By Josh Roberts Acute, Arthritis, Chronic, Exercises, Injury, Overuse

Navigating Injury: The Art of Pacing and Progression

At Peninsula Osteopathy, we understand that injuries can be both physically and emotionally challenging. Whether you’re recovering from a strain, sprain, or a more serious injury, the journey to healing requires a thoughtful and strategic approach. In this blog, we delve into the importance of pacing activities and effectively progressing or regressing rehabilitation exercises, offering insights that can significantly enhance your recovery process.

Pacing: A Key to Successful Recovery

Pacing, often referred to as finding your “activity threshold,” is a fundamental principle in injury rehabilitation. It involves striking the right balance between engaging in activity and allowing your body the necessary rest it needs to heal. Here’s how to implement pacing:

Listen to Your Body: The first step in effective pacing is tuning in to your body’s signals. If an activity causes pain, discomfort, or fatigue, it’s crucial to acknowledge these signals and adjust accordingly.
Gradual Progress: The journey to recovery is not a sprint but a marathon. Start with gentle activities that don’t strain the injured area and gradually increase the duration and intensity as your body responds positively.
Prevent Overexertion: Pushing yourself too hard too soon can lead to setbacks and potentially delay your healing process. Pacing helps prevent overexertion and promotes a gradual return to your usual activities.
Build Confidence: Pacing allows you to build confidence in your body’s ability to heal and adapt. It also reduces the anxiety that can arise from the fear of re-injury.

Progressing and Regressing Exercises: Your Customised Approach

Progressing and regressing rehabilitation exercises play a pivotal role in your recovery journey. These strategies involve tailoring exercises to your current abilities while ensuring that you challenge your body within its limits. Here’s how to effectively utilise them:

Progression: As your body heals and gains strength, progression becomes essential:

Increase Intensity: Gradually add resistance or weights to your exercises. This stimulates muscle growth and strengthens the injured area.
Expand Reps and Sets: Slowly increase the number of repetitions and sets to improve endurance and muscle conditioning.
Embrace Complexity: Integrate more complex variations of exercises. This engages multiple muscle groups, enhancing overall strength.

Regression: There might be times when you need to take a step back to support your recovery:

Reduce Intensity: Lower the resistance or weight to prevent strain, especially if you experience discomfort.
Limit Range of Motion: If a movement causes pain, reduce the range of motion or opt for a modified version.
Utilise Support: Incorporate assistive tools like bands or stability aids to provide support during exercises.

Musculoskeletal injury recovery is a process that demands patience, resilience, and expert guidance. At Peninsula Osteopathy, our expert practitioners are here to guide you through every step of your recovery journey. Pacing activities and skilfully adjusting exercise intensity are two powerful tools that can expedite your journey to healing. At Peninsula Osteopathy, we’re dedicated to providing you with the support and knowledge you need to make informed choices about your recovery. Remember, every step you take towards progress, no matter how small, is a step towards regaining your strength, mobility, and overall well-being.

July 3, 2023

By Josh Roberts Acute, Arthritis, Chronic, Exercises, Injury, Overuse, Strength

5 Ways Your Rehab is Helping

Rehabilitation exercises are a staple of injury recovery, however we’re all guilty of letting them fall by the wayside from time to time. This blog will show you the many interesting ways in which your exercises are effective, hopefully inspiring you to persevere with them! (And spoiler alert, its not all about strengthening weak muscles!).

1. Motor recruitment & coordination

Rehab exercises can rewire the brain maps responsible for controlling and recruiting certain muscles and patterns, improving the technique and efficiency of your movement. In early stage rehab, the use of external constraints can decrease the number of potential movement solutions – helping to offload painful areas and teach the body how to utilise pain-free movement patterns.

As you progress, the rehab should gradually increase the degrees of available motion to move from rigid movement to fluid and variable movement – more closely mimicking the requirements of a full and active life.

2. Cognitive restructuring

We often fear certain activities and movements as we believe they can make our injury worse. Frequent low load exercise can help to restructure our relationship with movement. By repeating safe movements we can change the way we think about exercise and physical activity, which allows us to do more of our necessary daily tasks and get back to our loved recreational activities.

