Why Does It Hurt?

“Renowned Physiotherapist Gordon Bosworth Shares Profound Insights in New Book “Why Does It Hurt?”

Practically taking forward Gordon’s vision of a world where physiotherapy is accessible and redefines the quality of life for millions, advocating for a deeper connection with our bodies and emphasising that healing is a unique and nuanced journey.

https://pressat.co.uk/releases/renowned-physiotherapist-gordon-bosworth-shares-profound-insights-in-new-book-why-does-it-hurt-945932b9626ec1c7280cc8971470db6d

Why Does It Hurt: Amazon.co.uk: Bosworth, Gordon: 9781738449019: Books

Top 5 Desk Stretches to Maintain Correct Posture and Prevent Back and Shoulder Pain

In today’s modern lifestyle, the majority of occupations tend to be more sedentary, confined to desk based work in front of a computer.  Contrary to what is commonly thought, there is no ‘right’ or ‘wrong’ posture, but it is the length of time spent in those positions that can feed into pain or discomfort.

To counteract this issue,  it’s a good idea to incorporate changes in position and, or regular movement breaks. Here are some of our top recommendations to consider implementing into your work day to minimise the chance of pain or discomfort. 

Every 1-2 hours

1. Change your position from sitting to standing
2. Alternate between these positions whilst you work
3. Go get a glass of water 
4. Bruegger exercise:

Stand up with your arms relaxed at your side.
Rotate your arms so your thumbs are pointing backward to open the chest.
Squeeze the shoulder blades together, keep your chin tucked and hold this position for the recommended time.

At lunch

Think about incorporating movement into your day. This could be a 10-20 minute walk outside, some light yoga, pilates or some of the following exercises/stretches:

Thoracic extension stretch

Prolonged sitting can lead to discomfort in the mid-upper back if you have been in a ‘hunched’ position. The thoracic extension stretch helps counteract this forward flexion and promotes a more upright posture.

  • Sit on the edge of your chair with your feet flat on the floor.
  • Interlace your hands behind your head, elbows pointing out to the sides.
  • Gently arch your upper back, leaning back slightly.
  • Hold this position for 5-10 seconds, repeat 5-10 times until it feels easier to move

Seated Forward Fold

This stretch targets the lower back and hamstrings, both of which can feel tight from sitting for prolonged periods in a shortened position.

  • Sit tall on the edge of your chair with one foot out in front (this is the side you’re stretching)
  • Slowly hinge forward from your hips, feeling the stretch through your hamstrings and secondarily, the lower back.
  • Hold this position for 10-15 seconds, repeating 4-5 times per leg

Shoulder girdle mobiliser – Wall angels

  • Stand or sit on the floor with your back and buttocks against the wall. Place your head (chin in), your shoulders, elbows and wrists against the wall with shoulders and elbows at 90 degrees.
  • Keeping the entire body in contact with the wall, slowly slide your arms upward along the wall.
  • Breath normally during movement and slowly return to the initial position – repeat 10-20 times.

Neck Stretch

Neck pain and stiffness are common issues resulting from being fixed on screens, and from being hunched over a keyboard for extended periods of time. This simple series of movements encourages bloodflow and working into all available ranges rather than being too static in one.

  • Position your head and neck in neutral position (looking forward, chin slightly tucked/not jutting out and sitting tall – imagine a thread being pulled from the top of your head) 
  • Imagine a large clock on the wall in front of you.
  • With your eyes open move your head and neck in a clock pattern. Start at the centre of the clock tracing away toward the number. When you get to the end range add a gentle over pressure to increase the stretch and then return to the centre of the clock after each number.

Incorporating regular stretching (and movement) breaks into your desk routine can significantly improve posture, alleviate back and shoulder pain, and enhance overall wellbeing, but if you are experiencing pain rather than tightness, it’s worth getting booked in for an appointment so we can provide a thorough assessment and treatment plan.

The Importance of Sleep Hygiene: Tips for a Restful Night’s Sleep

What is Sleep Hygeine

Sleep hygiene refers to a set of habits and practices that promote healthy sleep patterns. It involves adopting behaviours and creating an environment conducive to quality sleep. By implementing good sleep hygiene practices, you can enhance your sleep duration and quality, leading to improved daytime alertness and overall wellness.

Establishing a Consistent Sleep Schedule

Maintaining a regular sleep schedule is crucial for optimizing sleep hygiene. Going to bed and waking up at the same time every day, even on weekends, helps regulate your body’s internal clock. Aim for 7-9 hours of sleep each night, based on your individual needs.

