Category Archives for "active"

Post-Race Recovery

A proper warm-up prior to a run is important to increase the heart rate, blood circulation to the working muscles, and joint efficiency. However, cooling down is an essential component of the training process and should be completed at the end of every exercise session. It is important to cool-down after a run to transition the body back to a steady, resting state by decreasing the heart rate, breathing rate, and body temperature. Cooling down also returns the muscles to their optimal length-tension relationships and returns blood from the extremities back to the heart. Skipping a cool-down or performing it incorrectly can cause your muscles to become sorer and stiffer which may lead to unwanted injuries.

The following is a guide for optimal post-race recovery:

1. Slow jog or walk
Immediately at the end of a run, it is ideal to slow your pace down to a jog or a brisk walk to gradually lower your heart rate. Ending your run abruptly may cause blood to pool in your legs instead of returning it to the heart and brain. This can lead to a risk of fainting or feelings of lightheadedness. Jog or walk for approximately 5 to 10 minutes. 

2. Hydration
Exercising will cause more sweating and loss of fluid in the body which may lead to dehydration. Restore fluid levels in your body by rehydrating with water. It is important to stay hydrated to help manage your body temperature, remove waste from your body, and protect your tissues and joints. 

3. Total Body Stretching
a. Pigeon Pose:

Begin in 4 point position on a yoga mat. To stretch the right posterior hip, including the Piriformis muscle, straighten out the left knee pushing the left foot back. Then bring the right knee forward towards your chest while supporting yourself with your hands in front. Making sure that your left and right pelvises are level with each other, bring your right foot across turning it to the left side. Then reach forward on the mat with your hands bringing your elbows towards the mat while keeping both sides of the pelvis level and down. Hold for 30 seconds and do 3 sets on each side 2 times daily.

b. Hip Flexor Stretch:

Kneel down onto your left knee. Then rotate it about 45 degrees past the midline of your body. To keep your posture nice and tall imagine there’s a string pulling your whole spine upwards from your pelvis, right up your entire back and neck and up to the top of your head. Then engage your inner core muscles tight below your belly button and keep your low back flat. Next, bend the right knee forward and keep your posture nice and tall without leaning backwards. Then reach your left arm up pointing the fingers towards the ceiling nice and high and point your right finger tips to the floor. Hold this stretch for 30 seconds and repeat 3 times for each side.

c. IT Band / Lateral Quad Stretch:

Start by lying on your good side with the tight Iliotibial Band or “IT-Band” facing up. Keep your inner core muscles below the belly button engaged while keeping your low back flat. Then, bring the bottom knee towards your chest and with your left hand, reach down and back for your other leg above the ankle. Pull the heel back towards the bum while keeping the core engaged and the low back flat. Keeping the top knee and ankle parallel and level with the floor, lift your bottom heel onto the top part of your knee. Next, guide your lower leg down toward the floor with your heel while keeping the top leg, knee and ankle parallel and level to the floor. As the top leg is lowered down, have the top knee and thigh pointed downwards so it’s in alignment with your whole spine. Hold this stretch for 30 seconds and repeat 3 sets 2 times daily.

d. Lat Stretch:

To stretch the right lat, place the back of your right hand to your left side in front of you while clasping it with your left hand. Reach forward to your left and keep your elbows straight. Keep your knees wide apart and the back of your feet flat on the mat. Reach forward and lean to the right arm pit. Hold for 30 seconds, do 3 sets. Repeat on the opposite side if it’s also tight!

e. Shoulder Stretch:

To stretch out the right side, reach your right hand up and down your back keeping your right elbow pointed upwards. Avoid arching the back by keeping your spine in neutral. Pull the right elbow towards midline with your left hand while keeping the right elbow pointed upwards. Hold this for 30 seconds doing 3 sets on each side daily.

f. Rolling out the Hamstrings:

Put the roller on the ground and bring your hamstring onto it. Roll up and down onto your Hamstring muscle while supporting yourself with both hands. Find the sweet spots (or the areas that hurt in a good way) and continue to roll over these areas for 3-4 minutes in total. Do this 2-3 times a day just before you stretch out the hamstring.

g. Rolling out the Calf Muscles:

4. Additional Measures
Take a 5-10 minute cold water bath to reduce swelling. Allow 1-2 days post-run to allow the body to recover before massaging any tight muscles.

Running Injury Prevention

Running is a great way to improve aerobic fitness and cardiovascular health. Running not only burns calories, but can contribute to one’s mental and physical health. However, a large percentage of individuals who run are exposed to a wide range of running-related injuries, most of which are due to overuse. Up to 80% of the injuries occur in the lower extremities with the knee found to be the most commonly injured body part (Callahan, 2018). Patellofemoral pain, medial tibial stress syndrome (shin splints), achilles tendinopathy, iliotibial band syndrome, plantar fasciitis, and stress fractures are the most common diagnoses. 

RISK FACTORS
In the majority of cases, pain may arise in the lower extremities due to intrinsic factors such as being overweight, having weak core and leg muscles or with changes in foot type such as having flat feet. Extrinsic factors such as poor footwear, not stretching, or an unbalanced diet may contribute to running-related injuries. The main risk factor to running-related injuries was due to having a previous injury in the last 12 months. It is important for your physiotherapist or coach to be aware of all previous injuries that you may have sustained.

TREATMENT
Acute treatment includes stretching the posterior structures, massage, ice, activity reduction, taping, corticosteroid injection, or orthotics. Long-term treatment includes strengthening the intrinsic foot, ankle and hip. New footwear, night splints, or surgery may be indicated if conservative treatments are unsuccessful. Consult your physiotherapist or coach for the appropriate treatment. 

RETURN TO RUNNING CHECKLIST
Ensure there are no signs or symptoms of inflammation and you have gained the full ability to weight bear through your legs and feet. You should be able to hop in multiple directions on each leg and should be able to walk at a speed of at least 5.6 km/h (or 3.5 mph). Toe dexterity, or precise control of the toes, should be present in each foot and you should be able to balance in a wobble-free manner for more than 30 seconds. 

Below are some key exercises to stretch and strengthen muscles essential to improving running performance and reducing the risk of running-related injuries:

CORE ACTIVATION
A) Wall Squat

The exercise shown above can help with the retraining of the core stability, hip, leg and ankle muscles.

  1. Wrap a closed loop resistance band around the thighs just above the knees. 
  2. Position yourself so that your low back is fully leaning up against the big ball on the wall. Keep your posture nice and tall but don’t arch your low back when leaning upright against the big ball. 
  3. Engage you inner core stabilizers by contracting your pelvic floor muscles and pulling your transverse abdominal muscles below your belly button inwards, hugging your spine. Remember to keep breathing. 
  4. Leaning your weight on the ball slide downwards doing a wall squat while you maintain static isometric pressure against the resistance bands. Keep your knees over your ankles and in alignment with your second toes. 
  5. Hold the wall squat for 10 seconds. Repeat this for ten repetitions doing three sets daily.

B) Psoas March

The exercise shown above helps increase hip flexor and core strength.

  1. Being by lying flat on a mat so there is no arching of the lower back. Place your hands just below the belly button to cue engagement of the core muscles.
  2. Bring both knees up to approximately 90 degrees and wrap a band around your feet.
  3. Hold one knee stationary while pressing down the opposite leg. Then bring the extended leg back to the starting position.
  4. Repeat with the other leg while maintaining core activation and controlled breathing.
  5. Complete three sets of five repetitions on each side. Progress to sets of 10 repetitions for more difficulty.

MUSCLE STRENGTHENING & STRETCHING
A) Bridging Hamstring Curls

The exercise shown above helps strengthen the hamstrings, glutes, and core stability muscles to help protect the ligaments of the knee. 

  1. Lie on the ground with the stability ball under your heels with your legs straight and your toes pointing up. 
  2. Engage your inner core muscles below the belly button. Then extend your hips by squeezing your butt and lifting it off the ground. 
  3. Bring the ball in towards you by flexing your knees and hold for a second and then straighten your legs back to the start position while keeping your butt up and hips extended. 
  4. Keep your inner core engaged the entire time. 
  5. Start by doing 3 sets of 10 repetitions and then progressing it to 3 sets of 15 to 20 repetition 4 times per week. 

