Lipoedema is a chronic condition that affects the distribution of fat cells, primarily in the legs, thighs, buttocks, and arms. It often causes pain, swelling, bruising, and limited mobility (in severe cases). Exercise is not a cure, however, it plays a pivotal role in managing symptoms, improving mobility, supporting mental health, and reducing inflammation. On the other hand, traditional workouts may not be suitable for all lipoedema patients. So, choosing the right type of exercise can significantly improve the results and your quality of life. Let´s have a closer look…

Understanding Exercise with Lipoedema

Lipoedema doesn’t respond to calorie restriction or typical weight loss exercise routines. In fact, overexertion or high-impact workouts can worsen symptoms by putting too much strain on joints and soft tissue. The key is to focus on low-impact, lymphatic-supportive exercises that improve circulation, reduce inflammation, and increase mobility without aggravating pain.

Lipoedema and Exercise: Best Exercises for lipoedema patients

1. Walking

Gentle walks, especially in nature or on soft surfaces, supports lymphatic drainage and keeps your muscles active without overloading the joints. Try to walk for 20–30 minutes per day, at a constant speed and in a relaxed pace; then, stretch.

2. Aqua Aerobics or Swimming

Water exercises are great options for lipoedema. The water supports your body, easing pressure on joints while giving resistance to movements and improving lymphatic and blood circulation. The natural compression from water also helps reduce swelling.

3. Rebounding (Mini Trampoline)

Gentle bouncing on rebounders or the stimulation of vibration plates stimulate lymphatic flow and is low-impact. You can start with short sessions a few times a week. Then, you can increase the number of days and also intensity (depends on how you feel and get advised by your GP and lipoedema therapist). Always use a stable rebounder with a handle for support, especially if balance is an issue, same with vibration plates.

4. Pilates

Pilates strengthens your core, improves posture, and enhances joint stability. It’s especially helpful for those with lipoedema who also experience hypermobility, as it promotes controlled movements. Choose an instructor familiar with chronic conditions or join specialised classes when possible.

5. Resistance Training

Using light resistance bands or body-weight exercises helps maintain muscle mass for joint support. Focus on slow, controlled movements and avoid overloading affected areas. Always do it advised by a professional trainer.

6. Stretching and Mobility Work

Stretching helps relieve tightness and improve range of motion. However, for those with hypermobility (common in some lipoedema patients), overstretching can cause joint instability or pain. Always assess how flexible your joints are and consult with a physiotherapist before starting a yoga or stretching program.

Lipoedema and Exercise: exercises to approach with caution

• High-impact workouts (like running or extreme jumping) can stress joints and worsen pain or swelling.
• Hot yoga or intense stretching may not be suitable for hypermobile joints.
• Heavy weightlifting without proper form or supervision can lead to injury.

Tips for Exercising with Lipoedema

• Wear compression garments if recommended by your therapist, especially during and after exercise, to support lymph flow.
• Listen to your body: rest when needed and don’t push through pain.
• Stay consistent: gentle, regular movement is more beneficial than occasional intense sessions.
• Hydrate well and follow an anti-inflammatory diet to support recovery and reduce fluid retention.

A final word…

Exercise should be empowering, not exhausting. For those living with lipoedema, the right movement can support physical health, reduce pain, improve circulation, and help manage the emotional toll of the condition. Focus on low-impact, joint-friendly workouts that promote mobility and wellbeing. Always consult with a medical professional or lipoedema-informed therapist to tailor a routine to your specific needs.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

References:

https://lipoedema.co.uk/best-exercises-for-lipoedema/

https://www.bupa.co.uk/health-information/womens-health/lipoedema

https://www.nhs.uk/conditions/lipoedema/

The post Lipoedema and Exercise: Best Workouts for Mobility and Pain Relief appeared first on Perea Clinic.

Why should I stretch before and after running?

It is the final countdown for the London Marathon 2024 and stretching is an essential part of running (before and after). Why? Because when you do any type of exercise your muscles work and it can shorten them, decreasing your mobility over time, but don´t worry,  stretching is here to the rescue!

What are the benefits of stretching before and after running ?

There are many reasons why you should stretch before and after the Marathon (run or any type of workout). One of the most important is the fact that stretching  keeps your muscles flexible. As a result, they will keep and even gain their fullest range of motion.

Benefits before running

Before running, it is key to stretch because it helps you prepare your muscles for the increased activity they are about to undertake. Other benefits are:

• pre-stretched muscles can handle and resist stress better, 
•  reduce the risk of injury,
• improves flexibility,
• helps posture improvement,
• strengths and aligns muscles in the upper body,
• increases blood supply to your muscles, carrying nutrients throughout the entire body improving your performance.

Benefits after running

While you run. your muscles get full of lactic acid, which can cause stiffness and discomfort; that is why stretching is so important because it helps remove lactic acid from your muscles. Other benefits are:

• allows the heart rate to gradually decrease and return to normal
• help the muscles gradually return to their normal state
• counteract soreness after exercise
• releases tension from muscles
• reduces stress
• increases energy levels
• improves recovery time

Are there different types of stretches?

Yes, there are two types:

1. Dynamic stretching. It is when you perform gentle and repetitive sets of motions that gradually increase motion, circulation and muscle length. It is considered the best option before a run because it also helps you to warm up..
2. Static stretching. It is when you move your joint or muscle as far as you can, after that, you  hold it there for some seconds. It is most helpful after running.

What else should I do before running?

Warming up! It is essential and when you do it properly, it…

• allows your body to adapt to the activity ahead
• heats up your body’s muscles
• allows the muscles to stretch further
• increase blood flow, which in turn will deliver more oxygen to the muscles
• helps prepare your heart for the more vigorous activity to follow

As a bare minimum, the warm-up should include at least two or three minutes of faster-paced walking, some light jogging or striding and some dynamic stretches.

