Sports Injury

Supercharging the hip

Fighting sports have become huge in Singapore over the last few years with the rise of the one championship, KBX fight promotions, and specialist boxing gyms opening up.

Whether it's martial arts, Bootcamping, CrossFitting or PT you do - and anyone who works out frequently - puts their muscles and joints through intense loads. Don’t get me wrong, this is not a bad thing at all and with enough time to adapt, your bodies will benefit significantly from the increased demand. However as with any contact sport, there is no shortage of injuries.

In this article I'll outline a few good ways to avoid any hip injuries from martial arts - or any other rigorous training. I’ll also give you tips and show some simple exercises that can reinforce your hip and the surrounding structures so you are less likely to be injured and need physiotherapy.

After all, prevention is better than cure!

Hip injuries

Ouch, I’ve had a few, usually by throwing a flashy kick too high without warming up or pushing it too far whilst stretching with a partner and pulling my hamstrings. Muscular strains are very common and the majority will clear up in 2-6 weeks if you do the right things.

Please note it's important if you have any ongoing or recurring hip issues that you get them assessed by a physiotherapist ASAP, there are many different structures that could be at fault.

How to avoid them

Load up gradually – in other words don’t jump from sofa to sparring in one day, if your body is not conditioned to the stress you are about to put it through you’ll increase the risk of injury. This goes for returning vets as well as beginners.

Make sure you are warm – OK this might be a given but you’d be surprised how many guys think doing a quick jog up and down the room is enough. Get your blood pumping, get those neurons firing and do some dynamic stretches before you start.

Increase your hip mobility – This is important in all sports but extra important if you like flashy kicks, or intend to roll with someone who is going to try and pull your legs to the opposite sides of the room.

Supercharge your leg muscles – Try out the exercises below to supercharge your hip.

Here are my favourite exercises to build up hip mobility and muscle robustness – Also great to use as part of your warm up;

1.     Long stride with a twist

  • Start in a long lunge position, with your back leg completely straight.
  • Put both palms on the floor in line with your front foot.
  • Twist towards your front leg, lifting your nearest arm up to point towards the ceiling – your body should end up facing your front leg.
  • Hold for 10 seconds
  • Repeat 10 times each side.
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2.     Bridge with hip and knee drive

Beginners:

  • Start by laying on your back, with your knees bent and both feet flat on the floor
  • Brace your core
  • Squeeze from your glute and drive your hip up towards the ceiling

Advanced:

  • Start by lying on your back, with one knee bent foot flat on the floor.
  • Grab one leg and pull your knee in as close to your chest as possible.
  • Push up into a bridge with the leg still on the floor and hold for 5 seconds.
  • Repeat 15 times each leg.
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3.  Deep squat with counter balance

Beginners:

  • As below but without a weight.

Advanced:

  • Grab a kettle bell or a weight – doesn’t need to be too heavy you are using it as a counter weight so you can sit back into the squat.
  • Sit back into a squat and push your elbows against the inside of your knees to push them out.
  • Hold it and gradually sink lower into the squat as your muscles relax.
  • Repeat 5 times.
 
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4.     Cossack goblet squats

You can do this one of two ways depending on your current flexibility.

Beginners:

  • Start in a standing position,
  • Lunge down to the side keeping both feet facing forwards and holding the weight in front of you.
  • Repeat on the other side.
  • Sink lower into the position each time.

Advanced:

  • Start in squat position
  • Keeping as low as possible push over to one side
  • Then push across to the other
  • Repeat 5 times each side
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5.     Internal rotation with lateral pull

Beginners:

  • Start on all fours
  • Attach band around hip close to groin and make sure it is taught
  • Push your bottom down and backwards.

Advanced:

  • Attach a resistance band around your upper thigh as close to the groin as possible, and make sure it is taught
  • Internally rotate your leg as shown in the picture
  • Starting in an upright position, push your back leg back and your body forward as is doing the pigeon stretch
  • Repeat 5 times each leg.
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6.     Nordic Hamstring curl

  • This exercise is for advanced only, please make sure you have sufficient strength in your hamstrings before attempting this.
  • The main focus of this exercise is on the lowering phase known as the eccentric phase.
  • Get yourself into a neutral pelvic position and brace your core muscles as if someone is about to hit you in the stomach.
  • Keep your body as straight as possible and lower yourself down as low and as slowly as you are able
  • If you need assistance getting back up its ok you push with your arms up the start position then repeat
  • Repeat 3 sets of 4 repetitions.
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That’s my top six to supercharge the hip, I hope you enjoyed it and good luck trying them out. If you are interested in learning more handy tricks and exercises to help you stay injury free follow my instagram @thefightingphysio I am also available for consultations, treatment and advice at the UFIT Clinic one-north.

