In the news…

Eurosport.co.uk: The impact reduced practice data had on the quality of the United States Grand Prix is a worthwhile discussion point for Formula 1’s future template, says Ross Brawn.

Friday practice at Austin took place in wet conditions but Saturday and Sunday were completely dry and the race was one of the best of the F1 season.

Ferrari’s Kimi Raikkonen defeated the Red Bull of Max Verstappen and Lewis Hamilton’s Mercedes as F1’s three big teams duked it out on three different strategies.

Brawn believes there is a link between the reduced data the teams had from Friday and the entertaining grand prix and said it should become part of F1’s deliberations over how to make racing better. Full story: Eurosport.co.uk

Kimi Raikkonen, US Grand Prix, Ferrari

Sebastian Vettel: Formula 1’s red flag rules are ‘wrong’

Autosport.com: Sebastian Vettel thinks the way Formula 1’s red flag rules are policed is wrong, after getting a three-place grid penalty for not slowing enough in United States Grand Prix practice.

The Ferrari driver was deemed by the race stewards to have not slowed enough when the opening practice session was red flagged to allow marshals to clear gravel off the circuit following a spin by Charles Leclerc.

Vettel is adamant he backed off enough to respect the red flag rules once the session had been stopped, and is unhappy about the way that precise delta times are used to judge if a driver has gone too quick. Full story: Autosport.com

The signs of promise for Williams’ ‘next-gen’ Formula 1 future

Crash.net: Williams’ problems in 2018 have been more than just a slow race car – but there are plans afoot to turn things around and make this year the catalyst to its recovery.

2018 has been Williams’ annus horribilis in Formula 1. After being a consistent force in the upper-midfield through the V6 turbo era, the team’s fortunes took a significant dip this year, leaving it rooted to the foot of the constructors’ championship table.

Points have been hard to come by for drivers Lance Stroll and Sergey Sirotkin this year, both of whom have struggled with the troublesome Williams FW41 car. Besides scores in Azerbaijan and Italy, Williams has failed to breach the top 10 at any other race. In a year that has seen the likes of Sauber and Toro Rosso punch well above their weight, Williams has been mired at the back of the field. Full story: Crash.net

Sergio Perez, Force India

Sergio Perez: Force India keep Mexican driver for 2019 Formula 1 season

BBC.co.uk: Sergio Perez will stay with Force India for the 2019 Formula 1 season.

The 28-year-old Mexican has been with the team since 2014 and is seventh in the drivers’ championship with seven points finishes in the past nine races.

Perez has been credited with fending off a winding-up petition against the team by starting administration proceedings earlier this year, saving all 405 jobs at their Silverstone base.

“I’m very happy to finally announce my future,” said Perez. Full story: BBC.co.uk

US Grand Prix – Result

1. Kimi Raikkonen FIN Scuderia Ferrari
2. Max Verstappen NED Aston Martin Red Bull Racing
3. Lewis Hamilton GBR Mercedes AMG Petronas Motorsport
4. Sebastian Vettel GER Scuderia Ferrari
5. Valtteri Bottas FIN Mercedes AMG Petronas Motorsport
6. Nico Hulkenberg GER Renault Sport Formula One Team
7. Carlos Sainz Jr. ESP Renault Sport Formula One Team
8. Sergio Perez MEX Racing Point Force India F1 Team
9. Brendon Hartley NZL Red Bull Toro Rosso Honda
10. Marcus Ericsson SWE Alfa Romeo Sauber F1 Team
11. Stoffel Vandoorne BEL McLaren F1 Team
12. Pierre Gasly FRA Red Bull Toro Rosso Honda
13. Sergey Sirotkin RUS Williams Martini Racing
14. Lance Stroll CAN Williams Martini Racing
RET. Charles Leclerc MON Alfa Romeo Sauber F1 Team
RET. Daniel Ricciardo AUS Aston Martin Red Bull Racing
RET. Romain Grosjean FRA Haas F1 Team
RET. Fernando Alonso ESP McLaren F1 Team
DSQ. Kevin Magnussen DEN Haas F1 Team
DSQ. Esteban Ocon FRA Racing Point Force India F1 Team

Haslam clinches BSB Championship victory at Brands Hatch

Leon Haslam celebrated his first Bennetts British Superbike Championship title victory at Brands Hatch this afternoon, crossing the line in a safe sixth place to have the edge over Jake Dixon into tomorrow’s two races.

It was Glenn Irwin though who was victorious for the first time this season for Be Wiser Ducati, becoming the sixth different race winner of the year, with Dixon and Tarran Mackenzie completing the podium in the opening race to the triple-header weekend.

At the start of the race Glenn Irwin launched off the line to lead the pack into Paddock Hill Bend from Dixon and Mackenzie with Peter Hickman and Andrew Irwin in close contention. Superbike rookie Mackenzie had a big moment on the McAMS Yamaha on the third lap and that dropped him down the order.

Leon Haslam, 2018 British Superbike Champion

Leon Haslam, 2018 British Superbike Champion (www.mphotographic.co.uk)

On the fifth lap Richard Cooper and Tommy Bridewell crashed out unhurt at Druids, the pair had been running inside the top eight, with Jason O’Halloran crashing out a lap later at Graham Hill Bend.

Meanwhile at the front Andrew Irwin moved into second place on the seventh lap to put both of the Be Wiser Ducatis ahead of the chasing pack. Dixon wasn’t giving up without a fight though an he stalked the younger Irwin brother before making a decisive move with four laps to go.

Mackenzie then had Andrew Irwin in his sights too and he went for a dive down the inside at Surtees with two laps remaining to fire the McAMS Yamaha back into podium contention. At the front though Glenn Irwin had the edge to hold off Dixon and Mackenzie to the chequered flag as Andrew Irwin equalled his best finish of the season.

Peter Hickman held on to fifth place for Smiths Racing BMW ahead of Haslam who had done enough to become British champion after a season that has seen him score 14 race wins and only failed to finish off the podium four times.

Haslam was ahead of 2015 title-winner Josh Brookes and James Ellison with Danny Buchan edging out Michael Laverty to complete the top ten.

Hamstring Injuries and Rehab

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A hamstring injury is a strain, tear or pain at the back of the thigh or below the buttocks.
A common injury in sports and can occur in different grades.
The 3 grades of hamstring injury are:
  • grade 1 – a mild muscle strain or pull
  • grade 2 – a partial muscle tear
  • grade 3 – a complete muscle tear

The recovery time of a hamstring strain or tear will depend on how severe the injury is, depending on its grade and the individual. A grade 1 may take a few days to a week to heal, whereas grade 2 and 3 anywhere from a few weeks to a few months to recover from a muscle tear.

Hamstring muscles have their origin, where their tendons attach to bone.

The ischial tuberosity of the hip (often called the sitting bones) and the linea aspera of the femur.

The hamstring tendons flank the space behind the knee. The most medial muscle, the semimembranosus, inserts on the medial condyle of the tibia bone.

The semitendinosus inserts on the superior part of the medial tibia. The most lateral hamstring, the biceps femoris, inserts on the lateral side of the fibula. They are innervated by the sciatic nerve.

A hamstring injury can occur when any of the tendons or muscles are over stretched beyond their limit or range.

Occurring during sharp, explosive movements, such as jumping, sprinting or power lifting. Injuries can also occur over time or during slower movements that overstretch your hamstring.

Sports people who have recurring hamstring issues, have more than likely had previous hamstring problems.

Symptoms of hamstring injuries after examination usually reveal spasms, tightness, and tenderness.

The more severe injuries, may incur swelling with black and blue or bruised appearance that will follow. In some cases, a palpable defect (detectable by touching) will be present in the muscle. Tears and strains most often occur at the middle of the back of the thigh where the muscle joins its tendon or at the origin of the hamstring at the base of the buttocks (at the ischium).

Grade 1 – usually cause sudden pain and tenderness the back of your thigh. It may be painful to move your leg, but the strength of the muscle shouldn’t be affected.

Grade 2 – are usually more painful and tender. There may be some swelling and bruising at the back of your thigh and loss of strength.

Grade 3 – is usually very painful, tender, swollen and bruised. There may have been a “popping” sensation at the time of the injury and you’ll be unable to use the affected leg.

During the first 48 hours, you should care for your injury using the principals of RICE:

  • Rest – keep your leg as still as you possibly can and avoid movement.
  • Ice – apply cold packs (Physicool) to your hamstring for up to 20 minutes every 2 to 3 hours during the day. Don’t apply ice directly to your skin.
  • Compression – compress or bandage (Physicool) the thigh to limit any swelling and movement that could cause further damage.
  • Elevation – keep your leg raised and supported on a pillow as much as possible, to help reduce any swelling.

Some will recommend regular painkillers and anti inflammation tablets.  But we recommend a drug free approach using Painpro

Painpro™ modes

Early stages injury treatment

Mode 1 Pain relief – low and high frequency TENS; adjust intensity for a preferred comfortable intensity.