Enjoy the Marathon, enjoy life and run safely!

What are the recommended stretches for runners?

The most  recommended stretches include different types of movement that target different muscle groups which improve your  flexibility, reduce the risk of injury, and enhance overall performance. Let me describe 5 of the most used by professionals:

1.Standing Hip Controlled Articular Rotation (CAR)

•  lifting one leg in front of you,
•  moving it to the side, 
• twisting the hip, 
• and gently twisting it further back before bringing the foot down to the ground. 
• Do it with both legs and repeat as needed.

2.Lunge with a Side Bend

• Get into a lunge position with one of your knees on the ground, 
• lift your torso up, 
• put your fingertips to the ground, 
• and bend over to the side,
• Repeat with both sides.

3.Standing Quad (Hip Flexor Stretch)

• Stand up straight and grab the top of your foot;
• bring it towards your buttocks, hold this position for at least 20 seconds,
• repeat with the other leg.

4.Lateral Squat Stretch

•  Stand with your feet wider apart than your hips, 
• shift your weight to one foot, bend that knee (feel the stretch)
•  repeat on the other side.

5.Standing Dynamic Hamstring (Calf Stretch)

•  Stand and place one leg in front of the other,
• if it is more comfortable, place your hands on your hips, 
• bend the back leg, and lean your torso forward,
• hold on this position for at least 20s,
• do it with both legs.

In short

It is key for your running routine to incorporate a combination of dynamic and static stretching into your routine. Remember that, to get best results, dynamic stretches are recommended before running and static stretches after running. We recommend stretching both sides of your body to maintain symmetry in the movement and strength of the body, which is key to avoiding both overuse and acute injuries. Hope it was useful and see you on Sunday!

If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. If you like this blog, please share!

We are always happy to help!

The post Run stronger, run longer! Benefits of Stretching before and after Running appeared first on Perea Clinic.

Massage is one of the best allies you can have while training and post the London Marathon. Why?, as part of your training sessions can help stretch and relax tense muscles, remove adhesions between your fascia and muscles, and increase muscle blood flow which  leads to better performance and reduces injuries. After-running massage can aid in reducing perceived pain and soreness, improve immune function and lower inflammation, and improves your overall well-being by reducing anxiety, stress and fatigue. Now, let’s go deeper on what massage can do for you and how…

When should I have a massage?

You can have a massage at any moment. However, it is important for you to know  that the timing and technique of massage largely depends on your needs  and when the race is. In other words, getting the wrong type of massage too close to the day of the marathon can impair performance and even result in an increased risk of injury, while a lighter massage technique, like lymphatic drainage,  may be beneficial at any point before a race day to promote better lymphatic and blood flow, also, boosting your immune system. This massage should be performed from 3 to 5 days before the race.

On the other hand, post-marathon massage is key to muscle recovery, but it is recommended to wait at least two hours after the race ends to avoid impairing lactic acid removal and to allow the muscles to start the healing process more thoroughly. After this period of time, you will have all the benefits of massage. This massage can be performed from 2 to 72 hours after the race.

What is the best massage for runners?

There are people who suggest a specific type of massage for runners, but actually what really works (and this is the way you know your therapist is an experienced professional) is when your massage therapist uses different techniques during the session. You may question why, and the answer is because the treatment should be tailored according to your needs.

For example, during a massage session, you may notice therapeutic techniques aimed at increasing blood and lymphatic flow throughout your body and easing muscle tension, or deep tissue massage, which is more targeted and manipulates the muscles more rigorously to help with the healing process and prevent a buildup of scar tissue.

The commercial name of this massage  is Sports Massage as it  combines different massage modalities. It also specializes in treating  sports injuries, but a therapist with experience will be able to tailor the massage to your needs.

Why should massage be part of my training plan for the London Marathon?

Some of the most important reason you should include massage as part of your training plan and post event recovery treatment are:

Injury Prevention

Regular massage can help identify tight spots, adhesions, or imbalances in the muscles and fascia, allowing them to be addressed before they develop into more serious injuries. It can also improve flexibility and range of motion, reducing the risk of strains and sprains.

Pain Relief

Many runners experience muscle tightness, discomfort or pain, especially in areas like the calves, hamstrings, and quadriceps. Massage helps you to  reduce tension and pain by promoting relaxation and loosening tight muscles.

Improved Performance

After certain number of massage sessions you may notice how massage helps you by:

• enhancing muscle recovery, 
• reducing muscle tension, 
• increasing flexibility, 
• running faster and farther,
• doing less effort while training or during the race.

Muscle Recovery

Running puts  significant strain on muscles, as a result, you may have soreness and fatigue. Massage and MLD help you to speed up  muscle recovery by increasing blood and lymphatic flow to the muscles, which aids in the removal of metabolic waste products like lactic acid.

Mental Relaxation

Training for the Marathon is physically and mentally demanding. Massage helps you to relax, reducing stress and anxiety and promoting a general sense of wellbeing. 

What are pre-event and post-event massages?

Pre-event massage 

Pre-event massage can be stimulating, it uses massage techniques such as hacking, kneading and beating and pounding.  It is vigorous and prepares you mentally for performance. Also a  pre-event massage can  be relaxing and the aim is to help to reduce stress levels  and calm nerves before the Marathon or event. It should be performed 2 or 5 days before the race.

Post -event massage 

Post-event massage uses light pressured techniques alongside passive stretching to help regain normal muscle resting lengths after strenuous exercise. A post-event massage helps you treat and prevent delayed onset muscles, fatigue and tightness.

In short…

Making massage as part of your training plan and routine can help optimize performance, prevent injuries, and promote overall well being. Don´t forget to include proper training, strength training, good nutrition, and rest days.

