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Chronic Pain Treatment Melbourne

east brighton physiotherapy
By Michael Hall

Chronic pain is pain that is constant, relentless, draining pain for longer than 12 weeks. Unless you have had it, you can’t imagine it. It may involve back pain, neck pain (whiplash), migraine / headaches, tinnitus (ringing in the ears), phantom limb, fibromyalgia / fibrositis, chronic regional pain syndrome (CRPS) pain.

Chronic pain may affect every part of life, from sleeping, to morning to night. Every posture, movement, every activity, every word, every thought, every moment may be coloured by its presence until it becomes all consuming,

Chronic pain is serious

So pervasive, so invasive is chronic pain that it can wear you down, until it breaks you. Apkarian et al (2004) showed that people with chronic low back pain had lost 5-11% of neocortical brain matter, or 1.3cm3 of brain grey matter for every year of chronic pain. This is equivalent to 10-20 years of normal aging. The seriousness of dealing appropriately with chronic pain could not be more apparent.

Chronic pain is complex

One thing that is clear is that chronic pain is complex involving a complicated interplay of almost every bodily system. The sensations that we experience through our senses (sight, touch, hearing and smell), are transmitted to the spinal cord and then on to the brain. In the case of a severe pain, a response may be initiated from the spinal cord (reflex) directly as in the case of pulling our hand away from a fire. The brain also receives the information and on-sends it to all many different areas for processing, interpretation and the initiation of a response. These responses may affect all systems of the body from the activation of a movement, to changes in the immune system, to changes in the autonomic system. Essentially these responses have to do with either a protective response (fight or flight) or a nurturing growth and repair response.

Fight or Flight Vs Growth and Repair

The response that is activated depends upon how the stimulus is perceived. Our most primitive, automatic response is one of fight or flight. In the case of a perceived pain, threat, or fear, our body is readied to fight or take flight as our awareness is heightened, our heart pumps harder, breathing quickens, perspiration increases, muscles are tautened. At the same time, blood is diverted away from the digestive system and the nervous system is put on alert as the immune system is “deactivated”. In other words, our need to survive is prioritized ahead of every other need of the body, including growth and repair. This survival instinct, in the case of short term threats to our safety, is appropriate to help us stay alive. However, with repeated exposure to this pain, threat or fear, and repeated activation of the fight and flight pathway, our body’s ability to grow and repair may become impaired.

The brain is a computer with no delete button

The brain learns from every experience and may draw on the learning not just of this sensation, but of how the sensation is perceived you felt about this experience in the future. This means, just thinking about the experience is enough to trigger a response, irrespective of whether there is a problem with the body’s tissues or not. Moseley (2008) found that just imagining a body part worse than it is can increase the swelling and perceived pain, whilst imagining it better than it is can reduce the swelling and perceived pain. Maihofner et al (2006) also found that not only could the pain be magnified but that its location couldn’t be accurately identified. And further research has also shown that chronic back pain is experienced in a different location of the brain when compared with acute back pain (Moseley 2008).

Other studies have shown that using the reflection of an unaffected limb has reduced the pain experienced by individuals with their affected limb. Amputees have also been shown to have reduced phantom limb pain when their “legs” are projected walking underneath them on to a screen. What these studies show is that pain may not just be experienced at the local level but that chronic pain changes the brain biochemistry and actually rewires the brain’s neural pathways. This has major implications for the treatment of chronic pain and necessitates a holistic, multidisciplinary approach, if treatment is to be successful.

So where to begin

Given chronic pain’s complexity, chronic pain treatment or chronic pain management must tackle chronic pain on multiple levels, psychologically, physically and socially. Having said this, these levels may fall into two broad categories. The first is to discourage an environment of excessive or abnormal stress which may lead to a fight or flight response. The second is to encourage an environment of healing, repair, growth and building capacity.

