After you’ve completed a general warm-up, the muscles are warmer and more elastic, you should start some slow, relaxed, static stretching.

You should start with your back, followed by your upper body and then your lower body.

If you don’t have time to stretch all your muscle groups you should at least take the time to stretch all the muscles that will be heavily used during your workout.

I suggest that passive stretches be performed in sets of 2-5, holding each stretch for about 20sec, with a 15-30 second rest in between each stretch.

Children, and people whose bones are still growing, need only hold a passive stretch for about 7-10 seconds.

You should be taking slow, relaxed breaths when you stretch, trying to exhale as the

muscle is stretching. The proper way to breathe is to inhale slowly through the nose, expanding the abdomen (not the chest), hold the breath a moment, then exhale slowly through the nose or mouth.

1.    Neck Rotation

Turn your head to the side, stretching your chin toward your shoulder. Turn head back to center and repeat to the other side.

2.    Shoulder Stretch

Stand with feet shoulder width apart. Raise one arm overhead and stretch as far as you can without bending the torso. Repeat with opposite arm.

3.    Forearm Stretch

Extend your right arm straight out in front of you, palm downward. With the left hand, grasp the fingers of the right hand and pull back gently, stretching the wrist and firearm. Repeat with the left arm.

4.    Tricep Stretch

Raise one arm straight up, so you upper arm is near you ear. Bend at the elbow and let your hand fall to the back of your neck. With the other arm, reach behind your head and place your hand on top of the bent elbow. Gently pull down and back on the elbow. Repeat with other arm.

5.    Trunk Stretch

Stand with your feet a little more than shoulder width apart. Reach your left arm overhead and bend to the right at the waist. Repeat on opposite side.

6.    Chest Stretch

Stand with your feet shoulder width apart. Clasp your hands behind your back and gently press your arms upward, keeping your arms straight.

7.    Back Stretch

Lie on your back and bring one knee to your chest. Hold the knee with both hands and gently pull in. Alternate knees and repeat.

8.    Hip Roll

Lie on your back and bend your knees, feet flat on the floor. Let your knees fall to the right while reaching both arms across your body to the left. Hold the stretch, then roll the hips over to the left, stretch arms to the right and repeat the stretch.

9.    Lower Back Reach

Sit on the floor with your legs straight out in front of you. Reach forward toward your toes, keeping your chin up and lower back slightly arched. Try not to round the back or tuck the chin in – this decreases the effectiveness of the stretch.

10.  Butterfly Stretch

Sit on the floor, bend your knees out to the sides and bring the soles of your feet together. Place your hands on your knees and gently press the knees toward the floor. Keep your back straight.

11.  Lateral Hip Stretch

Sit on the floor with both legs straight in front of you. Bend your left leg and place the left foot over the right knee. Place your right hand on the outside of the left knee and gently pull the knee toward your right shoulder, twisting the torso to the left, until you feel the stretch in your left hip. Repeat with opposite side.

12.  Hamstring Stretch

Stand with legs shoulder width apart and the left leg slightly in front of the right. Shift your weight to the back leg (the right) and bend the knee, turning the knee and toe to the right. Extend the left leg and place the heel on the floor, toes in the air. Keep the back straight and bend forward at the hips until you feel the stretch in the hamstring of the left leg. Repeat with the opposite leg.

13.  Standing Hamstring Reach

Stand with one foot crossed over the other. Bend at the hips, reaching toward the floor and keeping the knees slightly bent. Repeat with the opposite foot crossed in front.

14.  V-Stretch

Sit on the floor with your legs extended to either side so they form a “V”. Bend forward, grasp your toes or ankles, and stretch your chest toward the floor. Try to go a little lower each time you perform the stretch.

15.  Leaning Calf Stretch

Stand about 2.5 feet from a wall. Place your hands on the wall and then lean in, gently pushing your hips forward. Keep your legs straight and heels flat on the floor.

16.  Standing Calf Stretch

Stand with your feet together. Extend one leg in front of you and place the heel on the floor, toes in the air. Keeping the back straight, bend forward at the hips until you feel the stretch in the calf. Repeat with opposite leg.