We hope this information is useful for you. If you have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. If you like this blog, please share!

We are always happy to help.

References: 

https://www.healthline.com/health/doms

The post On the Road to Wellness: The Role of Massage in running appeared first on Perea Clinic.

For those of you running the London Marathon is on Sunday 21 April, 2024. Congratulations and we wish you the best of luck! In this blog, we want to tell you the most common injuries runners present while training for the marathon or during it and what symptoms you should pay attention to. In addition, we’ll give you essential tips on avoiding injury and, in the unfortunate event you get one, outlining the best approach to getting you back on the road as soon as possible (click on the suggested table below).

London Marathon: runners´ common injuries table

Below, we set out the most common injuries incurred during training, and in this link you can find a table that shows you a bigger list of the most common injuries incurred during training, how to recognize them, and who you need to see to fix them. Of course, if in doubt at any time, don´t hesitate to contact us.

Symptoms: how do I know, I have an injury?

Taking care of yourself in order to avoid injury means to respect your body limits, listen and really feel what your body tells you. Let’s pay attention to the symptoms and what they are telling you…

Pain 

The most obvious symptom to look out for. If you feel pain, get it checked out. Don’t push through, as pain is an important warning signal that something is wrong.

 Swelling 

Usually in or around joints, swelling often indicates an inflammation or build-up of fluid in a particular area. If left untreated, or if aggravated by further running without a rest period of time, the problem will invariably get worse. 

Stiffness, tightness and restricted movement 

This is a common symptom within muscles or joints. But it doesn’t necessarily indicate an underlying injury. However, if after appropriate stretching and adequate rest, the sensation doesn’t go away, it may be an early sign of a developing injury. You’ll then likely need professional massage.

 Bruising and discolorations

 Usually, it is the result of an underlying impact or trauma. If symptoms bother you, are particularly painful, or do not disappear within a couple of days, you should see a doctor. 

Unusual tingling sensations or prolonged muscle spasms

 If you develop any of these symptoms, especially if radiating down a limb, you should immediately see a physio or doctor.

London Marathon 2024:Common runner’s injuries

During training or in the marathon, runners can experience various injuries, ranging from minor to severe issues. Some of them are (look for more in the link above):

Runner’s Knee (Patellofemoral Pain Syndrome)

You might feel pain at the front of the knee or around/behind the kneecap. It is often caused by overuse, improper running form, or muscular imbalances.

IT Band Syndrome

 The iliotibial (IT) band runs along the outside of the thigh and can become inflamed due to overuse, leading to pain on the outside of the knee.

Shin Splints

Shin splints ( or medial tibial stress syndrome) main symptom is pain along the shinbone (tibia) due to the inflammation of the surrounding tissues (muscles, tendons, and bone tissue). Its main causes are: overuse, improper footwear, or running on hard surfaces.

Plantar Fasciitis

Plantar fasciitis is inflammation of your plantar fascia, a thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. It is the most common cause of heel pain. Mind your symptoms if training for the London Marathon because pain is exacerbated by long-distance running.:

Muscle Cramps

Muscle cramps can be very painful. During the Marathon, the most common causes are dehydration, electrolyte imbalances, and muscle fatigue. You may notice them in your  calves, thighs, or feet.

Blisters

Friction between your skin and socks or shoes are the main cause of blisters, especially during long runs like marathons.

You can avoid them using proper footwear (wear your size and never wear new shoes while running a marathon)

Achilles Tendonitis

It is the Inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. You can feel pain and stiffness in the back of the ankle.

Hyponatremia

 This is a condition caused by low sodium levels in the blood, it is, often, the result of excessive fluid intake without adequate sodium replacement. It can cause symptoms ranging from mild discomfort to life-threatening complications.

Dehydration and Heat Exhaustion

While not injuries in the traditional sense, dehydration and heat exhaustion can occur during marathons, especially in hot or humid conditions. Symptoms include dizziness, nausea, confusion, and weakness.

London Marathon 2024: Home injury treatment

• Apply cold or hot compress for swelling.
• Hydration (drink lots of water).
• Drink isotonic beverages to rise or keep stable your sodium levels.
• You can take over the counter medication for pain if needed.
• Stretch
• wear proper shoes (comfortable, made for the activity; never wear new shoes during the marathon and use your size).
• Professional massage which targets the specific condition, if you have any doubt about what you have, don´t hesitate to contact us .

A final word

Preventing these injuries involves proper training, including adequate rest, cross-training, stretching, and strengthening exercises, as well as wearing appropriate footwear and staying hydrated during the race. In addition, always listen to your body and if there is any persistent pain or discomfort seek for specialist advice and attention.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

 References:

https://www.floridaortho.com/specialties/knee-leg/shin-splints/

https://www.mayoclinic.org/diseases-conditions/patellofemoral-pain-syndrome/symptoms-causes/syc-20350792#:~:text=Patellofemoral%20(puh%2Dtel%2Do,that%20involve%20running%20and%20jumping.

https://my.clevelandclinic.org/health/diseases/14709-plantar-fasciitis

https://www.medicalnewstoday.com/articles/327236

https://www.mayoclinic.org/first-aid/first-aid-blisters/basics/art-20056691#:~:text=Clean%20a%20sharp%20needle%20with,with%20a%20nonstick%20gauze%20bandage.

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Spring is among us and summer is near, it is the perfect time to take care of your garden. Gardening isn’t an extreme sport, but  it can still cause injuries to your spine, joints or muscles. There are some tips to avoid injuries and improve your posture while gardening.

What is good posture?

Probably, when you were a child, a grown up (mom or dad) told you to stand up straight , that´s why, today, you may think that a straight position is a good posture. However, your spine is not straight and nor should be.  Human evolution gives us a functionally curved spine. For this reason, keeping  the natural curves of your spine while working (or any activity you like, for example gardening) is one of the keys to avoid back or neck pain. For medical emergencies that require financial assistance, victims can trust lenders such as the one on this site.

