Prescription Foot Orthotics- More Information And Your Questions Answered

My name is Leslie Abrahams I’m, a leading UK physio and I’ve been recommending these type of Orthotics to my clients for more than 11 years now… and I’ve seen from first hand (and very close up) how such “foot orthotics” can really add HUGE value to any person’s quality of life and ability to maintain independence (and mobility) for much longer than would have been possible without!

What’s more, wearing them will, in many cases, especially if you’re aged 50+, will allow you to wear ANY shoes you want, safe in the comfort that joints are being protected whilst your favourite footwear is still being worn and you remaining active, safely.

Herein, I will provide a brief (and simple) introduction to Prescription Foot Orthotics.

Background, Q & A, Myths And Facts Of Prescription Orthotics

Okay, so what is a true custom orthotic? A true custom orthotic is one that matches your foot’s arch height (with modifications), width, and of course, length. The shell should be up to your metatarsal heads (3/4 length) with the heel cupped perfectly around.

True custom orthotics are made ONLY when a laboratory receives an impression of your foot – ideally from a 3-d laser scanner (I recommend a “Lab” in Ireland and Canada). Beware of orthotics that claim the foot “moulds” to the orthotic. Orthotics that are heat activated and “copy your foot”, are not as effective. Other problematic one’s are flexible orthotics that flattens out the moment you wear them.

It is true your foot needs to flex, but using very flexible materials does not give desired results.

The reason flexible material is used is because the client doesn’t think to complain because the orthotics causes no discomfort yet their original symptoms usually persist.

Orthotics should have some rigidity to them. Remember, the whole point is to provide support. Soft materials will just collapse.

In reality a custom orthotic changes the way your foot reacts during the walking cycle.

When first wearing orthotics, discomfort is usually felt because your foot is being forced into a more natural or “neutral” position. People who need orthotics usually have something wrong with their arch.

Eventually your feet adapt to the change and the discomfort goes away (including the original symptoms such as your knee, hip or back pain etc…).

One of the first questions I get when I recommend orthotics is:

“Why are custom orthotics more expensive than the ones you could go out and buy in somewhere like a pharmacy”.

Simply put, those “off the shelf” types are likely to be just plain old inserts and are generic. They’re made for “everyone and anything”. No thought, time or effort has gone in to the precision making and matching them up to an individuals needs and desires.

An orthotic, a corrective device worn inside a shoe, can help the muscles, tendons and bones of your feet and lower legs function without you suffering from pain and or stiffness. Custom-made orthotics are manufactured from a 3-D image of your foot (from a laser scanner) using raw materials.

When appropriately prescribed to treat a medical condition and custom-made (read: for you), orthotics can decrease pain, not only in your feet, but more commonly in other parts of the body, such as your knees, hips and lower back.

The term “orthotic” can refer to almost any device that is worn inside a shoe. Items called “orthotics” are readily available from Specialist Physios, podiatrists, chiropractors and other medical professionals.

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

There are three very different types of “orthotics” – custom, customized and off- the-shelf. There is a confusing amount of information available on orthotics and for many consumers making an informed decision is difficult.

So What Exactly Are Prescription/Custom Orthotics?

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 are designed to control alignment and function of your foot in order to treat or prevent injury-causing force on bones, joints, tendons and ligaments. Often they are used to limit motions such as excessive pronation (rolling-in) and excessive supination (rolling-out).

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.

How Do Custom Foot Orthotics Work?

This is a very detailed subject and too much to get in to here. But in general, most physical pain such as the back, ankle, hip or knee, is the result of a faulty relationship between the bones and muscles of the foot. Even the slightest misalignment can result in significant discomfort.

This abnormal function can result in problems such as bunions, hammertoes, arch and heel pain, corns, knee pain … even back pain.

The function of custom orthotics is much more than an arch support. Wearing the right orthotics realigns the structures of the foot and leg to prevent bone mal-alignment as well as muscle, tendon, and ligament fatigue. They are often used after surgery too, to help stop the recurrence of foot deformities.

As your foot rests on a properly constructed custom orthotic it is gently and consistently directed into the correct position (or at least a better position) for walking, running, and standing. Because your foot is now functioning properly, the pain of muscle strain and pressure points is relieved, and the progression of deformities is often stopped or slowed

So What Is Involved In Producing Custom Foot Orthotics?

The most important factor in designing foot orthotics that will provide optimum lifestyle prosperity (and health) is an orthotic prescription based on a thorough examination by an experienced and knowledgeable medical practitioner.

I cannot emphasise this enough. The “pre-fitting consultation” should include a complete bio-mechanical assessment and a look at how you walk and MUST include a comprehensive FULL BODY check.

