Physiotherapy Portal

Squat Mobility

Posted by Stuart Fossella on Tuesday, August 22, 2017

When a Squat isn't just a Squat

 Squat Technique

Everyone loves a Squat don't they?

Looks easy as well doesn't it? Natures very own sitting position. Just check out anywhere where there are few chairs on the streets, people simply squat instead.

But it doesn't mean that everyone can perform a squat with correct technique. What are you looking for in your Squat? For starters, it depends if you do a front or back squat.

And just to point out, you don't have to squat in the sporting context. As a half range squat would be what you need to do to sit in a chair! Exactly the type of pre gym based exercise that we prescribe to people who have had knee surgery - it’s not all dumbbells and barbells you see.

On the surface of things, squat looks like an easy movement to perform doesn’t it? But there are reasons why someone might not be able to do it with good technique.

  • A squat requires good control of:

  • The low back (to avoid overload and place undue stress it)

  • Good hip movement to allow full range of movement

  • Good Knee control and joint range to avoid over stressing the joint.

  • And, good ankle joint movement to allow a full squat.

If any of your motions or control mechanisms are lacking, then there either needs to be a compensatory movement pattern to gain the full depth of the squat - ie, if the hips lack movement, then a person may ‘cheat’ with the back or knees. Less than ideal - and this isn’t what a trainer, coach or therapist wants.

So what's the point I am making here?

The Squat is a complex movement and requires excellent near whole body movement and control.

The Squat is a great exercise for the whole body and excellent for developing powerful hip extension - but your ability to perform one may be limited by weak Glutes, hamstrings or restricted joint mobility in the hips, knees or ankles.

A poor ability to squat might even be related to Low Back Pain - ever noticed how even moving from standing to sitting or sitting to standing hurts when you have a bad back?

Check out this piece for a dissection of ‘the squat’ and the movement requirements to perform a full and deep one.


Dissecting the Squat


So what’s the point of all of the above? Well…If back pain is causing pain in moving from sitting to standing or your hips, knees or ankles are causing restrictions in your ability to squat in training. Then maybe it’s time to find out what the underlying issue is?

Do give us a call or Email, we don’t bite.

If you want even more information then call 01242 802365 or Email us on

You know where to find us.

And please feel free to share this with anyone you think might find it useful :-)

If you’d like more quick tips like this to help ease Sports Injuries, visit our website where you can download my free tips guide instantly:

Or click here: ->


Give us a Reply if you need any advice in the meantime.


Therapeutic Exercise

Posted by Stuart Fossella on Tuesday, July 18, 2017

Therapeutic Exercise

And are we going to do the Physio treatment as well?

 Leg Press

A patient said something very interesting to me the other day and it got me thinking...

I had a great review with a patient suffering from a tendon injury in the leg. This was causing pain and an inability for her to participate in sport and exercise.

After listening to her explanation of the problem I did the Physical examination and soon diagnosed that a tendon in her knee had been irritated. Based upon this I proposed a plan for putting things right. This did consist of some hands on stretching techniques, but I made it clear that the mainstay of her her treatment (in my humble opinion) was going to require getting the said tendon strong enough to tolerate the loads and demands that she wanted to place on it in her sporting activity.

She then asked, “if I would do some other Physio treatments.”

It was this sentence that left me thinking the most. What other Physio treatments did she mean? “You know she said, a nice massage and the machines you lot use”..

If I asked my mum or some close friends what they think I do day to day as a Physio, I don’t actually think that they could answer me. So take someone who has never had Physio treatment or had it at an old school clinic - I can't really expect them to know what we do.

I think it was the fact that I’d told this lady the way forwards was to get down to the gym with me that threw her the most.

Sure if I wanted to give her ineffective treatment that meant she was still suffering from the same knee pain (or back/ankle/neck pain) in 3 months time I could have suggested we do a nonsensical rubbing of the knee. Or just keep manipulating the tendon for months on end. And we see a lot of this...It’s often why people come to see us because they have had ineffective treatments elsewhere.

To address, stiffness or weakness (the main issues we see in Physio) then sorry, because our Physio treatment requires dedication and your input. Remember you are with us for perhaps 30 minutes a week. We need you to make use of the other 167.5 hours you have available to you.

I'm not suggesting you dedicate the rest of your day to the rehab and miss meal times and do 10 million exercises a day, it’s not like that. But it’s true we might set you 15 minutes worth of exercise to do 3-4 x a week.

If it's 15 minutes every other day, it seems like a good shout. Or you could just keep coming back every 6 weeks...for the rest of your life.

So if you are ready to let us help you, and you are happy to help yourself. Or you have had a failed try at Physio already or your injury simply isn't getting better. Please ask us if we can help you - to help yourself!

If you want even more information then call 01242 802365 or Email us on

You know where to find us.

And please feel free to share this with anyone you think might find it useful :-)

Acupuncture and Physiotherapy

Posted by Stuart Fossella on Monday, June 19, 2017

Want Needles with that?

 Acupuncture Needles

You probably didn't know that we all are trained in Acupuncture here at Straight Back Physio. But then we probably never told you.

You see at our old location we weren't insured to practice the treatment, so never offered it. But...

Our sparkly new home allows us to provide Acupuncture as a treatment!

So if it's something that you have given some thought to in the past but never tried then please do ask about its suitability to you and your injury.

You see, there are all kinds of claims made about Acupuncture and please remember we are not Acupuncture therapists. We are Physio's who might or might not use Acupuncture as an accompaniment to your other treatment techniques.

We don't make claims to use it to help you get pregnant nor give up smoking. But we think it can be really useful in helping to reduce what some people call 'knots in muscles' or tightness through muscles.

Particularly good for shoulder or Neck pain and Low back pain, Calf Strains and Achilles problems in our experience.

So if you have postural or sports related muscular tension or tightness then please ask us about your suitability to Acupuncture as something to help alongside your other rehabilitation.

More info from the Acupuncture Association of Chartered Physiotherapists Which we are members of by the way.

If you want even more information then call 01242 802365 or Email us on

You know where to find us.

And please feel free to share this with anyone you think might find it useful :-)

Crooked Back

Posted by Stuart Fossella on Thursday, May 25, 2017

Is your Back Crooked?

 Crooked Back Book Cover

I think that American Backs are made the same as British Backs...

Here is a link to a pretty novel book exposing the 'Crooked Back Pain industry', got to hand it to the creatives for that book title :-)

Check out this authors 6-year mission to highlight just what Back pain is and how it can REALLY be treated.

Check out this excert of the interview:

Perhaps the most shocking statistic in your book was regarding your poll of 100 doctors. This was a question posed to spine surgeons: ‘Would you have spine surgery?’ [Specifically lumbar fusion or disc replacement surgery.] And resoundingly, in this group, all said ‘No,’ except one. Now, that should tell you all you need to know.


Looks like we've said all along it's about REHAB - we know no one wants surgery on their spine, do they??

Like the piece that follows:

What's Causing your Back Pain?

Need more advice and want to avoid surgery???

 You know where to find us.

Sport Massage - Meet Luis De Sousa

Posted by Stuart Fossella on Thursday, May 18, 2017

How deep do you want it?

 Boy Lifting Arm

Meet Luis - he's the main man when it comes to Sports Massage, and he's going to be working out of our treatment room.

We don't work with clinicians or coach's that we don't trust or believe in, and that's why we don't ever refer to anyone else in Cheltenham for Sports Massage and there is a very good reason for that...

This is a man who will listen to how you like your Sports Massage:

Luis doesn't believe you need to leave people screaming and squirming on the couch to be effective.

Luis doesn't believe you need to leave people covered in bruises to give an effective Sports massage - Actual Bodily Harm isn't right!

Sports massage is going to help you recover from sports faster meaning you can 'go again' sooner than you'd realised.

With the help of Deep tissue techniques you will find a reduction in exercise-induced swelling and improved muscle and tendon flexibility...letting you train harder and faster again.

Preparation to perform well before, during and after training is what Luis is all about.

With his arrival comes an awesome deal:

Luis treats for 30 or 60-minute slots and we are so convinced you will love what he does and find his work useful that until the end of June he's offering an hours treatment for only £30. A great discount on his normal rates.

**Please note this offer is only for new patients to Luis and is valid until the end of June only**

Please get in contact with us here at Straight Back to either find out more or schedule a session.

Physio Advice on managing Back Pain

Posted by Sarah Fossella on Thursday, May 04, 2017

Keep Going...

Nice piece from The Chartered Society Of Physiotherapists on Managing Back Pain

Easy to digest info...

Short, Sharp and to the point

Need more advice, you know where to find us.

How to fix Sports injuries

Posted by Stuart Fossella on Tuesday, April 25, 2017 fixing Sports Injuries

 man doing weights

So you have a sports injury (or injury that’s not necessarily caused by sport) and it just won't settle and disappear.

You have waited 4-6 weeks already and its now starting to get frustrating. It's stopping you from training, competing or working well. It might even be affecting your sleep.

By now you probably still haven't given up hope of the injury getting better on its own. But maybe it's time to take the plunge and get some help - particularly if you want to fast track your recovery.

By now your partner is probably as fed up as you with the injury because you can't stop moaning about it :-).

Well it's time to begin to help yourself

What’s the next step you really should be taking to get yourself going again? Well, let us explain more because if you can begin to help yourself, well you are going to start to feel better, be more positive and your partner will be happy as well (as your moaning and groaning begins to dry up).

Ok, so…

The topic of this post is about consistency in performing Physio rehab when recovering from injury, (sports related or not).

So what do I mean by consistency in Physio rehab exercises?

Well…dedication to sticking with a rehab regime and consistently sticking to it for probably 6 weeks + - yeah not what you wanted to hear?, but likely to be more fun than not doing anything for 6 weeks (which is probably what you have been doing up until this point).

‘Straight forward’ injuries, if there is such a thing, such as muscular strains and ligament sprains require input, even at the most basic level. When we are injured the body works hard, and a heck of a lot harder than you would imagine to self-heal. Now, this is all good and well, but you need to do yourself a favour and help out a little (or probably even quite a lot in all reality) and this is where consistency in rehab comes from. In order for you to make lasting changes muscle, ligament, tendon and the Cardio Vascular system you need to stick to training or rehab, or whatever you want to term it.

The body does respond to a training regime or Rehab programme, but it takes time, weeks in fact of Consistent Rehab or training. Let me explain…

If I go to the gym 1 x per week and lift the smallest dumbbells that I can find am I likely to get rippling muscles that look good on the beach and make me stronger? Not likely - I’d need to consistently train with heavier weights and be specific about training for increasing muscle size (consistency).

If I'm a novice runner and I want to train to run a half marathon, then I could take in 1 run a week and stick to plodding along at an 11-minute mile pace, at this rate I'm not likely to ever be able to run 13.1 miles anytime soon am I? I need to base my training towards being able to run 13.1 miles, and make it specific to this (by being consistent in my training by gradually increasing the distance of my training runs).

If I eat nothing but chips every day of the week for lunch and follow this by eating nothing but pizza for dinner - I'm probably going to get heavier and fatter and prone to a heart attack because I've been consistent…in eating a crappy diet that is.


What I'm suggesting is that consistently doing nothing about a sports injury means my injury is likely to persist for longer than it should, and improve at a very slow rate. But if I addressed the injury and began to stretch out damaged or scarred muscle, and consistently did it - it will probably help.

If I stuck to a specific programme of exercise that was designed to help my torn muscle heal and get stronger it’s likely to heal in time (with accurate and consistent loading).

If I stuck to and consistently performed balance exercises to help heal damaged ankle ligaments, then I'd probably end up with better balance and stronger ligaments in the longer term, get it?

Of course its not as simple as doing willy-nilly exercises. They need to be specific and accurate for the particular Sports injury that you have.

Keep rehab consistent, and accurate and Progressive! - the other key ingredients to a successful rehab programme.

I only have to consider how we treat the pros over at Cheltenham Town FC on a day to day basis - you might believe it now when I tell you that we treat them with specific, accurate and progressive exercise that’s also consistent. It's their job but these guys are doing their Physio rehab every day, with perhaps 1 rest day a week. It’s why they seem to get back to sport quicker than us mere mortals - because they are treated with consistent frequency.

Sure there is more to overcoming injury than just doing the basics every day. But as a good starting point, you really should be doing your basic rehab , probably consisting of stretching and strengthening every day - consistently :-)

You know where we are - you can find our contact details on the website. If you need more input, we’d love to help you if we can.

Because we love what we do and love helping people out.

If a colleague, partner or friend may find this piece useful, we’d love it if you passed it on to them to read - Please share it around.

The Team at Straight Back

Consistency is the Key

We have Moved to Gym 66

Posted by Stuart Fossella on Thursday, April 20, 2017

We've moved home

 Boy Lifting Arm

You can now find us at Gym 66

Dear all,

The team at Straight Back Physiotherapy would like to inform you that with immediate effect all of our clinics will now be run out of Gym 66 in Cheltenham, just off Alstone Lane.

As the crow flies our new home is less than 1/4 of a mile from the High Street so we hope this doesn't inconvenience anyone too much.

In fact rather than inconvenience anyone we hope that our new home will benefit everyone. There is Free Parking available on the trading site - in any free slot, you can find.

There is a nice and comfy waiting area for you to sit in, and we have a new and sparkling treatment room to work out of.

Of course, there is a fully packed out gym with probably the best equipment in town.

In a few weeks time, we will have a new website filled with useful tips and tricks for you.

We hope that you benefit from our new location, and we hope that your overall experience of coming to see us will improve no end. We are just trying to provide excellence all round. Hope to see you soon.

Please see the link below for detailed information on where to find us now:

 Hit the link below to find our exact location

Find us here...


Thanks again,


Stuart, Sarah and Francesca

7 Minutes of fun

Posted by Stuart Fossella on Wednesday, April 05, 2017

Danny's Wee Day Out

Not strictly related to Physiotherapy, but I'm sure Danny has had his fair share in the past

I only saw this the other night at the Banff Mountain Film Festival - and as per all of Danny's videos it's great.

If you have got 7 minutes to spare (cmon, close Facebook) and have a look at this instead.

He's got skills, no denying it.

Pole Dancers chest pain

Posted by Stuart Fossella on Thursday, March 30, 2017

Chest Pain coming from the Back?

 Boy Lifting Arm

When Chest pain comes from the Back

So things come along in 3's right, just like London Buses.

In the last week alone I've seen 3 patients complaining of Chest pain that’s actually coming from the back.

You see the ribs attach from the spine to the front of the chest wall, curving around the chest.

Because of this curve and path that nerves and muscles run, pain can be sent from the back to the front of the body.

Just like sciatica is pain that is sent from the back down the leg, you can have pain that comes from the back but is actually felt in the chest!

Have a look at the following link for a review of the anatomy of the ribs and link to the spine.

The following link provides a 3D image of the Spine & Ribs hopefully allowing you to visualise how the pain may be felt in the chest Healthline Healthline

Hopefully it makes sense how pain can be sensed around and in the chest. Although the pain is felt here, perhaps more than the back its actually the back that needs the care and attention.

The last 3 people with this pain seemed to get it from:

  • 1) Not sure how.
  • 2) A tennis shot.
  • 3) From pole dancing (for fitness).

As with most treatment techniques, the aim of treatment is to minimise inflammation with ice and relative and rest etc and then restore full movement in the spine, and add strength to the area to maximise the outcome and reduce the risk of an injury recurrence!

Simple when you know whats going on.

But that's why we are here, so Bring us your problems :-)

Stay safe, and be careful the next time you are flying around the Pole dancing pole - great for fitness I hear.

You know where we are - and we’d love to help you out if we can.

If a colleague, partner or friend may find this piece useful, we’d love it if you passed it on to them to read.

The Team at Straight Back

Registered treatment provider for members of BUPA, AVIVA, AXA PPP and all other major insurance groups.