Can Osteopathy Support Marathon Training or Triathlon Preparation?

Training for a marathon or triathlon is hugely rewarding — but it places significant, repetitive stress on the body. Whether you’re preparing for the London Marathon or building towards your first Olympic-distance triathlon, the combination of mileage, intensity and time pressure increases your risk of overload injuries.

This is where osteopathy can play a valuable role.

At Back to Back in Wandsworth SW18, we regularly support runners and triathletes through structured training blocks — not just when they’re injured, but proactively to keep them moving well.

The Demands of Marathon & Triathlon Training

Marathon training typically involves:

• Progressive weekly mileage

• Long runs placing sustained load through the calves, Achilles and hips

• Speed sessions stressing hamstrings and hip flexors

• Reduced recovery time during peak blocks

Triathlon preparation adds:

• High cycling volume (hip flexor dominance, lumbar flexion posture)

• Swimming (shoulder load and thoracic rotation demands)

• Transition training, where fatigue alters running mechanics

When training volume increases faster than tissue capacity adapts, problems arise.

Common issues we see include:

• Achilles tendinopathy

• Patellofemoral pain

• IT band irritation

• Hamstring overload

• Bone stress reactions

• Lower back stiffness linked to cycling

These are rarely “random injuries.” They are usually load-management or biomechanics problems that build over time.

How Osteopathy Supports Performance

1. Early Identification of Overload Patterns

Before pain becomes an injury, the body often gives warning signs:

• Persistent tightness in one calf

• Reduced hip extension on one side

• Subtle asymmetry in single-leg strength

• Increasing fatigue that doesn’t resolve with rest

Osteopaths are trained to assess movement patterns, joint mobility and tissue load tolerance. Identifying these early allows adjustments before full injury develops.

For example:

• A restricted ankle joint may increase Achilles strain.

• Reduced thoracic rotation from cycling may alter arm swing in running.

• Gluteal weakness may overload the hamstrings late in long runs.

Addressing these proactively keeps training consistent — and consistency is everything in endurance sport.

2. Optimising Biomechanics

Marathon and triathlon performance relies on efficiency. Small mechanical inefficiencies repeated over thousands of steps become significant.

Osteopathic assessment looks at:

• Hip extension and pelvic control

• Ankle mobility and calf capacity

• Thoracic rotation

• Rib and breathing mechanics

• Lumbar spine load distribution

Manual therapy can improve joint mobility and reduce protective muscle tone, but this is only part of the picture. The goal isn’t just to “loosen” tissues — it’s to restore optimal movement so force is distributed more evenly.

3. Strength & Load Guidance

Endurance athletes often focus heavily on mileage but neglect strength.

Evidence consistently shows that strength training:

• Reduces running injury risk

• Improves running economy

• Supports tendon resilience

• Enhances late-race performance

Osteopaths can guide:

• Single-leg control work

• Calf capacity progression

• Hip abductor and glute strength

• Plyometric progression for race readiness

• Core and trunk endurance

This becomes especially important for triathletes managing cumulative fatigue across three disciplines.

4. Managing Recovery During Peak Blocks

During high-load weeks, athletes may experience:

• DOMS that lingers longer than expected

• Calf tightness after speed work

• Shoulder stiffness from increased swim volume

• Low back ache from long rides

Osteopathic treatment during these periods can help maintain joint mobility, improve circulation to overloaded tissues, and reduce compensatory patterns.

Importantly, treatment should be integrated into the training plan — not used as a last-minute fix when things break down.

5. Supporting Return from Niggles

Very few athletes complete a full marathon or triathlon block without any niggle.

The key is not eliminating discomfort entirely — it’s understanding when discomfort is acceptable and when it signals tissue overload.

An osteopath can help distinguish between:

• Normal training soreness

• Tendon overload

• Early bone stress reactions

• Neural irritation

• Joint-related referral pain

This clarity allows smarter decisions around:

• Whether to continue training

• How to modify load

• When to cross-train

• When imaging or GP referral is required

This is particularly relevant in marathon build-ups where ignoring early bone stress symptoms can end a season.

Osteopathy Is Not Just “Treatment”

The biggest shift in modern sports osteopathy is moving away from purely passive treatment.

Effective support involves:

• Movement assessment

• Load management advice

• Evidence-based strength programming

• Biomechanical optimisation

• Clear return-to-run frameworks

Manual therapy is a tool — not the entire solution.

When Should You See an Osteopath During Training?

Consider booking if:

• You notice asymmetry developing

• A niggle persists beyond 7–10 days

• You are increasing mileage significantly

• You’re entering peak training

• You have a history of recurrent injury

• You’re returning after time off

You don’t need to wait for a full injury.

Final Thoughts

Marathon and triathlon preparation place extraordinary demands on the body. The difference between successful completion and frustrating injury is often proactive management.

Osteopathy can support:

• Injury prevention

• Movement efficiency

• Strength integration

• Recovery management

• Smarter training decisions

Whether you’re building towards your first race or chasing a PB, structured musculoskeletal support can make training more resilient and more sustainable.

And ultimately, staying healthy through the build-up is what gets you to the start line confident — and to the finish line strong.

Back to Back Osteopaths is a trusted resource for marathon runner and triathletes alike. But we also see athletes from most other sporting disciplines.

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered

Book an appointment online today. Or not sure if your symptoms need treatment? Feel free to call our clinic in Wandsworth and we’ll happily advise.

Why Strength Training Is Essential for Injury Protection in the London Marathon

Training for the London Marathon is a huge physical undertaking. Over 26.2 miles, your body absorbs thousands of repetitive loading cycles. Every step places forces of two to three times bodyweight through your feet, ankles, knees and hips. Multiply that by 35,000–45,000 steps and it’s easy to see why injury rates in marathon training are high.

The common misconception? That more running is always the answer.

In reality, strength training is one of the most effective tools we have for injury protection in marathon runners. At our clinic in SW18, we regularly see runners who could have avoided weeks off training with a smarter strength foundation.

Here’s why it matters — and what to focus on.

The Marathon Is a Muscular Endurance Event

Marathon training is not just cardiovascular — it is muscular endurance under fatigue.

As fatigue builds:

• Stride length shortens

• Cadence drops

• Hip control reduces

• Ground contact time increases

This alters load distribution through the lower limb. When tissues fatigue, joints absorb more force. That’s when problems start.

Common marathon injuries include:

• Achilles tendinopathy

• Plantar fascia irritation

• Patellofemoral knee pain

• IT band pain

• Bone stress injuries

In many cases, the root cause is not “tightness” — it’s insufficient strength and tissue capacity for the demands placed upon them.

