Our physio Tom Barras won Bronze at World Rowing Championship

Tom joined us at PhysioQinetics in 2016 and continues to pursue his dream in representing Britain in the international rowing scene.

At the recent World Rowing Championship at Sarasota, Florida, Tom helped Team GB add a bronze medal to its tally on the final day by holding off sprinting Rio runner-up Damir Martin to claimed his 3rd place. He was cheered from the grandstands by Olympic legend Greg Searle, who managed the exact same feat twenty years ago - Tom is only the fourth Briton ever to win the men's equivalent!

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"I don't think I believed any of this was possible before this regatta," said Tom.  "With 250 to go I thought 'might have got this bronze medal' but then Damir Martin came back so fast.  I just gave it all I had left.  I love my country and I just wanted to hold on and get the medal.  That means the world to me and I want to keep nudging it on, hopefully I'll be in a good place come 2020 (Tokyo Olympics)."

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A breathless Tom told Olympic legends Steve Redgrave, Matt Pinsent and Katherine Grainger on BBC2's live coverage: "I'm absolutely delighted with that. The whole regatta has been amazing, and to get bronze is absolutely brilliant."

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Tom, who is in his first year as a senior, beat the 2017 World Cup winner Robbie Manson and the Rio Olympic silver medallist Damir Martin to claim bronze behind Ondrej Synek of the Czech Republic and Cuba’s Angel Fournier Rodriguez. He now sets his sight on a medal in the 2020 Tokyo Olympic Games.

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Photo credit: Naomi Baker

What is the best thing I can do for my lower back pain?

Answer: Exercise!!

This may initially seem strange to you but in this blog entry we will review the question that has been debated for many years by medical professionals.

Before the 1990’s bed rest was prescribed by GP’s for anyone suffering from lower back pain. However since then there has been a complete change in thought for the management of lower back pain. In the late 80’s and early 90’s many medical studies were undertaken to find if exercise or bed rest was most effective for treating lower back pain. Exercise strongly prevailed as the best of the two treatments, so ever since all medical guidelines now recommend exercising and staying active. Below is an example exercise sheet produced by us at PhysioQinetics to help our patients suffering from back pain.


The National Institute for Health and Care Excellence also recommend manual therapy, acupuncture and anti-inflammatories as well as exercise for lower back pain. They also promote Physiotherapy over the other manual therapies (Chiropractors and Osteopaths). This is due to a physiotherapist being someone who can “help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice." Watch one of our our physios demonstrating core exercise techniques below:-

With thanks to:




How to treat patella tendonopathy

With rugby Six Nations in full swing and England beating Italy on the pitch on Valentine's Day, PQ blog this week will discuss a common problem of the knee not only commonly seen in rugby players but also in runners and cyclists - patella tendonopathy.

But before we dive any deeper in with this blog lets have a look at the anatomy. A tendon is a fibrous connective tissue that joins muscles to bone. It is made mainly from collagen fibres and has a fairly poor blood supply compared with muscles, hence it may take longer to heal when injured. The patella tendon is a tendon for the large quadriceps muscles at the knee joint. This tendon also slightly differs from most as it holds the patella (knee cap) in place.

Patella tendonitis is an acute inflammation around the tendon but in more long-term cases it may be classed as patella tendonopathy which can be described as inflammatory or non-inflammatory degeneration of the tendon.

Symptoms of patella tendonitis may include, pain just below the knee cap, swelling, heat. There are many potential causes for patella tendonopathy, these may include increase in training (running, jumping, cycling), over stretching, tight quadriceps, or altered bodies’ biomechanics after trauma.

Treatment for this condition may include: massage, taping, strengthening exercises, ice.

The type of strengthening exercise recommended for tendonopathies is eccentric strengthening. This is when a muscle is being loaded but rather than shortening as we would expect a muscle to do (concentric) the muscle instead is controlling the movement by lengthening.

A good example of eccentric strengthening for patella tendonopathy is the lowering action in a squat. Such as in this video below:-

A Study of the Circulation in Normal Tendons and Healing Grafts. E Peacock http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1450994/?page=10
British Journal of Sports Medicine. What is the most appropriate treatment for Patellar Tendinopathy? J cook, K Khan

I have back pain - do I need a scan? (Part II)


This is a follow on post so we would recommend reading Part I first (click HERE to read Part I)

It has come to our attention that many Chiropractors are still commonly using X-rays as part of their routine lower back pain diagnosis procedure. Looking through current research it is difficult to determine how frequently X-rays are used by Chiropractors in the UK. However a study in Australia of 274 Chiropractors estimated that 68% of these would take an X-ray where an X-ray is not indicated. This is a worrying figure considering the unwarranted radiation exposure to the patients. (see Part I for more details)

An X-ray is only indicated if a tumour or fracture is suspected and this is documented in many Chiropractic guidelines. However, many Chiropractors are still using X-rays to determine if any spinal ‘subluxation’ has occurred. The word "subluxation" means partial dislocation of a joint. The contentious issue here is that there is simply no clinical evidence to suggest spinal subluxation either (1) exist in any clinical meaningful sense or (2) has any clinical relevance to low back pain.

