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Patient Interview

Nov 11, 2020

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)

Walking for health and longevity

16 May, 2024
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

10 May, 2024
“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!

By Alison Absolute Balance • 24 Apr, 2024
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
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