My knees painful when I run but I’ve ran all my life?!
You would not believe how many times I hear this statement across all ages….and not just with knees. Knees however take the biggest brunt of everything we do in our lives from twisting to help us in and out of the car, bending as we go up the stairs to taking our bodyweight when lunge and squat in the gym.
Therefore the littlest thing wrong with your knee and you feel it after or sometimes even towards the end of the exercise you’re doing. This pain will go but will keep coming back until it becomes permanent.
The knee is designed to be a hinge, not twisted and turned like we use it for in our lives. A knee that is being used in the wrong way or isn’t inline is therefore going to rub and get very irritated. It can be anything that causes this poor alignment or your hinge to be adjusted and then bones will then impact where they simply aren’t designed to. This causes pain and the bones to very simply wear down; just like the road that develops potholes over the years.
This wearing down of the road is called Arthritis, it’s not as scary as you think though or the debilitating “You can’t do anything and you’ve got to live with it” the GP will give you. As therapists we get very good results with arthritis as although we can’t fix or replace the wearing down of the bone we can take the pressure off so you don’t feel it when you’re enjoying your free time or exercising.
The main causes I see in the treatment room are feet that are not inline or a muscle imbalance. When the feet aren’t inline this causes the knees to roll in, bow or even snap back….therefore placing the hinge with more emphasis on one side than the other. A muscle imbalance does the same as the muscles are like pulleys and if one side of the pulley is too strong the other loses the battle and the knee or knee cap is simply pulled to an unnatural position.
So why now? It never hurt 10 years ago!
If you rub sandpaper over your hand it might hurt but it will fade……rub it every day for 10-15 years and that’s going to be tender. Your knee is exactly the same, it never one run that causes the issue but the accumulation of many runs over the years. I bet your gran used the saying…….”It’s the straw that broke the camel’s back”…….
So as you can see with your knee pain there’s never one cause but rather a number of things that need addressing if you want to continue running those miles or enjoying your free time. But there is light at the end of the tunnel….Arthritis isn’t all doom and gloom!
Until next time
I lifted a box out of my car and now I’m getting pain from my back to my foot?!
These are the tell-tale signs for sciatica……or a slipped disc…….a prolapsed disc…..or disc bulge
These are all the names sciatica goes by in the world. It’s one of the injuries that people fear the most but by actually working with it and understanding what’s going on can be helped and doesn’t have to be something that disturbs the rest of your life….the truth is ‘YOU DON’T HAVE TO SUFFER WITH IT AND WAIT FOR IT TO GO’ and ‘THERE IS ALWAYS SOMETHING THAT CAN BE DONE’. Even if it’s not 100% recovery….80% is still a hell of a lot better than you are right now.
So what is sciatica?
In the back there are discs in-between the bones, which act as shock absorbers, and every now and again they get irritated. In the worse-case scenario they bulge and the bulge touches the nerve….which is why it not only hurts in your back but also down to your foot.
The discs can be basically described as jam donuts and when you’ve leaned forward some of your jam has been pushed out the back of the donut and is touching the nerve sending signals all down the nerve.
When will it go?
The general recovery is 6 weeks, but not the 6 weeks of pain and painkillers (and their terrible side effects) your GP will tell you! I mean 6 weeks of it slowly getting better and you being able to do more, you’ll not be able to play football or run a marathon 6 weeks later but you’ll be able to start doing the things you love again…..but it won’t be easy I’m afraid!
What can I do to help it?
The worst term I hear is ……I had it before and someone put it back in……no physio can put it back in and if he or she can then you should be paying them £1000’s. and if they cracked it and it feels a load better it was simply a joint that had locked up.
As I described earlier the jam is now coming out the back of your donut so I bet your finding it comfortable leaning forward or lying in the foetal position? This however although it takes the pressure off the nerve is actually squeezing more jam out!