In fact, the limited clinical evidence shows that spinal subluxation, if it at all exists, is very rarely clinically relevant as a cause of pain; however this is a frequent Chiropractic diagnosis based from findings on an X-ray. The only problem with this is (as mentioned in part 1) that on imaging for the back a visible abnormality may not be the cause for the back pain. As we all have anatomical differences and for the majority these do not cause pain.

So our final thought is, if you have back pain and are offered a scan, question the health care professionals. ‘Why do I need one and what are you looking for?’

As a general rule in PhysioQinetics, we only refer for plain x-ray or MRI scan if we have sufficient clinical suspicion of an anatomical pathology and if we are considering referral to specialist orthopaedic surgeons for surgical intervention.

With thanks
• Why do Chiropractors order so many Xrays? Published in 2010
• Chiropractic diagnostic imaging from the Chiropractic board of Australia
• Management of people with acute low-back pain: a survey of Australian Chiropractors published in Chiropractic and Manual Therapies.

I have back pain - do I need a scan? (Part I)


This is a common question we get asked a lot here at PhysioQinetics and we are firm believers that a scan is not always necessary and here is why.

Research has shown that an X-ray for acute lower back pain is ineffective at showing medical professionals the extent of the injury or the level of pain experienced from it - unless you suspect a fracture from high-impact trauma. To put it simply, a spine that may visually look like it may have a deformity may be completely pain-free and one with severe pain may look 'normal' upon an x-ray. However what we do know is that the dose of radiation from an X-ray to the lower back is similar to that of 20 back to back transatlantic flights; therefore, it is best to avoid this level of exposure to radiation without good reasons.

Unfortunately the story is similar for the effectiveness of MRI scans. MRI scans are used to detect a disc bulge in the lower back and upon testing of people without back pain only 36% were found to have normal discs throughout the spine. The other 64% showed signs of a disc bulge but were completely without any symptoms. As such, visual evidence of a disc bulge on MRI does not necessarily mean that the disc can be blamed as the cause for back pain - it has to be matched with the patients symptoms before the disc bulge can be classed as the potential trigger of their back pain.

The NICE (National Institute for Health and Care Excellence) guidelines for lower back pain states that scans should only be considered with a referral to a spinal consultant, if surgery or further intervention is required.

In Part II, we will discuss how prevalent inappropriate use of X-rays are seen in some segments of the musculoskeletal healthcare industry.

For more information, please refer to the resources below:

2017: We ranked 1st and 2nd out of 977!


We had a yet another fantastic year here at PhysioQinetics!

Two of our clinics are featured again in the
top 10 clinics amongst 977 UK physiotherapy clinics listed in one of UK's largest and fastest growing business directory. Our customers have been continuously reviewing our performance and their satisfaction is reflected in their glowing recommendations!

We are proud to announce that our Uxbridge and Staines clinics achieved
FIRST and SECOND places at the end of 2017 - with more than 150 reviews raving about us on Google, Facebook, Freeindex, Thomson Local, Yell.com, etc. we know we are doing something rightHappy

2014 PhysioQinetics Patient Survey

PhysioQinetics pain location

In this information and evidence driven medical world, it is very important for us to audit our performance. Not only does this allows us to improve our clinic performance, it also shows to our patients our commitment to provide the best possible care to them. As such, we decided to conduct the 2014 PhysioQinetics Patient Satisfactory Survey. We are proud to present the analysis here:-

Between January and June 2014, we randomly selected 101 patients from across our 4 clinics in Uxbridge, Staines, Maidenhead, and Brentford. We asked our patients to help us answer a simple 8-point questionnaire.

The majority of patients came to us with back (38.6%) and knee (24.8) problems [see pie chart above]; these were followed by neck pain (12.9%), shoulder pain (10.9%) and other complaints.

Almost all (93.1%) patients surveyed had pretty severe (grade 4 to 5 out of 5) symptoms when they first visited us; but after an average of 3 to 4 treatment sessions, 92.1% of patients reported symptoms improved to only mild level (grade 1 to 2 out of 5).

In terms of symptom improvement, 50.5% of patients surveyed had at least 75% improvement; with 71.3% showing at least 60%, and a staggering 90% showing at least 50% improvement.