3. Nociceptive desensitisation

Nociception is the process of nerves sending messages to the brain from a particular body part that something is harmful. The brain then processes and codes the nerve signal and can create a sensation of pain.

During injury these nociceptive nerves can become more sensitive, due to many factors including inflammation at the injured body part. Exercising the sore body part causes the brain to respond to this demand by acclimating to the sensation, thereby decreasing the body’s pain response to the particular stimuli. The body gets used to the stimulus and it therefore becomes tolerable, no longer eliciting the pain response.

4. Descending pain inhibition

This phenomena is similar to taking medications that are designed to decrease pain, like panadol. Exercise causes nerves and chemicals to be stimulated that have a hypoalgesic effect – meaning they directly dampen the sensation of pain.

5. Progressive strength

Although early rehabilitation isn’t focused on building strength, it sets the foundation for further exercise progression. A good rehabilitation program should always be progressing towards a higher goal. As the aforementioned characteristics are achieved, the exercise prescription should increase its intensity – either by increasing load/weight, increasing volume, decreasing rest periods, or progressing to a more challenging movement.

Conclusion

Rehabilitation exercises are not just mundane routines, but powerful tools that facilitate a holistic recovery journey. They serve as more than just a means to strengthen weak muscles; they actively engage the brain, reshape our perceptions, and recalibrate our pain responses. Through consistent practice, we not only rehabilitate our bodies but also transform our relationship with movement and pain. Embracing these exercises not only aids in physical recovery but empowers us mentally, allowing us to reclaim our lives, one pain-free step at a time. So, let these insights inspire you to persevere with your exercises, for they are not just a path to recovery, but a gateway to a stronger, more resilient you.

September 15, 2022

By Gemma Percy Children, Exercises, Injury, Sporting

PROMOTING LONGEVITY IN SPORTS!

YOUTH INJURY PREVENTION

Fun facts:

• 81% of girls and 78% of boys aged 15 years or over complete sport or physical activity at least once a week.
• 65% and 59% of girls and boys participate 3 times a week.
• 42% of children under the age 15 are involved in some form of organised sport at least once a week outside of school hours.
• The most common demographic for ACL rupture is 15 year old girls.

With rising participation of kids and adolescents in organised sports it is no surprise that the number of injuries we are seeing in this population is also on the rise. If you’ve ever been involved with children you would know that most kids are far more bendy and flexible than the average adult – This is largely to allow us to grow and develop. Through our youth years we have growth plates all over our body that on average aren’t fully fused until we are about 15 years of age – once these growth plates have fused we are considered skeletally mature and growing ceases.

As little ones grow and develop interests in organised sports they are predisposed to a few common injuries – some of these are related to growth spurts and the non-fusing of growth plates at this age however a large number of injuries can be contributed to factors such as:
• Reduced muscle strength
• Lack of/ poor coordination
• Posture/Reduced trunk control
• Poor balance

Injuries can have long term effects, physically and psychologically, and often lead to drop out of sports – however a well planned and executed prevention program may reduce the chance of injuries such as ACL tears, ankle sprain and lower leg tendinopathies by up to 50% in youth!

Neuromuscular training, which can be defined as general and sport-specific strength and conditioning activities and exercises that aim to enhance health and skill related physical fitness components, has been shown to assist in reducing lower limb injuries – particularly in court based sports such as football, basketball, soccer and netball. Like our skeleton/bones our brains are developing and creating new pathways at a rapid rate when we are young, therefore repeated exposure to skill specific training at a young age can have long-standing and positive effects on prevention of injury.

Neuromuscular training provides best outcomes when completed both pre and during season 3 times weekly – Neuromuscular training can be incorporated into warm up for 15-20 minutes of a training session or pre game.

An example of this for ACL prevention may include:
• 2 x 10-12 each leg alternating lunges
• 2 x 6-8 sets of Nordic hamstring curls
• 2 x 10 – 12 reps of calf/heel raises
• 2 x 5 double leg broad base jumps
• 2 x 5 each leg single leg distance hops
• 2 x 5 each leg zig zag hops

It is important to note that for injury prevention to be effective proper biomechanics and optimal form should be taught and closely monitored during a session.

Start your kids with injury prevention habits today to help keep our young ones healthy and active into their adult lives.

