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Knee Osteoarthritis: Myths vs Facts

Knee Osteoarthritis: Myths vs Facts

First, let’s start out by outlining what osteoarthritis is. Osteoarthritis is a very common condition, affecting the entire body, but mostly the articular cartilage (cartilage which covers the ends of bones). Cartilage has a smooth surface, allowing bones to slide easily on each other with movement. In the knee joint, there are also some extra shock absorbing pads called menisci between the bones. Over a lifetime, there is normal wear of the menisci and thinning of the cartilage cartilage. In some people, this is accelerated due to previous injuries sustained earlier in life (ligament injuries, etc.). This process is what leads to osteoarthritis.

In an older population, a loss in meniscal health is coupled with thinning of the cartilage of the knee, referred to as osteoarthritis. Traditionally, this has been thought of as a ‘wear and tear’ disease, leading many to think that they cannot exercise and should not be physically active. This is in fact wrong, where cartilage needs moderate load through physical activity for optimal health. Exercise should be the first line of management in any scenario of meniscus injury or knee arthritis. Only failing this, should surgery be considered1.

I’ve got knee osteoarthritis. What do I do now?

So, you have developed knee pain and your MRI shows degenerative changes in your cartilage and meniscus, and osteoarthritis in your knee, what do you do now?

If you’ve been diagnosed with this condition then you might have experienced the all too common merry-go around with scans, appointments with various health professionals and a number of different treatments. This blog will help dispel some of the myths around knee osteoarthritis and help you on the road to recovery.

KNEE OSTEOARTHRITIS MYTH 1: My scan will show exactly what is causing my knee pain

Emerging pain research has shown that scans are poorly related to pain and disability. The degree of cartilage damage, meniscal degeneration or arthritis does not correlate to pain levels. On average, we know that 20% of people with pain-free knees have meniscal tears. This research study also showed that 19% of people (almost 1 in 5) over the age of 40 had a meniscal tear, with most of these people functioning with no pain. We also know that this number substantially increases in people who have had major knee injuries earlier in life (i.e. ACL ruptures)2. This has also been demonstrated in other parts of the body, with research showing that up to 50% of people aged over 40 years will have asymptomatic (pain-free) disc bulges in their spine and up to 90% of people over 60 years will have findings of disc degeneration. This research suggests that these findings are a normal part of pain-free aging, much like the wrinkles on your skin and changes in your hair3.

KNEE OSTEOARTHRITIS MYTH 2: I shouldn’t exercise my knee as it will worsen the damage in my knees

Well designed and implemented exercise relieves pain and does not harm or damage the knee joint cartilage and meniscus. In fact, weight bearing exercises are vital to deliver nutrition to the joint surfaces/cartilage and integral to reducing pain. The belief that therapeutic exercise may harm the knee joint is still common in people with knee osteoarthritis. This leads to decreased activity levels due to fear, which in turn has negative effects for the health of the knee. It is important that your knee pain is being managed based on your current levels of strength and control, so that an appropriate and individualised exercise program can be developed. Evidence suggests that people do just as well, if not better, with physiotherapy treatment compared with surgery.

KNEE OSTEOARTHRITIS MYTH 3: Surgery is required for all cases of osteoarthritis

Due to the mismatch between the degree of meniscal/cartilage damage, arthritis and pain, findings on xrays and scans alone should not be the reason for surgery. Arthroscopic (keyhole) surgery is a frequently offered management option for arthritic knees and meniscal tears, commonly provided to ‘clean out’ the joint. The rationale for removing damaged meniscal tissue is based on the concept that the meniscus is the primary source of pain in arthritis, where commonly this is not the case, despite scan findings4. In part, this explains why not all people respond favourably to knee arthroscopy.

As mentioned above, meniscal tears are common in symptom-free middle-aged and older populations without signs of knee osteoarthritis on xray5. More recent medical practices would actually suggest that there is little to no indication for the use of arthroscopic surgery in established knee osteoarthritis. Research has demonstrated that knee arthroscopy is no more effective than placebo (fake) surgery6. This research showed that if a patient underwent a knee arthroscopy or  fake knee surgery (placebo) they would present similarly in terms of levels of pain AND function up to 2 years after surgery. Having surgery is not the only option, regardless of how severe your knee pain is.

