How to Pick the Best Cardio Machine for YOU!

How many people pick this cardio machine to get your sweat on?

Let us tell you WHY there is a better choice…

1. This machine is NOT Functional….normal walking has our right arm swing with our left leg (called opposition) not like this machine where the same arm and leg move together. We would look like zombies if we walked the way this cardio machine trains us.

Exercises should simulate the activity that you are training for…

THREE good options:

  • Treadmill walking similar to normal walking (see related post)
  • Spinning or Upright Biking similar to road cycling

Rowing machine similar to open water rowing

2. This cardio machine applies NO Impact….you think this would be a positive but no impact means no bone density maintenance

  • You need to apply force from the body touching the ground with impact to help build and maintain bone mineral density and reduce your chance of osteoporosis
  • Even osteoarthritic joints need gentle impact to drive new nutrients into the joint to keeping it healthy and having less pain

3. This cardio machine causes NO HIP Extension….it has you doing more hip flexion (bending) than extending which means you are not using your glutes (butt) as much as you could.

  • When you use a big muscle group like the butt you can increase your metabolism and burn more calories
  • Also we do a lot of hip flexion in our everyday lives, like tons of sitting, so pick a cardio machine that allows you to extend your hip behind your body like walking on the treadmill

The Road to Recovery: It’s a bumpy ride! Active Rehabilitation

One of the issues that comes up frequently in an active rehabilitation context is the re-aggravation of an existing injury that often happens during the recovery process.In our minds, healing and recovery often looks like a straight line graph: The start point is the injury, and the end-point is feeling back to 100% normal. In reality, the graph would look much more like a jagged zig-zag of a line with almost countless small peaks and deep valleys, and the occasional prolonged plateau.

One of the most common comments we get from patients is that they felt great one day, and then the next day they felt like they were right back where they had started. Often, this experience leads to frustration and disappointment, because it makes the individual feel like they are not making any progress and that they will never achieve a better quality of life, improved pain management, or higher level of physical function.

What is hard to understand from inside that experience is the small milestones and achievements that happen throughout the recovery process. It’s hard to celebrate being able to raise your arm over your head for the first time in months, or your first step taken without a limp, when you are focussed on your end goal of being able to wash your hair or go for a run or hike.

What is often missed during this time of frustration is the reason why you are having the “flare up,” which is often BECAUSE you felt better the day before. It’s a basic feature of human nature to do everything you can to the full extent of whatever your abilities are at the time. When abilities are limited due to an injury, you are constantly pushing right to the edge of what you can do on a daily basis. So when you feel better for a day, you are naturally going to do everything you can because for once you feel like you are able to do you! The unfortunate consequence is that you will exhaust your resources and push your physical boundaries, so the next day tends to result in feeling exhausted and sore.

It works on much the same principle as how you would feel if you decided to run a half marathon without training for it. Afterwards you would expect to be sore and exhausted and TEMPORARILY be unable to do a lot of things, because you pushed your body beyond the limits of what you would normally have been able to do. In the same way that your body needs to recover from an intense workout, your body needs to recover when you’ve pushed the boundaries of your ‘in-progress’ level of function. Just remember you cannot compare to your pre-injury level of function just yet. Wait until you are closer to 90% recovered to start comparing to the end goal. Remember you are in the RECOVERY phase of healing.

That being said, we will often encourage some boundary pushing as part of your active rehabilitation process. If you never push hard enough to find out where your boundaries are, you won’t know when you have made significant progress. The trick is to find a balance of pushing them enough that you continue to see improvement, but not so hard that you have to spend the better part of a week getting back to where you were before you started. Often, especially early in the recovery process, those pushes are much more subtle than you would like, and it’s hard to see where progress is being made. When it comes to that, it is helpful to have objective baseline measurements and the guidance of an experienced therapist to gently point you in an appropriate direction.

A few things we often recommend to our patients and that we will keep track for you are:Objective, specific details about current abilities, examples:

  • Range of motion
  • Functional movements (Eg. squats, getting up off the floor, ability to wash hair)
  • Perceived pain (0-10 pain scale)
  • Frequency of headaches/other symptoms
  • Energy Level on a daily or weekly basis
  • Sleep duration

There are many more, and they will always be selected to be appropriate to each patient’s circumstances. Having a few key items to track allows you to feel some reassurance when from the inside, you don’t feel like you are making any progress. These measures can also help your therapist to determine if the current program is appropriate, or if it needs to be altered to better suit your needs.

The goal of active rehabilitation is always to get you back to as close to 100% as possible; however long it takes, and however many peaks, plateaus, and valleys your individual graph looks like. “Bad Days” or “Flare up” may feel like you’re taking two steps backwards, but often they are an indication that you felt good enough to try something you had previously been unable to do – and that is a clear sign of progress. So try not to let those “bad days’ drag you down!!

Think about an active rehabilitation plan supervised by your Physiotherapist or Kinesiologist for your Road to Injury Recovery.

Spinal Stenosis, What???

Are you experiencing pain in your back with walking? Stiffness in your back in the morning that lasts for less than 30 minutes? Are you more comfortable leaning on a grocery/shopping cart? Are you getting symptoms like numbness, tingling or pain down either one of your legs?

OR

Have you seen your doctor for back pain and been told you have Spinal Stenosis?

All of this can sound foreign and scary especially if you haven’t had back pain before. What this article sets out to do is to give you comfort that there is a lot you can do to manage your symptoms and keep your quality of life. If you are not sure what is causing your back pain consult a Physiotherapist or Physician for help.

What is Spinal Stenosis?

Spinal Stenosis/Foramen stenosis is the narrowing (stenosis) of the opening (foramen) on either side of the spine where the nerve comes out that supply our sensation and muscle movement.

Spinal Stenosis Low Back Pain

Reasons why Spinal Stenosis occurs:

  • Age
  • Natural change in the spine over time
  • Loss in disc height between the vertebrae
  • Arthritis around the back joints (bulkier joint with some boney growths (osteophytes))
  • Family History
  • Sedentary Lifestyle

Most commonly we see spinal stenosis in the neck (cervical) and low back (lumbar).

Why do I feel pain, tingling or numbness in my legs or arms?

Often this can be related to the Spinal Stenosis where the nerve that innervates the affected arm or leg is irritated where it exits through the foramen at the neck or low back because it is being encroached on by the smaller nerve opening (foramen). There are also other causes like, Multiple Sclerosis, pinched nerve, nerve damage, tumour, Diabetes, etc. Make sure to check with a clinical professional if this is occurring.

Why does my back feel worse with walking?

Walking keeps the curve of your spine in an backward arched position which causes more closure of the foramen (the holes on either side of the spine where the nerves exit from).

Why do I feel better leaning on a shopping cart or counter, etc?

When you bend forward, you mechanically open the foramen in the spine taking pressure off the irritated structures. Although this helps, you can’t always walk leaning on things everywhere you go.

What can I do to help reduce my pain?

MOTION IS LOTION…keep moving.

YES, this is the answer for a lot of things. You may feel like you should listen to the pain and in some cases this is true (consult your Physiotherapist or Physician to know if this is the case) but often you just need to gradually get moving.

What can I do that is safe that will help TODAY?

You can start practicing seated forward bends. Do 5 in a row and complete them many times throughout the day. Practice this when you go for your next walk, if your symptoms increase, stop at the next park bench and bust out 5-10 seated bends as shown below. These should make your Spinal Stenosis symptoms feel BETTER (i.e. less back and/or leg pain), if they don’t then STOP and consult your Physician or Physiotherapist.

Low back pain exercise

Repeat 5x times in a row throughout the day

There are other things that you can do to help with increasing your tolerance for longer distance walking and other activities. If you have success with these forward bends, then you would likely benefit from seeing your local Physiotherapist to learn more tricks like this to help manage your symptoms and to keep you moving!

