Keeping that New Year commitment

Keeping that New Year commitment

Keeping that New Year commitment to looking after yourself

The most beneficial thing you can do for yourself is engage in a daily movement routine. I say movement, because sometimes ‘exercise routine’ can conjure up thoughts of needing to ‘smash’ oneself by engaging in some sort of gruelling, physical activity where no pain, no gain is the mantra. This does have a place, but most people don’t need to do that to become mobile, happy and healthy.

The Comeback

Typically, if you are on ‘the comeback,’ or even starting from a pretty good base and looking to maintain, I always advised a regular mechanical check over to make sure all the moving parts are moving to their optimal. We look out for restricted areas that need to be released to allow you to return to activity and assess the functional capacity of the tissue to screen for injury risk and ultimately to prevent from injury in the first place.

If you have not regularly exercised in a while and you are starting back, remember slow and steady – build up! You have as much time as you need. There is no point going hard in January only to have to rest up in February and March….then struggle to get the motivation to start up again in April, which gets put off until May!

Along with appropriately warming up, cooling down, stretching and rolling, you can reduce your risk of injury, improve your recovery and performance by regularly attending a yoga class that is right for you and getting some regular massage treatment, especially in the early days…just like the professionals do.

Exercise

Exercise that focuses on awareness and control of your movement, such as Clinical Pilates, is a necessary part of your regime along with adequate recovery and preparation. Clinical Pilates is one of the best movement regimes to help you understand and become aware of how you move, to re-learn movement that may be ‘out of sync’ and need improving and to strengthen your muscles and joints at angles just not achievable with ‘regular’ training.

It is important to move beyond ‘re-training’ and to work with someone like an Exercise Physiologist, to take what you have learnt about your movement through pilates and apply it to movement tasks of everyday living. It is important to start to replicate usual movement and challenge with load so that you become stronger to perform your ‘tasks of daily living’ – It’s like training for a sport. You break the game or activity into ‘drills’ and practice until your capacity to perform them improves and feels natural…….most people, with recurring or chronic pain, simply need to do something like this, but really, to do this properly, you need help and coaching from a group of experts. Preferably experts who work closely with each other and know who is the best person to be working with at any given time.

Finally through out, it is important to maintain nutrition. A great place to start is with hydration and electrolytes, where Water and Magnesium are the main ‘go to’s’. These will help to keep your energy up, reduce training soreness and maintain your muscle health and suppleness. A great deal of injury prevention and recovery can be achieved with diet and strategic supplementation.

Dr Giulian Di Venuto is principal Osteopath and Director of MOVE Osteopathy and is available for Osteopathic consultations at both Brisbane City and New Farm Clinic. Move Osteopathy also offers, Remedial Massage, Myotherapy and consultations with our Exercise Physiologists, personalised exercise programs in our own rehabilitations gyms and clinical pilates.

Play AFL? Perform at your best – Part 2

Play AFL? Perform at your best – Part 2

Photo credit official instagram of the AFL. @afl

Injuries in the game of AFL are increasingly common year after year, and can be the difference between a win and a loss. Last week I wrote about one of the most common injuries hamstrings and in particular overstretched hamstrings. (read it here) This week i’ll explain to you a popular exercise that aims to tackle and reduce this common injury.

THE SUPPLE ‘POSTERIOR CHAIN’

The ‘posterior chain’ is comprised of some of the powerhouse muscles which are critical to movement; Lower back muscles, glutes, hamstrings and calves. Whether it be at the start of the season or coming into finals time, you want strong, supple hamstrings and calves that won’t let you down. As mentioned in our previous post, eccentric exercises are the gold standard in order to achieve this. Why are they gold standard? Whether you’re watching AFL on TV or standing at the other end of the ground because the ball is in the opposing 50m, hamstring strains occur when players are running and/or getting ready to jump. Slow motion studies conducted by Schache (et. al. 2010) showed that when running, during the late-swing phase, the hamstrings are acting eccentrically to slow the lower leg. This is proven to be the point where most hamstring strains occur, hence the reasoning why eccentrically strengthening out hamstrings is beneficial to preventing hamstring strains. A brief overview of the physiology of eccentric exercises was covered in our previous post. Well, how do I ‘eccentrically strengthen’ my hamstrings then? The Nordic Hamstring Exercise (NHE) is the most popular exercise, as well as best researched. You may have seen a video or two of this being done by athletes, as it’s a good measure of overall hamstring strength. What the high quality studies have shown is that by performing the NHE, you can achieve an 11% increase in eccentric hamstring strength, a 65% reduction in hamstring strains, as well as an 85% lower rate of recurrent hamstring strains compared to a control group following their usual training program. 1 2 3 This link will take you to a few variations of the Nordic Hamstring Exercise:

Is that it? Do this and I won’t have to worry about my hamstrings again?

Long answer short, not exactly. The Nordic Hamstring Exercise will target both hamstrings, whereas one leg may need it more than the other. Kicking off your preferred leg constantly uses a group of muscles on one side of the lower extremity, there as the non-preferred leg doesn’t get the same attention. This can vary the flexibility and strength of either hamstring muscle group. If you are really dominant on one side, whilst doing the NHE, the dominant muscle may be doing the bulk of the work, as it is able to compensate for the opposing hamstring. An Osteopath is able to assess your hamstrings and any compensatory strains/patterns going on in your body, in order for you to get the most out of exercise you do. What about calves? Your calves are another important muscle making up your ‘posterior chain’. The calf muscle responds really well to eccentric exercise like the hamstring does. One of the best ways to eccentrically strengthen your calves involves standing on your tiptoes and letting your heel drop down below the forefoot. This is the eccentric part. After lowering your foot past the step, take the weight off the ankle with the opposing foot and continue doing the lengthening of the calf. This is great as it can give you a larger range of motion in the ankle. Dr Chris Fielder – Osteopath (B. Clin. Sc, M. Osteo) Chris is an Osteopath practicing at MOVE Osteopathy in Brisbane CBD. He has an interest in all things AFL and loves to help people playing AFL at all levels to perform better and enjoy their sport. If you love playing your footy have an injury or want to avoid injury and perform better make an appointment to see Chris ph: 3229 3661 and stay tuned for more great posts from Chris on this topic.

References: 1.Mjølsnes R, Arnason A, Østhagen T, et al. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports 2004;14(5):311-317. 2.Arnason A, Andersen TE, Holme I, et al. Prevention of hamstring strains in elite soccer: an intervention study. Scand J Med Sci Sports 2008;18(1):40-48. 3.Petersen J, Thorborg K, Nielsen MB, et al. Preventive effect of eccentric training on acute hamstring injuries in men’s soccer: a cluster-randomized controlled trial. Am J Sports Med 2011;39(11):2296-2303.

Play AFL? Reduce your injuries!

Play AFL? Reduce your injuries!

