Knee pain is extremely common and can really make things very awkward and uncomfortable. Trust me I should know, only 8 weeks ago I tore my ACL (anterior cruciate ligament) in a freak accident that left me on crutches for 2 weeks and limping for the next 1-2 afterwards.
“CANCER”. For those who are not diagnosed with this condition, just saying the word out loud to yourself highlights many negative connotations associated with it.
We all consider the undesirable aspects associated with cancer and think to ourselves how lucky we are not to have that added stress in our life. But what about those who are diagnosed with cancer?
Life can already be quite overwhelming when considering the financial strains, family events and various appointments scheduled into each day. But then add cancer into the mix and what do you get? You get a situation that can be very debilitating both physically, socially and emotionally, and can cause an array of adverse behaviours such as excessive alcohol consumption, sedentary behaviour and smoking. There is some evidence to suggest that elevated stress levels heighten the inflammatory response associated with stress hormones which may be directly related to cancer development and growth, however, there is an abundance of research showing an in-direct link between stress and cancer growth due to the adverse behaviours mentioned above. Thus, having the ability to conquer stress, identify the best way for you to deal with stress, and to become resilient to it will positively impact the management of your cancer and the fighting process.
So we know that stress and anxiety are typically elevated in people with cancer, and we know through available research that we need to lower or eliminate these stress levels to stop risky adverse behaviours associated with stress, but how do we go about doing that?
Recently at our training studio we began an exercise program for clients diagnosed with cancer called Lift For Life. Our trainers discussed the idea of stress and anxiety with our cancer clients and what that means to them. During our discussion we identified many situations which cause stress in their lives, both related and not related to cancer. Some of these situations were:
After identifying what causes heightened stress levels, we brainstormed ideas we could implement to help overcome such stresses:
We recognize that stress factors in to a large degree. In the treatment of this deadly disease, and while we see the need for exercise and nutrition, there must also be a focus on improving the lifestyle habits and the personal ability of the person to be mentally healthy as well. Far too many programs focus on just the physical component or treat the physical symptoms, neglecting the importance of addressing the psychological and emotional needs to assist the body in healing itself. This is why our program is designed around exercise and education. There is an abundance of research illustrating the physical, health and emotional benefits of exercise for those suffering and over-coming cancer. Cancer brings with it atrophy, osteopenia, increased risk of cardiovascular disease and falling. The benefits of exercise and stress reduction can help alleviate many of these ancillary negative conditions associated with cancer. Some of these benefits include:
After the Lift For Life brainstorming session I had with my cancer clients I was surprised to find that no one had identified what I perceived as being the most important elements in overcoming stress and anxiety. Exercise and rhythmic breathing. Of course once I mentioned this, all clients agreed that these were both extremely important.
It is at this point you may be thinking “yes I know about the importance of exercise and the benefits associated both physically and mentally, but what has breathing got to do with it?”
When I think of someone being stressed or anxious, I picture someone hyperventilating into a brown paper back and trying to slow down their breathing. Most people who are stressed are stuck in a constant state of over breathing and hyperventilation. Often when people are stressed they are told to “take a deep breath and relax”. This is, however, quite problematic as this action reinforces anxiety and stress symptoms by overstimulating the sympathetic nervous system, and eventually causes habitual over breathing actions. Even when the stress is no longer present, a person will continue to breathe this way as this is how they have taught themselves to breath. Dr James Mercola (of the Game Changer) emphasizes this further when he stated “When you feel tense and anxious, the sympathetic fight-or-flight aspect of your nervous system turns on, quickening your breathing and increasing your heart rate, blood pressure and stress hormone production. Uncontrolled, rapid, chest-oriented respiration can actually initiate your sympathetic nervous system — even if no other stress factors are present — locking you into a state of breathing-induced stress”. Hence, learning how to breathe slowly and softly through the nose is critical.
There are many breathing exercises which can help to reduce stress levels, improve your health and calm your body. A simple breathing exercise which can be done anywhere and has been reported to help reduce stress and anxiety symptoms is as follows:
The 4-7-8 breathing technique taught by Dr Andrew Weil is also quite effective in reducing stress levels and regulating your breathing.
