Ep 26: What do you need to do to enjoy your trip overseas – build confidence in your body

Voiceover (00:02):

Welcome to The Confident Body, where experienced health professionals discuss how to get the most out of your body for the lifestyle you choose. We believe everyone can exercise and get the most out of life regardless of your injuries or health issues. Now here’s your host, senior physiotherapist, Michael Dermansky.

Michael Dermansky (00:23):

Hi everyone, and welcome to the show that helps you become more confident in your body so you keep doing the things that you love. My name is Michael Dermansky. I’m senior physiotherapist here at MD Health and I’ve got a special guest for the first time with us today. Liam. Liam, welcome aboard.

Liam (00:37):

Thanks having me.

Michael Dermansky (00:37):

Yes, you’re-

Liam (00:37):

Very exciting.

Michael Dermansky (00:39):

Yes. Well, he’s one of our exercise physiologists here at the Health and Q and he’s going to talk about that topic he knows about he’s been writing about. So yeah, again, welcome to the show.

Liam (00:48):

Thanks for having me.

Michael Dermansky (00:49):

Well, first question today, as an exercise and health professional, when a client tells you they’re going overseas for a trip to Europe, what does that usually mean to you?

Liam (00:58):

Well, for one it’s exciting.

Michael Dermansky (00:59):

Yeah.

Liam (01:00):

Because then they’re going away. They’re going to have some fun, but as a clinician, it’s okay. How can we best prepare them to be healthy and happy when they’re traveling?

Michael Dermansky (01:11):

Yeah. So, I mean usually they’ve said they want to go overseas as well and they’ve had previous holidays and often we hear them, they’ve had a previous holiday and it’s, their body hasn’t been ready for it and they haven’t been able to enjoy as much as of the trip that they wanted to. What are your thoughts when you hear that too? As you said, they’re excited first that they’re going to go for this trip overseas. Hopefully, they give us a bit of time to work on their body.

Liam (01:34):

And that’s the main thing, giving us time. There’s so many times when clients come in they go, “oh, I’m going away next week.” And we go, “okay, let’s try give you a few exercises.” But they haven’t developed the confidence that they can do those exercises or the repetition where they’re able to then just pull them off every couple of days when they’ve got time. So, then the exercises most likely don’t get used or they don’t get ticked off the list.

Michael Dermansky (02:01):

No, they really, really do.

Liam (02:02):

Exactly right. Which then leads to that constant cycle of, I’ve come back, every time I go away, I get injured or I get sore, and the problem’s just never going to be really fixed.

Michael Dermansky (02:12):

No, see that’s a big deal. You want to go upstairs and enjoy the trip, not just think, “oh, I’m going to get sore and every time I’m going to get stuck into more treatment while I’m away.” And that’s not what you want people to think.

Liam (02:23):

No, exactly.

Michael Dermansky (02:24):

I know it’s a very general question as well, but what’s good for somebody that wants to go away? What do they need to work on? What would you say if you were going overseas?

Liam (02:32):

Yeah.

Michael Dermansky (02:32):

And say you doing a tracking tour of the Swiss Alps, you were going to tracking tour of the Swiss Alps, what would you want to work on? And before you went over overseas and do that, doing that?

Liam (02:42):

So, is that typical saying you train what you work?

Michael Dermansky (02:45):

Yep.

Liam (02:45):

So, if you’re going away, say for a hiking trip like that, you need to get all your rotators and your extensives through your hips, your quads and your hamstrings ready to go so they can take that load, repetitive load. So, prodding in high levels of strength and then also kept creating a little bit of endurance within those muscles to be able to re-stand day after day hiking potentially.

Michael Dermansky (03:07):

Okay. So, you said around the hips, the rotators, the those, the extensively the hips as well?

Liam (03:13):

Yeah.

Michael Dermansky (03:14):

Why those particular muscle groups?

Liam (03:16):

Well, if you think about uneven surfaces-

Michael Dermansky (03:18):

Yeah.

Liam (03:19):

Going up and down hills-

Michael Dermansky (03:20):

Yeah.

Liam (03:20):

You’re going to have to use those muscles predominantly to stabilize your upper body. And if you’re wearing a backpack as well-

Michael Dermansky (03:26):

Yeah.

Liam (03:26):

That’s your base.

Michael Dermansky (03:26):

Yeah.

Liam (03:28):

If they’re not strong enough, everything below that, everything above that will start to then feel a little bit, not quite right. If you’ve repetitive days of walking on them.

Michael Dermansky (03:38):

Right. I mean they’re your major propulsion muscles.

Liam (03:40):

Yeah, a hundred percent.

Michael Dermansky (03:41):

When you move forward, your bottom muscles and your quadriceps and your hip rotators, like you said, they’re the ones that keep your hips stable or do the pushing for you. And if they’re not strong enough and they’re doing it repeatedly again and over and over again, they’re just not going to have the strength to do it properly.

Liam (03:53):

Exactly right.

Michael Dermansky (03:54):

Yeah, I’m sorry. It’s much harder work than it needs to be.

Liam (03:57):

Yeah.

Michael Dermansky (03:58):

How long is a decent timeframe? So, is there, if you are going to go, let’s be hiking in the opposite example, if you want to do a ten-day track like that too, how long is a decent period of time before you travel? Is it a good time to start training?

Liam (04:11):

Probably a good three to six months beforehand to really prepare the muscles. Like you think about timelines of how neuromuscular patterns lay down within that seven weeks and then you go from thirty week onwards, that’s where you see that strength improve and you think about, okay, I need to create a lot more than just initial strength. And then you create consistent strength.

Michael Dermansky (04:31):

Yep.

Liam (04:31):

Neuro muscles can cope with that load. So, that would definitely be that three month kind of onwards point.

Michael Dermansky (04:37):

So, go back to, you said neuromuscular control in the first seven weeks and then three months after that too. What does that mean for the listeners? What does that neuromuscular control mean?

Liam (04:45):

So, if you started a new movement, there won’t be that initial, this muscle is becoming stronger. The brain needs the send signals down to those muscle groups to start firing, to create more patterns to then break down the muscle to then create even more muscle. That makes sense?

Michael Dermansky (05:02):

Yeah.

Liam (05:03):

Very simplified version of how to explain it.

Michael Dermansky (05:06):

Yeah. Well basically, well, as you said, the first thing that happens is that your body adapts, it gets stronger, but it’s not because the muscles grow. It’s because then the nerve connections to the muscle become more efficient. So instead of say one nerve fiber contracting and getting twenty muscle endings to work, it does five and five and five. So, that ability to modulate the amount of contraction that happens is a big difference in the first changes in strength. If you haven’t gotten bigger, you just got more efficient for the first seven weeks-

Liam (05:35):

Well. Exactly. Exactly right.

Michael Dermansky (05:36):

And then what happens after the first seven weeks?

Liam (05:38):

So, then you finally, as you’ve got that muscle patterning down, that’s where we then get the breaking down of the muscle because we’re sending more signals to it. So, then it’s able to activate them, break it down, and then obviously with rest then we can repair them and try again. It’s just a constant cycle from there on in.

Michael Dermansky (05:54):

And the first three months was the last we, the first base level of strength occurs and it’s the fastest rate and then it continues to occur up to about twelve months, but at a slower rate. But the process still happening as well.

Liam (06:07):

Yeah, exactly.

Michael Dermansky (06:08):

And you said you first you want to build up base strength and then you want to build up endurance.

Liam (06:11):

Yeah.

Michael Dermansky (06:12):

What does that mean?

Liam (06:13):

Being able to withstand obviously longer time periods where we’re using those muscles, so that can even be with your strength. But on top of that, going for practice hikes, things like that where you can actually getting in the load to be able to withstand that pressure of taking those days repetitively. If we don’t have, if you just go, okay, I’ve got enough strength training off I go-

Michael Dermansky (06:36):

Yeah.

Liam (06:37):

You’re not going to then be able to support actually having the kilometers in your legs to withstand the journey.

Michael Dermansky (06:43):

So, the order way I hear it is that you work on your strength first. Build up a good base of strength first and then work on the volume that you will need to be doing. So, if you need to be hiking for a few days, you need to be able to have the kilometers in your legs to be able to do that, but only after you build the base of strength, is that right?

Liam (06:59):

Think about a marathon runner.

Michael Dermansky (07:00):

Yeah.

Liam (07:00):

That you’re not going to start, okay, I want to do a marathon next in the next three, four months. I run a marathon tomorrow. You need to slowly build up towards that to be able to get there.

Michael Dermansky (07:09):

Yeah. Simple as that. Yeah.

(07:11):

Yeah. Very good. So, have you seen the difference working with someone who has put in the work and really enjoyed their holiday and instead of just getting through it, have you got any examples of people you’ve seen with that?

Liam (07:23):

Yeah, definitely. Yeah, so there’s been a few clients probably over Christmastime that went away on cruises, things like that. They gave us a good couple of months to work through, say it was like shoulder impingement.

Michael Dermansky (07:37):

Yep.

Liam (07:38):

Rotator cuff issues. They were a bit worried because they were going to be carrying their luggage and so on and so forth around different places and getting off the boat every couple of days. And we gave them, yes, some exercises to take with them, but we were for a couple of months with those exercises to increase their strength to be able to support them when they were away. And as soon as they came back, they said they had no issues whatsoever.

Michael Dermansky (08:00):

And that’s the way you want it to be. I mean, that’s the kind of holiday you want people to have, that they’ve done the work beforehand so they can just enjoy the time as well.

Liam (08:07):

Yeah.

Michael Dermansky (08:08):

So, you gave me an example of someone you would be working on with who’d go for a walking tour in overseas as well. How would that program differ? Say, if they were going to go skiing Whistler or what would you add into that program if they were doing something that would be different?

Liam (08:23):

So, obviously skiing you’re going to be using a lot more high impact on turning. So, you’re going to then work on that once again, that initial strength through those same muscle groups that we were talking about before. But then would work a little bit more dynamically, change the direction, a little bit of potential plyometrics to add in there to be able to stand load coming from different angles because you obviously need to ski for longer days. You’re going to fatigue and you’re going to be changing direction all day. So, to be able to withstand that within your joints is going to be the biggest thing.

Michael Dermansky (08:55):

Okay. What’s plyometrics?

Liam (08:55):

So, that’s when you are not holding within an exercise and you’re just repetitively using muscle contractions, concentric, eccentric to go through a motion. So, it’s almost like ballistic. You’re going quite quick.

Michael Dermansky (09:09):

So, it’s that explosive action as well.

Liam (09:10):

Exactly. Right. Yeah.

Michael Dermansky (09:11):

So, that not just the pure strength, not plus you see single sort of direct speed stuff, but that explosive action that you need when you change direction as well.

Liam (09:22):

Yeah. You’re using that strength in a quicker fashion.

Michael Dermansky (09:25):

Yeah. Okay. Not worries it all. I mean I guess we’re going to be talking about hopefully soon in one of the other podcasts. We’re coming up close to ski season here in Australia as well.

Liam (09:33):

Yeah.

Michael Dermansky (09:34):

Have you heard the opposite stories as well where people haven’t done the work, have gone overseas and then told the stories of what they experience was like instead?

Liam (09:47):

Unfortunately, a lot more than the aforementioned story, which is quite upsetting because you always want the best for people. But when people, like I said at the start, when people come to you potentially a couple of days before going on a trip and then you go, okay, what can we do? The likelihood of coming back healthy is very, there’s a definitely reduced, I think. And what I’ve seen, there’s been a couple of clients that we have here where I feel like it’s a constant cycle.

