Wednesday, 4 December 2019

I Dare You to Care this December....about yourself!

With Christmas fast approaching one cannot help but notice an increase in people and vehicular traffic out on the streets.  Stress levels increase as people frantically search for the perfect gift and struggle to fit in Christmas plays, Christmas fairs and Christmas parties into their already busy lives.

Christmas is a time of giving and caring not just about others but ourselves.  What good are we to our loved ones if we are tired, tetchy and irritable.  We need to take care of ourselves in order to take care of those close to us.  So that is why I am daring you to take care of yourself this December!  Relieve some stress and tension and revitalise yourself with a Sports Massage.

Treat yourself to an hour Sports Massage with me at About Backs and Bones in Derby, bring a copy of this post along, and receive a Gift Voucher for a 30 minute Sports Massage with me at the same clinic to be used during January or February 2020 by either yourself or a friend.

Call me direct on 07887 744819 or the About Backs and Bones on 01332 553332 and ask for an appointment with Nina.

Monday, 25 November 2019

Unravelling the types of muscular contraction.

When a muscle contracts it generates a force.
In injury prevention we typically begin with isometric contractions; but what are they?

  • Isometric contractions generate force without changing the length of the muscle.  (a)  An example is when the muscles of the hand and forearm grip an object; the joints of the hand do not move, but muscles generate sufficient force to prevent the object from being dropped.

  • Isotonic contractions generate force by changing the length of the muscle and can be concentric contractions or eccentric contractions.  (b and c)

b) Concentric contractions cause muscles to shorten, thereby generating force and changing the angle of the joint. For instance, a concentric contraction of the biceps would cause the arm to bend at the elbow as the hand moves from near to the leg to close to the shoulder (a biceps curl)

c) Eccentric contractions cause muscles to elongate in response to a greater opposing force. Rather than working to pull a joint in the direction of the muscle contraction, the muscle acts to decelerate the joint at the end of a movement or otherwise control the re-positioning of a load.

Saturday, 19 October 2019

Preventing Knee Injuries

Knee injuries are a common problem for the non-sportsperson and sportsperson alike but can be prevented by maintaining correct form when lifting and carrying out daily tasks or athletic exercises and ensuring strong musculature through the legs and core.

I believe that the advice given below is sound for prevention of all types of knee injury prevention programmes and even rehabilitation after injury. Of course everything below is just some examples and you should seek professional advice to tailor it specifically to your needs!

Further into this article we will be focusing on the anterior cruciate ligament (acl) injury of the knee as it is most commonly injured in sports where participants land from a jump, suddenly stop, change directions or pivot in sports like football, basketball, hockey, rugby, or skiing. (Brukner and Kahn, 2012).

So where do you start?

Strength Training
It is important to strengthen the muscles surrounding the knee such as the quadriceps, hamstrings and calves as well as important functional muscles like the core stabilisers and
I tend to start people off with isometic (static) or small range muscle activation exercises focused around the simple squat and lunge and calf raise and lower for around the knee joint.  For the core and glutes we can go right back to basics with pelvic tilts, bridges and clams before progressing to more commonly known plank variations or stability ball exercises.

Practising Proper Stepping, Jumping, Landing and Multi-directional Movement Technique
This should be specific to the lifestyle and sport that the person undertakes.
As with the strength training exercises; movements should be executed with the correct biomechanics. When landing, the knee should follow the toes, ideally remaining in a straight line above the middle toe or slightly pointed outwards towards the little toe. The knees should never travel inwards towards each other as this puts stress through the ACL (valgus stress). The athlete should have a slight bend in the knee’s and the hips when landing and try to land in a controlled manner with more weight placed through the forefoot rather than the heel (Voskanian, 2013).

Plyometric training
Plyometric training involves high intensity agility drills which work to improve footwork by developing power and speed. This can involve agility drills like quick sprints, stops and starts, cutting, lateral movements and jumping, ladder drills or even dance mat work. These activities should mimic the quick motor responses that an athlete would perform in a game situation (Voskanian, 2013). 

