11 pictures taken on my iPhone

It's been a busy 6 months since opening up in the new clinic location. So over the last few days I've been having a catch up on all of my admin - bookkeeping, paperwork etc.

A couple of nights ago I was going through the 312 photos stored on my iPhone - deleting a few on the way through (I've managed to use much of my available phone memory - luckily I'm not too far away from an upgrade).

Anyway although I try and keep most of my posts on this blog related to the clinic and sports injuries I occasionally put up some 'personal' posts here too.

For that reason I thought it would be fun to share some of the photos on my iPhone.

1. Gemma (my Girlfriend) at Go Ape - Moors Valley.

2 + 3. Visiting my sister in the UAE - In the desert.

4. Ready to go out for Dinner - UAE.

5. Donkeys in the New Forest (Nr Moyels Court).

6. BBQ at Durdle Door.

7. Working from my Dad's 'office' while up visiting my parents in Scotland.

8. The Urban Beach (Boscombe) - one of my favourite spots on a summers evening.

9. After finishing 'the great south run' 10miles - don't ask my time, it wasn't good.

10. The wood burner at my parents house - great on a winters day.

11. Visiting the Lime Wood (Lyndhurst) for my Birthday lunch - others arrived in helicopters. It's all right for some!

Have you got IT Band Syndrome (ITBS)?

ITBS is more commonly known as 'Runners Knee'.

The Iliotibial band is a thick, very strong section of connective tissue that runs from the top of the hip down the outside aspect of the leg. It connects to the bottom of the knee at the fibula bone, with some of it's fibres running into the patella.

In the case of IT band syndrome rubbing takes place at a bony point called the lateral epicondyle. If the IT band is tight it will rub over this bony point when walking, running or jogging.

If you have ITBS you will find pain on the outside aspect of the knee, which is caused by the band rubbing on the bone. If left for a long period scar tissue will develop in this area.

Downhill running and high impact activities will typically cause the most problems.

As with many injuries you will most often find that there is some underlying bio-mechanical issue or inefficiency in the body. An example of this is that there may be a specific weakness in the hip musculature. This weakness is likely to cause tension to build up in the IT band. If this is the case then the treatment must focus on addressing both the painful knee area AND the issue in the hip too.

If the painful knee area is treated without 'fixing' the underlying weakness (or bio-mechanical problem) elsewhere then this injury will re-occur almost straight away on returning to training.

My National 3 Peaks Challenge Story

(Picture: Piper - The Highlands)

The 3 tallest mountains in the UK.

21 hours 50 minutes, 57214 steps, 25 miles and 11170 feet.

The three peaks challenge completed!

To those of you who haven't come across the

National 3 Peaks Challenge the aim is to climb Ben Nevis (Scotland), Scafell Pike (England) and Snowdon (Wales) in 24 hrs - including driving time.

This is a short post on how Matt (who talked me into doing the challenge) and I got on completing the 3 Peaks.

We started in Scotland at Ben Nevis on Friday 17th June and finished in Wales at Snowdon 21h50 later.

BEN NEVIS - The Start

(Picture: The Start - Ben Nevis visitor centre car park)

(Picture: Summit Ben Nevis)

Summit time: 2h05

Total time: 3h24

Height: 4409 ft

Steps (Pedometer): 21858

We were planning to start the challenge at 7pm (Friday), with the aim of getting up and down the Mountain before dark at around 10.30pm. However due to poor weather and less evening light we changed our plans and started early at 6.40pm.

The climb was in fairly poor weather; rain and cold, with thick cloud at the top. This made things fairly hard going, visibility at the top was down to about 15 feet.

We could easily see how people get in trouble on Ben Nevis, the cloud cover was fairly disorientating.

We managed to get up and down in fairly good time (3h24), with much of the descent done

running. By the time we reached the bottom I wasn't sure if we had gone off too fast and should have left 'more in the tank' for the next two mountains.

On getting down we managed to leave the Ben Nevis visitor centre car park fairly quickly. We got in the car for a 6 hour journey down to Scafell Pike (Lake district). At this point Matt and I did our best to get some sleep as we were being driven by my Mum and Gemma (my girlfriend).

SCAFELL PIKE

(Pictures: Top of Scafell Pike)

Summit time: ???