Injuries in the game of AFL are increasingly common year after year, and can be the difference between a win and a loss. The best 22 players you can field will increase your chance of winning, wouldn’t it?
The best way to decrease the chances of sustaining an injury whether it be during pre-season, training or on game day, is to work on your body so it is ready for the tasks necessary to play at peak performance.
The game of AFL requires players to have a high level of aerobic endurance, the ability to be able to kick and handball with both sides of the body, and the ‘football brain’ in order to read the play. Whilst these are staples of the AFL player, the underlying flexibility, agility and core strength is what can elevate a player to the next level and equally important, reduce injuries!
The most common injuries sustained by AFL players according to the latest AFL Injury Survey are hamstring and calf strains, as well as knee and ankle injuries. These areas also coincide with the most missed games per club through injury.
A common myth around the sporting arena is that building muscle inhibits flexibility, and vice versa where being flexible requires less strength. This could not be further from the truth.
The most common strain to the football athlete occurs at the hamstring muscle/s. The strain occurs when the muscle in question has been overstretched and fibres of the muscle/tendon have torn. This tear can be classified as Grade 1, 2 or 3.
So this begs the question;
What causes a muscle to be overstretched?
A muscle simply overstretches when the force required by the muscle is greater than the force the muscle is able to supply.
“Hamstring injury prevention and rehabilitation programs should preferentially target strengthening exercises that involve eccentric contractions performed with high loads at longer musculotendon lengths” (Schache et. al, 2012).
What does this mean?
The calf and hamstring muscles are at risk of being overstretched when they have a lack of eccentric strength. A lack of eccentric strength alongside ‘stiffness’ and irregular intermuscular coordination cause a strain to occur.
OK, why is this the case and how do I get calf and hamstring eccentric strength?
Eccentric exercises have been shown to add sarcomeres (basic unit of striated muscle tissue) and increase muscle strength at longer lengths. These adaptations act to protect a muscle against injury by reducing the damage caused by repeated eccentric contractions. Studies 1 have compared the effects of eccentric versus concentric hamstring strengthening exercises and showed that increases in strength at longer muscle lengths occur only after bouts of eccentric exercises. Therefore, training the hamstrings eccentrically may give them the ability to resist the high forces experienced during high-speed running and jumping in AFL and to avoid disruption of the muscle fibers.
It is important to note, a player is at higher risk of up to 30% of a calf or hamstring strain if they have had one previously.
You can train your body to be its best by being specific about what you need. AFL players a strong core, an evenness around muscle groups, a good level of flexibility, and a high level of aerobic endurance in order to give them the best chance at being and more importantly staying, injury free.
Stay tuned for the next post regarding specifics into how you are able to achieve this!

Dr Chris Fielder – Osteopath (B. Clin. Sc, M. Osteo)
Chris is an Osteopath practicing at MOVE Osteopathy in Brisbane CBD. He has an interest in all things AFL and loves to help people playing AFL at all levels to perform better and enjoy their sport. If you love playing your footy have an injury or want to avoid injury and perform better make an appointment to see Chris ph: 3229 3661 and stay tuned for more great posts from Chris on this topic.
References:

  1. Kilgallon M, Donnelly AE, Shafat A. Progressive resistance training temporarily alters hamstring torque-angle relationship. Scand J Med Sci Sports 2007;17(1):18-24.
  2. Mjølsnes R, Arnason A, Østhagen T, et al. A 10-week randomized trial comparing eccentric vs. concentric hamstring strength training in well-trained soccer players. Scand J Med Sci Sports 2004;14(5):311-317.
  3. Schache AG, Dorn TW, Blanch PD, et al. Mechanics of the human hamstring muscles during sprinting. Med Sci Sports Exerc 2012;44(4):647-658.
Ski trip this year? Prepare & avoid a ski injury with the following ………

Ski trip this year? Prepare & avoid a ski injury with the following ………

Preparation before you hit the slopes
No matter if you plan to ski or ride from first to last lift or just do a couple of runs between Apres ski sessions in a cosy bar it’s worth doing some preparation before you go to enjoy your holiday.
Obviously you need strength and flexibility and an Osteopathic assessment and treatment before you go on your holiday will ensure that you have your best possible bio mechanical alignment before you go on your holiday. We can help improve your flexibility and show you exactly what you exactly what stretches and exercises you will benefit most from
Whether you are a complete beginners or expert black run skier or snowboarder you will need some leg strength. Anyone who has ever done the ski lesson will be familiar with being told (at least 100 times in a lesson) “bend the knees”. Both skiing and snowboarding require you to keep your knees bent (flexed) so that you are able to use your body weight and move it over the edge of your skis or snowboard. If you don’t have some strength and endurance in your quads (the muscle in the front of your thigh!) you will certainly be feeling the burn pretty quickly which might mean you may not get so much use out of that 5 day lift pass! Try the following simple exercises to help prepare the legs

  • Simple quats and lunges using your body weight
  • If you go to the gym and have a bit of existing leg strength try squats in the “smith machine” with weight or a walking lunge with holding some weight in your hands
  • If you have not much existing strength and are not a gym junkie you could also try running up flights of stairs.
  • Look for the stairs everywhere you go start walking up them 2 steps at a time! (you could even put in a lunge or two on the steps while no one’s looking 🙂
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as well as leg strength, make sure you have good flexibility – you will definitely benefit from stretches to your Glutes, quads, hamstrings and calves
If you already know how to ski or snowboard well, you will already know it’s all about shifting your body weight over your edges Osteopathic treatment can help you achieve the best possible range of motion and freedom of movement to ski at your best. Giulian Di Venuto has treated many skiers that ski at an elite level and says the following

“Mechanical restriction in certain parts of the spine, pelvis and lower limb limits the technique and performance of the skier. I have found that when treating elite skiers there are some predictable areas of the body that if treated will correct difficulties within their style or technique and leads to improved confidence, performance and reduces the risk of injury” Dr Giulian Di Venuto – Osteopath

To help maintain great technique, strength and not burn your legs out you will also need to engage good abdominal and core strength. Brush up by doing the following.

  • traditional crunches and sit-up will help the abdominal strength
  • The squats and lunges also help to engage the core
  • Traditional Pilates and Swiss ball exercises that engage the core abdominal muscles

Avoiding Injury
Ski injuries are common and let’s face it you can pretty much hurt any and every area of you body if you have a spectacular stack or tumble. Bruises, cuts sprains, strains and of course fractures. You can strain muscles you didn’t even know you had! Knees are the most commonly strained when legs and skis don’t co-operate! Take a few of these simple tips

  • Take lessons, learn and progress
  • Take note of and follow the ski slope rules
  • Warm up with some simple stretches (especially hamstrings, quads, calves and glutes)
  • Use good equipment – and properly fitted boots. Poorly fitting boots can give you some VERY sore feet and boots that are too big can cause you to fall
  • Stay with-in your limits and in control on slopes that you know you can handle
  • If you focus on it ….. you are likely to run into it – so keep looking to the open space where you want to go …. and not trees or ski schools!
  • Keep your knees bent and lean your weight down the slope
  • If you start to fall try not to fall on an outstretched hand – it commonly causes serious strains and fractures
  • If you fall to the side – falling onto ski stocks hurts too ….and will give you some pretty impressive leg bruises
  • If you do fall get your skis etc untwisted and organised before you try to get back up
  • Ski stock straps around your thumbs can cause serious strains if you fall – fit them correctly over your wrists
  • Remember trees are hard and hurt if you hit them! and the best safety advice I can give you on the snow wear a helmet!
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What to do if you do injury yourself.
If you have fallen and it feels serious don’t try to ski off the mountain – get help from the ski patrol to avoid making your injury worse.
Get someone to check it out  – but not your mate unless they happen to be a Doctor, radiologist, Osteopath or Physio. There is always a well equipped sports medicine clinic at the mountain with professionals that are used to seeing and assessing ski injuries, snowboarding injuries and the like.
If it’s just a mild joint strain when you get back to your hotel get some ice (crushed in a plastic bag – wrapped in a wet towel) on your injury if there is any swelling it needs some elevation and light compression. Do not apply heat it will make it worse!  Your ski injury really should be rested or you run the risk of making it 10 times worse, but if you get the all clear to keep skiing you may want to consider supporting or bracing the joint. Bruises will also benefit from the same ice treatment.
Don’t hit the Apres Ski bar to tell your spectacular fall story unless you plan on only drinking hot chocolate – Alcohol will sadly only make the swelling and injury worse.
Save Hot tubs, spas and saunas for simply overworked sore muscles at the end of the trip, the heat will only increase any swelling you might have sustained.
Make an appointment to see us when you get home – falling down on the snow a few times even if you don’t sustain a major sports injury will usually “jam” things up and should be ‘freed up” before it becomes the catalyst for some other set of problems!
If you didn’t actually fall and hurt yourself but you wake up the next morning feeling like you have been hit by a truck – better do some pre-ski stretching, plan a day with lots of breaks (maybe at the closest day spa) and start planning next years pre-ski trip fitness regime 🙂
Dr Kellie Rawlings – Osteopath (B.Sc. M.H.Sc)
Principal Osteopath & Co-Director – MOVE Osteopathy