When Should I Start And How Often Do I Need To Perform The Exercises?
For general conditioning a 15-30 minute training session between 1 (minimum) and 3 (optimal) times a week is effective. 
For the athlete Voskanian 2013 as found that an ACL prevention program would be most effective in preventing injury if it is initiated 6 weeks prior to engaging in high-intensity sporting activity. Sessions should be 3 times a week and the program should be completed through the competitive season and can be used as a warm up prior to engaging in sporting activity.

As a Coach...Where Can I Find ACL Prevention Programmes?
The FIFA 11+ injury prevention program already has a proven track record in reducing knee injuries in youth and adult footballers. You can find the whole programme here

Wednesday, 2 October 2019

What's Blood got to do with it?

There are four main blood groups. Each type can be either RhD positive or RhD negative, which means that in total there are eight main blood types. 
Blood is made up of red blood cells, white blood cells and platelets in a liquid called plasma.
Your blood group is identified by antibodies and antigens in the blood.

Antibodies are proteins found in plasma. They're part of your body's natural defences. They recognise foreign substances, such as germs, and alert your immune system, which destroys them.
Antigens are protein molecules found on the surface of red blood cells.

Blood type A is the most ancient, and it existed before the human species evolved from its hominid ancestors. It has A antigens on the red blood cells with anti-B antibodies in the plasma
Type B is thought to have originated some 3.5 million years ago, from a genetic mutation that modified one of the antigens that sit on the surface of red blood cells. It has B antigens with anti-A antibodies in the plasma
Starting about 2.5 million years ago, mutations occurred that rendered that antigen gene inactive, creating type O, which has neither the A or B version of the antigen. It has no antigens, but both anti-A and anti-B antibodies in the plasma
And then there is AB, which is covered with both A and B antigens.
Red blood cells sometimes have another antigen, a protein known as the RhD antigen. If this is present, your blood group is RhD positive. If it's absent, your blood group is RhD negative.

This means you can be one of eight blood groups:
  • A RhD positive (A+)
  • A RhD negative (A-)
  • B RhD positive (B+)
  • B RhD negative (B-)
  • O RhD positive (O+)
  • O RhD negative (O-)
  • AB RhD positive (AB+)
  • AB RhD negative (AB-)

The antigens are what makes some blood types incompatible: 
If blood from a type-A donor were given to a person with type-B, the recipient's immune system would recognise the foreign proteins as an invader and cue an attack. The resulting immune reaction can kill. 

Type O-negative blood is known as the "universal donor" because it lacks the molecules that would provoke that reaction (the "negative" means it lacks another type of surface molecule, known as the Rh antigen).

Friday, 19 July 2019

Ligaments vs Tendons; Sprains vs Strains; unravelled!

People often interchange the terms sprains and strains when talking about injuries but there is a difference.  Read on and I hope I can clear it up...

Ligaments and tendons are both made up of fibrous connective tissue but they have different roles and functions.

  • Ligaments attach bones to bones
  • Ligaments help stabilise joint
  • Ligaments are not very elastic
  • Imagine a belt or strap connecting, for example, your shin and thigh bones
  • Tendons attach muscles to bones
  • Tendons help to move the joint and absorb some impact on the muscles
  • Tendons are more elastic than ligaments but not as elastic as muscles
  • Imagine tough bungee cords or straps, for example, your achilles tendon

Bearing the above in mind then the terms Sprains and Strains are used to differentiate between injuries:

  • A Sprain is an overstretch or tear to a ligament
  • Sprains commonly occur at the ankle, knee or wrist
  • A Strain is an overstretch or tear to a muscle
  • Strains commonly occur in the leg, arm or back

Sports Massage can aid recovery from both sprains and strains. Please get in contact to see how I can help.

Wednesday, 10 July 2019

Should you change to forefoot running?

I recently posted a link on my facebook page to an article investigating the pros and cons of forefoot vs barefoot running as there is a lot of hype and confusion about the two.

As a little add-on I thought that I would give my personal experience of changing to forefoot running in normal trainers.

A few years ago now I injured my knee playing hockey and despite all rehab have been left with internal damage and I had to retire from playing due to the pain from constant foot strike and rotational movements.  I found running uncomfortable and also had trouble in my basic karate stances.

