tag:blogger.com,1999:blog-41669073384349264192024-03-23T10:14:56.507+00:00Nicky Holbrook Sports Massage and Remedial TherapyTel. 07738257873 nicky@nickysportsmassage.co.ukNicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comBlogger76125tag:blogger.com,1999:blog-4166907338434926419.post-68694024315585910832024-03-21T12:54:00.006+00:002024-03-21T16:55:35.334+00:00Acupuncture treatments<p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_d_QUf7zMcGK5zAQLRGvV8hbj16-PqZy8W0ynihyphenhyphenIU1m8A2hRZZ7KIOaO-lHY16wD96RRfMgv38Sb8HaUSpO0hk-GiH5P8LrzmkfPnMAPJQg_vpuW5kiBEx6pYZwkHdlZuLF9gQ_5TJKq7veV2i97xHQffPwJUms3mA-kwhQ1ozk9ugygWjdz549db_VJ/s2000/B38A0A28-A8C1-459E-9EEA-006EA89CDF77.JPG" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="2000" data-original-width="1125" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_d_QUf7zMcGK5zAQLRGvV8hbj16-PqZy8W0ynihyphenhyphenIU1m8A2hRZZ7KIOaO-lHY16wD96RRfMgv38Sb8HaUSpO0hk-GiH5P8LrzmkfPnMAPJQg_vpuW5kiBEx6pYZwkHdlZuLF9gQ_5TJKq7veV2i97xHQffPwJUms3mA-kwhQ1ozk9ugygWjdz549db_VJ/w225-h400/B38A0A28-A8C1-459E-9EEA-006EA89CDF77.JPG" width="225" /></a></div><br /><h2 style="text-align: left;">Acupuncture now offered as part of treatments (as appropriate) or </h2><h2 style="text-align: left;">30 minutes Acupuncture specific treatments</h2><div><br /></div><div>I am practicing Western Medical Acupuncture, also called Dry Needling, which is an adaption of traditional Chinese acupuncture. Needles are inserted into trigger points or dysfunctional spots in the muscles and it is primarily focusing on alleviating musculoskeletal pain and improving movement quality and quantity.</div><div><br /></div><div>It does not follow the concept of qi, yin, yang or meridians. </div><p></p>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-16640501938096347992024-01-25T10:54:00.002+00:002024-01-25T10:54:45.566+00:00What is Sports Massage & Why it is relevant for EVERYONE?<br /><h3 style="text-align: left;">We can ALL benefit…. </h3><br />When I talk to most people about my work as a <span style="color: #800180;"><b>Sports Massage and Remedial Soft Tissue Therapist,</b></span> some take a deep breath in and go on to tell me about how they once had a Sports Massage and it was very painful, but “no pain no gain!” and similarly for those who have not experienced Sports Massage they associate it with a deep form of massage only for sporty people. <br /><br /><br />Please ditch both of those ideas. Sports Massage is a title for advanced hands-on Massage, Stretching, Mobilising and Rehab techniques that are highly relevant for all us many sports amateurs and professionals <i><span style="color: #800180;"><b>PLUS IT IS VERY RELEVANT FOR ALL OF U</b></span></i><b><i><span style="color: #800180;">S</span></i></b> who enjoy life, participating in exercise and activities to keep moving, fit, happy and challenged. <br /><br /><br />Essentially I am a Soft Tissue Specialist and my advanced training enables me to deliver corrective soft tissue treatments which are great for helping the healing process of injuries, rehab and mobility plus and maintaining healthy soft tissues to enhance training and improve performance. Injuries happen in many forms, not just from sporting incidents e.g. falls, accidents, overuse at work, in the gym, playing music or whiplash etc., and we all sometimes need “helping hands” to improve how we feel and can move and to enjoy and maintain our daily life pursuits. <br /><br /><h4 style="text-align: left;"></h4><h2 style="text-align: left;"><b><span style="color: #800180;">So this makes Sports Massage relevant for anyone!</span></b></h2><b><span style="color: #800180;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhndq2BbKX8I2fhEOVqfnwqd0KA398ShxxZi-iSxAp9V43NmK7PkccqSmdJh8iaTEJ9UibgG0XR6wpgJhh_YkmCT5aTJ4pQsI4aqa0wug-i10h3-C23_80RfFiqi8KfOPcltoFblpSwErG_EpytWkTExtd1PNAzPW3gq8xiAR889c3dpxrlusiBnQ_TgDZr/s2000/Melange.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="2000" data-original-width="1125" height="314" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhndq2BbKX8I2fhEOVqfnwqd0KA398ShxxZi-iSxAp9V43NmK7PkccqSmdJh8iaTEJ9UibgG0XR6wpgJhh_YkmCT5aTJ4pQsI4aqa0wug-i10h3-C23_80RfFiqi8KfOPcltoFblpSwErG_EpytWkTExtd1PNAzPW3gq8xiAR889c3dpxrlusiBnQ_TgDZr/w217-h314/Melange.JPG" width="217" /></a></div></span></b><br />This brings me on to explaining <span style="color: #800180;"><b>Remedial Soft Tissue Therapy</b></span> which is the knowledge and training to deliver corrective treatment and rehab to help ease and minimise pain, whether it is acute (recent from an injury) or chronic (long-term) pain. <div><br /></div><div><br /></div><div>So hands-on advanced <a href="https://www.nickysportsmassage.co.uk/p/sports-massage.html">Sports Massage, Remedial Soft Tissue</a> and <a href="https://www.nickysportsmassage.co.uk/p/myofascial-release.html">Myofascial Release</a> * techniques are beneficial to aid injuries and many ease complaints and conditions that effect our movement, health and well-being: <br /><br /><ul style="text-align: left;"><li>Aiding the healing process from injuries, operations or medical treatments</li><li>Addressing postural adaptions resulting from injury, lifestyle, employment demands, RSI (repetitive strain injuries). </li><li>Managing conditions such as sciatica, carpel tunnel, stiff necks, headaches, frozen shoulder, fibromyalgia, jaw ache etc. </li></ul><br /><br />Life throws many different things at us and hands-on treatments are great for relieving life’s every day tension, stress or pain from work or our favourite hobbies. <br /><br /><br />I hold qualifications to treat <a href="https://www.nickysportsmassage.co.uk/p/pregnancy-massage-and-post-natal.html" target="_blank">Pregnant and Post-Natal </a>ladies and <a href="http://www.nickysportsmassage.co.uk/p/oncology-massage.html">Oncology Massage</a> to ease the discomfort of cancer treatments and operations, <span style="color: #800180;"><b>Dry Cupping</b></span> and <b><span style="color: #800180;">Kinesiology Taping</span></b> too. Plus in early 2024 I will be qualified to offer <span style="color: #800180;"><b>Medical Acupuncture</b> (Dry Needling). </span><br /><br /><br />* <a href="http://www.nickysportsmassage.co.uk/p/myofascial-release.html">Myofascial Release Therapy</a> uses gentle hands-on techniques that work deeply into the soft tissues to ease chronic pain, restore alignment, function and mobility to muscles and joints and also encourage soft tissue healing and rehab.</div><div><br /></div><div>Any questions please let me know.<br /><div><br /></div><div><br /></div><div>Nicky Holbrook</div><div>January '24 <br /><br /></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-77324805001333364882024-01-24T11:23:00.000+00:002024-01-24T11:23:05.072+00:00Feeling heavy or tired legs, arms or abs after your exercise efforts? <br />New Year Motivation and feeling heavy or tired legs, arms or abs after your exercise efforts ? <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">Delayed Onset Muscle Soreness (the DOMS) explained</span></h3><br />DOMS is a sore and aching feeling in the muscles after unfamiliar and/or intense exercise e.g. a sudden increase in activity, a new or repetitive movement. <br /><br /><br />DOMS is caused by largely an immune system reaction caused by localised micro trauma to the muscles fibres AND to the surrounding fascia (fascia is all the connective tissues which create an interconnected tensional fibrous network)<br /><br /><br />We move using our muscles and fascia and sudden increased or new movements of an area of the body, causes tiny microscopic tears in the muscle fibres and the fascia is broken down. So the muscle fibres and fascia need to heal, a process started and managed by our immune systems. The body’s first response to start the healing process is inflammation, which firstly causes heat, redness, swelling and is then followed by an increase in circulatory and fluid activity. All of these together put pressure on our sensory pain receptors (nociceptors) which are abundant in our muscles and fascia. The healing process starts slowly in the first 24 hours and then is at full pelt from day 2 onwards so this is why we may feel more achy/ sore 1-2 days after exercise. <br /><br /><br /><span style="color: #800180;"><b><div class="separator" style="clear: both; text-align: left;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2H9Iv9JSL3tptn16mpX7PHwlSb5zINu4Mljt_uA-K8nrwUkzbGEHBNMxE8Ncwn5dXc87RSfrtR-ekic1W-bftiJjFcYRJELbo-PcY91gIkTlgz2ZjjukWrI-YUaz2XSZtrStd-OTH36lZRAeo_YjcmGUSx62YCAKxU0rrGu20hs5lDq4e9ZLd32cU6CYi/s586/Screenshot%202024-01-24%20at%2011.04.27.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="332" data-original-width="586" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2H9Iv9JSL3tptn16mpX7PHwlSb5zINu4Mljt_uA-K8nrwUkzbGEHBNMxE8Ncwn5dXc87RSfrtR-ekic1W-bftiJjFcYRJELbo-PcY91gIkTlgz2ZjjukWrI-YUaz2XSZtrStd-OTH36lZRAeo_YjcmGUSx62YCAKxU0rrGu20hs5lDq4e9ZLd32cU6CYi/w320-h181/Screenshot%202024-01-24%20at%2011.04.27.png" width="320" /></a></div>DOMS does not indicate muscle damage</b></span>. It should not be confused with an ache or pain after an acute feeling or injury. <br /><br /><br /><div>Recent research links DOMS to the hypersensitivity of the epimysium of muscles. The epimysium is the dense fascia which encapsulates entire muscles and this fascia is capable of “tensing and morphing” depending on the load through the body. Plus, it also seems our central nervous system responds more to nociception (pain) stimulation from our fascia than from muscles. <br /><br /><br />Interestingly, it is scientifically proven that DOMS is felt more when there is an increase in activities using our muscles and fascia in a lengthened position (this is called an eccentric movement) and for example occurs in the calves or hamstrings when we are running (in the push off phase as we leave the ground) or the quadriceps slowing us down as we run or walk downhill, or the triceps in the lowering phase of a bicep curl. <br /><br /><br /><span style="color: #800180;"><b>DOMS and building Muscle Strength</b></span> - as previously mentioned DOMS is a key part of our healing. After after exercise our body reacts to the increased load and stress the muscles have been put through by activating the release of growth factors involved in muscle development and this how soft tissue grows and how our body responds and adapts by strengthening the ability of our muscles to withstand future damage. Also our body adapts and the more you do the activity, the less you get this immune reaction because the system knows to expect a little damage. <br /><br /><br />DOMS generally gets better on its own after a few days but during this time range of movement and performance can be reduced. <br /><br /><br /><span style="color: #800180;"><b>DOMS and Massage </b></span> - there is evidence that suggests Massage is beneficial in reducing inflammation and the intensity of the stiffness and pain associated with DOMS. </div><div><br /></div><div><br /></div><div>There is also some evidence that compression garments, rest and some mineral supplements can reduce the duration of DOMS. <br /><br /><br />Please note though that causing muscle soreness to the point where we can’t even lift our arm, or walk, is too much! This could be a soft tissue strain or tear, which take longer to heal and are actually detrimental to muscle growth.</div><div><br /></div><div><br /></div><div><br /></div><div><br />Nicky Holbrook</div><div>January '24</div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-84023254085217549682023-11-17T11:08:00.004+00:002023-11-17T11:08:45.874+00:00Taping can reduce pain intensity! What’s the reason for this multi-coloured tape?<br /><h3 style="text-align: left;"><span style="color: #800180;">To follow I highlight the benefits of Kinesiology Tape, aka the coloured sports tape, that we often see on athletes. It is becoming more popular amongst across many sports and people to support recovery from injury and strains and also to treat general “aches and pains”. </span></h3><br />When treating my aim is to provide my clients with a window of opportunity that allows them to feel better, move easier and enjoy increased pain free movement. This is to help the healing process for acute (recent) pain from injuries, strains or operations and chronic (longer-term) pain. The use of taping (always at the end of a treatment) is an adjunct to hands-on treatments to continue to support healing, movement, doing rehab exercises and reduce pain.<br /><br /><br />There are many benefits of taping, which have all been demonstrated in research and studies, although it must be noted that the overall evidence remains inconclusive about the efficacy taping mostly because the exact mechanisms of how the tape may work remain unproven. <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">The benefits of taping can be:<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgN9FGApCYaekDosLdJuZ6G8csSz95BU-2gULbc1hrM5vpQWzA76IRCTpf58DBr_yyj8T4tCUM0wY2Bk1kltJPbLqFMDsmTnxD7xHeMcToCF1CF4_yEgbe-zTzyxXkmbKGSjBhyphenhyphenSl41VyCJLrFvoFVoWE6wjbyEqLj0Ofk8Y2GseEMyrWuJMBwZ8SyuuqPK/s2610/IMG_7424.heic" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="2610" data-original-width="1970" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgN9FGApCYaekDosLdJuZ6G8csSz95BU-2gULbc1hrM5vpQWzA76IRCTpf58DBr_yyj8T4tCUM0wY2Bk1kltJPbLqFMDsmTnxD7xHeMcToCF1CF4_yEgbe-zTzyxXkmbKGSjBhyphenhyphenSl41VyCJLrFvoFVoWE6wjbyEqLj0Ofk8Y2GseEMyrWuJMBwZ8SyuuqPK/w151-h200/IMG_7424.heic" width="151" /></a></div><br /></span></h3><h4 style="text-align: left;"><span style="color: #800180;">Distraction</span></h4>Taping on the skin can interfere with painful signals which are directed to the brain (1) and so this helps to change how the brain interprets and deals with the pain. You may have heard me explain that when we are in pain our sensory awareness of the affected area of the body is heightened and taping can turn down the pain volume.<br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Increases our proprioception & delays muscle fatigue</span></h4>Taping can provide a positive feeling of support, body co-ordination and control positively influencing our proprioception (<a href="https://www.nickysportsmassage.co.uk/2021/04/proprioception-or-you-may-call-it-our.html">click here for an article to explain this</a>) and so allows us to move better as if we weren’t hurt, helping to activate muscles and so helps the healing process. <br /><br />It can also reduce muscle fatigue. When doing rehab exercises this is very important, not only for the parts of the body that are currently hurting, but also for the surrounding areas. as they help to pick up the slack for muscles that are currently not working well.<br /><br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Distributes the forces of movement </span></h4>The tape allows full movement of a taped area. The tape has elastic properties and quick recoil and it can help distribute forces to other nearby areas through the fascia, ligaments and bones.<br /><br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Decompresses an area of swelling and inflammation</span></h4>When tape is applied to the skin, it has a small lifting effect underneath the skin, so creates more space in between the many layers of myofascial tissue under the skin and this can help inflammed areas by speeding up the exchange of fluids in the area.<br /><br /><br /><br />If you have any questions about taping and would like to discuss how it could help you please get in touch - call 07738257873 or <a href="mailto:nicky@nickysportsmassage.co.uk">email</a> with any questions or to book your appointment, plus you can <a href="https://app.rehabguru.com/appointments/cf3e279b24ac47fb04b579feaf3c1c69%3A88ce00da378e5f6a6ed5a1c86542678e27ca93ac1a95f727c78444f7d2fa6f58" target="_blank">book online</a>.<div><br /></div><div><br />Nicky Holbrook<br />November 2023<br /><br /><br /><br /><br />(1) Rocktape - www.rocktape.co.uk/how-it-works/<p style="background-color: white; font-family: Helvetica; font-size: 13px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 16px;"><br /></p><p style="background-color: white; font-family: Helvetica; font-size: 13px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 16px;"><br /></p><p style="font-family: Helvetica; font-size: 13px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 16px;"><br /></p></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-60228576481840866212023-11-17T10:24:00.003+00:002023-11-17T11:04:56.624+00:00Treating “knots” is all in a day's work!<br /><h2><span style="color: #800180;">Treating “knots” is all in a day's work!<br />This kind of soft tissue dysfunction is what massage was created for! </span></h2><br />Many of us will be familiar with muscle knots and it’s a commonly used term to describe a small area of muscular tension and pain, but actually there is no such physical thing as a muscle knot.<br /><br /><br />We describe having and being able to feel sore “knarly, crunchy or stringy” spots, perhaps at the top of the shoulder blade or in the calf for example. You may experience pain when you touch them, or they might be there all the time. Scientists refer to these as Myofascial Trigger Points (1) and are defined as irritable spots in muscle which are painful upon compression. <br /><br /><h3 style="text-align: left;"><span style="color: #800180;">So what causes these “knots”? </span></h3><div><span style="color: #800180;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsGD0dM9ymzuirN0aH9bb29ZxrPg2YE47bA9csO5quZXkRn6Iy6yYtj0Kem4nbEgJuvBLSUbj-nPXOggsV_VtRUmwD361N6HbsqvI_bTr-JPYuyKvAtktciokwCIfwuxhp3vZTjC3GSnuk2BqheL0RiWgmRtB5irtQ2kFqdX8773sPLuSIexDCyC-7GpgT/s644/Screenshot%202023-11-17%20at%2010.20.15.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="374" data-original-width="644" height="186" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsGD0dM9ymzuirN0aH9bb29ZxrPg2YE47bA9csO5quZXkRn6Iy6yYtj0Kem4nbEgJuvBLSUbj-nPXOggsV_VtRUmwD361N6HbsqvI_bTr-JPYuyKvAtktciokwCIfwuxhp3vZTjC3GSnuk2BqheL0RiWgmRtB5irtQ2kFqdX8773sPLuSIexDCyC-7GpgT/s320/Screenshot%202023-11-17%20at%2010.20.15.png" width="320" /></a></div><div>Our muscles are made up of lots of miniscule muscles fibres and in the case of these sore spot this is where muscle fibres have contracted (shortened) and when your muscles get damaged, even a little, this can cause inflammation in the muscle and also the fascia (fasica is our 3D connective tissue). The muscle overload could be from physical activity, postural imbalance, stress, injury or also from lack of use, a sedentary lifestyle - 8 hours plus sitting at a desk and looking down at your laptop etc. can all cause overload on the neck and upper shoulder muscles plus soft tissue conditions such as fibromyalgia or scar tissue from operations. </div><br /><br />When muscle fibres contract they become shorter, fatter and bunched up and this creates a physical squeeze on the circulation in the area. Vital supplies of fuel (oxygen and nutrients from the blood) for the muscles are reduced and also the removal of the noxious waste products by the lymphatic system becomes less efficient. So, the result is muscles which become exhausted, irritated, hot, possibly inflamed and painful. <br /><br /><br />This is also the start of a vicious cycle - the pain and spasm cycle. When we feel pain, our muscles contract and contracted muscles cause more sensitivity in our nervous system and so so again our muscles contract further, there's more pain and so it goes on! This becomes chronic pain and over time, if this is not addressed, chronic muscle tension causes other changes in the muscle tissues which become stiff and hardened which is a process called fibrosis. It is these small areas of bunched and hardened muscle fibres that we call knots and that either cause you pain in a certain area and you feel when you rub your own sore shoulders or calves or when I find and treat them through massage. <br /><br /><br />PLUS, sometimes the body’s nervous system’s involvement will add another layer of pain, as well as local pain these Myofascial trigger points can refer pain into other parts of the muscle or can refer pain to distant parts of the body. <br /><br /><br />Understanding how your body feels and why these knots may have formed is all part of your treatment and suggesting home care exercises and lifestyle changes could help too. For example - mixing up your exercise routine so you are targeting different exercises/muscles on different days. Different movements through the day and hydration can all be key too. <br /><br /><br />As a Sports Massage and Remedial Therapist treating these “knots” is all in a day's work. This kind of soft tissue dysfunction is what massage was created for. Chronic muscle tension, fibrosis and trigger points respond fantastically to the right massage treatment! <br /><br /><br />Please call 07738257873 or <a href="mailto:nicky@nickysportsmassage.co.uk">email</a> with any questions or to book your appointment, plus you can <a href="https://app.rehabguru.com/appointments/cf3e279b24ac47fb04b579feaf3c1c69%3A88ce00da378e5f6a6ed5a1c86542678e27ca93ac1a95f727c78444f7d2fa6f58" target="_blank">book online</a>.