​Injury occurs when the body is exposed to forces that it cannot process, manage or disperse, and are subcategorised into ‘Overuse’ & ‘Acute injuries’ (or ‘micro-trauma’ and ‘macro-trauma’).
 
Performing repetitive actions with poor technique, at regular intervals, may repeatedly overload the structures of the body, minimally, but repeatedly.  This regular exposure on the muscles, bones & joints (etc.) result in micro-trauma, as the structures struggle with the repeated micro damage, but fail to repair and regenerate fully, before being re-exposed. This is what is termed Overuse Injury.

There are a number of factors involved in developing an overuse injury, as detailed below (see Fig1.) but ultimately the exposure to overload, exceeds the time required for repair resulting in damaged tissue.

Understanding the WHY behind the onset of overuse injuries is the biggest challenge for your therapist, and is where our investigative skills come in to play!

Predisposing Risk factors for overuse injuries can also be considered as Extrinsic (something external to the body that can cause injury) or Intrinsic (being factors internal to the individual person) Fig 2. 
 
The second mechanism of injury is an acute exposure to stronger forces that acutely overload the structures beyond their capacity, moving them in a way they are not designed to move, or exceeding their ability to transmit the forces they are exposed to, resulting in macro-trauma or an acute injury.

​(that would be boring wouldn’t it!). 

The body is a complex machine, and therefore, understanding the mechanism of injury and locating the source of pain is not always a nice yellow brick road to follow.
 
Pain may not necessarily be coming from the site where it is felt.  Referred pain needs to be considered, as does the much more complex phenomenon of chronic pain.

Some medical conditions can masquerade as injury, with mimicking signs and symptoms so discussing your case with a qualified therapist is very important for not missing any red flags, and loosing time to seek medical advice.  If an injury remains unresponsive to treatment, seeking a second opinion or seeing your GP for further referrals is always advised.

The area of pain may not be the area of dysfunction!  In order for movement to occur smoothly, under full control and in a stabilised manner, the whole kinetic chain must work as a coordinated unit, with the separate body segments, or “links” (above and below the limb actually moving and functioning) all moving in smooth and co-ordinated sequences, starting from a proximal base of support (or stability).  This coordination throughout the kinetic chain results in a cumulative effective transfer of force and energy, resulting in controlled and efficient body movement and ultimately safe and effective movement.  A “kink” (injury or dysfunction) anywhere along this chain can result in excess strain or loading/over compensation (& therefore injury) to any muscle group/ or body segment further up or down the chain.  This is why rehabilitation exercises, and taking responsibility of your own injury is so key in a successful outcome – a therapists’ “hands on” treatment can be an excellent modality in your treatment journey, to ease out tension, release trigger points, stretch contracted muscle, break down scar tissue etc., but ultimately we cannot change how your body moves and stabilises' itself  (which is why I like to give exercises to all patients presenting with ongoing or acute issues and why I always encourage ((nag)) for you to do the exercises I set!) (It’s not just because I have turned into my mum).
 
With this is mind, let’s consider how the body moves when running.

The biomechanics of running is a combination of movements, swings and foot strikes that can be analysed and considered in sections when considering potential trigger factors for running related injuries.  Certain abnormal biomechanics have been clinically associated with certain lower limb injuries – and in my future blogs in this Running Injuries Series some of these will be considered – but the science of biomechanics is advancing with some research supporting these clinically noted associations, and some suggesting there is more to consider.   
In simplistic terms, running with optimum body mechanics should enable the kinetic chain to function effectively and transmit forces efficiently enough to not cause over or mis/dis use.
For example, free from excessive motion or restriction (which may cause asymmetrical mechanics and impact somewhere along the kinetic chain) the forces moving though the body should be transmitted effectively, reducing the risk of injury.  Now saying that, and completely contradicting myself! we must always consider that each individual has his or her own mechanical make-up and “normal” (due to structural characteristics), so variations will and do occur.  Although one person may have excessive “flat feet” (over pronation) they could be symptom free and never have had any issues, meaning although they don’t fit the text book profile of “ideal biomechanics”, we can’t consider their biomechanics to be somehow dysfunctional if they are injury free.

To briefly explain the biomechanics of running it is, similar to walking, broken down into stance and swing phases.  The stance phase is divided into contact, midstance and propulsion.  The swing phase divided into follow-through, forward swing and foot descent.  Unlike walking, there is a “flight phase” with running, when neither foot has contact with the ground.  These stance, flight and swing phases change in duration depending on the speed of running (jogging/sprinting), as does the portion of the foot that strikes the ground on landing. 

​It are these considerations that may be taken into account depending on the injury you present with, for example depending on your style of running you may be landing on different aspects of your foot, or your swing time and rhythm may be different or may be affected by commonly clinically associated muscular tightness/dysfunctions.
 
Now, finally, in our journey to understanding the concept of running injuries a little bit better, before moving onto specific body areas, and injuries commonly associated with running in the weeks to come,  let’ s consider quickly the phenomenon of pain.  

​Pain is not an accurate indication of tissue injury or damage! Yes, there are many pain-producing structures within the body that contain nociceptors (the receptors that “feel pain” and transmit these pain signals to the brain), but sometimes pain is reported without any detected localised damage or dysfunction, and sometimes pain is ‘referred’ to distant areas
 
Nociceptors (the pain receptors) can be “fired up” by chemical irritation (as present in inflammation in response to injury), and also by localised muscle spasms in response to an injury, or later, from fibrosities and scarring occurring from an injury repair.  This type of pain response is seen in acute pain presentations and has a clear physiological founding.  Now remember, pain is not transmitted from the site where you feel it, in fact pain is a message from the brain, in response to sensory information it receives, and then responds to (be that information be changes in chemical levels / pressure / stretch on the tissues at the area affected, changes in temperature, but also other sensory input such as sight / sound / touch).
 
Although pain is a useful and vital mechanism to prevent further harm and injury, pain can sometimes be present without any clear tissue damage, and when you enter the realms of chronic pain, things can get a lot more confusing.  Patients with no pain can image (XRAY/CT SCANS) with clear disc protrusions or disc ruptures in the lumbar spine, yet be completely unaware of their physical presentation as they are pain free and functioning well.   Therefore, pain is not a clear indication of lumbar vertebral issues with these patients.  Which leads to question where is the pain coming from and why is it there? Similarly, patients with Limb amputation can still experience pain in the limb that is no longer there.  If it is not from damaged structures, then what has caused the brain and central nervous system to overdrive pain signals?  And how can this impact of the diagnosis and management of injury?
 
Pain that has been present for more than 3 months is classified as chronic pain, and given that most structural injuries have “healed” within 3-6 months, this persistent pain COULD be attributed to more complex factors. It is important to consider the pain is coming from an over-sensitised nervous system, and there are many factors that could impact on that, to include;

• Our thoughts and emotions, mood states and stress levels can aggravate the nervous system
• Ingrained beliefs such as “I am in pain”,  “this hurts”, “I am injured”
• Diet and lifestyle – our fast paced life’s, things such as smoking/alcohol & certain foods can all sensitise our Nervous System
• Psychosocial impact on each individual – such as home life / social circumstances

All these factors need to also be considered when dealing with pain/ and or injury presentations, especially with ongoing pain.

So, as you can see, as I plan to move into more regional pain patterns and injuries associated with running, there are many different factors that may come into play with their management and resolution.  However, I hope this has pointed out some of the main pointers that I, as your therapist, is considering when you present with a niggle, and how you can become responsible for your own rehabilitation and injury resolution.
 
Thanks, and jump over to my socials to stay connected.

​I often refer to what I do as soft tissue therapy, but you may be unfamiliar with exactly what this term is.  Essentially, soft tissue therapy, is probably what you consider to be “massage”, but it is SO much more.  Let me explain why.

Yes, it is true that your treatment will include massage, and as a treatment medium,  massage can be exceptionally effective at breaking down adhesions, softening areas of tension, releasing restrictions, calming the nervous and muscular system,  and allowing patients to access the healing benefit of touch. 

But a well experienced soft tissue therapist will call on so much more than massage alone when compiling a treatment plan to help.
​
Soft Tissue Release (STR) / Myofascial Release (MFR), fascial work, Instrument Assisted Soft Tissue Massage (IASTM) and Muscle Energy Techniques (MET’s) also fall within the brackets of “soft Tissue therapy”.

​Additionally to that, a Graduate Sports Therapist can ALSO call on rehabilitation exercise prescription, be it a few simple stretches or some strengthening or proprioceptive exercises, given as “home work”, to consolidate the hands-on treatment and ensure progressions and improvements are encouraged and maintained.
 
Therapists often also have further qualifications, I hold certificates in Medical Acupuncture, Kinesiology Taping, ScarWork and other further qualifications, but there is abundant further education out there for a keen therapist (such as me, the eternal student!). 

​My treatments,  therefore have strong emphasis on clincal reasoning, and come from a sound understanding of functional anatomy, dysfunction and the mechanism of injury. 
However, with my roots in holistic therapies (I trained in reflexology when I undertook my initial sports massage diploma training), I am uniquely able to bring an intuitive and holistic approach to sessions, in order to offer a fully-rounded treatment suitable to all populations, which brings me on to my next point; Who is soft tissue therapy for?
 
