Ante/Post Natal Back, Groin, Hip and Pelvic Girdle Pain

Ante/Post Natal Back, Groin, Hip and Pelvic Girdle Pain

For many women pregnancy and becoming a mum should be a wonderful time but for around 1 in 5 women it isn’t. Your body has grown and nurtured a little human and this can be hard work and
bring up feelings and physical changes nobody told you about! There is a lot of mixed information out there about pain in or around the pelvis such as PGP, SPD, SIJ and alignment problems.


I remember when I first started treating women with pregnancy related pelvic problems and my
mentor Jilly told me something that has stuck with me…. Pregnancy isn’t meant to hurt! Although it is common (1 in 5) for women to experience some discomfort during pregnancy it is not normal and it is also very treatable.


Have you developed the pregnancy waddle? Are you struggling to turn over in bed? Are you ok for a little bit when you’re up and moving but in agony by the end of the day? Does everything hurt even when you sit still too long?


Your body goes through a lot of changes and it should adapt to the new demands that are being
placed on it. This can be carrying a tiny little human for 9 months but it can also be dealing with the awkward and repetitive positions you find yourself in with a new born and growing child. Your body has many ways to adapt to these new demands and allow you to carry on moving without a second thought; however this is usually the result of muscles and your pelvic joints working harder than they are designed for. Over time they will start to let you know when they aren’t happy! So listen to your body when those aches and pains kick in and moderate your activity.

Tips for managing:
 Exercise is okay! Our body is made to move, especially during pregnancy. It is important that
you continue with your exercises regime to maintain strength and body conditioning but
also for your general wellbeing. If it includes weight lifting just adapt the weight accordingly
or speak to your PT or physiotherapist for advice.
 Being active is important but resting is too.
 Pick the trips or tasks (including housework!) that are top of your list, don’t try to get
everything done in 1 day and make sure you have some time to rest. Get your family and
friends to help out when needed.
 Your pelvis likes symmetry, so putting weight through both sides equally can reduce how
irritated things become by the end of the day. Try not to stand on one leg or hang off your
hip. Keep your legs parallel and supported in bed with a pillow or pregnancy pillow. Try to
avoid crossed legs and stand up before turning to move, there’s no rush. Sit down sideways
in to the car and swivel round to get in with your legs together.
 Many women try pelvic belts and there are lots of different ones available online. These can
act as a short term measure but won’t fix the problem. It is worth having an assessment with
a physiotherapist to determine if a belt will help.
 Listen to your body!
(Remember that lying flat on your back when more than 12-16 weeks pregnant isn’t advisable)

For further information you can download this booklet provided by the UK Pelvic, Obstetric and
Gynaecological Physiotherapy group here: http://pogp.csp.org.uk/publications/pregnancy-related-pelvic-girdle-pain-mothers-be-new-mothers

If you’re in pain, struggling with your usual exercise routine or looking to get back to exercises
following delivery physiotherapy can help. We always advise you to let your midwife or GP know just to check everything is ok. They will usually refer you to a physiotherapist for an assessment and to help get your pelvis moving well with the strength it needs to support bump and baby after delivery.

Prehab vs. Rehab

Prehab vs. Rehab

What is ‘Prehab’?

Prehab is a proactive approach to avoiding pain and injury. It is the ability to build strength and stability around any vulnerable joints or areas of weakness, while improving mobility, balance and joint function to reduce the risk of injury.

 

Functional Screens

For most elite level athletes there really is no “off” season, but the brief period of time that they do have to recover from the previous season should be when prehab takes place. Before pre-season training even starts, all athletes should undergo a functional movement assessment to check for any muscle imbalances or asymmetries that could lead to injuries during training or game play. Asymmetries between the right and left sides of the body are fairly common, and are the leading cause of injuries. This baseline assessment will give trainers and coaches the information they need to implement any corrective exercises the athlete may need to perform prior to their sport-specific training.

 

Correcting for Life

How does this information apply to the sedentary “Average Joe” or amateur athlete? 

Prehab also helps correct problems created by life outside the gym or playing field. There’s a good chance you spend hours hunched over in front of a computer every day. This lifestyle causes your shoulders to roll forward and tighten. That’s bad enough, but now let’s says that you go out and try to play tennis. Since your shoulders are so tight, they lack the necessary stability and range of motion. Your body has an amazing knack for compensating and using alternative joints and muscles, however, this will ultimately end in overuse injuries and chronic inflammation.

