I feel it is no coincidence that this Christmas I was given two books which are undoubtedly related: Hemingway’s ‘The Old Man and the Sea’, and Melville’s ‘Moby Dick’. Both describe the immense efforts of people to overcome multifarious obstacles in order to capture a monster far bigger than themselves (although I haven’t read Moby Dick yet). It may be over-dramatic, but in some way this is how the marathon has become for me. Particularly since the calf problems, it has been a daily struggle to stay on top and build the mileage back up enough to make the marathon plausible. I put in calf-strengthening exercises daily, I now also slot in postural exercises and some ‘neural flossing’ as recommended by John. I am careful to warm up and down thoroughly around each run. I run three times per week, unsure each time whether the calf will fail again, but monitoring and adapting my runs accordingly. Add to this that I will not be satisfied purely with finishing the marathon, but I would like to run a reasonable time. My running is currently limited not by my fitness but by the leg, which sometimes does not allow me to run further. This is concerning given that my longest mileage since the injury is 15 miles. Still, I believe that my approach is giving me the best chance possible. It combines patience, determination, and discipline. Keep doing the exercises even though you may be bored. Keep training even though the weather may be terrible. Keep believing even though other people may not hide their doubt. There is never a guarantee of success, but you can always put in your best effort possible.
I went to the Moti running shop hoping for a recommendation for a physio to assess some problems with my calf. Lucky for me, John walked through the door at that moment and offered me a free assessment. With pause only to make a vital cup of tea, we got to work. John walked me through the issues with my body, step by logical step, gradually revealing a complete picture which I feel he knew practically from the start. Neither of my feet land in a straight line down from the knee. The two legs are different, with the right (where I have the calf issues) worse than the left. My right side is weaker than the left in certain areas: lifting the knee up towards the chest, and pushing down around the big toe. John traced these issues to the L2 and L5 vertebrae in my lumbar spine, and demonstrated that these were more tender than the others. Overall, I’m no longer surprised that I am having problems running! Whilst there is a considerable list of problems with the posture of my body, having them pointed out with such clarity has given me genuine optimism that something can be done about them. I hope that optimism is well founded.
For our final session – a follow-up after a three week break – I was glad to report that I’d been feeling no pain, and only a little discomfort and stiffness in my neck and shoulders still. This was usually in the morning, after sleeping on my side on rounded shoulders, as I always do. We discussed this and thought about how inevitable that might be, and which exercises and stretches actually alleviated that stiffness quite quickly.
Otherwise, John tested the power in my arms and hands, and the flexibility in my legs, all of which were significantly better and functioning quite well. There was still a bit of treatment we could do with the neck, so a bit of clicking and stretching later, I was feeling pretty well mobile and “stacked properly”, as John calls it.
I’m aware now that I really need to keep up the exercises and stretches I’ve been doing, to strengthen particular muscles and also keep my body mobile. I spend so much time in front of a screen at a desk that not to counter that with even the minimal amount of activity was putting huge amounts of strain on my joints, nerves, and muscles. I know now which joints, nerves and muscles these are, and at least part of the way to remedying the issues I’ve been having with them.
We agreed to check in after a couple of months or so to see how I’m doing. Right now, I’m incredibly happy with the progress I’ve made over six sessions, and pain-free.
Today I came to see John after two weeks off physio – I’ve noticed that the pain is almost entirely gone, and I’m now just a bit clicky and stiff at times. Any pain there is can be quite quickly resolved with posture amendments. Now, my challenge is to up my stretching, pilates and yoga so that it’s a part of a regular routine, rather than a remedy when I feel a bit stiff.
We talked about the ‘competence square’ (I think that’s what it was called) – travelling from Unconscious Incompetence (you don’t know what you’re doing wrong) to Conscious Incompetence (you know, but you’ve not yet fixed it) through to Conscious Competence (where I am now – I know what’s wrong and am fixing it)…next stage, of course, is Unconscious Competence. That should look like regular exercise, and less sitting at a screen; automatic dynamic sitting posture; better strength in my muscles and better posture all round; leading to better movement, and more comfort, zero pain.
We essentially came full circle today – most of the tightness in my pelvic region, glutes, and shoulders has been relieved easily by treatment and stretching. The remaining stiffness now is in my neck and thoracic spine, where the pain originally was that I came to get physio in order to alleviate. So there is a clear path I’ve taken, it seems, that has allowed me to work through the mobility problems throughout my body, and the significant problem areas are all that’s left.
After a bit of treatment, and checking what was stiff/painful/immobile, John and I talked a little about what I could do to maximise further recovery. Ultimately, it’s now up to me to incorporate into my regular routine the particular stretches I’ve been tasked with, experiment with other ones that may help, and generally optimise my lifestyle around my physical health. We’ve booked a follow up appointment to check in in three weeks time. I’m very happy with my journey from beginning to now!
John briefly went over what we had talked about the previous week in my assessment, and asked me whether I’d experienced any new pain from any of the exercise – which I hadn’t. We recapped dynamic sitting, to make sure I was enacting it correctly. Throughout the week, I had still been experiencing pain in my neck and shoulders, but I noticed it had eased significantly when I performed dynamic sitting. The remaining pain was most likely due to the fact that I hadn’t yet bought my planned amendments to my workstation – an adjustable laptop stand, and remote keyboard – and so my posture was still suffering from using a laptop in a way that adversely affected my posture. My vertebrae c3 and c7 were still overloaded much of the time, until I reminded myself to reset my posture which brought temporary relief.
He then tested my flexibility, from not only my neck and shoulders, but also in my hips and feet. He explained that this demonstrated the way that my nerves worked together throughout my body – the nerves, he explained, are like long bits of ‘floss’ that run throughout your body; when you stretch the right arm out, they pull rightwards along your shoulder blades, as though you’re flossing from left to right, and vice versa. Having this visual helped me to understand how and why my body was, or wasn’t, moving… For example, when lying flat my right leg could be raised over 90 degrees, and then adducted (turned inwards) with ease. Whereas my left leg struggled to raise to 90, and was incredibly painful in the hip and buttock when adducted at all.
John then felt the joints in my neck in a few places to identify issues, and clicked my back in a few places – which felt great. Testing the leg flexibility again, just five or ten minutes later, my left leg was almost as flexible as my right, with no pain whatsoever. John gave me a few exercises I could do to ease up the left leg joints and prevent the tightness in the nerves and joints. They were similar to some yoga moves I’d done before, and I could feel that they were quite relieving already.
That brought the session to a close, and we discussed meeting again the following week. I already feel that I’m progressing significantly, and a huge amount of that is in the explanation that John gives, and the resources he gives me to take away, such as videos of stretches and links to information about posture etc. This means I understand not only what to do to help myself, but why I’m doing it.
I was really glad of the option to have a 15 minute initial assessment. I’ve previously seen chiropractors, podiatrists, masseuses, and a physio, and so I was eager to accept what AAA Physio was offering: a free appointment that would tell me if a course of physio was right for me, and what it was that I might be able to address with another course of treatment at this point.
I was sure that I must have caused myself an injury, because my neck, shoulders and back were in almost constant pain, especially on my left side. I assumed that after years of discomfort issues which had got progressively worse, that I had only half-dedicated myself to resolving via one off appointments for treatment, I must have done some sort of irreversible damage – to the muscles in my neck particularly.
John very soon removed that fear, informing me that it was a nerve and particular joints – not a muscle – that was causing pain. He explained that there is a long nerve that runs between my vertebrae C3 and C7 that was likely causing the pain. He examined and adjusted my posture to demonstrate how my usual way of sitting was overloading those two particular joints. He told me that he believed we could achieve a “significant improvement with around 3 to 6 sessions.”
We ended the session by exchanging emails, and John gave me some exercises and examples of ‘dynamic sitting’ – all of which he gave me access to through his website so I could easily review them. That gave me something to work with until our first session.
We started the assessment with John redoing similar tests to my first appointment to strengthen his analysis and all the exercises gave the same results.
John used various techniques to determine my flexibility and movement range whilst talking me through everything he did. The best thing was comparing how I was at the beginning of the appointment to how I was after the 45 minutes. I started the appointment with stiffness in my right side with limited flexibility. He located where all the stiffness was in my back and then eased my spine by clicking it and releasing the pressure in several locations. Immediately we tested my leg flexibility and it was absolutely incredible to see the difference. I could move so much more and without pain or feeling weak.
It seems that years of my parents telling me to sit up straight fell on deaf ears as my posture has slumped, this could also be due to having a desk job for so long. John showed me ‘dynamic sitting’ which enables me to focus on how I am sitting at my office chair and adjust myself accordingly. Immediately I feel my core engaged and I feel taller and less slumped. The really helpful advice is to imagine lifting the label in the back of your shorts, it helped me roll my pelvis forwards whereas when I slump it just rolls back.
My homework is to continue with dynamic sitting and trying to think about how I am sitting every 20 minutes at work. Additionally I need to practice laying on my back and rolling back to my shoulders joint by joint into a pilates bridge and back down again. My first couple of attempts are shaky and my balance was all off but hopefully if I do at least 30 of these every evening I will improve.
My first ever physio appointment was a real eye opener.
After putting up with sharp right knee pain during running for over 4 years I thought it was finally time to have it assessed. After spending 30 minutes with John he had assessed me and discovered that it is lack of flexibility in my right hip that has caused lower back pain, knee pain and general leg weakness.
I was amazed to see the differences in both legs in terms of strength, flexibility, stiffness and movement. I was very impressed and keen to have my next session as soon as possible to find out more.
So, my fourth session with John focused mainly on pain relief. I came with aches and pains built up after a weekend seeing the tourist sights of Barcelona. I talked through my pain which had started to radiate from my side down through my hip flexor and into the front and back of my thighs. It was starting to affect not just my ability to climb and exercise but my every day movements like walking, sitting at my desk.
John spent most of the session working on my neck and spine. I hate manipulation so when John “cracked” my neck it took me a bit by surprise but did seem to loosen things up a little. He tried the same on other parts of my spine but my body was too tense to allow it to have its full effect. For my next session John suggested bringing in a colleague for a second opinion and to try some acupuncture on the muscles in my side, which are all in spasm. I’m slightly nervous. I’ve tried a couple of needles once and found the sensation pretty strange. But it has to be better than manipulation!
John suggested that I’m almost too flexible and that it is often the case that flexible people succumb rather too easily to gravity – that might explain why I often slouch or feel the need to rest my elbow on my desk at work. “For some people it’s a head game”, John told me and I think for me that’s the case. I have to remind myself constantly to hold myself upright. Perhaps I’ll leave post-it notes at my desk, in the car, at the kitchen table as a simple reminder.
Towards the end of the session, John then gave me a few simple exercises to relieve my pain and to slowly build up the basic core strength that appears to be lacking in my left hand side. These are all really easy so can be squeezed into my hectic days.
At my last appointment with John, we looked at my shoulder movement. It seems that isn’t behaving either. Instead of using it relatively independently, I seem to be shifting my whole trunk forward, in an attempt to compensate for a lack of mobility there. I was beginning to wonder if anything was working properly? But, John remained conifdent that I can be fixed.
We moved into the gym, where John showed me an exercise on the rower with just one leg in the foot strap. I’m used to rowers, but I could see that there is a lot more to the technique than I had thought. John also showed me a couple more jumping, stepping and balancing exrcises. They all seemed simple, but were pretty challenging to actually execute without falling off balance.
I left the session with lots of homework. However, the next day I was heading away on a weekend city break. Of course, I completely failed to do any of the exercises over those three days. What is more, John’s theory that my problem is walking, rather than sitting correctly was found to be painfully correct. After just morning of wandering the streets of Barcelona I was in a lot of pain. The pain travelled from my side to my lower back, down my buttocks, hip flexor and both the front and back of my thighs – all on the left hand side. I was stopping to sit and relieve pain every 30 minutes. Over the weekend, the pain lessened a little as I tried to walk less, but I was not feeling postive about things. I’ve tried to pick the exercises up again now that I’m back in Bristol, but will have plenty to discuss with John at today’s appointment. Lets hope he can help…