Acute Injury Management

By Hannah Longega, Physiotherapist, Action Potential Clinic, Kingswood. Follow Hannah and other members of the clinic

Congratulations if you were one of the 12,000 people who took part in this year’s Bristol 10k. Whilst we sincerely hope you feel fantastic and haven’t injured yourself on the way round, here are our top tips of what you can do to help yourself on the way to recovery if you have felt that dreaded twinge today.

Bristol 10K

 

Whilst most people have heard of PRICE (Protection, Rest, Ice, Compression and Elevation) for management of acute injuries you may not have heard of POLICE. This latest acronym has resulted from research by Bleakley et al 2012 who have suggested this update on finding that complete rest for a prolonged period may be harmful.

Protection:

Use braces, bandages, tape etc. to protect your injury whilst it heals. Exactly which option you use depends on the injury and so it can make it difficult to decide which one to go for, so speak to your health care professional if you are at all uncertain. In short this step helps prevent the injury from receiving too much loading in this early stage, which can lead to more damage being created.

Optimal Loading:

Optimal loading has replaced rest in this acronym.

 What does it mean?

It means avoiding movements in the direction of the injury or any strenuous activity involving the injured part at this early stage. Then as you recover progressively increasing the load that you put through the area.

 Why has it replaced rest?

  • It has been found that too much rest can lead to joint stiffness, muscle weakness and tightness.
  • Optimal loading has been found to restore strength and the structure of the injured area and to stimulate healing.
  • The right amount of activity can also help decrease swelling by using the muscle for instance the calf to move the swelling up the body when they contract.

However, the amount of loading put through the area varies depending on the injury so seek help from a healthcare professional if you’re at all in doubt. As a general rule of thumb do as much as you feel able but don’t push through the pain.

Ice:

As a general rule apply ice to the injured area for 10-20 minutes wrapping it in a damp, clean tea towel.

A few precautions with ice:

  • Do not apply to a numb area or an open wound
  • Take care not to get ice burn. So don’t apply ice directly to the skin, or leave it on for a prolonged period of time.

Compression

Make use of tubigrip or kinesiotape in order to prevent further swelling. In the clinic when we use tubigrip we tend to apply a double layer making sure that although the area feels compressed it is not painful and that there is good circulation below the bandage. We tend to recommend taking the bandage off at night for comfort.

We also make use of kinesiotape and have seen some great results including when Jake Hayes (chiropractor) injured his ankle training for the London Marathon this year. Whilst he had to take time out of his training the tape helped him back on track to run London in 2:43!

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If you are unsure about how to apply this, seek advice from your healthcare professional.

Elevation:

This can be an effective way to decrease the pain and the swelling.

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The London Marathon Experience

Jake Hayes, is a senior chiropractor at Action Potential Clinic, Bristol. Follow Jake and other members of the clinic

Have you ever wondered what its like to run the London Marathon? We sat down to find out with Jake Hayes (Action Potential Clinic, chiropractor) who has done just that a whopping 7 times!

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What was it like running the London Marathon?

It was a wonderful experience! At times it was very hard as it was hot this year. However, it is a fantastically supported event to be part of, with thousands of people lining the race there is literally not a hundred meters without people. This can be a little overwhelming due to the volume of people and the amount of noise that they generate. However, they provide fantastic support and really drive you on which keeps you motivated. I don’t run with my name on my vest anymore but if you do, you get what feels like 600,000 people shouting your name all the way which, feels pretty amazing!

What keeps you motivated when you are running such a long way?

If it’s a training run what keeps you motivated is the bigger picture. If you want to do something to the best of your ability then you need to put the time in. Apart from the fact that you enjoy it and you are out in the fresh air. Often at times training motivation for me is a bit of time to yourself, you can think about things and you see interesting things that you wouldn’t usually see.

In the actual run it is quite different, the motivation is to run as fast as you can whilst being quite disciplined – constantly checking your speed and your pace, checking runners around you and how are you feeling in terms of being relaxed, good posture, good running form. You check the runners around you to ensure you are following the racing line – to ensure that you are running as short a distance as you possible have to! You may recognise people around you and together you can share the load much like cyclists do.

