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Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Differential Diagnosis of Groin Pain: A Physiotherapist's Perspective

Mon, 27 Apr 2026 12:58:50 GMT

Groin pain is a common complaint we see a lot in clinical practice, particularly in sports medicine and physiotherapy. The differential diagnosis of groin pain is broad, encompassing a variety of musculoskeletal, neurological, and visceral conditions. This blog aims to provide an overview of the potential causes of groin pain that we might encounter, along with an outline of assessment and treatment strategies.

Common Causes of Groin Pain:

1. Muscle Strains

Muscle strains, particularly of the adductor muscles, are among the most frequent causes of groin pain. Athletes, especially in sports requiring rapid direction changes, are particularly susceptible. Symptoms typically include acute pain during activity and tenderness on palpation.

2. Hip Pathologies

Conditions such as femoroacetabular impingement (FAI) and hip labral tears can manifest as groin pain. Patients may report a deep, aching pain that exacerbates with hip flexion or internal rotation. Radiographic imaging is often required for definitive diagnosis (Kumar et al., 2020) .

3. Osteitis Pubis

Osteitis pubis is an inflammatory condition affecting the pubic symphysis, commonly seen in athletes. It presents with pain in the pubic region, which may radiate to the groin and inner thigh. It is often exacerbated by activities involving groin movements (Bahr et al., 2017) .

4. Hernias

Inguinal and femoral hernias can present with groin pain, often accompanied by a palpable mass. Symptoms may worsen with activities that increase intra-abdominal pressure, such as coughing or heavy lifting. Surgical intervention is usually required for definitive treatment (Gonzalez et al., 2018) .

5. Nerve Entrapments

Conditions such as meralgia paresthetica, resulting from compression of the lateral femoral cutaneous nerve, can cause groin pain along with numbness or tingling in the thigh. This is often related to tight clothing or obesity (Cameron & Swanson, 2019) .

6. Visceral Causes

Less commonly, groin pain may arise from visceral sources such as renal colic or gynaecological issues in females, including ovarian cysts or ectopic pregnancy. A thorough history and physical examination are essential to rule out these serious conditions (Lichtenstein et al., 2020) .

Assessment Strategies

A comprehensive assessment is crucial for establishing a correct diagnosis. Key components include:

History Taking: Understanding the onset, nature, and duration of pain, alongside any associated symptoms.
Physical Examination: This should include inspection, palpation, range of motion testing, and strength assessment of the hip and groin area.
Special Tests: Various orthopaedic tests may help identify specific conditions, such as the FABER test for hip pathology or the adductor squeeze test for adductor strains.
Imaging: When indicated, imaging techniques such as X-rays, MRI, or ultrasound can provide additional information about underlying structures (Cameron & Swanson, 2019) .

Treatment Approaches

The management of groin pain varies depending on the underlying cause:

Rest & Activity Modification: Initial treatment in the first few days, often involves relative rest and modification of activities to avoid exacerbating the condition.
Physiotherapy: Rehabilitation programs focusing on strengthening, flexibility, and neuromuscular control can help restore function and prevent recurrence (Bahr et al., 2017) .
Pain Management: Modalities such as ice, heat, hands-on treatment, or an injection may be employed to manage pain and inflammation.
Surgical Intervention: In cases of hernias or other structural abnormalities, surgical correction may be necessary (Gonzalez et al., 2018) .

Conclusion

Groin pain can stem from a wide array of conditions, and accurate diagnosis is vital for effective management. Physiotherapists play a crucial role in the assessment and rehabilitation of individuals with groin pain. By utilising a comprehensive approach that includes thorough history-taking, clinical examination, and targeted treatment strategies, physiotherapists can significantly improve patient outcomes.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

References

Bahr, R., Holme, I., & Lian, O. (2017). "The importance of a systematic approach to groin pain in athletes." *British Journal of Sports Medicine*, 51(5), 326-331.
Cameron, H. U., & Swanson, H. (2019). "Nerve entrapment syndromes." *Clinical Anatomy*, 32(5), 635-642.
Gonzalez, M. H., et al. (2018). "Hernias: a comprehensive review." *Surgery Today*, 48(7), 735-743.
Kumar, V., et al. (2020). "The role of imaging in the diagnosis of hip-related groin pain." *Radiology*, 294(1), 65-74.
Lichtenstein, I. et al. (2020). "Visceral pain: a clinical challenge." *American Journal of Gastroenterology*, 115(11), 1760-1767.

The Rise of Hyrox & The Hybrid Athlete

Mon, 27 Apr 2026 08:32:01 GMT

In recent years, the fitness landscape has significantly transformed, with new trends that cater to diverse athletic pursuits. One standout phenomenon is the rise of Hyrox , a competition that combines various fitness disciplines to create a unique challenge for athletes. This trend has also given birth to the concept of the Hybrid Athlete, someone who excels in multiple physical domains.

What is Hyrox?

Hyrox is a global fitness competition that integrates running and functional workouts. It consists of an 8km run interspersed with eight different workout stations, including exercises like sled pushing, rowing, and burpee broad jumps. The format is designed to test endurance, strength, speed, and agility, making it a comprehensive test of fitness.

The idea behind Hyrox originated from the desire to create a standardised competition in which anyone, from elite athletes to everyday fitness enthusiasts, could participate in. This inclusivity has contributed to its rapid growth and popularity, with events popping up in cities worldwide.

The Appeal of Hyrox

Inclusivity & Community: Hyrox events welcome participants of all fitness levels, fostering a sense of community. This inclusivity encourages people to challenge themselves in a supportive environment.
Varied Training: The combination of running and functional strength exercises encourages athletes to diversify their training regimens. This variety can prevent monotony in workouts and promote overall fitness.
Competitive Spirit: The competitive nature of Hyrox events motivates participants to push their limits. Athletes can track their progress, set personal goals, and compete against others, enhancing their training experience.
Global Reach: With events hosted in various cities worldwide, athletes can compete on an international stage, creating a shared experience among participants from different backgrounds.

The Hybrid Athlete

The rise of Hyrox has also popularised the concept of the hybrid athlete—an individual who trains for and competes in multiple physical disciplines. Unlike traditional athletes who may specialise in one sport, hybrid athletes blend endurance, strength, and skill training.

Characteristics of a Hybrid Athlete:

Versatility: Hybrid athletes often train in various modalities, including running, weightlifting, and functional fitness. This versatility allows them to adapt to different challenges.
Endurance & Strength: They possess both aerobic endurance and muscular strength, enabling them to excel in competitions like Hyrox, which require stamina and power.
Mental Resilience: The ability to switch between different types of training demands mental toughness. Hybrid athletes often embrace discomfort and push through physical and psychological barriers.

Training for Hybrid Athletes

To become a successful hybrid athlete, a well-rounded training plan is essential. Here are some key components:

Endurance Training: Incorporate long runs, interval training, and other aerobic exercises to build cardiovascular fitness.
Strength Training: Include compound lifts and functional strength workouts to enhance muscle power and overall strength.
Skill Work: Practice specific skills required in competitions, such as rowing technique or sled pushing mechanics.
Recovery: Prioritise recovery strategies, including proper nutrition, hydration, and rest, to prevent burnout and injury.

The Future of Hyrox and Hybrid Athletics

As Hyrox continues to gain momentum, we’ll likely see more athletes embracing the hybrid model. Fitness enthusiasts are increasingly looking for challenges that push their limits, and competitions like Hyrox provide just that.

Moreover, the rise of hybrid athletes may influence the fitness industry as a whole, encouraging gyms and trainers to offer more diverse training programs that cater to this new breed of athlete. The focus will shift from specialisation to a more well-rounded approach, emphasising the importance of being fit for various challenges.

Conclusion

The rise of Hyrox and the hybrid athlete signifies a shift in the fitness culture, promoting versatility, inclusivity, and community. As more people seek to challenge themselves beyond traditional fitness boundaries, the hybrid athlete is set to become a prominent figure in the world of sports and fitness. Whether you’re a seasoned competitor or a newcomer, the world of Hyrox invites everyone to embrace the journey of becoming a more well-rounded athlete.

What is the Epleys Manoeuvre? - Chelmsford Physio

Wed, 15 Apr 2026 21:18:56 GMT

What is the Epleys Manoeuvre?

The Epley manoeuvre, also known as the canalith repositioning procedure, is a treatment for benign paroxysmal positional vertigo (BPPV). BPPV is a common cause of vertigo, which is a feeling of dizziness or spinning. It is caused by small crystals that break off from the inner ear and get stuck in the semicircular canals. These crystals can cause the canals to move incorrectly, which sends false signals to the brain about balance.

The Epleys manoeuvre is a series of head movements that are designed to dislodge the crystals from the semicircular canals and return them to their normal position. The manoeuvre is usually performed by a doctor or physical therapist, but it can also be done at home.

How does the Epleys manoeuvre work?

The Epleys manoeuvre works by moving the crystals in the semicircular canals so that they can be flushed out of the ear. The manoeuvre is performed in a series of steps, each of which moves the crystals in a different direction.

The first step is to lie down on your back with your head turned 45 degrees to the affected side. The doctor or therapist will then quickly turn your head 90 degrees to the opposite side. The patient will then sit up and be instructed to tilt their head forward until their chin is on their chest. This position is held for a few seconds, and then the patient will be instructed to lie back down with their head turned 45 degrees to the opposite side of the original position. This process is repeated a few times, and the patient is usually symptom-free after the maneuver is complete.

How long should I rest after the Epleys manoeuvre?

You should rest for at least 10 minutes after the Epleys manoeuvre. This is to avoid "quick spins," or brief bursts of vertigo as debris repositions itself immediately after the manoeuvre. Don't drive yourself home until you are certain you feel “normal”.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is BPPV & How Physiotherapy Can Help

Wed, 15 Apr 2026 14:00:51 GMT

Benign Paroxysmal Positional Vertigo (BPPV) is a condition that affects numerous individuals, causing brief but intense episodes of dizziness and vertigo. This vertigo is triggered by certain changes in the position of the head. It's a common condition, especially amongst adults, but what exactly is it and how can physiotherapy help manage its symptoms?

What is BPPV?

BPPV occurs due to the displacement of tiny calcium carbonate crystals, known as otoconia, within the inner ear's semicircular canals. These canals are crucial for maintaining balance and providing feedback to the brain about our position in space. When the otoconia are displaced, they can move into the posterior canals of the labyrinth, causing confusion within the central nervous system and resulting in dizziness and balance issues characteristic of BPPV .

This condition is the most common cause of vertigo, presenting symptoms like a spinning sensation, which is short-lived (less than a minute) but can be quite distressing. Symptoms are specifically triggered by changes in head position relative to gravity. While it doesn't lead to hearing loss or tinnitus, it can bring about nausea, vomiting, blurred vision, headache, and neck pain.

How Can Physiotherapy Help?

The role of physiotherapy in managing BPPV is pivotal. The primary aim is to reposition the displaced otoconia from the sensitive inner ear areas to places where they cause less disturbance. This is achieved through specific maneuvers that have been developed and refined over time, such as the Canalith Repositioning Procedure (CRP) , also known as the Epley maneuver .

The Epley Maneuver: A Closer Look

The Epley maneuver involves a series of calculated head movements, conducted by a trained physiotherapist, designed to guide the otoconia out of the affected semicircular canal. It's a highly successful technique, with an 80-100% success rate in most cases, significantly reducing or even eliminating the symptoms of BPPV . The maneuver is considered a low-cost, safe, and effective treatment option, offering relief to those who experience the unsettling symptoms of BPPV .

Research and clinical evidence support the effectiveness of the Epley maneuver and other physiotherapy interventions for BPPV . A systematic review and meta-analysis published in the Journal of the American Medical Association (JAMA) highlighted the maneuver's success in significantly reducing vertigo symptoms and lowering the risk of recurrence.

Prevention and Management

While BPPV can occur in any age group, it is most commonly observed between 50 and 70. It is rare in individuals under 35 without a prior head injury. Understanding the condition, recognising its symptoms, and seeking prompt treatment can greatly improve the quality of life for those affected.

Physiotherapy offers a beacon of hope for individuals suffering from BPPV , providing them with effective treatment options to manage and alleviate their symptoms. Through specialised maneuvers like the Epley maneuver, physiotherapists can make a significant difference in the lives of those dealing with this condition.

FAQs About BPPV:

Contact Chelmsford Physio Today!

BPPV can be a challenging condition, but with the right approach, it's manageable. Physiotherapy stands out as a key player in treating BPPV, offering effective and non-invasive techniques. If you're experiencing symptoms of BPPV, don't hesitate to seek professional advice and treatment.

For those in and around Chelmsford, Essex, looking for assistance with BPPV or other physiotherapy needs, Contact Chelmsford Physio . Our team is dedicated to providing top-notch care, helping you get back to your best self.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Preventing Recurrence of BPPV: Lifestyle & Management Tips

Wed, 15 Apr 2026 10:01:31 GMT

Benign Paroxysmal Positional Vertigo (BPPV) is a common cause of dizziness that can be both uncomfortable and disruptive. While treatments like the Epley manoeuvre can help manage symptoms, BPPV may sometimes recur.

Fortunately, simple lifestyle changes and management strategies can help reduce the chances of BPPV returning. Below are some practical tips to help you manage BPPV and potentially prevent it from recurring.

Avoid Sudden Head Movements

BPPV is triggered by sudden changes in head position, so it’s helpful to avoid quick or jerky movements, especially in directions that might trigger dizziness. Try to move slowly and mindfully when bending down, turning your head, or getting out of bed. Taking a few extra moments to control your head’s position can help minimise the risk of an episode.

Sleep Position Adjustments

Certain sleeping positions can help prevent BPPV. Many people find that sleeping on their back with their head slightly elevated (using a couple of pillows) reduces the likelihood of symptoms. Some people also avoid sleeping on the side associated with their BPPV. A pillow that keeps the neck well-supported without excessive bending can also make a difference.

Balance & Stability Exercises

Strengthening balance through simple exercises may help your body cope better with changes in position and reduce dizziness. Exercises like standing on one foot (with support if needed), heel-to-toe walking, and gentle yoga can strengthen balance and make everyday movements smoother. These exercises help your brain and muscles adapt, making you feel steadier overall.

Avoiding Extended Periods of Head-Tilting

Keeping the head tilted back for prolonged periods, such as when looking up for extended times, can sometimes set off BPPV symptoms. If your work or hobbies require you to look up (like painting or home repairs), try taking breaks often, allowing your head and body to return to a neutral position.

Minimising Stress

While stress itself doesn’t cause BPPV, it can exacerbate symptoms and make it harder to manage. Finding ways to keep stress under control—through relaxation techniques, regular exercise, or even practising mindfulness—can help your body feel more resilient. Deep breathing exercises, stretching, or short walks can all provide quick relief from stress and may reduce the impact of BPPV if it does arise.

Staying Active

Regular activity helps keep your overall health in good shape, which in turn may help with BPPV. Walking, gentle stretches, and other low-impact activities can support good circulation, balance, and body awareness, which can all play a role in BPPV management. Keeping a balanced activity level that doesn’t overstress the body but keeps you moving may help you feel more stable day to day.

Check with Your Healthcare Professional

If you have had BPPV before, it’s a good idea to check in with your healthcare provider to discuss ways to keep symptoms under control. Regular check-ups can be useful, especially if you notice any changes in your balance or have questions about your treatment plan.

Managing BPPV isn’t just about handling symptoms; it’s also about making small adjustments to help prevent recurrences. Following these practical tips can support your overall health and make everyday activities easier and safer.

Contact Chelmsford Physio for guidance and support tailored to your needs, helping you enjoy a more comfortable, balanced life.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

To Stretch or Not to Stretch

Wed, 25 Mar 2026 18:21:06 GMT

Stretching, either prior to exercise or at the end, or both, is typically carried out by all individuals undertaking sporting activities, whether they be elite or recreational athletes.

The many forms of stretching available to an athlete, either passive or active, have long been thought to improve performance, decrease injury and generally be advantageous to the athlete. (Baxter et al, 2017 ) .

However, are you wasting your time stretching ?
Is stretching actually having a negative effect on your performance ?
Does stretching actually prevent injuries ?

Let’s Have a Look at What the Research Says!

Stretching has long been a key component of any athletes training or competition. Through the generations we have been told that if we don’t stretch we will get injured or not perform well that day. Almost all sports see stretching as a tool for warm up to improve performance and cool down, to reduce injury risk. However, in recent years the studies and research has failed to support this, and perhaps it is more based on tradition than science ?

We will now look at what the current and best literature says, and evaluate what athletes can and should do with respect to this controversial topic.

Does Stretching Improve Flexibility ?

Firstly, we need understand there are various types of stretching, and for the purpose of this blog we will look primarily at Static Stretching. This typically involves elongating a muscle to the point at which tension is felt and remaining in this position for a given amount of time. Multiple stretches are performed on a single muscle group, with a minimum of 30 second per stretch (Woods et al, 2007) . Bandy & Irion (1994) had investigated stretch times further and found that there were no additional benefits after a 30 second hold, reporting 30 seconds as the optimal hold time for static stretching.

The research has demonstrated that when simple static stretching is performed regularly over a 6 week period, flexibility can be significantly increased (Thacker et al, 2003)

However, what is important to remember here is whether more flexibility is helpful or unhelpful to the sport you play and the performance of your sport ?

Endurance Runners & Flexibility

There is evidence to suggest that typically, elite endurance runners are less flexible than their non-elite counterparts (Baxter et al, 2017)

In a study of endurance runners, Schwellnus & Collins (2011) found a gene COL5A1 associated with in-flexibility, which demonstrated that endurance runners who possess this gene had a considerably higher running economy than the other athletes participating in the study.

A study conducted by Gleim at al (1990) , using untrained individuals and found that the participants with the lowest flexibility consistently had the most economical running styles.

They reported that this was due to:

Better pelvic control
Excess range of motion
More energy to stabilise
Increased elastic storage
Reduced demand of 02

Thacker et al (2003) commented that there is optimal flexibility for endurance runners. Too much flexibility can actually can be more detrimental and unhelpful to a runner, than being a little bit stiff and tight in the lower limb.

Stretching & Performance

Performance potential relies on 2 main areas, physiological parameters such at V02 max & lactate threshold, as well as running efficiency which we will focus on in relation to stretching

Running efficiency is an area where stretching has the ability to impact on a runners success (Barnes & Kidling, 2015) . This raises the question of whether stretching should remain an assumed aspect of training? (Baxter et 10, 2017)

The debate surrounding the effects of static stretching has surfaced after it was suggested that acute stretching immediately before exercises had to ability to significantly inhibit performance on short, explosive events including:

1RPM leg press (Bacurau et al, 2009)
20m sprint performance (Nelson et al, 2005)
Vertical height jump (Young et al, 2001)
Kicking distance
1-mile uphill treadmill run was investigated by Lowery et al. (2014) . Compared to the non-stretching condition, the static stretching induced a reduced 1-mile uphill run performance.

This is potentially due to physiological changes seen in the muscle and the decreased ability to store elastic energy ? (Wilson et al, 2010)

No studies appear to be able to show that acute stretching has the ability to improve performance of athletes and notably no studies have reported positive effects for endurance runners. As a result, the debate has since evolved into whether static stretching decreases running economy for runners or simply does not affect it (Baxter et al, 2017)

Despite the majority of the literature on stretching for runners reporting that stretching causes a decrease in running economy, athletes continue to use stretching during their warm up regime prior to both training and competition.

The central idea behind this phenomenon is that stretching before an endurance event reduces mechanical efficiency of the lower body, primarily through the reduction of musculotendinous stiffness (Baxter et al, 2017)

Muscultendinous stiffness historically has always be viewed and thought of as a potential risk to injury, when in fact it appears to be advantageous to runners. Stiffness at the ankle and hip joints actually provide the best efficiency and results for runners and reducing this stiffness through stretching can have a negative effect on performance, as well as this less energy is then needed for muscle stabilisation.

There are no studies that were able to suggest that stretching immediately before running could improve running economy. The research suggests that runners may be best reducing their warm up routine to a low intensity, progressive run and removing stretching practices completely ? (Baxter et al, 2017)

Stretching away from running doesn’t appear to inhibit or improve running economy or performance. In groups that performed static stretching regimes over 6-12 week periods to improve flexibility, it was found that flexibility improved but there were no positive or negative effects noted to their running. So if you like stretching and feel better for stretching, feel free to continue, just make sure you stretch separately to any running.

Stretching & DOMS (delayed onset of muscle soreness)

Runners often using stretching to improve their recovery and reduce any DOMS effects post run. The research however don’t support this, and no studies have been able to demonstrate any significant difference in DOMS, between groups that stretch and groups that don’t stretch (Herbert et al, 2011)

Jamtvedt et al (2010) , supported this when they studied over 2000 individuals and concluded that no variation of stretching has the ability to alter DOMS. Its is recommended that runners suffering with DOMS investigate other helpful methods, such as massage, icing or hot & cold therapy (Snyder et al, 2011)

Conclusion

The available research suggests neither acute nor chronic static stretching has clinically beneficial effects for runners, on performance, DOMS and injury prevention. From the current literature, it can be concluded that stretching is an ineffective way of altering performance or injury risk and runners are advised to direct their efforts to other strategies. In terms of pre exercise, a progressive warm-up which incorporates graded intensity ( Dalleck et al, 2007 Baxter et al, 2017)

Any training plan should be individualised to the athlete and it is recommended to include resistance type training in order to improve running performance, economy and reduce injury risk (Dean et al, 2013) this may be more useful to incorporate into a weekly training schedule, and provide more beneficial effects to static stretching.

In conclusion, the literature suggests that stretching doesn’t provide any benefit to runners, and acute stretching can reduce running economy and performance for up to an hour, by diminishing the musculo-tendinous stiffness and elastic energy potential. In relation to injury risk, stretching shows little significance for helping runners (Baxter et al, 2017) . Runners are often at risk of overuse injuries, where stretching doesn’t appear to help, but strength based training and plyometrics ( jumping exercises ) may be a more helpful adjunct and better use of time ?

There is a term Strength Stretching, which refers to using strength training to improve both the length and strength of a muscle. This can involve eccentric type loading ( like heel drops off a step ) or heavy slow resistance training using weights.

Although the literature isn’t clear when it comes to stretching, what we do know is there is no “one size fits all” so its important to understand what you are doing, and whether that is helping or hindering you. Its important not just to perform an exercise because that’s what everyone else does, and that’s the way we have always done it.

A Chelmsford Physio we definitely don’t have a problem with anyone stretching, and we often support it some cases, where it can help how you feel both physically and mentally.

Yoga is a fantastic way for lots of people to exercise, and this involves stretching into end range positions. We have the knowledge and experience to help you come up with a bespoke training plan to improve your performance, achieve your goal and reduce the risk of an injury.

Just get in touch if you have any questions or if you like some help with your training!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Benefits of Tapering for Marathon Runners

Wed, 25 Mar 2026 10:12:05 GMT

Tapering is a critical phase in the training cycle of a marathon runner, often seen as the period leading up to the race where mileage is reduced to allow the body to recover and prepare for peak performance. This blog explores the benefits of tapering and its impact on marathon performance.

Understanding Tapering

Tapering generally refers to the systematic reduction of training volume and intensity in the weeks leading up to a race. According to a study by Smith et al. (2013) , a well-structured taper can lead to improved performance due to physiological adaptations and mental readiness (Smith, R., et al., 2013) . The duration and extent of the taper vary depending on the athlete's training background, race distance, and personal preferences.

Physiological Benefits

1. Enhanced Recovery: The primary goal of tapering is to facilitate recovery from the accumulated fatigue of training. During this period, muscle glycogen stores are replenished, muscle fibers repair, and joint inflammation subsides (Mujika & Padilla, 2000) . Research highlights that runners who effectively taper can experience an increase in muscle glycogen levels, which is crucial for endurance events like marathons (Jeukendrup & Killer, 2010) .

2. Improved Aerobic Capacity: Tapering has been shown to increase aerobic performance. A systematic review by Bosquet et al. (2007) found that tapering significantly enhances VO2 max and running economy, which are critical for distance running (Bosquet, L., et al., 2007) . These physiological improvements enable runners to maintain a higher pace over long distances.

3. Increased Mental Toughness: The psychological component of tapering is equally important. The reduction in training load allows runners to mentally prepare for the race, boosting confidence and reducing anxiety. According to a study by Dintiman (1981) , tapering also leads to improved focus and mental clarity during races (Dintiman, G. B., 1981) .

Performance Outcomes

Research indicates that tapering can yield significant performance benefits. A meta-analysis conducted by Martin et al. (2011) concluded that well-executed tapering strategies can improve performance by 2% to 10% in distance runners (Martin, L., et al., 2011) . This improvement can be the difference between achieving a personal best and falling short.

Practical Tapering Strategies

1. Duration: Most tapering periods last between 1 to 3 weeks before the marathon. An optimal duration allows the body to recover without losing the training adaptations gained during the build-up (Mujika, I. & Padilla, S., 2000) .

2. Reduction in Mileage: A common approach is to reduce mileage by 20-50% during the tapering phase, while maintaining some intensity in workouts to enhance neuromuscular readiness (Donnelly & Henneman, 1990) .

3. Nutrition: Adjusting nutrition during the taper is essential. Increasing carbohydrate intake helps to maximise glycogen stores (Jeukendrup, A. E., & Killer, S. C., 2010) . Consulting a sports nutritionist can help tailor dietary needs effectively.

Conclusion

Tapering is an essential aspect of marathon training that offers myriad benefits, from physiological recovery to enhanced performance outcomes. By strategically reducing training load, runners can optimise their readiness for race day, ultimately leading to improved performance. Implementing effective tapering strategies can be the key to achieving personal bests and successfully crossing the finish line.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Calcaneal Stress Fracture - A Marathon Runner's Worst Nightmare!

Wed, 25 Mar 2026 09:21:15 GMT

Running is a great form of exercise that provides numerous health benefits, but it can also lead to various injuries. One such injury that we saw in the clinic recently was a calcaneal stress fracture in a runner training for the Marathon.

This blog aims to discuss some of the causes, symptoms, diagnosis, and prevention of calcaneal stress fractures in runners.

What is a Calcaneal Stress Fracture?

A calcaneal stress fracture is a small crack in the heel bone (calcaneus) that occurs due to repetitive stress and overuse. It can occur among runners, especially those who increase their mileage rapidly. The calcaneus is crucial for absorbing shock and providing stability during running, making it susceptible to injury under excessive load (Kowalchuk et al., 2016) .

Causes of Calcaneal Stress Fractures

Several factors contribute to the development of calcaneal stress fractures in runners:

1. Increased Training Intensity: Rapid increases in mileage or intensity can overwhelm the bone's ability to remodel itself, leading to stress fractures (Nilly et al., 2018) .

2. Inappropriate Footwear: Running shoes that do not provide adequate support or cushioning can increase the risk of injury (Kerrigan et al., 2001) .

3. Poor Running Mechanics: Abnormalities in running form or inadequate foot strike patterns may lead to increased stress on the calcaneus (Lieberman et al., 2010) .

4. Bone Health: Factors such as low bone density, which can be influenced by nutrition and hormonal factors, can predispose runners to stress fractures (Kelsey et al., 2007) .

Symptoms of Calcaneal Stress Fractures

Runners with calcaneal stress fractures typically report pain, which often occurs during running and can then be present even while walking.

Diagnosis of a Calcaneal Stress Fracture

The diagnosis of a calcaneal stress fracture usually involves a combination of clinical evaluation and imaging studies. A thorough physical examination can reveal an inability to single-leg hop on the affected side, tenderness on bony palpation of the calcaneus & a positive calcaneal squeeze test.

While imaging techniques such as X-rays or MRI can confirm the presence of a stress fracture (Draper & Jones, 2007) . MRI is particularly useful as it can detect bone marrow edema, which is indicative of stress fractures even when X-rays appear normal.

BSI can often take weeks and sometimes months to be diagnosed. An Xray is probably not the best way to investigate, as changes can take months. An MRI or a Bone Scan is more sensitive at detecting changes than an X-ray.

Through early diagnosis and a structured management plan, the prognosis should be a full recovery and a return to running in 12-16 weeks. If not diagnosed at the right stage and poorly managed, these can worsen and worst case, end up needing surgery.

A bone stress injury is a risk for runners, especially those who do not adhere to proper training protocols. Understanding the causes, symptoms, and appropriate treatment options can empower runners to take proactive steps in preventing these injuries. By incorporating safe training practices and monitoring bone health, runners can continue to enjoy the benefits of their sport while minimising the risk of injury.

If you suspect a BSI or would like any help with a pain or an injury, get in touch now and speak to an expert physiotherapist .

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Best Forms of Recovery for Runners

Tue, 24 Mar 2026 09:47:14 GMT

Marathon training is tough and exhausting. With all the time spent training, are you fitting enough time in for your recovery to perform at your best? The physical demands of running can lead to fatigue and increase the risk of injury, making recovery an essential aspect of a runner's routine.

In this blog, we will explore the best forms of recovery for runners, backed by scientific research and expert recommendations.

1. Active Recovery

Active recovery involves engaging in low-intensity exercise after strenuous workouts. This approach helps to promote blood flow, reduce muscle soreness, and accelerate the removal of metabolic waste products. A study by LaStayo et al. (2003) found that low-intensity activities such as walking or cycling can aid recovery by decreasing delayed onset muscle soreness (DOMS) after intense workouts. Incorporating activities like yoga or swimming can also provide a gentle way to stay active while allowing the body to recover.

2. Hydration & Nutrition

Proper hydration and nutrition play critical roles in recovery. After a run, it's essential to replenish fluids lost through sweat and to consume a balanced meal that includes carbohydrates and protein. A review by Burkhardt et al. (2017) highlighted that consuming protein post-exercise can stimulate muscle protein synthesis, aiding recovery. Aim to consume a recovery snack within 30 minutes of finishing a run for optimal results.

3. Sleep

Sleep is the most powerful performance enhancer available to us.

There’s a clear, linear link between reduced sleep and increased injury risk.

Sleeping 5 hours instead of 9 can increase injury risk by up to 60%.
Just one night of 4 hours' sleep can lead to a 70% drop in natural killer cell activity – a key part of your immune defence.
Getting 6 hours or less per night can reduce time to physical exhaustion by 10–30%.
Prioritising quality sleep isn’t optional – it’s essential for recovery, resilience, and performance.

Sleep is one of the most critical factors influencing recovery. During sleep, the body undergoes repair processes that are essential for recovery and adaptation. A study by Lastella et al. (2020) showed that inadequate sleep can lead to poorer performance and increased risk of injuries. Runners should aim for 7-9 hours of quality sleep per night to maximise recovery.

4. Stretching & Foam Rolling

Incorporating stretching and foam rolling into a recovery routine can help alleviate muscle tightness and improve flexibility. A systematic review by Behm et al. (2016) indicated that foam rolling is effective at reducing muscle soreness and improving range of motion. Dynamic stretching before runs and static stretching post-run can also enhance recovery and promote flexibility.

5. Compression Garments

Wearing compression garments during and after runs may offer recovery benefits. A meta-analysis by Hill et al. (2014) suggested that these garments can reduce muscle soreness and swelling, enhancing recovery post-exercise. While individual responses may vary, many runners find compression wear comfortable and beneficial for recovery.

Conclusion

In conclusion, effective recovery is vital for runners to maintain performance and prevent injuries. By incorporating active recovery, proper hydration and nutrition, sleep, stretching, foam rolling, and compression garments into their routines, runners can optimise their recovery process. As always, it's essential to listen to your body and adjust recovery strategies according to individual needs and experiences.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Discover Ultrasound-Guided Injections at Chelmsford Physio

Wed, 11 Mar 2026 17:44:58 GMT

Based at Riverside Leisure Centre in Chelmsford, we are excited to introduce our ultrasound-guided injection service . This innovative approach to treatment combining advanced imaging technology with targeted therapeutic injections to effectively manage pain, reduce inflammation, and support healing in various areas of the body. Let’s explore the types of injections we offer and the conditions they can help treat.

What Are Ultrasound-Guided Injections?

Ultrasound-guided injections are a precise and minimally invasive procedure where a trained clinician uses real-time ultrasound imaging to guide the placement of an injection. This ensures the medication is delivered exactly where it’s needed, improving accuracy and effectiveness while minimising discomfort.

Types of Ultrasound-Guided Injections:

1. Corticosteroid Injections

Corticosteroid injections are commonly used to reduce inflammation and alleviate pain in conditions affecting joints, tendons, and soft tissues. They are particularly effective for:

Osteoarthritis in the knee , hip , or shoulder
Tendonitis, such as tennis elbow or Achilles tendonitis
Bursitis, including shoulder or hip bursitis

By directly targeting inflamed areas, corticosteroid injections provide significant relief for chronic pain and stiffness, allowing you to move more freely.

2. Hyaluronic Acid Injections

Hyaluronic acid injections , also known as viscosupplementation, are often used to manage joint pain and stiffness caused by osteoarthritis. Hyaluronic acid is a naturally occurring substance that helps lubricate and cushion joints. These injections can be particularly beneficial for:

Knee osteoarthritis
Hip osteoarthritis
Ankle joint issues

This treatment enhances joint mobility and reduces discomfort, making it a popular choice for individuals looking to maintain an active lifestyle.

Areas of the Body Treated

Ultrasound-guided injections are versatile and can be used to treat a wide range of conditions affecting various areas of the body. These include:

Shoulders: Rotator cuff injuries, frozen shoulder, shoulder impingement , shoulder bursitis , acromioclavicular (AC) joint pain
Elbows: Tennis elbow , golfer’s elbow
Wrists & Hands: Carpal tunnel syndrome , tendonitis
Hips: Osteoarthritis of the hip , bursitis, greater trochanteric pain syndrome
Knees: Osteoarthritis of the knee , patellar tendonitis
Ankles & Feet: Plantar fasciitis , Achilles tendonitis, Morton’s neuroma , arthritis

This precise technique ensures that treatments are tailored to the specific area of concern, providing targeted relief and promoting faster recovery.

Why Choose Chelmsford Physio?

At Chelmsford Physio , our experienced team is dedicated to delivering personalised care. By combining advanced ultrasound technology with evidence-based treatment options, we ensure you receive the highest standard of care. Whether you’re managing a chronic condition or recovering from an injury, our ultrasound-guided injection service can help you get back to doing what you love.

If you’d like to learn more about our ultrasound-guided injection service or book a consultation , contact Chelmsford Physio today. Let us help you take the next step towards a pain-free, active lifestyle.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Benefits of Ultrasound-Guided Injections

Wed, 11 Mar 2026 13:31:30 GMT

Ultrasound-guided injections are a medical procedure where an ultrasound machine is used to guide the placement of a needle and injection substance into a specific area of the body. The technique involves the use of high-frequency sound waves that create images of the internal structures of the body, allowing healthcare professionals to visualise the target area in real time. This enables them to accurately identify the optimal location for the injection and confirm the correct placement of the needle and the injection substance.

Ultrasound-guided injections have become increasingly popular in recent years as they offer several advantages over traditional blind/surface-marked injections.

The benefits of Ultrasound Injections include:

Improved accuracy: Ultrasound guidance enables healthcare professionals to visualize the internal structures of the body in real-time, allowing for more accurate needle placement and injection substance delivery.
Enhanced safety: By guiding the injection using ultrasound, the risk of tissue trauma, incorrect needle placement, and injection substance delivery is reduced, making the procedure safer and reducing the risk of adverse events.
Improved outcomes: Research has shown that ultrasound-guided injections result in better outcomes, including improved levels of pain relief, longer-lasting benefits, and improved post-injection function of the injected area.
Reduced need for repeated injections: Since the injection site's location is more accurately determined, the probability of unnecessary injections is reduced, potentially saving time and resources.
Increased patient comfort: Ultrasound-guided injections are often more comfortable for patients as the necessary depth of the injection can frequently be decreased, resulting in less pain and discomfort during the procedure.
Overall, ultrasound-guided injections offer a more precise, safe, and comfortable alternative to traditional injections, making them an increasingly popular choice in clinical practice.

What can ultrasound-guided injections be used for?

Frozen shoulder
Tennis elbow
Golfer’s elbow
Greater trochanteric pain syndrome
Osteoarthritis of the knee
Osteoarthritis of the hip
Morton’s neuroma
Carpal tunnel syndrome
Plantar fasciitis
Shoulder impingement
Shoulder bursitis
Acromioclavicular joint pain

Chelmsford Physio has developed a unique service directly tailored to the wants and needs of our patients. A one-stop shop, fast, efficient and safe service for patients to obtain pain relieving injections for a broad range of musculoskeletal conditions.

Chelmsford Physio has a specialised team of clinicians who have undertaken extensive training to provide this service. Our clinical specialists have trained as musculoskeletal sonographers (the clinical use of diagnostic ultrasound). They have also completed extensive training to be qualified to prescribe medications independently which means we do not require a referral from your GP.

This allows for our unique one-stop shop ultrasound-guided injection service, whereby patients are able to book to attend a single consultation and received a physical assessment, diagnostic ultrasound and ultrasound-guided injection all in the same visit. This is a highly specialist and innovative service that has been specifically designed to improve patients’ easy access to pain-relieving injections while simplifying patients’ journeys and maintaining a first-class level of care.

Visit us today to book your ultrasound injection session: Book Appointment Here

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Future of Knee Pain Relief: Is Arthrosamid the Answer to Long-Term Mobility?

Wed, 11 Mar 2026 12:43:35 GMT

For those living with the persistent ache of knee osteoarthritis, the treatment journey often follows a familiar path: anti-inflammatories, physiotherapy, and perhaps a series of steroid or lubricant injections. While these can help, the relief is often frustratingly temporary.

However, a pioneering treatment called Arthrosamid® is changing the conversation. It isn't just a temporary "top-up"—it is a long-acting hydrogel that offers a new way to manage knee pain for years, rather than months.

What is Arthrosamid?

Arthrosamid is an innovative, non-biodegradable hydrogel. Unlike Hyaluronic Acid, which is a substance your body eventually absorbs and breaks down, Arthrosamid is designed to be permanent.

It consists of 97.5% water and 2.5% cross-linked polyacrylamide. This unique composition allows it to integrate with the joint tissues, providing a durable, "cushion-like" layer that stays exactly where it is needed.

How Does it Work?

Most injections focus on the fluid inside the joint. Arthrosamid does something far more sophisticated. Once injected, it works in two distinct stages:

Immediate Cushioning: It immediately thickens the synovial fluid, reducing friction and acting as a shock absorber.

Tissue Integration: Over the following weeks, the hydrogel begins to "mesh" with the inner lining of your joint capsule (the synovium). This strengthens the joint lining and restores its elasticity, creating a long-term barrier against the pain and stiffness of osteoarthritis.

Why is it Different From Other Injections?

The defining characteristic of Arthrosamid is its longevity.

Steroids are great for "putting out the fire" of a flare-up but often wear off in weeks.
Hyaluronic Acid provides excellent lubrication but typically lasts around 6 to 9 months.
Arthrosamid has been shown in clinical trials to provide significant pain reduction and improved mobility for up to 3 years and beyond from just one single injection.

The Procedure: Precision through Ultrasound

At our clinic, we specialise in ultrasound-guided injections. Because Arthrosamid is a "permanent" implant, accuracy is paramount.

Using real-time ultrasound imaging, our clinicians can see the needle enter the joint space with millimetre precision. This ensures the hydrogel is placed perfectly within the synovial cavity, maximising the effectiveness of the treatment and ensuring the highest levels of patient safety.

Is Arthrosamid right for you?

If you have moderate knee osteoarthritis and are looking to delay or even avoid knee replacement surgery, Arthrosamid could be a game-changer. It is particularly effective for those who have tried other injections without lasting success and want to get back to an active lifestyle without the constant cycle of hospital visits.

Contact Chelmsford Physio today to book your assessment and start your journey to recovery.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The "Oil Change" for Your Joints: A Guide to Hyaluronic Acid Injections

Wed, 11 Mar 2026 12:20:07 GMT

If you’ve been struggling with stiff, aching joints, you may have heard of Hyaluronic Acid (HA) injections. Often referred to as "gel injections" or "lubricant shots," they have become a cornerstone of modern orthopaedic care.

But what actually happens during the procedure, and how does a single injection provide months of relief? Let's break down the science and the process.

What Exactly is the "Gel"?

Hyaluronic Acid isn't a drug in the traditional sense; it’s a biocompatible polysaccharide. In simpler terms, it is a thick, slippery substance that your body already produces to keep your joints moving smoothly.In a healthy joint, the synovial fluid (the liquid that surrounds the joint) is rich in HA. It acts as both a lubricant and a shock absorber. However, as we age or develop osteoarthritis, the concentration of HA drops. The fluid becomes watery, and your bones begin to rub together, leading to that familiar "grinding" sensation and persistent pain.

