Latest / The STA Clinician Podcast / STA204 'Therapy For Swimmers' with guests Carla Bickerstaffe and Jenny Lane

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STA204 'Therapy For Swimmers' with guests Carla Bickerstaffe and Jenny Lane · The STA Clinician Podcast

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You're listening to the Sports Therapy Association podcast, putting evidence
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back into soft tissue therapy.
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Music.
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Hey people, how are you doing? Welcome to the Sports Therapy Association podcast, episode 204.
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My name is matt phillips creator of runchatlive.com and
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as always this episode has been recorded live on the
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sports therapy association youtube channel and facebook page although
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tonight if you are joining us live it is on a wednesday rather than
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the normal tuesday and next week it's going to be on wednesday as well but if
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you're if you are listening to the podcast and you like the idea of joining
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us live then just have a look on our social media uk underscore sta or me at
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runchat live and you will see when we do change sometimes from a tuesday to
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a wednesday so very shortly in this episode entitled Therapy for Swimmers.
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My guests are going to be Carla Bickerstaff and Jenny Lane, who will be discussing
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the ins and outs of working with swimmers, including triathletes.
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But firstly, a huge thank you to my guest last week, who was Jane Wigg.
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Let's bring this up for people who have joined us live.
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Jane Wigg, who is the director of Lymphedema Training Academy,
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gave us a fascinating episode on lymphedema management for manual therapists.
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It's available Available as always on all popular podcast apps and YouTube.
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And it really was a great insight into where we are at the moment now with regards
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to manual drainage and lymphedema.
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And it really was an eye opener to how, once again, we need to update our thinking a little bit.
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Jane Wigg is at the centre of a lot of research into lymphedema.
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So it really is a great episode and I recommend you listen to it.
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Also, I just want to mention this is for STA members only.
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There is a coffee chat special coming up with a great friend of the podcast,
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the amazing Rachel Francis Thompson.
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It's going to be all about biomechanics. And if there's one person I wanted
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to listen to talking about biomechanics, it would be Rachel Francis Thompson.
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So that is for members only, I'm afraid. But if you are listening to the podcast
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and you're thinking, oh, maybe that sounds like a reason to join the STA,
2:10
then that would be one of them.
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It's one of the many reasons. It's number 11B for joining the STA podcast.
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But that'll be on Wednesday, the 17th of July next week at 7.30pm.
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It will be in direct competition with my podcast next week, but that's fine.
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Just choose what suits you better and then there'll be no judgment. That'll be fine.
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Details, as always, are going to be in the Members Only Facebook page for the
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Sports Therapy Association.
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Association and so do check it out there next week 7
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30 coffee chat special right that's
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it tonight we are going to have therapy for
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swimmers it is part of our first tuesday or
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wednesday of the month ask us anything but
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i spent a long time trying to get a big panel put together and my two next brave
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wonderful guests stepped forwards and said we will represent therapists working
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with swimmers so it gives me great pleasure now to bring up for you for tonight's
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episode therapy of swimmers guests Carla Bickerstaff and Jenny Lane.
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Music.
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Congratulations thank you from the bottom of my heart for actually stepping
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up and doing this i know it's nervous jenny you've already admitted you have
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a little bit nervous matt but thank you very much you'll soon within the next
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probably in my introduction only you've realized that this is a very relaxed
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output it really is not going to be anything too technical,
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but what we are going to get from you is your experience of working with swimmers
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which i'm very excited about i've already kind of held my hand up to the fact
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i haven't worked with many swimmers at all it's all runners runners runners
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for me with the odd triathlete thrown in so thank Thank you very much.
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Really looking forward to it.
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Let's start then for people who don't know, maybe start with you,
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Carla. Let us know where you are in the country.
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That'd be interesting. And also how you got into working for swimmers.
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So I am a sports therapist by trade and I'm based in Sheffield,
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but I do a lot of event work as well and clinical work.
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I have worked in swimming swimming in various capacities for the last 15 years.
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I started out as a competitive swimmer at the age of 12 and moved from swimming
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myself into master's swimming and competing as a master swimmer and coaching alongside that.
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So I've done a coaching role in swimming and I still am involved in coaching
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able-bodied and para swimmers.
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And then I now do a lot of sports therapy work
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with swimmers and I've done that more so for the last the sort of last sort
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of 10 years of my coaching career if you like I've done it alongside that so
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yeah it's very interesting and I think I just really enjoy it I've always done
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swimming it was seemed like the next logical step for me really just to sort of,
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add this extra skill that i've done at university why not throw that into the
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mix as well and see where we go kind of thing so yeah that's great i mean people
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may know if you're a keen listener to the podcast you were part of the panel
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for episode where was it back in.
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Come on up it was now i did have it written down in somewhere but you
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joined us for when we were talking about how to set up a
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sports or how to work how to set up a clinic with regards
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to the mobile and event work so is is the mobile
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event work something you've done a lot with swimming then so more
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so events than well i don't
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know if you call it mobile i've been poolside during training sessions so
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yes i suppose you could class that as a mobile work and
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but more so predominantly events been
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based at those and work that way so a bit a bit a mixture of everything and
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I've seen people in clinic I've seen them on pool deck I've seen them at competitions
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so a whole variety to go up sometimes that's lovely I mean I'm the same I do love variety,
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it was episode 188 I found it now how do you how to set up a sports massage
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therapy business part three mobile and event work so if you're interested in
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that then do listen back to episode 188,
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thank you Jenny let us know where you are and yeah how you got involved with working with swimmers,
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I'm in Loughborough and I don't have as much lovely experience as Carla does
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from a point of view of actually being a swimmer. I do swim.
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But I tend to find mine's a bit more recreational, really. I tend to use it
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more for relaxation and socially more than anything else.
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A group of my friends started doing some long distance swimming and open water
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swimming and a bit of cold exposure therapy.
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And so I've kind of gotten it from that point of view, really.
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So periodically I decide to challenge myself and do some longer distance open water stuff.
