COVID Policy

COVID-19 Policy

Your health and safety are my priority and I want to make sure you all feel safe and can plan your treatments at home or in the clnic, with the upmost confidence. I am committed to the highest levels of patient care and also transparency in how I operate and I will continue to keep you informed.

It is important to me that we will find our way together to do what we feel is correct with the information we have at the time and in line with the guidance from my professional body (CSP), to keep us all safe and well. Here are some important changes:

I will try to minimise the use of superfluous or unneccessary equipment.
Towels and couch covers will not be used (patient can provide them during home visits as well as pillow with fresh washed pillow cases).
Pillow cases at the clinic will be changed in between sessions.
Disposable cover / couch roll will be used as usual on the therapy bed and pillows.
I will be wearing the following PPE at your appointment, in compliance with current government guidelines including:

  • Non-latex gloves (single use)
  • Apron (single use)
  • IIR facemask (sessional use)
  • Eye protection visor
  • Uniform reserved only for while in clinic and single home visit and will not be worn to travel.
    Patients will need to hand wash before each sesssion and wear PPE (gloves, Type II masks) which will be provided upon arrival. You will be requested to remove your own PPE then bag it and sanitise your hands.
These measures will not affect your standard of care. To make an appointment or if you have any suggestions or questions regarding this policy or anything else please do not hesitate to contact me at
07413851407
or email me at

info@hito-physio.com.

Note:
All patients are advised to book exclusively online consultations and not to attend any LCM clinic if they are displaying any signs of Covid-19 and they should be self-isolating under current government guidelines.
Stay strong and balanced.
Alessio

How to keep your kids active at home

How to keep your kids active at home

How to keep your kids active at Home

One of the most difficult aspects of the lockdown has been to be suddenly stuck at home managing to work from home while re-inventing your daily family routine. For those with children, one massive challenge is to keep them busy (and studying) while you are working. Various people have adopted different strategies – some parents take turns between online meetings and video calls during their shifts, some booked online gym classes for kids and some creative families have managed to create a home playground between the living room and the garden. I’m sure parents have learned a lot about their kids’ general daily physical activity needs during this time, and I’m sure many have tried to improvise while at same time questioning themselves whether they are on the right path right path.

Before I became a physiotherapist, I was a PE teacher for 5 years in a primary school in my hometown in Italy. A big part of this job was the weekly commitment to prepare the best physical education for 5 classes of around 30 children aged 6 to 11 years old. This job has been one of the most rewarding and challenging experiences of my life because I was dealing with around 150 children with different physical needs and requirements. I thought it would be useful to share with you some important information and useful tips coming from this wonderful and intense experience.

1. Little helpers

I’m sure you noticed that after buying the best toys, young kids often ignore them preferring to follow you and play with your things (which are sometimes expensive or dangerous), copying you. This is a very important key point: one of the best ways to keep them engaged and busy is to make them your “little helper”, giving them tools similar to yours (plastic glasses or knives, no sharp or expensive objects, etc.) asking them to copy you or help you in some task. Whenever they do a good job, give them your verbal appreciation and some reward. This will make them feel important for you and for the family or group in general. Collaboration, commitment and sharing moments is really important for them and one of best aspects to keep them interested to explore the world with you and then by themselves.

If you do yoga or if you are lifting weights, you may have seen them trying to come closer and imitate you. I suggest that you encourage them to do this, using appropriate tools and keeping an eye on them. What is important is to allow them to be free to try without making them committed to a full training because it would be too intense. I saw parents trying to keep their child busy with them exactly for one hour of aerobics. This could be too intense for their body. Let them imitate you as much as they want and in the form they can.

2. Little adults

One of major mistakes we make is to treat them as children. It is true they are children but in their own way and time they are able to think, plan, decide etc. So it’s very important to treat them like little adults and give them time and space to share decisions with the family or at least express their opinion and point of view, which often will be so clever and from a unique perspective.

We often impose our decision on them asking them to follow and to agree without making them understand or participate. With this behaviour we show them that they have no power to decide, that they cannot understand and they only have to follow or execute: this is unfortunately the best way to prepare a complicated adolescence.

