Author: Joanne Pollard

WORKING FOR CANADA SNOWBOARD

The last couple of weeks I have been supporting the athletes of Canada SBX in prep for the upcoming Olympics. It has been a great couple of weeks working alongside this talented and positive team.

However, I will be back working in Val’Dlsere, out of Kineval this season. I will be home for most of the season, with the odd snowsport camp in between. Please get in via email physio@jopolladphysio.com or wats app 0033669776112 or facebook to book a consultation.

coaches end of camp drinks at Pitzal 3440m

PRE SEASON STRENGTH TRAINING

Here are some my favourite weighted / or compound exercises that I use myself and with athletes to build strength prior to snowboarding (although also good base exercises for skiing). Building strength not only helps performance or reduce that leg burn, but can also help reduce incidence of injury.

These exercises are for those people with exercise experience. Always start light (even without weight) and focus on good body form and posture. Here are just 4 exercises for skiers and snowboarders, so get training, get ready, winters on……

Jefferson squat
JEFFERSON SQUAT

JEFFERSON SQUAT: If a snowboarder, use your snowboard stance. Otherwise stand with your slightly turned out, especially your front foot (find your stance that feels good on your knees). Keep your core engaged and spine neutral. Ensure weight is evenly distributed between your feet and use your glutes to return to standing. Repeat, by turning 180 degrees the other direction.

RDL

RDL: Start with feet roughly shoulder width apart. Makes sure to set a neutral spine and ‘set’ or engage your scapula. Keeping core engaged use your glutes and hamstrings to keep the bar close to your body and smoothly move into a standing position. This exercise focuses on your hamstrings and glutes…..even though we often only seem to feel the burn in the quads muscles, these muscles are extremely important in providing stability – especially to the knees while skiing.

FRONT SQUAT

FRONT SQUAT: Stand with feet shoulder width apart, or your snowboard stance. The bar should feel light on your hands/rested on your shoulders. I particularly like this exercise as it develops body control in keeping upright, and not being allowed to collapse forwards – important when hitting uneven or challenging terrain. Again, keep a neutral spine, core engaged and shift hips backwards to squat. Aim as far as comfortable – ideally towards 90 degrees. Engage glutes to return.

OVERHEAD SQUAT

OVERHEAD SQUAT: Start with the bar above head – having the hands a little wider apart helps. Begin by setting your shoulder blades (think to slide them down your back). Keeping core engaged and head forwards, perform a squat. Watch knees don’t collapse in. Again this helps develop balance and control and the muscles that help prevent you falling forwards or collapsing.

Depending on what your aim is (more strength or strength endurance) , will determine how many sets/reps you complete. As a guide think between 4-6 reps for mid range strength and 3 -4 sets. These exercises are not prescriptive ; always seek advice of a professional, or get in touch with myself for any advice, or injury specific related concerns. Happy training 🙂

Working at the Cortina World Alpine Championships 2021

Follow this link for the little article I wrote up for skiclub GB recently on my time working with New Zealand skier Alice Robinson at the Cortina Alpine World Championships 2021 (where Alice got a 4th in GS).  It gives an insight to what goes on at these events, as well as the physio work I do….

 

Pre training visualization and activation

https://www.skiclub.co.uk/news/racing-riding-news/2021/02/behind-the-scenes-at-the-cortina-world-championships-2021

 

Race day at Cortina World Champs

 

Jan 20, 2021

Pre touring or running activation tips

With the lockdown continuing in many places, a lot more people have taken to running recently.  And those of us who are lucky to live in the mountains are hitting the touring hard.

 

After hearing some grumbles from clients/friends, I have put together a few pre mountain or pre running activation tips.  There are of course many exercises and things you could/should/would do, but here are 5 exercises that should take no longer than 5 minutes (unless you’re enjoying them and want to do more 🙂 )

They are a quick combo of release work and activation to try and encourage the often lazy muscle groups to get going, and try dampen down/switch off some of the over active ones.  This is of course different in people, but the trends are often over active, tight hip flexors and tensor fascia latae (TFL) (especially when touring long periods with extra weight on your feet).  And sometimes lazy/under-active gluteal muscles.

