Author Archives: Carmine Cientanni

July 11 – Issue 14

Charity Family Fun Day

Hello again and I start this issue by making aware a special day in the calendar. It is Sunday 7th August and is the day I am holding my annual charity event in aid of Cancer Research UK.   Previously I held just a 6-a-side tournament, the Teresa Lambiase Trefeo, which last year raised over £1500 which is fantastic. This year, with extra bodies helping out, it has become a family event with garden games, a bouncy castle, penalty shoot out, face painting to keep the little ones interested. There’s a beautician on site and also a golf challenge and a BBQ as well.

There is a raffle as well and tickets can be bought from myself if you cannot make the day and wish to make a worthwhile donation. Alternatively, you can donate at www.justgiving.com/Carmine-Cientanni.

Hope to see you there.

What does the sun do to us?

It is fair to say that the majority of people enjoy the sun and it makes us feel happy and lightens up our mood. People enjoy getting sun tans and generally being in its presence. But is there a reason for this and is this a reason that can be scientifically proven? Well the sun is great in the production of Vitamin d, a vitamin that without, would cause the disease rickets. With it, your skin becomes easier to tan and safely as well as it produces the pigment melanin which causes the skin to get darker.

Psychologically, it was suggested in the early 1980s that the heating effect of the sun can help in times of depression (Seasonal Affective Disorder).  The body also releases various hormones when you are exposed to sunlight. Prolactin helps with resting, melatonin helps your mood and energy levels, and growth hormone that helps growth and repair in the body. These all lead to a happy and relaxed individual. But it is also important to bear in mind that the sun can also be harmful to the body.

Erythema, or sunburn, as it is more commonly known is the main problem from the sun. Unprotected, extended exposure causes this. It cauld also lead to the breakdown of collegen and elastin in the skin. This in time causes premature wrinkles in the skin as there is less elasticity in the skin due to the suns inflicted damage. Other changes from sun exposure include freckles, sun spots and eye damage, that could lead to more serious problems such as cataracts.

The most serious problem that can form from excessive sun is skin cancer. This is a result of a gene called P53 mutating and copying themselves. Melanomas, the most dangerous form of skin cancer is also linked with sun exposure. If you are concerned with any of the conditions above, get in touch with your local GP and book an appointment to see if there are any problems.

Vitamins

Continuing with my nutritional theme in my newsletters, I thought it’d be important to address vitamins as well as they too play a vital role in maintaining a healthy and efficient balance in the body.

 There are 13 types of vitamins in the body, split into water soluble or fat soluble. Water soluble vitamins are not easily stored in the body as they remain stored in the fluid of the body and so pass through the body easily. These are vitamins C and the B-complex group. Fat soluble vitamins are vitamins A, D, E and K. They are not as essential to keep topping up in the diet, in fact it could take years for these vitamins to get to an insufficient level¹. The main purpose of vitamins is to link and regulate metabolic reactions that release energy from the food we eat. Water soluble vitamins are more important in energy metabolism, for example breaking down food groups such as carbohydrates and proteins and helping in their conversion to energy for the body. A well balanced diet would provide sufficient vitamins to keep the body at a suitable level of effiency.

A lack of vitamins can cause disease and deficiencies so it’s important to get the recommended amount in a balanced diet. Possible deficiences and diseases include anaema, rickets, scurvy and fatigue, amongst others.

Next issue will deal with minerals the body needs. If you would like further in depth information on vitamins, please feel free to contact me.

 Quick Facts

1. “You should apply sun cream 30 minutes before going into the sun so it can absorb into the skin.”

2. “The section of your arm from your elbow to your wrist is the same size as your foot.”

3. “Your nose is the same length as your thumbs.”

References

 1. Exercise Physiology, 5th Edition, McArdle W.d., Katch F.I. & Katch V.L., Lippincott Williams & Wilkins, London

April 11 – Issue 13

More Daylight

Hello and welcome to British summertime. The clocks have changed and daylight hours have increased. Hopefully the weather will also improve on last year in this period and it can be a very nice period.  In this edition you can find information on a commonly reported injury area, the hip. Also, following on the nutrition theme from the previous edition, there is an article about fats. As mentioned in my previous newsletter, I have had to increase my prices for the first time since I began Elite Therapy. New prices can be found on the back page. Take advantage of packages and discounts available to save money.

Hip Joint and Pelvic Girdle Anatomy

The hip joint is an extremely strong and stable joint and is rarely injured acutely. To put its strength and stability in perspective, in a standing position it would have to support half of the bodies weight. When running, jumping, etc., it would have to support around 5 times the bodies weight, so and unstable joint would lead to many acute injuries. It supports the trunk of the body on the lower limbs, and allows movement for the legs¹.

There are 6 joints in the hip; 2 sacroiliac joints, 2 femoro-acetabular joints, the lumbar-sacral joint and the pubis synthesis joint. They join the 3 bones of the pelvis, which are the sacrum, the pubic and the illium. They also join onto the femur bone of the leg. The femoro-acetabualar joint is a ball and socket joint that joins the femur to the pelvis.

There are 3 key ligaments that join head of the femur to the acetabulum in the pelvis. The are the ischio-femoral ligament, the ilio-femoral ligament and the pubofemoral ligament². The ligaments main purpose is to provide stability between the joints. The locomotion is then made a lot easier for the many muscles in the area.