Back and neck pain? Doctor or physio?

Back AND neck pain - doctor or physio: Who should you choose?

The question I constantly encounter here in Singapore is ‘I have a sore back. Should I come see you, or should I see a doctor first?’

Being a physio myself I am obviously biased, but physiotherapists train for four years to get a degree specialising in chronic pain issues and musculo-skeletal breakdowns. We should be involved from the beginning in the treatment and care of any back pain or neck pain issues.

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Unfortunately, here in Singapore (and in many countries around the world) the medical insurance companies require a doctor’s referral in order for physiotherapy claims to be approved, so the answer is usually ‘Go see a doctor, and ask them to refer you to me.’ If that seems like a complete waste of your time, and the insurance company’s money, then you would be correct. It now appears that we have good reason to be frustrated by this out-dated approach:

A recent study conducted by Cook et al., published in October 2017, investigated the amount spent and the overall recovery outcomes of patients with back or neck pain who went to either physiotherapists first, or to their local doctor. In total, they reviewed cases for 603 patients who reported neck and back pain between 2012 and 2014.

The results? Those that selected to see the physiotherapists straight away saved BIG on medical costs. In fact, each patient saved an average of $1,543 USD a year (over $2,000 SGD) compared to their counterparts who chose to visit a doctor first. And their outcomes one year later? No difference between the two groups. So, in effect, the group that went to see the physio got the EXACT same outcome, for significantly LESS cost.

Why is this? It may be due to the doctor’s reliance on imaging. For more on this, check my blog on the topic here.

So back to the question: ‘I have a sore back. Should I go see a physio or a doctor?’  

The answer: A physio – we’ll help your back and your wallet. The science says so…

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To discuss an issue with your friendly local physio in Singapore, please contact us here.

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ABOUT THE AUTHOR

DECLAN HALPIN, UFIT CLINIC DIRECTOR

Declan is passionate about helping his patients achieve their long term goals by identifying their weaknesses and imbalances, and developing a strategy to eradicate them. Declan has always maintained a strong sporting interest, and previously worked as an Academy Physiotherapist for Crystal Palace Football Club (a professional football club in London), and as a Rehabilitation Coach for the Western Province Stormers Academy (professional rugby club from Cape Town). Within Asia, he consults to the Indonesian Athletics Association as a Performance coach and physiotherapist. In Singapore, Declan has worked as both physiotherapist and strength and conditioning coach to the Singapore National Rugby team (who achieved bronze medal at the SEA Games). 

QUALIFICATIONS 

  • BSc Sport and Exercise Science 
  • MSc Physiotherapy 
  • AAP Dry Needling Certification 
  • L1 Crossfit Trainer 
  • Senior Medical Educator World Rugby 

From surgery to CrossFit in six months

In May 2017 James Metcalfe slipped in his condo carpark and shattered his elbow. It needed surgery and for two whole weeks he couldn't move his arm at all. He sought help from UFIT Clinic physio Paul Doohan - and fast forward six months does Personal Training with Melanie Lim at UFIT Tanjong Pagar three times per week.

Before that he had never stepped foot inside a gym before, and is now flawlessly lifting and doing sled pulls each session, and has complete use of his elbow and arm again. Thanks to Mel's advice he has also cut back on his beers and is losing weight and getting fitter and stronger every day.

Find out how he got back on the mend so quickly ...  

What was your injury and what did you do about it? 

I shattered my elbow. I got a spiral fracture of the radial head, dislocated elbow joint and tore all of the ligaments and tendons connecting to my bicep and tricep. 

 
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I was referred to Paul by an ex-UFIT employee who I know socially. She initially passed me to Declan who I saw twice before he went off on his one-north adventure leaving me in Paul’s hands.

How often did you see PAUL and were you able to train much then?

I saw Paul once a week every week for six months. I was totally unable to train at the beginning, I couldn’t move my left hand or arm at any angle. That progressed to picking up a simple day to day object, to developing the flexion and extention to being able to feed myself with that arm’s hand and doing up my buttons on a shirt which was a good test of progress. An extra button a week!

This built up slowly over a couple of months and I was then able to lift a light dumbell which is when I asked if he could refer me to a trainer and that's how I found Mel.  

What kind of rehab did you have?

