Precision Movement's KT gives her recommendations for reducing the risk of a flare up from pain and autoimmune conditions as well as re-injury during the Christmas party season.
Hello! I'm back. After a long sabbatical of blogging I've returned to share my insights, new finds and help information to help you all recover from injury effectively and maintain a healthy and enjoyable life through movement and fitness.
As many of your already know I am training to be a soft tissue therapist. In it's simplest form I can be referred to as a massage therapist but the techniques I am learning also help with soft tissue injury recovery. Massage is mostly regarded an enjoyable experience that helps you feel more relaxed. But it has many other important benefits for health, injury recovery and training. Read onto find out the top 5 benefits of regular massage treatment.
The flow of fluids
Massage has a pumping effect on blood circulation which helps transport nutrients for growth, repair and nutrition as well as removing waste products at a cellular level. Lymph is fluid found in tissues that is not part of blood that holds certain nutrients and also collects waste products from cells. Unlike the blood, the lymphatic system does not have a pump system. Lymph is moved through muscle contraction. However, if you are recovering from injury and unable to contract certain muscles then massage can help push lymph through the body more effectively.
Body maintenance for regular training
For those of you who train regularly massage is an important maintenance tool for recovery and increased training gains. When you exercise you create micro-trauma (tears) in muscle fibres. The body responds by laying down repair tissues (scar tissue) for healing. This is all perfectly normal. However, with repeated training sometimes the tissues doesn't get enough time to heal so scar tissue can build up without you noticing until there is a significant impairment in muscle function or pain. Regular massage therapy can help identify small areas of build up and break them down before they become an issue. Post-workout massage can increase the rate of healing and recovery which means your body is in the best working condition for your next training session.
Massage can be a great contributor to the healing of soft tissue injury. When muscle fibres are injured the body lays down scar tissue in the first stage of healing. When the fibres are healed the body clears up the excess scar tissue. However, sometimes due to a premature return to exercise scar tissue does not fully leave the healed area and then lays down more in response to micro trauma from exercise. An excessive build up of scar tissue can lead to layers of muscle fibres, which ordinarily glide over each other, sticking together. This can impair the function of the muscle and surrounding tissues and potentially lead to further injury. Massage can help break down the scar tissue and adhesions and realign the fibres so the muscle can heal and return to full function.
Localised tissue flexibility
Sometimes rather than a whole muscle, only a portion of the muscle becomes tight. Stretching the whole muscle cannot reach the portion that really needs to be stretched. Certain massage techniques can help stretch and release localised tissue and also helps to draw muscle fibres and sheets of muscle fibres and fascia (connective tissue) apart in different directions. Massage therapists can help identify areas of tightness before they start affecting performance and/or causing discomfort.
The immediate effects from massage are felt mostly through the nervous system. The direct affect of massage is that is stimulates nerve receptors in the tissues and reduces tissue tension. Nerve receptors also respond to touch, warmth and pressure which helps place the body in a parasympathetic state - otherwise known as a state of relaxation, healing and recovery. It helps decrease blood pressure, mental and emotional tension and encourages digestion. That is why you feel so good after a massage!
One stop shop
In fact, massage is beneficial on so many levels that in my opinion it can no longer be seen as a luxury or a treat. With our busy lifestyles, it is imperative that we stop and take time to relax, heal and recover. When you book a massage treatment you have no choice but to lie on the couch and be treated. Even if you don't want to go because you have a million other things you think you should be doing, after your treatment you'll feel like a different person! For me it's akin to the benefits of meditation or a micro-vacation!
As part of my training I am required to log 100 hours of practice treatments. I hold my free massage clinic on Fridays between 3-7pm in Mayfair. Treatment is 100% free until I qualify in July. The only charge is the clinic room hire of £20. So, if you would like to experience some or all of the benefits of massage email me at KT@precisionmovement.co.uk and we'll get you set up with a date for treatment!
As many of your know Precision Movement has been making extensive additions and changes to our little Mayfair studio space courtesy of Grosvenor House Apartments. And though she be little she is (mighty) fierce and versatile. Here are the new changes to the space and how they optimise your workout.
This March we had a custom designed BeaverFit rig installed into the ceiling. This has been the most anticipated change in the studio since we moved in. The rig will be used for pullup/chin up and brachiation training. Also check out the fat GRIPZ for extra intensity without extra load. It has proved super popular so far!
The rig also enables us to use TRx, Crosscore180 and Olympic Rings for suspension and aerial training. Bring on the strength! The rig is 3.5m long meaning we can have someone working on the Kinesis, someone working on the TRx and someone in the weight area quite comfortably.
The matted floorspace has been increased by a third meaning more workable space for people to use and more people using the space at the same time. It also means the floorspace becomes more versatile - we can bring out a barre for a ballet workout or clear the space for kickboxing or a yoga based work-in. We have had some guests using the space to practice their karate katas and MMA moves. We have left the space open for just this purpose because no single person's workout is the same and we want to cater to that as much as possible.
We now have adjustable weights up to 41kg each alongside the original rack of 1-10kg. We have a few olympic bars and weight plates for more traditional strength training as well as weighted medicine balls and powerbags. The original Kinesis cable machine is still installed as well.
The bring out put back system
We have lots of different equipment that can be used in the space - kettlebells, powerbags, battling ropes, agility equipment, olympic bars, medicine balls. We bring out what we need into the space for your specific workout and then put it back to open the space up again. It sounds really obvious but many gyms, particularly hotel and residence gyms are the same space as our little studio but packed full of machines which limits the type of exercise you can do in the space. Training has moved on past machines... there are some uses for machine work but at Precision Movement we are more steered towards challenging your body in different ways. Which is why we think our space is becoming one of the best hotel gyms in London.
The space is being used more than it ever has been and it's being used in many ways, for all kinds of movement, workouts and sports conditioning. If you haven't been down to visit yet, then please do. We'd love to have you!
Let's face it, I'm hard to sum up in a tidy little phrase - though many have tried! So I asked my lovely clients, the recipients of my knowledge and expertise to describe their experiences of working with me. My fabulous web/video/media guys at SquareGlu sprinkled magic dust over it to produce this little movie...
Thanks to to my lovely clients for taking part - I did tell you I'd get you your five minutes of fame! And thanks to SquareGlu for making such a professional end product.
