Winter Sports – Pain Management Advice for Musculoskeletal Injuries

Winter is a period that brings with it a different set of obstacles relating to musculoskeletal injuries.  Engaging in winter sports or activities in colder temperatures can increase the risk of injury. However proactive pain management strategies can help you navigate the winter season safely and effectively to minimise discomfort. In this blog, we will explore common winter musculoskeletal injuries and provide practical advice for managing pain.

Sprains and Strains:

Sprains and strains are one of the most common musculoskeletal injuries during winter. Sprained ligaments, muscles or tendons, particularly in areas such as ankles, wrists, and knees, can result in pain, swelling, and limited mobility.

 

Pain Management Advice:

Acronyms such as RICE, PRICE and POLICE are used to help manage the acute stage of pain. Dubious et al 2019 presented a slightly different acronym that helps with the immediate care but also the subsequent care of injuries. These acronyms are PEACE and LOVE: 

 

Protection – avoid activities and movements that increase pain during the first few days after injury

Elevation – elevate the injured limb higher than the heart as often as possible

Avoid Anti-inflammatories – avoid taking anti inflammatory medication (example) as they reduce tissue healing. Avoid ice

Compression – use elastic bandage or taping to reduce swelling

Education – your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role

 

Load – let pain guide your gradual return to normal activity. Your body will tell you when it’s safe to increase load.

Optimism – condition your brain for optimal recovery by being confident and positive.

Vascularisation: choose pain-free cardiovascular activities to increase blood flow to repairing tissues

Exercise – restore mobility, strength and proprioception by adopting an active approach to recovery


Back Injuries:

Winter activities such as skiing can put further strain on the back which may lead to injuries such as muscular spasms/strains, as well as injuries to the spinal structures such as the disc, or more commonly non specific structures of the lower back. All these injuries can arise both from contact or non contact scenarios.

 

Pain Management Advice:

  • Heat Therapy – Apply a heating pad or taking a warm bath relaxes muscles and may alleviate back pain. To note sometimes applying heat in an area that is highly irritable may not be possible at times and this may need further opinion by a health professional
  • Gentle movement – Perform gentle movements targeting the back muscles to improve flexibility and reduce tension
  • Activation exercises – engage in bodyweight/banded exercises that can help the musculature surrounding the trunk such as the glutes, hamstrings and quadriceps e.g banded sit to stands, crab walks with loop band around the ankles
  • Temporary altered lifting techniques – When lifting heavy objects, use your leg muscles instead of your back to minimise strain on the spine. As time progresses, you will be more confident to start bending your back without feeling overly protective of perfect ‘mechanics’

 

Fractures:

Frosty or icy surfaces can sometimes result in fractures as the incidence of slips and falls increase. Wrists and ankles are common sites of fractures that we tend to see in the clinic. These injuries require immediate medical attention.

 

Pain Management Advice:

  • Immobilisation –  Keeping the fractured site/limb immobilised using splints or casts as instructed by your physiotherapist or healthcare professional
  • Pain Medication – prescribed pain medication as directed by your doctor to manage discomfort during the healing process
  • Physiotherapy – Consult with your physiotherapist as to when to start your rehabilitation journey as this can vary depending on the types of fracture, your physiotherapist may be able to prescribe exercises that can improve range of motion and strength surrounding the injured site while minimising pain within the appropriate time needed

 

Overuse Injuries:

Engaging in winter sports or activities like cycling, skiing, ice skating, or snowboarding can heighten overloaded tissues and may need certain models of care depending on the activity at hand. Pain management advice may differ depending on when symptoms are reported – acute treatment is very different to long-term symptoms

 

Pain Management Advice:

  • In the clinic, we try to follow similar principles to PEACE & LOVE in addition to exercise as measures for pain relief
  • If we believe an overloaded tissue is causing your pain,we try to calm things down by offloading the affected tissue. This may include altering activities or equipment. For example, cyclists may have to adjust their bike set up, skiers could adjust their skis, and runners could adjust their footwear or weekly running volume. At times, we may prescribe rest to allow sufficient time for recovery to avoid overexertion. 
  • If both PEACE and LOVE principles as well as activity modifications do not help, an assessment by your physiotherapist would be the next step to follow