 

Knee Osteoarthritis – Know the facts.

It’s time to change the narrative around knee pain, and the facts are:
• Rest and avoidance makes pain worse
• Graded exercise is safe and helpful
• Pain does not equate to damage, but is moreso a reflection of the sensitivity of the knee
• Unhelpful beliefs and catastrophising can reduce confidence, lead to reduced physical activity and further deterioration of your knee health
• Muscle weakness is a big contributing factor
• Lifestyle factors such as a lack of sleep, lack of physical activity, weight gain and poor nutrition can have negative influences on pain

If surgery isn’t an option, where does this leave me?

There is emerging evidence from La Trobe University in Melbourne suggesting that exercise often yields better results than surgery and pain killers. Regular, structured exercises have shown to have a much greater pain-relieving effect than commonly used pain relief medication. In one trial with over 13,000 participants in Europe, patients experienced less pain, better physical function and better quality of life following 12 weeks of structured, twice weekly exercise sessions1. Fewer people were taking painkillers compared to before the start of the program. Well dosed and programmed therapeutic exercise is vital for knee health and the life-long management of physical disability related to osteoarthritis.

I am already physically active, but my knee pain isn’t going away

There is a difference between being physically active and exercising. Physical activities target cardiovascular qualities of health by increasing heart rate when exercising. Exercise/strength training is a type of physical activity carried out with a specific purpose of getting you strong and improving function. Walking is great exercise but usually isn’t specific enough to improve strength. Instead, targeted strength exercises such as squatting out of a chair with purpose (i.e. with optimal joint and body position) is more likely to improve your function and pain.

Strengthening exercises help reduce pain through different factors. A good understanding of the anatomy of the knee will help explain this. The knee is a joint between two bones, the femur (thigh bone) and tibia (shin bone). The ends of each bone are lined by smooth cartilage, which allows for sliding of the bones during movement. The capsule surrounds the joint, securing it and containing synovial fluid, a lubricant providing nutrients to the cartilage. The function of the cartilage is to allow smooth movement of the bones on each other and to shock absorb and spread load over its surface.

Exercise is all important when it comes to knee cartilage health. Think of cartilage as a wet sponge. When loads are applied, fluid is pressed out of the sponge. When loads are removed, the sponge sucks the fluid back in. When we exercise, load presses down onto our cartilage. The cartilage absorbs the shock and fluid squeezes out into the articular capsule. Once loads are removed, the cartilage sucks the fluid back in from the surrounding area. This mechanism is what delivers nutrition to the cartilage, necessary for healing, pain reduction and improved shock absorption7.

What type of exercise is best for my knee?

Keeping the above information in mind, exercises that target functional movements (such as squatting) and emphasise good alignment in your joints will be best. Supervised exercise, to ensure good quality execution are required to load the knee in an optimal manner. Quality is more important than quantity!

 

The team at PhysioTec are experienced Physiotherapists with expertise in exercise prescription. We will work with you to provide a plan and structured exercise routine to improve your pain and function.

Kevin Doan is a qualified APA Sports & Exercise Physiotherapist. Call 3342 4284 to book an appointment with Kevin.

 

References

1. Skou, ST & Roos, EM (2017) Good Life with Osteoarthritis in Denmark (G:LAD): evidence-based education and supervised neuromuscular exercise delivered by certified physiotherapists nationwide. BMC Musculoskeletal Disorders, vol. 18:73, pp. 1-13

2. Guermazi, Ali, Niu, Jingbo, Hayashi, D, Roemer, FW, Englund, M, Neogi, T, Aliabadi, P, McLennan, CE & Felson, DT (2012) Prevalence of abnormalities in knees detected by MRI in adults without knee osteoarthritis: population based observational study (Framingham, Osteoarhtirits Study). BMJ, vol. 345, pp. 5339

3. Brinijkji, W, Leutmer, PH, Comstock, B, Bresnahan, BW, Chen, LE, Deyo, RA, Halabi, S, Turner, JA, Avins, AL, James, K, Wald, JT, Kallmes, DF & Jarvik, JG (2014) Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol, vol 36, no. 4, pp. 811-6

4. Pihl, K, Ensor, J, Peat, G, Englund, M, Lohmander, S, Jorgensen, U, Nissen, N, Fristed, JV & Thorlund, JB (2019) Wild-goose chase, no predictable patient sub-groups who benefit from meniscal surgery: patient-reported outcomes of 641 patients 1 year after surgery. BMJ, vol. 0, pp. 1-11

5. Thorlund, JB (2017) Deconstructing a popular myth: why knee arthroscopy is no better than placebo surgery for degenerative meniscal tears. BJMS, vol. 51, pp. 1575

6. Moseley, JB, O’Malley, K, Petersen, NJ, Menke, TJ, Brody, BA, Kuykendall, DH, Hollingsworth, JC, Ashton, CM, Nelda, MPH & Wray, NP (2002) A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. The New England Journal of Medicine, vol. 347, pp. 81-88

7. Bricca, A, Juhl, CB, Steultjens, M, Wirth, W & Roos, EM (2018) Impact of exercise on articular cartilage in people at risk of, or with established, knee osteoarthritis: a systematic review of randomised controlled trials. BMJ, vol. 0, pp. 1-9

Whole-Body Strength Training for Cyclists

Whole-Body Strength Training for Cyclists

As a cyclist, you’re constantly joking about only needing “legs and lungs”. The goal of a cyclist is to be as light as possible, with the highest amount of power to weight ratio coming from the legs, pushing into the pedals. That is why there are plenty of memes out there of cyclists with stick thin arms and torso, but with massive quads and hamstrings, and titles such as “Don’t miss leg day!”. Jokes aside, imbalances such as these can have a potentially detrimental effect on your long-term health. Strength training for cyclists is key for injury prevention and performance.

As cycling is a relatively low weight-bearing sport, it is beneficial for cyclists to engage in additional loaded strength training to address a variety of issues from bone density to muscular balance. Obviously, strength demands differ between cyclists – a road cyclist, track cyclist, mountain biker or BMX rider will all have very different needs, but the tips I share below can be used a general guideline, across all types of cycling.

 

 

Strength training for cyclists are a great addition to your training routine

Strength and conditioning programs should be kept as simple as possible. As often is the case, it is the simple stuff that works best and has stood the test of time.  The programs I recommend to a lot of my patients, typically contain the exercises below.

Sample workout
Compound Push (Knee Dominant) Back Squat/ Goblet Squat
Upper Body Push (Horizontal) Dumbbell Chest Press, Bench Press
Upper Body Pull (Horizontal) Bent over rows, Seated rows
Compound Pull Offset/Single Legged (Hip Dominant) Offset Romanian Deadlift, Offset Trap Bar Deadlift
Trunk Stability (Anti Rotation) Pallof Press, Plank + KB drags
*One of the Compound movements needs to be single legged or offset Work in 3 sets of 5-8 repetition with 2 RIR (Reps in Reserve)

By utilising a full body routine such as this, all the major components of the body will be covered, and even if a session is missed, you’ll know you are always covering the full body in each session. Optimally, you would want to engage this routine two times a week for adequate loading-for-strength benefits.

Compound movements are multi-joint movements which utilise multiple groups of muscles at the same time. Utilising a multi-joint movement under adequate weight helps to develop the ability to generate force through those joints. For a cyclist, the ability to generate better force in the hips and knees, coupled with bike specific training, may lead to an increase in power production.

I also added a note in the table to ensure one of the hip or knee dominant exercise needs to be either single legged or offset. Single leg/offset work is often underutilised, but is a very effective tool for stability. It also assists with restoring any imbalances you may have developed over the years, either through injuries or poor habits. I recommend that single-sided work be done towards the back end of the exercise session, as you would not often use as heavy weight. What’s more, doing single-sided work with a bit of fatigue from all the previous work sets will really challenge ones stability under appropriate weight.

The Importance of Upper Body Strength for Cyclists

For a cyclist, upper body work is not hugely important from a max strength or bulk point of view, however having good muscle tone in the upper body musculature is important for general well-being in everyday life. You don’t want to be “that” cyclist who is strong in the legs but weak with poor tone in the upper body, “that” cyclist who injures the neck or shoulder lifting a bag of groceries. Dependent on what field of cycling, some streams like track cycling and BMX may require a bit more upper body bulk and strength compared to road cycling and mountain biking.

Don’t forget to switch it up!

For a bit of variation in your workouts, you can alternate your sessions by switching the compound hip/knee dominant work around so you can focus the heavier work on the other compound exercises whilst offset/single leg work on the other. This will create a nice balance in loading for different movement patterns. I would try to do the heavy and double legged compound work at the start of the session and do the single leg or offset compound movements towards the mid or latter end of the session. Also for upper body work you can switch between horizontal movements like bench press and bent over rows with vertical upper body movements like overhead dumbbell press and lat pull down. See example in the table below.

Sample Variation
Compound Pull (Hip Dominant) Traditional deadlift, Trap-bar Deadlift
Upper Body Push (Vertical) Dumbbell Overhead Shoulder Press, Barbell overhead press
Upper Body Pull (Vertical) Lat Pull Down, Chin Ups
Compound Press Offset/Single legged (Knee Dominant) Bulgarian Split Squat, Lunges
Trunk Stability (Rotation) Woodchop, Medicine ball trunk rotations
*One of the Compound movements needs to be single legged or offset *Work in 3 sets of 5-8 repetition with 2 RIR (Reps in Reserve)

Hopefully what I have covered here about strength training for cyclists will be helpful as a starting point for a simple strength and conditioning program. As always, check in with your strength and conditioning focused allied health professional to determine if these recommendations are suitable for you.

The best advice I can give is, keep it simple and sustainable. The session need not be super long in duration – aim for 30-45 minutes to be done with your program. Over time, as you develop more experience and build up a repertoire of exercises you are familiar with, in each of the categories, you will be able to interchange exercises that are similar in each category to keep your work out fresh and engaging.

 

As with undertaking any new program or form of exercise, if you have any medical concerns, please check with your doctor. Or, should you need some tailored advice for strength training for cyclists – come see us here at PhysioTec.
Eric Huang is a qualified physiotherapist who specialises in cycling related pain and injuries. He has a passion for all things cycling, is a competitive cyclist himself, and runs his own cycling crew. Call 3342 4284 to book an appointment with Eric.

 

References:

Nicols JF, Palmer JE, Levy SS (2003) Low bone mineral density in highly trained male master cyclists. Osteoporos Int. 14:644-649

Rønnestad, B.R., Hansen, E.A. & Raastad, T. In-season strength maintenance training increases well-trained cyclists’ performance. European Journal of Applied Physiology. 110, 1269–1282 (2010)

Westcott, Wayne L. PhD. Resistance training is medicine: effects of strength training on health. Current Sports Medicine Reports: July/August 2012 – Volume 11 – Issue 4 – p 209-216

Louis, J., Hausswirth, C., Easthope, C. et al. Strength training improves cycling efficiency in master endurance athletes. European Journal of Applied Physiology. 112, 631–640 (2012). https://doi.org/10.1007/s00421-011-2013-1

 

4 tips for pain relief when you’re stuck at home

4 tips for pain relief when you’re stuck at home

1. Manage your stress

The effect of the COVID-19 pandemic has been devastating worldwide. We are lucky in Australia that the spread of illness is now being well contained. However, the social distancing measures have not come without a significant cost for many businesses, their employees and our way of life. Higher levels of stress are common and in the coming weeks, parents will also be juggling home schooling and many people will experience pain working at home.

Stress has a direct and marked impact on pain levels, so if you experience pain working at home and your normal achy neck or back is worse than usual, stress may be playing a substantial role. Often one of the first things you notice when stressed, is muscle tension developing around the neck and shoulder region. You may also feel tension developing in the lower back, particularly if you are sitting rigidly on the edge of your chair. Be sure to sit back in your chair and relax, allowing the chairback to support you.

When you are feeling overwhelmed or feeling tension and pain build in your neck or back, try some relaxed deep breathing. It can work wonders!

 

2. Optimise your home working environment

Many workers have had no choice but to make a rapid transition to a home-office, with less than ideal ergonomic set up. Pain working at home can result.

Good Desk Set Up

Problem: Using a laptop or tablet for prolonged periods will mean a poor neck angle and substantial increases in loads on the joints and muscles of the neck and upper back.

Solution: Organise an external monitor and/or keyboard, to ensure you can look straight ahead at your screen. These were in very short supply but are available again now.

Problem: Your desk and/or seat height may not be suitable.

Solution: Most people won’t want to invest in a new home set up for this temporary situation. But you can improve the situation usually with pillows, back supports, footrests and even bricks to alter the height of a low desk!

Aim to avoid situations where:
a. your knees are higher than your hips
b. your elbows are bent more than 90degrees

If you need a wedge cushion, decompression cushion or a back support, you can drop by the clinic to pick one up or we can organise delivery.

One of our physiotherapists can also check out your home working environment via a Telehealth video consultation.

 

3. Continue (or start) your Physiotherapy Rehabilitation Program

Don’t let this golden opportunity pass you by! Often our patient’s lives are so busy with all the events they must attend for work or family, that their home exercise program goes by the wayside. This makes it difficult to fully overcome a persistent pain issue.

Now is the time to attend studiously to your home program and get on top of those problems once and for all. This will help control pain working at home and it’s also very important for athletes to use this time to maintain or improve conditioning to avoid injuries when returning to sport.

Our physiotherapists are now transitioning back into the clinic after a short break with COVID-19 social distancing, so you can:

  • organise a check up on your program,
  • address a problem you have been meaning to attend to for ages or
  • put a plan in place to maintain your conditioning to prevent injury when returning to sport or your regular physical activity

PhysioTec Physitrack

We can provide assistance either in the clinic or with our telehealth service.

Telehealth is a video consultation. It allows us to assess your movement, check exercise technique, and tailor an exercise program for home. If you do not have an existing diagnosis for your painful condition, we’ll take a thorough history and step you through a variety of tests. This will help us determine what the main problem is.

The telehealth consultation also includes a free app with an individualised program. These exercises have video, audio and text descriptions available. On top of this, the in-app features also include tracking so you can check off your exercises daily and a messaging system to keep in touch with your physiotherapist.

Read more about Telehealth here.

 

4. Engage in regular exercise

We already know the important benefits of exercise, some of which include:

  • Positive effects for mental health
  • Weight control
  • Improved sleep quality
  • Prevention and management of a variety of health problems
  • Physiological benefits for the body, such as improving strength and mobility, which in turn help us to maintain independence.

Additionally, and perhaps most importantly right now, we know that regular physical activity decreases the risk of a person contracting a communicable disease (such as viral and bacterial infections). It enhances the ability of a person’s immune system to control itself. (Campbell & Turner 2018, Dominski & Dominski, 2020). Therefore continuing, maintaining or starting an exercise program is encouraged.

While the gyms and Pilates studies are closed, your options are to exercise outside or at home. There are many free exercise classes available online, but for those with previous injuries, be cautious. Some of these low-quality programs will not be suitable and may aggravate your condition or produce a new one.

Our physiotherapists can check your home exercise technique easily with telehealth , helping you control pain working at home. If you have gym equipment at home, Eric Huang, our strength and conditioning physiotherapist is very happy to check your lift technique and provide some ideas to vary or progress your program.

Eric Huang Telehealth Physiotec

Did you know?

Our Pilates instructors are also providing a high-quality Online Pilates service. Each class is run by one of our qualified Pilates Instructors and lasts approximately 40minutes. The classes focus on strength and conditioning exercises with the aim of keeping you moving and helping you maintain good functionality.

Physiotec Online Pilates_2020

Those who have already started these classes with Alice or Lisa have been loving them! Each class is limited to 4 people, and exercises are adapted for every client’s condition or physical fitness. The small class sizes also allow the instructor to monitor your form and posture, thus maximising your performance and safety.

Classes are priced at $20 per session, sold in packs of 5.

Call us on (07) 3342 4284 or contact us today to book in your free class trial!

 

 

References

Campbell, J. P., & Turner, J. E. (2018). Debunking the myth of exercise-induced immune suppression: redefining the impact of exercise on immunological health across the lifespan. Frontiers in immunology, 9, 648.

Dominski, F., Dominski, B. (2020). Exercise and Infectious Diseases – Covid-19. British Journal of Sports Medicine Blog, March 17, 2020.

Physical Activity & Pregnancy

Physical Activity & Pregnancy

Physical Activity & Pregnancy

The Facts, the Figures & the False Conceptions

If you are pregnant or planning a pregnancy and you are unsure about the current guidelines for physical activity and what is safe, this is a must read! An excellent team of experts have appraised over 27,000 manuscripts and abstracts (Davies G & Artal R., 2019) in order to bring us the most up to date information and guidelines on physical activity during pregnancy.

THE FACTS:

Physical activity during pregnancy:

  • DOES NOT increase the risks of structural or functional birth defects which stem from in the womb (Davenport MH, et al., 2019)
  • Has a significant effect on reducing the severity of low back pain, pelvic girdle pain and lumbopelvic pain. (Davenport MH, et al., 2019)
  • Decreases the chances of using instruments during delivery (Davenport MH, et al., 2019)
  • Reduces the chances of depression during pregnancy as well as the severity of symptoms. Unfortunately, this does not apply to the post-natal period. (Davenport MH, et al., 2018)
  • Reduces the risk of excessive weight gain during pregnancy as well as weight retention postpartum. (Ruchat S, et al., 2018)
  • Results in a small increase in the mother’s body temperature which is safe for the baby. (Davenport MH, et al, 2019)
  • Effectively reduces the risk of developing gestational diabetes mellitus, gestational hypertension and pre-eclampsia. (Davenport MH, et al., 2018)
  • Reduces the odds of having abnormally large babies (Davenport MH, et al., 2018)

Additionally…

  • There is no association between physical activity during pregnancy and increased risk of miscarriage or perinatal mortality (stillbirth or deaths in the first week of life) (Davenport MH, et al., 2019)
  • There is not enough evidence to inform us if lying on our back to exercise is safe or if it should be avoided altogether during pregnancy (Mottola MF, et al., 2019)
  • There was no association found between exercise during pregnancy and complications with the newborn baby or harmful childhood outcomes (Davenport MH, et al., 2018)

THE FIGURES & RECOMMENDATIONS

(Mottola MF, et al., 2018)

  • An accumulation of 150 minutes of moderate intensity exercise each week is recommended in order to achieve the health benefits and reduce risks of pregnancy complications
  • Exercise over a minimum of 3 days per week, however daily exercise is encouraged
  • Variety is key in order to achieve greater benefits
  • Pelvic floor muscle training can be performed daily in order to reduce risk of urinary incontinence
  • Exercising flat on the back should be modified if the pregnant women is experiencing light headedness, nausea or feeling unwell
  • TAKE HOME MESSAGE: All women WITHOUT contraindications should be participating in physical activity during pregnancy

THE FALSE CONCEPTIONS

  • Exercise will harm the baby. The evidence has shown that there are no increased risks of miscarriage or a small baby when undertaking physical activity during pregnancy
  • Heart rate should be below 140 beats per minute. This is an outdated guideline from the 80s and there was no evidence to even support this guideline, it was based on expert opinion.
  • Exercise needs to be at a gym or with group fitness. Lots of studies that were looked at were walking programmes. Additionally, moderate intensity physical activity can include gardening, mowing the lawns and some household chores.

Other considerations for physical activity & pregnancy

There are other considerations specific to the mother during pregnancy and physical activity. These include, but are not limited to, the pelvic floor and risk of overload/prolapse as well as pelvic pain. If you are planning a pregnancy/already pregnant and have a history of pelvic pain or pelvic floor concerns, it is important to see your physiotherapist before commencing physical activity. Here at Physiotec, your women’s health physiotherapist can assess your pelvic floor muscles to ensure you are using them correctly, assess and address other areas of concern such as low back pain or pelvic pain and advise you on the safest exercises during pregnancy as well as into the post-natal period. You might also like to join one of our Pilates classes to stay strong or build strength and control before, during or after your pregnancy.

Download more information on Physical Activity during Pregnancy here

Try Torpedo Perturbation Training at PhysioTec

Try Torpedo Perturbation Training at PhysioTec

Perturbation Training

See one of our Physiotec staff, Colm Coakley, demonstrating some perturbation training using the CorMax Torpedo. Half filled with water, the Torpedo becomes an unstable load which your muscles need to figure out how to control. Consequently, it provides a great dynamic stability challenge! Also, due to the ever-changing stimulus, it keeps the nervous system guessing.  This requires the system to continually change the way muscles are stimulated to respond.

In response to pain, or sometimes due to excessive training in very rigid unvarying patterns eg like regularly holding a rigid plank for 2+minutes, the nervous system can begin to recruit muscles in very confined, ‘primitive’ patterns. This can lead to a loss of normal efficiency and load sharing-load sparing in muscle recruitment patterns. As a result, this can also potentially contribute to pain, injury and a loss of athletic performance. At Physiotec, we are always exploring and embracing strategies that can help our patients get the best out of their bodies and their lives. Come & join one of our highly qualified physio’s in an innovative and challenging workout.

When is your child safe to begin resistance training?

When is your child safe to begin resistance training?

When is it safe to begin resistance training?

It is a common misconception that resistance training in children stunts growth. Many parents and coaches remain convinced that weight training will result in short stature, due to potential damage to the growths plates (epiphyseal plate).

In actual fact, The Australian Strength and Conditioning Association (ASCA) have developed a position stand on youth resistance training, which is in contrast to these beliefs.

At PhysioTec, we believe there is a place for strength and condition in children. We maintain that supervision is essential, and believe that this is an ideal time to condition young developing children and adolescents to a level where there body can not only withstand, but excel in their chosen field.

Are you still unsure?

Well, if a child is ready to participate in organised and structured sports, such as cricket, football, rugby and basketball then they are generally ready to perform a supervised resistance-training program. This will allow them to handle even the most intensive sporting schedules

 

September 2017

Physiotec’s 7 laws of Strength Training

Physiotec’s 7 laws of Strength Training

 

7 laws of Strength Training

1 Train Consistently

Consistency with training is vitally important. Those who train week in and week out will experience steady improvements in fundamental lifting skills, strength and muscularity over time. Assess your weekly routine and see when you can fit in at least 2-3 30-45 minute sessions per week into your schedule

2 Warm Ups are essential:

The “RAMP” system provides a method by which warm-up activities can be classified and constructed. This system identifies three key phases of effective warm-ups.

Activities included in the ‘Raise’ section can be used to increase body temperature and blood flow. The ‘Activate and Mobilise’ section can be used to optimise strength, control and dynamic flexibility around areas central to performance in the gym. The ‘Potentiation’ section provides an ideal time to carry out activities such as speed and plyometric training in order to prepare the body to work at maximal capacity.

3 Use Good Form:

You do need to be very strict with your exercise form, and you need to learn the right type of form for your body on various lifts. This is especially important for bigger exercises like squats and deadlifts where the risk of injury is inherently higher than, say, dumbbell curls. Developing competency in the major compound lifts such as the deadlift, squat and lunge will reduce the likelihood of injury in the gym and can ensure you train consistently throughout the year and reach your goals.

4: Stimulate the muscles of the entire body:

To make a muscle grow, it must be stimulated on a regular basis. Compound exercises are designed to stimulate a lot of muscles throughout the body. For example the deadlift stimulates the forearms, traps, lats, scapular retractors, spinal extensors, glutes and hamstrings, even the core and quad muscles This helps explain why deads are such a great exercise. However, if all you did was deadlift, your pecs, delts, and biceps wouldn’t come close to reaching their full hypertrophy potential. Make sure your programs regularly incorporate enough exercises that combine to thoroughly hit the entire body.

5; Basic Strength Must Improve:

 Progressive overload is the most important aspect in the strength game. If you embark on a strength training regimen and fail to get stronger, you won’t gain much muscle. You must use heavier loads and perform more reps over time.

As you get more experienced in the gym, you should see dramatic strength progress compared to your beginning level in a squat variation, a deadlift variation, some kind of upper body press, and an upper body pull. And if you want to be your absolute best at anything, be it squats, deadlifts, bench press, power cleans, or even Turkish get-ups, then you need to perform the lifts consistently to groove the neuromuscular patterns and maximize motor learning. Failing to do so will leave unachieved progress on the table.

6 Muscle is made in the gym and built in the kitchen.

 Nutrition is key when it comes to strength development. The best training program in the world is no match for a poor diet.

If you want to develop strength and perform optimally, then you must take nutrition seriously. You need to take in the right amount of calories and the right blend of macronutrients for your goals and physiology. You don’t have to be perfect 24/7, but eating a consistent amount of carboydrates, protein and fats can help with strength and hypertrophy gains.

7 Sleep.

Some folks need more sleep than others and some can perform well with less, but you should still care about your sleep (quantity and quality) and prioritize it. Make a genuine effort to be consistent with your sleep schedule if you’re serious about getting results. Failure to do so will hinder your pursuit of strength and hypertrophy.

Regarding stress, your goal shouldn’t be to eliminate it altogether, but rather to optimize it. It’s good to be challenged in life, but there’s a fine line between eustress (positive stress, like a good workout) and distress (negative stress, like 65 hours a week at a job surrounded by toxic co-workers). Aim to stay in eustress most of the time for maximum results. Step back and analyze your life choices and habits. This is an area in which many lifters can make adjustments that lead to immediate results.

 

Resistance training for persistent pain

Resistance training for persistent pain

Resistance Training for Persistent Pain

Resistance Training

At Physiotec, we see many people with persistent hip and lower back pain. A lot of them are fearful regarding resistance training or are unsure what types of exercises are appropriate for them. There is often a misconception surrounding resistance training regarding its potential to be harmful or unsure for patients with persistent pain. At Physiotec, we aim to create an environment, which promotes strengthening in a safe and graduated way.

Benefits of resistance training

There are many benefits of resistance training including improving muscle mass and bone density, injury and falls prevention and overall movement patterns. In our new strength and conditioning gym, you have a unique opportunity to be closely monitored by a physiotherapist who combines their excellent knowledge of pain science and resistance training in the overall management of your condition.

Assessment and management programs

All our assessment and management programs are 100% individualized to suit your specific needs. Whether you are young or old or are experienced or inexperienced with resistance training, our Gymstart program offers you a new and exciting approach to the management of your presentation.

 

Saturday Acute Injury Service

Saturday Acute Injury Service

Ever hurt yourself on a Friday night or Saturday and wished you could have your injury seen to? Did you know Physiotec now offers Injury Clinic every Saturday from 11:30am-1:30pm. One of our skilled Sports Injury & Performance Physiotherapists will be on staff every Saturday to cater for the acute injuries sustained during Friday night/Saturday. The right advice and early management makes all the difference. Get treatment/advice now. Don’t wait!!!

We also have a normal clinical service and pilates on Saturday morning, but reserve places with one of Sports Injury & Performance team specifically for acute injuries that require urgent assistance.

Why Gym Start?

Why Gym Start?

Welcome to the first blog post of our strength and conditioning series. Physiotec has recently recruited physiotherapists with specific experience in strength and conditioning. We recognise the need to give people access to strength training, especially coming back from injury. However, uninjured people will also benefit from the service.

In our clinic, we see more and more people who are engaging in gym based training and this ranges from young adolescents to elderly people.  The goals for strength training for the individual may be different but the fundamentals are the same: good form and appropriate loading. It is our goal to provide this service for our clients to enjoy strength training in a safe and effective manner.

We aim to update our blog regularly and provide some easy to digest content on all things strength training. In the meantime, keep up to date with our clinic via social media:

Facebook:  https://www.facebook.com/PhysioTec

Twitter: @PhysiotecAUS