Creating a Sleep-Friendly Environment

Your sleep environment plays a vital role in promoting quality sleep. Consider the following tips:

  • Comfortable Bedding: Invest in a supportive mattress, pillows, and breathable bedding that suit your preferences.
  • Dark and Quiet: Ensure your bedroom is dark, quiet, and at a comfortable temperature. Consider using earplugs, eye shades, or white noise machines if necessary.
  • Declutter and Organize: Create a clean and clutter-free sleeping space, which can contribute to a sense of calm and relaxation.

Developing Pre-Bedtime Rituals

Engaging in calming activities before bed helps signal your body that it’s time to wind down. Some beneficial pre-sleep rituals include:

  • Avoiding Electronic Devices: The blue light emitted by smartphones, tablets, and computers can interfere with sleep. Power down your electronic devices at least an hour before bedtime.
  • Relaxation Techniques: Engage in activities that promote relaxation, such as reading a book, taking a warm bath, practicing mindfulness meditation, or listening to soothing music.
  • Limiting Stimulants: Avoid consuming caffeine, nicotine, and alcohol close to bedtime, as they can disrupt sleep patterns – caffeine can be in your system for up to 10 hours, so even if you feel sleepy 3-4 hours after your last cup of coffee, your brain may not be able to enter a deep sleep state due to stimulants.

Promoting Healthy Lifestyle Habits

Certain lifestyle choices impact sleep quality. Incorporate the following habits into your daily routine:

  • Regular Exercise: Engaging in moderate physical activity during the day can promote better sleep. However, avoid intense exercise close to bedtime as it can energize your body and make it difficult to fall asleep.
  • Balanced Diet: Maintain a healthy and well-balanced diet, avoiding heavy meals close to bedtime. Some foods, such as cherries, almonds, and herbal teas, may promote sleep due to their natural properties.
  • Limiting Daytime Napping: If you have trouble falling asleep at night, consider limiting daytime napping or keeping them short (around 20-30 minutes).

Conclusion

Prioritizing sleep hygiene is essential for achieving optimal sleep quality and reaping the benefits of restorative rest. By implementing the tips discussed in this blog, you can create a sleep-friendly environment, develop pre-bedtime rituals, and adopt healthy lifestyle habits. Remember, it may take time to establish a consistent sleep routine, but the long-term benefits are well worth the effort.


References

National Sleep Foundation. (2021). Sleep Hygiene. [Online]. Available at: https://www.sleepfoundation.org/sleep-hygiene

Division of Sleep Medicine at Harvard Medical School. (2007). Twelve Simple Tips to Improve Your Sleep. [Online].

National Health Service (NHS). (2021). Sleep hygiene tips. [Online]. Available at: https://www.nhs.uk/conditions/sleep-problems/self-help/

This resource from the NHS provides practical tips on improving sleep hygiene, along with information on common sleep problems.

The Sleep Council. (n.d.). Sleep hygiene. [Online]. Available at: https://sleepcouncil.org.uk/advice-support/sleep-hygiene/

The Sleep Council offers guidance on sleep hygiene practices, including advice on creating a sleep-friendly bedroom environment and establishing a consistent sleep routine.

Mental Health Foundation. (2021). How to sleep better. [Online]. Available at: https://www.mentalhealth.org.uk/publications/how-sleep-better

This resource by the Mental Health Foundation discusses the importance of sleep hygiene for mental health and provides tips for improving sleep quality.

The Royal Society for Public Health. (2020). Sleep: Understanding sleep health in the modern world. [Online]. Available at: https://www.rsph.org.uk/our-work/policy/healthy-communities/sleep.html

The Royal Society for Public Health offers insights into sleep health, including the impact of lifestyle factors and technology on sleep, and provides recommendations for maintaining good sleep hygiene.

The Sleep Charity. (n.d.). Sleep tips. [Online]. Available at: https://www.thesleepcharity.org.uk/advice-support/sleep-tips/

The Sleep Charity provides a range of sleep tips and advice, including information on sleep hygiene, sleep environment, and strategies for improving sleep for both adults and children.

Ice or Heat: Making the Right Choice for Injury Rehabilitation

Should you use ice or heat for injury rehabilitation?

Injuries are an unfortunate reality for many people, but when it comes to injury rehabilitation and pain management, one of the most common questions people have is whether to use ice or heat for treatment. 

