Blog entries

CrossFit Games Australia Regional: Behind the scenes - Through the eyes of a Physio

2012-05-22T05:59:25Z

CrossFit – It’s a growing sport, although many Australian’s still don’t know much about it. The past weekend marked the biggest event in the Australian CrossFit calendar; the CrossFit Games Australia Regional, with the strongest and fittest athletes from Australia and New Zealand competing for the crown of the region's fittest and a chance to be one of the men, women or teams representing the region as the CrossFit Games in the US in July.

Together with Antony Lo, Mark Collins, and John Daher, I was one of the physios responsible for patching the athletes up so they could continue to compete for the title. For the most part it was band aid therapy; a quick fix solution to allow the athlete to continue, together with advice to get the issue sorted when they get home and guidance as to how to go about it. It was a great weekend, and great experience. It was the first time I have worked at such a high pressure elite CrossFit event, and was a great learning experience. I thought I would share some of my observations from the weekend; keys for both performance and injury prevention (I am a physio after all); things that are generally useful for CrossFitters everywhere, and in fact anyone who pushes themselves in competitive events.

Listen to your body - sort out any issues early. Any asymmetries in mobility or imbalances in strength and stability will lead to impaired performance or injury at some point. As you increase training volume and load something will fall apart whether it is tightness in the hip causing a lower back or knee problem, or postural dysfunction leading to shoulder problems. Identify it early; and fix it early. Don’t let it get in the way of your performance on game day. In a competition situation you will be attempting new records and personal bests, picking up and fixing issues well before this means that you can push yourself safely and get more out of your performance in a competition situation.
Technique is everything. Yep that’s right, that thing your coach keeps banging on about when all you want to do is get in and get the training done, lift something heavy, finish the AMRAP or get a faster time than you did last time, and beat some of the other scores on the whiteboard. Watching event 5 (the snatch ladder) with the other physios; we were able to 100% predict whether an athlete would achieve or fail a lift based on their set position, and positioning of the lumbar spine when they initially took the load. This was with no prior knowledge of any of the athlete’s previous records. Technique matters. Get it right to avoid injury, and get it right to improve your performance. Perfect your technique before increasing volume and load so you don’t learn bad habits, and develop asymmetries and imbalances as compensations.
CrossFitters have strong mid sections, but rubbish core and pelvic control and stability. There were lots of anteriorly rotated pelvises wandering around on the weekend, this is a common compensation; rotate the pelvis forward, lock out the lumbar spine, and apply heavy load. It works. Temporarily…. This is why perhaps there was so much lumbar taping also wandering around on the weekend. Core and lumbo-pelvic control needs to be developed to withstand high volume loading, and loading in unexpected directions not just a squat. Developing good stability and control will facilitate improved technique and ultimately a heavier squat. The ability to generate stability and power through a wider range of motion is essential for both performance and injury prevention.
Know when enough is enough. Competing at an elite level takes a huge physical and emotional toll, and high level performance is a combination of physical ability and mental and emotional steel to be able to overcome nerves and performance pressure. Over the weekend I treated athletes who had broken down both physically and/or emotionally. They had pushed themselves beyond their endurance either physically or mentally and had now broken down. It takes a huge amount of courage for an elite athlete who has focussed their entire training on one event to recognise the warning signs and withdraw before this breakdown occurs. The easier option is to push through and continue. Withdrawing involves feeling a sense of failure, the feeling that all the training was for nothing, a potential loss of face and many more mixed emotions. This is an extremely brave decision, and I have huge respect for any elite athlete able to make this call. This is especially a difficult decision in a CrossFit competition situation where huge emphasis is placed on completing the workout, sometimes at any cost (in one situation over the weekend this involved the commentator asking the crowd to cheer on every squat performed by someone who was clearly injured and in pain for each and every one of those reps). Making a decision to withdraw means that the athlete has remained in control of the workout or situation and has not been defeated or beaten in any way. Ultimately they have avoided significant breakdown (either mental or physical) and are able to continue their training a much stronger athlete and retain confidence and focus without needing to take a down period to rehabilitate body or determination.

Overall it was an inspirational weekend with athletes achieving incredible things and the team spirit and camaraderie that make the CrossFit community so appealing clearly evident. A huge congratulations to all athletes present!

