August 2019 – Load Management for Injury Prevention

Motion Health Exercise Physiology Melbourne

By Catherine Macrae

Whether you are training for a marathon, a hiking holiday, a week at the ski slopes, or even just maintaining the ability to cope with tasks of daily living, managing load is relevant for everyone. Research highlights the need for education on modification of load in addition to strengthening the kinetic chain.

So how do we define load? It’s basically the total volume, type and intensity of activity that an individual undertakes in both training and competition. Measuring and monitoring load is important to the individual and Physiotherapist because we can use the information to our advantage in preventing any Non-contact soft tissue or bony injuries in the future. Your base ‘condition’ or ‘capacity’ will dictate how much load your body may be able to tolerate. If the loads that you apply to your bodies are greater than the tissues capacity to cope, then a reactive response can lead to inflammation, sensitivity and pain.


Courtesy of ‘The Running Physio’- Tom Goom.

The AIS have produced a paper based on best practice guidelines titled ‘Can we think about training loads differently’ – click here to read the paper.

They have set out five key principles of load management to assist in Injury Prevention

1. Establish moderate training loads and ensure these are maintained
Basically, tissues LOVE consistency! If you can apply a consistent level of loading over a period of time, the tissues begin to adapt and when sudden spikes in load do occur, they will be much more likely to cope.

2. Be aware that injuries can be latent following increased training loads
This is why managing and particularly monitoring load is so important. Sudden increases should be avoided, with a general rule of 10% load increases only!

3. Minimise large week to week fluctuations
Consistency is key! Common pitfalls occur when returning from training/loading breaks like holidays or injuries, and individuals resume training at the previous level of load. Illustrated nicely with Dye’s ‘Envelope of Function’ (Courtesy of Tom Goom ‘The Running Physio’)

4. Establish a floor ceiling of safety
Any training program should set out a minimal level of weekly loading, and a maximum level of loading. Ensuring training stays in the ‘Safety sweet spot’

5. Ensure training loads are appropriate for your current situation.
Loads should represent the current tissue capacity. Monitoring how someone is responding to load (i.e Fatigue, sleep, tissue response etc) assists us in graduating a training program appropriately.

The take home message from this, is GET MOVING! Tissues Love and adapt to regular loading. If you have a training aim or competition goal in the future, use the assistance of a Health Professional like a Physiotherapist or Exercise Physiologist, to establish a base training program and assist in monitoring the graduation of your loading to allow you to reach those targets safely, without injury!

July 2019 – Acute Ankle Sprains

By Kirsty Allen

Acute ankle sprains are one of the most reported musculoskeletal injuries amongst the general population, with up to 70% of people reporting an ankle injury in their life time. Representing roughly 15% of all injuries reported, the highest rates of ankle sprains are typically reported in sports and activities that are characterised by running, cutting and jumping, such as basketball, football and volleyball.

Inversion injuries/lateral ankle sprains (ie. the ankle “rolling inwards”) make up for more than 85% of all ankle sprains. Among the general population, ankle sprains are typically influenced by age, with those aged between 10-19 being the most susceptible to injury, as well as a predisposition through previous ankle injuries. Those who have a history of even one ankle sprain have been found to be 2 times more likely to sustain further ankle injuries. Such a high re-injury rate may be due to poor rehabilitation and/or premature return to sport.

With this, there is a strong association between ankle sprains and the development of chronic ankle instability (CAI). CAI includes mechanical instability (ankle range of motion exceeds normal physiological limits) and functional instability (feeling like the ankle it going to “give way” either at rest or during activity).

After an acute ankle sprain, the individual is likely to experience pain, tenderness and swelling in the ankle, as well as only being able to partially weight-bear on the affected side. These symptoms may last from a few hours to a few weeks, depending on the severity of damage and the management of the injury.

