Sports Training

 

rugby bad bulgarians

Can anyone spot the errors in these rugby players single leg squats?

Since the start of 2016 I have been helping the Devon Ladies Cricket team prepare for their upcoming tour of South Africa by advising on their strength and conditioning sessions at Exeter University’s High Performance centre. It’s been great to be part of such a hard working group of athletes focussed on improving and being the best that they can be. The team at Exeter Uni has devised a great strength and conditioning program for the girls and despite being pushed hard they don’t complain, instead they grit their teeth and find even greater levels of performance.

However the one area where Chiropractic rehab has been particularly helpful is core stability training including glute muscle strengthening. The girls biggest deficits on assessment were rotational instability of their trunk and glute/hip control of squat/lunge patterns. Despite their high levels of fitness and sport specific skill they are still in need of plenty of supervised “core” work to take their fitness to the next level.

squat with heel raise

The picture above represents one (limited ankle mobility) of many mistakes I see on a day to day basis in gyms from people of all levels of fitness. Subtle corrections in technique can make all the difference in an exercise being great for you instead of causing a repetitive strain injury. The Ladies cricket team and several of the other sports teams training at the uni are no different to the general public in the technique mistakes they commonly make.

trx correction

This is why the best personal trainers and strength coaches are worth their weight in gold. They don’t just throw a program at you with loads of squats, deadlifts etc and motivate you to lift more, run faster etc. Instead they start with an assessment of your capabilities, identifying your strengths and weaknesses and then creating a routine that works on improving your weaknesses not just enhancing your strengths. They are always on your case about technique because they know that good technique = fewer injuries and fewer injuries = more consistent training, this then leads to better results as you can string together more uninterrupted blocks of good quality training and competing.

Lots of people seem to be aware of the need for more core stability these days and stronger glutes. Yet these are the very exercises that I see most often performed incorrectly in many cases resulting in little to no glute or core activation even though technically the individual is doing a “core” or “glute” exercise. Remember just because the little picture on the machine says its for your glutes it doesn’t mean any which way you do the exercise your glutes will get stronger.

lunge correction

Unfortunately so few instructors in gyms are sufficiently trained on exercise technique to help you out in this regard. My Chiropractic clinic is based at the Westbank Healthy Living centre in Exminster, mainly because it’s one of the few gyms around that has properly trained staff who I can trust to refer my patients to for rehab and personal training. After Easter we are putting together an exciting new fitness class for adults of any age and fitness level.

The classes will be in 6 week blocks for up to 8 people per class. Week 1 will consist of assessment and basic home exercise plans will be created for each individual based on their identified needs. The subsequent 5 weeks of classes will be supervised rehabilitation training sessions focussed on improving whatever mobility, stability and motor control issues that were identified in the assessment. The total cost for this 6 week exercise course with personalised program is just £60. To book your place or enquire for more details email Paul Hindle: exsicc@gmail.com

 

Gardening season approaches

gardening back pain

I know with storm Imogen currently sweeping us off our feet the gardening season and warmer weather seems as far away as ever but it is only around 1 month now till the allotments start filling up with hideous postures sustained for a whole weekend and then people wondering why they have back pain on a Monday! So I’m giving a little bit of advice here for the green fingered among you with some tips and exercises.

Firstly if your winter has consisted of significantly less physical activity than the warmer months start doing some exercises now to build your fitness for gardening. Fitness for gardening might sound as useful as fitness for darts but both activities put your back into awkward and sustained postures that stronger, fitter muscles and more mobile joints can handle better.

Hip and ankle mobility are important to make bending less stressful on your back. Regular calf stretching and hip mobilising is a good idea for anyone who cannot do a deep squat with good technique. If you are actually very flexible then your biggest issue is likely to be “core stability” so exercises to strengthen the tummy muscles and glutes would be most beneficial.

When your back does hurt NHS Physio’s often recommend hugging your knees to your chest or touching your toes repeatedly from a standing position. Whilst both these exercises will give your muscles some stretching relief in the short term they are also contributing to an increased load on the discs of your lower back making them wear out quicker in the long term so don’t do them!

