Research Review: Are Warm-Ups worth the effort?

Most Physio’s, PT’s and Coaches firmly believe that a good warm up is essential in reducing the chance of injury and preparing the body for the activities to follow, but has this injury reduction benefit been actually proven in science?

In a research review published in The Journal of Sports Science and Medicine, academics from Monash University in Melbourne reviewed studies that looked to answer this question. Surprisingly over the past 40 years there have only been five studies that looked at the injury reduction benefit of a warm-up.

From the five studies examined, three of the studies supported the use of a warm-up to reduce injury whilst the remaining two did not.

The Monash researches went on to conclude from their evaluation that:

In the three positive studies there was a greater emphasis on general exercise to increase body temperature while the two negative studies were more involved in stretching warm-ups.
The three positive studies found that the reduced injury risk was associated with the age and type of activity undertaken.

Even allowing for the lack of research material, we still suggest that you undertake a thorough warm-up before performing exercise. For example:

5-20 minutes in total.
General activity to increase basic body temperature followed by some more specific range of motion stretching that replicates the events to follow.
A series of balance related activities to ensure your sensory receptors are prepared for the tasks to follow.
Gradually increasing intensity becoming more specific and “game like” as the training session or game approaches.

For assistance with your pre-exercise download our ‘Injury Prevention’ ebook

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

May 14, 2012 | Category: Sports Injury, Training Tips — Tags: prevention, sports injury, warm up — Kate Markland
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Health Tip: Diet Vs Exercise

Which is more important – diet or exercise? It’s one of the most commonly asked questions for those setting out to lose weight. And the short answer is ‘both’.

If you hate exercise and want to lose weight just by changing your diet, you’re setting yourself up to fail, says Dr Chris Tzar, an exercise physiologist from the University of New South Wales. Choose this path and there’s a 90 per cent chance you’ll regain any lost weight within three years, he says.

Besides, he points out, a healthy weight is only one component of good health, and many of the other benefits of exercise are invisible. “All the research clearly shows that exercise, even in the absence of weight loss, improves all your clinical markers like your blood sugar, your blood pressure, your cholesterol.” Regular exercise also helps keep your appetite more stable.

But what if, conversely, you love exercise but find it much harder to change what you eat? You only have to look at how much exercise it takes to burn off a single slice of apple pie (two hours walking) to realise that for most people, losing anything more than a few kilos through exercise alone will be challenging. It’s unlikely you’ll be able to work out enough to make up for any significant amounts of eating (let alone past amounts of eating). And like exercise, a good diet makes you healthier on the inside too.

Bottom line: For best results, you really have to tackle both your diet and your activity levels

That’s because dieting without exercise increases the odds of losing muscle from your body along with any fat. Since muscle cells burn more energy than fat cells – even when you’re not actually doing anything – losing muscle makes it harder to lose weight and keep it off. That’s why so-called resistance training, which builds muscle strength, is recommended, along with more aerobic exercise such as walking, swimming or running.

While there’s debate about the extent of muscle loss from moderate cuts to your food intake, most dieters cut their kilojoules by 25 per cent or more, Tzar says. And at that level, he believes muscle loss is likely.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

May 7, 2012 | Category: Training Tips — Tags: diet, exercise, weight loss — Kate Markland
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What are safe versus dangerous exercises?

The concept of ‘safe or dangerous exercises’ is a common topic of discussion among industry experts and, in many cases, there are plenty of grey areas. It is important to realise that an exercise that is considered safe for one participant may be potentially dangerous for another, but that said, there are a number of relatively simple indicators that can help identify movements that may be considered ‘potentially dangerous’ or ‘ineffective’ in the majority of health and fitness programs. And, of course, any personal trainer should be able to help further with this identification process.

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The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

April 30, 2012 | Category: Ageing, Back Pain, Knees, Shoulder, Sports Injury, Team — Tags: cycling, running, self help, sports injury, stretches — Kate Markland
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Calf Strain

Causes of calf pain can include muscle cramp, delayed onset muscle soreness (DOMS) and referred pain from the lumbar spine, however, by far the most common cause of pain in the lower leg is a strain to the musculotendinous complex of the Gastrocnemius and/or Soleus.

Within the fitness industry calf tears often occur in typical activities such as shuttle runs (requiring rapid acceleration and change of direction), split jumping (where one leg is thrust backwards on landing), incline running and sprinting. This injury is common in boxing sessions where participants are jumping and hopping on their toes and also in hill work on sand in the popular “Boot Camp” activities due to the unstable surface the sand provides and the intense muscle work involved in these sessions.