 

Conclusion:

When it comes to musculoskeletal injuries during winter, prevention and proactive pain management is key. By taking precautions such as wearing appropriate footwear, being mindful of your movements, and staying cautious on slippery surfaces, you can reduce the risk of injuries. In the event of an injury, we suggest following the pain management advice provided and seeking help from a physiotherapist or other healthcare professional if needed.

If you need further assistance with managing or coming back from a winter sporting injury, our team of physiotherapists are here to help. Click here to book an appointment today!

By Ehsam Popal | Senior Physiotherapist


References 

  1. Dubious B, Esculier J-F.Br J Sports Med Month 2019 V0 No.0
  2. Singh DP, Barani Lonbani Z, Woodruff MA, et al. Effects of topical icing on inflammation, angiogenesis, revascularization, and myofiber regeneration in skeletal muscle following contusion injury. Front Physiol 2017;8:93

 

Exercise and Mental Health – Lifting Weights to Lift Your Mood

One of the overlooked benefits of exercise is its impact on mental health and wellbeing. Alongside the physical benefits, exercise has been proven to improve mood,  stress, sleep and energy levels; as well as reduce the incidence and severity of mental health conditions like anxiety and depression. For a long time, the impact of exercise on mental health was seen as a “chicken or the egg” situation, but evidence is clear that this is a causal relationship.

Why exercise?

Exercise causes a number of chemical reactions in the brain, including the release of “happy hormones” like endorphins, dopamine and serotonin. This has a huge impact on how we feel, as these chemicals contribute to regulating mood, sleep and motivation (Basso & Suzuki, 2017). These changes occur extremely quickly and a single bout of exercise (e.g., a short 15-minute run) can lead to an immediate feeling of euphoria. This is known as the “runner’s high,” which can also be applied to general exercise. 

On top of its acute benefits, exercise is also extremely effective in the prevention and treatment of mental health conditions, particularly affective disorders like anxiety and depression. In fact, exercise has been shown to be more effective than antidepressants in treating depression without the side effects (Singh et al, 2023).

In an increasingly busy and connected world, exercise also benefits your mental health by giving you time away from checking your phone, emails or other sources of lifestyle stress, which can be quite meditative.  

How can we make sure we’re exercising enough?

Some people love the gym and can do a structured workout 5+ days a week; but if you’re not that person, you can still find a way to get at least 3+ exercise sessions in every week. Some strategies that can help you stay committed to training are to pick a type of exercise you like, have a training buddy to keep you accountable and to use exercise to explore (e.g., walking or cycling around a different area).

Still need some guidance?

Our friendly Exercise Physiologists at Exercise Lab can help by providing you with a suitable exercise program for your individual needs. Click here to start your journey today. 

 

By Simon Latham | Exercise Physiologist


References

  1. Basso JC, Suzuki WA. The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Brain Plast. 2017 Mar 28;2(2):127-152. doi: 10.3233/BPL-160040. PMID: 29765853; PMCID: PMC5928534.

  2. Singh B, Olds T, Curtis R, et al. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews. British Journal of Sports Medicine Published Online First: 16 February 2023. doi: 10.1136/bjsports-2022-106195

 

Rest Days Are The Best Days – Why Resting Is Just as Important as Going Hard

Did you know that April only has one week with 5 working days? Are you taking full advantage of that opportunity to regain some control over your schedule? Are you trying to fit too much into your public holiday and not maximising the time?
 
April is a fantastic month to reassess how the first quarter of the year has gone and implement some changes to your routine to maximise training, sleeping, family or work habits. By now, most people have let a few unhealthy habits creep into daily life and I believe April is the best time to weed them out. I like to RESET and refocus our energy towards our goals in April, so here are some tips and tricks on HOW to utilise the public holidays coming up! 
 

