Nutrition and Injury

Posted by Atif Razvi on February 25, 2019

Eat your way to a full recovery from injury! In this months newsletter we will be looking at the basics of nutrition to help manage inflammation and speed up our bodies’ ability to repair and recover.

When you sustain an injury, the body goes through 3 main stages of recovery:
1: Inflammation stage (0-5 days post injury). Blood flow increases at the site of injury to deliver a range of chemicals and blood cells needed to help remove damaged tissue and protect against infection. However, if inflammation is prolonged it can lead to a slower recovery,
2: Proliferation stage (Last between 4-6 weeks depending on the injury). New tissue (especially collagen) is formed. This tissue is generally much weaker than the original tissue, and serves as a foundation for further repair.
3: Remodelling stage (Depending on the injury can last up to 6 months). The repaired tissues remodel themselves into strong functional tissue at the site of the injury. If this stage doesn’t occur the tissue is weakened and prone to re-injury.

Food provides the building blocks for repair and recovery. By making simple modifications to our diet, each stage of injury recovery can be supported and optimized.

Nutrition to manage inflammation

Certain foods contain natural anti-inflammatory enzymes, such as turmeric, ginger, garlic, bromelain, flavanoids and blackcurrants. MAke sure to include these in your diet when you sustain an injury.
Supplement your diet with Omega 3 Fats by taking fish oil, cod liver oil, or flax seed oil supplementation, or Omega 3 rich foods such as raw nuts or avocado. These all have an anti-inflammatory function.
Avoid pro-inflammatory foods such as highly processed foods, fatty red meat, saturated fats, caffeine, sugar and alcohol.
Nutrition to support proliferation and remodeling

Muscles and nerves are made from protein and fats. Therefore it is essential that your diet has adequate quantities of good quality fat and protein. In general, it is recommended that a portion of protein is included in every meal that you have. Examples of good fats include coconut oil, Omega 3s, avocado, butter and mixed nuts.
Supplement your diet with Vitamin C and Bioflavanoids to help your body to lay down collagen, the tissue that begins your tissue repair.
Supplementation with specific Amino Acids such as Glutamine, Ornithine and Arginine has been shown to improve tissue repair and lead to reduced time to recovery. Visit your health food / supplement store for more information on these products.
NB: The information above is a basic nutrition guide to help manage and recovery from injury. If you have any specific dietary requirements or health problems, please consult your GP or nutritionist for advice before implementing the advice above.

Maintaining a healthy weight? Diet vs. Exercise explained…

Posted by Atif Razvi on February 25, 2019

By Yannik Wouts – Staff Physiotherapist

Being healthy is easy on paper, so why are there so many living such unhealthy lifestyles and why does it seem so easy for some people and harder for others? Unfortunately blanket statements like “eat less, exercise more” don’t help the majority of us to actually see results. There are infinite ways for us to live healthier but in reality, we are only limited to a finite amount of resources e.g. time, money and will power so unspecific recommendations that don’t take into account particularity can be as useless to us as the gym membership we never use.

Diet

A recent meta-analysis was published in the Journal of the American Medical Association by (Johnston, et al., 2014) that looked at 59 individual studies that looked into “which diet works best?”. The outcome of that study was that there were no major differences between the diets, and success was completely dependent on what the individual could adhere to. In other words the diets that worked the best were the diets that both reduced the amount of excess foods that particular person ate (in Western society mainly carb’s and sugar) and ones that matched that persons personal preferences towards taste and how easy it was to prepare.

Many studies have looked into the rise in increased serving sizes around the planet, especially in Western world. In the U.S total energy from intake of food has increased 500 kcal/d per capita since the 1970’s. This is in part due to the increase in amount of food bought outside of the home which has increased 13% since 1970 (1), and what food do most people buy when they’re out on the go… the wrong kind. Not only have meal sizes increased but the amount of calorie intensive foods we ingest has increased, particularly in the past few decades. These two factors have created a perfect storm and are having a massive effect on the rising in obesity levels and weight related illness (2).

Exercise

Exercise is the other main variable to being healthy and maintaining a healthy weight. There is evidence to say global participation in sports hasn’t changed much in the last couple of decades but we are sitting a lot more, both at work and at home. This is having a negative effect on our health (3). The human body is designed to move, to locomote and engage in all manner of manual labour throughout the day. Movement is essential to our survival as a species and hence why exercise is so important. This shift from a physically demanding life to one with few physical challenges has been sudden in the history of our species and as a whole we are not coping with it well.

