Do you like to run?

Do you hate to run but think its the best way to get fit and healthy?

Have you had to stop running due to injury?

Or have you given up on running due to recurring injuries?

 

The Truth is, due to modern lifestyle, may of us are not designed to run.

Don’t get me wrong, we are all designed to run, but due to lifestyle factors, work, stress, lack of sleep, poor nutrition, poor postural alignment and muscular balance, we are destined for injury.

These days we can’t just get up and run, we have too many postural and muscular balance issues that we are only asking for trouble. Modern life is very different to the conditions in which the human body evolved.

– We Sit Way to Much

– We don’t move enough

– We are not strong enough

– We over specialise in certain movements / postures.

These mismatches contributes to pain, injury and poor performance.

**Side Note**

If your questioning my statement that we were born to run then I have some info for you.

 

Humans Have:

1. Strong Nuchal Ligament at the back of the head, perfect for keeping the head still when moving quickly, no other primate has one.

2. Enormous Gluteus Maximus muscles, almost devoid of activity at walking speed but a fundamental motor of running gait.

3. Long tendons on hamstring and calf muscles ideal for storing and returning energy to running gait.

4. Short toes, which appear to make little difference to walking, but are vital to make endurance running efficient.

*REF: Bramble, DM and Lieberman, DE (2004) Endurance Running and the Evolution of the genus Homo . Nature 432: 345-352)

 

If you are serious about running and don’t want to get injured, or at least make yourself injury resilient, there are key areas you need to focus on before you hit the pavement.

 

Running Mobility:

Key Areas:

1. Big Toe Extension

Big Toe extension is vital to optimal push of mechanics. Any limitation in range of movement with cause compensation further up the chain.

 

2. Ankle Dorsiflexion

 

2. Hip Mobility 

2. Thoracic (Extension / Rotation)

 

Strength & Conditioning:

You should be doing at least 2 sessions a week focused solely on strength and conditioning. Most runners don’t, and most runners pick up repetitive overuse injuries that could have been avoided. Not only that, this stuff will make you run faster and stronger. So instead of running 7 days a week, do 5 days running and 2 days S&C.

Key Areas:

Targeting Calf / Achilles (Each exercises progresses to a more difficult exercise – once an exercise feels easy move onto the next)

– Isometric Calf Raise (Hold) 60 seconds

– Double Calf Raises 60 seconds 

– Single Leg calf Raises 60 seconds

– Eccentric Calf Raises

– Eccentric Calf Raises – 2 up / 1 down

Targeting Ankle Proprioception:

– 1 Leg Stand 60 seconds

– 1 leg Stand Eyes Closed 60 seconds

– 1 Leg Stand Eyes Open on Cushion 60 seconds 

– 1 Leg Mini Squats with toe taps

Targeting Glutes (2 minutes on each):

– Glute Bridges (2 legs progressing to 1 leg)

– Single Leg Glute Bridges

– Clams 

– Band Walks 

Targeting Hamstrings:

– Hamstring Curls with Sliders

– Hamsring Curls with Stability Ball

– Eccentric Hamstring Curls with Sliders

– 1 Leg Hamstring Curls with Stability Ball

– Eccentric 1 Leg Hamstring Curls with Sliders

Targeting Core:

– Bird Dog

– Planks Variations

– Side Planks Variations

The Best Strength Exercises for Runners

Single Leg Squats

Lunges

Split Squats

Bulgarian Split Squats

RDL (Romanian Deadlifts)

1 Leg RDL (Romanian Deadlifts)

1 Leg Bench Squats (stand on bench and lower one foot towards floor)

Box Jumps

KB Swing

Monster Band Walks

 

Strength Training Workout for Runners

An Example workout for Runners looking to do 2 sessions a week of strength training. Focusing on the key areas with strength and power. Not looking to add any mass or size.

Warm Up Should consist of your mobility exercises highlighted above.