Examination reveals tenderness localised to the site of the tear and if severe, a palpable defect or gap may be felt. Stretching of the Gastrocnemius will also reproduce pain, which is why the patient will usually walk with the foot turned outwards as this limits ankle dorsiflexion and reduces the need to dorsiflex the ankle whilst walking.

There is also a significant number of people who do not have the sharp, stabbing pain associated with the typical calf strain – but report more of an intermittent cramping sensation during exercise. This “cramping” sensation is often due to recurrent minor calf tears which can be linked back to old scar tissue from a previous (and more severe) calf tear – this scar tissue is common in patients that did not undergo adequate rehabilitation following their initial calf injury.

As with all episodes of pain it is essential the client is examined by a Physiotherapist or sports physician as soon as possible. The medical professional will evaluate the extent of the injury, outline an approximate time line for rehabilitation, as well as excluding any more serious problems such as achilles tendon rupture, lumbar spine referral and deep venous thrombosis (DVT).

Once the calf strain is diagnosed and other problems excluded, initial management will aim to reduce pain and swelling. This is best achieved with ice, elevation and compressive bandaging. The patient may also benefit from a small heel raise in the shoe to prevent excessive stretching of the calf when walking, females will typically be more comfortable in shoes with a moderate heel raise.

Gentle stretching to the point of a “tightness sensation” and muscle strengthening can begin after the first 24 hours. The exercise progressions commence with bilateral concentric calf raises and gradually progress to unilateral concentric, adding of weight and finally bilateral and unilateral eccentric lowering over the edge of a step. Final stage rehabilitation will involve plyometric and sports specific drills to ensure complete recovery prior to returning to sport. Soft tissue therapy is an important component of the management plan as residual scar tissue can lead to long term problems and injury recurrence.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

April 23, 2012 | Category: Foot and Ankle, Knees, Sports Injury — Tags: ankle, calf, muscle, sports injury — Kate Markland
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Back Pain – Causes and Treatments

Low back pain is one of the most common medical issues facing our modern society – with some reports indicating that over 70% of people will, at some stage, suffer from pain in this area of the body.

Some of the structures responsible for causing back pain include:

Injury to the small apophyseal ( facet ) joint at the rear of each spinal segment
Damage to the capsule ( soft tissue covering ) that surrounds each facet joint
Stretching of ligaments that secure each vertebral body to the one above and below
Overuse of injury to any of the small muscles linked to each spinal level ( and there are many)
Bone bruising and damage caused by direct impact or rubbing on other surfaces
Irritation to the nerve endings and blood vessels in the low back area.
Injury to the intervertebral disc between each spinal segment ( it was originally thought that the intervertebral disc itself had no pain sensitive nerve endings however nerve endings are now thought to be in the outer one third to one half of the disc

With such a large number of possible structures that can cause pain – it is important that all episodes of Low Back Pain are fully assessed and a treatment program commenced as soon as possible.

A typical Low Back Pain treatment program will involve the following stages:

Initial examination by a Physiotherapist to allow an accurate diagnosis and treatment plan to commence.
Eliminate possible causative factors – these may include changing posture, reducing prolonged sitting with poor desk setup and correcting poor lifting techniques in the gym and at home.
Reduce pain and inflammation – this is best achieved with physiotherapy treatment techniques, ultrasound, acupuncture, massage, heat, taping, bracing and possible anti inflammatory medications from your local doctor.
Improve and restore full range of spinal motion – this will involve gentle mobility exercises for the back, physiotherapy treatment techniques, swimming, walking, and other gentle exercise methods.
Restore and improve overall flexibility and strength – this stage involves the correction of specific flexibility issues and improvements in areas such as core control and general strength overseen by your physiotherapist.
Return to full sport and improve overall fitness – this final stage ensures that you return to your chosen sport and fitness activities with reduced chance of re-injury and correction of the initial causative factors.
Remember if you or a someone you know has back pain make sure you get a full assessment as soon as possible – call 01285 654059 to book your assessment.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

April 16, 2012 | Category: Back Pain — Tags: arthritis, back, back pain, physiotherapist — Kate Markland
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Do You Have Patello-Femoral Pain?

Pain at the front of the knee and under the kneecap is a frequent complaint we see at The Markland Clinic – this discomfort can be due to conditions such as fat pad impingement, patellar tendinopathy or more commonly – Patellofemoral Pain Syndrome – in this article and we will tell you more about knee pain and how to get rid it.