Data 1

We are proud to report that 84.2% of our patients needed 6 or less treatment sessions, and 63.4% needed only 4 or less treatment sessions to achieve the above excellent results - this is a clear testimony of how effective our treatment is!

Very importantly, this is the key message:-

Of the 52.5% of patients surveyed who had previously visited other physiotherapists, chiropractors, or osteopaths before coming to us, 94.3% of them, after their treatment sessions, thought we performed better than our colleagues!!

And 100% of those surveyed would recommend us to their friends and family!!

2013: We ranked 3rd out of 907!


We had a fantastic year here at PhysioQinetics!

Two of our clinics are featured in the
top 10 clinics amongst the 907 UK physiotherapy clinics listed in one of UK's largest and fastest growing business directory. Our customers have been continuously reviewing our performance and their satisfaction is reflected in their glowing recommendations!

Our head clinic came 3rd at the end of 2013 - let us work together towards the top spot in 2014!

Our testimonials

We have been receiving so many excellent feedback and testimonials!

“When it all goes physically wrong, there’s only 1 place to go - PhysioQinetics”
(on our Google review Dec 2013 - read it here)

Consistently 5 out of 5 stars rating from our satisfied patients at freeindex.co.uk - see it HERE

Here are some examples:

"PhysioQinetics has helped me get back to my full duties of work with their excellent physio techniques, friendly staff and guidance into helping me feel as great as I did before my back injury"

Mr M.N., London Ambulance Service

"I have been seeing Michelle for some months for two different conditions (rehab post broken leg and a slipped disc). I can thoroughly recommend the service which has been extremly beneficial. Her clinical and diagnostic skills are excellent and she actually diagnosed my back condition, which was confirmed on MRI scan. In essence, I cannot fault the services provided by PhysioQinetics and would not hesitate to recommend them to others."

Mr K.D., operations manager at RAC

"I was involved in a car accident and suffered from whiplash, a fracture to my right elbow, and soft tissue damage in my left elbow. Before I started my treatment at PhysioQinetics I had very limited movement of my head and arms, as well as drastically reduced strength in my elbows. Within a matter of weeks of starting physio my pain was much less on a day-to-day basis, and my head and arm movement were significantly increased. They are very knowledgeable and offer a service which is second to none, always going the extra mile to ensure patients receive the very best treatment. Thank you for aiding my recovery!"

Mr J.S., estate manager

The FA England Disability National Squad - Midfielder Josh Beacham


“The physiotherapists at PhysioQinetics have an excellent knowledge about the treatment and exercises needed for a speedy recovery and rehabilitation following football injuries. They have a very hands-on approach to treatment and I would highly recommend anyone to be treated here.”

Josh Beacham, Midfielder (Caps 2, Goal 1)
The FA England Disability National Squad


Should you use ice or heat on an injury?

One of the most common questions we get asked is whether ice or heat is best for pain and injuries.

Well, it depends. Both can be beneficial at different times.

Ice packs should be used on acute injuries, for example an ankle sprain or a muscle strain (especially in the first 48 hours).

Make sure you wrap the cold pack in a towel to avoid a freeze burn and do not apply it for longer than 20 minutes at a time. You can ice an injury several times a day, but you should allow skin temperature to return to normal between each application.

The ice pack helps to control/reduce the swelling, therefore will help to control pain.

Heat packs are mostly commonly used on injuries you have had for a while, for example aching in the upper shoulders from deskwork or longstanding low back pain. Heat helps stimulate blood flow to the area and relaxes the tissues. You should again be careful to avoid burns and should only apply heat for 20 minutes at time.

So remember:

- Never apply heat to an injury when swelling is involved

- Do not apply heat after exercise or while sleeping

- Do not apply ice to an injury before exercise

- Do not apply ice or heat to skin that is in poor condition or with loss of sensation

Paralympic Double Gold Medalist - Natasha Baker

“Being a Paralympic athlete I have very specific needs to suit both my disability and my sport, and my condition can change on a very regular basis. Michelle understands exactly what I need and I always come away feeling a million times better...

THE BEST physio that has ever treated me! I would highly recommend!”

Natasha Baker, MBE
London 2012 Paralympic Double Gold Medalist


We are the Consultants' choice!

These are some of the testimonials from our referring consultants:-

“As an orthopaedic surgeon, with a specialist interest in sports injuries and knee surgery, I regularly use the team at PhysioQinetics Physiotherapy for the treatment of my patients. It is vital for a surgeon to be confident that appropriate and expert rehabilitation will occur before and after surgery. The provision of quality physical therapy is also important in avoiding surgical intervention; and where surgery is necessary, improving its outcome. There is no doubt that I have the utmost confidence in PhysioQinetics to provide this service and I continue to receive excellent feed-back from my patients.