<br /><br /><br />Nicky Holbrook<div>November 2023<br /><br /> <br /><br />(1)Lavelle, Elizabeth Demers et al. "Myofascial Trigger Points". Anesthesiology Clinics, vol 25, no. 4, 2007, pp. 841-851. Elsevier BV, doi:10.1016/j.anclin.2007.07.003. Accessed 18 Aug 2020.<br /><p> </p></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-50545496644630975752023-09-14T11:11:00.005+01:002023-09-14T11:15:45.982+01:00Ankle mobility is very Important for foot & leg performance and to minimise injury! <br />I have treated a few lateral ankle sprains recently and whilst the lateral ankle ligaments, which are stretched when we roll out on our ankle, have rightly felt tender the lateral calves of the same leg have also felt sore and tense resulting in lack of ankle movement. Just after the injury, at the acute stage, this ankle stiffness is fine but past 1-2 weeks post injury increasing the mobility in the ankle joint is key for recovery and to avoid any compensatory patterns through both legs. <div><br /></div><div>I am often treating the ankles, calves and soles of the feet to increase mobility through the ankle joints. </div><div>Whether it walking, running or to get more efficient effort, depth and strength with your gym movements (especially squats) the ability of our ankle and foot to be able to respond, adapt and dissipate forces through the leg is VERY important and plays a big role in your foot and leg mechanics and injury risk. <br /><br /><div><h4 style="text-align: left;"><span style="color: #800180;">Ankle Mobility</span></h4><b><i><span style="color: #ff00fe;">Dorsiflexion</span></i></b> is the ankle movement which decreases the angle between your shin and the top of the foot (bringing your toes/top of foot up towards your body). And this is normally the movement which is the most restricted at the ankle. </div><br />When walking and running the whole foot should roll from the heel landing through to the push off the ground with the toes. When the whole foot is on the ground and as it prepares to push off the ankle has to flex and this action is Dorsiflexion. This is also when the foot, the leg and hip are absorbing the shock of landing and dispersing this shock through the leg. When squatting or jumping dorsiflexion allows us to get low to the ground to then push upwards.<div><br /><div><span style="color: #ff00fe;">Dorsiflexion</span> requires mobility of the ankle as well as engagement from the muscles of the calf and the foot surrounding the joint. Good dorsiflexion can help to avoid injuries in the knees, hips and low back areas. </div><div><br /></div><div>A <span style="color: #ff00fe;">good range of dorsiflexion movement</span> is anywhere from 10 to 20 degrees (from the foot in neutral toes pointing straight up or forward).<br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Dorsiflexion</span></h4><br /></div><div>Dorsiflexion movement is achieved at the talocural joint, which is formed by the bottom of the shin ( the tibia bone) and the top of the foot closest to the shin (the talus bone). This joint provides backwards and forwards movement of the ankle/foot (dorsiflexion and plantarflexion) and allows the tibia (shin) to move forward, relative to the foot, which is crucial for correct body positioning and efficient production, application and absorption of force. <br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Lack of dorsiflexion</span></h4><div><span style="font-family: Charter, Georgia, Times, serif; font-size: 19px;"><br /></span>If we lack dorsiflexion then the tibia tends to be stuck in purely a vertical position and hence it can cause our body to lean forward, and/or to compensate by the knee bending inwards when we bend at the knee, or the arch of the foot collapses inwards, the bottom rotates out sideways or the lower back curves more. Plus the reduced ability to absorb force through the foot places higher demands on the knees and hips, which may lead to an increased risk of pain or injury in these joints and their associated soft tissues. </div><div><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvW2AsXzQiD-AXuQla1suWlnVs2wiY_kADBJeDsPaYu1F_l6T7iVSLs4bxD7XuH4TQyYb_OGVymy7MOpmEQLYtM63Dl-y8yTCRqF041K4U3aRaMyOTNvQWebBrxHtyD-Csd4pY83I7QUnXPYjuhoBHIfVHpaalVdlZO97yCzzUr2980bQH6f8Jd61ogr5K/s2802/IMG_7144.heic" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhvW2AsXzQiD-AXuQla1suWlnVs2wiY_kADBJeDsPaYu1F_l6T7iVSLs4bxD7XuH4TQyYb_OGVymy7MOpmEQLYtM63Dl-y8yTCRqF041K4U3aRaMyOTNvQWebBrxHtyD-Csd4pY83I7QUnXPYjuhoBHIfVHpaalVdlZO97yCzzUr2980bQH6f8Jd61ogr5K/w149-h200/IMG_7144.heic" width="149" /></a></div><h4 style="text-align: left;"><span style="color: #800180;">Check your own dorsiflexion by trying this:</span></h4>Place foot on the floor facing towards a wall (see right photo) and the other knee bent on the floor, and see what the maximum distance away from the wall your big toe is, with the knee bent forward touching the wall and heel remaining on the floor. </div><div><br /></div><div>If you can touch the wall with your foot approx. 8cm plus away from the wall your dorsiflexion is fine, less than that I advise you to do something about it, especially if you are active and running/walking is part of you and your life. </div><div><br /></div><div>I advise <span style="color: #ff00fe;">Soft Tissue Massage & Myofascial Release treatments PLUS self-care exercises </span>to help lengthen and release tension in the calves and foot and mobilise the ankle joint. <br /><br />It’s worth taking time to care for your ankles because injuries can lead to further problems with both strength and flexibility in the muscles surrounding that joint. <br /><br /></div><h4 style="text-align: left;"><b><span style="color: #800180;">What can cause poor dorsiflexion? </span></b></h4><div>Ankle sprains, strains or breaks causing a build up of scar tissue which is dense and stiff. <br />Achilles strains or tears <br />Overuse/training tension in the calves and/or Achilles tendon <br />Plantar fascitis (stiffness on the sole of the foot especially in the morning) <br />Wearing high heeled shoes (could be a heeled trainer too) <br />Arthritis (which causes inflammation of the joints) <br />(these are just examples) <br /><br /><h4 style="text-align: left;"><span style="color: #800180;">To follow are 3 useful soft tissue exercises to try at home for ankle dorsiflexion.</span></h4><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTevEwAOj5SRdprIqZj35lKHHAhLlHCvEsVIYhUu88pBNEtAkiOp_8-MkIpjsDHt7jqusNrULKyvjO0cq-9VM6Tk93RUWBlA2IMEbmu4NjVHlOYV4M3FGgIEBbNeoZAvwXgta8hCjdR9M55ZVtMW1nohaPitTcowrleW8IZp0kQ_P-K8WSPrV08TJ1QwEw/s512/Screenshot%202023-09-13%20at%2011.55.50.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiTevEwAOj5SRdprIqZj35lKHHAhLlHCvEsVIYhUu88pBNEtAkiOp_8-MkIpjsDHt7jqusNrULKyvjO0cq-9VM6Tk93RUWBlA2IMEbmu4NjVHlOYV4M3FGgIEBbNeoZAvwXgta8hCjdR9M55ZVtMW1nohaPitTcowrleW8IZp0kQ_P-K8WSPrV08TJ1QwEw/w200-h131/Screenshot%202023-09-13%20at%2011.55.50.png" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="color: #2b00fe;">Foam Roll the Calf</span><br /><br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgipkLLnUTwn-zhC-_z-O_Lpaana6BqN33d0m-yowIJSMPH4bx6BtSgQWEvt09UD0PBLi26ln6LxpOeMmiHrYZ4_WZBJa8e5WpqJJmzmIaesPbh54AKSaw8iV-JAnML99wXnJgN2qfvFZvjzsELI1jGeGG9iKAw2onafWirNtrRfA-aZJWs5WTtRIeJUUyz/s414/Screenshot%202023-09-13%20at%2012.02.20.png" style="margin-left: auto; margin-right: auto;"><img border="0" height="176" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgipkLLnUTwn-zhC-_z-O_Lpaana6BqN33d0m-yowIJSMPH4bx6BtSgQWEvt09UD0PBLi26ln6LxpOeMmiHrYZ4_WZBJa8e5WpqJJmzmIaesPbh54AKSaw8iV-JAnML99wXnJgN2qfvFZvjzsELI1jGeGG9iKAw2onafWirNtrRfA-aZJWs5WTtRIeJUUyz/w200-h176/Screenshot%202023-09-13%20at%2012.02.20.png" width="200" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="text-align: start;"><span style="color: #2b00fe;">Standing, take one leg forward and a foot length back and again bend into the forward knee keeping the knee straight over foot so you can see the big toe</span><br /><br /></span></td></tr></tbody></table></td></tr></tbody></table><br /> <br /><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-EtGVEI6jBzfWAaTWOdZNGTtrGAch5EpJO0N4OwPr1km21xV2apM7eMk2MOncbMc1t3kxQK-2W-KS61fXMxtGw4mSDJQ0m8uEOcHvhqWA2m-I31Ztk4cd3Xu6hLxQUy4xmpJkRlYcwm6Mm-qlOA5v86GijWsOYcV6-gKw2ry-HJmUBaFzJsmXCfWTeUPf/s510/Screenshot%202023-09-13%20at%2011.58.10.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh-EtGVEI6jBzfWAaTWOdZNGTtrGAch5EpJO0N4OwPr1km21xV2apM7eMk2MOncbMc1t3kxQK-2W-KS61fXMxtGw4mSDJQ0m8uEOcHvhqWA2m-I31Ztk4cd3Xu6hLxQUy4xmpJkRlYcwm6Mm-qlOA5v86GijWsOYcV6-gKw2ry-HJmUBaFzJsmXCfWTeUPf/w200-h149/Screenshot%202023-09-13%20at%2011.58.10.png" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><span style="text-align: start;"><span style="color: #2b00fe;">Banded ankle dorsiflexion – use a resistance band or similar and tie around a table leg (or something similar). Place the band around the ankle joint, in the crease of the ankle (I feel lower than this picture shows) and bend into the front knee keeping the knee straight so you can see your big toe.</span><br /><br /><br /></span></td></tr></tbody></table></div><div>We have two calf muscles and to stretch the deeper one (the soleus) the knee needs to bend, hence the bent knees in the exercises above. <br /><br />Many of you will be more familiar with these 2 stretches and it is always good to do a mix of calf stretches:<br /><div> <br />1 - Standing, take one leg behind you to get a straight leg stretch (you can also lean into a wall for support to get a deeper stretch).</div><div><br />2- Standing on step, keep the ball of your foot on the step and allow one, or both ankles, to drop down off the step. <br /></div><br /><br />These exercises are focused on creating mobility in the ankle joint. <br /><br /><br />For any further advice and treatment please call or <a href="mailto:nicky@nickysportsmassage.co.uk">email</a>. <br /><br /><br /><br />Nicky Holbrook </div><div>Sports Massage & Remedial Therapist<br /><br />September 2023</div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-36900694243969915412023-06-02T11:06:00.002+01:002023-06-02T11:06:53.370+01:00 Knee pain in Adolescents <br />This year I noted more treatments of adolescents with pain at the front of the knee and I had many more discussions with parents about this too. I am at the stage of having teenage children myself so I am in this “circle” and it was also late winter/early spring so the later part of the season for popular sports such as football and netball. <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">The knee is a complex joint, allowing bending while supporting heavy loads and changing directions. </span></h3><div><span style="color: #800180;"><br /></span></div><div style="text-align: left;">It is sensitive to small problems in alignment, activity, training and overuse and any sport which involves a lot of running, jumping, change of direction or direct knee trauma is “hard” on the knees. </div><div><br /></div><div>So, I want to explain why adolescents are susceptible to knee pain and what we can be done to prevent the knee pain next season and treatment options. </div><div><br />The knee pain I am talking about here is not from a specific injury but gets better with rest and is worse with/after activity and generally I find it is accompanied by excessive quadricep tension. <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">Why adolescents are prone to anterior knee pain? </span></h3><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixyuTXtdI8dmmXaC0CBzbbvmsZQuzO4Mu8TSx5P2UhiTGJZiu6TmaU1jPnFXXeQfhbrEzRtvLNcYTlMM05hjBm03VGRW5VBw8OT_LbGIe4bQ8ChWHS0NWRwUqOBJguWw2TblEzGtdDK0RrEwzugRwJzybrVJCLOmkfcv7Gmu_pB-tEEmxt_cbqimic8Q/s530/Screenshot%202023-06-02%20at%2011.04.07.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="406" data-original-width="530" height="153" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixyuTXtdI8dmmXaC0CBzbbvmsZQuzO4Mu8TSx5P2UhiTGJZiu6TmaU1jPnFXXeQfhbrEzRtvLNcYTlMM05hjBm03VGRW5VBw8OT_LbGIe4bQ8ChWHS0NWRwUqOBJguWw2TblEzGtdDK0RrEwzugRwJzybrVJCLOmkfcv7Gmu_pB-tEEmxt_cbqimic8Q/w200-h153/Screenshot%202023-06-02%20at%2011.04.07.png" width="200" /></a></div></div><br />Adolescents grow fast, often going through growth spurts, and their bones grow quicker than the muscles, tendons and fascia (our soft tissues). For the knee this means the femur (thigh bone), tibia and fibular (lower leg bones) and the patella (knee cap) are growing and also changing shape. </div><div><br /></div><div>Recent research on teenage knee pain is pointing towards an association between the teenage knee pain and alterations in the knee cap shape and also the dislocation of the knee cap. <br /><br /><h4 style="text-align: left;"><span style="color: #800180;">The two most common and identifiable causes of knee pain in adolescents are both underneath the knee cap. </span></h4><div><span style="color: #800180;"><br /></span></div><h4 style="text-align: left;"><span style="font-weight: normal;">They are in slightly different sites at the front of the knee:</span></h4>1- immediately underneath the knee cap - this is called <span style="color: red;">Sinding Larsen Johansson Syndrome</span> <br /><br />2 - on the boney protrusion (tibial tuberosity) a little more underneath the knee cap - this is called <span style="color: red;">Osgood Schlatter Disease. </span><br /><br />The causes of the two are similar, they are both caused by the excess pulling of the patella tendon. The patella tendon is the tendon of the quadriceps muscles of the thigh, they merge into one tendon just above the knee and it continues down across and around the knee cap and inserts on the tibial tuberosity (a boney protrusion). Tendons attach muscles to bone. <br /><br />In the case of <span style="color: red;">Osgood Schlatters</span> there is too much pulling on the insertion point of the tendon, the tibial tuberosity, which is cartilage and thought to be weak before maturity and this causes the tenderness, inflammation and sometimes a more pronounced “bump” on the tibial tuberosity plus sometimes thickening of the patella tendon. This normally occurs in girls age 8 -12 and boys 12 - 15 years. <br /><br />For <span style="color: red;">Sinding Larsen Johansson syndrome</span> this is inflammation of the patellar ligament and so pain is immediately beneath the knee cap, again caused by too much pulling. Interestingly, this occurs mostly in younger boys and aged 10-13 years.<br /><br />Both Osgood Schlatters and Sinding Larsen Johansson are not permanent diseases and they tend to ease with age when growth is less rapid. However it is worth noting that there is evidence suggesting some adolsecent knee pain correlates with knee pain into early adulthood . <br /><br /><h3 style="text-align: left;"><span style="color: #800180;"><br /></span></h3><h3 style="text-align: left;"><span style="color: #800180;">What can be done to prevent this type of knee pain? </span></h3><div><span style="color: #800180;"><br /></span></div>Knee pain can exist without there being the obvious pain from either of the two above diagnoses. The predisposing factor associated with anterior knee pain is “tight” quadriceps and hamstrings. <br /><br />Adolescents who enjoy sport are naturally physically active and generally continue with their sport despite pain. It is hard to stem their activities, as many are part of teams, any time out can be a LONG time for an adolescent and sport provides a great physical and mental outlet. </div><div><br /></div><div>However for symptom relief a combination of training load reduction or rest and the limitation of the movement/sport that generates pain needs to be considered for improvement. This should also be combined with progressive muscle strengthening and a progressive return to activity. The muscle strengthening aims to address muscle imbalances (muscle “tightness”, strength and weakness). <br /><br />A recent study (2) over a 12 week period demonstrated high rates of success with knee pain improvement following a plan with included activity modification and load management in the first 4 weeks, then doing progressive home-based exercises and progressing to a gradual return to play over a 12 week period. Throughout the study pain levels were monitored and activity and exercises adjusted accordingly. <br /><br />This result is encouraging and this approach appears a good first strategy. <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">Sports Massage and Remedial Therapy role is: </span></h3></div><div><br /></div><div>to help reduce knee pain by treating the “tight” leg muscles (the quadriceps, hamstrings and calf muscles which all directly influence the knee) and to provide guidance to both the adolescent and parent on monitoring pain levels, modifying activities, home strengthening exercises and to advise on return to sport. <br /><br /><br /><h3 style="text-align: left;"><span style="color: #800180;">Other things to consider:</span></h3><div><span style="color: #800180;"><br /></span></div>It is worth noting that there are other factors that may contribute to adolescent anterior knee pain: </div><div><br /><ul style="text-align: left;"><li>Imbalance of thigh muscles (quadriceps and hamstrings particularly) that support the knee joint, one is tighter or stronger than the other. </li><li>Problems with alignment of the legs between the hips and the ankles </li><li>Using improper sports training techniques or equipment </li><li>Footwear suitability and changes in playing surface. </li></ul><br /><br />As always any questions on any of the above please get in touch. </div><div><a href="mailto:nicky@nickysportsmassage.co.uk">nicky@nickysportsmassage.co.uk</a><br /><br /><br /></div><div>Nicky Holbrook</div><div>June 2023 </div><div><br /><br /><br /></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-91791483682307821442023-06-01T18:36:00.000+01:002023-06-01T18:36:05.761+01:00Feeling heavy or tired legs, arms or abs after your exercise efforts ? Delayed Onset Muscle Soreness or the DOMS explained.