Strength Improves Tissue Capacity

Every tendon, muscle and bone has a load tolerance threshold. Training increases that threshold.

When you perform progressive strength training:

• Tendons become stiffer and more resilient

• Muscles generate force more efficiently

• Bones respond to loading by strengthening

• Neuromuscular control improves

This creates what we call load capacity — the ability to tolerate marathon training without breaking down.

Without this, your running volume can outpace your body’s ability to adapt.

The Calf Complex: The Unsung Hero

The calf complex (gastrocnemius and soleus) is one of the most overloaded structures in marathon running.

The soleus, in particular, works tirelessly to control forward momentum and absorb force during stance phase. As fatigue builds late in the race, reduced calf capacity often leads to:

• Achilles overload

• Plantar fascia strain

• Shin pain

Specific strength work should include:

• Straight-leg calf raises (gastrocnemius bias)

• Bent-knee calf raises (soleus bias)

• Heavy, slow resistance work

• High-repetition endurance sets

Many runners underestimate how strong their calves need to be for 26.2 miles.

Hip Strength Protects the Knee (your knee IS your hip!!!)

Poor hip strength and control can increase load through the knee and IT band.

When the gluteal muscles fatigue:

• The knee drifts inward

• Femoral rotation increases

• Patellofemoral stress rises

Over thousands of strides, this becomes painful.

Key exercises include:

• Single-leg deadlifts

• Split squats

• Step-downs

• Lateral band walks

• Side planks

The goal is not bodybuilding. It is controlled, unilateral strength under load.

Strength Reduces Fatigue-Related Breakdown

Research consistently shows that strength training:

• Improves running economy

• Reduces ground contact time

• Enhances force production

Better economy means less energy cost per stride. That translates to reduced fatigue late in the race — and fewer compensatory movement patterns.

Injury risk increases significantly in the final third of marathon training blocks, when mileage peaks and cumulative fatigue is highest. Runners who maintain strength work during this phase tend to cope better.

“But I Don’t Want to Be Too Sore to Run”

A common concern.

The solution is intelligent programming:

• Two sessions per week

• 30–40 minutes

• Focus on lower limb and trunk

• Avoid excessive new exercises during peak mileage

• Reduce volume slightly in taper phase

Strength training should complement running, not compromise it.

Heavy lifting during base phase. Maintenance during peak weeks. Light activation during taper.

Bone Health and Stress Fracture Protection

Bone responds positively to load — but it needs varied stimulus.

Running is repetitive. Strength training introduces different loading patterns that stimulate bone adaptation.

This is especially important for:

• Female athletes

• Masters runners

• Runners increasing mileage

• Those with a history of bone stress injury

Under-fuelling combined with high mileage and no strength training is a high-risk scenario.

Practical Weekly Structure (just some ideas…)

A simple template might look like:

Day 1: Lower Limb Strength

• Split squats

• Romanian deadlifts

• Straight-leg calf raises

• Core control

Day 2: Stability and Endurance

• Step-downs

• Bent-knee calf raises

• Single-leg bridges

• Side planks

Keep it progressive. Add load when movements feel controlled and technically sound.

Strength Training Is Performance Training

This isn’t just about avoiding injury.

Stronger runners:

• Maintain pace longer

• Resist form breakdown

• Produce more force per stride

• Feel more robust during peak training

The London Marathon rewards durability.

Final Thoughts

Marathon training already places huge demand on the body. Relying on running alone is often not enough to prepare tissues for the cumulative load of 26.2 miles.

Strength training:

• Increases tissue capacity

• Reduces fatigue-related movement breakdown

• Protects against common overuse injuries

• Improves performance

If you’re building towards the London Marathon, investing in strength now could be the difference between standing on the start line — or sitting out injured.

Run consistently. Lift intelligently. Arrive strong.

For more advice book into see one of our osteopaths at the clinic in Wandsworth SW18.

Look at our blog on bone stress injuries here

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered

London Marathon 2026: A Complete Guide to Bone Stress Injuries in Runners

With the London Marathon 2026 training cycle now building momentum, this is the period when we commonly see bone stress injuries emerging in runners across Earlsfield, Wandsworth and SW18.

Understanding the early signs can be the difference between finishing the race — or missing the season entirely.

What Is a Bone Stress Injury?

Bone stress injuries (BSIs) occur when repeated impact loading exceeds the bone’s ability to remodel and recover. They sit on a spectrum:

1. Stress reaction (early overload)

2. Stress fracture (structural crack)

During marathon training, runners may take 30,000–50,000 steps per long run. If recovery, nutrition and strength capacity don’t match the load, bone tissue begins to fail.

Common Locations in Marathon Runners

Tibia (shin) – the most common site

Metatarsals (forefoot) – pain during push-off

Calcaneus (heel) – deep heel ache

Femoral neck – deep groin pain (higher-risk and needs urgent assessment)

Early Warning Signs

Bone stress injuries rarely start dramatically. They build gradually.

Watch for:

• Localised pain (you can pinpoint it precisely)

• Pain that appears earlier in each run

• Pain on single-leg hopping

• Pain that persists after the run

• Pain that begins to hurt during walking

• Night pain (more concerning)

If pain is broad and diffuse, it may be shin splints. If it is sharp and focal, think bone.

Why They Increase During Marathon Training

Several risk factors stack up during London Marathon preparation:

1. Rapid Mileage Progression

Jumping from 15km to 25km long runs within weeks.

2. Hard Winter Surfaces

More pavement running, less terrain variation.

3. Inadequate Recovery

Busy professional schedules often compromise sleep and fuelling.

4. Low Energy Availability

Under-fuelling reduces bone turnover and resilience. This is particularly relevant in endurance athletes and female runners, but affects men too.

5. Lack of Strength Training

Bone responds to heavy load and varied force. Many marathon runners accumulate mileage but neglect progressive strength work.

Prevention: What Actually Works

Evidence supports:

• Gradual mileage increases (avoid >10% weekly spikes)

• Heavy calf raises (straight and bent knee)

• Split squats and single-leg strength

• Progressive plyometrics

• Adequate carbohydrate intake around training

• Sleep >7 hours per night

Bone health is influenced by both load and energy availability.

When to Stop Running

You should stop and seek assessment if:

• Pain is focal and worsening

• Walking becomes painful

• Hopping is painful

• Pain is deep in the groin

Continuing to train through a stress reaction often progresses it into a full stress fracture.

