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Avoiding overuse injuries to maximize fitness gains-Part 2🏋️‍♂️

Avoiding overuse injuries to maximize fitness gains-Part 2🏋️‍♂️

Today we answer the big one: Is there anything I can do outside of reducing my training/exercise volume and intensity to prolong the period that I make progress? In other words, you’re making great gains in the gym and you’re hungrier than ever to make even more gains, but you've noticed that your body is starting to feel beat up (check out part 1 for some helpful tips on what you should be looking out for). At this point, you're approaching that fine line between optimizing your performance and landing an injury. Decreasing your training/exercise volume and intensity would be the safest option to reduce the risk of potential injuries, but no one ever became great at what they do by always playing it safe. Instead, taking small calculated risks can yield substantially larger gains in the long run. With that said, it doesn't make much sense to take a calculated risk if we're not managing our recovery very well and leaving potential gains on the table, so let's first go over the following items: Nutrition, Sleep Hygiene and Stress Management. I'll be the first to admit that as a Physical Therapy Resident, my understanding of nutrition is rudimentary relative to my Registered Dietitian colleagues (Hi Maiya!). Nonetheless, I've spent the better part of my life being a competitive athlete and I've also earned two degrees in Human Kinetics, giving me an understanding of some of the basics. With this little caveat in place, if you aren't eating enough calories to meet your energy demands, you're leaving progress on the table. Not only will this reduce your stimulus for adaptations (i.e. you can't train as hard as you would with enough or more than enough food), but it will also reduce your body's ability to recover and/or adapt to the imposed stimulus (i.e. you won't recover from your training session as well eating less than enough food). I'll also add that knowing what to eat and when to eat can also have a profound effect on your ability to recover, but those topics would likely be better covered by Maiya, our Registered Dietitian here at Kinect Rehab and Performance. Another important piece to hone in on for one’s recovery is sleep hygiene. This topic has been covered in athletic circles for years, but not including it into today's blog post would be a grave mistake given the variety of disadvantages that come with sleep deprivation. I'll also add that making changes to your sleep hygiene is free outside of requiring a little bit of discipline. Vitale et al. (2019)'s review on sleep hygiene for optimizing recovery in athletes highlights many cons to sleep deprivation, including: slower reaction times, decreased vigor, poorer accuracy, decreases in strength, decreases in endurance, and not to mention declines in cognitive function that can impact one's decision-making skills during a pivotal moment in competition. Having said that, even adhering to some of the basics of sleep hygiene can improve one's recovery and performance. For my clients, athletic and non-athletic alike, I like to keep it simple unless they're very keen to fully optimize their sleep hygiene. Some of the strategies I'll use with my clients include: Sleep at least 7-9hrs every night, avoid using screens at least one hour before going to bed, avoid stressful and/or stimulating thoughts before bed, and sleep in a cool dark room. While these recommendations aren't a 'one size fits all', they serve as great starting point to getting enough quality sleep so that you're maximizing the benefits of your training sessions. Lastly, I would be remiss to not include stress management as a means of optimizing one's recovery. Given that stress and anxiety can impair one's ability to sleep, it is no surprise that utilizing stress management strategies can greatly improve one's ability to recover. It is therefore a no-brainer that we should have strategies in place that help us manage psychological stressors (e.g. deadlines at work/school, relationship conflicts, passing of a loved one, etc.). Unfortunately, providing specific recommendations in this post is unlikely to be helpful since every client that comes into our clinic is working through psychological stressors unique to them. Having said that, from a more general point of view, even just acknowledging that psychological stressors are currently at a high can help manage one's expectations, reducing the frustration that follows a disappointing performance. In my experience, psychological stressors also tend to be transient so weathering the storm is often a viable strategy to preserve a positive outlook on one's current situation. Key Takeaways: -Decreasing exercise intensity and volume is a safe route to avoid overuse injuries, but doesn’t necessarily maximize fitness gains -We should reflect on our own recovery habits (i.e. Nutrition, Sleep Hygiene and Stress Management) prior to making the decision to decrease our exercise intensity and volume Now, I know what you're thinking— “Alan, you hinted in part 1 that managing sleep and nutrition aren't the only tools you guys use at Kinect Rehab and Performance to optimize performance, what gives?”. Well, I hope you're not sick of my writing quite yet. In part 3, we'll be going over specific strategies to help you guys keep the gain train moving even further along (Hint: Exercise variability is your friend). References: Vitale, K. C., Owens, R., Hopkins, S. R., & Malhotra, A. (2019). Sleep Hygiene for Optimizing Recovery in Athletes: Review and Recommendations. International Journal of Sports Medicine, 40(8), 535–543. https://doi.org/10.1055/a-0905-3103

