Instil Confidence in Athletes not Reliance on the Practitioner
One of our Exercise Physiologist’s, Kyle, recently read an article by Adam Meakin’s (Physiotherapist) called ‘All that is wrong with Sports Physios’
Adam explained that a therapist conducted endless hours of massage, joint alignment and acupuncture on an elite athlete prior to competition. This routine of hands on treatment was done religiously and recommended by this therapist.
The athlete’s perception of her own performance was based around this approach. She believed that if she didn’t get the massage or joint alignment prior to competition it would have hindered her ability to do her best. This of course, is not the case. The recommendations given to her from her therapist seemed the best approach in her mind, but how was she to know any different? It is now known that massage and stretching can hinder performance rather than enhance it. Stretching and lengthening a muscle can cause instability of a joint (couple that with unpredictable and powerful contractions) and may cause injury.
It can be argued that as a result of this way of thinking, this therapist is not providing the “best practice” for the patient and could be classified as negligent. If she had been assessed appropriately, given specific strength exercises and mobility as well as educated on how she can be in charge of her own training it would empower the athlete rather than allowing them to become reliant on a therapist’s hands to help their performance.
We see this in elite sports all over Australia and although the trend is changing slowly there is still a reliance on rub downs and stretching. It is an age old habit that has been instilled from us from a young age and so of course it must be good, right? Research proves otherwise. Unfortunately, behavior is tough to change hence the importance of writing this article. Adam explains that many athletes believe they need to get ‘this poked, that cracked, or that taped’ before a race and if they don’t it will in some way have a detrimental effect to their game or competition. No one in amateur sport is living by this ritual and so the elite are obviously getting this terrible information from somewhere or someone.
The same approach should also be for the general public. Whether you are seeing your Physiotherapist for a back injury or your Exercise Physiologist for chronic disease management. They should be educating you on how you can take control of your own ailments. There should be a plan in place to treat, train, and manage on your own. To have the confidence that your body can do what is was made for with the correct approach.
Our 13 week program is there for a reason, it is well known that compliance and adherence to an exercise program are often the main hurdles to long term improvement. MD Health has implemented the 13 week program based on how long it actually takes to make physiological changes to your musculo-skeletal system. Some people may need more or less time. After this we want to encourage you to go ahead on your own. Some people prefer to keep attending our sessions and see even better results. Some manage quite well on their own at a gym or home and only come back if they have a niggle or new injury. Again, we try to help educate you to manage on your own; we believe you have the power to do it. Plus, no ones hands can not make your muscles stronger.
Prehabilitation – The Importance of Pre Surgery Strength Training
Prehabilitation or ‘prehab’ is not a new concept but it may be starting to gain some ground in the health industry due to recent findings.
The benefits of prehab has been known and taught in universities for decades however it is still not utilised to its full potential and the public are not well educated on its benefits.
Usually patients require or are encouraged to complete inpatient and/or outpatient rehabilitation post surgery yet they are not encouraged to complete any pre surgical exercise or strength work when we already know it can enhance the rehabilitation phase greatly along with many other benefits. The funny thing is that current research doesn’t just find positive outcomes for the patient but can also save hospitals a lot of money.
So What is Prehabilitation?
According to Mr Graham Mercer (Head of Orthopaedics at Repatriation Hospital, South Australia) ‘Prehabilitation is the process of enhancing functional capacity of the individual to enable them to withstand the stresses of orthopaedic surgery and the associated inactivity.’
From our experience at MD Health we see many people who are potentially in need of surgery in the future or are already booked for surgery. The results we obtain from the Full Body Assessment are a clear indication that they need to increase their strength to enable quicker recovery and better rehabilitation post surgery. It is very rewarding to see the positive effects that our clients achieve to get them ready for surgery and in some cases their surgeries are postponed due to improved function and reduced pain.
This in itself is a major reason why patients should be included into a graded exercise plan prior to surgery.
Based on information from Mr Graham Mercer, orthopaedic surgery places many issues within the hospital system these are:
Length of hospital stay post surgery
Patient expectation of inpatient rehabilitation
Growing waiting list for surgery
This means more money goes into funding all of these much needed services. The longer the patient stays the higher the costs.
After conducting a 6 month trial where prehabilitation programs were included as part of patient’s surgery they found that there was:
A reduction of inpatient rehabilitation.
Up to 94% of patients did not need to complete inpatient rehabilitation.
Reduction of length of stay post hip replacements
91% achieved their pre surgical goals
Prehab has a huge role to play in preparation, management and outcomes of surgery. You could almost say it is a wasted opportunity if not completed and there is more chance of pre/post surgical issues.
Here at MD Health Pilates we highly recommend strength training programs prior to surgery to help activate muscles and stabilise your joints to create the best atmosphere for surgery as well as aid in rehabilitation.
If you have a friend or family member who may be in need of or has been booked in for surgery please contact us to start a prehabilitation program today.
Improving our Pilates program, service and your outcomes has been and will continue to be one of our major goals at MD Health Pilates. At the moment, we have been working on these aspects of our program to be launched in the next version of our software (version 6fii).
1. Real time ultrasound imaging of the shoulder – Nicholas has recently undertaken further training in musculo-skeletal ultrasound imaging and has now taught all the other staff how to image the muscles and tendons. We have now further practiced and refined our skills through several in-services and worked out our standard protocols for testing the shoulder. This will now be used as a standard test when you have a shoulder injury
2. Headache assessment and treatment – Mark Charalambous, former physiotherapist at MD Health Pilates, recently trained all of our staff in better assessment and treatment techniques for neck related headaches. We have now further fine-tuned this process and incorporated it into the new version of our software.
3. Better hip assessment and specific treatment – Since we started incorporating new research and techniques for treating hip injuries over the last two years, we have a much better idea of what works well and what doesn’t. These changes will also be included in our new software and testing procedure.
4. Tendon injuries in general – Both Nicholas and Jacinta had done excellent training and taught the other staff how to specifically assess and treat tendon and tendonopathy injuries. We have re-written the process of how to better progress tendon rehabilitation programs throughout the healing process for the best outcomes
5. Heart and other cardiovascular conditions – If you have had heart related issues, you have probably found that we have been asking to rated your effort during an exercise or session out of 10 (RPE) or 20 (Borg scale) to determine the safest level of exercise for you. We have now worked to make this process easier to record and keep a track of during your sessions
6. Home exercises – We are in the process of updating our range of home exercises and working to mare the process faster and more specific to each individual
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 firstname.lastname@example.org
Jack came in last week and brought with him the ‘Nordbord’ or hamstring testing apparatus. This was specifically designed to assess athletes’ isometric hamstring strength vs their eccentric strength. The test involves kneeling on a pad with your heels through 2 straps that are connected to pressure senses that collect data to a computer.
You are first asked to do an isometric contraction (contracting your hamstrings without lengthening or shortening the muscle). Then you are asked to complete an eccentric load which involves keeping your knees and ankles grounded by the straps and your body falling buy ambien 10 mg forward as slowly and as far as you can before letting go. The computer then generates a comparison between your isometric control and your eccentric control. Ideally your eccentric strength should be better than your isometric strength and knowing this information is vital for preventing hamstring tears which are all too common in many sports! From the data a specific exercise plan can be prescribed.
Thanks for sharing with us Jack! Good luck with testing all of the athletes!
Check out this article on the QUT researchers that came up with the idea of the NordBord