Strength training is for more than just weightlifters!

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I’m amazed at how many runners still do not have strength training included in their training plan. I’ve written about strength training before, but maybe the benefits have not been advertised enough.

I embarked on a strength training program in June after I completed Dorchester Marathon. I started with doing HIIT training and strength training throughout the week. At first it was hard, bloody hard! But after four weeks I already felt stronger. After the initial four weeks I began running again. I used a simple training plan that included two strength training sessions a week and three runs (3 miles easy, 3 miles tempo and a long run starting at four miles). I started out at a 10:49 minute mile and four weeks later I was running a 9:58 minute mile.

Taking out the slightly faster 5k time what I did notice was how much easier it felt when I was out running. This is where many of the benefits lie. Yes, performance will get better (especially the longer you do it for) and this is often due to the perception of an easier run. More strength in your legs will help you feel better while running.

So, what exercises are best for runners?

This is the question I am most asked. My advice is to choose posterior strength exercises like deadlifts, Bulgarian squats, calf raises, lat pulls and superman’s. Hip strength and mobility exercises such as monster squats, x-walks and side-lying abduction. And finally, glute strengthening like hip bridges, hip hitches and step ups.

If you’re unsure where to start you can also seek the help of a personal trainer who specialises in running. If you live in the Maidstone area Bjorn Fitness is PT who specialises in running and is well worth it if you’re looking to up your game and keep injuries at bay.

That gets to my second point. Injury prevention. Strength training may not stop all injuries, but it will help to prevent overuse and underuse injuries. If you progress your strength training as you would your running, then there will be no negative effect on your running. Strength training will help your muscles cope with the demand place upon them when running and thus reduce the likelihood of injury.

Lastly, two strength training sessions a week will help you see the benefits during your running. Ideally don’t do a heavy session the day before a long run and if you must do both running and strength on the same day, do the running in the morning and strength in the evening.

If you need any advice on sports injuries, injury prevention and rehabilitation please email sara@prestoigesportinjury.co.uk

Are you under-recovering?

We've all been there. Focused on a goal, whether it be a weight, distance or time. So we push ourselves, sometimes too hard.

Symptoms of overtraining/under-recovering can seem mild at first, but they become more prevalent as time goes on. If we ignore the signs, we're heading into a downward spiral. Symptoms often start as an increase of muscle soreness, elevated heart rate, an increase in colds due to reduced immunity, increase occurrence of injuries, irritability, depression, loss of motivation, insomnia, decreased appetited and eventually weight loss. 

If you've ever had this happen then you know all too well that not recovering properly can leave us feeling pretty low. But, there are ways to ensure that you don't put yourself into this position.

Rest, yes, rest is the key. If we don't allow the body time to recover we will suffer. Make sure you take a break after a hard training day, don't force yourself to train 6-7 days a week without rest. You can also reduce the volume and intensity of the exercise. For instance, a runner can reduce effort or distance, a weight lifter can reduce reps or weight.

It is also important to make sure you are eating properly. Often, in search of weight loss, we don't eat enough for the amount of energy we are exerting. Having a balanced diet of carbs, good fats and protein is essential for a good recovery. Avoid fad diets. If you're unsure of where to start with nutrition, seek the advice of a registered dietician. 

A great way to make sure you stay on track is to use the help of a personal trainer to help you make a training plan. There are plenty of folk that can help you produce a running plan that will keep you on track, just make sure you take advantage of rest days!

Always remember that it's okay to take an unscheduled rest day. If you are feeling under the weather or sore from the training from the day before, one day won't hurt you. And if you think you're suffering from a lack of recovery, take a short time off and let your body recover with other types of exercise like swimming, stationary bike or cross training.

If you have any questions about sports injuries and rehabilitation please contact me at sara@prestigesportinjury.co.uk

Getting your family active

Summer break, a time when your kids are home all day bored and driving you nuts. You have less time for your own health and wellness and you’ve been turned into an entertainer for little ones.

But, what if there was a way to stay active and get your kids active as well?

First, you can make a mini boot camp for your kids, get them running for 20 seconds, a minute’s rest then do some squats, rest and finish with some star jumps. Before you know it all of you have had an intense 20-minute workout and they’ll be ready to rest.

Second, a simple family walk can help wear them out. Try and get them to find and identify wildlife or plant life. Get them interested in geography and maps as well by finding a local trail to follow. This will help expand their appreciation for the outdoors and nature.

Third, if it’s raining just have a dance-off in your house. Put on their (and your) favourite music and see who can dance the best!

There are also other exercises such as jump rope, hide & seek and more structured classes such as karate or judo which will help burn all that excess energy.

So, just because the kids are home during the summer, doesn’t mean you can’t stay fit and keep them healthy as well.

Stay strong while on holiday

Two words you don’t want to see together, eh.  You’re on holiday, right? And who wants to spend all day in the gym when you can spend it at the beach or by a pool?

You’re right. You shouldn’t spend a whole holiday exercising if you’re meant to be relaxing. So, the best option is to choose short high intensity workouts (HIIT).  They can be done in a hotel room with little space, require no equipment and should take less than twenty minutes. There are a variety of HIIT programs on the internet, so you’re spoilt for choice. You can alternate running in place, squat jumps and push ups to get a whole-body workout in your hotel room.

You can also include normal holiday activities such as swimming and cycling. Instead of taking a taxi or car somewhere, why not ride a bike (if it’s safe, of course). Or have a brisk swim in the morning at the pool, or in the sea?

There’s no need to spend all morning in a gym or on a long run (unless you want to) when you can incorporate fitness into your holiday with little to no disruption.

Obviously, on holiday you may be eating more than normal, and you shouldn’t feel guilty if you splurge a little.

