October 31, 2018
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Get strong and reduce your injury risk

Imagine if there was a form of exercise that could strengthen bones, benefit your heart, help you lose weight, improve your balance AND help prevent injury. There is! Strength (or resistance) training will do all that as well as help you look and feel better.

What is strength training?

Strength training is moving the joints through a range of motion against resistance, requiring the muscles to expend energy and contract forcefully to move the bones.

Strength training is not just about body builders lifting weights in a gym. Regular strength or resistance training will benefit anyone and also helps prevent the natural loss of lean muscle mass that comes with ageing. Being able to move well and with good control over your body will reduce the risk of serious injuries.

Other benefits of strength training

  • Protects bone health and muscle mass

  • Helps keep weight off

  • Helps with chronic disease management

Types of strength training

No single approach to strength training is best for everyone. The choice you make should be based on your physical fitness level, your fitness goals and past injuries. Strength training can be done using various types of resistance, with or without equipment:

  • Machine weights – an effective weight training tool that is safe when used with the proper technique

  • Free weights – versatile and inexpensive, they are generally safe when used with the proper technique

  • Own body weight – with the right technique this is mostly safe and requires no equipment or gym membership, meaning they can be done anywhere, anytime

 

How does strength training prevent injury?

There have been a number of studies that have shown how effective strength training is for injury prevention and management.

This applies to joint injuries, muscle injuries, tendon pain, running injuries... and more!

Strength training improves the strength of muscles, tendons, and even ligaments and bones. Stronger muscles and tendons help hold your body in proper alignment and protect your bones and joints when moving or under impact. Your bones become stronger due to the overload placed on them during training and the ligaments become more flexible and better at absorbing the shock applied to them during dynamic movements.

For example, strengthening the quadriceps muscles in the leg and the gluteal muscles in the hip will improve the movement and control of the knee joint, which is a common instructive in the management of anterior knee pain.

Things to keep in mind

  • A good warm up is critical to prepare your muscles for exercise

  • Ensure you allow enough rest time in between sessions to give your muscles a chance to recover

  • Use the correct form of the exercise, ensuring your body is in proper alignment.

It’s important to build your strength in a gradual and controlled way, and over a period of time as doing too much too soon is actually a significant contributor to injuries and injury risk.

Getting started

If you want to get started with a strength training program, it’s a good idea to get an individualised program that has been designed for you, and to work with a physiotherapist (or other appropriate health professional) to ensure you are executing the exercises properly.

Overall, the idea is for you to integrate exercises that build strength all over, ideally by doing moves that use more than one body part (like push-ups, or squats). Keep things simple at first and time-efficient, since the more convenient your exercise routine is, the more likely you are to stick with it.

October 26, 2018
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Getting back into exercise

By Jordan Wilson, Lifecare Phoenix Physiotherapist

With the days getting longer and the temperature warmer, this time of year simply invites you to get out and about. For many people sunnier days can trigger a feeling of wanting to be more healthy - to eat better, to get more active and make some positive lifestyle changes.

Sound like you? Hooray! It’s never too late to get started.

When it comes to getting ready for (or back into) an exercise program, the very best advice I can give is to go easy on yourself.

The most common issue I see in people starting up a new exercise routine is that they go too hard too soon and end up with an injury that sets them back weeks or more.

Plan and prepare

Be aware of your fitness level before you get started. You could book a consultation with a physio to help you, or at very least:

  • Set goals and be clear about what you are working towards – if you know what you want the process will be easy and you can track and measure how you are going. It could be to lose 3kg, or build muscle, or drop a dress size. Be specific because just having a goal to “get fit” is hard to measure and impossible to achieve.

  • Choose the right activity for you – you should be aware of what you enjoy and find motivating, start there and if you aren’t an exercise person, group sessions might be the way to go.

  • Set up a routine you can stick to – figure out which days you have time to slot in exercise and book it into your diary. It’s best if you can streamline the exercise with your daily routine, so doing something on the way to or from work is ideal.

Gradually build up

If you haven’t done much exercise for a while, no matter how prepared you are, you are probably going to be a bit sore over the first few weeks while your body gets used to what you are now doing with it! In the first few weeks don’t run too hard or too far, don’t lift super heavy weights or push beyond your limits, a planned progressive workload is the best approach where you increase your workload as things start to feel easier. An increase around +10% a week is about right for most people.

