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!
Strength 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.
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.
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.
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!
A 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
If you’re looking for a great personal trainer in Surry Hills then Central Performance has you covered. Many people know us as a physio or rehab-oriented facility, however you should know that a large part of what we do every day is work with healthy individuals, who are completely free from injury, using tailored exercise programs to improve peoples overall health and sports performance.
Here are some key ingredients that set our exercise services apart;
• it’s all about you. Every exercise program we deliver is specific just for that client and is based on their individual goals, wants, needs, current fitness level and preferences
• exceptional trainers who really care about you. We really make the time and effort to get to know you, your likes and dislikes, what you want to achieve and what might be holding you back. We make sure your time with us is a real highlight of your day, not just just another exercise session.
• a warm and friendly environment where you feel you really belong, amongst a group of people who always want the best for you.
• a dedicated team working hand-in-hand around you to give you everything you need for success. Because our team of trainers and coaches work right alongside our phyiso’s, exercise physiologists and massage therapists, if you do have any injury concerns then help and advice is always on hand.
We work with people at every level of fitness and sports performance, from gym newbies to athletes competing at national and international levels. Whether your goal is weight loss, sports performance, getting your body back to the way you like it, or maybe you just feel sluggish and you know you’ve got to get moving again, we can tailor an exercise program just right for you. Spending too long at the desk and putting on some kilos, or maybe your doctor says you need to get your weight or blood pressure under control with regular exercise? We can help.
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.
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.
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.
• 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
• 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.
Injuries are a common occurrence in sport, but no one wants to be sidelined for too long. We know that following your physio’s rehab program will help you recover, but nutrition is also an important part of your treatment plan. A good diet is essential for performance and recovery from physical activity, but when we get injured its easy to forget all the normal diet habits while focusing on recovering.
Food plays an important role outside of just fuelling your body. You may not know that food plays a significant role in inflammation, which is a key aspect of healing following an injury, so what you eat will impact your recovery. Food can also assist with rebuilding muscle, bone and repairing damaged tissue. So if you are currently injured or find yourself with constant niggles and aches, read below to learn more about the link between diet and your recovery.
When you are injured, your body produces inflammation. Pain, swelling, redness and heat draws healing chemicals to the injured area. The damaged tissue is removed, and a new blood supply and temporary tissue is built. Next remodelling occurs, where stronger, more permanent tissue replaces the temporary tissue. Inflammation is important in triggering the repair process during injury, but too much inflammation can delay healing and cause additional damage.
Strategies to help produce the right amount of inflammation can be extremely useful and this is where nutrition plays a big role. Choose anti-inflammatory fats such as;
At the same time, avoid a high intake of pro-inflammatory food such as;
Once the body begins the proliferation and remodelling stages of healing (building of new tissue), a balanced diet is necessary. Ensure you eat adequate;
It is common to reduce intake following an acute injury due to reduced activity levels and appetite, but energy expenditure may actually increase by 15-50% depending on the type and severity of injury. Reducing your intake could impact tissue healing and muscle wastage in the early stages of your injury, so guidance from a qualified sports dietitian can help you maximise your rehabilitation program by ensuring you are eating adequate protein, fat, carbohydrates and micronutrients.
It might sound like a cliché but a 2017 Scandinavian study found that a healthy diet with a variety of fruit, vegetables and fish reduced the odds of new injuries in adolescent athletes. Fruits and vegetables come in a range of colours which all have their own unique make-up of micronutrients essential for health and enhancing recovery between training sessions. Even if injuries sometimes seem out of your control, getting into the habit of eating a variety of fruit and vegetables in adequate amounts is not only beneficial for your general health, but could also play a role in reducing your risk of injury.
Tendons and ligaments in the body are made of collagen cross linkages. Several studies have looked at the link between gelatin ingestion and injury prevention. Supplementation with gelatin has been shown to improve connective tissue structure and function, potentially improve joint health, and reduce pain associated with strenuous activity. Ingesting gelatin with vitamin C increases the effectiveness as they work together to increase collagen synthesis and improve collagen crosslinking, e.g. in tendon tissue.