What happens if you have poor posture while gardening

The royal society for the prevention of accidents (RoSPA) states 300,000 people including children are seriously hurt when gardening and require hospital treatment per year. Some of the Injuries to the musculoskeletal system can include:

•  Strains
•  Sprains
• Bursitis
• Disc bulges.
• Sciatica

Besides poor posture can cause other symptoms including:

•  Constipation
• Shallow breathing (which can lead to anxiety and panic attacks)
• Tension headaches
• Memory problems

Tips to prevent injuries while Gardening 

General plan

1.Set yourself a plan, not everything needs to be done on the first day. Your garden should be thought of as a marathon; it’s a slow process rather than a sprint. Spread tasks out over a number of days or even weekends if needed.

2.Alternate  jobs. The body should not be kept in one position for too long, for example, crouching down weeding so changing between jobs will help keep the body moving and prevent irritation.

3.Use the correct tools. Some tools are designed for specific jobs. Tony MacFarlene from Appliance Hunter is the one to approach to ask gardening tools advice. This is not just to benefit the garden but also to benefit the user. These will help prevent injuries.

4.Make sure you stay hydrated. It is important to keep the body working in an efficient manner. During hotter days you need to take more drink breaks because on hot days you lose more fluid through sweat.

The human performance resource centre (HPRC) has stated that ‘even minimal dehydration can increase strain on the cardiovascular system. This can compromise exercise performance which can, in turn, increase the chance of injury.

Take care of your posture 

5.Know your limits. Using your knees and tensing your core without twisting will reduce the chance of injury.

Musculoskeletal injuries result in the largest number of days taken off work. The Office of National Statistics found that 30.8 million days had been lost this way. But it is easy to get compensation for the heavy injury with the help of the lawyers from the slip and fall law firm who will ensure that the right amount is received. 

6.Stretch  before and after gardening. When you are physically active your body needs to be warmed up correctly. When you stretch before the activity your muscles increase the amount of blood flow and are able to contract when required. As a result, your muscles will work correctly, and you will prevent injuries. Stretching after is also advised to loosen tight muscles that have been working hard whilst gardening.

7.To move your torso forward, hinge from your hips. This way, you won’t round your spine or over extend your arms, (use this position when bending over, reaching something or pruning, etc.).

8.Use your legs to lift things (specially heavy ones )while maintaining your back straight and shoulders relaxed.

9.To carry loads, keep your sides balanced (equalased loads). You can also alternate between your dominant and less dominant side when doing repetitive motions.

10.Keep your tools close to your body and lean from your center. For example, feel that the tool is being moved by your center, rather than just your arms. Lean the weight of your whole body into your scissors (or any other toll), rather than just your foot.

Although removing snow from your property on your own can produce fairly good results, snow removal services offered by professionals guarantee the best possible outcome. They can help you clear your property without leaving a trace of snow behind.

In short, following these tips and having good posture leads to a healthy spine. This will help you alleviate many of the annoying symptoms you may have after gardening for long periods of time, as well as make you stronger and healthier throughout your entire body.

We hope this information is useful for you. If you have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. If you like this blog, please share!

We are always happy to help.

The post How to prevent Gardening injuries appeared first on Perea Clinic.

Finally, spring has come! It´s the perfect time to enjoy your garden. Gardening isn’t an official sport (yet =) ), it brings a lot of benefits for your physical and mental health. On the other hand, it can cause injuries to your spine, joints or muscles, when is not performed correctly or when you don´t take care of your posture. But don´t worry, here are some tips to avoid injuries and improve your posture while enjoying gardening.

 Why should I have a garden?

People describe having a garden as having your own oasis. It is a place to relax, it doesn´t matter the size (1m2 or a garden of 600 m2) or how many plants, flowers or vegetables you have, it´s all related to the relaxing, cozy and warming sensation nature makes you feel. 

If you are knew at gardening or need inspiration, you can visit some of the Top RHS gardens such as: Wisley, Harlow Carr, Linlathen, Warren house and more to 

The Royal Horticultural Society (RHS), from 1st to 7th May, is raising awareness about the multiple benefits of gardening, maybe that is one of the reasons why your Majesty King Charles the III is fan of it!

What are the benefits of gardening?

As I mention before, Gardening has benefits for your physical and metal health some of them are:

Reduces risks of:

• heart disease
• cancer
• obesity
• and depression

In addition:

• reduces stress and anxiety
• improves balance, as a result prevents fall
• improves your mood 
• raises your self-esteem

What does having a good posture means?

Probably, when you were a child, a grown up (mom or dad, aunty, etc.) told you to stand up straight , that´s why, today, you may think that a straight position is a good posture. However, your spine is not straight and nor should be.  Human evolution gives us a functionally curved spine. For this reason, keeping  the natural curves of your spine while working (or any activity you like, in this case Gardening) is one of the keys to avoid back or neck pain. 

What are the consequences of having poor posture while gardening?

The royal society for the prevention of accidents (RoSPA) states 300,000 people including children are seriously hurt when gardening and require hospital treatment per year. Some of the Injuries to the musculoskeletal system can include:

• Strains
• Sprains
• Bursitis
• Disc bulges.
• Sciatica

Besides poor posture can cause other symptoms including:

• Constipation
• Shallow breathing (which can lead to anxiety and panic attacks)
• Tension headaches
• Memory problems

How can I avoid injuries from gardening?