What you do is go in the opposite direction…..you’ve got to push the jam back! I always say to my clients ‘you could come and see me 10 times a week but doing this at home is vital if you don’t want to waste the time and effort you’ve spent coming to see me’. Basically put your hands on your bum while you’re standing up and gently lean backwards to the point of pain. It’s going to hurt like hell but this is the best thing for you. Spend 5-10 minutes doing this an hour and then 10-15 minutes icing it after. The remaining 30 minutes should be spent sat upright….like you had to at school.
It’s a psychological recovery as much as a physical recovery for sciatica….you’re going to have to push through the pain to stay upright, push backwards every hour and avoid leaning forward. But if you don’t you’re in for a lot longer than 6 weeks of pain I’m afraid…..then you’re running the risk of surgery and a lifetime of problems.
I previously helped a guy who had sciatica and it was stopping him going to work and from doing cross-fit,….. this guy followed my advice and is now back in the gym progressing himself back to the level he was before.
Be like him…. rest, stretch and sit properly and avoid it stopping the things you enjoy for the rest of your life. I see too many people who have had sciatica, did nothing and let it ‘solve itself’ only to find it didn’t and now they’re hampered as they got older and I don’t mean 80 either, I mean 45 years old and not being able to enjoy the rest of their life.
Until next time
KBS Sports Therapy
My shoulders are stopping me from finishing my classes!
Every time I try an exercise class at the gym I get 30 minutes in and my shoulders start hurting and stop me from finishing….sound like you?
This is a very common complaint with shoulders…they get tired or sore as the class or session goes on till at the very least it stops you from enjoying it but most of the time means you have to finish early or get a substitute exercise. Then the next day they feel tight right up into the neck and often stop you from sleeping.
The shoulders in about 75% of the people I see are simply in the wrong position…the shoulders are rounded and pulled forward, which puts massive strain on the shoulder blades. This causes the muscles to be tired and then when you need them to do anything they’re already over worked but can’t keep up with what you need them to do.
This pulls the muscles and shoulder blade out of position, which in turn means the muscles under the shoulder blade aren’t as strong as the muscles on the top (traps). This then pulls the shoulder blades further up and around and it’s a never ending cycle that doesn’t stop and means you can never enjoy your exercise or sports.
What causes the shoulders to change position?
Simply put….. YOUR LIFE
How many of you sit in front of computers all day? I can guarantee you won’t be sitting right…..I’m not as I write this blog! And I know it doesn’t hurt at work but this is what causing the issue. Then when you try to do anything intense your shoulders are already exhausted and pulled so they can’t keep up with what you need them to do.
Likewise with anyone who uses their arms all day….I’m currently treating a hairdresser who can’t finish a body pump class. The body pump class isn’t the problem her working position is. Not that I made her quit her job though in order to finish a class, we simply corrected the imbalance.
How can I help myself?
The easiest way is to correct your seated posture…sit upright with the shoulder pulled back a little and your knees at 90 degrees. This is going to feel strange but after a few weeks of effort it will come more natural to you and then as you keep it up will become permanent. Also don’t slouch on the couch on a night when you get in.
A great exercise is shrugging your shoulders up towards your ears then back in behind you shoulder blades and holding this position. Start at 5 second and build up to 10 3-4 times a day.
These little changes will not only help your shoulder position but mean you can enjoy your classes and not feel that endless frustration you’re going through right now.
Until next time
KBS Sports Therapy
What’s the nipping pain in the front of my shoulder?
This typically is the first sign of a rotator cuff impingement and other symptoms include an ache that goes down into your arm and a pain above your shoulder blade.
What’s happening is the muscle (or muscles) that stabilise the shoulder are getting stuck or caught in certain arm movements…typically anything about the head or across the body. Sometimes the worst pain is felt in the simple things we do like opening a door handle, putting on clothes or pouring a cup of tea.
Why does it get stuck?
The shoulder is at a very basic level a golf ball sat on a tee but at a 90 degree angle, where a complex set of muscles must work in order to keep it in that position. Yes this minimal contact of the joint gives us the full range of movement we humans have, but this sometimes comes at a cost! The rotator cuff works to provide the stability it needs not just in the gym but also whilst you’re reaching for jars off the top shelf or getting ready on a morning but it has a very small space to work, specifically the supraspinatus muscle. When the shoulder muscles (or girdle) are overused these muscles get tight and close up this space.
