Posts Tagged biomechanical

Effective Exercise Treatment For Hamstring Strains

Strength, Flexibility and Running Are Key Elements of Hamstring Rehab Programs

Hamstring injuries can be tricky, and proper treatment is a definite must before testing them out again on the sporting field. Hamstring injuries are among the most common we see here in the clinic, and we believe in using a holistic treatment approach encompassing several areas to get those dodgy hamstrings healthy again!

 

The three main treatment avenues we use are: Strength, Flexibility and Running.

1. Strength

1 Leg Barbell DeadliftsStrength is a crucial part of keeping hamstrings healthy, and there are a number of exercises we like to use to increase hamstring strength. We use progressive overload in both hip and knee dominant exercises to ensure maximal strength levels are achieved. Some of these exercises include single leg bridges, Nordic curls, prone hamstring curls, single leg deadlifts and hamstring slider curls. Remember to mix up your exercises and give yourself plenty of rest between sessions.

2. Flexibility

Obviously, flexibility is a massive part of healthy hamstrings, however many people don’t release that flexibility of muscles other than the hamstrings also plays an important part of keeping those hamstrings healthy. Therefore it is important that flexibility components of hamstring rehab programs focus on glute, hip flexor, quadriceps and calf range of motion as well as the hamstrings themselves. Poor range or severe tightness in these muscles are an injury risk factor, so this should be a priority for anyone returning to sport from a hamstring injury.

3. Running

Running can be a difficult part of hamstring rehab, as in many cases it was the mechanism of the injury! It is however an extremely useful tool in hamstring rehabilitation, and once you’re over the initial hesitancy is the trick to getting those hamstrings firing again. Changing up the style of running training you do is key. We use a mix of progressive speed exposures, max speed exposures, change of direction and deceleration training, and again suggest varying the type and intensity of running training you complete.

 

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Should You Be Starting A Pre-season training Program?

Pre- Season training: why is it important?

For many people who play winter sports like football, soccer, AFL, netball and hockey, pre-season training is just around the corner or may have even started already. Completing a whole pre-season program is not only vital for fitness levels and skill practice, it can be a massive component of preventing injuries throughout the season!

Pre-season strength trainingA 2016 study found that elite AFL players who completed <50% of their pre season training were 2x more likely to sustain an in- season injury than those who completed >85%. This isn’t just relevant for AFL though; it’s relevant for all sports at any level.

This is a telling stat, and one that needs to be at the front of all athletes’ minds whilst participating in pre-season training. Even if you’re injured, there is something you can do. Pre-season isn’t just about “getting fit again”, it can be used for rehabbing those niggly injuries still hanging around from last season. The is also lots of research showing that increasing strength can help prevent many common sports injuries including hamstring and adductor (groin)  muscle tears, rotator cuff and other shoulder injuries, shin splints and other sprains and strains.  

Research from the Australian Institute of Sport (AIS) also shows that avoiding rapid spikes in training load helps you avoid injury not only in pre-season, but during the season as well. Going straight in to in-season training and competition loads causes a huge spike in strain through your body and this dramatically increases your risk of injury during the season.

So make the most of your pre-season training. Get yourself to those sessions, and work on everything you can! Remember, the work you do now will pay off come start of season if you make the effort!

Not sure what to do for your pre-season training? Let one of our Strength & Conditioning coaches  or Exercise Physiologists get you on the right program to boost your performance and reduce your risk of injury

Reference: Murray et.al 2016 Individual and combined effects of acute and chronic running loads on injury risk in elite Australian footballers

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Can Strength Training Help You Run Faster?

Run Faster For Longer With Less Chance Of Injury

The right strength program can improve your performance as well as reduce your risk of injury.

At Central Performance we see a lot of runners coming in either for physio treatment or running training with our running coach/physio superstar Ben Liddy. We know that runners love to run and can be like a bear with a sore head when they can’t run due to injury. One great, and often overlooked, way to both improve running performance as well as reduce the risk of injury is to add some strength training to your running training.

Traditionally it was believed that strength training won’t improve running performance as lifting weights will make people bulky and slow. However there is now good evidence that strength training improves running performance by increasing running efficiency. An increase in running efficiency means you to use less energy while running.

Strength training helps improve running efficiency by increasing the rate of force development (RFD) of a muscle. RFD is how quickly a muscle can produce force. The higher the RFD the quicker a runner is able to spring off the ground, reducing the ground contact time and therefore reducing the amount of energy they use.

