Complimentary Marathon Preparation Evening with Complete Health and Wellbeing!

Hi all! If you are running any marathon distances this year, well worth popping along…

Following the success of last January’s Pre-Marathon event, Complete Health and Wellbeing are hosting another free information evening to prepare your body and mind for the gruelling 26.2 miles.

Join Sports Physio, Chris Myers and the Complete Physio Team for an evening of Marathon Preparation. The evening will be packed with insight, experience and education which will aid novice runners through to regular Marathon competitors.

The topics being discussed are:

  • Injury Prevention with Physiotherapist Chris Myers
  • Marathon Training Plans with Personal Trainer Ben Leach
  • Optimum Nutrition with Nutritionist Marc Adams
  • How to Train Your Brain for Success with Hypnotherapist Phil Dobson
  • How to Use Mental Rehearsals to Improve Performance with Hypnotherapist Phil Dobson

The event is totally free and will be held on Wednesday 15th January 2015 at 6pm on the 28th Floor of The CityPoint building.

Places are very limited and can be reserved by contacting:

Any questions, please ask!



Squat, squat, squat, squat… ouch.


I’ve been doing regular CrossFit-type training for about six months now and have done A LOT of squats! Stiff, tired legs and DOMS are not on my Christmas card list! This seems like a good junction to talk a little bit about knee pain and one of the most common over-use type injuries, namely cartilage and meniscal issues!

Cartilage is a thin, elastic tissue that protects the bone and helps joint surfaces slide easily over each other. There are two types of cartilage in the knee: articular (joint) cartilage, which covers the surfaces of the knee joints (patello-femoral and tibio-femoral); and hyaline (meniscus) cartilage, which sits in two distinct thickened, disc-like shapes within the tibio-femoral joint and essentially acts as a shock absorber providing structural integrity and spreading load. In addition the menisci have an important proprioceptive role, providing lots of functional joint stability feedback.

Have a look at this 3D representation of how the menisci function:

Various factors affect how well the meniscus and cartilage function: foot/knee/hip position, stance and posture; work/sport; flexibility of the great toe; muscle imbalances; gluteal control; age; weight; other joint problems; previous injury…the list goes on.

CrossFitters are generally not spring chickens and often carry previous injuries–so it is quite possible that you may have damaged your cartilage in a past knee injury from playing sports or tripping whilst drunk or maybe even dancing badly then waking up with odd bruises and swelling that you have little recollection of. These can be fairly insignificant and heal quickly. Larger trauma like fractures and tendon or ligament injuries often come with a serving of meniscal damage but may be a less significant problem at the time.  However minor these injuries may seem, they add up over time.

Unfortunately like any other machine, the joints of the human body are subject to wear and tear simply through the numbers of repetitions performed, and this is the main point I want to make in this blog!

Just like a mechanical component, let’s say the tracking alignment of a car chassis and the effect it has on tire tread, if something is off line it will cause an unequal pattern or wear. So poor technique when doing squats, lunges, jumps, deadlifts, pistols, etc. can create that same wear on the meniscus. Over time this leads to a learned dysfunction and then inevitably to pain!

StreTch, Josh, Geoff, Tom and all the other trainers consistently drill us about technique when performing complex movement. Their aim (apart from building fear and denting our pride) is that we carry on this correct form into our capacity work, strength training and most importantly into the WODs and competitions. Unfortunately when I see people with injuries, usually they can pin point the start of their problem back to an intense training session or WOD.

When we fatigue, form lapses and injuries can happen. Continued poor mechanics and pain lead to further ‘shearing’ of the articular surfaces (this can go down to the bone) and meniscal tears.

The menisci are relatively avascular therefore it is thought that menisci don’t repair and regenerate very well (with the exception of the outer rim) – another reason why careful attention to pain and symptoms is recommended!

Do you have a cartilage or meniscal problem?

Well, you may if you have any of these symptoms:

  • Locking or popping of the knee
  • Instability of the knee
  • Persistent swelling-exercise or activity related
  • Pain or inability to fully squat (sit on heels)
  • Pain/pinching with your leg fully extended
  • Pain on twisting, turning or change of direction

What can you do?