Keeping your fitness up during a holiday means you’ll have more energy and feel better during and afterwards. You don’t need to do it every day, only a few times in the week to reap the benefits.

If you would like to know more about sports injuries or injury prevention please email me at sara@prestigesportinjury.co.uk

Moderation is the key

We’ve all heard the term. But what does it really mean for every person?

Well, let’s start with exercise. According to Public Health England every adult should get 150 minutes of moderate activity a week in sessions of 10 minutes or more. This includes brisk walking and cycling. If you prefer a higher intensity exercise such as running 7 5minutes spread across the week is also suitable. They also suggest strength training at least 2 days a week. This is the bare minimum we, as adults, should be doing to stay healthy.

Many of us don’t hit those guidelines and some of us will go well over them. Moderation is key. If you don’t do enough you’re not reaping the benefits and if you do too much, without working up slowly, you can over train and make yourself fatigued and unwell.

Next is food. Now anyone who knows me knows I love food. However, even I know I can’t eat donuts every day. Yes, I can indulge a little (not go crazy and over eat) on the weekends or at some point during the week. But, I shouldn’t be indulging every night. Nutrition is individual and if you are seeking help finding exactly what you should be eating I advise to find a qualified dietician to help you. Public health diet guidelines are not specialised per the individual and I highly doubt I could get away with eating 2000 calories a day and not put on a substantial amount of weight.

Aps such as My fitness Pal can help you track what you eat and how much you burn exercising. It’s not perfect but it is an easy way to start tracking your diet, be honest! It is important to see what you’re eating so you can make positive changes without feeling starved or denied your favourite foods. You shouldn’t feel guilty if you spurge occasionally.

Finally, recovery. Many people training for events don’t focus enough on their recovery. They train and train and train until they make themselves ill. Sleep is an important factor is recovery. But once again, in moderation. Sleeping less than 6 hours and more than 10 hours of days can have negative health implications. And if you’re training for a difficult event, you can always add a short 30-minute nap during the day, after a training session.

In summary, there is such thing as too little or too much of a good thing! Keep going in moderation and keep up the healthy living!

Run in a new place and put a smile on your face

I blogged before about losing your running mojo. This usually happens after a period of training cumulating in an event, such as a half marathon, marathon or ultramarathon. Often, we can feel deflated and unsure of what to do next. In times like these I like to suggest running tourism. I see may Park runners on Twitter going out and doing Parkrun tourism, even if it’s still relatively local.

Running tourism provides you with a new route, new people and new adventures. It doesn’t matter if it’s a Parkrun, or a self-planned running route, it is important to just try and seek new adventures.

Some words of warning, if you are going to plan your own route and don’t have any outdoor navigation training, I advise you to stick to well-published trails.  If you want to know more about outdoor navigation there are many running coaches who provide that kind of training, such as the National Navigation Award Scheme.

Some well-published trails include the North Downs Way here in Kent. I have run this trail in different locations and have been able to navigate it easily. Along with well-published trails, you’ll want to make sure you bring a phone with GPS, your ID, and a compass. If you think you might get lost, get some training first. Don’t risk it.

Running tourism is a lot more fun, and safe, if you bring a friend or two along. As always there is safety in numbers, especially if you are unsure of the area you are going to be in.

Research. This is so important. Make sure you research the area you want to run in. Use ONS maps to check the terrain and pack appropriately. Check the weather before you head off and be prepared to cancel if it is going to be poor.

Resources: For parkrun, they have a list of all their events on the website. If you’re looking farther out it is worth doing your research (see above).

So, enjoy the outdoors while the weather is nicer, and get out running in new and exciting areas of your own backyard.  

Couch 2 5K resources

Now that the weather is starting to turn warmer, many people will get the inclination to start running. I started running in May of 2013, mainly for health reasons. Ans I know many others that started running in May/June, so I though I would publish some helpful Couch to 5K resources for those of you ready to become a runner.

Obviously my first stop is the NHS Couch to 5K program. It’s a 9-week program and has helpful hints on progressions. It also has an App you can follow to keep you going.

There is also the Couch25K website itself. It is also a 9-week program and has plenty of articles on running with your pet, running for beginners and a list of books to help you with your running.

BBC has a Couch 25K running challenge, if that’s the kind of thing that motivates you. Many of us do well when we’re challenging ourselves. This too is a 9-week program.

And, finally, there are many Personal Trainers who provide Couch 25K programs. Bjorn of Bjornfit has an online Couch 25K forum on Facebook and provides gym clients help with running specific training and injury prevention.

My advice as a Sports Therapist is that you progress slowly. Don’t go out too quickly, let your body adapt to the training. Often, I treat people who have started or recently started running again, who don’t let their body adapt. This can lead to shin splints (MTSS), Achilles tendinopathies, plantar fasciitis and many other injuries. So, progress no more than 10% mileage per week, and be sure to eat enough food and sleep enough in the evening to recover properly.

If you’re interested in sports injuries and injury prevention and have any questions, please email me sara@prestigesportinjury.co.uk

Stay sensible in hot weather

For any of you who took part in any running over the London Marathon Sunday then you’re aware of the discomfort that warm weather running can be. Especially since most of you would have been training during the cold winter and very cold March.

Now that we’re into May we need to start thinking about how we can make warm weather running more tolerable so that you keep going in the summer.

First, try running earlier or later than normal to get most of the cooler temperatures. Avoid running during the peak of the day. If you must run during the daytime, try and find a shady path or trail to avoid the heat of the sun directly.

Second, stay hydrated. This doesn’t mean drinking all the water you can on a run but more like staying hydrated during the day and day before you’re running. Be sure to drink an electrolyte drink when you’ve been training in the heat.

