Sports Therapy Lambourn

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

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!

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.

Frankie Naylor Sports Therapy

Being short staffed – the straw that broke the camel’s back!

How many did you muck out today, ride out or feed? Yesterday I heard of someone that mucked out 35 and fed 105. How long can one person sustain this type of workload and what is the impact on their body?

Every day I treat people working in the horse racing industry who have physical jobs. Chronic injuries are part and parcel (to an extent).

Over the last few years I have noticed that workloads have increased significantly due to staff shortages. Chronic injuries are at epidemic levels.

https://www.theguardian.com/sport/blog/2019/may/14/talking-horses-new -study-finds-unsustainable-workloads-in-horse-racing

As a sports therapist the pattern of injury I see specifically is when an individual has to work on their weekend off or work that extra race meeting due to staff shortages and……… ‘Boom’ you’ve guessed it, it’s the straw that really did break the camel’s back! And that’s when they end up on my couch. A significant portion of their wage packet being forked out because they haven’t had that all important day and a half off out of fourteen to recover.

Chronic lower back pain and shoulder impingements are of the most common issues I see. Both which require a degree of rest from painful activities – but alas not in racing!

Many people leave racing at least in part because they feel that their bodies just cannot sustain the workloads long term (I know, they’ve told me!). This creates a tougher environment for the individuals left behind as they are having to make up the shortfall. And thus every pursuing injury happens a little sooner than the last as workloads increase and the next staff member hangs up their boots for a less physical role.

In addition as a nation we are seeing a population of young people with lower base fitness levels than ever. This is due to increases in automation coupled with poor diet and lifestyle choices. So the individuals coming into racing are more likely not to be fit for purpose, and are expected to take on greater workloads (as well as being Millennials!)…… and you don’t have to be a rocket scientist to predict the end result.

So what next? Chronic injuries are just one result of the staffing crisis. Housing, pay, amongst other issues all play their part too. Some trainers have confronted these situations head on creating far better working environments like good quality staff accommodation. Although this doesn’t directly impact on injury status. Will trainers have to consider investing in injury prevention for staff like they do for their horses?

Would you welcome injury treatments as part of a stable staff employment package? Let me know your thoughts. Comment, like, share.

If you work in racing and are struggling with an injury you can get in touch with Racing Welfare at racingwelfare.co.uk

Sports therapy rehab

Can sporting success be predicted by an individual’s approach to injury?

Racing has just been given the green light as we work to pull our economy from the brink post lockdown. As always there are some big named jockeys bordering on being fit to ride in some big meetings post injury. This gives high hopes to some of their counterparts coming up through the ranks. But what are the qualities needed to get those jockeys back to full fitness and remain at the top of their game?

I write this with one particular jockey in mind, a jockey that walked into Oaksey House about 10 years ago to (eventually) get (a little) help with a chronic injury. He was a natural athlete, a talented rider (a tamer of bears in fact!), and tough, really tough. And at the time I remember thinking that we were starting this rehab process about 6 years too late. A jockey that was deserving of so much more – RIP Banksy.

So can sporting success be predicted by an individual’s approach to injury? Yes I think it can give a good indication.

Why am I so sure of myself? Because I’ve worked with thousands of people going through the rehab process. Over time I have seen patterns arising differentiating the more successful individuals from the rest of the pack.

Take jockeys, I see particular attributes in the more successful individuals:

  1. They’re tough but not too tough. They don’t complain about every single niggle but when there is something significant to address they address it and sooner rather than later. One of the best indicators of future injury is previous injury. So getting niggles fixed before they become bigger issues enables the jockey to maintain fitness, weight and psychological wellbeing; as well as futureproofing their bodies for the long-haul!
  2. They have a good ‘team’ around them and they accept help from and allocate tasks to ‘the team’. This could be in the form of family members, a spouse, friends and or work colleagues. The team can help with all types of emotional and practical support from being that listening ear to driving them to their rehab sessions. This allows the individual to focus on the practicalities of being a jockey recovering from injury.
  3. And perhaps the biggie, the all-encompassing but rarely discussed aspect of achieving sporting success and staying injury free involves childhood experiences. We’re individuals taught how to ask for help? Were they listened to as children? Were they taught that their feeling we’re important too? A little deep? Not really! Getting the balance correct in the early years will set individuals up for life. Get it wrong and the cracks will start to develop.

So often I meet incredibly tough, capable, hard-working people who lack one or more of these 3 elements of success. Because of this doors just don’t open. The qualities that make them as amazing as they are also stop them from getting right to the top of their game.

So, be realistic about your injuries. Be tactical with your rehab. Build a team around you to help offload pressures both physical and emotional. And ultimately if you aren’t great at asking for help – learn quickly because without this ability achieving your potential will become a very difficult task.

If you’re a jockey and need to start the rehab process get in touch with The Injured Jockeys Fund at ijf.org.uk

What’s your experience? Do you ignore or address your injuries? Comment, like, share.

Sports therapy Berkshire

Rural Life (Covid-19) & Exercise Habits

The New Year’s resolutions should have been in full swing and that beach body should now be honed …..but Covid-19 has kind of put a spanner in the works. All this down time may allow you to think more closely about what facilities are really available to you from a location and financial perspective and which are the best options to allow you to achieve your fitness goals.

Living and working in rural areas can mean the choices available to you are limited especially when taking into account our biggest barrier to exercise – lack of time. Time spent travelling to your preferred destination means time not exercising. And when life is already hectic you need to think tactically when choosing where to exercise.

There have been some massive shifts in the fitness industry since I first started out as a personal trainer creating more choice for the user and keeping prices competitive. So if you haven’t yet donned the Lycra, hold fire and let’s look at some of the options available.

Perhaps the ‘Waitrose’ option would be a David Lloyd gym (davidlloyd.co.uk) encompassing swim, gym, classes, coaching, kids clubs and treatment facilities under one roof – great (I hear you gasp). But they’re not always local, local and you’ll be paying over £1000/year. If you’re still excited by this option do check the class timetables fit around your life before parting with your cash!

Council run facilities can be a good ‘Tesco’ option. Just note that if you’re situated in the middle of two different counties (as we are in Lambourn) membership of one facility won’t allow you to use sites run by another council.

Personal trainers are dotted around. You can find prospective PT’s on the Register of Exercise Professionals (exerciseregister.org) or CIMSPA (cimspa.co.uk). Check prospective PT’s are registered so you know insurances and qualifications are up to date.

And if you want to get involved in a specific sport you can go to the National Governing Body website sportengland.org where you can search for a recognised sport’s contact information.

Social media platforms like Facebook can be a great tool in deciphering whether classes and activities in rural areas are right for you.

And if you don’t have the funds or the time get onto You Tube and try something like ‘Yoga with Adriene’ (yogawithadriene.com). Classes are approx. 20 minutes and at 6.01M subscribers she must be doing something right!

So don’t let a lack of finances, time or a rural location stop you from achieving your exercise goals. Let us know what sporting activities you’ve been involved in and what you’d like to have a go at next.