In the Physio7 clinic, I use a 4-step system to treat complex, chronic and persistent pains. The system ultimately enables you to take ownership of your body.

The human body has a tremendous capacity to self-heal. If you cut yourself, you can watch it heal. There is a process and it takes time, but it happens, usually without you doing much to help. If it is a deep cut, you might get stitches and put a dressing over it, but those interventions are simply there to provide conditions for your body to heal itself.

So, when I see someone suffering from persistent and chronic pains, I ask myself what are the underlying problems that are preventing that person from healing?

With that in mind, the 4-step treatment system is built on a thorough assessment. I hope to establish which tissues are causing your pain (I’ll admit, this is easier said than done, as patients with chronic and persistent pains usually present with multiple pain-producing tissues), and more importantly, the underlying reasons why those tissues are damaged or sensitive.

I aim to uncover stiff, tight and weak links in your body and the imbalances that have caused excessive loads on the painful tissues.

I will look for which areas are moving well and which aren’t moving enough; which muscles are functioning well and which aren’t pulling their weight; and which ingrained movement habits are contributing to the problem.           

Assessment is an ongoing process. For complex, persistent pains, it can take a while to fully understand all aspects of your problem.

I urge you to have patience and persistence. Quick fixes are possible, but if it has taken years for the underlying problems to develop, are you willing to spend the time to fix them?

STEP 1: RELIEVE

I love to get to the root cause of your aches and pains. But I also know that your first priority is to get out of pain as soon as you can, so I make that my primary short-term goal.

This step can include desensitising painful tissues, relieving inflammation, relaxing muscles in spasm and teaching you simple pain-relieving postures and exercises.

I’m also a big believer in finding trigger points (knots in your muscles) that are producing symptoms. Did you know that there is a muscle in the side of your hip that can create pain right down the side of your leg as far as the ankle? This muscle can mimic sciatic pain, and I’ve seen targeted treatment relieve years of pain in a few minutes.

STEP 2: RELEASE

In the Physio7 clinic, I spend a lot of my time releasing stiff joints and tight, restricted muscles. One reason is that movement keeps the tissues healthy.

a. JOINT RESTRICTIONS

Let’s take our joints. The joint surfaces are bathed in synovial fluid, our very own WD40, which provides lubrication and nourishment. Moving the joint increases the production of synovial fluid within the joint.

As your physio may tell you, ‘Motion is lotion’.

However, not all movement is good.

When joints move, there is a very specific pattern of roll, spin and glide that occurs at each joint surface.

Joint surfaces are enveloped by an elasticated sleeve called the capsule. If the capsule is too tight, it changes the axis of motion. Now the roll, spin and glide occur in places that were never designed to tolerate this load.

Parts of the joint become too compressed or opened, and there may be increased shearing of the joint surfaces. Imagine a runner who takes 50,000 steps during a marathon. 1000s of unwanted shearing forces can lead to premature wearing of the affected joint.

If the main joint restriction is in the joint capsule, this needs to be mobilised in specific ways by a skilled practitioner. Once roll, spin and glide are restored, joint pressures should normalise.

b. MYOFASCIAL RESTRICTIONS

The second reason I spend time releasing stiff joints and tight muscles, is that restricted regions can act as stiff links in the chain, leading to pain elsewhere in the body.

For example, a tight hip flexor on one side of the body can lead to a malaligned pelvis, leading to a twisted lower back and compensations right down to your feet. It can also lead to excessive extension movement in the lower back, causing irritation of facet joints and secondary spasm in the lower back muscles.

Stretching is sometimes effective in releasing a tight muscle, but not always. I am always asking myself why that muscle is tight. Is it in spasm to protect a nerve or a painful joint? Is the muscle weak and trying to protect itself? Is the muscle glued together by scar tissue after old injuries?

It is only after careful examination that we can decide upon the best way to release restricted areas. That could involve the use of active release techniques, massage, instrument assisted release, vibration or percussive massage, hold-relax and contract-relax PNF techniques or stretches.

STEP 3: CONTROL

What about if you are someone who has loads of joint and muscle flexibility. That’s good right?!

Not necessarily.

In fact, extreme flexibility may leave you more prone to injuries. Loose, floppy joints that don’t have muscular control leave the joint surfaces and surrounding tissues at risk of strains, sprains and other injuries.

So while we aim to increase the mobility of stiff joints and tight muscles, it is just as vital that you can control all that movement.

Think about the wheels on a car. Those wheels need to be aligned and in balance if we want the tyres to wear evenly, and to give us extra years of use.

Granted, our bodies can adapt and repair in ways that car parts never can, but it is known that if our movements are well controlled by well synchronised muscles, we develop less wear and tear and injuries.

Movement control exercises can help improve the stabilisation and alignment of joints and reduce our likelihood of developing joint pains and injuries. They can also improve the coordination of functional movement patterns such as walking, running, lifting, pushing and pulling.

STEP 4: STRENGTHEN

Only once your joint motion and movement patterns are controlled should we add significant strength, speed and power into the rehabilitation mix.

Adding strength, speed and power to a body that doesn’t move well is like putting a Ferrari engine in a rusted up old banger. It won’t be long before it breaks down.

First we need to establish what your needs are.

We all need a certain amount of strength, speed and power to perform our everyday activities, but clearly a desk worker with sedentary hobbies will need less strength than a firefighter who plays rugby on the weekends.

Next, we need to skilfully balance the loads that are placed on your tissues (muscles, tendons, bone and connective tissues) with the capacity of those tissues to tolerate the load.

Do too much, too soon, and your tissues will break down again.

When managing injuries, this can be tricky, as injured tissues have less capacity than they did before the injury. Think about a pulled hamstring muscle. The day before that injury, you were sprinting like a champ without the hint of discomfort, but the day after, even walking was painful and restricted.

So we aim to move you towards your strength, speed and power goals by doing just enough to create positive adaptations in your tissues, but without tipping into overload and tissue breakdown.

I often meet clients who have remained pain-free for months or years by shielding themselves from high loads. However, as soon as they upped the ante and went for their first jog for years or did 6 hours of digging in the garden, their tissues couldn’t cope, and they got injured.

The lesson here isn’t to avoid exposing your body to high loads. Who wants to give up on doing all the fun, active things in the world?

The lesson is to gradually expose your body to higher and higher loads, to gradually make your body stronger and more resilient……. so that, in time, your body is perfectly prepared to go for a jog, to do 6 hours of digging, or whatever it is that you love to do.

Our ultimate aim is to help you tread the fine line where strong tissues meet high training loads, leading to strong, resilient tissues and high performance, but without injuries.