Tag Archives: exercise

Management of Osteoarthritis

What is Osteoarthritis (OA)?

Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage that provides cushion and support at the ends of bones gradually wears down. This is a degenerative disease that can worsen over time, often resulting in chronic pain affecting your day-to-day activities. Eventually if the cartilage wears down completely, the bones in the joint will rub directly on each other exacerbating the symptoms.

Common Symptoms of OA

  1. Pain and Tenderness
  2. Joint Stiffness
  3. Muscle Weakness and Loss of Flexibility
  4. Grating Sensation
  5. Bone Spurs- not a symptom but a sign
  6. Swelling

Most Common Risk Factors

  1. Old Age
    • Articular surfaces on the end of bones can wear down over time due to the natural aging process that occurs to muscles, joints, and bones.
  2. Obesity
    • Excess weight puts more stress on the joints (commonly occurs to weight bearing joints such as the hip and knee).
  3. Repeated Stress on the Joint
    • Over time this will cause the articular surfaces to wear down.
  4. Joint Injuries
    • A break or tear can lead to the development of OA over time.
  5. Genetics and Certain Metabolic Diseases
    • People with a family history of OA are at a greater risk.

Treatment for OA

An effective approach is seeking physiotherapy treatment at earlier stages, accompanied with an exercise program specific to you. You may feel some discomfort during exercising, but this feeling is normal and should calm down. If it is unbearable then do not continue with the exercise. Of course with any exercise, there are always risks associated, therefore consult your doctor prior to beginning any new exercise program.

                Exercise has many benefits for ALL people including improved health, fitness, and mood. Many people believe that exercising with OA could harm your joints and cause more pain, but research shows that people can and should exercise when they have OA. It is considered the most effective, non-drug treatment for reducing pain and improving movement in those with OA.

Recommended Types of Exercise

So now we know that exercise can ease symptoms of arthritis, but what is best for you? Well that varies from person to person so here are a few main categories of exercises to include in your program:

  1. Flexibility

                This category includes exercises that will help to improve or maintain the range of motion of the affected joint(s). By relieving stiffness in the joint and increasing the ability for the joint to move through its full range, you will decrease the risk of further damage, improve the function of the limb and joint, and decrease overall pain. There are two main categories of stretching to consider:

  • Dynamic Stretching: these are movement-based stretches that involve multiple joints. They should be performed prior to activity to prepare the body.
  • Static Stretching: these are stretches that take the muscle to its end range before holding that position for a minimum of 30 seconds. These stretches should be performed after activity when the muscle is already warmed up.

2. Strengthening

                These exercises work to build stronger muscles to help support and protect the joints. This allows for offloading of the affected joint which has the potential to relieve many symptoms. It is recommended to engage in strengthening exercises 2-3 days/week. Examples of strengthening exercises include lifting a limb against gravity, using free weights or elastic bands, or weight machines requiring you to push or pull against resistance.

3. Aerobic / Endurance

                These exercises help with overall fitness and improve your cardiovascular health. They typically involve the use of large muscle groups in the body in a repetitive and rhythmic manner. Canada’s guidelines for adults are to achieve 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week. This intensity typically involves you to breathe a little harder and sweat but not be out of breath. Activities falling under this category include walking, biking, dancing, or even everyday activities such as mowing the lawn or shoveling as long as you are achieving a moderate- to vigorous-intensity.

4. Balance

                This is a fourth, less recognized category that is very important to consider in your exercise plan. These exercises will target smaller groups of muscles to decrease your risk of falling and can help improve your ability to do other exercises. Balance exercises include anything with a smaller or unstable base of support such as performing activities on a foam pad or single legged exercises.

Summary

                Arthritis doesn’t have to keep you from living your life and participating in your everyday activities. Exercise and arthritis should coexist! Research has shown that people with osteoarthritis who exercise regularly have less pain, more energy, improved sleep and a better day-to-day function. Work with your Physiotherapist to create an exercise program that is right for you and kick start your road to a healthier life!

BodyTech Physiotherapy

Osteoporosis and Exercise

By Lauren Harding, Registered Kinesiologist

What is osteopenia and osteoporosis?

unnamedOsteopenia and osteoporosis are conditions characterized by a loss of bone mineral density (BMD). BMD is a measure of the quantity of minerals (calcium and phosphorus) in a precise volume of bone. The difference comes in their severity.

Osteopenia indicates a lower BMD causing bones to be generally weaker. This bone weakness becomes more pronounced with osteoporosis as the bones become more brittle and porous (filled with air pockets), ultimately increasing the risk of fracture. Though less severe, osteopenia is a serious risk factor for developing osteoporosis.

