Specialising in musculoskeletal, orthopaedic, spinal and sports rehabilitation

New Year, New You

The 5 most common Gym mistakes in January

It’s January and the new year brings about the reflection of new year’s resolutions.
This will no doubt involve some sort of new fitness regime
We all know the benefits of regular exercise, but what are the 5 most common mistakes that new comers and those returning to the gym make?

  1. The correct dose of exercise – The Goldilocks principle
  2. Consistency is key – You can’t get fit in one workout
  3. Dynamic Warm up – Save static stretching until the end
  4. Train Movements NOT Muscles – Train the brain
  5. Having a plan to your training – Let your plan be your guide

The correct dose of exercise – The Goldilocks principle

Exercise Prescribers here at Marylebone Physiotherapy, we are experts at getting the dosage of exercise correct for each client. Not too easy as to be ineffective and not too hard as to not be able to walk the next day. Not too cold, not too hot, but just right, is also known as the Goldilocks principle. Exercise can be defined as physical movement that is:

Repeated,

Planned,

Purposeful and

Structured.

We can use the acronym RePPS to help us remember this

Repeating a movement is the very definition of exercise. You learn to master a particular movement, then you load it up with heavier weights or speed up the movement. You can also perform the movement under fatigue.

Planning your exercise is covered later on in this Blog.

Purposeful relates to your specific fitness goals. Remember that weight loss is a side effect of fitness training and not the desired goal.

Structured refers to the way your training session is broken down into its component parts

Below is an example of a typical gym session:

Dynamic Warm up
Strength
Metabolic conditioning
Cool Down
Stretch
Use the RePPS principle for your next session.

Consistency is key – You can’t get fit in one workout

“You can’t drink the Ocean in one gulp!”

It is the same with exercise, you can’t get fit in one workout, just like you can’t live your life in one day.

The first six weeks of training you are unlikely to see any results. However, you are likely to feel better and have more energy. The best things come to those who wait, but in a society that wants instant gratification the wait can be frustrating.

Around 8 weeks the physical transformation becomes visible. We tend to lose body fat and gain lean muscle. Look forward to 12 weeks and things are looking even better

However, you will eventually plateau with your fitness gains and this is where you need to maintain it. Make time for exercise and be consistent.

Dynamic Warm up – save static stretching to the end

If you have not trained since your School, College or University days then things have changed. Wear warm layers and slowly strip them off as your body warms naturally with the heat generated from the movement.

We tend to favour a dynamic warm up in preference to static stretching. We can save that until the end of the workout. Because performing static stretches slows down your heart rate, lowers injury risk and helps reduce DOMS (Delayed Onset Muscle Soreness) we tend to leave it for after the workout. The other reason for this relates to studies where over stretching muscles in the warm up loses the protective effect of the tendon reflex that is designed to stop over stretching.

Dynamic as the name suggests means we are moving through a movement rather than holding a static posture. This could look like Squats and lunges or Press ups and toe touches. Starting with partial movements and building into full range, listening to the body and not pushing into pain or restriction.

Movement sequences that open the hips and rotate the body and examples of dynamic stretching.

Train Movements NOT Muscles – Train the Brain

Unless you are body building or focusing on particular muscles, then we at Marylebone Physiotherapy would encourage you to train movements not muscles. That’s why we have our own Movement Specialist, Katia.

Movement is a skill, and as such it needs to be practiced and challenged in order to not just make it better, but optimise the movement. The brain knows nothing of individual muscles, it knows only movement.

There are seven level 1 functional movements that you should be familiar with, these are:
Push
Pull
Twist
Hinge or bend
Squat
Lunge
Walking (Gait)

These seven movements form the basis of all functional movements the body has to perform.

Examples of Level 2 functional movements are running jumping and throwing.

Level 3 functional movements are the highest level and these require proficiency at levels 1 and 2 before attempting. Level 3 includes multi-directional movements or combinations of movements linked together.

An example of this is a Burpee.
This is a hip hinge into a press up, back into standing and then performing a jump at the top of the movement. The Burpee is normally completed at speed to add to the challenge of the movement.

Having a plan to your training – Let your plan be your guide

How do you get there if you don’t know where you’re going?

The answer is to have a plan. This will be based on your Fitness goals.

Are you doing a Couch to 5 km or Running a Marathon? Are you starting your first Boot-camp or competing at CrossFit?

Most Gym goers start with a “Push, Pull, Legs” Plan of three times a week

You could train one of the functional movements every day of the week. Or you could break the functional movements up into training each once during the week.

An example might be:

Monday – Push, Twist

Tuesday – Walk

Wednesday – Pull, Lunge

Thursday – Walk

Friday – Hinge, Squat

So, there you have it. The five most common Gym mistakes and how to avoid them happening to you.

Now it’s your turn to implement this new knowledge and have an injury free return to training.

This is your year to get fit, stay injury free and enjoy being healthy.

 

Pilates, a Lifestyle Change

Pilates is an exercise method that aims to strengthen the body with an emphasis on the core and control.

It is almost unique in its suitability for all ages and abilities and research has demonstrated its positive impact on patients with non specific chronic low back pain, for which numerous treatments have been unsuccessful.

In our clinic at Marylebone we offer Pilates lead by qualified instructors and physiotherapists who are able to tailor an exercise programme to any individual need. For our beginners or those aiming for a more personalised experience we offer one to one sessions, where the therapist is able to listen to any concerns and make sure that every exercise is completed optimally.

Pilates was initially a mat based exercise programme and I spent time teaching this technique in NHS hospitals to those suffering from MSk conditions as well as post surgically and pre/post natal. Here at Marylebone we teach traditional mat based Pilates but also use the more modern reformers. Whilst daunting to look at, the reformers can provide a more challenging workout whilst focusing on those principals of core control central to the Pilates technique.

If you are unsure whether Pilates is right for you, then you can always come along and try one of our free 30 min taster sessions with a qualified therapist. The team and I have worked with a range of conditions and have seen people progress from acute pain to enjoying physical activity again; we would love to hear from you and hope to see you here at Marylebone soon!

by Ashleigh Ellis CSP HSPC

BSc (Hons) Physiotherapy

Upcoming TrailMed Event in Velodrome

TrailMed are bringing their Health and Performance Laboratory to London! And there is no better place for it as in our East London Physiotherapy and Sport Medicine clinic in the Lee Valley Velopark.

CardioPulmonary Exercise Testing

Dr Patrick Musto will be conducting Cardio Pulmonary Exercise Testing on Saturday the 23rd February 2019 at the Velodrome.

CPET is a test accurately measuring the funcion of your heart and lungs in response to exercise. The results of the test will give you more information about your health and exercise capacity and allow you to plan your training programs knowing your thresholds.

If that sounds interesting do not hesitate to book yourself in while there are spaces still available! To book yourself in follow the link below.

Book Here

How is the test performed?

TrailMed will ask you to exercise on a bike while wearing a mask to set the protocol. The test will involve gradual increase in intensity of exercise to ensure your heart and lungs are stressed. Your breathing, blood pressure, and oxygen saturation will be recorded and monitored. The more you are able to do, the more information is gained from the test. The whole appointment will take up to an hour including explanations, consent, history, examination and testing. For further details visit TrailMed webpage.

If you are wondering what CPET and what benefits it brings but don't want to get tested yourself, Dr Musto will also be holding a CPET Talk and Demonstration on the same day. Express your interest by contacting TrailMed directly!

Rehab Matters, CSP Physiotherapy, Marylebone Physiotherapy, Health Consultants Inc, Acupuncture

Rehab Matters

The CSP is currently promoting a campaign ‘Rehab Matters’ which is aimed at improving access to rehabilitation services across the UK. This is an idea that is shared by Marylebone Physiotherapy & Sports Medicine and we thought we would share the CSP’s provoking film about two fictional characters who have very different experiences after leaving hospital as one receives physiotherapy and the other does not. Enjoy.

 

Tips for Surviving a Long Drive

We’ve all been there. Stuck in traffic and you’ve already been in the car for 2 hours. You start to feel that familiar discomfort forming in your lower back heading down your leg as you shift your weight in an attempt to relieve the feeling, or sit up straighter hoping you will last the next hour until you’re home.

It will come as no surprise that an epidemiological study looking at lower back pain in truck drivers found that over 50% of them reported lower back pain at one point over the duration of a month. Or, that the prevalence was significantly increased from both a ‘short resting time’ and ‘long driving time in the day’.  A larger study of taxi drivers also found that over 50% had reported LBP in the last 12 months and that long driving time plus frequent bending/twisting activities whilst driving, alongside stress also increased prevalence.

Unfortunately, like it or not, we can’t escape the world of long drives or travel – unless you fancy being a hermit for the rest of life – so we’ve come up with some simple tips that aim to keep you on the highway to a pain-free journey!

 

  1. Take the time before you set off to get comfortable. Research is limited on exact parameters as every person is different and what is comfortable for you may not be for someone else. Therefore, take the time to adjust what you can until you have the desired setup.

 

  1. Adjust your mirrors: generally, you should only have to move your eyes to look in your mirrors; this reduces the strain on your neck. Sit up straight when doing this, when you slouch you will no longer be able to see - it will act as a reminder to maintain good posture.

