So how has my progress been going, the honest answer – is non-existent! I felt it was really important to write this article as fundamentally there is one key message…
Sometimes you just have to accept you can’t do it all, the key is to make sure you start again.
The last few months have certainly made it challenging to achieve my very ambitious goal. I know I have certainly found it difficult to make time for exercise, whether it be because of the joys of lockdown, constant rule changes, a very active 16-month-old and of course the glorious British summer!
There is certainly nothing like watching the Olympics to inspire getting going again.
Time to hit the reset button, now that things appear to be “normalising”, forming a routine is becoming easier on all fronts, so it is time to revisit everything. Where to start…
From a treatment perspective, I have been maintaining my progress by continuing to work with Lachlan, Kirk and Tina. All of which has helped to eliminate the niggles/restrictions previously mentioned. Unfortunately now comes the hard bit, I need to put in the work!
I will be scheduling 4 fitness sessions a week that will incorporate my remedial exercises as a warm-up. I will also be aiming for a minimum of 10,000 steps a day, 90% of which will likely be spent being run ragged by our 16-month-old, so I shouldn’t have any problem there!
To get a gauge of where I am I have done a 5k to get a base fitness result and something to work from…
Clearly, this is some way off the overall goal of running a 5k in 20 minutes, but it gives me a starting point to work from.
Find out how the reset has gone next month, wish me luck!
Dark days and Christmas have certainly presented a challenge for the early starts, but given that we have been able to remain open throughout Lockdown, I have been able to have treatment and start my rehabilitation for a number of the key areas identified by the screens.
One of the luxuries of working in a health clinic is certainly access to treatments, so I have been working with a number of the therapists over the last couple of months.
Georgie – Pilates – Lower Back Mobility and Stability, Mid Back Mobility
Lachlan – Osteopath – Right Ankle Mobility and Midback Mobility
Now clearly this degree of access isn’t a luxury afforded to everyone, but I wanted to show you all how each therapist can offer different value and how often the best treatment plan may include more than one therapist.
So, using the above as a guide, here is what we have been doing –
Kirk – During our treatments, the focus has been on releasing my calf and progressing through a number of different exercises. Starting with some very simple ones like single leg balance and single leg calf raises, but as my strength and balance has improved, he has made things harder! Currently I am working on –
Single leg Glute Bridge with isometric hold (sounds good right!)
Split squat with band challenge
Single leg balance on a balance pad
Single leg calf raises
Step up with 2 second hold – trust me, the extra second makes a big difference
All of these are progressing well, but during our sessions we also noticed that I had reduced mobility within the joints of the midfoot and ankle which were limiting my progress, so this is when we cross referred.
Enter…
Lachlan – Given that joints are bread and butter for Osteopaths or Chiropractors, this is where we often cross refer. Lachlan assessed the joints that Kirk had identified as restricted and using very specific manipulation techniques, released the key areas of my foot and ankle. The great thing with manipulation is the change in movement is often instant but the key is then maintaining this change and this is often why it requires more than one treatment. Whilst I was in with Lachlan, he also worked on my mid back mobility using a combination of soft tissue work and manipulation. This was another area of reduced mobility identified by the screen.
Lastly…
Georgie – One of the key points identified in my screening was the lack of mobility and stability in my lower back, in particular how this was causing me to hinge in my mid back. Using her background in Pilates, Georgie has been working with me on increasing my lower back mobility and control. This has been a real eye opener for me as clearly, I spend a lot of my day making recommendations to people and what was apparent was how poor I was at some of these very things. In particular, my lower back segmental movement and control has become something I now work on daily. It is important to point out that due to the chronicity (long standing) nature of these restrictions, making changes to my lower back mobility is going to take time. Simply put, there is no quick fix. The long-term results though will be well worth the effort.
In summary, I now have a plan that I can work through at home that is specific to my needs and, in what is a relatively short space of time, the age-old niggles are fading away!
