Sports Injury Focus – Shin Splints

Signs and Symptoms:

Pain on the inside of the shin bone – usually appears gradually and gets worse the more running or waking on a hard surface that you do. Excessive walking in poor fitting shoes ( like flip flops) can sometimes also lead to shin splints.

* Week 1 

Complete rest is advised for the athlete.
Speak to the GP about anti-inflammatories and apply ice regularly to the damaged shinbone.

In this phase it’s important to check trainers for “wear” and loss of support. Also, consider custom orthotics that are proven to reduce the effects of shin splints and limit pain during exercise.

Athlete can cycle, swim, cross trainer and rowing machine to maintain CV fitness. Running is to be avoided at all costs.

From a Physio point of view – deep massage of the calf and Achilles muscles is urgent as is stretching of both. Sometimes strapping can be of help. Consider dry needling as a treatment modality as well.

* Week 2 

Continue with ice and rest from cycling or running. 

Swimming is encouraged and the rower is also possible and unlikely to reproduce any pain in the shin. If it does, stop. 

Continue with gluteal and core exercises and stretching in the gym. 

From a Physio point of view – deep therapeutic massage of the whole leg is vital and will continue x3 daily, immediately followed by passive and active stretching. 

* Week 3 

Consider gradual return to running. Note: Treadmill running is advised first due to less impact. All other fitness options are continued and core/pilates is increased.

From a Physio point of view – athlete continues to receive deep tissue massage, PNF stretching and hands on work to the leg and also the lower back region as a prophylaxis.

* Week 4 

Continue with ice.

Insert custom orthotics and begin gradual return to pre-injury activity.

Athlete will continue to apply ice immediately after any running for at least 6 weeks.

Core and pilates exercises maintained, as is all strength and flexibility work to the surrounding muscle groups.

From a Physio point of view – deep therapeutic massage of the calf muscle and surrounding muscles continues for approximately 2-3 weeks.

Review of recovery: 

Complete rest from running needed early on.

Stretch and massaging of calf and Achilles is pivotal to the successful recovery. As is doing the right core, Pilates and gluteal strength and control exercises.

Secret Tip(s): 

Check your trainers and change them every 3 months, consider custom foot orthotics and ice packs is the best thing that you can be doing to help your self with shin splints.

You must also be doing regular core control and back strength exercises, too. Let your Physio do everything else.

Do not be fooled by the absence of pain when you rest. Shin Splints are likely to only be painful in a weight-bearing situation (such as running or excessive walking).

Note: Return to running progressively and start with treadmill –> grass –> sand –> road.

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Sports Injury Focus – Runners’ Knee ( ITB Friction Syndrome)

Signs and Symptoms:

Signs & Symptoms of Runners’ Knee include burning sensation/pain that comes on gradually on the outside of the knee. Common in cyclists and runners. Often confusing as there is no major incident or trauma, yet the pain and or burning comes on gradually and appears to get worse. 

* Week 1 

Ice is vital. As is rest. 

Walking is fine and swimming is great too. With this kind of injury, maintaining flexibility and core strength, is important. 

From a Physio point of view – I’d be working on deep tissue massage of the tensioners of the IT Band(The muscles at the top of the hip) as well as stretching the band, quads and hip region. 

It’s also possible that the Athlete’s “back” will have stiffened so I’d be working to loosen that area too. It’s really important for the Athlete to be working on strength work of the Gluteal muscles and the core stability muscles. 

* Week 2 

Continue with ice and rest from cycling or running. 

Swimming is encouraged and the rower is also possible and unlikely to reproduce any pain on the out-side of the band. If it does, stop. 

Continue with gluteal and core exercises and stretching in the gym. 

From a Physio point of view – deep therapeutic massage of the whole leg is vital and will continue x3 daily, immediately followed by passive and active stretching. 

* Week 3 

Cycling and or running will be able to be introduced in this phase, providing the athlete has followed the treatment plan noted above. 

Gentle, half pace jogging is introduced and cycling (both on the flat). Athlete should not be expecting to feel any burning sensation. Fatigue and stiffness is okay. 

From a Physio point of view – deep therapeutic massage continues as does stretching. Increase gluteal and core exercise and begin re-introduction to 3/4 level activity and or practice. Ice remains important after every session (use heat before). 

* Week 4 

Athlete steps up to training. Sneakers are checked and or orthotics applied to footwear to re-correct the position of the foot. 

From a Physio point of view – massage and stretching continue for at least 2-3 weeks and athlete continues working on core stability and gluteal strength and control exercises. More functional baed exercises are included as well as good hip and knee control against gravity.

