Countdown to Spartan – Physiotherapy 3rd Assessment

Helen and Carl continue with their good progress towards the Spartan.  Carl is doing an excellent job in mixing up and marrying together the CV work and deep core & stability work that Helen needs if her goal is to remain injury free.

Carl has also taken on board the advice regarding his foot injury and has stopped using Vibram 5’s for running.  He continues to use them for walking and core work in the gym which is fantastic.  For his running he is using the Skora.  See the Freedom Feet website –

This shoe provides slightly more cushioning and a very slight heel lift as compared to the Vibrams.  Carl feels much less discomfort in this shoe.  However, if with the intensive demands he is putting on this area during the training, Carl finds that there is still some discomfort then he can always go towards a more traditional ‘running shoe’ with a higher heel again and more ‘shock absorbing’.

Helen Assessment

You will remember that from the first session we identified that Helen had some dysfunction a round her Right Shoulder and Right side of her neck, as well as her Right SIJ, so today we continued to help address these issues.  She has noticed some marked functional improvement in her Right SIJ symptoms and Right shoulder symptoms which is very encouraging.  Clinically she is also testing better but still has some discomfort with full neck rotation to the left and right, as well as some other signs.  The areas that have been manipulated over the past weeks have remained mobile, and today we found that she had some stiffness around her CT junction.  (Where the neck meets the upper back).  This was manipulated today and followed with some Mulligan SNAGs and NAGS to help encourage the rotation at this level.  She found that her rotation improved within the session and she now needs to continue with the great work with Carl in stabilising the neck and shoulder.

Again today I also noticed as I was treating her neck, (with her lying on her back) that her Right foot, although slightly improved, was again still pointing more towards the ceiling than out towards the wall.  The Left foot was nicely relaxed out and turned towards the wall.  The Right side of her pelvis was improved however.   I treated her SIJ again today.  Her sacrum which was ‘locked up’ last time was improved.  She still had trigger points Right gluts as well as into her Right Quadratus Lumborum but these released much more quickly today, and again it helped the turn out to her right foot

Helen continues to be in great hands here with Carl who is continuing with the need for targeted and controlled exercises.

The knee seems to be going well as she reported no problems with this today.  She should carry on with the eccentric exercise program for at least 6-8 weeks.

She also needs to continue with the gentle stabilisation work and massage to help her recovery

I will see her next week and let you know how we get on.

 Carl’s Assessment

As I mentioned above, Carl has continued to exercise and reports some improvement in his symptoms with the combination of core work around the pelvis to improve the proximal control and remove some of the overload to the foot, the acupuncture, and the change of footwear.

He mentioned today that he had noticed some stiffness also around his CT junction area, as well as a very slight reduction in left and right rotation, with stiffens only and no pain.

As with Helen, he had some stiffenss in his CT junction. so I manipulated this for him today and followed with Mulligan SNAGs and NAGs.  This had immediate effect and improved his movement and abolished the stiffness.  He needs to also continue with core, postural exercises as well as range of movement exercises.

For his Left foot I repeated the acupuncture today and have reiterated the need for them both to remain on Helens dietary recommendation to help with regeneration and repair as well as to reduce inflammation

I will continue to help with acupuncture, Helen and Carl will continue with their diet and training.  We will see how we go.

Posted by Willis Street Physiotherapy

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