How We Help at Back to Back Osteopaths (SW18)

For runners in Earlsfield and Wandsworth training for London 2026, we assess:

• Load management and weekly mileage

• Strength capacity vs training demand

• Running mechanics

• Recovery strategies

• Nutrition risk factors

Early intervention often means modifying training rather than stopping completely.

If you are preparing for London 2026 and experiencing persistent, localised pain — don’t ignore it.

A small problem in February can become a season-ending injury by April.

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered

Why Longevity Matters – And Why It’s About More Than Living Longer

Longevity is having a moment. From podcasts and books to gym conversations and health apps, everyone seems to be talking about how to live longer.

At Back to Back in Wandsworth, when we talk about longevity, we mean something much more meaningful than simply adding years to your life. We’re talking about adding life to the years that you have. Healthspan rather than Lifespan. We don't care about living until we are 100, the years you have need to be the best they can be. Helping you stay strong, capable and doing the things you love, for as long as possible.

We all know people who find walking or going up the stairs a challenge. Often just getting off the toilet can be hard, let along picking something off the floor that you have dropped. It should NOT be. We actually loose 10-15% of our muscle mass per decade after our mid thirties!  We naturally get weaker……! You can stop this. To have a fulfilling and active last few decades, you NEED to stop this.

Stats also suggest that up to 50% of people over 70 live with pain most days!

A great question we often ask is 'What do you want to be able to do in the last decade of your life'? Go walking or hiking, lifting the odd suitcase or looking after grandchildren. Just be able to comfortably garden for a bit??

Being independent is about the ability to look after yourself.

Most people don’t realise this until something goes wrong. An ache that won’t settle. Strength that quietly slips away. A fall that knocks confidence. A period of stress or illness that suddenly highlights just how vulnerable the body can feel. Longevity is about getting ahead of those moments, not reacting to them.

The science is clear, if you are over 60 year old and you fall and break your hip, up to 30% of those people die within a year and of those that do survive, 50% NEVER get back to where they were.

If longevity had a hierarchy, strength sits up near the top. Stretching is mentioned somewhere, but nowhere near the top... it has more of a supporting role, yet in day to day life we put so much onus on stretching.

Cardiorespiratory (CV) fitness comes first because large studies show that low VO₂max is one of the strongest single predictors of all‑cause mortality, with bigger risk differences between low and high fitness than for most other modifiable factors. Muscular strength is also a powerful predictor, but the effect size is generally smaller than that seen with cardiorespiratory fitness, which is why strength is best viewed as the second key metric rather than the primary one.

The Body as a “Strength Bank”

We often describe longevity as similar to financial planning. You wouldn’t wait until retirement to start thinking about your pension. In the same way, you shouldn’t wait until pain, weakness or loss of mobility appear before investing in your physical health.

Your muscles, bones, balance and cardiovascular fitness are your strength bank—and the deposits you make today massively influence your quality of life later on. The earlier you start building it, the more resilience you have when challenges inevitably come.

Why Longevity Matters Now

Modern life makes it surprisingly easy to lose physical capacity without noticing. We sit more, move less and spend far less time doing the kind of varied, functional activity that keeps the body robust. Research shows that:

• Grip strength is one of the strongest predictors of healthy ageing.

• Balance declines much earlier than people realise—often from our 40s.

• Muscle mass naturally drops 1%–3% per year after age 35 unless we actively maintain it.

• Low activity levels significantly increase the risk of chronic pain, frailty and falls in later life.

But here’s the good news: these trends are not fixed. They are modifiable. And improvement is possible at any age.

Small Changes, Big Impact

Longevity isn’t about extreme diets or chasing the latest trend. It’s about consistent, achievable habits:

• Moving more throughout the day

• Building strength safely and progressively

• Challenging balance regularly

• Improving sleep and managing stress

• Maintaining joint mobility

• Understanding and working with your body, not against it

This is where osteopathy plays a vital role. Many people want to build strength and resilience but feel limited by pain, stiffness or fear of making things worse. Our role is to educate you, help you move better, recover faster and build the confidence to do the things that keep you well.

Proactive, Not Reactive

Most people come to us when something hurts. Longevity turns that approach on its head. It asks:

How can I stay strong enough that future injuries are less likely? How can I build a body that supports the life I want to live?

Thinking this way doesn’t just improve lifespan—it improves healthspan, the number of years you can live fully, independently and joyfully.

The Takeaway

Longevity isn’t reserved for athletes or biohackers. It’s for anyone who wants to stay active, keep up with children or grandchildren, walk without fear, travel freely and feel in control of their health. The actions you take now—no matter your age—have a profound impact on your future.

And you don’t have to do it alone.

At Back to Back, we’re here to guide you every step of the way.

By James Dodd BSc (hons) Ost. FAFS.

GOsC registered

Hot Stone Massage with Leanne Bowden

Keep warm this winter - try our hot stone therapy massage! 

For a wonderfully soothing and powerful treatment this winter, try Leanne’s hot stone therapy massage. A thermotherapy treatment using heated basalt volcanic stones. Using a mix of flowing movements across the body with classic massage techniques to create the perfect blend of relaxation and reducing muscle tightness. 

The heat encourages an increase in blood circulation deep into the muscle and is a great treatment to relax chronically tight muscles. If you struggle to find a treatment to relax particularly stubborn areas, usually in the upper back, shoulders and neck, then this is the treatment for you! It can be combined with deep tissue techniques if you require a firm massage or for those that prefer a light/medium pressure, the stones can be used alongside holistic massage techniques. 

This is a really popular treatment at the clinic as it’s such a versatile and effective massage which is nurturing for both the body and mind. It has been particularly popular with clients affected by fibromyalgia, long covid and hypermobility. 

Hot stone therapy can be incorporated into all of my massage treatments (except pregnancy), so just ask reception when you book in.

Leanne Bowden

ITEC Massage therapist & VTCT Reflexologist @ Back to Back 

Book in by calling the clinic on 020 8605 2323

what is Osteoarthritis and Rheumatoid arthritis – isn’t all arthritis the same?

Arthritis is used as a general term to describe stiffness, pain, and inflammation in the joints but in truth there are many types of arthritis which produce differing symptoms.

In this blog post we are going to focus on two types of arthritis - Osteoarthritis and Rheumatoid arthritis. They both affect joints in the body but in very different ways.

Osteoarthritis (OA)

OA is a degenerative type of arthritis where joint cartilage breaks down over time causing stiffness, swelling and joint pain. This is the most common type of arthritis and usually affects larger weight bearing joints such as the hip, usually on one side of the body.

It is more common as we get older and after previous joint injury or surgery. Having a higher BMI, diabetes or previous gout attacks are also risk factors for OA.

