Week 8: TZ1 and subtalar and midfoot joint motion

This week we covered the techniques to mobilise the subtalar joint and mid tarsal joint on the treatment table. These joints were mobilised by understanding how these joints connect and influence each other in weight bearing. These techniques were easy to use, and performed in as close to the normal hip and knee position as possible.

Using techniques on the treatment table fail to include the forces of gravity, ground reaction forces, mass and momentum when in weight bearing positions.  We can use environmental aids and in standing positons to best replicate normal funciton, and then mobilise the joints of the foot.

 

To be able to select the best position to place the body and then drive the body to get the desired chain reaction we can use TRAZMA analysis. In this analysis we look at what the bones are doing and what the relative joint motion will be. This is a key analysis to help confirm the correct drivers and body positions are used to get the desired chain reaction.

 

This week we covered balance and how we can mobilise the joints to get better stability with motion. There are many positions to use to test balance and they all involve movement, instead of standing still on one leg. 

 

We are one week away from Gift Gathering 1. There is a good build up of skill before the gathering. Time to test it out. 

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Physical Edge attends Jenny McConnell Course in Tunbridge Wells

Physical Edge sent Rhys Chong to Tunbridge Wells, to attend the Jenny McConnell  2013 edition of gait analysis and lower limb course. Jenny is a world leader in the treatment of knee pain and based in Sydney, Australia (www.mcconnell-institute.com).

Jenny McConnell believes in the KISS principle. She has identified common gait analysis issues over many years of practice,  and can provide evidence from scientific research to support her ideologies. She keeps the work her clients do at home to 5mins per day and knows “little and often” is the key to success. In her practice in Sydney, she works on a managing pain over a clients life time. It is like having an MOT for your car. She has MOT’s for the body and prevents pain before it happens.

The course looked at how the entire body compensates for dysfunction in the movement system. The hips are an area which is not treated well, and it was highlighted on the course. The course looked at the role of orthotics and shoes in supporting the body. McConnell has a new orthotic for high heeled shoes and sandles, a much needed invention (right ladies).

Physical Edge will be introducing orthotic prescription as an addition to its services. There will be MOT sessions to help people manage pain over their lifetime.  Physical Edge hopes to build strong relationships with clients, by learning over the long term how to help clients live healthy and painfree lives.

Maximising performance in the off season

In professional sport the ‘off season’ offers an athlete the opportunity to rest, recover and mentally prepare for the following season. In the off season an athlete will do strength training and fitness training so that they are in peak condition when the new season starts. In tennis the fitness and strengthening will carry them through the season, and allows them to focus more on match play and technique.

In the amateur we can see that the off season either never occurs, or that the athlete decides to increase the intensity of their training – and injuries occur. The off season needs to be structured to maximise the benefits for the following season.

The off season also offers an opportunity for injuries to be treated sensibly and for the body to be rested to allow natural healing processes to occur. The powers of rest cannot be underestimated. This will include having plenty of sleep; it will also include having ‘active recovery’ whereby the body continues to exercise, but in a much lower intensity so that injuries can respond to treatment and heal.

Structure your year to peak for your events and also to have an off season. Your physiotherapist and trainer can work closely together to design an off season which will help heal your injuries and also maximise your potential for the following season OR for achieving an extra goal.

Personal Training Series: “Don’t care, get over the finish line”, can lead to injury

Some athletes are bloody minded and will do anything to win. Some clients only see the goal at the end but don’t think about the process of getting there. In physiotherapy I see many people who have trained incorrectly because they focus only on the event they are racing and not on how to train to get there.

Having a personal trainer and a physiotherapist work with you can vastly improve your chances of reaching your goal, with minimal to no injuries. The training process can be designed specifically for the goal and the exercises required to achieve the goal can be taught correctly.

When designing a training programme there are many variables to consider such as: exercise technique, timing of training, intensity of training, the environment of training, progressions of training, and even what is happening in an individual’s life. Having a team to work with you takes away the need to think. The professionals also have the experience and the knowledge to give you the best training advice.

When working with a physiotherapist and trainer you can contact them at any time. They can talk to you when you get injured, when you have questions about your training, and when you want to know what to do if you get injured. Having this team is like being a professional athlete, and provides the greatest chance of success.

I have seen amateur athletes start training, and progress doing extremely well without any help; then they reach a certain mileage in training and their body starts to break down.  At this point it is too late to change technique and training regime because the race is within a few weeks. Treatment is then about first aid care – doing everything possible to keep that person training despite the risk of increased injury, and the fact that the race is now in jeopardy. There are many emotions which accompany being in a position of unknown at race time. A person with injuries does not know how the body will react during the race; the target or goals in that race no longer apply; and all those weeks / months of training have been put at risk. To cross the finish line is often the goal after an injury has occurred. A plan then needs to be made to race the following year with correct training principles, guided by the personal trainer and physiotherapist.