 

Try spending 30sec-60secs with foam rolling / trigger point ball releasing the tighter muscle groups, then about the same amount of time ‘waking up’ or ‘activating’ the glut and stability muscles (i.e core and feet muscles).

 

1) TFL or hip flexor ball release

1) TFL or hip flexor release:  Here a small massage trigger ball is ideal, but a tennis or golf ball etc will do.  Depending on where you find the ‘spot’ place the ball against the wall and lean your weight into it.  If trying to target the TFL (the small triangular shape ‘meaty’ bit muscle just over/infront of the hip joint) place the ball here.  To target more the hip flexor at the front, you can lie stomach down and place the ball just below the pelvis (ASIS) and hip.

At first it may feel quite uncomfortable, but try to breathe slow and deep, and the discomfort should ease and release.

 

2) ITB foam rollar release

 

2) Foam rollar release

So not the most comfortable thing to try and release, but try and ‘roll’ up and down the whole length of the outer leg (top of hip all the way to the knee).  Try and keep your core engaged and reap the extra benefit of getting your core going too!

If you really struggle with upper body strength, you can place the rollar against the wall (at different heights along your outer leg) – then lean all your body weight into it.  Move the rollar along the leg.

 

Glut activation

3) Glut activation 1: If you have some theraband that is ideal, but if not you can still connect and focus on activating your gluts without.  Start either stood up, or as I am here with a slight forward lean (but keeping spine neutral and core engaged).  Keep the static leg soft and aligned over your second and third toes. Take the moving leg out sideways, and slightly behind.  Try to not let the toes turn out and open up – this gives your hip flexors more chance of firing, when the aim is to get the gluteus medius working (i.e your pelvic stabiliser).

 

Glut activation 2

4) Glut activation 2: Here we are trying to get the glut max firing, one of the main hip extensors which will help you propel forwards with power and efficiency in both touring and running.  Start again lined up, with a slight forward lean, but core engaged and spine neutral.  Try not to let the pelvis twist, or allow the lower spine to give into extension, allowing the lower back muscles to over dominante the movement.

It also helps to keep the moving leg relatively straight, to not allow the hamstrings to kick in too much.  If you’re familiar with pilates this movement is a little bit like single leg kick.  To really make sure the gluts are the prime mover, think to do a mini ‘butt’ squeeze first before moving into extension.

 

Runners reach a)

5) Runners reach a): Try reaching forwards and down, keeping your static leg soft, but relatively straight.  Watch the pelvis doesn’t open up and you keep your core switched on.

 

 

Runners reach b)

5) Runners reach b): from the position above, using your core bring your back leg up in front to a balanced single leg position.  Try to use opposite arm to leg, to mimic a running type action that your brain is familiar with.  If you really want to challenge yourself and get your balance system going, try with your eyes closed!!

 

As mentioned above, these exercises are in no way prescriptive and ‘one size fits all’.  But they are a good starting point.   The release work is also very good post run or tour – try working a little longer and combining with some stretches.  Have an experiment with the massage ball.  For me personally I get pretty tight in my upper back and shoulders from where I previously broke my back, and where carrying a heavy ABS bag leaves me quite sore.  So I try and get the massage ball into those spots.  Have fun, stay fit and healthy 🙂  And of course get in touch if you are looking for more specific advice.

 

 

What exercise & rehab should you really be doing help your Shoulder?

Frustrated or unsure what you need to be doing to help your shoulder?

First of all the shoulder is a complicated joint and also relies on its surrounding ‘friends’ – the neck, thoracic spine and scapula (shoulder blade), so don’t be too hard on yourself if you feel you aren’t progressing.  This blog aims to facilitate your exercises and rehab, to increase your range of motion, function and therefore reduce pain.

So who are these exercises for?

