Stop to admire the views, take photos, drink coffee and eat cake and enjoy it!

Also check out our other cycling blog posts for more tips and inspiration to ride.

Next time: upping your cycling distance and becoming properly addicted to riding!

Words by NoviceRunnerNik.




Body Part Of The Month: The Neck

neck pain

Body Part Of The Month: The Neck

For the next blog post in our Body Part Of The Month series, our spinal specialist physio Paul tells us about the neck.

The Neck

The neck is comprised of 7 vertebrae. It plays a vital role in providing the immediate base for the head to sit on and the origin point for many muscles of the neck and shoulder girdle. The vertebrae contain and protect the upper spinal cord and brain stem which can migrate down as far as the third vertebrae in certain movements. From an evolutionary perspective, good mobility is vital in the neck as a means of allowing wide range visualisation to spot danger. This mobility is maintained by good alignment of the various joints within the neck which, between the 7 vertebrae, vary considerably.

The joint between the base of the skull and the top vertebrae (atlanto-occipital joint) is shaped similar to the joint in the knee so allows hinge movements - this joint is where a large percentage of nodding (flexion and extension) occurs. The joints between the 1st and 2nd vertebrae (atlanto-axial joint) are much flatter and sloped slightly down which allows for the majority of rotation in the neck (up to 60% of neck rotation occurs at this joint alone).

There are lots of muscles that attach around the lower part of the skull and upper neck joints that when working well allow smooth movement - if they become overloaded or overstretched, this is when movement can become limited and this can have an impact upon the rest of the neck and lower down the spine. The other 5 vertebrae link with progressively steep joint angles as the cervical spine transitions towards the thoracic spine.

When your neck works well

The neck works best when weight is evenly distributed through each of the cervical vertebrae. There should be a mild front to back curve in the cervical spine (lordosis) which is concave to the rear. The head should sit squarely on the top of the neck. To allow this to happen there needs to be good support from the lower back and thoracic spine as the head is essentially balanced on top of a long stick comprised of lots of small parts stacked up vertically. Changing the position of some of the lower vertebrae means the head needs to change position to balance you properly - to test this, sit upright on a chair. Then slowly allow your lower back to bend and your pelvis to rock back - feel the effect this has on your neck (it should feel like it's sliding forwards and poking out your chin).

When your neck doesn't work well

Neck pain can be easily distracted by pain in other areas - often the shoulder and arm. Broad, vague areas of pain in the shoulder or upper limb can be more to do with some stiffness in the neck rather than local shoulder pathology. Neck joint or muscle stiffness can contribute to referral into shoulder or upper arm pain and, of course, being where the majority of sensory nerves to the arm originate, neck issues can have wide ranging impact. As well as that, disc issues in the neck can impact basic function downstream such as gait and lower limb power although this is rare. Local muscular spasm and joint stiffness can be very painful and this pain can significantly limit range of movement in one direction - when addressed quickly this can be quickly resolved.

Common neck injuries

Most neck issues we see are fairly mild and tend to be related to postural changes with prolonged sitting. Often neck pains in a whiplash style can occur following a fall where the arm or shoulder breaks a fall but the head keeps going, placing strain on the muscles to the side of the spine. Occasionally there is little immediate neck pain in this scenario, but it tends to creep up over subsequent days. Local muscular spasm is fairly common, often when turning the neck in an awkward way - this can be worse when carrying or lifting a load.

Avoiding neck pain

The key to avoiding neck pain is maintaining a good range of movement (this will vary from person to person) and a good head on neck posture. Whilst the local muscle length is important, a lot of good neck posture starts around the lower back and abdominal muscles that offer a base of support through the thoracic spine to the neck itself. Once this area is improved, local neck management can become a lot more straightforward.

As always, if you have any persistent niggles, aches or pains in your neck or other places, don't soldier on in silence making them worse. Get in touch with us if you need us.

Words by our specialist spinal physiotherapist Paul Martin.

Getting Back To Training!

woman getting ready for training

Getting Back To It!

It's starting to get lighter in the mornings and it's getting darker later. Is it feeling a little warmer, or is it too early to say? Has dry January only taken things so far and you know you need to get back to your previous exercise routine? You might even have some races or events pencilled into your diary for this year (fingers crossed!). If it's been a while since you've been able to do what you want to do, before you strap on your Dunlop Green Flash and head out for a 20 miler as you last did in October, a little bit of planning can help avoid injuries getting in the way of your return to previous levels.


What are you aiming to do?

Are you a runner that hasn't run for 4 months? A cyclist who last saw their bike in the shed before a pile of boxes got in the way? If the usual process to return to your exercise has been disrupted, try to think about what the demands of exercise on your body will be. Problems tend to arise when the body is unable to tolerate the load applied to it, either repeatedly or over a few episodes. If you have not been able to do what you wanted to, your body may have lost some of its tolerance to the load it previously absorbed well. So, before you restart how can you prepare your body for this?


What are your sport requirements?

What is it you need your body to do? Running is a series of springs from foot to foot maintaining and then generating momentum to move forwards. For this your calf muscles will need to be able to lengthen and shorten quickly (depending on how fast you run), your hips, knees and feet will need to be in good alignment facing to the front, abs need to work to help keep the pelvis level and offer support to the trunk and body above. Do you need to work all of these things? Maybe not, but spending some time doing some calf raises or a few gentle hops in the week or two building up to your return might help prepare your body.


Cycling needs less spring through the calf and ankles than running so may need less of this type of work, so doing more work with a fixed foot might be more useful (like standing up from a chair with one leg a few times, which replicates part of the cycling action), although good alignment remains key. Train some of the essential movements so that when you are doing them repeatedly there is some tissue resilience in place.

If you use equipment like a bike, it is worth making sure it is also in good shape to be used - getting equipment serviced will ensure it is safe to start using again.


How long should I be doing this for?

Sometimes, there is nothing more useful than doing what you want to do as no amount of hops, calf raises, step ups or lunges can properly replicate doing a 5k run. Start with a sensible distance compared to what your previous levels were and break it up if you need to. After more than a month off you'll need to rebuild gradually so keep expectations low in the early stages, just get used to doing what you want to do again and enjoy it for what it is without pushing it.


Give yourself a few weeks to build back up steadily and factor in rest days too. You might feel as if you're not doing much but your body needs time to recover from the changes in exertion. If you need some help apps like Couch To 5k can offer some guidance on how to build up to a goal.

Does this mean nothing will hurt?! Yay!!!!

No, not necessarily, but it'll give you a good chance of being less affected by pain. There will likely be some discomfort when restarting, but the important consideration is differentiating what you might expect to be a normal response to returning to activity from something that might require a little more attention. Some of these are quite obvious (e.g. a sudden twang whilst exercising) or may only come to light over a couple of days after restarting exercise. In the main, providing you are sensible in what to expect on your return and expectations going forward, there is no need to resist - it's time to get back out there!