How the Injection Helps: The Three-Fold Effect

When we inject medical-grade Hyaluronic Acid into a joint, it doesn't just sit there. It performs three vital roles:

Instant Lubrication: Like adding oil to a rusty hinge, the HA coats the surfaces of the cartilage, reducing friction immediately and making movement feel "smoother."

Mechanical Cushioning: Because the gel is viscous, it acts as a physical buffer, absorbing the impact when you walk, run, or climb stairs.

Biological Signalling: This is the clever bit. High-quality HA injections actually "trick" the joint lining (the synovium) into producing more of its own natural lubricant, creating a therapeutic effect that lasts long after the original gel has been absorbed.

What Happens During the Procedure?

Many patients are nervous about needles, but the process is straightforward and typically takes less than 20 minutes.

The Scan: We use a high-resolution ultrasound probe to "see" inside your joint. This ensures we aren't guessing; we can identify the exact pocket of space where the fluid is needed.

The Injection: Under real-time ultrasound guidance, the needle is guided precisely into the joint capsule. You might feel a sensation of "fullness" or pressure as the gel enters, but it is rarely described as painful.

The Recovery: There is no "down time." We usually advise 48 hours of relative rest (no marathons just yet!), but you can walk out of the clinic and drive home immediately.

Is it right for your joint?

While the knee is the most common site for HA therapy, it is also highly effective for:

Hips: For those with early-stage wear and tear.

Ankles: Excellent for hikers or those with previous sports injuries.

Shoulders: To help with "gritty" movement or stiffness.

Small Joints: Including the base of the thumb (CMC joint).

A Note on Accuracy: Studies consistently show that "blind" injections (done without a scan) miss the joint space up to 30% of the time. By using ultrasound guidance, we ensure that 100% of the Hyaluronic Acid reaches the target, giving you the best possible value and clinical outcome.

Contact Chelmsford Physio today to book your assessment and start your journey to elite performance.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Myth Busting: Ultrasound-Guided Injections - What to Expect

Wed, 11 Mar 2026 09:31:39 GMT

In recent years, ultrasound-guided injections have emerged as a beacon of hope for those enduring chronic pain and certain musculoskeletal conditions. However, myths and misconceptions often cloud these treatments' true nature and benefits .

This article aims to demystify ultrasound-guided injections, shedding light on what patients can genuinely expect from the procedure. By providing clarity, we hope to alleviate concerns and empower individuals to make informed decisions regarding their health and well-being.

Addressing Common Concerns:

1) Pain

One of the most significant worries for patients considering ultrasound-guided injections is the anticipated pain during and after the procedure. It's natural to feel apprehensive about injections; however, it's important to understand that these procedures are designed with patient comfort in mind.

Ultrasound guidance allows clinicians to administer injections with high precision, targeting specific areas with minimal discomfort. Most patients report feeling a slight pressure or a mild pinch, followed by immediate relief in the affected area.

2) Side Effects

Concerns about potential side effects are also common. Like any medical procedure, ultrasound-guided injections come with a risk of side effects, but these are generally minimal and temporary.

The most typical are mild bruising or swelling on the injected area, which usually subsides within a few days. The use of ultrasound increases the accuracy of needle placement, significantly reducing the risk of complications and side effects.

3) Recovery Time

Another major consideration for patients is the recovery time associated with the procedure. The good news is that ultrasound-guided injections typically have a very short recovery period. Patients often resume their normal activities within a day or two, making it a highly convenient option for those seeking pain relief without significant downtime.

Ultrasound-Guided Injections at Chelmsford Physio

At Chelmsford Physio , we pride ourselves on offering a range of physiotherapy treatments, including ultrasound-guided injections , to people in and around Chelmsford, Essex. Our skilled practitioners use the latest ultrasound technology to ensure the highest accuracy and effectiveness of the injections.

This service is part of our comprehensive approach to physiotherapy, aimed at providing personalised care that addresses the root cause of pain and promotes long-term health and mobility.

In conclusion, ultrasound-guided injections are a safe, effective, and minimally invasive treatment option for managing chronic pain and certain musculoskeletal conditions. By dispelling the myths surrounding the procedure, we hope to have provided a clearer understanding of what patients can expect, alleviating concerns and highlighting the benefits. If you're considering ultrasound-guided injections or seeking more information about how they can help in your specific situation, get in touch with us today!

Optimal Recovery Strategies for Marathon Runners

Wed, 25 Feb 2026 14:26:37 GMT

Training for a marathon is a demanding endeavour that requires not only rigorous physical preparation but also effective recovery strategies. Recovery is crucial for improving performance, preventing injuries, and ensuring that runners can continue their training without setbacks. This blog post outlines the best forms of recovery for runners training for a marathon, supported by relevant research.

1. Active Recovery

Active recovery involves engaging in low-intensity exercise following high-intensity workouts. Activities such as walking, cycling, or swimming serve to maintain blood flow and enhance recovery without adding significant strain on the body.

Benefits:

Active recovery can reduce muscle soreness and facilitate the removal of metabolic waste products. A study by Kimpinski et al. (2013) demonstrated that active recovery significantly decreased perceived soreness among runners.

2. Sleep and Rest

Sleep is a fundamental component of recovery. During deep sleep, the body repairs itself and undergoes muscle regeneration and glycogen replenishment. Runners should prioritise adequate sleep, aiming for 7-9 hours per night, especially during peak training weeks.

Benefits:

Poor sleep quality has been linked to decreased performance and increased injury risk. A study by Physiology et al. (2015) indicated that athletes who prioritised sleep displayed improved performance metrics and faster recovery times.

3. Nutrition

Proper nutrition plays an essential role in recovery. After long runs, it's vital to consume a balanced meal comprising carbohydrates, proteins, and fats to support muscle repair and replenish glycogen stores.

Guidelines:

- Post-Run Meals: Aim for a 3:1 ratio of carbohydrates to protein post-exercise. This can enhance glycogen recovery (van Loon et al., 2000).

- Hydration: Maintaining adequate hydration levels is crucial for recovery. Dehydration can impair performance and increase injury risk (Brownsberger et al., 2019).

4. Soft Tissue Therapy & Massage

Soft tissue therapy and massages can help alleviate muscle tightness and enhance recovery.

Effectiveness:

Research conducted by MacDonald et al. (2014) found that foam rolling was effective in increasing flexibility, reducing muscle soreness, and improving recovery after exercise.

5. Cross-Training

Engaging in cross-training activities, such as swimming or cycling, allows runners to build aerobic fitness while reducing the repetitive stress associated with running.

Benefits:

Cross-training can enhance overall conditioning without the impact stressors of running. A study by Karp (2012) emphasises the importance of cross-training in injury prevention and enhancing performance.

Conclusion

Recovery is a fundamental aspect of marathon training that should not be overlooked. By implementing a combination of active recovery, proper sleep, nutrition, physical therapies, and cross-training, runners can optimise their recovery processes. This holistic approach will not only improve performance but also reduce the risk of injuries, ensuring that marathon preparation is both effective and sustainable. Get in touch today to speak with a specialist physio who can help you!

The 5 Most Common Ski Injuries we see in our Physio Clinic

Wed, 25 Feb 2026 13:23:46 GMT

Skiing is one of the most popular winter sports, attracting millions of enthusiasts each year. However, the thrill of gliding down the slopes often comes with a risk of injury. Physiotherapists frequently encounter a range of ski-related injuries, which can vary in severity and type. This blog post explores the most common ski injuries treated in physiotherapy clinics, their causes, and some strategies for prevention.

1. Anterior Cruciate Ligament (ACL) Injuries

ACL injuries are among the most prevalent ski injuries. The ACL is a crucial ligament in the knee that helps stabilise the joint. Skiing often involves rapid direction changes and sudden stops, which can lead to ACL tears or strains.

Causes:

ACL injuries typically occur during falls, awkward landings, or sudden twisting movements while skiing. A study by Grooms et al. (2013) indicated that female skiers are at a higher risk due to anatomical and hormonal factors.

2. Meniscus Tears

The meniscus is a C-shaped cartilage in the knee that acts as a cushion. Skiing can lead to meniscus tears, especially during twisting motions or heavy impacts.

Causes:

Meniscus injuries often result from awkward falls or excessive twisting of the knee joint during skiing. According to a study by Vail et al. (2015), these injuries are common in combination with ACL tears, further complicating rehabilitation.

3. Shoulder Injuries

Shoulder injuries, including dislocations and rotator cuff strains, are common in skiing, particularly among beginners. The shoulder is often injured during falls, especially when an individual attempts to break their fall with an outstretched arm.

Causes:

Falls resulting in inadequate bracing can cause shoulder dislocations and strains. A study by Karp et al. (2014) noted that shoulder injuries in skiing are often overlooked compared to lower limb injuries.

4. Wrist Injuries

Wrist injuries are prevalent among skiers, particularly those who use poles. Common injuries include sprains and fractures.

Causes:

Skiers often extend their hands to catch themselves during falls, leading to wrist impact injuries. Pollard et al. (2016) discussed how the use of ski poles can both aid in balance and increase the likelihood of wrist injuries.

5. Lower Back Pain

Lower back pain is a common complaint among skiers of all skill levels. The sport places significant demand on the back muscles and spine, which can lead to strains or chronic pain.

Causes:

Improper technique, lack of conditioning, and fatigue can contribute to lower back injuries. Rahl et al. (2012) highlighted the importance of strength training and conditioning to prevent these injuries.

Prevention Strategies

While not all injuries can be prevented, certain strategies can significantly reduce the risk:

1. Proper Equipment: Ensure that your ski equipment is the correct size and well-maintained.

2. Warm-Up and Conditioning: Engage in pre-skiing warm-up exercises that focus on flexibility and strength.

3. Technique Training: Take lessons, especially for beginners, to learn the proper techniques for safe skiing.

4. Safety Gear: Wear protective gear, including wrist guards and knee pads when necessary.

Conclusion

Skiing injuries can vary in severity and type, but understanding common injuries and their causes can help skiers take preventive measures. By focusing on proper technique, conditioning, and appropriate equipment, skiers can enjoy their sport while minimising the risk of injury. If injuries occur, timely physiotherapy intervention is essential for effective recovery and rehabilitation. Get in touch today to find a specialist Physio at Chelmsford Physio to help you!

Waiting for the NHS? Could Private Physio Offer the Speed and Quality You Need?

Thu, 19 Feb 2026 17:39:27 GMT

When it comes to addressing physical injuries or pain, timely access to physiotherapy can make a significant difference in recovery outcomes. While the NHS provides essential health services, long waiting times can often hinder immediate relief. This is where private physiotherapy enters the frame as a viable alternative. Here are several benefits of opting for Chelmsford Physio over waiting for NHS services.

1. Faster Access to Treatment

One of the most compelling reasons to choose Chelmsford Physio is the speed of access to treatment. NHS physiotherapy services often involve lengthy waiting lists, sometimes extending weeks or even months. In contrast, private practitioners can offer prompt appointment scheduling, enabling you to start your rehabilitation without delay. For acute injuries or pain, this rapid access can be vital for effective recovery.

2. Bespoke/Individualised Treatment Plans

Chelmsford Physio have more time to devote to each patient due to lower caseloads. This allows for comprehensive assessments of 45 minutes, rather than the 20 minutes session on the NHS, and the formulation of personalised treatment plans tailored to individual needs. In a private setting, you can expect a thorough evaluation that takes into account your medical history, lifestyle, and specific goals, leading to a more effective recovery plan.

3. Direct Communication

At Chelmsford Physio, the communication gap that sometimes exists in NHS settings is significantly reduced. You will typically work directly with the same physiotherapist throughout your treatment, fostering a stronger therapeutic relationship. This direct communication can enhance your understanding of your condition and improve adherence to rehabilitation protocols, leading to better outcomes.

4. Flexible Appointment Times

Chelmsford Physio offer flexible scheduling options, including evenings and weekends. This adaptability means you can fit your appointments around your work or personal commitments, making it easier to prioritise your health without disrupting your daily routine.

5. Access to Advanced Treatments and Techniques

Chelmsford Physio invest in the latest technologies and treatment techniques. Whether it’s advanced manual therapy, acupuncture, or cutting-edge modalities like shockwave therapy & VALD assessment tools. Chelmsford Physio have access to resources that can accelerate your recovery & track your progress objectively. This allows for a more holistic approach to treatment that can cater to specific conditions effectively.

6. Greater Availability of Specialised Care

If your condition requires specialised attention (such as sports injuries, pelvic health, or neurological rehabilitation), Chelmsford Physio offers the advantage of specialised practitioners. You can choose a physiotherapist with the expertise relevant to your specific needs, which may not be readily available through NHS services.

7. A Tried and Tested Service

At Chelmsford Physio, we have over 650 5-star reviews. This isn't just a number to us; it’s a reflection of the speed and quality that our patients simply couldn't find elsewhere. See what they are saying about us below:

Get in Contact Today:

By choosing Chelmsford Physio, you are investing in a faster return to the activities you love, backed by a community of 650+ people who have already seen the difference that private, quality-driven care makes. To get your issue sorted don’t hesitate to get in touch with us:

Tel: 01245 895410

Email: hello@chelmsfordphysio.co.uk

Unlocking Elite Performance with VALD Dynamo Strength Testing at Chelmsford Physio

Tue, 10 Feb 2026 16:59:12 GMT

At Chelmsford Physio , we are proud to bring world-class technology to our patients and athletes with the VALD Dynamo Strength Testing System — the world’s most advanced handheld dynamometer and inclinometer. Whether you’re a professional athlete or an active individual striving for better performance, Dynamo provides precise data that helps tailor training and rehabilitation programmes like never before.

What is the VALD Dynamo?

The Dynamo Plus is a handheld, modular device that measures over 300 types of strength and range of motion (ROM) tests. Thanks to its smart attachments and integrated display, Dynamo makes accessible musculoskeletal measurement easy and efficient for both clinicians and patients.

But what exactly do dynamometer and inclinometer mean?

Dynamometer – A tool that measures strength and power output.

Inclinometer – A tool that measures joint angles and range of motion.

By combining these functions, the VALD Dynamo gives accurate baseline data on muscular strength and joint movement — data that is crucial for creating targeted training and rehab plans.

What Does This Mean for Chelmsford Physio Patients?

For many clients, it’s about more than just recovery — it’s about achieving peak performance. Whether you’re a competitive athlete or simply someone striving to be the best version of yourself, understanding where you are right now is essential to moving forward effectively.

Using VALD Dynamo , our clinicians can:

Assess baseline strength and movement specific to your sport or activity.
Identify imbalances, weaknesses, or limitations that may be holding you back.
Create individualised Strength & Conditioning (S&C) programmes tailored to your needs, goals, and physical status.

By grounding your programme in data, we ensure nothing is left to chance. You’ll be training in a way that’s specifically suited to your body, sport, and goals — whether that’s enhancing speed and power, improving recovery from injury, or simply taking performance to the next level.

Trusted by Elite Athletes – Now Available to You

The VALD Dynamo is used by some of the world’s top-performing athletes, including:

Football players moving from non-league to Premier League.
World-class tennis players competing on the global stage.
Formula 1 drivers pushing the limits of human performance.

Now, Chelmsford Physio brings this elite technology to our local community, making it accessible to everyone from weekend warriors to aspiring professionals.

The Process: Test, Train, Re-Test

Initial Testing – We establish baseline strength and movement data using VALD Dynamo.
Programme Creation – Based on your unique results, we design a custom performance or rehab programme.
Progress Monitoring – Regular check-ins and follow-up tests to ensure you’re progressing effectively.
Final Re-Test – After a periodised programme, we re-test to compare progress from baseline, giving you tangible evidence of improvement.

Why Choose VALD Dynamo Strength Testing?

Data-Driven Training: Programmes based on accurate strength and movement assessments, not guesswork.
Objective Progress Tracking: See real numbers that show your improvement over time.
Personalised Programmes: Tailored to your sport, goals, and current capabilities.
Injury Prevention: By identifying weaknesses, we help reduce the risk of injury.
Elite-Level Support: The same technology used by top athletes, now available to you.

Ready to Unlock Your Potential?

Whether you want to improve sports performance, rehabilitate from injury, or simply move and feel better, VALD Dynamo Strength Testing at Chelmsford Physio gives you the edge you need to succeed.

Contact Chelmsford Physio today to book your assessment and start your journey to elite performance.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Strength Testing: How Strong Are Your Hip Muscles?

Tue, 10 Feb 2026 14:50:22 GMT

Healthy hip muscles are crucial for balance, stability, and overall mobility. Whether you're an athlete, or simply someone looking to maintain a healthy lifestyle, the strength of your hip muscles plays an integral role. Here, we'll explore some simple ways to assess and enhance the strength of your hips with key exercises.

Why Focus on Hip Strength?

Hip muscles support the pelvis and spine, help in movements like walking, running, and bending, and are essential for maintaining balance. Weak hip muscles can lead to a higher risk of injuries, lower back pain , and imbalances in bodily movements. Strengthening these muscles better athletic performance, improved daily functioning, and reduced pain.

Testing Your Hip Strength

Before diving into strengthening exercises, it's beneficial to assess the current strength of your hip muscles. This can highlight any imbalances or areas needing attention. Here are some simple tests and exercises that you can try:

1. Front Plank with Leg Lift

The front plank is a core-strengthening exercise that also engages your hip muscles. To add a challenge:

Start in a standard plank position.
Lift one leg off the ground and hold.
Aim to maintain this position for more than 30 seconds on each side.

This variation not only tests your abdominal and hip muscle strength but also checks for balance and endurance.

2. Side Plank for Abductors and Glutes

This exercise focuses on the outer thigh and glute muscles:

Begin in a side plank position.
Elevate your top leg and hold the position.
See if you can maintain this for more than 30 seconds on each side.

Elevating the leg increases the challenge, helping to strengthen key hip muscles.

3. Side Plank for Adductors

To target the inner thigh muscles:

Start in a side plank position similar to the abductor exercise.
This time, focus on keeping your form tight while raising your top leg.
Aim for holding this position for over 30 seconds on each side.

This exercise is excellent for strengthening the adductors, which are critical for hip stability and alignment.

4. Bridge with Leg Lift

The bridge is a well-known exercise for the glutes and lower back:

Lie on your back with your knees bent and feet flat on the ground.
Lift into a bridge position, then raise one leg.
Hold this position for more than 30 seconds on each side.

This tests and builds your glute and hamstring strength, supporting the lower back and hips.

Strengthening Your Hip Muscles

If you discover any weaknesses during these tests, don't worry! These exercises are not only good for testing but also for strengthening your hips. Regular practice can help build endurance and muscle, improve balance, and prevent injuries.

When to Seek Professional Help

If you're struggling with hip pain or finding it challenging to perform these exercises, professional guidance can be invaluable. Seeking advice from a physiotherapy expert can provide tailored exercises and support to enhance your hip strength safely and effectively.

Contact Chelmsford Physio

For more advice on hip strength or if you need personalised assistance, don't hesitate to reach out. Contact Chelmsford Physio today, and let's work together to keep your hips strong and functional, supporting a happy, active lifestyle.

Strength Testing: How Strong Are Your Quads?

Tue, 10 Feb 2026 11:03:12 GMT

Single-leg squats are a fantastic way to test your strength and balance, especially following an injury like an ACL reconstruction . A study by Culver et al. (2016) found that patients who could perform at least 22 repetitions of single leg squats after ACL surgery had better knee-related outcome scores and improved quality of life at both 1 and 3 years post-op, compared to those who couldn't.

Why Single-Leg Squats?

This exercise isn't just for those recovering from injury . Single-leg squats are a powerful tool for anyone looking to improve strength, stability, and performance, particularly in sports. The movement challenges your leg muscles while also engaging your core and promoting balance, making it a comprehensive test of functional strength.

How to Test Your Strength

Take a moment to see how many single-leg squats you can do. To make it even more effective, compare your right and left leg performance:

How many can you do on each leg?

Is there a difference between your right and left leg?

A significant difference between the two sides could indicate a muscle imbalance, which may affect your performance or put you at risk for injury.

Ready to give it a try? Check out the video below for guidance:

Start today and use single-leg squats as a key part of your strength capacity testing and overall fitness routine. Whether you're recovering from an injury or aiming to optimise your sports performance, this simple exercise offers profound benefits!

Josh’s Journey to be a Chartered Physio

Tue, 27 Jan 2026 21:31:51 GMT

My journey to become a qualified Physiotherapist began with a desire to build on my existing experience in sport and private practice. Over the past two years, I’ve had the opportunity to complete a variety of placements, including stroke, respiratory, community rehabilitation and two musculoskeletal placements - one of which specialised in post-operative care. Each placement challenged me in different ways and enabled me to develop a deeper appreciation for patient-centred care across a range of settings. Throughout this time, I’ve been able to build on the skills I gained as a Sports Therapist while learning new approaches that have shaped a more holistic view of health and rehabilitation. Combining the strengths of both degrees has really helped me grow as a professional. The past two years have taught me invaluable clinical, professional, and personal lessons, and I truly believe they have played a key role in shaping me into a well rounded Physiotherapist.

Strength Program for Marathon Prep

Mon, 12 Jan 2026 15:25:11 GMT

Preparing for a marathon is a journey that involves more than just clocking up miles. Getting stronger plays a crucial role in enhancing your endurance and preventing injuries.

This guide provides a simple yet effective leg strength program tailored for marathon runners.

Why Strengthen Your Legs?

Strong legs are essential for marathon runners. They help in maintaining stability, improving running efficiency, and reducing the risk of injury.

By focusing on these muscles, you can improve your overall performance and endurance.

Simple Exercises to Build Leg Strength:

Chair Squats

How to Perform:

Stand in front of a chair with your feet shoulder-width apart. Lower your body as if to sit, then stand back up.
Aim for 3-4 sets 15-20 reps
Benefits: This exercise targets your quadriceps and glutes, crucial for power and stability.

Reverse Lunges

How to Perform:

Step back with one leg and lower your body until the front thigh is parallel to the floor. Return to the starting position and repeat with the other leg.
Aim for 3-4 sets of 6-8 reps L&R
Benefits: Reverse lunges are great for working the hamstrings and glutes, improving balance and coordination.

Bridge Drills

Bridge drills are great exercises to improve strength through the posterior chain of muscles. Aim for single leg holds, and try to build up your hold time to 30-40 secs on each side.

Calf Raises

Strengthen the lower part of your legs, and are possibly the most important part of the body to strengthen for running. You could start with some single leg calf raises and try to work on 3 sets to fatigue L&R.

We have written a specific blog on the importance of calf exercises for runners , with further information and a more specific advice/recommendations for exercise.

Additional Exercises:

Leg Presses : Target multiple leg muscles.
Hamstring Curls : Focus on the back of the thigh.

Incorporating Strength Training into Your Routine

Frequency: Aim for at least two strength training sessions per week.
Duration: Each session should last around 20-30 minutes.
Progression: Gradually increase the intensity, load and volume of your workouts.

Balancing Running and Strength Training

It's important to find a balance between running and strength training. Overdoing either can lead to fatigue and injury. Listen to your body and adjust your training accordingly.

To start with it might be sensible to perform your strength exercises on non running days. So your weekly plan might have 3-4 days for runs, and 2 days assigned for the strength exercises.

Conclusion

Strengthening your legs is a vital part of marathon preparation. The exercises mentioned are easy to incorporate into your routine and can significantly improve your running performance. Remember, consistency is key, and it's important to listen to your body to avoid overtraining.

For personalised advice and support, don't hesitate to contact Chelmsford Physio . Our team is dedicated to helping you achieve your marathon goals with tailored physiotherapy treatments in and around Chelmsford, Essex.

Possibly The Single Most Important Exercises for Any Marathon Runner

Mon, 12 Jan 2026 14:59:10 GMT

Marathon running is a test of endurance, strength, and mental fortitude. For runners preparing for this challenge, focusing on specific muscle groups is essential for optimal performance and injury prevention.

Among these, the calf muscles play a pivotal role. In this blog, we will explore the most effective calf exercises for marathon runners.

Understanding the Role of Calves in Running

Before delving into the exercises, it's crucial to understand why calf strength is vital for marathon runners. Your calf complex muscle will absorb an internal force of up to 8x your body weight on every step you take when running.

Strengthening these muscles ensures better endurance and reduces the risk of injuries such as calf strains or Achilles tendonitis.

Key Calf Exercises for Marathon Runners

1) Seated Calf Raise

The seated calf raise targets the soleus muscle, a vital component for long-distance running.

How to Perform:

Start with 3 sets of 10-12 reps with both legs.
As you build strength, aim for 20 reps.
Once achieving this, progress to single-leg raises to intensify the exercise.

2) Standing Straight Knee Calf Raise

This exercise focuses on the gastrocnemius muscle, crucial for explosive movements.

How to Perform:

Begin with 3 sets of 10-12 reps using both legs.
Work up to performing 20 reps.
Then, move to single-leg raises for a more challenging workout.

3) Standing Bent Knee Calf Raise

The standing bent knee calf raise also targets the soleus muscle but in a different position, offering a comprehensive muscle workout.

How to Perform:

Start with 3 sets of 10-12 reps using both legs.
Progress to 20 reps.
Then, transition to single-leg raises for increased intensity.

4) Loaded Toe Walks

Loaded toe walks help improve balance and strength in the calves.

How to Perform:

Choose a challenging weight.
Aim for 30 steps, 15 with the right leg and 15 with the left, moving slowly.
Repeat for 3 rounds.

5) Isometric Calf Hold on Leg Press

Isometric exercises are excellent for building strength and endurance.

How to Perform:

Find a challenging weight on the leg press.
Hold your heel off the plate for 6-8 seconds.
*Perform this on 3-4 times on both sides, alternating from left to right.
Repeat for 3 rounds.

Tips for Effective Training:

Progress Gradually: Avoid overexertion by gradually increasing reps and intensity.
Consistency is Key: Regularly perform these exercises to see improvements.
Listen to Your Body: If you experience pain beyond normal muscle fatigue, rest and seek professional advice.

Combining Exercises with Overall Marathon Training

While calf exercises are crucial, they should be part of a broader training plan that includes cardio, strength training, flexibility exercises, and adequate rest. Balancing these elements is essential for a holistic approach to marathon preparation.

Maybe look to work on 2/3 of the exercises above in a strength session. Aim for 2 strength sessions per week, with additional exercises for other muscle groups.

When to Seek Professional Help

If you're experiencing persistent pain or have concerns about your training regimen, professional guidance can be invaluable. At Chelmsford Physio, we're equipped to assist with tailored advice and physiotherapy treatment.

Conclusion

Strengthening your calves is a crucial aspect of marathon preparation, offering benefits in endurance, speed, and injury prevention. By incorporating these exercises into your routine, you can significantly enhance your running performance.

Remember, each runner's body is unique, and what works for one may not work for another. Therefore, it's essential to tailor your training to your individual needs and capabilities.

For personalised advice and professional physiotherapy services, feel free to contact Chelmsford Physio. We're here to support your journey to becoming a stronger, more resilient marathon runner.

Preparing for a Marathon: The Importance of Running Slow

Wed, 24 Dec 2025 16:08:29 GMT

Training for a marathon is not just about pushing yourself to the limits; it's also about understanding the value of slowing down. This might sound counterintuitive, but running slowly can be a vital component of your marathon preparation. Let's explore why and how to incorporate it effectively into your training regimen.

Understanding the Benefits of Slow Running

Why Slow Down?

Slow running plays a crucial role in building endurance, improving your recovery, and reducing the risk of injury. It allows your body to adapt to long distances, ensuring you're marathon-ready.

Building Endurance

Running at a slower pace increases your body's efficiency in using fat as a fuel source, which is essential for long-distance running. It also helps in improving cardiovascular health without overstraining the heart.

Top Tips for Effective Slow Running

1. Monitoring Your Heart Rate

Using a heart rate monitor is an excellent way to ensure you're running at the right pace. Aim for a heart rate of around 130-150 beats per minute. If you find your heart rate rising above 165 BPM it's a sign to slow down.

2. Rate of Perceived Exertion (RPE)

The RPE scale is a simple yet effective tool to measure your effort level. On a scale of 0 to 10, where 0 is no effort and 10 is maximum effort, your long slow runs should be at about a 3. This level ensures you are training effectively without overexerting.

3. The Talk Test

A practical and straightforward method is the talk test. If you find yourself struggling to maintain a conversation while running, you're likely going too fast. Slow down until you can comfortably talk.

Integrating Slow Running into Your Training

Creating a Balanced Schedule

Mix slow runs with intervals of faster running or other types of training. This variety not only keeps your regimen interesting but also challenges your body in different ways.

Listening to Your Body

Always be attentive to what your body tells you during training. If you're feeling overly fatigued or in pain, it may be a sign to take it easy.

The Importance of Calf Exercises

Preventing Injuries

Incorporating calf exercises into your routine is crucial for preventing injuries. Strong calf muscles support your legs during long runs and help in maintaining a good running form.

Complementing Slow Running

Calf strengthening exercises complement slow running by building the necessary muscle endurance. This combination significantly reduces the risk of injuries and prepares your body for the demands of a marathon.

Conclusion

Remember, marathon training is a journey that requires patience, dedication, and a smart approach. Incorporating slow running into your training schedule is an effective way to build endurance, prevent injuries, and prepare your body for the challenge ahead.

Ready to Start?

If you're gearing up for a marathon and need expert guidance, Contact Chelmsford Physio. We are here to support you every step of the way with tailored advice and physiotherapy treatment to enhance your training and ensure you're race-ready.

3 Essential Exercises For Runners to Prevent & Help With Shin Splints

Wed, 24 Dec 2025 11:39:52 GMT

Shin splints, also known as medial tibial stress syndrome, is a common condition that affects runners and other athletes who engage in high-impact activities. It's characterised by pain along the inside of the shin bone, and can be caused by a number of factors, including overuse, poor footwear, and muscle imbalances.

Fortunately, there are several exercises that can help alleviate the pain and prevent further injury. Here are the three of the best exercises for shin splints:

1. Toe Raises

Toe raises are a simple yet effective exercise for strengthening the muscles in the front of the lower leg, which can help reduce the strain on the shinbone. To perform toe raises, stand with your feet hip-width apart and slowly raise up onto the balls of your feet, then lower back down. Aim for three sets of 15 repetitions, gradually increasing the number of sets as your strength improves.

2. Heel Drops

Heel drops can help strengthen the muscles in the back of the lower leg, which can also help reduce the strain on the shinbone. To perform heel drops, stand on a step or other elevated surface with your heels hanging off the edge, then slowly lower your heels down as far as you can, then raise back up onto your toes. Aim for three sets of 15 repetitions, gradually increasing the number of sets as your strength improves.

3. Wall Stretch

The wall stretch is a simple stretch that can help improve flexibility in the calf muscles, which can also help reduce strain on the shinbone. To perform the wall stretch, stand facing a wall with your hands on the wall at shoulder height. Step one foot back and press your heel into the ground, keeping your knee straight. Hold the stretch for 15-30 seconds, then switch legs and repeat.

Incorporating these exercises into your routine can help you manage and prevent shin splints. However, it's important to consult with a Physiotherapist or other healthcare professional if you experience persistent or severe pain, as there may be underlying issues that require further attention.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Role of Physiotherapy in Laryngeal Disorders & TMJ Dysfunction for Singers, Coaches, and Teachers

Mon, 15 Dec 2025 18:37:01 GMT

As a singer, coach, or teacher, your voice is your most vital tool. However, issues related to the larynx or temporomandibular joint (TMJ) can hinder your vocal performance, causing discomfort and impacting your ability to communicate effectively.

Understanding Laryngeal Disorders

Laryngeal disorders can arise from various causes, including trauma, neurological conditions, overuse, disease, or infections. Common issues include vocal cord nodules, odema, and paralysis. These conditions can lead to hoarseness, voice loss, and swallowing difficulties.

Understanding TMJ Dysfunction

TMJ dysfunction occurs when there are problems with the jaw joint and surrounding muscles. Symptoms can include pain in the jaw, neck, and head, difficulty opening the mouth, clicking or popping sounds, and even earaches. These issues can significantly affect vocal quality and range, making it crucial for those who rely on their voices to address them promptly.

The Physiotherapy Approach

Physiotherapy offers a holistic method to manage your Larynx & TMJ dysfunction, focusing on hands-on assessment and treatment to alleviate pain and restore proper function.

Here’s how physiotherapy can help:

1. Comprehensive Assessment:

A qualified physiotherapist will begin with a thorough assessment of your Larynx & TMJ, including:

Posture Evaluation: Understanding how posture affects jaw alignment and tension in surrounding muscles.

Range of Motion Tests: Assessing how well you can open your mouth and move your jaw from side to side.

Muscle Palpation: Identifying areas of tenderness or tightness in the jaw, neck, and head.

2. Hands-On Treatment Techniques:

Once the assessment is complete, physiotherapists employ various hands-on techniques, such as:

Joint Mobilisation: Gentle movements to restore normal function to the TMJ.

Soft Tissue Release: Techniques aimed at relieving tightness in the jaw and neck muscles, improving flexibility and reducing pain.

Myofascial Release: A method targeting the fascia surrounding muscles to promote relaxation and reduce tension.

3. Intraoral Techniques:

For more targeted relief, physiotherapists may use intraoral techniques. This approach involves:

Intraoral Massage: Direct massage of the muscles inside the mouth can help release tension and improve muscle function.

Trigger Point Therapy: Identifying and releasing specific points in the muscles to reduce pain and discomfort.

4. Tailored Exercise Programs

Post-treatment, physiotherapists will create customised exercise programs designed to strengthen jaw muscles, improve flexibility, and enhance overall function. These exercises may include:

Jaw Range of Motion Exercises: To gradually increase mobility.

Stretching Exercises: To improve flexibility and reduce tightness in the jaw and neck.

Strengthening Exercises: Targeted workouts to stabilise the jaw and surrounding muscles.

5. Education and Self-Care

An essential aspect of physiotherapy is educating clients about self-care techniques to manage their Larynx & TMJ dysfunction. This may include:

Postural Training: Learning proper posture to minimise jaw strain.

Stress Management: Techniques such as breathing exercises or relaxation strategies to reduce muscle tension.

Voice Care Tips: Specific advice for singers and speakers on how to maintain vocal health.

Conclusion

TMJ dysfunction can be a formidable challenge for anyone who relies on their voice. However, with the support of physiotherapy—including hands-on assessment, targeted treatment, and tailored exercises—you can reclaim your vocal power. If you're a singer, coach, or teacher experiencing difficulties, consider seeking the assistance of a physiotherapist specialist. Your voice deserves to be heard!

By integrating physiotherapy into your routine, you can not only alleviate symptoms but also enhance your vocal performance, allowing you to communicate with clarity and confidence. Don’t let these issues silence your voice—take action today!

To book your consultation for Laryngeal Disorders & TMJ Dysfunction for singers call us on: 01245 895410

5 Top Tips for Training in the Winter Months

Tue, 25 Nov 2025 13:33:19 GMT

Next years success is built off this years winter training

Training during the winter months can be challenging due to cold weather, shorter days, and often treacherous conditions. However, with the right strategies, you can maintain your fitness routine and even enjoy the unique aspects of winter training.

Here are five top tips to help you stay motivated and safe while training in the cold.

1. Layer-Up

One of the most critical factors in winter training is how you dress. Wearing multiple layers allows you to regulate your body temperature effectively.

Base Layer: Start with a moisture-wicking base layer to keep sweat off your skin.
Insulating Layer: Add an insulating layer (like fleece or wool) to trap heat.
Outer Layer: Finish with a waterproof and windproof shell to protect against the elements.

Remember to also wear accessories such as gloves, hats, and thermal socks, as extremities are often the first to feel the chill.

2. Warm-Up Thoroughly

Cold muscles are more prone to injury, so a proper warm-up is essential. Spend extra time warming up your muscles before heading out. Try dynamic stretches and movements that mimic your training activity to increase blood flow and flexibility.

Examples: Leg swings, arm circles, and light jogging can help prepare your body for the workout ahead.

3. Adjust Your Training Schedule

With shorter daylight hours, it’s crucial to plan your workouts wisely. Consider training during the warmest parts of the day—typically late morning or early afternoon.

Safety First: If you must train in the early morning or evening, ensure you wear reflective gear and consider using a headlamp or flashlight to improve visibility and safety.

4. Stay Hydrated

It’s easy to forget about hydration when it’s cold, but your body still loses moisture through sweat and respiration.

Hydration Strategy: Carry a water bottle, and aim to drink fluids before, during, and after your workout. Consider warm beverages like herbal tea or electrolyte drinks to keep your body hydrated and warm.

5. Embrace Indoor Alternatives

Sometimes, the weather can be too harsh for outdoor training. Embrace indoor alternatives to maintain your fitness routine without risking your safety.

Options Include:

Gym Workouts: Utilise treadmills, stationary bikes, or group fitness classes.
Home Workouts: Explore online workout videos or apps that offer strength training, yoga, or cardio workouts you can do at home.
Bonus Tip: Stay Positive and Have Fun!

Winter training can be an opportunity to explore new activities, such as snowshoeing, skiing, or winter hiking. Embrace the season and focus on the unique experiences it offers.

Conclusion

Training in the winter months presents its challenges, but with the right strategies, you can stay active and enjoy your workouts. By dressing appropriately, warming up thoroughly, adjusting your schedule, staying hydrated, and exploring indoor alternatives, you can maintain your fitness and even find joy in winter training. So bundle up, head out, and make the most of the season!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Less Than 20 Weeks to go Until The London Marathon! Have You Got Your Training Plan Started Yet?

Tue, 25 Nov 2025 13:20:22 GMT

Conquering the Marathon: Under 6 Months to Go!

Embarking on the journey to conquer a marathon is a thrilling and rewarding challenge. It requires dedication, perseverance, and a well-structured training plan. With 4-5 months ahead of the race, you have ample time to prepare your body and mind for the incredible feat that lies ahead. In this blog, we will guide you through a comprehensive training program to help you reach the starting line with confidence and cross the finish line happy.

Month 1: Building a Solid Foundation

The first month of marathon training focuses on building a solid foundation of fitness. Begin by establishing a consistent running routine, gradually increasing your weekly mileage. Aim for three to four runs per week, including a mix of shorter, easy-paced runs and a longer run on the weekends. This will help your body adapt to the demands of running and improve your endurance gradually

It's also crucial to incorporate cross-training activities such as cycling, swimming, and at least 1 strength session to enhance performance and reduce injury risk. Don't forget to prioritise rest and recovery days to allow your body to adapt and rebuild

Month 2-3: Increasing Endurance

During the second and third months, the focus shifts towards increasing your endurance. Gradually increase your long run distance by approximately 10%-20% each week, while maintaining your regular weekly mileage. This progressive overload will challenge your body to adapt and improve its aerobic capacity

Incorporate tempo runs and interval workouts into your training regimen to enhance speed and stamina. Tempo runs involve running at a comfortably hard pace for a sustained period, while intervals involve alternating between high-intensity bursts and recovery periods. These workouts will improve your lactate threshold and boost your overall performance.

Month 4-5: Fine-tuning Performance

As you approach the halfway mark of your training, it's time to fine-tune your performance. This phase involves incorporating race-specific workouts to simulate the demands of the marathon. Include regular long runs at your goal race pace to familiarise your body with sustaining that intensity over a longer distance.

Additionally, practice running on different terrains and gradients, as this will prepare your muscles for the challenges of the race course. Don't forget to continue cross-training and strength training to maintain overall fitness and prevent imbalances.

Month 6: Tapering and Mental Preparation

The final month leading up to the marathon is all about tapering and mental preparation. Reduce your training volume and intensity gradually to allow your body to recover and reach its peak performance on race day. Focus on maintaining your fitness level rather than making significant gains

Use this time to fine-tune your race-day strategy, visualise success, and practice mental techniques such as positive self-talk and mindfulness. Develop a comprehensive race-day plan, including nutrition, hydration, and pacing strategies, and practice it during your long runs

Don't neglect your overall well-being during this time. Prioritise sleep, healthy nutrition, and stress management to ensure you arrive at the starting line feeling refreshed and ready to conquer the marathon

Conclusion:

Training for a marathon is a transformative journey that requires commitment and discipline. With six months ahead of the race, you have the opportunity to build a solid foundation, increase your endurance, fine-tune your performance, and mentally prepare for the challenge. Remember to listen to your body, adjust your training as necessary, and seek professional guidance if needed. Embrace the process, stay consistent, and trust in your training. When race day arrives, you'll have the confidence and preparation to cross that finish line and achieve your marathon dreams. Good luck!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Megans Fantastic Year, From the London Marathon to Representing Essex

Tue, 25 Nov 2025 10:55:00 GMT

2025 - The year of testing myself!

