Rehab and Performance

26/03/2021

Gym For Sport- How Hard Should We Be Training?
So we’re getting the message.
Being STRONGER allows you to perform better at your chosen sport.
Being STRONGER makes you less likely to get injured.
And the gym is a great, if not the best, place to get STRONG.
‘But the ONLY way we get strong is by MAXING out in the gym’
‘Unless you’re training to FAILURE, you ARE NOT getting STRONGER’
What if that WAS NOT necessarily true? What if we could train SHORT OF FAILURE, and still get stronger?
Smart people in universities have demonstrated this phenomena in Elite Rowers YEARS ago. They took the rowers through an 11 week program where half the group trained to FAILURE and the other half trained 3-5 reps SHORT OF FAILURE. It turned out that BOTH groups got STRONGER, with neither group gaining more strength than the other.
What’s more interesting, is when COMBINED with fitness training, these same researchers show that the groups that trained to FAILURE in the gym, gained LESS strength than those that trained SHORT OF FAILURE.
So, if you’re using the gym to get STRONGER for your chosen sport, is it necessary to train to FAILURE? Probably not. Worst case, if you’re also doing fitness training for your sport, it could even mean you don’t get as strong as someone that trains SHORT OF FAILURE.

25/03/2021

The Gym In-Season- A Good Program

Most of us that play winter sport understand that the offseason and preseason is when gains are made in the gym. We aren’t playing on weekends, we can afford to be run down from hard gym sessions. Plus everyone knows you lose strength across the season, best to try and get as strong as possible before the season gets underway.
But what if you can keep GAINING strength during the season?
What if you could finish the season STRONGER than you started?
What if you’re physically at your BEST when you’re coming into the finals?
Often we can’t train as hard in the gym in season. And we can’t train as often. But that doesn’t mean we shouldn’t train at all- because that will GUARANTEE you lose strength across the season.
Good gym programs will challenge you physically, while not interfering with your footy/soccer/netball training and playing.
Good gym programs will allow you to continue training regularly, even when you have to recover from hard games on the weekend.
Good gym programs will make you stronger at the end of the season, not just the start, even given all the games, the soreness and the challenges.
If your gym program doesn’t allow you to train fully for your sport, then it might not be a good program.
If your gym program doesn’t allow you to train in the gym regularly, even with the need for recovery from weekend games, then it might not be a good program.
If your gym program doesn’t make you stronger at the end of the season compared to the start, then it may not be a good program.

04/02/2021

Mobility- is it the solution to everything that hurts?

A comment I often get in my role as a sports physio, is that people blame not stretching for getting injured. “I don’t stretch”, “i should be stretching”, like we should know better.
But is stretching really a good way at preventing injuries?
Before i get into technical research, it pays to do a little thought experiment. If stretching is so good for injury prevention, then surely those of us who are most flexible should have the least injuries.
This doesn’t seem to be the case. Those who are deemed most flexible, with confirmed ‘Generalised Joint Hypermobility’ have at least the same rates of injuries in sport, and some research shows there’s a trend for GREATER risk of injuries around joints in particular.
There’s some research that shows a trend to greater risk of stress fractures in runners with the most flexible hips.
So being more flexible, at least genetically, could possibly be a slight disadvantage for injury prevention,
When looked at as an injury prevention program on its own, stretching seems to, at best, have no effect. Some very smart people in universities have been studying this for decades, and the total data shows that stretching seems to have no effect on stretching.
Don’t beat yourself up if you don’t stretch and you get injured. Injuries are often more complicated than that, with many factors outside of our domain of control. And being more flexible may not necessarily be a useful way of lowering your chances, it could actually cause more problems.

31/01/2021

If you're into your pre season, and your shins/calves are holding you back, check out my free prep program.
Developed last year for those returning to play after lockdown, it's a 3 phase program aimed at getting u back to running ready, faster.

Below is a quick taste of phase 1.

https://drive.google.com/file/d/1TwuN1u40eUzFgdYmaQ8sWqzmQSabg_Y4/view?usp=drivesdk

For the rest of the program click the link below/in my bio

https://mailchi.mp/b007dff9d22e/preprogram

30/01/2021

A post from last year, but something I think is very relevant for everyone starting back into pre-season after the shambles we now call 2020

👌💪

Shin Splints- Why Does My Shin Ache With Running?