Rotator Cuff: What is it and do I have one?

This is not actually one thing it is a group of muscles often mis-named by terms like rotatory cuff, rotator cup, and just plain rotater or roter. So no surprise that this group of muscles is complicated and misunderstood.

You may have heard people talking about having “torn their rotator cuff” and how they have a ‘bum shoulder’ now because of it. What are they really talking about, is four muscles of the shoulder Supraspinatus, Infraspinatus, Teres minor, and Subscapularis that may not be working optimally together. We believe there is not really a ‘bum’ anything just something that has room for improvement. We aren’t expecting you to remember or even be able to pronounce those words, but know that the rotator cuff is a group of four muscles. We remember them as the SITS group to keep them straight. The four muscles work together to stabilize the shoulder joint because the joint is very shallow, like a golf ball (arm bone) on a tee (socket). Each muscle on their own is responsible for producing a specific movement of the arm.

Your Supraspinatus muscle runs from the top of your shoulder blade out to attach on to the top of your arm bone. Its main purpose is to start the motion of lifting your arm up at your side.

Your Infraspinatus muscle sits below the supraspinatus on the shoulder blade. This muscle covers most of your shoulder blade and is shaped like a fan. It is larger and attaches right next to the supraspinatus on the arm. It’s main movement is to rotate your arm to touch the back of your head.

Your Teres minor is the smallest muscle in the SITS group. It sits below the Infraspinatus muscle also attaching to arm bone with the two muscles above. Because it is so small it only helps Infraspinatus with its main functions.

Your Subscapularis is the only member of the rotator cuff group that sits on the front side of your shoulder blade, between the blade and the rib cage. This is the largest of the SITS muscles, and it fans over the whole front of your shoulder blade and attaches on the exact opposite side of the arm bone compared to the other three muscles. It’s main function is to internally rotate your arm to put it in the sleeve of your coat, scratch your back or squeeze your arm to your side.

Rotator Cuff Muscles of the Shoulder

Rotator cuff injuries are quite common, many people find out later in life that they have a tear from many years ago without ever knowing it. However, some result from falling and jarring your arm and shoulder or during some other incident that involved a lot of pressure or force being pushed/pulled through your shoulder (e.g. seatbelt during a motor vehicle collision). These impacts can result in anything from minor injuries like partial muscle tears to more severe injuries like full thickness muscle tears or even, in rare cases, the muscle being torn completely off from where it attaches to the bone. Even where the muscle has been completely torn off, surprisingly surgery is almost never the first option and often it’s not used at all. In all cases, appropriate exercises can help to re-train and strengthen the attached muscles back to full or near full function.

However, outside of the more traumatic injuries that can happen to your rotator cuff basic overuse/misuse injuries are much more common (e.g. tendinitis, bursitis or non-inflammatory injuries like Tendinopathies). Repetitive movements can often result in muscle and tendon irritation and you will often see athletes in sports like baseball, volleyball, and tennis having some problems with overuse injuries in their dominant shoulder. These injuries are most often not caused by inflammation meaning they are not an ‘itis’ like tendinitis instead they are a dysfunctional thickening of the tendon referred to as tendinopathy. With overuse/misuse injuries, the most effective treatment starts with the Physiotherapist diagnosing the areas for improvement in painful movements and muscle compensation patterns. The Physio will assess the extent of the injury and then create an appropriate treatment plan to stabilize, strengthen and return to activity.

Treatment for shoulders typically starts in the acute phase, days after the pain starts. In the acute phase treatments like massage therapy, acupuncture, soft tissue work, IMS (needling) and shoulder stabilizing exercises are often used. As the injury starts to improve, the treatment will shift into a more active approach where exercises are used to target the movement patterns that resulted in misuse in the first place.

Find a Physiotherapist and a Registered Massage Therapist, in your town, to help get you on the right track to getting back to the activities you love!