Since the moment I got the news of my London Marathon place back in June 2024, my mindset changed to trying some new distances in my sport. To summarise my main achievements this year:

•⁠ ⁠Completed my first half marathon with a 3rd place finish in Chelmsford

•⁠ ⁠⁠Completed first (London) Marathon in 3hrs 11 mins

•⁠ ⁠Entered first 5 mile race, and won the Essex title

•⁠ ⁠⁠Entered first 10k and qualified for a road county vest

•⁠ ⁠⁠PB in 10k for Essex in 37 mins 8 seconds

•⁠ ⁠⁠Winning the XC league for senior women 2024/25

I am proud of my achievements but it’s never easy and there’s always fire in the belly to keep pushing myself. The smiling pictures and medals do not always show behind the scenes. I’m out every week, no matter the weather or fatigue from a long day at work. I consistently work 6 days per week and am squeezing in sessions in the dark early mornings or dragging myself out in the evenings. Running is something that brings me joy and the peace of being outdoors, exploring and seeing nature. Despite this, I have days where I drag myself out with zero motivation because I know the runner's high will be worth it. I’m under no illusion the mentality gets me so far in the sport, especially grinding out the pain in each race.

I’m now excited to see what 2026 has to bring. We’re just going into the cross country season where i’ve already been lucky enough to secure an Essex vest for intercounties. Maybe i’ll try another distance or experiment with something different. This sport has so much to bring and never fails to disappoint!

If you are ever wanting to chat running i’m definitely the person to do it with…

The Benefits of Joining a Gym in December: Get a Head Start on Your New Year Goals

Tue, 25 Nov 2025 09:40:09 GMT

As the holiday season approaches, many people are focused on festivities, family gatherings, and year-end celebrations However, December can also be the perfect time to start a fitness journey by joining a gym. While most individuals wait until January to kick off their New Year resolutions, signing up in December offers several unique advantages. Here’s why you should consider making that commitment now.

1. Less Crowded Facilities

One of the most significant benefits of joining a gym in December is the reduced crowd size. Most people delay their fitness goals until the New Year, meaning you’ll have more space and access to equipment. This allows you to settle into your new routine without the intimidation of large crowds or long wait times for machines.

2. Establishing a Routine Early

By starting your gym membership in December, you give yourself a head start on establishing a regular workout routine. This early commitment allows you to integrate exercise into your schedule before the New Year rush. When January arrives, you’ll already be accustomed to working out, making it easier to maintain your momentum.

3. Holiday Stress Relief

The holiday season can be a stressful time, with shopping, social obligations, and family gatherings. Exercise is a well-known stress reliever, and joining a gym gives you a dedicated space to unwind and focus on your health. A good workout can help clear your mind and improve your mood, making the holidays more enjoyable.

4. Access to Year-End Promotions & Deals

Many gyms offer promotions and discounts during the holiday season to attract new members. By joining in December, you can take advantage of these deals, including reduced membership fees, waived signup costs, or special offers on personal training sessions. It’s a great way to ensure you get the best value for your investment, and you could probably get a free month's training in December.

5. Social Opportunities

December is a time for socialising, and many gyms host holiday-themed classes or events. Participating in these activities helps you meet new people and makes your fitness journey more enjoyable. Building a community within the gym can provide you with accountability and support, which are crucial for long-term success.

6. Setting Realistic Goals

With the holiday season in full swing, it’s essential to be realistic about your fitness goals. December allows you to set achievable targets without the pressure of drastic changes. Use this month to focus on building healthy habits, such as consistent workouts and balanced nutrition, rather than aiming for dramatic transformations.

7. Kickstart Your New Year Resolutions

Starting your gym journey in December allows you to get a jump on your New Year resolutions By the time January arrives, you will already be on your way to achieving your fitness goals. This head start can give you the confidence and motivation to continue your efforts throughout the year.

8. Focus on Health & Wellness

Finally, joining a gym in December shifts your focus from holiday indulgence to health and wellness. Rather than waiting until January to make healthier choices, you can begin prioritising your physical fitness now. This proactive approach can lead to a more balanced and fulfilling holiday season.

Conclusion

December is often viewed as a time for celebration and relaxation, but it can also be the perfect opportunity to invest in your health. By joining a gym this month, you can enjoy the benefits of less crowded facilities, early routine establishment, and holiday stress relief while taking advantage of promotions and social opportunities. Don’t wait until January—start your fitness journey now and set yourself up for success in the New Year!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Benefits of a Game Ready Machine for Knee Injury Recovery

Tue, 28 Oct 2025 15:36:31 GMT

Recovering from a knee injury or surgery can be a challenging journey, often involving physical therapy, pain management, and rehabilitation exercises. One innovative tool that has gained popularity in recent years is the Game Ready machine. This device combines cryotherapy (cold therapy) and compression to support recovery. Here, we explore the benefits of using a Game Ready machine for knee injuries and post-surgery rehabilitation.

What is a Game Ready Machine?

The Game Ready machine is a specialised device designed to deliver cold therapy and intermittent pneumatic compression simultaneously. It consists of a control unit connected to a wrap that fits around the injured knee. The machine cools the wrap while providing gentle compression, promoting blood flow and reducing swelling.

Key Benefits

1. Reduced Pain and Inflammation

One of the primary benefits of using a Game Ready machine is its ability to alleviate pain and reduce inflammation. Cold therapy numbs the area around the knee, providing immediate pain relief. The combination of cold and compression helps to minimise swelling, which is crucial during the initial recovery phase.

2. Enhanced Blood Flow

The intermittent compression provided by the Game Ready machine encourages blood circulation to the injured area. Improved blood flow is essential for delivering oxygen and nutrients to the tissues, promoting healing and recovery. This can be particularly beneficial after surgery when circulation may be compromised.

3. Faster Recovery Times

Studies have indicated that using a Game Ready machine can lead to quicker recovery times. By addressing pain and swelling effectively, patients can engage in rehabilitation exercises sooner, which is vital for regaining strength and mobility in the knee. Faster recovery can also reduce the overall rehabilitation period, allowing individuals to return to their daily activities more quickly.

4. Convenience and Comfort

The Game Ready machine is designed for ease of use, making it a convenient option for patients recovering at home. The wraps are adjustable and comfortable, allowing individuals to use the machine while resting, watching TV, or working. This promotes consistent use, which is key to maximising its benefits.

5. Versatility for Various Injuries

Whether recovering from a ligament tear, meniscus injury, or post-surgical knee repair, the Game Ready machine is versatile enough to accommodate various conditions. Its adjustable settings allow for customised treatment based on individual needs and comfort levels.

6. Improved Range of Motion

One of the common goals in knee rehabilitation is to restore range of motion. The Game Ready machine can aid in this process by reducing pain and swelling, enabling patients to participate in physical therapy exercises that promote flexibility and movement.

7. Safe and Non-invasive

Using a Game Ready machine is a non-invasive treatment option, making it a safe choice for individuals recovering from injuries or surgeries. Unlike medications that may have side effects, the cold and compression therapy is generally well-tolerated and can be used alongside other treatments.

Conclusion

The Game Ready machine offers a range of benefits for individuals recovering from knee injuries or surgeries. By effectively reducing pain and inflammation, enhancing blood flow, and promoting faster recovery, it plays a crucial role in the rehabilitation process. If you or a loved one is facing knee recovery, consider discussing the use of a Game Ready machine with your healthcare provider to explore how it can support a smoother and more efficient recovery journey.

Looking to rent our machine? Get in contact today!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Normatec Compression Therapy in Chelmsford

Tue, 28 Oct 2025 11:58:22 GMT

Recover faster, feel lighter, and boost circulation with Normatec Leg Recovery Sessions – now available to rent at Chelmsford Physio .

What Is Normatec Compression Therapy?

Normatec 3 Legs by Hyperice is an advanced recovery system designed to improve circulation, reduce muscle soreness, and speed up post-exercise or injury recovery. Using dynamic air compression, the leg sleeves mimic natural muscle pumping to boost blood flow, reduce inflammation, and flush out toxins.

Trusted by elite athletes and physios worldwide, Normatec is now available for rental at Chelmsford Physio , giving you the freedom to experience high-end recovery in the comfort of your own home.

Who Can Benefit from Normatec?

Normatec is ideal for:

Runners, cyclists & triathletes
Gym-goers and sports enthusiasts
Post-op or post-injury recovery
Individuals with heavy, tired, or swollen legs
People with poor circulation or lymphatic issues
Long-haul travellers or standing occupations

Whether you're training for an event or simply want to speed up your recovery between sessions, Normatec delivers.

Key Benefits:

Improves blood circulation
Reduces delayed onset muscle soreness (DOMS)
Aids lymphatic drainage and reduces swelling
Speeds up recovery after exercise or injury
Relieves leg fatigue from work, sport or travel
Supports recovery from surgery or immobility

Why Rent From Chelmsford Physio?

Trusted clinic with expert physios on hand
Professional guidance before rental
Clean, safe, and fully maintained equipment
Local support during your rental period
Convenient location at Riverside Leisure Centre

Ready to Recharge Your Recovery?

Take control of your recovery with the same technology used by top athletes. Whether you’re dealing with post-run fatigue or long-term swelling, Normatec Leg Compression Therapy offers a smart, non-invasive solution.

Enquire today about Normatec rentals at Chelmsford Physio.

Let our team help you recover faster and feel better — wherever you are.

Jon McComish PGc BSc (Hons)
Clinic Director & Chartered Physiotherapist

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Recover Faster with Game Ready Ice & Compression Therapy in Chelmsford

Tue, 28 Oct 2025 11:45:19 GMT

If you’re experiencing pain, swelling, or stiffness due to an injury, trauma, or surgery, our 360º approach to your health and well-being is designed to help you heal quicker—and get back to doing what you love.

As part of your personalised treatment plan at Chelmsford Physio , your clinician may recommend Game Ready Ice & Compression Therapy—a professional-level system now available to rent directly through our clinic.

What Is the Game Ready System?

The Game Ready system combines active cold therapy with compression treatment in one powerful, easy-to-use solution. It’s the same technology used by elite sports teams, athletes, and rehabilitation professionals to manage pain, reduce swelling, and speed up recovery.

Unlike traditional icing methods, the Game Ready machine delivers consistent cold therapy while applying intermittent compression, allowing deeper penetration into injured tissues. This helps target inflammation more effectively and provides faster, more complete recovery.

How It Works

The system uses a specially designed sleeve that wraps around the injured area. Cold water is continuously circulated through the sleeve in a loop, drawing out heat and reducing inflammation.

At the same time, the outer layer of the wrap inflates with air to provide compression. This combination helps limit swelling, improve lymphatic drainage, and mould the wrap closely to the body—optimising the effect of cold therapy.

Benefits of Game-Ready Therapy

Game Ready therapy isn’t just a fancy ice pack. It’s a proven medical-grade system with real physical benefits:

Reduces pain, swelling, and muscle spasms
Decreases inflammation at a deeper tissue level
Promotes faster healing and tissue regeneration
Improves oxygen and nutrient delivery to the affected area

Whether you’re recovering from surgery, managing a sports injury, or simply looking for a smarter way to reduce swelling and discomfort, Game Ready is a powerful addition to your rehab plan.

Is Game Ready Therapy Right for You?

Game Ready can support recovery from a range of conditions and procedures. It’s particularly effective for:

✅ Sports & Exercise Injuries

Struggling with a niggle or acute injury? Game Ready helps reduce downtime and improve resilience, so you can return to training stronger.

✅ Pre & Post-Operative Rehab

Planning surgery or already in recovery? This treatment can help prepare your body pre-op and accelerate healing post-op with less swelling and pain.

At Chelmsford Physio, our specialist clinicians integrate game-ready therapy into bespoke treatment programmes that put you at the centre. With no time limits on appointments, expert guidance, and access to premium technology like Game Ready, we give you the best possible chance of making a full recovery.

Want to Try Game Ready Therapy?

Now available to rent at Chelmsford Physio —ask your clinician if Game Ready is right for your injury or recovery plan.

Contact Chelmsford Physio to book your consultation or learn more.

Jon McComish PGc BSc (Hons)
Clinic Director & Chartered Physiotherapist

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Understanding the Link Between Antibiotics and Tendon Pain/injury:

Mon, 27 Oct 2025 15:49:28 GMT

A Physiotherapy Perspective

Antibiotics play a crucial role in treating bacterial infections, but emerging evidence suggests that certain classes of these medications may also contribute to tendon pain and injury. This blog post explores the relationship between antibiotics and tendon health, emphasising the importance for physiotherapists and patients alike to be aware of these potential side effects.

The Connection Between Antibiotics and Tendon Damage

One of the most well-documented associations is between fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, and tendon injuries. Research indicates that these antibiotics can increase the risk of tendon rupture, particularly in the Achilles tendon (Miller et al., 2014). The exact mechanism is still being studied, but several factors contribute to this phenomenon.

Mechanisms of Injury

1. Collagen Synthesis Inhibition: Fluoroquinolones may interfere with the synthesis and maintenance of collagen, which is vital for tendon structure and integrity (Bahr et al., 2020). This disruption can weaken tendons and make them more susceptible to injury.

2. Inflammatory Response: Antibiotics can induce an inflammatory response in tendons, leading to pain and swelling. This inflammation may be exacerbated by the underlying condition for which the antibiotic is prescribed (Aydin et al., 2020).

3. Tendon Metabolism Alteration: Antibiotics can affect tendon cell metabolism, potentially leading to changes in the mechanical properties of tendons, making them more prone to injury (Friedman et al., 2016).

Risk Factors for Tendon Injury

Certain populations are at a higher risk of tendon injury when taking antibiotics. These include:

- Older Adults: Age-related changes in tendon structure and function can increase susceptibility (Aydin et al., 2020).

- Individuals with Pre-existing Tendon Issues: Those with a history of tendon problems or underlying conditions such as diabetes may face an elevated risk (Miller et al., 2014).

- Concurrent Use of Corticosteroids: The combination of fluoroquinolones and corticosteroids significantly raises the risk of tendon rupture (Bahr et al., 2020).

Clinical Implications for Physiotherapists

As physiotherapists, understanding these risks is crucial for patient management. Here are some recommendations:

1. Patient Education: Inform patients about the potential risks of tendon injuries associated with certain antibiotics, especially fluoroquinolones.

2. Monitor Symptoms: Encourage patients to report any signs of tendon pain or discomfort during antibiotic treatment, particularly in high-risk individuals.

3. Exercise Modifications: Advise on modifications to exercise regimens that may help reduce tendon strain, particularly during antibiotic treatment.

4. Collaborative Care: Work closely with physicians to ensure that the benefits of antibiotic therapy outweigh the risks, especially in patients with known tendon issues.

Conclusion

While antibiotics are essential for treating infections, awareness of their potential side effects, particularly concerning tendon health, is vital for effective physiotherapy practice. By educating patients and monitoring their responses to treatment, physiotherapists can play a key role in preventing tendon injuries related to antibiotic use.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Shockwave Therapy at Chelmsford Physio

Tue, 14 Oct 2025 19:56:32 GMT

Shockwave therapy is a non-invasive treatment that uses sound waves to stimulate the body's natural healing process. The sound waves are focused on the injured area, and they help to increase blood flow, reduce inflammation, and break up scar tissue. This can lead to pain relief and improved function.

Shockwave therapy has been shown to be effective for a variety of conditions, including:

Achilles tendinopathy
Plantar fasciitis
Lateral epicondylitis (tennis elbow)
Golfer's elbow
Rotator cuff tendinopathy
Hip pain
Knee pain
Shoulder pain
Carpal tunnel syndrome

Shockwave therapy is generally well-tolerated, but it can cause some side effects, such as bruising, swelling, and pain. In rare cases, it can also cause more serious side effects, such as nerve damage.

If you are considering shockwave therapy , it is important to talk to your doctor or physical therapist. They can help you determine if shockwave therapy is right for you and can discuss the risks and benefits of the treatment.

Here are some additional details about how shockwave therapy works:

The sound waves used in shockwave therapy are low-energy and do not damage tissue.
The sound waves are focused on the injured area, which helps to deliver the maximum amount of energy to the target tissue.
The sound waves cause controlled micro-trauma to the tissue, which triggers the body's natural healing process.
The body's natural healing process includes increased blood flow, reduced inflammation, and break up of scar tissue.
This can lead to pain relief and improved function.

Shockwave therapy is a safe and effective treatment for a variety of conditions. If you are considering shockwave therapy, talk to your doctor or physical therapist to learn more about the treatment and to see if it is right for you.

If you would like to discuss shockwave therapy before booking in please call 01245 895410 email hello@chelmsfordphysio.co.uk and one of our team will contact you to discuss.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Shockwave Therapy?

Tue, 14 Oct 2025 19:35:52 GMT

Shockwave Therapy has become increasingly popular in physiotherapy clinics due to its clinical effectiveness in successfully treating a variety of musculoskeletal conditions.

Acoustic waves are delivered to targeted areas of the body, stimulating natural healing processes to reduce pain and improve tissue healing & function.

Shockwave therapy has been used to treat plantar fasciitis , Achilles tendinopathy , patellar tendinopathy, gluteal tendinopathy , and lateral epicondylitis (tennis elbow). It is typically administered in 3 sessions of 10-20 minutes each.

Shockwave therapy has been shown to be very effective in the treatment of chronic tendon pain. A study by Rompe et al. (2008) found that patients who received shockwave therapy had a significant reduction in pain and an improvement in function compared to those who received a placebo treatment. Wang et al. (2014) found similar results in a study of patients with patellar tendinopathy. A systematic review and meta-analysis of randomised controlled trials by van der Worp et al. (2013) found that shockwave therapy was effective for the treatment of patellar tendinopathy, Achilles tendinopathy, and lateral epicondylitis.

The exact mechanism of action of shockwave therapy is not fully understood, but it is thought to work by stimulating natural healing processes, increasing blood flow, and promoting the release of growth factors. These effects can lead to improved tissue healing and regeneration, ultimately reducing pain and improving function.

Several further studies have investigated the effectiveness of shockwave therapy for various musculoskeletal conditions. A systematic review and meta-analysis of randomi s ed controlled trials found that shockwave therapy was effective for treating plantar fasciitis, Achilles tendinopathy, and lateral epicondylitis (Buchbinder et al., 2018). Another systematic review and meta-analysis found that shockwave therapy was effective for treating patellar tendinopathy (van der Worp et al., 2013).

Shockwave therapy is generally considered safe, but some potential mild side effects have been reported, including bruising, swelling, and temporary pain or discomfort. Patients with certain medical conditions, such as pregnancy, cancer, and pacemakers, may not be suitable candidates for this treatment.

Overall, shockwave therapy is an excellent treatment modality in combination with an exercise program for chronic tendon pain.

In conclusion, shockwave therapy is a non-invasive treatment modality that has shown excellent results for the treatment of various musculoskeletal conditions. Further research is needed to fully understand the mechanism of action and to optimise treatment protocols.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Achilles Tendon Pain and Shockwave Therapy

Tue, 14 Oct 2025 07:07:44 GMT

Achilles tendinopathy is a common injury in sports men and woman, particularly in runners and in those who are generally on their feet for long periods of the day.

Interestingly the change of footwear from winter to summer seems to impact as well, although not proven. It is a strong and thick tendon, however when it comes under repeated stress with little recovery that it cannot tolerate it will break down and become painful.

This makes it weaker, along with the muscle unit (calf muscles) that serve it; and the first line of treatment for achilles tendon pain is a progressive rehabilitation programme which involves loading the muscle-tendon unit, and then the kinetic chain ( the rest of the muscles around it; Cook et al, 2018 ).

Generally this takes 12-16 weeks, along with managing the amount of load the tendon is subject to, and completing a graded return to activity. However, conservative management will prove to be inadequate for a subset of people with these symptoms ( Sayana et al, 2007 ). So what do we do with these people.

In the past maybe injection therapy would be investigated; steroid injections, plasma-rich platelet injections, high volume stripping injections have all been trialled with some positive and some negative outcomes but unfortunately potentially more risk than gain. And then there is surgery.

However, now we have another option…. Shockwave Therapy , Extra-Coroporeal Shockwave Therapy or ESWT for short is the application of high energy sound waves to human tissue ( Chung and Wiley, 2002 ).

It was originally used in the treatment of renal stones but recently has grown in the musculoskeletal world as more and more studies suggest effectiveness in tendon pain such as the achilles tendon, when other non-operative treatments have failed ( Mani-Babu et al, 2015 ). ESWT has been shown to be a safe and viable option before needing to think about the more invasive therapies such as injections and there have been no risks or major adverse effects noted during its use ( Saxena et al, 2011; Schmitz et al, 2015 )

The shockwaves create an inflammatory response, reduce the number of sensory free nerve endings, enhance blood flow and trigger the bodies pain control system ( d’Agostino et al, 2015 ).

A number of studies have shown that ESWT is an effective treatment for achilles tendinopathy ( Rompe et al, 2007; Rasmussen et al, 2008; Vahdatpour et al, 2018 ), with the recommendation being at a minimum of three months ( Al-Abbad et al, 2013 ).

A combination of ESWT and the rehab exercises - loading / strengthening was more effective than loading alone ( Rompe et al, 2009 ), and perhaps those under the age of 60 and those with achilles tendon pain for less than 12 months may benefit earlier ( Taylor et al, 2016 ).

Have achilles tendon pain, or any other tendon pain? Think this might help you? Give us a call on 01245 895410 to discuss.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Plantar Fascia Pain and Shockwave Therapy

Tue, 14 Oct 2025 03:56:33 GMT

The National Institute for Health and Clinical Excellence describes the medical name for this procedure as ‘extracorpeal Shockwave Therapy for refractory plantar fasciitis’. Extracorpeal means outside the body and refractory means that the condition does not respond to conventional treatments. The first course of action for plantar fascia pain remains a ‘settle it down, and build it backup approach’. We try to settle plantar fascia pain with activity modification, ice, self massage, stretching, heel supports…and then we try to strengthen and load it back into peak condition. However, should this fail, and some do, then Shockwave Therapy is a useful safe and effective alternative to try and kick start the healing process.

As discussed in our last blog, the shock waves are inaudible, high energy sound waves which create an inflammatory response, reduce the number of sensory free nerve endings, enhance blood flow and trigger the bodies pain control system ( d’Agostino et al, 2015 ).

The main factor for Shockwave Therapy success is a relief of symptoms, for which there is level evidence for its success ( Level 1 is the highest level of evidence; Speed, 2013 ). In a study (reference) of 172 patients, the average reduction in pain score at 3 months was greater in patients who had the procedure (112 patients_ than in those who had the treatment (56 patients). Another study (reference) who compared a placebo procedure found those that had the real thing had less pain after 3 months and didn’t need pain medication. And finally a long term study (reference) found that out of 149 patients, 69% who had the procedure reported ‘excellent’ results (no heel pain) after 64 months, whereas all the patients who did not have Shockwave Therapy reported some pain.

It is worth noting that although Shockwave Therapy is a safe treatment, there can be some side effects of pain after the treatment, normally lasting 24-48 hours and some skin reddening or bruising (reference, reference)

If you have been suffering with plantar fascia pain for a while, and you have tried all the other methods of ice, self massage, rest, stretching, strengthening, heel supports, pain relief and you are fed of the pain, then give us a call to discuss Shockwave Therapy. Or if you have not tried any of above then give us a call and we can develop a plan with you!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is the difference between Rheumatoid Arthritis (RA) and Osteoarthritis (OA)

Wed, 24 Sep 2025 11:03:34 GMT

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two prevalent forms of arthritis, each with distinct pathophysiological mechanisms and implications for physiotherapy treatment. Understanding these differences is crucial for physiotherapists in developing effective treatment plans tailored to individual patient needs.

Overview of Rheumatoid Arthritis and Osteoarthritis

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune condition characterised by chronic inflammation of the joints, which can lead to joint damage and systemic effects (Firestein et al., 2015). It typically presents symmetrically, affecting multiple joints, and is often accompanied by morning stiffness lasting more than 30 minutes (Scott et al., 2010). Patients with RA may also experience fatigue, fever, and malaise (Smolen et al., 2016).

Osteoarthritis

In contrast, osteoarthritis is primarily a degenerative joint disease resulting from wear and tear on the joints, leading to cartilage breakdown and changes in the underlying bone (D’Agostino et al., 2016). It commonly affects weight-bearing joints such as the knees, hips, and spine, and is characterised by pain that worsens with activity and improves with rest (Kellgren & Lawrence, 1952).

Treatment Goals

In physiotherapy, the goals for managing RA and OA differ significantly. For RA, the primary focus is on reducing inflammation and preserving joint function (Burgos-Vargas et al., 2015). In contrast, physiotherapy for OA emphasises pain management, improving joint mobility, and enhancing physical function through tailored exercise programs (Fransen et al., 2015).

Exercise Considerations

Rheumatoid Arthritis:

For patients with RA, exercise should be carefully monitored and may include low-impact activities such as swimming or cycling. Physiotherapists often employ range-of-motion exercises to maintain joint flexibility, alongside strengthening exercises to counteract muscle wasting due to inactivity (Bennell et al., 2011).

Osteoarthritis:

In OA, exercise is crucial for managing symptoms and improving quality of life. Evidence suggests that strengthening and aerobic exercises can significantly reduce pain and enhance function (Fransen et al., 2015). Physiotherapists may recommend weight loss strategies for overweight patients, as this can alleviate pressure on the affected joints (Benson et al., 2019).

Manual Therapy

Manual therapy techniques can also differ between the two conditions. In RA, joint mobilisations may be used cautiously during periods of disease activity, focusing on gentle techniques to alleviate pain and stiffness (López-Olivo et al., 2014). Conversely, in OA, manual therapy can be more aggressively applied to improve joint function and reduce stiffness (Beech et al., 2013).

Patient Education

Patient education is vital in both conditions but focuses on different aspects. In RA, education often emphasises the importance of medication adherence and recognising flare-up signs (Harrison et al., 2017). For OA, patients are educated on self-management strategies, including weight management and activity modification to prevent exacerbation of symptoms (Hawker et al., 2008).

Conclusion

In summary, while both rheumatoid arthritis and osteoarthritis present significant challenges for patients and healthcare providers, the physiotherapy approach must be tailored to the specific characteristics and needs of each condition. Understanding the differences in pathophysiology, treatment goals, and exercise considerations enables physiotherapists to provide effective, evidence-based care that enhances patient outcomes.

The Impact of Plyometric Exercises on Running Performance

Wed, 10 Sep 2025 10:30:37 GMT

Plyometric exercises, characterised by explosive movements that combine strength and speed, offer significant benefits to runners looking to enhance their performance. These exercises can improve running economy, speed, and overall athletic efficiency. This blog explores the mechanisms by which plyometrics enhance running performance and provides insights into effective training strategies.

What Are Plyometric Exercises?

Plyometric exercises involve rapid stretching and contracting of muscles, often referred to as the stretch-shortening cycle (SSC). This cycle consists of three phases: the eccentric phase, where the muscle is elongated; the amortisation phase, where the muscle transitions between lengthening and shortening; and the concentric phase, where the muscle contracts forcefully (Markovic & Mikulic, 2010).

Examples of plyometric exercises include:

Box jumps
Drop jumps
Bounding
Jump squats
Pogo Hops

Benefits of Plyometric Training for Runners

1. Improved Power and Speed

Plyometric training increases muscular power, which is crucial for sprinting and accelerating. According to a study by McBride et al. (2002), athletes who incorporated plyometric training into their routines exhibited significant improvements in vertical jump height and sprinting speed. This increased power translates into more efficient running, especially in short distances.

2. Enhanced Running Economy

Running economy refers to the amount of energy expended at a given velocity. Research indicates that plyometric training can lead to improvements in running economy, allowing runners to maintain a faster pace with less effort. A study by Paavolainen et al. (1999) found that incorporating plyometric exercises improved running economy by enhancing muscle stiffness and the efficiency of the SSC.

3. Injury Prevention

Plyometric training can also play a critical role in injury prevention. By strengthening muscles, tendons, and ligaments, runners can enhance their overall stability and reduce the risk of injuries commonly associated with repetitive running motions. Studies have shown that well-structured plyometric programs can decrease the incidence of lower limb injuries in athletes (Gabbett, 2006).

Designing a Plyometric Training Program

When integrating plyometric exercises into a running routine, it is essential to consider several factors:

1. Frequency and Duration

Beginners should start with 1-2 plyometric sessions per week, focusing on quality over quantity. Each session can last between 20 to 30 minutes, depending on the runner's fitness level and experience.

2. Exercise Selection

Incorporate a variety of exercises targeting different muscle groups. For instance, box jumps can enhance leg power, while bounding can improve coordination and running form.

3. Progression

Gradually increase the intensity and complexity of the exercises as the runner adapts. This progression can involve increasing the height of jumps, the distance of bounds, or the number of repetitions.

4. Recovery

Adequate recovery is crucial to prevent overtraining and ensure optimal performance gains. Allow at least 48 hours of recovery between plyometric sessions.

Conclusion

Plyometric exercises offer a powerful tool for runners aiming to improve their performance. By enhancing muscular power, running economy, and injury resilience, these explosive movements can significantly impact a runner's efficiency and speed. For best results, runners should incorporate plyometrics thoughtfully into their training regimen, ensuring a balanced approach to strength and endurance development.

Incorporating plyometric training can be a game-changer for runners looking to elevate their performance. With a structured approach, the benefits can lead to faster times and a more enjoyable running experience.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Benefits of Sports Massage Pre & Post Marathon

Tue, 09 Sep 2025 15:28:05 GMT

Marathons are a true test of endurance, pushing the human body to its limits. As runners gear up for this challenging feat, it’s crucial to focus not just on training, but also on recovery. One effective method to aid both preparation and recovery is sports massage. In this article, we explore the benefits of sports massage before and after a marathon.

Pre-Marathon Benefits

Enhancing Performance

Before the marathon, a sports massage can play a significant role in enhancing your overall performance. It helps in loosening tight muscles, increasing flexibility, and improving range of motion. This preparation is key in helping you achieve your best run.

Injury Prevention

Regular sports massages before the event can significantly reduce the risk of injuries. By targeting specific areas prone to stress during running, massage helps in alleviating tension and preventing muscle strains.

Mental Preparation

Apart from physical benefits, sports massage also contributes to mental preparedness. It’s a time for you to relax, focus, and mentally prepare for the challenge ahead. The calming effect of a massage can help in reducing pre-race jitters.

Post-Marathon Recovery

Speeding Up Recovery

After crossing the finish line, your body needs to recover. Sports massage aids in this process by improving circulation, which helps in flushing out toxins and bringing nutrients to tired muscles.

Reducing Muscle Soreness

One of the immediate effects of a marathon is muscle soreness. A post-race massage can significantly reduce this discomfort by alleviating muscle tension and promoting relaxation.

Restoring Mobility

Post-marathon, your muscles might feel stiff and fatigued. Massage helps in restoring mobility and flexibility, making it easier for you to return to your daily activities and training.

Chelmsford Physio’s Sports Massage Promo

To support Chelmsford marathon runners, Chelmsford Physio is offering a special promotion of 10% off during September and October when you mention the code CM10% when booking!

Conclusion

Incorporating sports massages into your marathon training and recovery routine can greatly enhance your experience and performance. It’s not just about pushing your limits; it’s also about taking care of your body to ensure longevity in your running journey. Remember, a well-maintained body is a runner’s best asset.

For personalised advice and to take advantage of our special marathon offer, contact Chelmsford Physio. We’re here to support your journey every step of the way, helping you to cross the finish line with confidence and in good health.

Achilles Tendon Injuries

Tue, 26 Aug 2025 15:46:20 GMT

Achilles tendon injuries

At Chelmsford Physio we specialise in the rehabilitation of tendon complaints, both of the upper limb and lower limb. We see hundreds of Achilles tendon complaints in our clinic every year and a significant portion of them are post rupture.

The Achilles tendon is the strongest and thickest tendon in the body, but despite this it is the most common to rupture. The most common region for an Achilles tendon to rupture is in the middle of the tendon (known as the mid-tendon or mid-substance). However, they can also rupture at the attachment to the heel (known as the insertion) and also where the tendon meets the muscle (known as the musculotendinous junction (MTJ).

Interestingly and rather surprisingly, most patients with mid-tendon rupture have no Achilles pain prior to rupture. These ruptures commonly occur in sports with repetitive jumping and sprinting activities, which require a pushing-off type of force.

Recent studies have shown an increase in the incidence of Achilles tendon ruptures, with the Achilles Tendon being the most common tendon rupture in the lower body. This could be related to having a more active older population? Rupture of the Achilles tendon has an incidence of 31 per 100000 per year.

The injury nearly always occurs in adults between 30-55 years old. Acute ruptures often present with sudden onset of pain associated with a “snapping” or audible “pop” heard/felt at the site of injury. Patients often describe a sensation similar to being kicked or hit with a racquet in the lower leg (Shamrock et al, 2022).

Achilles Tendon ruptures occurs in athletes and non-athletes and is a debilitating condition with a long recovery. The Achilles tendon attaches the calf muscle to the heel bone (calcaneum) and is essential for activities of daily living such as walking, going up and down stairs, and running.

Achilles Tendon injuries typically occur in individuals who are only active intermittently (ie. “the weekend warrior“ athlete). The injury can often be misdiagnosed as an ankle sprain in 20-25% of patients. Furthermore, 10% of patients with no previous symptoms, (Shamrock et al, 2022) report a history of risk factors including –

· Tendinosis ( intratendinous degeneration )

· Use of Antibiotics ( quinolone antibiotics )

· Steroid injections

· Inflammatory arthritides

Diagnosis of Achilles tendon rupture

Patients usually complain of:

A sudden popping sound or giving way sensation
Weakness in the foot – unable to lift the foot properly to clear the ground whilst walking
Immediate acute pain, which often dissipates quickly

The diagnosis of an Achilles tendon rupture requires a comprehensive clinical assessment, including history taking and physical examination (including the Thompson Pinch Test) and a diagnostic ultrasound scan.

Kotnis et al. (2006) recommended dynamic ultrasound as a useful diagnostic tool, noting that if a > 5-mm gap is noted between tendon edges, that surgical intervention is indicated. Some studies and clinics will suggest a > 10mm gap requires surgical input.

Surgical Repair

The incidence of operations following an Achilles rupture has reduced over the past decade as a result of many high-quality trials showing comparable results between operative and non-operative treatment (Ganestam et al., 2016; Egger et al., 2017).

It is worth noting that in elite sport the trend is still to operate as previous studies have demonstrated these athletes return to full capacity faster than those treated with non-surgical options. More recent research does not support this claim.

Surgical repair of an Achilles rupture uses either an open, a mini open or a minimally invasive surgical (MIS) approach. This reflects how big the incision is; an open operation has the largest incision and therefore scar, but provides the best visualisation of the tendon for the surgeon.

It is unknown what provides the best repair. There are multiple randomised control trials which have compared the three methods but have shown conflicting results regarding superiority and complications.

The review by McMahon et al. (2011) is considered to be a well powered study demonstrating that minimally invasive surgery (MIS) had no difference in re-rupture rate, sural nerve injury, deep infection, blood clots (deep vein thrombosis – DVT), or adhesions compared to open repair. The major difference in MIS is a lower rate of superficial infections compared with open repair. Superficial infections effect the skin and do not cause any long term issues, but can be uncomfortable, inconvenient and can delay your rehabilitation. Interestingly, those treated with MIS were approximately three times more likely to report a good or excellent result.

The American Academy of Orthopaedic Surgeons (AAOS) recommends that surgical repair should be carefully considered in diabetics, smokers, those over 65 years old, the sedentary, the obese and those with a concern surrounding wound healing.

Non–operative (conservative) management

There are two main options for conservative management of the rupture of the mid-Achilles:

‘Cast Immobilisation’ for 4 weeks followed by a walking boot for 4 weeks. This is the more traditional method.
‘Functional bracing’ (walking boot with wedges) and early rehabilitation over 6-8 weeks.

Both methods are complimented by formal physiotherapy to restore full function. At Chelmsford Physio the majority of our patients are managed this way.

In one study 140 patients were treated with cast immobilisation and found that 86% had an ‘excellent’ or ‘good’ result (Wallace et al., 2004). However, functional bracing (using a walking boot) with wedges, to gradually reduce the amount of plantarflexion i.e., how much the foot is pointing down in the boot, over 6-8 weeks is preferred by patients to cast immobilisation, with earlier return to activity and lower re-rupture rates.

Furthermore, patients who immediately started fully weight bearing i.e., putting as much weight through the injured foot as pain allows, had no difference in outcome scores or return to sport to those who were immobilised and non-weight bearing. Those that engage in an accelerated functional rehabilitation programme, which involved patients beginning range of movement exercises immediately was associated with less tendon lengthening and a quicker return to running (Porter et al., 2015). At Chelmsford Physio we adopt an accelerated functional rehabilitation programme and have found this gets patients back to full function safely and effectively.

Conservative treatment avoids the potential risks of surgery, is a far cheaper option, and there is significant evidence that the outcomes are similar.

Outcomes following Achilles rupture

A review of 108 research studies (Zellers et al., 2016) in the British Journal of Sports Medicine (BJSM) showed that 80% of patients were able to return to their desired function and sport after an acute Achilles rupture. The mean time to return to sport was 6 months, but there was a large range from 2.9 to 10.4 months.

Increasing age and a higher body mass index (BMI) were found to be a strong predictor of a poorer outcome with decreased function and more symptoms at one year (Olsson et al., 2011).

Despite the vast majority of patients returning to sports it has been observed that functional deficits exist, for example reduced calf strength and reduced activity levels continue for 2 years after an acute Achilles rupture. This was the same for both surgical and conservative treatment.

Of note, there were few improvements in function and activity levels between year one and year two after an Achilles rupture. This indicates that the first year is essential in recovering from this injury. Physiotherapy is essential to make the required strength and functional improvements following an Achilles rupture.

One study demonstrated these deficits are still present 10 years after surgical repair for an Achilles tendon rupture (Horstmann et al., 2012). Despite this, patients appear to adapt to these functional deficits as most (8 in 10 patients) return to sport.

If an elite athlete e.g., a professional footballer ruptured their Achilles today, they would have a surgical repair. Why is this the case if the evidence does not favour one option over the other? Trends and cultures do effect decision making in medicine, like any other industry and decisions are not always made on hard science. The beliefs of the individual, the medical team of the club, the surgeon and even their agent can influence the decision. There is also some retrospective data on very active military recruits, that the surgical management group resulted in a return to full function 1.5 months before the non-surgical group and had less associated muscle weakness (Renninger et al., 2016). However, this study was retrospective and should be considered with caution.

But even elite athletes can struggle to return to full function following surgical repair for an Achilles rupture. In the National Basketball Association (NBA), Amin et al. (2013) showed that 39% of players who suffered an Achilles rupture and underwent surgical repair from 1988 to 2011 were unable to return to play in the NBA. Those who were able to play following this injury were found to have a reduction in playing time and performance.

Conclusion

In conclusion, debate still exists as to the best management options for mid-portion Achilles tendon rupture.

Recent large trials have consistently demonstrated that non-surgical (conservative) treatment with early functional rehabilitation results in acceptable outcome and thus is an effective treatment option. This avoids the potential unwanted side effects of surgical intervention, such as infection. There is no significant difference in re-rupture rate between operative and non-operative management in the literature. Of note in elite sport and very active individuals there is often still a tendency to carry out an operation to repair the tendon.

Whether you have surgery or not is dependent on having an open, honest conversation with your surgeon or clinician regards the pros and cons of each treatment option.

At Chelmsford Physio we are very experienced in the management of Achilles tendon ruptures whether you have a surgical repair or are managed conservatively in a walking boot. We will work closely with your orthopaedic consultant to ensure you return to activities of daily living and sport in a safe and timely fashion.New Paragraph

9 Inalienable Truths About Tendinopathy

Tue, 26 Aug 2025 09:37:21 GMT

There is a lot we do not know about Tendinopathy, but there are some inalienable truths that you should know as a clinician and patient (the references below provide proof).

1) Tendinopathy does not improve with rest

The pain may settle but returning to activity is often painful again because rest does nothing to increase the tolerance of the tendon to load.

2) Although there are some inflammatory biochemical and cells involved in Tendinopathy, it is not considered to be a classic inflammatory response

Anti inflammatories may help if you have very high pain levels but it is unclear what effect they have on the actual cells and pathology.

3) Tend inopathy can be caused by many different risk factors

The main factor is a sudden change in certain activities – these activities include:

Those that require the tendon to store energy (i.e. walking, running, jumping).
Loads that compress the tendon. Some people are predisposed because of biomechanics (e.g. poor muscle capacity or endurance) or systemic factors (e.g. age, menopause, elevated cholesterol, increased susceptibility to pain, etc). Predisposed people may develop tendon pain with even subtle changes in their activity.

