 A runner is as susceptible to ankle pain as any other lower limb injury. The repetitive demands of continual load acceptance during the running gait can create a high level of stress through this joint. The result ranges from an increasingly uncomfortable run to a complete inability to weight bear. Either scenario can be catastrophic to a carefully planned training programme or even the disruption to a regular health and wellbeing activity. The Ankle is made up of three bones, the Tibia and Fibular of the lower leg and the talus in the foot. These bones are held together by a series of ligaments most of which run along either side of the ankle joint. These ligaments offer stability to the ankle. There are also several tendons that cross the ankle attaching to muscles higher up the leg which create the movement of this joint. Each of these structures can become injured when running. The most common causes and types of injury are discussed in this article. Sprains What is it and what causes it? An ankle sprain is a generic term for an injured ligament in the ankle. However, there are numerous ligaments that can become injured in the ankle, all of which may be caused by a different movement. A sprain is caused when a joint is stretched passed its natural available range. Ligaments are bands of connective tissue creating an attachment between bones, forming a joint. When the joint is over-stretched a ligament becomes stressed to the point it can tear. The most common sprain is a lateral ankle sprain. It is often termed a ‘rolled ankle’ this affects the ligaments on the outside of the ankle. It is also possible to sprain the ligaments that support the inside (medial aspect) of the ankle too. Site of pain is usually a good indicator of which ligaments you have injured. The least common of ankle sprains is a high ankle sprain (Syndesmotic injury), this effects the connective tissue between the two lower leg bones (Tibia and Fibula) and commonly causes pain just above the front of the ankle joint as supposed to the outside of the joint as with a common lateral ankle sprain. Just like Muscle strains, ligament sprains can be classified in the three categories, grade I, II or III.  Runners may suffer an ankle sprain of any type by landing awkwardly into a stride, slipping off a curb, falling in a pothole, or tripping on uneven ground during a trail run. Symptoms
 How to prevent it?
Stress fractures What is it and what causes it? Stress fractures are common in runners and have been widely discussed in the guide to running injury series. The repetitive high impact forces created during the running gait cycle are absorbed by many bones in the lower limb. Over time these repetitive forces result in microscopic trauma to the bones. Through inappropriate training programmes, this microscopic trauma does not have chance to remodel and can progress to create fine cracks (stress fractures). Most common stress fractures in the lower limb are found in the foot or shin. However, the Talus and Navicular bone are not immune to these stresses. They are located within the foot just below the ankle joint. Stress fractures will present with pain on weightbearing. This is worse on impact and settles at rest. It is often a localised sharp pain pinpointed to the site of the fracture. In the case of the talus and Navicular this may be in the front of the ankle or deep within the ankle joint.  How to treat it?
How to prevent it?
Avulsion fractures What is it and what causes it? An avulsion fracture is when the forces stressed on a ligament or tendon are such that they create too much strain on the attachment causing a small piece of the bone to be pulled away with the ligament or tendon. The mechanism of these injuries is largely the same as a sprain and often presents in a similar way. Generally this is diagnosed by X-ray or CT scans.  How is it treated?
Tendinopathy A tendinopathy is the degeneration of a tendon. Tendons attach a muscle to the bone. A tendinopathy occurs when a tendon is overused and subjected to adverse stresses. The subsequent degeneration is displayed as thickening, splitting or even tearing of the tendon. The repetitive nature of running and the high impact on the foot and ankle mean the numerous tendons around the ankle are vulnerable to tendinopathies if not managed sufficiently. Common sites affected are:
Symptoms associated with all these tendinopathies would be pain, swelling, weakness and even possible balance disturbances at the site of the respective tendon. As with all tendon injuries the pain tends to be prominent at the start of activities settling as the activity progresses. It may completely disappear at rest. Tendinopathies rarely get better without intervention and should not be ignored.  Tibialis posterior tendinopathy  Peroneal tendinopathy  Achilles Tendinopathy How to treat it?
