Sports and Spinal Physio LTD
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Devastated by Back Pain

Posted by on May 13, 2014 in Spinal Pain | 0 comments

My life was devastated by back pain but now I’m playing football with my kids again…thanks to IDD Therapy Scott Bryan from Chingford thought his days as a scaffolder were numbered when the back pain he’d suffered with for years finally took its toll. “I suffered on and off with lower back pain and grinding sciatica in my leg for a few years but last year the episodes became more severe and sometimes my leg would actually go numb when I stood for too long.” Scott’s condition became progressively worse and soon the intermittent pain became constant – eventually he couldn’t sleep and the manual nature of his job as a scaffolder became impossible, forcing him to take time off work. “I was in so much pain I could hardly walk and was only sleeping for a couple of hours a night.  I needed to take painkillers every day but even with regular medication, the pain was too much for me to bear – and I’m a big strong bloke!  The most heartbreaking thing was not being able to play football with my sons – my family tried to stay positive but I know they were worried about me.” Scott’s GP suggested various manual treatments before putting him in touch with a back pain consultant who diagnosed him with a herniated disc and decided that surgery was the answer. “My doctor sent me for some osteopathy and acupuncture sessions but they didn’t help and an operation was the last thing I needed – being self-employed, I couldn’t afford the time off work for a start! I couldn’t see a future without the pain and I was feeling very despondent.  I decided to ask my old school friend and physiotherapist, Dan Smith for some advice – I didn’t realise that Dan was actually offering a non-invasive treatment specifically for disc problems and sciatica called IDD Therapy.” Intervertebral Differential Dynamics (IDD) Therapy is a non-invasive treatment involving the gentle drawing apart of specific spinal segments where discs are damaged or herniated (bulging). This relieves pain by taking pressure off targeted discs and any trapped nerves and helps to relieve muscle spasm. After a review of Scott’s recent MRI scan, Dan confirmed a large disc bulge pressing on some nerves in his spine and he decided that Scott was an ideal candidate for the IDD Therapy programme. “I felt so relieved when Dan told me I could be treated with IDD Therapy.  He explained that the damage to my disc was quite severe and would need several treatments but with every session the pain eased and I became steadily more mobile.  After the third session I was walking a lot easier and by the 15th I was able to go back to work.      I finished my treatment programme a couple of weeks ago and I’m feeling fantastic; my pain has drastically reduced and I’m able to walk, drive and sleep properly.  I still have to take care of my back and avoid heavy lifting but this is nothing compared to the debilitation I suffered before my treatment. Best of all, I’ve just had a great Easter break with my family and been able to play footie with the boys again.  It’s really not an exaggeration to say that IDD Therapy...

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Uncontrolled Movement – Pain, Injury and Treatment

Posted by on Mar 10, 2014 in Spinal Pain | 0 comments

The Concept of Relative Flexibility and Stiffness The term relative flexibility refers to the theory that during movement the body and in particular our joints and soft tissues will take the path of least resistance, that is movement will always occur at a joint or region that is more flexible than a stiffer neighbouring one (Sahrmann 2002). This can occur in tissue and joints next to each other as well as ones that are opposite.  For example the fourth lumbar vertebra (the second from last bone in your lower back) might develop increased movement during backward bending to compensate for a stiff upper back or stiff hip flexors.  Once a joint or soft tissue has increased in its range of movement to compensate for the adjacent stiffness the supporting structures (ligaments, capsule and muscle) become insufficient at resisting movement in this area. This increased range of movement (or compensation) strains the joint or muscle and causes pain and injury. Restrictions include joint stiffness, muscle or connective tissue shortening, muscle spasm, scarring and increased bone formation or osteophytes. Uncontrolled Movement Uncontrolled movement is the term used to describe a body part that a patient finds difficult to control. In the clinic we use specific tests to determine this .  Medical research has shown that pain occurs as a result of uncontrolled movement. Relative flexibility is linked to the site of uncontrolled movement i.e. the relatively flexible area is normally the site of uncontrolled movement. Treatment When planning treatment of any condition, one must address the stiff joints and muscles with mobilisation and stretching techniques. In addition the patient must be taught exercises that help to control the flexible parts/uncontrolled movement that are causing pain. A skilled approach is required to diagnose this correctly and to teach the most appropriate exercises. At Sports and Spinal Physio our Better Back Programme uses this approach to provide long lasting results for patients with back and neck pain. For video examples of various test we use to assess for uncontrolled movement please see our YouTube channel For further reading on Uncontrolled Movement theory and concepts please see Kinetic...