 

Prehab vs Rehab

It is much easier to prevent an injury than it is to rehab one. Once an injury has occurred, the rate of reoccurrence will increases significantly unless a tailored, clinician-prescribed programme is followed. This is why prehab is starting to play an important role in recovery for surgical patients as well. Studies have found that surgical patients who follow a prehab programme prior to surgery can recover up to 3 times faster than those who do not. For example, strengthening your quads and hamstrings prior to knee surgery will significantly improve not only the surgery, but also the outcome and recovery rates.

 

"I think its my rotator cuff"

"I think its my rotator cuff"

"I Think It's My Rotator Cuff"

The above statement has become something of a stock response to shoulder injury or pain. The truth is quite the opposite. With a few exceptions, most shoulder injuries are not the rotator cuff’s fault. It is just a victim. 

The shoulder’s unique anatomy, which allows the arm to move in multiple directions, contributes to a high incidence of shoulder problems like dislocations, tendonitis, and torn rotator cuffs. The shoulder, like the hip, is a ball and socket joint, which is normally pretty stable since most are comprised of a large “socket” into which the “ball” (end of the bone) fits nicely. The shoulder, however, is made up of a ball larger than its socket to allow for dynamic range of motion. This means all stabilization is left up to the surrounding muscles, ligaments, and tendons, primarily the rotator cuff.

What Is The Rotator Cuff Made Of?

The rotator cuff consists of four muscles all based around our scapula (or shoulder blade) and attach themselves from the scapula over to the humerus (your arm bone). The muscles are called Subscapularis, Teres minor, Supraspinatus and Infraspinatus. The way in which these 4 muscles attach to the humerus is shaped like a cuff, wrapped around the superior head of the bone.

What Does The Rotator Cuff Do?

Each muscle has a slightly different role to play in movement; subscapularis for example helps to abduct your arm, raising it over your head. This is the muscle most susceptible to injury for the average gym goer as the muscle runs through a small gap between bones known as the subacromial space. It can become inflamed or irritated if excessive abduction is performed, or if not warmed up effectively, and eventually causing impingement syndrome.

Infraspinatus can be quite tender when treated, but this is because it’s one of the easiest to palpate, and sits directly on top of the lower part of the scapula. The infraspinatus action is to laterally rotate the arm. An example of this would be performing breast stroke in swimming, or during a back swing in tennis. The infraspinatus will aid in pulling your arm out to the side through what we call external rotation. The Teres minor pairs up with infraspinatus functionally however has a slightly secondary function

Subscapularis muscle is much harder to reach, as it sits between your scapula and your ribs, this means for the therapist to have any palpation they will need to go under your shoulder blade. The primary sport that may affect it is boxing as the subscapularis function is to medially rotate the Humerus, contrasted with the infraspinatus. As a boxer performs most types of punches, the subscapularis will be doing a lot of work.

Stay On The Court This Summer

Hitting a tennis ball puts stress on specific joints, muscles, and tendons. Whether you’re serving or hitting a forehand, the mechanics involved in swinging a racquet can cause pain and discomfort. Tennis players need to assess the specific body parts that endure the most stress, and strengthen those muscles accordingly.

Most tennis injuries result from overuse. Players continually use the same muscles, and they can eventually breakdown over time through these consistent repetitive forces. The shoulder joint is among the most commonly affected body parts for tennis players. To avoid such injuries, you need to target and strengthen your shoulder muscles making sure that there are no weaknesses or imbalances causing incorrect joint movement.

Do not over-focus on the nature of the injury, while ignoring the mechanism of the injury:

When you’re talking about cuff injuries, in most cases the problem didn’t originate with the cuff itself, but much of late-stage rehab will involve rotator cuff strengthening. If you’re a tennis player, or involved in any other sport that puts a great deal of strain directly on the cuff, then that approach makes some sense. If your shoulder injury was the result of working out and lifting weights, this approach pretty much disregards the true mechanism of injury. 

Scapular stability and positioning is the common culprit. The muscles around your scapulae, such as trapezius and rhomboids, are enormous in comparison to the small rotator cuff muscles. If these muscles around your scapulae are weak and your scapulae are immobile, no amount of rotator cuff strengthening is going to be able to pick up their slack.

Structurally if you imagined putting a tennis ball on the top of a baseball bat, then turning it onto its side, that’s what the shoulder (glenohumeral joint) looks like. It heavily relies on ligaments, muscles and other structures to hold it in place.

London Marathon - All you need to know

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26.3 miles is a long way, but preparation can be a marathon in itself. What no one tells you when you sign up for a marathon is that the word “marathon” isn’t just a description of the endurance race you are going to run - In truth, the marathon journey is a lot longer than that and it involves a lot more than just running.

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Training for the marathon should be a positive and enjoyable experience, however for many runners, both new and experienced; there are many pitfalls that lie along the way. Inadequate training plans or consistently plagued by injury to name but a few. Below are some small pieces of advice for any of you runners out there to help you get to the start line, and over the finish line in style.

  • Body Preparation – the first step is always the hardest

You wouldn’t be a marathon runner if you weren’t full of excuses. We think nothing of signing up for a ridiculous endurance race, only to be put off training by the dark nights and miserable weather. If you feel that the running volume is too much initially then it is easy to supplement your training with gym based work. For example whilst doing low mileage in the early stages of your training programme, complement this with 4 weeks in the gym. This is making you stronger as a runner, using medicine balls, resistance bands, and kettlebells to work on running specific areas and weaknesses. The weekly running volume can be less alongside this training allowing you to build up your body’s resilience and fortitude, so that when the miles per week begin to increase you start to see maximum benefit and a reduced risk of injury

  • Maintaining your running form

Most of us know this is easier said than done once fatigue kicks in! There is no hiding from bad form, whether amateur or professional, especially towards the back end of races, however it is so important to practise your running form throughout your training as the miles steadily increase.  The aim is to see less deterioration in technique as the fatigue kicks in, as you are able to hold your good form for longer

  • Junk miles

Most runners have heard of this phrase, not all of us know what it actually means. Every time you go out for a run, whether it is an easy run, a long run, a tempo run – you should know why you are running that specific session. Having session structure adds value and purpose to your sessions, and most importantly allows you to train as efficiently as you should

 

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  • Stick to your plan

In an ideal world we would all have plenty of spare time to execute our training plans down to the last mile. However what happens if your work schedule changes or you are ill for two weeks? The best way to look at it is break it down into weekly blocks, and prioritise the key sessions of the week. Obviously your long run is going to be of most significance each week, we need to help our body adjust to the impact of road running and allow it to build aerobic endurance capacity during these sessions. It is also important to progress the length of these long runs as the programme moves along, so skipping on or two of your long runs can be detrimental to your training and increases the risk of injury. If you miss a tempo run or an easy run, DO NOT PANIC, and do not play catch up. Get through that weekly block and then make sure you hit the ground running at the start of the next week.

Just a quick note on injuries. If it feels like a niggle then it probably is, and the worst thing you can do is run through the pain just to get the miles in for that session. I would suggest getting some immediate advice from a rehab specialist or physio. They will be able to guide you back into your running programme, giving your shorter runs to build up training frequency to begin with. Be patient not to increase the volume too quickly as this may end in disaster and recurrence of the same injury

  • Simple guide to gel strategy

Nutrition strategy during a marathon is extremely important to avoid 'Hitting the wall'. Try different gels during your training runs to see which sit best with you and take a look at the guide below for help on timings. Essentially, what works on training runs will work on the day.

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  • Race Pace

Everybody has a target time, and race pace is essentially the average pace required to hit per mile over the 26.2 miles. So if your goal is to run just under a 4 hour marathon, your race pace would need to be 9 minutes per mile average. For the most part during your training, your long runs will be completed slowly than this pace, however it is important to incorporate regular sessions at the race pace so that you are confident that you can hit those times per mile come race day. Pacing is a difficult skill to master and needs lots of pre marathon practise!

  • Recovery

Recovery is paramount to keeping on top of your training programme and squashing any of those injury signs. It is only when we rest that the body gets the opportunity to adapt both physically and physiologically to the training volume and loads. Without the correct recovery via sleep, hydration and nutrition you won’t see the improved fitness levels that you could be seeing and you could end up injuring yourself

Finding a balance is key. Running produces high load and impact levels on the body, so finding what works best for you individually is very important. Many athletes supplement running with some off feet conditioning work through cycling or swimming. The most important thing is to listen to your body, give it time to adapt to the high training loads and ever increasing mileage.

