I was recommended a visit to John by a colleague after living with a knee injury for the past 2 years. John and I are currently working towards getting me back running which is something I have really missed since my injury. In my first 3 sessions, John has taken a really holistic approach to my injury and has identified different links and factors that haven’t been highlighted to me before, but which make a lot of sense. Now we are working on the way I sit and stand in normal life (which leaves a lot to be desired especially as my job is largely desk based) as a starting point to work towards running. I’m not having to do loads of exercises every day but rather I am trying to think about and be aware of how I’m holding myself (or try not to think too much as this seems to be the problem!) and to re-programme old habits. I have booked a 10k race in October so this is what we are working towards, fingers crossed!
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.
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.
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.
‘I suffered a severely fractured Calaneum (heel) bone during a stag do in Berlin in the summer of 2014. It resulted in open reductive surgery where a plate and screws were fitted and I was unable to weight bear for 3 months.
Once able to weight bear I was limping and in quite a lot of discomfort. I would get easily fatigued after periods of standing and after a day on my feet at work would need to spend the entire evening recovering. If I did socialise out after work I would pay for it the following day or sometimes days with further stiffness and pain.
I received hydrotherapy and physiotherapy sessions soon after fully weight bearing and although this helped to a degree it was still painful to walk. I still had a limp, some days were worse than others and I got to a stage where my physiotherapist expressed doubt about his ability to help me any further as I was unable to perform a heel raise on the one foot, usually doable by this stage.
John was recommended to me by a work colleague who had had a running injury. I was feeling mentally defeated at this point as it had been a year since my injury and I still couldn’t walk without some degree of discomfort. I had recently been to a wedding reception after a day at work and as a result the 2 weeks that followed had been more uncomfortable than usual. I was having severe doubts about ever being able to walk properly again.
After explaining my situation to John he worked the surrounding areas of my foot and manipulated areas in my back. I physically saw a change in my flexibility between the beginning and end of this first session. I could now move my right foot back as far as my left which I was unable to do before and it was noticeably easier walking up and down hills as I didn’t have this flexibility before. I’m now also able to perform a heel raise on the right foot and can hold this position for around 30 seconds. My confidence has improved considerably and I’m optimistic that I may even be able to resume more physical activities in the near future.’
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.
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.
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.
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.
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!
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.
Here is an update on how I’ve been getting on since my last treatment session with you back in December. I’ve delayed sending this as I wanted to include an update of the Highlander Mountain Marathon.
When I came to Physio in December I had been suffering with a strained adductor muscle (since August) and recurrent problems with my calf and ankle muscles which you’d diagnosed were caused by poor upper body posture from working at a laptop all day. I was keen to get these problems sorted out so I could be fit enough to start training in earnest in the New Year for the Highlander Mountain Marathon at the end of April. My training runs prior to seeing you had been very irregular, at the most consisting of a long weekend run and one other 10k run per week.
Your physio sessions got me back running again and the advice you gave me about my posture and running form chimed with advice I’d been given by Susie Baker, my Alexander Technique teacher, in the past.
New leaf in 2015
I decided to turn over a new leaf in 2015 and set myself a target of running or walking at least 5km every day. I’m pleased to say this is something that I am still doing and I usually only have a walking instead of running day once a fortnight or so.
Running every day
Contrary to fears that running every day was going to exacerbate the calf and ankle problems I had been suffering with, I found that the aches and pains lessened and then disappeared completely. Running every day gave me the opportunity to concentrate on my posture more and to practice running with good form. Knowing that I have to do 5km every day means that as soon as I get any pains or niggles I treat them straight away with either stretching, wobble board or foam roller as appropriate. I have even had a couple of sports massages from Katherine Golik to treat tired legs. I’m going to continue with running every day for the foreseeable future: I’m used to it now and it’s become a habit. The only thing I would add is more core exercises to enable me to maintain good form over longer distances.
Highlander Mountain Marathon and Butcombe Trail
As well as the Highlander Mountain Marathon in April (running 32 miles with 3,890m of ascent over a weekend with a backpack containing food, clothes, sleeping bag and tent), I ran the length of the Butcombe Trail during one long day in March: an unsupported solo run of 48 miles in 11 hours (which included time for map reading and stopping in several pubs on the way round for tea, coffee and extra water).
Man v Horse marathon
My next challenge is the Man v Horse marathon in June followed by a 50+ mile ultra in September.
1/ Please change your password to something more memorable to yourself.
2/ This interface works just like Word you can cut and paste form else where. Upload photos and when you get more adventurous video clips and teaching materials.
3/ To help others find you posts they are tagged with keywords and sluggs
4/ Title – its good to write a series which staying in order. E.g:
Ankle Pain No.01 – Week 1 – See the Physio
Ankle Pain No.02 – Week 2 – Rehab Advice
Ankle Pain No.03 – Week 3 – Getting better!!
Ankle Pain No.04 – Week 4 – Race Day Smashed it!!!!! 🙂
OUCH! HIP PAIN
Week two of not being able to run and after a pain-filled weekend trying to juggle a two year old who refuses to walk down the stairs, I hastily book a second appointment with John at his AAA-Physio Clinic in Bristol BS8. As I hobble (very much a left leg limp) the short distance from my office to Moti, I am aware that every step is pinching my left hip and is a struggle.
And so the debrief, I have managed to spin and row in the week since I first saw John, but the pain I’m experiencing hasn’t eased at all. In fact, if anything it’s much worse. Carrying said two-year-old halfway across the Downs to the circus certainly didn’t help.
I’ve been to the doctors (usual anti-inflammatory prescription and inconclusive x-ray) to no avail and am told it could be six weeks before I can run again…
After a brief look at the extension on my left hip (or lack of it) John sets to work on my back. I’m shocked at how painful my lower back is. Ten years post-surgery, I am somewhat used to niggling there but as John works his way around my lower spine, I feel sharp shooting pains that actually make me scream. And so, the initial diagnosis is reiterated. In my inability to stabilise my core, I’m causing myself all kinds of problems in my neck, arms and, most painfully, my hip.
BACK TO RUNNING
I think it’s going to be a slow road back to stability and running, but leaving the clinic, into the driving Bristol rain, I’m already feeling a bit stronger and if I really put my mind to it, can see how strong core (deep breath in relax into the stomach) does help ease the pain. Another challenge…and one I’m determined to win.
Top of right glute painful, John has identified that my right foot veers left just at the end of my stride, meaning my hip twists probably causing the pain. It’s only in the last month.
Question is what causes it; shoes, stance or what?
1. New tyres – popped in to Moti and the attentive chaps spent 45 mins sorting that in line with John’s instructions. Very different but comfy, hope an old foot injury in my foot isn’t aggravated as it always casts a shadow over new shoes.
2. Posture – while standing – ‘peering over cliff’, this is the one I’ve been concentrating on, feet, knees, pelvis and head, oh and chest and shoulders if a man can concentrate on more than 4 things at once! While sitting – pelvis, shoulders and head (superman eyes)
3. Running style – shorter stride landing on ball of foot not so heavily on heel, pelvis, elbows (pushing back and not too far forward), and the head, again. Needs working on at the next session.
I really should stretch more.
Been running and out on MTB, neither very good. Torn between resting and pain of getting fit again once John has worked his magic vs glute and back pain of continuing exercise.
Problem – I think I do a good level of exercise, 3-4 hours a week, often including 10-15 miles (running) off-road, I also do circuits at least once a week, in the hope that it will keep the body in shape, and that I can keep up with the kids and defeat ageing, while enjoying the countryside west of Bristol.
However, every couple of years the body rebels and all sorts of random parts of the body rebel. Back – Knees – Ankle – Neck
Treatment – ring John @AAA-Physio and get myself booked in. Somehow he identifies which bits of my back are the root cause and tells me I don’t sit properly at my desk. He also finds aches I didn’t know I had. A few crunches and 24 hours of thinking not much has changed… ..the old body is revived!
1) I really should stretch more often & use free the exercise sheets on John’s website
2) I shouldn’t wait till my backs ceases up or a muscle locks up before seeing John
3) Chasing balls is for dogs and not middle aged men!