Absolute Balance Exercise Physiology Group

Prehabilitation in Workers Compensation: Enhancing Function, Reducing Downtime

Mon, 01 Sep 2025 02:29:39 GMT

As the global population ages and the prevalence of musculoskeletal conditions continues to rise, the demand for orthopaedic surgeries has surged dramatically. With this increase comes a growing emphasis on not just the surgical intervention itself, but also on the preoperative phase as a critical window of opportunity to enhance patient outcomes.

One of the most promising strategies emerging in this space is prehabilitation—a proactive, personalized approach to preparing patients physically and mentally for surgery. Prehabilitation can be broadly defined as a personalized exercise program designed to improve physical function and optimize recovery outcomes for any upcoming surgical intervention.

In the context of workers compensation, prehabilitation offers additional value. By maintaining or even improving a patient’s physical function prior to surgery, individuals are often able to remain engaged in modified or light-duty work roles. This not only supports their psychological well-being and financial stability but also contributes to faster and more sustainable return-to-work outcomes post-surgery.

A recent meta-analysis by Punnoose et al. 2023, found that a targeted prehabilitation program increased muscle strength, improved joint function and led to a higher health-related quality of life (HRQOL) scores. These findings were consistent with patients undergoing Total Knee Replacements (TKR), Total Hip Replacements (THR) and lumbar spine surgery.

Some clinical applications are listed below:

Targeted approach of 4-6 weeks, with 2 sessions per week. This aligns with physiological evidence suggesting that a minimum of 4–6 weeks of strength training is needed for neuromuscular adaptations.
Mixture of supervised and unsupervised intervention
Multimodal programs (e.g. combining exercise with education or psychological support) may enhance outcomes

By improving outcomes and reducing recovery timeframes, prehabilitation stands out as a cost-effective, proactive approach to treatment.

James Chandler

Workers Compensation Specialist ‑ Team Leader South (AEP, ESSAM)

Exercise Rehabilitation Services – WA

How to Fit Exercise into Your Lifestyle

Mon, 01 Sep 2025 01:24:00 GMT

As Exercise Physiologists, a large part of our role is to empower an injured worker to integrate exercise into their lifestyle – something that is easier said than done for everyone!

A common misconception about exercise, is that, for an effective workout, it must be a gruelling 1-hour session in a gym or a 10km stomach churning run, however this is not the case! Here are some alternatives and strategies to gradually make positive changes to your life:

One easy way is to add movement to tasks you already do. Walking or biking instead of driving short distances, taking the stairs instead of the elevator, holding your newborn as you perform a few quick (and safe!) squats or completing short exercises during TV commercials are simple ways to stay active without setting aside extra time.

Another is to schedule ‘mini’ workouts like any other appointment. Set aside just 20 to 30 minutes a few times a week—whether in the morning, during lunch, or in the evening. Utilising exercise equipment that we give you during our initial assessment and picking a handful of exercises that you may particularly enjoy, is a great shorter alternative. Treating these moments as important and ‘you’ time can help build a consistent habit.

Exercising with others can make it more fun. Invite a friend for a walk, join a fitness class, or play a sport with family. When you combine social time with physical activity, it feels less like a task and more like enjoyment. The same goes for a sport or hobby that you may like, whether it’s swimming, yoga, hiking or dancing!

Experimenting with the introduction of one of these strategies can be an easier first step to making a positive lifestyle change. With a little planning and creativity, exercise can become a natural part of your lifestyle, helping you stay healthy and energized without adding stress to your day.

Alexander Gerry

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

The Beauty of a program: Couch to 5k

Thu, 19 Jun 2025 12:48:54 GMT

If you have doom scrolled through Instagram/Facebook or YouTube recently you may have been bombarded with advertisements for a slew of different exercise programs. These all usually have something to do with what you value and target you with a preamble on how to get it, how did I shrink my waist size, how do I build muscle or how I rehabbed my knee pain.

As an exercise physiologist it's my job to write these programs! Now although I don’t always enjoy interruptions to my news feed of cat videos and rugby highlights, I do actually think a lot of these programmes have merit! I love anything with a bit of structure that can help you progress yourself towards what you care about so today I wanted to write about one of my favourite programs of all time and that is the “Couch to 5km Running Programme”

Why Running?

I love running as an exercise choice, it gets you outdoors, it has increasing social connections via run clubs/park runs and is completely free! However, it’s hard to jump in to, I see a lot of people getting tripped up by some of the barriers that come with it. A lot of the people I see starting running don’t know about the many choices that come with exercise and in the exercise physiology business we call this the FITT principle!

- Frequency – How often are you doing your running?

- Intensity – How fast or slow are you running?

- Time – How long should I run for?

- Type – Why run over biking or rowing?

A dedicated programme takes care of these for you, and I think the Couch to 5k programme does a fantastic job of introducing you to all these different ideas.

Language!

The first thing I love about the “Couch to 5k” is its language. The use of simple and direct language leaves a bit of room for interpretation. You can see clear above on your first Tuesday run you will run for 1 minute and walk for 1 minute. In this small interval that speed is utterly and entirely up to you. Go as slow as you like or as fast as you like however I want you to run for the entire minute! Keeping things simple is so important and this guidance is exactly where I would want you to start off as a beginner runner, have some fun and run!

Progression!

From week to week the running times can be seen to get bigger and bigger! Slowly but surely these intervals only increase by 1 or 2 minutes at a time. Between each session you will be able to notice small increases, but your fitness catches up with that! The whole point of a programme is that it starts small and works up, no single day itself should feel like an insurmountable workout but by the end you’re able to run a whole 5k!

Rest!

This program builds in rest days and rest periods so well. Each day is spaced out giving some time for you two recovers but not so much so you can get some fitness in! Within the workouts as well these intervals leave you working for the right amount of time each workout.

Goals

Too often when working out our goals are too big and lofty. Being able to make big changes start with small actions and goals. You can’t change yourself image in one day so I like the time frame of 6 weeks (in some programmes 6-12 weeks) because by the end we have a set definable goal of what we want to achieve, and we can really feel thar progression of fitness!

Mathew Walker

Exercise Physiologist

Exercise Rehabilitation Services ‑ WA

The Importance of Warm Down Routines After Exercising

Fri, 13 Jun 2025 00:26:47 GMT

When it comes to exercise, most people focus on warming up or pushing through the workout itself, but what often gets overlooked is the warm-down which is a period of gentle movement and stretching after your main workout. Though it may feel tempting to skip it, a proper warm-down is crucial for both your physical health and your mental well-being.

Here is why this final phase of your workout deserves just as much attention as everything that comes before it:

1. Helps Prevent Injury

One of the most important physical benefits of a warm-down is injury prevention (Witvrouw, et al., 2004). After intense activity, your muscles are warm, flexible, and more prone to strain if you suddenly stop moving (Witvrouw, et al., 2004). Gradually slowing down your heart rate and stretching your muscles helps release tension and reduce muscle stiffness, which can significantly lower the risk of cramps, strains, and post-workout soreness (Witvrouw, et al., 2004).

2. Promotes Better Circulation

During exercise, your heart rate and blood pressure increases to support your body’s physical demands (Alter, 1998). If you stop abruptly, blood can pool in your limbs, leading to dizziness or even fainting. A warm-down helps maintain healthy blood flow by gradually lowering your heart rate and allowing your body to transition smoothly back to a resting state (Alter, 1998). This improves circulation and helps the body clear out metabolic waste products like lactic acid (Alter, 1998).

3. Supports Mental Clarity and Stress Relief

Exercise is a proven mood booster, and warming down can enhance these benefits. Taking time to breathe deeply and reflect during your warm-down allows your nervous system to shift from the high-energy "fight or flight" mode into the calmer "rest and digest" state (Van Hooren & Peake, 2018). This shift reduces stress hormones like cortisol and helps improve mental clarity, calmness, and emotional balance (Van Hooren & Peake, 2018).

4. Enhances Flexibility and Recovery

Including dynamic and static stretches during your warm-down helps maintain or even improve flexibility over time (Alter, 1998; Witvrouw, et al., 2004). Muscles are more pliable after a workout, making this the perfect time to gently lengthen and release them (Alter, 1998; Witvrouw, et al., 2004). This not only reduces soreness in the days following exercise but also supports quicker recovery and better performance in future workouts (Alter, 1998; Witvrouw, et al., 2004).

5. Reinforces Healthy Mind-Body Connection

Warming down creates a moment of mindfulness—a chance to tune into how your body feels after movement (Van Hooren & Peake, 2018). This reinforces a healthy relationship with exercise that is about more than burning calories or hitting performance goals (Van Hooren & Peake, 2018). It is a time to appreciate what your body can do and to give it the care it deserves (Van Hooren & Peake, 2018). This shift in perspective can be especially helpful in maintaining long-term motivation and preventing burnout (Van Hooren & Peake, 2018).

Conclusion

A warm-down might seem like a small part of your workout, but its benefits for your physical and mental well-being are significant. From preventing injury and aiding recovery to promoting mental clarity and deepening your connection with your body, those extra 5–10 minutes are well worth your time. So next time you finish a run, gym session, or yoga class, do not rush off, take a couple minutes to wind down. Your body and mind will thank you for it.

References:

Witvrouw, E., Mahieu, N., Danneels, L., & McNair, P. (2004). Stretching and injury prevention: an obscure relationship. Sports medicine, 34, 443-449.

Alter, M. J. (1998). Sport stretch. Human Kinetics.

Van Hooren, B., & Peake, J. M. (2018). Do we need a cool-down after exercise? A narrative review of the psychophysiological effects and the effects on performance, injuries, and the long-term adaptive response. Sports Medicine, 48(7), 1575-1595.

Reduce The Risk of Developing Knee Osteoarthritis

Fri, 23 May 2025 03:48:52 GMT

Each year, more than 53,000 knee replacements are performed in Australia, with that number steadily increasing. It's predicted that by the year 2030, this number will rise to over 150,000. Unfortunately, genetics play a significant role in whether you will develop osteoarthritis and require a knee replacement. However, there are several proactive steps you can take to reduce your risk.

Weight Management

Maintaining a healthy weight is important for reducing the risk of knee osteoarthritis. Excess weight puts additional stress on your knees, increasing the risk of developing osteoarthritis.

Live an Active Lifestyle

Engaging in a variety of exercises, including both strength training and aerobic activities, is essential for maintaining healthy knees. Strength training helps build muscle around the knee, providing better support and reducing the strain on the joint. Aerobic exercises, such as walking, swimming, and cycling, improve cardiovascular health and promote overall physical fitness. A well-rounded exercise routine can help reduce the risk of injury and osteoarthritis.

Avoid Repetitive Knee Injuries

Preventing knee injuries is another key factor in reducing the risk of needing a knee replacement. It’s been shown that people who have had multiple knee injuries and or surgeries are more likely to develop knee osteoarthritis later in life.

Brody Kilbey

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Step-Up for MSWA - Training Tips and Preparing for the Event

Thu, 22 May 2025 07:24:33 GMT

Central Park will be hosting the Step-up for MSWA charity event on Sunday, the 22nd of June 2025!

Below are some tips on training in the lead up to the event, and what you can do to prepare day of!

Training tips:

Take the stairs
The best way to train is to do more of what you’ll be doing—climb more stairs and increase your daily walking.
Add high-intensity activities like running, cycling, or incline walking to boost endurance, especially if you're aiming for a fast finish.
No fitness watch? Most smartphones can track your steps!
Sleep & eat well
Aim for 7–9 hours of sleep and fuel your body with a balanced diet: lean protein, whole carbs, and minimal processed foods. Good sleep and nutrition help with both performance and recovery.
Build strength
Stronger legs and joints help prevent injury.
Include squats, lunges, and calf raises in your routine to support stair climbing.

How to prepare on the day:

Eat smart
Have a light, balanced meal about 1–2 hours before the event. Include carbs for energy and stay hydrated.
Dress appropriately
Wear comfortable workout gear and proper shoes with good grip and support.
Bring essentials
Pack a water bottle, a sweat towel, and any medical needs (like asthma puffers).
Pace yourself
Keep a steady pace and listen to your body.
Stay positive
Remember you're climbing for a cause—supporting people living with MS! Be sure to enjoy the experience!

5 Simple Steps to Stay Consistent with Exercise

Mon, 28 Apr 2025 02:44:23 GMT

1. Time of Day

Identify, if you haven’t already, if you are a morning person or a night owl. Now I don’t necessary mean whether you struggle to wake up before 8am or find it impossible to fall asleep until the clocks strikes 12. I mean, identify when the BEST time is for YOU to complete 45-60 minutes of uninterrupted regular structured exercise (RSE). This can take time, but once you do find the ideal time of day for your RSE, stick to it, make plans AROUND your RSE time and make that time for yourself. Be firm but also be fair to yourself when life inevitably creeps back in to dismantle your routines. Find ways to work around it, and make it work for you.

2. Buddy System

Call on a partner, friend, family member, colleague, or your furry loved ones. This person should ideally be someone who you can hold accountable, and who you know will hold you accountable. In no way do you have to train together, bonus points if you do, but they are there to encourage, support, and empower you to get to your fitness destination.

3. Goal Setting

Like a lot of aspects in our lives a way to maintain consistency throughout your fitness journey is goal setting. Goal setting is a very powerful way to turn a dream or a thought into an actionable and achievable task. The simplest way to set a goal is to follow the SMART goal process.

Specificity:
What is it you are looking to target?
Improve strength – okay, stronger in what exactly?
Lose weight – absolutely, how much weight?
Measurable:
Can the above specific goal be measured if so, how?
Achievable:
Is the goal realistic or is it far-fetched. It's okay to have big goals, but it's more important to break your big goals down into smaller, more achievable goals.
Relevant:
Apply the goal to your life, a goal becomes reality before you know it if the goal has relevance to you. i.e. a running race coming up, would require you to train more, or maybe your wedding is on the horizon and you want to be in the best shape of your life.
Time bound:
The final element of any excellent goal is setting a time-based deadline. Now this doesn’t mean it’s the end, far from it, this is where you will evaluate your goal against your performance, and in turn, set another goal.

4. Have a Spot

This can mean a lot of different things for a lot of different people, and can greatly depend upon your goals (yes, a call back). For many people obtaining a gym membership is the ideal way to train and maintain consistency, for others, a home-based gym with the necessities is all they need, for some a good pair of running shoes and their favourite running loop. Having a dedicated space is very important however, can be different for everyone, find what works the BEST for you.

5. Practice

Like many aspects of our life, the more we do any one thing, the better we get. The same applies to behavioural changes like consistency. The first weeks can be easy because its new and exciting, or it can be daunting because its new and terrifying. However, in a roundabout sort of way, the key to consistency specifically with exercise, is finding the BEST form of exercise for YOU. Find the one where you get the most enjoyment from and run with it (pun intended).

Lachlan Simpson

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ QLD

Exercise for Mental Health: A Vital Component for Busy Individuals

Fri, 07 Mar 2025 04:01:51 GMT

Exercise for Mental Health: A Vital Component for Busy Individuals

In the hustle and bustle of modern life, juggling work, family, and social obligations can leave little room for self-care. However, prioritizing regular physical activity is crucial for maintaining not just physical health but also mental well-being. While the demands of a busy schedule might make it challenging to incorporate exercise into daily routines, the profound benefits it offers for mental health make it a non-negotiable element of a balanced and fulfilling life.

The Connection Between Exercise and Mental Health

Exercise has long been celebrated for its physical health benefits, including weight management, cardiovascular health, and increased strength and endurance. However, its impact on mental health is equally significant and often overlooked. Research has shown that physical activity can alleviate symptoms of anxiety and depression, improve mood, enhance cognitive function, and reduce stress levels. Some of the benefits of exercise on mental health include:

Mood Enhancement: Engaging in physical activity stimulates the release of endorphins, often referred to as the "feel-good" hormones. These chemicals act as natural mood lifters, helping to combat feelings of sadness and anxiety.
Stress Reduction: Exercise provides a healthy outlet for stress relief. Physical activity increases the production of norepinephrine, a chemical that moderates the brain's response to stress. Additionally, the repetitive nature of many forms of exercise can have a calming effect, akin to meditation, helping individuals feel more relaxed and centred.
Improved Sleep: Regular exercise has been shown to improve sleep quality, which is closely linked to mental health. A good night's sleep is essential for cognitive function, emotional regulation, and overall well-being.
Cognitive Benefits: Exercise has been found to boost brain function and protect against cognitive decline. Physical activity increases blood flow to the brain, promoting the growth of new neurons and enhancing synaptic plasticity. This can lead to improved memory, concentration, and overall cognitive performance, which are particularly beneficial for busy individuals juggling multiple responsibilities.
Social Interaction: Many forms of exercise, such as team sports or group fitness classes, provide opportunities for social interaction and connection. Building relationships and engaging with others in a positive, supportive environment can have a significant impact on mental health, reducing feelings of isolation and loneliness.

Exercise is an Antidote to Burnout

When work and personal life pile up, burnout becomes a real concern. The feeling of being constantly “on” with no time to recharge can negatively impact both your mental and physical health. Exercise provides a much-needed escape. It helps you disconnect from work pressures and reconnect with yourself.

Taking the time to move your body is a form of self-care that signals to your brain that you are prioritizing your well-being. As you engage in physical activity, your body releases tension, clears your mind, and gives you space to breathe—important factors in preventing burnout.

Overcoming Barriers to Exercise for Busy Individuals

For those with hectic schedules, finding time for exercise can be challenging. However, integrating physical activity into daily routines is possible with some strategic planning and creativity. Here are some tips to help busy individuals make exercise a priority:

Schedule It In: Treat exercise as a non-negotiable appointment, just like any other important meeting or commitment. Block off time in your calendar for physical activity and stick to it. Consistency is key to reaping the mental health benefits of exercise.
Incorporate Short Bursts: If long workout sessions are not feasible, aim for shorter bursts of activity throughout the day. Even ten minutes of exercise, such as a quick walk, stretching, or a mini workout, can contribute to overall mental well-being.
Combine Activities: Look for opportunities to combine exercise with other tasks. For example, take a walking meeting, use a standing desk, or do bodyweight exercises while watching TV. These small changes can add up and help you stay active.
Find Activities You Enjoy: Choose forms of exercise that you genuinely enjoy, as this will make it easier to stick with them. Whether it's dancing, hiking, swimming, or playing a sport, finding an activity that brings joy will increase the likelihood of making it a regular part of your routine.
Set Realistic Goals: Set achievable fitness goals that align with your schedule and lifestyle. Start with manageable targets and gradually increase the intensity and duration of your workouts as you build confidence and stamina.
Make It a Social Event: Involve friends, family, or colleagues in your fitness journey. Exercising with others can provide motivation, accountability, and an opportunity to bond over a shared activity.

Conclusion

Incorporating exercise into the lives of busy individuals is essential for maintaining mental health and overall well-being. The positive impact of physical activity on mood, stress reduction, sleep quality, cognitive function, social interaction, and burnout prevention makes it a valuable tool for anyone seeking to navigate the demands of a hectic lifestyle. By prioritizing exercise and finding creative ways to integrate it into daily routines, busy individuals can enjoy the mental health benefits that come with an active lifestyle. Remember, a healthier mind is a step towards a happier, more balanced life.

Blake Cocking

Workers Compensation Specialist ‑ WA Team Lead (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The Role of Load Management in Rehabilitation

michael.andrews@absolutebalance.com.au (Michael Andrews) — Thu, 20 Feb 2025 05:05:36 GMT

The Role of Load Management in Rehabilitation: A Framework for Returning to Function, and Injury Prevention.

Load management is often associated with high performance sport, but its principles are just as critical in rehabilitation. Whether guiding injured workers back to work, older adults to independent living, or patients recovering from injuries, progressively and systematically managing load is essential for recovery, injury prevention, and long-term function.

A major challenge in rehabilitation is balancing workload progression to optimise adaptation without overloading healing tissues. Sudden spikes in training load or returning to full activity too soon significantly increase the risk of re-injury. Exercise physiologists can use load monitoring, periodisation, and predictive planning to ensure a structured and safe return to work, life, or recreational activity.

Understanding Load and How to Monitor It

In rehabilitation, load refers to the total amount of mechanical and physiological stress placed on the body. This includes external load; the measurable work performed (e.g., weight lifted, steps taken, distance covered, time spent in physical activity), and internal load; the body’s physiological and perceptual response to that work (e.g., heart rate, rate of perceived exertion (RPE), pain, fatigue). Both external and internal load must be monitored to ensure that rehabilitation is progressive yet not excessive.

One of the most useful frameworks for load management is the Acute: Chronic Workload Ratio (ACWR), which helps determine whether a patient is progressing at a safe rate or at risk of overload. A sudden spike in acute load (ACWR >1.5) increases injury risk by 2-4 times in the following week. Therefore, a gradual increase in chronic load (≤10% per week) is essential to build resilience and capacity.

- Acute Load = The total workload over the past week.

- Chronic Load = The rolling 4-week average of workload.

- ACWR = Acute Load ÷ Chronic Load.

Patients often underestimate how small spikes in activity (e.g., resuming full work shifts after time off, or inconsistent engagement in their self-management plan) can lead to flare-ups or re-injury, and by tracking ACWR, we can educate the patient accordingly and prevent excessive acute spikes while ensuring a steady increase in chronic workload, reducing the likelihood of setbacks and ensuring a progressive return to function.

To apply these principles effectively, we need accurate and practical ways to measure and track load in real world rehabilitation settings. Unlike athletic settings, maximal strength testing (1RM) is often inappropriate in rehabilitation. Alternative methods include volume-based and time-based load tracking, perceived exertion and fatigue monitoring, and functional testing.

- Monitoring total weight lifted per session (sets × reps × resistance).

- Measuring time under tension for endurance-based activities.

- Using exercise RPE and session RPE to gauge effort.

- Reassessing movement capacity, endurance, and strength progression over time.

Using subjective feedback alongside objective load tracking allows for better exercise prescription and progression. Asking the right questions can guide real-time modifications:

External Load Questions:

- How much activity did you complete this week?

- How does this compare to last week?

- Did you struggle with any tasks or exercises?

Internal Load Questions:

- How fatigued do you feel after sessions?

- How long does it take you to recover?

- Are you experiencing pain or discomfort, and how does it change with activity?

Structuring Load Progression for Long-Term Success

Periodisation is the planned progression of training load over time, ensuring continued adaptation without excessive strain. While typically used in athletic settings, structured periodisation is just as valuable in rehabilitation, helping prevent stagnation by adjusting workload over time, ensuring progressive overload while respecting tissue healing and recovery rates, and guiding return-to-work planning by matching rehabilitation loads with real-world demands.

A structured approach allows us to compare a patient’s current workload tolerance to their end goal and reverse-engineer a safe progression plan. If a patient needs to tolerate X hours of work or Y level of activity, we can use their current capacity and reverse-calculate a safe, gradual progression timeline and by maintaining consistent, small increases in chronic workload, we minimise setbacks and ensure safe long-term recovery. Linear Periodisation is best suited for straightforward recovery cases with minimal variability in symptoms. While, nonlinear periodisation may be more practical for rehabilitation, as symptoms and capacity can vary day-to-day.

- Linear Periodisation: Steady, predictable increases in intensity, volume, or duration over time.

- Nonlinear (Undulating) Periodisation: Load fluctuates based on recovery, pain, and function.

Applying Periodisation to Rehabilitation Planning

Step 1: Establish a Baseline

Identify current weekly workload (e.g., hours of tolerated activity, steps, resistance training volume) and functional deficits (e.g., strength, endurance, movement capacity).

Step 2: Define the End Goal

What workload is required to return to work, sport, or daily function? This could mean sustaining an 8-hour work shift, lifting a certain weight, or tolerating daily activities without pain.

Step 3: Plan a Safe Progression

Gradually increase chronic workload by ≤10% per week. Avoiding acute spikes (ACWR >1.5) to prevent setbacks. Monitor pain, fatigue, and function to guide daily and weekly adjustments.

By integrating load monitoring, periodisation, and predictive planning, exercise physiologists can create safe, structured rehabilitation programs that optimise recovery, prevent re-injury, and guide patients back to work, sport, or daily life with confidence.

Key Takeaways for Exercise Physiologists

- Load management is essential in rehabilitation, not just in sports.

- Acute vs. chronic load balance is key. Avoiding acute spikes prevents injury, while gradual increases build resilience.

- Tracking external and internal load ensures a data-driven approach to exercise prescription.

- Periodisation structures rehabilitation progression, ensuring steady gains without excessive strain.

- Patient education on workload progression improves compliance and reduces re-injury risk.

References

Impellizzeri, F. M., Menaspà, P., Coutts, A. J., Kalkhoven, J., & Menaspà, M. J. (2020). Training load and its role in injury prevention, part I: back to the future. Journal of athletic training, 55(9), 885-892.
Gabbett, T. J., Kennelly, S., Sheehan, J., Hawkins, R., Milsom, J., King, E., ... & Ekstrand, J. (2016). If overuse injury is a ‘training load error’, should undertraining be viewed the same way?. British Journal of Sports Medicine, 50(17), 1017-1018.
Windt, J., & Gabbett, T. J. (2017). How do training and competition workloads relate to injury? The workload—injury aetiology model. British journal of sports medicine, 51(5), 428-435.
Jildeh, T. R. (2024). Editorial commentary: load management is essential to prevent season-ending injuries in the National Basketball Association. Arthroscopy, 40(9), 2474-2476.
Bache-Mathiesen, L. K., Andersen, T. E., Dalen-Lorentsen, T., Tabben, M., Chamari, K., Clarsen, B., & Fagerland, M. W. (2023). A new statistical approach to training load and injury risk: separating the acute from the chronic load. Biology of sport, 41(1), 119-134.
Williams, S., West, S., Cross, M. J., & Stokes, K. A. (2017). Better way to determine the acute: chronic workload ratio?. British journal of sports medicine, 51(3), 209-210.
Carey, D. L., Ong, K., Whiteley, R., Crossley, K. M., Crow, J., & Morris, M. E. (2018). Predictive modelling of training loads and injury in Australian football. International Journal of Computer Science in Sport, 17(1), 49-66.
Impellizzeri, F. M., Shrier, I., McLaren, S. J., Coutts, A. J., McCall, A., Slattery, K., ... & Kalkhoven, J. T. (2023). Understanding training load as exposure and dose. Sports Medicine, 53(9), 1667-1679.
Lorenz, D. S., Reiman, M. P., & Walker, J. C. (2010). Periodization: current review and suggested implementation for athletic rehabilitation. Sports Health, 2(6), 509-518.

April Hawser

Exercise Physiologist

Exercise Rehabilitation Services – NSW

Rehab a wrist Injury, from an Exercise Physiology perspective

Fri, 07 Feb 2025 02:41:57 GMT

How would I rehabilitate a wrist, hand or finger injury?

Rehabilitating a hand injury is challenging due to the hand's essential role in daily tasks, including heavy lifting and precise movements.

So, what are some key focuses to prioritise with rehabilitation of the hand and wrist?

Understanding hand anatomy is essential. The hand consists of 27 bones: 8 carpal bones (wrist base), 5 metacarpals (palm), and 14 phalanges (fingers), all connected by ligaments and serving as tendon attachments. When an upper limb injury occurs, immobilization is necessary for recovery. This leads to reduced upper limb use, resulting in muscle atrophy, decreased strength and feelings of tightness or stiffness, along with discomfort.

Not every movement requires a 'power' grip for strength and endurance restoration. Rehabilitation stages may involve using various objects to challenge the grip, facilitating a transition to dynamic everyday strength. The hand, as the most proximal structure of the upper limb, is crucial for daily tasks and fine motor control. A little tip that can help improve someone’s rehabilitation is implementing exercises that can incorporate a ball, broomstick or even different types of stationary! Rehabilitation for fingers, hands, and wrists varies for each individual.

A tailored approach, sometimes requiring minimal intervention or creative solutions, can lead to optimal outcomes.

Afiq Jackson

Workers Compensation Specialist ‑ Team Leader North West (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The Role of Sports and Exercise in Fostering Relationships and Instilling Purpose

Fri, 31 Jan 2025 02:43:10 GMT

Joining a sports club or team provides an opportunity to integrate into a community where you can forge lasting relationships. This experience can offer a sense of purpose and belonging.

Below are three separate occasions that illustrate how joining a rugby club and a squash club positively influenced my life:

Occasion 1: I began my university journey in a new city, knowing only a few friends from school. After taking a gap year in New Zealand, my school friends had already formed new connections at university, having started a year before me. One sunny morning at the beach, I was invited to join a touch rugby game with people I had never met. Fast forward three years, and the new acquaintances I made that day had become lifelong friends through my involvement at the local rugby club they played for. Participating in that touch rugby game allowed me to connect with like-minded individuals, which led to me joining the rugby club and giving me a sense of purpose and direction during my early university years.

Occasion 2: After graduating from university, I relocated to a new city to embark on my first real job. Drawing from my past experiences, I sought out the nearest squash club, having given up rugby due to an injury. Just like before, within two days of becoming a member of the local squash club, I received invitations to lunch and social gatherings at the homes of fellow players. Along with connecting with a wonderful group of individuals, the regular exercise and my commitment to a team that I had to show up for each week provided me with a similar sense of purpose I had experienced during my rugby club days. This experience was essential in helping me become the best version of myself.

Occasion 3: The final and perhaps the most significant moment to reflect on was when I relocated to a larger, busier city to advance my career. During this transition, I reconnected with an old friend from a previous club who had taken up running. Naturally, I joined him for a few runs, quickly bonding with the running group. After a year, I became involved in this running community, which ultimately resulted in my moving into a new home and meeting my now-wife!

To sum up, the potential that sports and exercise offer is limitless. In any setting filled with like-minded individuals, the possibilities are endless! I hope this blog inspires you to finally join that gym or sport you've been interested in for all these years!

Michael Andrews

Business Development Manager

Benefits of Staying Hydrated

Fri, 24 Jan 2025 02:40:51 GMT

Water is often hailed as the elixir of life, and for good reason. Our bodies are made up of about 60% water, making it essential for a variety of bodily functions (Meyer et al., 2019). Yet, many of us still don’t drink enough of it. Whether you're a busy professional or a stay-at-home parent, it’s easy to overlook the importance of staying hydrated. However, drinking enough water is vital for maintaining good health and optimizing daily performance. Below are five reasons why drinking water is good for you.

Improves Physical Performance

One of the most significant benefits of drinking water is its positive impact on physical performance (Meyer et al., 2019). During exercise, the body loses water through sweat, and staying hydrated ensures that your muscles and joints function efficiently (Meyer et al., 2019). Dehydration can lead to fatigue, decreased endurance, and even muscle cramps, which can severely impact your workout (Meyer et al., 2019). By drinking water, you help regulate your body temperature, keep joints lubricated, and ensure your muscles have the necessary hydration to perform at their peak (Meyer et al., 2019). Whether you’re running a marathon or doing light yoga, adequate hydration can improve your performance and make your workouts feel less taxing (Meyer et al., 2019).

Supports Digestive Health

Drinking water plays a crucial role in maintaining a healthy digestive system (Muto, 1988). Water helps dissolve fats and soluble fibres, preventing constipation and aiding in smoother bowel movements (Muto, 1988). It also flushes out waste products from the body, promoting better kidney function (Muto, 1988). When you don’t drink enough water, your body tries to retain water in the colon, leading to constipation (Muto, 1988). Staying hydrated ensures that the digestive process runs smoothly and prevents uncomfortable gastrointestinal issues (Muto, 1988). So, if you’re feeling bloated or sluggish, it might be time to drink a glass of water.

Boosts Skin Health

Your skin is the largest organ in your body, and just like any other organ, it needs water to stay healthy (Williams et al., 2007). Hydration helps maintain skin elasticity, reduces the appearance of fine lines, and promotes a natural, healthy glow (Williams et al., 2007). When your body is dehydrated, your skin can become dry, flaky, and prone to wrinkles (Williams et al., 2007). Drinking water helps keep your skin cells functioning properly, ensuring that your skin remains supple and well-moisturized from the inside out (Williams et al., 2007). Additionally, proper hydration may help in the fight against acne and other skin conditions by flushing out toxins that can lead to breakouts (Williams et al., 2007).

Regulates Body Temperature

Water plays a vital role in regulating your body’s temperature, especially when you’re exposed to extreme heat or engaging in physical activities (Boulze, Montastruc, & Cabanac, 1983). Sweating is the body’s natural cooling mechanism, and water is a crucial component in this process (Boulze, Montastruc, & Cabanac, 1983). When you're hydrated, your body can produce sweat efficiently, which helps cool down the body and maintain a stable internal temperature (Boulze, Montastruc, & Cabanac, 1983). Dehydration can impair this cooling process, increasing the risk of overheating and heatstroke, particularly in hot weather or during intense physical exertion (Boulze, Montastruc, & Cabanac, 1983). Drinking enough water helps your body maintain a normal temperature, preventing potential heat-related health issues.

Enhances Brain Function and Mood

The brain is highly sensitive to dehydration, and even mild dehydration can affect cognitive function, memory, and mood (Boulze, Montastruc, & Cabanac, 1983). Studies have shown that when you're dehydrated, you may experience difficulties concentrating, feel more fatigued, or even become irritable (Boulze, Montastruc, & Cabanac, 1983). Drinking enough water can help keep your brain sharp, enhance your ability to focus, and improve your overall mood (Boulze, Montastruc, & Cabanac, 1983). In addition to its cognitive benefits, staying hydrated ensures that your brain can function at its best, promoting better decision-making, problem-solving, and productivity (Boulze, Montastruc, & Cabanac, 1983).

Conclusion

Drinking water is one of the simplest and most effective ways to improve your overall health. From enhancing physical performance to supporting digestive health, boosting skin appearance, regulating body temperature, and improving brain function, the benefits of staying hydrated are undeniable. So, whether you're exercising, working, or simply going about your day, make sure to drink plenty of water. Your body will thank you for it, and you’ll feel the positive effects in no time. Keep that water bottle nearby and remember that hydration is key to living your best, healthiest life!

References:
- Meyer, F., Timmons, B. W., Wilk, B., & Leites, G. T. (2019). Water: hydration and sports drink. In Nutrition and enhanced sports performance (pp. 545-554). Academic Press. Retrieved from Water: Hydration and Sports Drink - ScienceDirect

- Muto, T. (1988). Digestion and absorption. Tokyo: Daiichishuppan Co., Ltd, 228. Retrieved from samples.jbpub.com/9781284021165/9781449649241_CH03_Insel_4886_1.pdf

- Williams, S., Krueger, N., Davids, M., Kraus, D., & Kerscher, M. (2007). Effect of fluid intake on skin physiology: distinct differences between drinking mineral water and tap water International journal of cosmetic science, 29(2), 131-138. Retrieved from Effect of fluid intake on skin physiology: distinct differences between drinking mineral water and tap water - Williams - 2007 - International Journal of Cosmetic Science - Wiley Online Library

- Boulze, D. M. P. C. M., Montastruc, P., & Cabanac, M. (1983). Water intake, pleasure and water temperature in humans. Physiology & behaviour, 30(1), 97-102. Retrieved from Water intake, pleasure and water temperature in humans - ScienceDirect

How Exercise Can Benefit Your Relationships

Fri, 17 Jan 2025 01:52:11 GMT

Hi all, Daniel from AB here! Today I want to share with you all how exercise can benefit your relationships. Exercise is often celebrated for its physical and mental health benefits, but its positive impact on relationships is equally significant. Engaging in regular physical activity can enhance your connections with others, fostering stronger, healthier relationships. Here's how:

Shared Activities

Exercising together, like jogging or hiking, creates shared experiences and strengthens bonds.

Improved Mood

Exercise reduces stress and boosts mood, leading to more positive interactions with others.

Increased Confidence

Feeling good about yourself can improve how you relate to others, enhancing social interactions.

Social Interaction

Joining fitness groups introduces you to new people, expanding your social network.

Better Communication

Exercise improves cognitive function, helping you communicate more effectively.

Quality Time

Physical activities provide a chance to spend quality time with loved ones.

Encouragement

Working out with others offers mutual motivation and support, strengthening relationships.

Exercise offers more than just physical and mental health benefits; it can also significantly enhance your relationships. By engaging in physical activities with others, you can build stronger bonds, improve communication, and create lasting memories. So, lace up your sneakers, grab a friend or loved one, and start reaping the relational benefits of exercise today!

Daniel Dewberry

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Starting the New Year off right

Fri, 10 Jan 2025 00:08:55 GMT

With a new year upon us every individual will be looking to achieve a new list of goals they would like to achieve for both their physical and mental wellbeing. It is important when setting goals for the new year to break it down into steps so that these can be achieved and keep you motivated along the way.

Here are a few steps to help.

Specificity

A goal must be clear and precise. Ambiguity leads to confusion, whereas specificity provides direction. Instead of saying, “I want to get fit,” try “I will jog for 30 minutes, five days a week.” This leaves no room for misinterpretation and gives you a concrete path to follow.

Measurable: Track Your Progress

Goals need to include criteria for measuring success. By tracking your progress, you can stay motivated and recognize when adjustments are needed.

Pro Tip: Use tools like journals, apps, or spreadsheets to monitor milestones. Celebrate small wins to keep the momentum alive.

Achievable: Stay Realistic

Ambition is admirable, but setting goals too far out of reach can lead to frustration and a lack of motivation. Ensure your objectives are challenging yet feasible given your current resources and timeframe. For instance, if you’re a beginner runner, completing a marathon in three months might be overly ambitious, but aiming for a 5K race is more realistic.

Pro Tip: Reflect on your past achievements to gauge what’s attainable. Stretch yourself but avoid setting yourself up for failure.

Relevant: Align with Your Values

Your goals should resonate with your larger life purpose and priorities. Fitness goals should reflect what you want to achieve—not what others expect of you. When your goals are personally meaningful, they’re more likely to inspire consistent action. For example, a person training for a marathon has a different motivation than someone aiming to reduce back pain through core exercises. Both goals are valid, but their relevance depends entirely on the individual’s priorities and circumstances.

Time-bound: Set a Deadline

A goal without a deadline is just a wish. Adding a timeframe creates urgency and helps you stay on track. Instead of “I’ll lose 5Kg,” say, “I’ll lose 5Kg by a certain date or I will lose 0.5Kg per week for 10 weeks”

Pro Tip: Break larger goals into smaller, time-bound tasks. This makes big ambitions feel more manageable and achievable.

By using the SMART goal structure, the goals you set coming into 2025 are far more likely to be achieved by keeping you on track and helping you recognise the small wins along the way. These small wins build confidence, discipline and motivation towards the larger goals which will help keep the momentum moving in the right direction.

Adrian McKenna

Exercise Physiologist

Exercise Rehabilitation Services ‑ WA

How to stay active during the Festive Season

Thu, 19 Dec 2024 00:51:30 GMT

T ime spent in natural outdoor environments has been found to increase cognitive function. Staying active during the holidays can be both fun and beneficial for your health. With all the festive activities, food, and time off, it’s easy to slip into a more sedentary routine, but there are plenty of ways to stay moving while enjoying the season. Here are some ideas to stay active this holiday period.

Holiday walks: Take advantage of the holiday lights and decorations around your neighbourhood or a local park. Evening strolls to view holiday displays can be a fun way to stay active. Summer in Australia is a great time to get outdoors as the days are longer.

Family sports and games: If you have a backyard or nearby park, gather your friends and family for a game of football, soccer, or basketball. The possibilities are endless.

Holiday morning walk or run: Start the day with a refreshing walk or run before the big feast. It’s an excellent way to clear your mind, get some fresh air, and set a positive tone for the day ahead. It can help boost your mood, reduce stress, and improve your metabolism.

Holiday advent active calendar: Create your own "active advent calendar" to keep you motivated throughout December. Each day, set a small fitness challenge that fits with your schedule and surroundings. This is a fun way to build consistency while staying active during the festive season.

Beach activities: Australia's coastline is perfect for surfing, whether you're a beginner or an expert. December is an ideal time to hit the beach as the weather heats up. Volleyball and cricket are amongst the most popular beach games.

References:
- Biddle, G.J. et al. (2022) ‘A Christmas themed physical activity intervention to increase participation in physical activity during Advent: Pilot randomised controlled trial’, BMJ [Preprint]. doi:10.1136/bmj-2022-072807.
- Boere, K. et al. (2023) ‘Exercising is good for the brain but exercising outside is potentially better’, Scientific Reports, 13(1). doi:10.1038/s41598-022-26093-2.

Shafiq Adie

Exercise Scientist

Corporate Health Services

How Exercise Physiology is more than Weight Loss and Chronic Disease Management

Wed, 18 Dec 2024 00:52:05 GMT

When many people think of exercise physiology, they often associate it with personal training. The common misconception is that EP is mainly referred for weight loss programmes or managing chronic diseases like heart disease or diabetes. While these are critical aspects of our profession, exercise physiology encompasses so much more. One of our increasingly recognised roles lies within the return to work (RTW) space, where accredited exercise physiologists (AEPs) are playing a pivotal part in helping individuals regain their health, confidence, and ability to re-enter the workforce.

Exercise Physiology is the science of using evidence-based interventions to improve physical health and functional capacity. As AEPs, we specialise in designing and delivering individualised exercise programmes for people with a vast range of conditions, including musculoskeletal injuries, mental health disorders, and workplace injuries.

The role of the exercise physiologist goes far beyond prescribing exercises. We are highly skilled professionals who combine scientific expertise with a compassionate, client-based approach. Our ability to identify and address the complex interplay between physical, psychological, and functional factors. By understanding work demands, personal goals, and barriers to recovery, AEPs retore physical health while building confidence and resilience.

As Workers compensation specialists and AEPs, we often face recognition challenges when compared to other allied health professions. One of our biggest barriers is limited public awareness. Despite our critical role, AEPs are less well-known outside specific rehabilitation or health contexts. Many people have never heard the term exercise physiologist and therefore do not understand our qualifications or scope of practice.

There is also a common misconception that exercise physiology overlaps with other allied health professions such as physiotherapy, or other health services such as personal training. In the workers compensation space, AEP’s and more specifically workers compensation specialist bridge the gap between other allied health professionals by designing functional and work-specific rehabilitation, tailored to the specific critical demands of the worker.

In this space, AEPs collaborate with workers, employers, and healthcare professionals to support recovery in many facets. This comprehensive approach reduces the risk of re-injury, increases worker confidence, and prepares workers for job-related tasks.

Exercise physiology in Australia is an invaluable resource in many health spaces. By addressing physical and psychological recovery and collaborating with other health professionals and increasing workplace readiness, AEPs help injured workers reclaim their health and way of life. As awareness and understanding of exercise physiology continues to grow, we will continue to define and redefine workplace health and rehabilitation.

Meagan Cristaldi

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ QLD

An update from AB's new CEO

Thu, 05 Dec 2024 06:56:58 GMT

2024 has seen sweeping change across the worker’s compensation industry in WA with the introduction of new legislation 1st July 2024, with it the first changes in more than 40 years.

There has also been change afoot at Absolute Balance we welcomed a new corporate facility in Palace Towers allowing Absolute Balance to supply wellness programmes to the many tenants of the building. Welcomed Queensland to exercise rehabilitation team with Lachlan leaving the familiarity of the Western Australian team to lead the newly established Queensland team.

The Executive Team at AB had a shake-up and we reflected on the contributions of both Derek and Ryan to the Exercise Physiology industry and Absolute Balance over many years. The business took a brave new step forward with Ingrid at the helm as CEO. Ingrid has always been a clinician at heart and has brought her clinical hat to her new role, empowering all team members to achieve the best possible outcome for each and every individual’s health journey within the Absolute Balance landscape. The strong communication and outcomes that has been a trademark of Ingrid’s style clinically has been a keen focus of the team over the past 6 months.

The business reflected on the unique position we find ourselves with Clinicians in every position from our corporate facilities team to our injury prevention team, our exercise rehabilitation team (now operating in three jurisdictions) and our management team. Our strong clinical focus came to the forefront as we navigated the new legislation and continue to strive to support a variety of stakeholders in achieving the ultimate outcome of healthy patients back at work in a timely manner.

Once again, the business was fortunate enough to participate in many events from the ARPA awards in WA, NSW and QLD, attend the inaugural WA PIEF conference, attend and present at the ARPA national conference, along with the ARPA National awards. There was plenty of other events along the way, we even explored our team’s artistic side and painted our kitchen.

The growth and change in the exercise physiology industry continues to excite the Absolute Balance Team and we look forward to the opportunities that 2025 brings.

Ingrid Hand

CEO (AEP, ESSAM)

Cold Water Immersion

Tue, 03 Dec 2024 06:38:34 GMT

Cold Water Immersion (CWI), often referred to as ice baths or cryotherapy, is a therapeutic practice gaining recognition for its great recovery benefits. By immersing the body in cold water, typically around 12°C, CWI promotes healing and reduces recovery time, making it a favourite among athletes and fitness enthusiasts.

Why Cold-Water Immersion Works

The science behind CWI lies in its ability to lower body and tissue temperatures, leading to reduced muscle damage, inflammation, and swelling. This process enhances blood flow, decreases metabolic activity, and alleviates muscle spasms and pain. Additionally, CWI stimulates the release of endorphins, improving mood and overall recovery perception.

Studies have shown that CWI has immediate benefits, particularly in boosting feelings of recovery within 1 to 48 hours post-exercise. While it does not significantly reduce delayed onset muscle soreness (DOMS) within 24 hours of eccentric exercise, notable relief is observed after 48 hours. The practice also proven effective in restoring muscular power within 24 hours of intense activity.

Future Directions in CWI Research

While CWI is backed by promising evidence, I believe more research is needed to optimize its use. Key areas include determining the ideal duration and temperature for immersion for specific benefits, understanding its role in musculoskeletal injury recovery, and clarifying when during rehabilitation it is most beneficial.

The Takeaway

Cold Water Immersion offers a powerful recovery tool, reducing soreness and promoting faster healing. For those battling intense exercise fatigue or managing injuries, CWI might be the refreshing solution they need.

Reference

Moore, E., Fuller, J. T., Buckley, J. D., Saunders, S., Halson, S. L., Broatch, J. R., & Bellenger, C. R. (2022). Impact of cold-water immersion compared with passive recovery following a single bout of strenuous exercise on athletic performance in physically active participants: A systematic review with meta-analysis and meta-regression. Sports Medicine, 52(7), 1667-1688.

Michael Pappas

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Which exercise modality is more effective for Type 2 Diabetes?

Tue, 26 Nov 2024 07:09:00 GMT

Resistance Training VS Aerobic Training | Which exercise modality is more effective for Type 2 Diabetes?

It’s no surprise that over the last decade, the prevalence of Type 2 Diabetes has grown exponentially claiming over 19,300 deaths and affecting over 1.2 million Australians since 2021. To put things into perspective, that’s 11.2% of all deaths and at least 5% of the Australian population affected with this condition! So, how do we prevent this?

The good news is exercise can help reduce and even prevent Type 2 Diabetes but with so many exercise modalities to choose from, which is more effective? Let’s use the 2 most common modalities: Resistance Training (RT) and Aerobic Training (AT) and compare the effects it has on Type 2 Diabetes.

Resistance Training is defined as a structured exercise program with the intention of building muscle strength and size using some external resistance. One study showed that individuals with leaner body mass improved insulin sensitivity by increasing the density of insulin receptors and enhancing glycaemic control, thus promoting higher uptake of glucose. Interestingly, isometric exercises were found to reduce pressor responses which help to reduce blood pressure for hypertensive individuals who are commonly found to have Type 2 Diabetes.

Aerobic Training is defined as exercise with a repeated pattern of movement that relies on adenosine triphosphate (ATP) as the primary source of energy. With obesity being a major metabolic comorbidity associated with Type 2 Diabetes, Aerobic Training were shown to be more effective at increase VO2 max, caloric expenditure and fat oxidation and thus reduce overall body fat mass. Furthermore, higher energy expenditure would elicit a hormonal response from the body to secrete human growth hormones which further stimulate lipolysis.

In conclusion, both forms of training modalities offer different means to reduce precursors associated with Type 2 Diabetes. Resistance Training promote muscle building and insulin sensitivity, whereas Aerobic Training decreased insulin resistance via reduction of fat mass and inflammatory responses. It is therefore recommended that Type 2 Diabetic individuals should incorporate a mixture to get the maximum benefits of both worlds.

References:

Australian Institute of Health and Welfare. Chronic Disease 2017-2018. 2018. https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/diabetes/overview
Bweir S, Al-Jarrah M, Almalty A, Maayah M, Smirnova IV, Novikova L, et al. Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetology and metabolic syndrome. 2009;1(1):27-.
Cornelissen VA, Smart NA. Exercise Training for Blood Pressure: A Systematic Review and Meta-analysis. Journal of the American Heart Association. 2013;2(1):e004473,n/a.

Kenny Nguyen

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Exercising for better skin

Fri, 22 Nov 2024 02:20:56 GMT

So why is skincare important when we exercise… here is everything you need to know!

Increase Blood Flow - circulate oxygen and nutrients to the skin and other areas of the body. Oxygen accelerates the wound-healing process and aids cell regeneration so that the skin can maintain a healthy, beautiful glow.

Flush Out Toxins – from UV, smoke/pollution can cause inflammation, acne, eczema. Exercise increases lymphatic drainage, removes toxins.

Decrease Stress - release of endorphins (hormones that make us feel happy) which can help decrease stress and anxiety. Decreased levels of cortisol (the stress hormone) also help the immune system function so that it can effectively combat skin damage and keep your entire body healthy.

