“”The Gym is open!!!” One physio’s lockdown experience: Part 2″

Thanks again to Jo who has found time to put fingers to keyboard….

So…it’s Saturday 25th July, day 2 of my 4 day shift, I’m still working down in Birmingham at the NHS PPE call centre- I can’t say getting up at 5.30am 4 days a week has been particularly easy- but I feel like I’m doing “my bit” and has been extremely beneficial- not just financially, but also working with a great bunch of folk.

The weekends are relatively subdued, with very few calls to take- but today there is some excited discussions revolving around the fact that gyms are opening today for the first time since the lock-down. So who’s going? Is it safe? What are people looking forward to getting back into? Classes? Weights? Yoga/ pilates?

My ears prick up, not only because I’m a regular gym user myself, but with my physio hat on, I wonder (perhaps rather pessimistically) if we will see some sports-type injuries in clinic?

“But exercise is GOOD for us right?!”

The positive effects of exercise are well documented, but like anything, too much of a good thing can cause us problems- or more specifically, in respect to exercise; too much of a good thing TOO QUICKLY causes problems.

The reason for this is revealed when we understand what happens to the human body and all it’s varied tissues (bone, muscles, tendons…) when we STOP doing an exercise or sport that we do regularly- and lock-down has provided this rather unwelcome and unique period of rest.

The human body is the most incredible organism- without any input from us, it can change and adapt almost on a daily basis! In terms of the musculoskeletal system, the stimulus to adapt comes from our environment and what we do in it. Some studies that have looked at this in professional athletes- showing that in as little as 2 weeks of rest, muscles start to get weaker and tendons contain a little less collagen (the protein that makes the tendon “stiff.”)

“But I’m not Usain Bolt!” I hear you say…

Well, this “de-training affect” as it is known, has also been shown in “normal” people. A research study carried out in 2000 (https://pubmed.ncbi.nlm.nih.gov/11127215/)   looked at bone mineral density and muscle strength around the hip joints of a group of pre-menopausal women who participated in a 12 month programme of impact training, along with lower body strengthening and resistance training. They measured these parameters at the beginning and end of the 12 month training period, but also at the end of a further 6 month period of rest. The researchers found that there were measurable increases (3.2%) in bone density around the neck of the femur (thigh bone) and also on average, a 15% increase in muscle strength- at the end of the 12 month training period. But these increases had disappeared by the end of the 6 month rest and returned to the baseline measures.

I see the affects of this in my work with the student athletes at the University of Derby. There are pronounced “spikes” of injuries which occur just after periods of rest- especially on returning after the longer summer break and also from the Christmas holiday.

The “partner in crime” with the de-training affect is the speed and intensity of training following this rest period. “They’ve just had 3 months off, they need to train EVEN HARDER than normal!” is a common phrase I hear from coaches. At this point, athletes often enter periods of very high intensity training, or perhaps training twice a day for the first week or so- which can be a recipe for disaster for some students.

The principle is the same for you- you might be thinking about returning to the gym as they open today- and planning to do more sessions in the first few weeks, or an extra spin class straight after your normal session/ or adding an extra 10kg on to the bar/ attempting new exercises not tried before…in an attempt to make up for lost time and try and address the lockdown bulge! 

We would call these “training errors” and they will all increase your risk of getting injured. Another piece of very interesting research that has guided the sports medicine fraternity, is that of Australian Physiotherapist Tim Gabbett (https://bjsm.bmj.com/content/50/5/273). He concluded that  “Excessive and rapid increases in training loads are likely responsible for a large proportion of non-contact, soft-tissue injuries.” In addition, he also concluded that an “appropriately graded” medium to high intensity exercise may actually protect against injury.

So- what does that mean for you? It’s not easy to give specific advice, but firstly, make a plan, based on what your pre-lockdown schedule looked like- did you train 3-4 times a week? Then start with 2. Don’t train on consecutive days- give your body a day off at least between sessions- this is when the muscles and other tissues adapt (get stronger)! Start with low-medium intensity workouts. If you like working with weights, start with weights that are a little lighter than you would’ve lifted pre-lockdown. This will allow you to focus on your technique- poor technique can also be another factor that can increase your risk of picking up an injury. Build up your session intensity/ weights SLOWLY aim to be back to your pre-lockdown level within an absolute minimum of 4 weeks.