Recovery

Mode 12 cell repair – PainPro™ also incorporates Microcurrent Technology.  Microcurrent has been the subject of multiple scientific research projects and is now regarded to be at the cutting edge of electrotherapy treatment.  By applying current at a specific intensity and frequency, the body can be “tricked” into significantly boosting Adenosine TriPhosphate (ATP) levels.  The process behind this is complex, but the outcome is simple:  Increased ATP levels means you can heal much quicker.  Studies have seen ATP levels boosted by over 400% – and healing times accelerated by up to 200%

Exercise & rehab stage

Mode 10 Muscle/ strength build – By using Electrical Muscle Stimulation (EMS)which has been routinely used in elite level sport for many years and is widely recognised (and medically proven) to significantly improve recovery from training or injury, enhance strength gains and promote muscular development.

When can i stretch or exercise after a hamstring injury?

Once the hamstring is pain free you can get back to gentle activity and stretching. Try not to do strenuous exercise too quickly this could make your injury worse, but avoiding exercise for too long can cause your hamstring muscles to shrink and scar tissue to form around the tear.

To avoid this, you should start some gentle stretches to get the length back into the hamstrings.

This should be followed by a programme of gentle exercise, such as walking and cycling or swimming, and hamstring strengthening exercises.

hamstring stretch

Check out our latest videos on our JDB Health youtube channel.

First of all start by strengthening the two opposing muscle groups, hamstrings and the quadriceps.

The hamstring is responsible for hip extension and knee flexion, while the quadriceps is responsible for the opposite actions of hip flexion and knee extension. Both of these muscle groups also stabilize the knee joint, especially during sporting activities.

Hamstrings are the smaller of the two muscle groups, generally being the more weaker with the quads being more dominant, therefore should spend more time on hamstring strength work to prevent injuries, as hamstrings will be more at risk to injury.

Good strength programmes should concentrate specifically on strengthening the hamstring muscles, improving the flexibility of your quadriceps muscles, and strengthening your core.

  • Romanian Dead-lift (RDL) – hamstring
  • Dead-bug – core exercise
  • stretching the quads

Having tight hamstrings can limit your mobility. Releasing them will increase your range of motion without causing you to lose strength.

Using a foam roller can sometimes not be as precise as a rigger ball, you can target smaller areas and pin any tight spots in the muscle.  Unlike other muscles where the individual heads are closer together, the hamstrings run farther apart along the femur. This is where the trigger ball is useful, it can get in between each hamstring head, where as the foam roller will miss this.

Hamstrings are arguably the most important muscle group in athletes

Most people think hamstrings only serve one function: knee flexion. Hamstrings having multiple functions such as; hip extension, which is vital for explosiveness, sprinting, jumping, and even low-back health.

Dead Lift

Have your feet flat on the floor, bend at the knees and grab the bar with hands shoulder-width apart.

  • Stand close enough to bar so your mid-foot under the barbell
  • Bend over and grab the bar with arms shoulder-width apart
  • Bend your knees until your shins touch the bar
  • Lift your chest up and straighten your lower back
  • Now stand up holding the bar maintaining good form.

Assisted Nordic hamstring curls

  • Have someone help by securing your ankles firmly while you engage your core.
  • Deep breath then as slow as possible begin to lower yourself to the ground maintaining a neutral spine and a straight body as possible, maintaining a engaged core..
  • Avoid flexing your spine.
  • Once you fail or reach the ground, press yourself up to the starting position and repeat.

Single Leg Deadlift

  1. Start by firmly placing your foot into the ground to maintain a stabilized position.
  2. Now slowly hinge at your hips, forcing the backwards, while also hinging your knee until you have a flat back. ( with No rounding of the back)
    Your moving leg should be straight out behind you,as straight as possible to keep your spine aligned. The higher your back leg goes, the lower your chest goes, being careful to never let your chest drop lower than your hips.
  3. As you start to hinge back and sit in to the single deadlift position, feel for the weight that is placed right outside your stabilizing foot.
  4. Now pick up the weight, make sure your shoulder is pulled back so your lat engages properly during the entire movement.
  5. Hinge your hip forward while bringing the weight with you. Lock out your stabilizing leg and squeeze your glute.

Why Painpro™ -TENS, EMS & Microcurrent are a cut above the rest?

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Why PainPro?

