WHAT ARE THE TOP RUNNING INJURIES?

Runners of all abilities and ages get injured. Earlier this year I completed a clinical audit of the runners I looked after from January to March to assess what injuries I was seeing and where to plan my professional development over the next few years. This made me look into the research to see if the trends I was seeing was the same as being reported.

I found “A Systematic Review of Running-Related Musculoskeletal Injuries in Runners” which was published in 2021. I’ve made up the infographic below for you. I won’t talk about my own audit as I would require consent from my patients.

SYSTEMATIC REVIEW OF RUNNING-RELATED MUSCULOSKELETAL INJURIES IN RUNNERS.

(KAKOURIS ET AL 2021).

The chart shows that Achilles tendinopathy had the highest incidence, followed by shin splints, plantar-fasciitis, patella-femoral pain (knee pain) and the dreaded ITB related pain. Most runners will have heard of these and even more will have experienced pain in one of these areas.
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You'll notice that the numbers do not add up to 100%. This is due to a small number of injuries not included. However if you read the study they are fully reported.
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📌70% of all injuries reported were down to overuse!

🧠This is massive but it’s also encouraging. We can have a big intervention on overuse injuries with their treatment, management and PREVENTION. Sometimes this can be through looking over a plan for trends and sudden increases in one type of running. It might be looking at where and how you recover. It might also be measuring muscle force or endurance and looking at weak points.

📌The majority of injuries were reported below the knee.

🧠This might because the propulsion phase in the running gait is generated from the foot and the lower limb muscles and bones, which leads to increased load on these structures. This could also be why so much research is coming out about how to strengthen the lower limb in runners.
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🏃‍♀️The authors recommend injury prevention measures to these area's to reduce the high incidence of injuries.
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🙋🏻‍♂️In all of my sessions with runners 🏃🏿 I try to implement education on load management and how to safely increase mileage, interval and hill training. I teach you how to analyse your training plan so you reduce the risk of making a training error and cause an overuse injury. I’m a huge believer in learning how to strength train for injury prevention and increased performance.
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I’m starting a new service where I’m offering online strength training for runners and triathletes. If you’re interested in learning how to implement strength training as part of your training to improve performance and reduce injuries then please reach out to me.

To book an appointment with me you can call my online secretary 07900363938 or email info@shauntyler.com.

Reference and read what I've read 📚
Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021 Sep;10(5):513-522. doi: 10.1016/j.jshs.2021.04.001. Epub 2021 Apr 20. PMID: 33862272; PMCID: PMC8500811.

🚨If you've just pulled your back or it's just "gone" while you were putting your socks on this morning, then you need this!
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🙋🏻‍♂️Hi, I'm Shaun and I'm a Registered Osteopath based in Colchester, UK. Every week I have patients who see me with acute low back pain. We define acute low back pain as pain that is less that 6 weeks old. Most acute low back pain will resolve within 4-6weeks depending on the onset and severity of your symptoms. Here's six points that I find really helps my patients and will give you an insight in how I treat my patients with this condition.
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1️⃣ Relative Activity Modification
I'll start by addressing what's causing you pain and discomfort. I rarely advocate complete rest. Complete rest is old thinking. It can lead to fatty infiltration of muscles, decondition your muscles, increase pain and can delay your recovery. That said, some people will need some sort of rest. It’s not as cut and dry as one size fits all. I will often get you to modify your work positions or bring in a pacing strategy to reduce stress on painful structures. It might be changing your exercise routine or training schedule. This is where having a clear line of communication with your therapist helps. See points 2 & 4, there should be constant feedback finding what works for the individual and what does not.
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2️⃣ Build a Therapeutic Alliance
I want me and my patient to become a team. I want to build trust so they can approach me with any questions or queries. I will in turn advocate for you and support you along your back-pain journey. Treating and recovering from acute low back pain is not a case of ‘go away and do these exercises.” I see patients who’ve been given a list of tens of exercises and are unsure if they should be doing them because they cause pain. By regular communication whether it’s face to face, by text or email we can build trust and really individualise your treatment and recovery.
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3️⃣ Osteopathic Assessment & Treatment
I start by listening to you (a lot), and taking a case history. We investigate different parts of your health & lifestyle because putting that plate in the dish washer should not have caused a muscle strain. There's often an accumulation of factors that snowball up to that point. I will assess you physically to see how your body is moving and functioning. This might include muscle testing and moving joints around. We will investigate what’s causing pain and what positions give you relief.

Osteopathic treatment might include soft tissue release & massage, dry needling, taping, stretching & spinal manipulation. The goal is to reduce pain and improve your movement, function & confidence. Most of my patients will leave confident that they have a plan to get them back to work, sport or doing what they enjoy.
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4️⃣ Education & Communication
I really try my best to make sure my patients firstly understand what's going on with their back. I advise on prognosis as all too often back pain doesn’t go away overnight. I like them to know what they need to do to help themselves. If they understand this then they seem to have less worry, less fear avoidance and better outcomes.

5️⃣ Rehab Exercises & Return to Activity
Whether you like exercise or not, you need to be increasing your activity levels to help your back and reduce pain. I tend to tailor specific exercises to my patients to begin with. I find this builds confidence in their body and spine. Often a back injury can leave someone thinking their back is weak or degenerative. The exercises will increase your mobility and range of motion. They will also increase strength, stability & endurance. On top of this we know regular exposure to exercise has a pain modulation and relieving effect on the body. My plans are often progressive so I can have them integrate themselves back to work or activity.
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6️⃣ Reassurance & Follow Up
Chronic low back pain can sometimes develop in a small number of patients who have acute low back pain. It's also thought that up to 80% of people will have a relapse over the following year. I educate my patients about this and keep our channels of communication open. It’s often useful to have follow up appointments to progress your exercises as your body gets stronger and moves better.