Part one is aimed at those at the early/mid stages of rehab, but is also useful for anyone wanting to improve posture, performance and quality of movement, whether it be in the gym or whilst doing your sport.  If you can activate or ‘wake up’ your shoulder girdle prior to exercise, you are more likely to get better movement and control – also very important and may be the part you are missing in your gym programme if certain movements give you pain.

So if you are getting pain at the gym – it is not going to help your shoulder to lift heavy weights, if your stability or your ‘scaffold’ muscles, aka the rotator cuff can’t maintain a good position.  Makes sense right?  These exercise are also ideal for those who have had a shoulder dislocation, A/C joint injury, fracture or muscle strain.  Also perfect for those who sit bent over in front of  computer who are prone to postural related injuries (which are VERY common).

 

So what is it you need to include to maximise your shoulder rehab programme?

Don’t worry to much about the why, but trust me on these few things helping with the overall picture of getting your shoulder functioning better.  In some way or another exercises should include compression, or weight bearing, thoracic (mid spine) movement and some facilitation into external rotation to help engage the cuff .  What this means to you is weight bearing through the hands or elbow, moving and loosening off your spine and sometimes using a theraband, or turning your hands slightly outwards, engaging the posterior cuff to enhance firing up the cuff muscles.  Because the cuff are relatively small muscles that continually  provide the stability & good positioning to your shoulder, they benefit from low weight controlled movements – not your bigger compound movements – so don’t just jump straight into bench press or push ups to get strong ok?

 

Other Tips to help your shoulder

Making a fist or holding a light weight is a great, simple way for your brain to automatically connect to your shoulder muscles, telling them to switch on – clever hey? So that is a great start to get things engaging.

The other is to start combining lower body movement with your shoulder movement – research suggests that in a movement such as an overhead through, at least 50% – 80% of overall shoulder strength comes from the lower limb and trunk.  The body is also tuned to work as a ‘whole’ unit, so combining movements is key to the overall outcome of your shoulder.

 

MOBILITY & ACTIVATION

Starting off with mobilisation, then more into activation and strength.  If you have not got a gym ball, a table with a cloth works well!

 

 

EXERCISE 1: Use either a gym ball or a cloth on a table.  Start with activation and good positioning of the shoulder joint and scapula.  You can use your fingers to facilitate the shoulder going slightly back and being ‘central’ in the socket.  Think to pull the shoulder blade down and in.  Maintain this while sliding the ball back and forth.  Progress by adding some spinal movement forwards and back, trying to maintain a neutral spine. Repeat x 12

 

 

EXERCISE 2: Abduction.  Typically one of the more difficult movements to get back.  As above ‘set’ your shoulder into a good position.  Start small range then build up to include spinal movement. Repeat x12

 

 

EXERCISE 3: Again a high table & cloth works well if you haven’t got a gym ball.  Try push the ball away from you.  Make sure to engage your core and allowing some thoracic (mid spine) extension, but try and keep a relatively neutral lumbar spine. Repeat x6-12.

 

 

EXERCISE 4: Shoulder flexion and bridge.  If you have a theraband (TB) then wrap it around your outer wrists- keep thumbs towards you and fingers up to the ceiling.  If not you can use a broom stick or similar, failing that use your good arm to help the ‘bad’ arm.  As you squeeze through your gluts to a bridge, simultaneously take the arms over head.  Repeat x 8-15 reps.

 

 

EXERCISE 6: Thoracic rotation & lateral flexion.  You can use anything for this- even clasp your hands together.  Try and keep your core engaged so that your pelvis faces forward.  Twist side-side and then rotate x 1 min.  Repeat x2-3 .

 

 

EXERCISE 7:  kneeling walk outs: A TB really optimises this exercise – wrap it around outsides of wrists – try maintain hands at ’10 to 2′ position on a ‘clock’.  Maintain your core and neutral spine, walk hands in and out.  30secs x3-5.

 

 

EXERCISE 8: Push step backs.  Push the ball away from your (shoulder protraction)  as you drive and step one leg backwards.  Try and feel that your shoulder blades are swimming around the outsides of your rib cage.  Alternate legs & repeat x20

 

 

EXERCISE 9:  Roll outs.  This is quite a challenge, especially for the core.  Start with very small range and build up.  If you can keep the TB around the outer wrists this is going to help engage the posterior cuff.  Try 5-10reps.

 

 

EXERCISE 10: Wall walks.  Again better if you have got the TB – you guessed it, to wrap around the outside of your wrists.  Hands at ’10 to 2′.  Try keep shoulder blades down the back and engaged as you walk the hands up and down.  Try 30-60 secs x3

 

DISCLAIMER: These exercises are not prescriptive and its always best to get advice specific to you.  This is just a snippet of a complete shoulder rehab program.  If you want more advice on your shoulder or any other injuries, please get in touch 🙂

ACL injury……ski season over??

 

ACL injury………ski season over??

 

 

WHAT IS YOUR ACL & WHY IS IT SO IMPORTANT?

There are two main ligament structures inside of the knee which provide crucial stability and support.  The PCL (posterior cruciate ligament) and the more commonly injured ACL (anterior cruciate ligament) which is the focus of this brief blog, and most commonly injured in skiing.  With a torn ACL your knee is likely to give way and lead to further knee damage and pain.

 

MOST COMMON WAYS TO INJURY THE ACL

 

Image result for mechanism of ACL injury
BJSM_BMJ

Certain factors arise to the ACL being injured:

  • planted foot
  • knee valgus (knee dropping in)
  • often combined with tibia (the lower leg bone) externally rotating (turning out)
  • over extension of the knee
  • ‘back seating’ on your skis so the lower bone moves forward/combined with quads over activation
  • landing awkwardly off a jump
  • sudden stopping or change of direction
  • a blow to the knee

Any or a combination of the above can cause trauma and damage.  Most of us have felt that sensation of our ski drifting out (externally rotating) and knee rotating in.  Add significant force or speed or force to this and you have a problem.  This can also occur in beginners in snowplough, or getting off a chair lift.

Phantom Foot is the term used to describe a skier who falls backwards, so their hips drop below their knees, with most weight through the downhill ski, and the uphill shoulder/arm twisted.

Finally if you land a jump leant back with the knee extended (and weight in the back of your boots), the force can not be adequately absorbed, and the tibia (lower leg bone) is driven forwards, stressing the ACL.

 

WHAT ELSE COULD I HAVE INJURED?

 

Image result for knee diagram
flickr.com

This blog won’t go into detail, but there are a few other structures that can be injured and cause pain.  The MCL (medial collateral ligament) on the inside of the knee, the LCL (the lateral collateral ligament) on the outside of the knee, then the meniscus; the cartilage inside the knee.  A good history of the accident combined with certain physio assessment tests can help decipher which structures are most likely damaged and the appropriate timescales for recovery and rehab.

 

WHAT SHOULD YOU DO? IS YOUR SEASON OVER?

First thing is don’t stress and no your season isn’t over.  In the past I have seen several seasonnaires who have been told its time to go home.  This isn’t necessarily true.  If you get straight on with optimising recovery you can often return to work relatively quickly.  The more tricky question is can you ski again?  Maybe not straight away, but there have been a lot of people who choose rehab alone, over surgery.  If you can get your muscle strength and neuromuscular control improved through physio and a lot of commitment you can get back.

These are the first stages advised if you think you have had knee trauma:

  • get a check X-ray (often the tibia bone can have a fracture, which complicates things and should be ruled out early on)
  • See a physio to advise on specific movement and strength exercises related to YOU
  • PRICER: protect (Potentially reduce weight-bearing and wearing a brace), Rest (relative to let inflammation do its thing), Ice (10 mins frequently throughout the day), Compression (light tubi grip or bandage), Elevation (get the leg up above your heart level), Rehab (early rehab specific to you and your injury) – generally you need to get it moving!

