How to avoid common sports injuries (and why we all need a physio!)

If you are reading this you’ll probably agree that regular exercise has many benefits.

Exercise is not just great for your body; it helps your mindset too.

The only problem is, even considered and careful exercise includes some level of risk and this means that anyone getting physical has the potential to get injured.


What are the risks?

Apart from accidents most sporting injuries come from people doing too much too quickly and overestimating their ability.

Whilst it can be important to ‘push’ ourselves to achieve a goal or hit a time, this should never be at the expense of sustainable fitness.

There’s also lack of preparation, poor technique and incorrect use of equipment.


Where are the problems likely to occur?

It’s all about your musculoskeletal system.

To put it very simply, it’s all about what holds our bodies together!

Any damage will therefore relate to your muscles, ligaments, tendons, cartilage and bones.

Problems can hit suddenly or they can gradually build up.


What can I do to minimise the risk?

Warming up properly before exercise is critically important. Don’t skimp on this and ensure your warm up is appropriate for the activity you’re just about to undertake.

If in doubt seek help from a professional.

Following on from the above, it is also important to only exercise within your capabilities and this means increasing your time and intensity gradually.

Ensure you have the right kit too. This can be quite a simple thing; for example, wearing the wrong running shoes can cause long-term issues even for occasional joggers and depending on your exercise of choice, forgetting to wear the right protection (a pair of shin pads or a gum shield for example) can have very serious aftereffects.

On a more expensive scale, you must also make sure that any fitness training equipment you are using is in correct working order and is set to meet your shape and size.

This can be any kind of kit from a step machine to a road bike to a rowing boat.


Professional care

Not all sports injuries can be prevented but the good news is you can significantly reduce any risk by working with a professional physiotherapist.

They’ll ensure you work at the right level, use the right equipment – and meet your fitness goals.

They will therefore, not just help you manage following an injury, they will also help you avoid future injury and reduce the likelihood of an earlier injury coming back to bother you.

It’s what we do

This is exactly what we do at Black Pear Physio.

To get in contact and get started call us on 01905 611 010.

Did Team GB success boost UK sports uptake?

With the 2016 Olympic and Paralympic achievements and celebrations now behind us, many people are hoping to see an uplift in UK sport and fitness activity.

So how about you; did the amazing medal wins by Team GB inspire you to try out a new sport or add in an extra fitness session?

Are more people now taking part in sport?

To begin with, let’s rewind to 2012 to see if the London Olympics had any effect.

According to a Government paper from four years ago, sport and physical activity adoption did not change following the UK-hosted games.

In 2006 just over half of us (around 53%) were sporty and this figure had not changed by late 2013.

They told us that ‘hosting the 2012 games has not had a statistically significant positive effect on participation.’

So how about Rio?

Well, the national Team GB sport day on 27th August has been hailed a success. This offered over 2,500 free sporting activities across the UK and attracted hundreds of thousands of participants.

And whilst clear statistics are not available yet, the general feel from local sport clubs is that there has been a post-Olympic uplift in interest and participation.

The jury is however still out, about whether this effect will last.

Here at Black Pear Physio we passionately believe that sport is for everyone.

Having fun in your sport and making it sustainable is key and we are on hand to not only bring you effective relief from any sports related pain, but also help you adopt habits and strategies that prevent injury, or if you have had a problem in the past, any recurrences.

To get in contact please call us on 01905 611 010.

We’d be very pleased to have a chat so that we can help you not only achieve your sports aim, but most importantly, keep it all going!

How to get to (and through) your marathon

As many of you will know, a marathon is a uniquely challenging event.

It takes months of training, eating the right food and getting enough sleep to make it to the start line.

And after investing so much in it, the last thing you want is an injury that forces you to pull out before the big day.

The good news is; with a sensible training plan and the help of a professional physiotherapist, injuries can be avoided.

How can physiotherapy help?

A physiotherapist can be your biggest ally in the ‘run’ up to a marathon.

Physiotherapy can help prevent injuries, treat current injuries and also accelerate your recovery, post-event.

Physiotherapists use techniques to improve circulation and break down scar tissue from previous injuries so you can use your muscles more effectively.

They can also identify areas of tension and prevent injuries from developing.

Top tips to stay safe

At Black Pear Physiotherapy we’ve treated a lot of running injuries.

Based on our experience here are our ‘four top tips’ to help you avoiding injury before you’ve made it past the finish line:

1: Build Steadily

Higher intensity running puts more strain on your leg muscles and joints. This can lead to ‘overuse’ injuries, so rest, ice and stretch as required, and don’t increase your training by more than 10% each week.

2: Vary your training

Varying your marathon training runs can improve strength, stamina and speed while limiting your chances of injury. Why not add fartlek training (variable speed sets) and hill runs to your routine?

3: Strengthen your core with Yoga or Pilates

Many lower limb ‘overuse’ injuries can be attributed to poor strength or activation of the core stabilisers: the gluteals, transverses abdominals, pelvic -floor and quadriceps. Yoga or Pilates is an excellent way to improve core strength and balance.

4: Don’t ignore injuries

If you experience pain, your body is trying to tell you something; so see a physiotherapist. And while you’re at it, they will be able to re-assess any old injuries to see if they’re likely to cause problems down the line.

