Health, Mobility

Muscle Knots: What, Why and how to get rid of them

November 14, 2016 • By

Muscle knots, self releaseIf I had to pick one question that I am most often asked when treating patients is, what are muscle knots? And what causes them?

And fair enough too, I would be asking some serious questions too if someone told me that I had some kind of ball of tissue within my muscle… That’s not normal right?


This excerpt by Paul Ingraham gives a good little explanation:

Does your body feel like a toxic waste dump?

It may be more literally true than you realized! Some evidence shows that a knot may be a patch of polluted tissue: a nasty little cesspool of waste metabolites. If so, it’s no wonder they hurt, and no wonder they cause so many strange sensations: it’s more like being poisoned than being injured. Back pain is the best known symptom of the common muscle knot, but they can cause an astonishing array of other aches and pains. Misdiagnosis is much more common than diagnosis.(1)

Muscle knots are very helpful. They are like signposts in our body, pointing to the areas that are overworked and struggling. If you come across a point in your muscle that is reasonably uncomfortable and causes you to grimace a little, then you know this is a spot that needs working over.

Muscle knots are localized, irritable points in skeletal muscle, not caused by any one specific event. This can basically be explained as a small permanently contracted part of a muscle. They can also act like tensioners, pulling at bones and joints via their tendons and causing all sorts of grief, including making you feel “out of place”

To add even more fuel to the fire, knots can also refer pain elsewhere, again, not where the actual knot is.

Take the Quadratus lumborum (QL) for example. This muscle in your back does a lot of good work but when irritated, can cause some confusing pain at times.

Ql Quadratus lumborum trigger point muscle knots

This muscle that runs down the side of your lumbar spine often refers pain into the hip and glutes, not at all where the muscle is.


So how do we get rid of muscle knots?

1. Heat

Heat increase blood-flow, eases pain and helps with muscle relaxation so definitely worth the effort of warming up your wheat bag!

2. Self-massage and self-myofascial release

Get a Foam Roller or massage balls into those tight areas. If you need a whole lot more guidance and self-treatment techniques, grab our New Ebook that has just released!

3. Exercise

Normalise muscle function through good exercise with and around the troublesome area. Whether it is upper trap pain and you need to get the lower traps firing better, hamstring pain because the Gluts aren’t doing their job or because you just aren’t moving right – exercise can help address this.


Hopefully that has cleared things up a bit! Give these tips a go and feel free to check out our new Ebook that is full of helpful tips and self-treatment exercises.


New Release Ebook: Self Treatment for the Busy Athlete

November 11, 2016 • By

New release Ebook best seller, physioI am very excited to announce that we have just published a book! It’s a small, easy to read and very helpful Ebook.

This has been a work in progress for some time, as there is always something that takes priority right? Well it is here now and full of great content to keep your body moving smoothly.

The main idea behind the book is to help you help yourself.

It will help you:

  • Improve flexibility (maybe even touch your toes if you can’t already!)
  •  Gain mobility
  • Decrease pain
  • And most importantly reduce risk of injury and improve performance

Oh, and it makes you feel way better too!

So head on over via this link and check out the newly released Ebook because if you have liked past exercises and self-treatment techniques that we have shown you in our past blog posts, then you will love this.


Tips for beating Knee Cap Pain

November 3, 2016 • By


knee cap painKnee cap pain, often called Patellofemoral pain, is very common in the active population and can be around, behind or above the knee cap.

It affects a lot of people with knee cap pain making up 8-33% of all knee injuries, which even though this is a large range, is still a lot either way! It can be tricky to treat as there is a number of different causes behind and treatment approaches.(1)

It can be tricky to treat as there is a number of different causes behind and treatment approaches but through utilizing current best practice treatment and research, these are the top tips that will help anyone with knee cap pain.

1. Exercise therapy

The first goal for most people if to reduce pain and that is what exercise has been shown to do in the short, medium and long term. It also improves function with a bit of perseverance so is well worth doing!

The aim here is to do exercises the work the hip and knee together and NOT the knee in isolation. The hip does a lot to control the knee and help stabilize the lower limb so make sure the hip is involved. If your knee is quite sore, start easy with sitting and lying exercises such as clamshells, side-planks and knee extensions.


As you get better, get upright and standing with some weight-bearing exercises such as wall squats, one leg squats and step-ups etc


Orthotic2. Foot orthosis

Orthotics are recommended to help relieve pain by guiding better joint motion. Just remember that these help in the short to medium term so working on the other tips in the meantime mean you get a great long-term outcome.


3. Physiotherapy (Physical Therapy)

Yup, go see a professional in real life as there are a number of things that, when combined, really help, including:

  • Patella taping to help guide the knee cap and retrain movement
  • Specific exercise prescription

Note: Patellofemoral, knee and lumbar mobilisations and electrophysical agents were not recommended.


4. Retrain movement

Stand in front of a long mirror and do a one leg squat. This is a great test to see how your lower limb is moving so keep an eye out for:

  • Your opposite hip dropping
  • How much your knee rolls in towards the center line
  • And how much your foot collapses in (pronates)

This way you can see what is going and work to re-train your movement. Find the problem, find what is hard and work at it.


5. Combined interventions

The best way to beat knee cap pain is to persevere with as many of the above 4 tips as you can for as long as is needed (up to 12 months). Stick to your exercises and go see a physio if specific exercises, individual to you are needed.



2016 Patellofemoral pain consensus statement

The “Best Practice Guide to Conservative Management of Patellofemoral Pain”


Core strengthening, Health, physiotherapy, training

Exercise for Flippies, Floppies and Stiffies

September 23, 2016 • By

You might be thinking I’ve gone mad and your mouse is sliding towards closing the tab… but using the Flippy, Floppy and Stiffy principle is actually a brilliant way of preventing injury!

It has been used for some time among physiotherapists to group patients simply and effectively and has nothing to do with anyone’s nether regions! In fact, it has also been used by top tier rugby and football teams as well , instead of grouping all their players together.(1)

Training your body according to your body type has huge benefits and if you get it wrong, you can be putting yourself at real risk. Take for example someone that is super flexible. If they were to do a lot of yoga and stretching only, they would get more and more mobile and lose more stability, which they didn’t have much of to start with, potentially leading to a joint sprain.

So here are the 3 types and how we can apply exercises to them:


beighton-hypermobility-scoreIf you are a floppy, you can probably bend down and touch the ground easily or bend your thumb down to touch your wrist. You are hyper-mobile, meaning you have a lot of mobility in your joints and laxity in your ligaments. You can get your Beighton score here to see how hyper-mobile you are.

If you are a floppy, you don’t need a lot of stretching.

You need strengthening of your muscles. This will help develop the muscles around your joints to improve stability and limit your joints going too far.


Stiffy stiff jointsStiffy

Stiffies, believe it or not, are typically male but that’s not a strict rule.

I’m a self-confessed stiffy. I can’t touch my toes without bending my knees a little, I’m terrible at sitting cross-legged and am simply not very mobile. For those of like me, of which there are a lot, you need to stretch and mobilise.

You need to stretch regularly, practice yoga and work on joint mobilisations and you will notice a huge difference.



And lastly, flippies have a foot in both camps. They are those lucky ones that aren’t over-flexible or stiff as a board.

You flippies probably have more work to do unfortunately as you will benefit from keeping mobile and strong, having a good mix between stretching and strengthening for the best outcome.(3)


So are you a flippy, floppy or stiffy? Categorise yourself and take a closer look at your regular workout routine – do you need to individualise it a bit better to suit your body type?


Health, Spine

Why Does My Back Hurt… Again!

September 13, 2016 • By

You might often ask yourself, why does my back hurt? Or, why do I keep hurting my back?

Well, a huge 34% of who have episodes of low back pain will get it again and again. This causes a huge flow on effect with time off work, doctor and physio visits, as well as loss of quality of life during that time. If we can better understand why acute low back pain recurs then we can better manage it.

First of all, this first part of this blog is easy to explain – why do things hurt. Here is a short video from one of the best at explaining pain:

Things hurt due to a combination of our peripheral receptors signaling our brain that they have felt something and importantly how our brain interprets this signal. For more information on pain and the different types, check out this post.

So, with that covered, but we come back to the question of why does my back hurt; do we really know why acute low back pain recurs in over one-third of people?

There is most likely a number of factors and we don’t know them all, that’s for sure. But what we do know is that following an episode of low back pain, activity of your deep back muscles is decreased on the injured side – even once the pain is gone.

Multifidus why does my back hurtIt’s been shown that the multifidus muscle which runs down the side of your spine, supporting, moving and stabilising your vertebrae has different activation to that of a normal back. This shows that even with good management when you have low back pain – the muscles don’t always get back to your normal by themselves, possibly leaving you more prone to another episode of low back pain.(2)

The good thing to remember is that in 90% of cases of low back pain they are pain free and better within 6 weeks and that 85% are classed as non-specific low back pain where there isn’t a diagnosis (you don’t need a label on it saying you have injured your joint, muscle, ligament or disc).

But even with that huge amount improving within 6 weeks – many of those recur again so it is important to ensure your muscles are fully rehabilitated, just like you would if you were returning to sport following a hamstring injury for example. Because if you can get that Multifidis firing better again that is one less thing to worry about and a much better chance of your back pain not coming back.

So if you keep asking yourself “why does my back hurt again!” go see a local physio for some advice and rehab exercises – they do work and the effects do last (1)