PREVENTION

A final note on prevention.  Do your pre-season strength and conditioning.  See my other blogs on my website for more on this, but in brief you want to develop all muscles of your core, gluts, quads and don’t forget your hamstrings – these are vital in helping to ‘put on the brakes’.  Many people only work on the quads for skiing but hamstrings are just as important.  Also you want to include some landing control, change of direction exercises with good alignment and bio-mechanics to improve neuromuscular control and decrease the chances of injury.

 

Get in touch if you have a pre-existing injury and want to avoid further re-injury, or have  a ‘new’ injury and want more advice 🙂

 

6 Balance & Body awareness exercises that may help save your skiing & snowboarding!

Recently I’ve been doing some fun activities, particularly gymnastics.  Even though I surprised myself what I could still do, I was also shocked that when taken out of my comfort zone, or away from ‘normal’ activities how my balance wasn’t so good!  I’ve really noticed how our bodies become good at normal/regular movement patterns, but as soon as we for example spin / move our heads / try and do more than one task we falter.  This is hugely applicable to skiing and snowboarding – the terrain is constantly changing, so learnt movement patterns need to adapt, our body needs to respond and this all requires good balance to do so!  We’re also frequently faced with more than one task; not only remaining in control while skiing/snowboarding, but also dealing with other people on the slopes (distractions) or having to deal with poor visibility.

 

Either way improving your balance is going to help you improve your body awareness, control and performance – and may just help you save that fall!  Below are some examples of exercises that you could incorporate into a balance programme, or just add one or two exercises a day prior to your ski holiday to get these balance mechanisms switched on and ready for action!  Similarly a couple of these exercise before heading out in the morning to hit the ski slopes, will help activate and wake up those balance systems and muscles!

 

 

  1. Balancing with eyes closed: this is a great way to help improve your proprioception – or your bodies ability to tell your brain what is going on in the muscles and joints.  This is of huge value in skiing and snowboarding, as continual feedback from your joints and muscles is important, but is hugely significant when it comes to riding in poor visibility.  Now that your eye sight can not be relied on in the white out conditions, its down to your proprioceptive system to help and keep you riding strong and stay in control.

 

 

 

2. Single leg reaches – you do not have to have a partner for this – you can just reach out or place some cotton buds, coins etc on the floor to aim for.  You want to focus on ankle, knee and hip control as well as your core.  Think to keep the pelvis facing forwards (or down the fall line in skiing)- think to keep activated those lower abs and core muscles will help.  Next try not to let the knee drop in and keep it roughly in line with your 2nd/3rd toes.  Also try not to let the pelvis, or hip drop down too much.  This is also a great way to strengthen the hamstrings and gluts, as well as the calf and feet muscles.  All good stuff in preparation and/or activation for getting on the slopes right?

 

 

3. Single leg balance and stick.  Here it helps to have a buddy to push you!  Start on two feet, then progress to one, then finally one foot with eyes closed.  Having someone nudge you from different angles and different points on your body will activate your saving reactions – which come in handy on tricky snow terrain, or when we are up against those powerful external forces while skiing and snowboarding, especially at speed.  The other option here when without a partner is to throw and catch a ball against a wall.

 

 

4. Rotational separation.  In skiing you need good control to maintain your shoulders and torso down the fall line, but allow the hips and lower body to rotate and move with control.  Devloping your core will help with these movements.  Even though the exercise above gets your rotating differently (with your upper, which we don’t tend to  want in skiing), it is still a great exercise to work in flexibility and control, separating upper body form pelvis and lower body.

Here you want to maintain a neutral pelvis and keep the core on so it stays facing forwards, and doesn’t drop on one side.  Watch that the knee stays in line and doesn’t collapse in.  Try and think to activate your core and obliques to point your upper body and arms over to one side, without too much twist at the pelvis.  Repeat 10 each side, then swap legs.  Again this is great for strengthening the hip, knee and feet muscles.