Osteoporosis is often labeled as the ‘silent thief’ since bone loss occurs gradually, typically without symptoms. However, these four factors can signal underlying osteoporosis:

  • Loss of height over time and/or development of a stooped posture
  • Sudden back pain without any obvious cause
  • Fracturing after a seemingly minor incident

 

How are these three conditions treated?

An excellent approach is early intervention physiotherapy treatment, accompanied by a well-designed exercise program. It is important to consult your doctor before starting a new exercise plan. As with any exercise, there is always risk associated.

Osteoporosis Canada recognizes exercise not only for increasing cardiovascular endurance, but also as a fundamental component to protecting your bones. Exercise maintains bone mass and builds muscle strength, as well as increases flexibility and range of motion, balance and coordination. Benefits also include reduced pain and inflammation, while promoting loss of excessive weight. Additionally, the risk of falling is reduced.

 

What types of exercise should I be doing?

There are 5 types of exercises recommended for individuals with osteopenia and osteoporosis:

Types of Exercise How Often Should I Do These?
Aerobic 3 to 5 days per week, a minimum of 150 minutes per week
Strength Training 2 to 3 times per week
Balance Every day
Stretching Every day
Posture Training Always

 

Aerobic Exerciseunnamed

Aerobic exercise is considered any continuous, rhythmic activity that strengthens and stimulates the heart and lungs, thereby improving the body’s use of oxygen. It is recommended that ALL adults get 150 minutes of moderate to vigorous physical activity a week, or about 20 to 30 minutes per day, for at least 10 minutes at a time. During moderate-intensity activity, your heart beats faster and you breathe harder. The rule of thumb is that you are able to talk during these activities, but you are working too hard to be able to sing. During vigorous-intensity activity, your heart beats faster still and you continue to breathe harder. You are unable to say more than a few words at a time during vigorous activity. It is important with osteopenia and osteoporosis to do weight bearing aerobic exercises. Examples of weight bearing aerobic exercises include:

  • Brisk walking, dancing, stair climbing, running, step aerobics, hiking, jogging, jump rope, and treadmill walking/running

 


Strength Training

Elderly_exercise

In order to increase your muscular strength, you must work against resistance until your muscles feel tired.

This helps to reverse muscle atrophy, a condition that occurs when your muscles start to waste away due to lack of use. Furthermore, resistance training strengthens the muscles surrounding your joints, ultimately reducing further joint damage and decreasing risk of injury. ALL adults should do 2-3 days of strength training a week. Exercises using free weights (dumbbells), exercise bands or weight machines are strongly recommended. Examples include:

  • bicep curls, sit-to-stand, lunges, rows, calf raises, bridges, triceps kickbacks, countertop push ups

 

Balance Exercises

Balance exercises help maintain your footing when an unexpected movement occurs in your daily life. Improving balance and coordination can reduce your likelihood of falling, therefore decreasing your fracture risk. Ironically, in challenging your balance, you run the risk of falling. For this reason, you must always take precautions such as having a chair nearby to hold onto. When you are training your balance, there are two main types of balance exercises:

  • Static Exercises – Stand still in one spot holding a certain posture in order to practice balance. For example, standing on one foot on the floor.
  • Dynamic Exercises – Balance is challenged more with adding movement. For example, walking ina straight line while touching the heel of one foot to the toe of the other with each step.

 

Stretching

unnamed (1)As you age, you lose flexibility which can increase your stiffness and discomfort, often preventing you from staying active. Stretching exercises help you to counteract this by increasing the range of motion of your joints and improving your flexibility. It is important to note that stretching should always be done after the muscles and the body are warmed up since stretching cold, stiff muscles increases your risk of injury. Just like in balance training, there are two main ways to stretch:

  • Static Stretching – Take the muscles to their end range of motion and maintain that position for at least 30 seconds in order to enhance soft tissue and muscular flexibility.
  • Dynamic Stretching – Functional, multi-joint movements that typically increase in range of motion and speed as the body begins to warm up.

While both are effective, dynamic stretching has been shown to be more beneficial than static stretching as a way to warm up prior to activity since it has been found to improve balance, strength, reaction time and agility. Static stretching, however, is still important and is most beneficial when performed at the end of exercise as a cool down. Static stretching can also be done separately when the body is warm as part of an everyday attempt to improve body mechanics, posture and flexibility.

 

Posture Training

unnamed (1)We all have a natural curve in our spine, however, weak back muscles and/or spinal fractures can cause an excessive forward curvature of the spine. Rounding of the upper back is known as exaggerated kyphosis. This puts pressure on the front of your vertebrae, placing them at even great risk of fracture. Posture training exercises help to improve the alignment of your spine by correcting shoulder, back and neck positioning. Focus should be placed on exercises that strengthen the back muscles and reduce forward head posture. Abdominal exercises that strengthen the core muscles, help to maintain good posture as well.

 

To Sum Up

An exercise program is a vital component in the management of osteoporosis.

Regular participation in aerobic and strength training is fundamental, as well as balance, posture management and stretching.  All in all, physical activity for individuals with osteopenia or osteoporosis can promote bone health and overall quality of life.

BodyTech Physiotherapy

The Importance of Hydration

Hydration

With increases in temperatures during the summer months, ensuring adequate hydration is extremely important, especially during activities requiring physical exertion.  Every cell and system in the human body relies on water to survive and to work correctly and efficiently, but water is lost every day through sweating, urination and breathing. Sweating is the body’s cooling mechanism, so naturally we sweat more when outdoor temperatures are higher or during exercise. A combination of hot, humid temperatures and physical activity can easily put the body into a state of dehydration. Dehydration decreases the ability of the body to regulate core temperature and decreases blood flow, both of which can have a detrimental impact on exercise performance.

Certain people will be more susceptible to dehydration than others, i.e. children lose water more quickly due to smaller body size, while older adults have difficulty conserving water and have a decreased sensation of thirst. Anyone who works or exercises in hot and humid conditions is also more likely to become dehydrated due to an increased level of sweating. Humidity makes it difficult for sweat to evaporate from your skin, which means it is harder for your body to regulate its temperature and keep cool. Although heavy and prolonged exercise makes people most at risk for dehydration, there is a cumulative effect.  This means with inadequate fluid intake over a few days, even mild or moderate exercise can create a state of dehydration. For athletes, mild dehydration of 1-2% of body weight can decrease the ability of muscles to use glucose, which diminishes aerobic performance and causes fatigue more quickly. Therefore, it is very important to ensure proper hydration in the days leading up to races or games.

How to tell if you are dehydrated:

  • Little urine output and/or urine that is darker than usual
  • Dry mouth, thirst
  • Fatigue
  • Headache
  • Dizziness, lightheadedness
  • Muscle cramps
  • Nausea

Drinking fluids and replacing electrolytes is the easiest and quickest way to treat dehydration. If you have any of the above symptoms and think you may be dehydrated, drink small amounts of water frequently in order to prevent an upset stomach. Sports drinks can also be helpful in treating or preventing dehydration, but take caution as the sugar in sports drinks can cause diarrhea. Eating foods high in water content, such as fruits and vegetables, will help in the rehydration process; and be sure to avoid anything that will continue to dehydrate you further, such as caffeine and alcohol. Severe dehydration will require a trip to the hospital for rapid hydration through an intravenous line. Symptoms of severe dehydration include loss of consciousness, rapid or weak pulse, low blood pressure, and confusion. Untreated severe dehydration can lead to complications, such as heat stroke, and can damage kidneys and muscles. Heat stroke occurs when the body overheats and is no longer able to sweat and cool itself down, usually due to prolonged physical exertion in hot conditions. This is extremely dangerous and requires immediate medical attention, before brain or other organ damage occurs. A milder form and precursor to heat stroke is heat exhaustion, which has symptoms such as heavy sweating, lightheadedness, and muscle cramps. It is very important to treat heat exhaustion before it becomes heat stroke, by moving the person into a cool, shaded area, cooling off with wet towels, and giving liquids if possible. If symptoms continue to worsen, call for emergency medical attention.

How much do you really need to drink?

Although there are many recommendations for how much water to consume, a general rule of thumb is to consistently drink throughout the day, before you feel thirsty. Exercisers will need to consume more than non-exercisers due to water loss through sweating. In the hour or so prior to a workout, try to consume 1-3 cups of water. During exercise, if possible, drink about ½ cup or a few mouthfuls every 15-20 minutes. This will help to prevent dehydration and is especially important if the weather is hot, or the activity is particularly long and strenuous. A handy trick to know how much to drink after finishing a workout, is to weigh yourself before and after. For every pound that you have lost during the activity drink about 3 cups of water. If you weigh the same amount before and after, it likely means you hydrated adequately throughout the activity, and can just continue drinking normally for the rest of the day.

Keeping cool and staying hydrated should be a priority in the hot summer months. Dehydration negatively impacts the body and can lead to a decrease in athletic performance, heat exhaustion or even heat stroke. Drinking water consistently throughout the day, and increasing this amount before and after exercise will help to keep you hydrated and safe during the summer.


BodyTech Physiotherapy

BodyTech Physiotherapy
519.954.6000 | BodyTechPhysio.ca

 

Running Injury Prevention Part 2: Stretches for Runners

The differences between a dynamic warmup and static stretching were outlined in our previous blog post, explaining that both are key to help prevent injury for runners. Part 2 of our running injury prevention series will cover the static stretches you should be doing after your run. Dynamic stretching as part of a warmup before activity helps to prepare the body for the demands of physical activity, and involves moving muscles through their range of motion. Static stretches done after activity are important to decrease stiffness by improving flexibility and joint range of motion. These stretches are called static because they involve elongating a muscle and holding it in the same position for a short period of time.

 

Why Static Stretching Should be Done After Activity

For many years the widely accepted belief was that static stretches before activity were important to reduce injury. Research in recent years has shown that not only do static stretches before activity provide no benefit, but can actually reduce strength, power and performance when running or jumping. The correct timing to receive optimal benefits from static stretching is following activity, once the muscles are warmed up and more elastic.

 

Benefits of Static Stretching After Activity

Static stretches after activity can improve flexibility, decrease muscle tension, increase muscle length, and improve joint range of motion. Shortened muscles can result in muscle imbalances, which impact performance and can lead to pain and injuries over time. An example common among runners is short hamstrings, which can lead to knee pain and injuries from the resulting stress placed on the knee joint. Short hamstrings are also susceptible to strains, and can cause low back pain as the pelvis is pulled down into an unstable position. In addition to causing muscle imbalances, short muscles also limit joint range of motion. This can decrease performance, affect running stride and therefore contribute to injury. Static stretches after activity also provide an additional recovery benefit of increasing blood flow to help remove waste products accumulated during activity.

 

Short vs Tight Muscles

Muscle tension is different than shortened muscles, and differentiation between the two can determine which treatment type will be most effective. Shortened muscles will feel tight and stiff with a limited range of motion, resulting from the muscle itself having a reduced length. Short muscles will put a strain on tendons and joints, which can contribute to discomfort and injury. Tight or tense muscles may have focused areas of discomfort caused by fibers that are unable to release their contraction. These are commonly known as muscle knots, and are nodules that can be felt in the muscle. Deep massage or foam rolling is required to release these spots of contraction, and stretching alone may not be enough.

If a stretching program is not relieving the feeling of tight muscles, there may be another underlying cause resulting in the sensation of a consistently tight muscle. Muscles can feel tight when they lack the strength or endurance to support the demands of activity. Additionally, a muscle can be too stretched out and also weak but still feel tight because it has to work too hard in a lengthened position. These muscles should be strengthened to decrease the feeling of tightness rather than stretched. A detailed physiotherapy assessment can help identify which muscles need to be stretched and strengthened and will address any underlying joint restrictions. A deep massage from a massage therapist can also be beneficial for all individuals with tight muscles.

 

Stretching Guide

A good stretching routine should include the major muscles used during the activity, and at BodyTech Physiotherapy we have created a stretching routing specifically for runners to do after their runs. Each stretch should be held for 25-30 seconds, gradually deepening the stretch upon exhalation. The stretches are easy to perform anywhere after a run, and we have also included number 8 and 9 with a foam roller as part of a routine at home or the gym.

 

BodyTech Static Stretches for Runners

1. Hip flexor – tuck buttocks under to tilt pelvis posteriorly, keeping back straight.

image1

 

2. Quadriceps – tuck buttocks under to tilt pelvis posteriorly. Make sure the flexed knee does not drift forward in front of the other knee.

image2

3. Hamstring – tilt pelvis forward while keeping back and buttocks in line to avoid arching the back.

image3

4. Hip Adductor – keep back straight and bend forward at the hips.

image4

 

5. Glute and External Rotator – keep back straight and rotate entire trunk at the hips instead of twisting upper body.

image5

 

6. Soleus – bend both knees and sit back over back leg, keeping torso upright.

image6

7. Gastrocnemius – from the soleus stretch straighten back leg while keeping heel on the floor.

image7

 

8. Iliotibial band – support with the top leg while maintaining a tight core to keep hips from dropping, rolling the side of the thigh from the hip to knee.

image8

 

9. Gastrocnemius – cross legs on roller and roll from the knee towards the foot.

image9

 

A warm up before activity in combination with static stretches afterwards provide multiple benefits for every athlete, including increased performance and decreased chance of injury. Running is a repetitive and symmetrical activity that requires a balance of muscle length and joint range of motion on both sides of the body for optimal performance, and both can be maintained through proper warmups and cool downs. The repetitive nature of running can also lead to overuse injuries, which is why the warm up and stretches afterwards are especially important as part of every smart runner’s routine.