Exercising in the heat – the good and bad

What are the health benefits of exercising in high temperatures?

There are some benefits of exercising in the heat for fitness, in particular, the short term effects on the heart.  Exercising in high temperature (over 32 deg), regularly for 5-10 days at a moderate level  for 60 minutes causes a heat adaptation effect, which means that your body increases circulating blood volume and your heart is able to pump more efficiently when in high temperatures.

This improves fitness performance in the short term, however, this performance improvement is only really limited to high performance athletes and not an average person.  In addition, more training in the heat does produce further improvements in performance, and training in the heat needs to continue in order to maintain improvements.

So fitness training in the heat is good in preparation for an event or if the event you are participating in is in the heat, but not for long term fitness.

The other potential benefit of exercising in high temperatures is weight loss.  Exercising at the same intensity in hot temperatures does use more energy than the same exercise intensity exercise in colder temperatures, however, it is hard to maintain the same level of intensity of exercise at high temperatures compared to low temperature, so the effects balance out.  Sweating itself is a passive process and doesn’t mean that you are working harder and burning more energy.  Bikram Yoga doesn’t burn much more kilojoules than regular yoga and burns a lot less kilojoules than regular cardio training


What are the potential harms of exercising in high temperature?

Exercising in high temperatures is not safe for everyone. If you have heart problems, issues with blood pressure or are pregnant, it is not safe to exercise in high temperature.  As the temperature rises and your core temperature rises, this increases the load on your heart which affects your blood pressure and the strain on the heart.  This is particularly true if you are unfit, so high temperature training should only be attempted after you have achieved your base level of fitness.

In addition, not being adequately hydrated during high temperature training can lead to heat related problem, such as cramps, dehydration and in worst case, heat stroke.


What are your concerns with Bikram Yoga?

Besides the potential harmful affects of dehydration, which is common for all high temperature exercise, Bikram Yoga heats up the ligaments and muscles, which increases the flexibility of the joints in the short term only.  This means that if the movements are not controlled and not kept within your normal limitations, you are more likely to injure your joints, muscles and ligaments.  Bikram Yoga should really be undertaken if you are experienced in Yoga and know your limitation and good technique, and should not be for beginners.


If someone trains in high temperature, does that ensure that they will see better fitness results?

Training at high temperatures does improve fitness, but only in the short term. Heat adaptation of training at high temperatures can be achieved after 5-10 days training, however, this is only maintained if you continue to train in high temperatures.  So this is great if you are preparing for an event for that extra performance boost, similar to altitude training, however, it is not beneficial for regular fitness or for more weight loss.  Make sure you have a good base of fitness first before starting high temperature training or you will be more vulnerable to heat related injuries such as dehydration and heat stroke


Do you believe that Bikram Yoga is a more effective and beneficial form of exercise as opposed to regular yoga?

Bikram Yoga is a good form of training for experienced Yoga participants, who want the extra challenge of the increased flexibility of the muscles and ligaments, which results from the high temperatures. However, it is not where you should start your yoga training.  Yoga is about postural control and positioning control.  The high temperatures increase your flexibility in the short term, which means you have to control a larger range of joint movement, great for a challenge, but more potential for injury.

Bikram Yoga uses mildly more energy than regular yoga in terms of weight loss, but would not be as effective as regular cardio training for weight loss, either in low or high temperatures, which uses substantially more energy than yoga.

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The Importance of Joint Mobility

The Importance of Joint Mobility to Accompany Your Strength Training Program

by Beth Chiuchiarelli
Accredited Exercise Physiologist at MD Health Pilates

To get the most out of your strength training or rehabilitation programs we not only need to strengthen the muscles that move and support the joint but we also need to maintain normal range of motion of your joints.

Joints have cartilage that provide articular surfaces for shock absorption so that bones are protected when there is a load placed on them. They have ligaments that provide passive support as well as a dense fibrous capsule made out of many collagen fibers that encase the joint and not only provides static support but also provide a type of torque (wind up action) of the joint to help provide a transfer of load to muscles during movement.

Our joints are made to move over a millions of times in a lifetime and so if there is anything in a joint that is compromised and you feel pain or there is swelling. The damage has probably already occurred. Mobility of a joint is important to allow better efficiency of these joints so that their movements are not compromised and joints need to be strong so that they move better and in the right position. They need to be mobile enough to allow the muscles to do their job properly. If a joint is stiff there is less ability for the muscle to move the joint through its normal range of motion. The better the joint moves the better the effect the muscles will have.

