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!

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.

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.

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:

Our team at Motion Health is available for any further questions

June Newsletter – Asthma

heart health

Asthma is a chronic inflammatory disorder of the airways associated with airway narrowing and obstruction. It is commonly provoked by triggers including allergens (e.g. pollen, dust, animal fur), pollution (e.g. car fumes, fumes from industrial waste), exercise or stress. During an asthma episode, the airways become hyper-responsive, leading to narrowing of the airways and obstruction of airflow. This causes symptoms such as wheezing, breathlessness, chest tightness and coughing. Asthma symptoms can be reversed either spontaneously or with medication

The 3 main factors that cause the airways to narrow are:
1. Swelling of the inside lining of the airways
2. Increased mucus production combined with products of inflammation (e.g. histamine)
3. Tightening of the muscle around the airways (bronchoconstriction)

Asthma is primarily managed through an “Asthma Action Plan” developed by the patient’s G.P. The Asthma Action plan is a written set of instructions developed for each asthma patient outlining medication requirements, methods for recognising worsening asthma symptoms, and what to do in the event of an attack.

There are 3 main types of Asthma medications used:
Controllers: usually taken daily in an effort to reduce the inflammatory processes associated with asthma
Relievers: effective in relieving airway narrowing; should be inhaled only when needed and in the lowest dose necessary.
Preventers: may also be used daily to reduce both symptoms and asthma attacks. Preventers can be particularly effective in reducing exercise-induced airway narrowing in most patients.

For people with well-controlled Asthma (i.e. minimal symptoms or flare ups) exercise is a safe and effective way to improve aerobic fitness and reduce the likelihood of an exercise-induced attack. By using pre-exercise medication, most people with asthma can participate in physical activity at a similar level to people without asthma. A specific benefit of a physical training program is that it allows people with Asthma to exercise with less bronchoconstriction at the same exercise intensity, although it does not abolish or reduce airway hyper-responsiveness.

The role of exercise is to assist people with Asthma to lead as normal a physical lifestyle as possible, including participation in sports. Regular exercise should be part of the lifestyle of all humans to maintain health and fitness. A major benefit of regular exercise for asthmatics is improved aerobic fitness (i.e. VO2max). This means that a given level of exercise can be carried out at a reduced percentage of his or her VO2 max, so providing a greater exercise threshold before exercise induced Asthma appears. Psychological benefits ensue and many asthmatics have become elite athletes, and world and Olympic champions despite some having severe asthma. Between episodes of asthma, many asthmatics sustain a healthy cardiorespiratory system that does not interfere with physical performance. If significant airways constriction occurs, exercise performance will be impaired.

If you would like more information on how to start an exercise program to manage your Asthma, it is important to see the right professional to ensure you are exercising appropriately. An Accredited Exercise Physiologist will be able to conduct appropriate exercise testing and prescribe a program tailored to your current fitness levels while taking into consideration your medical history and any physical limitations. Call Motion Health on 03 9825 2697 for further information

January Newsletter – Pregnancy & Exercise

Pregnancy is a time of many physical and emotional changes for women. Perhaps you are wondering whether or not you should be exercising during this time. Fortunately, there is a lot of research indicating that physical activity is not only safe but beneficial for expectant mothers. Exercise can help keep pregnancy weight gain in an acceptable range, reduce the severity of musculoskeletal pain, prevent or control gestational diabetes and reduce the risk of pre-eclampsia. Exercise may also assist mothers have less complications during pregnancy and labour.

During pregnancy, ligaments and tendons throughout the body stretch, both to accommodate the growing baby and to allow the baby an easier passage out during labour. This soft tissue laxity can lead to aches and pains, particularly in the lower abdomen, pelvis and lower back and possibly increase risk of injury. That doesn’t mean women shouldn’t exercise at all. If active prior to pregnancy, women can continue exercising at the same level although sedentary women should ease into activity slowly. It is recommended that all pregnant women should avoid certain types of activity such as contact sports, heavy lifting and high level balance activities.

Pregnant women are also prone to dizziness due to the rising hormones in the body that cause the blood vessels to relax and widen. This can cause blood pressure to be lower and temporarily cause dizziness. This is one important consideration for pregnant women engaging in exercise. It is important to choose an exercise intensity that will improve health without putting them or their baby at increased risk.

Every woman and every pregnancy is different. The severity and duration of pregnancy-related symptoms will vary depending on how far along into pregnancy a woman is as well as any co-morbidities that may be present. Medical clearance from a G.P or Obstetrician is recommended when a history of miscarriage or any existing medical conditions (e.g. Diabetes) is present. For the vast majority of expectant mothers though, exercise has many benefits and is an excellent way to withstand the rigours of pregnancy.

Pilates is an excellent choice of exercise for pregnant women. Some benefits that one may see from practicing Pilates during pregnancy include:

Improved postural control
Increased core and pelvic floor strength
Reduction of lower back and or pelvic pain
Increased endurance to withstand activities of daily living

Please contact us for further information on how we may be able you.

March Newsletter – Diabetes & Exercise

Did you know that exercise can not only reduce your risk of diabetes by up to 60% but also plays a vital role in the management of the condition?

Type 2 Diabetes Mellitus (T2DM) is a permanent health condition that occurs as a result of sustained elevated blood glucose (sugar) levels. As a result the pancreas is required to release increasing amounts of the hormone insulin, which is responsible for keeping blood glucose levels normal. After many years of this cycle the pancreas is no longer able to produce sufficient amounts of insulin to regulate blood glucose levels, which begin to increase ever higher. These high levels of blood glucose cause damage to both small and large blood vessels and can lead to nerve damage in the peripheries (loss of sensation and circulation in the feet), eye damage and stiffened arteries. T2DM also increases the risk of developing other conditions such as cardiovascular disease.

Two of the main risk factors are excess weight and physical inactivity. Over 80% of people diagnosed with T2DM are considered to be overweight or obese. The highest risk occurs when waist circumference is over 94cm for males and 88cm for females. This is due to excess fat stores producing toxins which make insulin less effective. This is particularly the case when weight is held around the middle of your body, impacting on the function of your vital organs.

T2DM is managed through lifestyle modification, that is diet and exercise and if necessary through prescription medication. Keeping a blood glucose diary can also help you keep track of how you are managing your condition and learning how your body responds to exercise and different foods.

There is a range of different medication prescribed in regards to diabetes management. It is important to understand how your medication works and how it will relate to exercise. This will help you to avoid hypoglycaemic episodes (low blood sugar) and better understand when, how often and how intense you should exercise.

Exercise is a key component to lifestyle management of this condition. Aerobic and resistance training are both effective but in different ways. For example aerobic exercise has been show to improve insulin sensitivity – the hormone released in response to glucose intake to remove sugars from the blood. Resistance training helps increase muscle size increasing the amount of energy that can be stored in the muscle itself rather than the blood stream.

If you or anyone you knows has T2DM talk to an Exercise Physiologist at Motion Health. We have a T2DM group that is eligible for medicare rebates with a GP referral along with 1:1 and group exercise physiology session that can be structured to assist your diabetes management. If you already attend Motion Health speak to us about how this can be included in your current exercise classes.