We’ve come to the conclusion that TENS is a viable and, some may say, even preferential treatment for pain relief. But of the myriad of devices of varying cost out there why should you choose PainPro? What’s so special about the PainPro that makes it the unit of choice for people considering TENS? To understand this, I’m so happy to say that we have to go into a little bit of Physics .

Why TENS

Historically, TENS had a reputation of being something that worked for a while then lose its effectiveness on the individual. To understand the reason for this it is important to understand the waveform of the applied current.

Waveform is the description that is used to illustrate what the electric current leaving the unit looks like:

The old style TENS machines used square waves as a basic repeated pattern. Whilst they provided pain relief their onset of action was very abrupt making the experience somewhat uncomfortable due to the fall time being virtually zero ie from resting to full intensity is virtually an instant process as is the return journey. This would cause sudden jerky movements that would not be conducive to normal behavior or relaxation during treatment.

As there is a basic repetition of the applied square wave after a while its effectiveness decreases. This is termed ‘accommodation’ and is a natural phenomenon within the body in response to constant and predictable stimuli, ticking clock, dripping tap, etc.

The modern machines have a sinusoidal wave that gradually reaches the maximum selective intensity before returning back to zero/starting position or resting phase. Whilst this is much gentler than the square waves, again the body can accommodate for these rendering them less effective over time.

Factors to consider when selecting a TENS machine

There are typically four TENS modes used in clinical practice:

Conventional TENS

Most common – High frequency/Low intensity TENS

Skin deep travel of waves → stimulation of afferent nerves → disruption of ascending pain pathways

Analgesic effect is of rapid onset but relatively short duration duration of action – typically lasting only a few hours post treatment.

Acupuncture – like TENS

Low frequency/High intensity/Long duration

Initiates and maintains a muscle contraction (effect is on the muscles so waves travel deeper and act to stimulate muscle afferent nerves: pain relief is primarily through the release of endogenous opioids via descending pain pathways)

Analgesic effect – slower onset of action but lasts longer than with Conventional TENS

Burst Train or Wave TENS

(Blended Sensory & Motor Level Stimulation)

A mixture of conventional & Acupuncture like TENS

Comprises the application of ‘Pulse Trains’ or bursts of pulses

The frequency of the trains is 1-4Hz and the internal frequency of the Trains is around 100HZ. Is often preferred due to a more comfortable patient experience.

Analgesic effect is generally maintained for several hours post application/treatment

Brief/Intense TENS

(Sometimes referred to as Noxious level stimulation)

Generally viewed as last resort or for painful procedures eg, skin debridement, suture removal etc.

Application is at high frequency (100-150Hz), long pulse duration and at highest tolerable intensity for short periods of time (≤15mins)

Modulated output is preferred:

This means the output varies as a mixture of two or more of the different TENS modes in a cyclic fashion to overcome ‘accommodation’ and provide more comfort to the patient.

The PainPro has a sophisticated modulated output of TENS and the whole unit not only concentrates on TENS and pain relief but, unlike other units it may be compared with, also has micro current technology delivered as a continually varied current to tap into and augment the body’s own healing capacity.

Thus the total treatment option or output of the PainPro is described as ‘Bioelectric Microcurrent Wave Technology’ to distinguish it from other units that don’t come close to the mark when it comes to offering the full range of treatments.

PainPro™painpro device
£16.00 £12.00

Use discount code JDB10 for 10% OFF at check out

Bioelectric theory of Pain

Background

Each tissue type in the body has its own signature electrical frequency. What happens when this signature frequency, or resting potential as is more commonly termed in the scientific community, is disrupted? And how does this manifest as pain and slow down the healing/recovery process?

To understand this we need to touch upon a little biochemistry!!!

All our cells are surrounded by a membrane (a lipid bi-layer) with proteins embedded in it. The membrane acts as an insulator and a diffusion barrier to the movement of ions.

Virtually all eukaryotic cells maintain a non zero trans-membrane potential by selectively regulating ions via ion pumps, e.g, Na+ K+ pump, the levels of specific ions both inside and outside of the cell. This creates a trans-membrane potential typically in the region of -40mV to -80mV (cell interior to exterior)

Why is this important? You may ask

The membrane potential has two basic functions –

  1. It allows the cell to function as a battery providing power to operate a variety of molecular devices embedded in the membrane
  2. Important in electrically excitable cells e.g, neurons and muscle cells for transmitting signals.

Under normal conditions the trans-membrane potential or resting potential is held at a relatively stable value which allows all the cell processes to function harmoniously.