We wanted to take this opportunity to introduce each of our Physiotherapists and their areas of speciality –
Jodie Pargeter
Jodie, a founder of The Health Hub, is a qualified, Chartered Physiotherapist whose areas of specialism include:
Women’s Health – Jodie is passionate about the management and treatment of women’s health with a particular focus on antenatal and postnatal physiotherapy. Having recently had a baby herself, it has only further enhanced her passion for this area, particularly having seen just how little provision there is in this area for new mums.
Acupuncture – Jodie will commonly use acupuncture as part of her treatments as she has found it to be highly successful, particularly when treating acute injuries such as; Ankle Sprains, Ligament Damage, Knee Injuries, Tennis Elbow, Post-Surgical Swelling etc. It is also a tool that can help manage long-term pain such as Arthritic Pain, Fibromyalgia, and other inflammatory conditions.
Frozen Shoulder is a condition that people often struggle with for years but this is a condition that Jodie has had a lot of success with, including both pain reduction and increased range of motion. So if you are struggling with this then get in touch, Jodie loves a challenge!
Elise Rawson
Elise is a qualified Chartered Physiotherapist whose areas of specialism include:
Neurological Rehabilitation – This is an area that Elise has chosen to specialise in, working with both adults and children. Neurological Physiotherapy covers working with patients to build or maintain as much strength and function as possible including patients recovering from Strokes, MS, Parkinson’s, Peripheral Neuropathy, Motor Neurone Disease and so the list goes on.
Vestibular Rehabilitation – Maintaining your balance involves 3 major systems of your body; your inner ear (vestibular system), your vision and your proprioception (sensory information from your body to your brain). When one of these systems gets impaired through disease or injury you can experience a variety of symptoms such as joint pain, falls, dizziness, vertigo and changes in your ability to walk. Often people’s lives are heavily impacted by this, but they aren’t always aware that, potentially, there are things we can do to help. Elise is a specialist in this area; she uses a series of tests to assess, diagnose and then treat your symptoms by retraining your vestibular and balance systems, thereby restoring normal function. Conditions, where this treatment can be extremely effective, include BPPV, Labyrinthitis, Meniere’s Disease, Vestibular Migraines and many more.
Sports Massage – Elise is fully qualified in Sports Massage which is a treatment she also offers at the clinic, as well as utilising these techniques as part of her Physiotherapy treatments.
Kirk Proto
Kirk is a qualified Chartered Physiotherapist whose particular areas of specialism include:
Sports Injuries – Having worked with Brighton and Hove Albion Academy as part of his training, Kirk has a passion for working with Sports Injuries. He uses a combination of hands-on treatment techniques combined with specialised rehabilitation exercises.
Pre and Post Orthopaedic Surgery Rehabilitation – Utilising his rehabilitation skill set he works with patients to manage their symptoms and strengthen the area pre-surgery to help ensure the best possible outcome, as well as taking patients through all elements of their recovery post-surgery. This is imperative to delivering the best possible outcomes, post-surgery, particularly for Knee Replacements, Hip Replacements etc.
Knee Injuries – This is an area where Kirk comes into his own, having had particular success working with Meniscal tears, ACL tears, Patellar Tendonitis and so the list goes on.
I have done the easy bit, Talking the Talk, planning what I am going to do and how I will make time for everything, but now for the hard part… Walking the Walk.
As outlined in Part 1, I am going to start by using assessments to identify my weaknesses and limitations. Initially, I am going to focus on the Functional Movement Screen and Selective Functional Movement Assessment.
We are starting with the FMS – Functional Movement Screen
I thought I would first explain a little bit about this screen…
It is worth noting this is a screen designed to assess someone who isn’t in pain. At The Health Hub, this is the screen we would typically use at the end of a patient’s treatment plan, to assess their ability to return to Sport or Training. Alternatively, we can use it for people who simply want to know how they can improve their body’s function to ensure they are able to move and stabilise correctly.
