Category Archives for "training"

Diana in Europe!

Diana, who works front desk at both the Burnaby and Cambie InSync Physio clinics, recently returned from her trip to Europe! Diana and her dragon boat team, Dragon Zone Premier, had the opportunity to compete at the 2018 Club Crew World Championships in Szeged, Hungary as one of the five Premier teams representing Canada. Her team placed 6th overall in the world with 48.803s in the 200m Mixed Premier Standard Boat Grand Final, 5th overall in the world in 500m Mixed Premier Standard Boat Grand Final, and 4th overall in the world in the 2km Premier Mixed Standard Boat Final. 

Following her competition, Diana got to see the beautiful emerald waters of Plitvice National Park, hidden blue caves near the island of Hvar, and the historical city walls of Dubrovnik, Croatia. 

Diana also got to explore the ruins of Pompeii as well as the Roman Forum and Colosseum in Rome, Italy.

One of her highlights was seeing the rows of colourful houses on the island of Burano and watching a talented glassmaker create a horse made of glass on the island of Murano, Italy. 

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

How to Program: Linear vs. Non-Linear Periodization?

Designing a work-out program for yourself? There are many different ways to create the ideal program that suit your fitness levels and fitness goals.

PERIODIZATION

Periodization entails systematic planning of various aspects of a training program through progressive cycling during specific periods. The goal of periodization is to optimize fitness levels while reducing the risk of injury. There are different components to the basic structure of a periodization cycle.

CYCLES 

A macrocycle is a complete training period that may be 1, 2, or 4 years in duration. A mesocycle is a period or multiple periods within a macrocycle aimed to develop a single training block. The mesocycle may consist of a preparatory period, a competitive period, and a transition or rest period. A microcycle is a structural unit that makes up a mesocycle. It details weekly plans for progressive overloads specific to the goals of the mesocycle. For example, four 4-week microcycles will equate to a 16-week training program or one mesocycle.

TYPES

Linear periodization progressively increases in intensity with minor variations in each microcycle. Beginner athletes typically utilize this type of training where the program starts with a higher initial volume then progresses to a lower volume as intensity increases. This traditional model has a greater focus on developing general strength and requires longer training periods. For example, an individual may be only focused on building muscle mass in a hypertrophy phase for all of their workouts within a week.

Non-linear periodization involves varying the intensity and volume within each week over the course of a training program. This allows individuals to train different muscle features within the same week. Non-linear programming is ideal for experienced or elite athletes. For example, an individual may incorporate workouts aimed at developing strength and power at the same time. This model also provides flexibility in scheduling for individuals as the goal of non-linear periodization is to complete the workouts whenever possible, instead of completing the program in a fixed number of weeks.

The red chart depicts a non-linear periodization within a week that varies the type of training, sets, reps, and recovery time. Conversely, the blue chart details a linear type of periodization where the first couple of weeks are aimed at focusing on strictly resistance type workouts with the same sets, reps, and recovery time for that designated time frame. A hypertrophy phase and a maximal strength phase follows accordingly.

PHASES

Four common types of phases in a training program are: hypertrophy, strength/power, peak, and recovery.

Hypertrophy involves building muscle mass. Exercises are completed with short rest periods and high volumes. Strength and power are completed with a reduced volume, but an increase in load and rest time. Peaking involves low volumes, higher loads, and long rest periods. Finally, recovery uses low volumes and low loads.

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How to Avoid High-Altitude Illnesses

Altitude training involves spending several weeks at a higher altitude (preferably over 2000 m or 8000 ft above sea level) to adapt the body physiologically. At elevations greater than 1200 m or 3950 ft, there is a decrease in atmospheric pressure which reduces the partial pressure of oxygen in inspired air. This causes decreased arterial oxygen levels and leads to increased ventilation and cardiac output, along with an elevation in heart rate. Performance will decrease for individuals that have not acclimatized to the change in pressure and are consequently exposed to a risk of high-altitude illnesses.

