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Muscle Tightness – To Stretch or To Strengthen.

Sore Back

Feeling Tightness: To Stretch or Strengthen?

Feeling “tight” is something we have all gone through in life at some stage. Whether that is after sitting at our work-desks for hours on end and getting a gripping discomfort in our neck or after a hard day training session and feeling like we can’t move our legs properly. You’ve clicked on this blog to find out how to deal with it. But before we do that, we need to take a bit of a dive into what tightness is. 

What is Tightness?

Contrary to common belief, tightness is not mechanical but a feeling. It is not the same thing as physical stiffness in a joint or shortness in a muscle causing a decrease in range of movement. 

Often, we may see someone come through the door complaining of tightness in their hamstrings after increasing their running; but on physical assessment they are able to touch the floor. And on the flip side of that, there are people who can barely reach past their knees and don’t complain of any feeling of restriction, discomfort or tightness in their hamstrings. 

A study by Stanton et al. 2017 hypothesises that back “stiffness” is a “perceptual protective construct” rather than biomechanics. Those who feel stiff, are self-protective; over-estimating forces applied to their spine but also more acute at detecting small changes in force. This perception can be altered with audio input without changing actual stiffness. 

This study is much in line with recent Pain Science pioneered by Professor Lorimer Moseley; providing evidence for the fact that pain can exist in the complete absence of physical tissue damage. 

Using this study, we can reason similarly that tightness is a protective construct and that when we feel tight, it is our body trying to protect us against the stresses we are placing on it; whether that is sitting for excessively long periods or pushing a Couch to 5 km running program a bit too enthusiastically. 

Sore Back

Why Am I Feeling Tight?

The precipitating factors that would have led to your specific individual tightness can only be accurately assessed by a thorough history and objective examination. 

However, in a nutshell, feelings of muscle tightness are usually a sign that the loads we are placing on our tissue are exceeding their capacity. 

For example, dramatically increasing your running load over a few weeks to prepare for a Marathon or heading back into your first few training sessions after the Off-Season, may cause tightness in certain muscles of the legs. This is a sign that we are doing a little too much and placing ourselves at a much greater risk of injury if you were to continue or increase that work-rate. 

On the other hand, you may feel tight after long days sitting at the desk. This is likely due to a lack of endurance in the muscle, inadequate blood flow to them and a build-up of metabolic stress. The feeling of tightness is literally urging you to get moving. 

 

How do I fix tightness?

Given that tightness is a subjective sensation and not reflective of joint stiffness or muscle shortening; all the stretching in the world will not be of much use unless there was in fact a biomechanical restriction. 

Resistance Training on the other hand, has been shown to create local adaptations in muscle to improve their endurance and reduce the likelihood of metabolic distress and feelings of tightness. 

Furthermore, Resistance Training will increase the load capacity of tissue and minimise the risk of actual injury. 

Research has also shown that exercise has an analgesic effect and can reduce Central Nervous System sensitivity. 

Next time you are feeling tightness in your upper traps after sitting for too long, try some Shrugs rather than Stretching it out and see how you feel?

 

“You Can’t Go Wrong, Getting Strong”

 

For a more comprehensive assessment of all the Contributing Sport, Work and Lifestyle Factors that may be contributing to your tightness; book in with one of our Physiotherapists for a Consultation to identify and address the underlying issues before it turns into Pain.

How To Help Your Shin Splints

What Can I Do to Help My Shin Splints?

 

What Are Shin Splints? 

Shin splints are a common overuse injury characterised by pain along the front of your lower leg near your shin bone. This pain is due to irritation from the overloaded tendons and muscles along the tibia or ‘shin bone’ constantly creating friction and inflammation at their attachment onto the bone.

Shin splints are common among:

  • Runners
  • Dancers
  • Athletes in sports that require a lot of running on hard surfaces (like tennis), or with unsupportive shoes like rugby/football boots

 

What Causes Shin Splints?

Causes of shin splints include:

  • extended periods of running  on hard surfaces
  • overexertion of your lower leg muscles
  • not stretching adequately
  • stiff and/or weak calf muscles
  • poorly fitted or worn out footwear
  • increasing your training loads suddenly
  • flat feet or high arch feet
  • weak gluteal muscles, weak foot/ankle stabilising muscles

 

If you experience pain in your shin area during exercise, we advise that you do not continue as the pain will only be exacerbated, causing it to prolong symptoms and recovery.

