This weeks ProSport Physiotherapy ‘Physiobench’ article on Athetlics Weekly is below along with some additonal videos.

I am a 23-year-old distance runner and I keep getting a clicking in my hip – it’s not painful as yet, but it is irritating and worrying. What can it be and how do I get rid of it?

This could me a number of things. If you get the clicking when you lift your leg upwards and the pain feels quite deep it could potentially be the cartilage in your hip joint which is catching. This may caused due to the hip joint been pushed forward as a result of a tight capsule at the back of the hip (Think a vacuum pushing the hip forward) which then causes the cartilage to click as you lift upwards.

If the clicking is as you lower your leg and feels quite superficial then usually this is the iliopsoas passing over the bursa (sac filled fluid). This can mean your hip flexors are tight and or weak and the tendon has increased tension. There is also a lot of other structures around that area that all have to pass within each other. The bursa can become sore and painful after a while.

As always from my previous articles in AW, we need to think about movement rather than getting bogged down with particular pathologies. To fix either of these issues we need to get your hip joint moving correctly again. Therefore a nice posterior hip capsule stretch is;

• Lie on your back and bring one leg to 90 degrees hip flexion and knee flexion.
• Clasp your hands together and push your knee so you are basically trying to push the hip further back into the socket to compress it.
• While holding the tension with your hands pull your knee up towards the same sided armpit with your muscles deep in your hip and hold for a count of two. The tension on the knee is modified throughout the movement so it is towards the hip joint.
• Repeat ten times by three to five times daily. This ‘resets’ the hip joint in the socket and stretches the posterior capsule.
• There should be no painful pinch in the groin when doing this, just muscles burning!

The adductors, ITB and piriformis may also be stretched to help reset the hip joint. I have created a blog post at www.prosportphysiotherapy.co.uk/blog with a hip joint stretching route for you to try.

Here are the additional Stretching Routines to try.

Foam Rolling ITBand from ProSportPhysiotherapy on Vimeo.

AIS Outside Glutes from ProSportPhysiotherapy on Vimeo.

AIS Piriformis from ProSportPhysiotherapy on Vimeo.

AIS Long Adductors from ProSportPhysiotherapy on Vimeo.

AIS Hip Extension from ProSportPhysiotherapy on Vimeo.

Enjoy,

The ProSport Physiotherapy Team.

Athletics Weekly; Hip Joint Stretching Routine is a post from: Pro Sport Physiotherapy.

Pro Sport Physiotherapy would like to thank Dave O’Sullivan for all his hard work and commitment over the last 3 years. Dave has been instrumental in setting up our Huddersfield clinic and has been heavily involved in staff training/education.

Dave has a growing reputation as being one of the best physiotherapists in the country and is a regular column writer for Athletics Weekly and Sportsrehabexpert.com. Dave has also conducted consultancy work with a wide range of other professional sports including hurling, gaelic football, golf  and athletics.

Dave finished his post at Leeds Rhinos with another super league trophy and has now taken up a new physiotherapy position in his native Ireland with Munster Rugby Union.

Thanks again Dave.

Dave O’Sullivan joins Munster Rugby Union is a post from: Pro Sport Physiotherapy.

You are only as strong as your weakest link!!

Today I am going to explain why I put so much emphasis on improving an athlete’s ability to move and why I think improving ones movement patterns is the quickest and best way to improve and succeed in your goals. This concept was first introduced to me by physical therapist, Gray Cook and I have successfully adapted it to fit my methods of treatment and performance enhancement.

The perfect athlete

The pyramid below represents the ‘perfect’ athlete. This athlete contains the perfect balance between functional movement, performance and skill.

The Perfect Athlete

Functional movement refers to the ability of the athlete to perform fundamental movement patterns efficiently. Every sport or athletics event contains some combination of fundamental movement patterns (e.g Accelerate, decelerate, twists, turn etc.). It is the athlete that can perform these movements with the most energy efficient pattern that will be able to get the most out of their functional performance and skill. The better the foundation (functional movement) the better the buffer zone to improve performance and skill. Note that for endurance athletes the ability to maintain a ‘perfect’ or ‘energy efficient’ stride pattern for a prolonged period is the functional skill. For a hurdler or discus thrower, the functional skill will be slightly different and contain different fundamental movement patterns.

What affects us achieving optimal movement patterns?

The technology era has a big effect on many athletes’ poor movement patterns. Prolonged sitting and poor postures can have a detrimental effect on achieving optimal patterns.  These cause stiff immobile joints that can lead to muscle weakness and hence poor movement capabilities.

Which athlete are you?

Unfortunately I have yet to see the ‘perfect’ athlete. When assessing patients and athletes for performance enhancement manual therapy and conditioning, there are three main types of athlete that I come across. The type of athlete will have a massive effect on how I proceed with treatment and planning of rehabilitation/corrective exercise programs. This concept will also prove why it is vital that an athlete gets the correct stimulus when looking to improve performance or rehabilitate an injury.

The Overpowered Athlete

The Overpowered Athlete

This is the athlete that performs reasonably well in competition and training however may struggle with recurrent injuries every so often such as calf or hamstring tears. This is because although performing well in events the athletes will be relying heavily on the strong powerful muscles which essentially become overused due to inefficient movement patterns that rely on a combination of strong and powerful with small and stabilising muscles. This athlete is built on a poor foundation and unfortunately it will only be a matter of time before they break down. This is why it is so important that I can get to the route of the problem and not just treat the site of pain every time an athlete presents with an injury.

The underpowered athlete

The Underpowered Athlete

The underpowered athlete will show great movement capabilities however will be poor at turning this into functional performance. For example a sprinter may show great fundamental movement abilities but struggles to transfer this into being explosive and powerful on the track. This type of athlete will benefit from strengthening the power muscles (usually hamstrings and glutes) in order to progress further. This is why it is so important for physiotherapists to have a good knowledge of strength and conditioning when working with athletes. This type of athlete will not respond as well to typical ‘physiotherapy’ exercises unlike the overpowered athlete.

The under skilled athlete

The Underskilled Athlete

The under skilled athlete is the athlete who moves and performs well but may be inconsistent at times due to a lack of technical mastery. This is the kind of athlete that the physiotherapist needs to work closely with the coach. For athletes that require a high level of skill (such as javelin or hurdles) I will never attempt to correct the athlete’s functional skill. This needs to be lead by the coach and the physiotherapist will unfortunately be only able to offer minimal assistance.  A common finding is that coaches are too quick to put athletes in this category without having them assessed for functional movement or performance impairments. A boost or improvement in one of the underlying layers can make all the difference at times to helping improve functional skill.

Wrap Up

I hope you will now begin to see the benefit of having a good foundation to enable you to improve your performance to the best of your ability. This article needs to be examined carefully by those athletes who appear to have stagnated and are struggling to make further gains. A reflection on their training program and the time dedicated to each section of their performance may hold the key in making further gains. This is why it might be best at times to spend an hour working on improving mobility and stability of major joints than going for a run! In the next few months we will be looking at getting the foundational level of the pyramid correct. For more information on previous fundamental movement techniques visit www.prosportphysiotherapy.co.uk/blog.  Remember you are only as strong as your weakest link!

Pro Sport Physiotherapy Treatment Approach is a post from: Pro Sport Physiotherapy.

This article appeared recently in Athletics Weekly:

THE REAR FOOT ELEVATED SPLIT SQUAT (RFESS) IS ONE OF THE BEST MOVEMENTS FOR RUNNERS TO MASTER

THE RFESS increases the strength of the gluteus and hamstring muscles that are essential for improved performance. Once an injured athlete is strong enough to tolerate this exercise, it is a constant in most of my lower limb rehabilitation programmes.

• The athlete places one leg behind them on a bench or step with the toes taking the weight of the leg on the bench.
• The other leg is placed in front of the body with the weight distributed evenly between the ball of the big toe, the ball of the little toe and the heel.
• The body must remain upright as any lean forward will result in the emphasis being placed more on the quadriceps muscles which is not what we want with this particular exercise!