Advice in this blog is general only and for more specific advice you should also consult your health professional and/or coach!

July 8, 2022

By Caitlin Wright Exercises, Yoga

Yoga – not just about being flexible!

What is yoga?

Yoga can be described as a mind, body breath experience. Yoga is a combination of physical postures (asana), breathing techniques (pranayama) as well as meditation and relaxation practices. Yoga at its core is for everybody regardless of age gender or physical ability.

It has only been in recent history that there has been more focus on the physical practice. However, yoga encompasses so much more. Yoga empowers individuals to thrive in their own body and mind. This is achieved by cultivating self awareness, self reflection and mindful movement.

Different types of yoga:

Yoga has evolved in the modern times and there are many different types of practices. Below is just a short list of examples:

Hatha* umbrella term- this type of yoga involves a set of physical postures and breathing techniques. Hatha is generally more slower paced than Vinyasa type.
Ashtanga
Iyengar
Kripalu
Kundalini
Bikram
Power
Yin* more meditative type of yoga that’s done lying on a mat and using props. This targets connective tissues. It involves long holds of 3-5 minutes.

Benefits of yoga:

Increases muscle stretch and tone
Increases flexibility of joints and nervous system
Improves balance and coordination
Improves respiration and energy
Improves circulation and lowers blood pressure
Increases self awareness
Improves focus
Helps with stress management
Encourages self care

Yoga Terminology: Here are 3 words that may help you understand some aspects of the yoga practice.

ASANA: YOGA POSES

Asana is defined as “posture or pose;” its literal meaning is “seat”. Yoga postures or asana are combined together to create a flow or sequence of poses.

PRANAYAMA: YOGA BREATHING

Pranayama are breathing exercises developed by the ancient yogis for purification. Prana translates into “life force energy” and Yama translates into “control or mastery of.” Therefore, Pranayama is used to control and cultivate the life force within the body.

NAMASTE

The literal translation is “I bow to you”. It has typically been used in Western yoga practice at the conclusion of a class. However, the usage of the word is evolving. Students are encouraged to be mindful of how and when to use the word.

Sama Vritti
A pranayama exercise to try

Sama Vritti aka equal breath or box breathing. Sama means “equal”, and vritti means “mental fluctuations”, Sama vritti pranayama uses equal lengths on inhales, exhales and breath retentions. This exercise can improve our ability to bring oxygen into the body, but is also great for calming the mind and improving relaxation.

How to practice:

Find your seat: This can be on a bolster, in comfortable chair or laying on your back.
Find your breath: With the mouth closed, inhale and exhale through the nose in a slow, even and continuous flow. Take your breath into you abdomen so the belly rises and falls.
Start your breath cycle: go at your own pace
Inhale for a count of 4 (you can choose a count that’s most comfortable for you)
• Hold the breath in for a count of 4.
• Exhale for a count of 4.
• Hold the breath out for a count of 4.
Find your flow: Repeat the four-part cycle for another 2-6 rounds of breath. When you are comfortable with the practice, you can increase the duration to 10-30 breaths or a maximum of 10 minutes.
Daily practice: to receive the most benefits from the practice

Introducing Therapeutic Yoga.

Have you always wanted to try yoga but felt intimidated by the larger classes at your local studio? Join our Osteopaths as Peninsula Osteopathy and Allied Health for more of a clinical approach to yoga practice. Breaking down pranayama and asana at a slow controlled pace. Tailored to meet individual needs from absolute beginners to individuals returning to yoga asana after injury. Smaller classes of 5-8 people, fun and free from judgement.

* Other classes that will be offered at our new movement space.

June 7, 2022

By Demi Donegan Acute, Chronic, Exercises

Lower Back Pain

Low back pain is pain felt in your lower back or lumbar spine. Most people have lower back pain at some point in their life. For most people back pain comes on quickly (acute back pain), but then improves or goes away within three to six weeks. However, it is common for it to come back, with some people going on to develop more persistent pain (that lasts for more than three months).

What causes lower back pain?

The causes of back pain are not fully understood. Most people with back pain don’t have any significant damage to their spine. The pain comes from the muscles, ligaments and joints.

Common contributors to back pain include:

repetitive or heavy lifting (manual handling)
sudden awkward movement
not getting enough regular physical activity (being sedentary)
poor posture
stress – muscle tension.

