United Health Kent

Merging simple yoga-based poses with strength-training challenges the core, hip and thigh muscles in ways that running doesn’t and helps minimise muscle imbalances that can lead to injury. These movements are synched to your breathing (inhaling or exhaling).

How often?
Complete this routine two or three times a week during rest, cross-training or ‘easy days’.

Raise the bar

Start with lighter weights than for usual strength training. Then  increase reps and add sets before trying heavier weights.

Warrior III slow tips

Why? Strengthens glutes, hip flexors and upper back.
How? Stand with feet together. Inhale, raising arms (shoulder-height). Exhale and shift weight onto right leg and raise left leg behind. Inhale and stand. Do 10 and switch legs.
 

Horse with lateral raise

Why? Opens your hips and strengthens your legs, arms and shoulders.
How? Stand with your feet wide apart, legs turned out 45 degrees, weights in both hands. Exhale while bending your knees (don’t lean forward) and raising your arms to the side and overhead. Inhale while lowering the weights and straightening your legs. Do 10 reps.

Half chair to chair

Why? Builds strength in your thighs, core, triceps and shoulders.
How? Stand with your feet together. Inhale while lowering your hips and raising your arms overhead. As you exhale, lean forward and lower your arms. Inhale again and extend your arms past your hips. Exhale again and squat deeper, then return to start. Do 10.

 Knee lift to lunge

Why? Improves balance and hip mobility and strengthens the back.
How? Stand with your feet together. Inhale, lifting your right knee, curling your left arm up and your right arm back. Exhale and lunge back with your right leg, alternating your arms. Inhale and return to the knee raise; exhale and lunge. Do 10, then repeat with the left leg.

Happy running!

1. Start off slowly and pace yourself – This is often a common problem, it is very easy to get carried away and overdo it on the first session. Whatever exercise/training you are doing make sure you start off slowly and build up over a few weeks.

2. Correct technique – poor technique is a major factor in contributing to injuries, make sure you get advice from a coach or trainer, especially if you are new to the sport.

3. Warm up – Make sure that you prepare your body for exercise don’t just go straight into high level activity.

4. Stretch – At the end of exercise make sure that you spend time gently stretching off your muscles. It is also a good idea to incorporate a separate stretching session into your weekly routine.

5. Rest between training sessions – Your body needs time to recover, repair and rebuild muscle, so make sure you have at least one or two rest days a week.

6. Correct equipment – Make sure that you have the correct size and style of equipment that suits you. This is especially important with running trainers so make sure you get a running assessment done by a specialist to ensure you are wearing the right pair for you.

7. Cross-training and strength training – Although practising the specific sport or particular technique is important, it is also vital to build and strengthen the right muscles to help you achieve this more efficiently and effectively. Strength training is key to help prevent injury and get the most out of your performance. You also need to build in other activities into your schedule in order to make sure you are not over training and keep things interesting!

8. Hydration – Exercise will use a lot of your water and electrolyte stores, so make sure you replenish by drinking lots, especially in warm weather. Sports drinks are best as they have a good mix of all the nutrients that you need.

9. Good nutrition and diet – Your body needs the correct fuel in order to perform at its best. Make sure that you eat a balanced, healthy diet and seek advice from your GP or a nutritionalist if you have any concerns regarding diet.

10. Consulting a Physiotherapist or sports specialist – As Physiotherapists we are highly skilled at identifying areas of weakness and diagnosing injuries. Make sure you get help early before the problem gets too bad. Often if you can get an early diagnosis and treatment you will make a faster, better recovery.

A common problem for cyclists, mountain bikers and runners is Iliotibial band (ITB) syndrome. Symptoms of ITB syndrome can include;

• Pain at or around the lateral epicondyle of the femur (on the outside of the knee)
• Pain at or around the lateral (side) of the hip/upper leg
• Tightness in the iliotibial band (the outside of the leg).
• Pain is normally aggravated by running, particularly downhill and cycling
• Pain during flexion or extension of the knee, made worse by pressing in at the side of the knee over the sore part
• Weakness in hip abduction (lifting leg out to the side)
• Tender trigger points in the gluteal (buttock) area may also be present.

 What causes ITB syndrome?

Certain factors may make you more susceptible to developing ITB syndrome;

• A naturally tight or wide ITB
• Weak hip muscles such as gluteus medius
• Trigger points within the ITB and gluteal muscles
• Overpronation
• Overuse
• Excessive hill running or cycling
• Running on a cambered surface
• Leg length difference.

