Why "prehab" is as important as rehab

“Prehab” is a term we use a lot at True Motion, but what is it and why do we practice it?

Prehab or pre-habilitation is about avoiding future pain or injury. It comes from the idea that our bodies may harbour areas of weakness that we are not aware of, or factors that predispose us to injury, and finding out about them in advance of actually being in pain means we can take steps to correct or build strength where necessary - and therefore be more likely to avoid pain or injury in the future.

At True Motion, we build prehab into our treatment, meaning that, as well as treating you for the condition you’ve come to see us for, we also look for areas of weakness that may predispose you to an injury in the future. By looking in detail at the way the body moves, we can highlight areas in which you may be more predisposed to an injury or problem, and then take steps to avoid it.

This idea of areas of weakness we’re not aware of is often referred to as the “silent injury”. Our body may have become used to moving in a certain way that may pre-dispose it to injury, but we’re not in pain so we might not notice.

Then one day, we hurt our ankle, knee or back and it feels like the injury has come from nowhere - when in fact, we may have been harbouring pre-disposing factors for some time, possibly a long time.

We want to point out though that the goals of prehab are different from trying to achieve an objective “ideal posture” or range of physical movements - that’s not what we believe or practice at True Motion. Rather, we believe that each body is unique and each individual has different requirements. It’s about looking at every patient as an individual, understanding their circumstances and taking action from there.

To make an appointment with us or find out more, call us on 020 7118 0422 or visit www.truemotionclinic.co.uk

Walking the Himalayas for Autism

This is a blog post by one of our Senior Physiotherapists, Alex Conty

My name is Alex Conty, I work as a physiotherapist here at True Motion. 

Starting in March 2017, I will be walking the length of the Nepalese Himalayas to raise £100,000 for children affected by autism both in Nepal and the UK. 

During this expedition, I will be walking 1700km over 120 days via the high level route of the Great Himalaya Trail, the longest and highest trail in the world.

I fly out to Nepal on 6th March, spend time in Kathmandu from 7th-15th March, including celebrating Holi festival. On 15th March, I travel to Taplejung in the east of Nepal and from there I trek to reach Kanchenjunga base camp - which is where the real expedition begins! 

From there, I will cross two passes over 6000 meters and twenty more between 5000 and 6000 meters high, visiting ten regions en route, from the regularly trekked Everest and Annapurna to the remote areas of Dolpo and Makalu Barun.

My aims are to:

  • Raise £100,000 for children affected by autism in Nepal and the UK
  • Educate people along the way to recognise the signs of autism amongst Nepalese communities
  • Promote awareness of autism in Nepal and the UK

I’m honoured to have secured the support of Sir Ranulph Fiennes as patron of my charity expedition. But I’m relying on donations to meet my fundraising goal.

Please DONATE if you can and let’s change the life of many children in Nepal and the UK for the better.

Full details of my challenge on www.himalayasforautism.org.uk

Follow me and my adventure on the expedition Facebook page - Please LIKE, FOLLOW and SHARE if you wish to see updates, photos and videos of what is going to be an amazing adventure https://www.facebook.com/himalayasforautism/

Thank you very much for your help and for your generosity, together we can make a difference.

Alex Conty, Senior Physiotherapist, True Motion

Winter sports - prepare now, enjoy later

Winter sports like skiing and snowboarding can be challenging on the body. Add these exercises into your programme now to help build strength and stability for the slopes.

Skiing squat jumps functionally strengthen hip muscles and condition for high intensity activity

This stretch actively mobilises hips and hamstring muscles, preventing hamstring and knee injuries

A carioca walk with added arm reaches build leg and torso coordination and knee stability
This side lunge with opposite hand reach develops whole-body stability and improves control of the hip and leg muscles on impact
Single leg hops with four-way arm reaches promote body stability and adaptability to impact

Q&A with Francesco, after completing the 2016 London Marathon

True Motion's Principal Physiotherapist and Osteopath, Francesco Contiero recently competed in his first ever marathon for charity. He completed the London Marathon on Sunday in under four hours and has been raising funds for Cancer Research UK - you can still donate here.

Congratulations Francesco, how do you feel and what was the best part?

I feel great! It was an unbelievable experience. The best part? The crowd was AMAZING. I mean, it was 42km of cheering and clapping! At the 20th mile I suddenly had to pull on the side due to a hamstring cramp, which luckily resolved itself in just a few seconds. The crowd standing on the sides kept supporting me and gave me the right motivation to start running again. It felt amazing. Painful, yes, but amazing!

