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Run or Rest?

If we sustain an injury most of us know or have heard of the acronym RICE (Rest Ice Compression Elevation).  We are led to believe that rest is an important component in order to help the injury heal.   However,  recent evidence and research now challenges the RICE phenomenon and in particular the rest element.

The question many runners or sports which involve running have is; can we run whilst we have pain?  For most of the runners I see in the clinic I aim to keep them running to some degree, but there are a number of factors to consider before I can make the best decision.

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Motivation Motivation Motivation – Where have you gone?

As a Physiotherapist, I know general adherence to physiotherapy treatment can be poor with only about 30% continuing after 12 weeks.  This is a problem because it has also been proven that treatment adherence has significant effects on outcomes.  This is also the case for adherence to exercise, to dietary changes, to taking medication.  Those who do it, who comply, DO BETTER

There are lots of different reasons, we lose our mojo.  Here are 3 tips to help you plan and stay motivated to your exericse programme.

Tip 1:  Think about your current situation


 Have a think about your current situation in relation to what your original goals were or what you really want to achieve.
For example, it might be to get back to running 5k 3 times a week pain-free.  It might be to get strong enough to be able to go skiing again after an injury.  Have a think or write down what you need to be able to do to achieve your goal.

Tip 2:  Next explore why you think you stopped doing what you were doing?    These are your barriers to adherence.

Some of the common reasons are:

  •         I forget to do my exercises.
  •         There were too many exercises.
  •         I didn’t have the time.
  •         I couldn’t see how it would help.
  •         I’ve had conflicting advice.
  •         I did it for a week or two but nothing changed.
  •         I didn’t know exactly what I was meant to do.

Tip 3:  Solutions to the Barriers

Use a table format with 2 columns or simply make 2 headings.

Heading 1: Will be the barriers  to exercise

Heading 2: Will be your solutions to these barriers.

Below  I have written out some of the common barriers that I hear on a regular basis in the clinic.  I have come up with some helpful solutions to overcome them. Of course you may come up with your own solutions that work for you.

Barrier 1:

Why am I doing these  exercises?  How do they relate to my injury?

Solutions:

 People who understand “the why” are more likely to adhere to their programme.  If you are unsure then speak to your physiotherapist.

Barrier 2:

Expecations:  “I’m no better and I’ve been doing my exercises for 2 weeks”

Solutions:

People who are really clear on the expecations of how long they will need to do their rehabilitation to make a difference adhere better.  This is something your physiotherapist should make clear to you.  If not ask.  If you think you are going to get better in 1 week but it actually takes 3 months you are likely to give up.  However, if you understand that in order to make a difference you will have to work at it for a longer period you are more likely to continue.

Barrier 3:

Time:  “I haven’t got time to do my exercises”

Solutions:

Think about what exercises can be incorporated into your daily routine.  For example: every time you boil the kettle repeat 10 squats. 

Sometimes one key exercise can be just as effective as three.

Think about creating a habit – doing your exercises at the same time and same place.  A bit like brushing your teeth.

Barrier 4:

Tiredness and Fatigue: ” I’m too tired”

Solutions:

The 5 minute rule:  Do something for just 5 minutesOften that 5 minutes will turn into a bit more but even if it doesn’t you will still have had a positive outcome.

Barrier 5:

Forgetfulness:  “I keep forgetting to do my exercises”.

Solutions:

Old fashioned I know, but sometimes writing out a plan with tick boxes stuck onto the fridge is a great incentive – there is something so satisfying seeing a row of ticks when completed.

Use Technology:  Set up reminders on your phone at a time you know
you will be able to do them.  There are also Apps out there now to help you. I put all my client’s exercises on an app called PT Momentum.  You just click on the app and all your exercises are there, just tick them off when completed.

Barrier 6:

Too many exercises:  Depending on your injury, you may need to work on a few exercises for a successful outcome. This can sometimes feel daunting.

Solutions:

Focus on one area:  Pick just one area or one or two exercises to do at each session then vary the exercises you choose in your next session. 

Barrier 7:

My Programme is boring.

Solutions:

Ensure you have plenty of variation in your programme. Many exercises can be varied easily to make them harder or easier.  Examples may include trying your exercises with your eyes shut or standing on one leg doing your exercises. Perhaps you could add weight or increase or decrease the speed of the exercise.  Add a timed challenge – how many can you do in a minute and test yourself every 4-6 weeks.

Patience and Time:  Remember to give yourself time to get better.  Many injuries take on average over 50 days to get better but adhereing to your rehabilitation is going to achieve you a better and quicker outcome in the long term.  

If you would like any more information on progressing or developing your rehabilitation please contact me below.

How can I reduce pain in my heel?

 Plantar Fasciitis or Plantar Fasciopathy or more simply persistent heel pain

 

A common issue I come across in Bridge 38 Physiotherapy is people presenting with heel pain or plantar fasciopathy (previously called plantar fasciitis).  Plantar fasciopathy is a generalised term for pain around the plantar fascia in the foot. The plantar fascia is the tissue that runs from your heel bone towards your toes and helps to support your foot when standing, walking and running.