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Stuff but but essentially my my clients come from
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triathletes and ultra marathon sorry i
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forgot what they're called now that's just iron man iron man thank you that's
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the one iron man and half iron man type of events so they they're the people
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who come to see me a bit more and you've crossed over at similar events as well
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haven't you with carla yeah so we we did the world para swimming
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competition i think carly you said it was 2019 wasn't it yeah it was yes sort of.
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November time 2019 i think it was it was in london we were based in london it
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was the world champs yeah and then we did the commonwealths together and in
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sandwell which was really good we've always swimmers so it was great really
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good she both got quite a lot of experience then both with competitive swimmers
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and recreational swimmers particularly in your case jenny yeah and and And there
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are different types of swimmers as well.
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So we're going to hear about open water and long distance and going to be an
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eye-opener because just the word swimmer, once again, you can't just classify them all the same.
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And I imagine when we start talking about it, you can't classify all the injuries in the same back.
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It depends on whether they are distant swimmers or whether they are open water
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or whether they're competitive.
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So really looking forward to it. Great. I'm just saying quick hi to people who
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are listening and joining us live.
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Hi, Cecily Hislop. Good to see you. Thanks for joining us live.
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And Sir Glenn Murphy, MBE.
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Great to see you, Glenn. thank you very much for joining us if you are listening
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live whether it's via youtube or via facebook then do feel free to ask our guests
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questions anything and everything to do with working with swimmers so.
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Let's get into actual injuries then. I've already kind of suggested,
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a bit of a spoiler it was actually, that depending on what type of swimmer you
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are, you're going to have different injuries.
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But what are we talking about in terms of, or maybe we have to start off by
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saying, yeah, what type of swimmer and then what are the most common injuries?
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Who wants to start the ball rolling?
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Well, I wouldn't say there's a particular type of swimmer, but I would say the
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most common things that I have seen are shoulders, like shoulder issues and
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lower back and hip issues.
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Which seem to be really common no matter who you are or what swimming you do
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just from the repetitive nature of the strokes and the amount of pressure you
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are putting through those joints,
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whilst swimming after if and
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obviously if you're swimming at a high competitive level there is a
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lot more sort of at stake to to
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perform but then also if there's if
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you're talking more stroke specific potentially like knees for breaststrokers
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but even even little things like ankles from the hundreds of thousands of turns
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that people do in a swimming pool diving off the and doing multiple starts in
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training and things like that they can.
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Surprisingly you can roll your ankle just pushing off
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a wall so you don't have to fall off anything thing so yeah it's kind of it's
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not always just the common stuff that you think you're gonna get sometimes you
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get the odd thing that will come in and they'll be like oh how did you do this
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and they'll be like yeah I just pushed off a wall swimming and you're like oh okay then interesting.
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So I would say if you are going to work with swimming be prepared for anything and everything,
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that's very interesting i would have guessed the shoulder i would never have
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imagined of course yeah the push off of the wall great and jenny your experience
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same sort of category is it shoulders most of all and then lower backs and then
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a variety of other things yeah yeah absolutely.
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I think probably more with the open water stuff with necks are.
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Quite a big issue as well just simply because you your position when
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you're in a wetsuit is slightly different and you
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you're you then have to sight as well to see where you're
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going because otherwise you just end up going going miles off track and things
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so it's you've got no lanes and and ropes
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particularly to guide you as to where you are and particularly
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if it's a bit choppy and you're feeling a bit sick which is
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quite common you you get disorientated well
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i did anyway this is already on
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mind blown because there's such a variety out there depending on
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where you are i mean again all i
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can come from compared to is running which i'm already running out but running we've
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got different types of terrain where there's kind of parallels and distances
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obviously but i'm wondering comparing it
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to running so that's all i can do i mean the research has
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kind of shown that an 80 percent of running injuries are key factors in
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appropriate training when appropriate loadings are basically doing too much
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too soon or too often and for runners this
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one of the big reasons for that and running's got a massive kind
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of injury prevalence is because a lot
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of the time runners can just put their shoes on 365 or six
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days a year and go for it and they can stay out as long as they want
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them going to rely on teams or anything in in your
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experience for swimmers is that a big factor as well are you having to tell
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swimmers look you're just doing too much or you're doing it too often or you
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need recovery days or you're going too fast is it similar or is there a whole
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different array of possibilities essentially yeah exactly the same type of thing it's it's.
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One of the biggest thing really that we tend to see in that car i don't know
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whether you agree but is is overuse injuries and fatigue you know in a similar
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way to running where you're you're it's a repetitive nature it's exactly the
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same and it's forced production behind it it's exactly the same so you know
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if you're doing speed sessions you're going to have a same kind of,
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sort of classic mode for for injury really so it's exactly the same so speed you know distance.
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Everything i would personally say would carla would you say the same yeah i think Think.
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I think it's a bit different. It depends whether you're doing it recreationally or competitively.
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If you are swimming competitively, you're very limited on your pool time because
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there's always a constant battle with councils and things like that for hiring
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their facilities because they have to provide swimming lessons and everything like that.
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So if you are part of a competitive club, when you get in the pool.
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Some coaches are like, right, we've got to cram
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in as much as we can because we've only got this two hour slot so we
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have to go like hell for leather for two hours whereas other
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coaches are very conservative and they will they will plan
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really well and across the board most people are
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really good sometimes you will
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get the odd younger kid who is quite
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talented and for whatever reason
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be it a coach is excited to get
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them progressing or parents are quite pushy and
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want to see them improve quickly they can get
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caught into the mill of doing too
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many sessions before they're ready for it and before they develop before they've
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developed correctly so there's a big element of understanding like the child
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development and everything like that and being able to advise parents and coaches
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and so yes it can happen more I don't know if.
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It's more in a pool or more like if you want to
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go swim in a lake you can there are certain places you can
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just turn up and do it and obviously if you were to do that every day that
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could have the same effect i suppose absolutely within
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swimmers i mean runners there some people like to do
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both and then some people like really just love the trails they need to be in
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the open air with cows and all that sort of stuff and other runners don't like
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that they prefer you know just running straight along the promenade or staying
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on the road in swimmers is they're kind of different excuse the pun but different
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lanes and kind of which attract swimmers where they either i'm a pool swimmer
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or i'm an open water swimmer or is your crossover.
