The red flags of skiing injuries

Downhill Skiing

Downhill Skiing

We are fast approaching snow sports season!  January through to April is my busiest sports injury time.  I see more injuries during this period from snow sports than any other time of the year.  Let's face it there is a risk to engaging in any sport - snow sports perhaps a bit more than others.  However, if you adhere to some basic advice you can minimise the risk of injury.  In this article I share that advice with you....

Not conditioned for snow sports

If you are going on a skiing vacation this winter now is the time to start getting your body ready.  I would recommend a gym programme that trains the biomotor abilities of skiing and snowboarding, which are balance, power, strength, and agility.  Specifically you need to have a strong stable pelvis and spine to widthstand the forces of skiing and snowboarding movements.   Rotational and lateral stability are very important too.  And you need stability and balance training so your brain and body can figure out quickly how to change direction and deal with the unstable surface of snow underneath you. This sounds like a lot I know.  The art of training efficiently for snow sports is something we can help you with at Precision Movement.  If you would like to learn more then get in contact with us for a chat. 

Attempting level that is beyond your current ability

Whether you are a daring beginner with a penchant for danger or a seasoned veteran of snow sports, it is always prudent to work within your abilities.  I have seen many injuries throughout my career caused by over-zealous dare-devil stunts!  I cannot stress enough how important it is to be sensible and the reason why is highly linked to my next point…

Someone running into you

Now this is probably the most common reason people get injured in snow sports and it is not something you have much control over unless you are the one crashing into someone else.  The best advice I can give here is, stick to runs that are within your ability, always have your wits about you, don’t rush, always wear a helmet even if it cramps your slope style and lastly, give crazies a wide berth!  Also, I’m going to add watch out for young children who are speed demons – they have no fear and also believe they are small enough to fit through the tiniest gaps between people. 

Lack of sleep and alcohol consumption

I personally think skiing and snowboarding is one if the best holidays because you get to be active as well as taking lengthy lunches atop a mountain and then partying with your friends into the wee hours of the morning.  It has everything that makes a holiday good!  With the good times also comes lack of sleep and more often than not a larger than normal consumption of alcohol.  Firstly, lack of sleep will impair your cognitive and neuromuscular abilities on the slopes the next day.  Basically, when you are tired all your communication channels become smudgy and lackadaisical which can increase your risk of injury.  Be aware of how many hours you sleep and if you’ve had a particularly late night then take it easy on the slopes the next day.  Alcohol makes you more tired and impairs your sleep.  I’m not saying don’t drink – just be mindful of what you consume with a thought to your activity the next day.

Ignoring weather conditions

I have had personal experience with this.  On my first snowboarding trip I decided to bravely venture out by myself on my last day and prove that I could snowboard unaided and find my way around the slopes like a pro.  Unfortunately, I picked the worst day – a complete whiteout.  I didn’t even know what a whiteout was until I was in it!  Obviously I thought I was going to die - first from motion sickness, then from losing my way and getting stranded.  Amazingly I survived without a scratch!  Accidents are much more likely to happen during adverse weather conditions because visibility is so poor.  Really consider whether it is worth going out when the weather is bad.  Sometimes staying in your chalet for the day in your long johns and ugg slippers sipping hot chocolate is a better option! 

I know some of these points seem a little obvious but it never hurts to be reminded, especially in the spirit of minimizing the risk of injury.  It’s always easier to say “in hindsight…”.  Let’s make this an injury free ski season – well as much as possible!  Happy skiing and boarding have some Raclette for me!

10 habits of successful back pain & injury recoverers!

Precision Movement reveals the 10 habits for successful back pain recovery
Precision Movement reveals the 10 habits for successful back pain recovery

Recovering from back pain and injury can be frustrating and tiresome.  If you are sensible you seek great treatment straight away.  If you are lucky then your therapist or medical practitioner will inform you of all the factors involved in getting you better effectively and quickly.  If not, then read this article.  It's a collection of my client's habits during their time with me - what they did to get better.  Some of them will surprise you..

Think yourself better

The first and most important habit of healing from injury is your mindset.  Henry Ford coined the phrase "whether you think you can or you think you can't you're right".  You need to make a pact with yourself about your mindset to getting better.  Firstly, think about your beliefs on injury and recovery - do you believe you will get better?  Secondly, believe the process of treatment you have chosen to get you better.  Thirdly, remind yourself every day that you are further from the initial pain and that bit closer to full recovery.  The clients who have recovered quickest from pain are those who have a positive happy outlook on life.  They are always laughing and smiling and find good in everything. 

Sleep

Sleep is an integral part of healing and recovery.  It's the time when the body is physically at rest and can heal from the tasks and 'damage' of the day.  This also includes healing of structures that are injured.  Physical recovery happens between 10pm-2am and mental recovery from 2am-6am.  When you are changing your posture and creating new movement habits both the brain and the body need recovery.  It also helps rejuvenate the immune system and aids the digestive system in processing and absorbing nutrients for recovery.

Nutrition

Eating the right foods for healing and recovery is essential.  I often find that if clients need to change their eating habits in conjunction with their recovery from injury many things change.  Their mood and outlook improves, they have more energy, they feel better and consequently they get better.  The big three things to steer clear of when recovering from injury are sugar and all processed foods, alcohol and any foods you are intolerant to.  These three things are highly inflammatory to your body and will slow the process of injury recovery.  Foods that heal are good fats like coconut oil, butter, ghee and olive oil and proteins such as meat, eggs and dairy (if you are not intolerant).  These are the building blocks of your body!

Hydration

If you do one thing from reading this article - drink more water.  Every cell in your body needs water. Dehydration affects your concentration when you are learning new things such as new movement patterns or holding better posture during an exercise.  Dehydration is also stressful to your body and at a time of healing you want to promote a calm parasympathetic state which is the optimal state for healing.

Stretching

Daily stretching is imperative for those with poor posture.  In order to make change you have to break down bad habits and rebuild new ones.  Just stretching twice a week in your training sessions will not make adequate change.  Super busy Mr K always had tight hamstrings which contributed to his ongoing back pain.  I continually asked him to stretch daily - just 2 minutes of stretching a day.  Eventually, he gave in and began stretching his hamstrings when he brushed his teeth in the morning.  Within 2 weeks he had normal hamstring range and his back began to settle.

Home programme

I give all my clients a home programme which helps with taking responsibility for their own recovery and it helps break down bad habits and rebuild new ones faster.  Clients who are initially resistant to doing their home programme even if it is just 10 minutes a day have a slower start on the road to recovery such as Mrs S.  Mrs S does her home exercises for a while and then stops.  Within weeks of stopping her home programme the pain returns.  Now she knows that she needs to do something 5 out of 7 days a week to stay pain free - so she does

Commitment and consistency

Commitment is essential to recovering from an injury.  If you are not committed to making change it just won't happen.  Consistency is imperative to effective recovery as well.  The nature of change means creating new habits - better alignment, better muscle activation, better synergy of muscles working together.  Habits require repetition.  Clients who are consistent always improve quickly.

Realistic goals

Sometimes clients come to me with very ambitious goals such as Mr R.  He had just had a knee operation and also an ankle injury and was keen to get back to his sports games within 2 months.  I explained that due to the aggressive nature of his sport that 2 months recovery with just 1 training session per week was not realistic.  He set a new goal of returning to full play in the next season giving himself 5 months to recover and get sport strong. 

Value the process of learning

Almost always, the unexpected change clients talk about from working with me is how much they learn about their own body.  They learn about why their current alignment is contributing to their pain and what the better option is.  They learn to identify how good posture feels.  They learn to correct their own alignment.  Clients tell me they are more motivated to make a change if they know how it will benefit them.  And it works! 

Taking responsibility

As I say to all my clients when they begin working with me, "We're in the car and we're on a journey to get you better.  I am in the passenger seat and I have the A-Z so I can guide you to where you want to go.  You are in the drivers seat.  You have to press the gas pedal and get yourself there."  When clients take full responsibility and become accountable for their actions they get better faster.  No one can make you better but yourself.  You have to change your mindset.  You have to do your exercises.  You have to make sure you get enough sleep and choose the right foods to aid your healing and recovery. 

For more information on how I can help you recover from your back pain or injury please contact me, KT, atKT@precisionmovement.co.uk.  For more information on how I work with injury recovery please visit the websitewww.precisionmovement.co.uk.

Top 4 Essentials for Injury & Back Pain Recovery

Precision Movement essentials for injury and back pain recovery
Precision Movement essentials for injury and back pain recovery

Injuries are not fun - they hurt, they stop you from doing things that you love and they do take time to get better.  There are certain essential elements to effective recovery that if adhered to definitely help speed up the process.  Read on to find out more...

The Right Exercise

Every injury will need some form of exercise rehabilitation.  If you have broken a bone or have had surgery your rest time will result in atrophy (shrinkage) of certain muscles surrounding the joint/area.  It is essential that you get these muscles firing again for appropriate support and functional movement.  Injuries that are caused by other than trauma are often accompanied by muscular imbalance which results in a joint or area taking too much stress or not having enough support.  In this case it is imperative that you rebalance the body with exercise, break down poor postural habits and movement patterns and learn ones that serve you more effectively. 

Once you have had the go ahead to begin exercise it is essential that you go through appropriately progressive and specific exercise that is bespoke to your needs.  This is where a corrective exercise specialist can really help you.  Jumping back on the treadmill or hitting it hard in the gym, however tempting, is not the answer and will most likely put you back on the triage stretcher.  For more information on the difference between corrective exercise and regular exercise click here.

Sleep

Sleep is where healing and recovery happens.  When you sleep your body is in a parasympathetic state.  This means it focusses on digestion, absorption of nutrients, transportation of nutrients to cells for healing and reparation and the removal of toxins.  The body revives itself from the daily stressors it has gone through as well as larger issues like the regrowth of broken bone or the healing of tendon or muscle tears.  Make sleep a number one priority if you are healing from injury.  Aim to sleep a minimum of 8 hours ideally between 10pm-6am Your physical recovery happens between 10pm-2am and mental recovery between 2am-6am. This is especially important if you are doing rehabilitative exercise as both your brain and body need this rest time to process new patterns, make new connections and strengthen those connections to make them the preferred pathways for stability and movement.

Nutrition

You are what you eat - or more accurately, you are what you absorb.  I have broken this section down further to three important areas - sugar, fats and proteins and hydration.