3. Rules

For any activity there are always some necessary rules to be fixed, depending on the situation. As much as you can, try to fix rules with them letting them experience why rules are necessary and what could happen if they not respected. Consistency is very important, so make rules understandable but also similar for everyone. Try not to make rules only for them because common rules are more likely to be followed. Often, we make the mistake to be make rules only for them and not for us and they will not understand why. Try to be strict as possible with rare exceptions.

If you said playground for 1 hour, put a timer and when the time is up make it happen without any other option or negotiation. Instead, try to discuss and negotiate things at the beginning when planning the activities with them.

Give rewards for following rules and also explain what will happen in case of rule-breaking. When this happens, actions matter more than words. Try to avoid yelling and comparison with siblings or other people they know, but instead give them some time off or commitment to do a “not so fun activity” versus letting them do their favourite activities as reward for respecting rules.

 

4. Be a good role model

It seems obvious but they will do exactly what you do because you are everything for them. Don’t be upset if you ask them to be tidy but you’re not. Tidying up, cleaning, as any good habit should part of any activity from cooking together to exercise. Remember that any moment is a good moment to teach something and let them learn

5. Planning

As any other activity sport or job, it’s always better to have a good plan. Make a list of activities (shared or not), a weekly plan or a daily routine. Share with them as much as you can, because you’re planning not only FOR them but also WITH them. Decide in advance times, location, activities, rules, time off, etc. and share those decisions with them.

6. Verbal + visual + physical

A good way to stimulate a good learning process is to properly explain it using your words but also showing them what you mean and letting them try it. This can be applied to various fields.

If you made a plan for the week or for the day, make it also visual by writing it down on a calendar. Another way is to make a board with pictures or objects to create a list or a sequence of events. If you want them to learn a new skill, teach them verbally but also manually, be their model or show them a video if you don’t know how to do it.

If they practice a specific sport and you spot something that could be improved make a video of them and show them their mistakes without being judgemental and then show them a video of someone with a perfect movement to imitate. Ask them to visualise a movement or a technique in their mind before to execute it. This will help them make a lot of progress.

7. Play, play and play

Playtime is everything for a child (and as adults we should keep a daily play time). They see most of their activities as a game and we should make most of their activities as a funny game or moment (even cleaning or typing up), rather than thinking in terms of sport we should think in terms of games or simple competitions.

8. Boring time

You don’t need to plan all their life. It’s good for them to have some free time without activity, without the tv or tablet and even without toys. They need free time without usual tools to find solutions by themselves. They will tell you that it is boring and they will probably get frustrated but plan at least 30 minutes everyday when they need to self-manage and find something interesting to do (even nothing). This will give them time to think and appreciate what they usually have and also increase their creativity to find something to do even if nothing is available (no toys, paper, pen, no tv, music, tablet, phone, etc.).

9. Physical abilities

As human beings we have amazing physical abilities and we should practice these all our lives. First it is good to understand that we have 2 main umbrellas of abilities:

As human beings we have amazing physical abilities and we should practice these all our lives. First it is good to understand that we have 2 main umbrellas of abilities:

  • Conditional (force, flexibility, speed/rapidity, resistance/endurance)
  • Coordinative generic (ability to learn, direct, control, reproduce, transform or adapt a movement) and specific.

Most of our trainings as adults are focused on the conditional aspects while in our childhood we required a lot of work on the coordinative functions rather than force, speed or resistance. The coordination comes first from practicing the basic motor skill (crawl, roll skip/jump, climb, bring, grab, throw, walk, run, etc.) during the early years, then combining them towards more complicated skills up to technical sport gestures. The specific coordinative skills include also the abilities to couple the movement or separate them, the eye-hands coordination, the orienteering in the space and time, the ability to react, to express a rhythm (playing or moving), and the body balance capacity.