This may all sound like common sense- but you’d be surprised how many injuries we see in clinic that are related to simple training errors like these! If you do pick up an injury or you’re not sure where to start, then book yourself in and we’ll be able to give you some more specific advice.

I hop you enjoy a safe gym-return folks!

Please get in contact if we can help at all: enquiries@impactphysio.co.uk / 0115 9721319

Let us know how you're getting on!

Attending your appointment: what to expect…

When you arrive for your appointment we will invite you into the building once you have reconfirmed your symptom free status. We ask you to wear a face covering for the safety of our team, and we will greet you wearing the appropriate PPE for your safety.

We will conduct as much of your appointment remotely to maximise the time you are at clinic for essential assessment and treatment that can not be done remotely.

Following our Risk Assessment we have implemented specific processes which address all the controllable risks. These include;

  • Team health screening prior to each clinic
  • A controlled one-way system
  • Reduced numbers of the team on site at any one time
  • Staggered appointments & time inbetween to allow for extensive cleaning & airing of rooms
  • Clear distance markers throughout the building
  • Numerous hand sanitising stations with guidance to ensure effectiveness
  • Appropriate PPE
  • Enhanced cleaning processes; related to virus protocols

Please get in contact if we can help at all: enquiries@impactphysio.co.uk / 07977 239893

“Walking the walk (or sitting the sit!) One physio’s lockdown experience.”

It’s 7.30am on a Sunday morning, day 2 of my 4 x 12 hour shifts…post-furlough I’ve needed to find myself some work that will keep me from going stir-crazy at home- working at the coal face back in hospital was not an option for me as a single parent- so taking up a position with Unipart, who look after the logistics for the NHS’s PPE supply chain, seemed to be a good second option.

10 weeks in now, and it’s been an eye opening experience- on all fronts- from both the  physical and mental perspective! I’m hoping that with my physio hat on, I can offer some thoughts that might help you cope with the ups and downs of working life- especially if your job involves a chair/ desk/ computer screen.

The first, and probably the most fundamental challenge I’ve faced, is that my pre-COVID working lifestyle couldn’t be any different from what I am currently doing. Most physios will tell you that they will invest just as much (if not more…) in a comfy pair of trainers for work, than they would on a pair of Lauboutins! We’re on our feet A LOT!

Working with athletes and patients alike, I’m constantly on my feet- either watching patients perform various functional movement tasks, demonstrating exercises or standing at the couch and treating. So, moving to a job that involves an hour’s drive either way and then sitting at a desk for 12 hours, for 4 days back to back- has provided a significant change in what my body does- in terms of position and the loads placed on the joints and muscles. 

We know from various research papers, that the human body adapts very quickly to new conditions; once elite level athletes stop training, there is a measurable reduction in muscle strength even after just 10 days! For us mere mortals, it will be a case a couple of weeks perhaps.

So…picture the scene- I’d survived my first 4 days- alien environment, lots of new stuff to learn, along with A LOT of sitting…I really felt like going for a run, get myself into the fresh air! When I say run, I should quantify that- it’s a steady 1 minute run: 2 minute walk. I should also say at this point, that I’m not a “runner” as such- I’m a regular gym goer and I throw myself enthusiastically around a netball court x 1 a week…with a VERY occasional run.

During this first run, at about the 30 minute mark, I felt a sharp cramping sensation in my right calf that literally stopped me in my stride- let’s stop, walk a little- have another go… nope! Definitely not going to “run this one off!” So, disappointingly, I limped the rest of the way home and popped a bag of frozen peas on it for 20 minutes. I could still feel it the following day so I concluded that I’d pulled it (but not torn; no bruising or swelling and although slightly sore, walking was much easier.) So, what to do about it? Something that we see commonly in clinic, are people who hurt themselves and then rest too much- many weeks in some cases- then returning to running once pain-free, without having prepared the injured muscle adequately, often resulting in re-injury. 

Fortunately, having worked with a lot of court-based sports at Derby University (with all the associated calf and ankle problems!) I know the importance of good strong calf muscles- and how they can protect the ankles and lower legs- so, I got going with the calf strengthening circuit that I had devised for the athletes to do. It’s a series of various types of calf raises (also known as heel raises) that don’t require any pieces of gym equipment (apart from a step/ set of stairs) that can be very helpful when trying to prepare a previously injured and weak calf muscle.

