The Hip Flexor Stretch

The Hip Flexor stretch is a common exercise used in both gym and rehab settings. Personally I use it a lot in conjunction with many other movements, in the treatment of musculoskeletal disorders and sports-related injuries.

While it can be an excellent prescription for many individuals, it is very often performed wrong. Some simple queues to help make sure your technique is spot on are:

– Tighten your tummy
– Squeeze your bum (glutes) on the side being stretched
– Try not to arch through your lower back
– ‘Spread the ground’ with your feet

Once your form is correct you can play around with the angle of the stretch for even greater results. Because of the oblique orientation of the iliopsoas muscle (hip flexor) I find that adding a slight degree of rotation towards the opposite knee can allow for further lengthening of the muscle and a better all around stretch.

This stretch, when prescribed in conjunction with good strength-based rehab exercises, can help to improve reduced hip mobility. And improved hip mobility has strong links to decreasing low back and knee pain.

Give it a try and let us know how you get on.

Riain Casey, M.I.S.C.P.

Chronic Ankle Instability

Chronic ankle instability is an encompassing term used to classify an individual who presents with both mechanical and functional instability of the ankle joint following an initial lateral ankle sprain injury.


Mechanical Instability refers to measurable laxity of the ligaments, i.e. ligaments that are less stiff following injury, with some joint restrictions and synovial changes. Functional Instability is the lingering feeling of giving way or unsteady feeling which is generally attributed to neuromuscular and proprioceptive deficits.


Research has identified a number of potential reasons for long term issues with ankle instability after a sprain. One theory is that the ankle proprioception, where the joint is in space, is impaired creating an impaired reflex arc of the muscles that help stabilise the ankle joint. Swelling of the joint can cause the feedback system of the ankle joint to also alter and cause long term neuromuscular deficits.


So clinically, what can we do to help and reduce this occurring?


  • Reduce pain and swelling of the joint
  • Loading in functional tasks as soon as possible e.g. walking, running, cutting
  • Establish baseline strength and power
  • Improve proprioception of the ankle joint
  • Practice tasks that are important to your need
    • Cutting
    • Agility
    • Deceleration
    • Landing/jumping mechanics


Thomas Divilly

M.I.S.C.P., C.S.C.S.

What is Dry Needling?

Dry needling is a therapeutic approach in which fine filament needles are inserted in to specific points on the body to relieve pain and improve function. The needles used are the same as acupuncture needles but a different treatment technique is used.

What is a Myofascial Trigger Point?

Myofascial trigger points (MTrP) are described as knotted/taut bands of muscles that give characteristic referred pain on pressure. These points can be the source of acute/chronic pain and also lead to other dysfunctions. There are several reasons why MTrPs develop in muscles. The most common are overuse, over stretch, over loading and trauma to muscles. Pain is produced due to muscle spasm which is a protective mechanism of the body. Some muscle fibres develop stubborn spasm, become tangled and do not allow normal muscle function. This causes the reduction of blood flow to the area, bad chemicals build up at the site and the body can’t flush them out due to the poor circulation in the area. These chemicals irritate surrounding nerve fibres and hence cause pain.

How does it help?

Dry needling causes a series of processes to occur at the site of the needling helping to reduce pain and aid healing processes. Twitch responses cause the muscle fibres to untangle and restores normal function. Increased blood flow to the area after needling, flushes out the pain producing chemicals and helps with the healing process.

Is dry needling safe? / What can I expect from the treatment?

Dry needling is generally safe and serious side effects are very rare. The most common side effect is when people experience soreness at the needle site which may last for a few hours, you may also notice a little bruise near the needle site which will fade within a few days.

There is no fixed pattern of effects after needling. Some report initial increase in symptoms followed by great relief, while other report immediate or gradual relief of pain. On rare occasions, people may feel very happy, tearful, sweaty or cold for some time. Drowsiness is also reported in a few cases. If it is your first treatment it is not advised to drive long distances immediately after as it is not possible to predict how one will react. Fainting may occur in a very small minority of people. There are no lasting ill effects of these side effects.

What if it doesn’t help?

Dry needling can give excellent results in appropriate cases. It is a great treatment tool but only one component of your overall therapeutic regimen. Your therapist will explore other treatment options if you fail to recover.


Catherine Simpson MISCP 

Iliotibial Band Syndrome-Lateral Knee Pain

Iliotibial (IT) Band Syndrome, or Lateral Knee Pain is an overuse injury caused by friction and compression of the structures between the IT band and the outside of the knee. Training errors and biomechanical abnormalities are some of the factors that predispose to IT band syndrome.

It is commonly an issue seen in cyclists, runners, army recruits and endurance athletes. IT band syndrome accounts for 15- 24% of overuse injuries in cyclists and 1.6 – 12% in runners. Pain generally worsens the longer the person persists with the sporting activity and may be associated with local swelling and inflammation of structures between the band and the inside of the knee.

A full assessment should be carried out to rule out other causes of lateral knee pain such as lateral hamstring tendinopathy, degeneration of the lateral meniscus of the knee, osteoarthritis of the lateral compartment of the knee or referred pain from the low back.

A general misconception is that the IT band can be stretched; when in fact it is just a thickening of the fibrous tissue that surrounds the thigh like a stocking and is restricted by strong attachments to the lateral side of the knee. The TFL (tensor Fascia lata) and ¾ of the gluteus maximus muscles insert into the IT band and it is these muscle that should be targeted to reduce the tension in the IT band and therefore leads to compression of the inside of the knee.

Manual soft tissue therapy through foam rolling, stretching and trigger point release of the hip musculature are useful techniques to reduce the tension through the IT band and relieve the irritation of IT band syndrome.

Catherine Simpson

MISCP MSc. Sports Medicine


Five Tips So You Can Avoid Injury

Sports Physio Ireland’s physiotherapist Riain Casey talks us through five tips so you can avoid injury.

Many injuries can be easily prevented. Some times small adjustments to our everyday lifestyle can have a big impact in injury prevention.

Simple things like correctly fuelling the body and a good healthy sleeping pattern are key to aiding the body recover from on-field activity. Coupled with a specific warm up to prep the body for the demands on field, good proper movement based training and maintaining fitness levels to meet the demands of the activity can greatly help reduce the risk of injury or re-injury.

Try out the tips and let us know how you get on.

Why Do You Have Back Pain?

Low back pain is the single most common cause of disability worldwide, with an estimated 80% of our population expected to experience some form of back pain at some point in their lives.

But why back pain?

The way we have evolved as a race means that most of us spend the best part of our day sitting, whether that be at a desk in work, in front of the TV, or in the car driving. It is very difficult to maintain perfect posture for these extended periods of time, therefore, as fatigue sets in, and we begin to ‘slouch’, we can easily place unwanted stress and tension on some of the joints and ligaments of our spine.

Why does it keep coming back?

We’ve all been there. You have been diagnosed as having a ‘slipped disc’ or a ‘trapped nerve’, a few treatment sessions later the pain has resolved and you have resumed your everyday life. Great. One year later, the exact same thing happens again and you are back to square one.

What we do differently at SPI?

At SPI, we base our whole assessment around discovering the ROUTE CAUSE of your pain. Whether that be muscle Imbalance, poor pelvic/core stability, reduced one legged control, postural issues, among many others, we work hard to correct these problems to ensure that your back pain does not become a recurring issue.

Here are some of the exercises I like to use to combat some of the issues mentioned above. Give them a try and let us know how you get on.

Riain Casey
Chartered Physiotherapist

MCL Injuries

We recently seen Karl Lacy tog out and play against Mayo with heavy taping on his leg to protect a recent Medial Collateral ligament (MCL) injury.

The medial collateral ligament is a band of tissue that connects the thighbone to the lower leg and helps prevent the knee from buckiling inwards. It can be injured when twisting or landing or when a standing leg is tackled from the outside forcing it to buckle inwards.

Initial management should be

  • Compress with a bandage
  • Use crutches to take the weight off
  • Apply ice pack

What are the symptoms?

  • Swelling.
  • Pain.
  • Local tenderness on the inside of the joint.
  • Bruising.

Specific tests and scans can diagnose the extent of the damage and the length of time the player will be out of action for. In Karl’s case, he obviously needed more time to regain 100% confidence in his ability the twist and turn to make those turn overs he has been famous for over the past few seasons.

Mild or Grade 1 injuries usually get better in 1 to 3 weeks and may only needhome treatment along with using crutches for a short time.

Moderate or Grade 2 injuries usually get better in about a month. You may need to wear a hinged knee brace and limit how much weight you put on your leg.

Severe or grade 3 injuries may require wearing a hinged brace for a few months, and limiting weight on the leg for 4 to 6 weeks.


Phase One Meniscal Tear Rehabilitation


When the knee suffers a meniscal and osteochondral fracture injury, it’s ability to absorb forces produced from stepping, running and cutting is diminshed. It’s essential to slowly and progressively load bear the joint in movements that simulate and compliment the movement patterns of the sport.

See the video of Sports Physio Ireland client, Ciaran, week one with Thomas, one of our Physiotherapists and Strength and Conditioning Specialists going through his initial rehabilitation.





Calf Strain fixing

Calf strains are one of the most common and preventable injuries in GAA athletes. A calf strain involves a pull or tear to one or more of the muscles at the back of the lower leg. These muscles are responsible the movement at the ankle which involves pointing your toes away from the body and play an important role in your walking and running patterns. A calf strain will therefore make it difficult to walk or play pain free when injured.

The Rehab of a calf strain will depend on the severity of the injury. The severity of the strain can be divided into grade one, two or three.  A grade 3 strain is the most severe and can take up to 12 weeks to recover from.

Initial treatment consists of ice and rest for the first day or two but the player should be up jogging and doing bike sessions within the first 3-5 days. Strengthening will be key before returning to the biggest challenge… Sprinting

Here is a sample a few of the Mobility/Strengthening Exercises incorporated into rehab sessions.

Let us know how you get on.

Joey Boland