Sugar is very inflammatory to cells - especially ones that are trying to heal.  Limit your intake of sugar and processed foods and focus on eating as clean as you can.  Clean eating means eat from the earth - nothing processed, nothing boxed or packaged, nothing containing preservatives.  It also means eliminating anything that is inflammatory to your body.  Gluten containing foods and dairy are two such groups that may need to be eliminated.  Eating foods that you are intolerant to sets off an immune response, puts your body into a nutritional state of stress and diverts the focus of injury recovery to survival against a substance that is considered dangerous to you.  It means taking precious nutrients for healing and recoveryof your injury to deal with the food that is irritating your digestive system. 

Proteins are the building blocks of cells.  I often recommend to clients who are healing from injury to use Great Lakes Gelatin Powder.   You can add it to tea or soups.  It contains high levels of collagen which are the building blocks for tendons, ligaments and bones.  You can purchase Great Lakes Gelatin from Pure Body Balance and for more information on how to use it look at Karen Maidment's cookbook Meals that Heal.

Hydration is an absolute essential to good health as well as healing and recovery from injury.  Aim to drink at least 2L of water a day, preferably mineral or filtered. 

Thoughts become things

Of all the elements of healing and recovery, in my clinical experience, your mind is the most important factor.  You will recover quicker and more effectively if you maintain a positive mental outlook about your injury and about life in general.  I often ask my clients to say affirmations with each repetition of a rehabilitative exercise, such as, "I am getting stronger", or "I am getting better every day".  I also advocate good old meditation to cultivate good mental energy and you can even target it to heal your injury.  It might sound a little hippy, but I promise you thoughts become things.  You can choose to be grumpy and irritated about your injury and tell yourself that it won't get better or you can tell yourself that you are getting better every day.  As one of my favourite sayings by Henry Ford goes, "Whether you think you can or you think you can't you're right".  My favourite healing mental states include gratitude and laughter.  Of late I've been reading a lot of articles about how laughter is becoming part of Cancer treatment.  So give thanks for all you have in your life and get your friends round for a good old laughter session.  You'll be healed in no time!

For more information about the right type of Corrective Exercise for the recovery of your specific injury please visit our website or contact KT direct at KT@precisionmovement.co.uk

My 5 recommended Articles on Fitness Nutrition

At Precision Movement, I get asked about what to eat for health, fitness, weight loss and general well-being all the time.  I have had nutrition as a topic to write about on my list for ages.  It is not for lack of knowledge.   The real reason is because I read articles that basically say what I would say and advise.  So, in the spirit of time economy and not being able to do better myself, here are my top recommended 5 articles on nutrition for general health and wellness including my top recommendation for a nutritionist in London who I regularly send my clients to.

You are what you absorb

The phrase you are what you eat is sadly outdated.  It doesn't matter how healthy your diet is unless you are absorbing the nutrients that you are consuming.  One of my favourite bloggers, Mark Sisson, explains why gut bacteria is an essential part of nutrient absorption and how to cultivate good bacteria from nutrition.

16 things that affect your gut bacteria 

Gut health

Another one on the health of your digestive system.  I interviewed my go-to nutrition guru Hannah Richards on why digestive health is the keystone to weight loss and good health.  I send all my fitness, injury and pain clients to Hannah and I only ever get amazing results!

Healing the Inside of You

Protein power!

What with the rise of Paleo eating there has been a real buzz around protein and it's importance in health and wellness as well as sustaining appetite.  Optimal protein intake is imperative if you are wanting to gain muscle mass but it's equally important for recovery from any exercise.  This is an interesting article on the symptoms you can experience from not eating enough protein:

Signs you are not Eating Enough Protein

Fats

Fats are always a controversial topic for discussion when it comes to weight loss and health.  I am siding with Johnny Bowden on this one as he discusses the power of coconut oil and how it actually helps you burn fat!

The Benefits of Coconut Oil 

But what should I actually eat?

I know I know its the million dollar question!  Ok here is my favourite list of pre and post workout snacks from Greatist.com.  They don't call themselves greatist for nothing!

50 of the Greatist pre and post workout snacks

So now you know what to eat for your workouts and how to get the most out of the food you eat come over to Precision Movement to improve your fitness.  Guaranteed we have a workout to suit you - check out the options here.  Contact KT at KT@precisionmovement.co.uk.

Training Yourself back from Adversity - my True Story

Precision Movement's KT talks about how training brought her back from adversity

Precision Movement's KT talks about how training brought her back from adversity

For those of you who know me I like to keep my personal life well personal.  But today I set a personal precedent and share how I used training to come back from adversity and why it is the healthiest and most positive way to empower yourself when someone or something kicks you down.  Earlier this year I got whacked with the adversity bat.  I'm not going to divulge much further than that as adversity comes in many packages - bereavement, heartbreak, illness, burnout, divorce are the big ones and they can all be as painful as the other.  The one thing they have in common is the ability to knock you sideways, leaving you shocked, stunned, lost, insecure and lacking confidence.  Your friends and family are great and they console and support you as best they can.  But what you really need is a way back up to where you were because you have commitments, a job and people that depend on you functioning and performing well.  The one thing I reach for when I am faced with adversity is training.  I've also got amazing friends who have entered Fitness Modelling competitions and Ironman competitions with the same goal - to train themselves out of adversity.  For me, it serves so many purposes.  Here are the main things that gave me my journey out of adversity back to my amazing energetic and fabulous self and why they played such an important role for me personally.

The Goal 

I felt really lost - like I was spinning which is a common feeling when your whole world is up-ended.  I needed a focus and exercise gave me that.  For an hour each day I was able to switch off my constant chatter and just focus on how it felt to train my body back to my usual fitness level.  I made myself work hard and endure the discomfort and it was mind-numbingly wonderful.  I set myself a very superficial goal which I would never encourage my clients or you to do but I had my reasons and it motivated me.  I wanted a visible six pack in 3 months and I wanted to build a 'suit of armour' with my body.  I knew I had to train very hard to achieve this and I also had to eat a very clean diet.  Once I had established this goal it was easy for me to stick to eating well and training hard.  I wore my best workout outfits for every training session and took photos of my progress periodically for motivation and to see my improvements. 

Training Myself to Sleep

I had a really hard time sleeping for about a month so I couldn't start training right away.  When I finally felt I could start, sleep came so easily and I cannot tell you how much it helped me.  Lack of sleep was slowing the mental and emotional recovery process for me.  Getting back to exercise and exhausting myself helped me sleep better and I was able to begin thinking rationally through the day.  My performance at work got better and this made me feel good.

Empowering Myself

The best part about training myself out of adversity was exercise empowered me.  I chose to focus on high intensity training for short durations.  I wanted to feel invincible.  As I had trained as a boxer years ago I went back to boxing and kickboxing training.  This was an obvious outlet for strong emotions.  As part of my training I also chose the short distance of 5k which I ended up doing every day increasing the speed over this set distance.  I also did a mix of bodyweight and strength training workouts a few times a week.  A certain points I was training twice a day.  After 3 months I was 'fight fit', I had decreased my 5k run by 8 mins and I was ripped!  See the photos below!

Precision Movment's KT shows her fitness results - a great body

Precision Movment's KT shows her fitness results - a great body

The Happy Hormone

Adversity can bring sadness which is a tough one to get through.  Once I began exercising I started to feel less sad and then I started to feel better and it didn't take long before I was experiencing the feelings of happiness again.  This helped me get through my day with more positivity and energy.  I found myself wanting to do activities and spend time with people again.  I quickly realised that sadness was not serving me for my next workout and I got out of the habit of allowing myself to be sad.

The Best Pathway 

There are many choices when it comes to dealing with tough stuff.  Some of us may use alcohol or other state changers to escape and numb tough emotions.  Some of us sink into depression for a while.  You may start comfort eating or not eating enough.  But I hope this personal experience that I've shared with you will inspire you to consider using exercise as a means of recovery from adversity - whether you are going through something now or when it may hit you in the future.  There are so many benefits - you will look and feel better, you'll gain fitness, you'll be healthier, happier, more energised, empowered, confident and life will soon become enjoyable and good again.

Have you trained yourself out of adversity?  Share your story with me on the Precision Movement Facebook page.  Do you need to train yourself out of a tough situation?  Get in contact with me, KT, at KT@precisionmovement.co.uk.  

Precision Movement's makeover - we've got it all!

Precision Movement's new look

Precision Movement's new look

Over the past 9 months Precision Movement has been through big makeover.  We've got a whole new image and some exciting new fitness services to offer you.  There is something for everyone.  So without further ado, please read on to find out more about our new look!...

The new space 

Precision Movement fitness room at Grosvenor House Apartments by Jumeriah Living

Precision Movement fitness room at Grosvenor House Apartments by Jumeriah Living

For those of you who don't already know, Precision Movement is now housed at Grosvenor House Apartments by Jumeirah Living on Park Lane in Mayfair.  Our compact yet open space is perfect for all types of personal training services.  The space is yours for the duration of your session including choice of music and temperature of the room.  Afterwards you can relax in the adjoining spa shower or in the unique atrium restaurant with exclusive access to guests of the hotel and clients of Precision Movement only.

Back and Injury Care 

Precision Movement back and injury care rehabilitative exercise

Precision Movement back and injury care rehabilitative exercise

Precision Movement was founded by KT who is an rehabilitative exercise specialist.  KT works with all types of injuries and back pain problems from post-surgical to non-specific and everything in-between.  She takes a complete approach to uncover the root cause of your discomfort so that you can heal and recover effectively once and for all.  KT begins with a comprehensive assessment to ascertain how you move and what your posture is like and then she works with you to improve alignment, get your muscles to support you optimally to take stress away from areas of discomfort.  Click here for a case study of her work.

 Precision Movement 2 - health fitness and wellness that works!

Precision Movement 2 health fitness and wellness that works

Precision Movement 2 health fitness and wellness that works

Precision Movement 2 is all about possibilities! When you are aligned, stable & strong we ask you one simple question – where do you want to go from here? For us we see your health & fitness possibilities as exponential. We help keep you fit for life, fit for your sport, or fit to look and feel your very best.  We can also train you for an event like a marathon or a triathlon.  We use the most fun and creative fitness methods to keep you entertained and challenged whilst taking the utmost care with your form and alignment.  We like to think we create mini athletes at PM2! Our clients leave feeling satisfied, worked and energised!  