The painful but quick kind. It was really a combination of many things, the technical terms you will have to ask Paul. From shocking the bicep muscle with electro pads at the beginning of each session to making them remember they were still there, and they were needed for the bottom half of my arm to work, through to massaging the joint and lots and lots of Paul distracting me with talking about the Premier League while pushing, pulling and increasing my range of motion.

 
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What have you enjoyed most about doing rehab with Paul?

He communicates directly like me, was sympathetic to the pain I was going through both physically and mentally, and is very obviously knowledgable in his field and I trusted him. We both played sport and both getting married within a couple of months of each other so time during the sessions went quickly. Beyond liking Paul as a bloke, he got results and quickly, so going back for the next session never felt like a trial. 

How is your training now? 

It's great! I train with Melanie Lim at UFIT Tanjong Pagar and haven't felt this physically fit in the four years that I have lived in Asia, and I could not have imagined training like this six months ago immediately after the accident. Mel kicks my ass three times a week at CFTP, but she does more than just make me sweat, she encourages me to believe in the power of the mind and that with self discipline and self belief so much is possible. 

 

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I’m so grateful to everyone that I have met, both at the Clinic and CFTP. For picking me off the ground seven months ago as a broken man, both mentally and physically, for telling me it’s going to be OK and giving me that adult cuddle that I needed, and equally for getting me fit, pushing me to do better and giving me a huge smile walking (lungeing & squatting more like), into getting married next month and finishing what has been a crazy year as a very happy man. 

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Let's hear it from PAUL THE physio ...

Paul Doohan, James' UFIT Clinic physio adds: "James had a pretty complex elbow fracture, after an accident in his condo. He was struggling a lot after his surgery, as he was unable to even button his shirts due to his pain and stiffness. This affected his activities of daily living massively. 

For a condition of this nature, the first thing we needed to do was to make James trust his elbow again. As an area of the body that is heavily innervated (remember hitting your funny bone?), an injury of this magnitude meant the whole arm was highly sensitive. Naturally patients like James are very protective of the fractured area, but very quickly this overprotection can cause more issues. Helping James move his arm and regain his strength wasn’t the difficult part, it was helping him trust his arm to allow him to do a press up, or catch a cup that was falling. 

When you have something that affects your life as much as James’ injury did, it was vitally important that we were on the same page from day one. He responded very well to his initial treatment, and was always diligent with the tasks I asked him to complete in his own time.

We set small goals, for instance monitoring how many buttons he could fasten on his shirt, to demonstrate the improvements he was making. Eventually, we got a position where we both agreed that he no longer needed to come, as he had met the goals he outlined when we started.

That handshake of a patient who has come such a long way is one of the most rewarding moments as a physiotherapist, and I was very pleased when that day came.

For James, having a patient with an honest and strong work ethic made my job a lot easier. I was able to provide the framework and knowledge on how he was going to get better, but it was his attitude in doing the at times monotonous work that means he has made such a good recovery. It was a pleasure to have the opportunity to work with James, and I can only see him continuing going from strength to strength.

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OVER TO MEL, JAMES' PERSONAL TRAINER

“Working with James has been an absolute joy - he’s hardworking, patient and inquisitive. I’m grateful for the trust he’s put in us as a team - together, our goal is continue to help him lose body fat, while rehabbing the injured elbow as much as possible.  

We believe in the importance of balance - loving what we do, and achieving results simultaneously. In the lead up to his wedding, we’ve progressed from static/isometric exercises in the trunk, to adding eccentric work and finally now, we are doing concentric exercises like squatting and bench pressing. A huge feat considering just months ago, he was in a sling! 

On Fridays, we do strongman training - anything from harnessed bear crawls, sled pushes, rope pulls. Due to his injury, we have had to be creative about programming work that may cause structural damage. Much of the hours James have put in are boring, cyclical aerobic work that the general population would not deem exciting - but it is his dedication to the goal, and positivity that keeps us on track. 

I've recommended some changes to his diet, including cutting out beers and tracking his meals. We are seeing the weight fall off, and his body composition change dramatically. Our secret goal is to get James to support his own bodyweight in a plank by the end of the year, and move up to push-ups.

Training James has thought me so much about the power of keeping a positive and growth-oriented mindset, regardless of the circumstance. He’s one of a kind."

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His determination and willpower is fantastic and will see him get the results he wants.