As you can see a big part of my osteopathic treatment is developing a relationship with my patient. If we can build a strong therapeutic alliance and you understand the reasons behind why we are doing or not doing certain moves or activities then you’ll be more likely to follow the plan and have long term results.

If you’d like to work with me then please get in touch.

📲07900363938
📧info@shauntyler.com

Acid reflux or heart burn is the predominant symptom of Gastroesophageal Reflux or GERD. It’s estimated that over 20% of the Western world suffer from GERD. It’s a painful and limiting condition that can effect diet, sleep, activity and work. It can lead to more serious conditions such as Barrett’s osophagus.

Sharma and Yadlapati (2021) stated that the pathogenesis of GERD is an interpaly of chemical, mechanical, psychologic, and neurologic mechanisms. Patients often present with impaired esophageal motility and lower esophageal sphincter (LES) dysfunction.

In osteopathy we are interested in the diaphragm muscle as it surrounds the osophagus, phrenic and vagus nerves. Good movement of the diaphragm ensures a change in pressure gradients in the thoracic and abdominal cavities to aid breathing and digestion. A dysfunctional diaphragm can inhibit the lower esophageal sphincter and cause contents to back wash into the osophagus.

In 2019 Eguaras and colleagues performed a randomised, double-blind placebo-controlled trial. They recruited 60 subjects suffering with GERD from a private digestive clinic in Spain. They received two sessions of a single manual osteopathic technique aimed at the patients epigastric area for 5minutes. After just one 5 minute treatment patients symptoms improved by 37.8%.

It must be pointed out that during most osteopathy treatments a variety of techniques are administered so this may lead to better improvements. The researchers had to limit the treatment to one osteopathic technique so they could clearly measure that each patient was receiving the exact same technique for same amount of time..

If you’ve been suffering from heart burn and would like to try osteopathy then please get in touch.

References:

Chen J, Brady P. Gastroesophageal Reflux Disease: Pathophysiology, Diagnosis, and Treatment. Gastroenterol Nurs. 2019 Jan/Feb;42(1):20-28. doi: 10.1097/SGA.0000000000000359. PMID: 30688703.

Eguaras N, Rodríguez-López ES, Lopez-Dicastillo O, Franco-Sierra MÁ, Ricard F, Oliva-Pascual-Vaca Á. Effects of Osteopathic Visceral Treatment in Patients with Gastroesophageal Reflux: A Randomized Controlled Trial. J Clin Med. 2019 Oct 19;8(10):1738. doi: 10.3390/jcm8101738. PMID: 31635110; PMCID: PMC6832476.

Richter JE, Rubenstein JH. Presentation and Epidemiology of Gastroesophageal Reflux Disease. Gastroenterology. 2018 Jan;154(2):267-276. doi: 10.1053/j.gastro.2017.07.045. Epub 2017 Aug 3. PMID: 28780072; PMCID: PMC5797499.

Sharma P, Yadlapati R. Pathophysiology and treatment options for gastroesophageal reflux disease: looking beyond acid. Ann N Y Acad Sci. 2021 Feb;1486(1):3-14. doi: 10.1111/nyas.14501. Epub 2020 Oct 4. PMID: 33015827; PMCID: PMC9792178.

💥Lumbar Disc Herniation Symptoms💥

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😨 The lumbar area of the spine (the lower back) is the most injured area. The vertebrae are and discs are bigger than anywhere else in the spine, and this reflects its function as a shock absorber.

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🦴A herniated disc is also known as a prolapsed disc & sometimes "slipped disc." There is damage to outer layer of the disc called the annulus fibrosis that allows the nucleus pulposis on the inside to herniate. This can compress and irritate the spinal cord & spinal nerves. This results in a multitude of symptoms that include pain, weakness, and sensory loss. This is often referred to as "sciatica."

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Presentation:

👷Often patients will recall an incident that triggered the pain such as lifting & twisting.

💥Pain is often described as sharp, burning, electric shock or a dull ache.

⚡️ Pain can radiate in the distribution of the affected nerve root.

❄️In more serious cases this can result in a loss of sensation, numbness, pins and needles, itching,

💪 Each spinal nerve innervates certain muscles of the lower limb called a myotome which can present as weak. L3/4 weakness would present as difficulty straightening the knee. L5 issues would prevent you to push up onto your toes.

💦 In extremely serious cases there may be changes in the bladder or bowel & sexual dysfunction. THIS SHOULD BE TREATED AS A MEDICAL EMERGENCY

🤸‍♂‍Often most movements of the trunk will cause pain. Some patients present with a certain movement such as side bending to the affected side or extension.

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📊Almost 85% of patient’s symptoms will resolve in 8-12weeks without any treatment. However, that is a long time to be in severe pain. Around 30% of patients complain of low back pain after 1 year. Chronic symptoms are also associated with mental health disorders such as depression & anxiety.

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🚶Most patients complain of worse pain when sitting & reduced pain when walking. Current advice is to try to keep moving in small doses. This might be 2-3 5-10minutes walks each day or a specific set of mobility exercises.

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🙋‍♂️Have you suffered from these symptoms? Please share in the comments what they were & how long it took to resolve to help someone suffering the same 👇

Living with chronic pain is disabling. For some sufferers it is the primary complaint of diseases such as fibromyalgia and for others it might be a progression of a degenerative disease such as osteoarthritis (Mao 2017).

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It's widely accpeted that you cannot treat chronic pain the same as acute pain. Patients have to manage their lifestyles and their own expectations (and possibly the expectations of family, friends and work colleagues). A more long term approach must be taken and patients encouraged to reflect and self-manage themselves with the guide of a clinician . Too often patients with chronic pain problems are looking for a magic bullet and will hang all of their hopes on a single treatment such as steroid injections. It’s only when they start to reflect on their activities, lifestyle and stressors that they can truly manage their condition and move forwards.

I've put together a list of techniques that I use myself to help manage my chronic pain that's resulted in a total knee replacement revision. I paticularly find exercise really helps me. If I am consistent and don’t push too hard then my knee feels loose and I can manage the pain quite well. However, if I get over zealous in the gym or do a really long walk I will suffer for a couple of days afterwards.

Read through and let me know what you think. Feel free to leave your tips in the comments.

References:

Mao J. Challenges of managing chronic pain BMJ 2017; 356 :j741 doi:10.1136/bmj.j741

I treat lots of runners in my Colchester osteopathy and running clinic. They range from people of all ages and abilities. I really like the challenge of each runner with the pressure of getting someone ready for an event combined with their unique biomechanics and training methods.

Over time I have seen patterns in new runners. I see the same mistakes being made repeatedly causing injury, pain, and time away from running. Here’s my top four mistakes that new runners are making.

1. TOO MUCH TOO SOON

New and experienced runners are guilty of this. You get the runners high, the more you run the better you feel. It can be intoxicating. But I will let you into a secret. 99% of running injuries I see in my clinic are from doing too much too soon. I performed an audit for 2021 and I saw one runner who was injured because of an accident and that was twisting their ankle in a pothole. Every other runner was direct result of a training error.

Whether you’re trying to increase your long run and weekly mileage, interval training or hill sprints - introduce them gradually. Yes, you might be able to complete the session, but can your body recover and adapt from it? For instance, did you know it takes tendons three times longer to recover than muscles? While there is nothing like looking back on a good training week and counting the miles make sure you plan recovery. Take time to assess your body and note how it feels. A niggle might be the start of something not having enough time to adapt.

Employ the 10% rule. If your goal is to increase your long run or your weekly mileage try not to exceed more than 10% of the previous week’s volume.

2. RUNNING THROUGH THE PAIN

While a little pain is good for us and strengthens us physically and mentally, it’s important to differentiate between a “working” pain and a “hurting” pain. The working pain might be your thighs burning while running up a long hill. We kind of expect this pain if we want to get better at running. A hurting pain might be a joint or tissue that gets sore the more you run and inevitably worse when you stop running especially 24hours afterwards.

3. NOT WEARING RUNNING SHOES

Running is a repetitive and high impact activity. If you’re new to running then your bones, joints, muscles, tendons, and other connective tissue will not be used to these high levels of impact and force. You need to get the right tools for the job. They will help cushion your feet and joints from the impact. Good quality running shoes help reduce your risk of pain and injury - meaning you’ll have a longer running career.

Get a pair of running shoes. They don’t have to be the most expensive pair on the shelf, and you probably don’t need a gait analysis for now. I advise using www.sportsshoes.com as they have shoes for anyone’s budget.

https://www.sportsshoes.com/running/

4. NOT TAKING REST DAYS

Running will absolutely improve your cardiovascular health, improve endurance, tone you up, help manage your weight and do wonders for your mental health. But let’s make one point clear. You’re not getting fitter during your run. All that’s happening is you’re stimulating your body and overloading your tissues whether that be the heart and lungs or muscles and tendons. Your body gets fitter after the run if you have enough rest. New runners should probably not run-on consecutive days to avoid overtraining and breaking down tissue. Think about creating the best environment for your body to recover. Good hydration, a healthy diet with plenty of fruit and vegetables and lean protein and prioritise sleep.

I hope you found these tips useful. Feel free to leave a comment if you have any tips to add.

I love treating runners. They are without a doubt my favourite patients. Probably because I’m an ex-runner myself. I say ex-runner, as I’ve had two knee replacements and dare not run anymore. I know the joy of getting out the front door and onto the road and what it can do to your mental health. I’m also more than aware of how dispiriting it is not being able to run due to pain and injury. I am passionate about running, running training, and running injuries and I make it my business to stay up to date. 

So, what is my philosophy of treating runners and how can osteopathy help? 

One of the key concepts of osteopathy is to treat every patient as an individual. I don’t care whether you’re a seasoned club runner or you’re two sessions in on the Couch25K plan. To me you’re a runner and you’re an athlete so you deserve to be treated like one with the best care in the area. I know you are at your happiest when you can run so I will do everything I can to keep you running. 

On the initial session I will take a full medical history and ask plenty of questions about your training (or lack of!). This might include, how long you’ve been running for? What are you last six weeks of training? How quickly have you increased your mileage? I will ask questions about your injury like, does your injury swell? Is it worse in the morning? Is it worse at the start or end of a run? Have you had it before? 

I will assess you biomechanically looking at posture, gait, joint range of motion and muscle balance. This will include single limb strength, quadricep to hamstring strength ratio. I will assess your joint mobility. This might include the flexion and extension of your big toe. How much dorsiflexion you have and explain to you how this relates to the Windlass mechanism and your running gait. I will try to explain things, so you understand and educate you as much as possible.

Once I’ve given you a diagnosis, we will BOTH agree on a treatment plan. Not only will this include treatment on the couch but a full progressive rehabilitation plan including strength training. We may have to talk about modifying your running frequency and intensity. 

On the couch you might be offered massage and osteopathic techniques such as mobilisation, manipulation, and neuromuscular stretching as well as dry needling and acupuncture. If you have a tricky tendon or plantar fasciitis there is access to shockwave therapy. 

Proper rehabilitation is key. We may need to implement simple exercises you can do for five minutes per day. If it’s more complex, then you might have to follow a progressive strength training plan. This is where follow up sessions come in. We’ll need to measure your progress whether it be increased strength, power endurance or increased range of motion in a joint. I will use this information to optimize and progress your current plan. 

My primary goal is to get you back on your feet and running as soon as possible. 

My secondary goal is to make you stronger, so you don’t have to come back for the same injury.