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The hamstring is one of the most important muscle groups while running. It has a variety of roles throughout the gait cycle. These include forces to control the knee as it extends thorough the swing phase and creating the hip extension in the stance phase as the body passes over the planted foot. There is no wonder that this can be such a problematic region of the body when considering injuries that a runner might suffer. With such a complex role, pain in this muscle group can be caused by various injuries along the hamstring. This article will explore some of these most commonly suffered by runners. Hamstring Tear/Strain What is it and what causes it? Muscle strains are categorised into three grades. Generally, a hamstring strain will occur in the muscle belly (in the middle of the posterior thigh) or at either end of the muscle belly in the musculotendinous junction (as the muscle blends into the tendon). The most significant of strains (grade II or grade III) are more commonly experienced in sprinters due to the explosive forces. These types of strains can also be suffered because of sudden change of direction or acceleration and deceleration. Trail or fell runners who leap, jump or frequently run hills may be more susceptible to these types of strains than the steady state road pounding miles of a distance runner. The grade III rupture is a significant injury which will stop the runner in their tracks. It is often described as a pop or crack. The runner will feel like they have been shot in the back of the leg and is likely to leave them lying on the floor in severe pain. There will be immediate bruising and swelling as the blood rushes through the torn muscle. There will be a reluctance to put weight through this leg and the runner will be unlikely to walk. This would need immediate medical attention and, in most instances, result in surgical repair. A grade II strain will present similarly to a lesser extent. Although painful the runner would likely be able to walk, and subsequent bruising and swelling may be less severe or even non-existent. The more commonly experienced hamstring strains for steady state distance runners are the low grade I strains. The principle of injury is the same. The muscle is overloaded to the point it becomes under stress enough to tear. The over loaded muscle could have been caused by fatigue with increased intensity or lack of recovery in training. The tight shortened muscle in this state can create increased tension through the fibres as the hamstring goes through the gait cycle. These forces can expose the fibres to tear. A grade I strain will cause the runner a degree of pain but perhaps something that they can continue to run through. This pain usually stops after a run leading the runner to believe there is not an injury present. There is also unlikely to be any visible bruising or swelling present.  How to treat it?
How to prevent it?
Tendinopathy   What is it and what causes it?
Proximal Hamstring tendinopathy is regarded as a commonly acquired injury in longer distance steady state runners. This is due to the gradual onset produced over time with a repetitive gait cycle. As previously discussed, the Hamstring muscle is under tension across two joints in the later stages of the swing phase (as the knee decelerates through extension and the hip drives into flexion). This position is thought to generate compression of the tendon at the top of the hamstring, causing irritation, inflammation, and pain. Aggravating factors may be a sharp increase in volume or intensity of running, an increase in stride length, or swift introduction to interval/fartlek training or hill running. Symptoms
Common knee injuries experienced by runners
Generally, people run to gain a positive reward, whether that is to improve wellbeing and achieve a physically active lifestyle or to achieve an ambition of running a Marathon or just simply because they enjoy the space and freedom. If this positive reward is met by frustrating challenges such as pain and injury it can soon become a negative experience. There are times when activities such as running can seem to bring about injury. There is usually an explanation for this and therefore a solution! Here are some common knee injuries suffered by runners. Patellofemoral pain syndrome (runner’s knee) What is it and what causes it? This is a common Injury suffered by Runners. It is often termed 'Runner's Knee'. In these circumstances, this type of Knee pain often comes on gradually over time. It can cause swelling in the Knee and generally presents as a dull ache in the Knee or behind the Knee cap. It is aggravated by activities such as walking, running and going up and down stairs. Common causes of this type of injury in runners are thought to be overuse and misalignment of the knee. There are many reasons for misalignment of the knee and it would be helpful to establish which of these is involved when addressing future prevention strategies. How to treat it?
Iliotibial band syndrome (ITBS) What is it and what causes it? Pain is experienced on the outside of the knee, there may be swelling present here. The pain is felt during running, usually coming on after a short while of activity and subsiding once activity has ceased. Often this is seen in longer distance runners and is exacerbated by running downhill and downstairs. ITBS is generally classed as an overuse injury where the tissue of the Iliotibial band (fascia running down the outside of the leg) is experiencing friction over the femoral condyle (bony surface) underneath. How to treat it?
Patella tendonitis What is it and what causes it? This is an inflammation of the tendon over the patella. The most commonly experienced site of pain is just below the patella as the tendon joins the Tibia. It is known as another overuse injury causes by repeated impact. In the early stages of this injury pain may only be felt at the start of a run and ease as the runner warms up. Perhaps becoming stiff once again following the end of the run. If left this may become more symptomatic throughout the whole of the run along with affecting daily living activities such as going up stairs or standing from a seated position. How to treat it?
Ligament injury What is it and what causes it? There are four main ligaments in the knee. Too much stress on these ligaments can cause them to overstretch and even tear. Ligament injuries are often resultant of a specific trauma such as a sudden twist, an awkward landing, an over straightening or a direct impact to the knee. If damaged the knee will often experience sudden sharp pain and swelling. It will likely be painful to weight bear and there could be a degree of instability. How to treat it?
It can be most helpful to seek advice from a registered Health Care Practitioner to ensure that you have an accurate diagnosis and to ensure an effective treatment plan is prescribed. Low back pain can not only affect our enjoyment of running but it also affects most of our daily living activities. This is not a pain that should be ignored, there are most likely elements of your running practice that can help address this niggling pain and the subsequent physical and mental energy drain suffered throughout the rest of your day. The repetitive high impact forces associated with running puts additional load through the spine. If the spine is not supported efficiently by the structures around it, pain, instability and muscle over activity can occur. Here are a few common conditions which can be experienced by runners. Sciatica What is it and what causes it? Sciatica is a widely used term to generically describe an irritation or inflammation to the Sciatic nerve. This is a large nerve that originates from the central spinal column in the lower lumber spine. It tracks through the buttock and down the back of the leg. The irritation to this nerve is caused by an impingement (compression) from numerous possible structures. The most common are at the intervertebral discs or the vertebral joints in the spine. Another culprit to display sciatica symptoms is the Piriformis (a muscle in the buttock). Sciatica is classically described as pain in the lower back radiating into the buttock and down the rear of the leg. The pain can be described as shooting or burning and can also present with numbness or pins and needles. Severe cases can result in loss of feeling, strength or function and change in sensation to the lower limb radiating as far as the foot. This article will look further into each of these causing factors to Sciatica.  Intervertebral Disc herniation (bulge/prolapse) What is it and what causes it? One of the most common causes of Sciatica is a Disc herniation. Intervertebral discs are found between each vertebrae they act as a cushion throughout the spine offering support and protection. The disc are made up of a ‘jelly-like’ substance called the nucleus which is encased in a more firm elastic type substance known as the annular. A herniated disc is when some of the nucleus pushes out from the centre of the disc through a tear in the annular. This bulging nucleus can compress the nerve at its root causing the Sciatica symptoms. This type of injury is commonly the result of a degeneration of the disc. This aging disc becomes less flexible and prone to tearing. Modern lifestyle posture such as slouching or excessive loading of these joints can stress the integrity of the discs. The activity of running with its repetitive high impact loading in a pre-stressed spinal posture can increase the possibility of a disc herniation. Spinal stenosis or Spondylolisthesis What is it and what causes it? Both of these tend to cause lower back pain due to a degeneration in the spinal structures. A Stenosis is the narrowing of the spinal canal. The spinal canal is a space through the center of the vertebrae, which is where the central spinal cord travels. The narrowing can be the result of thickened degenerative ligaments or arthritic changes to the bone. This over laying of bone can narrow the spinal canal leading to compression of the spinal cord. This will present as pain in the back and often refers the sciatica symptoms described above. A Spondylolisthesis is an instability of the vertebrae, excessive movement can result in a slippage of one vertebrae onto another, this may be as a result of a fracture (more common in younger athletes) or from degenerative changes to the spine commonly seen in the over 50 population. The slippage of the vertebrae causes instability at this level of the spine and subsequent risk of compromising the space in the spinal canal. Symptoms would consist of pain in the lower back and into the buttocks, pain on walking or standing for long periods of time, pain on bending backwards. The impact of running particularly on firm surfaces is likely to aggravate symptoms of pain due to the repetitive high impact. How to treat these spinal conditions?
How to prevent them?
Piriformis Syndrome  What is it and what causes it? Piriformis syndrome is a term used to identify the over activity of one of the deep buttock muscles (the Piriformis). This muscle is vital in the stability of the pelvis whilst running. When this muscle is overactive or fatigued it spasms causing pain. There can be instances of lower back pain associated with this condition. More commonly the pain radiates from the buttock on the affected side, tracking into the posterior thigh, creating the symptoms of sciatica described above. Depending on the individuals anatomy, occasionally the Sciatic nerve can become compressed by the Piriformis muscle. Most commonly when this muscle is overused, or training intensity is progressed too quickly. The Piriformis becomes tight and compresses the nerve within its muscle fibres. Pain can be experienced with prolonged sitting or standing from a seated position or while preforming a squat movement. This pain may ease with gentle movement. There may be tightness or restriction in the buttock on stretching it in a seated figure of four pose. There may also be pinpoint pain and tightness over the upper buttock to one side. How to treat it?
How to prevent it?
Sacroiliac Joint Dysfunction  What is it and what causes it?
The sacroiliac joint is located at the joining of the pelvis to the sacrum (the base of the spine). Its main role is to accept the weight bearing load between the upper and lower body. This joint can become instable or restricted, both of which can result in pain in the lower back and buttock. If the neural structures are affected Sciatic like symptoms can be presented. A dull aching pain is often one sided and can be aggravated by weight bearing activities such as walking or running, sitting for a prolonged period, or standing from a seated position. Running can bring about an onset of pain due to the repetitive high impact loading particularly if this is on firm surfaces. The Sacroiliac joint can also become injured following a fall, over striding while running downhill or stumbling off a curb. How to treat it?
How to prevent it?
If in doubt about any symptoms or pain does not settle, it can be most helpful to seek advice from a registered Health Care Practitioner to ensure that you have an accurate diagnosis and an effective treatment plan is prescribed. A Kraft Test is a blood test used to identify a condition known as hyperinsulinemia. It is a picture of how your body responds to food, in particular glucose - the basic component of most of the carbohydrates we eat increasingly in our modern diets. When glucose enters the body it’s important that its concentration in our bloodstream is kept under control, so the body quickly responds to the glucose influx with a regulating hormone called *insulin*. Most of us associate insulin with a treatment for diabetes, and it is. But actually, everybody naturally produces insulin in the pancreas. Some of us need more insulin than others and the particular “pattern” of that response is very telling as to the status of your metabolic health. In fact, many medical professionals think it’s the most important blood test for metabolic health. The reason it is so important is because the test is an early-warning of chronic disease risk. A Kraft Test can reveal if the patient has a condition known as hyperinsulinemia, which is known to increase the risk of a host of conditions including diabetes but also hypertension, heart attack, stroke, neuropathy and even things like tinnitus, vertigo and hearing loss. In fact, Kraft took to calling hyperinsulinemia “occult diabetes” or “hidden diabetes”. In his original study*, Dr. Joseph Kraft, the doctor and pathologist who discovered these patterns, grouped the patterns he observed in patients into five broad groups. These patterns were observed after asking his patients to take a glucose drink while in a fasting state. This allowed him to isolate the behavior of insulin as it responds to glucose over the subsequent 3 hours and is almost exactly the same protocol you will follow to discover your Kraft Pattern. His discoveries were remarkable. He found that of patients who had normal blood glucose levels (about half the population in his study), and who therefore were thought to be in a “normal” or healthy metabolic state, 50% actually had hyperinsulinemia and a further 25% were borderline for the condition. Effectively these people had an early form of diabetes and didn’t even know it. They thought they were fine! The key insight a Kraft Test offers is in the pattern of insulin response to glucose consumption. But what do these patterns actually look like and what do they mean? Let’s take each one in turn. What follows are high-level descriptions and meaning of each Kraft Pattern as described by Crofts*.  Pattern I
This is the pattern observed in normal metabolically healthy individuals. Note how the insulin responds to the consumption of glucose but does so in a moderate way and rapidly declines after it has done its job. Pattern IIA This pattern is observed in patients who have a “borderline” degree of insulin resistance. Here we see a higher fasting level of insulin (not a good sign) stronger initial insulin (post-glucose drink) concentration in the blood for the simple reason that more of it is needed to keep glucose under control. Pattern IIB This pattern is observed in patients who have what is called hyperinsulinemia - an early biomarker for diabetes risk. Here we once again see a higher fasting level of insulin. Importantly we also see an even stronger initial insulin (post- glucose drink) “spike” in the blood compared to those in Pattern IIA. Pattern III This pattern is also observed in patients who have hyperinsulinemia. Here again we see the characteristic higher fasting an post-glucose-drink insulin levels. But we also see a delayed “tail-off” in insulin as the hormone stays around longer in the blood. This is a more pronounced form of hyperinsulinemia and people with diabetes typically have this kind of pattern. Pattern IV A rarer pattern that some patients will present with. Here we see a very high fasting level of insulin, a non-delayed peak and then a long tail off. Again, this is likely to be a sign of diabetes. Pattern V Pattern V is actually a special case. Note how insulin stays very low throughout the test. This is because these individuals are likely Type 1 Diabetics. The opportunity to get this assessment is now and with new technology you can get a real time assessment at our clinic in Devon. *Detection of Diabetes Mellitus 'In Situ' (Occult Diabetes) - Joseph R. Kraft, M.D. Laboratory Medicine, Volume 6, Issue 2, 1 February 1975, Pages 10–22. Postprandial insulin assay as the earliest biomarker for diagnosing pre- diabetes, type 2 diabetes and increased cardiovascular risk - DiNicolantonio JJ, Bhutani J, OKeefe JH, et al. Open Heart 2017. Identifying hyperinsulinemia in the absence of impaired glucose tolerance: An examination of the Kraft database - Crofts C, Schofield G, Zinn C, Wheldon M, Kraft J. Diabetes Res Clin Pract. 2016 Aug. A problem with our current diagnosis of metabolic health is our obsession with monitoring glucose and viewing as the metric that matters. In the example below we have the two time points. The first is Insulin Resistance or pre diabetes and important to note the glucose is normal but insulin is elevated they are not the same thing we fail to appreciate that they do not go hand in hand that if glucose is low insulin is low or glucose is high insulin must be high. For an historical point- Dr Joseph Kraft a pathologist developed the kraft test- an Oral glucose tolerance test with insulin assessment. Testing over 15,000 patients he found that in over 50% of confirmed diabetes cases they had normal glucose levels but high insulin. This would have been missed if we only test blood glucose levels. Glucose is obsessively the marker we concentrate on with diabetes but it shouldn’t be! We have the ability to measure insulin, so why don’t we? We see here that insulin is highlighting the problem potentially 10 years before we see a change in blood glucose levels. This is the potential if we come away from a glucose centric paradigm.  How is hyperinsulinemia caused?   The first eating pattern of 3 meals a day is more of an uncommon eating pattern we see today. Every time you eat this is the reciprocal insulin response across the day. Compare that to the more common pattern of breakfast, mid morning snack, lunch, mid afternoon snack, dinner and possibly dessert. This causes many more insulin responses and with a insulin sensitive person this can be managed for a while. But for an insulin resistant person the insulin never comes down it is constantly elevated. Therefore, we can now see that hyperinsulinemia can be a consequence of insulin resistance and also a cause. Its a vicious cycle accelerating the problem until the person changes their habits. How do we correct insulin resistance? If hyperinsulinemia is the primary cause then lowering insulin needs to be the solution. We do that through the foods we eat and by managing these macro nutrients. Compared to drugs it doesn’t come along with side effects it actually has side benefits to all our metabolic markers and our waistline! How do Macro nutrients affect Insulin? Currently according to the global nutrient database this is the proportion of macro nutrients we are eating around the world, Carbohydrates were the major contributor to energy availability (70·5%), followed by fats (17·4%), and protein (10·5%). Fat does not increase insulin, there is no study that shows that according to Dr Ben Bikman PhD. Protein has a small effect but carbohydrates have a large effect (18). In the image below this is the effect size in a slightly different view. This is not declaring a war on carbs because the type of carbohydrates do matter, but when we acknowledge that hyperinsulinemia is the cause of insulin resistance, one of these diets is going to work much better at removing the offending agent. When we eat these macro nutrients there is a corresponding blood molecule. In diabetes (type 2) which is just a prolonged insulin resistance, which of these nutrients in the blood is the body struggling with. Glucose is the one we obsess over the most and the one we are all eating the most of. “If lifestyle is the culprit, it is also the cure! The food we eat is causing or can cure these metabolic issues! When we look through an insulin lens, we appreciate we just need to lower the insulin by managing our macro nutrients, control carbohydrates, prioritise protein, don’t fear fat, and maybe frequently fast. This can literally cure the problem.” Dr Ben Bikman   About 5 years ago my health was troubling me as I found it difficult to think
straight, formulate my words, had a lack of energy, motivation for exercise and I was putting on weight. This didn’t make much sense to me as a former athlete and with my job now as a strength and conditioning coach, so I am active all day everyday. I decided to get some blood work done and my triglycerides and HDL were out of the accepted range, which is doubly troubling considering these reference ranges are based on a sick population as it is. This lead me to look for answers and I found those answers and that is what I am going to discuss in this article from my knowledge through my learning through the Nutrition Network which I am now a nutrition Network advisor and the knowledge of many exceptional researchers, clinicians around the globe that have highlighted the impact of insulin resistance on our bodies and brain. Metabolic syndrome has been described as anyone having three of these five symptoms, increased waist circumference, increase in blood glucose, high blood pressure, high triglycerides and low high density lipid proteins or HDL the so called good cholesterol. In the UK currently it is said that 33% of adults have metabolic syndrome (1), this is not just a UK problem this is a global problem with high rates of insulin resistance in south east asia, the middle east, pacific islands, USA and Mexico, which showcases the prevalence of the problem. It is estimated that nearly a billion people suffer from Insulin Resistance across the globe, (2) yet it is not routinely screened. In the UK the problem actually could be a little worse, high blood pressure or hypertension is said to affect 58% of the population (3) which is a critical part of metabolic syndrome and usually the first sign that something has gone array. While we are not always measuring the other signs, we are always measuring blood pressure when we see a GP. So if 58% of the population have hypertension might that mean that 58% have insulin resistance. Why that connection? Metabolic syndrome used to be called Insulin Resistance syndrome which does a much better job at explaining what is causing the symptoms, much better than the vague term metabolic syndrome. So if 58% of people in the UK have hypertension its not much of stretch to suggest they have Insulin Resistance which is presenting itself as high blood pressure. Insulin Resistance is at the root of the common diseases we are seeing today such as Heart Disease, as it is fundamental in contributing to heart Disease and the damage to the vascular system, it would be very uncommon not totally impossible for someone to have heart disease without insulin resistance and hypertension plays into that. With Cancer, some cancers are not caused but made worse by Insulin Resistance, as it accelerates the growth of the cancer cells. Fatty Liver, the most common liver problem across the world, directly caused by insulin resistance and the insulin promoting the growth and the production of fat within the liver. Type 2 diabetes, with the high levels of insulin known as hyperinsulinemia is trying to manage the high blood sugar levels and causing more cells to become resistant, and Body Fat, you cannot make fat cells grow without insulin being elevated, regardless of calories consumed. In addition to these big 5 killers or problems, we have some that range from similarly lethal and tragic like dementia and Alzheimer’s disease, being the most common form and even stroke one of the most top expenses of the NHS. Then less lethal but very relevant to a population and particularly heart breaking for a couple we have the most common forms of infertility. The most common in women PCOS (more appropriately called metabolic infertility) insulin directly affects estrogen production from the ovaries and in Men Erectile Dysfunction which may be the first clinical sign of Insulin Resistance in otherwise healthy men. Due to what IR is doing to the blood vessels. The hope is that a person who is taking medications for hypertension, diabetes, migraine, and fatty liver etc doesn’t believe that they are all individual problems they are in fact the symptoms of the same root cause. Once we know this we can then impact that root cause and as Dr Robert Lustig has suggested in his great book Metabolical, the root cause is not druggable but is foodable. This is because these chronic diseases are disease of the mitochondria the power house of a cell that uses food to produce energy. So while treating the symptoms of these diseases with drugs it never gets to treat the mitochondria, only food can do that. How do you know if you have insulin resistance? Do YOU have high blood pressure, type 2 diabetes or gestational diabetes, PCOS (women), Erectile dysfunction (Men), fatty liver disease, or skin tags and dark patches on the back of the neck or under the arms (acanthosis nigricans). The skin can be a window into the metabolic soul! If you answered yes to anyone of these then you likely have insulin resistance. These are signs of an underlying metabolic problem, but most are undiagnosed! This is why the problem is likely much worse because you could have someone with these skin tags and acanthosis nigricans and have a normal blood sugar or blood pressure and therefore they are not considered to have any issues metabolically. (1)https://www.nhs.uk?conditions/metabolic-syndrome/ (2) PMID: 29480368 (3) https://www.gov.uk/government/publications/health-matters-combating-high-blood- pressure/health-matters-combating-high-blood-pressure Taylormade Performance and rehabilitation teaches Modified Pilates following The Australian Physiotherapy and Pilates Institute (APPI). This method combines traditional Pilates with the most current research into spinal stability. It breaks the exercises down into clearly defined levels to produce a gradual progression of load and control. Using this framework of exercises, we operate in the knowledge that our practices are up to date, safe and effective ensuring the most appropriate outcome for every client. This may be performance related, muscle toning, rehabilitation, posture or just to be able to move more efficiently and free of pain and stiffness. Whatever the objective our program has a proven track record of success.