Hip Flexors are More than Trouble Makers

Do you have low back pain that has been around far too long? Hip Flexors may be a contributing factor, so learn what they are and why they matter.

To put it simply, the hip flexors are a muscle group that works together to bend the hip, bringing the legs up towards your chest. If only it was that simple none of us would have low back pain, knee pain, pelvic floor issues, groin tightness, etc. The list can go on and on connecting the hip flexors to some pain or dysfunction. But the hip flexors are so much more than trouble makers, in fact, they are three very powerful muscles, the psoas and iliacus (often referred to as iliopsoas, pronounced like illy-oh-so-as) and rectus femoris (our main thigh muscle) We would be lost without them all work in concert to produce movement like kicking, walking, sprinting and dancing. These muscles are largely focused on bending the leg at the hip but the psoas muscle also helps to turn our hips outward like a ballet dancer (external rotation) and bend our trunk forward to pick up a box. The iliacus muscle also contributes to turn the hip out, but it is big helper in getting you up from laying on your back and swaying side to side like you are dancing at high school prom. Rectus Femoris has two purposes it bends the hip and straightens the knee (not shown in the image). The images below show how the muscles attach to the body.

Hip Flexors: psoas and iliacus

Tight hip flexors can put additional pressure on your spine that can contribute to lower back pain. They can also cause some exaggeration in the curve of your lower back which we often call sway back.

If the hip flexors are not working optimally, other muscle will try to jump in and do some of the work. The body is very good at coming up with compensation patterns to keep us moving. Other muscles that may start to do more work than they should include the glutes (butt muscles), the core (deep tummy & back muscles) and the pelvic floor (your pee stopping muscles). An imbalance in use of these muscles can result in some muscles overworking, while others are “underworking”. The result can be low back pain, strained posture, sacro-iliac ‘SI’ joint pain and pelvic floor issues.

The pelvic floor muscle group (muscles that make up the floor or bottom of our torso) plays an extremely important role with regards to support and stability of reproductive organs and other internal organs. Without the pelvic floor muscles all our organs would fall down because of gravity. Issues can occur if extra stress is placed on the pelvic floor muscles (sometimes related to shortness in the hip flexors). The pelvic floor muscles may start to “overwork” which may lead to an inability to “relax” this muscle group which can lead to potential pee leakage (incontinence) and/or low back or pelvic pain. On the other hand, the pelvic floor muscles may start to “underwork” as a result of mixed signals coming from other, overworking muscles. This can also lead to leakage, bowel incontinence and pelvic organ prolapse, where the organs start to fall down due to gravity and lack of support.

So, do you pee a little when you laugh, cough or sneeze? Do you have low back pain that seems to never really go away with trying many different treatments? Do you feel a ‘fullness’ in your pelvic floor that gets worse with long periods of standing? Well, a thorough assessment, stretching and strengthening routine with this added awareness of how some of the muscles in the lower body function would be a great place to start tackling some or any of these issues!

Common knowledge or common misconception? Motion is lotion.

Raise your hand if you’ve been doing a squat or lunge and been told “don’t let your knees go past the front of your toes”. Or “never bend forward because you may cause a disc bulge”? Or “don’t squat to the floor because it’s bad for your hips and knees”

There are many misconceptions that we hear in the clinic and around the gym that in some cases, cause more limitation or fear than necessary. In some cases, if we were to follow all of the ‘rules’ we would be walking around like robots!

Now, there are certainly situations that warrant specific movement restrictions and attention to form i.e. after surgery, while lifting heavy weights or when performing high intensity repetitive movements. But in everyday life, our bodies are amazing machines and are made to move! In fact, our joints stay healthy through movement and help prevent and manage conditions such as osteoarthritis.

When you stop to think about it, there are many movements we just don’t do in our daily life. Maybe because our daily demands don’t warrant it or our jobs have us working at a desk all day, for example.

