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Sports Therapy, my view from the bench.

In an industry that is  ever changing, here I publish my very own views on all things 'Sports Therapy', be that my own career, Injuries, differing therapy techniques or just hot topics within the field.
by Wayne Peter 20 Aug, 2021
If you have taken the time to come to this blog, then the chances are, you: Love to keep fit, train a number of times a week or maybe you have even signed up for your first ever event. Whichever that may be, each of those places significant demands on our body. Not only that but I expect 99.9% of you unfortunately are not elite athletes who have the luxury of time set aside for recovery. All have your own daily working lives to consider also. Exercise and training is a hobby and one you juggle around a career and family. So taking this in mind, the stress on our body systems can be considered even greater The conception is, that more time spent exercising, the increased workouts and greater the number of miles in the tank, the fitter, stronger and quicker we will get. Yes, an element of this is true, but without ample rest and recovery, you are only asking for trouble. Following good recovery protocols while banking all of those mentioned is a necessity and should be considered as important as the training itself. To continually keep putting the stress of exercise on your body without stopping to allow it to ‘heal and adapt’ is pointless. In actual fact, it is during the recovery period that the physiological adaptations are enhanced to make you a fitter /stronger/quicker. Its where the body ‘sucks all that work and effort in and those seeds planted, germinate and grow’ Its Imperative Recovery is planned into any training schedules before it’s too late and fatigue takes hold. Fatigue – I’m so tired even my tiredness is tired ! Prolonged periods of exercise, training with inadequate recovery will dump your body into a great big hole. Fatigue not only hinders your daily life but it will severely compromise the training you undertake and steeply reduce any performance outcomes. Fatigue is multi-faceted and also subjective; it comes in several forms and can creep on you slowly or hit you like a proverbial bus. Not everybody experience of fatigue is the same. You can experience any number of fatigues forms: Metabolic -waste products trapped within over used muscles causing pain and soreness. Tissue Damage – Injury thus preventing muscle use Neurological – overwhelming tiredness enough to stop performing normal everyday activities Psychological – interferes with cognitive and emotional performance including lack of motivation, stress, libido and impaired mental function Environmental Fatigue – Body’s inability to adapt to changes within it, eg we become more susceptible to infections, dietary issues may occur and other physical issues can occur or be inhibited within the bodies autonomic systems. In short fatigue takes us down, and once it is identified we are suffering with it its often a case of ‘after the horse has bolted’. We need to address the current situation but more importantly learn and make sure we never encounter it again. Good recovery practice – ‘ Go hard or Go home, UMMMM No’ It’s easy to get drawn into all the latest trends and fads, especially in the age of influencing and social media. We don’t know what is right and wrong, the fact a well-known sportsperson or athlete may be promoting some gizmo or potion, doesn’t mean its good. Remember they are being paid to do so and generally when you cross their hands with silver, they will promote anything. So, within all that noise, what can be described as the best Recovery protocols and ones we should be implementing? Well surprisingly enough the imperative ones are absolutely free (to a certain extent) and can be done in our own homes and adhered to daily! They are: ample Sleep/Rest, Good nutrition and ensuring always hydrated. Anything else can be considered supplementary, is usually subjective and all have their pros and cons. Sleep/ Rest This is essential and where the body recovers and regenerates (where we soak all the good work up). Not just getting ample sleep ( 8 hours daily) but also taking time out is highly important. Take time out, build in rest days to your schedule and treat yourself. A dramatic drop in performance and significant lingering of fatigue is a signal you are over training. Your body is now screaming for rest. Good nutrition “What you put in the machine makes a huge difference to what you get out." A good balanced diet is also imperative, it’s impossible to drive performance with crap. I’m not a nutritionist but we all know what is considered ‘good for us’ and considered ‘bad for us. I’m not saying become obsessive with your diet as that has major downfalls on its own, but airing on the side of ‘healthy’ is the best option, yet don’t forget to treat yourself now and then. Just like a car, the further you push your body the more fuel it needs. It wont run on empty and definitely won’t recover,by taking it into the red then you’re slipping back into that hole . N.B Consuming carbohydrates and protein after training/exercise is imperative (within 40 mins). Ideally, a 4:1 ratio of carbs to protein is the suggested norm. This helps the muscles rebuild and regenerate. Good Hydration You should be already taking in fluids during the day at least 1.5- 2 litres a day (tea coffee ), but its vitally important to consume more water and sports drinks during exercise, as we need to replace the fluids lost . Studies prove even being slightly dehydrated can affect performance. Research indicated that runners who only replaced 75 percent of their sweat lost during exercise, were 3 percent slower than when they rehydrated over 100 percent. Remember the body is 70% water, the moment it drops below that level it becomes unbalanced and inefficient. NB .Tea/ Coffee/ sugary and fizzy drinks don’t count as good hydration The following are methods considered by some to be beneficial , they are subjective and may not be backed by science , but in my opinion if they make you feel better then why not . Ice (cryotherapy) Icing, old fashioned but time-tested method of recovery. Exercise can cause a lot of inflammation in the connective tissues in your limbs, this is where overuse injuries often happen. By reducing the blood flow through icing or an ice bath, that inflammation is reduced. Massage If you can afford and have access to a fully qualified Sports Therapist or Massage Therapist it could be worth every penny. They can help alleviate and remove tension and metabolic compounds which become locked into your muscles after exercise. Alternatively, there are methods you can use at home e.g A Foam Rollers,massage guns etc Recovery Supplements Are just that, a supplement should not be used as a replacement to decent diet. They enable us to get the further protein, carbohydrates, vitamins and minerals into the body needed when training. But all of those can be found in a good healthy diet. If I was to suggest the best supplements to take alongside, I would suggest a good quality Whey protein after exercise and a fish oil taken daily. Gentle walk / swim/ or static bike Good practise and utilised in elite sport, gentle muscle use helps drive metabolic compounds produced during exercise (waste product) out of the muscles and secreted from the body. But don’t go to hard or too far, ‘gentle’ is the key word. Compression wear Again increases pressure around muscles which promotes blood flow again aiding reduction in metabolic. Warm Bath Increases blood flow again, relaxes muscles body and mind. Why not jump in and Relax. Whether you choose to utilize all or just a couple of these recovery methods, you are likely to notice improvements almost immediately. Keep in mind that whether you down a recovery shake, hop in an ice bath, or commit to a foam-rolling regimen, small changes in your approach to recovery can equal big improvements in performance and wellbeing.
by Wayne Peter 04 May, 2020
Still rolling your IT bands ? , Your therapist persists in sticking their elbows in them ? Yeh it hurts doesn't it , in-fact it's Bloody excruciating . So Why ?? Firstly what is it and what does it do? The " IT band " , iliotibila tract to use it's anatomical description , synergises leg abduction , rotation. and flexion and also stabilises the knee . It is a dense piece of connective sinnuse Spanning the Gluteal maximus tendons and tensor fascia lata ( Your bum and side of your hip ) and going on to connect to the Lateral Condyle of the Tibia (side of your knee). It's part tendon part fascia , it is RIDICULOUSLY strong . In-fact it's that strong a study by 'chaundry et al' concluded : A force of over 9000 Newton's (900kg) is required to produce just a 1% change to it's structural length . Putting that into normal perspective , it's the equivalent to having a Fiat 500 drive up and down the side of your leg . So next time you look at that Foam roller, or your Sports Massage Therapist starts polishing their elbows. Pause for thought and ask yourself . Is all that pain actually worth it ??? There are other things you can do to help release the structure as a whole , not intrusive and not painful and I will discuss them next time
by Wayne Peter 04 May, 2020
When a Therapist says it will take 5/6 sessions 🙄 The number one question I must be asked by my clients is: ' How many times do you need to see me again? '. My answer " I don't really want to see you again! ". Now this probably does not win me business man of the year , but I'm not a business man , I'm a Sports Therapist who believes in honesty and putting the client first before my own financial gain . If a patient is continually walking through my door , then one of us isn't doing something correctly . The body is a miraculous machine , which given the correct stimulus and guide will do a bloody good job towards healing itself from injury . My job as a Sports Therapist is to apply that stimulus (using techniques I feel fit the issue presented) and point the body in the right direction ,in terms of your own therapeutic response (Rehab and exercise ) .I explain It's 30% what I do but 70% of recovery is down to the patient by completing the rehabilitation and recovery protocols I've provided . Now yes there are odd occasions where things don't quite go to plan and hurdles in recovery do have to be tackled . But the crux of the message is , Exercise is the biggest factor in your recovery , not the amount of treatments from the Therapist , Movement is medicine '
