To listen to the interview it can be accessed free through iTunes by clicking, here or directly from the Marathon Talk website.

As always any comments or questioned are welcomed.

The topic of this edition of the blog is inspired by two things, firstly the Virgin London Marathon is fast approaching and there are 14 weeks until runners both experienced and new to the sport will be nervously standing on the startline Sunday the 25^th of April. Secondly, my good friend Tom has started a new podcast about marathon running last week which can be found at www.marathontalk.com and is also available from iTunes. So I thought this would be an interesting topic to share with you.

Now, to be able to stand on the startline of any run and especially the marathon, it is essential to get good consistent training in your legs. The biggest obstacle to achieving this is to get injured and every year thousands, yes thousands of runners, get injured to degree that it stops them from participating in their chosen events. It often starts with a niggle and develops into something more serious such as runners knee (IT Band syndrome), plantarfasciitis (foot pain), shin splints and even stress fractures. Here I am going to share 9 simple things that can be done to eliminated some of the risks involved with running. But first let me give you the bad news, injuries are not an act of divine intervention and are caused by one person and one person alone, you! And you are the only one who can do something about it too!

1.Get your running style analysed and select the right shoes. Go to a reputable running shop where you can be filmed to assess your running style (or running gait) and get the correct running shoes for your style should you be an overpronator or should you require more cushioning then now is the time to sort this out, you are about to spend a lot of time running in these and using the wrong shoes can cause more problems than it is worth. This is often the number one cause why people come to see me in the clinic with running related injuries. In our local area you can go to Up and Running in Leeds, Sweatshop in York or Sportshoes in Bradford where they offer this service for free.

2. Change your shoes regularly. The cushioning in a normal running shoe will wear out after 300-500 miles, in general, in a male, a shoe is made for an average runner at around 11 ½ Stone, so adjust the amount o f milage according to your body weight closer to either end of the scale. Now this is not an absolute number as it varies from person to person, but over the years I have found it to be near enough for the purpose of injury prevention. Quite often you will feel this happen as you start with little niggles in the foot, shin or your calves are getting tight. In a club runner running 30-40 miles a week this will only be 10 weeks before the shoe is worn out, it will still look new but don’t let that fool you, the cushioning will be worn out.

Similarly, if you run on consecutive days it is a good idea to have two pairs of trainers as the midsole which offers the cushioning takes up to 48 hours to regenerate itself and won’t be fully recovered.

3. Do not stand on the startline in new shoes, make sure you have worn them in with a few runs so that they will not give you blisters and discomfort. A good idea would be to run approximately 50 miles or so in them prior to race week, then not to wear them until race morning.

4. Warm up. By ensuring that your bodytemperature gradually increases before you start any intervals or hill work, you will allow the muscles to become warm, more elastic and much less likely to tear. Start off easy and progress into movements required for the upcoming session.

5. Build a general lower limb stretching regime into your workout plan. Although stretching has in recent years become a controversial topic and should we or shouldn’t we stretch, should we stretch before or after our workouts etc. I would suggest that stretching before workouts should be limited to dynamic movements and dynamic stretches, as long static stretches will inhibit your muscles and leave them weak for the work they are about to undergo. It is however very important to incorporate flexibility training into your regime. Sstretching maintains an optimal muscle length which will maintain optimal function for your lower limb which will lead to a better running economy through an effcient power transfer and can improve your performance. Who doesn’t want that! This does not need to happen imediately after a workout but can be achieved at home whilst watching tv or more formally in a gym based stretching class or in a yoga session

6. Gradually increase the amount you run and monitor how fast you run. Injuries indicate a breakdown point for your body, and it is important to not overstretch your bodys capability of absorbing the workouts. It is commonly quoted that increasing your total training load by 10% is safe but if you are not accustomed to running you may need to do this slower. It is commonly mentioned in coaching litterature that your training runs should be done at a slower pace than your marathon target pace. Likewise it is important to be progressive about how much speed work you do in a week beit intervals and tempo runs. Slowly increase the amount of repetitions and speed for these session. The body will gradually adapt to these workloads and you will arrive on the big day in tip top condition and injury free.

7. Make sure you vary your running routes and surfaces. Therea re a few things that can influence your likelyhood of getting injured. The running surface can be too hard, too soft, uphill and downhill or they can be cambered. All these things can lead to injury if too much time is spent running on any of these surfaces, the trick is to vary them a little. For instance if you have a route near your home and you run it 3-4 times a week and always in the same direction, roads in this country are usually cambered due to the amount of rain that falls and as such this will lead to increased muscle activation in the leg which is facing the side of the road and is one of the risk factors in developing ITBS (iliotibila band syndrome). So vary your routes and try to go off road if you can. But dont forget to train on similar terrain to your target race too, if it is a road race you need to do some of your training on road and if its a lot of hills then you need to practice running up and down hills as this places additional stress on your body.