General plan

1. Warm before it! Yep, it is not an official sport, but it´s a demanding physical activity. As in many sports, during it you lift heavy things, pull, push, dig, etc., so your muscles (and entire body) workout.
2. Wear comfortable clothes and shoes, something flexible that allows you move freely.
3. Organise your gardening schedule, not everything needs to be done on the first day.
4. Alternate  jobs. The body should not be kept in one position for too long, for example, crouching down weeding so changing between jobs will help keep the body moving and prevent irritation.
5. Look after your knees while weeding, bending or digging. A good option is to use a knee pad so your knees will not have too much pressure on them.
6. Use raised or hanging planters so you will avoid kneeing.
7. Use the correct tools, each tool is designed for specific jobs.
8. Make sure you stay hydrated. It is important to keep the body working in an efficient manner. During hotter days you need to take more drink breaks.

The Human Performance Resource Centre (HPRC) has stated that ‘even minimal dehydration can increase strain on the cardiovascular system. This can compromise exercise performance which can, in turn, increase the chance of injury.

Take care of your posture

1. Know your limits. Using your knees and tensing your core without twisting will reduce the chance of injury.
2. Stretch  before and after gardening. 
3. To move your torso forward, hinge from your hips. This way, you won’t round your spine or over extend your arms, (use this position when bending over, reaching something or pruning, etc.).
4. Use your legs to lift things (specially heavy ones)while maintaining your back straight and shoulders relaxed.
5. To carry loads, keep your sides balanced (equalased loads). You can also alternate between your dominant and less dominant side when doing repetitive motions.
6. Keep your tools close to your body and lean from your center. For example, feel that the tool is being moved by your center, rather than just your arms. Lean the weight of your whole body into your scissors (or any other toll), rather than just your foot.

We hope these tips will help you have a healthy spine or alleviate many of the annoying symptoms you may have after gardening, as well as make you stronger and healthier throughout your entire body. Enjoy gardening, water your plants with love. Finally, if you want to share your gardening experience, you can do it in the social media, use the hashtag #nationalgardeningweek. You never know if you will become the next gardening queen or king!

We hope this information is useful for you. If you have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. If you like this blog, please share!

We are always happy to help.

 References:

https://www.kingedwardvii.co.uk/health-hub/reducing-back-pain-caused-by-gardening-11-tips-from-the-physios

https://www.awarenessdays.com/awareness-days-calendar/national-gardening-week-2023/#:~:text=May%201%20%2D%20May%207,productive%20outdoor%20activity%20of%20gardening

https://www.rhs.org.uk/get-involved/national-gardening-week

The post Gardening: how to avoid Back Pain appeared first on Perea Clinic.

After months of hard work, sacrifice and preparation, the big day  looms ever closer. It is around this time that fears, concerns and  doubts can start to creep in. You start to wonder if you have trained  hard enough and long enough to complete your race or the London Marathon. This anxiety can push a novice runner to make a crucial error  in thinking. With the clock running down to the Marathon they  increase their workload, in effect, trying to cram in extra miles in a  late attempt to gain extra fitness.

Don’t let this be you! It is the complete opposite of what you need to  do. These last days before the event are an absolute crucial period  for restoring and preparing the body for the onslaught to come. In the 2 to 3 weeks leading up to the marathon it is vital to reduce  your training workload and intensity gradually and progressively. This section of your training is known as tapering, and it is  critical to your success, with numerous physiological benefits. Before we address the technical reasons  why tapering works, it is important to allay some of the common emotional concerns. Of course, the prospect of the marathon feels daunting, it’s part of what makes it such a legitimate challenge. And some  amount of apprehension can actually be beneficial. In fact, psychologists have a name for it, eustress,  which literally means ‘good stress’. It is a level of concern that can help you stay focused and motivated.  But don’t let the thought of the challenge overwhelm you. Provided you are injury free, have trained  reasonably regularly and have completed at least two long runs, you should be able to complete the  course. Just follow the guidelines for tapering and stick to your game plan during the marathon, and you  should be just fine.

Why tapering is important  

Those endless hours of training have a very specific purpose. They’re all geared towards bringing about  particular outcomes in the body. Without the series of physiological adaptations that occur, you won’t be  physically prepared for the demands of a marathon. 

These adaptations include improving aerobic capacity, increasing the body’s ability to store and use glycogen, and improving the efficiency of the heart and lungs. And that’s not all; you will have strengthened  connective tissue, and increased the number of capillaries in the muscles (and thus the body’s ability to  provide oxygen to your muscles). And the chances are your running economy will have improved, your  resting heart rate will be lower, and your breathing rate at higher intensities will be more controlled. It’s really remarkable just what a transformation your body goes through. But here is the thing; much of  that adaptation occurs during your periods of rest and recovery. With the marathon so close, it is essential  that you reduce your training load sufficiently in order that your body rests and repairs sufficiently. The high mileage runs can deplete levels of muscle glycogen, essential enzymes and antioxidants. All these  levels can be restored, and damaged muscle fibers replenished during a period of suitable tapering. What is  more, slowly reducing your intensity in the last 2 to 3 weeks will help prevent overall fatigue and bolster your  immune system. The goal is to get to the start line refreshed and in optimal health, not at breaking point. Getting the tapering process right can be a tricky business. Let’s look at a few pointers that will help you get it  right. 

How to taper properly  

First, you need to know when to start tapering. Ideally, that should be 21 days before race day. It is important  to embrace the process properly.  

 Week one 

Most importantly, you need to cut back on your mileage.  The first week of your taper, cut back to 75% to 50% of  your previous weeks overall distance. At this stage, it’s still ok to run three or four times a week but cut back significantly on your longer runs. This should include cutting  your weekend run back to about 10-12 miles.  

In addition, it is time to stop high intensity runs. So, at this  point you do not do any hill repeats, hill running or sprints.  This is because you are looking to avoid any further tissue  damage that might not heal in time for race day.  

