Do You Have Knee Pain?

Are Stairs Often Difficult?

Do You Need Some Help?

Is Your Training Being Impacted By Your Knee Pain?

Knee pain ( especially at the front of the knee and under the kneecap) is a common condition seen in our clinic especially in runners and also women between the ages of 30-50 starting out their new exercise program.

Common symptoms include pain with squats/lunges, difficulty climbing and descending stairs, and even pain when sitting for long periods with your knees bent.

There may also be swelling or weakness that is gradually getting worse.

A number of factors can cause anterior knee pain including

• poor movement patterning when running/squatting
• tight muscles in the outside of the thigh and calf
• poor alignment in your feet

These risk factors may have been present for many years, but only become a problem when you increase exercise volume or work levels.

If you are experiencing knee pain try a few of the following Physio Tips:

1. Ice your knees for 15-20 mins after each workout/work day
2. Decrease the incline on the treadmill or walk on flat areas instead of hills – this will reduce the rolling of the feet
3. Do small range (pain free) squats – instead of lunges in your training program – sometimes even the weight of the body in a lunge is too much for weakened thigh muscles to stabilize.
4. Ensure you are wearing proper supportive shoes during your workout – and replace them regularly.

The good news is that the majority of knee pain issues can be effectively treated with a range of Physio designed exercises and stretches – but beware – the longer you leave a problem – the harder it gets to fix.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

• do weak abdominals contribute to back pain?
• do strong abdominals prevent it?
• do those with the weakest muscles benefit the most from stability exercises?
• do stability exercises actually improved the performance of the targeted muscles?

There have been a number of recent research papers which cast doubt on the rationale for core stability exercises in the treatment of low back pain.  We will review each in turn, for starters lets begin with the recent Swiss paper whose title says it all.

Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function.  Mannion AF, Caporaso F, Pulkovski N, Sprott H.  Eur Spine J. 2012 Jan 24.

The group studied 32 patients with chronic low back pain who took part in a 9 week training programme of stabilisation. At the start of the programme they assessed the function of abdominal muscles transversus abdominis, obliquus internus and obliquus externus.

They found neither the inital abdominal muscle function nor any improvement after the programme of stabilisation exercises was a  predictor of a good outcome.  This therefore makes it difficult to attribute any therapeutic benefit to the specific effect of stability exercises on trunk muscles.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

Pain originating from the AC joint (the joint at the end of the collarbone – on top of the shoulder) is usually well localized and the client will often place one finger directly over the AC joint when asked to indicate the most painful area.

There is usually discomfort with humerus and scapula movement, particularly movements where the arm is brought across the body into a horizontally flexed position. Uncomfortable exercises in the gym may include bench press (particularly wide grip bench), dips and push ups. The person often has difficulty sleeping on the effected side.

Some suggestion to reduce stress on the AC joint include:

1)      Keep the elbows closer to the side with a shoulder width hand position during push-up and bench press.
2)      If bench pressing or doing push ups - decrease the depth of the repetitions to keep the elbows above the horizontal.
3)      Perform pull downs with a closer or even underhand grip.
4)      Reduce the amount of overhead exercise in the program.
5)      Avoid sleeping on the effected side until the pain improves.

If you have problems with your shoulders make sure you book an appointment with The Markland Clinic today call 01285 654059.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

A team at the health and sport science faculty at Funtendo University in Japan published a paper in the “Journal of Sports Science“ that examined the effect of aqua exercise on the recovery of lower limb muscle soreness after downhill running.

In this study 10 distance runners with DOMS were divided into 2 groups – the aqua exercise group performed 30 minutes of walking, jogging and jumping in water on three consecutive days whilst the other group rested. The study found that the aqua exercise group recovered their muscle power faster and had reduced stiffness and soreness compared to the resting group.

If you do have a problem with DOMS, a few pool sessions of walking and jogging the next day after exercise may help.