Here are 7 guidelines of how chronic pain therapy and chronic pain clinics must deal with chronic pain

  1. The first rule of many chronic pain management clinics is to acknowledge that chronic pain is real. Sometimes not being believed is the most difficult thing to deal with especially as chronic pain can’t be seen, imagined or picked up on a scan.
  2. Have hope that chronic pain can be overcome. Gaining an understanding of the complex mechanisms behind chronic pain can help to give this sense of hope as well as a sense of control and empowerment.
  3. Change your attitude and change your behavior. Easier said than done, it is important to see yourself not as a victim of chronic pain, but as a person who has choices and things that they can control. If you can focus on those things that you have control over and your control them perfectly, many of the things you can’t control will go away.
  4. Create an environment which encourages nurturing, growth and repair. Being supported by and feeling connected with others is important as is sleeping well when most growth repair occurs. Food which reduces inflammation (fish/krill and flaxseed oil, turmeric and ginger) and which assists with growth and repair (vitamin C, Activated B and adequate amounts of protein) may also assist. Relaxation techniques, meditation, prayer or even warm baths can all be used as strategies to help to reduce tension and promote an optimal healing environment.
  5. Whilst there is no evidence that hands on techniques (such as remedial massage and mobilization) and modalities such as heat is of benefit, at Bodywise Health we have found that they may help exercise to be more beneficial by reducing sensitivity and increasing exercise tolerance.
  6. For maximal benefits, exercise should first be directed towards increasing joint mobility, improving muscle length and balance with the objective of correcting and optimizing posture and movement patterns. For these exercises to be effective, they may be performed under the pain cover of heat, cold or electrical stimulation and must start at an intensity which is below pain thresh-hold. Then using the overload principle, this postural exercise program should be increased first in volume and then in intensity, so that a training effect may be experienced which carries over to sustained physical improvement.
  7. Taping or bracing may be used to “unload” hypersensitive body tissues and enable assisted accommodation of correct posture, further reducing physical forces on the body’s structures.

Chronic pain management doctors and the chronic pain specialist in chronic pain management clinics across Melbourne may prescribe non-steroidal anti-inflammatories and opioids to manage chronic pain.

Chronic pain management Melbourne may abide by the evidence which suggests that non-steroidal anti-inflammatory (NSAIDS) medication should be considered as an appropriate treatment for chronic low back pain. However, whilst there are demonstrated benefits, there are also significant side effects that may have meaningful clinical consequences. NSAIDS are favoured over opioids both in terms of cost and safety. (Roelofs et al 2008)

Whilst dealing with chronic pain is extremely challenging, it is important to know that hope is at hand.

With Bodywise Health providing physical, nutritional and psychological services, we are well placed to assist chronic pain sufferers. Whilst medication may have its place, it doesn’t empower you as to how to avoid chronic pain stresses nor build your capacity to tolerate stress. Unless you are enrolled into an appropriate, graduated, progressive and empowering physical, psychological and nutritional training program, it is likely that your ability to cope with everyday life will decrease over time.

Unlike medication which can become a “crutch” upon which the body becomes dependent to cope, Bodywise Health’s philosophy is to empower you, your body and mind, by giving you the knowledge, training and resources that enables you to get stronger, physically, mentally and nutritionally.

Bodywise Health has been providing chronic pain management solutions to the people in the Bayside suburbs of Hampton, Brighton, Sandringham, Highett, Cheltenham, Black Rock, Beaumaris, Elwood Elsternwick and more generally across Melbourne.

Bodywise Health contact details can be found by googling chronic pain management Melbourne, chronic pain management Bayside, chronic pain management Brighton, chronic pain management Hampton or chronic pain management Cheltenham.

Bodywise Health will work with any chronic pain specialist or chronic pain management doctors in Melbourne to ensure that you experience the best results possible.

The Bodywise Health chronic pain management program has had great success in assisting hundreds if not thousands of people over the past 20 years. It can help you too.

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

You have nothing to lose except your pain.

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 1 300 263 994.

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Child Birth Preparation & Exercises During Pregnancy

ergonomic advice
By Michael Hall

Physiotherapists play an important part in the antenatal care of pregnant women and their preparation for labour, birth and parenting. Physiotherapists educate women about the need for good posture during pregnancy and the principles of back care, teaching appropriate lifting skills, lifting and standing postures. Physiotherapists also educate women about the role of the abdominal muscles in supporting the back, and teach exercises to maintain adequate strength for these muscles.

