Rolled Your Ankle? Do you Go To Hospital? What To Do Next?

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Ankle Sprains...          

X-ray or no X-ray?

We have written this detailed document so you can learn more about the anatomy, physiology, what we do to assess the area, what treatments are appropriate post injury, and most importantly, do you need an X-ray? Just fill in the details below and click download for your free copy!

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New Clinic Opening Near You!

Catalyst Physiotherapy are pleased to announce a new location within the heart of Fleet. We will be working in close partnership with the Park Club Fleet, located on the first floor of the Hart shopping centre. 

This new and exciting move allows us to not use our expert physiotherapy skills such as massage, acupuncture, joint mobilisation and joint manipulations (clicking), but now we have an extensive array of equipment to get our clients back to your best! 

 

Physiotherapy

We're happy... 

Are you..?

With our combination of Physiotherapists, covering all specialities and interests, we can provide expert analysis and treatment to a wide myriad of issues, from elite level sports to an achy lower back.

Need to come and have a chat? Give us a call or email us and one of our expert clinicians will get in touch. 

 

Deadlifts Hurt? What do I do? Skip the deadlift? Squat instead? Lower the weight? Go home?

We have written this document to provide you with new ways to keep lifting, stay strong and remain healthy! It explains and lists what we modify as physiotherapists, if someone was to present with pain upon deadlifting. .

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Outstanding Opportunity for an Experienced MSK Physiotherapist

Outstanding opportunity for an experienced MSK and sports physiotherapist to fill a full time position and join our dynamic team in the beautiful county of Hampshire.

Catalyst Physiotherapy has two well established private practices in Basingstoke and Hook. You will be taking over a previous physiotherapist's full time diary as well as growing from an existing client base, meaning there is an excellent opportunity for significant remuneration.

Both clinics are located within fully equipped gyms, meaning we can, and do provide rehabilitation and treatment to all levels of clients. All of our physiotherapists receive a free gym membership.

We take an integrated team approach to get the best results for our patients and we actively encourage regular CPD and onward development for all of our physiotherapists.

About you:

You have over 3 year's experience, including working in private practice in the UK, excellent clinical reasoning, hand’s on and excellent rehab skills. Additional qualifications and skills in acupuncture/dry needling, clinical Pilates, running analysis, FMT, orthotics will be an advantage as well as experience with postnatal sports injuries in teenagers.

You work well individually and are keen to grow and work alongside a great team.

The practice is open from 7:00 am to 8:00 pm, the working rota will involve early and late shifts. At present we do not open Saturdays, but this may change if the candidate would prefer time off during the week.

Interested? If you would like to apply for this opportunity, please send us your most recent copy of your CV to dfox@catalystphysio.com. We aim to respond to your application within 14 days of the closing date.

We Have a New Physiotherapist and EX-INTERNATIONAL sprinter... Welcome Dawn!

Here is a big welcome to our new Physiotherapist, Dawn. She is a huge asset and brings a wealth of experience to the team. Dawn has a vast array of experience within Physiotherapy, and being an ex-international sprinter sure helps! Dawn also completed a BSc (hons) in Sports Science before turning to Physiotherapy. Here is her bio, any aches and pains, keen runner, Dawn is your answer!  

Dawn Hunt

BSc (Hons) MCSP HPC registered

Senior Physiotherapist

Dawn graduated from Cardiff University in 2008.  Since graduating Dawn has worked in a number of established and busy London based private physiotherapy clinics, which has allowed her to broaden her skills and knowledge.

Dawn has also had the privilege of working within her favoured sport of athletics, being one of the physios at some of the London based diamond leagues, and therefore having the opportunity to treat elite athletes.

Since qualifying as a physiotherapist Dawn has furthered her knowledge through undertaking a number of courses, including a specialist running techniques course as well as becoming a qualified acupuncturist.