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I think it's probably related a bit to whether they're triathletes or not as well.
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So potentially, not all triathletes want to just go out into the open water,
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but it tends to be just a big part of what if they're going on to bigger events
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that they progress on to.
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But I think there's, like we were saying before,
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I think there's a cold water element that brings a whole other dynamic into it as well,
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well which isn't any kind of distance and there's a
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very small likelihood of injury other than
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cramp which is difficult particularly as
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well if you're in open water you kind of you know
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you've got nowhere to hang on to if you've got that so it can be a bit of a
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problem but but yeah I think you do tend to get people who prefer to not be
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swimming in a pool where there's chlorine and they there There is an element
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of some people who really like the freedom of being out in nature,
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in an open water, rather than turning continuously.
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But again, as you say, I think it can cross over.
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But yeah. Are there advantages of either? Do you find yourself once saying,
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I'd really like to do a little bit more pool swimming?
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Or I want you to go and do some open water. Does that not really happen?
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Does that not make sense? in a rehab routine for example would there be a time
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saying i need to use the pool a bit,
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in the winter it makes sense i also
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think technique as well if you're trying to improve your technique to a
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certain extent it's the right from from the mortar point
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of view it's it's it's much better to do it in a
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pool rather than and then transfer it into a lake because
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of the other elements that you've got to think about because of the wind because
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of the weather because of the cold you know there's times when it is so cold
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that unless you've been training to to get into to the water at a certain temperature
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it's just not a sensible thing to do and you won't get any you can't be in there
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for any length of time so pool work is then essential.
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Yeah and I think coming back from an injury as well if you've had a
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previous injury if you are an open water swimmer or if you are
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even a long distance the the
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guys who tend to do longer distances in
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the pool so like your 800 to 1500 swimmers they might
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venture out into open water to sort of do a
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5k or a 10k but they are doing loads
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and loads of pool sessions as well or I mean
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if you look at elite elite guys they they might
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even live in the warmer countries where they can
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access open water that is not going to be freezing year-round things
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like that so yeah I think it's I think
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it's a bit of a mixed bag in especially in competitive swimming
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it's more a stroke thing than a distance thing
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you are either like a freestyler or a backstroker like
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that's that tends to be a split in your sort of
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lanes and things rather than but you
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do get the sprinters and your distance as well there so there's a
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whole host of factors contributing to
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loads of things and i suppose that's the same with the triathletes as well you
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get different distances with your triathlete or your competition so you can
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go from quite a relatively short swim which you can do in a pool much longer
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swims which which obviously generally are in open water.
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Great. You mentioned strokes, which is great because I was thinking about that.
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So again, like in running, we talk about how there's no one optimum running style.
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When you get to the more elite, then there's more similarities,
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but there's still variety.
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And you only have to watch certain races. You can see differences in whether,
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you know, they've got longer stride lengths or faster cadences,
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whether they're upright or lean forwards a bit.
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There's all sorts of different differences. A lot of them haven't got symmetry.
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There's some famous examples, you know, where they look like if they walked
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into a clinic, they'd be, oh, I know what's causing your neck pain.
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It's like, you know, I've just won a medal with this neck movement and it's
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kind of helping me. So I'm interested with swimming, with the different strokes.
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Is it regarded as there is an optimum style? Do coaches go for an optimum style?
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Or is there a variety you see amongst recreationalists and elites,
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which could, for example, make you think, oh, that's why you're getting injured,
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when really it's just anatomical variance and kind of like differences you should expect?
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Bit so if i come at it from a coaching point of view you are taught like the
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fundamentals of how you move through the water to do a stroke that is the same
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for everybody regardless of who you are.
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As you grow and you develop and your strength and your power develops that's
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where it becomes a little bit more individualized but fundamentally backstroke
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is backstroke you have to lie on your
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back and you have to do a circle with your arms you you can't
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get away from that so everybody is doing that but
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they are looking for a tenth of a second to make them that much faster than
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somebody else and that might be the way that their hand enters the water and
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if they rotate their wrists slightly too much it then obviously transfers down
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the arm into the shoulder which which then it can create an issue within the shoulder.
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So you are looking for the minutest of details when you're looking at unpicking
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somebody's stroke if they're coming in with a shoulder issue.
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So it's not always that easy to do in clinic because you can say to somebody,
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well, show me how you swim.
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That's really difficult to do on land. You really need to see them in the water
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and be able to watch them and maybe even talk to their coach with them to say,
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they've come to me with this issue.
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If you don't know anything about swimming, you can talk to their coach and go,
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does their stroke look okay?
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Is there anything within that stroke that we could maybe look at tweaking to
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see if it makes a difference to what they're feeling in their shoulder with that issue?
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Or do you need to unpick it and go right back to basics and
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really start again with them to prevent that issue either becoming
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a long-standing one or getting any worse it's it's
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i don't think i really am no you have
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yeah that makes perfect sense yeah i like the fact
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yeah you've got to line you back and put your arms behind you yeah there's not as much variation
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really in terms of whether your body's going to stink down
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a little bit one end or where you're going to be in the water it's it's
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it's kind of seems to be a little bit more restricted than maybe
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running or something when you're on land and obviously there
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are certain in competitive swimming anyway there are certain rules
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for each stroke that you have to follow in terms
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of how you have to swim them and like when you perform a turn it
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has to be performed in a certain way so that's very
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restrictive in the mechanics that you can play around
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with because there's only one way
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to do it and it's who can do it the fastest yeah yeah yeah
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yeah i think there is there is a guy who's sort
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of doing more open water swimming and much more longer distance
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swimming called Adam Walker I think it is and he's he's he got injured I think
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he was playing rugby he had knee issues and shoulder issues and there are people
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out there who develop a different types of strokes but I don't think you'd see
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that in competitive swims swimming so much I think that would be more.
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Either in recreation or the open water swimming, because I think there is a
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bit of leeway with open water swimming, just because there's lots of different
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factors that can affect you.
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And particularly if you're going that, I mean, I think he swam seven of the
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most difficult oceans and waters and all sorts of things. So he's very much
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more very long distance.
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And I think at that point he's developed this particular technique,
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which is meant to be really helpful if you have had injuries,
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know much more about it than that that's very interesting i
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like it yeah if it's endurance is your goal then you might find different
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ways of doing it to minimize kind of yeah
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energy expenditure and that sort of stuff so
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let's go to shoulders then for a second is there and i'm showing my events again
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here now is there a very common mistake which let's let's stick with crawl for
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example is there a mistake which a lot of swimmers maybe recreational swimmers
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make which which leads to particular injuries. I mean, yeah.
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Can you think of one where you would like me to see how they swim?
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Because, oh, you're doing this and that's why you're getting an overload on
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this particular muscle. Or is it not as clear as that?
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So normally it is to do with body position and hand entry and how people are breathing.
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So generally speaking, you're taught to swim front crawl facing the water.
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And breathe to the side if you're somebody that doesn't like putting your face
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in the water you will try and stick your head up the whole time okay and swim
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in front crawl which then alters the mechanics of everything and makes everything really difficult,
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so that can then obviously cause neck issues and and things like that so.
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That's that's a little bit easier to sort of
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get around in clinic because someone will say to you i hate putting my
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face in the water gotcha and already then you can be like right well this is
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these are the reasons why and work on it if it's something that's like like
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i was saying before they're just the angle that they're putting their hand in
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the water you're not going to know that without seeing them in the water and
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watching them because sort of following on from that and
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sort of going into the breathing side of it all as well.
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You have some people who'll bilaterally breathe and some people who won't be
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able to do that, either because they can't, when they're breathing out,
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they might take three strokes and then breathe out, or some people will take four strokes.
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And it depends on how you breathe, basically, as to whether you're going to
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unilaterally breathe or bilaterally breathe.
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And that's usually into the neck and shoulders, really. That makes quite a big difference, I think.
24:14
Very interesting i like it so i want
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to go back to the point you made about it's tricky
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isn't it because like with runners you might have a treadmill you can put them on the treadmill and
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there might be a few differences but most of the research suggests that on
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the treadmill they're going to run pretty accurately to how
24:29
they're outside it might be slightly faster cadence might be
24:32
more vertical oscillation but generally it's enough for you to make a
24:35
clinical judgment but with swimmers then
24:37
how do you get around that i mean if you can
24:40
go and see them in the pool that's great but that
24:43
might not be realistic for everyone so does video work
24:46
at all or what are some of the other options you've got yeah you
24:50
could get them to video a session of them i mean you can ask them to show you
24:55
in clinic but and you can apply forces that they that would simulate what they
25:02
do in the water and like you would do with like special testing and things like
25:05
that to see if that brings on the pain that they are feeling or the discomfort they're feeling.
25:10
But again having worked with swimmers when you ask them to do something on land,
25:16
nine times out of ten it is not what they did in the water because it's
25:20
a very different feeling the feel of the water is
25:22
very different to being on land how would
25:26
you do that would you try and lay them out kind of horizontally and so
25:29
you can do that you could
25:32
use your couch and do that you can also do like you
25:35
can do it in standing and sort of
25:38
forget about the legs aspect unless
25:41
it's a leg issue and then i don't know
25:44
you'd have to experiment like i think i believe on
25:47
that front but shoulder wise upper body wise
25:50
you can do it either on the couch or in standing and get them sort of like half
25:54
lean over like leaning forwards if it's a front crawl and you can get them to
25:58
show you how they put their hand in the water and then you can give them a force
26:02
against it so that it's like them pressing against the water,
26:05
that kind of thing. Interesting. Yeah, okay.
26:07
Sometimes it works, sometimes it doesn't because they, like I say,
26:12
they might not want to go into that position on land because they don't ever feel that...
26:17
That's what they're doing it's kind
26:20
of the awareness that people have in the water is
26:23
very different to you like on land and
26:26
and sometimes when you watch people in the water you might say to them oh you're
26:31
overreaching on backstroke and they're like oh no my hand's going in in line
26:36
with my shoulder you're like so they think they're going in here but actually
26:40
they're like over here yeah so
26:42
and you ask them to show you on land what they're doing and they go i do
26:45
this yeah yeah they're not really doing it
26:48
very interesting yeah i don't know
26:51
it's experiment see what works for you and yes it's like with running with someone
26:56
yeah the other runners who say oh yeah i'm definitely a forefoot strike or something
27:00
or i land on my heel and then you actually put them on the treadmill and show
27:03
them and they need that visualization before you can move on to whatever the
27:07
gateway training or whatever it is because yeah we don't really,
27:11
we've got a picture in our mind of what our body's doing but we don't know it
27:14
for real so So swimming analysis, actually having a video and slow motion stuff
27:18
might be quite important for giving that visual feedback.
27:21
Jenny, what do you do? Do you always kind of drag them down to your local pool
27:24
or down to the channel, shall I say?
27:28
How do you get to see them swimming? Have you got a pond in your clinic? Well, no.
27:36
Yeah, video, really. and and yeah i think
27:39
that's probably the easiest or going down and seeing them depending on
27:42
how how sort of viable that is really i i think it's communicating with coach
27:48
as well to to get the feedback from from them because really you know as carla
27:52
said you you you can't replicate it because they're the buoyancy that you get
27:57
from being in the water just changes the biomechanics in your
28:01
body just from that that situation definitely and certainly from from my point
28:07
of view that the type of people that i see are in wetsuits which has another
28:11
complication totally because it it,
28:15
restricts your movement law that you do have swimming wetsuits and they are
28:19
meant to fit nice and snugly but but you you have restriction in them you know
28:24
that that you can't really get away from that because you're meant to because
28:28
you're meant they're meant to give you a bit of buoyancy and to also keep you a little bit warmer.
28:32
So that just adds another kind of element. So sometimes it's worth seeing them
28:37
fitting in their wetsuits just to check that they have got what kind of range
28:41
of movement they've got in their wetsuit.
28:44
So there's a sort of different things that you can kind of approach.
28:47
But I would say, well, I think because I think that's that's the best type of idea.
28:52
But essentially, you just have to use your skills of talking to somebody and
28:58
your investigation skills and asking them,
29:01
you know, really detailed questions about how they feel at the end of a training
29:06
session and maybe getting them to record that.
29:08
So you can kind of see, you know, whether they feel more fatigued after having
29:12
done something particular and try to piece it together as to what might be occurring.
29:18
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Not to throw something else in there, but if you're working with a swimmer,
30:30
that totally changes it again.
30:32
Because depending on their disability, if they're a blind swimmer,
30:38
they can't see what they do in the water. They can only feel it.
30:42
And then you have to add a complication of how do they communicate that to you.
30:47
If you're working with a swimmer that has limb loss, their buoyancy is totally different.
30:51
And how they perform the skills is totally different.
30:54
It's how do you then work with them to get them to understand what you want them to do?
31:00
We take for granted the fact that we go, right, I'm going to show you an exercise,
31:04
I need you to do it. They can't see it.
31:06
How do you get them to do that exercise? You have to physically put them through
31:12
it and get them to feel what it feels like and then communicate with you on that front.
31:16
So I think sometimes working in in paris
31:20
women especially you have to up
31:23
your communication a little bit to
31:25
like the next level because it's the only way you can get you can sort of deal
31:31
with that and i think we found at the world as well not everyone speaks english
31:36
yeah so you've then got that added complication in there as well that you have
31:40
you need a translator with you when you're talking to the athlete.
31:44
So there's a whole host of very sort of like intertwined complications that
31:50
can make what you think is pretty simple going, oh, I just need them to change their hand entry,
31:55
then becomes this massive thing because they can't see you. They don't understand you.
32:01
They don't know what you're trying to tell them to do.
32:03
So what we think is, oh, yeah, I'll just get them to go from here to here,
32:07
then becomes crazy difficult.
32:11
Cool wow fascinating but
32:14
i imagine and this is an interesting this is a topic that alistair beverly
32:18
the learning disability physio talks about how we can learn we
32:22
can become better communication with able-bodied or able-minded or
32:25
people with kind of like who haven't got learning disabilities or
32:29
if we work with them with with
32:32
people with with who aren't able-bodied because you learn
32:35
other skills you learn how to communicate better when you're working with somebody
32:39
who maybe can't give feedback to you whether it's because they can't talk or
32:43
you can't understand them so I imagine there's been has there been a carryover
32:47
of skill from your experience of working with Paralympic power athletes and
32:51
that you know which has carried over to working with able-bodied swimmers?
32:54
100% I would say 100% I think
32:58
because with with power athletes
33:01
you you treat the individual as an
33:03
individual if that makes sense so you absolutely work on you try
33:06
and ignore or everything else that you've kind of learned and sort
33:10
of really try and hone in on on their specific problems and
33:13
not have any preconceived ideas of what they can
33:16
or can't do you kind of just have to accept what they are
33:19
able to do and then tailor your your treatment plan to that which sometimes
33:25
means really thinking outside the box and really coming up with different ideas
33:31
as to how you're going to treat them because you have to you know because you
33:34
can't treat them you can't always treat people in the same kind of way so.
33:39
So, yeah, I think so. I think it really helps you, A, with communication,
33:43
but B, thinking outside of the box a lot more.
33:46
I'd 100% agree with that. I think the more – I think it also makes you a better
33:53
therapist as well because you are more confident to ask questions.
33:58
A lot of people are scared to ask questions of para-athletes.
34:02
And I think you just have to be brave and ask those questions.
34:07
And actually there's a i don't want
34:10
to say there's a right and a wrong way to do it i think being
34:13
understanding but being direct don't don't
34:16
kind of skirt around the issue like ask them and they will tell you they're
34:21
really happy to do that but yeah definitely i think like jenny said treating
34:26
them as an individual that we all know it's not a one-size-fits-all for in any
34:31
sort of treatment but But more so,
34:33
I would say, with your swimmers and things like that,
34:36
it has to be very individualised.
34:38
Whatever plan you do, whatever treatment you do, you just sort of go from there.
34:43
And then that transfers massively into your everyday work as well.
34:48
Definitely. That's really interesting. Yeah. So it helps you appreciate that
34:52
everybody you see is going to have their individual differences.
34:56
And you have to think outside the box and make sure
34:59
that you're not assuming anything and getting a great subjective
35:02
in there brilliant love it i'm interested in difference
35:07
between male and female swimmers is there a difference in susceptibility or
35:11
prevalence of injuries do you know yeah i i mean ultimately i i watched the
35:17
joe gibbons shoulder podcast you did before and and And just really going back
35:23
to the whole menopausal woman,
35:24
there is, you know, a lot of menopausal women love cold water swimming and tend
35:32
to go for more, in my humble experience,
35:36
tend to go for some more open water swimming just because of the benefits that
35:40
they get to their menopausal symptoms.
35:43
And they generally have, as we all know, a bit of a prevalence towards shoulder,
35:49
potential shoulder injuries anyway.
35:52
So so yeah and also i think you know shoulder instability is is quite common
35:59
with us all sitting at desks and doing this type of thing and driving long distances
36:04
so so you've already you can already be at a,
36:08
a position where you could potentially get overuse injuries just purely from
36:13
posture and what you're doing in your everyday life that just comes to the surface
36:18
a little bit more readily i think in a swimming environment if you're doing
36:21
lots of repetitions a bit interesting yeah so yeah,
36:26
bearing in mind if if they are in menopause then yeah potentially there's going
36:30
to be slower recovery for tendinopathies and things more suitability tendinopathies
36:34
very interesting Interesting.
36:36
And Carla, for you, is there any difference have you seen in your experience or research?
36:41
To be honest, I wouldn't, I don't really know.
36:45
I don't think I've seen more boys and girls.
36:49
I think it's been sort of like similar across the board.
36:54
I think the difference will probably come as people get older.
37:01
Older like sometimes they will because that as they as they become more specialist
37:05
in a certain stroke or a certain distance that's when you might tend to find things coming from that.
