Leg Length Imbalance

Over the last couple of months I have treated three new clients displaying a variety of pain symptoms. These ranged from chronic back conditions to acute knee and hip pain. Now I know three doesn't sound like a great deal but in no more than a couple of months, having three clients present different pain symptoms with pretty much exactly the same underlying cause is a bit weird.

This is something I test for pretty much on the first day but what all three of these clients had in common was that they have experienced their pain symptoms for quite a long time and that they had seen a variety of other rehab professionals with limited or no results.

A you can probably tell by the picture and the title, the common cause of their pain symptoms was a clinically significant leg-length imbalance (anything above 1.4cm) that was throwing their pelvis and as a result their spine out of alignment. This creates excessive loading in all three planes of motion on their knee and foot on the shorter leg while shortening and tightening the muscles around the hip of the longer leg. This creates a significant imbalance between one side of the body compared with the other side and as discussed earlier, can lead to a variety of chronic pain symptoms developed over time. Now don't get me wrong, some people can through their life with this type of imbalance and not experience any pain symptoms, while in other people it may have a significant affect on that person's quality of life. These symptoms can be highlighted by an increase in physical activity or even something as simple as a change of footwear. 

Now this is a dead easy fix to help this, and it comes in the form of an artificial heel lift or simple orthotic. I have mentioned this before in articles, I usually do not endorse products and I am certainly not on commission (although I wish I was) but the one I have been using for the past couple of years with some great results with a variety of clients is the Clearly Adjustable Heel Lifts (see picture below).

Now I use these for a number of reasons; a) they are very cheap; b) they are comfortable; c) they are not permanent; d) we can adjust them to suit the individual and make minor adjustments over a period of time.

Now in no way am I saying this is the cause of all problems but it is more common than you think. So if you are in a great deal of pain or discomfort and other methods or treatments have not worked, book yourself into see a qualified therapist and get this checked out. 

 Being pain free really can be as simple as spending a tenner on a piece of plastic that fits into your shoe!

If this sounds like something you might be experiencing, or know someone who is then please get in touch. I would be only too happy to answer any questions you might have. 

Either drop me an email to: darrenthomas10@hotmail.com or give me a call on 07834616197.

Guest Blog: Soccer Butts - why the glutes are vital to a footballer and any other athlete

YOU'D PERHAPS be surprised to learn the identity of the body's most powerful muscle group, which drives good function on the footy pitch.

'I know the title of this article is a little tongue in cheek (excuse the pun) but I thought: What better time is there to talk about the most powerful muscle groups in the body and the powerhouses that drive good function and football performance.

'As you probably have guessed, the term "soccer butts" refers to the large and powerful muscles that make up the glutes (gluteus maximus, gluteus medius, piriformis and the hamstrings) or as we like to call them"The Back Butt".

'The Back Butt I hear you say? Surely we only have one butt. Right? Well maybe not. As a very general rule if we can think of the muscles in the back butt as the ones that control hip flexion, it would make sense to also have a "Front Butt" made up of the muscles that look after hip extension(hip flexors, hip adductors, TFL, quads).

'I think I have mentioned this in some of my previous articles, but when we look at the function of the human body it is made up of bullies and the bullied.

'What I mean by this is that there are areas of the body that commonly display poor functional movement but rarely get injured themselves or display pain symptoms as a result.

'We call these the bully areas or bullies and predominantly they are the feet, the hips and the thoracic spine. Many of you reading this are probably thinking I know loads of people who have hip pain or foot pain, but I bet you know way more people that have or have experienced lower back pain (lumbar pain), shoulder pain, knee pain or shin splints.

'These are the bullied areas of the body that often pick up the slack and develop pain symptoms because of the poor function of one or more of the bully zones.

The hips are certainly one of  the most prevalent causes of pain and dysfunction in the human body. 'They yield a massive amount of power and directly influence how effective your abdominal muscles are, what goes on at the knee joint, at your feet and even what happens in the shoulder.

'The relationship between the muscles of the front and back butts and the rest of the body is a very complex one. Maybe a little too complex to go into here, but rest assured that training your butts in the correct way for football and other sports will not only improve your speed, power, balance, agility and strength, but also vastly limit the amount of injuries you will pick up during a season.