I made the conscious decision to give up hockey as it was the sport that I had least control over body action.  I was however determined not to give up karate or other activities.  

Although I had a neutral running style I was a heavy heel striker, and so I decided to change to forefoot running.  I chose to change because our bodies were designed in such a way that our joints are able to absorb and dissipate impact energy when we strike through the balls of our feet.  Fundamentally this would deliver less impact through my knee.

I do have barefoot shoes for general walking and other activities I chose to keep my running trainers to give my joints more cushioning as my knee already has more than average 'wear and tear'.  I started gradually; jogging back the 3/4 mile from school drop off very slowly ensuring that it was all forefoot striking.  Oh boy did my calves ache, but not my knee, and a good stretch sorted them out!  After a few weeks I gradually increased the distance and found that not only did I have no knee pain; I was actually running faster.  Moreover, I was able to do squats and lunges after the run.  Something that had been impossible before.

Currently I am able to run, cycle, do karate and Muay Thai boxing.  Yes there are days when the knee lets me know that I have done too much but, as with everything else in life, it is a balancing act.  So my experience has been positive.  I have taken in steady in my transition from a heel striker to a forefoot runner and have benefited from it.  However I changed my running style out of necessity.  I would always caution against changing something for no real reason other than you fancy trying it.  If your current running style is causing no injury then consider very carefully the pros and cons of changing.

I you need any help with assessing your needs then please contact me and I will be happy to help.

Friday, 28 June 2019


So many people ask me how long it will take to recover from their injury and in truth there is no definitive answer because each one of us is different both in our biological make up and our mental approach to things.

That being said I would always emphasise QUALITY OVER QUANTITY when it comes to exercise rehabilitation.  Something which can also be translated into the way we approach any exercise we do and indeed how we all approach life!

It is no good doing hundreds of repetitions of something if you have poor technique as it could just cause more pain.  Take for example; someone who boasts that they can hold a plank for 4 minutes.  My first question would be why would you want or need to do that? My second, what was their posture like throughout that 4 minutes? And finally; do they engage the correct muscles throughout? So many people can do a 4 minute plank...poorly and indeed quite often when someone comes to see me with back pain they can do these types of exercises but they cannot engage their deep stabilising muscles correctly and therefore exacerbate their problem.

I always recommend going back to basics after any injury. Check that those small but vital stabilising muscles are switching on correctly. Make sure they have the endurance to support the big global muscles in their action before building up full strength and power.

I have been practicing Kyokushin Karate for may years now and in the syllabus book that you get as a beginner there is the route to power in karate.  It is so fundamental, not just to karate, but all exercise/sporting disciplines and if more people paid credence to it then more people would suffer less injuries due to trying to advance too quickly.  So here it is:

Position - Balance - Coordination - Form - Speed - Power - Reflex

As I mentioned above; we can also take the ethos of QUALITY OVER QUANTITY into anything we do.  My Daughter took up piano last year and it is recommended that they practice for 20 mins each day.  But what if that practice was poor in quality because she was tired.  She would just make mistakes and practice those mistakes over and over again.  Surely it is better to do a good quality practice for a shorter duration.  Even top Olympic athletes have to listen to their bodies and if they are 'not feeling the love' then give themselves an easier training session/rest period.  

There is such a fine line with pushing too hard and achieving you goals.  If you need advise with your injury prevention, treatment or rehabilitation needs then please contact me.

Wednesday, 19 June 2019

Untreated ankle sprains can create long term issues

I recently came across a good newspaper article about ankle recovery and prevention and it has prompted me to write this blog because I believe many people don't take ankle sprains seriously enough and they have the potential to cause serious long term issues such as Chronic Ankle Instability and Osteoarthritis.

