Author: The Camford Clinic

Questions to ask your practitioner.

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Whenever you go to see any professional, there are a few basic questions that they should be able to answer. The idea of these questions is to find out all you need to know to make an informed choice about your treatment and to me, these apply whether they are your GP, osteopath, or sports massage practitioner.

  • What is the working diagnosis?
  • What treatment techniques might you use?
  • What’s the risk?
  • What are the benefits?
  • How long will it take to feel a positive effect?
  • How long will it last?
  • How long will it take for me to get better?

If they can’t offer you reassuring answers to these, keep asking.

And if you come to see us, I would hope to answer them as part of our discussion automatically.

Running, pendulums and posture.

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Spring has arrived and there are simply no excuses for not getting out and running. However, there are many schools of thought on gait, foot strike and posture, most of which can be very confusing for the uncoached amateur, without access to external feedback and analysis.

This, therefore, is offered a brief review of the basics, some elemental pointers to quickly consider when moving.

Firstly, stop overthinking forefoot, midfoot or heel strike. This is more dependant on your shoes, personal mechanics, injury history and current mobility than idealised positioning. The impact point should be where your centre of gravity is about to be (given that inertia will carry your centre of mass over that point with no extra effort). Too far forward, most commonly due to overstriding, and the foot will act as a brake, whether you are landing on your forefoot or heel. This optimum positioning can be best achieved by allowing the leg and ankle to relax before landing and feeling the ground push up as you drive forward. The overall feeling should be that of an inverted pendulum with the mass at the top, such that your foot acts as the pivot, supporting and carrying you effortlessly over the top.

Secondly, spinal posture. Too many runners can be seen slumped forward and collapsing into their centre. This happens for a number of reasons (avoiding injured areas, poor soft tissue mobility, short hips…) but is a huge waste of energy, since it saps the natural rhythm from the elastic properties of the connective tissues. Again, this is a complex issue which cannot be corrected instantly, but checking that your pelvis is level, and your chest is open are nice simple cues with positive outcomes.

By correcting and cleaning these up, you should find that your running is smoother, requires less effort and in the end, is more enjoyable.

Total body circuits for injury detection and prevention

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There are a few simple exercises that, if carried out correctly, can help prevent injury in other areas of training by allowing you to spot where and when you are weak.

Amongst my favourites are:

Kettlebell swings. Preferably a full range of motion. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=251These work pretty much everything and can be used for strength, conditioning, warmup, incredibly useful.

Turkish getups. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=255 They look simple but demand huge range of motion and coordination of all the major joints to be successful.

Single arm overhead squats. http://www.catalystathletics.com/exercises/exercise.php?exerciseID=236 Another all over body exercise which will make everything fire in the correct sequence.

Dead hang pull ups http://www.catalystathletics.com/exercises/exercise.php?exerciseID=39

Mountain climbers, just to finish off http://www.youtube.com/watch?v=1J4hRICVjRo Focusing on maintaining a stable trunk throughout the movement.

By doing these as a circuit, ensuring good form at all times, they should prepare you for any other, more focused gym work or training you wish to do. Or, if you’re time compressed, just doing a 10 minute of a few of them (not everybody has a suitable pull up station in their home) will bring huge benefits.

One of the best resources for improving mobility is Mobility WOD, which has hundreds of excellent videos for fixing all the areas you may feel are restricted.

And if in doubt, come and see us for a full assessment of the issues.

Running form tweaks

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Running is both simple and complex, the process theoretically easy (left right left right repeat until end) the biomechanics rather harder due to the compromised nature of our existence.

Teaching or advising on form is therefore a potentially treacherous path, since each runner will be unique in their compromises and blocks.

When working, I tend to offer only 3 pointers- eyes forward, hips open and push away. I might, if the client is in a well supported posture and I experienced in body sensing, encourage them to open their chest, or loosen their ankles, but to focus on more can prove difficult, especially when tired.

These generate no confusing instructions, allow the runner to optimise their gait cycle naturally and help trigger appropriate neurological messages without overload.

All of which help reduce fatigue, injury and improve training effect.

80:20 Revisted

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With the forthcoming release of Dr Kelly Starrett’s new book, I have been reconsidering the advice we tend to offer injured (or preferably non injured) athletes. Dr Starrett (a Phd physical therapist) offers practical and applicable advice on injury prevention and recovery, stating that if you cannot perform basic functions safely (squatting, stretching etc) then you need to sort them out before you try running.

