Swimmer’s Injuries: What is swimmer’s shoulder?

Swimming is both a popular pastime and competitive sport, particularly within Australia where the pools and beaches are packed during the summer with locals and tourists alike as well as elite athletes training for their chance at a medal at the Olympics. In fact swimming is Australia’s most popular sport with over 3 million Australian’s regularly involved. It is also our most competitive sport on the international stage with 188 medals (60 gold) at the summer Olympics compared to our second highest sport, Athletics with 73 total medals (21 gold).

Competitive swimming consists of 4 different strokes with most swimmers focusing on one stroke (except for those individual medley swimmers). Despite this freestyle is by far the most common stroke performed, with athletes that compete in other strokes still swimming their fair share of freestyle each session. A competitive swimmer may often be required to swim 10-15km a day! That’s more than 2500 repetitions per shoulder. With such a high level of training and repetition it isn’t surprising that swimmer’s will often experience injuries throughout their career with shoulders, knees and spine being the main areas of concern

Shoulder injuries are by far the most common injury in swimmers with anywhere between 40-91% of competitors experiencing shoulder pain. Whereas most sports generate power from the legs, swimmers gain most of their movement from the upper body. At one point “Swimmer’s shoulder” was suspected to be due to impingement of the rotator cuff muscles, however further research has shown that shoulder pain in swimmers is multifactorial, including poor technique/biomechanics. As a result of these factors swimmer’s may experience conditions such as shoulder impingement, overuse injuries such as tendinopathies, muscle fatigue and increased shoulder laxity.  

So what can we do to help prevent and treat these injuries? Ensuring swimmers, coaches and health practitioners can identify early signs of injury and prevent where possible is of course the most ideal scenario. The most obvious step to preventing these types of injuries in swimmers is stroke correction. Correct stroke patterns to avoid overuse of smaller muscles and impingement as well as changes such as dropping elbow height, wider hand entry and earlier exit can help decrease these injuries in the shoulder. Minimising hand paddles and band sets can also help, especially when factors are identified pre-injury. 

 

An additional focus should be given to strengthening, endurance and flexibility exercises out of the pool such for the rotator cuff, shoulder blade muscles, core and lower back muscles. These can be exercises using a theraband or exercise ball, dumbbells and body weight and can often be guided by a health practitioner such as a physiotherapist or exercise physiologist depending on what is identified during an assessment. If an injury is already present then rest (such as avoiding aggravating strokes) followed by specific rehabilitation exercises and gradual return to full training load is optimal to achieve a return to sport and minimise the risk of re-injury.

Reference: Wanivenhaus, F., Fox, A., Chaudhury, S. and Rodeo, S., 2012. Epidemiology of Injuries and Prevention Strategies in Competitive Swimmers. Sports Health: A Multidisciplinary Approach, 4(3), pp.246-251.OTG – Create Custom Gear. 2021. The 10 Most Popular Sports in Australia. [online] Available at: <https://onthegosports.com.au/blogs/news/the-10-most-popular-sports-in-australia>.

Know More about Motor Neurone Disease

Motor Neurone Disease (MND) is the name given to a group of diseases which result in the degeneration of motor neurones. These motor neurones are responsible for communication from the brain to our muscles for required actions we utilise everyday such as movement, speech, swallowing and breathing. MND has several subtypes depending on origin and presentation of symptoms such as Amyotrophic Lateral Sclerosis (ALS), Primary Lateral Sclerosis (PLS), Progressive Muscular Atrophy (PMA) and Progressive Bulbar Palsy (PBP).

While MND is the generic term used in many countries such as Australia, New Zealand and the UK, you may have heard of several other names used, especially from the United States such as ALS or Lou Gehrig’s disease, after an American baseball player who died from MND. Well known scientist Stephen Hawking died of a rare form of early onset, slow-progressing MND back in 2018. Recently there was a large social media campaign for raising awareness of MND/ALS you may remember, the “Ice bucket challenge”. Whilst the Ice Bucket Challenge went viral back in 2014, several associations and Government’s continue to promote the challenge as a way to raise funds for MND research.

There is no known cause of MND with 90% of cases believed to be spontaneous and 10% of cases being hereditary and linked to a genetic mutation of a gene found in either parent, with this particular gene tested for given a family history. MND is diagnosed via a process of elimination utilising an individuals history of symptoms as well as nerve conduction tests, muscle biopsies and blood tests. Most individuals will pass away within 2-3 years of their diagnosis. 

Once diagnosed the main focus on treatment is to minimise symptoms and prolong quality of life. In Australia only one medication is currently approved for use (Riluzole). While research continues to explore other methods for treatment and even a cure for MND, current research has shown that a multidisciplinary team can provide a coordinated response to an individual’s treatment. Below is a table from MND Australia which explains the benefits of each member of the team. 

General Practitioner

The general practitioner (GP) is usually the first and primary person of contact for people with MND. GPs can carry out the basic neurological examination, and recognise symptoms which indicate the need for referral to a neurologist. The GP will then liaise with the neurologist, other specialists and allied health care providers in order to provide the best possible standard of care to maintain quality of life.