 

  1. Adjust your seat: you want to be sitting upright with only a slight recline (roughly 10-20 degrees). You may need to use a small lumbar support or a rolled-up towel to support the natural curve of your lower back. You may find a seat cushion useful to reduce the vibration and act as a shock absorber. Please see the links below for more information regarding driving ergonomics.

 

  1. Stop or move regularly. Now I know that we’re all desperate to get home after a long day but you may need to schedule in regular stops – and who doesn’t love a service station? Especially when there’s an M&S! If you really can’t (and you have the bladder of a horse) then try regularly rolling your shoulders, arching and curling your spine and using traffic stops to stretch your legs – just remember to put it in neutral!

 

  1. Get organised and think about taking either a cool or heat pack with you (whatever helps your pain).

 

  1. Cruise Control? Yes please! Use this where possible, not only does it make your driving experience easier but you can place your feet flat on the floor which is a better position for your spine. But don’t get too comfortable, you will have to brake at some point!

 

  1. Muscular effort in sitting has been shown to be greater than that of standing, so when you are out of the car ensure you are working hard with your physiotherapist to strengthen your back and core muscles and give yourself the best chance of preventing future pain that will ‘drive’ you crazy!

 

Miyamoto, M., Shirai, Y., Nakayama, Y., Gembun, Y. and Kaneda, K., 2000. An epidemiologic study of occupational low back pain in truck drivers. Journal of Nippon Medical School67(3), pp.186-190.

Chen, J.C., Chang, W.R., Chang, W. and Christiani, D., 2005. Occupational factors associated with low back pain in urban taxi drivers. Occupational Medicine55(7), pp.535-540.

http://drivingergonomics.lboro.ac.uk/health.html

Gkikas, N. ed., 2012. Automotive ergonomics: driver-vehicle interaction. CRC Press.

Kyung, G. and Nussbaum, M.A., 2009. Specifying comfortable driving postures for ergonomic design and evaluation of the driver workspace using digital human models. Ergonomics52(8), pp.939-953.

 

 

Ski Poles…friend or enemy?

There is a body of opinion that recommends not putting your hands in ski pole loops unless you are in fear of losing your poles, for example in deep powder snow, but this has always been a debate.

In the event of a fall, putting your hands inside ski pole loops greatly increases the risk of sustaining a Skier’s Thumb sprain. This common skiing injury is caused when the skier falls and lands on their hand or the ski pole, with the thumb in an extended position, spraining the Ulnar Collateral Ligament of the thumb. This is the ligament located in the web space in between the base of the thumb and the index finger.

This injury is also commonly seen in rugby players and goalkeepers. Immediately after injuring your UCL it is best to rest it for the first few days and apply ice for 15-20 minutes every 2-3 hours. It is wise to seek medical attention if the swelling and pain has failed to settle within the first week as this may be indicative of a more serious injury to the ligament like a partial or complete rupture, and you should rule out any associated fracture. Symptoms may include persistent pain and swelling and a sense of instability around the thumb during pinch activities. Wearing a thumb stabiliser if you have a previous history of this injury may be a good idea.

Happy skiing!

Marylebone Physiotherapist, Alexia Critien, Health Consultants Inc, London, Best Physiotherapist, Musculoskeletal treatment, Acupuncture, Massage, Clinical Pilates, Anti-gravity physiotherapy, Baker Street, Gloucester Place, BNP Paribas, Costa Coffee, Pret a Manger, The Dorset Cafe, Oxford Street, Marylebone train station,

Proprioception

Proprioception is the sense of knowing where your body part is in space, without having to look. This can be a difficult concept to grasp until you lose it, because so much proprioception occurs subconsciously. It is important in all everyday movements but especially so in complicated sporting movements, where precise coordination is essential.

Your proprioception capabilities can be impaired when joints are injured, such as with ligament sprains. When you lose proprioception of your joint after a sprain, you may experience an unstable sensation of the joint. The most common symptom of reduced proprioception is poor balance.

The Proprioceptive System is made up of receptor nerves that are positioned in the muscles, joints and ligaments around joints. The receptors can sense tension and stretch and pass this information to the brain where it is processed. The brain then responds by signalling to muscles to contract or relax in order to produce the desired movement. Following injury to joints and ligaments the receptors are also damaged, which means the information that is usually sent to the brain is impaired. This can leave the person prone to re-injury, or decrease their coordination during sport.

Proprioceptive and balance exercises teach your body to control the position of a deficient or an injured joint. A common example of a proprioceptive or balance exercise is the use of a wobble board after an ankle sprain. The unpredictable movements of the wobble board re-educates your body to quickly react to the wobbly movements without having to think about these movements. That is, your natural balance and proprioceptive reactions make the transition from a conscious to a subconscious state. A quality subconscious proprioception and balance system is important in everyday life and particularly in sport.