An important role of the physiotherapist is to educate pregnant women about pelvic floor function, correct exercise techniques and the importance of regular exercise. Physiotherapists provide information about general exercise during pregnancy, what can be done safely and what should be avoided, as well as teaching specific exercise techniques to maintain flexibility and strength.

Physiotherapists help to prepare pregnant women and their partners or support people for the physical work of labour. Physical relaxation skills are taught in conjunction with breathing awareness, encouraging women to remain active in labour. Women are taught a variety of labouring positions to allow gravity to assist, but offering comfort and the ability to relax.

They provide information about the use of TENS during labour, giving women the opportunity to use effective analgesia in labour without the risk of the side-effects of drugs.

The final role of the physiotherapist in antenatal education is to prepare couples for the early days in hospital and the first weeks at home with the new baby. The importance of daily rest is emphasised, in conjunction with some gentle exercise to help women return to optimal fitness and physical wellbeing. Couples are taught correct lifting techniques and how correct posture can be maintained when breastfeeding or attending to the needs of the baby. Couples are also informed about baby massage and the importance of the prone position in child development.

For more information or for an appointment, please call Bodywise Health on 1 300 263 994.

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 1 300 263 994.

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What’s Better? Running Barefoot or with Shoes? Here’s what the research says

core
By Michael Hall,

Let’s face it, with all the claims and counter claims that go with barefoot running, it’s difficult if not impossible to know who or what to believe. Runners, especially barefoot runners are passionate people and passionate people tend to be biased people. Discovering the truth however is important as the stakes are high. If you are a runner, the chances are that you have had or will have a running related injury. Running is the 4th most popular activity by participation1 and runners tend to be at high risk of injury. Yet, despite the millions of dollars poured into running research, shoe technology and advanced training programs, the incidence of running related injuries has remained remarkably consistent over the past 40 years.

Up until now, the approach used to prevent injury and tackle running related problems is called Running Shoe Theory (RST), or the prescription of running shoes based on your foot type. Unfortunately this theory has never been adequately tested and is now being called into question by many in the running shoe community.

The barefoot running phenomenon

In recent years, barefoot running (Barefoot Running Theory or BRT) has been proposed as being the answer to reducing running injuries as it allows the foot to work in a way that nature intended it to – something that can’t occur when the foot is put in a running shoe.
Analysis of barefoot running versus running in running shoes reveals that barefoot runners tend to run with a mid or forefoot ground strike (where the mid or ball of the foot hits the ground first) as opposed to shoe runners who land on their heel first in a heel - toe fashion.

Barefoot running – the Pros and Cons

It has been found that using a mid or forefoot strike pattern reduces the impact forces of when your foot hits the ground. However, it also results in a reduced step length and therefore an increase in the number and frequency of steps per given distance.4 So whilst the intensity of the impact stress might be reduced, the frequency and number of these forces actually increases, meaning that the overall effect might be the same.

The impact forces are much greater in heel strike runners being typically 1.5 – 3 times a person’s body weight. Cushioning in the heels of shoes reduces this impact force by about 10% making it more tolerable. Barefoot foot running and using a heel strike pattern actually produce a 7 fold increase in impact forces, thereby placing these runners at much greater risk of injury.

Another difference is that in heel strike runners, much of the impact forces are absorbed through the hip and knee joints as opposed to barefoot and forefoot runners where more of the forces are absorbed through the small mid foot bones and muscles as well as the ankle joints. Whilst a structurally sound and conditioned foot might be able to tolerate these forces, feet which are not biomechanically correct and habituated are more likely to be injured.

Other disadvantages of barefoot running include damage to soles of the feet from running on sharp, jagged, hot or even cold surfaces. To address these problems, running shoe manufacturers have developed minimalist running shoes (or barefoot shoes) which allow the foot to move as naturally as possible whilst offering some protection.

However, a possible advantage of walking or running on grass or at the beach is that of “earthing” where negatively charged electrons are absorbed through your feet providing an anti-inflammatory effect on your body.

Running in bare feet or minimalist shoes also enables better sensory feedback from your feet, thereby facilitating improved body awareness and dynamic balance reactions potentially leading to a reduction in injuries.

