Victory's Flexible Friends

Posted by Nell Mead at 08:00 on 17 Aug 2011

For the past few weeks, as I’ve been working to turn Victory into a larger and more interdisciplinary practice, I’ve been having fun doing some “quality control” – making sure that the practitioners I want to be associated with Victory are at the top of their game. So, all in the name of benefiting you, the client, (naturally!), I’ve been swapping treatment sessions with Victory’s sports massage therapists, and with The Foundry’s trainers. I’ve not yet been disappointed, and I’m quite sure you won’t be either.

This past week, I’ve branched out a bit. Pilates teacher Laura Hogg used to work at The Foundry but has now set up her own, more spacious, centre just a few minutes away in Shoreditch. I’d been wanting to meet her for ages, so grabbed the opportunity when she rang to request some physio treatment, to ask if she’d be happy to swap sessions with me.

I’ve never really done much formal Pilates or yoga, though I’ve learned some of the basic exercises over the years as I’ve expanded my knowledge of physiotherapy and core control. But last week I Laura gave me my first Pilates lesson (which was excellent – highly recommended!); and this morning I also met her colleague Jo Lawson, a yoga teacher from New Zealand.

Both Laura and Jo are very bendy, which makes the shapes they can contort their bodies into really rather lovely to look at, and inspirational to try to replicate. But they’re also both very encouraging and sympathetic to those of us who are not quite as flexible. And – somehow – after repeating the moves a few times, I gradually felt myself becoming, if not quite graceful, then slightly less rusty!

One of Jo’s stretches, which we did when I mentioned an old shoulder injury, was completely new to me, and I thought it was brilliant so with her permission I’d like to share it with you. You may well need some assistance with this at first (I did!) but after a bit of practice it should get easier.

• To stretch your right shoulder, sit on the floor with your legs out straight in front of you and toes pointing at the ceiling. Pull your right foot all the way into your groin.

• Then reach your right arm out towards your left foot, making sure your right shoulder is inside your right knee.

• Next, twist your shoulder inwards so that your right thumb rotates anticlockwise towards the floor. Lean your upper body forward and reach your arm around your raised right knee, so that your hand reaches as far round your back as you can manage. You should feel an agreeable pull between your right shoulder blade and your spine, as your shoulder blade is pulled forward to accommodate your knee.

• Your next move is to reach round behind your back with your left hand, and try to grasp the fingers of your right hand with your left.

• Seen from behind, the stretch should ideally look like this.

• However, most of us won’t be quite that flexible, especially at first. So if your fingers can’t reach each other, you can hold a towel or strap in your hands, and gradually work your fingers closer together. At first you may need a helpful someone to place the strap or towel into your hands behind you.

Relax into the stretch for a couple of breaths, focusing on allowing your muscles to relax and lengthen. Then let go of your fingers, unwind and repeat on the other side.

When people ask me – as they frequently do – whether they should choose yoga or Pilates, I often respond somewhat glibly (and generally, I think, truthfully) that it doesn’t really matter which you do as long as you find a good teacher. Now, with Shoreditch Pilates and Primal Yoga round the corner, I’m delighted to be able to say that I think I’ve found excellent teachers for both disciplines, and I’ll definitely be going back for more: see you in class!

*Thanks to Jo for kindly agreeing to model at a moment's notice!

Victory at The Foundry

Posted by Nell Mead at 08:00 on 8 Aug 2011

For us at Victory - well, ok, maybe just for me - today is a hugely exiting and momentous day.  And why, might you ask, would that be?  Well, partly because I left the Army exactly a year ago today.  But also because the lovely directors of The Foundry, Dave, Helen and Graeme, asked me a little while ago if I'd like to set up a proper rehabilitation centre in their premises.  So from today, Victory is officially a full-time entity, with two therapy rooms, in the one location - hurrah!

I, my dad and my lovely friends Claire and Jono have spent the weekend repainting the therapy rooms, and you'll also see logos appearing over the next few weeks and a bit more clinic furniture.  Dave's also suggested holding a launch party - definitely something to think about in the near future!

In the mean time, I'd like to introduce you briefly to a few of the characters you might meet when you come to Victory.  When I get a chance, I'll blog properly about each of them - this really is just a very brief hello.

Sarah Harvey is my lovely PA.  She keeps me on track with all the myriad things I'm supposed to do but keep forgetting.  She organises the team's diaries and makes sure I don't double book myself and do remember to pay bills and invoice clients.  If you ever need to contact anyone about the administrative side of Victory, or to arrange an appointment, Sarah's your girl - e-mail her here.

