The Beginning of my 2018 London Marathon Journey!

The information The Beginning of my 2018 London Marathon Journey! was originally discovered on The House Clinics Group

I am guilty of falling for the bright lights, cheering crowds and heroic stories from the 2017 London
Marathon. This led to me naively putting my name in for the ballot and somehow being lucky
enough to secure myself a place for the 2018 event!

Let me say first, I am not an experienced or frequent runner.

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Five years ago, I completed a very slow, torturous half marathon. Over the years since then I have
convinced myself slightly more to like running. However, I have been battling with iliotibial band
syndrome for about 2 years now which has really stunted any progress I would have liked to make.

So, I am on week three, staring down the track at 14 more weeks of training. Along this journey I am
going to be sharing little tips, tricks or pieces of advice regarding my training programme and any
additional exercises I will be including. It’s time to start practising what I preach and kick my little
knee problem out the way!

Over the last two weeks I’ve been paying my adductor muscles a little more attention. From my
experience they’re always a little neglected compared to other well-known muscles such as the
quadriceps, calves and hamstrings. If you have been prone to knee pain or injuries while running,
cycling or swimming then these muscles could be paying a large part in that.

The adductors are made up of 5 large muscles running along the inside of your thigh. They are
responsible for drawing the legs in together, they also control and stabilise the hips when walking or
running. Thie means if one side of your adductors is tighter than the other it could cause an
imbalance in the level of your pelvis; one hip can drop down when you walk resulting in hip or knee
pain.

Iliotibial band syndrome or ‘runners knee,’ can also be linked to tight adductors. If the inside of your
leg is particularly tight it causes an imbalance and a pull on the outside where the iliotibial band is
located. Stretching them can relieve some of the pressure on this band like muscle.

So, just spend a little bit of time before and after your runs to stretch and even foam roll those
adductor muscles.

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Article by Poppy Campbell – Physiotherapist.

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How flexible can we be with our stretching routine?

The article How flexible can we be with our stretching routine? can be found on The House Clinics official site

We’ve all heard that you should stretch before and after exercise, it’s the basis of every high school PE lesson. If you’re feeling a bit guilty now and racking you brains for your last stretching session, you’re probably not alone! How many of us actually do? And is it even that important?

We are talking here about stretching to help with injury prevention and to avoid muscle soreness post exercise. Not, stretching or conditioning for a specific injury.

bicycle-384566_1280You plan a 30-minute run or cycle into your day, you expect to be exercising for 30 minutes and then back to chores or watching tv immediately after this, we don’t often calculate in the warm up, cool down and stretching time into this block. I must admit I am also guilty of not scheduling in stretching, and sometimes I really don’t feel like I need to stretch after exercise. But unfortunately, I am not invincible and when I am struggling to walk down the stairs the day after a big gym session I curse and blame hindsight. But if I had stretched, would it even have made a difference?

A review in 2011 (Herbert. RD, et al.,) found that across 12 different studies pre-and- post stretching did make a difference and reduced post soreness over a one week period. However, these differences were not considered big enough to be clinically relevant. In fact, most research supports that stretching does not change or improve muscle soreness or DOMS. Brilliant.

Stretching can be defined as ‘the application of force to a musculotendinous structure to achieve a change their length’ (Arminger, P, Martyn, MA.,2010). You are aiming to increase the flexibility of the muscle-tendon unit to promote joint range, better performance and decrease the risk of injury.

Muscles need elastic energy to be able to compensate and accommodate for high impact, quick changes in direction. The muscle should be able to react quickly to this which if it can, could reduce the risk of injury. Sports that involve a lot of bouncing and high intensity changes in muscle length (football, badminton) would benefit from stretching so that muscles are prepared to do this. However, it may not make a difference with running or cycling which are generally low impact (Witvrouw, E., et al, 2004).

This would explain why Chris Hoy, the Olympic cyclist, says he rarely stretches unless it is combined with deep soft tissue massage, but Novak Djokovic, the tennis champ, has said he spends a lot of time stretching.

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We do know clinically and through research that stretching can increase joint range of motion (Harvey, L., 2002). If we can increase our joint range, it can reduce the stresses on muscles and therefore surely can help to prevent injury.

The American College of Sports Medicine guidelines advise adults should do flexibility exercises at least two or three days each week to improve range of motion – and so do I!