Core Stability - What is it & why is it so important?

2012-05-09T01:28:03Z

Core stability – it’s a bit of a buzz phrase, I’m sure you’ve all heard it, but do you know what it means, or just why it is so important?

An easy way to think of it is to imagine that there are two types of muscles in the body, “movement” muscles that switch on and then off to create movement (for example the biceps to bend the elbow), and “postural” muscles which help to create stability and control around a joint in a sustained manner. There is an extremely complex system of stabilising muscles throughout the body, however when we refer to the “core” we are usually talking about the muscles that stabilise the lumbar spine and pelvis. These muscles form a support and act to protect this area during movements, and when we apply an external load such as lifting an object or sitting for an extended period.

When the core stabilisers are not working properly (there is excellent research showing inhibition of these muscles due to pain and injury that does not correct without retraining) our body recruits the movement muscles in an attempt to compensate for the lack of, or poor stability. This places us at increased risk of injury and postural pain. If the core muscles remain inactive, the chance of re-injury is 80%.

The good news is that it is possible to retrain these muscles, and with retraining the incidence of re-injury decreases to only 30%. Often exercise programs focus only on the larger movement muscles, even specific core strengthening programs if not done properly just reinforce the incorrect compensatory patterns.

To learn how to activate your core, pop your hands on your hips while you are sitting. Rock your pelvis as far forward as it will go, and then as far back. Repeat this a few times then rest with it halfway between the two. You should now be sitting nice and tall. Breathe out slowly at the same time as trying to flatten your tummy back towards your spine. You should feel your pelvic floor lift slightly and muscles under your fingers switch on (if nothing happens try the same thing lying on your back with your knees bent and feet on the floor). Congratulations! Your core is now switched on.

Some will find this easy, and some a little more challenging. Once you have learnt to activate your core the next step is to strengthen it so that it can act to protect your spine in your normal daily activities, whether that might include sitting for hours at a computer, picking up a small child, lifting heavy weights in the gym, etc... There are many different ways to train and strengthen your core muscles. In fact, once you have learnt how to activate, and are able to maintain that core activation whilst performing a movement, any exercise you do can (and should) be a core strengthening exercise. Pilates style exercises are a good place to start, however it is important that you train your core in a way that is specific to your needs. If you are having trouble knowing where to start, we'd love to have a chat with you. You can call us on 9698 3333, or email me (jessica@peakhealthservices.com.au) for advice.

Running Injury Prevention Tips

2012-05-04T05:33:29Z

At this time of year we start to see an increase in the number of injured runners presenting to the clinic, in fact statistics show that up to 90% of marathon runners will experience an injury during a year of training. Running is an extremely repetitive exercise; if there is a fault with the movement (a weakness, tightness etc. etc.) no matter how minor, by the time you have repeated it several thousand times something will give. So clearly one of the biggest challenges for distance and marathon runners is not only being able to go the distance, but making it to the start line. Here are some simple tips and easy mistakes to avoid when preparing for an event:

Too much too quickly – in our experience this is the most common cause of runners walking in to the clinic. Adaptation to training takes time. In the same way that you wouldn’t expect to walk in to a gym and pick up 100kg without building up to it slowly, it also takes time for your muscles to build up the endurance strength for running. Make sure you have an appropriate program for your training and ability level.

Know your limits – If you are tired and fatigued; your running mechanics will change to compensate. Make sure that you incorporate rest days, and cross-training days into your training schedule. Again an appropriate training program for your specific goals and ability level will do wonders here.

Stretch – Very, very, very important. As we use muscles they work into shortened positions and short tight muscles demonstrate inhibition, this changes the mechanics of your running stride, leads to compensating movement patterns, and ultimately injury. Stretching should always be completed after every run and held for 30s minimum. Stretching prior to running is not necessary and can be counter productive, however if you are doing short interval speed work dynamic stretching and mobility work is essential. Click here for more information on stretching.

Regular Sports or Remedial Massage – Recovery. This is just as important as training. You won't improve if you don't allow yourself to heal and recover. When we exercise we cause micro-trauma in our muscles which then repair and are stronger, however this can also cause our muscles to become extremely tight and lead to mechanical issues. A good massage with a qualified, experienced therapist will identify and treat these areas before an injury develops. Regular massage will keep your muscles in tip top working condition, help identify and prevent injuries, and improve your recovery meaning you can train more effectively.