Unfortunately, when there is muscular weakness around a joint or you have an injury muscles become rigid and have poor contractile ability and the capsule can become thickened reducing its ability to provide the necessary movement the joint needs. This can cause the joint capsule as well as fascia and muscles to become stiff, this can reduce your ability to improve your strength and so you may notice that we usually prescribe some sort of treatment such as myofascial release in your sessions. What we also like to do is teach you how this can be done on your own.

There are many pieces of equipment in the market today to help you complete self guided myofascial release to improve your joint mobility. We recommend foam rollers, spikey balls, even a rubber bouncy ball is fine. Currently we have been trialling the way we can use the heavy power bands to help with improved joint range of motion as well as the Lacrosse ball – which is the size of a tennis ball however made out of rubber.

Once we have assessed your joints range of motion as well as its strengths/weaknesses we can prescribe a very specific exercise and mobility program for you.
For more information contact us on 9857 0644 or email us at


Hip Pain – Greater Trochanteric Pain Syndrome

Hip Pain – Greater Trochanteric Pain Syndrome

Hip Pain – Greater Trochanteric Pain Syndrome

Late last year Jacinta attended a course on ‘Greater trochanteric pain syndrome’. This syndrome covers many dysfunctions and injuries around the hip.
Greater trochanteric syndrome is caused by irritation of the bursa (fat pad) which is a shock absorber as well as a lubricant for the muscles around the hip that lie adjacent to it.
The bursa cannot be irritated on its own, there are many injuries that pre-exist that eventually cause the bursa to become inflamed.
Once the bursa is inflamed it can be hard to treat as it can become irritated easily. Exercise can help however it needs to be assessed appropriately and only then can a closely watched exercise program commence.

Completing a hip assessment is not an easy process, if you have had your hip assessed by us you may remember there are many objectives that we need to measure and test before we can derive exactly what is causing your hip pain. This is how we can prescribe the correct type of program.
One exercise that Jacinta has introduced to MD Health is a seated hip abduction hold with a belt. This is a great way to strengthen the gluteal muscles without causing irritation to the bursa! Once the pain has relieved we can progress to isometric holds with added resistance. You may have seen some of these exercises around the clinic!



Staff Exercise Tip

Staff Exercise Tip

This Months Staff Exercise Tip

By Nick Adkins, Exercise Physiologist

Like everyone who comes to MD Health, I love my exercise. What I love best is the variety of exercise that can be done. Throughout my daily life, I complete a mix of pilates, heavy resistance training, cardiovascular training and plyometrics.

Out of all the exercises I do, there are two which are my absolute favourite and I prescribe these to almost every single client I see at MD Health because they are so effective.

1. Four Point Kneel – Single Leg Hip Extension on the Reformer:

My favorite pilates exercise, it is a great exercise to stimulate activation of the Gluteus Maximus muscle as you start from the hips in a flexed position and push to a neutral position (the Gluteus Maximus is the main buttocks muscle, Beth wrote a great article explaining the importance of this muscle (
Many electromyography (EMG) studies have shown that Gluteus Maximus muscle is most active when going from Hip Flexion to Neutral. It is also a level 3 core exercise, so it is perfect for beginners.
How to complete this exercise:

– Start by selecting the appropriate resistance, either two red springs or one red and one blue for beginners.

– Put yourself in what we call the 4 point kneeling position on the reformer.

– Your hands should be directly under your shoulders for best upper body support, the heel of one foot should be resting against the foot bar, with the opposite knee resting on the carriage.

– Push through the heel resting on the bar, until the leg is COMPLETELY straight, keeping the hips level. The carriage will move forwards with you on it.

– Hold the contraction of the gluteus maximus for about two seconds, and then return to the starting position.

– You may also feel this in the shoulders, as they have to stabilize the upper body during the movement.

If this is too easy, try these progressions!

– When you have pushed out, raise the opposite (contralateral) side arm. This causes one of the Lattisimus Dorsi muscles to be stretched, placing more stress on the thoracolumbar fascia, making the ‘core’ work harder. This makes it a level 7 exercise.

– While completely pushed out, raise the other leg that is resting on the carriage. This forces you to stabilize through your hips and shoulders a lot more as you no longer have the support of the resting leg. This is an advanced level 9 exercise.

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2. The Squat:

My favorite exercise to do at the gym! I love the squat exercise for many reasons. Firstly, it is a natural movement. If you watch a toddler, they have the best squatting technique, unfortunately, as we get older, many of us become lazy and forget how to squat. This can be easily corrected.
Secondly, it is a full body compound movement; many major muscle groups to work together throughout the squat, in particular the Gluteus Maximus, the Quadriceps group and the ‘Core’ (Transversus Abdominus,  Multifidus etc.).

Depending on your exercise goals, the squat has many purposes. Working the largest muscles yields greater kilojoule consumption (ideal for weight loss), improved compound strength will lead to better function and stability (within your daily life or a specific sport). Squatting also stimulates the Central Nervous System (CNS) to allow greater work capacity and if you are lifting heavy, it also stimulates the Anterior Pituitary Gland to release more Human Growth Hormone (HGH) (ideal for putting on muscle bulk).

How to complete this exercise (perfect technique is vital with the squat!):

– Stand with your feet shoulder width apart, chest up, shoulders back and tummy in.

– Lower your hips back and down, while also bending at the knees. Keeping your chest up and looking straight ahead (you can also raise your arms out in front to aid balance if you haven’t squatted before).

– A great cue is to think about sitting in a chair, your bum goes back and down.

– Lower your hips until your upper legs are parallel with the ground, keeping your back straight.

– Throughout the movement, your knees should move out to the side just a little bit (this causes an external rotation bias of the hips, which puts more load through the glutes and also creates better foot posture as the arches are raised).

– Push through the heels of both feet and push your hips forward to raise yourself back up to the starting position.

IMPORTANT!! Your knees should NEVER roll in when squatting; this creates a valgus force through the knees, placing increased and unnecessary load on the MCL (Medial Collateral Ligament) and the Medial and Lateral Menisci (knee cartilage). If your knees roll in, there are a number of ways to correct your technique, you can reduce your range of motion until you have built more strength to control the knees (this is called a half squat – only lower half way down i.e. to a 45° angle at the knees). You can also tie a theraband around your knees, so when you lower, you have to place your knees out so the band doesn’t fall.

When you’re able to squat perfectly with just your body weight, you can progress to the more advanced versions of the squat, the most common is the Barbell Squat, where you have a loaded Barbell resting on the fleshy part of your upper back (upper trapezius fibers) to increase the load on the working muscles. The increased load is also great for working your core, as you have to stabilize your hips under the increased load.

There are great instructional videos for squat technique on the MD Health YouTube channel.

Beginners –


Full Body Assessment

Full Body Assessment

Not sure what to expect from our free full body assessment? Have a read of this:

Our Full Body Assessment (FBA) takes 60 minutes to complete. Initially we will chat about your injuries, medical history and short and long term goals.

From here we will conduct range of motion testing using a special gadget called a Goniometer. We assess the major joints in the body as well as your neck and back this allows us to see how mobile your joints are.

We then complete our strength testing! We use a manual muscle tester for this and this gives us a figure in kilograms.
We do these tests so that we can collect specific data on your body and we can compare this data when we reassess. It means we can be very specific when prescribing your exercise program and measure your improvements as you go!

It also means we know when your ready to increase the intensity of your exercise program and progress your goals even further!

To book yourself a free full body assessment call us on 03 9857 0644.


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Common Exercise Technique Mistakes

Common Exercise Technique Mistakes

This Week: The Push-Up

Push-Ups are one of the most commonly prescribed upper body exercises as they can be performed anywhere with no need for any exercise equipment. However because of this many people perform push-ups on their own, with no supervision and may be unaware of any technique mistakes they may be making, reducing the effectiveness and safety of the exercise.

1. Dropping The Lower Back and Head Forward

When performing a push-up it is important to use your trunk and neck stabilising muscles to maintain a straight line through your body. If you don’t do this, you will place extra pressure on the lower back and neck which can result in pain and injury.

2. Sticking the Backside in the Air

Some people will cheat on this exercise by keeping their backside up in the air as they go down onlinepharmacytabs into the push-up. A straight line should be maintained through the body, throughout the movement. If you are unable to do this, reduce the difficulty of the exercise by performing it from your knees rather than toes or reducing the depth of your push-up to the point where you are able to maintain good technique and control

3. Hunching Shoulders and Neck

People with poor strength in the stabilising muscles around the shoulder blades will tend to shrug their shoulders up towards their ears as they perform the movement. To avoid this keep your hands right under your shoulders and think about keeping your shoulders down as you go through the push-up.

For more information check out our Workout Wednesday video on “The Perfect Push- Up”

Written by Jack Hickey
Exercise Physiologist