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: 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: 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: The Shoulder injury in training

Shoulder pain is a common complaint when training in the gym. I have often seen shoulder pain occur when someone is doing a deep bench press or a very low shoulder press. This pain could be associated with a clicking noise or a sharp pain at the point of deepest position. Often the person tries to train harder to resolve the problem, because they believe that strengthening the shoulder will be the solution to the problem.

The other time shoulder problems can occur is when someone is given a new exercise which is very functional in many degrees of motion, using small weights quickly or pushing very heavy weights. Today exercises are often more functional which means that they do not function in single planes of motion. These movements can be very complex and require coordination and skill. When a person does this for the first time, and then they try to do this too fast with a heavy weight, they lose control of their shoulder joint and the shoulder joint is put under unnecessary stress. This stresses the shoulder over time and breaks down the tissues leading to injury.

When the total movement of an exercise is videoed it can be seen that the shoulder can also be put under stress because other parts of the body are not moving as well. When someone rotates their body and pulls weight up and out above their head, if their hips, pelvis or knee are not moving in a coordinated fashion the shoulder gets unnecessary stress and this can also lead to tissue breakdown and injury. An injury can occur from one explosive movement or from repetitive movements done badly over time. Sudden movements are often associated with a one off severe pain; however the repetitive movements done badly over time tend to creep up on a person. Pain develops insidiously and starts at a low level, gradually building to a point at which they must seek physiotherapy.

Rehabilitation protocol for shoulder pain can be very complex as the shoulder is the most mobile joint in the body. The shoulder can be prone to increased movement in some areas but stiffness in others. The spine, hips and knees – even the big toe – joints can all be causes leading to shoulder pain. The assessment protocol for assessing the shoulder will be a global one and treatment may involve working on areas other than the shoulder.

To prevent shoulder problems it is very important for a physiotherapist to work closely with a personal trainer. The trainer communicates clearly with the physiotherapist what they intend to do with their client, and then the physiotherapist can guide the trainer as to what potential risks there are. If this close relationship functions correctly between the physiotherapist and trainer than injuries can be prevented, goals can be achieved and long term damage to the body can be avoided.

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 –

Longest day of training yet and still legs stay strong

Yesterday I completed my last full day of training. It was a 6.5 hour ride over 85 miles. I started the day with my usual nutritional supplements. They do make a difference because my legs feel strong everyday.

We climbed for 2-2.5 hours and then descended into the most delightful Portuguese village for lunch. If I was back packing around Europe this is where I would want to come to see beautiful scenery, have sunny days and pay 2 euros for lunch.

The ride went smoothly until one of our cyclist got knee pain. We called for the car to pick him up. Up until this point I had been climbing smoothly at a good pace and feeling strong. When the car came my coach said “Rhys time for some madness”. I hated those words as this meant hard and fast riding as he wanted to beat the car down the mountain and into the next village.

We took off and I glued myself to his back wheel. We were cornering like rally drivers around the twisting downhill descents. In-between the descents were slight inclines which meant climbing 500 to 1000 metres as fast as possible. This was when the pain in my legs kicked in. I pushed as hard as I could and managed the first incline. I rested on the following descent in preparation for the next climb. My coach said “Rhys let’s get on it!” and accelerated again.

The lactic acid built up in my legs with each extra effort I made to push faster. With 200 meters to go to the end of the next climb I broke. The pain in my legs and my high heart rate were too much and I blew. My intensity of riding dropped and the car caught me up. My coach probably would have made it to the village but he waited for me. The moment of madness was over….so I thought.

We relaxed and I followed my coaches slip stream into the village. My legs were fatigued after 80 miles of riding. We still had the climb back to the house to go. I chose to take on the beast of all mountain routes just to finish the day hard. It was stupid but that is cycling for you. It took me 18.30mins with 11-14% gradients. If I stopped pedalling I would fall over. The final push to the top was mighty. Another hard day of climbing finished.

It was encouraging to find my legs still had strength in them and I knew the last ride tomorrow was going to be another good test. I learnt more about pacing myself today and following good lines on the descent. I learnt how to slow my breathing down again and regain composure when I am gasping for air when climbing. Keeping weight on the front handle bars was important to stop speed wobbles down hill.The training has made me stronger over three days.

