NHS Shared medical records

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People in the Carlisle area are receiving leaflets from the NHS relating to shared medical records across the region.

Practitioners within the NHS can now view your NHS medical records or appropriate section of it through a linked records system.

Your details with us remain unaffected by this change, as The Sportsphysio injury clinic is a private practice and does not have access to the linked network.  Consequently, you can be assured that none of your records held with us can be viewed on this system.

If you require more information about the NHS shared records system, you can speak to your GP or alternatively visit the Cumbria NHS website.

 


Ski Orthotics

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The Sportsphysio.com provide custom built orthotics for your ski boots.

The majority of ski boots have a fairly neutral footbed but not everybody has a neutral foot.

ski boots

Custom built ski orthotics can help you get the best from your boots

When your feet are correctly aligned within your ski-boots, you will be better able to regulate your balance, distribute your weight evenly and have greater control of your skis.  This can result in a dramatic improvement in your skiing.

Muscular or skeletal imbalances which may not be noticeable when walking, become amplified when skiing.  The smallest movement from a leg, pelvis or spine will have a great impact on the position of your skis, often requiring large corrections by the body, resulting in unnecessary and awkward movements from the torso, shoulders and arms in order to maintain balance.

Poor foot/ski alignment places greater strain on the ligaments of the knee, the hip and lower spine.  Correcting the alignment reduces this strain and reduces the risk of injury.  This is even more important in beginners who need to concentrate all of their efforts on technique.

Specific ski orthotics are designed to support the foot and control problems such as pronation and supination.

Why Ski orthotics?

People can be forgiven for thinking that if they wear orthotics in their every day shoes and trainers, these orthotics will just transfer to their ski boots.

Unfortunately this is not the case and doing so may cause more problems than you started with.

Normal orthotics or corrective insoles are designed for our  general, walking standing or running gait.  However, when we ski, the weight has to be perfectly balanced with the bulk of the body weight shifted to the midfoot.

Feet are fixed in one position on the skis and movement is now controlled by our body position, rather than through the foot.  The foot is a complex collection of joints which articulate in many directions to allow us to walk.  In skiing, this movement is superfluous and indeed annoying, as even the smallest motion becomes amplified when transmitted through the skis.

Ski orthotics can only be custom fitted, the wide variance in foot types combined with ski boots makes off the shelf orthotics useless for this application.

Other snow sports orthotics

The Sportsphysio.com can also custom fit specialist orthotics for snow boarders, ice hockey and ice skates.

The Sportsphysio.com Ski Boot Clinic - provides a skilled ski boot alignment service to help you avoid injury and get the best from your ski boots.


Choosing Ski Boots

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Ski boots are the technical interface between your body and your skis, so the better the fit, the greater your control.

Ski boots are not like normal footwear, a fashion item or statement about the size of your wallet.  They are a technical device designed to allow you to balance and control your skis.

Not only do your ski boots need to align correctly with your foot but choosing the correct size and type of boot is important.

Ski boots

You invest a lot of money in your skis and boots. We can ensure you get the best from them

Unfortunately, many skiers wear the wrong type of boot which are often too rigid.  This results in injury and technical problems.

Ski boot technicians

The first thing you need to do when buying ski boots, is find a skilled technician who has a good working knowledge of the boots they sell and can match the correct shell and liner to your foot, requiring the least amount of modification.

If you are greeted by “What shoe size are you?” or “What style / colour would you like?”…HEAD FOR THE DOOR!

One of the first things a ski boot technician should ask you is, “How often do you ski?” and where.  (This is no time to enhance the truth and try to make out that you are a maverick black run artist when in fact you go on two holidays a year and stick to the intermediate slopes).  This very important question has a great bearing on the fit of your ski boots;

  • People who ski less than 4 weeks in the season, will generally take more than one season to break in their boots. In this case the ski boots can offer a little more comfort. Unbroken boots which are too stiff can lead to misery on the slopes.
  • For skiers who ski more than 4 weeks per season and are more technically sound, a closer fitting boot will be necessary. These skiers will start to “pack out” their boots in only couple of weeks.  In these cases, a boot which is initially too comfortable will develop spaces, which allow dangerous shifting of the foot and poor energy transfer.

A skilled ski boot technician will measure your feet barefoot.  They should also be able to evaluate your feet in weight bearing and non weight bearing positions.

Any adaptations to how you distribute weight through your foot should be referred to a skilled biomechanics expert, who will custom build footbeds for your boots.

There are many fancy gadgets on the market that purport to allow “footwear fitters” to evaluate your gait by standing on a fancy plate and giving you amazing looking computer graphics.

Not only is this dangerous for normal footwear but is an absolute NO NO for ski footbeds, as these machines have no ability to evaluate your posture, movement or gait and taking a pressure measurement in standing or normal walking mode is pointless in this instance.  Gait analysis should always be carried out by an expert.

Ski Boot Flexion test

Regardless of your level of skiing, how the boot flexes is important and will be driven by the material that the shell is constructed from.

Testing flexion should be done with your weight evenly distributed on both feet, in a typical flexed skiing position and should ideally be done in a colder environment.  (The shell is designed to work in sub zero temperatures, not the heat of a shop).  Whilst testing in the cold is not always an option, a skilled technician will know the qualities of the shell and be able to advise.

If your boots are not flexing enough, try loosening the power strap or the top buckle to achieve your desired range. If this does not work, then professional “cutting” as described below, may be an option.

Beware the “one foot test”

Unfortunately, the ski boot flexion test is often carried out incorrectly, with the skier being asked to stand on one foot and flex forward as far as he or she can. This, combined with the heat of a shop, will never give an indication of the boot’s flexibility, neither do we ski on ONE foot.  This technique should ring alarm bells!

Ski boot materials

Some light or entry level ski boots are made from Polyolefin.  Whilst this material is more economical, it can stiffen too much on a cold day.

Most mid range ski boot shells are are constructed of Polyurethane.  Recent grades of Polyurethane offer improved low temperature flexibility and impact strength in a thinner shell, so are not quite as “clunky” as their earlier counterparts.

Higher end boots are generally constructed of Polyether, a material which has exceptional thermal stability and is very impact resilient, giving a consistent flex in varying temperatures.

Adapting Ski Boots

Buying a tighter fitting ski boot may not be the most comfortable but there are many techniques which can be employed to custom fit the boot to you.

Punching & grinding - Ski boot shells can be “punched” or “ground” to ease pressure points and it is always easier to do this than try to fill spaces.

Cutting – This technique is employed by racers to achieve a customised flex with the right amount of ankle and knee range of motion. If your boots will not flex in the cold, then professional “cutting” is an option.

Ski boot footbeds - Custom made footbeds or orthotics will fine tune the fit of the boot.  Most ski boots have a neutral foot bed and most people do not weight bear neutrally, this allows too much dangerous foot movement inside the boot, so regardless of your level or type of boots, having custom built footbeds will achieve a better fit and give you greater control.

It is important to point out that if you wear orthotics  in your shoes or trainers, these must never be used in a ski boot, as the stance and weight bearing is completely different.

Canting- If you apply too much pressure to the outside or inside of the foot and this cannot be fully corrected with orthotics, then a specialist can grind the sole of the boot or add a corrective device (shim) to bring the foot into neutral.  The little widget near the ankle of your boot labelled “canting screw” has nothing at all to do with proper canting but is a device for aligning the cuff of the boot with the foot.

Fitting ski boots

  • Always wear your ski socks to try boots on.
  • Secure your upper cuff buckles and power strap.  Buckles should only require the pressure of a couple of fingers to fasten.
  • Locate the bottom buckles over your instep and toes, flex forward until your shin is pressing hard against the boot tongue.  Now fasten these buckles, to give a snug but not too tight fit.  This technique allows your foot and liner to move back into the correct position in the shell, making sure the heel is located securely and allowing the toes more room.
  • When you stand up, your toes should gently touch the front of the liner and the heel should not be able to lift freely in the boot.  In the ski position, the foot should slide back, taking the pressure off your toes.
  • A neutral stance, with just enough flexion in the ankle and knee to allow the weight to be taken on the midfoot is the position your boot cuff should be in.  Many people adjust too far forward with the result of greater strain on knee ligaments, increasing the risk of injury.

Rental boots

Rental ski boots are usually well “packed out” which results in them being soft and flexible with too much room for the foot.  Whilst you will never achieve the custom fit that a pair of your own would provide, there are instances where hiring ski boots is the only option.

However, if you employ the same principles as though you were buying a pair, you should achieve a better fit.

Remember that ski boots are a technical device, they are not general footwear and as a rule do not feel all that comfortable to stand or walk in.


OHD training services

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Sportsphysio.com Occupational Services can provide risk assessment and management solutions to help businesses comply with current guidelines.

Many companies have their own occupational health departments and training the trainer, to allow them to keep up to date with latest research is an important factor in minimising risk and managing MSD’s.


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