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Case Study - "A Change In Mindset"

Exeter Sports Massage Case Study by Bob Fairbrother

Bob Fairbrother


Mark has provided me with a deep tissue massage service for many years. In each session he has conscientiously and rigorously treated the muscle tissue to help to manage issues and to warn of potential pending problems. Mark has helped me to remain injury for as long as possible.

Mark has also provided a service as a mentor which is very much a unique selling point of his service. He has always been prepared to sound out my training ideas, critiquing and challenging my thoughts and findings in such a way that has got me to think the extra step beyond each process. We have covered a multitude of aspects of running in which he has displayed good knowledge, well-founded advice and informed opinion which has led to me being a more rounded runner, reding risk of injury.

His support and sympathetic, yet creative and realistic, outlook have always enabled me to stay positive and grounded during injuries, helping me to balance my emotional response, during some trying times.

I am an older guy and Mark has treated me in the same respectful way that he would a high-level athlete.

I have nothing but high regard for Mark's integrity, knowledge and utterly engaged support and would recommend him whole-heartedly.


A senior male, primarily long-distance, trail runner.
Other activities: walker, regular gym user, occasional cyclist, swimmer and seasonal skier.

Past Medical History
Big toe missing on right foot sustained from a motor-cycle action at the age of 19.
+ On-going gait issues: calves and Achilles.
+ Up to 40% of the year was spent injured - contributing towards weight, health, self-image, identity, mental health and attitude issues. Diagnosed as experiencing gout.

Drug History
Allopurinol 150mg

Social History
Semi-retired. Management, Sales executive, business coach, mentor and sports coach.

Sport History
Played mixed sports as a child: football, athletics, tennis and running.
Played Football from Age 8 until 45. Reaching County League reserve level.
Marathon Runner. 40 plus half, full trail ultra-marathons.
30 years of skiing.
Squash player. Walked Kilimanjaro. Skied Svalbard.
...and occasional player of FIFA/FM does that count?

Training History - Usually 4 Sessions per week including (Covid conditions allowing):
+ Strength & Conditioning Gym Work x 1
+ Cardiovascular Fitness Running / cycling / swimming.
+ Mobility & Stretching Daily (yoga)
+ Crunchies programme
+ Specialised recovery exercises.
Using Nutrition specialist, Physiotherapist, Podiatrist and sports masseur.

Presenting Condition
Constant breakdown of calves /. Achilles.

Mechanism of Injury
The missing toe has created body alignment issues.
Heel spur to right foot (missing big toe on this foot).
Shortening hamstrings and calves due, in part, to sustained time in car and sitting at a desk.
Gait adjustment to breaking in new running shoes. Often the later iteration of a trusted shoe has changed leading to problems. Experimentation with new shoes has led to frustrating break downs and injury. I have to start training almost from zero to break the shoes in and acclimatise the leg muscles.
When I find a good pair of shoes, I now buy an extra pair. I pair for the gym and one for the trail.
I have learned the hard way to change shoes more frequently and accept that there will be a period of breaking in. Usually during a rest or close period of a 'season'.
Mark has helped me to analyse and has make constructive observations to help me to navigate through my frustration and my, at times, lazy approach to get a quick fix.
Injuries also arise from pushing my training too hard. Mark has helped me to take a more balanced, planned approach.

Running challenge history.
Road runner - transition to trail. Result: increased longevity of running due to softer ground.

Inserts: after constant rotation of injury / physio I was directed to a specialist. Andrew Stanley, Rebound, Settle. I accepted his recommendation of tailored inserts. Within a year I did my first trail marathon.

I started developing joint swelling issues. Eventually this was diagnosed as gout. I was prescribed allopurinol. I declined, trying to resolve by 'diet'. I saw a decline in the urate levels but then experienced 3 painful episodes close together. I started taking the drug. I later learned that the trauma caused by the changes in diet may have caused the swelling in the joints.

I began to have more of an understanding of the connectivity of nerves, muscles and bones throughout the body. I introduced yoga, strength building exercises and static weights programme and rolling sessions with success.

I met a nutrition specialist (Adam Fraser, Bristol.) who helped me to assess my personal nutrition needs and to modify my diet further. In conjunction with the app I learned that, while there should be moderate levels in all consumption, there were trends of high intakes of carbs and too much simple and complex carbs and not enough protein.

I have reduced sugar, alcohol, while increasing water intake and reduced meal portions. Combined with exercise I have seen a gradual reduction in my weight - but also an improvement in health.

