Tag Archives: ESSA

Fun Run Season is Here – How to Stay Injury-Free!

While other states are shivering into their hot chocolates, we are lucky enough in the far North of Queensland to be experiencing perfect running weather – beautiful crisp and sunny days with minimal humidity in the air. There is no better time of the year to be upping your running training and looking ahead to one of the many fun runs on offer around the area in the coming months.

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Not coincidentally, it is about this time of year that we start to see an influx of running injuries come through our clinic doors. As runners ourselves, we can understand the frustration and stress involved with having to sit out of training or worse, missing your planned race. There are many simple things that runners can do to minimise their injury risk and keep their bodies healthy and minds happy. We’re pretty sure you know all of these , but like most runners, need a simple reminder that you are not “special” – your body is not superman and it does, in fact, need just as much time to adapt to training stimulus as everyone else’s does!

 

  • Training Load

A large proportion of running overuse injuries are caused by simply doing too much, too soon. The classic situation is the runner who has had a few months off, maybe gained a few kilos and not been diligent enough with their strength work, and then decides to do an 8-week training program for an upcoming half marathon or 10km fun run. The first few weeks go by OK with sore muscles and slow shuffling, and then week 3-4 hits and you have shin or foot pain that won’t go away in a hurry…..Sound familiar? While the enthusiasm is great, it is important to “train for the training”. Consider your base level of fitness before jumping feet-first into any training program; if the first week of the training program looks “scary” to you, then you are not ready yet. Running is a wonderful sport for the body but it comes with a high injury risk if you are doing it sporadically. Once you are gradually building up the weekly mileage, give yourself a recovery week once a month, typically reducing the training load to about 60% of your previous week, further giving your body a chance to absorb the training. The healthiest and usually the fastest runners are those who are consistent with their training, year-round, allowing for natural and gradual increases and decreases in their load around race season and off-season.

 

  • Specific Strength Work

Every time you take a step when running, you are literally doing a single-leg squat with up to 4-6 times your body weight going through the chain from your foot up through your knee, hip, pelvis and spine. Think about that. The amount of recreational runners we see come into our clinic who cannot do one quality single-leg squat with one x their body weight – let alone quadruple that amount – is truly scary! Your muscles are very well equipped to take up the excess loads of running so that your joints and bones don’t have to get overloaded; in fact, well-trained muscles will act like springs and propel you forwards with ease and speed. We recommend that all runners do a minimum of 2-3 strength sessions a week, but it must be run-specific ie lots of core, glutes, single leg squat work and lower limb strengthening as well as the all-important balance and flexibility work. A quality session might take you 20-30 minutes, but it will be the best injury prevention investment you can make. An Exercise Physiologist or Physio with an interest in running can help you to design a program that addresses your weaknesses, and most can be done in your own lounge room without fancy equipment.

 

  • Running Technique

If your core and general strength is good, your balance and flexibility and adequate, and you are not excessively overweight, you will have a much easier time achieving optimal running technique. What is “ideal” technique is an often-debated topic amongst the literature, and when it comes down to it, everyone is different and will have a slightly unique “perfect form” that suits their body. Having said that, there are certain key factors that need to be considered to ensure that you are running safely, for both injury management and to increase your speed and efficiency. These include things like high knee lift to utilise the powerful glutes; mid or forefoot strike to optimise the calf muscles as a spring; a leg turnover of about 180 strides per minute (count how many times per minute your right foot hits the ground, then double it); a nice upright torso with a very slight forward torso lean etc etc. If you feel like you aren’t running at your best or you continually get overuse injuries such as shin pain and plantar fasciitis, having a qualified professional assess your running technique could prove to be a worthwhile investment. Coaches, Physios, Podiatrists, and Exercise Physiologists with an interest in running are all qualified to do such an assessment.

 

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Nutrition

Running is a wonderful sport for promoting weight loss and maintaining a healthy body weight. The best runners tend to be the lightest, but that doesn’t mean that you have to look like Paula Radcliffe to enjoy healthy running. If you are more than 5kg above your ideal body weight, be respectful of the extra load on your body as you increase your training load. Also ensure, no matter what your weight, that you fuel well before, during and after your hard run sessions. Optimal nutrition results in faster recovery, better performance and less injuries. Accredited Sports Dieticians are the best people to talk to about fuelling for both running performance and for weight management.

 

  • Shoes

This can be another controversial area that professionals love to debate over. Most qualified health professionals have their opinion on what shoe type is best for you; my advice would be to listen to your body. If you feel like it is hard to run fast, that your shoes are working against you, or that you get a lot of niggles in your current shoes, consider trying something different. I am a fan of the 4mm heel drop shoes and have had great success in them with all of my runners, but as with anything – change needs to be a very gradual thing. If you are used to running in super cushioned, 12mm heel drops and you suddenly swap to a “barefoot” style of running shoes (which I don’t recommend either, unless you weigh 40kg and look like the Kenyan Olympic marathoners), your body will be shocked by the change. You need to allow adequate time to adapt and ensure that you lower your training load and increase your strength work while you change over. I also advise people to have two pairs of runners on the go and to rotate them throughout the week. Most recreational runners doing 40-80km/week will need to change their shoes over every 3-4 months, depending on their weight and the surfaces they train on. This may seem expensive, but when you consider what equipment in some other sports (like cycling) costs, not to mention the cost of a potential injury, it is a relatively cheap investment for foot health!

 

  • Training Surfaces

Try to vary your terrain as much as possible – this is good for load but also a great way of incorporating some strength work and balance (eg. soft surfaces like trail running) into your running. Cement is the highest load for your body to cope with so try to do less than half of your training on it as a general rule.

 

  • Factors outside of Training

This is the one area that runners often neglect. Our training isn’t separate to the rest of our lives, it is included within it. That means if you are tired from lack of sleep, stressed from work or family, or under-fuelled from working through lunch – these things will all impact on your running form and also increase your injury risk. You need to consider how your body feels going into any run – and adjust accordingly. If you are wrecked from work or stress, don’t do that hard track session today; swap it for an easy 5km run and come back stronger for the track session in a few days’ time. I will also add here for the ladies that wearing high heels on fatigued legs is a great way to give yourself a stress fracture – you would be amazed how many times we have seen this in our female athletes! If you must have that big day at the races, at least wear lower heels and stretch calf muscles etc before and after the event.

 

 

The number one take-home point is that the body hates rapid change. The human body is an incredible specimen capable of adapting to remarkable training loads: think about what Ultramarathoners and Ultraman (back-to-back Ironman triathlon events) athletes are capable of achieving. They are no different to you or I – they don’t have magical superpowers that allow them to run 100km. They simply dedicated themselves to the process early in their lives and have consistently added training load to allow adaptation in a slow and planned manner. The bottom line is that our body will adapt beautifully to change, if we allow it time to do so. It’s not exciting, but if you ask any long-time marathon runner, it simply works. So if you’re like me and you idolise those crusty 70+ year-old distance runners that line up beside you at races, hoping that one day you too will be still running happily at their age, then take a leaf out of their book: consistency is the key to a long, happy running life.

 

Happy Training!

 

Kristy Shannon    B.Appl.Sc(HMS); M.PHTY

Physiotherapist and Exercise Physiologist

 

 

REFERENCES

American College of Sports Medicine., American Dietetic Association., Dieticians of Canada. (2009) Nutrition and Athletic Performance: Joint Position Statement. Medicine & Science in Sports & Exercise. 0195-9131/09/4103-0709/0

Barr, K.P., & Harrast, M.A. (2005) Evidence-Based Treatment of Foot and Ankle Injuries in Runners. Phys Med Rehabil Clin N Am 16:779-799

Beck, B.R., Rudolph, K., Matheson, G.O., Bergman, G., Norling, T.L. (2014) Risk Factors for Tibial Stress Injuries: A Case-Control Study Clin J Sports Med 0:1-7.

Buist, I., Bredeweg, S.W., van Mechelen, W., et al (2008) Prevention of Running-Related Injuries Among Novices. Am J Sports Med. 36:33-39.

Van Gent, R.N., Siem, D., van Middelkoop, M. (2007) Incidence and Determinants of Lower Extremity Running Injuries in Long Distance Runners: a Systematic Review. Br J Sports Med 41:469-480.

 

Are you an “Active Couch Potato”?

thomas run

thomas run

Fun runs are a great way to stay active and motivated

Fun runs are a great way to stay active and motivated


 

 

Recently we have seen the establishment of new “Physical Activity and Sedentary Behaviour Guidelines”, doubling the recommended amount of daily exercise to 60 minutes every day and for the first time, addressing our nation of couch potatoes.  “Sedentary behaviour” includes sitting or lying down, not including sleeping time during the night.

 

 

The New Guidelines: How Do You Stack Up?

– Doing any physical activity is better than doing none.  If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.

 

– Accumulate 150 to 300 minutes of moderate intensity physical activity or 75 to 150 minutes of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities each week.

 

– Be active on most, preferably all, days every week.

 

– Do muscle strengthening activities on at least two days each week (gym/Pilates/weights etc)

 

– Minimise the amount of time spent in prolonged sitting.  Break up long periods of sitting as often as possible.

 

 

“Active Couch Potatoes”

Frightening statistics show that Australians are sedentary on average for 7 to 10 hours a day, and this does not include sleeping.  The highest health risks exist for those people who are sedentary at work, at home, and who do not do any other formal exercise.  However, there does exist another group who accumulate their 60 minutes of exercise a day, but sit for the rest of the day at work.  It has become apparent that the health benefits of their exercise bout do not completely override their globally sedentary behaviour, and these “active couch potatoes” would benefit from being more active during their work day as well.

thomas run 

 

 

I have a sitting job, help!

We can actually take away a lot of positives from the new guidelines, most notably that simply being more active throughout your day can start to give you some of the health benefits that those weekend warriors are getting with their 3-hour, one-off bike rides.  If you hate exercise, this is good news for you.  By being creative and adding activity into your day, you can be doing your body a lot of good.  Walking or cycling to work; parking at the far end of the car park or a few blocks from work; going for a short walk to get your lunch; scheduling a “walking meeting” with a colleague; installing a standing desk in your workplace; and drinking more water so that you have to get up to go to the toilet more often are all easy ideas.  If you want to get even more creative, you can get in the habit of walking every time you answer the phone; doing 20 air squats every morning tea and lunch break; or setting yourself a task of 20 push ups and a 1 minute plank every time you watch the news at night.  Keeping the body moving and the engine revving is the key point.  And the best part is, we are creatures of habit: before long, it will be second nature to be moving more (and your body will be thanking you for it).  If you haven’t been very active in the past, it’s a good idea to start with small daily habits and then build in more structured exercise as you feel more comfortable to do so.  The key is to find things that you can make fit into your work and home life, and ideally that you enjoy as well.

thomas run

 

Where’s the Incentive?

Increasing amounts of studies are finding links between sedentary behaviour and weight gain, type 2 diabetes, poor muscle tone, heart disease and early death.  From a Physiotherapy perspective, we are seeing more and more overweight patients coming in with pain and disability from osteoarthritis through the hips, spine and knees.  The gold standard of treatment for these patients is to increase the supporting muscle strength around the joints, and to advise the patient to lose weight: even losing 10% of their body mass results in significant reductions in pain scores.  It is argued that many of these conditions could be largely prevented by keeping a healthy body weight and staying active in the first place. After all, these are weight-bearing joints, and if you are overweight you are asking a lot of your joints every time you move.   Similarly, from an Exercise Physiology perspective, we see many patients giving us highly creative “barriers” to exercise – reasons why they can’t or won’t prioritise physical activity in their lives, even when they are in pain and significantly overweight.  It is not uncommon to have patients say they would rather have surgery to “fix” their problem, than to increase their activity and allow their body to become stronger and lighter.  I am certain that a large part of this mindset comes from how “normal” it has become to be sedentary and overweight.  But does that make it OK?  Do you want to be “average”, if that’s what “average” has become?  Do you want to live to a ripe old age, only to be overweight and in pain for the majority of that time? I certainly don’t!

