Commonwealth Day #1 – Reflection 1

XX Commonwealth Games

Commonwealth Reflection #1:

So yesterday saw my first shift in the Commonwealth Games Polyclinic as a physiotherapist. Working alongside multiple professions under one roof is the idealist approach to rehabilitation and it works rather well.


Its my first experience at a multi-sport event, such as the Commonwealth Games, and yesterday was interesting. The polyclinic runs as an MSK service for athletes, volunteers and games family members.


The What?

Yesterday, I saw approximately 10 athletes from a variety of sports including discuss,  shot put, weightlifting, swimming, and table tennis. The variety of conditions presented included patella tendonitis, ulnar nerve irritation, patella femoral medial facet osteochondral defect, and congenital hip dysplasia.


So What?

All athletes receive a full and thorough assessment from one of the qualified therapists in the poly clinic MSK service. As part of the assessment  we have to take a subjective history. One of the learning points that I reflected on from yesterday was communication. The commonwealth games consisting of multiple nations from the commonwealth meant some athletes had limited understanding of the English language which meant they often came with a team member or staff member to aid communication. Naturally, this is time-consuming but can be effective as long ass questioning is succinct and appropriate. A further point around communicating through an interpreter is consent. It’s important that the athlete give consent for the other person to translate.

Lightening Bolt Strikes Again
Lightening Bolt Strikes Again

The polyclinic environment is vibrant and buzzing with athletes seeking professional advice to optimise their performance in readiness for their upcoming competition. The closeness of other professions within this setting means athletes, volunteers and family members can get medical services quickly. As a physiotherapist that has worked in the NHS and private sector, it’s often the case that these referrals can take some time to come to light. However, yesterday saw how effective a polyclinic environment can prove to be, and this was my first experience of the immediateness of a polyclinic environment. I was able to refer a patient to see a SEM doctor for a hip review within  a few hours – usually it would be quicker, but due to it being end of the day, an appointment was booked for the next morning.


A further example of the polyclinic environment functioning effectively was demonstrated when an athlete arrived at 3pm to see the SEM doctor with a suspected meniscus tear, saw myself for some immediate conservative management at 3:30pm, booked a MRI 6pm and results returned by 7pm. The speed of action from the polyclinic team meant that athlete was able to have diagnosis and intervention within a few hours and discharged back to the team medial staff for ongoing rehabilitation.

Now What?

  1. The immediate impact of the polyclinic environment has driven me to understand the further need for improved seed of onward referral in acute conditions. this not only eases the athletes and medical team state of mind but also provides the athlete with the best opportunity for recovery effectively.
  2. Communication in a clear and concise manner is important when treating international athletes. even a small mount of foreign language knowledge from the therapist can aid an assessment and information gathering. Use of posters and body charts or visual aids can aid non-verbal communication. Consent should always be gained from the athlete if translators are present, whether it’s a team member or medial team member.

Thanks for reading, hope you enjoy the blog, watch this blog for more Commonwealth games posts



World Cup Injuries – Luis Suarez’s Rehab

Courtesy of The Guardian
Courtesy of The Guardian

After the recent hype around Luis Suarez’s injury and the likelihood of him returning to crunch match tomorrow evening. I’ve re-blogged this post by Amy Buckley from AposTherapy about Luis rehab undertaken to get him back in the game. Enjoy:


Millions of football fans worldwide are following closely after Luis Suarez recovery from his recent knee injury. His absence from the game with Costa Rica had a great impact on Uruguay team performance, and now the speculations are if he’s going to play the game vs. England.

Our specialists at AposTherapy decided to provide some professional insights on Suarez injury, treatment and a recovery process.

Suarez suffered from meniscus tear, a knee joint injury, common among football players, when the knee is twisted whilst in a partially flexed position and the foot is firmly planted on the ground.

The medial and lateral menisci of the knee are two crescent-moon-shaped disks of tissue (fibrocartilage) that lie between the ends of the upper leg bone (femur) and the lower leg bone (tibia) that form the knee joint. The menisci act as shock absorbers, evenly distributing the load across the knee and helping to keep the joint stable.