What was your training regime like with your busy work schedule?

Since January, I trained using a schedule; I alternated long runs (usually early mornings), interval training and recovery jogs with weight training. Like many other runners, I experienced some soreness on the way. Back in February, I developed tendinitis on the side of my knee (inflammation to a tendon), and had to take some time off from training and self prescribe rehabilitation exercises. With the help of some colleagues for bodywork and training I was able to pull out of it. Such a relief to finish the 26.2 miles without any injury pain.

Early morning run

Early morning run

What did you do straight after, cold beer or hot coffee?

As all the Londoners have noticed, it was pretty cold on Sunday. So I have to say hot coffee straight after, but of course a nice beer in the evening!

What are your post marathon tips to prevent injury?

Generally speaking, after a run like this, a few days of soreness is perfectly normal. Best practice will be gentle walking and rest from strenuous exercise for a couple of days, as well as drinking lots of fluids. If during the race you picked up an injury then again rest and gentle stretches for a few days will be able to help in most cases, if this is not the case then do see a professional. It is likely that a few osteopathy or physiotherapy session can resolve it, without the need for further investigation. Furthermore, seeking a therapist’s advice will help you understand why it happened, tailoring not only the rehabilitation, but also the training for the next event.

How can people keep up the momentum after a marathon?

I believe setting short term goals are the best way to do this. I personally try to have a goal in mind for every 4/6 months. This gives me the time to train as I’d like, allowing me to adapt this to London's busy lifestyle. I am going to try to do another marathon next year, so why not starting training now? Well, maybe next week...

True Motion would be delighted to help you with any post-event pain or injuries, and we can also prepare you for your next marathon or sporting event. We are the perfect team of highly qualified Physiotherapists and Osteopaths, each with our mix of skills and specialties including sports medicine, acupuncture, rehabilitation and management of chronic conditions. We also have a running clinic - where we observe, assess and put together a bespoke treatment and training plan. Be sure to like and follow us on Facebook and Twitter and sign up for our newsletter to stay tuned for regular offers, tips, and more.

Calling all Marathon Runners: 20% off at our running clinic

We know you've all been training hard and we want to see you all cross the finish line! Whether you're hoping to beat your personal best or just make it to the end, our running specialists can help make those 26.2 miles easier, faster and much less painful!

We're offering every London Marathon runner 20% off* a thorough running assessment. All of our running experts are physiotherapists or osteopaths, so they know exactly how to help.

Every hour-long session in our running clinic includes:

  • Treadmill Video Analysis

  • Biomechanical Assessment

  • Postural Assessment

  • Individualised Treatment Plan

  • Training Programme Overview

  • Personalised warm up and cool down routines

  • Advice on footwear and accessories

So stop ignoring that twinge in your calf when you hit mile 14 and come to see us!

The Small Print:

Usual price £75, offer price £60. Open to Virgin Money London Marathon 2016 runners only. Deal is only available to clients who have not previously used the running clinic and applies to the initial consultation only, follow-up sessions will be charged at standard price. Cannot be used in conjunction with any other offer. Appointments are subject to availability. Offer expires 24th April 2016.

Stand up and live longer!

If you’ve been reading the news recently you’ll have heard about ‘Stand Up For Your Health’. If you follow us on Facebook you’ll have seen the TED Ed video about the dangers of sitting appear on your newsfeed. If you’re not following us on Facebook check out our page so you don’t miss out on any more entertaining and educational videos, and then read this handy summary.

Our bodies are built for motion, not for stillness:

  • Sitting for a few minutes to recover from exercise is ok, but the longer you sit the more agitated your body is, it’s waiting for you to get up and move!

  • Our bodies aren’t built to sit more than they move. We have over 360 joints and muscles which give us the ability to stand, our blood circulation relies on movement and our skin is elastic to accommodate movement.

So what happens when we don’t move?

  • The spine is a long structure of bones and cartilage discs, held together by joints, muscles and ligaments.

  • Check your posture now – are you sitting with a curved back and slumped shoulders? Sitting like this puts uneven strain on the spine and, over time, causes wear and tear of the joints, muscles and ligaments as they stretch to accommodate your sitting posture

  • The curved shape also shrinks your chest cavity, meaning your lungs have less space to expand when you breathe. This limits the amount of oxygen entering your lungs and your bloodstream.

  • When you sit, you are literally squashing, pressuring and compressing the delicate tissues around and inside your muscles, like nerves, arteries and veins. Have you ever experienced numbness, pins and needles, or swelling whilst you sit? This will most likely have been because you were blocking these tissues!