Start Position

Any forward lean will result in the wrong muscles being exercised.

• The athlete descends by bending the front knee and sitting the glute muscle down as if to sit back into a chair until the knee is bent to 90 degrees or as far as the athlete can go without leaning forward.
• It is advised to squeeze the glute of the back leg throughout to avoid arching the back or leaning forward.

Mid Position

Squeeze the glute throughout the exercise to avoid arching the back or leaning forward.

• The athlete then ascends back up by driving the mid-foot to heel into the ground. This ensures that the gluteus and hamstring muscles are giving the best possible chance to work correctly.

Cheating/Compensations

If the glutes and hamstrings are weak, the athlete will want to come back up by using their toes to drive back up. Another sign of gluteus and hamstring weakness is a lean forward as the athlete comes down and up which is why it is very important to stay upright throughout the whole movement.

Incorrect Technique

Notice the forward lean of the body as the knee travels over the toes.

Placing a stick along the back, mid-back and sacrum (base of spine) is an excellent way to ensure that the athlete stays upright because if they lose contact with any one of the three points of the stick, they will instantly know that the body is beginning to lean forward.

Help of a stick for Correct Alignment

If contact is lost with the stick on any of the three points the athlete will know they are beginning to lean forward.

The athlete’s brain can also cheat and use too much quadriceps by allowing the knee to go past the toes on the way down. This is why we cue the athlete to really sit back into that glutei muscle as if sitting into a chair. The golden rule is that the athlete should always be able to see their toes throughout the movement. If the athlete cannot see their toes because the knee has gone past them then we know we are only getting 50% of the benefit of this exercise!

Other benefits of this movement

As discussed in my previous article, it is essential that we strengthen movement patterns as opposed to using machine weights or isolated techniques. This movement pattern not only strengthens the hamstrings and glutes but also works on extending the back legs hip while lengthening those hip flexor muscles and also helps stretch the big toes muscles which is essential to keep mobile in order to perform an energy efficient stride! If the big toe is stiff and sore then a whole host of problems can arise up the body. It is therefore best to perform this exercise with the toes curled and extended as shown.

Sets and Reps

This is a very demanding exercise with massive potential for strength development. Therefore three sets of six reps of good depth on each leg should suffice. This exercise is best done at the start of a weights session after a correct movement preparation is covered. Dumb-bells can be held in the hands to progress the exercise for increased muscle stimuli, although ensure that the dumbbells don’t cause a forward lean.

Conclusion

This exercise gives an athlete serious bang-for-their-buck while sparing the lower back. The exercise should be a constant in every athletes programme no matter what their event. The stronger we are at pushing force through the floor, the better we will be in any event.

Tapping into 5th Gear when Running!! is a post from: Pro Sport Physiotherapy.

It is always nice to recieve feedback and we usually find these are the patients that do particularly well due to:

a) they are educated about what a good therapist should be and want to recieve the best treatment possible

b) they are commited to the rehabilitation program and will do what we ask of them in terms of adherence to rehabilitation programs and training and active recovery when indicated.

Here is feedback from a patient that travelled 3 hours each way and had one session with us at our physiotherapy clinic in Huddersfield.

“just thought i would drop you a line to let you know how im getting on with the stretches and the core work that you suggested. I have been doing these for around an hour to an hour and a half each day since i saw you, the difference i have found is massive. Its hard to explain how i feel whilst running and cycling now, it just feels like my body is more planted. The cyclo cross is finished now, i done my first fell race today on only six running sessions maybe not the best idea in the world however because of the excersises i have been doing my body felt stronger than it ever has. I have no technique at running downhill and would normally end up with a tight back doing that type of race where as this time no tightness.

Kenny, County Durham.

This is a genunine email and was not edited nor requested. What do we do different to other clinicans?

We look at the whole body and not just the site of pain! One of our favourite sayings is STOP CHASING PAIN!! We dont just give the same old exercises to every patient.

We look at the movement abilities of the patient and not only help them recover from injury but also increase their athletic ability! Whether this is an elite athlete or a tradesman lifting heavy loads 7 hours a day!