Some safer alternatives for back stretching include:

Prayer stretch

prayer stretch
Start on all fours, sit back onto heels and reach hands out in front, hold for 30 seconds.

Cat stretch

catcamel

and simply laying on your back with your legs supported by a chair.

egoscue static back

If these exercises aren’t enough to settle your back pain down after a few days then you probably need some actual hands on treatment like massage and manipulation. Having these types of chiropractic treatment every few months can also help keep back pain at bay by stopping the usual build up of muscle/joint stiffness over time.

Tennis Elbow…but I don’t play Tennis?

 

elbow pain

So tennis elbow is a relatively common condition even in the non sporty population. It refers to chronic inflammatory pain around the outside of the elbow (lateral epicondylitis). A similar problem can affect the inner side of the elbow and is termed golfer’s elbow (medial epicondylitis). Both conditions occur over a long period of time from overuse. The tendons around the elbow gradually become increasingly inflamed as the muscles pulling on them are being overused. Standard medical treatment involves anti-inflammatory medication and rest.

In some cases just stopping the aggravating activities for a while will settle it down. The most common aggravating activities besides sports like tennis and golf are; typing, writing, using a screwdriver, stirring and just generally gripping things a lot. It’s better for you to use ice for 10 mins at a time rather than ibuprofen etc (unless you like damaging your stomach, liver and kidneys!). Also gentle stretching of the overly tight forearm muscles should help.

For pain on the outside of the elbow/forearm (tennis elbow) gently make a fist with your thumb tucked into it and bend the wrist down to the floor with a straight arm. The lower of the 2 stretches in the picture below (open hand as in the picture is less of a stretch).

forearmstretch

The top stretch in the picture above is for golfer’s elbow and it is best to do it with the palm open as in the picture. Hold the stretch for up to 30 seconds and repeat several times per day along with the ice.

The most effective home (or gym based) exercise for any tendonitis is eccentric stretching. This means stretching the muscle/tendon whilst it is being lengthened under contraction. Normal static stretching involves lengthening the muscle under relaxation. Up to a point results improve with heavier loads (more than 1-2kg dumbbell) although you should always start light and progress gradually as pain allows! In the gym use a dumbbell, at home find something similar in weight and easy to grip (you can even use your other hand for resistance).

The key is to slowly lower the wrist of the painful elbow side under some form of resistance. The stretch should hurt a little bit but not a lot so be careful. 5-10 repetitions each day should be sufficient but it is vital that, especially if you are using a weighted object, you don’t contract the muscles to lift the wrist back to the start position. WTF you say? Yes really you need to use the other hand to lift the bad side wrist back to the start position so it can stay relaxed otherwise you are just going to aggravate the tendonsitis!

As with many musculoskeletal problems this simple home help advice may not be enough. Eccentrics are considered one of the most effective ways of resolving tendonitis. The trouble is they are a little complicated and if you do it wrong you will just make the injury worse. I have done my best to describe it here but if you are struggling it’s time to get the professionals to have a look and work their magic. Chiropractors are well trained in dealing with tendonitis and will not only massage the knots out of your muscles that cause the pain but also help loosen up the rest of your arms/neck and mid-upper back which are usually also part of the problem.

Call 07710791434 today and book your first appointment or book online. It shouldn’t take any more than 6-8 treatments to get you pain free.

400dpiLogo

Plantar Fasciitis, incurable or easy fix?

plantar fasciitis

So I was going to calm the blog writing down to monthly but this week just gone I had a couple of patients in suffering from plantar fasciitis. One of them has been suffering for over 12 months and the accepted natural course of the condition without treatment is up to and sometimes longer than 18 months. With treatment it shouldn’t last any longer than 4-6 weeks so why are so many people walking around for months or even years suffering from this painful, debilitating, easily treatable condition?