I put on compression leggings when I finished and relaxed. We headed for dinner and we all ate mountains of food. Our metabolisms were going ballistic. I am enjoying this experience and I can see cycling is very technical when riding in mountains. There is nothing that beats practical experience and that is exactly what I am getting here at the Delucci retreat.

Tips when wearing sunscreen and cycling

Yesterday I went cycling and was sweating in heat and hard climb. The sweat ran down my forehead and mixed with the sunscreen I had applied in the morning. It then ran into my right eye and it stung as the sunscreen lotion irritated my eye. I was climbing a hard hill at that stage and could not take my hands off the handle bars. I  let the eye get painful and by the end of the ride my eye was red from constant irritation.

My coach Gary said do not put sunscreen on your forehead and bring your helmet down to cover the gap between your glasses and your hairline. Is will soak up the sweat on your forehead.

Another useful tip I have learnt training here in Portugal.

Latest research findings on cramp in sport/ triathlon

In the July edition of 220 Triathlon there is an article on page 77″The science of cramping” which discusses the research into cramping and how to manage it.

In summary:

The research comparing triathletes and athletes who get cramp with those that don’t identified a common risk factor is exercising at unusually high intensity during a race, family history of cramps and a history of tendon/ ligament injury. Currently there is no exact known reason why cramping occurs.

Studies have found a 6% carbohydrate sports drink can delay the onset of exercise induced muscle cramps in endurance activities, but not prevent them entirely. Low levels of magnesium are linked to increased incidence of muscle cramps. Magnesium supplementation has been shown to help sufferers of “night cramps”

Take away tips:

1. Gradually increase training intensity. Remember unaccustomed fatigue plays a major role in muscle cramps.

2. Stretch regularly, paying particular attention to hamstrings, calves and any other muscle groups that are prone to cramp.

3. Use carbohydrate-electrolyte drinks during longer training sessions/races and/or during recovery, and ensure you consume plenty of calcium and magnesium rich foods.

4. If you’re a long term sufferer of cramps, consider magnesium supplementation.

Personal experience dealing with cramp

I completed the Switzerland Ironman last year and did 1 year of intense training. This year I am doing the Etape De Tour  and increasing my bike mileage from 4 hours to 8 hours on the bike and training 3-4 times per week. I will be going to Portugal to train on my bike in the hills and the heat.

I have suffered from cramp occasionally after exercise but also during exercise. The cramp usually affects my hamstring or calf muscles. I noticed when training for the Ironman muscles were getting tighter in the early stages of training. At this time I was starting to train 6 days a week and running and then cycling in consecutive days. My calves got so tight I had to walk down stairs sideways.

I went to get massage weekly and this helped but I noticed my legs were still very tight with continued training. My experience does fit with the article details above. I usually got the cramps if I pushed hard on time trials or at the end of long hard bike rides. The cramp could occur after training if I had a very hard training session. To get rid of them I stretched and in the end I was massaging my legs immediately after training to loosen them. I also wore compression leggings and this certainly made my legs feel much better.

The most important finding I discovered was the use of Magnesium supplementation. I went to New Zealand and was given a product from the salt Lakes of Utah. I started using it and noticed my legs felt significantly looser. My ITB, calves and hamstrings felt at ease and much better after training. the magnesium was better than the massage in terms of preventing muscle tightness.

I continued to take Magnesium through my training. I added it to my  alkalising drink I took through the day and also to my electrolyte drink in training. In my Ironman I did not suffer cramp during or after the race and my ITB friction syndrome did not occur.

I think I was suffering cramp because of the change in intensity of training and number of days trained and I was sweating out salts in my body and not replacing them in my diet.


I am a physiotherapist and an Ironman and I think the information in the article above is spot on. I would try magnesium supplementation, get massage and look after your nutrition. Stretching and self massage is important as you don’t have the time and resources to get a trainer and massage therapist to work on you everyday. If you do then get them in everyday.