Popcorn at the ready.... ;)
The number one question I get asked is "Are you a physio?" - unfortunately I cannot lay claim to this esteemed profession! I am not a physio. The second question is, "So are you a personal trainer then?". Again I cannot say I am a Personal Trainer either - well not anymore. I fall somewhere between the two and work under the grandiose title of "Corrective Exercise Specialist". This line of conversation invariably leads to a discussion about what type of exercise I do and how it differs from gym training. I will now humbly attempt to explain in an effort to give you a better understanding of the difference.... Wish me luck!
What is corrective exercise?
Corrective exercise is a special type of exercise usually used as part of the rehabilitation process in healing and recovery from chronic pain, injury or surgery, or given to those who suffer from poor posture. The emphasis really is on optimal alignment, stability, mobilisation and then strength development.
In comparison regular exercise that you might do in the gym or in sports has a different goal - often increased fitness, body shape change, weight loss etc. As the goals are different the exercises and movement given are bigger and incorporate more muscles. This helps co-ordination for sports and is also effective for conditioning the body to change shape and increase fitness. If I were to give these exercises to someone who is in pain and has poor alignment, poor stability, mobility and strength they would not be able to perform them effectively and could potentially hurt themselves further.
It's important to mention here that corrective exercise also forms a foundation for all movement and exercise. If your foundational principles are good then your risk of injury is much reduced. When clients come to Precision Movement with fitness goals we still take them through foundational principles to make sure alignment, stability, and mobility is optimal for more complex movements.
The types of exercises
The majority of exercises I do with clients at the beginning of their programmes are floor or swiss ball based. I ask them to repeat the repetitions many times to elicit postural change and I also ask them to engage in mindful exercise which includes some psychology techniques. Corrective exercise rarely makes you sweat and definitely doesn't increase your heart or breathing rate. It is not easy though! The areas we stretch are usually tight and stiff and the muscles we train are weak to begin with. When clients adapt and improve, programmes are updated to challenge them further.
A classic exercise I teach clients is the horsestance series. It looks very easy but it is actually quite challenging. Before clients can do this exercise effectively I'll also teach and often reset their breathing mechanics, help them effectively activate their core and how to activate stability through their hands and feet. When the exercise is performed correctly it is exceptionally effective in training stability and forms a solid foundation for more complex movements that you would do in the gym or in sports.
Typical exercises you might see in the gym are squats, lunges, pullups and pushups. These are all neurologically complex movements meaning the brain needs to send a huge amount of information to the muscular system to perform the movement successfully. You might use a kettlebell swing which is a dynamic form of a deadlift pattern. Running, martial arts and many other sports are also exceptionally challenging to the body and brain. To perform these exercises and sports well you'll need optimal joint stability, understanding of core function, breathing mechanics, optimal joint mobility and to minimise the risk of injury good alignment throughout the body as well as in the movement.
When does corrective exercise become regular exercise?
At Precision Movement we are specialists in change. Our goal with everyone is to get them to a fully functional movement state for life and whatever sports they participate in.
We don't want someone lying on the floor doing a mundane exercise forever. We may ask someone to do this in an early stage of rehabilitation to get certain muscles firing but when they adapt to the exercise we make it more challenging. All the exercises we give have many many progressions right up to regular exercise that you'll recognise well. Perhaps the difference in giving regular exercise at Precision Movement is we might make changes or modifications that are specific to an individuals needs eg. A static lunge might include a band to emphasise the inclusion of the hip stabilisers that have a tendency to be lazy - they might now be strong but the band acts as a reminder for the individual to maintain good knee alignment.
In a way, we use corrective exercise like servicing a machine. A machine that has been running for a while might need some parts changed, an oil or water change. Similarly, we'll do a maintenance check and make sure all the stabilisers are firing correctly and alignment and mobility are good.
For more information on corrective exercise for postural alignment, pain relief and management of injuries and degenerative conditions please contact us.
Last week I was asked to speak at the L Club in on Sloane Street about the importance of the spine for health throughout life. I thought I would share with you what I shared with the audience of the L Club how your spine develops, what injuries it is most vulnerable to at certain parts during your life and how you can minimise the risk of injury as you age. If you are tempted to just read what it says under your current age bracket this would be foolish. Remember what you have done in the past and what you do now will all influence how the spine will respond in later years. Read on to find out more....
When we are born our spines are curved like a shell. In the first 2 years up to when we walk we go through huge amounts of development and change in the spine. We learn how to move it and stabilise it and to sit up, crawl and walk the spine changes alignment. As we grow our spines take on three curves - cervical, thoracic and lumbar and these curves are responsible for maintaining good posture, keeping our intervertebral discs in place and providing shock absorption. This is one of the most important developmental stages of our lives and we should never underestimate the value of babies learning to move efficiently and effectively. The movements and postures that babies learn here serve them for the rest of their lives which means if faulty movements are developed it will affect movement, co-ordination, posture and strength development in later years.
This is the time when we should move and learn sports. Jumping around and pounding on our bones is the best way to make them dense and strong coupled with a good intake of calcium from leafy greens and vitamin D from the sun as well as good overall nutrition. Any weight bearing sports are good for bone density development (swimming is a non-weight bearing sport). Intense learning of sports is not recommended until age 7. Ideally children should try out lots of different activities. At age 7 if children show an interest in a particular sport they have enough neural development to learn more intensely. Children should not lift heavy weights as it can stunt growth.
When we get to 21 we have fully grown but we can still increase our bone density. Bone density is exceptionally important for the prevention of osteoporosis. Between 30-35 our bones begin ageing and it is no longer possible to increase our bone density - we can only slow the rate of decline. This is effectively done by weight bearing exercise such as strength training. The discs between your vertebrae have fluid and a jelly like substance inside which acts as part of the shock absorption I mentioned earlier. At at 30 our bones cannot get any denser. From here our bones go through a process of becoming less dense.
This is the time when the spine is most vulnerable to disc injuries. Mostly because of our lifestyles - too much sitting and not enough movement. Up to age 45 the discs are refilled with fluid each night as part of the recovery process when we sleep. This is why you are taller in the morning and shorter at night! One of the reasons why disc injuries happen between 30-45 years is because of years of 'ligamentous creep' the connective tissues in the spine stretching over time to accommodate poor posture. Ligaments are the strongest structures in our bodies connecting bone to bone and they give our skeleton stability. Once ligaments are stretched they do not go back to their original length. Over time, years of time, it makes the spine unstable and then the discs become vulnerable to pressing out on to the nerves.
