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"Nicola has worked with me at both club and International level. She has always been committed to getting myself and team mates back on the ice after injury. I’ve had a few injuries over the past few years and without Nicola tirelessly working on my rehab and motivating to push myself, my injury lay off time would have been so much longer." Jonathon Weaver, GB and Coventry Blaze Ice Hockey Club Captain
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"I had been suffering with constant back problems for some time, after trying different types of treatment I had resigned myself to the fact that it was something I would have to live with. A friend suggested going to Elite Therapy and after one session my back started to feel an improvement. Nicola worked on my posture and core stability and gave me exercises to improve my mobility. My pain has reduced considerably and I have the confidence to be active now without the fear of my back seizing up. I can’t thank Nicola and Elite Therapy enough." TP, Coventry
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"I would like to thank Elite Therapy and Joel for their professionalism and ethusiasm, in helping me gain the strides i needed to over come my injuries. This has allowed me to develop my skills within the European and international stage" Adam Biggs, Coventry Jets AFC, GB Lions AFC
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"We tend to spend a lot of time sitting at our desks producing design work for our clients. As part of encouraging our guys to adopt the right posture and take breaks from the computer we asked Elite to come in and offer massage therapy and advice on an individual basis. This was very well received and we will definitely be doing it again" Paul Hartley - Pyramid Design
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"I had been having back trouble for a number of years now - periodically it would flare up and I would come in for a few therapy sessions to manage the condition. A consultant has now determined that I require surgery to correct the condition. Joel has helped by taking a detailed holistic background history and developed a series of exercises to prepare me for the procedure and help aid the recovery process" AM, Leamington Spa
Flatfooted? Rearfoot Varus Discussed
Tuesday, 03 January 2012 00:00
Rearfoot varus (AKA- form of flat foot) is the most common pathomechanical concern that can contribute to structural deformities (or joint malignment) during weight bearing activities. Generally speaking, when the foot is non weight-bearing and off the ground, a structural deformity is not an issue. However, because we rely on efficient functioning of our feet in everyday activities, we need to accommodate structural problems so that we can move forward, such as in walking or running.
The foot needs to adjust to varying terrain and accept the weight of the body. If there is a structural problem (meaning fixed in a specific position) the foot must compensate it's normal movements in order to move the body forward in locomotion.
When rearfoot varus deformity is present, the foot places itself flat to the floor to accommodate the positioning of the ankle during weight bearing activities. Please note that the top ankle in the picture below is in a normal position and foot has a normal arch. The bottom foot, however, is not aligned as such. With the ankle in a neutral position, the foot is forced remain flat on the floor. This flat footed movement of the ankle and foot is also known as pronation. This movement generally occurs in all weight bearing activities for sufferers.
Note: the ankle joint we are concerned with in particular is called the subtalar joint.
There are two types of rearfoot varus that we need to be aware of, a compensated and a non-compensated deformity.
Note: Compensated - refers to a change in the structural alignment or position of one part of the foot to neutralize the effect of a structural problem in another part of the foot. For example, when the foot flattens to the floor to compensate for the position the ankle is in.
Uncompensated – refers to the structural position of the whole foot or one part of the foot in a non weight-bearing situation. In this case, the ankle joint is not aligned but the foot functions as normal.
Due to the nature of the flat footed position of the forefoot during weight bearing activities the front area of the foot does receive a greater amount of force than in a normal alignment. This force then causes the ankle joint to turn in and the heel to turn out as seen above in Figure C. As the turning in of the ankle increases, the position of the heel also increases. This forces the ankle joint into the opposite direction (causing a whipping action) contributing to the instability of the joint over time.
Efficient mechanics, physiotherapy and passive support are then necessary for a more efficient stance and gait (walking) pattern. Efficient use of supporting muscles (pelvic positioning, gluteal control, quads) during function, soft tissue massage for the release of muscular tensions and mobilisations of joint structures to tackle compensatory factors will all be beneficial. Acupuncture can also be considered to encourage healing and to reduce pain.
Passive supports (orthopaedic insoles) are also useful in supporting the foot into positions that the sufferer is unable to accomplish on their own (as seen in the picture below). The hope behind insoles would be to allow the foot/ankle to be placed into a better functional position.