Most of these factors can be addressed through changes to your training programme, the use of insoles or heel pads and a thorough rehabilitation programme.

Iliotibial band friction syndrome may require long-term Iliotibial band stretches and gluteal training to prevent issues reoccurring.

Disclaimer – this is a general exercise only. If you have pain that is made worse with this exercise then you should cease and should seek advice from a medical professional.

With Wimbledon only a few weeks away, the tennis season has well and truly started.Each year we see a number of patients who sustain injuries on the tennis court.

Two-thirds of tennis injuries are due to overuse and the other one-third is due to a traumatic injury or an acute event. Overuse injuries most often affect the shoulders, wrists, and elbows.

These injuries are largely preventable. Physiotherapists Angela  Sabine and Sarah Verrion from United Health Kent are happy to give advice on injury prevention, as well as suitable rehabilitation following injury. At the Sandwich Leisure Centre we can give advice on the best exercises to get fit preseason. The gym in the Leisure Centre is the ideal place to achieve fitness pre season or regain fitness after treatment.

Tennis Elbow/ Common Extensor Tendinosis

The injury most heard about is “tennis elbow,” which is an overuse of the muscles that extend the wrist or bend it backwards. It is also the muscle most used when the tennis ball impacts the racquet. Proper strengthening of this muscle and other muscles around it, along with a regular warm-up routine, will help decrease the likelihood of experiencing tennis elbow. Paying attention to technical components such as grip size and proper technique can also help prevent this condition.

Shoulder Injuries

Shoulder overuse injuries are usually due to poor conditioning and strength of the rotator cuff muscles. The rotator cuff helps to position the shoulder properly in the shoulder socket. When it is fatigued or weak, there is some increased “play” of the ball in the socket, irritating the tissues. The tendon or the bursa can become inflamed and hurt. This usually produces pain with overhead motions such as serving. If the pain persists, it can interfere with sleep and other daily activities.

Muscle Strains

Muscle strains usually occur from quick, sudden moves. A good warm-up followed by proper stretching can help diminish Muscle strains. The warm-up should include a slow jog, jumping jacks, or riding a bike at low intensity.

Proper stretching should be slow and deliberate. Do not bounce to stretch; hold the stretch 30 seconds or more. The best stretches are moving stretches, such as swinging your leg as far forward and backward or swinging your arms in circles and across your body. Proper stretching should last at least five minutes.

Prepare your body

When playing sport, you’ll need to prepare the muscles that are needed most. This is done in a warm-up session before the game and a cool down session afterwards. This should last about 15 minutes. Here are the muscles to concentrate on for tennis and how to stretch them:

Quadriceps muscles
These are in the thigh and can be stretched by standing on one leg, supporting yourself against a wall and then pulling the other leg up behind you by the foot. Keep your pelvis straight and pull the foot into the buttocks. You’ll start to feel the stretch in your thigh. Repeat with the other leg.

Hamstrings
The hamstrings lie at the back of your leg; the opposite side of your thigh. Stretch them by lying on the floor, pulling one leg up under the knee and then straightening that leg out. You’ll feel the stretch in your hamstring. Now do the same with the other leg.

Adductor (thigh) muscles
On the inner thigh are the adductor muscles. These can be stretched by adopting a wide leg stance and then leaning over to one side. As you do this, the weight bearing leg should bend and the stretch felt on the inner thigh. Repeat this with the other leg.

Calf muscles
Next up are the calf muscles. The upper calf can be stretched by lunging on to a bent leg and keeping the other straight with its heel on the floor. Do this gradually so the body weight eases on to the bent leg. You’ll start to feel a stretch in the calf. The lower calf can be stretched by placing the feet one in front of the other and then bending at the knees while keeping both heels on the ground.

Hip muscles
The hip muscles can be stretched by kneeling on one leg with the other at a ninety degree angle. Ease forward on to the bent leg and keep your back straight. Repeat with the other leg. The buttocks require stretching by lying down and then pulling one leg up to your chest. Feel the stretch and then repeat with the other side.

Trunk and pectorals
The trunk stretch involves standing with one arm straight above the head and then leaning over to the side. Repeat with the other arm. The pectorals (or chest muscles) can be stretched by clasping your hands behind your back and then slowly lifting your arms upwards until you feel the stretch. The final muscles to do are the triceps in the upper arm. Do this by raising the arm above the head, bending the elbow and grasping the elbow with the other hand. Slowly push backwards and feel the stretch. Repeat with the other arm.