You’ve been doing more running. Maybe soccer has gone back. Maybe you’re building up to a marathon later in the year? Whatever the scenario, the inside of your shins are now painful when you run.

What gives? “I thought doing more was good for me?”. It definitely is, ultimately this is how we get fitter and stronger, by doing more than we used to. But sometimes things increase at a faster rate than our bodies can adapt to. And when this happens, things can become painful.

What is it that’s painful in shin splints? It depends on how severe it is. In the most mild case, it’s the lining of the bone that your muscles, in this case your toes flexors and your soleus muscle, attach into. This lining is known as the periosteum, and it’s highly sensitive. When we up our running, and these muscles fatigue and start getting pulled this way and that, the periosteum becomes red and angry. And we notice it with impact while running.

Should this continue, and you notice it becoming more painful and aching at night, then the shin bone itself has likely become irritated. This is known as a stress response, and it’s when bone isn’t coping with repeated loading. And again, this is often due to muscles fatiguing and not being able to absorb impact when running. This impact then transfers onto the bone, which has a ceiling of impact it can tolerate before it starts stressing out.

This problem therefore has a spectrum of severity- the less bone involved, the less severe it is and the shorter timeframe to get better and vice versa.

So what do you do about it? While it does depend on the severity. Oftentimes you can keep doing some running, within what is comfortable. So this might mean you run , but not as fast, or for as long. Let your symptoms guide you. Once it starts getting worse with each step, stop and walk instead to make sure you aren’t adding stress to an area that already isn’t coping.

To help settle symptoms in less severe cases, like when your shins aren’t aching at night, NSAIDs in both oral and topical form can also help. But please check with your GP or pharmacist if this is appropriate for you.

Long term, increasing your foot and legs ability to absorb impact is important. Footwear can help here, but ultimately calf strength is king. Getting your calves stronger over time will build up their natural shock absorbing capacity, and therefore you can get through more running with less pain.

So if the inside of your shin is painful, and you’ve been upping your km’s, then you might have shin splints. Try and keep running within your pain tolerance, and get stuck into rebuilding your shock absorbers.

26/11/2020

Strength Training- Strengthen Your Body, Strengthen Your Mind
Strength training has the benefits of not just making us stronger, of building up our muscles, or helping us lift ever bigger weights.
Strength training has many health benefits, many of which i’ve discussed in my blog and many of which are starting to make their way into everyday media.
An under-appreciated by-product of regular resistance training is the boost in self confidence and self esteem that it gives you.
Smart people in universities have been showing these benefits for some time now. At the end of studies that measure not only that the person has greater strength, is able to lift more weight than they used to, they also have greater self confidence.
But anyone that has spent time doing regular resistance training feels the boost, we didn’t need the nerds to tell us that!
For mine, the reason for this boost in self confidence is intuitive. If i can handle more weight than i used to, i must be stronger than i thought. Therefore i can probably handle more physical challenges in everyday life than i thought i could before. So my confidence in my body and therefore in myself is increased alongside my physical strength.
I start to no longer second guess myself when faced with obstacles. I’m confident my body can handle anything that the world throws at it. I’ve been through some hellish workouts and escaped unscathed, weights that used to make me nervous are just part of training now.
I think the ability to overcome obstacles in the controlled environment of the weight room gives us greater confidence that we can overcome obstacles in everyday life. We have more trust in our bodies because we have experienced what it’s like for it to be able to handle more than it did before.
So don’t think the only pay off of resistance training is physical; there’s a major payoff psychologically as well.

22/11/2020

“Help, my groin pain has stopped me from playing sport!”- Osteitis P***s

Osteitis p***s, or athletic groin pain, can often result in quite disabling pain, stopping the athlete from being able to sprint, kick, and change direction with any intensity. At worst it makes it hard to get out of bed, out of the lounge, it generally makes life difficult.
So what is it?
Firstly, osteitis p***s is an umbrella term, a catch all name that essentially means that your groin is sore (‘thanks professor”), without identifying what it is in your groin that’s actually causing the pain. Not to mention why it became sore in the first place.
The thing is, there are many structures around this area that can become painful in the athlete: your adductors, your hip flexors, your abs, hernias, hip joints, p***c symphisis, bone….
So it’s important to firstly get a good grasp of which of these is the primary driver, because it will significantly influence what we do about getting it to settle, and getting you back to your chosen sport.
And while scans can be useful in this scenario, the challenge is a significant number of athletes will have groins that light up like xmas trees in scans that don’t have any groin pain at all. So when getting the results of your scan, it’s often challenging to tell what was lighting up before you got sore, and what’s actually causing the problem.
This is where a skilled clinician comes in. We listen to your story, we ask questions, we do tests that researchers have developed to tease out all the pesky features of your problem. Then, combined with any scans you might have or get, we can make a well informed, detailed diagnosis of your groin pain, what’s driving it, why it’s sore, and most importantly map out the pathway to getting the pain to settle and then get you back to training and playing.
If you have osteitis p***s, or find yourself struggling with it every season, get in touch and let’s start figuring out what’s causing it

19/11/2020

How Hard Should I Train?

We discussed last week that, for the best long term outcome with training you need find the goldilocks zone. While this is easy to understand from one end of the inverted U, that is by making sure we’re not doing too little, it’s harder to know if we’re doing too much.

So if training too hard isn’t good, how hard should you train, given we want to get fitter and stronger?

The first thing to consider is, how hard you train is relative to YOU. That is, it depends on how fit and strong YOU are, right NOW. Just because Joe Bloggs can lift that weight, or run that far, doesn’t necessarily mean you can, and it doesn’t mean that that’s enough for you. If your strength and fitness is different to Joe, then his lift or run might not be appropriate for you.

This example also holds true to what you used to be able to do. If past you could lift more than you can now, then basing your training programs around past you will only lead to overload and heartache.

The next consideration is does your training need to be maximal intensity, all the time? That is, do you need to max out in the gym, jack your heart rate in your run, every time you train to get fitter and stronger? There’s a growing body of research that answer this question clearly; “no”. But it does have to be hard enough, it does have to challenge you, to get the body to adapt. It has to fall into the goldilocks zone. Sub-maximal but still challenging is the key.

So how hard should you train? Taking the above two things into account, you should train at an amount determined by YOUR max strength and fitness. That is, if we know what your 100% is, and we know that we need to train short of that, then we can start to know how hard you need to train that is SPECIFIC to YOU.

This means that we actually need to know, or at least have an accurate estimate, of what your 100% strength and fitness is. Once you have this, we can find your goldilocks zone

15/11/2020

Training For Tendon Health- What Do I Prioritize?

Frustrated by recurring tendinitis?

Sick of having to modify your workouts because your achilles/tennis elbow/rotator cuff has decided to flare up like a toddler throwing a tantrum?

How can you keep training, and at the same time take care of these pesky tendon problems?

There’s a couple of fundamentals to keep in mind when training to prioritize tendon health. Taking them into account will give you the best chance of pacifying these petulant problems, but also essentially bulletproof them from flaring in the future

The first fundamental concept is that tendons, like muscles, CAN grow, thicken, adapt and get stronger. They just take longer, generally taking months, rather than weeks. And, like muscles, they get stronger with strengthening exercises.

The second fundamental is HOW we strengthen them. Research suggests that placing tendons under strain for longer periods of time is essential to making them adapt and get stronger. A good place to start is by utilizing isometrics- or holding a weight static for anywhere from 10-45s at a time. In fact, some research shows that not only can this strengthen tendons, it can make a grumbly one stop grumbling immediately after a set or two. So starting your routine with 2-3 warm up sets of isometrics is a great way to both warm up the tendon and get a dose of tendon strengthening in every session.

Taking the above fundamental further, incorporating tempo, strict strengthening exercises is another key to training for tendon health. By deliberately slowing down the lowering, or eccentric part of the movement, PAUSING for 1-2 seconds, then slowly returning to the start both helps to strengthen the tendon, but also limits the chances of the tendon being overloaded, limiting the chances of a tendon injury, or flare up of your tendinitis. But as tempo training is demanding, incorporating this into your routine 2-3 x week is more realistic.