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Bench Press and Shoulder pain

Posted by on Jan 21, 2014 in Sports Injury | 0 comments

Are there any precautions we should be taking when bench pressing? Should we be sticking to single arm standing cable pressing for maximum scapula (shoulder blade) movement to keep our shoulders ‘safe’ or do we just continue on with the big bench presses that are common in todays gyms? Bench has long been a favourite exercise of body builders, sports people and gym goers for development of hypertrophy and strength in the pecs, triceps and anterior deltoid. This is because bench press tends to get great results due to the ability to maximally load the muscles ie weight lifted/intensity. Lying on a bench to perform chest/bench press can lead to lack of scapula retraction (backward movement) and result in increased movement at the shoulder ball and socket joint. The forward shear of the ball on the socket will stress the joint and potentially add to joint laxity. It is our opinion that this stress on the front of the joint only becomes problematic in cases where significant laxity is already present, for example in people with previous capsular injury such as dislocation and subluxation. As well as people with multi-directional instability. This excessive ball and socket movement caused by lack of scapula retraction in bench pressing more commonly causes excessive (eccentric) loading in the subscapularis tendon and subsequent tendinopathy (damage to the tendon) rather than joint stress and subsequent laxity. So if you bench press heavy enough and frequently enough – areas will be overloaded and then injured. Ensuring correct technique will help to minimise the inevitable overload. Tips for avoiding bench press related injuries. 1) Periodisation: schedule breaks from bench pressing every 6 weeks or so and substitute exercises that allow more scapula movement such as cable press and push ups. Even dumbell pressing on a swiss ball allows more scapula movement than a bench does. Also be careful to make gradual increases in intensity and volume only. 2) Roller/Towel: place a rolled up towel or 1/2 foam roller long ways along the bench. This may also allow more scapula retraction. 3) Technique: always be careful of technique ie controlled eccentric movement (lowering) without any bouncing. 4) Range: Reduce the range so that the bar is only lowered to 10cm above the chest. 5) Grip Width: vary your grip width regularly. Generally a narrower grip width reduces loading on the above mentioned structures....

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5 reasons massage is not just about pampering yourself!

Posted by on Nov 25, 2013 in Sports Injury | 0 comments

Massage helps to: 1.Relieve Pain – stiff tight muscles can lead to pain 2.Promote Better Sleep– reduce tension, improve relaxation and affect the hormones that help us drift off to sleep. 3.Relieve Mild Depression – stress increases our level of cortisol, this hormone affects our mood. Massage reduces tension and stress and has the potential to rebalance our hormone levels. 4.Reduce Post Exercise Soreness – Massage helps to flush away the build up of lactic acid and other metabolites that cause post exercise soreness. 5.Improve Circulation – Massage improves circulation and lymph drainage. In addition to these 5 benefits we use massage to loosen up the stiff bits in your body that limit your movement and cause you to compensate with with movement elsewhere. It is these compensations that cause pain. So it works great with your physio treatment too! Want to know more? Please see our massage...

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IDD Therapy – Spinal Decompression – New treatment for bulging herniated and slipped discs