Symptoms of a meniscus tear depend on the size and location of the tear and whether other injuries to the knee occurred with it. A significant problem with meniscus tears manifests itself through ‘locking’ of the knee.  Luis reportedly suffered a lateral meniscus tear, a condition that may be pointed by a significant pain at the outer side of the affected knee.

Treatment options include: Nonsurgical treatment with rest, ice, compression, elevation, and exercises. Surgical repair to sew the tear together. Surgical removal of the torn section (partial meniscectomy). Neuremuscular control treatment. Total meniscectomy, which removes the entire meniscus, is typically avoided because of the increased risk for osteoarthritis (wear and tear).

Luis Suarez, for instance, underwent an arthroscopic. After his surgery, Luis was seen leaving the hospital immobilised with a brace.

Recovery from a meniscus tear depends on many things. The goals of rehabilitation are to restore range of motion, strength, and return the player back to a sporting condition.

Initial stages of rehabilitation will focus on restoring normal range of motion, normalising gait, eliminating swelling, and pain control to enable rehabilitation.

At the second stage of rehabilitation, the player works on good control of the knee through non-impact proprioceptive drills, hip and core strengthening, and quadriceps strengthening.

The final stage of rehabilitation concentrates on returning the player back to the sporting arena through completing sports specific movements and gradually re-introducing impact based activities.

At present, Luis is 3 weeks after his surgery, and through the help of his medical team, he will be working on impact control exercises, increasing the load and demand through a range of plyometric exercises. In addition, he will be working on sports specific balance and proprioceptive drills, hip and core strengthening, and return to light training in preparation for his appearance against England on Thursday.


By Amy Buckley posted Jun 17, 2014, AposTherapy Blog

Outdoor Training Time

The Warm-up Trail

In this series of blogs we are going to take a look into the world of training outdoors with Chris Watson, an expert in outdoor personal training and conditioning. Enjoy this weeks blog:

Run! Here come the boys…

Now that summer is finally upon us and the weather seems to be picking up (hopefully) it’s time to leave the treadmill behind and get outdoors and into your local park! Don’t get me wrong I love the gym but what’s the one thing many gyms don’t have? Space! Especially during those peak hours at lunchtime and after work. No more waiting for machines or banging into people at the squat rack. So what’s so good about training outside I hear you ask? Well, it’s free, you don’t need any kit and when the sun is shinning on a summers evening there’s no better place to train. So let’s get our gear on and get outside!

First you need to identify a suitable park, preferably within running distance from work or home. Use the run there as part of your warm-up. Find a good spot, something that has a handy bench and maybe a few trees nearby. Give the area the once over, gotta check for the usual suspects, glass, stones, dog muck, etc. Now you’re ready to get stuck in. The fun bit about outdoor training is using your surroundings, get creative! Sure have a plan in your head of what you want to do during your session, but you may find a tree perfect for pull-ups or an old tree stump for box jumps or a handy bench for dips. Every park offers hidden training gold.

I have various parks where I like to train as each one offers something a little different and that’s how I structure my training session or that of my clients. For example, a typical session will consist of a light jog to said park, a dynamic warm-up then usually 5/6 exercises over 3/4 sets with varying rep rates. I’d always allow a good hour. Start with a 10min run followed by a 5min warm-up to get nicely stretched. Around 25/30 mins for your session, finishing off with a light warm down run (back). Spend at least 10mins stretching at the end. Job done!

Man of Steel…

Over the next few weeks we’ll look at the different types of sessions you could plan. Whether you have an hour or just 20 mins. The exercises you could include and the effectiveness of weight-free training for burning fat. Things you can use, goals you can set and how you can bring a bit of fun to your training.

Thanks for reading and see you next week

[level 3 PT- outdoor training specialist]

Chris Watson

Enquires for PT to

Neuromuscular Control – What does it mean???

Neuromuscular Control – What Does it mean?