There has been some misleading research that showed exercise alone has limited effect on weight loss. This is in part due to the fact that when we first start to increase our exercise levels our body hasn’t yet adapted to the increased demand on the muscles and is still running relatively inefficiently (4). During this “transition” time which can change depending on how consistent you’re being with your exercise regime and mean we crave food more (4). Once our muscles are running more efficiently we require less fuel to do the same amount of work, so if we don’t cut back on our intake again we will see a plateauing out on the scales. Also as we exercise we have an increase in muscle which is heavier than adipose tissue (4). Let’s say that a 90kg man wants to lose 0.5kgs in a week. Through exercise alone, he needs to run about 5.5km per day. Through dieting alone, he needs to cut back 500 calories a day (the equivalent of two Starbucks Frappuccinos). Now let me make it clear that this does not mean exercise isn’t important although it is just a lot easier to not consume those extra calories than it is to burn them off later.

There are immeasurable reasons why regular exercise is beneficial but one I’d like to point out is it helps us to maintain a healthy metabolism (5). As stated above exercise alone hasn’t been shown to have a huge effect on weight loss but it does have secondary effects that will help you maintain a healthier balance muscle to fat and keep it there (5). Exercise has been shown to increase your resting metabolic rate (RMR) (5). The RMR is the total energy expenditure the body requires to function for 24 hours. This essentially means regular exercise helps to up-regulate and improve the function of all the organic material in our body. If you aren’t getting in your 30+ minutes of consistent exercise per day you won’t see the benefits. Taking the stairs or walking to work are two ways people can do to bring some regularity to exercise during the day. For a rough guide on how to work out the training zone that is appropriate for you just find your maximum heart rate which is (220-your age) and apply this model.

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Aerobic exercise (“relating to, involving, or requiring free oxygen”) has been shown to improve RMR better than anaerobic exercise like weight lifting (6). Like diet there is no particular benefit to doing specific exercise but there are a few points I will make. More intense exercise e.g. running will increase your heart rate more than less intense exercise e.g. walking. It will therefore take longer to burn the same number of calories walking than it would do running. So a 30 minute jog and a 30 minute dance lesson that takes your heart rate to the same level and keeps it there will burn the same amount of calories.

Keeping your heart rate in the training zone is another factor that can be easily over looked. Where the above example can break down is that maintaining a consistent heart rate while jogging is easier than dancing, as you are constantly moving when you jog. Any breaks in dance, to learn a move, talk or rest, will allow your heart rate to drop and you will fall down the ladder of training zones to the point where your exercise may not be having any effect at all. Sports is a really good way to help boost effort though competition and there is some research to say that having a personal trainer or buddy to motivate you to push harder than you would by yourself is beneficial (7). Not everyone is looking to test their physical capacity and may benefit from more relaxed forms of exercise like swimming or walking, again particularity is key.

Yannik’s Top Tips

Find some sort of exercise that you enjoy that gets your heart rate into the training zone,
Do it every day if you can and if not do something even if it’s a walk,
Cut back on the foods and drinks that you personally have an over representation of in your diet (most likely carb’s or sugar), you can eve replace those foods with healthier alternatives that you enjoy,
Make it easy on yourself so you don’t fall back into bad habits,
Use a buddy or trainer to help boost effort, motivation and accountability,
Don’t get into it with the mind-set that there is an end point to your health regime, always look to see how you can improve and incorporate things into your life so it becomes habit and not an effort.
Work Cited:

Nestle, L. R. (2002). The Contribution of Expanding Portion Sizes to the US Obesity Epidemic. American Journal of Public Health, 246-249.
Cara B Ebbeling, D. B. (2002). Childhood obesity: public-health crisis, common sense cure. The Lancet.
Hill J O, W. H. (2003). Obesity and the environment: where do we go from here? Science, 853-855.
Cris A. Slentz, Brian D. Duscha, Johanna L. Johnson, Kevin Ketchum, Lori B. Aiken, Gregory P. Samsa, :. J., et al. (2004). Effects of the Amount of Exercise on Body Weight, Body Composition, and Measures of Central Obesity. Archives of Internal Medicine, 31-39.
Zierath, B. E. (2012). Exercise Metabolism and the Molecular Regulation of Skeletal Muscle Adaptation. Cell Metabolism, 162-184.
Rania A. Mekary, A. G.-P. (2015). Weight training, aerobic physical activities, and long-term waist circumference change in men. Obesity, 461-467.
McClaran, S. R. (2003). The Effectiveness of Personal Training on Changing Attitudes Towards Physical Activity. The Journal of SPorts Medicine, 10-14.
Brownson R C, B. T. (2005). Declining rates of physical activity in the United States: what are the contributors? Annual Review of Public Health, 421-443.
Johnston, B. C., Kanters, S., Bandayre, K., Wu, P., Naji, F., Siemieniuk, R. A., et al. (2014). Comparison of Weight Loss Among Named Diet Programs in Overweight and Obese Adults. The Journal of American Medical Association.

