1. Every 45min of sitting, take a mini-break for 2min and walk around to stop the back muscles from fatiguing.  Prevention is better than cure! This will stop postural fatigue and pain from overloaded ligaments and muscles.
2. Check your back angle when sitting- see the picture below.
   

   Disc pressure with different seating positions

3. Do “The Marble Test” on your car seat to test if your car seat is stressing your back.  Place a marble on the front part of your driver’s seat- if the marble rolls backwards down to the back-rest, your car seat “FAILS”.  If the marble stays where it is your car seat “Passes”.  When the front part of the seat pad of a chair is higher than the back part of the seat pad, this forces the lumbar spine to slouch and compresses the discs.  Use a seating wedge to correct this.
4. Use a lumbar roll in the small of the back (at waist level) to maintain the lumbar lordosis- this is the natural arch in the small of the back and reduces pressure on the lumbar discs.
5. Sit tall in your chair with your chin slightly tucked in- this minimizes the “poking chin” posture that so many adopt when in front of a computer screen.
   

   Are you sitting correctly? BOOST PHYSIO Tyrone Kon giving posture advice.

6. Square yourself up to the computer keyboard and screen, or the steering wheel of the car.  Do not sit in a twisted position.
7. Your feet should be flat on the floor with your ankles beneath your knees. This gives a good foundation of support for the lower back and stops stress to the calf muscles.
8. Your knees should be slightly lower than your hips and your bottom should be to the back of the seat- this enables the optimum back angle of 100 to 110 degrees.
9. Avoid low, deep sofas as this decreases the back angle and pressure in the spine.
10. If you are having pain regularly while sitting- come and see us at our Hendon or East Finchley High Street Clinics for postural assessment, advice and treatment.
    

    BOOST PHYSIO Tyrone Kon giving posture advice

BOOST PHYSIO in Hendon NW4 and East Finchley N2 is a leading physiotherapy clinic specialising in all musculo-skeletal injuries and conditions.  We are open 8am-9pm and on Sundays too!  Call us on 020 8201 7788.

www.boostphysio.com

Like us on Facebook at www.facebook.com/boostphysio

Follow us on Twitter @boostphysio

Tyrone Senior BOOST PHYSIO treating back pain

Running injuries are very common, whether you are training for 5km or 42km!  We see everything ranging from achilles tendonitis, knee pain to back and neck pain!  What is our physiotherapy approach? One that is based on experience of training for 2 marathons and many more half-marathons, combined with out-standing physiotherapy skills and knowledge.

• full history and medical background
• thorough assessment of training programme, mileage, intensity and frequency
• full in-depth physical examination and assessment
• biomechanical assessment, usually including GAITSCAN pressure plate analysis
• diagnosis of condition and causative factors
• formulation of bespoke treatment programme

Gaitscan computerised pressure plate and gait analysis system

We are based in Hendon, NW London andEast Finchley N2.  Appointments are available 8am-9pm and recognised by all major health insurance companies.  BUPA, AXA-PPP, AVIVA, PruHealth, WPA etc…

Call us on 020 8201 7788

Laura stretching out a marathon runner

Ouch! Swelling and bruising after a twisted ankle indicates a Grade 2 injury which can take 6 weeks to heal.

Twisted or rolled over your ankle?  OUCH! It can be very painful and swollen. What is an ankle sprain and how does

one treat it?  Ankle sprains are one of the most common injuries that we treat at BOOST PHYSIO in North West London. If you have gone over on your ankle and want to know what to do, then read on. Laura Harman, Senior Physiotherapist at BOOST PHYSIO, explains the anatomy of ankle sprains and treatment including useful exercises you can do at home.

Anatomy of the ankle

The ankle is a complex structure made up of 3 different joints:

1) Talocrural joint (ankle joint)

The talocrural joint is what most people think of as the “true” ankle joint. It is made up of three bones; the tibia on the inside, the fibular on the outside and the talus underneath. This joint allow the up and down movement of the foot (dorsiflexion and plantarflexion)

2) Subtalar joint

The subtalar joint sits below the talocrural joint and is made up of the talus and the calcaneus. This joint allows the inward and outwards movement of the foot (inversion and eversion). The main role of this joint is to allow the foot to adjust to uneven ground.

Ice compression treatment is used soon after a sprain to reduce swelling

3) Inferior tibiofibular joint

The inferior tibiofibular joint is the joint between the ends of the tibia and fibula. Although there is minimal movement of this joint, it is important for stability of the ankle.

In addition to the joint, there are many muscles and tendons in the ankle that allow it to move in various directions. There are also numerous ligaments that provide the foot and ankle with stability.

The main ligaments for the ankle are:

1. Lateral collateral ligament – attaches the fibula to the calcaneus and provides stability to the outside of the ankle joint.
2. Deltoid ligament – attaches the tibia to the talus and calcaneus and provides stability to the inside of the ankle joint.