In todays' demanding lifestyle, with occupational, emotional and personal-life demands high,  both physical and emotional pressure is presented by and stored within the body.  Therefore, EVERYONE could benefit from a Sports therapy treatment, and unlike popular belief, it is not solely for the sporting or active person.  Your occupation could place repepitive physical demands that overload structures within the body (I have treated numerous trades men presenting with "tennis elbow" who have never touched a racket).  Desk work, parenting and prolonged stress states can lead to chronic musculoskeletal conditions, negative postural adaptations and strain on the body which may benefit from treatment.

Still unsure?  Away Pain Therapy are at the end of the phone, or email - get in touch for a no obligation chat or to have any questions answered. 

​Skincare trends come and go and the fight against wrinkles is an on-going saga for some. 

Stress levels are rising at worrying rates in the western world, and the negative impact high-stress can have on our overall well-being and health (not to mention on our skin health and outward appearance), is well documented, and well understood.  

Could an ancient well-being practice, incorporated into an indulgent facial massage, be the answer you have been looking for? 
Read on to learn how the Ayurvedic Face Massage Treatment currently on offer with Away Pain Therapy in Hove may offer just that……
 
What is Ayurveda?
Ayurveda is an ancient Indian healing system that aims to maintain a healthy balance throughout the body by addressing our food intake, taking herbal supplements as required, and utilising tools such as meditation and yoga. 
In Ayurveda there are 3 identified types of people, referred to as ‘Dosha’ types (Vata, Pitta & Kapha).  Dependant on which Dosha profile dominates you as a person,  certain traits are present that influence your physique, skin type, personality traits, strengths and weaknesses,  and determine which elements you are essentially ‘made up’ of (earth, water, fire, air, ether).  Working with this knowledge foundation Ayurvedic health care practices aim to bring equilibrium to the body and energy, in order to obtain and maintain optimal health and well-being.

In our non-stop, 'go-till-you-burn-out' western culture, the increasing need to follow the simplistic values of Ayurveda, and allowing ourselves some space and time to recuperate and self-heal,  is never more relevant. 
The Ayurvedic Face Massage offered at clinics in central Hove and Portslade offers you just this.  Taking a tiny fragment from the complex system of Ayurvedic principles, the massage works on an energetic level (due to its focus on  working on Marma points), and a physical level (thanks to the drainage and toning massage strokes) – aiming to bring balance to the subtle energy system of the body and boost complexion.
 
What is the Ayurvedic Face Massage Treatment?
50 minutes of pure bliss.

A tranquil, precise, calming massage that focuses on the Marma (pressure) points of the face, head, neck and scalp, bringing balance and harmony to the body as a whole.   

The treatment is nurturing, deeply relaxing and energetically balancing.  As well as the holistic stress-busting qualities of the Ayurvedic Face Massage treatment, the added bonus of this treatment is the aesthetic effects.  Toning, lifting and sculpting techniques, as well as lymphatic drainage and circulating boosting strokes, really gives you the best of both worlds.  Gua sha Rose Quartz Crystal roller techniques are also incorporated for their natural face-lift effects and toning qualities.
 
Is the Ayurveda Face Massage a facial or a massage?
It’s a tiny bit of both!

With Ayurveda steadily growing in popularity over a large number of years in the world of bodywork,  more recent years has seen a growing trend of incorporating Ayurvedic principles into the beauty world too.  With Brands such as Tri-Dosha, Uma oils, Mauli skincare & Urban Veda hitting the high street, skincare tailored to your specific Dosha profile has never been so accessible.

The Ayurvedic Face Massage incorporates the organic facial products to cleanse & tone the skin before massage application, to ensure no impurities are worked deeply into skin layers. 
A high quality facial oil is then applied for the Marma-focused massage, enriching the skin with complexion boosting oils.  Choosing a suitable product range to compliment your personal Dosha Profile, the Ayurvedic Face Massage is tailored to you and offers you a mini-facial alongside an holistic face massage in order to treat both aesthetically and holistically.  The treatment will bring balance to the body,  boost complexion and reduce stress levels.   

For a limited time only the Ayurvedic Face Massage can be booked at 25% off normal price, contact Kirsty on awaypaintherapy@gmail.com. 

As well as offering Sports Massage in Hove, Kirsty offers Reflexology in Hove, and the Face Massage in Hove, in order to offer clients treatments targeted specifically to stress management,  and to offer busy people some much needed time-out and holistic care.

see more on
 https://www.awaypaintherapy.com/mineral-magik-facials--face-massage.html
 

​As marathon season looms, many of those who have signed up and dedicated themselves to a 2019 marathon will no doubt be underway with some initial training, (or thinking about it anyway!)

Although it may be “early days” in terms of distance, many of the brave souls who plan to run them 26 miles next year may already be running distances they have never before managed, and although many will wait for the frivolities and over-indulgence of Christmas to be out the way before really throwing themselves into serious training, NOW is the time to start thinking and planning on how you can stay injury free. 
 
It’s a bit of a cliché, but prevention really is better than cure when it comes to the body, and what would be worse than months of gruelling, life-dominating training (Sunday morning long runs, booze free nights out, spending your hard earned cash on the new gadgets and gear), only to reach Feb/March next year and be hit with an injury?
 
Unfortunately many people out there perceive massage as a luxury.  (Obviously I’m slightly biased being a soft tissue therapist with 13 years’ experience of working with the body and seeing the results), but I consider regular, good-quality soft tissue work an absolute, body-saving, must-have (for everyone – not just runners).
 
So as you begin to think about and plan, and maybe even start your training…… have a little read on to see how sports therapy sessions may help you.
 
BENEFITS OF SPORTS MASSAGE
·       Improved flexibility – massage deliberately stretches and pulls muscles and other structures around, meaning the movement of these structures, and the joints that they cross, can be improved and restrictions reduced – resulting in greater range of movement. 
Assisted stretching and techniques such as PNF stretching & Myofascial release can also help to improve areas of restricted flexibility, and may be called on in treatment.
Massage also removes adhesions found between muscles & fascia, allowing the 2 structures to glide over one another freely, which is an important factor in the normal function of working muscles.
 
·       Improved circulation – blood flow through muscles is increased during massage, bringing fresh nutrients and oxygen to the area, and helping to remove by-products and waste – helping recovery, restoration and general well-being.
 
·       Relaxation of tight muscles – massage and other modalities will help to combat stored, or residual tension found within the muscles, especially as the longer runs creep into training and muscles begin to work harder than ever before. 
  
·       Improved stability & strength – sports therapy assessments, and rehabilitation can help to identify areas lacking strength or stability that may put you at increased risk of injury.  Home care rehab exercises can be included in the treatment packages in order to address these issues.
 
·       Old injury sites will contain collagen fibres or ‘Scar tissue’.  This scar tissue it less pliable than the tissue it has replaced, and therefore mobility / flexibility and pliability at an old injury site is hindered.  Manual Therapy can normalise the tissue structures around an old injury site meaning the muscle as a whole can work better.
 
 ·       Psychologically, massage can help with the anxiety of training for a big event, and having the support of a qualified therapist and somewhere to turn to for advise can have a great impact on training.  Giving yourself a regular time-slot to have a bit of down-time, and have any issues addressed is a therapeutic experience,  and can reduce stress and increase a sense of well-being that you can take into your training and general life.
 
·       Overall wellbeing - One study noted that the number of one type of White blood cell were boosted post massage (white blood cells are good for our immunity), and Cortisol levels (the stress hormone) were reduced.  Both factors will influence our immunity and overall well-being – key when you are training at intense levels.
 
TREATMENT SCHEDULES
In an ideal, (time-free and money-flush world), you would receive a massage once every 2-3 weeks in the 4 months leading up to your run, shortening this gap to a treatment every 1-2 weeks at the peak of your training.  However, understanding that this commitment is sometimes too financially and time-burden difficult, aiming for a massage once a month in the 4 months leading up the run, and being prepared to pop a couple of extra sessions in at the peak of training, is sure to still help.
 
By starting a good 4/5 months before the race date, time is allowed for long-standing tension patterns / weakness or imbalances from previous injury or current poor-biomechanics, to be identified and, (more importantly),  enough of a decent time-frame to actually address them.
Increasing treatments during the peak training period really keeps on top of things, as you push your body to the longer distances and prepare for the run itself. 
Calling on a Pre event massage, 7-1 days before the event itself, can be a great preparatory step both physically and mentally for a marathon.  Prepping the muscles close to the event to improve performance, relieve pre-race nerves, ready the body and ease away any last minute tensions can give you the best performance on the day, important if you are aiming to beat a P.B. 
 
And let’s not forget the post even treatment in the week following the run, because, let’s face it, you’ll deserve it by then and anything to help with the post-run ache will be welcomed, and it has been proven in studies that massage helps to alleviate DOMS (that post exercise ache).
 
I’ve supported many runners, some brand new to running, some seasoned marathoners, but in all honesty I can say that those who’ve committed to looking after their bodies, and value the role massage plays in their training,  have reaped the injury-free benefits and completed their runs to the best of their body-ability.

Check out the 'runners block booking' special offer currently running with Away Pain Therapy, and get in touch for more info on how we can help you in your marathon quest.