JAMES' dream team: his physio and personal trainer

Paul Doohan   is a musculoskeletal physiotherapist, and has extensive experience in professional sport, private physiotherapy and in the public hospital sector. Possessing certification with the Titleist Performance Institute, Paul specialises in the assessment and treatment of golfers, delivering effective results in injury management and prevention, as well as performance improvement.

Paul Doohan is a musculoskeletal physiotherapist, and has extensive experience in professional sport, private physiotherapy and in the public hospital sector. Possessing certification with the Titleist Performance Institute, Paul specialises in the assessment and treatment of golfers, delivering effective results in injury management and prevention, as well as performance improvement.

Melanie Lim   is a certified CrossFit coach and personal trainer, accumulating over 200 hours of coaching in various landscapes in Asia.  She has experience building boxes and communities around the common goal of achieving fitness, and finds motivation in seeing her clients desire and pursue change aggressively.  

Melanie Lim is a certified CrossFit coach and personal trainer, accumulating over 200 hours of coaching in various landscapes in Asia.

She has experience building boxes and communities around the common goal of achieving fitness, and finds motivation in seeing her clients desire and pursue change aggressively.
 

 

 

 

 

Why running is the best sport in the world

“The real purpose of running is not to win a race; it’s to test the limits of the human heart.” This is how American track and field and co-founder of Nike, Bill Bowerman, described why we run. 

What an outstanding description of a sport that sees over 16 million Americans doing at least three times a week! Running is the fastest growing sport over the last decade with an increase of 300% in participation noted since 1990 in the US alone. Within this statistic we see the greatest increase in female runners where 25% of all runners were females in 1990, compared to 57% being recorded as female runners in 2013.

But what is behind this phenomenon? Why are people, and females in particular, falling in love with a sport that historically has been hated.

Why? Because running is an addiction, often a love/hate addiction, but a highly empowering and freeing addiction. We often hear people describe how they “caught the running bug” and that’s exactly what they are talking about. Once you find running, it becomes your stress reliever, your fitness regime, your “me time”, your obsession and your passion. This is why runners call themselves “runners.” They see themselves defined by their sport, unlike most other sportspeople who play a sport, we (runners) are our sport.

Having said this though, most runners fall into running, they don’t necessarily choose running as their main sport. I don’t think young athletes look at professional middle distance runners with dreams of aspiration, when compared to premiership footballers, swimmers or tennis players. So it is often by chance that most middle distance runners find themselves addicted to running, myself included.

I was always an active child running around, and growing up with 5 older brothers made sure I was able to run (away) fast. I started playing Irish sports in school, as most Irish children do, but not loving any particular one. This saw me embark on high school with no involvement in any organised sport which a teenage girl is probably the worst position to be in. So many changes are going on inside a teenage girl in terms of emotional and physical changes that I needed an active outlet. So at the age of 15 I simply fell into running because two girlfriends were keen to run for fitness. We then campaigned to our school to allow to employ an athletics coach and the rest is history. My love for running just grew and grew the more I ran, it wasn’t planned nor was it an aspiration of mine, but now I could not imagine my life without running.

As my love for the sport grew, as did my running success. Racing and competing became my drug. Even to this day, the adrenaline rush and natural serotonin high that I get from racing is like nothing else. It is this high that is addictive and makes me want to run again and again, even sometimes foolishly through pain. This is why running is such a rapidly growing sport, this natural high and sense of empowerment, freedom and adventure is hard to find elsewhere. You are in control of it, you can run as fast, as slow, as hard or as long as you want. It is just you, your thoughts and the road.

As they say, success begets success, and this is very applicable to running. Once you race or compete for the first time you then strive to beat your personal best time/placing and this is never ending. That’s what I believe Bill Bowerman meant when he described the purpose of running as testing the limits of the human heart. Testing yourself time and time again, and seeing how far you can push your body’s limits. Pushing yourself to be the best version of yourself, the best runner within yourself.  

To those non-runners that I chat to I always say don’t knock it until you try it. That natural high I get from running, just me, the wind and the road, is a sensation that words don’t do justice to describe, you have to feel it. Experience it first hand and see if you can resist doing again and again, because I know that for this reason I will keep running for as long as my legs can carry me!

Happy running everyone!


ABOUT THE AUTHOR

Máire Nic Amhlaoibh

Máire began her career as an athletic therapist and trainer. Whilst in university she completed courses in trigger point release, kinesio® taping, massage, muscle energy technique and myofascial release to name but a few. 

If you're suffering from sporting injuries our superstar runner Maire is also an outstanding physio at the UFIT Clinic.

Find out more here