Consider a screening session – this is especially important if you are new to running, or have had a series of injuries in the past. Any bio-mechanical faults or problem areas such as weakness, tightness, asymmetries and other imbalances will be addressed, and you will be taught how to address them to prevent injury from developing. Additionally a program designed specifically for your ability level and with your goals in mind will be prescribed for you. Click here to request more information about our running assessments.

Listen to your body – Does it hurt? Yes? Ok, so FIX IT! Don’t leave it for 6 weeks telling yourself it will go away on its own. The longer you leave it, the harder it is to fix it and the more likely you will need to take time off running.

If you have any questions about your running training or about our running assessments and coaching, we would love to hear from you you can either call us on 9698 3333, or email us.

Recovery - What actually works?

2012-05-04T04:58:29Z

Feeling sore after your workout or race? Massage has been shown to be the only effective treatment for improved recovery outcomes. A recently published article investigated the evidence of effectiveness of various methods of recovery. The authors of the article looked at research done in the past, and selected only research that met a certain standard to be included in their review of the evidence. The results were very interesting interesting. From the abstract of the article;

'Exhaustive and/or unaccustomed exercise, mainly involving eccentric muscle actions, induces temporary muscle damage, evidenced by delayed onset muscle soreness (DOMS) and decreased muscle function. Different strategies to recover from its signs and symptoms have been studied and, as a result, a significant number of articles on this issue have been published. To assess whether some modalities currently used in physiotherapy such as massage, cryotherapy, stretching and low-intensity exercise are effective for treating the signs and symptoms of exercise-induced muscle damage. Massage was the only intervention with positive effects, reducing soreness at 24 h and increasing muscle recovery. There is inconclusive evidence to support the use of cryotherapy, while there is little evidence to prove the efficacy of stretching and low-intensity exercise.' Torres et al. Physical Therapy in Sport. 2012: 13(2);101-114

So for those of us who train hard the implication is that massage therapy might help with faster recovery and enable us to get better results from our training. If you have just signed up for the Sydney Running Festival, or are in hard training for the SMH half, it might be worth considering massage to improve your recovery and get the most out of your training program, email or call us to organise a time.

Healthy Recipe - Greek Lamb Skewers with Tahini Sauce and Spinach Pie

2012-04-16T02:24:11Z

A healthy version of traditional spinach pie teamed with greek style lamb skewers and tahini sauce make for a delicious meal, and some killer leftovers for lunches in the first half of the week! All the components are quick and simple to make, it usually takes me about 15mins to get the spinach pie in the oven, and another 15 to get the rest of it cooked and done. If you are looking for shortcuts you can buy pre-made skewers, just check what is in the marinade first, and Yalla make a delicious tahini dip without any nasties in it. You can serve this with sweet potato chips for a bit of colour (cut a kumera into chip sized pieces, lay on a tray, spray with olive oil and cook for 20mins at 200 degrees - bobs your uncle!). Enjoy!

Spinach Pie
500g frozen Spinach
1 onion finely diced
120g low fat ricotta
3 eggs
80g fetta
pinch of Mace (sub nutmeg)

1. Saute onion in a little olive oil until golden. Add spinach to pan and cook until defrosted and excess water has evaporated from the pan.
2. Mix eggs, ricotta, and mace into the spinach and onion mixture.
3. Chop fetta into small pieces and add to mixture.
4. Spread in baking dish and cook for 30mins at 180 degrees

Lamb Skewers
500g lamb leg steaks/diced lamb
2 cloves garlic minced
1 tbsp olive oil
1 tbsp chopped fresh oregano (use 1tsp of dried if you don't have fresh)

1. Put all ingredients into a bowl with the diced lamb. Toss to coat well. Let sit for 3-4 hours (or as long as you can)
2. Thread lamb onto wooden skewers and bbq until done.

Tahini Sauce
1/4 cup tahini
1tbsp lemon juice
1 clove garlic (small)
salt & pepper to taste

1. Place all ingredients in small food processor and whizz! You may need to add more lemon juice or water to thin it a little.

