This article outlines one of the major principles of how to get change with exercise over time, and that is progressive overload.
But, what does this mean?
When you exercise, the normal response from your muscles is to cause some disruption of the muscle fibres.
This is normal and should happen and is what can lead to DOMS (delayed onset of muscle soreness) the day or two after exercise. Over then next couple of days, the body repairs and builds the muscles up to a higher state than before so it can withstand greater load. So, the next time we exercise, we are able to do more than originally and need to be challenged to have further gains.
Variety is very important to both keep an exercise program fresh and to facilitate further changes in your body over time, however, there are 3 major things that should be kept in mind for a long-term program:
You need a good base of strength in the major postural muscles – A good, strength-based program should be the foundation of any exercise program. If you do not have a good base of strength in the core stabilisers, such as the core stabilisers (the multifidus and transversus abdominis muscles) and the pelvic stabilisers (gluteus maximus, medius and minimus), you just won’t get the full benefit of your gym program and have the potential for back injury.
Moderate changes each time, don’t over do it – Progressive overload, means exactly that, progressive changes. It is important to make incremental changes in your program each time, not huge leaps every time.
For example: if you are running, change either the time, speed or hills, not all over these at once. Changing all these aspects at one time leads to injuries such as tendinopathies (breakdown of the muscle tendons), which can take months to recover and really pull you backwards.
Regular assessments are very important – The only way to know how you are progressing and to make such you are on the right track is with regular assessments with your instructor/health professional. Initially every 6-7 weeks, then after a while, at least every 3 months means that you are always on track and the exercises appropriate for what you want to achieve. It is the job of the instructor/health professional to see the things you do not see and adjust your program accordingly.
There are a few things you can do to make sure that you’re doing exercises correctly.
Firstly, make sure that you know what muscle groups you want to work during an exercise. All exercises have to have a purpose to be effective and specific to your needs. For example, if you want to work on your knee control, it is important that you work on your quadriceps, in particular the inside muscle of the quadriceps (the VMO muscle), the major stabilisers of the knee cap. Do your research or ask a professional such as a physiotherapist or exercise physiologist to ensure that you work on the correct muscle groups.
Secondly, learn what a normal muscle “working” sensation feels like and what is pain. When a muscle is working, you should feel a slight “burning” sensation in the muscle you are targeting, which disappears when you stop the exercise. You should not feel a “pain” sensation in tendons of the muscles, in the joint or in different muscles that you are targeting. In addition, the next day or two, a normal sensation can be a soreness or bruised-like sensation. This is called DOMS (delayed onset of muscle soreness), and is part of the normal muscle growth process after exercise. It should not be painful in the area or the joint the day or two after exercise.
Thirdly, technique is also very important. The way you do an exercise can make the difference between a great day exercise and an ineffective exercise.
To address all these three issues, ask a professional physiotherapist or exercise physiologist to design and supervise your program, at least at the start to ensure you are getting exactly what you want from your program with correct form, technique and purpose.
Written by: Michael Dermansky – Senior Physiotherapist
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When you exercise, in particular after strength training, there will be a degree of slight tearing in the structure of the muscle the day or two after exercise.
This is normal, and occurs because you have taken the muscle beyond what it would normally do in order to give it a reason to grow and change. The muscle will then repair itself and become larger and stronger as a result.
This sensation, known as DOMS ( delayed onset of muscle soreness), feels like a heavy, sore sensation, similar to a bruised feeling in the muscle when you use it the next day or two. It is normal and goes away after a couple of days. Exercising again, although a bit difficult, will actually help this sensation go away more rapidly.
We see many different reasons for foot pain, some are simple to fix and others that need to be managed. This article highlights the 4 most common reasons we see foot pain and what you can do about it.
Plantar fascia pain – this is the most common muscular reason for foot pain. It is felt at the bottom of the foot, usually travelling from the end of the heel to the beginning of the toes, but can vary a bit in which part of the foot gets the most sore. The plantar fascia is a strong connective tissue that lines the bottom of the foot from under the heel to the beginning of the toes. It’s role is to support the normal arch of the foot and the position of the mid part of the foot. If the muscles that support the foot are not strong enough, especially the calf muscles, it puts more load onto the plantar fascia, putting it on constant stretch and causing pain. Reducing this pain is about taking the plantar fascia off constant stretch and improving the strength of the muscles surrounding the foot including the calf and deep muscles of the shin, the tibialis posterior muscle.
Shin splints – this is similar to plantar fascia pain, except the muscles breaking down are above the ankle instead of under the foot. It can cause pain into the back of the calf or into the inside of the foot. The main aim of treatment is to make the muscles stronger so they can cope with load. This often takes time and a modification of activities in the short term until strength improves, but this pain does get better with treatment.
Swelling of the ankles causing pressure on foot – swelling of the feet can cause more pressure on all the small joints of the foot and the plantar fascia. Generalised swelling of the feet and ankles can indicate issues of circulation or heart disease. If you find you have general swelling of the feet and ankles see your doctor for an opinion and appropriate management.
Bunions – pain and swelling on the inside of the big toe, is usually due to poor biomechanics of the foot over a long period of time and wearing shoes that are tight over the toes. This can be modified to a degree with treatment. You can improve the biomechanics of the feet by improving the strength muscles supporting the foot, such as the calf muscles to reduce pressure on the big toe. The big toe can also be mobilised to improve the movement of the toe to reduce swelling. If there is enough damage to the joint, it may require surgery to correct the bunion, but this can be assessed by your doctor.
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The carpal tunnel is a small tunnel the bones of the wrist create by their shape through which the tendons, blood vessels and nerves to the hand sit as they go into the hand. It exists to protect these structures, how with excessive activity of the wrist and any kind of swelling is the wrist, that can occur during pregnancy, can reduce the space in the tunnel, putting direct pressure on the nerves and blood vessels of the hand. Because the tunnel is made of bone at the bottom and a thick layer of connective tissue called the flexor retinaculum on the top, even a small degree of the swelling can compromise this space, compressing the nerve.
Once it occurs, causing pins and needles in the thumb and next 2 and 1/2 fingers, treating with exercise usually doesn’t change the procedure. Treatment requires cutting the thick connective tissue on the front of the wrist, called the flexor retinaculum, to relieve pressure on the nerve.
Exercise can not change the symptoms much when it has occurred and surgery is needed, however, you can always strengthen the muscles of the shoulder, elbow and wrist to reduce the pressure on the wrist in the hope of preventing this injury.
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Type 2 diabetes is a lifestyle disease that has become more prevalent in the recent years. According to the Australian Bureau of Statistics and Diabetes Australia, around 1.7 million Australians have diabetes (either type 1 or 2), with 280 Australians developing it every day. It is also costing the Australian Health System an estimated $14.6 billion! I would go as far as to call this an epidemic of the 21st century! Unfortunately, there is no known “cure” for diabetes (however, there are reported cases of people going from Type 2 Diabetes to insulin resistance), and such requires long term management of one’s lifestyle.
What is Diabetes?
Diabetes is when the pancreas does not respond to the hormone known as insulin, which then inhibits the body’s ability to utilise sugar (glucose) into the cells to be use as energy. This causes a rise in the amount of glucose in the bloodstream (blood glucose levels). This can either be from a lack of production of insulin or an increased resistance from the body’s cells . Diabetes is divided into three categories (or types):
• Type 1 Diabetes: This is an autoimmune disease where the body’s own immune system destroys the insulin-producing cells in the pancreas. • Type 2 Diabetes: This is considered a ‘lifestyle’ disease and is characterised by a reduced production of insulin from the pancreas and an inability of the body’s cells to respond fully to the insulin. • Gestational Diabetes: Occurs during pregnancy, where the body cannot keep up with the extra demand for insulin production resulting in high blood glucose levels
How can exercise help?
A structured exercise program, consisting of both resistance and aerobic training, aids greatly in the management of diabetes, especially for type 2 diabetes. As we exercise, the body uses stored energy, as our energy depletes, it must be replenished (this is done via glycolysis). This response promotes the body’s cells to respond to insulin, which then allows the glucose to enter the cells, which then in turn, lowers blood glucose levels. This makes exercise an effective way of managing blood glucose levels, while both aerobic and resistance training will help manage blood glucose levels, the added benefit of resistance training is as the muscles grow and get stronger, there is a greater amount of glucose utilised by the muscle cells for energy.
Along with a structured diet from a dietitian, this is the ideal way to manage diabetes in the long term. As always, talk to your Doctor or Diabetes Educator before commencing an exercise program (there are programs for exercise and diabetes claimable under Medicare) and make sure you are properly assessed by and Exercise Physiologist or Physiotherapist to get the best exercise program for you!
Article by Nick Adkins Accredited Exercise Physiologist at MD Health Pilates
References Australian Bureau of Statistics. (2013). Australian Health Survey: Users’ Guide, 2011-13. Retrieved September 19, 2015, from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/E79DB0C3CA8FBA6FCA257B8D00229E8D?opendocument McGinley, S.K., Armstrong, M.J., Boulé, N.G., & Sigal, R.J. (2015). Effects of exercise training using resistance bands on glycaemic control and strength in type 2 diabetes mellitus: a meta-analysis of randomised controlled trials. Acta Diabetologica, 52(2), pp 221-230. Yang, Z., Scott, C.A., Mao, C., Tang, J., & Farmer, A.J. (2014). Resistance Exercise Versus Aerobic Exercise for Type 2 Diabetes: A Systematic Review and Meta-Analysis. Sports Medicine, 4(4), pp 487-499.