Waterfall Physio

Waterfall Physio Your journey back to good health

16/11/2025

A well-known study of over 400 high-level endurance athletes (Ristolainen et al., 2014) found something important:

🔹 Athletes who took fewer than 2 rest days per week had a 5.2× higher risk of overuse injury.
🔹 Athletes who trained more than ~700 hours per year had roughly 2× the risk.

Pretty striking… but here’s the nuance you rarely see in social posts 👇

🧠 What This Really Means (Not Just “Take 2 Days Off”)

Before you panic about having exactly two rest days — let’s break it down intelligently.

The study suggests:

Athletes who never create space for recovery accumulate load faster than their tissues can repair.

Overuse injury risk rises when training is continuous and high-volume with no meaningful down-regulation.

BUT…

“2 rest days” doesn’t mean two full couch-bound days every week. It means two days where the global load drops enough for your body to recover.

For many endurance athletes, a “rest day” may be:
✔ Active recovery (easy Zone 1 spin, swim, or walk)
✔ Technique-only sessions
✔ Mobility, conditioning, or strength at low load
✔ Sleep + nutrition-focused day
✔ A day off running but light cross-training

The spirit of the finding = you need structured, deliberate recovery — not perfection.

🔍 Study Limitations You Should Know (Because Context Matters)

Even though the headline finding is useful, here are the caveats:

1. Retrospective + self-reported — athletes recalled symptoms and weekly rest days after the fact, which introduces memory bias.

2. “Rest day” wasn’t standardised — we don’t know if that meant total rest or light activity.

3. Group = Finnish high-level athletes aged 15–35 — findings may not generalise perfectly to recreational athletes, older athletes, or people with different training structures.

4. Training volume measured broadly — not broken down into intensity distribution, surface, monotony, or spikes in load.

5. Overuse injury was based on questionnaires, not clinical diagnosis — so definitions might vary between athletes.

In other words: the direction of the message is strong, but the exact numbers aren’t gospel.

🏁 Practical Takeaways for Real Athletes

As a physio working with endurance athletes every day, here’s the real-world interpretation:

1️⃣ You need recovery days — but they don’t all have to be full days off.

Aim for two days each week where intensity and load are meaningfully reduced.

THIS CAN AND MUST CHANGE AS YOUR TRAINING AND RACING CHANGE!!

2️⃣ If your volume is high (or you’re older, busy, stressed, or in a heavy block), you need more recovery, not less.

Life load = training load.

3️⃣ Watch for consistent soreness, sleep disturbance, rising resting HR, or performance drop.

These are earlier signals than injury.

4️⃣ Consistency beats bravado.

Skipping recovery doesn’t make you tough — it increases your injury risk.

5️⃣ Think long-term athletic durability.

Recovery is a performance enhancer, not a sign of weakness.

16/11/2025
16/11/2025

Every year on 14 November, we recognise World Diabetes Day, a reminder that managing diabetes goes far beyond medication. Lifestyle changes, education, and regular physical activity play a vital role in preventing and managing the disease.

Physiotherapists are key members of the diabetes care team. Through individualised exercise programmes, mobility training, and education, physiotherapy helps:
- Improve blood sugar control
- Enhance circulation and strength
- Prevent and manage diabetic foot complications
- Support overall energy, balance, and quality of life

Whether it’s preventing Type 2 diabetes or helping those already diagnosed maintain independence, physiotherapists empower patients to take control of their health one step at a time.

Let’s keep moving towards a healthier future.

07/11/2025

This is a seminal study from nearly 15 years ago that still doesn’t guide enough people’s thinking when planning training programmes.

🧠 Study Summary — Nielsen et al., 2012

Design: Prospective cohort study of 873 novice runners followed for 1 year, monitoring training volume, injury incidence & progression rate via digital training logs.

Key Findings: Runners who increased weekly mileage by >30% within 2 weeks had a 64–128% higher injury risk.

Injuries were distance-related (load accumulation rather than acute overload):

→ Achilles tendinopathy
→ Patellofemoral pain
→ Iliotibial band syndrome
→ Plantar fasciitis

Injuries didn’t appear immediately — often lagging 3–6 weeks behind the training spike.

Cardiovascular adaptations outpaced tissue adaptation → “fit but fragile” phase.

Take-home: Gradual, progressive load beats aggressive growth.

Tissues need time to catch up with fitness.

06/11/2025

An old post that’s worth resharing as it’s one of the biggest frustrations for injured athletes.

Returning an endurance athlete back to full training and competition is as much an art as a science.

One strategy I use to test an athletes tolerance is the “3 to see” rule.

This involves repeating the same run / bike / swim session 3 times to assess response.

If the reaction is appropriate then we progress either speed or distance (but never both simultaneously) and repeat the rule.

In cases where we may be more confident in the response then we can accelerate this to only 2 sessions, and of course, can protract it to 4 as needed to.

It takes away the guesswork and provides a framework to progress.

19/10/2025

Your jaw controls your pelvis - here’s how:

When your jaw clenches, your pelvis compensates.

The cascade:
1️.Jaw imbalance pulls your head forward
2️.Your neck muscles tighten to stabilize
3️.Your spine compensates by shifting
4️.Your pelvis tilts to maintain balance
5️.One-sided back pain, hip tightness, or SI joint dysfunction appears

Why this happens:
1.Your jaw connects to deep neck muscles that attach directly to your spine.

2.When jaw muscles stay tight, they create a chain of compensations that travel downward.

3.Your brain tries to keep you balanced, so when your head shifts forward from jaw tension, your pelvis shifts backward.

👉🏽This is why jaw clenchers often have chronic lower back issues that don’t respond long term to hip stretches or core work.

The pattern: Stressed → Clench jaw → Head forward → Pelvis compensates → Chronic pain

Most people treat the pelvis or lower back. But the trigger is higher up - in the jaw.

Fix the jaw tension, and the pelvic compensation often releases automatically.



25/09/2025

🌍💨 World Lung Day 💨🌍

Your lungs work tirelessly every day to keep you moving, breathing and living well. Physiotherapists play a key role in helping people strengthen their lungs, improve breathing, manage conditions such as asthma, COPD and post-COVID symptoms, and maintain overall health.

This World Lung Day, take a deep breath, get moving and remember that movement is medicine for your lungs.

👩‍⚕️ Speak to your physiotherapist for personalised exercises to support healthy breathing.

Let the debate begin... To 'safely' dope or NOT to ?
24/09/2025

Let the debate begin... To 'safely' dope or NOT to ?

In May 2026, Las Vegas will host the first-ever Enhanced Games — an Olympics-style competition where performance-enhancing drugs aren’t banned, but openly embraced under medical supervision.

Founded by Aron D’Souza and backed by figures like Peter Thiel and Donald Trump Jr., the event promises million-dollar prizes, record-breaking performances, and a reimagined model of elite sport.

Critics, from WADA to World Athletics, call it dangerous, unethical, and a “circus” that risks athletes’ health while normalizing doping for younger generations.

Whether revolutionary or reckless, the Enhanced Games is forcing sports to confront uncomfortable questions about science, fairness, and the future of human performance.

11/09/2025
09/09/2025
08/09/2025

As we close World Physiotherapy Day 2025, the South African Society of Physiotherapy celebrates every physiotherapist who empowers movement, restores independence, and improves quality of life across our nation.

Today reminds us of the vital role physiotherapy plays in building healthier communities and stronger futures. Let us continue to move forward together, advancing care, advocating for our profession, and making every step count.

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