Neurologist

The role of the neurologist is to undertake tests which diagnose MND and exclude other conditions which may be amenable to different treatments. The neurologist will be able to monitor the progress of the disease and help to initiate supportive care at appropriate times. Sometimes, the neurologist may encourage a person to seek a second opinion from another neurologist.

Physiotherapist

A physiotherapist helps to maintain the physical activity and mobility of the body, make the most of muscle strength and alleviate or prevent joint stiffness and pain caused by wasting, spasticity and cramps. Physiotherapists can instruct carers in a range of passive exercises, and the techniques of positioning and transfer to avoid injury to themselves or the person with MND.

Occupational Therapist

An occupational therapist (OT) helps to maintain mobility, function and independence. OTs can advise on different ways of performing tasks and the selection, acquisition and adaptation of disability aids. Occupational therapists can visit private homes to advise on equipment or home alterations.

Orthotist

An orthotist can construct and fit braces and spints that provide support and increase mobility. 

Speech Pathologist

A speech pathologist (SP) helps in the management of communication and swallowing problems. Communication aids range from simple manual systems such as alphabet boards, to voice-synthesising computers that can be operated from a single soft-touch switch. Speech pathologists can assess and advise on different swallowing techniques, food preparation and selection. This may be done in collaboration with a dietitian who can provide dietary and nutritional advice.

Community Nurse

A community or district nurse can provide a range of nursing and ancillary services to people in their own homes. Services are usually obtained by referral from a health professional such as a GP.  Provision of services varies from state-to-state so check with a GP or your state MND association.

Social Worker/ Psychologist

A social worker, psychologist, or accredited counsellor provides counselling on the psychological and emotional aspects of MND. In addition, a social worker offers advice on legal and accommodation services, and financial supplements available in the local community, or through Federal, state, territory or local government programs.

Palliative Care Specialist

Palliative care specialists can help with emotional support and advance care planning. They can also advise about medications to manage breathing difficulties and pain.

There are now several MND-specific clinics and programs of care in Australia. Contact your state MND association for more information.

MND Association Advisor

MND Advisors assist people with motor neurone disease connect to the services they need. MND Advisors also offer ongoing information to families and service providers as questions arise or needs change.

While exercise is an essential component of treatment for MND, it is important to note that not all exercise is suitable. Exercise should be carried out under supervision of a trained health professional to ensure injuries are avoided. While it is important to increase strength and function during the early stages of MND to increase an individual’s baseline strength and fitness, overtraining can become a concern, particularly during the latter stages of the disease in which individuals may lose function and find it difficult to recover. 

Training should focus on cardiovascular exercise, strength training, balance and functional exercises for both upper and lower limbs as well as fine and gross motor skills. Ongoing work for speech pathology and self care techniques should be maintained throughout the treatment process to ensure prolonging of function as well as compensatory techniques once an individual is no longer able to perform a particular task.

 

If you are looking for additional information regarding MND in Australia, including updates in research or donating, please check out MND Australia’s page at https://www.mndaust.asn.au/Home.aspx 

What is Peripheral Artery Disease (PAD)?

What is Peripheral Artery Disease (PAD) and is it safe to exercise with it?

Peripheral arterial disease (PAD), also known as Peripheral Vascular Disease is the reduced circulation of blood flow to a body part, other than the brain or heart due to narrow or blocked blood vessels. Arthroscerotic disease most commonly affects the arterial supply of blood flow to the lower limbs, however it may also affect the arteries of the upper limbs too. Physiologically PAD is characterised by atherosclerotic stenosis (narrowing) or occlusion (blockage) of the arteries due to the build up of fatty deposits within the blood vessels reducing blood flow to the working muscles. When these physiological changes occur, it presents in a number of symptoms whilst also affecting an individual’s functional ability and reducing their exercise tolerance.

How common is it?
It is estimated that 3-10% of the general population have PAD, with this number increasing to 15-24% in people aged 70 years and older.

Risk factors:
Diabetes, smoking, obesity, sedentary lifestyle, hypertension (high blood pressure), dyslipidemia (elevated cholesterol or fats in the blood).
People with PAD are at an increased risk of cardiovascular events such as heart attack and stroke.

What are the symptoms of PAD?
Intermittent claudication pain is the most common symptom of PAD, which is typically described as a ‘cramp-like’ pain, ache or tiredness affecting the calf and sometimes the thigh and buttocks when walking or other similar activities. Pain typically increases with an increase in exertion and is only relieved by rest. Other symptoms which may present are non-healing skin ulcers, blue or purple tinge to the skin, swelling, coldness of the affected body part, numbness, pins and needles and muscular weakness.

One of the most effective treatments for improving exercise capacity and functional ability is exercise therapy which is recommended as the first line of treatment for those with intermittent claudication pain due to PAD.

Is it safe to exercise with claudication pain?
Claudication pain develops due to the build up of plaque of the inner arteries, therefore narrowing the channel for blood to flow through. During exercise this decrease in blood flow reduces the amount of oxygen that’s received by the working muscles, resulting in leg pain. It is safe to exercise at a moderate intensity with intermittent claudication pain, however exercise should stop if claudication pain becomes severe.

