Pain behind the knee when running. #2

Neural Flossing for Knee Pain

Image of standing posture

"Set-up" for running posture

Went for a 90minute run this morning and didn’t have any pain during running, just a very mild ache at the end of my run (the after effects of yesterdays manipulation???). The run was around Ashton Court so very uneven surface which can be a trigger for the pain. I stopped every 20 minutes to ‘floss’ (odd looks from dog walkers) and felt the benefits of this each time. Did some more stretches at home and will do some more this evening.

Check out this link to see the Video how to do Neural Flossing

http://www.physiotherapy.co.uk/blog/?p=748

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No1 – Marathon prep 2012 – Fixing my knee pain

runner on treadmill 12km
Running Analysis prior to Marathon Training

Getting my Marathon training right in 2012!
I saw John at Moti for my 2nd physio appointment on 02/01/12 at MOTI. I first visited him before Christmas regarding an annoying pain in my right knee that I was worried might develop in to runners knee which I have had previously a few years back. My aim this year is to get a marathon pb (sub 3:40) at London. Last year I got struck down by sciatica mid way through my training and so did not make it to the start line. I decided to visit a physio to try and combat some of the reoccurring injuries I have kept getting on the right side of my body. I have been a regular visitor of Moti clinic for sports massage over the last year so decided to book a physio appointment with John through them.

Assessment with Physio
At my first two appointments with John he spent time going through my history of injuries, my performance in running and assessing my injury. In terms of toe to floor contact my right foot only scored 1/5 whereas as my left foot score 3/5. The general extension and abduction of right leg was also very poor.

Physio Treatment
John used various mobilization and manipulation techniques to increase my range of movement. I was surprised to see how just how much this improved my range of movement. After this treatment my right foot score had improved to 3/5.  At the end of the second visit a video analysis of my running style was carried out. Looking at the video above you can see how I rotate rightwards as I run. It almost looks as if I am dancing rather than running! Running like this instead of in a smooth forwards movement means I am wasting a lot of unnecessary energy. This is something we will be working at future appointments with the hope of clipping of some time from race performances.

The Plan!
In the meantime I will try and work on keeping an upright posture and driving my arms back while I am running. I will also continue doing core exercises and opting for more exercises that are in an upright position (like running) which John told me research is starting to show is more effective.

Posted in 10km, 5km fun run, back pain, knee, pain - lower limb | Tagged , , , , , , , , , , , | Leave a comment

I wish I’d said that No.002: The most complicated task today…………

The most complicated task today is finding a way to live a simple life. — W. A. Nance

Bigness is constantly confused with virtue. — Peter Gellatly (1969)

Live in the past; it’s cheaper. Live in the future; it’s better. — Magazine Ad

500 more quotes…

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Pain in my Lower Leg#3

John has continued to show me exersises i can do to fit around my work to help strengthen my leg but he has also carefully analysed my running technique. When he studied my running on a treadmill he showed me how much my left leg was heal striking which is whats causing my injury pain. He then showed me that this was all because of the distance my legs were landing in front of me, I am now pleased to say that through his guidance and this smaller stride technique the pain in my left leg does not feel as bad as it has during previous runs. Like all new things this will take me time to adjust to.

Posted in 10km, arm swing, back pain, fore foot running, forefoot running, Learn to Run, low back pain when running, Newton Running, overuse injury, pain - lower limb, Physio in Bristol, Physio Sports Injury Blog | Tagged , , , , , , | Leave a comment

Nerve irritation in the Lower back due to poor store stability

Fifth session, last post Jan 11th, 2012

I saw John for the 5th time in early January. In this Physio session John put me on a treadmill and assessed how I was running. He noticed that although I’ve only complained of right leg pain I hold my right arm still, suggesting that my whole body isn’t moving fluidly together. We discussed how I should be moving – whilst running both my arms and legs should move together and I should be standing straight and tall. John then turned up the speed of the running machine – I responded to this by lengthening my stride which has always seemed logical. This however causes instability and we looked at how my posture fell apart. Instead, to run faster I should be moving my arms quicker and taking shorter steps. When I tried this I found that not only was more comfortable, but the noise as my feet hit the treadmill was dramatically reduced. Suggesting that this movement is stronger and I’m loosing less energy.

I’ve been taking Pilates classes for the last month and feeling significantly stronger in my stomach area. My spine seems more flexible and I have more shoulder and neck movement. My lessons are good, but I’ve definitely got more out of them after having one on one physio session with John. We’ve been able to hone in on my body – the way I am moving and focus on my personal weaknesses. I’ve been able to use this increased awareness in the Pilates lessons.

I’m going through a process of becoming more conscious and responsive to my body’s movement. In my running and general exercise I’ve tried to remain mentally engaged and not to overdo it to the point where I lose concentration and focus. I’ve been trying to take things slowly and focusing on the quality of movement. So far I feel I am moving better and feel much stronger.

For homework, along with regular exercise, I’ve been doing basic Pilates exercises daily “the hundred” and “leg circles” and adding other exercises as I come to them in my lessons.

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Fixing my shin splints for London Marathon #1 – Physio Advice

Problem
The task
what the physio said
what i did next
plan

Posted in back pain, forefoot running, heel strike, Learn to Run, low back pain when running, Physio in Bristol, Physio Sports Injury Blog | Tagged , , | Leave a comment

My self diagnosed ‘pressure’ knee injury – part 2

Prior to my first ‘full’ appointment with John, I decided to check out some more of his advice and exercises on his website, especially regarding posture at a desk. I realised that I had a tendency to sit very poorly, with a curved spine for hours on end and so already started to make a conscious effort to improve that. I had also started doing some more focused core muscle exercises while at the gym. This small increase in effort over a couple of days resulted in John commenting almost right away that ‘things had improved from last time.’ The muscles in my left leg and lower back were by no means equal in movement with those on the right, but were noticeably less tight.