They’ll be here for a couple of weeks; it’s going to go on a little holiday and it’s here for a couple weeks and go on a little holiday. We’ll give them exercises to take with them. But because they haven’t had that initial period where they’re developing their strengths, setting down those patterns, they just will just always go back to that same spot. Which is quite upsetting. But it’s something that they hopefully will figure out in the long term and then will start to then work towards it.

Michael Dermansky (10:40):

Yeah, it is tough. You know that the base there and so, you know, give me someone who excited program to do that. Realistically, how many people actually do them with them. I think zero to nine is reality.

Liam (10:54):

I like to give people the benefit of the doubt. And I always do ask them, have they done their homework? But you never know if they’re lying to you.

Michael Dermansky (11:01):

The majority that will tell me that they’ve done it for a couple days and it stops.

Liam (11:05):

Exactly right. Yeah.

Michael Dermansky (11:06):

And the other type thing about that too, when they go overseas, do a holiday program as well, they’re not always doing it the right loads. They’re not doing it the right volumes. They’re not doing the right technique. So, it’s a patch. Exactly.

Liam (11:17):

Exactly.

Michael Dermansky (11:18):

It’s not going to get them further, it’s going to be hopefully minimizing the regression.

Liam (11:23):

Yeah.

Michael Dermansky (11:24):

Because I know we just, it’s hard to do when you’re using equipment’s there or no equipment at all and it’s hard to load people up at the right level directions.

Liam (11:31):

Exactly right.

Michael Dermansky (11:31):

That change.

Liam (11:32):

And I think that’s an important thing that to probably for listeners to take from this as well is if there is something that’s given to you, it’s about maintenance. The likelihood of constant increasing will probably won’t be happening and it’s just about keeping you where you need to be.

Michael Dermansky (11:47):

So, I mean, going back to that first three months, so if you’re training someone for three months, you brought a really good up here is that, you know, you’re changing as well. So, what do you as a health project professional working in fitness, when you change someone’s program in the first three months, what are you really looking for? What does that load increase mean? What are you thinking when someone’s doing an exercise program?

Liam (12:07):

So, I’m originally thinking, okay, let’s just get them confident with an exercise with a certain muscle group being activated. So, that is either with range or with base strength. And then from there, once I feel like they’re confident, stable in a movement, then you can start to increase the strength from there.

Once you’ve got then your good base of strength where they’re doing the repetitions quite easily and they’re not feeling too sore when they’re coming back in again or they’ve said that period from one session to another, they haven’t really felt much. Then you go, okay, now let’s compound it with various other movements to create a little bit more stability or drive through that muscle group to create even more strength.

Michael Dermansky (12:48):

So, that fine edge of pushing someone that goes a little bit beyond what their capabilities are at the time to force their brain, their muscles, their nerves to adapt and change, gives them a reason to adapt. And then, and we change the exercises from there to get them to that next level of- so they can keep adapting, as well. Because you want to see that change over time. You’re going that little bit more than what they can actually do. But if we’re not there on that edge, we’re not making a difference.

Liam (13:21):

Exactly right.

Michael Dermansky (13:21):

We’re not going to make a difference.

Liam (13:22):

And that’s where good education part of things kind of kicks in where we want to be pushing people into those limits. They might get comfortable with an exercise and they’re really happy staying there, but for them to progress further, we need to be able to push them into areas where it’s like, oh, this is a little bit uncomfortable. I’m struggling with it. I feel like I’m at day dot again.

Michael Dermansky (13:42):

Yeah.

Liam (13:42):

But you’re not actually-

Michael Dermansky (13:42):

You’re not day dot, you’re-

Liam (13:44):

You’re ready to go from a whole nother movement. So, let’s move from that.

Michael Dermansky (13:48):

And there’s the other flip side of that too. The balancing act between not going too far to that too, where I guess that’s the skill and art of it, is knowing that we are pushing someone to get a change. But not so far that they’re doing damage to the area. So yeah, it’s just such a fine line.

