Blooming Marvellous

PhysioExtra is doing its bit for Ham and Petersham’s Britain in Bloom 2019 competition bid.

The weather may be cold, but spring has definitely sprung in the beds surrounding the studio.

Regardless of what the Britain in Bloom judges decide, Leon’s splash of colour has already drawn plenty of appreciative comments from local residents.

Sitting comfortably?

The odds are that right now you are engaged in an activity that is harming your health.

Humans are not built to spend the day sitting, yet that is what most of us now do.

Just some of the consequences are that your gluteal and hip flexor muscleswaste away.

These muscles are important for stabilising you. When they weaken it increases your likelihood of injuring yourself when you do exercise.

“An ergonomically designed chair or workstation is important, but if you just sit in the same position for long periods of the day, you are still going to have problems,” says physiotherapist Leon Almashan.

He and his colleagues at PhysioExtra in Ham, Surrey regularly treat the results of our sedentary lifestyle.

“Most people do nothing until they get a back problem, then go to the doctor who prescribes painkillers,” says personal trainer Johnny Crook. “This only masks the problem.

“People often try to compensate for long periods of sitting by going to the gym and doing intense exercise sessions, or they go running. This can lead to injury if the underlying weakness is not dealt with.”

After a consultation and assessment, the experts at PhysioExtra develop an individual exercise plan that strengthens parts of the body that have wasted away due to lack of use.

“But coming to a personal trainer once a week isn’t going to fix it,” warns Crook. “You need to incorporate these exercises into your daily routine.”

In addition to specific exercises to strengthen key muscles, he also recommends the following simple steps:

  • Walk or cycle instead of driving
  • Use the stairs instead of the lift or escalator,
  • Stand up and walk around every 20 minutes when you are at your workstation


What is the most effective way to warm up?

Whether you are training to run a marathon, planning to play your favourite sport, or doing some gardening, warming-up should be the first thing on your to-do list. 

Doing a few simple movements prepares your body and mind for what you are going to do and, most importantly, reduces the risk of injury by increasing the heart rate and creating warm pliable muscles that are pumped full of oxygen and fuel. 

The most effective way to warm-up depends on the activity you are doing. Fitness levels and activity goals will influence what is included in a warm-up, but there are a few basic techniques that can be used as a starting point for your warm-up routine:

  1. Loosen up… warm muscles by gently mimicking the movements you will be doing in your activity – marching on the spot, squatting, arm circles.
  2. Increase your heart rate… running on the spot, gentle jogging, low resistance cycling, low resistance rowing.
  3. Dynamic stretching… moving your body through a range of movement – shoulder circles, arm circles, hip circles, lunges.

These are just a few suggestions to get you going. Your warm-up should leave you energised and ready to go. Always listen to your body, do not continue with any movements that cause discomfort and remember to cool down after. 

For a more activity-focused warm-up routine, advice on how you can improve and progress your current routine, or more info on warming-up get in touch with us here at Physio Extra, we are always happy to help.

By Nim Ragbir BSc (hons) MHCPC MCSP 

Chartered Physiotherapist

Dr Leon’s casebook

An essential skill for a physio is detecting the root cause of pain.

This is not always obvious, as pain is often referred.

Take the case of a lorry driver who came to PhysioExtra with severe sciatic problems.

He had already seen a series of physiotherapists and an osteopath.

After examining the patient Leon admitted that he couldn’t offer him any more treatment than he had already received from the seven other physiotherapists had seen.

But then he noticed that the patient wore quite tight jeans and carried a wallet in the back pocket.

The lorry driver said that yes, he did sit on the wallet while driving long-distance.

Leon advised him not to.

A week later the patient called Leon: “You’re a miracle-worker. The pain’s completely gone!”

Another patient came to Leon with a locked right knee. The cause turned out to be a corn on the little toe on the left foot. This was causing the patient to shift their weight onto their right leg, resulting in the muscles being overloaded in the thigh.

A bit of rolling out the ITB band and the removal of the offending corn soon cured the patient.

No pain, no gain?


Need help to get fit, but are worried about using a personal trainer?

Plunging straight from your sedentary lifestyle into a sweaty nightmare of pushups while being screamed at by someone standing over you with a six-pack is certainly off-putting.

Thankfully, the reality of training at PhysioExtra is a different story.

“You can’t go from doing nothing to HIT [high-intensity interval training] exercises,” says top trainer Johnny Crook. “If you’re going to get fit, you have to incorporate exercise into your daily routine. Trying to blitz it by going to the gym for an hour once a week is not going to work.”

His technique is to start easy.

“We begin with what you are able to do and repeat volumes of these exercise,” says Johnny. “We then gradually tweak them as basic mobility and strength improves.”

This ‘linear periodisation’ technique feels light and manageable, “but you will be amazed at what you have achieved after a few weeks,” he adds.

(Not a bad metaphor for life in general: break a task into small steps to make progress.)

“Most people don’t come to us to get the perfect body. We work on longevity, so you are going to be able to play with your grandchildren,” concludes Johnny. “But once you’ve built a strong base platform, you can go on to do those HIT classes without injuring yourself.”

Hmm. Seems pain may be unavoidable further down the line after all!


When to see a physiotherapist

A new year a new beginning….

This is the time of year for New Year resolutions with many based on improving our health and fitness. It can be a bit of a challenge to stay committed and motivated, so here at Physio Extra we will be helping you reach your goals with our weekly blogs packed full of useful info such as self-help techniques, basic first aid, info on common conditions and so much more… We would love to hear your comments, feedback and please do get in touch if you have any questions.



This is a very common question, which can be difficult to judge. “Do I wait as it could get better?” or “If I leave it will it get worse?” is the dilemma we can face especially as many of us can experience aches or pain which can be resolved with some form of self-treatment or rest.

The following four questions may help you with your decision:

  1. Is your pain mechanical?

Mechanical refers to the problem being made worse or aggravated by certain movements, activities, or even maintaining certain positions i.e. wrist pain being made worse by repetitive use of a keyboard; knee pain made worse by running; back pain increasing by prolonged sitting such as driving. If there is a mechanical component to your pain a physiotherapist will be able to help you through a biomechanical assessment, then if appropriate, treatment and teaching you exercises to increase your strength and endurance.

  1. Is the pain not changing or getting worse?

Any mechanical pain that is not getting better or even becoming worse would benefit from a physiotherapist’s assessment and diagnosis. This would help with understanding the cause of the problem, working out the approximate recovery time, working on a treatment plan, and taking preventive steps to ensure the problem does not return.

  1. Is the pain very severe and affecting your movement?

If the pain you are experiencing is affecting your daily functional activities i.e. washing, dressing, going to work, a physiotherapist will be able to assess you, form a diagnosis, treat the problem and give advice on the best way to reduce your pain and get you back to full functional ability as quickly as possible. Physiotherapists will also screen you for any signs of serious underlying pathology or problem, which may require you to go to A&E or seek medical advice.

  1. Has the pain been ongoing for a long time and is it preventing you from physical activities and sports?

Often we can feel unable to return to a sport or activity following an injury because the perception of being too weak or being worried about the risk of re-injury. Long-term mechanical problems and chronic pain can cause a restriction in movement due to biomechanical changes like muscle strength or length. A physiotherapist can assess muscle strength and muscle length, which will help formulate specific home exercise programmes. In addition, reduced proprioception i.e. balance and coordination can cause the feeling of being unstable when performing an activity. Through strengthening and balance exercises, Physiotherapy can improve proprioception and help you return to your sports and activities.

Hopefully the above questions will help you with your decision. If you have any questions please do give us a call, we are always happy to help.

Nim Ragbir Bsc (hons) MCSP MHCPC
Chartered Physiotherapist

Stop sitting and save your life in 2019

Right now is the peak time of year for fitness resolutions, but most of us should face the fact: we don’t have the willpower to exercise.

Yes, we know our sedentary lifestyle is killing us with a whole host of unpleasant side effects ranging from back pain and depression to diabetes and cancer.

Yes, we know that regular exercise significantly helps prevents strokes, anxiety, heart disease and dementia.

The government recommends at least half an hour of moderate exercise such as cycling or brisk walking five times a week plus strength exercises that work all the major muscles two days a week.

Richmond may be the sportiest borough in the country with over half of residents carrying out physical activity at least once a week, but 40% of the 40-60 age group in England walk less than 10 minutes a month.

It seems that we all know we should exercise but can’t face actually doing it.

And despite all our good intentions in the new year, we know we will find reasons for not doing it.

So what should those of us who lack the requisite self-motivation do to counter the risk of illness or death caused by sitting?

Gym membership is likely to be a waste of money if you don’t have the motivation to use it regularly.

We think a personal trainer is the way to go if you are prepared to invest in your health.

Not only does PhysioExtra have great people to help get you in good shape, we also offer physiotherapy to heal or prevent injuries.

If your budget doesn’t stretch to a personal trainer, try to factor exercise into your daily routine, rather than making it a separate activity. 10,000 – 15,000 steps a day is a good idea.

As a third of car journeys in London are under 2km, why not leave the car behind and walk? It would also have a major impact on air pollution.

A happy and healthy new year to you all!



Meet Leon’s new daughter, Jenna.

Mother and child are both well and Leon is currently training for a whole new set of challenges with his first child!

Smiling through the rain…

The Physio Extra crew were at their monthly stall at Ham Parade Market on Saturday.

Braving the persistent rain, Leon, Johnny and Nim offered local residents free massages and consultations for aches, pains, injuries, or general health and fitness questions.

They’ll be back again on the first Saturday of the month – and hopefully the weather will be kinder.

Free massage at Ham Parade Market!

Food, fun… and physio!

Free massages and physio consultations will be on offer from Leon and the Physio Extra crew at Ham Parade Market this Saturday, October 6.

They will be out in force this month as the market is celebrating its first anniversary and has turned into a very successful local event.

You will find the team opposite the Texaco petrol station at the Tudor Drive end of the Parade.


So if you have any aches, pains, injuries, or general questions about your health and fitness, why not drop in for a chat with Leon, Claudia, Johnny and Nim.

Leon Almasham