Imagine trying to thread a needle through a hole that’s too small…..that’s probably what’s happening right now in your shoulder! At first it starts as a slight nip then increases as the shoulder muscles get tighter to become very painful in everything you do to a point where it can even give you a constant throbbing ache when you’re trying to relax.
What can I do to help?
My first advice is to stop doing whatever is aggravating it and rest, this allows it to calm…….But the key to solving this problem isn’t in rest…..it will only come straight back again….It is to find out why it’s happening in the first place?!
Typically there will be a weakness in one of the bigger muscles so another will be overworking; this causes a knock on throughout the system of muscles that keeps the shoulder working. Every muscle is like a pulley so that if one isn’t working, strong enough or too tight another has to compensate.
By restoring the balance in the shoulder muscles it allows the bones to be in the position they need to be so the gap that the supraspinatus (the painful one you have right now) has to work is now opened up; meaning it doesn’t rub and get irritated.
Can I still go to the gym?
Yes you can and it’s vital to recovery but what you need to do is to avoid anything above head height and target the muscles in between the shoulder blades and squeeze them together with rowing style exercises.
A few weeks of simply bringing those shoulder blades together and improving your posture (sit like you had to at school) will help bring the shoulder back into balance.
Until next time
KBS Sports Therapy
Is a pain in the bum really sciatica?
You would not believe how many people come into see myself with a pain in and around the bum and the GP has told them its sciatica…..but sciatica isn’t an injury it’s a SYMPTOM!
In actual fact about 80% of the people I see who have been told it’s sciatica actually have a problem with a joint in their pelvis and this is what causes that pain in the bum!
The joint that’s not working is called the sacroiliac joint; this joint allows the lower back to twist and turn in everything we do. What happens is the muscles around it get tight and overused, often as a result of our everyday life or sports that we play. This in turn locks up the joint so that it gets stiff. Unfortunately a lot of the nerves from our lower back go across this joint so as you can imagine a tight joint grabs onto the nerves and sends pain into your bum and often around the hip and into the groin. This gets worse when you sit or stand for long periods as the muscles get very tight after being overused or used in the wrong way……
I bet you feel better when you’re up and about but then as soon as you sit down it comes straight back?!
This therefore needs a very different type of treatment and exercises to a disc bulge or trapped sciatic nerve. Its no use stretching backwards as this just makes the joint tighter, you need to go forward and across the body. I find massage works well and often just some simple hip twists at home alongside treatment can relieve the pain. The key to solving this long term however is to find out why its happening in the first place…..no one wants a temporary relief for it to come back 3-4 weeks later
Why is it happening now though?
It either comes from the feet and knees not being inline, the muscles simply not working properly or if you’re in a job where you do lots of twisting and turning. These things don’t even have to be something that you’ve just changed or started to do. Most of the time this injury in my clients is from a build up of everyday life.
The feet are the foundations of the body and just like a house it’s never going to work if your foundations are out. If the foundations are poor in a house then it’s going to crack, what makes a human any different! This knocks the muscles out and the body responds by locking the joint up.
Any muscle imbalance causes one to overwork, which pulls on a joint as its now working in the wrong way. The muscles then pull the joint closer and closer together.
Any finally any twisting and turning knocks out the alignment of the pelvis with the ribcage. The pelvis and rib cage work together as a big trunk. This repeated twisted and tuning then causes one part of your pelvis to work too hard so the muscles get tight and the joint locks up again.
So don’t take everything your GP says as true, do a little research yourself as there’s always another option out there.
Until next time
KBS Sports Therapy
I pulled a muscle yesterday….what do I do now?
My first response to this is always RICE: get it rested and some ICE on it to calm it down as it will be very sore right now.
There’s a huge misconception that icing helps bring the swelling down…it doesn’t, it just helps calm the area and reduces the pain you’re going through.
The body must start the recovery process from the trauma you have just sustained, so that you can heal properly. For this to work and for you to get the best recovery my recommendation is to rest and ice for 3-4 days after the injury. This is a vital time for the body to heal and then it can recover more effectively in the next few days and weeks.
After 4 days then start to get moving and stretched it out gently. For a hamstring or groin strain then a gentle walk or even a slow jog would be beneficial to help stretch it. As a treating therapist this is also the prime time to come in and get treatment.
Scar tissue is starting to be laid down soon so it is vital you use the muscle gently so that it aligns with the original muscle tissue. If you don’t the scar tissue instead of it being realigned can set like cement, which is then going to re-tear another time when you get back to your normal exercise or sports. This period is also where you would slowly progress the exercises you do and intensity of your walks or runs so that it’s not a ‘big jump’ back to competition.
The biggest single mistake I see is people resting till it feels ok and then returning…..it’s only 50-60% recovered at this stage and needs a lot more preparing it for the return to sport.
Typically 3-4 weeks for a ‘good’ muscle tear is average for you to return to the levels of exercise you were pre-injury. Any earlier and you’ll be feeling ‘ok’ and wanting to ‘give it a go’. From my own experience of previous calf pulls……DON’T! You might get away with it first time but it will go the second time! And even after you play your first training session or game or even finish you first run its going to feel sore and tender the next day…it’s the first time it’s been used properly in weeks. So ice it that night and lots of stretches the next day……. even more importantly don’t go out and try to do the same thing the next day! Have 2-3 days of rest, exercises and stretches as the muscle although will be repaired it’s still a little weak so overworking it will cause it to pull again.
Until next time
KBS Sports Therapy
As soon as I train harder I get injured and have to start all over again?!
17th July 2017
This is a frustration I see not just across runners but all sports……just as you feel you’re getting somewhere you pull the same muscle or get the same pain as the last time!
Why does it happen then…….
Simply put….something isn’t working properly!!
All the muscles and joints that you use when you run, cycle or play sport all need to work in harmony. If it’s a sport you’ve done all your life then your body has adapted and catered for it. A new sport or activity is something completely different. You’re body won’t have the muscle strength or function to react to what your body is now required to do.
Most of the runners that I see with this recurring injury haven’t been running for long and they’ve have started steadily and are now in a position where they want to run a half marathon or want to take it onto a more serious 10K then just a run around the park or dene.
This means your body has to work harder so just like anything you have to train yourself to do it. This takes time and thinking that as you have ran 3-6 months socially means your now able to run 10K as fast as you can simply isn’t correct. Your body isn’t going to like it.
My clients are sick of me using Mo Farah as an example…think how long he took from dominating the Olympics to running his first competitive marathon. If Mo has to take 6 months to a year to modify his body…where by the way he has the best supports staff in the world and doesn’t have to go to work…what makes us; Joe Bloggs think we can?! This is the message I need you to take, your body is amazing at adapting to anything you put it through but if you don’t give it time then it’s going to break down.
When I started my career the first month I was worried about how I was going to cope with the demands of the job as I was in pain all over my arms and back. Now I have job related tightness but I correct it at the gym and with regular massages to loosen the muscles off when I overuse them.
But I’ve done it for years and it’s only now that I get a problem!
Injuries cause the body to accommodate. Over the years you’ve trained and played I can guarantee you will have had little niggles and injuries. The body has to adapt for this so muscles get tight and joint get worn. Add to this you’ve been working for 10-20 years where if you sit at a desk all your core muscles get switched off. Or in a manual job where just like myself, your muscles get tired and stiff causing you to pull other muscles and they get overused as well.
Your body now finds it harder to help you compete.
But how do I know what is causing it?
It could be muscles that are tired, weak and overused or it could even be a biomechanical fault. You just don’t know until you get it checked. A good professional will assess and look at what’s going wrong. A muscular issue simply needs retraining whereas a biomechanical fault needs correcting….a foot or a pelvis that is out of line is going to cause a huge amount of stress on the body. A simple check up now could save you from a year of frustration before you give up and never do what you really want to do.
You’re fine to do a smaller level of exercise with no effects but as soon as you ‘step up’ your exercise level that’s when problems start……get it looked at.
Until next time
KBS Sports Therapy