The pain can feel worse with activity and better with rest and affected joints can produce pain at night.

The symptoms can take years to build as the arthritis develops slowly over time. As the OA progresses, bone spurs and subchondral cysts can develop on the joints which can be seen on MRI scans.

Rheumatoid arthritis (RA)

RA is an inflammatory type of arthritis caused by the body attacking its own tissues, producing inflammation. It is an auto-immune condition. It usually affects smaller joints such as the fingers and symptoms are usually symmetrical occurring on both sides of the body at the same time.

Symptoms can come on very quickly and can vary in intensity. Affected joints can feel very painful, stiff, and swollen and can get worse with rest and better with movement.

RA usually runs in families and is 2-3 times more common in women. As it is an inflammatory condition, blood markers for inflammation such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are usually high, along with a positive Rheumatoid factor (RF).

Alongside the musculoskeletal symptoms, RA can cause symptoms in the rest of the body such as tiredness, high temperature, sweating and dry eyes.

Treatment

It is worth having a full assessment and getting an accurate diagnosis for your symptoms so you can find the best course of treatment for you.

For both OA and RA early detection can be helpful so treatments and advice can be introduced, hopefully reducing the risk of joint damage and overall impact of the condition.

In many cases, RA requires medication such as disease-modifying anti-rheumatoid drugs (DMARDs), steroids and other biological treatments.

Physical therapy such as Osteopathy can also help to treat the symptoms associated with arthritis. At the clinic we help people with various types of arthritis with treatment, advice and exercises all centred around the individual’s needs. If required, we can refer for testing and imaging but often this is not necessary.

If you’d like more information or think we could help you, please contact us today.

By Stephanie Gammell. M.Ost. General Osteopathic Council Registered

Suffering with sleep issues since the pandemic?

The dictionary must be filling up with Covid-19 related terms by now. Yet another to add to the list is ‘Coronasomnia’ - insomnia caused by the pandemic. Many are coming to Reflexologist, Leanne with this issue and the causes vary.

She has found that majority of her clients report of one or more of the following since the pandemic began:

• Increase in screen time

• Lack of movement

• Working from home

• Decreased daylight

• Increased alcohol/processed food consumption

• Depression and anxiety

• Isolation/uncertainty/fear

Do any of the above relate to you? If so, some may be improved with small changes.

Take a walk around the block at lunchtime, a phone call outside, implement alcohol/junk food free days into your week and do some lunges around the kitchen while waiting for the kettle to boil!

Many people use reflexology for insomnia and sleep issues and find it can have a great effect on relaxing the body and mind. It can help your body to rebalance your systems and decrease stress, which in turn can have a lasting effect on your sleep patterns. By focusing on the adrenal glands, which are a key reflexology point when treating someone with insomnia, they can cope better with life situations and not use adrenaline so much to get through the day.

Contact us today to book an appointment with Leanne.

- Leanne Bowden, VTCT Reflexologist

Reflexology and Pregnancy

I frequently treat women in the last few weeks of their third trimester. At this stage they are often uncomfortable, struggling to sleep, sluggish bowel, acid reflux and swollen ankles, desperate to get this baby out!

How can reflexology help? The symptoms mentioned above, to name but a few, can often be reduced. Muscles will relax, making the body more comfortable, which can aid easier movement and better sleep. The bowel and digestive system is stimulated and detoxification is encouraged through this pathway, helping to regulate bowel movements. The pressure points and massage techniques used will aid the circulatory and lymphatic system, which will help the body process and relieve the fluid around the ankles.

Can reflexology bring on labour? Many women say it does. The treatment helps to prepare your body's systems and improve function so they are working as well as they possibly can to support you during labour. However, the treatment will not encourage your body to do anything it’s not ready for. Because reflexology is deeply relaxing it will put you at ease, helping your body to calmly respond and engage with the birth of your baby.

If you would like to book in for a reflexology treatment, please contact us today.

Blog post by Leanne Bowden, VTCT Reflexologist

Hypermobility Spectrum Disorder and Ehlers-Danlos Syndrome

Hypermobility is often a general term given to those whose bodies are able to move and stretch more than is considered for the normal range of motion. In this blog I will mainly talk about the musculoskeletal (MsK) presentations of this disorder. You can get this at a local joint level or more generalised global joint level. Further reading can be from the EDS society.

Over the years in the UK, specialists like Rodney Grahame started to make the suggestion that for some, being hypermobile, could be a problem. He and his team noted there seemed to be a link between flexible or very flexible people and pain. He felt that it was often overlooked and that so much of the time these patients were being misdiagnosed and so mismanaged.

In the earlier days of diagnoses, Hypermobility Syndrome (HMS) was the name given to patients whose joints moved outside their normal range and also had pain. Diagnostic criteria such as the Beighton and Brighton scores were used. HMS was also called Hypermobility Type 3, which was part of the larger syndrome of connective tissue disorders called Ehlers-Danlos Syndrome or EDS.

Over time and with increased awareness, further understanding and renewed research, the original diagnostic thoughts are still used, with the additional of new criteria. The diagnosis given to patients has also changed and been broken down to more specific Hypermobility Spectrum Disorder (HDS) or Hypermobile EDS (hEDS). There are differences to each of these…

The main differences between HDS and hEDS are beyond the need for this paper and the differences need to be thoroughly looked at by a doctor/osteopath/physiotherapist/chiropractor with an interest in this area before a complete diagnosis is given. Having the correct diagnosis and treatment plan is more important that giving patients labels.

In a nutshell, and from a MsK point of view, both HSD and hEDS can make tissues more vulnerable to overstrain and injury. It can be painful, extremely frustrating and lead to fear and anxiety. I also think it is important to add here that pain is so much more complex than we used to think and it is not just a measure of increased pain equals more tissue damage.

Diagnosis

The diagnosis of HDS/EDS needs to be from a medical doctor or a qualified practitioner such as a registered osteopath, physiotherapist or chiropractor with a specialist interest.

A thorough case history, family history and examination needs to be completed to get a full understanding as to why the patient is suffering and to make a comprehensive diagnosis. The list of signs and symptoms linked to HSD/hEDS can be extensive.

A look at the conditions

For some with HSD or hEDS the symptoms could be at all levels of the spectrum from the very mild to more severe and/or all levels in-between.