Total time: 3h58

Height: 3210 ft

Steps (Pedometer): 20356

After traveling to Scafell Pike overnight we arrived at about 4am. We were not sure how our legs were going to be functioning after 6 hours sitting still in the car. As it turns out the legs were actually OK, however this was the least of our worries.

After quickly getting out of the car at just after 4am we headed off on what we thought was the right track. We quickly caught up with 4 other walkers doing the 3 Peaks and checked with them that we were on the correct route. They confidently said "yes" so we got our heads down and got cracking - big mistake. To cut a long story short we had headed off on the wrong track. We had been 'at it' for 40 minutes before we realised that we had gone the wrong way! What was more soul destroying was that we realised that the quickest way to get back on track was to run right back to the start and begin again, there was no other obvious 'short cut' to get back on the correct trail from where we were.

By the time we had reached the bottom again we had wasted exactly 58 minutes, but more importantly we had sapped valuable energy out of our legs. Disaster. There was no other choice but to get started again. Although Scafell Pike is the smallest mountain in terms of height it seemed to be the toughest of the three mountains. There is a boulder field about mid way up and the top section is covered in scree which makes things hard work.

As with Ben Nevis the weather was poor so we reached the top in almost zero visibility and ice cold driving rain. We made a quick stop to take the photos and headed back down. Due to our mistake at the start we took almost 4 hrs on a mountain we were planning to complete in under 3 hrs. In low spirits we quickly got changed into dry gear and got in the car for the 5 hour journey to Snowdon.

SNOWDON

(Picture: Snowdon - at the peak)

Summit time: 1h35

Total time: 2h56

Height: 3560 ft

Steps (Pedometer): 1500 - approx

Although we wasted an hour on Scafell Pike we were still on to complete the challenge in the allotted 24 hrs - all was left to play for.

Our aim was to finish strong. That meant we had to complete Snowdon in under 3 hours. We knew it was going to be painful.

For the first time we set off without any rain, which was a great change.

We were most confident about completing Snowdon as it was the only mountain we had climbed prior to the challenge. In fact we had climbed it twice in one day while we were doing our training.

We managed a very fast time to the top, by our standards, making the peak in 1h35. The top was packed with other walkers so we quickly got our photos and began back down. By this time our legs were like jelly and are knees were sore but we had to get down quickly to make sure we made it in under 3 hours.

After what seem like an age we rounded the final corner, the visitor centre car park was in sight. We knew we were going to complete Snowdon in under 3 hrs! With 4 minutes to spare we jogged into the car park and had completed the National 3 Peaks Challenge in a total of 21h50.

Tired, beaten up but very proud we had managed to do all three of the highest mountains in the UK under 24 hours.

A great achievement.

21 hours 50 minutes, 57214 steps, 25 miles and 11170 feet.

What is a trigger point (or Knot)?

I get asked what a trigger point is on almost a daily basis.

For that reason I thought it would be best to write a short post with some basic information on trigger points.

What is a trigger point?

In the most simple terms a 'trigger point' is a section of muscle that has gone into a localised spasm. This spasm causes the muscle fibres in that area to become contracted.

Why do trigger points develop?

Trigger points can develop for a number of reasons but the most common cause are prolonged poor posture, acute injury or poor biomechanics.

Where do triggers points most commonly occur?

Trigger points can occur all over the body, however the most common area I personally treat is in the neck and shoulders. The calves or gluteus are another area I see on a regular basis.

Why do trigger points cause pain?

Triggers points cause pain in two ways.

The first is due to mechanical pressure that is caused by the tension in the trigger points.

The second is due to chemical irritation, due to the build up of lactic acid (and other waste products) in the muscles.

How can trigger point be treated?

Firstly the underlying reason for the trigger points development must be addressed. For example poor posture must be corrected.

Secondly trigger points respond well to (relatively) deep pressure. Trigger point therapy is very effective as the 'mechanical' pressure will be released. Alongside this extra lactic acid can be removed using varying soft tissue techniques.

Neck and Shoulder Pain? Read this!

***See below for a free printable exercise sheet to reduce pain and improve posture***

General neck and shoulder pain is one of the most common complaints I see in the clinic.

A significant percentage of this neck pain is related to poor posture.

The type of posture I'm specifically talking about is the 'hunched over the computer' type posture we all have a tendency to fall into.

The upper body is hunched, the shoulders are rounded and the head is forward (see the 'evolution of man' picture below).

Unfortunately we ALL spend far to much time in postures similar to this.

We are most at risk of this type of postural pain when we are driving, working at our desk and sitting on the sofa reading.

With many people this type of posture has become habitual.

It can become 'difficult' or 'hard work' to sit with correct posture.

This is because the body has adapted over time; poor posture has become the 'default' option for the body.

Poor posture has now become the 'easy' option to adopt.

The problem with this type of posture is that over time it causes huge imbalances in the muscular tissue around the neck and shoulders.

The chest muscles become tight and shorted, the muscles between the shoulder blades become weak and lengthen.

The knock on effect of these changes can lead to several problems.

These problems can range from the build up of trigger points in the muscles, nerve compression around the neck and shoulder, altered respiration, impinged blood supply as well as extra stress on the discs and joints in the neck.

The list of potential problems goes on and on.

The good news is that in many cases pain around the neck and shoulders can be resolved

successfully by simply focusing on improving your posture.

There are a number of practical steps that can be taken to gain some balance back in the shoulders and neck.

As a start I have included a sheet below of exercises specifically selected to reduce pain and improve posture in the upper body.

There are 4 exercises on the sheet, which includes both stretching and strengthening exercises.

These exercise are great if you have general neck and shoulder stiffness, if you have acute pain

they may not be suitable for you.

The complete exercise plan should take no longer than 15 minutes in total and should be performed every day (ideally in the evening).

Please print a copy off and put it up somewhere in your office or home where it will remind you to perform them daily.

Warning: DO NOT complete these exercises if your pain is high (or very acute).

Click here for a printable pdf sheet with 4 simple exercises that you can perform daily to improve your posture and reduce your neck and shoulder pain.

NB. This is a general program, more specific exercises and treatment methods may need to be used for differing issues however this is a good starting place for most postural based problems.

As always if you have any questions about your neck and shoulder pain or more specific questions about the exercise plan please do email.

(Evolution of man poster - are we going backwards?)

ACL Rupture? What is it & what should you do?

The ACL is the Anterior Cruciate Ligament, which is one of the four major stabilising ligaments in the knee.

The ACL prevents the lower leg bone (the tibia) translating forward on the femur (the upper leg bone). A complete rupture of the ACL will mean the ligament has completely separated, leaving the knee in a very unstable state.

A complete rupture can be diagnosed by a Physiotherapist or Sports Therapist in the clinic - this is done through a physical examination. However this diagnosis will often be confirmed with additional imaging (scan).

The injury typically occurs when the foot is in contact with the ground and there is a twisting force at the knee.

***Here Micheal Owen ruptures his left ACL in the 2006 World Cup match against Sweden. Watch the youtube clip here.

Symptoms of the injury include:

• A loud pop / crack at the time of the injury
• Immediate swelling at the knee
• A feeling of instability in the knee
• The knee giving way
• Problems fully straightening the knee
• Tenderness on palpation of the front and inside aspect of the knee

If there has been a complete rupture of the ACL, surgery will be required in most cases. The elderly and the less active may avoid surgery, however most reasonably active people will be advised to have surgery. The recovery time following an ACL rupture, will vary but can be any where from 6 months to as long as 12 months.

The recovery time will be dependent upon the surgeons approach and whether any other structures such as the knee cartilage or other ligaments were also damaged in the injury.

Rehabilitation following surgery will focus on reducing the swelling, increasing the range of motion and restoring full strength around the knee.

Marathon Runners - Good luck!

Good luck to all the marathon runners I've treated over the last few months.

The Paris and London marathons take place over the next couple of weekends so I have had quite a few 'last minute' emergencies with people coming in with knee / foot / ankle pain.

Lets hope everyone gets through their races and in good time!

I haven't run a marathon myself (yet) so I can't fully empathise with the level of training required to be prepared for the event. However I've certainly been inspired by many of the people I've treated.

Once again good luck...

I'm sure I'll see many of you in the week after, for your much needed post marathon massage!

Alex