“”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!

“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!

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.

 

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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Pilates @ ImpactPhysio

Here at Impact we like to do things differently – our Pilates instructors have huge amounts of experience and spend time planning and adapting our classes and 1:1 sessions for you. Here’s a clip of some of the stuff we get up to;

Pilates

If you would like to join us then contact us 0115 9721319 / enquiries@impactphysio.co.uk

Classes are at our Long Eaton and Kedleston Road (University of Derby) clinics – open to all

 

We have recently added the oov to our equipment classes – great for challenging the core and spine.

Our Kedleston Road Clinic is Now Open

The doors officially open on Monday to welcome physio, sports injuries, massage and Pilates clients to our new clinic in the high performance unit at the sports centre at The University of Derby on Kedleston Road.

Although we have been working with Team Derby for years, we are delighted to be part of the new high performance unit in the fantastic sports centre.

Our therapists are buzzing to be part of the team at The University of Derby; Rachel who has been working with Team Derby and covering the NBL fixtures since the inaugural win in 2014. Pete an experienced physio has recently joined Impact specifically with this venture in mind. Tom, a sports therapist will also be on site working alongside Team Derby teams during BUCS fixtures and Christine, a physio with extensive Pilates experience (a polestar mentor) will be delivering individual and group Pilates sessions to compliment her treatments.

To celebrate the official opening of the new clinic, we offer a 20% discount off your first physio session, booked during December 2016. Please contact us in the usual way

call 0115 9721319 or email contact@impactphysio.co.uk

 

Welcome Christine – our new Pilates Instructor

christine koh

Christine has recently joined the Impact team as a Pilates Instructor. She brings a huge amount of experience from Asia and the US as a Physical Therapist and Polestar Pilates Mentor. We are excited to be working with her. Christine is currently working solely as a Pilates Instructor in the UK as she awaits transfer of her registration to enable her to practice as a Physiotherapist.

Christine will be covering occasional classes at Long Eaton over the summer period as well as being available for individual sessions. She is also offering a summer schedule of classes at The University of Derby. Please contact us for more details.

enquiries@impactphysio.co.uk / 0115 9721319

 

Lower Limb Tendinopathy Course: Dr Peter Malliaras

Impact Physio are proud to host Dr Peter Malliaras who will be coming to The University Of Derby on November 1st to share his Lower Limb Tendinopathy Course.

 

Peter Malliaras is a physiotherapist specialising in tendinopathy management and rehabilitation, consulting at Complete Sports Care (Hawthorn, Melbourne) and a research fellow at La Trobe University (Australia) and Queen Mary, University of London (UK). He completed his PhD in 2006, identifying novel risk factors for tendinopathy among athletes, and has since co-authored over 45 peer review tendinopathy publications. Peter spent five years in the UK undertaking post-doctoral research focusing on tendinopathy imaging and rehabilitation, and consulting to the general public and elite athletes with difficult and non-responsive lower limb tendinopathy. Peter has been consulted in the rehabilitation of elite football, rugby, netball, volleyball, basketball, track and field, skating and cricket athletes, as well as the Royal Ballet (London).Prior to consultant work, Peter worked at the Victorian Institute of Sport, toured nationally and internationally with football, track and field, volleyball, basketball and weight lifting, and has been an official team physiotherapist at a Commonwealth Games meet.

Peter writes a fantastic blog..

http://tendinopathyrehab.com/blog/

CPD 10h = 2.5h pre-course reading/ watching videos + 7.5h practical course.  For Further details and book your place

https://www.vitalpm.com/events

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.