Past 45 the discs begin to dry up and the spine becomes stiffer. This actually has an advantage as the discs are less prone to pushing out against the nerves because they are less plump. However, less fluid in the discs means loss of disc height. Firstly, you lose height which is not so bad. Secondly, your vertebrae are much closer together so the ligaments become lax and can create instability. This hinders movement, particularly rotation, and can also lead to bone spurs and stenosis.
Depending on what you have done or not done with your body you may experience some pain or injury in your spine as you age - common but not normal issues are osteoporosis, arthritis, spondylitis, ankylosing spondylitis and postural imbalance. What I always find interesting is that most people as they age will have some sort of disc degeneration but not all suffer with pain from it. The key here is movement - the more active you are the less likely you are to feel pain.
The most important point here is what you can do to minimise the risk of injuries and diseases when you are older. Once you have these issues they can be managed but they are not reversible.
If you want to know more about minimising the risk of spinal complications when you are older or maybe you have a spinal injury that you'd like to know how to manage better then contact me at
Well the obvious answer is yes having a strong core contributes to the relief of low back pain. The bigger questions here are what is the definition of 'the core'? What muscles is the core made up of? Is it only abdominal work I need to do? The answer to this question is a resounding NO! How do I activate 'the core'? How do I move successfully whilst keeping my core activated? If you would like to know the answers to these questions then read on.....
What is the core?
Unfortunately it is mostly referred to as the abdominal region and this is a classic example of how a little information can cause more harm. Think of the anatomy of the core - the centre of your body - it is a cylinder. It has an anterior wall, the abdominals, but it also has sides, a back, a base and a lid.
Just like a house if you only re-inforce the front wall you will create imbalance in the house and the un-inforced parts will weaken and crumble. If you only train the abdominals you will create an imbalance between the front and back of the body. The abdominals will get stronger and the back muscles will get weaker. the pull on the bones from the abdominals and the lack of counteraction from the back muscles will cause a more flat back and a posterior rotated pelvis. For those with disc injuries this is just about the worst thing you can do because the discs are at even greater risk of coming out, irritating the nerve and causing you great discomfort.
Activating your core is not as simple as contracting a few muscles. The diaphragm acts as the lid of your core cylinder as well as playing a major role in respiration. Your breathing is very much involved in optimal core activation. If you have faulty breathing mechanics and/or the alignment of your ribcage and pelvis is out this affects the role of the diaphragm in core activation. Ultimately successful and useful core activation is a blend of alignment, good breathing mechanics and the understanding of how to activate ALL the muscles that make up the core.
Gently does it
Activating your core for support is actually very gentle - about 10-15% of a maximal contraction. If you contract to hard you'll do what is called a brace. This is not bad and in some cases is necessary such as in ultra heavy lifting but what happens to the cylinder is it becomes rigid and immovable. The point of activating the core for support is so you can move freely without restriction. If you are going red or cannot breathe when activating your core you are contracting too hard.
Intra-related - it's complicated
There is no use thinking I'll train all those component parts separately. In order to provide optimal support for your spine all these muscles need to work together. You have to train the brain to switch on these muscles like a conductor begins an orchestra together. If the firing order is out it will sound like a badly rehearsed concerto.
All together now
Once you have the component parts working in harmony then you must teach your body to move with this new core support system working. At first it will be a conscious effort but over time it will become automatic. This enables you to move effectively for life, for fitness, for your sport and with the correct support so you can move without pain and minimise the risk of injuring yourself further.
So now you know that your core is more than just the abdominals I would recommend seeking out a specialist who can teach you correct alignment of the ribcage and pelvis, correct breathing technique and correct core activation to support your spine. A good indication of a specialist in this field is one that can explain the mechanics and teach you the application simply and effectively.
If you would like to know more about core activation and how it can help support your back and other joints effectively for movement contact me at KT@precisionmovement.co.uk.
One of the number one questions I get asked is how to I avoid back pain? Nearly all of us will experience back pain at some point in our lives. But how wonderful would it be to minimise the risk of getting back pain? Read on to find out how.....
We all know too much negative stress is bad for us and some of you may know that it affects us physically. Stress is part of our lives and it helps us achieve success and conjure bravery when we need to step up to the plate. You have a stress threshold - a line that once crossed begins to compromise your immune system. It slows your recovery and healing rate so normal repairs that should occur result in tissues getting left and more damaged. This can be as small as an ulcer or a big as your back pain. The best source of information I can give to you is about your perception of stress and I cannot say it better than Health Psychologist Kelly McGonigal in her recent TED talk. It's 8 minutes and a revelation you will not want to miss out on.
2. Lack of movement
You are designed to move. Sustained poor posture is a major cause of back pain and structural damage. Make sure you move throughout the day. If you are desk bound, walk around the office, take the stairs for a few flights, leave for a lunch break. In the recent article "The making of a corporate athlete" by performance psychologists Jim Loehr and Tony Schwartz that was published in the Harvard Business Review it is recommended that every person does at least 2 strength training workouts a week for endurance and to promote mental and emotional recovery.
3. Poor posture
Sit, stand and walk tall. If you are exercising, exercise tall. Another major contributor to back pain is poor posture. If you already have back pain then poor posture will make it worse! You may be blissfully unaware that your posture is bad but if you are currently pain free it is well worth investing the time and effort to work on your posture to minimise the risk of injuries occurring. In this day and age, with the mountain of information and specialists to help you there is no excuse for poor posture. Seek help.
4. Repetitive faulty movement patterns
This is an extension of poor posture but relates more to exercising with poor form. I have seen so many clients walk through my door who hit the gym 5 days a week but when I assess their movement patterns it is clear they do not have good technique and their movement patterns are contributing to their pain. If you are working out in the gym and have not had any guidance at all in the past 6 months then ask a professional to look over your technique.
5. Poor nutritional intake
Your nutrients for every day micro damage to your body come from food. Food provides you with the building blocks for repair, to create new cells, to strengthen your muscles, to strengthen your bones and connective tissue. It is imperative that you take care of your nutrition and nourish your body it is as much a part of minimising the risk of injury as movement is.
For more information on exercise for the prevention of injury and for back pain and injury recovery please email me at
. Download my
eBook '7 steps to getting you back pain sorted'
by scrolling up and looking left!
