GIFT week 5: Looking at AFS and the Calf complex

GIFT week 5 was a week of further development of what AFS represents and the progression of bone and joint motion to the function of the calf complex. 
 
This week there was a strong emphasis on what makes an AFS exercise an AFS exercise. Specific points were made on drivers,3D motion, unconscious chain reaction, path of least resistance, Authentic movement and uniqueness of environment. I can see each week these concepts are continually emphasised, in various ways, to embed them firmly in our minds. I can see these will create the framework from which we will diagnose, prescribe exercises and tweak exercises. The Litmus test has been described in the DVD series called Chain Reaction. These tests are those points described above.
 
In the webcasts this week the focus was on the calf complex. What it does and how it works econcentrically. The joint motion was described for the transformation zones of gait. The function of the calf muscles were described at the foot, ankle, and knee levels. It was refreshing to get a true functional understanding of the calf complex. It makes sense that muscle does not work in one plane of motion or is purely a concentric or eccentric muscle contraction. 
 
The webcasts further expanded on lunge matrices. This week it was description of how Lunge matrices can be used to enhance balance. The key point is balance needs to be trained dynamically and not statically. It can also be trained in 3 planes of motion. I think clients will enjoy how balance training can be so variable. 
 
Gift is about communication and this week we expanded our sign language learning to include letters  M to R. It is empowering to learn sign language and I hope by week 40 I will be able to sign simple expressions.
 
The learning this week has taken a step up, and is testing our knowledge, to make decisions on what is happening to joint motion with different tweaks and drivers. The knowledge builds.

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.

Get your Biomechanics assessed early to avoid injuries

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.

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: 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.

Personal training series: Risk of long term injuries

 

Injuries can occur in several degrees of severity. Some injuries can be niggles which ease with time; some of these niggles continue to plague a person throughout their life. Severe injuries may require hospitalisation or immobilisation and rehabilitation; other sever injuries will handicap a person for life. There is a spectrum of minor to severe injuries, and each person’s injury sits somewhere along this line.

Why can’t you get rid of these injuries? When you get assessed by a physiotherapist the physiotherapist will tell you what the injury is and what needs to be done to heal that injury. I see the best results when the client follows the physiotherapists instructions and does their homework. Failed treatment usually results when a client comes to physiotherapy under the illusion that treatment for 30 mins twice a week will take away their pain without their having to make lifestyle choices to stop aggravating their injury.

When injuries are neglected during daily life and in training they become more deeply set in within the body. Pain can be remembered by the body through the nervous system. The nervous system is said to be ‘sensitised’ and will hence react to normal movement in an abnormal way. A person can live their life in pain even though the actual initial injury is healed.

Some injuries do require surgical intervention or help from various medical professionals. More than this, however, change in mental attitude is required about a client’s injuries. Sometimes injuries which have been present for a long time will continue to cause pain and it is about managing that pain through a different mindset.

Injuries should not prevent training; what prevents training is what decisions a person makes about what they are committed to do in their training and at home. Failure in physiotherapy and training should not be blamed on the clinicians; clients should look within to see the degree to which they are contributing themselves to the pain that they suffer. Physiotherapy requires input from the client just as much as the physiotherapist has his own input on the client.

It is clear that those clients who are most successful in physiotherapy are those prepared to make changes in their life. It is not easy to assess what changes you need in your life and that is where a physiotherapist and trainer can help you with their vast experience with other clients and their training. A physiotherapist and trainer can also monitor a client’s progress; help with maintenance of his good health; and inspire him to achieve goals that he never thought were possible.

My advice is that if you want to start training to help long term injuries, you would benefit from the input of a physiotherapist and personal trainer working closely together with your interests at heart.

Personal Training series: Heavy weight training and injury prevention

Many people like to look their best and this requires a toned shaped body. Some people want to lose weight and this will also involve weight training. It has been found that a combination of cardiovascular exercise and weight training can get faster results because increased muscle mass will burn more calories and hence improve reduction in weight, as well as a shaped body.