Third, slow down! Remember the pace you normally run at may not be comfortable or tolerable. Running at a perceived rate of exertion rather than a specific pace is more sensible.

Finally, if it’s too hot and you have access try running on a treadmill. Especially for shorter runs this may be the best choice to keep you going.

And remember if you’re on medication make sure to check if they have a sensitivity to heat.

Please stay safe in the heat and enjoy the weather!

No shame in being a newbie runner

Inspired by the upcoming marathon season, but not sure where to start? You’re not alone. All of us started as a newbie, so don’t be afraid or feel intimidated as there are many resources that you can use to get you started.

First, while information is good, don’t get too wrapped up in it. It’s best to just get out there and be proud of every milestone.

Equipment:

This is my bug bear. As a graduate sports therapist, I see many people who are having foot, ankle and knee pain, often due to improper shoes. So, my first rule is to get your gait checked. NOT by a high street store. Go to a specialist shoe store with appropriate gait equipment and advice. Two near me in Kent are: Up & Running, Sevenoaks and The Running Hub, Tunbridge Wells. You can also seek the advice of a local podiatrist.

Having the appropriate shoes is important especially when you start racking up the miles, you’ll thank me later.

Athletic Clubs:

A great way to make new friends and get support is through an athletic or running club. Most have organised runs twice a week and participate in races throughout the year. Clubs are also a good way to work on technique.

Injury Prevention:

Now this is a biggie! There are a ton of resources for injury prevention, however, the best advice I can offer is to make sure you include strength training into your regime. I have a beginners program here which will help you to get started without little equipment. It’s important to work your posterior chain, single-leg strength, core strength and hip mobility. This will make you a more efficient runner and help reduce injuries.

Another way to reduce injuries is to make sure you progress slowly. Don’t push yourself into injury. Don’t progress more than 10% per week, meaning if you run 6 miles per week, you should only progress by .5 miles the following week. It is also important to allow your body to recover after training, give yourself at least one day of non-running after a day of running, or plan on running 3 times per week.

If you do get injured don’t try and Google for help. Go see a Graduate Sports Therapist or Sports Physiotherapist and get your injury assessed and appropriate rehab started. I focus on sports injury rehab, as do many other sports therapists, but please ensure the person you are seeking help from is qualified. A graduate sports therapist or Level 6 is qualified to assess and diagnose injuries using clinical reasoning to give you the best rehab possible. Anything less than 5 is not qualified to assess injuries, so be sure to check their website and make sure they’re qualified.

Running Plans:

If you’re just starting out, try the NHS Couch to 5k training plan. It’s a run/walk program that’s great for getting you started. You can even use Parkrun as a way to help improve your running and meet new people, to find your nearest parkrun click here. When you complete that you can move on to the 5k to 10k plan, Cancer Research has some training plans that could get you started.

Nutrition:

I’m not a nutrition expert but eating fruits and vegetables and unprocessed foods are best. I have used books such as Fast Fuel – Food for Running as a guide, but there are a ton of resources out there. If you have money to spend you can also seek the advice of a local nutritionist who can help you meet your goals.

Coaching:

There are some great online running coaches that you can use to help you reach your goals. By using an online coach, you can relax and let them put together your plan. This means all you need to do is get up and go running. Two online coaches I can recommend are Kyle Kranz, he’s based in America, but does his plans and coaching online for anyone in the world. The other is Alexa Duckworth-Briggs from On the Run Health and Fitness who is a running coach, outdoor leader, sports massage and offers nutrition advice, she’s based in the UK.

Keeping hydrated, a guide.

We all know the importance of hydration during exercise, but do we really know how to measure it? As most people know, sweating leads to fluid and electrolyte loss. If we don’t replace the lost fluids or electrolytes we become dehydrated, leading to muscle fatigue, confusion, lack of coordination, inability to regulate heat and heat exhaustion.

It is important to know how to measure your water loss as it varies person to person, you can do this by weighing yourself before and after exercise and checking the colour of your urine. and ensure you are hydrated prior to exercise. The darker the colour the more dehydrated you are. The ACSM guidelines for dehydration and weight loss  are as follows:

Well hydrated: -1 to +1% (body weight (bw) change), Minimal dehydration: -1 to -3% (bw change), Significantly dehydrated: -3 to -5% (bw change), Severely dehydrated: -5% (bw change)

As stated above, prior to exercise you should check the colour of your urine and weigh yourself. If your urine is dark to very dark, be sure to hydrate as follows at least four hours prior to exercise: 16-20 fluid oz (450 - 570 ml) water or carbohydrate (5-8%) sports drink. Then 10-15 minutes prior to exercise take on 8-12 fluid oz (230-340 ml) of water.

During exercise for under 60 minutes you should take 3-8 fluid oz (85-230 ml) water. For over 60 minutes exercise you should ingest a carbohydrate/electrolyte sports drink 3-8 fluid oz (85-230 ml) every 15-20 minutes. DO NOT CONSUME more than 1 lt per hour of fluids!

When you have completed your exercise, be sure to weigh yourself to determine how much fluids you should ingest within 2 hours. ACSM guidelines suggest 20- 24 fluid oz (570-680ml) for every pound lost.

Be careful not to overhydrate as this can lead to a potentially lethal condition so do not ingest more than 1 litre per hour of fluids. If you suspect you have over-hydrated contact your GP to begin tests.

I hope this helps to keep you hydrated this spring and summer.

If you have any questions about sports injuries and rehabilitation, please contact me at sara@prestigesportinjury.co.uk

The easy answer isn't always the answer

So a wee while ago I read a blog post by Adam Meakins the Sports Physio about the devolving of self-efficacy. Basically we're becoming a society  of people who cannot take care of themselves and healthcare professionals who complicate the process.