Helen Skehan specialises in the treatment of RSI (repetitive strain injuries). She is the owner of
clinic in Islington, a clinic that she built herself over 16 years, houses 9 therapists and also offers massage and ergonomic assessments in the work place.
KT: Helen, what is RSI?
HS: RSI stands for repetitive strain injury. It is a term given to work related non-specific upper limb injuries and does not always mean the injury has come from repetition or is a strain. Patients present with a number of symptoms that may not always be the same from person to person.
KT: What symptoms are common with RSI?
HS: I test for many things - often clients present with varied pain in the neck, shoulder and arm, tingling ,numbness, temperature changes, swelling. I look for specific tightness, muscular imbalance and postural misalignment. I may also send clients to be tested by a rheumatologist to eliminate other underlying conditions.
KT: How does RSI develop?
There are many different ways RSI can develop. It is often a combination of a poor workstation, poor posture, lack of exercise (although not always sometimes I see patients who are real gym bunnies),not taking enough breaks at work, high stress, lots of typing and ignoring initial symptoms.
KT: How does stress play a part in the development of RSI?
I would say stress exacerbates symptoms. Mechanically, stressed induces increased muscle tension in the neck and shoulders where the nerves exit the spine and pass through the shoulder joint down the arm. Also, breathing rate increases and during stressful times we tend to adopt a upper chest lead breathing pattern which utilises the accessory respiratory muscles surrounding the neck and shoulders. The nerves are supposed to glide through neighbouring structures but if the muscles are contracted it can squeeze the nerves causing pain, numbness and tingling.
KT: What is your opinion on exercise for RSI? Does it create more strain or can it help?
HS: I always try to get my patients to engage in some form of stretching, mobilization and exercises. There is always a role for graded exercise in the recovery of RSI. It is important to go by a tolerance factor - the patient should not work into areas of pain.
KT: What affect does posture have on the development of RSI?
HS: Sustained postures for long periods in poor alignment are definitely not healthy and can contribute to RSI. Typically patients that have RSI injuries have a rounded upper back, a forward head carriage and their shoulders are rotated inwards. It is very common to find neck an shoulder stiffness as well as a lack of mobility in the upper back. Some patients can suffer from headaches. Even more distally you find that patients often have hamstring and calf tightness.
KT: What impact does modern technology like smart phones and portable laptops and tablets have on the recovery of RSI?
HS: All these devices encourage a poor posture as you tend to look down at the device you are using. People tend to overuse their smart phones which stresses the fingers, wrists, hands and forearms. With tablets and laptops they can be heavy to carry around and we tend to look down when we use them which strains the upper back and neck.
KT: What advice can you give to people using smart phones and tablets for work?
HS: Modern technology is improving all the time. For smart phones you can use the voice activation system to cut down on your typing time. Try to avoid using your phone and tablet when you travel on the tube and bus to give your hands and arms a rest. At work place a tablet on a stand or a removable keyboard. For laptops and desktop computers invest in an ergonomic mouse or a roller mouse that sits at the front of your keyboard.
KT: What are the early symptoms of RSI?
Any hand symptoms that are related to desk work including pain, muscle cramps, tingling, numbness, swelling or feeling of swelling and restricted movement. Also be aware of any of these symptoms in the shoulder and neck area even repeated small episodes. We should be able to function without pain. I would recommend diarising your symptoms and check over a period of time whether the symptoms remain or get worse. If in 10-14 days the symptoms are still there then seek treatment.
KT: What other advice would you give to those suffering with RSI?
HS: For those with mild symptoms I would advise regular movement that is based on improving postural alignment and mobilising the upper back. Backstroke can be helpful and calming to some. Avoid cycling as the posture can encourage symptoms to get worse. RSI is an injury that develops over time and through the continual use of bad habits. The most important thing is educating yourself on how to minimise the risk of injury and taking responsibility for your health and wellness at work.
For more information please visit the website at
or to make a booking with Helen please contact her clinic, Physio Solutions, on
0207 713 7780
. For more information on how exercise can help you recover from RSI injury please contact me at
I love this question! It is something I get asked when I am out socially and people discover I work with back pain and injuries. The truth is no one set of exercises fits all back pain problems. In fact, every person I see in my practice is so completely different it never ceases to amaze me. For instance someone with a disc prolapse may really benefit from a back extension mobilization and stretch. If I give the same stretch to someone with stenosis (bone spurs) it will push on the already smaller spaces where the nerves exit the spine and aggravate their condition. It gets more complex when I have someone who has both of these conditions or multiple spine issues. Believe me there is no one size fits all. Here are some golden rules about exercise that apply to most all back pain sufferers.....
If there is one thing you take away from this article please make it the importance of movement. Every day moving around trumps sitting or lying still every time. The key to movement for relief of pain, especially when it is very sore, is to do it gently. If you are desk bound at work get up and walk around, take the stairs for a few floors, get out for lunch, walk to the water cooler. Walking can often provide a sense of relief (however if it makes it worse and sitting relieves it then take a rest periodically). Things to avoid are heavy lifting and too much bending over to pick things up off the floor.
2. Specific back mobilizations
I recommend my clients do gentle back specific mobilizations upon waking daily to ease the back into the day. If you suffer from stiffness upon waking these mobilizations can be very effective at reducing your pain in less time. Ideally you should have someone show you how to do mobilizations that are specific to your back problem. However, you can download your copy of the
that I give my clients
. Be sure to read the instructions carefully - small and gentle is key!
3. Corrective exercise for postural alignment and stability
Here lies the key to getting your back pain sorted. Corrective exercise focusses on your alignment, stability and core activation and moves your through stages of development from small isolating exercises right up to functional often loaded movement. This is where you can get mobilizations, stretches and exercise tailored to your specific condition. At Precision Movement I always give programmes for the relief of pain when your back is sore, daily home programmes, a set of stretches to do at your desk, and a programme for the gym as required.
4. The Gym
If you are suffering from intense back pain avoid lifting heavy weights. Weights create axial (vertical downward) loading on your spine and if you are already in discomfort the worst thing you can do is increase the pressure on areas of discomfort. You could seriously hurt yourself. Do not use machines as a substitute either. Machines isolate and stress your big muscles without using the stabilizers around the joints. If your back is sore the last thing you want to do is make it more unstable or have the larger muscles pulling on it. It would be better to do some gentle yoga or pilates work being mindful of your postural alignment and core activation until your back settles. If you are a regular gym user make sure you have a professional with rehabilitation experience look over what you are doing.