In my instance, because I have no pain, this is where we are going to start. So let’s see how I get on…
The Screen consists of these 7 tests –
Overhead Deep Squat
In-line Lunge
Hurdle Step
Active Straight Leg Raise
Trunk Stability Push-up
Rotary Stability
Shoulder Mobility
How did I do? Not bad… But not great!
The higher the score the better the result if you score 3 it means you passed the exercise perfectly. If you score 2 for the exercise you can manage it with some modifications and you have guessed it if you can’t do it at all, you score a 1.
I scored 12 out of 21. It is worth noting that in studies where this is used with professional athletes a score of less than 14 puts that athlete at greater risk of injury.
The key weaknesses it identified for me were –
Poor Shoulder Mobility
Poor Right Leg Stability
Limited Right Ankle Mobility
Poor Core Rotational Strength
Very limited Straight Leg Raise
As you can see from the screen results there are a number of areas that I struggle with. We now want to know the all-important question… Why?
This is when we use the second screen the SFMA.
Selective Functional Movement Assessment – SFMA
Other than sounding jazzy what is it? The founders of the screen (www.functionalmovement.com) define it as follows..
“It is a movement-based diagnostic system which systematically finds the cause of pain – not just the source – by logically breaking down dysfunctional movement patterns in a structured, repeatable assessment.
Look at it this way. When you head to the hospital for shooting arm pain, the immediate course of action is to check your heart, not your arm. The symptoms down your arm are just a result of a problem elsewhere in the body. Similarly, the SFMA focuses on underlying dysfunctional movement to find the cause of pain, not just the source. This concept is better known as regional interdependence – how seemingly unrelated problems are actually driving the dysfunction.”
In a nutshell, it is a full body assessment that is aimed at finding areas of “dysfunction” (not working correctly) and these could be painful or non-painful. It starts by looking at large movements like touching your toes, rotating left and right, leaning back etc. Once we have established which of those movements you can’t do, we then need to find out why. So, we start with those that don’t hurt, as more often than not, pain is the result of our body compensating for an issue elsewhere. The screen will then tell us if the cause of the problem in a specific area is a mobility issue or a stability issue.
If we use me as an example, as I have mentioned previously, I can’t touch my toes and I failed miserably on the straight leg raise test but, so far, we don’t know why. Toe touch is one of the movements in the SFMA but it doesn’t hurt, so this would be considered dysfunctional and non-painful. Then comes the fun bit, we need to try and work out why? I am sure you are all thinking tight hamstrings, maybe/maybe not…
This is the fun part, the screen then goes into an area-specific breakout to establish the exact cause of the dysfunction. In the touching-the-toes example, this could be poor hip mobility, lower back tightness, nerve impingement, core weakness, tight hamstrings and so the list goes on. However, once we have identified what the cause is, we can do something about it!
In my example, I have no pain but my inability to properly perform this movement puts undue stress on areas of my body that are then trying to move more to compensate. Have a look at this picture below –
Can you see how much I am “hinging” in my midback? This can result in poor posture and tightness in my mid back which results in it needing manipulation to free it off. However, as we can see, it isn’t the cause of the problem, instead, it is a symptom of my lack of movement elsewhere. In my case, it is because I cannot flex through my lower back and this is also having a direct result on my hamstrings. In order to truly correct this, I need to address the cause, not the symptoms. In short yes, I do also have tight hamstrings and a tight midback but if I stretch my hamstrings and release my midback, I don’t get any lasting change. Instead, to make a lasting change I need to address the cause which, in my case, is my lower back mobility.
How many of you have been told you have tight hamstrings but even after stretching every day for a month, if you were to stop stretching for 1 week you would be back to square one again? This is why I love using this screen as it helps us work out why!
Now I have only highlighted the straight leg raise and the toe touch but clearly, I failed in more than just those two areas.
In summary here is what I have to work on –
Lower Back Mobility and Stability
Hip Mobility
Right Ankle Mobility and Stability
Left Shoulder Blade Stability
Mid Back Mobility
Other than that… I am fine!
Hopefully, this helps you see how pain isn’t always an indicator of function, as although I have no pain, there are clearly several areas where I can improve. This is what I meant in Part 1 about getting into the best shape of my life. In essence, my aim is to get fit to get fit and then truly get fit! The great thing about the screens is that they also help to quantify progress, so once I have worked on these areas, guess what we do… Re-Screen!
Next time we will look at what I am doing to address these issues.
What might be affecting your balance and what can we do to help?
Maintaining your balance involves 3 major systems of your body; your inner ear (vestibular system), your vision and your proprioception (sensory information from your body to your brain).
When one of these systems gets impaired through disease or injury you can experience a variety of symptoms such as joint pain, falls, dizziness, vertigo and changes in your ability to walk. Often people’s lives are heavily impacted by this but they aren’t always aware that, potentially, there are things we can do to help.
How can we help?
As Vestibular Specialist Physiotherapists, we use Vestibular Rehabilitation. This enables us to assess, diagnose and effectively treat your symptoms by retraining your vestibular and balance systems, thereby restoring normal function.
We do this by conducting in-depth assessments of all three of your systems to detect the area that needs focus and then formulate a patient specific exercise plan for you to carry out.
If you feel that you are struggling with any of these then get in touch today. Our Receptionists will arrange a time for me to call you back to discuss your case to ensure I can help before booking an appointment.
As they say, when one door closes another one opens…
We had always planned on taking over our previous practice, we felt it was simply a waiting game but, like all great plans, it doesn’t always work out as you thought and when it became clear that buying the practice wasn’t going to be an option, we had to make a decision. Should we stay where we were indefinite, with no guarantee of ever truly owning it, or follow our dreams?
Now I have never been one to believe in fate but as luck would have it, around the time we were told that our previous practice wasn’t for sale, the Health Hub premises came to the market. We made the decision to go for it and at the end of November 2019 we got the keys… although it looked a little different to how it does now!
It has been said that I like a plan(!), so as you can imagine poor Jodie was subjected to endless sketches and lists. At this point, I do need to highlight just how much of a superstar Jodie was, as during all of this she was heavily pregnant and still working flat out at our old practice. Something I have since been told isn’t the ideal run-up to giving birth. Who knew?! That said we finally settled on a design with one catch, we had to create it.
Thankfully we have a very good friend in the building trade who helped our vision come to life! On-site, my role was largely to get in the way, make tea and fix any sore necks following hours of plaster-boarding. Thanks to Dave and the team in 6 weeks, as it only seemed fair to let them have Christmas off, the premises were transformed from what you have just seen, to this…
So now we had the clinic of our dreams, with 6 shiny new rooms, and only the two of us to fill them. Clearly, we needed a TEAM. Thankfully a number of members of our previous practice made the decision to join us as well as a few great new additions. Finally, we were all set and we opened our doors on the 3rd of February 2020.
A lot of people have asked how has it been with a start-up during the pandemic but, in all honesty, we don’t see The Health Hub as a start-up as most of us have been working together for over 5 years. Instead, we simply see it as a new location where we are carrying on our passion for helping people.
On that note, we look forward to seeing you soon!
Sam, Jodie and the rest of the TEAM
P.S. If you are looking for a builder and would like Dave’s number, just ask!
How is it November already and what a year we have had, or not had depending on how you want to look at it! So, what do I mean by Walking the Walk….
Well like everyone this has certainly been a year for reflection, whether that be looking at work-life balance, wanting to exercise more, adjusting to a new working routine or maybe all of those combined. I am no different, admittedly lockdown for me was perhaps slightly different in that we welcomed our son Max 3 days before Boris appeared on our screens that memorable Sunday with the strong message of “Stay home, save lives”. Initially, it didn’t seem all bad, I mean it was only 3 weeks right…
Clearly, it lasted a little longer than that, and being in the business we are, remote working wasn’t really an option, which lead to a period of time when we had so much time! Time to be with family, to work on the house, the garden, study and of course our precious 1 hour of exercise a day outside the house. With all this time I was able to exercise more than I had done in months, eat well, relax and all in all returned to work with the best of intentions to continue in that spirit.