Previous to qualifying as a physiotherapist Dawn has also completed a BSc degree in Sports Science from Loughborough University, which has aided her physiotherapy career greatly with such enhanced knowledge of various aspects of sports nutrition, psychology and biomechanics all playing a large role in physiotherapy.

Dawn is also a keen athlete herself, having competed to an international level, being a part of the female 4x 400m team at several international competitions.  Her involvement in elite sport, again gives her wide knowledge of both elite and recreational sports participants and their requirements, specifically in relation to rehabilitation and injury prevention.

Say Hello to Hannah, Catalyst's Sports Massage Therapist

We here at Catalyst Physiotherapy would like to welcome our newest member of staff, Hannah! Hannah is a highly rated Sports Massage Therapist who works in a variety of settings. Not only this, she competes as a fitness model! Read through her blog below, if you require an appointment, contact us today! 

Hi my name is Hannah and I am a fully qualified Sports Massage Therapist now working along side Catalyst Physiotherapy. I have a vast experience working in various disciplines from boxing clubs to competitive body building gyms. Whether you're training for an event or looking for muscular maintenance, sports massage can provide you with enhanced training ability as well as rehabilitation from injury.

Having a sporting back ground myself through horse riding and female body building I have a great awareness of the impact muscular imbalances and tension can have on training, sleeping and day to day living. I am also a personal trainer which enables me to asses the origin of your ailments and help you resurrect the issues you may be experiencing issues with within your sport & discipline. I can help you build muscular strength in the areas you may be lacking so that you can progress further and get you one step closer to your goals.

Maintenance deep tissue massage is highly recommended to prevent injury and encourage circulation for those in demanding jobs, sports and also office based workers who often suffer with muscular pain. For any queries and to secure your appointment please contact Catalyst directly, I look forward to meeting you and helping you on your journey

Benefits of Massage:

  • Reduction of DOMS
  • Sports injury & rehabilitation
  • Improved circulation
  • Reduction in muscular tension & stress
  • Break down of scar tissue & adhesions
  • Removal of lymphatic waste
  • Improved range of motion
  • Improved flexibility
  • Relaxation
  • Improve muscle tone
  • Enhancement of athletic performance
  • Prevention of sports injury
  • Improve posture
  • Repair damaged muscle/tendon/ligaments

 

7 Ways to Make Squatting Safer For Your Knees

.At least in the research for high level olympic lifters, deep squats appear not to be as dangerous as some may think, as discussed in a previous article.  I don’t think this means that everyone needs to go ahead and start deep squatting.  I am a keen supporter of the deep loaded squat for some people but believe there are a lot of other considerations from a knee health perspective to think about before embarking on a long career of squat personal bests and pain free knees.

1 – Mobility

Since I’m a Physiotherapist I decided to put this one first.  when comes to me or the team not being able to complete a squat adequately, the first place I look is with their mobility.  These following areas are going to need some work when the squat is poor are:

  • Ankles
  • Tibial Rotation

 

  • Hip Mobility

 

2 – Patellar Tracking

The major reason for this is the goal of getting the knee to track over top of the toes during the squat.  I like to think of the patella as a train that rides along a train track known as the trochlear groove of the femur (picture).  As we squat, if the knees aren’t directly over the toes we may be getting the train not tracking along the tracks and getting some abnormal wear of the patello-femoral joint.  As discussed above, if we have some mobility issues, particularly in hip and tibial rotation as well as ankle dorsiflexion then we’re going to create a tracking issue. If you want to keep your knees healthy, this is a must! 

3 – Motor Control, Strength and Stability of the Core, Foot, and Hip

When it comes to proper patellar tracking along the trochlear groove we not only need to have adequate mobility, but also strength and stability.  Stability issues of the core, hips, and foot can all lead to tracking issues at the knee, thereby increasing knee stress.