It’s clearly not 100% scientifically sound, but stretching does make sense and flexibility training will increase flexibility. We just don’t know how much. Stretching is not just for after a swim, hockey game or half marathon. It’s important to consider stretching after sitting at a desk for 8 hours, an afternoon gardening or standing all day teaching a class. Your muscles are working and there are continuous strains being put on your joints here. So, give them a chance to relax and lengthen after.

Find that time to go through a stretching routine, it can take as little as 10 minutes! If you’re concerned about any stretches or are interested in the most effective ones – always ask your therapist.

My top stretching tips:

1. Always stretch both sides
2. Don’t push into a painful range, you are aiming to feel mild discomfort and stop there
3. Don’t stretch cold muscles, warm up with a walk or some gentle aerobic movements first
4. Don’t bounce on a stretch, go to the point of discomfort and hold
5. Do hold for between 15-30 seconds
6. Do include all the main muscle groups
7. Treat it as a relaxing 15-minute break, don’t resent the time spent stretching

By Poppy Campbell BSc (Hons) MCSP HCPC Chartered Physiotherapist

References:

ACSM guidelines: http://www.ACSM.org

Armiger, P, and Martyn, MA. Stretching for Functional Flexibility. Philadelphia, PA: Lippincott
Williams & Wilkins; (2010)
Harvey, L., Herbert, R. and Crosbie, J. (2002), Does stretching induce lasting increases in joint ROM?
A systematic review. Physiothery.

Herbert RD, de Noronha M, Kamper SJ. Stretching to prevent or reduce muscle soreness after
exercise. Cochrane Database of Systematic Reviews 2011
Weerapong, P., Hume, P. A., & Kolt, G. S. (2004). Stretching: Mechanisms and benefits for sport
performance and injury prevention. Physical Therapy Reviews, 9(4),
Witvrouw E 1 , Mahieu N, Danneels L, McNair P. Stretching and injury prevention: an obscure
relationship. (2004)

How Can I Treat My Ingrown Toenail?

The piece of writing How Can I Treat My Ingrown Toenail? is thanks to The House Clinics website

An ingrown toenail can be very painful and leave you wanting to do anything for a bit of relief, in many cases even the weight of the bedsheets can be unbearable. An ingrown toenail is one where the edge or corner of your nail grows down and cuts into the adjacent skin of your toe, or where the width of your nail is too wide for the width of your nail bed, leading to your toe becoming red, swollen and tender (inflamed). If left untreated, the inflammation can spread to the rest of your toe and the area can become infected and may ooze pus. It may smell unpleasant.

Causes
You may inherit many factors that make you more likely to have an ingrown toenail. These genetic factors may affect the way you stand and the way you walk. You may also inherit a tendency for your toenails to curl in at the edges rather than to grow straight. Wearing tight shoes, socks or tights can damage your nails and encourage them to grow into your skin. Incorrect nail cutting and trauma to the nail are perhaps the most common causes of ingrowing nails. It is not uncommon for people to leave spikes of nail in the corner when cutting.

Treatment

Prompt treatment by a podiatrist / chiropodist is recommended to minimise pain and this can often reduce the amount of treatment involved and also costs. Podiatrists are specialists of foot and ankle problems such as in-growing toe nails. Initially your podiatrist may cut, file, and dress the toe and give advice on prevention.

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If your toenail does not improve, your podiatrist may be able to partially remove a section of your toenail with the aid of a local aesthetic to minimise discomfort and this may be sufficient to allow the ingrowing toenail to heal and the nail to grow back satisfactorily.

If the above treatment is unsuccessful or not deemed suitable for you due to the severity of your ingrown nail your podiatrist may recommend a minor surgical procedure in which a section or your entire toenail is permanently removed. This will be done by cutting the offending piece of nail out surgically, under local anaesthetic and using phenol (a chemical) to prevent regrowth.

For more information about podiatry or chiropody treatments, don’t hesitate to contact us http://www.thehouseclinics.co.uk/contact-us/.

How can the McKenzie Method ® help your lower back pain (among others)?

The following blog post How can the McKenzie Method ® help your lower back pain (among others)? is from John’s Website

An active physiotherapist and an acute lower back pain

At the beginning of my career, a debilitating personal experience offered me an insight into what my patients feel. I worked at a busy hospital’s neurology department at that time in close co-operation with neurologists and neurosurgeons. I saw hundreds of patients struggling with lower back pain by the time they reached the door of the physiotherapy room.