We will help you move pain free, the way your body was designed to move!

ProSport Team.

Feeback from Long Distance Patient is a post from: Pro Sport Physiotherapy.

Usually the site of the pain is not actually the cause of the problem. At Pro Sport Physiotherapy we never chase the pain and always go straight to the source of the problem.

A nice exercise to help alleviate pressure on the lower back is the Waiters Bow or also known as the hip hinge. This teaches our brain to bend forward by sitting back into those hips which essentially means the lower back does not have to work so hard.

• The patient can use a stick to align the head, mid back and sacrum (just below the lower back).
• The patient must keep the 3 contact  points with the stick throughout the movement.
• The patient initiates the movement by sticking the bum back as if reaching back to touch a wall.
• There should be no movement in the lower back with all movement coming from the hips.

Waiters Bow Mid Point

• The patient returns to the starting position by squeezing the glutes and using these strong powerful muscles to come back up with no pressue on the lower back.

End Position

Getting Rid of Back Pain is a post from: Pro Sport Physiotherapy.

We have had a few enquiries regarding booking on for the next Running course which will take place on Sunday 13th March at Warehouse Gym, Honley, Huddersfield.

The application form is below to download and submit if interested.

http://prosportphysiotherapy.co.uk/athletic-development-running-course-application-form/athletic_development_for_endurance_and_track_athletes_level_registration_form/

ProSportPhysiotherapy

Athletic Development Running Course Application Form is a post from: Pro Sport Physiotherapy.

The course saw a great mix of coaches ranging from Endurance to Sprint coaches who were in charge of various age groups from young to elite athletes.  This provided some great opportunities for discussion on how to approach certain aspects for all ages.

The day kicked off with Dave O’Sullivan, Pro Sport Physiotherapy clininican introduce the performance system and how it originated along with giving the coaches an insight into the unique ProSportPhysiotherapy Assessment and Screening designed specifically for Athletics athletes. There was also some ‘magic’ performed with Dave showing the coaches how 1 part of the body can affect another part and how it all comes together in the brain to affect movement. (Hint: Not been able to touch your toes DOES NOT MEAN your hamstrings are tight!!)!!

The coaches then went through the specific sections of Self Administrated Soft Tissue and Flexebility along with practical demonstrations and again some great discussions were generated. The specific pieces taught were new to most of the coaches and some common errors that are made via the internet waves were ironed out to ensure optimal results in minimal time.

There was then a break for coffee and some mince pies and coaches had the opportunity to get to know each other better, exchange ideas and ask the course tutors any lingering questions.

The mid morning session consisted of the mobility and muscle activation sections with a major practical emphasis. As these modules progressed, the coaches were able to see how all these sections were beginning to fit together and how one section complimented the next and more importantly how they fitted into the overall approach.

The group then broke for lunch and again some good discussions and ideas were exchanged.

The afternoon session kicked off with Andy Peackock taking the group through correct core training specifically to athletics athletes and put to bed some myths and controversies surrounding core training.

Next up Andy covered some important strength training exercises and more importantly how to implement them effortlessly into their athletes programs without needing a personal training qualification to do so. These exercises reinforced the morning sessions principles and focused on movement patterns as opposed to isolating specific muscles.

After the afternoon tea and the rest of the mince pies were finished, Andy then took us through some thoughts on correct periodisation and nutrition which again sparked some great discussion and ideas from all coaches.

The day finished with some great feedback and details were exchanged between coaches and a great day was had by all. The tutors were delighted with the level of understanding the coaches displayed and there was some great questions in the follow up emails which were forwarded to all attending candidates.

Here is what some of the coaches said about the course:

The course presented by Dave O’Sullivan, Head Physio to Leeds Rhinos and Clinical Director of ProSport Physiotherapy and Andy Peacock, resident Personal Trainer to Fitness TV and Warehouse Gym was a real hands-on experience to soft tissue mobilisation, flexibility and mobility, which is clearly lacking in many athletes. The course was delivered in layman terms and explained very well by the course presenters, giving participants the opportunity to experience the various techniques and understand the common problems that arise amongst athletes. There were sessions on muscle activation, core training and strength training, delivering the essential foundations for successful strength training. The course covered nutrition and elements of periodisation, which were most helpful to the less experienced coaches and was supported by a detailed manual giving numerous pictures and references for the work covered. An excellent course with good attention to detail presented by two friendly, competent practioners.
John Buckingham
UK Athletics
Level 4 Performance Coach
January 2011

Thanks again for what you and Andy taught us. It was very informal and I gained a new insight to the benefit of stretching etc. I have tried out some of the techniques shown ( Can touch my toes at last) and they have gone down well. I am looking forward to reading your article in AW as other clubs will benefit from this knowledge.

Dave, Bolton Harriers

Following on from the recent course I attended – I would just like to say how interesting and helpful I found it.

Andrea, Roberttown Road Runners

The next course will be held on Sunday 13th of March 2011 at Warehouse Gym, Honley. This course will be aimed at athletes of all levels therefore you do not have to be a coach to attend! Athletics Weekly will also be present to review the course so sign up now! For more information on the contents of the course and how to apply for a place please click here: http://prosportphysiotherapy.co.uk/athletic-development-running-course-application-form/athletic_development_for_endurance_and_track_athletes_level_registration_form/

Athletic Development for Endurance and Track Athletes – Review is a post from: Pro Sport Physiotherapy.

With 2011 just underway, January is heaving with new club members for Athletic clubs while usually February and March are heaving for physiotherapists with injuries caused by not been fit to run. This article will discuss how to prevent injury, identify the first signs of injury and provide some key fundamental exercises to improve running performance.

The most important aspect of improving performance while reducing injury is the ability to move correctly. If one cannot move correctly, then they cannot run with an energy efficient stride and produce strength, stability and power to their full potential.

If for instance an athlete’s hip is stiff, this can cause the lower back or knee to do excessive work to compensate. Remember the brain will always find a way to achieve a running pattern but it might not always be the correct one! It WILL only be a matter of time before an injury arrives if the brain is cheating regularly.

A good way to preventing injury is to do a warm up that addresses these issues and will allow an athlete to improve their running stride. A good warm up will consist of some foam rolling, some active stretching and some active specific mobility work to specific joints in the body. This will ensure that the tissue quality is improved and the joints have the required mobility to achieve a safe and effective running pattern. This may take 10 to 15 minutes yet can improve performance and save valuable money from physiotherapy bills.

Foam Rolling - Essential for all athletes

Why is an efficient warm up important?

With most recreational athletes and runners, there is a good chance they will be sat at a desk or in a car for 6 + hours a day. To top this off, usually the person will be sat in a slouched rounded shoulders posture. Unfortunately this is the price we have to pay for technology! Is it any wonder that certain joints are prone to stiffness and restrictions? To top this off, when joints get stiff, they can also affect how certain muscles around those joints operate! The gluteal muscles are essential for running efficiently and unfortunately due to sitting and getting stiff hips, these muscles can usually be switched off pretty easily. This can lead to injuries in the back and pretty much any injury in the lower limb.

Avoid Sit Ups for Core Training!

This is a bold statement and somewhat controversial however if we look at the sit up and then combine this with the 6+ hours of sitting in poor postures, we can see that the sit up just adds to poor posture and hence poor running mechanics. When we crunch over, we tend to avoid using our diaphragm and instead use a poor breathing pattern. If we do not use our diaphragm correctly then we cannot use our core correctly! The lungs and an efficient breathing pattern are essential for distance running. Sit Ups also can place excessive strain on the hip flexors and lower back which can result in injury or poor running patterns.

Hip Mobility Exercise

A good hip mobility drill to avoid the above compensations is a stride position in which we can mobilise the hips while also activating the gluteal muscles. This drill is also useful for the brain to recognise prior to running as one hip is flexed (bent) while the opposite side is extended (straight) which is a fundamental pattern for running.

• The athlete gets in a press up position.
• The right foot is brought up beside the right hand while keeping the left leg straight.
• The athlete needs to keep the chest up and squeeze the straight legs gluteal throughout. This will ensure that the mid back is opened up while activating the gluteal muscles prior to running.
• This movement is held for 1 deep breath and then the legs switch positions.
• By using deep breathing instead of holds for seconds, this allows the athlete to reinforce correct breathing patterns and diaphragm activation which will ensure the core is given the best possible chance to function correctly.

Hip Mobility - Stride Position

Core Exercises

The front plank is a great exercise to train the core correctly but it is often done incorrectly.

• The athlete ensures that the elbows are directly under the shoulders and the feet are together in the starting position.
• The athlete must ensure that the bum is kept in line with the mid back and neck.
• The lower back MUST NOT BE ALLOWED TO ARCH at any point. Once the lower back begins to sag, the exercise should stop.
• A good way to avoid this is to actively squeeze the gluteal muscles throughout the hold.
• Holds for deep breathing rather than time will allow you to truly train the core to the best of its ability. E.g Hold for 3 deep breaths x 5 repetitions

Correct Front Plank

Identifying Signs of Injury

Identifying an injury early is essential to ensure damage limitation. Pain is a signal to the brain that something is wrong and should be treated very seriously. There is a big difference between severe muscle fatigue and build up of lactic acid versus pain caused by pathology!! The golden rule with most injuries is that the longer you run through an injury or leave it for months before getting help the longer it will take to heal and correct. A general rule of thumb for chronic injuries is that the length of time an athlete puts up with an injury is the time in half to get it correct. E.g an athlete carrying an Achilles injury for 3 months will usually take 6 weeks to get it right with the help of a medical professional. This is not always the case but a good guide and therefore it is a good idea to get advice before a niggle turns into something more serious.

Exercises that cause pain

If pain is a signal from the brain telling us something is wrong then it makes sense that we should never do any exercises that causes pain. NO PAIN NO GAIN is old fashioned and should not be used when dealing with injuries.  All exercises to help correct particular issues should be pain free with the exception of Achilles tendonosis heel drops which have been proven to be acceptable to have some discomfort during the exercise.

Stop chasing the Pain!

In 99% of cases I treat, the site of the pain is never the true cause of the problem. If an athlete only focuses on the site of injury then usually progress will be minimal and the problem will return eventually. This is the equivalent of getting a finger stuck in the doorway and putting a bandage over the finger. By looking elsewhere in the body we actually remove the thumb from the doorway and give it a chance to heal correctly and significantly reduce chances of reoccurrence. At Pro Sport Physiotherapy we use a series of tests with every patient which will show us how certain movements can affect other joints in the body.

Two key stretches usually missed out

Two key stretches that athletes can miss are the long adductors stretch and the piriformis muscles.

Why stretch the adductors?

The adductors are essential to stretch before running as these muscles are on throughout the whole gait cycle. These muscles help flex and extend the hip and this is their true role. For athletes with weak hip flexors or glutes then the adductors can become overused and tight leading to injury. The sciatic nerve also has to pass through adductors and hamstring therefore any adhesion between these two can have detrimental effects on performance.

1) Long Adductors

Adductor Stretch

• Start on the back and keep the foot pointed up to the ceiling throughout. Don’t let the foot drop to the side as this will put more emphasis onto the hamstrings.
• Initiate movement with the side of the hip bring the leg as far apart from the midline as possible. As the end of the movement, give gentle assistance with the rope ensuring to exhale as the rope exerts 2 pounds worth of overpressure. Hold for  2 seconds and repeat 10 times.

1) Piriformis/hip rotator stretch

The sciatic nerve has to pass through this muscle in the vast majority of runners therefore if this muscle gets tight then it can lead to a whole host of problems both up and down the body.

Bring the knee to the opposite arm pit without rotating the rest of the body.

• Hold the knee with the same side’s hand.
• Initiate movement by brining the foot to the arm pit. Give 2 pounds worth of overpressure with the opposite sides hand or rope and hold for 2 seconds. Always exhale during the stretch. Repeat 10 times.

