Carl Watts – The Experiment

1997 BMW Open: European Tour Record -24

I am very excited to have been asked to take part in The Experiment with Carl Watts.  This is a challenge to get Carl Watts a European Tour Card in 2014 after 13 years of retirement from professional competition.

Carl will be working with Andy Traynor PGA fellow from a coaching point of view and I will be working with both Andy and Carl to understand what is going in Carl’s body and how it is manifesting itself in his golf game.  We will then together devise a treatment and training plan to get Carls body into balance to give him greater distance and accuracy.

Over the next 12 months you can follow my findings here at PAMO Fit but you can also follow Carl’s personal experience on his blog.  Andy will also be detailing Carl’s journey from a coaches point of view.

Golf – A Story of Balance

Many sports while keeping us fit and active also cause imbalance in our body.  In many of the clients I see it appears none more so than golf.  Maybe it’s that the typical golfer tends to be a little obsessive with the game or is it simply that the golf swing requires every muscle in the body to work together to achieve the power and accuracy of driving that little ball down the fairway?   I call to mind what a physio said to me at the age of 13 with my first golf back injury – ‘The golf swing is the most unnatural swing you will ever do, so it’s no wonder people get injured.’.   I am not sure how natural any swing is… was hitting a tennis ball ever part of evolutions plan?
With 53% of male golfers and 45% of female golfers experiencing back pain it is something that most of us golf enthusiasts are going to experience, but it’s certainly not something we have to live with.  By understanding the impact of golf on our body we can train to improve our performance while at the same time preventing injuring.  Step 1 – let’s understand what happens when we hit the golf ball.
The Biomechanics

For simplicity I will break this down into three key positions or movements and describe at a high level the primary muscles involved in each to help give you an understanding on the impact on your body.
Although not a power player, golfers spend more time in this position than they do hitting the ball.  Think of all the times you stand over the ball thinking about the swing.  Yet the swing is over in a blink of an eye.  Hips Flexed, Knees Flexed, Neck Flexed.  Shoulders flexed and Adducted, everything bringing your limbs in towards the body.  This curling effect lasts long after the game of golf resulting in an anterior tilted pelvis and ‘forward head’ posture.  Jandas Upper and Lower Cross Syndrome is a good explanation of what is happening to your body here. Glutes no longer firing, Abs that no longer need to be engaged, stiffness in the lower back, taut hamstrings, chronically tight hip flexors, neck pain and even headaches can be attributed to this.
I am afraid it doesn’t end there as it is the layering of the muscle imbalances caused by the swing itself that can make golfers posture more complicated and requiring more specific action to address.
The Backswing
Slow, controlled, the winding of a spring. The greater torque created in this movement the more power that can be produced on the downswing as the coil is released.  There are two factors to consider here, one – the muscles involved in this action, but secondly the muscles that are hindering this movement. The opposing muscles, where if short and tight prevent you from getting enough rotation in the backswing and therefore enough power into the downswing.
This rotation of the upper body is actually made up of a 40 degree side bend to the left (in a right handed player), a 40 degree hip extension in the left side of the pelvis and 90 degrees of torso rotation to the right.  This rotation is made up of 20 degrees lumbar rotation, 50 degrees or thoracic rotation with the final element coming from the shoulders.  So not quite a straight forward turn and a lot of places where restriction in a muscle can cause you a problem!  Everything from the Hamstrings to the pecs need to be flexible to allow this motion to happen.
The Downswing
At a simple level we can consider this action the complete opposite of the backswing.  Once at the top of the swing we need to return to neutral and then mirror the movement up into the finishing posture by swinging through the ball mirroring the backswing but in the opposite direction.  Let’s consider this, if indeed it was a case of simply being the opposite movement we would in theory think that golf is the perfectly balanced game working each side of the body equally but the BIG differentiator here is power!  Although the backswing winds up the coil, the downswing is an explosive powerful contraction to unwind the coil.  What this results in is a set of muscles that are stronger and perhaps shorter than their opposite number. Imbalance.
The Repercussions

What we end up with a golfer is a blend of Upper and Lower Cross Syndrome issues coupled with rotational & spiral restrictions and imbalances running through their entire body.  It is not uncommon for me to see golfers who stand in ‘neutral’ looking twisted back and forth between ankles, knees, hips, shoulders and head.
This can lead to knee problems, back pain, neck pain, shoulder stiffness and of course elbow issues when the arms end up doing the work the shoulders should be doing, but are simply too tight to do it themselves.  In addition, even if you remain injury and pain free postural imbalances can weaken your golf swing and could be the reason why you are not getting the distances you crave.
The Action Plan

To ensure a balanced body and to get the most of out your golf game there are three core areas you need to work on when off the golf course.
Get in the Gym!  You need to put some time in to build strength in a balanced away across your body.  Strength will give you more power but more importantly if you have an awareness of your personal imbalances you can also do specific exercises to offset any biomechanical issues present in your body.  It is worth having a biomechanical assessment to see what is going on with you.  Not everyone swings the golf club by the book so it’s more than likely that you will have your own personal set of issues to work through.
So you have the power sorted but if you do not have the flexibility in your body to be able to get full range of motion on the backswing you will be seriously dwindling your power.  In addition it is key that you work on releasing the pent up power movers of your downswing so that they do not start to cause you postural issues, injury and pain.   Soft tissue therapy is a must, releasing all your tension and getting your body aligned but you also need to find a routine that you can perform when training to ensure that you are not relying solely on your massage therapist to achieve your goals.
Yoga is phenomenal when it comes to flexibility!  It progressively addresses and stretches each part of the body to get you back in alignment with ease.  How often do you spend an hour stretching?  If you struggle to focus on a stretch routine it is worth considering other ways to achieve this flexibility.  My local Golf Pro is now the biggest advocate for Bikram Yoga, coming from a place where he had no intention of ever being a Yogi.
You are now flexible and strong but can you keep your performance up over a tough, windy and possibly very wet round of golf?  On bad days it can take over 4 hours to get round the course so it is important that you have the endurance to do so.  Working on your cardio fitness is key and not to be forgotten when working on a well rounded training plan.
Testament to a reduction in pain, muscles stiffness and at the same time increased golf performance is Andy Traynor, PGA Fellow Professional:
Just a quick note to say that since you “balanced” my body no more pain – can side bend so much easier and have added 15 yards to my iron distance. As a PGA Professional I will be putting all my students with body alignment issues in touch with you.’

Why don’t you get in touch today and start making a difference to your game.
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Getting More ‘Pop’ in the Park

Today I walked through the first frost in Epping Forest, the sun was shining and the skies were blue.  I love when the weather turns as it means the ski season is nearly upon us!

It is also the time that the keen skiers and snowboarders get stuck in to their pre season training to ensure they get the most out of their time on the snow.  I have been posed a very interesting problem to solve by one of my clients – Mr Keen Snowboarder (lets call him Mr KS).  He snowboards for 4-6 weeks a year but is frustrated by the lack of progress he is making in the park.  He simply cannot get the height or ‘Pop’ he desires which means his jumps lack the ‘air’ you hear everyone rave about.

Keen to start a specific training plan that will help him on his his four week tour to Jackson Hole this Christmas he has asked my advice on what he needs to work on to make sure his body is in the best shape to get that much lusted after ‘POP’.  A keen snowboarder myself I have never been much of a park monkey so the mechanics of freestyle boarding is not something I have analysed in depth – but I do love a challenge so have embraced this request head on and am determined to get Mr KS lots of ‘air’ this winter.  I am going to diarise the treatment and training plan, and hopefully report back with some improvement by the time Mr KS hits the park.

The Basics

Where better to start then at the beginning and the ‘Pop’ is probably the base of most freestyle moves.  Given the variety of stances and how these affect the muscles used to achieve the movements we will start by looking at the mechanics of the ‘Pop’ using a flat stance as this is the closest stance to anatomical neutral, in other words in the position your joints should be in when in neutral.  This involves your bindings being at 0⁰ i.e. pointing straight forward, we need your hips slightly wider than hip width for balance so they are slightly abducted to shoulder width.  Now lets get started!

Being a dynamic action I have broken the ‘Pop’ down into 4 key positions Neutral (a), Prep (b), Power (c) and Finish (d).   We are going to look at the biomechanics of positions (b) – (d) to understand what muscles are involved and how to give us a better idea of how to train.

Prep  – Position (b)

This move prepares the body to generate the power needed to ‘Pop’.  It involves dropping your knees and hips deeper into flexion, adding dorsiflexion at the ankle to allow us to press through the board akin to the coiling in a spring, everything gets lower and tighter.  Below I have outlined the key muscles that contract in order to achieve this position (I am focusing largely on the hip and lower body at this point, but the core is key to all of these actions so its not to be ignored!):

Primary Muscles
Rectus Femoris, Iliacus, Psoas Major, Hamstrings (knee attachment), Tibalis Anterior.

Secondary Muscles
Gluteus Medius & Minimus,TFL, Adductors, Transverse and Rectus Abdominis (flexing the torso fowards).