A list of signs and symptoms could be long and could be widespread, but it covers chronic muscle, tendon, ligament or joint pain. This pain is often (although not always) relieved by rest. Ankles that sprain easily, clicky joints, a jaw that clicks. It may have been an incident (such as an ankle sprain) that his triggered a set of symptoms. Patients with HDS/hEDS are often clumsy, may get foggy thought patterns and fatigue more easily that others. Other symptoms that can coexist are palpitations, abomination concerns, anxiety, POTS (postural orthostatic tactical syndrome) or mast cell activation syndrome (MCAS).

Osteopathic TT for treatment for the severe HSD/hEDS patient ideally needs a team of like minded practitioners that address the needs of the patient.

From my point of view, Msk treatments need to be aimed at giving some pain relief and giving the patient strategies to manage their pain and movement patterns. I tend to avoid giving patients stretching to do as I feel that this could lead to more instability going forwards. This can lead to more chronic muscle tightness and pain as the body tries to protect itself by creating more tightness to stabilise itself.

I feel that osteopathy is great at providing relief for pain using gentle treatments and manipulation and some acupuncture. The more this is layered in with a gradual and progressive exercise programme to increase the patients capacity the better.

HDS/hEDS patients are a tough population to work with as there can be many bumps in the road of the journey. Just as they feel better, something else can start to become aggrieved. So, it is for this reason, that I feel that education for the patients is so key. For them to understand that pain is not always dangerous, it is just a message that is important. They need to be treated as a whole. They also need to also be aware of how vulnerable their bodies can be to changes that try to occur over and above the rate at which their body can adapt. Bodies can and do adapt. Those with HSD or hEDS can take longer to gain more capacity and resilience.

As our bodies gain greater capacity, they are able to deal with more. That is what strength and control is all about. Stretching does not give you greater ability to lift things in the garden or to bend to lift your child off the floor. Strength does!

From a movement point of view, aiming for efficiency and balance is useful so that one part of ones body is not talking all the hit for something else that is not working. Gait assessment can be useful to see what part of the patients gait makes the rest of their system struggle.

I often use the expression that I want people to have ‘reactive bodes’. What I mean by this is your bodies move and your muscles react to the movement. This sort of goes away from the ‘bracing’ model (unless you are picking 100kgs off the floor!!), which I am not sure I agree with.

By bracing or ‘pre-tensioning’ our body, it does not allow our body to move as it should and it isolates certain areas. Our bodies are amazingly integrated. When we move, no muscle EVER works by itself and so I am not sure how useful it is to isolate muscles when we exercise.


If you use a ‘Clam’ exercise as an example. This is when we lie on our side and lift the top leg up and down to ‘isolate’ and work your gluteus medius muscle. First of all, this muscle NEVER, ever works by itself when we move. But also, depending on your size and weight, the weight of your leg is not even close to what is needed to walk, run and squat etc. This muscle works as part of a ‘team’ of muscles and so are all best served working together as this is what happens when we move.

Having HDS/hEDS can certainly put challenges in front of you. There can be a few or many bumps along the road. But it does not mean that you cannot have a full life. As with many medical problems having a good mindset, a thorough understanding and having good capacity in your body all just helps. It is also ok to be frustrated with your body at times. Having a great bunch of people around you too massively helps.

Blog post by James Dodd BSc (hons) Ost. FAFS. Registered with the GOsC

Suffering from long covid? Try Reflexology to support your recovery and ease symptoms

What is long covid?

Since the pandemic began we have seen many sufferers of long covid struggling physically and mentally. A term coined by patients themselves, long covid describes the symptoms that continue or develop after the acute infection has passed, usually after 4 weeks of initial infection. The main long covid symptoms I have seen in my clients are fatigue, brain fog, breathlessness/tightness in chest, sleep issues, depression and anxiety.

As research is infant and ongoing there is a lot of uncertainty around how long these symptoms could last, some ranging from weeks/months/years to potentially lifelong. This is causing a lot of anxiety among those that are suffering with long covid symptoms as they are unsure how long it will last.

What is reflexology and how can it help?

Reflexology is a pressure point therapy applied through the feet and helps to support the body’s systems and organs by stimulating the central nervous system. Reflexology is used to promote healing and toxin release as well as deep relaxation for the body and mind, which all help to support the recovery process. Leanne has been treating many people through their long covid journey’s and most have experienced an improvement in brain fog, sleep quality and anxiety levels have decreased after treatment. It’s been a really tough couple of years and giving yourself time to rest and recover is crucial.

Book your appointment today

Leanne is our resident Reflexologist and is based at Back to Back on Mondays and Thursdays. If you would like to discuss your symptoms and try reflexology to support you through your recovery please call us on 020 8605 2323 or contact us via our contact page.

References:

Your Covid Recovery

Blog post by Leanne Bowden

The importance of sleep and a good mattress

Sleep ?

What is good sleep?

“a condition of body and mind that typically occurs for several hours every night, in which the nervous system is relatively inactive, the eyes closed, the postural muscles relaxed, and consciousness is practically suspended”.

As far as I am concerned, sleep is supposed to be a wonderful experience in a place where your body is able to relax and your ‘contours’ are looked after and supported. A great bed ‘has got you!’

Those that know me, know that I think the top 3 things (other than the building you live in) that you should spend money on is a great bed, amazing shoes and eyewear - gotta look after those eyes!. All are important things for our comfort and health. Have you ever acknowledged how you feel if your feet are uncomfortable or you sleep quality is poor? Your stress levels go up! A wonderful bed ideally should come high on your list.

There are many sleep statistics, but on average, the average person spends around 26 years of THEIR life sleeping. That is about a third of our lives!! Flip……!! And ……the average person also spends 7 years trying to drop off to sleep!!! Yikes. A major factor that will determine how well you sleep will be your comfort. If you are unable to get comfortable in your bed, the quality of your sleep will be poor and you may wake throughout the night. This doesn’t adhere to the definition of consciousness suspended. YOU know when you don’t sleep well.

Many patients we see at the clinic have mattresses that are VERY old, and many will just be unsupportive and sagging in the wrong places. An old mattress will also not be hygienic.

January sales will be upon us very soon. They may even start before Christmas!! Mattresses and beds can have various offers throughout the year… not just in January. So if you look at your bed and feel that it is actually about time to change it, be armed with as much information as you can be to make your purchase a success. It is also good to be aware of the return policies and T&Cs if you get your new purchase home and you are not happy. Some companies will only offer an exchange rather than return your money. So beware.

I actually think it is pretty tough to tell anyone what bed would be right for them for many reasons. They may have a partner of different size and weight. The may run ‘hot’ at night and so need a bed with more ventilation. They may have pets sleeping with them or children who join them at night. They may just just prefer a harder of softer bed. Ideally, I think you should be able to try the bed/mattress before you take the plunge. If you do buy online, make sure you can get a full refund if you don’t like it. And that you are not slapped with high costs if you need to return it.

‘Which?’ magazine has recently done another one of their great ‘test labs’ for mattresses. These reviews have been a great resource for many for nearly 50 years and they put each mattress tested through a battery of tests, looking at body support including how well it will look after you in each of the different ways many of us sleep. They test the durability of each one and they don’t just look at the expensive mattresses. What a great resource!!!

I am unable to give you all of their results. But the ones that come top of their reviews are:

Eve - The Original Hybrid

Emma-Premium

Emma - Start Hybrid

Memory Foam Warehouse - Coolmax Hybrid

Otty - Hybrid Mattress

And even Ikea Hamarvik came 6th in the list.

Interestingly , they do have a few VERY expensive ones in their tests and while they are good mattresses, they do not score near the top of their reviews.

Note that ALL of them (other than Ikea’s) are ‘hybrids’, meaning that they have a mix of foam and pocket springs. Having some sort of ’springs’ in the mattress does make it easier to turn. Don’t fall for promises of great memory foam that is cheap. In my opinion, cheap memory foam breaks down pretty quickly, leaving you with problems.

So… if you feel that you may need a change of bed or mattress, go to a good bed shop and lie on loads of different beds. Be prepared to spend a bit of time to get a feel for different beds. If you are buying just a new mattress, make sure you try the mattress on the same type of bed base that you already have at home.

If you have pain at night that is not going away or in-fact, getting worse maybe sure you see a health professional to determine WHY are in pain at night. Don’t just leave it.

This is also a useful link on How to Choose a Mattress from The Sleep Foundation.

We have an amazing team of Osteopaths and we also have a great massage therapist and reflexologist.

Call us on 020 8605 2323 if we can help.

Blog post by James Dodd

The Do’s and Don’ts of Tendinopathy

Traditionally tendon pain has been given the name Tendinitis. Tendinitis implies that there is an inflammatory reaction to a certain tendon. This diagnosis has recently been argued due to further research; firstly, there is a physical lack of inflammation seen around tendons when a change in exercise or daily habits occur. Secondly, when prescribing patients with Nonsteroidal Anti-inflammatory Medication (NSAIDS) to reduce inflammation, this has seen little improvement with tendon pain. In light of this, the new term ‘Tendinopathy’ was established for medical professionals to use to describe the variety of painful conditions from tendons.

Types of Tendinopathy:

Achilles (ankle) Tendinopathy

Patella (knee) Tendinopathy

Bicep (shoulder) Tendinopathy

Causes of Tendinopathy

The most typical cause of Tendinopathy is a sudden change in exercise habits. During the recent pandemic, we have seen this problem a lot at the clinic as patients have had more time on their hands to start working out again or to try something completely new.

To suddenly start to exercise, such as a long walk or run, will cause a change in tendon load. This creates stress to the tendons and muscles. Another way of stressing tendons, is attempting to pick up your previous level of fitness after having deconditioned over time. Due to the irregularity of working out or the start of a new routine, this will impact on the tendons functionality and strength. Our tendons need time to adapt to new situations and increased or sudden loads.

What you can do for Tendinopathy:

1. Identify what you need to achieve.

2. Look at specific biomechanics of that task. Make sure there are no other body restrictions.

3. Create a progressive loading programme.

4. Stay consistent with it - tendons need daily stimulus to load!

5. Be patient, tendons can be slow to progress.

What you don’t do for Tendinopathy:

1. Don’t neglect your tendon.

2. Don’t rest for days or weeks on end.

3. Don’t rely on orthotics for Achilles Tendinopathy

Blog post by Nick Jordan

Bone Stress Injury

A bone stress injury (BSI) is due to a bone’s inability to cope with repetitive mechanical loading.

This results in structural fatigue with localised bone pain and tenderness.

Essentially, BSI is an overuse injury and is normally multifactorial with a combination of biological, biomechanics and anatomical risk factors.

Lower limb stress factors are much more common than upper limb stress factors. Tibial stress fractures account for approximately half of all stress fractures, followed by the forefoot and then femoral shaft and neck.

It can be broken down into extrinsic and intrinsic factors:

Extrinsic factors:

Training errors

• Excessive volume

• Excessive intensity

• Sudden change in intensity

• Poor recovery

• Excessive fatigue

Surface

• Hard/soft/cambered

Shoes

• Poor shoes/worn shoes

Equipment

• Inappropriate kit

Poor nutrition

Psychological factors

Environmental conditions

Intrinsic factors:

Training errors

• Pes planus/cavus

• Hip anteversion

• Leg length

• Muscle weakness/imbalance

• Lack of flexibility

Genetic factors

Endocrine factors

Metabolic factors

• RED’s

Previous bone stress

Smoking

Family history

The management of BSI begins with off-loading the affected bone to reduce pain and assist healing. A holistic overview is taken to improve general wellness including sleep and nutrition. This is complemented with a gradual loading programme with physical therapy.

Rapid and clear diagnosis is essential in preventing the propagation of the fracture.

To assess the history of the BSI we will need to know:

• The type of impact sport/physical activity you’ve been doing

• Any changes in intensity, frequency, time, environment

• Changes in the recovery

• Any female REDs (relative energy deficiency)

• Your general nutrition

• Where the pain is, especially when loading, e.g. for a lower limb we’d look at where the pain is when running or hopping

The point you feel the pain will help decipher how long you have been suffering with that stress fracture. Early stress fractures often give pain towards the end of an activity, whereas with more well established BSI, pain comes on earlier on, or even at rest. It can also be more intense and linger for longer in more established BSI.

Examination

To examine a BSI we would look at a number of things, focal tenderness and swelling on palpation, percussion may reproduce the pain. We would look to run a tuning fork test and a fulcrum test. For lower limbs we’d look to see if you can stand on one leg and see if you can hop on the affected leg.

Imaging

Often an x-ray will suffice to view a stress fracture, although it can take 2-4 weeks for it to show on x-ray and sometimes cannot be seen at all. If it cannot be seen we can use a bone scan - the downsides of this is they are time-consuming and involve an injection and exposure to radiation. An MRI is sensitive and specific for BSI, it gives a very accurate correlation to the picture. It can be costly though.

