22nd October 2021
 Kew Gardens Physiotherapy

Phone: 07947 740769
Email: info@kewphysiotherapy.co.uk
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Topical issues and early injury management

Problems specific to sporting activity
This area is designed to give tips and perhaps open questions which we can answer for you in email or telephone format. It is not comprehensive by any means, and if ever in doubt, you should seek expert opinion either from a qualified health practitioner or from a qualified instructor specific to the sport.


Commonly, at this time of year and when it’s not raining too much, one likes to take part in outdoor activity.
Typically this consists of activities such as running, cycling and ball-chasing activity such as tennis.
As always, one has to prepare adequately for these things by having the correct footwear and the correct level of fitness and a gradual and sensible progression in intensity, especially if the chosen activity is not a regularly performed one. Below is a bit of info on running that you may find useful and hopefully informative.

Topical Issues & FAQs #01

RUNNING- pearls of wisdom…

This is the most common activity to take part in because it’s cheap and easy and less time consuming. We are all built differently and some of us are perhaps less suited to running than others, yet it’s an important parts of our lives for fitness, weight control and stress relief. It doesn’t matter whether you are an advanced runner or a beginner who plods along the towpath, we are all vulnerable given the right (or wrong) circumstances.
Below are some common faults found in habitual and more expert runners and what physiotherapy can contribute to help avoid injury.

This means that your feet are possibly too flexible leading to excessive flattening of the arch (although not all feet with flat arches overpronate). There are several factors that contribute to this, even motion at the hip can influence, but the net result is that shock absorption is compromised and too much force is passed to other structures in the leg.
The solution to this is use of the correct footwear that controls the amount or the rate of overpronation (see below). In addition to this, orthotic inserts in the shoe are sometimes advised to further help the foot achieve its correct function.

Hip muscle weakness
One of the most common and overlooked areas in the leg is the hip, especially when problems are in an area remote to the hip itself, such as foot or shin pain. Some of the hip muscles are big generators of force that are designed to control rotation (twisting movements) of the hip and maintain the hip in the correct planes of movement. The posterior and outer buttock muscles (gluteals) are best placed for this type of control. Because of how our skeletons develop, sometimes the hip will move too much in the wrong way and good muscle control is needed to counteract this.
Gait analysis (watching running styles with the use of video) and muscle strength testing can be valuable tools in identifying these movement faults that will lead to injury if uncorrected.

Try this
– stand on one leg and perform a half squat.

Look for this
- does your arch flatten completely? Does your knee move towards the opposite leg and you have difficulty controlling it and keeping it over your foot?

Then it’s possible that you fit into the poor hip control and overpronation category. You may have the required muscle power but you need to use it more effectively. Physiotherapy can help you by identifying movement faults and then helping you re-train to work more efficiently.

- a common myth is that if you stretch before you play sport you will reduce injury. There is no evidence to support this statement but what is true is that adequate flexibility so that joints and muscles move in a non compromising way is important.

A good way to prepare before sport is by performing dynamic movements/ stretches of the muscles that you will be working. For example, the hamstrings (back of thigh) can be prepared for sport by keeping body upright and swinging the straight leg forward in a controlled way. This can be repeated 10 or 15 times and the whole process done 3 times on each leg. You will then be moving the muscle on and off stretch therefore preparing it for what is to come during the sporting task.

After the activity, when the muscle is warm, then you can perform a fixed stretch lasting about 20 seconds, and repeat 3 or 4 times.
Other muscles other than the hamstring which commonly get injured in relation to running are the calf and sometimes the thigh, particularly in sprinting.

These muscle all cross over two joints so they are vulnerable biomechanically when the body is overloaded or fatigued. Good strength and flexibility is helpful for these muscles to remain healthy.

Physiotherapy can give you guidance and target the areas that need attention as priority, because otherwise the preparation for sport will take longer than the event itself if one stretches and strengthens everything. The key is to identify what can go wrong when consideration is given to the nature of the sport, biomechanical makeup of the individual, general fitness and how all these interact together.

The correct kit
– this does not mean a colour coordinated kit. It means breathable gear to fit the climate and most importantly the correct footwear.
We could go on for a while but there are basically 3 types of shoe: a shock absorbing shoe for those with supinated feet (commonly high arches, although that’s not the full story), a shoe that provides stability which is best suited for the normal foot and those who are perhaps a bigger frame runner, and the shoe that controls pronation well which is suited for those with flat arches and very unsupportive feet. Specialist running shops are best placed to give advice on the type of shoes available, but a physiotherapist is in an ideal position to also advice you on this but also relate this to your foot type, how you move and the type of injury that may have been a result of poor foot control.

In summary, if you have a stiff foot you need a soft shoe and if you have a floppy foot, you need a stiff shoe.

Give us a call or email if you are a runner of any ability and think that you have a problem or just want advice, we are happy to chat.

Frequently Asked Questions

1. What will happen at my first visit?

The physiotherapist will ask you to fill out a registration form which includes personal and medical details. They will then ask you detailed questions about your pain and the problem for which you are seeking help. From your answers the physiotherapist will already have a good idea what the main problems are.

An assessment of the relevant body areas will then be carried out to identify the structures at fault. You may like to bring some shorts to change into for the examination. At the end of the assessment the physiotherapist will sit down and explain in detail what the main problems are and agree with you the treatment plan. They will also let you know how many treatments it is likely to take and what sort of recovery they think you will achieve. Treatment and exercises will be given during the first visit as time allows.

2. Do I have to be referred by my doctor?

There is no need for a doctor's referral if you are self funding. However, if you intend to claim back treatments costs from you private medical insurance, most policies require a GP referral letter prior to treatment.
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