Precision Movement STRETCH 

Precision Movement Stretch dynamic flowing yoga based movement

Precision Movement Stretch dynamic flowing yoga based movement

Precision Movement STRETCH is an interactive flowing yoga inspired workout that takes you through poses to improve balance, flexibility and strength. We’ll also work to your individual fitness needs to address your posture.  It's great if you have just come off a long haul flight and need to get on London time and also great for an after-work work-in.  We’ll create a calm and peaceful environment for your mind to settle and for you to let go of your stress. You’ll leave feeling like a person reborn!  

Precision Movement KICK

Precision Movement boxing and kickboxing training

Precision Movement boxing and kickboxing training

Precision Movement KICK is all about boxing and kickboxing.  KT is a trained boxer and is a big advocate of using a sport to gain and maintain fitness.  Martial arts requires the use of the 8 biomotor abilities that make up fitness which means you'll get a little of everything.  The best part is of course that you get to kid land punch stuff really hard!  It is the best stress management tool I know and it really does get you super fit in a fun and challenging way.

Precision Movement Classique

Precision Movement Classique real ballet training

Precision Movement Classique real ballet training

KT trained and worked as a professional dancer before she got into fitness and injury rehabilitation.  She is a huge fan of teaching people REAL ballet technique not a fitness fad version - the type that actually transforms your body.  You’ll go through the techniques, exercises and mentally challenging routines that professional ballet dancers use to achieve their long lean legs and wash board abdominals without using any weights! You’ll also develop that statuesque posture and grace that makes the room stop and look at you.  If you really want to look like a ballerina then Precision Movement Classique is the workout for you! 

Precision Movement Expecting

Precision Movement expecting pre post natal training

Precision Movement expecting pre post natal training

Precision Movement expecting is a specially designed programme for women to support your movement and body maintenance needs before, during and after your pregnancy. When you are preparing to have a child we’ll create bespoke exercise programmes for you to energise and support your body without exhausting you.  We’ll adapt and modify your exercise programme to your needs at the different stages of pregnancy that will optimise your energy level, support and mobilise your changing body and help you manage healthy weight gain to make you feel positive and comfortable.  We’ll guide you gradually, safely and effectively back to shape. We will give particular attention to the realignment of your posture and the stability of your pelvis and spine through effective core activation and support. So that you can enjoy the first few months with your new arrival and still look and feel amazing!

Your trainer KT - still the same! 

Precision Movement's trainer KT

Precision Movement's trainer KT

Some things never change!  It's true I am still the same just a little older and much much wiser.  And shamelessly proud of Precision Movement's new space and look.  If you haven't visited me recently, please do come over for a tea or a fresh juice and I'll show you around.  Even better, book in for a workout - we've got everything covered now and we'd be delighted to help you with any and all of your fitness endeavours.  Remember you can follow me on Facebook, Twitter, Instagram, and LinkedIn to stay in the know, motivated and inspired...  Like I said, some things never change!  

Contact KT at KT@precisionmovement.co.uk and visit the website for more information about how we  can help you more specifically at www.precisionmovement.co.uk.

The Constant Case for Personal Training

Precision Movement explains the constant case for Personal Training

Precision Movement explains the constant case for Personal Training

When I'm out and about socially and I tell people what I do I get two reactions - one they ask me what they should do to look like Channing Tatum or Miranda Kerr or they tell me what they do for fitness.  I love hearing about what activities people engage in.  I feel like more and more Londoners are taking an active role in keeping themselves healthy and fit and this makes me very happy!  Sometimes and of late increasingly so, some people engage me in a debate about whether personal training is really valid any more.  What with the rise of crossfit, balletbarre style classes, group pilates and bootcamps fitness has never been more affordable.  But is it cost effective?  Are you getting pound of muscle for pound sterling? Perhaps it's less about cost and more about value.  Read on to find out why Personal Training is still valid and why, if you haven't already invested, you should seriously consider it. 

1 on 1 produces tailored results

Ok, subtly take a look to your left and observe the person next to you.  Notice how their body shape, size, proportions are completely different to yours.  Ok you can stop looking now before you get in trouble!  Think about what is important to you when it comes to fitness, health and how you want your body to look and feel.  Do you think the person to your left has exactly the same desires?  Probably not.  I train women who want a warrior princess look - toned, nicely shaped muscles but not big and bulky and I also train women who want to look like svelte ballet dancers.  I train men who don't want their legs to get too big because they wear slender fit jeans but they want a nicely defined upper body.  And I train men who want to look like The Rock. 

The greatest asset of Personal Training is it is PERSONAL.  It means that the session is dedicated, tailored, devoted to how you want your body to look and feel and what you want it to do for sports and life. The compromise you make when you go to a class is that if you want bigger biceps but the lady next to you wants a smaller butt - you just have to go with the flow of the class and hope you get what you need out of it. 

Much more of what you need

Any good Personal Trainer (and they are sadly few and far between) will give you what you want and most importantly what you need - which you are probably not even aware of until you learn of your imbalances or weaknesses. 

In a session that is dedicated to your wants and needs you will progress much faster and more effectively, correcting your personal imbalances and weaknesses.  You may also have functional or sports imbalances that need constant monitoring - such as excessive spinal flexion and weak extensors from daily cycling (find out more about this here), or a rotational imbalance from tennis. 

What you might not know in a group class is that an exercise you are doing may be contributing to your imbalance and could lead to an injury.  If there are 6, 16 or 60 people in your class an instructor may miss an imbalance that you have.  Imagine if even in a class of 6 for every exercise each person needed a slight modification?  The class just wouldn't flow.  If you know about what imbalances you have and what is good and not so good for you to do then participating in a class becomes more effective for you.

The Little Things

Classes definitely take a more generalist approach to exercise.  If if the class is labelled thighs, bums and tums the exercises are designed for many people to participate and follow along.  Even a CrossFit class has certain staple exercises and movement patterns that everyone does. 

However, what if I told you that to bench heavier you need to train trap 3 and external rotation in the scapular plane? And that weakness in these support muscles not only leads to a plateau in how much you can lift but also leaves you more vulnerable to injury.  You won't hear these terms bandied around in a class.  In a Personal Training session, a good one, your trainer will cover all bases of stability, support and function of a movement pattern.  It is not about the act of benching, it is about understanding and making sure all parts of movement pattern are considered and trained effectively.

The Whole Picture

These days, it is not enough for a trainer to know how to manipulate the variables of training and training zones.  Good Personal Trainers factor in all the variables of health and wellness.  They teach you about the importance of nutrition for the specific type of training you are doing, they teach you how to warm up and mobilise before your sports games, they educate you on the role of sleep, hydration, and stress on your progress.  There is no point participating in a high intensity cardio class 5 days a week if your nutrition doesn't support your activity, you don't sleep enough and you have a mega stressful job.  You'll end up gaining weight not losing in this scenario (for more information on how this happens click here).  Whatever activities you are involved in and however you choose to train for them, exercise is part of a lifestyle.  To support that lifestyle choice all the other health factors need to be considered for it to serve you effectively. 

A Little of the Good Stuff

So, now I've preached my case for the value of personal training have a think about how it might serve you.  Just to clarify, I am not against classes.  Like I say to all my clients, the key to any successful exercise is always good instructors.  And, it never hurts to learn a bit more about what your body needs so that when you attend classes you can make them work for you effectively.

I've had people come to me for a short while to learn how to train effectively and they happily apply this to the classes they attend.  Some of my clients work with me a few times a week regularly and also participate in classes.  And for the very busy executives and entrepreneurs I take care of all their fitness needs so all they have to do is show up - no thinking required!  For more information about Precision Movement can take care of your personal fitness needs please contact KT at KT@precisionmovement.co.uk.

Ligamentous Creep the Poisonous Weed of Inactivity

Precision Movement's KT explains how ligamentous creep causes back pain

Precision Movement's KT explains how ligamentous creep causes back pain

I often get asked by people why do I have back pain but my friends and family don't?  What is it about my back that is different?  There are many factors that contribute to back pain - genetics, activity throughout life, nutrition, stress and rest ratios, how you perceive pain and threats to your body.  In my clinical experience, I have found that lack of movement and poor posture are common with back pain.  In this article I explain a theory called Ligamentous Creep, how it occurs, how it makes the spine more vulnerable to injury and pain and what to do to minimise the chance of it happening to you.  Read on to find out more...

The Poisonous Weed of Inactivity

Sounds scary right?  It is true that inactivity is like a weed.  It sprouts one day quietly and then before you realise it's everywhere throughout your life.  You stop going to the gym, you stop cycling to work, playing frisbee with your friends in the park and then the couch becomes the love/hate friend you spend most of your time with. 

A typical inactive work day includes getting up and sitting on the tube to work.  Then sitting at work for 7 hours with minimal movement throughout the day, followed by more sitting on the tube home and then sitting to watch TV on your couch.  Noticing the trend here?  Sitting - it's the fertiliser for weed growth.

Ligamentous Creep - How it occurs

In the spine you have the bones (vertebrae), intervertebral discs, connective tissues (ligaments, tendons), muscles, nerves and blood supply.  Ligaments are super strong cables that connect bone to bone. They respond to tensile loading - being pulled apart.  When they are lax, they give no support. 

Precision Movement shows how sitting badly can cause pain

Precision Movement shows how sitting badly can cause pain

In a poor sitting position (see picture right) the ligaments at the back of the spine are being stretched and the ligament at the front of the spine is lax.  Ligaments can be stretched but they do not return to their original length.  If you sit like this throughout the day your ligaments will gradually 'creep' - or stretch over time.  Do this for long enough and it will create an imbalance and leave you susceptible to pain and injury.

Why it leads to injury and pain

When the ligaments are overstretched it changes the posture of the spine.  Remember the body adapts to it's environment.  Instead of the spine maintaining a neutral alignment that helps keep all the discs, nerves, vertebrae in place the spine warps into poor posture.  This poor posture can encourage the discs to push out onto the nerves.  It can cause impingements (pinching) of the nerve roots.  It also changes the length-tension relationships of the surrounding muscles - so muscles that help maintain good alignment become weaker or tighter, the spine can become  unstable and more susceptible to injury and pain. 

How long does it take to 'creep'?