Review of recovery: 

Complete rest needed early on – just until the pain settles

Stretch and massaging is pivotal to the successful recovery. As is doing the right core, gluteal exercises and functional rehab exercises. Most times the issues are related to biomechanics and this must be corrected or you’ll just be putting a band aid on the problem.

Secret Tip(s): 

Check your sneakers and change them every 3 months, consider custom foot orthotics and ice packs are the best thing that you can be doing to help your self.  Remember your compliance with your home exercises!

Let your Physiotherapist do everything else. 

Do not be fooled by the absence of pain when you rest. The IT Band is only painful in a weight-bearing situation (such as running) or cycling due to excessive over use. 

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Sports Injury Focus: Knee Ligament

Signs and symptoms: 

Athlete likely to have landed awkwardly, twisted, or fallen causing pain, stiffness and immediate swelling of the knee joint, often on the inside. 

* Week 1 

Immediate ice, compression and elevation of the injured knee. Begin gentle walking ASAP. Strapping

Often 3-4 days post injury. 

Note: it is expected (and okay) to be painful. However, straight line walking only. 

None whatsoever twisting or turning of the knee joint can be tolerated in week 1. 

Swimming is encouraged when possible and if pain allows (Tip: Athletes will often use a float between the legs to keep the knee straight and limit pain). 

From a Physio point of view – deep friction massage and very gentle stretching and massage would begin after just 4-5 days. 

* Week 2 

Very gentle (but prolonged) walking on the flat is vital and is to be encouraged. Towards the end of week 2, the goal will be for gentle jogging on a treadmill. 

Swimming continues (not breast stroke), cycling and cross trainers are all ok. 

From a Physio point of view – massage continues of damaged knee ligaments and of the quads, ham- string and calf muscles. Specific quad and gluteal muscle activation is essential

Stretching of all muscle groups is a must and balance work is now added for both legs. 

* Week 3 

Exercise and CV work is increased. 

Straight line running is picked up and the athlete will aim to be at three quarter pace by the end of this phase. 

Slowly, but surely, uneven surfaces are introduced and twisting and turning begins to be allowed. 

From a Physio point of view – all deep massage work continues, muscles and knee joint are stretched to max and proprioception exercises are now top priority along with full movement of the knee joint. 

* Week 4 

Athlete returns to training and possibly performance. CV work increase and continues. 

From a Physio point of view – all massage treatment and stretching continues for approximately 3-4 weeks and athlete pays attention to strength and proprioception exercises. 

Review of recovery: 

Take it very easy early on. But in the case of nearly all knee ligament sprains, too much rest will be harmful. 

Stretch and mobilise the injury at just the right time and no knee ligament injury can ever recover fully with prolonged rest. 

Secret Tip(s): 

Too much rest in the first few weeks will increase the likelihood of re-injury and a recovery plateau will occur. 

No breast stroke in the swimming pool. 

Do not be fooled by lack of pain when walking straight – twisting and turning “pain free” must be achievable. 

Note: It’s not uncommon for knee sprains to feel not much better even 6 weeks down the line. And it’s often because of too much rest in the first few weeks. 

Stay off the beach and avoid uneven woods/hilly areas when running, for at least 3 months post knee injury. 

Don’t be fooled by the lack of pain after two weeks either. 

It does not mean you are fit to play or run and if you haven’t followed all of the Protocol listed above, you will damage the ligament again sometime soon – often when you least expect it on an uneven surface.

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Sports Injury Focus- Ankle Sprains

We’ve seen lots of people with ankle injuries over the years. The common story we hear when clients come in, is that they have sprained the ankle ages ago and started to notice pain in the knee, hip or back on the same side as the ankle injury. There is always a knock on effect, and what most people don’t realise is lack of range of ankle movement( particularly what we call dorsiflexion) and loss of balance and strength and control at the ankle are the number one reasons why these problems persist.

Most people rest, take painkillers, wear a support and just assume that when the pain goes that the foot and ankle has fully recovered. Read on to get the correct information about how to properly manage a foot and ankle injury….

Ankle Sprains – Signs and symptoms:

Likely to have landed awkwardly, twisted, or fallen causing pain, stiffness and immediate swelling, mainly on the outside of the ankle joint, below the ankle bone. A ball of swelling will be noted or tracking of bruising down the lateral border of the foot. This is what we call ecchymosis. In my experience the worse this is my more likelihood you have a more serious ligament injury or a fracture. Injuries are classed in different grades, and upon diagnosis we will advise you to either wear a brace, get some crutches to offload the area, or we may advise an x-ray to exclude any bony injuries.