'For fans of Adam Sandler movies like me, you will probably be familiar the film Happy Gilmore and the favourite saying of his golf coach in the movie Chubbs (Apollo Creed) "It's all in the hips".

'In terms of human movement, no truer word has ever been spoken, take a look at the video below and enjoy trying out the exercises. They are designed to target successful hip motion and stability for better sporting function. Hopefully you can persuade your coaches and trainers to include them in your pre-season fitness regimes and warm ups.

Look out for part two in the Football Butts series where I will share some of the more intense techniques that will help you become faster fitter and stronger for next season. You never know, it could help you win the league next year.

As usual, I would love to answer any questions you may have or even just hear your thoughts on the article so please feel free to drop me an email:
darren@synergyhealthstudios.co.uk

Or simply leave a comment blow and I will get back to you as soon as I can

I am as always looking forward to hearing your thoughts.

Yours in better function, Darren

The Hamstrings: Why they get injured and what they are really meant to do.

I originally wrote this post a little while ago, while footballer Jack Rodwell was still playing for Everton. Since then,  there have been a few changes in Jack's career, most notably, a big money move to Manchester City. What has not changed however is the recurring hamstring injuries he is continuing to suffer from. Even a trip to the famous rehab  specialist Dr Müller-Wohlfahrt has not helped. Looks like the physio and rehab specialists at both Man City and Everton have not read my blog yet. The real shame is however, that these types of injuries are still all too common in football as well as other team sports, players are being continually let down by rehab, medical and conditioning staff who still have a very old school idea of what the hamstrings do during a football match or upright function in general.

So with these injuries fresh in the minds of all football fans on Merseyside, Manchester and the whole of the UK, maybe this is an ideal time to repost this blog and share with you some of the thoughts and ideas on how we might look and aim to treat a hamstring injuries and ultimately prevent them from reoccurring.

In order for us to prevent or treat a hamstring injury, we need to know what the muscle does. Throughout my university degree and personal training and sports injury therapy courses I was taught that the main job of the hamstrings is to flex the knee joint.

Although this is true when sitting or lying down, when walking, running or playing football THE HAMSTRING DO NOT FLEX THE KNEE! In fact, they do the exact opposite and act as knee extensor; it's actually gravity that flexes the knee and not our hamstrings.

In the video below Gary Gray mentions that the hamstrings are probably the most important muscle in human locomotion, they are responsible for decelerating motion in every plane, during every step, twist or turn.

As I have mentioned in the last article in the series, just like the knee, the hamstring are also an area that gets bullied and has to pick up the slack to help out other muscles and joints around them that are not functioning the way they should.

So with this in mind then, in the case of Jack Rodwell it would be a good idea to start looking at other areas of the body that may be working sub-optimally and putting the hamstrings under greater stress to increase injury risk in this area.

During the video Gary mentions, problems with foot, hip or thoracic spine function will put extra pressure on the hamstrings and possibly make a player more venerable and increase the risk of hamstring injuries.

I apologise for the complex answer, but while researching this article I came across this amazing video by a highly qualified Physiotherapist and "The Father of Function" Gary Gray, who explains this a lot more eloquently than I ever could:

So now we have a slightly better understanding of what the hamstrings actually do and what could potentially cause a hamstring injury, below are my top tips on what you should and should not be doing to help rehab and condition your hamstrings and prevent injuries:

* The hamstrings DO NOT flex the knee so get off those leg curl machines; they will only make the muscle shorter and tighter, actually de-conditioning the muscle for football.

* Avoid static or PNF stretching. There are no scenarios on a football field where you have to hold your muscles in an extended state for any length of time. In fact, recent evidence suggests that stretching your muscles in this way might de-train the nervous system and limit the ability of your muscles to load effectively and pull you out of a dangerous situation.
Dynamic stretching is much more effective: Moving your muscles into a lengthened state and coming straight back out of the movement prepares them much better for the demands of football.

Check out the video in my running blog (click here) these dymanic mobility exercises are designed for running but can be easily tweaked and adapted to help football players and participants of other sports

* Train as specific as possible to football. Come away from machines or any device that puts artificial loads on the body. As a basic rule free weights are better as they will load your muscles more closely to how they work on the field.