Posted by on Oct 28, 2013 in Spinal Pain | 0 comments

Well it’s here! Our IDD Therapy Spinal Decompression machine arrived two weeks ago. We feel very excited to be in the position to bring this fantastic new treatment for sciatica, back and neck pain to Brentwood and the surrounding areas. We are one of only 16 clinics offering this service in the UK. IDD Therapy Intervertebral Differential Dynamics (IDD) Therapy is the successful and trusted non-surgical spinal decompression treatment for back pain, neck pain and related conditions such as sciatica. We will become the 16th clinic in the UK to offer this exciting new treatment and we are very excited! Most spinal problems are as a result of a problem at a specific level, for example L5/S1 in the lower back. IDD Therapy can target the specific level and gently distract (draw apart) the segments of the spine by up to 5-7 millimetres, taking pressure off the joints, discs and nerves. Because IDD Therapy is computer-controlled it can sense resistance in your spine (muscle spasm) and adjust the forces slowly and gently to achieve a comfortable and painless stretching of your injured area. http://www.youtube.com/watch?v=qcEEJTcy3Sg Benefits of IDD Therapy  Improved Disc Rehydration – The treatment creates a negative pressure at the targeted disc promoting the movement of water, oxygen and nutrients into the disc which are required for improved hydration and repair of the degenerative (worn) disc. Decompression of Disc – Decompressing (taking pressure off) an injured or bulging disc may reduce any pressure or irritation to nerves. This may result in a reduction or resolution of back and neck pain and sciatica. Decreased Muscle Spasm – IDD Therapy additionally promotes improved mobility in the spine through decreasing muscle spasm and the stretching of the soft tissues, this facilitates the body’s natural healing mechanisms to operate more efficiently. Increased Spinal Flexibility – Stretching of the joint and soft tissues in conjunction with a reduction of muscle spasm and pain will result in increased mobility of the spine. Reduction in disc bulge size – In some instances IDD therapy has led to a visible reduction in size of disc bulge when comparing before and after MRIs. Why choose IDD Therapy? In one study 86% of IDD Therapy participants experienced a positive response from their treatment. IDD Therapy should be considered if you have back or neck pain and have tried various other treatments without success. You should consider IDD Therapy if: Your current treatment is not working You want to stop taking painkillers You are seeking long-term pain relief You want to return to normal daily activities You are looking to avoid surgery IDD Therapy is effective for the following conditions:  Chronic back and neck pain Sciatica Referred arm pain (Radiculopathy) Trapped or irritated nerves Bulging, herniated or slipped discs Degenerative disc disease Spondylosis (arthritis of the spinal joints) Facet joint disease Our thoughts on IDD Therapy “The use of manipulation and hands on techniques combined with correction of posture, movement faults and core stability can help most people with spinal pain; however some patients need something a little extra to help them feel better. With IDD we can precisely target the spinal segments in a safe, gentle manner to help patients in a way which is not possible with our hands or with traditional mechanical treatments” Clinic Director Dan Smith...

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Muscle Stretching – more harm than good?

Posted by on Jul 12, 2013 in Sports Injury | 1 comment

Stretching we all do it, but is it really necessary? Stretching became very fashionable in the 1980’s, there wasn’t a fitness programme or video that didn’t advocate it. But does it work and do we really benefit from it? What we do know is that static stretching for less than 40-60 seconds is a waste of time! Your muscle has built in stretch receptors that need to switch off to allow the muscle to relax and lengthen and it takes approximately 40 seconds for this to take place. Static stretching will make muscles longer, eventually and if done enough. However some research suggests that you have to stretch for up to 30 minutes a day to achieve this! So is stretching actually good for us? Lets take a good old fashioned stretch  – “touching our toes”. This can be done in standing or sat on the floor with our legs out in front.  Yes you feel a stretch in the back of your legs but what else is happening? Well once the hamstrings have reached their full stretch you begin to stretch your lower back, gluteal (buttock) muscles and most definitely your sciatic nerve (this is the burning feeling you get down the back of your leg). incorrect or over enthusiastic stretching can place the joint capsule, ligaments and nerves under too greater stretch and lead to injury or further irritation of injury. The key to safe and effective stretching is to control the body areas above and below the target stretch zone (desired muscle). A good stretching technique that we use in the clinic to  safely stretch  muscle is called an Active Inhibitory Re-stabilisation technique; watch this video to see how you can safely stretch your hamstrings and not hurt your back in the process . This type of stretch controls the body parts above (pelvis and spine) and below (knee and foot) the muscle and brings about reciprocal relaxation of the opposite muscle groups to allow lengthening of the target muscle. In the clinic we use other methods to lengthen muscles this might include trigger point therapy (release of the tight knots that cause a muscle to shorten) or myofascial release (soft tissue massage techniques) more on these another time. If you have a question regarding this or any other topic please email us info@sportsandspinalphysio.co.uk or call us on 01277...

