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






‘Absolutely phenomenal!’


After eight months of being unable to walk and after countless other treatments, Franco Gasparotti turned to Leon Almashan at PhysioExtra – and today Franco is setting off on an expedition to Mount Kilimanjaro.

Franco suffered Post Traumatic Stress Disorder after being seriously injured in the Coldstream Guards in Ulster. His weight ballooned to 27 stone as a result.

After losing an incredible 17 stone and reducing his waist size from 72 to 32 inches he is now a fitness consultant

He still needs skinfold removal surgery and is raising funds through the Kilimanjaro expedition.

The whole trip was put in jeopardy due plantar fasciitis.

“My heels were so bad, I could hardly walk,” says Franco. “I tried everything, then heard about Leon’s Shockwave treatment at PhysioExtra. I could hardly walk 12 feet, but the day after the first session I walked 12 miles and I’ve been walking 15 miles a day ever since, catching up on eight months of missed training.

“I can only describe the results of Leon’s treatment as absolutely phenomenal!”

For further information about Franco’s appeal: https://www.gofundme.com/francoappeal


Lose your ‘spare tyre’ – it can kill

Having a ‘spare tyre’ around belly worse than being obese, a long-term scientific study has found.


The Annals of Internal Medicine in the US found that normal-weight men with extra fat around their middles were twice as likely to die than those classed as overweight or obese.


The damaging effect on women was slightly less pronounced but still increased their risk of death by up to 40 percent.


This is because having a “spare tyre” is connected with the accumulation of visceral fat around the internal organs


Unlike subcutaneous fat, which lies just below the skin, deep-lying visceral fat is associated with many health problems, including type 2 diabetes, high blood pressure, and high cholesterol.

The good news is that you can do something about it. And no, the right response isn’t to put weight on all over!


Eating less calories and burning off calories is the way to go. A weight loss of five to 10 percent of your total body weight can help reduce visceral fat stores.


You can work with a dietitian to design a nutrition plan for you that focuses on improving your health.


To start with, increase your exercise – any activity that gets your heart rate up and you moving for an hour is good. This should also be mixed with some high-intensity training.


For every 10% of overall weight loss, you lose 30% of your visceral fat – and you can target it effectively with a 60-minute workout involving rowing machine sprints, light weight reps, squats and press-ups, for example.


Weight loss takes time. Don’t expect to lose weight overnight – you didn’t gain it overnight.


So maintaining motivation is key – and a good trainer is invaluable for this.






Weekend warriors

Someone with a shaven head in combat fatigues screaming at you as you agonisingly push your body to its limits.

If this is what comes to mind when you hear the words ‘boot camp’, think again: at PhysioExtra’s new Saturday morning boot camp on Ham Common the trainer, Austin, doesn’t wear any military clothing.

And he is actually a nice lad who certainly knows his stuff when it comes to varying exercises and stretches.

Quite a lot of the hour consists of warming up then stretching down.

Frankly I was knackered after the warm up. The press-ups and squat thrusts on the circuit demonstrated what I already knew: I am unfit. This felt harder work than pushing my ageing body around the park for a gentle jog once a week.

One of the positives about training in a group is that there is usually someone suffering more than you – or someone who makes it look easier, shaming you to not collapse in a sobbing heap. In other words: it caters for a mixed range of abilities from the super keen to the reluctantly resigned.

And despite the macho name, it’s more about encouragement than pressure. You do the exercises to your own level and can do simpler variations if you have any injuries (or are just decrepit like me).

If you haven’t done it before, it’s basically circuit training outdoors – which is marginally preferable to being in a gym. Especially if you have an aversion to Kiss FM.

Ham Common is beautiful. And being a nice area, there isn’t any dog poo.

The session costs £10 and the first one is free (plus a complementary beverage at the nearby café). It starts at 10 a.m.

You certainly feel like you’ve earned a weekend of sloth and indulgence afterwards.






Gardening injury prevention tips


Gardening has a rather gentle, sedate image, but perils await the unwary in the shrubbery!

Besides biting insects, harmful chemicals, sharp equipment and (for a couple of days a year anyway) sunstroke, the bending, lifting and twisting involved is a common cause of injury.

Gardening is an excellent workout, as anyone who has lugged a 40-pound bag of compost or spent an afternoon yanking out knotweed can tell you. And it should be treated like a sport by warming up beforehand – especially at the beginning of the season, or day, before you have limbered up properly.

Lower back injuries like slipped discs are not uncommon, but the good news is that a lot of injuries are preventable.

It’s tempting to try and get everything done when the weather is inviting, but don’t go mad and try to do everything in one go – break it down into gentler sessions, alternating between tasks to avoid overstraining the same muscles.

  • Drink plenty of water to keep your muscles hydrated.
  • Warm up with a hot shower or a brisk walk. Circle your arms
  • Take frequent stretching breaks – stand and lean backwards with your hands on your hips.

Leon back

  • Reach overhead and rotate your head side to side.

Leon stretch arms Leon arm behind head Leon arms to side

  • Roll the shoulders.

Leon shoulder 1Leon shoulder 2

  • Wear clothes that you don’t mind getting dirty so you don’t carry mucky things at a distance from your body, putting extra strain on your lower back and neck. Clutching that flowerpot close to your body reduces the strain tenfold.

Leon bucket wrong Leon bucket right

  • Don’t dig when the ground is too dry or the soil is too heavy with water. When digging, insert the blade of the shovel in the ground vertically and lift a small amount of soil at a time.
  • When raking, step into the movement, rather than bending forward and stretching out your arms.
  • Avoid overstretching. When trimming branches or high hedges, avoid strain on the neck use a stepladder or long-handled tools with bring the work within reach.
  • Use a gardening stool for weeding to avoid bending from the waist and using your back muscles.

Leon bend wrong Leon bend right

  • Evenly distribute your body weight while lifting and contract your abdominal muscles. Lift with the legs, bending the knees. Or ask someone to give you a hand with the heavy lifting.
  • Work at waist height with elbows bent and arms at your sides whenever possible. While mowing the lawn or pushing a barrow keep the back long and arms close to your sides with hands near hips.
  •  Don’t overfill the wheelbarrow. Two journeys with lighter loads is safer.
  • Avoid twisting the back. Keep your nose between your toes so the hips, shoulders and feet are turning in the same direction.
  • Likewise, when potting or pruning, make sure the hips, shoulders and feet are facing what you are working on. An adjustable workbench is a useful tool to avoid bending.
  • Warm down afterwards– repeat the stretching exercise, walk around the garden, and then soak in a warm bath.

Leon twist Leon twist 1 Leon quad Leon back of shoulders Leon bos start Leon knees Leon calf Leon crouch

Gardening is a great way of staying fit and getting into the habit of following these few simple steps will help you stay that way.

And if you already have an injury, give us a call and we’ll help get you back into the garden as soon as possible.