But how do you know if your calf muscle is strong enough to run? Well, as a general rule of thumb in the clinic, if someone who’s had a significant injury (knee surgery-ligament repair or muscle tear) and wanting to return to running or a running-based sport, I would ask the patient to perform a single leg calf raise endurance test (how many can they perform to fatigue- off a step?) I would expect to see around the 25 rep mark- or certainly no less than 5 reps difference compared to the non-injured side. 

I duly did this and within a week or so, I went out for another run- but knowing that I hurt my calf at around 30 minutes, I felt it sensible to keep it to 20 minutes (the reality being; it felt good so I managed 30, but no more!)

 

So- key questions to ask yourself before doing something new;

  • What does the new activity involve?
  • How does is differ to my normal “day to day” activities?
  • Am I strong enough/ flexible enough to do this new activity?

You may need some help addressing these kinds of questions- our staff can be really helpful when it comes to starting something new.

Closing thoughts;    “Most injuries occur in people who’ve done too much, too quickly having done too little for too long!”

Thanks++ Jo Keegan for finding the time to pen your experience and share it with us

Please get in contact if we can help at all: enquiries@impactphysio.co.uk / 07977 239893

Please also keep in touch just to let us know how you're getting on!

Essential Face 2 Face Appointments

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In this ever changing environment we want to continue to support the community whilst maintaining the safety recommendations which are required to reduce the risk of contracting and spreading COVID-19. 

We are now able to offer face to face appointments for those who cannot be treated remotely. 

We have protocols in place to ensure that risk is minimised. We will ask you to consider your own situation carefully before you are invited to the clinic. This includes your own health and circumstances, we will run through an extensive screening process prior to confirming your attendance.

We have procedures at our Long Eaton Clinic which include;

  • Controlled & Limited Access 
  • A one-way system & clear distancing markers throughout
  • Extensive cleaning & time between appointments for airing the room
  • Appropriate PPE for our team & we ask you to wear a face mask
  • Limited time in clinic; assessment questioning remotely prior to your attendance
  • Our team are health screened prior to confirming your appointment

 

We are happy to rearrange your appointment as required due to developing symptoms or if you are asked to self-isolate and its no longer appropriate for you to attend.

The health & well-being both of our team and of you are our priority at this time and we thank-you for supporting us.

Please get in contact if we can help at all: enquiries@impactphysio.co.uk / 07977 239893

Please also keep in touch just to let us know how you're getting on!

COVID-19 Action Plan

To all our clients at Impact Physio

We are monitoring the situation closely and are following the guidance of our governing bodies, the local health authorities and World Health Organization (WHO), to ensure we are doing our part to keep you and our wider communities safe. 

If you have any concerns about attending your appointment, then please don’t hesitate to contact us. If you need to reduce your risk due to personal or wider responsibilities to others, are within a vulnerable category yourself or need to self-isolate due to a persistent new cough or have a fever then please don’t physically attend your appointment.

We are able to offer either telephone consultations or video links to enable your management to continue. In most cases we can continue to offer assessment, advice and our classes in a virtual environment therefore avoiding contact risk.  Please don’t hesitate to contact us to discuss this further or make contact prior to your scheduled time to organise this.

If you are well and able to keep your appointment then we can assure you that we continue to maintain our high standards of infection control. We have also increased vigilance with the most-touched surfaces like door handles, credit card readers, and restrooms. We also ensure our team are following guidelines regarding their own health. 

We wish you all the best at this time and thank-you for your continued support. 

2020 changes

A new decade, new challenges… 

This year we are have rebooked some of our favourite challenges – continuing our quest to surf better! We have changed our 3 peak challenge to the “10 Peaks in the Lakes” and added a cool down “Great North Swim” the following day! Of course this will all be accompanied by lashings of cake in true Impact style raising money for some great causes.

This year Phil – who has been a stalwart at the clinic for over 10 years has been offered a full-time role at Nottinghamshire CCC, we wish him all the best and can’t wait until the close season already for him to re-join us!

We welcome Ben Trevor-Jones who has come over from Sydney University Sports Injury Clinic to join Derbyshire CCC for a PT role with the second team, he will be based at all 4 of our clinics!

Jenny Horrigan has recently joined us to offer Pelvic health services, this service is in massive demand and is an intervention that following assessment can make a huge impact on peoples lives. Jenny is based at Long Eaton & Pride Park.

Tom Lamb joins us for 6 months while he is completing his Sports Medicine Masters at The University of Nottingham, Tom has previously worked at Crewe Alexandra.

