Archive for April, 2017

Are you fit for exercise this Spring?

If you’ve been quite sedentary throughout winter, you may find your body is feeling de-conditioned.

Before you get out and about, take a look at our tips for getting your body ready for an increase in activity.


1. Ease into it

If you’re looking to exercise more throughout Spring, it’s important to gradually increase the time you spend exercising to reduce your risk of injury.

Start off by doing an hour of gardening or playing a friendly tennis match and work your way up. If there is a specific sport or hobby that you’d like to get back to, our team can put a bespoke exercise plan together for you that focuses on progressively developing specific muscles that you need to do that exercise. This is a great way to ensure that you get the most out of your activities without injuring yourself.

Another tip is to make sure that you warm up and cool down after exercising as this will help your body recover faster.


2. Stay hydrated

Don’t forget to keep topping up your water bottle. Dehydration can have a negative effect on your performance and is often caused due to excessive sweating and inadequate fluid intake. So keep drinking water at regular intervals throughout the day.


3. Treat knocks and niggles sensibly

If you increase your activity levels too quickly or you have poor form when exercising, you may find that you develop aches and pains. Although it’s common to get the odd niggle when getting back into exercise, it should be treated correctly from the outset.

If you are injured and have immediate swelling or feel unsure about the nature of your injury then please don’t hesitate to contact us.

In the meantime, here is some self-treatment advice known as the PRICE protocol:

Protect the area with tape or support. This helps to offload the area, preventing further damage and facilitates a quicker recovery.

Rest for the first few days or even weeks to reduce the frequency, intensity, load, or time that you use the painful area to help promote healing. This will also prevent further damage and long-term problems.

Ice should be used to help reduce swelling and inflammation. This can be applied up to 20 minutes every 2-3 hours. The quicker you can reduce the inflammation, the quicker you will be on the road to recovery.

Compression reduces the swelling around the injured site and provides support to offload the area. Tape is often one of the most effective methods for this.

Elevate the area of injury whenever possible. This reduces swelling and pain and maintains the range of movement to the area of injury. The higher the elevation, the better the effect. However, you should still be in a comfortable position.

Please seek advice if you feel unsure or worried that your injury may get worse.


4. Keep your body in good form with regular manual therapy

Manual therapy alongside an increase in activity has many benefits such as:

  • Better flexibility
  • Reduced stress
  • Increased energy levels
  • Improved posture
  • Pain relief
  • Relief from muscle tension & tightness
  • Faster recovery from injury

If you’re feeling de-conditioned, perhaps consider starting a Rehab, Pilates or Strength and Movement programme to get your body ready for Spring. If you’re interested in finding out more about these programmes, please call our Patient Services team on 01380 730473.

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Common Running injuries

Running is one of the most popular forms of sporting activity worldwide. It’s relatively cheap (except for a decent pair of shoes), convenient, and has many health benefits both mentally and physically.

However, if you are a keen runner there is also every chance that you have had a frustrating layoff with one or more of the most common injuries, which can interrupt your training.

The four most common running injuries we tend to see are:


  1. Runners Knee
  2. Shin Splints
  3. Plantar Fasciitis
  4. Achilles Tendonopathy


Let’s briefly deal with each in turn:

Runner’s Knee

This is a lay term that can lead to some confusion as it can encompass injuries such as iliotibial band syndrome (ILTB) anterior knee pain (AKP) and patella tendon injuries, all of which are completely separate injuries that may be chronic (gradually appear over time with overuse) or acute (due to sudden injuries).



The pain occurs on the outside of the knee joint, is worse during running but eases when you relax. This can be caused by tightness in the ilio-tibial band, poor foot function, i.e., over-pronating feet, unsuitable shoes and excessive training.


AKP or Chondromalacia Patella 

The pain is mostly around the kneecap, often just on the inside or below but can also radiate to the back of the knee. It occurs because the tracking of the kneecap within the femur as you bend your knee is altered. This can be due to muscle imbalances in the thigh or hip – some muscles are pulling too strongly and some are simply too weak. Inflexibility is another common factor here as is overpronation or poor foot function.


Patella Tendinopathy 

Even the casual runner can suffer from this although it tends to be more common in more high-impact sports injuries involving bursts of activity. The pain is usually localised to the tendon and starts with pain after exercises but can progress to debilitating pain through exercises. Most recent research has shown inflexibility of the hamstrings and quadriceps is very common; also the alignment of the patella (the kneecap) and the biomechanics of the feet can have a significant impact on this condition.


Shin Splints

This is another lay term that can encompass any of the conditions described below:

  • Compartment Syndrome
  • Stress Fractures
  • Medial Tibial Stress Syndrome

All of these commonly experience pain on the inner side of the shin during exercise and even at rest in more chronic cases. The individual history needs to be carefully taken to distinguish between them. The individual’s training, lower limb biomechanics, flexibility, and muscle strength must all be carefully assessed in addition to their running shoes in order to determine the cause and appropriate solution to the runner’s pain.


Plantar Fasciitis

This refers to pain on the underside of the heel which often radiates down the inside of the sole of the foot. Pain is usually worse on activity and also after prolonged inactivity, particularly on getting up in the morning the first few steps can be very sore.

The most common cause of this is often the biomechanics of the foot due to overloading of the plantar fascial tissue. This is often described as over-pronating seen in people with flattened medial arches, or under-pronating seen in people with higher more rigid arches. Overload of the tissues can all occur if the footwear does not have adequate shock absorption or is worn out. Plantar fasciitis is common in runners and by replacing running shoes can sometimes resolve spontaneously. On other occasions, it can be very persistent which could be due to the wrong type of running shoes being worn or that an orthotic is needed to improve the biomechanics. Tight calf muscles and Achilles tendons can increase the strain on the plantar fascia. To resolve this the individual needs a full biomechanical lower limb assessment and advice about their shoes and self-help measure including stretches, ice etc.


Achilles Tendonopathy

This is due to the degeneration of the tendon above the heel and forms part of the lower calf muscles. This means the tendon is not as strong and may be liable to rupture with continued excessive sporting activity.

The pain comes on gradually and is worse on activity and any focal area of degeneration can be very tender to touch. The tendon is very stiff first thing in the morning and is often thicker on the affected side.

Again training should be looked at, muscle strength, flexibility and foot biomechanics are all factors that need to be addressed. Specialist eccentric exercise programmes are often very successful for these types of tendon problems although they need to be continued for at least 3 months.


We have only outlined the 4 most common running injuries that we see here at the Clinic. Our thorough initial assessment would enable us to identify whether you were suffering from any of these conditions or from one of the many other running injuries that we also treat.

Your treatment can include if appropriate, individual training advice, strengthening and stretching exercises, joint mobilisations, pain relief, and goal setting through a complete rehabilitation programme. We would also be able to identify and correct any abnormal lower limb biomechanics, which may predispose you to injury.

However it is important to realise that the most frequent cause of running injuries is overtraining or what could be termed the “terrible toos”: Too much, too soon, too often, too fast, and too little attention paid to pain all too often lead to injury.

If you’re suffering from a running injury and would our help. Please get in touch by calling 01380 730473.

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Upper Limb Disorder

What is Upper Limb Disorder?

Upper Limb Disorder (ULD) can affect the neck, shoulder, arm, forearm, elbow, wrist, fingers, and thumb with symptoms of tenderness, ache, pain, stiffness, weakness, tingling and numbness.


What can cause Upper Limb Disorder?

Risk factors include repetitive or prolonged tasks such as a computer or manual work. The risk is increased if these repetitive or forceful movements are allied with a poor posture.


How can ULD be prevented? 

  • Changing your way of working can considerably relieve symptoms of ULD. Often, those that work in an office are prone to carrying out repetitive, uncomfortable actions or sustained positions. It is important to work with your employer to identify and change conditions that may lead to or exacerbate your condition. Take an office chair, for example, one size does not fit all and individuals have different needs related to their body size, age, abilities, and health.


  • Your employer needs to encourage regular short and frequent pauses in intensive work. Display Screen Equipment Regulations require employers to train employees incorrect use of display screen equipment (DSE), provide suitable furniture, and periodic assessments if DSE is used for more than one hour daily. This may include adjustable chairs, platforms, and footrests. If the equipment is provided specifically for you, make sure you use it correctly.

Who can help?

Physiotherapists are the best medical practitioners for you to see if you suffer from Upper Limb Disorder. Physio is an extremely effective treatment for this condition and the earlier we tackle the ULD, the better,  to reduce your pain and stop your symptoms from becoming difficult to manage.