 

 

5.  Heel raise balance control.  Start by lifting your arms above your head while simultaneously raising your heels off the ground with your knees straight.  Maintaining your heels off the floor slowly bend the knees – watch your knees do not collapse in.  Maintain this position for approx 5 seconds, then keeping the knees bent lower your heels down (also achieving a good stretch in the soleus muscle of the calf complex).  Finish by straightening up the knees to standing.  Repeat with control x 10

 

 

6. Spinning.  This may sound a little bizarre, but moving your body away from its normal boundaries is a great way of testing yourself.  Let go and have fun!!  Try spinning just 180 degrees then build from there.  This will wake up your vestibular system ( a balance organ within the ears).  It is the sensory system that provides the leading contribution to the sense of balance and spatial orientation for the purpose of coordinating movement with balance.  Sounds pretty pertinent to skiing and snowboarding right?  Give it a go, getting spinning!!

 

Other good exercise are doing multiple tasks at one time – so give any of the above a go, while trying to throw/catch a ball with a friend, or doing mental challenges such as counting down in odd numbers whilst performing the exercises.

 

 

 

 

Get tired calves and feet while skiing & snowboarding? Here’s why & ways to help prevent it

When it comes to ski and snowboard training we often to tend to focus on the juicy exercises involving the quads, gluts and hamstrings.  However when hitting the slopes, most of us feel that our calves ache, and feet get tired, right?  Any pre-ski training should involve exercises to work the muscles below our knees, not only our calves, but our peroneals, posterior and anterior tibilais muscles.  All these muscles stabilise the foot and consequently the knee.  These muscles, if not strong or able to cope with the demand whilst skiing and snowboarding, can cause uncomfortable cramps, or worse become pulled or strained.

Specifically snowboarders – do you ever feel like your calves and feet are on fire while on your toe edge snowboarding? Definitely give these exercises a go to give you more stamina and hold those edges longer! – no gym equipment or excuses needed!

 

** If you think you have an injury or weakness it is always best to have a consultation and a specific exercise plan – get in touch for more info.  Be particularly aware if you have history of Achilles tendinitis

 

STRAIGHT KNEE HEEL RAISES (CALF RAISE)

Start this exercise with your foot flat on the floor.  No trainers, or only minimalist shoes are good to encourage more stability in your foot.  This differs slightly from off the step calf raises – your ankle and foot must work hard to maintain alignment and balance.  This exercise can be done in sets such as x12 reps x 3sets and/or static holds to build endurance – i.e try holding the position 1 min at a time x3

Off a step is good for adding weight to increase calf complex strength and also achieving a mechanical stretch.  Allow yourself to be balanced with heels off  step  -raise all the way up and then drop the heels all the way down.  Unlike the variation above, I advise you hold on so that you can work on strength and add weight (no gym needed – using a back pack full of books is just as good.  Start with free body weight.  When you can complete x12 x3 easily, then start to add weight).

 

BENT KNEE HEEL RAISES (SOLEUS)

This is exactly the same as the exercise above, but with the knees bent.  Why?  Because there is another very important muscle lying under the calf, called the soleus, which also needs to be exercised.  It works hard constantly to maintain even just you standing upright – but particularly hard so that you don’t fall over skiing.  Its also going to allow snowboarders to stay more balanced and strong on their snowboarding toe edge.  Exercising this muscles will help to prevent that toe edge burn kicking in as quickly!

 

 

KNEE BENT THROW/CATCH

Following on from the exercises above, this exercise is designed to add a bit more instability and challenge – just like you would be faced with when out on the ski slopes.  Try and maintain balance with knees bent, while throwing and catching.  This is best done with a partner so you can challenge your throws!  However on your own, a wall is good enough!