Our top tips for getting back to it:

  1. Plan your return, don't just leap in back to last season's training levels.

  2. Build some strength and conditioning training suited to your discipline into your weekly routine.

  3. Start gently with low volume and come back steadily. The Couch to 5k app is great for new and returning runners.

  4. Check all your sports kit and have it serviced / maintained as needed.

  5. Rest and recovery is as important as actually doing your sport so incorporate recovery days into your training schedule.


And as always, if you have any persistent niggles, aches or pains don't soldier on in silence making them worse. Get in touch with us if you need us.

Words by Paul Martin and NoviceRunnerNik.




What does my physio think about stretching?

couple stretching

What does my physio think about stretching?

Do you ever wonder what your physio thinks about your favourite forms of exercise or whether your health or lifestyle choices are a good idea? In the second of a series of blog posts entitled “What Does My Physio Think…?” we’ve asked our physios what they think about stretching.

Is stretching beneficial? Should I stretch before and/or after exercise? Dynamic or static stretches? Do you stretch? How and when?

Emily, our soft tissue therapist, triathlon coach, athlete personal trainer, says: 

“In the sports world especially for team sports and cardiovascular based sports such as running, the current (it keeps changing) recommendation is dynamic stretches before exercise and static after.

As a coach and athlete, I’ve found that it depends on your sports and how you feel on the day. If you feel particularly tight at the start line, dynamic stretching may cause you to pull a muscle, so some gentle static stretches after mobilising to increase your range of movement could show good results. In general, warm up gently first before stretching.  Muscles are like Plasticine, malleable when warm, not so much when cold!”

Stuart, our specialist knee and foot & ankle physio says:

“Stretching is beneficial for maintaining or achieving normal functional ranges of motion and reducing post exercise stiffness / tightness. I generally stretch before exercise with dynamic movements then post exercise, I undertake static stretching, depending on my objectives. So pre-exercise I warm up and perform a range of dynamic stretches for 10 minutes before running. Afterwards I will spend 5-10 mins targeting tight muscle groups and stretching for 20-30 secs per time.”

Physio Paul, who specialises in sports injuries, comments

“Stretching is beneficial - pre-exercise a static stretch tends to be a good diagnostic to understand what areas you might need to warm up before starting sport - warm up should be a progressive process to commencing sport. Think of it as if you’re taking your car up through its gears - you want to be in top gear as you start, but you're better off going through each level to get there. Static stretching post-exercise is more beneficial than pre-exercise and should be the end of an active warm-down process (like the warm up in reverse).”

Pandemic Lessons Learned - Dealing With Uncertainty

 
man holding questionmark sign over face
 

Pandemic Lessons Learned - Dealing With Uncertainty


Dear all, I hope that you are safe and well and I think it is just about ok to still wish you a very Happy New Year! 

In June I wrote a blog post with the title “Looking after our mental health in challenging times”. At that point it looked like we might be nearing an end to the pandemic or at least there was some movement in the right direction. Six months later we find ourselves in a national lockdown and it is almost a year from when this first started.  

There is no denying it, this has certainly been a challenging time for a lot of people. Work adjustments, parenting challenges, relationship dynamics changing, social life alterations, sport and exercise modifications and so much more has meant we have had to adapt in the most unexpected of ways. When something is also out of our hands and the changes are enforced upon us, it can seem more challenging as the locus of control is external rather than internal.  

For today's blog post I thought it would be useful to discuss some of the lessons learnt and how we can approach the current situation to best manage life around us. Here are 3 main lessons we can learn:

Lesson 1- Control The Controllables

 “ You cannot control what goes on outside. But you can always control what goes on inside.” Wayne Dyer.

 In life we have a choice to make which although can seem reductionist and too binary, it can serve to let us control how we see life events happening. One is to see them as happening TO us and the other is to see them as happening FOR us. The former places us in a path of accepting that the events which occur which are not initially perceived as positive are almost there as a form of punishment. We demonise the event and see only the struggles we have faced and what we have lost. The latter mindset gives us a sense of opportunity and curiosity. No one can control this virus 100%. Our attempts with all the measures in place , vaccines, lockdowns etc serve to maintain, reduce and hopefully bring closer and end to it. But,  the virus is way more powerful than we are and will live it life as it sees fit. 

We can accept the situation as it is and learn to find elements in our life which we can take more control of,  or we can waste time and energy on gathering even more information, reading more news, hypothesising as to what may or may not happen with the virus. What becomes of the latter? There are thousands of people out there whose job it is to do this, the scientists, doctors and researchers who are paid to spend their time doing this. And yet we get drawn into joining them to feel some level of control over the situation when in reality, not even the experts have the answer.

If we spent more time focusing on what we could control we would undoubtedly have less anxiety, less fear, more time for ourselves, more energy to pursue meaningful endeavours which would serve our own personal development and overall health and wellbeing. Sure, we need to know the basics and what big changes have happened, but other than that, could it be that the time spent mulling over the uncontrollable could be better spent controlling our inside world?

 

Lesson 2 - Adaptation Not Abolition

“The key to success is often the ability to adapt.” - Confucius.

When something gets taken away from us or becomes more of a challenge we can approach the situation with 2 points, fixed or growth. The fixed mindset can tell us things like: 

  • Well that's it, I can't do that anymore so I’ll stop completely until this is all over.

  • If I can’t do it like I did before then I’ll just stop it altogether.

  • I’m all or nothing so I’ll wait until I can give it my all again.

  • It’s pointless just doing a little, the benefits won’t be enough.

 

I have heard similar principles being said over that least few months. People who, for example used the gym regularly, altogether stop as it’s not accessible. Or people who have less time now to dedicate to their rehab stop. It is our job as clinicians to help you find ways where you can adapt and not abolish all the things you used to do. There has to be a level of acceptance of the status quo and a willingness to adapt in spite of it. Having the above mindset allows you to have ready made excuses as to why you can’t continue doing at least some of the things you did. A growth mindset has the following dialogue:  

  • Ok. This has happened, what is possible for me instead?

  • I can’t do that anymore, but what could I do?

  • Even a small step is bigger than no step at all.

  • The skills I learn now could improve my old skill when I get back to doing that.

 

Let’s take playing tennis as an example, which has at times not been possible. If you were to take all the components of playing tennis down, what could you still work on and perhaps even improve? Perhaps you know that your footwork isn't the best at times. Buy a speed and agility ladder and work on that for a few months, that would no end help your game! Perhaps you've had that niggly shoulder whilst serving that you can't shake. Spend some time working on the strength and stability of that shoulder to allow you better performance when you're back.