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HAVE FUN!

2016 IN REVIEW

it's been a little over three and a half years since we officially opened our doors and for those of you who have not been with us from the beginning, you might be surprised to see just how far we've come!

 

Starting with 4000 sq. ft. of gym space and two clinic rooms, four of us shared a vision of changing the way people perceive athletic training by providing what is normally only available to professional sports people to the masses.

Since opening, our clinic team has tripled in size and we play host to a wealth of specialist performance trainers. We have introduced a growing members community to our train of thought, now with over 10,000 sq. ft. of elite standard gym space where we also accommodate a number of professional athletes and teams.

Back in 2013, we all had aspirations and ideas of what we wanted to achieve and whilst we are not quite there yet, we are so excited that you are all making this journey with us. The big question now is; where do we go from here and what have we got in store to make Bounce even bigger and better?

Well, one site is not enough! We are currently searching throughout London for a suitable spot to launch our second Bounce Gym and Injury Clinic - watch this space!

 

In and Out of Club

Over the past year, we have seen the launch of our Bounce X team events, in which a collection of members and staff have participated in various events, including Tough Mudder, Dragon Boat Racing and Clapham's "Pretty Muddy" where our ladies helped to raise money for Cancer Research UK. 

In-club, we held our "Million KG Lift Off" in which between members and staff, we managed to lift over one million kg in just 4 hours. In the process, over £1000 was raised for the children's charity, Momentum. More of these events will be happening throughout 2017, so keep your eyes peeled for details!

Members and staff take part in the hugely successful Million KG Lift Off - any lift counts!

Members and staff take part in the hugely successful Million KG Lift Off - any lift counts!

The Bounce Ladies burst through the finish of "Pretty Muddy"

The Bounce Ladies burst through the finish of "Pretty Muddy"

Our list of classes also continues to grow and break the mould of those put on by some of the mainstream health and fitness providers. If you haven't already, visit our Timetable page for a full breakdown of our schedule and available classes.

Want something new? We are always happy to looking into other ways of developing our small group training sessions, so please don't hesitate to share your thoughts and ideas with us.

Our list of affiliated schools, teams, clubs and athletes also continues to grow. We are proud to put our name to the UFCs fifth ranked light-heavyweight Jimi Manuwa, who has not only climbed up the rankings but also won the Fight of the Night accolade by knocking out Ovince Saint-Preux back in October. AFC Wimbledon's youth team are also flying high in the league with many regularly receiving call up's to the U23 Development Squad. GB Judoka Adam Hoshal most recently won bronze at the BJA Senior National Championship, not to mention the continuing success of Wimbledon Rugby Club on the back of two promotions in three seasons. We also have athletes competing on the international stage in lacrosse, netball, athletics, tae kwon do and triathlon, all training in-house.

AFC Wimbledon have enjoyed impressive performances in-gym and on-field over the past few seasons

AFC Wimbledon have enjoyed impressive performances in-gym and on-field over the past few seasons

In addition to individual athletes, Harlequins Rugby Club have utilised our Injury Clinic with our Head of Clinic and chiropractor, Andy Beckinsale, an official consultant for the club. If you play for a team, or are training for anything specific, let us know and we'll be more than happy to help!

 

Member of the Year

As many of your have seen from our social media pages, we've recently started an "Athlete of the Week" mini-blog. This is to showcase the talents as mentioned above but to also give our members a chance to get to know our athletes more personally. With that theme in mind, the staff here at Bounce recognise the impressive and undeniable effort that our members put into their training. As a result, we have decided to name a "Member of the Year". 

This decision was not made easily and we again would like to acknowledge everybody's efforts and encourage you all to keep up your hard work. We will be announcing this over our social media channels, so be sure to stay tuned!

 

"Just Ask"

You may have seen this phrase popping up around the gym and through some of our social media posts. It is not by accident! A huge part of how we practice is through the inclusion and integration of clinical knowledge and practice into performance training. Both members and non-members alike have some of the most experienced practitioners readily available at their fingertips. 

If you are carrying long-term niggles, in acute pain, pre or post operation or simply want help training around injuries, our clinical staff are always here to help get you back on track. Visit our Injury Clinic page for more information about our team and the services they provide.