Thanks to a senior colleague at the Rehabilitation and Rheumatology department, I was lucky to have become familiar with The McKenzie Method ® of Mechanical Diagnosis and Therapy ® (MDT) during my studies. Actively working with this unique technique in the last 15 years, I saw patients avoiding spinal surgery, recovering well using the tailor-made exercises and becoming able to self-manage their remaining symptoms and prevent recurrence.

My intense pain started out of the blue following a sudden forward bending movement. I immediately experienced intense pain in my lower back with mild radiation to the right. After my injury, I started using The McKenzie Method ® straight away.

I initially had difficulties with even the most basic daily activities, like sitting or bending forward. After a few days the pain eased but I was reluctant to get back to my physical job. So, according to a research from Nuffield Health I joined the estimated 3 million people a year who had to take time off work because of lower back pain. I explained the situation to my GP who offered painkillers, but I was able to control my symptoms without any drugs using The McKenzie Method ® .  As a physiotherapist, I treated myself regularly every day to reduce the pain and restore movements.

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I went back to work after a week off, my GP learned about how the technique works so he has been able to spread the word in his practice. In my opinion, I became a more experienced physiotherapist who knows first-hand what such pain feels like and what to do about it. Since then, my lower back has long been completely recovered.

What is The McKenzie Method ® ?

Patients often see clinicians with peripheral pain, such as soreness in their extremities. The first task should be to decide whether the cause of the symptoms is located in the painful area or not. This means the therapist needs to decide whether they are dealing with a musculoskeletal problem (e.g. stiff hamstring causing pain in the back of the thigh) or a possible neurological symptom, like a protruded spinal disc pressing a nerve that runs down the leg, causing pain in the hamstring. This diagnosis is a crucial first step to identify possible contraindications and to deliver treatment effectively.

The McKenzie Method ® of Mechanical Diagnosis and Therapy ® (MDT) is a complex evidence based examination and treatment system that can be used to treat both acute and chronic conditions. It allows the clinician to make the distinction mentioned above, and to plan and execute personalised treatment. The focus is on the patient’s individual symptoms and needs with strong emphasis on teaching them self-treatment methods. By doing so, it not only saves time and money for the patient, but also helps prevent relapse. MDT can be successfully applied to treat pain not only in the lower back but also in the mid back, neck and limbs.

In practice it consists of a number of consecutive steps. Following a thorough assessment of the actual condition, the patient’s history and the typical behaviour of their symptoms, the patient receives tailor made exercises with posture correction techniques. These should be practiced by the patient as instructed by the physiotherapist. Patients also learn what changes to expect and what indicators to look for when providing feedback during the following appointment.

This approach enables the therapist to find the optimal balance between a timely recovery and meeting the patient’s needs. As it is clear by now, the patient’s active role and close co- operation between patient and clinician are essential in delivering results.

Who was McKenzie?

Robin McKenzie was a physical therapist in New Zealand. He graduated in 1952 and started a private practice in Wellington shortly after. He was interested in treating spinal disorders and developed his treatment method now recognised worldwide as The McKenzie Method ® of Mechanical Diagnosis and Therapy®.

The origins

In 1956 Robin McKenzie made a remarkable discovery that changed the way of treating back pain. According to his story, he had been treating a patient, Mr Smith with right lower back and leg pain unsuccessfully for three weeks. As the patient arrived for his next appointment he was advised to lie down on the treatment table until the clinician was ready to start the session.

McKenzie did not notice that the head section of the table was left raised up after the previous patient. When he entered the room he saw that Mr Smith was lying face down, bending backwards. He was certain that he made a mistake and caused further damage to the patient.

To his amazement though, his patient got up pain free from the treatment table and experienced no pain in his leg. He mentioned that the pain in his lower back moved towards his spine from his right side. The next day they continued the same “treatment”. Mr Smith’s remarkable recovery taught McKenzie a lesson about extension and centralisation, and started the research that resulted in today’s MDT.

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What is centralisation?

Centralisation is the positive phenomena when your symptoms move to the centre of your spine from the peripheral area, e.g. arms and legs. Although the  pain might temporarily intensify in your neck or lower back while disappearing from your limbs, this is a sign of healing. Continuing the treatment causes these residual symptoms to gradually decrease and disappear.