These days, with web access virtually ubiquitous in the western world, there is a surfeit of information available at our fingertips. The difficulty is in discerning what works and what doesn’t. With the rise of athletic “biohackers”, who promote tips and tricks for small percentage improvements, finding the signal amongst the noise is even harder.

For most of us, performance improvement comes down to three simple things.

  • Optimise Nutriton / Diet
  • Train efficiently
  • Recovery / Sleep

Dr Starrett covers much of this in his excellent book Becoming A Supple Leopard and reviews indicate he will cover this in the running guide.

Breaking down the above bullet points, optimising diet means ensuring you eat cleanly and sensibly most of the time, getting a suitable balance of proteins, fats and carbohydrates, with plenty of micronutrients. Nothing clever or fancy but by not doing this, you are ensuring that your body is not going to operate effectively. This is the base upon which all the others stand, mentally and physically.

The part we all think about is the training aspect. We plan, prepare and put in the hours and miles to attempt to achieve our goals. But are we doing it in the most efficient manner? Could we save time by cutting out junk miles or hours in the gym, since more is not always better. Is there such a thing as a recovery run, or easy workout? Would that time be better spent with friends and family, which might help improve our mental state, or doing mobility work (as described by Dr Starrett)?

This ties in to point 3, recovery and sleep. Do you recover enough? Are you waking refreshed and ready to go each morning without needing an alarm or two? There is no set formula for this since the factors involved in recovery are complex, including external stressors, but by tracking basic biomarkers (resting heart rate, blood pressure, oxygen saturation (SpO2) etc) and personal reflection, we are able to observe how our bodies are responding to the load we place upon them. If your resting heart rate is elevated and your SpO2 depressed then you are simply not recovering from the load. Another simple test is to attempt to create a change in your heart rate during a training session. If during a run or ride, you cannot easily elevate your heart rate by increasing pace or effort, then there is a possibility that you are neurologically as well as physically tired and as such, backing off would be advised.

Some people are beginning to use heart rate variability (HRV) to track their stress and recovery. Like many tools, this gives a view into the workings of the body, in this case the autonomic nervous system, which can be used to explore the effect training or stress is having. Many researchers and doctors have shown that there is a link between low variability and mortality from a number of causes but these are measured using ECG over a long period of time (24 hours), especially after an acute myocardial infarction. Some work is being carried out with regards to the use of HRV to track physiological changes due to stress and training and although this appears to be useful over long term measurements, such that trends can be visible, it appears to be a back up to the other measurements and as such, outside of the 80% rule of most efficient use of resources.

To conclude, eat to meet your nutritional needs, train efficiently and recover effectively. Then start making the 20% changes.

Unlock your potential

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What would happen if you could:

  • Train more effectively
  • Recover faster and more efficiently
  • Heal from injuries quicker
  • Maximise your resilience

It would unleash your performance in every area of your life. You would have more time to spend on relationships, work or play, achieve more when competing and have less noise in your head when the time comes to focus.

The secret? To get out of your own way. Most of us are held back by learned patterns, old injuries and poor habits, trying to do more and more with less and less. Restrictions in one area reduces the body’s capacity to deal with stress in others. A tight hip will shorten your stride and overload the achilles, a stiff upper back will drop your maximal squat, restricted shoulders will limit your press or swim stroke. Mentally, stress at work will reduce your ability to make solid nutritional choices, family concerns will eat into your training mindset, anxiety will limit your performance at competition time.

If you can figure out what is restricting you, then removing those blocks can make huge differences.

Each persons blocks are different. Physically, look first at the ankles, hips and thoracic spine. Any old injuries, scarring or tissue changes (tight, weak, short) can affect the rest of the body in many ways. Can you perform the basic movements (push, pull, bend, squat, lunge etc, cleanly and pain free?)

Another physical issue is not listening when we need to rest, by ignoring the subtle clues in our physiology. Is your resting heart rate elevated, are you feeling more fatigued than normal for this workout, is your nervous system tired? (This can be tested via heart rate variabiity apps and simple biomechanical tests). Are you sleeping sufficiently? Once those areas are cleared, look at specific areas related to your sport or discipline and optimise your strengths and minimise the weaknesses, a process that will take a lifetime of self observation.

Mentally, we are always fighting against the patterns and habits picked up from everyone around us. Fear that we are not training hard enough can lead to overtraining, learning not to listen to the inner voice of weakness during a difficult moment, belief in an internal monologue that tells we are not good enough, often imposed by others, copying or competing with our training companions when we should be backing off.

By reading the cues, listening to ourselves and seeking the support and expertise of professionals, you can unlock your true potential in every domain.

A confession.

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I don’t want to see you with back pain, knee problems and shoulder injuries.

These issues are far too common. I see lots of them each week and it bothers me. I spend most of my days fixing these problems and although I can and will do it quickly and efficiently, I would prefer not to.

I want to see you before they start.

I want to get you in the clinic and give you the toolkit you need to enjoy the most fantastic machine in the known solar system, your body.

It is possible to keep yourself free of all these problems through some simple exercises, movement patterns and awareness.

So lets not talk about injury and problems all the time, lets start talking about what you can do to avoid the problems in the first place.

It’ll cost you far less as well.

4 Rules

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The body has a few rules it will constantly try to maintain.

Feet strong on the floor

Eyes level with the horizon

Give space for pain or restriction (to stop it hurting)

Allow Movement

These were evolved over millenia, from our first steps as bipedal mammals through to conscious, creative homo sapiens. Without these, we would die. Without the ability to move, we would not be able to hunt, or gather, feed or run away from predators. And movement would not be able to occur if we couldn’t adapt dynamically for scar tissue, injuries or other problems. Movement would also not be possible if we had an unstable base (feet not strong on the floor) or our eyes were not able to gauge distance, speed or balance by being unlevel. 

It is only when it exceeds that capacity to adapt do most people even become aware of the problems and related pain that follows. Athletes and active people may notice the restrictions occuring faster, when they begin to limit performance.

What can you do about it? Move, explore, find out what your body can do and what it can’t. If you find a problem you can’t work out yourself, see an expert who can treat you as a whole person, rather than a collection of symptoms.

You evolved to be amazing, don’t waste it.

 

 

 

Pain is not normal

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Pain is the body telling you something is wrong. It is driven, as with most things, by only a few factors – Degeneration, disease processes or dysfunction. However, as we age, we tend to normalise it, put it down to getting older, one of those things or to be expected. We are even told this by medical professionals, which reinforces the myth.

Aging happens, it is better than the alternative. Some of the processes of aging are unavoidable but many are not. By attempting to eliminate those triggers we can control, through correction of function and awareness of degeneration, then the pain left is triggered by either a disease process or changes which have already occurred. With the miracles of modern medicine and the bodies inherent desire to heal itself, even the majority of these can be improved with time, patience and external intervention.

Prevention is always better than a cure and the necessary activities to prevent degeneration are all things that we know. Eat a nutritious, well balanced diet, maintain a sensible weight, exercise regularly and moderately including resistance work. Dysfunction can be reduced or prevented by considering the way we use our bodies and becoming aware of our senses more. We are sensory creatures and yet spend so little time in our bodies that we recognise only those signals that are big enough to break through to our conscious awareness.

You do not need to live with pain unless there is a known and unavoidable reason for its presence. Even then, osteopathy and allopathic medicine can both help, together with self driven changes to give you back control. With a good working diagnosis and a plan, the future can look far brighter.

5 points to being pain free:

1) Get a diagnosis of why you have pain. If you don’t understand why, you can’t change the triggers
2) Start a treatment plan that you are actively involved with
3) Get your life patterns in order. Change diet, exercise or other factors that can influence the pain
4) Engage with the pain and take control, mentally and physically
5) Practice mental and physical activities within a pain free framework every day

The Camford Clinic
http://www.the-camford-clinic.co.uk
01420 544408

Focus and goals

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There is no past, no future, only now. Yet we spend most of our time ignoring whats in front of us and instead thinking about what has been or what might be.

I have been reading a selection of books on apparently different themes and they all boil down to that point. From The One Thing to The Way Of the Seal, Change Yourself and even An Astronauts Guide to Life on Earth, the crux of the matter is most of the time we aren’t in our heads.

When coaching clients in new movement patterns, I use 2 key words  as triggers. Attention and Intention. What is my attention on and what is my intention. For example, moving the shoulder joint, the attention is on the joint, the way it feels and glides, while my intention is that the arm should move slowly and under control at all times. Many find this very hard to do as the mind tends to rebel against focusing on just one thing.

Several of the books also discuss the importance of routines, or rituals in the morning and evening to create focus points in the day for improved productivity. Again, I relate this to clients and ask them to do their movement exercises when they know they are going to be undisturbed and able to concentrate for a few minutes.

So ask yourself. Where is my attention? What is my intention? Not just in a movement pattern but when working as well, it may for some interesting results.