Liagmentous creep happens over years.  Often in my practice, I see clients in their mid 30s to mid 40s with 'unexplained' back pain.  One day they just crouch down to put their socks on and their back 'goes out'.  The socks are the last straw.  Chances are that if you are inactive and sit for work all day, ligamentous creep will occur without you even knowing over a number of years.  Serious painful problems generally occur after 10-15 years of inactivity and poor posture. 

What to do about it

I am starting to think I sound like a broken record when I say activity throughout life is a big factor in keeping pain away.  The body loves movement and it should become a regular part of your life - a lifestyle choice.  The best type of foundational movement if you are desk bound is a gym session which blends corrective remedial work to maintain good core and back stability and alignment and functional strength training.  Other activities such as running, cycling and sports are also brilliant and you'll see these improving when you are aligned, stable and strong. 

Top tips for keeping the 'creep' away

1.  Invest in a Corrective Exercise Specialist or an experienced and knowledgeable Personal Trainer who can identify your weaknesses, correct postural alignment and teach you the fundamentals of functional strength training.

2.  Stay active throughout your work day by walking a few tube stops to work or cycle.

3.  A lunch time workout is a good choice if you have family commitments.

4.  Don't forget your weekends - you can take a walk or a cycle in the park or the countryside. 

5.  Kids are great for more activity.  Try to get involved in what games they are playing - whether its 10 mins in the garden or a whole day of kite flying on the beach.

At the first sign of any discomfort in your back, especially upon waking or with extended periods of sitting speak to your GP about getting a referral to a physiotherapist.  Also tell your Exercise Therapist or Personal Trainer so they can advise you and adapt your training programme accordingly.

For more information about how Precision Movement can help you with back pain or other discomforts from sitting at work all day please contact KT at KT@precisiononmovement.co.uk.  We are highly experienced in dealing with and helping the recovery process of all kinds of discomfort, pain and injury.  

When on vacation do what KT would do!

Precision Movement's KT shares top tips for avoiding back pain on summer holiday vacation

Precision Movement's KT shares top tips for avoiding back pain on summer holiday vacation

It's that beautiful time of year when we get to take a vacation.  Whether it's long haul or an hour from home, trekking amoung ancient ruins, exploring the hidden streets of a european city or chilling out on the beach - you want to make sure that back pain doesn't wreck your time away.  In Part 1 of this article I talked about back pain occuring during the travelling part of your trip. In part 2 I talk about how back pain can occur whilst you are doing the 'vacation' part of your trip and of course how to avoid it so you can enjoy every moment of the vacation that you have worked hard for all year and that you thoroughly deserve!

The Deck Chair

The deck chair, although a British institution, is the worst seating invention for back pain - ever! When you sit it the deck chair you have no spinal support at all - in fact it encourages the spine to excessively curve (see photo above) which can contribute to Ligamentous creep (read more about this theory here) and then to the intervertebral discs pressing out on to the nerves. On holiday when you want to sit for a good few hours in the sun perhaps reading a good book or the paper your back could really suffer from a lack of support in the deck chair.

Solution:

Choose a more supportive chair with an upright back. If the deck chair is the only choice then pad the low back area out with a pillow, cushion or a towel so your back is more supported and get up regularly to walk around and stretch.

The Sun Lounger

The sun lounger is a more preferable choice to the deck chair as you can vary your position throughout the day.  However, I myself am guilty of setting my lounger up so I can read comfortably for the entire day without changing.  The worst angle is setting the back support at a 45 degree angle.  It puts your back in a similar position to how it is in the deck chair.  It is also common to crane the head forwards when reading which places strain on the back of the neck and upper back.

Solution:

If you must use the 45 degree angle then place a towel or a cushion behind the low back to place your spine in a more neutral position.  Rest the head back or support your head with a cushion or pillow avoid excess strain in the neck muscles. Also, changing up your resting position really helps to minimise the risk of discomfort.  This can be a regular change in the angle of the back support to alternating between lying down and sitting, lying on your front and even on your side.  The more variation of resting positions you use the better your back will fare. 

Upping your activities

On vacation we like to do things that we can't do at home such as watersports and mountain sports .... We tend to forget on vacation how inactive we have been for the rest of the year in place of living in the moment and having an exciting time.  The forces that go through your body during sports like windsurfing, waterskiing, mountain biking, are very high.  These sports require excellent balance, strength in three planes of motion, co-ordination and endurance as well as a highly tuned neuromuscular system to react quickly to changes of direction.  Boris biking a couple of times a week really wont cut it! 

Solution:

The best thing to do to prepare yourself is to train before you go.  Ideally if you have an active nature then you should be training all year round so your body is aligned, stable, strong to withstand the forces of these adventure sports. We train clients in this way on our Fit for Life programme (LINK).  If you are a spur of the moment person opt and are not fit for the sport then approach it sensibly and ask about modifications to minimise the risk of injury.  Another good option for exercise on vacation is Hatha Yoga, tai Chi or Qi Gong - more gentle forms of exercise that carry less of a risk for injury.  If you are heading East then these options will be plentiful!  Many European resorts and main towns and cities have good yoga options too.

Horizontal paralysis

I'm not one for lying on the beach all day I personally get very bored.  But I know many people who see the beach as the holy grail of relaxation and they can quite happily lie out in the sun all day without moving a muscle.  This is not great for back pain or avoiding discomfort.  If you are going to lie down all day and then sleep all night your muscles will quickly atrophy (shrink and lose strength).  This includes the muscles surrounding the spine which leave the spine unsupported and vulnerable to injury. 

Solution:

Move regularly throughout the day by taking a dip in the sea or the pool.  Play a ball sport or tag with your kids or friends on the beach.  I remember when I was young my Mum used to chase me around the beach with soggy seaweed for hours of fun! If you are not keen on so much activity then just take a walk a couple of times throughout the day.  Lastly, if you like to dance then go dancing in the evenings - it's a real calorie burner.  Watch the ankles in the high heels though and avoid daring back bends if you are partial to a bit of back pain! 

I wish you all happy and safe vacations wherever you are relaxing, exploring or going a little crazy!  Remember these essential factors to minimise back pain occurring and look out for my article on safely returning to exercise post vacation which I am writing for The London Orthopaedic Clinic.  It should be out when you are all back to your London routine!

Planes, Trains, Automobiles and Back Pain

Avoiding back pain on your summer holiday vacation

Avoiding back pain on your summer holiday vacation

It's that beautiful time of year when we get to take a vacation.  Whether it's long haul or an hour from home, trekking amoung ancient ruins, exploring the hidden streets of a european city or chilling out on the beach - you want to make sure that back pain doesn't wreck your time away.  You might think that vacation is the last place that injury or pain can strike - you are in a beautiful place, your time is your own, you are happy and relaxed.  How could you possibly get injured?  In part 1 of this article I discuss why back pain can occur during the travelling part of your trip and give you tips on how to minimise the chance of you experiencing back pain so you can enjoy every moment of the vacation that you have worked hard for all year and that you thoroughly deserve!

Why is sitting so bad for the back?

The low back has a natural lordotic curve which helps the intervertebral discs stay centred between the vertebrae.  When you sit the low part of the spine becomes rounded and the lordotic curve is reversed.  Curving the spine for long periods encourages ligamentous creep (read more about this theory here) - the stretching of structural stabilisers that help keep your discs and spine aligned.  Ligaments can be stretched but they do not return to their original length.  Over time the spine becomes unstable and the discs can push out on to the nerves causing discomfort.  Instability of the segments means unwanted movement which can also create problems.

Sitting for long periods also causes compression of the spine.  Depending on what position you sit certain parts of the spine may take more pressure than others which can result in certain muscles taking on more work than necessary whilst others switch off.  This can cause discomfort also.

Travelling to your destination often requires sitting on a plane, on a train or in the car.  The back doesn't like sustained postures like sitting in a chair for several hours.  For each situation you might find yourself in there are a few changes you can make to make your back more comfortable.  So here are my top tips for minimising back pain on your vacation this year.

In the driving seat

Car seats are not great for back pain.  The back seat is often slanted downwards which means your hips are lower than your knees when seated.  This is especially true in supercars such as the bugati, porsche, maserati, ferrari and maclaren which are set very low to the ground.  The first thing you can do is change the angle of your seat so that the back of the seat is higher than the front.  If this is not possible i advise my clients to get a wedge cushion and place the raised part at the back of the seat.  This will help to raise the hips higher than the knees and place the spine in  better alignment thus reducing the risk of discomfort.

Props

Another common problem is that car, plane and train seats do not give adequate low back support.  I recommend to all my clients who have disc injuries that they invest in the Mckenzie inflatable back support for their car seat.  Place it in the mid part of your low back opposite your belly button and inflate to a size that makes your back feel supported - everyone will need a slightly different adjustment but aim for supper that keeps your back neutral.  This means a slight arch in your low back.

I like to move it move it

The third and most important part of avoiding low back pain when travelling is to take regular breaks to move around.  That means actually moving around not more sitting at a service station for a cup of tea or walking for 10 seconds to your friend at the back of the plane or the other train car and sitting with him for a natter.  Walk around, stretch, mobilise and move as much as you can where you are.  If you are travelling by car and you take regular breaks I know it takes longer to get to your destination and if it means making the choice between two weeks of discomfort and grumpiness over two weeks of happy, relaxed fun... I'll let you make the decision on that one! 

Switch it up baby

On the plane if you have the option to recline and lie down alternate between reclining, sitting up and lying down as this counts as changing your position.  If you are particularly tall opt for a business class seat with more leg room or at the very least the front row of economy class.  If you are already in discomfort a seat which allows you to fully recline on the plane is your best option as this is where pressures and forces on the spine are at their lowest.  Regularly stand up and walk the aisles of the plane even if your flight is a couple of hours.  Movement is absolutely key to keeping discomfort to a minimum.  Don't wait until you feel uncomfortable - take a walking break every twenty minutes.  I often find drinking lots of water helps as I need to use the restroom a lot which means getting up.  It also helps you stay hydrated...

Water your back

Whatever mode of transport you are taking drink lots of water - not juice or tea or coffee - WATER.  The discs of the spine are filled with fluid.  When you are dehydrated they reduce in height which means the vertebrae are more likely to cause compression of the nerves where they exit the spine.  Staying hydrated helps keeps the discs plump and maintain good height.  Hydration is also one of the most important parts of good health so never skimp on water!