“Because chances are it’s not your feet where you’ve got the pain. And so if you’re going to make changes down there (at your feet), the person doing it has to be sure how it’s going to effect everything else above it i.e. your knee, hip, back etc”.

What Shoes Do They Fit Inside?

All of, but not limited to these common types of Footwear:

How To Get Closer To Protecting Your Joints And Staying Active For Longer…

If you’d like to talk to an experienced Specialist Physiotherapist about the possibility of you wearing Prescription Orthotics and decide for your self if they will add value to your health, like it does so many other people, then please us in Bracknell ( 01344489398) or Windsor (01753866274) and request a FREE non committal, no obligation Telephone Consultation.

Alternatively, if you are confident that you wearing Prescription Foot Orthotics is the right move for you to make next, then you can also use this same number to arrange a “pre-orthotics fitting” consultation that will allow you to pick the perfect fitting orthotics… ones that are just right for you.

Fitting can take place at any of our locations and all of our Foot Orthotics are covered by a 100% Money Back, Life Time Guarantee. The top cover will need to replaced when it wears down with use, but the carbon fibre shell has a life time warranty.

Free Running Workshop!- Saturday 11th January 2020- 10.00am – 11.00am

FREE Running Workshop – Saturday 11th January 2020 – 10.00am – 11.00am

Apple Physiothearpy Bracknell, David Lloyd Royal Berkshire Club, Nine Mile Ride, Bracknell RG12 7PB

 

Are you new to running and unsure of what exercises you should be doing and what distance you should be attempting? 

Are you finding running hard work and too much impact on your body? 

Do you keep getting niggling annoying running injuries when you try and increase your speed or distance? 

If you answer yes to any of these questions, then start your journey towards becoming a more efficient and  less injury prone and faster runner with our FREE Running workshop taking place on Saturday 11th January at our Bracknell clinic.

What are the aims of the running workshop?

  1. To increase your understanding of prevention of injury

 

     2.  To improve your running performance with training and running technique tips

 

The Workshop will include practical elements (purely optional) where you will have the opportunity to try out some of the key  lower limb exercises to enhance your running strength, flexibility and functional balance. 

The practical program is entirely optional but if you would like to be involved with trying the exercises bring your running/training kit with you.

We will also give a practical demonstration of the gait analysis and talk you through the key components we look at when assessing and retraining your running technique to improve your overall running efficiency.

There will be a short Q+A session at the end will give you the opportunity to ask our team of running specialists anything running related. Our team on the day will include physiotherapists specialising in both running related injury and performance and orthotics management plus sports massage therapists.

 

To book your place call our Front Desk Team at Bracknell on 01344 489398

Please note that places are limited so booking as soon as possible is advisable.

Mike Davis

Mike Davis has been practising for nearly 20 years and has a wealth of experience in treating sports injuries and running injuries.

He is a keen runner and as a consequence has become a leading authority in running injuries and running based rehabilitation. 

Mike believes strongly that it is essential not just to treat and resolve the patient’s symptoms-e.g pain, stiffness, swelling but also to analyse and correct their faulty posture and movement patterns. His experience in treating spinal  and sports related conditions allied with his knowledge of the current evidence based research on the most effective exercises give patients the best possible opportunity to resolve their symptoms and speed their recovery from injury.  




Runners!

Runners – Don’t forget your core!!

Key tip for trying to avoid injury is to include specific core strength training in your running diary. With running being a highly repetitive impact activity you are at risk of overuse injuries especially to the knees and leg muscles particularly the hamstrings. When people think about “core exercises” they often think it is all about your abdominals but your core  involves over ten major muscle groups which work together. So what are the some of the key core muscles to strengthen for running? The glute (buttock) muscles are the biggest in the whole body and if they are inactive or weak then that can put more workload on smaller muscles such as the hamstrings and ITB which can then become overworked and strained.

So what are the best exercises to activate the glutes??

Studies show that the Single leg squat is excellent for activating the gluteus medius-one of the key buttock muscles. Stand on a step with your hands on your hips and raise the right leg so it’s in front of you. Balancing on the left leg bend your left knee and slowly lower your body until the heel of the right leg gently touches the floor. Straighten your knee back to the starting position pushing through your left heel and repeat ten times before switching sides. Ideally you should feel a sensation of effort in the outer buttock but if it provokes any pain or discomfort stop the exercise and consult with a physiotherapist.

For activating Glute Max-the major buttock muscle studies show that the simple step up exercise is one of the most effective. The key factor here is technique as it is a very easy exercise to do with faulty technique so that you don’t achieve effective activation of your buttock muscle.

If you click here, you can see and follow our technique cues but again if you feel any pain with this exercise stop immediately and do consult with a physiotherapist.

