Should you exercise after your treatment?

This is an interesting question, and one that we get multiple times a day.

We asked our Massage Therapist Lewis Horenko to give us his thoughts, as he also has a background in Sports Science.

The first thing to say is that the answer will vary depending on the injury you have, as people with mild aches are very different to people in severe nerve pain. But the findings of one study are worth considering when we look at this.

In this study, people were given an ultrasound to measure the thickness of the Lumbar Multifidus muscle, which is a key lower back stabilising muscle. Then they had their back adjusted (aka ‘cracked’). Then they had another ultrasound to assess the thickness of that muscle again.

They found that the muscle was thicker. This is a good thing, as it indicates the muscle is larger, and stronger.

Apart from this measurement, they gave the participants questionnaires on things like back pain and function. There were improvements across the board here as well.

What does this mean for exercising after treatment? Well, I think you should be trying to capitalise on this. If you’re in acute pain, if you have been specifically advised against exercising for some reason, then you want to take it easy for a few days, but outside of that it would make sense to take this bigger multifidus muscle and use it in some core strengthening exercises!

Here is a link to the original study https://www.academia.edu/20911196/Association_Between_Changes_in_Abdominal_and_Lumbar_Multifidus_Muscle_Thickness_and_Clinical_Improvement_After_Spinal_Manipulation?email_work_card=title

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Foam Rolling, Stretching, or a Combination – what works best?

We asked HPH Osteopath Marcus Ng to dig into the research and see if he could answer this question. As an avid basketball player & NBA fan, Marcus has a keen interest in all types of sporting injuries. Marcus can provide you with the best prevention tips and rehabilitation techniques that will allow you to get the most of out of your sporting performance, whether you are a weekend warrior or professional athlete. If you have any questions on sporting injuries you can email Marcus harleyplacehealth@gmail.com

According to a 2015 study, a Combination of Foam Rolling, followed by Stretching, produces the best results. 

In the study, a group of athletes were tested using all 3 protocols on different days. For example, they were told to just Foam Roll, then assessed/measured on one day. On another day, they were told just to Stretch, then assessed and measured again. Then on another day they were told to Foam Roll AND Stretch and measured for the third time. 

The greatest effects were seen when people did the combination, with an increase in ROM almost 50% greater than stretching alone.

It’s worth noting that in this study the participants did 3 sets of 30 seconds of foam rolling. That equals a total of 90 seconds, but it’s hard to say whether 3 sets of 30 seconds has the same effect as 90 seconds straight and according to the study mentioned earlier, the best results seem to be obtained when doing 90 seconds or longer. 

Reference: https://pubmed.ncbi.nlm.nih.gov/25883869/ 

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Screen Time – TV vs Phone Vs Tablet – What’s Worst?

We all know that excess screen time is bad for us. But does it matter which screen we are looking at? Do they all affect us in the same way?

Apparently some are worse than others, according to a recent study.

This data was published just a week ago so it’s red hot.

The obvious finding was that more screen time = worse health decisions. People who exhibited the heaviest use of screened devices “tended to eat fewer fruit and vegetables and more sweets and fast foods.”

“They also tended to have the least physical activity, get the least sleep, have the worst sleep quality, and experience the greatest perceived stress (compared with those with light or moderate screen use).”

The interesting thing though, was the difference between different devices.

People with heavy TV and smartphone use said that they had worse dietary patterns and health characteristics than people who spent a lot of time in front of computers, tablets, or devices connected to a TV.

Another interesting finding was the effect of “Bingeing” eg watching an entire series straight through, like I have done maaaaaany times in my life.

The team also found that watching many episodes of a show or many different shows in quick succession was associated with poor dietary patterns and increases in self-perceived stress.

To read the full article, click here.

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Small weight loss = much less pressure on joints

I’m often asked whether losing weight would help a particular problem. For example, “If I lost a few kilos, would it help my back pain?”.

I think that if someone is overweight, then losing a few kilos is a good idea anyway, as there are so many general health benefits to maintaining a healthy weight.

But I wasn’t really sure if it would help a particular injury. What I mean by that is I think if you have back pain, you should try to fix your back. If you just lose weight, but don’t try to fix your back, I doubt your back pain will disappear.

Well I might have to change my mind. A new study shows that losing weight takes a lot of pressure out of your joints.

An 18 month study of overweight and obese people concluded that “for each pound of body weight lost, there is a 4-pound reduction in knee joint stress among overweight and obese people with osteoarthritis of the knee.”

That’s right, “the benefits of weight loss may be multiplied fourfold for people who suffer from osteoarthritis of the knee.”

The benefits can stack up quickly. If on every step you have less pressure in your knee as a result of losing just 1 pound (half a kilo), by the time you have walked a mile you would have experienced 4,800 less pounds of pressure in your knee.

It’s annoying these stats are all in pounds and miles, but I’m sure you are seeing the message here – a little bit of weight loss can make a massive difference!

To see the full article click this link.

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Natural Remedies for Back Pain

Stuck at home and can’t get to your regular practitioner? Or if you’re simply experiencing pain and prefer natural alternatives to medications, our illustrious neighbour Naturopath Tania Flack from Bondi Health and Wellness put this guide together.

Of those Australians reporting back pain, nearly half experience difficulty with mobility, daily activities and self-care, which significantly impacts quality of life. And the financial impact of back pain on the Australian economy is staggering. It’s reported to cost approximately 1.2 billion dollars per year, split between hospital care, out-of-hospital appointments and prescription medications.

This article summarises:

Common causes of back injuries,

The best nutrients for natural pain relief and

The best dietary modifications for reducing inflammation.

Natural remedies for back pain
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Trouble Sleeping?

Then check this out. The team at Medical news Today just posted an article with 21 tips and tricks for improving your sleep quality.

Poor sleep has been linked to mental health conditions like depression, to reduced immune function, to weight gain, and to reduced healing capacity.

The thing I have done lately that’s made a big difference is I bought a pair of blue light blocking glasses. They were relatively inexpensive ($60-70) and I think they have really helped reduce the effect of TV or other devices at night. I got mine from Swanwick but there are lots of other options.

Here is the link to the Medical News Today article. My favourite 3 tips are:

15. Try breathing exercises

Breathing exercises are a very popular relaxation technique. Practicing deep breathing or doing specific patterns of breathing can help people de-stress and take their mind off anxious thoughts. This can be a powerful tool for getting to sleep.

A common option is 4-7-8 breathing. This involves breathing in for 4 seconds, holding the breath for 7 seconds, and exhaling for 8 seconds. This type of deep, rhythmic breathing is relaxing and can promote sleep.

11. Get the room temperature right

Being too hot or too cold can have a significant impact on a person’s ability to sleep.

The temperature at which people feel the most comfortable varies, so it is important to experiment with different temperatures.

However, the National Sleep Foundation recommend a bedroom temperature of 60–67°F (16–19ºC) to promote sleep.

2. Keep the lights off

Cues such as light also influence the circadian rhythm, which helps the brain and body judge when it is nighttime. Keeping the room as dark as possible when going to bed might help bring on sleep.

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Improving Immune Function

With a global pandemic running around, there’s never been a better time to work on your immune system. You want it functioning at its absolute peak right now.

As we age, our immune system ages too. This means it doesn’t quite function as well as it used to. Luckily there is something we can do about it.

I just read an article talking about this and thought I would share the link as well as give you a few of the key points. This stuff is important because we actually need our immune system to function BETTER as we get older, not worse.

Here are a few key quotes from the article:

“exercising and adopting the right diet may help a person maintain healthy immunity into older age “

“Chronic, low-grade inflammation is associated with almost all conditions linked to older age, including type 2 diabetes, cardiovascular disease, cancer, and dementia. It also plays a leading role in certain autoimmune conditions that are more common in older adults, such as rheumatoid arthritis. “

“One study found that aerobic fitness among 102 healthy males, aged 18–61 years, was inversely proportional to the number of senescent T cells in their blood after adjusting for age. In other words, increased physical fitness was associated with less immunosenescence. “

“Another study compared the immune responses of 61 healthy males, aged 65–85 years, to a flu vaccination. After adjusting for their age, the researchers found that the intensively and moderately active males produced more antibodies in response to vaccination than the least active males.”

“A growing body of evidence also suggests that people who eat a Mediterranean diet are less likely to become “frail” in older age, such as by losing muscle strength, walking slowly, and tiring easily. “

To see the full article and get all the tips, click here.

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To Heat or To Ice? That is the question….

Maybe not Shakespeare’s most famous question…..but an important question nonetheless. HPH Osteopath Jerome Smith has extensive experience working with professional sportspeople – after completing the FIFA Sports Medicine Diploma he worked with premier league footballers in the UK before moving to Sydney. Here are his thoughts on whether to use heat or ice.

A lot of times when people develop a new pain they are unsure about what to do and are worried they might make it worse. It’s common for people to either use ice or heat on an injury to try to obtain some pain relief, but aren’t necessarily sure which one suits their condition best. Here are the guidelines I usually follow:

If it’s a new (acute) injury (first 48-72 hours), you would be more likely to use ice. Ice will help decrease pain and inflammation whereas heat can increase it. Ice may also be helpful for older injuries if the area is still quite inflamed.

Using ice (a packet of frozen peas is perfect as it can mould to the shape of the affected area) should not be applied for periods longer than 15 minutes.

Older injuries are usually better served by heat, which will help increase the blood flow in the area and be a useful adjunct to mobility, such as stretching exercises.

Heat can be as simple as taking a warm shower or bath, wrapping yourself up in the season’s latest fashion scarf, or using something like a wheat pack.

Obviously you should discontinue ice or heat if they cause you pain.

I often advise patients to take a shower where they alternate cold and hot water on the site of an injury. This will open and close the blood vessels to stimulate blood flow.

Try 10 seconds cold water, 5 seconds warm-hot water, and alternate between the two 3 or 4 times. Another way to achieve this hot/cold cycle might be using an ice pack for a few minutes then a wheat bag for a few minutes.

If you have any questions feel free to call the clinic or drop us a line, or just ask us for more information at your next appointment.

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Returning to the Gym? Read this first.

HPH Physiotherapist Kenny Merlevede knows a thing or two about rehabilitation and returning to exercise after a break. Literally! He was cycling in Centennial Park recently and while trying to avoid hitting a wayward child on a bike he came off and broke his collarbone. The surgery involved 5 pins being inserted into the collarbone. With the right treatment and rehab approach he was back at work in a little over a fortnight and back to exercise the next week. Here are his thoughts on safely returning to exercise.

We are expecting to be seeing a lot of people with injuries related to the sudden desire to quickly get in shape. Their exercise regime drifted a little over the last few months but with Summer approaching they need to get their bikini body back. Bravo I say! But, we need to temper that enthusiasm/desperation with a little common sense. If you’re trying to fit 6 months worth of training into the next 6 weeks read on.

I think the most common times people get injured is when they start a new activity, or when they make a big change to the amount of exercise they are doing, even if it is something they have done before. To give you an example, if you’ve never included running in your fitness program but start doing so, that’s a time when your body is adjusting to the new stimulus and as such you’re prone to injury. Or if you usually run 5km three times a week but change to 10km five times a week, that’s also a time when you’re prone to injury.

It’s a fine line; you want to push yourself to get fitter, but if you push too hard you can hurt yourself. When you’re exercising, there inevitably comes a time when you will feel a bit of discomfort. When you reach that point you might wonder whether you can keep going and push through it, or if doing so could cause an injury. There is such a thing as ‘good pain’, which is the pain you feel during exercise but in the absence of an injury. Then there’s ‘bad pain’, which is the pain you feel when you have suffered an injury.

How do you tell the difference between good pain and bad pain? In other words, what are the signs that you may have injured yourself and you should stop your workout? Bad pain has the following characteristics:

• The pain you’re feeling is ‘sharp’

• The pain you’re feeling is ‘shooting’, or accompanied by numbness, tingling or pins and needles

• There was a sudden onset of pain

• The pain developed in association with something ‘popping’, ‘clicking’, ‘snapping’ or ‘giving way’ underneath you

What does good pain feel like? Think about when you climb a really tall set of stairs or a steep hill. As you start to breathe harder, you get less oxygen to your muscles. When that happens you start to develop lactic acid. At the beginning you feel almost nothing, then it becomes slightly uncomfortable, then if you’re able to keep going, it becomes really uncomfortable. So we would say that one point of differentiation from bad pain is that good pain has more of a gradual build-up.

The location of the pain is also a clue. Good pain will be generalised to a region, whereas bad pain is quite specific. For example, if you’re ‘feeling the burn’ in your quads from climbing stairs (good pain), then most likely the entire front of your leg will feel it, all the way from your knees to your hips. On the other hand, if you tear or strain your quadriceps (bad pain), the location of the pain will be a lot more specific – you’ll feel sharp pain right at the point of the tear and in a small area surrounding it.

I’m sure you’ve all watched something like the Olympic Games, where you can see prime examples of the two types of pain. For instance, in the 100m when someone tears their hamstring, they grab their leg as if they’ve been shot. They feel sharp, shooting pain that has a sudden onset, the leg gives way underneath them and they’re unable to continue.

Then you see someone in a longer-distance event with a grimace on their face as they push on and on. They’re definitely in pain, but the pain has built up gradually and doesn’t affect their ability to keep running (well, for a while at least). While this is not a nice feeling, this is the ‘good pain’ we’re talking about.

There’s a fine line between pushing yourself and hurting yourself. It just comes down to using a bit of common sense. Build up your training gradually. Warm up a little before going too hard. If something doesn’t feel right, you’re better off missing part of a session and being okay for your next session than trying to get a little bit more done and having to miss the rest of the week.

Stay safe and if you have any questions let me know!

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