The balance is a skill halfway in between conditional and coordinative and it is very important for many sports but also to keep good flexibility. An important ability often underestimated is the ability to alternate muscle contraction with relaxations. Most of people are quite good to contract and only a few are good to relax. Then who has a good contraction control often doesn’t know how to make it faster (rapidity) or alternate (right and left, flexor and extensor). The ability to perceive a muscle as relaxed or stretched is very important in the adult age, as prevention of certain injuries) or to keep a good posture.

Meditation during childhood or games where they need to squeeze and release certain muscles can be very useful. Another important aspect is to keep a good proportion between force and flexibility overall during the development phases. Any type of game is good to stimulate the coordination up to very complicated gestures.
At the beginning of childhood, it is good to make them imitate animal movement (walk like an elephant or jump like a frog, crawl like a snake or like a cat, etc.).

9. Twelve years

From birth, a child needs 12 years to have a complete body development. After that, the body continues growing during adolescence and part of adulthood but not developing. Growth is related to bones extending or thickening, muscle mass increase, etc. Development is more related to the maturity of the nervous system and many other aspects such as the laterality or the ability to forecast and visualise will be consolidated only at 12 years. My key advice in planning the activities of children below 12 years old are:

  • Turgor and Proceritas – These are two opposite phases during a child’s development: Turgor is an enlargement phase where muscles, fat mass and body strength increases while Proceritas is an extension phase where a child grows taller and slimmer, the bones are extending and the nervous system is expanding. In Turgor a child increases strength but loses flexibility while in Proceritas a child loses strength but increases flexibility. With these phases in mind, make your child exercise for the lacking quality depending on what phase they are in: so if your child is in Turgor then you need to work on their flexibility and coordination, but if your child is in Proceritas then they need to improve force, speed, balance and coordination.
  • Laterality – This is the quality related to the dominance of a brain hemisphere on a body half. The majority of humans have the brain’s left hemisphere as dominant which is in control of the right side of the body, so they will write, grab, throw with the right hand and kick, climb, jump with the right foot forward. It applies also to the eyes and ears (e.g. they will prefer to look through a camera or a pipe with the right eye or listening to the phone with the right ear). My advice is to let your child explore his own laterality and avoid forcing to change his dominant side. For example, some parents force their children to write with the right even if they are left-handed. A good way to exercise the laterality is to exercise movement in both directions like rolling to the left and rolling to the right, jumping to the left and jumping to the right, etc. Some children naturally develop double laterality so can do everything with both sides without any effort and you cannot notice any difference. If that is the case then it is good to naturally improve it but never force it.
  • Cardio: no thanks! – Often I see parents pushing children to do a lot of cardio like an adult. In reality they will only have all the enzymes to manage the lactate in their muscles and switch toward a full aerobic metabolism until they are 12 years old. Before this age, if they run, swim, or cycle too long they will develop more lactate than an adult so would potentially get more cramps, fatigue and muscle soreness during or immediately after exercising. It is best to listen to them and let them stop when tired of the same repetitive movement or sport.
  • From cartilage to bones – A newborn baby has less bones and more cartilage than an adult. In between cartilages there are bony nucleus of growth which will progressively produce a lot of bone tissue until they will reach 12 years of age. Only at this point the skeleton will be fully formed and it will be mainly made of bones with cartilages only in the joints as cushions. That’s why intense and repetitive actions of muscles over the bones through the tendons can create many pathologies (like the Osgood-Schlatter disease or the Sever’s disease) of the growing period where the joints become inflamed or the pull form the tendons creates micro fractures (avulsions). My advice is to not make your child exaggerate with sports and intense training before they reach the age of 12.
  • Do they need a six pack? – The linea alba is fibrous structure running in the midline of the abdomen and connecting the pubis to the xiphoid process (bottom of the sternum). It keeps the abdominals (rectus abdominis right and left) together and it will be consolidated up until 12 years old. Make sure your children do not do excessive abs exercises like an adult because this can cause inflammation (tendonitis), diastasis recti (separation of the abdominals) and abdominal herniations.
  • Team sports – Team sports usually requires control of a tool or a ball thrown in the air and grabbed again or passed or received, and needs a specific coordination as well as an ability to forecast where the throw will send the object. This ability of forecast visualising a trajectory starts to develop from the age of 7 and completes around the age of 12 but can be improved with more and more practice. This is why it is common to see children younger than 7 years old missing the ball or having a complete wrong trajectory when throwing. In that sense it is a good advice to suggest team sports from age 7 or even better around the 10th year. Team sports also improve a child’s social ability and cooperation which are very important aspects of daily life. With team sports, a child will learn to continuously adjust their movement with many variables (e.g ball trajectory, team movement) despite he will struggle to forecast them. This type of learning movement is called elastic map.
  • Individual sports – Individual sports are all the activities where there is a single athlete making a repetitive action toward a final goal. These sports are very good for developing coordination (e.g. cycling, swimming, running, gymnastics, snowboarding, ski, etc) and where the variables are related more to force and speed or balance. The learning process is called rigid map (because the situations are always similar) and the child will find it easier because there is no need to forecast. The only variables are related to the terrain conditions (wet, slippery, inclined, etc), equipment, height (diving or jumping from a certain point), space (running in a specific track or landing in a narrow space) or numbers of flips/rotations (box, snowboarding, skateboarding, gymnastics etc. Individual sports are good to increase self-confidence and sense of competition however they can have a lack of sociality.