Dr Victor Thompson is a clinical psychologist who specialises in sports and performance.  I met Victor nearly ten years ago when I became interested in sports psychology as a way of improving my results on the tennis court.  After four hours with Victor I won 20 tennis matches in a row, and I've been recommending him ever since.  At the moment, he consults with me on clients who have an emotional, psychological or stress-related component to their physical pain; so far this has been very successful and I look forward to being able to offer this service more frequently in the future.

Jake Thackray is a former Physical Training Instructor in the Royal Navy and is still a serving policeman.  He's been working at The Foundry for some time now as a specialist in sports massage and remedial therapy, and will continue his sports massage work with Victory.  At the moment he is mainly available on Monday evenings but over the next few months he will hopefully be around more regularly.

Busy bee Sarah Franklin is - by day - a fitness manager at Virgin Active Moorgate; but she is also qualified in sports massage therapy, and is available to see clients at Victory some evenings and weekends.  Although she has been working at The Foundry for some time, Sarah and I haven't yet swapped treatments (something I like to do regularly with all the Victory therapists) but I hear great things and am really looking forward to it.

Flight Sergeant Paul "Spot" Leppard leads the multidisciplinary Spines Team at the Defence Medical Rehabilitation Centre, Headley Court.  A qualified Exercise Rehabilitation Instructor (ERI), he also received his BSc in Sports Studies from the University of Wolverhampton in 2003.  He is available in the evenings and at weekends to provide exercise therapy for clients with back pain and spinal injuries.

Graduate Sports Rehabilitator Cat Cornwell is also currently working at Headley Court as a civilian ERI specialising in complex trauma.  She holds bachelors degrees in Sports Rehabilitation and Sports & Exercise Science, and is currently working towards an MSc in Neuromusculoskeletal Healthcare.  Last month she was also part of the Team True Spirit squad of Headley Court patients and staff to complete the Iron Man UK Triathlon.  With a very solid history of working with high level sportspeople including GB Women's Basketball squad, Cat is definitely the girl to take you from getting over an injury to being ready to start full-on personal training.  She is available in the evenings and at weekends.

Ryan Walsh is a former member of the Parachute Regiment and of the Army Rugby team - and is now a professional boxer - see him in action here.  He's a qualified Personal Trainer who has worked with Bath Rugby and was seen on the 2010/11 School of Hard Knocks series on Sky Sports One.  I've known Ryan since he was 17 and was surprised when he called to tell me he had qualified as a sports massage therapist; but even more surprised when he proved to be really rather good at it, with a good range of techniques and an instinctive touch.  You really can't teach someone to have good hands!

Former Royal Marine Phil McDougall is currently in the process of completing his Level 5 Sports Massage qualification at the London School of Sports Massage, and is due to start training at the British School of Osteopathy in September.  A thoughtful and instinctive therapist who is keen to learn, Phil will be available on Friday afternoons, and on other days by prior arrangement.  Given the famed rivalry between the Paras and the Marines, I'm intrigued to see how Phil gets on with Ryan...!

Capt Harold Ackroyd and Maj William Allen were the first two members of the Royal Army Medical Corps to be awarded the Victoria Cross.  Sarah suggested that we should name our therapy rooms in their honour - so we have.  For those who are familiar with Victory's layout, Ackroyd faces you when you reach the bottom of the stairs, and Allen is on the left.

Finally, there's Starvin' Marvin (on the right) - the leanest member of Victory.  He was named on 2 Feb after The Foundry held a Facebook competition.  He hangs around generally looking like a bit of a cool dude, and is always available to show you what bones look like and how joints should work.

The only down side to this is that - with not enough hours in the day - I'm having to give up my clinic at The Back Shop.  But the staff are great, and I still really rate the equipment they sell (particularly the Mobiliser!) and their ergonomic assessments, so I have no intention of losing touch with them completely.

Right - that's it, I've said enough.  You've met the gang: what are you waiting for? Come on in and meet us: get in touch to book that appointment you've been needing for ages....!

Victory and the City

Posted by Nell Mead at 09:00 on 29 Mar 2011

Last week I took an afternoon off to join personal trainer extraordinaire Dave Thomas from The Foundry, who was playing for Citi Rugby in the Norton Rose City Scrum, a corporate touch rugby event held at the Honourable Artillery Company's grounds in Moorgate.  As Dave is more commonly known as "Hospital" Dave, I was attending in the role of his personal physiotherapist - despite being a touch tournament, he was apparently carted off by paramedics last year with a badly-sprained ankle.  Opting to minimise the risk, I taped the dodgy ankle firmly in place before I allowed him anywhere near the pitch!

The event did have a serious side - it's run for charity, plus I had the additional responsibility of fixing Dave and his team! - but was also a lot of fun, and the HAC is a fabulous venue.  Each team is "coached" by a member of the Harlequins team (many of whom have never played touch rugby) - and this year, Citi were coached by Quins' captain Chris Robshaw, pictured here with Dave.

After a slowish start, Citi hit their stride and Dave - with a freshly flexible back and hamstrings - performed a try-saving ankle-tap diving tackle to deny UBS a win.  Unfortunately, in doing so, he managed to face-plant into the sand around the try line, temporarily blinded himself, and had to come off; but the vital tackle had been made and there was no real damage to Dave (which, I confess, was a relief to his physio!)

In the semi-final, Citi played against last year's winners, JP Morgan.  A stalemate ensued, and at full time the score was 0-0.  Each team lost a player and they played 5 v 5 for a few minutes... still no score.  4 v 4... still no score.  The teams went down to 3 v 3 and suddenly the pitch looked much bigger.  Dave - on the left wing - received the ball at about the half way line.  Accelerating off his right foot, he sprinted left, and - throwing an outrageous dummy - scored in the corner.  Citi were in the final.

As Dave had to train some clients, we left at this point.  I'm not sure whether he was more sorry to leave before the final, or happy to leave on a high.  But a text message an hour later confirmed that Citi had won the final - with Will Myers as player of the tournament. Well done Citi!

Shoulder pain - an underdiagnosed dysfunction

Posted by Nell Mead at 14:00 on 18 Feb 2011

This post is triggered by Dave Thomas of The Foundry, who commented yesterday on Facebook following a therapy session with me that “if you haven’t had your subscapularis walked on before, it’s a treat!” It seems to be a relatively unusual technique, but one of my favourites, and this is why.

The subscapularis (aka subscap, to rhyme with hubcap) is a triangular muscle which sits between the ribs and the shoulderblade (scapula) – its name meaning literally “below the scapula”. With its base covering the entire of the inside edge of the scapula, it narrows to a tendon which attaches to the inner part of the humerus (upper arm bone) and the shoulder joint capsule. Its role is to twist the arm inwards (place your hand on your stomach and try to push through to your spine: you’re using your subscap) and to pull the humerus forward and down when your arm is raised, thus preventing your shoulder from dislocating.

It’s one of the four muscles that make up the rotator cuff, (the others being supraspinatus, infraspinatus and teres minor, if you’re interested!) but far less frequently torn than the more vulnerable supraspinatus and infraspinatus. Probably because of this, it’s a muscle that’s often ignored by therapists when treating sore necks and shoulders, but in my view that’s a mistake. Good subscap function is essential to good neck and shoulder function, and I have a few theories as to why this is the case.

One theory is the effect that subscap has on the ribs. As I’ve mentioned, subscap sits between the ribs and the scapula. Normal shoulder movement depends on the scapula being able to glide freely over the ribs. When muscles are sore, they tend to tighten up and develop trigger points – isolated areas of muscle spasm; and subscap is no exception. It’s my belief that tightness and/or trigger points in subscap can be partly responsible for dysfunctional movement of the scapula over the ribs. This in turn places excessive strain on the rib and shoulder joints, leading to pain in the upper back, neck and/or shoulder.

I believe that another problem with subscap trigger points is the effect these have on blood flow and nerves. I suspect that when a muscle is tight, its spasmed fibres affect not only each other, but also other local structures such as blood vessels and nerves. In the case of subscap, this could – theoretically - affect the axillary (armpit) artery and the ulnar branch of the brachial plexus – the nerve that goes down to the inside of the elbow and the ring and little fingers. It’s certainly noticeable that patients often comment that they feel odd sensations in these areas, as I release their tight subscaps; or that once I’ve finished, they feel a rush of heat to the area (increased blood flow?)

Releasing the subscap is pretty tricky to do on your own. I often use my heels to release subscap in my patients – most therapists use their fists or fingers, but it’s hard to do that without jabbing your patient and causing more discomfort than necessary. If I have to release your subscap, I’ll ask you to lie on your back with your hand behind your head. This brings the edge of your scapula out to the side of your body, and I can then fit my heel between the edge of your scapula and your ribs, and use my bodyweight to stretch and massage the subscap, gently and rhythmically until the spasm subsides.

Not only does this tend to release the subscap spasm, it also frequently seems to relieve neck pain and increase in rotation at the neck, which is a great side effect. I’m not sure whether this is also due to better rib mobility, or whether there is some sort of chain reaction going on whereby the subscap release causes a release in the levator scapulae – any bright ideas gratefully accepted!

After I’ve released your subscap, I’ll show you how to stretch it yourself, using a chair, Swiss ball or yoga brick, so that you can maintain the improvement at home. 

If you're having problems with a shoulder, please e-mail me for advice or for an appointment.