However, more recent research is less positive. One study that evaluated claims that minimalist shoes can improve running efficiency and economy found that compared to standard running shoes, minimalist shoes did not decrease running expenditure or improve running economy.

Two other studies have shown that when experienced recreational runners have transitioned to minimalist footwear, there was an increased incidence of injury and of stress reactions in the foot bones.These studies suggest that even despite a careful, slow transition to minimalist footwear, there may still be an increased risk of stress fracture injuries.

Different people have different needs and therefore need different solutions

As can be seen from this article, there is much conflicting evidence as to the advantages and disadvantages of barefoot running. Perhaps this is a reflection that the people unique structural and running styles have not been addressed. If you are overweight, are de-conditioned, have poor core, gluteal, quadriceps and / or calf strength or you have reduced hip, knee and / or ankle mobility, you will be at risk of injury even before you start. Some people have flat feet whilst others have high arched feet. High arched feet tend to needs extra cushioning to absorb shock, whereas flat feet tend to need support to prevent “over stretching” of the foot ligaments and muscles. Therefore, prescribing a generalised, one size fits all approach is inappropriate and fraught with risk. It is therefore advisable that if you are going to take up or increase your running demands, that you get a physical assessment so that you can identify and address potential problems before they become an issue.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE).

Precautions and Advice

On balance, the evidence suggests you need to be wary when trialling minimalist footwear for running. If you have a previous history of plantar fasciitis or stress fractures, you should avoid barefoot or minimalist footwear when running. If you are absolutely determined to run with bare feet or minimalist footwear, you must avoid hills (with the associated greater impacts) and transition from short distances and time periods over a period of at least 3 months. Also, you must acquire a mid or forefoot ground strike pattern.

But does your physiology, biomechanics and speed predispose you to a “best” running style?

Most people run with a heel strike pattern11 which might be a reflection of the speed of ambulation. We are adapted to walk for long distances in a heel strike manner. Underneath the heel of your foot is a fat pad that is designed to absorb shock. Also, the lower calf muscle (soleus) is a postural muscle, which means that it can contract for long periods of time without getting fatigued.

Gradually as our speed ambulation increases, we move to a mid foot landing pattern and then to a forefoot strike pattern with sprinting.12 As the bones of the feet are small and the upper calf muscle (gastrocnemius) is a phasic (powerful but easily fatigue able) muscle, we are adapted to running on the balls of our feet for short amounts of time (e.g. sprinting). Because of these adaptations, running for long distances on your forefeet therefore might be putting you at risk of stress fractures and / or upper calf strains.

Having said this, if you run with a heel strike pattern and have weak gluteal, quadriceps, calf and foot muscles as well as stiff hips and ankles, your legs will tend to move excessively inwards, flattening out your feet (pronation) and setting you up for facet joint syndrome (back pain), gluteus medius tendinopathy (buttock pain), iliotibial fasciitis (outside knee pain), Achilles tendinopathy, ankle sprains and plantar fasciitis (underneath foot pain).

Possibly the best advice is to have a physical and / or running assessment and then once cleared to introduce a small amount barefoot running into your training. We know that repetitive activity can cause injury and running is certainly a repetitive activity. So having been cleared to barefoot run, start slowly and progress slowly at a rate that feels almost too easy for a 6 to 12 week conditioning period.

Following this time, start your sessions with a 5 minute warm up and then begin to gradually build up to 10, 20 second barefoot run throughs on grass or sand at about 80% effort (or more but within comfort limits). Then slow down to an easy jog and get your breath back before beginning the next run through. Do this twice each week and mix your sessions up at least monthly with different rest periods, tempos and drills.

When you run, focus on landing with your knee over your foot (2nd toe to be exact) and contract your buttocks as you push off your toes to stride forward. This will challenge and strengthen your body, helping you to avoid injury and perform better. Alternatively, go for a walk in bare feet at the park (on grass) or at the beach (on sand). It might be just one of the greatest discoveries of sensory stimulation, stress release and freedom that you experience all year.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE)

For more information on how Bodywise Health can help you to recover from or prevent running injuries, please call Bodywise Health on 1 300 BODYWISE (263 994).

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 1 300 263 994.

