Adapt. Perform. Physiotherapy & Performance

Adapt. Perform. Physiotherapy & Performance Bristol based physiotherapy and sports performance clinic. Helping you ADAPT Quicker. PERFORM Better.

29/04/2026

A clear MRI doesn’t always mean nothing is wrong.

A client recently spent around £400 on a private MRI following my recommendation to get imaging. The scan came back unremarkable. But reading the report, three phrases stood out — low field scanner, limitations of the protocol, and thin joint effusion.

The scanner was 0.3 Tesla. For what we needed to rule out, that wasn’t adequate.
Nobody in that situation did anything wrong. The client went through someone they trusted. That person was trying to help. But this is exactly why understanding what you’re booking matters.

Why field strength matters:
MRI field strength determines image quality and what the scanner can detect. A 0.3T delivers roughly a fifth of the signal of a standard 1.5T scanner. Fat suppression — the sequence that makes bone marrow changes visible, and the earliest sign of a stress fracture — doesn’t work reliably at low field. Research shows 0.3T scanners detect less than half the bone marrow changes visible on 1.5T.

A negative result on a 0.3T is not the same as a negative result on a 1.5T. Not even close.

What 0.3T is reasonable for:
Gross structural pathology — large tears, significant joint changes, ruling out more serious conditions. If something obvious is there, it’ll likely show.

What it struggles with:
Early stress fractures, bone marrow oedema, subtle soft tissue changes. Exactly what matters most in an active athletic population.

Before you book a private MRI — ask:
— What Tesla field strength is the scanner?
— Is 1.5T or 3T available?
— Is this scanner appropriate for what needs to be ruled out?

If you’re in Bristol — 1.5T options are available privately at Vista Health Patchway, Spire Bristol, Nuffield Health Bristol and Practice Plus Emersons Green. Ask before you book.

💾 Save this and share it with anyone considering a private MRI.

Have you ever had imaging that came back clear but didn’t match your symptoms? 👇

21/04/2026

This is the loading framework I use for every Achilles injury.

Tendinopathy. Rupture. Performance. The framework is consistent — but where you start and how you use in each phase depends entirely on your stage of condition, your current pain levels, and your training history.

A reactive flare in a well-conditioned athlete looks very different to a post-rupture presentation in someone returning to sport for the first time. The framework adapts. The principles don’t.

Here’s what it covers 👇

Isometrics — and there’s more than one type.
Overcoming isometric: pushing against an immovable resistance. Pure tendon load, zero movement.
Yielding isometric: resisting a load and holding position under sustained force.
Quasi-isometric: minimal velocity, maximum time under tension — the bridge toward dynamic loading.
In an irritable or reactive presentation this is often where you start and where you stay until the tendon is ready for more.

Heavy slow resistance.
Structural adaptation requires meaningful load and slow tempo. Bodyweight calf raises alone don’t provide the stimulus the tendon needs to actually change. Load it properly.
Stretch-shortening cycle.

The Achilles is a spring. It stores and releases energy — and that’s what running, jumping and changing direction actually demands. Band-assisted single leg pogos are a clinical bridge — the band offloads just enough bodyweight to introduce the SSC before the tendon can handle full load. Then the band comes off.

Sport specific loading.
Up to 90% of Achilles tendon ruptures happen during acceleration and deceleration. If your programme never reaches this phase — the tendon has never been tested at the speeds and forces your sport actually places on it. That’s not a completed rehab.
If your current training or rehab doesn’t progress through all of these at some point — it’s leaving something significant on the table.

💾 Save this. Each phase gets its own breakdown coming soon.

Where are you currently in your Achilles loading? Drop it in the comments 👇

ACL injuries are one of the most feared injuries in sport.And one of the most misrepresented.Most content gives you a si...
08/04/2026

ACL injuries are one of the most feared injuries in sport.

And one of the most misrepresented.

Most content gives you a simple cause and a simple fix. Train harder. Land better. Do your squats. And while those things matter — the reality is considerably more complex than that.

This carousel breaks down the six factors that actually drive ACL injury risk. Some of them are trainable. Some of them aren’t. And understanding the difference is what separates a genuinely effective prevention programme from one that just looks good on paper.

Here’s what’s covered 👆

— Neuromuscular control: around 55% of adult ACL injuries happen without any contact at all

— Hamstring strength: your hamstrings are one of the ACL’s most important muscular protectors
— and eccentric weakness is consistently linked to increased risk

— Biological s*x: female athletes sustain ACL injuries at 2–8x the rate of male athletes in pivoting sports, driven by anatomical, hormonal and systemic factors that are still under-researched and under communicated

— Surface and footwear: artificial turf, stud/cleat configuration, and boots designed around male biomechanics all contribute — particularly in women’s football

— Training load and fatigue: competition carries roughly 7x the ACL injury risk of training. Neuromuscular control degrades under fatigue. Load management protects more than tendons

— Previous injury: around 1 in 5 people who undergo ACL reconstruction will injure either knee again. The contralateral knee tears at roughly double the rate of the reconstructed one — a fact still frequently overlooked in rehab

No programme eliminates ACL risk entirely. But if you play football, rugby, basketball, volleyball or ski regularly — understanding these factors and training the modifiable ones specifically is one of the most important things you can do for your long-term athletic health.