9. Homemade obstacle course

A good idea to keep your children busy is to build up an obstacle course at home with various tasks in a sequence, along a track or a line. A good starting point is drawing a plan on paper and using any tool or equipment you can find at home (e.g. chairs, blankets, tape, containers, water, bowl, baskets, etc.).

Knowing everything I explained above, I encourage you to use your imagination and try include any type of exercises or motor skill you know. For example you can make a cardboard on the floor as a start and finish then align chairs to climb or pass underneath, a mat to roll or crawl, a ladder to climb, tiles to skip, obstacles to jump, tools to grab and bring, balls to kick and throw, etc. Easily you can find good ideas on YouTube and try also to practice with them to have some good fun all together.

I hope you found these information very interesting and helpful.
Please be in touch if you have any questions.

6 steps to avoid post-lockdown sports injuries

6 steps to avoid post-lockdown sports injuries

6 steps to avoid post-lockdown sports injuries

If you are normally a highly active person, the lockdown brought a drastic change of lifestyle since you could no longer access your gym, pool, spa or play your favourite sports. You also suddenly found yourself isolated or completely absorbed by new challenges like working from home, managing and home-schooling kids full time, and finding new strategies to balance relationships at home since the 24/7 house sharing could add inner pressure and create frictions. All this time, you probably felt the daily accumulation of adrenaline in your blood and the stronger need to discharge energy using your muscles. However your options were limited to going for a run, walk or cycle outside once a day, or doing home workouts using whatever space and equipment available to you.

With the progressive reduction of lockdown restrictions, many of you are probably planning to go back to sports and trainings as soon as possible to reduce accumulated stress, feel fitter quickly and recover pre-pandemic weight. In this situation, it is easy to fall in the trap of rushing back to your old fitness routine to get fit for summer, in the hope of going on beach holidays or wearing your favourite outfits soon.
In my personal experience as physiotherapist for the last decade, I constantly see a lot of patients especially in spring or prior to the skiing season, seeking help with body pain and struggling to complete their training plans. Most of them fast-tracked their path to injuries by rushing into training without any professional help on an initial physical assessment or advice on proper technique or regular monitoring of progress. In fact, when I was a physiotherapist at the Bournemouth marathon a few years ago, I met many people suffering from cramps, pulled muscles, and limping. They all had similar stories – absence of preparation, incomplete training and wrong technique.

Going back to your pre-lockdown sports and fitness activities is not as simple as picking up where you left off. Even if you have been a runner for 20 years you will be surprised to know that a period of downtime sets your fitness and even your techniques back. As a physiotherapist and former personal trainer, PE teacher and sports coach, I want to give you some advice to help you safely rebuild your fitness, go back to your old routine and avoid risks of potential injuries.