At Hatts, we can offer you an ergonomic assessment that will help to identify ergonomic risk factors, quantify them, and make measurable improvements to your workplace, ensuring that your jobs and tasks are within your physical capabilities and limitations. We can also offer you an effective treatment plan that will relieve your pain, restore your movement, and finally get you moving better than ever before.


For more information or to book an appointment give us a call on 01380 730473 or use online booking.

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Acute Whiplash

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It’s Time To Limber Up!

Warming up and stretching should be a key part of your exercise regime. The type of stretching you choose should depend on the type of exercise you are doing.


The two most commonly used types of stretching are static and dynamic.


If you have recently been injured or you are looking to improve your flexibility, then static stretching is ideal for you. A static stretch involves moving a body part to the end of its range and holding it for a length of time (usually around 20 to 30 seconds). For example, a quad stretch as in the photo displayed.


However, if you are a keen sportsperson, then dynamic stretching may be more relevant for you, especially during a warm-up before a competition or game. Dynamic stretches are great for working muscles such as the hamstrings, calves, and abductor muscles


A great example of a dynamic stretch used in a warm-up routine is ballistic stretching. This involves stretching a muscle to its limit and then stretching it further with a bouncing movement. It is really important that this exercise is carried out with caution as it can heighten the chance of injury if not performed correctly and safely. It is particularly useful in sports where a large range of motion is required, such as gymnastics.


Certain body tissues respond differently when stretched which means it is very important that you understand how to carry out these stretches appropriately. For example, abductor or groin strains do not respond well if they are stretched too early after an injury. In contrast, hamstring muscles do respond favorably to early mobilisation after a strain or tear.


So if you are injured or seek general advice on how to stretch correctly and safely, then get in touch as we are here to help. We have a whole range of services that can guide you in the right direction when stretching. For example, our Physiotherapist could offer you some advice or you could come along to our Pilates sessions and be guided through a range of stretches where you can reap the benefits in a safe environment.


For more information, give us a call on 01380 730437.

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Worry and stress lead to the fight/flight response which is a physical reaction to real or imagined danger. While helpful in the short term, if this response is sustained over the medium to long term it can cause damage.

The fight/ flight response is designed to get you out of a dangerous situation. It involves increased steroid hormone releases such as adrenaline and cortisol.


This affects blood pressure, insulin release, immune function and inflammatory response. These changes result in increased heart rate, respiration rate, blood pressure and loss of digestion. Ideal when faced with a sabre-toothed tiger. Not so ideal when stuck in a traffic jam!


In a chronic situation, these stress responses affect cognitive performance, suppress thyroid function, slow down wound healing and immune response, contribute to loss of bone density, muscle strength and increase abdominal fat.


Frequent colds result from the loss of ability to fight infection. The sufferer may also notice poor sleep, loss of ability to cope, decreased confidence, difficulty concentrating and making decisions, headache, stomach upset, butterflies, irritability and lowered energy levels.


The best treatment is a multi-pronged attack on the causes of stress:


Try to address your priorities  It’s easy to get uptight about relatively trivial matters if you don’t stop and check your perspective


Social support is critical  A close friend, partner, family member or pet can provide the reassurance needed at vulnerable times


Physical exercise – Exercise changes the focus from mind to body, relieves tension and uses up excess adrenaline


Be aware that some people are more sensitive to stress than others Monitor your mind and body for warning signals that you are starting to feel overloaded. Take action before everything gets on top of you.

You may like to try the following exercise as an instant stress buster. It is based on techniques used for meditation but you can work at whatever depth feels right for you:

Find a time and place that you can be sure you will not be disturbed and get into a comfortable position using pillows and cushions to support your body as needed. Bring your mind to your breathing. Do not try to change it; just observe your inhalation and exhalation. When your mind wanders bring it back to the breath. Initially try 10 minutes, notice how much more relaxed you feel afterwards.


Physiotherapists can provide relaxation techniques and advice on safe and enjoyable exercise programmes to build back mental and physical well being, so if you’re struggling to cope with stress, please reach out to us by calling 01380 730473 or booking an appointment online. 

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Osteoarthritis – Can Glucosamine and Chondroitin help?

There are many people who have heard that glucosamine and chondroitin can help with osteoarthritis (OA). Is this true?


Most of the research that has been conducted on glucosamine and chondroitin relates to people who are experiencing the symptoms of knee osteoarthritis.


What is osteoarthritis?

