It was a long day leaving home at 7am to catch a train from Euston. On arrival in Manchester, I was straight in and begun the CHEK Approach to Swiss Ball Training workshop at The Virgin Active Didsbury club, a club that I was the Regional Personal Training Manager about nine years ago, so it was nice to be back.

I had a really great bunch of guys in the class, very keen to learn and were able to handle my sense of humour (or lack of…).

After the seminar, Gavin Jennings, the owner of CHEK Europe played chauffeur and kindly drove me over to Leeds just in time for the seminar at Virgin Active Leeds. Whilst not ideal, I did have to eat my lunch in transit and we only arrived with minutes to spare before the start of the seminar.

The class was a little small in Leeds, but still , the group was very keen to learn and did very well in the class.

After the seminar, Gavin and I had dinner in Leeds before my train journey back to London. I tucked in to a juicy Rib Eye Steak that was absolutely mouth watering.

Following the meal, it was back on the train and I finally arrived home at 11.15pm and was tucked up in bed shortly after. All in all, it was a very enjoyable, busy, successful, if a little tiring day.

After a full week of Bikram Yoga last week, I was back in the gym the gym this week. Monday, Tuesday and Thursday I worked out using moderate intensities (8-10 reps) 3 working sets, often combining two movements per exercise, such as lunge with dumbbell shoulder press or Cable deadlift with row.

Wednesday, I was on the road presenting, “The Swiss Ball Approach to Swiss Ball Training”, at Virgin Active Barbican in the morning and Virgin Active Canary Riverside in the afternoon. It was very interesting to go back to clubs that I use to work in 10 years ago. The attendees were great and showed a great attitude towards learning and seemed to enjoy the workshop, I certainly did.

Today, I finished the week by attending a workshop at The Apple Store for a workshop along with my P.A. Leanne. We lean red a few tricks that will help us improve efficiency and the way we arrange our incoming emails.

I also finished the week with another Bikram Yoga class and it was the first time I competed the class without the heat making me feel dizzy.

Oh, and in between all that, I also made time for my lovely clients including one new one.

Have a great weekend everyone!

Stretching:

• Once the inflammation has ceased, the knee should be gently moved into pain-free ranges of motion to recover the full range of motion of the knee joint and help re-align scar tissue
• Any tight muscles around the hip, knee or ankle joints should be stretched within pain-free ranges. These will differ from person to person and can only be decided following a thorough biomechanical evaluation.

Strengthening:

• Once weight bearing is possible and inflammation has ceased, the following muscles should be strengthened: gluteus maximus, gluteus medius and minimus, transversus abdominus and external obliques.
• All weak muscles must be identified following a thorough biomechanical evaluation.
• Once a corrective exercise phase is completed to improve core stability and muscle balance, strength and then power phases are required along with appropriate plyometric, agility and speed work to prepare the body for your sport before a return to action to avoid injury recurrence.

For more information, you might want to check out my book, “Anatomy of Sports Injuries for Training and Rehabilitation.”

The Acute Phase:

• In the first 24 to 48 hours, use Rest, Ice, Compression and Elevation (RICE) of the affected knee to prevent further damage and optimize healing time.
• Always seek professional help if you suspect an ACL sprain
• Anti-inflammatory protocols such as the use of Traumeel® ointment, gel or injections, anti-inflammatory supplements and avoidance of known sensitive foods.

Post-acute:

• Sports massage above the affected area to aid venous return and therefore eliminate waste from the affected knee
• Sports massage to help reduce tension in tight muscles
• Heat treatments such as hot packs (after the swelling has gone)
• Corrective exercise, especially improving muscle balance in the lower limbs, leading to gradual return to training and competition.
• Strength training should begin with isometric, then slowly progressed to concentric and finally eccentric work.
• A total rupture usually requires surgery.

The recovery times you can expect with appropriate recovery management are:

Grade 1 sprain  - is a minor tear of the ligament. Mild local pain and tenderness may be felt and minor swelling and muscle spasm may be seen. Function of the joint isn’t too affected. With the correct treatment and care, recovery can take 2-3 weeks.

Grade 2 sprain – is a severe partial tear of ligament fibres. Pain is possible at rest and likely during weight bearing and stress testing.  Considerable swelling and a loss of function are likely. Recovery is likely to be 3-6 weeks.

Grade 3 sprain – is a total rupture of the ligament fibres. There will be severe pain, severe loss of joint function, loss of joint stability and muscular spasm. Rapid swelling is also likely around the joint. A possible pop can be heard if the incident is sudden or traumatic. Healing can take 3-4 months or more following surgery.

Stay tuned to find out the exercises you are likely to need…

You may have also heard in the news this week that Marcus Hahnemann, The Wolverhampton Wanderers goalkeeper has ruptured his ACL and will be out for five to six months.

ACL Sprains are most common amongst 15-25 year olds who participate in sports that require a pivoting motion. Basketball, soccer and skiing being amongst the most commonly affected sports. I have also experienced myself that tennis with all it’s changes of direction and twisting and turning at speed can also cause ACL sprains.

The ACL resists anterior translation of the tibia (shin bone), in relation to the femur (thigh bone) and is four to eight times more common in women than men.

Approximately 80,000 ACL sprains are reported per year in the USA. 70% of these injuries are non-contact.

The medial collateral ligament and medial meniscus are often be injured at the same time as the ACL.

The symptoms experienced with an ACL sprain include:

• Pain and instability of the knee
• Swelling of the knee
• Inability to bear weight on the affected knee
• A loud pop may be heard if it’s a complete rupture.

The causes of an ACL Sprain include:

• A twisting motion of the knee when changing direction or pivoting.
• Over-pronation in the affected limb.
• Core instability (possibly caused by visceral inflammation)
• Muscle imbalances around the hip and pelvis, especially weak gluteals and abdominals.
• Impact injuries, such as car accidents or tackles in rugby or soccer when the foot is planted on the ground.

Tune in next time, when I will be discussing the treatment of an ACL Sprain…