I highly recommend PhysioQinetics as a physiotherapy practice and will continue to utilise their skills in the future."

Mr David Houlihan-Burne FRCS(Orth)
Consultant Orthopaedic Surgeon
Specialist in Knee and Sports Injury Surgery
BMI Bishops Wood Hospital and The Chiltern Hospital


“The key to a successful early recovery following any upper limb injury is a knowledgeable and experienced physiotherapist who understands your needs. Michelle is an extremely well qualified physiotherapist who has excellent diagnostic skills and provides first class hands on treatment. She is at the forefront of her field and is always looking to continually improve the wide range of treatments that she offers. Her systematic professional approach to rehabilitation help to manage and prevent many problems from recurring.

The excellent feedback I receive from patients and the results she consistently achieves gives me great confidence in her ability and I have no reservation in recommending Michelle to anyone seeking high quality physiotherapy treatment, advice and support.”

Mr Francis Lam MSc, FRCS(Orth)
Consultant Shoulder and Upper limb surgeon
BMI Bishops Wood Hospital, The Clementine Churchill Hospital, Princess Margaret Hospital


Electro-acupuncture is an extension of traditional acupuncture. It can be considered as a combination of TENS (transcutaneous electrical nerve stimulation) and acupuncture. It is primarily used to treat chronic pain and pain caused by arthritis or fibromyalgia.
The wonders of electro-acupuncture are that it works faster than most therapies in relieving and getting rid of chronic pain.

Electro-acupuncture is the application of a small electrical current to the acupuncture needles and is a way to provide reliable, consistent stimulation to acupuncture points for maximum treatment effectiveness.

Please enquire for further details.

Physiotherapy for Footballers

Football is an extremely popular high speed contact sport, enjoyed by millions worldwide. Unfortunately the risk of injury with football is high and is often the result of a traumatic event, for example, colliding with another player or falling awkwardly after jumping for a ball. Injuries can also be caused over a period of time as the ongoing stresses and strains of the game take their toll on the body. Continuing to play with a slight niggle or ache often leads to a more serious injury that will require more intensive attention.

The aim of physiotherapy is to treat and fully rehabilitate the player in order to prevent further injury and to return the player to training in the shortest possible time.

Our Physiotherapists at PhysioQinetics will work with you to achieve the following:

1. To diagnose the injury and the possible cause giving advice on rehabilitation times
2. To promote healing of the injured tissues and to control the inflammation and pain
3. To thoroughly rehabilitate the injury restoring full flexibility, strength, balance & proprioception and correcting any muscle imbalances that may have developed
4. To discuss strategies to reduce recurrence of the injury

If proper management is not undertaken, you may return to playing too soon despite instability, proprioceptive disturbance, muscle tightness and muscle weakness. This will greatly enhance the risk of prolonged pain and increase the chance of re-injury. Your performance will also be impaired for the entire time that you are not correctly rehabilitated.

Common Football Injuries
Most football injuries affect the lower part of the body. The groin, pelvis, hip and thigh, knee, calf and foot & ankle are the sites most commonly affected.

The most common football injuries are:

Ankle sprain

An ankle sprain refers to damage to the soft tissue (mainly ligaments) around the ankle and is usually caused when the ankle is twisted inwards. This injury is usually caused by twisting the ankle playing on uneven ground or from the impact of a direct tackle. The ligament on the outside of the foot is the most commonly affected. With an ankle sprain you often experience ankle swelling and pain especially with weight bearing and twisting movements of the foot.

Hamstring strain

A hamstring injury usually occurs when the hamstring muscle is forcibly stretched beyond its limits and the muscle tissue becomes torn. This typically occurs during sprinting activities. The degree of strain or ‘tear’ is classified according to the severity as a grade I, II or III. As the hamstring muscles work over both the hip and knee joint they can also become susceptible to injury due to overuse and fatigue.

Knee Ligament Injuries

e.g Anterior Cruciate Ligament Tear
An anterior cruciate ligament tear is common in football due to the repetitive changes in direction and sudden turns. The ACL is a deep ligament that joins the thigh bone to the shin bone. The role of this ligament is to prevent excessive forward movement of the shin in relation to the thigh and also to prevent too much rotation at the knee joint. The ACL, with the other ligaments, also has a crucial role in maintaining joint stability. Injury to the ACL often occurs from landing from a jump onto a bent knee then twisting, or from landing on an overextended knee. Damage can also occur with direct contact to the knee from another player.
e.g Medial Collateral Ligament Sprain
This inside ligament of the knee joins the thigh bone to the shin bone. Its primary role, as well as providing stability to the knee, is to support the inside of the joint. This ligament is therefore usually injured when the outside of the knee joint is struck. This impact causes the outside of the knee to buckle, and the inside to stretch. This is common during ‘clipping’ in football. This can be a cumulative effect with ongoing stresses or by a sudden greater impact.

