Category Archives: Exercise tips

Arthritis

How to best manage osteoarthritis

What is Osteoarthritis?

Osteoarthritis (OA) is a joint condition that can lead to pain, stiffness and difficulty completing daily activities. OA may include a combination of damage to the joint cartilage or bone, in addition to inflammation around a joint.

Whilst an OA diagnosis can seem daunting, the positive news is that there are many strategies for those with OA to manage the condition effectively and keep participating in activities that they enjoy.

Diagnosis and Risk factors

OA can be diagnosed clinically based of a thorough examination of risk factors and presenting symptoms. Imaging (i.e. MRI) can be used to exclude other causes of joint pain, however isn’t essential for the diagnosis of OA. This is because what is seen on imaging, often does not correlate with the pain and symptoms an individual experiences.

Non-modifiable risk factors associated with OA;

  • Older age
  • Family history
  • Gender (females are at 1.5-2x greater risk)
  • Previous joint injury

Modifiable risk factors associated with OA;

  • Physical inactivity / sedentary lifestyle
  • Overweight / obesity
  • Excessive loading of joint due to high occupational or sporting demands

Management Tips 

For those with OA, there are first line management options which should be addressed initially. These include;

  • Weight loss if indicated: this can reduce systemic inflammation as well as decrease the mechanical stress on the joint
  • Exercise: can assist with a multitude of factors such as joint function, strength, range of motion, pain and confidence loading the joint
  • Education: there are often common misunderstandings around OA, some quite unhelpful for managing the condition effectively. It is important to understand how to effectively manage your OA, to keep participating in the activities that you enjoy!

Exercise Recommendations

Exercise can create positive adaptions to our cartilage, as it has been shown to respond well to movement and being appropriately loaded. This includes both aerobic exercise (i.e. walking, running, cycling) and resistance training.

It is important to note that some pain during exercise is acceptable and not associated with increased joint damage. Therefore, it is recommended that exercising within a pain score of 0-5 / 10 is safe and effective.

It is recommended to consistently aim for a minimum of x2 weekly exercise sessions, however x3-4 weekly is associated with better outcomes.

The intensity, duration and type of the exercise is largely individual specific, based off each individual’s current physical function, personal goals, pain levels, etc.

Bone health

The right exercise for bone health

Firstly, what is Osteoporosis?

Osteoporosis is a bone condition characterised by low bone mass and changes to the internal structure of the bone. These changes lead to increased bone fragility and therefore, increased susceptibility to fracture. A recent report from Healthy Bones Australia indicated that 67% of Australians aged 50yrs and older, have either osteoporosis or osteopenia.

Osteoporosis is typically diagnosed following a bone density test at the hip and spine. The resulting ‘T score’ from this test indicates whether osteoporosis or osteopenia is present. Osteopenia is the pre-cursor to osteoporosis, where bone density scores are lower than the average adult, but not yet low enough to be diagnosed as osteoporosis.

Bone Mineral Density Chart (T-score)

Risk Factors

The primary risk factors for osteoporosis and osteopenia are;

  • female sex, particularly post-menopausal women
  • age (>50 yrs)
  • sedentary lifestyle
  • malnutrition (specifically inadequate calcium and vitamin D)
  • smoking and excessive alcohol consumption

Exercise for Bone Health

Bone is adaptable and responds to appropriate forces placed on it. Current evidence indicates the most effective exercise to promote bone remodeling / strengthening is progressive resistance training and impact activities. A combination of both these forms of exercise have been shown to be the most effective for bone loading. Additionally, regular balance training is recommended to minimise falls risk and subsequently fracture risk.  

Exercise Recommendations

Resistance Training

  • 2-3 days per week
  • 2-4 sets of 5-8 repetitions
  • Focus on multi-joint exercises, targeting large muscle groups

Impact Exercise

  • 3 days per week
  • Gradual progression of jumping/landing impacts
  • Approx 50 impacts per session

Balance

  • 3 days per week
  • Progressively challenging exercises
  • Including dynamic balance and reactive balance components

It’s important to note that the above recommendations represent a ‘best case’ scenario, which will not be applicable or achievable for everyone straight away. The starting point and progressions for each exercise will always be individual specific, in order to be achieve a safe and effective program.

Exercise tips

Bad posture… what is that?

Bad posture… what is that?

With more people working from home, there has been a lot of theories on how long periods of poor posture can affect the body. Here is what we know:

Move through posture/positions.

Evidence and research have found that posture does not directly relate to causing injury/pain. Rather the accumulative load of one position, has been found to cause issues due to continuous larger loads through trunk muscles. Poor endurance often leads to fatigue, relying on other structures like ligaments and joints.

What would we suggest? Move positions! Get up out of your chair; stand up; kneel, walk around, dance (literally anything).

Mobilise. 

1a) Tx openers

1b) Thread the needle

 

 

 

 

1c) Tx extension
Hip flexor tightness.

When you are sitting at a desk, your hips and knees are bent, this can lead to a tightening of your hip flexors and hamstrings. Using a computer or writing at a desk can result in rounded shoulders and tight chest muscles.

Strengthen.

The current guidelines for strengthening are 2-3 times per week with 2-4 sets of 8-12 reps of each major muscle group. Focus on compound movements, moving through a full range of motion, but start at your own level and get help from a professional if you’re new to strength training.

Exercise tips

Parkinson’s disease and exercise

Exercising with Parkinson’s disease may seem daunting and scary… we are here to show how achievable and beneficial it can be! Exercise is an incredibly valuable tool in the management of Parkinson’s and should be prioritised at every stage. Below we will outline a few of the key reasons why, plus some specific recommendations to keep in mind when exercising with Parkinson’s.

Symptoms and Features

Parkinson’s disease is a progressive neurological disorder, resulting from a disruption in dopamine production from a specific part of the brain called the ‘substantia nigra’. Dopamine plays an important role in coordinating physical movement and behavioural functions.

Common motor symptoms resulting from Parkinson’s include bradykinesia (slow movement), tremor and rigidity. In addition to other potential physical features such as gait disturbances, muscle weakness and pain.

This is where exercise comes in… as exercise has consistently been shown to improve, or prevent regression, of those symptoms and physical features.

How does exercise help?

Regular exercise can have a neuro-protective effect on the brain and nervous system, whereby the brain can send and receive signals more efficiently. Specific to Parkinson’s, research has shown that dopamine can be used more efficiently in those who regularly exercised.

Exercise can also improve common physical symptoms, such as bradykinesia, by increasing muscle strength, power and mobility. Different types of exercise offer varied benefits, for example;

  • Cardiovascular exercise is recommended for the neuro-protective benefits
  • Co-ordination tasks and mobility for muscle rigidity
  • Resistance training for muscular strength and function
  • Balance training for reducing falls risk

Further to the range of physical benefits, consistent exercise can have significant benefits on cognitive functions, including improved processing speed, attention and executive function. Not to mention the positive impact on mood that we know exercise provides!

10 Balance Exercises for Seniors That You Can Do at Home — Snug Safety

Exercise Recommendations

Each individual with Parkinson’s can present with different symptoms, therefore an exercise program should be tailored to each person and their goals. Some guidelines which can be used as a framework include;

  • Aim for a minimum of 2.5hrs of exercise per week
  • Higher intensities of cardiovascular or resistance exercise are typically associated with improved outcomes
  • Include a combination of resistance, cardiovascular, balance and co-ordination exercises
  • Incorporate dual-task exercises (two movements at once) OR combine physical and cognitive tasks for an extra challenge
Diabetes

Exercise for Type 2 Diabetes

Regular exercise can be great for keeping strong, keeping fit and improving our mental health. But what about helping out with the ability to manage blood glucose levels for diabetes? Guess what……. It helps out with this too! Exercise is just like medicine when it comes to optimising our blood glucose levels into a target range.

How can exercise help with Type 2 Diabetes?

When we exercise, our muscle cells open up a door that allows for glucose in our blood to enter into the cell to be utilised for energy. This leads to a reduction in blood glucose levels that can last for up to two or three days. If we are consistent with our exercise, this will prolong the time and our ability to have blood glucose levels in an optimal target range. Furthermore, if we exercise and increase our muscle mass, this will also lead to an improvement in our ability to utilise blood glucose as we have more muscle cells to take up the glucose!

General exercise recommendations:

Aerobic
1. If you are new to exercise, begin with 10 – 20 minutes of light aerobic activity such as walking, cycling or swimming on most days of the week. 

2. Over time most adults with diabetes should aim to engage in 150 minutes or more of moderate-to-vigorous intensity activity weekly. This can be spread over at least 3 days per week, aiming to have no more than 2 consecutive days without activity. 

3. Shorter durations (minimum 75 min/week) of vigorous-intensity or interval training may be sufficient for younger and more physically fit individuals. 

Resistance training

1. Adults with diabetes should engage in 2–3 sessions/week of resistance exercise on non-consecutive days.

2. Aim for 1 – 2 sets of 8 – 10 repetitions initially when beginning a new resistance exercise program, and gradually build up to 2 – 4 sets of 8 – 10 repetitions. Choose between 8 – 10 exercises.

3. Exercises that utilise big muscle groups are recommended to make sure we utilise more muscle to soak up that blood glucose! Big muscle groups include leg press, chest press and lat pull down. 

It is recommended to speak with your general practitioner or Exercise Physiologist before commencing any exercise program.

Adrian Draper – Accredited Exercise Physiologist 

 

Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. 

Hordern, M. D., Dunstan, D. W., Prins, J. B., Baker, M. K., Singh, M. A. F., & Coombes, J. S. (2012). Exercise prescription for patients with type 2 diabetes and pre-diabetes: A position statement from Exercise and Sport Science Australia. Journal of Science and Medicine in Sport, 15(1), 25.