 

How to Prevent Shin Splints 

 A few tips to help you prevent shin splints include:

  • Wearing shoes that fit adequately and comfortably
  • Invest in shoe inserts (orthotics) if you have flat feet or high arches
  • Consulting your physiotherapist to perfect your running stride
  • Replace your shoes often
  • Gradual build up in your training level to prevent injury 
  • Embrace cross-training to avoid overusing the muscles in your lower legs
  • Be sure to always maintain a good stretching program
  • Have an adequate dynamic warm-up before any exercise
  • Strengthen your hips, ankles, and core muscles

 

How Can My Physio Help Shin Splints? 

Getting assessed by a physio will help you understand the condition so that you can better learn how to manage it. During your physio sessions for shin splints, you will likely be treated with:

  • Lower leg soft tissue releases
  • Strapping or taping
  • Strengthening exercises for weak ankles, hips, or core muscles tailored to your individual needs
  • Self-release techniques and stretches for tight muscles

You will also be given specific advice, tips, and suggestions to help manage the pain and get you on the path to recovery.

While you’re being treated for shin splints by a physio, it is advised you are taking relative rest by reducing or completely stopping the aggravating activity – pushing through the pain will only make things worse!

Shin splints can be very frustrating if you ignore it and fail to get the appropriate treatment. For detailed advice and an individual management program contact our team at Redfern Physio on 8068 5158, or book now by clicking the below link [insert book now link]

5 Healthy Lunch Ideas for Work

Rice Paper Rolls

5 Healthy Lunch Ideas for Work

 

Have you found yourself returning to work and slipping straight back into the same boring lunch routine as last year? Or maybe you’ve started relying on takeaway often because you’re lacking inspiration in the kitchen. It can take a while to get back on track with meal prep after a break, so here are 5 delicious and easy lunch ideas for work to help get you started:

  1. The classic sandwich

 

Sandwiches are often overlooked when it comes to healthy lunches, but the fact is, they can be one of the quickest and easiest, balanced meals around.  There are plenty of healthy breads to choose from when making a sandwich – wholegrain, sourdough, rye and spelt are all wholegrain options high in fibre and packed with nutrients. As for what goes between the bread, the options are endless! Aim to include the following for a satisfying and nutritious sandwich:

  • Protein: chicken, canned fish, lean meat, tofu
  • Vegetables: grated carrot, beetroot, cucumber, tomato, roasted capsicum, baby spinach, shredded cabbage
  • Healthy spread: nut butter, hummus, cottage cheese, avocado

 

 

  1. Healthy burrito bowl

 

Burrito bowls are versatile, tasty and require minimal prep time, making them an ideal work lunch. Using precooked brown rice and canned legumes helps this nutritious meal come together in no more than 5 minutes. Simply add brown rice to a bowl (or multiple containers if meal prepping for the week ahead). Add drained and rinsed legumes, and a variety chopped salad vegetables. Top with some chopped avocado and some grated cheese. Simple as that!

 

  1. The ultimate salad

 

It is a common misconception that salads are boring, but they don’t have to be! Preparing a salad that is healthy and tasty is possible, and a great option for work lunches during the warmer months. Here are 4 elements to include:

  1. Protein – to keep you feeling nice and full. Choose from chicken, fish, eggs, legumes, tofu or lean red meats and aim to fill ½ of your salad bowl.
  2. Carbohydrates – to boost your intake of fibre and micronutrients and to give you energy too! Opt for wholegrains such as brown rice, quinoa, barley, wholegrain bread.
  3. Vegetables (and fruit) – get creative and colourful to keep it interesting. Spinach, mixed leaves, rocket, grated beetroot, snow peas, mushrooms, shredded cabbage, roasted capsicums, mushrooms, grated apple or even blueberries work wonderfully in salads.
  4. Flavour – think nuts, seeds, hummus, guacamole, olives, sun-dried tomatoes, crumbled feta, fresh herbs and pesto. These are the ingredients to jazz up your salads. Drizzle salads with homemade dressing made with extra-virgin olive oil to avoid added salt and sugar in store-bought varieties.