References

1. ABS data, Australian Health Survey, Participation in Sport and Physical Recreation, Australia, 2011-12

2. Jenkins DW, Cauthon DJ. Barefoot running claims and controversies: a review of the literature. JAPMA 2011; 101: 231

3. Lope A. Hespanhol C. Yeung S. Pena Costa L. What are the main running musculoskelatal injuries: A systematic review. Nature.2010 Jan28;463(7280):531-5

4. Proceedings ISB XXth Congress, America Society of Biomechanics. 29th Annual Meeting Cleveland.2005:553

5. Oschman JL. Can electrons act as antioxidants? A review and commentary. Journal of Alternative and Complementary MedicinE. 2007 Nov; Nov13(9):955-67

6. Squadrone R, Gallozzi C: Effect of a five-toed minimal protection shoe on static and dynamic ankle position sense. J Sports Med Phys Fitness 51: 401, 2011.

7. J Sci Med Sport. 2013 May 24 pii: S1440-2440(13)00102-3

8. Med Sci Sports Exerc.2013 Jul 19.

9. Foot Ankle Int. 2012 Apr; 33(4):262-6

10. Med Sci Sports Exerc: 2013 Jul;45(7):e320-23

11. Sahrmann SA and Associates. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. Elsevier Mosby 2011.

12. Brukner P, Khan K And Collegues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.

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What the AFL season can teach you about injuries and how to prevent them.

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By Michael Hall,

We all want to avoid injury and get the best out of our bodies, don't we? And like all elite sports, the AFL provides some real key lessons in how you can achieve your physical best. Here are 10 tips for getting the best out of your body.

1.Be prepared

The Hawks were simply better prepared for a physically and emotionally demanding match. Rather than a disadvantage, it seems that the exhausting game against Port Power, was actually a blessing in disguise. The hardness at the ball, the speed of the game and the intense one on one contests, gave the Hawks a “taste” of what to expect.

It’s the same with you. For you to be able to reach your potential, you must prepare your body and your mind through “conditioning”. In other words, you must “train” so that you can get the most out of your body and life, without getting injured.

Training allows you to measure the load that you place on your body, so that you can create adaptation of your body.

Because the training environment is controlled, forces above and beyond what’s required in your sport and life activities can be safely placed upon your body for a specific time. This strengthens your body further so that it has a reserve capacity to cope with the demands likely to be placed upon it.

For a FREE trial of Clinical Pilates, please call Bodywise Health on 1 300 (BODYWISE) 263 994

However, to begin “training” safely, it is recommended that you begin with the next point first. That is....

2. Get a Physical Health Check from your doctor or health professional

It seems obvious, but before you take on a particular event, it’s important that you check that you have the structural, biochemical and psychological capacity to endure such a challenge. In a very short time, you can gain a snapshot as to any risks you may have or potential problems that you may face. By knowing these up front, you can deal with them before they ever become an issue. Some of these factors include:

* Heart arrhythmias which may lead to heart attacks;

* Excessive triglycerides or high concentration of low density lipoproteins (LDL’s) which are a risk for heart attacks and strokes;

* High blood pressure which is a risk for stroke;

* Excessive upper back outward curvature (kyphosis) is a risk factor for upper back pain, shoulder pain (Rotator Cuff syndrome) and chest pain (costo-sternal pain);

* Decreased lower back inward curvature (lordosis) is a risk factor for low back pain;

* Excessive turning in at the hips, inadequate balance, excessive turning in at the knees (knocked knees) and flattening (pronated) feet are risk factors for buttock pain (gluteus medius tendinopathy, piraformis syndrome or trochanteric bursitis), as well as knee pain (knee cap pain or knee osteoarthritis), ankle pain (inside calf shin splints, anterolateral impingement syndrome) foot pain (plantar fasciitis) and even toe pain (hallux valgus);

* Other physical inadequacies which include abnormal hip extension, ankle dorsiflexion which can lead to back, hip, knee, ankle and foot pain.

3. Start slowly and progress slowly

The biggest mistake most people make when training for an event is that they start too hard and too fast. What you must understand is that it takes up to six weeks and beyond for your body to adapt to the stimuli that training provides. Therefore in the early (2 to 3 weeks) stages, the principal that less is more certainly applies. Get to know your body and begin to gain an understanding of what it is capable of and where your tolerances lie.

If you are a beginner, start aerobic training for 10 minutes once to twice every other day at an intensity which enables you to speak in sentences and progress to 20 minutes increasing sessions by three to five minutes per week as you comfortable.

4. Use High Intensity Interval Training to get better, faster results

At the three to four week mark, after a five minute warm up pace, increase your intensity so that to being able to speak in words for 30 seconds. Then slow down and allow yourself to get your breath back. Repeat this process for the 20 minutes of your training.

At the six to eight weeks stage, increase your intensity to greater than 80% of maximum effort for 20 seconds. Then slow down and to go get your breath back and repeat this process for the duration of your training. This type of training called High Intensity Interval Training (HIIT) drives change and adaptation in your body’s cells, burning more kilojoules, fat accelerating your fitness and health improvement.4 A study, published in Cell Metabolism, showed that when healthy but inactive people exercised for even just a brief time, there was an immediate change in their DNA. While the genetic code remains the same, the intense exercise triggers important structural and chemical changes that lead to a re-programming for strength and fat burning.

In another study, recreational cyclists were able to double their endurance capacity in just two weeks by doing just three sessions of sprint interval training each week. (Note: To minimize the chance of impact injury, it is recommended that this HIIT be performed on a exercise bike with swimming or perhaps running up hill).

The American College of Sports Medicine recommends 20 minutes of more vigorous activity three days per week, noting that HIIT workouts tend to burn an extra 6-15 percent more calories compared to other workouts, thanks to the calories you burn after your exercise.

From here on vary your training time, intensity, volume, duration, surfaces and rest periods based upon periodisation concepts. For example, one day you might walk/run/cycle on the flat, another day you might do hills and on another day you might run on the sand or in waist deep water. For more information contact Bodywise Health on 1 300 BODYWISE (263 994).

5. Include corrective and capacity building exercise.

The day in-between should be reserved for correcting any muscle imbalances and relative joint stiffness before building your body’s capacity for exercise.

Your physical assessment will identify what muscles are relatively weak and tight and what joints are relatively stiff as well as faulty posture and movement patterns. Without correction, exercising will simply reinforce excessive or abnormal stresses on the body leading to “breaking down” of tissues and eventually injury and pain.

Because much of our lives are spent in activities that involve prolonged periods of sitting (e.g. computer, cycling etc.), bending (e.g. laboring, gardening etc.) and / or working in a slightly bent forward position (e.g. working at any bench, running etc.), typical exercises might include stretching and strengthening your muscles through full range in directions that are the opposite to our every day postures and movement patterns.

People sometimes comment, “But I am in a physically active occupation”. Whilst this is better than being sedentary, these occupations still don’t build your capacity. Rather, over time your ability to keep going still physically decreases. The reason is that as these activities are performed over days, physical stress is being applied to the body’s tissues for long periods of time. This is catabolic (breaking down) to muscle, tendons and bones leading to overuse syndromes such as tendinopathies and stress fractures. Hence, many of these injuries could potentially be avoided if you strength trained every other day.

For best strength results, train with free and cables weights and NOT on machines. Free weights and cable loading strengthens and neurologically trains your stabilizing muscles, joint capsules, joint and muscle receptors better preparing you for physically demanding and unpredictable activities. Also, vary your exercises every month to keep your body and your brain guessing. Changing your exercises, keeps your brain and body in a state of alert and readiness for action.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE).

6. Focus on technique

It is amazing when watching people do fun runs, cycle events or swimming challenges, how many are doing these with poor techniques. Poor technique equates to excessive or abnormal stress being put on body tissues. As the loading on their body structures increase with increasing training volume, intensity and duration, so does their risk of injury as tissues break down under the excessive or abnormal forces.

So get your running, cycling, swimming, golf technique etc. assessed to ensure that your activity is being performed with a maximum amount of efficiency and effectiveness. If these activities are not being performed optimally, then not only will you not achieve the best possible result, you are literally breaking down and wearing out your body at an abnormally fast pace. In the end this can only mean injury and pain. Much better to prevent it starting before it ever occurs.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE).

