Category Archives: knee

KNEES – RUNNING REBUILT #02

Last week I did Neural Flossing, by the end of the week I was experiencing hip pain in my left hip and stiffness when I stood up after sitting for long periods of time. To combat this, John provided me with a different stretch – putting my legs in a sort of figure of 4 while lying on my back, this stretched my lower hip and upper leg area – after a couple days of doing this the hip pain disappeared. The combining of this and the Neural Flossing is working on increasing the degree of movement in my left leg.

 

physio-neural-flossing-ra physio-neural-flossing-stretched physio-hip-stretch

This week I went on the treadmill to look at how I walk and run; a muscle in my left hip/upper bottom does not engage when I walk, I almost learn back which could be contributing to my back pain, as well as twisting my upper body while walking and even more so when running. While running I bounce up and down a lot and I put my heel out in front of me, which means that I am not exerting energy in the right places while running.

To combat these habits John gave me the following exercises to work on over the week:

  • 5-5: Setting the treadmill on 5 incline & 5 speed, where I need to engage my core and lean forward to promote me walking on the front of my foot rather than leaning back on the heel.  While doing this I put my hands on my hips/upper bottom to make sure my muscle was engaging.
  • Use the treadmill to lean forward like a ski jumper, and using one leg at a time to practice my leg movement where my foot will land in line with my body (rather than out in front), this is through pretending I was on a scooter with an angry horse leg that goes up, round and down. Then using the treadmill to pretend that I was bump starting a car – this was to help me with leaning forward, bouncing less while running, and running with my feet landing below me not out in front of me.
  • Arm Swing – stationary – this is engaging my core and standing like a person about to skip – moving my arms forwards and backwards close to my body in an exaggerated running movement, but not allowing my body to twist as I moved. Then doing this while on the balls of my feet – this I found a lot harder due to my inability to balance.
  • John also sent me a video clip that provided tips on running and form to improve over stepping – it focused on bum kicks, skipping and running barefoot.

arm-swing

This week took a lot of thought as I had to concentrate on a lot of different areas of my body at once, but it’s crazy what difference engaging your core can do.

Knee of little faith #01

It’s happened. After merely a few days of setting my (annual) New Year’s resolution of ‘don’t get injured’, I appear to have fallen at the first hurdle. Not literally thankfully – that could be messy – but I’m certainly not in one happy piece. 2015 is set to be my biggest athletic year to date with, at the very least, 2 marathons, a half Ironman and full Ironman, so, naturally, I panicked that the Ironman dream was over.

I am suffering with, what felt like, a twisted left knee; discomfort around the inside base of the knee, but only whilst I am running. The initial cause is unknown, although it may have had something to do with my last pre-Christmas 35 mile run. Weeks of no running and rest, since then, have yet to alleviate the problem, or my bad mood. However, a miracle, in the form of a friend’s advice, saw me booking an appointment with local physio, John Stephenson.

After performing a few one leg squats on both sides, John identified that there was indeed a difference between my two legs; notably that my hip was dropping on my left, but not my right. He explained that this was due to the nerve paths on my left side, specifically the four lumber spine nerves that innervate muscles in my leg and foot. John individually tested each lumber spin nerve path (L1-4) on both my left and right sides, at various points on the leg, via the application of force manipulations (i.e. pushing against my knee in a particular orientation and telling me to push back), and then assess the corresponding strength of my response. Of course, the strength of my right side passed with flying colours, but John identified that my L2 and L4 responses (namely my knee and toe extension) were very weak on my left hand side, including a very unresponsive duff big toe.

Although the anatomical explanations involved are rather confusing, one target of John’s fix is to remove the tightness in the muscles at the base of my back, where these nerve paths originate. This will then hopefully begin to remove the tendency of my knee to bend in during my runs. For now, my homework is a simple exercise (split squats), as well as booking up a few follow-up physio treatments.

Safe to say, I am feeling much more confident, after hearing John’s diagnosis and expertise, that the future won’t be limited to deep heat and ‘rest’. More importantly, Operation Ironman is still very much go-go-go. Consider my resolution reaffirmed.

Physio for knee problem #02

KNEE CAUSE AND EFFECT
I returned to John for my third physio session this week and we continued to explore the causes and effects of my postural imbalance.