Adam is 100% correct. And I felt I needed to write a post expanding upon this with my view.

We are humans and as humans we want to do things in the easiest way possible. We're always looking for the easy answer, the fastest results and what requires the least amount of effort. In one way this makes us very innovative, but on the opposite side of the coin it makes us very lazy. 

When it comes to sports injuries and rehab it is important that the client is on board with their own rehab. If they don't buy into it or aren't ready to help themselves then the whole process is a mute point. Many sports injuries require us as sports therapists or physios to use the biopsychosocial model, which in short means looking at the biology, psychology and social factors of the client. This means it's not just prescribing exercises to help a client, but the client needs help to reduce their stress and ensure their social circle and lifestyle doesn't impede the process. All this equals a lot of work from the client.

Because we're creatures who want the easy answer, most people will see many different professions before realising that most of them are not actually helping. Most seek those who perform manual therapy, which is the most passive of treatments, and means the least amount of work from the individual. However, passive usually doesn't work. So they see a variety of people and then get to a point where they realise they're tired of "treatments" and want to get better. Until a person is ready to make a change efforts to help using exercise and stress relief techniques are futile.

Reliance on passive treatments makes us, well, passive in our own health. Adam points as professionals we need to make sure we're not part of the problem and reassure our clients and not confuse or frighten them. Sometimes a client doesn't need a steroid shot or surgery or even complicated exercises, often simple is best. Obviously, we need to be aware of any red flags when assessing clients, so in the absence of red flags we can proceed as needed.

I'm sure some of my clients have left thinking "Well, that doesn't seem like much." But, I choose the best exercise for what we're trying to accomplish, not the most complicated and cool looking exercises. This may only be 4-5 exercises, maybe less, but less can be more. If a client sees the rehab as a burden that's going to take too much time, they won't do any of the exercises. Short and simple can be the best remedy. I'm not in the business of performing treatments that aren't necessary or try and make something simple sound complicated just to get more work. My clinic is a  no BS zone!

So, if you've been "treated" by a variety of professions and still aren't any better it might be time to seek the help of a professional who won't complicate the problem. If you are suffering from chronic pain there are physios out there who specialise in using the biopsychosocial model to help you help yourself.

If you have any questions about sports injuries or rehab please email me at sara@prestigesportinjury.co.uk

Don't forget to get your Zzzzzz for recovery

As athletes we often here about the importance of sleep for recovery. But what is recovery, and why is it so important?

For me, I feel that sleep is the most important part of recovery, and probably the one that most people ignore. Becoming deprived of sleep leads to an increase of cortisol, the stress hormone. People under stress often have higher levels of cortisol than those not under stress. A lack of sleep also decreases glycogen and carbohydrates, leaving your muscles lacking the energy stores required for exercise. Less sleep also means a higher likelihood of fatigue, low energy and poor focus. Which means a higher likelihood of injury. Sleep deprivation also effects the brains ability to repair memory, consolidate memory and release hormones such as testosterone.

So, what does sleep do for us? Sleep restores brain function and alertness, good for hard training sessions. It enhances muscle recovery through protein synthesis and human growth hormone release, important for body builders. Sleep also repairs damaged tissues, this can take from 24-36 hours post session.

Good sleep and recovery means a reduction in injury rates. Muscles that are tired and sleep deprived cannot protect tendons, ligaments and bones from injuries as well as recovered muscles.

There are 5 stages of sleep 1-4 are non-REM sleep and 5 is REM sleep. Both types are important and necessary. These 5 stages run in cycles thorough out the sleep period, lasting about 90 minutes.

So, what can you do to help improve your sleep?

Have a night time ritual. This means turning off and removing your phone from your bedroom. The blue light from electronics tricks the brain into thinking it is daylight, so be shot of it. Get to bed before midnight, this is the better time to begin sleep rather than after. Make sure your room is dark and cool, blackout curtains are helpful to keep unwanted light out. Buy a high-quality mattress that is comfortable for you. Before going to sleep you can meditate or partake in positive self-talk.

Have a morning ritual. Get up the same time each day, even weekends! Get sunlight as soon as possible. Wake up and open your curtains.

What can affect sleep. Poor nutrition can affect sleep, avoid processed, fatty and spicy food. Avoid alcohol and watch your caffeine intake in the afternoon.

It can be helpful to track your sleep to help determine if high or low intensity work outs should take place. If you are feeling sluggish or tired, postpone your hard workout for a light one such as walking, hiking or cycling.

If you feel signs of fatigue, be sure to take the time off to recovery. Fatigue can manifest as tiredness, cold-like symptoms, lack of balance and the feeling of heavy feet.

So, remember, when you build a training plan, be sure to build in recovery and sleep. IF you’re not sure how to make a training plan there are many coaches online or personal trainers who can help take that burden off your shoulders.

If you have any questions about sports injuries and rehabilitation, please contact me at sara@prestigesportinjury.co.uk

Mo' mobility, less problems

We’ve all been told that mobility training is good for us, but do we know why?

To start off mobility itself is the ability to control a joint in full range of motion. It is a consistent effort to increase the amount of range of motion in a joint through specialised strength training.

The first reason it is important is if you use the full range of motion from a joint you can execute more power and efficiency in your exercise. This is good news if you’re trying to increase reps or weight during training. It is also good if you’re a rugby player, football player or any other sport that requires explosive powerful movements.

The second reason is injury prevention. If you’re not using a joint in full range, there is the likelihood that you’re compensating both other muscles and joints for the lack of mobility. For instance, lack of mobility in the ankle can lead to stress to the knee, hips and lumbar. Similarly, if you don’t have full range of motion in the shoulder and your humerus is not in the optimal position in the glenoid labrum you can put your rotator cuff muscle at risk of injury.

