Fast approaching is The British Medical Acupuncture Society foundation course that I will be attending in London next week. In preparation, I decided I wanted to do a bit of an investigation to see what the general consensus was of acupuncture.

From speaking to the clients here in Mount Merrion Chartered Physiotherapy, I got the impression they really found acupuncture a great addition to treatment, and when used alongside manual therapy and exercise and they leave the clinic feeling more relieved from their pain compared to when acupuncture is not used.

Last week we welcomed Hannah Moran MISCP to our team of Chartered Physiotherapists.

Here is some news from Hannah....

“My first week has been full of learning, meeting new people and finding my feet. I began by diving into further inductions given by Practice Principal, Simon, which ranged from clinical aspects such as manual therapy and soft tissue techniques to business orientation, client management and payment systems. These inductions were invaluable to my settling into the clinic as I really got an idea of what the clinic is all about. It is a family run physiotherapy clinic which aims to provide a premium quality service to all clients and it is obvious that Lorraine and Simon really care about client satisfaction. Clients treatment plans have the unique feature of being personal and tailored to individual needs which many other services lack. I’m looking forward to getting stuck in and contributing to this unique environment.

 Yes I know, you’ve heard it before...but vegetables really are the business. As renowned food writer Michael Pollan¹ advised ‘eat food, mostly plants, not too much’. By food he means real, whole, unprocessed foods. Eating plants such as vegetables and fruit should form the bulk of the diet. All in moderation, not too much, eat until you are full, no more.

Hip and groin complaints make up a large percentage of clients I treat here in the clinic. Due to the vast number of anatomical structures at the hip and groin, there are a wide range of possible diagnoses.

To help guide my clinical reasoning when coming to make a diagnosis and finding the source of pain or dysfunction, I try to break hip diagnoses down into 3 different, but sometimes overlapping categories:

Articular (happening within the joint): This includes conditions such as osteoarthritis, hip impingement (femoroacetabular impingement, or FAI for short) and labral issues.

Do you dislike the thought of going to the gym but want to exercise more?

There are many benefits to exercising, too many to list here, for both body and mind.

For starters it might be helpful to avoid using the word “exercise.” The term sometimes makes it feel like a huge, unnatural and imposing task.

Instead using the word “movement,” reminds us that moving around is something we’re designed to do and that it’s not solely about sweating buckets in a spin class or being put through your paces with a trainer.

Trying to shift a few pounds?

Exercise is important for many reasons, but losing weight is not one of them. As 80% of our body composition is determined by what we eat, it is our diet that is important.

Diet does not mean ‘dieting’....which has been shown again and again not to work in the long term. No sustainable weight loss can be achieved by a diet which leaves you feeling hungry and craving food!

Patellofemoral Joint Pain (PFJP) is a common complaint in adolescents. The pain tends to be focused at the front of the knee and is often associated with a loss of mobility, strength and function. This may impact on the ability to take part in sports, and if severe may limit walking, climbing stairs and sitting.

My approach to the assessment and treatment of this condition includes the following:

Why is the warmup and cooldown so important?

The warm-up prepares the body for exercise and should be tailored for the specific exercise that will be undertaken. For football, both general and specific exercises should be performed.

The warm up may include:

- General exercise jogging or cycling for 5-10 minutes to warm the muscles and enhance circulation in preparation for stretching
- Low level resistance exercises to ‘wake up’ important core stabilising muscles which will help support the back, hips and legs during training.
- Once the muscles are well warmed up, more vigorous dynamic stretches can be performed carefully under supervision of the coach so as to avoid injury.

The cool down is important to safely restore the body back to its resting state. This may include include general exercises such as light jogging or cycling and static stretching strethching to help prevent post exercise muscle stiffness and soreness.

Why is strength conditioning important to prevent injuries and optimise performance?

Strength and conditioning (S&C) physically prepares the body for the demands of the sport. It includes all forms of resistance/strength work and also agility, endurance, speed and flexibility training.It can also help prevent injuries.

Specific exercises should be related to football and will primarily focus on the lower body such as running drills, lower limb strength and balance work. A good example is the FIFA 11+ exercise programme. These exercises should ideally be done in the gym at a under supervision of a certified trainer or chartered physiotherapist initially and then at home once safe and effective technique has been taught. These S&C exercises are used as essential ‘background’ training to prevent injury and improve sports performance.

Newsflash (old news in fact)...we sit way too much!

The majority of the modern world lives sedentary lives, and not even fitness enthusiasts are safe from the assorted health risks of sedentary living.

Going to your body pump, yoga, spin, Pilates, CrossFit, Les Mills class etc. for an hour a day even every day doesn't counteract the eight or more hours spent at a desk, commuting, or lying on the sofa in the evening.

Risks include musculoskeletal, metabolic, and hormone imbalances including higher blood pressure and the propensity to store instead of burn fat, an increase in appetite, and a tendency toward obesity, cancer, and heart disease.

To counteract the dangers of sedentary living it is essential to:

- Move more frequently, at least 2-3 minutes every hour, 10 minutes every two hours and for half an hour at lunchtime. Get up, reach up, bend down, twist, and walk, take a few flights of stairs, and go to the bathroom (even if you don’t need to go).

- Avoid prolonged moments of stillness, both when sitting and standing at your stand up desk, vary your body positions.

- Add more movement to your life, such as a 5-15 minute walk after meals to regulate the insulin response.

In this age of multimedia I find podcasts a very accessible way to keep up with current thinking and evidence in modern physiotherapy practice.

I recently came across a PhysioEdge podcast titled ‘Know Pain’ with interviewee Mike Stewart, a clinician and lecturer in pain management at the University of Brighton in the UK. 

The podcast focused on the problem of persistent pain and how to better manage it within what’s known as a biopsychosocial approach. The biopsychosocial approach sits well alongside hands on manual therapy, medical acupuncture including dry needling as well as prescription therapeutic exercise when required.