Acclimatization

Acclimatization is the process of adapting to the decrease in oxygen concentration at a specific altitude. With acclimatization, there will be an increase in heart rate, blood pressure, bicarbonate excretion, respiratory frequency and volume along with a reduction in plasma volume. To compensate for the decreased arterial oxygen levels, erythropoietin (EPO), a hormone in the body, will trigger more red blood cell production to aid in oxygen delivery to the muscles. Training at high altitudes allow athletes to produce additional red blood cells that will provide a greater cardiovascular effect on performance at competitions held at lower elevations.

Acclimatization requires an altitude exposure of more than 1 week. Staged ascents promote gradual and partial acclimatization when an individual resides at a moderate elevation before ascending to a higher elevation to reduce the adverse consequences of rapid ascent. The first stage of ascending should be greater than 3 days at a moderate altitude. Remaining at a moderate altitude for 3 to 7 days will reduce the symptoms and risk of altitude sickness. However, a time period of 6 to 12 days will improve athletic performance.

High-Altitude Illnesses

High-altitude illnesses can occur at elevations above 2500 m. Mild altitude illness can occur between 2000 and 2500 m.

Acute mountain sickness ( is commonly experienced by individuals 6 to 12 hours after ascending to elevations above 2500 m with the prevalence and severity increasing with higher altitudes. Symptoms include: headaches, nausea, dizziness, and sleep disturbance. Some risk factors may be a lack of previous acclimatization, history of migraines, age of 46 and above, or being a female. Symptoms typically resolve within 1 to 2 days with rest or with non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin. If symptoms become severe, descend immediately or use supplemental oxygen.

High-altitude cerebral edema (HACE) is a more severe form of altitude illness. Symptoms include: truncal ataxia (loss of body control), decreased consciousness, mild fever, and coma. If a headache is poorly responding to NSAIDs, then this is an indication of acute mountain sickness progressing to (HACE).

High-altitude pulmonary edema (HAPE) presents with a loss of stamina, dyspnea, dry cough, cyanosis (bluish skin), or pink, frothy sputum (phlegm). The risk of HAPE increases with increased altitude and faster ascents. HAPE occurs when fluid accumulates in the lungs due to rapid altitude ascent or ascent accompanied by strenuous exercise. Untreated HAPE may result in death approximately 50% of the time.

PREVENTION & TREATMENT

Prevention of high-altitude illnesses involve acclimatization before exposure, slow ascent, and appropriate pharmaceuticals for the corresponding illness. For mild AMS, take a rest day or descend 500 to 1000 m if there is no improvement in symptoms. For severe AMS, descend immediately and use supplemental oxygen at 2 to 4 L per minute. A hyperbaric may also be used for severe AMS. AMS may be treated with NSAIDs or acetazolamine. For severe AMS, use an appropriate dosage of dexamethasone.

Descend immediately if symptoms of HACE or HAPE are experienced. Use supplemental oxygen at 2 to 4 L per minute or a hyperbaric bag. Consider dexamethasone for HACE and nifedipine for HAPE. Consult a physician for more information on which drugs to use.

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7 Easy Exercises with a Towel

Home exercising can be just as effective as going to the gym by using household items such as a medium-sized towel. Check out the exercises below for a full body work-out:

1) Plank Walks: 

In a plank position with a towel under both feet and maintaining a neutral spine, walk forwards by placing one hand in front of the other for 10 to 20 steps.

2) Neck Rotation: 

Find where the hairline ends to locate a noticeable “bump” on the back of your neck. This is the spinous process for your 2nd cervical vertebrae. Place the edge of an unrolled towel on this spot, then cross your hands over, making sure the top hand is on the same side as the direction of rotation (e.g. right arm will pull towel downwards towards the middle of the chest if you are turning LEFT). Complete a pain-free rotation 3 times in each direction per day.

3) Knee Tucks: 

Start in a plank position with a towel under both feet and keep a neutral spine, then engage the lower abs below the belly button to pull the knees in toward the chest. Extend the legs back to starting position and repeat for 10 reps. 

4) Reverse Lunge: 

Place one foot in front and a towel underneath the other foot that is slightly behind. Slide the rear foot backwards until the knee of the front leg is at a 90 degree angle. Press the rear leg back into standing position by engaging the glutes and hamstrings. Repeat 10 times on each leg. 

5) Rotator Cuff Holds: 

Step into a door with the left foot and throw a towel over to the back of the neck with the left hand and reach with the right arm to grab the other end of the towel. Prop the right shoulder on the edge of a doorway and hold this position for 20-30 seconds while maintaining a neutral spine. 