 If you dig a little deeper into things, the space and time we have been given can serve as a powerful vehicle to allow you to upskill. It sounds so basic but I often say to patients “Ok, so you can't spend an hour in the gym anymore, can you spend 15 minutes doing a HIIT class?” They often respond with “Well what will that do?”. “ More than doing 0 minutes will” I say. In times such as these, sometimes we have to appreciate that maintaining and ticking over is just fine and that is way more conducive to just stopping.

  

Lesson 3 - Finite vs Infinite 

The infinite is in the finite of every moment.” - Zen proverb.

Life can be divided into things which are finite and infinite. Films, sports, a working day, a song, a train journey, a holiday, all these things have a start and an endpoint. It’s easy to conceptualise this and place ourselves in that time frame. What you notice about these things is that they are just that, they are things or events. What isn’t finite in life is our emotions, our development, our intellect, our wisdom, our growth and our experiences of life. It’s very easy to approach this pandemic and more specifically the virus itself as a finite thing. Whilst at some point, yes, Covid-19 will cease to exist, there will not be an end to viruses as a whole for now, or at least perhaps ever, in the life existence as we know it.

 I feel that at the moment so many people are placing such emphasis on dates, numbers, restriction changes to this that they approach it with an end in mind. Like other things in life, if we lead with expectation over appreciation of agreements then this can set us up for disappointment. If our expectations are met (let's say the news aligns with what we hoped for), we gain a momentary sense of relief and some level of freedom may come with it. But what next? Do we then start to set higher expectations? What if they aren't met? What if there is a u-turn like there has been so many times? Do we then continually just ride this rollercoaster of emotions ranging from elation to stress and worry? What actually changes?

 Something which can help in these situations is to actually place yourself way ahead in the future, several years even. Think about a conversation you might be having with someone who either lived through this or perhaps didn't, a niece or nephew or a grandchild.  Hopefully that conversation could go along the lines of “Remember that time when everything was really weird and we had to wear masks and everything was shut, how strange was that? But here we are, still living life.”

 This, like many things, will be a memory in years to come. It will have its place in history like other events. Check in with what is present to you and how the moments you have during this time are approached with a sense of openness and optimism. Ask yourself this one power question to keep present and focused: “How can I approach today different or better than I did yesterday and how will that keep me focused on the infinite approach to feeling and experiencing a different appreciation for the now?”

Thank you for taking the time to read this.

Alex. 

Alex is a physiotherapist with Physio Remedies and also a Life Coach. He works with people to gain greater awareness in any aspect of their life they may be struggling with by allowing them to explore what might be possible with more clarity in their goals and ambitions. Ultimately he aims to provide opportunities to people to lead a more fulfilled and extraordinary life by unlocking their fullest potential. You can get in touch with him at alex@alexmanoscoaching.com and follow him on Instagram at @alexmanoscoaching.

Winterise your exercise!

Cycling in the dark

Winterise your exercise! 

Covid-19 Lockdown or restrictions might have encouraged you to seek more of your exercise outdoors or to cycle to work. As winter draws in there’s no reason, with the right preparation and kit, why that can’t continue.

Emily, our massage therapist and resident triathlon coach, has given us her top tips to beat the dark, cold and wet on your rides, runs and rambles:

Ride!

Remember: There’s No Such Thing as Bad Weather

When it comes to winter exercising, the adage comes to mind that “there's no such thing as bad weather, only unsuitable clothing”.

Don’t let the historic rainfall earlier in October put you off. With the right preparation, commuting by bike can still be enjoyable regardless of weather. 

The benefit of cycling-specific coats is that many offer more breathable fabric and vents, as well as sufficient pockets!

Clothing

As the temperature drops, layering becomes key. Merino wool works well across varying temperatures.

Waterproofs are best kept for rainy weather as they can become too hot once you get going and work up a sweat.

Good gloves and socks and/or shoe covers can ensure the cold and wet weather doesn’t prevail. I usually opt for neoprene gloves and socks for the rainiest days.

There are also good options to keep your head warm and dry including when wearing a helmet. 



Be seen

It’s important to be seen by other road users, so bright and reflective clothing is a must, and can be complemented by reflective details on your bike, such as spokes, stickers and saddle bags. 

 
Be seen!

Be seen!

 

White lights at the front and red lights at rear should be used day and night as the days become shorter and darker. USB lights need charging every few days but mean there’s no need for endless supplies of AAA batteries. 

Be comfortable and confident

For confidence and comfort, wider tyres with more tread work well in winter and can protect you from the pitfalls of potholes and punctures, whilst mudguards can reduce the splash of puddles. 

IMG_6188.jpg
IMG_6189.jpg

Less seasoned and confident riders can take advantage of cycle routes, many of which include quieter streets, and dedicated cycle lanes so as to avoid much traffic. It’s worth plotting a quiet commuter-friendly route in advance. Apps like Komoot or OS Maps are good for that. 


Give it a try

If you’re unsure winter commuting is for you and don’t want to break the bank, places like www.sportpursuit.com and www.decathlon.co.uk are good options for gear and equipment. 

And check out Emily’s blog post about looking after your bike and yourself.

Run or walk!

Not into cycling? Head out for a brisk (temperature or pace) walk, jog, run or a mixture! While there are no races, it’s good to take your eyes off the Garmin, enjoy the scenery and some fresh air.

The same tips as above apply:

  • Be safe - run or walk in safer areas, street lit areas, with someone if possible (and within Lockdown or local restriction rules) and tell someone where you’re going and when you expect to be home. Use the privacy option on your GPS app of choice so it’s not clear to others where you start and finish your exercise.

  • Be seen - wear hi-vis and reflective clothing. Use a good head torch with a front and back light if you’re running or walking in darker areas.

  • Choose clothing carefully - make sure your clothing is suitable for the weather but also for the amount of exertion you will do. You’re likely to get quite hot when you run so start out with a couple of layers, gloves and a buff-type stretchy tube on your head if it’s chilly, all of which you can easily stow or tie round your waist as you get warm.

Stay indoors!

This is also a good time to do things that you haven’t had time to do previously: stretching, core strengthening, activating your Glutes. Emily is running three virtual classes a week to cover all the above. All you have have to do is roll out of bed and log on. (Pyjamas and coffee welcome!). 

Words and images by Emily Chong.


NoviceRunnerNik's Top Tips on Starting Running - Revisited

two friends running in the park

NOVICERUNNERNIK'S TOP TIPS ON STARTING RUNNING - REVISITED

Has the recent London Marathon inspired you to take up running or return to running? Are you looking to run as a way of exercising your way through Covid-19 restrictions or lockdown?