Once your injury free I have links with running coaches and clubs in the Colchester area. This can help increase your fun and commitment to running. You never know you might get a new PB!

If you consider yourself a runner and you’re experiencing pain, then it’s important to get your advice from a healthcare professional. I see so many runners of all abilities who have been in pain for months or made an injury worse as they’ve been listening to Barry the bricklayer give his “expert” advice on what worked for him when he self-diagnosed his own shin splints. Every onset of running injury is different just like we all have our own running style and DNA. Therefore, it’s important for a full assessment to be performed so we can get to the root of the problem and address it quickly. 

GET IN TOUCH

If you want to work with a friendly and knowledgeable local osteopath, then please get in touch to book and appointment. 

Call: 07900363938 or email info@shauntyler.com

All the competitiors and staff after a hard day of competition.

Yesterday I was a guest instructor for a charity bootcamp on Abbey Fields. It was organised by Gabriel Beckett the owner of Colchester Bootcamp. We helped raise £740.00 for the Samaritans.

As you can see by the photos there was a massive turnout. It was fantastic to see bootcampers of all ages working so hard and having fun.

It was run as a round robin. Three groups of thirty people, moving through three 40minutes fitness sessions with a five minute change over in-between. I taught the boxing session so it was great to take off my osteopath hat and put on my old bootcamp one. The atmosphere was infectious from the intensity, comoraderie and smiles.

I’d really recommend Colchester Bootcamp to anyone who’s looking to get fit and have some fun along the way. They are a great bunch of people and it’s a very friendly and caring community. The lead instructor Gabriel Beckett really cares about his members and offers lots of support and encouragement.

Keep an eye on this blog for the next charity bootcamp.

Is lower back pain creeping into your life? Are you waking up with a stiff back or finding it increasingly hard to put your socks on in the morning? The clocks have gone back and we have less daylight and less time for activity. Add in a little bit of low energy and mood with a reduction of mobility and it’s no wonder you might be feeling muscles spasms or restricted joints. This short blog will give you the tips and tricks to get your back pain under control.

If it’s your first bout of back pain or you have back pain accompanied with leg pain or any paresthesia such as pins and needles, numbness, burning or shooting electrical pains or anything you’re worried about then please drop me a line to get booked in so that your back pain is properly assessed so we can rule out any sinister underlying causes. Please email info@shauntyler.com to book in with osteopath Shaun Tyler.

The below advice is for general back pain. The most effective treatment is the one that is tailored specifically for you. This will include treatment, specific advice based around your age, activity levels, job and lifestyle. It should include self management techniques and a progressive exercise plan.

Lower Back Pain Advice

Don’t Panic… 90% of people who experience low back pain will be fully recovered by 12weeks. There is good natural history to low back pain. Back pain isn’t often caused by serious structural damage. Try to stay positive as having a good mental state will really help your recovery. However if you’re worried and you don’t feel that you’re managing the pain then please get in touch so we can help you.

Find a balance… I often refer to this as the “Goldilocks Principle.” Too much of one thing whether it be movement or rest can trigger more pain. Too little and there won’t be enough of a stimulis to help you.

Try to keep moving... Movement in the right dose will definitely help you recover quicker and manage your pain. Be mindful not to push through pain. Use the traffic light system below so you can gauge whether you’re doing too much or too little.

Try a pacing strategy… If you’ve read any of my socail media or blog posts then you’ll be familiar with this concept. Pacing is about taking a break before pain reminds you that you need one. This will take a little bit of getting used to to implement effectively. It will help you find “the just right” dose of movement to help you recover more quickly.

Try heat… Applying a heat pack on the painful area for half an hour a day is a great way to help reduce pain. It can also help improve blood flow to the area that brings with it nutrients and oxygen to help the area recover more quickly.

If you try these techniques and you’re still worried or in pain then please don’t hesitate to book in for an appointment with Shaun. You can email info@shauntyler.com or call 07900363938 to book your appointment.

This is a quick blog just to let everyone know that Shaun Tyler Osteopath will be taking a well earnt break next week. Clinic will be closed from Monday 16th August 2021 until Friday 20th August 2021. I’m off to Suffolk to get some fresh air, relaxation and to eat my weight in cakes and pasties :) 

If you’d like to book an appointment, then please call my number 07900363938. You’ll be able to speak to my super receptionist to get you a slot. 

Did you know that you can also book online?

You can book yourself an osteopath or exercise rehabilitation appointment in Colchester by clicking the link below. You’ll be able to choose a date and time that’s convenient to you. It’s very simple to use. 

https://bookings.gettimely.com/shauntyler/bb/book

Have you checked out my Instagram profile @shauntylerosteo? 

If not, then please give it a follow and have a look at the posts. There’s some interesting information and videos on what do if you have acute pain, lots of advice for runners, the older adult and for general aches and pains too. I’m trying to make it a go to resource for anyone with musculoskeletal pain in the Colchester area. 

I’d just like to take this opportunity to say thanks to all my lovely patients for supporting me and my family. It really gives me a buzz when a new patient comes to see me on a recommendation. 

Thanks for your custom and support. 

Shaun 

Do you always have a niggly calf?

Are you always “pulling” the same calf?

Are you a runner based in Colchester, Essex?

Often when I see a runner from Colchester with a calf strain they will present with a sharp pain or a “tight” feeling. I once heard a runner say that “it felt like I’d been shot!” If you runr and you’re always pulling the same calf muscle then read on as I’ve got some advice for you.

Most calf injuries occur in the medial head of the gastrocnemius. This is the inside of the upper calf. It’s the third most common site for muscle strains in elite athletes. The second most common site is near where the two muscles in the back of your calf blend into the Achilles tendon. This is called the musclo-tendinous-junction or MTJ for short. Lastly and less common is the lateral gastrocnemius, or the outside of the calf that can also be injured.