Following an acute injury, it is important to seek professional medical advice to allow for proper management and recovery. A Physiotherapist or Exercise Physiologist will work closely with you to help reduce swelling, increase passive and active range of motion, improve strength and stability and re-develop motor control and coordination through the affected joint allowing for a safe return to sport. It is essential to begin rehabilitation early after injury, as starting exercises in the first week provides significantly greater outcomes to short term ankle function.

If you have recently suffered from an ankle injury, or have in the past and experience any of the above instability symptoms, call Motion Health on 03 9825 2697 to book an appointment with an Exercise Physiologist or Physiotherapist today.

June 2019 – Physiotherapy for cervicogenic headache

relaxation massage

By Adrian Pranata

Headache is a common problem in society and is one of the most common reasons one would seek medical help. There are myriad causes of headaches ranging from stress, hormone imbalance, balance and sight problems to serious medical conditions such as a stroke or brain tumour. However, headaches can also be caused by problems in the neck. Neck disorder-related headache is termed cervicogenic headache (CH). CH usually presents as a dull ache that is projected from the neck to the left or right side of the head, behind the ear and may radiate as far as the eye on the same side. CH can be very disabling and may last for a few hours but it can recur 1-3 times in a week.

People with CH have also reported additional symptoms such as ringing in the ears, dizziness and restrictions with neck movement. CH is more common in females and has been seen in individuals as young as 6 to 40 years of age. It has been thought that CH is precipitated by sustained posture (e.g., sitting and sleeping) and physical trauma (e.g., car accident). These precipitating factors can irritate the nerves surrounding the upper neck joints which in turn would irritate nerves in the brainstem – which projects the signal to the head region resulting in painful sensation away from the neck.

Fortunately, CH can be treated effectively by physiotherapy. Physiotherapy management of CH is supported by high quality scientific research – which includes treatments of the neck joints, postural assessment and correction, neck muscle retraining and stretches, nerve exercises and advice on healthy work and lifestyle. Thus, early physiotherapy assessment and intervention is integral to optimise CH recovery.

It is not uncommon that CH is associated with tight neck and upper back musculatures. This gentle stretch can help alleviate the aches associated with tight muscles around the neck and upper back:
1. Gently bend your head forwards with one hand whilst guiding your chin towards your chest with the other until you start to feel a stretch at the back of the neck.
2. Hold this position for 30 seconds and repeat 5 times daily.

If symptoms persist, Physiotherapists are available at Motion Health. Call 03 9825 2697 for further information.

May 2019 – Delayed Onset Muscle Soreness (DOMS)

By Monica Nguyen

Delayed onset muscle soreness (DOMS) is muscle tenderness and stiffness that usually starts 12-24 hours after the activity. Most of the stiffness/discomfort usually occurs 24 hours after and can even last for 3 to 5 days after the activity that caused it.
It is thought to be related to microscopic tears in the muscle fibres, which result from exercise that stresses the muscle tissue beyond what it is used to.
DOMS can result from taking part in a new physical activity or training harder than usual. The good news is that the next time you do that activity you are likely to experience less soreness and recover more quickly. Most cases of DOMS gradually subside and have no lasting effects.

While there is no way to cure the condition immediately, here are some treatments you can do to relieve soreness and accelerate recovery:

• Applying ice to the area to decrease inflammation.
• Resting the muscles so they have time to heal before attempting the same routine again.
• Active recovery: doing an easy, low-impact aerobic exercise such as walking to increase blood flow to the muscles.
• Massage.
• Stretching the muscles.

However, if the following applies to you then it is best to seek the advice of your physiotherapist or Exercise Physiologist:
 the pain is still present and not resolving more than 48 hours post-exercise.
 the pain came on during the exercise (not the day after) and was more sudden in onset.
 the pain is located in and around the joints and not just limited to muscles.
 there is swelling and discomfort in and around the joints.

For more info re DOMs, give Motion Health a call on 03 9825 2697 or have a chat with one of our practitioners next time you are in the Studio.

April 2019 – Lower Back Pain and Exercise

Motion Health Pilates

Lower Back Pain? Keep Moving
By Joel Wallace

Almost everyone at some point experiences back pain, and for some this might be a regular occurrence.

It is very easy to fear back pain and treat it differently to how we would other pains and aches. This may be for many different reasons but is often due to uncertainty, past experience or belief we will make it worse.

Surprisingly to a lot of people is that in most cases we don’t need to rush for ‘treatment’ and it quite safe to continue normal activities and exercise. Most episodes of lower back pain resolve themselves in around 6-8 days.

Some things to keep in mind about back pain are:

• Pain does not equate to damage

• The rate of spontaneous re-absorption of lumbar disc herniation’s is about 67%.

• Exercise has been linked with positive effects on the discs such as promoting regeneration and strengthening the inter-vertebral discs

• Isolated exercise such as ‘core’, transverse abdominal and glute exercises are not more effective than any other type of exercise for lower back pain

• Posture has not been shown by research to play a major role in the development of lower back pain

• Bending, and twisting has not been shown to be an independent cause of lower back pain or associated with pain intensity.

• On the other hand – Avoiding or being fearful of certain movements have been associated with ongoing lower back pain

For a helpful approach around exercise and lower back pain, see the below simple advice by Cor-Kinetic:

Don’t over complicate exercise & activity for back pain, use the following guidelines for your symptoms:

• Low levels of activity = increase activity a bit

• High levels of activity = reduce activity a bit

• Stiff movement = focus on relaxed movements

• Need higher levels of loading for sport/work = load them up

• Specific feared movements = grade the exposure to specific feared positions/movements

• Positions/activities that are painful beyond a tolerable level = its ok to back off for a bit (make sure to reintroduce them)

• Negative associations around exercise/activity = Make it fun, engaging & meaningful

• Bit of pain doing stuff = it’s ok

If you have any questions or want to know more speak to your Exercise Physiologist or Physiotherapist at Motion Health.

Remember that you don’t always need to rush for ‘treatment’ and that movement and exercise is good for you.

March 2019 – Explaining Pain

Explaining Pain
by Catherine Macrae

‘All Pain experiences are a normal response to what your brain thinks is a threat’

The construction of the pain experience in the brain relies on many sensory cues. There are danger sensors throughout the body (Nociceptors), that when excited to a critical level, pass a message on to the spinal cord. Here excitory chemicals are released, which in turn can lead a message to be sent to the brain. The brain relies on credible evidence to process and decide if and what response is required.

Pain is not always produced. Sometimes the brain concludes that other behaviours such as movement are more appropriate to avoid threat or injury.

THE AMOUNT OF PAIN YOU EXPERIENCE DOES NOT ACCURATELY RELATE TO TISSUE HEALTH
Pain is only a protector. The unpleasant feelings produced by the brain are designed to change your behaviour, to allow for your tissues to heal or to avoid perceived threat.

SOMETIMES PAIN IS NOT HELPFUL especially when it persists. All tissues will heal, and the majority of pain will be gone within 3 months. However when Pain becomes persistent, the nociceptors are conditioned to become more sensitive to stimuli.

WE LEARN PAIN and become better at producing it. With Persistent pain thoughts and beliefs become more involved and can contribute to the problem.

RETRAINING THE PAIN SYSTEM:Accept that ‘Retraining the brain is complex’
We cannot easily ‘switch off’ the brain.Using Pain as your guide is also not always helpful. This can lead to drastic limitations of activity and meaning in life.

HOW CAN WE HELP?
Through education and helping you to understand your pain better, the research proves that it can help you cope, and shift unhelpful attitudes and beliefs about your pain.
We can also support you in moving more than you are or believe you are currently capable of through pacing and graded exposure techniques.

Read more about Pain from Lorimer Moseley, one of the world’s leading Pain Scientists at:
https://www.tamethebeast.org/

Our team at Motion Health is available for any further questions