Whenever there is tissue trauma or dysfunction:

  • There is a decrease in ATP and disruption of the sodium pump. (for those of you not familiar with ATP and its function we will come on to that in a short while)
  • The cells increase their electrical resistance and the injured area will have a higher electrical resistance than the surrounding tissue
  • This decreases electrical conductance throughout the injured area and decreases electrical capacitance which leads to impairment of function and inflammation
  • The cells become less able to receive nutritional input, water, minerals etc, and are unable to remove toxins.

All of these events are perceived by the individual as pain.

THIS IS NOT AN ENVIRONMENT THAT SUPPORTS HEALING!

Due to the damage, the loss of intracellular ions and the disruption of the sodium pump mechanism the damaged cells produce an electric current which is termed the ‘current of injury’ – almost like an SOS

WHAT CAN WE DO TO HELP?

We have TENS plus EMS in the PainPro to relieve pain centrally and locally

WHAT MORE CAN WE OFFER?

We now have in our new generation of PainPro microcurrent technology that mimics and augments the endogenous current flow allowing cells in the traumatized area to regain their capacitance.

  • REGAIN CAPACITANCE  → REDUCE
  • RESISTANCE → IMPROVED BIO ELECTRIC
  • FLOW → REESTABLISH HOMEOSTASIS → HEALING

ATP is replenished allowing membrane active transport to resume → Inflow of Nutrients & Outflow of toxins + waste (we’ll get to the role of ATP next)

Pre- clinical studies have shown that externally applied stimulation can:

  • Cause migration of epithelial cells and fibroblasts in to the wound site
  • Increase ATP concentrations in tissues
  • Increase protein and DNA synthesis
  • Promote healing of soft tissues or ulcers
  • Accelerate the healing of damaged neural tissue
  • Reduce oedema
  • Inhibit growth of various pathogens

History

Electric therapy is nothing new with the ancient Egyptians, Greeks and Romans using electric eels for headaches and neuralgia.

How does microcurrent treatment differ from TENS/EMS treatment?

The main treatment of TENS/EMS therapy is pain relief with concomitant small scale repair of tissues due to intermittent delivery of appropriate current frequency → direct pain relief.

Mircocurrent therapy is specially designed to tap in to the body’s own (SOS) frequency to normalize the environment, promote healing and hence remove the source of the pain → indirect pain relief/removal.

customer at runfit expo 2018

FOLLOW SAM WEDGBURY’S JOURNEY AND RECOVERY FROM HIS ACL INJURY ON INSTAGRAM

WHAT CAN YOU EXPECT IN A MICROCURRENT TREATMENT?

During treatment, electrodes are placed at strategic locations to direct currents to target tissues. Treatment microcurrents are very weak and typically sub sensory so do not stimulate sensory nerves hence the subject normally does not feel anything.

USES:

Microcurrent therapy has been used and recommended for:

Arthritis

Back pain

Diabetic ulcers

Fibromyalgia

Headaches

Herpes

Neck pain

Neuropathy

Sciatica

Shingles

Slow healing wounds

Sports injuries- ACL, MCL, breaks, fractures etc.

Tendon and ligament pain

Japanese Grand Prix – Result

1. Lewis Hamilton GBR Mercedes AMG Petronas Motorsport
2. Valtteri Bottas FIN Mercedes AMG Petronas Motorsport
3. Max Verstappen NED Aston Martin Red Bull Racing
4. Daniel Ricciardo AUS Aston Martin Red Bull Racing
5. Kimi Raikkonen FIN Scuderia Ferrari
6. Sebastian Vettel GER Scuderia Ferrari
7. Sergio Perez MEX Racing Point Force India F1 Team
8. Romain Grosjean FRA Haas F1 Team
9. Esteban Ocon FRA Racing Point Force India F1 Team
10. Carlos Sainz Jr. ESP Renault Sport Formula One Team
11. Pierre Gasly FRA Red Bull Toro Rosso Honda
12. Marcus Ericsson SWE Alfa Romeo Sauber F1 Team
13. Brendon Hartley NZL Red Bull Toro Rosso Honda
14. Fernando Alonso ESP McLaren F1 Team
15. Stoffel Vandoorne BEL McLaren F1 Team
16. Sergey Sirotkin RUS Williams Martini Racing
17. Lance Stroll CAN Williams Martini Racing
RET Charles Leclerc MON Alfa Romeo Sauber F1 Team
RET Nico Hulkenberg GER Renault Sport Formula One Team
RET Kevin Magnussen DEN Haas F1 Team

Calf Injuries, Treatments and recovery

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diagram of calf muscle

The calf muscle is located on the back of the lower leg below the knee, its made up of two main muscles.