6) Single-Leg Hamstring Curls: 

Get into a bridge position by lying flat on your back, hands to the either side of your body and knees bent. Place a towel under one foot, then slide this leg forward while keeping the other leg in the bent position. Slide the extended leg back into starting position. Remember to engage the core and glutes. Repeat 10 times on each side.

7) Back Extensions: 

Lie flat on your stomach and place a towel under each hand, then extend both arms forward so that your chest and chin are near the floor. With the core engaged, slide both hands towards your body and lift your upper body off the floor. Repeat 10 times. 
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How to Improve Flexibility with a Yoga Block

Flexibility is the ability to move a joint through its complete range of motion and is important in carrying out daily activities and in athletic performance. Maintaining flexibility of all joints produce efficient movement and reduces risk of injury. It can be improved in all age groups by regularly engaging in exercises targeting different joints. Joint capsule stiffness, muscle viscosity, ligament and tendon compliance all affect flexibility. Therefore, adequate warm-up and proper stretching is essential in optimizing joint range of motion. Chronic conditions such as lower back pain may arise if an individual has poor lower back and hip flexibility, in conjunction with weak abdominal muscles.

Flexibility exercises are most effective through warm-up exercises or passively through moist heat packs or hot baths to increase the muscle temperature. An effective warm-up is typically 5 to 10 minutes long, but may be longer for older adults or individuals with health conditions. Watch the video below, led by InSync Physio’s Claire McDonald, on how to do a comprehensive warm-up targeting all of the major muscles:

Evidence-Based Recommendations:

Frequency: more than 2-3 days per week with daily being the most effective
Intensity: stretch to the point of feeling tightness or slight discomfort
Time: hold a static stretch for approximately 10-30 seconds, hold for 30-60 seconds for older individuals
Type: static (active or passive), dynamic, ballistic, or proprioceptive neuromuscular facilitation
Volume: a total of 60 seconds of stretching time for each flexibility exercise is recommended
Pattern: repetition of each exercise 2-4 times

Stretching for Beginners: 

Yoga blocks can be very helpful for individuals building their flexibility by reinforcing balance and proper alignment. Use a yoga block for the following positions:

1) Forward Folds for Tight Hamstrings

Place a yoga block flat on the ground and sit directly on top with legs extended forward and feet flexed.

2) Hip Openers for Tight Hips

Sit on the ground and bring your feet together, then place a yoga block under each knee for support. Remember to sit up straight.

3) Standing Thigh Holds for Posture: 

Standing tall, place a yoga block between the thighs to tilt the pelvis downwards and realign the spine.
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How to Avoid Gastrointestinal Problems During Exercise

What should I eat or drink when exercising?

Many gastrointestinal (GI) problems can occur even if one trys to avoid eating before or during exercise. Studies suggest that approximately 30-50% of athletes experience some type of gastrointestinal issue that can impair performance and delay recovery.

The three main causes of GI problems:

1) Physiological
2) Mechanical
3)  Nutritional
During intense exercise, especially when dehydrated, blood flow to the intestines is reduced. This is believed to be one of the main factors leading to the development of GI symptoms.

General Symptoms:

  • nausea
  • vomiting
  • abdominal angina
  • bloody diarrhea
  • other abdominal symptoms (from mild discomfort to sever ischemic colitis)

Classification of Symptoms:

1) Lower GI Tract
2) Upper GI Tract

Runners tend to experience lower GI tract symptoms such as flatulence (excessive gas), diarrhea, or urgency due to the repetitive impact and reduced blood flow to the gut. On the other hand, cyclists may experience upper GI tract symptoms  due to the increased pressure on their abdomen while in an “aero” or crunched position of the body. These mechanical effects may be minimized with training.

Tips for Athletes:

1) Avoid high fiber foods in the day and several days before competition
2) During training, diet with adequate fiber will keep the bowel regular
3) Avoid aspiring and non-steroidal anti-inflammatory drugs (NSAIDs)
4) Use of NSAIDs prior to a race is strongly discouraged, especially for athletes with a history of GI problems
5) Avoid high-fructose foods (especially drinks that exclusively contain fructose)
6) Avoid dehydration as it can excaerbate symptoms and start races well hydrated
7) Ingest carbohydrates with sufficient water or drinks with lower carbohydrate concentration to prevent very high concentrations and osmolalities in the stomach
8) Practise new nutrition strategies and make sure to experiment with pre-race and race-day nutrition plan many times before the race day to reduce the chance of GI symptoms from occurring
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

3 Key Exercises to Improve Balance

Why is it important to include balance training in your regular exercise program?


Balance is needed for just about everything you do on a daily basis from carrying groceries to putting on your shoes. Balance training involves strengthening exercises that target your entire body, especially the core. This not only reduces the risk of injury, but may improve motor coordination (Oliveira et al., 2017). At least 3 days of balance training per week is recommended for inactive and active older adults (> 65 yr). Activities such as pilates, yoga, tai chi, dance, or brisk walking are suitable for improving one’s balance. Implements such as bosu balls, balance boards, or foam pads can be used to add variety to your exercises. 

Try the Following Exercises Below:

1) Step-ups

a.     Stand in front of a box with a tall posture
b.     Step up with one leg, then bring the other leg up so that both feet are on the box
c.      Step down one leg at a time and repeat 10 times for each leg
d.     Increase the difficulty by using a taller box or increase your step up pace

2)  One Legged Squat

a.     Stand with a tall posture
b.     Bend your right knee and lift your right foot off the floor
c.      Keep your chest upright and arms extended to the front, slowly lower your body to the floor by pushing your hips back and down
d.     Slowly push up to the starting position and switch feet
e.     Remember to keep your knee in line with your second toe as you squat
f.      Repeat 10 times on each leg
3)  Single Leg Dead Lift

a.     Stand on your right foot, enagage the core, and slowly bend forward at the hips
b.     Reach towards the floor with the left hand and lift the left leg straight behind you
c.       Hold for 1-2 seconds and squeeze your butt muscles as your return to the starting position
d.     Switch sides and repeat 10 times on each leg
e.     Optionally: hold a light dumbbell in one hand as you reach toward the floor

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InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

Step Up Your Beach Volleyball Game

Beach volleyball is an intense sport that requires good stamina and strength. Training various muscles of the body (core, lower body, upper body) to become stronger will allow you to hit harder and jump higher. Easily train on the sand using medicine balls, sand bags, kettle bells, or resistance bands with these specific exercises below.

CORE:

1)      Scissor kick: Lie down flat on your back with your arms extended straight out to the side, palms faced down. Raise one leg from the ground and then back down. Switch to the other leg. Do 16 reps for 3 sets with 1 minute rest in between each set. Variation: increase the difficulty of this move by placing a resistance band over your thigh area.
2)      Extended plank: start in a plank position withour elbows a few inches in front of your shoulders. Straighten your trunk and legs so that they are in line. Hold your abs tightly for 45 seconds to 1 minute. One set.


3)      Medicine ball slam: Hold a medicine ball with both hands and stand with your feet shoulder width apart. Lift the ball above your head, extending your whole body and slam the ball into the ground directly in front of you. Do 10 reps for 3 sets with 1 minute rest in between each set.

LOWER BODY:

1)      Squat jump twist: Stand with your feet shoulder width apart and squat down until your knees are at a 90 degree angle. Stand upwards and jump up in the air. Rotate 90 degrees as you jump up and land on both feet back to the starting position. Do 10 reps for 3 sets with 1 minute rest in between each set.

2)      Glute bridge walkout: Lie down flat on your back with your knees bent at a 90 degree angles and feet flat on the ground. Drive your hips up to end range, careful not to over flare your ribs. Slowly walk your feet out, one heel at a time and then return to the starting bridge position. Do 10 reps for 3 sets with 1 minute rest in between each set. Variation: increase the difficulty of this move by placing a resistance band over your thigh area.

UPPER BODY:


1)      Push press: Use a sandbag, medicine ball, or kettle bell and hold firmly with both hands in front of the chest. Push your sandbag or kettle bell straight up to the sky over your head. Do 10 reps for 3 set with 1 minute rest in between each set.