Neuromuscular control is certainly a complex procedure undertaken by the body but this has been made easier to understand by Vern Gambetta, a top performance coach from the U.S. Great reading and this will certainly improve that understanding of movement.

Movement is quite simple and from that wonderful simplicity comes the complexity of sports skill and performance. Twenty-five years ago in an attempt to better explain movement and how we should effectively train movement I came up with this simple diagram I call the Performance Paradigm.
It was somewhat like what Albert Szent-Gyorgi, once said, “Discovery consists in seeing what everyone else has seen and thinking what no one else has thought.” Essentially it is the stretch shortening cycle of muscle with a more global interpretation and proprioception brought into consideration. It is the basis for what some people call the Gambetta Method; to me it is common sense. I use this to evaluate movement efficiency or deficiency and then to guide training and if necessary rehab.

Essentially all movement is interplay between force reduction and force production. The quality of the movement is dictated by our proprioceptive system. We begin movement by loading the muscles – this is the force reduction phase. Basically this is the eccentric loading phase as a well as instantaneous isometric action that lends stiffness to the muscle. This is the most important component of the performance paradigm, but probably the most overlooked as well as the most misunderstood. There are several reasons for this; the most notable being that it is less measurable. Because it is more difficult to quantify we have tended to emphasize the more measurable component, force production. It is during the force reduction phase that most injuries occur. Think landing on one leg and tearing an ACL or planting to cut and spraining an ankle. It is during this phase that gravity has its greatest impact; it is literally trying to slam the body into the ground.

Once force has been reduced the subsequent result is force production. Force production is easy to see and easy to measure. Consequently it gets an inordinate amount of attention in the training process. We see it because it is the outcome. It is how high or far we jump. It is how much we lift. But just because it is easy to see and measure does not mean it should receive the inordinate emphasis, in training that it does. It must be stressed that it is the component of the performance paradigm that is highly dependent on the other phases.


The third component of the Performance Paradigm is proprioception. Ultimately it is the glue that binds a whole functional program together is proprioception. Proprioception is the awareness of joint position and force derived from the sense receptors in the joints, ligaments, muscles, and tendons. It is that component that gives quality to the movement. “The quality of movement, in part, is dependent upon neurologic information fed back from proprioceptors within muscles and joints to the higher brain centers. The information returning to the central nervous system from the periphery includes “data” concerning tension of muscle fibers, joint angles, and position of the body being moved.” Logan and McKinney (Page 62) It is the feedback mechanism that positions the limbs to be able to achieve optimum efficiency. It is a component of movement that has been all but ignored in most traditional training programs until recently. It is highly trainable, especially if it is incorporated as part of a whole program.

It is almost too simple. Perhaps to appreciate proprioception we should look at the extreme case of a stroke victim that is able to return to normal movement patterns. Why can’t an athlete who has all their capacities enhance the quality of their movement by focusing on the same things that the stroke victim has to focus on to get back to function? The key to that is proprioception. We must strive to constantly change proprioceptive demand throughout the training program in order to enhance the quality of movement.

The performance paradigm will serve as a guide to determine how we train all components. It can also serve as a very useful guide to help us to evaluate movement from a slightly different context. It should serve as a guide to be more functional in our approach by emphasizing the timing and sequence of all three components of the paradigm. The synergistic interplay between them will produce the highest quality of movement.

It is very easy to get caught in the trap of measurable strength. How much you can lift or how many foot-pounds of force you can express on a dynamometer are meaningless numbers. Functional training does not depend on measurable strength. Quality of movement, coordination and rhythm are more important. The goal is always to apply the strength that is developed in the actual sport performance. How is the force expressed? Can you produce and reduce the force? Force production is all about acceleration, but often the key to movement efficiency and staying injury free is the ability to decelerate and stabilize in order to position the body to perform efficiently. A good functional training program will work on the interplay between force production, force reduction and stabilization. The end result is functional strength

Thanks for reading, see my next post on ACL and neuromuscular control!!!