The hip can move in many different ways, giving us the need for many different muscles for the various movements. These movements are flexion and extension (bringing your leg forward and back), abduction and adduction (moving your leg away and towards the midline of the body) and internal and external rotation (turning the leg in and outward). Combining all these movements is called circumduction.

Main muscle which provide these movements are the gluteal and adductor groups, iliopsoas, rectus femoris and many small muscles in the buttock area. The hamstrings also play a small part in the movement hip extension.

There are also many bursae located around the hip area and pelvic girdle. They are fluid sacks and these aid in the movements by providing lubrication to make movements smoother.

As it can be seen, the hip is a very complex area and a lot can go wrong so it is important to keep the muscles of the area strong and stretch out regularly. This can be achieved by regular exercises and a suitable stretching program.

Fats in the Body

Fats, or lipids, come in various forms around the body and there are good fats as well as the bad ones we know all too much about. In fact the good fats are essential and play a vital part in regulating the body and keeping a good balance within the body. Roles that fats play include protecting vital organs, they provide a very large enrgy source and reserve, they carry vitamins and suppress hunger and they also are very good insulators.

Saturated fats and unsaturated fats are the simplest way to remember the good and bad fats. Saturated fats are bad fats and unsaturated fats are good fats. Sources of bad fats are found mainly in animal products, so red meats, dairy products, such as cheese and butter, and egg yolks. Unsaturated fats are found in natural sources such as nut oils, olive oils and avocado oil³.

This is a general overview on fats in the body. If you would like further information on fats or any other nutritional aspect, please feel free to ask and I would be more then happy to try and help.

If there are any other topics you may be interested in, send me an email and I will try and incorporate it in a future edition of Refreshing Rehabilitation.

Facts

“On every square inch of your body you have around 32 million bacteria.”

“Acid in your stomach is strong enough to dissolve a razor blade.”

“The average male excretes half a pint of sweat every day.”

Now available from Elite Therapy are gift vouchers in the values of £5, £10 and £20. They may be purchased at AFC Kempston. Unfortunately there is no online payment facility.  As a partner of the Bedford Leisure Card system, I am pleased to offer discounts to clients who wish to have a 45 minute or hour long massage session. All that is required is production of a valid Bedford Leisure Card. Current clients that introduce friends to a massage session will also benefit from receiving a 10% discount in there next session.

A discount package has also been devised for anyone who wishes to regularly receive a sports massage. If you pay for 3 sessions in advance, you will receive the fourth one for free. All sessions must be of equal duration.

Appointments can be made by contacting myself on the details provided or via email. The hours available are currently Monday to Friday evening from 4pm until 10pm and Wednesday, Thursday and Friday mornings from 8am until 1pm. There may be availability at other times so please enquire. Payments can be made with either cash or cheque, made payable to Carmine Cientanni. If you have changed any details such as your address or telephone number, please inform me as soon as possible so that I can update my records. If you wish to cancel an appointment, please inform me at least 24 hours in advance.  Missed appointments will be charged at half of the normal treatment rate.

References

1. Kay, S., Hip Joint and Pelvic Girdle—Anatomy Refresher, Kay S., SportEx Medicine, Issue 47 (Jan 2011), pp. 7-11.

2. Biel, A., Trail Guide to the Body, 3rd Edition, (2005), Books of Discovery, Boulder CO.

3. Exercise Physiology, 5th Edition, McArdle W.d., Katch F.I. & Katch V.L., Lippincott Williams & Wilkins, London

January 11 – Issue 12

Welcome to 2011

Happy New Year to all, I hope 2011 is a happy and successful year. Now that 2010 has passed, a fresh start can commence, with many having new years resolutions that they would wish to stick to.  Elite Therapy has had a good year, continuing to grow its existing client base and maintaining the same original clients as previous years. Hopefully the growth can continue.

A change in Elite Therapy that is, unfortunately, forced upon me is the increase in VAT, which means for the first time since I began I am having to slightly raise my prices, though I will only change them on the 1st of April, not like the 4th of January as the Government has decided. With this change I am informing all existing and new clients of the discount packages which allow you to book your appointment when you choose and if booked and paid before April, may avoid the price increase for a few more weeks and you would also get a session FREE as well. So please ask how you can do this and save some extra money!

I look forward to seeing you soon, Carmine

New Year Exercise

So Christmas has gone and its about the time that the majority of the population decide it’s time to shed a few pounds. So whether you are joining a gym or doing it yourself, here’s a few tips to help you along. It’s important you choose a suitable activity for you. This depends on age, weight, previous exercise experience and you must make sure you still eat the correct food for recovery.

For example, it wouldn’t be worth an elite runner walking for an hour as their body would be able to cope with it quite easily. As it would be inappropriate for a person who doesn’t regularly take part in physical activity, to go and cycle 50 miles a day as the body would not cope and injuries will begin to occur.

After you find a suitable exercise, with a suitable duration, decide on how many times a week you would like to do it. 2-3 times a week should be ok if you are just beginning. Recovery in between exercise days is important to help repair in muscles so that they can perform more efficiently in the next session. A massage session will also aid recovery and relax the muscles and rest of the body at the same time.

To progress, it is recommended that a maximum increase of 10% a week should be carried out. For example, someone who can run for 10 minutes should increase to 11 minutes per session. This may not sound much but, it is a big step if you could not do the previous aims.

