This series of blogs has been designed to give you information about the 17 most common issues related to training in a gym. Each blog discusses what is commonly seen by trainers and physiotherapists when people train in the gym – and also the importance of having a trainer and physiotherapist working closely together to create a training plan to prevent injury and maximise results.
The synergy of a physiotherapist and trainer working together has huge benefits in terms of continuity of care, injury prevention, and communication between all clinicians and you – the person trying to achieve the goal.
When a physiotherapist and trainer work together injuries can be prevented by early assessment to identify problems which may occur in the training process. The key principle here is prevention of injury rather than healing of injury once it has occurred. The physiotherapist is valuable in his / her knowledge of medicine and musculoskeletal injury, and the trainer is valuable in setting training goals and making sure you are motivated and carry through with your plan.
If you are interested in working with a physiotherapist and a trainer who have spent years refining the process of injury prevention contact us as at firstname.lastname@example.org now.
Many of us like to set goals which will push us to our limits. If we want to learn something well, we usually have a teacher or a coach, and this applies to physical training as well.
If you set a goal and along the way you get injured, or you can see that your sport is unsafe because your body cannot cope with the loads exerted on it, then have the common sense to change. The ability to listen to your body can prevent acute and long -term injuries. It is not worth training for weeks or months, to get injured and see your goals slip away.
A physiotherapist and trainer can help you make common sense decisions about your training goals. Both clinicians will listen to what you want to achieve, and assess your body, to decide whether or not your goals are realistic. Choosing the appropriate training goals will make training safe and achievable.
The body is not a machine, it responds to physical stimulus and will adapt over time. Setting goals which are small, on which you can build towards a much bigger goal, is the best way to train. A physiotherapist has knowledge in the areas of pathology, physiology and neurophysiology. A trainer knows how to train to achieve physical goals. Working with a Physiotherapist and Trainer gives you the professional support to choose the training program to best suit your needs.
Make a common sense decision now, before you waste time and money, and suffer injuries. Consult your physiotherapist and trainer as they work with you as you achieve your training goals.
There is a difference between osteopaths, chiropractors and physiotherapists. Physiotherapists’ background is often based upon rehabilitation and, in this sense, physiotherapists learn to assess the biomechanics of the joints of the body and then how that movement is coordinated in function. For this reason you see physiotherapists associated with professional sports teams.
Understanding the biomechanics of the body helps to identify the cause of an injury or, if an injury has already occurred, how to rehabilitate a person back to sport. A trainer’s role is to strengthen the body and, in this sense, they will look at how to control movements with specific strengthening exercises. The physiotherapist can complement the trainer by looking at the finer points of joint movement and by integrating other systems of the body, such as neurophysiology, pathology, and the cardiovascular system.
When training for the first time in the gym, or looking to achieve a goal, it helps to have your biomechanics assessed to aid in avoiding injury. An experienced physiotherapist and trainer can work together to protect from potential injuries which can occur if the body already has poor biomechanics. No two people are built the same, and therefore an assessment should be very bespoke. An example of poor biomechanics would be: a person who has a restriction in the ankle joint such that when they do squats, lunges or step-ups this causes a secondary movement in the knee, hip or back – and somewhere pain will start to occur. This is a very simplistic example of how to assess biomechanics, but it illustrates the importance of identifying these problem areas.
Biomechanical issues may not be a problem in the initial stages of training, where the number of repetitions or length of training is low. However, when training distances and intensities increase, these biomechanical issues will start to cause injuries. It is advised that you do not try to work through these injuries, but rather have them assessed, to allow your training to progress smoothly and with minimal chance of injury. The synergy of a physiotherapist and trainer working together is a formidable team in helping to prevent injury –and exists in many professional sporting environments.
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.
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.
In physiotherapy I see many sports injuries. Often I will see injuries which have been present for several weeks, months or even years. Clients tell me they were never told by their doctors or specialists to see a physiotherapist and that they decided to leave time for the injury to heal by itself. By the time they come to physiotherapy the injuries have set in to the body; the central nervous system has adapted to the pain and now can prolong pain. The musculoskeletal system has weakened or become tight, or moves incorrectly.
If you get injured call your physiotherapist to get advice straight away. Why wait? If you can’t see the physiotherapist, the physiotherapist can advise you over the phone what to do for your acute injury. It is in the phase just after inflammation that training can be very effective. Training in this time allows the body to adapt to load in a positive manner. The body becomes stronger, stiffer and moves correctly.