4) Exercise is the most evidence based treatment for Tendinopathy

tendons need to be loaded progressively so that they can develop greater tolerance to the loads that an individual needs to endure in their day-to-day life. In a vast majority of cases (but not all) Tendinopathy will not improve without this vital load stimulus.

5) Modifying load is important in settling tendon pain

This often involves reducing (at least in the short-term) abusive tendon load that involves energy storage and compression.

6) Pathology on imaging is NOT equal to pain – pathology is common in people without pain

Also, if you have been told you have ‘severe pathology’ or even ‘tears’ this DOES NOT necessarily mean you will not get better or have a poorer outcome. Further, we know that even with the best intentioned treatment (exercise, injections, etc) the pathology is not likely to reverse in most cases. Therefore, most treatments are targeted towards improving pain and function, rather than tissue healing, although this still is a consideration.

7) Tendinopathy rarely improves long term with only passive treatments such as massage, therapeutic ultrasound, injections, shock-wave therapy etc

Exercise is often the vital ingredient and passive treatments are adjuncts. Multiple injections in particular should be avoided, as this is often associated with a poorer outcome.

8) Exercise needs to be individualised

This is based on the individual’s pain and function presentation. There should be progressive increase in load to enable restoration of goal function whilst respecting pain.

9) Tendinopathy often responds slowly to exercise

You need to have patience, ensure that exercise is correct and progressed appropriately, and try and resist the common temptation to accept ‘short cuts’ like injections and surgery. There are often no short cuts.

What Is Rhabdomyolysis?

Tue, 26 Aug 2025 04:37:44 GMT

Understanding Rhabdomyolysis: Causes, Symptoms, and Treatment

Rhabdomyolysis is a serious medical condition characterised by the breakdown of skeletal muscle tissue, leading to the release of muscle cell contents into the bloodstream. This phenomenon can result in severe complications, including kidney damage, and it requires prompt diagnosis and treatment.

What Causes Rhabdomyolysis?

Rhabdomyolysis can be triggered by various factors, including:

1. Trauma: Any physical injury that damages muscle tissue can lead to rhabdomyolysis. This includes crush injuries, burns, or prolonged immobilisation (Lamprecht et al., 2019).

2. Overexertion: Intense physical activity, especially in untrained individuals, can precipitate muscle breakdown. This is often seen in athletes or during extreme exercise conditions (Bottinelli et al., 2019).

3. Medications and Drugs: Certain medications, such as statins, can contribute to muscle injury. Additionally, illicit drugs like cocaine and heroin have been associated with rhabdomyolysis (Melli et al., 2007).

4. Metabolic Disorders: Conditions such as diabetes and thyroid disorders can also increase the risk of muscle breakdown (Gordon et al., 2020).

Infections: Severe infections, particularly viral infections, can lead to rhabdomyolysis. The exact mechanism often involves muscle inflammation (Meyer et al., 2021).

Symptoms of Rhabdomyolysis

The symptoms of rhabdomyolysis can vary widely but often include:

- Muscle Weakness: A significant reduction in muscle strength.

- Muscle Pain: Often localised to the affected muscles.

- Swelling: The affected muscles may appear swollen.

- Dark Urine: The release of myoglobin from damaged muscles can lead to dark, tea-colored urine.

- Fatigue: General feelings of tiredness or malaise.

In severe cases, rhabdomyolysis can lead to complications such as acute kidney injury, which may present with decreased urine output and fluid retention (Melli et al., 2007).

Diagnosis

Diagnosis of rhabdomyolysis typically involves a combination of clinical evaluation and laboratory tests. Key indicators include elevated levels of creatine kinase (CK) in the blood, myoglobinuria (myoglobin in urine), and electrolyte imbalances (Bottinelli et al., 2019).

Treatment

The primary treatment for rhabdomyolysis involves:

1. Hydration: Intravenous fluids are crucial to help flush out myoglobin and prevent kidney damage.

2. Addressing Underlying Causes: Identifying and treating the underlying cause of muscle damage is essential.

3. Monitoring: Continuous monitoring of kidney function and electrolyte levels is necessary to manage potential complications (Gordon et al., 2020).

In most cases, with prompt treatment, the prognosis for individuals with rhabdomyolysis is favorable. However, delayed treatment can lead to serious consequences, including permanent kidney damage (Lamprecht et al., 2019)

Rhabdomyolysis is a potentially life-threatening condition resulting from muscle injury. Understanding its causes, symptoms, and treatment options is essential for early recognition and effective management. Individuals at risk should be educated about the signs of rhabdomyolysis and encouraged to seek medical attention promptly if they experience symptoms

What is it, and should you be worried? Our Physio Harry Matthews explains all.

Dance Specialist Physiotherapy at Chelmsford Physio

Tue, 12 Aug 2025 09:58:33 GMT

Sophie and Amanda are highly skilled chartered MSK physiotherapists with a unique specialisation in dance therapy. With backgrounds as professional dancers themselves, they bring an insider’s understanding of the physical demands of the performing arts to their practice. They work with performing artists from across the country and internationally, offering expert care in both vocational performing arts training environments and within the intense schedules of West End and touring musicals.

Tailored Care for the Unique Demands of Dancers

Their practice is finely tuned to the specific needs of dancers, addressing the intricate balance between athleticism and artistic expression. Dance physiotherapy requires a deep understanding of the biomechanical demands of performance, where the body’s movements are not only precise but also expressive. Sophie and Amanda adapt their approach to cater to the high-impact, repetitive motions of dance. In a typical week, they might treat injuries such as tendinitis, stress fractures, and muscle strains, all while focusing on injury prevention and the optimisation of both athletic and artistic performance.

Shaping the Next Generation of Performers

In addition to their clinical work, Sophie and Amanda also sit on audition panels for vocational performing arts colleges, where they assess dancers’ biomechanics and athletic abilities. This role allows them to help shape the next generation of performers by identifying potential issues early and ensuring that aspiring artists have the physical foundation needed to succeed in their demanding careers. Their goal is not only to help artists recover but to enhance their physical capabilities, allowing them to perform at their best, night after night.

ACL Injuries in Female Football

Tue, 29 Jul 2025 18:12:36 GMT

Females are generally at a higher risk of anterior cruciate ligament (ACL) injuries compared to males. The evidence now suggests that females can be x8 times more likely to suffer an ACL injury compared to their male counterparts.

Why is this?

Several factors contribute to this increased risk in females:

1. Anatomical Differences: Females typically have a wider pelvis, which can affect the alignment of the knee joint and increase stress on the ACL.

2. Hormonal Factors: Hormones, particularly estrogen, may influence ligament laxity and strength, potentially affecting the stability of the knee.

3. Biomechanics: Women often exhibit different movement patterns, such as increased knee valgus (inward collapse of the knee) and less hip and knee flexion during activities like jumping and landing.

4. Neuromuscular Control: Females may have less neuromuscular control, which can affect their ability to stabilise the knee during physical activity.

These factors combined contribute to the higher incidence of ACL injuries among females, especially in sports that involve jumping, cutting, and rapid changes in direction.

What can we do?

Some research suggests that ACL Prevention Programs can reduce the risk on an ACL injury by between 50-80%

The anterior cruciate ligament (ACL) is one of the key ligaments that helps stabilise the knee joint. Injuries to the ACL are common, particularly among athletes in sports that involve cutting, jumping, and rapid direction changes. Preventive measures have gained significant attention in recent years, with various programs developed to reduce the incidence of ACL injuries. This blog will explore the effectiveness of ACL prevention programs, their components, and the evidence supporting their implementation.

Understanding ACL Injuries

ACL injuries often occur during sports activities, with females being at a higher risk due to anatomical and hormonal factors (Hewett et al., 2006). These injuries can lead to long-term consequences, including joint instability and an increased risk of osteoarthritis (Brophy et al., 2010). Given the serious implications of ACL injuries, effective prevention programs are essential.

Components of ACL Prevention Programs

ACL prevention programs typically focus on three main components:

1. Strength Training: Strengthening the muscles around the knee, especially the quadriceps and hamstrings, can improve stability and reduce injury risk (Zakas et al., 2013).

2. Neuromuscular Training: This involves exercises designed to enhance balance, coordination, and agility. Neuromuscular training can improve an athlete’s ability to control their movements, which may help prevent injuries (Hewett et al., 2005) .

3. Flexibility Training: Incorporating flexibility exercises can improve the range of motion in the joints, which is crucial for preventing injuries. Stretching can also help in recovery and overall performance (Kumar et al., 2020).

Examples of ACL Prevention Programs

Several well-researched ACL prevention programs have been developed:

- The FIFA 11+ Program: Designed for soccer players, this program includes a warm-up routine that focuses on strength, balance, and agility (Kiani et al., 2016). Studies have shown that the FIFA 11+ program can reduce the risk of ACL injuries among youth players.

- The PEP Program (Prevent Injury and Enhance Performance): Targeting female athletes, this program emphasises proper technique in jumping and landing, alongside strength and flexibility training (Hewett et al., 2005). Research indicates that participation in the PEP program can significantly lower the risk of ACL injuries.

- The Sportsmetrics Program: This program involves plyometric training, strength conditioning, and agility drills. It has been shown to effectively reduce the incidence of ACL injuries among female athletes (Myer et al., 2005).

Evidence of Effectiveness

Numerous studies support the effectiveness of ACL prevention programs. A meta-analysis conducted by Sugimoto et al. (2016) found that such programs can reduce the risk of ACL injuries by up to 50%. Furthermore, a systematic review highlighted that programs incorporating neuromuscular training were particularly effective in reducing injuries among female athletes (Griffin et al., 2000).

While the evidence is compelling, the successful implementation of these programs requires commitment from coaches, athletes, and sports organisations. Regular training sessions, proper coaching, and education on injury prevention are critical for maximising the benefits of these programs.

Conclusion

ACL injuries can have serious long-term consequences for athletes. However, with the implementation of structured prevention programs, the incidence of these injuries can be significantly reduced. By focusing on strength, neuromuscular control, and flexibility, athletes can enhance their performance while minimising the risk of injury. Continued research and education in this field are essential to refine these programs and ensure their effectiveness across various sports.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What Is Frozen Shoulder Diagnosis And Treatment

Tue, 29 Jul 2025 17:06:33 GMT

Frozen shoulder, or medically known, ‘Adhesive Capsuilitis’, is a disorder which involves the connective tissue surrounding the shoulder, the capsule. The shoulder capsule is just an envelope of tissue that surrounds the shoulder joint, this shoulder joint capsule can become inflamed which can result in tightening and scarring of the shoulder joint capsule which gives rise to ‘Frozen Shoulder.

Frozen shoulder is synonymous with a stiff shoulder and a reduction in shoulder range of motion, however it is commonly misdiagnosed. Healthcare practitioners often diagnose a stiff shoulder as frozen, despite it not always being the case.

What Is Frozen Shoulder & What Happens During?

True frozen shoulder usually occurs in people between 40-60 years of age and is idiopathic, that is to say it usually comes on spontaneously. It tends to be more common in women and also in people who have diabetes; there has also been a link with thyroid disorders and the drugs that are used for their treatment. Despite these links a direct cause for ‘Frozen Shoulder’ is still unknown.

It is a very debilitating and restrictive condition that can have a very large impact on the lives of those affected. The condition is known to be self limiting, that is to say it resolves itself usually over time without any surgical intervention however on average a frozen shoulder can take up to one and a half years to recover.

The pathology is generally split into three distinct stages:

Freezing – This is the painful stage and mostly when you will present to a healthcare practitioner for accurate diagnosis. The shoulder becomes stiff and painful and you slowly start to lose the range of motion in your shoulder (Can last up to 6 months).

Frozen – This stage is characterized by a decrease in pain (slow) coupled with a more significant restriction in the shoulder (can last 4-12 moths).

Thawing – In this stage the shoulders slowly starts to recover, the shoulder becomes looser and movement gradually returns ( it can last 4-12 months).

Common Symptoms Of Frozen Shoulder

The symptoms occur gradually over time. As highlighted earlier an initial sign is stiffness in the shoulder, however lots of shoulder pathologies also present with a stiff shoulder and therefore that cannot be used to rule in or out a diagnoses of frozen shoulder.

A strong dull ache within the shoulder joint is common with pain usually increased with movement of the joint. Patients will present with difficulty with tasks such as putting on a jacket, tying up a bra, washing their hair, putting on a belt or any other overhead movements first.

As the pathology worsens the level of restriction will increase and normal daily activities can become increasingly difficult and painful. Pain often being something we in Physiotherapy can help with management of as well as advise of when we may need some assistance in reducing pain, be that with medication or injection.

Physiotherapy Diagnosis of Frozen Shoulder

An accurate diagnosis of Frozen Shoulder can be made by your physiotherapist with a comprehensive subjective history and thorough examination. Your physiotherapist may also decide to confirm the diagnosis with an MRI or a diagnostic ultrasound.

As stated above most cases of true ‘Frozen Shoulder’ will take a number of months to recover, others may take even longer depending on how quick the thawing stage can commence.

Treating Frozen Shoulder

The management of Frozen Shoulder can be greatly assisted by your physiotherapist . Your physio can use various techniques to help manage pain and restriction, help decrease the effect on your daily life and effectively monitor any progression or advancement into different stages of the condition. It is important to note however that physiotherapy cannot ‘cure’ the condition, treatment is widely focused at maintaining as much shoulder movement as possible, managing the pain and when in the thawing stage ensuring a speedy recovery and return to normal shoulder movements. The use of corticosteroid injections has been shown to help reduce the effects of the inflammatory stage allowing your physio to work with you sooner. However their effect appears to be best used during the initial inflammatory stage with little or no effect after this.

In severe cases surgery can also be indicated, an athroscopic capsule release has been shown to have a good effect at restoring motion and relieving pain, where the tight capsule is released surgically.

The nature of this condition is different to others where you generally have to wait until the condition wears itself before it resolves. This does not mean you can do nothing to help it though; there are lots of exercises and management techniques that your physiotherapist can assist with to ensure this nasty condition does not have too large an impact on your life.

If you are struggling with Frozen Shoulder, please get in touch today and get some advice from an expert who can help.

Frozen Shoulder: Causes, Symptoms, and Treatment

Tue, 29 Jul 2025 13:42:29 GMT

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in the shoulder joint. The condition typically develops slowly and progresses over time, often taking months or even years to fully resolve. In this blog post, we'll discuss the causes, symptoms, and treatment options for frozen shoulder.

Causes of Frozen Shoulder

The exact cause of frozen shoulder is not fully understood. However, it is generally believed to be the result of inflammation and thickening of the shoulder joint capsule, which is a flexible connective tissue that surrounds and protects the shoulder joint. This inflammation and thickening can lead to a decrease in the joint's range of motion, making it difficult to move the shoulder and causing pain.

Frozen shoulder is more common in individuals who are between the ages of 40 and 60, and it is also more common in women than in men. Other risk factors for developing frozen shoulder include:

Diabetes
Thyroid disorders
Cardiovascular disease
Parkinson's disease
Stroke

Symptoms of Frozen Shoulder

The primary symptom of frozen shoulder is pain and stiffness in the shoulder joint. This pain is often described as a dull ache and can be felt both at rest and during movement. As the condition progresses, the stiffness in the joint can become severe, making it difficult or even impossible to move the shoulder.

Treatment for Frozen Shoulder

The treatment for frozen shoulder typically involves a combination of physical therapy, pain management, and in some cases, surgery. The goal of treatment is to improve the range of motion in the shoulder joint and reduce pain.

Physical therapy: Physical therapy is often the first line of treatment for frozen shoulder. A Physiotherapist can work with you to develop a range of motion and strengthening program that is tailored to your specific needs. These exercises can help to improve the flexibility of the shoulder joint and reduce pain.

Pain management: In some cases, pain management techniques may also be used to help reduce the pain associated with frozen shoulder. This can include the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections.

Surgery: In severe cases of frozen shoulder, surgery may be necessary to release the joint capsule and improve range of motion. This surgery is typically done as an outpatient procedure and involves using a small incision to access the joint capsule and release any adhesions.

Conclusion:

Frozen shoulder is a common condition that can cause pain and stiffness in the shoulder joint. While the exact cause of the condition is not fully understood, it is believed to be the result of inflammation and thickening of the joint capsule. Treatment typically involves physical therapy, pain management, and in severe cases, surgery. If you are experiencing pain and stiffness in your shoulder joint, it is important to speak with your healthcare provider to determine the best course of treatment for your specific needs.

To find out more on this view our latest YouTube video! https://www.youtube.com/watch?v=0tvkaSS3CsM

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Severs Disease

Thu, 10 Jul 2025 17:37:55 GMT

Sever's disease, also known as calcaneal apophysitis, is a common and often painful condition that affects the heel of growing children and adolescents. It is a result of inflammation in the growth plate of the calcaneus, the largest bone in the heel (Blume & Constantine, 2019). This condition typically occurs in children between the ages of 8 and 14 years, with a peak incidence between 10 and 12 years of age (Scharfbillig et al., 2011).

The primary cause of Sever's disease is repetitive stress and strain on the growing heel bone. This can be due to a variety of factors, including:

1. Rapid growth spurts: During periods of rapid growth, the muscles and tendons may not be able to keep up with the growth of the bones, leading to increased stress on the growth plate (Blume & Constantine, 2019).

2. Overuse and high-impact activities: Participation in sports or activities that place a high demand on the heel, such as running, jumping, or playing on hard surfaces, can contribute to the development of Sever's disease (Scharfbillig et al., 2011).

3. Tight calf muscles and Achilles tendon: Tight muscles and tendons in the lower leg can pull on the growth plate, exacerbating the condition (Blume & Constantine, 2019).

Symptoms of Sever's disease typically include heel pain, tenderness, and swelling in the affected heel. The pain is often worse with physical activity and may improve with rest (Scharfbillig et al., 2011).

Treatment for Sever's disease typically involves a combination of the following strategies:

1. Rest and activity modification: Reducing or temporarily stopping high-impact activities can help alleviate the stress on the growth plate and allow for healing (Blume & Constantine, 2019).

2. Stretching and strengthening exercises: Stretching the calf muscles and Achilles tendon, as well as strengthening the lower leg muscles, can help reduce stress on the growth plate (Scharfbillig et al., 2011).

3. Ice and anti-inflammatory medication: Applying ice to the affected area and taking over-the-counter anti-inflammatory medication can help reduce pain and inflammation (Blume & Constantine, 2019).

4. Supportive footwear and orthotics: Wearing well-cushioned shoes or using heel cups or arch supports can help distribute the load on the heel and reduce stress on the growth plate (Scharfbillig et al., 2011).

In most cases, Sever's disease is a self-limiting condition that resolves as the growth plate matures and closes, usually by the age of 14 or 15 years (Blume & Constantine, 2019).

With proper physiotherapy treatment and management, most children with Sever's disease can continue to participate in physical activity and sports, with a focus on gradual return to full activity.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Understanding Osgood-Schlatter Disease

Thu, 10 Jul 2025 17:20:44 GMT

Osgood-Schlatter disease is a common condition that affects the knees of growing children and adolescents. It is characterised by inflammation and pain in the area just below the kneecap, where the patellar tendon attaches to the shinbone (tibia) (Gholve et al., 2007).

Osgood-Schlatter disease is a common cause of knee pain in active, growing children, typically occurring between the ages of 10 and 15 years (Fukuda, 2013).

The primary cause of Osgood-Schlatter disease is rapid growth during adolescence, combined with increased physical activity and stress on the patellar tendon (Gholve et al., 2007). As the child grows, the bones, muscles, and tendons may not develop at the same rate, leading to increased tension and stress on the growth plate at the top of the shinbone (Fukuda, 2013).

Symptoms of Osgood-Schlatter disease typically include:

1. Pain and tenderness just below the kneecap, where the patellar tendon attaches to the shinbone (Gholve et al., 2007).

2. Swelling and inflammation in the same area (Fukuda, 2013).

3. Increased pain with physical activity, such as running, jumping, or climbing stairs (Gholve et al., 2007).

4. Tightness or stiffness in the quadriceps and patellar tendon (Fukuda, 2013).

Treatment for Osgood-Schlatter disease typically involves a combination of the following strategies:

1. Rest and activity modification: Reducing or temporarily stopping high-impact activities can help alleviate the stress on the growth plate and allow for healing (Gholve et al., 2007).

2. Stretching and strengthening exercises: Stretching the quadriceps and strengthening the leg muscles can help reduce stress on the patellar tendon (Fukuda, 2013).

3. Ice and anti-inflammatory medication: Applying ice to the affected area and taking over-the-counter anti-inflammatory medication can help reduce pain and inflammation (Gholve et al., 2007)

4. Supportive bracing or taping: The use of knee braces or patellar tendon straps can help support the affected area and reduce stress on the growth plate (Fukuda, 2013).

In most cases, Osgood-Schlatter disease is a self-limiting condition that resolves as the growth plate matures and closes, usually by the age of 14 or 15 years (Gholve et al., 2007).

With proper physiotherapy treatment and management, most children with Osgood-Schlatter disease can continue to participate in physical activity and sports, with a focus on gradual return to full activity.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Exercising in the Heat 🥵

Tue, 24 Jun 2025 13:41:43 GMT

Exercising in hot temperatures can be challenging and potentially dangerous if not approached correctly. However, with the right preparation and precautions, training in heat can be a safe and effective means of improving athletic performance. In this blog, we will discuss the top 5 tips for training in heat, backed by what the science tells us

1. Hydration:

The first and most crucial tip for training in heat is to stay hydrated. Dehydration can lead to significant health risks, including heat exhaustion and heat stroke. It is essential to drink plenty of fluids before, during, and after exercise in hot conditions. Studies recommend drinking 750ml of water at least 30 minutes before exercise and at regular intervals during the workout to replace fluids lost through sweating.

2. Acclimation:

Gradual acclimation to hot conditions can help improve exercise performance and reduce the risk of heat-related illnesses. Researchers found that gradual exposure to heat can improve cardiovascular function, reduce core body temperature, and increase sweating rates. It is recommended to gradually increase exercise time and intensity in hot conditions over 7-14 days to acclimate the body to the heat.

3. Rest and Recovery:

Rest and recovery are essential for preventing heat-related illnesses and improving athletic performance. Research suggests that taking breaks and allowing time for the body to recover during exercise in hot conditions can reduce the risk of heat exhaustion and heat stroke. It is recommended to take frequent breaks, find a shaded area, and drink fluids during exercise in hot conditions.

4. Clothing:

Wearing appropriate clothing can help reduce the risk of heat-related illnesses and improve athletic performance in hot conditions. Studies recommend wearing light-colored, loose-fitting, and breathable clothing that allows sweat to evaporate quickly. This helps regulate body temperature and prevent overheating.

5. Timing:

The timing of exercise can also impact athletic performance and the risk of heat-related illnesses. Research suggests that exercising during the cooler parts of the day can reduce the risk of heat exhaustion and heat stroke. Early morning or late evening exercise when temperatures are cooler can improve performance and reduce the risk of heat-related illnesses.

In conclusion, training in heat can be a safe and effective means of improving athletic performance if approached correctly. Staying hydrated, gradual acclimation, rest and recovery, appropriate clothing, and timing are the top 5 tips for safe and effective training in heat, backed by science & research. By following these tips, athletes can optimise their performance in hot conditions while minimising the risk of heat-related illnesses.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Preparing Your Body for Summer Sport

Tue, 24 Jun 2025 09:57:03 GMT

As the warmer months approach, many of us look forward to getting back into our favourite summer sports like tennis, golf, and cricket. However, diving straight into intense physical activities after a period of inactivity can lead to injuries and strains. Here are some straightforward tips on how to prepare your body for summer sports and make the most of the sunny season.

1. Start with a Check-Up

Before you hit the court, course, or field, it's wise to assess your physical condition. If you've had previous injuries or health concerns, consider a quick visit to a healthcare professional. They can provide advice tailored to your needs and ensure you’re ready to engage in physical activities.

2. Gradual Warm-Up

Warming up is crucial to prepare your body for the demands of any sport. Start with low-intensity activities that mimic your sport of choice. For example, if you’re a tennis player, begin with gentle jogging and some light racket swings. Golfers might start with stretching and gentle swings, while cricketers can benefit from light jogging and stretching the arms and shoulders.

3. The Importance of Flexibility

Flexibility can significantly enhance your performance and reduce the risk of injuries. Incorporate a daily stretching routine focusing on major muscle groups that you will use in your sport. Dynamic stretches, which involve moving as you stretch, are particularly useful for athletes and can be performed as part of your warm-up.

4. Strengthening Exercises

Strong muscles support and protect your joints during physical activities. Focus on exercises that strengthen the legs, core, and arms. You can use body-weight exercises such as squats, planks, and push-ups, or light weights to build strength. It’s also beneficial to incorporate balance exercises, which can help improve stability, especially important in sports like golf and cricket.

5. Hydration & Nutrition

Your body performs best when it's well-fuelled and hydrated. Make sure to drink plenty of water before, during, and after playing. Eating a balanced diet rich in vegetables, fruits, proteins, and carbohydrates will also help maintain energy levels and aid in recovery.

6. Pre-Sports Massage

Consider incorporating a pre-sports massage into your routine. This type of massage helps prepare the body for physical exertion and improves performance. It’s particularly beneficial in sports that require repetitive motions, such as tennis, golf, and cricket. A pre-sports massage can increase flexibility, reduce muscle stiffness, and decrease the risk of injury by promoting better blood flow to the muscles.

7. Listen to Your Body

Always listen to your body’s signals. If you feel pain or discomfort, take a break or consult with a healthcare professional. It’s better to address minor issues before they develop into serious injuries.

8. Rest & Recovery

Adequate rest is as crucial as the activity itself. Ensure you get enough sleep and give your body time to recover between sports sessions. This not only helps in muscle repair but also prepares you for the next round of physical activity.

By following these simple steps, you can enjoy your favourite summer sports while minimising the risk of injury. Remember, the key is gradual progression and listening to your body at all times.

For further advice on how to prepare for summer sports or to explore treatments like pre-sports massage, contact Chelmsford Physio. Our team is dedicated to helping you enjoy a healthy, active summer.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

4 Great Exercises for Returning to Pre season: Regain Your Strength and Agility

Tue, 24 Jun 2025 08:42:27 GMT

Returning to sport after some time away from the pitch—whether due to an injury or an extended break—requires a thoughtful approach to ensure a safe and effective comeback. Enhancing your strength and agility is crucial for not only improving your game performance but also for reducing the risk of future injuries. Below, we discuss four excellent exercises that are particularly effective for regaining sports-ready fitness. These activities have been carefully selected to address the essential physical demands of sports.

1. Master the Squat:

Squats are an excellent all-rounder in any athlete’s toolkit, especially for sports players. This powerful exercise targets several key muscle groups including the quadriceps , hamstrings , glutes , and core . These muscles are vital for lower body strength, explosive power, and stability—qualities that are indispensable for sprinting, jumping, and swiftly changing directions during a match. Begin with bodyweight squats to ensure you master the form—keep your back straight and knees in line with your toes—and gradually add weights as your strength builds.

2. Enhance Agility with Lateral Drills:

Sports aren't just about speed; it’s also about how quickly you can change direction. Lateral agility drills, such as the Ladder Drill and Shuttle Run, are perfect for enhancing your footwork, coordination, and agility. These exercises mimic on-field movements, helping you improve your manoeuvrability, which is crucial for dodging opponents and adapting quickly to dynamic game situations. Start with simple patterns and increase the complexity as you become more comfortable.

3. Build Explosive Power with Plyometrics:

Plyometric training involves explosive movements that can drastically improve your power, speed, and overall athletic capabilities. Exercises like box jumps, depth jumps, and lateral bounds help train your muscles to exert maximum force in minimal time, boosting your acceleration and vertical leap. Begin with lower-intensity variations and progressively challenge yourself with more advanced exercises to safely increase your muscle strength and joint stability.

4. Strengthen Your Core:

A robust core is the foundation of a strong, agile sports player. Incorporating exercises such as planks, Russian twists, and medicine ball throws can significantly enhance the strength of your abdominal muscles, obliques, and lower back. These exercises improve balance, posture, and body control, all of which are essential for maintaining high performance throughout the game. Focus on correct form and gradually increase the intensity of your workouts to build a stronger core.

Returning to sports demands a well-rounded regimen that focuses on building strength, agility, power, and core stability. By incorporating squats , lateral agility drills , plyometric exercises , and core strengthening into your routine, you can effectively prepare your body for the rigours of the game. Always remember to consult with a professional coach or healthcare provider before beginning any new exercise program to ensure it’s suitable for your specific needs. Additionally, consider a pre-sports massage , which can be particularly beneficial before returning to the game, helping to prepare your muscles for the physical demands of sports.

As you embark on your journey back to the sports field, dedication and consistent training will be key to your success. For tailored advice and support, don’t hesitate to contact Chelmsford Physio . We're here to help you achieve your best on and off the field.

Chelmsford Physio

https://www.chelmsfordphysio.co.uk/sports-massage

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

How Sports Massage Helps With Recovery

Tue, 10 Jun 2025 15:56:38 GMT

Sports massage is a type of massage specifically designed to help athletes recover from training and competition. It’s a manual therapy that uses various techniques to improve circulation, reduce muscle tension, and remove waste products from the tissues.

For marathon runners, recovery is just as important as training. Sports massage can play a vital role in helping your body bounce back after the intense physical demands of long-distance running.

The Benefits of Sports Massage for Recovery

There are many benefits to sports massage these include:

Reduced muscle soreness: Sports massage can help to reduce post-exercise muscle soreness by increasing blood flow and removing waste products from the tissues. This can speed up the recovery process and ease the pain and stiffness associated with DOMS (delayed onset muscle soreness).

Improved range of motion: T raining often places repetitive stress on certain muscle groups, leading to tightness and restricted movement. Sports massage helps to reduce muscle tension and scar tissue, restoring flexibility and improving range of motion.

Increased relaxation: After the physical and mental effort of running, sports massage can help lower stress and anxiety levels. This promotes better sleep and overall recovery.

Reduced risk of injury: Regular sports massage can help to prevent injuries by keeping muscles supple, improving circulation, and maintaining joint mobility. This is particularly important during the high-volume training phases of marathon prep and the recovery period afterward.

How Does Sports Massage Work?

Sports massage uses various hands-on techniques to improve circulation, reduce muscle tightness, and clear waste products from soft tissues. Some of the key techniques include:

Effleurage: Gentle, gliding strokes to warm up the muscles and prepare them for deeper work.

Petrissage: A kneading motion that helps to break down muscle knots and improve blood flow.

Friction: Deep, targeted pressure used to break up scar tissue and release adhesions.

Tapotement: Rhythmic tapping used to stimulate the muscles and enhance circulation.

Vibration: Gentle shaking or oscillation to relax muscles and boost lymphatic drainage.

These techniques can be especially effective soon after a marathon to support a quicker, more comfortable recovery.

When Should You Get a Sports Massage?

Sports massage can be beneficial at any time, but it is particularly helpful:

After a marathon or long-distance run to support your body’s recovery process.

During marathon training to ease muscle tension and prevent injuries.

Before race day to relax tight muscles and mentally prepare for the event.

How Often Should You Get a Sports Massage?

The frequency will depend on your training schedule and how your body feels. Some marathon runners benefit from weekly massages during peak training, while others may book one after each long run or post-race. It’s important to listen to your body and adjust accordingly.

Conclusion

Sports massage is a valuable tool in any runner’s recovery routine, especially for marathoners. It can help reduce soreness, improve flexibility, support mental wellbeing, and keep you running strong. Whether you’re training for your first marathon or are a seasoned runner, incorporating sports massage can make a real difference.

To find out more on sports massage and to book your session, visit us today:

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Could Lymphatic Drainage Massage Help You?

Tue, 10 Jun 2025 14:43:30 GMT

Lymphatic drainage massage (also known as manual lymphatic drainage or MLD) is a gentle form of massage that is used to improve the flow of lymph fluid through the body. Lymph fluid is a clear, colourless fluid that helps to remove waste products and toxins from the tissues. When the lymphatic system is not functioning properly, lymph fluid can build up, causing swelling (edema).

MLD is a specific technique that uses light, rhythmic strokes to move lymph fluid through the body. The therapist will use their hands to apply gentle pressure to the skin, following the path of the lymph nodes. MLD can be used to treat a variety of conditions, including:

Lymphedema
Breast cancer-related lymphedema
Cellulitis
Edema after surgery
Swollen ankles
Sinus congestion
Headaches
Fibromyalgia
Chronic fatigue syndrome

How does Lymphatic Drainage Massage work?

The lymphatic system is a network of vessels that carry lymph fluid throughout the body. Lymph fluid is made up of white blood cells, proteins, and other fluids. It helps to remove waste products and toxins from the tissues, and it also helps to fight infection.

MLD works by stimulating the lymphatic system to move lymph fluid more efficiently. The therapist uses gentle pressure to massage the skin, which helps to open up the lymph vessels and allow lymph fluid to flow more freely. MLD can also help to reduce inflammation and pain.

Benefits of Lymphatic Drainage Massage

MLD has a number of benefits, including:

Reduces swelling (edema)
Improves circulation
Reduces inflammation
Relieves pain
Improves skin health
Boosts the immune system

Who can benefit from Lymphatic Drainage Massage?

MLD can be beneficial for people with a variety of conditions, including:

Lymphedema
Breast cancer-related lymphedema
Cellulitis
Edema after surgery
Swollen ankles
Sinus congestion
Headaches
Fibromyalgia
Chronic fatigue syndrome

What to expect during a Lymphatic Drainage Massage:

A lymphatic drainage massage typically lasts for 30-60 minutes. The therapist will begin by assessing your lymphatic system and then applying gentle pressure to the skin. The massage will be slow and rhythmic, and the therapist may use a variety of techniques, such as effleurage, petrissage, and friction.

You may feel some tingling or warmth during the massage, but it should not be painful. If you do experience any pain, let the therapist know so they can adjust the pressure.

Aftercare for Lymphatic Drainage Massage:

After a lymphatic drainage massage, you may feel relaxed and refreshed. You may also notice that your swelling has decreased. It is important to drink plenty of fluids after your massage to help flush out toxins. You may also want to avoid strenuous activity for a few hours after your massage.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Benefits of ACL Prevention Programs

Tue, 27 May 2025 12:05:34 GMT

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries in sports, particularly in athletes participating in high-risk activities such as football, rugby, basketball, and skiing. These injuries can lead to significant physical, emotional, and financial burdens. However, research has shown that ACL prevention programs are effective in reducing the incidence of these injuries. This blog explores the benefits of such programs, emphasising their importance for athletes and recreational participants alike.

Understanding ACL Injuries

The ACL is crucial for knee stability during various movements, including pivoting, jumping, and rapid changes in direction. Injuries to the ACL can occur due to traumatic events or biomechanical factors. Female athletes are at a higher risk for ACL injuries, with studies indicating that they are two to eight times more likely to suffer an ACL tear than their male counterparts.

The Role of ACL Prevention Programs

Strength Training: Targeting the muscles around the knee to enhance stability.
Plyometric Exercises: Improving explosive power and agility.
Balance Training: Enhancing proprioception and coordination.
Technique Modification: Teaching proper landing and cutting techniques to reduce stress on the knee.

Research indicates that these multifaceted approaches can significantly decrease the risk of ACL injuries.

Benefits of ACL Prevention Programs

1. Reduced Injury Rates

Numerous studies have demonstrated that ACL prevention programs can lead to a substantial reduction in injury rates. A meta-analysis by Sugimoto et al. (2016) found that such programs can reduce the risk of ACL injuries by 50% or more, particularly among female athletes. This reduction not only preserves athletes' physical health but also enhances their long-term athletic careers.

2. Improved Performance

In addition to reducing injury rates, ACL prevention programs can improve overall athletic performance. By focusing on strength, agility, and balance, athletes often experience enhanced performance metrics. A study by Myer et al. (2005) showed that athletes who participated in prevention programs exhibited improved jumping ability and speed, contributing to better performance in competitive settings.

3. Cost-Effectiveness

ACL injuries can lead to significant medical expenses, including surgery, rehabilitation, and lost time from work or sports. Implementing prevention programs can be a cost-effective strategy for sports organizations and teams. According to a study by Griffin et al. (2000), the financial burden of ACL injuries can be mitigated by investing in prevention programs, which may ultimately save healthcare costs and improve athletes' quality of life.

4. Enhanced Awareness and Education

Implementing ACL prevention programs raises awareness about injury risks and prevention strategies among athletes, coaches, and parents. Education about proper techniques and the importance of strength training can foster a culture of safety in sports. Research by Hewett et al. (2009) emphasises the need for ongoing education to ensure that athletes understand the mechanics of their movements and the implications for injury prevention.

10-15 minutes of plyometrics, balance, strength exercises pre training and matches can really make a difference. You can check out different examples of injury prevention programs at

Sport metric program
FIFA 11+ warm up
The PEP program
The Knee Program- Netball Australia
The FootyFirst program- AFL

Conclusion

The implementation of ACL prevention programs is a critical strategy for reducing injury rates, enhancing athletic performance, and promoting long-term health among athletes. As research continues to support the efficacy of these programs, it becomes increasingly important for sports organisations to invest in preventive measures. By prioritising injury prevention, we can create safer athletic environments and ensure that athletes can enjoy their sports for years to come.

Jon McComish PGc BSc (Hons)
Clinic Director & Chartered Physiotherapist

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Why does my knee hurt when I run?

Tue, 27 May 2025 07:47:48 GMT

Whether you are a seasoned runner, or new to the sport, knee pain is common and should not be the reason you stop running forever. Despite popular belief, running does not appear to be bad for your knees studies would suggest, in fact, recreational running can be really positive for joint health, for many different reasons.There are so many different reasons you can get pain when running, but we will focus on patellofemoral joint pain for this article.

The patellofemoral joint is the joint in which the knee cap (patella) joins to the thigh bone (femur). When the quads are relaxed, you can wobble your knee cap about as it sits above the joint, but when you contract your quads, the knee cap is stabilised by both the muscles and the joint itself. This joint allows the force of the quads to be transferred to the shin bone (tibia) and therefore strighten the knee. The patella sort of works as the fulcrum, a bit like a see saw.

As you run, you repeatedly straighten the knee, which puts pressure through the underside of the knee cap and into the femur. This is normal, and what it is designed to do. But sometimes the back of the knee cap can become irritated, and this is patellofemoral pain.

Patellofemoral pain is usually not a ‘damage’ to the joint, but more of an overload of a structually sound kneecap, so surgical intervention is not usually indicated and will normally resolve with physiotherapy, although it can take a long while to get better with a structured rehab program, expectations here are key!

So why does it occur? Well, there are many different reasons, but these can be categorised into 2 types:

1) Increased load – this is that you put more pressure through the joint than it is used to. So could be because of increased mileage, increased speed, more hills or more sessions a week.

2) Decreased capacity – the health of our tissues vary dependent on some internal factors too. For example, the amount of sleep you have had, your nutrition/hydration, levels of stress, decreased support from the quads to support the knee, feeling unwell or a reduced strength due to recent inactivity.

Symptoms of patellofemoral joint pain

Pain in patellofemoral joint pain tends to be located on the front of the knee, although it is usually really difficult to poke. So it can be frustrating to try to describe where the symptoms are, are usually feel they are "inside the knee somewhere".

Pain is usually worse going down stairs rather than up and tends to come on while running and gradually get worse the further you run.

Pain that may get worse after prolonged periods standing, running or engaging in other impact sport. In the most severe cases everyday activities such as using the stairs and kneeling can be very painful.

Crunching, clicking or a grating sensation that you can feel and/or hear in your knee. It may get worse when you bend or straighten your knee. This is normal but can be concerning for some patients.

How do I resolve my patellofemoral pain?

Well, obviously this sort of depends on what the initial cause was! Usually though the first thing to do is decrease (not stop!) the amount of load going through the knee. This could be by adjusting the way you run, or adjusting the amount of exercise/running your currently doing. Effectively, try not to do exercise that makes your pain go above 3/10 during or after. It’s also often a good idea to begin exercises for the gluteal muscles and the quads, initially simple things that don’t cause pain like straight leg raises and side lying abductions. These will tend to be comfortable but would also need to be progressed towards squatting and lunging style exercises as able.

Essentially the aim is to offload the knee a little to settle the pain, and then build up the amount of pressure through the knee gradually again with exercise and a graded running plan.

So initially, try to reduce the aggravating factors and start some quad and glute exercises to see how these go and if still struggling give us a call.

Jon McComish PGc BSc (Hons)
Clinic Director & Chartered Physiotherapist

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Pre-Season Preparation with Chelmsford Physio

Fri, 09 May 2025 10:52:28 GMT

Pre-season training is a crucial time for athletes and sports teams as they prepare for the upcoming season. It is a time when athletes can focus on improving their fitness, strength, and skills to help them perform at their best when it matters most. One key component of pre-season training that is often overlooked is physiotherapy. In this blog, we will explore the benefits of incorporating physiotherapy into pre-season training and how Chelmsford Physio can assist.