If you have been doing any strength training, it is time to cut  back on that too. There is little to be gained in terms of  strength work at this stage. As an alternative, consider a deep tissue massage. It will probably feel like a work  out in itself. And the type of massage needed to untie knots, and restore some balance in your muscles, is best  done at least a week before the marathon.  

Finally, during week one of the taper, look to increase your intake of protein. This will help repair and restore  muscle tissue. Good sources of protein that include the majority of essential amino acids include fish, Greek  yoghurt, soya beans and chia seeds.  

 Week two 

Now you should be significantly reducing your workload. Absolute maximum should be 50% of the volume of  your longest week. It might almost feel like you are cheating, but you need to slow down too. Your runs will be  run slightly slower than marathon pace and will probably feel ridiculously comfortable, and that’s fine (however, it’s good to do just a couple of miles at marathon pace during one of your runs). Believe us, your body will  thank you for this rest later.  

As a rough guide, your longer weekend run should be 8 to 10-miles, and your week days should be no more  than 4-miles. And although you are running less, try and keep your diet balanced and healthy at this point. Do  not cut back on calories. However, if you are partial to any processed foods or takeaways, look to avoid them  until after the marathon. Your body needs proper nutrition to replenish muscles at this juncture.  

You’ll need plenty of antioxidants in your diet at this stage too. They will help combat oxidative stress. Good  sources of antioxidants will include spinach, broccoli, red bell peppers, carrots, tomato based products and  avocados. Good fruit sources will include blueberries, raspberries and strawberries, to name just a few!

 Week three 

In this last week before the marathon it is time to completely wind down. Any runs you do this week should  not exceed 4-miles, and they all should be done at a  gentle pace. To stay loose, and help overcome anxiety, it is useful to do a 2-mile run 3 days and 1 day  before race day. This week is far more about restoring  the body. Focus on four key elements. How you eat,  what you drink, how you rest and how you sleep.  

Make sure you take on board an adequate amount of  carbs (but don’t try to carbo-load unless you are VERY clear on what you are doing). Go easy on the coffee,  and try not to drink alcohol if you can avoid it. Work at staying hydrated, stay off your feet as much as you can,  and sleep as much as you can. Follow those guidelines as closely as possible, and you should be good to go.  

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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Running the London Marathon is a challenge on so many different levels. It’s not just about the obstacles you face on the day of the run. As the event day gets ever-closer, the training becomes more physically challenging, but also starts to test you psychologically and emotionally too. By this stage, you have already put in a lot of hard work. With each mile you run in training your determination to complete the challenge at the end of April grows ever greater. So one of the most emotionally challenging setbacks at this stage, can be developing an injury.

Naturally, you will want to get over this obstacle and get back to training as soon as possible. But we need to add a word of caution. Running with an injury (acute or chronic) can have serious long-term implications to your health. The old adage of ‘no pain, no gain’ does not apply to injuries! So don’t be a martyr to your cause or you may have to defer to next year.  

That said, many minor injuries incurred in the coming weeks can still be effectively treated before race day. If you are unlucky enough to get injured, below is an explanation of some of the most common treatment methods and why they are so effective. 

Acute Injury Treatment  

Diagnosis:

The first step to treating an acute injury is getting it properly diagnosed, either by your GP or a professional sports injury specialist (such as a physiotherapist, sports & remedial therapist or osteopath). The sooner the injury is treated and the symptoms addressed, the quicker the rehabilitation process can start, and the more effective the treatment will be (also, to avoid it becomes chronic).

PRICE Protocol to treat acute injuries

The term ‘PRICE’ is an acronym for a procedure that is regularly used to treat more minor injuries such as strains and sprains, as well as closed fractures. The individual letters stand for protection, rest, ice, compression and elevation. The objective of PRICE is to reducing swelling, alleviating pain and speeding up recovery. 

Protection:

For many years this protocol was referred to simply as the RICE method. The recent addition of the “protection” element was made as a common-sense measure. Aimed simply at avoiding aggravating the injury further, it refers to the use of props such as crutches, walking canes, splints, braces or slings. The objective is to immobilise or reduce activity in the affected area. 

Rest:

This is a crucial element needed to allow time for the body’s natural healing process to kick in. Depending on the extent of the injury, however, the recommendation may vary between complete rest or active rest. Some movement is often beneficial. Gentle and pain-free movement can often help to restore range of movement in a joint. And regular isometric exercises can often help maintain muscle tone and guard against muscle atrophy (when muscles waste away from lack of use).

Ice:

Crushed ice wrapped in a paper towel, or frozen peas wrapped in a thin tablecloth, can act as a makeshift icepack for applying to injuries to reduce swelling. The ice is usually applied for 10-15 minutes at a time roughly once every two hours. Applying at intervals in this manner is considered more effective than a long and continuous application. 

Compression:

This involves wrapping the injured area in an elastic bandage. Again, the goal is to reduce swelling. It is imperative that the bandage is not too tight because that can actually increase swelling and reduce blood circulation! You’ll know if the bandage is too tight because you’ll probably experience numbness or tingling sensations in, or around, the affected area.

Elevation:

This involves raising the injured area above the level of the heart. The goal is to prevent the pooling of fluid at the site of the injury and, again, to help reduce swelling. Elevation is most effective 24-48 hours directly following the onset of the injury.

The need to reduce swelling seems intuitively the right thing to do. However, inflammation is part of the body’s natural immune response to injury. There is growing evidence from within the Sports Science community that there are benefits to allowing some level of inflammation to persist in some instances. 

This brief outline of the PRICE protocol is intended as a guide for treating more minor complaints. If you are unsure as to how to deal with an inflamed injury, it is always advisable to seek professional guidance.

Heat and Cold 

As mentioned, cold treatment is a good way to help combat inflammation. This is especially so in the 48 hours immediately following an acute injury. Cold treatments work by decreasing blood flow. 