Session 1:

Superset 1:

A1. Heavy Squat 4 Sets x 6reps

A2. Dynamic: Box Jumps 4 x 10

Rest 2-3 minutes

Superset 2:

B1. Bulgarian Split Squat 4 sets x 8 reps each leg 

B2. KB Swings 4sets  x 20 reps

Rest 1-2 minutes

Superset 3 (focusing on hamstrings / glutes / core):

C1. Glute Bridges 2-3 sets x 1 minute

C2. Hamstring Sliders 2-3 sets x 1 minute

C3. Plank 2-3 sets x 1 minute

No Rest

 

Session 2:

Superset 1:

A1 Heavy Deadlift 4 sets x 6 reps

A2 Dynamic Split Lunges 4 sets x 10 reps each side

Rest 2-3 minutes

Superset 2:

B1 Single Leg RDL 4sets  x 10reps  each side

B2. Single Leg Step Offs  4sets  x 10reps  each leg 

Rest 1-2 Minutes

 

Superset 3 (focusing on hamstrings / glutes / core):

C1. Glute Bridges 2-3 sets x 1 minute

C2. Hamstring Stability Ball Curls 2-3 sets x 1 minute

C3. Side Plank 2-3 sets x 1 minute each side

What is the Plantar Fascia?

The plantar fascia is a thick, fibrous band of connective tissue. Its origin is the medial surface of the heel, running along the sole of the foot like a fan, being attached at its other end to the base of each of the toes. 

It is a tough, resilient structure that has a number of critical functions during running and walking:

> It stabilises the metatarsal joints during impact with the ground.

> It acts as a shock absorber for the entire leg.

> It forms the longitudinal arch of the foot and helps to lift the arch to prepare it for the ‘take-off’ phase of the gait cycle.

A force equal to almost 3 times your body weight passes through the foot with each step.  On running, this is much higher and typically happens 90 times a minute. 

Plantar Fasciitis

Plantar Fasciitis is thought to be a degenerative process rather than inflammatory due to damage of the plantar fascia in the form of micro-tears due to overuse. 

Damage tends to occur near the heel, where stress on the fibres is greatest, and where the fascia is the thinnest. The fascia broadens as it extends towards the toes. 

Plantar Fasciitis is often associated with calcaneal spurs. These are depositions of calcium where the fascia suffers most damage. 

Signs & Symptoms: 

1. Painful to walk first thing in morning 

2.Feet are painful after standing, walking, running, specifically in the Plantar Fascia origin 

3.Some Shoes are better than others 

4. Tender on the sole of the foot closest to the heel.

Risk Factors / Causes: 

1. Over Weight Increases the risk. 

2. Flat Feet (Pronation Distortion Pattern)

3. Loss of Ankle Mobility 

4. A sudden increase in training load

5. Poor Footwear 

Treatment of Plantar Fasciitis

Initial Plan: 

1.No Barefoot Walking 

2.Wear Orthotics

3.Before Moving after rest – write the alphabet with your foot in mid air. 

4.No Running 

5.Find a Local Supplier of  Shockwave Therapy

Self Assessment:

So once you’ve taken care of the initial plan its time to assess yourself to figure out whats

causing your problem and what areas to focus on in your efforts to treat plantar fasciitis

and to prevent it coming back. 

1. Foot Posture

 

If your feet look like this:

Then you need orthotics. Before you do anything else go see a local podiatrist or orthotist. 

If your feet are a little less extreme then you may get away with not having orthotics, but in both cases you will want to do these following exercises to strengthen up your foot arches and work on the stability of your foot and ankle. 

Fix 1. Towel Grab

Fix 2. 1 Leg Balancing

Fix 3. 1 Leg Toe Taps

 

2. Big Toe Extension 

Do these tests to determine 1. If you lack big toe extension 2. If its due to joint immobility or soft tissue restriction. 

If you lack big toe extension, as you walk you’ll roll your foot into over pronation to compensate for the lack of mobility. This is usually one of the biggest causes of bunions. 

 

Fix: Joint Restriction – Calf Raises with big toe extension 

Fix: Soft Tissue Restriction – Calf Stretches  

& Plantar Fascia Rolling

3. Ankle Mobility 

Do this test:

While doing the knee to wall test, if you have over 10cm then its good, 6cm or less is bad. Also look for symmetry between feet As above, if you lack ankle mobility, your compensatory pattern is to over-pronate. 

 

 

Fix: Ankle Mobility Restriction – Knee Wall Tests

Fix: Ankle Mobility Restriction – Ankle Mobilisation

Fix: Soft Tissue Restriction – Calf Stretching

4. Pelvic Stability / Pronation Distortion Pattern 

Is your problem from further up? Do you lack hip stability and glute strength that you cant control the biomechanics of the lower limb. Does your knee fall inwards? Tibia Internally Rotate? Feet Drop in and over pronate?

Have a look at this picture and compare it to yourself. 

 

Fix: Clams

Fix: Side Lying Leg Raises 

Fix: Side Plank

 

Fix: Monster Band Walks 

 

Fix: 1 Leg Squats

Fix:  Bulgarian Split Squats

5. Glute Strength (or Weakness)

Following on from the previous point, are your gluten weak so that it allows the above posture to occur?

 

Test 1: Glute Bridge 60 seconds

 

Test 2: 1 Leg Glute Bridge 30 seconds

 

 

Summary 

If you are suffering with plantar fasciitis or even if you are not currently but noticed that you have flat feet or worse, the pronation distortion pattern shown above,  then this is what your are going to do:

Initial Plan:

No Barefoot Walking Until Pain Free

Wear Orthotics

No Running until you can walk pain free. 

Get Some Shockwave Therapy 

Week 1 

Roll Your Feet with a Tennis Ball / Spiky Ball 1-2 minutes per foot each day 

Stretch Your Calves (Gastroc / Soleus) 6 times per day for 1 minute each 

Week 2 

Continue with above but add in:

Big Toe Extension 

Ankle Mobility

Week 3 & 4

Move into strengthening:

Towel Grabbing for 2 minutes twice per day

1 – Leg Balancing 1 Minute per side each day

Week 5 & 6

Glute Strengthening: Glute Bridges / Clams / Side Planks / Monster Band Walks

Eccentric Calf Raises:

Up on 2  and Lower on 1 (3 x 15) 

6 second decent. 

What is the Achilles Tendon?

The Achilles Tendon is a thick, fibrous band of connective tissue, that connects the calf muscle to the heel bone (calcaneus).

 

Achilles Tendiniitis 

Achilles tendinitis is caused by inflammation of Achilles tendon causing pain, swelling and irritation. There are two main types.

  1. Non-insertional: Fibres in the middle of the tendon begin to degenerate due to increased stress and tension. 
  2. Insertional:  The lower heel portion where the tendon is attached to heel bone is affected

Achilles Tendinopathy / Tendinosis 

Achilles Tendinopathy is similar, however, it is a chronic condition without the earlier signs of inflammation, thought to be a degenerative process rather than inflammatory due to damage of the achilles tendon in the form of micro-tears due to overuse.

In both instances, due to over-stretching and tearing of the tendon fibres, inflammation occurs resulting in pain. This  is called achilles tendinitis. If this condition is prolonged or repeated episodes of tendinitis occur, it results in a chronic condition where no inflammation take place but is replaced by thickening and swelling of the achilles tendon. The fibres then harden and even calcify restricting further movement, placing excess tress and tension on surrounding musculature and pain. In some cases, there may be evidence of bone growth ‘spurs’ forming from where the achilles tendon inserts into the bone of the heel. 

Signs & Symptoms: 

1. Gradual Onset of pain and stiffness over the tendon which will become worse with strenuous exercise

2. Tenderness of the tendon and heel

3. Swelling or thickening of the tendon may also occur

4. Pain on active movement of the ankle joint

5. Pain can occur at rest especially first thing in the morning when getting up. 

If you feel a sudden snap or pop in the heel or back of the calf, it may be an achilles rupture.

 

Risk Factors / Causes: 

1. Over Weight Increases the risk. 

2. Flat Feet (Pronation Distortion Pattern)

3. Loss of Ankle Mobility 

4. A sudden increase in training load

5. Tight Calf Musculature 

6. Poor Footwear 

7. Poor Running Technique

Treatment of Achilles Tendinopathy

Initial Plan: 

1.No Barefoot Walking 

2.Wear Orthotics

3.Before Moving after rest – write the alphabet with your foot in mid air. 

4.No Running 

5.Find a Local Supplier of  Shockwave Therapy

Self Assessment:

 

So once you’ve taken care of the initial plan its time to assess yourself to figure out whats

causing your problem and what areas to focus on in your efforts to treat plantar fasciitis

and to prevent it coming back. 

1. Foot Posture

 

If your feet look like this:

Then you need orthotics. Before you do anything else go see a local podiatrist or orthotist. 

If your feet are a little less extreme then you may get away with not having orthotics, but in both cases you will want to do these following exercises to strengthen up your foot arches and work on the stability of your foot and ankle. 

Fix 1. Towel Grab

Fix 2. 1 Leg Balancing

Fix 3. 1 Leg Toe Taps

 

2. Big Toe Extension 

Do these tests to determine 1. If you lack big toe extension 2. If its due to joint immobility or soft tissue restriction. 

If you lack big toe extension, as you walk you’ll roll your foot into over pronation to compensate for the lack of mobility. This is usually one of the biggest causes of bunions. 

 

Fix: Joint Restriction – Calf Raises with big toe extension 

Fix: Soft Tissue Restriction – Calf Stretches  

& Plantar Fascia Rolling

3. Ankle Mobility 

Do this test:

While doing the knee to wall test, if you have over 10cm then its good, 6cm or less is bad. Also look for symmetry between feet As above, if you lack ankle mobility, your compensatory pattern is to over-pronate. 

 

 

Fix: Ankle Mobility Restriction – Knee Wall Tests

Fix: Ankle Mobility Restriction – Ankle Mobilisation

Fix: Soft Tissue Restriction – Calf Stretching

4. Pelvic Stability / Pronation Distortion Pattern 

Is your problem from further up? Do you lack hip stability and glute strength that you cant control the biomechanics of the lower limb. Does your knee fall inwards? Tibia Internally Rotate? Feet Drop in and over pronate?

Have a look at this picture and compare it to yourself. 

 

Fix: Clams

Fix: Side Lying Leg Raises 

Fix: Side Plank

 

Fix: Monster Band Walks 

 

Fix: 1 Leg Squats

Fix:  Bulgarian Split Squats

5. Glute Strength (or Weakness)

Following on from the previous point, are your gluten weak so that it allows the above posture to occur?

 

Test 1: Glute Bridge 60 seconds

 

Test 2: 1 Leg Glute Bridge 30 seconds

 

 

Achilles Tendon Repair & Conditioning 

When it comes to the management of Achilles Tendinopathy / Tendinosis, a focus on progressive loading of the achilles tendon is paramount. Loading the tendon promotes tendon healing by essentially “re-injurying” the tendon and forcing the body to re-start the healing process. 

 

Start Out with Isometric Exercises which provide a good analgesic effect on the tendon.

Hold the Calf Raise for 60seconds.

Repeat 3 times at varying heights.

Do regularly throughout the day.

Then when the pain subsides move onto more concentric and eccentric exercises which have the benefit of lengthening the tendon while strengthening. 

 These exercises are just a sample of many that can be used in a comprehensive treatment program. Set out to do 3 sets of 15 repetitions performed daily. If there is a bit of discomfort while doing it, its fine. Tendinosis / Tendinopathy is one of the few conditions in which its fine if theres a bit of discomfort as the tendon needs to be strengthened. 

 

 

Summary 

If you are suffering with achilles pain or even if you are not currently but noticed that you have flat feet or worse, the pronation distortion pattern shown above,  then this is what your are going to do:

Initial Plan:

No Barefoot Walking Until Pain Free

Wear Orthotics

No Running until you can walk pain free. 

Get Some Shockwave Therapy 

 

Week 1 

Roll Your Feet with a Tennis Ball / Spiky Ball 1-2 minutes per foot each day 

Stretch Your Calves (Gastroc / Soleus) 6 times per day for 1 minute each 

Week 2 

Continue with above but add in:

Big Toe Extension 

Ankle Mobility

Move into strengthening:

Isometric Calf Raises 1 minute x 3 times per day at least (hold with heel at different heights to work full range)

Towel Grabbing for 2 minutes twice per day

1 – Leg Balancing 1 Minute per side each day

Week 3

Replace Isometric Holds with:

Concentric Double Leg Calf Raises (3 x 20 per day – 3/3/3 Tempo)

 

Week 4

Replace Double Leg Calf Raises with:

Concentric Single Leg Calf Raises (3 x 15 per day – 3/3/3 Tempo)

 

Glute Strengthening: Glute Bridges / Clams / Side Planks / Monster Band Walks

Week 5

Eccentric Calf Raises:

Up on 2  and Lower on 1 (3 x 15) 

6 second decent. 

Week 6

Eccentric Calf Raises:

Up on 2  (box or step) and Lower on 1 (3 x 15) – 6 second decent.

Bench Eccentric Lowers (3 x 15)

 

Maintenance:

Roll Feet 3-4 times per week 

Stretch Calves Daily 

Ankle Mobility / Achilles Strengthening /  Glute Strengthening 2-3 times per week. 

In my experience, unless due to direct trauma, the cause of knee pain is never from the knee itself. Rather you have to look above to the hip and the controlling muscles and below to the foundations and stability coming from the foot and ankle joints. Usually you find there’s too much uncontrolled movement or stability around the knee rusting in overuse injuries. Don’t get me wrong, there are multiple ways to injure your knee, and the knee is as complex as it is simple, however, the most common injuries surrounding the knee that we deal with on a daily basis are form overdue and poor biomechanics.

The 3 Most Common Knee Injuries we see in the clinic are:

1. ITB Syndrome 

2. Patellofemoral Pain Syndrome

3. Patellar Tendinopathy

All 3 tend to be overuse injuries caused by poor alignment and control.

ITB Syndrome

The ITB is the band that travels from the lateral hip down to the knee, controlled by two muscles, the Tensor Fascia Latae (TFL) and the gluteus Maximus ( glute max) helping to keep the knee aligned and to control unwanted movement.

Pain starts when the ITB is being overworked in an attempt to keep the knee aligned during walking and running and both the glute max and TFL tighten. This causes the ITB to pull tight and rub against the lateral knee joint resulting in irritation and pain.

Signs and Symptoms:
– Pain over the lateral aspect of the Knee when exercising
– Usually stops when you stop exercising
– Pain going upstairs but little to no pain going downstairs.
– Pain will usually increase the longer you exercise.

Progression of Injury

The pain becomes unremitting, and is felt as a constant dull ache behind the knee cap as the lateral pull of the ITB has started to cause a closely related injury called patellofemoral pain syndrome. You may also feel a dull throbbing at rest.

Treatment of ITB Syndrome

DO NOT FOAM ROLL THE ITB, instead focus on releasing and stretching the Glute Max and TFL, while correcting knee alignment and control.

 

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is pain at the front of your knee, around your kneecap (patella). Closely linked to the ITB Syndrome, and is basically knee cap overload. Due to poor alignment and lack of control of movement at the knee, the patella grinds within its groove as the knee is flexed and extended causing irritation of the cartilage and pain.

Signs and Symptoms:

– Pain when Walking up or down stairs
– Pain when Kneeling or squatting
– Pain when Sitting with a bent knee for long periods of time

 

Patella Tendinopathy

This tendon runs from the kneecap to the tibial tuberosity on the lower leg bone (tibia) and serves as the tendinous attachment for the quadriceps muscle. Injury, degeneration and inflammation to this tendon is called Patella Tendinitis, but once it becomes chronic and no more inflammation is found its then called a tendinopathy.

This injury is also known as jumpers knee and is associated with sports that involve frequent jumping, but this isn’t always the case.