Please be mindful that the info below is a very basic guide. Please consult a health professional in order to get a proper idea of the severity of your injury before proceeding with anything we have provided below.

* Week 1 

We use the regime called P.O.L.I.C.E. Protection, Optimum Load, Immediate ice, compression and elevation. Strapping the joint will also help.

Begin gentle walking ASAP. Often 3-4 days post injury. Note it is expected (and okay) to be painful. However, straight line walking only.

None whatsoever twisting or turning of the ankle joint can be tolerated in week 1. Swimming is encouraged when possible and if pain allows.

From a Physio point of view – deep friction massage and very gentle massage of calf and Achilles would begin after just 4-5 days. We also use ultrasound and interferential at this stage. Strapping can also help.

* Week 2 

Very gentle (but prolonged) walking on the flat, is vital and to be encouraged. Towards the end of week 2, the goal will be for gentle jogging on a treadmill.

Swimming continues, cycling and cross trainers are all ok.

From a Physio point of view – massage continues of ankle ligaments and of the calf and Achilles tendon to prevent tightness and future problems. Stretching of all muscle groups is a must and balance work is now added to both ankles. Ankle mobility is important too.

* Week 3 

Exercise and CV work is increased.

Straight line running is picked up and athlete will aim to be at three quarter pace by the end of this phase.

Slowly, but surely, uneven surfaces are introduced and twisting and turning begins to be allowed.

From a Physio point of view – all deep massage work continues, muscles and ankle joint are stretched to the max and proprioception exercises are now top priority along with full movement of the ankle joint.

* Week 4 

Athlete returns to training and possibly performance. CV work increase and continues.

From a Physio point of view – all treatment and stretching continues for approximately 3-4 weeks and athlete pays attention to proprioception exercises. Lots and lots of balance work. We will also have a look higher up the chain and make sure that the calf muscles, hamstrings, gluteals and quads are doing what they should be doing.

Review of recovery: 

Take it very easy early on. But in the case of nearly all ankle sprains, too much rest will be harmful.

Stretch and mobilize the injury at just the right time and no ankle injury can ever fully recover with prolonged rest.

Secret Tip(s): 

Too much rest in the first few weeks will increase the likelihood of re-injury and a plateau. Do not be fooled by lack of pain when walking straight – Twisting and turning “pain free” must be achievable.

Note: It’s not uncommon for ankle sprains to feel not much better even 6 weeks down the line. And it’s often because of too much rest in the first few weeks.

Stay off the beach and avoid uneven woods/hilly areas when running, for at least 3 months post-injury. Don’t be fooled by the lack of pain after two weeks either.

It does not mean you are fit to play or run and if you haven’t followed all of the Protocols listed above, you will damage the ligament again sometime soon.

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Sports Injury Focus – Achilles Tendon Problems

Here at Apple Physio, we have worked with people with achilles issues for many years and truly have a great knowledge of how to diagnose and manage this issue. We see people with minor strains to complete rupture, and the recovery plans and treatment process varies. 

Truth is, without knowing you or your medical history intimately, I cannot tell you which of these will work best for you. And even if I did know the root cause of your sports injury, there are no guarantees that any one single strategy will work. As a disclaimer please do seek professional help and get a proper assessment of your injury.

Achilles Injury – Signs and symptoms: 

Immediate sharp pain in the back and bottom of your leg. Right above the ankle joint. Often happens when running or jumping and gets worse/comes on gradually as you run.  Sometimes this can build up over a period of time and is aggravated by movement, especially walking up hill or stairs. Calms down with rest and sometimes you can feel crepitus ( creaking) of the tendon.

* Week 1 

Complete rest. 

Apply lots of ice. Swap footwear to soft, comfy, high-heeled shoes. No need for strapping or supports other than to apply ice. 

Every hour for 10 minutes is recommend. 

Typically, a pro athlete suffering with an Achilles tendon issue would be advised to go swimming, take one or two gentle walks (on the flat) and when possible, work on core stability exercises with a balance ball. 

The right selection of footwear is important – avoid plimsoles or sandals. Find and wear a pair of trainers with a nice thick “heel” to prevent any tension on the tendon. 

From a Physio point of view – after about days 2-3, I’d begin some deep massage and very gentle stretching and work on the ankle joint to prevent any stiffness or get rid of any swelling. 

I’d also massage the calf muscle and check the lower back for any stiffness to rule out any nerve problems that could create more long-term problems. 

* Week 2 

Ice continues – often until day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is. 

Typically, one of my players would now be exercising on a bike, swimming would continue and towards the end of week 2, I’d be aiming to have the athlete doing some very gentle jogging. 