I have become a convert to the idea of sleep being the corner stone of everything in life (Why We Sleep - Mathew Walker). Concentration, mood, knowledge retention, brain waste clearance and injury recovery. Though not a good sleeper I enjoyed better sleep hygiene with an increase of 30 mins to 1 hour sleep per night.

My research suggested that deep tissue massage might help with the connectivity issues and aid recovery. I was strongly recommended to use specialist Mark Cowen.

I initially found this deep tissue massage painful. But, after a few weeks, I got used to the treatment and my body started to respond to the treatment. I found that it aided recovery and I felt good, if beaten up, when the session was over. It was important to drink water and to allow the body to absorb the treatment the day after the session - only allowing light training.

Mark, as well as being an excellent sport masseur, has also become an indispensable training mentor. This has been his USP.

Over the years that I have worked with Mark he has been responsible for a change in my attitude towards injury recovery. Enabling me to develop a more mature, philosophical approach to time out from injury - resulting in a more balanced moods.

Mark is an engaged, skilful, listener and has responded by giving some excellent knowledgeable feedback, informed opinion that has challenged my thinking and the ideas that I have researched.

He has also helped me with my training plans and helped me to understand that there needs to be flexibility in the plan and listening to the body and not be afraid to change that plan.

Mark has also helped me to develop my own training plans. I was aware of the concept of resting being just as important as training in order for the body to absorb the work and for the muscles to build. But I was not necessarily incorporating enough resting time into my training schedules. My fear and pressure on myself coming from the need to train hard and to try to catch up on lost time due to injury. Mark has coached me into accepting rest time and building it into my plan.

Mark has instilled in the me the idea of having the patience to build robustness to make me near bullet proof via a properly executed training plan.

He has trained me to understand that being mentally tough is as much about doing the right thing in training (resting when necessary) than finding the mental strength to survive the final leg of an ultra-marathon.

He also introduced me to the idea of managing my effort so that I save my big burns for the right occasions. He helped me to visualise a box of matches and you only have so many matches to burn - use them wisely and save them for the right occasions.

Mark's consistent drip, drip of this mental coaching and mentoring and patience (reporting injuries to him which are often an indicator that I have not followed planned protocols) mean that he gets me to take the helicopter view and learn from my mistakes.

Mark has been brilliant at mentally getting me to accept that injuries are almost inevitable and to learn to celebrate the small wins on the road back to recovery.

I am not a young athlete. Mark is an athlete and deals with some serious athletes on a daily basis yet he treats my goals with respect and gives me the care, attention, thought and enthusiasm for my problems as he would for a top-class athlete.

My goals.
Build robustness.
Sleep / recovery.
Diet attention
Sensible training planning with higher regard for built in rest
Be flexible enough to change training plan. Do not be rigid in following a timetable. Be self-aware enough to know when to hold off or when to do a bit extra, to push a little harder.
Don't exercise binge - consistency.
Attitude adjustment towards injuries and accepting that they are inevitable.
Be opened, minded and be always be prepared to listen to knew ideas
Celebrate the small wins

End result

Most runners will experience 1-2 injuries per years resulting in 5-30% or more per year lost training time.

I was spending about 40% of my time during a year injured.

I think that I have reduced that to around 20% (about 4-6 weeks per year).

I attribute this improvement partly to my own research and development but also due to Mark's massage service and his mentoring input of which I suspect he has been responsible for at least 50% of my recovery improvement.

Mark Cowen's impact during Covid-19 times

During this time of Covid it has been necessary to stop seeing Mark Cowen for his sports massage services for over a year.

During the last year I have not benefited from a fortnightly muscle massage, resulting in increased post running soreness and a reduction in overall muscle building and robustness in the legs.

I have learned resting, stretching, yoga and rolling techniques that have improved my recovery but my year out from Mark has shown me that there is, on balance, a clear benefit in Mark's massages.

But, just as importantly, I felt that I had lost some benefit in the regular face to face mentoring and discussion that is such a unique selling point of Mark's service.

I have had an unusual cluster of setbacks (eye operation, allergic reaction causing breathing issues (not Covid) and a calf injury all amounted to an unlucky four months of time out from training.

While I am a resilient character and self-driven it is undeniable that I have experienced some diminishing faith in what I can do during this time.

After 3 months of no meetings, we introduced regular phone calls with Mark that has led to a significant improvement in my well-being, approach and has been a boost to my training.

Phone session with Mark have stabilised my mental approach and got me back into the regular patterns.

I don't think it is a coincidence that I have seen my injuries make a small comeback since I have not been able to use Mark's services both as a masseur and as a mentor.

For me clear proof of Mark's skills as a deep tissue masseur but also because of his skills as a very good sports mentor.

- Bob Fairbrother - Runner & Longstanding Client