 

low res version What About my Kids?

It is more important than ever to keep our kids active, healthy and happy.  Structured exercise is not only crucial for developing little minds and bodies, it is also important for social and health reasons too.  Getting into the habit of being active early on can set you up for a lifetime of good habits, which is a gift that you can give your children for life.  For kids 5-17 years of age, aim for at least 60 minutes of moderate to vigorous activity daily; and up to several hours daily to achieve even greater health benefits.  Ideally this activity will be a mixture of strength and aerobic activity, which is where structured sports like soccer and netball, and active family time like cycling and walking the dog all come into the mix.  Of most importance is the new recommendations to limit use of electronic media (TV,computers, ipads etc) to less than 2 hours a day.  With childhood obesity on the rise, it is more challenging and hence more important than ever to aim for these goals.

 

 

Everyone is unique with their daily lifestyle, job requirements, and previous injury and health history.  If you need help fitting these guidelines into your lifestyle, or have concerns about previous health issues or injuries, a few sessions with an Exercise Physiologist will help you to work out a program that you can do on a daily basis, without pain, and ideally with ease.  Research has shown us time and time again that the most successful activity programs are achieved when the whole family gets involved and supports one another.  Our children model themselves off our behaviours – from food to exercise to language, and they are facing the most sedentary generation in history: let’s teach them from a young age how to be anything but “average”!

 

More information about healthy living, including references to other Australian Government guidelines concerning healthy weight and healthy eating, can be found at www.health.gov.au

 

REFERENCE LIST

 

http://www.health.gov.au/paguidelines

 

Healy, G.N., Dunstan, D.W., Salmon, J., Shaw, J.E., Zimmet, P.Z., Owen, N. (2008) Television time and continuous metabolic risk in physically active adults.  Med. Sci. Sports Exerc. 40(4) 639-645.

 

Sugiyama, T., Healy, G.N., Dunstan, D.W., Salmon, J., Owen, N. (2008) Joint associations of multiple leisure-time sedentary behaviours and physical activity with obesity in Australian adults. Int J Behav Nutr and Phys Act 5(35) 5868-5-35

 

Nelson, M.C., Gordon-Larson, P., Adair, L.S., Popkin, B.M. (2005) Adolescent physical activity and sedentary behaviour: patterning and long-term maintenance. American J of Prevent Med. 28(3) 259-266

 

Patrick, K., Norman, G.J., Calfas, K.J., Sallis, J.F., Zabinski, M.F., Rupp, J., Cella, J. (2004) Diet, Physical activity, and sedentary behaviours as risk factors for overweight in adolescence.  Arch Pediatr Adolesc Med 158: 385-390

 

More than half of all Australian adultsare not active enough.  Source: Australian Bureau of Statistics (ABS) 2013.  Australian Health Survey: Physical Activity, 2011-12. ABS Cat. No. 4364.0.55.004. Cnaberra: ABS

 

 

 

6 Things You Didn’t Know About Exercise Physiologists

1. The qualification matters.

Exercise Physiologists (EPs) are not just glorified personal trainers.  At the moment in Australia, it takes a minimum of 4 years of University training to earn a degree in Clinical Exercise Physiology, which includes over 400 hours of practical clinical experience.  This then permits the individual to apply for accreditation as an Exercise Physiologist with ESSA, the Australian body for Exercise Science.  This allows the EP to have the relevant insurance, professional contacts and medical referrals such as Medicare.  To maintain their accreditation, they much invest a significant amount of time and money annually into professional development courses around the country. 

 

 

 

 

2. There are Different Specialty Areas within Exercise Physiology.

 

Just like within Physiotherapy and medicine, an EP by law must graduate with qualifications and competency in all areas of Exercise Physiology, but will generally choose one or two specialty areas to base their career on.

 

These specialties include:

 

 

Cardiac Testing (eg ECG stress testing in hospitals);

Cardiac Rehabilitation (eg in-hospital following a heart attack);

Clinical Pilates;

Coaching (from kids through to elite level);

Neurological Rehabilitation (eg following a stroke or Parkinson’s Disease diagnosis)

Mental Health;

Musculoskeletal Rehabilitation (eg strengthening after acute sports injuries, or for injury prevention);

Chronic Pain Management (eg Low Back Pain);

Research (typically university-based); and

Public Health (eg weight management and disease prevention, education).

 

 

3. They are the future of our Health System.

In the last 5 years doctors globally have started to recognise the key role of exercise and weight management in prevention of increasingly common chronic diseases such as diabetes, high blood pressure, depression & anxiety, osteoporosis, cancers and so on.   With a health system that is currently in crisis (in terms of both costs and resources), EPs will be at the forefront of health care in the coming decades.  Take home message: don’t be surprised next time you see your GP and they prescribe 60 minutes of physical activity a day and 5 visits to an Exercise Physiologist instead of medication and a handful of tests!

 

4. A good training program may seem easy at first.

The Commando off The Biggest Loser will scream at you until you finish 50 chin-ups in your first session.  A “Bootcamp” instructor may demand you flip ridiculously huge tyres, regardless of your injury history.  An EP will not.  Every person has a unique set of challenges to work with, and it is imperative that both the EP and the client have clear and common goals established from the first session so that an individual program can be developed that will work for the long term.  The research tells us over and over that the quick-fix programs not only do not work, but tend to make the problem (whether it be weight, injuries or pain) worse in the long term.  Be patient, trust in the fact that you are in the best and most qualified hands, and acknowledge the relationship with your EP as the worthwhile investment into your health that it is.  Think of it like this: you can put in the time and money to be healthy now, or you can put in the time and money being sick later.  Both are hard.  You choose.

 

5. The best trainer in the world cannot make up for a shitty diet.

In this day and age I would find it hard to believe that anyone genuinely does not know that being sedentary, eating processed foods, and smoking are bad for your health.  But we still have the issue of increasing obesity and chronic disease.  Hence, we know that simply educating people is not the whole picture, and that is where an EP comes into the equation by helping you to create the best possible health and lifestyle plan for you and your family.

 

But here’s the catch: simply “buying into your health” by seeing an EP for exercise sessions and an eating plan won’t make you healthier – you have to actually put in the hard yards and stick to it.  If you are not meeting your weight loss goals and are working out every single day with your trainer while eating cereal, sandwiches, candy, soda, and other crap – don’t blame the trainer. Your weight, the way your body looks and your health are predominantly a function of what you put in your mouth. Exercise can positively alter what your body does with the food that you eat, in addition to the phenomenal emotional, physical, and mental benefits it offers.

 

The human body is an amazing machine and the knowledge that you can gain from working with an EP is an incredibly powerful tool; embrace it, and discover how good life can be when you achieve optimal health.

 

6. I am yet to meet a person who cannot benefit from a few sessions with an Exercise Physiologist.

Where most other health professionals are limited to fairly specific areas, an EP is truly is the “jack of all trades”.  They work with clients of every age, from healthy to sick, from elite athlete to chronically ill, from families to individuals.  They can: make you fitter; stronger; more injury proof; reduce your pain; improve your posture; improve your flexibility; make your spine stronger; rehabilitate your body (from toe injuries to hip replacements to heart attacks!); assist with weight loss – or weight gain; muscle sculpting; power; help to reverse chronic diseases (from depression to diabetes); even keep you fit during pregnancy and immediately after.  If you have ever wanted to improve any aspect of your body, health or happiness, then you could benefit from seeing an EP.

 

Exercise Physiology sessions can be expensive for many people, so to get the most out of your sessions, do some prep work beforehand.  Spend some time thinking about your goals, your main limitations, your strengths and weaknesses.  Write them down, along with any questions you may have.  Turn up on time, and listen to every word, and don’t be afraid to write notes!

What are you waiting for?!

 

– Kristy Shannon

B.Appl.Sc(HMS); M.PHTY

Kristy has a degree in Exercise Physiology from the University of Queensland and a Master’s Degree in Physiotherapy from Griffith University.  

 

An accredited EP can assist with safe rehabilitation from injury through to full fitness

An accredited EP can assist with safe rehabilitation from injury through to full fitness