We must acknowledge the damage that stress can cause on our health and when we are already in a state of poor health, a little bit more than normal is enough to create more problems. Stress cannot be avoided for it is something we will all encounter at many times in our lives. However, being stuck in an extended state of stress will do serious damage to your body. Learning different strategies and having tools and resources to combat the symptoms associated with stress and anxiety are essential in the prevention and treatment of cancer as well as all kinds of other health problems and diseases.
References:
http://www.mercola.com/
http://www.cdc.gov/
Cancer Council Australia
Nick Jack is owner of No Regrets Personal Training a Rehabilitation & Sports Training Studio located in Melbourne Australia. Having worked as a Trainer for over 10 years and has qualifications as a CHEK Exercise Coach, CHEK Golf Performance Specialist & Master Rehab Trainer and Twist Conditioning Sports Conditioning coach he specializes in working with rehabilitation and injury prevention programs. You can check out his website at www.noregretspt.com.au
Recently we have been working very closely with several clients suffering brain injuries, severe movement dysfunction, and muscle loss caused from either accidents or strokes. The effects of these conditions can often be quite devastating and some people never regain the skills they had prior to the incident. Having said that, there are some that do recover and develop significant improvement in daily living tasks. Surprisingly, it can happen quite quickly if the right stimulus is provided. This article looks at some of the research we have been able to use and implement effectively with several clients.
“I have been getting personal training from No Regrets Personal Training for 6 months now and I have loved every minute of it! Nathan is such a patient, caring and understanding person but he still pushes you. I have definitely improved out of sight since going to training, my movement, my balance, my walking, my strength and my overall appearance have improved quite a lot and I only expect it to continue! I haven’t missed a session because I love it!” –Shannyn Moon
Shannyn is only 31 years of age and has suffered from 2 severe strokes that have left her with partial paralysis on her right side. Her goal is to be able to walk down the aisle for her wedding in her words “like a normal person”.
According to the National Stroke Association:
A stroke is caused by an interruption of the flow of blood to the brain or by a rupture of blood vessels in the brain. The damaging effects of a stroke depend on what parts of the brain are affected, as well as the amount of damage. Common after affects contribute to resulting weakness on the side contra lateral to the brain injury.
In the past, exercise and more specifically strength training, with stroke victims or brain injuries has been misunderstood and at times even controversial. Most people with stroke are usually prescribed “safe” or moderate exercise programs, with more emphasis on cardio vascular exercise or using isolated exercises and stretches to treat the affected side. Typically machines are used for strengthening as they force the muscles to work in a symmetrical method that eliminates mistakes at the same time making it safer. I myself used machines when starting as a trainer as I was told that free weights are too risky and that the client would benefit from doing bilateral movement as opposed to single arm or single leg exercises. I found that this approach did not really help these clients to improve what they came to see me for in the first place which was – how to move better!
It also did not address the problem of spasticity or lack of flexibility with the affected arm or leg, which is often severely restricted in pronation and bent. Using an isolated stretch seemed to do nothing to change the actual length tension of the muscle as soon as we stopped stretching. I suspected the solution would be with the strengthening and movement approach but I needed a different model than machine training and isolated movements. What I found was that a much more integrated approach of using movement focused exercises, with more reliance on single arm and contralateral activity produced significantly better results.
I first came across the Complex Movement concept many years ago when working with sporting athletes looking to improve movement efficiency to ultimately develop improved strength and power. It just took me some time to think that I could use the same principles of teaching sports to people with injury or even just beginners. Originally I believed if I used the typical muscle approach to training this would automatically equal faster and more powerful. Yet I found anytime I used a complex task that was actually a lot lighter load, but required much more brain concentration and focus, and they were able to execute it as close to perfectly as possible, the strength gains and improvement across multiple skills, was much higher than when we focused on strength alone. This now makes up a big part of our sports program.
Over time I began applying this theory to beginners, then to injury and rehabilitation, more recently with older adults where I found this to be also true. And interestingly enough the gains were more significant with the rehab and older adults more so than the sports due to the amount of skill and strength lost.