The player or athlete can expect to feel some form of burning sensation, but as long as it isn’t “cramping” or “biting” this is fine – and a good thing. 

From a Physio point of view – massage is now vital.
It’s now that the scar tissue build up is “dangerous” and if the massage isn’t done, it’s the number 1 reason for an Achilles tearing again in the first two weeks back to running or playing. 

* Week 3 

Ice has stopped. Now, heat is being used rather than ice in this stage. 

Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using a ball). 

Fitness levels are increased significantly. Swimming, cycling, gentle jogging is stepped up (still on the flat). And by the end of this phase, the athlete may or may not be asked to be doing three quarter pace running by now. 

From a Physio point of view – hands-on treatment is vital, massage continues and work on the Achilles, calf, hamstrings, gluteal muscles and lower back is essential to prevent future reoccurrence. 

Ankle joint and balance work is important too. PNF stretching is also introduced. Static, Isometric exercises to the calf and achilles tendon is initiated.

* Week 4 

Athlete 90% fit. 

CV work increases and a return to practice and full drills are possible and the goal, by the end of week 4. 

Athlete is put through drills that will include sprints, shuttles and plyometric work, including running backwards. 

Note: Hill running and sand is disqualified for at least 3 more months for this type of injury.


From a Physio point of view – hands-on massage continues, PNF stretching is vital and passive and active eccentric stretching and strength work is stepped up. 

* Week 5 

Athlete returns to sport.
Fitness and performance work increases. 

From a Physio point of view – massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions. 

Note: Daily hands-on massage will be needed for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening the muscles. 

*Week 6

Review Of Recovery: 

Take it very easy early on, stretch and mobilize the injury at just the right time and no Achilies injury can every recover fully without deep massage or the right amount of rehabilitative work. Especially strength starting with static/isometric to a more dynamic eccentric type exercise.

*Week 7

Secret Tip(s): 

Too much rest in the first few weeks will increase the likelihood on re-injury. 

Stay off the beach when running for at least 3 months post injury. 

Don’t be fooled by the lack of pain after two weeks either. It does not mean you are fit to play or run and if you haven’t followed all of the protocol listed above, you will damage the tendon again sometime soon. If you are able to do plyometrics comfortably – i.e. run jump and push off the affected leg. Then you have a good chance of prevrnting the issue from returning again in future.

If you’d like to talk to an experienced Specialist Physio about the possibilities if you currently struggling with an Achilles problem and you decide for yourself that Physio will add value to your health, like it does so many other people, then please connect with us. 

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01753 866 274 or email us on windsor@applephysio.com and tell us what’s going on.  A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

Sports Injury Focus – Calf Muscle Injuries

The calf muscle. Muscle and achilles tendon issues. Pain on the side or front of the lower leg. We truly have a great knowledge of how to diagnose and manage this.  We see people with minor strains to complete muscle rupture, and the recovery plans and treatment process varies. The injuries (and the recovery plans) are in no particular order of importance and they all have one thing in common – they all work. There’s a great saying that goes: Small hinges swing big doors. And it’s often the simplest advice that wins in the end.

Truth is, without knowing you or your medical history intimately, I cannot tell you which of these will work best for you. And even if I did know the root cause of your sports injury, there are no guarantees that any one single strategy will work. As a disclaimer please do seek professional help and get a proper assessment of your injury.

Calf Injury – Signs and symptoms:

Immediate sharp pain in the muscle at the bottom of the leg, just below the knee. OR in the middle of the muscle belly. Often people describe the pain as having felt like they’d been “shot” in the back of the leg. These are injuries of a more acute nature. Some people describe a niggle that tends to get worse with activity and calms down when they not using the muscle. The persistent niggle is a little more difficult to deal with as there are many factors to consider. Training regime and biomechanics for example.

* Week 1

This is always about P.O.L.I.C.E Protection, Optimal Loading, Ice, Compression and Elevation
Ice is best applied little and often. 10 minutes every hour, should be enough.

Typically, a pro athlete would be advised to go swimming, take one or two gentle walks and when possible, work on core stability exercises with a balance ball.

The right selection of footwear is important – avoid plimsoles or sandals. Find and wear a pair of trainers with a nice thick heel to prevent any tension on the muscle.

From a Physio point of view – after about day 5, I’d begin some deep massage and very gentle stretching and work on the ankle joint to prevent any stiffness or get rid of any swelling.

* Week 2

Ice continues – often until day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is.

Typically, one of my athletes would now be exercising on a bike and swimming would continue.

