Month: September 2020

Sports Therapy Lambourn

Traumatic brain injuries and the link to depression – focus on the source not the symptoms?

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Have you or someone close to you ever suffered a head injury? The effects of even mild concussions can have lasting effects, sometimes more so when you think you’ve fully recovered.

On the 23rd of June Grand National winning jockey Liam Treadwell took his own life. He was the second jockey in as many months to do so. His last post on social media, read, ‘Simpler and happier times in life’. It referenced a photo posted four years previous of him enjoying a beer in Barbados. The photo had him leaning against six crates of beer. I thought it poignant that the crates be labelled ‘Banks’, the surname of Liam’s weighing room colleague, James who died in February under similar circumstances.

Liam had suffered a severe head trauma in 2016 in a fall at Bangor leaving him unconscious for four minutes. The rehabilitation process continued for six months and he was left with a number of side effects. Remarkably he continued his career as a jockey but retired in 2018 after a marital breakdown and other difficulties. Unable to shake his love for riding he took out his licence again in 2019 and rode successfully until Lockdown halted racing in March 2020.

Around 50% of people suffering traumatic brain injuries are affected by depression within a year post injury. This rises to nearly two thirds within the first seven years*. Changes in neurotransmitter levels and damage to emotion centres in the brain can cause the change. And yet we still perceive depression as being a disease of the mind. An area of our being that can’t quite be reached, seen, measured or corrected. An overwhelming prospect to face for sure.

The impact of brain trauma can be physical, life changing and dramatic. Alternatively it can subtly entwine into the existing personality of an individual until the wearer is no longer recognised as their original self. Symptoms take over the life and the life becomes the symptoms as we lose sight of the root cause and the person.

People will say that Liam was depressed and that led to his suicide. I would argue that perhaps his death ultimately was simply due to his head injury. Perhaps we need to recognise and focus on the root cause instead of waiting for the symptoms to engulf the person. This will undoubtedly lead to more prompt supervision of individuals.  

The racing industry is increasingly encouraging jockeys to ‘reach out’ to get help if they are feeling depressed or suicidal. I feel that many will fall through the cracks if this is their principal tactic. Jockeys are tough and face potentially life threatening situations daily. They innately control fearful situations by concealing emotions. Furthermore being a jockey allows them to practice this art until it is not just habitual but ingrained. So you’re dealing with individuals who are profoundly set up to supress emotions. They are literally experts.

Waiting for some jockeys to ‘reach out’ would be like waiting for Trump to lead like Obama. It’s just not going to happen. If you were to remove the onus to step forward away from the jockey and replaced it with compulsory mental health screening for all you’d surely have a better chance of detecting and monitoring those in need. Psychological screening, blood tests and brain scanning are all potential methods for detecting mental health issues.

www.mind.org.uk and www.headway.org.uk are organisations that can help with mental health issues.

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* Fann, J.R., Hart, T., Schomer, KG. Treatment for Depression after Traumatic Brain Injury: A Systematic Review. Journal of Neurotrauma 26:2383-2402, 2009. Cited in http://www.msktc.org

Frankie Naylor Sports Therapy

Is sitting making your blood boil? Literally!

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Sitting – the route of all evil? Our bodies dislike it on so many levels and I treat the effects daily. Physically we know the issues but emotionally? ‘Yeah right’ you say dismissively!

It’s normal for people to come to me with a bad back. I’m used to that. But the pattern I’m seeing more and more is the one that links lower back pain to stress and anxiety. So what is happening to people now that wasn’t happening 5, 10 or 15 years ago?

The answer could be that we are all sitting more. That extra hour sitting at work each day to pay that extra bill or that extra hour sat in traffic. It’s all adding up. And more time at work means less time exercising.

Sitting, whether it be at a desk, in a car, on a horse (yes!) or for farriers shoeing (you’re in that same folded position) affects our body’s (bio) mechanics. Structural imbalances increase and consequently so does the risk of injury.

Predominantly, sitting tightens the psoas muscle which sits deep in the abdominal area and connects the spine to the thigh bones. But here’s the interesting bit ……. psoas is directly linked to adrenaline production. Tight psoas signals that you’re in danger preparing your body for flight or flight by releasing adrenaline. So what happens if you continue sitting and there’s no fight or flight, where does the extra adrenaline go? Well if no physical activity takes place you simply end up with increased levels of adrenaline circulating your body. And it’s this that increases the likelihood of becoming stressed and potentially suffering with anxiety.

So what does a tight psoas feel or look like? From a postural perspective I tend to see a forward rotated pelvis (bottom sticking out), an internally rotated leg(s) (toes turn in), leg length discrepancies (unable to get stirrups level) and knee and lower back pain.

The clients I see who seem to suffer the most with stress and anxiety caused (at least in part) by a tight psoas are the ones who work full time in an office based role but who also ride horses. So they drive to work, sit at a desk, drive to the yard, sit on a horse then drive home (you get the picture).

What I feel when I treat someone with a tight psoas is tension through the sides (tight quadratus lumborum muscle, which attaches the spine to the pelvis) and tension through the abdominal area (tight psoas). The client will immediately feel tension on palpation of these areas but are usually blissfully unaware of an issue otherwise. Loosening psoas can often be achieved in just one treatment. And clients have reported significant decreases in levels of stress and anxiety almost immediately and with lasting effect.

So if your therapist is still closed do try to do some of the leg work to fix this yourself! I have trawled through various stretches online to find the best self-help methods for a tight psoas. Personally I find that a simple half kneeling stretch (see below) combined with a side lying foam roller technique (to also target quadratus lumborum) works well for most. But as with all these methods the techniques need to be fine-tuned to the individual…..so do get in touch if you’d like more information.

And it’s never just one thing that’s needed to fix the problem. Lifestyle choices play their part too. Try sitting less with the help of a standing desk. A number of my clients are now using these with great results. You can check out the reviews on the best standing desks here https://www.independent.co.uk/extras/indybest/house-garden/furniture/best-standing-desks-a9371281.html

What are your experiences? Comment, like, share.