What makes McKenzie Method ® different?

 Reliable assessment: evidence based examination system leads to an exact diagnosis.

 Early prognosis: following the assessment, accurate classification helps to estimate the prognosis of the patient’s condition.

 Focus on self-treatment: the McKenzie Method ® highlights regular self-treatment techniques, enabling patients to gain more independence.

 Better outcomes: using MDT is cost effective, producing better results and enabling patients to avoid operation in many cases.

 Prevention of recurrence: patients can apply the taught self-management techniques straight away if the pain returns later in their life.

What can you expect during treatment?

Step 1 – Assessment: The clinician assesses the patient with a systematic, evidence based examination process. Thorough history of the symptoms will been taken with specific questions related to the typical behaviour of the pain.

Step 2 – Classification: The therapist uses different repetitive movements and certain positions to classify the condition.

Step 3 – Treatment: Based on this symptom group and the reaction to certain movements the patient receives an individual treatment program which needs to be practiced regularly during the day.

Step 4 – Prevention: The patient learns a lot about their condition during the process of mastering the exercises. Understanding the causes and learning ways to treat and prevent symptoms enable the patient to self-manage their symptoms and prevent relapse.

What conditions can be treated with the McKenzie Method ®?

Note that the following list only contains the most common symptoms. To decide whether your condition can be treated with MTD, please see a qualified clinician.

 Acute and chronic mechanical conditions of the spine and extremities
 Pain radiating from the lower back to the leg, sciatica symptoms
 Pain radiating from the neck to the arm, numbness or pins and needles
 Headaches

Ask yourself:

 Do you suffer from lower back pain and/or neck pain?
 Do you feel stiff and inflexible in the mornings?
 Do you have difficulties bending forward or backward?

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 Have you experienced lower back pain with radiating symptoms into your leg?
 Do you have re-occurring neck pain while driving or working in front of the computer?
 Have you been diagnosed with sciatica, slipped disc or herniated disc?
 Do you have difficulties staying in an upright position?
 Have you noticed your posture is crooked?

If you answered yes to at least one of these questions, then The McKenzie Method ® of Mechanical Diagnosis and Therapy ® (MDT) would probably be beneficial to you.

For more information visit the McKenzie Institute ® website.

By Eszter Csukas BSc HCPC MCSP, Chartered Physiotherapist

References:
http://www.mckenzieinstitute.org
https://www.nuffieldhealth.com/article/six-million- britons-living- with-undiagnosed- back-pain

Using turmeric to help with your inflammation

The short article Using turmeric to help with your inflammation was originally written and published on The House Clinics site

Turmeric is a bright yellow spice used in most Asian recipes. The spice is known for its rich anti-inflammatory properties thanks to the rich curcumin ingredients. The curcumin is effective in alleviating inflammation in conditions like muscle sprains and arthritis.

Simply adding turmeric to your cooking will increase the benefits of turmeric, there are other methods that will boost your intake and help in reducing inflammation. These include;

Tea

A hot turmeric beverage is an awesome way to enjoy the healing spice and treat inflammation. You can boil a spoonful of turmeric in four cups of water then add lemon or honey to enhance taste. You can also add ginger to maximise on the anti-inflammation benefits

Turmeric rub

Turmeric powder mixed with milk, sesame oil or warm water to make a paste that will definitely reduce swelling and reduce inflammation when applied to the skin. The paste can also be used to clean wounds and encourage healing.

Dietary supplements

Supplements offer another way of consuming turmeric. Supplements are especially good if you are on the go or you want to avoid the taste of turmeric. 1000 milligrams of turmeric supplement is medically recommended for those suffering from joint inflammation.

Chiropractor, Jonathan Cook, says “Throw away your anti-inflammatory pills take a Turmeric supplement instead.

Turmeric’s anti-inflammatory properties have been compared to those of non-steroidal anti-inflammatory drugs (NSAIDS).

The  colourful plant foods are good for our health because of their plant pigments and turmeric is no different. It has a range of health promoting benefits due to curcumin, the yellow pigment.

Clinical trials have found it to be more effective than a placebo for relieving pain and swelling in people with osteoarthritis and rheumatoid arthritis.’’

 

 

 

How To Prevent Back Pain While Driving – Part 2

The following blog post How To Prevent Back Pain While Driving – Part 2 is due to The House Clinics – Chiropractic & Physiotherapy Clinic

Good posture for driving

In our previous article, we talked about how common it was for people to report that driving seems to make their back pain worse.

We dealt with the issue of why this happens and helped to uncover the causes of your back pain while driving. We talked about how adjusting your seat and lumbar support, as well as your rear view mirror can help improve your driving posture.

In this article, we’re going to cover other adjustments you can make to your driving conditions that will help to improve things even further.

Remember, if you have any questions at all, you can always get in touch with one of our chiropractors or physiotherapists at The House Clinics. We’re more than happy to provide you any support you need.

Seat belts are vital element of car travel, and one which is often blamed for back aches. Although the tension across one shoulder and neck can be uncomfortable, it may save your life so the best thing is to make it as comfortable as possible.

The best way to do this is to make sure the seatbelt is fitted to your body, thereby providing maximum support with minimal discomfort.

The seatbelt should lie across the top of your shoulder and not on the top of your arm and definitely not across your neck. Depending on your height you should take the time to move the fitting on the wall of the car which will adjust the height at which the seatbelt crosses you.

Car pedals

Footwear and positioning is such a simple but often overlooked aspect of car driving that can play a large part in your comfort while driving. Having adjusted the seat your feet should land at the pedals without having to overreach with your leg.

You should be able to fully press the pedal to the floor with only foot and ankle movement and a little bit of leg movement.

In terms of the footwear, definitely avoid high heels or very thick soled shoes as this will make you over-extend your ankle to put pressure on the pedals. High heeled shoes also make it harder to brake in an emergency and also cause you to lift the thigh off the seat slightly, thereby reducing leg support.

Similarly, be aware of the clothing you choose, tight clothing will restrict your movement and contribute to bad posture while driving.

The final piece of advice is to take regular breaks, particularly with a long journey. You should try to stop and stretch your legs at the very minimum every two hours, but more often is better.

In an ideal world you would leave early to allow plenty of time for the journey and stop to stretch and walk around every half hour. If this seems impossible there are other things you can do to help. We are now quite used to the in flight exercises on long haul flights; well you can do a similar thing during a long car journey.

For example when stuck in traffic, try these exercises in your seat. Try buttock clenches, rolling your shoulders, and upper body side bends.

Hopefully this article will give you some pointers to try to ward off that back pain while driving. If you continue to get symptoms try visiting your local chiropractor for further advice and treatment.

How To Prevent Back Pain While Driving – Part 1

The blog post How To Prevent Back Pain While Driving – Part 1 can be obtained from The House Clinics in Bristol

How to avoid back pain while driving

When speaking to patients with back pain, one of the most common complaints is that driving seems to make it worse. Treatments such as physiotherapy (click here for more info) or chiropractic, both of which you can find at The House Clinics, can help correct bad posture, but there is clearly a pattern here and this article will explore why travelling by car can make the pain worse, and what you can do to prevent this.

The reason back pain comes on or gets worse while driving is largely due to inactivity and poor posture. Particularly with longer journeys the postural muscles that hold us upright begin to fatigue and we end up in a more slumped position.

At this stage the ergonomic design of the seat plays a large part as you will tend to rely on support from the car seat to support your back. Establishing the ideal driving position is difficult as people’s height and weight vary widely, but here are a few tips and tricks to give you the best chance of arriving pain free.

Firstly if you share the car, then each time you get in make sure you move the seat back to the right position for you. The back of the seat should be set back slightly and your elbows should be at a comfortable angle for driving otherwise you will end up leaning forwards which gives tension in your shoulders and upper back.

Back Pain

If necessary adjust the lumbar support or use a cushion in your low back. Your hands should fall naturally onto the steering wheel to prevent leaning forwards and there should be a slight bend in the arms. Having adjusted the seat and steering wheel, check that there is the recommended ten inches of distance between you and the airbag cover on the steering wheel.

The next checks to make are the mirrors. The mirrors should be turned to you, rather than the other way around. This means you want to be able to check all mirrors with minimal head movements, as the more you have to make an effort to see out of the mirrors the more strain you will put on your neck and back. You should be able to see all around the car simply by moving your eyes.

In our next article, we’ll talk about the effect of seat belts and the importance of footwear. Check back soon as we will be posting part 2 very soon.

Thanks for reading and we hope you found that helpful.