Knee Cartilage Tear

A tear in the cartilage of the knee is a fairly common in football caused by a forceful twist. The cartilage damaged is actually one of the two menisci within the joint. As the knee joint bends the thigh bone should roll, spin and glide on the top surface of the shin bone. If there is a rotation caused by a twist whilst the joint is bearing weight then the menisci can get jammed between the two bones. Depending upon the force, a tear may occur.


Hernia’s and groin pain are common in football due to the stresses to the pelvic region through kicking, sprinting and turning. The two most common conditions of the pelvis to affect footballers are an Inguinal hernia and Gilmores groin (sports hernia). If you have a hernia you will typically have pain and stiffness in the groin area after a game where activities such as getting out of the car or the bed are painful. You may also notice a small lump or protrusion in your groin.

Bell’s palsy - one of our many successful stories with acupuncture

We recently received enquiry from a young lady called Miss Y who suffered from new onset Bell’s palsy which resulted in paralysis of half of her face due to facial nerve dysfunction. This is medically known as 7th cranial nerve lower motor neurone palsy, which is often of unknown cause.

Her GP prescribed her a course of steroid medication which is in accordance with the latest medical evidence but she showed little improvement after 10 days of using her prescribed steroid. Time is really the essence here as if she does not improve within the first 3 weeks, then she has as high as 70% chance of permanent facial paralysis.

One can only imagine the distress this may have caused this young lady with half of her face paralysed.

She called us and we immediately arranged intensive therapy sessions using a strategy of combining acupuncture and specialist facial massage on specific acupuncture points. We also taught her special facial exercises to stimulate her facial nerve and muscles.

Within 2 weeks, she noticed remarkable recovery and this is what Miss Y has to say:

I will definitely recommend this clinic. My physiotherapist is highly professional, very friendly and careful. I had an unusual problem, but here I got a professional help. My physiotherapist suggested me a good treatment including massage and acupuncture. I'm very happy with the result. 5 stars out of 5”.

If you suffer from Bell’s palsy, don’t just risk waiting, contact us now to arrange our intensive treatment sessions to maximise your chance of any recovery!

Cupping therapy for back pain and fibromyalgia

Cupping is a very effective and safe treatment for back pain and fibromyalgia. Cupping is able to loosen stiff muscles, unblock pinched nerves, and unbind Muscle knots.

A small fire is inserted into a glass cup which creates a vacuum. The cup is quickly placed onto the patient's back, shoulders, hips or legs. The cup instantly pulls on the muscles and tissues up into the cup.

This suction draws the blood to the surface and helps to relax tight and bound muscle tissue.

The theory behind cupping is that it moves or stimulates your body's natural energy — also called Qi.

Cupping is used together with Acupuncture and Massage therapy to increase the muscle relaxing and pain relieving effects of each of these treatments. When used together, these three treatment therapies provide powerful pain relief and loosening of tight and bound up muscle tissues which could be causing you pain and pulling your spine out of alignment.

Cupping, massage, and acupuncture work wonderfully in adjunct with physiotherapy treatment. Cupping will tend to leave a circular mark which should last about 3 to 5 days. Cupping is not painful. It feels like a really good deep tissue massage, unwinding deep knots in your muscles.

In alternative medicine, pain is believed to be caused by problems relating to your Qi flow. This can be related to stress in the body, imbalances of hormones and fluids, lack of blood flow, and temperature in the muscles and joints. When a suction cup is place on a problem area, the vacuum pull of the cup creates warmth and circulation in the area. Very soon, you will feel that the pain is reduced.

Acupuncture for pain relief

Many people are often a little bit wary of acupuncture as they’re concerned about the idea of needles sticking into them. However, it’s a really beneficial treatment and has many uses. Acupuncture is commonly used to help treat musculoskeletal conditions (which mean conditions relating to bone and muscle), examples such as arthritis, joint and muscular pains, tennis elbow, neck pain, the list is endless. Lower back pain is a very popular reason for seeking acupuncture. Acupuncture for lower back pain is recommended by the National Institute for Health and Clinical Excellence in the current guidelines.

Acupuncture for pain management has been used for centuries. It is a powerful and natural treatment.

The needles stimulate points on your body that release endorphins and other natural pain relievers. They also, according to research, increase the electromagnetic signals between the different cells in your body, increases blood circulation to different parts of your body and relaxes your muscles. It helps to encourage healing, relieve pain and promote emotional well-being.

