Wednesday, 30 December 2020

Nearing the end of 2020...


Here we are, nearly at the end of 2020 - a year which has been so different to what we expected this time last year. I hope you and your family and friends are well, and that 2021 what will be an easier, kinder year.

I was reading an article by Joanne Elphinston earlier today where she discussed the words resonating with her: resilience but also adaptability, tempered by kindness and patience for ourselves as well as others. There will have been times where we had to weather the storm the best we could and other times when we had the energy to take a breath and look around us for how we can adapt to this unfamiliar situation we find ourselves in. This chronic state of affairs is stressful and exhausting even as it becomes familiar, and so we should be patient and kind with ourselves as well as others - but also recognise that there will be days where it's hard for us or those around us to be patient or kind. 

At present the 919 Clinic is closed for the Christmas holiday; I hope to reopen on Tuesday 5th January but if we move into Tier 4 in Sheffield I will have to remain closed until further notice. Those of you who have been in for recent treatments will have experienced my new couch cover, made from medical grade, phthalate-free fabric that I can clean after each treatment. I think it looks very smart and it has reduced my washing load whilst maintaining hygiene standards.

As we approach New Year's Eve I wish you all the best for the future; take care, hope to see you in 2021.

Monday, 30 November 2020

Letting that back relax... (video)

We often hold tension in our backs without being aware of it; this exercise explores tuning in to relax the back whilst engaging the arms and legs in gentle movement. It is a simple exercise that transfers to how we walk, stand, run....

As you explore the exercise, notice how your body feels against the ground and how your body is absorbing and reacting to the movement. Begin with gentle pressure as you press your legs and arms down into the ground or your feet against the wall and observe what happens with your back. Allow yourself to become as relaxed as possible and notice how the sensation of pressing down travels through your body.

Click on the link below to watch the video:

Wednesday, 25 November 2020

Back again - hopefully!

As I understand it, even if Sheffield is in Tier 3 I can resume treating all clients (within the guidelines outlined on my website) once we come out of lockdown next week!

I am taking bookings for clients at the 919 Clinic from Thursday 3rd December; I am still handling all the bookings myself to please contact me by email or phone rather than the Clinic (contact details on my website). Thursday is filling up fast but there are plenty of appointments available for the following week! 

I am still following the guidance set for close contact work during this pandemic; please do look at the information on my website:

If the situation changes I will post on here to update you.

Tuesday, 10 November 2020

Women's health: pelvic floor

 I listened this morning to a fascinating interview with the physiotherapist Grainne Donnelly. Her practice specialises in male and female pelvic health and a strong message from her was that there is a lot of help out there. She also spoke about her frustration around women having their concerns about their pelvic floor issues being dismissed (including by some medical professionals) due to a common assumption that they are just to be expected and accepted rather than treated, and the need to normalise talking about pelvic health. She stresses how important it is to help women get back to their normal levels of activity including sport.

Her website has resources including free guides for patients on how to improve pelvic health:

The interview I watched is on Facebook; skip the first 17 minutes as that is about working during the lockdown, and when Grainne comes on she initially loses her connection but after she comes back (26 minutes in) it is all really interesting, useful and accessible information. She finishes with some great examples of how to engage with pelvic floor exercises as so many people are not doing them correctly.

As she says at the start of the interview, over a third of women experience post natal pelvic floor issues some of which are life changing and yet aren't talking about them; let's change that!

If you are wondering about male pelvic health there is indeed a second interview scheduled on just this topic, on the same Facebook page.

Friday, 6 November 2020

Lockdown 2 update

First of all, I hope you are well both physically and emotionally; a second lockdown is tough on so many of us, maybe the more so for being the second time around. I am here if you want someone to listen - just email me and I can arrange a Zoom meeting or telephone call.

If you are in pain and struggling, I am still here to help at the 919 Clinic, within the given guidelines.

Here is the latest statement from my professional organisation:

'Business is not ‘as usual’ and this should be absolutely clear. Numbers of infections are increasing exponentially and this lockdown has been introduced to control that. The Law states clearly that a person must not leave their house unless for specific exemptions. Access to Health Services is one of those exemptions.

We, as Level 4/5 when working to treat injury and pain to prevent escalation which may lead to dramatic disruption of daily life activities or lead to access to NHS services, are providing a health service and therefore we can remain open. Again as Level 4/5 we are considered autonomous practitioners as the level of your qualification implies a Clinical Reasoning skill set therefore you do not need to work underneath or having clients referred to by an AHP.

