Massage of lower leg

Optimising Mobility for Runners

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The aim of optimising mobility for runners is so you can run freely, easily and without pain. The role of a Sports Massage Therapist is to help runners down this road (excuse the pun!), by treating the area of pain with soft tissue massage, and to help increase mobility in restricted joints through manual manipulation and exercises that the runner can do at home. This helps to increase the recovery time as well as decrease the chance of injury reoccurrence.

The main joints for runners that we look at are the big 3:
1. Toe: Big Toe Extension (movement required for standing on tip toe)
2. Ankle: Dorsiflexion (movement required for heel walking)
3. Hip: Hip extension (movement required for extending leg behind you)

Big toe extension is important for the toe off stage of gait (the manner in which you walk/ run) which provides the stability for this movement. If your big toe lacks the flexibility needed, then there will be compensation movement further up the chain, for example in your foot, knee or hip, which may then cause pain or injury in this area.

Mobility tip: Place a massage ball (if you don’t have access to this then a cricket ball can be used) under your foot whilst you are sitting in a chair. Roll the ball around until you find a point of pain and then hold the ball in this position whist extending and flexing your toe. Carry this out for a couple of minutes a few times a day.

If there is lack of mobility in the ankle, and therefore a decreased range of motion into Dorsiflexion, this can cause compensatory movements including internal rotation of the foot, or femur.

Mobility tip: Place a resistance band over the top of your foot at the base of your tibia, and with your other foot behind you, stand on the rest of the resistance band. Now lunge forward. Repeat for a couple of minutes on each leg a few times a week.

The amount of hip extension needed for running is rarely, if ever, needed for any other movement in life, so limited mobility into hip extension is a fairly common issue with runners. This can result in compensatory patterns in the lumbar spine, causing lower back pain, or other muscles groups having to work harder such as the quads and calves.

Mobility tip: Go into a kneeling position and place one foot on a wall/ sturdy surface behind you so that your toes are pointing up, and then place your other foot in front of you with your foot in front of your knee. Ensure you have a neutral spine whilst in this position. Place your hands by your front foot, in a sprint position. Move your hips forward to feel a stretch up the front of your leg going into your hip flexors. Hold this stretch for 30 seconds on each side and repeat 3 times. By releasing the front of the leg will increase hip extension.

These are just a few examples of the importance of mobility, and tips on how to increase your mobility.
If you would like to find out more and be tested/ treated get in touch with The Physio Clinic today to book your Sports Massage Appointment.
https://www.thephysioclinicbristol.co.uk/sports-massage/physio-clinic-73

By Kate Griffiths

Physio jargon……high and low threshold training!

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At the Physio Clinic Bristol, we are experts in assessing and treating movement dysfunctions, weather you have come in following a specific injury or you are committing to the TPM Active, Performance Matrix process.  We will provide a detailed analysis and retraining of your movement system.

Two terms come up a lot during the rehabilitation process HIGH threshold training and LOW threshold training so I thought it would be helpful for all you guys working on your movement health to have better understanding of the two terms.

Put simply with have two main types of muscle (or motor units as physio’s would say!). Slow low threshold muscles and fast high threshold muscles. During day-to-day function or when participating in sports your body will select and recruit the appropriate muscle unit depending on the task. There are however differences in how these different muscle units are switched on, the speed at which they switch on, the force they use and how quickly they fatigue.

The table below outlines these differences.

Function Slow motor units Fast motor units
Contraction speed Slow Fast
Contraction force Low High
Recruitment threshold (how easily are they switched on) Low threshold – easily activated High threshold – requires higher stimulus
Fatigability Fatigue resistant Fast fatiguing

Comerford and Mottram (2012)

Put into context, day-to-day tasks such as walking, postural control, cooking and cleaning predominantly recruit the low threshold units.  Activities that require speed, heavy force or high loads e.g. throwing, heavy lifting, running, jumping etc. predominantly recruit high threshold units.

Research demonstrates that pain is more likely to inhibit low threshold motor units, the body will often compensate for this disruption employing recruitment strategies that are normally used for high threshold tasks – this can lead to over working of muscles, strain on the musculoskeletal system and ultimately pain.

If you feel that you are constantly foam rolling tight muscles or that you get pain during day-to-day activities, then book it with one of the team at The Physio Clinic Bristol and get your movement system analysed. We will correctly identify with system is not working efficiently and get you on the road to recovery.

Although the low threshold training might seem slow, non-fatiguing with low force often establishing the correct recruitment of this strategy is vital for successful rehabilitation.

Birgitte Hoff

Birgitte Hoff

To Heat or Not To Heat?

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To heat or not to heat? Football-injury-300x200 (1)

Some questions answered on the dilemma on whether to apply heat or cold to an injury.

 

This is a question we come across often here at The Physio Clinic, so we are writing down a few guidelines to help in the dilemma… “should I use heat or ice?”

 

Hot and cold are the two most common pain-relief therapies for muscle and joint pain. They both are advantageous in that they are easy to apply and are inexpensive.

Which one you use depends on whether the pain is a new one (acute) or one that keeps re-occurring (cronic).

In general a new or acute injury will result in inflammation and possibly swelling (just think of a freshly sprained ankle!).  Application of ice in the form of an ice pack/bag of peas wrapped in a clean damp cloth will cause vasoconstriction or narrowing of the blood vessels and so decreasing blood flow to the area which reduces pain, muscle spasm and inflammation. Applying ice will not stop the inflammatory process as this is necessary to kick start the healing process but it can help to temporarily ease pain.

It is recommended that ice be applied every few hours for 24-48 hours after the injury. Ice should not be applied for more than 20 minutes and skin should be checked every 10 minutes to check for ice burns. As physio’s we always recommend that ice should be used in combination with rest, compression and elevation after an acute injury.

Heat in general is used on more ongoing aches and pains including those niggly cases of low back or neck pain. Heat does the opposite of cold in that it causes vasodilation or opening up of blood vessels. This in turn increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments and tendons. The warmth can also decrease muscle spasm and thereby increase joint range of motion. Again application time should be limited to a maximum of 20 minutes and skin should be checked every 10 minutes to prevent burning. In applying heat only a warm hot water bottle or heat pack wrapped in a clean cloth should be applied to prevent risk of burning.

With both hot and cold it is important not to apply either to open wounds, infected or broken skin. Areas of diminished sensation occurring with poor circulation or diabetes should also be avoided.

If you are in any doubt- seek professional advice.