 

 

  1. Rice paper rolls

Rice Paper Rolls

Rice paper rolls are quick and easy to make, and are a great change for the lunchbox, especially when the weather is warm! You can fill them with a huge variety of ingredients. By adding some protein such as shredded chicken breast, prawns, tofu or tempeh they will make a substantial and satisfying lunch. Aim to add plenty of colourful vegetables, and fresh herbs as well as cooked vermicelli rice noodles. A dipping sauce of equal parts fish sauce, sesame oil and soy sauce plus some lime juice and chopped cashew nuts is a delicious addition!

 

  1. Simple veggie frittata

 

Frittatas are a great way to use up all the leftover vegetables in your fridge at the end of the week and are ideal for work lunches. They can be eaten warm or cold, and are loaded with veg, protein and healthy fats, so are super healthy for you! Simply transfer any cooked and cooled vegetables of your choice into a mixture of whisked eggs and milk. If you have time, roast the vegetables for extra flavour! Pour into a greased pan and bake in the oven until set through. Serve with a slice of wholegrain bread and side salad. Easy and so nutritious.

 

Want some help with your healthy habits? Book an appointment

Food & Mood

Food & Mood

Food and Mood 

Depression and anxiety are the most prevalent mental health conditions worldwide affecting a large portion of the population. Many aspects of lifestyle are important factors in keeping healthy, both physically and mentally. The relationship between food and mood has gained particular interest recently. 

Food & Mood

A number of studies have already demonstrated that a good quality diet is important in reducing the risk of mental health disorders. However, the idea of food having the ability to improve mood and clinical outcomes for those with existing depression and anxiety is a relatively new and exciting area of research. 

A randomised control trial called the SMILES trial asked this exact question, ‘if I improve my diet, will my mood improve?’ The trial recruited participates experiencing depression symptoms and split them into two groups, a control group and a dietary intervention group. The dietary intervention group were encouraged to follow a Modified Mediterranean Diet, a dietary pattern focused on fruit, vegetables, wholegrains, legumes, nuts, extra virgin olive oil, and fish but including slightly higher intake of red meat than traditional Mediterranean diets. The results showed that those in the dietary intervention group had much greater reduction in depression symptoms than the control group over a 3-month period. A higher percentage also met remission for depression. Put simply, those who improved the quality of their diet experienced the greatest reduction to their depression. 

While acknowledging the complex nature of mental health conditions, the SMILES trial shows how certain foods and dietary patterns could indeed affect mental health in a positive way.

So how might you move towards a more Mediterranean-style diet to look after your mental health? Below are some ideas:

  1. Cook with extra virgin olive oil and use in salad dressings. Drizzle it on cooked dishes and use in mashed potato instead of butter.
  2. Eat more fish. Aim for twice a week to start and choose salmon, mackerel and sardines, all rich in omega-3 fatty acids.
  3. Switch to wholegrains. Brown rice, wholegrain bread, quinoa, barley and oats are all great choices.
  4. Snack on nuts and seeds or add to salads.
  5. Use avocado as a spread instead of butter or margarine or try in a smoothie. 
  6. Limit red meat and poultry. Add small amounts or replace with plant proteins such as legumes and tofu.
  7. Enjoy fruit for dessert or snack. 
  8. Limit heavily processed food and sugar-sweetened drinks.

All About Ankles: Syndesmosis

All About Ankles: Syndesmosis

 

Have you ever been watching sport, particularly Rugby League, AFL or Football, and seen a player go down injured with what looks like some kind of ankle injury, only to hear the announcer use the term ‘syndesmosis’?

 

‘Oh, that looks like a syndesmosis injury’

 

‘That must be their syndesmosis’

 

‘I’m not too sure what it is but I’m going to say syndesmosis

 

Now, I’m not having a dig at the announcers in anyway. Maybe they are a former player (which is common) that has experienced something similar. But, for most people, the term syndesmosis sounds like a buzz word some announcers use to sound clever, whilst your sitting there having no idea what they’re talking about.

 

You may even think, ‘it just looks like a normal ankle sprain’. And here is where things change. Syndesmosis injuries, or ‘high ankle sprains’ are more complex in comparison to injuries affecting the lateral ligaments and can (if managed poorly) lead to greater disability and poorer outcomes in regards to long term pain. Everyone I seem to talk to or see in the clinic has had some kind of old ankle injury that ‘was just a sprain’ and didn’t think much more of it. This is until they develop progressively worsening symptoms in their ankle or feel as if their ankle rolls ‘all the time’. In that manner, sometimes a sprain isn’t just a sprain.

 

So, to make things easier to understand, and for the next time an announcer drops the term ‘syndesmosis’, I’m going to go through what the term syndesmosis means, and how we go about management of this condition.

 

Syndesmosis Injuries – High Ankle Sprains

 

Put simply, the syndesmosis is an area between your Tibia and Fibula (lower leg bones) where ligaments in the ankle act to secure the distal aspect of the lower leg, above the ankle joint. Hence, they are commonly referred to as high ankle sprains (refer to photo below).

 

 

 

When the syndesmosis gets injured, it will involve at least one, if not all of the structures that secure the joint. In the majority of cases, for this injury to occur requires significant force to the ankle (such as a tackle or an opposition player falling onto the ankle). This mechanism is where the foot is forced into external rotation (turning out) and the ankle into dorsi flexion (pointing upwards). When a player is injured, they usually describe the sensation of the ankle and foot being twisted outwards under force followed by sharp pain at high in the ankle. This force places increased stress on the syndesmosis joint, forcing the tibia and fibula apart, causing ligaments to either strain, or in worst cases, rupture.

 

 

Like most injuries, syndesmosis issues are graded in severity with Grade 1 being minor strains through to Grade 4 injuries which are substantial and may require surgery to stabilise the joint. Thankfully, most Grade 1 and Grade 2 injuries can be managed non-surgically with great results. Grade 3 injuries can also be managed conservatively but may require a surgical opinion with an orthopaedic specialist. This can depend on a number of reasons such as which ligaments of the syndesmosis have been injured, the sport you play, type of work you participate in and lifestyle habits.

 

As for management, let’s look at an example case. And by example case, I mean my own personal experience. I suffered a Grade 2 injury to my syndesmosis after I was tackled from the side during a game of Rugby League. The below outlines the week by week processes I went through to manage and eventually return to sport.

 

Week 1 – 2

Placed into CAM boot but allowed to walk as tolerated. I would remain in boot for the first 2 weeks. For the first 72 hours, the injury was allowed to settle using the PRICE (protection, rest, ice, compression, and elevation) regularly. The boot was also able to be removed to complete basic ankle range of motion exercises, only to neutral or plantar grade.  In the second week, I began balance exercises in the boot and commenced non-weight bearing exercises for the other lower limb muscle groups.

 

Week 3 – 4

Boot was removed and I was able to commence double leg strength exercises in weight bearing positions. I could also commence exercise bike for conditioning. I also attend a local pool to begin hydrotherapy exercises such as water running, single leg strengthening and water jumps. The water allows you to complete these exercises at a reduced level of body weight without the chance of aggravation. All exercises were progressed with the physiotherapist and regular testing was undertaken to determine progression.

 

Week 5

Passed all Return to Running criteria and began to run with ankle strapped in straight lines. This was progressed during the week to increase intensity and slight directional changes. Exercises and strengthening continued to progress with plyometric and single leg strengthening.

 

Week 6

Running drills for change of direction were introduced. This progressed from simple drills with focus on technique to game simulated drills in chaos with an emphasis on maintaining technique. Re-introduced to light game-based skill drills such as passing and non-contact ball work.

 

Week 7-8

Progressed through all return to sport criteria during weeks 7-8 which was guided by a physiotherapist based on specific testing criteria. This criterion involved knee to wall differences between injured and non-injured side, symmetrical lower limb strength, various hopping tests, balance tests and questionnaires.

 

Overall, if managed well under the guidance of a physiotherapist, athletes and individuals can make a full recovery and return to their sport or activities without problems. It is important to note, as mentioned earlier, if your failure to complete guided rehab exercises and implement appropriate loading strategies, long term problems can occur.