What can we do?

 
RESET is the key word; we best move forwards by looking back at the start.
 
 
REFLECT: Take a look back on the past 3 months and see what worked, and more importantly, what didn’t work for you.
 
EVALUATE: Are the goals you set in line with your priorities and what needs to change?
 
SIMPLIFY: Make it an achievable challenge relative to your situation, small steps lead to big actions.
 
ESTABLISH: Tweak your plan to make it work better for you and help decrease any barriers.
 
TIMEYou need to block out time to achieve your goals. Make an appointment  with yourself in your diary to make sure you are prioritising you.
 
 
I encourage you to use the public holidays and the above framework to set yourself up for the rest of the year. This rest and reset will enable you to move forwards with a clear focus!
 
Click here to learn more about our team at Exercise Lab.
 
 

By Rachael Kent | Exercise Physiologist 

Foundations / Habits – Behaviours that lead to Success

“Making a choice that is 1% better or 1% worse is insignificant in the moment. But over the span of moments that make up a lifetime, these choices determine the difference between who you are and who you could be.” – James Clear (Author of Atomic Habits)

It’s no surprise that our habits make up who we are as a person and go on to shape our identity. The compound interest of our habits lead to the actualisation or failure of reaching our personal goals. That being said, let’s explore some easy habits that you could incorporate into your daily life. 

 

Stairs over elevators
A small yet easy hack, which you would have no doubt heard of is to strive to take the stairs over the lifts and escalators where possible. This will help you to simply burn more calories while also keeping your knees and hips strong through constant exposure to loading. Our primary tips when using the stairs are to try to keep your knee in line with your foot (rather than letting it collapse inwards), and not to push through pain that is either reproduced or aggravated when using the stairs. 

Picking up the pace
Current physical activity guidelines by the World Health Organisation (WHO) recommend 150-300 minutes of moderate intensity physical activity; or 75-150 minutes of vigorous intensity aerobic physical activity (WHO, 2020). This, of course, can be performed via multiple bouts throughout the week. In addition to this, WHO also recommends 10K steps on a daily basis as a good proxy for physical health. However, it’s not necessarily how many steps to you but rather the cadence. Therefore, by walking slightly faster than usual, you are checking off both boxes. Faster walking will increase your heart rate while also allowing you to be more time efficient. Several observational studies have shown that faster walkers have longer life spans. Our only caveat is to ensure that you prioritise safety and be careful if it is raining or if there is uneven paving. 

Optimising sleep hygiene
A good night’s rest goes a long way, as we’ve all experienced a lack of sleep. Sleep hygiene is the current buzz around town. As we recognise how multifactorial healthcare is, the importance of sleep quality and duration continue to become non-negotiable. In adults 7.5-8 hours of good quality sleep is recommended on a per night basis (Chaput et al., 2018; Walker, 2017). Several studies have reinforced that a good sleep schedule lowers your risk of cancer, diabetes, dementia, heart attacks and strokes, all while enhancing your memory, alertness, skin, immune function, pain and mood. It really all sounds too good to be true. Below are proven methods on how to optimise your sleep hygiene:

– Consistency is key: barring the occasional late night, try to sleep and wake up at a set time. Just be aware that the above benefits tend to blossom after at least 6 weeks of consistency (Worley, 2018).

– Keep your room dark, quiet and cool to minimise disruptions and increase melatonin release to assist in putting you to sleep.

– Avoid screen exposure 2 hours prior to bed and 1 hour after waking up. Natural light exposure after waking is recommended to reset your circadian rhythm (Blume et al., 2019), as it has been throughout the lifespan of our species. Reading prior to sleep is much more effective than falling asleep watching TV or browsing our phone. 

– A routine of relaxing habits prior to bedtime will ensure a smoother wind-down process: Meditating, stretching, breathing techniques, yoga and taking a warm bath are all great strategies to try. 