The gastrocnemius is the chunkier muscle in your calf. It’s a biarticular muscle meaning it connects over two joints, the knee and the ankle. It has a high density of fast twitch muscle fibres. Most injuries are more acute and the runner will experience a sharp pain or tight calf muscle. This might be from increasing interval training or speed work into their training too quickly. Imagine driving off your back leg during your stride, up on your toes with your knee extended. This puts stress through the gastrocnemius and this is where the “pull” happens. It’s a bit like cracking a whip.

The soleus is the slimmer muscle lower down the leg just above the Achilles. It’s a mono-articular muscle meaning it only attaches over one joint. It attaches onto the fibula and the tibia bones then into the Achilles tendon onto the heel. It’s made up of predominantly slow twitch muscle fibres. Injuries to this muscle are more sub acute or chronic. The mechanism of injury is similar to running uphill. The foot is dorsi-flexed (pulled upwards) and the knee is bent so there is stretch across the soleus. Injuries to this muscle often occur when a runner has increased their mileage, they’re doing lots of hill work.

Here’s a list of the main causes of recurrent calf strains in runners.

Lack of Tissue Capacity

One of the problems I see with a lot of runners is that their calf muscles aren’t able to cope wit the amount of training and miles they put their legs through. Your calf muscles and Achilles tendons absorb up to 9 x bodyweight with each stride. It stands to reason that you may want to pay some special attention to your calves. It might be even more prudent to see if the side you keep injuring is as strong as the good side. Adding in a couple of short strength sessions that include some calf raises, hops and plyometrics can really go a long way to increasing tissue capacity so you can adapt and recover from your runs.

Training Error

It’s been reported in studies that 60-70% of all running related injuries are caused from training errors. This means you’re probably running too much or too fast with too little recovery or after doing too little for too long. Keeping a training diary and recording any niggles can help you manage your training and recovery. If you’ve just started hill training and you’re getting a pain in the soleus and it’s getting worse with each session then you’ve got some objective data to inform your decision making. As an osteopath it’s also really helpful when a runner brings their training diary as I can identify trends and spikes in load.

Could it be a nerve?

Sometimes a recurrent calf strain can be caused by an irritated nerve. The calf is supplied by the tibial nerve. Symptoms are almost the same. A tight calf, pain on movement andpossibly weak. The nerves can become compressed and inflamed causing a lot of discomfort. Sometimes it can cause cramping. This is often misdiagnosed as a calf strain. It’s important to see a health professional to make a diagnosis and treatment plan. Often the nerve pain can be coming from another area of the back. If it is from the back that is a sign of L5 radiculopathy and must be assessed and managed as a matter of urgency.

Impaired Biomechanics

As a registered osteopath I take an interest in the biomechanics of the muscles and joints. Runners with recurrent calf strains usually have a tight calf complex causing a lack of dorsiflexion. This can be from high arches, bone anatomy, plantar-fascia problems, osteoarthritis of the big toe or a lack of big toe extension. Every person is different this is why having a bespoke assessment that takes into account biomechanics, training experience, current training plan, past history of injuries and even medication can save time, money and get you back running as quickly as possible.

Worn Out Shoes

I know you love your current running shoes but let’s be honest, how many miles have they done? Do they make your foot feel stable and supported? Has the grip worn away and you’re sometimes slipping in the wet? When you put them on do you feel like you’re standing on the sides of your feet? If you’re nodding side to side at this moment then it’s time you changed them for a newer model. Your shoe is the first point of contact with the ground and if it’s not doing its job then your biomechanics and shock absorbing properties will be below optimal. If you feel you require a gait assessment then please get in touch as I work with an amazing podiatrist at Colchester at Reflex 18 Injury Hub.

If you’re based in Colchester and would like to see me face to face to discuss your calf strain then please drop me a line or give me a call. Not only will I make you better, I will make you better than you were before.

Email: info@shauntyler.com Telephone: 07900363938

For the past few days I've been researching about gut health and how it's linked to osteoarthritis and pain. This quote is from a study that's updating the common thinking that osteoarthritis is about wear and tear on the joints.

Our gut contains a reservoir of microbiome that is capable of influencing health of the whole body throughout multiple systems of the body. (Turroni et al 2020).

With a New Year around the corner and the inevitable new years resolutions that come with it, we are all thinking about our health. From the small amount of research I've read it's made me realise the importance of gut health. The gut is linked with onset and progression of various metabolis and inflammatory diseases and now includes osteoarthritis.

If you're wanting to make a change in 2021 and possibly reduce pain or the risk of inflammatory diseases then I would look into improving your gut health.

This doen't mean going out and buying a magical supplement or following a fad diet. It means starting with being a bit kinder to yourself. Try to reduce stress, drink more water, eat less sugar and make your diet more colourful. all of these things that we have complete control over can help keep your gut diverse and healthy.

Be kind to yourself.

It doesn’t matter if you want to run faster, longer, perform better or move without pain then you need to identify your weakest link & then have a plan to strengthen it. I try to treat all of my patients as athletes. Like the athlete on the start line I want my patients to get the most out of their lives. I try to create a professional, supportive environment to help coach them to being happier & moving with confidence & without pain.
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Your weak link might be your stiff hip, the ankle you always twist or that nagging back problem that always seems to "go" just as you get on holiday.
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For an athlete or sportsperson this might be a weak muscle or restriction that makes another part of the body work harder. This might lead to increased fatigue, sub optimal technique & biomechanics. This often leads to niggles and eventually injury. Injury means pain and pain means reduced playing time.
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In periodisation there is a phase of training called GPP or General Physical Preparedness. In football this might be pre-season, in athletics the pre track phase. Basically, it's where you work on specifics in your fitness, co-ordination, movement & mobility so that you can improve on more skill related work later in the season. It might also be rehabbing an old injury or niggle. Think of this phase as finding the persons weakness & then making a plan to eliminate it.
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To MY patient I see in my clinic, this would involve finding out what that person wants to achieve. What do they love doing? What do they want their body to be able to do? How often would they like to do it? How far away from that activity are they now? What barriers are in their life stopping them from getting there? I assess where they are now physically and mentally. Then I design a plan to get that person to where they want to be. This is often based around osteopathic treatment, exercise and lifestyle changes. In my experience only by working with my patient collaboratively can they improve their physical performance so they can work towards that goal.
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Here's some examples of my patients goals I’ve helped them work towards.