What Type Of Strength Training Is Best For Runners?

Training needs to be personalAlso contrary to popular belief, the best form of strength training for runners is not light weights with high reps to build endurance. Research shows that the most effective form of resistance training for runners is heavy weights with low reps and plyometric (power) training. Using heavy weights for low reps helps to increase neural drive to the muscle which helps to improve RFD. Plyometrics also help to improve RFD and power development. Plyometrics involve jumping exercises and help teach the body to use muscles and tendons like springs, reducing ground contact time and thereby improving running efficiency.

The best types of resistance exercises for running are compound exercises such as deadlifts, squats and lunges. These exercises use almost all the lower body muscles in a coordinated fashion. 

Research shows that weight training twice per week causes significant improvements in running efficiency and performance. It has also shown that for competitive runners reducing weight training to once per week during the competitive season maintains the improvements made with twice per week.

Can Strength Training Also Reduce My Injury Risk?

Strength training also helps to reduce the risk of injury to runners and all other athletes. A recent review in the British Journal of Sports Medicine showed that resistance training can lead to a 66% decrease in sports injuries and a 50% decrease in overuse injuries. The below picture does a good job illustrating why strength training is important injury prevention for runners.

As you can see the soleus muscle, one of the muscles in the calf, needs to handle between 6.5-8.0 times bodyweight on ground contact during running. Having to tolerate such huge forces obviously requires a lot of strength otherwise the rsk of injury is greatly increased. A good guide for having adequate strength in the calf muscles is to be able to confidently do 30 single leg heel raises on each leg.

Tendinopathies are a very common type of running injury. They occur when the amount of load going through a tendon overloads the tendon’s ability to recover from it. Commonly occurring tendinopathies for runners are hamstring and achilles tendinopathies as both the hamstrings and calf muscles are extremely important in running. One of the best ways to improve a tendon’s capacity to handle load is by resistance training. Heavy resistance training provides a beneficial stimulus to tendons to help them build strength, remodel and allow them to adapt to high volumes of load put through them during running.


We’ve Got Runners Covered

The Central Performance Running Centre helps runners of all abilities improve their performance and reduce their risk of injury. Our strength coaches and exercise physiologists can get you on a personalised program that is effective, efficient and tailored just right for you. 

You can book online or call us on 9280 2322 for more info. 

This post was written by Hugh Campbell, our senior Exercise Physiologist. He has extensive experience and has attended numerous post-graduate courses on running biomechanics and the role of strength training in runners. 

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How Do I Manage A Tendon Injury?

Tendon Injuries

What are they? What should I do? What should I not do?

Tendinopathy is a common condition that results from overloading a tendon. It used to be called tendinitis however research shows that usually not much inflammation is involved, hence the name change. Lower limb tendinopathy is common in sports including running, basketball, netball & football. Upper limb tendinopathies occur frequently in tennis & other racquet sports, swimming, & throwing sports like cricket & baseball.


What is tendinopathy? And how did I get it? 

Tendinopathy occurs when the tendon’s main tissue, called collagen, becomes damaged because it is no longer able to cope with the load being put through it. This overloading usually happens when there is an increase in exercise frequency, volume or intensity. This may be someone starting the gym again after a break, when stepping up training in preparation for a race or fun-run, or when you start pre-season training after resting from your sport in the off-season.

As the tendon becomes overloaded it starts getting irritable and in some cases swollen. You will usually feel pain in the morning after waking up, when you move again after resting or sitting at your desk for a while during the day, and maybe at the start of exercise. Often in the early stages of tendinopathy your pain will disappear as you warm up, but usually comes back again after you cool down, rest or sleep. It will usually get worse over time if you keep overloading it. 


Ok, so what should I do?  

There is a lot of conflicting advice out there about how to deal with tendinopathies. Much of it is out-dated and we now know that old-style things like stretching and completely avoiding painful activities will actually slow or prevent your recovery.

For a great overview of tendon injury & management guidelines check out this video from Professor Jill Cook, a leading research expert in tendon management.


Here is a summary of the main Do’s and Don’ts for recovery from tendon injuries

 
DO:

•  Continue to exercise at a sustainable level. As a general rule a little bit of pain is acceptable during exercise in a tendon with tendinopathy. As a rule of thumb 3 or 4 out of 10 pain level during exercise is okay as long as the pain stops within an hour after finishing exercise and isn’t worse that night or the next morning

•  Get your tendon assessed and begin treatment early. Like many things the earlier you get on to it the faster your recovery, the less treatment you are likely to need, and you give yourself the best chance for a great recovery.