 

The Plantar Fascia supports the foot when standing, walking or running

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To Stretch or Not to Stretch?

Many Clients I see, particularly those involved in sport, are often tight and complain no matter what they do their calf just doesn’t seem to release or that hamstring muscle has “always been tight”.  Many report they stretch or may use the torturous foam roller to help. Both forms can help but only for a short time but as soon as they resume activity the tightness returns.  So this begs the question is there any benefit to stretching and should we still do it?

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Should I carry on running with pain?

I see many runners in the clinic with a variety of running injuries from achilles tendinopathies, to knee pain and groin pain.  One of the big issues I discuss with every runner is whether or not they can continue to run with pain and if so are they damaging themselves?

Well in todays 5 minute video I share with you my expertise on this very subject.  You will find out

1. whether you are ok to run with pain.

2. If you are able to continue to run, how will you know you are not causing further harm?

3. What are some of the common warning signs that mean you should not be running and when to get it checked out.

 

 

 

Why “Rest” May Take you Longer to Recover From Injury

If you’ve ever googled recovery from an injury you may have come across the R.I.C.E principe.  This stands for Rest, Ice, Compression and Elevation.  “Rest” implies that following an injury you should rest it and it will get better.  This advice is still given by many GP’s and accidenct and emergency clinics.   The trouble is, this advice does not tell us how long to rest for and what exactly does rest mean?

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Posture – Is there such a thing as good or bad posture?

Posture – is there such a thing as good or bad posture?

Is this such a BAD posture? Read on to find out more!.

 

 

 

Many people I see in the clinic want to improve their posture.  If I ask them to demonstrate what they think they want their posture to be like, invariably they will sit up straight pinning their shoulders back and pulling the their stomach.

Is this posture any better than me sitting above in the opposite position of slumped at a desk?  The simple answer is No.

Posture if fundamental for efficient movement.  It is not the case that we have two choices either good or bad posture. We all move through a range of body positions depending on our activities.  Even when standing still and breathing the body is active and moving in subtle ways to maintain balance and control with minimal effort.

If we actively try and fix our posture in the traditionial shoulders back stomach in approach we will create rigidity which prevents freedom of movement and will reduce physical performance. It will restrict our ability to breath effectively and create tension in neck, shoulders and lower back, similar to sitting in a slumped position.

This upright posture is tiring and hard to sustain. After 5 minutes you resort back to sitting in a slumped position, and so the cycle of upright vs slumped begins.

What can I do to help?

One of the simplest things I tell people to do is move.  Sometimes we view our posture as the reason we get back pain or neck pain but actually the reason may be as simple as not moving or changing position.  So simply getting up moving around and then going back to what you were doing may be all that is required.

However,  if you know you are going to be spending time sitting for longer periods here are some really brillian tips.

Even Better is that they are easy to do and involve minimal effort and can be done in any position anywhere.

 

Ballooning:

  • First stand or sit in a relaxed position almost slumped.
  • Now imagine a large helium balloon with a string attached to the back of the top of your head.
  • Then visualise this large balloon gently lifting the weight of your head off your body. Imagine it lengthening the back of your neck so that your chin drops down slightly.
  • Allow yourself to lengthen without straining.
  • If sitting notice how the balloon takes you from the back of your sitting bones to feeling like your body is now sitting on top of the sitting bones.

This should feel effortless. If you feel any tension anywhere stop let go, give yourself a little shake and switch on your balloon again.

Jo Elphinston founder of JEMS explains more about ballooning in this great little  video.

What should it feel like?

No Tension: Ballooning involves minimal effort and, therefore, there should be no tension anywhere in the body.

Breathing should feel easier . Try sitting bolt up right and take in a large breath and see what it feels like and do this again sitting slumped.  Now switch on your balloon and take in a deep breath.  You should notice quite a difference in how deeply you can breath.

Automatic Support from the muscular system:  Place one hand on your stomach when sitting slumped then notice as you  switch on your balloon your stomach naturally lengthens and draw inwards.  You have activated your trunk muscles by cleverly stimulating a reflex which was triggered by your head position.  This is involved much less effort than actively pulling in your stomach.

Relaxed Shoulders: Take a note of the difference in your shoulder position when you have your balloon on and off . Again you will feel that the  shoulders and chest have opened up slightly as your balloon goes on.  No fixing shoulders backwards or pulling shoulder blades back and down. Just light effortless opening.

For more information feel free to contact Fiona at Bridge 38 physiotherapy .

Why Everyone Should Practice Improving Their Balance.

Introduction

Balance refers to an individuals ability to maintain their line of gravity within their base of support.  You might also hear people talking about postural control and postural stability. Poor balance is surprisingly common and I see it in the clinic on a daily basis. Infact almost everyone I see when I test their balance say “oh my balance is rubbish”.  Poor balance has been linked to injury risk. Even in sports which involve sitting such as dressage riding and kayaking, significant differences in left and right standing balance have been noted to correlate with technical problems and injury even when seated.

Poor balance is also linked with falls in the older population.Improving your balance will reduce the liklihood of injury or reinjury and allow the body to make fine adjustments without inappropriate muscle tension.

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