Prevent Signs of Aging - Decreased stress levels, oxygenation in the skin, and healthy sleep regulation are all essential to maintaining a healthy, youthful look.

You’re probably thinking, “Why should I care about my skin before I go have a sweat sesh if I plan to shower afterward?”

A pre-workout skincare routine because working out with dirt, debris, or even makeup on your face can wreak havoc on your skin. Likewise, your additional post-workout skincare routine will rid you of leaving sweat, dirt, and debris that could lead to a potential breakout if left unattended. Recommend following these steps pre-workout to guarantee a fresh face and clear skin:

Step 1: Cleanse Face and Remove Makeup

Regardless of whether you have on makeup, you want to wash your face so that you have a clean complexion before you start your workout. A quick and simple solution recommend is a gentle cleanser or micellar water - lift away pore-clogging dirt and debris from the surface of your skin & waterproof makeup, too.

If you are running out of time to clear your skin between a lunch break dermatologist have said, “You’ll sweat and it’ll get a little messy, but it’s not all that bad to have makeup on your face during exercise." If you’re about to workout, it’s best to do so with a clean, makeup-free face. As your body heats up during a workout, your pores open and you definitely don’t want all the surface grime to settle into your pores.

Step 2: Apply A Facial Mist

Hydrating is key during any workout – internally as you drink H2O during your workout, as well as externally on your face! Apply a facial mist to provide your skin with a boost of hydration. Will improve the overall texture of your skin and leave it feeling soft, smooth, and refreshed during your workout.

Step 3: Hydrate with A Moisturiser

Stick with a moisturizer that is lightweight and absorbs quickly. Using a mineral-rich moisturiser can boost the skin’s moisture barrier function.

Step 4: Apply SPF
If you plan on getting your fitness on outdoors, plan on applying to all exposed areas of your body. Sunscreen protection is one of the most important steps in any and all skin-care routines!

Advice applies even if you’re working out in a gym with windows that let light in. “Anytime there’s visible light, you’re exposed to some part of the electromagnetic spectrum,” “Growing evidence is showing that all light is important when it comes to skin damage and aging.”

Post-workout:

Cleansing Is Key
Remove sweat, bacteria, and impurities accumulated during the session. Gentle cleanser suitable for your skin type to remove sweat without stripping away essential oils - helps prevent breakouts, skin feel fresh.

Hydration and Replenishment
Sweating can dehydrate the skin, making it essential to restore lost moisture. Incorporate a hydrating moisturiser or serum.

Preventing Breakouts and Acne
The combination of sweat, oil, and bacteria can clog pores and lead to acne flare-ups. If you're prone to acne, consider using products with ingredients that slightly exfoliate like pineapple fruit extract or lactic acids.

Protecting Your Skin
Even after your workout indoors, your skin might still be exposed to harmful UV rays. Apply sunscreen if you're heading out post-exercise. Sun protection is crucial to shield your skin from premature ageing, pigmentation, and other sun-related damage.

The Importance of Timing
It's ideal to cleanse and moisturise your skin within 30 minutes of finishing your workout. This time frame allows for efficient removal of sweat and prevents it from settling into your pores, reducing the risk of skin issues.

According to the cosmetic surgery professionals, it is better not to cool down for a long period of time, but to actually go straight to the shower to start on your post-workout skin care routine so that the sweat and bacteria don’t settle. “Sweating creates a warm and wet environment for bacteria to grow.”

Facts you may not know:
Use a clean towel if you need to blot your sweat, definitely don’t use your dirty hands or your sweaty t-shirt

K eep your hair off your face. If you have longer hair, it’s best to keep it pulled back and away from your face during a workout. This helps prevent oils (not to mention any hair products you used that day) from also clogging your pores, which can contribute to breakouts.

It’s also helpful to cool off skin to prevent breaking of blood vessels and return skin temperature to a normal level quicker, even a quick splash of cool water post-workout is good practice.

Exercise not only benefits your muscles; it also improves your skin's health. Studies show that activities like endurance and high-intensity aerobic training can help reduce signs of aging and enhance your overall complexion. Whether you work out at a gym or exercise outdoors, always remember to moisturize your skin, protect your skin with sunscreen, and refresh your skin afterward with cool water.

References:

1. https://premierdermde.com/the-importance-of-a-pre-workout-skincare-routine/
2. https://southerncosmetics.com.au/news/home-workout-skincare-dos-and-donts-when-working-out/
3. https://www.everydayhealth.com/skin-beauty/skin-care-musts-before-after-your-workout/

The Effects of Fatigue on Workplace Injury Risk: Identifying and Reducing Risk Factors

Tue, 29 Oct 2024 07:20:41 GMT

Fatigue is a significant concern throughout many work environments, affecting workers across various industries. Fatigue can be a by-product of long hours, demanding tasks, inadequate rest, and stress. While fatigue is often overlooked, its implications for injury risk are often profound.

Understanding Fatigue in the Workplace

Fatigue in the workplace can manifest as physical exhaustion, mental tiredness, or a combination of both. Physical fatigue results from prolonged exertion, while mental fatigue arises from extended periods of concentration and decision-making. Both forms can impair a worker's ability to perform tasks safely and efficiently, which can lead to a higher risk of accidents and injuries. Other factors such as sleep loss, and environmental conditions can significantly impact a workers’ fatigue levels. Individual factors such as age, hydration, fitness level, diet, smoking and alcohol intake are also just as important to consider.

Mechanisms Linking Fatigue to Injury Risk

Decreased Coordination and Balance
Altered Perception and Reaction Time
Increased Muscle Strain
Compromised Judgment
Neglect of Safety Protocols

It is important to highlight that industries requiring workers to complete extended periods of manual labour are more likely to be involved in workplace incidents. The risks become elevated as fatigue is mixed into already high-risk environments.

Mitigating the Risks of Fatigue

There are several ways to help mitigate the risks of fatigue. These can be but are not limited to:

Implementing Fatigue Management Programs
Adequate Rest and Recovery
Monitoring Workloads
Providing Ergonomic Support
Encouraging Healthy Lifestyle Choices
Creating a Supportive Work Environment

Fatigue is a critical factor influencing injury risk in the workplace. Understanding the mechanisms linking fatigue to injuries can help organisations implement effective strategies to mitigate these risks. By prioritising rest, monitoring workloads, and fostering a culture of safety and support, employers can enhance worker well-being and significantly reduce the likelihood of accidents. Addressing fatigue is not just a matter of improving productivity; it is essential for ensuring the health and safety of all workers.

Daine Richards

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Meet 50% of our new starters in QLD

Fri, 25 Oct 2024 02:28:24 GMT

Meet Rowan 50% of our new QLD AB squad.

Hello everybody, I’m Rowan, Accredited Exercise Physiologist at Absolute Balance. I studied in sunny Townsville at James Cook University, graduating in 2014. Shortly after, I landed a position at a local chiropractic clinic as the sole Exercise Physiologist among chiropractors, physiotherapists, and massage therapists. After a year, I transitioned to Max Employment as a Health Services Officer, covering Townsville, Ingham, Ayr, and Charters Towers. In this role, I helped job seekers secure suitable employment, an unexpected shift from my previous experience but one that ignited my passion for the role of exercise in mental health.

After a few years, I decided to move to Brisbane, where I ventured into the occupational rehabilitation field. However, I soon realized that vocational rehabilitation wasn’t the right fit for me. This realisation led me to focus on pre-employment medical assessments, including functional capacity evaluations, drug testing, and lifting capacity assessments. Fun fact: I encountered every drug in the tests except cocaine—it's puzzling why people would use methamphetamines the weekend before their employment screenings!

Eventually, I traded in corporate attire for shorts and joggers as I embraced a role in the gym environment. I enjoyed working directly with Medicare, DVA, NDIS, and private patients, so much so that I decided to start my own business (2021) with Meagan, the other 50% of the new Queensland team. As we launched our company, I found myself asking, "What the hell do I do now?"

That's when I reached out to ol’ Derek Knox to be our business mentor. My experiences with Derek likely echoed those of many others: he was constantly emphasising my "why" and the "red brain-green brain" concept, all while sharing his extensive industry knowledge, and taking time out of his busy schedule just to hear me say things like, ‘nothings really going on this month’, and ‘red brain is bad right?’.

Now, I find myself back in the WorkCover space—though this time, I'm not involved in vocational work—and I'm thoroughly enjoying it.

If you’ve made it this far, thank you very much for your time, but let’s finish up with 2 truths and a lie, feel free to email me your answers:

I hid on a plane, causing a lot of problems, when I was 5yrs and travelling alone from Sydney to Hobart.
I was shipped off to military boarding school in Sydney for 9 years.
I caused $40,000 worth of damage to a hotel because I left the kitchen sink tap on.

Rowan Dicks

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ QLD

The Story of a Fork and a New Beginning

Mon, 14 Oct 2024 07:36:24 GMT

At Absolute Balance, we have a rather unique tradition: every new team member receives an engraved fork upon joining the company. Now, you might wonder—why a fork? Well, it all started in our old office, where forks seemed to vanish mysteriously. No one could ever figure out where they went, and instead of solving the mystery, we decided to turn it into a fun tradition. To make new staff feel welcome (and to ensure they always had their own cutlery!), we started gifting everyone a personalised fork.

When I officially joined the team (and decided to move from Perth to Sydney), I was entrusted with a special mission: delivering the engraved fork to another new team member in Sydney. This fork, however, was no ordinary utensil—it had already racked up some serious miles. Initially flown from Perth to Sydney, it missed its delivery and was flown back to Perth. Now, I was tasked with bringing it back to Sydney by car—making it the most well-travelled fork in Australia!

After completing my university practicum placement with the Perth team as part of my exercise physiology degree, I was eager to take on a new challenge and grow within the company, so I applied for a role with the New South Wales team. I was thrilled when I got the position. This move marked a significant step in my career—transitioning from a student to a fully-fledged exercise physiologist, ready to make a positive impact on the health and wellbeing of my clients. The long journey from Perth to Sydney, with the engraved fork in tow, became symbolic of this exciting new chapter in my life.

Day one took us from Perth to Norseman, and it began with a flat tire—maybe not the ideal start, but we were determined! Feeling a mix of excitement and hope about my new career, I was ready to tackle the journey. And honestly, by the time we hit the road, this fork had more travel points than most people.

The drive across the Nullarbor Plain was a test of patience, but it also highlighted the vastness and beauty of the Australian landscape. Somewhere along the 90 Mile Straight, the clutch on the car started acting up—because every epic journey needs a bit of drama, right? We nursed the car all the way to Border Village, a roadhouse just over the South Australian side where the roadhouse staff were amused by the story of the well-travelled fork.

As we continued, we stopped in Kimba, a charming little town in the heart of Australia. It was here that the fork got its own ‘midway point’ photo-op, with Kimba’s beautiful silo art providing the perfect backdrop. The town’s community vibe and warm welcome were exactly what I needed as I adjusted to the idea of leaving my old life in Perth behind and embracing this new adventure.

After a quick pit stop in Port Augusta to fix the clutch (thankfully, the car made it!), we continued our journey through vineyard country along the Murray River and into Victoria. Having coffee by the river, watching the sun rise and set, and knowing that I was getting closer to my new home was a beautiful experience. The last night on the road was spent in Wagga Wagga, where the rain finally caught up with us. As we camped out in the wet and chilly weather, I laughed at the thought of the fork enduring all these adventures, from the outback to the vineyards and now to a rainy campsite. Despite the weather, we stayed cozy in our swag, and the fork was safe and dry, ready for its final destination.

Arriving in Sydney felt like a milestone—not just for me but for the fork, too. It had travelled thousands of kilometres and was finally ready to meet its new owner. It was an exciting moment to hand it over, symbolizing the beginning of a new chapter for both of us.

Starting my new role as an exercise physiologist with Absolute Balance has been an incredible experience. After meeting the Sydney team, I felt a strong sense of belonging and support. Having spent time with the Perth team during my practicum, I knew I was joining a company that valued honesty, integrity, teamwork, and empathy—values that I hold close to my heart as I embark on this new journey to make a positive impact in the lives of my clients.

This journey was more than just a road trip; it was a personal and professional adventure that taught me the value of resilience, adaptability, and finding humour in unexpected situations. As I settle into my new role, I’m excited to apply these lessons in my work, supporting my clients and helping them reach their health and fitness goals. So, next time you see someone in our team with an engraved fork, you’ll know the story behind it—and you’ll know about the one fork that travelled further than any other.

April Hawser

Exercise Physiologist

Exercise Rehabilitation Services – NSW

The Healing Power of Hydrotherapy: Benefits You Need to Know

Tue, 24 Sep 2024 00:47:52 GMT

Hydrotherapy, or water therapy, has been used for centuries as a natural way to promote healing and well-being. From ancient Roman baths to modern spa treatments, the therapeutic effects of water have fascinated many. Today, more people are turning to hydrotherapy for its numerous physical and mental health benefits, particularly in the rehabilitation world. Let’s dive into some of the key benefits of incorporating hydrotherapy into your rehabilitation.

1. Pain Relief and Muscle Relaxation

The most significant benefit of hydrotherapy is its ability to alleviate pain and relax muscles. Warm water can increase blood circulation, which helps reduce inflammation and soreness in the muscles and joints. This makes hydrotherapy particularly beneficial for individuals suffering from musculoskeletal injuries.

2. Improved Mobility

Hydrotherapy can enhance mobility, especially for those recovering from injuries or surgeries. The buoyancy of water reduces the weight placed on joints, allowing for easier movement and a greater range of motion. Exercises performed in water can strengthen muscles without the risk of strain, making it an excellent and safe option for rehabilitation.

3. Stress Relief and Relaxation

Water has a calming effect on the mind and body, making hydrotherapy an effective way to manage stress and anxiety, which increase when injuries are sustained. Soaking in warm water or engaging in gentle water exercises can promote relaxation and a sense of well-being.

4. Enhanced Circulation

The warmth of hydrotherapy can stimulate blood flow, promoting better circulation throughout the body. Improved circulation can aid in the delivery of oxygen and nutrients to tissues while also facilitating the removal of toxins. This boost in circulation can be especially beneficial for individuals with circulation issues or those recovering from injury.

5. Support for Weight Loss and Fitness

Hydrotherapy can be an effective addition to a weight loss or fitness regimen. Water resistance makes exercises more challenging, helping to build strength and endurance without placing excessive stress on the body.

6. Social Interaction and Community Building

Participating in hydrotherapy classes or group sessions can foster social connections and support. Engaging in activities with others can enhance motivation and accountability, making it easier to maintain a consistent wellness routine. The sense of community often found in hydrotherapy settings can also contribute positively to mental health.

Conclusion

Hydrotherapy is an adaptable and accessible therapeutic option that offers a range of benefits for both the body and mind. Whether you’re looking to alleviate pain, enhance mobility, or simply relax, incorporating water therapy into your routine can lead to significant improvements in your overall well-being.

As always, it’s essential to consult with a healthcare professional before taking the plunge into a new exercise, especially if you have an underlying health condition.

Caitlin Chase

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Having trouble sleeping because of pain?

Fri, 23 Aug 2024 01:56:51 GMT

There are many factors that can interfere with a good night’s sleep – whether it is from work stress, or family responsibilities to illnesses. Improving sleep when you’re in pain can also be challenging, and it is no surprise that quality sleep is sometimes elusive. However, there are several strategies that can help manage pain and promote better sleep quality:

Relaxation Techniques:

Deep Breathing: Practise deep breathing exercises to help relax your body and mind. Mindfulness and Meditation: Engage in mindfulness or meditation practices to reduce stress and improve overall sleep.

Sleep Environment:

Comfortable Mattress and Pillows: Ensure your mattress and pillows provide adequate support. Temperature Control: Keep your bedroom cool, dark, and quiet.

Pain Management:

Medications: Consult your family GP about management strategies or pain relief medications that are suitable for nighttime use. Heat and Cold Therapy: Apply heat and cold packs to the affected area before bed.

Sleep Hygiene:

Consistent Schedule: Go to bed and wake up at the same time everyday where possible. Wind-Down Routine: Develop a relaxing pre-sleep routine, such as reading, taking a warm shower, or practising gentle yoga. Limit Screen Time: Avoid screens at least an hour before bed to allow the production of melatonin, keeping the brain calm and making it easier to fall asleep.

Lifestyle Adjustments:

Physical Activity: Engage in regular physical activity. The more active you are, the more your body pushes you to sleep at night.

Diet: Avoid large meals, caffeine, and alcohol before bed.

Hydration: Stay hydrated, but limit fluids in the evening to reduce nighttime awakenings.

By integrating these strategies, you can create a more conducive environment for sleep and manage pain more effectively. Sleep is essential for optimal health and exercise is one of the best ways to boost your sleep quality.

There is no right or wrong time to work out, whether you do it in the morning, noon or evening, aim at least 30 minutes of physical activity per day in a way that makes you feel good. Not sure how to start? Consult a healthcare professional or your nearest exercise physiologist about starting an exercise programme that is tailored to your goals.

Haseef Salim

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Olympic athletes rehab vs everyday rehab

Mon, 19 Aug 2024 03:02:29 GMT

When we watch Olympic athletes achieve incredible feats, it’s easy to focus solely on the individual. After all, it’s the athlete who stands atop the podium, receiving the medal. However, behind every Olympic champion is a support team—coaches, medical practitioners, allied health professionals, mental health experts, and family members—whose contributions are crucial to the athlete’s success. The existence and importance of these teams remind us of the value of support networks in every aspect of life, including the process of returning to work and life after an injury.

The Role of Support Teams in Olympic Success

Olympic athletes are extraordinary, but they do not reach the pinnacle of their sports alone. A coach tailors training programs and strategies, guiding the athlete through physical and technical development. Health professionals, including Exercise Physiologists, Physiotherapists and Sports Doctors, ensure the athlete’s body can withstand the rigors of elite competition. Nutritionists design meal plans that fuel peak performance, while sports psychologists help athletes maintain mental resilience under immense pressure. Family members, friends as well as the aforementioned health professionals provide emotional support.

This multifaceted support system ensures that athletes can focus on their performance while knowing they have experts taking care of everything else. The synergy of these different roles creates an environment where athletes can thrive, recover from setbacks, and ultimately succeed.

Parallels to Everyday Life: Returning to Work After Injury

The concept of a support team isn’t just for elite athletes; it’s equally important in everyday life, especially when someone is recovering from an injury and preparing to return to life and work. An injured person, much like an athlete, faces physical, mental, and emotional challenges. Having a comprehensive support system can make a significant difference in their recovery and integration to their usual life.

In the context of returning to work, the support team will include healthcare professionals, rehabilitation experts (Exercise Physiologists), workplace rehabilitation services, friends and family members. Each plays a vital role:

1. **Healthcare Professionals**: Doctors and Specialists assess the injury and create a tailored recovery plan. They monitor progress, making adjustments as needed, and provide the necessary medical treatments to aid recovery.

2. **Rehabilitation Experts**: These professionals, such as Exercise Physiologists and Physiotherapists, work with the injured worker to design tailored exercise programs to reduced symptoms, restore physical mobility, and function for life and work.

3. **Workplace Rehabilitation Providers**: Employers and independent organisations play a crucial role by ensuring the worker feels supported during their transition back to work. This could involve modifying job responsibilities, offering flexible hours, or implementing a gradual return-to-work plan. Open communication between the worker and workplace rehabilitation providers is essential to ensure that the worker’s needs are met.

4. **Friends and Family**: Emotional and psychological support from loved ones can’t be underestimated. They provide encouragement, help maintain a positive outlook, and offer practical assistance in day-to-day life.

The Importance of a Holistic Approach

Both Olympic athletes and injured workers benefit from a holistic approach to support. Just as an athlete’s success is not solely about physical prowess, an injured worker’s recovery is not just about physical healing. Mental and emotional well-being are equally important, and a strong support team can address all these areas.

In both cases, the presence of a support network helps the individual stay focused, motivated, and resilient in the face of challenges. Whether striving for Olympic gold or returning to work after an injury, having a dedicated team can make all the difference. By surrounding ourselves with the right support, we can all achieve our personal best, regardless of the obstacles we face.

Hadyn Sleeman

Regional Manager (B.Sc (Physio), Dip. L & M)

Lengthened partials, the latest training concept

michael.andrews@absolutebalance.com.au (Michael Andrews) — Mon, 05 Aug 2024 03:10:57 GMT

THE GROWING EVIDENCE AROUND ‘LENGTHENED PARTIALS’ AND THE BENEFITS THEY CAN PROVIDE TO GYM-GOERS

As the field of sport science advances, there are numerous amounts of research studies being published daily. Over the past year, a new training concept has gained some traction in the fitness world, and it’s referred to as ‘lengthened partials. Whether you’re an athlete, allied health professional or even just a general gym-goer, learning about this type of training can provide your body with a different muscle building stimulus and also give you a different approach to your training.

Lengthened partials stem from using partial range of motion (ROM) during an exercise. Partial ROM can be done at short muscle lengths, for example on a bicep curl, working from the top of the curl, down to 90 degrees and back up. However, partial range of motion can also be done at long muscle lengths, for example on the same bicep curl, working from the bottom of the curl, up to 90 degrees and back down – this is essentially what ‘lengthened partials’ are.

Initial research on this topic came from an article in 2021 which measured participants muscle hypertrophy (increase in muscle mass) on the leg extension when doing either full ROM or partial ROM on the exercise. The study concluded that participants who did partial ROM during the exercise had higher levels of muscle hypertrophy than participants who did full ROM. Another study in 2023, saw an increase in calf muscle hypertrophy when performing ‘lengthened partials’ instead of full ROM on a calf raise exercise.

How is this possible?

While it’s hard to exactly pinpoint what is causing these adaptations, past studies have shown that muscle strength and mass increases when tension is applied directly to the muscle.
Therefore, experts believe, when training at longer muscle lengths (and performing lengthened partials), it provides the muscle with the most amount of tension possible (during the stretched position) which can therefore translate to greater muscle hypertrophy.

What does this mean for you?

While lengthened partials have shown positive results thus far, it shouldn’t be seen as a complete replacement for full ROM training.
Having complete muscle contraction during your exercises provides its own benefits but lengthened partials can be included as a different sort of stimulus.
Next time you're in the gym, have a go with doing your set at full range of motion and then as you started to fatigue, switching to partial range of motion at the lengthened position to finish the exercise.

What if I’m injured?

In the field of exercise rehabilitation, lengthened partials become even more important.
When someone is injured, they may experience more pain and discomfort during the peak contraction of an exercise.
Therefore, by implementing lengthened partials into your rehabilitation program, you can still achieve great muscle stimulus and hypertrophy while also limiting some of the range of motion that could be causing exacerbations in pain levels.

While lengthened partials still require more research, they are showing positive signs for muscle-building enthusiasts. Next time, you find yourself injured or just getting bored of your usual gym program – try out lengthened partials and see how you find it. As always, if injured, ensure you consult with a qualified health professional before attempting the above training method.

Nick Del Borrello

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Can Exercise Benefit a Traumatic Brain Injury?

Fri, 26 Jul 2024 01:04:16 GMT

A traumatic brain injury (TBI) is a form of acquired brain injury usually occurring when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and/or violently hits an object or if an object pierces the skull and damages brain tissue, examples include car accidents, sports injuries and in the case of one of my patients falling off a horse. Symptoms of a TBI can differ drastically depending on the extent of the damage to the brain, they can range from light headaches, dizziness and blurred vision to memory loss, seizures, slurred speech and weakness of the extremities.

With such an array of symptoms categorising a TBI it begs the question: can exercise benefit those who suffer with such an injury considering it all stems from the brain? A brain injury is quite different from a broken bone or torn muscle, which can be addressed much easier and generally has a much shorter recovery timeframe. There are many complicated processes occurring that control our thoughts, emotions, and bodily functions and with traumatic brain injury patients, we must treat the patients physical brain damage but also account for their cognitive/emotional side effects

Studies have demonstrated that there is the potential for exercise to improve cognitive impairment , mood disorders, and post-concussion syndrome following TBI as well as general quality of life depending on the exercises that are prescribed for each patient.

While the individual may have the fear of worsening symptoms through exercise, what they may not know is that if patients don’t exercise, it can increase the risk of weight gain, depression, cardiovascular disease, or quitting positive habits they used to enjoy.

Appropriate prescription by an accredited exercise physiologist is critical for the management of symptoms, but this allows us to be very creative to individually adapt exercises across multiple modalities of exercise such as; balance, strengthening, flexibility, cardiovascular fitness and even cognitive exercises.

Strengthening

Strength training helps develop the body’s major muscle groups, thus promoting overall body strength. Additionally, this type of training encourages bone growth, manages weight and stress, and improves posture and balance.

· Bicep Curl

· Sit to Stand

· Seated Exercises

Balance

Balance is crucial to maintain for patients recovering from TBI. Balance training helps you improve your body agility, coordination, and muscular strength. Additionally, improving balance reduces your risk of falling.

· Single Leg Balance

· Weight Shifts

· Tandem Walking

Cardiovascular

Cardiovascular exercises are workouts meant to increase the heart rate and respiration, thus strengthening the heart muscles and lung capacity. It also helps raise the oxygen levels in the body, keeping the blood circulation and the body’s systems healthy.

· Cycling

· Walking

· Step Ups

Flexibility

Flexibility workouts enhance your range of motion and develop joint strength and muscle abilities. Furthermore, regular flexibility training can help prevent muscle stiffness, ataxia, and spasticity, which are all common problems of TBI patients.

· Shoulder/Neck Stretching

· Hamstring/Quadriceps Stretching

· Lower Back Stretching

Cognitive

Just as you can improve muscle function through rehabilitation exercises, you can improve cognitive function through cognitive exercises.

· Journal or Creative Writing

· Puzzles

· Cognitive Therapy Games

References

NeuLifeRehab1 (2022) Why exercise is important in the rehabilitation of brain injury patients, NeuLife. Available at: https://neuliferehab.com/why-exercise-is-important-in-the-rehabilitation-of-brain-injury-patients/ .

Traumatic brain injury (no date) National Institute of Neurological Disorders and Stroke. U.S. Department of Health and Human Services. Available at: https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury .

Zhang, Y. et al. (no date) The benefits of exercise for outcome improvement following traumatic brain injury: Evidence, pitfalls and future perspectives, Experimental Neurology. Academic Press. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0014488621003666 .

Can exercise help with traumatic brain injury treatment?: Brain: UT southwestern medical center (no date) Brain | UT Southwestern Medical Center. Available at: https://utswmed.org/medblog/tbi-exercise/ .

Kai Baxter

Workers Compensation Specialist ‑ Team Leader NSW (AEP, ESSAM)

Exercise Rehabilitation Services – NSW

Protect your brain through exercise

Wed, 17 Jul 2024 00:27:39 GMT

I don’t know about you, but every week I see a news headline telling me that I'm slowly destroying my brain and cognitive function. Whether it’s through prolonged social media use, lack of sleep, or eating the wrong foods, it seems like I just can’t win.

Something I never see in these posts is evidence-based solutions on how to prevent this decline. As an accredited exercise physiologist, I'm in a perfect position to be able to share what I believe is the easiest, most cost effective, and important neuroprotective intervention, EXERCISE! Below are 5 points that I think everyone should know, when it comes to how to protect our brains through exercise.

1. Can exercise really help my brain?

Yes, it can! Exercise has been proven to not only improve mood, memory, and attention span, but also provides positive physical changes to the brain. Exercise can create new brain cells and neural pathways and is one of the most transformative things that someone can do for their brain.

2. What type of exercise is best?

Any type of aerobic activity that increases heart rate. This can include walking, running, team sports, swimming, cycling, stair climbing and many more. If your heart rate is increasing, you’re doing the right thing.

3. How much exercise should I do?

I like to think of this in a very simple way, every drop of sweat counts. The more physically active we are, the more benefits we will see, and there is currently no researched limit to this. With, general recommendations are 30-45 minutes of moderate aerobic exercise, 2-4 times per week.

4. What is the minimum amount of exercise I can do to see benefits?

Just one workout will release chemicals which will improve your mood, decrease stress levels and improve your attention span in the hours following your workout. For long term benefits, the lower end of the guidelines mentioned above are a good place to start.

5. Is it too late to start?

While it’s true that the longer you’re physically active for in your lifetime, the better outcomes you’ll get, it’s never too late to start! There’s some great research that’s shown that people who begin walking later in life still have a significant reduction in developing Alzheimer's dementia disease, along with all the other benefits that walking brings to your body.

If you have any health conditions that may impact on your ability to perform exercise such as a heart condition, it’s best to consult with your general practitioner before commencing.

Brody Kilbey

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Chicken noodle soup saves the day

Fri, 12 Jul 2024 00:52:21 GMT

With cold and flu season underway, a bowl of chicken noodle soup with garlic can be a comforting and beneficial remedy. This classic soup not only warms you up but also offers numerous health benefits and in combination with some light exercise, and plenty of hydration you’ll be back feeling healthy in no time.

Chicken noodle soup is packed with nutrients and the broth provides hydration, helping to keep you well-hydrated, which is crucial when you're sick. The chicken offers protein, which is essential for the immune system to repair and build new cells. Vegetables in the soup provide essential vitamins and minerals, further supporting your recovery.

Adding garlic to the soup enhances its health benefits. Garlic has natural antibacterial and antiviral properties, which can help your body fight off the cold or flu virus more effectively. It contains a compound called allicin, known for its immune-boosting effects. Garlic also acts as a decongestant, helping to relieve the stuffiness associated with colds and flu.

While lying in bed and eating soup may be the only thing you feel like doing when you are sick, engaging in light to moderate exercise when you have a cold or flu can offer several benefits. Gentle activities like walking, stretching, or yoga can help boost your immune system by promoting better circulation, which can aid in the faster movement of immune cells throughout your body.

Exercise can also enhance your mood by releasing endorphins, which can help combat the lethargy and malaise often associated with illness. Additionally, physical activity can help clear nasal congestion and improve your respiratory function, making it easier to breathe.

If you are unlucky and fall victim to the common cold or flu, remember to drink plenty of water, try to do some light exercise and ensure you do get plenty of rest.

Links:

https://www.recipetineats.com/homemade-chicken-noodle-soup-from-scratch/

Peter Webster

Workers Compensation Specialist ‑ Team Leader North East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Core Beliefs

Wed, 26 Jun 2024 01:16:29 GMT

Your core. A simple phrase with a surprisingly varied degree of understanding, definitions and misinformation. To some it is the muscles in your abdomen or tummy area, the ones that stabilise your trunk and form that iconic 6-pack of abs. To some it has layers, deep core, superficial core, pelvic floor. To others it follows the idea of the anatomy trains and spiral lines.

Whatever your definition these are usually identified as the muscles that must be worked and strengthened to reduce back pain. A strong and stable core equals less back pain and less back injuries. This is a statement I have come to loath over time. It is not that this statement is necessarily incorrect, rather the way it is educated to patients and the way it is implemented to treat back pain. I prefer; a mobile core leads to healthier movement patterns and reduce back pain.

Our spines are designed to move. It is not a rigid pole but a series of small parts that make up a whole which work together to twist and bend and rotate around themselves. Often, I will see core training implemented in a way that holds minimal value to a person’s day to day movements. Hold a plank, lie on your back and crunch, keep a straight back while you squat or lift a weight from the floor. All lines I’m sure have heard before and many of us, including myself, have used before.

A strong, stable and rigid core is not as meaningful as a mobile core. A mobile core being strong and controlled through movement. A heavy focus on core training where positions are held or repetitive movements to contract the muscle can actually increase back pain. The reasons for this come from the patient feeling the need to tense their abs throughout the day and close the space between their ribs and pelvis. The patient then has increased abdominal pressure and limits their movement throughout the day being more rigid – negative movement patterns.

Core muscles should be included as a part of whole body. Core vs the rest is a mentality that trivialises the body and can inhibit recovery while leading to adoption of negative movement patterns. The core is interconnected with the rest of the body and should be treated as such. With regards to lower back pain, there are many other know contributing factors. Especially non-specific lower back pain (NSLBP) which accounts for an overwhelming majority of back pain, up to 90% of cases depending on your source of reference. Psychological and Psychosocial factors play a large role in recovery of these injuries and conditions. An incredibly important aspect of treatment and one that is worth mentioning but a topic for another day.

I challenge you to explore lifting through movements that are not “textbook.” Remember we work with patients, not competing athletes who must stick to strict rules (although sometimes these do align). Squat with flexion, lift with imbalanced weights and encourage twisting. As with any exercise start simple, start small and build up to heavier and larger movements as your patient progresses.

Cameron Addison

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

How to Apply Effective Communication Skills for the Injured Worker

michael.andrews@absolutebalance.com.au (Michael Andrews) — Fri, 21 Jun 2024 02:06:04 GMT

Within the Workers Compensation industry, communication skills between all stakeholders are key, however, communication to the injured worker is essential to achieve the best possible outcome and return them back to their lives. Applying these skills is important to ensure that the injured worker is engaged in their treatment and empowering to self-manage their injury. Despite this, there are certainly barriers to effective communication.

Effective Communication

Effective communication requires honesty and openness combined with mutual respect. Giving good information through successful communication is important to achieve client goals. There are three types of communication which we need to be mindful of.

Visual (body language)
Verbal (words)
Vocal (tone of voice)

Non-verbal communication can be a major component to deliver the ‘true’ message. Non-verbal communication includes body language and tone. There are 4 types of non-verbal communication.

Facial expressions
Eye contact
Posture
Gestures.

Barrier to Communication

There are often multiple barriers to communication between the treating exercise physiologist and the injured worker. This is often called ‘noise’ which may create a communication gap and that the message being heard is often far different than what was intended. Examples of ‘noise’ is inclusive of, receiving a notification on your phone/smart watch, looking at your computer or device, people watching, personal perception or judgement, other thoughts (e.g. “did I remember to empty the dishwasher at home?”).

These are just some examples of ‘noise’, however, being present and an effective listening is vital to make the injured worker feel heard during their recovery.

Effective Listening

According to MindTools.com there are five key techniques to being an effective listener.

Pay Attention – this seems simple, but often during busy lifestyles lead to us not being present when someone is talking.
Show that you are listening – e.g. nodding your head.
Provide feedback – responding to their comment or question.
Defer judgement – as humans, we continue to constantly judge people. Our own personal morals or values can get in the way of really hearing what the other person is saying,
Respond appropriately – true effective listening is a model of respect and understanding. Asking questions throughout an initial assessment or ongoing treatment keeps the worker engaged and felt heard.

Better Questioning Skills

Questioning is vital to effective communication. This involves seeking information via layering different types of questions and responding to their question with a response.

Closed questions give you facts, they’re easy and quick to answer and they keep control of the conversation with the person doing the questioning. The first word of the question sets up the dynamic of the closed question. These are words like: do, would, are, will, if (Changing Minds.org, n.d)

Open questions deliberately seek long answers but also get the worker to think and reflect, provide opinions or feeling, plus hand control of the conversation to the respondent. Open questions begin with words such as: what, why, how, describe.

Example:

Closed question: Are you inactive because of your injury?

Open question: Describe to me your current activity levels because of your injury?

To conclude, effective communication skills can help you avoid conflict or misunderstanding. It can positively impact your rapport with the injured worker, to make them feel heard and understood and more importantly, improve their outcome with their injury. Effective communication is a skill to be learnt and practiced. Adopting these techniques and understanding the barriers to communication will ultimately engage your injured worker in your treatment and allow them to be heard and understood.

References:

Mind Tools, nd.. Active Listening – Hear what people are really saying. (Online) Available at: https://www.mindtools.com/az4wxv7/active-listening
Changing Minds.org, n.d. Open and Closed questions. (Online) Available at: https://changingminds.org/techniques/questioning/open_closed_questions.htm

Joel Skinner

Workers Compensation Specialist – Team Leader North-West (AEP, ESSAM)

Exercise Rehabilitation Services - WA

Socks 4 Docs – Support Doctors’ Mental Health

Thu, 13 Jun 2024 03:30:00 GMT

I’m wearing my green and yellow kangaroo socks to work. It’s a bit of an odd pairing with suit pants, but I’m doing it to support Crazy Socks 4 Docs. This day is something that I had never heard about before joining Absolute Balance, but it has been held on the first Friday of June every year since 2017 to raise awareness and attempt to address the stigma around mental health in doctors.

A report published by Beyondblue explained that doctors reported substantially higher rates of psychological distress and suicidal thoughts compared to both the Australian population and other Australian professionals. The difference in the level of very high psychological distress was most noticeable when it looked at a population that was aged 30 years and below. Within this population, 5.0% of male and 6.6% of female doctors were classified as having very high levels of psychological distress, compared to 1.6% of males and 3.4% of females in the general population, and 0.4% of males and 0.6% of females that worked as other professionals.

So how can we support this amazing cause? The Socks 4 Docs website details 3 simple steps that we can all follow:

Step 1: Find some really crazy coloured socks and put them on.
Step 2: Take a photo of those socks or you in those socks.
Step 3: Post the photo on social media and use the hashtag #crazysocks4docs

It’s important to always check in with your friends and family to have the important conversations that might not be easy but could save a life, and support is always available. Please see the link to the lifeline Australia website below. Participating in Crazysocks4docs and taking a first step towards making a difference is that easy! So, get out your wackiest socks and your phone’s camera, and get posting to make a difference for doctors’ mental health!

References:

- crazysocks4docs.com.au

- Lifeline Australia - 13 11 14 - Crisis Support. Suicide Prevention.

Jordan Greenwood

Workers Compensation Specialist (AEP, ESSAM)

Active Ageing

Fri, 31 May 2024 03:29:30 GMT

It’s no secret that with age, comes a higher risk of health complications. Ageing includes the inevitable degression of bone density and muscle mass along with an increase in risks of adverse events such as heart attacks and stroke. So, what can we do about it?

Exercise has been shown to prolong the onset of neurological and psychological changes that come with aging. Specifically, 150 minutes of moderate intensity exercise is considered the guideline that Australians need to be reaching to maintain good health, fitness and wellbeing. This is known as ‘active ageing’. Participating in exercise has also been proven to lower the risk of cardiac events such as strokes and heart attacks. By regularly participating in exercise this can prolong the breakdown of muscle and can help to maintain and improve strength. In addition to the physical health benefits of exercise, it can also help regulate mood, improve sleep and improve symptoms of anxiety and depression.

There are many different modes of exercise, including some you can do at home! Examples of some home exercises you can do at home include bodyweight strength training, brisk walking/jogging/running, yoga, Pilates and more.

References:

Ciumărnean, L., Milaciu, M. V., Negrean, V., Orășan, O. H., Vesa, S. C., Sălăgean, O., Iluţ, S., & Vlaicu, S. I. (2021). Cardiovascular Risk Factors and Physical Activity for the Prevention of Cardiovascular Diseases in the Elderly. International Journal of Environmental Research and Public Health, 19(1), 207. https://doi.org/10.3390/ijerph19010207

ESSA. (2021). Pre-Exercise Screening Systems. Www.essa.org.au . https://www.essa.org.au/Public/ABOUT_ESSA/Pre-Exercise_Screening_Systems.aspx

Exercise and aging: Can you walk away from Father Time . (2014, March 9). Harvard Health. https://www.health.harvard.edu/staying-healthy/exercise-and-aging-can-you-walk-away-from-father-time#:~:text=Exercise%20boosts%20the%20HDL%20(%22good

hunterrehab. (2021, January 28). Healthy Ageing What is it? and How can I do it? Hunter Rehabilitation & Health. https://www.hunterrehab.com.au/healthy-ageing-what-is-it-and-how-can-i-do-it/

Embracing Carbohydrates

Wed, 29 May 2024 05:34:33 GMT

Why Keto Might Not Be the Right Fit for Everyone

In the ever-evolving landscape of diet trends, one approach has gained substantial traction: the ketogenic diet, or keto for short. It's hailed for its potential to induce rapid weight loss and improve certain health markers. However, amidst the hype for high-fat, low-carb eating, the role of carbohydrates often gets sidelined. Let's delve into why carbohydrates are essential for a balanced diet and why an elimination diet like keto may not be suitable for everyone.

The role of Carbohydrates: Fuel for the Body and Brain

Carbohydrates are often misunderstood and unfairly demonized in some diet circles. Yet, they serve as the body's primary energy source, fuelling everything from basic bodily functions to high-intensity workouts. Glucose, derived from carbohydrates, powers our brain, muscles, and vital organs. Without an adequate intake of carbohydrates, our energy levels can plummet, leading to fatigue, brain fog, and compromised physical performance.

Moreover, carbohydrates come in various forms, each offering unique benefits. Whole grains, fruits, vegetables, and legumes are rich in fibre, vitamins and minerals. Fibre, in particular, supports digestive health, regulates blood sugar levels, and promotes satiety, aiding in weight management and reducing the risk of chronic diseases like heart disease and type 2 diabetes.

Why Keto Might Not Be the Answer for Everyone

While the ketogenic diet has garnered praise for its effectiveness in weight loss and certain health conditions like epilepsy, it's not a one-size-fits-all solution. Here are some reasons why the keto diet might not be suitable for everyone:

Nutritional Imbalance: Keto severely restricts carbohydrate intake while promoting high fat consumption. This can lead to an imbalance in macronutrients, potentially depriving the body of essential vitamins, minerals, and antioxidants found abundantly in carbohydrate-rich foods.
Difficulty Sustaining: The restrictive nature of the keto diet makes it challenging for many individuals to adhere to long-term. Social situations, dining out, and even family meals can become sources of stress and temptation, leading to feelings of deprivation and ultimately, diet abandonment and binge eating.
Potential Health Risks: While short-term studies suggest benefits, the long-term effects of sustained ketogenic dieting remain uncertain. High intake of saturated fats, common in keto-friendly foods like butter, bacon and sausages may increase the risk of heart disease and other health complications over time.
Lack of Individualization: Every person's nutritional needs and metabolic responses vary. What works wonders for one individual may prove detrimental to another. Adopting a rigid, one-size-fits-all approach like keto overlooks this crucial aspect of dietary customization.
Impact on Physical Performance: Carbohydrates play a pivotal role in supporting athletic performance, particularly during high-intensity exercises. Endurance athletes, in particular, may struggle to meet their energy demands on a low-carb diet, leading to decreased performance and recovery.

Having Balance

Rather than demonizing entire food groups, a balanced approach to nutrition emphasizes variety, moderation, and individualization. Carbohydrates, when sourced from wholesome, nutrient-dense foods, form a crucial component of a healthy diet. Incorporating whole grains, fruits, vegetables, and legumes provides a wealth of essential nutrients while promoting satiety and overall well-being.

Instead of chasing quick fixes or succumbing to dietary extremes, focus on forming a sustainable eating pattern that nourishes your body. Consult with a qualified health profession to develop a personalised nutrition plan that aligns with your goals, preferences, and lifestyle.

In conclusion, while the ketogenic diet may offer short-term benefits for some individuals, its restrictive nature and potential health risks warrant careful consideration. Embracing carbohydrates as part of a balanced diet not only fuels our bodies and minds but also promotes long-term health and vitality.

Sean Young

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Walking for health and longevity

Thu, 16 May 2024 09:52:02 GMT

A recent study investigated how the number of steps we walk each day affects our chances of living longer. Researchers completed a meta-analysis (collecting many studies and looking at the combined results), that measured step counts and compared it to people's all-cause mortality (risk of dying from any cause). They looked at seven trials with over 28,000 individuals and discovered that for every 1,000 extra steps completed each day, the all-cause mortality rate fell by around 12%.

They also investigated if factors such as the location of the research or the age of the participants affected the results, they found no statistically significant differences. Taking more steps generally reduces your chance of death. Walking 16,000 steps per day was associated with a 66% lower risk of all-cause mortality when compared to walking only 2,700 steps. To put it another way, walking only 2,700 steps per day was linked to a 3x increased risk of death compared to walking 16,000 steps.

Before leaping to conclusions, keep in mind that just because those who walk more tend to live longer doesn't mean that walking directly makes you live longer. It's possible that healthy people are naturally more active. However, some other studies have shown that even moderate walking programs can benefit a variety of health indicators, once again implying that walking more may help you live longer.

In the meta they also compared some well-known causes of all-cause mortality, smoking and obesity against walking. It was surprising to see that walking only 2,700 steps a day had a greater effect on mortality with a 200% increased risk, than smoking or even obesity at 70-80% increased risk and 74% increased risk at a 40 BMI respectively.

So, while going to the gym, lifting weights and doing classes to staying healthy is defiantly beneficial, this study emphasises the value of simply moving more in your daily life. Even if you have a busy schedule or live in an area that is not conducive to walking, finding strategies to increase your daily steps could lead to a longer, healthier life.

References:

Leuphρων, R. (2014, August 11). How many steps/day are enough? For adults. PubMed (original PMID: 21798015, PMCID: PMC3197470, DOI: 10.1186/1479-5868-8-79)

A 3-Minute Snapshot of a Move Across the Country

Fri, 10 May 2024 00:31:21 GMT

“Failure is a bend in the road, not the end of the road. Learn from failure and keep moving forward.”

Roy T. Bennett

Hypothetically, if I asked you to move to the other side of the country, to a new landscape, new work environment, and to the unknown, what would your answer be?

In August 2023, I answered “F**k, yes”, and I want to take you through a journey of learnings, maturity, and growth that only saying “yes” can get you.

Fast forward to the 15 ^th of October 2023, after packing a sea container with belongings, selling my car, and booking a one-way flight to Brisbane, Queensland, I was set. With all the back-end tasks out of the way, I was taking off to what was about to become the most uncomfortable (and horrifying) period of my life.

Different city, different lifestyle unfamiliar people, even more unfamiliar landscapes, more responsibility, more opportunities. These were the thoughts rushing through my head while on a one-way trip to my next chapter. And it didn’t take long before the wheels were turning, and I was finding my feet, well, only as quickly as one can after venturing into their uncomfortable.

I was thrusted into a new and exciting work environment, with an opportunity to build brand and self-awareness in a new state and legislation. I very quickly realised that I was so far out of my comfort zone, that I wasn’t even sure what zone I was in anymore. “Where do I start? What do I do? Who do I speak to?” Are all rationale thoughts to have, and looking back now, I can safely say that I felt out of my depth, lost, and overwhelmed with the road ahead.

Through the motion of failure, and my not so successful trials, I have become far more resilient, confident, mature, I have learnt not to fear rejection but embrace it, I have adopted a mindset where “no” is a conversation starter, not a finisher. Through all this my ability to treat clinically, build relationships, and produce positive outcomes has improved.

The journey has been challenging, but so incredibly worth it. I am becoming more comfortable with the uncomfortable and I wouldn’t have changed a thing.

Lachlan Simpson

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ QLD

We live in a 3D world, it's time to start training that way!

Wed, 24 Apr 2024 01:48:40 GMT

The human body is designed to move in a three-dimensional plane divided into the following segments:

Sagittal Plane: Cuts the body into left and right halves. Forward and backward movements.
Frontal Plane: Cuts the body into front and back halves. Side to side movements.
Transverse Plane: Cuts the body into top and bottom halves. Twisting/rotational movements.

Too often we get caught training mostly in a sagittal plane, think running, squats, bicep curls etc. While these are all good exercises, in day-to-day life we don’t only move along a sagittal plane. What happens when you need to quickly get out of the way of the e-scooter flying towards you on the foot path or make a quick sidestep to avoid a pothole – these movements are along the frontal plane. While movements such as turning to check your blind spot while driving or turning to talk to the person next to us are in the transverse plane. When it comes to injury prevention and movement efficiency it is important to incorporate exercises from all planes of movement into training programs.

Sagittal

If a line ran down the middle of the body splitting it from left to right, movements parallel to this line are within the sagittal plane of movement. The sagittal plane is the most common plane of movement and is trained overwhelming more than the frontal and transverse planes of movement. Movements/exercises considered to be in the sagittal plane include running, squats, deadlifts and bicep curls.

Now while all these exercises are good, with the way our lives having evolved into many desk sitting roles, driving from place to place etc, to then go to the gym and focus heavily on movements that are predominantly up – down, and forwards – backwards we can end up reinforcing these pathways and becoming somewhat robotic, heavily limiting our natural movements.

Frontal

If a line ran down the middle of the body splitting it into front and back, movements parallel to this line would be within the frontal plane of movement – essentially any movement that involves moving away from or towards the midline. Often neglected in strength programs, frontal plane exercises include Cossack squats, lateral lunges, and side raises.

Transverse

If a line split the body in half separating it into top and bottom with the pelvis being the point of division, any movement parallel to this line would be considered to be in the transverse plane of movement. Movement along/through a transverse plane is generally more rotational such as a Russian twist or trunk twist.

By focussing largely on sagittal plane movements, we are risking developing muscle imbalances, limited mobility and uncoordinated movements in the neglected planes. Our body is designed to move on a 3-dimensional plane so make sure to train in a way that will allow it to move the way it’s supposed to.

Katie McGrath

Injury Prevention Specialist

Injury Prevention Services

Stretching and mobility benefits

Thu, 18 Apr 2024 11:31:44 GMT

Stretching and mobility exercises are indispensable components of both injury prevention and recovery strategies. Incorporating dynamic stretches before physical activity can help prepare the body for movement by increasing blood flow to muscles and enhancing joint flexibility. This dynamic warm-up routine primes the muscles and connective tissues, reducing the risk of injury during subsequent activity. Furthermore, static stretches, performed after physical activity, helps alleviate muscle tension and improve flexibility, thereby minimizing the likelihood of strains and tears.

In the realm of injury recovery, stretching and mobility exercises play a crucial role in rehabilitation protocols for individuals recuperating from various musculoskeletal injuries. Following an injury, muscles can become tight and weakened due to disuse or trauma. Gentle stretching exercises aid in maintaining or restoring flexibility, preventing muscle atrophy and contractures. Additionally, targeted mobility exercises assist in restoring range of motion and functional movement patterns, allowing individuals to gradually regain strength and flexibility while reducing the risk of re-injury.

Moreover, stretching and mobility exercises promote tissue healing by improving circulation to the injured area. Increased blood flow delivers essential nutrients and oxygen to damaged tissues, facilitating the repair process and reducing inflammation. By incorporating a comprehensive stretching and mobility routine into their regimen, individuals not only safeguard themselves against future injuries but also expedite their recovery journey, enabling them to return to their activities with greater resilience and confidence.

Mariah Adolphus

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Meet a Team Leader at AB

Fri, 05 Apr 2024 04:21:17 GMT

Hey, my name is Blake, and I am an Exercise Physiologist, Workers Compensation Specialist and Clinical Team Leader at Absolute Balance. I graduated from Edith Cowan University in 2015 after completed my Bachelor of Science (Exercise Science and Rehabilitation).

I grew up on a farm Northeast of Perth past Gingin with my parents and two brothers, both of which are back working on the farm, which has been in our family for generations. My love for sport and interest in the human body initially prompted me to complete my Bachelors in Exercise and Sports Science, and my initial thoughts on a career were either Physiotherapy or Phys Ed Teacher. However, this quickly changed when I commenced my first Exercise Physiology unit in my Sports Science degree as it opened my eyes to exercise rehabilitation, and how important it was to individuals with injuries.

Having experienced multiple injuries personally playing football (AFL), basketball and tennis, I can fully empathise with how much injuries can impact your life. Being an EP and being in a role where I can make a positive and meaningful impact on individual’s lives who have sustained an injury is extremely important to me.

This doesn’t only extend to the patients I see, but also the team members I lead within Absolute Balance. I guide a team of five in the Northeast region at Absolute Balance, assisting them with their own patients and leading them to grow as Exercise Physiologists and individuals. Although it has its challenges, leadership is extremely rewarding and has helped me grow both personally and professionally.

Whilst I am not at work, I am spending my time at the gym, at football training and games during February-September (or in the car travelling to and from comes with the gig of country football), spending time with my wife and our dog Otis. I spend the other half of my weekend manicuring my lawn and watching good shows and sports.

Blake Cocking

Workers Compensation Specialist ‑ Team Leader North East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Pain in my lower back!

Fri, 22 Mar 2024 03:15:19 GMT

Does your spine look like the picture on the left or does it look more like the one on the right?

As Exercise Physiologists, we often see all sorts of presentations of the spine and in this blog, we will be covering a condition known as ‘lordosis’. More specifically, we will be focusing on the lower or ‘lumbar’ aspect of the spine, which is where we see this condition commonly.

What is Lordosis?

Normally, the spine is naturally curved forward a little bit which helps with shock absorption and supports optimum posture but in lordosis there is an inward exaggeration of the spinal curve which can be felt on the outside as a deep dip in the lower back.

Who does it affect?

Simply put, anyone of any age group can develop lordosis and it is most seen in people who are pregnant, as a hereditary condition in children and adults with obesity or reduced bone density are at a higher risk of development of this condition.

What is the cause?

A common cause for lordosis includes poor posture as a result of weak core muscles and muscular imbalances which can be attributed to the modern-day lifestyle where we are sitting more than ever. Other causes include conditions such as osteoporosis, spondylolisthesis, kyphosis and as previously mentioned, obesity.

What are the symptoms?

An obvious symptom of lordosis is lower back pain. As you can see in the photos above, there is a higher risk of complication involving entrapment of a nerve when there is excessive spinal curvature leading to increased compression of the spinal vertebrae. Although sometimes lordosis can be asymptomatic and a person can go about their daily lives without too much of an issue, in more serious cases, those affected can potentially experience lumbar radiculopathy or sciatica, where there is compression of the exiting lumbar nerve roots and lead to symptoms which can be described as burning, tingling, radiating pain, paraesthesia and numbness in one or more uncommonly, both legs.

How is it treated by an Exercise Physiologist?

As they say, prevention is better than cure and to reduce the risk of potential future development of lordosis, maintenance of a healthy weight and engaging in core-strengthening exercises will assist with reducing the pressure placed on the spine as well as maintaining proper posture. However, if you are somebody who is already experiencing back pain as a result of lordosis, it is never too late to engage in physical therapy to improve pain-free range of movement, flexibility and mobility of the spine. Posture can also be improved significantly with strengthening of the appropriate musculature in the trunk, hips and lower limbs and addressing compensatory patterns that may have developed over time.

For example, when a person spends a significant amount of time in a seated position, the muscles in the lower or lumbar aspect of the back can become excessively tight from trying to support and stabilise the spine. Additionally, muscle groups such as the hamstrings, glutes and abdominals become weak and inhibited, contributing to poor biomechanics.

Physical therapy has been proven to be highly effective by taking a conservative approach to manage symptoms and improve function. With adherence to an appropriate rehabilitation programme an injured worker will have a higher chance of returning to work as well as a return to normal activities.

Chris Chen

Workers Compensation Specialist ‑ Innovation Team Leader (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Importance of a Rhythm

Fri, 08 Mar 2024 07:06:03 GMT

Rhythm is one of the most important elements of music across all its forms. Rhythm gives structure to music. It assists tone, it influences tempo and can control cadence, just for a quick snapshot. What I’ve found over my time playing music as hobby, is that rhythm is ever important and ever consistent. It’s something we can create, maintain, tweak, and develop but ultimately it remains consistent in providing structure. It’s also something we all have in our day-to-day life and in relation to our overall health, a rhythm can provide a positive impact on our overall health and wellbeing.

So, you’re probably wondering where I’m going with this and how does it relate to exercise or health?

Over time, or maybe just through personal growth and more awareness I have found that there are certain structures or constants that are frequent in my day and when performed consistently over a period time, provide the opportunity for me to perform at the best I can be and have a positive impact on my health and wellbeing. That being said, when these structures aren’t followed through or forgotten, it can then create the opposite effect; whereby we may feel stress, fatigue, unmotivated and not on the right track. For me I have found that I have a general rhythm that I try to maintain, the hard part is consistency (which is the challenge for most things!).

Think of this another way. It could be your routine, your non-negotiable’s, the one-percenter’s, your daily habits or even just the beat of your day. Things that you do daily, that create structure, consistency, and the mainstay standards you have for yourself that help you be the best version of yourself. For some it can involve a variety of things and as you’re reading this, I am sure you are already thinking about some of these items.

Okay, what are these constants? They can be as specific as you like or as general as possible, they could incorporate activity and exercise (I hope so!) or involve silence and stillness. It could include reading, journalling, meditation, the way you sleep or eat, the rules, restrictions, or freedoms you have put in place. There is no right or wrong way. If it works for you and you can be consistent, then ultimately this is your rhythm and as such your guide to maintaining your health!

Coming into a new year, dealing with significant change, or working through a new challenge, there’s always a chance you can be thrown a curveball and then get stuck trying to work through it, whereby there are usually sacrifices made with our day-to-day rhythm, which then impact our health and wellbeing in a negative manner. It’s important in these moments to reflect to our rhythm or routine (whatever name you have for it) and make sure we don’t make those sacrifices, and we strive to maintain our peak health and well-being.

Afiq Jackson

Workers Compensation Specialist ‑ Team Leader North West (AEP, ESSAM)

Building & Developing Mindset.

Fri, 01 Mar 2024 03:12:19 GMT

Hey guys, Mike Andrews here. I am the Business Development Manager at Absolute Balance, a role I have filled for just over 18 months. This exciting role has allowed me to learn an immense amount about myself and the team that makes up our business.

The team of exercise physiologists, the corporate team, and injury prevention, have phenomenal positive outcomes and back to work results, proving their elite level of work. The team is changing lives on the daily, however I often notice how they overlook their own impact, and just shrug it off as “just doing my job”. I agree, they are doing their job, but the impact and effect is way more than that and there is importance in knowing your impact.

Now this is where I come in, and I love my role, without a doubt, I consider it an absolute privilege. I spend quality face to face time with our team, assisting and coaching them on their mindset around their impact of “just doing my job”. As a result of my role and my interaction with the team believe “BDM” should stand for Building & Developing Mindset.

Each team member has a different approach to their work, comes from a different mindset, background, and has their own strengths, and or weakness, an aspect which makes the time spent with them so rewarding. Everyone will find their sweet spot with their mindset at different stages which is great! With that being said, the real goal for the business is combining the individual strengths into a highly functioning team. In my view, the simpler and more straight forward the goals/attributes the better.

I’ve stated three that I believe will result in a highly functioning team, which are:

1. Clear vision.

2. Clear roles for each team member.

3. Celebrating the process.

As important as each attribute is, I believe the last one outweighs the rest. When you combine the energy and passion our team have with an improved mindset, each day will be more rewarding and enjoyable. My role is to help assist the team members to use their attributes and strengths to find their sweet spot or ultimate mindset. That’s why I believe my role is so enjoyable and ultimately should stand for Building & Developing Mindset.

Michael Andrews

Business Development Manager

Central Sensitisation and Exercise

Tue, 20 Feb 2024 00:15:31 GMT

What is Central Sensitisation?

Central sensitisation (CS) is a condition of the nervous system that is associated with the development and maintenance of chronic pain. CS can present as pain away from the site of injury, widespread and referred pain, pain that can come and go, pain from non-painful stimuli and mechanical allodynia (pain from stimuli that is not normally painful). Accumulating research suggests that CS is also driven by neuroinflammation in the nervous systems. Neuroinflammation can result from major surgeries, drug treatments, autoimmune disease, and other pain related conditions or injuries. Neuroinflammation can also result in adverse effects, such as chronic pain and neurodegenerative diseases including Alzheimer’s disease, Parkinson’s disease, multiple sclerosis and stroke.

The Role of Exercise in Central Sensitisation:

Exercise plays a big part in improving CS. Regular physical activity can help reduce pain sensitivity and regulate the stress response of the body. It has an expansive influence on peripheral health and function, and by activating the relevant neural pathways, exercise also improves numerous disorders of the central nervous system. Plus, exercise can improve sleep quality, mood and overall well-being, all of which can have a positive impact on CS. Introducing exercise to someone with CS requires a gradual and individualised approach. Starting with lower impact activities such as walking, swimming and yoga can avoid triggering pain or discomfort. The intensity and duration can be gradually increased, and exercise consistency is key.

Inter-Limb Strength Transfer, a Fascinating Concept!

When you train or exercise one side of your body, such as your non-dominant hand or leg, there can be a transfer of skills and strength to the opposite side to a degree. This means that even though you're focusing on one side, the benefits can extend to the other side as well. For an individual with CS that affects one limb or part of the body, the concept of working on your un-affected side, can actually improve strength and coordination in the affected side and reduce the decree of atrophy in inactive muscles. This effect has the strongest evidence when completing 3-5 sets of 8-15 repetitions of eccentric contractions with rest times of 1-2 minutes between sets.

References:

Ru-Rong Ji, Andrea Nackley, Yul Huh, Niccolò Terrando, and William Maixner (2018) Neuroinflammation and central sensitization in chronic and widespread pain.
Rafel Cirer-Sastre, Jose V Beltrán-Garrido, Francisco Corbi (2017) Contralateral effects of unilateral strength training: a meta-analysis comparing training loads.
Jadwiga N Bilchak, Guillaume Caron, Marie-Pascale Côté (2021) Exercise-Induced Plasticity in Signalling Pathways Involved in Motor Recovery after Spinal Cord Injury

Exercise & your Immune System

Fri, 16 Feb 2024 02:21:24 GMT

Hello everyone, Daniel here again!

For my blog today I wanted to share with you all how exercise plays an important role in supporting your immune system, as there is much belief that when you are sick or unwell you should avoid all exercise or physical activity all together. Depending on your condition, rest and inactivity certainly does play a huge role in your recovery. However, there are also many appropriate forms of physical activity and exercise that can assist speed up your recovery and/or further prevent your immune system becoming compromised.

Below are five ways exercise benefits your body’s defence mechanisms.

Raises Body Temperature: During exercise, your body temperature increases. This elevated temperature can help prevent bacterial and viral growth, acting as a natural defence mechanism.
Enhances Antibody Response: Regular physical activity improves your body’s response to viruses and vaccines. It strengthens your antibody production, providing better protection against infections.
Reduces Inflammation: Exercise helps lower chronic inflammation, which is linked to various health issues. By keeping inflammation in check, your immune system functions more effectively.
Supports Weight Management: Maintaining a healthy weight through exercise positively impacts immune function. Excess body fat can impair immune responses, so staying active helps prevent this.
Promotes Overall Well-Being: Consistent exercise contributes to your overall health, supporting various bodily functions. Being active most days of the week is an excellent goal for both general well-being and immune system health.

Daniel Dewberry

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The year of 2023...

Wed, 20 Dec 2023 03:00:02 GMT

As the year draws to a close it is a fantastic opportunity to look back on the year that has been, a time to reflect on the challenges and honour the wins.

As we reflect, we celebrate both professional and personal successes. We had team members purchase houses, celebrated engagements, and some welcomed new additions to their family, whether that be a baby or a pet. Professionally, we continued learning and growing enabling Absolute Balance to expand our physical and metaphorical footprints. We are proud of our achievements this year. We have welcomed Ingrid Hand our new CEO as well as Regional Managers and Team Leaders into the fold to support our ever-growing teams located in the Perth Metropolitan area, the Southwest of Western Australia and across in New South Wales and Queensland. I would like to take this opportunity to thank our team for their tireless work in achieving some great projects this year.

Our CRM that we call GUS continues to evolve for better patient care,
Our premises that brings the team together weekly for professional training and development as well as the opportunity for the team to have fun and to connect.
We had the opportunity to showcase the Exercise Physiology industry to engaging stakeholders through several industry specific educational events.
We remain dedicated to supporting worthy charities through our team’s participation in community-based events. Specifically, this year, we maintained our commitment to the Smith Family and their commendable efforts in providing opportunities for underprivileged children to fully engage in their education.

On a final note, I wish to thank our clients and partners. Your support has helped Absolute Balance reach our yearly objectives and we look forward to working together in the future to achieve the best outcomes for you. But for now, from the team at Absolute Balance Exercise Physiology Group, we trust you have an enjoyable Festive Season, enjoy the time off to reset, recharge and ignite for what next year has ahead for you.

We wish you a safe holiday period and a bright return in 2024.

Derek Knox

Director/Founder (AEP, ESSAM)

What leadership means to me

Tue, 12 Dec 2023 02:45:00 GMT

Hi all, Daniel Dewberry here again!

Recently I was anointed the new East Team Clinical Team Leader at Absolute Balance, a leadership role that I am excited and motivated to undertake. Upon starting this new leadership role, I wanted to share with you all what leadership means to me and what leadership qualities I value the most.

To me leadership is not just a position or a title, but a mindset and a skill that can be developed and improved. Leadership is about influencing others to achieve a common goal and inspiring them to grow and learn along the way. Leadership is also about being authentic, ethical, and responsible for one’s actions and decisions. I believe the following qualities are essential to being a successful leader.

Empathy:

A leader should be able to understand and relate to the emotions, thoughts, and perspectives of others, especially those who are different from them. Empathy helps to build trust, rapport, and collaboration among the team members, and helps to address their needs and concerns. A leader should also be compassionate and supportive and show appreciation and recognition for the team’s efforts and achievements.

Integrity:

A leader should be honest, transparent, and consistent in their words and actions. Integrity helps to establish credibility, respect, and loyalty among the team members, and sets an example for them to follow. A leader should also be accountable and own up to their mistakes and learn from them.

Communication:

Communication is a vital skill for any leader, as it helps to influence, motivate, and inspire others to achieve a common goal. There are many aspects of effective communication in leadership, such as adapting your style, listening actively, providing feedback, and using stories.

These are some of the leadership qualities and values that matter to me, and that I strive to cultivate and demonstrate in my own leadership journey. I believe that by developing these qualities and values, I can become a more effective and influential leader, and make a positive difference at Absolute Balance.

Daniel Dewberry

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Rest to Progress

Fri, 08 Dec 2023 02:30:00 GMT

I was looking at the calendar this week and startled myself with how close we are to rotating once more around the sun. With December and Christmas just around the corner many thoughts begin to circle. Family. Delicious food. A cool beer. What will my New Year’s Resolution be? For those who have experienced an injury or illness and going through a critical period of rehabilitation, “what will happen to all my progress over Christmas?”

The Christmas period can be a busy time for many people; balancing end of year proceedings at work, seeing all their family and friends, keeping physically fit and trying to keep that holiday weight off. One aspect that is often overlooked is taking time to look after ourselves and our mental wellbeing. The point of this piece comes from a question I had from a concerned patient who has been religiously attending the gym as part of their rehabilitation. They experienced a workplace injury and subsequent surgery. For them family is the most important thing in their life and is a major driving force and motivation. Their concern was that they had a dilemma around wanting to continue to attend the gym to progress themselves and feeling that this would take away from spending time with their family.

To some the answer may be a simple. Stop the gym for a period and see the family, or to others it may be focus on the rehabilitation missing family for a year is a small sacrifice. I could see this was troubling them and it comes up regularly from patients over this time. My answer to this is in two parts. The first is based on the relationship of mental well-being and its impact on the long-term recovery of physical illness and injury. Ensuring that the patient is happy and content with their life means they are more likely to have a positive mental state and be better equipped to engage with their rehabilitation programme. Simply stay engage as much as you can but take the time to enjoy yourself with your family. Have that extra day off to enjoy the sun and relax with the Christmas dinner.

The second is less of an answer to the patient and more to us as clinicians. How can we help modify the programme to facilitate this period. A simple and common solution is modifying the exercises in a way that they can be performed at home. Utilise home based items or home-based equipment if available. Making sure to clearly relay that this is a temporary modification to ensure there is no regression in an accessible way.

Simply put, rest to progress. Rest the mind and relax the body. Do this for a short period to come back refreshed and ready to kick goals make meaningful gains. When we address both the mental and physical aspects, that is when we can help get the most out of our patients.

References and Resources:

https://www.physio-pedia.com/Mental_Health_Issues_and_Rehabilitation
Ohrnberger, J., Fichera, E., & Sutton, M. (2017). The relationship between physical and mental health: A mediation analysis. Social science & medicine (1982), 195, 42–49. https://doi.org/10.1016/j.socscimed.2017.11.008
Lamers, S. M., Bolier, L., Westerhof, G. J., Smit, F., & Bohlmeijer, E. T. (2012). The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis. Journal of behavioral medicine, 35(5), 538–547. https://doi.org/10.1007/s10865-011-9379-8

Cameron Addison

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Finding my why.

Mon, 04 Dec 2023 07:04:25 GMT

Hi, I’m Brad, and I’m an Exercise Physiologist at Absolute Balance.

Comparably to most of these profile introductions, I pursued a career in exercise rehabilitation after growing up with a ball at my feet and running laps around a track. When it became time to pick a career in high school, the only one that made sense to me was something to do with sport. I grew up playing footy in winter, and doing athletics in summer, which became more than an after-school activity to keep fit, growing into a hobby that quickly turned into an obsession, which I have been lucky enough to shape into my career.

Watching athletes training videos online, posters and cut outs on my bedroom wall, staying up to 3am to watch competitions on a pixilated video live stream, and standing out in the rain to watch open training sessions at footy, I just loved all things sport, and I couldn’t get enough of it.

My love for rehabilitation and helping people came from my dad. He had his first spinal surgery when I was a baby, and growing up visiting the spinal rehab ward in hospital was an experience I think has encouraged me to want to help people.

The combination of my dad’s values and attitude towards his own injury bestowed the foundation for my own personal values and desire for helping people from all walks of life. Outside of work I compete for WA in athletics, getting the opportunity to travel around Australia to compete over the 10km and 20km distances in Racewalking. If that didn’t keep me busy enough, I also work at the West Coast Eagles as a sports trainer, working in the medical department, and donning the pink vest on game day running water at AFL games.

Whether it’s an elite sports person, blue colour worker or CEO, being able to assist somebody to get back to what they love after an injury has allowed me to combine my personal values and generosity with my passion for sport, exercise, and rehabilitation.

Bradley Mann

Accredited Exercise Physiologist ‑ Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Meet Tiff! Our brilliant south team leader.

Wed, 15 Nov 2023 05:59:57 GMT

Hi there, my name is Tiff, and I am an Exercise Physiologist, Workers Compensation Specialist and Clinical Team Leader at Absolute Balance. I graduated from Curtin University with a master’s in clinical Exercise Physiology, which felt like a natural progression from my Exercise, Sport, and Rehabilitation Science bachelor.

I grew up on acreage in country WA, just outside of Mandurah, with my parents and two younger sisters. My studies were fuelled by my passion for exercise, sport and helping people. Rehabilitation first piqued my interest when I saw those around me experiencing sporting injuries. I’ve also had my fair share of injuries along the way with playing field hockey for the past 20+ years (and probably for the next 20+ years).

Having felt the impact of a work injury myself at the young age of 19, I can empathise fully with how much it can impact every aspect of life. Thus, having a role where I can make a meaningful contribution and positive impact on individuals who’re going through the same thing is special to me. I love being able to go home and tell my fiancé the success stories of my patients or achievement of my team members.

I guide a team of 8 in the South region at Absolute Balance and leading them to best help their own patients and grow as Exercise Physiologists is amazing. Leadership has many challenges, but I absolutely love the growth and rewards that come of it. Whilst not at work I thrive when I balance exercising, time with my loved ones (and cats), camping and travelling. I love all things outdoors and the beach, but you can also catch me with indulging in good shows, books, or music.

Tiffany Mullins

Workers Compensation Specialist ‑ Team Leader South (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

What does a baby and rehabilitation have in common?

Tue, 07 Nov 2023 03:15:59 GMT

Our first child, a gorgeous baby girl called Mila is nearly 10 months old. I have watched her go from an immobile blob to independent sitting, to crawling and now to standing in the space of a handful of months.

Why am I talking about my daughter?

I am a Physiotherapist with over 16 years' experience, and I have watched and supported injured people through their rehabilitation. Some successfully and some not so successfully. Injuries ranging from mild sprains and strains all the way through to horrifically traumatic injuries. There is more common ground between a baby learning to stand and an injured athlete or worker then you would think.

Let’s start with Mila and her goal to stand independently. This took 6-8 weeks from ideation to success, an eerily similar timeline to most moderate musculoskeletal injuries.

Mila started with inadequate, muscle strength, ligament support, confidence, knowledge of the task and basic balance skills. All required traits to stand successfully.

Internally, she had a clear goal in mind, she wanted to do what her dad was doing; stand up and eventually walk around. Once she knew what it was, she wanted to achieve she worked backwards from there.

Build her core, arm and leg strength, experience failure, figure out she needs to pull up on something to get through the first phase, learn and acquire that skill, now time to pull up and come crashing back down…hard. Repeat and fall again but a little softer this time. Cry a little. Try again yet fall even harder and bump her head. Cry a lot. Few bruises. Next day straight back at it.

Mila would have done this close to a hundred times, every day, for weeks on end. She did not have the physical attributes nor the experience to achieve this, but she had unrelenting persistence, consistency of effort and support from her Mum and Dad.

Finally, she did it! The look on her face was one of pure elation.

Now, tying this back to recovery from an injury. There are significant and clear commonalities between a baby and a successful rehabilitation journey.

A clear goal
Persistency – in the face of perceived ‘fails’, a few tumbles and a bit of soreness.
Consistency – in efforts and showing up every day.
Support – from a knowledgeable and caring team
Time and a safe environment

If a baby can do it, so can you!

Hadyn Sleeman

Regional Manager (B.Sc (Physio), Dip. L & M)

The latest and greatest to join AB.

Wed, 25 Oct 2023 03:32:04 GMT

I'm Kimberly Nguyen, an Accredited Exercise Physiologist at Absolute Balance.

Originally, exercise rehabilitation wasn't my first career choice. I pursued a double major in business and HR, following in the footsteps of my older siblings who had successful corporate careers. However, I soon realized that this wasn't the path I wanted to take.

During the period when I was studying, I had various careers, from working as a consultant for electrical goods to teaching people how to throw axes! All of these experiences had something in common: they were very client focused. I knew I wanted to work with people, but not in a transactional way. Thus, my passion for sports and exercise led me to study exercise physiology. I started with an undergraduate degree in Exercise Sport Science and continued my studies in Clinical Physiology. My goal has always been to make a meaningful and positive impact on the lives of my patients. I am dedicated to helping them manage their symptoms, regain their ability to enjoy their favourite activities, and pursue their hobbies.

Outside of work, I spend my free time bouldering, going to the gym, or playing video games with my friends.

Kimberly Nguyen

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The i3-s Strategy? Say what...

Tue, 17 Oct 2023 06:49:19 GMT

Patients commonly seek treatment for a primary condition, for example in the worker’s compensation space. An Exercise Physiologist’s goal is to prescribe an exercise programme that addresses the primary condition. However, patients can present with co-existing comorbidities which ultimately can impact their exercise programme. Patients with a comorbidity can participate in exercise if the prescribed exercise is appropriately modified to the presented comorbidities without impeding the effectiveness towards the primary condition or patient’s goals.

Part of an Exercise Physiologist’s role is to recognise a patient’s comorbidities and their associated contraindications and limitations to exercise. To assist with this process the i3-S strategy has been developed to assist in recognising comorbidity-related adaptations to exercise rehabilitation to a primary condition. It is broken into 4 steps: assess health status, comorbidity contraindications/restrictions, exercise adaptations and synthesis of information.

1. Assess Health Status

Involves retrieving the relevant comorbid diseases of a patient.
Once comorbidities have been identified, relevant clinical factors for each comorbidity can be examined.

2. Inventory of Comorbidity Contraindications and Restrictions

Contraindications and restrictions are derived from each comorbidity identified in step 1.
Medical clearance may be required to continue with exercise.
Restrictions may limit a person’s ability to participate in exercise, however they don’t exclude a patient from all exercise however adaptations are required.

3. Inventory of Adaptations to Exercise

Adaptations can be derived from each comorbidity identified in step 2.
Adaptations to exercise are endless, they can be physiological, behavioural and environmental.
In this stage, it is important to identify clinical signs, monitoring and parameters that are required to be throughout exercise programme.

4. Synthesis of Information

This step involves combining the information collected in each step and implementing an individualised exercise program to the patient.

Ultimately, this strategy can be implemented to ensure an evidence-based exercise program is prescribed targeting their primary condition whilst taking into account their co-existing comorbidities. Throughout the process, emphasis is placed on applying clinical reasoning. Patients should be viewed in their whole rather than their index condition.

References:

Dekker, J., de Rooij, M., & van der Leeden, M. (2016). Exercise and comorbidity: the i3-S strategy for developing comorbidity-related adaptations to exercise therapy. Disability and rehabilitation, 38(9), 905–909. https://doi.org/10.3109/09638288.2015.1066451

Caitlin Chase

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The healing power of Greens.

Wed, 04 Oct 2023 01:16:57 GMT

How a high vegetable intake assists in pain management.

Vegetables have long been hailed as nutritional powerhouses, providing a plethora of health benefits. One lesser-known advantage of a diet rich in vegetables is its potential to assist in pain management. Whether you are dealing with chronic conditions like arthritis or trying to alleviate discomfort from an injury, increasing your vegetable intake can be delicious and effective way to ease your pain.

Anti-Inflammatory properties

Pain often stems from inflammation in the body. Vegetables, especially leafy greens like kale, spinach and broccoli, are rich in antioxidants and phytonutrients that combat inflammation. They can help reduce the production of pro-inflammatory molecules and promote a balance immune response.

Fibre for digestive health

A diet high in vegetables provides a large amount of dietary fibre, which help supports a healthy digestive system. Good digestion is essential for nutrient absorption, and when your body absorbs nutrients efficiently, it can help support the healing process and minimize pain. Vegetables like broccoli, Brussel sprouts and carrots are great sources of fibre.

Tissue Repair

Vegetables are packed with essential vitamins and minerals that play a crucial role in tissue repair and regeneration. For example, vitamin C, found in Capsicum, citrus fruits and broccoli, is vital for collagen production, which helps maintain healthy joints and cartilage.

Alkalizing effect

Many pain conditions are associated with an acidic internal environment, which can exacerbate inflammation and discomfort. Vegetables have an alkalizing effect on the body, which can help reduce pH levels. Alkaline rich veggies like cucumbers, spinach and celery can contribute to a more pain friendly internal environment.

Weight management

Maintaining a healthy weight is essential for managing pain, especially if you suffer from conditions like osteoarthritis or back pain. A diet rich in vegetables is naturally low in calories and can help support weight management. Furthermore, vegetables are filling, making it easier to control calorie intake.

Reduced oxidative stress.

Oxidative stress is linked to various pain conditions. The antioxidants in vegetables combat oxidative stress by neutralizing harmful free radicals. Dark, leafy greens, as well as colourful vegetables like sweet potatoes and beetroots, are excellent sources of antioxidants.

Better blood sugar control

High blood sugar levels can contribute to inflammation and nerve damage, leading to pain conditions like diabetes. Vegetables, especially those with a low glycaemic index, help regular blood sugar levels. Examples include cauliflower and asparagus.

In conclusion, a diet rich in vegetables can be a powerful tool in pain management. Their anti-inflammatory properties, nutrient density, alkalizing effect, and impact on digestive health makes vegetables an essential tool with reducing and managing pain. By incorporating a colourful array of vegetables into your daily meals, you can not only enhance your overall health but also provide your body with the tools it needs to cope with pain. So, make veggies an essential part of your plate, and watch them work wonders. As our mum always said when we were kids, eat your greens!

Sean Young

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Get to know Haseef!

Thu, 21 Sep 2023 03:55:38 GMT

Hey everyone, my name is Haseef and I’m one of the AEPs (Accredited Exercise Physiologists) here at Absolute Balance.

I graduated with a bachelor’s degree in Sports Science, Exercise & Health before furthering my studies in Clinical Exercise Physiology. Throughout my course, I managed to undergo placements covering a variety of domains, and I was fortunate enough to meet individuals from all walks of life and help them with their respective conditions.

Originally from Singapore, I grew up in a family with 7 siblings where all of us would play and compete with one another. Competition was fierce growing up and there were bound to be injuries at some stage. Due to previous injuries, I gained a better understanding of how a personalized strength and conditioning program is key to keeping up with your fitness goals as well as reducing your chances of getting injured. Throughout my years as a sportsman, I have been lucky enough to have people look after me in times of injury and rehabilitation, so I believe it is my duty to pay it forward for all the support I have been given.

Currently I play hockey for a local club, and I try to incorporate the knowledge I have learnt towards developing my game as well as helping those around me. I am a firm believer of “use it or lose it” so I try to keep moving doing absolutely anything. During my free time, I enjoy baking and catching up with friends and family over a delicious meal. If you’re lucky, you might even get the chance to try the famous cinnamon scrolls that everyone keeps raving about. I heard it’s pretty good and made by yours truly!

Haseef Salim

Accredited Exercise Physiologist (AES, AEP) (ESSAM)

Helpful ways to stick to your exercise routine.

michael.andrews@absolutebalance.com.au (Michael Andrews) — Thu, 14 Sep 2023 03:01:47 GMT

When it comes to exercise, many individuals struggle to integrate exercise into their lives with 50% of people who start an exercise program dropping out within the first 6 months. It’s a wonder that this happens, as now days the benefits of exercise are widely known and there is no shortage of information out there that is available to spur anyone on to get started! So, what is the reason people drop out?

Well, there are several key reasons why with the common answer being, motivation, time, access to facilities or equipment, energy, workout partner, and self-efficacy. Nearly everyone has experienced these in some way, shape or form or another. Whether it’s running out of time at the end of the day, having a facility or park that is too far away or too expensive for a membership, or just being too tired to do so. These barriers can pop up day to day and vary from person to person making it hard to come up with one best way to help combat these.

Here are a few strategies to try out to help make exercise a regular part of your life:

Creating a Pros and Cons table:

By listing out the pros and cons of engaging in exercise and the potential change in someone’s lifestyle, it can create motivation to continued engagement. Listing out the cons of not engaging and focusing on what may be potentially lose by not engaging in exercise can put into perspective the benefits. Listing out pros can also help form long and short-term goals of the program, providing motivation and a target to achieve to help with ongoing motivation to stay engaged.

Self-monitoring:

Keeping track of activity keeps a record of what you have achieved! But don’t just record the number, benefits are also seen from recording activities, moods, and thoughts associated with exercise. This way it’s easy to identify reasons for not exercising and come up with work arounds to combat these as well. This can also be tied into goal setting and provide a target to reach, and achieving goals provides boosts of motivation and encourages continued adherence to exercise.

Involving a friend or family member:

Social support has widely been known to help with behavioural change, whether that is a community club, partner, or friend to come and exercise with yourself. They can play an important role in providing encouragement to increase physical activity and to reinforce your adherence to the exercise program.

Providing education on exercise:

Quite often individuals only know that exercise is good for you and that’s it. As experts in the field, we can often assume what we know is common knowledge to everyone else, which isn’t the case. Providing education on the benefits of exercise and the reasons for exercising assist with creating behaviour change in individuals by outlining the positives of exercise and boosting their self-efficacy, helping combat one of the key reasons for not engaging which is a lack of self-efficacy.

These different strategies can be used by anyone, and each one can be applied in a variety of ways to suit the individual, as one strategy may work better depending on the person. These are just some ways to help provide a boost to anyone who is trying to stick to exercise, as all have been shown to help overcome the common reasons for dropping off.

References:

Dishman RK. Exercise adherence: Its impact on public health. Champaign: Human Kinetics Books; 1988.
Ryan R, Frederick C, Lepes D, et al. Intrinsic motivation and exercise adherence. Int J Sport Psychol. 1997; 28:335–354.
Linke SE, Gallo LC, Norman GJ. Attrition and adherence rates of sustained vs. intermittent exercise interventions. Ann Behav Med. 2011 Oct;42(2):197-209. doi: 10.1007/s12160-011-9279-8. PMID: 21604068; PMCID: PMC3181282.
Dalle Grave R, Calugi S, Centis E, El Ghoch M, Marchesini G. Cognitive-behavioral strategies to increase the adherence to exercise in the management of obesity. J Obes. 2011; 2011:348293. doi: 10.1155/2011/348293. Epub 2010 Oct 28. PMID: 21052533; PMCID: PMC2968119.

Jaydn Simkin

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Wonders of Workers' Compensation

Mon, 11 Sep 2023 06:43:45 GMT

The workers compensation system can be a challenging, and often daunting, space to traverse for those affected by an injury and even seasoned professionals who live and breathe all things workers compensation. Below are a series of questions or statements I have received from patients or from people who have received an injury or not yet in the system.

Where do I begin?

Seek immediate first aid treatment and report the incident to your employer.
See a doctor to discuss the injury with them and ask for a “First Certificate of Capacity”.
Fill out a “Workers’ Compensation Form” (link in resources)
Make a copy of each form and hand the original to your employer.
Your employer has 5 working days to complete the section of the form relevant to them and lodge it with their insurer.
The Insurer then has 14 days to review the claim and will inform you if the claim is accepted, disputed or pending.

What does each claim status mean?

Accepted – you will receive wage compensation and compensation for reasonable treatment.
Disputed - You will be informed as to why it is disputed. If you disagree you can ask for the claim to be reassessed. If you still disagree you can with the outcome, you can raise this further with the Workers’ Compensation Conciliation Service.
Pending – The insurer is requiring further information. They have 10 days to acquire this information and reach a decision. If 10 days passes it defaults to the status of disputed.

Can you only claim physical injuries?

Not at all! Psychological injuries are less common and harder to diagnose, however the avenue is there to pursue if your mental health has been affected. This can include scenarios such as a workplace bullying or stress from being overworked.
Additionally, there are unique circumstances where hearing loss or asbestos related diseases can be compensated.

I am worried about my future employment. If I declare my injury, they won’t hire me, right?

A common concern from many patients, and rightly so when it could affect your livelihood. A workplace does not have the right to ask you whether you have received or filed for a works’ compensation claim in the past. Nor are you under an obligation to disclose this to them.
Your employer does have the right to know about any injuries or other medical conditions that may impact your role.
Essentially, they cannot discriminate against you for having been in the works’ compensation system, however you have to be able to perform the requirements of the role you are applying for.

I don’t want to keep taking money while not working, I’m thinking about closing my claim and just pushing through the pain.

To some people they can feel like a burden while not working and receiving compensation. You are not! An injury as the result of an accident or the workplace environment is not necessarily your fault. You are entitled to compensation you are receiving.
Receiving and completing treatment prescribed to you to get you back to full function is extremely important for yourself and your employer. In a way you can view performing your prescribed exercises or other treatments as your temporary job role and that is what you are doing to earn your wage.

I am concerned about returning to full duties and hours. I have not worked a full day in months.

It can be daunting going from attending appointments and conducting treatment at home, to returning to a full work week. We understand this and if appropriate someone known as a Vocational Rehabilitation Provider (Voc) can be brought onboard. This will be done in a gradual manner over a period of time, so you won’t become overwhelmed.
A Voc’s role is to assist with developing a return-to-work plan. They will attempt to have this take place at your worksite on lighter or alternate duties and gradually increase your hours and the intensity of your duties over time.

Recourses

Workcover WA Website: https://www.workcover.wa.gov.au/
Workcover phone number: 1300 794 744
Workers’ Compensation Form: https://www.workcover.wa.gov.au/resources/forms-publications/worker-forms/#claimform
Workers’ Compensation Conciliation Service: https://www.workcover.wa.gov.au/resolving-a-dispute/workers-compensation-conciliation-service/

Cameron Addison

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Redefining Posture

Fri, 18 Aug 2023 00:48:52 GMT

The concept of good posture has long been ingrained in our minds as a benchmark for how we should sit, stand, and move. However, a growing number of people are starting to challenge this notion, asserting that the idea of “good” posture might not be as concrete as we have been led to believe. Human bodies are diverse. Each person has a unique bone structure, muscle distribution, and anatomical variation. What might be considered “good” posture for one individual could be uncomfortable for another. The notion that there is a one size fits all posture contradicts this diversity of human anatomy, for what might be considered proper posture in one situation may not be suitable for another. For example, lifting with or without an injury.

Insisting on a singular “good” posture might lead to rigidity and discomfort, as our bodies are designed for mobility, and remaining in one position for prolonged periods, even if it is considered “good” posture, can lead to stiffness and discomfort. Instead of fixating on a static posture, it may be beneficial to consider the importance of movement and variation. Research shows us that encouraging regular movement is more beneficial for overall health and comfort. Rather than dismissing the idea of good posture completely, redefining the concept could be considered. Instead of aiming for a static and rigid posture, the focus should shift towards body awareness, balance, and comfort. This allows for individual variation and more importantly,

MOVEMENT.

References:

Saraceni N, Kent P, Ng L, Campbell A, Straker L, O'Sullivan P. To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther. 2020 Mar;50(3):121-130. doi: 10.2519/jospt.2020.9218.
Smythe A, Jivanjee M. The straight and narrow of posture: Current clinical concepts. Aust J Gen Pract. 2021 Nov;50(11):807-810. doi: 10.31128/AJGP-07-21-6083

Shanae Malpass

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

The Power of Early Exercise Intervention in Acute Musculoskeletal Injuries

Wed, 09 Aug 2023 05:08:32 GMT

As allied health professionals, our primary goal is to ensure the best possible outcomes for patients recovering from musculoskeletal injuries and surgeries. Traditional approaches to rehabilitation have often emphasized rest and immobilization during the initial stages of recovery. However, emerging research suggests that early exercise intervention can play a pivotal role in enhancing recovery and restoring function. In this blog, we will explore the significant benefits of early exercise intervention in acute musculoskeletal injuries and surgeries, shedding light on the advantages it offers to patients' overall rehabilitation process.

1. Accelerated Healing and Tissue Remodelling.

One of the most compelling reasons for incorporating early exercise intervention is its ability to promote accelerated healing and tissue remodelling. Controlled, gentle movements can enhance blood flow to the injured area, facilitating the delivery of oxygen and nutrients to support tissue repair. A study by Ferreira-Valente et al. (2018) reported that early exercise following musculoskeletal injuries promotes angiogenesis and collagen synthesis, essential for tissue healing and remodelling.

2. Preservation of Muscular Strength and Joint Function.

During the early stages of recovery, patients often experience muscle atrophy due to disuse. Early exercise intervention can counteract this muscle loss, preserving and even enhancing muscular strength. A systematic review by Hultman et al. (2019) highlighted that early mobilization and targeted strengthening exercises positively influence muscle preservation during post-surgical rehabilitation.

3. Pain Management and Neurological Adaptations.

Pain is a common challenge in musculoskeletal injuries and surgeries. Contrary to conventional wisdom, early exercise intervention can be a powerful tool for pain management. Low-impact exercises and movements can activate the body's natural pain-relieving mechanisms, such as the release of endorphins. A study by Smith et al. (2017) demonstrated that early exercise interventions positively influence pain thresholds and reduce pain perception.

4. Psychological Benefits and Patient Empowerment.

Injuries and surgeries can be emotionally challenging for patients, leading to anxiety and feelings of helplessness. Early exercise intervention allows patients to actively participate in their recovery process, promoting a sense of empowerment and control over their healing journey. A meta-analysis by Turner et al. (2020) found that early exercise interventions in orthopaedic rehabilitation improve patient motivation, confidence, and overall psychological well-being.

5. Reduction in Rehabilitation Duration and Healthcare Costs.

By kickstarting rehabilitation early on, the overall duration of the recovery process can be significantly reduced. Early exercise intervention can expedite functional recovery, allowing patients to return to their daily activities and work sooner. A study by Aamot et al. (2019) reported that early exercise interventions in post-surgical rehabilitation led to shorter recovery periods and reduced healthcare costs.

The benefits of early exercise intervention in acute musculoskeletal injuries are evident, making it an essential component of modern rehabilitation protocols. By incorporating appropriate exercises at the right time, we can promote accelerated healing, preserve joint function, manage pain, and empower patients on their road to recovery. Embracing this evidence-based approach and collaborating to optimize patient outcomes will improve the overall quality of care in our field.

References:

- Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2018). Physical therapy and exercise in pain management. Pain Reports, 3(5), e674.

- Hultman, J., Sääf, M., & Halvorsen, K. (2019). Early active mobilization after flexor tendon repair in zone II. JBJS Reviews, 7(2), e4.

- Smith, L., Louw, Q. A., Crous, L. C., & Grimmer-Somers, K. (2017). Preoperative exercise halves the postoperative complication rate in patients with lung cancer: a systematic review of the effect of exercise on complications, length of stay, and quality of life in patients with cancer. British Journal of Sports Medicine, 51(10), 792-797.

- Turner, R. R., Beckenkamp, P. R., Griffiths, L. R., & Hughes, D. L. (2020). Psychological aspects of anterior cruciate ligament injuries. Journal of Orthopaedic Surgery and Research, 15(1), 22.

- Aamot, I. L., Forbord, S. H., Gustavsen, M. T., Nordvik, H., Stensvold, D., Ugelstad, I., ... & Dalen, H. (2019). Home‐based versus hospital‐based high‐intensity interval training in cardiac rehabilitation: A randomized study. European Journal of Preventive Cardiology, 26(2_suppl), 17-25.

Cameron McRae

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

5 simple tips to help your workout session – if you aren’t doing this already!

Tue, 08 Aug 2023 00:21:16 GMT

From personal experience as well as observing others in the gym, there are small factors I have noticed that can make a big difference in the effectiveness of a workout or training session – whether it be the physical or psychological. Below are some of my tips to follow during your workout sessions (if you aren’t already doing this!).

Warm up

We should always, ALWAYS, warm up before getting into any workout. Allow yourself time to prepare your body and mind for the session to come. As we know, warm-ups can also help to reduce our chances of injury. Try to be specific with your warm-up, focusing on mobilizing and stretching joints and muscles that are going to be hit hard during your session. An easy way to do this is taking the specific joint and its surrounding muscles through full range of motion in a controlled manner. You can also perform repetitions of the exercise with little to no resistance.

Mind-muscle connection

As cliché as it may sound, there is plenty of reason why this is a significant factor when it comes to training. Focusing on the muscles we are working during the exercise is shown to help neuromuscular connections and increase muscle fibre recruitment. This leads to bigger strength improvements and better-quality reps. With each repetition we should be focusing on squeezing (contracting) the muscle as hard as we can. It also prevents us from compensating with other muscles that aren’t the focus of the exercise.

Rest

Rest times during your workout can be almost as important as the work being done during the session. Rest times as long as 3-5 minutes between sets for exercises that involve very heavy weights allow you to perform a greater number of reps over multiple sets. This rest duration is shown to improve absolute strength. Rest durations between 30-60 seconds can be beneficial for building muscle size using moderate weights. Shorter rest durations will be more beneficial for building your cardiovascular and muscle endurance. Being able to manipulate your rest times can see you make some significant gains with your training.

Music

Playing some good tunes while you work hard can have ergogenic effects on your workout performance. These include reducing your perception of fatigue and increasing your work capacity. The psychological effects of music cannot be underestimated and may help you to push yourself a little further when you are fatigued. Next time you train, pick music that is familiar and matches with the tempo or intensity of your exercises.

Follow through

Possibly one of the biggest hurdles we face is finding motivation to go to the gym – but once we are there, another hurdle is finishing exactly what we set out to do! There are experiences where I have gone to train, only to alter my program because I didn’t feel like doing a certain exercise. Or to start an exercise only to cut it short because I don’t want to finish one more set, or one more round. And it wasn’t because I wasn’t capable, but because I know my body is going to ache, or my lungs are going to burn. But that “suffering” or hard work will only last for a short time. Regardless of how hard you push your training; you are going to go home and eat and drink and feel better after. So why not endure and follow through on what you’ve set yourself for the session. The water might taste a little sweeter afterwards too!

References

de Salles, B., Simão, R., Miranda, F., da Silva Novaes, J., Lemos, A., & Willardson, J. (2009). Rest Interval between Sets in Strength Training. Sports Medicine, 39(9), 765-777. doi: 10.2165/11315230-000000000-00000

Karageorghis, C., Terry, P., Lane, A., Bishop, D., & Priest, D. (2012). The BASES Expert Statement on use of music in exercise. Journal of Sports Sciences, 30(9), 953-956. doi: 10.1080/02640414.2012.676665

Karvonen J, Lemon PWR, Iliev I (eds): Medicine in Sports Training and Coaching. Med Sport Sci. Basel, Karger, 1992, vol 35, pp 189-214. doi: 10.1159/000421152

Bastien Auna

Workers Compensation Specialist ‑ Team Leader NSW (AEP, ESSAM)

Exercise Rehabilitation Services ‑ NSW

Cardiovascular exercise for Analgesia in Injury recovery.

Wed, 12 Jul 2023 02:58:51 GMT

Injury and pain often come hand in hand, creating physical discomfort and hindering our daily activities. While there are lots of methods to manage pain, cardiovascular exercise has been shown as a beneficial and natural approach to promote analgesia during injury recovery. Below are some of the major benefits cardiovascular exercise has for managing pain.

Release of Endorphins:

Engaging in cardiovascular exercise triggers the release of endorphins, which are natural painkillers produced by the body. These naturally occurring opioids interact with receptors in the brain, reducing the perception of pain and promoting feelings of well-being and mood, which in turn can also help alleviate symptoms of anxiety and depression. Studies have shown that the endorphin release during exercise can contribute to the analgesic effects experienced by individuals with injuries (Bartley et al., 2016).

Enhanced Blood Circulation:

Cardiovascular exercise, such as running, cycling, or swimming, significantly improves blood circulation throughout the body. This increased blood flow delivers essential nutrients and oxygen to injured tissues, promoting the healing process. On the flip side, enhanced circulation also helps to remove metabolic waste products and inflammatory substances, reducing pain and swelling (Naugle et al., 2012).

Reduced Inflammation:

Inflammation is a natural response to injury, but excessive or prolonged inflammation can exacerbate pain. Regular cardiovascular exercise has been found to modulate the inflammatory response, leading to a decrease in the production of pro-inflammatory molecules. This anti-inflammatory effect helps to manage pain and supports the healing process (Pedersen & Febbraio, 2012).

Incorporating cardiovascular exercise into your injury recovery can provide substantial analgesic benefits. From the release of endorphins to improved blood circulation, reduced inflammation, and enhanced mental well-being, the advantages are three-fold. Remember to consult with your healthcare provider before starting any exercise program to ensure it aligns with your specific injury and overall health condition.

References:

- Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. Br J Anaesth. 2013;111(1):52-58.

- Naugle KM, Fillingim RB, Riley JL 3rd. A meta-analytic review of the hypoalgesic effects of exercise. J Pain. 2012;13(12):1139-1150.

- Pedersen BK, Febbraio MA. Muscles, exercise, and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8(8):457-465.

Chris Goddard

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Applying the "principles of training" to an injured worker.

Tue, 20 Jun 2023 07:10:24 GMT

The principles of training are a fundamental aspect that go into the planning and progression of athletes in all stages of their sporting career. They are similarly critical to the way in which we manage the rehabilitation of an injured worker. As Exercise Physiologists at Absolute Balance, we apply these principles daily to ensure our clients best progress their functional rehabilitation. It is also important that these principles are educated thoroughly to the client to ensure they can apply them in an independent manner and seek longevity away from supervised treatment.