<div class="separator"><br /><h4 style="text-align: left;">DOMS is a sore and aching feeling in the muscles after unfamiliar and/or intense exercise, e.g. a sudden increase in activity, a new or repetitive movement. </h4><br />DOMS is caused by localised micro trauma to the muscles fibres AND to the surrounding fascia (fascia is all the connective tissues which create an interconnected tensional network throughout the whole body and whose form can be shaped by tensional loading (1)). </div><div class="separator"><br /></div><div class="separator">Our body moves using our muscles and fascia and sudden increased use, a new or repetitive action of a certain area of the body, causes tiny microscopic tears in the muscle fibres and the fascia that binds all our muscle fibres together is broken down. So the muscle fibres and fascia need to heal and the body’s first response to start the healing process is inflammation, which causes heat, redness, swelling and then this is followed by an increase in circulatory and fluid activity. All of these together put pressure on our pain receptors and so this is the ache/soreness that we feel. <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipRyT72kv4ftf00IjFEwarhaAhCZ3oEfbGb1Vmfq6bk1E1j42Wp24DrVcpMpT_RWhR2ssSKx-ju2WqjyLX-_vD5e0ukwb3OHQ0M3AIBjHP1Whs7fcj8qqrr6XwMZE5zt0ArYz-7Vjwjr4I9Qb-SR741-MnH4JxUxr7c5oLB4uOh5cgqqbwCHDgQVxfTA/s390/Screenshot%202023-06-01%20at%2015.21.17.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="390" data-original-width="324" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipRyT72kv4ftf00IjFEwarhaAhCZ3oEfbGb1Vmfq6bk1E1j42Wp24DrVcpMpT_RWhR2ssSKx-ju2WqjyLX-_vD5e0ukwb3OHQ0M3AIBjHP1Whs7fcj8qqrr6XwMZE5zt0ArYz-7Vjwjr4I9Qb-SR741-MnH4JxUxr7c5oLB4uOh5cgqqbwCHDgQVxfTA/w166-h200/Screenshot%202023-06-01%20at%2015.21.17.png" width="166" /></a></div><br /></div><div class="separator">The healing process starts of slowly in the first 24 hours and is at full pelt from day 2 onwards so this is why we may feel more achy/sore 1-2 days after exercise.</div><div class="separator"><div style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><br /></div><div class="separator"><br /></div><b>DOMS does not indicate muscle damage</b>. It should not be confused with an ache or pain after an acute feeling or injury. <br /><br /><br /></div><div class="separator">Recent research links DOMS to the hypersensitivity of the epimysium of muscles. The epimysium is dense fascia which ensheaths entire muscles and the fascia is also capable to “tensing/morphing” depending on the load through the body. Plus, it also seems the our central nervous system responds more to pain stimulation from fascia than from our muscles (2).<br /><br />Interestingly, it is scientifically proven that DOMS is felt more when there is an increase in soft tissue tension by lengthening the muscle (this is called an eccentric movement). For example this occurs in the calves or hamstrings when we are running (in the push off phase as we leave the ground) or the quadriceps slowing us down as we run downhill, lowering a dumbbell after a bicep curl or controlling the lowering after a dead lift. <br /><br /><br /><h3 style="text-align: left;">DOMS and building Muscle Strength</h3><div style="text-align: left;">DOMS is a key part of our healing process after exercise, our body reacts to the increased load and stress that the muscles have been put through by activating the release of growth factors involved in muscle development. So this soft tissue growth is how our body responds and adapts by strengthening the ability of our muscles to withstand future damage and the rebuilding of collagen links in the fascia. Collagen provides structure, strength and support in the body. </div><br />DOMS generally gets better on its own after a few days to a week but during this time range of movement and performance can be reduced. <br /><br />There is evidence that suggests <b><i>Sports Massage</i></b> is beneficial in reducing the inflammation and the intensity of the stiffness and pain associated with DOMS (2). </div><div class="separator"><br /></div><div class="separator">There is also some evidence that compression garments, rest and some mineral supplements can reduce the duration of DOMS.<br /><br /><br /><br />(Please note though that causing muscle soreness to the point where we can’t even lift our arm, or walk, is too much!!!!! and this could be a soft tissue strain or tear, which take longer to heal and are actually detrimental to muscle growth).<br /><br /><br /><br />Nicky Holbrook<br />June 2023<br /><br /><br />References:</div><div class="separator">(1) As ‘fascial tissues’ whose morphology is dominantly shaped by tensional loading and which can be seen to be part of an interconnected tensional network throughout the whole body (Findley & Schleip 2007),<br /><br />(2) The fascial network: an exploration of its load bearing capacity and its potential role as a pain generator - Dr. Robert Schleip<br /><br /><br /><br /></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-68857741587102040792023-03-27T10:51:00.000+01:002023-03-27T10:51:08.704+01:00 Cycling, the muscles involved in turning those cogs!<br />Some of you will know I like cycling, its a big part of Triathlon training! For those of you who enjoy time on your bike or for those who are interested to get out on a bike, to follow I explain the muscles we use when we are cycling and how to avoid injuries. <br /><br />As cycling is not a weight bearing activity injuries don’t tend to “just happen”, they generally occur due to overuse/overtraining (perhaps too much too soon) or not having the right set up on your bike. <div><br /></div><div>Cycling is an excellent cardiovascular activity, is good for building leg strength and is a good alternative to running post an injury.<br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Main Muscles for Cycling</span></h4><div><span style="color: #800180;"><br /></span></div>The primary muscles for cyclists are in the hips and legs. <br /><br />When sat on the saddle most of the power is generated from the downward pedal stroke (between the 12’o’clock and 5 o’clock position of the pedal). For this movement a little hip flexion along with the downward movement of hip and knee extension are the primary moves, but there are other muscles used as we move the pedal round. <br /><br /><br /><span style="color: #800180;"><b>The primary muscles used are: </b></span><div><span style="color: #800180;"><b></b><span style="caret-color: rgb(128, 1, 128);"><b><br /></b></span></span>Pushing down on the pedal from the top (at 12 o’clock) are the hip extensors which are our buttock and back of the thigh muscles (so the glutes and hamstrings).</div><div><br />Straightening the leg in the later push down phase we also use our knee extensors, these at the front of the thigh (the quadriceps (quads)). Plus pushing down through the foot we also use our calf muscles (gastrocnemius and soleus).</div><div> <br />Dropping the heal slightly to complete the downward phase (at 6 o’clock) our ankle dorsiflexors are working. These are found on the top of the foot/front of calf (tibialis anterior) and these muscles then help the start of the up stroke, pulling the foot backwards and up. </div><div><br />Pulling upwards by bending the knee our knee flexors are at work and these are our hamstrings and some inner thigh muscles and also our superficial calf muscle (the bulky gastrocnemius).</div><div><div class="separator" style="clear: both; text-align: center;"><br /></div>Finally continuing to pull the leg up to the top (to 12 o’clock) are the hip flexors, at the front of the thigh and hip (the rectus femoris our main quadriceps muscle and iliopsoas which are deeper hip flexor muscles which come down through the pelvis). </div><div><br />And then the pedal cycle starts again…. </div><div><br /><br /><b><i>It is important to remember that the greater downward force of the opposite leg is helping the momentum of the up stroke. </i></b><br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Below is a useful diagram to show how much the muscles are used in the pedal stroke. </span></h4><div><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFXVvqQCvS-iryzdEhH22MZ982cE0_F-QraCJRjIjL4HV9Hd7vp3RTwx81KUukKrQgWVtOCLwBkvO7flnrqRUo5K1PAJjOOVc0VSp5qU_HS96HNfwCKFWODer-6Cjt1LqPIGk6ln8OPHws14jOTBAP6tQP8ol_NSxRvJ4P7ljsZyS0kQn5B-6M2fZZhQ/s1036/Cyclingmuscles.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1036" data-original-width="730" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFXVvqQCvS-iryzdEhH22MZ982cE0_F-QraCJRjIjL4HV9Hd7vp3RTwx81KUukKrQgWVtOCLwBkvO7flnrqRUo5K1PAJjOOVc0VSp5qU_HS96HNfwCKFWODer-6Cjt1LqPIGk6ln8OPHws14jOTBAP6tQP8ol_NSxRvJ4P7ljsZyS0kQn5B-6M2fZZhQ/w450-h640/Cyclingmuscles.png" width="450" /></a></div><br /><div>As mentioned above and as you can see from the diagram the gluteals, hamstrings and quadriceps are used a lot. Therefore, cyclists can suffer from stiff sore thigh muscles as they are in great demand and the larger hip flexor muscles (at the front) can become stiff and shortened, particularly because of the body’s position when sitting all crunched up in the saddle. Picture the trunk bent over slightly and the pelvis tipped forward which naturally puts the hip flexor muscles in a shortened position. In addition this might be compounded by a similar sitting position if you are desk bound all day.</div> <br /><br />Shortened muscles cannot perform well. Sitting a lot could also lengthen the buttock (gluteal muscles), which creates a weakness, and strong gluteal muscles are key to the downward stroke. <br /><br /><br /> The hamstrings, glutes and calf muscles (all at the back of the leg) are used extensively to push down in the pedal stroke, so strains can occur here, especially if you are not pushing down equally on each pedal, or if you are over stretching, perhaps because your seat is too high, or you are using one leg more than the other? This could be due to postural issues or could be an imbalance that has built up over time?<br /><br /><br />So the lower body is obviously important, however, we must not forget there is some upper body involvement too.<br /><br /><br /><br /><b><span style="color: #800180;">Upper Body Muscles Used:</span></b><br /><br />The lower back, neck, shoulders and arms can really suffer from long hours on the bike and being hunched over the handle bars. The lower back muscles can be used to compensate for the glutes or hamstrings if they are weak. The forward reach to the handlebars - you might be over stretching to reach the handlebars and the weight of the body in the arms, or even holding/gripping onto the handlebars can all create tension. <br /><br /><br />So there is a lot of the body working to keep turning those cogs! <br /><br /><br /><h4 style="text-align: left;"><span style="color: #800180;">What are your cycling goals?</span> </h4><div><br /></div><div style="text-align: left;">Are you training for any cycling Sportifs, or a cycling adventure holiday or triathlon training, keeping fit and healthy. </div><br /><br />A lot of people find they can ride their bikes without any problems but will feel incredibly stiff after a long ride. Sports Massage Therapy allows your muscles to recover and heal quicker, plus another benefit is improved flexibility for your joints which can help you feel more comfortable and achieve more aerodynamic positions on the bike. <br /><br /><br />Get in touch if you would like to discuss any problematic niggles that are holding you back and stopping you from enjoying your rides even more! <br /><br /><br />Enjoy being out on your bike! <br /><br /> <div class="separator" style="clear: both; text-align: center;"><br /></div></div><br /><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-986777720162465062023-03-24T15:13:00.006+00:002023-03-24T15:25:42.369+00:00Pregnancy & Low Back Pain & Massage Therapy <p>Pregnancy related low back pain is a common complaint that occurs in 60-70% of pregnancies. (1)</p>This type of low back pain can occur at any time during pregnancy, but it is more common in the 2nd to 3rd trimester as the uterus and baby grows adding additional weight and hence necessary postural changes occur. <br /><br />Low back pain can be felt in the low back (lumbar spine) region, the pelvis, the glutes (buttocks), plus possibly down into the back of the thigh and calfs. Hence, it can affect pregnant women’s quality of life and sleep and may cause an inability to work. <br /><br />The causes of low back pain during pregnancy can be due to a combination of physical, hormonal, circulatory and psychosocial (anxiety, believes) factors.<div><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyTxJlr2CkLrSVWlZwE_3WVxTizsbVGaFaYMlNOpjlkIWccoaiApHoXsSEQnxv55dqWhtss7_FPAk-2RvKBPqeMiIySoF0qC2KV1Uo1OBRo4W7lYLGpd0I3dXZrAsnFARAfn3ChvlpMepdOL3EuQK_15G5PfCx6oqdqwBVnD8h-mWEGVTToPiH2ZCkeA/s598/Screenshot%202023-03-24%20at%2015.01.42.png" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="480" data-original-width="598" height="258" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjyTxJlr2CkLrSVWlZwE_3WVxTizsbVGaFaYMlNOpjlkIWccoaiApHoXsSEQnxv55dqWhtss7_FPAk-2RvKBPqeMiIySoF0qC2KV1Uo1OBRo4W7lYLGpd0I3dXZrAsnFARAfn3ChvlpMepdOL3EuQK_15G5PfCx6oqdqwBVnD8h-mWEGVTToPiH2ZCkeA/w320-h258/Screenshot%202023-03-24%20at%2015.01.42.png" width="320" /></a></div><div><b><span style="color: #800180;">Physically - </span></b>During pregnancy the body changes and adapts in many ways to accommodate the increase in weight and the different distribution of load through the body. The body’s centre of gravity is shifted forward so with more weight at the front of the body the pelvis tilts forward and to compensate the head and shoulders shift back. This generally increases the inner curve of the lower spine (lumbar lordosis) and hence there is greater stress and compression through the lower back. The abdominal muscles also stretch, owing to the expanding uterus, and they can become tired and loose their ability to support the torso. So again there is greater onus on the lower back to support the torso.</div><br /><br /><div><b><span style="color: #800180;">Hormones</span></b> - the change in hormones occur immediately when pregnant and some women do experience low back pain in their 1st trimester (before the increase in weight) that could possibly be caused by hormone changes creating inflammation and hence pain. The hormone relaxin increases through pregnancy which causes a softening of collagen ( the structural protein of our soft tissues) and ligaments. The ligaments around the sacro-illiac joints (at the top back of the pelvis) can be a common area of pain. <br /><br /><br /></div><div>The good news is Massage Therapy is a safe during pregnancy and can be useful to relieve low back pain, ease movement and helpful for stress and tension relief and well-being. <br /><br />A study in 2016 explored the effect of deep tissue massage for low back pain in women, which included twice a week deep tissue massage for 2-months and found it decreased pain and improved functionality of the pregnant participants. (2)</div><div> <br /><br />I completed my <span style="color: #800180;"><b>Pregnancy & Post-Natal Massage training</b></span> over 9 years ago, it is a special time to treat someone and requires a specialist approach. </div><div><br /></div><br /><b><span style="color: #800180;">Pregnancy Massage</span></b><div>Massage during pregnancy is safe to have on the right part of the body at the right time. Generally both Mum-to-be and I, as the Therapist, err on the side of caution through the first trimester and don’t advise massage treatment, although there is no science linking Massage with any complications. <br /><br />I like to allow a 90 minute treatment pre-birth as I find this allows time to treat the whole body and to relax. Massage can be very effectively delivered to the low back, and other body areas, in a side-lying position. <br /><br />Continuation into Post-Natal Massage (and this obviously doesn’t need to be after 6 weeks, it could be 6 months, 1 year post birth) is important too, a chance for the body and mind to recover and repair, to ease and mobilise joint pain and scar tissue and recent research studies have shown that Massage may improve soft tissue healing rates too. It also allows time to precious time to rest. <br /><br /><br />As always any queries please get in touch.<div><br /></div><div><br /><div>Nicky Holbrook</div><div><a href="mailto:nicky@nickysportsmassage.co.uk">nicky@nickysportsmassage.co.uk</a></div><div><br /></div><div><br /></div><div><br /></div><div><a href="https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/back-pain/" target="_blank">NHS Pregnancy related conditions</a></div></div></div><div><br /></div><div><br /></div><div><br /></div>(1) Mogren I., Pohjanen A. <a href="https://pubmed.ncbi.nlm.nih.gov/15834344/">Low back pain and pelvic pain during pregnancy: prevalence and risk factors.</a> Spine (Phila Pa 1976). 2005 Apr<br />(2) Romanowski M., Spiritovic M. <a href="https://www.researchgate.net/profile/Mateusz-Romanowski/publication/304572952_Deep_Tissue_Massage_and_its_Effect_on_Low_Back_Pain_and_Functional_Capacity_of_Pregnant_Women_-_A_Case_Study/links/5785f39008aef321de2c380d/Deep-Tissue-Massage-and-its-Effect-on-Low-Back-Pain-and-Functional-Capacity-of-Pregnant-Women-A-Case-Study.pdf">Deep tissue massage and its effect on low back pain and functional capacity of pregnant Women-a case study</a>. Journal of Novel Physiotherapies. 2016;6(03).Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-1918698207483744002023-02-07T15:19:00.001+00:002023-02-08T12:17:49.128+00:00Key Indicators for Sports Massage & Myofascial Release treatment?<p><br />I love treating my clients and achieving positive results together, perhaps hitting a PB, walking longer, returning back in the pool, getting up and feeling ready to go! I am often amazed at how much pain and discomfort we all put up with! I know we all feel and accept different levels of pain but we must recognise when something doesn't feel right, seek professional advice and treatment. <br /><br /><br />So, I thought it useful to share with you some key indicators when and why to seek Sports Massage and/or Myofascial Release treatment. The need for treatment of course varies in type, frequency and intensity as everyone is different and as a Soft Tissue Specialist I use techniques which I feel relevant for you and your reasons for treatment and promote self-care and rehab exercises.</p><p><br /></p><h3 style="text-align: left;"><span style="color: #800180;"><b>Key indicators that you might need a Massage</b></span></h3><h3 style="text-align: left;"><br /><span style="color: #800180;"><b><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEit5cfY6L6tqUuWfWPmqepBEPJr61tBi2ANrYCAaojDDMMbKVrS-EnLT2H2dnf3wrKiZFafOwQ9yGyogVb0ZuXJ5CYZAUT4MS5BvuuTt-ctzkHYxhVX2DRPghXUSvX-WzVn15sbJOixc-Dqe7s9lXEFwvplglY-3TALGEsiZ7RZCiegX5P1XzuYlV7zIQ/s2048/PNG%20image.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="2048" data-original-width="2048" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEit5cfY6L6tqUuWfWPmqepBEPJr61tBi2ANrYCAaojDDMMbKVrS-EnLT2H2dnf3wrKiZFafOwQ9yGyogVb0ZuXJ5CYZAUT4MS5BvuuTt-ctzkHYxhVX2DRPghXUSvX-WzVn15sbJOixc-Dqe7s9lXEFwvplglY-3TALGEsiZ7RZCiegX5P1XzuYlV7zIQ/s320/PNG%20image.png" width="320" /></a></div></b></span></h3><b><span style="color: red;">Injury</span><span style="color: #ffa400;"> </span></b>- a recent soft tissue sports injury, accident or operation, e.g. sprained ankle, Achilles tear, groin strain, back pain, Whiplash, post-operative scar tissue. Massage is appropriate any time after the acute phase, which is generally 3-5 days after the injury occurred, and is when the initial inflammation has subsided and you are able move the effected area more or weight bear and walk. Whilst treatment directly on the trauma area may not be appropriate in the early stage post injury, treating around the area and limiting any compensatory niggles is key along with relaxing. Going forward the aim is to aid the recovery and healing process and break down and prevent scar tissue formation in order to encourage and develop the full range of movement and strength.<div><span style="font-family: Helvetica;"><span style="font-size: 12px;"><br /></span></span><br /><br /><span style="color: red;"><b>Sporting maintenance & performance</b> </span>— it is common to see elite athletes receiving sports massages pre and post-events, AND it is just as important for all of us who enjoy participating in sport and exercise in order to keep healthy, happy and challenged. The benefits of Massage are many — the main one for training and performance is it aids the soft tissue healing process. Post exercise the soft tissues need to heal and hands-on treatments are proven to help the body recover quicker, hence enabling us to continue to train, increase our performance and helping to minimise overuse injuries. <a href="https://www.nickysportsmassage.co.uk/2023/01/massage-is-not-indulgence-massage.html" target="_blank">Read here for more info on how Massag supports training</a><div><br /><br /><b><span style="color: red;">Niggles, Pain, Headaches</span></b> - the DOMS (delayed onset muscle soreness) is a feeling in response to exercise, we don’t always feel this but generally we do after a different type, intensity or volume of exercise (<a href="https://www.nickysportsmassage.co.uk/2021/09/feeling-heavy-or-tired-legs-or-arms.html" target="_blank">read here for more information on DOMS</a>). A “niggle” which perhaps we notice whilst or post exercise and then it disappears only to reoccur with exercise, don't let it build into something more than a niggle. Or a crick in the neck from sleeping, or neck and headache, or perhaps back pain from gardening that lingers? Recovering from surgery. Don't let pain become a focus, seek advice & treatment.<div><br /></div><br /><b><span style="color: red;">Restricted range of movement </span></b>— noticing when you feel stiff, restricted movement or a certain movement causes pain. The soft tissues influence our joints ability to move and when there is a restriction a joint can’t move efficiently, so over time the body will adapt, "get used to" a posture or position and this can compromise other joints and cause soft tissue pain elsewhere. Using advanced stretch and Massage techniques the aim is to increase the comfortable range of movement which creates an opportunity for you to move more and the body to re-familiarise itself with this movement too. <br /><br /><br /><span style="color: red;"><b>Tiredness & Fatigue</b> </span>- we all lead busy lives and juggle many balls, ongoing tiredness is a top sign that you may need a restorative Massage. If you have not been sleeping well, drained of energy, muscle tiredness and fatigue, recovering from an operation or illness hands-on treatment allows you to stop, take time for yourself and feel how your body is. Massage treatment can have a positive effect on our nervous system allowing our sympathetic nervous system (our heightened alert/fight) activity to decrease and increase our parasympathetic nervous system, the body’s natural rest and digest activities. <br /><br /><br /><b><span style="color: red;">Feeling Stressed or Anxious</span></b> - the power of touch through Massage therapy is great and promotes relaxation, a chance to focus on you, how your body feels and hence quietening the busy mind. Mindfulness through Massage. <br /><br /><br /><span style="color: red;"><b>Or Just Needing a Massage</b>-</span> your own intuition! <br /><br /><br />I also want to add treating through <b><span style="color: #800180;">Pregnancy</span></b> and <b><span style="color: #800180;">Oncology</span></b> treatment (treating those affected by cancer, both through and post treatment) as I hold additional qualifications for both. <br /><br /><br /><h3 style="text-align: left;"><b><span style="color: #800180;">Pregnancy</span></b></h3><div style="text-align: left;"><span style="font-weight: normal;">The body adapts in amazing ways through Pregnancy however these natural physical adaptions can cause pain, particularly owing to the additional weight and size as the baby grows <a href="https://www.nickysportsmassage.co.uk/p/pregnancy-massage-and-post-natal.html" target="_blank">(please read more here)</a>.</span></div><br /><h3 style="text-align: left;"><b><span style="color: #800180;">Oncology</span></b></h3><p style="text-align: left;">Treating through or post treatment for cancer is always a gentle to offer comfort, relaxation and reduce tension, pain and anxiety and is adapted to suit your needs, the stage of your disease and your treatment (<a href="https://www.nickysportsmassage.co.uk/p/oncology-massage.html" target="_blank">please read more here</a>).</p><br /><br />Of course whether you need a Massage or not, getting a professional treatment is more likely to leave you feeling better and happier. So don’t worry about whether you really need a Massage, book a treatment and I find most people hugely benefit!<div><br /></div><div>Any questions please do let me know.<br /><br /><br />* Note - of course, with all of these symptoms they can be indicative of other conditions in which alternative treatments or therapies might be more suitable.</div><div><br /></div><div><br /></div><div><br /></div><div><br /></div><div>Nicky Holbrook<br />Sports Massage & Remedial Therapy, Myofascial Release Therapy, Soft Tissue Specialist<br /><ul>
</ul><div> <div><br /></div></div></div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-88990687522733708962023-02-07T12:03:00.005+00:002023-02-08T17:55:21.214+00:00Frozen Shoulder - causes and how Sports Massage can help!I think most of us have heard the term Frozen Shoulder and know someone who has experienced this. <br /><br /><br />Frozen shoulder tends to affect more women than men, and is more prevalent in the 40-60 year old age group. It is not an aging/degenerative condition and Frozen Shoulder is a temporary. <br /><br /><br />Essentially Frozen Shoulder (or its proper name Adhesive Captulitis) is restriction and inflammation in the actual shoulder joint and hence results in significant loss of range of movement. So, the restriction comes from the shoulder capsule, the bit that that keeps the joint in place and keeps the lubricating synovial fluid inside. <div><br /><div><br /></div><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbu44_-2Teupj8ApRPh7Es8hZfLg0dJaUVHvdnwjG-AefIqMsbH0Vwl7fK9e_o69l5CJnlfOKa2Iu_UT-Z23jf-ryZ6YZYDG5AeiZ59UlYMjIobS_K88J9KPLNVe27Qj-DuATyhd8VFqLuxhVYbAsR2u40IiqF66naDWWLMUGMZPFCRSPM3ocudUNYvw/s816/Screenshot%202023-02-02%20at%2017.31.28.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="566" data-original-width="816" height="222" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjbu44_-2Teupj8ApRPh7Es8hZfLg0dJaUVHvdnwjG-AefIqMsbH0Vwl7fK9e_o69l5CJnlfOKa2Iu_UT-Z23jf-ryZ6YZYDG5AeiZ59UlYMjIobS_K88J9KPLNVe27Qj-DuATyhd8VFqLuxhVYbAsR2u40IiqF66naDWWLMUGMZPFCRSPM3ocudUNYvw/s320/Screenshot%202023-02-02%20at%2017.31.28.png" width="320" /></a></div>The affected range of movements are abduction (raising your arm up and out to the side) and external rotation (for example perhaps trying to put on or take off a coat, or put on a seat belt). Whilst it is the joint that causes the restriction the shoulder’s associated soft tissues, can be affected too as the rotator cuff are continuous with the joint. <br /><br /><h3 style="text-align: left;"><span style="color: #800180;"><br /></span></h3><h3 style="text-align: left;"><span style="color: #800180;">Possible causes</span></h3> The causes of Frozen Shoulder are poorly understood however there are risk factors namely past/recent injury to the shoulder, shoulder surgery, Diabetes Type 1 and is more common for women. <a href="https://insightsimaging.springeropen.com/articles/10.1007/s13244-016-0491-8">Read here</a> for an excellent in depth article on Frozen Shoulder. <br /><br /><h3 style="text-align: left;"><span style="color: #800180;"><br /></span></h3><h3 style="text-align: left;"><span style="color: #800180;">Managing Frozen Shoulder and how Massage treatments can help</span></h3>Frozen Shoulder will gradually disappear so it is temporary. It is important to understand there are three phases to a Frozen Shoulder and fortunately Massage can play a key role in management of pain, movement & rehabilitation through the different phases:<br /><br /><h3 style="text-align: left;"><span style="color: #800180;"><br /></span></h3><h3 style="text-align: left;"><span style="color: #800180;">Phases:</span></h3><span style="background-color: white;"><b><span style="color: #ff00fe;">1 - Acute/Freezing </span>- t</b></span>his is when you start to notice a loss of movement, and can be the most painful stage, you may not be able to sleep on your shoulder at night. This may last approx. 2 to 8 months.<br /><br />At this stage relaxing Massage techniques are focused on reducing pain, gentle mobilising and treating the associated soft tissues further away from the shoulder e.g. the neck, thoracic and lumbar back.</div><div><br /></div><div><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicKzyFfRz_sGEQTUQGYSn3rsaL2sjD49km_2dal12GlBaGPr6gW-cCR0H8nLoGslh9VCkfP3rEGJnG_HK8OtxmFf93quFDTygLpjEXhB2ZYPXWyQrQcGI3mZ090EbrsY-0hBZwHiGIGJwzQQGqmv_EOGbBDZM28f7eOoN6njpOoq-yslMZhF8buCaNEw/s640/IMG_4484.jpeg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="631" data-original-width="640" height="198" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicKzyFfRz_sGEQTUQGYSn3rsaL2sjD49km_2dal12GlBaGPr6gW-cCR0H8nLoGslh9VCkfP3rEGJnG_HK8OtxmFf93quFDTygLpjEXhB2ZYPXWyQrQcGI3mZ090EbrsY-0hBZwHiGIGJwzQQGqmv_EOGbBDZM28f7eOoN6njpOoq-yslMZhF8buCaNEw/w200-h198/IMG_4484.jpeg" width="200" /></a></div><div><b><span style="color: #ff00fe;">2- Sub-acute/Frozen</span></b> - the pain gradularly starts to decrease but the stiffness and lack of movement persists, generally lasts 4-12 months. The focus on Massage therapy is similar to the Freezing stage, working within the boundaries of the individual.<br /><br /><br /><span style="color: #ff00fe;"><b>3 - Chronic/Thawing</b></span> - the stiffness gradually starts to disappear and movement is gradually recovered. Generally lasts 1-2.5 years. The key to this phases is rehab, as the soft tissues will be weak from the lack of movement. Massage therapy is key to help restore, activate and re-familiarise the tissues to achieve normal movement this is alongside diligent self-care rehab exercises. <br /><br /><br />Note I use the term Massage however this also includes Myofascial Release techniques which are highly effective, gentle non-invasive and sustained techniques for shoulder treatments.<div><br /><br />Also, the lack of movement and pain in the shoulder does not always mean you have Frozen Shoulder, being such an intricate joint there could be other shoulder, neck, back muscle, fascia, ligament, dislocation or nerve issues to consider.</div><div><br /><br />Seeking professional advice to assess the shoulder is important to ensure you have the right prognosis, treatment and rehab and hence relevant treatments other than Massage could include Physios, Consultants, MRI, Osteopathy, Acupuncture. Often a team approach is appropriate and as always everyone’s sceanrio and choice is individual.<br /><br /><br />If you would like to discuss or query anything from or about this article, please contact me.<br /><br /><br /><br />Nicky Holbrook<br />Sports Massage & Remedial Therapy, Myofascial Release Therapy, Soft Tissue Specialist<br /><div><br /></div></div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-56192343994832658182023-01-23T12:06:00.002+00:002023-01-23T12:21:26.816+00:00Running Elastically - the elastic recoil properties of our fascia<h3 style="text-align: left;"><span style="color: #800180; font-size: medium;">Running elastically allows us to propel ourselves forward using less energy and hence we can run faster and for longer. </span></h3><span style="font-size: medium;"><br />Running is a hop, flight and hop movement and so when we are running we are stepping over something and so at some point we are in the air floating (both feet off the ground, amazing!), whereas when we are walking one foot is always in contact with the ground. To achieve this floating we create the right amount of tension and compression for fascia’s <span style="color: red;">elastic recoil</span> to bounce us forward in the air and this is running “elastically”.</span><div><span style="font-size: medium;"><br /></span><div><span style="font-size: medium;"><br /></span><span style="font-size: medium;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_sdO_626_x0FXfFO868zJkTpVgfZy-8hR19-3-VNu8d2wvN24lHxSv2CDO5mgnXXoEdJwbCagT_utQ0_nL_H-hB13wkwBObzyhd6iH4TLOZqKmozGh_Xfnfd_kRs3yCwKQyiuCgzKcfL58bF3Li3FnZOuvJHXqSb6hYA783rg5yCXo4ZbyPI7bx6QIw/s1206/Screenshot%202023-01-23%20at%2012.07.38.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1206" data-original-width="1206" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh_sdO_626_x0FXfFO868zJkTpVgfZy-8hR19-3-VNu8d2wvN24lHxSv2CDO5mgnXXoEdJwbCagT_utQ0_nL_H-hB13wkwBObzyhd6iH4TLOZqKmozGh_Xfnfd_kRs3yCwKQyiuCgzKcfL58bF3Li3FnZOuvJHXqSb6hYA783rg5yCXo4ZbyPI7bx6QIw/w400-h400/Screenshot%202023-01-23%20at%2012.07.38.png" width="400" /></a></div><br /><br /></div><br />Our fascia, which is defined as “a sheath, a sheet or any number of other dissectible aggregations of connective tissue that form beneath the skin to attach, enclose and separate muscles, joints and other internal organs.” (Stecco 2015). Or as I like to call it - our adjustable big yellow 3D biop-tensegrity (meaning tension & compression) onesie found under the skin. </span><div><span style="font-size: medium;"><br /></span></div><div><span style="font-size: medium;">Fascia influences and aids all our body’s movements, through tension and compression throughout the body, rather than singling out individual muscle contractions for individual actions. <br /><br /></span><h4 style="text-align: left;"><span style="font-size: medium;">Fascia stores energy</span></h4> <span style="font-size: medium;">Fascia has the ability to temporarily store energy and return it quickly, giving us the ability to bounce. We see this in cyclic movements, such as running and cycling, and it is the same as explosive rhythmic running in animals such i.e. gazelles or cheetahs. Running elastically uses less energy, and less muscular power, and so importantly it helps prevent typical overtraining injuries. <br /><br />So how do we “run elastically”? For ease of understanding I am going to focus on one key point and this is the importance of the positioning and flexibility of the ankle and the foot, or more precisely the arch of the foot and the Achilles tendon, for the foot strike phase. <br /><br /></span><h4 style="text-align: left;"><b><span style="color: red; font-size: medium;">Ability of the foot arch and Achilles to recoil and propel </span></b></h4><span style="font-size: medium;">In order to achieve <span style="color: red;">elastic recoil </span>from the arch and the Achilles the ankle needs to be dorsiflexed (which means bringing your toes slightly towards your nose) for landing. In dorsiflexion the subtalar joint (the joint between the ankle and the start of the foot) locks therefore upon foot strike there is less stress through the body. The impact force from this foot strike stretches your Achilles tendon and all the fascia of the arch of the foot (which includes the lower leg and toe tendons which run and insert on the sole of the foot) plus the force is momentarily stored as elastic energy. <br /><br />Upon landing the Achilles reaches its maximum safe stretch and your stretch reflex causes your calf muscles to contract to start the propulsive take off stage of running. So for take off the foot rocks from heel to toes and the ankle starts to plantarflex (the ball of the foot points into the ground) and as this muscular contraction happens simultaneously the arch of the foot releases its stored elastic energy, which has be shown to create <span style="color: red;">17% </span>(1) of forward force, and the Achilles tendon then releases its stored energy which has been shown to create <span style="color: red;">25%</span> (1) of forward force, and we are propelled forward to float through the air! <br /><br />This is the fascia’s <span style="color: red;">elastic recoil</span> creating the push and bounce forward adding to the force generated by our muscles. The stronger the release of this recoil the less time the foot is on the ground and the body is moving freely forward in the air! This is the free energy created by the impact force from each foot strike. <br /><br />It is important to remember that fascia and tendons are the major recoil force and the stiffer you are the more energy it takes to stretch them so keeping all our soft tissues supple and flexible eases our movement and the amount of energy it takes to move!! <br /><br /><br /><i>Please note, this article is intended as brief explanation about the importance of the foot strike in running sports and healthy soft tissues and how it can help us become more effective and efficient runners, it is not a set of running instructions. It is something for you to think about. </i><br /><br /><br /><i>The next thing of course is to keep this in mind while training! Please let me know if you have any questions or I can support your training and treat your Soft Tissues</i></span><i>. </i><a href="mailto:nicky@nickysportsmassage.co.uk" style="font-style: italic;">Email Nicky </a><i> . </i><div><span style="font-size: medium;"><br /><br /><br />Author - Nicky Holbrook, Sports Massage and Remedial Soft Tissue Therapist plus Myofascial Release, Lindfield, <a href="http://www.nickysportsmassage.co.uk">www.nickysportsmassage.co.uk</a><br /></span><br /><br /><span style="font-size: x-small;">(1) Dr Wilbour Kelsick Presentation, 26th June 2017, British Fascia Symposium, Worcester. </span><br /><br /><br /> <br /><br /><br /> <br /><br /></div></div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-458908885987392042023-01-23T11:52:00.000+00:002023-01-23T11:52:16.934+00:00What is Fascia? Myofascial Release explainedAs part of my ongoing studies a few year ago I completed an <span style="color: #ff00fe;"><b>Advanced Clinical Diploma in Myofascial Release</b></span> to complement my Sports Massage & Remedial Therapy qualifications. I loved every minute of this course, the research and assignments and especially all the practical application - both giving and receiving treatments. I integrate Myofascial Release techniques into the majority of my treatments, so I thought I would explain more. <div> <br />Myofascial Release are hands-on body wide techniques for acute and chronic pain and overall well-being to “release” soft tissue restrictions, scar tissue and postural patterns. These restrictions could form as a result of injury, stress, trauma, repeated movements at work or sport, how we sleep or poor posture? Our bodies’ fascial layers lay down adaptive patterns depending on our personal everyday movements and use. <br /> <br /><h4 style="text-align: left;"><span style="color: #2b00fe;">So what is Fascia?