37:15
But I would say mine's been pretty equal or I've just been really lucky it's
37:20
been equal I don't really know
37:22
but yeah it's I don't know I don't know if I've seen more injuries of a
37:29
certain type from one person than another I couldn't really
37:33
tell you to be honest what about something like
37:35
hypermobility is that a problem for swimmers
37:38
does that open the door to different injuries
37:41
for those since the podcast I've nodded
37:44
emphatically at me like I was asking a crazy question like you
37:48
think maybe I should rephrase my question in what ways can hypermobility cause
37:53
those problems when you're working with a swimmer um well like i said earlier
37:58
the feel in the water is a big one because when if you're trying to get someone to sort of go straight,
38:05
because of the way that they are sort of like built shoulder wise they can overreach
38:10
which then has a detrimental effect through the rest of it and also a lot of
38:15
people think that you move in swimming by just kicking down in the water so
38:20
let's say use front crawl as an example like Like, you actually kick up as well.
38:25
So you have to go down and up. If you've got hypermobile knees,
38:28
that can create, like, quite a big issue there. Like...
38:34
If you're doing loads and loads of just kicking to develop your speed,
38:38
develop your strength, things like that, because you're putting force on the
38:41
water on the downbeat and you're putting force on the water on the upbeat.
38:45
Yes. In the short term, answer to your question. Yes. Great examples. Yeah.
38:51
I'm thinking of what I say to students now often when I'm saying there's no
38:54
such thing as a stupid question. I'm just reminding myself of that.
38:57
I'm hoping I'm asking the questions which listeners are thinking. thinking
39:00
i'm talking of questions there's an interesting question here from israel
39:03
who's a fantastic barber based in
39:06
hove i best recommend him entirely but israel asks is
39:09
it beneficial to swim for shoulder recovery this is interesting angle actually
39:12
which i didn't think we were going to mention but do you
39:15
find that yes swimming can be beneficial when
39:18
you're trying to help somebody recover from a shoulder injury i would
39:22
say that's very dependent on what the
39:25
injury was in the first place and what their
39:29
swimming capability is if they
39:32
are let's say they're somebody who always swims
39:36
breaststroke and the issue
39:39
that they've had as an injury has been from i don't know
39:42
like an overhead movement then they should be
39:45
okay to swim don't take that as gospel like
39:48
but because it's
39:52
non-weight bearing if you're doing it recreationally then potentially
39:56
yes if it's a competitive swimmer then
39:59
that's a whole different like return to play kind of protocol and things like
40:03
that and lots of adaptations in training and things like that so it very it
40:09
depends on the injury basically it has to be individualized it has to be tailored
40:14
into what they're doing that sort of thing i would imagine open water is different again.
40:20
Yeah yeah absolutely just
40:24
because of the the length and and distance you know you've got to think of of
40:30
safety before you get into the water and if you're going to get into trouble
40:32
when you're far away from the side you do have an injury it can be tricky but
40:38
but equally sort of going a little bit back to the hypermobility stuff.
40:43
Sometimes I've got a particular friend actually who who's in,
40:48
she does a lot of open water swimming and she finds that swimming in a in
40:50
a wetsuit is helpful for her because
40:54
because it limits her range of movement and so
40:57
she finds that it stops her from from
41:01
going going too far basically very
41:04
interesting and that goes for the knees as well as the shoulder you've got
41:07
that restriction and interesting yeah and is
41:11
it a case where i mean that kind of moves me into the
41:14
next one to talk about kind of injury prevention or
41:18
reduction of risk of injury i mean the the
41:21
i know in running it's very tricky to talk about what helps reduce injury because
41:26
injuries is so multifactorial and it's and it's very difficult to reproduce
41:29
studies and that but strength training is that something that is recommended
41:34
for swimmers and has been linked with reduction of injury or just recommended
41:37
for performance or how does that work.
41:40
I'll let you go for that one so if
41:43
we go right to the very top british swimming
41:47
have produced protocols for swimmers
41:51
to follow which they they call like is people will
41:55
know it as like our map or ramp which is to raise
41:57
activate mobilize and prime muscle they have built a framework of exercises
42:02
and things around that which swimmers will spend a lot of time dry land doing
42:07
that before they even get in the pool for a warm-up so they might be on they
42:11
might be on deck half an hour 45 minutes before their warm-up start time and
42:15
they will be doing this warm-up protocol
42:17
that is then filtered down through clubs and things like that and you can easily
42:21
access it online sort of like you can google it and it will come up it will give you a whole host of
42:27
exercises and different levels of those exercises but
42:31
doing that before they go in
42:34
the the water then they'll generally do a pool session they'll get out and they'll
42:37
they'll stretch afterwards and then they do a lot of gym like a lot of conditioning
42:42
work like full body work and a lot of lifting heavy weights so I think the combination
42:49
of the of everything together.
42:52
Is helpful and is kind of built into
42:56
swimming so it's but
43:00
again it depends on your level if you are just going recreationally
43:03
then there are certain things that maybe you
43:06
can pull out of that like arm up routine that you
43:10
can use before you get in the water that they're not
43:13
going to stop you getting injured because as we know you can push off
43:16
the wall and roll your ankle like it's not it's
43:19
not guaranteed but it can be beneficial and like going in the gym there's yes
43:24
we might want to work a bit more sort of like shouldery or hip work but fundamentally
43:32
doing full body strength work is what you need.
43:39
Help make you a faster swimmer yeah really yeah
43:43
i guess it is all about power isn't it and
43:46
force and being able to push through the water and prepare yourself forwards because
43:49
it's not like with running there's no kind of like recoil or
43:52
using ground force or anything it's purely if you don't move
43:55
then you're not going to move yeah and you've got to
43:58
do in a skillful way it's fascinating so interesting hearing about it
44:01
just uh just to help israel here
44:04
um with the shoulder yes shoulder dislocation the gp advised
44:07
me not to swim but i carry on doing it my shoulder feels better
44:10
afterwards should i follow the gp advice very tricky
44:13
to say isn't it we can't go against what gp said but then again you know it's
44:17
i mean this is this is one of the things we've talked about other episodes i
44:21
mean gp probably have 15 minutes or so to talk to you and advise you and it's
44:26
something really you need to talk with your sports therapist or sports physio or somebody
44:32
who you're seeing, because it depends on you.
44:35
And it depends on what level. It might be a static kind of movement in the water
44:39
just to get some mobility and a little bit of force, a bit of loading might be great for you.
44:44
But it very much depends so much as well. Sorry, we can't help you with that.
44:47
I'm not going to give you a definitive answer.
44:49
Don't rely on advice just for a 50 minute consultation.
44:53
Need a bit more than that for them to give you an educated answer most cases sometimes
44:56
not depends on what your situation is but
45:00
i hope that helps israel people who
45:03
are listening to this carla and jenny and they're thinking wow you've
45:06
these guys have suddenly made working with swimmers sound really
45:09
interesting and varied and i love the
45:12
idea of it what is some of your tips for
45:16
getting to work with swimmers i mean you've taken it to like elite levels
45:19
working at commonwealth games and working for victor games
45:22
and in all sorts of wonderful places and i'm sure it's been
45:25
great but how what's the first thing that swimmers sorry a therapist should
45:29
start doing if they want to get some more therapists coming through their door
45:32
any tips i always find that if you if you have an interest in it give it swimming
45:40
yourself go down to the pool maybe turn up a couple of.
45:45
Swimming clubs have a chat to some of the coaches be a bit interested and curious
45:50
yourself do a little bit yourself and then see see if it is something that you really enjoy,
45:56
yourself i think make some friends speak
45:59
to as i say speak to the coaches and see if
46:02
your services see if they can help see if
46:05
you can help them in any kind of way provides what sort
46:08
of events are you talking about again for somebody who's totally ignorant i
46:11
know park run for runners great every saturday morning nine o'clock but what sort
46:14
of swimming events could therapists go along to with their sports
46:17
therapist jacket on or whatever t-shirt and start hanging out
46:19
with and talking with people i would i would
46:22
say you'd have to target your local leisure centers and you
46:25
would have to look at the timetables and see if there's
46:29
a swimming club or a tri club that use that pool as
46:32
their training base you should be able to google and find contact information
46:36
for the head coach or whoever's in charge of that session and i would make contact
46:40
with them and say to them this is this is just introduce yourself this is what
46:44
i want to do this is this is who i am like could could you use my services, like...
46:51
I think you have to be prepared to do a little bit for nothing to start off with.
46:55
I know some people hate that and some people go, I'm absolutely doing nothing.
46:59
I need paying for my time. I totally get that.
47:02
Our time is precious and we do warrant being paid for it. But actually,
47:07
the voluntary stuff gets you in the door.
47:10
The voluntary stuff then opens the other doors to bigger and better things for you.
47:15
And if you're good at what you do as well. If you are rubbish,
47:18
they will very quickly go, thanks for no thanks.
47:21
Like you have to build that reputation. You have to build that trust and go from there.
47:27
Ultimately, what's one or two hours versus however many hours that you could
47:31
be gaining from swimmers who
47:33
are then coming to you from outlaying like a couple of hours of your time.
47:37
I've also offered coaches free sessions so they can come and see what I do.
47:42
Yeah, I think it really comes from them.
47:46
You know, they're the people who can then say, actually, I know somebody who
47:50
could help you. And I know that and they can then understand what your role
47:53
would be alongside their role.
47:55
So they can then so you can work synergistically together, I think.
47:59
And it develops a good rapport with them, too. So that's a great idea.
48:03
Get that going, because then you could have that referral where you're getting
48:06
people who need a coach. You're thinking, I'm not competent to coach.
48:09
So I'm going to put in contact with this great coach. And then the coach can
48:12
send you people who are suffering from pain.
48:14
And yeah, that sounds like great. Get your network of referrals going.
48:17
Going and i think i think is if you again i'm delving more into the competitive world but.
48:24
Lot of swimmers spend more time
48:27
with their coaches than they do with their parents so a.
48:31
Lot of coaches know a lot more about those individuals than
48:34
their parents probably do so having having a
48:36
good relationship with a swimming coach I would
48:39
say is key because they will they will be
48:42
like oh they came into training at this time on a Monday and they
48:45
said this hurt or this whatever or they
48:47
will be like that's not somebody who normally complains about anything
48:50
so when they say that they are in in pain they are
48:53
in pain kind of thing so and you
48:57
don't always get that from a pay from a parent and I
49:00
think like Jenny says if if the coach believes in
49:03
what you're doing and is happy and confident in
49:05
your skills if they say to the swimmer I'd
49:08
like you to go and see Jenny the swimmer will be like oh yeah
49:11
cool because coach says it's good I'm off like that kind
49:14
of thing because they will they will just hang on their every word kind of
49:17
thing so it that's that I
49:20
think that's a key thing to to look at is making
49:23
those links with local clubs and possibly the same
49:26
for like open water like tri clubs they'll have people
49:29
there in the pool but then they might say oh well
49:31
we actually train at the lake at this time on a
49:34
friday night come down there meet everybody and you
49:37
do do tend to find that triathletes are
49:40
quite passionate and do spend a lot of their time training and so to them it's
49:45
very valuable to make sure that you know if they're starting to feel a bit fatigued
49:49
they might want to come and just see you on a regular basis and in some similar
49:53
way with running really you can slot it into their training plan so that they
49:56
come to you for a bit recovery.
49:58
Like post event pre-event at the end of blocks of of training training blocks
50:04
you know you can work it really nicely alongside the coaches so again it's it's
50:09
kind of good to work alongside them from that point of view.
50:13
Great advice. It does often boil down to not relying, not forgetting.
50:18
It's so difficult. We're going to do this next week. But social media and the
50:21
digital world kind of make us think that we don't have to go down to the local
50:25
club and just talk to people and make relationships.
50:28
But it doesn't replace it, does it? Especially if you're trying to get into
50:30
a new market, you need to meet these people maybe a few times just to get their confidence.
50:35
And then and then, yeah, establish contacts that way. So, yeah,
50:39
getting down to your local clubs. Great.
50:42
Amazing advice. I think Cecily has summed it up nicely here.
50:45
Cecily Hislop says, as I know nothing about swimming, good, it's not just me,
50:49
it's been great finding out about what swimmers do to aid their fitness and strength.
50:53
Fantastic. And I guess if you work with triathletes and you're very confident
50:56
about the running, thanks to what you guys have talked about today,
50:59
I mean, there's a little bit of education, obviously, but having that confidence
51:02
to work with swimmers as well and talking to them, a lot of it,
51:05
the subjective that you've mentioned, getting to know them and treat them individually,
51:08
there's lots of crossovers, isn't there if you're a great
51:11
therapist and and you do these sort of
51:13
things and you can work with somebody from a different sport even if it feels a
51:16
bit intimidating at first so great advice thank
51:19
you cecily right then 8 55
51:23
um if people are interested in
51:26
following you guys on social media going back
51:29
to social media now carla you're on instagram sports
51:33
massage by carla yeah they can follow you there and also
51:36
facebook if you look up carla vickerstaff sports massage it'll
51:39
take you to the facebook page quite active on those worth people
51:42
following you what sort of thing yeah it is
51:45
i would say that they're linked together so i only
51:48
post to one i make my life but i would
51:51
say yes i i always went into social media with the i am not posting every single
51:57
week because then people come to expect it and i'm not that kind of person that
52:00
can keep up with that so it is a bit ad hoc i would say a lot of my stuff on
52:05
there is event based about where i am what I'm doing, that kind of stuff, who I'm with at events.
52:11
Yeah definitely people are interested in that then yeah give it
52:14
a go if you have some good ideas that's the
52:17
way to look at it fantastic and jenny you
52:19
are on facebook in particular jenny lane sports massage therapy um
52:23
and you work at loughborough physiotherapy and
52:26
sports injuries clinic as well don't you yes i do yes and
52:29
so i've got this i've got a presence on on there as well
52:32
we'll put those links we'll put those links
52:35
into the show notes so people can read about you there and what you do
52:38
it must be really so you work in a multi-disciplinary clinic then
52:41
yes yeah and it's it's fabulous
52:44
I used to own my my own clinic 15 years
52:47
and just with my husband's job I've
52:50
had to move around the country a bit more so I've worked lots of
52:52
different places and I've worked as a sole trader and I've worked
52:56
at Bishop Abbey as well for a while before I came to Loughborough so it's
52:59
been nice to get to work in a multidisciplinary team
53:02
and I'm really lucky the places that I've been into that
53:06
they believe in what we do as well kind of you know that's great
53:09
to see that looks like a really good outfit there with different disciplines
53:12
contributing that's great fantastic well thank you Carla and Jenny it's been
53:16
really interesting I'm hoping that listeners out there particularly those who
53:20
are interested in working with swimmers but don't it's been a great eye-opener
53:24
with great ideas and suggestions.
53:27
Next Wednesday that was a very quick hour Carla and Jenny really that flew by
53:32
because I was just Just clinging on to every word.
53:34
Thank you for that. Just amazed that I'm already at next Wednesday.
53:37
Yeah, we are coming back next Wednesday. Not next Tuesday, it'll be next Wednesday again.
53:41
We are going to, actually, it's a nice little segue talking about digital and social media.
53:46
We're going to be talking, it's going to be part one of a two-part focus on
53:50
AI, artificial intelligence in healthcare.
53:53
And it was stimulated by a piece I saw by the amazing Joe Turner of mehab.co.uk,
53:58
who I've been dying to have on the podcast for ages. and and,
54:03
never just reached out and contacted, but it's a really nice article that Joe wrote.
54:08
I think it was called, it was in MSK Mag. It was Dear Chat GPT,
54:12
are you going to have my job one day or something like that. It was great.
54:15
And it's talking about to what extent will AI ever replace human health practitioners.
54:19
So that's going to be next week, which I recommend that you come and join us live.
54:23
Like I say, Joe Turner is a fantastic physio and
54:27
so much more than that with regards to understanding pain
54:30
and and just client relationships and communication
54:33
it's gonna be a great episode and then part two
54:36
back to tuesdays on the 16th of july my guest is going to be marcus slade who's
54:41
co-founder of physio genie technology who's going to be discussing actually
54:45
what we can use ai systems for if we're going to move into modern therapy practice
54:49
and how ai can help us without taking over and us just not turning up i think
54:54
they've opened now Now, there's an article in The Guardian,
54:56
I've still got to find it, how there is now an AI physiotherapy being offered
55:00
where it's just purely run by AI,
55:02
which scared Jo to death and annoyed her.
55:07
Made her write this wonderful piece in MSK Mag, which is great.
55:11
Because the day that comes where we think we can help our clients without having
55:15
to be there and just using AI, that's a very scary time.
55:18
And it just doesn't replicate what we do at all. so anyway right
55:21
so that'll be next wednesday if you'd like to join us either on
55:24
sports therapy youtube channel or sports therapy association
55:27
facebook but anyway for tonight once again thank you
55:30
carla and jenny for giving up your time i really
55:33
appreciate it thank you everyone who joined us live and
55:37
for people who joined us or listened to
55:39
this podcast if you are listening to the podcast and do please leave a rating and
55:42
review if you've enjoyed it just helps the great word of our guests get out
55:45
there more glenn murphy also has
55:49
summed it up nicely sir glenn murphy sorry glenn says totally
55:52
agrees cecily i can't believe i've never chosen a swimmer great to hear this info wonderful
55:55
if we've instilled some confidence not me if carla and jenny have instilled
55:59
some confidence into you glenn to work more swimmers that's fantastic it sounds
56:03
like it'd be a great crack be really be really rewarding right that's it people
56:06
thank you very much and carla and jenny don't go anywhere don't press any buttons
56:10
i just want to say thank you to uh afterwards but for For everyone else,
56:13
I hope you enjoyed the episode and hopefully see some of you next Wednesday,
56:17
eight o'clock on the Sports Therapy Association podcast. Take care.
56:22
Music.