Knee Pain: A Complex Problem to Solve

It is not uncommon for a client to turn up at my door and state they have been told by friends, colleagues, team mates and sometimes other therapists that they have ‘Runners Knee’ and don’t know what to do about it.  ‘Jumpers Knee’, ‘ITB Syndrome’ and many other complaints present but all have one thing in common – a knee that is in pain!  Personally I think these name’s are misleading, non specific and not very useful in terms of identifying for the client what exactly the problem is and more importantly what the client needs to do to heal. 

Fibromyalgia & Myofascial Release: How You Can Help

Fibromyalgia is a chronic condition that is characterised by widespread pain across the body which is often accompanied by secondary symptoms including fatigue, anxiety, difficulty sleeping, joint stiffness, headaches and even difficulty concentrating. It is not yet known what the exact cause of the condition is, it is thought that the pain may be caused by neuro-chemical imbalances affecting how the CNS and the brain interact and process pain. It is also speculated that lifestyle, genetics and psychological factors may play a part but research is ongoing at present. What is clear is that for its duration this condition causes mass discomfort for the person suffering from it and it seems to be becoming more prevalent in society given greater awareness of the condition. This in turn means that as therapists we are seeing more clients present with this condition who ask – ‘Can you help me?’ and the answer to this question is ‘Yes you can!’.

Injuries: Ice or Heat?

A question I am asked all the time is when something hurts should you use ‘Ice or Heat?’.  As always the

answer is – it depends……


When you initially strain a muscle or sprain ligaments or tendons there are tears in the fibre, bleeding and swelling.  This leads to inflammation and heat being radiated from the area as the dead cells are removed and new ones brought in to start the healing process.

Power Tennis, the ‘Grunt’ and your Core

After a thrilling day at Wimbledon on Friday, my own little tennis ‘victory’ and some pretty tender ribs for the last week, I have been inspired to think about why my ribs hurt, why we ‘Grunt’ under pressure and how we can get more power in our tennis shots.

I myself can be guilty of the ‘Grunt’.  It comes at two stages for me.  Firstly when I am completely overstretched for a shot, the ‘Grunt’  makes an appearance – the result of me digging deep to get the power to return the ball with at least some pace when in this weak, lengthened position.  Secondly, it seems to appear on even the tamest of shots when I am in the third set and feeling weary.  So it’s clear that for me at least the ‘Grunt’  helps me to find power where there is none.  So why do so many women tennis professionals grunt on almost every shot?   Am I missing a trick?

Following the Foot Trail: Look Local, Think Global

Feet.  Something I avoided for years given a propensity to tickley feet myself and just simply blocking them from my mind.  It’s over the last 12-18 months that I have become OBSESSSED with feet.  They tell us so

much about the story of someone’s body and can act as great guide do identifying dysfunction in our clients.  What I want to give you today is an idea of what the foot could be telling you at the most basic level to give you an insight into why you need to look whole body, when you are suffering pain or dysfunction in just one area.  First time I see a client I like to do a ‘Toe to Top’ visual assessment.  What can I see just by looking at how my client stands or walks.  Is the arch overly high?  Are the feet flat?  If so what does that tell me?  Well it may not tell me anything definitively but it certainly gives me clues as to what to check next.

How Long to Heal?’ Part III: ‘You’ Harnessing Your Intrinsic Ability to Heal

And so we come to the final installment, although in writing this I feel this should have been Part 1 given how critical it is to healing and that is how what you put in your body dictates not only the length of time needed to heal but the quality of the job itself.

What you put in to healing is what you get out! The Food Factor

As discussed over the last two blogs, your body has its work cut out in terms of removing damaged cells, laying down new healthy cells, fibres, collagen and to do this is needs the right base materials.  We all know the quality of the building is only as good as the quality of the materials used – your body is no different!  In order for your body to generate the right parts at a cellular level, it needs the right mix of vitamins, protein and hydration to do this.

‘How Long to Heal?’ Part II: The Type of Injury

Now that we have established that your injury needs to go through a number of stages and processes to heal the next step is to establish is the type of injury.  There are two aspects that I will consider here ‘What tissue is damaged?’ and ‘How badly is it damaged?’.

‘What’ you have damaged makes a significant difference to healing time whether it is muscle, tendon or ligament can be the difference in weeks and months when it comes to healing:

Freeing Fascia: The Massage Connection

‘Fascia’, if you haven’t heard of it, take note as it is the big thing in ‘Soft Tissue’ these days.  What is this stuff dubbed ‘The Cinderella’ tissue by Dr Schleip and how does it impact how we treat clients as massage therapists?  In its simplest terms it is a web of collaginous fibres that hold everything in the body together so we act as one strong and co-ordinated unit, a single organ.  Fascia connects skin, veins, organs, nerves, muscles and bones together so we can move and function by distributing the stresses and strains across our body.  On that basis, if it is restricted or damaged its impact on the body can be vast.If that is the case then why has Fascia been ignored for so long?