Below are a few examples of how much you may burn doing everyday exercises.

Walking on a treadmill 4-8 calories per minute

Walking outdoors 6-8 calories per minute

Jogging on a treadmill 13-18 calories per minute

Running on a treadmill 18-28 calories per minute

Swimming (breast stroke) 10-15 calories per minute

Swimming (front crawl) 10-14 calories per minute

Cycling (leisurely) 4-10 calories per minute

Cycling (fast) 10-16 calories per minute

Remember to select activities that are suited to you, not just the ones that burn the most calories as they may lead to injury.

How much Protein do I need in my diet?

A lot has been discussed lately about the amount of calories to intake in the day to remain healthy. However, there is less mentioned about what those calories should be to be healthy.   Carbohydrates, proteins and fats make up the majority of a diet, along with fluids, vitamins and minerals that don’t carry very much calorific content. Proteins should make up around 10-15% of calories in a typical diet.

Proteins make up around 10-12kg of the bodies weight, most of it in muscles. They are needed for repair of tissue as well as to help build on existing muscle and maintain the bodies efficiency in movement and injury and illness prevention, amongst other things.

It has been suggested that the body would need around 0.83 grams of protein per kilogram (kg) of body weight per day to maintain the recommended daily allowance. So for an 80kg male, a daily intake of 0.83 grams of protein times 80 would be needed daily to maintain a suitable balance in the body. This is 66.4 grams of protein a day.    The best sources of protein are found in eggs, fish, lean beef, chicken, cow’s milk, brown and white rice, amongst others.

During exercise, proteins are not used as a primary source of energy, so dietary intake should not be changed. However, during intense training programs, daily intake could be increased to 1.2-1.8 grams per kg of body weight, to assist with recovery of muscles and if there is the desire to increase muscle mass in the training program. This should be discussed with a coach or a professional able to advise on dietary requirements.  

References

 

1. Exercise Physiology, 5th Edition, McArdle W.d., Katch F.I. & Katch V.L., Lippincott Williams & Wilkins, London

October 10 – Issue 11

Running Special

Welcome to the Autumn edition of Refreshing Rehab, not that we had much summer to look back at!  With days rapidly getting shorter and temperatures never really getting high, it feels like there has been no summer at all.

Throughout October you also have the chance to get 50% off your next appointment! All you have to do is introduce a friend or family member to the treatment and you can save yourself money as well.

On Sunday 22nd August, I held a charity day in aid of Cancer Research and raised just over £1300. I am very pleased as I was aiming to raise £1000.

The current issue deals with various running problems and injuries. Running has a part in the majority of sport as well as everyday fitness for the mass public.

Achilles Tendonitis

Achilles tendonitis is the inflammation or swelling of the Achilles tendon at the back of the leg, attaching to the heel. It is the tendon for the calf muscles and if injured causes a lot of pain, even when simply standing. The injury is a common one in runners as it is a repetitive injury. This means that when you run and train slightly above the normal range of the tendon, it get disrupted and fibres tear. If these damaged tissues do not get sufficient recovery time to repair, and more training is performed, the tissue becomes further damaged and eventually will become inflamed. The result is Achilles tendonitis. The rehabilitation is very important as it is an injury that has shown high re-injury rate, mainly due to a poor rehabilitation period from the previous injury. If you feel your Achilles tendon is injured or is just painful and you don’t know why, get in touch with a professional to help you recover in the best way possible.

Patellofemoral Pain

Patellofemoral pain is a pain felt at the front of the leg, behind the knee-cap or patella. The femoral part of the name suggests the problem is due to the knee-cap rubbing against the femur (thigh bone). The cause of the pain could be from a multiple of factors. These may include gender, age and even previous injuries amongst others. The pain may be constant and this would lead to a medical visit, though if the pain is onset by activity or exercise a check-up is valuable as it will indicate possible problems and how to deal with it. Patellofemoral injuries are common as there are so many factors that can instigate it. Runners may find that an ankle problem has lead the knee to move slightly to cause malalignment in the knee. This could lead to certain muscles in the quadriceps group to become weak or tight. A specific rehabilitation program is needed to return the muscles and knee to there original positions.

Stress Fractures in Runners

Stress fractures are caused by repetitively running without allowing time for damaged bone fragments to be repaired. Most common areas to sustain stress fractures are the foot, tibia (shin bone) and femoral neck (top of thigh bone). During rests osteoblasts and osteoclasts work hard to reform any little bits of stressed, damaged bones. If this time is not sufficient then more damage is piled onto the bone and repair is accelerated to deal with the extra activity. If the body cannot cope with the demands put on the bones, a stress fracture will inevitably occur. To prevent stress fractures happening, follow a careful running program, allowing for the individuals needs, current condition and previous injuries. Don’t run too much, too often and make sure that there is enough time between exercise sessions for the body to recover.

Plantar Fasciitis

This condition is an inflammation of the plantar fascia. The planter fascia is a strong connective tissue going from the toes to the heel. It keeps the base of the foot together and stops the foot stretching too much. When fibres in the fascia get damaged and have no time to repair, the fascia becomes inflamed as a response mechanism. Causes of the condition could be weight, footwear and foot type, profession, traumas, new activities or previous and other injuries and conditions. You may feel pain in the heel after activity with the condition even though there may be no pain during exercise. Treating the condition could involve a bit of rest to allow inflammation to reduce, followed by massage, ultrasound and maybe strapping.