Why Not to Cheat

Posted by Atif Razvi on November 9, 2018

Cheating as a word is always seen in a negative light. Cheating on a test or when playing sport are things which most of us tend to avoid. How about when it comes to exercising though? Do you always make sure you are doing that exercise exactly as you know you should be doing it? Or do you figure it’s better to do more and that the rest will follow? I would hope that most of you have answered that you make an effort to do the exercise to the best of your ability because when you cheat in exercise you are only hurting yourself and likely slowing your recovery process.

We cheat in exercise for a number of reasons. The most common reasons are:

To avoid pain (including the pain of making our muscles work, I know, it sucks)
Due to stiffness or lack of flexibility
A lack of awareness about how to do the exercise properly

A person who may be sore or may have stiffness (for various different reasons) will often try and use other muscles to get movement going in the body. This use of other muscles (or trying to avoid using muscles altogether!) is common, but it is cheating, and something that we don’t really want to be doing. Allowing our bodies to take the easy way out it’s not going to be positively influencing our bodies in the way we probably wish it would. Common trick movements that we tend to perform is hitching our shoulder when performing a bicep curl resulting in our neck and shoulder muscles doing more work than the biceps themselves. This can result in all these other muscles getting sore and maybe stronger, but they are not ones that we actually want to work.

Another reason we may hitch the shoulder when doing a weight is if we are doing something with a weight which is too heavy, resulting in our body needing to recruit other muscles to be able to perform the movement. This is again considered cheating, and is why working with a weight which is suitable to your strength is important. Doing a sit to stand squat is also another easy place to cheat in movement, by using your momentum to push yourself up rather than driving up through your legs. Again, we are relying on parts of our body which currently work well to continue to work, and not working on those not so good areas.

When we exercise properly we place stress on the muscles, which forces them to work, which enables us to build strength, mass and endurance. As physiotherapists we are here to help make sure that you are getting the most out of the exercises you are doing. Be this to strengthen or stretch we want you to do it right for your own benefit. We may start to sound like broken records but this is because we want to see you improve! If your exercises are feeling easy or you aren’t sure about what is happening just ask, we can happily modify your technique or give you harder exercises if you are too good for your current ones. We are here to help, and here to help you get the most out of your exercises, by not cheating.

BY BRIDGET STEWART – STAFF PHYSIOTHERAPIST

The In’s and Out’s of Breathing?

Posted by Atif Razvi on February 12, 2015

Breathing is such an essential part of life. It’s what allows us to move, function and repair our bodies. But many of us don’t realise how powerful a tool that breathing can be in our daily lives. Today, I want to focus on some points regarding exercise, encouraging good patterns of breathing and trying to deter those of us who forget how important breathing is.

For many of us our natural tendency when working out, particularly when doing something that is a bit of a challenge, is to hold our breath. Research tells us that this is because it helps us to engage our core muscles better so makes us feel stronger when doing an exercise. But holding our breath isn’t a great thing to do, we don’t really want people getting lightheaded due to lack of oxygen when exercise, or worse, passing out. Most of the time we breathe without thinking, but when it comes to exercise sometimes we need to make that conscious effort to breathe more regularly.

With sports like running, maintaining the 3:2 ratio of inhale vs exhale is what helps us to settle into a rhythm, which then can help us feel more comfortable settling into a stride which can be maintained for longer periods of time. With a sport like running when you have a rhythmic pattern it is easy to follow breathing in for three steps, then breathing out for the next two. Maintaining this pattern can allow it to turn into a habit which we then no longer have to think about how we are breathing. By maintaining a more relaxed style of breathing rather than trying to rush through it with every step it helps to lower your heart rate and ensures that you are adequately removing the carbon dioxide from your body as well as ensuring you have enough oxygen to keep going. This technique can also apply to any sport when the focus is on cardio, find a rhythm and settle into this, adapting your breathing to fit around the continuous movement.

Sports which don’t have that same repetitive nature gives us a different challenge when it comes to breathing, particularly lifting activities. As a general rule we want to breath out when we are exerting ourselves or doing the most challenging part of the movement. This might be if you are having to lift, push, pull or when you are at the biggest point of stress through the movement. The benefit of breathing during this point of exertion is to protect your body and prevent if from injuring itself. When you aren’t breathing, internal pressure increases which can cause a rise in blood pressure, put more strain on muscles or blood vessels or even cause come more medical issues like a hernia. The main thing to ensure with lifting is that you aren’t overstressing your body by not breathing with lifting, or lifting too heavily, because there is never an ideal time to get injured.

So, there we have it. A few small tips to help get you started on your mission of achieving better breathing in exercise, hopefully gives you something to ponder on. Or even allow you to run without getting as short of breath! Whatever this may do to you hopefully we have sparked an interest, because our breath is so simple yet so effective and is something I hope to continue to explore with you next time.

Bridget Stewart is a physiotherapist working in our clinic in Johnsonville.