The athlete can expect to begin on a bike or start on the rowing machine to keep up with CV fitness but running should be avoided for now.

From a Physio point of view – deep massage is now vital. We’ll also review and correct biomechanics and start to work on improving ankle range of movement.

It’s now that the scar tissue build up is “dangerous” and if the deep massage isn’t done, it’s the number 1 reason for calf muscles tearing again in the first two weeks back to running or playing.

* Week 3

Ice has stopped. Now, heat is being used rather than ice in this stage.

Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using a ball).

Fitness levels are increased significantly. Swimming, cycling, gentle jogging is stepped up. And by the end, the athlete may or may not be asked to be doing pace running by now.

From a Physio point of view – hands-on treatment is vital, massage continues and work on the Achilles, hamstrings, gluteal muscles and lower back is essential to prevent future reoccurrence.

PNF stretching is also introduced.

* Week 4

Athlete 90% fit. CV work increases and a return to practice and full drills is possible and the goal, by the end of week 4.

Athlete is put through drills that will include sprints, shuttles and plyometric work.

From a Physio point of view – hands-on massage continues, PNF stretching is vital and passive and active stretching is stepped up. We’ll also start to add in jumping and plyometrics.

* Week 5

Athlete returns to sport. Fitness and performance work increases.

From a Physio point of view– massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions.

Note: Hands-on massage will be need for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening up the muscles.

Review of Recovery:

Take it very easy early on, stretch and mobilise the injury at just the right time and no calf injury can ever recover fully without deep massage, stretching and proper plyometric strength work.

Secret Tip:

Too much rest in the first few weeks will increase the likelihood of re-injury.

Don’t be fooled by the lack of pain after two weeks either. It does not mean you are fit to play or run and if you haven’t followed all of the protocol listed above, you will damage the muscle again sometime soon

If you’d like to talk to an experienced Specialist Physio about the possibilities if you currently struggling with a calf strain and you decide for yourself that Physio will add value to your health, like it does so many other people, then please connect with us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your sports injury. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.



Sports Injury Focus – Hamstring and Groin Injury

Here at Apple Physio we have worked with people with Hamstring and Groin injuries for many years and truly have a great knowledge of how to diagnose and manage this issue. We see people with minor strains to complete rupture, and the recovery plans and treatment process varies. We may be able to diagnose the area of the strain via Physical Assessment or we may request you get a scan of the area to ascertain the severity or grade of the tear. The hamstring/groin is divided into 4-6 different muscles, so it is important to determine which muscle belly is affected.  The injuries (and the recovery plans) provided in the weeks below are in no particular order of importance and they all have one thing in common – they all work. There’s a great saying that goes: Small hinges swing big doors. And it’s often the simplest advice that wins in the end.

Signs and symptoms:

Immediate sharp pain in the back of the thigh or inner thigh. Often when sprinting, or a challenge that stretches the muscles of the hamstring or groin forcefully and it’s not uncommon for bruising and swelling to appear and sometimes track to behind and side of the knee. Can be very disabling in the first few days and very painful to walk.

Tip 1

This is always about Ice and rest. Compression. Not much else.

Typically, I’d advise an athlete to go swimming, take one or two gentle walks and when possible, work on core stability exercises with a balance ball.

From a Physio point of view – after about day 5 I’d begin some deep massage and very gentle stretching. It’s here where we’ll determine if you need some additional investigations and may refer you to get an ultrasound scan in order to confirm the severity of the injury. Sports Taping and compression(via a thigh support or tubigrip) may help as well. Be careful if you have a flight soon after an injury like this. Consult your doctor or speak to your Physiotherapist if you are unsure.

Tip 2

Ice continues – often up to day 10 depending upon how much bleeding has taken place and how badly damaged the muscle tear is.

Typically, an athlete would now be exercising on a bike, swimming would continue and towards the end of week 2, I’d be aiming to have the athlete doing some very gentle jogging. The player or athlete can expect to feel some form of burning sensation, but as long as it isn’t “cramping” or “biting” this is fine – and a good thing.

From a Physio point of view – massage is now vital. It’s now that the scar tissue builds up is “dangerous” and if the massage isn’t done, it’s the number 1 reason for hamstrings or groin muscles tearing again in the first two weeks back to running or playing. Massage will be applied as the athlete can tolerate. Flushing is the term we would use.

Tip 3

Ice has stopped. More heat is being used rather than ice in this stage.

Stretching is now vital. I’d be recommending the athlete to attend Yoga classes, increase the amount of Pilates exercises and that he or she be working on their balance (using an exercise/ gym ball). However, stretch to the point of tolerance being careful not to hurt the healing tissue further.

