Tweaks and Twangs


You’ve been trapped in an office all day, then trapped in traffic on the way home. You feel like you’ve barely moved all day, you feel stiff and your back aches from the terrible little plastic chairs in the conference room. On the positive side, the sun is still shining when you get in and you decide to beat the blues with a run to stretch your legs (and maybe practice your new running technique)

It’s all good baby! Amazing how the office politics matter so much less when you hit the road. The wind in your hair, fresh air in your lungs. It’s like being born again.


Sorry dude. That was your hamstring, calf, your quad. That was you twisting your ankle, a tweak in your Achilles or your plantar fascia lighting up. You know it’s nothing to worry about. It’s a twinge, a minor niggle. It’s not the kind of thing you’d rush off to the doctor for or the kind of thing you’d pay to have someone (like us) fix. It is frustrating though, and it could be a few of weeks out of action easily, longer if you stick to your Injury Management Plan A, which is to bury your head in the sand and hope for the best.

Injury Management Strategy #1 (for most of us)



You’ve all heard RICE – Rest, Ice, Compression and Elevation, which is very vague, generic advice for handling an injury in the extremely early stages. Its questionable, there are arguments for and against the whole ‘ice’ thing for example, but its easy advice to follow and it’s not going to do any harm or break the bank. Want to go a little bit further to speed up your recovery? Here’s some stuff to try.

1) DO NOT take anti-inflammatories like ibuprofen. Controversial, attention grabbing start right? With acute injuries (sprains, strains, cuts etc) ibuprofen can SLOW DOWN the healing process. If you want the technical version, ibuprofen inhibits the production of an enzyme called cyclooxygenase, which makes a hormone called prostaglandin, which stimulates the inflammatory response. If you take ibuprofen early after a traumatic injury you are stopping your body from reabsorbing the damaged tissue, dead blood cells etc. Try paracetamol instead if you need pain relief

2) Keep it moving! It’s shocking the amount of people who take the rest thing too far following a minor muscle/ligament injury. Even on day one you should be keeping the affected area moving. It improves circulation (therefore speeding up healing) and keeps your nervous system in tune with that part of your body. One of the big problems coming back from injuries of the foot and ankle in particular is that you lose balance and awareness of the joint, making it more likely to get reinjured. Gently moving the joint or affected muscle as often as possible will help to keep normal neural feedback in the area and keep everything switched on. For bonus points gentle isometric contractions (where you tighten the muscle without actually moving, for example pushing against a wall) can also be very effective for both pain relief and healing.

3) Take Cissus Quadrangularis. This hard to pronounce little fella is a supplement made from a plant that grows in Africa and India. It has been used for centuries as an analgesic and to promote healing, and in ancient times was particularly used to help fracture healing. Today it is widely used in bodybuilding circles to decrease post-exercise soreness and help to heal soft tissue injuries. The evidence isn’t fantastic, but the same could be said for a lot of things and subjectively with our own patients we’ve had some good outcomes reported. You can take 100-500mg daily depending on the strength of the version you buy. This is the brand we generally recommend but I’m sure they are all pretty similar

4) Heat it up – After the 72 hour inflammatory period where heat would do more harm than good, get a heat pack or hot water bottle and heat that sore hamstring or bicep as often as you can. 20 minutes 2-3 times a day is a good start. The idea of this is to decrease any protective tightness in the muscles and increase blood supply to the damaged tissue. Fresh, oxygenated blood will allow your body to heal the injury quicker and more effectively

5) Foam Roll that badboy. Seriously. If you haven’t got one of these High-density-foam-rollerdrop everything you are doing and run/hobble to the nearest sports equipment shop and get one. They are a fantastic self-massage tool that work for most body parts (apart from smaller ones like ankles and wrists). There are hundreds of youtuber videos of this one, so I’m not going to make another. Just Search foam roll + body part on youtube and you’ll see 100 people teetering on top of these things releasing off the tight, irritated tissue.
The best way to use them is to follow a simple test-retest system. Find a movement that makes your injury feel sore (for example a squat, calf raise or press-up). Use the foam roller for 1-2 minutes, then retest. If improved then continue, if not then you may need to change technique or move the roller slightly. It should feel pretty sore while you’re using it, but it generally eases off quickly.

6) Phase back in graadduaallllyyy. After a couple of weeks laid up with an injury DON’T expect to go back to running, boxing, playing football again instantly. Professional players don’t go from being injured on the bench to playing 90 minutes straight away and neither should you. Start with low impact activity such as swimming, cross trainer or static cycling to get the muscle working without too much impact, then gradually progress back to your normal level of activity, distances and speed.

Enjoy! Any questions or future topic requests please leave them in the comments or facebook us at WDC physiotherapy. Remember these are just simple steps you can take to start addressing your own problems. That’s not to say everything is self-treatable and you should always go and see a qualified professional if you are unsure or struggling