The most current recommendations are: ingest a gelatin supplement (such as 15g of Great Lakes Gelatin Collagen Hydrolysate) with at least 50mg of vitamin C one-hour before training to assist injury prevention. If injured, collagen can be consumed daily to aid recovery by increasing collagen and tissue strength.
These are general guidelines only, so more specific individualised advice, speak to Kelsey our Sports Dietitian.
Bone health is critical for everyone; we’re taught from a young age to include dairy products in the diet for their calcium content, but vitamin D is the other main nutrient that we need to build strong, healthy bones.
Runners particularly are at a high risk of bone stress injuries, as well as those in indoor sports (because they are away from sunlight/vitamin D opportunity), non-weight bearing sports such as swimming, or physique-sensitive sports such as diving, gymnastics and body building. Studies have found runners with higher vitamin D intake recover quicker from injury, and those with higher bone density have decreased frequency of bone stress injuries.
Vitamin D can be obtained mostly from safe exposure to the sun, and in smaller amounts from some margarines or milks fortified with vitamin D. You can also ingest it from mushrooms that have had sun exposure. Using a vitamin D supplement depends on your body’s levels of vitamin D, so this should be discussed with your doctor or sports dietitian before commencing.
Research in soccer matches found that injury risk increases towards the end of each half of the game. This is when players are fatigued, decision making and fine motor skills are impaired and running biomechanics are modified. The findings are transferrable to other sports – if you are fatigued towards the end of your game or race, you are more likely to injure yourself. Fuelling and hydrating adequately are the best measures to prevent injury by delaying onset of fatigue. Appropriate fuel and hydration plans that help you to maintain exercise intensity for longer and reduce fatigue need to be very personalised because they depend heavily on you, your body and the activity or sport that you are participating in.
Injuries are all too common in sport, exercise and even normal activities. Whether its rugby, running, swimming, gymnastics or even just DIY and gardening, injuries are a regular occurrence. Given the powerful effect of nutrition on our general health, its no surprise it also plays an important role in your recovery from injury. So if you have an injury, past or ongoing history of injuries, or even someone you know is constantly injured, make sure you book an appointment with our sports dietitian. Kelsey can provide you with a personalised injury management nutrition plan to assist your rehabilitation program and get you back into your sport, exercise and regular activity faster. Contact reception on 9280 2322 or head to our online bookings page to book in your first session with Kelsey. For more info you can also see our Dietitian’s page.
In Part 2 of this blog post series, we covered the hormone changes that occur in the first phase of the menstrual cycle, the follicular phase. This week we will go into the second phase of the cycle, the luteal phase.
The luteal phase occurs from day 14-28, assuming a 28-day cycle. We know this phase all too well as this is when PMS (pre-menstrual syndrome) symptoms occur! Be aware of food cravings, especially if your symptoms sideline you from your usual workouts.
This phase is the high hormone phase with progesterone at its peak. Progesterone increases the body’s core temperature, lessening tolerance to heat during workouts and increasing sweat which causes the body to lose more sodium. Because of this you need to really make sure you stay on top of your hydration when working out in the hotter months of the year in the second phase of your cycle!
During the luteal phase, the body uses carbohydrate less effectively for energy, instead utilising fat. If you are trying to reach high exercise intensities or need to perform at your best during this time, extra carbohydrates around training sessions may be necessary for you to be able to exercise at your best. Protein breakdown also increases, so its really important to make sure you are recovering adequately with protein sources after a workout.
Examples of high protein snacks to enjoy post-workout includes plain yoghurt with nuts, a fruit smoothie made with milk, yoghurt and fruit, or some boiled eggs.
Try having red meat or salmon for dinner post-workout to aid your recovery and help you get in your essential nutrients during this time of the month.
If you are looking for an effective periodised nutrition plan to suit your cycle and training demands, our sports dietitian Kelsey Hutton can give you everything you need. Your initial assessment with highlight your goals, current nutrition levels & areas to focus on. Your personalised plan gives you a practical & effective way to fuel your body with everything it needs for peak performance.
In part 1 of this blog post series, I talked about the concept of the female athlete triad. Menstrual dysfunction, low energy availability and low bone mass can affect active women without the right nutrition and exercise plan individualised to their needs. Now in part 2 & 3 of this blog post series, I will discuss hormonal changes across the menstrual cycle that can have an effect on exercise and nutrition.
Every females cycle will differ, but assuming a 28-day cycle, there are 2 phases – the follicular phase (day 1 -14) and the luteal phase (day 15 – 28). Day 1 of the cycle is when menstrual bleeding begins.
During the follicular phase (day 1-14), the hormones progesterone and estrogen are at their lowest, with estrogen slowly rising until ovulation occurs on day 14. Testosterone levels are also raised slightly, so muscle building is optimised. Energy levels are at their highest in this phase, and your body is able to effectively use carbohydrates as an energy source in this phase, so you can reach higher exercise intensities during training. As estrogen peaks towards the end of the follicular phase, changes in collagen structure means tendon and ligament tears are more likely to occur, so its important to ensure you are particularly careful with your exercise warm ups and technique.
Increases in strength and energy during the follicular phase means you can take advantage of your body being able to use carbohydrates more effectively as a fuel source and to aid muscle growth and recovery. Think about including carbohydrate foods as a pre-workout meal and including high fibre carbohydrate sources with your meals. Some examples include a banana smoothie before your workout, and brown rice with stir fried chicken and vegetables for dinner. Sleep is also a key consideration during this phase, make sure you are getting enough sleep after your big training sessions to aid recovery!
Stay tuned for Part 3 of this blog series which will go into the hormone changes across the second phase of the cycle and the impacts this can have on exercise performance.
If you are interested in a periodised nutrition plan to suit your cycle and training demands, our sports dietitian can provide individualised guidance. Contact reception on 9280 2322 or head to our online bookings page to book in a chat with Kelsey.
This is the first part of a 3-part series covering some nutrition considerations that relate specifically to women during exercise. For female athletes, weekend warriors and regular exercisers, hormone changes across the month can dampen motivation to exercise and can affect performance. This 3-week blog series will delve into the hormones that are impacted during the menstrual cycle, dietary strategies to assist performance at different stages of the cycle, and a concept known as the ‘female athlete triad’.
The female athlete triad is an interrelationship of menstrual dysfunction, low energy availability (with or without an eating disorder), and decreased bone mineral density.
Particularly common in young female athletes, amenorrhea, or the absence of menstruation for 3 months or longer, can lead to decreased bone health as bones lose calcium due to lower estrogen levels. Over time, this can lead to increased risk of fractures/breaks, bone mass loss, osteopenia and osteoporosis. A loss of menstruation often occurs when there is low energy availability. The body is using all its energy for metabolic processes and for training/exercise/competition, so may not have enough energy left to cover other daily demands such as menstruation. Low energy availability doesn’t just affect those with low body fat percentages or with diagnosed eating disorders, it can exist in those with adequate body fat levels! This can occur from an imbalance of training demands and food intake, especially when there are time constraints and other commitments involved.
If any of these signs or symptoms sound familiar to you, our sports dietitian can provide guidance on managing your health while fuelling exercise demands. Contact reception on 9280 2322 or head to our online bookings page to book in a chat with Kelsey.
Now that you know what the female athlete triad is, the next blog post will focus on hormone changes across the menstruation cycle and how this can impact performance. Luckily, there are dietary strategies that can be used to optimise performance at different times of the month. Stay tuned!
At 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.
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
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.
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.