However, in many situations it can be beneficial to promote blood flow by dilating blood vessels. In this instance, heat treatment can help. It also has the useful side-effect of helping to relax sore and tightened muscles. Often, electric heat pads or heat wraps are used for treatment, but a hot water bottle can substitute as an easier alternative.

Typically, heat treatment is used for stiff tendons and conditions such as osteoarthritis. It can be used during a warm-up to help alleviate stiffness in muscles. It has also been used to help relieve muscle spasms (especially in the lower back), as well as helping with some strains, sprains and tendonitis.  

As if to further complicate the matter, there is a type of therapy that alternates between the use of both hot and cold treatments. As a simple explanation, it is a good way to trick the body into boosting circulation but also helps to release extra nutrients into the muscle. This can be very beneficial in speeding up muscle repair. Combined hot and cold treatment is therefore a popular treatment in helping to reduce the impact of DOMS (delayed onset of muscle soreness).

Knowing whether to use hot, cold or both types of treatment can sometimes be confusing. If in any doubt about what works best in your specific circumstances, contact us directly, or your own GP/specialist for further clarification. 

Depending on the type of injury,  Sports & Remedial massage could help to speed up recovery, but we will recommend to wait 48 hours to receive one. Do your research and make sure  your  Sports Massage therapists has experience and knowledge on treating running injuries.

What type of Massage is Sports & Remedial Massage? 

 Unlike many “relaxing” forms of massage, Sports & Remedial Massage is a massage modality specialised in treating sports injuries , muscle imbalance and muscle pain affecting joints and tendons.  It tends to be firmer and deeper. It has some broad health benefits such as improving blood pressure, lymph flow and circulation. But crucially, it gets right to the heart of the issue when rehabilitating muscles and joints from injury. 

The underlying goal is to counteract the stress and tension that can build up in soft tissue during strenuous exercise. It is a sophisticated and specialist modality that borrows many techniques from Physiotherapy and Osteopathy. Treatments within the remit of Sports & Remedial Massage include soft tissue release, neuromuscular interventions, fascial and positional release. 

Used in combination, the above-mentioned treatments can help reduce pain and tension, stretch and restore connective tissue and help relax over-active muscles. Sports & Remedial Massage is not appropriate for all running related injuries, but in can be hugely beneficial in the vast majority of cases. 

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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Runners´ injuries are often a little like credit card bills to the irresponsible shopper. If you ignore the early warning signs, the long-term costs can be far worse. And just as a prudent investor must plan to protect their assets, a runner must have a strategy to take care of their number one asset: their body.

Simply pounding the pavement for mile after mile is a recipe for disaster. Taking a broader view of how to look after your body during training will significantly reduce your risk of injury. Your training plan should factor in stretching, warm-ups and cool downs, strength work and much more besides. But before we take a more detailed look at your regime, let’s have a think about how you currently use your body while running. 

prevent injuries: Your Body 

1.Posture

As we’ve mentioned before, the forces acting on the body whilst running are significant. Any postural imbalances in the body further exacerbate these forces and heighten your risk of injury. It’s like hammering a nail without lining it up properly. It soon gets damaged and bent out of shape. It’s the same with the body when subjected to mile after mile of impact from running! 

And although you may be unable to totally perfect your posture before race day, there are plenty of straightforward interventions that can help you redress any imbalances before then. 

First, you can get your posture formally analysed. It’s always better to see a posture specialist (call us if you don’t know anyone), as an experienced physiotherapist or osteopath will help you counteract some of your imbalances. You can also consider activities such as yoga and Pilates, which help you develop your core-strength and flexibility. Both will have a positive impact on your posture. In any event, it helps to keep these running tips in mind:

• Keep your head and chest up and pointing forward 
•  Keep your elbows close to your side and relax your shoulders. 

As you run, mentally remind yourself of these postural cues to boost efficiency, and consequently put less stress on your body. 

2.Gait Analysis 

Your gait is your ‘manner of walking’, although in this case, it refers to way in which you run. The key element of a gait analysis focuses on what happens to your foot as it strikes the floor with each step. 

The vast majority of runners ‘overpronate’ as they run. This basically means that the foot rolls excessively inward as it lands. This increases the chance of common injuries such as shin splints, plantar fasciitis and knee problems. Specialist ‘stability’ running shoes help compensate for this and can be instrumental in guarding against injury. As the body puts too much stress on the lower leg muscles, it causes them to fatigue and the tendon to become inflamed.

Supination (or under-pronation) is a less common gait issue. It also leads to injuries of the lower limbs and joints but doesn’t usually require a specialist running shoe.

It is important to give your physio, masseuse or osteopath the results of your gait analysis. They can work on muscle tension or joint restrictions that are exaggerating any problems. This may not reverse your gait issues altogether, but should prevent it from getting any worse, and will reduce the risk of injury. 

3.Body conditioning

A marathon is an endurance event, and relies almost entirely on aerobic conditioning. However, to maintain stamina and guard against injury, some body conditioning is advisable. There are some key running exercises you can do to help you in your quest. The best exercises to include are functional exercises and ones that help you retain good posture. Good examples include lunges, squats, the body plank and leg lifts. Again, seek out guidance on how to perform these exercises if you are unsure. But whatever you do, don’t overlook strength exercises in your pursuit of aerobic fitness. 

Prevent injuries: Your Training Routine

4.The Warm Up…

As tempting as it might be to head straight out of the door and get on with your run, you must force yourself never to skip your warm-up. The warm-up is vital in instigating the physiological responses the body needs to cope with the demands of a run. 

As the name suggests, a warm-up causes the body’s muscles to heat up, which is important because it allows them to stretch further. In addition, it increases blood flow and thus provides more oxygen to the muscles. And perhaps most vitally, a good warm-up prepares the heart for the more vigorous activity to follow. 