So John started this session by once again checking the range of movement of my legs, lower back and, a bit more surprisingly, arms. Again, my lower right side performed well, exhibiting good movement and strength, whilst my left side was less flexible and weaker. My arms, however, exhibited largely the same movement as each other, showing that my problems stemmed from my lower back. At this point, through a slightly bizarre mixture of twists, rolls and squeezes, John stretched and ‘cracked’ both my middle and lower back. The improvement in my range of movement was noticeable immediately. I gained roughly 20 degrees of forward rotation in my left leg and a significant increase in strength, I was amazed! After this ‘manipulation’, we focused on exercises and postures that I should adopt to ensure that I strengthened my core and prevented the injuries from reoccurring.

While I always felt like I knew what a good posture entailed, John showed me that I had been slightly mistaken. My ‘good’ posture involved maintaining one single slight curve through my spine, rather than the outwards curve at the top and the inwards curve at the bottom. I was shown that, by raising roughly where the tag on my shorts were, I would achieve this desired ‘S’ bend. Since the appointment I have been trying to adopt this posture whenever possible, but it certainly takes some concentration and getting used to!

John then taught me how to perform a version of a ‘roll back’, a move derived from pilates that, as I understand it, is designed to stretch out your spine and strengthen your core. This involves sitting up, slowly collapsing and rolling back along your spine, before rolling back up to sitting. I was also taught the basis for how to run without bouncing, by maintaining a constant head height – achieved by reimagining how I carried my weight on the pads of my feet.

Alongside these exercises, John provided advice about some further reading, some improvements for my cycling technique and also the kind of desk chair I should consider in the future. It also turns out that John is pro barefoot running and that some of the techniques I was learning may help me achieve this in the future.

I have been instructed to bring my trainers to the next session, so I have high hopes of being able to run again soon!

Posted in back pain, knee, knee pain, Physio in Bristol, Physio Sports Injury Blog, Sports & running injury, Triathlon, Uncategorized | Leave a comment

My self-diagnosed pressure ‘knee’ injury #1

Self Diagnosis
I might have been partially right on the pressure part, but the problems extended a long way past my knee!

image showing problems with left leg allignment

image showing problems with left leg allignment

Background:

Roughly 8 weeks ago I injured my knee during a particularly hard high-gear session on a watt bike. Though running has always been my focus, I have recently turned to triathlons (not least to provide a more interesting training schedule!). I am a competent runner (I think) and was looking to push forwards into more endurance-based events only to find my progress hampered by a knee injury that would tend to flare up roughly 5kms into a run – hardly great news for endurance events. So I booked an appointment for some physio with John.

Diagnosis:

John started with a fairly broad examination of my legs and their respective ranges of movement; from watching my attempts at single leg squats to push and pulling my legs through most axes. It became apparent that my right leg performed fairly ordinarily. Its movement was as expected in most directions (apart from being a bit tight – something I would attribute to my ongoing bike training) and I was able to successfully counter any pressure that John directed. My left leg, however, was a different story. I had previously been told, during a trainer fitting, that my left leg did a lot more of the work when I was running. John believes that this miss-diagnosis is due to its ‘noisy’ range of movement. In a forwards direction from my hip, my left leg has a much smaller range of movement than my right. It also has a tendency to roll outwards at my knee when I am lying down. That being said, my foot structure is apparently fairly good, with all toes engaged when placing pressure on the floor – a nice positive that I can hold on to!

Having tested my range of forward motion and muscle strength in both legs, John proceeded to check my backwards movement range by getting me to lie on my front and lift my foot, first from my knee and then from my hip. Again, my right leg motion was said to be good. Again, my left leg motion somewhat underwhelmed. During this exercise John also tested the tension in various places in my lower back and needless to say the muscle on the right-hand side was much firmer than that on the left.

At this point, John believes that my problems stem from the muscular structure (or lack thereof) of my lower back, which causes recursive problems through my left leg – more specifically, that my movement aggravates the left-hand side of my L2 nerve, which causes a pain that manifests itself in my knee. This has been attributed to poor core stability – likely caused by poor posture throughout my fairly sedentary desk-based studying. My lower left core stability problems cause my left leg to perform inefficiently and engage different muscles in, as I understand it, bizarre manners to try and compensate for reduced range of movement, which, in turn, leads to further hip flexor and lower back problems, further aggravating my knee and so on and so forth.

Having returned from my first appointment, I checked out a variety of other blog posts made on John’s website and it seems I am not the only one with these problems. It also seems that John manages to fix everyone else – so all I can say is ‘bring it on!’

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Pain in my lower leg #2

After my second session John advised to continue with the excersises recommended in my first session, but now also to begin looking at my running posture itself. He anaylised my running and suggested i try atleast initially a smaller stride technique to help soften the impact on my lower leg and to help harmonise the movement of my arms with my legs.

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Pain in my Lower Leg #1

Pain in my lower left leg

I have not been running now for about 2 months…….

I have been un able to due to a pain in my lower left leg.

PHYSIO
After my first session with Physio John Stephenson, I immediately felt more re assured as he quickly established by “foot scoring” of my feet, that my leg injury was due to an inbalance in my feet.

Learn to Run with AAA-Physio

Learn to Run with AAA-Physio

Coming away from the session he gave me several homework techniques i could fit around my work, which included a neural flossing, roll and leg kick, and also a toe fold to help me strengthen my left leg.

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