I have always found a marathon a race of two halves, the first being relatively easy due to the excitement, seeing landmarks such as tower bridge, cutty sark and of course all the people lining the route. It feels amazing to run past the landmarks that you have seen on TV. However, you run over Tower Bridge and then you realise that you are only half way around. Up to this point you tend to run on a bit of a cloud of excitement and adrenaline, then at this point the adrenaline starts to go and it becomes a numbers game of how many miles you have left to run.

What was involved in the training for the marathon?

I follow a specific training plan by Pfitzinger and Douglas called Advanced Marathoning, this is a well recognised marathon training plan. This was an 18-week training plan that involved running between 55 and 70 miles per week (approximately 10 hours per week of training).

Fundamentally, to run a marathon you have to run distance, so one long run per week. You build up the distance covered during this run and should aim to run at least a couple of 20 mile runs in the training programme. Within the last 3 weeks you generally taper down the amount of miles you run. In my programme the pace and distance varied daily from 5-20 miles. This included tempo runs that are fast and short, longer and slower runs for endurance, interval training, track runs and 5k runs which are for speed, strength and psychological strengthening.

What are you high points from the marathon?

Ultimately, it is always a fantastic feeling of achievement to cross the finish line. You have put in a long training plan of 3-4 months on average and it is a long journey. Often initially this is a journey that you don’t know if you will be able to complete, as you don’t know if you can run 26 miles, as you won’t do this number of miles in training.

Also, seeing friends and family in the crowd, I’m lucky that I get to see my family 4 – 5 times around the route. Running past the landmarks that you have seen on the TV. from being a child is also a high point.

What tips would you give to anyone who wants to have a go at running London?

Start something simple by running short distances. It is a marathon and not a sprint! If you really want to do it, running a marathon is a big undertaking and is not to be taken lightly.

You need to see whether you enjoy running enough, and if you are physically capable of running well enough which, you won’t necessarily know to begin with, so just start by running two to three times per week for 20 minutes. You could walk and run, alternating just so you can build up your fitness.

Expect it to take time! It took me a year to train to do a sub 3-hour marathon, now because I run all the time it doesn’t take me, as long to reach the level of fitness required for this time

Remember to enjoy it!

by Hannah Longega, Physiotherapist, Action Potential Clinic, Kingswood

Feeling inspired? How to enter the London Marathon 2015

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It’s not easy to get a place running in the London Marathon, as we hear in clinic from you guys. So to point you in the right direction here are the main ways you can use to enter:

 

  1. The Online ballot for the London Marathon 2015 (http://www.virginmoneylondonmarathon.com) will open on 22 April 2014. Last year 125,000 entries were received within 11 hours. It is expected that this year 125,000 people will be allowed to enter before the ballot closes. Successful entries will be notified in October.
  2. Race for a charity. Charities are allocated ‘Gold Bond’ places. To get one of these you’ll have to pledge to raise around £2000, this is because the charities themselves will have had to pay an entry fee for each runner. To find out more, and to browse a list of participating charities, check out the Virgin London Marathon Charity Listings (http://www.realbuzz.com/activity-listings/virgin-money-london-marathon/)
  3. Have you entered previously? If you’ve completed the marathon in a fast time previously there’s a chance you could qualify for an automatic ‘good for age’ entry. For men aged 18-40 this is between 2h45 and 3h05, and for women aged 18-40 it’s 3h15 – 3h45. If you are quicker than this you can qualify for the UK Athletics Championship entry, otherwise qualifying times increase for older age categories
  4. Did you pull out this year? If you did you may be eligible for a fast track re-entry. Entries must be in by 5pm on June 20, 2014. Click on this link for further information: http://www.virginmoneylondonmarathon.com/marathon-centre/enter-virgin-london-marathon/deferred-entries-due-illness-or-injury/

 

Jake will be applying for his 8th London Marathon through the third route. Hopefully, some of you will be able to join him there next year!