 

If you have an ankle injury or have previously sustained a syndesmosis injury which continues to limit your function and activity levels, we can perform a detailed initial assessment and prescribe you a tailored exercise program to manage your symptoms and get you back on the field or track.

Dietitians, the missing part of the injury recovery puzzle.

Dietitians, the missing part of the injury recovery puzzle.

 

By Antonietta Del Pinto & Fiona Kupresanin 

 

Has your physiotherapist ever referred you to a dietitian before? Because they probably should have! 

Imagine if you could win the race by having a 50m head start. This kind of edge is the power of combining both physiotherapy and dietitian guidance in your injury journey. 

Here are a few examples of how adding a consult with a dietitian can help your injury process and give you that head start. 

 

Injury Prevention: 

Physiotherapists don’t just work towards returning you to sport or helping decrease your injury pain. They continue the process assisting to decrease your chance of secondary injuries. This can include long term strengthening programs and ongoing load monitoring adjustments, to ensure you have the best chance of decreasing any secondary injury. So what role does seeing a dietitian have in injury prevention? Fuelling your activity adequately can assist with energy levels and fatigue prevention, in turn reducing the risk of overtraining and injury.  Seeking individual advice from a dietitian can assist you to make food choices that ensure you are getting energy delivered at the right times for your chosen sport or activity to prevent fatigue and injury.

Did you know that Johnston ., et el 2013 found that athletes who don’t have adequate time to recover between training, fatigue will accumulate compromise performance and result in an increase risk of injury and illness. 

 

Joint Pain: 

Joint pain and osteoarthritis are one of the most commonly seen injuries in the clinic. Physiotherapists can assist to manage daily pain levels, by restoring your joint range of movement and increase your overall strength levels. Increasing your strength can decrease the loads going through your joints. A long term strength program can also decrease your joint pain and allow you to participate in more sport and activity. 

How can a consult with a dietitian assist your joint pain? 

It is well researched that diet and lifestyle changes can decrease your joint pain. 

Messier ., et el 2005 found that each kg of weight reduction, decreased the compressive force within the knee joint. So every kg of weight lost was shown to have a 4 fold reduction of load going through the knee. Some studies have reported up to 50% decrease in knee pain with a 10% body weight loss. 

The Mediterranean Diet has also been shown to reduce inflammation and pain in those with joint pain and osteoarthritis. The Mediterranean Diet is a way of eating that is high in anti-inflammatory and anti-oxidant nutrients including plenty of fruit, vegetables, legumes, wholegrains, nuts, seeds, herbs, spices and olive oil. 

 

Improving Performance: 

How can physiotherapy and dietetics help to improve your sports performance? As mentioned before, physiotherapist’s don’t just return you to sport. They can help take you to a higher level, faster and stronger post injury. Throughout your rehabilitation stages there will be a time where you transition into some form of training. This means added training sessions and rehab sessions. To maximize your return, working closely with a dietitian can assist you achieve your return to sport goals. 

Sports performance can largely be influenced by the correct fuelling of macronutrients prior to sport and more importantly the right dosage after activity to help your recovery. Training under fuelled can result in poor performance and feeling like you are lacking energy and unable to perform at your best, it also increases your risk of injury and illness. Dietitians can also discuss the use of supplements to help you achieve the best performance you can. If supplements are right for you and your sport, a dietitian can help prescribe how best to incorporate these into your diet. 

These are just a few examples of how combining the power of physiotherapy and dietitian guidance can give you that 50m head start in winning your injury race. Every injury is different and every case if different from the next, therefore it is important to get tailored guidance that is individualised for you. At Redfern Physiotherapy & Sports Medicine we believe incorporating the whole team can give you the best outcome in your journey. If you are looking for that cutting edge in your injury journey, speak to your physiotherapist about booking a dietitian consult now. 

References: 

Johnston RD, Gabbett TJ, Jenkins DG (2013) Influence of an intensified competition on fatigue and match performance in junior rugby league players. J Sci Med Sport. 16(5):460-5.

Messier S, Gutekunst D, Davis c, DeVita P (2005) Weight loss reduces knee joint loads in overweight and obese older adults with knee Osteoarthritis. Arthritis & Rheumatoidism Journal. 52:2026-2032. 