However, if there is any pain in the region of a joint, or if the pain does not decrease within a few days then call The Markland Clinic to check out the injury.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

With the football and netball season now in full swing it is an important time to make mention of ways to reduce ankle sprains and how to effectively overcome these injuries. The Markland Clinic have long supported the need for effective balance training (also called proprioceptive training) to reduce the incidence and recurrence of ankle sprains. We no have even more research to support our plans.

A 3 year study of High School University Football teams reported in “The American Journal of Sports Medicine” showed that a simple 5 minute per day balance program reduced the incidence of non contact inversion ankle sprains by a massive 77%.

From experience may athletes find balance training a little boring but it makes sense to add some simple exercises between sets in your weights workout to reduce your injury risk.

Here are some simple exercises to use:

• 1 Leg Squats
• Jump forward and backwards  x 8 reps
• Hop forward and backwards x 8 reps
• Side Jumps x 8
• Jump Turn (turning 90 degrees each jump) 1 x clockwise and 1 x anti clockwise
• Try some with your eyes closed (make sure you are in open area with no obstacles)

Physiotherapists can guide you on advance training, using exercises such as:

• 1 leg Balance and Squat on a BOSU
• Side hops onto a BOSU
• Wobble Board balancing and Squat
• Side Step and change direction

Make sure you are under guidance with a qualified Markland Clinic Physiotherapist for such activities.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

Pain in the heel is a frequent problem in active people – especially those involved in activities such as running and jumping. There are a variety of conditions that can lead to the symptoms you are experiencing; however, the most common condition is called ‘plantar fasciitis’.

Plantar fasciitis has been referred to previously as ‘heel spurs’ – however, the presence of an actual spur of bone coming from the heel bone (calcaneous) may not be the cause of the pain. Many people with no heel pain may have bony spurs, yet conversely, many people with the symptom of heel pain do not actually have a spur at all.

Plantar fasciitis is a condition that involves irritation and/or minor tearing of the plantar fascia, which is a tight band of connective tissue on the sole of the foot. The pain with plantar fasciitis often comes on without obvious cause and is felt deep in the heel. Symptoms are usually worse first thing in the morning and can ease with gentle exercise. Pain is often aggravated by prolonged standing on hard surfaces.

The most important step in the initial management of heel pain is to replace the major aggravating activities with low impact options to reduce the amount of stress being placed through the foot and heel. This may involve reducing the running duration or substituting running and walking for a period of stationary cycling until the symptoms ease. It is also important that your running shoes are still providing good support – get your physiotherapist to check them out if you are at all worried about their level of support.

Local physiotherapy treatment involving massage of the plantar fascia, stretching of the fascia itself, as well as stretching of the calf muscles is also an important part of treatment. Many heel symptoms are also related to poor lower limb biomechanics, especially excessive pronation (inward rolling of the feet); therefore, a full biomechanical assessment with your physiotherapist is recommended.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

http://www.bluegym.org.uk/group/swimminginthebluegym

http://www.epicevents.org/section.php/32/1/the-epic-lakes-swim-series–2012-

http://www.greatswim.org/

http://www.outdoorswimmingsociety.com/index.php?p=events

http://www.swimhellespont.com/the-hellespont/

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

In this test the leading foot is placed close to the wall – you then lunge forward until the knee of the leading foot touches the wall whilst keeping the heel down– if the knee successfully touches the wall you redo the test but move the foot a little further from the wall. Repeat the test until you are no longer able to touch the knee to the wall then measure the maximal distance that the toes can be away from the wall but the knee still touch. Then repeat for the other leg.

