Boom Bust – Cricket

On average, 9% of crickets have an injury of some sort at any one time, although in fast bowlers 15% are injured at any given time. Therefore, chronic injuries in cricket are common at all levels. The pressures of squad selection whether it be at a social, amateur or professional level can contribute to players been selected if they are carrying an injury. Niggles can soon develop into full blown injures in cricket due to the repetitive nature of the sport in competition and in training.

There are very different physical demands involved in different types of cricket, which has meant the injury profile is slightly different between 5 day test matches, weekend to 4 day matches and one day matches. The launch of Twenty20 cricket has placed a new physical requirement on cricketers but it is difficult and too early to analyse the effects of these demands in sport injury research.

Lower back pain is particularly prevalent among young fast bowlers. The repetitive action of bowling for long spells places excessive stress on soft tissues, cause stress fractures of the vertebrae inducing conditions such as spondylolysis or spondylolisthesis.

Research has indicated that muscle injures such as hamstring and side strains are the most common cricket injures. These are due to the functional demands of the sport where occasional sprinting and ball throwing maybe repeated over a 7 hour day.

Common Cricket related injuries

  • AC Joint injury
  • Achilles Tendon rupture
  • ACL injury
  • Ankle ligament damage
  • Lower back muscle strain
  • Lower limb muscle strains
  • Rotator cuff tear
  • Shoulder impingement syndrome
  • Knee ligament damage
  • Neck and shoulder pain
  • Finger, hand and wrist fractures

How to resolve/treat these issues using the Boom-Bust theory

  • Take note of the previously issued blog about the cycling boom-bust theory and apply the same principles regarding physiotherapy lead treatment and advice.

Furthermore it is important implement preventative strategies to main your health and homeostasis.

Preventative strategies

  • Core stability control
  • Normal muscle length and strength ratios
  • Dynamic neural tissue mobility
  • Specific strengthening to large and regularly used muscle groups
  • Technique improvement and correction
  • General aerobic and anerobic fitness

Give us a call to discuss anything you need or check out our other Boom Bust articles.

Boom-Bust Cycle for Tennis

Tennis is a great sport; however, it can cause injury to many parts of the body due to the high speed of racquet impact, repetition and use of your spine, legs and especially your dominate arm. This can predispose you to a variety of shoulder, elbow, wrist, hip, knee and ankle injuries. All of which can quite easily become chronic in nature due to the repetitive nature, speed and impact of the sport.

The best known injury related to tennis is Tennis Elbow; however it is relatively uncommon in tennis. It’s a potentially difficult injury to manage as it is a muscle and tendon related injury that can become chronic quite quickly and persist for a long time if not managed well.

A slight niggle can exacerbate into a full blown debilitating injury inhibiting participation. Trying to play through the pain will only make matters worse and will require medical intervention from an experienced physiotherapist.

Common Tennis related injuries:

Lower limb injuries (thigh, knee and ankle) are the most common tennis injuries. They are caused by the sprinting, jumping, pivoting, stopping, jarring and pounding nature of tennis.

Upper limb (shoulder, elbow and wrist) injuries are usually caused by high velocity and repetitive movements required in tennis.

Back injuries and pain are common due to the rotation required to hit ground-strokes, and the combination of rotation, extension and lateral flexion involved in the serve.

How to resolve/treat these issues using the Boom-Bust theory

  • Take note of the previously issued blog about the cycling boom-bust theory and apply the same principles regarding physiotherapy lead treatment and advice

Furthermore it is important implement preventative strategies to main your health and homeostasis.

Preventative strategies

  • Use a tennis racquet suitable for your style of play, experience and size. Tennis players, especially those with arm and shoulder injuries, should seek professional advice when selecting a tennis racquet and choosing string tension. Ask an experienced tennis coach.
  • Check and maintain the playing surface to ensure it is in good condition and free of hazards.
  • Use tennis balls appropriate for your playing surface. Avoid using wet or flat/dead balls.
  • Seek professional advice on footwear. Most tennis shoes are more robust than running shoes due to the multidirectional requirements.

For further tips on our Boom Bust series check out our blogs.

Shoulder instability

The shoulder joint is a marvelous unique structure, being the most mobile joint we have. No other joint can match it in the degrees of freedom it has. However, this mobility comes at a price, the risk of becoming unstable.

Anatomy of the shoulder


Note how the ball (head) of the humerus fits into a shallow socket on the scapula called the glenoid. You can see that this ball does not fit into the glenoid cup exactly, thus allowing for the wide range of movement provided by the shoulder, but at the cost of skeletal stability. Joint stability is provided instead by the rotator cuff muscles , related bony processes and glenohumeral ligaments.