</span></h4>Fascia is a network of connective tissue, I often describe it as the one big yellow onesie that encapsulates our entire body, from head to toes. It is one continuous adjustable 3D bio-tensegrity (a mix of tension and compression) tissue that binds and enfolds all of our movement based soft tissues (so muscles, tendons, ligaments) PLUS our bones, joints organs, cells, circulatory and nervous system too, so no part of our body moves or exists in isolation. <br /><br />The importance of fascia and “everything being connected” is relatively new scientifically. Understanding how our bodies move, carry tension, distribute force and absorb impact plus throw in our real-life movement is ALL a very individual thing and is influenced by many variables. When we move our muscles either contract or elongate and the fascia can amplify the muscles force by approx. 30%. I always like to imagine a golf swing or rowing movement and how we compress and load and then our propulsion comes from our body unwinding and extending. Think how our body lower body adapts as we reach up high to put something in a cupboard.<br /><br />When we are healthy fascia provides tension, support, cushioning, protection and is able to adapt and so allows us to move safely and freely, plus it allows beneficial fluid flow. Fascia has fibrous qualities providing our support but also has an element of elasticity and hence provides us with “our spring in our step”. <br /><br />Fascia is also very highly innervated with sensory neurons, which respond to touch, pressure, load, temperature and movement and it plays a huge role in proprioception, interoception and nociception. Expanding these later 3 are our sense of where our body is in space, our inner sense of self and how we perceive pain. </div><div><br /></div><div>Our fascia needs to be able to adapt and morph to distribute forces and maintain appropriate pressure from our everyday lives however if it can’t adapt then eventually dysfunction and over time restrictions and inefficient movement occur through the whole body. Hence, with any physical or emotional trauma fascia can bind and restrictions can occur in parts of the body.<br /><br />Restricted, over used, weak fascia can all make us prone to injuries and chronic pain and can cause pain, numbness, tingling, stiffness and headaches.<br /> <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9IqgQBs3MQ4eRmDhaH1TdtW8buK_1dGkugOXXvtd2LWE6H3lMhdihi2EgWdiDKSGgbPjupiOkMeckpSzsFkVvNoDGMrhNxVlBT6vS0QX-PCen84EwN3W1SLyorzpVEG8MXWDxddTTb8sW/s640/CCE0E501-66F2-44CC-85C9-2DFE73811F6A.jpeg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="640" data-original-width="640" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj9IqgQBs3MQ4eRmDhaH1TdtW8buK_1dGkugOXXvtd2LWE6H3lMhdihi2EgWdiDKSGgbPjupiOkMeckpSzsFkVvNoDGMrhNxVlBT6vS0QX-PCen84EwN3W1SLyorzpVEG8MXWDxddTTb8sW/w320-h320/CCE0E501-66F2-44CC-85C9-2DFE73811F6A.jpeg" width="320" /></a></div><h4 style="text-align: left;"><span style="color: #2b00fe;">Myofascial Release treatment</span></h4>Myofascial Release is a term used to describe a variety of hands-on treatment techniques, which treat acute injury and chronic pain. The treatment is not just about where the restrictions or pain are felt but where they might be coming from across the whole body. The techniques may involve compression, traction, position of ease, rebounding, unwinding and mobilisation of the fascia. They are gentle and subtle techniques applied with “listening hands” following the “yield and release” (these are purely descriptive words to describe the feeling) of the soft tissues.<br /><br />Myofascial release techniques are suitable for many chronic on-going conditions such as arthritis, fibromyalgia, MS, treating sensitive soft tissues through cancer treatment, nerve sensitisation etc <br />I integrate these Myofascial release techniques alongside other soft tissue ones and sometimes I treat purely using these techniques which allows a very natural, relaxing and invasive approach.<div><br /></div><div><br />If you have any question about Myofascial release you can read more <span style="color: #2b00fe;"><a href="http://www.nickysportsmassage.co.uk/p/myofascial-release.html" target="_blank"><span style="color: #2b00fe;">Here</span></a> </span>or please <a href="mailto:nicky@nickysportsmassage.co.uk">Email</a> or call 07738257873 to discuss any queries or <a href="https://app.rehabguru.com/appointments/cf3e279b24ac47fb04b579feaf3c1c69:88ce00da378e5f6a6ed5a1c86542678e27ca93ac1a95f727c78444f7d2fa6f58" target="_blank"><span style="color: #ff00fe;"><b>Book an Appointment</b></span></a><br /><br />Nicky<br /><br />Sports Massage & Remedial Soft Tissue Therapist BTEC<br />Advanced Clinical Dip. in Myofascial Release<br /><u><a href="https://thesma.org" target="_blank">MSMA</a></u></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-77399061242861573892023-01-09T12:06:00.005+00:002023-01-09T12:06:56.284+00:00<br /><h2 style="text-align: left;"><span style="color: #800180;"> Massage is “not an indulgence”! Massage doesn’t just make muscles and our fascia feel better, it makes them heal faster and stronger! </span></h2><br />Massage is a hands-on sensory (touch) and mechano (movement) based Therapy and using hands-on techniques creates positive stimulation to our soft tissues. <br /><br />Recent research (1) proves that Massage improves healing and recovery after an injury, operation or DOMS (as delayed onset muscle soreness is microlesions in the fascia & muscles). <br /><br /><br /><h4 style="text-align: left;"><span style="color: #ff00fe;">Mechnotherapy </span></h4>Importantly applying mechanotherapy - whether this be Massage, Myofascial Release, stretching or even self-care foam rollers or massage guns: <br /><ul style="text-align: left;"><li><b>increases the removal of immune cells (which are present because it’s our bodies natural response to injury)</b></li><li><b>increases the release of neutrophils (a type of white blood cell) from the muscles which helps the process of muscle fibre regeneration and hence healing and proper function.</b></li></ul><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGRu6X9F-NEfTbkxR8c438zsJa-QjiuGtQShp7egbgWY-LU3f11sG0HeGEjwzgvpdkpPEnysCmQC1V59eyPpcqUT0uQOHovAAGS3ymsDw-sWRqjQHhtirlg3SEcLjraF82oTDWPTq5FyuDZN5fkeq6qoZJYXHKB9hkSavBabMx55kl3kasJEc-VLTxag/s640/IMG_4491.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="640" data-original-width="480" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGRu6X9F-NEfTbkxR8c438zsJa-QjiuGtQShp7egbgWY-LU3f11sG0HeGEjwzgvpdkpPEnysCmQC1V59eyPpcqUT0uQOHovAAGS3ymsDw-sWRqjQHhtirlg3SEcLjraF82oTDWPTq5FyuDZN5fkeq6qoZJYXHKB9hkSavBabMx55kl3kasJEc-VLTxag/w150-h200/IMG_4491.jpeg" width="150" /></a></div><br /><div><br /></div>By moving and loading the soft tissues differently Massage creates different types of stimuli to the brain restoring proper function and can bring increased interoception (self-awareness of how your body is) and proprioception (our body’s innate ability to sense and adapt to it’s location, movement and actions). <div><b style="color: #ff00fe;"><br /></b></div><div><b style="color: #ff00fe;"><br /></b></div><h4 style="text-align: left;"><b style="color: #ff00fe;">Sensory Therapy</b></h4><div><div>The sensory therapy of Massage, both from touch and movement, positively influences the sensory receptors of the nervous system and this includes the nociceptors which are specialised neurons which are stimulated by mechanical stress or noxious chemical and thermal stimuli and send these messages of pain/danger to the brain for processing. <div><br /></div><div>These receptors respond positively to gentle and considerate touch, strokes, vibration, sheer and sustained and repetitive loading that could result in a reduction and modulation of our pain experience. It can reduce muscle guarding and give us a chance to feel better, brighter, confidence to move more and help ourselves.<br /><br /></div><div><br /></div><div><b><span style="color: #ff00fe;">So, Massage can speed up healing and recovery </span></b></div><div>This is true for any soft tissue injury - from sports incident, feeling heavy and tired from a heavy training load or the DOMS post a heavy workout. Or post operatively, post Pregnancy or breaking the cycle of constant pain.</div><div><div><br />In addition, there is there are many benefits of relaxing to the power of touch and taking the time for you.<ul>
</ul></div></div><div><br /></div><div>Any questions let me know.</div><div><br /></div><div>Nicky Holbrook</div><div>January 2023</div><div><br /></div><div><br /></div><div><br /></div><div>References:</div><div>(1) <a href="https://wyss.harvard.edu/news/massage-doesnt-just-make-muscles-feel-better-it-makes-them-heal-faster-and-stronger/?fbclid=IwAR20LJIjUZL0dBMIHECl11G6gvimHMOeYhru0VO-ZQyvBhKER-qig6pg6_k">https://wyss.harvard.edu/news/massage-doesnt-just-make-muscles-feel-better-it-makes-them-heal-faster-and-stronger/?fbclid=IwAR20LJIjUZL0dBMIHECl11G6gvimHMOeYhru0VO-ZQyvBhKER-qig6pg6_k</a></div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-86659933363234364282023-01-09T12:00:00.000+00:002023-01-09T12:21:28.921+00:00Hoping to hit the white stuff, skiing or snowboarding? How Sports Massage can help you get the most out of your time on the slopes? <h3 style="text-align: left;"><span style="color: #800180;">Make sure you get the best out of the ski slopes this winter season…. As with any sport it is a good idea to prepare…</span></h3><br />It is important when heading on your first snow trip, or hitting the slopes after a long time (usually at least a year since your last ski trip), to understand which muscles you will be using and preparing them for the impact of long fun days on the slopes.<br /><br /><b>Sports Massage</b> is ideal preparation to get the most out of your time on skis or snowboarding, to prepare and check in and with your body and to test for any muscle imbalances (tightness or weaknesses).<br /><br /><br /><h4 style="text-align: left;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEhvUiP9KqoXa4EYLVgfycwWIm63I_7Dwmld-2TyR8i0ZWc2nOoYsTFtmJTOAoyG7WHTAS0zJS3lMm3Lu3qgSlpNARsgJ14TRV8k_7hiOHPHoSQUQDSagUUBMBRG_6PNMqYz8cly2teDQVNVGgJP1PDeTELQttHDc4ElUsp3jz-xwtxPzi6brO39kb8ugw=s640" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="480" data-original-width="640" height="240" src="https://blogger.googleusercontent.com/img/a/AVvXsEhvUiP9KqoXa4EYLVgfycwWIm63I_7Dwmld-2TyR8i0ZWc2nOoYsTFtmJTOAoyG7WHTAS0zJS3lMm3Lu3qgSlpNARsgJ14TRV8k_7hiOHPHoSQUQDSagUUBMBRG_6PNMqYz8cly2teDQVNVGgJP1PDeTELQttHDc4ElUsp3jz-xwtxPzi6brO39kb8ugw=s320" width="320" /></a></div>Pre-trip Massage</h4>A thorough check of all the prime muscle movers of the legs and the core to assess for any imbalances, to treat and allow me to give you some exercise advice on where to focus movement, strengthening or stretches. This is ideally at least 4 weeks before you go.<br /><br /><br /><h4 style="text-align: left;">Post-trip Massage</h4>When you return you may experience some muscle soreness, as we could be using muscles for a whole week, which we are not used to! So post skiing sports massage can help to reduce post-exercise soreness and inflammation and hence reduces your recovery time. <br /><br /><br /><h3 style="text-align: left;">What muscles do we use for skiing and snowboarding?</h3>To help you prepare for your ski or snow boarding trip let’s consider the leg and core muscles involved:<br /><br /><br /><h3 style="text-align: left;">Skiing:</h3><br /><b>Quadriceps (front of thigh) </b>– from the moment you put on your boots in the morning your quadriceps are engaged as skiers are constantly in a bent knee position. Your quads flex your hips and extend at the knee, so this is the skiing position and they are used in every turn and stop. The quads support and protect the knees so strength here is important.<div><br /><b>Hamstrings and gluteals</b> – the hamstrings flex the knee so is constantly in use and the hamstrings are the opposing muscle to the quads. As you come out of a ski turn, you will be using these muscles to extend the legs (straightening a bit) through the hips and the knees (again using the quadriceps for this). These muscles also provide hip stability so are essential as a skier shifts weight from side to side, enabling us to perform a parallel stop.</div><div><br /><b>Adductors (inner thighs) -</b> keep the skis apart.</div><div><br /><b>Calves</b> – the ski boot position means our ankle is constantly flexed and the calves are constantly engaged in a lengthened position.</div><div><br /><b>Core (abdominals and back) </b>– as with every sport and movement your deep core muscles provide a skier with stability, balance, control and improved power. Your ability to turn the shoulders and hips enables you to make small movements to adjust in any direction, which improves your balance, and it enables stronger leg muscle movement. A strong core is essential to handle the lumps and bumps and our back prevents us from falling forward downhill.</div><div><br />Finally <b>arms</b>, using poles to move yourself along the flat, although hopefully you won’t be doing too much of that!<div><br /></div><div><h4 style="text-align: left;"><div class="separator" style="clear: both; text-align: left;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEhhINII9kBaBn40m_Acy0ickGOC7MHRIolUWVvFe00Ef4VKXUivpzHn3wd1aV-8cdqLP-uSb6FSXSkLv38jE7c29ON6C_vc6HzuUrIDH7htFBXFK2CsqMoJl0wFW5zaxmvN54aM44ze76cTLxzoBdcs02dbW33kS2Rie0AVyvAa1MHYZNhg7oj9q5q0Jg=s556" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="367" data-original-width="556" height="264" src="https://blogger.googleusercontent.com/img/a/AVvXsEhhINII9kBaBn40m_Acy0ickGOC7MHRIolUWVvFe00Ef4VKXUivpzHn3wd1aV-8cdqLP-uSb6FSXSkLv38jE7c29ON6C_vc6HzuUrIDH7htFBXFK2CsqMoJl0wFW5zaxmvN54aM44ze76cTLxzoBdcs02dbW33kS2Rie0AVyvAa1MHYZNhg7oj9q5q0Jg=w400-h264" width="400" /></a></div></h4><h4 style="text-align: left;"><br /><div class="separator" style="clear: both; text-align: center;"><br /></div></h4><h3 style="text-align: left;">Snowboarding – is asymmetrical sport, as the two feet are glued sideways parallel on the board, and you are constantly rocking back from heel to toe to stop, start and turn:</h3><b>Calves</b> – the shin, feet and our calves, enable the heel to toe action to control speed and direction and are constantly working<br /><b>Quadriceps</b> – again snowboarders constantly have their hips flexed and slightly knee bent position, meaning the quadriceps are constantly engaged and again supporting the knees.<br /><b>Hamstrings and gluteals</b> – are working hard in a lengthened position, as the knees and hips are flexed and forward and these muscles provide the hip stability and are active transferring weight to turn and carve<br /><b>Core (abdominal and back) </b>– the rocking motion from heel to toe, controlling the body moving forward and back, and pushing yourself up to start off all require strong control and balance.<br /><br /><br />Be prepared and you will get so much more fun out of your snow holiday!</div><br /><div><br /></div><div>Any questions please get in touch <a href="mailto:nicky@nickysportsmassage.co.uk">Email Nicky</a></div><div><br /></div><div>Nicky Holbrook</div><div>Updated January 2023<br /><div><div><div><br /></div><div><br /></div><div><br /></div><div><br /></div><div><br /></div><div><br /></div></div></div><div><br /></div><div><br /></div></div></div><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><br /><br />Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-32607730166573543242022-10-20T11:44:00.000+01:002022-10-20T11:44:19.989+01:00Benefits of Massage Pre and Post Surgery <h3 style="text-align: left;">Softening your Soft Tissues for Hip or Knee Replacement Surgery or any planned Surgery</h3><br />Hip or Knee replacement surgeries are commonly performed operations when there is excessive wear and tear of the joint and it is causing pain and stiffness. Post-operation, rehab and exercises are essential to ensure positive results however these exercises can often be painful as muscles shorten and stiffen perhaps from the on-going pain and compensatory patterns and from post operative inflammation. <div><br /></div><div><br /><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGAflOszCxFF8hnOkvGJCFx4Noic58gB8F_nlbFH7ZOVlvJWK3G7pjnQtcD1eW6OlAo5y-vIslRD7sYfpaqytCb5yuQy6TcJOZPpZoJZA6Q4HEOw10OmX-qkrkCT_foIGoVEpXJzsdYf9o7qFyCoqHjnDQbFk-Dj0A1_nCK0fxxs1cskMn_1tkJwa4tg/s512/Screenshot%202022-10-13%20at%2013.47.02.png" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="400" data-original-width="512" height="156" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGAflOszCxFF8hnOkvGJCFx4Noic58gB8F_nlbFH7ZOVlvJWK3G7pjnQtcD1eW6OlAo5y-vIslRD7sYfpaqytCb5yuQy6TcJOZPpZoJZA6Q4HEOw10OmX-qkrkCT_foIGoVEpXJzsdYf9o7qFyCoqHjnDQbFk-Dj0A1_nCK0fxxs1cskMn_1tkJwa4tg/w200-h156/Screenshot%202022-10-13%20at%2013.47.02.png" width="200" /></a></div><h4 style="text-align: left;"><b><span style="color: #800180;">Pre-operation benefits</span></b></h4><div><br /></div>In my experience having hands-on Massage before an operation can really help your soft tissues recover afterwards (remember your soft tissues are our muscles, tendons, ligaments and fascia). </div><div><br /></div><div>Massage prior to an operation will ensure healthy soft tissues with free fluid flow, importantly blood to deliver oxygen and nutrients and lymph which removes waste products, bacteria, and damaged cells hence aiding post-operative soft tissue recovery. It is also beneficial to relax the whole body and mind. </div><div><br /></div><div><h4 style="text-align: left;"><b><span style="color: #800180;">Post Operation</span></b></h4><br /></div><div>After an operation gentle Massage and Myofascial Release treatment is safe post limb surgery at any point (away from the external wound) and after other surgeries it is advisable to check with your Medical team first of all. </div><div><br /></div><div>The benefits of treatment are again to aid fluid flow for soft tissue healing and recovery and positively stimulates the para-sympathetic (aka rest and digest) nervous system which essentially slows the human body down. This leads to the activation of more tranquil functions for repair and maintenance for a balanced and healthy body. Also hands-on treatment is beneficial around the surgery site (only when external wounds are fully healed) and for the associated joints to ensure good mobility and greater pain free range of movement. It is important for the internal soft tissues to heal according to how the body needs and you want to move. </div><div><br /></div><div>This all means the post-operative rehab and strength exercises are more likely to be effective too. </div><div><br /></div><div>If you are awaiting surgery or are post-operative, or know someone who is, I am always available to discuss how I can help. <br /><div class="separator" style="clear: both; text-align: center;"><br /></div></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><br /><br /></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-15644240813678417332022-10-20T11:39:00.000+01:002022-10-20T11:39:00.125+01:00Joints snap, crackle or popping?I think it is reasonable to say that at some point we have all experienced an audible click or popping sound when moving from our joints, sometimes it's when we warm up or start to move. These often come from our knees, ankles, hips or shoulders and this can leave us thinking what is wrong, am I causing myself harm by continuing to move? <div><br /></div><div>The short and general answer to this is <b>NO</b>, <b>the sounds you are hearing are normal </b>and you are <b>NOT causing yourself any harm</b> and here I explain why. <div><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAXDnDyCxe2jcSh0UHajFOAN43eMIAU4UFYXd6noAdPGXsJR3iEtU0wzNs10Z8W5_mHbyXwbHm3qKMpiu5FrhXFlTvemv7kEsmrqt_Yvfv-FbDXhMtfEQDbYa8qEOfY5HVikQWTMMOYeAXjdQbD9W0mqtDAWZouskz15dj98fDFWr40hKV522bOOPl0g/s1242/cracking.