Already posted a reel covering 4 exercises that address the modifiable factors directly. Check it out on the profile if you haven’t seen it.

💾 Save this and send it to anyone who needs the full picture.
Have you or someone you know had an ACL injury? What sport — and was it contact or non-contact? 👇

07/04/2026

You can’t eliminate ACL injury risk completely.

Surface type, footwear, hormonal factors, contact from another player — these are all real contributors that no training programme fully controls.

But the modifiable factors are significant. And most athletes aren’t training them specifically.

Here’s where to start 👇

— Drop landings: train the movement pattern where most non-contact ACL injuries happen

— Nordic hamstring curl: your hamstrings take load off the ACL — train them eccentrically

— Lateral squat: ACL injuries happen in lateral movements, so train there too

— Bent knee calf raise: the soleus influences knee joint load and is almost always neglected
Four exercises. All evidence-informed. All modifiable.

💾 Save this for your next session.
Have you had an ACL injury — or are you actively working to prevent one? Was it contact or non-contact? 👇

01/04/2026

Most hamstring programmes only live in the gym.

But hamstrings get injured at sprint speed — in late swing phase, under massive load, at their longest position.

Your programme needs to go there too.

The 3 exercises every footballer needs 👆

— Nordic for eccentric strength at length

— Single leg RDL for structural capacity

— High speed running for sport-specific exposure

Bonus tip: not ready for flat sprinting yet? Hill sprints are a great bridge — same intent, lower peak load, lower risk.

💾 Save this for your next session.

Which one is missing from your current programme? 👇

Hamstrings don’t tear because they’re weak.They tear because they couldn’t tolerate the load placed on them — at that sp...
25/03/2026

Hamstrings don’t tear because they’re weak.

They tear because they couldn’t tolerate the load placed on them — at that speed, at that length, at that moment.

Most rehab and prevention work misses this completely.

Swipe through to understand what’s actually happening when a hamstring goes — and why the standard advice keeps letting footballers down.

Part 2 coming soon: the exercises that actually fix this.

19/03/2026

A lot of people get plyometrics wrong.

They start with high-intensity reactive work…

Without building the ability to control and manage force first.

Single-leg plyometrics can expose your body to
~4-8× bodyweight

That’s not the issue.

The problem is when the system (your body) isn’t prepared for it.

Before progressing, you should be able to:

* Control landing and manage force
* Demonstrate adequate strength
* Tolerate repeated loading
* Maintain movement quality

Because plyometrics increase:

👉 Force
👉 Speed
👉 Tendon load

High force doesn’t cause injury.
Poor preparation for it does.

18/03/2026

Plyometrics aren’t just about jumping higher.

They’re about how your body:

• controls force
• stores energy
• returns it efficiently

During the stretch–shortening cycle, muscle and tendon work together as a single unit.

Muscle produces and regulates force.
Tendon stores and rapidly returns energy.

Strength training builds the capacity of this system.
Plyometric training teaches it to perform.

With training, the system becomes more efficient — allowing greater power output with less energy cost.

This is why plyometric training should be:

👉 progressed
👉 dosed
👉 individualised

Based on:

• injury status
• strength levels
• total training load
• sport demands

True plyometrics aren’t just reactive.
They’re efficient.

12/03/2026

How to progress plyometrics.

Plyometrics aren’t just “jump training”.
They should usually progress through stages that build the ability to accept, produce and reuse force safely.

A simple framework:

1️⃣ Accept force
Landing mechanics, eccentric braking and tendon tolerance.

Examples: snap downs, step-off landings

Suggested exposure:
2–3 sets × 3–6 contacts
(~10–20 total contacts)

Focus: control the landing before progressing.

⸻

2️⃣ Produce force
Developing jump power and concentric impulse.

Examples: squat jumps, broad jumps, box jumps

Suggested exposure:
3–4 sets × 3–5 contacts
(~10–20 total contacts)

Focus: maximal intent and clean mechanics.

⸻

3️⃣ Rebound force
Introducing faster stretch–shortening cycle work.

Examples: pogos, hurdle hops, line hops

Suggested exposure:
2–3 sets × 8–12 contacts
(~20–35 total contacts)

Focus: quick ground contacts and stiffness.

⸻

4️⃣ Repeat force
Applying elastic power repeatedly in sport.

Examples: bounds, reactive hops, cutting drills

Suggested exposure:
3–4 sets × 4–6 contacts
(~15–25 total contacts)

Focus: maintaining speed and control under higher intensity.

⸻

The biggest mistake in plyometric training is progressing because the exercise looks easy, rather than because the athlete is ready.

Before moving to faster reactive work, athletes should typically demonstrate:

• good landing mechanics
• adequate strength for the task
• tolerance to repeated contacts
• pain and swelling settled (in rehab)

This progression is useful across ACL rehab, tendon rehab, runners and field sport athletes.

True plyometrics are earned.

⸻

03/03/2026

Running requires:

– Elastic energy use (SSC)
– Force production
– Repeated load tolerance

Power improves stiffness.
Strength builds force capacity.
Accessory work addresses common deficits.

Training to improve capacity isn’t random — it’s specific.

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19 Backfields Lane, St Paul's
Bristol
BS28QW

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