In addition we need to consider the limiting factors to these movements as if we are to get deep into this position then we need to have a good range of motion in  the joints involved. Shortness in the opposing muscles e.g. tight hamstrings will restrict the depth of this position meaning we have less range to push through in the next move.

Power  – Position (c)

Now we are ready to unleash the coiled spring.  The main driver here is extension through the hip which in turn is followed by extension of the knees and plantar flexion of the ankle.    This is the point that the kinetic chain kicks in to lift the board off the ground and into the air, the more power we create the more air we get. Remembering that we are extending our hips from an abducted position Gluteus Maximus becomes a big player in this hip extension:

Primary Muscles
Gluteus Maximus, Hamstrings, Quadriceps, Soleus & Gastrocnemius.

Secondary Muscles
Gluteus Medius & Minimus,TFL, Adductors, Erector Spinae and Transverse Abdominus.

Again we must not forget any limiting factors and being aware of what our range of motion is for these key movements.  Is your Iliopsoas holding you back from extending upwards?

Finish  – Position (d)

So now we have the power and our body has lifted off the ground we pull the finishing move to maximise the air.  To do this we revert to the same actions as position (b) flex hips, flex knees and dorsiflex ankles drawing them towards the chest.  The same primary and secondary muscles but with more power as in this case we have gravity to contend with!

So what does this mean and how do we train to maximise height and power?  Well this is where we need to be specific and look at each person’s individual biomechanics. It is not as simple as saying, ‘strengthen your legs’ as maybe your legs are strong but inflexible preventing you from firing on all cylinders when entering the power move.  To illustrate this lets come back to my client – Mr Keen Snowboarder.

He has a lot of lower body strength, but he suffers from a severe posterior tilt of his pelvis.  This manifests itself in chronically tight hamstrings and calves along with other repercussions higher up the chain.  Is this the reason he is not getting the ‘Pop’ he chases year in year out?  If he cannot get sufficient differential between position b and position c then the amount of power he can achieve is greatly reduced.  In addition his glute maximus firing pattern is incorrect.  Glute max has been inhibited and the hamstrings are doing all the hard work. Finally there is evidence of hip instability. If the hips are not controlled, the knees fall inward reducing the power of the extension action needed to pop you off the ground.

To get my client moving we are going to start on the following plan of action as I like work on a no regrets basis and addressing these postural imbalances will help regardless of the specifics of this move:

   o Improving proprioception of the glutes
   o Strengthening the  erector spinae group and the hip flexors
   o Releasing the hamstrings, abdominals and calves with hands on treatment and stretching
   o Adding some functional exercises to work on performing the kinetic chain required e.g. the jump squat

Next I am going to start looking at whether or not your stance affects your power in the park given how varied these can be, but we will have to also weigh that up with everything else you want to achieve when you are out riding the snow.   Stay posted!

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What are the Benefits of Sports & Remedial Massage Therapy?

This is a question I get asked on a daily basis, along with statements like ‘but I don’t do sport !’.  Although ‘Sport is in the name there is no need to be a sports person to benefit from this treatment. 

The term Sports Massage was coined as it was a therapy originally used to prepare sports men and women for events.  It ensured these athletes performed at their best, kept injury at bay and to recovered quickly from training and events.  It was not long before people realised that this treatment could help anyone with soft tissue issues (think of your sore back, stiff neck and general aches & pains) and it moved to the mainstream.   

SRMT involves a wide variety of techniques that have different effects on the tissues.  Many of the techniques involve hands on massage/manipulation of the soft tissue to make a physiological change e.g. lengthening shortened muscles, breaking down scar tissue, releasing trigger points and improving circulation.  It also involves techniques that work directly with the Central Nervous System to turn muscles on/off where they have become extremely tight or extremely lax.    Nowadays it is not uncommon for your therapist to use tools, tape and more as part of your treatment.  All this and it doesn’t stop at muscles, we also focus on tendons, ligaments and fascia to ensure you have full range of motion and a balanced posture to keep you functioning at your best.

The key to the effectiveness of a Soft Tissue Therapist is in their understanding of the anatomy, physiology and biomechanics.  It is with this knowledge that they can choose the best techniques to apply to the right parts of the body to get real results.  This will mean that your therapist will fully assess you before they begin to ensure they understand the root cause of your problem.   We don’t want to turn a tight muscle off it is the only thing keeping you upright!

At a physical level SRMT increases circulation, warms tissues, improves drainage, separates fibres, breaks down scars/adhesions and releases fascial restrictions.   These effects can speed up the healing process, relieve pain, reduce stress, release tension and correct imbalances within the body.  In addition massage is also proven to release endorphins – the natural feel good factor, leaving you walking away with a wonderful sense of well being.