What is an ankle sprain?

An ankle sprain is a very common injury. It can occur during sporting or everyday activities.  An ankle sprain is injury to the ligaments of the ankle. Ligaments are elastic band type structures that support and stabilise joints. During normal movements the ligaments stretch to allow us to move. When a ligament is stretched too far it results in an ankle sprain. Ankle sprains are essentially overstretching or partial tearing of the ligaments. In severe cases, the ligament can completely rupture. There are different types of sprain depending on the severity of the injury:

Grade 1 – Tearing of a few ligament fibres

Grade 2 – Tearing of a considerable portion of the ligament fibres

Grade 3 – Complete tear of the ligament

Ultrasound and electrotherapy for sprained ankle to speed up healing

Ankle sprains occur when the foot is rolled inwards or outwards, beyond it’s normal range of motion. This can happen in a number of ways, some of which are listed below:

a)      Running or walking on uneven ground

b)      Slipping off the edge of a curb or step

c)       Jumping and landing awkwardly

d)      Loosing your balance whilst wearing high heels.

The lateral ankle ligaments are much weaker than the medial deltoid ligament. As a result, inversion injuries were the foot rolls inwards are far more common that eversion injuries were the foot rolls outwards.

Treatment of ankle sprains

The most important period following an ankle sprain is within the first 48-72 hours. In this time it is important to follow the PRICE principles. PRICE helps to limit the bleeding and subsequent swelling that cause pain and joint stiffness.

Protection  – Protect the ankle from further damage.

REST – Reduce activity to help decrease bleeding and swelling. This can be achieved using crutches.

Later stages we use mobilisation techniques to restore full flexibility to the ankle

ICE – Primarily used to decrease tissue metabolism in the early stages of the injury.

Compression – Decreases bleeding and therefore swelling. This is usually achieved using a compression bandage.

Elevation –helps to decrease the build up of fluid.

After the first 48-72 hours, you can begin to gradually put more weight through the ankle and start some basic ankle exercises (follow this link to view an example of early phase exercises for ankle sprains). It is important to carry out these exercises in order to prevent joint stiffness.

In order to promote the healing process of the ankle, other treatments can be used such as massage and ultrasound .

Once the pain starts to settle, it is important to strengthen the muscles surrounding the ankle before returning to any sporting activity in order to prevent future injuries.

The usual healing time for an ankle sprain is 4-6 weeks.

BOOST PHYSIO Has 2 High Street Clinics – one in Hendon NW4 and one in East Finchley N2.  Call us for an appointment on 020 82017788.

Rehab exercise is needed to ensure full strength and balance is returned to the injured ankle

Dan is our most recent addition to BOOST PHYSIO East Finchley

Dan is a senior BOOST PHYSIO and runs clinics on Monday, Tuesday and Thursdays from 6pm-9pm and also alternate Sundays from 9am-1pm.

Take advantage of our opening promotion at our East Finchley clinic- come for a double session for the same price as a single session… so that is only £48 for an appointment which lasts up to 1hr, which is the price of the appointments of up to 30min.

Call us on 020 82017788 to arrange an appointment.
Want to know where the clinic is? Look here at our website.

Have you looked at our Facebook page yet? You can like us here www.facebook.com/BoostPhysio

Follow us on Twitter @boostphysio

Avoid lower back pain by following our advice sheet on Dos and Don'ts for your back

Sitting at your computer causing you back pain or sciatica?

Is loading the dishwasher causing you back pain?

Is dusting the floor stressing your discs?

These simple day to day activities that we take for granted could be stressing or even injuring your lower back!  Want to know how to avoid unnecessary pressure on your discs, muscles and ligaments in your back during common daily activities and chores?  Steven Berkman of BOOST PHYSIO Hendon, has created an online tutorial and advice sheet covering DO’s and DON’Ts your lower back.You can view the full advice sheet by following this link. There are even short video clips demonstrating the correct techniques for you to watch.

If you wish to discuss your injury in detail or book an appointment why not call us at BOOST PHYSIO?  Our telephone number is 020 82017788. We have 2 High Street physiotherapy clinics- one in Hendon NW4 and one in East Finchley N2.

By The BOOST BLOGGER- Steven Berkman, Chartered Physiotherapist

1. The Vertebrae: There are 7 Cervical Vertebrae (spine bones in the neck) with small thin discs in between.  Disc problems in the neck are far less common than in the lower back, because the cervical discs are thinner and the nucleus of the cervical disc is less likely to bulge out, compared to in the lower back.
2. The Muscles: Most neck pain is from postural tension in the surrounding muscles.  The trapezius muscle is a large kite shaped muscle
   

   Stretch to the neck muscles, including Scalenes and Upper Trapezius

   extending from the base of the skull, down the neck radiating out towards the shoulder blades and run down and attach to the 12th thoracic vertebrae (that is just above the lower back!). The upper portion, us physios call the “upper traps”, tend to often be source of pain in the neck area. The trapezius become overworked and tense (often feeling knotted) by constant overuse- if you find that your shoulders are often up towards your ears this is a sign that they may be overworked. Remember during the day to frequently relax your shoulders downwards, pulling your shoulder blades down and in towards your lower back.

3. Your posture: Posutre is often the foremost cause of neck pain we deal with- particularly tensed upper trapezius and what we call a
   

   BOOST PHYSIO Tyrone Kon giving posture advice

   “poking chin posture”. Poking chin posture tends to occur when using a computer, as one sits the head starts to lean forwards with the chin poking forwards loading the facet joints of the neck and stressing the soft-tissues in the neck.  Over time this posture can also cause some pressure on the nerve roots exiting the spine.

4. Effective treatments: Treatment always depends on the source of the problem. At BOOST PHYSIO we always analyse what the root cause of the problem is and make sure we treat it.  We find that deep tissue and myofascial trigger point treatment, along with Vertebral Mobilisations, stretches and remedial exercises are crucial.  We frequently use acupuncture which is very effective.
5. Warning signs: Loss of power in the muscles of your arm or hand can indicate compression of the nerve roots as they exit the spine.  Nerve compression can sometimes cause permanent damage to the nerves and must always be assessed carefully.  If you suspect this is the case see your physio or your GP who will advise on the appropriate course of action.

Our East Finchley branch of BOOST PHYSIO

hour session for the price of a half-hour, only £48! This is available once per patient at our East Finchley clinic only and for patients paying at the time of booking.

Senior BOOST PHYSIO Tyrone Kon

BOOST PHYSIO is a recognised London Marathon 2012 Injury Clinic

Your preparation for the London Marathon 2012 is now reaching a critical stage with 6 weeks to go!  

Here follows our 6 tops tips for coping with the coming weeks.

1. Don’t try anything new!  What you have done so far is hopefully working for you, so don’t change it.  Don’t start a new training method, don’t start adding hill sprint repeats to your workout if you aren’t doing them already. 
2. Allow yourself more recovery time.  Consider skipping one of your mid-week runs, to give your body time to cope with your long runs.  A 20mile training run can take your body 1-2 weeks to recover from.  At this stage the long runs are more important than your mid-week training runs of 5-10miles, so sacrifice one of these runs to boost your recovery.
3. Enjoy your training. You are almost there. Enjoying your running helps to increase the flow of endorphins (those feel good hormones that give you the high). However run while you are stressed increases cortisol (stress hormones) levels which slow down recovery.
4. Have a sports massage.  Good deep tissue sports massage speeds up muscle recovery, irons out those tight muscles and prevents overuse injury.  View this as an essential part of your preparation, rather than a treat.
5. Avoid injury. A twisted ankle at this stage could put you out of the marathon all together, so try to avoid those silly injuries.
6. Avoid infection. Two weeks getting over a cold will dent your preparation.

Last words of advice, at this stage you should be able to complete a 16mile run comfortably. If you are not yet up to this level of mileage your training is lagging behind.  Don’t try and catch up for lost miles, this is a recipe for injury.

BOOST PHYSIO is a recognised London Marathon 2012 Injury Clinic. If you have any injury concerns or need sports massage please call us to arrange an appointment.  BOOST PHYSIO is a private physiotherapy clinic based in Hendon, North West London.  Call us on 020 82017788.

Take care in the icy conditions

1. Avoid leather soled or high heeled shoes outdoors.
2. Choose shoes that are rubber soled with chunky tread that will cut into and grip slippery surfaces better.
3. A walking stick or Nordic walking pole gives extra stability.
4. Watch where you are going! Sounds obvious, keep a look out for icy patches.
5. Colder muscles are tighter, less elastic muscles so keep the muscles warm.
6. Neck pain? Wear a warm scarf around the neck to stop the muscles going into spasm from the cold.
7. Arthritic fingers? Wear warm gloves- this makes a big difference by maintaining temperature and hence pliability of the connective tissues when the temperature drops.
8. For back pain- wear an extra layer of clothing close to the body to keep the chill of the back muscles.
9. Arthritic knee? A neoprene sleeve is very effective at maintaining warmth to the knee- this is the same material wet-suits are made of.
10. If you do slip and take a tumble if you have any doubts- check it out.  Each year we have patients who leave injuries from falls on the ice for far too long without having them assessed.  In 2010 I saw a 22year old who slipped and injured his shoulder.  He waited for 6 weeks before attending to it thinking it would get better- I sent him immediately for a scan which showed he had fractured his shoulder!

If you have fallen or injured yourself BOOST PHYSIO in Hendon will examine and assess you thoroughly and help you recover more quickly.