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Whitley Bay Osteopathic Centre – Assessment, Treatment & Pain Relief

Posted by on Jun 25, 2013 in Uncategorized | 0 comments

In a new article on the partner pages of the Sports and Spinal Physio website, friends and web partners, Whitley Bay Osteopathic Centre promote the value of osteopathy in the treatment of musculo-skeletal pain. The Whitley Bay Osteopathic Centre has a great reputation in the north east of England for the successful treatment of back pain and muscular injuries. Like all reputable clinics, the Whitley Bay Osteopathic Centre start by taking a comprehensive medical history. They work closely with other medical practitioners in the diagnosis and treatment of pain. Osteopathy works from the principle that injury to one part of the body can elicit pain and further damage in another part of the body. An example of this might be poor posture leading to tension in the neck and shoulder muscles that manifest itself as headache or migraine. Osteopathic treatment varies from patient to patient. Generally speaking, osteopathy is a ‘hands on’ treatment ranging from the light touch of cranial osteopathy to the more dramatic joint manipulation of high velocity thrust (HVT) treatments. More common is the comfortable stretching of muscles and ligaments in and around the affected areas. Treatment sessions typically last for 30 minutes during which time the osteopath will prescribe stretching and joint manipulation exercises to be carried out by the patient between sessions. The majority of Whitley Bay Osteopathic Centre patients see a marked improvement in their symptoms within three or four sessions. For further information check out the article here or visit the Whitley Bay Osteopathic Centre website at...

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Jean’s Neck Pain

Posted by on May 15, 2013 in Spinal Pain | 0 comments

Jean’s Neck pain   Jean attended the clinic a few months back with right sided neck pain. Jean’s story is all too familiar, a 3 year history of intermittent neck and upper shoulder pain which hurts when working at the PC, driving her car (especially reversing) and whilst out socialising with friends. An MRI had shown wear and tear in the lower neck discs with a slight bulge in the C5 disc which was bulging more to the right. She had tried ant-inflammatories which gave her some relief. Examination of Jean identified the following:   A forward head position – head is carried forwards on neck The right shoulder blade was rotated downwards (imagine turning a clock on a wall in a clockwise direction) The right shoulder blade was additionally lower than the left Neck rotation to the right was limited compared with the left Repositioning of the right shoulder blade by rotating it anti-clockwise and lifting upwards and supporting,  increased her rotation to the right equal to the left   Jean was taught to reposition her shoulder blade and practice holding in the new position. She was also taught to turn her head to the right while keeping her shoulder in this new position and instructed to keep her eyes level so as not to lean her head and neck to the right as she turned. She was given exercises to improve the activation (switching on) and strength of serratus anterior, upper and lower trapezius muscles (shoulder blade muscles) as well as exercises to improve the control of the deep neck muscles. Jean worked as an accounts manager and most of her day was in front of a PC. As such an ergonomic work station assessment was conducting using photos that she sent to us via email. From this we were able to make product recommendations that would improve her working environment and positioning while at the desk.   Jean was seen 9 times over a 3 month period each session involved progression of exercises and some hands on to loosen some restricted joints and tight muscle. At her 9th session Jean was 90% better, she was able to drive and socialise pain freely and only had pain if sat at her desk for too long (our advice being to take short 1-2 minute breaks on a more regular basis).   In conclusion, despite Jean having a bulging disc and wear and tear (like many of us) changes to her posture, movement patterns,  muscle support system (in this case the muscles supporting the shoulder blade) and her working environment and habits  improved her symptoms. She will always have wear and tear and a bulging disc but clearly this was not the cause of her symptoms otherwise she would still have them.   For all the geeks out there that want more information about muscle dysfunction in subjects with neck pain please check out the November 2012 Kinetic Control...

