Happy New Year & Clinics W/C 07/01/2019

Happy New Year to you all, we are looking forward to 2019 and all it may bring!

Next week I am at Leeds Beckett University examining the BSc Sports & Exercise Therapy students. Therefore I have had to change some of the clinics. I will still be in on the Saturday morning, but Amelia will holding the fort with clinics on Wednesday & Thursday in Bedale and Friday in Northallerton. Booking appointments with Amelia could not be easier via the online booking button on this page or via the Facebook page. Simply select Amelia from the “team” drop down box and her availability will come up (see below).

Exercise Prescription vs Manual Therapy

Exercise prescription versus manual therapy, or do they work hand in hand? The aim of a sports therapist, or indeed any practitioner, is to rehabilitate an injury and help maintain and improve performance. This is done through the use of manual therapy and exercise prescription, but there is no hard and fast rule on how much manual therapy should be done versus exercise prescription. This article will explore current literature and aim to give insight into the basis for clinical decision making when it comes to methods of treatment.

Exe vs Man Th Blog1Manual therapy includes massage, joint mobilization and joint manipulation; it aims to reduce pain and increase mobility of joints. Exercise prescription can be used in a reactive or proactive way, it will aim to improve the flexibility, stability, strength, endurance and power.

Chronic low back pain (CLBP) was prevalent in the research, one study by Aure et al. (2003) suggests that 60% to 80% of the western population will experience low back pain at some stage. The study had 49 participants, one group received manual therapy with the addition of 11 exercises for the spine, abdomen, lower limbs, spinal segments and the pelvic girdle. Another group performed general exercise therapy for 45 minutes; the programmes were individually designed. Results, with a one-year follow up, showed that there were significant improvements in both groups but the manual therapy group showed better results.Ex vs Man Th Blog 2 A contrasting study by Geisser et al. (2003) found that CLBP was improved following manual therapy alongside a specific exercise program but it did not improve perceived function, stating that other psychological factors need to be addressed. Both studies were randomised control trials which are seen as the gold standard for research. However, neither study effectively blinded participants or therapists which is likely to influence the results.

Moving away from CLBP, a study by Hoeksma et al. (2004) looked at the use of manual therapy versus exercise therapy in osteoarthritis of the hip. The graph below (Figure 1) details the effect of manual therapy versus exercise therapy, it shows that manual therapy had better results on range of joint motion from flexion to extension. This result is unsurprising as the manual therapy group included manipulation and ‘vigorous stretching’ while the exercise therapy group included exercises to improve muscle function and joint motion.  Diercks et al. (2004) found the opposite in a contrasting study looking at manual therapy for frozen shoulder versus exercise therapy.

Exe vs Man Th Figure 1

Figure 1 – Results on range of motion from flexion to extension (Hoeksma et al, 2004)

The manual therapy group (physical therapy) received passive stretching and manual mobilisation and the exercise therapy group (supervised neglect) received exercises within pain limitations. Results (Figure 2) showed that the exercise therapy group had better outcomes up to 24 months after injury. This is depicted by the graph below, which shows the difference in treatment over a 24 month period; the exercise therapy group was more successful in this case.

Exe vs Man Th Figure 2

Figure 2 – Results of both groups (Deircks et al, 2004)

 

Hoving et al. (2002) conducted an alternative study, investigating the use of manual therapy, exercise therapy and care by the GP for neck pain. Neck pain is common in the general population and this study found that the success rates after 7 weeks for manual therapy, exercise therapy and care by the GP were 68.3%, 50.8% and 35.9% respectively. Although it would appear that manual therapy was the most successful, patients were allowed to continue exercises at home throughout the trial and continue taking medication which makes it difficult to control the outcome measures in isolation. Figure 3 shows that manual therapy was most successful. However, the outcome measures (perceived recovery, severity of physical dysfunction score, average pain intensity score and neck disability index score) are subjective measures relying on the patients to report how they feel. This is an unreliable way to measure due to a potential lack of understanding, dishonesty or outside influence from the patient,

 

Exe vs Man Th Figure 3

Figure 3 – Manual therapy, neck pain and GP care (Hoving et al, 2002)

 

In conclusion, from a brief look at the literature it is clear that manual therapy and exercise prescription work in varying degrees depending on the injury. There is no one course of treatment that is best overall and the choice depends on the stage and severity of the injury. It is also important to note, when using a patient-led approach to therapy, manual therapy may be more appropriate for one person but another may prefer exercises. It is not necessarily a question of manual therapy vs exercise prescription, but instead using a patient-led approach and selecting the most appropriate course of treatment.

Amelia.

Goodbye and Hello

Mugshot JosieFirst the sad news. Unfortunately, we say goodbye this week to our sports therapist Josie Grieve who has been a great part of the team for the past year. Josie is relocating and we would like to wish her all the very best for the future. She will be missed.

lucy-walker-headshot

Next the good news! Lucy is back from her snowboarding holiday – injury free too – and will be back working in the Bedale clinic this Thursday. It was great to get some excellent feedback regarding Lucy over the last week and she has made a great start to working as part of the team. With marathon season just around the corner, now would be a great time to get booked in and get those niggles seen to.

Appointments with Lucy are available at a discounted rate of JUST £20 until the end of January 2017. Get in quick and get your session booked.

5 Tips to Running Your 1st 10k

The Northallerton 10k is just over two weeks away and for many it will be there first 10k. To help you prepare for the event I asked Josie to write 5 tips to preventing running injuries. The event is already full, but there will be limited entries on the day. We will be there on the day providing taping, massage and advice pre and post race, near the start/finish on the high street in Northallerton.

Training for a 10K? – Tips to prevent injury. 

Are you preparing to run your first 10K but not sure about how to do so safely? Well you have come to the right place. Below is 5 of the most common mistakes and misconceptions people make when training for a running event:

1 – Failing to warm up and cool down

It is so easy to forget or neglect to warm up and cool down before going out for a run. Warming up is vital to help prepare your body for the stress it is going to be put under when running. I would recommend a gentle jog then completing the lunge matrix, calf raises and leg swings, to get your muscles prepared. Not only will you find the warm up will help prepare your body for the training session it will also allow you to get in the right mind set for the run ahead. Cooling down after the run will allow you to gradually reduce your heart rate back to normal and stretch out you muscles.

Lunge matrix – (Credit: Coach Jay Johnson).

2 – Incorrect footwear

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A lot of you (including myself) may have a trusty pair of trainers which you have worn to death but just can’t seem to part with them. When our trainers start to wear out they lose the shape and support which we need to prevent injury when running.

When it comes to choosing some new trainers I understand there are many different types and deciding which ones are best for you can be tricky. Personally my best advice is to go to a running shop and get a good pair of trainers to suit you, go for comfort first, then work from there. Trust me you will thank me later.

3 – Increasing milage too rapidly

So you’ve finally decided to enter your first 10k race, but now it’s getting closer to the event your 3 and 5k training sessions just aren’t going to cut it anymore. A lot of you panic (I myself have fallen victim to this) and jump straight into 10k training. Though doing this you are putting a lot of stress on the body

In the sporting world there is a basic rule stating you shoulder increase your training session or weekly mileage by 10% only. Personally I think this is a good rule to follow making sure you gave yourself adequate recovery time in-between each training session.

4 – Ignoring any little niggles or twinges

The majority of us will have little niggles and twinges from time to time especially when starting out running and it’s important to understand that REST is not always the answer. Although for a lot of injuries this will help in the first instance; when you get back out running the injury will more than likely re-occur and get progressively worse. This is because there is usually a reason for the injury occurring in the first place; whether it be bad running technique, a muscle imbalance of even an incorrect training program. This is why it is important to get any niggles of twinges checked out as soon as you feel them occur in order to prevent them from advancing into a more serious injury.

5 – Neglecting strength training 

So you’re doing everything by the book; wearing the correct footwear, warming up and cooling down before each session, increasing your running distance and speed slowly and giving your body enough time to recover in-between, yet your still getting little niggles and twinges. Why? Well it’s rather simple, you need to incorporate some strength training into your program. This is because if your muscles are weak more often than not they can’t take the demands we put on our bodies when running.  Don’t panic, strength training doesn’t always have to mean lifting heavy weights, in fact using your own body weight is one of the best forms strength training you can do. Exercises such as calve raises, Nordic curls and bridges are excellent to incorporate into your training. As an added bonus you will also find that strength training not only helps with injury prevention it can also contribute to your overall running performance.

So to conclude: Make sure you warm up and cool down after a running session, get yourself a pair of good running trainers, increase your mileage at a steady pace giving your body enough time to recover, get any niggles of twinges checked out, incorporate some form of strength training into your program and most importantly ENJOY YOURSELF.

Thanks Josie Grieve.
Sports Therapist

Mugshot Josie

Josie Grieve (MSST)


Josie works out of the Yarm clinic every Tuesday. To book an appointment you can easily book online here.

New Clinic and Therapist Coming to Yarm!

The Pilates Studio Yarm logoSo I’m really excited to announce that I’ll be opening a new clinic in January. It will be located at The Pilates Studio Yarm and it will be great to be working with owner, Helen Smith and the other Pilates instructors. We are still finalising days and times, but these will be updated on the website and Facebook etc once they are sorted. Below are links to the Google Maps page and The Pilates Studio Yarm website can be found here. The new clinic does mean that I will unfortunately have to close the Thirsk clinic and I would like to thank all the patients that I have seen there over the last few years. You are of course more than welcome at any of the other clinics, but there will be no Thirsk clinic from the New Year.

Google Maps

Mugshot Josie

Josie Grieve (MSST)

New Therapist –Josie Grieve (MSST) will be working with me at Yarm and it’s great that she is going to be able to help out. I first met Josie when she came to do her work placement with me at Northallerton Rugby Club and was really impressed and Josie has since helped me out with some event massage. Josie is a qualified acupuncturist as well as a Sports Therapist. Take a look at her profile here.

We will post some more info soon!

Changes to the cost of services from April 2015

Firstly apologies for not getting this post out sooner.  Just to let you know of the changes to the cost of the different services offered at Ed Pratt Sports therapy. For full details click here.

But it’s not all bad news!  If you are a member of one of the clubs/organisations below, let me know at the time of booking and discounts are available (you may need proof of membership).

  • Northallerton Rugby Club
  • Bedale and Aiskew Runners
  • Northallerton Swimming Club
  • Bedale Football Club
  • Northallerton Hockey Club
  • Hambleton, Bedale and Thirsk and Sowerby Leisure Centre Staff

I am fully qualified to assess and treat sporting and occupational injuries, you do not have to me a sports person to visit the clinics. I am a member of The Society of Sports Therapists.

Society Member CMYK Logo

Great North Run Top Tips

The Great North Run is now one week away and we know that this can be a worrying time for many runners. Are you prepared? Have you done enough training? These are two questions that will be going through many of your heads right now.

We have sports therapy clinics in Northallerton, Thirsk and Bedale in North Yorkshire and see many runners who are putting in those final preparations before a big race day. This may be to work on some stretches with us or get a sports massage to ensure their muscles are in the best state possible to get on the start line.

To help you get ready for Sunday we have created six tips to ensure that your half marathon goes smoothly.

1. Get a sports massage, which can help ease areas of tightness in your muscles prior to your race.
2. Go at your own pace. You know what you’ve done in your training and should have a fair idea of what you’re capable of, so start with a plan and try to follow it. The start will be a big scrum and hectic with people getting in the way and making it difficult to find your rhythm, but it will spread out, so use your watch or GPS and the mile markers to keep track of your pace. Don’t go off too fast and remember to give yourself a nudge if you fall off the pace a bit!

3. Enjoy it! It will be an amazing day, whatever the weather, with live music, fancy dress and thousands of other people. When it gets tough, which it probably will, look around you and remember why you’re there – to post a PB, to do your 10th race, to raise money for charity.

4. Drink to thirst. At these events you can be surrounded by people telling you to drink more. Think about what you’ve done during your training and stick to that.

5. Don’t change your running routine / add anything new on the day. Stick to what you know.

6. After your race you need to rehydrate, refuel and keep moving. This should help to prevent you from stiffening up. Try gentle, cyclical stretches for the calves, hamstrings and quads (thighs).

Save £5 on a sports massage with Ed Pratt Sports Therapy

We understand the importance of getting you back out training as soon after a race as possible and this can be made easier with a sports massage. It will help ease those aches and pains so you can start working towards your next goal. To get this special Great North Run offer all you need to do is book an appointment with Ed at any of his clinics and let him know your race number so he can confirm you took part in the event.