Signs and Symptoms
– Pain Just below the kneecap, specifically when the quadriceps muscle is being used – walking upstairs
– Stiffness in the anterior knee
– Tight Quadriceps muscles
– Unable to kneel

Risk Factors / Causes of ITB Syndrome, Patellofemoral Pain Syndrome and Patella Tendinopathy:

– Flat Feet (Pronation Distortion Pattern)
– Loss of Ankle Mobility
– Poor Hip Stability
– Weak Glutes (Max, Med & Min)
– Weak VMO
– Tight TFL & Quads
– A sudden increase in training load
– Poor Footwear
– Poor Running Technique

Knee Pain Self Assessment 

If a correct and meaningful treatment plan is to be put in place, we first must see where we are starting from. Once these weaknesses are identified and understood, corrective strategies can then be adopted and a rehab plan formulated to not only fix the underlying cause of your knee pain, but also make you perform better, while making more injury resilient.

Postural Assessment 

If optimal stability and control of the knee are to be encouraged, the pricinples of correct static posture and biomechanics must be fully appreciated. Once these poor posture and stability patterns are identified then corrective strategies can be adopted.

The Most Common postural distortion pattern seen in knee pain is the pronation distortion pattern described below.

This can be a result of compensatory patterns from the top down (lower back and hip strength and control) or bottom up (foot posture and stability)

As you continue reading you’ll discover what the likely culprits of this posture are but if you do suffer from this posture statically or dynamically then i would suggest getting a trained professional to check you out before you progress.

 

Top Down Causes:

– Length length Inequality

– Poor Core Stability

– Poor Glute Strength

– Tight Adductors / Hip Flexors / TFL

Bottom Up Causes:

– Flat Feet

– Lack Big Toe Extension

– Lack Ankle Mobility

– Tight Calves

– Poor Movement Patterns

– Poor Footwear

 

Ultimately this can lead to a number of related injuries, not listed to:

– ITB Syndrome

– Hip Bursitis

– Lower Back Pain

– Patellofemoral Pain

– Patellar Tendinopathy

– Hamstring Strains

– Calf Strains

– Achilles Tendinopathy

– Plantar Fasciitis

– Shin Splints

Foot Posture

Over Pronation 

If your feet look like the picture on the left, DON’T YOU DARE start running on them. You need some serious strengthening of your intrinsic foot musculature and insoles / orthotics are recommended. Go see a specialist orthotist for some custom made orthotics, you’ll need more than just off the shelf. You’ll also want to follow the foot strengthening exercises highlighted further down.

Pronation 

If your feet look like the picture in the middle then you may get away with not having orthotics but some off the shelf ones would be recommended. You will also want to do the foot strengthening exercises below.

Neural

Feet like the picture on the right? Great feet! Look after them.

Big Toe Extension 

Do these tests to determine 1. If you lack big toe extension 2. If its due to joint immobility or soft tissue restriction.

Assess Range of motion  in Standing, Standing with knee bent, and non-weightbesring.  50 degrees is normal.

1: Standing – 50 degrees Good / Less than 50 degrees bend knee.

2: Knee Bent – Less than 50 degrees could be tight calves or joint restriction.

3: Non Weight bearing – 50 degrees or more = tight calves / Still less than 50 degrees = joint restriction

If you lack big toe extension, as you walk you’ll roll your foot into over pronation to compensate for the lack of mobility. This is usually one of the biggest causes of bunions.

Fix: Joint Restriction – Calf Raises with big toe extension
Fix: Soft Tissue Restriction – Calf Stretches & Plantar Fascia Rolling

Ankle Mobility

Do the test shown in the video:

As above, if you lack ankle mobility, your compensatory pattern is to over-pronate.

Over 10cm = Good / 6cm or Less = Bad

Also check for symmetry between ankles.

Hip Stability

To Test Static Hip Stability do a 1 Leg Stand as below:

Look for any:

– Drop in Hip Level

– Knee Falls Inwards

– Foot Rolls Inwards

To Test Dynamic Hip Stability do a 1 Leg Squat as below:

Look for any:

– Drop in Hip Level

– Knee Falls Inwards

– Foot Rolls Inwards

Glute Strength

Perform a glute bridge for 60 seconds.

Perform a 1 Leg Glute Bridge for 30 seconds each side.

Hip Flexibility

Thomas Test

Knee Pain Treatment

So you have figured out your faults, your weaknesses. Now its the fun stuff. The exercise you can do to fix it all.

Poor Hip Mobility

Foam Roll Quad

Release TFL

Stretch Hip Flexors & TFL

Stretch Adductors

Poor Ankle Mobility

Foam Roll Calf

Stretch Calves

Knee to Wall Mobilisation

Ankle Mobilisation

Big Toe Mobility

Roll Plantar Fascia

Big Toe Mobilisation

Foot Posture Strengthening

Towel Grabs

Glute Strengthening

Glute Bridges

Clams

Diagonal Monster Band Walks

Monster Band Walks

Hip Stability

1 Leg Balancing

1 Leg Mini Squats with Toe Taps

Core Strengthening

Plank

Side Planks

VMO Strengthening

Glute Bridge with Knee Squeeze

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Terminal Knee Extension

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Patella Tendinopathy – Specific Treatment

Tendon Loading:
When it comes to the management of Patella Tendinopathy / Tendinosis, a focus on progressive loading of the patella tendon is paramount. Loading the tendon promotes tendon healing by essentially “re-injurying” the tendon and forcing the body to re-start the healing process.

Start Out with Isometric Exercises which provide a good analgesic effect on the tendon.

Partial Squat Holds (Double leg and Single Leg)

No video file selected

Wall Sit – Vary Height – Start Higher – Single Leg and Double Leg

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Then when the pain subsides move onto more concentric and eccentric exercises which have the benefit of lengthening the tendon while strengthening.

1 Leg Squats to Bench – Eccentric

1 Leg Pistol Squats on decline Board

1 Leg Bench Step Lowers

These exercises are just a sample of many that can be used in a comprehensive treatment program. Set out to do 3 sets of 15 repetitions performed daily. If there is a bit of discomfort while doing it, its fine. Tendinosis / Tendinopathy is one of the few conditions in which its fine if theres a bit of discomfort as the tendon needs to be strengthened.

Summary

Ultimately, there are plenty of exercises you could be doing, but you don’t have to have a complicated routine with all the fancy equipment and exercises. The key is consistency. Figure out your weaknesses, pick the exercises that you can do easily with little or no equipment that can be done anywhere. Make a short routine – 15 minutes and do it daily. Once you outgrow those exercises, move onto more difficult ones, but always revisit the old ones to top them up.

Good Luck and Make it fun.

The Challenge has 4 different exercises which you have to do each day, with the reps or time slowly increases day by day to help you build your core muscle strength gradually.

The great thing with this challenge is that it doesn’t include any of the traditional sit-ups or crunches that can be harmful for you lower back.

Follow the challenge chart included on the link above each day and let us know how your progress each day by tweeting us @SliverpoolChiro with the hashtag #30dayabschallenge

Self Administered Soft Tissue Release of the Posterior Deltoid using a Tennis Ball

Often you’ll find that the posterior deltoid muscles, along with the external rotators (infraspinatus / theres minor) form adhesions and myofacial trigger points. This will cause dysfunction within the shoulder mechanics, resulting in pain and discomfort.

A great way to release this tension, trigger points and pain is to use a tennis ball.

Perform the posterior deltoid release technique for 2 – 3 minutes working all the soft tissue around the shoulder, hold on any areas of tenderness for about 30 seconds or until you feel a release and then move onto the next area.

McGill Curl Up – Core Exercise / Crunch & Sit Up Alternative.

The McGill Curl Up is a Great execise to work the abdominals without recruitng your hip flexors or injuring your lower back like crunches and sit-ups.

If you want to find out why you should avoid doing crunches and situps then download the FREE report on here.

To perform the McGill Curl up, lie on your back with one leg straight and one leg bent. Place one forearm under the small of your back to help maintain the curve in your lower back (if you find this painful or uncomfortable then remove your arm and place a small rolled up towel instead).

Place your tongue on the roof of your mouth and avoid poking you chin out. Brace your abs and raise your shoulder blades off the floor about 4 inches. Hold in this position for 10 seconds and then return to the starting position. Repeat for 6 repetitions.