Fitness levels are increased significantly. Swimming, cycling, long distance running is stepped up. And the athlete may or may not be asked to be doing three quarter paces running by now.

From a Physio point of view – hands-on treatment is vital; massage continues and work on the gluteal muscles and lower back is essential to prevent future reoccurrence.

PNF stretching is also introduced. (This simply means a contract relax technique to increase tensile strength of the muscle fibre and also increased the range of movement. PNF stretching can also modulate pain.)

Tip 4

Athlete 90% fit. CV work increases and a return to practice and full drills is possible and the goal, by the end of week 4.

Athlete is put through drills that will include sprints, shuttles and plyometric work.

From a Physio point of view – hands-on massage continues, PNF stretching is vital and passive and active/functional stretching is stepped up. Isolated hamstring strength and inner thigh work is included through a good full range of movement.

Tip 5

Athlete returns to sport, fitness and performance work increases.

From a Physio point of view – massage continues to prevent scar tissue build up and stretching is continued before, during and after training sessions. Isolated hamstring strength work is included through a good full range of movement. Here we include my favourite – Nordic hamstring curls and the squashed frog and side lunge for the inner thighs. The aim to make the hamstring and groin even more robust and strong to prevent re-injury.

Note: Hands-on massage will be needed for approximately another 2-3 weeks to prevent scar tissue (collagen) tightening the muscles.

Review of recovery:

Take it very easy early on, stretch and mobilize the injury at just the right time and no hamstring or groin muscle can ever recover fully without deep massage, stretching and the right amount of strength work vs the functional activity requirements.

Secret Tip:

When jogging or running for the first time… a *burning* sensation is to be expected and is OKAY. There’s no need to stop. But you must stop if it cramps or feels as though the muscle is “biting” sharply…

Too much rest in the first few weeks will increase the likelihood of re-injury.

Don’t be fooled by the lack of pain after two weeks. It does not mean you are fit to play or run and if you haven’t followed the rules listed above, you will damage the muscle again sometime soon.

Conclusion:

Truth is, without knowing you or your medical history intimately, I cannot tell you which of these will work best for you or if your recovery will follow the plan above. And even if I did know the root cause of your sports injury, there are no guarantees that any one single strategy will work. As a disclaimer please do seek professional help and get a proper assessment of your injury in order to tailor your treatment plan.

But imagine this… how great it would be if you try just one of the strategies below every day…within a few weeks you could have gotten some way towards winning back your active, healthy “sporty” lifestyle.

If you’d like to talk to an experienced Specialist Physio about the possibilities if you currently struggling with a hamstring or groin strain and you decide for yourself that Physio will add value to your health, like it does so many other people, then please connect with us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your sports injury. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.



6 Shoe Mistakes That Could Be Causing Your Foot Pain

If you’ve ever hobbled off of the dance floor at a wedding with your heels in hand, or if you’ve ever found yourself looking forward to the moment you go home after a long day spent in meetings, so you can slip your new pair of suit shoes off – you’ll know shoes can easily cause foot pain.

This holds true for all types of footwear, not just the fancy kind…

Exercise shoes, office shoes, sandals, and that pair of weekend running around shoes we all have – they can all lead to painful feet too.

But before you throw out every pair of shoes in your wardrobe – let’s talk about your feet.

A lot of us are unaware of just how big of a role feet play when it comes to supporting your body.

Feet play the big job of supporting your body weight and take the impact of standing, walking, running and everything else you do throughout the day.

Your feet are made up of 52 bones, 66 joints and OVER 200 muscles, tendons AND ligaments – so when your feet don’t get the support they need, it’s no wonder why you can get issues!

A lack of support can also cause pain beyond your feet – your knees, back and other parts of your body begin to overcompensate, which can lead to pain in those areas too… not good.

With all of the above in mind – here are 6 shoe mistakes that cause foot pain, are you making any of them?

  1. You’re Unaware Of Your Arches

Generally speaking, there are two types of feet:

  1. High arched
  2. Low arched

And the demands for these two types are quite different!

For someone with high-arched feet – they have taller gaps on the soles of their feet.

For someone with low-arches – the curves between the balls of the foot and heels, are closer to the ground.

The curve of your shoe should support your arches so they can, in turn, support the rest of your feet and body. A good running shop, shoe shop, or even a Physio clinic with a special machine – can figure out what’s best for you.

We customise shoes for patients all the time, and the difference in their pain means they can get back to walking around comfortably and independently again.

