DC Injury Clinic

26/02/2026

Don't believe the hype 🤜🏼

How do we therapists explain how treatment(/s) work?

If you seek treatment, what is your understanding of how treatment works?

Do the two align?

... does it matter?!

For therapists, know that our treatments *do* help people in pain (1). Generally speaking, when we follow the 'do no harm' mantra, most treatment modalities (whichever your favourite flavour) offer some pain-relief, and this is vital, and - often - the sole reason for someone booking an appointment.

The mechanics of 'how the treatment works', however, seem to matter less than which treatment modality we choose (2) with other variables including natural history (healing rates), regression to mean, contextual effects (including patient and therapist preferences), biases (including patient and therapist history, experience and expectations), and of course .... drumroll ... placebo (3) taking at least equal importance.

For you, the person in pain, you can rest assured that Manual Therapy treatments have great scope to help people in pain ... just not always in the way that social media would will have us believe 👍🏼

📄1. Effectiveness of treatments for acute and subacute mechanical non-specific low back pain: a systematic review with network meta-analysis. Gianloa et al., 2021
📄2. Do manual therapies help low back pain? A comparative effectiveness meta-analysis, Menke 2014
📄3. Placebo 2.0: the impact of expectations on analgesic treatment outcome, Ulrike, 2020

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🙏 In pain and want that to change? Drop me a message on here!

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23/02/2026

DOMS stands for Delayed Onset Muscle Soreness.

It is the discomfort felt post hard exercise, and it can start more or less straight away, but is often most prevalent 6-48 hours after your session.

There is a common thought process that the more DOMS you are feeling, the better the session you have had, and so the more progress you are making.

But is this strictly true?

In short, No (thanks for reading 😆)

Post-exercise muscle soreness is a poor predictor of muscle damage or trauma, and that muscle damage/trauma is in turn a poor predictor of positive change.

Extreme muscle soreness should not be the aim of your session, and can be counterproductive.

Positive change comes from turning up consistently.

And being able to turn up consistently relies on an exercise regime (or coach) that isn't burying (or "beastin" 🤢) you every session, rendering you out of action for the next 5 days.

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💻 In clinic and remote/online appointments available

11/02/2026

If you work in health or fitness, this will sound familiar 👇🏼

- Clients with pain that just won’t settle
- Missed sessions… or clients quietly disappearing because something hurts
- Wondering “is it safe for them to keep training?”
- Symptoms that don’t match textbooks … or Instagram advice
- Feeling like you’re on your own with tricky cases

For over 15 years I’ve worked alongside PTs, Coaches and massage therapists helping them:

🏋🏼‍♂️ keep clients training (or return them safely)
💪🏼 reduce missed sessions
✅ improve outcomes and retention
🤓 feel confident when cases get complicated

So, I’m offering up something new 🤜🏼

Professional Development & Support for Personal Trainers & Massage Therapists.

This is practical, personalised support to help you help your clients.

There are two ways to work with me:
1️⃣ Ongoing support
🗓️ Monthly sessions (in-person or online)
- Simple explanations of why pain happens
- Joint-by-joint & injury-specific problem solving
- Real client case discussions
- Realistic return-to-training planning

2️⃣ On-demand help
🚨 Ad hoc sessions
- Stuck with a difficult client?
- Want feedback on an assessment or program?
- Need reassurance before trying something new?

Let me know if I can help 👍🏼

08/02/2026

RED-S occurs when there is low energy availability, i.e. when not consuming enough calories to support the energy demands of training.

However, it has more widespread adverse impacts than simply a lack of energy:
- Endocrine dysfunction: decreased training response
- Metabolic disruption: decreased endurance performance
- Bone health: increased risk of bone stress injuries
- Decreased functional immunity: more prone to infection
- Gut malfunction: impaired absorption of nutrients
- Decreased neuromuscular co-ordination: increased injury risk
- Psychological impact: inability to recognise the risk of developing RED-S
- Amenorrhea: the cessation of a woman’s menstrual cycle

Whilst Relative Energy Deficiency in Sport (RED-S) was previously described as the Female Athlete Triad (menstrual dysfunction, disordered eating and decreased bone mineral density), it is not a female only condition, and male athletes should never ignore any of the listed symptoms.

Anyone working with athletes should be acutely aware of these symptom’s and their implications, and of course have the knowledge and skillset to recognise them.

Choose your Team wisely 👍

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💻 In clinic and remote/online appointments are available, Link in bio 👍🏻

05/02/2026

Many runners program hills as part of their training, where a typical session might be finding a local hill, and running up it 10 times/until you're sick.

Often, the downhill bit is seen as recovery ... or, worse, not considered at all.

And yet, conversely, all therapists will regularly hear that pain is worse when going *down* hill.

I believe all runners would benefit from becoming better downhill runners, but especially those runners taking on trails or hilly courses.

The repeated bout effect (i.e. doing it more than once) after downhill running manifests as changes to global and central fatigue parameters and running biomechanics - and without altering the energy cost of running!

Basically, less muscle soreness, less loss of strength, and lower production of creatine kinase (muscle damage).

It makes perfect sense.

📄 Neuromuscular, biomechanical, and energetic adjustments following repeated bouts of downhill running, Arash Khassetarash et al., 2022

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💻 In pain and want that to change? Drop me a message on here!

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⛔ This is not medical advice, and is for educational purposes only. Any exercises are carried out at your own risk.

30/01/2026

This may ruffle a few feathers 🫣

There is always a natural call to authority, and surgeons appear to be at the top of the healthcare hierarchy.

I have been very fortunate to have been invited in to watch multiple surgeries (and one thing I will say, scrubs are commmmmfffy 😆), and the consultants I have the most experience of working with are exceptional surgeons.

But surgeons are trained differently - not necessarily better - when it comes to rehab.

Every department, every professional, on every step of your road to recovery, has its strengths.

But the very best ones are the ones that communicate the clearest and the ones who do not wish to be something they are not, and so refer on.

But I will still come across post-operative rehab cases where the rehab advice they have been given is:

"wear this boot/brace/sling until you feel you don't need it anymore"
"never touch a barbell again"
"you will never be able to run again"

I have never come across a post-operative case (in 15 years) for whom this generic advice fits, or is enough.

And that is because I deal with people; not knees/backs/shoulders/ankles.

Rehab takes time, confidence, adherence - and sometimes someone to walk alongside you.

Let me know if I can help 👍🏼

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📩 In pain and want that to change? Drop me a message on here!

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🚫 This is not medical advice, and is for educational purposes only. Any exercises are carried out at your own risk.

23/01/2026

My STRENGTH & CONDITIONING WORKSHOP FOR RUNNERS have proved very popular recently, and I am hosting another at the end of the month!

By attending this 2 hour workshop, you will;.

🏃‍♀️ Learn the key components of Strength and Conditioning, aimed specifically at running.
🏃‍♂️ Appreciate the importance of why we as runners should strength train.
🏃 Leave with a full repertoire of equipment free, body weight exercises designed to keep you doing the thing you love – running!
🏃‍♀️ Help reduce your risk of injury
🏃‍♂️ Improve endurance, and speed
🏃‍♂️ Understand where and how S&C fits into your program
🏃‍♀️ Critically appraise some myths about common training and therapy concepts! (or how to spot the BS!)

Let me know if you would like to attend the next one, or book yourself in via the website 💪🏼

When: Friday 27th February, 2026
Where: Washbourne House Therapy Centre

17/01/2026

PLEASE READ AND HELP IF YOU CAN.

Friend of DC Injury Clinic Matt has helped 100s of families over the years, and a coupon of days ago had his business (and livelihood) broken into.

Matt has never asked for anything from anyone, but we know that he and his family will be eternally grateful for the support.

Anything you could donate will help to replace these tools so Matt can continue to provide bikes to the local community.

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The bike shed. Old Town.(formerly Run & Repair) is a local bike shop run by local man Matt Jones. Since 2020, over 800 bikes have been passed on for free to the local community through the ‘Bikes for key workers’ scheme during the pandemic and the annual ‘Bikes for kids at Christmas’ scheme by Matt.

Matt won a Pride of Swindon award in 2022 for services to the community.

On 16th January, Matt discovered that his workshop had been broken into. Over £1500 worth of tools were stolen along with bikes. Not only has this affected Matt’s livelihood but he no longer has the tools he needs to fix and pass on the remaining bikes donated by the people of Swindon, to children and families in need in the local community.

Anything you could donate will help to replace these tools so Matt can continue to provide bikes to the local community.

The Bike Shed Old Town (formerly Run & Repair) is a local bike shop run b… Danny Clayton needs your support for The Bike Shed Old Town (formerly Run & Repair)

07/01/2026

If you work in health or fitness, this will sound familiar 👇🏼

- Clients with pain that just won’t settle
- Missed sessions… or clients quietly disappearing
- Wondering “is it safe for them to keep training?”
- Symptoms that don’t match textbooks … or Instagram advice
- Feeling like you’re on your own with tricky cases

Here’s the brutal truth: pain is part of being human. And that pain does not mean you’re a bad coach or therapist.

But the industry now expects more: more knowledge, better reasoning, clearer explanations, and confident decisions - especially when things aren’t straightforward.

For over 15 years I’ve worked alongside PTs, Coaches and massage therapists helping them:

🏋🏼‍♂️ keep clients training (or return them safely)
💪🏼 reduce missed sessions
✅ improve outcomes and retention
🤓 feel confident when cases get complicated

So, I’m offering up something new 🤜🏼

Professional Development & Support for Personal Trainers & Massage Therapists.

This is practical, personalised support to help you help your clients.

There are two ways to work with me:
1️⃣ Ongoing support
🗓️ Monthly sessions (in-person or online)
- Simple explanations of why pain happens
- Joint-by-joint & injury-specific problem solving
- Real client case discussions
- Realistic return-to-training planning

2️⃣ On-demand help
🚨 Ad hoc sessions
- Stuck with a difficult client?
- Want feedback on an assessment or program?
- Need reassurance before trying something new?

Continues in comments...

09/12/2025

“Where you think the pain is, the problem is not.”

A very popular phrase in this industry, made famous by Dr. Ida Rolf.

And whilst it absolutely can be true, there are plenty of scenarios whereby there is a beauty in simplicity.

It is very easy to read a Social Media Rehab Guru (TM) post and worry that that lower leg pain you have must be due to nerve damage, or muscles that are "not activating", or muscles that are "over-activating", or because your pelvis is upside down and inside out, or because of that whiplash incident in 1997 - and to then over-analyze and overcomplicate things to the point where we have lost focus on the issue at hand.

And it is very easy in clinic for therapists to link any issue with a multitude of other issues that you had no idea you had.

Remember, sometimes that calf pain *is* a tensioning of a nerve caused by issues originating elsewhere.

But sometimes...
..just *sometimes* ...
.. it's a calf problem.

Find someone who knows the difference

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🤕 In clinic and remote/online appointments are available, Link in bio

04/12/2025

I see a lot of people who present with hip pain, hip mobility issues, pelvic pain etc. … or simply for an assessment because they have been told that they “look wonky” 🙄

It ranges from elite dancers to farmers; CrossFitters to the relatively sedentary.

Contrary to common (often nocebic social media driven) belief, the visible structure and symmetry of the pelvis is often nothing more than observation.

And whilst the cause of hip discomfort can vary massively, the vast majority of conditions, once assessed, are non-sinister, require very little intervention, and are safe enough to continue all activity to some level.

However there can be times when hip pain is the symptom of something less pleasant, and it is our job as therapists to know what to look out for, and how to differentiate.

If you are struggling with hip pain yourself - or perhaps you are training clients and you are not sure how to help them further (or even if you should) - drop me a message 👍🏼

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🤕 In pain and want that to change? Drop me a message on here!

👍🏼Find this useful? Like, Share or Save for later.

24/11/2025

The next Strength & Conditioning for Runners Workshop sold out in less than 18 hours, which I am very grateful for - thank you to everyone who has signed up: the rewrite starts now to make sure it is always as current and up to date as it can be 🫡

I know there are a few runners who were hoping to attend, or who may still be interested, so I am looking at adding another date early in the new year!

Let me know in the comments if you would be interested 💪🏼