4 – Technique

Technique is arguably the most important aspect of all of these finer points discussed for knee health in the squat.  The only reason I didn’t put it first is because we need points 1-3 in alignment in order to complete deep squats properly and efficiently.  Squat technique could be a whole article series in itself so I won’t go into depth here but there are some points I’d like to go over in the squat that directly affect knee health

  1. The further your knees come forward in the squat the greater the shear forces become in the knee.  Having the knees back more in the squat will decrease these forces.  However, pushing the knees back will increase shear forces on the spine.  It’s a catch-22 that we’ll discuss more in depth another time.  
  2. Faster lowering into the bottom of the squat and subsequent reversal of movement places more compressive and shear forces on the knee.  Decreased speed into the bottom of the squat improves this stress.
  3. Fatigue changes kinematics.  As athletes fatigue in the squat they generally have less control at the bottom of the squat (Increased knee stress) and increased trunk forward pitch (Decreased knee stress but increased spinal shear stress)

This information gives us a little additional information on how to either increase or decrease stress on the knee.  Just keep in mind that you’ve got a catch-22 on your hands as modifying position can also increase stress elsewhere.

5 –  Quadricep Strength

The quadriceps attach to the patella and have a direct relationship to both patellar tracking and controlling shear forces in the knee.  As discussed above and in prior articles, the knee takes increasing posterior shear forces in the squat maximizing around 90 degrees and increasing with fast speed of execution into the bottom of the squat.  A strong quadricep will help to buffer this and prevent as much stress on the knee.

The quad exercisesI like to prescibe are lunge and split squat variations.  While attempting to maximize quadriceps activity and prepare for the squat I like to keep the step relatively short to mimic the mechanics of upright squatting. Another favorite of mine is to elevate the front foot to increase knee flexion and more closely mimic the deep squat knee mechanics.  These are also great for improving asymmetries from side to side.

 

6 – Preparation, proper progression and volume management for deep squatting

Having been reading more of the current research lately about volume management and injury I think that a lot of the principles apply to squatting as well.   Squats need to be slowly incorporated into a comprehensive strength and conditioning program with adequate thought toward total knee stress throughout the training, week, month and year.  Doing too much too soon without much thought toward the total program’s stress on the athlete can leave your athlete with sore and painful knees. FACT.

On numerous occasions I have athletes or the general public who start having knee pain after starting a high volume olympic lifting program or after workouts with very high squat volume.   Any sudden changes in training volume can cause issues.  If you’re an athlete who needs to be able to handle high training volumes of squatting make sure you work your way slowly toward your goals.

7 – Exercise Variety

So the pattern overload concept.  The concept is that if we are constantly wearing the body in a consistent way, then we are more susceptible to overuse injuries and degenerative changes in a predictive way.

Finding the ideal squat stance for the individual is going to be incredibly important for health of not only the knees, but spine and hips as well. 

Some variety you can try throughout the course of the year would be:

  • Vary stance used in the squat
  • Vary bar position and torso inclination (high vs. low bar back squat, front vs. overhead vs. zercher)
  • Vary bar types (Safety Squat, Camber, Buffalo)
  • Vary Tempo (Slower eccentrics, pausing at the bottom of the lift)
  • Vary Depth (Powerlifting style breaking parallel, olympic lifting maximal depth, box squatting variations
  • Vary the movement – Utilising more single leg variations like squats, lunges, split squats and step-ups can help minimise pattern overuse and break up the monotony of training. 

Finally, some considerations of when it might not be safe to squat?

  • Current knee pain – If you’ve got knee pain then get yourself checked out before attempting any squatting program
  • Pathology in the knee – advanced arthritis, meniscus injury, ligamentous injury (ACL and PCL especially).  Again see a professional first.
  • Poor mobility – Having mobility problems will almost certainly lead to compensatory movement and increased stress in areas you probably don’t want it.  Find someone to help you out in this regard as well.

Hopefully this article shed some light on what should be in order to have someone squat proficiently and safely.  The stress on the knee will be minimized if we take these factors into consideration.  

