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5 Reasons why working out on machines may put you at greater risk of injury and what to do instead

5 Reasons why working out on machines may put you at greater risk of injury and what to do instead

med x lumbar pic

 

By Michael Hall

Today, we have more technology, more health devices and exercise equipment than ever before. In particular, computerised strength training machines now promise you everything from protecting you against injury, to being the best type of strength training that there is!1 But do the claims really stack up in the light of the current health research. Read on to find out.

First a bit of background. This article refers to computerised and non-computerised strength training machines that control and direct movement and not to strength training equipment that uses cables, springs and slings.  This is important because your physical health is dependent on your core stability. Essentially this is the ability of your brain and body to utilize your muscular strength, endurance and control to maintain healthy working relationships of all your muscles and joints in all movements and under all conditions.2 And unlike what most health articles and marketing would have you believe, core stability does not just refer to the stomach region, but the stability of all your joints close to your trunk especially your neck, back, shoulder and shoulder girdle as well as your hips, pelvis, and upper leg.3

Global Vs Local Muscles

Over the last 30 years, advances in our understanding of the concept of core stability has led to a revolution in the rehabilitation and prevention of injury. The breakthrough came when it was recognised that muscles are differentiated in their makeup and function between global muscles and local muscles.4

Global muscles (called prime mover muscles) are larger longer muscles that attach further away from your joints. They are dynamic, phasic muscles in that they switch on and switch off and provide power and strength to movement.

Local muscles (called stabiliser muscles) are small muscles that attach very close to where your joints contact each other. These local stabiliser muscles are often called tonic or postural muscles because they are always switched on providing a low level (5% maximum voluntary contraction5), constant, directional tension to hold joints in ideal alignment.

Feed-forward Control - The Key to Injury Prevention

Even more amazing, it was discovered that these muscles actually contract before you move to counter-balance the pull of your large, global muscles. There is a feedforward or preceding command to the small muscles around your joints to “stiffen” your skeleton in preparation for movement.

Most movements within our bodies operate on this feedforward system.6 It seems that your brain and nervous system estimates the forces that are going to be applied to your body during the movement and prepares your muscles and joints in advance.

Joint stabilisation and body control should be sub-conscious and automatic. If it doesn’t occur before movement, excessive or abnormal forces will result and you will be more at risk of injury.6 And this is exactly what happens following injury or with restrictive, regimented and inadequate every day movements and training. The automatic, sub-conscious control becomes impaired and you begin to lack the background stabilisation of your body that protects you from injury.

5 Reasons why strength training on machines does not protect you from injury

  1. Machines primarily work your global, prime mover muscles. Whilst strengthening these muscles might improve the strength, tone and look of your outer muscles, they have relatively little effect on your local, stabiliser muscles, leaving you vulnerable to injury insufficient stabilisation. Computerised machines do not train your reflexes or stabiliser systems that protect you from unguarded, reflexive movements. Although you will feel stronger, you will still be at risk from quick, movements that you do without thinking because the background control has not been trained.
  2. Machines do not allow for functional movement, which is the type of movement that you do in everyday activities. Because machines dictate specific directions of movement, they do not allow your body segments to work together in a normal, functional way. Consequently, they don’t prepare you for and protect you from everyday life activities.
  3. Because machines are exercise isolated muscles in precise, predetermined directions, they are more likely to lead to muscle imbalances, incorrect postures and movement patterns, excessive or abnormal stresses and eventually to pain and injury.
  4. Whilst machines might train your muscles, they do not train your brain. In other words, they don’t train your nervous system’s anticipatory and sub-conscious control of your body. To improve your sub-conscious control, you must do sub-conscious training. Like many systems of your body, it is a “use it or lose it phenomenon”. Practicing and refining your balance reactions in every day functional activities will refine the feedforward control of the nervous system. Neglecting reflexive activities will cause your reactions to be inadequate and delayed, leading to worsening performance and the increased possibility of injury.
  5. Training on machines doesn’t provide the movement variety that is required in every day functional movements. You see, your body and your brain are very efficient at adapting to movement. This means that your body will get very good at doing machine based training, but this won’t transfer across to everyday activities.

Is lack of strength really the cause of your injury?

Most patients have attended Bodywise Health over the past year NOT because of some trauma but because of some insignificant, quick, unguarded movement that that have done without thinking. Statements such as “I just bent over to pick up a pen” or “I just reached forward to open the window” are all too familiar when people give their accounts as to how they sustained their injuries. In almost all cases, strength or the lack of it does not appear to be a factor as to the cause of their injury. It does not seem to be a strength issue, but rather a timing and control issue.  It is people’s lack of sub-conscious movement control that appears to be the common factor leading to the onset of their injuries.

Core Stability Vs Core Strength

Training on machines does not address these deficiencies, but rather compounds the problem because it reinforces global muscle strength at the expense of local stabiliser muscle control. In other words, whilst your power, dynamic movement muscles get stronger, the base upon which they work get weaker, leaving you vulnerable to quick movements and activities that you do without thinking.

Whilst health clubs, personal trainers and machine based rehabilitation centres often promote core strength as being paramount for optimal physical health, please understand that it is actually your core stability which is more important in protecting you from injury. Whilst core strength is a component of core stability, the more crucial components of core stability are the endurance of your muscles and your nervous system control.7

The term “core instability” implies lack of core control. Therefore, to improve your core stability you need to learn to stabilise better and the best way to learn to stabilise better is by “training” on progressively more “unstable” surfaces and then with increasingly more dynamic functional movements.

Some ideal unstable surfaces for training include swiss and bosu balls, pilates reformers, duradiscs, rockerboards, pools and even standing on one foot. The more unstable you are, the more you have to stabilise and the more you will train your brain and nervous system’s ability to protect you from injury.

What are you training for?

Training is highly specific. This means that the training effects gained in one activity do not transfer well over to other activities. Therefore, if you want to look good, want to perform well on machines and are not concerned with avoiding or preventing injury, then by all means “work out” on resistance machines.

However, if your main goals are to perform optimally and prevent injury in sporting or every day functional activities, then you must “train” your brain and body in these activities. Your brain and body only know movements, not muscles. Correct and improve the control of your movements and you will not just look better but you will stay better, perform better and live better as well.

Wishing you the best of health,

Michael Hall
Director
Bodywise Health

For more information on how Bodywise Health can help you to improve your core stability, please call Bodywise Health on 1 300 BODYWISE (263 994). 

References

  1. www.keiser-training.com.au/quality/keiser-training/works
  2. Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation and enhancement. J Spinal Disord 1992;5(5):383-9.
  3. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain. Spine, 1996;21(22):2640-50.
  4. Richardson CA, Hodges PW, Hides JA. Therapeutic exercise for spinal segmental stabilization in low back pain – scientific basis and clinical approach. 2nd Edn. Edinburgh: Churchill Livingstone, 2004.
  5. Bergmark A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orth Scand, 1989;230(Supp):20-4.
  6. Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes, 2002
  7. Chek P. Primal Pattern Movements. A Neurodevelopmental Approach to Conditioning. Correspondence Course 2003.
  8. Grakovestky, S. The Spinal Engine. New York: Springer-Verlag Wien, 1988.

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Why stretching can worsen an injury and what to do instead

670px-Stretch-for-a-Scorpion-in-Cheerleading-Step-1Stretching, it’s been a cornerstone treatment and training technique for decades. So ingrained and accepted has stretching been that for a long time its benefits pretty much went unquestioned. That was until a couple of years ago, when a 20 year review of the research revealed that pre-exercise stretching was ineffective at preventing or reducing the prevalence of exercise induced injuries. 

Given this, it is reasonable to question stretching’s effectiveness with injury treatment. You see, stretching has been promoted has having many benefits1 including:

  1. Increasing muscle and joint flexibility
  2. Increasing muscle relaxation
  3. Decreasing muscle soreness
  4. Improving circulation
  5. Preventing excessive adhesions
  6. Promoting a flexible and strong scar

Despite this, many of these benefits have not been fully investigated and / or proven.2

If you think about it, almost all physical injuries are due to some sort of breaking down of tissue. For example, a strain is a tear of muscle tissue and a sprain is a tear of the ligaments and / or capsule tissue that holds joints together.

Research has indicated that after about 5 days following an injury, a scaffolding or frame work of tissue is laid down randomly as a bridge over the damaged tissue.3 Initially, these fibres are fragile and easily broken if too much tension or stress is applied.

As the laying down of fibres tends to peak at about 3 weeks, these fibres become progressively more durable and mature. This means that applying tension to the healing tissue becomes progressively more important to align the fibres along the lines of force and ensure a strong and functional repair.4

Stretching, if applied before this phase of healing, may have a number of detrimental effects. These include:

  1. Re-injuring the healing tissue (overstretch strain) by tearing the new, fragile tissue repair;5
  2. Weakening tissue (overstretch weakness), making it more susceptible to re-injury;5
  3. Delaying healing by reducing blood flow;6
  4. Degrading the quality of tissue repair by impeding the nerve supply into the new tissue.7

In our experience at Bodywise Health, people will often state that they “feel” better for a short time following stretching. However, on closer questioning and analysis, it is often evident that over the longer term, the improvement in their condition has stalled.

What to do instead
Immediately following a soft tissue injury, ice and immobilisation should applied for the first few days following injury.9 Immobilisation enables a tissue framework to form across the injured tissue, knitting the damaged ends together and increasing the strength of the healing tissue so it can withstand greater muscle pulling (tension).9,11

After the first few days following injury, early active protected (using taping or bracing) movement into directions which are pain free and which don’t stress the injured tissue has been shown to have numerous benefits including improving circulation, preventing joint stiffness, reducing swelling, accelerating healing and stimulating a better, stronger tissue repair. 5,8,10

However, care must be taken when moving an injured tissue. Probably the number one cause why people don’t get better from injury or don’t get better as quickly as they should, is because they re-injure the damaged tissue. In the early stages, any movement must therefore be pain free and feel almost “too easy”. Progression in movement must only take place, after it has been established how much movement is safe for the injured tissue.

At about the 2 week mark, contracting the overlying stabilising muscles in the position of maximum comfort and below the threshold of pain has the benefit of aligning fibres and producing a stronger, healthier scar.11

It also prevents muscle wasting and begins conditioning the tissue repair to stress or force in a safe and measured way, thereby helping to protect it against re-injury.

As long as the injured tissue remains pain free, this strengthening program may be progressed first in the number a contractions applied and then with increasing movement, before increasing the loading force.

The specific exercise techniques and protocols that work best are beyond the scope of this article because they differ for different injuries and circumstances.

At Bodywise Health, we have found however that stretching as a treatment technique has most value if applied later in the treatment program, after the healing tissue is more resilient to force. At this point stretching can be important for remodelling the scar tissue into a flexible, strong repair as well as for restoring full bodily movement and function.

I hope that this helps.

Best Wishes,

Michael Hall
Director
Bodywise Health

For more information or for a FREE injury assessment and 2nd opinion, please call 1 300 BODYWISE (263 994)

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If you want to recover faster from injury, STOP using...

Suction Cups-mobile 01

By Michael Hall

… ice, at least AFTER the inflammatory phase has settled down. The same goes for immobilisation and anti-inflammatories. Why? Because ice (cold) slows down the healing rate1, prolonged immobilisation causes joint degeneration and muscle wasting2 and anti-inflammatories have been shown to “delay healing in acute ligament, muscle and tendon injuries”. 3,4,5,6,7,8


As mentioned in my last blog on “What to do if you get injured”, immediately following injury a short period of Protection, Rest, Ice, Compression, Elevation, Referral (PRICER) IS the most effective means of reducing the complications of the bleeding and inflammatory phases of healing, namely those of excessive swelling, excessive tissue breakdown by the immune system and the release of free radicals as part of this process.


However, for soft tissue injuries, using ice and immobilisation should be limited to the first few days following injury.9 Immobilisation enables a tissue framework to form across the injured tissue, knitting the damaged ends together and increasing the strength of the healing tissue so it can withstand greater muscle pulling (tension).9,11


Complete immobilisation is mostly needed for acute broken bones (fractures). For muscle and other soft tissue injuries, early active protected (using taping or bracing) movement into directions which are pain free and which don’t stress the injured tissue has numerous benefits including improving circulation, preventing joint stiffness, reducing swelling, accelerating healing and stimulating a better, stronger tissue repair. 5,8,10


However, care must be taken when moving an injured tissue. Probably the number one cause why people don’t get better from injury or don’t get better as quickly as they should, is because they re-injure the damaged tissue. In the early stages, any movement must therefore be pain free and feel almost too easy. Progression in movement must only take place, after it has been established how much movement is safe for the injured tissue.


As with early protected movement, applying heat (packs, etc.) for 15 minutes hourly (once the acute inflammatory process has settled) is one of the best ways to increase cellular activity and accelerate tissue repair. Heat brings oxygen and nutrient laden blood to an area, thereby optimising nutrient and waste product exchange. Heat also accelerates cellular activity, increasing the rate at which new tissue is laid down.11


Heat can be both superficial (heat packs, ray lamps etc.) or deep (ultrasound, short wave therapy etc.) with generally, deeper heat applications being more beneficial with deeper tissue injuries. As with any application of heat, care must be taken to check your skin every 5 minutes to avoid burns.


One of the biggest barriers to healing is excessive swelling which can cause oxygen starvation (hypoxia) to the injured tissue. It follows therefore that reducing swelling and optimising circulation will accelerate tissue healing and repair.


There a number of ways of reducing swelling and improving circulation.
1. Not aggravating the injured tissue;
2. Keeping the body part elevated above heart level will promote fluid drainage;
3. Moving the body part within pain limits enhances the effect of elevation as the contraction of muscles promotes fluid movement;
4. Compression garments with pressures ranging from 30 mm Hg to 60 mm Hg;
5. Lymphodema massage, a gentle stroking massage that moves fluid back towards the heart;
6. Bodyflow, a muscle stimulating technology that has been proven to accelerate healing and speed recovery from injury and intense exercise, by reducing swelling and enhancing circulation. It has been used by the English Olympic team as well as many AFL clubs to promote a faster recovery and enable earlier preparation for the next event.

The beauty of Bodyflow is that it is portable, meaning that you are able to apply it to yourself anytime, anywhere. At Bodywise Health, we have found that by using Bodyflow in the first couple of weeks following an injury, this has translated into faster recovery times from injury, often cutting days and sometimes weeks off normal recovery times.

There is no doubt that there are many things that you can do to assist in your own recovery from injury. And, if performed correctly, they will save you time and money as well as the disappointment of not being able to participate in the activities that you want to do. Treating an injury earlier and correctly, really does give you “the biggest bang for your buck” in terms of outcomes for effort. You have only one life. Don’t spend it on the sidelines any longer than you have to.

I hope that this article will help you to achieve a better faster recovery from your injury.

If you are injured and would like to know what is the best and fastest way to get better, please call 1 300 BODYWISE (263 994) for your FREE assessment and advice.

Yours sincerely,

Michael Hall
Director Bodywise Health

  1. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft tissue injury. Am J Sports Med 2004;3(1)251-61.
  2. Brukner and Khan and Colleagues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.
  3. Tischoll P, Jung A, Divorak j. The use of medication and nutritional supplements during the FIFA World Cups 2002 and 2006. Br J Sports Med 2008:42:725-30.
  4. Derman, EW. Pain management in sports medicine: use and abuse of anti-inflammatory and other agents. Sth African Fam Prac 2010;32(1)27-32.
  5. Wharaam PC, Speedy DB, Noakes TD et all. NSAID use increases the risk of developing hyponatremia during Ironman Triathalon. Med Sci Sports Exerc 2006;38(4):618-22.
  6. Paolioni JA, Milne C, Orchard J et al. Non steroidal anti-inflammatory drugs in sports medicine guidelines for practical but sensible use. Br J Sports Med 2009;43(11);863-5.
  7. Ziltenher JL, Leal S, Fournier PE, Non-steroidal anti-inflammatory drugs for athletes: an update. Ann Phys Rehab Med 2010;53(4);278-88.
  8. Alaranta A, Alaranta H, Helenius L. Use of prescription drugs in athletes. Sports Med 2008;38(6);449-63
  9. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries: optimizing recovery. Best Prac Res Clinis Rheumatol 2007;21(2):317-31.
  10. Kannus P, Parkkari J, Jarvinen TLN et al. Basic science and clinical studies coincide active treatment approach is needed after a sports injury. Scand J Med Sci Sports 2003;13(3):150-4.
  11. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries biology and treatment. Am J Sports Med 2005;33(5)745-64.



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What to do if you get injured

Knee RICE

By Michael Hall

There is no doubt that your treatment in the immediate 24 hours following an injury has the biggest impact on how long and how well it may take you to recover from an injury. Weeks and sometimes months can be saved from your recovery time if you receive optimal, acute injury management. So, if you want to achieve the best outcome, it is critical that you get this initial management right.  The following is a guide on how to get the best results.

The Bleeding Phase - Perhaps the MOST Important Phase of Healing

“The most important time in the treatment of acute soft tissue injuries is in the 24 hours immediately following injury”.1

When you injure soft tissues, the blood vessels are also often damaged. Blood then pools around the injured tissues causing swelling which stops oxygen exchange, leading to further tissue damage. This bleeding phase may last from just a couple of hours for less vascular tissues such as ligaments up to 24 hours from crush injuries (corked) to muscle.

Consequently, the most important thing that you can do at this stage is to reduce bleeding and swelling at the site of injury. The best way to do this is summarised in the letters PRICER and HARM:

Protection

Ice

Compression

Elevation

Referral

Protection

Protection of the painful or injured body part is essential to prevent re-injury. This can be best achieved through unloading or at least partially immobilizing the injured area through the use of taping, braces, slings, cam walkers and crutches. Even supporting your injured arm with the uninjured arm can work. Part of the value of using these aids is that not only will they stop you from aggravating your own injury, but they will also alert others to the fact that you are injured and therefore need to take care around you.

Rest

Following injury, you should cease activity to limit bleeding and swelling to reduce the size of the scar in injured soft tissue.2

Ice

Ice or cold treatment is used to slow cellular activity.3 It has been proven to reduce bleeding, inflammation and tissue death as well as accelerate early muscle regeneration.2,4,5 It has been our experience at Bodywise Health, that most people don’t achieve optimal results because the ice/cold pack are not cold enough.

For best results, place an ice or frozen gel pack in a damp tea towel and strap it in place with moderate compression. Check your skin every five minutes to ensure that there are no adverse reactions such as whiteness or crispiness of the skin. Remove the cold pack immediately if this occurs.

The most effective method for reducing pain immediately following an injury (ankle sprain) has been found with Intermittent ice (cold) application.6 This involves 10 minutes of ice, 10 minutes of rest and then 10 minutes of ice every two hours over the initial 24 to 48 hours.

More usually ice is applied for 20 minutes continuously every two hours for at least six hours following injury. 4,6,7

At Bodywise Health however, we have achieved faster recoveries and better results with applying ice for 15 minutes every one to two hours for two to five days or at least until the severe pain and inflammation (signs-heat, redness, swelling) have settled down.

Please note, ice should not be applied if you have impaired circulation or if you suffer from an allergy to cold. In addition, you must take care when applying ice as prolonged applications can cause ice burns and nerve damage.8

Compression

Compression not only supports injured tissue, it also reduces bleeding, swelling and scarring and aids healing by improving circulation. It should be applied during and after ice application from the time of injury for perhaps up to two to three weeks post injury. The compression bandage must be firm but comfortable and begun a hands breadth below the injury extending to a hands breath above the injury with each layer overlapping the previous layer by one half.

Elevation

Lifting (elevating) your injury above your heart is also minimizes bleeding and swelling.2 Elevating arm injuries is best achieved by using a sling or even the opposite arm. Likewise, leg injuries should be elevated above the pelvis by lying down and using a chair, pillow or bucket to raise the leg.

Referral

The greatest impact for limiting tissue damage and optimizing injury outcomes lies in the first three to five days following an injury. At Bodywise Health, we have found that the sooner we can assess and effectively treat an injury (i.e. same and / or next day), the better the repair, the faster the recovery and the better the outcome that people achieve, without exception.

In the first 72 hours after being injured, you must also avoid HARM-ful factors. These include:

Heat packs, heat rubs and hot baths (showers) as these will increase bleeding, swelling, tissue destruction and inflammation at the injured site.

Alcohol as it may mask pain, reduce muscle function and impede recovery.9

Running/moderate activity will cause further damage.

Massage/vigorous soft tissue therapy as this will also cause further swelling and bleeding.

There is no doubt that immediate, effective treatment is the best way for you to limit the financial, time, stress and opportunity cost of an injury. So if you want to save money, if you want to save time and if you want to get your life back as quickly as possible, make the most of this time. It could save you weeks and months of treatment.

If you are injured and would like to know what is the best and fastest way to get better, please call 1 300 BODYWISE (263 994) for your FREE assessment and advice.

I hope that this helps.

Kind regards,

Michael Hall

Please note:

• Rebates are available through your private insurance extras cover;

• For complex or chronic conditions, you may qualify for the EPC (Enhanced Primary Care Program) allowing you to receive 5 allied health services each calendar year with a referral from your GP.

For more information, please call Bodywise Health now on 1 300 BODYWISE (263 994).

Further information and advice can be accessed through:

  1. Sports Medicine Australia at http://sma.org.au 
  2. The Australian Pain Management Association at http://www.painmanagement.org.au
  3. The Australian Physiotherapy Association at www.physiotherapy.asn.au/DocumentsFolder/Advocacy_Position_Pain_Management_2012.pdf
  4. Arthritis Australia at http://www.arthritisaustralia.com.au
  5. The Victorian Arthritis Association at http://www.arthritisvic.org.au

References

  1. Brukner and Khan and Colleagues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.
  2. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries: optimizing recovery. Best Prac Res Clinis Rheumatol 2007;21(2):317-31.
  3. Bleakley C, McDonough S, MacAuley D. The use of ice in the treatment of acute soft tissue injury. Am J Sports Med 2004;3(1)251-61.
  4. Bleakley CM, O’Connor S, Tully MA et al. The PRICE study (Protection, Rest, Ice, Elevation): design of a randomized controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain(ISRCTN13903946) BMC 2005;33(5).745-64
  5. Jarvinen TAH, Jarvinen TLN, et al. Muscle Injuries biology and treatment. Am J Sports Med 2005;33(5)745-64.
  6. Bleakley C, McDonough S, MacAuley D. Crotherapy for acute ankle sprains: a randomized control study of two different icing protocols. Br J Sports Med 2006;40(8):700-5
  7. MacAuley D. Ice therapy: how good is the evidence? Int J Sports Med 2001;22(5):379-84
  8. Moeller JL, Monroe J, McKeag D. Cryotherapy-induced common peroneal nerve palsy. Clin J Sport Med 1997;7(3):212-16
  9. Suter PM, Schultz Y. The effect of exercise, alcohol or both combined on health and physical performance. Int J Obes 2008;32(S6):S48-52.
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