17.  Quadricep Stretch

Lie face down and reach back with your right arm to grasp your right ankle. Pull your foot toward your buttocks. Be sure to keep your hips and pelvis on the floor. Repeat with left leg.

18.  Standing Quad Stretch

From a standing position, reach back to grasp your right ankle with your right hand. Pull your foot toward your buttocks. Place your other hand on a wall or chair if you need balance support. Repeat with left leg

There are many types of running shoes out there so it’s very important that before you start running you choose a shoe that will support your foot in the way that it needs, this will help you perform better and keep you injury free.

To help these new shoes work you must also give consideration to your training schedule (i.e., building up slowly and allowing your body enough recovery time) as well as possible strengthening exercises to correct weaknesses and imbalances that predispose you to injury.

There are three general considerations which must be understood before buying a pair of running shoes.

1)    What is my foot type? (high arch, flat foot, or normal arch)

2)    What is my Gait cycle or Stride pattern? (pronater, supinater, or neutral)

3)    What shoe types are there? (neutral cushioning, motion control, or stability)

FOOT TYPES

Fig 1: Flat Foot

If you see almost your entire footprint, you have a flat foot, which means you're probably an overpronator. That is, a micro-second after footstrike, your arch collapses inward too much, resulting in excessive foot motion and increasing your risk of injuries such as plantar fascitis, shin splints, knee pain, low back pain, etc. Heavier people often have feet in this category.

You need either stability shoes to reduce pronation and are best for mild to moderate overpronators, or motion-control shoes which are best for severe overpronators, as well as tall, heavy or bow-legged runners.

Try and avoid highly cushioned shoes with little stability features.

Fig.2: Normal arched feet

If you see about half of your arch, you have the most common foot type and are considered a normal pronator. When the arch collapses inward, this "pronation" absorbs shock. As a normal pronator, you can wear just about any shoe, but may be best suited to a stability shoe that provides moderate arch support (or medial stability). Don't pick running shoes that have a lot of stability or motion control. Lightweight runners with normal arches may prefer neutral-cushioned shoes without any added support.

Fig.3: High arched foot

This shows an extremely curved print which means that you have a very high arched foot which causes the foot to be rigid and does not allow it to roll inwards enough and therefore you have very little shock absorption.

If you supinate (this is also called underpronation) it usually shows with wear on the outer side and the little toe

area of your shoes. You should look for cushioned shoes with flexibility to enable foot motion and you should avoid motion control or stability shoes, which restrict foot mobility.

It's very important that if you have high arches that you periodically re-measure your feet because running will cause your arches to gradually fall, making your feet longer.

1)   GAIT CYCLE (STRIDE PATTERN)

Have somebody watch you walk or you might be able to watch yourself in a mirror.  What you want them to look for is if your foot rolls in excessively (pronation) or doesn't roll in enough (supination) during the weight bearing phase or gait.  Also watch for feet turning out (like a duck), this usually leads to excessive pronation.  People that walk "up on their toes" usually have tight calf muscles and need to stretch them out to prevent injuries.

Severe Overpronation

The outside of the heel strikes the ground first and the foot rolls inward excessively which means the foot and ankle cannot properly stabilize the body. Shock is not efficiently absorbed when overpronation occurs. The best shoes for moderate to severe Overpronators are Stability shoes or Motion Control shoes depending on the severity of overpronation.

Mild Overpronation

The outside of the heel strikes the ground first and the foot rolls inward slightly absorbing the shock more effectively which allows the foot and ankle to properly support the body. The foot pronates slightly, but not excessively. The best shoes for Mild Overpronators are Stability shoes that have some medial posting.

Neutral

The outside of the heel strikes the ground first and the foot rolls inward slightly absorbing the shock more effectively which allows the foot and ankle to properly support the body. The foot pushes off evenly at the end of the gait cycle with mild pronation. Your ankles and feet maintain the vertical line of the lower leg.

A Neutral foot wears the shoe in the middle which means that your gait is Neutral and you should be in Neutral Cushioning shoes for feet that are more rigid.

Supination

The outside of the heel strikes the ground first but the foot does not roll inward during the gait cycle. Instead it stays on the outside causing the impact to be concentrated on a smaller portion on the lateral side of the foot. This decreases shock absorption and causes the smaller toes to do most of the work during push-off.