Bibliography:

  1. Hartmann, H., Wirth, K., & Klusemann, M. (2013). Analysis of the Load on the Knee Joint and Vertebral Column with Changes in Squatting Depth and Weight Load. Sports Med.
  2. Reinold, M. (2009, May 11). Solving the Patellofemoral Mystery. From http://www.mikereinold.com/2009/05/solving-patellofemoral-mystery.html

 

Need us? Contact us today! 

Should I Have Knee Meniscus Surgery?

The most common orthopedic surgery in America had it’s final epitaph written this month with a level-1 study showing that surgery for meniscus locking is no better than placebo. Given that this was the final indication for the surgery, based on the research, to use a party analogy, the booze has run out for this little soiree. So if you’re asking yourself, “Should I have meniscus surgery?” the research on the topic has now spoken, and the answer is a resounding “NO!!!”

What Is a Meniscus Tear?

The meniscus is a natural shock absorber in the knee that provides some spring in your step and helps to protect cartilage. It can become torn with age or trauma, mopst commonly upon twisting of the knee, and greater than 90% of the surgeries on the structure are not repairs, as most patients believe, but are instead excisions, or cutting out, of the torn part of the meniscus.

Meniscus Tears in Middle Age Are like Wrinkles—Everybody Has Them

The big misconception that has been propagated like a “scandalous” rumor in a small town is that meniscus tears as seen on MRI after a middle-aged patient reports knee pain are significant. THEY ARE NOT. Just as many of your middle-aged friends who don’t have any knee pain or problems have meniscus tears; hence, the fact that your MRI has one is as important as those new wrinkles on your forehead in need of a little Botox.

The Research Showing Meniscus-Tear Surgery Doesn’t Work

The first canary in the meniscus surgery coal mine happened way back in 2002, when a study by a Baylor College of Medicine orthopedic surgeon showed that debridement (the cleaning up of a knee that has arthritis and degenerative meniscus tears) was no better than a placebo.  The procedure over the last 15 years has slowly slipped into medical oblivion.

The next study came from an unlikely source; turns out the Framingham, Massachusetts, town that has given us such great heart data through the years also has a government-sponsored osteoarthritis study. This and other studies concluded that just as many middle-aged people without knee pain had meniscus tears as those with knee pain. Ouch…

In 2012 a large high-level research study published in the New England Journal of Medicine showed that on average, patients who had meniscus surgery didn’t do any better than those who skipped the surgery and just had physical therapy. Many orthopedic surgeons criticized the study by saying that these patients had some arthritis and that there was still a justification for performing the procedure on patients with a meniscus tear without arthritis. That fantasy went “bye bye” in 2013 when a high-level study showed that meniscus surgery in patients without arthritis was no better than a fake surgical procedure. There was still one condition left where meniscus surgery might be helpful—a meniscus tear that was causing locking of the knee. However, a new study out this month just burst that bubble!

The New Study Puts the Final Nail in the Meniscus Surgery Coffin

The new study out of Finland looked at 146 patients who had “mechanical symptoms” (i.e., locking or catching thought to be caused by the meniscus). They randomized about one-half of the patients to meniscus surgery, and about half got a sham surgery. They found that the surgery provided no benefit to relieve knee catching or occasional locking, and they cautioned against patients getting the surgery.

Now, I know surgeons will argue that there still may be a justification for the surgery in patients with severe frequent locking of the knee or in patients who are younger and have an acute meniscus tear. In the first instance, they may be right, and in the second, given that studies have shown a rapid onset of arthritis and increased forces on the cartilage after a meniscus surgery, I would caution that the circumstantial evidence is that surgery should be avoided in those patients too! 

In Summary there is little scientific justification at this point in patients 35 and older that operating on their torn meniscus will do any good, and it’s only a matter of time until insurers and national healthcare systems begin relegating this procedure to the dustbin of medical history. So if you’re asking yourself, “Should I have meniscus surgery?” answer yourself with a resounding “NO”!

Courtesy of http://www.regenexx.com/should-i-have-meniscus-surgery/