B) Step-Ups

The exercise shown above helps strengthen the hip, quad, and core muscles to prevent leg injuries.

  1. Start with a tall posture and your inner core engaged below the belly button. 
  2. Bring the opposite arm up while using your glute muscles to fully extend the hip up as you step with one foot onto a step box.
  3. Keep your thigh strong by preventing the knee from buckling inwards, as well as keep your knee over the heel so it doesn’t go over your toes. 
  4. Do 3 sets of 10 on each side. 

C) Wall Plank Resisted Knee Highs

The exercise shown above helps reduce anterior hip pain and weakness that may contribute to running-related injuries.

  1. Place a closed loop light resistance band around your feet. Slightly flatten the lower back and keep the inner core muscles engaged below your belly button to stabilize your posture. 
  2. Going into a plank position on the wall, bring one knee in a straight line up towards your chest and then slowly lower it back down with control. 
  3. Repeat this on the other side while alternating each knee to chest doing a total of 10 repetitions for each side. Perform a total of 3 sets, 10 repetitions for each side. 
  4. A progression of this exercise is to perform the knee lift twice as fast but still lowering the leg and foot back down with control while you keep your core muscles engaged and maintain core stability control throughout all repetitions and sets.

D) Lateral Quad Stretch

The exercise shown above is particularly helpful if the Iliotibial Band is tight due to stiffness in the lateral quadriceps muscle. Overuse knee pain can be caused by excessive running. 

  1. Start by lying on your good side with the tight Iliotibial Band or “IT-Band” facing up. Keep your inner core muscles below the belly button engaged while keeping your low back flat. 
  2. Bring the bottom knee towards your chest and with your left hand, reach down and back for your other leg above the ankle. 
  3. Pull the heel back towards the bum while keeping the core engaged and the low back flat. 
  4. Keeping the top knee and ankle parallel and level with the floor, lift your bottom heel onto the top part of your knee. 
  5. Next, guide your lower leg down toward the floor with your heel while keeping the top leg, knee and ankle parallel and level to the floor. 
  6. As the top leg is lowered down, have the top knee and thigh pointed downwards so it’s in alignment with your whole spine. Hold this stretch for 30 seconds and repeat 3 sets 2 times daily.

References:
https://www.uptodate.com/contents/overview-of-running-injuries-of-the-lower-extremity

What is PNF Stretching?

Proprioceptive Neuromuscular Facilitation, also known as PNF stretching, is a technique employed to improve muscle elasticity and range of motion. PNF is frequently used by therapists to restore functional range of motion and increase strength capabilities in patients who have sustained soft tissue damage or in post-surgery rehabilitation. It is found that consistent performance of PNF stretching and PNF stretching post-exercise may increase athletic performance by increasing range of motion. It is evident in literature that there are two types of techniques that can be utilized under PNF stretching.

The contract-relax method (CR) includes lengthening the targeted muscle and holding it in that position while the targeted muscle is contracted to its maximum isometrically for a period of time. A short period of relaxation and a passive stretch of the targeted muscle follows this initial contraction phase. The contract-relax-antagonist-contract method (CRAC) begins with the same procedure as the CR method. However, it takes a further step by contracting the antagonist muscle to the targeted muscle instead of passively stretching the targeted muscle.

How to Properly Perform a PNF Stretch:

Contract-Relax (CR) Method:

1) Stretch targeted muscle to the limit of normal range of motion. Contract the targeted muscle group for 5 – 10 seconds while a partner or immovable object such as a band applies sufficient resistance to inhibit movement of the muscle group.

2) Relax the targeted muscle group for 3 – 5 seconds.

3) Have your partner passively stretch the targeted muscle group by applying a controlled, deeper stretch for about 20 – 30 seconds into a greater range of motion.

4) Relax the muscle for approximately 30 seconds before repeating the above process 2 or 3 more times.

Contract-Relax-Antagonist-Contract (CRAC) Method:

1) Stretch targeted muscle to the limit of normal range of motion. Contract the targeted muscle group for 5 – 10 seconds while a partner or immovable object such as a band applies sufficient resistance to inhibit movement of the muscle group.

2) Relax the targeted muscle group for 3 – 5 seconds.

3) Contract the antagonist muscle (opposite to targeted muscle group) for 5 – 10 seconds.

4) After brief period of relaxation, have your partner passively stretch the targeted muscle group by applying a controlled, deeper stretch for about 20 – 30 seconds into a greater range of motion.

5) Relax the muscle for approximately 30 seconds before repeating the above process 2 or 3 more times.

Example of PNF Stretching for the Lower Body: 

Begin by lying on your back with one leg on the floor and the other leg extended and stretched into the limit of your normal range of motion. 

Contract the hamstring of the stretched leg and have your partner resist leg movement. 

Relax the hamstrings then have your partner passively stretch the leg past its normal range of movement.
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How to Safely Exercise When Pregnant

Remaining active during a pregnancy may help reduce some discomforts and help prepare the body for delivery. Acute exercise generally increases oxygen uptake, heart rate, stroke volume, cardiac output, and lung volume during pregnancy. Remember to complete the “PARmed-X for Pregnancy” health screening prior to participation in a prenatal fitness class or other exercise. Medical clearance should be obtained prior to exercise for women who were sedentary prior to pregnancy or have a medical condition.

Benefits:

  • reduced backaches
  • reduced constipation and bloating
  • may help prevent gestational diabetes
  • improved weight management
  • increase in energy
  • improved mood
  • improved posture
  • better sleep patterns
  • development of muscle tone
  • promotes strength and endurance
  • better coping with labour

Contraindications to Exercise:

Absolute Contraindications:

  • hemodynamically significant heart disease
  • restrictive lung disease
  • incompetent cervix/cerciage
  • multiple gestation at risk for premature labour
  • persistent second or third trimester bleeding
  • placenta prevue after 26th week of gestation
  • premature labour during current pregnancy
  • ruptured membranes
  • preeclampsia/pregnancy-induced hypertension

Relative Contraindications:

  • severe anemia
  • unevaluated maternal cardiac dysrhythmia
  • chronic bronchitis
  • poorly controlled Type 1 diabetes mellitus
  • extreme morbid obesity
  • extreme underweight
  • history of extremely sedentary lifestyle
  • intrauterine growth restriction in current pregnancy
  • poorly controlled hypertension
  • orthopaedic limitations
  • poorly controlled seizure disorder
  • poorly controlled hyperthyroidism
  • heavy smoker

Warning Signs to Terminate Exercise Session

  • vaginal bleeding
  • dyspnea before exertion
  • dizziness
  • headache
  • chest pain
  • muscle weakness
  • calf pain or swelling
  • preterm labour
  • decreased fetal movement
  • amniotic fluid leakage

Exercise Recommendations:

Aerobic Exercise

Frequency: 3-4 days per week (women who exercise less than 2 days or greater than 5 days may increase their risk of having a low-birth-weight baby) 
Intensity: Moderate intensity exercise is encouraged for women with a pre-pregnancy body mass index (BMI) of less than 25 kg per squared meter. However, women with a pre-pregnancy BMI of greater than 25 kg per squared meter should engage in light intensity exercise.
Time: More than 15 minutes per day is recommended. Individuals may gradually increase the duration to a maximum of 30 minutes per day of moderate intensity exercise for a total of 120 minutes per week. A 10-15 minute warm-up before exercise and 10-15 minute cool-down of light physical activity after a training session is recommended. 
Type of Exercise: Use large muscle groups in dynamic, rhythmic physical activities.

Resistance Exercise

One to three sets of 10-15 reps with approximately 2-3 minutes rest in between each set is recommended. Engage in light to moderate resistance exercises. The following are sample routines according to different trimesters from Brad Schoenfeld (NSCA). 

References:
http://americanpregnancy.org/pregnancy-health/exercise-during-pregnancy/
https://www.nsca.com/uploadedfiles/nsca/resources/pdf/certification/quizzes/quiz_pack_articles/october_2011_33.5.pdf
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5 Conditioning Exercises for Rock Climbing

Rock climbing is a fun, but challenging activity that requires strength, endurance, and skill. It is important to strengthen your arms and legs to move up near-vertical or overhanging rock. Having a strong core and torso will help keep the body balanced and up against the wall during the climb. Check out the following exercises below that to help condition your body before you tackle your next mountain or rock climbing wall.


EXERCISES:

1) Pull-ups 

These are an upper body, compound exercise that targets the biceps, latissimus dorsi, and upper back muscles. Use banded pull-ups if body-weight pull-ups are too difficult. Then progress to weighted pull-ups for 4 sets of 10 reps.

a. Hang from a pull-up bar and grasp the bar about shoulder-width apart with palms facing away from your face
b. Retract and adduct the scapula
c. Pull yourself up while bringing your elbows down to the floor until your chin passes the bar
d. Lower yourself all the way down, breathe, and repeat the pull-up

2) Staggered pushups

These engage your entire core as well as target your shoulder and chest muscles. Begin with regular pushups with hands side by side and slowly increase the difficulty by extending your one hand a few inches away from the other in various directions

a. Assume a prone position with your body straight, supported by your extended arms and your toes. Your hands should be outside of shoulder width but staggered, with one being higher than the other. This will be your starting position.
b. Initiate the movement by flexing the elbows, lowering your torso to the ground. Do not allow your hips to rise or to sag
c. Pause at the bottom of the motion, and then extend at the elbows to return to the starting position
d. At the completion of this set, reverse your hand position for the next round.

3) Finger hangs 

Can be performed on a door frame, rock rings, or pull-up bar simulate finger gripping on a rock climbing wall and helps to build hand and arm strength. Hang for five seconds, then rest for another five seconds. Repeat for a full minute. 


4) Weighted step ups 

These help condition your legs for power during a climb. Do 10 – 20 repetitions on each leg. Use a light to moderately heavy barbell or a dumbbell in each hand.


a. Stand facing a bench, step or plyometric box and place the ball of one foot up on the bench
b. Push up into full extension and then jump back to the floor, landing as softly as possible, returning to a squat position.

5) Cable rotations 

These target core strengthening and mobility that can help stabilize the body while moving the body in various positions across a rock wall.

a. Adjust the pulley handle to chest height. Step out and away from the weight. Feet are shoulder-width. Stand with a tight core and flat back. Push the handle out in front of you. Keep elbows slightly bent
b. Twist from the hips. Move arms across the body, achieving a full extension
c. Return to starting position
d. Once complete, do the same amount of sets/reps on the other side.

BONUS: Watch Claire (PT) from INSYNC PHYSIO demonstrate the “Ultimate Workout for Agility and Core” 
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

Exercising in the Cold

With the temperature getting closer to 0°C, many factors including the environment, clothing, body composition, nutrition, age, and exercise intensity in the cold may elicit additional physiologic strain or injury risk beyond that associated with regular conditions. An individual’s core temperature may drop and contribute to hypothermia, frostbite, or diminished exercise capability. Care must be taken into wearing proper clothing and footwear to minimize cold stress to the body or slippage.

Clothing Considerations:

1) Three layers:
a.     inner layer such as lightweight polyester or polypropylene
b.     middle layer such as polyester fleece or wool
c.      outer layer to transfer moisture to the air and repel wind or rain
2) Protect your head, hands, feet, and ears
3) Adjust insulation to minimize sweating
4) Use clothing vents to reduce sweat accumulation
5) Do not wear an outer layer unless rainy or windy
6) Reduce clothing insulation as exercise intensity increases 

Exercise tips:

1)  Check the forecast before heading outside as a combination of wind and cold can penetrate your clothing layers, increasing risk of frostbite
2) Drink plenty of fluids
3) Wear sunscreen or bring heat packs to warm up your hands and feet
4) Know the signs and symptoms of frostbite:
a.     typically occurs when temperatures fall below 0°C (32°F)
b.     more prevalent with exposed skin (e.g. face, hands)
c.      some early signs include: feeling of numbness or stinging
5) Know the signs and symptoms of hypothermia:

a.     abnormally low body temperature (heat production is less than heat loss)
b.     some early signs: shivering, slurred speech, loss of coordination, fatigue
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.