Have you got the strength to power through?

Have you got the strength to power through?

Do you get part way through your trainings or games and start to get sore/tight for no apparent reason? It may not be that something is damaged, it may be you need to build up the strength of a particular muscle group!
Our muscles help us to move, dodge and burst into activity, but with repetitive use through games or training, these muscles can start to fatigue and not work as well as we would like. When these muscles start to get tired, our joints aren’t as protected as they were at the start of our activity, and they can start to work in different, less ideal ways, putting stress on different structures and often cause that annoying pain that creeps in half way through our activity. The key to getting through these niggles while we play is STRENGTH!

Often we think we are getting “tight” and that we need to stretch out the soreness, when in fact it is the opposite, we need those fatiguing muscles to tone up and work harder, like they were at the start of our training or game.

One of, if not the most, important muscle in keeping our lower limbs functioning in the right way and keeping our alignment correct is our glutes (buttock muscles). When these muscles start to tire our hips can start to roll in, our knees roll in and the arches of our feet start to flatten. This can lead to a number of aches and pains in the limbs, especially knee and hip soreness. They also work in tandem with our hamstrings, which are a commonly injured muscle group, especially in footballers (could this be related to common glute weakness??)!

The other muscle that works extremely hard when we are running and playing sport is our calf muscles, the ones connecting our knee to our ankle that propel us forward and spring us into the air.
These muscles can often feel tight during sport, and while this can be because of genuine “tightness”, it can also be because of weakness, and the more fatigued they get, the tighter they become. This leads to calf and ankle soreness, “shin splints” and general tightness in the lower limbs. Your physio can quickly and easily assess the strength and endurance of your muscles and see if they are a contributing factor to your pain, or, if they are in fact the key reason you are experiencing soreness. As a general rule we want the strength on our left side to match that of our right side, and there are certain limits we should be able to reach before fatigue, as a test to see if we are strong enough in certain areas.

If you are a sports person, try these exercises:


For “good” calf strength, you should be able to raise up on to your toes on one foot 20+ times without pain or discomfort, and should be able to do this on both sides.


calf stretch

For “good” glute/hammy strength, you should be able to raise your hips up on one leg 15+ times without pain
or discomfort, and again should be able to do this evenly on both the left and right sides.

glute exercise

*If any of these exercises cause pain or discomfort, cease immediately and contact your physio!

Does rubbing our shin splints really work?  –  NO

Does rubbing our shin splints really work? – NO

Does it really hurt? – YES

Shin splints is an umbrella term generally used to categorise different types of shin pain, and with pre-season kicking off and all of the dry/hard ovals around the place, this is the time of year people tend to have this complaint!

There are 2 main causes of common shin splints:

  1. Tight calves – puts uneven pressures on the lower leg and pulls in areas we don’t want!
  2. Over Pronation (flat feet) – This loads up the inside muscles of the lower leg that run on the inside of the shin, making them become tight and dysfunctional.Both of the above causes can be made worse from running in incorrect footwear, or running on a hard surface, whether it be on a road or a hard dry oval.

Shin splints responds well to particular stretches and exercises, again depending on the driving cause, and Dry Needling has proven to be an effective way to release the muscles causing the problem!

Here is a good exercise to begin with, this calf stretch may help to loosen the tight muscles causing your pain.

Try this stretch for 20 seconds each leg twice a day.

Where to from here?

Often the muscles that are to blame are quite deep in under the calf/shin, so to get into them with massage/trigger points can be very painful. Dry Needling however can get in deep to the tight, knotty areas without causing too much discomfort in the rest of the muscle, often getting a good release and getting very fast relief from shin splints.
Taping is also a good way to relieve this pain in the shins, by supporting the foot in the right position, we can offload the muscles that are being over worked and causing them to get tight, this can allow people to often continue their chosen sport/exercise without the pain in their shins with each step!

Diagnosis and Assessment

Diagnosis and assessment is crucial with shin splints, as it can have different causes and different muscles associated with it, it is important that the correct treatment plan is identified early, before it gets worse! Your physio can assess your contributing factors and often apply treatment to get you relief straight away. They can also arrange any referrals or set you on the right path for other treatments or changes that may need to be made (different shoes, orthotics, training regime changes, exercise programs, etc).


Written by Marc Elliott, Physiotherapist

Ice or heat for my stiff neck?

Ice or heat for my stiff neck?

When we get an injury we all want some relief, but we also want to make sure we aren’t doing any more damage to the area and to know that what we are doing is beneficial.

But what about when you’ve woken up and your neck feels ‘locked’? Every time you try to turn it you get a sharp pain or stiffness. What is best?

Which brings us to the age old question, should I apply Cold or Heat??

What does Ice do?

When cold is applied to an area, it restricts blood flow and causes constriction of blood vessels, hence causing the bleeding of an injury to be reduced, along with any inflammation.  It can be a very effective pain reliever (once you have got over the ‘cold’ bit).

And heat?

Heat application causes dilation of blood vessels and increases the blood flow to a muscle, which can have a relaxing effect and aid in pain relief.

Both are useful and both can provide relief, however it is important to know at what stage to use them and the symptoms to look for that can help you choose which medium to use!

So if you have injured yourself

As a general rule, if an injury is showing signs of inflammation, ie. It is hot, red or swollen, then Ice is recommended as this will reduce the inflammatory process.

Other signs of inflammation can be

  • pain at night or when you settle for the day,
  • throbbing pain, or
  • pain that is a dull ache/throb deep in the area of injury.

Usually inflammation occurs for 2-3 days post injury, so if you roll an ankle, pull a muscle, get a knock or have a definite injury, ice for the first 2-3 days is recommended, using it for 20 min every 2 hours.