Avoiding overuse injuries to maximize fitness gains-Part 1🏋️‍♂️

Avoiding overuse injuries to maximize fitness gains-Part 1🏋️‍♂️

We've just hit the month and a half mark since the gyms have reopened in Toronto, and it has been refreshing to see so many of our clients itching to regain some of the fitness they lost over the course of several COVID-19 lockdowns. We get it! You're hungry to get back to where you were prior to the pandemic and can barely contain yourself at the thought of breaking a new personal record. Many, if not all, of the clinicians here at Kinect Rehab and Performance feel the same way about our own fitness and athletic journeys. Unfortunately, being excited to make new gains doesn't make you injury-proof and we all know that getting injured is a fast way to lose progress. Rather than analyzing movement mechanics and making minor technical changes to facilitate performance improvements, lately I've found myself more frequently wrapped up in conversations surrounding load management. Simply put, doing too much too quickly can get you into trouble from an injury prevention standpoint. Of course, this begs several important questions that need answers: How much training/exercise is too much? How do I recognize when to pull back on my training/exercise routine (and do I have to)? These are great questions and as you would imagine, they're all relatively unique to the individual and their current situation. As much as we can really dig deep into the scientific literature and satisfy our inner geek, I'll spare you some of the boring details and we'll get straight into some of the practical answers to both of these questions. For starters, I think we all know how much is too much exercise/training. If you've ever taken a fitness and/or sport performance goal seriously, you've hit that point where it was no longer as fun to push forward. Some describe it as going through the motions while others describe it as losing motivation, and that eye on the prize starts to shift towards more restful behaviours. If any of you are like me, that usually looks like having difficulty getting out of bed in the morning, drinking more caffeine to find the energy to get through the day or looking through the takeout menu rather than sticking with your nutrition goals. Unfortunately, staying the course and ignoring some of these earlier signs to reduce training volumes and intensity have been landing a number of our clients into clinic. That means we've been seeing more and more overuse injuries, including: Tennis elbow (lateral epicondylitis), Golfer's elbow (medial epicondylitis), Jumper's knee (patellar tendonitis), Shin Splints (medial and lateral tibial stress syndrome), bicipital tendonitis and low back strains. Now don't get me wrong, we love seeing our clients but we much prefer to see them in situations where we're fine-tuning their performance rather than seeing them upset and in pain. Aside from the obvious (injuries hurt!), I'll also add that from a psychosocial standpoint, injuries tend to make individuals less confident and less motivated athletes. But now I'm ranting and perhaps this is something we'll revisit in a future post. At this point, I really hope you're not thinking "Alan, so at the first sight of feeling tired and unmotivated, I should stop training?". That couldn't be further from the truth! But I would say it's time for an honest audit of your training and recovery habits. In my experience as a former coach for competitive Tae Kwon Do and Powerlifting, one of the most important skills for an athlete to learn is how to walk the line between pushing forward to maximize progress and landing an injury. With that said, it can be rather helpful to have an experienced coach and/or rehab professional on your side. Key Takeaways: You body's desire for restful behaviour is an early warning sign that you might be training beyond your ability to recover Ignoring your body's desire for restful behaviours can increase your risk of injury over time Training as hard as you can while respecting your body's desire to recover is how you optimize performance gain while mitigating injury risk If you're curious about how to maximize the time you spend making gains rather than constantly pulling back on your training volume and intensity, you won't want to miss part 2! We'll be covering a variety of options to keep the gain train moving (Hint: Sleep and nutrition are key to maximizing your recovery, but they're not the only tools we use at Kinect to optimize performance).

Muscle imbalances

Muscle imbalances

Could your muscle imbalances be the underlying mechanism of your chronic pain? A muscle imbalance is a disruption of local and global relationships between functional muscle groups of our body. There are a few variables we use to help evaluate muscle balance: activation, strength, control, and length. The hard part is imbalance can be a combination of all four and to varying degrees! An even crazier thing is that muscle imbalance seldomly shows up in the form of pain right away, if at all. Instead, it creeps up, primarily affecting the way your body functions, creating compensatory muscle patterning. We call this, functional dysfunction. Most of the human beings on this planet live and can function with it unknowingly. Ignorance is bliss. Try this, ask 3 of your friends to squat as low as they can. You will likely find that all 3 of them squat in a distinct way, using different strategies. Most will associate the differences with the structural make up of a person (bone alignment). Rarely, will it be associated with the way a person's muscles are balanced/imbalanced. So when does muscle imbalances commonly become a problem people are aware of?When it starts to cause a domino effect that leads to a person's experience of pain or injury. Often, when muscle imbalance is an underlying culprit, we often hear of client's telling us stories of recurring visits to their rehab therapists for various injuries or pains that feel like they came from nowhere. Their problems are often never fully resolved.
The next time you find yourself experiencing recurring/frequent injuries or long standing pain that seems to have no full solution, the underlying mechanism could be an imbalance in your muscles.

