Monthly Balmain Sports Physiotherapy ‘Drinks & Nibbles’

We will be hosting ‘drinks & nibbles’ at our practice on the last Friday of each month at 6pm, throughout 2007. All our current and past clients / friends are welcome, so feel free to drop in for a relaxing wine or cleansing ale!

Weight for Age

Resistance training isn’t just for gym junkies; it has a host of benefits, particularly as we grow older, from helping control diabetes to preventing osteoporosis. Unfortunately resistance or strength training suffers from something of a low profile, with many people unaware that muscle strengthening exercises can be good for your health and may even help you lose weight.

In terms of physiology, resistance training increases muscle strength by pitting the muscles against a known weight or force. The muscle cells then adapt to the extra workload by getting bigger (hypertrophy) and using more nerve cells to help the muscles contract with more efficiency and power.

Resistance training is most often associated in people’s minds with the type of training done by body builders (i.e. Arnold Scwarzenegger) and weight lifting athletes. When training, these athletes lift heavy weights, a minimal number of times (i.e. 4-8 repetitions). This type of resistance training generates significant increases in muscle strength / power and muscle size (hypertrophy), while only obtaining minimal health benefits….but they will look good on the beach!!

However there is a second type of resistance training that not only strengthens muscles but also improves their endurance and muscle tone (i.e. shape), in a manner similar to other forms of exercise such as walking and swimming. It involves lifting a lighter weight many times (10-15 repetitions minimum) and has been shown to achieve significant health benefits, by preventing a wide range of medical conditions and chronic diseases.

Benefits of Resistance Training

1. Increased muscle strength, power, endurance and size
2. Increased bone density and strength
3. Reduced body fat
4. Increased muscle-to-fat ratio
5. Boosted metabolism (i.e. burning more calories when at rest)
6. Lowered heart rate & blood pressure after exercise (thought to reduce the risk of hear disease)
7. Enhanced performance of everyday tasks

Research shows that resistance training can be a form of treatment for specific medical conditions that are more likely to affect middle-aged and older people. It can help, improve or prevent depression, diabetes, heart disease, weight loss, low back pain, osteoarthritis, falls in older age, osteoporosis and sleep disorders.

Studies show that resistance training provides additional, but modest weight loss when combined with aerobic exercise and a healthy diet, says exercise physiologist Chris Tzar, from the University of NSW Lifestyle Clinic. One in three adults over the age of 65 experience a fall each year, with hip fractures the most common resulting outcome, which can seriously affect a person’s ability to remain independent. Cathy Nall, the current Australian Physiotherapy Association President, reports that “exercise programs designed by physiotherapists can help improve strength, balance, endurance, fitness and bone density, all of which help lessen the chance of falling”.

Resistance training can also help prevent the development of future problems, given that the older we get, the harder it is to do simple daily activities like getting out of a chair due to a loss of strength. However this isn’t inevitable, as it is largely reversible and can be prevented by doing resistance training.

Getting Started

You don’t have to sign up to expensive gym memberships or slave at a heavy duty weights machine to do resistance training. It can be done at home or at the local park, at your own convenience, using your own body weight, a few lightweight dumbbells and maybe even an additional stretchband. These could be as simple as squats, lunges, crunches or bicep curls. Depending on your level of fitness and experience with performing resistance exercises, these exercises may even be modified i.e. push ups might be modified to doing in standing against a wall initially.

Prior to you starting, a comprehensive history and physical examination by one of our sports physiotherapists will ensure that you are directed and taught appropriate exercises for your experience levels, while also working you towards your established short and long-term goals. Depending on any existing medical conditions, the physiotherapist may also direct you to your general practitioner / sports physician prior to starting, to ensure that it is safe for you to commence resistance training.

For a beginner you may start with a program of 5 exercises, with each exercise being done in 2-3 sets of 10-15 repetitions. This would be done 3-4 times per week, with a rest day in between. The rest day allows the muscles to recover from the physical stress of the exercises performed, such that they will be ready for the next training session. In order for the muscles to get stronger, you must fatigue them, and as a general rule of thumb, the exercises are the correct resistance if you start to feel ‘tired’ at approximately the 8-12th repetition of each exercise. If you can complete them easily i.e. the muscles are getting stronger, then it is time to progressively increase the amount or resistance and / or repetitions being completed, to ensure that the muscles are continuing to be overloaded and fatigued, and hence made stronger.  This is the most important aspect of any resistance training program, and is called ‘progressive overload’.