But… life gets in the way! Now I am back at work and the dark morning and evenings are closing in, all those habits are fading away. Suddenly, I am making convenient food choices, not exercising as often, and just generally not in the physical condition I should be. I will admit trying to juggle running a business alongside being a dad is taking some getting used to but it is far from impossible and just like all things it simply requires some planning.
Like all good plans, it needs to start with some goals. So here are mine –
Get into the best physical condition of my life – more on this shortly
Ensure I have time with my family
Play golf regularly – with an aim of playing off 18 or less by Spring next year (currently I play sporadically so don’t have a handicap)
Simple! Now the hard part… HOW?!
I am going to start by looking at my time and working out where I can exercise and play golf in a way that has the least impact on my family time whilst also allowing me to work the hours I work.
Training
The obvious time for exercise is before work, so let’s assign 4 x 30-45 minute sessions on a Monday, Wednesday, Friday and Saturday. Yes, this means getting up at 6 am but I have a 6-month-old so this shouldn’t be too tricky!
Golf
I am going to aim to practice twice a week.
NEXT UP
I need to know where I am, to begin with in order to know what I need to work on in my sessions and how to gauge my progress. To do this I am going to go through 3 physical screens, to see how I move and how that applies to my first goal.
These screens are a Functional Movement Screen, a Selective Functional Movement Assessment and a TPI Golf Screen, all of which we offer here at THE HEALTH HUB.
Why? Because there is a huge difference between appearing to be physically fit and truly being physically fit. What I mean by this is, how many people do you know that hit the gym regularly, cycle, run, or play sports yet they all train around niggles or physical limitations. For example, when I was playing rugby regularly at a reasonable level, I would gym four to five times a week, train twice a week and play once a week. Was I physically fit, in a manner of speaking yes. But… Could I touch my toes – NO, did I have weaknesses in the gym I ignored it – YES, did I have niggling injuries I played with and never corrected even to this day – YES.
So you see although I was physically fit, I wasn’t functionally fit. This is the difference, and this is what I mean by getting into the best physical condition of my life. I want to be able to touch my toes, correct those weaknesses, fix those old niggles and THEN get fit!
Join me next time to see how I get on with the 3 ASSESSMENTS and what they flag up for me to focus on!
In an effort to kick start your new fitness goals and with the best intentions you embark into the world of running…
You start to see big improvements very quickly, being able to run further and faster with each run as well as notice the health benefits of having more energy and looser fitting clothing. You feel good and start to enjoy your regular runs.
After several weeks you start to notice pain in and around your knee, maybe 3k into a run or even 5-6k in.
Initially, the pain subsides after the run and is not noticeable when resting. Over time the pain increases and starts to affect your daily activities such as walking, and going up and down stairs and can even keep you up at night.
You stop running in an effort to rest the knee and allow the pain to subside. In the short term, you start to see the pain decrease but as soon as you start to run or undertake any other physical activity the pain returns.
Over time, the pain becomes constant. This prevents you from continuing to run or general exercise and you see all those health gains slowly disappearing making you feel miserable.
Causes
Knee pain is a common complaint and can be due to a number of different reasons/injuries.
One of the most common sources of pain associated with increased activity levels over a short period of time is a condition called Patella-Femoral Pain or ‘Runners Knee’ (a fancy term of pain between your knee-cap and thigh bone!)
Our bodies have an amazing way of being able to adapt to increased physical demands that we can place through our bodies by making bones, muscles and all those structures in between stronger.
However, if we do too much too soon, our bodies do not have the chance to adapt and therefore increase the risk of injury and associated pain.