Hoffa’s Fat pad impingement- is it causing your knee pain?

Hoffa’s Fat pad impingement- is it causing your knee pain?

If you’re suffering from a pain at the front of your knee then it may be coming from your fat pad! We aren’t saying you have a weight problem – we all have a pad made of fatty soft tissue just behind the bottom of our knee cap. 

There are three fat pads at the front of the knee however, the Infrapatella Fat Pad, sometimes called Hoffa’s Fat Pad, is one of the more common causes of pain.

How does Fat Pad Impingement present?

  • Pain in the front of your knee exacerbated by extension or prolonged flexion – prolonged standing will be provocative, sometimes even a straight leg raise will hurt. Prolonged sitting may also irritate the pain.
  • The fat pad is tender to touch – this will be just below the knee cap
  • puffy anterior knee –the fat pad is a bit like a sponge and when inflamed will become engorged in fluid.
  • Pain may be worse when barefoot or wearing flat shoes compared with a heeled shoe

 

Treatment: Acute vs Chronic

The main difference between treating acute or chronic infrapatellar fat pad pain is screening for and correcting causative factors. When acute trauma is identified as the reason for inflammation, then focus is concerned primarily on offloading the fat pad and allowing it to settle. When the pain is a persistent issue that has developed over time, it’s likely there is an underlying reason that needs to be resolved.

This process can be described in two stages:

Stage 1: Reduction of Inflammation

  • Activity Modification – reduce aggravating activities which may mean reducing walking or running time/distance, reducing prolonged standing and anything else provocative
  • Wearing heeled shoes (no we don’t mean high heels but anything with a good heel lift and support) – avoiding barefoot or flat shoes especially if it is painful
  • Ice Massage over the tender area
  • Offload Taping – lifting the inferior patella away from the fat pad with a ‘V-Tape’ technique. This may be applied 24/7 until symptom free. Our experienced team of physios will be able to teach you the appropriate taping technique.

 

An example of ‘V-tape’ technique to offload the fat pad

Stage 2: Recondition the limb / Fix the cause

  • Progressive loading exercise: with a strong focus on the quadriceps and also considering glutes and hip external rotation exercises for control of the knee.
  • Isometric Knee Exercise: may be useful in the early stages, working within a safe zone of 20-40° of knee flexion can be manageable if the pain is irritable.
  • Stretching: of the quadriceps and hip flexors may be beneficial.

 

 

Things your physiotherapist will assess:

  • Knee Hyperextension – if the patient has poor control over inner range quadriceps or stands often in a hyperextended position then this may irritate the fat pad. Quads control exercises may be prescribed to correct this.
  • Patella Hypermobility – the patella may have a large amount of movement which can impinge the fat pad. Dynamic quad exercises can be prescribed to treat this.
  • Patella position – tight structures on the lateral aspect of the knee may cause a lateral pull or maltracking. Treatment and focussed stretches can help to manage this.

These two stages are not mutually exclusive and quite often will overlap.

If you have any of the symptoms listed above or are suffering from any other type of knee pain, consult our team at Redfern Physiotherapy and we will get you on the right path to recovery.

Planning to eat a plant-based diet in 2021?

Planning to eat plant-based in 2021?

The popularity of plant-based diets has been on the rise for some time and there is evidence to suggest that this trend is here to stay. The shift to plantbased diets has been predominately driven by concern surrounding health, animal welfare and the environment. 

So, what is a plant-based diet? Exactly as it suggests, a diet that is based on plants. 

Plant foods include fruit and vegetables, wholegrains, nuts and seeds, lentils and legumes and healthy fats such as olive oil. 

A vegetarian diet is an example of a plant-based diet with some flexibility. While it doesn’t include any meat, poultry or seafood, it does allow animal-derived products such as dairy, eggs and honey. 

A vegan diet on the other hand, strictly excludes all animal and animal derived products (dairy eggs and honey included). 

Other variations of plant based have also immerged in recent years, such as a pescatarian diet (vegetarian diet plus seafood) and a flexitarian diet (vegetarian diet with occasional consumption of meat, poultry or seafood). 