A great example to think of this is how often do we ever bend our hips and knees past 90 degrees (i.e. deeper than chair height)? Or our ankles past neutral? For a lot of us, really not often, especially when we work standing at a till, sitting at a desk or driving in a car.

Here is a great tip from a well respected physiotherapist, Bahram Jam, to help keep you feeling young and your joints mobile while reducing the dread of bending down to pick something off the floor

Practice unloaded deep squatting everyday.

  1. Try holding onto a kitchen counter, banister or rail and gently lower yourself until your bum touches your heels and your armpits touch your knees
  2. Hold it for a few seconds while you get comfortable
  3. Then repeat 5-10 times using your arms throughout to help with the movement, if needed
Deep Squats for mobility

This is a simple yet great way to keep your back, hips, knees and ankles healthy and mobile by using their available range of motion!

Obviously this goes against what we may hear about not bending our hips past 90 degrees and knees past our toes. The movement itself is not damaging. In fact, it helps keep the mobility in our joints while making things like getting on and off the floor or squatting to pick things up much easier.

Of course this should not replace any medical advice but if you have any concerns or would like ideas to help stay mobile and keep your joints healthy and strong visit a local physiotherapist or kinesiologist!

Pitch Out Injuries – FIFA 11+

The 2018 World Cup is upon us! If you are anything like the team at Lab Health, your competitive juices will be flowing. You’ll too want to hit the pitch with your friends and try and recreate the magic of your favorite players!

Since we are rehab professionals…. The World Cup causes us to think about the soccer injuries we see in clinic. Because of that, this is the perfect time to talk about injury prevention before hitting the field. After all, the best cure is prevention and exercise is the best prevention!

A quick background…

Some of the most common injuries in soccer involve knee ligaments (ACL, MCL etc.), ankle sprains, groin, hamstring and calf strains. These injuries can range from minor to severe and can potentially keep an athlete out of the game for an extended period of time. In fact, up to a quarter of a million Anterior Cruciate Ligament (ACL) injuries happen in Canada and the US each year (1) potentially leading to significant time away from soccer and increasing their risk of developing osteoarthritis later in life. Yikes!!

Fortunately, research shows that with consistent proper ‘neuromuscular training’ (I know, big words make us glaze over but this one is important so bare with me) can reduce many soccer related injuries. Luckily, there is a FANTASTIC resource for neuromuscular training and injury prevention specifically for soccer that is freely available with a quick Google search (or by clicking here for the PDF) called FIFA 11+.

What is FIFA 11+?

FIFA 11+ is a simple warm up program for soccer players aged 14 and up. It contains a well laid out series of neuromuscular exercises aimed at building proper strength and form to help decrease the number of soccer related injuries.

The program was developed by a team of experts and backed by research proving the program’s effectiveness. Studies have shown a 29% decrease in training injuries, 37% decrease in match injuries and up to 50% decrease in major injuries for those who stick to regular implementation of these exercises (2 or more times per week) (2).

Not only has FIFA 11+ been shown to significantly reduce the injuries in male and female players, consistent implementation has other benefits as it has been shown to improve muscle strength, coordination and performance (3,4).

How long does it take to complete and how often should I do it? Do I need fancy equipment?

All you’ll need to complete this warm-up is an open field or gym, a ball, a buddy, a few cones, and 20 minutes of your time! It’s recommended that you complete this warm up before every training session (or at least 2 times weekly) and a shorten version before every game.

Some of the exercises don’t look all that different from what I already do?

The program is designed to replace your current warm-up. Although the exercise are not anything new or groundbreaking, the real benefit is realized with commitment to consistently completing the warm-up with attention to proper form and control during the exercises. FIFA 11+ provides a step-by step guide with useful pictures demonstrating proper form that will help prevent potentially harmful joint movements. Check out the video below for an example of what we are talking about.

This is an example of good form while performing a FIFA 11+ jumping exercise. Notice how she is landing on the balls of her feet, hips and knees have sufficient bend and her knees stay in line with the middle of the feet. All of this allows for proper support and control at the knee and ankle joints.

Would this benefit me if I play other sports?

Yes! A recent study has shown the benefits of regular adherence to FIFA 11+ has decreased the number of injuries in elite male basketball players (5).

Summary

If you are a young soccer player or older recreational player, consider replacing your current warm-up with FIFA 11+. You will start to see the benefits with committing to twice weekly for 10-12 weeks! Start incorporating these exercises early, often and continue them throughout your playing days to reduce injury! If you would like some guidance on form, frequency and force of these exercises see a Physiotherapist or Kinesiologist familiar in neuromuscular retraining to help keep you playing your best and preventing injuries!

References

  1. Campbell, C. J., Carson, J. D., Diaconescu, E. D., Celebrini, R., Rizzardo, M. R., Godbout, V., … & Constantini, N. (2014). Canadian Academy of Sport and Exercise Medicine Position Statement: neuromuscular training programs can decrease anterior cruciate ligament injuries in youth soccer players. Clinical journal of sport medicine, 24(3), 263-267.
  2. FIFA 11+.
  3. Barengo, N. C., Meneses-Echávez, J. F., Ramírez-Vélez, R., Cohen, D. D., Tovar, G., & Bautista, J. E. C. (2014). The impact of the FIFA 11+ training program on injury prevention in football players: a systematic review. International journal of environmental research and public health, 11(11), 11986-12000.
  4. Bizzini M, Dvorak J. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide—a narrative review. Br J Sports Med 2015;49:577-579.
  5. Longo, U. G., Loppini, M., Berton, A., Marinozzi, A., Maffulli, N., & Denaro, V. (2012). The FIFA 11+ program is effective in preventing injuries in elite male basketball players: a cluster randomized controlled trial. The American journal of sports medicine, 40(5), 996-1005.

BMI, Scale, Measuring Tapes…which to trust!

BMI is not the only measure of health: fat vs. function.

Many or most of us truly understand the internal struggle of being a lifelong yoyo dieter, someone who would love to be a few pounds lighter, fit into a smaller pant size, have a flatter stomach, etc. We all understand the magnetic strength of the scale and how obsessive we can get over the number on the screen. However, the ongoing trend among medical professionals to use body mass index (BMI) over the scale’s number, as a primary indicator of health and fitness, is not capturing the whole picture either. 

BMI is a simple measure of your height to weight ratio, calculated by taking your weight in kilograms and dividing it by your height in meters squared (kg/m²).  What it can offer is a basic idea of whether you fit into a normal weight category. Since the measures are easy to get, BMI offers a simple shorthand for busy professionals to make quick decisions. What BMI does not take into consideration is your muscle mass, overall body composition (proportion of fat, muscle mass, bone density, etc.) or any other useful health markers. 

There are many informal but just as valuable health markers that we can easily measure ourselves. For example:

  • Being able to walk up a flight of stairs without getting winded?
  • Getting up off the floor without help?
  • Completing regular activity (3-5x/week for an accumulate 150 minutes/week)?
  • Ability to lift your groceries?
  • Walking up or down stairs without pain?
  • Reaching over your head? 
  • Maintaining blood pressure within normal healthy range?
  • Being able to do things that matter to you without being limited by your body?​

The reality is, being substantially overweight can cause an individual to have trouble with many of the scenarios above. However, many people who technically fall into the overweight and obese range on a BMI scale have no problems with most or all of those same things. So the issue becomes: What should we consider as appropriate health markers? The number on the scale or how well you can complete functional activities?

This is in no way an argument for being obese. There are huge risk factors associated with carrying 40+ extra pounds on your frame, from increased load on your joints to a greater risk of diabetes and other diseases. This instead is a discussion for people dealing with the frustration of being within a healthy range of function and body composition, but cannot see it reflected through BMI or a number on the scale. 

There are better metrics on which to measure your health, fitness, and wellness are functional abilities and goals. Keep your focus on functional fun tasks that will make a difference in you everyday life, like…

+ If your knees hurt every time you squat to pick something up or go up and down stairs, then working to build strength and stability around the joint to prevent the pain is something tangible and attainable. Not to mention the huge boost to your quality of life when moving around your house gets easier and less painful.

+ If walking a few blocks to the grocery store is out of the question because you get winded or can’t carry your groceries home, then working to increase your cardiovascular ability is huge. 

If you’re already someone who doesn’t have to think about taking your dog out for an hour long walk, then maybe it’s the ability to hike up Mount Finlayson without getting rubber legs by the time you get to the bare rocks near the top that would be a better metric for your fitness. Or increasing your deadlift personal best, or lowering your 500m split on the rowing ergometer, or running a 10k in 45 minutes or less, etc. 

The point is, the number on the scale and BMI are not valid singular measures of  health and fitness and there are better indicators of your overall health for you and your health professionals to measure. Many athletes are considered to be overweight by definition of their BMI simply because their muscle mass increases their overall density for their height. All of this is not to ignore that losing a substantial amount of weight is a huge accomplishment too, it takes a huge amount of work, discipline, and drive (and even more-so to maintain that accomplishment). It is simply to acknowledge that there is an ongoing excess of focus put into a number on the scale, instead of on the ability of the individual to live and enjoy their life. BMI and weight loss is one part of a broad spectrum that make up one’s health.

So, stay strong, stay active and try to not let a number define you! ​​Thank you for reading and we’d love to hear your thoughts in the discussion below!

Movement is Medicine: treating osteoarthritis with exercise

Osteoarthritis (OA) is most common in the knees and hips, followed by other joints like ankles and hands. For many people, the diagnosis of osteoarthritis in one of their joints feels like a life sentence of inactivity and inevitable slow descent into frailty. Often, the diagnosis comes after several months or even years of increased joint pain, and some kind of loss of function that results in a doctor requesting an X-ray. Once the joint is shown to be damaged, there is a common thread of “well, do what you can!” and “If it hurts, stop”. Anti-inflammatory medications and other pain medications may also be prescribed, which can have little or no impact on current or worsening pain. Unfortunately, these common coping strategies often result in a downward spiral of function due to decreased use of the joint, weakening muscles and joint instability; all of which results in increased pain during movement. This combination causes the person to use the joint less and less and.….. You see where this is going.

What Has Changed? Over the past decade, there has been a movement to change both the mindset and the treatment of osteoarthritis.  Scientists and therapists alike have become more aware of the mechanisms of joint maintenance and what we can do to conserve strength without risking any additional joint damage.  The current research shows that the connective tissues inside the joints  (i.e. meniscus, joint surface, etc.) are actually supported by movement and consistent loading and off-loading of the joint in low to moderate impact activities like walking and strength training serve to protect and maintain the joint’s integrity.  This change in mindset is in large part attributable to a group of researchers out of Denmark. Over the last 5 years they have enrolled more than 30,000 participants in their research called GLA:D. These participants joined supervised exercise and education groups all over Denmark that were  tailored to managing the symptoms of osteoarthritis of the knees and hips. Denmark is too far away for you to travel for OA management and that is why Bone and Joint Canada and The Arthritis Society have brought the training and certification program here to Canada and more recently, British Columbia to train Physiotherapists and Kinesiologists here at home. 

But Moving Hurts! Most of us are conditioned to see pain as potential damage and for that we reasonably choose to stop doing whatever hurts, because it feels like we are doing more harm than good. However, the pain that is associated with osteoarthritis is more often related to weakness, instability and poor movement patterns, not increased damage to the joint. 

So how can we get more active without intolerable pain? Since there is no known cure for OA, our best strategy is to manage the symptoms and improve function. As we said above, the best approach for treatment is NOT premature surgeries but treatment that includes specific exercises for strengthening, mobility and balance along with education.  The GLA:D program provided by a trained Physiotherapist and Kinesiologist are best suited to guide you through specific and appropriate exercises to help you manage your symptoms and improve function. Following 7-weeks of the GLA:D exercise and education program, participants reported more than 25% reduction in symptoms when measured right after the program and 1 year following the programs completion. So by participating in the program you are likely to have long-term lasting symptom reduction.  Participants also reported an overall increase in activity, reduction in pain intensity and use of pain killers and fewer lost days of work. 

Fortunately, the GLA:D program is now available in Canada and will soon be offered through Lab Health! The program is 7-weeks in length and includes two education sessions (the first one is free) and 6 weeks of twice weekly, one hour exercise sessions. CLICK HERE to sign up for the FREE GLA:D Program education session, no commitment required, just come and learn along with the rest of us!

Click to learn more about GLAD Canada or for more information on Osteoarthritis and it’s management CLICK HERE.  

References:https://labhealth.janeapp.com/ 1) http://gladcanada.ca/index.php/the-healthy-hip-and-knee-joint/

Treadmill Training Made Easier

Learn How to Use the Treadmill for Best Results

How to use the Treadmill… Well this may seem very simple and basic, and it is, but you have no idea how many people, including fitness professionals, don’t know what the buttons on the treadmill are for!

Sport specific training, like trail running or road racing, should resemble the training/race environment, as much as possible. What this means is, if you race on trails then train on trails, or if you race on the road then train on the road. But we all know this is not always easy or convenient depending on the weather, timing, your rehab needs, or if you have an injury and can’t yet tolerate the demands of the road/trail environment!

So, how do you make treadmill training resemble the training/race environment? If you are going to race on TRAILS:

  • Train in ‘Random’ or ‘Hill’ mode
    • This will engage the muscles more similarly to the ups and downs of actual trails

If you are going to race on the ROAD:

  • Train in ‘Random’ or ‘Quick Start’ with at least 1% incline
    • This will make you have to work a little harder than on 0% grade (no incline) which is never going to happen on the road

     PRO TIP!! Always put at least 1% incline on the treadmill for walking or running as it will simulate walking on land that much more. Why you ask? Because you naturally use your butt muscles to pushing you forward with each step on the land however on the treadmill the tread going round and round is what pushes you forward. So to get those glutes (butt muscles) firing more on the treadmill, you can set the incline to at least 1% so that you have to propel yourself forward.  We all know what our butt feels like after a good hill climb, so apply that same hill climbing (incline) principle on the treadmill to make it more similar to real life walking or running on land.

Speed Training: Are you that person that holds the speed button down to switch between faster and slower speeds to complete your speed interval training? Well, I was for the longest time but there is a way easier way to do it!!

      PRO TIP: Use the ‘Speed Interval’ Button

It will ask you for your ‘LOW’ (jog/recovery) speed and your ‘HIGH’ (sprint/challenge) speed and your incline (remember at least 1% for this, don’t pick 0% as Road or Trail running is never 0%) AVERAGE Speed Settings (don’t be fooled if the machine is in km/h then these numbers won’t work but most Treadmills display in mph (USA units)

  • Walk <4.0mph
  • Jog >4.0-6.0mph
  • Run >6.0-10mph
  • Sprint >10mph

The treadmill will start with your LOW/JOG speed but you can now switch between your JOG and your RUN speed with ONE click of a button. See the video below.

It will NOT switch between speeds automatically! You will have to push the FLASHING ‘Speed Interval’ button at your desired interval/frequency.

How do I know how long I should run at each speed? So this more comes down to the type of training outcome you are looking for.  Training Outcomes:

  1. HIIT (High Intensity Interval Training)
    1. Increase overall speed
    2. Increase Cardiovascular tolerance (endurance)
  2. FARTLEK: (Swedish for ‘speed play’; change at your will with no specific plan)

Tune in for a post on Interval Training, How to reach your PERSONAL BEST on your next run or race!