7. Balance the load on your body

Loading on your body involves four variables: Intensity, Volume, Duration and Rest. If any of these variables together as a group or individually cross a loading threshold, injury will occur. Understand that low intensity stress, applied frequently for a long period of time with no rest can be as damaging as doing too much intense exercise too soon.

The key is in knowing where the injury threshold is crossed and this is why we rely on treatment and training principals to the body’s build capacity whilst avoiding injury. This is easy to do in the gym because we record the training load and its effect. For example, three to five sets of eight to twelve repetitions 80% or more of the maximum amount you can lift in one go every other day, is generally recognised as a strength training guide.

However, it’s much more difficult in everyday life to know if we are crossing an injury threshold because we generally don’t measure how much we sit, how much we bend, how much we turn to one side etc. and even if we did, the effects may not manifest themselves for years.

One method for finding out if your overtraining or becoming ill involves taking your pulse for one minute each morning upon waking. After a week, you will know what your average resting pulse is. Then if your pulse increases by more than 10%, this is an indication that you are overtraining or becoming unwell.

Dr. Ainslie Meares, an Australian Psychiatrist and the father of meditation in Australia, recommended two, 10 minute sessions of “stilling” the mind and body each day. There are now many studies which have proven the beneficial effects of meditation. So whether it is just being quiet, prayer or meditation, stopping your body and brain’s busyness for 10 minutes twice each day could go a long way to enhancing your health and preventing injury.

“Listening to your body” and becoming aware of what it is telling you is the starting point for change. Measure your training (and your life) and take note of its effects. Notice when you are feeling stiff, tight, achy etc. and try and determine what activity and its load has caused this. Then change it. You might change the intensity, time or tempo of the activity or the rest periods. Back off and rest when you are feeling fragile both physically and / or mentally and then begin again when you feel able. By becoming conscious of how your body is feeling and taking remedial action, you will very likely prevent many potential injuries and illnesses before they ever occur.

8. Recover well

One training variable that is often not considered by the average weekend warrior is rest and recovery. It’s no coincidence that often AFL footballers are pictured standing waist deep in the water the day after a football match and certainly, swimming and water activities are perhaps amongst best activities for recovery. But there is more to consider than just standing in water.

Often following any unfamiliar activity, your body will feel “sore”. This “soreness” is indicative of an inflammatory reaction, where the white blood cells of your immune system break down the affected tissue so that it can be rebuilt stronger and with increased capacity to withstand the forces when they are again applied. The recovery time for this to occur generally takes about 48 hours. If the same stimulus is applied before complete recovery occurs, the tissue is weakened, reducing your exercise capacity and your ability to stay injury free.

Bodyflow is an advanced technology (available at Bodywise Health and for home rental) that further accelerates this process. By electrically stimulating the smooth muscle within the walls of the small veins (vessels that take blood back to the heart), blood pooling is prevented, swelling is reduced and recovery enhanced. Used by many AFL clubs as well as the English Olympic team, Bodyflow has been shown to hasten the recovery process, enabling more effective training to begin sooner thereby enabling the potential for better results. The beauty of Bodyflow is that you can use it in the convenience and comfort of your own home to “treat” yourself.

Lymphodema and remedial massage are also a critical in recovery. It is no coincidence that many athletes receive remedial one, two and perhaps more times each week to facilitate recovery. This massage is not a luxury but an essential component of an overall strategy to prevent injury and improve results. Like Bodyflow, lymphodema massage removes swelling and improves circulation.

However remedial massage goes further. Very often tissues that are irritated, tight and / or restricted, that people are not aware of, are “sensed” by skilled remedial massage therapists and alleviated, again heading off potential injury. The more intense the activity, training or sport, the more frequently massages are generally given and the more that they are adapted to address the specific needs of the tissue, person and activity.

As you increase your training consider having a remedial massage at least monthly if not sooner. It can be a great way to optimize your physical and emotional health. Again “listen to” and be “guided by” your body and don’t leave it too late.

9. Get adequate sleep

Adequate sleep means at least 7 hours of good quality sleep each night. Deep sleep is simply essential for renewal, recovery and repair – the essential elements of good health. It is important for the immune system, and it reduces the risk of heart disease, cancer, diabetes, depression, obesity and improves concentration. The Chinese body clock and circadian rhythm indicates that there are various times of the day that the body is more likely to be performing certain functions.

Recommendations for a good night sleep include:

* Get to sleep by 10.30pm to enable adequate physical repair and body detoxification.

* Eat early and avoid a large meal with refined carbohydrates (e.g. sweets, pastries etc.) that will cause a blood sugar spike and cause you to wake up when the blood sugar drops.

* Avoid caffeine in the afternoon; (caffeine inhibits adenosine, sleep molecule of the brain which aids in getting to sleep)

* Avoid alcohol as this tends to keep sleep light which is not optimal for repair and restoration.

* Avoid intense exercising just before bed (exercise raises cortisol levels which breaks down tryptophan, an amino acid needed for the manufacture of serotonin and then melatonin, the sleep hormone).

* Warm milk contains tryptophan and may assist in getting to and maintaining a deeper sleep.

* Stretching on a mat in the 20 minutes before going to bed, is an ideal way to reduce joint stiffness and muscular tightness, thereby promoting better relaxation and rest.

* Dim lights, avoid stimulating activities (computer, TV, suspense novels etc.) and reduce temperature to between 16 and 18 degrees in the hour or two before bed.

* Sleep in pitch blackness as this assists in the pineal gland in production of melatonin, the sleep hormone.

* Exercise at least 20 to 30 minutes, 5 days each week as this stimulates the production of Adenosine, the sleep molecule.

* Get at least 15 minutes of sun light each day to optimize Vitamin D production.

* Write down a plan of the next day’s activities before going to bed to free your mind of tasks that need to be done.

* Move all electromagnetic devices away from your bed as far as possible.

* Get to bed at the same time each day;

* Read something calming or do something restful whilst in bed (e.g. listen to something relaxing), not watching TV.

10. Optimise your nutrition

It makes sense, that optimal recovery, repair and regeneration can only take place if you have adequate amounts of the optimal nutrients.

This means at least:

* 0.8 grams of protein each day per kilogram of your body weight if you are sedentary and up to 1.7 grams of protein per kilogram for athletes involved in football and power sports (note taking > 20 grams protein at one time results in oxidation).

* Adequate amount of zinc, magnesium, vitamins B3 and B6 and chromium which aid muscle recovery and prevent injury.

* Reducing grains and avoid refined simple carbohydrates (especially refined flour and sugars) to decrease blood sugar and insulin spikes which cause inflammation;

* Reducing omega 6 fatty acids (e.g. processed foods, animal fats = pro-inflammatory) and increasing omega 3 fatty acids (3-4 fish meals each week, nuts etc. = anti-inflammatory and promotes cellular repair). The ratio of omega 3 to omega 6 should be 2-4: 1.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE)

The AFL season provides you with some great life lessons. Implementing these teachings into your own life can help you be more, live more, achieve more so that you can have more of what life has to offer. Why would you want any less? Why go through another day in injury or pain or with less than optimal energy and conditioning to live fully and freely. Every day is your “Grand Final”. You never get to relive it. Seize today and begin working towards better health and a better life.

For a FREE physical health check or injury assessment, please call Bodywise Health on 1 300 263 994 (BODYWISE)

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 1 300 263 994.

References

1. Chadwick V, Ford A and McPhee R. A Practical Guide to Nutrition for Allied Practitioners (Level 1) Course Notes May 2014

2. Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes, 2002

3. Heyward C. Advanced Fitness and Exercise Prescription. Human Kinetics. 6th Edition, 2010.

4. The Leader, September 8, 2014

5. Cell Metabolism March 7 2012: 15 (3); 405-411

6. J Appl Physiol (1985). 2005 Jun; 98 (6): 1985-1990

7. The American Journal of Sports Medicine PDF

8. Chek P. Program Design; Choosing Reps, Sets, Loads, Tempo and Rest Periods, Correspondence Course Manual 1995

9. Brukner and Khan and Colleagues. Clinical Sports Medicine. McCraw Medical. 4th Edition, 2012.

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