•  Start heavy, slow resistance exercise. Tendons need a load placed on them to allow them to repair themselves. The best way to start loading a tendon with a tendinopathy in a controlled fashion is with heavy, slow resistance exercise. Look for a tempo of approximately 3 seconds on the concentric (lifting) phase and 4 seconds on the eccentric (lowering) phase. Again a little bit of pain during heavy slow, resistance exercise is okay as long as it stays at a 3-4 out of 10 level and does not persist after stopping exercise.

•  Be consist with your exercise. Tendons prefer to be used consistently and performing your exercises regularly will help with your rehabilitation from a tendinopathy

 
DON’T

•  Stop exercising or using the muscle completely. Like we said earlier, tendons need consistent loads to be placed on them in order to repair themselves. Stopping exercise completely may temporarily stop the pain but that pain is likely to return when you return to exercise as very little healing will have taken place.

•  Stretch the tendon. Stretching a tendinopathy is similar to itching a mozzie bite, it might provide some short term relief for the pain in the long term it will likely slow the healing. This is because stretching a tendon will usually cause it the tendon to get squashed against the bone it attaches to. This compression against the bone will usually aggravate the tendon and slow down its healing.

•  Try and rush your rehab. Tendons do not have a good blood supply and therefore are slow to recover. In some tendinopathy cases it can take 12-18 months for the tendon to remodel and recover. Be patient and consistent with your rehab. If you rush it and try and increase your exercise and loading of the tendon too quickly you will likely aggravate the tendinopathy and slow down your recovery.

 

For more information call us on 9280 2322 or book online to get your tendon checked out by one of our friendly physios.

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Runners Knee

Runner’s Knee – Patellofemoral Pain

Sydney-siders love a good run! And with the Blackmores running festival coming up, beautiful scenery & awesome weather it’s easy to see why. So today we look at the most common type of knee pain that can affect runners as well as people playing many other sports that involve running and jumping.

 

The knee is the most common site for pain in runners, but it’s not just “runners” that are at risk. Many other sports that involve running &/or jumping have a relatively high risk of knee injuries. One very common cause of knee pain is Patellofemoral Pain Syndrome, which accounts for up to 40% of all knee problems in sports medicine centres. The pain is felt around or behind the kneecap & occurs when the kneecap (patella) does not align correctly into the groove on the end of the thigh bone (femur). It is common in young people, & affects more women than men.

 

 


Symptoms Of Patellofemoral Pain Syndrome

Pain is either felt around the front part of the knee or along one or both sides of the kneecap. It can sometimes be hard to find a specific spot where the pain is felt the most, especially because sometimes it feels like it is hidden away behind the kneecap. Your knee may be making some grinding or clicking noises, & there may be some swelling.

Often there is no specific cause (eg a fall or twist) of patellofemoral pain. Sometimes you may be able to relate it back to an increase in running or jumping volume, or things like new shoes or more hill running. It often begins as a niggle then gradually gets worse if you continue to exercise on it, eventually stopping you doing your normal training. It usually settles temporarily if you stop exercising but keeps coming back when you return.

Patellofemoral pain is usually made worse with anything that increases the load within your knee, eg taking your weight in a bent-knee position. Examples of painful activities can include;

  •    •  squatting, lunging & kneeling
  •    •  going up & down stairs or hills
  •    •  jogging or running, especially on hills or slopes

Some people also get pain from sitting in a bent-knee position for long periods of time, eg working at a desk or sitting in a movie theatre. This is because this position squashes the inflamed back surface the kneecap onto the end of the thigh bone, causing pain after a while.


Causes Of Patellofemoral Pain Syndrome

The main cause of patellofemoral pain is when the kneecap doesn’t “track” properly in the femoral groove when we bend our knee. It can get pulled out to the side of the groove, meaning that it rubs on the wrong places & becomes inflamed. Excessive or rapid increases in loading, usually due to increasing training or running volumes too fast, are also common factors that contribute to patellofemoral pain.