There are many forms of Pilates from Mat work exercises that utilise the control, resistance and mobility of the body alone to exercises using the reformer, a specific piece of equipment that provides external resistance to exercises. There are various smaller apparatus such as the Pilates Ring, the small over ball, the foam roller, the resistance band and the Barrel to name a few. The modified Pilates method that we practice also provides a host of diversity by creating levels of intensity for each of the original 34 Pilates exercises. The variety and diversity that can be achieved with Pilates makes it such a successful mode of exercising in a group. It allows the instructor to adapt and create a variation of an exercise to cater for different abilities within the same class without setting up completely different programmes for each member of the group. It also provides an opportunity for the participant to witness improvement and progress in their practices. Our tailored approach that underpins all our services is carried through to our Pilates groups. We can achieve this by keeping our Pilates groups small (on average between 4-6 participants), whilst using the modified Pilates approach and the variations it offers. The individual induction we recommend prior to joining a class provides an insight into the participant’s ability, control and experience ensuring they are safely whilst suitably challenged. Pilates is recognised as a beneficial activity for promoting wellbeing. Its exercises focus on a mind and body connection promoting concentration on body awareness and visualisation of movement. It utilises breath work to enhance the performance of exercises. At Taylormade we have experienced further wellbeing benefits expressed by our clients that attend group Pilates. Some groups have practiced together for over six years. This time each week provides opportunity for both new acquaintance and conversation to develop as well as opening up a time for old friends to socialise whilst carrying out their Pilates. Our informal sessions always provide a relaxed and welcoming environment. Pilates is becoming increasingly recognised in the world of sport with top athletes such as Andy Murray, Christiano Ronaldo, Maria Sharapanova, Chris Robshaw and Lebron James all providing testimonies to the discipline.
Pilates can impact an athlete in many ways, 5 key areas are :
What is Pilates:
Pilates is a form of exercise which concentrates on strengthening the body with an emphasis on core strength. Pilates also focuses on the mind-body connection. While doing the various exercises your mind needs to be constantly aware of your breathing and the way your body moves. This form of exercise was developed by Joseph Pilates in Germany where he was a carpenter and gymnast. He invented Pilates as an exercise program for injured dancers and soldiers while living in the UK. Joseph Pilates believed that physical and mental health were closely connected. In the 1920’s he immigrated to the US and opened a Pilates studio in New York. Originally this form of exercise was called Contrology. Today it is widely practiced by many in all aspects of life and its key principles are transferred into our everyday life.
In December we pioneered the first Metabolic Kraft clinic in the UK. Together with Dr Donal Collins and collegue Debbie Cox we tested 7 of my current clients to provide them with real-time Kraft curves and a metabolic profile interpretation like this A “Postprandial insulin assay is the earliest biomarker for diagnosing pre-diabetes, type 2 diabetes and increased cardiovascular risk” Dr James J DiNicolantonio. My clients therefore were eager to know what sort of shape their metabolic health was in. In addition this assessment allows if there is metabolic dysfunction a faster response to lifestyle changes than glucose assessment. Made famous by Dr. Joseph Kraft, a clinical pathologist, who ran 3,650 glucose-insulin tolerance tests. developing what is now known as the Kraft curve.  Of the 3,650 glucose tolerance tests, 1,713 were defined as normal (for diabetes mellitus) according to the criteria of the American Diabetes Association.
Of the 1,713 tests which would have been judged normal strictly on the basis of glucose tolerance, 50% were demonstrated abnormal on the basis of insulin tolerance, and another 14% were borderline results. 2.5% were displayed insulin response. This means that 2/3 of the tests that would have been judged normal by the Glucose Tolerant Test were found to be latent diabetic when the Kraft Prediabetes Profile test was taken into consideration. This is the power of insulin assessment! My clients were all in good metabolic health and thoroughly enjoyed the experience and the opportunity to learn more from each other and from themselves in what action they have taken over the last few years is keeping them healthy. Some of the comments from the day were: “It was very enlightening. Pleased my ‘internals’ are working well… must be all the good groundwork we have been putting in” “Thank you for this amazing health check. It is reassuring to know all’s well.” “Great experience, nice to meet other people interested in their health. The whole experience was really well organised and professional. Thank you for the information.” “The new insulin testing offered by Taylormade Performance & Rehab is truly enlightening. Andy’s explanation of insulin’s role in the body and associated potential diseases, coupled with my own personalised insulin resistance profile gave a real insight into my own health. Highly recommend this to anyone who wants to look after themselves both today and for their future selves.” “Long term health has been a key driver for changing my eating habits, I want to be a fit and healthy role model for my children and I want to be around to watch them grow up. The metabolic testing was really part of that whole journey - it confirmed to me that I’m on the right path and that I am healthy- if I hadn’t made the changes I did 2 years ago then based on the results I would most certainly be more at risk of disease and poor long term health.” If you are interested to learn more about the Kraft test pllease also see the soon to be launched site www.meterbolic.org and video attached below. https://youtu.be/SRrT0QT2ALw We would love to add more sites around the UK and the world. So, if this sparks your interest and you want to have a test, support or collaborate, then please drop a DM to myself for information and discussion. Would love to hear from you and discuss your role in the next phase of our Metabolic Revolution! For sports people genetic tests should be the natural base to evaluate how much of their potential they are exploiting.
Many sports people are convinced that adequate training combined with correct nutrition (and here we could open a bible of considerations) permit them to achieve the best performances. However before an allergy there can be an adverse reaction to a food which then becomes an intolerance, but even sooner an adverse reaction is then a reduction in absorption of nutrients, so basically many people have "correct" nutrition that due to different reasons (intestine, genetic predisposition, over feeding) doesn't let them use the 100% of proteins, vitamins etc.etc). On this basis if you accept this concept the first thing to test is the engine, is the "burning efficiency" of the engine working well and checking if the fuel used is the best for that specific engine. So the first easy test to offer is the intolerances one (TIAMI 180 but if the analysed subject is not in particular a food explorer that loves to test and eat anything the TIAMI 90 is more than enough). TIAMI is FOOD INTOLERANCE TEST IMMUNOENZYMATIC METHOD in a Italian TEST INTOLLERANZE ALIMENTARI METODO IMMUNOENZIMATICO (TIAMI). TIAMI 90 crossed with a food weekly journal allows for a clear picture of how much food energy is being exploited in the patient. TIAMI test offers as well the possibility to evaluate intestine wellness 'cause if the patient is eating correct food in terms of tolerance but complains about some problem with intestine (abdominal swelling, difficult or too easy evacuation, acne, excessive sweating, etc.etc) we can presume that there is a dysbiosis in progress that causes an inflammation . What could be worse for our well-being than not doing any kind of physical activity?
Probably do it wrong.... Let’s start from the assumption that we are not all born to do marathons or endurance races like "ironman" then the first consideration that has to be made before venturing into any sport discipline, is what type of exercise best suits us and our actual physical “shape”. With several pounds more than our weight form, when trying to recover our physical fitness to decide to go jogging every evening for 90 minutes is not the most suitable choice, our knees and our back if asked would not agree... We have always to consider that a wellness program starts from a healthy diet developed on our predispositions, our tastes and our lifestyle so, once again, combining homemade or "hungry" food programs with Olympic exercise only leads to stress unnecessarily on our body and our metabolism. We have to be aware that in a slimming program the exercise aspect helps for a 20-30% not anymore. To continue to eat “random” even if combined with the best fat burning exercise does not lead to anything: many people after weeks spent training have not lost weight, and in cases that they have lost it is more in liquids than fat mass. Before starting any sport activity it is always recommended to do a medical examination in order to check our state of health to avoid future problems: if 20 years ago we were a skilled footballer or good tennis player remember that it was 20 years ago. Time unfortunately is not a friend of health and basing our recovery in form in a program on past splendors is not a wise approach. To support well-being 150 minutes per week of aerobic activity are enough; however it’s totally useless to do everything on the weekend and you should try to distribute these 150 minutes on seven days.(20 per day) Often on Sundays you see on the streets "cyclists" who would like to be a Tour de France participant, weighted in pedaling, body and spirit, “veterans” of a 80 miles tour then after that from Monday to Saturday the only sport practiced was the “fridge door opening” convincing themselves that a single exhausting weekly session resolves the "problem" weight/ well-being. It would be enough to look at our profile in the mirror to verify that this is not so. Twenty minutes a day, a little less or more, can be found and it is a small sacrifice that our health will appreciate. If we combine this manageable physical activity with an adequate food plan, based on a preventive medical investigation and not on the diet downloaded from the internet, our silhouette will join the applause of health and we will find ourselves enjoying a new optimal sense of wellbeing. In conclusion: "do it yourself" as it is a cheap choice does not always bring positive results, so we do less but do it better. Don’t work harder work smarter! No drastic and dramatic choices, no low-calorie diets, no exhausting gym session at 9 pm because we don’t have time before: let’s wake up half an hour before, take your breakfast at home, let’s get used to having healthy snacks, eating healthily and taking care of ourselves and our silver years will be better because we have invested a little but consistently. Little but on a regular basis is the best formula that ensures lasting results without stress. Andy Taylor & Dr.Fabrizio Reggiani With 7 in 10 people (in the UK) looking to make health improvements post COVID-19, now is the best time for YOU to make that step.
We use a tailor made approach to your health assessment that looks at your physical, mental, social aspects of your life. Apart from the physical assessment we want you to have an idea on how you feel about yourself and what you are capable of and what areas of your life are a priority for you and what you are putting in place to make those areas as strong as you want them to be. How it works: 1. Measurements •Body Composition Analysis, Body Composition Scales Bioimpedance Analysis (BIA), Tanita, Non-intrusive, Simple print out Takes 20 seconds, •Waist Circumference. Waist to height score •5km Row cardiovascular MAF assessment •Squat, Lunge, Press, Pull, Brace, Hinge Strength Assessment •Wheel of life Assessment, Self Esteem Questionnaire, Self efficacy for exercise Questionnaire 2. Consultation Explain metrics, educate, coach, agree goals & actions before next measure 3. Book follow-up Next appointment in 3 month period Membership provides x4 measures per year for £240 Monthly Assessment £720 per year THIS IS NOT A GYM MEMBERSHIP. This is a Health Membership. However….. We do offer a Supplementary Scheme which includes •Online training remote or via app; 1-1 or Group Workouts, Classes, etc. •Coaching, Remote coaching, Personal training, Pilates etc. •Nutrition coaching, advice, food delivery, meal preparation •Education Seminars •DNA Testing, blood testing ...and much more We are pleased to be offering our clients and you the opportunity to use the Pulseroll products and purchase them through our website.
We have been using the products with our clients over the last two months and the feedback has been so good that we have jumped at the chance to be able to offer our clients and you the opportunity to purchase their scientifically proven products with unique features. The Pulseroll Vibrating Foam Roller PRO with its wider length than the classic roller, the Pro is the most powerful product in the Pulseroll family. Due to the vibrations, there is almost NO need to roll, technique is minimal and it is far less painful to use than a traditional foam roller. Reduce Next Day Soreness and Muscle Pain, 5 speed variations, Controlled easily with the one-touch remote control Percussion Mighty Mini Massage Gun The mini massage gun has been designed to be your pocket-friendly ally. It helps to keep aches and pains at bay wherever and whenever they occur. Reduce Next Day Soreness and Muscle Pain, Increase Blood Flow and Flush Away Lactic Acid, Perfect to use all over the body. Pulseroll Percussion Massage Gun PROThe Pulseroll Massage Gun PRO treats problem areas with short, strong pulses. A hand-held deep-tissue tool that uses rapid strokes to stimulate blood flow to the muscles. Reduce Next Day Soreness and Muscle Pain, Increase Blood Flow and Flush Away Lactic Acid, Perfect to use all over the body Pulseroll Vibrating Massage Peanut BallThe innovative peanut shape ideally fits comfortably around the muscles, targeting the desired area with precision and best suited for myofascial release, trigger point therapy, and deep tissue massage. Can be used on almost any part of the body, Controlled easily with the one-touch remote control, Portable and Lightweight Pulseroll Vibrating Massage Single BallSmall but powerful; the Pulseroll Single Ball helps to reach and specifically target trigger points, combined with our vibration technology that can penetrate deeper into the desired muscle fibres. 4 vibration settings, Can be used on almost any part of the body, Portable and Lightweight. All products have been scientifically proven Scientifically Proven to Reduce Next Day Soreness and Muscle Pain, Increase Blood Flow and Oxygen to Muscles and have been Approved by Physio's and Pro Athletes. To get hold of the product you need today check out our online shop to order https://www.taylormaderehab.com/store/c10/Sleep_and_Health.html#/ |
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PERFORMANCE AND REHABILITATION CLINIC
Injury Management and Conditioning Specialist
Taylormade Rehab, 1 Belle Vue, Fenny Bridges, Honiton, Devon EX14 3BJ | 07800 824557 | 07855 386634
© 2019 Taylormade | Performance & Rehabilitation Clinic. Injury Management & Conditioning Specialists | Website design by brightblueC
© 2019 Taylormade | Performance & Rehabilitation Clinic. Injury Management & Conditioning Specialists | Website design by brightblueC