Liam (14:03):

Yeah. Yeah. And that’s where us as clinicians always asking when they’re first coming in, what’s the last couple of days been like is so important. If we’re missing those crucial, I guess, rest time periods and how they’re feeling, we can then miss completely, we need to increase or we need to decrease that load. If we’re honest with them and they’re honest with us, then we can go from there.

Michael Dermansky (14:26):

So, it’s interesting you bring it up when we brought up the previous podcast as well, how important that rest period is.

Liam (14:30):

Yeah.

Michael Dermansky (14:30):

It’s not, you are doing lazy, you’re not doing nothing. Oh, oh, I’ve taken a day off. No, you haven’t taken a day off. This is a major part of your program.

Liam (14:38):

Yeah.

Michael Dermansky (14:39):

That you haven’t, you’ve allowed your body to adapt so that we can push you again future loads so you can continue to adapt over that long period of time. Because we’re not thinking the short game with you. We’re not thinking that day one, two, what were you like this week? Did you do a hard work workout this week? That’s not our mind. Our mind, how do we get you from A to B in three months from now?

Liam (14:59):

Yeah, Yeah. Where’s your goals at?

Michael Dermansky (15:00):

Yeah.

Liam (15:00):

And how are we going to get you there?

Michael Dermansky (15:02):

Yeah.

Liam (15:03):

Simple as that.

Michael Dermansky (15:04):

And so that active, that response that you have the next two days lets us know, have we loaded you up enough to get the arrotation we wanted this week?

Liam (15:12):

Yeah.

Michael Dermansky (15:13):

Or have we been too nice to you?

Liam (15:14):

Exactly right.

Michael Dermansky (15:15):

So that, but we’re not that we have to push you a little bit more next time or have you pushed you too hard.

Liam (15:21):

Yeah.

Michael Dermansky (15:21):

That we are not going to get us to the goal we want it three months from now.

Liam (15:24):

Yeah. Yeah. Even today, for example, I had a client and I asked them how they’re feeling and they just went good. And I went, okay, you are only in the first three weeks of this journey. I want a little bit more than that. How are you actually feeling? How’d you recover from your previous session? What have you been doing in the last couple of days to, yes, make you feel good?

Michael Dermansky (15:42):

Yeah.

Liam (15:42):

And they just listed off, oh, okay. I’ve, I’ve been taking less Panadol, which has been really good. Cause my back’s not as sore anymore.

Michael Dermansky (15:48):

Fantastic.

Liam (15:48):

Cause I’ve been feeling like when I’m doing the exercises at home, I’m actually feeling more confident with it and I can go through the range without pain. And you go, okay, instead of just stopping going, okay, they’re good, let’s go. I’ve now got of them of five more points of information, which can then help me in that session to progress them a little bit further. And we, that’s what we did.

We did a little bit of harder exercise today. He said he really felt it. I was like, okay, this is a positive thing. Now from there, when he is in next, we asked the same question.

Michael Dermansky (16:16):

See, that’s a very interesting point. You said the client told you then they, you know that, how are you? Good, what does that mean? I have my knee’s been feeling a bit better. I can do, I’ve had required less Panadol before. That’s massive for us. So, we know that we can actually further load you and because we’re not, we’re dealing less with the problem area and moving much more towards performance then.

Which I think we talked, I talked about the last podcast with David as well. Is that fine line between performance training and rehab. It’s a very fine line that’s very, very blurred. Where we know that when those injuries become less on your mind and they become less irritable, we can then further improve your strengthen load.

Liam (16:56):

Hundred percent.

Michael Dermansky (16:56):

Can you give me another examples you think, off the top of your head of other story, great stories you’ve heard from clients about when they’ve done the work they’ve gotten ready. I know we’ve interviewed a couple of our clients, Steven Kathleen on the last podcast, what their [inaudible 00:17:11] was like. And that was just a great story. But anyone that you can think of as well specifically that told you about their training and about their trip overseas, they’ve really enjoyed as well.