Windsor Pilates Studio Open Day Sat 23rd November 10-2pm

We have limited FREE spaces for reformer and tower sessions. We also have a few spaces available for a small equipment Mat class.

Spots will go very quickly so call us on 01753 866 274 and secure your space now!

Click here to submit your info on our contact page:

At Apple Physiotherapy we are super proud to be one of the only studios in the area to offer such small and exclusive classes. Our Exclusive Reformer / Tower Classes will never have more than 4 people – this enables the instructor to modify and tailor each exercise to suit the individual participants whilst enjoying exercise in a small group environment safely.

In addition to our new Reformer/Tower Studio and our mat studio we have a wonderful new Private and Semi-Private equipment studio.

Our highly skilled and experienced Pilates Team will empower you through your movement journey at one of our many studios.  In our friendly studio atmosphere you will be supported and encouraged to find and achieve your own goals.

We see the multidisciplinary benefits of Pilates and passionately endorse Pilates for rehabilitation, mental wellbeing and fitness purposes.  Here at Apple we are very proud to be able to offer various options to suit all levels.

We also offer 121 sessions, Duet classes, and Mat Pilates.  Whether it’s Pilates group classes or using the fitness equipment… working out as buddies or a small group will bring everyone faster results! Attain stronger, defined, healthier and confident bodies.

Our 121 sessions are an amazing introduction to the wonderful world of Pilates and are great for those who might feel nervous about exercising in a group environment.

Our Mat classes only consist of a maximum of 8 people.  This allows our instructor to get hands on with each participant which ensure you get maximum benefit for each individual session.

Our studios at both Bracknell and Windsor offer a wide range of equipment including the Cadillac, Ladder Barrel The Wunda Chair and Reformer.

Are you in???

Below is our timetable – why not get in touch to enquire about our prices and the great value packages that we have on offer.

Click here to submit your info on our contact page:

Meet the newest members of the Apple Physio Team

We are pleased to introduce you to Mike Davis and Kevin Young who have joined The Apple Physio Team:

Mike Davis

Mike Davis has been qualified for over 18 years and has a wealth of experience in treating sports injuries and spinal (neck and back) pain. He has spent the majority of his time in private practice in London working with some of the top orthopaedic and spinal consultants in the UK.

He is a keen runner and as a consequence has a particular interest in running injuries and running based rehabilitation. His other strong interest is in shoulder pain and shoulder rehabilitation.  He uses a wide variety of treatment skills ranging from Acupuncture to joint manipulation plus massage and exercise therapy to alleviate and resolve symptoms such as pain and stiffness .

Mike believes strongly that it is essential not just to treat and resolve the patient’s symptoms-e.g pain, stiffness, swelling but also to analyse and correct their faulty posture and movement patterns. His experience in treating spinal conditions allied with his knowledge of the current evidence based research on the most effective exercises for spinal pain will give patients the best possible opportunity to gain strong healthy pain free spines.  

For anyone with running injuries Mike can undertake a detailed biomechanical analysis of your running technique which often is one the causative factors leading to injury. With expert analysis Mike can help fine tune and improve your running pattern to make you a more efficient runner and ultimately less vulnerable to re-injury.

For those looking to lose weight who are unsure of how or where to start Mike can also offer advice based on the current scientific research on nutrition and he can dispel  lots of common myths associated with weight loss and provide the most effective strategies for long term gradual weight loss and improved general health and conditioning.

Kevin Young

                                                                      

He has worked in sports for 25 years.  He has worked closely with many local rugby teams, American Football players and professional boxers. 

He started to use video & gait analysis, using treadmills and on-track/field facilities to diagnose and rectify lower limb and foot biomechanical problems.  

Kevin has also achieved a BSc (Hons) in Traditional Chinese Medicine & Acupuncture and Diploma in Tui Na (Chinese Medical Massage) as well as a MSC in lower limb musculo-skeletal studies specializing in lower limb injuries, biomechanics and gait analysis.

He also is a lecturer in Anatomy, Structural diagnosis and Tui Na massage at College of Integrated Chinese Medicine Reading as well as being a visiting lecturer in Acupuncture, biomechanics and running & gait analysis at Cardiff Met University (Master’s program) and at Glyndwr University (Bachelor of Science) in Wrexham

Kevin uses Eastern and Western diagnosis and treatments to offer patients a different take on treating musculo-skeletal injuries.

Kevin will working at our Windsor clinic. As well as treating all musculoskeletal conditions Kevin will also be offering Eastern and Western acupuncture as well as gait analysis and customised orthotics. 

Contact our front Desk teams on 01344 489398 or 01753 866274 to book your assessment with Mike and Kevin now.

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.