5. Running, biking, rowing and cross trainer cardio machines
If you would like to do some cardio work the key to not aggravating your back is to change it up. Sustained positions can be aggravating for the back. When your back is sore avoid jumping and running as a greater amount of load is placed through the spine and this can be jarring to the back. Cycling and cross trainer are gentler options for cardio and can be alternated. For the bike make sure you are sitting properly and have a professional check your position before you begin. I would avoid rowing when your back is bad especially if you have any disc prolapses and proceed with caution under supervision.
For more information about how corrective exercise can help your specific back pain or injury contact KT at
. Download my eBook '7 steps to getting your back pain sorted' - the link is on the right hand side (just scroll up a bit!).
I recently saw a man working out at my Mayfair studio who was wearing a back brace. I asked him what it was for and he proceeded to tell me that he had terrible back pain and was advised to exercise with a sturdy back support. If there is one thing that I find contradictory, it's wearing a brace that stops movement so that you can exercise/move in the gym. If you want to make your back pain worse then wearing a back brace or support is the quickest way to do it and here's why....
Casting is for breaks
Have you ever broken any bones? Last year I worked with a lady who broke her ankle. She was in a cast for 6 weeks and a boot for another 6 weeks. When she started her rehabilitation with me the difference in the musculature from left to right was incredible. It looked like she had two separate legs! You see the body is mighty clever. If you are not using muscles they atrophy (shrink). A similar phenomenon happens to astronauts when they go into space for long periods. Because there is no gravity their bones become less dense. The good news is that when there is an increased need for muscle the body responds and adapts to the stresses it is put under.
This is why I am so adamantly against back braces for back pain. If you have back pain from disc prolapses, spinal stenosis, disc degeneration, or non-specific back pain back braces are really not going to help you in the long term. I am not saying do not wear one but I would like to educate you on what they do to the body so you can make a more informed decision about wearing one.
The off button
Effectively, just like a cast, a back brace will cause muscles to switch off. One of the first things you learn when you start corrective exercise is how to activate the core. Core activation is absolutely essential to the support of the spine and surrounding structures. Switching off these muscles is just asking for trouble. You cannot rely on a brace to give you the support you need - that is the job of your muscles and connective tissues! If you stop conditioning the muscles under controlled conditions with gradual development you will leave your back even further unsupported and at risk of further injury.
The point of exercising is to move. Wearing a brace can result in muscles getting tighter as they are not able to move through a full range. This will create further imbalance as certain muscles will become tighter and others will overwork to compensate further pulling you out of alignment and causing more stress on your back.
If you are wearing something that restricts movement and causes muscles to switch off you will effectively change messages to your brain and alter movement patterns. The brain responds to the movement patterns you put it through and with repetition it creates a blueprint that is stored for future use. It means we do not have to learn a movement every time we come to do it. However, if you change the variables for instance by putting a brace on, the brain will change it's blueprint accordingly. When you take the brace off and go through daily movements, the brain will use the newly formed blueprints with restricted range of motion and less muscle activation. This leaves you even more vulnerable to injuring yourself further.
What to do
You body has its own brace system - your core. The great thing about the core is you don't have to put it on every day - it is always with you. If you do not know how to activate it then seek out help from a corrective exercise specialist. To find out more about your core read my article "Does having a strong core relieve low back pain?" Equally important is your postural alignment. If movement is not your specialist area then chances are you won't know if you have poor posture or to what extent your posture is affecting your back pain. Optimal alignment, core activation and gradual progressive corrective exercise are the keys to getting your back pain under control. There are no quick fixes.
If you are currently wearing a brace and would like to explore another option for improving your back pain then contact me at
I love sharing knowledge! Which is why I have compiled a list of my top 5 reads for chronic back pain sufferers. They are all easy to read and most of them have tips and information you can apply immediately. If you are suffering from chronic back pain and you really want to know what to do about it and how to handle it then read on....
A comprehensive information packed book that explains how pain comes about and what it means. Although it's a little pricey I think it is must read for chronic pain sufferers.
A wonderfully entertaining book that uses the authors personal anecdotes to explain the mechanisms of pain and about taking responsibility for recovery.
This is a good book for anyone with disc prolapse. It gives easy to understand advice and information and is a great starting point for approaching recovery.
This book is a bible of information if you are a desk bound office worker with back pain or any workplace associated injuries such as carpal tunnel or RSI.
I recommend this book to everyone I meet. It looks at all areas of your health and wellness and is an integral part of healing nad recovery from any pain or injury.
And here is one I wrote myself - myeBook '7 steps to getting your back pain sorted' - scroll up and you'll see it on the left. Happy reading!
Have you set your New Years resolution (NYR)? No? Good! Don't do it. Seriously do not set a New Years resolution this year. Here is what is faulty with the NYR...
Often we set a short term goal that can be achieved within 3 months - to stop smoking, lose weight, go to the gym, stop drinking so much etc. Some of us achieve it most of us lose interest. If we do achieve our goal (yay - well done you!) we are prone to slip back into our old ways and vow to ourselves in 9 months we'll try again.
Why? Because life is too important. We are creatures that seek out good times and fun. We want to participate. So how do we deal with the conundrum of good times v being good?
Precision Movement challenges you to set a Life Resolution (#liferez). The liferez is a lifestyle change. It starts with taking a good look at your life and saying what can I change here to be healthier, happier and have optimal wellness and enjoy my fitness?
The liferez is exceptionally easy to assemble. You choose your changes and when, where and how to implement them and the reasons for doing so. Ideally make one small change each month. If you feel your change is successfully implemented and fits well with your life then go on and change something else.
Your liferez is designed by you. You can choose anything you would like to improve from as little as one less cup of coffee per day to taking your first vacation in 5 years. We all have different needs, priorities and responsibilities so make changes that serve your life. If getting to the gym 5 days a week is impossible for you then don't include this in your liferez. Seek out what would work better for you. Measure your progress by your own life yard stick.