Liam (17:20):

It was actually one who is away at the moment, and she comes in twice a week religiously since I’ve been here for, what’s that last year?

Michael Dermansky (17:29):

Yes.

Liam (17:30):

And she’s been building up to a, what is that, a three-month trip over in Ireland and all through the UK.

Michael Dermansky (17:37):

Oh, yeah. She’s sending us the photo still.

Liam (17:38):

Yeah. Lots of hikes and so on and so forth. And she’s had little flare-ups along the way through different things that she’s done in her lifestyle, but we’ve always worked towards it. And this has always been that goal. Increases strength so that she can go on those hikes and that she can go on lots of planes to go see her family. And yeah, definitely hearing from what she’s been saying is, “yeah, I’m happy, I’m feeling good and I can do the things that I can.” Which is great.

Michael Dermansky (18:03):

I think we’ve been getting daily messages from, on her Instagram show, all the different areas she’s traveling to as well.

Liam (18:10):

Yeah.

Michael Dermansky (18:11):

And the fact that she can do that, and she’s not young, is she?

Liam (18:15):

No, no. Not at all.

Michael Dermansky (18:15):

No.

Liam (18:17):

But the way that she’s moving is… Could be seen as being very young because she’s taken control of her body and she’s understand, okay, I need to do these things to get me to where I want to be and I’m going to do them, which is simple.

Michael Dermansky (18:33):

And she’s enjoying the lifestyle. That’s the whole point.

Liam (18:35):

Yeah.

Michael Dermansky (18:35):

It’s not to have a boring retirement, to have a great one and do all those things you have on your bucket list and actually tick those things off.

Liam (18:42):

Exactly right. Exactly right.

Michael Dermansky (18:43):

Anything further you want to tell listeners before we finish off with today?

Liam (18:47):

I think if you are thinking about, okay, I’ve booked a holiday, I’m going away. I’ve had a pathology that’s been in the forefront for a while, letting us know as soon as possible that you’ve got something planned and we can put into your goals is the best thing you can do.

Michael Dermansky (19:02):

Yeah.

Liam (19:02):

Because then we can, even though we won’t directly always talk about it in our minds and what we see is constantly going to be building you towards that.

Michael Dermansky (19:10):

Yeah.

Liam (19:10):

So, the more notice that people can give us, the further we can take people and the more comfortable they’re going to be with exercises that we give them when they go away, the more likelihood on top of that, that they’ll actually do those exercises to maintain themselves.

Michael Dermansky (19:24):

And lastly, they’ll actually enjoy their trip.

Liam (19:26):

Yeah, a hundred percent. Yeah. Instead of going, ah, I’m constantly in pain all the time.

Michael Dermansky (19:31):

Yeah.

Liam (19:32):

I wish I had things to be able to help me. We’re going, oh, I’ll just do these things for half an hour, fifteen minutes in a day. Let’s go from there. It’s a second thought.

Michael Dermansky (19:42):

Yeah. And you said at the very start, if we have at least ideally three months.

Liam (19:46):

Yeah.

Michael Dermansky (19:47):

Ideally six months, but we have three months before you’re going away for a large trip, that gives us a huge amount of time to make a really impact on how you are going to enjoy your trip overseas.

Liam (19:56):

Exactly right.

Michael Dermansky (19:56):

Well, thank you very much for your time again, Liam.

Liam (19:58):

Yes.

Michael Dermansky (19:59):

It’s been really good hearing your insights into what people can do to actually have a great time overseas and we’ll hopefully have you in the show again.

Liam (20:05):

Awesome. Thank you.

Michael Dermansky (20:06):

Thanks for your time.

Speaker 1 (20:07):

Thank you for listening to The Confident Body. For practical articles to help you build a confident body, go to MD health.com/articles.