2)      Push ups: Starting in the plank position, place your palms onto the ground under your shoulders and lock out your elbows. Dig your toes into the ground and keep the feet close together. Slowly lower your body down until you are a few inches off the ground. Then push your body up to the starting position. Do 10 reps for 3 sets with 1 minute rest in between each set.

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How to Squat Properly

Squats are an excellent way to target the full body and to build significant strength. It heavily relies on your thighs, calves, lower back, arms, and abs. Some key benefits include building muscle, burning fat, increasing endurance, and improving proprioception. However, proper form is needed to avoid back or knee pain.  
HOW TO SQUAT WITH A BARBELL:
Starting Position
1.      Stand with feet approximately shoulder-width apart, toes pointing straight ahead, and knees aligned over second and third toes.
         As much as 5-8° of external foot rotation is allowed in the starting position, some consider this normal anatomical position.
2.      To perform the high-bar back squat, rest the barbell on the shoulders, behind the neck, with hands grasping the bar wider than shoulder-width apart.

3.      To perform the low-bar back squat, rest the barbell on the middle trapezius region with hands grasping the bar wider than shoulder-width apart.
         It is important to note adequate shoulder mobility (external rotation) is required to hold the bar securely.
Movement Pattern
1.      Slowly begin to squat down by hinging at the hips and then flexing at the knees.  
2.      Allow glutes to “stick” out behind the body as if sitting into a chair.
3.      Keep the chest up and the cervical spine in a neutral position. Avoid excessive cervical flexion, extension, or anterior translation (jutting the head forward).
4.      Squat to a depth that can be safely controlled with no movement compensations.
         Common movement compensations include knee valgus (knock knees), rounding or arching of the low-back, an excessive forward lean of the torso, and overly externally rotating or pronating the feet.
5.      To rise back up, contract the gluteals and place pressure through the heels as the knees and hips are extended.
6.      Stand up straight until hips and legs are fully extended. Fully contract the gluteals in the standing position for maximal muscle recruitment.

FOR BEGINNERS:

1. Place the big ball up against the wall and have your lower back against the ball
2. Roll up a towel, place it between your knees and shimmy your feet out slightly in front of you.
3. Make sure your knee is in line with your second toe, squeeze the towel and keep your core engaged.
4. Squat down until your knees are at 90 degrees and hold that for 10 seconds.
5. Do 3 sets of 10. Rest for 5 seconds between each rep.

For reference:
http://www.ptonthenet.com/articles/biomechanics-of-the-squat-4016

InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.

Quick and Easy Foot Exercises for Bunions

A bunion is an enlargement of the joint at the base of the big toe and it is a frequent cause of foot pain. The tissues around the joint cause the big toe to rotate toward the smaller toes and result in pain, redness, or swelling. Bunions may arise from a number of factors such as inherited foot type, flat feet, or excessive pronation. Rheumatoid arthritis (gout), tightly worn shoes, or foot injuries can further exacerbate symptoms. Weak muscles in the foot and calf may also contribute to bunion-related pain and movement issues. Strengthening these muscles with the exercises below can help stabilize body movement and support the arch of the foot from rolling inwards. Additionally, wearing proper shoes, cushioning pads, orthotics, and avoiding activities that add pressure to the bunion can help provide relief for the foot.

FOOT EXERCISES
Perform the following exercises barefoot. Begin exercises from a sitting position to a standing position on two legs, then using one leg and alternate. Hold each repetition for 5 seconds. Repeat exercises until muscles become tired.
A) Toe Lift: plant your heel and front of the foot on the ground, then lift all the toes upwards

B) Toe Spread: plant your heel and front of the foot on the ground, then lift and spread the toes. Try to push the little toe downwards when spreading the toes.


C) Heel Raises: stand with your knees bent, then raise your heel off the ground while keeping pressure on the big toe.

Check out the following video on a single-leg balancing exercise to strengthen the lower body: 
https://www.youtube.com/watch?v=D1qMS4ew2eE

J Orthop Sports Phys Ther 2016;46(7):606. doi:10.2519/jospt.2016.0504
InSync Physiotherapy is a multi-award winning health clinic helping you in Sports Injuries, Physiotherapy, Exercise Rehabilitation, Massage Therapy, Acupuncture & IMS.