Specificity:

When we make a programme for an injured client, it is important to understand the goal/s you are working towards with respect to the injury and the job role they are physically required to fulfil. Specificity outlines the need to programme towards aspects of the client’s job role to ensure they are conditioned to return to their pre-injury status. This will also provide the client with more confidence in their return to work. As workers compensation specialists, Absolute Balance specifically programmes work specific exercises for our clients to track their return-to-work progress.

Frequency:

When programming frequency it is important to consider the wide range of variables which can impact the rehabilitation of a client. This can include the stage the client is at in the rehabilitation, the type of exercise they are required to complete, how much they are currently working and their overall rate of recovery. We want to ensure the client sits comfortably between ‘overdoing it’ and ‘underdoing it’. In saying this, it is a constant learning process between the client and clinician which develops overtime through more experience working cooperatively.

Intensity:

Is another principle that is dependent upon a wide range of variables, particularly the stage in which the client is at in their rehabilitation and the requirements of their job role. Intensity is typically a subjective measure which a clinician can gather through tools such as RPE or rate of perceived exertion. Intensity can generally increase in the later stages of rehabilitation and more so for workers in physically demanding job roles such as in trades or mining.

Duration:

Typically, under the workers compensation scheme we allocate a certain timeframe to undertake an appointment. With this comes the need to identify how much of this time is utilised for work i.e., completing the exercise, rest, and other aspects such as education and general discussion. As clinicians we can modify the duration a client needs to spend completing their exercise per session and collectively in a week, and the size of their rest periods. Rest periods can be effectively tailored to best mimic the job demands which can be progressively changed depending on the stage in the client’s rehabilitation.

Progressive overload:

Is the principle of gradually increasing the stress placed on a specific muscle or muscle groups, joints, and collective structures in the body. This can be implemented through increases in weight, repetitions, duration, frequency etc. The overarching goal is to progressively increase the capacity of the individual by careful modifying a programme in line with their functional improvements. An easy way to identify the need for this is reported reduction in symptom presentation and rate of perceived exertion on a previously difficult programmed exercise.

Reversibility:

Commonly associated with the phrase ‘use it or lose it’, reversibility outlines a reduced functional capacity due to decreases or termination in exercise participation. It is important as clinicians we educate clients to progress them into an independent form of management where they continue their exercise habits far beyond the programme, effectively following the clinical framework.

References:

- Lambert, M.I., Viljoen, W., Bosch, A., Pearce, A.J. and Sayers, M., 2008. General principles of training. Olympic Textbook of Medicine in Sport. Chichester, UK: Blackwell Publishing, pp.1-48.

- Kraemer, W.J. and Ratamess, N.A., 2004. Fundamentals of resistance training: progression and exercise prescription. Medicine & science in sports & exercise, 36(4), pp.674-688.

Daine Richards

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Exercise Rehab - I wish I knew then what I now know.

Mon, 29 May 2023 23:43:09 GMT

Hey everyone! My name is Daniel Dewberry and I have been working as an Accredited Exercise Physiologist in the rehab team at Absolute Balance since December 2021. From the age of nine right up until my mid-twenties I loved to play basketball, playing it socially and competitively. Throughout my time playing I sustained many injuries to my right knee, ranging from MCL tears to patella dislocations. When I look back and reflect on how I went about my rehabilitation, I have regrets not committing to the process whole heartedly.

As an Accredited Exercise Physiologist today I understand that exercise rehabilitation is an essential part of any recovery process after an injury or surgery. It is important to complete your exercise rehabilitation because it helps you regain your strength and mobility, reduces pain and inflammation, and prevents further injuries. Exercise rehabilitation also helps you improve your balance, coordination, and flexibility, which are important for your overall health, well-being, and ability to play sport. Not completing your exercise rehabilitation program can lead to several risks, such as chronic pain and disability. It can also lead to muscle weakness, joint stiffness, and loss of range of motion. Not completing your exercise rehabilitation program can also increase the risk of re-injury.

These are all things I wish I fully understood and was aware of being a teenager and wanting to continue to play competitive sport. Over 10 years later with multiple similar injuries I am forever having to complete some form of rehabilitation for my knee. This has unfortunately led me having to continue to avoid engaging in specific activities that I once used to love and enjoy – so to everyone and anyone who has sustained an injury I thoroughly encourage you to be patient, be thorough and trust the rehabilitation process. It will save you the trouble later in life!

Daniel Dewberry

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Maximizing Performance and Preventing Injuries

Fri, 26 May 2023 00:55:23 GMT

Warm-up exercises are an essential part of any physical activity or workout routine. They prepare the body for intense movements, increase flexibility, and reduce the risk of injury. Two common warm-up techniques used by athletes and fitness enthusiasts are dynamic warm-up and static stretching. While both serve the purpose of priming the body for exercise, they differ significantly in their approaches and benefits.

Dynamic Warm-up

Dynamic warm-up involves performing active movements that simulate the motions of the upcoming activity or sport. This technique offers several advantages:

Enhanced Performance: Research has shown that dynamic warm-up routines can improve muscular power, speed, agility, and balance, resulting in enhanced overall performance (Chaouachi et al., 2008). By activating the muscles and increasing body temperature, dynamic warm-up primes the body for the demands of the activity, enabling athletes to perform at their best.
Increased Flexibility: Dynamic warm-up exercises contribute to improved muscle and joint flexibility. This increased range of motion is particularly beneficial for activities that require high levels of flexibility, such as gymnastics or martial arts (Faigenbaum et al., 2006). By improving flexibility, athletes can execute movements more efficiently and with reduced strain on their bodies.
Injury Prevention: Dynamic warm-up plays a crucial role in injury prevention. By activating the muscles, increasing blood flow, and promoting improved muscle elasticity, this warm-up method helps reduce the risk of musculoskeletal injuries (McCrary et al., 2015). Properly prepared muscles and joints are less susceptible to strains, sprains, and other injuries during physical activity.

Static Stretching

Static stretching involves holding a stretch position for an extended duration, typically between 15 and 60 seconds. Here are the benefits of incorporating static stretching into your routine:

Improved Flexibility: Regular static stretching exercises can enhance muscle and joint flexibility, leading to increased range of motion. This increased flexibility is advantageous for activities that involve sustained stretching, such as dance or yoga (Peck et al., 2014). Improved flexibility enables athletes to perform movements with better form, precision, and reduced risk of overstretching.
Injury Prevention: By increasing muscle flexibility and joint mobility, static stretching plays a vital role in injury prevention. This technique can reduce the risk of musculoskeletal injuries, especially in activities involving repetitive or forceful movements (Behm & Chaouachi, 2011). Flexible muscles and tendons can better withstand stress and strain, minimizing the likelihood of strains, tears, and related injuries.
Muscle Recovery: Static stretching after exercise has been shown to aid in muscle recovery. By increasing blood flow to the muscles and facilitating the removal of metabolic waste products, post-workout static stretching can help alleviate muscle soreness and promote faster recovery (Herbert et al., 2011). This can allow athletes to bounce back more quickly and resume training or competing at their optimal level.

Conclusion

Dynamic warm-up and static stretching are valuable components of any physical activity or sports routine. Both techniques offer unique benefits that can improve performance and reduce the risk of injuries. Dynamic warm-up prepares the body for action by enhancing performance, increasing flexibility, and preventing injuries. Static stretching, on the other hand, promotes flexibility, injury prevention, and aids in muscle recovery. By incorporating these techniques into your training regimen, you can maximize your potential, stay injury-free, and enjoy the rewards of an active lifestyle.

Remember, it is essential to tailor your warm-up and stretching routines to your specific needs, sport, and individual preferences. Consult with a qualified fitness professional or sports coach to design a warm-up and stretching protocol that best suits your goals and requirements.

References :

Chaouachi, A., Chamari, K., Wong del, P., et al. (2008). Stretch and sprint training reduces stretch-induced sprint performance deficits in 13- to 15-year-old youth. European Journal of Applied Physiology, 104(3), 515-522.
Faigenbaum, A. D., McFarland, J. E., Schwerdtman, J. A., et al. (2006). Dynamic warm-up protocols, with and without a weighted vest, and fitness performance in high school female athletes. Journal of Athletic Training, 41(4), 357-363.
McCrary, J. M., Ackermann, B. J., & Halaki, M. (2015). A systematic review of the effects of upper body warm-up on performance and injury. British Journal of Sports Medicine, 49(14), 935-942.
Peck, E., Chomko, G., Gaz, D. V., & Farrell, A. M. (2014). The effects of stretching on performance. Current Sports Medicine Reports, 13(3), 179-185.
Behm, D. G., & Chaouachi, A. (2011). A review of the acute effects of static and dynamic stretching on performance. European Journal of Applied Physiology, 111(11), 2633-2651.
Herbert, R. D., de Noronha, M., & Kamper, S. J. (2011). Stretching to prevent or reduce muscle soreness after exercise. Cochrane Database of Systematic Reviews, (7), CD004577.

Blake Cocking

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Start your exercise journey, enjoy the journey, don't look back.

Tue, 23 May 2023 05:18:38 GMT

In today's fast-paced world, it's not uncommon to have a packed schedule that barely leaves time for sleep, let alone exercise. Despite the numerous benefits of staying physically active, establishing, and maintaining an exercise routine can be an uphill task, particularly if you have a demanding job, family responsibilities, or other commitments. Yet, carving out time for regular workouts is crucial for boosting your health, mood, and overall well-being. Exercise and Sports Science Australia recommend daily exercise, averaging 2.5 hours depending upon intensity and strengthening activities at least 2 days per week. In this blog, we'll explore the common challenges of establishing and maintaining exercise in a busy life and provide actionable tips to help you stay fit and healthy.

Plan:

Planning is crucial when it comes to fitting exercise into your busy schedule. Take a few minutes to create a weekly schedule, including the times when you can fit in a workout. Take advantage of little time pockets throughout your day, such as early mornings or lunch breaks, and make sure you stick to your schedule.

Make it a routine:

Making exercise part of your routine can help ensure it gets done consistently. Pick a time during the day that works best for you and commit to it. For instance, you can make it a habit to train for 30 minutes every morning, or 20 minutes every night before dinner.

Utilize bodyweight exercises:

Bodyweight exercises are an excellent way to build strength without the need for equipment. They can be done anywhere and anytime, making them perfect for busy days. Some examples include push-ups, squats, lunges, and planks. A quick bodyweight routine can be done during a break or between meetings.

Multitask:

You can also incorporate strength training into everyday activities. For example, you can do calf raises while you brush your teeth or hold a plank while watching a TV show. Multitasking allows you to exercise while still getting other tasks done.

Join a fitness class:

Attending a fitness class can help you stay accountable and motivated. They can also help you create a workout plan that fits your busy schedule. You can choose a class that meets at a time that works for you and use that as your allocated exercise time for the day.

Exercise in short bursts:

You can break up your workout routine into shorter sessions throughout the day. For example, you can do strength exercises for ten minutes in the morning, ten minutes over lunch, and another ten minutes in the evening. This makes it easier to fit in workouts without feeling overwhelmed.

Set Goals and Track your progress:
A lack of clear goals can kill motivation. Set realistic and achievable fitness goals, which enable you to see progress towards your end goal, such as losing weight, running a 5k race, or being able to climb stairs without getting out of breath. Break it down into smaller goals, for example, aim to increase the intensity or duration by 10% each week. Tracking your progress allows you to gain some perspective about how far you’ve come and celebrate your successes. You can track your progress in different ways; by measuring your heart rate, keeping a record of your distance and time, or by taking pictures of yourself to track any physical changes.

Mix it up:
Variety can help you stay motivated, especially if you become bored with your exercise routine. Incorporate different forms of cardiovascular exercise, such as running, cycling, swimming, or HIIT classes. This will keep things exciting, challenging, and help prevent boredom.

Find a Partner
Having a workout partner or a trainer can be crucial to maintaining motivation. They provide accountability, support, and can be great cheerleaders along the way. You can also share your progress, goals, and challenges with each other, which keeps you both on track.

Focus on the benefits.

Focus on the benefits of completing daily cardiovascular exercise and twice weekly strengthening exercise. It can help lower the risk of heart and chronic diseases, increase endurance, help with weight loss, reduce stress, and improve overall health and wellbeing.

In conclusion, incorporating strength and cardiovascular exercises into your busy schedule may seem difficult, but it can be done. With proper planning, dedication, and a little creativity, you can make fitness a part of your daily routine. Maintaining motivation to complete daily cardiovascular exercise can be challenging, but incorporating these strategies can make it easier and more enjoyable. Remember to set realistic goals, track progress, find a workout partner, mix up your routine, and focus on the benefits. With these tips, you’ll be well on your way towards achieving your fitness goals. Remember, maintaining a consistent exercise routine is crucial for your overall health, physical fitness, and mental well-being.

References

1. Keogh, J. W. L., Winwood, P. W., & Simpson, C. L. (2017). The Exercise Recommendations for Clients with Knee Osteoarthritis by Exercise and Sports Science Australia. Journal of Science and Medicine in Sport, 20(9), 895–899

2. McCarthy, D. J., & Dale, M. J. (2019). Exercise and Sports Science Australia position statement on exercise prescription for the prevention and management of osteoporosis. Journal of Science and Medicine in Sport, 22(4), 424–427

3. Cahill, M. J., Proudfoot, N. A., Mills, B. D., & Barr, S. I. (2019). Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for overweight and obese adults. Journal of Science and Medicine in Sport, 22(9), 969–974

4. Winwood, P. W., Keogh, J. W. L., & Weeks, B. K. (2018). Exercise and Sports Science Australia (ESSA) Position Statement on the Role of Resistance Training for Health and Disease. Journal of Science and Medicine in Sport, 21(10), 1070–1077

Emma Wilson

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

The human body needing a service?

michael.andrews@absolutebalance.com.au (Michael Andrews) — Mon, 15 May 2023 06:15:46 GMT

Have you heard of the human body needing a service?

Every vehicle requires service at least twice a year to run efficiently without any problems. So, does the human body require a service? Well, YES!! The human body needs adequate fluid, sleep, and nutrition to be healthy and function normally from a physiological aspect. Similarly, the human body structurally needs to be mobile and have sufficient mobility to function easily.

So, what is mobility?

Mobility is commonly referred to as a person’s overall range of motion within the joints. Often mobility is misunderstood for static stretching. The difference is that static stretching is referred to stretching a muscle by using body weight against limb support, i.e., lengthening a muscle. In comparison, mobility requires the muscles and soft tissues acting on the joint to have dynamic flexibility, strength, and stability.

Why is mobility important?

In brief, mobility is essential for a positive quality of life and daily function. Research has identified that reduced mobility is responsible for declined functional ability, poor psychological health, and increased risk of injury. Have you ever noticed walking longer distances or upstairs feels like a struggle? This may be due to decreased lower back, hip, and ankle mobility. You may refer to this as being stiff, this is because the joints responsible for gait don’t have an adequate range of motion to function.

What are the benefits of mobility?

Mobility prevents the risk of injury, improves sports performance, posture, functional movement, sustained physical independence, and improved stress levels, to name a few.

How to service your body?

There is no set rule on how! However, depending on the occupation and lifestyle, daily mobility training is recommended to ‘run’ better. Add the exercises below to your toolkit to ensure your body runs like a V8. Complete each exercise for 3 sets of 30-60 s. otherwise click ME to access mobility, stability and flexibility exercise videos.

Mobility exercise:

Cat cow pose
Thread the needle
Inchworms
Lumbar extension
Thoracic extension
Hip 90/90 switch.
Prone thoric flexion
Frogs stretch and rotation.
Child pose
Front to back leg swing.

REFERENCE:

Behm, D. G., Blazevich, A. J., Kay, A. D., & McHugh, M. (2016). Acute effects of muscle stretching on physical performance, range of motion, and injury incidence in healthy active individuals: a systematic review. Applied physiology, nutrition, and metabolism, 41(1), 1-11.

Storm, J. M., Wolman, R., Bakker, E. W., & Wyon, M. A. (2018). The relationship between range of motion and injuries in adolescent dancers and sportspersons: A systematic review. Frontiers in Psychology, 9, 287.

Brahms, C. M., Hortobágyi, T., Kressig, R. W., & Granacher, U. (2021). The interaction between mobility status and exercise specificity in older adults. Exercise and sport sciences reviews, 49(1), 15-22.

Moscão, J. C., Vilaça-Alves, J., & Afonso, J. (2020). A review of the effects of static stretching in human mobility and strength training as a more powerful alternative: Towards a different paradigm. Motricidade, 16(1), 18-27.

Iwata, M., Yamamoto, A., Matsuo, S., Hatano, G., Miyazaki, M., Fukaya, T., ... & Suzuki, S. (2019). Dynamic stretching has sustained effects on range of motion and passive stiffness of the hamstring muscles. Journal of sports science & medicine, 18(1), 13.

Ferrucci, L., Cooper, R., Shardell, M., Simonsick, E. M., Schrack, J. A., & Kuh, D. (2016). Age-related change in mobility: perspectives from life course epidemiology and geroscience. Journals of gerontology series a: biomedical sciences and medical sciences, 71(9), 1184-1194.

Mansoor Sarvari

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Stress: A real headache.

Fri, 05 May 2023 00:07:33 GMT

Migraines are debilitating headaches that affect millions of people worldwide and unfortunately, I have been one of them. Migraines are characterized by severe throbbing or pulsating pain, often accompanied by other symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Though as with everything in life these symptoms can vary from person to person. As migraines can significantly impact an individual’s quality of life, it is important to understand the potential triggers and how to manage them. Today I would like to discuss my sole migraine trigger, stress.

While the exact mechanisms remain unclear, evidence suggests stress can be a contributing factor for migraine onset, chronification and symptom burden. Additionally, stress can interact with other genetic, environmental, and lifestyle factors, making it challenging to determine the exact role of stress in triggering migraines for each person. Nonetheless, research indicates managing stress may be an important aspect of migraine management for specific individuals. Below are some techniques that you may find beneficial to reduce stress levels:

Aerobic Exercise

Exercise promotes overall well-being, helps manage stress levels, and has evidence to support improvements to migraine frequency and severity. While there are no current recommendations for the duration, research suggest gentle aerobic exercise such as walking or cycling are beneficial. It is important to start slowly, listen to your body, and find a type of exercise that work best for you.

Try low impact exercises such as walking, cycling and yoga, focus on finding an exercise that you enjoy and can tolerate.
Can begin with short bouts of activity and increase as you are able to tolerate more.
Working up to an accumulative 30 minutes per-day

Diaphragmatic breathing

Utilising breathing techniques can help provide a distraction from your migraine symptoms while getting your nervous system to ‘wind-down’.

Lie on your back with your knees bent and your head supported.
Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
Breathe in slowly through your nose so that your stomach moves out, causing your hand to rise. The hand on your chest should remain as still as possible.
Exhale through your mouth in a slow and controlled manner. The hand on your stomach should move down while the hand on your upper chest remains as still as possible.

Neck Stretches

Many people develop muscular tension in their neck, shoulders, and upper back. For certain people (such as myself) this can be an aggravating factor to migraines. When completing the following neck stretch, focus on your breath and go a far as tolerated.

Sit up straight with both hands at the sides.
While keeping everything else still, rotate the head to the left about 45 degrees (which is about halfway toward the shoulder).
Tilt the chin downward until a good stretch is felt on the back right side of the neck.
To increase the stretch further, the left hand can be brought up to the back of the head to gently pull down a little more.

Migraines are multifactorial, meaning stress may only be one factor for your symptoms. Consult with your Doctor for an appropriate treatment plan that is individualised to you.

Do you Floss?

michael.andrews@absolutebalance.com.au (Michael Andrews) — Mon, 01 May 2023 01:08:17 GMT

Most of us know about dental floss and quite a few of us can do the dance “Floss”, but how many of us have ever heard of a nerve floss??

Chronic overuse injuries, muscle strains, and tendinopathies are known for causing muscle and joint mobility issues and are generally treated with gentle exercises prescribed by Accredited Exercise Physiologists. When assessing range of motion and pain in clinic, muscle and joint mobility are typically investigated by health professionals to understand limitations with movement, and to help design an exercise program that is safe and effective at improving symptoms.

What many people don’t know is that Accredited Exercise Physiologists can also assess nerve length and mobility as well during treatment to assist with identifying and rehabilitating musculoskeletal conditions. Nerves are an important component of mobility and can also be affected by changes to our muscles and joints. NEURODYNAMICS is the term used to describe neural tension testing (assessing how tense your nerves are!) It is easy to do and requires very little or no equipment. Assessment techniques consist of movements that pretty much replicate the actual exercise prescribed for treatment. Exercises are designed to mobilise nerves via a “flossing action” through the joint, hence the name Nerve Floss!!

The goal of treatment is to decrease pain and irritation, improve range of motion, and improve any other neurological symptoms that may be experienced. Nerve flossing is important to consider, and may help with your rehabilitation if you experience any (but not limited to) of the following:

Carpal tunnel
Sciatica
Lower back pain
Peripheral neuropathy
Shoulder impingement
Elbow tendinopathies
Post-operative rehab

Ultimately, our nerves are important to consider during injury management. It’s not just our muscles and bones that can be impacted, but our tendons, ligaments, connective tissues and nerves as well!!

RESOURCES:

Ballard, E., Fontenot, M., May, J., & Scifers, J. R. (2018). Neurodynamics. Athletic Training & Sports Health Care, 10(4), 149-153.

Shandelle Drain

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Exercising for Mental Health....and how it saved me!

Wed, 26 Apr 2023 02:26:34 GMT

Life can be a lot sometimes. To cope with the normal stressors of life, it’s important to maintain good mental health…. but what does that even look like? Mental health is a state of wellbeing that affects how you think, feel and act. It influences how you handle stress, how you relate to others and how you view yourself and the world around you. When left unchecked, you can develop mental health conditions and disorders like anxiety and depression. Over 2 in 5 Australians aged 16-85 have experienced some sort of mental disorder in their life. A person doesn’t need to meet the criteria for a mental disorder to be negatively affected by mental health though, and maintenance of our mental health should be equally as important as our physical health. It’s well known that regular exercise has many positive health outcomes for the body and our physical health, but what’s often overlooked is the impact exercise has on mental health. I have always been a bit of a fitness fanatic, but it took hitting rock bottom to truly understand the role exercise could play in my life.

Two and a half years ago, my life was turned upside down when we welcomed two identical tiny humans into the world. With no family support in the country, we knew parenting would be hard – and it was - but no one prepared me for the unavoidable chemical changes your body sustains with being a new mother. Regardless of how much support or how many babies you have, the hormonal changes are inevitable. Now add sleep deprivation, identity crisis and a global pandemic and you have a pretty good recipe for mental health issues. These were the darkest moments of my life. I had never felt so alone, incapable, overwhelmed and just immensely sad. All.of.the.time. Exercising at that point seemed impossible, let alone desirable like it once was. 2 months into my parenting journey (in the middle of a Covid lockdown) I was admitted into the MBU (Mother & Baby Unit) at King Edwards Hospital for 3 weeks, where I was diagnosed with post-natal depression, anxiety and attachment disorder. Fast forward a week into my treatment, I was told for about the 20 ^th time that unless I started taking medication (anti-depressants), my condition wouldn’t improve. I fully support medication as a means of treating mental illness, but knowing my body and predisposition prior to having children, I knew this wasn’t my way out. I could tell my resistance to treatment was getting frustrating for all involved and I began feeling a bit hopeless.

One day, a nurse suggested working exercise into my care plan. Exercise? I had completely forgotten that word even existed. 30 minutes of exercise a day was worked into my routine and that same day she arranged for someone to care for my children while I went outside for a run. In my current state of mind, going for a run (or going outside for that matter) was the last thing on the planet I felt like doing. I still remember the exact moment I started running when something in my brain clicked – this was exactly what I needed. Unfortunately, depression can have somewhat of a paralytic effect. I knew I needed this exercise, but certainly wasn’t prepared to do it of my own free will. It took someone practically pushing me out the front door to get going. Each day though, it became easier for me to put my shoes on and head out by myself. After just a week of my new regime, I was reassessed and found to be less reactive and more positive throughout the day. Don’t get me wrong, it wasn’t an instant fix. It wasn’t until 6 months later I finally noticed I was actually looking forward to things and enjoying activities again.

Fast forward again to today – I live an active and healthy lifestyle with my husband and two crazy toddlers, I love my job and find myself surrounded by positive people. Most importantly, I now have the capacity to enjoy all of the little thing's life throws my way. I know without a doubt that exercise was the catalyst that drove my recovery.

It’s no wonder running had such a big impact on my mental health. Exercise releases mood-improving chemicals in your brain such as endorphins and serotonin. It can also help reduce feelings of loneliness and isolation by getting you out and interacting with other people. Practicing mindfulness while doing exercise has also been shown to reduce stress and improve mental health.

As depression most often makes you feel very tired and unmotivated, it can be hard to get started. One strategy is starting slow and setting small goals for yourself. This could be making sure your dog gets a daily walk, or taking the stairs at your office and giving yourself a mental high five when you get to the top. I promise you that achieving those small goals will feel good. If you need some support, ask friends or family members to help motivate you and keep you on track. Alternatively, there is a range of health professionals that can help – including exercise physiology.

Exercise physiologists specialise in delivering exercise, lifestyle, and behavioural programs in order to prevent and manage chronic conditions and injuries, including mental health conditions such as depression and anxiety. They can help set your goals and keep you accountable in a safe and supportive environment. Most exercise studies have shown a significant reduction in depression after eight weeks or more.

Whatever your exercise intensity – every little bit counts. You must start somewhere, and a great place to start is by chatting with your preferred health provider. Most importantly, talk about it! Share your story like I have. Invite your friends to join you on your exercise journey. The more people who know, the more support you’ll have…and before you know it, you’ll be inspiring others to do the same!

About mental health | Australian Government Department of Health and Aged Care

Managing-depression-with-exercise.pdf (blackdoginstitute.org.au)

National Study of Mental Health and Wellbeing, 2020-21 | Australian Bureau of Statistics (abs.gov.au)

Mental Health Benefits of Exercise: For Depression and More (healthline.com)

Carly Saunders

Administrative Assistant

Absolute Balance Exercise Physiology Group

Dupuytren's disease - How can exercise help?

Thu, 20 Apr 2023 05:54:39 GMT

In recent times as an Exercise Physiologist working with injured workers, I have been exposed to Dupuytren's disease more and more often. While I was a student this was lightly touched over, however I’ve found myself wondering how or why it has become more and more prevalent. Understanding that this is a condition is hereditary for the most part, I have found myself rehabilitating more and more workers particularly those who work in heavier industries. So, for this reason, I wanted to better understand the condition and what the evidenced suggests is the most affective forms of treatment.

Dupuytren's disease is a condition that affects the hand and occasionally the feet, causing the fingers to contract and curl towards the palm. The condition typically develops gradually, and the underlying cause is not yet fully understood. While there is no cure for Dupuytren's disease, there are several rehabilitation strategies that can help improve hand function and quality of life. This blog will explore the various rehabilitation techniques for Dupuytren's disease, including exercises, splinting, and surgical intervention.

Exercises

Exercises can help improve hand function and mobility in individuals with Dupuytren's disease. There are several types of exercises that are recommended, including range-of-motion exercises, strengthening exercises, and stretching exercises. Range-of-motion exercises involve moving the affected finger(s) through their full range of motion. These exercises can help prevent stiffness and maintain flexibility in the hand. Examples of range-of-motion exercises include finger bends, finger lifts, and finger curls.

Strengthening exercises involve using resistance to build strength in the hand and fingers. These exercises can help improve grip strength and overall hand function. Examples of strengthening exercises include finger squeezes, grip exercises using a stress ball, and resistance band exercises. Stretching exercises involve gently stretching the hand and fingers to improve flexibility and prevent contractures. Examples of stretching exercises include hand stretches, wrist stretches, and finger stretches.

Splinting

Splinting is another rehabilitation strategy that can help improve hand function in individuals with Dupuytren's disease. A splint is a device that is worn on the hand or finger to help prevent contractures and maintain range of motion. Splints can be custom-made or off-the-shelf, depending on the individual's needs. A splint is typically worn for several hours each day, depending on the severity of the condition. The goal of splinting is to stretch the affected tissue and prevent further contractures. Splinting can also be used after surgery to prevent the fingers from contracting again.

Surgical intervention

In some cases, surgical intervention may be necessary to improve hand function in individuals with Dupuytren's disease. Surgery is typically recommended for individuals who have severe contractures or who have lost significant hand function. There are several surgical techniques that can be used to treat Dupuytren's disease, including fasciectomy, fasciotomy, and needle aponeurotomy. The choice of surgical technique depends on the severity and location of the contracture.

Fasciectomy involves removing the affected tissue from the hand or finger. This is typically done under general anaesthesia and requires several weeks of rehabilitation. Fasciotomy involves cutting the affected tissue to release the contracture. This is typically done under local anaesthesia and requires several weeks of rehabilitation. Needle aponeurotomy involves using a needle to puncture the affected tissue and release the contracture. This is a minimally invasive procedure that requires less rehabilitation than other surgical techniques.

Conclusion

In conclusion, Dupuytren's disease is a condition that affects the hand, causing the fingers to contract and curl towards the palm. While there is no cure for Dupuytren's disease, there are several rehabilitation strategies that can help improve hand function and quality of life. These strategies include exercises, splinting, and surgical intervention. It is important for individuals with Dupuytren's disease to work with a healthcare professional to develop a personalized rehabilitation plan that meets their individual needs.

References

American Society for Surgery of the Hand. (2019). Dupuytren's Contracture. https://www.assh.org/handcare/hand-arm-conditions/dupuytrens-contracture

Mayo Clinic. (2021). Dupuytren's Contracture. https://www.mayoclinic.org/d

Tony Galati - Rando

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Stop Drinking Your Calories!

Tue, 18 Apr 2023 02:51:11 GMT

Calories can easily sneak into our day without us realising through what we drink. As the calories ingested from sugary drinks such as soft drink, fruit juices or alcohol don’t offer any nutritional value you are likely to consume extra calories throughout the day rather than compensate for the calories in your drinks as you would with food. In just one 375ml can of Coke there is 40g of sugar, Red Bull contains 27g, Powerade 35g and Lipton Iced Tea has 26.4g. To put it into perspective, The World Health Organization recommendation for a healthy adult is no more than 50g of sugar per day. In terms of calorie content, a single can of Coke contains 161 calories which is the equivalent to ¼ cup of hummus and veggies, 1 tablespoon of peanut butter on a rice cake or 1 small apple and 10 almonds.

Easy ways to reduce your sugar intake through liquid:

Keep track of your drinks: If you are tracking calories make sure you are including the calories in what you drink as well as what you are eating.
Use water as your go to for hydration throughout the day: Water will hydrate you much more efficiently (without the added sugar or calories) than a sugary soft drink or fruit juice, it will also help to keep your hunger in check.
Don’t add sugar to your tea or coffee: This one’s a no brainer. If you think you’ll find it hard to cut it out immediately try reducing the amount of sugar you use gradually.

If weight loss is your goal, cutting out (or at least down) your consumption of empty calories will significantly improve your results.

References:

Gill, J.M., & Naveed, Sattar, N. (2014) Fruit Juice: Just another sugary drink? The Lancet:Diabetes & Endocrinology. 2(6), 444-446

Vartanian, L.R., Schwartz, M.B., & Brownell, K.D. (2007) Effects of Soft Drink Consumption on Nutrition and Health: A systemic Review and Meta-Analysis. American Journal of Public Health. 94(4), 667-675

Katie McGrath

Injury Prevention Specialist

Injury Prevention Services

An Exercise Physiologist's guide to finish a half marathon injury free.

Thu, 06 Apr 2023 01:15:59 GMT

Have you recently signed up to run a half marathon? It can be a great challenge and accomplishment for runners of all levels; however, it requires a lot of preparation and training in order to complete the distance safely and effectively. In this blog, we will discuss some different types of training that can help you train for a half marathon to help you get your personal best and more importantly to beat your mates!

Long runs are a crucial part of any half marathon training plan. These runs will help you build up your endurance and get your body used to running for an extended period of time. Start with shorter distances and gradually increase your distance over time, allowing your body to adjust to the distance.

Tempo runs are a great way to improve your speed and stamina. These runs involve running at a pace that is slightly faster than your normal training pace for an extended period of time. This will help you develop your lactate threshold and teach your body to sustain a faster pace for longer periods of time.

Interval training involves alternating between periods of high intensity running and periods of rest or recovery. This type of training can help improve your overall speed and cardiovascular fitness. A popular interval training workout for runners is the "Tabata" workout, which involves 20 seconds of all-out effort followed by 10 seconds of rest, repeated for 8 rounds.

Strength training is an important component of any half marathon training plan. It can help improve your overall fitness, reduce your risk of injury, and improve your running form. Focus on exercises that target the muscles used in running, such as squats, lunges, and calf raises.

Plyometric exercises involve explosive movements that can help improve your running power and speed. These exercises include things like box jumps, squat jumps, and jump lunges. Incorporating plyometric exercises into your training can help improve your overall athleticism and make you a stronger, faster runner.

Stretching or practicing yoga can be a great way to improve your flexibility and prevent injury during half marathon training. Focus on stretches that target the muscles used in running, such as your hamstrings, quads, and calves. Yoga can also help improve your balance and mental focus, which can be beneficial during longer runs.

Cross-training involves participating in activities other than running, such as cycling, swimming, or rowing. Cross-training can help improve your overall fitness and give your body a break from the repetitive motion of running. It can also help prevent injury by strengthening muscles that may not be used as frequently during running.

In conclusion, training for a half marathon requires a combination of endurance, speed, strength, and flexibility. By incorporating these exercises into your training plan, you can improve your overall fitness and prepare yourself for the challenge of running 21.1 kilometres. Remember to start slowly and gradually increase your distance and intensity over time, and always listen to your body to prevent injury. Good luck on your half marathon journey!

Peter Webster

Workers Compensation Specialist ‑ Team Leader North East (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

The weak knees of an Exercise Physiologist.

Tue, 04 Apr 2023 08:05:07 GMT

Sweaty palms, heavy arms, spaghetti (mum’s), but mainly weak knees.

At one stage it seemed like almost a pre-requisite for joining the team at Absolute Balance, but I, like several of my colleagues, fell victim to the dreaded ACL injury. Unfortunately, not once but twice; a right knee ACL rupture in 2017, followed by a left knee ACL rupture and medial and lateral meniscus tears in 2020. In 2017 I underwent an ACL reconstruction with hamstring graft, after which I returned to competitive sport comfortably at 18 months. In 2020 I decided not to undergo surgery, instead attempting a non-operative approach. I made major progress but ultimately due to my knee still “giving way” I would not be able to return to competitive sport unless I underwent surgery. Since then, my ongoing strength program has allowed me to return to running comfortably, engage in recreational activities, and significantly reduce occurrences of my knee giving way. From my journey I was able to experience first-hand some key factors in managing ACL tear rehabilitation successfully.

An experienced and knowledgeable support team.

In 2017 I did not have a strong support network of professionals to guide me through my post-operative rehabilitation. The surgery outcome itself was a success but my rehabilitation was disjointed. I lagged in my rehab stages, still not having full range of knee flexion at 12 months post-operation. I experienced poor mental health, and ultimately had a delayed return to competitive sport at 18 months.

In 2020 I was able to navigate my recovery with the right guidance and support from a physiotherapist experienced in non-operative ACL rehabilitation, an experienced and honest surgeon (who told me impartially a return to competition would not be likely without surgery), and an exercise programme (self-prescribed as an AEP) guided by their recommendations. This allowed me to achieve strength and fitness levels greater than I had before the injury.

Prehab = low risk, high reward.

A positive of my training post ACL rupture is I can’t make it worse as it’s gone and it’s not growing back (although recent studies have shown in some lucky people, it can do just that). The caveat is being mindful not to get carried away and cause damage to everything else, now that I can do most activities I enjoy. The improvements in muscle strength from the non-operative approach should hold me in good stead leading into my eventual ACL reconstruction.

A meta-analysis by Poulsen et al (2019) identified that the risk of developing osteoarthritis after a significant knee injury was 4-6 times higher than a non-injured knee, however this risk was similar regardless of operative or non-operative approaches. Studies also support the completion of preoperative rehabilitation consisting of progressive strengthening and neuromuscular training prior to surgery, as patients were shown to have greater functional and subjective outcomes (Failla et al (2016), Rejiman et al (2021)).

Make an educated decision.

Ultimately the choice comes down to the patient, but it is important that they are presented with the research, risks, and benefits, to make an informed decision. As allied health professionals, it is important for us to provide up to date information on their injury, recovery timeframes, and support them in their journey. Lifestyle, demands, age, and comorbidities should be factored into the decision making; however, a positive outcome is more likely when a patient is provided the right support, and surrounded by a team of professionals who are looking out for their best interest.

References.

Failla, M. J., Logerstedt, D. S., Grindem, H., Axe, M. J., Risberg, M. A., Engebretsen, L., . . . Snyder-Mackler, L. (2016). Does Extended Preoperative Rehabilitation Influence Outcomes 2 Years After ACL Reconstruction? A Comparative Effectiveness Study Between the MOON and Delaware-Oslo ACL Cohorts. Am J Sports Med, 44(10), 2608-2614. doi:10.1177/0363546516652594.

Poulsen, E., Goncalves, G. H., Bricca, A., Roos, E. M., Thorlund, J. B., & Juhl, C. B. (2019). Knee osteoarthritis risk is increased 4-6 fold after knee injury - a systematic review and meta-analysis. Br J Sports Med. doi:10.1136/bjsports-2018-100022.

Reijman, M. et al. (2021) “Early surgical reconstruction versus rehabilitation with elective delayed reconstruction for patients with anterior cruciate ligament rupture: Compare randomised controlled trial,” BMJ [Preprint]. Available at: https://doi.org/10.1136/bmj.n375.

Bastien Auna

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Exercise Physiology in the workers compensation system?

Fri, 17 Mar 2023 00:25:07 GMT

This was my main question when I started as the Business Development Manager with Absolute Balance nearly 8 months ago. My experience over the past ten years of employment had been split between various industries such as the sporting goods, retail, and educational software industry. Little did I know the amount of empathy and learning that about to happen!

My introduction was fast paced and full of new faces and perspectives. The first month flew by and included the amazing experience of meeting roughly thirty odd exercise physiologists. My learning quickly snowballed into understanding each consultant and the reason they became an exercise physiologist. The reasons behind each consultant were both inspiring and humbling at the same time.

With every conversation, a team member took the time to explain the industry and the role the Absolute Balance team plays. My understanding and appreciation grew with every conversation and interaction. I quickly realised I was now surrounded by the best of the best in the industry. Each session I spent with an AB team member I learnt more about the workers compensation system, and its purpose. Accidents at work are unfortunate and often have huge implications for all parties, mainly the employee who has now sustained an injury which will prevent them from earning an income and providing for themselves or their family, thus the workers compensation system assists with this period of an employee’s life.

The Absolute Balance has built up a team of experiences exercise physiologists, who all operate on similar basics and methods. We believe these basics are the reason we achieve the results we do and why so many stakeholders chose us. A main stakeholder we spend a vast majority of time with is the treating General Practitioner. What we find so often with the GPs that we work with is how time-consuming workers compensation claims are, difficulties in getting report and then having to translate this on medical certificates. Because of this we are the only company that uses visual evidence to show return to work progress. What this means for the GP is that they can easily see their patients progress, through graphs and videos and have certainty when updating medical certificates, without having to read through pages of reports.

As specialists in workers compensation, we know that the GP wants the best outcome for their patients, and to assist them to get back to living their best lives. As specialists in worker compensation claims, we drive return to work outcomes, prescribing exercises that directly relate to the requirements of the patient’s job role. This enables a GP to have full confidence in the treatment we have recommended, knowing that we all have the same goals. Because we know that workers comp claims can be frustrating. We will provide a dedicated workers compensation specialists to be the GPs point of contact for the duration of the claim. A problem shared is a problem halved – we are here to help. We will come in regularly to show how the patient is progressing and be present in all case conferences, handling all the back-end details for the GP.

We strongly believe this will give the treating GP, confidence, and clarity during a workers compensation file. From a personal perspective I cannot wait to continue to learn in the industry and help the AB team go from strength to strength.

Michael Andrews

Business Development Manager

An Exercise Physiologist's Perspective

Tue, 14 Mar 2023 06:00:00 GMT

We as Exercise Physiologists see people who present with a whole range of pathologies, including those who have undergone surgery. At Absolute Balance, we specialise in helping injured workers within the Worker’s Compensation system and our goal is to help affected workers navigate through their rehabilitative journey as smoothly as possible and assist with a safe return to work and quality of life.

Living with an injury can be extremely frustrating and most people have experienced an injury of some kind. We understand that this can be very debilitating and limit us from doing the most basic activities of daily living such as walking, brushing your teeth, opening a jar, hanging out the washing (the list goes on). Throw in the sleepless nights, reduced independence, ever-increasing mental stress and anxiety that creeps in and it’s enough to make anyone go mad. The good news is that there is growing evidence that exercise rehabilitation benefits everyone, whether they have an injury or not. We have seen many workers return to their full-duties and everyday activities just by giving it a chance and being committed to their recovery.

On the first day we meet with the referred patient we discuss with them how life looked like before they suffered an injury. This includes their job role and the tasks they are required to do and recreational activities that they previously enjoyed. We try to help them understand it will be a journey and that we are there to encourage and empower them through it all to get them back to work and doing what they love. Now, the important thing to note is that a good outcome for an injured patient is equal to a good commitment to recovery, given that muscles don’t just get stronger or more flexible magically.

We understand that not everyone has been in a gym before and that it can be quite an overwhelming and intimidating experience at first. However, as an Exercise Physiologist, our role is to ensure that an injured patient is completing their exercises safely and appropriately by seeing them on a regular basis, keeping track of their functional progress, providing feedback and creating a rehabilitation programme specifically tailored to them as an individual. By the time an injured patient has completed their programme, we often see a significant improvement in strength, flexibility, endurance and most of all, confidence. Confidence to go back to work and trusting in their own ability to return to their normal way of life.

Chris Chen

Workers Compensation Specialist ‑ Innovation Team Leader (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Health benefits of hot and cold exposure.

Fri, 10 Mar 2023 02:33:44 GMT

Heat exposure and cold plunge are two distinct types of therapy that can have significant benefits for the body. Heat exposure can include activities like sauna use and steam rooms, while cold plunge therapy usually involves immersion in ice-cold water. While these therapies are often used separately, there is growing evidence that combining heat and cold therapy can have a synergistic effect and provide even greater benefits for the body.

Benefits of Heat Exposure

Heat exposure has been used for centuries as a form of therapy for various ailments. Sauna use, for example, has been shown to have benefits for cardiovascular health, respiratory function, and skin health (Leppäluoto et al., 2018). Sauna therapy can also have positive effects on the immune system, reducing the risk of infection (Laukkanen et al., 2018).

Improved Cardiovascular Health: Steam rooms help in improving cardiovascular health by increasing heart rate and dilation of blood vessels, essentially mimicking moderate physical activity. This increase in blood flow helps to improve oxygenation of the body's tissues (Kukkonen-Harjula & Kauppinen, 2006).
Respiratory Benefits: Steam rooms can help to alleviate respiratory issues such as asthma, bronchitis, and allergies. The heat and humidity in a steam room can help to clear the respiratory tract and soothe the airways (Jokic et al., 2016).
Improved Skin Health: Saunas can help to improve skin health by opening up the pores and promoting sweating. This sweating can help to remove dead skin cells and other impurities from the skin, leaving it looking refreshed and rejuvenated (Crinnion, 2011).
Pain Relief: Saunas can help to relieve muscle and joint pain by increasing blood flow to the affected areas. The heat from the sauna helps to relax the muscles, which can alleviate pain and soreness (Oosterveld et al., 2009).
Improved Immune System: Saunas can help to improve the immune system by increasing the production of white blood cells. The heat from the sauna stimulates the body's production of white blood cells, which are responsible for fighting off infections and diseases (Ernst et al., 1990).

Benefits of Cold Plunge

Cold plunge therapy, on the other hand, involves immersion in ice-cold water and is often used after exercise to reduce inflammation and speed up recovery. Studies have shown that cold plunge therapy can improve muscle soreness, reduce inflammation, and improve athletic performance (Bieuzen et al., 2013). Cold water immersion can also have benefits for the cardiovascular system, improving blood flow and reducing blood pressure (Lombardi et al., 2017).

Combined Benefits of Heat Exposure and Cold Plunge

While heat exposure and cold plunge therapy are often used separately, there is growing evidence that combining the two can have even greater benefits for the body. One study found that combining sauna use and cold-water immersion can improve cardiovascular function, reduce inflammation, and improve overall health (Leppäluoto et al., 2015).

The benefits of combining heat exposure and cold plunge therapy may be since the two therapies have opposing effects on the body. Heat exposure increases blood flow, while cold immersion reduces blood flow. Alternating between the two can create a "pumping" effect on the blood vessels, which can improve circulation and reduce inflammation (Takagi et al., 2018).

When considering mental health, there is growing evidence to suggest hot and cold exposure can have very positive effects:

Improved Mood: Exposure to hot temperatures can release endorphins and serotonin, which can improve mood and reduce feelings of anxiety and depression. Cold exposure has also been shown to improve mood by activating the sympathetic nervous system, leading to an increase in norepinephrine levels.
Stress Reduction: Both hot and cold exposure can help reduce stress levels. Heat exposure can lead to a relaxation response, while cold exposure can activate the body's natural stress response and help the body better cope with stressors.
Improved Sleep: Heat exposure can improve sleep quality by promoting relaxation and reducing muscle tension. Cold exposure has also been shown to improve sleep by decreasing the time it takes to fall asleep and increasing deep sleep.
Increased Energy and Focus: Exposure to both hot and cold temperatures can increase energy levels and improve cognitive function. Heat exposure can increase blood flow to the brain and enhance cognitive function, while cold exposure can increase alertness and focus.
Improved Immune Function: Cold exposure has been shown to improve immune function by increasing the production of white blood cells and activating the body's natural defence mechanisms.

Conclusion

In conclusion, heat exposure and cold plunge therapy are two distinct types of therapy that can have numerous benefits for the body. While they are often used separately, the growing evidence of its benefits is exciting. By alternating between heat and cold therapy, individuals may be able to improve their cardiovascular health, reduce inflammation, and improve overall health and well-being.

References

Crinnion, W. J. (2011). Sauna as a valuable clinical tool for cardiovascular, autoimmune, toxicant- induced and other chronic health problems. Alternative medicine review, 16(3), 215-225.

Ernst, E., Pecho, E., Wirz, P., & Saradeth, T. (1990). Regular sauna bathing and the incidence of common colds. Annals of medicine, 22(4), 225-227.

Jokic, A., Kostic, M., Jokic, N., & Simic, D. (2016). The effect of sauna on patients with bronchial asthma. Vojnosanitetski pregled, 73(9), 803-808.

Kukkonen-Harjula, K., & Kauppinen, K. (2006). Health effects and risks of sauna bathing. International Journal of Circumpolar Health, 65(3), 195-205.

Oosterveld, F. G., Rasker, J. J., Floors, M., Landkroon, R., van Rennes, B., Zwijnenberg, J., ... & Koel, G. J. (2009). Infrared

Hewett, Z. L., Pumpa, K. L., Smith, C. A., Fahey, P. P., & Cheema, B. S. (2018). Effect of a 16-week Bikram yoga program on heart rate variability and associated cardiovascular disease risk factors in stressed and sedentary adults.

Ed Daccache

Workers Compensation Specialist ‑ Team Leader South (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Why I became an Exercise Physiologist - Afiq Jackson

Fri, 03 Mar 2023 00:14:16 GMT

Since being a Team Leader at Absolute Balance, I get the amazing opportunity to assist with the onboarding of the new starter that join our ever-growing team and identifying ‘Why did you become an EP?”, will always be something I ask as early as possible. Starting with WHY and trying to understand someone’s WHY is the most important step in understanding the purpose, meaning or belief behind any action they take.

As Simon Sinek says, ‘it doesn’t matter what you do, it matters why you do it.’

The most significant benefit I have found with understanding the WHY of a colleague is that whenever the ‘going get tough’, either through life or work, if I can always relate it and link it back to the WHY, we can almost get through any challenge and achieve any outcome. So funnily enough, I was only asked the other day by a colleague, ‘Afiq, why did you choose to be an exercise physiologist?’. To my surprise I paused, it had been a while since I considered the notion. Interestingly as I left the conversation, it seemed like the last 9 years since I had graduated played like a mini camera reel quickly in my head and I was trying to hone in on the moment I thought this is why I do what I do.

Rewind...

I studied Exercise Physiology back in 2014 and at the time, it seemed like the natural progression after completing a Bachelor of Exercise Sports Science and I also think it was what some of my other friends had continued to do the same prior. I had a strong desire and interest towards movement and biomechanics; specifically understanding the role that they played in the rehabilitation of an injury. I also paired that with the fact I enjoyed meeting and working with different people and hearing their stories.

Then I worked for a boutique fitness company for 6.5 years not utilising nearly half of what I learnt through my studies, and I got to work on changing the fitness industry and making an impact in people’s lives through exercise. In that time frame I progressed through varying positions to a national role, but at the end of the line, something wasn’t clicking. Whilst I didn’t lose my why, I look back and realise I wasn’t working for my why as much as I thought I was, so I left that company and took the time to work out what’s next.

That time took 4 months. Refreshing, nervous and scary but valuable and much needed.