Exercising in the Heat

2012-03-13T00:00:07Z

As the weather warms up it can be very tempting to say to yourself “it’s too hot to exercise”. Is it safe to exercise in the heat are you risking things like dehydration and heat stroke?
Heat during exercise comes from both external sources such as ambient temperature, and internal sources. When we exercise heat is produced as a by-product of the reactions used to fuel our working muscles. Our bodies have several very effective mechanisms that are used to dissipate this heat. As our internal temperature rises, our body diverts more blood flow through the surface blood vessels, and we begin to sweat and lose heat through evaporative heat loss. The effectiveness of sweating as the body’s mechanism depends on how hot the day is, how humid the weather is(less sweat will evaporate on hotter days), how much wind there is, and how fit and well-conditioned the person exercising is (fit people sweat more). Problems arise when the body is no longer able to cool itself adequately or inappropriately hydrated.
Heatstroke: Normal core body temperature sits at around 37.5 degrees. Heatstroke occurs when the core body temperature rises above 41 degrees. Symptoms of heatstroke include dizziness, weakness, nausea and headaches, confusion and disorientation. A person suffering from heatstroke needs immediate rapid cooling, and medical attention.
Dehydration: In hot and humid weather we produce more sweat for evaporative cooling. To allow for this and also to maintain performance levels while exercising (did you know that dehydration impairs physical performance?) it is important to make sure you are adequately hydrated. The amount of water you need depends on many variables, however monitoring thirst levels and urine colour (should be pale and clear) gives a good indication. If you are exercising for a long period you will need to make sure that you have access to water at regular intervals. It is better to sip regularly throughout the duration of the exercise than to drink huge amounts all in one go.
Hyponatremia: or fluid overload. If you drink too much fluid too quickly, then the concentration of sodium in your blood will drop. Medically this is a far more threatening condition than dehydration and medical attention should be sought if you suspect someone has this condition. However hyponatremia will generally resolve itself if no more fluid is ingested.
Current research has been unable to provide us with any hard and fast guidelines as to how much and when we should drink during exercise, as there are too many variables to take into account. To avoid dehydration and hyponatremia we suggest a common sense approach, if it is very hot and you are sweating a lot, you will need to drink more. Use your thirst and monitor you urine colour to avoid over-hydrating. And as the weather heats up try exercising early in the morning or late in the evening to avoid the worst heat of the day. If your routine is to exercise in the middle of the day consider using a gym with air conditioning (or very good fans), or an indoor pool as alternative forms of exercise. Finally if it is a really scorching hot day, modify your exercise (again common sense approach), as the amount of heat our body produces is directly proportionate to the intensity of our exercise.

Swimming - Tips for Injury Prevention

2012-01-17T04:43:47Z

Swimming is great exercise, particularly in the warmer weather. It is great for core strength, shoulder endurance, and overall cardiovascular fitness. However with shoulder injuries reported in around half of the people swimming regularly the risk of injury is high. The vast majority of injuries occurring in swimmers are due to overuse and/or poor technique, this means that these injuries are preventable. Here are some simple tips to help keep you in the water this summer:

1. Warm up: make sure you are ready to swim with adequate range at the joints and muscles, and increased blood flow to the muscles. Swim a couple of laps slowly first rather than just hitting the water full bore.

2. Know your limits:the RTA is right, fatigue kills. When you are tired your muscles will not be working in the most efficient way, and you are much more likely to injure yourself. Have a rest, don't push through, especially if you are new to swimming as other muscles will start to try and compensate, changing the way your shoulder functions and making it more predisposed towards injury.

3. Stretch:tight muscles are inefficient, and can cause injury. Stretch following every swim. Muscles to stretch include your triceps, deltoids, upper trapezius and rhomboids.

4. Regular sports massage: regular massage is invaluable as it will identify and treat injuries before they occur. Any areas of tightness will be adressed allowing your shoulder to maintain optimal mechanical function and keep you in the water.

5. Listen to your body:if it hurts, fix it early. Have it assessed and treated properly, most issues if caught early are easy to fix, the longer something is left the more reinforcement compensatory patterns get, and the harder it becomes to retrain a movement. Don't let a little niggle become a big problem.