Benefits of Pre-Season Prep

1. Injury Prevention

Pre-season training is a time when athletes are most susceptible to injury, as they increase their training volume and intensity. Physiotherapy can help to identify and address any potential areas of weakness or imbalance in the body, which can lead to injury. By incorporating physiotherapy into pre-season training, athletes can reduce their risk of injury and improve their overall performance.

2. Improved Flexibility and Range of Motion

Physiotherapy can help athletes improve their flexibility and range of motion, which can be crucial for certain sports. For example, football players need to be able to move quickly and change direction frequently, while basketball players need to be able to jump and land safely. By improving flexibility and range of motion, athletes can move more efficiently and help towards reducing their risk of injury.

3. Enhanced Strength and Conditioning

Physiotherapy can also help athletes improve their strength and conditioning. Physiotherapists can design customised exercise programs that target specific muscle groups and movements that are important for the athlete's sport. By incorporating these exercises into pre-season training, athletes can improve their overall strength, endurance, and power, which can translate into better performance on the field or court.

4. Faster Recovery from Injury

Injuries can happen at any time, but they are especially frustrating during pre-season training when athletes are trying to build their fitness and skills. Physiotherapy can help athletes recover from injuries faster by providing targeted treatments that promote healing and reduce pain and inflammation. This can help athletes get back to training more quickly and minimise the impact of the injury on their performance.

5. Mental Preparation

Pre-season training is not just about physical preparation; it is also about mental preparation. Physiotherapy can help athletes develop mental toughness and resilience through techniques such as visualisation and goal setting. By incorporating these techniques into pre-season training, athletes can improve their mental game and be better prepared to handle the demands of the upcoming season.

6. Individualised Care

Physiotherapy is a highly individualised form of treatment, which means that each athlete's needs and goals are taken into account. Physiotherapists can perform assessments to identify areas of weakness or imbalance in the body and develop customised treatment plans to address them. This individualised care can help athletes achieve their full potential and perform at their best.

How Chelmsford Physio Can Help

Pre-Season Testing/Screening

Before the season begins, our comprehensive testing and screening processes assess an athlete’s physical condition and readiness, pinpointing areas for improvement and preventing potential injuries.

Bespoke Plans & Programs

Our physiotherapists design bespoke plans and programs specifically tailored to the needs of your sport and personal goals, ensuring you receive the most relevant and effective training.

State-of-the-Art Facilities

Our Riverside facilities are equipped with advanced equipment for both testing and training, enabling us to provide top-tier preparation for all athletes.

Sports Massage and Recovery Services

We offer specialised sports massage packages tailored for football players , rugby players and other types of sports, which are crucial for recovery and performance enhancement. Additionally, we utilise Normatec systems for cutting-edge recovery support.

Our Team

Our highly skilled and experienced team works with elite athletes and professional sportspeople, providing expert care and guidance to help you perform at your best.

In conclusion, incorporating physiotherapy into pre-season training can provide numerous benefits for athletes and sports teams. From injury prevention and improved flexibility to enhanced strength and conditioning and mental preparation, physiotherapy can help athletes prepare for the upcoming season and perform at their best. By working with a qualified physiotherapist, athletes can receive individualised care that addresses their specific needs and goals. If you are an athlete or coach preparing for pre-season training, consider incorporating physiotherapy into your training plan to help maximise your performance and reduce your risk of injury.

Jon McComish PGc BSc (Hons)
Clinic Director & Chartered Physiotherapist

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Megan's Marathon Story (London Marathon 2025)

Mon, 28 Apr 2025 11:08:02 GMT

The London Marathon 2025… what a day and an experience. You always hear people say how amazing it is and words can’t describe it. Personally i’ve always wondered how and why but I think they’re right, theres not a word to summarise it.

For me it’s always been a bucket list experience and was never about a time. Don’t get me wrong as a competitive runner, I wanted to challenge myself so I had a target time in my head. However, I knew if I didn’t get that time I would still have been so happy to have completed it and ever participated.

The training went as well as could be expected. Long hours put in for long runs and then the taper arrives and you’re grateful for a bit more spare time back. A few bruised toenails but nothing that I couldn’t handle. As a physiotherapist I tried to be rigid with my training knowing its importance and avoiding injury in the build up and on the day. I couldn’t face telling a client I hadn’t done what I would have advised!

The week building up to the Sunday I started to question if I had anything else to talk about apart from marathon day, it seemed to have become my only personality! Sunday morning bright and early start to get to Blackheath for 8am, navigating the less than ideal Sunday public transport.

Something that took me completely by surprise is quite how emotional the day is. Arriving at the start area and calling my boyfriend with excitement and ending it welling up, joking with him I needed to pull myself together.

It was so lovely to get to speak to different people about their marathon journeys, whether it be their first or tenth. Those due to complete the Abbott World Majors that day, for which I am completely in awe of. Everyone has a story and a reason and I think you can feel that in the air, mixed with nervous energy.

The race in itself is a bit of a blur, the first 5k flew by and I was greeted by my first family member cheering me on which was an instant boost. This continued to follow, my sister had spent months unbeknown to me organising all my family and friends to be at different points around the course to cheer me on. Many of which I didn’t expect or know to be coming. All had banners and screamed my name loud enough that I would spot them. I cannot imagine how I would have done it without them.

And of course the unwavering support from every spectator, no 100m was left empty without people cheering and shouting. The music, dancing and posters were constant entertainment to take your mind off the miles and body aches.

After Canary Wharf I could feel my feet burning and definitely a few blisters were forming. The heat on the day was a blessing and a curse, I love the sunshine and it definitely brought out the thousands of spectators. For us runners it became a challenge especially in the last few miles, counting down to the water stations. I’m not going to lie the last 7km’s was painful and mentally I had to dig deep but I kept thinking to myself there was no way I wanted to give up until I crossed that line.

Getting the medal over my head was my bucket list moment made, simply incredible.

The biggest blessing and my top advice for anyone tackling one next year would be to book a day pass at a gym for a shower. Best shower of my life! Also meant I could be presentable to go and meet my family and friends at a pub to celebrate☺️

So for anyone considering it, enter that ballot today. Not a moment of regret and an experience everyone deserves the opportunity to have. For now, i’ll rest my feet, try to stop myself crying at the thought of the day and get back to work!

3 Ways to Help You Achieve a Healthy & Happy Neck

Fri, 18 Apr 2025 11:13:36 GMT

Neck pain is a common complaint affecting people of all ages. The discomfort and limited mobility associated with neck pain can significantly impact one's quality of life. Fortunately, there are several evidence-based strategies backed by research that can help relieve and prevent neck pain. In this blog post, we will explore our three top tips to help you manage neck pain effectively.

1. Movement:

Rather than calling it stretching, concentrate on moving your head to the end of its range, then apply some over-pressure. Try working on these on a little & often basis, maybe spend 1-2 minutes performing them every 1-2 hours.

If you sit for work take regular breaks too. Prolonged static postures can lead to pain & tightness in your neck muscles.

2. Strength:

Strengthening the neck and shoulder muscles can provide stability and support to the cervical spine, reducing the risk of neck pain.

Isometric exercises are a type of strength training exercise that involves contracting your muscles without any visible movement in the joints. Unlike traditional exercises that involve dynamic movements and joint range of motion, isometric exercises focus on static muscle contractions.

During an isometric exercise, the muscle length remains unchanged, and there is no joint movement. Instead, you exert force against an immovable object or maintain a specific position against resistance. This creates tension in the targeted muscles, which helps to build strength and improve muscle endurance.

We can use a ball to perform these for the neck. Heading to ball forward, backwards, from the left & from the right.

Try building up the hold time to 30-45 seconds for each movement. You could try to repeat 3-5 holds, 2-3 times a day.

3. Relaxation Techniques:

Mindfulness & Meditation: Engaging in mindfulness meditation can help reduce stress and promote relaxation. Set aside a few minutes each day to focus on your breath and bring awareness to the present moment.

Gentle Exercise: Engaging in low-impact exercises such as yoga or tai chi can help release tension from the neck and promote overall relaxation.

Adequate Sleep: Getting sufficient sleep is crucial for overall well-being. Harvard experts recommend maintaining a regular sleep schedule and creating a sleep-friendly environment to support restful sleep.

Neck pain can be disruptive and affect your daily life. By incorporating these three tips into your routine, you can effectively manage and prevent neck pain. Remember to move regularly, strengthen your neck and shoulder muscles, and practice relaxation techniques. However, it's essential to consult with a healthcare professional if your neck pain persists or worsens to rule out any underlying conditions. Prioritise your neck health and enjoy a pain-free and active lifestyle.

This blog post is for informational purposes only and should not replace professional medical advice. If you have specific concerns about your neck pain, please consult with a qualified healthcare professional.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

How to Get The Biggest Bang For Your Buck in Recovery?

Wed, 16 Apr 2025 10:00:38 GMT

Living an overall healthy lifestyle is the most important step you can do to help maximise your recovery from your workout.

How Long Does Muscle Recovery Take?

Depending on your fitness levels and the difficulty of your workout will vary the time that it takes for your muscles to recover.

The volume, intensity, and duration of your workout all play a significant factor on how demanding it is on your body. After a light workout, your muscles may take 24 hours to recover, however a more challenging training session might take two to three days.

Factors hat can affect your recovery time:

Sleep quality
Nutrition
Stress levels

Despite what you might see on social media, fitness blogs, and your local gym there is no better way to help recovery than eating nutritional foods and getting good quality night’s sleep.

Dr Peter Tierney has developed a great visualisation for the best ways to recover.

Sleep

Sleep enables your muscles time to recover from exercise. The benefits of sleep are tied to Human Growth Hormone (HGH) stimulating protein synthesis which peak during sleep helping stimulate muscle growth and repair. Lack of sleep can also cause inflammation in the body, which often result in muscle aches and pains.

Sleep is best measured in cycles. One cycle lasts about 90 minutes while an average adult needs for to six cycles every 24 hours to enhance recovery.

Quality Nutrition

Protein – when you exercise, the proteins that make up your muscle fibres become damaged. Consuming protein after a workout can give your body the help it needs to repair the damaged tissue.

To maximise muscle growth an average adult should aim between 1.8 – 2.4 g of protein perKg of bodyweight.

Massage

Massage is proven to improve recovery to help reduce muscle soreness by relieving tightness and tension with an increase in tissue elasticity. An increase in tissue elasticity occurs as muscle temperature increase due to an increase in blood flow.

So, we’ve touched upon a few ways you can help your recovery post training. Perhaps you want to join us next month for a few recovery tools, Normatecs and Ice Baths, that you may have seen on social media and in the news and how they can help you enhance your performance.

 Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Hypermobility Syndrome ( HMS ) & How Can Physio Help?

Wed, 16 Apr 2025 09:26:04 GMT

What is Hypermobility Syndrome (HMS)?

Being hypermobile means some or all of your joints have an unusually large range of movement. This means you can move your limbs into positions that others can’t. This is due to the genetic differences in the flexibility or ‘stretchiness’ of the connective tissue in our bodies (ligaments, tendons, muscle, skin).

HMS can sometimes be confused with being called ‘double-jointed’. If you are generally more flexible or have a special party-trick it doesn’t necessarily mean that you have HMS. It is suggested that 10-30% of adults have some form of hypermobility with only 4-15% of people having Hypermobility Syndrome.

Is This Bad?

No! Most often people don’t even realise their joints are more mobile than others. However it can occasionally cause symptoms such as pain, recurrent strains and sprains, joint dislocations, reduced balance and co-ordination. Don’t forget being extra mobile in some joints doesn’t mean you have HMS.

Hypermobility Syndromes exist on a spectrum, with some specific types being more severe than others. Conditions that can cause hypermobility such as Ehlers-Danlos Syndrome and Marfan Syndrome.

How Do We Assess For Hypermobility?

Amongst other questions and assessments there are two classification systems that can be used. They don’t necessarily mean you have HMS but they can provide a clue!

Beighton Score – out of 9 one point for each

Bend right little finger back past 90 degrees.
Bend left little finger back past 90 degrees.
Bending right thumb so it touches your forearm.
Bending left thumb so it touches your forearm.
Straightening right elbow beyond straight.
Straightening left elbow beyond straight.
Touching the floor with flat palms.
Lying flat leg keep your straight knee touching the floor can you lifting heel off.
Lying flat leg keep your straight left touching the floor can you lifting heel off.

Brighton Criteria – Major and minor symptoms

Major – Beighton score of 4+; joint pain 3 months; in more than 4 joints

Minor – Beighton score of 3 or less; joint pain less than 3 months; dislocation or slipping out of joint (subluxation); soft tissue injuries like tendon problems; stretchy skin.

If you have two major, one major and one minor or 4 minor you are likely to have HMS.

What is best: Stretch, Strengthen, or Stabilise?

The answer is all of the above, however, stabilisation will benefit the body more thoroughly for functional activities. One of the backbone treatment techniques used in Functional Manual Therapy that works marvellously for people with HMS is Proprioceptive Neuromuscular Facilitation (PNF.) PNF is the most efficient way to tap into the body’s natural stabilisation system of tonic muscle fibres. Research suggests most people in general do well with consistent physical activity.

This cannot be more true for those with HMS. Inactivity often triggers symptoms, therefore a regimen of physical therapy is indicated to guide a person back to regular exercise. This is especially true for anyone who wants to participate in sports. An active lifestyle can stave off much of the complaints of hypermobility due to the stabilisation required to complete the skills required in sport. It is smart to train specifically for any activity and having a physical therapist who understands your specific needs is key.

Are There Any Benefits From Extra Joint Movements?

Yes! Having additional movement at certain joints can help you to throw a ball further or stretch more. This is helpful in sports such as cricket and gymnastics and sportspeople who can control their joints and body are able to perform amazing movements and skills that other couldn’t dream of. In our clinic we particular see a large number of gymnasts due to my close links with the British Gymnastics and for these athletes this is a massive benefit to their athletic ability in most cases.

Think You Could Have Hypermobility?

Don’t worry or panic, come and see us at Chelmsford Physio and we can guide your physio to help you excel and manage any negative symptoms.

So long as we don’t expect a specific medical condition requiring further medical assessment, we can help you to manage your symptoms with advice on lifestyle, activity and essential rehabilitation exercises. As mentioned above, having hypermobility and being able to control your body can be a huge advantage in sport! And with the right training programme hypermobile people can achieve truly remarkable feats!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Megans TCES London Marathon 2025

Wed, 26 Feb 2025 09:32:28 GMT

One of our staff members, Megan , was lucky enough to secure a ballot spot for the TCES London Marathon 2025 in April.

Megan is a keen runner but has always remained middle distance so despite all her years of training, the prospect of a marathon remains intimidating. So far training has been going well, and she has been enjoying a change in training style to adapt to a much longer distance. However, she is very aware the hardest part is still to come!

Despite getting a ballot place Megan has decided to fundraise for charity alongside. The charity she has chosen to donate to is the RNLI . This is a charity close to her family as was always supported by her Grandad who they lost a few years ago. Therefore, this run is dedicated to him and his charity of choice.

Any donations would be appreciated and for all others who are joining her on the starting line in April, Good Luck!

What Does The Latest Research Tell Us About ITB Syndrome?

Thu, 20 Feb 2025 22:27:38 GMT

A recent study aimed to explore the evidence surrounding ITB syndrome, in terms of pathology and management.

What you’ll read below is a snippet from the review.

Back to the study!

STUDY TITLE: Iliotibial band pathology: synthesising the available evidence for clinical progress – Geisler P (2020).

Key Points From The Study:

Iliotibial band syndrome (ITBS) is thought to be a pathology of compression of sensitive structures, not friction.
The ITB cannot be stretched and therefore treatment should not focus on stretching.
Hip strength and control are thought to be key parts of management.

Background and Objective

ITBS is thought to be the most common cause of lateral knee pain, and yet it’s a pathology that is poorly understood and drastically under-researched! This narrative review sought to examine the literature to provide an overview of current thoughts on pathology and management.

Pathology

For some time, ITBS has been considered a ‘friction syndrome’ with the ITB thought to cause friction on the structures beneath it, leading to pain. More recent research however suggests that ITB pathology is more likely to involve compression of sensitive structures beneath the ITB rather than friction. This distinction is important as it has influenced treatment which has been targeted at stretching the ITB (to reduce friction) and steroid injections to reduce inflammation (e.g. in the bursa).

You can’t stretch the ITB!

The ITB is a strong, complex structure with multiple attachments along the femur and distally around the knee. It provides stability for both the hip and knee joints and is thought to store and release energy like a spring. Current thinking is that a) you can’t stretch it, and b) you wouldn’t want to anyway!

Rehab Options

Loss of strength and control around the hip are thought to be key in the development of ITBS, especially weakness in hip abduction and external rotation, and increased hip adduction during loading (e.g. running). Training error is also thought to be a factor in over 60% of cases.

Treatment should aim to first calm symptoms and then address causative factors. The author suggests a progressive, 3-level programme:

Level 1:

Low load, mostly open chain exercises (such as side-lying abductions, side planks, side-lying external rotations, and hip extension strengthening e.g. glute bridges).

Level 2:

Moderate load, closed chain exercises (such as mini-squats, lunges, and step-ups).

Level 3:

Higher load exercises, including impact and sports preparation (such as goblet squats, single leg squats, and plyometrics).

At Chelmsford Physio, we specialise in the rehabilitation of tendon complaints, both of the upper limb and lower limb. We see and successfully treat lots of ITB syndrome complaints in our clinic every month.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Thank you for reading!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Blood Flow Restriction (BFR) Training

Wed, 19 Feb 2025 21:12:43 GMT

What is Blood Flow Restriction (BFR) Training?

BFR is a technique that combines low-intensity exercise with blood flow occlusion that produces similar results to high-intensity training. It has been used in the gym setting for some time but it is gaining popularity in clinical settings. VanWye et al, (2017).

BFR training was initially developed in the 1960s in Japan and is known as KAATSU training . It involves the application of a pneumatic cuff (tourniquet) proximally to the muscle that is being trained. It can be applied to either the upper or lower limb.

How Does Blood Flow Restriction (BFR) Training Work?

The cuff is inflated to a specific pressure with the aim of obtaining partial arterial and complete venous occlusion. The patient is then asked to perform resistance exercises at a low intensity of 20-30% of 1 repetition max (1RM), with high repetitions per set (15-30) and short rest intervals between sets (30 seconds). Pope et al, (2013).

The aim of BFR training is to mimic the effects of high-intensity exercise by recreating a hypoxic environment using a cuff. The cuff is placed proximally to the muscle being exercised and low intensity exercises can then be performed. Because the outflow of blood is limited using the cuff capillary blood that has a low oxygen content collects and there is an increase in protons and lactic acid, the same physiological adaptations to the muscle (eg release of hormones, hypoxia and cell swelling) will take place during the BFR training and low-intensity exercise as would occur with high-intensity exercise.

Wilson et al, (2013)

Basically, by restricting blood flow on the limb using a cuff, we can reduce the amount of blood flowing out of the limb, but still allow blood to flow in. When we combine this with very light exercise/loading – such as lifting a lightweight or even pedalling a bike, metabolites (what your muscles produce when they work) build up in the limb. This is beneficial, as BFR “tricks” your body into believing it is working harder than it actually is due to the presence of the metabolites.

In a rehabilitation setting such as at Chelmsford Physio clinic, inside Riverside leisure centre, this is vitally important as it allows us to achieve muscle strength/growth while not stressing damaged or vulnerable tissues (e.g. An arthritic knee, fractured ankle or post-surgical or ACL) but still get significant benefits.

Normally we would have to wait for these tissues to heal before being able to load them to achieve these benefits.

Who Could Benefit From Blood Flow Restriction (BFR) Training?

BFR is widely used with athletes and in gyms across the world. It is also commonly practiced with physiotherapists in clinics too, with the 3 main groups being:

1) Post-Operative Patients - Patients following surgery like an ACL reconstruction , Achilles repairs, knee replacements and many other operations. To goal is to get the muscles around the area working and strong as quickly as possible, but this can be difficult due to pain and so we struggle to put the necessary loads and forces through the area. However, by using BFRT we can use low load, not aggravate pain/symptoms, but still, significantly train the muscles around it appropriately.

2) The injured Athlete - If you have an injured athlete and want to get them back to their sport asap, BFRT can be a great tool. While an athlete is injured and can’t put high force through the injured area, we can use BFR to get high training effect at low load meaning we protect the injured area but still keep it strong.

3) Older Patients – who maybe suffer from arthritis or struggle to put a sufficient load through their tissues to improve their strength and symptoms. BFR again can be a great tool, to allow them to train with lighter/easier loads to get similar effects as training with higher/heavier loads and therefore see the necessary strength gains.

Is Blood Flow Restriction (BFR) Training Safe?

In short, yes, BFRT is actually very safe, just as safe as regular strength training in fact. But there are some people that cannot use BFR training, here’s a list of common things (not all things) that may exclude someone from being able to use BFRT:

History of cardiac or vascular health issues, or severe varicose veins.
Pregnancy.
Active infection or open wounds.

Your physiotherapist will ask you many questions about your health prior to any BFR training to assess if it is appropriate for you.

At Chelmsford Physio , we specialise in the rehabilitation of everyone from international athletes to the older population having knee and hip replacements.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Thank you for reading!

Chelmsford Physio

https://www.chelmsfordphysio.co.uk/podiatry

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Biomechanical Analysis: Unearthing the Root Causes of Foot and Lower Extremity Pain

Tue, 11 Feb 2025 14:33:24 GMT

Experiencing pain in your feet or lower extremities can be not just discomforting but also a hindrance to your daily activities. While there are various reasons for such pains, a biomechanical analysis often holds the key to understanding and effectively addressing these issues. In this article, we delve into how biomechanical analysis can help in identifying the root causes of foot and lower extremity pain.

Understanding Biomechanics

Biomechanics refers to the study of the mechanical laws relating to the movement or structure of living organisms. In the context of physiotherapy , it involves analysing how the bones, muscles, tendons, and ligaments work together to move. Any imbalance or irregularity in this delicate system can lead to pain and discomfort.

The Role of Feet in Biomechanics

Feet, being the foundation of our body, plays a pivotal role in our biomechanics. They bear the weight of our entire body and are essential for movement. Problems in the feet often lead to a domino effect, causing issues in the knees, hips, and even the lower back.

Common Causes of Pain

Improper Footwear

Wearing shoes that do not support or align with the natural structure of your feet can lead to pain. This is often seen in individuals who wear high heels or ill-fitting shoes for prolonged periods.

Overuse and Sports Injuries

Athletes or individuals engaging in regular physical activities might experience pain due to overuse of certain muscles or from sports-related injuries.

Age-Related Changes

As we age, changes in the structure of our feet, such as the flattening of arches, can cause pain and discomfort.

Medical Conditions

Certain medical conditions like arthritis, diabetes, and obesity also contribute to foot and lower extremity pain.

Gait Analysis

This involves observing how an individual walks or runs. It helps in identifying issues like overpronation (rolling inwards of the foot) or supination (rolling outwards of the foot), which are common causes of pain.

Pressure Mapping

Pressure mapping technologies can be used to understand how weight is distributed across the feet. This is crucial in identifying areas that are under excessive stress.

Treatment and Management

Based on the findings from the biomechanical analysis, a tailored treatment plan can be developed. This may include:

Orthotic Therapy: Custom-made insoles can be used to correct foot imbalances.

Exercise Regimens: Specific exercises to strengthen the muscles and improve flexibility.

Footwear Advice: Guidance on selecting the right footwear to support your feet.

Manual Therapy: Techniques such as massage and mobilisation to alleviate pain and improve function.

Understanding the biomechanical causes of foot and lower extremity pain is crucial in developing effective treatment plans. By analysing how the body moves and identifying any imbalances, it’s possible to address the root cause of the pain, rather than just treating the symptoms.

For a comprehensive assessment and personalised treatment plan, contact Chelmsford Physio . Our team is dedicated to helping you achieve pain-free movement, and enhancing your quality of life.

Sports Podiatry for Runners & All Sport?: Enhancing Your Performance with Expert Foot Care

Tue, 11 Feb 2025 12:48:49 GMT

The Role of Podiatry in Sports

Athletics, whether at a professional level or as a weekend hobby, demands a lot from our bodies, especially our feet. Sports podiatry focuses on diagnosing, treating, and preventing foot and lower limb problems experienced by athletes and active individuals. It plays a crucial role in helping athletes maintain optimal foot health and improve their overall performance.

Why Runners Need Specialised Foot Care

Runners, in particular, are susceptible to a range of foot-related issues due to the repetitive impact and stress placed on their feet. Common problems include plantar fasciitis, Achilles tendinitis, and stress fractures. These issues, if not addressed, can lead to more severe injuries, impacting an athlete's ability to perform.

Preventing Injuries

Preventative care is a significant aspect of sports podiatry. By understanding the biomechanics of an athlete's feet, podiatrists can identify potential issues before they become problematic. Custom orthotics, footwear advice, and specific exercises can help in preventing injuries.

Enhancing Performance

Beyond injury prevention, sports podiatry also plays a vital role in enhancing athletic performance. Correct alignment and balance of the feet can improve efficiency, speed, and stability. Podiatrists can provide tailored advice and treatment plans to help athletes achieve their peak performance.

The Benefits for All Athletes

Sports podiatry isn't just for runners; athletes across all sports can benefit. Sports like football, basketball, and tennis require quick, repetitive movements that can strain the feet and ankles. Receiving expert foot care can help in managing these stresses effectively.

Tailored Solutions

Each sport has its unique demands, and therefore, the approach to foot care needs to be customised. A sports podiatrist can offer tailored solutions that cater to the specific requirements of different sports, ensuring athletes receive the most effective care.

Choosing the Right Footwear

One of the critical aspects of sports podiatry is advising on the right footwear. The correct shoes can make a significant difference in performance and injury prevention. Factors like arch support, cushioning, and the right fit are essential considerations.

Regular Check-Ups and Maintenance

Regular check-ups with a sports podiatrist are crucial for maintaining foot health. These visits can help in early detection of issues and ensure that any minor problems are addressed promptly.

When to Seek Professional Help

If you experience persistent foot pain, changes in foot structure, or recurring injuries, it’s time to consult a sports podiatrist. Early intervention can prevent more severe issues and keep you on track with your sporting goals.

In conclusion, sports podiatry is an essential element in the toolkit of any athlete, especially runners. It’s not just about injury treatment but also about performance enhancement and injury prevention. Regular consultations and tailored solutions can significantly contribute to an athlete's success.

Contact Chelmsford Physio

For those in and around Chelmsford, Essex, seeking expert advice and treatment for sports-related foot issues, contact Chelmsford Physio . Their team of experienced professionals is dedicated to helping you achieve your best performance with optimal foot health.

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3D Foot Scan: A Revolutionary Tool for Personalised Podiatry Care

Tue, 11 Feb 2025 12:15:05 GMT

Transforming Foot Health with Technology

In the realm of podiatry, the evolution of technology has ushered in an era of precision and personalisation. One such advancement that stands at the forefront is the 3D Foot Scan. This state-of-the-art tool is revolutionising the way we approach foot health, offering bespoke solutions to individuals seeking podiatry care.

What is a 3D Foot Scan?

A 3D Foot Scan is a cutting-edge diagnostic tool that creates a precise, three-dimensional model of your foot. This technology captures every contour and aspect of the foot's structure, providing unparalleled insights into its unique biomechanics. Unlike traditional methods, which often rely on visual assessments or two-dimensional imaging, 3D foot scanning delivers a comprehensive and accurate representation of your feet.

The Benefits of 3D Foot Scanning

1) Personalised Treatment Plans

The detailed imagery from a 3D foot scan allows for highly tailored treatment plans. Podiatrists can identify specific issues, such as arch height variations, pressure points, and gait abnormalities, with unprecedented accuracy. This leads to more effective and targeted therapies.

2) Enhanced Orthotic Design

For those requiring orthotics, 3D scans ensure a perfect fit. Custom orthotics, designed based on your scan, can significantly improve comfort and support, addressing issues like plantar fasciitis, flat feet, or other foot-related problems.

3) Early Detection and Prevention

Early detection of potential foot problems is a key benefit of 3D foot scanning. By identifying issues before they develop into more serious conditions, preventive measures can be taken, promoting long-term foot health and mobility.

4) The Process: Simple and Swift

Undergoing a 3D foot scan is a straightforward, quick, and non-invasive process. It involves placing your feet on a scanning device, which captures all necessary data in a matter of seconds. The result is a highly detailed 3D image, ready for analysis by a podiatry professional .

5) Who Can Benefit?

3D foot scanning is beneficial for a wide range of individuals. Athletes can enhance their performance and reduce injury risks, while those with chronic foot conditions can find relief through customised treatment plans. It's also ideal for anyone looking to improve their overall foot health and comfort.

6) Future of Foot Care

The future of foot care is here with 3D foot scanning. This technology not only offers immediate benefits but also paves the way for ongoing research and advancements in podiatry care. It represents a shift towards more patient-centric, effective, and efficient treatment methods.

7) Embracing Innovation in Podiatry

The 3D Foot Scan is more than just a diagnostic tool; it's a symbol of the innovative strides being made in podiatry. By embracing such technologies, we are stepping into a future where foot health care is more accurate, personalised, and accessible.

Contact Chelmsford Physio

For those in and around Chelmsford, Essex, experiencing the benefits of 3D Foot Scanning is within easy reach. Contact Chelmsford Physio to discover how this revolutionary tool can enhance your podiatry care and contribute to your overall well-being.

Take a Step Towards Better Health: How Podiatry Can Improve Your Pain & Performance!

Tue, 11 Feb 2025 09:56:43 GMT

Podiatry is a branch of medicine that focuses on the diagnosis and treatment of foot and ankle disorders, as well as assessing lower limb biomechanics and how that affects the whole lower limb. One of the most important tools in podiatry is pressure plate technology, which allows podiatrists to analyze the pressure distribution and force exerted on the foot during walking and running.

At Chelmsford Physio, we offer an innovative solution for identifying changes in foot posture and lower limb biomechanics using state-of-the-art pressure plate technology. By understanding how your feet adapt when you experience pain, we can help to alleviate discomfort through a combination of podiatry and physiotherapy. We also provide personalised recommendations for footwear and foot posture to help prevent future injuries.

Pressure plate technology works by using sensors embedded in a plate that the patient walks or runs on. The sensors measure the pressure distribution and force exerted by the foot, and this information is then used to create a detailed analysis of the patient's gait. This analysis can be used to identify foot and ankle disorders, such as plantar fasciitis and flat feet, and to develop a treatment plan that is tailored to the patient's specific needs.

One of the key benefits of pressure plate technology is that it provides objective data that can be used to monitor the effectiveness of treatment over time. For example, if a patient is undergoing physical therapy for plantar fasciitis, the pressure plate can be used to track changes in the pressure distribution and force exerted by the foot as the patient's condition improves.

In addition to its diagnostic and monitoring capabilities, pressure plate technology can also be used to develop custom orthotics and footwear that are specifically designed to address the patient's unique needs. By analysing the pressure distribution and force exerted by the foot, podiatrists can identify areas of the foot that are under stress and design orthotics and footwear that redistribute pressure and provide support where it is needed most.

Research has shown that pressure plate technology is a highly effective tool for diagnosing and treating foot and ankle disorders. In one study, researchers found that pressure plate technology was able to accurately diagnose plantar fasciitis in 89% of cases, compared to just 60% accuracy with clinical examination alone (1). Another study found that the use of pressure plate technology in combination with custom orthotics led to significant improvements in pain and function for patients with plantar fasciitis (2).

In conclusion, pressure plate technology is a powerful tool that is revolutionizing the field of podiatry. By providing objective data on the pressure distribution and force exerted by the foot, this technology allows podiatrists to diagnose foot and ankle disorders with greater accuracy, monitor the effectiveness of treatment over time, and develop custom orthotics and footwear that are tailored to the patient's specific needs.

Our goal at Chelmsford Physio is to not only help alleviate your pain but to empower you with the knowledge and tools to prevent future injuries. By understanding how your feet adapt to pain and how to maintain proper foot posture, you can avoid further discomfort and improve your overall quality of life.

To find out more and to book an appointment visit us below:

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

New Year, New Resolutions!

Fri, 24 Jan 2025 09:05:09 GMT

With the start of a New Year, come new plans and new goals. There are ways to make these more realistic and less likely to fail. When things go wrong, we normally see the consequence as an injury in the clinic. Often these injuries are what we describe as a feature of a ‘training error’ and often this can be avoided with better advice, education and planning.

Are you Training for a Race or a Marathon ?

On a personal note, I’ve set myself a target this year. My goal is the Manchester Marathon, and I’m aiming for a good for age time. At my age, this basically means, running the marathon in under 3hrs and 5min.

So what can I/we do the help this process and achieve the goal/target we have set, as well as avoiding an injury ?

Firstly, nobody has immunity from injury, but there are things we can try to do to reduce the risk of an injury, whilst at the same time improving our performance.

1. Prioritising Your Recovery as Much as Your Training

50% of your training should be recovery, getting this wrong is just as likely to cause increased risk than overtraining.

With your recovery, are you allowing sufficient time between your sessions to adapt? Unless you are an elite level runner, you will need at least 24hrs maybe even 48hrs depending on the type of run/training to recover before the next session.

Ensuring good sleeping routines and a healthy nutrition plan! Sleep is the most powerful, legal performance enhancer we have and its free.

Less than 7 hours sleep, and your time to physical exhaustion can drop by 10-30%. That’s mile 16 in the marathon, still a long way to go!

Regularly getting less than 7 hours sleep a night, almost doubles your risk of injury!

2. Your Program Should be Bespoke to you!

Compliance is key to achieving a good outcome and helping avoid a training error and injury. Its important to make your training plan fit around you, your work, your home life, your social life, your other commitments. If you keep having to chop/change your sessions to fit around other commitments, this increases the risk of an error leading to an injury.

3. Too Much too Soon!

We have this conversation a lot in clinic, with people who end up with an injury by increasing the training load too fast. You may hear or read about the 10% rule, this is well used and helpful for a novice runner. It relates to adding 10% distance to your total running week each week, and it usually added to your longer run. This can be a good place to start, but when it comes to a runner with more experience and training in the bank, we can often increase this 10% to 20% or even 30% in some cases.

As you can see, it’s the rate of change on the tissues that carries the risk of an injury here. The longer you spend the training, the more opportunity it gives your tissues to adapt effectively. So a novice should ideally allow >20 weeks to train for a marathon, whereas an elite runner could potentially train for a marathon in under 12 weeks.

4. Minutes not miles

Using minutes not miles to plan your training can be more helpful, than using distance and pace. Its simple and easy to plan, especially when the most important metric when we are building running is volume and intensity. We aim to build up to the total time on feet when running and the intensity of some of the sessions. This allows us to progress training sensibly, and reduce the risk for injury. When we run for distance the emphasis often becomes about getting the distance done/covered as quickly as we can, and as a result we the pace increase.

By taking away the distance element, the emphasis shifts away from how long it takes to run that distance and so allows us to control the intensity of the session better.

Another helpful metric is heart rate (HR), if you know it or you can work out your max HR you can then monitor training zones. The 80:20 rule, this is widely used by elite level runners and refers to 80% of your training being completed at a low intensity, and 20% of your running being completed at a moderate to high intensity. Too much high intensity running doesn’t allow for sufficient recovery and therefore is an injury risk.

5. Less Stretching & More Focus on Strength!

There is good evidence to suggest that elite endurance runners are less flexible that their non-elite counterparts (Baxter et al, 2017)

The literature suggests that stretching doesn’t provide any benefit to runners, and acute stretching can reduce running economy and performance for up to an hour, by diminishing the musculo-tendinous stiffness and elastic energy potential. In relation to injury risk, stretching shows little significance for helping runners ( Baxter et al, 2017 ). Runners are often at risk of overuse injuries, where stretching doesn’t appear to help, but strength based training and plyometrics (jumping exercises) may be a more helpful adjunct and

better use of time?

When you run impact forces are typically 2-3 times your body weight on every stride. These forces pass through your joints, muscles and tendons. For example, if you weight 60Kg and runs at 6.30min/mile pace (1072 strides), with impact forces at least x2 body weight (120kg x563) = 64320/64.32 tonnes per foot per mile!!

So you get the idea, why strength is so important for your running. We have further information on our website and our YouTube page with exercises to help with your strength.

6. Enjoy it!

If I’m honest, I enjoy the process more than any race. Often when it comes to the weekend of a race I end up stressing over how the race will go and the outcome. I know this is so pointless and a waste of my time and energy, but I find it a real challenge to relax and just enjoy the build up. I end up not racing very much, maybe 1 race in the Spring, which I train from thought the Winter and then another race later in the year, which helps keep me focused and training through the summer. This way I have a long build up process to each race, which works for me.

Feel free to follow my training on Strava, and I will start posting more about my runs and training on our social media. I hope you find it helpful, as it’s helpful for me to have some accountability here, now I’ve put it out there.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Skiing...When You Haven't Skied for a While

Thu, 23 Jan 2025 10:18:16 GMT

For those who haven't skied in a while, it's easy to overlook the preparation, risk, and conditioning needed to prevent injury. In this guide, we'll cover everything to ensure you're ready to hit the slopes with confidence!

Risk of Injury

Although skiing and snow boarding are generally associated, as high injury risk activities recent research looking at the prevalence of these injuries has shown a recent decline. The numbers have reduced from 5 – 8 injuries per 1000 skiers to 2 – 3 per 1000.

Research has also shown that the most common injuries in skiing are to the knees which accounts for 1⁄3 of all injuries and that in snowboarder’s injuries to the wrists are the most common. A study in Japan showed that snowboarders had twice the injury rate of skiers.

When looking at preventing injuries there are obviously areas that we have no control over, which can increase the chances of injury. These can include poor visibility, the quality of the snow and crowded pistes. However there are also many areas that we can control such as wearing protective garments including wrist protectors and helmets which are compulsory in many resorts now.

Conditioning

One area that has been proven to reduce injuries in skiing is through skiing specific physical conditioning. With snow based disciplines, as with the majority of sports, it is important to be balanced and maintain good alignment and weight distribution through your trunk and lower limbs.

However, unlike a lot of other sports, with skiing you are trying to maintain a relatively static position while travelling fast down a hill. This, therefore, is going to require different muscle activity and joint positioning compared to an activity such as running, meaning a specific conditioning program is necessary.

Alignment

When looking at skiing you need to assess your alignment to avoid excessive loading through your knees and hips.

A lot of pain experienced through the front of the knee with skiing is a result of over loading through the patella femoral joint (where the knee cap sits). When you go into your skiing position your knees should be in line with your 2nd to 3rd toes and not dropping in towards the inside of your big toes. (as shown in the figure below)

Knee dropping inside the big toe: incorrect Knee in line with the 2nd to 3rd toes: correct

Once you have addressed this imbalance it is then important that you are achieving the correct hip and knee movement. As you go into the skiing position your weight needs to be more into the front of your feet rather than at the back as this will distribute your weight better through your skis giving you greater control.

This is slightly different to the sit stand motion we use on a daily basis where our weight is distributed more through our heels and therefore it can take a little bit of training to get right.

Strength

In order to maintain this alignment it is vital to have good strength through the gluteal and quadriceps muscle groups. In addition good strength is possibly the best way of preventing pain and injury with downhill sports. Due to the down hill nature of skiing the quadriceps need to be worked eccentrically.

This means they are worked from a straight knee position to a bent knee position and the quadriceps muscles are lengthening. Two of the best exercises to achieve this are deep squats and vertical split squats (as shown below).

Vertical Split Squats

Proprioception & Endurance

Proprioception is the body’s awareness of where it is in space and is therefore a very important factor in reducing injury risk, especially when skiing in poor visibility. Simple ways to address this are through balance exercises such as single leg standing with eyes closed or Single leg hop downs.

Similar to other sporting injuries , skiers and snow borders are more vulnerable as they get more fatigued and this can be addressed and reproduced through generic cardiovascular exercises such as cycling and running.

It is important to mention that these guidelines are for uninjured skiers. If you have an ongoing complaint or old injury then a more specific personal program would be necessary.

If we can be of help with pre skiing conditioning or perhaps worried about a new or past injury then get in touch and we can take a look at our Chelmsford Clinic.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Starting Back at the Gym After a Break

Wed, 22 Jan 2025 06:51:59 GMT

Noticed the number of gym adverts increase recently? Noticed a bit of an upturn in attendance at the gym in the past couple of weeks? A combination of the New Year's Resolution market and December excesses mean this is peak gym membership season. So what are we trying to work against?