Management for BSI

• Offload/stop participating in activity, especially high impact exercise

• Maintain fitness levels through cross training - swimming, cycling, pool running

• Consider immobilising your injury - e.g. using a brace

• See an Osteopath who can work with you to gradually strengthen and improve flexibility

• Address any dietary needs

• Ca and Vitamin D supplements will help improve any bone issues and deficiencies

• Look at hormonal balance for those who may suffer from a hormonal dysfunction

• Address REDs if necessary

If you are concerned about an injury, BSI or other, please give us a call today on 020 8605 2323.

Blog post by James Dodd

Chronic Heel Pain; Is it Baxter’s Nerve Entrapment?

By James Dodd BSc (hons) Ost. FAFS

Do you suffer from Chronic Heel Pain?

Sufferers of chronic heel pain often are often diagnosed with Plantar fasciitis, however not all cases of heel pain are due to this. Other causes include nerve trapping, joint inflammation, stress fracture and Baxter’s nerve entrapment. In fact, Baxter’s nerve entrapment can cause up to 20% of cases of chronic heel pain.

So, what is Baxter’s nerve?

Baxter’s nerve is a tiny nerve coming from the larger plantar nerve on the inside of the ankle. It supplies the small muscles of the foot and sensation to the heel. When the nerve becomes impinged it causes a sharp, burning pain, often associated with pins and needles and numbness and pins around the heel.

What causes Baxter’s nerve entrapment?

Baxter’s nerve entrapment can occur after injuring your ankle or heel, but more commonly, it develops slowly, without injury. It is unclear how it happens but there are theories that the nerve might become trapped from pressure, due to reduced movement of the ankle joint, flattened feet, and/or a pressure from a heel spur or plantar fasciitis. It can happen to anyone and doesn’t appear to be gender or age specific.

What are the symptoms and diagnosis

Symptoms often include:

• Pain when you touch the inside of the heel

• A sharp/burning pain around the inside aspect of the heel

• Pain when walking and placing your foot on the floor after a period of rest

• Some people may suffer from pins and needles around the inner aspect of under the heel. Especially when the nerve is knocked or trapped.

Although Baxter’s nerve entrapment presents very similarly to plantar fasciitis, there is a subtle difference in where the pain is felt and some of the symptoms. Baxter’s nerve entrapment is felt on the heel and the medial arch of the foot, whereas Plantar fasciitis is more concentrated just on the heel. As noted above Baxter’s nerve entrapment can also include a sensation of numbness or pins and needles.

Imaging such as ultrasound or MRI can help with diagnosis. You might see thickening of the small Baxter’s nerve on the inside of the heel, or if your scan appears normal this increases suspicion of nerve trapping as the cause of pain. In severe cases, nerve trapping can cause shrinking of the muscles on the outside of the foot which will be seen on MRI.

What is the treatment of Baxter’s nerve entrapment?

Often, we would start with simple, gentle treatments, such as taping and orthotics (inner soles for your shoes), stretching and foot strengthening. We would give an individual strengthening routine and specific stretches to work on at home. Sometimes an injection of cortisone can be helpful, this would be done with ultrasound to ensure we target the correct site of Baxter’s nerve trapping. Finally, in some cases, surgery to release the Baxter’s entrapment might be needed.

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If you are suffering from any form of heel pain, get in touch with the team today and see what we can do to help you.

Blog post by James Dodd

TREATING YOUR MUSCLES AS WE EASE OUT OF LOCKDOWN

A GREAT POST FROM AMAZING MASSAGE THERAPIST ALEX

“LOTS OF SITTING AT MY HOME DESK… TRAVELLING FROM ONE ROOM TO ANOTHER IS THE MOST MOVEMENT I’VE DONE TODAY… WATCHING TONS AND TONS OF TELE.”

These are the most frequent comments I have heard from my clients throughout lockdown. The amount of movement we do has largely decreased throughout the pandemic. Not helped by the fact that gyms and sports had ground to a halt, travelling to and from work is so much less and throughout the winter months we are limited on the time we can spend exercising outside. A whole year of this has caused stiffness in our joints, poor posture, tightened muscles and has had a negative impact on our body. So, what are we going to do about it?

The time to act is now! As we are easing out of lockdown, we need to prepare our bodies for the freedom they are about to endure. The classic quote of ‘don’t run before you can walk, is a perfect example of why we need to re-train and treat our muscles, before throwing ourselves into the fitness world again. We've been cramped up at home for so long our muscles will feel cramped and stiff too. Here’s my step by step guide on coming out of lockdown safely for your body, helping to reduce injury when you do get back on the horse (or bike!) again. 

STEP BY STEP GUIDE:

1. See a specialist - It is important to know how your body has adapted within lockdown. Going to see an Osteopath, Personal Trainer and/or a Massage Therapist, will give you a greater understanding of your body and what areas you’ll need to work on. One of the biggest problems I see with my clients is they rush straight into generic workouts, which can put huge pressure and stress on the body if it’s the wrong type of session for you. Being given specific exercises by a specialist can prepare and strengthen the areas that need the work safely, leading you to be confident when starting out in your sport or fitness journey.

Blog post by Alex Warren

2. Move in all planes - We have become very static during lockdown, with some of us only performing the majority of exercises in a linear motion, like cycling or running. Our bodies should move in all planes comfortably and efficiently, so adding in some transverse and frontal planes of motion (rotational and side to side movements), such as a banded trunk rotation/oblique twist or isometric lateral bear crawl with pull throughs, will help improve and strengthen total body function. Your specialist Back to Back will be able to set you up with some exercises tailored to you and your needs involving all planes. 

3. Build up strength SLOWLY - Going into the gym before lockdown and whacking on 100kg for the back squat may have been a breeze. Do not be lulled into a false sense of security when heading back into the gym thinking you could easily lift that 100kg again. Build up to that weight slowly again, no matter what exercise you are performing. Muscle memory will kick in and you will (hopefully sooner rather than later) get back to where you were. Receiving instruction from a personal trainer to look at form and technique is also a really sensible way to ease yourself back into training in a safe and effective manner. They can provide specific programmes to get you up to speed and even perform at a stronger level than before!

If we can help in any way, call us on 020 8605 2323 for an appointment with Alex or one of our great osteopaths.

CANCANEAL APOPHYSITIS (SEVER’S DISEASE)

This is painful inflammation of a child’s growth plate at the heel.  Normally, this affects children between 8 – 14 years old as their calcaneus (heel bone) is still developing.  It is also at a time when children often increase the amount of exercise they do.  With increased and repetitive use, the achilles tendon ‘tractions’ on the growth plate at the heel and so causing pain and inflammation.  Approximately 60% of Sever’s is bilateral.

Causes

It is essentially an overuse injury at the time of growth.  Sports that ‘load’ the achilles tendon and heel such as running and jumping are normally the culprits.  Often a bout of Sever’s can become aggravated at the start of a season after a ‘rest’ period or exercising on harder ground as it gets colder.  Tightness in the calf can also lead to increased load onto the heel bone.  It bad cases, it may take until the child stops growing before complete resolution.  It is also really important to try to observe why there has been more load placed onto their heel… this may be from a stiff hip or other area.  This is key to successful treatment.

Diagnosis

This needs to be based on a full and correct examination by your osteopath, doctor or other medical professional.   X-ray or MRI may be used to confirm the diagnosis or monitor the progress, but often this is not necessary.

Treatment

Calcaneal apophysitis has no known long-term complications and is self-limiting; that is, it should go away when the two parts of bony growth eventually join together (occurring around 16 years of age).

It is important to limit (temporarily) excessive or rigorous activity in its painful stages.  But it is also about management, as you can get times when it calms and at other times, it can then flare up again as they increase activity.  Soft shoes and heel cups can make a difference and it is important to make sure the child has sound biomechanics (eg no excessive pronation or muscular imbalance). Regular and correct stretching of the tight muscles in the calf and thigh are essential.   Ice can be of great help if used correctly.  Anti inflammatory medication may be of use – but do check with your medical professional about this first.

Seeking help from your osteopath or good physical therapist can really help too.  They will check for poor biomechanics and work and stretch the calf and thigh and manage this injury with some good strengthening exercises.

Return to sports or activity

The goal here is to get your child back to their desired sport or activity as soon as safely possible.  It may be a gradual return to see if the condition regresses.  If they return too early, it may lead to more chronic pain.

To return to sport your child should have no pain at rest and should be able to walk pain free.  They should also be able to jog, sprint and hop pretty much symptom free too.

If after the pain resolves…. it is important that there is still a regime of regular stretching of their calves, thigh and leg muscles.

Blog post by James Dodd

Telehealth /Videolink consultations at Back to Back

Don’t despair if you are in pain or need advice! #Telehealth is here!!!

What is Telehealth?

Telehealth is the delivery of rehabilitation services through online video and phone technology. It does not entirely replace in-person care, but allows osteopaths to provide virtual assessments, coaching and supervision, and prescribe at-home treatment plans to keep your recovery moving forward.

This could be to:

• Diagnose and manage acute injuries

• Continue and progress your home exercise programme

• Discuss changes to your symptoms

• Just for some help and advice

Many people will be thinking ‘What can they do from a Telehealth video call’? Each session includes a detailed case history, virtual examination, diagnosis and a custom rehabilitation plan.

Research is already suggesting really good outcomes from this kind of intervention.

Another really great advantage of Telehealth consults is that we are ‘Functional Osteopaths’, so that we can take you though a really good examination and start to give you some movements and exercises straight away.

It is also a great way to enable us to diagnostically rule out any concerns that we may have and if you do need further investigations, we are able to sort this out for you.

What you need:

• Access to of the following devices:

• A computer/Laptop with camera and microphone
• A tablet or Apple or Android smart phone
• Access to an internet connection.
• An adequate quiet space, cleared to perform some movements and exercises during the appointment
• No special software is needed

IF you think you will benefit from a #Telehealth appointment, call 07813 811 421 or email on james@backtoback432.co.uk

Why you need MORE rest...

Have a listen to this great podcast about rest and how important rest is to us at a time when we are making ourselves MORE busy. It is from a series from the lovely Rangan Chaterjee. YOU do not need permission to rest and relax!!

Strength is often forgotten and sarcopenia

This post is about strength. Strength is important. Strength is SO often forgotten in place of the need to stretch!

How many times have you been in the garden for a few hours or been doing DIY and the next day you are struggling to move? Often I ask people how they have prepared themselves for this amount of bending or DIY under load and they look at me as if I am mad! They then tell me that they sit at a desk all day and all week.

To enable our bodies to cope with bending for an extended period of time, lift things that we are not used to or even to bend and reach in a new way…. we NEED to have the capacity in our body to cope this. Claire Minshull had a lovely way of describing ‘capacity’ and she compared it to a fuel tank. She said that if your fuel tank is full, you should have good power, but if it is almost empty, you may well struggle to do pretty basic things.

Capacity is strength!

Capacity gives you more endurance.

Capacity helps you to do more.

Stretching will help you to move better to new places, BUT it will not give you more capacity to lift and bend in a sustained way. It not give you more endurance. STRENGTH or increased capacity will.

As we beautifully age…. and become less active, many of us get Sarcopenia.

The definition of Sarcopenia is the loss of skeletal muscle mass and strength as a result of ageing. The main reason for this outside illness is living a sedentary lifestyle which many of us have. We do more sitting and generally do less. Getting little or no physical activity on a regular basis puts people at an increased risk of developing sarcopenia as they age.

Can we do something about us having or getting sarcopenia? Yes!!

There is an important correlation between inactivity and loss of muscle mass and strength. This suggests that physical activity should be a protective factor for the prevention but also the management of sarcopenia. It gives you greater control and will be protective against things like falling.

As you get stronger, the stairs become easier, getting up from a chair is so much easier, as is getting off the loo or up off the floor.

So, if you are tending to be very sedentary or struggling to get the motivation to do more to help your self, get some advice of how to get moving more and maybe even to start to add load to your system to keep your muscles and bones strong. It is great for the health of our bodies and helps with longevity.

See below. The picture at the top is a fit 40 year old. The picture at the bottom is a fit and strong 70 year old. Then picture in the middle is a normal 74 year old. One that does very little. Probably watches a lot of TV and reads a lot. You can see the massive muscle wasting and this has been replaced by fat. The middle man is not fat. He just has much less muscle mass. So he will struggle to do much. Stairs will be hard and so will getting up from a chair.

You don’t have to go to the gym for hours to achieve this. But you do need to challenge your bodies a bit. Starting gradually and build. Start with longer walks and then walks up and down hills. If you are unsure about this, get advice from a medical professional.

It is all about choices. But this is one choice that most of us can make with a positive end result.

If you want some help with this, call the team at Back to Back on 020 8605 2323.

Keep fit and well and STRONG.

Blog post by James Dodd

RED-S or RELATIVE ENERGY DEFICIENCY IN SPORT

Just a great Podcast to listen from Physio Matters.

Really highlighting that you need to have sufficient calories or energy to meet the demand of high level activities or sports. If you do not get enough, any number of problems can start. A must listen session regarding an important issue with take home messages much more wide reaching than just for this condition and some real clinical pearls from the outset. Therapists, coaches and managers must be more aware of this!