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Anterior Cruciate Tear…What happens next?

Last night I attended a talk by Steve Bollen MB,FRCS,FRCSed. Orth., who is is an extremely experienced knee surgeon who has an expertise in Anterior Cruciate recontructions.

Over the years we have seen many advances in knee surgery where the ligament used was an artificial material and the rehabilitation was slow and very restrictive,having to keep the limb immobilised and be non weight- bearing. This often was very difficult especially when you were  treating a very active sports person whose life resolved around being active.

Well things changed and the realisation that early mobilisation with having an accomplished Surgeon operating, followed by  an accelerated rehabilitation by an experienced Sports Physiotherapy Team gave excellent results.

Marie and I have been lucky enough to work with Steve for many years and have had and continue to have  a good working relationship with him. The talk underlined that over the years he has helped many people to get there working and sporting, both amateur and professional lives back.

The Fitness Debate

Well over the past few weeks we seem to be inundated with the perfect way to get fit from Dr Michael Moseley, Matt Rudd, Joe Wicks to name but a few. Included are doing 10000 steps to which means wearing type of   Fit Bit  watch( just to name one) recording your activity levels from walking to sleeping- which could be in something George Orwell could have predicted  to doing a couple of strenuous bursts of activity of 2 xs 20secs… the HITT program where a specialised bike is required.

Reading around these programs I felt that the average person should maybe start from a basic level which is progressed slowly. I typed in Sensible ways to get fit  into a search engine and NHS Choices came up phew…

So thinking of starting and finishing  2018 in a healthier place then this is a good place to start.


Charity Event…Count me in.

Just a reminder when the Mulled wine is flowing and the subject of a Charity Event for an absent friend or relative seems like a good idea that maybe before you sign up consider how to best make sure that it can become a reality and not just a disappointing letdown.

Don’t think enthusiasm and emotion can get you through. This is not a replacement for a sound intelligent training plan and possibly a  quick MOT on old niggly injuries.

I have had may patients who put a lot of time an effort in and out of the gym or  only to be disappointed or badly injured just before or during the event .

Get advice early so your event can be productive and enjoyable.

Don’t Fall For It!

Only frail people fall don’t they? No… one in three over 65 ,many in decent health will have a fall this year. It may be yourself or someone around you . We can’t stop the ageing process but we can manage it better.

Between the age of 50-70 , we can lose 30% of muscle strength and yes you can decrease this by doing some form of regular activity. The basic recommended activity level is 30 minutes five times a week: gardening ,cycling,jogging,walking even vigorous housework can count.

The advice is also to do twice weekly muscle strengthening, for all ages but particularly for the over 65’s.

We treat many people would do regular aerobic exercises but don’t seem to include flexibility or strengthening. Many joint such as knees and shoulder benefit greatly from retaining their muscle mass.

If you are unsure of an appropriate program then your physiotherapist can advise you.

Don’t become that 1 in 3…

Stand up who wants to stay healthy?

A recent article in the Times highlights the fact that sitting down for too long can contribute to conditions including heart disease, diabetes and cancer. The damage may not be undone by exercising outside the workplace.

Scientists commissioned by Public Health England, writing in the Journal of Sports Medicine,said that employers should encourage the workforce to stand as between 65 to 75% of office workers’ working hours  is spent in chairs .

In Scandinavia, it is estimated 90 % of office workers have access to sit-stand workstations compared to 1% in Britain.

Now not all firms can suddenly invest in these type of workstations but they can encourage some basics  behaviour changes . These  may include standing or walking at breaks and lunch, moving the waste bin further away , walking to speak to colleagues instead of emailing, standing to speak on the phone,standing meetings and eventually standing desks.

In addition obvious improvements in posture and gentle stretching exercises  every hour will decrease pressure on the spine  and also improve overall well-being and reduce absentism.

So who wants to stand up now?

Effects of Running and Walking on Osteoarthritis .

There is always a lot of speculation is always around regarding which is best to prevent Osteoarthritis in the hips and knees. There are a few factors to consider apart from the forces applied to the joints themselves. Comparing sports such as soccer, weight-lifting, cross country walking and running brings up interesting results for example that running itself can have less incidence of Osteoarthritis.

There is also the fact that regular running can reduce body weight which can also be helpful in reducing the risk of Osteoarthritis and sometimes leads to an increase in cartilage strength.

So scaremongering about running can sometimes  be counterproductive.

A patient’s history in other sports can be useful and also their occupation can be relevant. As repeated squatting at work can lead to problems.

So running can be a very  useful form of exercise but can actually be  helpful to prevent, rather than cause degeneration of the knees or hips.


Tread slowly.

So the first day of spring is here… We gardeners can’t wait to get onto our plots and start digging and weeding in preparation for that moment when you sit back and enjoy a glass of wine in summer admiring all the hard work we are about to embark on now.


Prepare for this task as you would when you restart any activity or sport do some preparation. Start slowly and always warm up. Make sure you take plenty of fluids when you are working , as it is easy to forget how long you have been pulling , digging, pushing lifting, bending etc…

Stand up regularly and stretch backwards, change activities often so different parts of the body are used i.e don’t stay digging and twisting for more than 30 mins. Stand and admire your handiwork more often.

Start slowly- the season is longer than you think.

Back Talk

Well everybody seems to know someone with back pain or has had it themselves in the past. We have therefore decided to start regular talks regarding understanding of how to have a healthy back and to manage our ever increasing busy and stressful lifestyles including being kind to our backs.

We are beginning FREE monthly talks on causes , management, correct lifting techniques and simple home exercises . They will be on the first Wednesday of every month.

Ring our clinic 0113 2754848 or contact us on the

Remember get FIT for skiing

I have recently seen a few past patients who are telling me excitedly that they are going skiing in the next few weeks. Many have had knee problems which have resolved. Have you started your strengthening programme again then ? “Sorry no I haven’t” is the usual reply.
Whether you have had a problem in the past or never had had an injury, it is worth starting a some preventative strengthening routine. If in doubt get some proper advice from a Physio or trainer so not to spoil a great experience.

New Innovations in Hip Pain Management

Last week we attended an excellent course on Hip Arthroscopy. This is a procedure that enables Orthopaedic Surgeons to examine and treat early problems in hips of the under 45 year olds, so that it may prevent  the necessity for a full hip replacement .

Although hip replacements can be very successful in the older patient it is not an operation that enables the younger patient  to return to a full an active life . Dancers and professional sportsmen and women often need an intervention early in order them to continue their career.

We learnt from the course not only the rehabilitation protocol but the need and means for an early diagnosis . Many of these hip problems can be successfully treated by Physiotherapists with rehabilitation only but the  need to be able to recognise if and when referral is applicable is an important skill.

Thanks to Mr Jon Conroy and colleagues for an excellent course.