One view is that since it differs from person to person in texture & quality it has been difficult to describe.  In addition it cannot be split easily into segments that we can name like muscles and bones (Dr. Schleip) which again has made it harder to document and study.   The good news is that technology has now improved to a level where Fascia can now be studied in more detail so research is catching up on proving why this tissue is so important and how it impacts the body.

Injuries: How long to heal? Part I: The Stages of Healing

The dreaded question we face as therapists – ‘How long to heal?’.  It is not because we don’t want to commit to a timeline but it is because there are so many variables to healing time that it truly is like asking
‘How long is a piece of string?’.  To go some way to helping you understand the process and what you can do help the body along I have written a three piece blog on Injuries.


  • Part I:  The Stages of Healing
  • Part 2:  The Type of Injury
  • Part 3:  Your Impact on Healing

Dynamic Stretching: Miguel Angel Jimenez, Mad Man or Genius?

After a thoroughly enjoyable weekend of golf watching, I thought I would take inspiration from The Masters for this week’s blog.  The subject of this tale I hear you ask?  Miguel Angel Jimenez or “The Mechanic” as he is fondly known.  Whether it is his tumbling red curly hair or the cigar smoking he is undoubtedly one of the most lovable characters on tour, but for me it is warm up routine that shows me there is more to this man than his caricatured outer persona.

Miguels Magic Warm Up
Watch Miguels Warm Up Tips here:  

It may elect laughter from some of the tour pro’s and spectators on the warm up range but what they may not know is that Miguel’s stretching routine is dynamically releasing muscle after muscle, fascial layer after layer to allow him to start his round with optimal power and flexibility.  Is this why at 50 years of age he is still able to win on tour and finish 4th at Augusta this week?
So what is Dynamic Stretching?  We are all used to getting a muscle into a stretched position and holding it for 20-30 seconds.  This is called ‘static stretching’ and is what most people have been doing as part of their warm up for a long time.  Over the last few years there has been a real movement towards stretching by moving into a position, moving some more, then returning to the start.  The difference here is that yes the muscle is getting a stretch but because you are moving the tendons, ligaments and muscles have to contract and work while you do this which has the added benefit of giving greater levels of functional ability and strength in doing so.  It doesn’t take a genius to realise that this must lead to a better warm up as not only are you stretched but your muscles are fired up and ready to go!
And finally there is the Fascia.  So what is it and why is it important?  Our body consists of many organs, muscles, circulatory systems and nerves that work together to make us human.  What holds them all together and ensures they work together harmoniously so we move as one strong being is Fascia.  A connective collagenous tissue that is multi-directional allowing movement in all planes while keeping everything connected but free to move.  Now imagine your muscles are loosened up and ready to go but your fascia is stuck, adhered, knotted.  How freely can the muscles move if they are pinned down by this restriction?  And what is more if this fascia connects everything so that our muscles work together as opposed to independently if we have not stretched the fascia itself how can the whole body work freely to deliver power and movement? 
A closer look shows the genius of Miguels warm up.

First it starts with the wrists, twisting from right to left, left to right golf club in hand, loosening up the wrist flexors, extensors, supinators, pronators, right up to the upper arm and into the shoulder.  Right side, then left side. The use of the golf club adding some overpressure to stretch the muscles further than with movement alone.

Next he moves into the stretching the superficial back line, using the golf clubs as a stretching pole to reach the arms out and away from the body stretching the muscles of the shoulders, neck and spine.  Flexing forward, stretching the hamstrings, bending the knees and squatting down into the ankles releasing the calves.  Every part of the back line opening up and releasing

Moving on Miguel opens up the Superficial front line, reaching the clubs over his head, opening his chest, extending the body upwards and backwards opening the neck flexors, abdominals and hip flexors.

Next, comes the spiral lines, the most important lines for golf.  From the ankles to the knees up to hips, he rotates them in, rotates them out.  Briefly moving up to the triceps and the chest again, the harder parts to stretch to ensure that nothing remains untouched.

The lateral line comes next, side-bending right, opening up the hip abductors, the QL, the obliques, then mirroring these moves to the left. Again the use of the clubs to add overpressure and additional stretch while challenging the muscles to work, contract to fire.

And finally the swing.  With everything in place its time to stretch into the movement itself, preparing the body to fire and move for the sport in hand.  Again the genius flows through, Miguel swings right to left, right to left, but power comes from movement and if we cannot move from left to right our power is diminished…. so of course he repeats the movement left to right, left to right.

What part of the body remains unstretched? Unmoved?  Unworked? Nothing.  The perfect dynamic warm up. Genius.
So now you know the science behind the madness why don’t you give ‘The Mechanics’ warm up a go before your next round and just feel the power you release?

Related Links:
Interested in Fascia? Watch this video: