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Insomnia has been shown to increase pain. It can be a difficult situation for patients who find it difficult to get to sleep because they are in pain, and then their pain is exacerbated because they are unable to sleep. Sleep deprivation in healthy individuals can even bring on whole body symptoms of fibromyalgia and can decrease descending inhibition (pain is more sensitised) (Choy, E 2015).

Sleep is a very hot topic at the moment, and understandably so. With technology at our fingertips and people being more wired than ever, sleeping less than 8 hours per night is becoming the norm. Unfortunately this is not at the benefit of our health.

A population who definitely understands the struggle of sleep is parents. Some new parents may not get more than an hour or two of sleep per night for the first 1-2 years – maybe longer. There could potentially be nothing more annoying than a new parent coming in to see their physiotherapist for back pain or neck pain – and being told that a large contributing factor for their pain is lack of sleep. News flash – they are aware they are getting less sleep. Something that may be more realistic is to acknowledge that the lack of sleep may increase feelings of pain, and not to panic about this. It is less likely that you have a structural issue going on, and more that you have some hypersensitivity due to lack of sleep. Sleep may not be the easiest thing to change, but things you can change is trying to fit in 5 minutes of exercise per day, drinking enough water and using a heat pack. Then when you do get some better sleep – you will probably feel a million dollars!

Another population that comes into mind is people who are unable to sleep because of their pain. They end up in a vicious cycle because their pain makes it difficult to get comfortable, every time they roll over they wake up in pain, then they get less good quality sleep, and then their pain increases because that have not had good sleep. Some things that can help people get to sleep include

  • Use a heat pack when you go to sleep
  • Apply some Fisiocreme on sore areas before going to sleep
  • Try sleeping with a pillow between your knees, under your knees, or hugging the pillow
  • Do not worry about what position you sleep in, find one that is comfortable for you

For more information about sleep – check out episode X on the Physical Performance Show

Emily Georgopolous (APAM)
Physiotherapist
Masters of Physiotherapy

Featured in the Top 50 Physical Therapy Blog

Click here to book an appointment with Emily or view our Active Rehab Class timetable here.

References
  1. Choy, EHS 2015, ‘The role of sleep in pain and fibromyalgia.’, Nature Reviews. Rheumatology, vol. 11, no. 9, pp. 513–520.

The post How does sleep affect my pain? appeared first on POGO Physio Gold Coast.

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Shockwave therapy is non-invasive modality used by therapists to use in combination with exercise prescription to return a tendon and/or muscle to normal function. A large amount of high quality studies have looked at what shockwave therapy is most effective at treating, which shockwave device to use and on which setting.

To just cover a few confusions within the area, “extracorporeal” is not a type of shockwave, the word just means “outside of the body” – therefore all types of shockwaves are extracorporeal. There are two main types of shockwave devices used in clinics:

1. Focus Shockwave

  • 3 types (spark discharge, Piezo-electric, electro-magnetic)
  • small focal area
  • better for bones or deeper structures, spasticity
  • more painful

2. Radial Pressure Wave (POGO’s device)

  • half the price
  • very versatile
  • not as accurate or deep
  • less painful
Degenerative Tendons

The timeline of an injured tendon starts with a normal tendon, if there is excessive load or individual errors the tendon may become a reactive. If this continues without altering load or training regime, this “reactive tendinopathy” can enter tendon dysrepair. Once at this stage it is harder to return to a normal tendon and after some time can descend further into chronicity and become a “degenerative tendon”.  It is at this stage where ESWT is most effective and is believed to be the only way the tendon can be returned to normal. 

Shockwave essentially breaks down this tendon and allows inflammation and remodelling to occur. It increases inflammation via pro-inflammatory neuro-peptides such as substance P and CGRP. This inflammation allows the tendon to attempt to heal at a cellular level. This combined with progressive loading/exercise that is aimed to eventually reach 70% of the client’s max effort – will return the chronic and seemingly helpless tendon back to normal function.

Pain relief

ESWT is well known for its pain relief benefits.Through research, we now know that ESWT has a role in returning a degenerative tendon into a reactive tendon. However, it also does have an analgesic effect. Pain relief by ESWT is best achieved when the machine is used a noxious stimuli via the “pain gate theory”. This means that in order to reduce the pain experienced from a tendinopathy, the shockwave session must be “uncomfortable” or involve a low-mid level of pain.

Shockwave increases inflammation

ESWT is pro-inflammatory, the reason behind its use is to change the cells of a degenerative tendon to a more acute, reactive tendon thus increasing blood flow and stimulating the body’s natural healing process. However, it is important to note that by being pro-inflammatory, non-steroidal anti-inflammatory medications such as mobic and ibuprofen will inhibit the effectiveness of ESWT. Furthermore, CS injections used in combination with ESWT is likely to produce poor outcomes due to the two acting against each other.  

It is also recommended that when treating an acute and/or inflamed injury – ESWT is not indicated as the body will attempt to heal the injured structure itself. If this healing fails or “stalls” then ESWT becomes indicated and is a recommended adjunct therapy option.

Indications for shockwave (via the ISMST)
  • Achilles
  • Plantar fascia +/- heel sput
  • Lateral epicondylitis (tennis elbow)
  • Greater trochanteric pain syndrome (GTPS)
  • Calcifying rotator cuff
  • Bone pathologies (non-union)
  • Wound healing (work around the wound)
Other indications
  • RC tendinopathy without calcification
  • Medial epicondylitis (golfer’s elbow)
  • Adductors
  • Pes anserinus
  • Tib post tendon
  • Bone marrow oedema (painful)
    • Osgood Schlatter Disease (precaution)
    • Sever’s Disease (precaution)
Muscle pathologies
  • Myofascial pain and MTPs (use single shot not continuous)
  • Muscle sprain with discontinuity
Contraindications for shockwave
  • Malignant tumour in the treatment area
  • Tumours
  • Pregnancy/fetus in the treatment area
High energy
  • Lung tissue in the treatment area
  • Epiphyseal plate in the treatment area
  • Brain or Spine in the treatment area
  • Severe coagulopathy
Settings

Therapists using the shockwave machine must ensure that you have the correct transmitter attached to the bar. If you are treating a tendon that is superficial then the D20 is appropriate. When treating a deeper tendon or a myofascial trigger point it is recommended you used the D15 transmitter. When selecting the energy, increase the bar pressure setting from the default amount. The default amount is set at the lowest setting of clinical value. Raising it to around 3-5 bar pressure is suggested for majority of tendons and muscles. Research shows that the most beneficial energy (bar pressure) to use on the client is the highest amount that is tolerable. Furthermore, the more energy used per session, the quicker the injury will resolve.

Summary of evidence

When deciding between focus shockwave or radial pressure wave, there remains no statistical significance between the two in regards to treatment outcome, as long as the same EFD (energy) is being used. ESWT has been proven as effective and safe non-invasive treatment option for tendon and other pathologies of high quality RCTs with positive outcomes.

    • 88.5% (23/26) of all RCTs on radial had significant results
    • 81.5% (66 out of 81) of all RCTs on focus had significant results

Optimum treatment protocol for ESWT appears to be 3 treatment sessions at 1 week intervals, with 2000 impulses per session and the highest EFD (energy) that can be applied

    • If client is unable to tolerate high energy then more sessions may be required
    • When treating a tendon it is advised to wait 5 days minimum between sessions
    • If after 3 weeks there is little to no improvement then reassess the client, check their injury and stage of healing

It is clear from the research that combining exercise with ESWT provides the best outcomes. Current evidence suggests ESWT may be a reasonable treatment to consider for management of chronic musculoskeletal conditions that fail to respond to conservative care given favourable safety profile and low risk of side effects.

In conclusion, seeking a medical professional that can accurately assess and diagnose your injury as well as deem it appropriate or not appropriate for ESWT is highly recommended.

Alec Lablache
POGO Physiotherapist

Featured in the Top 50 Physical Therapy Blog

References

NB: all information extracted from DJO ESWT course and supplied by shockwave expert and physiotherapist Cliff Eaton. For more information or to answer any question regarding electrotherapy visit www.electrophysicalforum.org or www.djoglobal.com.

  • Korakakis, V., Whiteley, R., Tzavara, A., & Malliaropoulos, N. (2018;2017;). The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: A systematic review including quantification of patient-rated pain reduction. British Journal of Sports Medicine, 52(6), 387. doi:10.1136/bjsports-2016-097347
  • International Society for Medical Shockwave Treatment (n.d). Introduction and prerequisites and minimal standards of performing ESWT. Retrieved from https://www.shockwavetherapy.org/about-eswt/indications/
  • van der Worp, H., Zwerver, J., Hamstra, M., van den Akker-Scheek, I., & Diercks, R. L. (2014). No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: A randomized controlled trial. Knee Surgery, Sports Traumatology, Arthroscopy, 22(9), 2026-2032. doi:10.1007/s00167-013-2522-z
  • Zhang, L., Fu, X., Chen, S., Zhao, Z., Schmitz, C., & Weng, C. (2018). Efficacy and safety of extracorporeal shock wave therapy for acute and chronic soft tissue wounds: A systematic review and meta‐analysis. International Wound Journal, 15(4), 590-599. doi:10.1111/iwj.12902

The post What is Extracorporeal Shockwave Therapy (ESWT)? appeared first on POGO Physio Gold Coast.

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In episode 170 of The Physical Performance Show Brad Beer shares a conversation with Zane Robertson – NZ Marathon Record Holder 2:08:19, 59:47 half marathon, Comm Games Bronze (5000m, 2014), Olympian in this featured performer episode.

Zane Robertson debuted in the 2019 Gold Coast Marathon with an impressive 2:08:19 just an average of 3:02 per kilometre to set a new New Zealand Marathon record. Zane took 3rd place in the 2019 edition of the Gold Coast Marathon and this added to his record list. Zane’s other records include the Oceanic Record for the half marathon running a swift 59:47, the 10km road Oceanic Record of 27:28. Zane has also been a Dual World Championships Finalist, a 2016 Rio Olympic Games 10,000m track finalist. Zane was also the 2014 Commonwealth Games Bronze Medallist in the 5000m at Glasgow.

But what makes Zane Robertson’s success so unique is not just his remarkable results but the story that underpins how Zane Robertson has achieved what he has. Zane and his identical twin brother Jake at just 17 year old laid it all on the line. By moving to East Africa in Kenya 13 years ago in order to become the best runners they possibly could. They moved to East Africa to train with the best distance runners on the planet.

During this episode you will hear Zane share around some of the hardships that he endured as a Junior Runner. The bullying at school growing up, classmates and also even teachers. The studying that he and Jake did to learn and understand what it would take to be a world class runner. The pressures of being an unsponsored athlete including at the time of recording. The heartache that comes with injury including 2 sacral stress fractures that cost Zane a 2018 Marathon Debut at the Commonwealth Games. The emotions and feelings Zane was experiencing in the lead up to his Marathon Debut at the Gold Coast Marathon. The training insights of the Kenyans and the Ethiopians, strength and conditioning principles, the importance of training tendons and Zane lays down a physical challenge to us for the week. At the time of recording, Zane now calls Ethiopia home, having married Baeza his Ethiopian sweetheart and this is a little insight into the world of Zane Robertson, New Zealand Distance Running Star.

To listen to Episode 170:

Click the icon to listen to the interview on iTunes or listen using the soundcloud player below

170: Zane Robertson - NZ Marathon Record Holder 2:08:19, 59:47 half marathon, Comm Games Bronze (5000m, 2014), Olympian - SoundCloud
(3977 secs long, 8 plays)Play in SoundCloud

Don’t forget to SUBSCRIBE at the links to ensure you get performance insights from our future upcoming exciting guests.

Listen in as we delve into the following:
  • Introduction to Zane Robertson
  • How Zane discovered his talent in Running
  • Where his drive came from
  • Experiencing Bullying throughout school
  • His injuries and how it impacts his life
  • Why he has lived in East Africa for the past 13 years
  • How he approached his first Marathon
  • How he conquers his fear during Marathons
  • Differences in training from the East to the West
  • His advice in overcoming bone injury
  • High moments in his career
  • Darkest days of his career
  • Zane on strength and conditioning
Show Sponsor Gold Coast Marathon

Like the Physical Performance Show, the Gold Coast Marathon encourages runners of all ages and abilities to push their boundaries and strive to complete a personal challenge.

The Gold Coast Marathon is held annually on the first weekend in July and is a must do event for any budding athlete, weekend warrior or family looking for a challenge to complete together.

Run for the good times at the Gold Coast Marathon. Visit the Gold Coast Marathon here.  

Quotes:

“Space out” – Being in the Zone
“Aggressive” – Racing Style
“There is no magic mileage figure. Magic is not in a figure, it’s in an effort” – Best Advice
“45 second wall sits” – Physical Challenge
“Work on talent that counts.”
“Everyone will have their day.”
“The more body weight you put into the ground, the more return you’ll get if your using your body right.”
“Training your tendon is a must.”
“Easy days go; easy, hard days; go hard.”
“Learn to read your own body not someone else’s.”
“Find what makes you happy.”

“Differences of Training in East Africa and NZ”

  1. Pacing: Easy days are easy – effort and easy effort.
  2. Diet
  3. Rest
To follow Zane Robertson

Instagram:  @zane_robertson_nzl
Twitter:  @runninelvis
Facebook:  @Runninelvis59

Running Away From Nothing - Robertson Twins - YouTube
DRIVEN: The Robertsons (Trailer) - YouTube
Timeline:

00:00 Start
02:19 Introduction to Zane Robertson
06:05 How Zane discovered his talent in Running
15:05 Where his drive came from
16:07 His injuries and how it impacts his life
19:30 Why he has lived in East Africa for the past 13 years
20:40 How he approached his first Marathon
22:50 How he conquers his fear during Marathons
24:55 Differences in training from the East to the West
28:37 His advice in overcoming bone injury
36:15 High moments in his career
39:40 Darkest days of his career
45:13 Zane on strength and conditioning
49:23 Performance Round
57:30 Physical Challenge
1:06:07 Finish  

People Mentioned:

Mo Farah – British Distance Runner
Matt Fox – Sweat Elite – Train Like the World’s Best (ft Matt Fox) Episode 136 of The Physical Performance Show
Alex Hutchinson – Author New York Times Bestseller ENDURE Episode 123 of the Physical Performance Show
Bernard Lagat – Kenyan Long Distance Runner  – Episode 77 of The Physical Performance Show
El Guerrouj – Retired Moroccan middle-distance runner
Don Willoughby – Coach  

For questions and comments about this Episode

The post The Physical Performance Show: Zane Robertson – NZ Marathon Record Holder 2:08:19, 59:47 half marathon, Comm Games Bronze (5000m, 2014), Olympian appeared first on POGO Physio Gold Coast.

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The menstrual cycle not only has a profound effect on fertility, the natural fluctuations of hormones impact exercise metabolism, plasma volume levels, thermoregulation and more (1). This significantly affects training and performance (1).

Effects of hormones on performance
Oestrogen: Progesterone:
Inhibits muscle growth Decrease glycogen use Increases fatty acid oxidation   Increased break down of muscle Reduced cardiac output Elevated core temperature Increased heart rate
Matching training types with fluctuating hormones throughout the cycle:

The menstrual cycle is typically 28 days long and can be divided into the follicular phase (days 1-14) and the luteal phase (days 15-28). Ovulation occurs around the middle.

Follicular phase

Day 1 is the commencement of the period. Both oestrogen and progesterone are at the lowest in this phase. Carbohydrates are the preferred fuel source during this period making it a good time for strength training, high intensity training, and competing. As the period finishes at around days 5-6, estrogen starts to increase, peaking at around day 12 along with luteinising hormone which causes ovulation.

Luteal phase (high hormone phase)

Oestrogen initially drops off with ovulation, then both estrogen and progesterone peak around five days before menstruation. During the luteal phase, muscle glycogen utilisation is reduced and there is a lesser reliance on carbohydrate to fuel training (2). With fats now the main fuel source, endurance ability may be improved, so incorporation of longer and lower intensity activity is ideal. Inclusion of recovery and stretching days will also help adaptation to training.

What does this mean for performance

Whether you’re training, or racing, rating of perceived exertion will be lower during the follicular phase, and performance likely higher. Matching the appropriate training type to suit each menstrual phase will help to perform at your physical best.  

Also watch the Podcast episode 105 with Gwen Jorgensen HERE>>

Sarah Fletcher Accredited Remedial Massage Therapist

Featured in the Top 50 Physical Therapy Blog

Book an appointment with Sarah here

References
  1. Sims. S, (2016) Roar How to match your food and fitness to you female physiology for optimum performance, great health, and a stronglean body for life
  2. Devries. M, Hamadeh. M, Phillips. S, Tarnopolosky. (2006) Menstrual cycle phase and sex influence muscle glycogen utilization and glucose turnover during moderate-intensity endurance exercise (2006

The post Structuring training around the menstrual cycle to perform at your physical best appeared first on POGO Physio Gold Coast.

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High speed running or sprinting carries with it large potential performance benefits, whilst also larger risk of some injuries. Here we discuss why you need it and how to minimise the risk of injury from high speed running.

1. To Reduce The Risk of Injury of High Speed Running

This may sound counter-intuitive, however; you need to do high speed running to protect against the risk of injury associated with high speed running (HSR – 85-95% of max sprinting speed) or sprint running (SR – greater than 95% of Max speed).

High speed running is a common mechanism of soft tissue injury in athletics and running based sports. For example a study of 210 athletes, followed the occurrence of 28 hamstring strain injuries in AFL, of which over three quarters were to the biceps femoris muscle. High-speed running was the primary mechanism of injury (60.7%) followed by kicking (17.9%) and running while bent over to collect the ball (7.1%) (1). With HSR or SR being a common mechanism of hamstring injury, as well as calf and quadriceps strains, how does one reduce the risk of these injuries.  The performance benefits of HSR and SR, as well as the nature of competitive sports means avoiding these activities is not possible. In order to optimally prepare players for the high speed elements of match-play, players require regular exposure to periods of HSR and SR during training environments (2).

GPS-derived data from sports such as elite rugby league demonstrate that greater volumes of HSR resulted in more soft tissue injuries, where-as other studies show that short periods of increased high speed running volume is related to injury (3, 8).  Recent studies have reported a U-shaped relationship between exposure to maximal running speed and subsequent injury risk (4, 5). Whereby those who have higher chronic training loads (of HSR and SR) allow for players to be exposed to increased volumes of running at reduced risk. Data suggests that a 3:21 day acute chronic workload ratio for both high speed and sprint based running has been shown to be related to injury risk in elite football players (5). While there is also an association between running exposure and the risk of hamstring strain injury (HSI) in elite AFL players, with risk greatest when looking at acute loads prior to injury (7–14 days). Players exposed to large and rapid increases in HSR and SR distances were more likely to sustain a lower limb injury than players who were exposed to reduced distances. However, players with higher chronic (long term) training load were able to tolerate greater distances at maximal velocity with reduced injury risk compared to those with lower chronic load.

This indicates there appears to be a level, whereby the consistent exposure to HSR and SR, without rapid increases in the short term, is protective against soft tissue injury. Additionally higher intermittent aerobic fitness allows players to tolerate higher running volumes and changes in running volumes at reduced risk of injury (5).

Another investigation has observed that faster players over 5, 10, and 20m were at reduced risk of subsequent injury. Additionally that an athlete’s ability to do repeat maximal efforts over a short period of time can protect them from subsequent injury risk. In order to optimally prepare players for these maximal velocities and high-speed elements of match-play, players require regular exposure to periods of high-speed running during training environments (7).

Therefore there is reduced risk of injury from HSR or SR by attaining higher levels of aerobic fitness and developing high chronic levels of HSR and SR through gradual exposure.

2. Nothing replicates the loads of high speed running as high speed running.

Want the most demanding muscular and tendon challenge, sprint. It is difficult to mimic both the amount of tensile load and the high rate (or speed) of loading. High-speed running is the most commonly cited mechanism of HSI (6). It has been suggested that this is due the hamstrings reaching peak lengths and levels of force and activation during the terminal swing phase of high-speed running, where they act to decelerate the flexing hip and rapidly extending knee. Additionally, it has been suggested that the forceful eccentric contractions associated with high-speed running may lead to the accumulation of eccentrically induced muscle damage,leaving the hamstrings more susceptible to strain injury (6). Other research has looked at subjects’ maximal isometric contraction force of the knee flexors ranged from 4120 to 8241 N, the knee flexor force during the initial stance phase of sprinting was 40% larger than that produced by the maximal isometric knee flexion. The peak hamstring force across the knee joint ranged from 5777 to 11,554 N, which is at least 8 times the subjects’ average body weight. (8) Clearly, a huge load acts on the hamstrings during sprinting. Below illustrates some of the muscular loads with sprinting in bodyweights (BW).

Not only is the load relative to body weight very high during faster running, the rate of loading is also much higher. This speed in which load is applied can only be mimicked by progressive increases in running speeds. Exercises such as hopping, a maximal hop, or accelerations don’t produce the same rate of loading as HSR or SR.

3. Performance Benefits

It is no secret that numerous sports benefit from players being able to move quicker than their opponent; make a breakaway, get to the ball first, chase down a defender. Meanwhile in running it is largely accepted that the best improvements to running performance involve a combination of a large amount of easy running and a small amount of high speed running. This is often described as the 80/20 rule. See more about the 80/20 running here.

Quick tips for implementing high speed running to your program

  1. Don’t just sprint – begin by running speeds a bit quicker than your 1km time. If a 1km rep isn’t something your familiar with use a 3 of 5km time.
  2. Gradually work on bringing the speeds quicker for 30-60sec intervals
  3. Have a walking recovery between reps
  4. Follow high speed days with a rest day or only easy running
  5. Remember rapid increases in the amount of high speed running or running at significantly faster paces that you are used to carry an injury risk if you don’t build gradually.

Happy Running, Happy Sprinting.

Lewis Craig (APAM)
POGO Physiotherapist
Masters of Physiotherapy

Featured in the Top 50 Physical Therapy Blog

References:
  1. Opar, D. A., Williams, M., Timmins, R., Hickey, J., Duhig, S., & Shield, A. (2014). Eccentric hamstring strength and hamstring injury risk in Australian footballers. Medicine & Science in Sports & Exercise, 46.
  2. Malone, S., Owen, A., Mendes, B., Hughes, B., Collins, K., & Gabbett, T. J. (2018). High-speed running and sprinting as an injury risk factor in soccer: Can well-developed physical qualities reduce the risk?. Journal of science and medicine in sport, 21(3), 257-262.
  3. Gabbett TJ, Ullah S, Finch C. Identifying risk factors for contact injury in professional rugby league players—Application of a frailty model for recurrent injury. J Sci Med Sport 2012;15:496–504.
  4.  Malone S, Roe M, Doran D et al. High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football . J Sci Med Sport 2016 Aug 10th pii: S1440-2440(16)30148-7. doi: 10.1016/j.jsams.2016.08.005.
  5. Malone, S., Roe, M., Doran, D. A., Gabbett, T. J., & Collins, K. (2017). High chronic training loads and exposure to bouts of maximal velocity running reduce injury risk in elite Gaelic football. Journal of science and medicine in sport, 20(3), 250-254.
  6. Ruddy, J. D., Pollard, C. W., Timmins, R. G., Williams, M. D., Shield, A. J., & Opar, D. A. (2018). Running exposure is associated with the risk of hamstring strain injury in elite Australian footballers. Br J Sports Med, 52(14), 919-928.
  7. Malone, S., Hughes, B., Doran, D. A., Collins, K., & Gabbett, T. J. (2019). Can the workload–injury relationship be moderated by improved strength, speed and repeated-sprint qualities?. Journal of science and medicine in sport, 22(1), 29-34.
  8. Sun, Y., Wei, S., Zhong, Y., Fu, W., Li, L., & Liu, Y. (2015). How joint torques affect hamstring injury risk in sprinting swing–stance transition. Medicine and science in sports and exercise, 47(2), 373.
  9. Duhig, S. J., Shield, A. J., Opar, D., Gabbett, T. J., Ferguson, C., & Williams, M. (2018). Infographic. The effect of high-speed running on hamstring strain injury risk. British Journal of Sports Medicine, bjsports–2018–099358. doi:10.1136/bjsports-2018-099358

The post Why You Need High Speed Running appeared first on POGO Physio Gold Coast.

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Like any performance-based activity (whether you are competitive or not), running can have a stressful effect on the body. Which if not varied or combined with the appropriate recovery strategies, can predispose the runner to unwanted injury and pain. Not only that – a runner who learns to recover better, will most likely perform better.

Hatha Yoga and its practices provide a vast toolkit for the avid runner to learn more about their body and how to manage it in the face of daily training stressors. With a combination of postures (asanas), breath control exercises (pranayama), and meditative/concentrative exercises (dharana/dhyana) – the runner (or anyone for that matter) can skilfully learn to modulate their nervous system voluntarily as well as improving muscle strength/endurance and joint range of motion (1,2,3).

The Nervous System can be broken into various subparts – however for the sake of simplicity, the automatic part of our nervous system has two main settings; (as explained more in depth in a previous blog – Yoga Breathing for Reduced Stress, Pain and Improved Performance. Sympathetic (fight/flight) and Parasympathetic (rest/digest), that exist on a spectrum between each other. Recovery/relaxation occur properly when our nervous system is in a more Parasympathetic state; we get more blood flow directed to our gastro-intestinal system for digestion, and our heart and breathing rates lower.

Hatha Yoga practice has been shown to promote a reduction in sympathetic activation, enhancement of cardio-vagal function, and a shift in autonomic nervous system balance from primarily sympathetic to parasympathetic (1). This can be advantageous for the runner looking to optimise their training regime and minimise the negative effects of physical and psychological stressors in their day to day life. Hatha Yoga practice can be an effective way to down-modulate nervous system tension whilst still improving respiratory capacity (Vo2 max), muscle strength and increasing range of motion in tighter joints post run (1,3).

To assist in your recovery post-run, I’ve put together a general yoga sequence below:

Yoga Recovery Sequence for Runners - YouTube

Yoga Nomenclature: “Asāna” simply means posture – the word preceding asāna refers to the type of posture e.g. Trikona-asana – “Triangle Pose”

Practice Requirements:
  • Enough spot for a mat to roll out – in a quiet space if possible
  • Focus on slow deep nasal breathing throughout – ideally an inhale:exhale ratio of 1:2
  • Spend 5 breaths in each posture as a minimum
  • For every 15 minutes of posture practice – minimum of 5 minutes resting lying down at the end
Yoga Recovery Sequence for Runners

1. Modified Uttanasana (forward fold) – Padahastāsana (hand to foot posture) – Trikonasana (triangle pose)

Note: Repeat Trikonanasana on L) side

2. Downward Facing DogRunners Lunge (Psoas/hip flexor focus) – Hamstring stretch

Note: repeat lunge + hamstring stretch on right side

3. Janusirsasana (Head to knee posture) – lumbar extensors, quadratus lumborum, adductors and hamstrings

4. Upavistha Konasana (Wide angled forward fold) – adductors and hamstrings

5. Agnistambhasana (Fire Log Pose) & Gomukhasana (Cow face Pose) – gluteal and deep external rotators

6. Baddha Konasana (Bound Angle / Cobblers Pose) – adductors and medial quadriceps

7. Virasana & Supta Virasana (Heroes Pose + Reclined Heroes Pose) – Quadriceps and Hip flexors

8. Halasana (Plow Pose) – deep posterior line: spinal extensors, hamstrings, calves + anterior deltoid and biceps

Modification: place pillow or large object under feet and a blanket underneath shoulders

9. Viparita Karani – “Relaxed Legs up the wall posture”

Note: This pose means “opposite of action” – try to completely let go of striving thoughts and effort in this pose to get the maximal restorative effect. If your hamstring length prevents you from being close to the wall – simply move away from the wall until a more comfortable position is found

This sequence is designed to apply generally for an average runner, if any pose is uncomfortable or seems inappropriate for you – simply remove it from the sequence.

For personalised yoga prescription/coaching relevant to your goals and needs – contact us at POGO for a one-hour initial session.

Oliver Crossley (APAM)

POGO Physiotherapist

Featured in the Top 50 Physical Therapy Blog

References
  1. Büssing, Arndt, Andreas Michalsen, Sat Bir S. Khalsa, Shirley Telles, and Karen J. Sherman. “Effects of yoga on mental and physical health: a short summary of reviews.” Evidence-Based Complementary and Alternative Medicine2012 (2012)
  2. Pauline, Munoru, and Elijah Gitonga Rintaugu. “Effects of yoga training on bilateral strength and shoulder and hip range of motion.” International Journal of Current Research3, no. 11 (2011): 467-470.
  3. Tran, Mark D., Robert G. Holly, Jake Lashbrook, and Ezra A. Amsterdam. “Effects of Hatha yoga practice on the health‐related aspects of physical fitness.” Preventive cardiology4, no. 4 (2001): 165-170.

The post Yoga Recovery for Runners appeared first on POGO Physio Gold Coast.

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In episode 169 of The Physical Performance Show Brad Beer shares a conversation with Glynis Nunn – OAM, Olympic Heptathlon Champion (1984) in this featured performer episode.

Glynis Nunn has had a long and distinguished sporting career which spans more than 30 years as an Athlete, Coach and Administrator. After, Glynis’s Dual Heptathlon Gold Medals at the 1982 Brisbane Commonwealth Games followed by the 1984 Los Angeles Olympic Games, Glynis was granted the Medal of The Order of Australia. Glynis is a qualified Secondary Physical Education and English Teacher and a Level 5 Track and Field Coach. Glynis has trained Athletes for the World Youth and Junior Games, The Commonwealth Games, World Championships and The Olympic Games. She currently serves as the Director of the Gold Coast Academy of Sport and also as the Executive Director for the Australian Track and Field Coaches Association.

We cover so much during this episode including the development of Junior Athletes, what matters, what doesn’t, mindset, overcoming challenges. We debunk some myths around Junior Strength and Conditioning and Glynis issues her Physical Challenge for the week.

To listen to Episode 169:

Click the icon to listen to the interview on iTunes or listen using the soundcloud player below

169: Glynis Nunn - OAM, Olympic Heptathlon Champion (1984) - SoundCloud
(3848 secs long, 9 plays)Play in SoundCloud

Don’t forget to SUBSCRIBE at the links to ensure you get performance insights from our future upcoming exciting guests.

Listen in as we delve into the following:
  • How Glynis started her career
  • When did Glynis realise her potential
  • Athletes Glynis admires
  • Encouragement and Recognition
  • How Glynis processes potential in junior athletes
  • 1984 Competition Experiences
  • Hardest Time in her career
  • Key Mistakes on Strength and Conditioning for Juniors
  • Best suggestion for school curriculum – Physical Education
  • Best Advice
  • Physical Challenge for the Week
  • How Glynis stays fit
  • Work Glynis is doing as Executive Director at the GC Academy of Sports
  • Greatest thing Glynis learned through sports
  • Top 3 Characteristics for Physical Health and Performance
Show Sponsor Gold Coast Marathon

Like the Physical Performance Show, the Gold Coast Marathon encourages runners of all ages and abilities to push their boundaries and strive to complete a personal challenge.

The Gold Coast Marathon is held annually on the first weekend in July and is a must do event for any budding athlete, weekend warrior or family looking for a challenge to complete together.

Run for the good times at the Gold Coast Marathon. Visit the Gold Coast Marathon here.  

Quotes:

“Enjoy what you do and challenge yourself.” – Best Advice
“Do 10 minutes of run 50 and walk 50.” – Physical Challenge
“It doesn’t necessarily mean you have to be winning when you’re young.”
“As a Coach I make sure that I don’t burn them out.”
“You’ve got to make sure that there is room to grow in their training regime.”
“You make your life choices.”
“It’s really important to learn how to lift correctly.”
“The pillar of strength is from the shoulders to the hips.”
“Every Technique and program is individual.”
“When you start something don’t give up.”

Top 3 Characteristics for Physical Health and Performance
1. Dedication and Commitment
2. Love what you do
3. Own what you do

Key Mistakes on Strength and Conditioning for Juniors
1. Lift heavy too early
2. Someone told them to do strength and conditioning till they are 18.

To follow Glynis Nunn

Instagram: @nunncearns
Facebook: @Glynis Nunn
Website: Gold Coast Academy of Sport
Website: Track and Field Coaches  

1984 Olympic Games Track & Field - Heptathlon 800 Meters - YouTube
1984 Olympics Day 8 Track & Field Womens Heptahlon Gold Medalist Glynis Nunn imasportsphile - YouTube
Timeline:

00:00 Start
01:58 Introduction to Glynis Nunn
03:52 How Glynis started her career
09:17 When did Glynis realise her potential
13:13 Athletes Glynis admires
15:18 Encouragement and Recognition
19:15 How Glynis processes potential in junior athletes
27:21 1984 Competition Experiences
36:00 Hardest Time in her career
42:53 Key Mistakes on Strength and Conditioning for Juniors
49:24 Best suggestion for school curriculum – Physical Education
52:11 Best Advice
53:00 Physical Challenge for the Week
54:25 How Glynis stays fit
56:15 Work Glynis is doing as Executive Director at the GC Academy of Sports
58:35 Greatest thing Glynis learned through sports
59:33 Top 3 Characteristics for Physical Health and Performance
1:00:46 Finish

People Mentioned:

John Gulson – Mentor, Physio Teacher
Ian McQuillan – Coach
Arthur Ashe – Tennis Player
Denise Margaret Robertson – Australian former Olympic Sprinter
Nick Willis – New Zealand Middle Distance Runner
Liz Hudson – Coach
Erica Nixon – Australian Hooker
Jackie Joyner- Kersee – 6 time Olympic Medallist

For questions and comments about this Episode

The post The Physical Performance Show: Glynis Nunn – OAM, Olympic Heptathlon Champion (1984) appeared first on POGO Physio Gold Coast.

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We are shown messages every day informing us that smoking is not good for the health of those who smoke cigarettes. The Australian Institute of Health and Welfare found that approximately 50% of all persistent cigarette smokers are killed by their habit.  25% of these people died during their middle age years (35-69). On average, cigarette smokers die about 10 years younger than non-smokers.

Apart from lung disease, there are a few other reasons why your physiotherapist is keen for you to quit smoking.

1. Smoking may contribute to chronic back pain

It was found that daily smoking of cigarettes can increase the risk of low back pain amongst young adults. It was found that this was dose dependent, meaning the more cigarettes smoked per day, the higher the incidence of low back pain (Alkherayf & Agbi, 2009). It was also found that smoking from an adolescent age (16 years and older) or smoking 9 cigarettes per day, was associated with persistent low back pain (Mikkonen et al 2008).

2. Smoking may reduce your bone mineral density

Smoking cigarettes was associated with higher loss in bone mineral density in menopausal women, compared to those who did not smoke. Women who currently smoke, and those who previously smoked, also showed to have lower bone mineral density compared to those who did not (Kapetanović & Avdić, 2014).

3. Smoking can slow healing

Compared to non-smokers, current smokers have a significantly higher risk of superficial surgical site infection and overall wound complications following lumbar spine surgery (Martin et al, 2016). It was also found that current and former smokers have increased total complication risk following total hip or total knee replacement (Duchman et al 2015).

Current smokers  have twice the risk of experiencing a non-union after fracture, spinal fusion, osteotomy, arthrodesis or treatment of non-union and the healing time for these are longer compared to non-smokers.It was suggested that smokers should be encouraged to abstain from smoking to improve the outcome of these orthopaedic treatments (Pearson et al 2016)

4. Smoking may increase your risk of pelvic organ prolapse

In women who had not yet given birth, it was found that there was a higher prevalence in pelvic organ prolapse in those women who smoked, to those who did not (28% prevalence vs 12% in non-smokers.

Emily Georgopolous (APAM)
Physiotherapist
Masters of Physiotherapy

Featured in the Top 50 Physical Therapy Blog

Click here to book an appointment with Emily or view our Active Rehab Class timetable here.

References

Alkherayf, F., & Agbi, C. (2009). Cigarette smoking and chronic low back pain in the adult population. Clinical and Investigative Medicine. Medecine Clinique Et Experimentale, 32(5), E360-E367.

Amila Kapetanović, & Dijana Avdić. (2014). Influence of cigarette smoking on bone mineral density in postmenopausal women with estrogen deficiency in menstrual history. Journal of Health Sciences, 4(1)

Australian Institute of Health and Welfare. Australia’s Health 2006.Canberra: AIHW, 2006, cat no. AUS 73.

Duchman, K. R., Gao, Y. J., Pugely, A. T., Martin, C. O., Noiseux, N., & Callaghan, J. (2015). The Effect of Smoking on Short-Term Complications Following Total Hip and Knee Arthroplasty. The Journal of Bone and Joint Surgery, 97(13), 1049-1058.

Mikkonen, P., Leino-Arjas, P., Remes, J., Zitting, P., Taimela, S., & Karppinen, J. (2008). Is Smoking a Risk Factor for Low Back Pain in Adolescents?: A Prospective Cohort Study. Spine, 33(5), 527-532.

Martin, C. T., Gao, Y. R., Duchman, K. J., & Pugely, A. (2016). The Impact of Current Smoking and Smoking Cessation on Short-Term Morbidity Risk After Lumbar Spine Surgery. SPINE, 41(7), 577-584.

Pearson, R., Clement, R., Edwards, K., & Scammell, B. (2016). Do smokers have greater risk of delayed and non-union after fracture, osteotomy and arthrodesis? A systematic review with meta-analysis. BMJ Open, 6(11), E010303.

Worcester, S 2005, ‘Smoking May Up Risk of Pelvic Organ Prolapse’, Ob. Gyn. News, vol. 40, no. 23, pp. 23-23.

The post 4 Reasons you should quit smoking – from a physiotherapy point of view appeared first on POGO Physio Gold Coast.

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Human respiration (breathing) is the only physiological system in our bodies that is under both autonomic and voluntary nervous control and thus it is a key tool/limb in the wider practices of Yoga (1).

The Autonomic Nervous System is the automatic part of our nervous system that controls and modulates things out of our conscious control; such as heart rate, blood pressure, digestive system function and more. For the sake of simplicity – the Autonomic Nervous System has two main settings – Sympathetic (fight/flight) and Parasympathetic (rest/digest) that exist on a spectrum between each other.

Things like pain, lifestyle and training stressors bring us into a more sympathetic nervous system state – where our heart rate, blood pressure, and experience of anxiety increase (3). This can often lead to a negative feedback loop of sorts – where more physical and mental stressors beget further sympathetic nervous system ‘activation’.

Something more specific such as acute pain can trigger a stress response in the sympathetic nervous system, which results in increases in muscle tension, heart and respiratory rates, blood pressure, blood glucose levels, and blood coagulation. The adrenal cortex supports this stress response with glucocorticoids that enhance the “fight or flight” response but also suppress the immune system and heighten susceptibility to illness, (3) infection, and other complications. Unrelieved pain heightens the response to subsequent pain episodes; anticipation of it causes the same stress response that actual pain stimulus does. (3)

A key way Pranayama exercises work is through altering autonomic nervous system function – bringing our breath under conscious control, we can learn to voluntarily control and modulate our nervous system (1,2). Breath regulation in Yoga can include modulation of slowing down or pacing the breath, manipulation of nostrils, chanting of humming sounds, retention of breath and more (1). Slow breathing is the first and most important step in Pranayama as it has profound effects on the body;

  • reduced perception of stress (1)
  • decreased oxygen consumption (2)
  • decreased heart rate (2)
  • decreased blood pressure (2)
  • increased parasympathetic activity (2)
  • experience of alertness and reinvigoration (2)

Prolonged pranayama practice has been shown to cause a long-term shift in autonomic nervous system functioning, specifically, with slow breathing pranayama there is a noted increase in parasympathetic activity and a decrease in sympathetic dominance. To start experience the effects listed above, sit down in a comfortable position, preferably with crossed legs and a pillow underneath the buttocks as required. Sitting comfortably tall, hand over your knee and hold your right hand in the position pictured below:

Complete the following steps:

  1. Breathe in through both nostrils completely – at a slow and comfortable pace, and fully exhale
  2. Using a metronome or internal count – breathe in through your left nostril for 3-5 seconds (more if comfortable). Keeping your thumb over your right nostril
  3. At the end of the inhalation – comfortably hold your breath for 3-5 seconds (more if comfortable. Be sure not to push into any strain or tension – as this is counterproductive to the exercise
  4. Release your thumb and press the 4th and 5th fingers onto your left nostril – exhaling through your right for 5-10 seconds (ideally TWICE AS long as the length of your inhale)
  5. Repeat this cycle from steps 1-4, five to ten times

REMEMBER: don’t strain whilst practising the above pranayama technique – keep a relaxed and gentle attitude throughout. Get Started with this technique after your training session – or at the end of your day.

For more information of individualised yoga practice/therapy for your concerns – contact us at POGO for a booking.  

Oliver Crossley (APAM) POGO Physiotherapist

Featured in the Top 50 Physical Therapy Blog

References
  1. Saoji, Apar Avinash, B. R. Raghavendra, and N. K. Manjunath. “Effects of yogic breath regulation: a narrative review of scientific evidence.” Journal of Ayurveda and integrative medicine(2018).
  2. Jerath, Ravinder, John W. Edry, Vernon A. Barnes, and Vandna Jerath. “Physiology of long pranayamic breathing: neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system.” Medical hypotheses67, no. 3 (2006): 566-571.
  3. Schaffer, Susan D., and Carolyn B. Yucha. “Relaxation & Pain Management: The relaxation response can play a role in managing chronic and acute pain.” AJN The American Journal of Nursing104, no. 8 (2004): 75-82.

 

The post Yoga Breathing for Reduced Stress, Pain and Improved Performance appeared first on POGO Physio Gold Coast.

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In episode 168 of The Physical Performance Show Brad Beer shares a conversation with JKim Keedle – Formula 1 Racing Haas in this Interest Edition.

Kim Keedle is a Physiotherapist who graduated with a Bachelor of Physiotherapy from Melbourne University in 2012. Years later after working within an elite sport in the UK, Kim has offered a coveted position with the newly founded Haas Formula 1 Racing Team. From there Kim took up a position to be the Physiotherapist for Romain Grosjean, Haas F1 Team Driver and has now been on the F1 Racing Circuit for several years.

During this episode we uncover what the drivers do to remain healthy, the loads the drivers endure and the training required to keep the drivers at their physical best, along with so much more.

To listen to Episode 168:

Click the icon to listen to the interview on iTunes or listen using the soundcloud player below

168: Kim Keedle - Formula 1 Racing Haas (Interest Edition) - SoundCloud
(3729 secs long, 6 plays)Play in SoundCloud

Don’t forget to SUBSCRIBE at the links to ensure you get performance insights from our future upcoming exciting guests.

Listen in as we delve into the following:
  • Formula1 Racing Episode on Netflix “Drive to Survive”
  • Differences in drivers and audience upon
  • How Kim Keedle started in his career
  • Development in Formula1
  • Improvement to pit stops
  • Pit stop Injuries
  • Goals during the pre-season
  • Strength Training and Testing
  • How the staffs/drivers process their work
  • What the typical day looks like in preparation for the 21 day race
  • Priming Session Training
  • Being Part of the Medical Team
  • Emotional Highs and Lows during the race
  • What happens during a race crash
  • Understanding G-Force
  • Breaking forces in the legs
  • Demands of the drivers
  • Resilience of the Formula1 Athletes
  • Requirements for Formula1 Drivers
  • Where does Kim’s inspiration come from professionally
  • Characters for F1 Driving
  • Percentage given to drivers physically and psychologically
Show Sponsor Gold Coast Marathon

Like the Physical Performance Show, the Gold Coast Marathon encourages runners of all ages and abilities to push their boundaries and strive to complete a personal challenge.

The Gold Coast Marathon is held annually on the first weekend in July and is a must do event for any budding athlete, weekend warrior or family looking for a challenge to complete together.

Run for the good times at the Gold Coast Marathon. Visit the Gold Coast Marathon here.

Quotes:

“Achieving Calmness and Confidence.” – Being in the Zone
“Make sure to have a good pre-sleep routine.” – Best Advice
“Incorporate Squats in your training session.” – Physical Challenge
“It’s really important to have consistent performances, 3 seconds or less within a pit stop.”
“General Rule is 60% Psychology and 40% Physical.”
“You still need to be a good athlete to try to use Formula1 Cars.”
“Characteristics needed for F1 driving”

  • Very good Trunk and Neck Strength
  • Reasonable level of Cardiovascular Fitness
  • Relatively lean
To follow Kim Keedle

Instagram: @kimkeedle
Twitter: @KimKeedle
Email: kkeedle@gmail.com
Drive to Survive Series on Netflix

Timeline:

00:00 Start
02:15 Introduction to Kim Keedle
04:00 Formula1 Racing Episode on Netflix “Drive to Survive”
04:41 Differences in drivers and audience upon
07:30 How Kim Keedle started in his career
09:50 Development in Formula1
10:59 Improvement on pit stops
12:37 Pit stop Injuries 14:08 Goals during the pre-season
15:50 Strength Training and Testing
18:45 How the staff/drivers processing their works
21:30 What the typical day look like in preparation for the 21 days race
24:15 Priming Session Training
24:52 Part of the Medical Team
28:10 Emotional Highs and Lows during the race
29:55 What happens during race crash
33:38 Understanding G-Force
35:13 Breaking forces in the legs
38:00 Demands of the drivers
41:38 Resilience of the Formula1 Athletes
44:03 Requirements for Formula1 Drivers 
46:06 Where does Kim’s inspiration come from professionally
47:07 Characters for F1 Driving
49:30 Performance Round
53:40 Percentage given to drivers physically and psychologically
54:46 Best Advice
55:40 Physical Challenge for the week
58:50 Finish

People Mentioned:

Romain Grosjean – Haas Formula 1 Driver
Daniel Sims – Coach
Mark Weber –Australian Racing Driver
Jason Barton – Triathlete
Tim Slade – V8 Race Car Driver Team BOC & Freightliner Racing, Episode 4 of The Physical Performance Show For questions and comments about this Episode

The post The Physical Performance Show: Kim Keedle – Formula 1 Racing Haas appeared first on POGO Physio Gold Coast.

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