1. Research and plan

In sports, proper planning is just as important as regular training. A good starting point is to fix a deadline for yourself then count the weeks back to the present. Be realistic about how much time you will have to dedicate to your training, considering your current routine. My advice is to adjust your deadline and move it back to factor in your current fitness levels and add some extra time in case of any sudden or unexpected variation in your planned routine.

You will need to build up micro daily routines which will be the elements of your weeks toward the construction of macro-periods (months). It is also important to plan for rest days, to give your body time to recover and rebuild. I also recommend to find a physiotherapist or a personal trainer who can do an online session or a session with social distancing, to perform an initial assessment (of your motor qualities such as coordination, force, flexibility, resistance, endurance and speed), discuss your goals and get some expert advice on technique and training.
In building your micro daily routines, consider the following:

  • Coordination and flexibility require daily repetition
  • Force needs at least 2-4 trainings per week depending on the type (pure, max, fast, explosive, resistant) you need for the sport you will practice. Pure and maximum force comes from low reps (1-6) and high weights (90-95% of your max).
  • Reduce the weights to the 80% of your max and increase the reps to 8-12 if you want to build muscle mass.
  • Add fast movements if you want improve the rapidity (how quick you can make a movement, i.e. rapid press ups) and so the speed (how fast you can go with your full gesture, I.e. the max speed you can reach running, cycling, rowing, etc.). Never lose the movement control if increasing the speed.
  • Jump to 15-20 reps with 40-60% of your force max, if you look for your cells to adapt to lactate to improve endurance.
  • Reduce the weights and move to 20-50 reps if you need a minimum of good strength while working in aerobic or semi-aerobic.
  • The resting time in between sets should be of 5-7 minutes for the high force, 2 minutes for rapidity and muscles mass, 1 minute for endurance and resistance.
  • The resting day in between trainings should be 5-7 days for the pure high force, 2-4 days for the medium force, 1-2 days for endurance/resistance.
  • Speed/rapidity resistance/endurance need 2-4 sessions per week.
  • Flexibility improves with long stretches, far or after the other training sessions, holding a pose below the threshold of pain, for a minimum of 90 second towards 5-7-10 minutes.
  • 10-30 stretches are only good for a good warm up or reduce fatigue after or in between exercises.
  • To save time , you can combine most of them in the same session with specific circuits.
  • Don’t forget the core: I always advice to regularly add yoga and Pilates to improve joint stability, flexibility and strength, shaping the right focus and mindset/mindfulness typical of those disciplines.
  • Balance trainings will be helpful to increase coordination, control and flexibility, preventing injuries and reducing tightness.
  • Consider to include eccentric series (or negative series) if you need to build up elasticity or add plyometrics exercises if your fitness level is quite good and you will practice a sport requiring jumps or explosive motion.
  • Any 3-5 weeks of regular increasing routine (add more volume or intensity) the body needs a rest week where your practice whatever you feel enjoyable without stressing to much the muscle-skeletal system (light jogging, gentle swim, walks, light weights, relaxing cycling, etc).

If you kept in the right consideration everything I wrote above, you can already see that to get ready you will need a few months depending on your starting level.  If you want just to be fit, my best advice is to become an all rounder – stretch everyday, variate activities, alternate force with cardio or circuits, daily warm up with yoga and Pilates, weekly have some fun activities to stimulate balance.

A good training plan is not just about a timetable, you should also consider your diet, supplements, training equipment and gear, even down to the right water bottle.

Depending on your chosen sport, you may need to have different plans and often you need to combine different disciplines to build up all the skills you need.  Do a lot of research or ask advice from someone who is already practicing and has a lot of experience or consider investing in expert advice. If in this planning process you realise that you do not have enough time, my advice is to postpone your deadline by a few months or even moving it to next year rather than rushing yourself and risk getting injured.

2. Be progressive: volume before intensity

One great rule is to increase the volume of training before increasing the intensity.  Volume is made of number of sets, reps, weekly sessions, duration, frequency, number of exercises per muscle or type of quality you want to build up. On the other hand, intensity is made of force, weight and speed. Another good way to self-calculate the intensity is to multiply the kilograms lifted per the number of reps per the number of set per the total of exercises (example: 10kg x 3 sets x 10 reps = 300kg, 12kg x 3 sets x 10 reps = 360 kg). As you can see adding just 2 kg for the same exercises is like if your muscles lifted 60 extra kilograms. Try to make the same calculation for each exercise in your routing and add all numbers and you can find a generic parameter of how intense are your trainings. Moreover, you can better understand how to play between volume and intensity: keeping the same total of kg you can reduce number of sets and reps increasing the load or viceversa.