  • Work out what movements/exercises cause problems. Try to correct faults and work through the full range. Talk to the coaches and get others to watch you perform movements.
  • Don’t ‘bounce’ on your knees during movements or reps! We are all looking for a nice deep squat below 90 degrees but you must maintain muscular control through the full range. Otherwise you are just relying on recoil and momentum to bounce you back up from your heels putting extreme pressure on the ligaments and posterior horns of the menisci. These forces are magnified exponentially when you add weight!
  • Look at your alignment with all knee movements-is left the same as right? If not, why?
  • Wear the correct footwear! There are so many trainers out there! Do you over pronate or under pronate, and does it worsen when you squat or lunge? If you can’t correct it then consider an orthotic.
  • Check the mobility of you hip, ankle and big toe–is there a restriction on the problem side?
  • Check the flexibility of the main muscle groups on the affected leg – hams, quads, glutes, gastroc. and soleus. Fix this with stretches and foam rolling!
  • If the knee is swollen, rest it. You don’t have to stop training! There are hundreds of exercises for you to do, so be smart and work around the knee.
  • Don’t ignore it! Most musculoskeletal problems can be fixed if you get at them early – the right advice and management can save you a lot of pain, money, missed training and a meeting with an Orthopaedic Surgeon!

Hopefully this post gives you some things to think about whether you have knee pain or not! If you want any further information or want to talk about your knee or any other niggles, feel free to grab me down at the arches or send me an email:

Happy Xmas and New Year!

Cheers, Emerson

Posture and shoulder injuries…

Through the eyes of a Physio…


We can’t all be angels when it comes to posture!

Far too many of us have poor posture and our desk based lifestyles cause an imbalance between the anterior and posterior muscles on the shoulder.  There are many different exercises we can do in the gym to help improve this structural balance issue, but each individual athlete needs to make the effort to improve their posture outside of the gym.

Awareness is key and understanding your posture and what you can do about it is a good place to start. I was asked to write something for Crossfit Hackney ( about posture and common shoulder issues:

CrossFitters, like all other athletes can pick up niggles and injuries. It’s inevitable! The three common types of shoulder pathologies I see, associated with training, are:

– Rotator cuff (Bursitis, impingements, sprains and tears)

– Acromioclavicular joint problems (sprains, degeneration)

– Postural dysfunctions (structural, instability, postural)

… and then of course there are issues in the neck, which can present themselves as shoulder pain.

Our shoulder is a ball and socket joint that allows for almost 360 degrees of movement.  Many different muscles are involved in the movements and stability of the shoulder joint. Tightness and/or weakness of the muscles around the shoulder can soon cause a restricted range of motion, shoulder impingement, pain and discomfort.  If you are very protracted (shoulders forward) you will inevitably be tight in you pec-minor, have over-active upper traps, and put unnecessary stress on the posterior shoulder and rotator cuff. This ultimately causes compression of the sub-acromial space, acromioclavicular joint, wear and tear and leads to restriction and pain.

When I start treating people with shoulder issues, the first port of call is to address posture and start to gain an awareness of how you sit, stand and move. A lot of problems are due to our modern day activities on phones, iPads, laptops, being sat at a desk, driving and cycling to name just a few. Remember you may train or exercise for maybe one or two hours a day but sit at a desk for over eight hours!

So here are some tips to help improve your posture.

Desk ergonomics – three easy things to look at:

1. Make sure your chair allows your knees to be at a 90 degree angle

2. Make sure the middle of your screen is at eye level when you sit tall. If you work from a laptop, get a stand and mobile keyboard.

3. When sitting tall, do a sweep with the arm extended (semi-circle) and everything you use (phone, pens, paper, mouse, etc) should be within that arc.

And try this exercise:

1. In sitting, start slumped

2. Tilt your pelvis forwards, so you are sitting tall (in extension)

3. Ease off slightly, so you are neutral (in the Lumbar spine). You should feel your deep abdominals kicking in to brace you and not feel much tension in the lower back.

4. Draw your shoulder blades back, down and together – gently squeeze

5. Retract your chin slightly (double chin)

6. Hold this position for 10 seconds. Repeat ten times, hourly!

7. Set a reminder on your watch, phone or put a post-it in corner of your screen!

To check you are doing this correctly, get a friend to see how much tension you have in your upper traps in slumped sitting and then again in this improved postural position (it should be a lot less).

There’s a very informative video to watch:

Try this for a week at work and see how you feel!

Also have a look at StreTch’s ideas on shoulder mobility in CrossFit and some excellent descriptions from Kelly Starett: