Whether you're a casual runner or full-time rugby player, when injury hits and stops you taking part in sport, pairing effective treatment with tailored rehab is the best way to get you back to full fitness, as soon as possible.
SoGlos sits down with Alex Johnson, sports and exercise therapist at Cheltenham's Pea Green Physio and semi-pro rugby player, to discover how the clinic helps patients to not only recover from sports injuries, but prevent them from happening again, through a combination of hands-on therapy, the latest technology and prescribed exercise.
Alex, tell us a bit about your sports background and your role at Pea Green Physio.
In my sporting life, I'm a semi-professional rugby player. I started playing rugby when I was seven, worked my way up through the age groups with local clubs and then eventually joined the academy at Bristol Bears. I was then fortunate enough to play for Hartpury College and then Leeds Beckett University, where I played some Bucks Super Rugby – the highest level in the UK for universities.
There I managed to pick up a semi-professional contract, playing with Otley RUFC in Yorkshire, where I stayed for three seasons before moving back to Gloucestershire last year.
At Leeds Beckett I studied sports therapy, which in general covers mainly sports injuries. We do injury assessments, first aid – in rugby it's a lot of pitch-side work, things like taping, bringing players off for concussion protocols; and massaging.
At Pea Green Physio, I'm a sports and exercise therapist, covering a range of areas including massage and injury assessments, along with personal training and rehab. We have a gym here at our Cheltenham clinic, which allows me to take my patients through their entire rehabilitation process from start to finish.
What are the most common injuries that people pick up when they’re playing sport?
Generally speaking, a lot of what we see are muscle injuries – so that's strains, which are common with runners, whether from overuse or a high workload; and contusions – things like bangs and bruises.
We also see a lot of joint issues, from rolled ankles, to sprains from say, landing on an outstretched hand, things like that.
We also rehabilitate dislocations and fractures. Patients might go to hospital, they've done their six weeks in their plaster cast, for example; and then they come to us for rehabilitation.
How do you treat sports injuries at Pea Green Physio?
When a patient comes in for the first time, we give them an injury assessment – a series of tests that can help us pinpoint exactly what's up.
If we're dealing with tight or stiff muscles, we might do some soft tissue work through massage – trying to promote blood flow, loosen off those muscles, get rid of all the lymph that's built up – which makes it a lot easier to move.
For joint injuries, we might work on strengthening those joints with some isometric balance and loading work.
At Pea Green, we have a lot of fantastic state-of-the-art medical technology that we can use, too. Our EMTT – magnetic technology – is really good for dealing with swelling and inflammation; we've got a variety of shockwave machines, from radial for treating chronic superficial tendinopathies, to focus shockwave that treats everything from bone stress injuries and neuropathies, to deep seated osteoarthritis, joint pain and acute and chronic tendon issues – these help promote the healing phases.
Mixing that with the hands-on treatment and a comprehensive rehabilitation programme leads to the best outcomes for our patients.
It's also important to make sure that patients aren't susceptible to re-injuring. So we're not only treating the problem, we're stopping reoccurrence, because the last thing we want people doing is coming back in with multiple injuries.
What does rehabilitation look like for patients?
Following treatment, we'll prescribe patients with a bespoke exercise plan, with a view to rebuilding strength and stability.
We like to take our patients through their exercises in the gym here at the Cheltenham clinic, to make sure that they know what they're doing – we don't want to send someone away pushing through their pain because they think that's what they need to do.
We have your typical squat rack with set cables attached, that allows us to put a bench in with some bars; along with some kettlebells and dumbbells.
We offer personal training sessions as well, which allows patients to come in to the clinic specifically to do their exercises with us. From there, we can tweak a few things, we can progress or regress, making sure that they're on the right path instead of sending them away to the gym and them hoping that they're doing the right things.
It can be a scary thing if you’re not quite sure what you’re doing – that's the aim of these one-to-one personal training sessions, to help patients build confidence and train correctly, independently. The last thing you want is to be doing something wrong and thinking you're doing it right; and you're not actually making any progress.
What kind of things can patients do themselves, away from the clinic to boost their rehab?
Through exercise prescription, we can ensure patients are continuing their rehabilitation at home. The exercises we'll give you will depend on your injury – it might be some weight loading, some resistance band work, it could be some squats and movement.
I'm a big believer that movement is the best thing for a lot of injuries – rest is great for specific things, but a lot can be treated with movement, so we want our patients to keep moving.
Prescribing them balance and strengthening work can enable them to complete day-to-day tasks, as well as giving them a nice platform to recover and rehabilitate from.
How can other therapies offered by Pea Green aid the recovery process?
At Pea Green, we have a mantra that if we need an extra set of eyes or hands, then we're always fluid with moving patients between ourselves, because we always want to get the best outcome we can.
In the same way my colleagues might send patients to me for soft tissue work and bespoke sports and injury rehabilitation, I might send a patient over to Wilson (Mbutu) who's our expert MSk physiotherapist qualified in ultrasound diagnostics; Helen (Hopkins) who's a leading clinical expert and educator in chronic and complex pain with a specialist interest in radiofrequency, BioWave and vagus nerve stimulation; or Steph (Smith-Rowles) who's an expert in radial and focus shockwave therapy, is an MSk and men's health specialist, for example.
It's like a big spiders web, a network of trusted orthopaedic, pain and neuro consultants and podiatrists that extends outside of Pea Green, for things like imaging, or referrals from a private hospital or GP.
Finally, what are your top tips for preventing sports injuries?
One of my top tips is what we call 'prehab', which is the idea of doing exercises to prevent injuries. If we can stop injuries before they happen, that's ideal. For example with rugby players, we can have them doing things to build up knee, back and shoulder stability, so that when they go into contact, their bodies are prepped and ready to go.
That can be anything from balance, plyometrics – force exposure like jumping, landing, working in awkward positions – we want to make sure that if a player does get bent or twisted into an awkward position, they're able to pull themselves out of it, or they've got that little bit of give.
Then, a warm up is great. It's just making sure that your body is ready to go. When you go in cold, you're more susceptible to injury.
To add to that, cool downs are important too – the last thing you want to do is finish a gym session and just go straight home and sit on the sofa. When you exercise your muscles, they stretch; and when they cool back down again, they tighten up, because your body is trying to protect itself.
And then there's progressive overload, which means progressing each week to make sure that you're getting the best development. You don't want to be starting from one thing and jumping straight into another – we get a lot of overuse injuries that way. It's about making sure you're moving and growing every week, instead of just going from zero to hero straight away.
For more information about sports and exercise therapy with Pea Green Physio – or to book in for an express injury assessment with Alex, costing £55 – call 01242 420810, email info@peagreenphysio.co.uk, or visit peagreenphysio.co.uk.