Start your training with 2 days per week then add 1 session after 1-2 weeks and so on towards 4-5 trainings per week.  Start with low weights with a maximum of 10 reps then add 2 -3 reps every 5-7 days.

Start with 2 sets and add one set more after 1 week, move to 4-5 sets if necessary and only when you are already comfortable with 3-4 weekly sessions.

Start with 1 exercise per muscle area or motor quality and add one more each week up to 2-5 per session.

Increase the weights only when your routine is already stable and you can manage good recover between sessions.

Add 5kg on the isotonic machines (10kg if training the legs) anytime you repeat the same training (i.e. circuit day, legs/arms days, etc). On the free weights the increments will be lower to 1-3kg (5kg-10kg for legs or global exercises). 

Increase the speed only when you are 100% sure to have a good technique, with a full range of motion and in full control.

Increase the reps/duration or reduce the rest between sets if you want burn more calories.

Talking about cardio, increase time or km/miles before increasing speed: add 5 minutes or 2-3 km each session.

This way, your body will keep improving every week and without pushing too hard, it will take a few months to reach your target level.  In general, whatever is your initial level or sport, after 1 month you should be able to have 3-4 sessions of 30-60 minutes per week, exercising around 3 sets of 10 reps.

Of course there are many possible variations depending on sports and physical activities.

Finally consider that intensity and muscle stress progressively increase depending on the type of muscle contraction: isometric (contraction without movement) à isokinetic (contraction with constant speed similar to aqua exercises) à auxotonic (elastic band) à isotonic (gym machine) à rapid/explosive/plyometric on isotonic machines à free weights/body weight à eccentric (with machines or free weights) à plyometric/explosive with free weights. So body weight exercises at home can be more intense than gym machines or elastic band. Jumps or push ups with rebounds or hand clapping are the very intense and should  be part of your routine only when you are super fit.

3. Make yours the best technique

Even if you consider yourself an expert in your physical activity, there is always some little detail that you can improve or correct.  Ask advices, study more and invest in some private coaching.

For example, get your bike fully fitted based on your own body specs, use the right shoes for your sport or get advice on the right in a specialised sport shop.

If you are a runner, consider to have a gait or run video analysis, and book with a physio to check your joint mobility and myofascial restrictions or compensations.

A postural analysis is also a great beginning.

Speak to a physiotherapist or coach to review your plan.

4. Eat, hydrate, sleep, repeat


Try to have a healthy diet and lifestyle by reducing processed food, sweets, alcohol and smoking. Explore other options like the ketogenic or vegetarian or vegan or fully raw to find the best match for your performance (there are many documentaries about these options). All physical activities and animal food sources tend to increase body acidity while most of raw vegetables and cereals are alkaline. The ageing process is made of lack of water intake and increase of blood/fluids acidity. Drink at least 2.5 litres of water per day up to 3.5 litres, and consider taking alkaline water as it is also beneficial for your health.

Adding supplements like vitamins, minerals, proteins shakes or super foods is another great field which needs to be explored depending on your goals and sports.

Sleep at least 6 hours or more if possible. Some research showed how the best sleeping time is made of multiples of 1.5 hours so we rest better if sleeping 6 hours or 7.5 or 9 hours. Sleep hygiene is very important too and lot can be said about mattress, sleeping posture, breathing exercises and pre-sleep meditation.

5. Listen your body

Your body tells you everything you need to know, so the best you can do is to listen.  Nobody knows you better than yourself but you need to be able to pause and listen your inner messages. Persistent or recurrent aches or pains are signs of micro-injuries or misalignments or body compensation which need to be assessed by your physio or doctor.

The pain due to the lactate accumulation usually comes during or at the end of a strenuous activity, often leading to strong cramps during your sport action.  The excess lactate will move and transform in the liver, and this process can take a few hours after the session but tends to gradually improve. Lying down with your legs or arms up helps with moving the excess of lactate into the trunk and through the liver.

Another good habit is to do 3-5 minutes light exercises after training to de-fatigue or de-stress while the muscles keep pumping the blood around and towards the liver.  The worst choice is to suddenly stop after the last repetition. A good post-training aid comes from ice cold shower/bath or alternating hot/cold water.

The pain appearing after 24 hours and lasting up to 72 hours from the training is called DOMS (Delayed Onset Muscle Soreness) and is normal and functional to the training progress. The DOMS is physiological and consist in the rupture of a small amount of muscles fibres (less than 2-5%) which will stimulate the body to build up more of them thus increasing your muscle mass and improving strength.  During DOMS, it is always good to reduce the intensity or train another part of your body or change activity (like doing cardio instead of repeating weightlifting). If the pain persists over 72 hours the muscle damage and inflammation was too much so you probably need to reduce the intensity first and also the volume if this is not enough.

6. Be proud to keep walking wherever you will arrive

“Any travel starts with a single step” so the most important thing is your will to improve, discover, grow, explore, change.
It doesn’t really matter if you will miss this year marathon or skiing season. Just keep going, keep training, respect yourself and the amazing body you have whatever is your fitness level.

Be grateful for what you have, what you can think, plan, dream and achieve.
“The teacher arrives when the student is ready”: I’m sure you are on the right path for you, you will meet the right people to share, learn, copy, listen, improve.

I hope you will find useful all the above information as you restart your fitness journey. In case you have any doubt feel free to contact me for a remote consultation or video assessment.

Be consistent, commit with gratitude and compassion trying all you can to make the best version of yourself.

Demystifying Myofascial Induction Therapy (MIT)

Demystifying Myofascial Induction Therapy (MIT)

Demystifying Myofascial Induction Therapy (MIT)

When we experience a physical or emotional trauma, from an injury or a surgery or stress, our fascial tissue reacts and hardens like a protective body armour.  This produces myofascial adhesions, giving us the sensations of tightness, having knots in the muscles, restricted movements and functions.  In the long term, this situation will create a Myofascial Dysfunction Syndrome (MDS) which affects almost everyone and is part of the ageing process.

Myofascial Induction Therapy (MIT) is a highly specialised hands-on technique that focuses on the restoration of altered body function through the treatment of the myofascial system, preventing or reversing the MDS.  MIT was created by Prof. Andrzej Pilat from over 2 decades of extensive research about the fascia, and this treatment is taught and practiced in a number of countries in Europe and South America. It can be considered as a natural evolution of previous researches and methods having its roots grounded on the practice of Osteopathy by Andrew Still, Rolfing and Structural Integration by Ida Rolf, the Anatomy Trains by Thomas Myers and Myofascial Release (MFR) by John Barnes.

What is the myofascial system?

The myofascial system is the network of connective tissue beneath the skin that attaches, stabilises, encloses and separates muscles and other internal organs. It is a 3D web similar to a spiderweb made of collagen and elastin fibres, connecting everything in the body, creating the body shape, providing support, stability, strength and flexibility through the muscles, cushioning any impacts and internal friction between the different body layers. It also regulates the exchanges between cells and compartments, defining the dimensions of the “pipes” into nerves, blood vessels and fluids pass.

Why does MIT matter?

MDS is a systemic condition affecting the whole body as defence mechanism, not only against the force of gravity but also as reaction and compensation for life events. As part of the ageing process, MDS results in increased tissue acidity, stiffness and dehydration with loss of local circulation.  With MDS, the blood vessels, nerves and lymphatic system are squeezed because of the jamming layers created by the chaotic collagen fibres.  This results in a vicious circle of restriction-pain-compensation-reduced mobility-dehydration-reduced circulation-increased acidity.  The more restrictions, pain, and compensation occur, there is higher risk of anomalous internal frictions, altered functions and osteoarthritis.