Lorraine Geutjens has completed her “return to work” HCPC registration after family time and now works PT with us at the Long Eaton base. Lorraine has experience working within the MOD and Nottingham City Hospital in MSK.

And lastly but not least Ali Crewesmith who also works at the Physio Dept. at London Road Community Hospital will be based at our Kedleston Road / University of Derby clinic on a Monday evening.

 

Impact Challenge: Supporting the Teenage Cancer Trust

Delighted to be part of the team supporting Sam with his quest to raise funds for the Teenage Cancer Trust – a charity close to his heart. A small group of us signed up to the x-runner 10k obstacle course challenge, commonly called the mud-runner! We slipped and slid around the course, getting extremely wet and muddy, so much fun we have already signed up again for next years event!

The team back at base added to the funds with a cake sale based at our Long Eaton hub, raising over £300 to add to Sam’s impressive £2000 total.

virginmoneygiving – the TCT run

 

 

 

 

 

 

Healthy happy lifestyles

We’re all getting ready for Christmas and hopefully looking forward to some time off to spend some quality time away from our daily routines. It’s at this time of year too that we often look to consider what 2018 might bring us and what we might like to change.

We all want to try and live a happy healthy life and the role of exercise is key. However, with busy lifestyles work can often get in the way and if we are involved in repetitive or sedentary job roles this may be detrimental both physically or mentally.

Many people spend a large proportion of their time at work. It’s common to feel too busy doing your job to take the time to consider how it impacts on your health.

Office workers particularly spend hours sitting still and carrying out repetitive tasks. The human body isn’t designed for this; we’re supposed to be moving around, so all this time spent at a desk needs to be well managed and regular breaks to maintain activity are advised. Often long periods of inactivity can lead to general back ache and/or neck and shoulder pain.

Other problems include feeling pressurised, anxious and low in mood. These types of conditions are experienced by most adults from time to time. If identified early and managed well, they should not result in time off from work.

There are several steps you can take to ensure you incorporate enough physical activity into your day to help you stay fit and healthy for work. These include:

  • Getting some fresh air every day
  • Doing easy exercises every couple of hours
  • Taking micro breaks
  • Simple stretches to keep mobile
  • Ensuring your work station is comfortable

Source: http://www.csp.org.uk/publications/fit-work 

We hope you have a wonderful Christmas time, a special thanks goes out to all those who will be working continuing to look after us either through health services or safety. The whole Impact Team wishes you a Happy 2018!

Pain….. why does it hurt so much?

pain

[vc_row css_animation=”” row_type=”row” type=”full_width” text_align=”left”][vc_column][vc_column_text]I received a lovely email this week thanking me for making someone feel so much better.

What did I do?  IMO – not very much…. I just asked some questions and then explained what I thought might be going on and what I thought might be a good idea to try.

To put things into context – I received a call from someone we have worked with in the past. They described back pain which came on after doing a lot of something they don’t normally do, we chatted for a bit, I made a few suggestions and said goodbye.  12 hours later, here’s a small cut and paste from their email…

Thanks so much for the chat this morning.  You are a wonder worker.  Already your advice has made a big improvement for me.  Thank you. 

Why? Well that’s the thing – the pain that was being experienced is a combination of lots of things. In this case, my impression is that doing something that they hadn’t done before, quite a lot of it, meant that they were feeling places that they hadn’t felt for a while. The resultant sensation wasn’t nice, which was then made a huge amount worse by worry, anxiety and fear. Worry about why it was so painful, anxiety that they won’t be able to do something special in a few weeks time and fear that there is something seriously wrong. This had been going on for about a week and things weren’t getting better.

Pain is complicated. Hopefully this story illustrates that for such a quick turn around of the severity of pain and improvement in symptoms that this was brought around by how the problem was interpreted and dealt with. In this case having the confidence that it was OK to keep moving and try some very simple exercises combined with reasoning that nothing was seriously wrong meant that the problem had reduced significantly.  Sometimes it helps to reason what might have caused the problem, what was aggravating and easing it and what might help to improve things.

There are lots of experts who can explain it better than I can, I’ve included some of the video’s below. This example is meant to show how sometimes a bit of simple advice and explanation can make a huge difference.[/vc_column_text][vc_empty_space height=”62px”][vc_column_text]

Understanding pain

Here’s a few video’s from experts in the field explains the complexity of pain.

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Why do we hurt? 

Do we actually experience pain, or is it merely illusion?