Get the right equipment

Getting advice from a good sports shop on the right racket to use and what grip size to buy is very important. Having the right racket stops a lot of the mechanical stresses on the wrist and elbow which lead to tendon overuse.

Good trainers are equally important to give the player grip on the court and support the ankles during the fast twist and turns during the game.

The rear foot elevated split squat (RFESS) is one of the best exercises for runners. It increases the strength of the gluteus (buttock) and hamstring (back of thigh) muscles that are essential for improved performance.

To perform the exercise:

• Place one leg behind you on a bench/step with the toes taking the weight of the leg on the bench.
• The other leg is placed in front of the body with the weight distributed evenly between the ball of the big toe, the ball of the little toe and the heel.
• The body must remain upright DO NOT LEAN FORWARDS as any lean forward will result in the emphasis being placed more on the quadriceps muscles which is not what we want with this particular exercise.
• You then bend the front knee and move the glutes muscle down as if to sit back into a chair until the knee is bent to 90 degrees or as far as you can go without leaning forward.
• It is advised to squeeze the glutes of the back leg throughout to avoid arching the back or leaning forward.
• You then stand back up by driving the mid-foot to heel into the ground. This ensures that the glutes and hamstring muscles are giving the best possible chance to work correctly.

It is very important to stay upright throughout the whole movement. If you cannot just perform a smaller movement until you become stronger.

The brain can also cheat and use too much quadriceps by allowing the knee to go past the toes on the way down. This is why you need to sit back into the glutes muscle as if sitting into a chair. The golden rule is that you should always be able to see your toes throughout the movement. If you cannot see your toes because the knee has gone past them then you are only getting 50% of the benefit of this exercise!

Note: Remember to warm up and cool down with any exercise programme. If you feel pain during this exercise cease immediately and seek advice from a Doctor or Physiotherapist.

Knee pain is probably the most common injury complaint amongst runners. This isn’t surprising as forces of up to 550% of body weight pass through the joint when running!

Common Running Knee Injuries

 IT Band Syndrome 

The IT band is a thick band of fascia which runs down the outside of the thigh and this can rub over the bony part on the outer knee and  this friction can cause pain and inflammation.

 Patellofemoral Pain Syndrome 

Is a condition caused by mal-tracking of the knee cap. The maltracking usually results in the knee cap moving too far laterally, causing pain and potential damage to the cartilage. Pain when running downhill or after running are very common symptoms of this injury.

 Popliteus Injury 

The Popliteus is a muscle at the back of the knee joint which is important in straightening the knee. This muscle can become overworked in runners, especially when the hamstring muscles are also tight.

 Jumper’s Knee 

Jumper’s knee is more correctly known as Patella Tendinopathy (or tendonitis). It is a condition causing pain and inflammation of the patella tendon which attaches the knee cap to the shin bone.

 Hamstring Tendinopathy 

The hamstring tendons at the back of the knee can become inflamed due to overuse, especially when lots of acceleration or deceleration is involved. Sprint training and intervals may contribute to this injury.

Poor training techniques are the most easily corrected errors. The common pitfalls to watch out for include:

• Training too much too soon for beginners (maximum increase of 10% a week).
• A sudden increase in training distance or intensity in experienced runners.
• Introduction of new elements such as hill or sprint sessions.
• Running on cambered roads (where one foot is lower than the other).
• Lack of flexibility work or focus on training one muscle group only (i.e. quads over hamstrings).

This is general advice only. If you have any pain see you doctor or contact us.

Introduction

Mountain biking has increased in popularity over recent years and with this we have seen an increase in the injuries associated with this great sport. Mountain biking involves off road riding over tracks with variable surface conditions. The high speeds achieved during downhill sections can lead to falls and sometimes serious injury. There are several published reports of serious head injury as a result of falls, which makes a helmet essential!

Saying this most mountain biking injuries are not serious and the majority of falls result in relatively minor cuts and grazes.

5 Common mountain biking injuries:

1. Cuts ad grazes

2. Broken collar bone

3. Acromio-clavicular joint (SCJ) sprain

4. Knee Pain

5. Low back pain

Disclaimer: This advice is general advice only, if you are experiencing symptoms associated with cycling or mountain biking you should seek medical advice from your Doctor of Physiotherapist.