An imbalance of physiological processes leads to inflammatory cascades at a molecular level which affects the synovium, bone and cartilage and produces joint degeneration. Risk factors for knee OA include age, genetics, trauma, knee alignment and obesity. (see our OA article for more information)


What does the research say?

Reviews published in respected journals (including the British Medical Journal) in the period from 2005-7 have suggested that there is no clear benefit of oral glucosamine or chondroitin as compared to placebo. However, glucosamine is as safe as a placebo.


There have been some less rigorous studies that have suggested that glucosamine is superior to placebo with regard to effects on pain or function but this depends on which system of scoring pain and function is used. Some studies have argued that glucosamine and chondroitin affect subchondral bone remodelling and decrease structural change in the knee- this is still open to debate.


How much to take?

The Arthritis Campaign advises that it is reasonable to trial 1500mg of glucosamine sulphate daily if you have been experiencing chronic knee pain as this may reduce the progression of some aspects of OA shown on XRay and it is unlikely to cause you any more harm than taking a placebo (except to your wallet).

However, it is important to remember that it is possible to have OA changes on XRay but with no discomfort and equally a relatively clear XRay with a lot of discomforts.


Can physio help?

There is general agreement that exercise does have beneficial effects on pain and disability particularly that caused by knee OA.

Physiotherapy advice on a programme of exercise can help you get back on your feet. Generally, it is possible to advise and develop an individual exercise programme with a minimum of two sessions of physiotherapy. You can then use your exercises to maintain and improve the muscular support of your joints.


To book an appointment with one of our Physios, please call us on 01380 730473 or book online. 

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The PRICE protocol for acute injury management

It can be argued that the most important period in terms of minimising the effects of an injury and helping to make the rehabilitation process easier, is how that injury is managed in the first 48 hours.

Things TO DO – the PRICE principle:

  • Protection – immobilize injury wherever possible, this may include the use of crutches, slings or a brace
  • Rest – as guided by your physiotherapist
  • Ice – treat 20 minutes every two hours with an ice pack wrapped in a damp towel to avoid burn
  • Compression – with strapping or tubi-grip, DO NOT wear compression overnight
  • Elevation – keep the injured area above the level of your heart wherever possible

Things NOT TO DO – the AAA principle:

Alcohol – DO NOT drink alcohol, it thins the blood and increases bleeding, thus making an injury WORSE

Activity – DO NOT use an injured limb unnecessarily, it increases blood flow and could increase bleeding, thus making an injury WORSE

Assessment – DO NOT hesitate to seek the advice of an appropriately qualified physiotherapist who can provide further information about how to manage your injury. Only take medicines if prescribed and do NOT exceed the stated dose.


If you are in any doubt as to the diagnosis or severity of an injury you should seek further advice from a qualified health professional.

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Get fit to hit the slopes

When sat in a deck chair buried in the snow, and sipping on a hot chocolate, we can enjoy watching other skiers seamlessly fly down the mountain. However, despite how easy it may look, a good level of fitness is necessary if you want to enjoy your time on the slopes.


Having a good level of strength, stamina, flexibility and balance is key for skiing and without it, you are more likely to get injured.


Skiing is a sport in which you have sessions of moderate to high levels of activity for periods ranging from 1-10 minutes, followed by periods of rest. There is a great deal of continuous muscle activity, particularly in the legs, which you may not be accustomed to.


If you can find the time to work on an exercise programme before you hit the slopes, then this is something we would highly recommend. Even if this means slightly adapting your regular exercise routine so that it is steered towards working muscles that you use regularly when skiing.


We recommend that you begin your pre-skiing programme at least 4-6 weeks before your holiday. The most effective way to do this would be to join our QuickStart Strength & Movement programme which is designed specifically to help you achieve your performance goals, so in this case, becoming a fitter and better skier. To find out more information on our QuickStart Strength & Movement programme click here.


In the meantime, here are a few regular exercises that you can do in preparation for your holiday that could make all the difference:


Warm up and stretching

This is an essential part of any exercise programme. Always aim to spend 10-15 minutes during some static and dynamic stretching. 


Leg and upper body strength work
Your legs will need a great deal of strength to maintain your control down the piste. Static wall squats for the quads is a classic exercise but you need to consider hip strength and stability too.


Core stability
A stable core helps your body work effectively and maintains your balance and control. Make sure you do core work that is suitable for your level of ability. Pilates can be a great option here, and this too is something we offer as a service. Click here for more information on our Pilates membership.


The muscles in your legs need to be flexible enough, especially as they will tighten up after a day on the slopes. Your calf muscles particularly need to be flexible to enable good ankle flex in your boots which helps give you good control.


Taking the time before your ski holiday to prepare will be more than worth it. If you get fit to hit the slopes, you’ll be able to ski for longer, feel less tired afterwards and enjoy the experience a whole lot more. For more advice on how to prepare for the slopes, give us a call on 01380 730473.


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Top Tips for Healthy Feet

From work shoes and trainers to high-heels and bare feet, our feet take us almost 115,000 miles, or five times around the earth in a lifetime, with little or no attention. Take a look at our top tips to help keep your feet in tip-top condition.


Keep Your Feet Clean and Dry

Dirt left on the skin can cause irritation and infections. Remember to wash your feet before going to bed and dry them thoroughly – especially between the toes where moisture can breed germs.


Use a Urea-based Moisturiser

The single best thing you can do for your feet is to moisturise them daily with a urea-based cream. As the skin on your feet is much thicker than other parts of your body a standard moisturiser just won’t cut it. A urea-based foot cream is perfect for replacing lost moisture.


Sand Your Feet

Gently sand your feet using a foot file in slow circular motions. Your feet should always be sanded when dry, as sanding when wet is less effective and can cause jagged edges.


Cut Toenails Carefully

Trim your toenails straight across – trimming down the edges can cause in grown toenails.


Limit Wearing High heels

If you wear high heels for work, limit the time you spend in your heels. Try wearing comfortable shoes to and from the office, and slip into your heels when in the office.


Watch Out for Foot Bugs

Communal areas such as changing rooms for swimming pools and gyms can be breeding grounds for verrucas and Athlete’s Foot. Wear flip-flops to avoid catching these bugs.


Check Your Feet Regularly

Don’t ignore your feet. Check your skin and nails regularly for cracks, blisters, verrucas, nail infections and other signs that things may not all be right. If you notice any changes to your feet, or are suffering from foot pain, contact your Podiatrist.


If you have any questions on foot health or would like to book in for an appointment, call us on 01380 730473.

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What are orthotics and how can I benefit from them?

What are Orthotics?

Orthotics, correctly known as Orthoses, are custom-made shoe insoles or inserts that correct the alignment of your feet to reduce or completely resolve any symptoms.

Although you can buy pre-made orthotics in local shops such as Boots, custom-made orthotics are the most effective way of treating poor foot alignment as they are made bespoke to your feet and for your condition.

If you have orthotics designed for a particular sport, they will be made to support particular movements or positions and support specific loads or stresses associated with your activity.


Orthotics at Hatts

All our custom-made orthotics require a prescription to be taken by a specialist biomechanical Podiatrist, along with a Gait Analysis assessment to identify the corrections required to realign your foot.

At Hatts, this bespoke service is delivered by our biomechanical specialists. In order to create these bespoke orthotics,  a cast impression of your foot will be taken before it is sent off to our laboratory. This ensures that your orthotics fit perfectly to the shape of your feet to support the exact correction required – giving you the most effective treatment possible.

Once your orthotics have been made, they will be fitted and your Podiatrist will advise you on wearing them in. Following your initial wear period, your symptoms will be reviewed and if necessary minor adjustments can be made to your orthotics.

Your custom orthotics will be manufactured to a very high standard using the latest materials and techniques. They are expected to last approximately 10 years with minor refurbishment.

Bespoke orthotics really can be life-changing. It is important not to ignore foot pain as any foot conditions not treated could have a detrimental effect on the way the rest of your body moves.


If you suffer from any kind of foot, knee, hip, or lower back pain, we can help. Book your Gait Analysis appointment online or by calling us on 01380 730473. Appointments are available at any of our clinics in Devizes, Marlborough, or Frome.

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Plantar Fasciitis

Plantar fasciitis affects approximately 10% of the population. Find out about this condition, its causes, symptoms, and how a Gait Analysis at the clinic can help.


What is Plantar Fasciitis?

Plantar fasciitis is a condition that presents itself as a sharp pain in the heel of the foot. It is caused when the strong fibrous tissue that joins the heel to the ball of the foot gets irritated and inflamed. The condition is derived from the words plantar which is the bottom of the foot, and fascia which is the fibrous connective tissue responsible for supporting the arch and transmitting weight across the foot as you walk or run.

Plantar fasciitis is most commonly seen in middle-aged adults and in athletes.


What are the symptoms of Plantar Fasciitis?

The most common symptom is a sharp pain at the bottom of the heel, which can sometimes feel like walking on a marble. It is usually worse when you get to your feet first thing in the morning, or if you walk or run after a period of inactivity. In some cases, pain can also extend along the bottom of the foot where the plantar fascia extends to join the ball of the foot.


What causes it?

Irritation or inflammation of the plantar fascia can be caused by 2 main factors; intrinsic and extrinsic.


Intrinsic factors include:

– Feet with very high arches or very low arches

– Feet that roll inwards while walking

– Tight Achilles tendons or calf muscles

– Being overweight


Extrinsic factors include:

– Standing on your feet for a large part of the day – such as is the case for Teachers and Factory Workers

– Wearing footwear that does not support the foot correctly


How we can help with treatment?

Plantar fasciitis is definitely a treatable condition, with many different options available depending upon individual circumstances. At your Gait Analysis appointment, our Podiatrist will determine the cause of your plantar fasciitis and recommend a treatment plan that is bespoke to you. This could include:


Orthotics: The most effective treatment for plantar fasciitis is the use of custom orthotics, or insoles. Orthotics are are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your plantar fasciitis.


Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. This treatment works best alongside other treatments listed here.


Corticosteroid Injection: This can be effective at relieving symptoms in the short term. Our Podiatrist will use Corticosteroid injections in combination with other treatment options such as stretching or orthotics.


Physiotherapy: You may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your plantar fasciitis.


Massage: If your plantar fasciitis is caused due to tight calf muscles, our massage therapists can help to ease the tension in your muscles, thereby addressing the cause.


Night splint: The use of a night splint may be recommended to help prevent overnight tightness of the Achilles tendon and plantar fascia.


Find out more about a Gait Analysis and how it can help you here >

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Shin Splints

Shin splints is the term used to describe pain along the inner edge of the shin bone usually caused by repeated trauma to the area. Common amongst runners, footballers, and rugby players, find out more about this condition, its causes, symptoms, and how we can help.


What are Shin Splints?

Shin splints are medically known as medial tibial stress syndrome (MTSS) due to the anatomical location of pain which is located along the inside of the shin starting approximately 5cm above the ankle extending up to one-third of the shin bone. It often presents as a deep bruise-type pain.

It is a specific overuse injury-producing pain on activities such as running. Shin splints are more common in females than males with a 4:1 ratio but are still prevalent in men.


What are the symptoms of Shin Splints?

Shin splints typically present themselves as a deep bruise or aching pain. It is often present at the start of running which subsides after a few minutes but then can return towards the end of a run due to fatigue and a change in running biomechanics. It can also be painful first thing in the morning the day after a run. Normally, day-to-day function and walking is unhindered, but shin splints can progress if left untreated. If you experience pain during walking it may suggest a more severe bone injury such as a stress fracture.

What causes it?

Historically there have been a number of popular theories on the causes of shin splints, however, the most recent research findings suggest it is a bone stress injury and is believed to be linked to an increase in bending stress placed on the bone. The bending stress on the bone is greatest at the lower shin and this can be exacerbated due to abnormal biomechanics. There are many reasons why a person may have abnormal biomechanics which may include:

  • Increased foot pronation (flat feet)
  • Poor core stability
  • Poor glute or hip muscle strength
  • Tibial varum (abnormal bone alignment of the lower leg)

How we can help with treatment?

Many different options are available to treat shin splints and these will depend upon your individual circumstances. At your Gait Analysis appointment, our biomechanics Podiatrist will determine the cause of your shin splints and recommend a treatment plan that is bespoke to you. This could include:


Orthotics: Custom orthotics or insoles are one of the most effective treatments for shin splints. Orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your shin splints.


Running Analysis: As shin splints is nearly always linked to running we provide specific running gait analysis to look at your technique which may highlight abnormality or technique issues which can then be worked on via various methods.


Shockwave Therapy: This is an excellent treatment option for chronic or resistant cases and helps increase your healing capacity. Shockwave therapy works best alongside other treatments listed here.


Physiotherapy: You may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be contributing to your shin splints.


Massage: If your shin splints is due to tight leg muscles, our massage therapists can help to ease the tension which provides effective relief of symptoms.


Find more about a Gait Analysis and how it can help you here >

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Flat Feet

Flat feet is the term used to describe feet with low or no arches. In this blog article, you’ll learn about what causes flat feet in children & adults, when you should seek professional help, and what treatment options we can offer you.


Flat feet in children

Children have flat feet from birth until the foot develops, usually between 6-8 years of age. However, after this period not everyone develops an arch. This can be down to genetics and may run in the family and be inherited from parents. If there is a genetic link, this rarely causes problems.

In many cases of flat feet, the feet tend to roll inwards too much during standing and walking which causes flattening of the arches. This may be due to ligament laxity in the foot joints. This is known as pronation. This is a common reason why children have flat feet as they tend to have looser joints than adults. In rare cases, the flat foot shape can also be due to the way the foot formed in the womb, where for example, a joint may be malformed or two or more bones may be fused together. Children’s feet in these cases are stiff and flat, and the problem is usually obvious in childhood.


Flat feet in adults

The people referred to above have always had flat feet. However, occasionally a flatfoot develops later in life. This is known as adult acquired flatfoot. This is most often caused by a ruptured or weakened tendon (the tibialis posterior tendon), ligament laxity in adult life, arthritis or an injury-causing stiffness and distortion of the joints of the foot. In all these cases there is often pain and limited daily function. Some people with neurological conditions such as spina bifida, muscular dystrophy, or cerebral palsy may develop flat feet due to muscle weakness secondary to disease of the nervous system. In neurological cases, the feet are stiff and the deformity tends to get worse over time.


When should I consult professional help?

You should consult a podiatrist if:

  • Your feet cause you a lot of pain when standing or walking
  • Your shoes wear out very quickly
  • Your foot or feet seem to be getting flatter
  • Your feet seem very stiff
  • You cannot feel your feet normally, or they seem weak


What can be done about flat feet?

In many cases, no treatment is needed. This is when there are no symptoms such as pain. If you have pain in your foot, ankle, or lower limbs, it may be due to your flat feet. If you or your child experience pain you should consult a podiatrist for a professional opinion. If your pain is due to your flat feet a podiatrist may prescribe custom-made orthotics, which are medical insoles made specific to the needs of the individual. In some cases, surgery is required to straighten the feet. If you require surgery your podiatrist will refer you to a podiatric surgeon or orthopaedic surgeon


How we can help with treatment?

Orthotics: Orthotics are an excellent treatment for people with painful flat feet or flat feet that are causing pain elsewhere such as the knees due to poor biomechanical control. Our orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact support required to aid your foot’s normal function and relieve the cause of your pain. To assess if orthotics are suitable for you, book in for a Gait Analysis appointment.


Physiotherapy: If your flat feet are caused by muscular tightness, injury, or weakness, you may also see one of our team of Physiotherapists for manual therapy and an individually prescribed exercise programme to help build strength in weak muscles that could be causing your flat feet.


If you suspect you’re suffering from flat feet, we can help. Book your Gait Analysis appointment online or by calling us on 01380 730473. Appointments are available at any of our clinics in Devizes, Marlborough or Frome


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Hitting the target with Devizes Bowmen archery club

It was a grand evening with the Devizes Bowmen archery club on 16th September 2015. The team at James Hatt & Associates welcomed 16 of the club’s members for an evening of presentations and practical exercises, with food and entertainment thrown in for good measure.

Club Treasurer, Neil Lockhart, got in touch with us earlier this summer – requesting if we could host a talk about the impact archery has on specific muscle groups, how to avoid unnecessary injury, and what to do if injury does occur.

This was the perfect opportunity for our Clinical Lead, Guy Kingston and our Rehab Therapist, Ryan Stewart to get their teeth into learning about a new sport and how the specific movements positions and forces involved in archery affects the body.

On the day, club members enthusiastically got involved in the presentation – asking questions, discussing issues, and picking up Guy on his archery terminology!

Ryan too got everybody involved with practising warm-up exercises (at which point some members got carried away with dance-moves), and stretches to warm and loosen those muscles before hitting the targets hard.

Neil Lockhart sums up the evening well – “Guy and his team hit the target with this session providing our members with practical information and specific warm up exercises, which given that our members’ ages range from 11 years to over 80 years old, was a real challenge. Archery is a physically and mentally demanding sport, and I can already see us having a team warm up before shooting on a Saturday morning.”