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="402" data-original-width="1242" height="130" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAXDnDyCxe2jcSh0UHajFOAN43eMIAU4UFYXd6noAdPGXsJR3iEtU0wzNs10Z8W5_mHbyXwbHm3qKMpiu5FrhXFlTvemv7kEsmrqt_Yvfv-FbDXhMtfEQDbYa8qEOfY5HVikQWTMMOYeAXjdQbD9W0mqtDAWZouskz15dj98fDFWr40hKV522bOOPl0g/w400-h130/cracking.png" width="400" /></a></div><br /><div><br /></div><div>The term for these clicking/popping sounds is joint crepitations and there is no research to suggest there is a link between the joint crepitations and an active muscloskeletal problem (1). Plus a study surveying 247 symptomatic people and 250 normal knee people revealed 99% of people have joint crepitations but no pain (2). </div><div><br /></div><div>Of course if you feel pain with the joint crepitations, or it is new pain, or. you it bothers you, then you should get this checked out by a health professional. <br /><br /><h4 style="text-align: left;"><span style="color: #800180;">So what causes these sounds?</span></h4>Sometimes the tendon or the ligaments make a clicking/snapping sound as they pass over a boney protuberance, This can often be heard when flexing the hip or knee and also the back of the shoulder, e.g. when doing shoulder rolls. <br /><br />Another reason is when the end of the bones move in the joint in the synovial fluid. This movement causes a pressure change in the joint and displaces gas bubbles which “pop" (like the sound of pressurised air when you first open a jar of jam)! <br /><br />The knee is the most common joint to feel joint crepitus and the theory for this called “slip-stick” which can occur when the kneecap and femur (thigh bone) move on one another and this produces vibrational signals, which we can often feel if we lightly place our hands over the knee. Sounds from the knee can also be heard and felt as the knee cap locates into a groove into a groove as the muscles warm up. Plus there is the fine grating feeling, which I know I feel, and this is explained by fluid moving behind the kneecap. <br /><br />So as you can see, it’s important to understand that generally noises from a joint are normal and should not cause you to stop any physical activity and you are not damaging your joints. </div><div><br /></div><div>Remember as I said before anything that is causing you pain or you are concerned about then do get in touch or seek professional help.<br /><br /><br />References <br />1. Physiotutors. - <a href="https://youtu.be/NQOZZgh5z8I">Why your Joints Crack?</a><br />2. 1987 MCCoy et Al -People's beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour. </div><h1 class="Head u-font-serif u-h2 u-margin-s-ver" id="screen-reader-main-title" style="box-sizing: border-box; color: #505050; font-family: NexusSerif, Georgia, "Times New Roman", Times, STIXGeneral, "Cambria Math", "Lucida Sans Unicode", "Microsoft Sans Serif", "Segoe UI Symbol", "Arial Unicode MS", serif; font-size: 1.5rem; font-weight: 400; line-height: 1.333; margin-bottom: 16px !important; margin-left: 0px; margin-right: 0px; margin-top: 16px !important; margin: 16px 0px; padding: 0px; word-break: break-word;"><br /></h1></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-61629173973281585282022-07-07T11:09:00.001+01:002022-07-07T13:33:14.145+01:00Training our “myofascial system” for running - to elastically recoil and propel us forward! <br />A few years ago now I wrote two articles on “Running elastically and using less energy" (you can read <a href="https://www.nickysportsmassage.co.uk/2016/07/running-elastically.html">Part 1</a> & <a href="https://www.nickysportsmassage.co.uk/2018/06/how-to-running-elastically-practical.html">Part 2</a> here) and how this is achieved, for runners (and walking) through the fascia of the foot and the Achilles tendon. I can’t quite believe it but I wrote these articles over 4 years ago and science moves on and so with an even greater understanding of fascia and its importance to our efficient movement we are looking at training our “myofascial system” to reap the energy saving and performance benefits of our body’s ability to elastically recoil and propel us forward. <br /><br /><br /><h4 style="text-align: left;"><span style="color: #990000;">Firstly, what is our Myofascial System? </span></h4><br />In latin Myo means muscle and fascia means band and fascia is our connective tissue. Our myofascial system consists of all our muscles, tendons, ligaments, bones, blood and more.… I sometimes describe fascia as our “one big yellow web like onesie that binds, connects and supports everything under the skin”. It forms the structure of the body and it is very richly innervated in mechanical (movement) and sensory (stimulus from external - light, touch or internal factors - proprioception, blood pressure, hormonal balance) nerve cells. Fascia is now recognised as the largest system in our body as it touches and connects every bone, nerve, organ, muscle and every major system and subsystem of the human body. <br /><br /><br /><h4 style="text-align: left;"><span style="color: #990000;">Running involves the whole body</span></h4><div><br /></div>Running is a complex spring like movement involving the whole body. There are many people that make running look easy, I always remember seeing Mo Farah (in person) run the Cardiff half-marathon a good few years ago and he and his fellow runners looked effortless, their stride length was huge and they looked like they were flying through the air. And, by the way, we do fly when we run, as we repeatedly hop, fly (both feet are off the ground), hop. Plus, watching Paula Radcliffe, the graceful way her torso and arms moved to propel her on too. <br /><br />Running (well all movement) requires a continuous balance of tension and compression throughout the body. Movement is created by the concentric (shortening) and eccentric (lengthening) of our myofascial system which in turn provides stability in one area and generates power in an other. and to maximise this air time we need the elastic recoil of the myofascial system. <br /><br />A simple example of this is when running the ankle should dorsiflex (toes/foot up towards your shin) when landing which means the ankle is in a locked position causing less impact plus the Achilles is well positioned in a lengthened position to absorb the ground force and store this energy ready for release in toe off. This is the elastic recoil of the myofascial system. Also for a golf swing it is important to have mobility in the thoracic (mid back) spine and shoulders for spine rotation and hip and ankle mobility too, the hips need to rotate internally and externally throughout the golf swing to help provide effective rotation and roll through the ankles reducing the need for compensatory movements during the swing. The core provides the stability to maximise the power through the swing. The swing “winds” up the body, ready for release. <br /><br /><h4 style="text-align: left;"><br /></h4><h4 style="text-align: left;"><span style="color: #990000;">Back to Running</span></h4><div><br /></div>Running injuries are common and it is well documented that 70% of runners will sustain an injury over a year period. Injuries tend to relate to one of more of the following: <br /><br /><br />Poor technique or coordination <br />Minimal or poor elastic bounce through the myofascial system (stiff tendons or perhaps scar tissue causing restrictions) <br />Muscle weaknesses or imbalances (perhaps this is from the hip abductors, or are the quads overly dominant versus the hamstrings)<br />Biomechanical problems - perhaps over-pronating at the foot, or knee valgus (the knee rolls in)<br />Over-use or too much too soon - causes microtraumas and inflammation<br />Lack of overall body strength<br />Inadequate recovery time - over training, too much too soon.<br /><br /><br />All of these can cause inefficiency, imbalances, stresses in the myofascial body-wide system. For example studies have indicated that skeletal or muscle imbalance at the pelvis/hips can cause knee pain or ITB compression.<br /><br /><h4 style="text-align: left;"><br /></h4><h4 style="text-align: left;"><span style="color: #990000;">Functional Training</span> </h4><div><br /></div>Fascia has a very important role in maintaining muscle function.<br /><br />So when considering your running training plan, even for the majority of us recreational runners, it is key to include exercises that will functionally train the whole body. Functional training means exercises which are specific to a sport. So in the case of running rather than just strengthening the hip to support the knee training should include the whole body’s myofascial system, shoulder to toe! <br /><br />Studies have shown that if we train our bodies in their normal range of motion i.e. deadlifts for example, then we only strengthen the fascial tissues arranged in line with the active muscle fibres required for that movement, but running is a much more dynamic and unpredictable movement, therefore functionally training the broader parallel and supportive myofascial tissues is key. <br /><br /><h4 style="text-align: left;"><br /></h4><h4 style="text-align: left;"><span style="color: #990000;">Functional training our Myofascial system for running</span></h4><br />Functional training exercises need to mimic the movement of running and so exercises should include bouncing or plyometric movements, single leg movement patterns, coordination drills ( e.g. arm and leg movements). <br /><br />Energy is stored in the myofascial system in the eccentric (lengthening) phase of movement, landing, and released on the concentric (shortening) phase, toe off in running as the achilles tendon and lower leg muscles releasing the back swing in golf. So exercises need to start with an eccentric pre-stretch that loads the myofascial system in preparation for the unloading, concentric, shortening movement. <br /><br />Our fascia has a high elastin content, so loves this loading, it is highly adaptable and provides a lot of proprioceptive input (how our body instantly adjusts and feels).<br /><br /><h4 style="text-align: left;"><br /></h4><h4 style="text-align: left;"><span style="color: #990000;">Example Myofascial system exercises for runners</span></h4><br />To follow I have included a few exercise ideas, so this list is not exhaustive or prescriptive to do these only. These type of exercises can be incorporated into a strength session. They can be done at home or in a gym. <br /><br /><br /><h4 style="text-align: left;"><span style="color: #800180;">Extended Arm Overhead Pull with Resistance</span><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMYKFNyb8h2nUsgrh_8erRXwlyJnrJOoMDB1ntuVuJm8no95cEm5gVMG6IpoEBXS__w40wnfry8YDFhMO464WqYZPCBF0pB7l6NQ8Oq_vIUkZNLp5tH2Lw836NS4oVajWTEmhfNHxvHHvKakOfFaWgIwZEub9sGXUEPRK8QLktDIVehM3slRA0fpyyzw/s3465/IMG_5011.heic" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="3465" data-original-width="1584" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMYKFNyb8h2nUsgrh_8erRXwlyJnrJOoMDB1ntuVuJm8no95cEm5gVMG6IpoEBXS__w40wnfry8YDFhMO464WqYZPCBF0pB7l6NQ8Oq_vIUkZNLp5tH2Lw836NS4oVajWTEmhfNHxvHHvKakOfFaWgIwZEub9sGXUEPRK8QLktDIVehM3slRA0fpyyzw/s320/IMG_5011.heic" width="146" /></a></div></h4><div><br /></div>The aim is to build abdominal and lateral (obliques) strength, plus pelvic and hip stability from the single-leg stance of this exercise.<div><br />(this first exercise does require a bit if imagination to tie a resistance band or loop (I have something I can loop over the back of a closed door (the benefits of lockdown shopping!)<br /><br />Flex one hip with a flexed knee, with your thigh midline and your pelvis level.<br />Check you are well aligned, lift the chest and look slightly upwards, then begin to march against the overhead resistance<br />Slowly increase the pace to a slow run maintaining a firm resistance/tension on the band<br /><br />Make sure you keep upright and do not over extended the spine and you should feel tension in the abdominal wall area. I like this one.<div class="separator" style="clear: both; text-align: left;"><b><span style="color: #800180;"><br /></span></b></div><div class="separator" style="clear: both; text-align: left;"><b><span style="color: #800180;">Quick Step-Ups</span></b></div><div><br />The aim is to strengthen the trunk, pelvis, hip, knee, ankle and foot and improves single-leg balance.<br /><br />Use a step, your stairs, or a step in the garden.<br />Stand facing the step.<br />Step one foot on the stair, keep the other on the ground<br />Check your alignment, hips and feet square, and the explosively push with the back leg up onto the step<br />Step off with the leg that was first on the step<br /><br />Repeat alternating legs<br /><br /><br />Next, these <b>3 exercises are plyometric exercises (short explosive exercises) which use the stretch and then shorten muscle cycle with the goal of increasing power.</b><br /><br /><br /><span style="color: #800180;"><b>1 - Double leg hopping</b></span><br /><br />This helps to develop strength and coordination of the lower leg, the broader the fascia of the ankle and foot.<br /><br />Stand upright with both feet on the ground, good posture, and hands by your side<br />Push off the ground with both feet (jump) and immediately dorsiflex the ankle (toes/foot up to your calf)<br />Land with the foot dorsiflexed still and land on your toes.<br />You reman in the same spot and repeat<br /><br /><br /><span style="color: #800180;"><b> 2 - Single Leg push off and hop <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirFv8CanP8Rwjbu_5wLbXs_BMJyCoqzdc_P4bNtvJ1TNlO4upCZPj_USU9-L1D_1m3vgVqtte4XUVVwCX_7hFDBVIFaWEuILU2_LBpPeJ6XFlHBx4JOLhvkjQx6MnndsSX5uvKHAwfO-kIkWn3YPOW7KnhE5LGaqzpKZs81zqHUuJoZhb6_ty9ml3dmQ/s1472/IMG_5033.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="1472" data-original-width="850" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirFv8CanP8Rwjbu_5wLbXs_BMJyCoqzdc_P4bNtvJ1TNlO4upCZPj_USU9-L1D_1m3vgVqtte4XUVVwCX_7hFDBVIFaWEuILU2_LBpPeJ6XFlHBx4JOLhvkjQx6MnndsSX5uvKHAwfO-kIkWn3YPOW7KnhE5LGaqzpKZs81zqHUuJoZhb6_ty9ml3dmQ/s320/IMG_5033.jpg" width="185" /></a></div></b></span></div><div><span style="color: #800180;"><br /></span>This helps to develop strength and power of the lower leg and the broader fascia of the knee, ankle and foot<br /><br />Stand upright with both feet on the ground and hands by your side<br />Push off the ground on one leg, leaping forward and immediately dorsiflex the ankle.<br />Try to land one stride length ahead on the ball off your foot on the same leg as you took off from, with the knee is extended.<br />And then repeat moving forward with alternating legs.<br /></div><div><br /></div><div>This one I find really hard (I think the picture shows this! Ha!)</div><div><br /></div><div><br /></div><div><br /></div><div><br /></div><div><br /></div><div><br /><br /><b><span style="color: #800180;">3 - Jumping Spilt Lunges</span></b></div><div><b><span style="color: #800180;"><br /></span></b></div><div><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOx_ZQqJ0htcuzcKIxL_s_s3tptw2S4p2my4gJ1wbo_DQymaWEIVlB2HXf9GsngEMqBLxEEgbQE1Y6kF28ECa29D92WCwZqShU1Mr05Gb873BgthfSaOPS5ukP8A8DXj4RymaraZvZ9K0NG9pGo9LMZ5ytoAWo_0wI1r69jWjIb0YIosq2DBvH6BMs1Q/s3166/IMG_5018.heic" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="3166" data-original-width="2822" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOx_ZQqJ0htcuzcKIxL_s_s3tptw2S4p2my4gJ1wbo_DQymaWEIVlB2HXf9GsngEMqBLxEEgbQE1Y6kF28ECa29D92WCwZqShU1Mr05Gb873BgthfSaOPS5ukP8A8DXj4RymaraZvZ9K0NG9pGo9LMZ5ytoAWo_0wI1r69jWjIb0YIosq2DBvH6BMs1Q/w194-h200/IMG_5018.heic" width="194" /></a></div></div><div>This helps develop the strength and power through the pelvis, hip flexors, hamstrings, quadriceps, gluteals plus the broader fascia of the knee, lower leg, foot and ankle.<br /><br />Get into a lunge position with feet shoulder width apart. The front leg should have the knee flexed at 45-90° and the hip flexed about the same, the trunk is upright above the pelvis, and the other leg is extended, knee bent behind you in a similar 45-90° flexed position. Have your arms in the opposite position to your legs, so one forward one back (like running or marching).<br /><br /><br /><br /><br />These explosive plyometric exercises I find a lot harder. </div><div><br /></div><div>Plyometric exercises are a vital part of any training and as they are more challenging they form part of the final stages of a rehab plan or performed when you are feeling good (not injured in any way). It is worth investing time in this sort of exercise, for strength, power and speed. <br /><br /><br /><br /><b>IMPORTANT - NOTE</b> I haven’t included reps or set advice. I am not a qualified run coach, I am a Soft Tissue Therapist and qualified to provide rehab advice. A training and rehab plan is always individual and depends on many factors. These exercises and ideas are born from my education, many seminars, reading, running, rehabing and training myself - so these are example exercise ideas. If you would like further details on these exercises and others please feel free to get in contact. <br /><br /><br /><br /><a href="http://www.nickysportsmassage.co.uk">www.nickysportsmassage.co.uk</a><br /><div><br /></div><div><br /></div><p style="font-family: "Helvetica Neue"; font-size: 11px; font-stretch: normal; line-height: normal; margin: 0px; min-height: 12px;"><br /></p></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-46818603265737122972022-07-06T13:49:00.000+01:002022-07-06T13:49:51.375+01:00Our brain decides our Pain<br />We have all injured ourselves at some point in our lives, at least stubbing our big toe a few times or walking into a desk! Pain can be felt from a recent injury and it improves over a few days/weeks and some pain can be chronic, perhaps building over a few months or long-term and sometimes there appears to be little explanation as to why this pain is felt.<div><br /><br /><b>Pain is actually an output from the brain</b> not a direct response from the area where pain is felt. Nociceptors, these are our pain sensing neurons all over the body and they sense injury, inflammation and if something is not right and happily pass signals up to the brain. Our brain then decides on the threat and decides how to react. Our brains perception of the injury or threat and its reaction is influenced by a lot of things - past trauma or injury, our past experiences, environment, hormonal health and balance. </div><div><br /><br /><b>Pain is a natural protection response</b> and provides us with a message that something is “upset,” some part of the body needs to be protected or rested, and so the local soft tissue inflammatory response will make movement more limited and painful. I really like this explanation that pain provides us with a “safety buffer” (Professor Lorimer Moseley ref. 1), therefore stoping us from creating an even bigger problem. <br /><br /><br /><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7hV3NmpG7WLVXbd9Gojzj_VjjnzOgu8Rp41Za5lYy_mhw2DZmgIX87KiqCJSREpRCHBEA6ZEh20S9EN6oqjls9keSMCAN2fM681dTnx642A9THyMymztfSC1FM6WosuKAq1zZrGueOh16F2eFUL4i4g5mrHNa0tSveVewn3mPW9VRnFCnWgEc2FkVpQ/s1716/Bufferzone2.png" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="1180" data-original-width="1716" height="215" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7hV3NmpG7WLVXbd9Gojzj_VjjnzOgu8Rp41Za5lYy_mhw2DZmgIX87KiqCJSREpRCHBEA6ZEh20S9EN6oqjls9keSMCAN2fM681dTnx642A9THyMymztfSC1FM6WosuKAq1zZrGueOh16F2eFUL4i4g5mrHNa0tSveVewn3mPW9VRnFCnWgEc2FkVpQ/w426-h215/Bufferzone2.png" width="426" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><h4><span style="font-family: "Helvetica Neue Light"; font-size: 8px;">Long-term pain & pain hyper-sensitivity increases the safety buffer too, so they feel the same, the body thinks we are constantly in an “injured” state</span></h4><br /><br /><div style="text-align: left;">If you imagine running a marathon and mile 23 your legs start to ache and are heavy, so this is a warning that the soft tissues have almost reached their tolerance point, so we are in the “safety buffer zone” (see image above).</div><div style="text-align: left;"><br /></div></td></tr></tbody></table><div class="separator" style="clear: both; text-align: center;"><br /></div>With injury and/or inflammation the tolerance point of the tissues is lower and the safety buffer is also bigger meaning that pain is felt earlier on and more easily. In the short-term pain is effective to help us take care of ourselves and heal.</div><div> <br /><br />IMPORTANTLY the exact same thing happens to the "safety buffer", it is bigger and hence more easily reached, if the pain system becomes hyper-sensitive - there is increased sensitivity of our body’s natural alarm system. The body continuously adapts to this threat and various chemical/hormonal changes take place which allow the system to become better at sending pain signals. There is persistent pain and this can spill over into other soft tissues. This can be the vicious circle of long-term pain. <br /><br /><br />BUT another IMPORTANTLY is… our nervous system is always malleable, we learn lessons about our pain, what feelings, environments, movement influence it and our soft tissues can be encouraged to “soften”, heal and mobilise creating positive change in the body’s natural homeostasis. <br /><br /><br />So, to manage and start taking control of pain, something has to change? Figuring out exactly what the change is can take time and be hard but can be achieved by physical, psychological and well-being treatment, therapy and education. <br /><br /><br />My role as a Sports Massage & Remedial Therapist is to listen and to understand you and your pain, to assess and with hands-on advanced Massage & Myofascial Release techniques treat your soft tissues with the aim of enabling you to move better and by moving better generally you can decrease your pain. Mobility and strengthening will generally create positive change. <br /><br /><br />So, don’t let those niggles manifest - whatever they maybe. </div><div><a href="http://www.nickysportsmassage.co.uk">Nicky’s Sports Massage</a> to understand, explain, treat and provide self-care exercises. <div><br /></div><div><br /></div><div><br /></div><div>Nicky Holbrook</div><div>July 2022<br /><br /><br /><br />(1) Prof. Lorimer Moseley - Flippin Pain - Prof. Mosely has worked with the NHS presenting talks, videos, podcasts to explain pain, how our body perceives and feels pain and how to help ourselves. You will numerous talks online, Youtube, Facebook if you type in his name and Flippin Pain. <br />Image 1 Prof. Lorimer Mosely -Flippin Pain.</div><div><div><br /></div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-72710935938944030372022-05-10T09:16:00.001+01:002022-05-10T09:16:42.542+01:00Tendons, Tendonitis, Tendonosis?<br /><h3 style="text-align: left;"><span style="color: #800180;">Tendons attach muscles to bones, so they transmit the forces that generate our movement and also absorb the impact forces of movement. </span></h3><br />Tendon injuries make up a lot of my treatments, the most common being either an acute strain (recent) like an Achilles tendon (calf) or a chronic (long-term) rotator cuff (shoulder) pain. <br /><br /><b><span style="color: #cc0000;">Tendonitis</span></b> is the inflammation of a tendon. Microtears in the tendon, often resulting from overuse or overloading cause inflammation. This can occur from sporting injuries but can also apply from everyday life overuse i.e. tennis elbow - perhaps from too much DIY, particularly the screwing movement or hammering or shoulder issues from painting and rolling. <br /><br />If tendonitis fails to heal then it becomes chronic and becomes a <b><span style="color: #cc0000;">Tendonosis</span></b>, which is the degeneration of the tendon’s collagen, which is a tendon’s main fibrous protein material, and this can occur from overusing the already injured tendon. This can be a vicious cycle and can cause weakness, tearing, pain and prevent you from fully healing and regaining previous strength. <br /><br />The point where the tendon merges into the tendon is called the musculo-tendinous junction and it allows the force generated by muscle contractions to be exerted on the joints and the skeleton. It is an area which can be prone to injury as it is the primary site of force transmission. <br /><br /><br /><b><span style="color: #cc0000;">How to avoid tendon injury?</span></b><br /><br /><br />1 - <b><span style="color: #cc0000;">Tendons love consistency</span></b> - the load they had yesterday is the load they would love today, so when we are increasing the intensity, frequency and volume of exercise we need to make small changes. Intensity is the most important factor to consider to reduce a painful tendon. This is important to consider with your training plans. <br /><br />This is one of the reasons why the advice for running is do not increase your total volume/intensity etc. by more than 10% per week. <br /><br /><br />2 - <b><span style="color: #cc0000;">Stiffness</span></b> - is a positive for tendons, it helps to transmit forces rapidly and without the use of too much energy. If a tendon is too flexible though it is sluggish and doesn’t transmit forces well. <br /><br /><br />3 - <b><span style="color: #cc0000;">Balance between stiffness and elasticity</span></b> - there has to be a balance as a tendon that is too stiff will be more susceptible to strain and will compromise the movement and placement of a joint. <br /><br /><br /><br /><span style="color: #cc0000;"><b>Keeping our tendons healthy to minimise tendon injury risk: </b><br /></span> <br /><br />1 - <b><span style="color: #cc0000;">Tendon elasticity</span></b> - can be improved by mobilising the tissue. In a stiff or inflammed tendon there are areas of tight tissues and stretching does not help these areas, as this just tends to “stretch” the areas above and beyond the area of tight tissue. So mobilising the tendon’s tissues is key and it helps to align any scar tissue too. You can try to do this yourself or call on a Soft Tissue Therapist (do call ME to discuss how I can help!). With the Achilles for example the best way to mobilise the tissue is try to push through the tissue creating a “s” shape using your fingers from both hands (look at this picture)<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzgD6wumSnNWwH-YlVLLe5axF-0eK3HixPgDt2DFIo0oFKL7S4CTcmLYYqKbCMizFGvWuIefREwwXLSl4aSCX27v1mIi8vAH32dLFFYrbFxIIUT2RQa5uDccTP3FwZ4aaZQplFF6ih96ws5-WMTm-4887IoZDWIcKNb8S2LRJlM8t70WhGn49s8xBe-A/s4032/IMG_4838.heic" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="4032" data-original-width="2942" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzgD6wumSnNWwH-YlVLLe5axF-0eK3HixPgDt2DFIo0oFKL7S4CTcmLYYqKbCMizFGvWuIefREwwXLSl4aSCX27v1mIi8vAH32dLFFYrbFxIIUT2RQa5uDccTP3FwZ4aaZQplFF6ih96ws5-WMTm-4887IoZDWIcKNb8S2LRJlM8t70WhGn49s8xBe-A/w146-h200/IMG_4838.heic" width="146" /></a></div><br /><br />2 - <b><span style="color: #cc0000;">Tendon stiffness</span></b> - as I mentioned above stiffness is a positive for a tendon and this means doing strength based exercise to increase collagen production and (which as mentioned before is the main structural protein and fibrous tissue of a tendon). This increases its stiffness and ability to cope with load. <br /><br />Note - strength training doesn’t have to involve the gym and weights, using the body’s own weight with exercises such as single leg squats, lunges, rocking on heels to toes for balance, planks etc. <br /><br />Tendons do not adapt and heal quickly and hence when incorporating targeted strength exercises into a training plan or recovery plan then this takes time….it can be 12 weeks to 9/12 months to build strength and capacity. <br /><br /><br />3 - <b><span style="color: #cc0000;">Vitamin C, Hylauronic acid and water</span></b> - to aid healing and rehab there have been recent studies that have linked the important role of Vitamin C and Hylauronic acid (1) with the production of collagen cells to help strength and Hylauronic acid to reduce inflammation. So maintain healthy diet and/or seeking advice about supplements. Keep well hydrated too as tendons are mostly water. <br /><br /><br />My aim as a Soft Tissue Therapist is to always treat your specific niggles/pain and to advise on how to manage your injury and rehab self-care exercises. <div><br />If you would like any advice on any specific recent or chronic injuries or pain then do get in contact. I offer 15 mins free Consultations, either by Zoom or face to face. <br /><br /><br /><br />Nicky Holbrook</div><div>nicky@nickysportsmassage.co.uk<br /><br /><br /><br /><br /> Reference (1). <a href="https://chronicinjuryandhealth.com/vitamin-c-tendonitis/ " target="_blank">https://chronicinjuryandhealth.com/vitamin-c-tendonitis/ </a><br /><br /></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-45983639569103189122022-05-09T15:20:00.003+01:002022-05-09T15:20:42.769+01:00Do compression socks actually work? <h3 style="text-align: left;"><span style="color: #800180;">Do compression socks (clothing) actually work, what are the benefits, what do they do? </span></h3><h3 style="text-align: left;"><span style="color: #800180;">Here are some quick answers...</span></h3><div><br /></div>From reading a research paper which analysed all previous studies about the effects of compression clothing on running performance and recovery and it concluded “that by wearing compression clothing, runners may improve variables related to endurance performance slightly (i.e., time to exhaustion) due to improvements in running economy, biomechanical variables, perception, and muscle temperature. They should also benefit from reduced muscle pain, damage, and inflammation.” <br /><br />In addition I have read other studies and research and overall the evidence for compression clothing remains inconsistent and the language used is always MAY improve or help or some positive effects but not enough to be conclusive. So there is no resounding YES for compression clothing enhancing performance and recovery but importantly at the same time there are NO known negative effects.<br /><br />For sporting performance the current commercial believe is that wearing compression garments can enhance performance and improve post-exercise recovery time. <br /><br /><br /><b>So what does this actually mean for you and I?<br /></b><br /><br /><span style="color: red;"><b>First of all, how does compression clothing actually work? </b></span><br /><br /><br />Originally, compression wear was developed for swelling disorders in the limbs, and this led on to compression socks to treat vascular disorders, such as varicose veins, and to help to prevent blood clots in bed-ridden patients after surgery. These are typically knee high socks with the compression highest at the ankle and tapering off towards the knee. <br /><br />The socks work by creating positive pressure on the one-way valves in the veins and the difference in pressure between the ankle and the knee encourages blood to flow back to the heart, against the forces of gravity (which is why it is advised for frequent flyers to minimise deep vein thrombosis too). <br /><br /><br /><span style="color: red;"><b>What does this mean for you and your training, perhaps your running, cycling, triathlons, tennis ? How can compression socks/sleeves help you? </b></span><br /><br /><i><br /></i><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpXEW4hpidU1e2rxVPRxZ4HI3zRUnk01s3TEiomBFznaU-4XGs6xu1g5iT8Q3Y8ApNZjYv_nb4A-ewzCfgitPpoEPTN61DcwRaiUXDgWlM3v-3QWmoZu9tCLbv0ZD6-5HvFuSJ_IpKTUZVr4EftYpVd8N1hP-uNbfFYFWXA5ciEOxtOe6BDXejZ_wV3A/s760/Screenshot%202022-05-09%20at%2015.15.33.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="760" data-original-width="732" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpXEW4hpidU1e2rxVPRxZ4HI3zRUnk01s3TEiomBFznaU-4XGs6xu1g5iT8Q3Y8ApNZjYv_nb4A-ewzCfgitPpoEPTN61DcwRaiUXDgWlM3v-3QWmoZu9tCLbv0ZD6-5HvFuSJ_IpKTUZVr4EftYpVd8N1hP-uNbfFYFWXA5ciEOxtOe6BDXejZ_wV3A/w193-h200/Screenshot%202022-05-09%20at%2015.15.33.png" width="193" /></a></div>First of all, <span style="color: #cc0000;"><b>DURING activities, particularly during endurance events</b> </span>(according to studies) the major selling point for compression clothing are:<br /><br /><br /><b><i>Improved circulation of blood</i></b> and other essential fluids. Because compression clothing can enhance the flow and exchange of fluids in the muscles, this means aiding the delivery of oxygenated blood, which is vital for the aerobic energy system, removing waste such as deoxygenated blood and processing lactate (lactic acid) to prevent cramps and muscle fatigue.<br /><br /><br /><b><i>Muscle oxygenation </i></b>- studies have concluded better endurance, specifically noting better mechanical performance (muscles less fatigued) over a distance of 10K.</div><div><br /></div><div><br /><b><i>Joint awareness and stability</i></b> - compression helps to stabilise the muscles and decrease the amount of muscular vibration.<br /><br /><br /><b><i>Muscle (and skin) Temperature</i></b> – keeping the muscles warmer, means more blood flow and more oxygen is readily released, muscles contract and relax and nerve transmission is better and it feels good. <div>For some compression clothing can be too hot during activity, so have a look at the potential benefits of using post-exercise.<br /><br /><br /><b><i>Comfort and Perception</i></b> - the feeling of comfort, support, stability, muscles at a warm happy temperature have a positive perceived effect on fatigue.<br /><br /><br /><i><b>Lowers heart rate</b></i> - this is more of a possible the evidence remains even more inconclusive - this was proven in running to exhaustion over a 5km distance . A lower heart rate is good for sustaining a higher level of effort, good for endurance.<br /><br /><br />And then <b><span style="color: #cc0000;">POST-EXERCISE the potential benefits are IMPROVED RECOVERY</span> owing to</b>:<br /><br /><br /><b><i>Reduced Muscle soreness (DOMS (delayed onset muscle soreness)</i></b> - a reduction in the perception of muscles soreness and pain post intense exercise. Decreases in DOMS (delayed onset muscle soreness).<br /><br /><br /><b><i>Increased Blood flow and removal of waste products</i></b> - this aids better healing and recovery and lactic acid levels (the by product of anaerobic metabolism) have been found to be notably lower immediately post exercise aiding muscle recovery <br /><br /><br /><b><i>Decreases swelling</i></b> - inflammation is a natural part of the recovery and repair of soft tissues after strenuous exercise and compression garments are thought to apply external pressure upon the body, thus decreasing swelling and hence the experience of pain. <br /><br /><br /><b><i>Muscle support</i></b> - again the feeling of a muscle being support, stable and it lessens muscle vibration<br /><br /><br />So there are many potential benefits for during and post-exercise however, again the results of all studies to date do not provide overly conclusive results about these benefits, but nonetheless positive marginal ones and no known negative ones.</div><div><br /><br /><br /><b><span style="color: red;">So are compression socks, sleeves, shorts worth the money?</span></b><br /><br />It seems that they are not a game-changer. The most conclusive evidence suggests they are best used to prevent excessive soreness and muscle damage from hard training sessions and there is some evidence that over longer endurance activities they could improve your performance. <br /><br />There is of course the “placebo effect” and the positive comfort and perception that compression garments give so I think if this works for you, then why not give them a try! <br /><br />Training plans for different events are hard so I think anything positive that helps you body and soul. Is worth trying!<br /><br /><br /><br /><b><span style="color: red;">What about injuries? Are compression socks good for shin splints, calf cramps, strains and Achilles tendonitis? </span></b><br /><br />YES, for all of the reasons noted above, but they are not going to cure any of the above injuries, You should still follow initial acute injury principals of <a href="https://www.physio-pedia.com/Peace_and_Love_Principle">LOVE and PEACE</a> and get an injury assessed for proper recovery and the cause to be addressed. Note, for recovery from an injury it is better to wear a sock rather than a sleeve so that the foot doesn’t get swollen, as it can’t get past the compression at the ankle!<br /><br /><br /><br /></div><div><b><span style="color: red;">Buying and how tight should a compression sock feel?</span></b> <br /><br /><br />An important point when looking to buy compression socks is they should be rated and sold in millimeters of mercury (mmHg) at the ankle and calf. So a sock labeled 15-20 mmHg is 20 mmHg at the ankle and 15 at the calf, and this is a medium level and is recommend rating for general sporting use.<br /><br />Normally when you buy compression garments you measure the top of your calf or arm and when trying them out the garments should feel tight yet comfortable to wear and should not cause any additional pain.<br /><br /><br /><br /><i>NB. The above article is meant to give you an overview of the benefits of compression clothes in a sporting/exercise context. This is my summary of a number of articles and papers I have read. I hope this helps! Any queries let me know!</i><br /><br /><br /><br /><br />Nicky Holbrook<br /><br />May 2022<br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />I had some socks a few years ago, but never really felt I got any benefit but in the last month I have been using a new compression calf sleeve for a calf issue and I feel it has really helped my calves recover post exercise. <br /><br /><br /><br /><br />I am aware of course of the placebo effect and I like wearing them, not all the time, but as there is no known negative effects to using them, then why not?<br /><br /><br /><br /></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-86041773950477726202022-04-07T10:44:00.004+01:002022-04-07T10:46:11.910+01:00Stiffness or pain on the sole of your foot in the morning?<p> </p><div class="section"><div class="layoutArea"><div class="column" style="background-color: white;"><div class="separator" style="clear: both; text-align: center;"><b><span face=""arial" , "helvetica" , sans-serif"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUEbCo_qKsIzr5deT1OXOLODrZqGsFE08d7ZV6Kvv7bSh32mApu3-kVC9TNWdBtHKN3qwqNYp-cmpg0a1mz3qz3NxJB8DYwGN4-L5kb9P3pQBtRc-pwCs9XHE8rHcJpbT7qY-fUa3oLeh6/s1600/Screenshot+2020-05-27+at+13.24.59.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="1020" data-original-width="946" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiUEbCo_qKsIzr5deT1OXOLODrZqGsFE08d7ZV6Kvv7bSh32mApu3-kVC9TNWdBtHKN3qwqNYp-cmpg0a1mz3qz3NxJB8DYwGN4-L5kb9P3pQBtRc-pwCs9XHE8rHcJpbT7qY-fUa3oLeh6/s200/Screenshot+2020-05-27+at+13.24.59.png" width="185" /></a></span></b></div><span face=""arial" , "helvetica" , sans-serif">Many of you will have heard of the term “plantar fasciitis” and some will be familiar with stiffness around the heel first thing in the morning or after exercise or running. Plantar fasciitis tends to be the most common cause of heel pain and so to follow is a brief explanation of what it is but more importantly what we can do to get rid of the pain and get moving.</span></div><div class="column" style="background-color: white;"><br /></div><div class="column" style="background-color: white;"><span face=""arial" , "helvetica" , sans-serif">The plantar fascia (basically the tissue of the sole of your foot) is a flat band of soft tissue that connects the toes and the heel bone together and the achilles tendon feeds into the plantar fascia as it come down the back of the ankle around the heel. It supports the arch in your foot. </span></div><div class="column" style="background-color: white;"><span face=""arial" , "helvetica" , sans-serif"><br /></span></div><div class="column"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">When the plantar fascia becomes too tight, or short, it can pull against your heel bone causing inflammation and pain, so your heel will end up hurting whenever you walk or run. You can get the condition in one foot or both feet.</span></div><div class="column"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;"><br /></span><h4><span style="background-color: white;"><span face=""arial" , "helvetica" , sans-serif">What causes plantar fasciitis?</span></span></h4></div><div class="column"><br /></div><div class="column"><span face=""arial" , "helvetica" , sans-serif" style="background-color: white;">Repeated over-activity and too much demand placed on it causes micro tears and shortening to the plantar fascia, which is the body's normal healing process, but if the plantar fascia doesn't have time to recover and heal in between use then there is continuous inflammation, pain, excessive nervous system sensitivity and changes to its normal function. </span>There is also increasing evidence that plantar fasciitis is due to collagen degeneration in the fascial tissue. Collagen is the main structural protein of the body’s connective tissues (which are our bone, tendons, ligaments, cartilage).</div><div class="column"><br /></div>Causes could be: <br /><ul><li>a change in footwear i.e. sometimes changing our shoes in the summer from supported to flat shoes, flip flops or possibly wearing worn out shoes </li><li>Increased activity levels i.e. ramping up your walking or running too much too soon. </li><li>Postural issues, flat feet or perhaps compensations from the knee or hips causing excess pressure </li><li>Impact to the heel i.e. stepping on something, jumping and causing an injury</li></ul><div class="layoutArea"><br /></div><h4><b>How to manage and get rid? </b></h4><br />The plantar fascia helps to contract the sole of your foot and the achilles tendon connects the muscles at the back of the leg (gluts, hamstrings, calves) to the heel and foot so this is where REHAB needs to be focused. <br /><br /><b>Massage and soft tissue treatment </b>can be extremely effective in helping overcome the pain and limitations of plantar fasciitis. Focusing on the plantar surface of the foot, ankle and foot joint mobility and combined with massage, release and stretching techniques to the lower and upper leg and possibly to the glutes too. <br /><br />You can also help yourself with some Rehab ideas: <br /><br /><ol><li><b>Rest</b> - if you are experiencing sharp/acute pain then you need to reduce your activity and avoid hard surfaces, wear good cushioned shoes and sometimes it helps to wear a shoe with a small heel (not flat) or a heel insert to shorten the achilles tendon and calf muscles. If your pain is from walking or running induced then rest, and make sure you are comfortable walking before recommencing, or at least reduce your activity </li><li><b>Ice</b> is helpful too if your pain is acute. Place your foot on some wrapped ice for 5 mins and you can do this 3- 5 times a day. </li><li>Importantly<b> exercise and movement</b> is good and if you pain is manageable then here are some Rehab Exercises to try first of all:</li></ol></div><div class="layoutArea"><br /></div><h4><b>Rehab Exercises</b></h4><br /><ol><li>Big toes stretch and wiggle - sit with one ankle resting on your knee and with your hands stretch the sole of your foot, wiggle the toes and massage the foot whilst wiggling the toes, particularly the big toe too. </li><li>Roll a tennis size ball (or slightly smaller) on the soul of the foot - you can do this at any time seated or standing for 3 - 5mins. </li><li>Ankle mobility - take the ankle slowly round all in a circle, pull the toes back, point the foot and toes and tip the foot from side to side, trying to trying to exaggerate all possible angles of the foot and ankle. You can do this actively and also passively using your hands to assist. </li><li>Calf stretches, to start with: </li></ol><ul><li>Lean into a wall or worktop and extend one leg straight behind you and feel a stretch potentially through the foot, calf and/or hamstring, hold for 30 secs </li><li>In the same position now behind the opposite leg at the knee and try to take your knee over your toes, this is a stretch for the deeper calf muscles, hold for 30 secs </li><li>Short foot exercise - seated, first of all (you can progress to standing) with a foot flat on the ground, try to crunch your toes back forwards your heel (shortening the foot) - this uses the smaller intrinsic muscles of the foot </li></ul><br />It is necessary to progress from these initial stretch and mobility exercises to strengthen the foot/calf muscles to better tolerate the load created by walking and especially running. It may also be necessary to consider gait and/or footwear changes. <br /><br />Shockwave Therapy (which I don’t offer, see footnote 1 below) has also been found to have positive effects too and possibly visiting a podiatrist for orthotics. <br /><br /><br />This is an introduction to heel pain and how you can start to take control and manage it. If you have any questions on the above and would like to book an appointment for treatment, please call or <a href="mailto:nicky@nickysportsmassage.co.uk" target="_blank">email me</a>. </div><div class="section"><br /><div class="layoutArea"><br /><div style="background-color: white;">Nicky Holbrook</div><div style="background-color: white;"><a href="http://www.nickysportsmassage.co.uk" target="_blank">Nicky'Sports Massage</a><br /></div><div style="background-color: white;"></div><div style="background-color: white;">Updated April 2022</div><div style="background-color: white;"><br /></div><div style="background-color: white;">1. What is <a href="https://www.nhs60.co.uk/shock-wave-treatment/" target="_blank">Shockwave Therapy</a>?</div></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comHaywards Heath, UK50.999041 -0.10633322.688807163821153 -35.262583 79.309274836178844 35.049917tag:blogger.com,1999:blog-4166907338434926419.post-44837590499188244442022-03-22T12:32:00.001+00:002022-03-22T12:32:32.333+00:00Mother's Day 2022, Special offer - save £20<br /><h3 style="text-align: left;">Mother’s Day! <span style="color: #800180;">Mothering Sunday </span>on <span style="color: #ffa400;">March 27th</span></h3><h3 style="text-align: left;"><br />Give the gift of relaxation, ease, recovery, quiet "me time" - a real treat!</h3><h3 style="text-align: left;"><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhonXbLHqBo5KS-blOMp4tfQlMsKNHTw2apkeqrSQ0yAS8tO-dgDwkScSKGM8e1g6QhcBGBdsxwGtryNaXVYf9BNyBIta5ZbnUcqyfZlj-RbjuD3FzX02NzrYLnG_xFAM5edpQntAur0FFYoNiLawuK_ND7mKDxNQY63U7YYH3d7xs0K594-KPj6EIyfQ/s1142/Mother's%20Day.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="672" data-original-width="1142" height="188" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhonXbLHqBo5KS-blOMp4tfQlMsKNHTw2apkeqrSQ0yAS8tO-dgDwkScSKGM8e1g6QhcBGBdsxwGtryNaXVYf9BNyBIta5ZbnUcqyfZlj-RbjuD3FzX02NzrYLnG_xFAM5edpQntAur0FFYoNiLawuK_ND7mKDxNQY63U7YYH3d7xs0K594-KPj6EIyfQ/s320/Mother's%20Day.png" width="320" /></a></div></h3><span style="color: #cc0000;"><b><div><span style="color: #cc0000;"><b><br /></b></span></div>SPECIAL OFFER on Gift Vouchers for 3 x 60 minutes treatments.</b></span><div><span style="color: #cc0000;"><b> </b></span><div><span style="color: #cc0000;"><b>The offer is £20 OFF (usually £160) so NOW £140.</b></span></div><div><span style="color: #cc0000;"><b> </b></span><div>(This applies to Gift Vouchers for 3 x 60 minutes treatment only and purchased before Sunday 27th March 2022)</div><div><br /><br /><br /></div><div>60 minute treatment Gift Vouchers are also available, the cost is £55.</div><div><br /><br /><span style="color: #cc0000;"><b>PLUS</b></span> I am offering the purchaser of any Gift Voucher purchased before Sunday 27th March, £10 OFF their own next treatment (to be used before the end of June 2022).</div><div><br /></div><div><br />This offer is available to anyone, so please pass on if you know someone who might be interested.</div><div><br /></div><div><br /></div><div>Gift Vouchers can be purchased by online payment and can be emailed, picked up, or I can drop off locally in Lindfield or Hayward Heath.</div></div></div><div><br /></div><div><br /></div><div>Please <a href="mailto:nicky@nickysportsmassage.co.uk">Email</a> or contact Nicky tel. 07738257873</div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.comtag:blogger.com,1999:blog-4166907338434926419.post-37782273329554492692022-03-04T15:11:00.002+00:002022-03-04T15:13:01.635+00:00How the Menopause effects women’s soft tissue and bone health <div class="separator"><div class="separator" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: right;"><img border="0" data-original-height="700" data-original-width="1086" height="206" src="https://blogger.googleusercontent.com/img/a/AVvXsEgiaaDIIXwsynn7OGRjeRL1LH95QhnB07wfmSuiqaCoSr8-2j1IITdojTx_qvhAzm1USTQ1VlCYMq68vNb_DDOnZdKicR3WRJyyhYSNQ1vloYKfZ0xrVg7tCFni1HPwUgOrI9_ydBua8964ErFCEcFOCuCory1mi1GMWwoKzgnM_U0EeuB3FPOlLCG7Qw=s320" width="320" /></div></div><div><br /></div><div>The menopause and its effects is a subject that is gaining greater research, press interest and awareness. Last year some of you may have watched Davina McCall’s TV programme plus a new government Menopause Taskforce was established at the end of last year co-chaired by the Minister for Women’s Health with our own MP Mims Davies being involved in this Taskforce too. One of their first big successes is the reduction of NHS HRT (Hormone replacement therapy) prescription charges for women!</div><div><br /></div><div><br /></div><div><br /></div><div>My aim of this article is to make you aware of <b>how the Menopause unfortunately negatively effects women’s soft tissue and bone health (</b>remember our soft tissues are our muscles, tendons, ligaments and fascia). It effects our soft tissues because of the depleting and then continuous low levels of oestrogen. The average age of the Menopause in the UK is 51 so we all have a lot more to achieve and enjoy post menopause and hence the need to be informed to know how to help ourselves. </div><div><span style="text-align: right;"><br /></span></div><div><span style="text-align: right;">As women hit the menopause, and even before this during the peri-menopause (when our menstrual cycles haven’t quite stopped), oestrogen levels are starting to fall. They rapidly fall when the menstrual cycle stops and then remain low for the rest of a women’s life.</span></div><div><br />To put this fall into perspective, oestrogen levels vary hugely from women to women and also vary hugely and quickly during our menstrual years and cycle. They normally range from 70 to 1480 pmol/L (1) and the highest level is at the pre-ovulation stage. However post the menopause Oestrogen levels are continuously approx. less than 130 pmol/L. <br /><br /><h4 style="text-align: left;">Reduces the strength, structure and healing potential </h4>The lower level of oestrogen in the peri, during and post menopause stage of life <i>REDUCES</i> the strength, structure and healing potential of soft tissues and the density and hence strength of the bones. <br /><br />This means that some women at this stage of their lives are more likely to suffer soft tissue injuries, such as frozen shoulder (a temporary and still relatively unexplained condition that effects more women than men aged 40 to 65!), plantar fasciitis or lateral hip/gluteal pain.<br /><br />Oestrogen is a very important hormone, obviously known for the development and regulation of the female reproductive system, also for general health and wellbeing and <i><b>importantly it is also key for soft tissue and bone health. <br /></b></i><br /><h4 style="text-align: left;">Key role of Oestrogen for our musculoskeletal system: </h4><ul style="text-align: left;"><li>Improves and regulates muscle mass and strength - regulates muscle metabolism (for energy and function) and protein synthesis (for growth and regeneration) enabling muscles to generate optimal strength, power and then rapidly repair. </li></ul><ul style="text-align: left;"><li>Increases the collagen synthesis of soft tissues. Collagen is a protein and makes up 25% to 35% of the whole-body protein content. It is mostly found in fascia, cartilage, bones, tendons, ligaments and the skin<span style="color: black;"> and to a lesser extent the muscles.</span></li></ul><ul style="text-align: left;"><li>Decreases the stiffness of tendons and ligaments. This has both positive and negative effects as pre-menopausal women are less likely to get an Achilles rupture, yet overly high levels of oestrogen provide too much ligament laxity and so are a threat for injury. For example, pre-menopausal women are 2-8 times more susceptible to an ACL injury than their male counterparts (2). </li></ul><ul style="text-align: left;"><li>Regulates bone metabolism and maintains bone mass - our bones are living tissue constantly regenerating, healthy bones have osteoblasts (bones cells which help to build bone) and osteoclasts (bones cells which resorb bone) and oestrogen helps balance this constant mix of the breakdown and reformation of bone. </li></ul><h4 style="text-align: left;"><br /></h4><h4 style="text-align: left;">What lower levels of oestrogen mean for our soft tissues, starting from the peri-menopausal stage: </h4><ul style="text-align: left;"><li>Decline in muscle mass and strength owing to slower growth and repair of muscle (and all soft tissues). Muscle protein synthesis changes with age and this is further affected by sex. In a study in 2014 (3) in postmenopausal women, higher rates of muscle protein synthesis and breakdown were observed when compared to age matched men and premenopausal women. Even though higher rates of protein synthesis might be expected to improve muscle quality, the women in the study still experienced a rapid decrease in muscle mass and strength. Muscle mass is largely dependent on the balance between the synthesis and breakdown of muscle protein. The study noted there still needs to be further research to understand if the decreases in muscle mass in women are due to muscle protein breakdown outstripping protein synthesis or that the muscle proteins being synthesised are not those needed for muscle contraction, tension and mass! </li></ul><ul style="text-align: left;"><li>Decrease of collagen production, which effects the tendons, ligaments, bones and cartilage particularly, so again there is reduced strength, increased stiffness and for bones can mean fragility. As I mentioned above oestrogen gives women increased laxity (or flexibility to load) and so pre-menopausal women are less likely to have Achilles tendon injury compared to men, whereas post-menopausal women have the same risk of Achilles injury to their men counterparts (4).</li></ul><ul style="text-align: left;"><li>Slows the regeneration of bone — fewer bones cells are produced so bone breakdown outstrips bone building which results in weaker, less dense and more fragile bones. The bone mineral density decreases. This is the well researched link to women being at a higher risk to Osteoporosis (a disease that thins and weakens bone) or Osteopenia (decreased bone density).</li></ul><br />This leaves us women more vulnerable to age-related musculoskeletal frailty but please don’t take away from this article that this is all negative as it is very important to note that we can help ourselves!<br /><br /><h4 style="text-align: left;">How to help ourselves?</h4><br />We can minimise the decline in Oestrogen and its effects on our soft tissues through diet. Post exercise consuming protein is a key for to help muscle repair and regeneration (<span style="color: #2b00fe;"><a href="http://www.nickysportsmassage.co.uk/2021/09/importance-of-protein-for-muscle-health.html" target="_blank"><span style="color: #2b00fe;">see my article on the Importance of Protein</span></a>)</span>. Eating nutritious foods can help, an ideal diet should be rich in fruits, vegetables, protein and fibre. Getting enough calcium, magnesium and vitamin D and K are critical for bone density and muscle health (<a href="https://www.bbcgoodfood.com/howto/guide/eat-beat-menopause" target="_blank"><span style="color: #2b00fe;">see BBC Food article on foods for the menopause</span></a>).</div><div><br />Plus, regular resistance exercise (<a href="http://www.nickysportsmassage.co.uk/2021/09/benefits-of-strength-training.html"><span style="color: #2b00fe;">see my article on the importance of strength training</span></a>) and strength benefits are definitely achieved with regular walking! The good news is the post-menopausal body still responds and adapts well to regular exercise and nutrition. <br /><br /><h4 style="text-align: left;">Soft Tissue Therapy and Massage is also a powerful tool to deal with the menopause and its longer term effects on the soft tissues.</h4>Soft tissue treatment increases the repair rate of tissues (5) and when combined with guided rehabilitation can help keep us moving well, feeling good and recover from any soft tissue injuries or post-operative scars and recovery. It supports good joint health, encouraging the natural flow of joint fluid. <br /><br />Disturbed, fragmented sleep can be a problem and a relaxing, flowing massage in the evening, will down regulate our nervous system promoting a healthy parasympathetic (our bodies natural healthier balanced and peaceful status) response from the nervous system, encouraging a good nights sleep.<br /><br /><br />The menopause and ageing is natural process and our goal has to be healthy ageing and to try to slow the deterioration of our physical and mental function as much as possible. </div><div><br />If you have a niggle that is starting to effect your daily life then don’t ignore it, seek advice!</div><div><br />Please get in touch if you have any comments on this article or would like to discuss how Soft Tissue and Massage treatments can help you.</div><div><br /></div><div>Nicky Holbrook</div><div><a href="mailto:nicky@nickysportsmassage.co.uk">nicky@nickysportsmassage.co.uk</a></div><div>March '22<br /><br /><br /><br /><br />References:<br />1. <a href="https://www.blogger.com/#">https://gpnotebook.com/simplepage.cfm?ID=570818627</a><br />2.The effect of estrogen on tendon and ligament metabolism and function, Leblanc DR, Schneider M, Angele P, Vollmer G, Docheva D, J Steroid Biochem Mol Biol. 2017 Sep;<br />3. Influence of sex and estrogen on musculotendinous protein turnover at rest and after exercise,<br />Hansen M, Kjaer M, Exerc Sport Sci Rev. 2014 Oct<br />4. <a href="https://www.blogger.com/#">https://pubmed.ncbi.nlm.nih.gov/30697162/</a><br />5. <a href="https://www.blogger.com/#">Massage doesnt just make muscles feel better it helps them heal faster and stronger?</a><br /><br /></div><div><div><br /></div></div>Nicky Holbrookhttp://www.blogger.com/profile/03388660432258495110noreply@blogger.com