So what is an ankle sprain?
A sprain is an overstretching or tearing to a ligament; the thin strap that holds bones together.  A ligament is less elastic and has a poorer blood flow than a muscle or tendon and therefore tends to heal slower.
The most common ankle sprain occurs when the ankle rolls outward and the foot turns inward. An Inversion Sprain.  It results in stretching and tearing of the ligaments on the outside of the ankle.
Less commonly, the ankle rolls inward and the foot outward in an eversion injury, damaging the ligaments at the inside of the ankle. 
The high ankle sprain is the least common. It can happen when the foot is forced to rotate toward the outside (away from the other foot), or when the foot is planted so it can't move and the leg is rotated toward the inside.

How severe is your ankle sprain?
There is a generalised grading system for ankle sprains:
  • Grade I is stretching or slight tearing of the ligament with mild tenderness, swelling, and stiffness. The ankle feels stable, and it is usually possible to walk with minimal pain.
  • Grade II is a larger but incomplete tear with moderate pain, swelling, and bruising. Although the ankle sometimes feels stable, the damaged areas are tender to the touch, and walking is painful.
  • Grade III is a complete tear of the affected ligament or ligaments with severe swelling and bruising. The ankle is unstable and may feel "wobbly." Walking is usually not possible because the ankle gives out and there is intense pain, although initial pain may quickly subside.
How long does it take to heal?
Research shows that it take ankle ligaments about 4-6 weeks and up to 12 weeks to heal completely but I always say "how long is a piece of string?!"  Everyone is different and how you choose to approach rest, exercise and treatment all has an impact upon recovery

What exercise can you do?
  • For grade 1 and 2 sprains the best course of action would be immobilisation with boot or brace and RICE treatment initially then early range of motion exercises without weight bearing. The boot/brace/tape serves as a scaffold for the ankle so that the injured ligament can heal in the appropriate position and scar tissue that forms around the injured ligament can form in an anatomically correct position. Early weight bearing out of the boot/brace/tape puts patients at a very high risk of re-injury. 
  • After you are able to place your full weight on the injured ankle without pain, you may begin proprioceptive training to regain balance and control of the ankle joint.  Proprioceptive and balance exercises teach your body to control the position of a deficient or an injured joint (ankle). Swimming is also good.
  • Activities such as jogging, running and cycling should only take place once your ankle is stable enough to balance on for 3 minutes without pain.

How can a sports massage therapist help?
Sports massage can help reduce swelling and increase blood flow to the injury site.  This can speed up the healing process as it increases the flow of natural nutrients to the area, reduces the build up of scar tissue and aids mobility.
The therapist should also be able to guide you through a structured exercise rehabilitation program tailored to your specific injury and need to return to work or sport.

In short....
Don't just wait for your ankle sprain to heal on its own; seek appropriate treatment and advice from a trained professional!

Wednesday, 12 June 2019

Is Sports Massage just for sports people?


Sports Massage is a type of deep tissue massage aimed at relieving muscular aches pains and strains.

Anyone can benefit from sports massage.

I have treated a full age and activity range from children as young as 11 to elderly clients nearing 80 from all walks of life.

Yes people do come to have a specific injury treated but the majority of my clients return time and again to relieve stress and tension from work or repetitive strain injuries as well as to prevent injuries from occurring due to a musculoskeletal issue such as a leg length discrepancy or scoliosis.

Of course I do see those with a more active lifestyle and those that train in specific sports.  In the 16 years that I have been practising sports massage and exercise rehabilitation I have treated gymnasts, triathletes, racquet sport players, boxers and kickboxers, ice hockey players, professional football and rugby players and even the referees!

Out of all of the above I would say that the most common reason why people come and seek treatment from me is for lower back or neck and shoulder pain.

There may be some medical contraindication which may prevent treatment such as DVT but fundamentally; if you are in pain and feel that it is muscular then try a sports massage!

If you are still unsure if sports massage is for you then you can always contact me and I will be happy to chat about your options.

Thursday, 9 May 2019

Nina adds the occasional Friday to her work days

appointment time image
Good news for all those who struggle to find an appointment time with me.  I have now added the occasional Friday morning to my work rota at About Backs and Bones Health Clinic in Derby.
Please call the clinic, my mobile or facebook me to book your treatment time. 
Remember I do half hour and hour appointments Mondays, Wednesdays and the occasional Fridays between 09:45 and 14:45.
See you soon!