Supination is the most uncommon of all foot types. There is not a shoe that corrects supination, but the best shoes for Supinators are a wider based more flexible Neutral Cushioning shoes with single-density midsoles.

1)   SHOE TYPES

Neutral Cushioning
A Neutral Cushioning shoe is best for runners with a high arch who do not pronate effectively. These shoes do not have medial supports but are more concerned with midsole cushioning. The midsole will provide the extra shock absorption as the lack of pronation is missing. Along with a runner who does not overpronate, Neutral Cushioned shoes also work well for midfoot and forefoot strikers.

Stability
Stability shoes are for runners who have normal or medium arches with mild to moderate overpronation issues. 

These shoes have some medial support and good midsole cushioning.

Also, just like overpronators should not wear neutral shoes, nonpronators should not wear stability shoes.  The medial support (arch support) can actually cause adverse effects to a nonpronator. 

Motion Control
Motion Control shoes are for runners who generally have a low or flat arch and are moderate to severe overpronators. These shoes employ extra support devices on the medial side to slow excessive pronation and tend to have wider and flatter outsoles. Heavier runners who need extra support and durability may also want Motion Control shoes. A mild pronator would not want to wear this shoe. 

Summer is almost here and a perfect opportunity to dust off those running shoes, head outside and get fit this year.

This might be your first try at running, or a return visit. The less running you’ve done recently, the more you can expect to improve your distance and speed. On the other hand, the less you’ve run lately, the more likely you are to hurt yourself by doing too much running, too soon. It is important to ensure that you maximise improvements and minimise injuries as you start or restart your running programme.

Here are some tips to help get you started:

Have a goal

Run a 10km race before March!

Buy the right shoes

See article on “choosing the correct pair of running shoes”

Plan in advance

Set time aside in your day/week for your training.

We are creatures of habit so getting into a routine will make life easier for you. (i.e., days of the week & time of day you run)

Keep a diary

Do this to keep track of your sessions so they’re not just gone and forgotten about. Each single session forms part of a bigger picture. This includes recovery days!

Monthly Consistency

You will have good and bad weeks with training, that is a given. Rather look at your consistency on a monthly basis and don’t try make up for lost time by trying to do more on another day.

Less more often is better than more less often.

With more improvement and less injury in mind follow the Programme plan below, showing you where to start with incremental progressions to challenge and improve your fitness levels.

PROGRAMME PLAN

Step 1: Starting Point

Start by running 15-20 minutes, three or four times a week. Stick to this for the next 4-6 weeks before progressing onto step 2.

A four-day week works well if you’re pressed for training time, you want maximum results from a minimalist programme, you’re often sore and achy from training, or your motivation is lagging.

To keep things interesting try choose a different route for each of the days you run.

Always warm up for your workout with a couple minutes of walking and/or slow jogging, and cool down afterwards with the same.

If you cannot reach 20 minutes of continuous running, try to run eight or nine minutes, walk one or two minutes, and repeat.

When you succeed at reaching the 20-minute goal-and you will-gradually increase your time by 2-5 minutes every week until you can comfortably run for 30min.

Even with walking breaks, you can cover 3km in 30min, and you might soon be running 5km in that time. It’s important to run these efforts at an easy, comfortable pace.

The key when starting out is continuous movement and getting used to spending time on your feet. Only gradually increase time as indicated in the programme - don’t increase your intensity just yet, keep it comfortable.

The programme is set up using time as opposed to distance. This makes it versatile for many levels of ability.

Step 2: Challenge yourself

Now that you can comfortably run for at least 30 minutes four times a week it’s time to challenge yourself.

You still have four sessions in a week but now you’re going to replace two of your sessions with the below alternatives for the following 4 weeks:

1)    Long run (Preferably on the weekend)

Start at 30-45min and gradually increase you time by no more than 10% per week (About 5 minutes). Every fourth week reduce the duration of this long run back to where you started to allow the body to recover.

The long run is the cornerstone of any running programme. It increases your aerobic fitness, teaches your body to run efficiently and burns tons of calories.