What to do if you have back pain?

Stay as active as possible – talk to your Osteopath or doctor if you need specific advice for your situation
Manage your stress
Relaxing – learn some relaxation techniques to reduce stress levels, try some heat packs or gentle exercise to calm your nervous system
Learn more about your particular injury – what makes it better, what makes it worse?
Lift and carry safely – ask for help if something is too heavy to lift alone.

Exercise and low back pain:

Exercise is great medicine for lower back pain, with no specific type being the best. Just stay as active as you can, allowing for the restrictions in movement that may come with pain. If you enjoy gardening, then staying active may mean pottering in your garden, even if heavy jobs such as digging or pruning are too much for you. If you run regularly, staying active may mean continuing training but reducing the distances you run each week. This will all depend on the severity and presentation of your pain. Speak to your Osteopath or GP for specific advice for your situation.

If you are having persistent low back pain, a strengthening program may be necessary to help you overcome or manage your presentation. This should be relevant to the way you prefer to exercise.For example if you stayed active by walking, to gain further health benefits you now need to walk further or faster, walk up hills, or carry extra weights. It is important to seek guidance in this as each presentation of back pain is different and should be tailored to you.

December 23, 2021

By Gemma Percy Exercises, Running, Sporting, Tendon pain

Tame Your Achilles Tendon Pain!

With the warmer weather and a new year in sight it is likely many of you are experiencing a surge in motivation to get your body moving more – however it is important to bear in mind that doing too much too soon or too quickly can wreak havoc on the body if unprepared! In this article we will touch specifically on Achilles tendinopathies unravelling the who, what’s, how’s and why’s behind why your Achilles might be angry.

What is a tendon?

A tendon is a well-organised collagenous tissue designed to bear large loads and act as an imperfect spring as we move our body. Tendons are all over the body connecting our muscles to our bones and work to store and release energy to produce high and fast loads that allow us to walk, run and jump at max efforts!

Who gets Achilles tendinopathy?

Achilles tendinopathies hold no prisoners affecting nearly all population groups – young & old, walkers & runners and those playing multi directional sports. So what causes tendinopathies to develop? The largest risk factor for developing a tendinopathy is a sudden and unprepared change in load – for the Achilles this could include:

• Increased distance of walking/running
• Increased speed
• Introducing hills
• Change of footwear
• Change of surface
• Training for an event

This change in load causes the tendon to become overloaded resulting in a cascade of changes within the cell make up of the tendon resulting in inflammation and often pain.

Symptoms of Achilles tendinopathy:

Those with Achilles tendinopathy will often complain of localised pain over the Achilles insertion, pain that is worse with walking or hills, morning pain/stiffness. Typically pain associated with a tendinopathy will be worse before and after a session and tend to improve throughout the session itself.

How to manage Achilles tendinopathy?

So what to do if this is all sounding a little too familiar? It is a common misconception that when experiencing pain we should immediately stop all aggravating activities and rest – however when dealing with tendons this is not the case. Due to the nature of tendinopathies it is important that part of the treatment involves loading the tendon to improve its capacity to store and release energy through explosive movements.

Initially to reduce pain you may be required to partially de-load your tendon and stop explosive efforts that require large amounts of stretch & shorten through your muscles. This could include reducing the km’s you walk/run by 50% and resting from all jumping activities while working on slowly loading the Achilles tendon.

In the initial stages of your Achilles tendinopathy your health professional may use therapies such as:
• Manual therapy – soft tissue massage, joint mobility and stretching
• Myofascial dry needling
• Taping to offload the affected area
• Heel wedges or orthotics

Those with Achilles tendinopathy may also find it useful to:

• Limit prolonged standing
• Limit calf stretching
• Limit flat shoes/barefoot

Finally your health professional will work with you to develop a rehab program that will target strength of the Achilles tendon – this will likely include isometric exercises, which require you to hold a certain position for periods, isotonic exercises such as calf raises and in the later stage the introduction of specific hopping, jumping and explosive exercises to ensure a safe and pain free return to walking, running or sport!

For more specific and tailored advice be sure to chat to your Osteopath to work out a plan that works best for you and to address any barriers or fears you may have associated with your Achilles pain. Always consult your healthcare provider before commencing a new exercise program.

December 17, 2021

By Josh Roberts Exercises, Running, Sporting, Strength

How to Overcome Your Hatred of Exercise

Being physically active is an extremely daunting prospect for many people. A lot of us have had very negative experiences with exercise over our lifetime. Social pressures, perceived failures, injuries, pain, and being forced into sports and activities that we genuinely don’t enjoy, has tainted exercise for many of us. Now, into our adult life, there are other responsibilities that soak up so much of our time and energy. It can feel almost impossible to carve out enough time to get a workout in.

Unfortunately, our aversion to exercise is really hurting us. The benefits of physical activity are so broad and encompassing, and so extremely meaningful and powerful. If scientists were able to design a pill that provided the same physical, mental and social benefits as exercise, every person on the planet would be taking it.
Although it’s not as easy as taking a pill, physical activity doesn’t need to be hard and complicated either. Physical activity should be as easy and as painless as possible. It can, and should, fit into your life in a way that becomes second nature.

Exercise can become something that anyone can enjoy, it just needs to be reframed and rethought. These tips are here to help you form a positive habit and build exercise into your lifestyle.

1. Start small

Image: https://www.mentalfloss.com/article/67661/16-little-words-and-phrases-describing-small-amounts

Doing any physical activity is better than doing none. If you’re fairly inactive at the moment, just take the first step. It doesn’t need to be grand. In fact, habits are more likely to stick if they have a low barrier-to-entry and a good chance of immediate success. That means, don’t worry about fancy equipment or expensive gym memberships. What’s the most simple activity that you can think of that involves moving your body? Walk, dance, crawl, roll, sweep, dig, run, jump, swim, ride, play, pilates. Anything. Just move a little bit more than you did yesterday and you’re becoming physically active! Achieving a meaningful goal, no matter how small, will unlock the brain’s neurotransmitters to 1) make you feel good about yourself, and 2) rewire the neural circuitry of the brain to make that habit more permanent.

2. Have fun

Image: https://host-students.com/dance-workouts-you-can-do-at-home/

In what way could you move your body that will provide you with a feeling of happiness and fun? It’s different for everyone, and it can often take a long time to find the activity that lights you up. So be ready to experiment. And think outside of the box, it doesn’t need to be an organised form of exercise – like running, golf, kayaking, rock climbing, frisbee, etc – it can be any random activity that involves movement; kicking a ball around with your dog, dancing in the kitchen, walking to the supermarket, rearranging furniture in your house… Absolutely anything. Don’t restrict yourself to the schoolyard parameters of beep tests and team sports.

3. Team up

Image: https://www.austinfitmagazine.com/March-2015/stay-in-shape-by-walking-with-friends/

More often than not, you’re not the only person in your social circle who is looking to get more active. Be vulnerable and ask a mate if they’ll start going on a morning walk with you once or twice a week. Having an accountability partner makes it easier to get out of bed when the alarm starts ringing. It’s harder to bail on a buddy than it is to bail on yourself. Plus, the benefits of chatting, laughing and spending time with other people compounds the mental and emotional benefits of exercise!

4. Be forgiving

Image: https://centerforliving.org/blog/5-best-self-care-tips-this-fall/

It’s OK to miss a day, a weekend, a week, a fortnight… Don’t sweat it. We’re all human, fallible and imperfect. Sometimes life gets in the way – you get tired, become distracted, unmotivated or lazy. That doesn’t mean you’re a bad person. Your self-worth doesn’t depend on you being perfect, or exercising every day, or being kind and calm and caring to every person you interact with! You are allowed to stuff up. You’re allowed to be selfish. You’re allowed to sit on the couch eating ice cream and watching telly. You’re enough, regardless of these behaviours. So when you miss a day, wrap a metaphorical arm around your own metaphorical shoulder and forgive yourself – there’s always tomorrow, and every day thereafter, to go out and exercise. Habits aren’t built in a day, so having one off won’t derail the train. In his book Tiny Habits, leading behavioural expert B.J. Fogg says it best; “people change best by feeling good, not feeling bad”.

The Nuts and Bolts

Adult Australians are recommended to do 2.5-5 hours of moderate intensity exercise per week, or you can halve that time and do your exercise at an intense level for 1.25-2.5 hours.