"I want to be able to pick up my grandchildren"
"I want to complete a marathon for charity"

“I’d like to be able control of my back pain better”
"I want to run a sub 40minutes 10km"

“I want to be able to have less pain so I can lose weight” “I’d like to be able to manage this problem on my myself”

"I want to join the Para's"
"I want to be confident doing the gardening"
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Once you know where you want to go then you can identify what's holding you back. It's only by addressing the weak parts that you can truly move with confidence and less pain. I take a biopsychosocial approach to this. Not only will we address the physical factors but also investigate other parts of your lifestyle. How much stress are you under & is this effecting your pain levels? How much sleep are you getting? What relationships are supporting you & which are holding you back? Is time management holding you back from putting the work in? It’s is an active process. You will need to take action. It will take commitment, consistency & effort.

At some point you have got to put the work in.
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I’m not your average therapist. I’m a modern osteopath who combines 20years of personal training experience into helping patients transform their lives. I’ve suffered with chronic pain myself & I’ve had the obligatory 3 sessions of physio on the NHS. This didn’t work for me. I’m passionate about making people healthier so they can lead happier lives. I’m based in Colchester, Essex. If you're ready to take the next step & invest in yourself then drop me a line to discuss how we can work together. This might be face to face or virtually.

Email: info@shauntyler.com

Instagram @shauntylerosteo
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Please give this a like & share it with someone who you think needs this.

Sciatica is really painful and debilitating. Often the leg pain is much worse than the low back pain. Pain can run down the back or outside of the leg into the calf, foot and toes. Sometimes it’s a constant ache or numb other times it can be sharp, electrical or burning.

In my practice at AbbeyField in Colchester I’ve treated alot of patients with sciatica. If you’re suffering from sciatica it’s so important to try to keep moving. If you can walk then get moving. If the pain is more debilitating then try some gentle exercises lying on your back. The more you’re moving then the more your are using your muscles as pumps to help flush out inflammation and reduce pain and sensitivity. If you can’t do any of these things then you should seek help from a professional.

I use neurodynamic techniques alot when I’m helping patients with nerve pain and sciatica. They are quick and easy to use. There’s alot of research to support their use (which I won’t go into now). Doing these exercises help reduce irritation of the nerve and may reduce pain and increase range of motion.

If you’re in pain and suffering from sicatica then try this routine below. Work within your own range of motion and pain levels. Start with ten repetitions of each version and build it up to twenty over a few days. Aim to perform this routine three times a day. I was told on a course by an eminent researcher in this field that 10 repetitions evey hour during the day is optimum.

A word of caution that there are many different neurodynamic exercises so it’s important to to see a health care professional to prescribe the right type of exercise and the right dose for you. This exercise isn’t a panacea and should be used along with conventional care such as seeing your registered osteopath, physiotherapist or chiropractor.

Introduction

A week ago, I decided to set myself a 30day challenge of committing to yoga. I’ve been suffering with aches and pains all over my body which I’m sure is a combination of my body adapting to a total knee replacement and increased time working over a plinth treating patients - as well as being the wrong side of 40!

For those patients who’ve seen me will know that I’m a big advocate of exercise and healthy movement. I believe everyone should be moving and exercising to improve physical and mental health. For the past few years I have been very on and off with my fitness and yoga. I thought I would try to finish 2020 with a commitment to daily healthy movement. My aim is to use YouTube so that I can fit in the practice around my family and work. I’m going to keep a weekly blog to let you know how I get on and hopefully inspire you to join in. 

If you type “Yoga YouTube” into Google, you’ll see Yoga with Adriene dominates the rankings. She’s the most popular yoga instructor on the internet. She has rave reviews and there’s so many sessions and plans to choose from. There are 30day plans, sessions for back pain, total body stretch, anxiety and many more. If you look over my Instagram page @shauntylerosteo you can see I’ve followed her before. I like her easy teaching style and personality. She seems real and the sessions are for real people that isn’t InstaYoga where I’m expected to stand on my head in the first session!

I have chosen to follow “Yoga with Adriene Home - A 30 Day Journey.” Firstly, because it fits into my day. There are only five sessions that are over 30minutes. Surely, I can make time for less than 30minutes of exercise per day. We shall see. Secondly because it’s progressive. Each session has a goal and gradually introduces new moves and poses. 

Days 1-7

I’ve got my first week of yoga under my belt. I actually feel quite accomplished with this achievement. I’ve really enjoyed the practices, and this has helped motivating me for the next one. While I’m a little bit frustrated that my left knee won’t bend, and I can’t kneel on it, I have managed to work around some of the movements and find alternatives. So far this has worked for me. I’ve learnt that I’ve got a lot of lower back and hip stiffness and my balance on my left leg is pants. There’s some neural tightness in my right hamstring which is a little nerve entrapment so I’ve added some flossing exercises to manage this. I’ve had to modify sitting cross legged by sitting on two folded towels. This seems to take the stress off my left knee and both hips and makes it alot more comfortable and less painful.

However, it’s not all bad. I feel much better mentally and physically for committing to daily yoga. I can breathe deeper and I’m calmer. I think I’m nicer to live with. I know that I can get flustered easily and my patience isn’t the best. This is probably the biggest change so far for me. It’s well documented that yoga is good for dealing with stress and anxiety. I’ve actually made it through this week without shouting at the kids.