Research study findings published in Brain Research, suggest acupuncture has a significant effect on specific nerve structures and it has been found that acupuncture switches off areas within the brain that are associated with the processing of pain.

Overall, there are many ways in which acupuncture can help relieve pain. So if you are interested, contact PhysioQinetics to book your session here

Pilates to help reduce low back pain

Back pain is one of the most common medical problems reported around the world. It is estimated that 85% of the population will experience back pain at some point in their lives. Those most at risk of developing back pain are people who are overweight or inactive; who spend a lot of time sitting at work; or whose jobs require them to lift, twist and bend. Once you experience back pain once, you are likely to experience it again in your life. The most common cause is poor posture and body mechanics in the workplace.

People with low back pain tend to have weaker lower back stability muscles. The deep abdominal muscles are responsible for providing stability to the lower back and therefore preventing pain and injury. Retraining and strengthening this muscle has been proven to decrease pain and improve function. The Pilates method is based around developing awareness and activation of the deeper core muscles, therefore helping in reducing and preventing back pain. There is extensive research that supports the effectiveness of Pilates exercise for low-back pain.

Our Pilates classes at PhysioQinetics are small (max of 4 participants) and this will ensure you get the individual attention and feedback that is required in this form of exercise. Interested? Book your session with us now

Kinesio taping for sport injuries

You may see these colourful tapings on some world class athletes such as David Beckham, Serena Williams, and Tiger Wood.

What are they?

They are Kinesio tapes - they are used to reduce pain, enhance performance, prevent injury, promote improved circulation/healing and help prevent muscle cramping and lactic acid build up.

Want to find out more? Click here for further information

Acupuncture and Cupping therapy

Acupuncture and Cupping Therapy is an incredibly effective treatment that date back thousands of years in China. If you have been suffering from back pain, sciatica, muscular pain and spasms, then Acupuncture and Cupping Therapy may be the answer for you.

In cupping therapy, a small fire is inserted into a glass cup which creates a vacuum. The cup is quickly placed onto the patient's back, shoulders, hips or legs. The cup instantly pulls on the muscles and tissues up into the cup. This suction draws the blood to the surface, improves circulation & lymphatic drainage and helps to relax and release tight muscles.

Cupping is used together with Acupuncture and Massage therapy to increase the muscle relaxing and pain relieving effects of each of these treatments. When used together, these three treatment therapies provide powerful pain relief and loosening of tight and bound up muscle tissues. Cupping, massage, and acupuncture work wonderfully alongside physiotherapy care.

If you are interested in trying our acupuncture and cupping therapy, why not give us a call at 01895 255139?

Our "Patient Information Leaflet Series" uploaded!

We have created a series of information leaflets which can be downloaded in our Resource page - they include useful advice on how to tackle common musculoskeletal conditions and also instructions (with demonstration!) on exercises that can be done to improve symptoms. Have a look here!

Why all the hype about Pilates

You probably hear lots of hype about Pilates -- that it's the latest celebrity workout method and such, and that alone may make you want to dismiss it. But don't! Pilates is actually an excellent workout that is perfect for helping build muscle, raise metabolism, relieve aching joints and muscles, and can be done even by people who don't have a high level of fitness, or energy.

Pilates is a method of exercise that was developed in the 1920s by physical trainer Joseph H. Pilates. The method is based on improving flexibility and strength for the total body, with a focus on strengthening what Pilates called the "powerhouse," -- the abdomen, lower back, and buttocks - that supports your body and enable easier movement.

Pilates helps you perfect your posture, prevent injury, increase flexibility, and even improve circulation -- which can be a help to a sluggish metabolism. Pilates exercises are usually performed very carefully and in a controlled way, with concentration and breathing, promoting a mind-body balance in addition to fitness benefits.

The muscles that Pilates aim to target are the deepest layer of your abdominal muscles, called your transverse abdominis and your pelvic floor muscles. They act as your internal corset and should activate a fraction of a second before other muscles in your body contract and initiate movement. In doing this it ‘braces’ the low back and serves to protect it during movement. Research has shown that this function is lost after someone experiences back pain; even after the pain has gone, the muscle weakness will still be there. Pilates exercises target this muscle to re-train and strengthen it, thus decreasing the chance of back pain recurring.

When starting out in Pilates, it's best to have an initial assessment with a Chartered Physiotherapist as this will highlight any muscle imbalance or restricted joint range of motion that will determine the Pilates exercises that are prescribed and the ones that should be avoided, introduce you to the Pilates method, and guide you in activating your core muscles. However, if you really want to get started on your own, I'd highly recommend the APPI Low back pain DVD.

The Pilates for low back pain DVD is designed and presented by Physiotherapist Elisa Stanko from the Australian Physiotherapy & Pilates Institute. It includes a 50 minute class which is your key to enjoying reduced low back pain and increased freedom in your everyday activities. This DVD can be purchased from PhysioQinetics and costs just £16. Please enquire for further details.

7 warm up tips

Most sports injuries are preventable. A significant proportion of the muscular problems we treat could have been avoided by warming up properly first.

The reasons for warming up are straightforward:

It increases the flow of blood to muscles, which heats up the body. This means that you are less likely to overheat when you start exercising, and this is when muscles are most likely to take on strain that they can’t bear.

  1. A good warm up only needs to take 15 minutes.
  2. Start with a brisk walk or light jog.
  3. Step up gradually from gentle to brisk movements.
  4. Concentrate on movements related to the exercise that will follow (like swinging a golf club or tennis racket)
  5. Stretch gently once the body has warmed up; each stretch should last for thirty seconds.
  6. Open up your lungs with slow deep breaths.
  7. Remember that it takes longer to warm up on a cold day; warm clothes will help.

Do you have elbow pain?

Here’s some quick ways to improve the pain and get out there to enjoy the short lived British summer!

• Stretch out: Tendons attaching to the bones around the elbow joint need to be kept healthy by stretching them. Overloading the tendons by repetitively being pulled by the forearm muscles is a common cause of elbow pain. Place your arm straight out in front of you, drop your wrist so that the fingers point to the floor. Use your other hand to gently and respectfully pull your wrist into a slightly more stretched position. Hold 30 seconds and repeat gently up to 6 times throughout the day.

• Massage: Use some moisturising cream and gently massage the over-worked forearm muscles that are causing the problem. With the elbow bent and placed against the stomach, it’s the muscles in the forearm at the elbow crease that need to be targeted. Gently lift them and release as well as small circular movement. Keep your hand relaxed during this.

• Technique: Often the muscles are over pulling on the tendons and bones because of poor grip technique and inadequate sizing of the racquet. Look at how you lift the kettle or make a fist. If your hand extends back fully when you are doing these activities, then you are potentially contributing to the problem with inappropriate muscle activity. If you do this when holding the racquet, get a coach to look at your technique and ensure that the racquet handle is the optimal size for you.

• If your neck also hurts, you have pins and needles or if you have a long history of elbow pain and gripping doesn’t particularly bother the problem, then the nerve underlying the muscles may be the cause of the problem. Often neck pain problems can refer down the arm and mimic tennis elbow. In this case, see your GP or Chartered Physiotherapist to release out the nerve at fault.

7 tips to decrease aches the morning after...

There is nothing more depressing than waking up the morning after you have exercised feeling sore and stiff.

This is caused by the build up of waste products around muscle groups that you have pushed particularly hard.

The key to avoiding the aches is to remove these waste products as quickly as possible after exercising.

  1. Drink lots of water to flush out toxins.
  2. Focus on a good warm up before exercise begins and a good cool down that includes stretching all the major muscle groups.
  3. Cold water baths are not much fun, but they remove waste products and reduce swelling. The key is to spend ten minutes immersed in water at 15 degrees Celsius.
  4. If you have a cold bath, follow it with a warm shower an hour later to warm up again. The contrast between hot and cold will also pump up your circulation to remove waste products.
  5. A hot bath immediately after gentle training or the day after strenuous exercise will help relax muscles.
  6. If you have the facilities, one minute in a cold tub (10-15 degrees Celsius) and two minutes a hot tub (about 37-40 degrees Celsius), repeated about 3 times will accelerate healing.
  7. A sports massage the day after exercise will help reinvigorate tired limbs.

A combination of these will allow quicker recovery and reduce severe muscle soreness and stiffness. But don’t worry, your aches should all disappear in two to three days and you should be less achy next time!

14 tips to avoid back pain

It isn’t always sport or accidents that cause injury.

A large number of our clients with back and neck pain have created the problem by working at a computer. Here are 14 tips to avoid causing yourself damage at work:

  1. Good posture is vital. This means a straight lower back, shoulder blades pushed back, your head in line with body, and no chin poking! These require a good chair and your computer to be at the right height.
  2. Move around every 30 minutes to wake up your postural muscles.
  3. Drink lots of water to keep hydrated; frequent visits to the bathroom will also remind you to keep moving!
  4. Sitting down doesn’t mean you have to be statuesque. Stretch your arms, legs and neck while you are at your desk.
  5. Get someone qualified to look at your workstation.
  6. Exercise during the middle of the day; and don’t use a lack of gym membership as an excuse – a brisk walk will do your muscles no end of good.
  7. Stick a post it note on your desk that says ‘Posture’; when you start to ignore it, make ‘Posture’ your screensaver!
  8. Sit right back in your chair and bring the chair as far as possible under your desk.
  9. Don’t lean on your desk.
  10. Use a lumbar roll to keep your back in place (you can purchase these at our reception area).
  11. Stand up if possible when taking phone calls.
  12. You may not notice your shoulders and neck tensing up; make sure you relax them as often as possible.
  13. As little as 3-5 deep breaths an hour will help to relax tense muscles.
  14. Address any stress issues – maybe try yoga at lunchtime.

Look after your own back when doing lots of DIY or gardening!

  1. Don't just suddenly spend a whole day digging or weeding etc. Varying the tasks that need doing will help you change position and therefore use different muscles helping to reduce problems associated with prolonged static postures.
  2. As much as is feasibly possible try to maintain your low back (lumbar) curve with all the activities. Being bent over for quite a while coupled with heavy work or repetitive work can overstrain back muscles making the back more vulnerable to injury.
  3. Take regular breaks. In the workplace the EEC regulations suggest we move every 45-60 mins but I'd suggest if you're doing something very heavy, static or repetitive, more frequent breaks are a good idea.
  4. Warming up and stretching - normally we just associate this with sport. But manual work is exercise too. Making sure that you have good length (check out the link for stretches) and strength into your back and leg muscles can help reduce overstrain on your back. If you're not sure what's tight or weak maybe book an appointment with a physio or someone similar who can assess you and give you specific advice on what to do.
  5. Wearing the right footwear - instead of wearing flip flops for ladder work or digging try wearing trainers or something with some support in it.
  6. Choosing the right equipment for the job. Equipment for gardening and DIY has advanced quite considerably over the years, if you're doing a lot of something it may well be worth investing in the right bit of kit for the job helping to limit problems etc.

What is the Cryocuff cold compression therapy?

The Cryocuff is a fantastic bit of physiotherapy equipment .

It is a cold-compression therapy system that is ideal for treating joint swelling and pain.

We tend to use it most often post-operatively. For example following total knee replacement, ACL reconstruction surgery, knee arthroscopy, post-menisectomy, and post shoulder surgery.

These are applied by your physiotherapist to the affected area and the garment is filled with iced water! As the garment fills with the iced water it begins to compress the affected area! Voila!

You may be familiar with the acronym RICE which is used in acute injury management: Rest, Ice, Compression, Elevation.

Cryocuff treatment forms a crucial part of the ice and compression of the RICE regime.

Your physiotherapist may recommend this as one form of treatment if there is swelling present.

Top 10 tips to try and help reduce your back pain during pregnancy

• Stand with your back to the wall, and then try tilting your pelvis by flattening the small of your back into the wall.

• Avoid heavy lifting or carrying, particularly of toddlers as they do not stay still and wriggle causing increased pressure on the spine. It’s worth bargaining, bribing and persuading toddlers if it keeps your back safe. Give them lots of cuddles sitting down on the sofa as compensation.

• Trial a heat pack / hot water bottle in the small of the back to allow the muscle tension to relax.

• Lean forward on all 4’s on your hands and knees (similar to a good labour position) as this helps to take the weight of the baby away from your spine and reduces pressure.

• Trial sleeping on your side with a pillow between the knees or a small towel under your waist as this will help keep your pelvis level and reduce the strain on your back.

• Some women find that a corset or back support belt relieves pain. Often mothers are concerned that this will affect the baby but this is not the case.

• Get your bra size checked regularly. As breasts grow throughout pregnancy, ill-fitting bras can cause tightness around the spine and therefore cause pain.

• Test out different shoes as this differs for each individual. If you have a flattened low back, you may wish to trial small heels, or if you have an arched low back you could try flat shoes.

• Get your husband / partner involved! Ask them to do some gentle massage to the soft tissues of the back. Don’t let them pummel you though!

• Most importantly – start to strengthen the ‘core’ muscles of the lower abdomen and the pelvic floor to assist in supporting the baby and your back.

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Top tips for posture problems and neck pain

Poor posture can cause neck pain by putting extra strain on ligaments and muscles. Standing with the shoulders slouched and chin jutted forward, working with your head down for long periods of time, slumping while seated and sleeping face-down are common postural problems that affect the neck. Suggestions on how to prevent posture related neck pain include:

  1. Correct your posture when standing or sitting, lift your chest, drop your chin slightly and relax your shoulders.
  2. Ensure your workstation is set up to help you sit properly.
  3. Stretch and change position frequently while you are working.
  4. Try not to sleep on your stomach, which overextends your neck.
  5. Choose a supportive pillow that maintains the natural c curve of the neck.
  6. Combat the muscle tightening effects of stress with relaxation techniques.
  7. Exercise regularly to improve muscle tone and posture.