 

 

STRAIGHT KNEE THROW CATCH

As the exercise above – but with the knee straight to focus more on the calf muscle

 

 

TOE TAPS AND POGOS

While skiers need strength in this muscle, this one is focused more for the snowboarders.  It targets the muscle at front of your shin, known as your tibialis anterior. At any stage of snowboarding, if this muscle is strong it will certainly help.  While you are learning this muscle is constantly battling to try and maintain your balance on those tricky edges!  As you ride more, those challenging traverses often need stability and endurance from this muscle to maintain your heel edge.  Most snowboarders will be familiar with the burn and dreaded fear of  a heel edge traverse!  These exercises will certainly help:

  1. toe taps: keep the foot flat and try and tap your toes up and down as quickly and as many times as you can in 30secs (you will find this harder than you may think) – repeat 3-5 times.  You can then add a flat (disc) weight if at the gym and try and lift the weight up.  At home a bag of sugar or similar can work.
  2. pogos: imagine you are skipping with a rope – but you are going to keep you feet flat – i.e. not jump on your toes as normal.  Perform these flat footed bounces as fast as you can – again aim 30 secs x3 – 5 (think to focus on weight through the heels, and keep the toes lifted up)

 

 

PLYOMETRICS: peroneals

The aim of this exercise is to work on plyometrics and eccentric load for the muscles on the outside your lower leg.  These muscles again are vital in stabilising the foot in skiing and snowboarding – but particularly in snowboarding.  Often these muscles have to work in a slightly lengthened position, or have to fight mixed terrain within the snowpack, so need this ‘reactive’ type of strength and stability.

Start standing on a step (or your stairs).  Start from two feet and hop down onto one foot.  As soon as your foot makes contact with the floor, immediately hop up and think to flick your toes inwards (like tapping a ball inwards with your big toe), before your foot comes back down to land neutral.

This can be slightly progressed by starting single leg on the step and jumping off, landing, then hoping straight off that same side.

 

There are many exercises that can help –  here are just a selection.  Any single leg reaching with the foot or arm, or balance cushions and wobble boards are all great ways to do this.  You do not have to do this as a complete workout-  you may prefer to add one or two of these exercises at the end of your normal workout.

Future blogs I will look at some more balance focused exercises which will also help the endurance and stability of these muscles, which will hopefully allow you to ride better for longer!

 

 

 

5 Top Tips what to look for when looking for a Physio

1.CHECK THEIR PHYSIO QUALIFICATIONS

Sounds simple, but you may be surprised the number of people working without the proper qualifications and registration with the relevant legal governing bodies.  In France, where you ever you are, you can perform a search on the  http://www.ordremk.fr/ – follow the trouver mon kinésithérapeute, to find registered physios.  The UK has the hcpc with a similar register of physios in the Uk:  https://www.hcpc-uk.org/check-the-register/

 

2. INSURANCE

Any physio that is fully registered will also be fully insured.  Having completed 9 seasons in Val, I have dealt with many insurance companies and can fully support anyone going through the process.  I am also the only British physio within resort who is able to accept people who are on the french system (with carte vitales), and can claim treatment costs back.  Shoot me a line if you want to know more (physio@jopollardphysio.com or 0033669776112)

 

3. KNOW THEIR PHYSIO EXPERIENCE & RELEVANT AREA OF EXPERTISE

While all physios undergo a degree in physiotherapy, time and exposure to certain injuries helps build in-depth knowledge in that area.  Having qualified in 2007 I have been lucky enough to work in all ‘core’ areas of physio, but have chosen to follow my passion in skiing and snowboarding and been fortunate to work with international teams.  My experience from many ski seasons and international work, I am confident I can help with all injuries, and fitness queries to get you back on the slopes as quickly and safely as possible.

 

4. METHODS OF TREATMENT

You may have had a certain treatment in the past that works well for you.  Or you may never had physio before.  Either way, finding someone with experience and an array of ‘tools’ can benefit you and your treatment.  Over the years I have had added many qualifications to my physio skills -here are a few of the main ones: spinal manipulation techniques, dry needling, sports massage diploma, myofascial K taping, pilates, yoga for physiotherapists, strength and conditioning.  I often use a combination of treatments (including compex) to and strength and conditioning advice to optimise rehab.