2)    Strides or Pick Ups

After ONE of your easy runs I want you to finish with 4-6 strides or pickups. They’re simple pickups or accelerations of about 100m. Find a smooth stretch of road or grass and gradually accelerate to almost top speed. This should take about 30-50m, then hold the speed for another 50m before gradually decelerating. Jog for 30-60sec and repeat. Strides are always done at a fast-but-relaxed speed. It’s important to keep them smooth and controlled at all times. Pay attention to your form.

Maintain your two 30 minute easy runs but follow the hard day / easy day training system ensuring that more difficult sessions (i.e., long run and Strides) are split between your two easy or recovery days.

Step 3: Spice it up

It’s time to do just that!

Keep going with the long runs and strides as detailed in step 2.

Except take one of the two easy 30min runs and replace it with your choice from the two options given below.

Stick with this option for the next 4 weeks. If you want to change to the other option given below do so after 4 weeks as your body needs time to adapt to the demands you give it.  

1)    Fartlek

Fartlek means “speed play” in Swedish, and that’s what fartlek workouts should be: Play. Fartlek runs are playful because they consist of unscheduled, unrestricted fast and sow running.

So, instead of doing your regular run of 30-40 minutes, run the same time with fast bursts followed by slow recoveries. The fast bursts should last from 30 seconds to 2 minutes. Often they’re based on distances between landmarks like trees, hills or phone poles. The more variety the better. Running a fartlek workout is like being a child again, and challenging one of your budies with a “race you to the house on the corner”.

Fartlek running develops sustainable strength and speed. It’s also a good way to sneak speed sessions into your training programme.

2)    Hill repeats

Find a smooth moderate steep hill that has good, consistent footing.

Run easy to the base of the hill, then gradually increase your effort up the hill. Don’t sprint, but run at a strong, steady effort for between 1 to 4 minutes. Emphasise knee lift and a strong, forward-and-back arm swing. Try to maintain pace all the way to the top, then turn around and jog back slowly to your starting point to recover.

Repeat 4 to 10 times.

Hill repeats develop power and leg strength and improve your form, endurance and overall mental toughness.

DON’T FORGET:

To warm up and cool down

Run safely at all times

Use pain as your guide

Add a little stretching and strengthening

Eat the right foods and keep hydrated

Whether you are just beginning a new exercise program or a veteran on the training scene it is essential to progress at the right pace to meet your goals and avoid injuries.

Injury prevention is possible if you are prepared for your activity and can follow some of the guidelines given below. Remember there is no short cut to achieving your goals so you need to balance training with rest to avoid overuse injuries.

If you are new to exercise, the first thing to do is to get your doctor's clearance before starting. This is especially important if you have any health issues, haven't been active recently or aren't sure of your health status.

Warm Up Before Exercise
A proper, gradual warm up prepares the body for the activity it’s about to do and goes a long way to preventing injuries. The warm up can consist of easy aerobic exercise to gradually increase the heart rate, body temperature and muscle elasticity.

Gradually Increase Time and Intensity
When starting an exercise program, many people have lots of enthusiasm initially, and go too hard, too soon. Begin with moderate exercise of about 20 minutes, 3 times a week and gradually build upon this.

Start within yourself and as a general guideline aim to increase your activity by no more than 10 percent per week. That includes distance, intensity, weight lifted and time of exercise.

Visit a Personal Trainer
If you don't know what to do or where to begin, a good trainer will get you started safely while teaching you the necessary body mechanics and techniques involved to help you avoid any injuries.

Don't Workout on Empty
While you don't want to exercise immediately after eating a large meal, eating about 2 hours before exercise can help fuel your exercise and help you avoid bonking during your workout.

Drink Before You Exercise
Dehydration can have an adverse affect on your performance, so stay well hydrated. Try to drink about 500ml of water in the two hours before your workout and then take in water during your workout to replace any lost fluids.

Listen to Your Body

If you experience any sharp pain, weakness or light-headedness during exercise, pay attention. This is your body's signal that something is wrong and you should stop exercise. Pushing through acute pain is the fastest way to develop a chronic or overuse injury.

Take Time for Rest and Recovery
In addition to getting enough sleep, it is important to take some rest days. Working out too much for too long can lead to overtraining syndrome and possibly reduce your immunity.

Train for your sport

Use specific skills training to prepare for your sport. 

Cross Train

In addition to helping reduce workout boredom, cross-training allows you to get a full body workout without overstressing certain muscle groups.

Dress Properly for Your Sport
This includes using appropriate safety equipment for your sport, choosing proper footwear, replacing running shoes as needed and wearing clothing that wicks sweat and helps keep you cool and dry. Read more about how to layer clothing for cold weather exercise.

Don’t have time to go to the gym or would prefer to keep fit in the comfort of your own home?

This home exercise circuit is simple, easy to follow and gives you a great total body workout. It requires no equipment, other than what you’ll find around your house.

You can choose between two programmes:

1.        Select 10-15 of the following exercises. Perform 1 set of each, moving continuously from one exercise to another. Only rest at the end, once all exercises have been performed once before repeating 2-3 times.

2.        Select 10-15 of the following exercises. Perform 2-3 sets of each exercise before moving onto the next one, take 30sec rest between sets and 60sec rest between each exercise.

We all want to be able to run faster, in order to do so we naturally look towards our training programme. However, there is an alternative... you can improve your running technique instead. This means getting faster without having to improve your fitness, although it will take some regular practice and concentration to improve your running technique. Over time these alterations can give a big return on the amount of effort needed.

Running is meant to be a natural, relaxed and continuous fluid movement so when reading these guidelines mentioned below don’t look to make wholesale changes over night. We are all different so rather use these guidelines as a means of refining or tweaking your own natural technique.

Heel Up (Smaller, Quicker arc)

Often when a runner has poor or tired running technique the foot gets left behind and follows a large arc when coming up towards the backside. Try pull the heel straight up under the hips, keeping the lever (i.e. legs) shorter and the arc small and quicker.

Don't fix on landing, just think of lifting the heel up. This means the ankles only ever move up and down and not back and forth. Your legs should land themselves without any muscle activity, just by gravity pull.

Change support quickly from one leg to another (Leg Speed)

Running is all about leg speed so aim for a high leg turnover of at least 180 foot-strikes per minute at any running speed. This minimises the impact stress and reduces the time your foot spends in contact with the ground and allows for optimal use of elastic recoil.

Don't try to increase stride length to increase your speed.

Land with your foot directly beneath your hips, never out in front

Keep shoulders, hips and ankles along one vertical line so when on support your knees are bent and your feet are behind the vertical line going through your knees. This reduces braking and impact stress, letting you carry energy from the previous stride efficiently into the next.

Don’t Heel Strike with your foot in front of your bodies centre of gravity as this acts as a braking action to your bodies forward “rolling” momentum. This means you have to work harder in keeping your body weight moving forward, up and over your foot strike. It also increases the stress on joints as you will tend to land heavily.

Knee Up (Ankle first, knee follows)

Create propulsion through hip extension and not knee flexion or knee extension. This allows for a longer stride length and creates a more efficient, horizontal propulsion engaging larger muscle groups to do the work.

This is very important but can also be counter-productive if the lift of the knee comes above a position where the leg is parallel to the ground.

Keep the heel unweighted throughout the stride cycle

Efficient runners keep almost all of their weight on the forefoot throughout the weight-bearing phase of each stride cycle. This provides both shock absorption and energy return for propulsion for the next stride.

Don't point toes and don't land on them.

Leaning Forward

Keep your body leaning forward slightly and free falling (not bending at the waist), if you don't you again brake your action and put strain on your lower back.

Arm Movement

Arms performance is a natural balance for legs movement so your arms should swing through in the direction you are travelling, not across your body (i.e. lateral movement). If there is excessive lateral movement you will be twisting your whole body, through your shoulders and causing problems for your joints. The height at the front and back of the arm swing will depend on the speed you are running.

Keep Hips High

When dropping your hips you get the feeling of “Sitting as you run”

If your hips are not held high enough you will tend not to extend your stride as you should. Also, it is harder to get significant knee lift and you'll probably run fairly flat footed, relying primarily on the strength in your quadriceps and not using hamstrings and calves to their full ability.

Have you ever stopped to wonder why some individuals stick to a structured training schedule while others give up at the first obstacle? Or why, a few months into your perfectly-planned program, your enthusiasm dwindles?

There can be many explanations but the complex phenomenon that affects all of these to some degree is motivation.

This is where a simple yet often-misused motivational technique called goal -setting can provide some structure for your training.

Short and Long-term goals give you motivation, direction and purpose, and the key to effective goal-setting is the S.M.A.R.T principle.

1. First, goals must be Specific. This has been clearly shown to improve performance. Difficult goals are more effective in enhancing performance than easy goals and explicit ones are more effective than general 'do your best' ones

For example, if you're a runner, rather than professing a desire to reduce your 5K time, you should state: 'I intend to knock 20 seconds off my 5K time over the next six months'.

2. Your training target ought to be Measurable. Goals can be so vague that they are useless. If achievement cannot be measured, then your self-confidence will not benefit from goal setting, nor can you observe progress towards a greater goal. Set precise, quantitative goals.

3. Goals should also be Adjustable. Goal-setting is a dynamic process. If, for instance, you become injured you should be able to lower your goals accordingly. On the other hand, you may make such rapid progress that you can raise them. Ultimately this means that they must conform to the first two criteria: being specific and measurable.

4. Goals must be Realistic. Goals can be set unrealistically high. When a goal is perceived to be unreachable, no effort will be made to achieve it. Conversely, goals should be difficult enough so that you're not struck down by acute boredom because you've achieved them too easily.

5. Finally, your training targets ought to be Time-based. If you don't give yourself a specific time frame in which the goal must be achieved, then the urgency for attainment is reduced. The previous example of trimming the 5K time by 20 seconds within six months satisfies this criterion. Try to resist the temptation to move these time constraints back to accommodate life events, such as minor injuries; the result is that the value of the time limit is negated. It is important to identify when this happens, and to set about designing new objectives with new time parameters. This way your goal-setting plan won't lose its effectiveness.

Where Goal Setting Can Go Wrong

Goal setting can go wrong for a number of reasons:

• Outcome goals (i.e., focus on winning a competition) can be set instead of performance goals (i.e., focus on improvements relative to one's own past performances). Where a person using outcome goals fails to achieve the goal for reasons outside his or her control, this can be very dispiriting and can lead to loss of enthusiasm and feelings of failure. Always set performance goals.
• Goal setting can be unsystematic, sporadic and disorganised. Here goals will be forgotten, achievement of goals will not be measured, and feedback will not occur into new goals. The major benefits of goal setting have been lost. Be organised and regular in the way that you use goal setting.
• Too many goals may be set, leading to a feeling of overload. Remember that you deserve time to relax and enjoy being human.

Action steps to get you started

1)      Decide on at least one short & long term goal

2)      Make a plan & write it down to help keep track of your progress. Nothing motivates like success

3)      Tell people about your goal so that you actually buy into it. This will give you focus.

4)      Establish a routine that will eventually become a habit.

Sometimes it does feel difficult to buy into the goal that you’ve actually written down. Keep it simple and just take the first step and write something down. Stick it up somewhere you can see it…look at it, re-think it, refine it, sleep on it but eventually you will come up with the right goal. A goal that you believe in and is worth the effort and sacrifices it will take to achieve it!    

It won’t be easy and requires self-motivation, discipline and above all commitment. This is key to achieving your goals.

A lot of people ask questions about specific treatments for sports injuries, like running injuries and other common pulled muscle complaints.

The type of sports injuries I am referring to here are the soft tissue injuries. These injuries are very common in most sports and include sprains, strain, tears and bruises that affect muscles, tendons, ligaments and joints.

Examples of common soft tissue injuries would include things like hamstring tears, sprained ankles, pulled calf muscles, strained shoulder ligaments, corked thighs, etc.

Remember a sprain refers to a tear or rupture of the ligaments, while strain refers to a tear or rupture of the muscles or tendons.

The sort of injuries I am NOT talking about here, are injuries that affect the head, neck, face or spinal cord. Injuries which involve shock, excessive bleeding, or bone fractures and breaks. The treatment of these types of injuries goes way beyond the relatively simple soft tissue injuries that I am discussing here.

