Sports Therapy with Simon Heale

at Chelsea Natural Health Clinic, Fulham Rd SW10

What is it?

Succinctly, Sports Therapy is the application of various treatment approaches to sports-people or for injuries occurring through sports or exercise. It includes:
Sports and Remedial Massage
Western Acupuncture
Sports Hypnosis
Performance Coaching
Stretching and strengthening techniques
Advice and Referrals

Rather than describe the ins and outs of each element, I will share with you this week two cases: one, an Achilles Tendon injury and the other preparing and treating a man for his imminent Channel swim.

Treating Achilles Tendon Injury

Mrs S came to see me after severely injuring her Achilles Tendon (AT) training for the 2009 London Marathon. An elite athlete, Mrs S was aiming for a 2:50 finish. The diagnosis was AT tendinopathy and not a torn AT as initially thought, the injury occurring as a result of long term neglect and other factors.

Briefly, AT injuries result from a number of factors including a steep increase in training and intensity, poor self management, muscle imbalance and possible biomechanical issues. The AT presents with the mid-portion extremely tender with strong trigger pain points either side. In more chronic cases there will be an audible creaking as the tendon moves within the tight and tender surrounding sheath. (Paratendon)

Initial treatment to most muscular injuries follows the RICE protocol:

Treatment usually commences from 48 hrs to 7 days following the initial injury or once the swelling and acute phase has passed.

Mrs S required 5 sessions over 3 weeks after which she was able to return to gentle running. Initial examination showed over-worked calf muscles, shortened hamstrings and weakened gluteals. Treatment included soft tissue massage to ease the calves, trigger point work to stimulate the gluteal area, and deep friction along the edges of the AT. A short stretch is introduced early on. Acupuncture in the form of dry-needling techniques is used to reduce swelling, to ease local pain points and to stimulate tissue healing. The patient was shown an eccentric stretch to not only stretch the calf and AT but also to begin strengthening the area.

Over the three weeks treatment achieved all of the treatment criteria: to reduce swelling and pain, increase flexibility and eliminate paratendon creaking. The modalities used were acupuncture (dry-needling), deep tissue massage and friction, resisted stretching, eccentric stretching, heat. Light, non weight-bearing exercise was resumed (patient choice) after one week increasing to slow running after three weeks.

The combination of treatment modalities, rest, stretches and exercise in this case led to a successful treatment of Achilles Tendinopathy. It is also possible that the timing of the intervention, i.e: sub-acute with little or no inflammation present, aided in the speed of the recovery.

Long and middle distance runners are more prone. In runners it presents in a high proportion as overuse, too much running, steep increase in intensity and/or speed, biomechanical issues, insufficient rest, little or no stretching.
Early intervention, correct diagnosis and treatment, appropriate exercises, patient education: self-management, including rest, allows for an efficient Achilles Tendinopathy treatment protocol.

Mrs S resumed full training after 4 weeks and went on to win her next 10k race in 37minutes.

For any information on how Sports and Remedial Massage, Sports Therapy or Sports Hypnosis can help you either contact me using the form below or call me on 07932 393972

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