Health benefits of going plant-based

The health benefits of plant-based diets are numerous. Plant foods are nutrient dense, packed with vitamins, minerals, antioxidants and fibre. It is therefore not all that surprising that plant-based diets have been associated with lower levels of chronic diseases such as type 2 diabetes, cardiovascular disease and certain cancers. Diets high in fibre and resistant starch, found in plant foods, have also been associated with improved gut health now linked to mental health and other positive health outcomes.  

You don’t necessarily need to go vegetarian or vegan to get the health benefits associated with plants foods. A moderate change to your diet such as replacing one serve of animal food with plant food a day can have a great impact on your health. 

Despite all these potential health benefits it is worth noting that not all plant-based diets are created equal. A plant-based diet focused primarily on processed or packaged foods will not necessarily be any healthier than its animal-containing alternative. A wholefood diet approach is always best to minimise saturated fat, salt and added sugar.

Plant-based diet downfalls

 

Following a strict plant-based diet (i.e., vegan), or even vegetarian diet, requires some planning to ensure nutritional adequacy. While most nutrients we require are abundant in plant foods, there are a key few vitamins and minerals that are only found in animal foods or are better absorbed when they come from animal sources. Strict plant-based diets can also make it harder for those with particularly demanding energy requirements to meet their energy needs (e.g., adolescents or athletes).

 

Key nutrients for consideration in plant-based diets:

Iron

Iron is found in both animal and plant foods, however, the type found in plants (non-haem iron) is less readily absorbed making requirements harder to meet. 

Vitamin B12 

Only found in animal foods, and essential for healthy blood cells and neurological function, Vitamin B12 must be added by consuming fortified foods (e.g., breakfast cereals, dairy milk alternatives) or supplementation. 

Protein 

A key macronutrient in meat, poultry, seafood and animal derived foods. While there are plenty of plant-based proteins too, think tofu, lentils, legumes and quinoa, they can often be overlooked when transitioning to a plant-based way of eating.  

Calcium 

Essential for muscle function and bone health, the highest amounts of calcium are found in dairy products. Adequate calcium intake may not be a big issue for less strict plant-based diets; however, vegan diets require considered planning to ensure calcium intake is adequate. 

Omega-3 fatty acids

Found in the highest quantities in fish, and extremely beneficial for health, omega-3 supplementation may be required. 

As you can see while the health benefits of going plant-based are plentiful, so are the nutritional considerations.  The consequences of nutrition deficiencies can be greatly detrimental, so it is highly recommended that you seek individualised nutrition advice from your doctor and a dietitian when following a strict plant-based diets. Please don’t just rely on social media, websites on the internet and advice from family and friends. 

Nutrition in Managing Osteoarthritis

The Role of Nutrition in Managing Osteoarthritis 

Osteoarthritis (OA) is the most prevalent form of arthritis, affecting a rising number of people worldwide. 

The pain associated with OA is one of the key barriers to maintaining physical activity in those with the condition, which in turn can greatly impact quality of life. Those affected would benefit from ways to self-manage their condition and this is where nutrition can play an important role.

Is there a diet to cure OA? 

Is there a diet to cure OA? Short answer, no. However, while there is no miracle diet that can cure OA, we do know that maintaining a healthy body weight and ensuring nutrient needs are met can help symptom management and improve quality of life. 

Maintaining a healthy body weight is one of the important ways diet can assist with OA management. OA occurs when the protective cartilage that cushions joints wears down over time, so reducing unnecessary impact on these joints is an effective management strategy. Excess body weight can cause increased wear and tear as well as joint inflammation and pain for those with OA. Research suggests that a reduction of as low as 5% in body weight can improve pain felt in affected joints. Everyone has different energy requirements and understanding what this is for you can be difficult. Seeking individualised nutrition advice from a dietitian can help make sure you are mastering nutritious, balanced meals and getting your portion sizes right. 

What should I eat?

 

What should I eat? Research suggests that the Mediterranean Diet could help reduce inflammation and pain in those with OA. The Mediterranean Diet has been thought to assist with OA management due to the anti-inflammatory and antioxidant nutrients abundant in this way of eating. It includes plenty of fruit, vegetables, legumes, wholegrains, nuts, seeds, herbs, spices and olive oil, a moderate amount of fish, seafood, poultry, eggs and dairy, and small amounts of red meat and sweets. It also emphasises enjoying food socially, in moderation, and has been seen to be beneficial in maintaining a healthy weight. 

Nutrition research in the area of OA is constantly evolving, and while there is currently limited evidence to suggest any one particular nutrient can prevent or delay OA, certain nutrients have been deemed to be important for symptom control. For example, adequate protein intake is important for those with OA to ensure adequate muscle mass and strength is maintained as low muscle strength has been linked with increased pain. Research has also shown that vitamin E may have an anti-inflammatory role that may reduce the progression of OA, and higher intakes of vitamin D has been implicated in less progression of cartilage damage. Future research is sure to shed more light on the importance of specific nutrients. 

For more information about the benefits of healthy eating in OA management our dietitian is available for in clinic and telehealth appointments. To make an appointment call us on (02) 8068 5158 or book online by clicking here.

Eccentric Training – why do we use it?

If you have ever been to the Physio, chances are that you been asked to perform some eccentric exercises – but what exactly does this mean?

 

‘Eccentric movement’ refers to a muscle contracting whilst it is lengthening. On the contrary, ‘concentric movement’ is when a muscle is contracting whilst shortening.

 

The simplest example to explain this is performing a bicep curl.

  • The upwards part of the movement (hand to shoulder) is when the bicep is shortening under load, thus contracting “concentrically”.
  • The downwards part of the movement (hand lowering down) is when the bicep is lengthening under load, thus contracting “eccentrically”.

 

Without knowing it, you work several muscles eccentrically every day!

 

  • Every time you take a step – The tibialis anterior muscle in the front of your shin bone helps to flex the foot upwards when you run or walk, but then works “eccentrically” to help lower the toes to the floor. Without this control, your feet would slap the ground every time.
  • Every time you go down the stairs – The quadriceps muscles contract “eccentrically” to prevent the knee from collapsing too fast or too far forward.

 

Notice that these two examples often correspond to body parts that tend to be sore after exercising. This is because eccentric contractions are deemed a more efficient way to exercise the muscles compared to concentric contractions given they are able to work the muscle harder with less energy expenditure.

 

It is for this reason that the phenomenon of delayed-onset muscle soreness (DOMS) is greatest when a muscle has been placed under a greater eccentric load. This i explains why your shins are sore after running on a firm surface and why your quadriceps is sorer after running down hill.

 

But why are eccentric contractions so important for rehab?

Eccentric training is commonly used to treat tendinopathies, hamstring strains and for preventative purposes in a wide array of sports.

 

Research has suggested that the implementation of eccentric exercises for the treatment of common injuries such as Achilles and Patella tendinopathies can help to significantly decrease pain levels, improve function and increase tendon strength. It is suggested that this is achieved by increasing the muscle strength at longer lengths by exposing the tendon to a greater load, and therefore progressively being able to withstand loads that could have caused the initial damage.

 

This is further evident in a study by Mafi et al, 2001, which found that when comparing eccentric and concentric exercises in the treatment of mid-portion Achilles tendinopathy, patients performing eccentric contractions had greater improvements compared to those performing concentric contractions. The results found that 82% of the eccentric exercise group were able to return to their baseline function and activity compared to only 36% of the patients who performed the concentric exercise regime.

Hamstring strains are another common injury seen in various sports and also has a high recurrence rate. As a result, eccentric training has been well researched and has formed part of the gold standard rehabilitation process for these types of injuries. The Nordic Curl is a popular and highly effective eccentric hamstring exercise for the prevention of hamstring strains.

 

A study by Mjølsnes et al, 2004 found that eccentric hamstring training resulted in an 11% increase in eccentric hamstring strength and a 65% reduction in hamstring strains in football teams that implemented the Nordic Curl exercise compared with those that do not.

 

All our rehab programs at Redfern Physio are tailored to your specific needs and these may include eccentric exercises. Now, the next time you’re asked to perform these as part of your rehabilitation plan we hope you have a little more understanding into the reasons why. To book an appointment with one of our experienced therapists please click on the link below or call us on 8068 5158