Headaches

Headaches

Sick and tired of headaches? You’re not alone on this one. As many as 9 of 10 North Americans suffer from headaches. Some headaches can be more consistent, more intense or longer lasting than others. We all share the common feeling of wanting them gone as quickly as they pop up. Here's some information about headaches you may find useful: Headache Triggers This can sometimes be complex and multifactorial. Causes of a headache may include specific foods, environmental stimuli (noises, lights, stress, etc.), grinding your teeth, dehydration, and other behaviors (insomnia, excessive exercise, blood sugar changes, etc.). Cheeses, tannins in wine and MSG are also well known triggers of a headache. About 5% of all headaches are secondary and they are like warning signals caused by physical problems. The remaining 95% are primary headaches, and can be further categorized into these groups: Tension, Migraine or Cervicogenic headaches. These types of headaches are not caused by disease; the headache itself is the primary concern. Tension Headache - Presents as a band-like head pain with a pressing or tightening quality. These can be mild to moderate in intensity. They are not likely caused by underlying problems in the neck or head. Tension headaches have frequent episodes that last for minutes to days. There is no associated nausea or vomiting but there may be other associated sensitivities including light (photophobia) or sound (phonophobia). They are commonly brought on by stress and can present with myofascial tenderness around the head and neck. Migraine Headache - Appears as one sided pulsating pain of moderate or severe intensity in the head. Migraines can oftentimes present with a phenomena called an "aura", a sensory disturbance that is experienced immediately prior to the migraine. These disturbances can include flashes of light, blind spots and other vision changes or tingling in your hand or face. They are not likely caused by underlying problems in the neck or head. Migraines are recurrent and can last as little as 4 hours or as long as 72 hours. One or more of the following are present with a Migraine: nausea, vomiting, photophobia (light), and phonophobia (sound). The pain is aggravated by routine activities. Cervicogenic Headache - The problem or source of these headaches comes from the head/neck and are mechanical in nature. It can affect one or more regions of the head, face, or both. Cervicogenic headaches are often associated with reduced neck range of motion, local neck tenderness, and trigger points that refer to the head. When myofascial tender spots are the only cause, the headache should be diagnosed as tension-type headache, not cervicogenic headache. How Experts Can Help Proper diagnosis and headache classification is important for effective relief and treatment. In rare cases, a referral to a specialist and co-management is the most appropriate course of care but that will be determined upon assessment. The plan of management will be individualized to the patient’s specific case. The treatment options may include: 👨🏻‍🏫 Patient Education 🦴 Joint Mobs & Manipulation 💆‍♂️ Muscle Release Therapy 🪡 Acupuncture ⚡️ Electric Stimulation 🏋🏻‍♂️ Rehab/Exercise 🧘🏻‍♀️ Ergonomic and lifestyle changes 👨🏽‍⚕️ Referral and co-management Evidence has demonstrated that these treatments including spinal manipulative therapy, can be effective with cervicogenic and tension-type headaches. Studies have demonstrated that care offered by Rehabilitation Therapists (i.e. Chiropractors, Kinesiologists, Occupational Therapists, Physiotherapists & Massage therapists) can also improve the intensity and frequency of migraines. If you haven’t already, consult a health professional about your headache concerns and see what they can do to help you! References Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014; 37: 42-63. Bryans R, Descarreaux M, Duranleau M, et al. Evidence based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011; 34: 274-89. Bryans R, Decina P, Descarreaux M, Duranleau M, et al. Clinical Practice Guideline for the Management of Headache Disorders in Adults. Canadian Chiropractic Association (CCA) and Canadian Federation of Chiropractic Regulatory and Educational Accrediting Boards (Federation) Clinical Practice Guidelines Project. 2011 Jun. Dr. Vic Weatherall. Advance Chiropractic.https://advancechiro.on.ca/headaches/ December 2014