The typical Patellofemoral Pain patient presents with a history of a generalized ache at the front of the knee, placing the palm of the hand directly over the kneecap to indicate the region of pain. The pain is often aggravated by running (especially downhill), stairs and sitting for prolonged periods with the knee bent- this is termed a positive “theatre sign” or “movie sign” with patients preferring to sit in the aisle seats to allow them to keep the knee extended during the performance.

Effective management of Patellofemoral Pain Syndrome starts with a full physiotherapy assessment to identify the problem and outline the best course of treatment to get the patient back to full training and activities as soon as possible.

The initial stage of treatment (as with most overuse injuries) is to actively control pain and inflammation – this is best achieved with a combination of ice, rest from aggravating activities, anti inflammatory medication.

An important component of the rehabilitation process is the need for an effective strengthening program to restore pre injury function. The majority of exercises should be performed pain free with close attention being paid to any post exercise pain and especially increased pain the morning after a rehabilitation session – the need for appropriate strengthening must be balanced with possible aggravation of symptoms.

The exact exercises chosen will depend on the severity of symptoms and will e guided by your physiotherapist but the majority of programs initially focus on isolating the Vastus Medialis Obliquus ( the small muscle on the inside of the knee) to contract prior to the activation of the rest of the quadriceps group.

Many patients with Patellofemoral pain have issues relating to excessive subtalar pronation (flat feet) which can act to increase internal rotation of the lower limb contributing to alignment issues.

While patella femoral pain is a very common injury it is also very treatable and with the right combination of rehabilitation exercises, stretching and biomechanical correction the sufferer will be back to sport in next to no time.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

April 9, 2012 | Category: Knees — Tags: knee, pain, patella, sports injury — Kate Markland
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Research Update: Core Stability and Cycling

A study printed in the “Journal of Strength and Conditioning Research” looked at the relationship between core stability and cycling performance.

The US researchers recorded data on pedal force and hip, knee and ankle joint motion of 15 competitive cyclists during bouts on a high speed treadmill cycling. In between the treadmill cycling bouts the cyclists where taken through a 30 minute workout designed to fatigue the core stabilisers – basically the researchers where interested in the effects of CORE fatigue on cycling technique and performance.

The CORE fatigue workout involved a circuit style session of 40secs on and 20secs off with a combination of seated upper torso rotations with a medicine ball, side bends with weighted plates, standing torso rotations with pulleys (like a woodchopper) and incline sit-ups with weighted plates.

The results showed that core fatigue did effect and alter cycling mechanics – especially in regards to knee motion – in a way that may increase the risk of injury. This study promotes the need for improved core stability and endurance to ensure correct alignment is maintained during extended cycling sessions.

It also has implications in that we need to ensure that core stability training is included in the program for cyclists but we also need to be aware that a session of core training prior to a bout of cycling may increase the injury risk in that session due to altered cycling mechanics.

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

April 2, 2012 | Category: Back Pain, Training Tips — Tags: back, back pain, cycling, muscle, research, sports injury — Kate Markland
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Why Ankle Sprain is a Health Hazard

I recently suffered an ankle sprain and I am not sure of what I need to do to assist my recovery and prevent this from happening again? Is it true that I will always have weak ankles from now on?

Ankle sprains are truly one of the most common injuries we see in our physiotherapy clinic and, as you correctly mentioned, can certainly lead to prolonged problems if they are not diagnosed fully and treated effectively from day one.

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The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

March 26, 2012 | Category: Foot and Ankle, Sports Injury — Tags: ankle, pain, running, teenagers, tennis — Kate Markland
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Hamstring Injury – Are you completing all 6 steps?

Hamstring injury is one of the most common problems we see at The Markland Clinic and it is unfortunately an injury that often recurs – especially if a thorough rehabilitation program is not completed.

Researchers in the UK completed a thorough review of current hamstring injury rehabilitation protocols titled “Training Considerations after Hamstring Injury in Athletes” which was published in the 2009 Strength and Conditioning Journal 31(1).

In their review the researchers concluded that there are essentially 6 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence – these are:

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The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

March 19, 2012 | Category: Sports Injury — Tags: football, hamstring, muscle, sports injury — Kate Markland
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Spring 2012 PhysioFocus Newsletter

Click here to check out our first newsletter Spring 2012 PhysioFocus

The Markland Clinic providing first class specialist Physiotherapy in Cirencester and Swindon

If we can help you in anyway please contact Erica

at Cotswold Leisure Centre, Tetbury Road, Cirencester, Glos, GL7 1WG 01285 654059

at David Lloyd, Latham Road, Swindon, Wilts SN25 4DL 01793 469309

March 18, 2012 | Category: Blog, TMC News — Kate Markland
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