Basic Principles of Resistance Training

1. Warm Up / Cool Down: thoroughly to reduce the risk of injury.
2. Wear Appropriate & Comfortable Clothing
3. Tailor the Lift: you need to ensure your exercises are specific to the body areas you want to improve.
4. Don’t hold your breath when lifting weights: Breath out when lifting weight.
5. Use a full range of motion: this works the muscle fully and reduces the risk of joint injury.
6. Control the Weights: perform the activity slowly and with control. Moving other body parts only increases the risk of injury.
7. Rest: in between sets of 1-2 minutes.
8. Modify Program: ensure you see a sports physiotherapist to vary your program in terms of intensity, volume and variety, to provide continued improvement in fitness and strength.
9. Stop Program: if you injure yourself or feel pain. Seek an assessment by your sports physiotherapist.

Musculoskeletal Screenings - Are they Useful?

We are once again just entering the commencement of the competitive Winter sports seasons, where athletes at all skill levels are trying to regain their aerobic fitness that was somehow lost over the summer break as fast as possible. Our kids will now resume playing multiple sports at both their schools and local sporting clubs.

During the Pre-Season Campaign, if not prior to, it is important to develop good aerobic fitness, muscle strength, control and balance, and to maintain good muscle length. If any of these factors are not adequate for any joint or muscle, the risk of injury is increased.

Musculoskeletal screenings of athletes were introduced at the Australian Institute of Sport in the mid-1990’s. The aim of these screenings was to prevent injury, maximise performance and identify injury trends within individual sports. Since this time, musculoskeletal screening protocols have been adapted for each sport by sports physiotherapists associated with each of the State Institute Program’s throughout Australia.

Performing musculoskeletal screenings prior to commencing a sporting season remains our best method of assessing athletes for identification of potential risks of injury. Once identified, an individualised program is then designed to address the problem areas for the athlete to include into their normal training routines. This then ensures these risks are no longer a factor when the training / games / season become more intense, which reduces the risk of injury occurring.

The tests carried out during a screening varies with each sport depending on the physical demands and requirements of the sport. They need to provide as much useful information about that individual athlete, which can then be compared to the known injury trends and risk factors for that sport. The tests will look at general joint range of motions and muscle lengths, as well as a number of sport-specific tests. For example, netball is predominantly a lower limb sport, and hence the majority of a netball musculoskeletal screening concentrates on a biomechanical assessment of the lower limb (leg and foot) as that is the region that is most often injured. Hence, a hop lunge test replicates the sudden stopping required when playing netball. In contrast to this, a swimming screening concentrates on the upper body (trunk and upper limbs). A common swimming screening test is getting athletes to lift both their arms up together while they are on their stomach, which assesses their thoracic (upper trunk) flexibility.

A musculoskeletal screening can provide invaluable information to an athlete, whether recreational or elite, for them to independently manage potential injury risks before they occur. This will then minimise the time they may spend on the sidelines watching their teamates play!

Title: Physiotherapy Interventions Improve Tennis Elbow with Superior Long-term Outcomes than Corticosteroid Injections.

Subjects: 198 subjects between 18-65 years of age, with a clinical diagnosis of tennis elbow for a minimum of 6 weeks.

Intervention: All subjects divided into 3 groups:

(1)       Physiotherapy group: elbow mobilizations, elbow / forearm eccentric strengthening exercises.

(2)       Corticosteroid group: Injection, then a repeat injection 2 weeks later if needed.

(3)       Wait & See group: re-assured to remain active without aggravating their pain.

Results:

(1)   At 6 wks, 65% group 1, 78% group 2 & 27% of group 3 reported being much improved.

(2)   Recurrence rates were higher & recovery delayed in the mid to long term with group 1, compared with groups 2 & 3.

(3)   Group 2 was superior to Group 1 & 3 after 52 weeks.

Quote of the Month

“So many people spend their health gaining wealth, and then have to spend their wealth to regain their health”                                   

A.J.Reb Materi