Finally, mobility is a good way to warm up the joint prior to exercise or events. Warming up the joint is created by movement and the shifting and warming of synovial fluid in the joint. This also works out any restrictions from tight muscles from affecting your event.

The great news is that you don’t need that much time for mobility, 10-15 minutes a day is enough to start reaping its benefits. When you start doing it you may also notice where your weaknesses are in each joint and can make specific changes to your strength training routine to remedy it.

A good way to get started is to choose some full mobility exercises such as: overhead squats (with a lightweight pole or bar), a prayer stretch on a bench and knee-to-elbow bird dogs. There are examples of these on you tube from a variety of practitioners.

If you have any questions about strength, mobility and sports injuries please email me at sara@prestigesportinjry.co.uk

Is whole body cryotherapy worth the hype?

Short answer, Not really. I’ll explain further.

Cryotherapy is a method of recovery which is done by lowering the skin temperature of the body. Some of the most common modalities are ice packs, ice massages, gels and cooling creams. Recently whole-body cryotherapy (WBC) chambers have been introduced to high level foot ball and rugby teams. But is this new, and costly, method really the best way to enhance recovery through cryotherapy?

I hit the research hard. One of the first studies I found from Hausswirth, el al (2011) claims the benefits of WBC on highly trained runners. One large flaw in this study is that the other modalities involved were far-infrared (not a highly reliable modality) and basically sitting in a chair for ten minutes. These two “sham” modalities would, of course, show that WBC is a reliable way to recover after running.  It’s studies like this that make me angry. They manipulate the data by introducing two modalities they know won’t work to “prove” that WBC is reliable.

Other research I won’t even mention here were studies paid for and sponsored by companies that make WBC chambers. I don’t give research like this the time of day. Many involve manipulated data to sell a product to teams that can afford it.

A more recent study by Viera, et al (2015) studied the effect of WBC on a vertical jump after high intensity training by placing participants in a chamber at the suggested -110 degrees for 3 minutes and a control temperature of 21 degrees for the same time. In this study there was no significant difference between the WBC and control group. Thus, suggesting that some of the “benefits” of WBC are possibly due to the placebo effect. 

One of the better studies from Holmes & Willoughby (2016) looked at previous studies and compared WBC to cold water immersion on recovery and skin temperature. One of the claims of WBC is that the extremely cold temperature is more effective at lowering the skin temperature than other modalities. In this study participants used a WBC chamber at -110 to -120 degrees for 2-4 minutes and cold-water immersion at 8-14 degrees for 5-10 minutes. The results showed that using cold water immersion lowers the skin, muscle and core temperature more effectively than WBC. The study suggests that further high-level studies on WBC be performed to confirm their claims.

My personal opinion is that WBC is very expensive and some of the membership rates are well over £100 a month. Most people would not use the WBC more than once or twice a week, making it a very expensive means of recovery. Plus, it means coming home from your run or workout, getting in the car, driving to a centre, going in a chamber for 3 whole minutes then driving back home. A lot of effort when you can simply fill your tub with cool water once you get home and sit and chill in it. Studies are not conclusive of its claims, and with that kind of cost, you may be better off buying a gym membership or hiring a personal trainer.

However,  saying that, its definitely worth trying. I will admit though getting a snapshot of yourself in the mittens, slippers and headband in a chamber is pretty cool, but unless it works for you, it’s just a lot of money for cold air.

If you have any questions about sports therapy, sports injuries and cryotherapy please feel free to email me sara@prestigesportinjury.co.uk

Don't let Resolutions get you down

I’m not the biggest fan of New Year’s Resolutions. Most people make themselves ridiculous goals that they have no chance of keeping like never eating chocolate or to stop drinking alcohol entirely. It’s all too easy to get caught up in the Resolution Mayhem and not actually sit and think about what goals you would like to achieve in the next year.

I like to break my goals down into sections: professional, personal and running. Obviously, my professional goals include things I want to learn in the upcoming year, clinic ideas and marketing of the clinic. Personal goals include things I want to learn independently, books I want to read and travel goals. The running goals I keep separate as I see them as different challenges. It may be a desired distance, race or number of races I want to complete in the next year.

Breaking your goals down into sections is a good way to start without overwhelming yourself. Also, write them down or put them in a spread sheet, this is a good way to chart what you need to do to meet your goals. For instance, I try to read a specific number of journal articles in a year for my professional goals. So, I keep a list in my spreadsheet of which one I read and what knowledge I obtained from it. I also like to list my book list for personal goals and check them off once read, truthfully, I do the same with my race list for running.

Once you’ve sectioned off your goals, you can break them down further. For instance, if your goal is to lose weight first, decide how much you may need to lose (you should see your GP for an idea of your ideal weight, don’t just guess it as it may be too low). Once you know what you need to lose break it down by week or month. Then make your exercise plan, a personal trainer will be able to help you with this part as it is often difficult to decide what exercises to do when. Plus, we often choose not to put the things we really don’t like on the list. Once you have your exercise plan, think about your diet. What can you eat less of? What should you eat more of? If you’re a chocoholic like myself, it is hard to give it up, however, you can decide to eat less of it or eat dark chocolate in small doses. If you’re not sure of what you need to eat find a good nutritionist either in person or online and they can help you plan and determine what you need to eat based on your activity level and goals.

By putting your small goals into a checklist of the bigger goal you can see your results much easier. This may be in the form of a spreadsheet or an app on your phone. Either way it is important to track your progress and don’t be disheartened if you have a bad week occasionally, just get yourself back on track as soon as you can. This is especially important for anyone who has had a sports injury, nothing is worse than the setback, however if you get appropriate rehab and advice you can be back in a healthier state.