For that sore back or neck

Heat is generally used for a more chronic injury, or if an injury has passed this inflammatory stage and is feeling more stiff and tight. Because of the increased blood flow, heat can help relax tight muscles, and with increased blood flow and nutrients to the source, can be a nice way to get some pain relief.

Signs to use heat may include

  • feeling stiff and tight,
  • waking in the morning with tight/stiff areas that improve as you get moving,
  • pains that feel better when you have a hot shower or do some exercises to warm them up
  • general aches and pains that have been there for a long time and haven’t recently been stirred up.
And my locked neck?

If you did something to injure your neck (twisted quickly of jolted it somehow).  Ice is best.  BUT if you just woke up feeling stiff and didn’t do anything to injure it, Heat will help relax the muscles and ease some pain.  As always, if unsure contact your friendly physiotherapist.

To sum it up:

ICE is best if – red, hot, swollen, acute injury (2-3 days), achey/throbbing pain, sore at night when resting.

HEAT  is best if – stiff, tight, feels good when shower or do exercises, morning stiffness, no acute injury.

Winter Sports – Prevent the ‘ouch’!!

Winter Sports – Prevent the ‘ouch’!!

As the weather cools, the football, netball and hockey seasons are hotting up.

This often means people are running more than in the off season (when we’re holidaying at the beach, eating Xmas pudding etc).

And it also often means people are running faster than usual, cutting, weaving, running backwards the works!

To best prepare yourself (and/ or your children) there are some simple rules to follow.

1. Warm into it.

Ensure that your chosen sport isn’t a major shock to the system by, training slowly at first and allowing recovery days. Ie don’t expect to start off where you finished last year.

2. Get your Footwear right.

Training in sand shoes rather than boots while the grounds are still firm and there’s lots of running makes sense.

Make sure your shoes fit well and support you properly.

If your ankles pronate a lot (ie you have flat feet, with small or no arch) it is worth giving your footwear the “twist test”.

A supportive shoe (e.g.Asics, New Balance) will not twist much, thereby preventing excessive pronation of the ankle and reducing stress on your ankles, knees and hips.

Older sand shoes and different brands like Nike and Adidas will often twist more (offering less support).


Note: a twistier shoe is not an issue if you have good arches/ hind foot control.

For more information ask your Physio or Podiatrist which is the right footwear for you.

3. Warm Up

In the old days warming up for sport meant a slow lap of the oval followed by some static stretches sitting on the ground, whilst yawning and complaining about stuff. But that was then. Now we understand warming up is as much about waking up as getting warm.

That means we need to prepare our brains and our bodies for the movements to come.

Getting the heart rate up by running a lap is still a good start, but then we need to slowly start practicing the tasks we want to perform.

e.g. handballing, lifting knees up, jumping, hopping, pivoting, paddling balls along the ground, kicking, running faster, running backwards etc—you know the movements you will need for sport.

We start this DYNAMIC warm up slowly and then gradually build the speed.

By the end of the warm up you should have a light sweat going and be puffing slightly.

Good to go!

4. What about stretching???

Dynamic/ Ballistic stretching still has its place in the warm up regime, but static stretching for flexibility is best done after sport.

Research in the early 2000’s showed that static stretching before sport didn’t actually reduce injuries and if anything had the opposite effect!!

However, we still need good flexibility, so static stretching is best done after your training/ game as you cool down, or even at home after a hot shower.

What are the best stretches?

For running sports (especially for children growing quickly) it is most important to stretch the Calves, Hamstrings, Hip Flexors and Quadriceps muscles.

How to look after injuries…

How to look after injuries…

Acute injuries can be very painful (like twisting an ankle going down the stairs, or pulling a muscle lifting something heavy).
Doing the right things in the early stages and avoiding some common no-no’s can really help.
If you have hurt yourself, the best advice is to follow the following guidelines.

In the first 48-72 hours after injury Do use R.I.C.E.R (not steamed rice…)

RICER borderedRest: This means resting the injured area, stopping running, avoids the activities that hurt it.  Using Crutches is often helpful if weight bearing is painful.

Ice: Using icepacks can dramatically reduce inflammation (painful, swelling and pressure) after injury. A pack of frozen peas wrapped in a damp cloth…so it feels coooooold 20 mins on, then 20 mins off, every hour. The cold also often works as a good pain reliever in an acute injury.

Compression: Prevent an injury from swelling by wrapping it in a compression bandage. Leave the bandage on removing only to ice it, so yep even wear it in bed. *Ensure that it is firm but not cutting off circulation—blue toes/fingers means it’s too tight.

Elevation: Elevate the injured body part, to avoid gravity’s effects i.e. keep an injured ankle up on a pillow above the height of your knee.

Referral: So you have done all the right things but it is still not right?  Time to refer it to a physio.

The R.I.C.E.R regime also applies to a back or neck strain (when you’ve done something to cause strain).
Avoiding the following No-No’s also makes a big difference to healing time in the first 48-72 hours

Heat – Using heat packs, hot baths etc. may Increase blood flow, inflammation and bruising
Alcohol– Even a few beers, can increase the degree of swelling and inflammation
Running – This relates to any vigorous exercise that may increase the stress on the tissues and compromise the early phase of tissue healing
Massage– Is best to avoid in the initial stages of injury, as it encourages blood flow which can increase inflammation.

What about Physio??

Physiotherapists are experts in assessing Musculoskeletal injuries (it’s what we do all day, every day). Your Physio will assess an injury and help you protect it to encourage optimal healing. There may be exercises and / or positions of comfort that are helpful and your Physio will guide you in these. They will also show you what not to do….NB often stretching an injured area slows down the healing in the early stages.
Your Physio can also help decide whether an injury needs specialist input, x-rays /scans etc.