In Part 2 of this article I discuss the culprits of back pain when you have actually arrived.  If you can't wait then click here to read it.  I wish you all happy and safe vacations wherever you are relaxing, exploring or going a little crazy!  Remember these essential factors to minimise back pain occurring and look out for my article on safely returning to exercise post vacation which I am writing for The London Orthopaedic Clinic.  It should be out when you are all back to your London routine!

Endless back pain gone in 6 weeks!

Precision Movement Case Study Mrs A

Precision Movement Case Study Mrs A

It's that time again when I share another one of my success stories with you all.  Meet Ms A, a 72 year old lady who loves walking holidays, travelling and puts my social life to shame!  Ms A came to see me because she had been suffering with constant upper back pain for many years from a collapsed vertebrae in the middle of her spine.  She also has osteoporosis and fractured her hip 12 months ago, fractured her elbow four years ago and injured her knee in a skiing accident 50 years ago which has always bothered her.  When she first came to see me she was unable to walk from the grocery store to her house carrying a light bag of shopping without experiencing pain.  Her main goal was to get out of pain so she could go back to enjoying her walking holidays.  Here is what happened...

The Assessment

Ms A was experiencing pain in her neck, upper back and mid back.  As you can see from the photos below Ms A had a very rounded upper back, a kyphosis, and this part of the spine had no movement - it was blocked.  You can see from the photos that the back of her neck was very crunched and the head had migrated forwards.  The muscles of the chest and front of the shoulders were very tight.  This was creating great strain on the front of the neck and the upper and mid back as the muscles try to hold the bones from falling forwards and down.  Not so visible from the photos was the increased lumbar curve (low back).  Both the upper and lower curves of the spine were too big.  In the middle of these curves is the thoracolumbar junction created where the T12 vertebra meets the L1 vertebra.  Ms A's L1 is collapsed which meant the increased curves here were putting excessive pressure on this joint causing more discomfort.

Precision Movement Case Study Mrs A before photos

Precision Movement Case Study Mrs A before photos

Referral to a Specialist

The assessment results revealed that Ms A needed specialist manual therapy for her neck.  I referred her to Mr Nicholas Potter, world renowned chiropractor who specialises in neck and upper back injuries.  Mr Potter was able to realign Ms A's neck so that I could begin working on strengthening the muscles around the neck and upper back to maintain the newly adjusted alignment.  Ms A had great success with her treatment and felt it highly complimented the work I did with her.

The First Phase

The first part of Ms A's programme centred around opening up areas of her body that were tight - namely the chest, anterior shoulder and the upper back.  I used specialist mobilisations to gently open up the upper back encouraging more movement in the area.  Then as the upper back and chest started to open I introduced some gentle exercise to work on the muscles that encourage a more upright position for the upper back and help the shoulders stay open and back.  It was the combination of opening up tight areas and strengthening weak areas that helped Ms A's posture begin to change.  For the old knee and hip injuries I used exercises to stabilise the pelvis and knee joints - starting with isolated exercises and slowly integrating more and muscles to work with each other.  I worked with her twice a week and gave her a mini home programme of stretches to do every day.  Ms A was exceptionally diligent and as a result her body began changing very quickly - despite her age.

Initial Changes

Ms A began to experience changes within 2 weeks of beginning her programme with me.  The treatment she received for her neck had an instantaneous affect - relieving years of neck discomfort.  Within 6 weeks her upper back pain was gone and she was able to happily carry out daily tasks like shopping and walking without discomfort.  Ms A loves the theatre and found sitting for long periods very troublesome for her back.  We were able to increase her tolerance to sitting from 10 minutes to 2 hours.  Her reassessment results showed more than double the initial range of  movement in the spine in all directions.  Her initial head alignment was 7.2cm forwards of her sternum and reduced to 4.2cm which greatly reduced the strain on her upper back.  Her shoulders also migrated backwards by 1.5cm each side which was a result of opening up the chest and front of shoulders and strengthening the upper back.  Ms A noted that she felt less round shouldered, and all of her movements in daily life were easier as well as feeling dramatically reduced discomfort.

The Second Phase

As Ms A had improved so much in the first phase we quickly moved on exercises that encouraged the endurance of her postural muscles and also more functional movements such as a modified squat pattern.  Ms A tired quickly in her sessions, so we focussed on the quality of the key movement patterns and I gave her the rest and recovery she needed.

More Changes

A week 8 of the 12 week programme Ms A went on a walking holiday for 4 days and only experienced discomfort once through the whole trip which she was able to ease with the stretches and mobilisations I had given her.  She was delighted with her progress having suffered with daily discomfort for years to hardly any problems at all even on her walking holiday!  You can see from the photos below that Ms A's posture dramatically improved.  An unexpected development was weight loss.  Because Ms A had less pain she was able to move around more during the day and she also took up swimming twice a week.  Even though the exercise I did with her was gentle and progressive, it enabled her to return to swimming increasing the total volume of weekly exercise and resulted in a drop of 2 dress sizes in just 12 weeks!  Ms A came in to see me during week 9 and told me she was able to fit into trousers she hadn't worn in years - she said she had a whole new wardrobe of old clothes to choose from.  Look at her dramatic improvement from week 1 to week 12 below:

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

Precision Movement Case Study Mrs A before and after photos

In Ms A's words...

"I was really keen to reduce and manage my back pain and I thought KT's approach sounded like it would help me.  It didn't take very long for me to be able to get through my day without pain and she helped me identify what was likely to make it hurt - things like sitting for too long.  She gave me exercises and stretches that I do every day now.  I particularly like rolling out my back.  The big test came when I went on my first walking holiday about 7 weeks into working with KT and my back was miraculously pain free for the whole holiday!  I was so pleased.  I've also been able to get back into my swimming.  An added bonus was that I have lost quite a lot of weight which I wasn't expecting.  I have a whole 'new' wardrobe of clothes that I can fit into again!  So many people have noticed how different I look.  I thought I would be riddled with pain forever but now I am pain free thanks to KT's help."

You are never too old!

So there you have it - you are never too old to make changes that improve the quality and enjoyment of your life.  If you are interested to learn more about how I can help you reduce discomfort and improve posture then please email me at KT@precisionmovement.co.uk.  Let's have an informal chat about your specific situation to see how I can help.

What to do if you have back pain from cycling

Bradley Wiggins

Bradley Wiggins

It's Tour De France time!  And if like me, you live in London, you could probably mistake London Town for the French Alps as there are so many cyclists on the roads these days.  In fact, cycling has become the most popular mode of transport in recent years.  Perhaps Londoners are becoming more health conscious, maybe it's the lure of trying out the Boris Bike.  I think it's amazing to see so many people taking a practical approach to health and making their commute part of their fitness regime.  I've seen a few people fall in love with cycling, getting the latest carbon fibre frame, custom aligned to their body, all the cycling garb, the cleats - before you know it they are wearing a yellow jersey!  But then, unexpectedly, back pain strikes and feeling pro very quickly becomes feeling low.  So how do you avoid back pain when your bike becomes your best friend?  Read on to find out....

The cycling position

If you assume the pro position on the bike or even a metropolitan modification of this position then you'll probably look a lot like Bradley Wiggins (see above).  Maybe you even think of yourself as looking a bit like Bradley but I'm not here to comment on that!  You can see that the spine is rounded - excessively rounded which makes you more streamline and therefore faster and more efficient.  However, sustaining this position for long periods can create imbalance in the spine which can lead to irritation, discomfort and injury.

Getting your bike fitted properly

There is not much you can do on the bike - although it goes without saying that you see a bike specialist to make sure your bike is optimally fitted to your proportions.  If you can, try to find a company that can observe you actually cycling so they can see what's happening when you move.  I would recommend www.bike-science.com who can do a 3D analysis of your position and movement on the bike.

Rebalancing your body

I have several clients that cycle to work and recreationally at weekends.  For these Tour De France wannabes, I make sure that I put in exercises that extend the spine or reverse the bike position curvature of the spine.  I also include exercises to upright and extend the upper back as well as externally rotate the arms and retract and depress the shoulders.  All these actions are the reverse of the position on the bike which encourages flexion of the spine, internal rotation of the arms, protraction of the shoulder blades.  I also include exercises that work the glutes, hamstrings and lower back in an extended position.  In cycling the glutes and hamstrings work against a flexed torso but we need these muscles to co-ordinate in upright as well.  Here are a few suggestions to get you started and make sure you go through them with a trained specialist to make sure you are in the correct alignment and use correct technique.

Precision Movement exercises for cyclists with back pain

Precision Movement exercises for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

Precision Movement exercise for cyclists with back pain

The best bike solution if you have a back problem

dutch bike best for back pain

dutch bike best for back pain

The best bike for bad backs is the Dutch style with high handle bars.  Yes it's more of a cruising bike with a vintage feel - you are not going to see Chris Hoy on one of these - but it is the best choice for those who have back problems or structural damage.  The higher handle bars encourage your spine to stay more upright which helps keep to maintain the discs and vertebra in the optimal alignment thus reducing the risk of discomfort. 

If you are prone to back problems or have an injury like a disc prolapse it is better to take short journeys between 20-30 mins and then get off and walk or stretch a bit rather than doing a 3 hour power cycle.  The spine does not like sustained postures so the more you can change up your position the less likely you'll irritate your back. Cycle for enjoyment which means take it easy with the speed and the resistance.  

Don't forget your helmet and happy pain free cycling! 

For more information on exercise for cyclists whether recreational or professional please contact KT at KT@precisionmovement.co.uk.  If you are injured and would like more information on how KT can help you please visit the website at www.precisionmovement.co.uk.

The case of the wonky man who became straight

Screen Shot 2014-07-11 at 11.51.53

Screen Shot 2014-07-11 at 11.51.53

I've had a few requests for some real life Precision Movement case studies.  I do love suggestions and I also love sharing my success stories with you.  So meet Mr G, a man in his early 60s, who approached me to work with him after a recent diagnosis of a degenerative central nervous system disorder.  He had previously engaged in some exercise but his posture was poor and he had several injuries and surgeries in the past.  His main goal for working with me was to improve his posture and gain better stability and strength to be as well as possible physically to cope with whatever happens in future.  Here is what happened...

Just a mini disclaimer to say I have tried to make this as readable as possible - not too technical and dry.  I've also reduced it down so it's not too long.  With that said, I do hope you enjoy getting a deeper look into the inner workings of how I actually help people and could help you too!

Day 1 - The Assessment

As you can see from the photos below his posture needed attention.  His assessment results showed that his upper back was too rounded and his low back had no curve at all.  He was also stiff in his neck, shoulders, spine, and hips and a severely restricted right knee. The biggest visual discrepancy you can see from the photos is that his right hip was 7 degrees higher than the left and his left shoulder was 5 degrees higher than the right.  There were many more complex results from his initial assessment but for the purposes of giving a digestible overview I won’t divulge any more.

Case Study by KT at Precision Movement

Case Study by KT at Precision Movement

Weeks 1-6

The first stages of training focused on breathing mechanics, teaching him core function so he understood it consciously and was able to then activate and have awareness of this during exercises. I also focused on opening up the areas of Mr G's body that were locked and tight with a series of bespoke mobilizations and stretches.  I worked specifically to target the muscles that were contributing to his mal-alignment – notably the tightness of the right side of his body that was causing the shoulder and hip height discrepancies.   I then taught Mr G specific exercises to strengthen the areas around his shoulders and pelvis.  After just 6 weeks he had significant improvements in alignment and joint stability.

Weeks 7-12

Once a base level of stability and alignment was established I continued to work on this as well as improving Mr G’s neuromuscular (brain and muscle) communication to wake up and continually stimulate his central nervous system.  After 12 weeks you can see from the photos that Mr G’s hip and shoulder heights were almost equal.   His spinal curves had improved although still needed more work.  His head carriage (position of the head in relation to the body) reduced by a third.  His shoulder blades moved 2cm closer towards his spine.  He had a significant increase in hamstring (back thigh) and quadriceps (front thigh) flexibility as well as internal and external rotation at the hip.  He was able to successfully stabilize his hips and shoulders whilst his legs and arms moved around the joints.  Most notably he ‘grew’ 2.5cm. 

Case Study by KT at Precision Movement

Case Study by KT at Precision Movement

In Mr G's words

"I signed up for KT's 12 week course when I had been diagnosed with Parkinson's Disease.  I felt that I should be as well as possible physically to cope with whatever happens in future.  KT devised a programme specifically for me and within a short period I was seeing fantastic results.  I am most definitely taller and much better physically.  I cannot count the number of very flattering comments I get from old friends as well as feelingsignificantly stronger.  KT also makes detailed records of all aspects of my body and the results at the end of the course are there for all to see.  Now that my 12 week schedule is over I will see KT on a regular basis every 6 weeks to ensure that I am following the programme she has set me correctly.  Her demeanour and knowledge make her an excellent and caring coach and she always knew how to flatter me to get the best out of me!  I have no hesitation in recommending her."

For more information on how KT can help you get out of pain, improve your posture and gain strength please contact her on 07515 856 009 or email KT@precisionmovement.co.uk.  

Movement is the foundation of your career success

Precision Movement Career Climber Programme

Precision Movement Career Climber Programme

I've been looking for concrete evidence of the affect of physical work on career success for a while and a few weeks ago I was given "The Making of a Corporate Athlete", written by Jim Loehr and Tony Schwartz in The Harvard Business Review back in 2001.  These two extraordinary gentlemen brought an elite athlete preparation and training protocol to CEOs and high level executives to dramatically improve work performance as well as enhance health and happiness in their lives.

The High Performance Pyramid

They work to a principle called The High Performance Pyramid.  Their model shows that building on rituals of physical, mental, emotional and spiritual components helps CEOs and high level execs excel at peak performance under pressure.  Notice that physical movement is the FOUNDATION!  Effective, vigorous exercise  can promote a sense of emotional well-being which leads to peak mental performance that affirms our purpose for doing what we do and living how we live.

Corporate Athlete

Corporate Athlete

A Real Example

One of my clients is a truly hard working jet setting executive of a big company.  He came to me years ago with back problems which are now under control.  After we'd fixed his back issues he set his goals on gaining strength and getting fit.  Occasionally he misses his regular bi weekly sessions due to work travel.  He always returns and says the same thing to me, "KT, I just function better at work with my regular workouts.  My head is clearer, I have more energy and motivation.  Without my regular workouts I start to get depressed and frustrated towards the end of the week.  I don't know why but exercise just works for me."  He also notes that his work capacity, mental and emotional well being and energy are consistently higher and serve him better when he regularly exercises.  

What You Can Do

1.  Look at your surroundings near work and home.  Do you want to workout at home or in a gym or outside? Factor in travel time to and from a gym or the park.

2.  Look at your work week and see where you can make 2 x 1 hours slots for your workouts. There are 168 hours in a week - you can take 2 hours to improve your performance at work and increase and maintain your health and fitness.  Before and after work are possibilities as well as a lunch time slot.  Don't forget your weekends!

3.  Seek out an experienced and qualified personal trainer who can plan your programme and progress you appropriately.  All you need to do is show up!

4.  Stick to it.  Commit to a set period of time - I like 12 weeks and notice what happens!  It won't take long for you to start enjoying the benefits of regular exercise in the office as well as in your personal life.

KT developed the Career Climber Programme to help people in business and executives maintain the exercise part of their performance under pressure with engaging, fun workouts that are bespoke to the individuals fitness needs.  All you need to do is show up - the rest is done for you.  For more information please contact KT on 07515 856009 or email KT@precisionmovement.co.uk.

How corrective exercise helps disc injuries

Disc herniation Precision Movement

Disc herniation Precision Movement

The most common injury I see in my practice is varying stages of disc prolapse.  Most people steer clear of any movement when they have a disc injury for fear of setting off the intense and unbearable pain and making the injury worse than it already is.  However, as my client Mr A discovered, the right type of exercise is actually the safest and most effective way to manage your disc injury going forwards.  Read on to find out how Mr A went from daily agonising pain for years to no pain at all in just 3 months.

What is a herniated disc?

A disc prolapse (often called a slipped disc) is where the jelly (nucleus propulsus) in the disc inbetween two vertebrae pushes out and sometimes through the outer ring (annulus fibrosis) of the disc into the spinal cord canal.  It can push on the nerve roots and cause pain in the local area, or affect the nerve down through the hip or down the leg.  Other more severe symptoms that can occur are numbness, tingling, an electrical feeling and temperature change down the leg often referred to as sciatica which I talk more about in my article entitled '

How Corrective Exercise can help Sciatica

'.  

Causes

There are many reasons why a disc prolapse occurs.  It can occur from a trauma such as a sports injury or a car crash that results in a blow to the spine or surrounding areas.  A more common cause is from poor posture leading to ligamentous creep over a number of years.  The vertebrae are designed to keep the discs in place but it is repeated poor posture and inactivity that leads to the disc creeping out.  I talk more about this concept in another article entitled "Ligamentous Creep - the poisonous weed of inactivity" - coming soon so make sure you stay tuned via my newsletter!  Other factors such as nutritional health play a part in disc and spine health.  

In the case of Mr A - there was no traumatic accident.  He had been inactive for most of his adult life and his sedentary desk bound job probably did not help in preventing his back pain and subsequent injury develop.

The 4 stages of disc herniation 

The first stage is referred to as a disc bulge.  This is where the outer ring is intact and the inner jelly just pushes out creating a bulge.  The second stage is called a disc prolapse where the outer ring is weakened and the jelly begins to push into the weakened area but the outer ring remains.  The third stage is called extrusion where by the jelly breaks through the outer ring.  The fourth stage is called a sequestration where fragments of the jelly enter the spinal canal.  

The last two stages have an added complication in that pain may also occur from chemical irritation of the jelly in the spinal canal.  This can be more challenging to manage as the pain is not just coming from mechanical causes.  Unfortunately, once your structures, namely the disc, is damaged it cannot be repaired.  However, management through medical treatment and corrective exercise can be exceptionally effective.  

In the case of Mr A, he had suffered from back pain for 15 years.  It was diagnosed as a disc prolapse and 12 years later he had surgery, a micro-discetomy to remove part of the disc that had moved into his spinal canal and was causing agonising daily pain.  12 months after his surgery, he came to see me still in terrible pain.

Exercise to the rescue!  

Exercise is an incredibly important and often successful part of recovery from discomfort with disc herniation.  Nearly all people I see in my practice have a disc herniation from inactivity, poor posture and sitting at a desk all day.  

A common postural imbalance that correlates with disc herniations is a very flat low back often coupled with tight hamstrings.  I also see a fair amount of people with an excessive upper back curve and weak postural stabilisers throughout the spine.  However, just sticking your butt and chest out and stretching your hamstrings will not fix the problem - in fact you could make your pain much much worse!  

There are specific stretches, mobilisations and exercises I give to correct these imbalances and help the disc sit better between the vertebrae.  Often breathing mechanics, core activation and localised spinal stability are compromised as well.  Each person I see has different imbalances and to a different extent which is why it is not possible to give blanket advice and exercises.  

John Medina explains in his book 'Brain Rules' how exercise also helps to increase the growth of new blood vessels throughout the body to get  deeper access into the tissues.  This helps the tissues dispose of toxic waste that builds up in and around an injury and areas of pain.  The more you exercise, the more tissues you can reach and the more toxic waste you can get rid of.  Exercise actually physically aids your recovery.  

Mr A had many postural imbalances that were causing more stress on his disc injury.  Even though he had surgery to remove a part of the disc that was most irritating, his spine was very unstable and he had lots of tight muscles in his pelvis and upper back.  He worked with me for 3 months and diligently followed his exercise programme. Within 4 weeks he was noticing a marked decrease of discomfort on a daily basis and by week 8 he was virtually pain free.  

What can I do now?

Ideally seek out a specialist in corrective rehabilitative exercise who can assess your  whole body postural alignment.  It is increasingly common to hear and see of patients doing exercises poorly or completely wrong which can make symptoms worse.  It is imperative to do your exercises with good form and it is advisable to do them under the observation of a corrective exercise specialist like we have here at Precision Movement.  This is mainly because your body will have a preferred way (poor alignment way) of doing movement and with each repetition you do you'll need to remember and apply newly learned alignment to make desired changes.  

If you are suffering with disc herniation related pain please do email me at 

KT@precisionmovement.co.uk

to set up a complimentary 20 min phone consult to see how I may be of assistance to you.  You don't have to suffer forever - life is too short!  

How corrective exercise differs from regular exercise

KT at Precision Movement

KT at Precision Movement

The number one question I get asked is "Are you a physio?" - unfortunately I cannot lay claim to this esteemed profession!  I am not a physio.  The second question is, "So are you a personal trainer then?".  Again I cannot say I am a Personal Trainer either - well not anymore.  I fall somewhere between the two and work under the grandiose title of "Corrective Exercise Specialist".  This line of conversation invariably leads to a discussion about what type of exercise I do and how it differs from gym training.  I will now humbly attempt to explain in an effort to give you a better understanding of the difference....  Wish me luck!

What is corrective exercise?

Corrective exercise is a special type of exercise usually used as part of the rehabilitation process in healing and recovery from chronic pain, injury or surgery, or given to those who suffer from poor posture.  The emphasis really is on optimal alignment, stability, mobilisation and then strength development.

In comparison regular exercise that you might do in the gym or in sports has a different goal - often increased fitness, body shape change, weight loss etc.  As the goals are different the exercises and movement given are bigger and incorporate more muscles.  This helps co-ordination for sports and is also effective for conditioning the body to change shape and increase fitness.  If I were to give these exercises to someone who is in pain and has poor alignment, poor stability, mobility and strength they would not be able to perform them effectively and could potentially hurt themselves further.

It's important to mention here that corrective exercise also forms a foundation for all movement and exercise.  If your foundational principles are good then your risk of injury is much reduced.  When clients come to Precision Movement with fitness goals we still take them through foundational principles to make sure alignment, stability, and mobility is optimal for more complex movements.

The types of exercises

The majority of exercises I do with clients at the beginning of their programmes are floor or swiss ball based.  I ask them to repeat the repetitions many times to elicit postural change and I also ask them to engage in mindful exercise which includes some psychology techniques.  Corrective exercise rarely makes you sweat and definitely doesn't increase your heart or breathing rate.  It is not easy though!  The areas we stretch are usually tight and stiff and the muscles we train are weak to begin with.  When clients adapt and improve, programmes are updated to challenge them further.  

A classic exercise I teach clients is the horsestance series.  It looks very easy but it is actually quite challenging.  Before clients can do this exercise effectively I'll also teach and often reset their breathing mechanics, help them effectively activate their core and how to activate stability through their hands and feet.  When the exercise is performed correctly it is exceptionally effective in training stability and forms a solid foundation for more complex movements that you would do in the gym or in sports.  

Typical exercises you might see in the gym are squats, lunges, pullups and pushups.  These are all neurologically complex movements meaning the brain needs to send a huge amount of information to the muscular system to perform the movement successfully.  You might use a kettlebell swing which is a dynamic form of a deadlift pattern. Running, martial arts and many other sports are also exceptionally challenging to the body and brain. To perform these exercises and sports well you'll need optimal joint stability, understanding of core function, breathing mechanics, optimal joint mobility and to minimise the risk of injury good alignment throughout the body as well as in the movement.

When does corrective exercise become regular exercise?

At Precision Movement we are specialists in change.  Our goal with everyone is to get them to a fully functional movement state for life and whatever sports they participate in.  

We don't want someone lying on the floor doing a mundane exercise forever.  We may ask someone to do this in an early stage of rehabilitation to get certain muscles firing but when they adapt to the exercise we make it more challenging.  All the exercises we give have many many progressions right up to regular exercise that you'll recognise well.  Perhaps the difference in giving regular exercise at Precision Movement is we might make changes or modifications that are specific to an individuals needs eg.  A static lunge might include a band to emphasise the inclusion of the hip stabilisers that have a tendency to be lazy - they might now be strong but the band acts as a reminder for the individual to maintain good knee alignment.

In a way, we use corrective exercise like servicing a machine.  A machine that has been running for a while might need some parts changed, an oil or water change.  Similarly, we'll do a maintenance check and make sure all the stabilisers are firing correctly and alignment and mobility are good.

For more information on corrective exercise for postural alignment, pain relief and management of injuries and degenerative conditions please contact us.

Is chiropractic right for your injury or condition?

Dr Luther Moss Chiropractor

Dr Luther Moss Chiropractor

I am often asked about which medical treatment is best for back pain or a particular injury.  I refer clients to chiropractors as they share a similar philosophy of movement and health as I do.   Dr Luther Moss DC, MChiro, PgCert, MCC, co-owner of ML Chiropractic in Fulham, SW London is one such chiropractor that I refer to and I had the opportunity to interview recently about why chiropractic is so helpful to clients recovering from injury and with general overall health.  Read on to find out more....

What is chiropractic? 

Chiropractors are concerned with maintaining the alignment, flexibility and strength of the body in order to ensure optimal nervous function and health. Although adjustments (which can often result in a crack or pop) are commonly used by chiropractors, we have many other techniques for treatment that I use with patients who still experience fantastic health benefits of proper alignment strength and mobility.

What is the nervous system and how does good joint alignment help its function?

The nervous system is the master control system of your body.  The brain is the main computer and the spinal cord and nerves are the wires that allow your brain and body to communicate.  Every process within the body is, at its source, controlled by the function of the nervous system and therefore having a healthy and well functioning nervous system is a fundamental requirement for health. Alignment and flexibility of the body (especially the spine) influences the nervous system’s ability to communicate signals from the body to the brain and then back to the body. Through a specific nerve sense called proprioception (movement sense) movement helps to regulate the function of the nervous system.  Movement and the nervous system are interdependent - they both need each other and when healthy, help each other function better.

How does chiropractic help poor alignment and injury?

If joints, specifically spinal joints, are misaligned or inflexible then their ability to produce this movement sense is reduced and so compromises the function of the nervous system. Of the 100billion or so nerve fibres in the spinal cord, over half are responsible for transmitting this movement sense and of those 90% come from the spine. Therefore movement, alignment and function of the spine is of paramount importance when considering the health of the nervous system.  

In injury better alignment and flexibility leads to faster recovery due to increased nervous function and in daily life it leads to better performance, co-ordination and protection against injury.

(In essence movement represents to the brain what electricity is to a battery on charge, it literally charges the brain to allow better function. Once you understand the huge influence that alignment and flexibility of the spine has on this process, the need to take good care of your spine quickly becomes apparent.)

What roles does chiropractic play in general health?

95% of all health issues are related to one or more of the 3 key areas of health; how we move; how we eat and how we think. Dysfunction in one or more of these areas forces the body to adapt which over a period of time comes at the expense of our health.

Chiropractic focuses on the physical alignment and function side of how we move, optimising function with a view to optimising nervous system performance and allowing our body to express a better level of health. We also help to address the other key areas of nutrition and cognitive function in order to provide a whole health approach to patient care.

What do you specialise in?

My personal area of interest is headaches and migraines. Through detailed neurological testing I firstly help to identify if there is any cause for concern and can make the appropriate referral if necessary.  Following this a combination of detailed history taking and chiropractic and orthopaedic physical examination helps to identify the likely cause of the complaint. In many cases misalignment or dysfunction within the neck region is the main culprit. With proper correction of alignment and function of the spine in these cases, the responses can be incredibly powerful with some lifelong sufferers of headaches reporting a complete resolution of their problems  I find these patients very satisfying to work with.

What do you think your treatment is MOST helpful with?

The patients that we get the best results with are those who are trying to turn their lives around and have under exercised and overeaten for many years and have normally suffered from long term spinal/body pain. The work we do allows us to coach these patients in the different aspects of their life helping them to become pain free and more importantly have a better level of physical and physiological function.

What do you typically see patients for?

Although the range of patients we see is very large the most common complaint we see is those suffering from lower spinal pain of no apparent onset. This is normally a result of long term problems with posture, movement patterns, diet and stress. People are often confused as to how so much pain can come from no-where but unfortunately that is often the result of failing to properly look after your body.

We also see a range of athletes looking to improve their performance and injury resistance and many people simply come for regular checks to help counteract their physically and emotionally stressful jobs.

How often does someone need treatment?

That is a difficult question to answer as every case is different. However just like getting fit, restoring alignment takes time and dedication; there is no quick fix as we are trying to retrain the body and how it functions.  For example someone suffering from acute lower spinal/disc injury a treatment programme may involve 6 treatments in the first 3-4 weeks followed by a further 6 over the next 2 months.

Is your system an intense short term treatment method or more of an ongoing maintenance? 

Acute injuries or people with a long term problem often require a period of high intensity treatment initially but our aim is always to get the person as independently healthy as possible as quickly as possible.

Chiropractic is based on a system that is dedicated to optimising people’s long term health and function.  Many people then return to us on a regular basis to help maintain alignment and nerve function, they see it as part of their normal health routine alongside exercise and a healthy diet.  The frequency of these ‘maintenance’ visits vary from 4-12 weeks.  These people are the ones who experience the maximum health benefits from maintaining alignment.

How do you use your treatment for back pain? 

Chiropractic adjustments and treatments are recognised as one of the safest, best techniques for the treatment of lower spinal pain. Studies have shown that recovery from mechanical lower back pain using chiropractic has proven to be faster, more effective and less expensive than medical alternatives.

We also see many people recovering from injury or surgery. We can help improve healing times and maintain function during these difficult and often painful periods of time.

Do you believe the patients you see need corrective exercise? 

Absolutely.  Everyone should be exercising regularly as it is actually impossible to be optimally healthy without exercise and movement being a regular part of your life.

In patients that present with a specific problem, after resolution of their pain or alignment it is essential that they undertake some form of structure exercise in order to maintain the benefits of the treatment and to protect them against injury.  

For example someone who presents with headaches as a result of their posture in front of the computer at work can benefit hugely from chiropractic care, however if they fail to improve their postural muscle strength and movement patterns after stopping chiropractic treatment the reality is that their problem with re-occur at some stage. 

It is vitally important that these people follow a properly structured routine of exercise focussing on the appropriate muscles and guided by a well trained professional. Pounding miles on a treadmill will not help with alignment problems, patients require a detailed, bespoke and structured exercise routine.  Patients who follow a routine show faster recovery from injury, better resilience against future injury and of course, a better overall level of health.

What general advice can you give? 

The most important piece of advice is to keep mobile. Immobility i.e. too long hours of sitting or staying still is literally damaging our bodies and our brains. Research now shows that keeping mobile helps to maintain normal brain/neurological function and helps to prevent the onset of many chronic diseases such as arthritis, cardiovascular disease and diabetes.

Luther's top 5 tips for optimising your health:

-Do a minimum of 3 minutes stretching in the morning and the evening (make sure you follow good advice on stretches)

-Set an alarm on your computer for every 40-60minutes and then move when it goes off. Even rolling your shoulders and turning your head from side to side makes a difference, ideally get up and walk for 2-3 mins.

-Do at least 3 sessions of 20 minutes intensive exercise per week - ideally get a personal trainer!

-Challenge yourself regularly by learning new exercise routines or movement patterns to force it to maintain its strength and adaptability.

-Finally drink at least 1.5-2 ltrs of fresh (preferably filtered) water each day. Many people are dehydrated and this is very damaging for your health.

For Precision Movement readers, Luther has kindly offered 50% off initial chiropractic consultation (normally £75) and he is also happy to talk to anyone on the phone for a 10 minute phone consultation free of charge or answer any questions by his personal email - 

luther.moss@ml-chiropractic.co.uk

.  You can book an initial consult by calling

0207 731 7640

.  For more information please visit 

www.ml-chiropractic.com

.  ML Chiropractic is located at ​

604 Fulham Road, London, ​SW6 5RP

Top tips for staying fit on holiday

Precision Movement fitness on holiday

Precision Movement fitness on holiday

As many of you know I work at Grosvenor House Apartments on Park Lane.  Many of the guests visit London in the summer months and I am often asked about how to incorporate exercise, that is usually a part of their life back home, whilst on vacation.  Wouldn't it be amazing after all your hard work to get that beach body if you came back from vacation looking just as good! Want to know how?  

1.  Stay Active  Being on vacation doesn't mean you have to be lazy.  Yes it is a chance for a rest but if you keep your body moving you will enjoy your holiday much more by keeping it energised.  If you are sitting on the beach then at least you'll feel toned and confident and that your chill out is well deserved.  There is also a greater chance you'll return home looking just as good as when you left - bonus!

2.  Prepare 

Before you arrive at your holiday destination know what fitness classes and options are available to you.  At GHA we offer our guests the option of a range of personal training services so when they arrive they can continue with their fitness as if they are still at home.

3. A change is as good as a rest

It is often said that change is as good as a rest.  If you regularly pound it out in the gym maybe try something new on your vacation - a yoga or ballet based session or an outdoor workout. Each destination you travel to will have unique fitness activities for you to try and can add to your overall vacation experience.  If you live in a city and are travelling to a beach destination go for a run on the beach or try out a watersport.

4.  Early bird 

It is better to do high intensity workouts in the morning when your cortisol levels are highest.  Getting your workout done early means can enjoy sightseeing, beach time, exploring a city, shopping and whatever else you have planned.  A calmer yoga or ballet based workout is best done late afternoon early evening when your cortisol levels are lower and can act as a restorative transition for your evening activities.

If you are interested in how to maintain your fitness here in London during the holiday season pleasecontact us.  For more information visit ourwebsite.

How corrective exercise can help sciatica

sciatica

sciatica

Sciatica is the irritation or compression of the sciatic nerve which originates in the lower spine and runs through the buttocks and down the legs.  Although very painful, sciatica is the cause of an underlying issue which I explore here in this article.  I also explain the value of exercise in helping to relieve discomfort and for management of sciatica going forwards.  

Sciatica is the irritation or compression of the sciatic nerve which originates in the lower spine and runs through the buttocks and down the legs.  Symptoms are often pain of varying degrees described as burning or tingling or a sharp stab in and around the buttock and down the legs and can also be accompanied by numbness, tingling, a giving way of the leg or a sense of weakness. Pain may also worsen with sitting and can make walking difficult.

Although sciatica can be debilitatingly painful the pain and irritation of the nerve is a symptom of the underlying cause which could be from a disc bulge or prolapse, disc degeneration, stenosis, spondylolisthesis,  piriformis syndrome and sacro-iliac dysfunction.  Any of these causes can compromise the exit of the nerve from the spine and compress it causing pain.  

The symptoms versus the cause 

The point I would like to emphasise here is the underlying cause - if we can get to the root of the problem and manage it effectively the symptoms of sciatica will go away.

Often sciatica is caused by a structure like a disc pushing on a nerve.  It is true you cannot fix structural damage but you can improve alignment, stability and strength of the surrounding area.  Malaglined discs are often associated with poor posture or weakness of the surrounding muscles.  Without wanting to complicate things further, an initial problem starting elsewhere in the body can cause the spine to adapt and change thus leading to sciatica.  Ideally when treating an injury or chronic pain the body should be observed as a whole.  

Exercise is essential

This is where exercise becomes invaluable as part of a long term recovery plan for sciatica sufferers because corrective exercise can help realign poor posture and strengthen weak muscles.    

Stretching can ease off localised tension that a muscle takes on when the nerve begins to hurt.  Exercise helps to strengthen weak areas of the spine, core and pelvis.  This in turn can improve alignment of the spine and reduce the pressure on the nerves.  As posture improves and the individual becomes stronger the chances of reoccurrence are reduced.

John Medina explains in his book Brain Rules how exercise also helps to increase the growth of new blood vessels throughout the body to get  deeper access into the tissues.  This helps the tissues dispose of toxic waste that builds up in and around an injury and areas of pain.  The more you exercise, the more tissues you can reach and the more toxic waste you can get rid of.  Exercise actually physically aids your recovery.  

What exercise can I do?

It is common to give stretches for sciatica because the affected muscles and the sciatic nerve itself can be stretched and this provides a certain amount of short term relief.  sciatic stretches alone are usually not enough to make a long term change to symptoms.  They are, however, a valuable inclusion in a bespoke series of exercises given to an individual.  Stretching and mobilisation of the fascia (connective tissues) and nerve flossing techniques are also common inclusions for sciatica exercise programmes. 

Exercise for sciatica is focussed around relieving discomfort and realigning, stabilising and strengthening areas of weakness as well as opening up areas of tightness that are contributing to poor alignment.  Finding out what the underlying causes are is imperative as it determines what exercise is needed.  Exercises given for disc related issues are almost the opposite for stenosis and spondylitis.  Ideally exercise should be bespoke to the postural needs of each individual.

What can I do now?

Ideally seek out a specialist in corrective rehabilitative exercise who can assess your  whole body postural alignment.  It is increasingly common to hear and see of patients doing their exercises poorly or completely wrong which can make symptoms worse.  It is imperative to do your exercises with good form and it is advisable to do them under the observation of a corrective exercise specialist like we have here at Precision Movement.  This is mainly because your body will have a preferred way (poor alignment way) of doing movement and with each repetition you do you'll need to remember and apply newly learned alignment to make desired changes.  From personal experience of this in my practice, for the first 3-4 weeks each repetition of movement requires a correction of alignment from me to the client until they start to learn new patterns of movement and create programmes in the brain for the new alignment.  

How I choose your exercises & progress you

I have been writing quite a bit about corrective exercise of late.  This blog entry is about an important exercise of corrective exercise called isolation to integration.  It explains more clearly through example the need for corrective exercise, how I use it and progress through exercises to get clients back to fully functional movement.  Read on for a geek out and an inside look into the working mind of KT!....

Isolation

When I first begin working with a client who has poor posture and or pain/injury I often, although not always, break movement right down into pieces.  There are a number of reasons why I do this.  

1.  Ready, aim.... 

The first is often certain muscles will not be firing enough or at all and in complex movements like the squat or a pushup other muscles will have taken the job of the lazy muscles which has caused an imbalance in posture.  In order to get the lazy muscles firing we isolate them so the other now stronger and 'preferred' muscles are less involved.  

2.  Brain training 

This leads to the second point of isolation,  when you create poor patterns where lazy muscles stop working and others take over this creates new movement blueprints that are stored in the brain.  The more you repeat the movement pattern the stronger the blueprint in the brain becomes.  Eventually, this faulty blueprint programme will run automatically.  To override it, we need to break the pattern down and build it back up again.  We often need to start by training the muscles in isolation to achieve this.  

3.  Easing into it 

This brings me neatly onto the third point; because your faulty movement blueprint is so strong, it takes conscious brain power and focussed concentration to retrain the muscles and movements for a new preferred blueprint.  Isolated movements help the brain to adapt more easily and also help you to make progressive change that will minimise frustration.  

Integration

Is it needed?

After all that praise for isolation I am sure you must be thinking there is no place for integration in rehabilitation and corrective exercise.  Not true at all!  Integration is the ultimate goal here and I am keen to get you to integrated functional movement for life and sports safely and effectively as soon as possible.

Integration means using the isolated retrained muscles with other muscles in bigger more challenging complex movements.  This does not mean however, that you jump into what you have been doing before.  You'll need to go through certain progressive stages to successfully achieve higher quality complex movement function.  Some people I work with go through this very quickly, others take longer.  It depends on how body aware you are, how quickly your brain and body adapt and how diligent you are with the exercises you are given.

Progression is an essential part of successful rehabilitation and corrective exercise.  Particularly with injuries and those with chronic pain, muscle tissue needs time to adapt and change.  If you push too hard to fast you'll end up injuring yourself further and it will take longer to rehabilitate and correct posture.

An Example 

A classic example that I work with is a weakness in lateral and rotational hip stabilisers in a squat pattern.  This is a very simple explanation of a common and easy to fix problem, and is often combined with many other imbalances.  For this examples we'll keep it simple.  Please do not attempt these exercises without supervision from an exercise professional.

A very isolated exercise is the side lying wall angel.  This isolates the muscles that rotate the leg out and move the leg sideways.  

Screen Shot 2014-05-01 at 11.50.05

Screen Shot 2014-05-01 at 11.50.05

I may then move to integrating that with a hip extension by placing a band around the knees to work the muscles that rotate the leg out and move it sideways as well as the muscles that left the hips up (glutes and hamstrings).  From there I might add more load and range by upgrading it to a swiss ball hip extension with the band.  

Screen Shot 2014-05-01 at 11.55.44

Screen Shot 2014-05-01 at 11.55.44

This may lead to a squat pattern again with the band around the knees getting to a more functional pattern of movement.

Screen Shot 2014-05-01 at 11.54.13

Screen Shot 2014-05-01 at 11.54.13

In each stage above there are mini phases of development and some individuals may start at a higher level than wall angels.  

The point is these stages allow for retraining of the brain and the body for better movement patterns and alignment which help the healing and recovery of injury and pain, improve function and efficiency of movement, as well as reduce the risk of future injuries.  

I do hope this explanation of one of many of the concepts we use in corrective exercise helps you to understand how we can help you recover from pain and injury better.  If you have any questions or comment please

Contact Me