Firstly the NHS lacks the necessary resources to treat plantar fasciitis so unfortunately if you have just gone to your GP you have likely been told it will go away on its own after around 18 months. If you’re lucky you might have been referred to an NHS physio. Unfortunately this is when you will then realise they also are limited in what they can do for you. You will receive some stretches and maybe some ice advice which are part of the correct treatment protocol but they will not be allowed to give you the required number of treatments (which involves massage, manipulation/mobilisation and exercises) to get the problem sorted.

plantar fascia percentages

Secondly there still seems to be some confusion as to how best to treat plantar fasciitis. Some therapists seem keen to use extracorporeal shockwave therapy. This is essentially high powered ultrasound designed to break up the fascia/tendons in your heel area so that they heal in the correct alignment and hey presto no more plantar fasciitis. Unfortunately several years of research on this controversial treatment have shown it doesn’t work very often as the tissues rarely heal the way you want them to as the biomechanical problems causing them in the first place have not been fixed first. Also it is basically burning your soft tissues so people are left with lots of painful burns on their feet. It should only be a last resort for the 10% of people who don’t respond to manual therapy and exercise before they try surgery.

plantar ultrasound

Plantar fasciitis is not as complicated as it sounds. Basically the connective tissue (fascia), tendons and muscles under the arch of the foot have been repetitively strained over a long period of time by poor walking and/or running biomechanics. The most common reason is hyperpronation of the feet. This could be due to several reasons including weak foot arch muscles, weak glute stabilising muscles, excessively turned out feet/hips or just excessive distances walked/ran without a rest, particularly in inappropriate footwear and on undulating terrain. The latter is especially true in the armed forces.

pronation

Therefore to get better you need to firstly find out what the biomechanical problems leading to it are and get exercises to help correct those (and in some cases insoles/kinesiotaping). Secondly you will need several massage/manipulation sessions over a few weeks to loosen up the various muscles that are excessively pulling on the plantar fascia, please note this is also true for shin splints. Thirdly you need to regularly ice the foot and stretch the calf muscles to give your body the best chance at healing the damage that has built up in the plantar fascia. In most cases this should take less than 6 weeks.

plantar insoles

So if you have been suffering unnecessarily from plantar fasciitis for weeks, months or even years and you want to get it sorted as soon as possible seek out a suitably qualified manual therapist near you. Obviously I’m bias and would say chiropractors should be the first choice due to their superior training in diagnosis, manipulation & biomechanics whilst still having no worse training than anyone else in massage, exercises and stretching but in all honesty any manual therapist who understands the biomechanics of plantar fasciitis and can loosen up the right muscles and give you the right exercises will get you sorted.

If you live near enough to Exminster I can sort it for you at Exminster Sports Injuries and Chiropractic Clinic, call 0771079434 to make an appointment or book online. As long as you follow the exercise/ice advice no more than 6-8 treatments should be required to get you literally back on your feet.

What’s up with that tape athletes wear?

paul rocktape

We just got back from the Exmoor round of the Ultra Trail running series. The next round is January 31st 2016 on Dartmoor. By we, I mean Paul Hindle representing Exminster Sports Injuries & Chiropractic clinic and now Riviera wellbeing’s newest part time chiro and Natasha Hindle (nee Harris) representing Essential Chiropractic Torquay. Our role today was pre race kinesiotaping and post race massage. So why the hell did we bother putting tape on people? If you didn’t ask that question tough I’m telling you anyway 🙂

Kinesiotape is the overall name applied to any elasticated therapeutic tape that is placed over the skin to; improve mobility, reduce swelling & pain and improve biomechanics. Most brands can stretch 140% of their resting length. We use a brand of kinesiotape called Rocktape. The colours don’t matter at all therapeutically speaking but if you want to have a bunch of pink skulls running down your arm then its cheaper than a tattoo. What does matter is where you apply the tape and how much stretch you apply to it.

