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.
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.
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.
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.
The danger of training can often be setting goals too high. It is very easy to decide that training with a trainer is the start of a whole new change of life. In some ways it is, but in other ways the goals that are set with the trainer need to be realistic for your body type and athletic ability. Of course, you can gradually build up to bigger and bigger goals, but at the start it helps to set achievable goals and test how your body adapts.
I have noticed that when clients come in with an injury they may suddenly decide to compete or race, where before the injury they had no desire to train. There is something about getting treatment or starting training which triggers within people a desire immediately to take part in races. I have had clients who injure their knees and yet suddenly want to do a marathon; this is a great example of setting goals which at the time are unrealistic. A more appropriate strategy may be to recover from the injury, build up strength, start looking at running technique, and slowly build the distance you run eg 10km, 15km, 21km and then a marathon.
I had another client who wanted to run a half marathon 3 months after giving birth; she reported pain in her body and required treatment which stopped her from training. 9 months down the track she completed the half marathon, and retrospectively acknowledged that she initially started training too early; she now knows that her body needed the time to heal from the birth of her child before it was ready to withstand the impact of running and training. Her half marathon was a great success; she enjoyed the day and did not get injured. If you are going to do a half marathon for the first time, you want it to be an enjoyable experience. If she had done the race 3 months after giving birth, it would have been a painful experience and probably put her off running forever.
Having a physiotherapist and trainer work together can help you assess the current state of your body, and then help you set a plan to develop your strength, endurance and power. They can also look at your technique before helping you to set an appropriate goal. Having a trainer is hugely beneficial in overseeing your progression, and the physiotherapist can see how your body is improving and give you guidance as to how quickly training can progress. The physiotherapist also has the advantage of understanding medical conditions and the impact this will have on training.
Working progressively towards a goal often requires a change in a client’s mind-set. Patience is not everyone’s natural tendency; however if someone wants to achieve a goal there will be an element of patience required. If the goal is inappropriate – since the client does not want to wait to go through the training process – then a new goal needs to be set. At the end of the day the client will fail if the goal is set too high, and this reduces motivation for training in the future.
When a client sets goals or has ambitions which are too high we call these fantasies. Physiotherapist and trainer can put goals into perspective, set realistic targets, and make the process enjoyable
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.