In the week I had been returning to the gym and found that, whilst there have been dramatic and notable improvements in my squat, which had been fairly reduced before, I was still having difficulty at the very extremes of my movement. I found that, when rowing for example, I was able to achieve a very “tucked up’ position only after easing my knee into the posture over a period of about 30 seconds.

ON YER BIKE!
I had also been biking, partly on John’s recommendation, as this allows fluid to flow around the knee and promotes recovery. I am finding cycling to be fine, with no real discomfort except upon extreme hills – which I am still avoiding for this reason. Occasionally I experience stiffness the next day but this is only equivalent to what I experience when sat stationary for an hour or two.
MANIPULATION
Once again John performed some manipulations, this time on my neck. This was both an alarming and enjoyable procedure; I’ve never heard my neck make so many cracks before, yet I felt as though a lot of built up tension had been released. This too had a remarkable and instantaneous effect upon my flexibility.

ILIO-TIBIAL BAND
Towards the end of the session we practised walking and running. It seems that, due to the muscular imbalance in my body, I over-rely upon my IT band for walking and thus my hip rotates forwards. I was shown how to become aware of this and told to practise on an ergo-rower, treadmill or when walking and running.

Physio for Knee Problem #01

KNEE DAMAGE
I first came to see John three weeks ago after damaging my knee. The injury was caused, about a fortnight beforehand, by performing the (slightly ridiculous) task of standing up with a friend on my shoulders whilst on the side of a fairly steep slope; as I stood up I felt something lock and, as soon as I had put my friend back onto the floor, I felt a painful ‘ping’ inside my knee.

The day after I had sustained my injury I could barely walk, I limped up and down stairs and generally avoided putting any weight onto the leg. The knee had swollen and was fairly painful to the touch, causing movements or weight-bearing to be difficult. Thankfully, at first, the swelling seemed to reduce with each passing day and the pain involved in using the joint subsided with it. This lasted for around a week at which point my recovery seemed to stall and I contacted John.

PHYSIO
My first physio session was mainly focused on determining the cause of the pain and swelling: John spent a long time testing my flexibility and movement range, along with probing my knee for ligament damage. He said that, at first, he had suspected my ACL had been damaged due to the injury being caused whilst facing downhill on a slope, luckily this was not the case. By the end of the session John believe the cause was likely to be a twisting within the kneecap caused by muscle imbalance that had caused the fat pad to become upset and possibly to catch.

We ended the session by discussing “dynamic sitting”, a method of adjusting seated posture to relieve muscle tightness and fatigue that will hopefully correct my postural imbalances. I feel that this is particularly important to me as my job involves a large degree of “screen time”.

During my second session with John we continued to discuss my postural imbalances and to try and work through some of their causes, along with trying to mitigate against their effects. We worked through some tests to determine neural strength and found that, in many places, the muscle on the left side of my body had decreased mobility with respect to the right: particularly those associated with the L5 nerve root. John performed some manipulations on my back that seemed to immediately have a positive effect on these areas – I was able to raise my left leg an additional 10° from my attempt before the manipulation!

PLANS
At the end of my second session we discussed dynamic sitting some more. I have now purchased a standalone keyboard and mouse that I am using to correct my posture whilst at a computer and it seems to be having a positive effect. We also discusses ” neural flossing ” and John set me some homework to investigate and try this.

Climber’s story #01

I’ve visited John in the past for knee issues but this time I was desperate…..

In this picture; tight muscles and ligaments on the front of the LEFT thigh are forcing the spine to overwork
Back & Pelvis biomechanics causing back and hip pain

It all started last summer on a trip to Montenegro. It was a pretty active trip – climbing mountains, rafting, sea kayaking. Halfway through the trip I started to experience extreme pain in the left side of my ribs and abdomen. The pain was so bad I made two trips to the local hospitals – an interesting but fruitless experience. Back in the UK, I was poked and prodded. An x-ray, ultrasound and bloods revealed nothing. A viral infection of my intercostal muscles was the doctor’s diagnosis. It would pass. I stopped climbing (my favourite hobby) and tried a chiropracter. After a few painful weeks it had receded to a twinge but never went away.
>
> Then at Christmas my body started to misbehave again. This time the rib pain came back but it was accompanied by the emergence of painful lumps on my left hamstring. What next I thought? I’ve always been a healthy active person, and I’m only 35 but now I was anxious. Back at the doctors I had more tests, more scans, but still nothing. I left the doctors with no diagnosis and no follow-up planned, but still in pain.
>
> This is the point at which I found myself back at John’s clinic. Perhaps he could help. We discussed my history and my job, which is desk based but involves lots of travel up to London for meetings. The first thing John did was a bit of a mechanical review. He checked my posture. My head is sitting further forward than it should giving me a round shouldered effect. My range of movement rotating to the right is limited and my left hip flexor is really tight. John thought there may be problems at the top and bottom of my spine, both musculoskeletal and nerve related. The side pain could simply be because this is the area that has been forced to compensate for all the weaknesses elsewhere. He even thinks that the hamstring lumps could be the result of toxins being “dumped” here from other parts of my body.
>
> I was relieved that there could be light at the end of the tunnel. John performed a few manipulations and treatments and there was an improvement in my range of movement by the end of the session. He gave me some exercises to do and was confident that he can help me. But I know I have to put in the work and make the exercises part of my daily routine. We agreed to arrange another session and I left Moti a little lighter and a lot less anxious than when I arrived.

Student Discount Physio in Bristol – £33

Discount Physio for Students in Bristol
Discount Physio for Students in Bristol  https://aaaphysio.cliniko.com/bookings

Student Discount Physio in Bristol

Tins of beans for dinner, studying and recycled toilet paper. Its tough being a student, so we thought we’d make life that little bit easier….

Bring along your student card and receive your physio treatment for as little as £33*.

Book online 24/7 or drop-in in person to the AAA-Physio Clinic @ Moti Running Store, 49 Whiteladies Road (Near The BBC)

*T&C’s apply – Pre-booking & payment essential.
£33 is the price for a 30 minute follow up appointment

Screen shot of the AAA-Physio booking using our online diary
Simple booking using our online diary

This entry was posted in ankle, groin injury, heel pain, Neck Pain, overuse injury, pain – lower limb, Physio in Bristol, Plantar Fasciitis, run off road, Shoulder Physio Expert, Sports & running injury and tagged ankle and knee pain, Bristol half marathon, bristol physio, BS6, BS7, BS8, BS9, groin strain, help with running, Knee Pain, off peak discount, Shin pain and shin splints, sports injury clinic, Sports Injury Clinic in Bristol, student discount physio on by physiojohn.

 

Posture and stability training for teenagers

These drills from The Running School (R) , have great potential for improving the trunk and lower limb strength and stability in a range of age groups.

I can see this style of exercise being particulary effective and engaging for teenagers. JS Physio MSc

Bristol Physio John Stephenson has been providing movement retraining courses for Health Professionals & Physiotherapists since 1999. He also works on a 1:1 basis with private clients wishing to improve their low back stability and running efficiency. Or for a more gentle introduction, ask about the Walk:BacK & Row:BacK programmes!
Book a consultation or free minute open clinic online:
https://aaaphysio.cliniko.com/bookings

10K Bristol in 60 or less #2

To cut a long story short (ish). Basically I was getting very annoyed and frustrated back in June 2012 because my head wanted to run long and fast but my body wasn’t having any of it. My IT Band was hurting every time I reached about 3 miles.
My IT band problem came on suddenly in Autumn 2011. I think it was when I did a 10 mile run having previously only done about 7 or 8 miles. I rested it and then kind of got used to it happening. It became worse in the spring of 2012 when I was trying to do sprint intervals as a build up to the Bristol 10K. I became really fed up when it slowed me down at the Bristol 10K 2012 and messed up my aim of finishing in under 60 mins (by 1 min), so I decided to seek help!
Moti recommended John to me. John is very thorough and finds out what is the cause of the problem and after a couple of sessions he had me running in a whole new way and after quite a bit of thought (there’s a lot of thinking involved) and effort I can now run basically as far as I want to without ITB pain. Have been back on several occasions for re-tweaks and re-aligning after my body rebels.
I didn’t manage the Bristol 10K in under 60 mins in 2013 I think it was because I had been taught a whole new way to run by John. I’m pretty sure I will do it soon because now I think I have mastered the new technique!
Oh, and don’t tell John, but I’m back doing sprint intervals training once a week! (My speed is definitely improving), and i’m still rubbish at doing any of your exercises so I don’t bother!
Hope to be back soon for a re-tweak. Thanks John 🙂