As a bare minimum, the warm-up should include at least two or three minutes of faster paced walking, some slow jogging or striding and some dynamic flexibility exercises. Unlike “static” stretching, where you hold a muscle in an elongated, fixed position for a period of time (which is more beneficial after your run), dynamic stretching uses controlled movements to improve your range of motion. This loosens your muscles and increases your heart rate, body temperature, and blood flow to help you run more efficiently. Use small movements for the first few reps, and increase the range of motion as you go. As dynamic stretching is most effective when it’s sport-specific, you should target muscles used for running in your pre-run routine

If you are not yet familiar with dynamic flexibility, take the time to learn the basic principles from a Personal Trainer or Physiotherapist. Modern sports science recommends this form of stretching as part of your running preparation, as is very effective for improving performance. 

5…and the Cool Down 

You often see novice runners sprint the last section of a training run and then hunch over their knees as they eagerly check their watch to see how fast they have gone. Is this you?! If so, unfortunately you are increasing your risk of injury. Ensuring that you cool down progressively and adequately is important from a physiological perspective. It is the first step in helping the body recover for the next run. 

One of the easiest ways to ensure you cool down properly is to ease off (rather than speed up!) towards the end of your run. Decelerate into a slow jog, then walk for two or three minutes. 

This allows your heart rate to normalise gradually and aids venous return, which in turn helps prevent blood pooling. You want to avoid blood pooling at all costs, because it can cause havoc with your veins. A gradual cool-down will also help you to restore a normal breathing pattern and help you to avoid faintness or dizziness. 

Be sure to include static stretches as part of the cool-down process. These should cover all the most important muscles used in running, including the calves, thighs, hamstrings, glutes, lower back, the IT band and the adductors. If you are inexperienced in stretching these muscles, seek out expert advice by contacting us or your own sports therapist.

6.Massage

You will probably be familiar by now with the phenomenon that your muscles feel sorer the day after the run than immediately after the run itself. The technical name for this DOMS (delayed onset of muscle soreness). Important research from 2017 demonstrates that massage can play an important part in alleviating DOMS and improving muscle performance. People who receive massage also ‘experience measurable changes in their body’s immune and endocrine response’. This is central to guarding against infection and the breakdown of muscle tissue that can be caused by viruses. In essence, a proper sports massage will speed up recovery and allow you to run pain-free more quickly. Massage reduces muscles tension and helps to increase range of movement, so you can move more freely. 

7.Mindset

 There are many steps you can take to help prevent injury. But all are predicated on and enhanced by having the right mindset. You need to be dedicated enough to train regularly and sufficiently, but sensible and cautious enough to rest when appropriate. You need the discipline to consistently do both a proper warm-up and cool down. Putting your health first is a winning mentality. 

Getting ready for the Marathon?

We hope this information is useful for you. If you need advice or have any questions about how to prevent injuries our sports therapist, physios and osteopaths can  help you. For more information about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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Lower back pain is an extremely common complaint in new runners. Our modern lifestyle often works against us. Too many hours sitting at a computer and so many labour saving devices have taken a toll on our posture. Lower back pain in runners tends to be either muscle-related or joint related. 

 Commun Lower back muscles problems 

When it comes to your lower back muscles, it’s all about core strength, and the coordination of your legs. When you run, your core muscles have to work hard to support your spine and lower back, while your hips, glutes, and hamstrings have to work together to keep you stable. When one muscle or a group of muscles becomes fatigued, your lower back has to work harder to keep you upright and on your feet, which can cause pain or injury. One of the lower back areas more affected when running is your sacroiliac joint. 

Anatomy of Sacroiliac Joint 

One of the most common lower back complaints is sacro-iliac (SI) joint irritation. It can be very debilitating if it affects a recreational runner. The purpose of your SI joints is to provide stability. It connects the bottom of your spine, known as the sacrum, to your pelvis. The two SI joints form where the hip bones meet the sacrum. 

How to identify Sacroiliac Joint Irritation

Symptoms : You may feel pain around the thigh, buttock and lower back. There is often localised swelling and puffiness at the site of the joint itself. The pain becomes noticeable when running uphill, whilst using the stairs, or moving from a sitting to standing position. You may also experience pain or discomfort if you have been sitting for prolonged periods of time. 

Causes: There are a variety of possible causes for this condition. Often it is a result of imbalances and postural issues. For example, a difference in leg length or muscle imbalances can set it off. In some instances, poor foot posture will put pressure on the knees that can create weaknesses and fatigue to hamstring and gluteal muscles. Also, excess weight or running on uneven surfaces can have a negative impact. 

Prevention: Stretching, yoga and exercise can help to improve flexibility and strength in this area. Manual therapies such as osteopathy, physiotherapy and massage, can help to relieve pain and strengthen muscles around the SI joint. 

Treatment: Initially you need to rest. If there is inflammation, both anti-inflammatory medication and heat/cold treatment (properly applied) can help. Once the worst of the pain is over, it actually helps to do gentle stretches and exercises. These should be supervised by a professional therapist who can guide you through the proper techniques and principles. If the pain persists, you should see a doctor, as in the worst cases, surgery may be necessary.

Final Word 

Completing a marathon is a major achievement. It does however, put the body under a certain amount of stress. It can take up to a month or two for the body to fully rehabilitate afterwards. It makes sense to give yourself every chance of being fighting fit and healthy at the end of it all. If you are experiencing problems with your Sacroiliac Joint our osteo, physios or Sports therapist  at Perea Clinic would be more than happy to guide you through the proper process of recuperation. This can include appropriate massage, good nutrition and further guided stretches and exercises.

We hope this information is useful for you. If you need advice or have any questions about our treatments, please contact us. You can find us in Mill Hill Broadway and Islington. We are always happy to help. If you like this blog, please share!

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