  • Sitting also deactivates fat burning molecules in the blood, which increases stasis, or decreases the flow of the blood in the blood vessels.

These impact your brain…

  • Most of the time we sit down to use our brains, but being stationary reduces blood flow and reduces oxygen levels in the bloodstream. Your brain requires both of these to be alert so your concentration levels will drop as your brain activity slows

…and your life expectancy

  • The ill effects of sitting have long-term effects too. It is linked with some cancers, diabetes and kidney and liver problems.

  • Inactivity causes 9% of premature deaths a year, that’s over 5 million people

We have been telling our patients about the dangers of sitting for years, but something we nearly always hear back is ‘how am I supposed to move more if I have a desk-based job? I can’t just wander around the office all day, I’ll get fired!’

This is a very good point, so here are some tips to help you get up and about without risking the sack:

  1. Take a walk every 30-45 minutes, or at least once an hour. Walk to the toilets, to the water machine, to the printer, to talk to the strange security man who always looks a little lonely. Set a timer, with your phone on vibrate, so you don’t lose track and forget. Spending 5 minutes upright is the ideal, but just getting up from your desk is a start.

  2. Take a stroll at lunchtime. You get out of bed, you get on the tube, you get to the office, you eat at your desk, back on the tube and into your house. How long do you actually spend outside each day? Make a concerted effort to take a 20 minute stroll at lunch, you’ll get movement and vitamin D (vital for strong bones), bonus!

  3. Experiment with a standing desk. If you work for yourself, or have a great HR department, then a standing desk could be your saviour. Don’t launch into an 8 hour standing day, work up to it 30 minutes at a time with breaks in between (because sitting for a rest is ok!). There are standing desks which can be converted into seated desk with the touch of a button, very nifty and worth checking out.

  4. Get a sitting wedge. Not strictly getting you up and about but it will help your sitting posture by encouraging you to sit up straight, banishing curved backs and slouched shoulders.

Can you touch your toes?

Often our patients tell us that they are hypermobile, but is this really true? There’s a big difference between being too flexible and being hypermobile, and that’s what we’re going to be talking about today.

What’s the difference between flexibility and hypermobility?

Hypermobility is a syndrome, which means it is a medical condition. It affects the whole body, that means all joints from head to toe. It can also contribute to joint pains, stomach problems, fainting, palpitations and varicose veins. Patients with hypermobility syndrome often find that they can easily dislocate joints and have other unexplained health problems or symptoms. 

Flexibility usually involves a few areas of the body being more mobile than usual, and often results in patients having a few 'party tricks'. We've seen someone who was able to lick their elbow! Patients who are too flexible usually have a history of dancing, gymnastsThe problem with ics, acrobatics or other sports. The problem with flexibility is that too much can be a bad thing as it can often cause joint problems and pains.

How do I know if I have hypermobility syndrome?

True hypermobility is diagnosed using the Brighton criteria. This is a combination of joint mobility tests, called the Beighton Scale, and a list of symptoms.

Test yourself

The Beighton Scale is a good place to start. Try the following tests and see how many points you get:

  1. Standing up, bend forward and try to touch the floor. Can you put your hands flat on the floor whilst keeping your knees straight? If yes, 1 point. If no, 0 points.
  2. Straighten your arms as much as possible, do your elbows bend backwards? If it only happens on one side, 1 point. If it’s on both sides, 2 points. If neither side, 0 points.
  3. Standing up, straighten your legs as much as possible, do your knees bend backwards? If it only happens on one side, 1 point. If it’s on both sides, 2 points. If neither side, 0 points.
  4. Can you bend your thumb backwards to touch your forearm? If it only happens on one side, 1 point. If it’s on both sides, 2 points. If neither side, 0 points.
  5. Place your hand flat on a table. Can you bend your little finger back over 90 degrees? If it happens on one side, 1 point. If it happens on the other side too, 2 points. If neither side, 0 points.

How many points did you get?

0: You definitely don’t have hypermobility syndrome, however, you might want to make sure you’re not too hypomobile (not enough joint movement)!

1-3: You’re most likely extra flexible. You may have hypermobility syndrome if you also have joint pains, have dislocated a joint more than once, or if you have ever had a hernia or varicose veins.

4 or more: You may have hypermobility syndrome, especially if you have joint pain which have lasted for more than 3 months in more than four different places.

What should I do about it?

Testing yourself at home is never as reliable as getting a specialist to do it for you, so if you think you might have hypermobility syndrome it’s best to consult a medical practitioner to examine you properly. Doctors will often ask for blood tests to make sure that there isn't anything else going on. If you don't want to talk to your doctor, the True Motion team is able to assess you for the physical signs of hypermobility syndrome.