8. Have an assessment with a physiotherapist who is used to treating endurance athletes to check biomechanics, flexibility and core stability. A lot of biomechanical problems can be addressed such as overpronating feet or leg length discrepencies, and these problems usually brings with them associated muscle problems such as underactive and shortened muscles. Having someone assess wether there is a need for insoles and to prescribe you a flexibility and core stability program to address these problems will increase your chance of running in a more optimal pattern using the correct muscles and this will reduce your wisk of getting injured. To read more about how core stability influences your performance read my previous article which you can access by clicking here. Prevention is always better than the cure!

9. Recognise when you are getting injured and deal with it sooner rather than later. There are four phases of injury:

Phase 1. Pain after exercise but settles after a few hours

Phase 2. Pain causes discomfort but there is no reduction in your training or performance

Phase 3. Severe discomfort and pain which limits your training and influences your performance

Phase 4. Pain is so severe you are unable to run

These phases are progressive and the further you progress the more treatment and more time will be needed to fix the problem. The earlier you deal with you problem the quicker you will be back running. Never get past phase two without seeking advice from a chartered physiotherapist. It’s a false economy to save two sessions early on only to need ten sessions further down the line.

I hope you have found this interesting and if there are any points you wish to discuss with me then please either contact me in the clinic or throught the website and I will be more than happy to talk to you about them.

Happy Training,

Ove Indergaard

The topic for todays blog is a new ( to these shores) and unique treatment method for musculoskeletal disorders called Neurac (Neuromuscular Activation). The Neurac method consists of specially tailored tests, exercises and techniques in Redcord slings, and has proven to give immediate and long time results for a lot of musculoskeletal disorders. Research shows that physical inactivity or pain can deactivate one or more muscles, forcing other muscles to compensate and become stressed or over-worked. This often leads to movement dysfunction and pain. 
the Neurac method aims to activate these deactivated or partially deactivated muscles. The activation can cause immediate relief from acute and chronic muscle pain in just one treatment.

One patient who I was treating a couple of months ago was struggling to lift his arm above his head after he had had a fall and landed on his shoulder. He was due to go in for surgery for this but felt that he wanted a physiotherapy opinion before going ahead with the surgery After examining the problem and establishing the cause we performed a couple of muscle activation exercises in the Redcord slings and he was able to use his full range of motion, within three sessions this became a permanent change. Now this doesn’t happen every time we use the slings but most patients notice a marked improvement in symptoms after the first session.

So how does it work?Well the first stage is to identify the weak links in the system or if you like inactive muscles and weaknesses in the core muscles or the coordination between muscles. Even top trained athletes may have weak links, which can occur when stabilizer muscles switch off due to pain, strain, fatigue or inactivity. Individual treatment and/or training program are then developed based on the indentified weak links. The program consists of controlled, pain free exercises in slings. The goal is to improve the interaction between the brain, neural receptors and muscles. This treatment is called Neurac (Neuromuscular Activation), because that is what it does it activates these ‘sleeping’ muscles by stimulating the neural and muscular system. The tests and exercises have been specifically designed for this purpose. The reactivation of this system restores function, builds up strength and prevents relapses.

Our clinic is the only clinic in Great Britain with the Redcord sling system installed in the clinic and that has been trained in the treatment method although the method is very popular in Scandinavia, Central Europe, the USA and in several Asian countries. If you are interested in learning more about how this unique and new treatment method can help with your pain and dysfunction please contact us and we will be very happy to discuss it with you. You can also learn more from the Redcord Website (www.Redcord.com)

Are you ready to be activated?

A few years ago when we talked about the core we thought of our stomach muscles and everyone was doing lots and lots of abdominal work in isolation, working on their six pack to improve their core strength. Then in the early nineties a clever group of physiotherapists in Australia managed to isolate a dysfunctional muscle in the deep abdominal muscles in a population of low back pain sufferers, and this has subsequently become the basis for many postgraduate courses looking into low back stability and core stability, in the fitness world this has spilled into things like pilates. With this approach, muscles are taught how to activate in isolation to rehabilitate or activate them which make them work more normally and in theory this would give your core stability.

These ideas have now been developed further and new ideas have come out of this and we don’t focus necessarily on single small muscles but rather look into how the body is working in functional positions and identifying the weak links in the chain.