If you would like contacts in the fields of stretching, nutrition, triathlon training do contact us here at Physical Edge and we would like to help in anyway we can. Got to love triathlon.

Temperomandibular training session

Today we had Sarah from New Zealand give us the latest updates on treating the temporomandibular joint.
She described how the joint contains a fibrocartilaginous disc and if has no nerve supply in its intermediate section. It is this section that is compressed in the joint normally. When the joint is pulled out of alignment the anterior or posterior sections of the disc can be compressed and there structures have nerve supplies and create pain.

The TMJ can be effected by Bruxism (clenching jaw), trauma, postural issues, and structural changes. The cause of the pain can involve the upper cervical spine as these three segments communicate with Trigeminocervical nucleus and can produce pain anywhere innervated by the trigeninal nerve (Supplies skin sensation to the face and head).

In the above conditions is important to address the muscle imbalances around the TMJ and his can be treated with trigger point release and muslce releasing inside the mouth. The neck posure can be improved with rehabilitation. Acupuncture will be effective in treating  sinus pain and headaches.

In trauma mobilisaiton of the TMJ will include traction and Mobilisation with movement.

The results have been great and symptoms can be changed in 2 weeks. In New Zealand botox is used to release muscles in acute pain before treatment starts. I am going to meet a chiropractor on the weekend to find out what chiropractors do in treating TMJ pain.

First 2.5 hour run, 4km swim and 5 hour bike ride

I was looking forward to this weeks training as I was starting to train the bigger distances and I wanted to know if my body would remain pain free.

The run was first and, as it is my weakest discipline, I was not sure how the legs would cope. I finished a day of work and raced home to start running. I think working all day and not eating well at work can make the run difficult because my energy levels are lower.

In the first 1.15 hours I focussed on keeping a race pace to avoid my hamstrings getting tight early in the run. I ran from Putney to Ealing Broadway and felt good. The outside of my knees were getting tight but I kept the pace going and my legs were  not getting worse.

I was feeling good with 10mins left to run so I started to run faster. This was a big mistake as a muscle in my right foot cramped. It felt like tearing in my foot and I was concerned it was my plantarfascia. I slowed right down and kept a slow jog to see if it would wear off. It lessened enough for me to hobble home and I wanted to make sure there would be no long term problems. Being a physiotherapist has it benefits at times like this and when I assessed it I could see it was only a muscle cramp as I first thought. With Massage and rest it would ease out completely. The next long run is next week and I plan to take it slow all the way home.

The swim was at the Lido pool in Tooting Bec. I chose to swim here because it was 90 metres long and I could wear my wetsuit in the pool. I trained at the end of a days work and was tired getting into the pool. I also had to rush to get there before it closed and it was not ideal mentally or physically to train in this state.

I got in the pool and it was cold. I had 44 lengths to swim and even though I had a wetsuit on I could feel the cold right through it. To make 44 lengths mentally smaller I counted the first 4 lengths down to zero and then divided the last 40 laps into 4 sets of 10 laps.

I was swimming slowly and I wanted to feel relaxed and focus on my technique. Other swimmers were passing me and it was really disappointing but I stuck to my plan. By the 34th lap I was feeling the cold and I did not kick much to save cramping in my legs. I finished the 44 laps in 1.26 hours. I called Emile my swim coach as this was much slower than I anticipated. He said it was a good time and he could check my technique and work on kicking more to help me go faster. There is still time to improve my swim time with 5 weeks to go before the Ironman. The wetsuit rubbed excessively on the back of my neck and left skin abrasions. I have put savlon healing cream on the damaged skin and hope it heals fast before my next swim. I have Glide to put on my skin in the next swim. This helps reduce friction with the wetsuit.

Today I rode 5 hours and then ran 30mins. Got lost heading to Windsor and back to London but got there in the end. The last 1 hour was tiring and I could feel my legs were aching. The run went well and I had energy after finishing so I was happy. I kept a slow pace throughout the ride and this allowed me to complete the entire ride comfortably.

The discipline that causes me the most pain is the running. I will see next week how my legs cope with a 3 hour run. I am still enjoying the training and the enormity of the race still is in the back of my mind.