Hamstring injuries: prevention and treatment – an update

This paper on the BJSM, Hamstring injuries: prevention and treatment—an update, is a must read for anyone who deals with athletes or are susceptible to hamstring tears

“Despite increased knowledge of hamstring muscle injuries, the incidence has not diminished. We now know that not all hamstring injuries are the same and that certain types of injuries require prolonged rehabilitation and return to play. The slow stretch type of injury and injuries involving the central tendon both require longer times to return to play. A number of factors have been proposed as being indicators of time taken to return to play, but the evidence for these is conflicting. Recurrence rates remain high and it is now thought that strength deficits may be an important factor. Strengthening exercise should be performed with the hamstrings in a lengthened position. There is conflicting evidence regarding the efficacy of platelet-rich plasma injection in the treatment of hamstring injuries so at this stage we cannot advise their use. Various tests have been proposed as predictors of hamstring injury and the use of the Nordboard is an interesting addition to the testing process. Prevention of these injuries is the ultimate aim and there is increasing evidence that Nordic hamstring exercises are effective in reducing the incidence.  “

Getting the most out of your warm up

What is it you are trying to achieve with your warm up routine? The answer is the obvious prepare yourself for the workout you have planned. That said why is that very often people either don’t do much if any warm up or if they do it is 5 minutes on the treadmill/bike/cross trainer which whist not worthless doesn’t really do much beyond the “warm you up” part of the what your warm up should be. Continue reading “Getting the most out of your warm up”

Achilles tendinopathy

Any sport that has you running or jumping, or if you include these in your prep for them, has the potential for achilles tendon problems. It is not uncommon for people to think that they have an issue with an achilles tendon and for it to be a different tissue in the area. The pain actually being in the  toe flexors or posterior tibialis both of which sit in front of the achilles but these can be easily ruled out during the initial examination . Once it is established that it is an achllies problem we can begin work on addressing it. We now use the term tendinopathy instead of tendonitis as recent research has shown that there are rarely any inflammatory changes in the tendon. Continue reading “Achilles tendinopathy”

The windlass mechanism of the foot; What is it and why is it important?

What are we talking about when we are discussing the windlass mechanism with regards to the foot? The windlass mechanism is an integral part of normal foot mechanics and gets the name from the similarity to that of the windlass in sailing where it describes the pulley system used to raise and lower sails. In the foot the action is created by the plantar fascia, the band of strong, thick connective tissue that spans the base of the foot from the calcaneus to the toes, as it stretches around the metatarsal heads when the foot comes into dorsi flexion during the propulsive phase of the gait cycle. Continue reading “The windlass mechanism of the foot; What is it and why is it important?”

Kinesiology taping

We’ve all seen athletes be they on the running track or a football pitch with various pieces of brightly coloured tape on their bodies. The tape is likely to be kinesiology tape and whilst it really first came on the scene at the 1988 Seoul Olympics, though it has been around since the 1970’s, and it really gained a lot of exposure at the 2008 Beijing games. I must admit I came a bit late to the use of Kinesiology tape though I had read quite a few articles around it’s use and the perceived benefits within a treatment protocol. I have to say I was a bit skeptical about it but it was definitely on my to do list with regards to finding out more about it. Earlier this year I went on one of Rocktape’s courses after reading a lot of good things about their courses in comparison to others with regards to the content and their approach and I have to say I wasn’t disappointed as the course was indeed very good covering a lot of the research on the tape, it’s effects and why it may work. This was great as they discounted many of the more outlandish claims and reasons why it may work. Rocktape aren’t afraid to acknowledge the limitations of what taping can do, Andy Caldwell, the instructor on the course was very clear about it being a tool that can aid the recovery process and that it’s use did not negate the use of standard rehab protocols, nor do they try to hide studies and we were presented with both positive and negative results from various studies and highlighted the limitations of many of the studies whether they were negative or positive in the results.

Since I’ve been using the tape in the clinic I’ve seen some very useful results in the form of symptom/pain reduction. With myself as an example, I have been suffering from quadriceps tendinopathy in my left leg for some time and I tried the tape out on it. The pain was affecting me when I was running and squatting and whilst it didn’t prevent me from doing either  it was very annoying. With squatting it would take a good few sets before it felt the pain disappear and the movement feel smooth whilst with running it was just general niggle during and after the run. After the tape was applied I noticed an improvement in movement and the level of discomfort the following workout was reduced and similarly when I was running. I still had to rehab the area but the reduction in pain definitely was a bonus during the first 2-3 weeks as the rehab got a chance to have an affect.

With two different clients I have seen useful results. In one case they were experiencing pain in the plantar fascia and up into the achilles insertion and whilst the taping didn’t seem to reduce the symptoms at rest they were able to run without pain after we applied a spiral line of tape from the foot to the hip. In another client they were experiencing a redction in lateral flexion and rotation to the right through the torso and after the application of tape along the lateral line on the right we saw an improvement in both movements.


Rehab and conditioning studio


I’m quite excited to say our new rehab and conditioning studio is almost finished and after some final tidying up at the weekend we’ll be good to go. We’ll be offering personal training here with Chae Cramb as well as using it for our rehab sessions.

Changing your running technique

I’ve mentioned in the blog before the idea of different foot strikes when you are running be they forefoot, midfoot or rear foot. A rear foot or heel strike tends to get a bad press, especially when the idea of running barefoot was at it’s peak yet there is nothing wrong with running with a heel strike vs mid or forefoot and most of us will tend towards a heal strike until we are running at a sufficiently high pace. You will also tend to see even faster runners or those who tend towards a mid/forefoot strike moving towards a heel strike as they tire, most noticeable during longer races such as marathons or the running portion of an IronMan. Continue reading “Changing your running technique”

Edinburgh Marathon offer

It’s around 12 weeks to the Edinburgh Marathon and 6 weeks to the Edinburgh Great Run so many of you may be in full training mode preparing for them. To help with your preparation we are running a special offer through March where we are reducing the price of our block booking offers to £215 for 6 appointments and £110 for 3 appointments, full price for 6 appointments is £270 and £135 respectively.