Quick Facts

“Endorphins that are produced during running give the ‘feel good’ feeling in the body.”

“Jogging for an hour burns roughly 500 calories.”

“The record for the most distance covered in an hour is 13 miles and 197 yards.”

July 10 – Issue 10

Summer is Here, 50% Off in August

Welcome again to another edition of Refreshing Rehab!  The days are getting longer and the weather has been pretty nice, hopefully it’s here for a little while longer. Throughout August you also have the chance to get 50% off your next appointment! All you have to do is introduce a friend or family member to the treatment and you can save yourself saving money as well.

I mentioned that I was holding a charity event in the previous newsletter and we raised £728 on the day. It ws a fantastic day and the money goes to a fantastic cause! I have already started organizing the next one on Sunday 22nd August, so I hope to see you there If I don’t see you before.

Nutrition in Sport

Many people ask how nutrition can play such a vital part in an active individual. It’s easy really. Food provides the fuel for our body to operate, with certain foods used for specific functions in the body.

The body at rest, needs around 1200 calories a day to function at its best. This is without doing anything. With exercise the body changes. As you take part in regular exercise, your metabolism speeds up and the daily calorie requirement increases.

It is important to fill your body with the right calories however. Food high in carbohydrates will provide muscles with the energy you require, though too much carbohydrate can cause any extra to convirt to fat. So be careful with the portion size.

Eating a low fat, high carbohydrate and high protein meal straight after exercise is the best way to get the correct calories back into your body. The carbohydrates refill the muscles with essential glycogen for energy and protein will provide repair for the damaged muscle fibres. For example, If you weigh around 70 kilograms and you run at a 10 minute mile pace, you will burn around 650 calories in an hour¹. This will burn fat as it is running at a sub-maximal pace and when you eat afterwards, as long as your meal is around 650 calories of healthy components, you will have maintained the weight you were before, but you will have replaced some fat out of the body with a more efficient body system.

           Feel free to ask how many calories you should be consuming daily with the amount of exercise you are doing, so you can have a guideline of what you should be eating and feel free to ask anything else about nutrition that you feel you may need to know. You can also get you percentage of body fat tested with a non-invasive machine that can help hit goals and inform you on future targets.

Osgood-Schlatter Disease

This is a knee complaint which is most commonly diagnosed in active adolescents, specifically during a growth period as well. It is the result of the tibia (shin) bone in the leg growing quicker than the quadriceps muscle group. This means that at the tibial tuberosity, inflammation and pain will occur as this is the attachment of the muscle². It is more frequent in young males, and the symptoms disappear when the individual has grown fully. The signs of this are that you get pain just below the patella (knee cap), usually during activity and straight after. It would be painful to touch the area and you may find the skin may be red and hot as well. Treating this disease is not easy and can lead to inactivity of the individual for some time. Resting  and educating the individual on what is occurring in the body is essential. If the individual  can perform reduced activity, this should be encouraged, but a visit to the G.P. is important to get a correct diagnosis and plan of action.

 Quick Facts

1. “Your skin is 1mm thick when you are born, growing to 2mm in adulthood.”

2. “The acid inside your stomach is strong enough to dissolve a razor blade.”

3. “Your thigh bones (femurs) are stronger than concrete.”

References

1. McArdle, W.d., Katch, F.I. & Katch, V.L., Exercise Physiology, 5th edition, Lippicott, Williams and Wilkins, London.

2. Peterson, L. & Renestrom, P., Sports Injuries, Their Prevention and Treatment, Taylor and Francis, London.

April 10 – Issue 9

           Welcome again to another edition of Refreshing Rehab!  I hope the snow was fun, though inevitably it became annoying. Now the weather is slowly improving and the days are getting longer we can put it behind us!

           On Sunday 30th May, my friend and I are holding a charity 7-a-side football tournament and raffle in aid of cancer research and St. Francis hospice in Berkhampstead. If you (or you know anyone) are interested in entering a team or buying some raffle tickets, please contact me. Teams are £50 and raffle tickets £1 a strip. Prizes include food hampers, meal vouchers, beauty vouchers, wine, amongst others! If you would just like to make a donation, you can pass it on to me at AFC Kempston.

Stretching

Stretching has been a vital part of preparation and maintenance of a persons well being for many years. The main point of argument is what stretches to do, when and why. It is, after all, the most tedious part of activities, even if it is also one of the most important so its important to know a little about it!

The idea of stretching is to increase muscle control, the flexibility, length and pliability of a muscle, reducing the risk of the muscle becoming strained during exercise, or any sort of activity for that matter.

A stretch is when you elongate a muscle to its longest possible length. It is often done unintentionally, for example, stretching when yawning in the morning as soon as you get up. Athletes should stretch prior and after activity as it reduces the risk of injury during performance. It aids in keeping a better range of motion in the muscle and could prevent the onset of muscle soreness (DOMS) after activity¹.

Stretching the whole body is the most beneficial thing to do thought the majority of people do not have the time for this, so stretching the main muscles that will be used is the most vital thing. For example, a footballer would concentrate their stretches in the legs.