However, Massage as we know it, needs to be dramatically reduced. This is because spending a long time in a room at such close contact is increasing the risk of transmission especially while the numbers of infections are growing exponentially. When we reopened in July the numbers were down so much that the risk of having an asymptomatic individual into your clinic was very low. Now it is different, that risk has increased hence these new guidelines reflect the stricter controls put in place to mitigate such risk.'

To sum up: if you are in pain and it is getting worse or seriously affecting your daily life then I can treat you after we have conducted a remote consultation and established that treatment is justified at this time. You can contact me by telephone or email (see my website for details:

Hope you stay both well and safe.

Wednesday, 4 November 2020

Lockdown information for November

I have just received guidance from my professional association regarding the lockdown; I am allowed to work within the remit of reducing pressure on the NHS - so where someone is in a condition such that their everyday living is severely affected. An example of this may be waking up to find that you have back or neck pain that is preventing your normal function.

Before booking you in for an appointment I am required to do a remote consultation so that I can justify a face to face treatment. I am expected to keep massage to a minimum so the main appointment focus will be exercises, JEMS etc. Maintenance and relaxation massage treatments are not permitted.

I will put up a post on here with more details on Friday after I have received more detailed guidance tomorrow. Do feel welcome to contact me if you have any questions.

I am going to offer free 30 minute Zoom consultations during Lockdown; this is where we can go through some JEMS exercises to help you, but also where you can talk to me in confidence about any anxieties, worries or stress that you have just as if we were in my treatment room. Please email me (details on my website, if this is of interest to you. This is a challenging time on so many different levels and I would like to offer what help I can.

Take care, and I hope you stay safe.

Monday, 2 November 2020

Swing those shoulders! (video)

 This exercise looks to integrate balance, global body motion and foot awareness as we move forwards. 

As we rotate our torso during walking our shoulders will swing freely and that elastic energy will help with our forward propulsion - as long as our hips are soft and our feet connected :-) This exercise builds on 'Hunting in the Forest' with listening foot, thigh slides, body rotation and vertical hip release as foundations. 

Remember to relax, and to allow your helium balloon or other preferred visualisation to switch on your deep postural support so that you have a central longitudinal axis to rotate round. Breathe easily.... 

Click on the link below to watch the video:

As you do the exercise notice:

- where you are feeling your weight through your foot as it rolls through the step. Note whether your weight is moving to the sides of the foot or staying along a fairly central line. Take your time, check your helium balloon is supporting you and relax. 

- is your hip taking your weight or is it sliding out or in?

- are you leaning forwards or backwards? Is your sternum sinking forward or jutting out?

As you practice the exercise your timing will improve; initially you may feel a little off balance or out of synch. Don't worry about this - it's great that you notice as then your neuromuscular system can begin to fine tune the movement. Shorter (smaller) steps are often easier to coordinate - this is also true when you are outside running or walking.

Sunday, 1 November 2020

Mental health during Covid-19

The charity Mind has a lot of useful information if you or someone you know is struggling with how they are feeling right now. Don't feel you have to wait until you really can't cope; look for help as early as possible.

The news of another lockdown will have triggered anxiety and stress in many of us. It may well trigger our amygdala to 'hijack' us into a flight/freeze/fight response; common signs of this include:

- finding it difficult to concentrate on tasks or remember information.

- shallow breathing, maybe faster than normal.

- sweaty palms.

- sleep disturbance.

- feeling short tempered or jumpy.

We may notice that we are feeling very strong emotions such as fear or anger.

This response, part of the limbic system, is an ancient survival one designed to help us cope with physical threats. If we sense something that the limbic system interprets as a potential major threat it will assume we need to act faster than we can think and initiate an instinctive response, over-riding the more rational part of the brain that normally analyses sensory information and decides on an appropriate response. This system works well for transitory threats such as a vague shape that may be a bear, getting us to a safe place from where we can then analyse the sensory input more rationally, but is not so great for the chronic stress events that are common in post industrial life.

How to switch from the amygdala response to a calmer one:

- over ride the amygdala by encouraging the rational part of the brain to kick in. This is why people tell children to count to 10! Other ways of doing this include writing down any thoughts that are going round and round in your head. Taking them out of your head and onto a piece of paper creates a context: you can analyse them and decide how much of a problem they really are. Write down any possible action you can take. If the thoughts come back, remind yourself that you have already written them down. You can annotate and illustrate as you like.

- breathe. Take notice of how you are breathing and ask if you can relax, slow down. Check how evenly your torso is moving with your breath; relax any tension and ask your breath to travel to all areas of your rib cage. As you breathe in feel the breath travelling over the back of your teeth even as you breathe in through your nose - notice how your face and neck relax.

 - shift your focus to potential positive outcomes, actions and visualisations. We often focus on the worst case scenarios and catastrophise; this reinforces anxiety. They don't have to be big positives: small ones are cumulative. Identify things that you have some control over. Set yourself a daily achievable goal and when you complete it make sure you acknowledge this - maybe tick it off a list - to stimulate a feel good factor and a sense of control. Make sure you recognise the positive things that happen each day - maybe write them down or draw a picture or symbol. 

- if you are finding it difficult to sleep explore a positive memory, for instance mentally walk through a woodland, recreate a favourite climb or visualise sunbathing on a beach. This is a relaxing distraction for the brain.

- ground yourself. Take a moment to notice what you see, feel, smell, listen, taste (if appropriate). You can focus on the world around you, for instance what the wind is doing,  or just something close by such as a pebble, leaf, textile or paintwork. If able to, go outside; the low level but varied stimulation and natural light an outside environment provides is very soothing for us, especially if you can find some green space.

- learn to recognise the warning signs of a potential amygdala hijack; as you become better at interpreting your physical and emotional signals you can initiate coping strategies earlier and avoid a hijack. Do not judge yourself for these feelings; they are a natural survival response, just one that you wish to moderate in this context. The act of recognising signs such as tetchiness and body tension and acknowledging the trigger is calming in itself; it engages the rational thought process and gives a sense of control. You can also learn to identify potential triggers and use your strategies to diminish the response. 

- Minimise your exposure to anxiety feeders such as social media and the news, and do something absorbing instead such as gardening, housework or making something. If you have to stop work, ensure you still keep to a routine and remember to include self care and fun activities. 

- Talk to others; this will help put your own thoughts and feelings within a context.

Friday, 23 October 2020

Recovering from Covid-19? Some useful info.

 I came across this webpage when looking into information on long Covid and thought I would share it here. It includes links to advice and exercises from the WHO, the Chartered Society of Physiotherapy, Moving Medicine and Cresta Clinic and AWRC.

I haven't read through or watched everything yet (there is a lot!) but it seems to have helpful advice on managing different aspects of recovery including managing breathlessness, stress, fatigue and muscle weakness plus dietary tips.

Tuesday, 20 October 2020

In memoriam: Tammy

Tammy in August this year.

On Wednesday 14th October we very sadly said goodbye to our beloved dog, Tammy. 

Photo copyright Dan Money 2016

Many of my clients know all about this lovely hound and some got to meet her so I thought I would share this news on here. She was 13 years old and had been fit and healthy for her age although she had been slowing down over the last two years due to neural degeneration that affected her rear end, and more recently the onset of arthritis in her hips. Throughout 2020 her walks became steadily slower and more about the sniffing smells than chasing sticks but she was still pottering along happily enough.Then came October and a sudden, dramatic deterioration in her mobility and energy levels. A trip to the vet and blood tests revealed Acute Lymphoma Leukemia which has an awful prognosis. Her quality of life was going down so rapidly that we made the heartbreaking decision to have her put to sleep; the vet came to our garden and we were able to stay with her.

Still enjoying sticks in May 2020

Tammy came to live with us in January 2011 when she was three years old and she enriched our lives beyond measure; she is missed more than words can say.

Monday, 21 September 2020

'Hunting in the Forest': moving smoothly forward... (video)

This exercise builds on Listening Foot, Knee Raises and Vertical Hip Release to explore taking your weight forward smoothly and efficiently onto a secure but springy and responsive leg as you walk. Your hip is the stable interface between your leg and your torso.

As ever, remember that being strong and stable as the hip takes your weight is not the same as bracing :-) Bracing resists movement whereas we want the hip to accept and respond to the weight transfer in a manner that keeps connected with the springs in our knees and ankles as well as movement in the torso. 

Click on the link below to see the video:

Thursday, 10 September 2020

A walk home


Curbar Edge

Sunday was lovely weather, just right for being outside, so I decided to walk home from Curbar Gap after being dropped off there. This is the kind of distance I used to do regularly (about 12 miles or so) but since my knee issues I haven't really done many walks of over eight miles; my thought was that this needs to change!

It is a really pretty route: Curbar and Froggatt Edges, then Longshaw Estate and Burbage South before heading to the Limb Brook valley via Houndkirk Rd and then Ecclesall Woods and head for home with the option of going through Lady Spring, Park Bank and Chancet woods. It has the advantage of a lot more downhill than uphill! Around Houndkirk Road I noticed that I was experiencing hip pain. This is something that began a few years ago and became steadily worse until it was keeping me awake at night. I eventually began a series of Pilates sessions with an excellent teacher and that sorted the problem out within a month; I had lost coordinated movement a few years earlier after an injury and was using a compensation pattern. 

Higgar Tor from Burbage South

So, what to do in the middle of a walk with no Pilates teacher to hand? I noticed that my upper back was braced and absolutely static, no counter rotation happening at all. With that in mind, I visualised my helium balloon supporting me from the crown of my head to gently ease my back into a helpful central longitudinal axis alignment that would also be relaxed and responsive. All well and good but no noticeable change in my back. Next, I paid some attention to how my foot was coming into contact with the ground and how that felt as the movement transferred up my leg and into the pelvis, how my pelvis carried my trunk forward over the foot - just noticed, didn't try to change anything. I continued to encourage my back to soften and the spine to ease upwards whilst checking that my sternum was staying in a neutral position - that I wasn't tensing up and sticking my chest out. Ten minutes or so passed and there it was - the back relaxed and the counter rotation returned, tuning in with the foot strike and the hip movement. My gluts were able to do their job and the feeling of easy propulsion returned. It felt good! I have been practicing this tuning in to walking exercise quite intensively over the last few months and at last it paid off. I will make a video to demonstrate and post it up here soon.

Looking towards Sheffield and home from Houndkirk Road


Saturday, 5 September 2020

So, how's the running going?

  (Tammy in the Peak District; sadly, too old to run with me now but still enjoys her walks.)

So, a while back I mentioned that I had begun running again. Well, it's been a slow progress but I am past the 5km mark and have been spending the last few weeks consolidating that. Sheffield is VERY steep and hilly so I find it wise to use the couch to 10k plan as a rough guide rather than an absolute training regime, not least because I am still building up from a long period of injury issues and at my grand age of nearly 49, I don't bounce back quite the way I used to. My knee has been fine on the whole although it still had its not so good days, but unfortunately I managed to irritate my Achilles tendon on the other leg last week so I am having to settle that back down again. Too much, too soon - I had begun pushing myself on those hills! 

I have found all the JEMS exercises I have been doing really helpful, both in my running and walking. I was making my way up some very steep steps out of a valley and I noticed that my trunk was staying upright but relaxed and responsive because I was flexing so well at the knee and hip, allowing my pelvis to carry my trunk whilst my gluts and legs did what they are supposed to. I think as well as the foundational exercises such as listening foot, hunting in the forest (explores how you are carrying yourself as you walk) and thigh slides, the frequent knee raises and vertical hip release practice have been a turning point for me, especially with keeping my weight over my feet whilst lowering my centre of gravity to keep relaxed control when going downhill. There are links to the exercise videos for these both on my blog and on the JEMS website: 

Go to the YouTube channel link.

The JEMS Facebook page also has useful videos such as this one, so much shorter than my explanation of vertical hip release! There is also another one on the YouTube channel.

Thursday, 6 August 2020

Breathing during the time of Covid-19

Two interviews on the radio caught my attention this week. One was about a trial into providing singing classes with the ENO voice coaches for those experiencing chronic breathing problems after being seriously ill with C-19. Another was looking at the effect of stress on where we hold the tension in our body. In both cases the body tends to shift to overusing the accessory muscles for breathing, for instance the scalenes, sternocleidomastoid, pectorals and the abdominal muscles. This can cause a tense, braced posture with the shoulders coming in, and excessive neck tension. 

So, why singing lessons? A voice coach will help people to use the diaphragm; this is the muscle we use during passive breathing. The coach will also encourage people to move from just breathing into the upper part of the chest wall - a frequent stress response - to using the whole of the rib cage. I often notice with my clients who have very tight upper body muscles that they tend to gasp when asked to breath in, using great effort in the upper body muscles. Instead of this, the coaching encourages relaxed, deep, effective breathing. This relaxed style of breathing has another positive effect as it encourages letting go of the fight/flight/freeze stress response and moving into rest, digest and repair mode.

My blog post on 08/05/2020 includes two videos demonstrating breathing exercises.
There are also many online videos and articles by yoga, singing and breathing instructors. Let's all relax and breath easily.

Interesting massage article.

A colleague pointed me in the direction of this article and it is an interesting read. In particular, it addresses the now outdated concept that harder and deeper (painful!) is better. My own massage practice has shifted to concentrating more on the neural aspect of the treatment; the feedback to the nervous system from the massage treatment. This compliments the JEMS approach which is also very much about interacting with the nervous system. These days I think of massage as a conversation with the body; rather than charging in heavy handed, you ask nicely to be let in. The more relaxed the client is, the more effective the touch communication and hence the overall treatment.

Tuesday, 4 August 2020

Vertical hip release (video)

This video explores how to relax the hips to allow a bit of bounce, to facilitate movement and absorb forces. As well as being important for sport this is also a great help in everyday life, from helping us to sit down through to walking down stairs and hills. 

This is a movement that I have to practice frequently as I lost it after I injured my knee; you may notice that at the beginning of the video I have a tendency to slide my hips forward rather than dropping downwards, and as the video progresses I am able to correct this.

Monday, 20 July 2020

Covid-19 secure: your treatment

So, this is my new work look!

This is what I will be wearing when I greet you on your arrival: clean clothes, a face visor that I clean between each client, a face covering, and a disposable apron that will go in the bin at the end of the session. I will be holding a non-contact thermometer to check your temperature, and will also have a health check sheet to go through with you. If you haven't brought your own clean face covering I will have a disposable one for you, and some hand sanitiser. 

The need for increased hygiene does unfortunately mean an increase in disposable items (I am also using disposable face rest covers) but I am trying to minimise this and will be using a washable face covering. I have replaced the bolsters and face rest with ones that I can wipe down with a suitable cleaning product after each treatment, and will also be cleaning the couch and changing the couch cover and towels after each treatment. I have removed all unnecessary items from the room and those that I still need are stored in the cupboards or containers so that I can clean all surfaces, including chairs, work tops, switches and handles, at the start of the day and after each treatment. The floor gets a good clean, too! 

The room is aired for at least fifteen minutes in between appointments; at present I am allowing thirty minutes to make sure I have enough time to do everything required by the new guidelines.

Please have a look at the Covid-19 page on my website for more information
To book an appointment or to ask a question contact me directly (details on my website,

Friday, 10 July 2020

Return to work!

Yesterday the massage industry was given the green light to resume work, as long as we follow strict guidelines to maintain as safe an environment as possible within the ongoing pandemic. This is great news, but caught me a little on the back foot as we were not expecting the next update until the 23rd July and my Professional Association had only just emailed out the latest update to the Guidance on Wednesday!

With all that in mind, I am hoping to be back at the 919 Clinic from the 21st July. Things will be different, including how to book in. I will give out more information on this once I have processed everything. You will need to book with me directly, by email, text or phone, and I will need to go through Covid-19 screening questions when you book and again when you come in for your appointment. Please do be patient with us whilst John and I get used to the new system! We may have to ask you to wait before moving between different areas of the Clinic to ensure only one client is in an area at a time.

At present, I will not be able to treat you until fourteen days have passed if:

- you have any symptoms of C-19: high temperature, new and continuous cough, loss or change to your sense of taste or smell.

- you have been in contact with someone experiencing these symptoms.

- you have been abroad within the last fourteen days, in particular to countries in lockdown or experiencing high numbers of Covid-19 cases.

If you have been treated for Covid-19, in particular if you were hospitalised, or if you are in a high risk group and was shielding you will need to check with your GP for approval for the treatment before booking an appointment.

Once I have been through all the paperwork I will create a Coronavirus page on my website with all the necessary information.

Check my website for my contact details:

Looking forward to seeing you all again!

Wednesday, 8 July 2020

Heaven and Earth stretch and balance (video)

This is a lovely stretch and balance to do to wake up your proprioception and feel a connection along your whole central longitudinal axis, from your foot all the way up to the hand stretched above your head. The aim is to centre yourself over your foot - so maybe do listening foot to prepare - and then lengthen and open up whilst remaining relaxed. The knee lift exercise from my earlier blog post may be helpful if you find floating your knee up challenging. 

I find it really helps to let your foot relax into the ground, and then really press your hands away from each other, so you feel connected and grounded from the foot even as you stretch up. Allow your head to float up as your spine lengthens. It's lovely to feel your hip joint opening up and that connection through the whole body.

If you find the above video does not fit your screen, you can click on it or on this link Heaven and Earth stretch to see it on Vimeo.

Thursday, 25 June 2020

Covid-19 update

There was a possibility that I would be returning to my massage practice at the 919 Clinic in July, but the latest government update on businesses allowed to reopen does not include massage therapists. This is understandable as it is a close contact treatment. My professional association is asking for more clarity on when we are likely to be able to return to practice. If you were hoping for a treatment, I am so sorry that you will have to wait longer but it is with the aim of keeping you safe. John is available for physiotherapy treatment if you are in pain.

Meanwhile I am making plans for when I do return to practice. I will be putting away everything that is not required for the treatment, so the room will seem much barer - indeed, more clinical! I am replacing my usual bolsters and headrest with vinyl covered ones that I can clean thoroughly between appointments, and I have bought disposable face coverings so I can supply one to clients who do not bring their own (although I would encourage clients to do this). The photo above shows two of the new bolsters, a pack of disposable face masks, some hand sanitiser I am trying out (I already use hand sanitiser in between clients in addition to hand washing but as I will now be applying it far more frequently I want to make sure I get on with a brand before buying in bulk) - and a wobble cushion! This last item is an excellent way to engage the nervous system and wake up the muscles to improve adaptability and balance, and I can clean it in between clients.

