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Hip and knee pains can occur due to injury or for any number of reasons and therefore it is important to always visit your practitioner for diagnosis and advice so that you can obtain the correct treatment for your condition.  However, here is a little self help advice that may just help you relieve some tight tissues that can result in hip and knee dysfunction and pain.

This video demonstrates two stretches that are common culprits for these complaints. (It may appear that the video has been cut short and in a way it has. I shortened it as I was speaking too much with information that may have confused you.) The only thing you may like to add to the second stretch, to make it more effective, is to raise the arm on the same side that you have the knee in contact with the floor.

1/ ILIO-PSOAS STRETCH

The ilio-psoas muscles are one of the major postural muscles; it is the main hip flexor whose origin is the anterior (front) surface of the 12th thoracic to the 5th lumbar vertebrae of the spine and attaching to the lesser trochanter of the femur (thigh bone).
Anterior_Hip_Flexes_ilio-psoas-muscles

When these muscles are tight/dysfunctional they prohibit you from taking a full stride, altering the movement of lumbar vertebra, this can lead to lower back pain, increased lumbar lordosis or an antalgic stance as well as possible hip/groin pain or, in guys (obviously), testes pain (read this if this is of interest to you).

2/TENSOR FASCIA LATAE

The tensor fascia latae (TFL) muscle originate from the iliac crest and insert into the iliotibial band (ITB); aiding in hip stabilisation, flexion and abduction. The ITB runs along the lateral or outside aspect of the thigh, to the lateral condyle of the tibia, or bony bit on the outside of the knee; crossing both the hip and knee joints. The TFL is an important stabiliser structure of the lateral part of the knee as the joint flexes and extends and therefore, they can cause a lot of hip and knee problems.

Iliotibial Band Syndrome

Iliotibial Band Syndrome

SELF-TREATMENT 

Soft tissue work – with your prickly ball or jack-knobber or foam roller (READ MORE HERE)- (we carry all of these at the clinic).

Increase flexibility – by doing daily stretches demonstrated in the video at the beginning of this blog.

Strengthening exercises – stretching is not going to do it all. The mentioned muscles may be having to work too hard because they are compensating for other muscles that are not firing properly. A plan of exercises to strengthen these involved muscles is needed. Your practitioner will be able to tell you which muscles are involved. The most commonly involved muscles are weak gluts as well as foot pronation causing incorrect alignment and function. However, please visit your practitioner as she/he will be able to advise you.

Hope you find this helpful.

Written by Anne French, BSc(Hons), MSc Chiropractic, D. C.

2 SPECIAL MASSAGE OFFERS FOR FEB!

(i)  COURSE of 4x 30 minute MASSAGES  @ £96 ( SAVE 20%)
(ii) COURSE of 8x 30 minute MASSAGES @ £180 ( SAVE 25%)
Many of you have spent January trying to shed those excess Xmas pounds, now we’re entering February, so why Massagenot continue your health regime by committing to look after your body with a series of 30 minute treatments to ease away the aches & pains & stresses of daily living.
MARATHON RUNNERS
This is also a perfect opportunity for you to add a regular Sports massage into your training programme in the lead up to & after the marathon – PRE/POST EVENT MASSAGE. Reap the benefits of sports massage:
* INJURY PREVENTION – identifying potential problem areas & working on them/ breaking down areas of scar tissue/stretching tight muscles
* ENHANCING PERFORMANCE – speeds up recovery inbetween training sessions/ removes waste, improves circulation & nutrition to heal the tissue cells/improves flexibility/improves quality & quantity of training.
* Courses can be booked from 1st February 2014
* Treatments can be shared with partners/friends
* All treatments must be used by 30/04/2014

My first pair of Vibram Five Fingers ™ (VFF’S) was a pair of Classics, in grey and orange. I loved them. The first thing I did, of course, was research how to wear them in – not! What I did do was put them on and go out all day walking miles. To begin with they were amazingly comfortable. I even quite liked the odd glances my feet were getting. But by the afternoon I was regretting my decision. I crawled home, with my calves like rocks and the soles of my feet on fire. It was at that point I looked to see how I should start wearing them.