So, if you have already set your goals or if you’re not sure just remember to break them down and track them. If you have any questions about sports injuries or rehabilitation, please email me: sara@prestigesportinjury.co.uk

Who do I see, a graduate Sports Therapist or a Sports Massage Therapist?

Often as a graduate sports therapist I get mistaken for being a Sports Massage Therapist. It’s a tad frustrating as having completed a three-year BSc it’s safe to say I’ve had a significant more amount of educational and in-clinic training than a Sports Massage Therapist/Soft Tissue Therapist.

So, what’s the difference?

Sports Massage Therapist/Soft Tissue Therapist:

A Sports Massage/Soft Tissue Therapists will have the scientific knowledge of and manual therapy skills to address specific of soft tissue injuries, their function, and the result of manual therapy on injured and uninjured tissues. They will have experience in anatomy, principles of health & fitness, principles of soft tissue dysfunction, sports massage treatment

Sports Massage is a Level 3 course focusing on injury prevention and performance enhancement through manipulation of the muscles, ligaments and fascia (debatable – will blog about next year).

Most high-quality Sports massage courses will be ITEC/BTEC/VTEC Level. Many Sport Massage/Soft Tissue Therapists are registered with the Sports Massage Association of as part of the Complimentary and Natural Healthcare Council. However, there are other bodies they can be members of, and there is no statutory requirement.

It is also important for the therapist to have attended a course approved by a professional body above, as there are many "fast track" courses out there which are not always providing quality courses.

Here is a brief summary of ITEC/BTEC/VTEC Levels:

3: Sports Massage Therapist - qualified to work on non-injured tissue.
4: Sports Massage Therapist - qualified to work on injured tissue
5: Sports Therapist/Massage Therapist - qualified to work on injured tissue, recognise sports injuries and prescribe rehabilitation exercises
6: Sports Therapist (can be diploma or graduate) - qualified to do all the above and diagnose soft tissue injuries using clinical reasoning.

Graduate Sports Therapist:

First, the title of sports therapist is not a protected title, so you’ll find most of us who are graduates us the term “graduate sports therapist” or put our degree qualifications on all our paperwork.

I’m not going to get into the nitty gritty of who is better a  diploma or a graduate sports therapist as it depends on the practitioner not the qualification.

Diploma level 5 sports therapists often do courses on the weekend with coursework and exams during the course process and graduates spend 3 years developing the required skills while being assessed throughout.

A graduate Sports Therapist will have an undergraduate diploma and would have completed a course verified by one of the sports therapist professional bodies: Sports Therapy Association, Society of Sports Therapists or the Sports Therapist Organisation. There is no statutory requirement for regulation, but it’s best to find someone who is registered with one of these professional bodies to ensure they are practising at the correct level and attending CPD courses.

Graduate Sport Therapists focus on the assessment, diagnosis and rehabilitation of soft tissue injuries. While courses may vary, a graduate Sport Therapist will have courses in anatomy, ethics, biomechanics & gait assessment, fitness testing, injury prevention, sports massage, clinical assessment and decision making, advanced manual therapy, sports nutrition and first aid/sports trauma skills.

Both professions are helpful for people who participate in sport and need to have appropriate insurance for their profession. Both can provide sports massage for recovery, but only Level 6/Graduate Sport Therapists can assess and diagnose injuries using clinical reasoning, and Level 5's can recognise sports injuries and prescribe appropriate rehabilitation exercises. This becomes very important if you have an injury as Level 3 Sports Massage/Soft Tissue Therapists should not be working with injured tissue, diagnosing injuries or prescribing exercises.

Sadly, many CPD providers are teaching techniques which are beyond the remit of lower level qualifications. This can cause problems for the therapist as they will likely not be insured for those techniques, and therefore, should not be using them in their practice or advertising them on their website.

It is important to know the qualifications of your therapist, if you're not sure just ask them. They are not always noted on their website and some therapists may be advertising abilities beyond their qualification level. If you're looking for a non-injury related sports massage a Level 3 will be suitable, however if you are having pain or are injured you should book in with a Graduate/Level 6 Sports Therapist for an assessment and rehab program. 

If you have any questions about sports massage and sports therapy, please do not hesitate to email me: sara@prestigesportinjury.co.uk

Exercise is the cure for what ails you!

We all want to live forever, right? Well, sadly while that’s not possible, we can live longer, happier and more productive lives through the magic of exercise.

Yes, I said exercise. There have been many news articles recently telling of all the advantages of a healthy, active lifestyle. Many of us sit at work, and then sit at home living almost sedentary lives. This lack of exercise is giving rise to obesity, type 2 diabetes and heart disease, as well as increases in dementia and mental health problems.

So, why is it that exercise is so good for us?

Over 30% of children in the UK are overweight or obese, so it’s important to make time for exercise in your child’s day. Exercise in children stimulates bone, muscle, joint, heart and lung development. Exercise also helps children maintain their weight, allows them to develop friendships with other children and reduce the chances of anxiety and depression.

For adult’s exercise improves cardiovascular health and lowers bad cholesterol which in turn reduces the likelihood of stroke and heart disease. This is best achieved with at least 15 minutes per day of walking at a brisk pace or any other activity that can be done at a brisk rate like cycling, rowing or running.

Muscle and bone health is also improved with exercise. By using resistance (strength) training you improve the function of muscles and allow the bones to remain strong and healthy. This will lead to fewer fractures, injuries and falls later in life. If specific exercises are used strength training can also reduce low back pain.

If you already suffer from osteoarthritis, it is important to continue to exercise to keep the joints moving and strong. This can be done through walking, swimming or cycling to reduce pain.

