Your physiotherapist has a wide variety of skills and can help you with so much more than just pain and injury. Here are a few reasons to visit your physiotherapist that can keep you healthy and pain-free, before injury strikes...

Stiffness and Inflexibility
 
Almost all of us have experienced pain and stiffness after a day of increased or unaccustomed exercise. This kind of stiffness usually wears off quickly and is referred to as DOMS (delayed onset muscles soreness). However, if you find yourself feeling stiff for more extended periods, or even most of the time – it might be time to see a physio. There are many different causes of stiffness and inflexibility. By far the most common is lack of movement. Our joints and muscles both lose flexibility if not moved through their range regularly. Muscle stiffness can feel like a tightness with a bouncy feeling of restriction, and joint stiffness can create a harder ‘blocked’ feeling when you try to move. 
 
When it comes to stiffness that evolves from lack of movement, you may not even notice that you have lost range, as it can be easy to adapt your movements to compensate. Your physiotherapist can help you to identify where you have areas of inflexibility and help you to exercise, stretch and mobilise your joints to get them back to a healthy range. Disease processes such as osteoarthritis and rheumatoid arthritis can also cause prolonged stiffness, and your physiotherapist is well equipped to help you deal with these conditions. 
 
Reduced Strength or Weakness
 
There are many possible reasons for weakness in the body, from generalised disuse, weakness in one muscle group following an injury, neurological weakness or structural weakness of joint following a ligament tear. Musculoskeletal deficiency of any kind can predispose you to future injuries and are difficult to resolve without targeted exercises. Your physio can determine the cause of your weakness and prescibe the best treatment to restore your strength. 
 
Reduced Balance
 
Keeping your balance is a complicated process and your body works hard to make sure you stay on your feet. Humans have a small base of support for our height and we use all our senses together to determine which movements we should make to stay upright, including our visual, vestibular, muscular and sensory systems. As balance is essential for walking, if one system that supports our balance begins to weaken, the others will quickly compensate, so you may not notice that your balance has worsened until you fall or trip over unexpectedly. 
 
As a general rule balance deteriorates as we get older, but this doesn't mean that falling should be an inevitable part of aging. Actively working to maintain or improve your balance can have a significant effect on your quality of life and confidence in getting around. Your physiotherapist is able to test all aspects of your balance and provide effective rehabilitation to help keep you on your feet.

Keeping active can be challenging. For many people, going out for a run or taking time to perform a full workout can be daunting, especially if this is not a part of their usual routine. 
 
There are a few quick and easy ways to add some movement to your day, starting with something as simple as boiling the kettle. As the average kettle takes 2-3 minutes to boil, challenge yourself to see if you can complete these three exercises while waiting for your cup of tea or coffee. You can focus on one each day, or work through a different one each time. 

1. Challenge your balance. 
 
Standing on one leg is something many of us assume we can do, yet rarely take the time to check. This is an essential skill that can deteriorate without being noticed until everyday activities, such as getting dressed, are impacted. Being able to stand on one leg is important for putting on shoes, trousers and reduced balance can be a risk factor for falls. 
 
Start by seeing if you can stand on one leg with your eyes open for the entire time the kettle is boiling. Test both legs, making sure you are close to a bench that you can use to support yourself. To increase the difficulty, try balancing with your eyes closed, then progress to balancing on your tiptoes. If you can balance on your tiptoes, with your eyes closed, then you can ask your physio for more suggestions.
 
2. Heel Raises
 
Start by keeping your knees slightly bent and lift both heels off the ground at the same time. You can begin with repetitions of 5, have a quick rest then repeat. Challenge yourself to increase the speed of your heel raises and see how many you can fit into your waiting time. As you bend your knees, aim to keep your knees over your second toe. If you feel this is a little too easy, you can progress to single-leg heel raises, which will also improve your balance!
 
You can start a daily competition with the people in your household to see who can complete the most repetitions in a set time period.
 
3. Squats
 
Squats are a great exercise to keep your large muscles working. You can start with 5 shallow squats, aiming to slowly increase your number and progressively squat to a lower position. As with heel raises, when you start to find squats to be less of a challenge, you can move to single-leg squats. 
 
Don’t hesitate to ask one of our physios for tips on how else you can stay active at home or in the office. 

Nothing can ruin your enthusiasm for a new workout program faster than the pain and stiffness that sneaks up on you the day after. This delayed reaction from your muscles, known as DOMS (delayed onset muscle soreness), has affected almost all of us at one time or another. While there is no sure-fire cure or prevention for DOMS, here are a few tips to help reduce your symptoms next time you hit the gym

Understand what it is
DOMS is thought to be a result of micro tears in muscle tissue during eccentric exercises in particular. While DOMS is not a sign of a serious injury and usually goes away on its own within 48 hours, it can be very uncomfortable and a deterrent to continue exercising. It can also leave you at a higher risk of injury, and for athletes who are competing in a tournament and need to recover quickly, DOMS can be particularly problematic. 
 