MIT and its specific techniques is the best solution to restore the fascial tissues and reverse its deterioration due to MDS.

How can MIT help me?

MIT can help with a wide range of conditions:

  • back, neck and joint pain
  • Chronic pain
  • poor posture
  • Visceral pain (e.g. period pain, irregular periods, infertility, kidney/gallbladder stones, gastric reflux and hiatal hernia, IBS, constipation, urinary/intestinal infections, colitis, etc.).

After 1-2 months of regular MIT sessions, while the symptoms are disappearing, the whole body keeps improving towards a new healthy balance.  A review of patients after 6-12 months of undergoing regular MIT sessions reveals a continuous improvement beyond the findings detected during the last therapy, because the body system kept “rolling” the ball of the “induction”, amplifying the tissues changes and restoring the body to its original healthy state.

How does MIT work?

MIT is not a massage but a soft touch hands-on method based on a standard orthopaedic assessment and specific techniques to seek, find and dissolve the myofascial restrictions, ultimately treating MDS.

MIT involves a sustained light mechanical compression (minimum 5 grams) on the skin from as brief as 90 seconds to as long as 20 minutes.  This generates an “induction” or a manual input which triggers a cascade of biochemical reactions and tissue-brain communications which will stop and reverse MDS.

The techniques used in MIT usually involves the following:

  • Placing hand(s) on tissues to be treated
  • Pressing lightly to find the barriers (the limits of skin movements) and applying a constant pressure to tension the tissue
  • Holding constant pressure depending on the depth of the restriction and the body’s reactions (pressure is reduced if there is any pain)

The above techniques is most effective with the patient’s active participation in communicating the changes in symptoms and sensations during the treatment.

What happens after the session?

The first MIT session or “induction” will start a 48-hour biochemical process where the fascia cells will re-absorb the old collagen fibres in the external structure and produce new fibres resetting the system with its own natural microscopic tension. Patients are normally advised to rest, practice low to medium impact physical activities and avoid sport or extreme conditions during this 48-hour period. During this time the patient can have an immediate sense of release, tiredness, need to eat carbohydrates and drink more water, sense of deep relaxation and need to sleep earlier or longer, and changes in the bladder/bowel excretion. The effects of the process should reduce following this 48-hour period, and the patient’s symptoms generally start to improve.

How many sessions?

The number of sessions can vary from patient to patient, depending on a number of factors such as: the severity and number of symptoms or restrictions, hydration of the tissues, compliance with the exercise program, age of the patient and other postural/medical conditions.

During your first session, the therapist will assess the above factors and provide a recommendation on the number of sessions that may be required.  This will be revisited at each session, depending on the body’s response to the therapy.  The average number of sessions to resolve any body pain is 3 to 6 sessions, however more sessions may be needed to address other issues such as correcting posture or improve the function of organ(s).

How often should you have a treatment?

It is advisable to have at least 1 session per week in the first 3 to 4 weeks, which is the average timeframe to significantly reduce the pain in the affected area(s).  Patients experiencing several symptoms in different areas of the body are advised to start with 3 to 4 sessions in the first 2 weeks then moving to once a week.

The frequency of treatment can vary depending on the severity of symptoms and the number of areas to treat, however since each session or “induction” boosts the effect of the previous session, the frequency of treatment reduces over time.  Thus patients can move from a weekly session, to once every fortnight, to once every 3 weeks, then once a month.

What is the difference between Myofascial Induction Therapy (MIT) and Myofascial Release (MFR)?

MIT and MFR have a lot of similarities: they are based on the same concepts and clinical reasoning and they can complement each other. The “induction” in MIT relates to the soft touch manual input that not only releases restrictions and treats the pain but also activates a cascade of biochemical reactions and microscopic tensional changes restoring qualities and functionalities previously compromised.  On the other hand, MFR is more passive in seeking to “release” the restriction or pain in an affected area.

The key aspect of MIT is the activation of a tissue-brain-tissue conversation which goes beyond the local pain or restriction, generating changes in the whole body’s posture, mobility and functionality, with the benefits lasting for months or even years.