Exercise GuidelinesMany clients ask how much exercise should I be doing? It is a question that is often asked and not many people seem to be able to answer. In many cases, injuries are caused by deconditioning and muscle atrophy, which leads to problems with pain and loss of physical function. It is important that people get sufficient exercise to maintain their level of function and current fitness levels, however it is important that people know how much activity they should be doing.
General Exercise GuidelinesThe Australian Government department of health states that adults between the ages of 18-64 should accumulate a total of 300minutes of vigorous exercise per week, including completing specific muscle strengthening exercise on 2days. For people aged 65 years + it is recommended that people complete 30 minutes of moderate intensity exercise every day.
What is vigorous exercise?Vigorous exercise is counted as exercise where you are breathing hard and fast, with a moderate increase in your heart rate.
What is moderate intensity exercise?Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell if you're working at a moderate intensity is if you can still talk but you can't sing the words to a song.
Is walking enough?People often ask if walking is enough. If you are walking at a moderate intensity as described above, for 30 minutes per day, then you should be meeting recommended exercise guidelines for people aged 65 +. However, if your physio advises strengthening a muscle group or area, then walking is not sufficient.
How to build strength?https://www.youtube.com/watch?v=2tM1LFFxeKg Strength is often recommended to rehabilitate an injury and protect an area of the body. Strength is built by placing the tissue under stress so that you are causing microscopic damage to the tissue. Once this damage occurs, the body will heal the area, making it stronger and able to withstand greater stresses in future. Our bodies have adapted to be able to cope with the demands of everyday activities, so it is important that when strengthening a muscle you are placing it under sufficient loads that are greater than what the body typically experiences. If you are not meeting the recommended exercise guidelines including 2 sessions of muscle strengthening per week, you may be vulnerable to muscle loss or atrophy, and may be developing a greater risk of injury. In summary, completing adequate levels of activity are important for maintaining physical functional and limiting the effects of injury. Physiotherapists are experts in instructing people on how to exercise in the presence of injury or pain. If you are unable to meet your activity levels due to injury, then ask the physio how to work around the injury whilst we help the body to heal.
Remedial massageThe intention in remedial massage is to ‘remedy’ the body. This style of massage holistically looks at the entire body, with its focus being treating pain, structural dysfunctions and helping in injury rehabilitation. Remedial massage therapists use assessments and tests to find out what structures are causing your pain or your postural dysfunction. Usually muscular pain such as low back pain, is caused by either weak muscles, overactive muscles or compensating muscles. Once the remedial therapist has found the cause of your pain/discomfort, the massage will then be focused around treating the muscles that are causing the pain in your body. Therefore remedial massage is specifically tailored to each individual unlike most relaxation massages. A remedial massage will involve a variety of techniques, targeting specific muscle groups. Some techniques include trigger point therapy, PNF stretching, Myofascial release and muscle stripping. The pressure in remedial massage can be at times deeper than in relaxation massage, but always working in what is tolerable for the client. People who will benefit from a remedial massage include anyone who is experiencing muscle tension, or anyone experiencing acute or chronic pain, some examples being low back or neck pain. Like relaxation massage remedial massage is also beneficial at stimulating blood flow throughout the body and assisting in toxin removal. Although remedial massage may not be considered as relaxing at a relaxation massage, it’s still very effecting at calming the mind and body. Especially seems as remedial massage treatments can take away your musculoskeletal pain, which has a direct effect on your mental and emotional state.
What is degenerative disc diseaseDegenerative disc disease is commonly seen in lower back and neck CT’s and MRI’s. It is a radiological term used for explaining anatomical changes in a disc rather then a pathology. Having this in mind when degenerative disc disease is coupled with pain it is most commonly due to issues with surrounding structures e.g. weakness and/or stiffness. Having degenerative disc disease does not always mean that it is causing pain output. Weaknesses of surrounding structures can lead to shear, compressive or tensile forces which make the more vulnerable discs stress. The protocols to then treat a painful back with a history of degenerative discs is to make sure surrounding structures are strong and supple. This will take away the forces on the vulnerable discs. It does not mean though that those discs will heal it only means a better managed pain state. These discs will always be structurally vulnerable due to their lifetime of stressors. Do not wrap yourself in bubble wrap to avoid this natural wearing of discs as it will most likely happen quicker. Be aware of remaining constantly active throughout your lifetime and treat your body with the respect it deserves.