Second class post and loving it
The liferez is an endurance event - it's your life. You wouldn't want to sprint through your life akin to same day DPD delivery would you? You'd want to take your time, sit in the post office for a while and enjoy the view, take a few travels, maybe get lost and redirected before arriving at your destination a la 2nd class Royal Mail. With the liferez you'll make smaller steady changes that you can work into your life over time. They'll take a little effort in the beginning but will soon feel routine.
With the liferez you will value the T&Cs and you get to make up your own. My T&Cs are based around the 80/20 rule. 80% of the time I am golden and 20% I splash out and throw caution to the wind. My T&Cs stipulate that after my splash out I return to my golden ways and this keeps my liferez in check.
The great thing about the liferez is as long as you use it consistently it has a lifetime guarantee. It will always serve you.
When you have pain the only priority is to make it go away, quickly. The problem with back pain is it takes a bit of time to settle and usually it takes a whole approach - the combination of manual therapy, corrective exercise and a few lifestyle habits. If you are keen to get out of pain but are skeptical about how your doctor can help then have a read of my 5 top tips for speaking to your GP about getting your back pain sorted.
Your first port of call when you have pain is usually your GP. Your GP is the gateway to further treatment options as you need referral letters to specialists. Here are my 6 top tips for speaking to your GP about your back pain so you can open a discussion about a whole approach and get the best possible outcome for further treatment.
1. A whole approach
It is widely known now that back pain does not respond to one solution. Pain relief is the goal but how you get there can make a difference as to whether your back pain returns or not. Go in with a mindset of taking a whole approach to getting better. A whole approach means taking on board all systems of your health and using more than one method to settle your back.
2. A word on pain medications
It is tempting to take pain medication that will be offered. If you decide that you will take it make sure you know the side affects of the medication and talk to your doctor about how long you should take it for. Also note that pain medication puts a strain on your liver and aggravates your digestive system. Be careful about what you do when you take medication - it takes away the pain so you can hurt yourself further without knowing until the effects of the medication wear off. Pain medication is a band aid form of treatment. It will not make your back pain better it will only take away the alarm that tells you something is wrong. Ask you doctor about alternative forms of pain relief such as acupuncture that have less side affects.
3. Be specific
I am sure GPs are faced with countless "I have back pain, it just hurts" patients! What is helpful to any medical practitioner is the quality of information you can give them. Notice patterns of pain, when the pain occurs, when it gets worse and what makes it get worse. What makes it get better? Does it ease throughout the day? All this information helps your GP to make a decision about how best to help you. Also, if you go in armed with information and an approach of wanting to get better you are much more likely to get the desired response from your doctor.
4. Bare minimum referral
As a bare minimum your doctor should refer you to a manual therapist. Ask your GP For a referral to a good physio or osteopath in the local area. I prefer this as a first step to your treatment plan over pain medication but it depends how bad your pain is. This is a good start for your treatment plan as you will be working with a musculoskeletal specialist who can advise you more specifically for your condition.
5. Corrective Exercise for postural realignment
Also ask your GP about a corrective exercise specialist or rehab specialist in the area that can assess and correct your postural alignment which will be contributing to your back pain. These specialists can train the active systems (neuromuscular) to give you better postural support and movement for your back. Corrective exercise is now considered an integral part of recovering from back pain.
5. Looking inside the body
You may need to go back to your GP a few times before scans are discussed. Looking inside the body through an x-ray or MRI can really help you and your doctor understand what is causing the pain. I have a friend who has been suffering from back pain for nearly a year and repeatedly went to his doctor for advice. The last time he went I told him to insist on an MRI. He got one and a cyst was discovered in his spinal canal. This was the cause of his pain and no one would have ever known unless he had the MRI. Talk to your GP about whether you need a scan and if not now when it may become an option. A scan may show that nothing is structurally wrong with your back but at least you can begin looking for other causes.
For more information on how corrective exercise for optimal postural alignment can help your back pain please contact me at KT@precisionmovement.co.uk. For a more comprehensive guide to sorting your back pain please download my free eBook "7 steps to getting your back pain sorted" the sign up is just to your left!
Low back pain is the 2nd top reason why people take sick days from work. 80% of the UK population will at one time in their lives experience back pain. One of the most common symptoms I come across when I see new clients is the complaint of waking up with pain or stiffness. I am going to explain why this is such a frequent complaint and also offer a few tips on how to relive your morning discomfort so you can start the day in a better state.
The spine throughout the day
Over the course of a day we lose height. This is to do with the effect of gravity on our spines and also a loss of fluid in the discs. This is a normal occurrence and one of the important reasons why we must get enough good quality sleep. For my top 10 tips on the best sleep ever read my blog post on sleep.
What happens when you sleep?
Sleep is when your body gets to work on healing and recovering from the day’s events. This includes the restoration of fluid in the discs between your vertebrae. The expansion of the discs with fluid can sometimes cause pressure on the nerves that run through the spine and this can cause discomfort on waking.
Nerves get on my discs
Nerves are sensitive creatures and they do not like to be touched. They like space and freedom to do their job. When a disc expands over night from the intake of fluid it can press upon a nerve and create a sensation of aching or sometimes quite a sharp uncomfortable pain. This can occur for many reasons – perhaps poor posture which is pulling your discs out of alignment, maybe a disc prolapse or bulge. I cannot answer what your specific cause is – only a medical practitioner can help to diagnose an injury. When the body experiences pain especially around the spinal cord where your central nerves run through, the muscles surrounding the area may contract to stabilize the area. The body knows that the nerves running through the spine are exceptionally important for function and survival and it will do anything to preserve their health. In this case it means contracting and tightening up the surrounding area.
What can I do?
If you find that you are consistently waking up in pain then start keeping a mini journal of your symptoms. I would then recommend you seek medical assistance – the first port of call is your GP. If you explain your symptoms he/she will be able to assist you further. You can also download my eBook ‘I have Back Pain – what do I do?’ which give you 10 steps to sort out your back pain, who to see and in what order and what options there are for treatment.
I see many clients with the main symptom of waking in pain. I help to realign their posture and strengthen their spine and pelvis which helps relieve their pain. Exercise is invaluable – but if you are experiencing morning pain it must be the right type of exercise to realign, stabilize and strengthen areas that are compromised. If you are diagnosed with a specific back condition like a disc prolapse or disc degeneration seek specialist care from a CHEK Practitioner or similar corrective rehabilitative exercise specialist.
You can also try Precision Movement’s morning mobilizations. These are gentle movements in a safe and unloaded position that help ease the stiffness of the muscles and encourage gentle movement of the nerves to ease them up. Often just a few sets of these movements are enough to get on with your morning – however, they do not replace proper treatment and corrective exercise so seek further advice and expertise.
How can I help?
If you are suffering with ongoing back pain and would like to do something about it that really works then please contact me for an informal chat. I can be reached on 07515856009 or by email at KT@precisionmovement.co.uk.
At Precision Movement I see so many clients with back pain who sit at a desk all day for their work. Back pain, neck, shoulder and hip pain as well as RSI injuries are all very common amoungst those who are seated throughout the working day as the sitting position encourages us to adopt poor posture. Also maintaining the same position for hours at a time is not good for your health of your back or body. Here are Precision Movement’s top 10 must have adjustments to your workspace to minimize the risk of discomfort, pain and injury at work.
1. Awareness of alignment
Slouching and poor sitting habits will contribute to back pain. The longer you sit badly and pay no attention to your posture the more likely you are to incur discomfort, pain and injury. Awareness and reminders throughout the day are a great start. Set your computer screen saver to say SIT UP STRAIGHT or POSTURE PERFECT. If you are on your phone throughout the day set your home screen with a similar message.
2. Chair/sit to stand desks
Source a good chair for your work-space that supports your spine and deters you from slouching at work. I like the range at www.back2.co.uk. There is a fantastic product on the market that really helps with long periods of sitting – the sit to stand desk. You can adjust the desk height easily throughout the day to alternate between sitting and standing. I highly recommend this.
3. Hand height
If you work at a computer then your forearms should be held at a 75-90 degree angle in relation to your upper arm. The elbows and wrist can rest on the work surface if you regularly use telephones, calculators and write as this reduces strain through the shoulder and neck area. For those that are drawing or designing at a drafting table angle the table up so you do not have to lean over your work. A general rule of thumb is the closer your hands and eyes have to work together for a task the higher the desk height should be.
4. Height of chair
Your chair height is determined by the height of your desk. Ideally your knees should be at an angle of 90 degrees or slightly less and the feet should rest comfortably on the ground. The backrest of your chair should sit right in the middle of your low back area. The placement of the chair should be such that you do not have to lean over your desk to work or that you feel too cramped.
5. Seat pan
You should be able to adjust the angle of the seat pan on your chair. As a general rule if you read and write a lot then tilt your seat pan forwards which helps to maintain healthy spinal curves. If you mostly sit in front of a computer screen then tilt your seat pan back (up to 5 degrees). However, if you have a specific injury like a disc prolapse your seat pan position will be unique to you and I would advise taking expert advice – see the end of the article for more advice on this.
6. Foot position
Allow your feet to rest evening on the ground ideally with a 90 degree bend at the knee. If your feet do not touch the ground when you are sitting in your chair then use a footrest and this should ideally be angled up at 15 degrees. If you wear high heels I would advise that you work in flats when seated at your desk. The increase angle through the ankle can lead to injury even when you are not weight bearing. You can always quickly change into your heels to walk to a meeting although ideally flat shoes are better for you whether you are walking or sitting!
7. Computer screen height
Set your computer screen height so that it is horizontal with your eyeline. You definitely do not want to be looking down as this will encourage slumping forwards which strains the shoulder and neck area.
8. Computer screen distance
The ideal distance between your eyes and the screen is 14-30 inches or 35-75cm. If you screen is too close it will strain your eyes and if it is too far away it will encourage you to lean forwards thus pulling you out of alignment.
Use a headset or a hands free kit if you are on the phone for much of the day. If you are seated at a desk infront of a computer or need to hold documents while you are speaking you are more likely to hold the phone between your ear and shoulder which over time will most certainly lead to discomfort and potential injury. A headset will enable you to work effectively without compromising your alignment.
10. Getting up through the day
The most important advice I can give you is to get up out of your chair throughout the day. Not only will your back and body thank you for this but it will allow your mind to rest briefly before returning to the work you are doing. Make a cup of tea, walk to the water cooler, walk to another floor for a meeting, definitely get out of the office for lunch. If you can frame your work day with exercise such as cycling to work or hitting the gym even better.
KT at Precision Movement can provide bespoke ergonomic assessments and adjustments to your work space. KT can also provide advice on ergonomic aids if your workspace is not as adjustable as it can be. For more information email KT@precisionmovement.co.uk.
For this weeks blog post, I’d like to touch on a subject that is often overlooked. What plays a major role in the alignment and stability of your body, is critical for your survival and is also integral to maintaining a sense of calm?
It’s breathing. Your ability to breathe is truly amazing. It keeps you alive, it’s highly linked to how you feel and what state your body is in, it’s autonomic (you don’t have to tell yourself to breathe) but you can also take conscious control of it. The control and awareness of your breathing is your own little magic remedy for stress relief. Do a quick test now and count how many times you breathe in and out per minute.
A normal natural breathing rate is 12-16 full breaths (inhale and exhale) per minute. Obviously, when you are exercising breathing rate increases as a necessity of the need to transport more oxygen to the muscles for work. If you breathing rate is higher than normal for every day living this may be an indication that you are stressed. This could be mental, emotional or it could be nutritional or digestive. Whenever the body is disturbed or under stress it has the same response. Breathing rate increases with stress.
Discover your Depths
There are a few ways to breathe. The most common, although not most beneficial is chest breathing. This is a short sharp shallow breath, which is usually quite fast and is associated with the stress response. This type breathing contributes to getting more oxygen into the top area of your lungs as muscles in the upper back, shoulders and neck are use to lift the chest during strenuous exercise. This is not however, a breathing technique that should be used in every day life.
Breathing that causes pain and injury
When someone breathes like this they usually inhale and exhale through their mouth and this can often bring the head position forwards and create mild (and sometimes major) stress on the neck and shoulders. The body will also respond hormonally, as it thinks it’s under stress so it will secrete a low constant level of cortisol – the stress hormone.
Breathing for healing and recovery
Deep breathing/belly breathing or diaphragmatic breathing is a full breath where by the whole lungs are filled with air, the diaphragm drops down and the organs below it push out against the abdominal wall. Two thirds of a full breath happen below the chest, then last third of the breath should lift the chest if needed. This type of breathing takes the body into a state of relaxation and rest. Often a diaphragmatic breath is inhaled through the nose and exhaled out through the nose or in through the nose and out through the mouth.
Breathing for exercise
A simple effective berthing technique that helps you to relax and destress is to inhale for 6 counts hold your breath for 3 counts then exhale for 6 counts and rest for 3 counts. It takes a bit of time to slow down the breath so go easy to start. Practise this for 5 minutes a day and within a week it will seem easy.
where I shared the link to
on How stress can be your friend I promised I would also share the other 5 unsuspecting sources of stress that may be compromising your health. Although is true that your conscious perception of stressful situations can transform the outcome, there is little you can do about forms of stress you do not know about.
Did you know that stress can come from foods, hormone imbalance, electromagnetic sources, too little or too much exercise, and temperature changes? And did you know that all these sources of stress can contribute to a relapse of your injury, pain or discomfort?
Stress build up throughout the day
I'll use an example of how stress can build up without you even knowing. You wake up to an alarm after a restless nights sleep. You force off your tiredness with a coffee and rush out the house because you are late. You leave the house without a coat and it's too late to go back to get one now - you'll be cold all day. When you get to work the computers are down The You won't finish that proposal for a client today, you'll lose the contract and your bonus! You have a makeshift late lunch and more coffee to stay awake. You decide to shake off your stress by going for a run even though your back hurts and when you get home, you order a take-out and you can't wait to get the kids in bed so you can 'unwind' with a few glasses of wine before you fall asleep on the sofa in front of the TV. Sound familiar?
Many stressors one response
What if I told you that everything in the above example stresses your body? Think of your body having a threshold - a tolerance for all the stressful things we put it through. What if I told you that repeating this over and over would create a build up of stress that might result in a seemingly 'random' injury or illness? It does. The body only has one response to stress. It does not matter if the stressor comes from a food that you are unknowingly intolerant to or over exposure to the sun. The body's response is to shut down so it can heal. Repeated abuse of these systems results in tiredness, compromised immunity and suppression of healing and recovery. This leads to discomfort, pain, injury, illness and disease.
How to combat these sources of stress...
In this blog i'll give an overview of how to combat these unsuspecting sources of stress so you can begin to change your mindset on how to deal with your discomfort, pain, injury and or illness. As each of these subjects are pretty hefty on their own I'll be sharing information in more depth over the coming weeks.
Eat from the earth. Refrain from eating any foods that are packaged, processed and tampered with. Reduce stimulants like coffee to the minimum to prevent stressing out your adrenals. Be aware of your alcohol intake
Sleep enough and rest properly. Sleeping and rest are not the same thing! Sleep 8 an average of 8 hours in a blacked out room in silence. Maintain balance between work and life. Acknowledge that you are not superman/woman and that rest is as important as action.
Get enough sunlight for vitamin D but not too much - hardly a problem in the English winter months! Eliminate all electronics from your bedroom and switch off lights at the mains.
Definitely exercise but make sure you are not overdoing it. If you are injured seek professional help to recover effectively. Strike a balance between healing restorative exercise like tai chi and hatha yoga and more energising forms of exercise like hitting the gym or running.
5. Make stress your friend
If you haven't watched this video on how to make stress your friend I highly recommend it. Kelly McGonigal says it better than I ever could.
This seems rather obvious but pay attention to your body temperature. Anything that keeps you too hot, burns you or adversely keeps you too cold is a stressor. Make sure you are temperate in all situations - at home, work and when you sleep.
Lastly, this is a huge topic and I'll be covering smaller chunks in finer detail as the weeks go on so you can begin to make changes that will result in a healthier, happier pain free life! If you have questions please email me.
Information sourced from Paul Chek's How to Eat Move and Be Healthy book, CHEK Institute, USA.
If you are in business and or climbing the corporate ladder you'll know all too well that feeling of invincibility. It's a divine trait and can also be equally as detrimental - unsuspectingly to your spine and your heart.
Clients come to me in their mid-30s to mid-40s with back, neck and shoulder pain and in their mid forties to fifties with heart trouble. One way or another, a life time of stress will get you. And when it does you will have to stop completely to heal and recover. There is nothing more soul destroying than being close to the height of your career and having to take 6 months or longer off because you can't get out of bed. It's probably not something you think about at all - and I am with you that you shouldn't have to. An awareness and application of a few basic support systems can minimise the risk of present or future work related back pain and injury. Here are my top 5 counteractions to minimise the risk of irreparable damage to your spine so you don't have to think about it!
1. Your state of mind. No one is invincible. If you are striving to achieve a top job it is an endurance race not a sprint. Pace yourself and take time out. The first step is to rethink the invincibility cloak - save it for dress up with the kids!
2. Your body heals and recovers from the stress you put it through daily when you sleep. Sleep is not an option for minimising injury and illness prevention in the future - it is a necessity. Both quality and quantity are important. Aim to sleep for 8 hours a night ideally between 10pm and 6am. Take out any electronics from your bedroom and switch off lights at the mains. Your room should be pitch black and as quiet as possible for a really good quality of sleep.
3. The food you put in your body becomes you. If you eat sugary processed foods your body will be starved of the nutrients that heal and restore from daily stressors. Also not eating enough will cause stress and impair effective recovery. Every cell in your body is renewed over 7 years. So short term fixes will not work well for injury and illness prevention in the future. Make a commitment to yourself to make a change for life - feed your success by eating what nature grows for you.
4. Movement is absolutely essential for injury prevention. If you sit at a desk during your working day you MUST make an effort to move either in the morning or in the evening. Exercise plays a direct role in maintaining good posture and keeping your joints strong and stable. A balance of high intensity and restorative exercise is also important. Too much high intensity will stress you out and could lead to an over-training injury. The quality of movement has a huge impact on how successful it becomes for injury prevention. If you turn up the gym and have a go on what looks good or manageable I would suggest seeking advice. At the very least find a good trainer or corrective exercise specialist with experience, top qualifications and a passion for their job to design and regularly upgrade a programme for you.
5. Strive for a balanced life. Spread your energy and interests wide. This idea is about giving your brain a new stimulus - a chance to work in another way. It is said that a change is as good as a rest right? So change your stimulus to give your brain a rest. Mental stress is as detrimental to your body as physical. This will mean stepping away from the office - and the blackberry.
Taking these 5 points on board and implementing them for life going forwards will minimise the chances of injury and illness so that you can enjoy a long, healthy and successful career.