Physically, I can feel my muscles starting to engage in my legs during the standing poses - even though I’m not nearly low enough. The scar tissue around my knee is really tight and painful and I’m hoping through this gentle practice it will start to relax and I’m get more range of motion. So far, I can’t turn the pedals on a bike. I use an electric mountain bike and pedal one legged. I’d love to be able to use a normal bike.

What I really like about this challenge is that somehow Adriene seems like she’s in the room and speaking directly to me. She constantly encourages me to “find what feels good” and this always seems to come at a time when I’m trying to push myself too hard or reach too far into a pose. I’m learning to explore what my body is feeling in each pose and just let it feel good. This approach is much more beneficial for me. I think this is due to the amount of pain, guarding and anxiety I have towards my knee replacement. I’m not getting any intense muscle soreness the next day and my knee pain hasn’t got worse. So far, just feeling good and relaxing is good enough for me.

My Tips

• Find a time and space that allows you to get away from any distractions so it’s just about you.

• Definitely find a level of yoga that truly reflects where you are physically.

• Purchase a decent yoga mat - it really helps.

• Don’t be afraid to modify any of the poses - it’s about you nobody else.

A study followed 264 recreational runners over a 22 week period. They uploaded their physical activity to an online platform where scientists analyzed the data to assess for running related injuries.

The researchers defined a running related injury (RRI) as "a physical pain or complaint located at the lower limbs or lower back region, sustained during or as a result of running practice and impeding planned running activity for at least 1 day."

87 of the recreational runners (about a third of the cohort) reported at least one injury over the 22 weeks.

The researchers concluded that the participants who rotated two or more pairs of shoes in parallel had a protective effect against running related injuries. This might be because there's a slightly different distribution of load with each pair of shoes, therefore changing the stress on the musculoskeletal system.

This is a fairly cheap way of trying to reduce your risk of an injury. It can take up to 48hours for the foam in the training shoes to decompress. EVA foam that is commonly used in running shoes is known to compress over time and shorten the life of the shoe. We know there are high loads when running so it’s imperative the shoe has time to “recover.” If we think about when we have a gait analysis we are dealing with tiny movements often measured in mm so a compressed sole could have an effect on your foot posture as well as the shock absorbing ability of the shoe.

If you are going to start to rotate shoes then I would advise trying to stick to the same model that works for you. This will allow continuity for your foot and running style especially if you’re training for something like a marathon, triathlon or Ironman.

If you do decide to choose different shoes for different runs then I would advise using the same principles as you would with your training. You’d integrate a new training technique slowly into your current regime and that should be the same with your training shoes.

Obviously there are more productive ways to manage running injuries such as monitoring training load, recovery and some strength training. However, if your budget stretches to I would advise investing in an extra pair of shoes. It’s about marginal gains and sometimes these small changes can go a long way to creating a more productive training environment.

If you need help with a running injury please get in touch:

07900363938

info@shauntyler.com

shauntyler.com

Reference:

Malisoux L, Ramesh J, Mann R, Seil R, Urhausen A, Theisen D. Can parallel use of different running shoes decrease running-related injury risk? Scand J Med Sci Sports. 2015 Feb;25(1):110-5. doi: 10.1111/sms.12154. Epub 2013 Nov 28. PMID: 24286345.

In January 2020 the World Health Organisation (WHO) declared the outbreak of coronavirus (COVID-19) to be a Public Health Emergency of International Concern. Fast forward four months and in the UK, we have been in a Government imposed lock down for four weeks. How are we coping?

Personally, my children have taken it quite hard not being able to see friends or go to school. As well as a massive change in routine. The only essential travel we have is a walk to the supermarket to buy food and a drive out to Alresford to deliver groceries to elderly vunerable relatives. 

While I and my family understand the need for self-isolation for public health reasons to help stop the spread of COVID-19. What about the effect on our mental health? 

In my own work as an osteopath I normally see 10-12 different patients per day. That’s 10-12 different conversations and interactions everyday not to mention the small talk when buying a coffee, going to the gym or just seeing people in the street. Four weeks in and those interactions have disappeared. As much as I love my children the conversation isn’t exactly stimulating. 

We are bombarded with daily death tolls and failings in health and social care. People have replaced “good-bye” with “stay-safe” and this all adds to the stress we are feeling as a nation. What practical things can we do to help safeguard our mental health?

Sleep Well

Sleep is one of the most underated interventions for our health.

It’s been well documented that people who don’t get enough sleep suffer more stress and anxiety. While we’re off work it might be tempting to stay up for a couple of hours later to squeeze in another episode of that Netflix series. One night is ok, but, making a habit of late nights will have a detrimental effect on the quality of your sleep and your recovery. 

Try to get into an evening routine which is sometimes referred to as “sleep hygiene.” Stop working at least an hour before you aim to sleep. Have a hot bath or shower and put your phone on silent. I have reports from patients who use eye masks in bed and find they get off to sleep much quicker. 

Exercise Often

Making exercise a family affair and part of the daily routine ensures you can fit your workout in.

Boris has told us that we are allowed out once a day for physical activity. Make the most of it. Now is the time to dust off your trainers and get outside. It doesn’t matter if you walk or run or bike. Just get your heart rate up and keep moving for 30minutes. 

If you can get outside, the fresh air will make you feel invigorated and the exercise will pump the endorphins around your body. You’ll also feel a great sense of achievement. There is a load of scientific evidence supporting exercise to improve mental health. Only yesterday the Chief Medical Officer, Chris Whitty was advocating the use of exercise and said he couldn’t see a scenario where exercise would be bad. 

