Lindsey Vonn is out of the Olympics... Theo Walcott ruled out of the World Cup.  Both ruled out because of Anterior Cruciate Ligament injuries. But what exactly is this ACL and why is it so important?     The ACL is one of the four main ligaments of the knee that help to keep the joint stable. It runs from the front of the shinbone and heads up and backwards to attach to the back of the thighbone. As with all ligaments it 's role is to provide stability between bones and resist external forces to prevent the knee from collapsing. In reality the ligaments don't do all of the work, strong and accurate muscle control aids to keep the knee aligned, but the role of the ACL cannot be underestimated. This can be demonstrated by the fact that in most cases it will be surgically reconstructed, it 's that important! Unfortunately without the ligament the knee is considered unstable, and the joint is at risk of developing secondary arthritic changes. An ACL injury can occur in several different ways, most [...]

Growth spurts in young athletes can lead to an increased incidence of injury. The long bones (femur, tib/fib) grow in length before the muscles elongate and develop enough strength to counteract the sudden increase in lever lengths. Imagine a young soccer/gaelic player who suddenly has a longer leg but not the muscles to generate the force required to move that heavier and now longer leg. Something will break down, usually the proximal muscles, such as the abdominals and groin. We Chartered physios tend to work on the understanding that the bones grow about a year before the muscles develop length and strength. And this forms the basis of injuries sustained by growing young bodies. If the bones grow longer but the muscles remain the same length, then the muscle will have a relative tightness. The structure most susceptible to overload in this situation is where the muscle, via the attaching tendons, joins the bones. At these sites, we have growth plates. The injuries we see in young athletes that are growth related and influence the growth plates are called ‘traction apophysitis’ [...]

This is an example of a client who contacted us wanting to improve her 5 and 10k times. We evaluated her running pattern and jump landing from a 12inch platform. Her running kinematics were quite good however inactivation of her gluteals in stance phase of running were made very apparent when evaluating jump landing. On jump landing the shift in midline and pelvic drop our quite apparent. We gave her a programme to engage her gluteals and develop endurance in these muscles. This will help keep centre of mass high to help her stride length and make her more efficient. Increase stride length and stride frequency = improve race time! Simple!

Cycling has grown in popularity in the last 4-5 years. Unfortunately some people fail to get their new bike set up for them from the start.  Poor positioning on the bike can lead to injury and a decrease in performance.  Also it is very important to remember that are bodies are subject to change. So the initial bike set up may not very well suit you in 6-12 months. If you are cycling to work and back or doing sportif events across the country, you should be comfortable on your bike. If you have neck, back, or knee pain, saddle sores, or hand or foot numbness, your bicycle probably doesn't fit you properly. Good bike fit can also improve your pedaling efficiency and aerodynamics and actually make you faster. Here are the basic bike-fitting principles: Adjusting the Saddle Your bike seat should be level to support your full body weight and allow you to move around on the seat when necessary. Too much upward tilt can result in pressure points. Too much downward tilt can make you slide forward while riding and put extra [...]

What does using a foam roller actually do? Muscles are surrounded by a soft tissue known as fascia. It is thought that this tissue can influence flexibility and joint range of movement. Research suggests that using a foam roller is a form of “Self Myofascial Release” and that it makes the fascia more flexible and breaks down scar tissue and adhesions. Which one should I buy? McDonald et al used a roller with a hollow but solid PVC core surrounded by a layer of neoprene foam and had very positive results. Miller and Rockey (2006) used the more traditional roller composed entirely of foam and found rolling made no significant difference to hamstring flexibility. Curran, Fiore and Crisco (2008) compared these 2 types, the Multilevel Rigid Roller and Bio-Foam Roller and found “significantly higher pressure and isolated contact area” with the Multilevel Rigid Roller. In short, it appears the hollow but solid core design is more effective than the traditional foam roller as it appears to place higher pressure on the fascia. It can be expensive though How long should [...]

Sprains, strains, and other soft tissue injuries can set back your training schedule.  For years the standard protocol was R.I.C.E.and many injuries have been nursed to full recovery with this plan.  But new studies and discoveries may suggest that, although R.I.C.E. is effective, there are other faster, more effectiveways to treat soft tissue injuries.  A recent study published in the British Journal of Sports Medicine has many health and fitness professionals replacing R.I.C.E with P.O.L.I.C.E. R.I.C.E. (rest, ice, compression, elevation) was the old protocol for soft tissue injury.    P.O.L.I.C.E. (protection, optimal loading, ice, compression,elevation) is the new protocol many professionals recommend.  The last three steps in each are the same: ice,compression, and elevation.  Controlled,clinical research on all three lack sufficient support to say scientifically why  these methods work.  Studies on ice regarding its analgesic effect and effectiveness in inflammation control are new despite the implementation for a long time.  Compression and elevation also lack scientific support.  But, if the methods work then eventually science will upturn the stone that explains why.    Rest makes sense to some degree.  If an [...]

The old wives tale of "bed rest" as being an approach of many individuals for a long number of years who suffer with back pain.  Thankfully, with improving scientific research and evidence of the effectiveness of exercise in the treatment and management of low back pain, this approach is changing. Back pain management is increasingly based around encouraging activity and restoring normal function.  Unfortunately, years and years of a message that you should go to bed and rest if you have a pain in your back is not easy to undo and so a disparity between current best medical practice and patient’s actual behaviour exists.  Low Back Pain: Is uncommon in people aged under 35 years Peaks between the ages of 35-50 years Effects Men and Woman equally Commonly affects individuals with sedentary jobs Often flares up following a period of relative inactivity Usually lasts between 2-6 weeks In the vast majority of cases of low back gentle aerobic exercise such as walking, jogging or swimming will not further harm the condition and will in fact aid its recovery.  If [...]

A balanced exercise plan for men is to incorporate the 4 main types of exercise: 1. 'Heart healthy' or cardiovascular exercise works for at least 30 mins a day or 150 minutes in total each week. So try walking, jogging, cycling, hiking, swimming, sports and recreational activities that are fun and you enjoy. Exercise can be done in short bursts throughout the day- so try 10 minute bursts x3 throughout the day. Vigorous exercise also counts- so try an aim for 75 minutes of vigourous effort activity spread across the week as an alternative- enjoy playing football, badminton, spin or road cycling. 2. Strength exercises- try a variety of upper and lower body exercises twice a week. It helps to keep your bones and muscles strong and healthy. 3. Flexibility or stretch exercises- try at least twice a week to help promote bone and muscle health. Enjoy trying a yoga, Pilates, or martial art sesion to help you relax and de stress also. 4. Balance exercises- try at least twice a week. These are the Cinderella of forgotten exercises but [...]