The Good News ….
Patella-Femoral Pain can be treated successfully with a combination of strengthening exercises and a graduated return to running/desired exercise.
Strength Exercises
Strengthening muscles that surround your knee as well as around your hip can help both with settling your symptoms as well as prepare your body as you start to return to exercise.
Try these out ……
Wall Assisted Squat
Stand with your back against the wall, feet shoulder-width apart and about 30 cm away from the way.
Lower your body by bending at the knees so that your thighs become parallel with the ground.
If this position is too painful in your knees, lower yourself so that your knees are at a 45° angle.
Hold for 3-5 secs and return to the start.
Repeat this 12x and complete 3 sets daily.
Glute Bridge
Lying on the floor with your feet flat on the floor and knees bent at a 90° angle.
Squeeze your buttocks and lift your hips up so that your shoulders, hips and knees are aligned.
Hold for 2 secs and return back to the start
Repeat this 12x and complete 3 sets daily.
Return to activity
A return to activity can commence once symptoms have settled, starting with shorter, slower runs and slowly building both distance and speed gradually.
If you have any concerns about your knee pain or any other pain/symptoms you may be experiencing, why not book an appointment at The Health Hub to see one of our many friendly professionals?
Here we have combined a number of therapies in order to be able to offer you the complete package to keep fit and healthy. Our simple motto underlines what we believe works best…
ASSESSMENT
Our assessment follows a holistic approach, taking time to understand the nature and cause of your knee pain as well as an in-depth physical assessment focussing on movement analysis and identifying those structures at fault.
DIAGNOSIS
Using our detailed assessment, we are able to provide a diagnosis to help shape and guide the treatment and rehabilitation process.
TREATMENT
Treatment is individualised and centred around your goals, using a range of therapeutic modalities for symptom relief, exercise rehabilitation and education.
RESULTS
The most important person throughout this whole process is YOU! Throughout your time at The Health Hub, our focus is to help you achieve your goals and to be able to live a fuller and healthier and fitter life.
We just wanted to bring you all up to speed with where we are in terms of physiotherapy at the clinic. Jodie is still enjoying her well-earned Maternity leave and is looking at a graduated return to work around October, starting with a couple of half days initially, but don’t panic if you have an issue now! We are delighted to introduce our two new Physiotherapists, Kirk Proto and Elise Rawson. Both are excellent Physiotherapists in their own right with differing areas of expertise as you will see below.
Kirk qualified as a Physiotherapist at the University of Brighton following a career change having previously worked in the finance industry for a number of years. His decision to pursue a career in Physiotherapy was borne out of a passion to help others restore function and improve their quality of life. He has a strong interest in sports injury and rehabilitation being a keen sportsman himself. Kirk also enjoys working with people pre and post surgically, so if you are going to be having or have had any orthopaedic surgery recently get in touch as he will be able to help ensure you get the best result possible.
Elise qualified from the University of Brighton in 2011 with an MSc in Rehabilitation Science. Previous to this degree she completed a bachelor’s degree in Sport and Exercise Science at the University of Chichester. Since qualifying Elise has worked in both the NHS and private settings and has specialised in neurological rehabilitation in both adults and children as well as vestibular pathologies. Neurologically this includes things like stroke rehabilitation, working with MS patients to maintain as much strength and function as possible, Parkinson’s, Motor Neurone Disease and so the list goes on. Vestibular pathologies include BPPV, Labyrinthitis, Meniere’s Disease, and Vestibular Migraines and many more. Alongside this, she also treats all the usual issues you would expect to see a Physio for, with her in-depth experience using posture and movement analysis, sports massage, therapeutic handling and functional strength training. Elise is also qualified separately in sports massage which she is also offering at the clinic and is currently completing her yoga teaching qualification, so watch this space!
So if you have been struggling with niggles since the lockdown has been lifted then please get in touch and we can get you booked in!