If you’d prefer to exercise indoors then YouTube is a free resource with thousands of free workouts for you to try. There’s everything from yoga to Pilates to bodyweight instructor lead workouts. You can even type in the duration of the workout you’re looking for. Personally, my favourite is the YouTube channel Yoga with Adrienne as I can choose the duration to fit in with my day. There are also local Colchester trainers who offer online workouts. For a bodyweight workout if would recommend Gabriel Beckett at GB BootCamp. The lovely super awesome Andrea Jane Evans offers fun boxing workouts suitable for just about everyone.

https://www.facebook.com/groups/538476933205618/

https://www.facebook.com/andrea.j.evans.9

The main thing is to stick to a routine. Exercise the same time each day if you can and preferably outdoors to get that zap of Vitamin D. If you can get your kids or partner to do it with you then you’ll have more chance of making it a habit and sticking to it.

Eat Healthy

Try to aim for a diet that is colourful and packed with nutrients.

If there’s one excuse I’ve heard over and over then it’s “I’ve not got time to make healthy food.” Now is the time to make that fruit salad with your breakfast or that smoothie as a snack. Eating a healthy diet is like exercise. You need to build it up slowly. Start by drinking a bit more water and a few pieces of fruit and vegetables per day. Your digestive and immune system will really thank you for it. There’s nothing sexy or complicated about this advice but its evidence based and most people I see don’t hit five portions of fruit or vegetables per day. When we make healthier food choices then we begin to feel better with ourselves. 

Embrace Stillness

Taking a few minutes out for ourselves allows us to recharge out batteries.

We have been constantly bombarded with articles in the media about making the most of the time to learn a new skill. If you’re lucky enough to find ten minutes in the day to sit still and relax then embrace this time. Take time to be mindful of your thoughts and what you’re telling yourself. Don’t let this internal dialogue run away and cause you to catastrophise over something you cannot change. 

At the same time I’m promoting movement and exercise try not to fall into the dark guilt trap. It takes a lot of motivation to get up and get moving. Especially if you’re in pain or have a mental health problem. If you miss a planned workout don’t sweat, it and beat yourself up. Be kind to yourself and try again tomorrow. 

Reach Out If Required

Be brave and reach out to someone if you need help.

If you are feeling down, lonely or isolated then don’t be afraid to reach out. Mental health issues do not define you and it isn’t who you really are. The sooner you make contact with someone the sooner you will be on the road to recovery. You are not weak or a failure. In fact, by asking for help you are being braver than you can ever imagine. Talking is a powerful tool in rationalising mental health problems. 

You may want to speak to a close friend or someone you can trust. They can help sign post you to the right person. Often with mental health people don’t think they are worthy of a GP appointment. They can help book appointments for you and even accompany you for moral support. 

Be brave and talk. 

Stay Social

Humans are very social creatures - stay in touch.

 Social interactions are part of every day life. However, with this lock down we are distancing ourselves from most physical contact. . There is a human need to be part of group and accepted in society. Dysfunctional social behaviour has been implicated with depression and other mental health disorders. This is the time where we really do need to make the effort to pick up the phone or FaceTime that person who’s fell off the radar. If someone is telling you they’re fine but their behaviour contradicts this then keep an eye on them. Offer them an invitation to an online chat or quiz night but also be patient if it takes time for them to take you up on an offer.

It’s so important that we don’t just look after ourselves physically but mentally too. By practicing these simple self-care tips you can not only improve your own health and well being but you might just help somebody else too.

Pinch 👌punch 👊 it's the 1st of the month ⏱. I can't belive March is upon us already. Have you made any goals for this month? There are 31 days in March so that's 31 opportunities to make a positive change. 

My personal goal is to try a gluten free diet and to try to get into a daily routine of performing my knee exercises. 

I've been in quite some pain and had a lot stiffness in my knee over the past 6months due to an infection and it's really taken its toll on me. Being in constant chronic pain is draining both physically and emotionally which is overwhelming. 

I've decided to put myself back into the driving seat and see what this month brings. To keep up my motivation I will be posting some of my sessions on here and on my Instagram stories over at @shauntylerosteo .

These are questions patients often ask. 

1. Do I need to get undressed?

At Shaun Tyler Osteopath I always try to protect your modesty. I often ask patients to bring shorts to change into if they have low back pain or hip, knee or ankle injury. If it is a neck or upper back problem I ask for you to change into a vest. 

2. What is the cost?

The cost of each session at Shaun Tyler Osteopath is £45 per session. The first session is 60minutes and follow up sessions are 45minutes. We accept cash or card. 

3. I'm a little nervous can I bring someone with me?

Of course anything that makes you feel more relaxed. Shaun actively encourages patients to bring along a friend or relative. 

4. Will I be expected to do exercises?

In a nut shell, yes. Every patient Shaun see's is given an exercise and a plan to follow. Shaun is a big believer in self-care and empowering his patients to manage themselves. Advice might be about taking breaks from your desk to manage neck pain to using eccentric exercises for Achilles tendinopathy, to adjusting your load and frequency while training for a marathon. You'll be given a written plan that you can download to your phone with video’s on how to follow the exercises. 

#colchester #osteopath #abbeyfields #essex #colchesterosteopath#physio #runninginjury #lowbackpain #shoulderpain #painmanagement

Every client and patient I see is unique and has a different end goal to their treatment, rehab and training.

I might have two patients with the exact same injury but it's the end goal that makes the treatment plan different. My runner with a knee injury will want to return to training and racing as quickly as possible. While my over 70 year old grandmother with knee pain wants to be able to walk the stairs to prove to herself she still has her independance and ability.

Being in pain or injured is frustrating and can really get you down in the dumps. An end goal makes it easier to visualise your recovery and keep you motivated and on track. It drives the treatment plan and often I prescribe small progressive blocks of exercise to get you to that personal goal.

If you'd like to work with a caring therapist who will keep your spirits high, motivated and working towards YOUR goal then drop me a line for a chat.