Rocktape is particularly good at sticking to your skin for up to 7-8 days even if you swim or have regular showers. It is designed for use by swimmers, triathletes and those who sweat a lot. It shouldn’t be used as a substitute for massage & manipulation but if you don’t have time or the money for those things then it can be a quick way to gain increased flexibility without doing lots of stretching etc. It’s best used in conjunction with manipulation/massage, stretches and exercise however.

rugby rocktape

Many different professional sports people use kinesiotaping these days and whilst some of its effect are likely to be placebo it clearly leads to:

When you are about to do a sporting event or if you are struggling at work with some repetitive strain injury then kinesiotape can be a less harmful/more effective alternative to taking painkillers. Put the offending muscle on stretch and slide the tape over the muscle without any stretch. It can also be used to reduce bruising/swelling ie to help settle a new injury during the acute phase (first 2-5 days). Today we mostly taped tight calves for the runners who were struggling with Achilles tendonitis. Obviously long term they need to start on the eccentric stretches and reassess the intensity/distance of their training program but for today it got them through a race they wanted to do, without pain.
calf tape

If you would like to try Rocktape you can see Paul in Exminster on Monday, Wednesday and Thursday or in Paignton (Riviera wellbeing) on Tuesday & Friday. Alternatively if Torquay is easier for you Natasha is available Tuesday, Thursday & Friday at Essential Chiropractic. Next month the blogs will slow down eventually becoming monthly not weekly, remember if you want a specific topic discussed leave a message below or email exsicc@gmail.com.

Running, good or bad for you?

 

Last weeks blog discussed arthritis and I mentioned the commonly held belief that running causes knee and hip arthritis may not actually be true. Studies have shown that compared to non-runners those who run regularly generally have a lower level of knee and hip osteoarthritis. But running can still cause many injuries including shin splints, achilles tendonitis, ITB syndrome, patellar tendonitis and glute medius tendonitis to name a few. Being physically under prepared for running is a key reason for this. Meaning that if you are running way more distance or way faster than you are used to running or you are too heavy for the amount of running you are doing then you will get overuse injuries like the ones mentioned above.

So what if you want to use running to lose weight? Well start sensibly with a mix of walking and running so you can build up your fitness slowly over many months. For example look for objects on your route that you can target like lamp-posts to run to and then walk until the next one and repeat. Don’t make big increases in your mileage, if you’ve signed up for a marathon but never run more than 5 miles a week before don’t try and go for long runs straight away, build your distances up slowly using examples like the couch to 5k program offered by the NHS.

The next important aspect whether you are elite, overweight, a beginner or anyone else you will also need to have good “core” stability to reduce the chances of overuse injuries from poor biomechanics when running. You need good rotational stability in your trunk muscles to reduce any twisting in your spine when running so you don’t run like phoebe from friends! Exercises such as rolling patterns, planks & bird-dogs will improve your rotational stability. You will also need good hip stability to stop your knee from dropping inwards each time you land, this is where the oft mentioned glute medius muscle comes into play and you can use exercises like side lying clams, monster walks, 1 legged squats and hip aeroplanes to strengthen these muscles.

If we look even further down the chain of muscles used for running then your ankle will also need some lateral stability to maintain a good foot arch so exercises such as toe scrunches, 1 leg balance, calf raises and hip aeroplanes (yes I mentioned this one twice for a reason :-)) will help to reduce inward movement of the knee the same way lateral hip exercises will. For these muscles to have an easier time of it good mobility of your feet, ankles, hips and pelvis (sacro-iliac joints) will allow for full, unimpeded running motion that does not need to be compensated for. Therefore it will also be good to do foot, calf, hamstring, quad, glute, inner thigh and lower back stretches regularly and/or have regular chiropractic to help maintain your mobility.

The other factor I wanted to go into a little bit of detail about in this post is the choice of running technique itself. The two main options are forefoot running and heel strike, referring to the part of your foot that makes contact with the ground first when running. Heel strikes are more economical in ultra long distance running (longer than marathon) but will increase the forces transmitted through your bones on each step. This leaves you more at risk of ankle, knee, hip and low back joint pain but is easier on your muscles. It is also a slower technique so if you are trying to run fast you should definitely be striking with the forefoot first.

Forefoot running as mentioned above is the predominant technique of sprinters, middle distance runners and some long distance runners as it allows you to use the powerful spring mechanism of your foot, achilles calf complex to rebound off the floor with each stride. This does reduce the load on your joints but means your muscles & tendons are taking over and so their injury risk becomes higher.

SSC

This means things like achilles tendonitis, calf strains, hamstring strains and plantar fasciitis become more common although most of these can be avoided with the things described in the paragraphs above like sensible time, distance and speed for your current fitness, good mobility, good core stability, good technique and regular chiropractic treatment.

So most of you will be best with forefoot running. A few might benefit from heel striking instead but all will benefit from having a body that can cope with the demands of running in the first place so be honest with yourself do you need to put more miles in, more speed or first concentrate on mobility/stability exercises whilst slowly increasing your running load. Core stability won’t make you a faster runner in the short term but if you get injured less then the consistency of regular training not interrupted by injury will make you a better runner in the long term.

If you would like to learn more about this and get any of your niggling running injuries fixed then call 07710791434 or book online via this website. Exminster Sports Injuries and Chiropractic Clinic are also teaming up with Essential Chiropractic Torquay at the Exmoor ultra marathon series next Sunday 27th September to offer pre race advice and rocktaping, so if you’re there and you want to know more come over and say hello and pick up some discount vouchers for clinical assessment/treatment.

Does every adult have arthritis?

pain pic

It seems even 20-30 year olds can go to their GP now and be told their aches & pains are “just their age” or “just arthritis” so do we really all have it? Well the short answer is YES but lets be clear about what is meant by arthritis. There are several different conditions that have the word arthritis applied to them, some of them have nothing to do with your age, some of them require medication and some of them are easily managed with lifestyle changes & manual therapies like chiropractic.

Inflammatory arthritides are the group of related arthritis (literally means joint pain) conditions that include rheumatoid arthritis, ankylosing spondilitis, reactive arthritis & gout. They are very painful and occur in sharp bouts of pain, with red, hot, swollen joints. They can be controlled by medication or less harmful methods like ice and comfrey. The underlying causes are usually a combination of genetics and lifestyle, particularly poor diet. Physical therapies like chiropractic can help improve mobility but are best avoided or minimised during severe inflammatory episodes. Emotions also play a role in the intensity of pain and the occurrence of inflammatory bouts so treatments like cognitive behavioural therapy (CBT) and emotional freedom technique (EFT) can help in some cases.

Osteoarthritis: By far the most common form of arthritis is osteoarthritis also known as degenerative joint disease and almost every adult will show some signs of this on x-ray in at least some of their joints especially the neck, back and knees. It cannot be cured and it cannot be avoided. This is the reason for the provocative headline of this article, but now the good news. In most cases especially if you start doing something about it early enough the pain and disability of osteoarthritis can be minimised and the progression of it slowed down so that it barely bothers you throughout your life. To find out how read on below!

Osteoarthritis is essentially wear & tear on your body throughout your life. If you hop around on one leg for years expect some early onset hip degeneration in that hip. If you are significantly overweight and/or have bad biomechanics of your hips & pelvis expect some advanced degeneration of your low back and knees. Many people think running is a key provoker of knee degeneration but recent studies have actually shown that this is not the case and non-runners actually have greater levels of degeneration. The biggest problem with running is that most people run with bad technique and run too far for their fitness levels, as well as having underlying biomechanical dysfunctions of the feet, hips and pelvis which put more pressure on the knees.

So hopefully you can start to see from the paragraph above that the majority of degeneration is not just your age or genetics it is how you perform movements, how often you perform them and how vigorous you perform them. Previous traumatic injuries like fractures also increase levels of degeneration around the injured area. Another factor is repetitive strain from work whether it is a physical job affecting things like shoulders and knees or a sedentary job affecting necks and low backs because of a lack of movement. I should also mention here that what you eat & drink can speed up or slow down degeneration of joints. An unhealthy diet particularly excessive sugar and insufficient healthy fats will speed up degeneration.

How do you slow it down then? Well eating healthily and doing regular moderate intensity, good technique exercise will help, especially working on things like core stability, hip mobility, thoracic (mid back) spine mobility, deep neck flexor endurance & foot/ankle mobility (See conditions pages for more exercise advice). You can do this with the right guidance from a knowledgeable fitness trainer/chiropractor and chiropractors can also help speed up the mobility improvements and pain relief with regular treatment to keep your joints loose, this should be somewhere between every 1 and 6 months depending on how much you are looking after yourself at home/in the gym.

If your degeneration gets bad enough you will likely have to resort to painkillers, injections and surgery but these should be a last resort as they do not solve the problem they will just help make the worst problems more bearable. So if you want to start taking control of your body find a good chiropractor and start getting some treatment and exercise advice that can help you grow old gracefully and make the most out of your free time. If you’re close enough to Exminster come to our clinic at the westbank healthy living centre (07710791434). Feel free to learn what you can from our information pages on this site, more free stuff coming soon!

Is Gluten Free Healthy?

gluten free

Walk in to any UK supermarket these days and you will probably see a “free from” section, often referring to gluten free products but also dairy free, wheat free, nut free etc. Now if you have an allergic reaction to any of these ingredients then it is obviously great that many shops, café’s and restaurants now cater for a wider range of customers. However I have noticed that a reasonable number of people seem to be confusing these products with healthy eating. In some cases they may be healthy products but just because something is “free from” doesn’t mean it is automatically good for everyone.

The most popular free from labelling at the moment seems to be gluten free foods. For those who don’t know Gluten is essentially a protein composite (gliadin & glutenin conjoined with starch) found in many grains including wheat, barley and rye. When these flours are used in baking the dough will rise easier than gluten free versions and have greater elasticity. The final product will likely stick together better and be more chewy. Gluten is therefore a source of protein in foods such as breads, cakes & pastries.

Some people suffer symptoms such as abdominal bloating, gas, diarrhoea, vomiting, migraines and joint pain after eating foods containing gluten. Around 1 in 100 people in the UK are thought to suffer from an autoimmune condition called coeliac disease where gluten consumption leads to inflammation of the small intestine. A recent study (2012) in the USA found a prevalence of around 1 in 141. There is no cure for coeliac disease but following a gluten free diet will alleviate symptoms. When the symptoms described above occur without the presence of an autoimmune response in the small intestine the person may be suffering from Non-coeliac gluten sensitivity (gluten insensitivity) or an insensitivity to a different food stuff such as short chain fermentable carbohydrates (FODMAPs). Irritable bowel syndrome (IBS) symptoms may also improve by avoiding gluten containing foods.

If you do suffer from any of the symptoms described above then try replacing the gluten containing foods in your diet with gluten free alternatives. If your symptoms disappear you don’t need to see a doctor to know you should be on a gluten free diet! HOWEVER, many gluten free products have a lot of added sugar in them so they are definitely not healthy. If you want to have a healthy diet you should only be having them as alternatives to gluten containing unhealthy sugary snacks on the rare occasions you are allowing yourself unhealthy sugary snacks.

Choosing gluten free products for healthier eating as a bread substitute can a good idea if you want to reduce your calorie intake but be careful to choose low sugar, low salt options such as lightly salted rice cakes or ryvitas. When looking at food & drink labels low salt is defined by the NHS as less than 0.3g salt (or 0.1g sodium) per 100g. High salt products are over 1.5g salt (0.6g sodium) per 100g. An average adult should have less than 6g (roughly 1 teaspoon) per day of total salt. High sugar products are defined as more than 22.5g “of which sugars” per 100g under the carbohydrates section of the label. Low sugar products are defined as less than 5g per 100g.

Personally I think with regards to sugar this is still way too high and would say anything over 10g per 100g “of which sugars” is a high sugar food which should be minimised in your diet. Your GP will be delighted with you if you avoid high sugar food and drink as your chances of developing heart disease, strokes, diabetes and some forms of cancer will significantly decrease. Your dentist will also be happy as your teeth will suffer much less decay and your chiropractor won’t need to see you as much as you will have less inflammatory joint/muscle pain from conditions such as osteoarthritis.

Remember food companies don’t care about your health only your spending habits so they will make gluten free products as appealing as possible within the (very lax) labelling rules. Gluten free and other free from products will reduce or eliminate any symptoms coming from gluten insensitivities but they are not necessarily healthy alternatives when you factor in sugar/salt content. If you want good tasting meals that are also healthy try making your meals from scratch using quality sourced, minimally processed ingredients. The following website has some good examples: CleansimpleUK