TA Physio

prehab not rehab for sport injury prevention
prehab not rehab for sport injury prevention

Top 5 Cycling Injuries

Top 5 Cycling Injuries

The increased popularity with cycling both road and mountain bikes has seen an increased rise in cycling related injuries. Competitive cycling involves high speeds created by large gradient downhill sections and this can lead to falls. The higher the speed the greater the forces sent through the body and generally the more serious the injury, hence the essential helmet.

The TA Physio Top 5 Cycling Injuries:

1) Lower Back Pain

2) ITB Syndrome

3) AC Joint Sprain

4) Cuts & Grazes

5) Feet Numbness

What is it?

The repeated and prolonged held position in cycling means stress goes through the whole of the spine. The flexed position required to maintain good aerodynamic performance and generate force to pedal leads to lower back pain. In some cases this can lead to herniated lumbar discs and nerve root impinging, but this is rare.


Prevention is better than cure. Back pain can be avoided by simply having your bike set up correctly to avoid over reaching in the case of a frame being too large and hunched posture in the case of the frame being too small. Check out the frame size calculator. It is also essential to warm up, head to toe, cycling mainly involves the lower limbs but the spine is involved. Don’t neglect it!

2) ITB Syndrome

What is it?

The ITB (Ilio Tibial Band) is highly talked about in rehabilitation and physiotherapy, it’s seen as a problem in many knee injuries and is commonly affected amongst cyclists due to the repeated bending and straightening of the knee. It runs from your hip to the outside of your knee, so The repetitive motion of cycling, or running, can lead to ITB becoming irritated as it moves over the outside of the knee.


The prevention if ITB Syndrome is down to bike set up. Saddle height dictates knee position, if it’s too high then the knee over straightens, if it’s too low then the knee over bends. Ideally, the frame should have 1-2″ clearance from crotch to the top tub of the frame. The saddle height should be set to allow a small knee bend when the pedal reaches the bottom of the revolution. Also, Its advisable to avoid in toeing when cycling, this increases the stress through the ITB. The ITB can be offloaded and supported through the cycling motion with some SportTape Kineisiology tape.

Sport Tape UK ITB Taping
Sport Tape UK ITB Taping

3) AC Joint Sprain

What is it?

The Acromio Clavicular Joint (AC Joint) is one part to the should complex and consists of the collar bone joining to the front of the shoulder blade which is held together by strong ligaments.

The AC Joint Sprain refers to the damage to these stabilising ligaments. It takes a large force to cause these sprains like a fall or hitting a monster drop such as a pot hole or off road obstacle.

The position of holding the handle bars to control your bike means the elbows and wrists are generally locked in position. When a large force is applied, these forces are shifted to the shoulder joint.

Check the drop sign for AC Joint Sprains
Check the drop sign for AC Joint Sprains


The simple answer is to avoid falling. The AC Joint is vulnerable to injury during falls and large front wheel forces created by those lovely potholes. Try to use the elbows as a shock absorber if you can’t avoid those huge public road pot holes. AC Joint sprains occur at different degrees, and the severity of the injury dictates what can be done to rehab it.

4) Cuts, Grazes & Burns

What are they?

The cuts and grazes generally occur from falls to the ground, but most cyclists in competitive sport suffer friction pains at some point in their careers.

Saddle Position is Key, especially if its a 100mile sportive
Saddle Position is Key, especially if its a 100mile sportive

The commonest location for friction to occur is where the rider meets the bike, the saddle. Saddle sores are common amongst amateurs but miraculously professions and regular cyclist develop an iron like resilience to this issue.


The cuts and grazes can be avoided by concentrating on your ride and staying on your bike, there is no room for daydreaming in competitive riding.

The saddle sores can be aided by a comfortable saddle, correct saddle angulation, sufficient cycle short padding. The more you ride, the easier it gets, so ride regularly to get used to it. It may be possible settle this post ride by sitting on an ice pack for 10 minutes but this may raise some eyebrows in the post ride pub.

5) Foot Numbness

What is it?

Foot numbness is a loss of feeling in the feet, it is common amongst cyclists and it’s not solely down to the cold weather we suffering the UK. It can occur due to an ill-fitting cycling shoe squeezes the metatarsal heads, cleats being placed too far forward causing increased pressure around the ball of the foot, cycling technique including low cadence and excessive hill riding can lead to numbness.


Prevention of foot numbness can be achieved through correctly fitting shoes. Position of the cleats is important, ensuring that pressure is not focused on the ball of the foot. Hill climbing is important in cycling events but hill training should be tapered, so reducing hill climbing may help the problem. Hill climbing involves excessive push phases of cycling which means increased foot pressure, hence numbness.

Thank you for reading TA
Physio’s Top 5 Cycling Injuries.

Please contact us should you have any questions about your cycling injury.



The Glute vs TFL Muscle Battle: Proper Exercise Selection to Correct Muscle Imbalance

Hey guys, I’ve been very busy lately so thought I would share this brilliant blog post by Josh Stone regarding exercise prescription and exercise selection. It’s following a study about clinical exercise selection and its outcomes:

Selkowitz, DM, Beneck, GJ, and Powers CM. Which Exercises Target the Gluteal Muscles While Minimizing Activation of the Tensor Fascia Lata? Electromyographic Assessment Using Fine-Wire Electrodes. J Orthop Sports Phys Ther. 2013; 43(2):54-64.

Overview and Introduction:
Vladamir Janda revolutionized human movement dysfunction and rehabilitation when he described three compensatory movement patterns as a result of pattern overload and static posturing. Most musculoskeletal injuries are multifactorial, but more often than Janda’s described three compensation patterns – upper crossed syndrome, lower crossed syndrome and pronation distortion syndrome – are the key contributor to our pain complaints.


Since Janda introduced this topic research has continued to answer what and why questions surrounding these compensatory patterns. We have learned hypertonic / hypotonic muscles and the delicate interplay they have on integrated functional movement. Studies continue to show how these dysfunctional patterns lead to our most common injuries – PFPS, ITBS, Achilles tendinopathy, plantar fasciitis, epicondylopathy, biceps tendinosis, impingement syndromes, MTSS, etc.

As research evolves we continue to fine-tune our clinical decision making. For several years now rehabilitation journals have published articles linking a myriad of injuries to lower-crossed syndrome, gluteal inhibition, and over-activation of the tensor fasciae latae (TFL). We have learned that these should be a focal point in our rehabilitation techniques to resolve lower extremity overuse injuries. The article by Selkowitz, et al., in the Feb 2103 edition of JOSPT is unique and what I believe to be one of the most clinically relevant studies to be published in the last few months. I liked it so much I had to blog it
Statement of the Problem:
A common descriptor associated with lower-crossed syndrome is femoral internal rotation and hip adduction. From a rehabilitation perspective we must enhance neuromuscular firing of hip abduction and external rotation. In addition we must inhibit over activity of hip adductors and hip internal rotators.

As a health care practitioner we understand the delicate interplay of functional anatomy. The problem is how do we inhibit a chronically hypertonic TFL while activating the hypotonic gluteal group if they both produce similar movements? It is a fine balance we must be cognizant of when designing rehabilitation programs.

This study examined which exercises elicit the greatest gluteal (medius / maximus) activation while minimizing activation of the TFL. This is exactly what we need to know when designing a rehabilitation program to target lower crossed compensatory patterns.

Study Methodology:
Electromyographic data of the gluteus medius and superior gluteus maximus was collected utilizing fine-wire electrodes on 20 healthy participants during the execution of 11 exercises.

Seven of the 11 exercises -bilateral bridge, unilateral bridge, side step, clam, squat and two quadruped variations – demonstrated statistically significant greater muscle activation in the gluteus medius and gluteus maximus when compared to the TFL. Side-lying hip abduction, hip hike, the lunge, and the step-up were either not significant or demonstrated higher TFL values compared to the gluteal group.


The authors ranked the exercises in order of highest gluteal to TFL ratios. Clam, side step, and unilateral bridge had the highest ratios, while lunge, hip hike, and squat had the lowest ratios.

Clinical Application of Data:
Altered arthrokinematics and muscle imbalances are a common cause of overuse injuries. Lower-crossed syndrome is a common compensatory pattern that is associated with hypertonicity of the hip flexors complex, which elicits altered reciprocal inhibition of the gluteal group. Targeting this dysfunctional pattern using proper exercise selection indicated here can prevent injuries, improve patient outcomes, and restore optimal function. When designing your program be sure to reference the material here to determine a proper rehabilitation program.

Studies are equivocal on reliability of surface EMG vs intramuscular. However, the authors cite using the method by Delagi and Perotto, which appears reliable. Still one has to question specificity and sensitivity to a minimal degree.

The participants were instructed on proper exercise technique. However, substitutions patterns are common in patients exhibiting muscle imbalance. Any slight deviation from proper technique can skew the data. I am curious how closely exercise technique was monitored and what occurred when deviation did occur.

Like I said from the top, rarely do we have a published data with such clinical relevance. Studies that show how deep ultrasound penetrates a rats muscle are great, but clinically have little clinical utility. Data revealed here will guide decision making on proper exercise selection and ensure they are applying the proper strengthening exercise to specifically target the underactive glutes while avoiding the over active TFL. Kudos to the authors.

Endurance Test – South Downs – South Downs MTB

Wonderful Image of Richard Sterry on South Downs from Anne Dickins –

So the South Downs mountain bike endurance race is just a round the corner, and to give those crazy enough to take on this 17 hour challenge, you may want some insider tips to get one up on fellow enthusiasts.
Many cyclists taking part in this challenge are already in training, if you’re not then it probably best you get training now and make friends with your mountain bike saddle.
It’s common for novices to partake in these events without thorough preparation, but even experienced endurance athletes get injuries. Hopefully, this will give you some training advice and preparation to avoid injury. The basis of any good training should consist of the following approach: –
1. Functional
2. Tapered & Endurance Based
3. Restful
4. Race Prepared
1. Functional training is a key component in many prehab and rehab programmes. The therapy behind this approach to training is quite simple, train the muscles and respiratory systems to do what you want them to do. It’s important to put the time in on the bike to feel the benefit when it comes to race day. It’s not good enough to just poodle around to your local shop, you need to put in the hours on your bike including things like repeated hill climbs. Other than wearing out the tires on your bike, you can do some function training at the gym too. Kettlebell training is a good example of function training that trains all over the body as well focusing on the large muscles group that extends the hips known as glutes. During cycling, the glutes play a massive role in producing the power phase, this is demonstrated perfectly below with the red muscle group (A).

cycling muscles

2. Tapered training – The importance of training is obvious if you want to succeed at endurance events, muscles don’t adopt by sitting in front of the TV, however, training needs to be tapered and graduated. Realistically, this 17 hour mountain bike event is the equivalent of running a marathon, so gradually incremental training is key. The best way to monitor your training increments, is by totalling the mileage ridden each week, but training is not just about miles. As well as distance and endurance, training for these events need o include speed sessions on hills. Not all mountain biking is down hill, so get on those hills and push your self to the limits and you will notice easier ascent during the 17 hour marathon.

Josh Ibbett smashes South Downs Double record: 17h 47m 30s

3. Restful training does not mean sitting in front of the TV watching mountain bike videos and wistfully thinking that’s going to make you a better rider. It’s equally important to get rest days catered into your training routine as it is intense training days. During these rest days, even consider daily activities as a work out i.e climbing stairs, going to work, walking to the shops. Rest is important for recovering muscles as well as a balanced diet and high nutritional intake.4. Being race prepared is vital, do not underestimate the power of the mind. Have a strategy in mind that will help you complete the race, pace your self to save some energy for the final push. An other key element in race preparation is ensuring your bike is biomechanical set-up to give you that extra advantage, its worth spending money to get a professional bike fitting, it may just help you pip your mate to the post. And finally, dont be afraid to attempt an event before the main event, this will enable to put all these race preparations into practice and iron out any gremlins.

Down and Dirty
Down and Dirty

Happy biking and enjoy the race.
Thanks for reading
TA Physio

Kiniesiology Taping Course



This exciting one day clinical Physiotherapy course will enable participants to:

  • Develop their understanding of the role of Kinesiology taping
  • Develop expertise in the application of Kinesiology Tape for common clinical conditions
  • Become proficient at applying Kinesiology  tape effectively to a variety of regions


Venue: Birmingham City Hospital, Dudley Road, Birmingham, B18 7QH

Date: Saturday 16th February 2013 (9 am: 4.30pm)


Tutor: Melanie Betts , MSc (Manip Ther); MMACP; MCSP; HPC;

London 2012 Olympic Volunteer Physio, Private Practitioner, World Student Games (1995) and World figure skating championship (1995). Great Britain Swimming Team from 1995-1999. She  was the physiotherapist for the Great Britain Target Shooting Team 2001-2010. These roles took her to Manchester 2002 & Melbourne 2006 Commonwealth Games, and the Athens Olympic Games 2004. She is also a sought after MSc Manual Therapy/ MACP Clinical mentor.

Fee: £95 (Includes all taping materials)

Contact: Gerard Greene, MSc (Manip Ther); MMACP; MCSP; HPC; PgCertEd

Ph: 07968 011832


Facebook: HarbornePhysio


Marathon Injury Prevention (SECRET TIPS)

So knowing how competitive runners can be,  I thought I’d give the insiders tips on how to get ahead and stay ahead in your marathon preparation training.

Having done some further research, I had a good chat with Max Dillon who runs for Milton Keynes Running Club in triathlon’s, half marathons, marathons and 35/40/50 mile fell runs. Now, Max has vast experience for his age in running and he knows when and how to train. Having completed half marathons in sub – 1hr 20 minutes, training and staying fit is necessary to get the best results.

This article will look at Max’s advice for training and recovery as well as injury prevention:

Thinking about doing a marathon can be daunting but once you start the training, it becomes addictive. The issue being that many runners DON’T:

1) build the training gradually

2) allow enough COMPLETE rest days

3) or train hard enough when needed.

The advice and experience given by Max could be invaluable to make your training and performance more finely tuned, and help you get ahead of the competition:

  • Training should built from the ground up, gradually increasing the running miles.
  • Speed work needs to be hard and fast, this is advised by elite Ethiopian runners.
  • Long runs should be gentle and more enjoyable, these are about building endurance not speed.
  • Rest days are key for injury prevention. Complete rest is required. Consider that daily activities are NOT rest, and try to completely rest to avoid fatigue or overtraining.
  • Ice baths can help recovery after long runs. Evidence for this post-training is inconclusive BUT some runners believe it helps recovery. 10 minutes in an ice bath is good enough for Jessica Ennis, its good enough for you.
  • Compression Leggings can assist with venous blood flow post training to aid recovery. I.e Wear them to bed, that’s Max’s advice not mine. Keep the lower extremity blood flow and warm to the legs can assist with recovery. Again evidence is limited with these leggings, but give it a whirl!
  • To avoid common running injuries, try Sport Tape. its great for reducing overactive and control muscle fatigue especially something like Shin Splints.

  • When hill running, this requires vast amounts of eccentric quadricep control, especially running down hill. Do some eccentric quads loading exercises in the gym and build it gradually.
  • Day before the race, do a 20 min very light jog or strides to shake everything out. this is make sure your ready for race day and have no lethargy.
  • Active recovery post race is key, NO RUNNING, light swimming or gentle spin bike session will aid with muscular movement and quicker recovery.

A lot of this advice is individual to each runner but if you don’t try them, they you’ll never know if they can help.

A few common running injuries occur when first training, so these can be prevented by early assessment, early intervention, early return to sport. The commonest are Patellofemoral Pain Syndrome, Hip and Proximal Weakness, and Delayed Onset Muscle Soreness. TA Physio can assist with all these problems to enable you to continue running.

Let me know how it goes, if you have any questions for TA Physio or Max Dillon, then add them in the comments box below.

Thanks for reading.

TA Physio