What if I’m not hypermobile but just too flexible?

When there is extra flexibility, we need to try and balance it out with stability. We need flexibility to allow our muscles to work properly and allow our bodies to move, however to control these movements we also need stability. It’s when our bodies aren’t stable enough that the problems begin!

What is the best treatment plan for flexibility? 

There is no one-size-fits-all answer. Researchers can’t decide whether exercise or manual therapy, like osteopathy and physiotherapy, work best. The reason for this is that we’re all unique. Everyone is different and every treatment plan needs to take into consideration so many possibilities that no scientific research can give us a definite answer that will work for everybody.

At True Motion we use a combination of manual therapy and functional exercises to work on building stability to support your natural flexibility, so you can make the most of being bendy - flexible patients tend to be fantastic at yoga! - whilst avoiding joint pains which get in the way of daily life.

Why you need phytonutrients

Today we're talking about food, in particular the hidden ingredients in fruits and vegetables that can do wonders for your health.

Want to decrease your risk of cancer and heart disease by 42%? Research has found that by eating 7 portions of fruit and vegetables a day this is entirely possible. The national guidelines aren't going to be changed yet, a controversial decision based on the fact that most people already fail to eat their 5 a day. It is thought that asking us to aim for 7 a day could result in everyone giving up completely. This doesn't mean we shouldn't be trying to eat more vegetables, and with such great health benefits, how can you say no?

What's so good about fruit and veg?

One of the reasons is that they are so colourful. The best way to go about getting the most from your fruit and veg is to eat as many different colours as you can. The colour of fruits and vegetables shows you some of the nutrients it contains, thanks to natural chemicals called phytonutrients. There are over 25,000 phytonutrients which provide many health benefits, from protecting against cancer to reducing the risk of asthma. Just one orange has up to 170 different phytonutrients, so get nibbling!

To make sure you’re getting as many phytonutrients as possible from your food, have a look at the list below, we’ve highlighted the main phytonutrient for each colour. If you eat at least one food from each group every day you’ll easily be hitting 7 a day, and your plate will be colourful and tempting too!

The Food Rainbow:

tomatoes

RED

Lycopene has been shown to protect against prostate cancer (especially cooked tomatoes) and heart disease. The highest levels of lycopene can be found in red or pink foods:

Seven cherry tomatoes, half a red pepper, half a pink grapefruit, 150g watermelon.

 
carrots

ORANGE

Beta-carotene is important for healthy skin, nerves and eyes. Which means the rumours are true and carrots really do help your eyesight! To improve your night vision include a portion of something orange:

A large sweet potato, 3 heaped tablespoons of chopped carrots, 1 slice of cantaloupe melon or 3 fresh apricots.

 
apricot

YELLOW

Flavonoids help to decrease inflammation which can contribute to pain and they act as natural antibiotics which means they can prevent you from getting ill. So bolster your defences by snacking on yellow-orange fruits like:

A medium peach, a large slice of pineapple, one orange, tangerine or mandarin.

 
kiwi

LIGHT GREEN

Lutein is fantastic for eye health, reducing the risk of macular degeneration and cataracts. It is most concentrated in light green foods:

Two heaped tablespoons of cooked spinach, two kiwi fruits, half an avocado or half a green pepper.

 
leaves

DARK GREEN

Glucosinolates are proven to fight inflammation, balance hormones and lung and stomach cancer. They’re mostly found in dark green, leafy vegetables so ignore your protesting inner child and eat your greens!

Two spears of broccoli, two handfuls of sliced cabbage, eight brussels sprouts, or a cereal bowl of watercress.

 
BLUEBERRIES

PURPLE

Anthocyanins have been linked to a decrease in heart disease, arthritis and type 2 diabetes. They’re mostly found in berries so grab a handful or two of these, they’re perfect with yoghurt:

A handful of grapes, fourteen cherries, 2 handfuls of blueberries, or seven fresh strawberries.

 
garlic.jpg

WHITE

Allyl sulphides can stop you from developing osteoporosis (brittle bones), boost your immune system and reduce the risk of developing Alzheimer’s disease and dementia. Try to have at least one of these every day, and the vampires will stay away too!

1 clove of garlic, 1 medium onion, or 1 medium leek

 

How to fit them all in:

So now you know all the amazing benefits of fruits and vegetables, how are you supposed to pack 7 portions into your day?

A good aim is 3 portions of fruit and 4 portions of vegetables. To achieve that a typical day could look like this:

BREAKFAST

Yoghurt with homemade granola and blueberries (find the recipe here!)

SNACK

Oatcakes with carrot sticks and hummus

LUNCH

A super salad with tuna, watercress, avocado and tomatoes with a scattering of seeds and a peach for pudding

SNACK

Strawberries with rice cakes and peanut butter

DINNER

Roasted chicken with broccoli and a sweet potato and garlic mash

(You’ll notice that there’s actually ten servings in this example, but I want to prove that even if you’re someone who doesn’t snack you can get your 7, and even more!)

We're off to fill our trolley with colours, why not give it a go for a week and see how you feel? We'd wager a bet that you'll be feeling brighter!

Why you should do yoga

One of my most memorable patient moments happened when I was still training. I was in an initial consultation with an 87 year old lady. To assess how well her muscles and joints were working, I asked her to do some simple movements. The first of these was to bend forwards as if she was going to touch her toes. I wasn’t expecting her to get too far, in my previous experience most people in their 80s couldn’t get much further than their knees. To my surprise, and that of my observer, this tiny lady folded herself in half and placed her hands flat on the ground! It turned out she had been doing yoga for over 40 years, and you could clearly see the benefits! She came to the clinic for a twinge of back pain, the first time she had experienced this in her life, and she recovered in 3 weeks. If that isn’t a fantastic advert for yoga, I don’t know what is!

What is yoga?

Yoga has been around for thousands of years, originating from the Sanskrit word ‘yuj’ which means to ‘yoke’ the spirit and physical body together. There are many different styles of yoga and the beauty of it is that there’s a style for everyone, from children to high end athletes and everyone in between! The aim of yoga is to energize your body and calm your mind.

What are the benefits?

Improved flexibility. Probably the most obvious benefit of doing yoga. People often think of yoga as an easy exercise but don’t be fooled by the gentle movement, it’s tougher than you think! If you stick with it you’ll notice that your muscles begin to loosen and your posture improves, you’ll even be able to bend forward and touch your toes!

Healthier joints are found in yogis (the official terms for those who practice yoga), as the poses take your joints through their full range of movement. Doing this can prevent osteoarthritis, or wear and tear, of the joints by soaking areas of cartilage that aren’t normally used. This delivers the nutrients required to keep your cartilage healthy and stop it from wearing out. When it comes to joints, use it or lose it really does apply!

Better sleep. Research has found that practicing yoga at least twice a week helps us to sleep better and feel less fatigued. This is thought to be related to yoga’s ability to reduce stress and anxiety.

Fewer food cravings. Regular yoga practice has been found to be associated with mindful eating and an increased awareness of physical and emotional sensations when eating. Practicing yoga strengthens the mind-body connection, helping you tune into emotions related to your cravings and helping you make better food choices.

Better immunity. Yoga practice has been found to actually change your genes and boost your immunity (your body’s ability to fight disease). This, along with all the other benefits, means that you will not only feel fitter and more alert, but will also get ill less often.

What type should you choose?

There are many types of yoga, which often makes it difficult for those unfamiliar with yoga to choose which one is best for them. Many studios have a beginner’s class, which is usually the best place to start as you can learn the basic poses and breathing techniques before moving onto a more specialised class.

Hatha: Perfect for beginners, traditional Hatha yoga forms the basis of all other types of yoga. It combines breathing, yoga poses and some meditation. Having attended a few Hatha classes I highly recommend it, especially as my yoga studio hands out blankets during the final relaxation pose!

Ashtanga: This type is very athletic and involves 6 vigorous sequences of postures. It’s one of the oldest forms of yoga, and is one to try once you’ve experienced some of the gentler versions, especially if you have any aches and pains.

Bikram: Bikram yoga classes usually last for 90 minutes and go through a sequence of 26 postures and breathing exercises. Bikram is performed in a room heated up to 40 degrees centigrade with 40% humidity, so approach with caution if you are like me and don’t do well in the heat!

Iyengar: The focus of Iyengar is on healing the body and mind through supported postures. Like Hatha, it is one of the oldest forms of yoga which makes it great for beginners or anyone with health problems, such as insomnia or stress.

Vinyasa: Developed from Ashtanga yoga, Vinyasa classes combine a rhythmical flow of poses with music. If you’re into dancing this is probably a good choice, as classes tend to focus on the natural movement of the body.

How to Find a Yoga Class

If you can’t find a class near you or you have previous experience and want to continue your practice at home, try having a look at some books or online videos. Some good ones I’ve found are: