Conversation with an NHS physio

I had this conversation with Emily Davies Physiotherapist, answering your most asked physio questions! This blog post is in support of the We are the NHS campaign. If you enjoy it, please do share on Instagram!

1. How do you know whether a pain/a niggle is something you can run through or something to rest and check?  

Symptoms such as swelling, pain when weight bearing, redness, the joint area giving way, numbness, pins and needles, reduced strength/ movement due to pain can all be worth a professional opinion.

Ask yourself how long have you had this pain for. It’s not uncommon to get pins and needles after exercise as well as redness/ swelling if you’ve been working hard but this can often resolve on its own. If this is something that’s happening persistently it’s definitely worth getting it looked at. 

If symptoms aren’t persistent and you’ve only had this pain/ niggle recently when running, rest is your best friend! Listen to your body if it’s in pain. Our body needs rest to strengthen and adapt. Rest, ice and elevation can often help these niggles! If after this you are still getting pain, ignoring it will only end up doing more harm and the recovery is likely to be worse. 

2. What’s your best advice for those that sit at a desk all day?   

Planning your day in advance is a massive help in ensuring you achieve what you set out to. If you are sitting at a desk all day, getting up every hour is so important; whether that is just going to the kitchen to make yourself another cup of tea! (Check out this blog post on how I keep active when working a desk job).  

If your job means you aren’t active during the day, make up for this in the evening, it doesn’t have to be something intense! It could be going for a walk outdoors- this will be great for your mental health too, releasing those endorphins and improving your mood! Try and set yourself a goal, that way you are more likely to stick with it e.g. how many steps do you want to achieve each day? 

If it means you are sitting at a desk all day, you need to look after your posture and your musculoskeletal system. Make sure you are sat at a chair you find comfortable with back support, feet flat on the floor, screen at eye level, try and avoid crossing your legs! Working at home during the pandemic is not easy but it’s important you have the correct equipment to ensure you aren’t straining your posture/ body. Speak with your workplace if it is concerning you. 

3. How is it best to return to running after a long period of time off?  

Build it back up slowly, if you dive straight into the level you were previously at, your muscles and joints will be at risk of injury.  Stretching your calves, quads and hip flexors after your runs will help to reduce risk of injury. 

Make yourself a goal! What would you like to achieve with your running? But it is really important you make this goal realistic to yourself and over a realistic time frame! How far do you want to be able to run and by when? 

Make sure you take some days off to start with to give your body time to recover. Even just going for a gentle walk, cycle or swimming (when we can access swimming pools again!) can also help build our endurance/ strength. Swimming is brilliant as it is a non-weight bearing form of exercise which provides our joints with a bit of a rest!  

Footwear is also so important! Make sure you’ve got some correctly fitting trainers with good shock absorption qualities for running and are supportive for you! There are more top tips on running form in one of the answers below!

4. Words of wisdom for someone starting physio at university?  

One thing I wish I’d have had a better understanding of before I started my degree in Physiotherapy was the range of areas involved in this profession. Having a good understanding of this will put you in a great position at your lectures on all the different areas e.g respiratory, musculoskeletal and neurology 

Don’t be afraid to use your course mates for studying! The best way I found to learn anatomy/ practical treatments was with my course mates. Remember you aren’t the only one learning this whole new topic, your course mates will be in the same position as you so learning together will widen your depth of knowledge! 

Printing off lecture power points and annotating them as you go is another tip I recommend! With permission of you lecturer, recording lectures was hugely helpful for me. This way, for anything I didn’t understand or was struggling to learn I would listen to the lecture over again to confirm my understanding. 

And finally, your placements! This is where you get to transfer all that you’ve learnt into real life situations. Really make the most out of your placements, get as much experience in different professions that work alongside physios so you are aware of the bigger picture of your multidisciplinary team! And ask as many questions as you can!

 5. What’s the most common issue you see as a physio and the easiest way to avoid it?  

Achilles tendinitis is a common injury we see a lot of, especially during lockdown where more people are taking up running due to gyms being shut.  Most Achilles injuries can be treated at home with support of a qualified physiotherapist. It is important to get issues like this checked as overuse of our tendon can lead to a rupture, resulting in surgery in worst cases.   

To avoid injury in the first place, increase your activity level slowly whilst stretching and strengthening the area. A good tip is being aware that we have two calf muscles (gastrocnemius and soleus) so we must stretch them both! 

Again, having good fitting trainers with enough padding to help with shock absorption will help prevent this injury. 

6. What makes a good physio?  

A good physio knows the importance of building trust with you, as it is likely you will see your physio over a period of sessions, so it is important to make sure you have a mutual regard and respect during the sessions. I’d check for continuity reasons that you will have the same physio for all your treatments rather than have to build up a rapport with a new physio on each session! 

7. Should you stretch? If so, how often? Any specific stretches you’d recommend? 

Stretching is SO good for your body! Stretching can improve range of movement, decrease stress levels, reduce pain/stiffness, reduce risk of injury and improve blood flow and circulation.  

Stretching once in a blue moon will not make a difference to your flexibility, consistency is key!

I would start off with a manageable amount of stretches each day e.g. 5 and as long as the stretch is not painful, I’d recommend holding for between 30-60 seconds. Try to implement stretches into your daily routine, even better after you have been exercising so your muscles are warmed up.  

Be aware that as the muscle we are stretching becomes more flexible, it is at risk of becoming weaker so completing strengthening exercises of the same area is recommended.   

The main stretches I would recommend to anyone starting off would be targeting our main muscle groups! This would include the hamstrings, hip flexors and glutes. I also think that stretching out our muscles in the shoulders/chest (trapezius and pectorals) is important in improving posture, especially now people are working from home more.  

8. Any general advice on running form?   

Be aware of your posture, it is so easy when you are running to forget about posture but try to be aware of your shoulders, keep your back straight and make sure you aren’t leaning forwards. Having a stooped posture when running can lead to back, shoulder and neck issues in the future.  

Find a stride that works for you; land gently to help prevent any injuries. Elbows tucked in by your side and good arm swing will help maintain a rhythm and propel you forward also.   

Again, completing frequent stretches and strengthening exercises for our big muscle groups e.g. abdominals and glutes will help stabilize your running technique. 

9. How is it best to support recovery e.g. on a rest day, after training etc? Top tips?  

Stretching after training will support our recovery by eliminating lactic acid build up and improving our blood flow. Try and incorporate stretches after every work out to support your recovery. A gentle walk on a rest day will also help reduce joint stiffness by circulating the blood flow. Correct nutrition will also support our recovery e.g.  Consuming an adequate amount of protein will help recover muscle fibres that may have been damaged through exercise as well as helping to replenish any depleted energy stores. Recovery days are important as these are days which allow our muscles to repair and therefore strengthen and improve performance. Everyone is different in regard to how many rest days a week they should have but I would recommend to rest the muscle group the day after you exerted it. Definitely make sure you are sleeping enough also, our body needs sleep to recover, try to get a good 7-9 hours. 

I would also recommend foam rollers, ice/ heat packs and even a sports massage to also aid recovery for more intense training schedules.  

10. How should I treat/prevent runner’s knee? 

If you start to experience pain around the knee (patella area more specifically) when you are running, bending your knee, kneeling, walking down hill/ downstairs, you may have runners knee. It’s a very general term for knee pain that may not have stemmed from running.

It is a problem that can often resolve itself.

To treat it I would recommend resting the knee from strenuous activities for around 2 weeks e.g. running, squatting, lunging. Not everyone will get swelling with this pain, but a cold ice pack on the area for 20 minutes or so every 4-5 hours can ease not just swelling but the pain also. Elevating your knee when you can will also help with swelling. 

To treat / prevent this condition, correct footwear can help improve position of your feet and therefore pressure around the knee. I’d also recommended stretching and strengthening the area around the knee. For stretching, I would target the quadriceps, calf, hip flexors and hamstrings. For strengthening I would recommend calf raises, wall slides, clams, step ups and glute bridges. As always, if this pain persists, get it looked at by a professional. 

Many thanks to Emily for answering these questions!

Emily is supporting NHS England’s ‘We Are The NHS’ campaign. To find out more about a career in the NHS, please search NHS Careers’ or visit We Are The NHS to find available roles and training support on offer.

Dealing with injuries as an athlete

At university, I undertook a short course on sports psychology, hoping to garner some insight into what makes pro athletes tick, and how the rest of us can improve our own psychology to improve our sport. The topic that stuck with me most, however, was talking about the effects of injuries on athletes, and not just professional ones. Since sports have strong mental as well as physical benefits, the stress and anxiety caused by injury can sometimes be almost incapacitating. Figuring out how to keep fears and potentially serious mental health problems at bay is both vital and complex.

While I’m no expert, I have an unfortunate amount of personal experience dealing with recurring injuries, namely IT band syndrome, caused by doing ‘too much, too soon’ in most athletes, but initiated and exacerbated almost solely by road running for me. My first physio told me to ‘stop running’, in favour of all other sports, which did nothing to help the actual problem, since I was always going to run, I just needed to know how. And so commenced 6 years or recurring injury.

After a huge flare-up during training for and running Tokyo marathon in early 2019, I worked with my second physio, Zoe, from Physio Motion (London based) to figure out the cause of my particular injury (weak glutes, poor running form to compensate) and work on those issues. Since then, I’ve been able to run two ultramarathons and 50+km weeks on trail (big for me – previously 5km would hurt) with no pain until recently, on a very tiring 10km road run around Bristol.

So, in my current mindset, I thought it might be helpful to share my top tips for dealing with injuries, both mentally and physically.

Get a diagnosis

For many people reading this, your injuries will be recurring, so you’ll have a good idea of what the pain is, and what it means. However, for many others, you’ll have a ‘lateral knee pain’ or ‘calf niggle’ and won’t know what’s gone wrong. Getting a diagnosis is vital to taking the right steps to recovery. Taking time off until it doesn’t hurt and then going straight back to what you were doing before doesn’t treat the root cause of the problem, so you might have the same issue again. Get a diagnosis and a plan to recover.

Know what’s gone wrong

This might be personal to me, but when things go wrong, I need to know why. Understanding the details of why something went wrong, what happened in the lead up and what I can do next time to avoid the same thing happening helps me feel in control of the issue. It also helps prevent it happening again. If I think about it, the recent cause of my flare up was: 2 weeks off followed by 3 very stiff road runs in quick succession, followed by a lack of stretching on top of 9 months without a regular or sufficient physiotherapy strengthening routine. Know your triggers and work to fix them.

Accept reality

If you are injured, the chances are that you felt a niggle before it turned into a full-blown injury. If you had taken a step back at ‘niggle’, it may never have turned to ‘injury’. So now you’re injured, it’s time to accept that reality. It may not be the reality forever, but for now, pushing through the pain doesn’t make you hardcore, it makes you stupid (speaking from experience). It also means your injury will likely take longer to heal and you’ll spend more time away from what you love. Accepting your current state means that it’ll likely last for less time.

Treat recovery like training

If you’re anything like me, you get pretty exciting when a new training plan comes your way, but groan at the idea of a physiotherapy/rehab plan. However, technically, a rehab plan is the same as any other training plan – it’s taking small steps to improve from the position you’re currently in, to the position you want to be in. Switching your mindset from ‘rehab is a chore’ to ‘rehab is training’ can help keep motivated. The more you stick to your rehab plan, the sooner you’ll be back to the training you love.

Enjoy the time off

When you know you can’t run/do the sport you love, it seems like all you want to do is that thing, but in reality how many times did you think ‘I wish I didn’t have to go on this run’ when you still could? Time off is a chance to take stock, recover both physically and mentally, and improve other skills too, be it in the gym or at work. You’ll be amazed how much free time you have all of a sudden! Again, this is about mindset – you can choose to resent the free time, or you can choose to do something productive with it (rest is also productive).

Speak to others

While being pragmatic is always best when it comes to injuries, sometimes speaking to someone else who can share your frustrations can make you feel less alone. Sharing tips and irritations can be helpful, and having a downright bitch about your injury every now and again can feel good. It’s unfair that I’m injured. I read my body well, I rest well, I eat well, I don’t do huge mileage, and yet here I am once again. It’s immensely frustrating. Once you’re done, pick yourself back up and get on with your rehab plan.

Go back slowly

At the end of your 6 weeks or 6 months, you’ll likely be trepidatious but excited to get back to running/whatever sport you love. However, these are the tentative first steps after months of recovery and work. Don’t go out all guns blazing, however fresh you feel. Work with your physio to plan your return to training. A 2km run is as valid as your previous 20km runs. Don’t let ego or excitement get in the way of a slow and sensible return to training – your body will thank you in the long run (so to speak)! And if anything, you should be finishing your sessions feeling like you want to do more.

This piece has been helpful to write for myself at least, so I hope it also helps a lot of you! Save it, share it, bookmark it on your laptop. 65% – 80% of runners get injured each year, so it’s likely that you’ll need this advice at some point, whether that’s now or in the future. Good luck with your recovery!

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Train like an athlete

Health and fitness is everywhere – from your food being marketed as ‘high protein’ or a ‘post workout bar’ to your favourite influencer dancing around in an Ivy Park tracksuit. It’s inescapable, and as someone who used to be teased for eating healthily and enjoying the school PE classes, it’s exciting.

However, I find myself questioning more and more how much these people and brands are actually focussed on fitness and health. I 100% believe that brands focussing more on health is generally a good thing, even if that’s just jumping on the bandwagon in an effort to look ‘cool’ or sell more products, but I worry about the amount of people buying into things that will make them LOOK more #fitness without actually providing them the actual fitness to back that up.

I am probably biased – I have been doing ‘fitness’ since I was about 15, always in the form of functional training, whether training for the national schools squash championships, BUCS cross country or my latest boxing match. But seeing people take part in a 12 week plan to ‘grow their booty’ (without any focus on actual fitness/strength) and then give up is frustrating for me. The amount of emphasis placed on looks (often at the expense of performance) leads me to worry about the longevity of the West’s ‘passion’ for fitness. It reminds me of when I was growing up and the Kate Moss ‘heroine chic’ look was in – you didn’t have to take heroine, as long as you looked like you hadn’t eaten in 3 weeks (thinking about it, this was probably for the best, but since fitness is actually very good for you, it would be nice if people were as dedicated to BEING fit as they are to LOOKING fit). 

It’s easy to imagine my view comes from a place of ‘I was here first, everyone else is just pretending’ but that’s genuinely not it. There are a number of reasons for my concern, and all (I believe) are legitimate. 

  1. When you train for aesthetics, the emphasis gets placed on your looks and how much working out can make you look a certain way. For every person who sticks to fitness after discovering the other benefits, there is someone else who quits after they become disillusioned about the lack of a six pack they were promised after 90 days. Fitness isn’t looking a certain way, it’s about a bunch of internal factors that we can’t even see. 
  2. There are a lot of actual, real life athletes on Instagram, whether they’re competing for the country or working overtime to allow them to self-fund their training and competition fees. However, brands are often choosing to work with people who ‘look’ a certain way over those who actually DO a sport. As someone who works in the fitness modelling world, I see this all too often. Of course, aesthetics are important, but I’ve been told I’m ‘too muscly’ for a job that literally requires lifting weights. Who could look more like a person who lifts weights than someone who got the body they have by literally doing just that. It would be nice to see a little more championing of people who actually DO a sport. 
  3. I like to think that we’ve moved past the point of extremes, because health is sort of by definition ‘balanced’. However a number of fitness guides and classes encourage plenty of extreme behaviour to look a certain way. Sure, they work, but are they ‘healthy’? Training like an athlete (i.e. functional training) focusses on performance and all-round fitness. Runners lift weights, rugby players practise sprints and everyone works on mobility and balance. Training purely for aesthetics can lead to serious physical problems further down the line, especially from poor form and over training certain areas. This is something I’m still working on too – it’s the only way to make training sustainable.

Thankfully training purely for aesthetics often becomes the gateway drug for all the other benefits of exercise, and those who start working out to lose weight can discover a plethora of other benefits. Other factors become the driving force behind working out, and at this point a person’s fitness becomes way more balanced (I’m sure a number of you can relate)!

It’s not entirely necessary to want to run a marathon or to achieve a triathlon PB, but training like an athlete can leave you feeling mentally healthier, accomplished and physically sound well into your older age. Rest and recovery is a key part of an athlete’s training plan, and whilst reducing workout intensity might not give you THAT body in 90 days, it sure as hell will keep you motivated enough to continue working out long, long past then. 

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Best workout classes in London

Since two years ago I’ve been somewhat addicted to travelling around London trying new workout classes. Between that and events hosted by various studios, I’ve tried by fair share of fitness classes in London! People often ask what I would recommend for when they visit London so I’ve decided to do a post about it.

In no particular order, these are my favourite classes in London. Of course, what I like and what you might like might be totally different, but recommendations are always useful to get you started in a new city 🙂

 

Barry’s bootcamp

Say what you like about Barry’s, but it’ll always be a class that I love. Granted, I don’t think I could do it everyday, but the combination of endorphin-raising running and strength-building weights, it’s the perfect workout for me. In short, it alternates between treadmill runs and floor workouts, giving you rest from the treadmills whilst you’re working out on the floor, and rest from the floor when you’re on the treadmills. It was one of the first classes I ever did, and never fails to make me feel accomplished. With studios popping up around London (Shoreditch, Euston, Notting Hill and Victoria), there’ll likely be one that’s easy to get to (the Notting Hill is my favourite!).