Christmas Calories

Some sources estimate that during Christmas Lunch, an 'average' person may consume up to 5,200 calories through starter main course, dessert and drinks. These figures were sourced from a supplements firm, so there is a vested interest here, however the same article suggests this would take jogging 52 miles (i.e. 2 marathons) to burn it all off. Whilst this may not be everyone's preferred option to address the balance, come early January, with the December splurge behind us, it is a good time to start a new regime so that next Christmas we are ready for it!

However the initial push to get the ball rolling can end up with disillusionment, pain and injury or frustration at a lack of progress and subsequent withdrawal from the process. Here are a few easy steps to try to stay on target so that the monthly membership costs aren't going to waste:

Pace Yourself

Don't try to burn 5200 calories in one go. It won't work (unless you are going to swim the channel in which case that's about a daily energy requirement and a little extreme).

Ease into it- consistency is most important and in the early stages you may be better coming out of the gym or finishing your exercise thinking you could have done more. Build it up over a few weeks until you can hit it harder when your body will be better conditioned to the work.

You Are Where You Are

Remember when you used to go to the gym 5 times a week 6 years ago? Regularly bench pressing 90kg, squatting 120kg and managing an hour on the treadmill? Easy there tiger.. that was a little while back. If you are returning to the scene of previous triumphs, take those weights and reps right down.

You will get much more getting your technique right on a light weight that you can increase over a few sessions than by jumping back in where you were. You might get away with it for a couple of sessions but your body's powers of recovery will start to lack.

Recovery is Important

If it's been a while, build up from a couple of sessions per week. Most gains are made when the body is recovering and in the early stages there may be a lot to recover from. If every session feels like torture, give yourself a chance - do your exercise, but drop the weight or reps a little.

Focus on technique or something different to what you might normally do. Preparation (warm up, the right food and hydration levels for you, making sure you are doing the best session for you) is important, but recovery (light refuelling, stretching, resting afterwards) is just as vital.

Enjoy it!

It is supposed to be fun! Exercise doesn't have to be about slamming away on the treadmill almost doubled over with exhaustion in a gym full of seemingly uberfit obsessives wondering how on earth Mo Farah does it.

It can be a cycle to the station, restarting some team sport, going for a longer walk with some friends, anything that gets your heart rate up for a prolonged period of time. It is often easier to exercise with someone as you are both doing the same thing and if you aren't feeling it one day, there is the perception you are letting someone else down if you pull out of what you were going to do together. Stick with it, long term it will be worth it!

The other barrier for lots is embarrassment in the gym. Try not to think people are watching and everyone is in the same boat, more so than ever in January. But pick a gym that you enjoy the feel or atmosphere as you're more likely to go.

For personalised advice and support, don't hesitate to contact Chelmsford Physio . Our team is dedicated to helping you achieve your goals with tailored physiotherapy treatments in and around Chelmsford, Essex.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Understanding Piriformis Syndrome: Insights & Physiotherapy Interventions

Mon, 25 Nov 2024 13:18:08 GMT

Piriformis syndrome is a condition characterised by pain in the buttock region, often radiating down the leg. It occurs when the piriformis muscle, located deep in the gluteal region, irritates the sciatic nerve. This syndrome can significantly affect mobility and quality of life. In this blog, we will explore the causes, symptoms, diagnosis, and effective physiotherapy interventions for managing piriformis syndrome.

What is Piriformis Syndrome?

Piriformis syndrome is often described as a neuromuscular disorder that results from the compression or irritation of the sciatic nerve by the piriformis muscle. This muscle is responsible for the external rotation and abduction of the hip. When it becomes tight or spasms, it can lead to pain and discomfort, mimicking sciatica (Cameron & Swanson, 2019) .

Causes:

Various factors can contribute to the development of piriformis syndrome, including:

Muscle Tightness: Prolonged sitting, overuse, or lack of flexibility in the hip muscles can lead to tightness in the piriformis.

Injury: Trauma to the hip or buttock region can cause inflammation or spasms of the piriformis muscle.

Anatomical Variations: Some individuals may have anatomical variations that predispose them to nerve compression.

Repetitive Activities: Activities such as running, cycling, or prolonged sitting can exacerbate symptoms (Kumar et al., 2020) .

Symptoms:

The hallmark symptom of piriformis syndrome is pain in the buttock, which may radiate along the path of the sciatic nerve down the leg. Other symptoms may include:

Numbness or tingling in the buttock or leg
Pain that worsens with prolonged sitting or standing
Discomfort during activities that involve hip movement, such as climbing stairs or squatting (Bahr et al., 2017).

Diagnosis:

Diagnosing piriformis syndrome involves a thorough history and physical examination. Key steps include:

Clinical History: Gathering information on the onset, duration, and nature of the pain.

Physical Examination: Assessing range of motion, strength, and tenderness in the hip and buttock region.

Special Tests: Tests such as the Piriformis Test or Freiberg’s Test can help identify piriformis syndrome by reproducing symptoms during specific movements (Cameron & Swanson, 2019) .

Imaging studies, such as MRI or ultrasound, may be utilised in complex cases to rule out other conditions.

Physiotherapy Interventions

Physiotherapy plays a crucial role in the management of piriformis syndrome. Key interventions include:

1. Manual Therapy

Manual therapy techniques, including soft tissue mobilisation and joint manipulation, can help alleviate muscle tightness and improve mobility in the hip region (Bahr et al., 2017) .

2. Exercises That Stretch & Strengthen Muscles

Stretching the piriformis and surrounding muscles is essential for reducing tension.
Strengthening the hip and gluteal muscles can help support proper biomechanics.

3. Postural Education and Ergonomics

Educating patients about proper posture, especially during prolonged sitting or repetitive activities, can prevent exacerbation of symptoms. Ergonomic adjustments at work or during sports can also be beneficial.

Conclusion

Piriformis syndrome can be a debilitating condition affecting many individuals, particularly those engaged in activities that strain the hip and lower back. Physiotherapy offers a comprehensive approach to managing this syndrome, focusing on pain relief, improved mobility, and restoring function. By employing a combination of manual therapy, targeted exercises, and education, physiotherapists can help patients regain their quality of life and return to their daily activities.

It must also be noted that Piriformis Syndrome can often be misdiagnosed and if the exercises prescribed for this make your symptoms worse, please stop and see a Specialist Physio.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Strength Training for Runners: The Facts & Figures

Fri, 25 Oct 2024 17:40:46 GMT

Strength training is crucial for any runner to help reduce the risk of any injury and improve your performance.

You cant go wrong by getting strong, so check out this great article by Rich Willy : 5 Myths of Strength Training for Endurance Running .

Key Points:

1) Reduced Risk of Injury:

Resistance training can reduce the risk of overuse injuries by approximately 50% ( Lauerson, Bertelsen, and Anderson, 2014 ).

2) Myth-Busting Weight Gain:

A common misconception is that resistance training leads to weight gain and reduces running performance. In reality, adding resistance training to an endurance program doesn’t increase total body mass.

3) Improved Performance:

Strength training can improve running economy and speed. For instance, six weeks of heavy weight training (2x per week, 4 sets of 4 reps at 80% 1RM with lunges and heel raises) improved 5km race times by nearly 4%—those who didn’t incorporate weight training saw no improvement ( Karston et al., 2016 ).

4) Intensity Matters:

Light circuit-style resistance training doesn’t boost endurance running. Instead, runners should engage in heavy strength training after a preparatory phase of 2–4 weeks using lighter weights (2–4 sets of 15 reps).

5) Focus Beyond Glutes:

While glute muscles are important, the calf and thigh muscles play a larger role in supporting our bodies during running. The calf muscles alone contribute about 50% of the torque needed for body support while running (Willy et al., 2017). Notably, the calf's push-off strength declines by around 31% between ages 20 and 60 ( Devita et al., 2016 )—so keep those calves strong!

6) Mechanics, Not Myths:

Strength training won’t “fix” running mechanics. Contrary to popular belief, weak glute muscles don’t necessarily cause the knee to collapse inward, and there’s little evidence linking weak glutes to hip adduction (knee movement inward) during running ( Baggaley et al., 2015 ).

7) Stick to Core Exercises:

Exercises that mimic running don’t necessarily translate to better running performance ( Willy and Davis, 2011 ). Instead, focus on essential exercises like deadlifts, squats, lunges, and calf raises to build a strong foundation.

Our Physiotherapists , Sports Therapists , and Sports Massage Practitioners are available to assess injuries, formulate a bespoke treatment plan, and design a personalised rehab plan. Whether you’re dealing with a sports injury or a pain while running, we’re here to help.

To book, call us at 01245 895410 or email hello@chelmsfordphysio.co.uk .

What Does Megan Get Up to When She’s Not Being a Physio?

Fri, 25 Oct 2024 15:22:03 GMT

At Chelmsford Physio , we’re always keen to share a bit about our team and their passions outside of the clinic. Megan Williams , one of our talented physios, has a not-so-secret love: cross-country running!

Megan has been with us for over three years, and her expertise in sports injuries is evident, especially given her dedication to athletic training. But outside of helping clients recover, she’s clocking miles across local trails and fields, a commitment she’s built up over the last 15 years. It all began when she was a shy 11-year-old, clinging to her friend’s shirt to get around the track. Today, Megan trains five times weekly, often joined by other dedicated women who keep her motivated—rain or shine.

Through her hard work and dedication, Megan has seen great success, recently placing 2nd in the Essex cross-country league for senior women. She’s also represented Essex in inter-county events, and during the warmer months, you might spot her at the track competing over 1500m.

For Megan, running is more than a hobby; it’s a source of inspiration that fuels her energy in and out of the clinic.

The Demands of Cross-Country Running & The Role of Physiotherapy

Fri, 25 Oct 2024 14:59:38 GMT

Cross-country running presents unique physical demands that challenge athletes at various levels. The combination of varied terrain, weather conditions, and the extended duration of races requires not only endurance but also strength, flexibility, and injury resilience. Understanding these demands and the role of physiotherapy can help athletes optimise performance and minimise the risk of injury.

Endurance & Cardiovascular Fitness

Cross-country running primarily relies on aerobic endurance, as races can range from 3 to 10 km, and often run on uneven surfaces such as grass, dirt, and trails. According to Noakes (2012) , endurance running activates the cardiovascular system, demanding efficient oxygen transport and utilisation by the muscles. This requires consistent training to enhance cardiovascular capacity and muscular endurance.

Muscular Strength

The varied terrain of cross-country courses necessitates strong leg muscles for uphill runs and stability for downhill descents. Studies indicate that runners must develop significant strength in the quadriceps, hamstrings, and calves to navigate challenging landscapes effectively (Miller et al., 2016)

Mental Resilience

The mental aspect of cross-country running should not be underestimated. Runners face not only physical challenges but also psychological ones, such as maintaining focus and motivation over long distances and varied terrains. According to Buman et al. (2010) , mental toughness is essential for performance, especially in adverse conditions.

The Role of Physiotherapy

Physiotherapy plays a crucial role in supporting cross-country runners through injury prevention, rehabilitation, and performance enhancement.

Injury Prevention

Physiotherapists can help identify biomechanical issues that may predispose runners to injuries. Through gait analysis and strength assessments, physiotherapists can design tailored exercise programs focusing on strengthening weak areas and enhancing flexibility (Kettunen et al., 2002) . This proactive approach reduces the likelihood of common running injuries, such as shin splints , IT band syndrome, and plantar fasciitis .

Rehabilitation

In the event of an injury, physiotherapists are equipped to develop comprehensive rehabilitation programs. These programs typically include pain management strategies, guided exercises to restore strength and mobility, and gradual return-to-run protocols. Research shows that early intervention by physiotherapists significantly enhances recovery outcomes for runners (Bahr & Krosshaug, 2005) .

Performance Enhancement

Beyond injury management, physiotherapy can also contribute to performance enhancement. Techniques such as manual therapy, dry needling , and sports massage can improve muscle function and recovery (Cameron & Monroe, 2017) . Additionally, physiotherapists can provide advice on proper running mechanics and training regimens, ensuring that runners maximise their potential while minimising injury risks.

Conclusion

Cross-country running is a demanding sport that requires a combination of endurance, strength, flexibility, and mental resilience. The role of physiotherapy is multifaceted, encompassing injury prevention, rehabilitation, and performance enhancement. By working with physiotherapists, cross-country runners can better navigate the physical challenges of their sport and achieve their personal bests.

To book, call us at 01245 895410 or email hello@chelmsfordphysio.co.uk .

How Physiotherapy Can Relieve Tennis Elbow: Guide to Effective Treatment & Recovery

Tue, 24 Sep 2024 10:44:20 GMT

Find Out How Physiotherapy Can Help Alleviate Tennis Elbow Symptoms

Are you struggling with Tennis Elbow?

Tennis elbow, clinically known as lateral epicondylitis, is a common condition characterised by pain around the outer part of the elbow It is primarily an overload type injury, where the tissues have performed more work than they have the capacity to tolerate.

Physiotherapy plays a crucial role in managing and alleviating the symptoms of tennis elbow. This blog will explore the physiotherapeutic interventions that can help in recovery and prevention of this condition.

Understanding Tennis Elbow

Tennis elbow is caused by the overuse of the muscles and tendons in the forearm, leading to micro-tears and inflammation. Symptoms typically include pain and tenderness on the outside of the elbow, which can radiate down the forearm and may worsen with specific movements, such as gripping or lifting ( Kirkley et al., 2002 ).

The Role of Physiotherapy

Physiotherapy is a non-invasive treatment option that focuses on rehabilitating the affected area through various techniques. Here are some key physiotherapeutic interventions for tennis elbow:

1. Education and Activity Modification

One of the first steps in physiotherapy is educating patients about their condition. Understanding the causes and symptoms can empower patients to modify their activities to prevent exacerbating the injury ( Wipperman & Goel, 2016 ). This may involve altering grip techniques or taking breaks from repetitive tasks.

2. Manual Therapy

Manual therapy techniques, such as soft tissue mobilisation and joint mobilisation, can help reduce pain and improve range of motion. These techniques involve the physiotherapist applying pressure and techniques to the muscles and joints surrounding the elbow ( Cameron et al., 2016 ).

A study by Syed et al (2024) has shown that adding MWMs to eccentric exercises resulted in enhanced pain reduction and improved function of the upper limb.

3. Strengthening Exercises

A tailored exercise program is essential for recovery. Physiotherapists often design strengthening exercises to enhance muscle endurance and stability ( Bisset et al., 2006 ). Gradually increasing the strength of the extensor muscles can alleviate strain on the elbow. The progression will include eccentric focused exercises for the wrist extensors, as well as the strength chain of muscles up to the shoulder and back.

4. Therapeutic Modalities

Physiotherapists may use Shockwave therapy, for chronic Tennis Elbow symptoms that still persist after around 3 months.

Shockwave therapy delivers acoustic waves to the affected area, which can help reduce pain by promoting the release of endorphins.

The treatment stimulates blood circulation in the elbow, enhancing nutrient delivery and waste removal, which can speed up healing.

Shockwaves can promote the regeneration of damaged tissues. This includes stimulating the production of collagen, essential for repairing tendons.

By alleviating pain, patients often experience improved range of motion and functionality in the elbow.

5. Taping & Bracing

Taping techniques and epiclasps can help reduce strain on the elbow by resting the muscles and tendons. Physiotherapists can provide guidance on the appropriate type of tape or brace and its correct application ( O’Connor et al., 2009 ).

Conclusion

Tennis elbow can be a debilitating condition, but physiotherapy offers effective strategies for managing symptoms and promoting recovery. Through education, manual therapy, targeted exercises, and the use of therapeutic modalities, patients can regain function and prevent future occurrences. If you are experiencing symptoms of tennis elbow, consulting a physiotherapist may be the first step towards recovery.

2024 Paris Olympics: Team GB & Ireland Highlights

Tue, 27 Aug 2024 11:58:01 GMT

Team GB & Team Ireland both had a remarkable performance at the 2024 Paris Olympics, achieving significant milestones and delivering memorable moments across various sports. Here are some of the key highlights:

Historic Milestones ��

Team GB celebrated reaching the significant milestone of 1,000 Olympic medals during these Games, marking their sustained excellence at the Olympics over the years.

Tom Pidcock's Double Gold: ��

Tom Pidcock stood out by defending his Olympic title in mountain biking, overcoming a tyre puncture in a dramatic race. He also competed strongly in the men's road race, reinforcing his status as one of Britain's top cyclists.

Swimming Success & Tom Daley's Retirement: �� ‍♂️��

The British men's 4x200m freestyle relay team, consisting of Matt Richards , Duncan Scott , Tom Dean , and James Guy , secured gold, adding to the nation's swimming dominance. This Olympics also saw the retirement of Tom Daley , a decorated diver and a beloved figure in British sports, who concluded his illustrious career with a silver in the men's 10m synchronised diving event alongside Noah Williams . Daley's retirement marked the end of an era for British diving, as he left the sport after participating in four Olympic Games and winning multiple medals.

Keely Hodgkinson’s 800m Victory: ��‍♀️

Keely Hodgkinson shone in the women's 800m, winning gold in a thrilling race that saw her execute a perfectly timed sprint in the final stretch, securing her place as one of Team GB's standout athletes of the Games.

Josh Kerr’s Battle in the Men’s 1500m: ��‍♂️

Josh Kerr faced off against Norway’s Jakob Ingebrigtsen in an intense 1500m final. Kerr secured a silver medal in one of the most competitive middle-distance races of the Olympics, narrowly missing out on gold but delivering a performance that captivated fans.

The Closest Men’s 100m Final: ��‍♂️

The men’s 100m final in Paris was one of the closest in Olympic history, with the top three finishers separated by mere milliseconds.

Andy Murray's Farewell: ��

Sir Andy Murray made his final Olympic appearance, competing in the men's doubles. Although he didn't secure a medal, his presence was a significant moment as he retired from Olympic competition after a legendary career.

Katarina Johnson-Thompson's Silver: ��‍♀️��

In athletics, Katarina Johnson-Thompson secured her first Olympic medal, a silver in the heptathlon, overcoming years of injuries and near misses.

Irish Success at the 2024 Paris Olympics: ��

Ireland celebrated its best-ever performance at the Olympics, securing four gold medals, an incredible achievement for the nation. The golds came across a variety of sports: in swimming, where they stunned the field; in rowing, continuing their strong tradition; in gymnastics, with a breakthrough performance; and in boxing, where they upheld their proud legacy. This remarkable achievement marked a significant moment in Irish sporting history, showcasing the country's growing strength across multiple disciplines.

For more information check out the below resources:

What is a Baker’s Cyst?

Mon, 26 Aug 2024 10:14:47 GMT

A baker's cyst, also known as a popliteal bursitis or cyst, is a fluid-filled swelling that develops at the back of the knee joint (Brukner et al., 2017) . It is a common condition that often occurs as a result of an underlying problem within the knee, such as arthritis or a knee injury.

The knee joint contains a small fluid-filled sac called a bursa, which helps to reduce friction between the tendons and bones around the joint (Järvinen et al., 2014) . In a baker's cyst, this bursa becomes swollen and enlarged, creating a visible bulge at the back of the knee.

Baker's cysts are typically painless, but they can become painful if the cyst ruptures or if it grows large enough to put pressure on the nearby structures (Handy, 2001) . Symptoms may include:

A visible, painless swelling at the back of the knee
Tightness or a feeling of fullness in the knee
Occasional pain, especially with knee movement
Stiffness in the knee joint

Baker's cysts are often associated with other knee problems, such as osteoarthritis, rheumatoid arthritis, or a tear in the meniscus (the cartilage that cushions the knee joint) (Chatzopoulos et al., 2008) . Treating the underlying condition can often help to resolve the baker's cyst.

Treatment For a Baker's Cyst is Rarely Needed:

Anti-inflammatory medication: To reduce swelling and pain
Physical therapy: Exercises to improve knee strength and flexibility to help the underlying cause

In many cases, a baker's cyst will resolve on its own, particularly if the underlying knee problem is addressed (Greaser & Alpert, 2001) . However, it is important to seek medical attention if a baker's cyst is causing significant pain or discomfort, as it may require treatment to prevent further complications.

How to Balance Pain & Exercise

Mon, 19 Aug 2024 17:48:31 GMT

The fact of the matter is pain is a part of life; for some it is short lived, and for others pain becomes a full time experience. But that shouldn’t mean that exercise and looking after yourself in this way is off the table.

Did you know as many as one in four people in the UK suffer from chronic pain ? If so, it won’t be a surprise to you when we say that one of the most common questions we get asked during a consultation is “can I exercise in pain?”.

The short answer to this question is yes, you can exercise in pain. To explain why, we need to investigate the complexities of pain itself. The International Association for The Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”.

But pain is multifactorial and is not as simple as pain = damage. In fact, pain is a poor indicator of tissue integrity. Psychological, social, and biological factors all add up to the pain experience. We know that pain related fear can be more debilitating than pain itself. Therefore, to assess, understand and treat pain we must have a grasp of all these factors and not simply look at pain as something to be avoided.

Exercise can reduce chances of cardiovascular issues, help with mood and mental health, boosts energy, strengthens bones, and improves sleep as well as allowing us to be social.

In medical literature, exercise has been recommended as a treatment for chronic pain. Exercise can release endorphins ( the body’s natural pain killer) as well as helping reconceptualising pain . In short challenging our beliefs about pain and tissue state, allowing ourselves to explore movements that were once perceived as being dangerous and becoming more comfortable.

Despite this, some people we see in clinic find exercise particularly painful, therefore we need to further understand exercise and its relationship to pain. A recent systematic review asked this question and showed that exercising with pain can have benefits including short term significant improvements. This is our first, clear sign that pain is not harmful.

So, How Can We Exercise Safely Whilst in Pain?

Well now that we have discussed the benefits of exercise and pain, we want to delve into the practicality of it, so we have collated our top tips for exercising when in pain. But first, it’s important to remember that all people are different, as are all pain presentations, therefore, we offer these as general guidelines to follow, not injury-specific advice. For that we recommend seeing a medical professional for a full assessment .

1. Monitor Your Pain Level

We like to use a subjective scale that is personal to you to measure our pain. This scale is between 0 and 10 where 0 is no pain and 10 is the worst pain you’ve experienced. Don’t let pain go above a 3⁄10 at the time of exercising. There is evidence which supports going all out with exercise, and there is evidence which supports small amount of pain being ok. We say don’t push past a 3⁄10. This is less because we are worried about damage, and more that we don’t want your issue to flare up, all we want to do is exercise in a comfortable range that will allow progression. Your clinician may vary this dependent on where you are in your symptoms.

2. Prioritise Sleep

We need to ensure that pain doesn’t affect your sleep after you exercise. Sleep is incredibly important for recovery, so we want to ensure a good night’s sleep of 6 – 8 hours, especially after exercise. A better night sleep can also aid with lifestyle changes such as increased activity because when you’re well rested, you’re more likely to be able to keep it up, whereas a sleep deprived person might need to opt out of exercise to continue resting. Pain can also be directly affected by poor quality sleep. Therefore, we don’t want the pain to affect your sleep. If your pain levels are doing this, decrease the intensity or load of your training and speak to a healthcare professional.

3. Ensure no Increase in Pain The Following Day

Monitor your pain levels the day after exercise, with the aim of no further intensity in your pain levels. The last thing we want to do is cause a flare up, so if this happens be sure to reduce the load/intensity the next time you exercise, and again, speak to your treating clinician if you are concerned as not all prescriptions of exercise are perfect.

4. Take it Week-by-Week

Ensure graded progression (starting off light and building up) and make exercise goal orientated. Once you’ve found your baseline, make sure you slowly increase the level, intensity and/or load week on week. Goal setting has been shown to be an effective way of ensuring adherence to a programme and can be a good motivator to progressions.

5. Try an Activity You Enjoy

There is no one perfect exercise regime. There are studies which support all types of exercises and strict exercise guidelines around pain are lacking. Evidence suggests that doing a hobby or something you love will increase your chances of sticking to the routine, so keeping exercise simple and enjoyable may be the best option for you.

6. Plan to Fail

Have plans in place for both good at bad scenarios. As the saying goes prepare for the worst. Most of the time things do go to plan but on the occasions things don’t its good to have prepared for these potential scenarios for example exercise regressions or increased pain, this helps prevent you feeling demoralised or fall of the bandwagon of treatment.

What's Up with Those Clicky Knees?

Wed, 31 Jul 2024 11:01:44 GMT

Do your knees sometimes make a clicking or popping sound when you move them? You're not alone - many people experience this phenomenon, often referred to as "clicky knees." While it can be a bit disconcerting, in most cases, clicky knees are not a cause for major concern. In this blog post, we'll explore the common causes of clicky knees and discuss potential treatment options.

What Causes Clicky Knees?

There are a few primary reasons why your knees might be making clicking or popping sounds:

Cartilage Movement: The knee joint is surrounded by cartilage that can sometimes shift or move suddenly, leading to a clicking or popping noise (Brody & Thein, 2018) . This is often harmless and can occur with normal knee movement.
Tendon Snapping: The tendons that run over the knee joint can sometimes snap or glide over bony prominences, producing a clicking sound (Core, 2022) . This is particularly common in athletes and people who are physically active.
Arthritis: Osteoarthritis, a degenerative joint condition, can cause the cartilage in the knee to deteriorate over time. As the cartilage wears down, the bones may rub against each other, leading to clicking or popping noises (Hinman et al, 2014) .
Injury or Trauma: Injuries to the knee, such as a torn meniscus or ligament, can also cause clicking or popping sounds as the joint structures heal and reposition (Hing et al, 2017) .

Is Clicky Knees a Cause for Concern?

In most cases, clicky knees are not a significant cause for concern and do not indicate a serious underlying condition. However, if the clicking is accompanied by pain, swelling, or instability in the knee, it's essential to consult a healthcare professional (Brody & Thein, 2018) . These symptoms may suggest a more serious issue that requires medical attention.

Treating Clicky Knees

For mild cases of clicky knees without other symptoms, the following treatment options may be helpful:

Exercise and Stretching: Strengthening the muscles around the knee joint and improving flexibility through targeted exercises and stretches can help reduce clicking (Brody & Thein, 2018) .
Weight Management: Maintaining a healthy weight can take stress off the knee joints and potentially reduce the frequency of clicking (Hinman et al, 2014) .
Physiotherapy: A Physiotherapist can provide specialised treatment, such as manual therapy techniques, taping techniques and personalised exercise programs, to address the underlying causes of clicky knees (Hing et al, 2017) .

In cases where clicky knees are accompanied by significant pain, instability, or other concerning symptoms, your healthcare provider may recommend more advanced treatment options, such as corticosteroid injections or, in severe cases, surgery (Hinman et al, 2014) .

If you're concerned about your clicky knees, don't hesitate to consult with a specialist at Chelmsford Physio . With the right treatment and lifestyle adjustments, you can often find relief and maintain healthy, happy knees.

Finding Relief for Mechanical Neck Pain: The Power of Manual Therapy & Exercises

Wed, 31 Jul 2024 10:51:52 GMT

Neck pain can be a frustrating and debilitating condition, impacting your daily activities and overall quality of life. One of the most common types of neck pain is mechanical neck pain, which is often caused by posture, muscle strain, or injury. While medication and rest can provide some relief, research has shown that a combination of manual therapy and targeted exercises can be an effective long-term solution for managing mechanical neck pain.

What is Mechanical Neck Pain?

Mechanical neck pain is characterised by pain, stiffness, and limited range of motion in the neck and shoulder area. It is typically caused by mechanical or structural problems in the neck, rather than underlying conditions like inflammation or nerve damage (Javanshir et al, 2017) .

Some of the most common causes of mechanical neck pain include:

Posture, especially during prolonged periods in a static position
Muscle strain or spasm due to injury or overuse
Degenerative changes in the cervical spine, such as osteoarthritis
Trauma, such as a whiplash injury from a car accident

The Benefits of Manual Therapy

Manual therapy is a hands-on approach to treating musculoskeletal conditions, including mechanical neck pain. Skilled healthcare professionals, such as Physiotherapists or Osteopaths, use a variety of manual techniques to improve joint mobility, reduce muscle tension, and alleviate pain (Gross et al, 2015) .

Some of the proven benefits of manual therapy for mechanical neck pain include:

Improved range of motion: Manual therapy techniques, such as joint mobilisation and manipulation, can help restore normal joint and muscle flexibility, leading to an increased range of motion in the neck (Gross et al, 2015) .
Reduced pain: Manual therapy has been shown to decrease pain levels in individuals with mechanical neck pain, often providing immediate relief (Gross et al, 2015) .
Enhanced muscle function: Manual therapy can help relax tense muscles and improve muscle activation, which can in turn improve overall neck and shoulder function (Javanshir et al, 2017) .
Faster recovery: Research suggests that the combination of manual therapy and exercise can accelerate the recovery process for patients with mechanical neck pain, compared to exercise alone (Gross et al, 2015) .

The Importance of Targeted Exercises

While manual therapy can provide short-term relief, incorporating targeted exercises into your treatment plan is crucial for the long-term management of mechanical neck pain. Exercises that focus on strengthening the neck and shoulder muscles, as well as improving posture and flexibility, can help prevent future recurrence of the condition (Javanshir et al, 2017) .

Some of the most effective exercises for mechanical neck pain include:

Neck stretches: Gentle stretching of the neck and shoulder muscles can help improve flexibility and range of motion.
Neck strengthening exercises: Exercises that target the muscles responsible for neck movement, such as the deep neck flexors and extensors, can help stabilise the cervical spine.
Postural exercises: Exercises that focus on improving posture and alignment can help reduce the strain on the neck muscles and prevent future episodes of mechanical neck pain.

By incorporating both manual therapy and targeted exercises into your treatment plan, you can effectively manage your mechanical neck pain and improve your overall quality of life.

Unlocking Fitness: The Comprehensive Benefits of Kettlebell Training

Wed, 26 Jun 2024 17:19:40 GMT

Kettlebell training has been found to add significant value to athlete training programs, by enhancing strength, power, endurance, explosive power and postural co-ordination ( Jaiswal et al, 2024 ) .

The Surprising Benefits of Kettlebell Exercises:

Kettlebell training has grown in popularity in recent years, and for good reason. These cast-iron weights offer a unique and highly effective workout that targets multiple muscle groups simultaneously. If you're looking to mix up your fitness routine and experience the transformative power of kettlebells, read on to discover the surprising benefits this training modality can provide.

Improved Cardiovascular Fitness

Numerous studies have found that kettlebell workouts can significantly improve cardiovascular health. A 2010 study published in the Journal of Strength and Conditioning Research examined the effects of a 12-minute kettlebell workout and found that it elicited an average heart rate of 93% of participants' maximum heart rate (Farrar, Mayhew, & Koch, 2010) . This level of intensity helps to strengthen the heart muscle, increase lung capacity, and boost overall aerobic fitness.

Enhanced Muscular Strength and Endurance

Kettlebell exercises require the engagement of multiple muscle groups, including the core, legs, and upper body. This full-body activation leads to increased muscular strength and endurance. A 2013 study in the Journal of Strength and Conditioning Research found that 8 weeks of kettlebell training significantly improved participants' deadlift, jump squat, and bench press performance (Lake & Lauder, 2013) .

Improved Flexibility and Mobility

The dynamic, swinging motions of kettlebell exercises promote improved flexibility and mobility in the hips, shoulders, and spine. A 2010 study in the Journal of Strength and Conditioning Research observed significant increases in shoulder and hip mobility after just 4 weeks of kettlebell training (Jay et al, 2013) .

Time-Efficient Workouts

Kettlebell workouts are renowned for their efficiency, allowing you to achieve a full-body workout in a relatively short amount of time. This makes kettlebells an excellent choice for individuals with busy schedules who still want to prioritise their fitness. A study published in the Journal of Strength and Conditioning Research found that just 20 minutes of kettlebell training can provide the same cardiovascular benefits as running at a moderate pace for 50 minutes (Fett, Trompetto, & Hackney, 2011) .

In conclusion, incorporating kettlebell exercises into your fitness routine can provide a wide range of benefits, from improved cardiovascular health and muscular strength to enhanced flexibility and mobility. Whether you're a seasoned fitness enthusiast or just starting your journey, exploring the world of kettlebells can be a game-changer in your pursuit of better health and fitness.

For further advice on how to train using a Kettlebell, get in touch now and speak to an expert at Chelmsford Physio. Our team is dedicated to helping you enjoy a healthy, active summer.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Femoroacetabular Impingement of the Hip?

Fri, 26 Apr 2024 11:34:52 GMT

Femoroacetabular impingement (FAI) is a painful condition caused by irritation and inflammation of the soft tissues of the hip joint. This can occur because the femoral head (the ball of the hip) pinches up against the acetabulum (cup of the hip joint). This can be due to extra bone growth, on one or both of the bones that form the hip joint, giving the bones an irregular shape. When this happens the bones don’t fit together properly, and therefore rub against each other during movement. Over time this friction can damage the joint, tendon and/or the cartilage surrounding the joint (known as the labrum), causing pain, stiffness and limited activity.

If left untreated it may increase a person’s risk of developing chronic hip joint conditions such as osteoarthritis.

For this reason, timely and effective treatment is essential, for all stages of hip impingement. In this post, we will discuss hip impingement symptoms, causes, and effective treatment options.

Anatomy of the Hip Joint

The hip joint is what’s called a ball and socket joint. The acetabulum in your pelvis comprises the “socket” portion and the femoral head, or the top portion of the thigh bone, creates the “ball” portion of the hip joint. It is one of the largest and most important joints in the body (see image below).

A thick soft tissue layer called articular cartilage covers the surface of the bones i.e. the ball and

the socket. This layer of cartilage creates a smooth, low friction surface that ensures the bones

glide easily over each other during movement.

There is an outer rim of cartilage (fibrocartilage) known as the labrum that surrounds the

acetabulum. The labrum adds extra stability to the joint by deepening the socket of the

acetabulum, and acts to seal off the joint fluid to help keep the joint lubricated. The labrum also

allows the ball and socket joint to operate smoothly during activity.

What Causes Femoroacetabular Impingement of the Hip?

The abnormalities associated with FAI are often present at birth. But they can develop later in life,

especially during the teenage years. When the hip bones are shaped abnormally, there is little that

can be done to prevent FAI.

There are three types of anatomical variation which can lead to femoroacetabular hip:

There are three types of anatomical variation which can lead to femoroacetabular hip impingement:

Pincer: This type of impingement is caused by extra bone growth which extends over the rim of the acetabulum in the hip socket. The labrum can become pinched by the prominent rim.

Cam: In this type of impingement, the ball has a more oval than round appearance. This means that the head cannot rotate smoothly in the acetabulum, creating friction when the ball hits the edge of the socket. This repeated friction can cause bony growth on the head of the joint, adding to further impingement.

Combined: This means that both the cam and pincer types of FAI are present.

When one, or both, of these lesions are present, they can cause pinching or impingement of the hip joint structures; mainly the labrum around the edge of the joint. As previously described, the labrum is a layer of cartilage which encircles the socket of the hip joint. It is susceptible to damage when repetitive impingement takes place. Over time this impingement of the hip joint can cause pain, especially with prolonged periods of sitting or during and after exercise.

Risk Factors Associated with FIA

Research suggests that the development of femoral acetabular impingement is mainly congenital; i.e. you are born with it. However, there are a number of risk factors associated with femoral acetabular impingement (FAI). These include;

Hip muscle weakness especially the gluteal muscles
Hypomobility (reduced range of movement) or hypermobility (excessive range of movement) of the hip joint
Muscular stiffness/tightness in the muscles surrounding the hip
Altered gait (walking) pattern
Previous hip injury such as a fracture
Pelvic posture
Type of sporting activity carried out at a young age (adolescent years when growing). For example, it has been shown that those who participate in football at a young age have a predisposition to developing FAI secondary to a CAM lesion. Because active people tend to work the hip joint more vigorously, they may begin to experience pain earlier than those who are less active. However, exercise does not cause FAI.

What are the Symptoms of Femoroacetabular Impingement of the hip?

You can have hip impingement for a number of years and not know it, because it is often not painful in its early stages.

When hip impingement causes symptoms, the main symptoms are pain in the groin and outside of the hip. Often the pain is aggravated when turning, twisting, running or squatting and accompanied with hip stiffness i.e. decreased range of motion in the hip. The pain can be sharp with movement, but is also described as a more constant dull ache.

The most common symptoms of FAI include:
Moderate to marked hip or groin pain with certain hip movements or positions
Pain can also be reported in the thigh, back or buttock
Stiffness and reduced movement in the hip joint
Clicking and/or catching sensation in the hip
Locking or giving way
Decreased ability to perform activities of daily living and sports
Limping when walking or running

How do we Treat Femoroacetabular Impingement of the Hip?

Femoroacetabular impingement normally responds extremely well to physiotherapy and activity modification.

While it is not possible to reverse the bone and joint changes that occur with FIA, there are a number of treatment options available to help reduce your pain and symptoms, and allow you to live a full and active life. The main treatment goals of physiotherapy for FIA are:

Reduce your hip pain and joint inflammation.
Increase your hip joint range of movement and muscle flexibility.
Strengthen your lower limb muscles.
Improve your balance, proprioception and agility.
Optimise your functional movements and activity level, e.g. walking, squatting, climbing stairs.
Physiotherapy Treatment for Hip Femoroacetabular Impingement

Your physiotherapist will provide a specific, tailored, treatment and rehabilitation programme, which may include:

Relative Rest – Advice activity modification and rest, to allow your pain to settle and minimise the chance of irritating your symptoms further. Prolonged sitting in low chairs and sitting cross legged should be avoided.

Patient Education – Understanding the cause of your symptoms is an important part of your treatment process. It can give you peace of mind and also help you to take a more active role in your rehabilitation.

Pain Management – Painkillers and non-steroidal anti-inflammatory medication can often be useful in the early stages of management (any medication needs to be approved by a pharmacist or doctor).

Manual (hands on) Therapy – Your physiotherapist may use manual therapy such as joint mobilisations or soft tissue techniques, to release the joints, muscles and soft tissues. This will help improve joint movement and reduce muscle stiffness or soreness.

Range of Movement Exercise – Your physiotherapist may teach you some stretching exercises for your hip joint and surrounding muscles, to help restore normal movement of your hip.

Hip Strengthening Exercises – Your physiotherapist will design a progressive resistance program to ensure all your lower limb muscle groups are strong. It will specifically target your deep gluteal muscles, which will help to stabilise your hip joint.

Proprioception and Balance Exercises – Damage to your joints and soft tissues, can have a negative affect on your balance. These exercises will help your brain to reconnect with your hip, and give you a better sense of balance during movement and activities.

Biomechanical and movement re-education – Lower limb joint injuries can alter your movements, especially walking and running. Your physiotherapist may need to re- teach you how to move correctly.

Functional and Sports Specific Training – Once your pain, movement and strength have improved, your physio will work on specific, functional training to help you safely resume more demanding activities and sports.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

A Recent Case Study in Clinic of a Stress Fracture we Picked up

Tue, 26 Mar 2024 17:54:08 GMT

BSI in runners are more prevalent than you might think. We had an interesting case in clinic recently, a 27 year old runner, training for the London Marathon.

A very fit, active & healthy, Experienced athlete, good training history and works as a Personal Trainer. Presented with anterior hip pain, complaining of a hip flexor strain.

Based on the history and physical examination, it clearly wasn’t a hip flexor strain and we arranged an MRI to assess the hip joint, it confirmed an early stress fracture to the neck of his femur.

These are relatively common overuse injuries in runners. Often seen in running and jumping athletes and are associated with increased volume or intensity of training workload

Common sites for a BSI include:

Femur
Tibia (Shin Splints)
Fibula
Metatarsals

Shin splints is the most common form of early stress injury. This diagnosis reflects a spectrum of medial tibial pain in early manifestations before developing into a stress fracture.

Through early diagnosis and a structured management plan, the prognosis should be a full recovery and a return to running in 6-12 weeks. If not diagnosed at the right stage and poor management, these can worsen and worst case end up needing surgery.

If you suspect a BSI or would like any help with a pain or an injury, get in touch now and speak to an expert Physiotherapist:

Call: 01245 895410

Email: hello@chelmsfordphysio.co.uk

What to do & NOT to do on Marathon Day

Mon, 25 Mar 2024 23:02:58 GMT

You've put in the miles, sacrificed your lie-ins and bought the lycra, now marathon and half marathon day is on the horizon. Make sure you're in top shape at the start line with our DOs and DON’Ts for final marathon preparation:

DO's

Rest - our muscles are fueled by glycogen, a carbohydrate, which is depleted after long periods of exercise. Resting in the days leading up to the marathon allows glycogen levels to increase. Think of it like filling up your car for a long journey, so now you need to think about what fuel…

Re-fuel - as a general guide increase carbohydrate intake for 36-48hrs before the race. Carbs with a low glycemic index (GI) are best as they release energy for a longer period. This includes wholemeal pasta, roasted and salted peanuts, milk, fruit (especially cherries and grapefruit) and wholemeal bread. Mash potato, chips and white rice are considered high GI and are probably best

avoided pre-marathon. In terms of how much to eat, comfort is important. Don't be tempted to completely stuff yourself and risk feeling ill after! Elite athletes aim for 10 - 12 grams of carbs per kilogram of body weight per 24hrs. Meaning an 80kg runner would aim to eat 800 - 960 grams of carbohydrate per 24hrs. This is probably a little excessive for most and not the best thing to try for the first time on marathon weekend!