– Avoid caffeine and alcohol prior to bed-time (we can forgive the odd party or dinner with friends): Caffeine has an average half-life of five to seven hours (Institute of Medicine (US) Committee on Military Nutrition Research, 2001). This means that a coffee at 2pm will still be in your system close to bed-time and potentially affect the quality of your REM (random eye movement) sleep. Alcohol is especially disruptive to REM sleep (Colrain et al., 2014). 

Showing up
It’s easy to exercise or train when you feel good, but it’s actually crucial to show up when you don’t feel like it. By showing up you are strengthening your identity towards that behaviour. The next time you feel unmotivated or are finding it difficult to show up, even just arriving at the gym and performing 1 set or putting your sport shoes on and going for a short walk will go a long way in the grand scheme of achieving your health and wellbeing goals. Remember, “If you can get 1% better each day for one year, you’ll end up 37 times better by the time you’re done” (Cear, 2018).

By Veeral Patel, Senior Physiotherapist 


References:

 

 

Clear, J. (2018). Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones. Penguin Random House.

Chaput, J. P., Dutil, C., & Sampasa-Kanyinga, H. (2018). Sleeping hours: what is the ideal number and how does age impact this?. Nature and science of sleep, 10, 421–430. https://doi.org/10.2147/NSS.S163071

Institute of Medicine (US) Committee on Military Nutrition Research. (2001). Caffeine for the Sustainment of Mental Task Performance: Formulations for Military Operations (2nd ed., pp. 33-72). National Academies Press (US). https://doi.org/10.17226/10101

Colrain, I. M., Nicholas, C. L., & Baker, F. C. (2014). Alcohol and the sleeping brain. Handbook of clinical neurology, 125, 415–431. https://doi.org/10.1016/B978-0-444-62619-6.00024-0

World Health Organization. (2020). WHO Guidelines on physical activity and sedentary behaviour. World Health Organization. https://www.who.int/publications/i/item/9789240015128

Blume, C., Garbazza, C., & Spitschan, M. (2019). Effects of light on human circadian rhythms, sleep and mood. Somnologie : Schlafforschung und Schlafmedizin = Somnology : sleep research and sleep medicine, 23(3), 147–156. https://doi.org/10.1007/s11818-019-00215-x

Walker, M. (2017). Why we sleep: Unlocking the power of sleep and dreams. Scribner.

Worley S. L. (2018). The Extraordinary Importance of Sleep: The Detrimental Effects of Inadequate Sleep on Health and Public Safety Drive an Explosion of Sleep Research. P & T : a peer-reviewed journal for formulary management, 43(12), 758–763.

Starting the Season: Progressive Overload or Deload?

As the Winter sporting seasons begin to kick off, it’s imperative to continue checking in with your body  to minimise injuries during the season. The start of the season is when we tend to see an uptick in injuries as individuals ramp up their loads up without observing how their body is handling the stress.

 

Our connective tissue continuously adapts to the loads we place on it. However, like all parts of our body, our connective tissue has a certain limit. Tendons are a type of connective tissues that are significantly affected by sudden changes in load. A common tendon injury we see when presented with excessive or sudden changes in loads are termed tendinopathies (aka “unhappy tendons”). Our most up to date understanding of tendinopathies can be summarised in the model below:

(Cook et al., 2016)

We effectively want to keep our tendons happy and pain-free by incorporating interventions that address overall tendon function and capacity (Cook et al., 2016). Tissue capacity is a measure of how much load your tissue can currently handle. When we slightly exceed our tissues current capacity, we inherently challenge our bodies to adapt in order to make the activity easier the next time we perform it. However, stressing our tissues well beyond their capacity levels exponentially increases the risk of injury. 

 

Previous injuries that have not been rehabilitated completely can develop into recurrent injuries; as well as become key contributors for the cascade of compensatory factors that place abnormal forces through otherwise healthy body tissues (Hylin et al., 2017). A good proxy for avoiding this spiraling effect is to be aware of niggles throughout your training or sporting season. It is always better and easier to manage niggles or aches immediately, rather than down the track after they have blossomed into chronic injuries. In fact, niggles and previous injuries are the primary predictors for the development of future injuries (Whalan, Lovell & Samson, 2020).