 

            So what should I have done? Essentially: ease into wearing them gently. Wear the shoes for short periods of time, round the house, building up to local trips. The same principal as it is with running; add it slowly. Start with short distances, gradually going further. Listen to your body; don’t overdo it. Also stretch! Especially stretch your calves, quads and hamstring muscles. (There will be more information on stretching coming soon). So that is what I started to do. It took some time but I built up my resistance gradually. As I got into the barefoot idea I sought more information. One name that popped up regularly is a book by Christopher McDougall Born to Run: The Hidden Tribe, the Ultra-Runners, and the Greatest Race the World Has Never Seen. It is an interesting pop science book, with a positive outlook on barefoot running.  

 

            Eventually after 6 months I was able to wear my VFF’s happily all day, with no ill effects. One of the best things about the shoes is you forget you are wearing them. So when people started looking at my feet in confusion I would wonder why. I even had 10 people round me in a shop asking questions. Including where to get them. My advice has always been go where you can try them on. The fit is vital. They don’t fit like normal shoes, so you must go where they can give good advice. For example in Brighton and Hove, I would always recommend Inter Sport, Nick Rivett on Church Road. They are great in there.

 

            So remember if you want to try these amazing shoes, get them fitted properly, start slowly and stretch.

 

Written by Margaret Sinclair

Part 1:

Two years ago I entered the world of ‘barefoot’ footwear; an increasingly popular alternative to ‘normal’ shoes and trainers. These are my experiences.

The theory is that humans had been running barefoot for a long time before big brands started manufacturing the modern trainer. They had to run, and run well to catch their food and to avoid being food. Therefore the foot is perfectly designed to run without all these mod cons of cushioning and stability etc. That is, at least, the theory.

People who advocate barefoot running claim benefits ranging from improved posture, faster running times and fewer injuries. Also a more connected feeling to their body and earth. They can be very evangelical about it. Opponents to the new ‘fad’ claim that there is increased injury (especially metatarsal fracture) and possible future problems from such unsupported foot use. There is evidence to support both arguments. The answer is somewhere in-between and is individual to each person.

I have Vibram Five Fingers© (VFF’s for short) they are like gloves for the feet. They have very thin soles to enable increased awareness of what is under your feet and allow as much intrinsic mobility of the foot as possible. They also have individual pockets for the toes, allowing increased ‘wiggle’ ability. It is the nearest thing you can get to walking barefoot, with some protection from what is on the floor, which can be gross.

One of the things you have to know before you wear them is that everyone will look at your feet and ask you questions about them. They are a bit like Marmite; people will love them or hate them.

The second thing to know is that you have to build up wearing them slowly… Or you will end up in pain! The muscles of the foot need time to build up and this does need to be done slowly. You would not just go and run a marathon without some training, not without hurting something anyway. In the same way, you need to train your feet and legs to work barefoot again. So start small and build up time and mileage.

So how did I get to own my first pair of VFF’s, one of the more unusual looking ‘barefoot’ shoes? It was not for all the benefits highlighted above. My partner saw a man wearing them, thought they looked suitably odd, decided they would suit me perfectly and accosted the man for details. And there began my love affair with these weird looking but, in my opinion, amazing shoes.

Written by Margaret Sinclair, Osteopath.

Well done all you Brighton Marathon runners. What a great atmosphere from some great people.

It was my great privilege to try to help those runners that found their way to my portable massage table outside the clinic on Church Road. Interestingly – not one of my many patients that ran the Marathon needed my help. (Could it be that they already know how gentle I am with soft tissue work – or – that they are in such good shape?)
So much fun mixed with so much pain. Don’t know how many of you did it. Such conviction.

Congratulations and see you next year.

Low lunge 1

Regular running without sufficient stretching will cause muscular tightness leading to imbalances in body.  The body will then find ways of compensating to address these imbalances, leaving the runner prone to injury.  Incorporating a few yoga postures into your routine will increase your flexibility and strength, helping to safeguard against injuries.  In addition, a regular yoga practice allows one to become more attuned to the body and any warning signals it sends.