Starting treatment when an injury has been present for weeks, months or years will take longer. The amount of input the client has to put in outside of the physiotherapy clinic is also increased. What you are trying to do is to tell the body a new way of moving and being, and it takes time for the body to adapt to this new stimulus. The stimulus has to be applied frequently and regularly. Sometimes 100% resolution of the injury is unrealistic; in some cases it is more realistic to teach a person how to manage their pain rather than cure the pain completely.
It is obvious that it is important to treat acute injuries immediately and to seek medical care. Being proactive at the start avoids a tedious recovery time, which is likely to be the case if treatment is sought much later.
Once the physiotherapist has seen you through the acute phase of your injury, he can work with a personal trainer to design a training programme which is appropriate for your goals. The exercises given to you may have to be adapted for the injury, and these can be changed as the injury heals. Having a personal trainer watch you during the training process ensures that you do not do anything wrong, and risk reinjuring the body part.
The physiotherapist will know when your body is ready to train at full intensity again. The close relationship between the trainer and the physiotherapist is beneficial because the professionals know each other, talk the same language and can progress you through your training at the appropriate times. If you have physiotherapy questions, do contact us as http://www.physical-edge.com.
Having a goal is great because it drives you when times get tough during training, and it keeps you focussed through the training period. The time it takes for you to achieve your goal will vary depending on what that goal is. Sometimes I have seen people set goals with time frames which are too short.
When I completed my Ironman in Switzerland, I gave myself 1 year to prepare for the race. I worked with several coaches. Having 12 months gave me to time to learn and to get it right. I needed the time – because I was working – to fit in skill sessions, such as learning how to swim correctly, and to find the equipment I needed to race. I did get injured in the early stages of my training because my body was adapting to 6 days a week training. Having 12 months to train for the race allowed time for my body to recover from its injuries and to get back to full fitness to train again.
When the time to train before a race is too short there is greater risk of failure. I have had a client wanted to race the ‘Marathon de Sables’ in 2 years’ time, and to do an Ironman in 1 year’s time – and she had no background in endurance training; she also had an existing ankle injury. Setting goals like these is unrealistic; if you talk to a coach he will put a true time frame in for each event you want to complete. Personally I think it is better to leave more rather than less time to complete endurance events.
Remember, talk to your physiotherapist, coach or personal trainer when you want to set a new goal – to make your time frames realistic and to avoid injury at the same time.
The foot is often overlooked by medical professionals and trainers. The foot can be a common cause of problems in other areas of the body. Biomechanics of the foot can be complex; however if assessed with video analysis, looking at joint play within the foot and how the muscles are coordinated to control the foot, then often the problem can be identified.
I have treated a runner who developed groin pain because he developed a stiff first toe (big toe). He was a 100m sprinter which involved rapid bursts out of the blocks and ten seconds of very intense running. Over time the big toe created abnormal ankle movement which led to knee, hip, pelvic and lower back pain. The weakest link among all these joints was his groin. The groin pain affected him so badly he could no longer compete for that season.
Another illustration is someone who has had a previous ankle injury and the ankle joint is stiff. When comparing the right and left sides they can see that one side of their body has less ankle movement when they squat. The restriction in the ankle will create abnormal knee and hip motion and have consequences on the pelvis and lumbar spine. The ankle joint can be a difficult joint to increase mobility. To keep the improved range of motion often requires regular home stretching. Sometimes a Physiotherapist is required to help return normal joint play to the smaller joints within the foot.
The foot and ankle are made up of an array of small and long bones; these bones all have to work in a coordinated fashion to enable the ankle joint to move correctly. It is the job of the physiotherapist and trainer to identify where these smaller restrictions may be – where they affect or present as generalised pain in other parts of the body.
Clinically, if the ankle has been fractured or sprained there can be restrictions due to a poor healing process. If the restriction has come on with no trauma then maybe the ankle has been restricted over time due to myofascial restrictions throughout the foot and ankle. The latter can be corrected much more quickly. When a client has on-going assessment by their personal trainer and Physiotherapist myofascial restrictions like this can be easily identified, especially in the foot but also throughout the rest of the body.
The foot and ankle are the first parts of the body to connect with the ground when walking, standing, running. Before training, it is important that the foot and ankle have normal range of motion to prevent injury.