 

The tricky part is determining when you should continue to push your training versus deloading and recovering. Although there are recommended guidelines around this, it should be individiualised based on current tissue capacity, previous injury history and possibly associated compensatory factors (i.e., biomechanics/movement patterns).

 

If you are unsure where your current tissue capacities lie, want to screen previous injuries or assess your biomechanics, seeing a physiotherapist or exercise physiologist can be quite useful in determining the best plan around injury prevention, as prevention really is the best cure. Click here to book an appointment today!

 

By Veeral Patel | Senior Physiotherapist


References

  1. M. Whalan , R. Lovell & J. A. Sampson, (2020). Do Niggles Matter? – Increased injury risk following physical complaints in football (soccer), Science and Medicine in Football, 4(3), 216-224, DOI: 10.1080/24733938.2019.1705996
  2. Cook JL, Rio E, Purdam CR, et al. (2016). Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? British Journal of Sports Medicine, 50, 1187-1191.
  3. Hylin, M. J., Kerr, A. L., & Holden, R. (2017). Understanding the Mechanisms of Recovery and/or Compensation following Injury. Neural plasticity, 7125057. https://doi.org/10.1155/2017/7125057

On the Run: Failing to Prepare = Preparing to Fail

If you’re serious about getting into running (or any exercise for that matter) and it’s been a while since you’ve thrown on the runners, there’s a few things to consider and tick off the checklist before heading out the door. 

The list below contains some important factors for injury prevention that people often forget when starting a running program.

Correct Loading Mechanics:

The load placed on your body when running is huge – depending on your speed and gait patterns, you place anywhere between 3-8x your body weight with every step! A 5km run will average a little over 6000 steps, so loading your joints correctly (particularly your hips and knees) is important for the longevity of your joints. 

Hip strength and stability should be at an adequate level to support movement and loading patterns pertaining to running. These include (but are not limited to) hip extension and thoracic rotation.

Difference in Limb Strength:

Strength discrepancies between your left and right leg are normal and common. However, exceeding a 10% difference in strength for a given muscle group (in comparison to its counterpart) can lead to joints experiencing loads they were not biomechanically designed to withstand. The negative impact on the joint is only exacerbated by the increased impact from walking to running.


Before we clear someone to start running or continue after an injury or time-off, it is important for us to run some tests. We use AxIT technology to record and measure the strength between the muscles of their right and left legs. 

For example:

  • A normal Hamstring to Quadricep ratio less than 0.66 has been shown to negatively affect lower limb performance (2)

  • Hip abduction/adduction ratios of less than 80% have been shown to influence physical performance. (1)

Correct Loading & Preparation for Tendons and Ligaments 

Creating programs which strengthen and prepare muscles is straight forward. However, progressive loading of the tendons and ligaments is often less considered when returning to running – leading to overuse injuries. Tendons and ligaments are incredibly smart.  Like muscles, they adapt in their size and/or material properties according to mechanical load. Developing stiffer tendons by increasing collagen synthesis will assist with the way that both the muscle and tendon together – are able to withstand load. 

Initially, a walking program should be followed to introduce a gradual increase in load to the tendons and progression of volume (e.g., kilometers). When both strength levels are adequate and a progressive walking program has been completed, a running program can be initiated.

As a general guideline, increases should be around 10% per week. However, this is not a concrete rule and should only be used as a guideline for tendon adaptation whilst taking other injuries into consideration. 

Like muscles, tendon and ligament fibers break down slightly during training and during the recovery period – build up stronger in adaptation. The difference is that muscles yield a higher blood supply, therefore their recovery is much faster (up to 24 hours)!

Image courtesy of ‘Modern Physiotherapy Aus, 13/03/2023

Green line: – acute increase in collagen & protein synthesis. Peaking around 24 hours post exercise and staying elevated up to 80 hours post exercise.  Maroon line: degradation of collagen which occurs simultaneously. Degradation occurs earlier and to a greater extent. This is a normal tendon response.  Purple line: The net balance of collagen synthesis and collagen degradation. A negative net balance occurs 18-36 hours after exercise, following with a positive balance up to 72 hours later (3)

 

Click here to learn more about our team at Exercise Lab.

By Pip Tockuss | Exercise Physiologist


References

  1. Hip Strength testing. (2020). Strength by Numbers. Retrieved March 23, 12 C.E., from https://www.strengthbynumbers.com/resources
  2. Knee Strength Testing. (2020). Knee Strength Testing. Retrieved March 23, 12 C.E., from https://www.strengthbynumbers.com/resources
  3. Managing patella tendinopathy in powerlifting Pt.1 – Understanding Tendinopathy. (2023). Modern Physiotherapy Aus. Retrieved March 23, 13 C.E., from https://modernphysio.com.au/managing-patella-tendinopathy-in-powerlifting-pt-1-understanding-tendinopathy/

Strength Training – Is “no pain, no gain” necessary?

resources BOSIC

There has been a long term belief in the fitness community that soreness or DOMS (Delayed onset of muscle soreness) is a good indicator of a successful gym session, but is this true?

Being sore after a workout is the side effect of your muscles trying to adapt to the new stimuli that you are presenting them with.

DOMS is a muscle soreness and stiffness that occurs 24-72 hours after training. It is a sore, aching, painful feeling in the muscles after unfamiliar and unaccustomed intense exercise. The idea is that the soreness you are feeling post exercise is ideal and a great indicator of gains to come in the form of muscle growth (hypertrophy) and will lead to an increase in overall performance. But what if I were to tell you that this indeed simply a myth?

Flann et al. conducted a study where they compared two groups, one pre-trained group and one naïve group, doing resistance training with the same workload. The pre-trained group initially followed a three-week ramp-up program to prepare their bodies for the same subsequent eight-week resistance program that both groups would follow together.

The results showed that both groups demonstrated significantly differing levels of muscle damage, with the pre-trained group having no demonstrable muscle damage throughout the eight weeks. However, the naïve group showed muscle damage well above normal levels and much greater levels of perceived muscle soreness. Even though the naïve group showed increased measurable muscle damage and perceived DOMS, both groups showed equal gains in quadriceps muscle size and strength. Concluding that muscle damage and elevated levels of perceived soreness are not required for gains in strength and hypertrophy, therefore disproving the notion of “no pain, no gain.”

A better way of measuring your workout effectiveness and “gains” is to employ the principle of progressive overload. Progressive overload simply means gradually challenging yourself more as you get stronger and increasing the intensity of the training stimulus.

Some examples of this include:
increasing the weight
increasing the number of reps you’re performing
increasing the distance you run


References

Kyle L. Flann, Paul C. LaStayo, Donald A. McClain, Mark Hazel, Stan L. Lindstedt; Muscle damage and muscle remodeling: no pain, no gain?. J Exp Biol 15 February 2011; 214 (4): 674–679.

Getting Back Into Training & Exercise After A Break

podiatry BOSIC

It’s a brand new year and everyone is creating their own goals to accomplish, many of which involve fitness and health. As physio’s, we see so many people starting to exercise again which is so great to see. So let me guide you through your first few weeks to get you back safely.

Here is an amazing chart showing what happens to our muscles if we have gone on holidays or have had an injury that has stopped us from exercising.

Image sourced from Sports Injury Bulletin

Blue line – if you only reduce your usual training by 10% you will only get a minimal amount of fitness loss

Yellow line – if you reduce your training by 50% you will get a 5-10% of fitness loss

Red line – if you reduce training by 70% (i know i have over these holidays) you will have a 5-20% loss of fitness

Purple line – bed rest or no training means it may take you several months to return to your strength before you took the break

Green lines – starting to retrain and fitness coming back

Unfortunately we lose our fitness more rapidly when we don’t train or decrease training compared to gaining fitness. This also accounts for professional athletes, that is what makes their job so hard to maintain. 

 

Here are some tips on how to get back to training safely:

  1. Do not go back to the weight you used to use before your holiday, make sure you drastically decrease then slowly increase. This is a good time to have a physio or exercise physiologist help find your new baseline.
  2. When getting back to running, we lose this fitness faster than our strength fitness. For example, sprinting fitness decreases in one week, how crazy is that!!!  Start off slow and decrease your distance. If you feel this is not enough, do a little strength work out after your shorter and slower run. Your fitness will start to improve and you can decrease risk of injury this way.
  3. Have fun while doing it. Put on your favourite tunes or go to the park to get some fresh air! If you’re in Australia, don’t forget to wear sunscreen!

Now that you know you have to increase slowly, stay tuned for my next blog on how many repetitions you should be doing for strength vs endurance training! And if you have any questions or would like help attaining your new baseline to stay injury free, click here to book an appointment with me and I can help you on your New Year’s journey to fitness!

 

Your friendly physio, Paulina Backiel

 


 

References (from Sports Injury Bulletin)

Issurin V. Block periodization: breakthrough in sports training. Ultimate athlete concepts; 2008.

Shattock K, Tee JC. Autoregulation in Resistance Training: A Comparison of Subjective Versus Objective Methods. J Strength Cond Res. 2020 Feb 13. doi: 10.1519/JSC.0000000000003530. Epub ahead of print. PMID: 32058357.

Helms ER, Byrnes RK, Cooke DM, Haischer MH, Carzoli JP, Johnson TK, Cross MR, Cronin JB, Storey AG, Zourdos MC. RPE vs. Percentage 1RM Loading in Periodized Programs Matched for Sets and Repetitions. Front Physiol. 2018 Mar 21;9:247. doi: 10.3389/fphys.2018.00247. PMID: 29628895; PMCID: PMC5877330.

How To Strengthen Your Hamstring For Running And Why?

exercise physiology BOSIC

Where are our hamstrings?

What is most commonly called “the back of our thighs” is where our hamstrings are. They are 3 really strong muscles that help us be able to walk and run.

What do they do?

Their main action is to extend the leg behind our hip and bend the knee. However, in running they are extremely important for absorbing the energy we create and controlling our limbs just before we plant our foot back down on the ground. 

The muscle that gets left behind.. literally!

Usually the hamstrings get ignored and the front part of your thigh “the quads” start to overpower. This can lead to an imbalance, changing biomechanics of your running resulting in higher risks of injury. We have a lot of muscles in our lower limbs for a reason, these muscles have to work together to propel us forward especially in running. If one of these muscles overpowers the other, the weaker muscle has a hard time catching up. And for example our running no longer becomes a smooth pattern but disorganized. This is when injuries occur.

How loud are you when you run?

For example if the hamstring is supposed to slow down the leg before it touches the ground, but if it can’t then that can result in the person hitting the ground too hard with their foot. This will increase the force going into the ground (because it was not absorbed by the hamstring) and then that force comes back at you more than double as much. The faster we go the more energy our hamstring needs to absorb to slow down our foot before it finally reaches the ground. 

Other injuries due to weak hamstrings

Another biomechanical issue we see is overstriding. This is when the hamstring gets overpowered and the knee does not bend fast enough before being placed on the ground. This is where injuries such as shin splints and stress fractures can occur.

So are you actually training your hamstrings enough? If not here are some exercises to try:

  1. Good Mornings
  2. Romanian Deadlift
    Progression: Single Leg Romanian Deadlift
  3. Double Leg Hamstring Bridges
    Progression: Single Leg Hamstring Bridges

 

Written by Physiotherapist, Paulina Backiel

 

References
 Schache AG1, Dorn TWWilliams GPBrown NAPandy MG.Lower-limb muscular strategies for increasing running speed.J Orthop Sports Phys Ther. 2014 Oct;44(10):813-24. doi: 10.2519/jospt.2014.5433. Epub 2014 Aug 7.

Move More This Movember

BOSIC sports medicine

It’s that time of the year again! Movember is upon us! If you haven’t heard of Movember (you must have been living under a rock?), it is an annual event that involves the growing of moustaches during the month of November to raise awareness for men’s health issues. The purpose of the event is to promote men living happier, healthier and longer lives. It is a big topic here in Australia but is one that is still unfortunately not spoken about enough. 

Did you know?

  • Men die 6 years younger than women on average.
  • Heart disease is the leading killer of men in Australia.
  • 3 in 4 suicides are men.
  • Over 70% of men in Australia are overweight or obese.
  • Men visit the doctor less frequently and for shorter durations than women on average.

Despite the above statistics looking a bit doom and gloom, exercise has been proven to be a proactive way to improve both your mental and physical health. Exercise plays a key role in keeping Aussie blokes healthier, happier and alive longer.


Benefits of Exercise

  • A high level of cardiorespiratory fitness is one of the best predictors of overall health.
  • Exercise is key in the rehabilitation of injuries such as back pain and sporting injuries when wanting to return to full health!
  • Regular physical activity helps to maintain a healthy body weight and reduce the risk of many chronic conditions and injuries. These include but are not limited to depression, anxiety, diabetes, cardiovascular disease and some cancers.
Physical benefits of exercise
  • Increased muscle mass, improved bone density (stronger bones), lowered blood pressure and cholesterol, reduced inflammation, improved cardiovascular efficiency, weight loss and less risk of developing diabetes.
  • Improved focus and energy levels
  • Improved sleep! Specifically, moderate-to-vigorous exercise can increase sleep quality for adults by reducing sleep onset – or the time it takes to fall asleep – and decrease the amount of time they lie awake in bed during the night.
Emotional benefits of exercise
  • Reduce feelings of stress and depression
  • Enhance your mood and overall well-being
  • Exercise releases endorphins that naturally make you feel happier relieve stress
Social benefits of exercise
  • Exercise makes you feel more motivated! Especially when you are surrounded and are pushing each other to do better!
  • You will become more accountable and disciplined! A great way of proving to yourself and others is sticking to a programme and showing up and doing your best even on the days when you least feel like. Pushing your boundaries and beliefs can be very rewarding to you and those around you.
  • You can meet like minded people and interact with people about sports and exercise that are of interest to you.
  • You can become a better friend/partner/worker by dealing with your negative emotions through exercise.

How much exercise is the right amount?

The Department of Health has recommendations for how much exercise men should get every week.

  • 150 minutes of moderate physical exercise each week such walking, gardening, light cycling or 75 minutes of vigorous aerobic exercise such as running and sports participation.
  • At least two muscle strengthening sessions. For example body weight exercises, circuit training in the park or in the gym or in groups.

This equates to around 5 x 30 minute exercise sessions per week. This exercise prescription might sound overwhelming. However remember that the working day provides a lot of opportunities to get moving more, during Movember, and all of the time.

Variations on this will occur depending on an individual’s fitness, age, and the existence of other health conditions. If you require advice or guidance about an exercise programme, or if you have an injury that is preventing you from participating in physical activity, speak with team at Barangaroo Physio today on 02 8599 9811 or book an appointment online.

Top tips to move more in Movember!

  • Take the stairs more!
  • Get a smartwatch to track your steps!
  • Park further away than normal
  • Grab a coffee and take a stroll around the park
  • Do favours for people such as grabbing lunch or shopping for groceries
  • Get off the bus one or more stops earlier
  • Stretch out or do a home workout whilst watching the television

References

https://www.menshealthweek.org.au/events/resources/male-health-infographics
https://exerciseright.com.au/aerobic-fitness-best-predictor-of-health/
https://www.amhf.org.au/infographics
https://www.obesityevidencehub.org.au/collections/trends/adults-australia
https://www.nia.nih.gov/health/infographics/emotional-benefits-exercise
https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf