Posts Tagged Danny James

The Powerful Combination of Physio and Fitness When Coming Back From an Injury

Being injured and in pain is the worst. It holds you back from performing activities you enjoy and even everyday tasks can be tougher to do to the standards that you’re used to. There are often also mental hurdles to overcome when trying to come back to sports or the training that you love.  

When you sustain an injury that needs physical therapy, this means that one or more of the body’s systems was not robust enough to handle a particular stressor it was up against at the time. 

This could be because of an exercise choice, too much of a particular activity over time, not be ready for the particular activity or simply fatigue that leads to less than ideal movement quality. There can be many reasons. Either way, the body was not resilient enough to fend off the stressor and it broke down. The best way that we know to build up resilience against injury is through fitness.

One of the biggest challenges that we can face when trying to navigate an injury and resume regular movement or training is knowing exactly what’s appropriate to do. When can we begin to veer off the rehabilitation road and flow onto the training highway?

The answer lies in a connecting the various professions that have the most to offer at ALL stages of your journey. Specifically, your physiotherapist and your strength and conditioning coach or trainer. 

For a long time there’s been a gap between physiotherapy and strength and conditioning when there is so much to gain when these worlds collide and there is a combined focus and collaborative effort towards not only getting you back to the activity that you most enjoy but also making sure that you are even more unbreakable in the future.

When you’ve been injured, you’ll need a physiotherapy lens at the site to examine the damage extent, get you out of pain and on the road back to function. Towards the end of treatment, your strength coach or trainer then merges into the game to deliver fitness strategies that should result in you needing fewer trips to the physiotherapist and the long term result of building resiliency against future damage.

The fact of the matter is, your physiotherapist can get you out of pain and back to normal, but they’re often not equipped with the tools to get you far stronger than you were and need. It may very well have been (and often is) a lack of strength and readiness for the activity that led to the injury in the first place.

Your strength coach can get you better than you were, stronger, faster, fitter and less damage prone, but they cannot directly apply the same healing and rehabilitation strategies.

Both of these skill sets have the same goal; to apply a certain stimulus and provoke a certain adaptation that results in you getting a little better. They just exist at different ends of the continuum.

Often, if you’ve been hurt what you need is some combination of the two skill sets working with you at the same time for best effect. 

Danny James, Head Strength & Conditioning Coach at Central Physio & Performance Fitness
Danny James, Head Strength & Conditioning Coach at Central Physio & Performance Fitness and can be reached at danny@centralperformance.com.au

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Is Your Phone Ruining Your Sleep?

Are you having trouble falling asleep?

A tonne of research has shown us that the use of electronic devices prior to sleep time can wreak havoc on our ability to fall asleep.

It turns out that the short-wavelength blue light emitted from smartphones, tablets, and other devices disrupts proper melatonin production.

Melatonin is a hormone released primarily by the pineal gland that regulates sleep-wake cycles. It is released at night and in conditions of prolonged darkness as a signal to the body that its night time.

Figueiro et al. 2012 looked at a small sample size of 13 individuals who used self-luminous tablets to read, watch movies and play games prior to bed.

The study concluded that light from these self-luminous displays 2 hours prior to bedtime diminished melatonin production by about 22%, possibly affecting circadian rhythms and normal sleep cycles.

Some things you can do to help not only get a good night’s sleep but help get to sleep in the first place include:

1. Develop a ‘POWER-OFF POLICY’ before bed

Switch off your electronic devices at least 1-2 hours prior to bedtime.

2. Develop a ‘Wind down’ routine before bed

Slow down and de-stress as much as possible before bed. Some other suggestions include taking a walk, meditating, reading a book, gratitude journaling.

3. A quite, cool, and dark place

Reduce any distracting noise, avoid warm clothing or bedding and aim for a temperature of approximately 18 degrees Celsius.

4. Avoid coffee, heavy meals and liquids before bed

Limit feelings of fullness, digestive discomfort and sleep disturbances due to late-night bathroom trips.

Danny James is the Head of Personal Training and Strength and Conditioning services at Central Physio and Performance Fitness, located in Surry Hills in the Sydney CBD area. danny@centralperformance.com.au

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What’s Better For Recovery From Strength Training? Whole Body Cryotherapy, Cold Water Immersion, or Placebo.

In our post on compression garments and recovery, we brought up the potential role of the placebo effect which sparked some questions and commentary.

Adding a little more to the placebo/recovery discussion, in a new study from Wilson, et al. 2019 compared the effects of cold water immersion (CWI), whole body cryotherapy (WBC) or a placebo (PL) intervention on recovery markers after a resistance training session.

Although a single training session does not reflect the everyday workload demands placed upon competitive athletes, there was substantial enough effect on the recovery markers used following the single training session to directly compare the three interventions.

What did they do?
24 males with a minimum training age of 12 months were matched into CWI (10mins at 10 degrees Celcius), WBC ( 3 and 4 mins at – 85 degrees Celcius) or PL group and performed a high volume lower body resistance training session at 80% of predicted 1RM.

Recovery markers were assessed before and after at 24, 48, and up to 72 hours post-exercise including ”Perceptions of soreness and training stress, markers of muscle function, inflammation and efflux of intracellular proteins.”

What happened?
The single training session did cause the expected perceptual soreness and muscle function disturbance with WBC managing to attenuate soreness at 24hrs and positively influencing peak force at 48 hrs post, greater than in CWI pr PL group. This has been a consistent finding in the literature to date: Stanley et al. 2012; Leeder et al. 2011; Versey et al. 2013; andRoberts et al. 2014.
It should be noted however that the WBC temperatures used in the study (- 85 degrees Celcius) were higher than those typically suggested (-110 to 140 degrees Celcius) possibly influencing results.

Aside from this small difference, it appears that ”many of the remaining outcomes were trivial, unclear or favoured the PL condition.”

The study concluded that while WBC may perform slightly better on some recovery indices following a single resistance training session, overall neither WBC or CWI performed better than the placebo treatment at accelerating recovery.

Readers should be aware that we are still not aware of the chronic effects of cold water therapies and that some research has suggested it can negatively interfere with vascular and muscular adaptations from resistance and endurance training while CWI has shown some small benefits for recovery from endurance protocols.

Danny James is the Head of Personal Training and Strength and Conditioning services at Central Physio and Performance Fitness, located in Surry Hills in the Sydney CBD area. danny@centralperformance.com.au

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Recovery (part 4): Compression Garments

Although a relatively recent addition in Australia, Compression Garments (CG) have rapidly become quite the fashion statement, initially designed to promote recovery from hard training and competition and subsequently to help improve performance.

Compression Garments are a type of tight-fitting form of clothing made from elastic material providing a gentle compression of the limbs. Some of the reported positive outcomes include:

  • Help Thermoregulatory control (maintaining correct body temperature)
  • Provides greater joint-position awareness
  • Enhanced local blood blow
  • Enhanced removal of post-exercise waste products
  • Enhanced muscle oxygenation
  • Reduced muscle oscillations
  • Reduced swelling
  • Reduced creatine kinase concentrations 
  • Reduced perception of post-exercise muscle soreness and fatigue

There is also the possible placebo effect and psychological aid of wearing CG and perceived recovery and performance improvements to be factored in, as anecdotally athletes often speak positively of their helpful effects. The magnitude of physiological recovery improvements observed in the literature are similar to what has been seen with cold-water therapies or light exercise.

While the research currently has shown some recovery benefits from wearing CG it should also be noted that a great deal of the research is of poor quality and clouded with inconsistencies.

It should be added that there is also the risk of bias due to sponsorshipship and potential financial gain.

While there have been some benefits shown and no observed adverse effects on performance or recovery with their use, there is still also no reliable criteria for best practice.  

It is therefore suggested that if CG are used they should be used as an adjunct to more proven and reliable recovery enhancing modalities such as enough quality food, good sleep hygiene, as well as fatigue and stress management strategies. Currently, the research is not strong enough to provide conclusive recommendations.

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Recovery (part 3): Stretching

Stretching has been tied to performance since the very beginning and currently, there is some evidence to suggest that there are small recovery benefits to be gained from post-exercise stretching.

For this instalment, we’ll be looking at some of the current evidence on stretching for recovery. Stretching to increase flexibility or as part of a warm-up will be covered in more detail another time.



The most common reasons for post-exercise stretching are to reduce soreness, help recovery and to regain pre-training flexibility, and while stretching is still common practice, much of the initial supporting theory has been debunked. 

Type

There are many types of stretching but the two categories most often subscribed to for recovery are static and dynamic. 

Static:(Self-administered, in place/no movement) 

Passive:(Partner administered) 

Dynamic:Active (movement based) 

Ballistic: Active / fast bouncy actions at end range)


Effects on Muscle Soreness 

A dig through the current literature will show that while there is some research suggesting positive results from post-exercise stretching on muscle soreness, much of it is low quality. While there is also widespread anecdotal observation of reduced muscle soreness with post-exercise stretching, there appears to be very little or no effect on muscle soreness reflected in the current body of evidence.


Blood Flow 

Static stretching appears to temporarily constrict the blood vessels through compression reducing blood flow, oxygenation and red blood cell delivery to the muscle. Shortly after the applied stretch, however, there appears to be a sudden and enhanced surge of blood flow greater than in pre-stretch conditions. This short-lived shunting effect may assist the recovery process through enhanced nutrient delivery and waste removal although this has not been firmly established in the literature.


Enhanced Parasympathetic Activity 

The PSNS is the branch of the Autonomic Nervous System associated with a ”rest and digest” response. Essentially, it slows the system down, reduces neural excitability and helps facilitate the recovery and adaptation process.
Static stretching has been shown to influence PSNS modulation, acutely (same day) and across several weeks after a consistent application over 28 days. This was demonstrated by positive changes to heart rate variability, which in recent times has become a popular metric for measuring ANS status and training readiness. 


Flexibility 

More research in recent times has pointed to static stretching leading to an improved stretch tolerance, rather than increased tissue flexibility. Some research has also suggested that improvements in flexibility may occur due to a temporary decrease in neural excitability or resting tone as a result of static stretching. Some newer evidence suggests that flexibility improvements may also be the result of change to the mechanical properties of the muscle-tendon unit through stretching.

In summary: 
. Static stretching has little to no effect on post-exercise muscle soreness

. Following post-exercise static stretching, a ‘shunting’ effect occurs resulting in a temporary increase in blood flow and waste removal.

. Static stretching promotes relaxation by enhancing PSNS activity.

. Static stretching creates short-term improvements in flexibility, and reduced neural drive.

While it appears that there are a few mechanisms through which static stretching can influence recovery, these changes are not meaningful enough to warrant using static stretching as a stand-alone, or primary method of recovery. 

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Recovery (part 2): Sleep

Following our introduction to recovery, we’re going to continue the series looking at some of the research around many popular recovery methods and offer some practical take-aways that you can begin to apply right away.

First up on the list is sleep – one of the most important influences on recovery, one of the simplest to address and yet is often the most overlooked of all performance variables.


Sleep is a needed resource for psychological and physiological wellbeing, during which time many of the bodies more potent repair and recovery processes are kicked into overdrive.  It is generally accepted that the primary purpose of sleep is restoration – To recover from previous wake-period operations and/or prepare for functioning in the subsequent wakefulness period. 

Sleep is also vitally important for memory consolidation and metabolic healthby potentially modifying energy intake and expenditure which can undermine dietary efforts.

An individual’s recent sleep history (consisting of both duration and quality) can have a dramatic influence on daytime functioning. Research has firmly established that sleeping less than 6 hours per night for four or more consecutive nights can: 

1. Impair cognitive performance and mood

2. Heighten risk of illness and injury

3. Disturb metabolic health, appetite regulation and immune function

There are many reasons why sleep habits may be negatively affected, some of which include:

Stress, nervousness, thinking, worrying, planning.

Illness

Sudden change to routine

Unsuitable diet/nutrient deficiency

Poor sleep habits and environment (eg noise, lighting, temperature, late television watching, late caffeine use, late activity). 

In addition to the above, Erlacher et al. 2011 asked 632 german athletes from various sports about their sleep habits leading up to important events or competitions, with the results showing that: 

  • 66% slept worse than normal at least once prior to an important competition
  • 80% reported problems falling asleep
  • 43% reported waking early, and
  • 32% reported waking up through the night

Factors identified as reasons for poor sleep included:

  • Thoughts about competition (77%)
  • Nervousness about competition (60%)
  • Unusual surroundings (29%)
  • Noise in the room (17%) 

The value of quality sleep is clear and it is easy to see how it can be impacted by many of the above variables which we all face from time to time. What isn’t so easy though, is how best to mitigate these factors to ensure that you get a good night sleep and subsequently prevent the associated performance decline from sleep loss.

Suggestions for improving sleep:

1. Develop a ‘POWER-OFF POLICY’ before bed

Switch off tv, computers, tablets, and smartphones 1-2 hours before sleep time. These will disturb the production of hormones that prepare you for sleep. 

2. Develop a ‘Wind down’ routine before bed

Slow down and de-stress as much as possible before bed and try to establish consistent sleep and wake times. A shower before bedtime has been shown to improve sleep onset latency. Research has also shown that almost half of all insomnia cases are linked to stress or emotional upset. Avenues to reduce stress are highly individual and situation dependent, so finding ways to reduce stress are paramount to improving sleep, and long-term health and wellness. Some proven strategies include: 

  • Exercise 
  • Deep breathing exercises 
  • Meditation
  • Daily journaling 
  • Gratitude journaling
  • Taking a walk
  • Being outside/sun exposure
  • Social activities / being with friends and loved ones

Habits and Environment

3. A quiet sleep space is a key

If noise can’t be avoided try using headphones with instrumental music at a low volume, or keep a fan on for an acutely distracting ‘white noise.’

4. Temperature, darkness, and clothing

Approximately 18 degrees Celsius is a cool room temperature that has been shown to help comfortable sleep occurrence. Thick bedding and clothing must also be avoided if it causes overheating. A dark environment with limited lighting can also help the body recognise that it’s night time and time to begin the process of preparing for sleep. 

5. Coffee and heavy meals

Avoid caffeine, big meals and heavy amounts of liquid before bed. 

6. Take Naps Where You Can & Need To

Naps can be beneficial to catch up on lost sleep, however, avoid them later into the afternoon if it might impact your regular sleep time. Blanchfield et al. 2018 recently showed that a short afternoon nap improves endurance performance in runners that obtain less than 7 hrs of nighttime sleep. Napping might be an important strategy to optimise endurance exercise in other athletic and occupational scenarios when sleep is compromised (eg long-haul, intensified training etc).

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The Benefits Of A Pre-Activity Movement Screen


FMS Tests

Once the athlete or client’s training goals have been established it is important that we as coaches identify potential limitations and risks that may impact our chances of success.

Simple logistical constraints such as availability of training time and equipment can be a limitation and need to be considered, however these are of lesser importance than reducing the risks that are inherently involved with training in the weightroom or practice.

Before seeking enhancements in fitness, the Strength and Conditioning professional’s primary concern is injury prevention. If a client or athlete is hurt through the training process it will be necessary to place restrictions on their program which may slow the rate of improvement towards the goal. For the athlete or client, an injury can mean diminished movement capacity and quality of life. Injuries can lead to missed practice and missed games, lost opportunity and income, and perhaps the end of a career. These are all very possible scenarios and all parties involved should be leaning as close as possible to the side of prevention.

In order to attenuate the likelihood of an injury occurring we need to be aware of the factors that heighten risk. As it relates to endeavours of physical activity, it is documented that the main contributory factors to injury, in order of greatest to least are:

1. Previous injury  

2. Right vs left side asymmetry

3. Motor control deficit

4. BMI

5. Poor training Choices

Knowing the evidenced predictors, it is imperative that we use a system of screening and assessment that identifies these factors before implementation of a proposed training solution. Such a process would be highly influential toward addressing an individuals needs, maximising the return on our efforts and minimising future risk. 

We use the Functional Movement Screen (FMS) as the first step of our appraisal process. The FMS is a system to evaluate current movement quality for people who wish to increase physical activity. It is designed for those that do not have pain or injury as a way to prioritise further assessment where necessary, and help decide the appropriate entry point for an individual onto the training path. It is simply the beginning of the information gathering process.

Low Score = You can still go; you just might need to go a little slower for now

Low Score = You can still go; you just might need to go a little slower for now

The screen is composed of seven fundamental movement patterns and three clearing tests that require a balance of mobility and stability and place the individual in extreme positions where deficits in these areas are noticeable. The FMS aims to set a minimum standard of movement competency, provide insight into potential movement problems if the baseline is not met, and guide appropriate exercise selection and progression. If an individual can not display an easy access of fundamental movement availability as per the FMS criteria, then the training program becomes dialed to match the outer reaches of the individual’s current ability. A low FMS score does not necessarily exclude an individual from the training process. It simply means that our exercise selection is directed towards not exploiting those areas where limitation is present. Advancing into higher-stage activities with a movement foundation that is poorly prepared incurs a greater training cost and if the athlete is not injured, at best there will be a higher need for recovery to offset the increased physiological price and a reduced level of preparedness can result.

The screen is an objective, reliable and repeatable baseline standard of movement, that filters out many of the contributing factors to damage risk such as poor movement quality, right-left asymmetries and presence of pain. The FMS is not a diagnostic tool, however, presence of pain while undertaking the screen is a red flag that requires treatment by a medical professional until it is resolved. 

As Strength and Conditioning practitioners, we would like to know if joints can get into trainable positions that we need to meet our end goal – where training those positions only contributes and does not impair movement or system, and produces a more robust and prepared performer. In under fifteen minutes, the FMS can provide an answer. It is a first stage audit of our exercise choices and a guide for best practice. 

Lauren and Bella

Danny James is the Head of Personal Training and Strength and Conditioning services at Central Physio and Performance Fitness, located in Surry Hills in the Sydney CBD area. danny@centralperformance.com.au

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