No two people have the same body; and even if two people look the same their ability to withstand load can be vastly different. Commonly in the clinic my clients complain about holding good posture. They report how other colleagues in their places of work can sit with bad posture but never develop pain. Why is this?
There are some people who have a musculoskeletal system which is able to withstand the abnormal loads on their bodies in poor sitting postures: there are others who have a very low tolerance to the stress of sitting with poor posture. There may be many reasons for this but I think a major factor is simply genetics. Genetics cannot be changed. Therefore, two people should avoid comparing themselves when it comes to posture, movement and pain.
Another example of this is athletes – who play sport regularly – and get more injuries than others who may sit at home with an unhealthy lifestyle and watch TV. If you play sport you are generally going to be healthier on the inside but maybe more prone to injuries on the outside. Unfortunately this cannot be avoided as sport does put abnormal loads on the body. If the body cannot adapt to these loads then injuries will occur.Those people who sit on a sofa and eat unhealthy foods do not expose their body to the stresses of sport and in the long run may have fewer injuries and actually better joint condition.
When a physiotherapist assesses a person a bespoke testing protocol is followed; this protocol will take into consideration the movement patterns this person puts themselves through in normal daily life as well as in their sports or hobbies. This assessment is a very functionally based assessment whereby the client can see where their issues are in daily function or sport – and then has a goal to achieve in the rehabilitation process.
The physio will do a thorough examination of the musculoskeletal system and identify individual variances within each person. Physiotherapists can then report to the trainer what the potential consequences of training that person will be. This method will also identify what limitations this person may have when setting goals. When a physiotherapist and personal trainer work closely together you get a synergy like no other. The client gets fully assessed at the start and the constant feedback throughout the training process will provide a bespoke feedforward system for goal attainment and injury prevention.
When a physio and trainer work closely together injuries due to movement can be predicted. Sometimes a client can do an awkward movement once, twice, ten times but if they decided to run a marathon with the biomechanics that they have they will develop an injury. The training process must be adapted to provide help to prevent this injury increasing strengthen and flexibility in various parts of the body to enable that person still to run a marathon.
It is my intention that a client is able to train with very few major injuries; continue to train if they have minor injuries; and attain their goals on time. The client also has the benefit of knowing the physiotherapist, and of knowing that the trainer and physiotherapist are working together as a team.
I believe being healthy is important, as it affects every area of life – if you are healthy you can do more and feel better doing it. Often people find it difficult to motivate themselves to go to the gym or to do sport; they need someone to direct them in their training, give them focussed goals, and keep them motivated along the way. Personal trainers play a significant role in this regard – helping people achieve their physical goals. Today personal trainers often work in one-on-one training facilities, to offer functional gym training in a smaller more intimate environment;the gym generally has better equipment, is cleaner and the trainers can offer state of the art functional training.
Having spoken with several high profile trainers in London, we have identified the need for physiotherapists to work with trainers.People find it frustrating when they get injuries and the trainer sends them to a physiotherapist they do not know; the physiotherapist may not clearly communicate back to the trainer what the client’s injury is, and how to help heal that injury during training. Sometimes training is stopped for no reason and the client is taken away from his / her training goals.
The way to improve the training process is to have a physiotherapist work with the trainer from the very start. By getting assessed by a physiotherapist before training starts, a person can discuss their injuries and how their body operates with a medical professional. The physiotherapist will identify the injuries, past and present, which may present during training sessions; even if there are no current injuries, the physiotherapist can identify potential pitfalls a person may encounter as they go through their training regime towards their goals. Once the person is assessed by the physiotherapist the physio can feed back to the personal trainer what to look out for during the training process, what limitations there are for that person in training, and whether the training goal is appropriate. The trainer can then confidently train a client knowing that he/she is supported by a medical professional who understands injuries and how the body functions in response to them.
The personal trainer will continue to communicate closely with the physiotherapist during the training process; the physiotherapist will continue in their assessment of a client throughout their training regime in order to maintain correct movement of the body and further direct the trainer towards more advanced training goals. By working well together in this way the physiotherapist and trainer help to provide a better service to their clients. If an injury does occur during training the physiotherapist will already know the client, and the trainer will be able to communicate immediately with the physio on how to proceed. The synergy of this relationship far exceeds any personal training system by itself.
The benefits to the client are:
- Prevention of injuries during training
- Faster goal attainment
- Faster return to training if an injury does occur.
If you are interested in working with a physiotherapist and personal trainer contact us at http://www.physical –edge.com