Healthy Recipe - Ocean Trout and Summer Salad

2012-01-12T00:28:07Z

This is an awesome, healthy dinner that can be in the table in 15 minutes (20 minutes if you count the time you take to stop and buy fish on your way home). The really brilliant part is it is completely flexible, if there is something you don't like, leave it out or change it for something you do like.

Ingredients:

(Serves 2)

350-400g oily fish (I like ocean trout)
1 ripe tomato
1 lebanese cucumber
1/2 avocado
2 large lettuce leaves
5 slices grilled zucchini*
4 cherry mozzarellas
good quality olive oil
red wine vinegar
cracked pepper

1. Turn oven on to 200 degrees, oil a baking dish or tray and place fish on tray skin side up. This helps it to stay moist. Put fish in the oven for 15 minutes.
2. While the fish is cooking, chop salad ingredients into suitably chunky pieces and place in a bowl. Tear cherry mozzarella's over the top, crack pepper to taste, and drizzle salad with olive oil and red wine vinegar.
3. After around 15 minutes take the fish out of the oven, if you prefer well done leave it for an extra 3 minutes. Put fish and salad on plates and enjoy.

* either buy pre-grilled and marinated, or make your own by slicing two zucchini into 1/2 cm thick diagonal slices, frying for 30 seconds each side, then leaving in a dish in the fridge overnight to marinate in one tbsp olive oi, one tbsp white wine vinegar, and one clove of garlic very thinly sliced.

Client Profile - Kaley

2011-12-05T23:48:59Z

Kaley works in PR and is a new convert to the benefits of exercising regularly. I caught up with Kaley recently to ask her about her experiences with Mark...

How long have you been having the outdoor personal training sessions for?
I’ve been doing outdoor personal training sessions with Mark since August this year.

Why did you start personal training with Mark at Peak? What was holding you back from starting sooner?
I’d tried to commit to a proper workout schedule all year, but I kept making excuses and finding ways to get out of going to the gym. So I thought I’d try using a personal trainer – someone who would keep me accountable. I had to decide if I was really going to commit to getting fit and healthy. I hadn’t started personal training sooner because I thought I could do it on my own. Since that obviously wasn’t working, I got up enough courage to do the one-on-one training sessions instead. There’s no hiding and no excuses.

What have your results been like?
My results have been really good, and it’s a work in progress. I’ve lost over 10kg since August and lost 8.5cm from my waistline. I’ve also increased my fitness levels dramatically - I could barely do a push up before I started and wheezed my way through the first training session like I had asthma (which I don’t!). Now, I feel energetic and empowered after a training session and I’m noticing changes in my mood, I’m feeling much healthier and I have a closet full of newly baggy clothes!

What do you like most about training with Mark?
I like that there are no excuses - Mark asks the hard questions. And he doesn’t just care about the training; he wants to know about the food I’m eating and how I’m feeling in general. It’s holistic. I also like that, even though he doesn’t yell at me (I’d always imagined personal trainers yelling at their lazy subjects), I’m still a bit scared of him which is just extra motivation during the week to do the things I’m supposed to do!

Would you recommend Mark?
Absolutely!

Find out more about our personal training, or make an appointment for your free goal setting and assessment session.

Client Profile - Rob

2011-11-23T22:55:51Z

Meet Rob, local hairdresser at Surry Cutters, dog lover, all round good guy. I had a chat with Rob recently about his experiences with running coaching:

How long have you been having the running coaching sessions for?
6 weeks.

Why did you start running coaching at Peak?
Bored with exercising on machines at the gym. Felt my cardio was not improving from this. I did a boot camp and was out of breath with the running part.

What have your results been like from the running coaching service?
Amazing. I ran 8.5k in latest session which included the Woolooraha Hill. I was also over the moon when Jared motivated me to run up Mt. Steele five times in drill training.

What do you like most about running coaching? Weekly appointment and goal setting. Instruction, preparation, tips for overcoming give up times, encouragement.

Would you recommend running coaching at Peak? Yes , I tell all my clients and friends of my success and experience of this personal running service. The running sessions have now given me the physical and mental attitude to run by myself on a regular basis. You feel like the Nike slogan - You can do it!