It helps to get the right advice to train. Speak to your physiotherapist – who works closely with a personal trainer – to create a winning team.

Personal Training Series: Coaching your way to a healthy lifestyle

Health is an area in many people’s lives which is neglected. To live a healthy life requires taking action, as with other areas of your life, to get results. There is a wealth of information from professionals and websites offering the know-how to live a healthy life. So why are we not all healthy?

I have found – as with other areas of my life – that you need coaches. Coaches not only motivate you and keep you on track; they also provide you with the most recent information about living a healthy lifestyle. A coach can put a plan in place which is easy to follow, adaptable to your lifestyle, and is measurable over time.

In today’s world, you can approach many different types of professionals to get this help, but I have found that it works best if just one person takes overriding responsibility for you achieving your results. Generally the coach who can help you is the one who lives the life they teach. In health there is a holistic approach and there is a Western medical approach, and I think a combination of the two is needed. The areas that may be included in assessment of your health are: your medical history; your lifestyle habits; your physical training habits; and your mental approach.

I am a physiotherapist and I work closely with personal trainers developing healthy lifestyles for clients. I am able to draw on the help of medical professionals, such as doctors and surgeons, and also holistic professionals, such as Pilates instructors, homeopaths and counsellors. Personal trainers have a wealth of skills which they can use with their clients including lifestyle coaching, physical training, nutrition and exercise goal setting.

This series of blogs is designed to give my perspective, as a physiotherapist and someone who lives a healthy lifestyle, on how you can avoid injury when working with a trainer. The blogs are separated into common scenarios I see as a physiotherapist in my clinic. The aim is to assess those clients we see and to learn more about injury prevention when working with a personal trainer.

In the following weeks there will be 20 blogs which will give a comprehensive outline of how you can work best with a personal trainer and a physiotherapist. Please call or contact us via email with any questions you may have about these blogs.

Personal Training Series: Ignoring pain

The human body has a pain sensing system. This system is designed to preserve the body and prevent long term damage. In training the body responds to stimuli and training pain needs to be overcome. However, there is a limit, and it is important to understand for your own body what that limit is.

I saw a documentary on television where a young boy had no pain sensing system. He would go to school and ask his friends to punch him in the stomach; he pretended he was superman because he felt no pain. One day his parents noticed bruising and swelling around his legs and abdomen, and took him to hospital. The doctors discovered he had severe internal haemorrhaging from being punched too much. This young boy’s lack of a pain sensing system could have led to his death.

Another documentary showed scientists trying to reproduce the pain sensing system in the body because it is so important for preserving life. With all the technology and advances in science today they were unable to replicate the system. It is highly complex and adapts to its changing environment. We need it to learn what not to do, what we can do, and what is dangerous.

In training, if we ignore pain completely then injuries often occur. It is important to put in perspective what you are doing, the experience you’ve had in training, and what you think your body can do – you must have realistic limitations as to how much pain you will withstand.

Be sensible and listen to your body. Focus on gradual increase in loading in training, and be happy with steady progress in your training goals. Aim long term rather than short term. Keep in touch with your physiotherapist and trainer to guide you through this process and avoid injury.

It is not much fun being injured and in the long run ignoring pain from an injury will make your training time longer. Get your body assessed by a physiotherapist and work with a personal trainer to prevent injury and to enjoy your training.

Personal Training Series: Putting the patient at risk

A patient came to me from training one on one with a trainer. She’d achieved many of her training goals in the gym, and therefore decided she wanted a new challenge. She asked the trainer to set a new challenge; and so the trainer decided to make her an Olympic weight lifter. This client was 5 foot tall, of medium build, and had never done heavy weight training before. The trainer gave her a deadlift to do, and in the process she felt a sudden sharp pain in her lower back and dropped the weights. She was in agony, could not sleep and noticed the pain whenever she was sitting for prolonged periods of time. On assessment she had significantly damaged ligaments around her sacro-iliac joint and it was now hypermobile. The treatment for this condition required regular physiotherapy, Pilates, and a modification of her training.

The above story is an example of an inexperienced trainer pushing the client beyond what should be expected of him / her (in this case a 5 foot tall medium built woman). The client has stopped going to that trainer and now requires more low level exercise training, rather than high level training such as running and weight training – which is what she originally desired.

When a physiotherapist and a trainer work closely together this situation can be avoided. The physiotherapist and trainer will assess whether an exercise programme is appropriate to give to the client, then find an alternative training method or set a different and more realistic goal if necessary. The client benefits from avoiding injury, continuing training, and having constant surveillance of how his / her progress is going. This is an example of why a physiotherapist and a personal trainer working together with a client makes a great team.