There are different types of stretching that can be performed, whether individually or with assistance from another individual. Individual stretches can be static (without moving) or dynamic/ballistic (with movement). Research is inconclusive on which stretch is best to do before and after activity. Personally, I prefer dynamic stretches prior to exercise, but only following a cardio-vascular exercise to increase blood flow in the body. I prefer dynamic stretches as they mimic the actions to be performed in the activity. Static stretches in my view should be performed after activity as the body is trying to recover to its normal resting condition. Research also suggests static stretches prior to activity could be detrimental to performance for an individual¹. Holding stretches for a long enough period is also important and this is generally regarded as 15-20 seconds per stretch. It is also thought that doing each stretch 2 or 3 times is the best thing, though it has also been suggested that some stretches only find benefits after the first repetition².

There are many assisted stretches, also called passive stretches. Common varieties performed in massage sessions or for rehabilitation purposes can include proprioceptive neuromuscular facilitation (PNF), postisometric relaxation (PIR) or muscle energy tecniques (METs). They are all slightly different with different ways to stretch and restore the muscles most efficient function. To find out more about any of these techniques and if you would like to encorporate them in your therapy sessions, please feel free to get in touch and find out further details.

Knee Ligaments

The knee is a very complex structure, held together by strong ligaments to provide support and stabilize the joint. The 4 main ligaments that do this are the anterior and posterior cruciate ligaments and the medial and lateral collateral ligaments. Put simply they are 2 in the middle and 2 at the side.

The 2 cruciate ligaments are so called as they cross over in the joint capsule(some texts also refer to them as intracapsular ligaments). The anterior cruciate ligament (ACL) begins at the anterior intercondylar area of the tibia and passes backwards, outward and upwards and attaches to the femur on the inside of the lateral condyle. The posterior cruciate ligament (PCL) is the opposite. So it starts at the posterior intercondylar area of the tibia, goes forewards, inwards and upwards to the outside of the medial condyle of the femur. The PCL is the stronger of the two³. The most common way of injuring these very strong ligaments is to over extend the knee (damages ACL) and over flex the knee (damages PCL), usually through an impact of some sort, ie. Falling powerfully on a hard surface and bending the knees very quickly.

Quick Facts

“Every hour 1 billion cells in the body need to be replaced”

“Every squre inch of your body contains 19 million skin cells”

“The adult human body reqquires 88 pounds of oxygen daily.”

 References

1. Nelson, A.G., Kokkonen, J., & Arnall, D.A.,  Acute Muscle Stretching Inhibits Muscle Strength Endurance Performance, Journal Of Strength And Conditioning Research / National Strength & Conditioning Association Vol. 19.2 (2005), pp 338-343.

2. Sharman, M.J., Creswell, A.G. & Rick, S., (2006), Proprioceptive Neuromuscular Facilitation Stretching, Sports Medicine, Vol. 36 (11), pp. 929-939.

3. Marieb, E.N., Human Anatomy & Physiology, 5th edition, Benjamin Cummings, London.

January 10 – Issue 8

Into The New Decade We Go

2010 is here and I hope it brings a fresh start or happy continuation of the preceding year. With all the sales going on at the moment, I think it only right that I join the bandwagon!  So until Valentines Day (That’s the 14th February for those who may forget), you can get a 25% saving on your next visit if you recommend a friend and they visit for the first time. You can also get a 10% saving on any Aloe Vera product available from the Forever Living Product range. Please ask for a brochure if you are interested. The prices of an appointment will also remain the same despite VAT prices returning to 17.5%.

Cramps….What are they?

Cramps are a very annoying malfunction in the muscle and can occur at any time in the body, more commonly following a lot of vigorous and intensive exercise which concentrates on a specific muscle or muscle group¹.

The exact nature of a cramp is still unknown, but scientists have 3 main theories that it may be. The first is dehydration. As you exercise for prolonged durations, the body loses fluids through sweat and breathing amongst other things, meaning less fluids in the muscles to enable it to function correctly and cramp occurs as a result.

The second may be electrolyte depletion. This is the lack of minerals, such as potassium and sodium, needed for a contraction of muscle fibres. With no contraction (the shortening of a muscle) the fibres will stay in a fixed position, thus cramping.

The final theory is the one preferred by scientists and this is altered neuromusculature activity. This is probably caused as the activity is performed. Slight muscular ruptures and muscle bleeding as time goes by would contribute to how the muscle should function at its most efficient state. This will cause slight changes in neuromuscular responses and may lead to cramp.

Studies have suggested that to prevent cramps, sufficient fluids should be ingested, prior during and after exercise. It may also be beneficial to drink an electrolyte drink, such as lucozade or Gatorade, to prevent the depletion of potassium and sodium in the muscles as this is another theory of the cause of cramp.

The individual can also prevent the onset of cramp by not wearing clothing that is too tight and restricts blood circulation. Illness can also induce cramp as well as cold weather, extreme heat and an accumulation of lactic acid in a muscle².

A good warm-up will help prevent cramp and as previously mentioned, sufficient fluid intake during activity is important.

If cramp does occur in an individual, moving the cramping muscle to the opposite direction. For example, a common calf cramp will draw the foot downwards, so you would need to draw the foot upwards to reverse the cramp. It is easier if another individual can help, though in some muscles it may not be possible.

When do Injuries Happen?

As I play and coach football, I find It interesting to know when my players, my team-mates or even I would be more likely to get injured.

The principles still apply to all sports though the largest study conducted with professional football clubs (91 out of 92 for the period of study) showed that the most injuries happen at the beginning of the season.

This goes along with common belief that when there is a break it is very important to gradually increase work load on the body. The most common injuries were found to be muscular and not caused by an opponent but by the individual, when they run³.

From this information a lot can be applied to training at specific times of the season. This can include what intensity to work at, what duration to train for, what stretches to perform and when, and what levels need to be maintained through a sporting season.

The main problem with the study above is that it is focused on professional athletes. Though the principles are the same, recreational athletes and lower level athletes need to be aware of breaks such as the current winter break that may have caused postponements in a specific sport. Before going into competitive matches again, make sure you are back to a suitable fitness level as most injuries found are cause by the individual themselves.

The different stages of the season have been reviewed in previous issues of my newsletter.

Quick Facts

“Skin in the average human weighs around 9 pounds.”

“There are around 11 miles of blood vessels that connect the skin together.”

“The least sensitive area of skin in the body is found in heel of the foot”

References

1. Schwellnus, M.P., Causes of Exercise-associated muscle cramps (EASC) – altered neuromuscular control, dehydration or electrolyte depletion?, British Journal of Sports Medicine, 43, pp. 401-408.

2. Peterson, L. & Renstrom, P., Sports Injuries, 3rd edition, Taylor and Francis, London.

3. Hawkins, R.D., Hulse, M.A., et  al., The association football medical research programme: an audit of injuries in professional football, British Journal of Sports Mediceine, 2001, 35, pp. 43-47.

October 09 – Issue 7

Once again, welcome to the latest edition of my newsletter. The British summer once again has failed to deliver consistent weather but we all come to expect that now. I hope that it didn’t ruin your summer. With the children back at school and settled in the roads will be busy again, though the house may be a bit tidier now there is no-one left there to mess it up! Soon there will be the next big event, yes, you are right, Christmas!!!!! By the time the next newsletter is sent it will have come and gone! So if you would like to treat a friend or relative to a massage you can get gift vouchers from myself to the value of £5, £10 or £20. If interested, get in touch through my contact details. Don’t forget that introducing a new person to the business will entitle you to 10% discount on your next visit!

Persistent Lower Back Pain?

What do you do if you have an annoying pain in your back that you don’t know what it is and how it came around? First of all you need to try and recall any impact you may have had or if you did something out of the ordinary which made the back work more then usual, then find a therapist and tell them about it to find out how to fix it. The incident could be a very old problem that didn’t get the right rehabilitation when it happened so it repaired in a less then optimal way. A therapist will attempt to find out if there is a structural problem or if the problem is a muscular problem. There are many muscles in the back and the lower back has a major part to play in keeping the trunk upright and keeping good posture. Once a decision has been made on the problem, targets for the individual are to be made. Initial targets are to reduce pain in a safe and cost effective way so the individual can still carry out everyday tasks and improve their psychological feelings about the problem¹. Rehabilitation programs for the individual should include 3 things:- Suitable exercises, manual therapy and advice and education to the injured individual.

 Exercises 

Exercises should be pain free and that may mean non-weight bearing, so water exercises. This allows the heart to have a good work out and doesn’t put as much impact on the lower back as we previously mentioned that the lower back work very hard to maintain posture and stability in the trunk. There should also be a variety of strengthening exercises for the back muscles and core muscles.

Manual Therapy

Manual therapy should be used alongside  the other intervention of exercise. Manuaal therapy will reduce pain in the individual as it relaxes the muscles and improves the functionality of those muscles as well, reducing stress when they are made to work.

Advice to client

This is also an essential part of the rehabilitation process as an individual who is recovering from injury will need to know what to do when they leave the therapy session. Exercises and stretches to perform between meeting are essential and performing these will allow the recovery to continue without the therapist as well. On the opposite end, there must be guidance on how much to do because exercising too much may cause the problem to worsen instead of improve.

How fit am I and how can I find out???

The definition of fitness is difficult to pinpoint, as people have different views on what fitness is and how fit you should be. The American College of Sports Medicine define fitness as the ability to perform your everyday activities with the absence of illness and injury². So for most people finding out how fit they are actually means, “How long can I keep going before I have to stop?” This is called aerobic capacity or understood in easier terms, how long will my heart go before it wont let me exercise any more! There are a number of ways to find this out and they are through special tests which can differ in duration, intensity and objective. The most common is the multi-stage fitness test or bleep test which is used at all levels of ability at all ages to assess how much a person can run. The test is simple to set up and you follow timings of a beep on a pre-recorded test, which get harder to complete the further you run. You run between 2 markers set up 20 meters apart and must reach the opposite marker before the beep sounds. You can buy the tests online or ask if a local gym has one you can use to perform the test. If this is not possible and you would like some sort of indication of your aerobic levels, feel free to get in touch and I will try and advise on a suitable test you can perform. From this test athletes performing at higher levels within their sport may decide to undertake more specific tests, such as the wicket sprint test for cricket³ or the sit and reach test for hamstring flexibility in gymnastics.                 

              Other tests used are:-

  • Yo-yo intermittent test
  • 12 minute Cooper test
  • Birtell 40 meter shuttle test
  • Balke treadmill test
  • Bruce protocol test
  • Harvard step test
  • Astrand-Rhyming Cycle ergometer test

 If you would like to know further information on how to perform any of the above or any other you may have come across, please feel free to ask.

Quick Facts!!!

“A hiccup is a result of an involuntary contraction of the diaphragm which causes air to rush to the lungs and vocal cords to snap shut.³”

“There are 639 muscles in the human body, yet it was only in the 18th century that they got their modern day names.³”

“The muscular system is made up of around 6 trillion muscle fibres, thinner then a human hair, but  able to support 1000 times its own weight! ³”

References

1. Jackson, A., Pysiotherapy Guidelines for Managing Persistent Low Back Pain: Exercise and Manual Therapy, SportEx Medicine, Issue 34 (October 2007), pp. 16-19.

2. ACSM, www.acsm.org

3. Woolmer, S., The Modern Approach, SportEx Dynamics, Issue 16 (April 2008), pp. 19-21.

July 09 – Issue 6

Summer Sun, Will We Get Some?

With summer approaching, everyone is thinking the same thing, how much sun will we get in England? There are predictions for a hot summer with heat waves, so hopefully that is the case. This in mind, make sure you have topped up the supply of sun cream you have, keeping you safe from the rays we love. If there are moments of temporary forgetfulness and sunburn gets the better of your skin, have a try of aloe vera gelly, its been thoroughly recommended by many people to help sooth the burn. Properties of aloe vera help relieve pain and provide nutrients and vitamins to assist with the repair process of the skin.

Small Health Checks

Getting regular checks on your health is very beneficial and helps endlessly. Checking on what your weight is like can help with weight management, whether it be for weight gain or weight loss. It is also easy to find you Body Mass Index (BMI) from this. Your BMI indicates what weight range you fall in, whether it is a normal range or going to either extremes, which are morbidly obese or severely underweight. These extreme conditions can cause very serious health problems such as anorexia, and heart disease amongst others. If you know your height and weight and wish to know your BMI, just enquire at your  appointment. You may also wish to find out your body fat count or your hip to waist ratio, and what they mean for you.

Goal Setting in Rehabilitation

Rehabilitation after an injury is a frustrating time, especially for active individuals and athletes. The biggest problems is taking steps that are too big for the body to adjust to and further damaging the injury. This is why goal setting is so important in rehabilitation, with the final goal being a full return to the level of activity required before the injury occurred. The first thing to do is to have a thorough talk to a therapist on how serious the injury is and how long this injury will realistically take to overcome with proper rehabilitation. From there, a rehabilitation programme can be devised for the individual, so that the quickest return to exercise may be possible without the risk of re-injury to the individual. Lots of small, achievable targets help individuals as they are clear to see and show a clear link to the final goal. Without these small steps, the individual would only see the finish and try to reach it too quickly. You can use your stairs at home as an example. You would not be able to get to the top of your stairs in one jump. You must take each individual step, though occasionally you may be able to skip a step to get to the top. Psychologically it is much more rewarding for an injured individual to achieve each small step, as they will be more motivated to progress to the next step. When setting these small goals, you must consider a few things. They are how challenging the steps are and if they are realistically achievable. The programme must also be specific to the individual and the activity and exercise that they wish to perform. 

Summary

1. Make goals specific to the individual.

2. Set lots of small targets to get to the overall goal.

3. Make the goals achievable.

4. The targets should be realistic.

Enjoyment and fun is key to motivate individuals to achieve goals

Foot Care in Sport

Feet are a very important part of the anatomy, often neglected by athletes, leading to injury. Sometimes they are serious ones as well. The majority of sports are weight bearing sports, which means foot contact with the ground whilst performing. Good trainers are essential in preventing injuries. A good cushioning in the trainer will prevent problems with the heels and can also have implication with arch problems, such as flat feet. Getting the right size trainers is also essential. Blisters are always a concern when shoes do not fit. The small space left causes friction leading to the blisters. Feet swell with exercise so it is important to bear that in mind as normally well-fitted trainers will be small with exercise. This may also mean the individual curls their toes, which may lead to tight toe muscles. Nails should be regularly cut to prevent any broken toe nails from the movement of the foot against the end of the footwear. When washing make sure feet are dried thoroughly as many infections can develop, such as Athletes foot. This is a fungal infection which can be easily treated by products available at the chemist. Corns and calluses can also be problematic if not prevented or treated well. They are a build up of dead, hard skin in areas of increased pressure, maybe from weak footwear support or maybe due to direct pressure on the ground². Using a foot scrub after a bath or shower on any developing areas of hard skin will prevent corns and calluses developing. The skin will be of a yellowish nature and are predominantly found around the ball of the foot, which is below the joint of the hallux (big toe). These are just a few of the conditions that may arise from a lack of foot care. The feet may cause problems higher up in the skeleton and other tissues around it and the first area to be affected after the foot is usually the ankle, then the knee, and working around the body if not prevented and adjusted. If you are concerned with your feet and think there may be something wrong, check for your local podiatrist and enquire on whether an appointment may be of benefit to assess the concern at hand. 

Quick Facts!!!

“Pound for pound, bone is as strong as steel and 3 times stronger than the same amount of reinforced concrete.³”

“The skeleton makes up 15% of the bodies weight. Bones are made of half water and half solid matter.³”

“The solid matter in bones contain around 2 pounds of calcium and a pound of phosphorus, which is enough for 2000 matches!³”

 References

1. Arvinen-Barrow, M., Back to Basics: Using Goal Settings to Enhance Rehabilitation, SportEx Medicine, Issue 37 (July), pp. 15-19.