“I am sure that a few of our members will be seeking further advice from Guy’s team in the near future. It was surprising how many people had some minor injury that never got mentioned until signing up for this session. Although one member’s expectations on reversing the aging process was not met, all other expectations were exceeded!”

A grand evening with the #DevizesBowmen – ‘Get Fit & Stay For for Archery’ presented by Guy Kingston & Ryan Stewart with some #exercises, #entertainment and #food thrown in for good measure.

Posted by James Hatt & Associates – Healthcare Clinic on Thursday, 17 September 2015


At James Hatt & Associates we’re passionate about promoting an active lifestyle, which is why we were glad for this opportunity to work with a local sports club.

If you’d like us to give an informative, practical and fun presentation to members of your club, get in touch with us today.

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Gait Analysis – what is it and why is it useful?

Biomechanics is about the way your body moves and how your lower limb and foot movements can affect you.

Think of your feet as the foundation of your body. If your feet are misaligned or roll too far one way or another, your body compensates for this by changing the way your foot, knee, hip or lower back behave. Over time this change can cause pain to the lower limb and lower back.


Common symptoms related to poor biomechanics include:


  • Foot pain
  • Heel pain or arch pain
  • Knee pain, hip pain or lower back pain
  • Flat feet
  • Toe deformities such as bunions and hammertoes

The most effective treatment for correcting poor foot posture is custom orthotics or insoles. Orthotics are suitable for people of all ages and because they are bespoke to your foot, offer the exact correction required to realign your foot and aid its normal function.


Children & Teenagers – Young children can suffer from flat feet if their arches do not develop correctly by the age of 6-8 years. Being constantly active, children place a host of demands on their growing feet and legs and can complain of many symptoms common to adults.


Adults – You will walk about 100,000 miles in your lifetime, so minor misalignments in your feet can cause pain in your foot, ankle, knee, hip, or lower back. Incorrect or uncomfortable footwear can further aggravate poor biomechanics.


Athletes – Sports that place stress on the foot, ankle, and knees such as running, football, rugby, and hockey require specialist orthotics that not only fit you, but accommodate for the special movements, positions, and forces encountered for your particular sport


Don’t ignore foot pain. If you suffer from any kind of foot pain, knee pain, hip pain or lower back pain call us to book a consultation at our clinics in Devizes, Marlborough & Frome

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How a Gait Analysis helped Paul get back on his bike

Read about Paul’s experience with a Gait Analysis, and how it helped him get back to doing what he loves best – cycling.


My right foot was giving me a lot of discomforts particularly when I went for a ride on my bike. It reached the stage where after only 20 minutes of cycling the area behind my smallest toe was really bothering me. I tried different shoes and thicker socks but it made no difference. As cycling is my main hobby and the way I keep some level of fitness I knew I needed some professional help.


By good chance, I was put in touch with Benn at Hatt Clinic. I went for a consultation which resulted in him recommending I have an injection to calm the inflamed area on my foot. Plus he described the custom insole package that Hatt Clinic provides. It’s fair to say that even though I wasn’t totally sure it would work for me I was becoming so concerned I would have to reduce my cycling I gave the go-ahead there and then.


Benn took a cast of the soles of my feet and I arranged to come back in three weeks’ time.


I returned with two pairs of my cycling shoes as planned and Benn inserted my new shiny insoles into the shoes. They were a good fit in both pairs. Benn explained he had designed the insoles to reduce the pressure behind my smallest toe on both of my feet which seemed a good idea to me. Plus the insoles had a fair amount of carbon fiber which is always good news from a cyclist’s point of view.


I couldn’t wait to get home and go for a ride. Benn had suggested I start with a gentle ride of up to 30 minutes to start with. Naturally, I ignored this sensible advice and decided to go for the Full Monty. I pedaled away from home and went in search of the nearest hill which I blasted up as fast as I possibly could. And then I found another and yet more. In the end, I was riding for just over two hours. The insoles felt great. In fact, I had forgotten all about my feet and was just enjoying the fresh air and thrill of riding. And riding pain-free.


I’ve now ridden around 700 hundred miles in my new insoles and they have been just superb. I’ve also had a follow-up visit with Benn which was all part of the course of treatment that comes with the plan. Thanks Benn!”


If you’re struggling with foot pain, and like Paul, it’s stopping you from doing the things you love, get in touch and book in for a Gait Analysis Appointment

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