Lateral Hip PainHave you recently started to get pain in the side of your hip? Has it been there before and then come back again? Have you had corticosteroid injections that have relieved pain temporarily or not at all? If so, read the blog below to help you get on-top of your stubborn hip pain and start the pathway back to performance. Lateral hip pain can be referred to as Greater Trochanteric Pain Syndrome, Trochanteric Bursitis, Glute Medius Tendinopathy or Hip Bursitis. All these terms are used to describe pain inside the hip and buttock region, on the bony part on the side of your hip (greater trochanter) and sometimes down the outside of the thigh. The hip pain can be aggravated by sitting cross-legged, prolonged walking, prolonged sitting, climbing stairs/hills and lying on the painful hip. Ultrasound imaging of lateral hip pain often illustrates inflammation or thickening of the trochanteric bursa or ‘bursitis’. A bursa is a small fluid-filled sac that provides a cushion between bones and tendons throughout the body to minimise friction. You may have been given a corticosteroid injection into your bursa to ease this inflammation. These injections can be effective in reducing your pain, but this may only be short-lasting! Often trochanteric bursitis is a secondary reaction to a Gluteus Medius/Minimus tendinopathy or weakness in this hip muscle group. Dysfunction in these muscles can increase the compression force on the bursa and tendons. Prolonged and repeated compression of these structures without suitable exercise and lifestyle modifications can cause thickening and inflammation of the bursa, and potentially tendon degeneration.
Benefits of GardeningWhether you’re growing fruit and veggies, flowers or succulents, getting your green thumb on can have a surprising number of health benefits for you and your family. Stay fit and active in the garden Depending on the size of your garden, maintaining it can be also be a great way to be physically active. This could be as strenuous as mowing the lawn, or as gentle as getting a good stretch and practice stabilising yourself while kneeling, sitting or reaching. In fact, gardening is a recommended activity as it can encourage the use of many motor skills, improve endurance and strength and keep you moving. Eat your greens Do you have a picky eater at your dinner table? Kids who are picky eaters may be keener to try new foods that they’ve helped to grow. Watching the plants sprout and grow and waiting until fruit and veggies are ripe and ready to eat can help build their enthusiasm and excitement about healthy foods. The effect works on everyone, not just those with hard-to-please tastes. Growing your own fruit, vegetables and herbs will encourage you to eat seasonally, add more variety to your diet, encourage you to prepare homemade healthy dishes and learn to appreciate fresh produce. Understand seasonality These days, we can buy pretty much any fruit and vegetable we want from the supermarket, at any time of year. But eating seasonally has important benefits for our bodies. Different fruits and vegetables are “in-season” at different times throughout the year. For example, asparagus and apricots grow in spring and summer, while Brussels sprouts get going in winter. Eating seasonally can keep healthy eating exciting by encouraging you to try new recipes using in-season produce. You will also get a wider variety of different coloured produce, providing nutritious vitamins and minerals in your diet throughout the year as the produce you eat changes with the seasons. Find out what’s in season at different times of the year in Queensland using the Healthier. Happier. Fruit and Veggie Seasonality Charts [PDF 369KB] and ask about the ideal planting times for your area at your local garden centre or nursery. Relax and meditate Gardening is also a great way to relax, providing opportunities to still the mind and get away from the busyness of everyday life. There is even evidence to suggest that gardening can help ease symptoms of mental illnesses like depression and anxiety. Whether you’re gardening by yourself, or getting the whole family involved, it’s a great way to spend some time outdoors, away from screens and to-do lists, and engage with nature. From repetitive tasks like weeding that provide opportunity for meditation, to practising patience while waiting for plants to grow, gardening is a great exercise for your mind as well as your body. Breathe easier Gardening doesn’t have to be an outdoor activity – there are many varieties of plants that can be grown inside, too. As well as making rooms look nice, indoor plants can help improve air quality in enclosed spaces. Some studies also suggest that indoor plants can boost the concentration and focus of office workers. Not all plants will grow well indoors, so you’ll need to research which varieties will grow well in the lighting and temperature of your room. Things to keep in mind when starting out Different fruits and vegetables grow best at different times of the year. The Healthier. Happier. website has articles on what plants to grow during different seasons and a guide to easy grow-your-own healthy foods. If you’re planting an edible garden, remember that not all plants are safe to eat. Make sure you plant non-toxic varieties, checking at your local garden store if you’re unsure. Don’t use chemical sprays or fertilisers on your edible garden. Always wear gloves when working with plant material, soil and fertilisers, and be sure to wash your hands when you’re finished. When working outside, remember to be safe in the sun by wearing a broad-brimmed hat and protective clothing, wearing sunglasses, using a broad spectrum SPF 30 or higher sunscreen, working in the shade when possible and drinking plenty of water. Some councils and community groups offer gardening workshops, or set up community gardening sites, to help locals learn about gardening and growing edible plants. You can also find more information about starting a garden on the Better Health website and from this list of links on the Healthier.Happier Website Information care of the QLD Government website https://www.health.qld.gov.au/news-events/news/health-benefits-of-gardening
TendinopathyTendinopathy refers to an unhealthy tendon characterised by overuse and the presence of tiny tears along with the breakdown of collagen fibres and other changes to the intracellular structure of the tendon. Here are some vital facts to know about tendinopathies. 1) Tendinopathy does not improve with rest. Pain may settle temporarily but returning to activity is often painful again because rest does nothing to increase the tolerance of the tendon to load. 2) There is NO good evidence that these injuries are caused by inflammation. Therefore, anti-inflammatories often have limited effectiveness for these injuries. 3) The main factor for tendinopathy is overuse or simply too much of certain activities. Activities that require the tendon to store energy such as walking, running, jumping, along with loads that cause compression are the most common causes of tendinopathy. Tendon pain is sometimes caused with only subtle changes in activity. 4) Exercise is the most evidence-based treatment for tendinopathy – tendons need to be loaded progressively so that they can develop greater tolerance to load. In a vast majority of cases tendinopathy will not improve without this. 5) Modifying load is important in settling tendon pain. This often involves reducing tendon load that involves energy storage and compression. 6) Pathology on imaging is NOT equal to pain. This is one of the things that most people have the most difficulty understanding about tendon injuries. You can have severe pathology or tearing of the tendon, but this will not determine the amount of pain you will have or necessarily affect your recovery. Tendon pathology is also common in people without pain, 7) Tendinopathy rarely improves long term with only passive treatments such as corticosteroid injections, massage, acupuncture, dry needling, etc. Exercise is the most important treatment and passive treatments should only be used as adjuncts. There is lots of evidence to support this and if you are interested, more information can be found in the links provided. 8) Exercise needs to be individualised to a person’s pain and presentation. There must be progressive increase in load to enable restoration of function whilst respecting pain. 9) Tendinopathy responds very slowly to exercise. You need to have patience, ensure that exercise is correct and progressed appropriately, and try and resist the common temptation to accept ‘short cuts’ like injections and surgery. There are no short cuts.
Abate M, Gravare-Silbernagel K, Siljeholm C, et al.: Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Research and Therapy. 2009, 11:235.
Cook J, Purdam C: Is compressive load a factor in the development of tendinopathy? British Journal of Sports Medicine. 2012, 46:163-168.
Littlewood C, Malliaras P, Bateman M, et al.: The central nervous system–An additional consideration in ‘rotator cuff tendinopathy’and a potential basis for understanding response to loaded therapeutic exercise. Manual therapy. 2013.
Malliaras P, Barton CJ, Reeves ND, Langberg H: Achilles and Patellar Tendinopathy Loading Programmes. Sports Medicine. 2013:1-20.
WHY YOUR DOCTOR SHOULD REFER YOU TO AN EXERCISE PHYSIOLOGISTWe all know we should exercise, and the science is clear, exercise is medicine. The following explains what an Exercise Physiologist is and why your doctor might refer you to one. What IS AN EXERCISE PHYSIOLOGIST? Accredited Exercise Physiologists (AEPs) are university-qualified allied health professionals. They specialise in designing and delivering safe and effective exercise interventions for people with chronic medical conditions, injuries or disabilities. Services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia.
WHAT CAN AN EXERCISE PHYSIOLOGIST DO FOR YOU?EXERCISE TO IMPROVE YOUR MENTAL HEALTH Mental illness can have an impact on a person’s cognitive, behavioural and social functioning. Those with a mental illness often struggle to engage in their regular work, social and physical activities which can further impact the illness. Mental illness includes anxiety, depression, schizophrenia, bipolar affective disorder and personality disorders. There is mounting evidence that suggests exercise is an effective treatment method for people suffering from acute and chronic mental illness, with some studies suggesting that exercise is just as effective, if not more effective than pharmacological intervention in alleviating depressive symptoms. EXERCISE TO MANAGE CHRONIC PAIN AND ILLNESS Chronic pain is pain that persists beyond the expected healing time of an injury. Unlike acute pain which is caused by tissue damage, chronic pain is less about the structural or tissue damage and more about the sensitivity of the nervous system and ‘non tissue related factors’. Significant research has shown that exercise is an essential component in the treatment of chronic pain. Studies have shown that it can be an effective way to reverse this downward cycle of deconditioning and worsening pain, and gradually over time help those with chronic pain engage more in activities of enjoyment and essential activities of daily living with greater ease. EXERCISE TO REDUCE YOUR RISK OF FALL AND IMPROVE YOUR BALANCE Falls can result in permanent disability, restriction of activity, loss of confidence and fear of falling, all of which reduce quality of life and independence. There is now good evidence that exercise can prevent falls in older people by decreasing a number of key risk factors. For example, exercise can improve muscular strength, balance, balance confidence and walking speed, as well as psychological factors such as mental ability and mood. EXERCISE TO INCREASE YOUR MUSCLE MASS AND BONE STRENGTH Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone density). Any bone can be affected by osteoporosis, but the most common sites are the hip, spine, wrist, upper arm, forearm or ribs. Exercise can help bones modify their shape and size so they become stronger and this can prevent injuries. Exercise also increases muscle strength and improves balance which can help reduce the risk of falls. EXERCISE TO CONTROL YOUR DIABETES OR PREDIABETES Diabetes mellitus is a metabolic disease indicated by an elevated fasting blood glucose level due to deficiencies in insulin secretion or inability to use insulin. Everybody benefits from regular exercise but for people with diabetes mellitus (Type 1 or 2) exercise can play a vital role in the management of their condition. Exercise cannot reverse the damage to the cells in the pancreas that leads to the decreased production of insulin. Exercise can improve the way the muscles respond to insulin, which, in turn, helps regulate the blood glucose level for some hours after the exercise. Exercise also increases glucose uptake by the muscles and can lower the dose of insulin required by improving the body’s response to insulin. EXERCISE TO IMPROVE OUTCOMES DURING CANCER TREATMENT AND BEYOND Cancer is developed when abnormal cell function occurs. can develop within all parts of the body and can invade surrounding and distant sites by spreading through the blood vessels and lymphatic systems. If diagnosis and treatment are not administered in the early stages of the disease, cancer can be life-threatening. The potential benefits of exercise during and after treatment are significant and research has proved its effectiveness. Exercising during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments. Our Accredited Exercise Physiologist at Pottsville and Cabarita Physiotherapy will take you through a full screening to assist in prescribing you the appropriate program to achieve your goals in a safe manner. You can book an appointment with our Exercise Physiologist Sammy here or call 6676 4000
Anyone who is physically active should be able to appreciate the importance of ankle stability. Whether your running, changing direction quickly, jumping or lunging you require strength and control around the ankle to ensure correct posture. If this is lacking then you are at a greater risk of injury. Furthermore conditions like shin splints and plantar fasciitis become more common.
Our ankles support our bodies. As such, this joint carries an incredible amount of weight and has to be quite mobile to allow for an array of movements. It is no surprise then that ankle sprains are very common. The problem with this type of injury is that it is often shrugged off and quickly forgotten. Even with a minor sprain the ankle joint becomes fragile and more likely to give way during movement. This will have an impact on how you control your entire body during movement and can lead to compensations and conditions in other parts of your body.
If you have sprained your ankle, recently or in the past, then it is important to talk to your physiotherapist. If it is a recent injury your physiotherapist will offer guidance on how to reduce swelling and pain within the joint. Taping and supportive footwear will help provide support whilst the ligaments heal. Once the swelling and pain reduces then your physiotherapist may use gentle joint mobilsations to treat any resulting stiffness and you will be guided on the appropriate way to regain stability within the joint through appropriate exercises.
The exercises are specifically designed to help strengthen the ankle. Ankle stability exercises are also a good idea if you are usually active or if you have sprained your ankle in the past. See your physiotherapist and they can do a biomechanical screen to pick up if your current condition is as a result of deficits around the ankle or if you are at a greater risk of ankle injury.
Some simple ankle stability exercises that you could try include:
-Drawing the alphabet with your foot in lying and then trying it whilst standing and balancing on one leg
-Practicing balancing on one leg with eyes open then trying this with eyes closed.
-Using a trampoline, piece of foam or bosu ball to practice your proprioception and balance in a range of different movements.
-Compare the control between the two ankles and you might notice some differences
To find out more on how to improve ankle stability or if your condition is related to your ankle then come in and see one of our physiotherapists who will be able to guide you through the correct exercises for this.