  1. You Choose Your Running Shoes For Appearance

Have you ever bought a pair of running shoes because you think they look good? You’re not alone, many of us do, I’ve been guilty of it too!

But the truth is, picking the right performance shoe should be a strategic process.

When you need a new pair of trainers, go into a specialty running store and speak with a specialist. You need to consider things like the type of exercise you’ll be doing – running over 20 miles outdoors each week is VERY different from doing Pilates classes a couple of times a week.

A running analysis can do you the world of good too. We can do a GAIT analysis at both our clinics using a 2D and 3D video approach. Connect with us to find out more.

If you can afford to, have a couple of kinds of trainers for the workouts you do most often.

Wearing a tennis shoe for running, or a basketball shoe for weightlifting, can encourage injuries – choose wisely.

  1. You “Break In” Your New Pair Of Shoes

While it’s true that some shoes made of multiple materials, like hiking boots, might need some “breaking in” before you can get to the point where you feel like you’re walking on clouds – you should be careful not to rush the process.

Your shoes need to become accustomed to your feet over time to avoid pain and those nasty blisters that so often come with a new pair of shoes.

Instead of pushing through the pain – wear your shoes in a little at a time until they loosen naturally. Whether you’re doing this at home or while you’re out and about getting jobs done – keep a pair of socks and plasters handy to prevent blisters.

4. You Walk Around Barefoot At Home

As soon as you step through the door do you throw your shoes off and that’s you done for the day?

For a lot of us, taking our shoes off is one of the best feelings! But for some people, walking or standing barefoot on surfaces like hardwood floors, marble or tile puts stress on the structures of the feet either causing or making pain worse over time.

This can happen when the fleshy parts on your heels and balls of your feet which help cushion our bodyweight wear down.

If you have foot pain that feels worse when you walk around barefoot – get a pair of slippers to wear around the house to ease the pain.

Remember though that over time the best solution is to train yourself to walk around bare feet. It is actually better for you long term. But most of us in this modern day have become so accustomed to having something between our feet and the floor, some sort of support is thus required long term.

  1. You’re Still Wearing That Worn Down Pair Of Boots From 2014

Many of us only throw away a pair of shoes when they’re looking a bit worse for wear and worn down.

But once the sole of your shoe starts to break down, it changes the way your foot strikes the ground which can cause pain in your feet, hips, knees and back – this can also happen before your shoes start showing obvious signs it’s time for a brand new pair!

Depending on your activity level, it takes a few months to a year of daily use to wear out footwear.

If you really love a pair of shoes then re-soling them or adding an insert can help prolong their wear.

But don’t hold onto a pair of shoes too long before it’s too late!

  1. You Don’t Use Insoles

…Or understand their purpose.

Depending on your foot type and foot pain, you might already have the insoles that come with your shoes – however, they may not be right, or even supportive for you.

To ease the pain, stop it from getting worse or even to prevent it from coming on – it’s a smart idea to get yourself a pair of customised insoles (also known as Orthotics).

Rarely, however, are true custom orthotics available in many places, and most definitely not in shoe stores, in retail stores and even pharmacy’s.

Prescription Foot Orthotics ARE the most accurate custom functional foot orthotics and are made from non-weight bearing moulds of your feet (but you don’t need a note from your doctor to have one).

They also act to make activities such as running, walking – even standing – more efficient. What’s more, they can act to redistribute pressure on the bottom of the foot to relieve pain from excessive pressure or calluses.

The takeaway: Your feet are probably doing way more than you give them credit for, so they need shoes to match.

The right choices for you will depend on your activity levels, height, weight, walking and running style. But if you’re experiencing any kind of foot pain that lasts for days, it makes it almost impossible to live your life as normal.

If you’d like to talk to an experienced Specialist Physio about the possibilities if you currently struggling with foot and ankle pain and you decide for yourself that Physio will add value to your health, like it does so many other people, then please connect with us.

Here at Apple Physio all of our team have vast experience dealing with Foot and Ankle pan so if you need any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free foot and ankle pain guide that we can send you. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email or post you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

The 3 Simple Steps To Ending Foot & Ankle Pain And Exercising Again Within Days! (…if you’ve had an acute injury and still need to see a Physio…)

  1. Use Ice (…Not Heat) To Stop Pain

Ice is by far the best way to ease pain.

My tip, use ice whenever you’re feeling achy or painful, such as at the end of a very busy day or if you have been out for a long walk. This principle is particularly important if your ankle or Achilles tendon appears swollen or red. Any pain underneath the heel of your foot will also settle by following this principle.

Apply an ice pack for 10 minutes or so, little but very often (every hour). This is very important if the injury is “new” or just a couple of days old.