Barry’s Bootcamp website. (£20 per class)

 

Power of Boxing

This class is hugely underrated, potentially because it’s not smart and swanky like the other gyms. Don’t expect showers and hairdryers. Instead expect a bloody good workout with unpretentious people who love working out. The structure of the class includes floor circuits, punch-bag work and then pad-work in the boxing ring, which no other class I’ve found successfully does. It’s exhausting – expect to be dripping by the end – but leaves you feeling amazing. Every. Single. Time. PoB also works with a local charity to help reintegrate offenders into the community, which I think is amazing. This class is also super affordable, so if you’re not looking to splash out, this is the one for you 🙂

Power of Boxing Website (£12.50 per class)

 

KXU – The Games

This is a relatively recent addition to my list of favourite classes. Think Crossfit/strongman but in swanky gym. But don’t be fooled by the beauty of KXU – this class will KILL you. I would definitely recommend this to anyone who’s relatively fit/strong already and wants a challenge! Unlike a lot of the classes in London, this one makes no attempts at telling girls to ‘lift light’ – the heavier the better! This studio is almost worth visiting purely for the aesthetics too J Would recommend if you want to lift heavy and then enjoy a (somewhat overpriced) shake in one of the most beautiful locations you’ll find in London.

KXU website (£24 per class)

 

BXR – Strength and Conditioning

Another favourite for different reasons to the others. BXR is a boxing gym endorsed by Anthony Joshua. It’s based near Baker Street, which makes it pretty accessibly from most central locations. I put this in the mix because of both the class and location – it’s really smart inside, and contains the nicest changing rooms of any gym I’ve ever been to. The strength and conditioning class is one that focuses on form and strengthening the body in a way most classes don’t. There’s a lot of foam-rolling and resistance band work, which I feel a lot of classes avoid because they don’t burn as many calories as other classes. However, for longevity and injury prevention, there’s nothing like a good S&C class, so I would definitely recommend this to compliment your other training.

BXR website (from £30 for 3 introductory sessions).

 

I hope this helps you try some new workouts and find what works for you! We’re all different and what is amazing for someone often doesn’t work for the next person. Give these a go (there are often introductory deals) and let me know what you think! 🙂

Behind the scenes – shooting with easyGym

 

As some of you may know, in December I was asked to model for easyGym’s new ‘Set to Sweat’ programme, a 12 week guide aimed at beginner to intermediate women to improve their fitness, strength and physique. The shooting was done over 4 full days, filming each stage of each and every exercise.

I wrote this post to share with you some insights into the programme and what it was like to take part in such a big shoot.

But first, a HUGE shoutout to Felix the photographer and Sarah the assist (and fairy godmother/coffee bringer) for keeping the shoot interesting, relaxed and endlessly hilarious!

You’ll be seeing the full results of the shoot on the 8th March when the full guide comes out (also conveniently women’s day!). I’m so excited to see the final product – as you might know, I’m a huge advocate of getting women into the weights room, so it was so good to be able to partake in such an amazing shoot! Watch this space.

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Day 1 – already in need of a stretch

 

The gym:

Our shooting was done at easyGym in Wandsworth, one of their many locations around England. On the first day I arrived and was swiped in by the photographer, Felix up to their first floor (deceptively named, as it was about 7 flights up – thank goodness for lifts)! The gym was laid out almost totally open-plan, with cardio, floor, weights and free weights sections allowing plenty of space. It also meant there was little to no terror whilst entering the weights section because it was a continuous floor plan (no testosterone room, yay!). One entire wall was a huge window, which was really nice on the cardio machines that looked out onto the view (although it left a bit to be desired!). During our 4 days of shooting, there was only one piece of equipment that we couldn’t find (ab wheel) and there were plenty of each of the other machines, which meant no waiting!

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Cardio day

The exercises:

The exercises ranged from isometric holds on the floor, to bodyweight exercises to some quite intense weights-based exercises: after 10 minutes of bench pressing I started to wonder if I was even fit enough to take the photos, let alone actually do the programme! But the range of exercises meant that no one body part got too tired to continue, and over the four days every part of my body was fully worked out!

 

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Final day of shooting

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Day four, outfit two

The modelling:

Fitness modelling does not come naturally to me (or maybe for anyone?). I’m more than happy to workout and for people to take photos, but want a nice face along with that? Reeeeeeally tough! My workout face is probably NOT something you want blown up on a billboard. BUT, with a lot of practise (and some snazzy lighting from Felix), I finally got the hang of letting my face relax while my body did all the work. It’s the little things like licking your lips, scrunching your face and holding your breath that are difficult to get rid of, because you hardly notice you’re doing them.

I was able to choose my own clothes for the workout, but as a classic girl I brought along about four outfits every day to let Felix and Sarah decide which I should wear. Nothing that might clash with the easyGym orange, and nothing with big patterns, so that left basically my entire, mostly monochrome wardrobe.

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It’s always very serious on set

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Over and out

Thanks to easyGym for the use of their amazing gym!