Poor biomechanics (i.e. the way our body controls movement) is the major factor that contributes to incorrect tracking of the kneecap in the femoral groove. Common biomechanical problems include:

  1.    1.  your pelvis drops to one side, increasing the tension on the outside of the leg & pulling the knee cap outwards
  2.    2.  poor glutes (hip muscle) strength means that your knee collapses inwards & rolls inside past the line of your big toe
  3.    3.  there may be an imbalance between the muscles on the inside of your quads (VMO) versus the outside (VL).
  4.    4.  you foot rolls in too much (pronation), causing the knee to collapse inwards so that your quads muscles have an outwards angle of pull on your kneecap.

Females are more likely to develop patellofemoral pain than males (3:2). This is due to women having a bigger “Q Angle”, which is where the quads muscles have a more outwards pull on the kneecap because women’s hips tend to be wider than mens.


What Can I Do About My Knee Pain?

Assessing & correcting your biomechanics is a big part of getting your knee pain resolved. You need to release any tight muscles on your outer thigh & hip, usually by using a foam roller or spikey ball. You will also need to strengthen muscles that are not keeping your leg and knee in the right alignment. The usual problem is that your knee rolls inwards over your big toe too much, so strengthening your glutes muscles to correct this is critical. Making sure that your inner quads muscle (your VMO) is strong enough to balance your outer quads muscle (VL) is also important. 

Your foot position also needs to be checked. The most common foot problem is over-pronation, where your inner arch collapses & rotates your shin and knee inwards too much. You will need to ensure that you have the right shoes for your foot type, eg if you are an over-pronator then pronation control shoes or orthotics are likely to help you. However as physio’s we always find that shoe type or orthotics alone are not the full solution – they are only one component. You must correct your other biomechanical factors like hip control as well.


We can help you beat your knee pain

Every day our friendly & experienced physio’s work with runners & athletes at all levels, from weekend warriors to national champions. We can help you with fast relief & get you back out there on the road, track, field or court. We specialise in finding & fixing the underlying cause of your problems so that once we’ve got you feeling good, you stay feeling good. 

If you need help with your knee pain then you can book an appointment online or contact us for more info, or give us a call on 9280 2322 to chat to one of our friendly team. 

 

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Do I Need a Physio, an Exercise Physiologist (EP) or a Personal Trainer (PT)?

So what actually is the difference between Physiotherapy, Exercise Physiology and Personal Training?

At Central Performance our physiotherapists, exercise physiologists & personal trainers all work side-by-side to care for our clients. Our  aim is to perfectly match our clients with the right program whatever their level of physical health, injury & performance. The flowchart below shows how it all fits together.


Central Performance Client Pathway


3 questions we often get asked by clients are; 

1. What does an exercise physiologist do?
2. How is exercise physiology different from physiotherapy?
3. How is exercise physiology different from personal training?

Firstly, exercise physiologists use exercise to treat chronic health conditions. The most common types of problems that our exercise physiologists treat are;

• Musculoskeletal Injuries, eg back & neck pain, osteoarthritis, sports injuries/sprains & strains, post-operative recovery like ACL knee reconstruction, shoulder & knee problems

• Cardiovascular & metabolic problems, eg high blood pressure (hypertension), heart problems, to reduce bad cholesterol (LDL & total) & increase good (HDL) cholesterol, &  diabetes management

• Mental health, eg depression & anxiety

Similar to how a doctor prescribes medicine, exercise physiologists prescribe exercise programs. When deciding on the correct program to prescribe they consider a range of factors about the client’s condition, any other unrelated conditions, previous injuries or health problems, & the client’s previous exercise experience. For example, a young male who presents with 6 months of back pain but no other injuries or medical conditions will receive a different ‘dose’ of exercise to a post-menopausal woman with a 10 year history of back pain who also has hypertension (high blood pressure). The goal is to match the client with the right type & amount of exercise, as well as to make the exercise interesting so that the client is much more likely to be consistent in their sessions.

Shoulder physiotherapyFor question 2 above, there are a few distinct differences between an exercise physiologist & a physiotherapist. Firstly, exercise physiologists specialise in treating chronic conditions while physiotherapists are more likely to see people with acute & sub-acute injuries. A chronic health condition is one that has lasted for longer than 6 months & can be musculoskeletal, metabolic or cardiovascular. By contrast acute & sub-acute injuries are within the first 3-6 months of when they began, although they also may be recurrent – where each episode is only short, but episodes may occur repeatedly over months or years.

The second difference is that physiotherapists are able to diagnose injuries & order some types of medical imaging, whilst exercise physiologists are not. If someone presents to a physio with a ‘tweaked’ hamstring after football on the weekend a physio is able to diagnose if they have a hamstring strain & what grade the hamstring strain is. By contrast an exercise physiologist isn’t allowed to give a client a diagnosis in that fashion & this is linked to exercise physiologists specialising in chronic health conditions rather than acute injuries. Similarly, physiotherapists can refer clients for some investigations such as x-rays while an exercise physiologist can’t.

Thirdly, exercise physiologists receive extensive training & education in the physiology of metabolic & cardiovascular health conditions. This gives them the skills & expertise necessary to prescribe exercise for people suffering from metabolic & cardiovascular health conditions. Physiotherapists don’t receive training to the same level in these conditions unless they have a special interest  in them & pursue further study.

Ball rollout for core stabilityRegarding the last question, there is a lot of overlap between exercise physiologists & personal trainers when it comes to musculoskeletal health. Exercise physiologists can be thought of as focusing more on corrective exercise for injury recovery, whereas personal trainers focus more on performance exercise where there are not significant restrictions imposed by injury or disease.

Personal trainers do not receive such extensive education or training in physiology, biochemistry or pathology to treat chronic health conditions. As a result they are not eligible for private health fund rebates or referrals from GPs under the Chronic Disease Management plan. Exercise physiologists however are eligible for private health fund rebates & most health insurers cover exercise physiology. Similarly, MediCare will also provide rebates for exercise physiology when referred by a GP under the Chronic Disease Management plan.

Exercise physiology rather than personal training may also be suitable for people who have no experience with exercise or gyms. Because exercise physiologists primarily treat people with chronic health conditions they receive training in cognitive behavioural approaches to help clients feel comfortable & confident while exercising. A similar cognitive behavioural approach can benefit those who have little to no experience with exercise & are therefore nervous to start exercise.

As you can see physiotherapy, exercise physiology & personal training all have different areas of specialisation. At Central Performance we believe in integrating all three in our multidisciplinary approach to provide you with a perfect pathway from pain to full performance, whatever your goals may be. For example a back pain client may initially see our physio’s for diagnosis & hands-on treatment to settle their pain & return to gentle movement. Then they may progress to exercise physiology for initial correction of movement biomechanics plus a return of baseline stability & strength. Once this is achieved they can progress to personal training to really build their strength & endurance, or train to achieve any other sporting or health goals they have.


Contact Us for More Info: For more information or help deciding which service would be the best for you to start, please contact us on 9280 2322 or via email. There is also lots more information on the webpage for each of the services – see physiotherapy, exercise physiology or personal training


 

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Lower Back Pain in Golfers

Lower back pain is by far the most common complaint for golfers of all ages and ability levels. Data collected from the Titleist Performance Institute (TPI) show that 28.1% of all players have lower back pain after every round. The most common trend is for trail-sided back pain, ie. pain on the right side of the lower back for a right-handed golfer or left sided back pain for a left-handed golfer.

In actual fact the lower back is generally not the cause of the injury but is the area of the body that is overloaded the most and eventually suffers from the pain. Most of the time it is the fault of the body segments above or below the lower back that are dysfunctional. If the hips, upper back, shoulders or ankles do not move correctly it puts more pressure through the lower back than it is supposed to cope with and it subsequently breaks down. For example, if you are tight through your upper back or hips, the rotation required to bring you to the correct position at the top of your backswing is unable to occur in the upper back and hips. This forces your lower back to compensate and attempt to rotate further. Your back is then repeatedly loaded with more force than it can take, ultimately resulting in the facet joint injuries we see so commonly in golf. It may be an injury that comes on all of a sudden during a swing, or it can be a gradually stiffening/tightening of the back or soreness that is present after a round.

There are 3 aspects within a golf swing that have a strong relationship with lower back pain. The first is an S-posture at initial setup position. As you can see in the picture below on the left, the S-posture creates increased compression forces through the lower back due to the excessive lumbar lordosis (curve). This compression puts heavier load through our facet joints and with repetition this can result in an acute irritation of the facet joints or gradual degenerative changes through these joints.

Instead of the S-posture set-up, we ideally need a straighter line through the lumbar spine. This requires core stability to draw the spine out of the large curve and maintain a stable lower back position throughout the swing. If you have an S-posture, you can begin to correct this by practising basic motor pattern and core exercises, sometimes beginning in lying or kneeling positions, then progressing into more relevant standing golf positions.

The second major feature of the golf swing that correlates with lower back pain is the “Reverse Spine Angle”. At the top of the backswing the line between our head and centre of the pelvis should point away from the target. A “Reverse Spine Angle” is where this line of the spine is tilted towards the target. In this position the facet joints of our lower back are in an open position so as we move into the downswing and ball contact there is a rapid compression onto the facet joints as we close down onto them. People may develop a “Reverse Spine Angle” because of an inability to separate the movement of the upper body from the movement of the lower body, such as restricted rotation at the upper back or tightness through the latissimus dorsi muscle (the lats). It can also be caused by restriction in trail hip range of motion or weak gluteals and core muscles.

“Early Extension” is the third characteristic of the golf swing which can result in lower back pain. This is the movement of the hips and/or spine straightening up too early in the downswing. It can be seen on the second image below where the buttocks moves forwards away from the back line, when it should actually remain in contact as the hips rotate rather than straighten. “Early extension” again jams down and compresses onto the facet joints of the lower back. The physical causes for this can be reduced hip rotation of the lead hip, poor rotational mobility in the upper back, tightness/shortness in the lats, poor gluteal or core strength and overall a poor overhead deep squat movement.

As well as assessing the golf swing to determine if these swing characteristics are present, a golf assessment must also include a physical screen. TPI teach a Physical Screen consisting of 16 tests, ranging from hip range of motion, upper back rotational range, overhead squat patterns and even to wrist range of motion. All of these body segments need to be working together as a unit to achieve a successful, safe and reproducible golf swing.

TPI’s philosophy of the golf swing is this:
“We do not believe in one way to swing a club, rather in an infinite number of swing styles. But, we do believe there is one EFFICIENT way for every player to swing and it is based on what the player can physically do.”

At Central Performance we have two practitioners who are TPI Certified to assess the golf swing and perform your golfing physical screen.
Helen Hathaway – Physiotherapist
Danny James – Strength and Conditioning Coach
We are by no means golf coaches who are the experts at swing analysis, but would love to work with you and your golf coach (if you have one) to ensure that the mechanics of your body allow for the most efficient and safe swing for you.

Our physiotherapist, Helen, and strength and conditioning coach, Danny, run Golf Biomechanical Assessments consisting of a Physical Screen and a Golf Swing Analysis. They piece together the information gathered from these tests and establish a plan to help you get the most out of your body to improve your golf game. For some, the goal may be to get through a round of golf without feeling stiff in the back for two days following. This may mean manual treatment with Helen to improve joint range of motion and muscle length, as well as a program of corrective exercises to restore normal function. For others, it may be that they want to improve the power in their swing and could benefit from strength and power development with Danny. If you are having pain or discomfort with your golf, or feel that your game could be improved by improving your body’s mechanics, feel free to call and chat, or email helen@centralperformance.com.au

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From Pain To Performance

client-performance-pathway-rooms-26-10-16At Central Performance we believe that clients in the 21st century are looking for a new model of health & fitness. In our view the line between “rehab” & “fitness” is blurred if not fully broken down. Our goal is to allow our clients to progress seamlessly from acute injury management right through to exercise for life-long fitness & sports performance, all guided by an expert team within one great location.

We find that our clients expect much more than just short-term symptom relief. Of course fast pain relief is still a crucial first step, but these days people want (& deserve) much more. They also want to know what implications their current problem has for their future health, & what they can do to prevent future injuries. Many people also want to know about options to improve their overall health & wellbeing, & for some they are looking for programs to improve their sports performance. Meeting these expectations requires a multi-disciplinary approach that focuses on each individual’s goals, lifestyle, history, exercise preferences & sporting aspirations.

These expanded needs & expectations demand a much broader view of “healthcare”. The line between injury rehabilitation & physical fitness is now very blurred, meaning that treating an injury is only the first stage in the “rehab” process. Once the pain is settled, what then? Should clients just be discharged back to their pre-injury lifestyle, bearing in mind that for most injuries the client’s pre-injury lifestyle was a big contributing factor to their injury! Think back pain in sedentary desk workers, hamstring tears for weekend-warriors who don’t get a chance to exercise during the week, OA knee pain in overweight individuals.

If a client’s “rehab” stops when their current pain episode settles down, we believe they’re just setting themselves up for more problems. These days most people realise this & are looking for a different approach, however they often don’t quite know how to go about fixing the situation. Central Performance now provides you with an effective & convenient solution, with a team of experts all working together in a single location.

OLD MUSCULOSKELETAL MODEL – Triage Care

In this model musculoskeletal services had a short-term focus on the diagnosis & relief from a specific episode of pain or injury, eg an episode of back pain or an ankle sprain. Once this episode was relieved patients were discharged, usually with some exercises to keep going with (which we all know almost no-one actually did!) & advised to make some lifestyle changes.
Working with this model there was almost an assumption of “I’ll see you next time something goes wrong” – whether it was the same problem recurring or something new.

Essentially, this paradigm focused on treating pain & then returning people back to their pre-injury lifestyle & level of function. But they became symptomatic in their pre-injury level of function, so if they just return to this level the chances of them becoming symptomatic again are very high.

The solution? People often find it hard to improve their overall health & fitness by implementing lasting lifestyle changes, but our new model of care at Central Performance is having great success in removing the physical, social & psychological barriers to make it much easier.


Old Model                                         →               New Model

Triage & symptom relief               →              Effective short term & long-term management

Isolated injury focus                      →              Whole-body health & fitness management

One or two main providers         →              Team approach; an expert in each area


THE NEW MUSCULOSKELETAL MODEL OF CARE: Patient-Centred Pain to Performance Model

When seen graphically in the pathway chart below it is easy to see that the “rehab” phase, i.e. the symptom relief phase, is just the start of our client’s patient’s path to sustained better health. In fact injury management & performance improvement are really just opposite ends of the same spectrum. There is no true dividing line between when exercise for rehab finishes & exercise for performance improvement begins.

Central Performance Client Pathway

It is crucial to note that our definition of “Performance” is completely individual. For one person performance may mean being able to play with the kids in the back yard, for another it may be elite sport. For some it may be staying mobile enough to keep living independently, for others it may be using exercise to combat depression. A desk worker may define performance as being able to do long hours without neck pain, another may define it as recovering from ACL reconstruction to return to the rugby field. Whatever each client’s definition of performance is, our services focus squarely on helping them achieve it.

It is also important to see that given the much broader scope of healthcare this model encompasses, it is impossible for one provider to be an expert in all areas. This is critical to the Central Performance care philosophy which states that:

At Central Performance we bring together a team of experts in each area of your program, all combining & working together in one convenient location.

The ability to provide all these services at one location is important because it removes many barriers that often hold people back. Convenience & time-efficiency are two aspects, but trust & familiarity are really the most important. For example if a client has been receiving physio & is now ready to progress on to more exercise-based management they are always much more comfortable knowing that they can still come to the same familiar place, they know the reception team, & whenever possible we have already introduced them to the person who they will be seeing for the next part of their program. Often there is a period of co-treatment, where clients may still have some physio sessions mixed in with their exercise sessions.

Most importantly we find that our clients will have built trust in their physio, & they know that their physio will have communicated closely with their exercise provider, so they know & trust that this next phase of their program will be at the same high standard as their physio program. This is vital as it greatly increases the number of clients who successfully make the transition from low-level injury-related exercise to exercise for sustained health, fitness & performance.

The same seamless integrated care happens at every stage of each client’s program. We help & support you right from initial recovery through to reaching your goals & making real & lasting improvements in your all-round health, fitness & lifestyle. Our clients have the real confidence of knowing that they will always see the right person at the right time, every step of the way.

For more information on how this new model of health & performance can help you reach your goals please contact us or call the clinic on 9280 2322.

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Human Biomechanics – how our bodies really work!

Despite how the body may be portrayed in anatomy charts or how it is usually trained in the gym with body-building inspired workouts, the human body is a linked system of connected (interdependent) parts. For example, an injury at the ankle effects how the muscles of the hips work, which in turn can impact the opposite shoulder.

This model explains nicely the concept of Regional Interdependence. 
To summarise the above picture:
Here’s an example that commonly presents at our practice – LOWER BACK PAIN in office workers. In this day and age, a vast number of people spend much of the day sitting at a computer or in meetings for hours on end. Most of us sit with somewhat of a slouched posture, or even a slight slump (flexed posture), which is enough to cause changes to our spines. By spending large amounts of time with a flexed lower back it starts to loosen up and we lose the necessary stability in the lower back. Because the spine needs stability the body then compensates by stiffening and reducing mobility at the hips and through the thoracic spine (upper back), i.e. the segments above and below the lower back. This occurs because the body looks to the joints above and below to provide the missing stability when a stable joint has lost tension/stability.Unfortunately this results in a positive feedback loop (a vicious cycle) – as the hips and upper back become stiffer and less mobile it becomes easier for the person with lower back pain to move through their lower back. The more the person moves through that area, the looser and more painful it becomes because of sheering forces on the joints. As a result, the hips and upper back become stiffer and less mobile.

Professor Stuart McGill, the world’s foremost spine biomechanics researcher, says “people deserve their pain”. This is a harsh way of saying that the way our bodies move (movement pattern) reinforces our pain. In order to resolve low back pain we not only have to strengthen the appropriate muscles and structures (for STABILITY), while loosening and releasing others (for MOBILITY), but also re-train movement to make these changes stay.

CLICK TO EMAIL HUGH FOR MORE INFORMATION
Central Performance’s Biomechanical Assessment 

At Central Physio and Performance Fitness we offer a Biomechanical Assessment designed to identify which areas of the body are not moving in the way they should be. These inefficient movement patterns may be at the root of your injury.  The Biomechanical Assessment will help identify whether it is a loss of stability, mobility or control at a joint or multiple joints.

WHAT IS A BIOMECHANICAL ASSESSMENT?
The Biomechanical Assessment  is comprised of two different movement assessments – the Selective Functional Movement Assessment (SFMA) and Functional Movement Screen (FMS). The SFMA is the more clinical and diagnostic of the two assessments and utilises the above mention model of Regional Interdependence to determine whether you have appropriate levels of stability and mobility at each joint. The FMS is the more dynamic of the two assessments and used to screen for asymmetries and dysfunctions in 7 basic movement patterns scored between 0 and 3. The FMS is commonly used by professional sporting teams in a variety of sports including the NBA, NFL and NRL as well as having been used and researched by the U.S. Armed Forces, the police force and fire services. Research has found that a score below 14 correlates with a 3 times greater injury risk during physical activity.

This Biomechanical Assessment is performed by our accredited exercise physiologist, Hugh Campbell. Hugh is highly trained in the SFMA and FMS processes, but more importantly is skilled in developing a treatment program based on his findings. For some people this may consist of some heavy hands-on manual therapy with the physios and massage therapist to release and mobilise stiff joints before moving onto exercise with the exercise physiologist to gain control of the new movement. For other people it may require little to no physio treatment and can start straight away with our exercise physiologist on a corrective exercise program before graduating to performance enhancement training with our personal trainers.

As part of our Biomechanical Assessment you will receive a free second session with Hugh where he will talk you through the findings of the screenings and establish a personalised exercise program to target problem areas and work towards your goals.

WHO IS IT SUITABLE FOR? 
The Biomechanical Assessment is appropriate for anyone of any age, fitness or sporting level.

A biomechanical assessment would be suitable for you if you:

  • have been suffering from recurrent or chronic pain
  • have suffered from an injury and need to rebuild strength or mobility
  • want to develop a program to return to exercise when you have not been training recently
  • have postural issues
DETAILS:
Price: $104
Included – 1hour Assessment plus 45 minute follow-up session
Hugh Campbell 
ESSA Accredited Exercise Physiologist
Certified Weight Lifting/Sports Power Coach  
Hugh has always been a sports fanatic and harboured a deep interest in how the body works. This fascination with sport & physical performance led him to study a Bachelor of Exercise Physiology from UNSW, which he completed in 2012. Now, as an Exercise Physiologist he loves to build a relationship with his clients & assist them through the Central Performance Restore phase of their treatment. It’s extremely fulfilling for him to watch them not only overcome their chronic injuries but also help them reach new levels of physical performance they previously thought unattainable.To provide the best possible service to his clients, Hugh has continued with furthering his education and is undertaking a Masters of Exercise Science (Strength & Conditioning) from Edith Cowan University. He has also competed the Australian Weightlifting Federation Level 1 coaching, Function Movement Screen Level 2 & Selective Functional Movement Assessment Level 1 qualifications. In addition he has developed & currently delivers the strength & conditioning program from the UNSW cricket club.If you have any questions regarding the Biomechanical Assessment and whether it is right for you, please don’t hesitate to contact Hugh at the clinic.

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