There are 2 main types of shoulder instability:

  1. Trauma related
  2. Excessive laxity of the shoulder ligaments and poor muscle control.


  • The most common cause of instability
  • Usually caused by a fall or direct impact to the shoulder
  • The large force causes structural damage to the ligaments and socket rim (labrum).
  • This tends to lead to repetitive dislocations in some people.
  • Rehabilitation can reduce the chances of this.

Laxity of ligaments and poor muscle control

  • Can be caused through weakness in the rotator cuff muscles
  • Weakness of the muscles that control the scapula and rib cage can also cause instability.
  • It is difficult to keep the ball in a socket that is not controlled through strong ligaments and muscles.
  • Requires specialist rehabilitation to achieve the complex muscle control.
  • Some cases surgery can assist the muscle retraining process through tightening up the capsule and ligaments.


When a shoulder is unstable, it can dislocate. This means that the head of the humerus separates fully from the socket.





Significant trauma is usually required to cause a shoulder to dislocate. The usual direction is anterior. It can go out at the bottom or inferior, or a combination of anterior and inferior. Very rarely does it dislocate posteriorly, but can happen.


An unstable shoulder can also sublux, which is a temporary slip of the head of the humerus. It usually relocates itself on its own or when the patient wiggles their arm or changes the position of the arm.

Additionally an unstable shoulder can cause sensations of instability without any physical separation of the joint. We call this apprehension.


  • Once subluxed or dislocated recurrence is very likely.
  • In people under 25yrs old there is approximately an 80% chance of recurrence.
  • The recurrence rate reduces as age advances.
  • Once a shoulder dislocates a second time, it will almost always continue to re-dislocate with the arm in certain positions and often with less and less trauma.

 Because of the high recurrence rate, the goal of any treatment is to reduce the possibility of recurrence. In spite of this treatment, the recurrence range is still fairly high.

Laxity of ligaments and poor muscle control

When trauma occurs it can cause damage to ligaments, causing them to be stretched, torn or detached from the bone. These can then heal in a loose position of which may increase the risk of future instability.

Alternatively, some people are born with somewhat loose shoulder ligaments. Instability can occur without trauma or injury. The textbooks don’t tell you this do they, but we aren’t all built the same, in fact no two or us are, variation in anatomy is just human!

Muscle control is vital in insuring stability at the shoulder joint and to maintain its correct biomechanics.

Researchers have discovered the importance of your rotator cuff muscles to dynamically stabilise your shoulder joint. These muscles must be strong in order to protect and prevent the shoulder from re-dislocating or subluxing.



As physiotherapist’s at Black Pear we can assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs and get you back to full function.

Contact us here at Black Pear Physiotherapy on 01905 611 010…check out the website for more tips or why not book an appointment to let us help you get back to full function.

How good is your back swing technique?

Do you have the right movement pattern to be able to perform at an optimal level?

It is important to breakdown the fundamental movements involved in the golf back swing so you can improve your distance and consistency while minimising strain on your body.

The majority of movement in your back swing should come from a rotational movement happening in your trunk, but this is a complex movement and it is very easy to cheat and end up moving your legs, arms and lower back, all to compensate for the lack of control and flexibility.

You need stability in your legs and remain free to move in your torso.

If you want to learn to isolate and improve the trunk rotation in your back swing…the key is to load your weight into your back leg properly as you start to turn.

Focus your attention on how your weight is balanced over the top of your feet. It should be evenly distributed through your mid foot and not all back on your heels.

Once you have properly used your legs to set up your address position, slowly initiate your trunk turn and try to keep your lower body relatively still. Keep the weight to the inside of your foot and stack your knee over your foot and your hip over your knee.

At the top of your back swing you should feel like your back leg is taking most of the load of your body. Your back knee should still be bent and feel like your strongly over the top of your back foot.

The back swing movement should create the natural but subtle weight shift to the back leg freeing up weight from the front foot which will allow the pelvis to rotate into the back swing too.

The combination of the twist and a strong stable back leg creates the foundation of power and consistency in your swing.


Ignoring the role of the legs for stability:

It is common to see people initiating the rotation by pushing their hip backwards and straightening their back knee, this will allow you to rotate from your ankles and get the club back, but it will take you off plane and eliminate all the power your legs can generate.

It creates more degrees of freedom to both screw up your swing and hurt yourself.

Tips for training

  • practice with no club
  • start the movement slowly
  • attempt only small amplitude or a half swing
  • as you get better push for further range
  • the further you rotate the more your legs should be doing to maintain stability in your knee


  • Hold full back swing for 20-30 seconds
  • You should feel your legs working and your hip and torso twisting and stretching.
  • This movement and static exercise and warm-up is a great warm-up before you play. Spend 2-3 minutes isolating these rotational movements and your back will thank you after the round.

GolfSwingTraining checklist….

Do you have the right postures?

Can you get into position and hold it?

Do you have the flexibility in your torso?

Do you have the strength in your legs?

If the answer is no, call us today for a physiotherapy assessment we can assist you in getting the right flexibility and strength that is needed to help you get back into the swing of things!!!




SteveRedgraveRowing is a great way to get fit as well as enjoying the beauty of your local river or lake.

It’s a fantastic sport for developing core, leg and arm strength plus all the cardiovascular benefits. It is a sport that utilises our body’s levers: arms, legs and back – to push the oars through the water.

The rowing stroke is a repeated continuous cycle, from a position with the legs flexed, elbows straight to a fully extended knee position and elbow flexion with the oar handle drawn into the body.

A strong back is a vital component to increase power and avoid injury. Poor technique is common and can lead to injuries.

To you rowers out there…you should always be looking to improve the way you row to reduce your risk of injury. Undertaking core and strength training will provide you with the muscular power to cope with the demands of the sport.


Common rowing injuries

  • Lower back pain – most common injury due to constant bending back and forth.
  • Upper back pain
  • Neck pain
  • Knee pain
  • Elbow pain
  • Wrist tendinopathies – from oar rotations
  • Rib fractures – tends to be in elite athletes who are over training.

To help prevent injuries:

  • Maintain a good level of general health and fitness.
  • Warm up thoroughly.
  • Ensure you are stretching as part of your cool down routine.
  • See a physiotherapist for assessment of your muscle strength, length and biomechanics to identify any weaknesses.

Injury advice:

  • Stop immediately if an injury occurs to help prevent further damage.
  • Seek treatment promptly from a physiotherapist.
  • Early management results in less time away from rowing.
  • Apply rest, ice, compression, and elevation until you seek treatment (for soft tissue injuries).
  • Do not resume activity until you have completely recovered from injury and have been advised it is safe by your physiotherapist.
  • Watch your technique and address any errors.

Handy tips for training…

  1. For cardio vascular fitness – try running, rowing, cycling
  1. For strength and endurance- try lifting some weights both fixed and free – make sure all major muscle groups of your legs, bottom, arms, back and shoulders are considered.
  2. Make sure your core stability is good – maybe try Pilates. This is essential to maintain your good posture and technique and keep the boat well balanced.

>>>> Try these tips to help improve your performance and limit potential problems, a varied training programme is important.

Add all these components to your training programme together with skill and practice and who knows what you might achieve.

Contact us here at Black Pear Physiotherapy on 01905 611 010, visit our website for more tips or why not book an appointment to help you row your way to success!



Boom Bust for cycling

Following on from the introduction, we now want to be more specific in terms on how, when and what to do to help resolve your persistent reoccurring injury. Cycling is our first chosen sport that we can look into. So what sort of common chronic injuries do cyclist get that potentially inhibit progress and continue to frustrate “the hell out of you”?

As easy as it is to visualise cyclist crashing and falling of their bikes it is not these types of superficial injuries that prevent them from continuing their plight to success unless it’s involves broken bones. Repetitive cycling may cause overuse injuries which make up a large portion of cycling injuries as a result of certain components not being correct.

Components that may lead to injury:

  • Muscle imbalance/compensations
  • Incorrect bike set up
  • Wrong positioning
  • Too much too soon
  • Not enough recovery
  • Poor recovery strategies
  • Poor diet and/or dehydration
  • Existing injury

Common Cycling related injuries

  • Patellar Tendonitis
  • ITB Syndrome
  • PFJ Syndrome
  • Muscle strains/tears (Calf, Quadriceps, Hamstrings, Hip Flexors)
  • Bursitis

How to resolve/treat these issues using the Boom-Bust theory

  1. Seek help from a physiotherapist. They will assess what you are currently doing and make suggestions to help you get over your issue. They may also screen your functional ability and note any musculoskeletal flaws you may have that could be contributing to your symptoms.
  2. Listen to the advice you have been given and implement the strategies that have been issued. Take some responsibility for your own health and show good compliance with any exercises or restrictions that have been recommended.
  3. Set realistic goals with your physiotherapist. They will be educated on what works best and at what rate so take note and don’t do too much or too little. Pace yourself and stick to the plan.
  4. Use the 10% rule. Establish a daily base line of activity (e.g walking) that does not produce a pain flare or exacerbate your symptoms and gradually increase the time or distance by 10% each week.
  5. Record your activity. Be as specific as possible. Use your devices to track your distance and time and log it down and compare.
  6. Recover well and get enough sleep to ensure your energy levels are replenished each day.

Contact us here at Black Pear Physiotherapy on 01905 611 010 for more tips or why not book an appointment to help you on your road to recovery.

Boom Bust Cycle

Persistent injuries can be a thing of the past if you know how best to abolish the pain by finding the right solution to the underlying causes. Niggling injuries that just don’t want to go away can really interrupt a training program especially when you have a specific goal to achieve or an event in which you want to get a personal best. Setbacks caused by reoccurring injuries can really prolong progression and enhancing physical performance.

If this is something that you can relate to, whether it is in a competitive environment or social setting it can either way be very frustrating.

Injuries that do not resolve and keep reoccurring can be described as “chronic injuries”. The longer the injury has been present, the longer it may take to resolve so getting appropriate input is paramount as soon as possible. People with chronic injuries sometimes tend to overdo an activity which causes pain flair ups which halts their progress.

This process is known as the Boom-Bust Cycle.

This process can be related to all types of setting and over the next couple of months we shall be posting blogs relating to sporting and none sporting activities with advice on how best to treat your condition.




Ouch, my knee hurts

Knee Injury RunningWhether you are a weekend warrior or a highly competitive athlete, you have likely experienced or come in contact with someone who has suffered from some sort of knee pain. Knee injuries, especially to those who are physically active can be extremely annoying and can hinder your activities greatly.  Particularly at this time of year when so many people are in training for the marathon season and are building up their running hours.

The knee itself is a large and complex joint that can be easily injured due to the number of forces that can act upon it.  It consists of four bones: the femur, tibia, fibula and patella.  Also in place are cartilage, meniscus, and several bursa, ligaments and muscles/tendons. All of these structures must work together to produce movement and provide stability to prevent injury

Knee pain can arise from a sudden injury or can progressively build up over a very long time.  Either way, the key to successful treatment lies in accurate diagnosis and treatment based on the best available evidence.

Knee Injury

Anterior knee pain is the most common knee disorder, affecting 1 in every 4 active individuals.  Women are 6-8 times more predisposed to knee injuries than male counterparts in sports that require jumping, landing, cutting, and pivoting maneuvers.  Anterior cruciate ligament injuries are one of most disabling injuries of the knee joint resulting in long term neuromuscular deficiencies. Of those who have sustained an ACL injury, approximately 70% will not return to full competitive sporting activities.  Non-contact ACL injuries account for about 80% of all ACL injuries, with 70% occurring during ground contact after landing from jump and the other 30% occurring while decelerating to change direction.

If your knee is swollen you should arrange for an appointment to be assessed.  It is important to establish what is wrong with the knee in order to treat it correctly in the early stages.

If your knee has started hurting for no reason it may be that local structures around you knee are weak or stiff causing an imbalance and pain. It is very common for remote areas to cause knee pain, for example dropped arches in your foot or weakness in your buttock muscles can create biomechanical problems that can lead to pain.

Knee Injury Prevention

By now you must be thinking “I’m doomed!”  It seems like it right? But have no fear, research shows that moderate physical activity and specific exercise regimens play a significant role in prevention of knee injuries.  Preventative exercise programs may lead to fewer injuries and the loss of your training hours.

Preventative Exercises

Here are some examples of basic exercises that should be incorporated in a knee injury prevention program.  It is important to always precede exercises with some form of warm-up and flexibility program.  All exercises should be performed with intensity and perfect body mechanics (i.e. head high, back straight, tight abdominals, and fast feet) and always allow for adequate recovery time.

  • Flexibility
    • Glutes, Hamstrings, Quadriceps, ITB, Gastroc-Soleus, Hip Flexors
  • Strength (Quadriceps, Gluteals, Hamstrings, Core)
    • Stiff-legged Deadlifts, Lunges, Squats, Monster Walks
    • Russian Twist, Abdominal Rollout, Woodchoppers
  • Plyometrics
    • Backward/forward/lateral jumps, box jumps, bounding, depth jumps, lateral box push offs
  • Balance/Proprioception
    • Cariocas, Wobble board balancing
  • Agility
    • Rope skipping, Agility T Drill, Sprint Lateral Shuffle, Illionois Course

To maximize the benefits of an injury prevention program, incorporate yoga and pilates into your exercise regime. When practiced regularly, the benefits are numerous.  Physically, a combination of yoga and pilates can improve muscular strength, endurance, flexibility, postural alignment, body awareness, circulation, digestion, hormonal balance, respiration, immune function, strengthen bones, normalize blood pressure and reduce or normalize body weight. Mentally, it can improve your alertness, concentration, sleep patterns; reduce stress and anxiety and improve your ability to relax.

Above all, don’t suffer in silence.  A knee injury can be easily treated and you can be back to full fitness and training again with the right information and the right pathway to recovery programme for you.

Three simple tests predicting when our lives will end…

Just a bit morbid don’t you think?

Since 1946 the Medical Research council have been undertaking tests of 5000 people born in this year, at the age of 53 they completed the tests named ‘Longevity tests’ during home visits with specially trained nurses. These tests are supposedly able to measure an individual’s personal fitness levels and then give them a predicted age of which they will live to.

The tests incorporate three major areas that determine a person’s level of fitness, and these include; balance, strength, and endurance. To test their balance participants were asked to stand on one leg with their eyes closed for as long as possible and were timed using a stop watch. Those who managed to stand for longer than ten seconds were deemed the healthiest men and women and those who managed less than three seconds were deemed the unhealthiest. What you may find shocking is that those 53 year old who could only manage three seconds balancing- with one foot mid-air were five times more likely to die within 13 years. If you are a 53 year old reading this and cannot balance at all, I’m sorry to say but researchers predict that you are, sit down before you topple over, 12 times more likely to die within the next 13 years.

Another area that participants were tested on was their strength of gripping, this was measured with an electronic handgrip dynamometer which subjects had to squeeze as forcefully as they could. After squeezing with both hands the greatest result was recorded in kilos. Men in the test who performed the worst squeezed 47.8 kg, and those who performed best managed 54.5 kg. In women the best result was 33.9 kg and the worst 27.9kg.

The last test that the participants undertook was a test rather resembling musical chairs- individuals had to sit up and down again in a chair as many times as they could within 1 minute. The performers deemed the ‘healthiest’ managed to do this 37 times in one minute (35 for women) and the unhealthiest ones- the ones more likely to die sooner were able to sit up and down 23 times in one minute (22 for women).

After completing all of the tests researchers combined all three test results into one score- giving an average of all of the results combined. Those who performed the worst were 5 times more likely to die within the next 13 years of their life than the ones who performed the best.

The Longevity tests are usually only undertaken on much older people but from the results that have been found the researchers have proven that these tests are also very useful for predicting health problems in the middle aged. By undertaking the tests doctors can identify people who are in need of making changes to their lifestyle in order to steer clear of ill health and fundamentally enabling people to live longer.

The Medical research centre are not the only ones who have found that being fitter with a higher endurance level can benefit health. In the British Medical Journal American researchers found that increasing physical activity- even by just a slight amount per day (1 hour per week more) had a huge effect on lessening the effect on people who suffer with or already have arthritis of the knee. People with arthritis who did four and a quarter hours of exercise per week were 43% less likely to develop disabilities e.g.: shopping, cooking, cleaning etc: compared to people who only did 3 and a quarter hours per week.

So to sum up, if you are 53 and don’t do any physical activity you ought to start soon, taking a gentle stroll in the park could just save your life (for thirteen years).

Acupuncture to treat headaches?


The National Institute for Health and clinical Excellence (NICE) has recently recommended acupuncture as a treatment for headaches in people of all ages.

The guideline reveals that one person in 50 people experiences headaches as a result of overusing painkillers – which can reduce the medication’s effectiveness and cause further pain.

NICE recommends a number of treatment options one of which being the use of acupuncture, it also highlights how important it is to get a correct diagnosis and appropriate treatment. They state that patients should consider having a course of around 10 sessions of acupuncture over 5 to 8 weeks to really see long lasting effects of reduction in headaches.

Physiotherapist Paul Battersby, a senior lecturer in acupuncture and director of the Acupuncture Association of Chartered Physiotherapists (AACP), welcomed the report.

‘These new recommendations confirm the AACP’s long held view – supported by positive evidence – that the use of acupuncture for tension type headaches achieves beneficial results,’ Mr Battersby said.

‘Half of patient responders report a 50 per cent improvement in their condition after a course of acupuncture’.

So what is the science behind acupuncture? It’s unclear how acupuncture works to ease pains and symptoms however it is believed that it stimulates muscles and releases substances called endorphins which are the body’s natural pain killers. It is also believed that acupuncture blocks neurotransmitters which send out pain signals to the brain.