* Move in all three planes at a variety of speeds. Football is a multi-planer, dynamic game that is not played in straight lines. Your training should involve twisting, turning and side to side movements that stress the hamstring in ways it would be stressed during a match. Where possible try to make these movements as reactive and random as you can.

I hope you enjoyed the article guys. As always, please leave a comment to tell me what you think or alternatively, please contact me by email: darren@synergyhealthstudios.co.uk, or Phone: 07834616197 with any questions or queries you may have.

Preventing sporting Injuries Taking a look at the knee: Part 2

Hi everyone, welcome back to my preventing injuries and bullet proofing your body for sport series. This time we are revisiting the knee and I have teamed up with Ben Woolley our Head Physiotherapist at Synergy Health Studios. Myself and Ben have created a great video showing you fantastic technique to help rehab knee injuries and help prevent them from occurring in the first place. As promised in my previous article (Taking a look at the knee part 1: click here) the video provides a practical example of a technique we would incorporate into our rehab and conditioning sessions to help improve the function and stability of the knee.

Remember though guys, you don’t want to be training through pain so if any of the techniques in the video hurt more than a dull ache then you need to see a professional therapist for some bespoke help.

I hope you enjoy the video and please feel free to leave a comment to let us know how you got on with the exercises or to ask further questions regarding injury treatment or training for better function. Also, feel free to email me at darren@synergyhealthstudios.co.uk regarding anything you do not want to share publicly.

Thanks again for following my posts, keep an eye out for future articles and more great information regarding functional training and rehab!

Preventing Football Injuries: Taking a look at the knee

Welcome back to our Preventing Football Injuries series. Our trip up the body from the foot and the ankle now takes us to the knee.

'There have been a number of quite high profile injuries to premiership football players over the past few months.

I originally wrote this post February 2012 when Premiership players Nemanja Vidic of Manchester United and Everton's Phil Jagielka sustained pretty serious knee injuries.  We are getting down to the business end of the football season now and players are having to deal with a variety of ground conditions as well as increased pressure and competition for promotion and cup wins. So with the competition getting more and more intense, I thought, what better time to help you guys out with some information on how to reduce the risk and hopefully avoid knee injuries to help you extend your playing careers.

'When looking at the knee, we observe a simple yet complex joint. We look at the knee as an area that is constantly bullied by other structures.

'Our understanding of function tells us that during upright movement (anything stood upright), the actions of the knee are almost entirely governed by what is happening at the foot and the hip (and to a lesser extent the entire trunk and upper body).

'If one or a combination of these structures are not functioning correctly and are unable to control motion through the required range of motion for a particular activity, the knee joint is taken through movements that go against its optimal functioning. Potentially leading to increased injury risk.

'As we have said numerous times before, football is one of the most dynamic games on earth. Players have to cope with constant speed and direction changes, external impacts from other player as well as a variety of different movements such as running, jumping, heading and tackling, all putting a different strains on the knee.

'Ground and weather conditions also play a big role so if your body is not properly prepared then your likelihood of picking up a serious injury will be greatly increased.
Remember Michael Owen's ACL rupture during the 2006 World Cup?

'So with what we have just talked about and having just looked at the video, the question I wanted to raise in this article is this:

'Are we as therapists, trainers and coaches, properly applying the principles of football biomechanics to create the best possible treatment and training environment to help players recover from and ideally avoid future knee injuries?

'My answer to this is probably a controversial one but from what we saw in the video and the frequency of knee and muscle injuries in football at all levels, I would have to say a resounding NO! As in previous articles we need to ensure that our rehab and conditioning cover as many principles of movement specific to football as possible.

'With this in mind then, let us go through some of the principles or unarguable laws of nature that should be addressed when rehabilitating the knee and any other football injuries:

1.The body does not work in isolation. The movement at one joint or segment will have some sort of chain reaction effect on all other parts of the body. So train or treat your body as a whole machine. Get away from those resistance and Smith machines at the gym.

2.Every move we make is tri-planer. In other words, our body is always moving in all 3 planes all at the same time. So make sure you are not just training in the saggital plane like most traditional gym movements. Adapt your treatment and workouts to move in multiple directions at different, ranges, angles and speeds.

3.Get up off the treatment couch. Our muscles and joints move in a completely different way during upright function. We should not be using seated or supine assessment or treatment methods as our main form of diagnosis or treatment. They certainly have their uses but only to help you confirm what you have seen during upright movement.

4.External forces such as gravity, momentum, ground reaction and even other players and the ball drive movements through our body. This is a big one, but because of this our muscles do not drive our bones. They react to the movements of our bones to slow down the effects of gravity, momentum, ground reaction and other external forces by lengthening (loading)to slow things down before exploding to produce force and create movement. Don't believe me; try jumping without first sinking down towards the ground before takeoff.

5.Football is reactive. At least 99% of what you do on the field is completely subconscious. Making our training and treatment sessions as reactive as possible will help turn on your nervous system to automatically protect your muscles and joints from potentially dangerous situations (have another look at the Michael Owen video)

As you will probably all agree this is a bit longer and a little different to the previous articles, but don't worry a video giving you great tips and training methods will be on its way as a follow up to this article.

The principals covered in this article will not just apply to football however but to all dynamic team sports, where players have to react and adapt to stimulus within a game scenario. Obviously the techniques used will be adapted to be more specific to other sports but as a general rule, the principals described above would be the same.

Please fire any questions you may have my way and I will be happy to answer them. You can contact me on 07834616197 or email: darren@synergyhealthstudios.co.uk. Or alternatively just leave a comment below and I can get back to you that way.

Ankle Rehab Part 2

Recovering from Winter football ankle injury

IN THE third of a series of guest blogs by sports injury specialist Darren Thomas, Darren discusses further tips for recovering from ankle injuries sustained on those unforgiving winter pitches. Darren, from city centre health studio Synergy, has also filmed a video showing techniques any footballer can use to enhance their rehab. He says, ‘Last time we talked about the importance of warming up the ankle and taking the muscles and bones around the ankle through motions that they might go through on the football field. ‘We also talked about the speed you would do these movements at so we can get even closer to what goes on in the ankle during football. ‘In this article, the video gives some examples of exercises or rehab techniques to implement a little later in the rehab phase if pain symptoms allow. ‘These exercises, although have a focus on stabilising the ankle will also help you develop power, speed and reactivity while focussing on the energy systems you would use during football. ‘These are great exercises to incorporate into your warm up/conditioning parts of your football training sessions or before a game. ‘You may be able to incorporate these exercises any time during the rehab phase if pain symptoms allow. The exercises can also be done a slower rate, or if you feel you are ready at a much faster rate than on the video to help improve reaction times and changes of direction speed. Tags: biomechanics, Fitness, injury rehab, Personal Training, Physiotherapy, rehab, sports injury, synergy health studios

Bullet-proof your ankle for football

Bullet-proof your ankle for football

Having to contend with my own re-occurring ankle complaint over the last 18 months, and seeing several former team-mates also sidelined for months, I was interested in how to ‘bullet-proof’ my seemingly fragile pins. Darren says, ‘With Lateral ankle injuries common place among football players and in fact all sports people; this seems as good a place to start our series on preventing football injuries. ‘Studies suggest that lateral ankle injuries make up around 15% of all recorded sports injuries, with around 70% of these people suffering a recurring injury within 6 weeks- 24 months. ‘The video attached to this article gives you some examples of exercises and techniques we have utilised to successfully to treat and prevent future lateral ankle injuries here at Synergy. ‘We would generally use these types of movements as conditioning exercises for the ankle quite early on in the rehab process and then again as warm up exercises during the later stages of rehab and conditioning sessions. ‘Remember, there is no set rule when rehabing an injury. Everyone is completely different and there is not set time for an injury to heal itself. These exercises might not be right for everyone but they should provide a decent starting point. ‘On the video I go through the movements quite quickly, if this causes pain then the movements can be just as effective at a much slower and controlled pace with a smaller range of motion. ‘If however you are using these exercises during your warm up start slow and build up to a fast and quite intense pace. As long as you can control the movement, the quicker the movement the better, as movements during a match or training will be quite fast and intense. ‘I am happy to answer any questions. You can contact me via Twitter: @darrensynergy or email: darren@synergyhealthstudios.co.uk ‘Look out for part two of this series where we will go through some techniques for the later stages of rehab focussing more on the whole body movements and the energy systems you would utilise during a football match’.