Prepare - got a pen and some paper? Right, now make a list of everything you need for race day! Shorts, shoes, socks, GPS watch, race number, safety pins, emergency loo roll, gels, post race

bag, sweat band, vaseline, pre-race breakfast, and anything else you can think of should go on that list. Get it all ready and laid out the day before so you don't have a thing to worry about on marathon day. Also give some thought to how you'll get to the start line and when you'll leave as roads are usually closed. It sounds like a military operation but the aim is to make it as stress free as possible and help you enjoy the day.

Plan - decide how you want to approach the race and what your goals are and use this to guide your race plan. It's very easy to start too quickly and pay the price later on. A marathon is a long way - save some energy for the end. You may have heard of 'negative splits' - the idea being to run the second half of a race quicker than the first. Some will aim to do this for a marathon but those

last 5-6 miles are seriously tough so it may not be realistic. Another approach is to aim for an even, comfortable pace the whole way. This can help prevent 'hitting the wall' but requires discipline. Work out your target pace and try and stick to that, resist the temptation to speed up early on as you run the risk of paying for it in the later stages. A GPS watch can be really helpful for monitoring

speed but failing this run near a pacer or chat to fellow runners to get an idea of pace.

Relax - once you're prepped and ready relax, there is nothing more you can do! Your marathon is about the last 4-5 months of training not the final few hours. You've put the work in, put your feet up and chill out!

DON'TS

Panic - it's very common for people to have a 'temper tantrum' and panic just before a race.

Suddenly you assume everything will go wrong and you're totally unprepared. In fact we have had people call the night before wanting an emergency physio appointment the night before a marathon! You will get little niggles in the taper but they'll settle and be fine for the race. Stay calm,

it'll all be fine.

Test out new stuff - race day is not the time to try out new shoes, a different running style or a radical new diet. Keep marathon day for what you've tried and tested. If it works for you, stick with it!

Squeeze in an extra run - the temptation to squeeze in more miles or compensate for missed sessions can be very high leading up to the big day. Resist! Stick to your taper, rest and re-fuel.

On race day...

Use the morning routine you've used for your long runs (adapt it as needed for your start time). Get an early start to give you at least 2 hours between eating and racing. Stick to whatever breakfast you've tried and tested! Get to the start line with plenty of time. Try to have used the toilet well before start time as queues can be long on race day. Stick to the plan, probably the most

common mistake to make on race day is to run the beginning of the race at a much faster pace than planned. This will drain you precious glycogen stores and is a sure fire way to increase your

risk of hitting the dreaded wall. Stick to your pre-race plan and keep a close eye on your pace.

Don’t dodge in and out of people at the start. Just go with it. After a couple of kilometres the crowds will filter out and you will be able to settle into your pace.

Run as though you are trying to hold yourself back to start. Its a long race, you will catch the time easy, but if you are hanging on at the end you will lose much more.

The race does not start until 20 miles, so arrive there feeling good, and then kick on if you can. Don’t be a slave to the watch Work out what your 5km times should be and check them instead of looking every 1km.

Finally and most importantly enjoy the day, you have worked long and hard to get to the start line now soak up the atmosphere and enjoy the experience.

For any pre-race sports massage or advice please feel free to contact us we are more than happy to help with any pre race injuries or help planning your race strategy. For post-race recovery why not come for a massage at our clinic.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Stress Fractures in Runners

Mon, 25 Mar 2024 17:32:30 GMT

Running is a highly popular and beneficial form of exercise, but it also carries the risk of various injuries. Among these, stress fractures are a common concern for runners. Stress fractures are small cracks in the bone that develop due to repetitive stress and overuse. In this blog post, we will delve into the causes, symptoms, treatment, and prevention of stress fractures in runners, drawing upon research from Harvard University.

1. Understanding Stress Fractures:

Stress fractures occur when the repetitive force applied to a bone overwhelms its ability to repair itself. They typically develop in weight-bearing bones, such as the tibia (shinbone), metatarsals (foot bones), and femur (thigh bone). Runners are particularly susceptible to stress fractures due to the repetitive impact forces exerted on their lower extremities during training.

According to researchers, the most common risk factors identified for stress fractures in runners include sudden increases in training volume or intensity, improper footwear, poor running form, nutritional deficiencies, and underlying bone density issues.

2. Recognising Symptoms and Seeking Treatment:

Early detection of stress fractures is crucial to prevent further damage and promote optimal healing. The symptoms of a stress fracture may include localised pain that worsens with activity and diminishes with rest, swelling, tenderness, and potentially a noticeable limp.

It is highly recommend to seek consultation with a specialist, if a stress fracture is suspected. Diagnosis typically involves a thorough physical examination, imaging tests (e.g., X-rays, MRI), and sometimes bone scans to confirm the presence and location of the fracture.

Treatment of stress fractures often involves a period of rest from running and other high-impact activities. It is important to implement a gradual return-to-running program under the guidance of a specialist. Other treatment modalities may include pain management, immobilisation with a cast or walking boot, physiotherapy, and addressing any underlying factors contributing to the fracture (e.g., correcting running technique, improving bone health).

3. Preventing Stress Fractures:

Prevention is key when it comes to stress fractures in runners.

a. Gradual Training Progression: Avoid sudden increases in training volume or intensity. Gradually build up mileage and incorporate rest days into your training schedule to allow for adequate recovery

b. Proper Footwear: Choose running shoes that provide appropriate support and cushioning for your foot type and running style. Consult with a knowledgeable professional to ensure a proper fit.

c. Cross-Training and Strength Training: Engage in cross-training activities (e.g., cycling, swimming) to reduce the repetitive stress on your bones. Incorporate strength training exercises to improve muscle strength and stability, which can help absorb impact forces during running.

d. Balanced Nutrition: Maintain a well-balanced diet that includes adequate calcium, vitamin D, and other essential nutrients for optimal bone health. Consult with a registered dietitian or healthcare professional to ensure you meet your nutritional needs.

e. Listen to Your Body: Pay attention to any signs of pain, discomfort, or unusual changes in your running routine. Address these issues promptly and seek professional advice if needed.

f. Sleep: gaining 7-9 hours sleep at night is a key component when training for a marathon. Regularly getting less than 7 hrs sleep, doubles your risk of an injury.

Stress fractures can be a significant setback for runners, but with proper understanding, early detection, and appropriate management, they can be effectively treated and prevented. By incorporating the knowledge and recommendations derived from Harvard research, runners can take proactive steps to reduce the risk of stress fractures, ensuring a healthier and more enjoyable running experience.

Remember, when it comes to stress fractures, prevention is always better than cure. Prioritise gradual training progression, appropriate footwear, cross-training, strength training, and a balanced diet to keep your bones strong and resilient. By taking care of your body and listening to its signals, you can continue to pursue your running goals while minimising the risk of stress fractures.

Why we Taper for a Marathon

Mon, 25 Mar 2024 15:50:56 GMT

Preparing for a marathon is a physically and mentally demanding task. As the race day approaches, runners often implement a strategic training technique known as tapering. Tapering involves reducing the training load and allowing the body to recover in the weeks leading up to the marathon. But why do we taper? In this blog post, we will explore the scientific rationale behind tapering and why it is an helpful component of marathon preparation

1. Enhancing Physical Recovery:

Tapering provides an opportunity for the body to recover and repair. Intense marathon training places considerable stress on the musculoskeletal system, causing microscopic damage to muscles, tendons, and other connective tissues. By tapering, runners allow these tissues to heal and adapt, reducing the risk of injury and improving overall performance.

Tapering can help restore glycogen stores in muscles, improve muscle strength, and increase the concentration of enzymes involved in energy production. These physiological changes contribute to enhanced athletic performance on race day.

2. Reducing Fatigue and Overtraining:

Overtraining is a common concern among marathon runners. Pushing the body too hard without adequate recovery can lead to excessive fatigue, decreased performance, and even burnout. Tapering allows the body to replenish its energy stores, reduce accumulated fatigue, and restore hormonal imbalances caused by intense training.

Many studies suggests that tapering can help decrease muscle damage and inflammation markers, such as creatine kinase, C-reactive protein, and interleukin-6. These findings indicate that tapering plays a vital role in reducing the risk of overtraining syndrome, optimising recovery, and maximising performance potential.

3. Improving Psychological Readiness:

Marathon training is not just physically demanding; it also takes a toll on the mind. The mental aspect of running a marathon is crucial, as it requires focus, determination, and resilience. Tapering provides runners with an opportunity to recharge mentally, reducing stress and anxiety associated with intense training.

Research reports tapering can improve sleep quality, reduce psychological stress, and enhance overall well-being. Adequate rest during the tapering period helps runners feel fresh, motivated, and mentally prepared for the challenges of the marathon.

4. Maintaining Fitness Gains:

One might worry that reducing training volume during the tapering phase could lead to a decline in fitness. However, scientific evidence suggests otherwise. Tapering does not result in a loss of fitness; rather, it allows the body to consolidate the gains made during training.

Research has demonstrated that tapering can help maintain endurance while reducing training-related fatigue. The study found that runners who tapered adequately before a marathon maintained their cardiovascular fitness and experienced improved running economy.

Tapering is a scientifically supported strategy that plays a vital role in marathon preparation. By reducing training volume, allowing physical recovery, minimising fatigue, enhancing mental readiness, and consolidating fitness gains, tapering optimises performance potential on race day.

Research has shed light on the physiological and psychological benefits of tapering, emphasising its importance in preventing overtraining, reducing injury risk, and achieving peak performance. As you embark on your marathon journey, remember to incorporate a well-structured tapering phase into your training plan. It might just be the key to reaching your full potential and crossing that finish line with a smile.

‘The Hips don’t lie’ Don’t blame it all on the hip flexors

Mon, 26 Feb 2024 20:23:52 GMT

Running is a great form of exercise that offers numerous health benefits. However, like any sport, running can also lead to certain injuries and discomfort. One common complaint among runners is anterior hip pain, which refers to pain experienced in the front of the hip joint. In this blog, we will explore the causes, symptoms, and treatment options for anterior hip pain in runners.

I. Causes of Anterior Hip Pain in Runners:

Anterior hip pain in runners can arise from various factors, including:

1. Hip Impingement Syndrome:

Also known as femoroacetabular impingement (FAI), this condition occurs when there is abnormal contact between the ball (femoral head) and socket (acetabulum) of the hip joint. Over time, this repetitive friction can lead to hip pain.

2. Hip Flexor Strain:

The hip flexor muscles, can become strained or irritable due to overload or poor running mechanics. This can result in anterior hip pain.New Paragraph

3. Labral Tear:

The labrum is a ring of cartilage that surrounds the hip socket. It can be torn or damaged due to repetitive stress or trauma, causing anterior hip pain.

4. Stress Fractures:

Runners who engage in high-impact activities are at risk of developing stress fractures in the hip joint. Stress fractures can cause significant pain and discomfort.

II. Symptoms of Anterior Hip Pain:

The symptoms of anterior hip pain may vary depending on the underlying cause. Common signs and symptoms include:

1. Pain or discomfort in the front of the hip, groin, or upper thigh region.

2. Pain that worsens with running, especially during activities that involve hip flexion.

3. Stiffness or decreased range of motion in the hip joint.

4. Clicking or locking sensation in the hip joint.

5. Difficulty with activities such as walking, climbing stairs, or sitting for extended periods.

It is important to consult a specialist in this area, for an accurate diagnosis and appropriate treatment.

III. Treatment Options:

New Paragraph

1. Rest and Modification of Activities:

Reducing or temporarily avoiding activities that exacerbate the pain can help alleviate symptoms and promote healing. It is uncommon to stop all exercise, but maybe swapping running for swimming maybe a helpful modification fo a short period.

2. Physiotherapy

A physio can develop a bespoke exercise program to improve hip strength, flexibility, and running mechanics. This may include stretching exercises, strengthening exercises, and gait analysis.

3. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):

Over-the-counter NSAIDs, such as ibuprofen, may provide temporary relief from pain and inflammation associated with anterior hip pain. However, these should be used under medical supervision, and might be worth consulting your GP or pharmacist.

4. Injections:

Corticosteroid injections are not often needed, but may be recommended to reduce inflammation and alleviate pain. These injections are generally administered under the guidance of a consultant and maybe considered when symptoms don’t settle with the Physio & a given timeframe.

It is crucial to work closely with a specialist to determine the most suitable treatment approach based on individual circumstances.

Anterior hip pain can significantly impact a runner's performance and overall quality of life. Understanding the causes, recognising the symptoms, and seeking appropriate treatment are vital for a successful recovery. While this blog provides valuable information, it is essential to consult a specialist for an accurate diagnosis and bespoke treatment plan. By taking the necessary steps to address anterior hip pain, runners can regain comfort, resume their training, and continue to enjoy the benefits of running.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Insoles vs. Orthotics: Understanding the Difference and Choosing the Best Support for Your Feet

Thu, 14 Dec 2023 13:35:06 GMT

Feet are the foundation of our body, and taking care of them is crucial for overall well-being. Whether you’re an athlete, someone who stands a lot during the day, or just looking for extra comfort, you might be considering insoles or orthotics. But what’s the difference, and which is the best choice for your feet? Let’s delve into the world of foot support to help you make an informed decision.

What are Insoles?

Insoles, also known as footbeds or inner soles, are removable layers that sit inside your shoes. They are designed to provide extra comfort, cushioning, and support. Insoles can be made from various materials like gel, foam, or leather, and are widely available in shops and pharmacies. They’re a popular choice for those looking to relieve foot fatigue or for added comfort in everyday shoes.

Benefits of Insoles:

Enhanced Comfort: They provide a cushioning effect that can make standing, walking, or running more comfortable.
Versatility: Insoles can be used in various types of footwear.
Affordability : Generally, insoles are less expensive than custom orthotics.

What are Orthotics?

Orthotics are custom-made devices prescribed by healthcare professionals to support and align your feet. Unlike insoles, orthotics are tailored to your specific foot structure and medical needs. They are often used to treat specific foot problems like flat feet, plantar fasciitis, or foot pain related to diabetes.

Benefits of Orthotics:

Custom Fit: Orthotics are designed to fit your feet precisely, providing targeted support where it’s needed most.
Medical Correction : They help in correcting foot abnormalities, improving gait, and reducing pain.
Durability: Orthotics are typically more durable than over-the-counter insoles.

Insoles vs Orthotics: Which is Right for You?

The choice between insoles and orthotics depends on your individual needs. If you’re looking for general foot comfort or relief from minor foot fatigue, insoles might be the right choice. They’re easy to find, relatively inexpensive, and can be a great way to add extra cushioning to your shoes.

However, if you have a specific foot condition, chronic pain, or a structural foot issue, orthotics are likely a better option. While they are more expensive and require a visit to a healthcare professional, the customised support they offer can be invaluable in treating foot-related problems.

How to Choose the Best Option

Assess Your Needs: Consider whether you have specific foot problems or just need extra cushioning.
Consult a Professional : For chronic pain or medical conditions, it’s best to consult a healthcare professional.
Consider Your Lifestyle: Your daily activities and the type of shoes you wear can influence your choice.
Budget: Insoles are more budget-friendly, but orthotics may be a worthwhile investment for long-term foot health.

Whether you opt for insoles for added comfort or orthotics for medical reasons, the right foot support can make a significant difference in your daily life. Remember, the health of your feet impacts your overall well-being.

If you’re in the Chelmsford area and unsure about which option is best for you, don’t hesitate to contact Chelmsford Physio . Our team can provide expert advice and help guide you towards the best solution for your feet.

Gait & Running Analysis: Unveiling the Secrets to Your Foot's Performance

Thu, 14 Dec 2023 11:52:49 GMT

For many of us, running is more than just a form of exercise; it's a passion, a stress-buster, and for some, a way of life. However, did you know that the way you run, and your gait, can reveal a lot about your foot's performance and overall health? Gait and running analysis is a crucial aspect of understanding and improving your running technique, thereby enhancing performance and reducing the risk of injury. In this blog, we’ll explore the world of gait analysis and how it can help runners of all levels.

Understanding Gait Analysis

Gait analysis is a method used to assess the way you walk or run. It involves looking at your body mechanics to identify any abnormalities or imbalances. While this may sound complex, it's essentially about understanding the movement of your feet and legs during each phase of your running stride.

The Importance of Proper Gait

A proper gait is key to effective and injury-free running. An abnormal gait can lead to various issues, from minor discomfort to serious injuries. Common problems include overpronation (where your foot rolls inwards too much) or supination (where your foot rolls outwards). These imbalances can lead to knee pain, shin splints, and even back problems.

How is Gait Analysis Done?

Gait analysis is typically conducted using a treadmill and video recording equipment. As you walk or run on the treadmill, our expert podiatry therapist will observe and record how your feet land and leave the ground. This footage is then analysed to identify any irregularities in your movement.

Benefits of Gait Analysis

Injury Prevention : You can reduce your risk of running-related injuries by identifying and correcting gait abnormalities.
Performance Enhancement: A more efficient gait means a better running performance. You can run longer and faster with less effort.
Customised Solutions: Gait analysis helps in selecting the right footwear and, if necessary, custom orthotics to support your unique foot structure.

Who Can Benefit?

Gait analysis isn't just for professional athletes. Whether you're a seasoned marathoner or a casual jogger, understanding your gait can immensely benefit your physical health and running performance.

What to Expect During a Gait Analysis Session

A typical session involves a physical examination, observation of your walking or running style, and a detailed analysis of the findings. The specialist might ask you to run at different speeds and inclines to get a comprehensive understanding of your gait.

Post-Analysis: What’s Next?

Based on the analysis, you might receive recommendations on improving your running form, exercises to strengthen specific muscles or suggestions for suitable footwear. In some cases, further physical therapy might be advised.

Understanding the intricacies of your gait and running style is a step towards a more fulfilling and injury-free running experience. Gait analysis offers insights into your body mechanics, helping you make informed decisions about your training and footwear.

Remember, every runner is unique, and what works for one may not work for another. It’s about finding what’s right for your body.

Contact Chelmsford Physio

If you're interested in understanding your gait and improving your running performance, consider booking a gait analysis session. Contact Chelmsford Physio for expert advice and personalised care. We support your journey towards a healthier, more efficient running experience.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Biering Sorensen Test: A Powerful Tool for Assessing Spinal Endurance and Building Spinal Strength

Mon, 06 Nov 2023 10:44:30 GMT

In the realm of Physiotherapy and strength training, having a strong and resilient spine is crucial. The Biering Sorensen test, named after the researchers who developed it, is a widely recognised assessment tool used to evaluate spinal endurance. Beyond being a test, it can also be utilised as an effective exercise to improve spinal strength and endurance. In this blog post, we will delve into the details of the Biering Sorensen test, its purpose, and how it can be integrated into a comprehensive exercise routine.

Understanding the Biering Sorensen Test:

The Biering Sorensen test is a simple yet demanding procedure designed to evaluate an individual's endurance in the muscles of the lower back and the surrounding core area. It involves assuming a horizontal position, with the upper body and legs unsupported and parallel to the ground. The test measures the amount of time a person can maintain this position, known as the "trunk extensor endurance time."

Purpose of the Biering Sorensen Test:

The main objective of the Biering Sorensen test is to assess the endurance capacity of the back extensor muscles. It helps identify any weaknesses or imbalances in the core region, which can contribute to lower back pain, and functional limitations. The test provides valuable information for designing targeted exercise programs aimed at improving spinal endurance and preventing back injuries.

Performing the Biering Sorensen Test:

To conduct the Biering Sorensen test, follow these steps:

1. Lie face down on a padded surface with the hips and legs secured.

2. Position the upper body parallel to the floor, with the arms crossed over the chest or placed behind the head.

3. Lift the chest and maintain a neutral spine position, with the neck in line with the rest of the spine.

4. Hold this position for as long as possible, without sagging or lifting the legs.

It's important to note that the Biering Sorensen test should be performed under the guidance of a qualified professional to ensure correct form and prevent injury.

Benefits of the Biering Sorensen Test as an Exercise:

Beyond its role as an assessment tool, the Biering Sorensen test can also be utilised as an exercise to strengthen the core and improve spinal endurance. By incorporating it into a regular workout routine, individuals can experience the following benefits:

1. Core Strength: The Biering Sorensen exercise specifically targets the muscles of the lower back and the core, including the erector spinae, glutes, and abdominal muscles. Performing this exercise regularly can enhance core strength, and endurance.

2. Spinal Endurance: By challenging the back extensor muscles to maintain an isometric contraction for an extended period, the Biering Sorensen exercise improves spinal endurance. This increased endurance translates into better support and protection for the spine during daily activities and athletic endeavors. A hold time of less than 1 minute has a higher likelihood of a recurrence of low back pain, whereas a hold time of over 3minutes significantly reduced the likelihood of a recurrence of low back pain. Interestingly, females perform better than males in this test, with the reason for this not being understood as yet, and older females better than younger females.

3. Injury Prevention: Weaknesses in this region can contribute to a higher risk of developing lower back pain and injuries. By strengthening the muscles responsible for maintaining proper spinal alignment, the Biering Sorensen exercise can reduce the likelihood of such injuries and promote long-term spinal health.

4. Functional Fitness: Strong core muscles are essential for performing various functional movements, from lifting heavy objects to maintaining balance during dynamic activities. The Biering Sorensen exercise helps develop the core strength necessary for optimal performance in everyday tasks and sports.

The Biering Sorensen test serves as a valuable assessment tool for evaluating spinal endurance, identifying weaknesses, and designing targeted exercise programs. It not only provides insights into an individual's core strength but can also be utilised as an effective exercise to improve spinal endurance and prevent back injuries. By incorporating the Biering Sorensen exercise into a well-rounded fitness routine, individuals can enhance core strength, promote spinal health, and enjoy the benefits of a strong and resilient back. Remember, it's always advisable to consult with a qualified professional before attempting any new exercise regimen.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Returning to the Gym After an Episode of Back Pain:

Thu, 28 Sep 2023 09:27:09 GMT

Back pain can be a debilitating condition that affects millions of people worldwide. If you've recently experienced an episode of back pain and are eager to return to the gym, it is crucial to approach your fitness routine with caution. This blog aims to provide you with a comprehensive guide on safely returning to the gym after an episode of back pain, allowing you to resume your workouts while minimising the risk of re-injury.

Seek Professional Medical Advice:

Before resuming any physical activity, it is helpful l to consult with a qualified healthcare professional, such as a Physiotherapist. They can assess your condition, help you understand the cause of your back pain, and provide individualised recommendations and precautions based on your specific situation.

Gradual Return and Patience:

Returning to the gym after back pain requires a gradual approach. Avoid the temptation to jump back into intense workouts immediately. Start with low-impact exercises and gradually increase the intensity and duration of your workouts over time. Patience is key to allow your body to adapt and strengthen without overexertion.

Focus on Strength:

A strong spine is essential for maintaining a healthy back. Incorporate exercises that target these muscles, such as planks, bridges, and bird dogs, into your routine. You can’t go wrong, by getting strong. You should follow a plan that has structured exercises to suit you, with graded exposure to more challenging exercises.

Avoid High-Impact Activities:

High-impact exercises like running or jumping can be too much for your back during the early stages of returning to the gym. During the initial phase of returning to the gym, it is advisable to avoid such activities. Instead, opt for low-impact exercises like swimming, stationary cycling, or using an elliptical machine. These activities provide cardiovascular benefits while minimising risk of rein jury.

Gradually Increase Load and Intensity:

As you progress and your back becomes stronger, gradually increase the load and intensity of your workouts. This progression should be slow and controlled, allowing your body to adapt and recover adequately between sessions. Avoid sudden increases in weight, repetitions, or intensity, as it can increase the risk of re-injury.

Listen to Your Body:

Pay close attention to any discomfort or pain during your workouts. If you experience pain or discomfort in your back, stop the exercise and try to let any pain/discomfort settle. Pushing through the pain can exacerbate your condition and lead to further injury. It is vital to differentiate between muscle soreness, which is a normal response to exercise, and pain originating from your back. If unsure, its always worth consulting with your Physiotherapist to get further advice.

Returning to the gym after an episode of back pain requires a cautious and gradual approach. By following these guidelines, seeking professional advice, focusing on strength, warming up properly, avoiding high-impact activities, maintaining good technique, listening to your body, and gradually increasing load and intensity, you can safely resume your gym routine while minimising the risk of re-injury. Remember, patience and consistency are key to achieving long-term success and maintaining a healthy back.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Don’t Let Injury Stop You Performing at Your Best

Tue, 26 Sep 2023 10:14:50 GMT

As a physiotherapist, I see people of all ages and abilities who have been injured. Whether you're a professional athlete or a weekend warrior, injuries can happen to anyone. But the good news is that there are things you can do to prevent injuries and get back to performing at your best as quickly as possible if you do get injured.

How physiotherapy can prevent injury

Physiotherapists are experts in human movement and function. We can assess your biomechanics, identify any areas of weakness or imbalance, and develop a personalised exercise program to help you strengthen those areas and improve your flexibility. This can help to reduce your risk of injury in the first place.

What to do if you are injured

If you do get injured, it's important to seek professional help as soon as possible. A physiotherapist can diagnose your injury, develop a treatment plan, and help you to rehabilitate and return to your chosen activity safely.

Here are some tips to help you prevent injuries:

Warm up before any activity, even if it's just for a few minutes.
Cool down after any activity.
Listen to your body and rest when you're tired.
Use proper technique when performing activities.
Wear appropriate footwear and clothing.
Make sure your equipment is in good condition.

How Chelmsford Physio can help:

If you are injured, Chelmsford Physio can help you to get back to performing at your best as quickly as possible. Our experienced physiotherapists will work with you to develop a personalised treatment plan that meets your individual needs. We offer a wide range of services, including:

Injury assessment and diagnosis
Treatment of musculoskeletal injuries
Exercise therapy
Manual therapy
Sports rehabilitation

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Embracing technology: The Benefits of Virtual Appointments for Physiotherapy

Wed, 13 Sep 2023 09:19:23 GMT

In recent years, the healthcare industry has witnessed a remarkable transformation with the integration of technology into various aspects of patient care. One notable example of this is the rise of virtual appointments for physiotherapy. With the advent of video conferencing and other digital tools, patients can now receive expert physiotherapy guidance and support from the comfort of their own homes. In this blog, we will explore the numerous benefits of virtual appointments for physiotherapy and why this innovative approach continues to be popular among patients and practitioners alike.

Convenience and Accessibility:

Virtual appointments eliminate the need for patients to travel to a physical clinic, saving them time, money, and the hassle of commuting. Whether you live in a remote area, have mobility limitations, or simply have a busy schedule, virtual physiotherapy appointments provide unparalleled convenience and accessibility. All you need is a computer, tablet, or smartphone with an internet connection, and you can connect with your physiotherapist from anywhere in the world.

Enhanced Comfort and Privacy:

Many patients feel more comfortable conducting physiotherapy sessions in their own environment. By opting for virtual appointments, individuals can participate in therapy sessions from the privacy of their homes, which can contribute to a greater sense of relaxation and reduce anxiety. This comfort factor may lead to improved patient engagement and a more open and honest dialogue between the physiotherapist and the patient.

Continuity of Care:

Virtual appointments ensure continuity of care, allowing patients to maintain their treatment plans even when faced with travel restrictions, inclement weather, or other unforeseen circumstances. This virtual platform enables physiotherapists to monitor progress, make adjustments to treatment plans, and provide ongoing support, ensuring that patients receive consistent care and guidance throughout their recovery journey.

Time and Cost Savings:

For both patients and physiotherapists, virtual appointments offer significant time and cost savings. Patients no longer need to spend time commuting to and from appointments, reducing travel expenses and minimising the time taken off work.

Expanded Reach and Specialist Access:

Virtual physiotherapy appointments break down geographical barriers, enabling patients to access specialised care regardless of their location. This is particularly beneficial for individuals residing in remote areas or regions with limited access to physiotherapy services. Patients can now connect with highly skilled physiotherapists and specialists who may be located in different cities or even countries, expanding their options and ensuring they receive the best possible care.

Tech-Enabled Monitoring and Feedback:

Incorporating technology into virtual appointments opens up new possibilities for monitoring patients' progress and providing real-time feedback. Physiotherapists can leverage wearable devices, motion sensors, and other health monitoring tools to remotely assess patients' movements, track their exercises, and analyse their progress. This data-driven approach allows for personalised treatment plans and empowers patients to take an active role in their recovery process.

Virtual appointments for physiotherapy are a valuable way for patients to receive care, providing numerous benefits such as convenience, accessibility, comfort, continuity of care, time and cost savings, expanded reach, and tech-enabled monitoring. As technology continues to advance, we can expect virtual appointments to become even more integrated into the healthcare system, enhancing patient outcomes and transforming the way we approach physiotherapy. Embracing this digital transformation opens up a world of possibilities, ensuring that patients receive the care they need, when they need it, no matter where they are.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Unforgettable Moments: Highlights from the World Athletics Championships in Budapest

Wed, 30 Aug 2023 15:11:32 GMT

Team GB Shines at the World Athletics Championships 2023 in Budapest

The World Athletics Championships 2023 held in Budapest witnessed spectacular performances from athletes around the globe, including the impressive achievements of Team Great Britain (GB). In this blog post, we will highlight some of the standout moments and remarkable successes of Team GB at this prestigious event, showcasing the nation's prowess and dedication to athletics.

Katarina Johnson-Thompson's Heptathlon Triumph:

Another remarkable achievement for Team GB came from multi-event athlete Katarina Johnson-Thompson. Over the course of two intense days, Johnson-Thompson showcased her versatility and determination in the heptathlon. With outstanding performances across seven events, including high jump, long jump, and hurdles, she secured the gold medal and etched her name in the history books as the world champion in women's heptathlon.

A Stellar Performance in Relay Events:

Team GB's relay teams also delivered exceptional performances in Budapest. The men's 4x100 meters relay team, comprising talented sprinters, demonstrated their speed and precision. With excellent baton exchanges and an impressive display of teamwork, they clinched the silver medal, narrowly missing out on the gold.

Similarly, the men’s & women's 4x400 meters relay team showcased their strength and determination. With a captivating display of speed and endurance, they secured the bronze medal, making their mark on the global stage and highlighting the depth of talent in British athletics.

Emerging Stars and Promising Performances:

In addition to the established stars, several emerging talents from Team GB showcased their potential and gave glimpses of a bright future for British athletics. Young athletes such as the rising long jumper and the promising middle-distance runners displayed their skills, resilience, and determination, leaving a lasting impression on the international stage.

Budapest became a stage for new names. Josh Kerr’s performance in the 1500m stood out, when he shocked everyone & himself to claim gold. Surely announcing his arrival on the global stage with a breathtaking performance.

Rising star Keely Hodgkinson's 800m silver was her third podium on the global stage at the age of 21.

I think one of my favourite moments was watching Ben Pattison claim a brilliant bronze medal in the 800m. He wasn’t tipped to make the podium in such a strong field, but he ran a really smart race, picking the right line, and then showing incredible grit, determination & desire to hold off the chasing pack & claim his medal. His reaction & post race interview was great too!

The World Athletics Championships 2023 in Budapest provided an incredible platform for athletes worldwide to demonstrate their skills, passion, and dedication to their respective disciplines. Team GB's performances were nothing short of exceptional, with athletes achieving remarkable success and bringing home gold, silver, and bronze medals. From Katarina Johnson-Thompson's mastery of the heptathlon, to brilliance of Josh Kerr in the 1500m. Team GB showcased their talent, determination, and commitment to excellence. The relay teams also made their mark, further solidifying Britain's standing in the world of athletics. As the curtain falls on this edition of the championships, Team GB's performances serve as an inspiration for athletes and fans alike, setting the stage for continued success in the future.

As we look forward to the next major championship & more incredible performances, what were your favourite moments from Budapest 2023?

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

3 Top Tips to Help With Acute Neck Pain

Wed, 30 Aug 2023 14:16:20 GMT

Neck pain is a common complaint that affects a significant portion of the population at some point in their lives. Whether it's due to posture, muscle strain, or underlying medical conditions, neck pain can be debilitating and impact daily activities. In this blog, we will explore three top tips to help you effectively manage neck pain and find relief.

Regular exercise and stretching can improve neck pain, flexibility, and overall function. The key in the early stages is performing exercises and changing your position on a regular basis, every 20-30 minutes can really help.

Neck stretches: Gently rotate your head to the left as far as you can for 3-5 seconds and repeat to the right. Drop your ear to your shoulder as far as you can for 3-5 seconds and repeat on the other side. Shoulder rolls: Roll your shoulders forward and backward in a circular motion to release tension in the neck and shoulders.
Neck strengthening exercises: Perform exercises that target the neck muscles, such as gentle neck isometrics (applying resistance with your hand while resisting with your neck) or chin tucks (tucking your chin inwards while keeping your head level). You can use a ball against a wall to perform these isometric exercises, please see a link to our video on how to perform these https://youtu.be/pHGFYgE1lc8?si=N1yITikesV5PFEfD
Apply Heat or Cold Therapy:

Heat and cold therapies can provide temporary relief from neck pain and reduce inflammation.

a. Heat therapy: Apply a warm compress or take a warm shower to relax tense muscles and increase blood flow to the affected area. Use heat therapy for short periods, around 15-20 minutes at a time.

b. Cold therapy: Apply an ice pack wrapped in a thin cloth to the painful area for 15-20 minutes. Cold therapy helps reduce inflammation and numb the area, providing pain relief.

c. Alternate heat and cold: Some individuals find relief by alternating between heat and cold therapy. Start with heat for a few minutes, followed by cold for a few minutes. Repeat this cycle several times.

Neck pain can significantly impact your quality of life, but by implementing these top tips you can effectively manage and alleviate discomfort. Remember to practice regular exercise and stretching, and consider using heat or cold therapy as needed.

At Chelmsford Physio we see thousands of clients every year with neck pain, and help them successfully resolve their symptoms. We have expert physiotherapists that can help with your neck pain, by helping you understand what is driving/causing your symptoms and formulating a personalised treatment plan. If you’d like some advice on how we can help, please get in touch!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Brachalgia?

Wed, 30 Aug 2023 13:47:21 GMT

Brachalgia, also known as brachial neuralgia or brachialgia, is a medical condition characterized by pain in the arm. It can also be compared to Sciatica, where Sciatica affects symptoms in the leg, this give’s symptoms in the arm.

This condition can significantly impact an individual's daily activities and quality of life. In this blog post, we will delve into the causes, symptoms, and available treatment options for Brachalgia, providing you with valuable insights into this condition.

Causes of Brachalgia:

Brachalgia is often caused by nerve compression or irritation in the brachial plexus, a network of nerves located in the shoulder region. Several factors can contribute to the development of brachalgia, including:

1. Cervical Radiculopathy: This occurs when a nerve root in the cervical spine becomes compressed or irritated, leading to pain and other neurological symptoms that radiate into the arm.

2. Herniated Disc: A herniated disc in the cervical spine can exert pressure on the adjacent nerves, causing brachalgia symptoms.

3. Thoracic Outlet Syndrome: This condition involves the compression of nerves or blood vessels as they pass through the thoracic outlet, resulting in brachalgia and other associated symptoms.

In terms of diagnosis, an MRI can be helpful in understanding the source/root of the symptoms and help guide the treatment plan and management.

Symptoms of Brachalgia:

The primary symptom of brachalgia is pain in the shoulder region & arm that can vary in intensity and duration. Other common symptoms include:

1. Radiating pain: The pain may radiate from the neck down to the fingertips, following the path of the affected nerves.

2. Numbness and tingling: Individuals with brachalgia may experience numbness, tingling sensations, or a "pins and needles" feeling in the affected arm.

3. Muscle weakness: Weakness in the arm muscles may occur due to nerve compression, leading to difficulties with gripping or lifting objects.

Treatment Options:

The treatment approach for brachalgia depends on the underlying cause and severity of symptoms. Here are some common treatment options:

1. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and pain medications may be prescribed to manage pain and reduce inflammation.

2. Physiotherapy: Specific exercises and stretches can help alleviate pain, improve range of motion, and strengthen the muscles surrounding the affected area.

3. Nerve Blocks: In some cases, nerve blocks may be administered to provide temporary pain relief by numbing the affected nerves.

4. Surgery: Surgical intervention may be considered in severe cases or when conservative treatments fail to provide relief. Procedures like discectomy or decompression surgery can help alleviate nerve compression.

Brachalgia can significantly impact an individual's quality of life due to the persistent pain and discomfort it causes in the shoulder region and arm. Understanding the underlying causes and available treatment options is crucial for effective management. At Chelmsford Physio we have expert Physiotherapists who can help with the diagnosis of brachalgia, and plan an appropriate treatment pathway. If needed we also liaise with GPs and we work some of the best spinal surgeons & pain consultants to help further.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is FAI & how can Physiotherapy help!

Tue, 25 Jul 2023 14:03:36 GMT

Femoral acetabular impingement (FAI) is a condition that affects the hip joint and can cause pain and restricted movement. In FAI, the bones of the hip joint rub against each other abnormally, leading to damage to the joint. This condition can affect athletes and non-athletes alike and can be a result of genetic factors, trauma, or overuse. In this blog, we will explore what FAI is, its causes, symptoms, and treatment options, and how Physiotherapy can help.

What is Femoral Acetabular Impingement?

Femoral acetabular impingement occurs when the ball and socket of the hip joint rub against each other abnormally, causing damage to the joint. This condition can be caused by a number of factors, including genetics, overuse, and trauma. There are three types of FAI: cam, pincer, and combined impingement.

Cam impingement occurs when the ball of the hip joint is not round and cannot rotate smoothly in the socket, leading to damage to the cartilage and labrum of the joint. Pincer impingement occurs when there is too much bone around the socket, causing the ball to rub against the bone, leading to joint damage. Combined impingement is a combination of both cam and pincer impingement.

Symptoms of FAI

The symptoms of FAI can vary from person to person, but typically include pain in the hip or groin area, reduced range of motion, and stiffness. The pain may be sharp or dull and may worsen with activity. In some cases, FAI can lead to the development of osteoarthritis in the hip joint.

Diagnosis and Treatment of FAI

To diagnose FAI, a Physiotherapist can perform a physical examination and may order imaging tests, such as X-rays or magnetic resonance imaging (MRI). Treatment options for FAI include physiotherapy, medication, and in some cases, surgery. Physiotherapy can help improve range of motion, reduce pain, and strengthen the muscles around the hip joint. Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In severe cases, surgery may be necessary to repair the damaged joint.

How Physiotherapy Can Help with FAI

1. Strengthening exercises: Physiotherapists can design a program of strengthening exercises to help improve the strength and mobility of the hip joint. These exercises can help reduce pain and prevent further damage to the joint.

2. Range of motion exercises: Range of motion exercises can help improve the flexibility and mobility of the hip joint, reducing stiffness and pain. Physiotherapists may use techniques such as stretching and joint mobilisation to help improve range of motion.

3. Manual therapy: Physiotherapists may use manual therapy techniques such as massage and joint mobilisation to help reduce pain and improve joint mobility. These techniques can help reduce muscle tension and improve circulation to the affected area.

4. Education and advice: Physiotherapists can provide advice on how to manage the condition, including advice on posture, ergonomics, and activities to avoid. They can also provide education on how to perform exercises correctly and how to prevent further damage to the joint.

5. Prevention: Physiotherapy can also help prevent future injuries or damage to the joint. Physiotherapists can provide advice on how to improve technique and conditioning to prevent further damage to the joint.

Conclusion:

FAI is a painful condition that affects the hip joint and can cause reduced range of motion and stiffness. It is caused by abnormal rubbing of the bones in the joint, and can be diagnosed through physical examination and imaging tests. Treatment options include physiotherapy, medication, and in severe cases, surgery. If you are experiencing hip pain or reduced range of motion, consult a doctor or physiotherapist to determine the underlying cause and develop an appropriate treatment plan.

Physiotherapy can be an effective treatment option for femoral acetabulum impingement, helping patients manage their pain, improve their range of motion, and prevent further damage to the joint. Physiotherapists can design a program of strengthening and range of motion exercises, use manual therapy techniques to reduce pain and improve joint mobility, and provide education and advice on how to manage the condition and prevent further damage. If you are experiencing hip pain or reduced range of motion, consult a physiotherapist to determine the underlying cause and develop an appropriate treatment plan.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Plantar Fascia & How Can Podiatry Treatment Help?

Tue, 30 May 2023 15:12:31 GMT

Plantar fasciitis is a common foot condition that affects many people, causing pain and discomfort in the heel and arch of the foot. While there are various treatment options available, podiatry has been shown to be a particularly effective approach in managing plantar fasciitis.

Podiatrists are healthcare professionals who specialise in the diagnosis, treatment, and management of foot and ankle conditions. They are trained to identify the underlying causes of plantar fasciitis and to develop bespoke treatment plans that address the specific needs of each patient.

One of the key ways in which podiatry can help with plantar fasciitis is by providing custom orthotics. Orthotics are specialised shoe inserts that are designed to support the foot and improve its alignment, which can help to reduce stress on the plantar fascia and promote healing. A systematic review and meta-analysis of randomised controlled trials found that custom orthotics were effective in reducing pain and improving function in patients with plantar fasciitis.

Another way in which podiatry can help with plantar fasciitis is by providing targeted stretching and strengthening exercises. These exercises are designed to improve the flexibility and strength of the foot and ankle, which can help to reduce pain and improve function. A randomized controlled trial found that a 12-week exercise program consisting of calf muscle stretching, plantar fascia stretching, and strengthening exercises was more effective than standard care in reducing pain and improving function in patients with plantar fasciitis.

In addition to custom orthotics and exercise therapy, podiatrists may also use other manual therapies such as massage, mobilisation, and dry needling to help alleviate pain and improve function in patients with plantar fasciitis. These techniques can help to improve blood flow to the affected area, reduce inflammation, and promote healing.

Furthermore, podiatrists may also provide education on proper footwear, foot posture, and lifestyle modifications that can help to prevent further injury and promote healing. This may include recommendations on the type of shoes to wear, how to modify activities to reduce stress on the feet, and how to maintain proper foot posture throughout the day.

Overall, the evidence suggests that podiatry can be an effective approach in managing plantar fasciitis. Custom orthotics, exercise therapy, manual therapies, and education are all important components of podiatry treatment for plantar fasciitis. Therefore, if you are experiencing symptoms of plantar fasciitis, it may be worth considering podiatry as a treatment option.

In conclusion, plantar fasciitis can be a painful and debilitating condition, but podiatry can offer an effective approach to managing the symptoms. Custom orthotics, exercise therapy, manual therapies, and education are all important components of podiatry treatment for plantar fasciitis, and the evidence suggests that these approaches can help to reduce pain, improve function, and promote healing. Therefore, if you are experiencing symptoms of plantar fasciitis, it may be worth consulting with a podiatrist to develop a personalised treatment plan that addresses your specific needs.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Plantar Fasciitis (Fasciopathy) & Physio

Tue, 30 May 2023 14:42:30 GMT

Plantar fasciitis is a common foot condition that affects many people, especially athletes and those who spend long hours on their feet. It is characterised by pain and inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot from the heel to the toes. While there are various treatment options available, physiotherapy has been shown to be an effective approach in managing plantar fasciitis.

Physiotherapy for plantar fasciitis typically involves a combination of manual therapy, exercise, and education. Manual therapy techniques such as soft tissue mobilisation, strengthening, and stretching can help to reduce pain and improve mobility by targeting the affected tissues. For example, a systematic review and meta-analysis of randomised controlled trials (RCTs) found that manual therapy was effective in reducing pain and improving function in patients with plantar fasciitis (1).

Exercise therapy is also an important component of physiotherapy for plantar fasciitis. Specific exercises can help to improve strength, flexibility, and balance, which can all contribute to improving the condition. For example, a randomised controlled trial found that a 12-week exercise program consisting of calf muscle stretching & plantar fascia strengthening exercises was more effective than standard care in reducing pain and improving function in patients with plantar fasciitis (2).

In addition to manual therapy and exercise, education is also an important aspect of physiotherapy for plantar fasciitis. Patients are typically taught about proper footwear, foot posture, and other lifestyle modifications that can help to prevent further injury and promote healing. For example, a randomised controlled trial found that a 6-week education program that included advice on footwear, stretching, and activity modification was effective in reducing pain and improving function in patients with plantar fasciitis (3).

Overall, the evidence suggests that physiotherapy can be an effective approach in managing plantar fasciitis. However, it is important to note that the effectiveness of physiotherapy may vary depending on the severity and duration of the condition, as well as individual patient factors. Therefore, it is important for patients to work closely with a qualified physiotherapist to develop a bespoke treatment plan that addresses their specific needs.

In conclusion, plantar fasciitis can be a painful and debilitating condition, but physiotherapy can offer an effective approach to managing the symptoms. Manual therapy, exercise, and education are all important components of physiotherapy for plantar fasciitis, and the evidence suggests that these approaches can help to reduce pain, improve function, and promote healing. Therefore, if you are experiencing symptoms of plantar fasciitis, it may be worth considering physiotherapy as a treatment option.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

3 Exercises For Stage 1 Early Ankle Rehab - Post Sprain

Tue, 30 May 2023 14:09:47 GMT

Ankle sprains are a common injury that can occur during physical activity or daily life. While the severity of the sprain can vary, it's important to properly rehabilitate the ankle to prevent future injuries. Exercise is a crucial component of this rehabilitation process. Here are three of the best exercises to perform following an ankle sprain:

1. Ankle Range of Motion Exercises

It's important to work on regaining the full range of motion in your ankle after a sprain. This can be done through simple exercises such as ankle circles and ankle alphabet. Ankle circles involve rotating your foot in a circle, while ankle alphabet involves using your foot to "write" the letters of the alphabet in the air. These exercises can be done multiple times per day and will help prevent stiffness in the ankle.

2. Calf Raises

Calf raises are an effective exercise for strengthening the muscles in the lower leg, including the calves and ankles. To perform a calf raise, stand with your feet shoulder-width apart and rise up onto your toes. Hold this position for a few seconds, then lower back down. Repeat for multiple sets of 10-15 repetitions.

3. Balance Training

After an ankle sprain, it's common to experience decreased balance and stability. Balance training can help improve these issues and prevent future injuries. One effective exercise is the single-leg balance. Stand on one foot and hold this position for as long as possible, aiming for 30 seconds or more. Repeat on the other foot. As you progress, try closing your eyes or standing on an unstable surface such as a foam pad.

It's important to note that these exercises should only be performed after consulting with a medical professional, as the severity of your ankle sprain may require a different course of treatment. Additionally, it's important to start slowly and gradually increase the intensity of these exercises over time.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Science Behind Podiatric Biomechanics: Understanding Foot Function and Treatment

Mon, 15 May 2023 16:42:10 GMT

When it comes to foot health and the diagnosis of lower extremity conditions, podiatric biomechanics plays a crucial role. This fascinating field combines the principles of biomechanics with the expertise of podiatry to analyse the structure, alignment, and movement of the feet and lower limbs. In this blog, we will delve into the realm of podiatric biomechanics, exploring its significance in understanding foot function and how it aids in the diagnosis and treatment of various foot conditions.

1. The Basics of Biomechanics:

Biomechanics is the study of how forces and movements affect the human body. In the context of podiatry, it focuses specifically on the feet and lower limbs. By examining the forces acting upon the foot during various activities like walking, running, and jumping, podiatric biomechanics aims to identify abnormalities or imbalances that can contribute to foot pain, injuries, and other related conditions.

2. Foot Function and Gait Analysis:

One of the key aspects of podiatric biomechanics is the analysis of foot function and gait. Gait analysis involves observing and measuring how an individual walks or runs to identify any irregularities or deviations from the normal pattern. Podiatrists use sophisticated equipment, such as pressure plates and motion capture systems, to assess factors like foot pressure distribution, timing of movements, and joint angles. This information helps them understand how forces are distributed across the foot and identify any biomechanical abnormalities that may contribute to foot problems.

3. Understanding Biomechanical Abnormalities:

Podiatric biomechanics helps identify various abnormalities that can affect foot function, such as:

a. Overpronation: This occurs when the foot rolls excessively inward during walking or running, potentially leading to conditions like flat feet, plantar fasciitis, shin splints, and knee pain.

b. Supination: The opposite of overpronation, supination refers to an excessive outward rolling of the foot. It can result in issues like high arches, ankle instability, stress fractures, and lateral ankle sprains.

c. Leg Length Discrepancy: When one leg is shorter than the other, it can cause an imbalance, leading to foot, ankle, knee, or hip problems. Podiatric biomechanics can help determine the extent of the discrepancy and guide appropriate treatment options.

4. Treatment Approaches:

Based on the findings of biomechanical assessments, podiatrists can employ several treatment approaches to address foot conditions:

a. Orthotics: Custom-made shoe inserts, called orthotics or orthoses, are designed to provide support, correct alignment, and redistribute forces to alleviate pain and improve foot function.

b. Footwear Modifications: Podiatrists may recommend specific footwear modifications, such as using shoes with appropriate arch support, cushioning, and stability features to accommodate biomechanical needs.

c. Exercise and Rehabilitation: Targeted exercises, stretches, and physical therapy techniques can help strengthen muscles, improve flexibility, and correct imbalances contributing to foot problems.

d. Biomechanical Taping: Taping techniques can provide temporary support and realignment to alleviate pain and promote healing in certain foot conditions.

5. Prevention and Long-Term Foot Health:

Podiatric biomechanics is not limited to treating existing conditions but also focuses on preventing future foot problems. By identifying and addressing biomechanical abnormalities early on, individuals can adopt strategies such as proper footwear selection, maintaining a healthy weight, engaging in regular exercise, and practicing good foot hygiene to optimize foot function and prevent injuries.

Podiatric biomechanics provides a comprehensive understanding of foot function, gait patterns, and biomechanical abnormalities. By utilising this knowledge, podiatrists can accurately diagnose and prevent short, medium and long term conditions that can impact on daily and sporting lifestyles.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

My Marathon Story (Jon McComish) - Chelmsford Physio

Wed, 26 Apr 2023 12:51:54 GMT

I really enjoyed watching the London Marathon on Sunday. One of the best sporting events

of the year, and something that means so much to so many. More than 45,000 runners,

each with their own story, motivation and reason for running. From the 23 year old Kenyan,

Kelvin Kiptum making history in the men’s race smashing the course record and finishing

with the second fastest marathon time in history. To Sifan Hassan winning the female race

in her debut marathon despite stopping twice for a stretch, then nearly getting run over by

a support motorbike when she ran off for a drinks bottle. Incredible stuff!

I was sitting at home yesterday, refreshing the London Marathon app, following the

progress of a list of clients and friends on their race. Thankfully every one of them finished,

and with some seriously impressive times.

One week previously, I was running my own marathon in Manchester. I had decided to run

it during the summer of 2022, and I put a 5-6 month training plan in place.

I’ve always run, but mainly for sports like football. For me I enjoy exercise and keeping fit, so

I’ve always tried to maintain fitness to run between 5-10k.

In March of 2013 I ran the Colchester half marathon and then in the April I ran the Brighton

full marathon. Since then I played football and might run the occasional 5k or 10K. During

lockdown I decided to stop playing football and to run more regularly myself. I also enjoy

cycling, and decided to mix the week by alternating between running days and cycling days.

Off the back of lockdown and the new training regime, I decided to challenge myself with

the Chelmsford Half marathon in March 2022. This went better than expected and once I

recovered fully I decided to give the marathon one more go.

Most people reading this will understand and appreciate how difficult it is to get into the

London Marathon through the ballot. I think I’ve tried numerous times over the years and

been unsuccessful each time.

So after missing out on the London Marathon, I looked at other options and the Manchester

Marathon had been recommended and sounded like a good option for me. I signed up

towards the end of the summer and tried to maintain 3 steady runs a week, and some

strength work in the gym. I decided to start a training plan 5-6 months in advance of the

marathon, that meant having a program in place from November. I reached out to a physio

friend, who specialises in running and we discussed a plan. My original goal was to run a sub

3.05 hour marathon, which is a time for my age. As the training got going, we decided a

sub 3 hour marathon was a better goal and we worked on a training plan/program to

achieve that.

My training plan was fitted around my work and home life, to make the sessions easier to

achieve.

My training plan looked like this:

Monday – 40min recovery run & strength to fit around work 12-8pm

Tuesday – rest day, due to work and kids swimming after work

Wednesday – Intervals in the afternoon, after work 8-2pm

Thursday – 40min recovery run & strength to fit around work 10am-6pm

Friday – long run, to fit with working from home day

Saturday – rest day, as busy family day

Sunday – Tempo run in the morning

This plan really worked for me, and I think I only missed one run in four months training.

My weekly plan consisted of five runs and two strength sessions. We used minutes not miles

for all the sessions.

Minutes not Miles

Using minutes not miles to plan your training can be more helpful, than using distance and

pace. It’s simple and easy to plan, using minutes when we are building up our running in

terms of volume and intensity. We aim to build up to the total time on feet when running

and the intensity of some of the sessions. This allows us to progress training sensibly, and

reduce the risk for injury. When we run for distance the emphasis often becomes about

getting the distance done/covered as quickly as we can, and as a result the pace can

increase, and the intensity follows.

By taking away the distance element, the emphasis shifts away from how long it takes to

run that distance and so allows us to control the intensity of the session better.

80:20 training

Another helpful metric is heart-rate (HR), if you know it or you can work out your max HR

you can then monitor training zones. The 80:20 rule, this is widely used by elite level

runners and refers to 80% of your training being completed at a low intensity, and 20% of

your running being completed at a moderate to high intensity. Too much high intensity

running doesn’t allow for sufficient recovery and therefore is an injury risk.

Another helpful tool is (RPE) Rate of Perceived Exertion, below is a table on how RPE works.

80% of marathon training should be completed at a low intensity (RPE 4 or below), with the

other 20% being performed at moderate to high intensity (RPE 6 & above).

Recovery

A pillar of any training program is recovery, and not prioritising this will increase your risk of

injury and can detract from your performance. 50% of training should be recovery.

Prioritising sleep was really important to me and my training. Less than 7 hours sleep a

night, can double your risk of injury. I tried to aim for 8 hours sleep every night, and used my

watch to monitor my sleep and my HR.

Another tool I used was Normatec Recovery boots. I would wear these on as many evenings

as possible, especially after any tough sessions that day. I would put my feet up on the sofa,

put the Normatecs on level 8-10 and let them do their thing for 45-60mins. The next

morning was always easier after using them.

Stretching and Strengthening

There is good evidence to suggest that elite endurance runners are less flexible than their

non-elite counterparts (Baxter et al, 2017).

However, when you run impact forces are typically 2-3 times your body weight on every

stride. These forces pass through your joints, muscles and tendons. For example, if you

weight 60Kg and runs at 6.30min/mile pace (1072 strides), with impact forces at least x2

body weight (120kg x563) = 64320/64.32 tonnes per foot per mile!!

In my training I didn’t perform any static stretching. I did perform some mobility drills on a

regular basis. I’m lucky to work at Riverside Leisure Centre, where there is a fantastic gym

which I could access to perform my weekly strength program. This really helped me and I

had a few small niggles but never had an injury throughout the process.

Nutrition

This isn’t an area I claim to know lots about, so I contacted a friend who specialises in this

and helped me fit a nutrition plan around me. I learned early in my training what my body

like and responded to, and I stuck to that throughout my training and on the race day.

The five month training block had gone exactly to plan. I ran the Essex 20 (20 miler) in

preparation and I felt great. It gave me the race day preparation, so a good rehearsal for the

marathon day. It also gave me the confidence I could run the pace I wanted for in excess of

20 miles.

Taper

A good marathon taper can make up around 5% increase in your finishing time. A taper

period normally starts the day after your last long run and you gradually start cutting back

on your training distance and effort. A marathon can be specific to each runner, and ideally

should be individualised.

This is where things started to go wrong for me. Nothing to do with the taper or planning,

but there are some things you can’t control in life. I developed a chest infection 1 week out

from the marathon race day, which couldn’t be much worse in terms of timing.

I got to see a GP, who prescribed some antibiotics which I took from the Monday to Friday.

I also needed to take inhalers 3-4 times a day to relieve the symptoms.

Then on the Tuesday my Gran in Ireland passed away, and the funeral was planned for the

Saturday. I considered cancelling the marathon, but after chatting with my wife, and my

family I thought I would go ahead with it and I planned my flights home to Ireland for the

Friday morning and then direct from Dublin to Manchester on the Saturday night.

My wife met me in Manchester on the Saturday night and we checked into the hotel and

got some sleep.

Race Day

I didn’t feel anywhere near 100% on the day of the marathon, but I thought I would see how I

feel as the race progresses. My training had me on for a sub 3hr race, but time would tell.

The setup at Manchester was fantastic, everything was so easy. The start and the end of the

race was from Old Trafford, the bag drop area was slick. I was warmed up and all ready for

my 9.20am start.

My plan was to run with the 3hr pacer and see how I felt, I decided to follow my HR as a

guide, rather than my pace. The first hour didn’t feel great, my HR was probably 20 beats

higher than it should’ve been, and it felt tough, much tougher than the Essex 20 one month

earlier. The second hour didn’t get too much harder, I managed to find a rhythm and stayed

close to the 3hr pacer whilst monitoring my HR.

The last hour just got tougher and tougher, and I struggled to stay with the 3hr pacer from

mile 23 onwards. I ran the last 2-3 miles on my own, and I won’t lie, it was tough going and

would’ve been easy to stop and walk. I just kept thinking about all the training I had done,

and how much effort my wife made to come to Manchester and support me.

I gave it everything on the day and finished in 3hrs and 1min, so close and a great time all

things considered. This time hopefully gives me a place in the London marathon next year.

If I’m honest I really enjoy the process, and it’s probably more about the process for me

than the race itself.

I decided to write this to reflect on the process and answer some of the questions I regularly

get asked in clinic every week. On reflection, I’m so glad I didn’t pull out and I don’t have

any regrets from the training. Looking back to my first and only other marathon in 2013, I

finished in 3hrs and 24mins, and I didn’t enjoy the race at all. If I’m honest my training

wasn’t smart, I didn’t plan it very well and I struggled on the day. I’ve highlighted the key

parts of the training that I have learned from and improved on over the 10 years.

I hope it is of help to some of you reading and if you would like any further information, just

let me know.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

The Best Glute Exercises For You!

Wed, 29 Mar 2023 09:08:58 GMT

What to consider, to get best ‘bang for your buck’!

Collings et al (2023) looked at Gluteal Muscle Forces during Hip-Focused Injury Prevention and Rehabilitation Exercises. This is an EMG-informed musculoskeletal modelling study of gluteal forces in range of exercise.

This study aimed to compare and rank gluteal muscle forces in eight hip focused exercises performed with and without external resistance and describe the underlying fibre lengths, velocities, and muscle activations.

This can be very helpful, when it comes to exercise selection. By choosing the most specific exercise and getting the dosage of that exercise correct, you will get the most effective improvement in symptoms/performance.

This information ties in nicely, with our blog on Greater Trochanter Pain

https://www.chelmsfordphysio.co.uk/greater-trochanter-pain-syndrome and with the recent Instagram post of lateral hip pain and Glute strength exercises.

The one obvious exercise that is missing for this study is the Step Up. When it comes to Glute activation and strength, it's hard to beat the Step Up. This can be a fantastic exercise, used at the right stage in the right way. It is often added as a stage 2 or stage 3 progression exercise, once there is a good strength base.

In a comprehensive systematic literature review by Krause Neto et al (2020)

The results of this systematic review have shown that Glute Max activation varied among the exercises investigated. In general, the step-up exercise and its variations present the highest levels of Glute Max activation. Therefore hard to beat when it comes to working those Glutes, specifically Glut Max.

In a study by Stemmons-Mercer et al (2009) this was a comparison of Gluteus Medius Muscle (EMG) Activity During Forward and Lateral Step-up Exercises in Older Adults.

The purpose of this study was to examine the (EMG) amplitude of the Glute Med muscles bilaterally during forward and lateral step-up exercises.

They concluded that the lateral step-up exercises are associated with greater Glute Med muscle activity than forward step-up exercises.

If you are struggling with hip pain, or would like help with Glute related exercises, please get in touch today and get some advice from an expert who can help!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What Is An Ankle Syndesmosis Injury

Tue, 28 Mar 2023 21:17:50 GMT

What is the injury and how does it occur?

The syndesmosis is a complex ligamentous structure binding the distal fibula and tibia. This can occur when a player is tackled and the player’s mass forces the ankle into dorsiflexion, pronation and external rotation.

What are the effects?

These types of injuries usually present with more pain and disability than a typical ankle sprain. Combining sensitive tests such as inability to hop, inability to walk, tenderness of the syndesmosis ligament and the dorsiflexion-external rotation stress test can help in the diagnosis.

How to treat an Ankle Syndesmosis injury

Syndesmotic sprains without instability should be treated non-operatively but usually require twice as much time rehabilitating compared to normal ankle sprains.

At Chelmsford Physio we specialise in the rehabilitation of all types of ankle injuries pre-operatively and post-operatively, as well as non-operative management. We see lots of athletes following ankle sprains of all types and we pride ourselves on the quality of rehabilitation we provide in the fantastic gym we work out of. We work together with some of the best knee surgeons, so as needed, we can liaise together to give you all of your options.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Serving It Up In Women's Tennis

Tue, 28 Mar 2023 19:52:45 GMT

Firstly, I would like to say hello. It’s my first blog here at Chelmsford Physio and I am settling in well amongst some great clinicians and fantastic clients.

Let’s get to it in the performance blog series!

I am extremely proud to introduce my new role as a performance coach for Leylah Fernandez – Canadian professional tennis player. A role that mixes Sports Therapy, S&C and Sports Science allows me to maximise her performance on and off the court.

Recently I have returned from the US after a short period training in Miami and my first tennis tournament – Indian Wells. Indian Wells has been around since 1974 and takes place in California with the second largest outdoor tennis stadium in the world.

Tennis is a sport based on unpredictability. The unpredictability of point length, shot selection, strategy, match duration, weather and the opponent all influence the complex physiological aspects of tennis play. As a performance coach of a professional tennis player it is important to understand the demands of the sport and the capabilities of the player.

So let’s take you through a typical training day...

We start the day off with a 15 – 20 minute mobility routine before breakfast and then head to the practice courts. When at the practice courts we do a 10 – 15 minute warm up incorporating skipping, footwork and reaction drills. After this she goes onto court where the tennis coach takes over and we use a lot of video analysis to break down her technique. This session lasts approximately 2.5 hours before we head to the gym for our daily strength/speed session. During a strength session we look to target a high number of anti rotation work with trunk strength stability. After lunch we go back to the court to work on the

corrections from the morning session before finishing the day with a daily treatment.

I hope this gives you a little bit of an insight into the life of a performance coach on tour with a professional tennis player. I will be back next time to talk about all things performance nutrition and how to fuel for training and competition like a professional athlete.

You can catch me in clinic on a Tuesday and Thursday!

Tom

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Tennis Elbow?

Thu, 19 Jan 2023 13:00:58 GMT

Tennis elbow, also known as common extensor Tendinopathy and lateral epicondylalgia, is a very

common condition affecting the muscles and tendons that extend your fingers and wrist, causing

pain on the outside of the elbow. The pain is particularly aggravated when you grip objects and

play racquet sports. Pain can also spread into your forearm and wrist.

The pain is usually a dull ache or burning pain that is aggravated by activities involving gripping.

Despite the name, tennis elbow only affects a small percentage of tennis players. It is typically

caused by any activity that puts repeated stress on the muscles and tendons that attach on the

outside of the elbow joint, including painting, gardening, DIY, or even frequent computer use.

We will structure your treatment programme specifically to your goals and will support you through

the process from diagnosis to return to your activity or sport.

Anatomy for Tennis Elbow

The elbow joint is the point of articulation between the upper arm and the forearm. It is made up of

three bones, the humerus (upper arm bone) and the radius and ulna (the bones of the forearm).

The elbow joint is held together by ligaments, tendons and muscles, which all work in partnership

to provide mobility, stability, and strength to the elbow.

Your forearm muscles extend your wrist and fingers. Your forearm extensor tendons attach these

muscles to the bones in your elbow. The extensor tendons attach onto the bony bump on the

outside (lateral side) of the elbow (the lower part of your humerus) called the lateral epicondyle;

hence the condition also being known as lateral epicondylalgia. This is where the site of pain is.

The tendon usually involved in tennis elbow is called the extensor carpi radialis brevis (ECRB).

What causes Tennis Elbow?

It is an overuse injury; as the muscles of your wrist and hand repeatedly contract, it can cause a

strain on the tendon or tendons that attach onto the outer elbow (lateral epicondyle). This excess

strain results in minor tears in the tendon (microtrauma), which then becomes painful and inflamed.

Tendon irritation is often known as tendinitis or tendinopathy.

If the pain persists over a longer period of time (more than a few months), the problem can become

chronic which can make it more difficult to treat.

It almost always affects your dominant hand.

Common Causes of Tennis Elbow Include

Unaccustomed activity and hand use, e.g. painting a fence, DIY, or excessive typing and mouse work.
Activities or sports that involve excessive gripping.
Muscle imbalances – weak forearm muscles or tight muscles.
Poor stability and strength around the shoulder girdle.
A poor technique i.e., a poor tennis or squash shot (usually back hand).
Incorrect equipment i.e computer equipment, tennis/squash racquet or grip size.

Risk Factors for Tennis Elbow

There are several risk factors which may make you more susceptible to experiencing tennis elbow:

Age – It is most common in adults between 30 and 50 years old, though it does affect people of all

ages.

Occupation – It often affects typists or people who do a lot of computer work, painters, carpenters,

plasterers, plumbers, chefs, and other professions that require some degree of repeated motion in

the wrist and forearm.

Sport/Activity – It is more prevalent in those that play racket sports such as tennis and squash,

golf, and also in individuals that lift weights in the gym.

What Are The Symptoms of Tennis Elbow?

Typically someone suffering from tennis elbow will experience pain when performing gripping tasks

or resisted wrist/finger extension such as lifting a kettle, gripping weight and playing sports. There

will be tenderness directly over the outside of the elbow over the bony epicondyle, and there may

also be painful points in the muscles along the forearm. Pain can be present when the forearm

muscles are stretched and some people may also have neck stiffness and tenderness. Most elbow

movements will be pain-free (unless gripping hard at the same time), despite that being the area of

pain.

The symptoms of tennis elbow usually begin to appear gradually, as the condition is a progressive

one, rather than related to an acute injury. As the condition progresses, the associated pain

gradually increases over the course of a few weeks or months.

Common signs and symptoms of tennis elbow:

Ache or burning pain on the outer elbow, gradually increasing over time.
Reduced grip strength.
Usually affects the dominant arm.
Pain worsens with sports or activities that require gripping.

Pain is often also felt while performing basic actions, such as writing or when gripping

small objects, lifting a kettle, turning a door handle or opening a jar.

Tenderness to touch on the bone and muscles on the outside of the elbow.

Swelling on the outside of the elbow.

How do we Diagnose Tennis Elbow?

Obtaining an accurate diagnosis of tennis elbow is essential. It allows the clinician to select the

most effective treatment plan for you. A diagnosis will be made by your physiotherapist who will

carry out a comprehensive subjective and clinical assessment. It is not essential at this stage to

have a scan.

They will ask questions about your past health, symptoms, and exercise regime, which will give

your clinician a good indication of your diagnosis.

After your consultation, the specialist physio will complete a series of tests to help confirm a

diagnosis. This may include:

Assessing the range of movement and strength of your wrist, elbow, and shoulder.
Assessing your grip strength.
Measuring muscle length and flexibility of your forearm and upper limb.
Checking other regions of the body as needed, such as your neck, back and shoulder. This

will help to determine if other areas also require treatment to improve your condition.

Gently, but skillfully, feeling around your elbow and forearm, to find exactly where it is most painful.

Functional tests – if your pain is present during a specific activity or task, you may be asked to

perform these, so the physiotherapist can assess exactly what is aggravating your pain.

There is a specific test called the “Mills test” which is an accurate clinical test for diagnosing tennis

elbow.

The clinical assessment is normally sufficient to diagnose tennis elbow. However, it is limited in

providing any further information about the exact structure of the tendon and surrounding tissues,

and the severity of the condition. This is where an ultrasound scan can be useful.

Diagnostic Ultrasound Scan for Tennis Elbow

A real-time diagnostic ultrasound scan will help to confirm the diagnosis of tennis elbow, ascertain

the severity of the problem and to check if you have a tear in your tendon. It provides more detail

than an MRI.

An ultrasound scan is able to clearly visualise the tendon structure and inflammation associated

with tendinopathy. It is regarded as the gold standard imaging technique for assessing tendon

structure and pathology, better than MRI.

An ultrasound scan showing tendinopathy indicating tennis elbow. An ultrasound scan is better

than an MRI scan for visualising the tendon.

The scan allows for accurate assessment of the severity of the problem and can aid in treatment

selection. Once a full diagnosis has been made, your clinician will be able to discuss the most

effective treatment options with you.

Treatment for Tennis Elbow?

Physiotherapy and rehabilitation for tennis elbow.

At the clinic we have treated a variety of patients with elbow pain, from Racing drivers, gymnasts to

recreational sports and women, and more sedentary individuals who get pain picking up objects.

Your physiotherapist at Chelmsford Physio will provide you with a personally tailored regime for

your tennis elbow, based on your clinical assessment.

Generic tennis elbow exercises, particularly those found on the internet do not help everyone! Your

programme must be tailored to your own personal goals. For example, the rehabilitation

programme for a professional tennis player will be different to a plasterer or brick layer, or

someone who wants to simply pick up the kettle or shopping bags with no pain.

This will often include:

Patient education – it is important to understand your condition and to be active in your recovery.

You will be given a clear explanation of the diagnosis, and we will discuss what is required to

address your symptoms and reach your goals.

Relative rest – advice on rest and activity modification allowing your elbow pain to settle and the

extensor tendon to heal. In severe cases, it might be that a wrist splint is required to allow the

forearm tendons to completely rest for a short period of time.

Pain management – ice applied to the affected area can be very effective in helping control pain

and inflammation. Over-the-counter medication such as painkillers and anti-inflammatories can

also ease pain and inflammation.

Specific loading/strengthening exercises – clinical research has shown that heavy slow

resistance (HSR) strengthening exercises can have a positive effect on tendinopathy. This is a key

component of your treatment programme and requires commitment and consistency. We are

specialists at exercise prescription and progression and will develop a bespoke programme for

you.

Range-of-movement exercise – your physiotherapist may teach you active, self-stretching

methods. They may also do some hands-on, passive stretching with you. Together, these can

really help decrease muscle tightness and tension and restore normal motion of your joints and

muscles.

Manual therapy – your physiotherapist may use manual therapy such as joint mobilisations and

soft tissue release techniques to the surrounding muscles. This will help improve movement and

reduce muscle stiffness or soreness

Muscle strength – muscle weaknesses or imbalances throughout the upper limb can cause or

contribute to problems with tennis elbow. Your physiotherapist will design a safe resistance

program to ensure all your muscle groups are strong and working in synergy to aid your recovery

and prevent recurrence of injury.

Functional and sports-specific training – once your pain, strength, and range of movement

improve, you can begin more demanding, sports-specific rehab.

What if physiotherapy treatment has not worked for your tennis elbow pain?

If physiotherapy options have been unsuccessful, there are a few other treatment modalities

available to you. It is important to remember that physiotherapy should always be the key

component of any tennis elbow treatment pathway, but we always appreciate that physiotherapy

alone does not get every patient better.

The good news is at Chelmsford we provide other treatment options that work in conjunction with

physiotherapy to improve your pain and help the tendon to heal.

Shockwave therapy and injection therapy can complement your rehabilitation programme and can

significantly reduce your pain and speed up your recovery.

At Chelmsford Physio we specialise in the rehabilitation of tendon complaints, both of the upper

limb and lower limb. We see and successfully treat hundreds of Tennis Elbow complaints in our

clinic every year.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Thank you for readin g!

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

Can ACL Injuries Self-heal and Can you Become a ‘Coper’ ?

Fri, 13 Jan 2023 15:20:13 GMT

Do you always need surgery after your ACL injury?

For many years it was believed that the only way to return to sport following an ACL injury was to have surgery. We believed that the knee would be unstable and continue to give way. We also believed that this instability would lead to increased arthritis and ultimately end in an early knee joint replacement as a result.

Well, we know a lot more now and things are changing as a result!

In a high quality randomised controlled trial back in 2010, by Frobell et al with minimal loss to follow-up, a strategy of rehabilitation plus early ACL reconstruction did not provide better results at five years than a strategy of initial rehabilitation with the option of having a later ACL reconstruction. Results did not differ between knees surgically reconstructed early or late and those treated with rehabilitation alone. These results should encourage clinicians and young active adult patients to consider rehabilitation as a primary treatment option after an acute ACL tear.

In 2012, Costa Paz et al proposed that patients could manage or cope without ACL reconstruction. Their observational study found that ACL injuries could spontaneously heal after rupture. Therefore natural healing could occur and thus avoid the need for ACL surgery. This has been researched further since, with stronger studies backing this reported finding.

The seminal Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON, 2013) trial found that non-operative treatment of rupture of the ACL with exercise was successful in at least half of patients.

However, there has been a significant rise in ACL reconstruction in the UK as well as worldwide, year on year. Therefore, are we moving in the right direction and is this the best option if you injure your ACL ?

Don’t get me wrong here, ACL reconstruction works and works best with the right pre-operative pathway. The evidence is there to support the option for surgical reconstruction of the injured ACL. However, the vast amount of papers on ACL management every year appear to focus on ACL reconstruction, and not very many have focused on the surgery vs rehabilitation debate. So we must base any decisions on the best available evidence, ensuring that there is shared decision making with every injured athlete and ensuring fully informed consent is included. There are different treatment options & choices, and various pathways to go down. Like all things, there is no one size fits all and there is plenty of grey.

In professional sport there is probably a different conversation, when it comes to an athletes career and their potential income or loss of it, the choice is nearly always for ACL reconstruction as soon as possible. However, for many other athletes there are ways to cope and avoid surgery and the 12 month post-op rehabilitation that should follow ACL reconstruction before returning to sport.

Its important to note that ACL reconstruction does not prevent you from developing arthritis in your knee. It’s the injury that counts, and has the effect on arthritis not whether you chose to have surgery or not. 10 year follow up studies, show no significant difference in arthritis between knee’s who were reconstructed and knee’s that were managed non-operatively.

Are you a "Coper"

Currently, the best definition of a ‘Coper’ is provided by Wellsandt et al (2018), following on from the work by Hurd et al (2008). The 4 points below are based on hop tests, questionnaires and the reported episodes of true giving way.

A timed hop score of 80% or more of the other side
A KOS-ADLS score of 80% or more
A GRS of 60% or more
1 or less episodes of giving way since the injury

In a prospective cohort study by Grindem et al (2015) those that underwent a 5 week pre-operative rehabilitation program fared better in all Knee Osteoarthritis Outcome Score (KOOS) subscales (Pain, ADLs, Sports and QoL) in comparison to a control cohort.

This is not a static label and can change with rehab, in as quick as 5 weeks. This also demonstrates a win-win outcome, from engaging in a rehabilitation program no matter what pathway you chose.

If you have suffered an ACL injury, there are different choices, options and pathways. The take home message here is we need to do more to educate and inform athletes who injure their ACL and want to get to sport. ACL reconstruction may the best option for some, but for others it may be that we try a 5-12 week structured and specific knee rehabilitation program and see if they can be a “Coper’.

At Chelmsford Physio we specialise in the rehabilitation of all types of knee injuries pre-operatively and post-operatively, as well as non-operative management. We see lots of athletes following an ACL injury and we pride ourselves on the quality of rehabilitation we provide in the fantastic gym we work out of. We work together with some of the best knee surgeons, so as needed, we can liaise together to give you all of your options.

If you have any questions or would like some further advice, please don’t hesitate to get in touch.

Chelmsford Physio

Riverside Leisure Centre, Victoria Rd, Chelmsford CM1 1FG

What is Sciatica?

Wed, 02 Nov 2022 09:20:01 GMT

Sciatica is a clinical diagnosis to explain radiating pain in one leg which follows the distribution of the sciatic nerve, with or without associated neurological deficits of parasthesia (altered sensation) and muscle weakness.

A common misunderstanding we see, from a lot is people coming to see us with what they believe is or they’ve been told is Sciatica, when its actually pain from another source.

Back pain is not Sciatica!

Not all leg pain is Sciatica!

Often we see people with referred leg pain coming from muscles or joint in their back or their hip.

The Sciatic nerve branches off the base of the spine, and has nerve roots from L4 to S2.

Sciatic pain is often worse with flexion of the lumbar flexion, where bending sitting and coughing/sneezing aggravate the symptoms.

The sciatic nerve provides sensation the different areas of the leg and power to the various muscles of the posterior aspect of the leg. In some cases when the Sciatic nerve is affected a person can experience altered sensation in an area of their leg (pins & needles or numbness) or a muscle can feel weak, or even experience footdrop is severe cases.

Taking a clear history of the onset, and the symptoms helps a Physio make their diagnosis.

It's very important for a Physio to ask anyone with back pain or Sciatica questions about their bladder & bowel control, as well as the sensation in the saddle area between their legs. These are red flags symptoms, and need to be referred urgently for investigation.

A clinical examination should then be carried out looking at movement of the lumbar spine, as well as a thorough neurological examination including a straight leg raise (SLR ) test, dermatomes (sensation), myotomes (muscle strength) and reflexes.

An MRI scan can help to understand what is causing the Sciatica. An MRI is normally requested if the symptoms don’t improve in the first 6-12 weeks and don’t respond in the way we would expect.The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.New Paragraph

The Best Way To Treat/Help Sciatica!

Often medication can helpful to manage the pain to allow the person to keep active and perform the movements and exercise to help them resolve the symptoms.

Manual treatment can be helpful to improve pain and movement, which again helps to improve the recovery.

Selecting the right exercise can really make a difference, some exercises can make the symptoms worse but some can really help to centralise the leg and speed up the recovery.

Bedrest does not help!

The correct education & advice, can be extremely helpful. If the person suffering with Sciatica understands what’s going on, then their self management can be much better and therefore they can help themselves in their recovery.

Most Sciatica resolves over 6-12 week period, but if it doesn’t what do we do ?

As mentioned above, we can help arrange an MRI scan if the symptoms are not improving and refer to a specialist to be assessed for further interventions.

In some cases there are injections, nerve root blocks which can be performed.

Surgery is a very last resort and considered when all conservative options have been exhausted.

If you are struggling with back and/or leg pain, please get in touch today and get some advice from an expert who can help.

What Is Greater Trochanter Pain Syndrome

Tue, 01 Nov 2022 10:15:18 GMT

It's Something We See A Lot & There Are Things We Can Do To Help.

Firstly, its important to understand what’s causing/driving your pain.

One of the most coming diagnosis we see is Greater Trochanter Pain Syndrome, this commonly relates to pain from the Gluteal tendon. Previously a diagnosis of Trochanteric Bursitis was used, but this relates to the bursa, when actually the root of the problem is the Gluteals.

Finding The Source of Pain

It's really important to rule out some other possible sources of pain, or differential diagnosis. This can be done through the subjective information we take when we ask all our Qs in the session, and through the physical examination which helps us to rule things in and rule things out.

The main aggravating factors, or what makes the pain worse, often relates to

prolonged sitting postures
climbing stairs
high impact activities, or running
laying on that side in bed at night

Some of the differential diagnosis to rule out may include:

Hip Arthritis or other hip joint pathologies
Referred pain from joints/muscle in the back
Sciatica

How Do We Treat This?

Once we are clear from the history taking and the physical examination, we can then come up with a plan to help. This most commonly includes

Exercises, these are some that can help pain and help improve the strength of your Gluteals and the other surrounding muscles. This can often be the most effective way to treat this issue

Glute Bridge

Side l ying hip abduction

Side Plank Short Lever

Then progressing to more advanced exercises like side plank starting with short lever side plank, time yourself!

Side Plank Long Lever

Then attempting full length side plank, and again time yourself! Can you manage 30 sec hold L&R

Other options that can help are:

Manual treatment, if appropriate these techniques can help with pain and movement at the hip or back, and can then make the exercises easier to perform.

Shockwave therapy, for symptoms that have become chronic (more than 3 months) this can be a really effective treatment to help improve pain, function and tissue health.

Ultrasound and injection, if we need to investigate this further then Ultrasound can be a very helpful tool by which to assess the tissues and understand the extent of the injury. If all other options have been exhausted and appropriate, then you can discuss the option of a steroid injection to help with the hip pain. We work closely with specialists who can help with this, and we can easily refer for investigation and injection.

If you are struggling with hip pain, please get in touch today and get some advice from an expert who can help.