The most important part of that time was establishing again my why. ‘Why did I study for 4 years to be an Exercise Physiologist?’. But to peel a layer back further, being an Exercise Physiologist was just the method, mode, tool, or service that I used to achieve the why. I realised that at the centre of the last 9 years and the reason I did the roles I did and worked in the places I had, was that ‘I wanted to help make someone better than they were yesterday’.

So fast forward to now. My role at Absolute Balance is balanced in two spaces, as an Exercise Physiologist and as the Clinical Team Leader and luckily for me I get to make a difference on bettering someone everyday doing both. I get the opportunity to instil small changes in habits, behaviours and attitudes with both patients and colleagues every day. I’m fortunate enough to help a patient go from being unable to kneel and pick up their bag to climbing sets of stairs with relative ease. Each day just helping make a small improvement, that 1%, is why I do what I do.

It's important to never lose sight of the why, as it is most likely going to be the main intrinsic motivator behind all actions or outcomes that people try to achieve. If you find you’re ever facing a hurdle or challenge professionally, or even personally, think back to your why and that should help you create the steps or process to get what you desire.

Afiq Jackson

Workers Compensation Specialist ‑ Team Leader Northwest (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Who is Erin Jutsum?

Fri, 17 Feb 2023 00:36:23 GMT

Hi everyone, I’m Erin and I am an Accredited Exercise Physiologist at Absolute Balance.

While I have always enjoyed sport and being physically active, I initially did not envision myself pursuing this field as a career. I became interested in Exercise Physiology when I saw the positive impacts that exercise had on a family member with a chronic health condition. Becoming a running theme; during my postgraduate degree I also never thought I would work within the Workers Compensation scheme. This changed after sustaining a lower back and shoulder injury 2 months into my course. While I didn’t enjoy the chronic pain, I have now come to appreciate this experience, as it has taught me the various (and often unexpected) ways an injury can impact someone’s life.

I am now passionate about providing exercise rehabilitation to help others feel empowered and confident in their bodies when returning to meaningful activities. Outside of work I like to spend my time going to the gym and playing volleyball. To lead a balanced life, I like to counteract these physical activities by spending an inordinate amount of time inside playing videogames.

Erin Jutsum

Workers Compensation Specialist (AEP, ESSAM)

The year of 2022...

Mon, 19 Dec 2022 04:54:45 GMT

As the year draws to a close it is a fantastic opportunity to look back on the year that has been, a time to reflect on the challenges and honour the wins.

As we reflect, we celebrate both professional and personal successes. We had team members purchase houses, celebrated marriage, and some welcomed new additions to their family, whether that be a baby or a pet. Professionally, we continued learning and growing enabling Absolute Balance to expand our footprints physically and metaphorically.

We are proud of our achievements this year. We have welcomed additional Regional Managers and Team Leaders into the fold to support our ever-growing teams located in the Perth Metropolitan area, the Southwest of Western Australia and across New South Wales. I would like to take this opportunity to thank our team for their tireless work in achieving some great projects this year including:

GUS - Our very own internal CRM system that allows report generation, appointment scheduling and better efficiencies to occur. Implemented last year but utilised better in 2022. It has reduced the administration and created a better Patient experience and positive outcomes. As a result, we were able to ascertain data that provided valuable information around training areas and potential clinical efficiencies for both our team as well as our stakeholders.

Our New Premises – Having recently celebrated 12 months at Osborne Park we have witnessed our teams work and communicate in a collaborative way as well as provide a base for professional development and training. It has truly become our home especially each Friday when the team convenes for training, file reviews and team bonding.

Panel Presentations – Throughout the year Absolute Balance presented new training platforms for our partners. It was well supported, for that we thank you and we trust that all who attended gained a better understanding of the Exercise Physiology world and how developing strong teams assists in greater patient care and outcomes.

Community Engagement – proceeds from all panel presentations were forwarded to our charity of choice. This year we supported the Smith Family. Absolute Balance will continue to support such worthy charities with our teams attending community-based events.

Finally, I wish to thank our clients and partners. Your support has helped Absolute Balance reach our yearly objectives and we look forward to working together in the future to achieve the best outcomes for you. But for now, from the team at Absolute Balance Exercise Physiology Group, we trust you have an enjoyable Festive Season, enjoy the time off to reset, recharge and ignite for what next year has ahead for you. We wish you a safe holiday period and a bright return in 2023.

Derek Knox

Founder / Director

Daine Richards - The beast from the East.

Thu, 15 Dec 2022 06:55:43 GMT

A fresh face from the far East!

Hello everyone, my name is Daine and I have been working as an Accredited Exercise Physiologist in the workers compensation realm at Absolute Balance for just over 7 months now. A little about me. Before May of this year, I lived my whole life in Wollongong, NSW, which is where I went to school and then studied my Exercise Physiology degree at the University of Wollongong. I then moved over to Perth after a short while contemplating my career in work and sport, juggling national and international level hockey with study and work. With many opportunities over in the West, I saw it as a great move to delve into a new life in a professional career whilst also being able to balance my keen interest in sport.

Since being in Perth, Absolute Balance has assisted me with this tough juggle, allowing me to settle into a comfortable role delivering quality rehabilitation services to injured workers, whilst also training and competing on a weekly basis. On the other hand, my general interests include going to the beach, skating and food.

Now why Exercise Physiology and particularly Absolute Balance? Personally, I’ve always had a keen interest in musculoskeletal anatomy and injury through university and coming from a sporting background.

I also saw the impact a work-related injury could have on a person's professional and non-professional life and thought a career assisting these individuals would be both intriguing and fulfilling. In my time at Absolute Balance, I have had the opportunity to rehabilitate several individuals back to work and what they love doing and have found great pride when experiencing the significant impact this time can have on a person’s life. Furthermore, encouraging, educating and seeing others adopt exercise into their life is ultimately rewarding.

Furthermore, I look forward to continuing to develop my professional skillset and broadening my knowledge to cater for a wide variety of complex claims under workers compensation. Still being quite new to Perth, I am also always open to any travel recommendations to make the most of this fresh start!

Daine Richards

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Can exercise be beneficial after a traumatic brain injury?

Mon, 24 Oct 2022 02:11:29 GMT

A traumatic brain injury (TBI) is a form of acquired brain injury usually occurring when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and/or violently hits an object or if an object pierces the skull and damages brain tissue. Symptoms of a TBI can differ drastically depending on the extent of the damage to the brain, they can range from light headaches, dizziness and blurred vision to memory loss, seizures, slurred speech and weakness of the extremities.

With such an array of symptoms categorising a TBI it begs the question can exercise benefit those who suffer with such an injury considering it all stems from the brain. A brain injury is quite different from a broken bone or torn muscle, which can be addressed much easier and generally has a much shorter recovery timeframe. With the brain, there are a lot of complicated processes occurring that control our thoughts, emotions, and bodily functions. With traumatic brain injury patients, we must treat the patients physical brain damage but also account for their cognitive/emotional side effects

90% of patients have the ability to exercise after a mild traumatic brain injury (TBI), but patients are sometimes hesitant to experience a worsening of symptoms. While the fear of worsening symptoms is reasonable for each client, what they may not know is that if patients don’t exercise, it can increase the risk of weight gain, depression, cardiovascular disease, or quitting positive habits they used to enjoy

An Accredited Exercise Physiologist prescribed exercise programme may have to account for many different symptoms depending on each individual TBI. Appropriate prescription is critical for the management of symptoms, but this allows us to be very creative to individually adapt exercises across multiple modalities of exercise such as balance, strengthening, flexibility, cardiovascular fitness and even cognitive exercises.

Strengthening

- Bicep Curl

- Sit to Stand

- Seated Exercises

Balance

- Single Leg Balance

- Weight Shifts

- Tandem Walking

Cardiovascular

- Cycling

- Walking

- Step Ups

Flexibility

- Shoulder/Neck Stretching

- Hamstring/Quadriceps Stretching

- Lower Back Stretching

Cognitive

Just as you can improve muscle function through rehabilitation exercises, you can improve cognitive function through cognitive exercises.

- Journal or Creative Writing

- Puzzles

- Cognitive Therapy Games

References

- NeuLifeRehab1 (2022) Why exercise is important in the rehabilitation of brain injury patients, NeuLife. Available at: https://neuliferehab.com/why-exercise-is-important-in-the-rehabilitation-of-brain-injury-patients/.

- Traumatic brain injury (no date) National Institute of Neurological Disorders and Stroke. U.S. Department of Health and Human Services. Available at: https://www.ninds.nih.gov/health-information/disorders/traumatic-brain-injury.

- Zhang, Y. et al. (no date) The benefits of exercise for outcome improvement following traumatic brain injury: Evidence, pitfalls and future perspectives, Experimental Neurology.

- Academic Press. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0014488621003666.

- Can exercise help with traumatic brain injury treatment? Brain: UT southwestern medical center (no date) Brain | UT Southwestern Medical Center. Available at: https://utswmed.org/medblog/tbi-exercise/.

Kai Baxter

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – NSW

Our Latest Newbie - Hannah Binstead

Mon, 03 Oct 2022 23:44:25 GMT

Hi everyone, my name is Hannah, and I am an Accredited Exercise Physiologist at Absolute Balance Exercise Physiology Group. Outside of my profession, I am a lover of running, my dog, the beach, or all three at once!

I made the great move to Absolute Balance with 18 months of Exercise Physiology experience under my belt where I was exposed to many different areas of rehabilitation. I love that Absolute Balance allows me to focus on being a Workers Compensation Specialist in the insurance field. Prior to working as an Exercise Physiologist, I worked for 10 years in hospitality (yes, I can make a great coffee… or cocktail) but while I loved the fast-paced role, I knew there was something more for me in the big bad world!

While studying Exercise and Sports Science at Edith Cowan University, I decided to move into the clinical side of sports medicine which got me hooked on rehabilitation and physiology. I have always played a lot of sport, as well on the side lines being injured so it is great to have the knowledge of rehabilitation with musculoskeletal injuries, though there is always more to learn. My dream is to keep helping individuals at any stage of recovery, to holistically enjoy their life with quality and assurance.

I look forward to meeting you ��

Hannah Binstead

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Welcome Claudia Perry - AB's new starter

Tue, 13 Sep 2022 00:26:25 GMT

Hi everyone, I’m Claudia and I am an Accredited Exercise Physiologist at Absolute Balance.

After working for a few years as an Environmental Scientist, I realised that wasn’t the career for me. I have always had a passion for helping people and from a young age I have loved sport and physical activity. I decided to go back to university and study Exercise Physiology, which I saw as a great opportunity to combine both these things. I love being an exercise physiologist, because it gives me the opportunity to have a direct positive impact on my patient’s quality of life. I place great value in empowering my patients to self-manage their injuries and return to the activities that are meaningful to them.

After having a previous negative experience as a patient within workers compensation, I am passionate about providing the best possible rehabilitation services, to maximise the chances of successful return to work. In my free time, I enjoy going to the beach with my husband and my two rescue dogs, rock-climbing and hiking. I also enjoy doing renovations on my house, although I definitely over-estimate my handyman abilities. I love travelling and exploring new places, next on my list is New Zealand and Canada!

Claudia Perry

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Welcome to the team Georgia Elliss

Mon, 01 Aug 2022 06:34:06 GMT

Hey everyone, my name is Georgia Elliss, and I am a newly recruited Exercise Physiologist at Absolute Balance.

Let’s start with how I got to where I am today, shall we?

It is quite simple really; growing up I loved sport and exercise, plus I always wanted to find a career where I could help people. So that lead me to a 4-year University degree at ECU where I could combine my two passions and become an Accredited Exercise Physiologist.

I now have 2 years’ experience in Musculoskeletal Exercise Rehabilitation with Workers Compensation Clients; and am looking to further progress my experience, knowledge and skills in this field at Absolute Balance. It is so rewarding watching a client go from not being able to complete normal activities of daily living due to their injury and progressing back to their full-time work duties. Recovering from an injury is not easy, and the fact that I get to assist my clients through their rehab journey to eventually see smiles all round by the end of it all is why I love my job.

Now for a little bit about me, if you didn’t know!

I am 24 years old and absolutely adore quality time with family and friends. I have an amazing partner, and the cutest dog named Cassie. Snorkelling is one of my favourite things to do on the weekend because the beach is my happy place and I just love the underwater world. Additionally, I enjoy travelling the world, exploring new places and going on some epic adventures. My proudest achievement in life so far must be buying my first house last year.

My favourite Quote is “Believe you can, and you will”. This has helped me get to where I am today, and I am super excited to progress my career as an Accredited Exercise Physiologist with Absolute Balance and look forward to all the experiences along the way.

Georgia Elliss

Workers Compensation Specialist (AEP, ESSAM)

What is Osteoporosis?

Thu, 21 Jul 2022 00:32:38 GMT

You may have heard the term Osteoporosis, but what actually is it?

Osteoporosis is the most common chronic metabolic bone disorder. It can affect all age groups, gender, and races, but is more common in women and the older generation. The bones become “porous” meaning their structure is weak, thin, fragile and capable of breaking easily. As a result, a minor bump or accident can cause a broken bone to happen. This condition currently affects 1 in 3 women over the age of 50 and 1 in 5 men. If actions are taken early, this can we can prevent this condition from happening.

Our bones follow a process where our bone tissue is continuously lost by resorption and rebuilt by formation. Bone loss occurs if the resorption rate is more than the formation rate. The mass of our bones become remodelled and shaped from birth to adulthood to where we reach our peak bone mass at puberty and begins to decline afterwards.

Risk factors associated with the development of osteoporosis include increasing age, sex, family history of the condition, low vitamin D levels, low intake of calcium, low body weight, smoking, excess alcohol consumption, physical inactivity, long-term corticosteroid use and reduced estrogen levels.

The primary objective in healthy adults is to prevent premature bone loss, which would predispose the individual to increased fracture risk in later life. As we age, our objective changes into preventing and/or treat osteoporosis in order to minimise the risk of suffering fragility fractures.

Here are 5 tips to help with maintaining bone health no matter how old you are:

Exercise

Exercise plays an important role in maintaining bone health. Bones benefit when a certain amount of impact or strain is placed on them making specific types of exercise most beneficial. In addition, improvement or maintenance of muscle mass, strength and functional capacity are important for our balance.

There are two types of exercise programs you can implement into your lifestyle.

Weight bearing loading exercises. These are exercises done on your feet using your own weight such as jogging, skipping, dancing, tennis and stair walking.
Resistance Training. Doing exercises with added weight which will progress over time such as pin loaded machines, dumbbells and barbells.
Mobility, Stability and Flexibility exercises are also encouraged as this will challenge your balance and help reduce the risks of potential falls.

2. Nutrition

Ensure your diet is rich in bone-healthy nutrients. This includes having calcium, vitamin D and protein which are the most important nutrients for bone health. Safe exposure to sunshine will help you get enough vitamin D as well.

Examples of key foods associated with high calcium content are milk, cheese, yoghurt, nuts (almonds & hazelnuts), tinned salmon, fruit and vegetables (figs, oranges & broccoli).

3. Lifestyle

Motivate yourself into making healthy lifestyle choices by maintain a healthy body weight, avoid smoking and excessive drinking. Smoking is associated with a reduction in bone structure and strength. And if alcohol is consumed, it should be consumed in moderation, up to one standard drink per day for women and two standard drinks per day for men. Alcohol can also impair bone formation.

4. Risk Factors

Advise your GP if you have had a previous fracture or fall, have a family history of osteoporosis or take any specific medication that may affect your bone health.

5. Testing & Treatment

Get yourself tested and treated if you’re at high risk as you will likely need medication and lifestyle changes to help protect yourself against fractures.

References

Ebeling PR, Daly RM, Kerr DA et al. (2013). Building healthy bones throughout life: an evidence-informed strategy to prevent osteoporosis in Australia. Medical Journal of Australia Open 2 (Supplement 1):1–46.

Sozen, T., Ozisik, L & Basaran, B. (2016). An overview and management of osteoporosis. European Journal of Rheumatology. 46-54.

Osteoporosis, 2020 <https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/osteoporosis/contents/what-is-osteoporosis>

Success Story - Merchant Seaman

Thu, 07 Jul 2022 02:49:06 GMT

I was only in my first 3 months with Absolute Balance when this patient came into my world. He was also my first experience with rehabilitating a right ankle subtalar fusion. This workers compensation patient had a history of arthritis, which due to the nature of his job, had become significantly degenerative. As a merchant seaman (specializing in integrated rating), he spends months on end out at sea on large vessels delivering commercial goods.

The 54-year-old patient had been managing rheumatoid arthritis through conservative medical therapy, however after 18 months, the he was recommended to have surgery for the degenerative ankle, a surgery that would most likely inhibit him to ever run or jump again. The surgery would most definitely mean he would not be able to return to sea again.

So, imagine being told that you will never be able to do the thing you love and enjoy the most ever again? How would you take that? What would you do about it? Luckily, this patient had a never say never attitude and he had an Exercise Physiologist that had the same idea. So, in July 2021, eight weeks after having subtalar fusion, we commenced his rehabilitation journey.

Due to the type of surgery, the patient presented with limited to no range of movement and he indicated that he may not get any significant range of movement back. But what we could do is educate the patient on working around this barrier. After twelve weeks of being in a Cam Walker, we began rebuilding basic single leg strength and balance. As we progressed through the rehabilitation, achieving minor milestones each phase, the patient’s confidence began to grow along with the hope of returning to his pre-injury job.

The great part of this job is the opportunity to be creative and think laterally when it comes to how we can educate and rehabilitate patients through movements that they have never completed before or show the direct correlation from a pre-injury task to a replicated movement in the gym. Interestingly, two of the patients’ favourite exercises that he noticed the greatest correlation to his pre-injury task, was in fact a reverse sled drag and sled push. The patient and I saw benefit that by having a resisted load to drag, it yielded significant quadricep recruitment, combined with assisting in gait mechanics.

Each week he could lift and carry a little heavier, he could ambulate up and down steps that little quicker, he could kneel and crouch that little more repetitively and he could push and pull that little bit easier. The last hurdle was making the six-month review to make sure the bone graph had fully taken and completing a pre-employment medical.

We knew, the minute that tick of approval had come through it was go time for that medical assessment. So, we prepped for three weeks to complete that medical. We were confident the pre-injury role could be completed, we had visual media to show everyone that he could do it. Sure enough, after a 5 months journey of consistent and patient rehabilitation, I got the best phone call from the patient. “I passed, I’m going back to sea, thank you!”. My response “this was all your hard work; I just gave you some guidance to get there.” This outcome was a result of education, empowerment and engagement.

The patient let me know a few weeks later that he was getting redeployed back out to sea, on the ‘big boy’ he called it and that this was his final goal. We had got him back to where he wanted to be, back on the sea where he was most happy. That’s why we do what we do.

Afiq Jackson

Workers Compensation Specialist ‑ Team Leader North West (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

James Chandler - The New Kid on the Block

Thu, 07 Jul 2022 02:01:03 GMT

G’day everyone,

I’m James (Jim / Jimmy / Jimbo), an Exercise Physiologist who specialises in the workers compensation scheme.

I was born in the big smoke of Perth, however moved down south at the age of 12 and grew up in the surfing town of Margaret River. I lived on a farm around 30 minutes from the beach, so I can safely say I must be one of the only locals who didn’t surf. As such, my afternoons were typically spent in the paddocks rather than in the swell. Growing up on a farm taught me a lot about patience and hard work, along with the ability to find enjoyment in even the most mundane of activities. After graduating high school in 2015, I returned to Perth to study Sports Science & Management at UWA, before completing my Masters in Clinical Exercise Physiology in 2021. I chose Exercise Physiology as I had a keen interest in sport and rehabilitation, along with believing the huge role exercise can play in a persons general health and wellbeing.

On the weekends you may find me playing Tennis, attending live music gig’s and passionately supporting the mighty Fremantle Dockers. I also love camping and ‘escape’ up north during the colder months, which I refer to as my winter hibernation.

Following my degree, I moved into what is affectionately known as “Voc Land”, or Vocational Rehabilitation. My primary role was to coordinate the return to work plan for injured workers and discussing with stakeholders how to best support the individual with their return to work. I also provided pre-employment medical assessment’s for a wide array of jobs.

It was during this role I discovered the effect a well structured exercise program can have on returning an injured worker back into meaningful employment. As such, I reached the conclusion a career with Absolute Balance would align with my beliefs as a practitioner as I could form meaningful relationships face-to-face, not from behind a screen. Since joining Absolute Balance, I have focussed on encouraging all individuals to best manage their injury and empowering them to return to what matters most to them. I have a keen interest in shoulder and knee rehabilitation, as I have gone through similar injuries in my ‘professional’ sporting career and can empathise with the journey ahead.

I genuinely look forward to meeting new people and creating meaningful relationships, which drives me to ensure everyone in the workers compensation system feels valued and cared for, and not just another claim number.

James Chandler

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services – WA

Patient Spotlight - Boiler Maker

Thu, 23 Jun 2022 09:25:23 GMT

In February 2022 a workers compensation patient was referred to us after sustaining a medial meniscus tear in her right knee while at her workplace. This patient is employed as a boilermaker welder for one the major mining companies here in WA. After sustaining the injury in January 2021, this patient continued to complete her 8/6 FIFO roster on modified duties, until finally succumbing to surgery in November 2021.

This patient advised she was a single woman, lived alone and enjoyed heading on solo camping trips on her week off from site. An activity she could no longer enjoy as a result of her injury. By the time this patient was referred to Absolute Balance, she was back at square one after a failed bout of conservative treatment, that had ultimately led to surgery. The patient admitted to being sceptical of exercise rehabilitation due to her previous failed attempt with conservative treatment, that was mostly based around Manuel therapy and dry needling techniques.

I first met this patient for one of eight sessions in early February of 2022 where I was quick to pick up on the external factors at play and the patient hesitance to engage in a structured exercise regime.

By identifying critical job demands and requirements for this patient’s role, I was able to develop a prescription-based exercise program aimed at strengthening the surrounding musculature of the knee joint as well as educating the patient on safe manual handling techniques that could be implemented at work to avoid moving her knee into compromised positions.

As much as the patient wanted to complete her job role pain free, the patient had a strong desire to re-engage with the outdoors which was something she was very passionate about. Identifying the patients love for the outdoors as a critical component to the patient’s mental health, I was able to supply the patient with self-managing equipment such as a Fitball and various tensile resistance bands, that could be utilised by the patient while on site but also while camping in the great outdoors.

By acknowledging the patient’s willingness to utilise self-managing equipment for her to participate in camping/recreational activities, the patience compliance and overall recovery was fast-tracked, leading to the patient being certified fit for full duties before the end of our 6 ^th session, well inside expected recovery timeframes.

This case is one of many examples of the amazing work the Exercise Physiologists at Absolute Balance do that impacts their patients’ lives, looking holistically at the patient and by understanding that someone's job can define them as a person.

This is how we save lives. We ensure that injuries that occur at work do not mean that an individual cannot engage in meaningful employment in the future or have to change their life goals to meet their new circumstances. Our vision of making exercise the answer for all health conditions resonates through our everyday treatment of patients with our team embodying this vision. I look forward to sharing more patient stories with you over the coming months as we continue to help more injured workers in 2022.

Jakeb Tartaglia

Workers Compensation Specialist ‑ Team Leader South (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

How Much Should My Kids Be Exercising?

Thu, 16 Jun 2022 01:25:51 GMT

When most adults think about exercise, they picture workouts in gyms, going for a run, or lifting heavy weights. But for kids, exercise often means play, games, and being social. Exercise for children typically involves group activities such as playing tag, riding their bikes, and participating in club and team sports. So how important is exercise for kids and how much exercise should school-age children actually be doing each day?

The importance of exercise: Being active during childhood has many short and long-term health, social, emotional, and intellectual benefits. Active kids have stronger bones, muscles, and cartilage and are at a lower risk of developing certain diseases or becoming overweight. Active kids also sleep better – something no parent would object to. In addition to improving health, being active in childhood provides kids with opportunities to socialise and learn teamwork and cooperation skills. They are also more likely to have higher self-esteem and better mental health. Being active in childhood also results in better concentration in other aspects of life, such as in school.

Being active during childhood also has long-lasting benefits that continue into adulthood. Children who exercise are more likely to be active adults. There is also evidence to suggest that adolescent physical activity provides long-term benefits on bone health, reduces the risk of developing certain types of cancer, and improves aspects of mental health.

What are the different types of exercise kids need? There are three elements of fitness that children need: aerobic, strength, and flexibility. Aerobic exercise refers to endurance and improves the efficiency of the heart and the body’s ability to deliver oxygen to its cells. Aerobic exercise occurs during a game of soccer, or when swimming, skipping, or jumping.

Strength exercise develops muscles and bones. Doing strength exercises doesn’t necessarily mean lifting weights, rather, kids can improve their strength through climbing, doing handstands, or through body weight exercises such as push ups and sit ups.

Flexibility can be improved through stretching and allows bones and joints to move easily through their full range of motion, as well as increases blood flow to the muscles and helps prevent injuries. Activities for flexibility include dancing and gymnastics, martial arts, and stretches.

So how much exercise should kids be doing? It is recommended that children do at least 60 minutes of moderate to vigorous physical activity each day. This can be all at once or spread throughout the day. Strengthening activities should be incorporated at least 3 days per week and flexibility should be practiced daily.

How can you get your kids to be more active? Kids can exercise through play or organised sports such as netball or running. Team sports are especially good as they have a social aspect. It is also important to note that children model their parents’ behaviours. This means that if they see you exercise, they are more likely to do so as well. As such, exercising with your kids is another great opportunity to increase your and their physical activity and enjoy spending time together.

References

Australian Government Department of Health. (2021, May 6). For children and young people (5 to 17 years). Australian Government Department of Health. Retrieved March 21, 2022, from https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-children-and-young-people-5-to-17-years

Dimitri, P., Joshi, K., & Jones, N. (2020). Moving more: physical activity and its positive effects on long term conditions in children and young people. Archives of disease in childhood, 105(11), 1035-1040.

Gavin, M. L. (Ed.). (2022, February). Kids and exercise (for parents) - Nemours KidsHealth. KidsHealth. Retrieved March 21, 2022, from https://kidshealth.org/en/parents/exercise.html

Hallal, P. C., Victora, C. G., Azevedo, M. R., & Wells, J. C. (2006). Adolescent physical activity and health. Sports medicine, 36(12), 1019-1030.

Lahti, A., Rosengren, B. E., Nilsson, J. Å., Karlsson, C., & Karlsson, M. K. (2018). Long-term effects of daily physical education throughout compulsory school on duration of physical activity in young adulthood: An 11-year prospective controlled study. BMJ open sport & exercise medicine, 4(1), e000360.

Morgan, P. J., Lubans, D. R., Callister, R., Okely, A. D., Burrows, T. L., Fletcher, R., & Collins, C. E. (2011). The ‘Healthy Dads, Healthy Kids’ randomized controlled trial: efficacy of a healthy lifestyle program for overweight fathers and their children. International journal of obesity, 35(3), 436-447.

My First Experience in Theatre

Thu, 21 Apr 2022 00:25:29 GMT

On the 25 ^th of January I had the pleasure of observing Dr Jean-Louis Papineau from Coastal Orthopaedics at Bethesda hospital for plate removal of distal tib/fib open fracture with manipulation under anaesthesia. This was the third surgery for a patient who had a traumatic workplace injury 10 months prior. I felt it was important to gain a more thorough understanding of the procedure involved and recovery required. Throughout the procedure I had the chance to engage and be apart of every stage with explanations for why extra steps were taken and how they were likely to improve the outcome.

It become obvious that surgeries although having the same guidelines and procedures, would require patients to recover in different ways and with more specific rehabilitation. For me it is easier to now understand why some patients recover differently than others. Did you know that an additional cause of pain following surgery is from the tourniquet applied above the surgical site to reduce blood flow during the procedure?

Dr Papineau explained that although patients will present with the same or similar injuries it is crucial that advice is tailored specifically due to the individual characteristics and differing anatomical/physiological make up. During this observation Dr Papineau said the patient had a pronounced development of scar tissue in a short period of time and this was likely to occur again following this procedure. As such he strongly encouraged me to push the patient through discomfort and reinforce, he could not damage the ankle in order to reduce the impact of the oncoming scar tissue before it settled.

A major commonality I noticed between surgical teams and Absolute Balance is the importance and value placed on communication. Whilst in theatre every person was actively involved in a process be it providing tools and equipment, monitoring anaesthesia and multitasking with two surgeons operating on different things at the same time. The benefits to this team approach can include better patient outcomes, reduced operating times and confidence in supportive colleagues. Likewise in the Workers Compensation industry it is crucial that all stakeholders involved on a claim are aware of what is occurring at what stage and how long it is expected to occur. This collaborative approach results in significantly better outcomes.

It is always such a valuable learning experience to be able to observe surgery on a patient to get a better understanding of their personal rehabilitation requirements. This time is an invaluable chance to speak directly with the surgeon regarding prognosis, timelines and staged recovery planning to name a few. This experience has changed my approach through greater understanding of scar formation and discussing the aggressiveness of rehabilitation with specialists. I would urge all allied health professionals to ask about opportunities to learn from a specialist in theatre, for me, I would be very interested in observing a muscular or tendon repair such as a supraspinatus tear which I commonly treat. I hope this further experience would assist my understanding of the slow nature necessary of this type of repair.

Cameron McRae

Workers Compensation Specialist (AEP, ESSAM)

RPE-based training – What is the Borg RPE Scale and how can I apply it to my workouts?

Thu, 21 Apr 2022 00:17:23 GMT

What is RPE?

The Borg Rating of Perceived Exertion (RPE) Scale is a subjective scale which is used to estimate one’s own level of exhaustion. The original scale was a 6-20 scale, relating to heart rate, whereby 6 denotes a resting intensity and 20 is maximal intensity. For simplicity, there exists a modified scale of 1-10.

RPE can be applied to both resistance exercise and cardiovascular exercise and is usually obtained either immediately following a bout of exercise or after the session is complete (session-RPE). The Borg Scale defines an exercise to be of a particular intensity based on the range it sits in (see figure below for details). The RPE scale offers an intuitive approach to exercise in the form of self-monitored training intensity.

It should be noted that despite distinct categories of light, moderate and hard intensity, the RPE scale is more accurately represented as a spectrum.

Given time and practice, the Borg RPE Scale can yield more accuracy and consistency as one’s perception of exertion will improve. Coaches may also ask for a client’s RPE to gauge their progress and difficulty of the session.

How can I apply RPE to my own training?

RPE can be set at a pre-determined value prior to performing a set or bout of exercise. On days when energy levels are diminished, or when working through an injury, deliberately working at a low RPE could be a viable strategy to avoid excessive fatigue and prevent further injury. An example of this would be acquiring a knee injury and decreasing the amount of weight lifted on squats, effectively lowering the RPE.

On the other hand, on days where energy levels are high and performance seems to be at its peak, training at a high RPE could be beneficial. For instance, testing 1-repetition-max performance requires RPE 10, therefore it would be more appropriate to perform this on days with higher energy levels to avoid injury.

This method of adjusting the session intensity as you go is a sustainable way to approach training and may be appropriate for the majority of people. It is important to keep in mind that for people with specific training goals and deadlines such as competitions, abiding by the programmed intensity leading up to competition could yield a better outcome.

If strength progression is a goal, an individual may notice that their RPE for a given set performed each week may be slowly dropping, implying that strength has increased and therefore it would be time to increase the weight. This method of tracking progression may also apply to other forms of exercise such as running. Performing a 5km run may invoke a post-session RPE of 9, but after completing the same run frequently for 2 months at the same pace, the RPE may drop to 7, indicating that it is time to increase the pace or distance.

How hard should I be working?

RPE should be varied across a training program such that each week is not consistently at a high RPE in order to avoid burnout and fatigue. It is impossible to sustain a session-RPE of 9-10 for every session. With this in mind, the optimal RPE range to work within would be 6-10. This recommendation varies slightly throughout the current literature and there also exists newer studies which investigate low RPE coupled with high frequency training for hypertrophy. However, for the most part, training at a reasonably high RPE will return good results and let one feel accomplished after the workout.

RPE vs RIR

RPE is often used synonymously with Repetitions in Reserve (RIR), another method of subjectively scoring intensity. RIR describes the number of repetitions which could have been performed at the end of a given set, ie. The number of repetitions that were “left in the tank”. For example, after completing a set of 5 repetitions on the deadlift, one may think they could have done 2 more repetitions if they really tried. In this case the RIR would be 2, and their RPE could be somewhere between 7-9 depending on how they felt after the set. There is a slight discrepancy between these two subjective measures, however both will help gauge a similar finding.

The Borg RPE Scale is extremely useful for day-to-day exercise sessions. It can be used to track exercise progression and to adjust exercise intensity accordingly. It also encourages workouts to be completed at lower energy/effort levels on days where we simply aren’t feeling it, reminding us that doing something is definitely better than doing nothing.

References

[Image]: USING THE RPE SCALE - CMS Fitness Courses https://cmsfitnesscourses.scdn6.secure.raxcdn.com/wp-content/uploads/2018/12/cms-fitness-courses-rpe.jpg

Ciolac, E. G., Mantuani, S. S., Neiva, C. M., Verardi, C. E. L., Pessoa-Filho, D. M., & Pimenta, L. (2015). Rating of perceived exertion as a tool for prescribing and self regulating interval training: a pilot study. Biology of Sport, 32(2), 103-108.

https://doi.org/10.5604/20831862.1134312

Haddad, M., Stylianides, G., Djaoui, L., Dellal, A., & Chamari, K. (2017). Session-RPE Method for Training Load Monitoring: Validity, Ecological Usefulness, and Influencing Factors. Frontiers in Neuroscience, 11(612), 1-14.

https://doi.org/10.3389/fnins.2017.00612

Loomis, B. (2021). Struggling with RPE? This is the blog for you. 3D Muscle Journey. https://3dmusclejourney.com/struggling-with-rpe/

Changing your body composition.

Wed, 20 Apr 2022 23:10:58 GMT

How to stop blaming our genetics and start seeing changes!

There are 5 different variables we can change to start seeing some changes.

1. Quit the processed foods

What we put into our body is the most critical variable we can change that will guarantee changes, and it’s not about eating less. What you eat each day makes up portions of your cells, hair, skin, nails, muscle, fat and so much more. The nutrients you consume aren’t just getting transported through your digestive system and bloodstream; they are also a vital part of everyday tissue generation that makes us who we are. When we look at a food it represents so much more than calories it is nutrients that makes up your cells, so chose wisely.

Studies have shown that those who eat processed foods eat an average of 500 calories more per day than those who eat unprocessed food. In one study this excess calorie consumption eventuated in a kilo weight gain over a 2-week period. Not only do processed foods contain high amounts of added sugars, fats and sodium (salt), they also often contain artificial ingredients, and they don’t always list everything they add. For example, companies don’t have to list what combination of chemicals they include when they mention the food has “artificial flavour”.

With excess calories and unknown chemicals, we can ask ourselves the question; do we really want unknown chemicals making up the cells of our body?

2. Food sensitivity

Ever felt bloated or fatigued after a meal? This could be due to food sensitivity. Being intolerant to a specific food may mean that your body is identifying it as a foreign body that needs to be eliminated. The body then attacks it and spends its energy doing that rather than spending energy on protein synthesis. This may cause some inflammation, swelling and headaches.

Over 20% of the population have a food intolerance and many don’t even know about it. If you start to notice this feeling it may be beneficial to try an elimination diet. This diet is simple, it involves removing the food you’re suspicions of for 14 days and reintroduce it. If you notice you feel better, then you know to make a change and remove that food from your diet or continue to have it and suffer the consequences. If you feel no difference, then you’re able to cross that food off the list and try another food.

3. Sleep

Research has shown that getting inadequate sleep may lead to retention of body fat and increased risk of weight gain. How? Evidence shows that the lack of sleep leads to reduced production of leptin (sanity hormone) and increases levels of ghrelin (appetite hormone). This combination may compromise the effectiveness of a well-balanced nutrition and training program.

4. Fibre for the win

Fibre filled food is a natural probiotic, which provides your gut with good bacteria, which is desirable for fat loss and overall health. The average western diet contains 15g of fibre which is half the minimum recommended. Aim to get at least 30g of fibre per day to maximise your weight control and provide your gut with the bacteria in loves.

5. Train what you love

By partaking in an activity that you enjoy, you’re more likely to stay consistent and avoid skipping those days when you really can’t be bothered. Whether it is weights, cardio, group training or a walk along the beach, doing a type of exercise you enjoy is good for the body and the mind.

References

Cadegiani, F. and Kater, C., 2018. Body composition, metabolism, sleep, psychological and eating patterns of overtraining syndrome: Results of the EROS study (EROS-PROFILE). Journal of Sports Sciences, [online] 36(16), pp.1902-1910. Available at: <https://www.tandfonline.com/doi/full/10.1080/02640414.2018.1424498> [Accessed 2 February 2022].

McRorie, J., 2015. Evidence-Based Approach to Fiber Supplements and Clinically Meaningful Health Benefits, Part 1. Nutrition Today, [online] 50(2), pp.82-89. Available at: <https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/digestive-physiological-outcomes-related-to-polydextrose-and-soluble-maize-fibre-consumption-by-healthy-adult-men/4F8D79E001C3976AF303724B14648D0F> [Accessed 3 February 2022].

Nardocci, M., Leclerc, B., Louzada, M., Monteiro, C., Batal, M. and Moubarac, J., 2018. Consumption of ultra-processed foods and obesity in Canada. Canadian Journal of Public Health, [online] 110(1), pp.4-14. Available at: <https://link.springer.com/article/10.17269/s41997-018-0130-x#citeas> [Accessed 1 February 2022].

Westerterp-Plantenga, M., 2020. Challenging energy balance - during sensitivity to food reward and modulatory factors implying a risk for overweight - during body weight management including dietary restraint and medium-high protein diets. Physiology & Behavior, [online] 221, p.112879. Available at: <https://www.sciencedirect.com/science/article/pii/S0031938420301967> [Accessed 2 February 2022].

Why do we get muscle cramps?

administrator@heliummarketing.agency (Helium Marketing) — Thu, 31 Mar 2022 00:58:13 GMT

Have you ever been woken up during the night by a sudden painful muscle cramp? These can occur at any time whether it’s during our sleep, pregnancy, or during strenuous physical exercise. But have you wondered why is this happening?

Muscle cramps are sudden, involuntary, and painful muscle contractions which self-extinguish within seconds to minutes. Any muscle can be affected but the muscles in the calf and foot are particularly prone to happen more than others. The exact cause of cramps is still unknown but there are some risk factors as to why this is occurring: poor physical condition, mineral and electrolyte imbalance (potassium, sodium & magnesium), dehydration or tight and fatigued muscles. What generally happens, is you feel a sudden sensation of uncontrollable and painful spasm in the muscle and it twitches.

There are treatment options or preventative strategies that can help, but there isn’t enough research yet to understand which treatment or strategy works best. Nevertheless, there are interventions available for the treatment. These treatment options include:

Stretch and massage the affected muscle – lengthen the cramping muscle using a gentle, sustained stretch then lightly massage the area until the cramp subsides.
Decrease exercise intensity - ensure you are getting enough rest after your physical activity.
Sports Drinks- These contain electrolytes and minerals including sodium, potassium, magnesium, and chloride. They are essential for muscle health and help the body to absorb water.
Pickle Juice- it’s becoming a popular treatment especially in the high-level athlete world but more research is to be completed.
Further treatment – see your doctor if you experience regular muscle cramping or if cramps last longer than a few minutes. You may have an undiagnosed medical condition that requires treatment.

There also some strategies we can use to prevent muscle cramps from occurring. These are some suggestions which you can apply to reduce the likelihood of them happening.

Increase your level of physical fitness.
To do reasonable/moderate stretching before exercise.
To respect pause/rest during exercise and/or between exercises/competition.
Drink plenty of water before, during and after exercise.
Make sure your diet is nutritionally adequate and include plenty of fruits and vegetables.

If you notice that you are getting muscle cramps on a regular basis or the pain is severe, it’s best to book in a visit with your GP as there could be some underlying medical issues.

References:

Qiu, J & Kang, J. (2017) The Scientific Pages of Sports Medicine. Exercise Associated Muscle Cramps- A Current Perspective. 3-14

Miller.K.C, Stone. M.S, Huxel.K.C & Edwards. J. E (2010). Sports Health Atheltic Training. Exercise-Associated Muscle Cramps: Causes, Treatment, and Prevention. 278-281

Communication

administrator@heliummarketing.agency (Helium Marketing) — Thu, 17 Feb 2022 00:54:38 GMT

Communication can be many things; however, it is based on the process of using words, sounds, signs or behaviours to express ideas, thoughts or feelings and exchange information. Verbal communication relates to anything relating to speaking with others and has been affected most recently due to mask mandates. It is key for maintaining successful relationships, building productivity, reduce errors which facilitates things to run smoother. Luckily, communication is not solely dependent on verbal exchanges. There are four other aspects towards communication which need to now be enhanced and utilised as we adapt to the new way of living. These four additional aspects towards communication include.

Non-verbal communication, which relates to facial expressions, posture, eye contact, hand movements, and touch. These all have a major affect on how the information shared is processed via the other person.

Written communication, can be done via email, a memo, report, Facebook post, a contract, etc. The goal of written communication is to transfer communication in a clear and concise manner, so misinterpretation of a message is minimal.
Listening, initially this does not seem to fit into the term communication very comfortable, however, active listening is one of the most important concepts behind communication.
Visual communication has skyrocketed in recent years. This includes things like videos, images, Facebook memes, pamphlets, etc.

We are constantly communicating each day, even though we may not be talking we are expressing body image, listening or on our phones looking through images. It is important to recognise how we present ourselves especially now that our senses have heightened due to mask mandates, we are becoming more sensitive to the way people are presenting themselves.

Overall, five ways we can communicate more effectively include.

Be an engaged listener
Express yourself
Pay attention to non-verbal signs
Control your emotions, and
Make intentional language choices

So where does this fit into the life of an Absolute Balance Consultant? Understanding there is more to communication than just verbal is vital for the effective delivery of information. Effective communication in all forms increases engagement, provides clarity and direction, prevents and resolves problems, builds trust, improves team building and most importantly increases engagement. Overall, we can all benefit from learning and understanding how to communicate best with others, whether it is verbal, non-verbal, written, visual or just actively listening. It can benefit not only ourselves, however, the people around us as well.

Olivia Skalko

Workers Compensation Specialist

Exercise Rehabilitation Services ‑ WA

References

Module 2: Effective Communication Techniques. Carer Gateway. Australian Government. Retrieved from: https://media.healthdirect.org.au/publications/CarerGateway_Resource_02_Effective_communication_techniques_v03.pdf

Effective Communication. HelpGuide. Retrieved from: https://www.helpguide.org/articles/relationships-communication/effective-communication.htm#:~:text=Effective%20communication%20is%20about%20more,and%20intentions%20behind%20the%20information.&text=Effective%20communication%20sounds%20like%20it,with%20others%20something%20goes%20astray .

9 Effective Communication Skills. Habits for wellbeing. Retrieved from: https://www.habitsforwellbeing.com/9-effective-communication-skills/

Make cardio your next strength session!

administrator@heliummarketing.agency (Helium Marketing) — Wed, 16 Feb 2022 23:56:51 GMT

“The heart is a muscle, now I wanna make it strong” – Gang of Youths

One of the hardest working organs in the body, beating on average 115, 000 times per day, the heart’s role is to pump blood through the circulatory system to deliver oxygen and other important nutrients to your body’s tissues.

Gang of Youths were on the money when they said, “the heart is a muscle, now I wanna make it strong” – it’s cardiac muscle to be exact a type of muscle only found in your heart and the only type of muscle that moves involuntarily. Now given its vital role in the body, we certainly want to make sure it’s strong, so how do we do that? Cardiovascular training!

Generally, the thought of cardio will divide a room, but love it or hate it, the benefits of cardio training are endless. Just as bicep curls will get those guns going, cardiovascular training will strengthen the cardiac muscle of your heart, reducing the risk of developing cardiomyopathy. Other benefits include reducing the risk of heart attack, heart disease, high blood pressure and high cholesterol – by making your heart work a little harder you can reduce your risk of heart disease by a third.

Cardio exercise is any activity that makes your heart beat faster over a sustained period of time. It is recommended for adults to accumulate 150mins of moderate exercise per week which is just 30mins five days a week and can be as simple as walking, running, swimming, cycling, dancing, the list goes on!

In 2017 the Australian Institute of Health and Welfare reported that inactivity is responsible for 11% of cardiovascular disease cases. So, we know that we need to move more, you don’t necessarily have to go hell for leather, just get moving - a strong heart is a healthy heart!

*If you already have a heart condition, make sure to consult your GP before beginning any kind of exercise program.

References:

Blomqvist, C.G. & Saltin, B. (1983). Cardiovascular adaptations to physical training. Annual Reviews Physiology. 45 (169-189).

Hellsten, Y. & Nyberg, M. (2016). Cardiovascular adaptations to exercise training. Comprehensive Physiology. 6 (1-32)The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.

About Me - Cameron Addison

administrator@heliummarketing.agency (Helium Marketing) — Thu, 10 Feb 2022 00:33:03 GMT

Hello everyone, my name is Cameron Addison, an Accredited Exercise Physiologist at Absolute Balance.

I left high school with a keen interest in how the human body worked and ways to improve its function. Originally leaning towards physiotherapy before discovering an unknown job role to me “exercise scientist.” Moving into that pathway I discovered exercise physiology, pathologies and exercise as form of rehabilitation. Falling in love with this field I decided to pursue a Masters degree to eventually become an Accredited Exercise Physiologist. Absolute Balance stood out as a leader in the workers compensation field who were values driven to provide the best outcomes for their clients. This reflected how I work and compelled me to join the team.

I have oriented towards pain science and how our bodies perceive and adapt to pain. Using exercise, we can help to assist in desensitising areas to pain through strengthening and mobility surrounding areas. Furthermore, it is an excellent method to manage flare ups from everyday ventures.

Jumping between a range of sports as I grew up from soccer to triathlons to water polo and others before finding hockey which I still play today during winter and complement with squash in the summer. From these I have had a few injuries most severe of which were a lower back injury and ankle surgery requiring me to be in a wonderful cast and moon boot in the Australian heat… fun times. Both I struggled through with Physio alone, realising now how much my recovery time and quality could have been improved if I had a structured exercise program.

Outside of sport I enjoy relaxing at home and seeing family over the weekend. Classically heading down to the beach or a friend’s pool to responsibly soak up some sun. In my spare time I like to spend it tinkering with gaming PC, enjoying upcoming videogame titles and learning about a new, exciting and somewhat polarising technology cryptocurrency. As we move into a faster paced, more interconnected world I think it is of growing importance that new technologies are developed, embraced, and integrated to provide better services and improve all our qualities of living.

While at Absolute Balance I look to add to my clinical toolkit with new methods of treatment as well as expanding my experience within the workers compensation system to be able to provide the best outcome for my clients. I am looking forward to being part of an established and inspiring team as I continue to grow as an AEP.

Cameron Addison

Accredited Exercise Physiologist (AEP) (ESSAM)

Exercise Rehabilitation Following a Spinal Fusion

administrator@heliummarketing.agency (Helium Marketing) — Thu, 10 Feb 2022 00:25:26 GMT

The human spine plays an integral part in allowing the body to move freely and bend with flexibility, while also acting as the body’s central support structure (Oxland, 2015). Patients that present with symptomatic instability, structural deformities, or elevated pain, may be treated with an interbody spinal fusion (Enders & Coughlin et al, 2020). Common spinal deformities including scoliosis, kyphosis, and lordosis, which are commonly caused by degeneration, are typical precursors for spinal fusion surgery.

Spinal fusion surgery is a neurosurgical or orthopaedical surgical technique where a bone graft is added to a segment of the spine. Bone grafts are commonly taken from the patients’ hip, harvested from cadaver bone, or a manufactured synthetic bone substitute (Ullrich, 2013). This sets up a biological response in the body that causes the bone graft to grow between the two vertebral elements to create a bone fusion (Ullrich, 2013). Two vertebral segments are fused together to stop the motion at one segment. Cervical and Lumbar spinal fusions have provided a greater than 90% likelihood of relieving radicular symptoms and stabilisation, or improving myelopathy (Levin & Hale et al, 2007). Following spinal fusion surgery, stiffness and soreness are likely to occur, thus exercise rehabilitation has long been a common feature in the postoperative management of patients undergoing this procedure (Madera & Brady et al, 2017).

Rehabilitation following a Spinal Fusion:

Postoperatively, physical therapy and rehabilitation modalities are frequently used to improve patients’ activity levels, range of motion, and core strength (Madera & Brady et al, 2017). Immediately following surgery, short distance walks are recommended in conjunction with static lower limb musculature stretching, in line with specialist recommendations (Miller, 2016). Strengthening exercises have long been the cornerstone of physical therapy. Evidence states that motor control and strengthening exercises play a vital part in postoperative rehabilitation as neutral spine exercises are recommended to increase core strength and improve disability index scores (Madera & Brady et al, 2017). As trunk muscle function and health related fitness in patients with chronic back pain are often extensively impaired, comprehensive training programmes are required. Effectiveness of exercise interventions are partly adherence dependent, thus supervised rehabilitation assist in goal setting, as well as monitoring progression and motivation (Tarnanen & Neva, 2012)

When looking at the current literature, multiple studies support a multidisciplinary approach, using evidence-based guidelines, to deliver the best outcomes for individuals following spinal fusion surgery (Madera & Brady et al, 2017.)

