Thursday, 29 May 2014

Commonwealth Games Training

Today's author is Simon Eason.  Simon is a Clinic Director and Physiotherapist at Garstang Physiotherapy Clinic

I have my second major round of Commonwealth Games training tomorrow (30th May) and Saturday.  I travel up to Glasgow to be "formally accredited" which is fancy way of saying that I have to prove who I am and that I am licensed to practice.  I will be given my ID badge and then be sent to be measured up for my uniform (more red than I usually wear but thankfully quite tasteful).  Then, on Saturday morning I have to report bright and early to Hampden Park, the athletics venue for the games, for Medical role specific training. I'm not sure exactly what will be involved but it will be great to meet some of the people I'll be working with and to start to get a proper idea of what my role will involve.  I'm also hoping that I'll get to meet Clyde, the games mascot who's the cheeky looking larger than life character above.  

I've got my dates and will be away for 8 days in total with a couple of 2 day breaks in the middle.  I start working on Friday 18th July which is before the opening ceremony and my last shift will be on Tuesday the 29th.  I'm gradually starting to feel more excited about the event and am really looking forward to it now that it's not so far away.  

Thursday, 15 May 2014

I like to ride my bicycle...

Today's author is Simon Eason.  Simon is a Clinic Director and Physiotherapist at Garstang Physiotherapy Clinic

We seem to have been inundated by cyclists over the last few weeks at the clinic with a huge variety of different problems.  I'm aware that the cycling community has some fairly strong viewpoints about riding set ups and divisive issues such as whether or not to wear a helmet, and I'll touch on some of these below but please bear in mind that I write from the point of view of health rather than what may or may not be technically correct for a cycling purist.  For the record, I have recently bought a bike and, having not ridden for some 15 years, have enjoyed riding it despite a few aches and pains.  I managed 18km in an hour on my first mountain bike on Sunday and haven't suffered too much.  I do use a helmet; I've treated too many people that didn't.

Firstly, to be very clear, cycling is a great form of exercise.  Lots of cardiovascular work, good muscle strengthening combines with a reasonable workout for your core and gets you out in the fresh air and, assuming all goes well, there's little or no joint impact.  There was a nice little article on the BBC website yesterday about the physiology of professional cyclists but remember that they've had years of training. How is Bradley Wiggins different from the average man?

The main thing we run into in the clinic is people's desire to ride like a pro.  It's easy (if you have the money) to buy a very advanced, lightweight bike which is perfectly set up for racing but not quite as well set up for the average middle aged person about to ride it.  Here's a few areas where people go wrong:

Make sure your bike is the right size for you and is properly set up in the first place.  Even slight changes in size can make massive differences to the angles at which your joints have to operate and can make the difference between a great experience and a very poor one.  If you don't know what you are doing, get advice from someone who does, either a reputable dealer or an experienced friend.  Backs and Necks suffer most from a bike that's the wrong size or poorly set up but too much weight bearing through your arms can leave you with upper back pain and shoulder problems too.

High seats and low handle bars are great for power through the pedals and good aerodynamics but can give quite a few back and neck problems.  The low back is put into a very flexed posture for a long period and absorbs quite a few bumps from the road.  The more horizontal the back, the more you then have to extend the neck to be able to see where you are going.  We see quite a few people with sore backs and necks and even very minor adjustments to your setup can help - a seat 1/2 an inch lower, handle bars 1/2 an inch higher or closer to you can make a few degrees difference and that's a lot for an hour's ride.  It may be less efficient for the bike but you may enjoy your ride a lot more.  I saw a man a few weeks ago who lowered his seat by an inch but changed his pedal crank length to compensate.  His back pain resolved.   This point is valid especially for people as they get older as their body may not have quite the tolerance that it have a few years previously!

Knees are also a common problem.  Often, this is poor technique; your knees are designed to run in one plane - straight up and down.  As you pedal, your thighs should be roughly parallel with your knees running over your feet.  If your thighs point in or out you may well end up with knee pain.  Often this can be resolved by looking at your foot position on the pedal - if your foot points in or out, the rest of your leg will follow. Poorly set up bikes can exacerbate this.  If your seat is too low, not only do you not get full value for every down stroke, your knees have to work harder to compensate.  Do you have shoes/pedals with a cleat? Even a degree or two of rotation can cause significant knee and hip pain.  Don't be afraid to make minor adjustments if you're getting pain, I've known people's problems disappear overnight by correcting this position.

Finally, don't bit off more than you can chew.  If you're a new rider or a returning one like me, don't do too much too soon.  Build up your strength and fitness gradually, adjust your set up in response to small niggles and problems and don't be afraid to get advice either from an experienced rider or shop or from a physiotherapist about your body. Happy cycling


Friday, 14 March 2014

Simon at the Commonwealth Games

Today's author is Simon Eason.  Simon is a Clinic Director and Physiotherapist at Garstang Physiotherapy Clinic

I got my first taste of the Commonwealth Games on Friday last week; I was quite excited beforehand but now it really is starting to build.  Lots of patients have been asking about what's happening, when and what will I be doing so here's an idea for you all.

Orientation training took place at the Emirates Arena with is just west of the city centre in Glasgow (near Celtic Park) and is in the same building as the Sir Chris Hoy Velodrome.  It's an amazing venue - very modern with room for 4,500 spectators, a great view of the track, plenty of leg room (good for me) and good facilities.

We were the first group to have training so we were sworn to secrecy about some of the content so I can't say who presented it or who was on stage (some well known Scottish names!) but it was a fun morning.  As well as having fun, we were treated to a dramatic history of the Commonwealth, formerly Empire, Games and found out quite a bit about the sports and venues and got a sneak preview of the uniforms that we'll be wearing.  There will be 17 sports and 261 medal events including 22 para sport events which are mixed in with the rest, not separate as in the Olympics.  The venues are a mix of old and new with Ibrox, Celtic Park and Hampden Park all hosting events but with several new, purpose build venues also being used.  These venues will all go on to be permanent, usable venues for the people of Glasgow.

The Games will be on between the 23rd July and the 3rd August but I could be asked to be there any time between the 13th July and the 6th August do deal with Athletes whilst they live in the village.  I'll hopefully find out my exact dates by the end of the month.  

I'll be working at the athletes village and will be part of a large team of physiotherapists who are available to treat athletes of any nationality or speciality.  We treat whoever walks through the door! Our job will be to get them though their event.  I have to go for more specific training in May so I'll find out more then about the details of my job.

I've spent quite a chunk of my life as a physio (I started university in 1997) and have worked both for the NHS and in private hospitals, clinics and now my own practice.  I've treated some fairly impressive athletes and sportsmen in the clinic and love dealing with them - they are often very focussed, very driven, incredibly fit and body aware and they prepared to work really hard on anything that us physios ask them to do.  I'm really lucky that I like my job and I enjoy the company of virtually all of  my patients, including the not so athletic!,  but I've never had the opportunity to work consistently with sportsmen and women of this standard for a sustained period. I'm hoping to learn a lot from them and from the other physios around me
and needless to say I'm really excited at the prospect and slightly nervous. I volunteered for the experience in itself and because I love what I do but I also hope that it will make me a better physio. and that I can use my experience to help the people that I see every day.

I'll let you all know more when I can.   Thanks,


Monday, 3 February 2014

Can You Get Through Your Marathon?

We’ve had our first London marathon runner of the year – we seem to get a handful every year, usually about this time as they start to increase the intensity of their training.   The good news is that we can deal with most problems fairly effectively and get people through their race, especially if we get to see them at this stage when there are still a few weeks to go. 
Most runners pick up injuries from time to time but marathons, half marathons and extreme 10km events are becoming increasingly popular and a significant number of the runners we see are part time occasional runners and most of their injuries are preventable.  

A typical case for us at the clinic is a 35 year old man who comes in with Achilles pain.  He’s training for the London marathon and has had a niggly pain for the week or two which is worse in the mornings and after a couple of miles into his run.  He used to a good runner but hasn’t done as much over the last few years.  He didn’t do much training pre Christmas as he felt that he had a “good base level of fitness and knew what he was doing”.  He had a bit of a panic after Christmas though as the marathon was suddenly imminent, dug out his old running shoes and went out for an hour’s run. 

He has managed to build up to the 10 mile distance over the last 3-4 weeks but is now getting increasingly concerned by his discomfort.  He’s taken ibuprofen for the pain and continued to run but it’s not getting any better.  Please help.

The good news with this case study is that with a few weeks to go, these cases can be dealt with and he’ll run his marathon.  We’d give him some advice about his training programme, get him stretching properly, and treat his pain with massage, ultrasound or acupuncture.  Most physiotherapists hate having to tell people to avoid exercising so we won’t ban you from running for any longer than is necessary (if at all).  Even when seeing someone at the last minute, we can usually get people through the event with a bit of help. 
But, prevention is always better than cure so these are our top tips for injury prevention:

     Wear good shoes

It’s impossible to overstate how important your shoes are.  Like tyres on a car, they are your only source of contact with the ground.  You will run a lot of miles in the build up to and during your event.  Buy good shoes from a reputable shop.  A sole should be fairly stiff to support your foot but well cushioned to protect you from the impact.  Most people should avoid a “flared” heel.  Old, worn trainers should be replaced gradually with a new pair but not immediately before a race – break them in slowly. 

Many sports shops now offer biomechanical assessment so that your shoes are the right ones for you.  Special shoes, such as anti pronatory shoes, can be really useful but only if your feet are pronated.  If your feet are neutral, they’ll just make things worse.  If in doubt, consult a podiatrist who can advise you regarding what sort of shoe is good for you. 

       Build up gradually

Increase your distances and speeds slowly – make sure, for example, that you are comfortable running two to three miles before you start running five.  Increase a mile or two at a time and avoid big jumps in distance.  The same rule should be followed with speed.  If you are used to running 8 minute miles and you want to increase you pace, try dropping to a shorter distance to ease the strain on your body.  There are many books and computer apps available that will give you good guidelines for training.

       Rest days

Let your body recover between runs.  Your body will cope with daily runs if you do short distances at slower speeds but for most people, running every other day is sensible.  Injuries are far more likely when your body is tired and many overuse injuries such as tendonitis can be avoided with regular rest days. 

      Train early

Don’t leave your training too late – it puts you under pressure to train at too high an intensity, too quickly.  You will try and skip the early shorter distance training runs and avoid resting as you have too much to do.  It may be possible to train for a marathon in six weeks but it’s not recommended.

 Manage Injuries and Niggles

Deal with problems as they arise.  If you are running 50 miles per week, that niggly tendon probably won’t get better.  Get some treatment or take a few days off.  You need to weigh up which is going to have a greater effect on your performance – a week off training or running the event with your heels in agony.  Generally, all other things being equal, a fit runner will beat an injured runner every time. 


Remember that if you manage your training well, you are far less likely to get injured.  There’s loads of information out there in books, on the internet and in magazines like Runners World (who put quite a lot of good tips on their twitter feed @runnersworld).  Sift through it and use it.
 If you do get injured, please get help.  A good physiotherapist will be able to help you, as will a good podiatrist .  They can give you advice and treatment that is right for you as an individual, whatever you level.

Simon Eason is a Chartered, HPC registered  Physiotherapist and runs Garstang Physiotherapy clinic in Lancashire