Firstly, I’ll look at the importance of the immediate treatment (the first 48 to 72 hours), and then I’ll outline the ongoing treatment necessary for a full recovery.

The sooner you start treating a sports injury, the more chance you have of a full and complete recovery. The longer you wait, the worse it is going to be.

R.I.C.E.R regime

The most effective, initial treatment for soft tissues is the R.I.C.E.R regime. This forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.

When a soft tissue injury occurs there is a large amount of uncontrolled bleeding around the injury site. This excessive bleeding causes swelling, which puts pressure on nerve endings and results in increased pain. It is exactly this process of bleeding, swelling and pain which the R.I.C.E.R. regime will help to alleviate. This will also limit tissue damage and help the healing process.

R: (rest) It’s important that the injured area be kept as still as possible. If necessary support the injured area with a sling or brace. This will help to slow blood flow to the injured area and prevent any further damage.

I: (ice) By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred

How do you apply ice? Crushed ice in a plastic bag is usually best. However, block of ice, commercial cold packs and bags of frozen peas will all do fine. Even cold water from a tap is better than nothing at all.

When using ice, be careful not to apply it directly to the skin. This can cause “ice burns” and further skin damage. Wrapping the ice in a damp towel generally provides the best possible protection for the skin.

How long? How often? This is the point where few people agree. Let me give you some figures to use as a rough guide, and then I will give you some advice from personal experience. The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours.

These figures are a good starting point, but remember they are only a guide. You must take into account that some people are more sensitive to cold than other.

C: (compression) Compression actually achieves two things. Firstly, it helps to reduce both the bleeding and swelling around the injured area, and secondly, it provides support for the injured area. Simply use a wide, firm, elastic, compression bandage to cover the injured part. Make sure you bandage both above and below the injured area.

E: (elevation) Simply raise the injured area above the level of the heart at all possible times. This will further help reduce the bleeding and swelling.

R: (referral) If the injury is severe enough, it is important that you consult a professional physical therapist or a qualified sports doctor for an accurate diagnosis of the injury. With an accurate diagnosis you can then move onto a specific rehabilitation program to further reduce your injury time.

Things to avoid

There are a few things which you must avoid during the first 24 to 72 hours after an injury.

• Any form of heat at the injury site. This includes heat lamps, heat creams, spas, jacuzzi’s and saunas.
• Avoid all movements and massage of the injured area.
• Avoid excessive alcohol.

All these things will increase the bleeding, swelling and pain of your injury.

So what happens after the first 48 to 72 hours?

When any damage occurs to the soft tissue (muscles, tendons, ligaments), the body immediately goes into a process of repair. Where the individual fibers have been ruptured, or torn, the body begins to bind the damaged fibers together using a fibrous protein called collagen or, as it is more commonly known, scar tissue.

Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged tendon in an effort to draw the damaged fibers back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it is even possible to see and feel this bulky mass under the skin.

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the

tissue is also compromised.

So, how do we get rid of that annoying formation of scar tissue?

Firstly, you must keep active – do not listen to anyone who tells you to do nothing. Now is the time to start active rehabilitation. Most of the swelling will have subsided after the first 48 to 72 hours and you are now ready to start light activity.

Light activity will not only promote blood circulation, but it will also activate the lymphatic system. The lymphatic system is vital in clearing the body of toxins and waste products, which can accumulate in the body following a sports injury. Activity is the only way to activate the lymphatic system.

A quick word of warning, never do any activity that hurts the injured area. Of course, you may feel some discomfort, but never push yourself to the point where you are feeling pain.

Listen to your body. Do not overdo it at this stage of the recovery.

To remove most of the unwanted scar tissue, you now need to start two vital treatments.

The first is commonly used by physio’s, and primarily involves increasing the blood supply to the injured area. The aim is to increase the amount of oxygen and nutrients to the damaged tissues.

This will help to supply the tendon with the oxygen and nutrients that they need for a speedy recovery. Physio’s accomplish this aim by using a number of activities to stimulate the injured area. The most common methods used are ultrasound and heat.

Secondly, to remove the unwanted scar tissue it is vital that you start to massage the injured tendon and connecting muscles. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will be able to do that.