For individuals with PAD, it is recommended to begin with 10-20 minutes of continuous aerobic type exercise 3x per week, and gradually build up to 40 minutes of continuous moderate intensity exercise per session. A long term goal for individuals with PAD would be to meet 150 minutes of aerobic activity each week as recommended for older adults as aerobic exercise leads to significant improvements in pain-free and maximum walking distance.

It is recommended that individuals with PAD engage in resistance based exercise training at least 2 to 3 training sessions per week performing 3 sets of 8-12 repetitions on non-consecutive days. Resistance exercise sessions should be progressive and gradually work towards moderate to high intensity (60-80% of 1 repetition maximum), where it is safe and appropriate ensuring whole body movements are incorporated to increase muscular strength and endurance of individuals.

Benefits of exercising for those with PAD:

Exercise aims to alleviate symptoms, improve functional capacity and reduce the risk of cardiovascular diseases such as heart attack and stroke in those with PAD. Further to this, exercise improves pain-free walking distance, reduces cholesterol, improves blood pressure and muscle morphology, meaning increasing an individual’s ability to exercise tolerance.

References:
Askew, C. D., Parmenter, B., Leicht, A. S., Walker, P. J., & Golledge, J. (2014). Exercise & Sports Science Australia (ESSA) position statement on exercise prescription for patients with peripheral arterial disease and intermittent claudication. Journal of Science and Medicine in Sport, 17(6), 623-629.

Importance of Falls Prevention in the Elderly

Falls are a major public health concern with around 30% of adults aged over 65 experiencing around one fall each year accounting for 40% of injury-related deaths in this age population. One of the most life-threatening injuries caused by falls are hip fractures due to postoperative complications or from effects of bedrest leading to death in around 25% of people. With this being said it is extremely important not only to prevent falls, but to know how to minimise the impact of falls. (“Info about falls | Australian and New Zealand Falls Prevention Society”, 2021).

To identify your risk of falls you can take a short falls risk assessment here: https://studioxphys.com.au/exercise-physiology-quiz/

Preventing falls:

Some things that can be done immediately to decrease the risk of falls include:

  • Arrange your house so there are minimal tripping hazards around

  • Have your hearing and vision checked regularly

  • Limit the amount of alcohol you drink as this decreases balance and reaction time

  • Stand up slowly to avoid dizziness due to sudden changes in blood pressure

  • Wear non-slip socks and shoes

  • If you think your medication is causing you dizziness as a side effect, tell your doctor as there may be a better option for you.

  • Always tell your doctor if you have fallen since your last check-up, even if you weren’t hurt

  • Especially if you are at a very high risk of falls, it can be useful to obtain an emergency button on a necklace or bracelet that you can wear when you’re alone

An exercise program designed for your needs can significantly reduce your risk of falls. An accredited Exercise Physiologist can help with this.

(Liu-Ambrose et al., 2019).

Preventing falls through physical activity:

  • Stay physically active!

  • Increase balance and reaction time

  • Increase bone density to decrease the likeliness of fractures due to falls

  • Increase strength (this can help you to catch yourself or get up after a fall)

(Lee & Kim, 2016).

Getting up after a fall:

Especially if your risk of falls is quite high, it can be very beneficial to be prepared if the event does occur. 

Falling can be quite startling and upsetting, so if it does occur:

  •  Try to remain calm. Remain on the ground for a few moments to allow the shock to wear off so you can properly decide if you are hurt.

  • If no help is available, carefully roll over to your side.

  • Slowly get onto your hands and knees and crawl to a stable chair.

  • Hold the seat of the chair and slide one foot forward so it’s flat on the ground and try to bring your body to turn around and sit on the chair.

  • If you are hurt or can’t get up on your own, call 000.

(“Prevent Falls and Fractures”, 2021).

The idea of falling can be a scary one, however, there is a lot you can do to protect yourself or a loved one! For help getting started, speak to one of our lovely staff members at StudioXphys.

References:
Info about falls | Australian and New Zealand Falls Prevention Society. Anzfallsprevention.org. (2021). Retrieved 22 April 2021, from https://www.anzfallsprevention.org/info/.
Liu-Ambrose, T., Davis, J., Best, J., Dian, L., Madden, K., & Cook, W. et al. (2019). Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall. JAMA, 321(21), 2092. https://doi.org/10.1001/jama.2019.5795 
Lee, S., & Kim, H. (2016). Exercise Interventions for Preventing Falls Among Older People in Care Facilities: A Meta-Analysis. Worldviews On Evidence-Based Nursing, 14(1), 74-80. https://doi.org/10.1111/wvn.12193 
Prevent Falls and Fractures. National Institute on Aging. (2021). Retrieved 22 April 2021, from https://www.nia.nih.gov/health/prevent-falls-and-fractures.

Mental Health and Exercise: What is the link?

Being able to optimise the whole body’s health is imperative in leading a fulfilled life, yet confronting, learning about and promoting mental wellness is often not prioritised. Maybe it is because we cannot physically see our mind; emotions, moods, stress and those alike however, are certainly felt and experienced creating positive or non-desired mental health states.

What causes mental wellness to be poor?

Anxiety impacts 1 in every 6 Australian’s and is the leading mental health concern worldwide . Depression, post traumatic stress disorder (PTSD), bipolar, eating disorders among others, contribute to altered psychological and physiological states within the body. Sensations, belief systems and thought patterns become heightened and therefore invite the body to respond; physiologically, the heart rate and rate of breathing might increase, making you feel like you are overstimulated, overwhelmed and/or ready to run. Psychologically, negative self talk, poor emotional regulation and a sense of separation from self can also be felt and observed. There isn’t one causation factor for mental illness, but past exposure to traumatic events and experiences, continual over or under stimulation as well as biological and physiological changes in body can be contributing factors.

How does this impact overall health?

Let’s talk about mental health in two categories; acute and chronic. Acute mental health is the onset of distressing mental health symptoms requiring immediate treatment and care; this can be a brand new occurrence or a worsening of a long term condition. Chronic mental health is when symptoms present for longer than usual periods of time, often greater than 3-6months. When experiencing either acute or chronic mental illness, the body’s internal physiology  is exposed to constant changes within the nervous system which effects ones ability to naturally regulate vital functions within an optimal capacity. When the body is under this type of stress, other illness and co-morbidities become more prevalent such as chronic obstructive pulmonary disorder (COPD), asthma and lower back pain. Those with mental illness are also 2-3 x more likely to be effected by Type 2 Diabetes Mellitus and are at a 4 x greater risk of cardiovascular disease (CVD) [1]

Where does exercise come in?

Research shows that different conditions respond best to certain exercise stimulus, however largely aerobic exercise, such as walking, swimming, running and other ‘huff/puff’ inducing activities, as well as resistance training, body weight or weight based activity, positively aids in impacting mood, emotional regulation, stress states, self-efficacy and overall enjoyment and satisfaction [1,8,9,10].

When you undertake exercise, there are a number of things that happen inside your body. The rate of your heart can increase, bringing greater blood flow to areas of the body such as your extremities (arms and legs) as well as to your brain, providing increases in energy through greater oxygen uptake, and overall positive functioning due to the utilisation and release of certain chemical hormones such as serotonin, which aids in emotional processing and dopamine, which supports memory and motor development. 

Another major factor that plays a large role is the autonomic nervous system, which houses two important subsystems. The sympathetic nervous system is the fight/flight response that can be felt in states of stress, accelerating the heart rate and making you feel like you are on over drive. For those that live with anxiety, this can become a constant state of being, therefore adopting practices that develop whole body awareness such as Yoga, Tai Chi and Qi Gong, invite the parasympathetic nervous system to come in to play; this system down regulates the body, lowers the heart rate and prepares the body for rest, digestion and sleep. 

Seeing an Accredited Exercise Physiologist, someone who specialises in exercise movement prescription and the physiological processes of different conditions (including mental illnesses), is a great place to start if you are unsure which type of exercise is best for you.

Facts and Tips: 

  • Fact: Through research, exercise, aerobic in particular, has been found to show increases and improvement in neural cell development (neurogenesis) within the hippocampus (an area of the brain which is responsible for learning and memory)! [5,6]
 
  • Tip: Start small with your exercise; 5-10mins a day is enough to start to build a routine, gradually increasing to your desired goal!
 
  • Fact: Participating in group based exercise has been shown to positively boost enjoyment, self-efficacy, and sense of community via building social support system [10]
     
  • Tip: To start with, think about exercise as just movement. If you say to yourself, ‘lets just get some movement in!’, you might be more accepting of just popping out to the garden, going for a quick walk or moving your body by doing something that you love e.g. hiking, swimming, climbing, yoga etc. 
 
  • Fact: 12% of cases of depression could be avoided by participating in just ONE hour of exercise per week [8]. 

So what is the link?

Linking the knowledge of how the body works, how your body works and what can positively impact it, is vital in optimising overall health and wellbeing. Being able to educate, listen and learn about what you are experiencing builds autonomy and ownership over your own health, therefore growing confidence in knowing what you need, when you need it and how much.

Although we see the profound benefits of exercise on mental health outcomes, it is important to understand, like many things, that it will impact each individual differently. Therefore, it is highly beneficial that you seek medical advice before commencing exercise and surround yourself with a team of supportive health professionals such as a psychologist, good general health practitioner and an accredited exercise physiologist. When you have support from a team that understands and has your best interests at heart, your wellness has the best chance to positively grow. 

For more information, there is a great downloadable eBook on Exercise and Mental Health available over at https://exerciseright.com.au/mental-health/ 

  • Guidelines and descriptions for specific conditions can be found in future articles.

Samantha Cameron

Accredited Exercise Physiologist, Certified Yoga 575hrs Teacher

References: 
  1. Exercise and Mental Health eBook, ESSA, 2018
  1. Di Liegro, C. M., Schiera, G., Proia, P., & Di Liegro, I. (2019). Physical Activity and Brain Health. Genes, 10(9), 720. https://doi.org/10.3390/genes10090720
  1. Sharma, A., Madaan, V., & Petty, F. D. (2006). Exercise for mental health. Primary care companion to the Journal of clinical psychiatry, 8(2), 106. https://doi.org/10.4088/pcc.v08n0208a
  2. Heijnen, S., Hommel, B., Kibele, A., & Colzato, L. S. (2016). Neuromodulation of Aerobic Exercise-A Review. Frontiers in psychology, 6, 1890. https://doi.org/10.3389/fpsyg.2015.01890
  1. Kirk I. Erickson, Michelle W. Voss, et. Al Feb 2011, 108 (7) 3017-3022; DOI: 10.1073/pnas.1015950108 Exercise training increases size of hippocampus and improves memory
  1. Gosnell, S. N., Meyer, M. J., Jennings, C., Ramirez, D., Schmidt, J., Oldham, J., & Salas, R. (2020). Hippocampal Volume in Psychiatric Diagnoses: Should Psychiatry Biomarker Research Account for Comorbidities? Chronic Stress. https://doi.org/10.1177/2470547020906799
  1. Harvey, S. B., Øverland, S., Hatch, S. L., Wessely, S., Mykletun, A., & Hotopf, M. (2018). Exercise and the Prevention of Depression: Results of the HUNT Cohort Study. The American journal of psychiatry, 175(1), 28–36. https://doi.org/10.1176/appi.ajp.2017.16111223
  1. How to look after your mental health using exercise, https://www.mentalhealth.org.uk/publications/how-to-using-exercise 
  1. S. Rosenbaum, A. Tiedemann, C. Sherrington, J. Curtis, P.B. Ward, dx.doi.org/10.1016/j.jsams.2014.11.161 2014; Physical activity interventions for people with mental illness: A systematic review and meta-analysis, 
  1. Irakli Mania, M.D. Harun Evcimen, M.D. Maju Mathews, M.D., M.R.C.Psych. Department of Psychiatry Drexel University College of Medicine Philadelphia, Pennsylvania 2006, Exercise for mental health 

What is Chronic Obstructive Pulmonary Disease?

What is COPD?

 

Chronic Obstructive Pulmonary Disease, also referred to as COPD is the collective term for a number of lung diseases that prevent proper breathing due to inflammation of the lungs, which often cause difficulty breathing, coughing and wheezing. The main causes of the disease are smoking or long term exposure to air pollutants without adequate ventilation (this may come from a living environment or an occupational environment). COPD is a progressive condition, which means that there is no cure, however, what we can do is slow down the rate at which it gets worse and treat the symptoms of it through physical activity, medications, and breathing techniques.

There are 4 stages of COPD:
These stages are based on your symptoms, severity of the condition and your spirometry lung test FEV1 results. FEV1 refers to ‘Forced Expiratory Volume’, which is the amount of air you can breathe out of your lungs in the first second of expiration. The severity increases as your FEV1 decreases.

  1. Mild
    You may not notice any symptoms or may have some shortness of breath when you do something tiring like walking up a hill.
    (ie: FEV1 at least 80% of predicted value).
  2. Moderate
    When going for a walk, you may have to stop every few minutes to catch your breath.
    (ie: FEV1 at least 50% to <80% of predicted value).
  3. Severe
    It may be difficult to leave the house or do your daily routine due to shortness of breath.
    (ie: FEV1 at least 30% to <50% of predicted value).
  4. Very severe
    You may have lung or heart failure and could be short of breath when at rest. At this stage the disease greatly impacts your daily functioning.
    (ie: FEV1 at least <30% of predicted value or FEV1 <50% of predicted values plus severe chronic symptoms).

What stage you’re in can indicate the quality of life and what treatment interventions may be necessary. 

How does it affect me?

In COPD, the airways in the lungs are inflamed and damaged. As a result, instead of allowing air to flow freely, they collapse and close up when you exhale. This causes air in the deeper parts of your lungs to get trapped which means you are not getting rid of carbon dioxide as well. This signals to the body to increase the rate and depth of breathing. As more and more air gets trapped, less room is left for fresh air which means you also don’t receive as much oxygen. This causes many issues and can have a huge impact on your life as a result. 

 

Managing symptoms through Pursed Lip Breathing (PLB):

One inexpensive way we can do this is through something called pursed lip breathing. One way to think of doing this is when you tighten your lips to blow out candles. The breath out should also be longer than the breath in. This technique forces the air to come out more slowly and as a result increases the pressure in the lungs. This increased pressure helps force the weak airways to stay open and also gives the lungs more time to allow carbon dioxide to move up to the mouth to be exhaled. When we can release more carbon dioxide, the shortness of breath decreases which is one of the most prominent symptoms of COPD. There is strong research to show that PLB can decrease dyspnea (shortness of breath) and increase the exercise capacity in those with COPD.

Contact us to learn more about how you can better manage your chronic breathing problem using exercise and self-management strategies.

References:

ALA. (2015, September 25).American Lung Association [Video Reference]. 

Devine, J.F. (2008). Chronic Obstructive Pulmonary Disease: An Overview. American Health & Drug Benefits (7): 32-42

Mayer, A.F., Karloh, M., Santos, K., Pereira de Araujo, C. L., Gulart, A.A. (2018). Effects of acute use of pursed lip breathing during exercise in patients with COPD: a systematic review and meta-analysis. Physiotherapy, 104(1), 9-17. https://doi.org/10.1016/j.physio.2017.08.007

Yang, Y., Wei, L., Wang, S., Ke, L., Zhao, H., Mao, J. (2019). The effects of pursed lips breathing combined with diaphragmatic breathing on pulmonary function and exercise capacity in patients with COPD: a systematic review and meta-analysis. An International Journal of Physical Therapy. https://doi.org/10.1080/09593985.2020.1805834

Why should I be exercising whilst undergoing cancer treatment?

Do you know that there is growing evidence that suggests exercise should be used as an adjunctive therapy with patients undergoing chemotherapy, radiation or immunotherapy treatment as it not only provides greater tolerance to therapies, but also increases their effectiveness.

 

Cancer in our community has become all too common with statistics stating that an Australian is diagnosed with cancer every 4 minutes. Cancer not only impacts a person’s physical and mental health, it has a ripple effect impacting people’s family, work, social life and independence.

 

Advances in anti-cancer treatments mean that people are living longer with cancer, however are not living as well as they could be due to the negative side effects associated with treatment. Many of these common side effects such as fatigue, brain fog, loss of muscle mass and strength, as well as psychological symptoms can remain once active treatment has finished and consequently put people at higher risk of developing other cancers and comorbid conditions such as osteoporosis, diabetes and cardiovascular disease.

 

Ongoing research supports that exercise is a safe and effective intervention to counteract many of the negative physical and psychological effects of cancer treatment. People who exercise regularly following a cancer diagnosis experience fewer and less severe side effects, as well as lowering their risk of cancer recurrence and cancer- specific mortality for some cancers.

The benefits of exercise for people living with cancer include:

 

  • Reduces cancer-related fatigue.
  • Improves quality of life during treatment.
  • Improves physical function to help with everyday activities.
  • Improves immune function.
  • Improves strength and flexibility.
  • Maintenance of muscle mass and bone mineral density.
  • Reduces stress, depression and anxiety.
  • Reduces hospitalisation duration.
  • Improves chemotherapy competition rates, and effectiveness of chemotherapy. 
  • Reduces risk of developing new cancers and other diseases such as osteoporosis, diabetes and cardiovascular disease.
  • Improves survivorship rates vs non-exercise groups.

Cancer tumours change the blood vessels around them which can restrict the amount of cancer-killing agents reaching the cells, however emerging research suggests that exercise acts to normalise the blood vessels around these tumours. Therefore exercise may improve the effectiveness of treatments as more drugs and more of the body’s natural defence mechanisms can continue to attack the disease.

 

As exercise improves our overall immune system, it’s possible that cancer cells can be flooded by a greater amount of our body’s natural cancer-killing agents. It is proposed that exercise acts to control some of the hormones that stimulate the spread of cancer and that exercise may change the way the genes associated with cancer are switched on and off. Exercise turns on genes that slow the spread of cancer, therefore suppressing tumour growth which may reduce the relative risk of cancer related death by up to 50-60%.

 

Exercise prescription needs to be highly individualised for those living with cancer. The exercise prescription that works best is based on a person’s medical history, exercise and physical activity history, treatment plan and severity of condition. It is recommended that exercise is prescribed by an Accredited Exercise Physiologist to best maintain a person’s health, minimise the side effects associated with treatment and maximise rehabilitation and survivorship.

References:
Cormie, P. (2019). Ex-Med Cancer. Ex-Med Cancer Final Report: A community based exercise medicine program for cancer survivors.
Cormie, P. (2019). Exercise and Sports Science Australia. Exercise and Cancer E-book. 
Cormie, P. (2016, March 19). “A new contender in the fight against cancer”. https://www.youtube.com/watch?v=xIQh4fUZkJs

Managing Arthritis with Massage

What is Arthritis?

Inflammation, the process that causes the redness and the swelling in your joints damage to joint tissues caused by the disease process or from wear and tear muscle strain caused by overworked muscles attempting to protect your joints from painful movements fatigue caused by the disease process which can make your pain seem worse and harder to handle.

In addition, the emotional ups and downs of arthritis may affect your pain. If you feel depressed and stressed, your pain may seem worse. You may get caught in a cycle of pain, depression and stress that makes everything seem harder to handle.

Pain does not have to be a part of daily life. By taking action to reduce pain, you may find that even routine tasks that have become difficult–like bending down or opening a jar–become easier.

Minimizing and Managing Pain using Massage:

  • Your mind plays an important role in how you feel pain and in how you respond to illness. People with arthritis often feel helpless and depressed about their condition. With these feelings come decreased activity poor self-esteem and increased pain. So, building a sense of control by adjusting your thoughts and actions is an important part of pain management.
  • Remedial Massage is 1 excellent way to bring Arthritis under control.
  • Regular Massage therapy using selected oils and Hot stone Therapy can have a positive impact on a client with Arthritis oils such as Ginger, Mustard, Cinnamon and Wintergreen all help to reduce inflammation and increase circulation thereby lowering a client’s inflammatory levels, increasing endorphins, and reducing cortisol brought on by stress
  • Massage using Hot Stone Therapy relaxes the muscles surrounding the inflamed joints and reduce the synovial fluid that is protects the joints.
  • As the pain levels drop and muscles relax, with the release of endorphins brings a sense of relaxationand wellbeing.
  • Hot and cold treatments. Using either heat or cold treatments can reduce the stiffness and pain of arthritis.

Cold packs numb the sore area. They are especially good for severe joint pain and swelling caused by a flare (a period during which disease symptoms return or become worse). Heat treatments relax your muscles. You can use dry heat methods such as a heating pad or heat lamp or moist heat methods, such as a bath or Hot Stone Massage Therapy

  • Pain and stress have similar effects on the body. Muscles become tight and breathing becomes fast and shallow. Heart rate and blood pressure go up. Relaxing can help you reverse these effects. It gives you a sense of control and well-being and makes it easier to manage pain.9whilst there is no cure for Arthritis, the use of regular Massages and specific oils to reduce inflammation, a healthy diet and weight bearing exercises , and medication can all contribute to less pain and an active Lifestyle .

Is It Safe To Exercise During Pregnancy?

It’s pretty obvious that the female body changes a lot during pregnancy, both physically but also how the soon to be mother feels in her body. This is such an exciting time, but these changes can be sudden and potentially daunting. These women may be unsure if they can exercise at all during pregnancy, what types of exercise is safe to do, and how to modify accordingly during each trimester. And it is completely normal to have these questions!

Below are 5 main areas that change during pregnancy.

  • Hormonal; Relaxin increases and peaks in week 12, increasing the laxity of ligaments in the whole body.
  • Cardiovascular; cardiac output (the amount of blood pumped by the heart in a minute) increases by 50% due to extra blood volume.
  • Musculoskeletal; Posture changes due to extra body weight being carried. Abdominal muscles lengthening and more weight being beared down on the pelvic floor muscles.
  • Respiratory; Increase in oxygen being consumed which results in more carbon dioxide being produced. This results with feelings of breathlessness, more easily. Eg. climbing a flight of stairs and then being puffed out.
  • Metabolic; In early pregnancy, the body’s insulin sensitivity increases. In late pregnancy, there is a decrease in insulin sensitivity. This can have an impact on our blood glucose levels.

 

As we now know, the body is going through a wealth of changes in this time, so it is not uncommon for a new or pre-existing medical condition to present itself during pregnancy. These conditions can include, but are not limited to;

  • Urinary incontinence
  • Gestational diabetes
  • Pre-eclampsia
  • Pubic symphysis disorder
  • SIJ dysfunction
  • Rectus diastasis
  • Post-natal depression

 

Now with all of these changes and conditions being said, YES, it is very likely it is still safe to exercise. Your Exercise Physiologist/Physiotherapist will take all of these things into consideration and be able to help you safely exercise throughout the duration of your pregnancy. They can also help with the recovery process post-birth.

 

Why should I exercise during pregnancy?

 

Exercise and physical activity has an enormous list of benefits to the body without pregnancy, and these carry through to pregnancy too. Exercise can positively impact on metabolic changes by reducing the rates of and severity of pre-eclampsia and hypertension (high blood pressure). It is known that exercise decreases insulin resistance, therefore, potentially decreasing the likelihood of gestational diabetes. Endorphins are produced during and post-exercise, giving us that happy, feel-good feeling that aids in reducing pain and stress. This is particularly beneficial to those with post-natal depression. If you are someone experiencing incontinence, exercises can be provided that aim to strengthen the pelvic floor muscles that are now aiding in supporting the increase in pressure from growing and carrying a baby. This is only a very very short list of benefits of exercise during pregnancy, but it is evident that ultimately, exercise can decrease the severity and rate of pregnancy symptoms.

 

If you are in the stages of trying to conceive, are pregnant at any trimester or have recently given birth and would like to continue/start exercise but you’re unsure if it’s safe and where to start, please reach out to an Exercise Physiologist/Physiotherapist and they can guide you safely through this journey.

***Please note that every pregnancy is different and it is important to seek clearance from your GP/obstetrician. Some medical conditions may be contraindicated to exercise.

Abu, M. A., Ghani, N. A. A., Shan, L. P., Sulaiman, A. S., Omar, M. H., Ariffin, M. H. M., … & Man, Z. C. (2017). Do exercises improve back pain in pregnancy?. Hormone molecular biology and clinical investigation, 32(3).
Barakat, R., Pelaez, M., Lopez, C., Montejo, R., & Coteron, J. (2012). Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial. The Journal of Maternal-Fetal & Neonatal Medicine, 25(11), 2372-2376.
Brown, J., Ceysens, G., & Boulvain, M. (2017). Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes. Cochrane Database of Systematic Reviews, (6).
Campolong, K., Jenkins, S., Clark, M. M., Borowski, K., Nelson, N., Moore, K. M., & Bobo, W. V. (2018). The association of exercise during pregnancy with trimester-specific and postpartum quality of life and depressive symptoms in a cohort of healthy pregnant women. Archives of women’s mental health, 21(2), 215-224.
Daley, A. J., Foster, L., Long, G., Palmer, C., Robinson, O., Walmsley, H., & Ward, R. (2015). The effectiveness of exercise for the prevention and treatment of antenatal depression: systematic review with meta‐analysis. BJOG: An International Journal of Obstetrics & Gynaecology, 122(1), 57-62.

How to Get the Most Value Out of Your Physiotherapy Appointments

Physiotherapy can evoke many different emotions and provide different experiences for everyone. Whether it’s your first or twentieth time attending a physiotherapy appointment, it can be an exciting, stressful, emotional, painful, or even confusing experience. At StudioXphys we strive to make each consultation as enjoyable, fulfilling, and rewarding as possible for all of our clients, and the following list provides a few examples of what you can do to significantly improve the experience for yourself, as well as for your physiotherapist.

1.      Come prepared with goals – the more specific the better!

Helping people achieve their goals is one of the most enjoyable parts of being a physiotherapist, however, if we aren’t given specific goals it can make our approach to planning the rehabilitation journey a difficult process. The most common response when we ask our clients what their goals are is, “I want to be pain free”. While this is a great goal and something we want to help everyone attain, it doesn’t give us a specific goal to work towards in our treatment plan. Instead of saying, “I want to be pain free”, try to rephrase it as a SMART (Specific, Measurable, Attainable, Relevant, and Time based) goal. An example would be, “I want to be pain free on my follow through so I can improve my golf swing and play 18 holes of golf in 6-8 weeks ”. Please come prepared with one or more SMART goals relevant to whatever it is that you want to get back to doing so we can personalise your treatment plan to help you achieve your goal(s) as eff

iciently as possible!

2.      Come prepared with as many details surrounding your symptoms as you can

If you have booked in for a physiotherapy appointment start thinking about the nature of your symptoms so when you discuss them with your physiotherapist so they can better understand your condition, and come to a quick and accurate diagnosis as quickly as possible. Some examples of what to think about would be how long you’ve had your symptoms for, what activities or movements make them worse, how they are affecting your weekly routines, what makes them feel better, what time of the day they come on, etc. The more detail you can give the easier it will be to formulate an accurate diagnosis and create an accurate and optimal treatment plan.

3.      Have realistic expectations about the time it will take to heal

Everyone wants a quick fix these days, however, this is usually unrealistic when it comes to the human body. Our bodies have an amazing ability to heal over time and there are many strategies that we can put into place to accelerate this process throughout the stages of healing, but the reality is it takes weeks (low grade muscle strain), months (torn ligament), and sometimes even over a year (severe fractures) for some of the structures in our body to heal completely! The healing process continues long after the pain has decreased, and it is extremely important to continue to follow the treatment plan until the affected structures have completely healed to reduce the risk of reinjury or sustaining an injury elsewhere. Trust your physiotherapist’s recommendation for the expected time of the recovery, and ask questions if you don’t understand why it may take longer than you expected.

4.      Ask questions

Come to each consultation prepared (especially the first one) to ask any questions that you want to know regarding your injury or condition. We take great pride in educating our clients, answering any questions they have to the best of our ability, and making sure that we are on the same page in terms of expectations, understanding, and reasoning for the plan that we’ve put in place. Sometimes you may think of questions in between sessions and then forget them during your consultation – if this is the case, make a note in your phone or write them down on a piece of paper and bring these questions to each consult to discuss with your physiotherapist.

5.      Commit yourself to the routine that has been proposed by your physio

Your time with your physio during each session will be valuable but limited. They will treat you, educate you, and provide the best plan for you to achieve your goals, but what you do in between sessions is where all the magic happens! Be honest if you haven’t kept up with the plan that they have put in place, and let them know if it’s unrealistic / not working for you as soon as possible so they can modify it and work together with you to make it more achievable. We commit lots of time to planning each follow up appointment assuming that the plan set out in the previous meeting has been followed, so be honest, committed, and realistic when approaching your rehabilitation.

6.      Come prepared with any relevant paperwork or medical history

If you have any records or information to help us better understand the injury or condition that you’re dealing with, or any other past medical history, please bring this to your first appointment. Examples would include enhanced primary care plans (EPC), medical imaging reports (MRI, ultrasound, Xray, etc.), lists of medications, post-operative instructions/restrictions, past injury history, etc.

7.      Stay positive and have fun!

Physiotherapy is not always an easy process, however, if you follow the previous tips you will be much more likely to enjoy the process, significantly improve your quality of life, and achieve all of your goals!