I will post again with all the provisions I will be making for client safety once I have a date to return to practice. At present, guidance includes alongside other recommendations: 

  • required questions asked to check the client's health and risk of exposure to Covid-19 on making the appointment and again on day of appointment; this will determine if the treatment can go ahead. 
  •  asking the client to wait outside the Clinic, for instance in their car, until it is the correct time for their appointment.
  • meeting the client outside the Clinic to sanitise their hands and ensure they are wearing a face covering (which will be kept on the whole time they are in the Clinic).
  • providing a plastic box for the client's possessions including clothes; the box will be sanitised after they have collected them.
  •  cleaning all surfaces in communal areas and the treatment room before and after the treatment.
  • stripping and sanitising the couch after each treatment and placing couch cover and towels in a bag that will then be kept closed until they are washed.
  • airing the room for fifteen minutes after each treatment.
  • ensuring that there is only one client at a time in shared Clinic spaces such as reception.
  • payment should be contactless.
  • cleaning my own hands before and after treatments and after cleaning the room.
  • I am to wear a face covering at all times. (Update 03/06/2020: latest guidance suggests that a visor will be required).
Some of these precautions you will be pleased to read that I was doing already, for instance the hand washing. Some are very new and will take getting used to, for instance the face covering, but I am sure this will seem routine very quickly. 

Saturday, 13 June 2020

Aches and pains from desk work? A run through of postural tips and simple exercises (video)

When you are working from home and can't get a massage, self care becomes even more important.
The video begins with some postural tips, then goes through some exercises that may be helpful. I have covered all the exercises in separate videos on my blog but thought it would be useful to put them all together for you as an overview for desk related aches and pains. Please note that due to Covid-19 lockdown the video was made in my home rather than the Clinic.

video link for desk related aches and pains tips

The exercises include: thigh slides, spinal elasticiser, breathing, full body rotation and forward bend plus a bit about the feet. Hope it's helpful! 

Wednesday, 10 June 2020

Rolling the pelvis to relax the back (video)

Modern life can result in tension building up in the back and reducing mobility in both the spine and pelvis. This can affect ease of movement in many ways, and the sacral rock and pelvic clock exercise is a gentle and relaxing way to address it. The aim is to make the movement as smooth and slow as possible, exploring the subtleties that are lost through tension or forceful movement. This is a great exercise to do several times a week, especially if you have been sitting down a great deal.

If you feel you wish to take the movement further the video shows how to move into a bridge that engages all the spine as you bring your hips up and then lower them down again. As you do this, check that your back is staying relaxed and maintain a firm, even contact between your feet and the ground.

Please note that due to Covid-19 lockdown the video was made in my home rather than the Clinic.

Tuesday, 9 June 2020

Lifting the knees without overusing that back (video)

This video explores being able to move your legs independently of your trunk whilst still keeping a connection. So often when people lift their knees up they collapse the back forward or tilt to one side; this loses the power we get from the gluteal muscles and affects a huge range of activities from running and climbing through to hill walking and going up stairs. 

Please note that due to Covid-19 lockdown the video was made in my home rather than the Clinic.

knee raise video link

Sunday, 7 June 2020

919 Clinic update

First of all, physiotherapists are now allowed to practice so John is available for appointments. If you go to the 919 Clinic website you can find out more information about this on the Covid Form link, including the new safety and hygiene protocol He is encouraging people to opt for Zoom consultations where possible to minimise risk, but will see you for an in-person treatment if it is essential and you are not needing to self isolate. 

As you would expect with the current risk of Covid-19 transmission, massage therapists are not allowed to practice at present. The earliest provisional date for return to work we have been given is July, but it may well end up being later. I am acting on advice from my professional body which in turn is following guidance from the government, and am looking at the PPE that I will need to have in place before I resume practice. I will not return to practice until given the go ahead by my professional body. I want to keep you safe. 

I know that many people are really missing their treatments, and indeed I am missing the regular massage that I received prior to lockdown. As well as the exercise videos I have been posting to help keep you mobilised, I will be putting up some simple and safe self treatment videos. John also demonstrates useful exercises and stretches on the 919 Clinic website.

I hope you are all managing to stay safe and well during this difficult time. As ever, if you need someone to talk in confidence, as you would during a massage treatment, do feel that you can contact me; I am here to listen.

Saturday, 30 May 2020

Let's see how the running goes....

My new running shoes! 

When I first tore my meniscus back in December 2016 I initially had a very successful return to running. I did lots of rehab right from the start, and in late spring 2017 I began a couch to 5km plan that combined varied running with cross training, taking care to listen to my body rather than follow the plan rigidly, with the pleasing result that I ran my fastest ever 5km and carried on progressing to 10km. Then a rather over enthusiastic physiotherapist session caused my meniscus to tear again, and this time I couldn't rehab it (it's likely there was an underlying issue with the meniscus before the physio session, so it probably would have torn at some point anyway; it turned out later that I have discoid shaped meniscus that tear easily). I ended up having surgery in 2018 to repair and trim two tears, but it continued to be easily aggravated with the knee frequently swelling up and after an attempt to return to running in 2019 didn't go well I decided to knock it on the head and focus on improving the underlying function of the leg in the context of the whole of me. I have really missed my running but the most important exercise for me is long walks so I concentrated on this instead. I am no longer climbing as it's too much temptation to put torque through the knee, which I was warned off doing by the surgeon.

So, lots of somatic style exercises and JEMS exercises to restore the natural movement I had lost through chronic injury. I also tend to overly focus on my knee - understandably - which amplifies negative sensation leading to tension and anxiety. I am now aiming to widen my focus away from how the knee is feeling.

Endless squats and lunges with increasingly heavy weights have strengthened up my legs but there is still muscle wasting on the vastus medialis (partly because the knee has often had some swelling present) so I am including other functional movement exercises. I noticed that I lose optimal movement when I am moving down steep ground so I need to practice vertical hip release and incorporate this into my exercises. I need to improve my one leg dips on the injured side and I continue to work on foot sensitivity and propriocetion. I introduced exercises to encourage the return of spring and bounce to absorb forces and be energy efficient.

Last week I went for a tentative short run, a standard walk 30 seconds, run one minute for ten minutes. It went ok, no problems 24 or 48 hours later so I ordered some new shoes online (on the sale, hurrah!) from a favourite outdoor shop that I want to support whilst it is closed to visitors during the lockdown. New shoes felt important as my current ones have been shaped by my gait since surgery and so have negative connotations for me; they are also wearing out. Of course I went for a run the morning they arrived: a short, gentle 3km where I walked the steepest bits (I need to acclimatise my Achilles tendon on the uphills and get better control for the downhills before I run them), and slowed down or walked for 30 seconds to a minute when I got very breathless. I visualised the helium balloon supporting my central longitudinal axis, and kept my stride short. It felt great! Now lets see how it feels 24 hours later, then 48 hours....

I did notice that I wasn't rotating freely with my trunk so as well as thigh slides and greyhounds (an exercise I haven't posted about yet) I will be doing a couple of simple Muscle Energy Technique stretches as follows (please be responsible for your own comfort and safety when doing these, don't force the stretch):

Lie on your side on the floor or your bed. Keep your bottom leg straight and bend your top leg so the knee comes towards your chest but is still able to rest comfortably on the surface - you can use a pillow to support it, especially if you have irritable hamstring tendons. Position your bottom arm straight out in front of you so it is at right angles to your torso and let your top shoulder roll back, taking the top arm and your upper back with it. Now really stretch out that bottom arm and hold for ten seconds before taking a deep breath and relaxing. As you breath out see if you can let your shoulders and back roll back a little more; relax and breath easily in this new position. Now press your top knee gently into the surface it is resting on and sustain for ten seconds before relaxing and again letting your back roll back as far as it can do comfortably. Relax in this position for thirty seconds, then roll back and bring yourself slowly back up. Repeat on your other side.

Half moon stretch, one that I like to do pretty much anywhere - against a wall, lamp post, tree.... I began to describe this but really, it is easier for you to google how to do it as it is a yoga pose. It's often shown with no support but I like to lean my hands against something so I can really relax. Stand sideways on to the structure you are going to lean against, make sure it will take your weight. Your chest and pelvis must face straight forward through the whole exercise, at right angles to the support. In my experience if people aren't feeling the stretch it is because they are turning their chest and pelvis inwards. I always hold the stretch for at least 45 seconds on each side. I find it a very relaxing stretch that restores the sensation of connection through the body whilst also releasing tension.  

Friday, 29 May 2020

Core stability

What comes to mind when you think about core stability? For many, it conjures up strength and being able to hold the plank forever, and certainly strength is a useful aspect of core stability that provides endurance. However, it is helpful to consider function: what does core stability give us, why would we want it?  

I would like you to consider core stability as responsive and adaptive. Many muscles and other connective tissues work together with our nervous system to absorb forces, recover and adapt, so that we can maintain our trunk where we need it to be; providing a connection between our head, arms and legs. Like a spring, this works with movement, dampening forces rather than just blocking. 

The core muscles are found in our trunk and provide the connection between our legs and arms. When I hit a tennis ball, reach for a saucepan or use a fork to stir the compost pile, I am powering from the feet and legs as well as the shoulders and a steady, responsive trunk provides a stable and adaptive platform to transmit that power. You can feel this connection for yourself when you do push ups against a wall. If you let your trunk collapse, you lose both power and control. However, if we concentrate on bracing the trunk we lose an important aspect of core stability: the ability to note and respond rapidly to challenges such as a push or pull.  

Stability is adaptive and responsive. If you think about everyday life, would it be helpful to walk about braced, as if your body is a suit of armour? How would it affect your ability to react to someone throwing a ball at you, or if you slipped on mud? The trunk is most resilient to challenges when it uses a range of mechanisms. At the foundation of core stability are the local stabilisers: postural muscles such as the diaphragm, the transversus abdominus and the multifidus. These work continuously to stabilise the joint that they cross: before, during and after an action that other muscles such as global stabilisers and prime movers are providing the power for. Through nervous system training, these local muscles activate before we even need them, anticipating the perturbation that is about to happen. This is why we need to practice activities until we can focus on what we want to achieve rather than micromanaging how we are going to do the movement. Our core stability kicks in without us even having to think about it – although if we see a huge impact coming our way we may consciously brace a bit more. This is fine if we release again afterwards, but if we are always consciously holding ourselves the global muscles that are activated can override the local stabilisers and we lose the fine control that those local muscles provide. Rather than thinking on/off, it is helpful to think of the core muscles continuously monitoring the situation (via the nervous system) at low effort and making small adjustments. 

People with back pain are often concerned with improving their core stability. Investigations have found that they are often protectively activating muscles to protect their spine, which is a natural reaction. This corset like activation has the effect of limiting movement which has the counterproductive effect of putting more stress on a limited area instead of sharing the load by involving more of the body in the movement. You can try this out for yourself by comparing reaching your arm up for something first with your back and abdomen tensed up; then with your torso relaxed feel the ground with your feet and let the movement come from there. Your foot provides neuromuscular feedback that helps the core muscles to engage and react appropriately to stabilise you, your torso is able to lengthen and the effort is shared. Now repeat tensing/relaxing but this time seeing how it affects turning your torso; it should feel much easier when you keep relaxed and allow the movement to initiate from your feet and feel that connection through the body. 

Pain, even anticipated, and injury can cause the postural muscles to switch off, and to remain switched off even once you have recovered. In these cases, it is beneficial to explore movement in a safe, relaxed way that helps the neuromuscular system to engage again and to let go of the protective tension. Again, think of the postural stability muscles as springs, that bring you back to where you need to be. If the feedback system is not performing optimally, then there will be a loss in anticipation, adaption and recovery – in other words, stability - that will be further exacerbated by protective tensing. 

Developing resilient core stability involves vestibular, visual and sensory feedback as well as that from the muscle spindles and joints. Often the best way to train this is through varied challenges, as we want to be able to maintain stability through a variety of situations that are often unpredictable. The correct level of challenge will depend on your starting point, but examples could include: keeping your balance sitting on a swiss ball or standing on a wobble board whilst catching and throwing a ball; keeping your balance on both or one leg: with your eyes shut, or whilst moving your arms around, or maybe whilst performing lunges, or whilst someone pulls you gently in different directions using a band around your waist. You can explore different ways of engaging with the activity and see what feels most efficient and easy; notice what is happening with your body and what it is feeling. You will be generating feedback that will improve your anticipation and response, and hence your stability resilience. You will be helping the local postural muscles to activate so that you get smooth control and support; without those, no matter how strong you get the movement will lack that solid foundation and precision. If you are doing core muscle exercises such as the kneeling superman, please do ensure that you are not tensing and overusing your back muscles - as before, if you can feel two mountain ridges appearing either side of your spine that has itself disappeared into the valley, you are overusing your back. Instead, think of lengthening through the body, pressing out through the crown of your head (your face should be looking down so that your neck is aligned with your spine) and the heel of your foot; continue that lengthening sensation through your leg and arm as they extend away from each other in alignment with your spine. Some videos will instruct you to tense your gluts and abdominals before moving; maybe experiment with doing this, then release and experiment with the strategies I have discussed above and explore how it feels. 

Part of moving well is developing a range of options that your body, including nervous system, can choose from. Selecting only strength limits our potential. We need responsiveness, adaptability, endurance and robustness. 

You can read more about this, including useful exercises to explore, on the JEMS blog page:
For instance, the post on (not) all about the gluts; golf swing, skiing and dancing the tango; posts about the foot - all so useful even if you never play golf, ski or go dancing!