2. Barlow, A., Foot Care for Sport, SportEx Dynamics, Issue 20 (April), pp. 11-13.

3. Biel, A., Trail Guide to the Body, 3rd Edition, Books of Discover, London.

April 09 – Issue 5

Welcome once again to the next edition of my quarterly newsletter.

I hope the new year has started well for everyone and that those new years resolutions have not been broken yet! I would also like to say Happy

Mothers Day to all those mothers out there as we recently passed their special day!

A new facility that available in the clinic is a non invasive body fat moni- tor. If you’re interested in finding out your body fat percentage please ask for further information as there are certain body conditions that may show a false reading. It only costs £2 and may be a great tool for small targets in training or diet plans.

Massage alleviates DOMS

Firstly, what is DOMS? It stands for the Delay of Onset of Muscle Soreness. This occurs from the build up of waste products, such a s Lactic acid, in the muscles when exercising at higher in- tensities that the body is used to. These waste products reduce muscle func- tionality and cause pain and stiffness.

It has been suggested that a massage lasting 30 minutes following ex- ercise delays the onset of DOMS and also reduces the amount of pain experi- ence. There was also a suggestion that performances that followed a mas- sage were at a higher level than if a massage was not received.1

 

Aloe Vera and its Benefits


Aloe Vera has a history of being a good healer in many situations, whether it be for burns or stings, but its characteristics and attributes go far beyond that. The Aloe plant has around 200 varieties with the Aloe Vera or Aloe Barbadensis plant being the most potent and therefore the most widely used.

From the plant, the gel under the thick outer layer is where the benefits are found. The gel contains vitamins, minerals, amino acids (some of which the body needs that it can’t produce itself) and sugars amongst other things as well. With all this goodness in the plant, it has now been used for far more things including sports.

Healing gel, heat cream, supplementation are just some of the sporting benefits produced from the plant. There are also fantastic drinks that help maintain the bodies essential balance in nutrients and minerals, giving a great energy boost and improving nutrient uptake. The products you need to buy that have Aloe Vera in them need to compromise of Aloe Vera as the majority ingredient, otherwise there use is not as ef- fective.

So even if you would like to sample some of the products that may help with skin conditions such as exzema, or burns and rashes, please ask. There is a whole range of products, available from myself or online.

What is a ‘frozen shoulder’?

Frozen shoulder is the common term for the medical con- dition adhesive capsulitis. From the name, it is implied that there is a swelling in a capsule that has been joined or fixed by abnor- mal tissue adhesions.

It is believed that the onset of a frozen shoulder derives from an injury or incident that has previously involved the shoul- der. A chronic inflammation of the capsule, with adhesive fibres further reducing mobility are the main factors in the condition, along with the reduction of synovial fluid (which aids joint mobil- ity) due to the inflammation.2

The injury takes time 2 develop or “freeze”. Usually around 3-5 months and signs are a constant pain in the shoulder with a reduced range of motion in the shoulder, pain whilst sleeping and movement problems in colder weather.

The problem is most common in individuals over 40 and more common in women than men. Rehabilitation for this comdi- tion is a long and painful one and greatly depends on how long the individual waits prior to seeking medical help and the gen- eral condition of the individual. In healthy individuals full rehabili- tation may be around 5 months, but could last as long as 3 years if the individual is for example diabetic or has a history of heart problems.

Rehabilitation consists of physical therapy, massage ther- apy, medication and in severe cases surgery.

What Happens in an Injury? Part 3

The final two stages in the injury process are the remodeling phase and the functional sport-specific phase.

The remodeling phase is generally thought to occur in the 2-3 weeks following trauma. It is when the collagen laid down in the damaged area is replaced by stronger collagen. It is also the point in which full pain free range of motion should be achieved, allowing the following stage of functional sport-specific movements to be performed.

Whilst the new collagen is being laid down in the damaged area. This is the perfect time to perform full stretches to reinforce correct fibre alignment and elastic- ity. Massage is a very good aid to assist in this process as it would break up any unwanted left over scar tissue and encourage the progress to full range of motion. This is achieved by passive (therapist controlling movement) and active (client controlled movement) stretching. This is taken to the point where the new collagen is being stressed slightly more than it has been laid down and thus promoting full elasticity in the fibres.3

Once pain free range of motion along with muscu- lar strength and muscular balance have been achieved, the final stage of injury commences.

As discussed, the final stage is called the func- tional sport-specific phase. As the name implies this stage concentrates on the movements that the active individual needs to perform in the activity they perform.

As the individual has not been in maximal perform- ance it’s usually a good idea to get an initial base test re- sult. This allows targets to be set in this phase.

Depending on the activity depends on what ex- ercise what actions are to be performed. The princi- ples however, are all the same. Straight line move- ments are always performed first as they are less stressful on the muscles and joints as a whole than twisting and turning movements. These are to be en- corporated gradually into the exercise programme if necessary to the individual at hand.

Massage is still a vital part to this phase as it promotes removal of any waste products that the body would not normally have produced before injury such as dead cells and lactic acid. It also aids in the recovery of the muscle fibres for the following exercise ses- sion. To complete the phases a final test should be performed to show improvements required to return to maximal performance.

 

quires.”