Even professional athletes take this approach. It’s the reason why sporting teams have an off season, as it allows them to gradually prepare for match fitness and set up a strong base for the season ahead.

Support and maintenance

Key to a good exercise program is your ability to stick with it over the long term. Here are a few things that will help support your goals:

  • Keep things interesting and fun – there is no point doing exercise if you don’t enjoy it. Play around with how and where you exercise e.g. if you run, you could drive to the beach or a try different running track once a week to keep things interesting.

  • Sleep and diet – both are important to ensure you achieve your goals. Studies have shown that fatigued athletes sustain more injuries, recover slower and perform worse than those who get their 8+ hours. And the right food provides the fuel your body needs to exercise and the nutrients required to build stronger muscles in the recovery stage.

  • Keep moving throughout the day – look for opportunities to add incidental exercise into your day- take the stairs rather than the lift, park the car at the end of the car park when you go shopping. Stand up at work to do reading and set a reminder to do a little stretch every 30 mins or so.

Ask a physio

Seeing a physio can be hugely beneficial throughout your exercise journey especially in the early stages. We can address any little niggles you may be feeling and provide specific treatment and exercises to ensure they don’t hinder your ability to get fit and rear their ugly head just as you get into the swing of things

If you’re unsure about what activity or exercise will work best for you or have trouble thinking of some specific goals we can help with that too. We’ll work with you to set up an exercise program tailored to your overall target and guide you through what to do, how often to do it and realistic and personalised goals to aim towards.

Hopefully these simple tips will encourage you to get back to regular exercise - it’s never too late to get started.

For some more tips and advice take a look at my blog http://www.jordanwilson.physio

September 26, 2018 -->

You can’t stop the clock, but you can slow its tick.

By: Rachel Marin, Master of Clinical Exercise Physiology

As you get older, an active lifestyle becomes even more important for your health and to ensure you maintain independence, recover quickly from illness and reduce the risk of disease.

As an exercise physiologist, new clients will often ask me, “Isn’t it better for older adults to ‘take it easy’ and save their strength?”

And the answer to that is an emphatic ‘NO’. Regular physical activity is very important to the health and capabilities of people as they age. In fact, studies show that ‘taking it easy’ is the riskier path to take, and that people who are physically active have increased overall health and longevity compared with physically inactive people[1].

What do we mean by physical activity?

Regular physical activity can be something as simple as a brisk 30-45min walk nearly every day. It’s about choosing what’s right for you to keep you fit and well for the long term.

Some older people may be affected by chronic health conditions such as arthritis or osteoporosis, which may limit their exercise options, in most cases these physical limitations don’t rule out all activities.

The best approach to take is to talk to your physiotherapist or exercise physiologist who will work with you to create a personalised exercise program that is healthy and safe.

It’s never too late!

There have been a number of studies that have shown that it is never too late to start exercising, and that physical activity is the main contributor to longevity even if you don’t start exercising until your senior years.

As you age, exercise is one of the best things you can do to keep the effects of ageing at bay. In fact, exercise has the ability reverse the symptoms experienced by those with heart disease, diabetes, hypertension, some cancers (breast and colon cancer), depression, osteoporosis, and dementia[2].

No matter your age or physical condition, it’s never too late to get your body moving. Dedicating just 30 minutes of time each day to exercise can ensure your body will continue to benefit well into your 80s.

“We do not stop exercising because we grow old, we grow old because we stop exercising.” 

Kenneth Cooper, MD


[1] Sallis, 2009, Blair, 2009

[2] Sallis, 2009, Blair, 2009, Taylor, Zaleski, Panza, & Bhardwaj, 2016

September 10, 2018 -->

LifeCare Southcare and Australian Doctors for Africa

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Welcome back to Max. He has just returned from Ethiopia, where he represented LifeCare Southcare and Australian Doctors for Africa. Here he is helping teams in a public trauma hospital in Bahir Dar, to promote active mobilisation and successful early discharge in the orthopaedic wards.

These expeditions are extremely important as they not only provide care to nations with limited resources, but they help to educate medical support teams that have limited access to new methods of treatment.

If you’re interested in learning more about Australian Doctors For Africa, please click here.

August 7, 2018 -->

Let’s overcome incontinence

Written by Michelle Hall, Continence and Women’s Health Physiotherapist at LifeCare Cockburn

It may surprise you that approximately one in four Australians, over the age of 15, suffer from bladder leakage, also known as urinary incontinence – that equates to nearly 5 million of us! 

This most commonly occurs with coughing, sneezing or other exertion, which is referred to as stress urinary incontinence. What you may not be aware of is that there is now a wealth of evidence that this common and sometimes embarrassing condition can be effectively treated with pelvic floor muscle training, taught by a qualified Continence and Women’s Health Physiotherapist. 

More common than you think

There are some misconceptions about urinary incontinence. It is usually seen as a ‘women’s issue’, and while it is more common in females, with a third of women suffering from incontinence, men still make up a large proportion of those affected. Many people also assume that this is only an issue for the elderly, however half of women who report incontinence are aged under 50 years.  

Improve your situation. No referrals needed

Fortunately, incontinence doesn’t have to be a lifelong problem and for the majority of people who experience incontinence, physiotherapy treatment can help manage or cure symptoms. A large study done at the University of South Australia has shown that physiotherapy proved effective for 84% of women who received pelvic floor muscle training and lifestyle advice with a qualified Continence and Women’s Health Physiotherapist. The 'cure' rate was still approximately 80% after 1 year, which is comparable to, or even better than, the 'cure' rate reported with surgery.

Continence and Women’s Health Physiotherapists have extra qualifications in treating issues related to incontinence and other pelvic floor muscle dysfunction. Unlike seeing a specialist doctor, seeking help from a specially qualified Physiotherapist does not require a referral. To ensure that you are booked in with an appropriate practitioner, make sure that the receptionist is aware that your appointment is for incontinence or pelvic floor muscle training.

What to expect during your assessment

Your initial consultation will take about 45minutes. To assess your condition your Continence and Women’s Health Physiotherapist may do a postural and movement assessment and an external pelvic examination. Sometimes an internal examination may be advised to achieve an accurate diagnosis, however if you are not comfortable with this, your physiotherapist can assess your pelvic floor using an external, real-time ultrasound.

Make a change

While common, urinary incontinence is not just a normal part of aging, it can be treated! Get in touch with one of LifeCare’s Continence and Women’s Health Physiotherapists for an assessment and management program.

 

References:

Neumann PB, et al (2005) Physiotherapy for female stress urinary incontinence: a multicentre observational study. Australian and New Zealand Journal of Obstetrics and Gynaecology. Volume 45, Issue 3, pages 226–232

Continence Foundation of Australia. https://www.continence.org.au/

August 7, 2018 -->

Your pelvic floor, pregnancy and physiotherapy.

Written by Michelle Hall, Continence and Women’s Health Physiotherapist at LifeCare Cockburn

You’re told to do your Kegel exercises to prepare your body for having a baby; but what does that really mean? How do you know whether you’re doing them properly? It’s one of those things that can be embarrassing to talk about, and yet a conversation and training session with the right person can be extremely beneficial for your long-term health.

 What happens to my pelvic floor muscles during pregnancy?

One of the main reasons we encourage women to have their pelvic floor checked during pregnancy is to determine what type of pelvic floor they have and best prepare their pelvic floor for childbirth. A weak pelvic floor will require a different type of exercise program to an overactive or hypertonic pelvic floor.

Typically, pregnancy hormones cause a ‘softening’ of the ligaments and muscles, which can lead to reduced joint support. This, along with changing posture and the extra weight of a growing baby, can weaken your pelvic floor muscles.

When these muscles weaken during pregnancy, it can often lead to incontinence (accidental leaks of urine when you exercise, laugh, lift, cough or sneeze). It can also lead to lower back pain or pelvic organ prolapse symptoms such as an ache or heaviness, or a lump or bulge inside your vagina that occurs when your bladder, bowel and uterus aren’t receiving enough support.

How can physiotherapy help?

Research shows us that women who do their pelvic floor exercises, “kegels”, during pregnancy have a quicker recovery of their pelvic floor after childbirth, with a reduced risk of bladder and bowel problems. By seeing a Women’s Health Physiotherapist during your pregnancy, you can make sure you are exercising your pelvic floor correctly with pregnancy appropriate exercises. Believe it or not, studies have shown that 50% of women do not do these correctly.

After giving birth, as a busy mum, it sounds onerous to have to make time to do pelvic exercises. The good news is ‘Kegels’, also known as pelvic floor muscle exercises, generally can be done in minutes and you don’t have to go to a gym to do them.