The gastrocnemius is the larger calf muscle. The gastrocnemius has two parts or “heads,” which together create its diamond shape.

The soleus is a smaller, flat muscle that lies underneath the gastrocnemius muscle.

The gastrocnemius and soleus muscles merge at the base of the calf muscle. Tough connective tissue at the bottom of the calf muscle merges with the Achilles tendon. The Achilles tendon inserts into the heel bone (calcaneus).

while walking, running, or jumping, the calf muscles pull the heel up to allow forward movement.

What causes pain in the calf muscle?

Often pain in the calf muscles are related to injuries such as;

  • calf strain
  • Plantaris muscle rupture
  • Medial gastrocnemius strain
  • Achilles tendonitis
  • Bakers cyst
  • Blood clot
  • Leg cramps

The severity of pain varies from person to person, typically a sharp, dull or aching pain, with more severe symptoms like swelling, weakness of the leg, fluid retention or redness,warmth or tenderness of the calf.

  • Grade 1 Calf Strain- Mild discomfort with minimal or no limit to activity.
  • Grade 2 Calf Strain-  Discomfort with activities such as walking, with possible swelling bruising and tenderness.
  • Grade 3 Calf Strain- Severe pain that can cause inability to walk with swelling and significant bruising.

Calf strain

Calf strains are very common and causes by overstretching or excess force through the lower leg.

How long does it take to a calf strain to heal?

Grade 1 can heal between 7- 10 days.

Grade 2 can be within about 4- 6 weeks.

Grade 3 usually within 3 months time scale.

What Treatment can i apply for a calf strain?

Always seek medical advice and assistance with in 48 hours.

Apply the principals of RICE

Rest- avoid activities to protect the muscle from ore damage.

Ice- use ice packs such as Physicool (as seen below) or frozen peas anything that can cool the affected area to reduce inflammation.

physicool wrapped on a calf muscle

Compression- to provide support and also reduce swelling.

Elevate-  place the affected area up higher than normal to decrease swelling. example- place leg up on a chair while siting.

Applying the RICE procedure will help with the healing process and help you on your way to recovery after suffering an injury, hopefully getting you back to activities and daily routines quicker.

What exercises can i do for a calf strain?

Some exercises to help with rehabilitation of the injured calf. Once the calf is pain free you can progress with gentle light stretches of the calf, start and ease your way into the stretch. You can push more into the stretch if no pain occurs.

Calf wall stretch.
  1. Stand facing a wall with your hands on the wall at about eye level. Put your affected leg about a step behind your other leg.
  2. Keeping your back leg straight and your back heel on the floor, bend your front knee and gently bring your hip and chest toward the wall until you feel a stretch in the calf of your back leg.
  3. Hold the stretch for at least 15 to 30 seconds.
  4. Repeat 2 to 4 times.
calf stretch 1
calf stretch 2
Ankle plantar flexion
  1. Sit with your affected leg straight and supported on the floor. Your other leg should be bent.
  2. Keeping your affected leg straight, gently flex your foot downward so your toes are pointed away from your body. Then slowly relax your foot to the starting position.
  3. Repeat 8 to 12 times.

Calf raise
  1. Stand behind a chair or counter with both feet flat on the floor.
  2. Using the chair or counter as a support, rise up onto your toes and hold for 5 seconds.
  3. Then slowly lower yourself down without holding onto the support.

Using a Trigger ball on my calf.

Lie on the floor while placing the rigger ball or peanut under the bulk of the calf muscle, then slowly roll up and down using your arms to desired areas (mainly the tight areas) rotating the leg either side to hit every area.

You can stop, hold an apply more pressure in tighter areas to trigger and release the muscle.

Ben Tollitt used Painpro™ to help with rehab from his acl injury 5 weeks early

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How Painpro™ helped Ben Tollitt with his ACL rehab

Ben is a talented professional football at Tranmere  Rovers. Ben suffered an horrific set back with a grade 3 Acl injury. This is how he combined his rehab and Painpro™ to help speed up his healing and progression.

ben tollitt

It helped me with many of the systems it had to offer. The muscle building setting helped massively as I was performing muscle contractions with the device rather than on my own so it gave me extra help in getting muscle strength back quicker and better than it was before. When I could then do gym weights I used this setting whilst performing workouts for extra help.