12/11/2020

The Goldilocks Zone
· You start training, and find that you’re getting fitter, stronger. Your body is now more resilient, tolerating more than it did before. So if by doing more than you did before got you this far, then doing even more must be better, right?
· Firstly, in essence the ‘overload principle’ is the cornerstone to planning training, to getting yours, mine, any athletes body fitter and stronger- by making them do more than they are used to doing. And adding more to your training will likely see your gains in fitness and strength improve
· But this is true only up to a point.
· We also intuitively understand that too much of anything is fraught with danger. Too much food, too much awake time, too much work, too much caffeine. While there’s a short-term payoff, there is a downside.
· Visually this is demonstrated in an inverted ‘U shape’, where at either end of the spectrum, too little or too much results in downside.
· But this has also been retold throughout history in the fairy tale of goldilocks and the 3 bears. In each scenario, the first two options Goldilocks chooses are either too little, or too much before she settles on what’s ‘just right’.
· While some exercise is better then nothing for our health and to help us recover from injury, more isn’t necessarily better. We want the amount to be ‘just right’, falling into the ‘Goldilocks Zone’.
· Should you find, when doing more, that you’re struggling to do as much as last week, if your workday is affected by the fatigue of this morning’s workout, consider doing less, consider finding the ‘Goldilocks Zone’. And having a strength and conditioning coach can help you find where that zone is likely to be, based on your individual level of strength and fitness.

08/11/2020

Hamstring Injuries- The Stretching Kind
· The State of Origin match last week was tough to watch in many ways.
· The injury to Cameron Murray was painful viewing, with his leg getting forced into an unusual position. What was more distressing was watching Cameron try and run and have his leg collapse underneath him.
· But after all is said and done, he had sustained a hamstring injury. It looked far more severe right?
· Stretching hamstring injuries are a different flavor of injury compared with hammy’s that go when sprinting. They tend to be far more severe, taking longer to recover, often resulting in tendon injuries that require surgery.
· The difference between these two ways of injuring the hamstring became apparent when researchers began looking at injuries sustained in ballet versus soccer. Ballet dancers ended by taking 3-5 x the amount of time to recover compared to the soccer players. When analyzed further, the reason seemed to boil down to how the injury occurred; the difference between sprinting and stretching injuries.
· These injuries are rare though, if you’ve injured your hamstring, chances are you haven’t had this flavor of injury. However if there was any stretching involved when it happened, there’s a chance.
· If you’re concerned, best to have a Sports Physio check it over. We are highly trained in picking up these injuries and starting you down the pathway to ensure you get the best outcome.

05/11/2020

Blood Flow Restricted Training- a real life cheat code

With big injuries, often a lay off training is necessary, to allow injured tissue to heal, for repaired tissue to reconnect. And while this is absolutely essential to get the best outcome (fractures and tendon repairs come to mind), the trade off is a resultant loss of muscle bulk, and with it a loss of strength. This complicates things down the track as a loss of muscle bulk and strength is itself a risk of injury.
So we’re then forced to take longer to return to sport than just the healing time frame, we have to allow for the time it will take to restore the lost muscle and strength.
But what if there was a way to build muscle and strength that required little, if any, external load. What if we could maintain muscle during your layoff without jeopardizing the healing process?
You’d think I’d be selling snake oil right?
But there’s a method of training, known as blood flow restricted training/Kaatsu training/ occlusion training, which is continuing to demonstrate benefits in exactly this way.
Essentially, by occluding some or all of the blood flow out of your limb, taking care to ensure that blood is still flowing in, one can perform often very low intensity training and have a response that is the same as if you’ve just a max out gym session. It’s benefits have been shown in anything from non weight bearing, no resistance straight leg raises, to walking 3km/h on the treadmill, to supplementing rugby players training to give them a break from heavy training after a hard match.
The best part of all of this is that your recovery timeframe will be much shorter, because we’ve maintained your muscle bulk and strength throughout your convalescent period. Once the tissue has healed, we’re good to go.
I’ve developed evidence informed programs utilizing this exact principle to allow athletes to return to play much faster than they otherwise would have.