Warm-up and cool-down
By taking the time to let your muscles warm-up, your muscles can operate at optimum flexibility, reducing the tension on muscle tissue during exercise. A cool-down encourages effective blood flow to muscles after exercise, so that any waste products such as lactic acid and calcium can flow back into the bloodstream rather than staying in the muscle tissues. 
 
Get a massage or use a foam roller
By massaging tight and sensitive muscles, you can improve blood flow, promote tissue healing and reduce pain. Both massage and foam rolling can help to relax tight muscles and enhance tissue recovery in the first 24-48 hours after exercise.
 
Stay hydrated
Keeping hydrated allows your body to remove waste, stay flexible, and help tissues heal optimally. The trick is to maintain hydration throughout your day, not just when it's time to exercise. It's also essential not to wait until you are thirsty, as you could already be dehydrated at this point. 
 
Other ideas includes gentle exercise such as 20 minutes on a stationary bike, and mild stretching. If you are particularly brave, ice baths have recently been shown to have mild benefits in pain reduction following intense exercise.

1. Try a new activity.
 
When injury strikes, it can be tempting to stop exercising altogether and just rest while you recover.  An injury can be frustrating, but it can also be an opportunity to try out a different sport. If you’re a runner with an ankle injury, you can keep up your fitness by swimming instead. Cycling can be an excellent option for people for dealing with knee pain, and if you’re a swimmer with shoulder pain, maybe switch to running for a while. Check with your physiotherapist for some ideas to keep you moving. 
 
2.  Exercise within your limits.
 
If you’re getting pain at 5km, this doesn’t always mean you should give up running altogether. Your physiotherapist can help you monitor your symptoms carefully and plan an exercise routine that keeps your fitness up while reducing symptom flare-ups. Staying as active as possible throughout your recovery can also mean that you a better placed to get back to your best performance once symptoms subside.
 
3.  Take the opportunity to improve your footwear and equipment.
 
Injury and pain can be a great prompt to look at your equipment and technique. For example, with hip and knee pain, the type of shoes you wear can have a significant difference. Often pain has more than one cause, with technique and equipment often having a substantial impact on the stress placed on your body. Your physiotherapist is an excellent source of advice in this area, don’t hesitate to ask for an assessment.
 
4. Take to the water
 
Hydrotherapy has long been used to help patients with joint pain or muscle weakness exercise. The water helps reduce joint stress and provide extra sensory input that can reduce pain. Exercising in water can be especially helpful for sufferers of chronic pain or those who have pain with weight-bearing. Speak to your physio for a hydrotherapy program if you’re not sure how to approach exercise in water.
 
Our physiotherapists are happy to discuss your condition with you and share their tips to help you stay pain-free.  

What is it?
Our knees are complex hinge joints, designed to provide stability from side to side and smooth movement forwards and back as you walk, kick and run. The patella, or kneecap, is a small bone embedded in the tendon of the quadriceps muscle that protects the knee and also provides extra leverage to the quadriceps, amplifying their strength. The patella moves up and down in a groove at the front of the knee as the knee bends and straightens. Usually this movement is smooth, with little friction, however, if something causes the patella to move in a dysfunctional way, the soft tissue between the kneecap and the knee can become irritated, causing pain in a typical pattern. This condition is often referred to as ‘runner’s knee’, PFJ syndrome or patellofemoral pain syndrome (PFPS).

What causes it?
The patella usually sits in a balanced position in the shallow groove at the front of the knee and moves easily without friction. The patella is attached to the quadriceps muscle at the top and connected to the lower leg via the patella tendon at the bottom. When the quadriceps contracts, this pulls on the patella and acts to straighten the knee. If one side of the quadriceps is stronger or tighter than the other, it can cause the kneecap to pull to one side and over time become irritated.

There can be many factors that cause a muscle imbalance or weakness on one side of the quadriceps. In most people, the outer aspect of the quadriceps tends to be stronger and tighter than the inner muscle.

Certain postures and leg positions require the outer muscles to work harder and the inside muscles to become less active. Lack of arch support in your feet or simply a physical abnormality of the knee can also place stress on the movement of the patella.

What are the symptoms?
This condition is characterized by pain felt on the inside or behind the patella with activities that require repetitive bending of the knee. There may be a sensation of crunching, clicking or grinding and some people report that their knee suddenly gives way. The pain is commonly felt when running, going up and down stairs or when doing squats and is generally relieved with rest. The pain may start as a small niggle and gradually become worse over time.

How can physiotherapy help?
The first step in effective treatment is to exclude any other conditions and have a physiotherapist confirm the diagnosis. Your physiotherapist is able to determine which factors are contributing to this condition, which could include poor posture, a lack of arch support in your feet or poor running technique.

Once these factors have been identified, you will be provided with a specific treatment program to best approach your condition. PFJ syndrome usually responds well to biomechanical analysis and correction of any muscular weakness and imbalance. Having the correct shoes and orthotics can also make a huge difference. There are some short-term treatments, such as patella taping, dry needling, trigger point therapy and ultrasound, which may help alleviate symptoms quickly and keep you active while you address the other factors contributing to your pain.

Stretching has long played an important role in the world of sport and fitness, with many athletes stretching religiously before and after exercise in hopes of preventing injuries.

More recently, this practice has been called into question with many people wondering if stretching really makes a difference to athletic performance. The answer, like most things, is not black and white, as we explore a little in this article.

A brief introduction to stretching
 
Stretching is a type of movement that increases flexibility by lengthening muscle fibres to the end of their range. Stretching before and after exercise has been thought to reduce the risk of injury, improve athletic performance and reduce muscle soreness after exercise.
The two most common types of stretching are static and dynamic stretching. Static stretching is when you lengthen your muscle and then hold that position for a period of time.
 
Dynamic stretching uses movement and momentum of the body to stretch muscles to their end range, without holding the stretch at the end.
 
What does the research say?
 
Some research has suggested that static stretching before an activity can actually reduce power, strength and performance. However, these reductions were shown to be minimal and not noticed at all if the stretches were held for less than 45 seconds.  It has also been found that stretching does improve flexibility but only for a short period of time. A few minutes after stretching, your joints move further, and with less resistance, so you may have improved flexibility immediately after stretching.
 
Why stretch at all?
 
One thing that is undeniable is that stretching feels great, with many people feeling more relaxed and reporting a rush of endorphins after a good stretching session. It is also difficult to test the long-term effects of stretching specific muscles showing abnormal tightness. A long-term static stretching routine will improve your overall flexibility, and this is thought to help prevent injuries, although the evidence is inconclusive.
 
If you’re an athlete, the decision to stretch or not can be a personal one. A warm-up prior to intense exercise that includes some form of dynamic stretching is generally recommended for reducing injury risk, but of course is no guarantee. Strength and balance training may have a far greater impact on reducing injuries in the long term.
 
Your physiotherapist is able to guide you on the best stretching advice for your individual activity and they may be able to identify some areas where improving your flexibility will help to reduce injuries and improve performance.

Being active is one the most important aspects of a healthy lifestyle and there are many different ways to get your heart rate up. No matter what your choice of activity is, there is always some risk of injury. In this article, we have listed some tips to help you prevent accidents and injuries.

1. Choose the right footwear
 
The correct footwear can go a long way in protecting your feet and ankles from injury and can even prevent serious accidents such as falls. Every activity places different demands on your body and tailoring your footwear to suit these stressors is a great strategy for preventing injuries.  For example, basketball players often wear shoes with support that extends above the ankles to help protect against ankle sprains, while hikers require thick and supportive soles to cushion and protect their feet. Wearing shoes that are too large or have poor grip can lead to slips and falls, particularly when exercising in the outdoors. Your physiotherapist can guide you with the correct choice of footwear for your chosen activity.
 
2. Pace yourself
 
When you start to see improvements in your fitness and strength, it can be tempting to push your limits to see just how far you can go. The danger in this is that often your tissues are still adapting to the increased demands of your new exercise regime. Increasing your weights, training time or running distances by too much too soon can lead to major setbacks. Give your body time to adjust and progress in a slow and steady manner.
 
3. Check your form and posture
 
Checking your posture in the middle of a workout is probably the last thing on your mind, however poor form is a leading cause of injury in athletes. As an example, lifting weights when your spine is not in its optimal position causes many low back injuries. Taking a second to check your posture before starting a lift is highly recommended.
 
4. Seek professional advice
 
Coaches and trainers are able to help you spot vulnerabilities and share their knowledge, helping you get the most out of your chosen activity.  Often it is easier to prevent bad habits from forming than it is to break them once they are already in place. Invest in the advice of an expert, they can help you to avoid injuries as well as reach your peak performance.
 
Your physiotherapist is able to identify weakness in your training technique, biomechanical vulnerabilities, tight and/or weak muscles and can help guide you through your recovery if an injury does occur. However, prevention of injuries is always preferable to treatment, whenever possible.