With the recovery cell repair settings they helped massively by placing the pads on affected areas like knee, quads, hamstring, etc it allowed me to recover quicker on back to back days of work and also on days off so that I healed quicker but was also able to perform in the gym during my rehab to a higher standard more often.

The ACL is a ligament situated deep inside the knee. Its helps to provide stability, but it also acts as the knee’s brain. It’s full of sensors, so when the knee is running,sprinting, turning and twisting, it provides the brain with all this information about the speed it’s moving at and keeps it nice and stable and in the correct position. If you damage it, your knee will become wobbly and unstable.

ACL injuries are very common in footballers due to all the twisting and turning at sharp speeds. When we think about footballers’ movements – they sprint, jump, land, twist, and turn compared to a runner who just run in a straight line, so their ACL isn’t as integral to their movement and performance as a footballer. Pitches are harder and firmer which doesn’t help, the speed of the game has increased and players are playing more games. All these factors all play their part in ACL injuries in footballers.acl injury in football

From injury to return to play

Stage 1, pre-operation:

  • Control swelling
  • Restore full mobility of the knee.
  • Maintain strength of the quadriceps and hamstring muscles. Using contraction device (such as painpro)
  • Regain normal walking patterns, no limping

Home treatment:

  • Apply the PRICE principles of rest, ice compression and elevation.
  • Wear a hinged knee brace to protect the knee from further injury.
  • Perform patella mobilizations.
  • Knee mobility exercises including heel slides, knee flexion and prone knee hangs.
  • Ankle mobility exercises.
  • Quadriceps and hamstring isometric exercises (static contractions with pain pro muscle building setting).
  • Hip strengthening exercises including bridging and adduction.

Stage 2, post op (week 0-4):

  • Control swelling.
  • Improve bending of the knee up to 90 degrees.
  • Improve straightening of the knee to full.
  • Continue quads and hamstrings contractions with pain pro on muscle building setting
  • Walk partial weight bearing in crutches. Get rid of crutches after 2 weeks

Home Treatment:

  • Apply principles of P.R.I.C.E.
  • Wear a Knee Brace to protect the knee from further injury – your surgeon will advise on how much movement the brace should allow.
  • Continue to perform patella mobilisations.

Exercises:

  • ¼ squats.
  • Bridging.
  • Step ups.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Hamstring curls – only if patella tendon graft is used, not Hamstring graft.
  • Calf Raises.

General body weight exercises and movements with limited strain.

Stage 3, post op (week 5-12):

  • Control swelling.
  • Improve bending of the knee up to 120 degrees.
  • Maintain full straightening of the knee.
  • Improve quads and hamstrings strength.
  • Continue walking with a “normal” pattern, increase proprioception and balance.
  • Remove Brace at 6 weeks.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • ½ squats.
  • Lunges.
  • Leg Press.
  • Step downs.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Sit to stand.
  • Single leg balance exercises.

Build up the exercises during this stage from body weight to exercises with resistance and weight like normal gym work just not full on yet.

Stage 4, post op (week 13-20):

  • Continue to control swelling.
  • Regain full movement of the knee.
  • Continue to improve quads and hamstrings strength.
  • Continue to work on balance and proprioception.
  • Start jogging and progress speed straight line only.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

Exercises that are typically introduced at this stage, in addition to the previous stage’s exercises are:

  • Hopping single leg.
  • Double leg jumps.
  • Static bike.
  • Jogging – start slowly and ensure there is no limp before going quicker.
  • Increase running speed slowly and progressively over a period of weeks but only in straight lines no twisting or turning.

Gym work should now be resisted weights work and from this point build up the amount of weight can be lifted

Stage 5, post op (week 21-24):

  • Introduce twisting, turning and cutting movements.
  • Introduce ball work (if required).
  • Continue to improve balance around the knee.
  • Achieve at least 90% strength in the quads and hamstrings in comparison to the other uninjured leg.
  • Improving confidence.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • Box Jumps
  • Start to gradually introduce twisting and turning movements.
  • Start to introduce striking a ball (if required).
  • Start to perform functional sports specific drills.

Along side this continue gym work

Stage 6, post op (week 25+):

Return to sport

Improvements Ben Tollitt made and stages he bettered during rehab compared to a normal ACL rehab period.

Stage 1.