It is highly recommended that every woman has a postnatal assessment with a Women’s Health Physiotherapist around 6-8 weeks post birth to gradually regain strength in the abdominals, trunk and pelvic regions.

Many women are keen to return to sport and recreational activities after having a child, and that requires a strong pelvic floor. So, if you’re planning to get active and hit the gym or are prone to sneezes from hay fever in the spring, make your pelvic floor a strong and resilient friend.

Learn how to exercise your pelvic floor muscles correctly and safely before, during and after your pregnancy by asking to speak with one of our trained Continence and Women’s Health Physiotherapists at LifeCare.
 

  

References:

Morkved S, Bo K. Effect of pelvic floor muscle training during pregnancy and after childbirth on prevention and treatment of urinary incontinence: a systematic review. Br J Sports Med 2014;48:299–310.

Neumann PB, et al (2005) Physiotherapy for female stress urinary incontinence: a multicentre observational study. Australian and New Zealand Journal of Obstetrics and Gynaecology. Volume 45, Issue 3, pages 226–232

Continence Foundation of Australia. https://www.continence.org.au/

August 1, 2018 -->

The truth about osteoarthritis

Written by Olivia Clarke, physiotherapist at Northern Sports Physiotherapy Clinic

We all know someone who suffers from arthritis, hence it won’t come as a surprise when we say that osteoarthritis is the most common form of arthritis. With such an aging population, osteoarthritis will continue to become more prevalent. Therefore, how we manage this becomes even more important.

Osteoarthritis is a degenerative joint condition, where the surface layer of the cartilage slowly ‘wears away’ over time. This affects the joints ability to absorb shock and as a result usually affects weight bearing joint such as knees and the spine. 

osteoarthritis knee.jpg

OA is caused by increased mechanical stress on a joint. This can occur from:

  • Repetitive workloads
  • Occupational factors
  • Postural changes
  • Obesity/overweight
  • Prior injury
    Most common symptoms
  • Joint pain
  • Inflammation
  • Joint stiffness
  • Painful cracking, grinding, clicking
  • Pain after prolonged periods of being stationary

So, if it’s common and degenerative, what’s the good news?

The good news is that just because a joint had OA, doesn’t mean it will necessarily become painful. If it does become painful there are several things you can do to help settle the pain. 

1.    Exercise and strengthening

This is the gold standard for treating OA. The joint will absorb load better if there is adequate strength and mobility in the joint. Therefore, doing the correct style of exercise will improve strength and reduce pain in the long term. Your physiotherapist can help with identifying the best exercise to suit your needs. 

2.    Lifestyle changes

OA can affect your quality of life, but it doesn’t have to. Try things like weight loss, increasing your low intensity exercise and limit prolonged sitting to short periods to help reduce the pain. Your physiotherapist can also guide you on items which may help reduce pain such as JOYA shoes for knee OA. 

3.    Medications

Pain relief can be used when required to reduce inflammation and get you moving again. See your GP about the medication that is right for you. 

If your suffering from OA and want to get back to your best, then give your local physiotherapist a call.

July 3, 2018 -->

Time to hit snooze - the impacts of poor sleep

Written by Ky Wynne, physiotherapist at LifeCare Prahran Sports Medicine.

Sleep is known to be important for learning, memory and cognition. The function of sleep is still not completely understood, however it appears sleep assists with recovery from the previous day and helps prepare for the upcoming day [1]. Sleep has been shown to be a vital component of recovery from sport and activity [2], along with having a consistent association to lower risk of illness and even death [3]. The recommendation is that adults obtain eight hours of sleep per night [1], as periods of sleep deprivation or poor-quality sleep can impact negatively on cognitive and physiological function.

The causes of poor sleep quality

The cause of poor sleep can be multifactorial and with the pressures of daily life leaving most people poor of time, it has become more common for people to be lacking in vital sleep. Some contributing factors that impact sleep quality include personal choice, work, illness/injury, young children, medication, medical conditions, stress/anxiety, caffeine, alcohol, and the environment (e.g. noise levels) [4]. Studies [2, 5] show athletes are often at risk of having poor sleep. The reasons affecting sleep quality in athletes are thought to include the timing of competition (e.g. night games), environmental conditions (e.g. light exposure from stadiums), caffeine ingestion, travel schedules, and heavy training schedules. Concussions have also been reported to cause increased symptoms of sleep disturbance [3]. Adolescent athletes are particularly at risk of poor sleep, with sport and school both factors impacting sleep quality, subsequently increasing their risk of injury [6]

Sleeping Female.jpg

The impact of poor sleep

Poor sleep (sleep loss, deprivation, insomnia etc) affects a multitude of different body functions and systems. Neurocognitive function (e.g. memory, attention), athletic performance, and physical health are all adversely affected [5]. The adverse impacts of poor sleep are displayed visually in figure 1, and include [1, 2, 3, 5, 7]:

  • Impaired cognitive function & performance: memory, attention, alertness, learning, response time, emotional regulation, cognition and vigilance are all impaired or reduced.
  • Reduced muscle repair & regeneration: down regulation of protein synthesis pathway that repairs muscle damage, adversely affecting recovery.
  • Increased exercise induced injuries.
  • Increased risk for chronic health diseases: higher risk of type 2 diabetes, obesity, cardiovascular diseases.
  • Increased perceived exertion: higher RPE (rate of perceived exertion) reported during activity, sport and exercise.
  • Increased inflammation: increased pro-inflammatory cytokines (proteins which are secreted by certain cells of the immune system and have an effect on other cells) (TNFa, PGE2).
  • Altered endocrine function: increased cortisol (stress hormone), with reduced growth hormone and testosterone.
  • Reduced immunity: increased risk for infections (e.g. upper respiratory tract infections).
  • Increased pain sensitivity: higher risk for chronic pain, especially back, shoulder and neck.
  • Impairs nervous system activity: increased sympathetic nervous system activity.
  • Impacts mental health: increased mood disorders and risk of depression.
  • Impaired muscle glycogen repletion: this affects energy stores and recovery.
  • Reduced appetite: this then subsequently affects muscle repair, recovery and performance.
     
 Figure 1. Impact of poor sleep (sourced from  @kywynnephysio )  [8]

Figure 1. Impact of poor sleep (sourced from @kywynnephysio) [8]

Improving your sleep quality

  • Exercise: Regular exercise of moderate intensity is recommended to assist in improving sleep quality [3]
  • Sleep Environment: optimising your sleep environment through factors such as noise and light control can be beneficial [5].
  • Nutrition & Diet: high protein diets may improve sleep quality, whilst foods high in melatonin (e.g. tart cherries) may assist in decreasing sleep onset time. Minimal calorie diets can impair sleep quality if too low [1].
  • Sleep Duration: expanding the amount of sleep time [5].
  • Monitoring: regular monitoring of sleep quality, mental health, physical function and other wellness measures can be important, especially in athletic populations [3].

Need to improve your sleep and want to know how a physiotherapist can help? Get in touch with your local LifeCare clinic by clicking the button below. 

References
[1] Halson, S. L. (2014). Sleep in elite athletes and nutritional interventions to enhance sleep. Sports Medicine, 44(1), 13-23.
[2] Nédélec, M., Halson, S., Abaidia, A. E., Ahmaidi, S., & Dupont, G. (2015). Stress, sleep and recovery in elite soccer: a critical review of the literature. Sports Medicine, 45(10), 1387-1400.
[3] Chennaoui, M., Arnal, P. J., Sauvet, F., & Léger, D. (2015). Sleep and exercise: a reciprocal issue?. Sleep Medicine Reviews, 20, 59-72.
[4] Better Health (2018). Sourced from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/sleep-deprivation.
[5] Simpson, N. S., Gibbs, E. L., & Matheson, G. O. (2017). Optimizing sleep to maximize performance: implications and recommendations for elite athletes. Scandinavian Journal of Medicine & Science in Sports, 27(3), 266-274.
[6] Milewski, M. D., Skaggs, D. L., Bishop, G. A., Pace, J. L., Ibrahim, D. A., Wren, T. A., & Barzdukas, A. (2014). Chronic lack of sleep is associated with increased sports injuries in adolescent athletes. Journal of Pediatric Orthopaedics, 34(2), 129-133.
[7] Fullagar, H. H., Skorski, S., Duffield, R., Hammes, D., Coutts, A. J., & Meyer, T. (2015a). Sleep and athletic performance: the effects of sleep loss on exercise performance, and physiological and cognitive responses to exercise. Sports Medicine, 45(2), 161-186.
[8] Figure 1. Sourced from: https://www.instagram.com/p/BjgeGedFt_t/?taken-by=kywynnephysio