Try these few yoga postures after each run (and on non-run days if you can) and your body will thank you for it! Here are a few important guidelines before you begin:

–          Cast aside your trainers and practice in bare feet on a yoga mat if you have one.

–          For the standing poses, pay attention to your feet.  Always keep the inner arches lifted to avoid pronation and press down evenly through the ball joints of the big toe, little toe and the centre of the heels.

–          Stay in each pose for 5 to 10 deep breaths through the nostrils.  If you can’t breathe comfortably, then ease off a little until you can.

–          Keep your core strong by drawing your lower abdominals (below the navel) in towards the spine.

–          Once in a pose, try to draw your awareness inwards by focussing on your breath and feeling what is going on with your body, rather than concentrating on the external form of your body.

–          Never ‘bounce’ your way into a posture – hold steadily and comfortably!

–          Only go as far as is comfortable but whilst feeling the stretch – if you keep practicing regularly you’ll be amazed at the difference.

Setting the foundations – Mountain Pose

Stand with your big toes touching and heels as close together as comfortable and spread your toes.   Have your arms by your sides (middle finger in line with outer side seam of your trousers).  Ground down evenly through the balls and heels of the feet whilst lifting the inner arches.  Engage your quadriceps to stabilise your kneecaps.  The pelvis should be in ‘neutral’ with the lower back neither arched nor flattened.   Draw in the lower abdomen to feel a gentle release in your lumbar spine.  Lift the ribcage away from your pelvis and reach the crown of the head upwards, whilst allowing your shoulders to relax down.  You may feel a little taller!

Mountain pose

Benefits:  teaches correct alignment of the whole body and good preparation for other yoga poses.

Chair pose ‘Utkatasana’

 From Mountain pose, inhale and raise your arms over your head pressing your palms together (if this is uncomfortable, keep hands shoulder distance apart).  Exhale, bend your knees, tracking directly over your toes, coming into a squat as if you are just about to sit into a chair – the torso should lean forwards so it forms a 90 degree angle with your thighs.  To come out, inhale to straighten your legs and exhale lower your arms back to Mountain pose.

–          Keep your heels grounded and your spine in neutral with the back of the neck long

–          Gaze forwards or upwards, encouraging your breastbone to lift without arching your lower back

–          If the palms are pressed together, draw the inner elbows towards each other to broaden the upper back.

Chair pose

Benefits:  Strengthens the ankles, calves and thighs whilst stretching muscles of shoulder and chest.

Warrior III

From Mountain Pose, exhale and fold your torso forwards until it is parallel with the floor whilst simultaneously raising your left leg behind you, so that you form a ‘T’ shape with your body. Reach your arms back by your sides; or out to your sides for more balance.  Gazing forwards may help your balance whilst gazing to the floor will further lengthen your spine. To come out, exhale, lower your leg and arms and stand upright.  Repeat with the opposite leg.

–          Keep the hips square to the floor.  The tendency is to lift the hip of the raised leg, so encourage the thigh to internally rotate to correct this and point all 5 toes down to the floor.

–          If it is too much to be parallel to the floor then you can come to the halfway point, but always keeping your lifted leg in the same line as your torso.

–          Push back through the heel of your lifted leg as if you were pressing the sole of your foot into a wall behind you.

Warrior

Benefits:   a great strengthening pose for both legs and the gluteals, whilst stretching the hamstring of the standing leg.  Also tones the shoulders and strengthens the core and back whilst improving balance and concentration.

Flank stretch ‘parsvottanasana’

From Mountain pose, Inhale to step your right foot forwards about 2 ½ – 3 feet with the toes pointing forwards, then turn your left foot outwards about 45 degrees (think ‘ten to’ on a clock). You do not want to be standing on an imaginary tightrope with your heels directly aligned, instead imagine you are standing on a narrow railway track so that as you square your pelvis and torso forwards, your sitting bones are aligned with your heels and you feel balanced.  Exhale to take your arms behind your back and hold opposite elbows with your hands, so your forearms are parallel to the floor (or hold your wrists if your shoulders are tight).  Experienced yogis could take ‘reverse prayer’.  Inhale broaden your chest and draw your shoulders together and lengthen your spine.  Exhale fold forwards from your hips over your right leg as far as you can whilst keeping the spine long and both legs straight.  Gaze towards the right foot.  Feel the stretch in your hamstrings. To exit, inhale whilst pressing through your feet to come up and then exhale to release your arms.  Repeat with the left leg forwards.

–          Do not round your back – fold from your hips and lead with your breastbone.

–          Keep your neck in line with your spine. 

–          Avoid collapsing in the chest by keeping your shoulder blades drawing together towards your spine.

–          Keep both legs active – engage your quadriceps to avoid ‘locking’ out your knees. 

–          Press down through the ball joint of your front leg’s big toe and the heel and outside edge of your back foot.

Flank stretch

Benefits:  Strengthens the legs; stretches the spine, shoulders hamstrings and hips.  Opens the chest.

Low lunge

This pose is best done on a mat or at least put some padding, such as a folded towel, under your back knee.  From an all fours position, exhale and step your right foot forwards between your hands with the toes pointing forwards.  Your right knee should be directly over your right ankle, shin vertical.  Then slide your left knee backwards until you feel a stretch in the front of your left hip and thigh.  The top of the left foot should be flat on the floor.  Inhale to lift your torso to an upright position and rest your hands lightly on your right thigh, with your chest lifted and shoulders back and down.   To come out, exhale lower your torso and bring your hand back under your shoulders.  Repeat on the left leg.

–          Press down firmly with your front foot

–          Draw your tailbone down to the floor whilst lifting the pubic bone upwards

–          Keep your lower abdominals engaged and lift through your pelvic floor.

–          To deepen the stretch, if you feel stable:  Inhale and reach your arms overhead, pressing your palms together and lift your gaze towards your thumbs.

Low lunge 1

Low lunge 2

Benefits:  Stretches the quadriceps and hip flexors of the back leg.  Provides a gentle extension for the spine so lengthens the front of the torso and counteracts rounded shoulders.

Boat Pose ‘navasana’

Sit on the floor then bend your legs and clasp the back of your thighs with your hands, drawing them towards your torso.  Lean back with your torso slightly whilst lifting the breastbone, drawing your lower abdominals in and find balance on your sitting bones.  Now lift the feet off the floor as you allow your arms to reach forwards at shoulder height.  Your torso and thighs should form a ‘v’ shape. Try to raise the shins parallel to the floor keeping the feet together.   To release bring your feet back to the floor and arms by your sides.   Repeat 3 – 5 times.

–          Spine should be straight throughout – keep lifting your chest and drawing your shoulder blades back and down.

–          If this is too difficult or you find that your back is rounding, drop your toes to the floor.

–          To deepen the pose, straighten your leg so that your toes are level with your eyes.

Boat pose 1

Boat pose 2

 

Benefits:   strengthens the abdominals, hip flexors and spine.

Hero’s pose

Kneel on the floor, the tops of your feet should be on the floor with the toes pointing straight back (this is very important – if your toes are turned outwards this will strain the inner knee).  Your knees should be very slightly apart and feet a little wider than your hips.  You will probably need a prop to sit on so place a few yoga blocks (if you have them) or a telephone directory or some folded towels between your feet, so as you sit down your buttocks are raised off the floor.  Sit with a tall spine and feel the stretch in your quadriceps and the front of your ankles.

–          Hold for as long as is comfortable – build up gradually, eventually aiming for a few minutes.

–          If you do not feel the stretch then you can lower your prop or perhaps take it away altogether so that you are sitting with buttocks on the floor.

–          Ensure there are no pulling sensations in your knees.  If you find that there is then check the alignment of your feet (toes pointing straight back) or make your prop a little higher.

Heros pose 1

Heros pose 2

Benefits:  lengthens the quadriceps and front of the ankles.

Written by Ginny Haswell, Yoga Instructor. 

Running the Brighton Marathon?