Ben was able to;

bike

Do weights in the gym

No pain

No swelling

Full quads muscle strength

Stage 2:

More than 90 degrees knee bend

Fully straight leg

Walking after 5 days

Better than normal quad strength

Doing single leg volleys standing on operated leg

Brace removed week 1 not week 6

Stage 3:

At week 6 (instead of week 13) was told I could jog)

Full knee bend not just 120 degrees

Full muscle strength back with good amount of hyper extension

Stage 4:

Twisting and turning week 16 not week 21

Full sprinting

Performing football ‘Hoff circuits’ week 16

Joining in with non contact pre season training week 17 not week 21

Stage 5:

Ben returned to full training with the team rather than returning and building up his training minutes over  a period of training session.

Ben’s rehab was 5/6 weeks ahead of schedule  schedule.

Ben Training during his rehab from ACL



Ben using Painpro™ to help maitain muscle mass

Ben Tollitt using Painpro™ helps him stay ahead of schedule by 5 weeks.

The ACL is a ligament situated deep inside the knee. Its helps to provide stability, but it also acts as the knee’s brain. It’s full of sensors, so when the knee is running,sprinting, turning and twisting, it provides the brain with all this information about the speed it’s moving at and keeps it nice and stable and in the correct position. If you damage it, your knee will become wobbly and unstable.

Stage 1, pre-operation:

  • Control swelling
  • Restore full mobility of the knee.
  • Maintain strength of the quadriceps and hamstring muscles. Using contraction device (such as painpro)
  • Regain normal walking patterns, no limping

Home treatment:

  • Apply the PRICE principles of rest, ice compression and elevation.
  • Wear a hinged knee brace to protect the knee from further injury.
  • Perform patella mobilizations.
  • Knee mobility exercises including heel slides, knee flexion and prone knee hangs.
  • Ankle mobility exercises.
  • Quadriceps and hamstring isometric exercises (static contractions with pain pro muscle building setting).
  • Hip strengthening exercises including bridging and adduction.

Stage 2, post op (week 0-4):

  • Control swelling.
  • Improve bending of the knee up to 90 degrees.
  • Improve straightening of the knee to full.
  • Continue quads and hamstrings contractions with pain pro on muscle building setting
  • Walk partial weight bearing in crutches. Get rid of crutches after 2 weeks

Home Treatment:

  • Apply principles of P.R.I.C.E.
  • Wear a Knee Brace to protect the knee from further injury – your surgeon will advise on how much movement the brace should allow.
  • Continue to perform patella mobilisations.

Exercises:

  • ¼ squats.
  • Bridging.
  • Step ups.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Hamstring curls – only if patella tendon graft is used, not Hamstring graft.
  • Calf Raises.

General body weight exercises and movements with limited strain.

Stage 3, post op (week 5-12):

  • Control swelling.
  • Improve bending of the knee up to 120 degrees.
  • Maintain full straightening of the knee.
  • Improve quads and hamstrings strength.
  • Continue walking with a “normal” pattern, increase proprioception and balance.
  • Remove Brace at 6 weeks.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • ½ squats.
  • Lunges.
  • Leg Press.
  • Step downs.
  • Static bike – high seat with NO resistance, in pain free range of movement.
  • Sit to stand.
  • Single leg balance exercises.

Build up the exercises during this stage from body weight to exercises with resistance and weight like normal gym work just not full on yet.

Stage 4, post op (week 13-20):

  • Continue to control swelling.
  • Regain full movement of the knee.
  • Continue to improve quads and hamstrings strength.
  • Continue to work on balance and proprioception.
  • Start jogging and progress speed straight line only.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

Exercises that are typically introduced at this stage, in addition to the previous stage’s exercises are:

  • Hopping single leg.
  • Double leg jumps.
  • Static bike.
  • Jogging – start slowly and ensure there is no limp before going quicker.
  • Increase running speed slowly and progressively over a period of weeks but only in straight lines no twisting or turning.

Gym work should now be resisted weights work and from this point build up the amount of weight can be lifted

Stage 5, post op (week 21-24):

  • Introduce twisting, turning and cutting movements.
  • Introduce ball work (if required).
  • Continue to improve balance around the knee.
  • Achieve at least 90% strength in the quads and hamstrings in comparison to the other uninjured leg.
  • Improving confidence.

Home Treatment:

  • Continue to apply cold therapy post exercises.
  • Continue to perform patella mobilisations.

Exercises:

  • Box Jumps
  • Start to gradually introduce twisting and turning movements.
  • Start to introduce striking a ball (if required).
  • Start to perform functional sports specific drills.

Along side this continue gym work

Stage 6, post op (week 25+):

Return to sport

Improvements I made and stages I bettered during rehab: