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.
Contrary to popular belief Physiotherapists do more than just massage! We also work in areas other than the sporting field, such as hospitals, private practice, community rehab centres and in the home.
As Physiotherapists, we are highly trained in understanding how the human body moves and functions. Reduction in pain and stiffness, improvements in balance and mobility or simply correct exercise technique are all specialties for a Physiotherapist. We use a combination of treatments for strength and mobility such as exercise, soft tissue massage (yes massage!), joint mobilisations and education in order to achieve client’s goals.
In hospitals, Physiotherapists can work in an acute setting with post surgical patients, post transplant and medical patients. Sub- acute Physiotherapists have a role in neurological rehabilitation (conditions such as stroke, multiple sclerosis and Parkinson’s) and musculoskeletal rehab, helping patients to achieve independence in their daily activities. They also have an important place in paediatrics (kids) and gerontology (oldies).
Here at MD health, as a Physiotherapist we work to assess and treat your injuries, to get you back to optimal functioning. We work along side our Exercise Physiologists, utilizing a combination of Pilates exercises and various treatment techniques in order to provide a holistic approach to lifelong health and wellbeing.
Jacinta Meharry Physiotherapist at MD Health Pilates
As a large proportion of life is spent at work, the tips below are to help you move well, stay well and assist in preventing back pain in the workplace.
Prior to any lift ask yourself if there is an easier way to do this. Could I use a crane, forklift, wheelbarrow or other device to do the hard work for me?
For those heavy lifts, asking for help doesn’t make you any less.
Do a quick safety check of the area and what you plan to lift.
Prepare your body by warming up BEFORE you lift and carry.
If you do have to lift, then use a sound lifting technique with your fee comfortably apart and in a stable position. List using your hips and knees, not your back.
Avoid twisting-turn by using your feet, not your back.
Think tall, chest lifted, shoulders relaxed, chin tucked in and head level.
Posture should be stable, balanced and relaxed.
Don’t stay seated for too long.
Regularly stand up, stretch and walk around.
If you work in an office ensure that your workstation and computer are correctly positioned.
Adjust your seat to sit comfortably. Adjust the lumbar support if available.
Take regular breaks on long journeys
Don’t sit with your wallet in your back pocket.
Be careful what you do after a long journey, take a few seconds to straighten up before lifting things out of the car.
With every step, shock is absorbed by the feet, knees, hips and spine to decrease the force of impact. Wearing the correct footwear helps reduce these forces further whilst not affecting the normal function of the foot.
Simple exercise such as walking or swimming is the best
Before and after exercise, make sure you warm up and cool down with gentle stretches.
If your back hurts, don’t ignore the pain! See a physiotherapist
Article by the Australian Physiotherapy Association as a part of Tradies National Health Month. For more information visit http://www.tradieshealth.com.au/
Why We Need Strong Buttocks to Prevent and Fix Back Pain
The gluteals (buttocks muscles) are a very important muscle group; they serve many functions in the stability of the lower back and pelvis. However, nowadays we spend more time sitting on our buttocks than actually using it.
In fact, according to the Australian Bureau of Statistics, on average we are sitting at least 4 hours a day (usually watching television) and spending only 30 minutes doing some form of physical activity. That’s a total of 13 hours of watching TV per week!
One in three workers spend at least three-quarters of their time sitting. Office workers sit up to 23 hours per week compared to less than 4 for labourers.
Is it no wonder we see many people with back pain coming into our clinic. If we are all sitting for most of our day our bottoms are probably asleep!
To help you understand a little more, there are 3 layers of buttocks muscles. The smallest (Gluteus Minimus), medium (Gluteus Medius) and biggest (Gluteus Maximus). The three muscles are all intertwined and yet have different roles to play, overall they help support and stabilise your pelvis, hips and of course your spine.
Without proper use of these muscles we tend to be more inclined to injuries such as back pain, pelvic pain, hip pain and much more.
When we conduct our Full Body Assessment, we look at the entire human body and how one area affects another. One very common thing we see is poor gluteal strength and activation. This can be caused by many things such as previous injury, but the biggest contributing factor is our lifestyle.
In today’s society, we are sitting more then ever and when we are seated; our glutes (particularly Gluteus Maximus) is on constant stretch and not being used. This results in poor gluteal activation which leads to weakness and eventually injury.
If there is weakness throughout the gluteal muscles, we lose significant support for the lower back, pelvis and hips, causing increased loading on passive support structures such as bones and ligaments. Increased loading of these structures is the major cause for spinal injury. One such example is picking up a heavy object off the floor with poor technique. When you do this there is more compressive loading on your back and you are more likely to experience back pain.
One of our main focuses is to improve the strength of our glutes to prevent an injury. If you already have back pain, done worry it is never to late to strengthen your bottom, in fact it will be a major part of your rehabilitation.
Strong glutes should be the main focus for many people, but as always, you should be properly assessed by a qualified health professional such as a Physiotherapist, Exercise Physiologist or Sports Doctor for a tailored and specific strengthening program.
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.