In this TEDx talk, Lorimer Moseley explores these questions, and position the pain that we feel as our bodies’ way of protecting us from damaging tissues further.

He also looks at what this might mean for those who suffer from chronic pain.[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_video link=”https://www.youtube.com/watch?v=gwd-wLdIHjs”][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” type=”full_width” text_align=”left” css=”.vc_custom_1508837556558{margin-top: 60px !important;margin-bottom: 60px !important;padding-top: 60px !important;padding-right: 30px !important;padding-bottom: 60px !important;padding-left: 30px !important;background-color: #ffffff !important;}”][vc_column width=”1/2″][vc_column_text]

Understanding Pain: Brainman chooses

An animated video on managing pain.

The video was produced by a team from Hunter Integrated Pain Service (HIPS), University of South Australia, University of Washington and Hunter Medicare Local (Hunter ML)[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_video link=”https://www.youtube.com/watch?v=jIwn9rC3rOI”][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” type=”full_width” text_align=”left” css=”.vc_custom_1508837556558{margin-top: 60px !important;margin-bottom: 60px !important;padding-top: 60px !important;padding-right: 30px !important;padding-bottom: 60px !important;padding-left: 30px !important;background-color: #ffffff !important;}”][vc_column width=”1/2″][vc_column_text]

Our fears and beliefs about pain 

Jack describes to Prof Peter O’Sullivan about how he had chronic back pain.

He was told he had a back of a 70 year old, he needed fusion surgery and couldn’t play sport .

He now does manual work with little pain – he tells his story of re-gaining his life.[/vc_column_text][/vc_column][vc_column width=”1/2″][vc_video link=”https://www.youtube.com/watch?v=j4gmtpdwmrs”][/vc_column][/vc_row][vc_row css_animation=”” row_type=”row” type=”full_width” text_align=”left”][vc_column][message type=”with_icon” icon=”fa-info” icon_size=”fa-lg” close_button_style=”light” background_color=”#eded93″ border_color=”#eeee22″]

If you’re worried about pain or a problem that’s stopping you getting on with what you want / need to do then get in touch. Book an assessment and we’ll thoroughly assess you to determine what you can do about it.

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Please get in contact if you have any questions.
0115 9721319 / enquiries@impactphysio.co.uk

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National Three Peaks Challenge

So we did it!   

 

July 18/19th a team of us set off up to Ben Nevis for the start of the national 3 peaks challenge. Driven by the awesome Sara – we arrived in time for a meal before heading off up the mountain – we were fortunate enough to have clear skies – great views – and if anything slightly too hot at 25 degrees! We enjoyed a panorama at the summit and beautiful skies on the descent, arriving back at the van with a few minutes of daylight spare – total climbing time of 5 hours 40!

 

The walking team slept to Scafell while Sally kept Sara company chatting all the way – a few minor detours for road closures we arrived at Brackenclose carpark at 04:20 – 10 minutes ahead of schedule. Good news as Jo was waiting to join us – fresh legs and enthusiasm to boost the team for a sunrise ascent!

Once again created with clear skies, although a bit windier – we took the scramble route at hollow stones to mix up the walk. Once again fab views from the summit with clouds in the distance – threatening but kept away.

Unfortunately Chris had to make a slow descent struggling with a sore achilles but, the rest of the team made the most of dipping their feet in the stream as by then we had paired up with another group of firefighters doing the same challenge and timings so chris was happy descending with a fella with a sore knee!

 

 

We headed off to Snowdon 90 minutes behind the schedule so decided to enjoy the challenge rather than race for a 24 hour finish – but once again Sara made great time so while the team slept (again!) we got to Pen-y-pass at 14:20 to meet Louise – another welcome sight – clean, fresh and raring to go – although the rain was lashing and thunder rolling – luckily out of the valley by that time!

We made a 2 hour ascent which meant we got to the top of Snowdon within the 24 hours, and made a steady descent as by that time the route down was pretty much a waterfall! Wet and soggy hugs and high fives back at the carpark – the end of an awesome event.

 

 

 

We’re delighted to have raised nearly £800 for a fantastic cause. Thank-you for all your support.

Impact Physio Nat 3 peaks challenge

registered link

https://theairambulanceservice.org.uk

 

 


 

 

Coronavirus

In this unprecedented time, we encourage you to continue to put your health & well being first.

Whatever your pain / problem please make contact and we can help you.

Things are changing fast – for the latest information, please see our Coronavirus page.