We want your feedback! One of our main priorities is that everybody's individual experience of Bounce is a great one. We constantly strive to be better and aim to provide you with a service that is better than the rest. A recent addition to the gym floor is that of a comment box. We welcome your feedback, requests and suggestions of how we can continue to grow and improve.

Not only do we encourage our members and our clients to ask for our expert advice but we make an active effort to utilise the vast array of skills we share among our staff. Why use just one professional when you have so many at your disposal?

 

Member Benefits

As if all of that isn't enough, we are now extending our services beyond the doors of Bounce. We've been working hard to find other ways to help you not only achieve your training and performance goals but also feel more like a professional athlete too. As a member of Bounce, you will now receive 10% off personalised meal plans provided by Fresh Fitness Food when you use our unique discount code BOUNCE10. Tailored to your goals and freshly prepared before being delivered directly to your door! In-club, we have a partnership with Kinetica to help you make the most of your hard work with pre and post workout supplements.

Now that you're eating and training like a professional, why not look like one too? Ladies, we've partnered up with Sweaty Betty in Wimbledon Village to help you not only perform better but look great while doing so. For the students among us; double up for 20% off! Guys, don't worry we've got you covered too. Visit the Prince store, also in the village, for all your gym kit and racquet needs - whether its for restringing, new court shoes or just some fresh tee's, we've agreed 10% off for you!

Okay, so we all have a life outside of the gym. Never fear, we've got you covered on the social front too. Hemingway's Lounge Bar in Wimbledon Village, Jacks of London in Wimbledon Town Centre and Park Vintners in Wimbledon Park will now be offering 10% off exclusively to Bounce members.

We will soon be handing out key fobs that you can present at these outlets and make receiving your discounts even easier!

 

Don't Forget!

As we mentioned earlier, our expert clinic team has tripled in size and as a member you will receive 50% off your first appointment. Regardless of your injury our team comprising of physiotherapists, osteopaths, chiropractors and sports massage therapists will be able to help.

We know how hard it can be to get motivated after the winter break, so why not bring a friend to train with you and start the New Year off the way you want to continue it? If you successfully refer a friend, you can receive one month of membership for free.

From all of us here at Bouce, we would like to extend our thanks and gratitude to all of you like-minded people for joining us on this exceptional journey. It's been an amazing start to what will hopefully be an even bigger and better story.

We look forward to seeing you all soon and wish everybody the very best for 2017!

 

The Bounce Team

UFC 204 - Manuwa vs Ovince St Preux

Bounce athlete and UFC number 5 ranked Light-heavyweight fighter Jimi Manuwa has been working with Bounce for 10 months since a loss at the hands of Anthony 'Rumble' Johnson at UFC 191.  

Jimi needed to improve his size and power and turned to Bounce.

The Strength & Conditioning program went to plan, Jimi stepped into the UFC 204 Octagon bigger, stronger and better conditioned than ever.  

The hard work paid off and Jimi took a perfect KO victory. Jimi also took the performance of the night bonus for his ferocious hand speed claiming a big KO

Skill Development in Young Athletes

Tom is a senior lecturer in Sports Science at the University of Worcester and Head of Performance at Bounce. In the past Tom has worked in professional rugby, professional football and with elite athletes in many endurance sports.

“In the strength and conditioning field, skill development is the hot topic right now. Strength and power have and always will be vital aspects of performance, although skill development is of equal if not more importance.

Typically, young athletes focus on being the biggest and strongest. However, if we look at the most successful and consistent international teams it is evident that size and strength are not always the best route to success or maintaining a less injury-prone squad.  

This is true of many sport. For example, many English rugby teams are accused of focusing too much on developing strength and size with their athletes and not enough on skill development. 

On the international stage we regularly see some of the smaller, albeit most skilled athletes seemingly punching above their bodyweight and out-performing larger opposition. Take rugby players Ben Smith (New Zealand), Brian O’Driscoll (Ireland) or Johnny Wilkinson (England) for example; three of the best players in the world of recent years but relatively small considering modern day standards. Yet during play they appear more powerful than their size would suggest them capable of. Having superior fundamental skill development than other players allows them to skip out of tackles and tackle above their bodyweight.

Have you ever questioned why some players, although smaller than their opposite number, seem to do this week in week out?

This is where skill development comes in. At Bounce we teach a system that incorporates fundamental movement skills alongside strength training. In the past this has been woefully overlooked by many professional setups but it’s a hugely important area for aspiring athletes. Specific movements transferrable across nearly every sport are often taught incorrectly at a young age (sprinting, jumping, rotating, cutting, changing direction, acceleration and decelerating all fall into this category). It is very common to see athletes even at a professional level performing these movements inefficiently and with poor technique. Should these individuals spend more time practicing and enhancing their basic movement skills, their on-field performance could be so much better and also improve their chances of remaining injury-free. At a time where injury rates in contacts sports are at an all-time high this is obviously important.

Every so often a player comes along who has strength, size, power and an amazing level of skill development. Think Jonah Lomu or Sonny Bill Williams. 

It is fairly easy to increase strength and put on size compared to learning proper fundamental movements. These skills are more complicated to teach and take longer to learn than the traditional strength and conditioning of the past hence the importance of teaching them at an early age. Pre-adolescence ideally. It is true that some people are genetically gifted with excellent mechanics and naturally move very well.  These guys are the lucky ones! The rest of us have to work hard to improve our skill development if we want to make better athletes.”

At Bounce we are lucky to have some of the best strength and conditioning staff around to teach the athletes of tomorrow. 

 

Lift for charity - Every rep counts

Open gym on Saturday 24th to lift One million kgs to raise money for momentum. Bring your friends and help make this happen..

Time and Leisure article on the Bounce Performance Academy

Time and Leisure article on the Bounce Performance Academy

"In a quiet back street of Wimbledon Park, hidden behind a small office block is a team of specialist trainers running a cutting edge personal and team-training facility called Bounce.

The personal trainers who started this venture are all former professional athletes, and started Bounce in 2013 focusing on adults. They have trained members of the Harlequins RFC, The England Rugby Team, Fulham FC and Wimbledon RFC, triathletes, runners, cyclists and countless mums and dads. When former rugby player and the Head of Sport at Kew House School, Marc Sweeney became involved with the Bounce team, they decided it would be great to offer their elite training programme to young athletes – so they recently launched the Bounce Academy for 11-16 year olds."

‘There is nothing like this around to help enhance the performance of young athletes with potential,’ explains Phil Chesters, a Bounce trainer and professional rugby player with the Ealing Trailfinders.

I was invited to Bounce to have a firsthand look at the sports programme in action. A group of young athletes were participating in a four-day performance camp. ‘Our big focus is getting technique and posture correct, then we move onto acceleration. The Academy is based on the EXOS programme, which is an American programme focusing on technique, movement skills, core strength and acceleration. The German Football team uses EXOS coaches for conditioning,’ Marc tells me. Marc and Phil are trained EXOS coaches and Bounce is the only sports facility in south west London offering young athletes this form of specialist coaching.

As we watch the children at the academy repeatedly practicing and perfecting sprint starts and acceleration, Marc tells me that each child is tested at the start of the camp, monitored and tested at the end, and presented with a detailed assessment showing exactly where they improved and by how much.

‘Children are not taught to run properly – not at home, not at school. We teach the correct technique, movement patterns, acceleration and multidirectional speed. It not only improves performance and speed but learning the correct technique prevents injury and prolongs a sports person’s career. Both Phil and I were saying earlier that we wished we had access to training like this from a young age. There is no doubt our careers would have been bigger and longer,’ Marc says.

Not surprisingly, the interest in the Bounce Academy has been huge. The Wimbledon College first rugby team and students from the Fulham Academy recently went through the programme. ‘We would like to reach all of the local schools who have students with sporting ability in any sport from rugby to football, tennis and hockey, running and cycling,’ informs Marc. Bounce Performance Academy camps run in school holidays, and the team has also launched a scholarship scheme, which allows two students to attend the camp for free.

This specialist coaching is allowing promising young athletes to considerably improve their performance. Bounce participants learn training methods and have expert guidance to enable them to progress. It is great to see that young athletes with potential now have access to a training programme ordinarily only offered to elite athletes performing at the highest levels. 
www.mybounce.co.uk

 

Bounce open day

Bounce open day

 On Saturday 18th April we officially announced the opening of our new members gym.