 

  1. Use Heat To Loosen Up Stiffness (Not Ice)

And here’s when to use heat for ankle and foot pain.

My tip would be to apply a hot water bottle on a morning when your ankle/achilles is likely to be feeling more stiff, than painful. This sends a rush of blood to the injured area making it feel a little more loose and supple. Another tip would be to stretch the achilles or ankle by moving your foot up and down and side to side, whilst in bed, for 5-10 minutes, before you stand up.

This also helps blood supply to the injured area meaning you’ll feel a lot less pain when you first step out of bed or take a walk along the corridor. Again, 10 minutes should do it.

  1. Avoid “Too Much Rest”

If your injury is new or recent, it’s really important to avoid the long-term complications that come with too much rest. You can achieve this by getting “safely” active. For something like an ankle sprain, most doctors will advise rest – and lots of it. But most of them would be wrong to do so.

You absolutely must consult the right person such as a physio for advice on ways to get active again, safely, fast. For if not, then it’s not uncommon for that very same ankle sprain to develop into something much more problematic than the initial pain – that being long term scar tissue and persistent pain which will limit simple things like twisting and turning when you walk or run.

With any ankle sprain…walking, swimming, cycling and even very gentle, straight line jogging should be encouraged from as early as 5-7 days. If not, then things like achilles tendon problems and plantar fasciitis are absolutely inevitable as a consequence of failing to take such advice.

Please also know that there is a very strong link between having suffered an ankle sprain, and then suffering with achilles tendon problems (and plantar fasciitis) and vice versa. Thus, early movement (safe) is important.

 

Get Physical With Physiotherapy

There isn’t a faster way to END foot and ankle pain than by going to see a Physio. Getting to see a hands-on specialist Physio means you’re going to get very fast access to care that will soothe and relax those tight aching muscles, loosen and lubricate stiff, stuck and painful joints, and strengthen your body so that you can go back to doing the things that you love.

You can often leave a good Physio session with concerns eased and physical pain reduced, inside 30-40 minutes.

Here at Apple Physio all of our team have vast experience dealing with Foot and Ankle pain so if you need any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free foot and ankle pain guide that we can send you. Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email or post you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s, who want to keep healthy and active.

Take Your Foot Out of Your Mouth – 4 Common Myths of Foot and Ankle Pain

You probably don’t give much thought to the health of your feet — until they start to ache.

Your feet have a total of 52 bones, 66 joints and more than 200 muscles, tendons and ligaments between them — and there are about as many reasons your feet may hurt.

Here are four common myths about foot pain:

Myth 1 – All foot pain is caused by poorly fitting shoes.

Yes, foot pain, both temporary and chronic, can be caused by shoes that don’t fit correctly — as anyone who has had the misfortune to wear a pair of too-tight shoes already knows. But there are a number of other reasons your feet might hurt that go beyond blisters and calluses.

Myth 2 – I can never wear high heels if I have foot pain.

While it’s true that high heels increase foot pain and regular wear can cause bunions, you don’t have to swear them off forever. But you do need to be smart about the pair you wear and how long you wear them for. Opt for a lower, wider heel that provides a more secure base for your foot and ankle and don’t wear them for more than a few hours a day.

Myth 3 – I shouldn’t wear shoes if I think I have a foot sprain.

In fact, going barefoot or wearing flip-flops can make a sprain worse because you need the added support of a stable and protective shoe with a stiffer sole for your foot to heal. In addition, you should try to keep your injured foot elevated as much as possible to ease swelling and apply ice for 20 minutes two to three times a day.

Myth 4 – There is no treatment for foot pain.

There are many ways to treat foot pain, including shoe inserts and custom orthotics, anti-inflammatory medications, but there isn’t a faster way to END foot and ankle pain than by going to see a Physiotherapist.

Getting to see a hands-on specialist Physio means you’re going to get very fast access to care that will soothe and relax those tight aching muscles, loosen and lubricate stiff, stuck and painful joints, and strengthen your foot and ankle so that you can go back to doing the things that you love.

Here at Apple Physio all of our team have vast experience dealing with Foot and Ankle pain so if you need any advice please don’t hesitate to contact us.

If you’d like more info on this, and some easy, actionable tips you can use now to start easing your neck and shoulder. We have a free foot and ankle pain guide that we can send you.

Connect with us on 01344 489398 (Bracknell) , 01753 866274 (Windsor) or email us on windsor@applephysio.com and tell us what’s going on. A member of the team can take your details and we can email or post you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


fullsizeoutput_39a3

Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and beyond, who want to keep healthy and active.