With all this mind you can see why Sport & Remedial Massage Therapy has become such a key part in people’s health plan.  So go on, add regular sports massage to your list of ‘must haves’!

If you are still unsure if it can help you then simply get in touch –

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One of the most common complaints that I see at my clinic is Tennis Elbow, clinically know as ‘Lateral Epicondylitis’. Now don’t be fooled, it is not only tennis players who suffer with this sharp pain on the outside of their elbow, but anyone who is overusing the wrist extensor muscles – overzealous action with the garden shears seems to be as common a cause as the tennis racket these days!
Tennis elbow responds very well to soft tissue treatment but if not treated and if it becomes chronic then sometimes more aggressive treatment may be required.  I have briefly outlined three cases of tennis elbow that I have worked on in the last 6 months, to highlight how individual each instance is and how tailored treatment is key to ensure the best possible outcome:
Case 1 – The Recreational Squash Player
The client has recently returned to playing squash after a 12 month hiatus.   Four weeks into her return she is experiencing pain on the outside of her elbow.  There is no pain when playing squash but following squash the pain is quite severe and the elbow is very tender to touch.  No previous history of tennis elbow and the client is keen to resolve the pain as quickly as possible so they can get back to training for the coming season.
Physical Assessment showed that tennis elbow was indicated as suspected by the client. On testing the range of motion in the shoulder joint it was evident that the client had a highly restricted range of motion.  The pectoral muscles were shortened and tight meaning that the client was struggling in opening their back swing when preparing to hit the squash shot leading the muscles of the forearm being used to hit the ball and follow through.
We treated the tennis elbow directly using a variety of soft tissue techniques to release the tension on the tendons around the elbow and to reduce the inflammation.  In addition we worked on increasing the shoulder range of motion and increasing scapula control.  This involved a series of strengthening and stretching exercises for the client to perform as homecare.
Once the tennis elbow started to improve I recommended the client had a number of coaching sessions to correct her swing.  This ensured that as her shoulder and elbow issues where being resolved she retrained her body to hit the ball correctly preventing re-injury.
Given the early intervention with soft tissue therapy and with the appropriate homecare the client was back to being pain free and playing lots of squash in 4 weeks.  The client continues to do the exercise and stretch routine on a regular basis. 
Case 2 – The Overzealous Gardener
The client presented with acute tennis elbow on the left side (client is right handed).  Onset of the condition was 1 week ago following a hard day’s work in the garden where the client trimmed the trees in his garden using the garden shears.
On examination tennis elbow was indicated, there was inflammation and tenderness of the tendons surrounding the outside of the elbow and it was still in the acute stage.  No restriction in the shoulder, neck or upper body.  The client was keen to return to play golf as soon as possible.  Given the acute nature of the injury I used Kinesio tape to reduce the swelling and inhibit the wrist flexors taking the pressure of the tendons allowing them to heal.  Over the following sessions we started to mobilise and gently stretch the tissues regaining full range of motion.  The client was also given some gentle strengthening exercises for the wrist extensors to ensure that next time he pushed himself too hard in the garden the injury would not resurface. 
The client did not rest sufficiently and continued to play golf and racketball increasing the healing time required.  The clients issues were resolved in about 8 weeks after five sessions.
Case 3 – The Tennis Player with a Twist
The client presented with pain to the lateral aspect of the right elbow and has been playing more tennis than usual given it was the summer.  The client wanted treatment of the elbow so as she could play tennis pain free.
On interview it was indicated that the client had a fracture to her collar bone about ten years previous but was sure this had nothing to do with the tennis elbow.  On assessment there was scar tissue present around the break point and restrictions to the fascia around the attachment of the pectoral muscles.  This restriction was restricting the range of motion in both the shoulder and the elbow and may have been exacerbating the tennis elbow in the client.
We treated the tennis elbow directly but also started to break down the scar tissue and to release the fascia around the collar bone.  The friction technique was also performed by the client as part of their homecare along with the necessary strengthening and stretching exercises that I recommended.
After 3-4 weeks and 3 sessions the tennis elbow symptoms had disappeared but we continued to work on improving the range of motion in the shoulder for a further 3 weeks.  Although the client continued to play several hours of tennis a week they incorporated regular sports massage sessions into their training plan and the tennis elbow has not returned in the last 5 months.
As you can see not only the treatment but the homecare in each case differed but in all cases the tennis elbow was resolved and the clients are now managing their bodies to minimise the risk of re-injury.
If you are suffering from tennis elbow, get in touch to be fully assessed so as we can pinpoint the root cause.  We can then treat your elbow but also work on the cause to help keep you pain free for longer.
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