The C word, cancer. If you exercise regularly you are less likely to develop cancer. This is due to the advantages that exercise has on weight management. Maintaining a healthy body weight reduces the likelihood of bowel and breast cancer as obesity is a major risk of developing cancer.

Diabetes effects 3.2 million people in the UK, by reduce weight through exercise you can reduce the likelihood of developing type 2 diabetes. Regular exercise can also keep blood glucose levels within ideal range and lower blood pressure.

Improvements in mental health. Regular activity can reduce your chances of developing depression and help reduce its symptoms in those already diagnoses. This is due to the chemicals in the brain, dopamine and serotonin, which are affected positively by exercise. This improves your mood and thinking. A good place to start is with an outdoor running group, parkrun or just taking brisk walks with friends. People diagnosed with mental health conditions are also at a greater risk for respiratory and heart disease, so exercise will help reduce the likelihood of both.

The greatest benefit of exercise is weight management. Being overweight predisposes you to a variety of diseases. IT’s important to also eat a well-balanced diet and allow yourself to recover after exercise.

How do we know how much exercise to do?

According to the NHS and Public Health England the aim is to be active every day for at least 150 minutes per week of activity. This means moderate activity of at least 10 minutes or more such as brisk walking, cycling, running or swimming. Public Health England also advised of at least 2 or more days of strength training of the legs, hips, abs, chest, shoulders and arms. The addition of balance training can also help reduce the likelihood of falls in older age.

So now you know the whys and the how’s there is no excuse to get off your laptop or smartphone and go out in the outdoors and exercise.

If you would like to know more about how exercise can help you and what you can specifically do for your sport please contact me sara@prestigesportinjury.co.uk

Before you up that mileage, you need to get stronger!

Everyone knows that resistance training is good for running, right? Then why is it that so many runners choose not to incorporate strength (resistance) training into their program? Part of the answer may lie in the fact that many runners do not know the benefits of strength training can add to their running. Running itself is not enough, using weights can help reduce the effects of muscle loss as we age (8% every decade after 40 years of age).

So, what can strength training do for runners? First off it reduces overuse injuries by strengthening the tendons, ligaments, muscles and fascia. Next it can help stabilise the joints through increase muscle strength. Finally, it can help tissue capacity which leads to a higher tolerance to load, speed, range and endurance changes. But it is not just the muscular system that benefits, strength training also improves bone health, inflammation and anxiety. All these changes lead to a better performance and running economy – good right!

So, what is resistance training, well in the short it is exercise that requires the muscles to hold against and applied force or weight. It can be done is many ways such as dumbbells, resistance bands, kettlebells, power bags, medicine balls or even body weight. As a sports therapist, I often incorporate resistance training into my rehabilitation programs for those with overuse musculoskeletal conditions.

But general resistance training is not what runners need. Runners benefit from single-leg loading, posterior chain strength, hip stabilisation and core strengthening exercises.

Single-leg loading exercises such as Bulgarian splits, step ups and lunges help reproduce the conditions of running. It is basically a sport-specific exercise that will help the body adapt to the requirements of running.

Posterior chain (lats, erector spinae, glutes, hamstrings and calves) strengthening helps with shock absorption, propulsion and power. Weakness in the posterior chain can affect running mechanics and lower limb kinematics. Ineffective body form may cause excessive body movement leading to hip and knee injuries.

Hip strengthening, including quadricep strengthening, has been known to reduce patellofemoral pain and prevent overuse knee injuries. Hip stabilisation is beneficial for low back, sacroiliac, hip, knee and ankle pain as well as improve performance.

Core strength (not just your abs!!!) helps improve performance through better movement. NO single muscle helps with spine stabilisation it is the combination of all muscles during specific movements.

There have been many myths about resistance training and running and it is important to realise that you will not get bigger, injures, slower or tighter through strengthening. You will only get healthier and perform better.

If you are interested in starting a strength program it is important to seek the advice of a graduate sports therapist, sports physio or knowledgeable personal trainer to assess your function first and determine which exercises will be best for you. They will also ensure you start at the appropriate level and progress appropriately and safely.

TO summarise, resistance (strength) training is a good thing for runners that should not be avoided, especially as you move into longer distance running (half marathon and above).

If you have any questions about resistance training, please feel free to contact me sara@prestigesportinjury.co.uk

Are the "Jack of all trades" all they're made out to be?

So what's better someone who is a "jack of all trades" or a specialist?

I began asking myself this question as I pondered over the variety of CPD courses I could take over the next year. Do I expand my portfolio into coaching or perhaps a personal training qualification? There are many options for sports therapists and other therapists out there to choose from. But what is best?

My dad used to say he could fix anything except the crack of dawn and a broken heart. And I reckon he could, except for a vacuum cleaner once. He was a skilled mechanic and, even though he had no degree, an excellent engineer. He used his decades of experience to fix cars, planes and pretty much anything with an engine. He had skills that could translate to other areas without changing his occupation. And for me his advice led me to the decision to expand my sports therapist skill set rather than take on a new skill.

I have a tiny aversion to people who try to do everything all the time. I think it's great that they're ambitious, but to me it just means that some skills may be lacking or not fully developed. For example, if you train to do osteopathic techniques, hypnotherapy and personal training is it possible to stay highly skilled in all those areas without letting one slip? We are all allotted the same 24 hours in a day, but I can't imagine anyone is using all their skills all the time or even giving each skill the same amount of work.

Some skills work well together such as sports massage, acupuncture, mobilisations/manipulations, strength & conditioning and rehabilitation exercises. Those are skills that can be used in a variety of settings and can be honed, in some cases, at the same time. But other skills would require a different setting or in some cases could cause a conflict of interest.

I once came across a rugby club whose coach was also their physio. To me this is a blatant conflict of interest as he had no way to separate his desire for his players to play and his need to think of their health and welfare. There were many players that should not have been playing that day, but still did even after suffering concussions. I feel the same way about personal trainers who also do sports massage or sports therapy, and continue to be a personal trainer. Is it not feasible that one could make their clients work out harder than prescribed so they're sore and then suggest they see them for a sports massage? I'm not saying these things happen, but these are the things I think about when deciding my own CPD pathway. Could my clients perceive a conflict of interest in what I do?

For me the welfare of my clients is the most important part of my clinic. This means providing them with quality, knowledgeable information with regards to sports injuries and ways to treat their injuries. So this is where I will focus my future CPD endeavours.

I have already attended a Movement Screening & Strength Training for Runners course in order to provide my running clients with better analysis and techniques for their rehabilitation. And the best part about this course is that the instructors (both physios) had specialisms. One is a hip/running specialist and the other is a strength & conditioning specialist.

I am also a firm believer in the referral. If a client comes in and I feel acupuncture might help or perhaps they would like advise on a personal trainer I am happy to refer to other professions. I think it's important to collaborate with other sport injury professionals so that we can all provide the best care with the best techniques for our clients. If an injury is out of my skill set I have a responsibility to refer onwards.

So, why be a "jack of all trades, master of none" when you can be the best sports therapist, osteopath, chiropractor, physiotherapist, sports massage therapist or personal trainer that you can be for your clients!

If you have any questions on CPD, sports therapy or conflict of interests  please feel free to email me on sara@prestigesportinjury.co.uk

Can sports injuries really be prevented?

As a sports therapist reducing the likelihood of an injury is just as important as injury diagnosis and rehabilitation. As stated above, no injury is 100% preventable there are guidelines that we can follow to attempt to reduce the likelihood of an injury occurring in any given sport.

The first rule is to know your sport. This seems like a no brainer, but it is important to understand the biomechanical, external and internal factors that exist within any given sport. For instance, I work with a local rugby team so a variety of players will be sprinting, tackling, scrummaging and rucking on an outdoor surface in a variety of weather conditions.

When identifying risk factors, we must first look at the athlete(s) internal risk factors such as age, gender, body composition and fitness level. In my sport the risk factors associated with a forward will be very different when compared with a back. There are modifiable (body composition, fitness level) and non-modifiable (age, gender) risk factors. When targeting any intervention, we need to look at both factors. Modifiable risk factors such as fitness level can be improved, and thus keep the player from sustaining injuries due to exhaustion. Non-modifiable risk factors such as age, cannot be changed, however, we can use methods to help reduce the risk of injury (see later below).

The next risk factors to identify are external risk factors such as playing outdoors or on a court. If participating in sport out on a pitch when it’s been very dry can be very different then when it is very wet. Knowing how to adjust your interventions will help keep your players safe. In my experience I’ve had players sprain their ankles on hard ground more than soft. And the likelihood of injury when tackling or jumping is increased.

The final piece is knowing the mechanism of injury (MOI). This is learned through experience and research. For a sports therapist it is often the MOI that is the key to what the injury likely is. As before with ankle sprains the key note is a plyer will tell me “I rolled over on my ankle”. I then perform the normal ankle joint, muscle, ligament and special tests to confirm my diagnosis. But this is also useful with overuse injuries. For instance, an athlete might tell you “The pain has become worse over time” or they’ll not no actual injury incident occurred.

As a sports therapist involved with team sports we need to map all the risk factors and MOI’s and use a variety of techniques to reduce the likelihood of injury, which may include the following:

Warm up: A simple warm up plan may reduce risk to injury by 50%. And while there is little research on the duration or intensity of a warm up it is best to allow the players to determine it individually. Some benefits of a warm up include increase ROM of joints, relaxation and concentration and speed of nerve impulses and a decrease of muscle stiffness. All those factors that can potentially reduce the risk of injury, especially in older players. A very good example of this is the FIFA 11+ program which uses a structured warm up of 10 exercises 1-2 times per week and has been proven to reduce injuries in football.

Taping/Bracing: In rugby we use tape frequently. It is often used to restrict undesired movement such as inversion of an ankle or to protect the acromial clavicular joint from injury during tackles. This often applies to players returning from an injury after a thorough rehabilitation program.

Protective equipment: This includes helmets for cycling or horse-riding and mouth guards for collision sports, common sense really!

Suitable equipment: It is imperative that your athletes are wearing appropriate equipment, even for running. A trail runner will not be wearing the same trainers as a road runner or sprinter. It also includes ensuring racquets for tennis or squash are of the right grip size otherwise an athlete may over grip the racquet and incur an overuse injury.

Recovery: This is the biggest issue I see in my clients. It is important to allow your muscles to recovery after any strenuous activity. The can include using active recovery and walking for ten minutes after a hard run, using cold water immersion, massage and eating properly after exercise.

When starting a new training program, it is advised to get appropriate advice from your GP first, then a professional such as a sports therapist or personal trainer for exercise guidance. Graduate sports therapists can perform an injury prevention screening which uses functional tests to measure any biomechanical dysfunction and if any adjustments are required, will issue you exercises, stretching or other methods to help improve any dysfunction. After a screening it would be advisable to see a personal trainer to introduce you to exercises at the proper level of your fitness.

Sports therapists can also perform sports massage which is an excellent way to recover after hard training sessions.

If you have any questions about injury prevention or other services that sports therapist can provide, please do not hesitate to contact me.

Sara Green, Sports therapist, BSc (Hons)

sara@prestigesportinjury.co.uk

www.prestigesportinjury.co.uk