by Wayne Peter 04 May, 2020
Muscle Cramp With Pre season football just around the corner and endurance sport season (Running / cycling ) now in full swing, discussed is a subject that I am sure a number of you may encounter or have done so historically Cramp or Exercise-associated muscle cramps (EAMC) to give them their technical term , are among the most common problems encountered by an athlete and probably the most common I deal with pitch-side during this busy period . This problem typically happens only during extreme exertion and is far more common towards the end of games/races or sessions. It seems to be extremely subjective with some players frequently experiencing cramp more than others . Due to this it seems likely that there is a genetic component to cramp (a predisposing gene has also been identified). The fact that many athletes describe a family history of cramp also supports this hypothesis. Age also seems to be a factor with older individuals having an increased risk of cramping. What may surprise you though, is , scientific research disproves the widely held belief that cramp is caused by either dehydration or electrolyte abnormalities, where evidence suggests that it does appear to be a direct consequence of muscle fatigue. Cramp typically involves muscles which cross two joints (like the calf, hamstrings or quadriceps) but can often affect others , Athletes can often describe a prodromal – “cramp prone state” – when the muscle feels vulnerable which then precedes the onset of symptoms . At this period the individual may have a sense of tightness or muscle pain or be apprehensive that cramp is imminent. I like to describe cramp to athletes as a sort of protection/warning mode , letting go the body know via painful spasm that the muscles are exhausted and further use could result in greater injury .By forcefully engaging an involuntary contraction thus not allowing us to use that muscle effectively So how do we treat Cramp ? The acute, on-field management of muscle cramp involves stretching the affected muscle with contraction of the antagonist (opposing muscle) , you've seen the one , player standing over the other stretching out the leg . Once an athlete has developed cramp however, it is very likely that they will need to be substituted or cease activity Given that acute muscle cramping can be difficult to manage, it is important to try to prevent this from happening, a 'prevention is better than cure ' , if you like . The key protocols involves being adequately prepared and conditioned for your sport How can we prevent cramp ? Well it's not guaranteed we can prevent it occurring but there is a possibility you can reduce the likelihood. -Make sure that you are well trained and prepared for your match or sport . This comes down to an active strength and conditioning regime . Seek a suitably qualified individual to help you with this if you are unsure -Keep and train regularly at similar match /race intensity, and duration. -Increase and undertake regular flexibility sessions (stretch) during a match as this can be helpful. -Remain well hydrated and fuelled, and ensure adequate carbohydrate intake (this will help to prevent and slow down the onset of fatigue ) * Note if you suffer from regular cramp and it is not during or post exercise then it is suggested you seek advice from your GP.
by Wayne Peter 04 May, 2020
"Ah its only a bit of pain, we are not doing anything if it doesn't hurt ! " If ever you hear the above sort of statement from a therapist, chances are you're at the wrong one. Any form of massage should not hurt !!! Massage is a therapeutic intervention to muscles tendons and fascia and receiving it should be subjective, its not a 'one fits all technique ' The fact you have to lie there with gritted teeth in a state of constant apprehension, should scream warning and also highlight what is happening isn't therapeutic at all, just painful, would you punch yourself in the leg several times with the notion it's painful so obviously it is doing you good ??? A good therapist and the pressure they apply with their techniques will be governed by the response of their patient ' let me know the depth and pressure that feels comfortable for you?, Would be a reassuring statement to hear. Deep tissue massage says what it is on the tin , as therapists we are trying to engage a therapeutic response from the deeper tissue as well as the superficial .By pressing harder and inflicting pain , the bodies nervous system will just go into ' flight or fight mode' and guard against the intruder that is inflicting the discomfort, by tensing and contracting the muscular system ( that grit your teeth and groan into the treatment table time ). In doing this the therapist can no longer access those 'deeper areas of tissue' so in all , not achieving anything positive. There is more than one way to skin a cat and far more effective methods than inflicting pain, a good therapist will know and utilise those. So next time your lying there thinking your doing your body a favour, remember pain generally means damage and damage is not good and the perceived feeling of well being afterwards, is only probably because your body is thanking you for no longer subjecting it to torture . Wayne
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