If someone starts weight training from scratch injuries are often common because the correct movement patterns are unknown. Most people know that they can hire a one-on-one trainer to assist them in this process.

Weight training has many forms; if the weight training is kept at a light to moderate weight, and the movement patterns are correct, injuries can be prevented. Problems start to occur when weight training becomes very heavy. In order for muscles to grow they require a stimulus harder than the time before; training can start gradually and increasing in weight is a simple process. When a person starts to reach the maximum weight that they can push then challenges will occur.

The challenges of pushing weights higher than a person’s current maximum lifting weight will be controlling the weight when putting it into a starting position; lowering the weight in a controlled fashion; avoiding excessive joint position; and finally pushing the weight back to the start position. Sometimes lifting heavy weights will require standing, a lunge position or a position other than on a stable bench. When a person has to control a heavy weight, as well as the position of their entire body, the movement becomes very complex.

Commonly the injuries I see when someone lifts heavy weights are at the very start of the movement and in the middle of the movement. The weight is very heavy and at the start of the movement the person has to lift from a standing still position. To generate extra power a person will compensate by swinging their body to help; it is at this point that an injury may occur to the lower back, the sacroiliac joint, the knee or any other joint that is the weakest joint in the link. The time pain occurs is in the middle of the movement because the middle of the movement is the most awkward; controlling the body puts the body in its weakest position, and tissues get injured.

A client was training and wanted to be pushed more, and therefore was told to start Olympic deadlifts. She was 5 foot, of petite build, and when she explosively lifted this weight her sacroiliac joint popped. Treatment for this joint has taken several months and she now requires pilates and controlled movement training to keep her pain at a satisfactory level.

At some point in a person’s training lifting heavy weights may become necessary. If a physiotherapist can identify weak areas within the body – and the trainer is aware of these areas – then when lifting  a heavy weight in a complex movement pattern, the trainer can help a client control and prevent injury.

My advice is always to have your entire body assessed before you start lifting weights to give the trainer the information they need to prevent an injury from heavy weight training.

Personal Training series: Physical Edge Physiotherapy team working specifically with Personal Trainers for superior results

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

Shoulder pain when swimming and coaches advice

I sam for the first time in my Orca wetsuit and it felt amazing. The suit is so light and flexible and it keeps me really boyant. I swam in the suit for 300 metres and I felt pain develop in my left shoulder as I was finishing the recovery phase of the stroke. I took the suit off and I could change the pain by turning my body more towards the pain shoulder (left) at the time I felt the pain. It knocked my confidence in the suit so I spoke to my swim coach Emile and these were his words of wisdom.

Swim Coach (Emile) writes…

Re the left shoulder issue, assuming there are no pre-existing skeletal issues then it’s likely to be one of the following:

1. Levering off the left hand particularly when breathing to the right.

You may be putting unnecessary pressure in a downwards direction to support breathing to your right. Ideally when breathing on either side the leading arm will remain high and stretch forward. Occasionally through lack of rotation to the right, lack of confidence breathing to the right or simply an urgency to begin the propulsive phase of the leading arm (as when sprinting) the leading arm presses down and when coupled with the added weight of the head turning to breathe you can apply unnecessary pressure to the shoulder area. Because of the repeated nature of swimming the slightest pressure although not an issue for a short distance swimmer will start to cause problems for the endurance swimmer. As is the case with many aborted channel crossings.

Remedy – ensure you fully rotate, keep the head position low in the water when breathing and project the leading arm comfortably forwards rather than downwards

2. High elbow recovery on the left side without adequate rotation.

You may well be recovering the elbow too high for the rotation on that side. If the rotation is limited and the elbow recovers high the result is an impingement in the rotator cuff area. Again a common injury for channel crossers which is why to avoid the issue they tend to under rotate and recover with very low wide arms.

Remedy – you could take the channel crosser approach but I would suggest for anyone with good core strength able to support full rotation you simply rotate more on the left side and experiment with a slightly lower elbow recovery.