The core muscles does not only consist of the abdominal musculature, but also consists of the trunk muscles, pelvic muscles and quite importantly the muscles of the hips and shoulders. You see it is already getting quite complicated. These muscles have the specific role of providing stability for the limbs to be able to do highly specific and detailed tasks, and in sports this quite often means the ability to transfer forces from the centre out to the limbs as seen in activities such as running kicking and throwing. But also this transfer of power is also evident in things like pushing a door open, hoovering and ironing. If certain muscles or muscle groups become weak and inefficient there becomes a weak point in the chain which may cause either a poor alignment of the joints causing stress onto structures and muscles around those joints, this is often seen in runners who have ITB problems or shin splints, as well as not being able to support the spine in performing functional activites such as lifting.

To give you some numbers, the hip and abdominal musculature account for about 50% of the energy used during throwing, if the just one muscle involved in this energy transfer that occurs between the hips and the shoulder is not doing its job there will be a less efficient movement in the chain and there will have to be some compensation to achieve the same task. In a study by Kibler published in 1996 there was an analysis of a tennis serve and they reconed if there was a 20% deficit in the core muscles, then there would need to be 34% more arm speed or 80% more shoulder muscle mass to compensate for this. Interestingly in another study they found that 49% of athletes who had torn their roator cuff in their shoulder demonstrated poor flexibility around the hip and weakness in the hip abductors which they thought was linked to the poor power transfer causing the shoulder to over compensate.

If you are suffering from any upper and lower limb injury as well as pain in the spine, your functional core stability needs to be assessed and an appropriate rehabilitation program needs to be set. This should be very individual to you and work with your lifestyle whether your problem is doing the house work or if you are an elite athlete. The program needs to be progressive and as soon as you have mastered one activity it needs to be progressed to ensure a quick return to your sport or activities.

If you have any questions of how we can help you with the problems you are facing or you would like to improve your core stability for performance reasons we will be more than happy to help you reach your goals of a happy and health lifestyle.

When you sustain a whiplash injury, your neck is thrown initially backwards and then forwards and causes a transfer of force through in your neck muscles and is usually so great that the muscles fail to slow this movement down and causing damage to the muscles and ligaments that support the neck.

Most of our patients who come to see us after having sustained a whiplash injury have spent time waiting for it to sort itself out and sometimes not utilised the simplest things you can do to minimise the severity and loss of function sometimes associated with these kinds of injury.

Here are some simple tips and activities that can help you on your road to recovery:

1. Stay Active – Your neck will benefit from normal movement and it is important to keep working if you can. You may need to alter some of the activities that you perform at work and ask your employer if you need help with this.
2. Exercise – Exercise helps to reduce pain and the movment will help your body to recover naturally. The sooner you get moving the quicker you will recover.
3. Control the pain – You can use pain killers or anti-inflammatories and these will allow you to get moving quicker and prevent any stiffness from setting in. Please ask your GP or Pharmacist if you are unsure about what to take and when.
4. Hot or Cold – Use which one you prefer. Apply heat or use a cold pack wrapped in a damp towel for 15 minutes, they can both help to reduce pain and muscle spasm

If you find that your symptoms are not settling with this then physiotherapy can be very helpful in enhancing your recovery. Through Advice and Education, Massage and Manipulation and by the use of other modalities such as Acupuncture or electrotherapy we can help to return you to full function as soon as possible.

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Sed nam metus dui, mauris purus proin, ac metus a, sapien libero aenean rutrum nunc viverra vestibulum, tincidunt nulla ante faucibus nullam. Turpis sociosqu nunc scelerisque turpis eleifend, tellus iaculis ut massa ad amet et, viverra velit sit. Sed nam metus dui, mauris purus proin, ac metus a, sapien libero aenean rutrum nunc viverra vestibulum, tincidunt nulla ante faucibus nullam. Turpis sociosqu nunc scelerisque turpis eleifend, tellus iaculis ut massa ad amet et, viverra velit sit.

We are currently 3 physiotherapists working in the practice and we believe in providing a high quality, efficient evidence based approach to the management of the problems and issues we deal with on a daily basis. We take pride in being approachable and friendly so should you wish to discuss your problems and how we can help then either drop by or phone and make an appointment. We do offer a free 15 minute consultation exactly for this purpose. When you phone you will be greeted by our administrator Linda who will be happy to help you.

Please visit our main website for further information regarding how we can help, our opening times and more!

We hope you enjoy our blogs.

All the best,

Ove Indergaard MSc MCSP HPC

Chartered Physiotherpist

Registered with the Health Professions Council