Wrap Up

These are just a few tips to reducing risk of injury while improving running performance. The proof should be in the pudding and by doing these warm ups and following the information above, the athlete should be able to feel a more efficient running pattern while clearing up niggling injuries in weeks rather than lingering on for months.

Eliminating the Risks is a post from: Pro Sport Physiotherapy.

Welcome to the first Running tip of the month from Pro Sport Physiotherapy. As we are located up stairs in Up and Running in Huddersfield and have clinics in Leeds and York, we naturally see a lot of runners from West Yorkshire and Lancashire. We have now been open for business for the past year and the ‘tip of the month’ piece each month will address common issues that we are seeing frequently in the clinic in the previous month or so.

Ankle Mobility

The ankle joint is a very important joint in the body for runners. It is the first major joint in the body that comes in contact with the ground every time a runner walks or runs. Dysfunction in this joint can mean uneven force distribution from the ground right up through the knee, hip and back.  Poor ankle mobility has been clinically proven to be associated with Achilles pain, shin splints, ankle, knee, hip and back pain.

If we look at poor force distribution across our body and think of it like this:

• If 1 yard = 1 step
• 1 mile = 1,760 steps
• 10 miles = 11,760 steps

To conclude: Run ten miles a week with poor ankle mobility = Achilles, shins, ankles, knees, hips or lower back may be taking a beating 11,760 times a week.

This combined with daily activities and post exercise stiffness and its no wonder our knees or backs are sore! If we have poor ankle mobility then it is only a matter of time before pain catches up with us and we get injured!

HOW DO I KNOW IF I HAVE POOR ANKLE MOBILITY?

Ankle mobility will vary from person to person. What we look for at Pro Sport Physiotherapy is that a person’s Left ankle has the same mobility as the Right ankle. If this is not the case then there may be increased work demands on the decreased side. At ProSport Physiotherapy we expect all of our athletes to have 10cm toe to the wall on each side!! Anything less than this and there is a masive increased risk of injury!

Ankle Mobility Start Position

Ankle Mobility End Position

The following test is a simple way to test your ankle mobility and see if there are any major differences:

• Place your foot by a wall and bend your knee so it touches the wall WITHOUT your heel raising off the floor as shown above. The knee should be over the third toe when touching the wall. (This helps avoiding excessive pronation to help and cheat!!)
• If you can do this then move your foot back a few more inches and retest.
• Find the exact point at which you can JUST touch the wall with your knee without the heel coming off the floor.
• You will then measure the distance from your toe to the wall with a measuring tape or mark it with a piece of tape and note the distance.
• This will be your distance for that leg.
• Repeat on the other leg and compare both sides. If there is a difference of more that 1cm then this could be an increased risk for injury.

Points to note: Ensure that the knee stays over the third toe while touching the wall. Sometimes there will be a tendency to leave the knee cave inwards past the big toe in order to reach the wall. This is a compensation pattern and do not allow this to happen!

I HAVE A DIFFERENCE BETWEEN LEFT AND RIGHT, WHAT NOW?

The beauty of this easy test is that it also becomes your corrective exercise! Find that exact spot where you can just touch your knee to the wall without the heel coming off the ground. Come back an inch further and repeat this movement 10 times and then repeat but in a circular motion clockwise for 10 times and then in an anti clockwise motion 10 times trying to touch the knee to the wall. After you have done this then retest your range again. This can take some time to change and should be done before every run on both sides to promote good running mechanics while decreasing the risk of injury.

Note: If you feel a jamming pain in the front of the ankle when doing this exercise or test then there may be a joint problem that may require some manual therapy. If the restriction is just above the achilles then stretching and the above exercise is suited!

If you have any questions about this test or any comments then you can contact us through our website; www.prosportphysiotherapy.co.uk , email: info@prosportphysiotherapy.co.uk or tel: 07003 400 543.

From all at the ProSportPhysiotherapy team, have a great Christmas and we look forward to continue to bring you cutting edge information on Running Performance, Golf Performance and general Human Performance in 2011. If you have any requests for special blog posts email us at the address above!

Running Tip of the Month – December ’10 is a post from: Pro Sport Physiotherapy.