If there is a difference in the result for each leg of more than 10% then it is advisable to have a comprehensive assessment done to determine the cause of the imbalance – it may be due to past ankle injury, past fracture or calf tightness – a great test and very predictive of possible lower limb injury when training volume is increased.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

The Markland Clinic is looking for YOU if you are:

• COMMITTED TO PROVIDING A PROFESSIONAL SERVICE
• MOTIVATED TO MANAGE YOUR OWN WORK LOAD 
• PEOPLE ORIENTATED
• CONSCIENTIOUS
• RELIABLE AND TRUSTWORTHY
• ORGANISED
• OPEN MINDED

TO APPLY CALL 0844 5024713 NOW

Note: instead of submitting a CV when you telephone you will be asked to answer a couple of short questions on your career to date. We find this provides a great way for you to express yourself.

DUTIES AND RESPONSIBILITIES

Client relations

• collaborate with other staff members to facilitate provision of client care
• act as a liaison between clinician and client
• respond to calls, emails and enquiries
• handle client documents/ reports
• maintaining good relationships with referrers

Daily clinic management

• diary and appointment scheduling
• monitoring work flow within the clinics including client appointments and informing clinicians of delays ad changes to diary
• ordering equipment and stock
• handling post
• taking payment

Marketing

• coordinate planning, implementation and review of marketing activity
• organising events

Finance and accounting administration

Business Development

• develop systems and processes to improve efficient running of clinic and delivery of a high standard of care and customer service.
• assist in developing and implementing clinical education programs to keep clinicians informed of new trends

Support Clinic Owner

• prepare management reports
• maintain ongoing communication with clinicians and director
• any other relevant tasks relating to clinic performance growth

Carry out any reasonable duties as required by management.

KNOWLEDGE, SKILLS AND EXPERIENCE

• Good grasp of English language in spoken and written form
• Able to work independently and self motivate
• Ability to use initiative, prioritise and organise workload
• Ability to focus and complete tasks despite interruptions
• Ability to establish effective working relationships with clients, clinicians and other team members
• Previous experience working in and running an office
• Previous customer service experience
• Preferable previous experience of working in a small business
• Excellent IT skills
• Full UK driving license
• Able to work flexible hours when required

TERMS OF ENGAGEMENT

• 37.5 hours – there is flexibility within this
• Salary £16,000-£20,000
• Hours to be spread over weekdays between the hours of 7.30am and 8pm
• Job share considered

DEADLINE FOR APPLICATIONS 5pm Friday 20th Jan

TO APPLY CALL 0844 5024713 NOW

Remember: instead of submitting CV’s when you telephone you will be asked to answer a couple of short questions on your career to date. We find this provides a great way for you to express yourself.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

Injury Tip One – Increase Slowly: Many people get so excited by starting running and impatient at their slow progress that they go from 3 months on the lounge to attempting a marathon in 4 weeks – this is a recipe for disaster. Make sure you increase your running and training times by small increments only – a 5 -10% increase in either distance or time each week is plenty and will ensure you stay pain free. One of the biggest predictors of injury in runners is rapidly increasing training volume – the more training you do the greater the risk it is simple maths.

Injury Tip Two – Check your Shoes: Many people get excited about starting a training program however they make the mistake of grabbing their favourite pair of Dunlop Volleys (a favourite shoe worn by roof tilers – not marathoners) and then wonder why they get foot, knee and leg pain 2 weeks into their program. Make sure you get a good pair of running shoes BEFORE you start your training program – unfortunately for your bank balance you do get what you pay for when it comes to running shoes.

Injury Tips Three – Watch out for Hills: Many new runners get injuries due to following a route that has too many hills in it – hill running is a great training tool but hills also cause incredible demands on the joints of the lower body and can accelerate injury risk in certain people. Try and stay on the flat for the first few months and then add some hills in as your fitness improves – it is better to be running on the flat than not running at all.

Injury Tip Four – Get a Check-Up: We mentioned a moment ago that one of the biggest predictors of injury is training volume – the other biggest predictor is past injury history. It amazes us here at The Markland Clinic the number of people that had an injury at the end of their last training or sport season – and do not have any treatment of assessment on that area prior to starting next seasons training . The injury may have left some scar tissue, reduced range or muscle weakness that will greatly increase the injury risk when training resumes.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Hannah

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309