5. AVAILABILITY & LOCATION

This is a pretty obvious one, but it is much better to touch base with a physio as soon as possible – even if it is just to enquire how they can help.  I will always endeavour to see anyone as soon as possible, especially if it means they can get an extra few hours on the slopes.  My cabinet is located easily within Val (see contact for directions), and I can also make visits out to chalets – especially if any injury means you are immobile.

 

DRY NEEDLING…..What it is & how it could help your injury & pain

WHAT IS DN & HOW IS IT DIFFERENT TO ACUPUNTURE?

A thin filiform needle is inserted into a trigger point , connective tissue or fascia and is used alongside other forms of physiotherapy to promote pain relief, reduce stiffness and facilitate range of movement and function. It’s has been use since the 1980’s but recently become very popular.

ACUPUNTURE is a similar concept of needling but can be seen as more holistic, looking at the body’s state of energy flow and meridians.  Acupuncture focuses on fixed points where as DN targets more specific muscle pain points. The therpapist will palate and find these pain / tight spots.

The areas of muscle pain are known as myofascial trigger points. Muscles can have one or several points.  They are seen as hyper irritable spots in skeletal muscle that are associated with hypersensitive palpable nodules in taut bands…. That knot you feel in your upper shoulders most of you will be familiar with?!

Often these trigger points will REFER PAIN , so we may put needles in quite far away from where you will be perceiveing your pain.  BACK & SCIATIC pain would be a good example of this…… Often needling would be used around the back for pain that is felt down into the leg.

Studies have shown 30-85% of people presenting to a clinic are found to have myofascial trigger points to be the cause of their pain!

 

WHAT ARE THE EFFECTS?

By inserting a needle into these taut bands / trigger points we are aiming to re set the muscle and help reduce the referred pain. A local response of redness , swelling , heat and pain such as seen in an inflammatory reaction will be elicited – briefly this will stimulate the good chemicals to be released and  begin to reverse the ischemic (or toxic like) effects which commonly occur with injury. This may help REDUCE PAIN, INCREASE ROM, MOBILITY and FUNCTION

 

WHY SHOULD YOU TRY IT?

For all the reasons listed above!  It is another modality that can be used alone or in conjunction with other physio techniques which may help facilitate your healing, or better allow you to access a movement pattern/range of movement you have been struggling with.  Also the many ways needling can act on the body in terms of pain relief, it may benefit you where perhaps other treatments no longer have such a desired effect.  It can also be a very quick procedure so ideal in sports settings.

 

WHAT WILL YOU FEEL?

there are various sizes of needles and the therapist will choose one depending on the muscle and each individual . Treatment is often pain free but it is common to feel a ‘twitch response’ . The needle can be manipulated to further stimulate the fascia and muscle tissue to produce a local stretch response. Keeping it brief needling works on pain at different levels within the body ( locally, within the spinal cord and the higher ‘brain centers’ ) but overall has been seen to facilitate opioid release and pain modulate.

Everybody’s experience is different but often when needling the lower limb patients report a feeling of lightness.  It’s also quite common to feel a dull ache following treatment

Below is a nice example of how fine the needles are – nothing to be afraid of!:

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example of how small the needles are in DN & acupuncture

 

DEEP (trigger points) VERSUS SUPERFICIAL (pain relief)NEEDLING:

superficial needling uses needles that are much smaller and don’t penetrate more than 1cm, but are often left in for up to 15 mins.  Where as deep needling uses needles up to 125mm treatment normally lasts for a couple of mins.

superficial DN:

– reduced local & referred pain ( activates mechanorecptors coupled to C fibers)

– increased ROM ( stretching in fibroblasts within connective tissue/ fascia)

– if stimulating skin according to hiltons law you the same nerve will innervate the muscle directly below, so potentially have an overall greater effect

deep DN:

– local twitch response ( targeted at specific muscle )

– reduction of noxious inflammatory immune related chemicals

– resetting and reduction of pain within a muscle

– overall increased ROM, decreased pain and increased function

 

If you would like to know if needling can help you with an injury be sure to get in touch!