Our NoviceRunnerNik, who has actually been a runner for the last ten years or so now (time for a new nickname?), has revised her top tips on getting started, first published in April 2019, to take into account current pandemic restrictions:

  1. Start with a Couch 2 5K app or program such as the NHS Couch 2 5k – this introduces you slowly to running over 9 weeks and gradually builds up your fitness and stamina. Much more sensible than my approach of just going for a 3 mile hilly run just like that and hating the feeling of my lungs exploding out of my chest! I very nearly didn’t run again after trying that!

  2. Be aware of those around you - remember to keep two metres away from anyone who isn’t in your household or support bubble and be careful stepping into the road to avoid people. The general public you may encounter might be even more anxious if they come across a runner than a walker, hopefully for obvious reasons. If you find your routes are very busy consider running at less busy times or changing where you run.

  3. Run more slowly – particularly if it feels like your lungs are exploding out of your chest. If you can hold a conversation with someone (you might need to imagine that someone if you’re running alone) whilst you’re running, then that’s a great pace to run at. If you can’t, then slow down. You’ll enjoy it more - promise!

  4. Buy decent, comfortable running shoes - if you can, have your running shoes fitted by a specialist running shop. Tell them your budget and what you want to do. They needn’t cost the earth. You’ll be less likely to pick up an injury wearing shoes that fit you and are fit for the job.

  5. Don’t increase your longest distance or number of miles in a week too quickly, however much you’re enjoying it, or you risk overuse injury. An often quoted rule of thumb is to increase both by no more than 10% per week. Use a free phone app such as Strava to record your runs so that you know how far you’ve been.

  6. Run your own run – don’t worry about what speed or distance someone else is doing. Run to how you feel, rather than a pace you think you should run at on your GPS watch or your running app.

  7. Run with other people, within local pandemic restrictions – join a running club or run walk group (when they are operating). Or find a friend to run with. Running with others takes your mind off the running and motivates you to turn up and run. Running clubs will have varying routes with leaders so that you don’t even have to think about where to run. In my experience running club members are really friendly and approachable. They aren’t all elite athletes racing for TeamGB (some of my running club members do run for TeamGB but you wouldn’t know it!). And you always have running to talk about.

  8. Buy some proper running clothes - you’ll be more comfortable and you’ll feel the part more and be more motivated to run. You don’t need to spend a fortune. Always wear a decent, supportive sports bra or chest support if you need it. They're vital bits of kit, especially if a few extra grams are being carried in that part of the anatomy.

  9. Vary the routes and surfaces you run on – to keep you interested and to get your body moving in different ways - try footpaths, coast paths, grass, mud etc but be careful.

  10. If / When parkrun is back, get parkrunning! parkruns are currently paused due to the pandemic but if you haven’t heard of parkruns they are free, timed weekly 5k runs, happening all over the country, every Saturday at 9am. You can walk, jog or run them so they are perfect for new runners and they are great for measuring your progress, if you wish. They only happen because people volunteer to organise and marshal at them so give something back now and again and volunteer too.

  11. Running can be really addictive! Don’t blame me if your running habit starts to escalate out of your control!

Stay safe!

Words by NoviceRunnerNik.

What Does My Physio Think: will running ruin my knees?

runner's knees

What Does My Physio Think: will running ruin my knees?

Runners are sometimes told by people (who often are non-runners) that running will ruin their knees. We asked our physios and therapists if this is true:

Stuart, our specialist knee and foot & ankle physio says

“Running can actually improve knee health and stimulates cartilage when impacting through the weight bearing phases. Thus it is beneficial to overall joint health so keep on running if you can!”

Our specialist spinal physio Shari says:

“No, not unless you have been advised not to run by your Specialist consultant and/or orthopaedic surgeon. There are certain pathologies that can be worsened by running, but in general when speaking with Specialist Knee Orthopaedic surgeons 5 -10km maximum running distance is ok in moderation.”

Physio Paul, who specialises in sports injuries, says

“There is every chance of ruining your knees if you run very badly, but maintaining good alignment and control through the lower back/abs, hips, knees and ankles can reduce this risk.”

Emily, our massage therapist, triathlon coach, athlete personal trainer, comments: 

“Knee joints are synovial joints which means they produce lubricant to minimise friction. The cartilage in the knee joint is a very smooth surface that aids gliding. Your knees are supposed to bend forwards and backwards over a lifetime. Assuming there is no structural damage and the surrounding muscles are strong and supporting your joints, there are worse things you can do to your knees than running, for example prolonged sitting.”

So - keep on running! And if you’re worried about your knees, give us a call on 02030 12 12 22 to book an appointment with one of our specialist physios.

Bodypart Of The Month: The Shoulder

 
124273639_s-shoulder-muscles_500x500.jpg
 

Bodypart Of The Month: The Shoulder

Next in our Bodypart Of The Month series is the shoulder. We asked our specialist shoulder physiotherapist, Nick Smith, to tell us all about it.

The Shoulder

The shoulder, or Glenohumeral joint (GHJ) is a ball-and-socket joint like the hip joint. The hip joint has a ball that sits in a very deep socket making the joint very stable.  The ball of the shoulder loosely fits in a shallow cup (the glenoid). It is very much like a golf ball on a tee. The GHJ has the greatest mobility of any joint in the body, but is less stable than the hip and more prone to injury.

Soft tissue structures helping to stabilise the GHJ include:

  • Joint capsule and ligaments.

  • Glenoid labrum - a ring shaped cartilage structure that increases the depth of the glenoid by 50%.

  • Rotator cuff (RC) muscles, deltoid and long head of biceps.

In the shoulder there are 6 bursa, sacs filled with fluid found between tissues (bone, skin, tendons and muscle), acting as a cushion to decrease the friction and the irritation between the tissues that move between each other.

When your shoulder works well

When your shoulder is working well the rotator cuff (main function is to keep head of the humerus centred in the glenoid as the shoulder moves, and to lift and rotate the shoulder in the many directions) muscles are working together allowing your shoulder to function without pain and you can participate in your chosen sport or activity.  

When your shoulder doesn’t work well

When your shoulder is not working well this can lead to soft tissue inflammation and possible damage. Injuries include rotator cuff tendonitis and tears, Sub acromial pain (impingement), SLAP (labrum) cartilage tears and bursitis.

Common shoulder injuries

Shoulder dislocation, often due to trauma and falling on an outstretched arm, is a common injury I see in clinic. Most dislocations respond well to physiotherapy and rehabilitation. Occasionally surgical stabilisation may be required if you sustain bone and soft tissue trauma during the dislocation.

Rotator cuff tears are also a common injury and are caused by injury, overuse and degeneration. The treatment of rotator cuff tears depends on the size and location of the tear. Small tears can be managed with physiotherapy and strengthening exercises. Full thickness tears will require surgical repair and then physiotherapy.

Avoiding shoulder injuries

Don’t over load your shoulder too hard too quickly. Build up your strength, resilience and tolerance to load. Ensure you have to correct technique for your chosen sport and activity.

Got shoulder pain or niggles? Call us to make an appointment with Nick on 02030 12 12 22.

Words by Nick Smith.

Running the Virtual London Marathon #40thRace

Image courtesy of Virgin Money London Marathon.

Image courtesy of Virgin Money London Marathon.

Running the Virtual London Marathon #40thRace

Inevitably, as with pretty much every event ever scheduled for 2020, the London Marathon has been rescheduled and changed format to allow for the safety measures needed to help combat the Covid-19 pandemic. If you hadn’t heard, it is going ahead on its rescheduled date of Sunday October 4th 2020 in various formats.

The elite race will be held in a closely controlled biosphere environment on a closed lapped circuit in St James’s  Park. Those with a place in the mass-participation 2020 event can take part in The 40th Race by running the famous 26.2 mile marathon distance virtually, anywhere they like from 00:00 to 23:59:59 BST on Sunday 4th October. If you don’t have a place yet, there are apparently still charity places available (at time of publishing this blog post). You can search for them with this link.

Ways to run your #40thRace London Marathon

Without the build up on the day, forty thousand fellow runners and the crowds cheering you on, the motivation to start and complete your remote marathon could be difficult to come by. You could just step out of your front door in your standard running kit and run your marathon, but why not mix it up a bit? You don’t even have to run it all in one go.

We’ve found some ideas to make it more fun and help with motivation at the same time.

You could:

  • Get a household member  to drop you off somewhere else and you can run the distance home – it’s quite a motivation to know that you’ve got to get home.

  • Run to a destination 26.2 miles away, having arranged to meet someone with a medal and a space blanket to collect you at your finish point.

  • Set up a route that goes past the houses of some of your friends so they can cheer you on, fill up your waterbottles or have a good chat with you.

  • Run a route which takes in local landmarks or tourist attractions for some interest (and good photos?).

  • Get your friends to run or walk a few miles or the whole route with you, socially distanced, of course.

  • Use the full 24 hours! Run a mile every hour (plus a couple of extra miles in one of the hours) and use the rest of the hour to do all those small jobs you never get around to such as hanging pictures, cleaning your car, weeding your front garden etc – just like Beau Miles did in his 24 hour marathon challenge.

  • Run your marathon in fancy dress, even if you hadn’t been planning to this year. Do train in your outfit to check that it’s ok to run in though!

We really shouldn’t need to say this but we will - do remember to stay socially distanced and within Government rules at all times. Stay hydrated and well-fuelled and look after yourself.

Don’t forget to consider your post race recovery as well. Emily, our sports massage therapist and resident triathlon coach, gave us her Top Tips For Marathon Recovery last year.

Have a great #40thRace!

Don’t forget that we’re open for face to face consultations at The Lansdowne Club and virtual consultations from the comfort of your own home via Zoom so if you’ve got any niggles or injuries, call us for an appointment on 02030 12 12 22.

Words by NoviceRunnerNik, image courtesy of Virgin Money London Marathon.

Top bike tips for commuters and road cyclists

unclip to stop.GIF

Top bike tips for commuters and road cyclists 

Whether you’ve just converted to commuting by bike recently, or are just starting to ride for longer at the weekends, here are some great tips from our massage therapist and resident triathlon coach and bio-mechanist, Emily : 

Skills that you definitely should have (if not, get practising!): 

  1. Be able to take one hand off the handlebar to signal or drink from a bottle. Engaging your core by tucking your tail bone in and relax your grip will help. 

  2. Be able stand up and sit down while pedalling, this increases air flow for ventilation and helps with bottom numbness / saddle sores as well as giving you more power to go uphill. As you stop at a traffic light, stand up, step off the pedal with your curb side foot on to the ground and take your bottom off the saddle. It is a lot safer than stopping seated, tip toeing to balance, especially in cleats.

Unclip to stop.

Unclip to stop.

Strength and conditioning 

Especially if you are new to cycling, off the bike training will help building the necessary muscles much quicker and help keep injuries at bay. Single legged exercises are far more effective, because, well, we are not bunnies! 


Single legged bridge 

 
Single legged bridge
 

Side plank leg raise

 
side plank leg raise
 

Single leg squats (assisted)

 
single leg squats
 


Stretching

If you only have time to do one stretch, this table top pigeon pose will help loosen your glutes and your back. You can hang in this pose for a few minutes, turning your chest both sides to adjust the angle, and have a cup of tea at the same time!

 
Table top pigeon

Table top pigeon

 


Nutritions

  1. Electrolytes - just water is not enough. As you sweat, a range of salts are lost and your blood becomes diluted. These electrolytes will need to be replenished or the consequences are dire. To make sure you get the correct amount, always follow instructions for the correct ratio of water to electrolyte tablet. Better yet, do a sweat test to be sure:  https://www.precisionhydration.com/pages/why-personalise-your-hydration-strategy

  2. Your body takes between 30 minutes to 2 hours to convert food into usable energy. Your glycogen index has between 1 - 2 hours’ worth of energy stored. So fuel before your ride, and, depending on how long your ride is and how hard you are riding, refuel frequently! 



Mechanicals

At a minimum, make sure your brakes are working, your handlebar does turn  and your tyres are inflated to the required pressure. 

Tip 1) Tyre pressure and size are all printed on the side of the tyre for your information.

 
tyre pressure and size on tyre
 


Tip 2) When taking out a wheel on a bike with hydraulic disc brakes, especially when putting into a car or transporting it, or putting on a turbo, wedge a card between the pistons to prevent them closing together.

 
put a card into the disc brake space
 


Tip 3) Bike pumps usually work like this: lever down to push into valve; lever up to lock in position; pump to appropriate pressure; lever down; use both thumbs to push the pump head away (wriggling it could damage the tyre valve) 

attaching a pump to a bike valve


Tip 4) Bike grease is like any grease, you can get rid of it with bike specific degreaser, or just soap and water. 

Happy cycling!

Words and images by Emily Chong.









What does my physio think about foam rolling?

man foam rolling

What does my physio think about foam rolling?

What is Foam Rolling?

Foam rolling -  rolling parts of your body over foam rollers, which come in a variety of densities, textures and sizes, using your bodyweight to apply pressure and give a self-massage before and after exercise to help with recovery – is very popular in the fitness world. The idea is that you roll slowly and when you find a tender spot, you focus in on it by rolling back and forth until you feel it soften or release. But does it actually help?

Is foam rolling good for me?

Our spinal specialist Physio Shari says

“As popular as foam rolling is, there isn't actually any research evidence that supports it. I don't routinely recommend it.”

Emily, our soft tissue therapist, triathlon coach, athlete personal trainer, comments: 

“It depends on where you roll and when you roll. There are many conflicting studies and reports. From an athlete’s point of view, it boils down to if it makes you feel better, roll it, if it causes pain more than 7/10, then don’t. Foam rolling can feel like a self-massage which should be done when the muscles are warm and as part of recovery.”

Stuart, our specialist knee and foot & ankle physio says:

“Foam Rolling or any other form of muscle release may help reduce tightness and soft tissue stiffness and thus can assist. It can be beneficial after exercise.”

Our sports injuries specialist Nick comments:

“Whilst there’s no credible evidence to back up claims of the magic of these things, if they help then why not? They won't do any harm.”

If you’re injured, in pain or just need some advice, call us on 02030 12 12 22 to book an appointment with one of our specialist physios.

Getting Back To Normal - Shoulder Related Tips!

shoulder pain

Getting Back To Normal - Shoulder Related Tips!

Nick, our shoulder specialist physio, is back for face to face appointments with his shoulder and upper limb clinic on Tuesday 14th July. We asked him for his shoulder-related tips on getting back to ‘normal’ – whatever that looks like for you!

It's more than 100 days since lockdown began - how has this affected you?

How fit do you think you are following 3 months of relative inactivity? 

During lockdown you might have worked on your general fitness, but has this been sport specific fitness? We are now able to play tennis, golf and open water swim.

Tennis related injuries seen in clinic:

  • Rotator cuff related shoulder pain (RCRSP): this includes subacromial pain (impingement), bursitis, rotator cuff tendinopathy and symptomatic partial and full thickness rotator cuff tears.

  • Tennis elbow and wrist/hand.

  • Low back pain, hip and groin, knee and patella tendon, calf muscle and ankle sprains.

Golf injuries:

  • Low back and neck pain

  • Shoulder, elbow and wrist/hand pain

  • Hip, knee and ankle pain

Swimming injuries:

  • Shoulder: RCRSP

  • Neck

  • Knee

Tips for getting back:

  1. To avoid tissue overloading and causing injuries don't go back to your chosen sport too hard or too fast. 

  2. Always warm up and stretch prior to starting to exercise.

  3. Aim for graded exposure and progressive loading, build up your resilience, tolerance and capacity. Increase your effort by approximately 10% per week to achieve your chosen goals.

Home working and ergonomics: 

We've probably all tried to recreate our desks at home, some more successfully than others! Prolonged sitting and working with incorrect postures can have an adverse effect your neck, upper back, shoulders, and thoracic spine. 

If you’re still working from home and are suffering from shoulder / neck pain, it’s likely that your desk set up isn’t ideal. 

Tips for better working from home:

  1. Arrange a virtual workstation assessment of your home office to improve your desk set up.

  2. Consider the purchase of more ergonomic office equipment such as a monitor, keyboard and mouse for your laptop, a height adjustable ergonomic office chair, a headset for your phone if you spend lots of time on it.

  3. Keep active at your desk – move around every 20 minutes. Have a good stretch at lunchtime and the end of the day. Walk around if you can whilst you’re on the phone.

  4. Read our blog post How To Work From Home Pain-Free for more tips.

  5. Visit your physio to check out pain or niggles that persist.

Keep safe and remember movement is life!

To book an appointment with Nick or any of our other physios or a workstation review, call us on 02030 12 12 22.

Words by Nick Smith.

 

 

 

8 Tips To Master Your Mindset Through Injury

 
head and mind jig saw puzzle illustration
 

8 Tips To Master Your Mindset Through Injury


I hope you are all safe and well and are hopefully coming out of this period in a good place. Although this time has been challenging for many, it certainly has given us some space to reflect on many things which hopefully will serve you well moving forward. 

Today I wanted to talk about how to manage your mindset through an injury. This is such a crucial part of overcoming an injury, and in fact, can be the difference in the time of recovery and also the success of the recovery. Injuries are difficult to deal with as they stop you doing the things you love doing or even more practically can stop you from being able to manage normal daily activities. There is a huge three way connection between the mind, the brain and the body. As an analogy I like to think of it like this. Imagine an oil refinery, the petrol and a car. The oil refinery is the mind, the petrol is the brain and the car is the body. 

Processing     →     Fuel     →     Performance

Oil refinery     →     Petrol     →     Car

Mind     →     Brain     →     Body

Ultimately what we fuel our body with, physically, mentally, emotionally, spiritually, will determine the performance of the car. I know first hand, both having being injured and also having seen 1000s of injuries, just how a person’s mental attitude can help. When I worked in professional football, what amazed me was the difference in how players coped with similar injuries and how this impacted on their recovery. Although we can’t cheat physiology, healing and anatomy on a grand scale, we can certainly change it by altering our brain physiology which has an impact on our perception of pain and function and can lead to a quicker and more successful return to full health. 

Below are 8 tips for managing the energy that goes into overcoming your injury. No matter how big or small your injury is, there is always a place for improving the overall well being of your mind to help your recovery. 

1. Accept and don’t blame - At times of course, our actions may have been a factor in our injury. If we suddenly did something we were completely unaccustomed to then yes, we could look back and say ‘Oh why did I do that?!’. This is ok, but rather than blame ourselves, we should use it as a lesson for the future. We don’t set out with an intention to injure ourselves! We most often have good intentions, to be healthier, fitter, stronger etc, and this enthusiasm can overlook the fact that our body was perhaps not prepared for that change. Accepting that it has happened and moving on to deal with it as best as possible is key. 

2.  Don’t compare - No two injuries are ever the same and they are certainly not the same in how they present in different people. It is important to stay present to your injury and focus on that and that alone. You can certainly draw on experiences of previous episodes you may have had or people you know who have had similar but use that as a check point rather than a strict comparison. You may judge your progress negatively if you compare it to others who have recovered quickly. Stay in your own reality. 

3. Goal setting - This is a really crucial area and it is up to you and your therapist to come up with short, medium and long term goals. The most important of these are the short term goals as they will keep you present. At the start of your rehab your therapist should know what your ultimate goal is as this differs for everyone. Short term goals however are the key to keeping momentum going. You should establish a set of what we call process goals and then little tests you have to pass before you can move onto the next stage of rehab. This really is more for your therapist to do and then give you the exercises to reach those milestones but it’s really important to understand how these process goals will move you closer to your long term outcome. In the back of your mind, have that long term goal in sight, but each day focus on the tasks right in front of you. This is what will cause the mini shifts day in day out and before you know it you’ll be closer to your dream destination!

4. Clean language - The way we describe our injury and how we visualise what is going on in our body is really important. Unfortunately, it is not just patients who use inappropriate language when describing injuries. Therapists can also fall into habits which aren’t beneficial to an a understanding of the pathology of the problem. There is a lot of fear which can creep into a patient’s mind when they are spoken to in language which serves to, at times, catastrophize the problem. Depending on the injury of course, examples of such words are ‘unstable, broken, inflamed, tight, flared up, out of place’. Now in some instances, it may be appropriate to use some of those terms but a lot of the time it just isn’t scientifically right. The two most common misconceptions I hear are “My ITB is tight’ and “My back is out of place”, both of which aren’t really true! Speak to your therapist to gain a good understanding of what’s going on and use better language yourself in describing it. It can be a real game changer in moving forward with your rehab and altering your mindset. 

5. Visualisation - The power of visualisation is very real. You may have seen the images of F1 drivers mentally practising the circuit prior to getting in the car, tennis players getting into the zone during breaks, dancers working through routines in their heads etc. This constant mental imagery closes the gap between the thought and the action and allows the two to be more whole. This can work in rehab too. There are studies which show that adding visualisation can help the recovery from injuries. Sitting there and visualising healing taking place, picturing a healthy joint, muscle of whatever is injured, and looking positively at the recovery can aid both pain and also function. It is almost like a mini hypnosis which can be so powerful. It may sound odd, but talking to your injury verbally for a few minutes a day can help with recovery. 

6. Breathing - Similar to number 5 this is a really simple technique that we can use. The reason breathing properly and mindfully is so important is the effect it can have on the physiology of our body. Although you won’t notice the immediate effect of, say, breathing for 5 minutes a day on your rehab, over time the change is real. Breathing helps to regulate cortisol levels, the hormone which is released during times of stress. Regardless of where the stress is coming from, cortisol will be elevated in this state. During injury, stress may go up. Exercise has the effect of releasing your happy hormones: endorphins which can counteract the stress hormone. So, if your exercises routine has been disrupted and this balance of hormones has been affected, taking just 5 minutes twice a day to focus on some breathing techniques can really help regulate stress. You can try diaphragmatic breathing, box breathing, alternate nostril breathing - there are many forms of breathing out there. Please make sure that you are in good health, have no associated heart or respiratory conditions, are not pregnant and do not have other health issues that could be a contraindication to doing some of these techniques. 

7. Be adaptable - In some instances we have to accept that an injury may force us to reconsider what we can do going forward. I personally know how this feels.  After having had several ankle injures, I have now accepted that I can’t do the things I did 10 years ago which is ok and I have since found new things to help and also keep my enthusiasm up for exercising despite not being able to do exactly the same things. Re assess your current exercise routine, be open to trying things you haven’t tried before, understand that our bodies do change with age - what may have previously worked for us may not be serving us as well now. I am a big believer in having variety in your exercise, unless of course you have a very, very specific sport or event which requires you to train very specially. For example, it would be counterproductive for a 100m sprinter to suddenly take up lots of yoga as they actually rely on an element of stiffness to produce power over a short space of time. Train your body in different ways to ensure good balance of strength, flexibility, power and fitness. 

8. Make sacrifices - Ultimately it comes down to how important an outcome is to you. Your ultimate goal and your lifestyle have to be aligned if you want to see the best and quickest results. Not only can our brain not comprehend conflicting thoughts, nor too can our body. What do I mean by this? Well, if you want to lead a healthier lifestyle and yet keep telling yourself that you love fast food, your brain will become confused and so too will your actions. Similarly, if your goal is to ski after a knee injury and your physio has set you a programme of going to the gym 3 - 4 times a week, choosing to go out socialising on two of those days instead is not going to produce the results you need. It may sounds common sense but it is often not common practice. Your daily habits will, over time, produce the results you want. It’s that simple. Be prepared to sacrifice some things, perhaps only for a while mind you, to focus on what matters most at the time. 

I hope that these points have been useful in identifying some areas you could work in to optimise your rehab. I am a huge believer in mindset and how it affects the body and paying attention to the above can really help shift you in the right direction. 

If you would like to find out more about any on the above then please feel free to contact me at alex@physioremedies.com.

I wish you well in your rehab and I appreciate you for taking the time to read this article.  

Stay healthy, stay strong!

Best wishes 

Alex. 


Words by Alex Manos.



COVID-19 The Road To Recovery

Covid-19-road-to-recovery sign

COVID-19 The Road To Recovery -

Advice From The Chartered Society Of Physiotherapy


Have you had Covid-19 or know someone who has had it?

The Chartered Society of Physiotherapy (CSP) has developed a brand new animation to help patients who are recovering from Covid-19 to self-manage their symptoms with physiotherapy guidance. This is a great resource for you to share with your friends and families to help ease some of their anxiety about recovering from the virus and getting back to normal life. The animation is titled COVID-19 The Road To Recovery and you can watch it below:

This short, 90 second animation illustrates what people can expect when recovering from Covid-19; reassuring them that it may take time to get their energy and fitness back. It also provides advice on simple measures that anyone can take to ensure the best recovery possible; like keeping active and partaking in low-intensity exercise.

If you or anyone you know have concerns about your recovery from COVID-19 we encourage you to seek the advice of a Chartered Physiotherapist, GP or other Health Professional, who can provide bespoke advice and support. You can also see more information about Covid-19 recovery from the CSP by visiting this link - Covid-19: the Road to Recovery.

If you’d like an appointment with one of our physios, please call us on 02030 12 12 22 to book an appointment.

Looking After our Mental Health In Challenging Times

looking after your mental healthv

Looking After our Mental Health In Challenging Times

Managing purpose and productivity during the coronavirus pandemic

Our mental health has a huge effect on our physical health and it’s important we take notice and care of both, particularly during challenging times such as these. As physiotherapists, we talk a lot about physical health so we asked our specialist physio Alex, who is also a Life Coach and Yoga instructor, to talk about looking after your mental health:

I hope that you are all keeping well and have been safe and healthy during this unusual time. It’s encouraging to see that the green shoots are hopefully appearing and slowly but surely we will be returning to a more normal way of living. It has been a challenging time for everyone no doubt in many ways. Not only has the financial implication taken its toll on many, the major shift in balance of work, life,  family and  social time has made it a challenge to re adjust. 

I wanted to briefly share some of the insights I have had and how I have managed to keep momentum going despite a huge reduction in my day to day work which has given me time and space to explore other things. I do this to see if I can hopefully help guide you into a mindset which focuses on the positive which has come from this. 

I wanted to write about two concepts which have perhaps been a challenge for many to find results in: they are productivity and purpose. So much of our value in terms of productivity and purpose comes from our time spent at work and for many of us who have not been able to continue working in the same way, this dramatic shift could have been met with a lot of resistance and a sense of feeling lost. A lot of our work is based around a problem and then solution type scenario. Whatever line of work we are in there is usually a starting point and an end task to to our duties and with that comes a sense of accomplishment, recognition and validation for our efforts. We gain purpose from being productive in the work we have been given to do, that's completely natural.

So what happens when our external source of productivity gets taken away? How do we generate that internal fuel to drive our feeling of purpose? What happens when our daily focus suddenly shifts and we have a blank canvas as to what we can attend to? 

The brain and mind is a wonderful thing and one of the beautiful contradictions is that when we get the things we often yearn for, we miss, we wish we had more of, we are often not prepared and actually struggle to manage them. It’s the reason why so many lottery winners actually end up losing all their money or run into emotional and social problems because they suddenly step into a new way of life which they themselves have not created, so they actually are unaccustomed to it, it’s alien to them.

So what can we do to manage this so we come through it with purpose, productivity and a sense of value? 

Here are 5 ways we can look at what has happened and happening with a fresh and positive mindset, a mindset which will make us appreciate things. 

  1. Ask yourself this simple question. Prior to the change, what were the things I really wanted more of? Of those things, which ones were in my control to make use of and appreciate. 

  2. What areas in my life needed more attention? Perhaps it was health and fitness, your relationship with a significant other, your relationship with your children, your intellectual life, your emotional and spiritual well being, your career (perhaps a career change), your time spent communicating with family and friends. Looking at those areas, what steps have you taken to elevate them to a new level? Where can you find areas of personal growth to work on? 

  3. What can you be truly grateful for? The simplest way to do this is to start a gratitude journal or practice. A nice way to do this is the ’10 finger gratitude practice’. Each day, sit quietly somewhere for 5 minutes where you know you won’t be distracted (the start to the day is usually best if possible) and open your hands. Close your eyes, visualise and internally repeat 10 things you are grateful for and each time you do, close one finger until you have done 10. Then take your hands openly and place them over your heart and breathe deeply 5 times inhaling the things you have just show gratitude for. Literally fill your body with a sense of appreciation for what you have. 

  4. Understand that rest is a necessary thing. Taking a pause from usual life, if you are fortunate to be able to come out of it unscathed, is a blessing. If, we say live to an average age of 80, 5 months off equates to 0.5 percent of your life. Think about it, 0.5 percent of your life to recharge, re group, re evaluate what matters and spend time doing some of the things you really really want to do.

  5. I personally came from a place of thinking that we are just merely passengers on this planet. As much as we have created some wonderful things we have also done some extremely damaging things to the planet. I take solace in thinking that perhaps the planet needed a break from us to recharge, regroup, find it’s beauty again, breathe and restore some of it’s natural existence so that us humans can live in more peace and harmony with our surroundings and the other creatures and living beings which we share this world with. Think about the dolphins in Venice, the flamingos in Mumbai, the pandas in Hong King zoo mating. Theses amazing pictures and stories which have come out of the earth having some time to itself. 

Another wonderful tool we have at our disposal in this modern era is the availability of free information. At the touch of a button we can watch a TedTalk, a you tube video, listen to a podcast, download free programs, access free exercise routines. So many wonderful ways we can keep exploring self development and personal growth, for FREE! 

When we come from a mindset that things happened for us and not to us we can hopefully begin to accept the challenges and appreciate the new opportunities that may arise in this time. 

  • There is purpose in reading a book 

  • There is purpose in spending uninterrupted play with your children 

  • There is purpose in having the chance to sit as a family to share a meal more often 

  • There is purpose in taking a walk in the woods and saw during the amazing weather we have had

  • There is purpose in listening to podcast

  • There is purpose in watching that Netflix series you have been wanting to 

  • There is purpose in starting to learn a new language 

  • There is purpose in learning to cook 

  • There is purpose in just slowing down

There is purpose all around us. Once you can detach from needing an end result to something, needing that goal crossed off, one can find purpose in the journey and the existence of just being present and appreciating the things right in front of our eyes.

In perhaps one of the greatest movie speeches of all time and a personal favourite of mine, Al Pacino playing Tony D'Amato in the film Any Given Sunday, says ‘That’s what living is, the six inches in front of your face’. It’s a wonderful philosophy as it can keep us grounded and in the moment. 

I hope that you have enjoyed reading this message. This kind of work is a passion of mine and I have been fortunate to learn from some of the very best and I am grateful to have a platform to share and serve people in a way which I too have been served by others. 

Words by Alex Manos.

Body Part Of The Month: The Spine

body part of the month - the spine

Body Part Of The Month: The Spine

For the next blog piece in our Body Part Of The Month series, our spinal specialist physio Shari tells us about the spine.

The Lumbar Spine And Lower Back Pain

At some point in our lifetime 80% of the population will suffer from lower back pain. There are a number of different causes of lower back pain and if your pain is persisting it is always recommended to seek the opinion of your health care professional.

Causes of Lower Back Pain

Sometimes the cause of back pain can be a muscular strain from being in an awkward posture after gardening or a long flight, and other times the cause may be from a structural problem.

Below are listed some of the common things I see in practice:

  • Non-specific lower back pain

  • Discogenic lower back pain

  • Radicular pain-caused by neural impingement and often experienced as symptoms in your thigh or leg, be it pain, numbness, pins and needles or weakness

  • Facet joint pain

  • Spondylolisthesis: forward slip of the vertebrae

  • Fractures

  • Osteoarthritis

  • Stenosis: narrowing of the space in your spine where the nerves are present, and associated with arthritis

  • Rheumatological conditions - auto-immune conditions

  • Sacro-iliac joint pain

  • Pregnancy related pain

  • Hypermobility associated pain

Assessing Lower Back Pain

When treating my patients initially I will take a thorough history of your condition, and ask about your past medical history, your current symptoms, medications, activity levels, stress levels, occupational requirements and goals. Then a physical assessment will be undertaken to determine your diagnosis. Occasionally scans and investigations are needed, and you may be referred to a specialist consultant doctor.

Following this we will formulate a treatment that will best address your issues whether it be improving the mobility of your spine, your pain or strength deficits.

 Treating Lower Back Pain

Exercises that address the flexibility of your spine and the surrounding joints such as your upper back, as well as your hips and pelvis can also be beneficial, as can exercises that address the activation and strength of your stabilising muscles, to help get you back to the activities that you enjoy.

Sometimes taping and belts can be helpful in the acute stages of pain or where stabilisation is needed such as in pregnancy. Occasionally medication may also be necessary to reduce the inflammatory pain in your spine so that you can undertake the prescribed exercises.

In severe cases of pain spinal injections by a specialist doctor are needed to reduce inflammation, which then can enable patients to be able to undertake their exercise rehabilitation.

In most cases it is best to maintain your mobility and activity levels as long as this isn’t aggravating your symptoms.

Words by our specialist spinal physiotherapist Shari Randall.