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Gareth Bale’s Ankle Sprain

Posted by on Apr 17, 2013 in Sports Injury | 0 comments

Gareth Bale’s Ankle Sprain I am sure many of you would have heard about or seen Gareth Bales ankle injury, if not follow this link to our Facebook page to see it . Gareth rolled over on his ankle last week and from the video/photo his ankle appears to be at right angles to his leg – ouch! Now most ankles have approximately 30-50 degrees into this direction (inversion) certainly not 90 degrees so how is it that he is scheduled to return to playing football in 2 weeks?   Before I explain how, it’s important to understand a little more about the ankle. The bottom of the tibia (shin bone) and fibular bone form a mortise for the talus bone to sit into (a mortise is essentially a hole designed to receive a corresponding projection – the talus). This part of the ankle allows movement in a forward and backward motion (foot up and down). The Talus bone sits on top of the heel bone (calcaneus) and allows for rolling in and out motion (inversion and eversion). All of these bones are held together by ligaments on the outside and inside of the ankle. Any excessive movement is guarded by our ligaments. So in other words, when our ankle or foot goes too far into one direction the ankle ligaments become tight to prevent the bones from coming apart (dislocating).   Back to our story….So how come Gareth Bale can roll his ankle greater than the normal 50 degrees and return to play football in such a short time? Normally this type of injury would tear the ligaments and (a) lead to the player being out for 6-12 weeks or (b) in some cases requiring reconstructive surgery. If you followed the story you will know that Gareth Bale has previously experienced this injury and as such has stretched these ligaments to allow this degree of movement. Is this okay then? Well not really, although he will make a fast return to playing football his ankle is at much greater risk of rolling again due to the lack of ankle stability and restraint offered by the stretched ligaments. In the long term he will probably also suffer osteoarthritis due to the additional movement or “play” occurring between the joints.   Finally what other options does Gareth have? Ankle surgery to reconstruct his ligaments and offer him improved ankle stability might be an option, but would Spurs Football Club want their prize asset to be out for 3 months while recovering from this procedure? If he does continue to play on with this problem and develops severe osteoarthritis he could be looking at a surgical ankle fusion in years to come –...

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Trainer Trouble…

Posted by on Apr 3, 2013 in Sports Injury | 1 comment

Trainer trouble! I wanted to share a patient story with you that is quite common around this time of year.  Clive came to see us at the clinic a few weeks back he had been training for the Virgin London Marathon and had developed shin pain (shin splints or as now called Medial tibial stress syndrome). He had attended the marathon exhibition the week before and after undergoing a video gait analysis by a well known sports company was advised that he had over pronation and was to ditch his Mizunos trainers and buy their product (and get a second pair for free!). There was no repeat video in his sparkling new trainers instead he was sent on his way a few pounds lighter after being told they would fix his problem. On attending our clinic he felt the new trainers had made little difference to his shins and was now unable to run due to pain. We videoed him again and unsurprisingly to us his feet pronated far more in the new trainers!  At this point I asked Ian Griffiths Sports podiatrist to take a look.  Both Ian and I agreed the best step was for him to ask for a refund on the new trainers and  continue with the Mizunos but add some orthotics into them to increase stability/control.  Two weeks later feeling a lot better following reduction in running, some soft tissue work, ultrasound and taping Clive ran a half marathon (much to my own fears!). Good News – no shin pain. Bad news – fairly severe blistering from the orthotics. At this point both Ian and I agreed he needed a change in trainer and suggested either an Asics or Brooks stability shoe which we felt would provide him with increased stability/control (decreased pronation) and reduced blistering. However we were reluctant for Clive to change shoes four weeks out from the Virgin London marathon for fear of making him worse or causing new injuries! Clive being more daring than us decided to do it anyway! So last week he went to Runners Need in Romford and bought a brand new pair of Brooks Adrenaline. While at the shop he had a further video gait analysis and he noticed a significant improvement in rear foot and ankle alignment even without the orthotic. With this in mind and ignoring all the rules regarding breaking in a new shoe he ran the Brentwood Half marathon last weekend  in a personal best time without any shin pain or blisters. The moral of the story is…. 1. Big brand marketing at exhibitions are normally sales people without any medical /biomechanical training just trying to push a product that may or may not be what you need. 2. Always re-evaluate intervention – assess for changes good or bad after you receive treatment or change sports equipment or technique otherwise you will never know if you have improved what you set out to change. 3. A process of elimination is often required to achieve the perfect outcome. Rarely is there a simple fix. 4. You don’t always need orthotics to bring about improved biomechanical outcomes (sometimes a change in footwear is enough). That said in this case they clearly made an immediate impact. NB: In addition to the footwear changes – Clive...

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