We can help

At Black Pear Physiotherapy we offer a range of treatments and services to help you stay injury-free from day one of your training to the finish line.

Contact us on 01905 611 010 to make an appointment and we’ll help get you not only get to, but also get through, your next marathon.

Knee Ligament Injuries

Knee Ligament Injuries

What is a Knee Ligament?

A ligament is a short band of tough fibrous connective tissue composed mainly of long, stringy collagen molecules. Ligaments connect bones to other bones in and around joints. They do not connect muscles to bones; that is the function of tendons. Ligaments limit the amount of mobility of a joint, or prevent certain movements altogether.

What Causes Knee Ligament Injuries?

You can injure a ligament through a sharp change in direction, landing wrong from a jump, or the most common a blunt force hit to the knee, such as in a football tackle. The incident usually needs to happen at speed. Muscle weakness or incoordination predispose you to a ligament sprain or tear.

Major Knee Ligaments

ACL: Anterior Cruciate Ligament
PCL: Posterior Cruciate Ligament
MCL: Medial Collateral Ligament
LCL: Lateral Collateral Ligament Coronary Ligament
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Symptoms & Severity of Knee Ligament Injuries?

The severity and symptoms of a ligament sprain depends on the degree of stretching or tearing of the ligament.

In a mild grade I sprain, the ligaments may stretch, but they don’t actually tear. Although the joint may not hurt or swell very much, a mild sprain can increase the risk of a repeat injury.

Grade I sprains usually heal within a few weeks. Maximal ligament strength will occur after six weeks when the collagen fibres have matured. Resting from painful activity, icing the injury, and some anti-inflammatory medications are useful. Physiotherapy will help to hasten the healing process via electrical modalities, massage, strengthening and joint exercises to guide the direction that the ligament fibres heal. This helps to prevent a future tear. A moderate grade II sprain, the ligament tears partially. Swelling and bruising are common, and use of the joint is usually painful and difficult.

When a grade II sprain occurs, use of a weight-bearing brace or some supportive taping is common in early treatment. This helps to ease the pain and avoid stretching of the healing ligament. After a grade II injury, you can usually return to activity once the joint is stable and you are no longer having pain. This may take up to six weeks. Physiotherapy helps to hasten the healing process via electrical modalities, massage, strengthening and joint exercises to guide the direction that the ligament fibres heal. This helps to prevent a future tear and quickly return you to your pre-injury status. With a severe grade III sprain, a ligament tears completely, causing swelling and sometimes bleeding under the skin. As a result, the joint is unstable and unable to bear weight. Often there will be no pain following a grade 3 tear as all of the pain fibres are torn at the time of injury.

When a grade III injury occurs, you usually wear a hinged knee brace to protect the injury from weight-bearing stresses. The aim is to allow for ligament healing and gradually return to normal activities. These injuries are most successfully treated via physiotherapy and may not return to their full level of activity for 3 to 4 months. Definitely seek professional advice in these cases.

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.

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.




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.

Benefits of limbering up

We all know that we are meant to warm up before exercise, right?

Well we should do anyway.

But with so much talk about different ways and methods of warming up it can lead to many of us feeling baffled and a bit confused about the best way of doing it. Everyone seems to develop their own routines and ways they find best to warm up which they stick to however is this really what we should be doing?

A warm up is not only brilliant both to prepare your body, muscles and joints physically for the effort you are about to exert, but also for your brain to be mentally prepared too. In sports like dance and climbing warming up can help mentally by helping you remember technique or in dance terms choreography.

There are two types of warming up methods which are; passive,- an external source warming you (e.g. warm shower) and active-you warming yourself up (e.g. by using exercise methods). It has been found that although passive warming up has some short term benefits active warming up is much more effective if done correctly and is not too intense. An active warm up engages muscles which is a major benefit in preventing injury.

The benefits of warming up before exercise are numerous. Below I have just listed a few of many benefits of a decent warm up:

  • increases blood flow to muscles
  • increases rate of oxygen delivery
  • increased speed of nerve impulses
  • decreased stiffness of connective tissue

So how should we go about warming up?

Firstly raising heart rate is essential, this can be done in any way; skipping, jumping, running, cycling. You should always start slowly in order to prevent injury and then gradually build up the intensity. If you’re not starting to sweat after ten minutes you know you must be doing something wrong!

The second part of a good warm up is flexibility. A term you may not be familiar with which should be done at the second stage of a warm up is dynamic stretching. This type of stretching loosens muscles so that they can perform their full range of motion. In dynamic stretching you should first start off with shallow movements and then build up the full range in stages. An example of this can be with the shoulders doing “windmills” whereby you start off by rotating the arms around slowly and gradually increase the diameter of the circle. You may feel like you are about to take off and fly, but it’s actually a very good way of making sure you don’t pull a muscle in your arms.

The final part of the warm up is sport specific activity it is important to practise the range of movements of the sport you are about to do before you dive straight in which can result in injury. By practising movements you are not only just warming up your muscles you are also engaging your brain, therefore making you better and more accomplished at a certain type of exercise.