James McNally

Workers Compensation Specialist ‑ Team Leader East (AEP, ESSAM)

Exercise Rehabilitation Services

References

Oxland, T. (2015). Fundamental biomechanics of the spine – What we have learned in the past 25 years and future direction. Journal of Biomechanics, 49(6), 817-832.

Enders, J., Coughlin, D., Mroz, T., Vira, S. (2020). Surface Technologies in Spinal Fusion. Neurological Clinics in North America, 31(1), 57-64.

Ullrich, P. (2013). Lumbar Spinal Fusion Surgery. Spine Health.

Levin, D., Hale, J., Bendo, J. (2007). Adjacent segment degeneration following spinal fusion for degenerative disease. Health and Medicine, 65(1).

Madera, M., Brady, J., Deily, S., McGinty, T., Moroz, L., Singh, D., Tipton, G., Truumees, E. (2017). The role of physical therapy and rehabilitation after lumbar fusion surgery for degenerative disease: a systematic review. Journal of Neurosurgery, 26(6), 694-704.

Miller, R. (2016). Guide to Physical Therapy After Spinal Fusion. Spine Health.

Tarnanen, S., Neva, M., Dekker, J., Hakkinen, K., Vihtonen, K., Pekkanen, L., Hakkinen, A. (2012). Randomised controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol. BMC Musculoskeletal Disorders, 13(1), 123.

Lateral Epicondylitis (Tennis Elbow)

administrator@heliummarketing.agency (Helium Marketing) — Thu, 10 Feb 2022 00:20:57 GMT

Lateral epicondylitis (LE), also known as "Tennis Elbow", is the most common overuse injury in the elbow. It is a tendinopathy injury involving the extensor muscles of the forearm. These muscles originate on the lateral epicondylar region of the distal humerus. Overuse of the muscles and tendons of the forearm and elbow together with repetitive contractions or manual tasks can put too much strain on the elbow tendons.

Fact - Only 5% of people who experience tennis elbow associate the injury to tennis.

The main symptom of LE is pain, which can be produced by palpating the origin of the extensor muscles at the lateral epicondyle. The pain can also radiate both upwards along the upper arm and downwards along the outside of the forearm, and in rare cases, into the third and fourth fingers.

A study by Warren suggested there are four stages on the development LE and intensity of symptoms:

Faint pain a couple of hours after the provoking activity.
Pain at the end of or immediately after the provoking activity.
Pain during the provoking activity, which intensifies after ceasing that activity.
Constant pain, which prohibits any activity

One of the main treatment methods for LE is exercise-based intervention. The study of Vicenzino et al. found that physical therapy interventions including elbow joint mobilization with movement combined with exercise has been shown to have better results than "Therapeutic Corticosteroid Injection" at 6 weeks and to wait and see at 6 weeks but not 52 weeks. Recent research regarding cervicothoracic joint mobilization in conjunction with local treatment for LE has shown improvements in strength, pain, and tolerance to activity compared to local treatment alone.

An Accredited Exercise Physiologist prescribed exercise programme has been shown to both reduce symptoms and increase function of the affected limb. Once of the main exercise principles for the management of LE is eccentric exercise. An eccentric contraction is the motion of an active muscle while it is lengthening under load. The initial eccentric exercises for LE include wrist extension, pronation and supination and radial deviation, with the concentric phase of the exercise may be performed passively or with assistance from the un-injured side. Positioning of the injured side with the elbow is in full extension, forearm in pronation and the arm is supported, results in the greatest strengthening result for the extensor tendons. However, should you have moderate/high symptoms completing exercises in this position, flex you elbow to 90 degrees. Optimal dosage of exercise for the best outcomes is still to be determined, however the eccentric exercises should be performed slowly initially, with the speed of movement increased as the rehabilitation protocol progresses.

Other treatments for LE include:

Anti-inflammatory medications
Counterforce braces
Extracorporeal shock-wave therapy
Acupuncture
Injections: Cortisone, platelet-rich plasma (PRP) and autologous blood injection (ABI)
Surgery

Blake Cocking

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

Ma, K. L., & Wang, H. Q. (2020). Management of Lateral Epicondylitis: A Narrative Literature Review. Pain research & management, 2020, 6965381.

Tyler TF, Thomas GC, Nicholas SJ, McHugh MP. Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: a prospective randomized trial. J. Shoulder Elbow Surg. 2010; 19:917Y22.

Stanish WD, Rubinovich RM, Curwin S. Eccentric exercise in chronic tendinitis. Clinical orthopaedics and related research. 1986 Jul 1;208:65-8.

Bisset, L., Coombes, B., & Vicenzino, B. (2011). Tennis elbow. BMJ clinical evidence, 2011, 1117.

Warren, RF. Tennis elbow (epicondylitis): epidemiology and conservative treatment, in AAOS Symposium and Upper Extremity Injuries in Athletes, Pettrone, F.A., Ed. St. Louis: C.V. Mosby, 1986; 233-243. Level of Evidence: 1B

Plantar Fasciitis

administrator@heliummarketing.agency (Helium Marketing) — Thu, 10 Feb 2022 00:14:16 GMT

Plantar fasciitis is one of the most common and most easily identifiable causes of chronic foot pain and affects both young active patients and older sedentary individual. Plantar fasciitis is an inflammation of the plantar fascia, a piece of strong, thick tissue that runs along the bottom of the foot. It connects the heel bone to the toes, creating the arch of the foot. Inflammation is onset by the process of stretching plantar fascia beyond the normal range of extension, which causes fibrous tissue to tear, or over-stretch. This may be painful and may feel worse when walking (especially on the first steps of the day) and improved when resting.

Treatment

Stretching of the plantar fascia and calf
Wrapping non-stretch tape around the affected area to offload plantar fascia strain.
Wearing more supportive footwear
Wearing an orthotic foot support
Wearing night splints.

These nonoperative treatments lead to complete resolution of pain in 90% of patients but can take 3-6 months. For long term sufferer’s corticosteroid injections temporarily relieve pain but may increase the risk of plantar fascia rupture. Botulinum toxin injections relax the calf muscles, which decreases the stress in the plantar fascia. Operative treatments include gastrocnemius recession and medial head of gastrocnemius release, which decrease the stress on the plantar fascia.

Peter Webster

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

References

J. Miller and Z. Russell, ‘Plantar Fasciitis’ (Physio Works) < https://physioworks.com.au/injuries-conditions-1/plantar-fasciitis > accessed 6 June 2019.

Thompson JV et al., Diagnosis and management of plantar fasciitis. J Am Osteopath Assoc. 2014 Dec;114(12):900-6. < https://www.ncbi.nlm.nih.gov/pubmed/25429080 > accessed 7 June 2019

Gill and Kiebzak et al., Outcome of nonsurgical treatment for plantar fasciitis. Foot Ankle Int. 1996 Sep;17(9):527-32. < https://www.ncbi.nlm.nih.gov/pubmed/8886778 > accessed 7 June 2019.

How to ‘Correct’ our Posture

administrator@heliummarketing.agency (Helium Marketing) — Thu, 10 Feb 2022 00:09:51 GMT

Posture has always been the topic of discussion impacting individuals in the corporate workplace. Given the nature of the role, sitting in front of the computer screen for long periods of time can be detrimental to the body, causing pain and stiffness especially in the lower back. It is also emphasised that sitting upright can improve our posture and protect our spine from unnecessary pain. This idea has been ingrained in us as a society that we constantly look for the next best solution to correct our posture. But does it really need correcting?

Common Beliefs about Posture

It is agreed upon by the community that straightening our back is the safest way to sit and bend down. Individuals are normally advised to sit upright and perform lifting tasks in a natural lordotic* posture or sometimes even with a straight back. It is also assumed that maintaining these postures will protect the spine. Through these beliefs, it links everyday tasks such as sitting, standing, bending, and lifting as key indicators related to lower back pain.

Similarly in the fitness industry, it is advocated to protect the spine when lifting weights. A term we often hear in a gym setting is to “activate our core muscles” in order to maintain “perfect form”. Despite the growing beliefs about proper lifting techniques, there is no strong evidence suggesting that avoiding any posture prevents lower back pain nor is curving our spine associated with pain. While additional effort is required when maintaining the ideal posture, there is also no evidence suggesting that it aids in reducing pain.

Change the “Posture Narrative”

There is no single “correct” posture
Differences in postures are a fact of life
Posture reflects beliefs and moods
It is safe to adopt more comfortable postures
The spine is robust, adaptable and can be trusted
Sitting is not dangerous

Comfortable postures differ between individuals and adopting more relaxed postures while getting reassurance that they are safe can provide symptom relief. Any posture will be uncomfortable if we spend enough time in it. Having the perspective that pain can be prevented by avoiding certain postures only reinforces higher levels of fear which leads to moving more cautiously. Instead, focus on moving frequently and standing or sitting in a way where you feel is comfortable. Find a posture that is more optimal for you, and this can always be ever-changing.

References:

Pavlova, A., Meakin, J., Cooper, K., Barr, R., & Aspden, R. (2018). Variation in lifting kinematics related to individual intrinsic lumbar curvature: an investigation in healthy adults. BMJ Open Sport & Exercise Medicine, 4(1), e000374. doi: 10.1136/bmjsem-2018-000374

Slater, D., Korakakis, V., O'Sullivan, P., Nolan, D., & O'Sullivan, K. (2019). “Sit Up Straight”: Time to Re-evaluate. Journal Of Orthopaedic & Sports Physical Therapy, 49(8), 562-564. doi: 10.2519/jospt.2019.0610

Swimming tips on controlling breathing

administrator@heliummarketing.agency (Helium Marketing) — Fri, 14 Jan 2022 05:07:35 GMT

It sounds funny but learning to breath properly is often the first major improvement in new swimmers looking to be more competitive. Mastering this challenge will set you up to progress further into the world of ocean swimming as well as making you a force to be reckoned with.

Firstly, good swimming posture is vital. The ideal swimming posture is eyes mostly pointed down with a very slight tilt up, hips towards the surface of the water and feet just below the surface with small fast kicks. An optimal swimmer will be able to maintain this posture throughout the event.

Below are some further steps you can take to improve your breathe control in the water:

1. Start all swims lowering your stress and anxiety. This may include breathing before getting in the water, writing a journal or even going for a walk. This step will help reduce your heart rate and make you feel more comfortable in the water.

2. Breathe every 2 strokes. But why not breathe every 3 or 4 or 5 strokes? Well after about 30-60 seconds our body switches from the anaerobic energy system to the aerobic energy system. This means that after this time, the body needs more oxygen to produce energy and therefore breathing more can potentially give you better energy production, so you have more power to push your arms and kick your feet.

3. It is a common myth that we breath from an urge to have oxygen. When we breath, carbon dioxide is produced as a waste product. The body senses this build up and creates an urge to exhale and inhale for ‘fresh air’. This is commonly known as the CO ² reflex. Moral of the story? Don’t hold your breath!

4. Following from point #3 holding your breath while your head is under water is a waste of time. Instead, try to exhale constantly whilst you are face down, and thus when you turn your head to catch a breath all you must do is breathe in for a split second whilst continuing your stroke. This can significantly increase your speed as you will need less time with your mouth out of the water and can therefore speed up your stroke pace. When first learning this, it can be helpful to think ‘breath In, Out, In, Out.’

5. Lastly, you don’t want to lift your head when you go to breathe. Ideally, you will rotate your head to the side just until your mouth is clear of the water to breathe. This will keep your body better aligned in the water and increase your streamline speed.

Most importantly, just like everything else worth doing in life practice makes perfect. So, Practice. Practice. Practice.

Cameron McRae

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

References

Gaal, M., n.d. Proper Breathing Technique for Swimming. ACTIVE.com. Available at: <https://www.active.com/triathlon/articles/proper-breathing-technique-for-swimming-875008> [Accessed 11 November 2021].

Dawson-Cook, S., 2016. Don’t Hold Your Breath. Usms.org. Available at: <https://www.usms.org/fitness-and-training/articles-and-videos/articles/dont-hold-your-breath?Oldid=3250> [Accessed 11 November 2021].

Riewald, S. and Rodeo, S., 2015. Science of swimming faster. Human Kinetics.

How do I Improve my shoulder range of motion?

administrator@heliummarketing.agency (Helium Marketing) — Fri, 14 Jan 2022 05:00:43 GMT

The Busselton Jetty swim will see competitors swim either 3.6km or 1.6km before making their way to the pub for a well-earned beverage. It is important to note that elite distance swimmers will complete an average of 85/100 strokes per minute, now that’s a lot of strokes!

So, if I was to advise you that shoulder pain is the most common musculoskeletal injury found in swimmers, would that surprise you?

Let’s be honest, the swim stroke Freestyle, is by far the most popular and well renowned swim stroke on the planet. The Freestyle swim stroke is divided into four primary phases referred to as the catch, pull, exit and recovery. When these four phases are repeated multiple times, its easy to see why the shoulder joint and surrounding musculature are put under a lot of stress.

Now let’s get into the fun stuff, I’m about to take you through three shoulder mobility exercises to not only improve your range of motion, but also improve your stroke efficiency in the pool or open water.

Throughout these three exercises, make sure you breathe and can smile—if you can’t, then it’s too intense and you need to back off. Your body will only make lasting changes that it is comfortable with and your facial expression and breathing are strong indicators of this.

Shoulder Mobility + Tennis Ball: This can be uncomfortable at first, but over time it really helps to open up the shoulder joint. Lie on your back and place a tennis ball between your spine and scapula with your palm up and arm on the floor. Bring the arm across your body toward the opposite hip and bring it back up overhead in a diagonal motion. You can also take your arm across your body, then bring it up overhead, and then return it to your slide in a snow angel motion.

T-spine Mobility + Double Tennis Ball: Lying on your, back place two tennis balls (either taped together or in a tied-off sock) at the bottom of your spine where your ribs connect. Perform a quarter sit-up movement a few times and then slide the balls up one vertebra. Perform the same sit-up movement on this vertebra and then scoot up to the next one. Continue until you’ve reached where your shoulder meets your spine. Focus on the mid-back and not the lower back or neck for this exercise.

Seated Wall Angel Knees Bent: Sit on the floor with your back upright against a wall. Place your forearms and elbows against the wall. Squeeze your shoulder blades together and while holding them tight, move your arms up and down the wall as long as you can keep contact with the wall and your elbows.

Jakeb Tartaglia

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

References

Shapiro C, Shamus E, (2001)

Sports injury prevention and rehabilitation. New York: McGraw-Hill: Vol 103-154.

Tovin, B. (2006)

North American Journal of Sports Physical Therapy. Atlanta, Georgia: Vol 1-4

Picture References

https://www.google.com/search?q=Spikey+ball+release+spine&tbm=isch&ved=2ahUKEwjmvcCq7pH0AhWbjtgFHXyyBZcQ2

https://www.google.com/search?q=seated+wall+angel&tbm=isch&ved=2ahUKEwiM09Ko7pH0AhW2yXMBHV5cAuMQ2- 366&rlz=1C1CHBF_en-GBAU976AU976#imgrc=K5XJ3m0NaGLmJM

Why should you be working on your freestyle kick?

administrator@heliummarketing.agency (Helium Marketing) — Fri, 14 Jan 2022 04:44:25 GMT

A focus toward an efficient freestyle kick is often underappreciated when looking from the outside in. Usually there is a stronger emphasis on what the upper body is doing, for example the number of strokes performed, how much drive the upper body provides when pulling one through the water and how elite swimmer’s can make their stroke look effortless. However, under the surfaces, there is a lot of work happening by the hips that can sometimes go un-noticed.

When you kick through the water, the drive that your ankle, knees, and hips provide allows your body to stay higher in the water. What this in turn does is minimizes the amount of ‘drag’ that you have in the water. The higher your body stays in the water, the more streamlined you become which means there is less water working against you in your stroke. This ideally allows you to then launch into your stroked with greater force through your core and hips with a stronger kick.

Now back to my main question, why should you work on your freestyle kick? Well, here are some benefits that focusing on a kicking technique will give us, specifically, ‘added drive or propulsion’ and ‘a higher swimming posture’. These two benefits can be seen when time is put into developing and maintaining an effective flutter kick. So, you see, if you aren’t focusing some training attention to your kicking technique, then you are missing out!

How to improve your ankle mobility and strength for your freestyle kick?

· Dynamic Ankle Mobility

Most people know what passive stretching is but doing active and dynamic movements targeting the ankle specifically can be highly beneficial to increase your ankle mobility. Adding into your warmup movements such as, a) walking on your toes and b) walking on your heels, can significantly improve upon your ankle mobility. Flexible hips and ankles can lead to a more powerful kick! You can also include exercises like drawing circles with your ankle or a ‘figure 8’, bouncing on the balls of your foot, can also be beneficial for you ankle flexibility and mobility.

· Ankle Strength and Stability

Heel raises are a fantastic exercise that allow you to strengthen your calves and increase ankle stability at the same time. The great thing about this exercise is that you can perform this at any given time! All you need is a step or ledge to allow your heels to work lower past and then drive up through the balls of your feet. See the video below on how to perform this exercise. https://youtu.be/eqSgFs3ZlJs

· Who here can skip?

Something that may benefit by adding into your warmups is skipping! Why you ask, well it is a great way to get your ankles to strengthen and develop stability and as above you can do this anywhere! Skipping is also good for your overall fitness and a great way to get the heart rate up prior to getting into the pool. Some other benefits of skipping are that it helps keep your posture upright, is a low impact way to train fast twitch fibers, develop ankle strength and proprioception and develop ‘fast feet’ which is great for your turns on the wall!

The most important thing to remember is spend more time on your kick! Don’t forget about the lower body, so kick often and kick more! No number of dry-land exercises is going to compare to that extra 10-15mins you spend on your kick with your kickboard. Don’t forget to alternate between high intensity kicks and if you get cramped for space or want a new challenge, why not try some vertical kicking. Make sure you enjoy and have fun along the way!

Afiq Jackson

Workers Compensation Specialist (AEP, ESSAM)

Exercise Rehabilitation Services ‑ WA

References:

Mullen G J, (2018)

Swimming Science: Optimum Performance in the Water

Lucero, B (2011)

Strength Training for Faster Swimming

Rosen, M (2019)

Open Water: The History and Technique of Swimming

Early Intervention in the Rehabilitation of Workplace Injuries

Mon, 20 Sep 2021 05:20:00 GMT

Workplace injuries have a massive impact on an employee. Early intervention for any workplace injury is crucial, not just for the worker but also for the organisation. Early intervention primarily involves a multidisciplinary team addressing the engagement of both the worker and management, which is all upheld by open and prompt communication.

When constructing a multidisciplinary team getting an Exercise Physiologist on board early for a worker’s compensation claim is pivotal in guiding the rehabilitation process in the correct direction. Having a specialised team implemented early allows for progression in the return-to-work process, physical rehabilitation, and if needed, psychological support. This ultimately has been shown to reduce the overall cost of claims and improve the injured worker’s wellbeing.

When implementing a holistic approach early in the rehabilitation process, there are many benefits for the injured worker, such as continual development of functional capacity, reduced time off work, reduced cost of absence, keeps the worker at work, and aids activities of daily living and psychological well-being. These benefits allow for continual development in the overall progression of the claim and return to work process. A systemic review conducted by Schultz et al. (2013) reported that implementing early intervention rehabilitation for compensable lower back injuries reduced overall disability of the employees. Another study conducted by Cullen et al. (2018) found that when performing a multi-domain approach to compensable injuries early, allows for a smoother transition to work functioning while reducing costs. This small sample of studies demonstrates that implementing a multidisciplinary team early is an essential determinant for employees to return to work in a timely fashion.

Absolute Balance’s Accredited Exercise Physiologists are experts in tailoring targeted rehabilitation programmes for return-to-work programmes with extensive experience in working in multidisciplinary teams.

David McClung

B.Sc. Exercise Science and Rehabilitation (AEP, AES) (ESSAM)
Regional Manager – Accredited Exercise Physiologist

References:

Schultz, I. Z., Crook, J. M., Berkowitz, J., Meloche, G. R., Prkachin, K. M., & Chlebak, C. M. (2013). Early intervention with compensated lower back-injured workers at risk for work disability: Fixed versus flexible approach. Psychological Injury and Law, 6(3), 258-276.

Cullen, K. L., Irvin, E., Collie, A., Clay, F., Gensby, U., Jennings, P. A., … & Newnam, S. (2018). Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: an update of the evidence and messages for practitioners. Journal of Occupational Rehabilitation, 28(1), 1-15.

Job Dictionaries – useful for the lifecycle of an employee

Mon, 06 Sep 2021 04:59:00 GMT

Job Dictionaries are used to varying degrees across workplaces and tend to be more commonplace in industries that are considered ‘higher risk’. A Job Dictionary will generally break down the physical, environmental, and cognitive considerations of a job role so that it can be used at different stages through the lifecycle of an employee.

Pre-employment medicals are becoming more popular through both physical and non-physical job roles. Generally, when someone is completing a pre-employment medical for a physical job role, they will need to undertake a functional capacity evaluation as part of the medical. A Job Dictionary will assist in a couple of aspects of the medical.

Firstly, a high-quality provider conducting pre-employment medicals will tailor their assessment to match the critical physical demands as identified through the Job Dictionary. If your provider isn’t doing this at a minimum, then the assessment becomes a costly exercise without a meaningful outcome.

Secondly, the doctor or occupational physician should be using the Job Dictionary to make an ultimate determination on whether the candidate is suitable for the job role. This is assessing all aspects of the medical in line with what needs to be undertaken as part of the role.

A completed Job Dictionary will highlight the areas within a job role that are ‘higher risk’. Sometimes the reality of what is physically involved with a job role isn’t intricately known until identified through a Job Dictionary.

Now that higher risk tasks have been identified, something can be done about it to try and mitigate any associated risk. This can be from procuring new equipment, implementing new policies and practices, undertaking additional training for staff or even starting warmup for work or conditioning programs for workers.

A problem can’t be solved unless you are aware that a problem exists.

Unfortunately, the reality of life is that there will always be injuries at work, particularly with physical job roles and an aging population. Again, a Job Dictionary becomes a fantastic tool for all stakeholders that assist in managing workplace injuries. This can include the employer representative, the treating GP or specialist, the vocational rehabilitation provider and the treating exercise rehabilitation provider.

A Job Dictionary helps in different areas within a workers’ compensation claim. It can help with identifying suitable duties to keep the employee engaged and connected to work and reducing the likelihood of the medical practitioner signing them totally unfit as they are unsure of what the job role involves.

It will help all stakeholders know exactly what needs to be achieved from a functional perspective to get the employee back to their pre-injury duties. It will allow the treating exercise rehabilitation provider to tailor their rehabilitation so that it matches the exact requirements of the job role. This will also provide the worker with confidence that they can complete their job role as they will be able to demonstrate it in a controlled environment such as a gym.

So, as you can see a Job Dictionary is an extremely useful tool for the entire lifecycle of an employee. For more information, contact the team at Absolute Balance Exercise Physiology Group.

Aaron McErlaine (BSc – ExHealth, BSc – ExRehab, Dip WHS, Cert IV TAE)

Health & Injury Prevention Services Manager (AEP) (ESSAM)

Job Dictionaries – useful for the lifecycle of an employee

Absolute Balance Exercise Physiology Group

Shrugging Off Your Shoulder Pain?

Wed, 18 Aug 2021 05:53:00 GMT

Many people have unfortunately had to suffer a shoulder injury in some form at some point in their lives and it’s common to fall into the belief that there’s nothing that can be done except to tolerate the symptoms associated with it. These symptoms vary significantly and include a combination of things like lack of sleep, pain and even discontinued day-to-day use of the affected limb due to a lack of confidence and fear of increased symptoms. Adding to that, it often gets worse the longer it is left untreated, but the good news is that there is more available evidence out there that highlights the benefits of treating conservatively.

As Exercise Physiologists working in the Worker’s Compensation system, we see a lot of shoulder injuries and prescribe specific exercises to treat various shoulder pathologies that have either happened due to a freak accident or are the result of gradual degeneration caused by repetitive movements required by the demands of a physical job role.

Shoulder impingement is a common issue that we see and often affects people who are doing a lot of overhead-type movements that are above 90 degrees. The pathology can be described as a condition where the subacromial structures between the humeral head and coracoacromial arch are compressed, causing various signs and symptoms. Commonly, these symptoms may include restricted range of motion, decreased strength of the upper-limb and increased reported pain. Both Clausen et al and Sharma et al., agree that there is a major reduction in strength found in people affected by shoulder impingement, particularly with shoulder external rotation and abduction movements, which may be caused by muscular conditioning following the onset of shoulder impingement as well as deficits in motor control of the muscles.

Fukunaga et al., discussed eccentric-focused exercise was found to be effective for shoulder rehabilitation by activating the rotator cuff muscles, which put simply, are a group of muscles responsible for keeping the ball of our humerus (upper arm bone) in the shoulder socket and giving us the ability to move our arms over our heads, swim, play sports like tennis and volleyball e.t.c due to the unique anatomical make-up that allows the shoulder to move in a multitude of directions. Shoulder impingement may also be associated with muscular imbalance; therefore; careful examination of flexibility and strength of important muscles about the shoulder complex is vital to understanding the root cause of impingement and prescribing effective treatment. By understanding muscular imbalances associated with impingement, physical therapists can prescribe appropriate exercises for both treatment and prevention (Page P).

If you or someone you know is currently suffering from a shoulder injury, please feel free to get in touch with us today for one-on-one support and assistance with effective return to work and improved quality of life.

Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist

Satpute K, Reid S, Mitchell T, Mackay G, Hall T. Efficacy of mobilization with movement (MWM) for shoulder conditions: a systematic review and meta-analysis. J Man Manip Ther. 2021 Aug 1:1-20. doi: 10.1080/10669817.2021.1955181. Epub ahead of print. PMID: 34334099.

Fukunaga T, Orishimo KF, McHugh MP. Electromyographic analysis of select eccentric-focused rotator cuff exercises. Physiother Theory Pract. 2021 Jul 27:1-9. doi: 10.1080/09593985.2021.1949767. Epub ahead of print. PMID: 34313183.

Sharma S, Ghrouz AK, Hussain ME, Sharma S, Aldabbas M, Ansari S. Progressive Resistance Exercises plus Manual Therapy Is Effective in Improving Isometric Strength in Overhead Athletes with Shoulder Impingement Syndrome: A Randomized Controlled Trial. Biomed Res Int. 2021 Jun 30;2021:9945775. doi: 10.1155/2021/9945775. PMID: 34307681; PMCID: PMC8266437.

Clausen MB, Bandholm T, Rathleff MS, Christensen KB, Zebis MK, Graven-Nielsen T, Hölmich P, Thorborg K. The Strengthening Exercises in Shoulder Impingement trial (The SExSI-trial) investigating the effectiveness of a simple add-on shoulder strengthening exercise programme in patients with long-lasting subacromial impingement syndrome: Study protocol for a pragmatic, assessor blinded, parallel-group, randomised, controlled trial. Trials. 2018 Mar 2;19(1):154. doi: 10.1186/s13063-018-2509-7. PMID: 29499710; PMCID: PMC5833202.

Page P. Shoulder muscle imbalance and subacromial impingement syndrome in overhead athletes. Int J Sports Phys Ther. 2011 Mar;6(1):51-8. PMID: 21655457; PMCID: PMC3105366

Shrugging Off Your Shoulder Pain?

Absolute Balance Exercise Physiology Group

Who do you need on your team?

Wed, 18 Aug 2021 03:43:00 GMT

In the confusing world of Workers Compensation, there is often multiple parties involved when it comes to a claimant’s treatment and the management of a claim. The parties involved in a claim have a very large influence on the duration and outcome of a claim and whether this be a positive, or negative influence. Looking at the statistics, we are seeing an increase in the number of claims lasting over 60 days, over the last year this number has increased by 12.7% alone, with the number of short duration claims reducing by 5.3% (WorkCover WA, 2018). There may be a multitude of factors as to why we have seen these changes in claim duration and we don’t have the exact answer for that, however, we can assist to reduce the duration of the claim by ensuring we have the right people on the treatment team. Similar to administering CPR, early identification, early access, and early intervention are critical with any workers compensation claim if we want to keep claim durations and costs low. It is important for the parties involved to communicate effectively so that everyone is on the same page with treatment plans, and for all parties to know their boundaries and limitations regarding their specific treatment modality.

So, who is essential on the team?

The worker, the Insurer, the workplace and the treating General Practitioner are all essential to establish a good working team in the early stages of a claim. If these parties can work closely together and communicate effectively, they may be the only parties involved in a claim. These parties can then work together to identify if and when other interventions may be required to assist with the treatment plan. For example, if a worker has sustained a musculoskeletal injury, a Physiotherapist may be required in the acute stages of the injury followed by treatment from an Accredited Exercise Physiologist to assist with reaching full functional capacity for the critical physical demands of the job role. It is the responsibility of all involved parties to also identify circumstances where assistance may be needed from a Vocational Rehabilitation provider. For example, in a circumstance where the claimant may need alternative duties or has work restrictions, a Vocational Rehabilitation provider would be considered essential to assist with a graduated return to work plan. Other parties that may be useful on your team (if identified as required) include Surgeons, Occupational Therapists, Psychologists’ and other allied health providers.

Many of these decisions are often actioned by the treating General Practitioner or the Insurer. If these referrals are sent directly to the treatment provider, it enables the process to be quickened with earlier access to treatment for the claimant. Concurrent treatment modalities may often be required with more complex claims where it becomes even more important to maintain communication, expectations and boundaries to ensure a positive outcome. If you would like more information on Workers Compensation Rehabilitation programmes at Absolute Balance, please don’t hesitate to contact us at info@absolutebalance.com.au .

Alixe Marion (B.Sc. Exercise Physiology)
Senior Accredited Exercise Physiologist
(AES, AEP) (ESSAM)

References

WorkCover WA. (2018, December). www.workcover.wa.gov.au. Retrieved from WorCover WA: https://www.workcover.wa.gov.au/wp-content/uploads/2019/03/6.1-Attachment-2-Claims-Experience-Status-Report-December-2018.pdf

Who do you need on your team?

Absolute Balance Exercise Physiology Group

Scapula Dyskinesis: its impact on shoulder stability, pain, and rehabilitation outcomes

Mon, 26 Jul 2021 06:03:00 GMT

The scapula plays an essential role in optimising the shoulder’s function, offering a position of support and motion of stability (Kibler & Sciascia, 2010). The scapula position enables muscle activation and strength development to enable force and energy transfer of the kinetic chain. The role of scapula plays a pivotal in injury management and rehabilitation for multiple shoulder pathologies (Kibler & Sciascia, 2019).

Scapula dyskinesis is a term that describes the dysfunctional movement of the scapula (Paine & Voight, 2013). Normal scapulohumeral rhythm is the synchronised movement of the scapula and humerus to shoulder motion, which is an essential factor for efficient shoulder function. Scapula dyskinesis interrupts normal scapulohumeral rhythm, which can lead to the scapula’s position and stability being put in a vulnerable situation. There is evidence to suggest that poor scapula rhythm can lead to shoulder pain and instability or be an underlying issue of overuse injuries (Pain & Voight, 2013; Moseley et al., 1992; Kuhn et al., 1995). Thus, implementing exercises addressing the scapula’s mechanics plays an important role.

Rehabilitation for scapula dyskinesis

Rehabilitation of scapular dyskinesis requires addressing the causative factors that create the individual’s abnormalities, then focussing on the restoration of the balance of muscle forces that allow for optimal position and motion (Kibler et al., 2013). Implementing exercises to address the causative factors and the mechanics of the scapula is an effective strategy to offer a position of support and motion of stability for rehabilitation.

When looking at the current literature, multiple clinical studies have reported that the incorporation of scapula exercises in rehabilitation programmes has led to positive patient-rated outcomes in patients with impingement syndromes and self-reported instability (Kromer et al., 2013). Another study concluded that patients who had suffered full-thickness rotator cuff tears showed that a rehabilitation programme comprised of scapula exercises reduced overall symptoms and resulted in up to 80% of patients opting for no surgery (Kuhn et al., 2013). These studies demonstrate that implementing exercises addressing the underlying issues of scapula dyskinesis can improve patient-rated outcomes and overall symptoms. Therefore, addressing the causative factors of scapula dyskinesis and prescribing exercises targeting the scapula’s kinematics is an important contributor to providing a holistic approach to shoulder rehabilitation.

If you would like more information on shoulder injuries or other rehabilitation programmes that Absolute Balance can provide, please do not hesitate to contact us at info@absolutebalance.com.au .

David McClung (B.Sc. Exercise Science and Rehabilitation (AEP, AES) (ESSAM))
Regional Manager – NSW/ACT – Accredited Exercise Physiologist

References:

Kibler, W. B., & Sciascia, A. (2010). Current concepts: scapular dyskinesis. British Journal of Sports Medicine , 44(5), 300-305.

Kibler, W. B., & Sciascia, A. (2019). Evaluation and management of scapular dyskinesis in overhead athletes. Current Reviews in Musculoskeletal Medicine, 12(4), 515-526.

Kibler, W. B., Ludewig, P. M., McClure, P. W., Michener, L. A., Bak, K., & Sciascia, A. D. (2013). Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘Scapular Summit’. British
Journal of Sports Medicine , 47(14), 877-885.

Kromer TO, Tautenhahn UG, de Bie RA, et al. Effects of physiotherapy in patients with shoulder impingement syndrome: a systematic review of the literature. J Rehabil Med 2009; 41:870–80.

Kuhn, J. E., Dunn, W. R., Sanders, R., An, Q., Baumgarten, K. M., Bishop, J. Y., … & Ma, C. B. (2013). Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. Journal of Shoulder and Elbow Surgery , 22 (10), 1371-1379.

Kuhn, J. E., Plancher, K. D., & Hawkins, R. J. (1995). Scapular winging. JAAOS-Journal of the American Academy of Orthopaedic Surgeons, 3(6), 319-325.

Paine, R., & Voight, M. L. (2013). The role of the scapula . International Journal of Sports Physical Therapy, 8 (5), 617.

Moseley JR, J. B., Jobe, F. W., Pink, M., Perry, J., & Tibone, J. (1992). EMG analysis of the scapular muscles during a shoulder rehabilitation program. The American Journal of Sports Medicine , 20(2), 128-134.

Scapula Dyskinesis: its impact on shoulder stability, pain, and rehabilitation outcomes

Absolute Balance Exercise Physiology Group

PTSD, Exercise Rehabilitation and Return to Work

Mon, 26 Jul 2021 04:02:00 GMT

On a daily basis I assist my patients with various conditions in their progressive return to work and pre-injury capabilities. One of these conditions is Post-Traumatic Stress Disorders (PTSD) with regular exercise providing significant benefits. The health benefits of regular exercise on physical and mental well-being are well researched. In regards to mental well-being, regular exercise is correlated with improvements in mood, self-esteem, cognitive function, sleep and reduced anxiety and depression.

I recently completed an exercise rehabilitation programme with a Paramedic diagnosed with PTSD following several distressing events at work. A multidisciplinary team comprised of exercise physiology, psychology, and occupational therapy was utilised to great effect. The exercise component consisted of a structured gym-based programme at a convenient facility for the patient. The goals of the programme were to assist with establishing a routine, mood enhancement, exposure to social settings, and work-specific conditioning. Consideration of an old back injury was also taken into account.

In a positive sign the patient responded extremely well to the exercise programme with a regular routine established and progressive reductions on the Depression, Anxiety and Stress Scale -21 (DASS-21). Regular communication was maintained with all stakeholders and the patient was actively engaged in all components of their rehabilitation programme. At the conclusion of the exercise physiology programme a graduated return to work was implemented and the patient demonstrated the ability to successfully maintain the prescribed exercise interventions and was able to perform them independently.

The collaborative approach and regular communication between stakeholders aided the positive outcome and graduated return to work for the patient. Exercise rehabilitation provided a means of establishing a routine, increasing social interactions, enhancing mental health, and demonstrating the readiness to return to work. Continuing with regular exercise will assist with maintaining both physical and mental well-being and reduce the likelihood of exacerbations.

If you would like more information on how exercise rehabilitation can assist you, please contact us at info@absolutebalance.com.au

Daniel D’Avoine BSc(ExerSc&Rehab)

Exercise Rehabilitation Team Leader – Workers Compensation Specialist

References:

Crombie, K.M., Brellenthin, A.G., Hillard, C.J., & Koltyn, K.F. (2018). Psychobiological responses to aerobic exercise in individuals with posttraumatic stress disorder. Journal of Traumatic Stress, 31 (1), 134-145.

DOI: 10.1002/jts.22253

Hall, K.S., Morey, M.C., Beckham, J.C., Bosworth., H.B., Sloane, R., Pieper, C.F., & Pebole, M.M. (2020). Warrior Wellness: A randomized controlled pilot trial of the effects of exercise on physical function and clinical health risk factors in older military veterans with PTSD. The Journals of Gerontology: Medical Sciences, 75 (11), 2130-2138.

doi:10.1093/gerona/glz255

Hegberg, N.J., Hayes, J.P., & Hayes, S.M. (2019). Exercise intervention in PTSD: A narrative review and rationale for implementation. Frontiers in Psychiatry, 10 (133),

DOI: 10.3389/fpsyt.2019.00133

Saeed, S.A., Cunningham, K., & Bloch, R.M. (2019). Depression and anxiety disorders: benefits of exercise, yoga, and meditation. American Family Physician, 99(10), 620-627.

PTSD, Exercise Rehabilitation and Return to Work

Absolute Balance Exercise Physiology Group

How does your language affect someone’s return to life and return to work?

Wed, 21 Jul 2021 00:17:00 GMT

How often do we hear that our words and language have an impact on people in everyday life and in a clinical rehabilitation setting? All the time, right?

Which is why as an Exercise Physiologist helping people with returning to everyday activities and work, it is vital that the appropriate language is used from the initial consult and reinforced during supervised exercise rehabilitation sessions.

Recurrent and persistent lower back pain is a common thing to see in individuals on a day-to-day basis as an Exercise Physiologist. Modern research knowledge suggests individual’s pain beliefs have a strong effect on their pain experience and management. Research suggests that most individuals with lower back pain believe traditional causes such as biomechanical and anatomical are the reason for their symptoms. The findings of the study support a complex and thorough approach to shifting understandings of lower back pain beyond biomechanical and anatomical causes to consider other factors.

A cross-sectional survey completed by Setchell et al 2017 illustrated that 89% of people with persistent lower back pain report their negative beliefs were learned from health professionals. The above finding reinforces that language does play a powerful role in an individual’s return to work, life and their initial beliefs and expectation regarding their injury and their recovery.

So, what do we need to do? Whilst clinicians often recognise the importance of psychosocial factors it has been found that we can still focus too frequently on the mechanical/anatomical cause of pain over the psychosocial factors of lower back pain. Therefore, it is important that during an initial assessment that the psychosocial understanding of painful conditions such as lower back pain is consistently reflected in the beliefs of individuals and reinforced during supervised sessions.

Recent best practice guidelines reflect that understanding and addressing these pain beliefs is an important component of reducing the burden of lower back pain, shifting understandings of lower back pain beyond mechanical/anatomical causes to consider psychosocial factors that can prolong recurrent lower back pain. Having a consistent focus on a number of factors and providing education to an injured individual early on with positive language can play a big role in an individual’s life. Language is important.

Jason Peschke

Accredited Exercise Physiologist (AEP, AES) (ESSAM)

Setchell, Jenny & Costa, Nathalia & Ferreira, Manuela & Makovey, Joanna & Nielsen, Mandy & Hodges, Paul. (2017). Individuals’ explanations for their persistent or recurrent low back pain: A cross-sectional survey. BMC Musculoskeletal Disorders. 18. 10.1186/s12891-017-1831-7.

How does your language affect someone’s return to life and return to work?

Absolute Balance Exercise Physiology Group

Depression, Illness Perceptions and Exercise

Thu, 10 Jun 2021 00:55:00 GMT

Many people experience a decline in their mental health following an injury. Surveys have shown that approximately 20 to 50 percent of people with musculoskeletal conditions show signs of elevated depressive symptoms. Depression has been identified as a risk factor for poor recovery outcomes, longer claim times and increased work absence after a work-related musculoskeletal disorder.

We tend to develop an idea about our injury to make sense of it and adapt to the difficulties that it causes, known as an illness perception. Illness perceptions are emotional and cognitive representations that you have around your injury and are not only based on symptoms, but also the injury-related consequences, past experiences, and related anxiety. Studies have shown that negative illness perceptions and the injured worker expecting a slower recovery is associated with increased depressive symptoms, reduced adherence to treatments, poorer treatment outcomes and longer claim times. It is possible that recovery expectancies are the vehicle by which depression influences return to work results in those with musculoskeletal injuries. Individuals who were 100 percent certain that they would return to work within 6-months have been found to be 4 x more likely to return to work during that time. Therefore, positive illness perceptions are important and result in improved health outcomes, quality of life, function, and emotional status.

Exercise and physical activity can provide numerous benefits for not only musculoskeletal injuries, but for depressive symptoms as well. For individuals who participate in regular physical activity, even at lower levels, they are at decreased risk of experiencing symptoms of depression and are less likely to experience future depressive episodes. Further, regular exercise can assist in weight management, improving diabetes control and decrease the impact of cardiovascular disease, which often occurs in those with depression.

Treating professionals should talk to their clients about an exercise regime that suits their personal preferences and circumstances. An Accredited Exercise Physiologist has specialized training in the construction and delivery of exercise and lifestyle interventions for individuals with work and non-work related chronic and complex illnesses, including depression. Illness perceptions often present as a barrier to commencing and maintaining an exercise routine. Thus, it is vital that the exercise professional has an in-depth understanding of the client’s condition and comorbidities to best assist in the individuals exercise and recovery journey.

Tiffany Mullins B.Sc, M.Clin.Ex.Phys

Accredited Exercise Physiologist

References

Berk, M., Sarris, J., Coulson, C., & Jacka, F. (2013). Lifestyle management of unipolar depression. Acta Psychiatrica Scandinavica , 127 , 38-54. https://doi.org/10.1111/acps.12124

Carriere, J., Thibault, P., & Sullivan, M. (2014). The Mediating Role of Recovery Expectancies on the Relation Between Depression and Return-to-Work. Journal Of Occupational Rehabilitation , 25 (2), 348-356. https://doi.org/10.1007/s10926-014-9543-4

Exercise is Medicine. (2014). Depression and exercise [Factsheet]. Exercise is Medicine Australia 2014. Retrieved 17 May 2021, from www.exerciseismedicine.org.au.

Mammen, G., & Faulkner, G. (2013). Physical Activity and the Prevention of Depression. American Journal Of Preventive Medicine , 45 (5), 649-657. https://doi.org/10.1016/j.amepre.2013.08.001

Stanton, R., Happell, B., & Reaburn, P. (2014). The mental health benefits of regular physical activity, and its role in preventing future depressive illness. Nursing: Research And Reviews , 45. https://doi.org/10.2147/nrr.s41956

Ünal, Ö. (2019). The relationship of illness perceptions with demographic features, pain severity, functional capacity, disability, depression, and quality of life in patients with chronic low back pain. Turkish Journal Of Physical Medicine And Rehabilitation , 65 (4), 301-308. https://doi.org/10.5606/tftrd.2019.3248

Depression, Illness Perceptions and Exercise

Absolute Balance Exercise Physiology Group

Patellofemoral Pain Syndrome

Thu, 10 Jun 2021 00:37:00 GMT

Patellofemoral pain syndrome (PFPS) is a common overuse injury also known as “Runners Knee”. PFPS is caused by an injury to the soft tissues of the knee and can cause discomfort, pain, and inflammation to the patella. The soft tissue injury can be caused by a variety of issues including, biomechanical dysfunction, increases in training load, training errors, and running in incorrect footwear on unsuitable surfaces. In many cases there is an imbalance between two of the muscles in the quadriceps group, the Vastus Medialis Oblique and the Vastus Lateralis. This imbalance causes issues with the tracking of the patella during flexion and extension of the knee.

Symptoms of PFPS may include:

An Accredited Exercise Physiologist prescribed exercise programme has been shown to dramatically improve both pain symptoms and functional limitations. Initially exercises should be isometric (static) and closed kinetic chain (feet are fixed in position) as this minimizes stress on the patellofemoral joint. Strengthening of the quadriceps is key in the rehabilitation of PFPS. The initial stage of the programme should include supine straight leg raises and static quad activation. It has also been shown that training the hip muscles in conjunction with the leg muscles can help improve symptoms of PFPS. Exercises that focus on abduction such as banded clamshells and lateral rotation exercises should also be included. Taping of the patella during exercise helps to maintain correct patella alignment during exercises. Alternative treatments of PFPS include the use of analgesics, bracing and foot orthoses.

To reduce the chances of developing PFPS or recurrence it is important to:

Peter Webster (B.Sc Exercise and Rehabilitation)

Accredited Exercise Physiologist

References:

Jayaseelan, D. J., Holshouser, C., & McMurray, M. W. (2020). FUNCTIONAL JOINT MOBILIZATIONS FOR PATELLOFEMORAL PAIN SYNDROME: A CLINICAL SUGGESTION. International journal of sports physical therapy , 15 (4), 643–649.

Kölle, T., Alt, W. & Wagner, D. Effects of a 12-week home exercise therapy program on pain and neuromuscular activity in patients with patellofemoral pain syndrome. Arch Orthop Trauma Surg 140, 1985–1992 (2020).

Nakagawa, T., Muniz, T., Baldon, M., Dias, C., Menezes, B., Serrão, V.(2008). The Effect of additional strengthening of hip abductor and lateral rotator muscles in patellofemoral pain syndrome: a randomized controlled pilot study

Patellofemoral Pain Syndrome

Absolute Balance Exercise Physiology Group

The Need For Good Knees

Thu, 10 Jun 2021 00:17:00 GMT

“I wish I could run again…”

“I can’t kick a footy with my son…”

“I can’t go to work…”

These are just a few examples of the sort of thoughts that run daily through the mind of someone who has suffered a serious knee injury and is left to experience a significantly reduced quality of life.

According to a study conducted by Herzog et al.; there were 283,810 ACL reconstructions with an overall rate of increase of 22% from 2002 to 2014.

As far as injuries go, an Anterior Cruciate Ligament rupture can be potentially career-ending for athletes and has been seen to put people out of work for an extended period.

Many studies have been conducted, highlighting the importance of pre and post-operative rehabilitation for an ACL reconstruction.

According to a study conducted by Kruse et al.; “Rigorous rehabilitation after anterior cruciate ligament (ACL) reconstruction is necessary for a successful surgical outcome.” Giesche et al.; conducted a study that looked at the effectiveness of pre-rehabilitation and stated “At 12-weeks post-reconstruction, the pre-rehabilitation group had a lesser post-operative decline in the single-leg-hop for distance. Similar findings were found in terms of quadriceps strength. At both pre-reconstruction and two-year post-surgery, the pre-rehabilitation groups reached significantly higher self-reported knee function than the controls. At two years post-surgery, return-to-sport rates were higher in the pre-rehabilitation groups. The results provide evidence for the relevance of pre-rehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as return-to-sport.”

At Absolute Balance, we see a whole lot of people who have suffered knee injuries so severe that they required an ACL reconstruction and have seen how the physical limitations gradually impact a person’s mental state and overall quality of life.

You can take care of your knees by stretching, stabilising and strengthening the lower-limb musculature with targeted exercises following an injury and understand that it isn’t the be-all and end-all of your ability to live a full and functional life.

As a result of prescribing a structured rehabilitative exercise programme as part of someone’s treatment following an injury, we have seen many injured workers return to work effectively.

If you would like more information on how exercise rehabilitation can assist you, please don’t hesitate to contact us at info@absolutebalance.com.au

Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist

References

Kruse LM, Gray B, Wright RW. Rehabilitation after anterior cruciate ligament reconstruction: a systematic review. J Bone Joint Surg Am. 2012 Oct 3;94(19):1737-48. doi: 10.2106/JBJS.K.01246. PMID: 23032584; PMCID: PMC3448301.

Herzog MM, Marshall SW, Lund JL, Pate V, Mack CD, Spang JT. Trends in Incidence of ACL Reconstruction and Concomitant Procedures Among Commercially Insured Individuals in the United States, 2002-2014. Sports Health. 2018;10(6):523-531. doi:10.1177/1941738118803616

Giesche F, Niederer D, Banzer W, Vogt L. Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review. PLoS One. 2020 Oct 28;15(10):e0240192. doi: 10.1371/journal.pone.0240192. PMID: 33112865; PMCID: PMC7592749.

The Need For Good Knees

Absolute Balance Exercise Physiology Group

Importance of the Scapula in Shoulder Pathology

Wed, 28 Apr 2021 02:41:00 GMT

Each week we help numerous patients with various shoulder conditions, including bursitis, rotator cuff tears, and post-surgical rehabilitation. A key factor in successfully returning these patients to their pre-injury activities, work and function is evaluating and addressing scapula dysfunction that may be present.

The scapula provides an attachment for several key muscles for optimal shoulder function, including the trapezius (upper, middle, and lower portions), rhomboids (major and minor), serratus anterior, levator scapulae, and rotator cuff. These muscles work in a coordinated manner to facilitate efficient scapula and arm movement. When the scapula fails to function in its intended manner the shoulder is more susceptible to injury. A common presentation is the weakness of the serratus anterior and/or lower trapezius muscles, with concurrent tightness of the pectoralis minor.

Now some people may have poor scapula mechanics without even knowing and function without any noticeable deficits. However, there is likely to be progressive damage occurring that can prove costly. Think of a car with the wheel alignment slightly out. The car will still function but there will be increased wearing of the tyre and possibly other structures. What will the difference in cost be if the wheel alignment was corrected early on versus 12 months later? This is an example where early intervention can help mitigate the risk of future complications.

Exercise Rehabilitation:

The focus of the rehabilitation programme will be based on the findings of the functional assessments. The programme will generally commence with a focus on restoring range of motion and addressing areas of tightness. Interventions are included to improve the resting alignment of the scapula, and progress to address dynamic control (i.e., with movement). As progress continues to be made, the exercises will adopt postures specific to the individual’s hobbies, activities of daily living, and work. Below are examples of two exercises to improve scapula control with varying levels of difficulty:

Fitball wall roll

Action – press the ball into the wall and slowly extend arms towards the ceiling.

Considerations – ensure scapula control is maintained on the lowering phase.

Crawl:

Action – simultaneously move one arm and the opposing leg forward. Continue to move forward in a crawling manner.

Considerations – hand, wrist, or elbow issues. Prescribed towards the latter stages of rehabilitation.

Completing a structured exercise rehabilitaiton programme over a period of 6 to 12 weeks is extremely beneficially and is expected to faciliate improvements in function and a progressive return to pre-injury activities and hobbies. However, continuing with a maintenance programme is vital to preserving the muscular recruitment patterns. Just like brushing your teeth, including exercise as part of your daily routine is a step in the right direction.

If you would like more information on how exercise rehabilitation can assist you, please don’t hesitate to contact us at info@absolutebalance.com.au

Daniel D’Avoine BSc(ExerSc&Rehab)

Exercise Rehabilitation Team Leader – Workers Compensation Specialist

References:

Castelein, B., Cools, A., Parlevliet, T., & Cagnie, B. (2016). Modifying the shoulder joint position during shrugging and retraction exercises alters the activation of the medial scapular muscles. Manual Therapy, 21 , 250-255.

Paine, R., & Voight, M.L. (2013). The role of the scapula. International journal of sports physical therapy, 8 (5), 617-629.

Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P., & Tazji, M.K. (2019). Efficacy of abdominal control feedback and scapula stabilisation exercises in participants with forward head, round shoulder postures and neck movement impairment. Sports Health, 11 (3), 272-279.

Yildiz, T.I., Turgut, E., & Duzgun, I. (2018). Neck and scapula-focused exercise training on patients with non-specific neck pain: a randomized controlled trial. Journal of Sports Rehabilitation, 27 , 403-412.

Importance of the Scapula in Shoulder Pathology

Absolute Balance Exercise Physiology Group

Why is Early Intervention so important for the Treatment of Acute Lower Back Injuries?

Wed, 07 Apr 2021 03:44:00 GMT

As most of us know and have heard early intervention is always best when it comes to the rehabilitation for acute injuries. But why is this so important and what can we improve to ensure the best outcome for an injured individual?

As an exercise physiologist specialising in the workers compensation system, it is very common to be referred an injured worker months after their injury. This could mean that the worker has had no active treatment, may have poor coping strategies, a lack of education about their injury and the recovery timeframes, have had little assistance navigating the workers compensation system, and could have commenced no return to work to assist with a return to function.

Studies have shown that with acute lower back injuries early intervention is more effective in the short term than advice on staying active, leading to more rapid involvement in function, mood, quality of life, and general health. An additional and highly important point found was that the timing of intervention affects the development of psychosocial features, which are very common in the workers compensation system. If treatment is provided later, the same psychosocial benefits are not achieved. Therefore, early intervention is a necessity for improving an individual’s function, mood, quality of life, general health and decreasing the development of biopsychosocial features that can hinder an injured workers engagement in a return-to-work plan, treatment compliance, and their return to pre-injury function.

At Absolute Balance we understand that during the initial assessment with an individual it is crucial to focus on explaining the cause of pain and instructions to stay active, which studies show can promote long-lasting physical and mental health in individuals with acute lower back pain. Returning to work is a part of returning to function and research indicates that not implementing early intervention for acute work-related back pain can lead to high pain and disability, low recovery expectations, and fears that work may increase pain or cause harm which are risk factors for chronic work disability.

If you would like more information on individualised client-focused goal setting and how to build stronger rapport with your clients, please do not hesitate to contact us at info@absolutebalance.com.au .

Jason Peschke

Accredited Exercise Physiologist (AEP) (ESSAM)

References

Turner, Judith A. Et al. Worker Recovery Expectations and Fear-Avoidance Predict Work Disability in a Population-Based Workers’ Compensation Back Pain Sample, Spine: March 15, 2006 – Volume 31 – Issue 6 – p 682-689.

Wand, M Benedict et al. Early Intervention for the Management of Acute Low Back Pain, Spine: November 1, 2004 – Volume 29 – Issue 21 – p 2350-2356.

Whitfill, T., Haggard, R., Bierner, S.M. et al. Early Intervention Options for Acute Low Back Pain Patients: A Randomized Clinical Trial with One-Year Follow-Up O

Why is Early Intervention so important for the Treatment of Acute Lower Back Injuries?

Absolute Balance Exercise Physiology Group

Collagen and its role in Rehabilitation from an Injury

administrator@heliummarketing.agency (Helium Marketing) — Wed, 07 Apr 2021 03:09:00 GMT

The recommendations for diet, exercise, supplementation, and our health are changing on a regular basis, with new research and scientific studies delving deeper than ever before into how to best sustain the health of the human body. An up-and-coming area of research, specifically for athletic populations and rehabilitation, is the use of Collagen supplementation to treat injuries to muscles, tendons, ligaments, cartilage, and connective tissues.

To start with, I will answer the question ‘What is Collagen?’

Collagen is an abundant protein within the human body, found in all connective tissues, the skin, muscles, and bones, and is often referred to as the scaffold or glue that provides strength and structure to these tissues. Collagen is comprised of amino acids, once ingested Collagen is broken down to its amino acid form, transported through the blood and to the tissues where the amino acids are used to synthesise new tissue and rebuild damaged tissues.

So, what does this mean for rehabilitation from an injury?

The evidence suggests that supplementation of Hydrolysed Collagen is useful in the treatment of all injuries to the connective tissues or cartilage, with most current research being conducted specifically with tendinous injuries. The most recent research suggests that when collagen is supplemented into the diet while recovering from an injury, collagen synthesis can be increased up to 20%, particularly when taken 1 hour prior to completing exercises (Lis and Baar, 2019), this has a positive impact on the body’s ability to heal, repair and build Collagen containing tissues. The consensus of the available research supports that Collagen supplementation could very likely reduce the time it takes to recover from an injury, which is an amazing concept!

Although the research demonstrates supplementation of Hydrolysed Collagen to have the most promising responses, it is possible to consume high amounts of good quality Collagen in our diets to also assist with the recovery process. The good news – Collagen is easily found in animal products, with the highest bioavailable amounts found in cartilage, bone marrow, tendons, and gristle. If you are the adventurous type, the best sources of Collagen are in chicken feet and pig skin, and marine collagen including fish skin, scales, and bones! If none of these foods sound appealing, the good news is that Collagen can be easily added into your diet through consuming bone broth and gelatin.

The only downside to dietary consumption of Collagen is that you cannot specifically measure and predict accurate dosages for yourself or others, however the health benefits of consuming Collagen rich foods in your diet still far exceed other types of supplementation when recovering from an injury. The only other factor to consider is that your Collagen needs to be consumed with Vitamin C as this is vital for Collagen Synthesis. The specific dosages for Vitamin C vary, however the RDI of 45mg/day combined with 15-25g of Hydrolysed Collagen or Gelatin seems to be a winning combination.

The information above is of course evidence-based and supported by the latest scientific research, however, each injury is different, and each patient should speak to their treating medial practitioner regarding what would benefit them the most with their recovery. If you are interested in knowing more on the topic, get in touch with the team at Absolute Balance through the website www.absolutebalance.com.au or email info@absolutebalance.com.au .

Alixe Marion (BSc – Exercise Physiology)

Workers Compensation Specialist

Senior Accredited Exercise Physiologist

References

Lis, D. and Baar, K., 2019. Effects of Different Vitamin C–Enriched Collagen Derivatives on Collagen Synthesis. International Journal of Sport Nutrition and Exercise Metabolism, 29(5), pp.526-531.

Collagen and its role in Rehabilitation from an Injury

Absolute Balance Exercise Physiology Group

Tend to Your Forearm Tendonitis!

administrator@heliummarketing.agency (Helium Marketing) — Wed, 07 Apr 2021 02:39:00 GMT

Have you ever experienced a burning sensation in the small tendons and muscles in your forearms? Do you encounter this feeling after strain, overuse or too much exercising involving your forearms? You may be suffering from forearm tendonitis.

Forearm tendinopathy and tendonitis are some of the most frequent encountered disorders of the upper extremity. With forearm tendonitis individuals present with progressively increased pain in their forearms over a subacute or chronic period. Although forearm tendonitis can be caused by a sudden injury, such as a motor vehicle accident, it most commonly occurs through repetition of a particular movement over time. The importance of proper technique in work duties and hobbies is crucial to reduce the stress put on the forearm tendons and musculature. Other infrequent causes include nerve entrapment in the forearm or arthritis.

The main symptom of forearm tendonitis is inflammation of the forearm tendons. This can cause pain, redness, and swelling around the elbow, wrist, and hand. Secondary symptoms of inflammation including warmth, weakness, throbbing, burning, stiffness, numbness, or the development of a lump on the forearm. Compromised forearm tendons and musculature intrinsically effects range of everyday arm or hand movements.

R.I.C.E:

Rest – Although it can be difficult to stop using your forearm muscles in everyday tasks, constricting movement in a brace or splint will reduce the overall healing time of the inflamed tendons.

Ice – Applying ice to the affected area for 10-minutes a day is an immediate effective treatment after the forearm has been heavily used or inactive for a long period of time. Applying ice to the area will temporarily reduce blood flow and significantly reduce inflammation, swelling and pain.

Compression – Different sleeves and wraps are designed to compress either the full area or segments of it. Applying pressure will also reduce swelling by restricting the flow of blood and other fluids.

Elevation – Keep the forearm raised at a level above the heart to reduce the blood flow to the affected area. This intern will reduce swelling and other symptoms.

Exercise Rehabilitation:

Stretching and strengthening exercises of the forearm and surrounding musculature have been shown to assist in reducing the symptoms of inflamed and injured tendons. Targeted forearm stretching exercises including wrist extension, elbow extension and wrist rotations will help rehabilitation and strengthen the forearm slowly, as well as improve blood circulation through the forearm and into the wrist. Localised strengthening exercises including wrist curls, reverse curls and forearm pronation/supination can help build lost forearm strength and help prevent forearm pain from reoccurring.

Ergonomic Assessments:

By using biomechanical principles, adjustments can be made to your workstation to reduce the risk of overuse/repetitive movements that increase the risk of developing forearm tendonitis. This includes observing force, repetition, volume, and exertion on certain muscle groups to complete daily work tasks. Simple adaptations including using an ergonomic keyboard and adjusting your desk to an appropriate height can reduce the repetitive strain on your forearms.

James McNally (BSc – GradDipClin Exercise Physiology)

Workers’ Compensation Specialist ( AEP ESSAM)

References:

Eric Wagner, Michael Gottschalk. (2019). Tendinopathies of the Forearm, Wrist and Hand. Clinics in Plastic Surgery , 46 (3), 317-327.

What Is Forearm Tendonitis, and How’s It Treated? (2021) Healthline. Retrieved from: https://www.healthline.com/health/forearm-tendonitis#home-remedies

What are the causes of forearm pain? (2018) Medical News Today. Retrieved from: https://www.medicalnewstoday.com/articles/320782

Tend to Your Forearm Tendonitis!

Absolute Balance Exercise Physiology Group

Trigger Finger

administrator@heliummarketing.agency (Helium Marketing) — Wed, 31 Mar 2021 04:50:00 GMT

Trigger finger is a mechanical condition that often causes the finger or thumb to get stuck in a bent position, sudden locking and releasing of the finger or thumb during flexion and extension. Trigger finger can also be known as trigger thumb and stenosing tenosynovitis. The tendons of the finger or thumb become inflamed and can no longer easily slide through their sheath as normal, in some cases a nodule can also form on the tendon. Symptoms can include stiffness when bending the finger or thumb, snapping or popping sensation when moving the digit and pain or soreness at the base of the thumb and palm. The most common digit effected is reported to be the thumb.

The cause of trigger finger is believed to be multi-factorial including exposure to shear forces, biomechanical factors, anatomical difference in the pulley system and performing unfamiliar activities. Most cases are caused by secondary thickening of the flexor pollicus longus tendon, however other joints and the carpal tunnel can also be involved. Other possible contributing causes include diabetes mellitus, carpal tunnel syndrome and repetitive finger movements. Diagnosis is mainly based on presentation and clinical symptoms. Trigger finger can occur in anyone; however, the most common reported population is middle-aged women. It frequently occurs in people in people who have hobbies or jobs that include repetitive motions, strong grasping and gripping such as farmers, musicians and construction workers.

First-line treatment for trigger finger is usually conservative treatment. Conservative treatment includes NSAIDs, splinting, corticosteroid injections and physical therapies. Another treatment option can include surgical intervention. As Exercise Physiologists we can assist with physical rehabilitation by providing an individualised exercise programme, monitoring symptoms and adjusting the exercise rehabilitation programme accordingly. Recommended exercises include passive and active joint range of motion, stretching, digit blocking and tendon gliding exercises. Through exercise we can improve and maintain pain free range of motion, improve strength of the surrounding musculature and assist to prevent the risk of recurrence.

Katie Lintott

Accredited Exercise Physiologist (AEP) (ESSAM)

References

Howitt, S., Wong, J., & Zabukovec, S. (2006). The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. The Journal of the Canadian Chiropractic Association , 50 (4), 249–254.

Vasiliadis AV, Itsiopoulos I. Trigger Finger: An Atraumatic Medical Phenomenon. J Hand Surg Asian Pac Vol. 2017 Jun;22(2):188-193. doi: 10.1142/S021881041750023X. PMID: 28506168.

Ferrara, P. E., Codazza, S., Maccauro, G., Zirio, G., Ferriero, G., & Ronconi, G. (2020). Physical therapies for the conservative treatment of the trigger finger: a narrative review. Orthopedic reviews , 12 (Suppl 1), 8680. https://doi.org/10.4081/or.2020.8680

Trigger Finger. (2020, December 18). Physiopedia, . Retrieved 07:03, January 8, 2021 from https://www.physio-pedia.com/index.php?title=Trigger_Finger&oldid=262566 .

Trigger Finger

Absolute Balance Exercise Physiology Group

Cardio Vs Resistance Training: Which is better?

administrator@heliummarketing.agency (Helium Marketing) — Tue, 30 Mar 2021 01:19:00 GMT

There are many different forms of physical activity that provide benefits to our overall health. These activities can be in the form of running in the park, lifting weights in the gym, or even doing circuit training through bootcamp sessions just to name a few. For some people, the question remains, “What is the best form of exercise?”

Physical activity has been proven to have many benefits such as improvements in cardiovascular fitness, muscular strength, muscular endurance and develop overall physical and mental well-being. As mentioned earlier, there may be instances where some individuals are more inclined towards aerobic exercises such as running and cycling, whereas others prefer the muscular strength aspects achieved through resistance training.

These activities are two common forms of exercise and they have their fair share of benefits towards our overall health, but which one is better? As beneficial as they both are, we also have to understand that it is not a ‘one size fits all’ for everyone when it comes to performing physical activity.

Benefits of Cardio

Benefits of Resistance Training

A study was conducted over a 12-week period comparing the effects of the different exercise modalities and it concluded that performing a combination of both aerobic and resistance training gave greater benefits in terms of weight loss, fat loss and cardio-respiratory fitness as compared to the respective exercise modalities on its own. This just proves that one mode of exercise is not necessarily superior to the other but having a combination of the two would achieve better results. At the end of the day, everyone is aware that any form of physical activity is beneficial for you. We just have to remember that most people may have difficulty finding the time to exercise so it is important to understand which exercise modality is most effective and suited to work around the individual’s circumstances.

Haseef Salim

Accredited Exercise Physiologist (AEP, AES) (ESSAM)

Department of Health | Physical Activity. (2021). Retrieved 12 February 2021, from https://www1.health.gov.au/internet/main/publishing.nsf/Content/phy-activity

Ho, S., Dhaliwal, S., Hills, A., & Pal, S. (2012). The effect of 12 weeks of aerobic, resistance or combination exercise training on cardiovascular risk factors in the overweight and obese in a randomized trial. BMC Public Health , 12 (1). doi: 10.1186/1471-2458-12-704

Cardio Vs Resistance Training: Which is better?

Absolute Balance Exercise Physiology Group

Patient Case Study – Full Rotator Cuff Avulsion Rehabilitation

administrator@heliummarketing.agency (Helium Marketing) — Mon, 29 Mar 2021 00:22:00 GMT

Patient details: 65yr old male, Obese, Hypertension, no other comorbidities

Occupation: Heavy haulage truck driver

Injury Details: Fell between two truck trailers onto the right arm causing major rotator cuff tearing. Right shoulder arthroscopic subacromial decompression, excision of the AC joint and open repair of a massive avulsion of the entire rotator cuff on the 24/08/2020.

Critical Physical Demands of the job role: Ingress/Egress from large trucks and heavy machinery requiring 3 points of contact and ladder climbing. Lifting to 30kg from floor to shoulder height, forceful manoeuvring of items weighing up to 30kg at chest height, occasional heavy lifting above head height up to 30kg, repetitive upper limb use when tying downloads. Physical tasks can be completed for periods of up to 4 hours on a repetitive basis.

Rehab Timeline: The patient commenced physiotherapy immediately post-op and completed this for the first 6-weeks, he then transitioned to an exercise rehabilitation programme under my supervision at the request of the surgeon. From weeks 6-12 post-operatively, the focus of the exercise rehabilitation programme was to restore pain-free shoulder passive and then active ROM and begin isometric rotator cuff activation exercises and basic Theraband exercises in preparation for moving into the strengthening phase of the programme after week 12.

On review with the treating surgeon at 12-weeks post-operatively, the surgeon was happy with progress given the complexity of the injury, and clearance was provided to commence gentle strengthening exercises. From week 12 onwards, strengthening exercises were gradually introduced whilst also keeping focused on further building and maintaining the patient’s active ROM and rotator cuff function. Overhead exercises were not introduced until 5-months post-operatively when the patient was able to demonstrate good scapulothoracic control into overhead positions. The patient made steady progress over a period of 3-months (see graph below), with weekly reviews to ensure he remained on track with his exercises and they were appropriate for his presentation and abilities.

At the 6-month post-operative review, the patient was able to demonstrate normal pain-free shoulder range of motion (symmetrical to his non-injured arm), excellent power and strength with all rotator cuff integrity testing, and had reached the appropriate milestones to facilitate a graduated return to work programme. Using the evidence from the supervised exercise programme, the surgeon was able to provide clearance for the patient to return to modified duties with a 15kg lifting restriction below shoulder height only.

The patient is due to review with the surgeon again at the 9-month post-operative mark, the goal prior to this review is to further build the patient’s strength and tolerance for work-specific physical tasks and gradually build strength and capacity for overhead movements. The exercise programme will be suitably modified to begin to replicate the critical physical demands of the job role to ensure the patient is exposed to these tasks in a controlled environment, where a focus on correct manual handling and sound technique can we implemented. The ideal scenario would be for the patient to return to his full pre-injury duties at the 9-month mark, with some possible permanent restrictions in places for overhead lifting, due to the nature of the injury and surgery completed.

Keep an eye out for further updates on the patient’s journey over the coming months!

Alixe Marion (BSc – Exercise Physiology)

Workers Compensation Specialist

Senior Accredited Exercise Physiologist

Patient Case Study – Full Rotator Cuff Avulsion Rehabilitation

Absolute Balance Exercise Physiology Group

Rib Fractures

administrator@heliummarketing.agency (Helium Marketing) — Mon, 15 Mar 2021 23:54:00 GMT

Rib fractures are often caused by trauma to the chest region. Due to the structure of the ribs (long thin bones), they are prone to breaking because of direct trauma or repetitive trauma. Some common causes include a fall, motor vehicle accident, coughing, some sports or an assault. Symptoms of a rib fracture include pain with deep breathing, coughing or with touch. Rib fractures can occur at any age; however, the elderly are at higher risk due to the decrease in bone density. Often rib fractures or the trauma endured can lead to other illnesses or injuries such as pneumonia, bruising of the lungs, pneumothorax, and a collapsed lung.

Treatment of patients with rib fractures may include a team of professionals such as a pain specialist, surgeon, and physical therapist. Depending on the risk of complications, some patients may be hospitalised or require surgery. Symptoms can also be managed with anti-inflammatory drugs, however the key to successful treatment of rib fractures is physical therapy. This would generally begin with controlled breathing exercises; this ensures the lungs are being fully inflated and reduces the risk of developing pneumonia. Studies have shown thoracic stretching and mobility exercises, breathing exercises, have a positive impact on patients who have sustained chest injuries, specifically regarding chest wall expansion and physical function. Rib fracture treatment is considered complete once the patient can breathe and cough normally without discomfort, walk and complete activities of daily living with no aggravation. This can take up to 3 months to fully heal depending on the severity of the fracture.

An Exercise Physiologist can assist with putting together an individualised exercise programme including breathing exercises, thoracic mobility and stretching as well as progressing to more functional exercises to get you back to your regular daily activities.

Katie Lintott

Accredited Exercise Physiologist (AEP) (ESSAM)

References

Baiu, I., & Spain, D. (2019). Rib Fractures. Jama , 321 (18), 1836-1836.

Julie A. Ekstrum, Lisa L. Black & Karen A. Paschal (2009) Effects of a Thoracic Mobility and Respiratory Exercise Program on Pulmonary Function and Functional Capacity in Older Adults, Physical & Occupational Therapy In Geriatrics, 27:4, 310-327, DOI: 10.1080/02703180902803895

Rib Fractures

Absolute Balance Exercise Physiology Group

Motivational Tips to get back into that exercise routine

administrator@heliummarketing.agency (Helium Marketing) — Wed, 10 Mar 2021 00:07:00 GMT

Struggling to get back into your exercise routine? We know finding the time and motivation to get moving can be difficult.

Oxford Dictionary defines MOTIVATION as the feeling of wanting to do something, especially something that involves hard work and effort.

Here are some tips which I hope offer you a healthy boost of inspiration and encouragement to get active again.

We as humans are creatures of habit. We evolve our daily lives through routine so a great idea is to figure out the best time of day that suits you to get active and make it a standing appointment. It’ll be tough at first but a routine becomes habit very quickly. The body then switches to autopilot and it becomes second nature.

Look at what the exercise gives you and how it makes you feel once you smash those goals you’ve been aiming for. Focus on the benefits of exercise, and what is going on within your own body. You have circulation flowing, building new tissue, clearing the mind and to function at a higher metabolic rate during the day. This right mindset can be incorporated into your daily routine just like brushing your teeth or going to work.

Figure out what works for you, it could be going to the park and walking the dog, heading to the beach with the family or going out for a walk and having breakfast with some close friends. These are fun, engaging and eventful activities which have no time constraints and it gets you moving.

Find an exercise that you will thoroughly enjoy and the bonus is, you will be improving your physique along the way. Whether that is going to a group fitness class because you love the team environment and energy or pulling weights because you want a challenge or you’re a lover of running and enjoy the wind in your hair choose something that you are passionate about and embrace it. Remember, exercise doesn’t have to be boring, and you’re more likely to stick with a fitness program if you’re having fun.

So, get back out there understand the reasoning you are exercising. Whether it be physiological, psychological or social you are the one that knows best for yourself. Now that you’ve regained your enthusiasm, get moving! Set your goals, make it fun and pat yourself on the back from time to time.

Jessica Peters

Exercise Scientist

Oxford Learner’s Dictionaries. Motivation. https://www.oxfordlearnersdictionaries.com/definition/english/motivation?q=motivation

Finding Your Motivation for Exercise. American College of Sports Medicine. https://www.acsm.org/read-research/resource-library/resource_detail?id=e22a58ac-3830-401e-995c-ab4ffa600686

Motivational Tips to get back into that exercise routine

Absolute Balance Exercise Physiology Group

Carpel Tunnel Syndrome: What is it?

administrator@heliummarketing.agency (Helium Marketing) — Mon, 25 Jan 2021 05:51:00 GMT

The carpel tunnel is a narrow, rigid passageway of ligament and bone that is found at the base of the hand. It houses the median nerve, which is a mixed sensory and motor nerve that runs from the end of the brachial plexus (located at the root of your neck) through the forearm to provide sensation and feedback to the thumb and first three fingers. Carpel tunnel syndrome is one of the most common peripheral nerve entrapment disorders in the upper limb and occurs when the median nerve becomes compressed or squeezed at the wrist. This kind of injury is most commonly caused by sudden trauma to the wrist, such as a sprain or fracture, that causes swelling. Other common causes include an overactive pituitary glad, an underactive thyroid gland or rheumatoid arthritis. This compression on the median nerve leads to symptoms including feelings of pain, numbness and tingling in the hand and arm.

When treating carpal tunnel syndrome, it is important to begin as early as possible once symptoms start. Non-surgical treatments can assist in making the problem go away if you’ve only experienced mild to moderate symptoms that come and go for less than 10 months.

Exercise Rehabilitation:

Range of motion and nerve gliding exercises have been shown to be the most effective in improving pain, pressure pain threshold, and overall function in patients with carpel tunnel syndrome. Nerve gliding (also referred to as nerve flossing or neural gliding) is a stretching technique that takes areas of the body through specific ranges to help target and free up injured nerves and improve mobility.

Evidence shows that symptoms should begin to improve within two weeks of consistent daily nerve gliding exercises. After six to eight weeks, it is expected to feel no tightness or pain within your affected wrist.

Other Non-Surgical Therapy:

James McNally (BSc – GradDipClin Exercise Physiology)

Workers’ Compensation Specialist

References:

Ruth Ballestero-Perez, Gustavo Plana-Manzano, Alicia Urraca-Gesto, Flor Romo-Romo, Maria de Los Angeles Atin-Arratibel, Daniel Pecos-Martin, Tomas Gallego-Izquierdo, Natalia Romero-Franco. (2016). Effectiveness of Nerve Gliding Exercises on Carpel Tunnel Syndrome: A Systematic Review. Journal of Manipulative and Physiological Therapeutics , 40 (1), 50-59.

NK Visweswaraiah. (2013). Yoga for Occupational Health and Rehabilitation. Indian Journal of Physiology and Pharmacology , 57 (5), 20-21.

National Institute of Neurological Disorders and Stroke. (2020). Carpel Tunnel Syndrome Fact Sheet. Retrieved from: https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/carpal-tunnel-syndrome-fact-sheet

Carpel Tunnel Syndrome: What is it?

Absolute Balance Exercise Physiology Group

Should you be doing more beyond pre-employment medicals to prevent injuries to new employees?

administrator@heliummarketing.agency (Helium Marketing) — Mon, 25 Jan 2021 05:37:00 GMT

Particularly in jobs that are manual task intensive, completing a pre-employment medical is very much standard practice nowadays. These medicals can vary in length and quality. But even high-quality pre-employment medicals may have their pitfalls and still leave new workers at risk of musculoskeletal injuries.

Whilst a candidate may be able to ‘pass’ a pre-employment functional assessment, this assessment is usually always completed in under 60 minutes. Particularly with workers in the mining industry, these candidates may then have to go away and work for 14 days straight in a physical job. It is unlikely that this assessment is going to be able to replicate this volume of work in a meaningful way.

So, what does this mean?

It means that your new employees may still be at greater risk of a workplace injury as they are not fully conditioned for work. This can particularly be in groups such as younger workers or apprentices as they are still maturing or haven’t previously worked in physical jobs. Providing further conditioning may assist in reducing their risk of injuries.

A review conducted by Clemes et. al. (2009) found that tailored strength and flexibility training was effective in reducing manual handling related injuries. As an extension of this, providing further job specific conditioning, improving strength and flexibility may assist in reducing the risk of injuries in newer employees.

Absolute Balance is in the process of running a pilot program for new employees that work in physical job roles. The programme aims to condition these workers for their new working environment, with the aim of ultimately reducing their risk of musculoskeletal injuries.

For more information on this program and how it is being implemented, contact Aaron from Absolute Balance aaron@absolutebalance.com.au

References:

Clemes, S. A., Haslam, C. O., & Haslam, R. A. (2009). What constitutes effective manual handling training? A systematic review. Occupational Medicine, 2010 (60), 101-107.

Should you be doing more beyond pre-employment medicals to prevent injuries to new employees?

Absolute Balance Exercise Physiology Group

Rotator Cuff Repair and Exercise Rehabilitation Programme

administrator@heliummarketing.agency (Helium Marketing) — Mon, 04 Jan 2021 05:36:00 GMT

I would like to share one of my success stories of my recent patient who sustained a left shoulder injury at work in February 2020. An MRI showed a full-thickness tear of the supraspinatus tendon, moderate subscapularis tendinopathy and complete long head of biceps tendon tear. My patient had a left shoulder arthroscopy and open rotator cuff repair March 2020 and commended his exercise rehabilitation programme in July 2020. The individualised exercise rehabilitation programme was implemented to facilitate a return to pre-injury duties as a Groundsmen.

Job Specific Programme

The patient was completing pre-injury hours with a lifting restriction of 5kg and working below shoulder height. The patient’s pre-injury duties involved maintenance of irrigation around the school grounds including digging, repair and replacement of sprinklers and checking underground electronics. The physical critical demands of the patient’s job role are sustained bent over postures, combined with predominately repetitive hand-arm movements between waist and shoulder height. He is required to lift and carry 20L buckets of sand.

The exercise rehabilitation programme initially focused on increasing pain-free range of movement, joint mobility and stability through his left shoulder. The patient’s programme quickly progressed to addressing recruitment patterns of the left shoulder and supporting musculature with a focus on a variety of positions and postures. The final stage of his programme was to increase upper limb strength in a variety of postures with a focus on correct manual handling and repetitive movements with lifting load away from the midline of his body. The programme included eccentric strengthening exercises for the rotator cuff, concentric and eccentric strengthening for the scapular stabilisers. The focus was external rotator cuff strengthening due to an imbalance between the over strengthen internal rotators and weakened external rotators.

Outcome of Exercise Rehabilitation

The patient is now at 100% functional capacity in the gym for his pre-injury role. The patient was compliant to his exercise rehabilitation programme and return to work plan. He initially completed one supervised session per week for the first eight weeks combined with two to three unsupervised sessions per week. The supervised session was reduced to once per fortnight, which allowed the patient to progress to self-management. At the end of the exercise programme, the patient showed significant improvements in his range of movements and mobility through his left shoulder. The patient has gained strength with lifting load away from the midline of his body and lifting load in various postures necessary for his pre-injury duties, which allowed for job hardening, giving him the confidence to perform his work duties pain-free. As a result, the patient was certified fit for pre-injury duties and due to obtain a final medical certificate at his next specialist review.

Daniel Nguyen (B.Sc. Exercise Physiology)

Senior Accredited Exercise Physiologist (AES, AEP)(ESSAM)

Reference

Byram IR. American Orthopaedic Society for Sports Medicine (AOSSM) 35th Annual Meeting Abstract 8363. Presented July 10, 2009.

Rotator Cuff Repair and Exercise Rehabilitation Programme

Absolute Balance Exercise Physiology Group

A day in trade with Mr Daniel Meyerkort – Orthopaedic surgeon

administrator@heliummarketing.agency (Helium Marketing) — Mon, 04 Jan 2021 04:57:00 GMT

As an Exercise Physiologist we normally see our patients in the sub-acute to chronic stages of post-operative rehabilitation. I recently had the pleasure of observing Mr Daniel Meyerkort from Perth Orthopaedic and Sports Medicine Centre in theatre at Hollywood Hospital in Perth. I was lucky enough to witness three procedures during the afternoon observations, two of which will assist with understanding the process of post-operative exercise prescription for my patients in the workers compensation system who have undergone these surgeries. I was able to witness a lateral ankle ligament and tendon repair, chronic exercise-induced compartment syndrome fasciotomy and an ACL reconstruction with meniscal root repair.

It was humbling to see the professionalism of the team in the room from wheeling the patient in and going through pre-op procedures to wheeling the patient out for post-operative recovery. The team run like clockwork whilst still taking the time to ensure every patient is safe. It was amazing to see the differences in skills required from delicate stitching through to pulling through new ACL grafts that are required with some force! It is easier to appreciate why some patients pull up with more pain than others due to the invasiveness and force of some of these procedures. I have quickly learnt over my time that two patients will not recover from the same surgery in the same way. I also learnt that a lot of the patients will present quite sore not only from the surgery but also the tourniquet applied above the surgical site.

Mr Meyerkort explained that despite patients presenting with the same injuries, advice will change depending on the patient themselves. Not only the amount of injury sustained is taken into account but their age, associated risks and comorbidities, the occupation of the person as well as their standpoint on having surgery. This is always why I encourage my patients not to “Dr Google” as the advice is never going to be the same for every person. Every person’s rehab journey post-surgery is never going to be the same either. It was also great to hear the amount of education that is given to the patient’s surrounding their surgery.

It was surprising to see that even with viewing the imaging of the patient’s knee prior to surgery it is sometimes never fully clear to see the extent of what is going on until you are in the surgery. Mr Meyerkort kindly talked through each of the surgeries whilst able to repair on the go. During the ACL reconstruction he was able to go through the knee and find out the exact parts of the meniscus that needed repairing and his team where able to demonstrate and explain the thread work required and the importance of positioning and precise drilling required through the tibia and femur. The ACL procedure was the longest and most technical of the three with the aim of restoring stability to the knee. Mr Meyerkort demonstrated the extraction of the hamstring graft first using a long instrument to take the semitendinosus and gracilis to use for the graft. Careful inspections of the tendons is a must to make sure the thickness is of exact amount to provide stability. While Mr Meyerkort was repairing the meniscal damage and clearing the fat pad of the knee, the hamstring graft was being meticulously prepared. Throughout the surgery the knee was regularly tested through flexion and extension to ensure everything was on track. This is something that as an exercise physiologist I can draw on, as functional testing should be intermittently performed on the patient to ensure treatment is effective. Through fine and technical threadwork along with some brute strength, the ACL graft was pulled through the knee and secured in a tight position to restore the patient’s stability with the entire surgery lasting approximately two hours.

It was fabulous to see the acute stages of injury repair and the start of a patient’s rehab journey. I was able to draw comparisons in Mr Meyerkort’s work which rings true in the exercise physiology world.

1. You always have to consider the patient as an individual and no one treatment will have the same effect on that patient.

2. No person will have the exact same outcome and it is important to consistently test and check along the way

3. To always have respect and care for the patient and listen to their needs and concerns and be able to adapt in your approach where possible.

It is important to empower the patient through their recovery. If you have a question surrounding pre or post-operative rehabilitation, you can contact an Accredited Exercise Physiologist.

Taylor Downes

Accredited Exercise Physiologist

BSc/GradDipClinExPhys | B.Ed. Human Movement | (ESSAM, AEP)

A day in trade with Mr Daniel Meyerkort – Orthopaedic surgeon

Absolute Balance Exercise Physiology Group

New Years Resolution?

Mon, 04 Jan 2021 03:20:00 GMT

Do you have a new years resolution for your health and exercise in 2021? It may be obvious to most that creating personal change is something that directly ties into growth and self-improvement. The same principle is necessary when it comes to exercise habits, and therefore your fitness. Recent evidence-based psychological studies suggest that individuals who feel the need to rely on external prompts as a motivational influencer are far less likely to adhere to the goals they set. This blog will discuss how to create exercise–based change, the effect these changes may have, and why you shouldn’t wait until the new year to get fitter!

Bringing more exercise into your life doesn’t have to be drastic to begin with. Start small, log your progress with a note pad and pen, or in your iPhone notes, and build on it gradually week by week. This is essentially known as the progressive overload principle. Smart progressive overloading will make you fitter and bring you closer to your fitness goals, without the risk of overtraining and losing morale.

When you start exercising more often or bring about exercise-based change, the following physiological and psychological changes may come along with it:

Get in touch with our team of experienced Exercise Consultants today if you’re interested in finding out more about how to create a healthier, balanced exercise lifestyle. After all, the most important conversations are those that we have with ourselves – so if you’re genuinely unhappy with how you look in the mirror each morning, NOW is the time to do something about it. Not on the first of January.

Jeremy Boyle

Exercise Scientist

References:

Jones, F., Harris, P., Waller, H., & Coggins, A. (2005). Adherence to an exercise prescription scheme: the role of expectations, self-efficacy, stage of change and psychological well-being. British journal of health psychology , 10 (Pt 3), 359–378. https://doi.org/10.1348/135910704X24798

Kavanaugh, A. (2007). The Role of Progressive Overload in Sports Conditioning. Conditioning Foundamentals. NSCA’s Performance Training Journal , 6 (1).

Klok, M. D., Jakobsdottir, S., & Drent, M. L. (2007). The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity reviews , 8 (1), 21-34.

New Years Resolution?

Absolute Balance Exercise Physiology Group

Turn your walk into a workout!

administrator@heliummarketing.agency (Helium Marketing) — Thu, 17 Dec 2020 01:30:00 GMT

With summer upon us, many people (myself included) will be spending a lot more time outdoors enjoying the hot sun and clear skies. There is already a noticeable increase in people going for a walk or run early in the mornings and in the evenings. Walking with purpose is a great way to improve or maintain your overall health. While improving or maintaining cardiovascular fitness, walking can reduce your risk of heart disease, diabetes, and mental health disorders. While many of us are guilty of spending too much time on our bums and on our backs, spending more time on our feet performing weight-bearing activities with moderate to high intensity helps to slow down bone loss and aging.

The key, however, is walking with purpose. Walking at a slow leisurely pace, although still beneficial, will not see you gain the most out of your time in the sun. Unless sickness or injury inhibits you should aim to walk at a brisk pace, faster than you would if you were walking around the house or going shopping – although I have seen some impressive power-walkers at the local Westfield. Walking with intensity gets your heart working harder and will lead to greater changes in your aerobic fitness and cardiovascular health.

If you’re already a pro at walking with purpose, you can take this one step further and introduce some bodyweight exercises along your walk. Depending on how far or how long you walk you can set yourself some stops or stations along the way. An easy way to do this is set a timer for your walk. Set a timer for 3-5 minutes depending on how long you intend to walk for. Every 3-5 minutes stop and perform high repetitions of an exercise/exercises before continuing. This will be sure to increase your heart rate and build strength and endurance in your muscles.

Example Walk Plan

Walk Duration: 20 Minutes

Every 4 minutes stop and perform:

Aim to perform each repetition with quality and complete exercises one after another with little to no rest. Your walk will then become your “active recovery” period. Suddenly you have yourself a cardio workout plan built around your morning/evening walk. The same program can be adjusted if you decided to go for a run. Throwing in some body weight exercises during your walk can help you maximise the short time you have to walk the dog or clear your head. So, the next time you go for a walk, why not turn it into a workout!

If you have been limited to walking because of sickness or injury, please make sure you seek clearance from your GP and relevant health professionals before attempting to increase your activity levels. If that happens to be the case, our team of qualified Exercise Physiologists at Absolute Balance are well equipped to prescribe effective, outcome-based exercise programmes to assist in your rehabilitation and ensure safe exercise progression. You can contact us at info@absolutebalance.com.au

Bastien Auna

Accredited Exercise Physiologist (AES, AEP) (ESSAM)

References

Lee, I. (2007). Dose-Response Relation Between Physical Activity and Fitness. JAMA , 297 (19), 2137. doi: 10.1001/jama.297.19.2137

Murtagh, E., Murphy, M., & Boone-Heinonen, J. (2010). Walking: the first steps in cardiovascular disease prevention. Current Opinion in Cardiology , 22 (5), 490-496. doi: 10.1097/hco.0b013e32833ce972

Murphy, M., Nevill, A., Neville, C., Biddle, S., & Hardmann, A. (2002). Accumulating brisk walking for fitness, cardiovascular risk, and psychological health. Medicine & Science in Sports & Exercise , 34 (9), 1468-1474. doi: 10.1097/00005768-200209000-00011

Turn your walk into a workout!

Absolute Balance Exercise Physiology Group

To take a break or adapt your training style – the holiday season dilemma

administrator@heliummarketing.agency (Helium Marketing) — Thu, 17 Dec 2020 00:47:00 GMT

It’s safe to say 2020 has been a year full of adapting. Fitness-wise with the shutdowns and restrictions as a result of COVID-19 we are all well practiced in how to keep a fitness routine alive while gyms are closed – show of hands for using household items in place of weights! So the question is should you take a break or adapt your training style over the holiday season?

If you are looking to keep some consistency to your training regime but won’t have access to a gym or any gym equipment during the festive season try changing up the tempo of bodyweight exercises to make them more challenging by using the Time Under Tension principle. This is an easy and effective way to manipulate the amount of stress on your muscles when you aren’t able to add extra load through weights (or canned goods hello COVID-19 closures). For example, in a squat or push up try lowering for 5 seconds, holding at the bottom for 5 seconds then coming back up in 1. The idea being that by lengthening different phases of a movement will increase the volume of your training and force the muscle to work harder.

If you’d rather scale back your training and give your body a bit of a break that’s great too! Remember winding down or taking it easy doesn’t have to mean doing nothing at all. It doesn’t have to be strenuous but try to incorporate some type of physical activity into most days, we are lucky that for us the holiday season falls when the weather is beautiful making it easy to get outside and keep active. Remember anything is better than nothing so walk, run, swim, play, whatever it is just keep moving!

That being said, allow yourself to enjoy the festive season and if you decide you want to take a few days off completely then do it and don’t feel guilty about it. At the end of the day if you are usually consistent with your training a few days off isn’t going to ruin the hard work you’ve put in over the rest of the year.

We will all find ourselves somewhat overindulging this time of year, but it is important not to be tempted to overcompensate by hitting the gym twice as hard when you go back. We need to move away from the idea of using exercise as a punishment for eating more than we should have or not training for a few days, using guilt as an incentive to get into the gym is not a sustainable mindset. Instead, own the decision you made to take a few days off, eat the food you ate or the drinks you consumed and get back on track with a healthy sustainable goal.

Whether you decide to adjust your training or to take a break from your usual fitness routine we at Absolute Balance hope you have a restful and enjoyable festive season and look forward to working with you again in the new year.

Katie McGrath

Exercise Scientist

References:

Gentil, P., Oliveira, E., & Bottaro, M. (2006). Time under Tension and Blood Lactate Response during Four Different Resistance Training Methods. Journal of Physiological Anthropology, 25: 339–344.

To take a break or adapt your training style – the holiday season dilemma

Absolute Balance Exercise Physiology Group

HDL Cholesterol and LDL Cholesterol Explained: Made Easy to Understand

administrator@heliummarketing.agency (Helium Marketing) — Tue, 15 Dec 2020 04:03:00 GMT

Cholesterol frequently gets a bum rap, but it’s necessary for your body to function properly.

Cholesterol is a waxy substance a bit like fat. It moves around your body via your bloodstream, in packages called lipoproteins. These packages are made of fat on the outside (lipo) and protein on the inside (protein).

Sometimes, these lipoproteins leave cholesterol in your arteries, which contributes to the build-up of plaque and increases your risk of heart disease and stroke.

Rather than two different kinds of cholesterol that are ‘good’ and ‘bad’, there are two different types of lipoproteins that cholesterol travels in. Having some of both types of lipoproteins is essential for good health.

High-density lipoproteins (HDL cholesterol) the ‘good’. They remove cholesterol from your arteries and take it back to your liver to process and eliminate.

Low-density lipoproteins (LDL cholesterol) the ‘bad’ cholesterol. They leave cholesterol in your arteries.

While you need some LDL and HDL cholesterol for your body to work properly, too much cholesterol in total can lead to health problems, as the extra LDL cholesterol builds up in your arteries.

Below are a few lifestyle habits to follow to lower cholesterol.

If your cholesterol is high, your Doctor might prescribe medication that can help lower cholesterol too.

References:

Liu, J., Sempos, C., Donahue, R., Dorn, J., Trevisan, M. and Grundy, S., 2020. Joint Distribution Of Non-HDL And LDL Cholesterol And Coronary Heart Disease Risk Prediction Among Individuals With And Without Diabetes .

Van Lenten, B., Hama, S., de Beer, F., Stafforini, D., McIntyre, T., Prescott, S., La Du, B., Fogelman, A. and Navab, M., 2020. Anti-Inflammatory HDL Becomes Pro-Inflammatory During The Acute Phase Response. Loss Of Protective Effect Of HDL Against LDL Oxidation In Aortic Wall Cell Cocultures.

HDL Cholesterol and LDL Cholesterol Explained: Made Easy to Understand

Absolute Balance Exercise Physiology Group

Mirror Box Therapy

administrator@heliummarketing.agency (Helium Marketing) — Mon, 07 Dec 2020 14:44:00 GMT

Mirror box therapy is derived from the use of a mirror to reflect the use of a normal functioning limb to trick the brain to reinforce movement without pain. It involves placing the affected limb inside a box or covered with the reflective side displaying the “working limb” back to the person. From their perspective, they see two fully functional limbs. This type of therapy has been widely used for people with amputated limbs who experience phantom limb pain, complex regional pain syndrome and people recovering from stroke.

Phantom limb pain is where a person feels painful sensations from a limb that is no longer there. The mechanisms of phantom limb pain are not widely understood; however it is thought to be due to peripheral mechanisms due to the injury-causing disrupted input from afferent nerves back to the spinal cord and changed in central neural mechanisms. Mirror box therapy can assist people with phantom limb pain by using the mirror to assist with visual feedback making it real for the patient to see movement and move the “phantom limb”. They receive feedback through vision and proprioception which assist the person to see real movement and that this can occur without pain. The idea is to trick the brain to remodel the cortical systems that may provide relief through visual dominance of the motor-sensory process and activation of mirror neurons through visual movement.

There are some limitations to the use of mirror therapy in rehabilitation with restrictions to the location of injury as well as the extent of injury and the variety of pathologies that induce pain. Mirror box therapy can be easily added into exercise-based routines using active or passive range of motion movements and other exercises for patients based on their level of ability. It is best to consult an accredited exercise physiologist prior to undertaking treatment.

Taylor Downes |B. HM. | GradDipClinExPhys|

Accredited Exercise Physiologist (AEP) (ESSAM)

Najiha, A., Alagesan, J., Rathod, VJ., Paranthaman, P. Mirror Therapy: A review of evidences. IntJ Physiother Res 2015;3(3):1086-1090. DOI: 10.16965/ijpr.2015.148

Subedi, B., & Grossberg, G. T. (2011). Phantom limb pain: mechanisms and treatment approaches. Pain research and treatment, 2011, 864605. https://doi.org/10.1155/2011/864605

O’Connell NE, Wand BM, McAuley JH, Marston L, Moseley GL. Interventions for treating pain and disability in adults with complex regional pain syndrome‐ an overview of systematic reviews. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009416. DOI: 10.1002/14651858.CD009416.pub2.

Mirror Box Therapy

Absolute Balance Exercise Physiology Group

Exercise and Back Pain

administrator@heliummarketing.agency (Helium Marketing) — Mon, 07 Dec 2020 13:44:00 GMT

Almost everyone has experienced a degree of back pain throughout their lifetime, preventing them from completing activities of daily living and leisure activities. Most often than not a vast majority of people will completely cease involvement in exercise or sporting activities after experiencing a bout of back pain as they are fearful it will cause more harm than good. However, this is a common misconception and in most cases exercise and movement are the natural stimuli to begin the healing process.

It is recommended that no more than one- or two-days rest at the onset of back pain is needed, as inactivity protracts the likelihood of prolonged pain. Increased periods of inactivity cause deconditioning of the lower back leading towards increased stiffness, weakness, and decreased mobility. As the old saying goes use it or lose it.

Exercise plays a dual role of both treating and preventing lower back pain. Regular stretching and exercise help by nourishing and repairing spinal cord structures which will help solve pre-existing issues. Whilst continued movement will help prevent future exacerbations by ensuring the lower back is strong and mobile.

Exercise is known to have many benefits in the process of treating lower back pain and when completed in a controlled and sensible manner these benefits may include:

The key to a successful gym programme to aid in the reduction of lower back pain is adherence. Exercise is one of the most important factors long term pain relief, even small bouts of 10 minutes a day is enough to notice benefits. Start small and progress slowly, remember some movement is better than none. Below are 5 easy exercises to get you started on you pain free journey!

5 Exercise to Help with Lower Back Pain

Cameron Galati

Accredited Exercise Physiologist (AEP, AES) (ESSAM)

Hochschuler, S. (2020). Exercise and Fitness to help your back. Journal of Spine Health .

Gopez, J. (2017). Exercise and Back Pain. Journal of Spine Health.

Exercise and Back Pain

Absolute Balance Exercise Physiology Group

Whiplash and Whiplash Associated Disorders

administrator@heliummarketing.agency (Helium Marketing) — Mon, 07 Dec 2020 13:13:00 GMT

Whiplash associated disorder (WAD) is a term used to describe the collection of symptoms associated with an injury of the neck usually sustained in an accident. Whiplash and whiplash associated disorder are often terms used with the intention of equivalent meaning, however whiplash refers to the mechanism of the injury instead of symptoms present whereas WAD is a range of neck-related clinical symptoms which are usually chronic in nature. Both conditions are common and are usually the result of sudden acceleration-deceleration movements most commonly following the involvement in a motor vehicle or sporting accident.