Image: https://www.amhf.org.au/essa_helps_men_move_with_new_male_specific_exercise_resource

So what does that look like in practice? Here’s a couple of suggestions to get you up to the baseline requirement for physical activity without breaking a sweat.

You can briskly walk 15-minutes from your car to your workplace (and vice-versa) 5 days a week, and you’re hitting the low-level guideline. If you haven’t walked much for many months or years, start with a 5-minute walk and build up over a few weeks.
In the morning before work, put some music on while making breakfast, and dance around like a fool for 15 minutes til you get a little breathless. Do the same when you get home that evening, and bingo, there’s your 30-mins of daily moderate intensity activity.
Go for a 5 minute walk in the morning sun. Put on your favourite song and dance for 5 minutes. Do 2 push ups. Quickly vacuum the hallway. Throw a ball to your dog 5 times. Park 500m away from work. Do 5 squats on your lunch break. Get home and go for a 5 minute walk in the afternoon sun. Water the garden. Surely that’s 30 minutes all up?

Take Home Message

Don’t make it complex. Don’t make it hard. Make it fun, make it silly and make it likely to succeed. Once you get a few wins on the board you’ll be even more likely to start adding in more, higher intensity, activities.

September 4, 2021

By Josh Roberts Exercises, Running, Sporting, Strength

5 Must-do Exercises for Beginner Runners

Some people might say I’m crazy but I seriously love running. It sets up my day, drags me out of bed, and gives me a boost of endorphins that allow me to drive all the way to work with very few road rage incidents. I use it as a way to catch up weekly with friends, meet new people, and keep myself relatively healthy. It’s easy, basically free, and accessible to almost anybody.

There are a myriad of benefits to running! It’s a safe and effective way to improve cardiovascular health, bone density, muscular endurance, boost mood, and improve energy. With these few exercises, some smart programming, and a few expert tips you too can enjoy all of these benefits – physical, mental and social.

But beware, all of the exercises in the world won’t make up for doing too much too soon. An estimated 60% of running related injuries are linked to increasing mileage too quickly. Get a running plan in place that is tailored to your needs and slowly increase your weekly load in 10% increments. If you’re new to running altogether, start by increasing your daily walking before beginning to add small bouts of running.

Every individual has their own unique injury history, strengths, weaknesses, and running goals. Therefore it may be helpful to speak to the team at Peninsula Osteopathy + Allied Health, to get screened and assessed on your current capacity, and provided with an individually tailored plan to ensure you hit the ground running! (Pun intended).

Single leg sit-to-stand

Single leg strength, stability, and endurance is a huge component of running efficiency and capacity. The average runner should be aiming to take around 160-180 steps per minute, so for a 25-minute jog, each leg must support the weight of the body approximately 4000+ times! The single leg sit-to-stand is the perfect way to begin loading the muscles of your hip, buttock and leg – in a similar fashion to the way they are required to work during running. Your health practitioner can help ascertain when and how to progress the exercise, by adding weights, increasing the range of motion, and more!

Glute bridge

This exercise focuses on hip extension and increasing the control of your lumbopelvic region (from your low back into your hips and buttock). Our hip extensors, such as the gluteus maximus, are the powerhouse of the running stride. The glute bridge can be altered to become single leg, weighted or with different tempos, all of which may be smart progressions for your practitioner to explore with you.

Hamstring bridge

Weakness in the single leg hamstring bridge test has been shown to predict hamstring related injuries in AFL players and military personnel. While we may not be reaching the pace of an AFL player, hamstring strains, tendinopathies, and niggles are still very common amongst casual runners. Start double leg and work towards a single leg variation.

Copenhagen adduction

Hip and groin pain is another common running niggle. This exercise increases the strength and control of your adductors (groin) while also providing a side plank core control exercise – bang for buck! Begin with a short lever (knee on the chair) and progress to long lever when ready (ankle on the chair).

Calf raises

The calf complex is made up of the gastrocnemius (the big two headed muscle you can see) and the soleus (underneath and severely under-appreciated). The soleus actually produces the majority of force in the ankle during running. To strengthen the soleus do calf raises with a bent knee and to strengthen the gastrocnemius do them with your knee straight. Did anyone notice that I snuck in 6 exercises?

Bent Knee Variation | Straight Leg Variation

September 3, 2020

By Belinda Kelly Exercises, Sporting, Strength

STRENGTH! WHAT IS IT GOOD FOR?

Training for strength

Strength training uses the most weight with the least amount of repetitions with long rest periods in-between. Aiming for the ability to lift large amounts of weight for less time. Following the process of task-specific training, this is most effective for people who are trying to increase their overall load to be moved.

Training for Muscle Hypertrophy (growth)

Hypertrophy refers to muscle size as well as strength, you may see this in body-building where they utilise lighter weights, more repetitions and less time resting for particular muscle groups. Muscles require metabolic stress to increase in size, thus as a result of lactate acid build up and micro tears, the muscle then uses its repair process to rebuild and grow larger. This principle is best used for those beginning any exercise program as this utilises the aims of both muscle strength and movement, combining components of strength and endurance principles.

Training for Power

Power training involves using reasonably lighter weights and longer rest periods whilst the aim of the movement is to encourage speed. Power generally refers to the ability to move at high speeds. Power also includes the use of physics where force equals mass times acceleration and power training aims to practicing the acceleration part of the lift. Power principles are usually seen in athletes or powerlifting where weight is increased but require a high speed to move a certain weight. Power based exercises can also be found in HIIT workouts where explosive movements are completed with reduced rest.

Training for Muscular endurance

Endurance training requires more repetitions to ensure muscle functioning can last longer, usually with lighter weights. Rest is usually less for this principle as endurance is suggestive for long durations with little recovery. Endurance based programs for created for marathon runners, or for the everyday person to be able to withstand loading for an extended amount of time.

Which one is for you?

Consider your goal – what do you want to achieve out of your exercise program?
Consider your day-to-day activities – what do you do each day that requires a specific exercise program relative to your daily routine?
Consider what you have done previously – exercise, work and medical history can all have an impact on the physiological systems used within each of the above principles.
A training program is a variety of structured exercises using the principle FITT will guide you towards achieving your goals better.
• Frequency
• How many times a week for an activity?
• For sedentary individuals, start with 2-3 days/week of aerobic exercise and build up to 5 days/week. Build an exercise regime suited to your lifestyle.
• Intensity
• How hard to exert?
• Someone new to exercise should start at a low intensity, but health changes occur at a moderate exercise intensity
• Type
• Which type of activity should you do?
• Should be enjoyable, affordable, and achievable
• Time
• How long in minutes
• This does not include the warm up or cool down.
• 10 min bouts of exercise can be accumulated throughout the day
• If walking is the exercise – first increase the time before increasing the intensity (walking uphill/at a quicker pace)

Training or exercise programs are always most efficient when tailored specifically for individuals and their goals.

Medical Clearance and assessment is always advised prior to beginning any new exercise regime
Individuals unsure of the correct technique, exercise programming or structuring of a resistance program individual to their goals should consider receiving information and education from a qualified health/fitness professional, or Exercise Physiologist.

Any questions or concerns or if you would like to book in for an appointment to discuss your exercise goals, please contact the clinic on 5253 2345. You can also book online on our website!

Written by Tiarna Preer, Exercise Physiologist

References:

American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. Philadelphia :Lippincott Williams & Wilkins, 2000.

This pronouncement was written for the American College of Sports Medicine by: William J. Kraemer, Ph.D., FACSM (Chairperson); Kent Adams, Ph.D.; Enzo Cafarelli, Ph.D., FACSM; Gary A. Dudley, Ph.D., FACSM; Cathryn Dooly, Ph.D., FACSM; Matthew S. Feigenbaum, Ph.D., FACSM; Steven J. Fleck, Ph.D., FACSM; Barry Franklin, Ph.D., FACSM; Andrew C. Fry, Ph.D.; Jay R. Hoffman, Ph.D., FACSM; Robert U. Newton, Ph.D.; Jeffrey Potteiger, Ph.D., FACSM; Michael H. Stone, Ph.D.; Nicholas A. Ratamess, M.S.; and Travis Triplett-McBride, Ph.D. Progression Models in Resistance Training for Healthy Adults, Medicine and Science in Sports and Exercise: February 2002 – Volume 34 – Issue 2 – p 364-380

August 5, 2020

By Gemma Percy Elbow, Exercises, Sporting, Tendon pain, Uncategorised, Work Injury

Tennis Elbow – in the non-tennis playing individual!

What is tennis elbow?

Are you someone suffering from pain on the outside of your elbow and Dr Google is telling you that you have tennis elbow, despite never touching a tennis racquet in your life? Tennis elbow, otherwise known as lateral epicondylalgia, is an overuse injury affecting the outside of your elbow resulting in pain, tenderness and substantial limitations in functionality of the upper extremity.

Clinically tennis elbow presents as pain that is aggravated with repeated movements of the elbow or wrist, pain with lifting and decreased or painful grip strength.

Lateral epicondylalgia commonly affects those in office jobs, construction/repair, cleaners and healthcare workers and is associated with repetitive bending and straightening of the elbow joint for more than 1 hour per day.

In greater depth lateral epicondylalgia is both a load related and systemic based condition that ch

aracteristically has an acute inflammatory stage and a chronic degenerative stage. Lateral epicondylalgia affects the extensor carpi radialis brevis tendon and occurs when there is weakness and decreased capacity of the tendon to manage loads resulting in micro tearing within the tendon. This micro tearing further reduces the tendons capacity and elicits a pain response with in our body such that activities of daily living such as picking up a coffee cup can be sufficient enough to trigger pain.

Lateral epicondylalgia often goes hand in hand with a mild degree of shoulder girdle weakness. When using our arms for day to day activity we require a transfer of energy along the chain from shoulder to elbow to wrist – in tennis elbow a weakness in the shoulder leads to an increased demand on the elbow and wrist and hence an overload as discussed above.

The good news is that tennis elbow is generally self limiting meaning that within 6-12 weeks you are like

ly to experience significantly less pain, improved functionality and healing of the underlying tissues.

So how can treatment help?

Treatment of tennis elbow may involve soft tissue massage, joint mobilisation/articulation and mild or gentle stretching in combination with strengthening exercises to prevent reoccurrence. The goal of treatment is to reduce the duration of symptoms and associated disability. Treatment is thought to stimulate mechanoreceptors, which in return inhibits or blocks pain signals from nociceptors reaching the brain.

Your practitioner may also suggest a brace or assist you with taping techniques of the elbow to increase your function. Taping/bracing plays a role by placing tension at point on the muscle distally to irritated/damaged tendon site promoting healing of the damaged area.

In some cases injection of cortisone may be indicated however there is research to suggest that injection may lead to poorer long term outcomes in function and movement.

Getting started – What can I do from home?

The best thing you can do to help yourself is to rest from aggravating loads – this may include avoiding repeated wrist, forearm or elbow movements. It is important not to avoid all upper limb movement as this may further decrease the ability of your tendon to load! When completing movement or exercise it is important to take note of your pain levels – if what you are doing is increasing your pain rating by more than 1/10 it is advisable to stop that activity/exercise where feasible.

Caution should be taken with stretching, as overstretching may further increase tension/load on tendon and influence the pain response – when stretching the extensor muscle group you should complete this with your elbow bent at 90 degrees and stop if pain persists. The use of ice (cryotherapy) may be of benefit in reducing the inflammatory response and assist in reducing the acutely painful elbow.

Exercises that may be beneficial in reducing pain and improving the overall function are outline below:

1. Isometric wrist extension

• Start in a seated position with your forearm resting on a table and your palm facing down.• Place your other hand on the back of your affected hand.
• Attempt to lift your affected wrist up, whilst resisting the movement with your good hand (Ensure you keep your forearm in contact with the table.)
• Hold this position for 10 seconds
• Repeat 10 times, 3 times through with a 60 second rest between sets.

2. Scapular retraction

• Start in a standing position with your arms by your side and palms facing backwards.
• Gently push your hands backwards and feel a gentle squeeze between your shoulder blades (Ensure you keep your shoulders away from your ears)
• Hold this position for 2 seconds and slowly return to starting position
• Repeat 10 times, 3 times through with a 60 second rest between sets.

We encourage you to consult a health care practitioner if your pain persists or for more personal advice and advanced care of tennis elbow.

Category: Exercises