Both ice and heat can be effective in managing pain and promoting recovery, but understanding when to use each modality is crucial for optimal healing, as they work in very different ways.

The role of ice

Ice, in the form of ice packs or cold compresses, is commonly used in the initial stages of an injury, at the first onset of pain. Its primary purpose is to reduce pain as the ice can also have a mild anesthetic effect by numbing the area and providing pain relief. Studies have shown beneficial use of ice prior to exercise in the early stages of rehabilitation, by reducing effusion related muscular inhibition – therefore by applying ice prior, you improve the activation and beneficial effects during exercises.

When to use ice

Acute injuries: Ice is particularly useful for acute injuries, such as sprains, strains, or fractures. Applying ice within the first 48 hours after an injury can help reduce pain.

Inflammatory conditions: Ice can be beneficial for managing inflammatory conditions like tendinitis or bursitis. Applying ice to the affected area can help alleviate pain and allow greater adherence/tolerance to loading. 

Post-exercise recovery: Ice can be used as part of post-exercise recovery, especially after intense or strenuous workouts. Applying ice to muscles or joints can help reduce muscle soreness, when used in contrast with heat, can promote blood flow.

The role of heat

Heat therapy, typically in the form of heating pads, hot water bottles, warm baths or saunas, is generally used in the later stages of injury rehabilitation. Heat promotes blood circulation, relaxes muscles, and enhances recovery post-exercise. It can also provide pain relief by soothing tight or stiff muscles.

When to use heat

Chronic Injuries: Heat therapy is often beneficial for chronic injuries by reducing pain and promoting muscle relaxation. Arthritis or muscle strains that have moved beyond the initial acute stage can involve muscle tightness, stiffness or spasms. Heat shouldn’t be used on new injuries as it can increase blood vessel permeability and be counterproductive to oedema management.  

Training recovery:  Delayed Onset Muscle Soreness (DOMS) is a natural part of training hard, with some people enjoying that ‘worked hard’ ache, for others it can be demotivational for their rehabilitation and training. Heat is effective for improving recovery from DOMS by inducing physiological changes at a cellular level, such as growth hormone factor release and reduction in creatine kinase levels. As well as a more general reduction in pain levels post-exertion, with a  soothing effect and helps to relax tight muscles by making the tissues more supple.

Before physical activity: Applying heat before physical activity or exercise can enhance blood flow and loosen up the muscles, reducing the risk of injury. This is not a replacement for a thorough warm-up routine, along with the practicalities of having a sauna and/or hot bath near where you are training! Heat pads or hot water immersion could be useful when doing rehabilitative exercises for small, isolated joint conditions such as thumb osteoarthritis or hallux valgus exercises.

Finding the balance

In some cases, a combination of ice and heat may be recommended. This approach, known as contrast therapy, involves alternating between cold and hot treatments. The cold application reduces inflammation and pain, while the heat promotes blood flow and relaxation. Contrast therapy can be particularly useful for chronic conditions or during the later stages of injury rehabilitation.

Heat and ice are both useful, primarily through reduction in pain, so how you choose to utilise these tools in your rehab will be unique to you. Hopefully with the info provided, you will be able to inform a decision yourself on this. As always, if you’re unsure, always consult a professional, or get in contact with one of our team!


References:

McGorm, Hamish; Roberts, Llion A.; Coombes, Jeff S.; Peake, Jonathan M. (2018). Turning Up the Heat: An Evaluation of the Evidence for Heating to Promote Exercise Recovery, Muscle Rehabilitation and Adaptation. Sports Medicine, (), –. doi:10.1007/s40279-018-0876-6

Dubois B, Esculier J (2020), Soft-tissue injuries simply need PEACE and LOVE British Journal of Sports Medicine;54:72-73.

Bleakley C, Glasgow P, Phillips N, Hanna L, Callaghan M, Davison G, Hopkins T, Delahunt E (2010). Management of acute soft tissue injury using Protection Rest Ice Compression and Elevation: Recommendations from the association of chartered physiotherapists in sports and exercises medicine (ACPSM). https://www.physiosinsport.org/media/wysiwyg/ACPSM_Physio_Price_A4.pdf

Ankle & Foot Strengthening: Why it Matters

The feet contain almost 25% of the body’s bones, hundreds of ligaments, and connective tissues, and coupled with the complexity of the ankle joint, large volume of neural tissues – it’s an incredibly designed structure.

Whether you’re a full-time athlete, recreational fitness enthusiast, or you just want to remain pain-free and move well; not looking after your feet and ankles may contribute to injuries or movement dysfunction. 

‘The kinetic chain’ is a term that is used to describe the interconnected nature of the body aiding our movement. It begins at the feet, therefore if they are weak, they can collapse in, which can cause consequences higher up the kinetic chain. Pronation, or ‘rolling in’, of the foot can result in inward collapse at the knee joint (valgus stress), twisting of the hip (internal rotation), and extension of the lumbar spine. Any unnecessary stress placed on the joints and ligaments in these areas, can contribute to a number of injuries, such as sprains, torn ligaments or tendons, and bone stress related injuries. 

Moreover, another good reason to have strong ankles is to minimise the risk of falls. Research by, Ryoichi Ema et al in 2017 , has shown that having stronger (and faster reacting) calf musculature has decreased the risk of falls in elderly populations – though this can easily be extrapolated to be true for younger populations also. 

How do we achieve strong and functional feet and ankles?

In addition to baseline strength, it is important for the neuromuscular systems to be worked, as proprioception (the body’s ability to perceive its own position) plays a role in stabilising the body from the feet up.

Shoes and orthotics can provide a short-term solution to suboptimal foot biomechanics, but don’t really address the problem. In fact, they can compound the weakness in these muscles and ligaments if excessively relied upon. 

Strengthening the feet and ankles doesn’t need to be hard work or time-consuming, as the repetition of specific movements and exercises can have a high impact. Due to the nature of strengthening the foot and ankle, workouts can be conveniently done at home and don’t require lots of equipment or an intense workout. 

Top 3 foot and ankle exercises

Of course, with our assessment, analysis and treatment, every individual is provided with a unique plan specific to their problem and aligned with their goals – whether it’s daily life or performance orientated.

Below is an example of three exercises that are simple yet effective in helping to achieve strong, stable, and healthy feet and ankles. 

  • Single leg balance

Simple yet effective, it’s an exercise which can be done anywhere and with no equipment. Remove your shoes and neutralise your spine (stand straight and balanced). Then lift one foot off the ground while keeping your upper body upright and aligned. Hold for around 30 seconds, and repeat three times on each side. 

Regression – tandem stance for ~30 seconds or reducing time held in single leg stance.

Progression – close your eyes or make the surface underfoot less stable (i.e. a cushion/pillow).

  • Standing heel raises

Stand hip-width apart, next to something you can lightly hold onto for stability. Slowly lift your heels by going up on your toes, and lower yourself back down with control. You can hold the position on tip-toes for longer as you advance, and try to repeat three sets of 10-15.

Regression – seated calf raises with some weight on the knee (a rucksack filled with books or water bottles etc).

Progression – try performing on a single leg or hold a weight to make things harder.

  • Towel scrunch

Get a small towel and sit on a chair, placing one foot (no shoes) flat on top of a smoothed out towel. Make sure your knees are at 90 degrees and your toes are facing forwards. Keeping your heel on the ground, pull the towel towards you by scooping it with the arch of your foot and your toes. Try to repeat three sets of 10-15 on each foot.

Regression – Try both feet together or focus on the movement of the toes without resistance of the towel.

Progression – add a weight (some hardback books or filled water bottles) on the end of the towel to add some resistance.

Inform Performance E36: Physiotherapy at the Olympics with Gordon Bosworth

Taken from Inform Performance:

Episode 36: Andy McDonald chats to Physiotherapy Consultant Gordon Bosworth. Gordon is Founder and Clinical Director of The Bosworth Clinic and has been involved in elite sport for most of his life.

Specialising in performance therapy, Gordon has supported elite athletes and teams across multiple sports and notably was Physiotherapist to the British Bobsleigh and Bob-Skeleton Team, a member of the Great Britain Teams at the Winter Olympic Games in Nagano, Sochi, Salt Lake City and Torino. He was also Medical Lead for the Canadian Speed Skating Team at Vancouver Games & Chief Physiotherapist to British Athletics at the London Games in 2012. More recently he worked with the Canadian #1 Women’s Bobsleigh and Cross-Country Teams at the PyeongChang Games. A clinician of great calibre and experience.

In this episode, Andy & Gordon discuss:  Gordons background, Effective Physiotherapy at Olympic Games, Involvement with ALTIS, Gordons Approach, Understanding optimal function first, leveling the playing the field, Structure governs function, Approach to manual therapy, Second opinion work & consultancy.