Whiplash is one of the most controversial musculoskeletal conditions as a precise anatomical diagnosis is usually unachievable. There are 4 grades of whiplash depending on the severity, pathology, signs and symptoms present. Neck pain is the most common indicator of a whiplash injury, other symptoms include stiffness of the neck, headache, visual disturbances, shoulder pain and pain, numbness, tingling or weakness in one or both arms. For some whiplash patients their symptoms become debilitating and progressively worse, for these patients their condition develops into a whiplash-associated disorder. Psychosocial symptoms such as depression, anxiety and fear can also be seen in patients with a whiplash injury as well as psychological factors surrounding the accident itself. Anyone who has already sustained a neck-related injury in the past is more susceptible to whiplash.

For many reasons whiplash injuries can be difficult to treat. Factors such as severity and presence of pain symptoms, interactions of psychological, legal, and physical factors can impact the time to recovery and the effectiveness of treatment methods. Most recent studies suggest active treatment, early mobilization and a gradual exercise programme lead to improved outcomes compared to treatment options which include motion restriction and rest. An exercise programme incorporating specific neck range of motion, strengthening, and stretching exercises can assist with recovery of a whiplash injury. Studies also suggest an early intervention and exercise can reduce pain intensity, improve functional capacity, reduce absences from work and improve range of motion of the neck to pre-injury levels. In patients with chronic whiplash and whiplash-associated disorders exercise, early mobilisation and returning to activity improved long-term outcomes. Overall, recovery times can vary due to the interactions of many factors, however early intervention and exercise can offer the best chance for recovery.

Katie Lintott

Accredited Exercise Physiologist (AEP) (ESSAM)

References

Michele Sterling (2011) Whiplash-associated disorder: musculoskeletal pain and related clinical findings, Journal of Manual & Manipulative Therapy, 19:4, 194-200, DOI: 10.1179/106698111X13129729551949

Yadla, S., Ratliff, J. K., & Harrop, J. S. (2008). Whiplash: diagnosis, treatment, and associated injuries. Current reviews in musculoskeletal medicine , 1 (1), 65-68.

Whiplash and Whiplash Associated Disorders

Absolute Balance Exercise Physiology Group

My Joints Click, Is There an Issue?

administrator@heliummarketing.agency (Helium Marketing) — Mon, 07 Dec 2020 12:45:00 GMT

Do your joints click and pop when you are active? I would be surprised if you did not. The technical term for the noises coming from our audible joints is “crepitus” and people of all ages experience it. Personally, my knees “click”, my right hip “clunks” and when I roll my shoulders there’s an internal “thud” sound that accompanies the movement. I have a lot of clients who are initially worried about such noises, associating the crackles and pops with further damage to the joint.

The good news is it really is quite normal to experience crepitus and most of the time has no sinister affect on the body. As we age, of course our joints are aging with us, leading to general wear and tear to the structures of the joint, most notably the cartilage. Crepitus can then occur from these rougher surfaces rubbing together as you complete a movement, such as a click in your knee as you stand up from your chair or a pop in your ankle as you shift your weight on your foot.

In regard to exercise, it is also quite normal to hear repetitive clicking as you complete each repetition of a given movement. This could be caused by a tight muscle which is causing some friction around the bone. Some gentle, targeted stretching may be all that is required to sort that snapping out. Overall, exercise is a great way of maintaining your joint health, the more your body moves, the more your joints will lubricate themselves. – “Motion is Lotion” as they say.

One caveat, if the crepitus is accompanied with pain then there is the possibility of an underlying injury and a review with a healthcare professional would be the best course of action to mitigate any risk of damage as you go about your day to day life. For further information please contact Absolute Balance through info@absolutebalance.com.au .

Callan Smith (B.Sc. Exercise & Sport Science, B.Sc. Exercise Science & Rehabilitation)

Senior Accredited Exercise Physiologist (AEP) (ESSAM)

References

Robertson, C., Hurley, M., & Jones, F. (2017). People’s beliefs about the meaning of crepitus in patellofemoral pain and the impact of these beliefs on their behaviour: A qualitative study. Musculoskeletal Science And Practice , 28 , 59-64. doi: 10.1016/j.msksp.2017.01.012

My Joints Click, Is There an Issue?

Absolute Balance Exercise Physiology Group

Client Feedback – Callan Smith

Tue, 24 Nov 2020 00:56:00 GMT

“I recently suffered a work injury and was referred to Callan Smith for aid in my recovery. I’m back to pre-injury fitness and probably a bit better, due in great extent to Callan’s assistance.

From the beginning he was realistic, friendly and thoughtful. He actually listened to my symptoms and (for which I was particularly grateful) never made it all about my weight.

He has given me a doable workout which doesn’t hurt, and has extended it as my symptoms have improved. I am actually enthusiastic about my gym visits as I know they will make me feel better instead of worse.

Thank you very much, Callan”

Client Feedback – Callan Smith

Absolute Balance Exercise Physiology Group

Client Feedback – Taylor Downes

administrator@heliummarketing.agency (Helium Marketing) — Tue, 24 Nov 2020 00:52:00 GMT

“In February 2020 I broke my ankle which required surgery on 6 March, with a subsequent second surgery on 21 May 2020. Once the second surgery was completed I was able to commence some rehabilitation which was arranged through my vocational rehabilitation provider. I commenced with Taylor Downes about the 12 June 2020 where Taylor had me complete a number of basic assessments and exercise movements with my ankle. Over the next few months I progressed into commencing a number of further exercises and completed my programme which was allocated from Taylor.

From my initial commencement in a Hydro pool to when I completed my programme I was able to run for five minutes on a treadmill.

I have continued with some of the programme and adding some further exercise items which I now walk 5 minutes and now run for a good ten with no pain or discomfort in my ankle. Taylor assisted me with my progress throughout, even when I had issues with previous injures in my back Taylor was more than helpful to discuss other exercise ideas for me to complete which would also assist and strengthen other areas to compliment my previous injuries.

Thanks very much for the assistance in my rehabilitation from my broken ankle.”

Client Feedback – Taylor Downes

Absolute Balance Exercise Physiology Group

Biceps Tendon Injury and Rehabilitation

administrator@heliummarketing.agency (Helium Marketing) — Mon, 23 Nov 2020 00:53:00 GMT

I recently completed a successful rehabilitation programme with a client who was recovering from a biceps tendon rupture. The injury was sustained at work and was surgically repaired. The programme was implemented to facilitate a return to pre-injury duties as a Mechanical Fitter.

The biceps brachii muscle is located in the upper arm and originates from the scapula, via two tendons. The distal biceps tendon crosses the elbow to attach the biceps brachii to the radius of the forearm. These attachments enable the bicep to perform elbow flexion and supination of the forearm. Injuries to tendons vary in nature and include gradual overuse or acute tears from lifting an excessively heavy object. In this case, the injury was sustained whilst performing a heavy lift.

The exercise rehabilitation programme focused on progressively exposing the tendon to higher forces and variable movement patterns to facilitate a return to pre-injury capacity. Due to the physically demanding nature of Mechanical Fitting, an emphasis was placed on work hardening to ensure conditioning was achieved to perform all aspects of the pre-injury role. This included lifting, pushing, pulling, carrying and pronation-supination of the forearm. The exercises were also performed at variable rates of contraction and incorporated isometric (static) interventions to further emphasise work-specific conditioning and to aid the rehabilitation of the tendon. Research has shown that strength training is beneficial for stimulating adaptations in both muscle and tendon and is beneficial for tendon pain.

The outcome of the programme was successful, as all the critical physical demands specific to Mechanical Fitting were achieved and a final medical certificate was issued. Two key reasons for the positive outcome were the high level of motivation and accountability for performing the gym-based programme. It’s personally rewarding when an outcome like this is achieved.

If you would like more information on elbow injuries or other rehabilitation programmes that Absolute Balance specialise in, please don’t hesitate to contact us at info@absolutebalance.com.au

Daniel D’Avoine BSc(ExerSc&Rehab)

Exercise Rehabilitation Team Leader – Workers Compensation Specialist

References:

Borms, D., Ackerman, I., Smets, P., Van den Berge, G., & Cools, A. (2017). Biceps disorder rehabilitation for the athlete: a continuum of moderate- to high-load exercises. American Journal of Sports Medicine, 45 (3), 642-650.

Rio, E., Kidgell, D., Moseley, L.G., Gaida, J., Docking, S., Purdam, C., & Cook, J. (2016). Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. British Journal of Sports Medicine, 50, 209-215.

Wentzell, M. (2018). Post-operative rehabilitation of a distal biceps brachii tendon reattachment in a weightlifter: a case report. The Journal of the Chiropractic Association, 62 (3), 193-201.

Biceps Tendon Injury and Rehabilitation

Absolute Balance Exercise Physiology Group

Pubalgia (Or Sports Hernia)

administrator@heliummarketing.agency (Helium Marketing) — Sat, 21 Nov 2020 04:17:00 GMT

Pubalgia is a chronic condition where there is an imbalance of the adductor and abdominal muscles at the pubis, that leads to an increase of the weakness of the posterior wall of the groin. This imbalance leads to a deep groin pain. Complete tearing or displacement can occur unilaterally or across the midline to the other side.

Management with Exercise:

An active training programme is superior to passive treatment without active training

Ronan Power, B.Sc Exercise Physiology (AEP, AES) (ESSAM)
Senior Accredited Exercise Physiologist

Pubalgia (Or Sports Hernia)

Absolute Balance Exercise Physiology Group

Meet the Team – Chris Chen

administrator@heliummarketing.agency (Helium Marketing) — Sat, 21 Nov 2020 03:59:00 GMT

Hi everyone, my name is Chris Chen and I am a Senior Accredited Exercise Physiologist at Absolute Balance.

Exercise has always been something I am passionate about since I was in high-school. I spent a lot of time reading up and watching videos about how to get stronger, how to get leaner, what food burns fat and anything else you can think of that relates to something to do with health and fitness.

Additionally, soccer is a sport that runs rich through my family as my Dad has been playing since his own primary school days and my brother and myself grew to love it as well.

However, during a high-school match I suffered a devastating injury to my left knee and completely ruptured my ACL. I wasn’t sure what was going on at the time and I continued to exercise at the gym as I believed that if I kept my muscles strong, I’d be able to recover. Unfortunately, I was a naïve teenager and didn’t realise that ligaments aren’t able to repair on their own.

I realised soon after that the exercises I was doing in the gym appeared to be working and I didn’t feel like my leg would give-way anymore and that’s when I began my journey into Exercise Rehabilitation.

I ended up doing a degree in Exercise Physiology at Murdoch University after deciding I wanted to learn more about how exercise can be prescribed as medicine and how I’ll be able to help others who have had to go through similar circumstances.

Exercise has allowed me to continue doing all the things I want to do, and I still get to put on my soccer boots from time to time.

Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist

Meet the Team – Chris Chen

Absolute Balance Exercise Physiology Group

“Let your patients have a say in their rehabilitation”

administrator@heliummarketing.agency (Helium Marketing) — Sat, 21 Nov 2020 03:39:00 GMT

Now you may have heard this before, but letting your patients have a say in their treatment leads to better outcomes. When health professionals hear this saying they may think that this means having a rehabilitation program that is convenient to the client where they advise what location is best for them, establishing realistic treatment frequencies and durations which suit their work/life schedule. This certainly plays a large factor in recovery and treatment adherence, but it is not the takeaway message from the saying “let your patients have a say in their rehabilitation.”

So, what is the takeaway message from the saying “let your patients have a say in their rehabilitation” and what does it lead to?

What if I told you there is evidence out there by Gardner, 2019 showing 21% increased improvement in disability and a 35% increased improvement in pain with a therapist who allowed the patients to set their goals when compared to a therapist giving standard exercise advice. Makes sense, right? Now think about your patients you are working with. Have you allowed them to think about their goals and what they require to improve their program adherence, improve their pain and disability levels?

My takeaway message from “let your patients have a say in their rehabilitation” is that there’s a difference between treating people and treating pain. Working in the workers compensation field it is important to make relevant work and life goals to ensure program adherence is consistent and thus leads to goals being reached. If you would like more information on individualised client-focused goal setting and how to build a stronger rapport with your patients please don’t hesitate to contact us on info@absolutebalance.com.au.

Jason Peschke

Accredited Exercise Physiologist (AEP, AES) (ESSAM)

Gardner T, et al. Combined education and patient-led goal setting intervention reduced chronic low back pain disability and intensity at 12 months: a randomised controlled trial BR J Sports Med, 2019.

“Let your patients have a say in their rehabilitation”

Absolute Balance Exercise Physiology Group

Pain Theory Continued

administrator@heliummarketing.agency (Helium Marketing) — Sat, 21 Nov 2020 03:12:00 GMT

In my last blog I discussed the Progression of Pain Theory looking at one of the first theory’s from the ancient Athenian philosopher Plato to more recent theories by David Wall and Ronald Melzack which views pain through a mind-body perspective. At present pain is defined as “an unpleasant sensory and emotional experience associated with the actual and potential tissue damage or described in terms of such damage”. This definition fits well when considering the biopsychosocial pain model which recognises an individual’s biology or pathology, cognitive aspects and social aspects of an individual’s life.

The biopsychosocial model was first introduced in medicine by George L. Engel and was mostly related to all chronic illness. Engel’s model suggested that as a medical illness became more chronic in nature, then psychosocial “layers” e.g., distress, illness behaviour, and the sick role emerged to complicate assessment and treatment. Later, J.D. Loeser, applied this model to pain. Taking into account these perspectives, there were four dimensions related to the idea of pain: nociception, pain, suffering, and pain behaviour.

The current Biopsychosocial model is described as a pain experience with three dimensions,

Biological factors, psychological factors and social factors.

As time has gone on and our understanding of pain theory has developed, how someone experience pain unique to the individual and their circumstances. When assessing chronic pain conditions as exercise physiologist we have to consider all of these components in order to effectively treat an individual and get the best outcome possible.

Stayed tuned for my next pain theory instalment where I will look at the assessment process and what Exercise physiologists need to consider when assessing chronic pain.

Claire Hills ( B.EXSpSc,Grad.Dip.(Clin.Ex.Phys))
Senior Accredited Exercise Physiologist (AEP) (ESSAM)

References

Adams, L., & Turk, D. (2018). Central sensitization and the biopsychosocial approach to understanding pain. Journal Of Applied Biobehavioral Research , 23 (2), e12125. doi: 10.1111/jabr.12125

The Biopsychosocial Approach. (2020). Retrieved 24 September 2020, from https://www.practicalpainmanagement.com/treatments/psychological/biopsychosocial-approach

Pain Theory Continued

Absolute Balance Exercise Physiology Group

Patient Interview

administrator@heliummarketing.agency (Helium Marketing) — Wed, 11 Nov 2020 02:45:00 GMT

Patient Interview: Phulpreet was referred to us following a lower back injury he had obtained at work. Given Phulpreet’s pre-injury job role was quite heavy and labour intensive, I recommended he commence a gym-based program to ensure we had adequate equipment so he was able to demonstrate lifting capacity in order to return to full pre-injury duties. Phulpreet, however, was not 100% confident with attending the gym on his own given he had no previous gym experience. Fast forward to now, just five short weeks into his program, Phulpreet is averaging 4 weekly visits to the gym (one of these being supervised) and has gone from being certified fit to complete supervisory duties, to close to full capacity whilst also reporting a significant improvement in lower back symptoms.

I asked Phulpreet a few questions at our most recent consultation to understand how he (and I assume quite a few others) feel when we recommend a gym membership and they have not stepped foot in a gym before. I also wanted to address how he has gone from feeling quite anxious in a gym environment, to attending 4 times per week and more importantly how he feels as a result.

Prior to your injury, what is your exercise history?

“Absolutely nothing, it was all just work-related. I felt because I lifted heavy things at work, I did not really need to attend the gym because I was doing enough”.

What was your view around the gym prior to starting this program?

“I was nervous about what other people thought of me. Was I doing exercises with the right technique? What if I was doing it wrong?”

What did you expect when getting referred to us at Absolute Balance?

“I thought you were going to push me too hard I was going to be so sore and wouldn’t want to come back.”

2-3 sessions in, how did this change?

“Was such a big improvement, I started with mat work which was good to start and once you had taught me to breathe properly and release the tightness throughout my back my pain improved almost immediately. Because you taught me the technique, I didn’t even think about other people watching me at the gym. Because I felt so much better it made me want to come to the gym to get better.”

How has your perception around pain changed?

“Significantly, I don’t have to rely on other people for my daily activities and I’m no longer in pain throughout the day. It also helped me get my health back on track, I feel a lot better after coming here.”

What advice would you give to someone else who has been recommended to attend the gym but has no previous experience like yourself?

“Do not compare yourself and do not look at others for comparison, pay really good attention to your instructor as they are there for you to help you.”

At our initial assessment, Phulpreet was able to lift 5kg from floor to waist and waist to shoulder, he struggled to complete full range squats or multiple cable rotations due to on-going pain throughout his back. Phulpreet’s average pain score was 6/10 following prolonged sitting or standing and was very guarded when asked to move into lumbar flexion and extension. The photos below were taken just five weeks into his program and his average pain score has decreased to an intermittent 1/10 pain.

Given Phulpreet was quite reluctant to attend the gym given the minimal prior experience, I spent additional time throughout our sessions on teaching him correct technique, how to adjust machines, gave him a few key points on what to focus on throughout each movement and tried to limit the exercises I prescribed to one area of the gym. From speaking with Phulpreet, it was these little changes that reportedly made him feel much more confident with attending the gym as he felt no one was staring at him for doing something with wrong technique or not being able to adjust the machines.

By identifying these barriers early, it ensured that I could address these and make sure there was not going to be any push back when it came to Phulpreet’s progress and compliance to the program. This has helped immensely when proving functional capacity within the gym and making sure he was comfortable within the gym environment. Phulpreet also mentioned to me at our last meeting that he was planning on continuing his gym membership even after our supervised sessions have ceased.

Please feel free to contact our team at info@absolutebalance.com.au if you have any queries regarding how best we can help.

Channai Graham (B.Sc-Ex.Sp.Sci,Post.Grad.Dip.(Clin.Ex.Phys))

Senior Accredited Exercise Physiologist (AEP) (AES) (ESSAM)

Patient Interview

Absolute Balance Exercise Physiology Group

The PAWfect exercise buddy

administrator@heliummarketing.agency (Helium Marketing) — Thu, 29 Oct 2020 23:31:00 GMT

Do you own a dog? We all love our four legged friends and guess what they make the PAWfect exercise buddy – they could be the main reason that many people participate in physical activity.

Here are 4 Reasons how your doggo is good for your health:

1 – THEY KEEP YOU ACTIVE:

It can be pretty hard to find the motivation to get out of the house and go for a walk/run, but when you look over and see those literal puppy dog eyes, it makes it extremely hard to say no.

Having a dog is a great excuse to engage in outdoor activities, especially walking and running which carry huge health benefits.

2 – THEY GET YOU OUTSIDE

Research suggests that exercising outdoors can contribute to a reduction in stress and improved mood. Fresh air as mentioned in a previous blog is extremely beneficial. The dose of Vitamin D from sun exposure helps fight mental conditions such as anxiety and depression and is also great for bone health. Fresh air also releases serotonin, the “feel good brain chemical”, making you feel perkier than you may have done when inside.

3 – THEY REDUCE STRESS AND ANXIETY

There is research to suggest that the company of your pet can have effects on reducing stress and anxiety, in turn reducing blood pressure. They are your most trusted confidant, and non-judgemental friend.

4 – ITS FREE

Although your dog may cost you a small fortune in food, treats, vet bills and maybe outfits, taking him for a walk/run is completely free and absolutely priceless in terms of the benefits to your health.

So maybe……A dog is the answer to a healthy lifestyle?

Line Malan

Exercise Scientist

References:

Knight, S. and Edwards, V., 2020. In The Company Of Wolves .

Ocregister.com. 2020. Power Of Pets: Exploring Psychological Effects Of Adding A Dog To The Family – Orange County Register

The PAWfect exercise buddy

Absolute Balance Exercise Physiology Group

My Recovery Journey (Part 2)

administrator@heliummarketing.agency (Helium Marketing) — Thu, 29 Oct 2020 05:53:00 GMT

It has been a while since I wrote my first blog ( My Recovery Journey Part 1 ) and a bit has changed over the last few weeks. I am now currently three months post my ACL reconstruction, which I am very grateful has been coming along really nicely, however, I would be lying if I didn’t say that I am definitely starting to miss being able to go for a run or complete a high-intensity circuit (especially with summer coming!). Below I have listed another few tips for those also on this journey about how I have kept myself as motivated and positive as possible over the last six weeks.

TAKE REGULAR PHOTOS AND VIDEOS

During the first 1-6 weeks of my rehabilitation there were noticeable differences with pain, range of movement and ability to stand and walk. Over the last 4-6 weeks, as I am getting stronger and more functional, the improvements are becoming smaller and harder to notice. At times I have found myself becoming impatient with the “lack” of progress I perceived I was making. Luckily, I have been documenting my recovery each week through photos and short videos and have found this EXTREMELY helpful and reassuring. I can clearly see in my video’s, improvements with the quality of my movement, range of movement and even tempo of movement whether that be fast or slow and controlled.

JOURNAL YOUR RECOVERY

Following on from the above point, I would recommend choosing a few tasks or challenges and commenting on these each week. My main examples are my ability to walk up and downstairs, my gait and how long it was taking me to walk a lap of my local park. Looking back now I can see that when I was four weeks post op, it was taking me 16 minutes to walk one lap of the park and I still felt I was limping quite heavily, and at 10 weeks post-op it was taking me on average 9 minutes and I had written that I felt my gait was almost back to normal. It has been a great “pick me up” for when I am having a frustrating day and serves as a reminder that even if some points of the rehab cycle aren’t as significant or rapid as others, all of the little things I am doing are pushing me in the right direction.

RETURN TO WORK/LEISURE ACTIVITIES AS QUICKLY AS YOU CAN

I returned to work and the gym as fast as I could after my operation (after consulting with my treating specialist first). I was very lucky that I had a supportive workplace that were able to assist with transport and a second (able bodied) person to complete the physical tasks I could not. I firmly believe that having a regular routine again, having to complete some physical demands within my job role (within my limits) really assisted with speeding up my recovery. It also really boosted my mood having that mental stimulation as well as a social outlet (I had a lot of talking to make up for…!)

TRUST THE PROCESS!

Although I know I am still a while away from a “full recovery” it is important to constantly remind yourself to trust the process. We know that rehabilitation works and is a fundamental part of recovery post-surgery. It is important to make it part of your routine and lifestyle as motivation can come and go, especially if your recovery is going to take a long duration of time. Remember, management of your rehabilitation is a lifelong process! If you need assistance with an exercise rehabilitation treatment plan following an operation, feel free to contact us at info@absolutebalance.com.au for more information.

Tayla O’Halloran (B.Sc. – Exercise Physiology)

Exercise Rehabilitation Team Leader (AEP) (ESSAM)

My Recovery Journey (Part 2)

Absolute Balance Exercise Physiology Group

Why nobody reads your Job Dictionaries

administrator@heliummarketing.agency (Helium Marketing) — Thu, 29 Oct 2020 00:44:00 GMT

Job Dictionaries are tools that are widely used across many industries, particularly those that have occupational risks. They can certainly be an effective tool but in a lot of instances they would not be given a second glance by one of the key stakeholders that they have been created for.

One of the core reasons why Job Dictionaries are created by companies are to provide a useful tool to doctors to assist with the return to work process in the Workers Compensation System. Giving medical professionals an inherent understanding of a worker’s job requirements is essential for effective return to work planning, but this is where many Job Dictionaries fall short.

As most people know, doctors are extremely time poor with booking after booking and are regularly running behind. Occupational health clinics can be even worse with a waiting room piled up waiting to see the doctor. With this in mind, do you think that Job Dictionaries are catered for this?

Working as an Accredited Exercise Physiologist in the Workers Compensation scheme in Western Australia, I quite often see Job Dictionaries of patients that I am providing rehabilitation for. It stuns me that these documents are always in excess of 10 pages, and most recently came across a document that was 43 pages long. Just seeing the number of pages gave me flashbacks to studying English in high school and reading through lengthy, tedious texts.

As a result, the doctors don’t end up reading the Job Dictionary document and will either just ask the patient what their job role involves or just assess them as a generic patient. So, you have paid for a big document that nobody actually reads, and you are potentially having workers signed off totally unfit from work as the doctor doesn’t know what they actually do.

What needs to change then? To get the most out of your Job Dictionaries, a succinct breakdown of the core physical tasks in a short and easy to read document is crucial. Don’t think that longer and more detail is better as it just won’t be read. With this in mind, Absolute Balance created a two page, easy to read Job Dictionary to ensure that it wouldn’t be ignored by the treating GP.

For more information on how Absolute Balance can assist, please contact Aaron at Absolute Balance on 0499 919 670 or aaron@absolutebalance.com.au

Aaron McErlaine (BSc – ExHealth, BSc – ExRehab, Dip WHS, Cert IV TAE)
Health & Injury Prevention Services Manager (AEP) (ESSAM)

Why nobody reads your Job Dictionaries

Absolute Balance Exercise Physiology Group

Improving Our Flexibility and Functional Range of Motion

administrator@heliummarketing.agency (Helium Marketing) — Thu, 29 Oct 2020 00:35:00 GMT

In today’s fast-moving society, people are finding it harder to keep up with the demands of a busy schedule and physical health slowly becomes less of a priority. As we get older, become more stressed and less active, our flexibility begins to suffer and if not addressed has the potential to lead to a host of functional issues and muscular imbalances.

Muscle weakness and poor flexibility are the two major components for joint pain and dysfunction. Enhanced flexibility decreases the chances of injury, relieves pain, and improves overall performance. Regular stretching exercise protocols increase the flexibility of muscle, range of motion and also provide functional benefits.” (Jyoti et al., 2019; Sexton et al., 2006)

According to Sexton et al.; “Loss of functional range of motion can alter the function of the various components of the kinetic chain, thereby increasing injury susceptibility.”

It is important that we maintain our flexibility to ensure there is facilitation of normal functional motion. “If one link of a kinetic chain is hypomobile, the proximal links must alter their function to preserve the overall “normal” function of the integrated kinetic chain. This compensatory alteration of proximal joint function leads to long-term changes in the flexibility associated soft tissues (muscles, tendon, ligament and fascia), as well as changes in neuromuscular activation patterns, as each component of the kinetic chain seeks of the path of least resistance during performance of functional movement patterns.” (Sexton et al.)

Our kinetic chain is the result of numerous interdependent motions within each of our joints. For example, the amount of forward flexion occurring between the first and second lumbar vertebrae is relatively minor but the sum of all the movements from the joints involved between different spinal segments produce larger overall movements of the spine.

Discrepancies with functional range of motion may result in overcompensation within different areas of the body and if left unaddressed over a long period of time, may produce a larger affect on the whole kinetic chain.

How can we improve our flexibility?

There are a few ways we can improve our flexibility. Two of the most common methods that you may have heard of are static stretching and dynamic stretching.

Static stretching means to hold and maintain a posture, whether that is sitting or standing while flexing or extending the involved body segment.

Dynamic stretching can be explained by using whole-body movements to take the body segments through their normal range. For example, performing leg swings forwards and backwards or swinging the leg side to side to warm-up the muscles prior to exercise.

According to a study by Muh et al.; their aim was to determine static and dynamic stretching towards changes in limb muscle strength and flexibility among volleyball players.

In the study sample of 20 volleyball players, the results showed significant differences between static and dynamic stretching towards changes in muscle strength of the limbs. Muh et al. found that static stretching is proven to increase limb muscle flexibility but demonstrated decreased muscle strength, while dynamic stretching demonstrated a lower increase of limb muscle flexibility but displayed an increase in limb muscle strength. They concluded static stretching was more influential in improving limb muscle flexibility.

Until more recently, static stretching had become a basic part of warming up but dynamic stretching has proven benefits in better priming the body for exercise due to requiring the whole body to move, increasing body temperature, proprioception, motor stimulation and whole body range of motion.

In conclusion, by improving our flexibility we can minimize the risk of muscle, tendon and joint injury, while also improving muscular performance capability.

If you would like more information on improving your flexibility and functional range of motion, please contact Absolute Balance by mail at info@absolutebalance.com.au or view or website www.absolutebalance.com.au

Chris Chen (BSc – Exercise Physiology)

Senior Accredited Exercise Physiologist

Muh. Ismail H, Ita R, Erfan S. Comparison between static and dynamic stretching in changes of limb muscle strength and flexibility of volleyball players. Journal of Physics: Conference Series. 2020; 1-6

Jyoti, Shabnam J, Vikram Singh Y. Knee joint muscle flexibility in knee osteoarthritis patients and healthy individuals. International Journal of Health Sciences and Research. 2019; 6: 156-161

Sexton P, Jeffrey C. The importance of flexibility for functional range of motion. International Journal of Athletic Therapy and Training. 2006; 11: 13-17

Improving Our Flexibility and Functional Range of Motion

Absolute Balance Exercise Physiology Group

Disc Degeneration Disease

administrator@heliummarketing.agency (Helium Marketing) — Thu, 29 Oct 2020 00:14:00 GMT

The spine is a masterpiece in complexity, allowing us to maintain upright posture whilst protecting the spinal cord – a highway for a nervous system and essentially the brain’s pathway to our entire body. The intricate formation of vertebra and over 100 joints allow extreme flexibility and range of motion. So it’s no surprise that things can go wrong. Back pain is extremely common in Australia, with the Australian Institute of Health and Welfare (AIHW) stating that 1 in 6 Aussies (16% of the population) had back problems in 2017/18. Accounting for 4.1% of Australia’s total disease burden in 2015, the economic impact of back pain is massive, and a majority of this pain is associated with intervertebral disc pathologies.

Let’s take it back for a second and focus on the individual. Say you hurt your back, go to the doctors and after some investigation you’re told you have degeneration of the discs and some other medical jargon. Take a deep breath, you’re not alone – in fact it is extremely common and it estimated that 30% of people between the age of 30-50 years will have some form of degeneration within the spine. So, what exactly is it and what can we do?

Disc Degeneration Disease (DDD) is a pathology thought to be associated with ageing, where the disc loses hydration and height, affecting their ability to provide cushioning and mobility between the vertebrae. A loss in elasticity can lead to a collapse of the disc, with the potential to cause pain and inflame nerves surrounding the region. Early dysfunction can start as young as 20 years of age and whilst considered a ‘disease’, its more of a natural occurrence that comes with ageing. It is important to note that having a disc disorder does not equate to having pain, and often many people continue living totally asymptomatic.

Once diagnosed, disc degeneration is generally managed through conservative treatment, being exercise rehabilitation, passive therapy and medication. The goal of exercise is to reduce pain by increasing the strength of supporting musculature around the spine and mid-section. Stabilisation exercises can increase the spine’s capacity to resist higher loads in the degenerative discs. By improving coordination between the abdominals and back musculature, one can expect to experience a reduction in pain and increase in mobility. Strength training is particularly important for treatment and further prevention as sedentary people can lose as much as 3% to 5% of their muscle mass each decade after age 30. Further treatment includes education and behaviour modification. Teaching people about their condition will address fear avoidance and promote consistent exercise, understanding that training will not cause any further damage and alleviate symptoms. Finally, if conservative treatment is not leading to improvements, surgery may be considered.

In summary, disc degeneration is relatively common and most people that exhibit symptoms will find it very manageable. Regardless of the severity, exercise should form the cornerstone of a quality treatment plan. Whether surgery is required or not, physical activity can provide a reduction in symptoms and accelerate a return to normal activity. Absolute Balance aims to make exercise the answer for all health conditions. So if you are looking for further information, we recommend you speak to your GP and an Accredited Exercise Physiologist for a tailored programme.

Ed Daccache

B.Ex.SpSc, Grad.Dip.Ex.Sc (AEP, AES) (ESSAM)
Accredited Exercise Physiologist

References:

Australian Institute of Health and Welfare. (2020). Chronic Musculoskeletal Problems: What are Back Problems. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems/contents/what-are-back-problems

Body Works Guru. (2019). Healing a Degenerative Intervertebral Disc. Retrieved from https://bodyworkguru.wordpress.com/tag/spine-health/

Physiopedia. Degenerative Disc Disease. Retrieved from https://www.physio-pedia.com/Degenerative_Disc_Disease#cite_note-36

Disc Degeneration Disease

Absolute Balance Exercise Physiology Group

Muscles aren’t male or female so why does there seem to be an idea that men and women should train differently?

administrator@heliummarketing.agency (Helium Marketing) — Mon, 12 Oct 2020 00:55:00 GMT

Physiologically speaking all muscles, connective tissues, bones etc look and function the same way regardless of whose body they belong to. So, in that sense alone there is no sensible reason that a resistance training program for a woman should differ to that of a man. Studies have shown that when compared to their individual pretraining baselines, men and women respond to strength training in very similar ways and in fact when compared unit for unit, the muscle tissue of a female is similar in force output to that of a male.

In terms of muscle mass difference, women have roughly two thirds the muscle mass of men, so while generally absolute strength is greater in men due to their greater body mass and fat free mass there is no evidence to suggest that women should train differently than men.

With that being said, fitness is not and should not be a one-size-fits all approach, it’s not quite that simple. There are also some differences between men and women when it comes to a hormonal standpoint that can greatly impact the overall response (muscle adaptation) and ease of body composition changes. However, the idea behind programming resistance training for all genders is the same and when tailored to the individual in terms of loading, everyone is able to incorporate the same main lifts (i.e squats, deadlifts, lunges etc).

Strength and strength training is important and this preconceived idea that women should not be strength training or should be training differently to men leaves many women confused about what type of training they should be doing and worrying that lifting weights will cause them to ‘bulk up’, when on the contrary it is perfectly safe and recommended/encouraged for women to follow a strength training program just as men (provided programmes are relative to the individual in terms of loading). Ladies, you will not, I repeat will not ‘bulk up’. Not only will you become functionally strong and decrease the risk of injury, strength training also assists in building and preserving bone mass, lowering the risk of type 2 diabetes and cardiovascular disease and much more, with benefits like these why wouldn’t you want to start a strength program?

Katie McGrath

Exercise Scientist

References:

Hollowy, B.J., & Baechle, T.R. (1990). Strength Training for Female Athletes. Sports Medecine 9, 216-228

Ivey, F.M., et al. (2000). Effects of Strength Training and Detraining on Muscle Quality: Age and Gender Comparisons. Journal of Gerontology 55(3), 152-157

Kell, R.T. (2011). The Influence of Periodized Resistance Training on Strength Changes on Men and Women. Journal of Strength and Conditioning Research 25(3), 735-744

Muscles aren’t male or female so why does there seem to be an idea that men and women should train differently?

Absolute Balance Exercise Physiology Group

Exercise During Pregnancy – Third Trimester Tips

Tue, 18 Sep 2018 04:58:00 GMT

Following on from my blog in May where we covered pregnancy ‘Fact vs Fiction’, I wanted to highlight some tips and tricks to get you through the third trimester while staying as active and healthy as possible. As with the first and second trimesters, there is plentiful advice on what to do and what not to do when it comes to exercise during pregnancy, the hard part is deciphering the useful information! As many expecting mums (including myself!) may have experienced, in the third trimester everything gets a lot harder as we get closer to the due date, so what does this mean exercise wise?

First off, there are some things to consider;

– During the third trimester you may experience some discomfort through the pelvic region and sacroiliac joints

– The pelvic floor is experiencing its toughest challenge and may be starting to show signs of weakness

– Your lung capacity is reduced quite significantly which may make some cardiovascular exercise difficult

Secondly, there are a few questions to ask yourself;

– Have I maintained my normal exercise routine throughout the pregnancy so far?

– Have I modified my exercise routine but maintained at least the recommended 30-minutes of moderate intensity physical activities on most days of the week?

– Do any exercises cause me discomfort during or post-exercise completion?

If you answered yes to question 1; Keep on going! Medically speaking, there is no reason to stop completing your normal exercise routine unless risk factors are identified that may cause harm to you or your baby, or if you feel discomfort or pain while completing your exercises.

If you answered yes to question 2; you’re doing well! Keep on completing what you can with slight modifications to your routine. You may find that more gentle exercise such as antenatal aqua classes, walking and Pilates are more comfortable to complete and will assist you to maintain a good level of physical activity until the end.

If you answered yes to question 3; now might be the time to ask for some professional advice from either an Exercise Physiologist or Physiotherapist, they will be able to safely guide you through the final trimester of pregnancy while offering support and assisting you to maintain some physical activity.

Regardless of which question you answered ‘yes’ to, there are some important exercises that you should start to work into your exercise routine as you inch closer to D-day. The three ‘golden’ exercises you should be completing are;

1) Pelvic Floor Exercises! This is the most important exercise to be completed leading up to the due date and post-partum once you are cleared. Why are these exercises important? They help reduce the risk of bladder incontinence! They will also assist you to bounce back much quicker post-partum.

2) Squats! Don’t worry – I’m not referring to heavy weighted squats, I’m referring to comfortable body weight squats to assist to open the pelvis naturally with the most benefit coming from a full range squat and hold to engage the pelvic floor. This exercise may be difficult to complete especially if you’re experiencing pelvic pain and may need to be modified.

3) Pelvic tilting and transverse abdominus activation exercises! These are essential to keep those hips moving during the final stages of pregnancy, they are also helpful to maintain tone in the deep abdominal muscles that can assist during labour. These can be completed many ways to accommodate for those little complications that may arise for each individual, it is best to ask a professional for the right advice for you.

As always, before commencing any form of new exercises we recommend you seek medical clearance from your treating doctor to ensure you are healthy and ready to get started. For more information, jump on the website www.absolutebalance.com.au or send us an email to info@absolutebalance.com.au .

See you all on the other side! (3 weeks to go!)

Alixe Marion (B.Sc. – Exercise Physiology)
Clinic Manager – Senior Accredited Exercise Physiologist (AEP) (ESSAM)

Exercise During Pregnancy – Third Trimester Tips

Absolute Balance Exercise Physiology Group

Exercise During Pregnancy – FACT VS FICTION

Tue, 15 May 2018 04:33:00 GMT

In this day and age, it is easy to find information on exercise during pregnancy and sometimes there can be such a flood of information that the answer becomes blurred and confusing as to what is the best way to exercise during pregnancy, what should be avoided, and what should be continued. Hopefully this short blog provides a little clarity to those who are expecting along with myself. The current guidelines from the Australian Government for exercise during pregnancy recommend completing at least 30-minutes of moderate intensity physical activity on most, if not all, days of the week. If you were inactive prior to pregnancy, it is recommended to participate in activities such as walking and swimming to gradually build your exercises tolerance. For physically active individuals, activities such as walking, swimming, jogging, cycling, aquarobics, strengthening exercises yoga, stretching and Pilates are all considered safe to complete during pregnancy. It is recommended this level of activity is continued throughout pregnancy unless it becomes uncomfortable to do so.

As an Accredited Exercise Physiologist and a pregnant woman, I agree with these guidelines and would recommend them to most of my GENERAL clients I see in clinic during pregnancy. In my clinical opinion, I do think these guidelines are somewhat lenient and the target for overall activity completed should be higher, especially for individuals who are capable of achieving more or already very physically active. This is where the information becomes fuzzy for those of us that are moderately to highly active pre-pregnancy; The big question – “do I have to stop completing my normal exercise routine?” the simple answer is, no! Of course, there are some precautions that will need to be considered as you enter the later stages of your pregnancy but generally, if you have been consistently completing a certain activity and are considered ‘skilled’ in the activity, it is safe to continue to complete this until your doctor or midwife advises you otherwise or until it becomes uncomfortable to do so.

Some important things to take into consideration while exercising during pregnancy:

Exercises considered ‘High-risk’:

So, in summary for my fellow pregnant ladies, if you are currently active – keep doing what you’re doing! If you are not yet active, I would advise you to get moving! If you are entering your 2 ^nd and 3 ^rd trimester and are unsure about what exercises are safe for you to continue completing, speak to your doctor or midwife, or pop in and see me at our Absolute Balance Clinic for assistance with a specific pregnancy programme. As always, before commencing any form of new exercises we recommend you seek medical clearance from your treating doctor to ensure you are healthy and ready to get started.

For more information, jump on the website www.absolutebalance.com.au or send us an email to info@absolutebalance.com.au .

Alixe Luckins (B.Sc. Exercise Physiology)

Senior Accredited Exercise Physiologist

Clinic Manager

Exercise During Pregnancy – FACT VS FICTION

Absolute Balance Exercise Physiology Group

Exercise and Pregnancy Part 2: The ‘What’ and ‘How’

Wed, 16 Aug 2017 04:39:00 GMT

We know that physical activity both during pregnancy and post pregnancy is both safe and beneficial in various ways, but what sort of exercise is recommended and how much is needed to acquire those positive benefits?

Firstly, it’s important to note that prior to undertaking any exercise, women should consult with a medical practitioner to discuss any medical concerns regarding exercise.

Women with uncomplicated pregnancies are encouraged to maintain or initiate exercise before, during and after their pregnancy – working towards achieving 20 to 30mins of moderate-intensity activity per day on most or all days of the week (150 minutes per week). Activities which utilise large muscle groups, such as walking, swimming, stationary cycling or low-impact aerobics are recommended. Resistance training can be undertaken twice per week and should include all major muscle groups with light resistance. Pelvic floor exercises are also recommended.

Women who were regularly active at higher intensity exercise such as running, jogging, aerobics or strength training prior to pregnancy may continue to exercise at these higher intensities whilst it is comfortable to do so. Women who were more sedentary prior to pregnancy should commence slowly and gradually aim to increase their exercise tolerance.

A few handy tips:

For more information on how to get started with a tailored exercise program, contact the Absolute Balance team on info@absolutebalance.com.au or visit our website www.absolutebalance.com.au for more information.

Bianca Dobrich |B.Sc. Human Movement, Grad Dip. Exercise Rehabilitation

Exercise Consultant – Accredited Exercise Physiologist (AEP) (ESSAM)

P 9244 5580 – F 92445582

References:

Exercise and Pregnancy Part 2: The ‘What’ and ‘How’

Absolute Balance Exercise Physiology Group

Exercise during pregnancy – Lets Go Baby!

Fri, 09 Sep 2016 06:48:00 GMT

Many women are hesitant to engage in any sort of exercise during pregnancy, and rightfully so. In the past, it was believed that exercise had increase risks associated with pregnancy, but many of these beliefs have not been proven with scientific evidence. Recent research has suggested that not only is exercise during pregnancy safe, but it is beneficial for both the mother and the baby. It is thought that three quarters of women don’t do enough exercise during their pregnancy. Exercise throughout pregnancy won’t harm you or the baby; in fact it may help prevent complications such as gestational diabetes and pre-eclampsia. Additionally it also may help you with shorter labour and increase chances of giving vaginal birth.

There a many benefits of exercise during pregnancy:

If you would like some more information on safe and specific exercise programs at Absolute Balance during pregnancy, please visit our website www.absolutebalance.com.au or email info@absolutebalance.com.au .

Daniel Nguyen (B.Sc. Exercise Physiology)
Accredited Exercise Physiologist (AES, AEP)(ESSAM)

Exercise during pregnancy – Lets Go Baby!

Absolute Balance Exercise Physiology Group

Core Stability Training: Post Pregnancy

Fri, 07 Aug 2015 08:05:00 GMT

In this blog I would like to discuss core training, with a particular focus on training the core effectively after pregnancy. Firstly, I feel it is necessary to define what ‘the core’ is and the job it does with regard to exercise and movement (don’t worry, I won’t bore you with too much anatomy and physiology. I’ll keep it as light a read as I can).

The core can be defined as a muscular box that surrounds the abdomen and works to stabilise the lumbar spine during movement. It consists of the pelvic floor as the base, the diaphragm as the roof, the abdominals (TvA wraps around body) and obliques at the front, the paraspinals and glutes at the back and the quadratus lumborum as the sides.

When functioning as it should, the core musculature prevents any unwanted movement of the spine when still and when moving the limbs, by the co-ordinated co-contraction of deep and superficial muscles on both the anterior and posterior aspects of the body (McGill 2007, Akuthota et al 2008). Basically; the top, bottom, front, back and sides of the abdomen stiffen in a particular sequence to stop any rotation, flexion (forward bending), extension (backward bending) or lateral flexion (side bending) of the lumbar spine.

I often see people performing sit-ups, crunches or dorsal raises to train their core musculature. Whilst this could potentially increase the strength of various core muscles (in the sense that you are able to flex the trunk more forcefully), it does not increase the ability of the core to stabilise the spine. This is because the musculature of the core does not work in isolation or to generate movement, all the muscles must be trained to activate in sequence so that there is no excess movement throughout the lumbar region when we move the limbs (McGill 2007, Sahrmann 2002, Fredericson & Moore 2005, Kibler 2006). Research suggests that exercises such as sit-ups and crunches are less effective ways to train the core, because these exercises focus on generating motion rather than preventing motion as well as potentially increasing the risk of injury to the intervertebral discs (McGill & Callaghan 2001). Many exercise professionals are now utilising stability exercises that specifically focus on limiting motion, for example, Planks, Bird-Dog and Pallof Press variations are used instead of the crunch and sit up variations.

During pregnancy various physiological and anatomical changes occur to allow a human to grow inside of you (or your partner). These changes often have an effect on your ability to stabilise the core. A hormone called relaxin is released, which softens connective tissue to allow for the uterus to expand (Conrad 2011). This leads to various postural changes that will need to be addressed before you begin to re-train the core. First of all, I have to admit that I have never been and (without some serious scientific breakthrough occurring) I never will be pregnant, so I’m speaking from a purely theoretical and research based perspective here, not from personal experience. However, that being said I am able to offer advice that will help with retraining your core after pregnancy.

A common problem experienced by women during pregnancy is a widening/thinning of the connective tissue that holds the two bellies of the rectus abdominus muscle (6 pack) together called Diastasis Recti (DR). This occurs due to the release of relaxin as well as the force of the uterus pressing on the abdominal wall. A small amount of widening of the tissue occurs in all pregnancies and will occasionally close by itself, however for a large number of women the gap does not close, which can be problematic. If you have DR it is important to fully strengthen and activate the muscles of the core to close the gap before engaging in any exercises that require the abdominal muscles to be used to prevent excess extension in the lumbar spine. This means no planks, push ups, quadruped exercises until the muscles have properly healed. There are specific exercises that are able to help with this type of abdominal separation which are based on the work of a physical therapist called Shirley Sahrmann. The pelvic floor musculature can also be affected by pregnancy.

The pelvic floor musculature forms the base of the core; it stretches from the pubic bone to the base of the spine (coccyx) and helps to control bladder function. If the pelvic floor is weak you may have more difficulty preventing the bladder from leaking during more strenuous movement e.g. lifting, coughing. This is called stress incontinence and is common amongst women who have given birth. It is unlikely to repair without training, so it is important for future bladder control to re-gain control of the pelvic floor after pregnancy and birth.

Women can also experience an anterior pelvic tilt during pregnancy (Franklin & Conner-Kerr 2007). As the uterus grows to accommodate the growing baby, the pelvis can tip forward. This causes certain muscles to become over tight or hypertonic and others to become atrophied/weak or hypotonic. The hip flexors become hypertonic and the glutes and hamstrings become hypotonic. If correct function is to be restored it is necessary to re-train the weakened muscles and stretch/loosen the muscles that are too tight. This allows the pelvis to tilt back to a neutral position, which is important for gaining optimal spinal alignment. If an anterior pelvic tilt is present, you can fix the issue with glute strengthening exercises such as glute bridges and hip thrusts as well as hip flexor and quad stretching/releasing exercises such as foam rolling or various quad/hip flexor stretches.

So, finally – what does all of this mean to you?

I’ve simply highlighted some issues that can occur and some things to avoid, now comes what you should include in a training plan. You will first need to assess your pelvic position and the level of separation of the rectus abs; once that has been assessed you can work through the Sahrmann progressions to fix the DR or begin to mobilise the hip flexors and activate the glutes if you have an APT present. After retraining the pelvic and abdominal musculature to function as it should you will be able to up the intensity.

This means including exercises that place stress on the core to force it to limit motion in the spine, for example:

Anterior Core Exercises – such as planks, ab roll outs or stir the pot

Posterior Core Exercises – such as hip thrusts, glute bridges, hip hinges or bird dog progressions

Lateral Core/Anti Rotation – such as Pallof press variations, cable chop variations and side plank progressions.

You will need to perform these exercises with near perfect technique for them to have maximum benefit. I would advise hiring a personal trainer to help for the first few weeks or months (depending on how confident you are with the exercises). It may also be a good idea to look for exercise demonstrations and tips online, sites such as BeFit-Mom or Girls Gone Strong may be very useful. Youtube can also be invaluable as a resource for learning about different exercises as long as you are able to find the right trainers/coaches. Try the MobilityWOD, Bret Contreras, or Eric Cressey channels for more advanced core training and exercise form advice (be aware that these exercises may be later stage progressions in your training plan). Or if you’re more of a reader, take a look at the books: Becoming a Supple Leopard by Kelly Starrett, Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann or Low Back Disorders: Evidence-based Prevention and Rehabilitation by Stuart McGill. Admittedly they may not be the most exciting read for everyone, but they do offer an expert perspective on both joint mobility and spinal stability.

Stay well,

Josh Yates B.Sc. Sports Science/Psych

Achieve Balance at Absolute Balance

Core Stability Training: Post Pregnancy

Absolute Balance Exercise Physiology Group