 Richard Husseiny, Sports Therapist and Anne French, Chiropractor, will be offering FREE road side help for those runners who need just a bit of help.

You will find us on the street, outside our clinic at 198 Church Road, ready and able to help and cheering you on.

Tell your friends and spread the word…

Richard Husseiny, our Sports Therapist, has been with Coast since the first day we opened. In that time he has completed a BSc (Hons) Sports Therapy, LSSM Dip and MSST and is currently on the home run of his MSc in Strength and Conditioning.

Richard has worked with focused determination to achieve his goal of training professional athletes and all that hard work has paid off because he has been taken on as the Strength and Conditioning Trainer of the Olympic diving team. Way to go Rich!  We are really happy for you.

 

Rich has written this months blog on an injury that many runners suffer with, unnecessarily, Iliotibial Band Syndrome.

 

 

Iliotibial Band Syndrome           

The marathon season is fast approaching, with 2 of the UK’s most popular marathons close by. If you are running either the Brighton or London marathon this year, you should be well into you’re training and hitting double figure distances. Having miles under your belt is the key to successful marathon running. Yes, interval training will enhance your aerobic condition and improve your ability to run at a higher VO2%, but running economy is optimally enhanced by the volume of miles that you do.

 

The nature of distance running, and that of cycling, means that the linear, repetitive stride pattern can cause overuse injuries very quickly, if you fail to look after your body. Stretching AND a well-structured strength plan are essential for better performance and optimal tissue quality. Without this in place, common injuries can occur such as ITB syndrome.

 

Iliotibial Band Syndrome

 

 What is the ITB?

 The Iliotibial band (ITB) is a superficial thickening of tissue. It attaches from the TFL (tensor fascia latae) and the butt (gluteus maximus) muscles; tracks down the outside of the thigh and inserts just below the knee. The ITB is therefore involved with the running stride (flexion and extension of the hip) and also acts to stabilize the knee.  ITB Syndrome arises with the repetitive rubbing of the ITB over a bony part of the knee called the lateral femoral epicondyle, causing inflammation and resulting in pain.

 

Symptoms

 Symptoms range from a dull to sharp pain in areas around the knee, which can spread up the length of the lateral thigh to the hip area. This may not occur until mid way or even after your run. It may be fine on the flat but could swiftly increase with hill runs due to exaggerated hip flexion. This is not an injury that suddenly occurs; without doubt it is due to increased muscle stiffness and the repetitive load when increasing mileage.

 

Treatment

 Symptoms may subside with total rest, but that isn’t going to get you prepared to run. This is where we can help at Coast Clinic. The following 3 aspects of treatment we offer are key:

 

1)      Soft tissue therapy

2)      Flexibility training

3)      Well structured strength plan

 

 1)      Soft tissue work will release the tense musculature, release the myofascia and help the ITB run smoothly over the thigh muscles. It will also reduce any scarring that has built up in the tissues and release muscle tension through the whole area. This then buys you time to work on developing your own flexibility.

 

2)      Daily stretching and foam rolling is essential when training for a marathon. This will maintain and develop the improved tissue quality achieved through soft tissue manipulation. This must be kept up, foam rolling is a great way to prepare for any physical exercise both before and after.

 

 

3)      Strength work is also vital to performance. Muscle imbalances are very common, and can cause problems such as ITB syndrome. The very nature of marathon running is highly repetitive, which quickly highlights weak musculature. If a butt muscle (e.g. gluteus medius – which is an important hip stabilizer) is weak on one side, the hip range of movement, stability and function can quickly become compromised. Therefore, identifying any weaknesses and prescribing specific strengthening exercises are very important. Further benefits to strength work include improved muscle strength, joint stiffness (different to musculature stiffness) and tissue quality, lead to further improvements to performance and injury prevention.

 

We offer all these services at Coast (and we carry foam rollers). We can enable you to prepare and compete at any level from amateur races to the Olympic Games.

Written by Richard Husseiny, Sports Therapist.

Richard has his own blog. If you would like to follow him you can find him at  http://richardhusseiny.blogspot.com

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