This led me to reading hundreds of books and completing many courses in this area to develop programs and exercises with the goal of trying to improve a person’s movement efficiency. Basically we are training the neuro musculoskeletal system with our goal to get your body’s systems to work in a highly coordinated and effective fashion, so that functional tasks are completed successfully.
This aligned perfectly with our goal for rehabilitation and more specifically stroke victims because the goal of the individual who has experienced a stroke is to reach the highest possible level of independence and be as productive as possible (Just like Shannyn wanting to walk down the aisle!) The difficult and challenging part here is that the progress and recovery is so unique for each person, depending on the level of damage and paralysis. There is no one magic exercise that works every time. A method of assessing where to start and determining how each person learns best will decide how effective the program would be.
Using a reverse engineering approach with the focus being on the end result – improved human movement and function, we needed to use a way to find out what movement patterns they needed, and how good they were at completing each one. From this we could design a stepping stone approach to learning and devise plans and programs to enhance each movement pattern.
But this is where it gets very interesting and even contradictory. With the “Average Joe”, who lacks overall conditioning, we could use a more simple and isolated muscle approach to build some strength and reserve before tackling the more complex integrated movements.
For example to improve the ability to squat we could use an approach of:
With the stroke or brain affected clients we had more success with starting with more complex and difficult tasks often completed in a split stance, using contralateral arm and leg movements. (See picture).
This takes advantage of how the neuromuscular system is designed to work in the first place, which is in a highly coordinated manner. The body really is a complex system made up of many chains known as slings. These slings, when they are working well, help us move efficiently, produce more force, and create more speed. However, when there is a weak link in the chain, most people don’t address the chains but rather target the muscles. Very, very rarely do muscles work in complete isolation or anywhere close to it. Some muscles contract to provide movement while some muscles contract to provide stability. This is all done at the same time. They don’t work separate to each other. In addition to this and as we have already discussed, the more co-ordinated and complex movements have a greater effect on the brain. And because the brain controls the muscles, it makes sense to try and change this!
I highly suggest reading the book Motor Learning and Performance by Richard A. Schmidt and Timothy Lee as this really helped with my program effectiveness and adapting different learning styles for each client. We knew that our purpose of conditioning was to teach your body how to train smarter and move better for life. We need to improve various abilities such as strength, balance, co-ordination and agility all relative to each other. I like to use the analogy of getting an upgrade on your computer. In the gym it is the perfect place to master these skills. Your ultimate goal should be to master every form of movement enough times that it becomes automatic! Once you learn to move properly in a gym you don’t worry about your technique when you’re playing a sport, moving something at work or even just lifting something in the garden. If you’ve done it right in the gym, and done it enough times it’s already built into the system. This is what is referred to as a Motor Engram. This is why it is so important for a new gym goer or someone recovering from injury to learn ONLY GOOD MOVEMENTS. This way it will teach the body the perfect automatic movement it needs to prevent further injury.
In the beginning we would intervene and guide the clients movements so that it was as close to perfect as possible. We knew that to change a movement we needed approximately 5000 perfect reps to make it automatic. But what we found more effective, was to not intervene and only help when required, and actually allow for some mistakes to be made. This would allow the problem solving nature of the brain to develop. Providing video feedback and use of mirrors became extremely effective in the client learning how to overcome the problems faster than us trying to help all the time. To the right is a video showing an example of us using video feedback to teach a client recovering from ACL surgery to stabilize better on one leg.
And with Shannyn using external nervous system stimulus to the feet to improve walking, she made more improvement than any other exercise we had ever tried. Using a bare foot approach of walking across several different surfaces to enhance the actual foot mechanics changed her movement pattern almost instantly. Her damaged foot for the first time began to dorsi flex and find its way across the uneven terrain. We got her to walk across
The different nerve sensations and the requirement of the foot to feel its way across the surface forced the nervous system to adapt and create better method of movement. Coupling that with video feedback for them to observe and try to change enabled us to alter their permanent way of walking faster than using standard stationary exercises we had used before.
Strength training for strokes and other accident related injuries cannot be underestimated. At times, isolated movement and muscle approach is needed and can be beneficial in adding some muscle, but a program that utilizes an integrated movement approach will produce faster and superior results. Finding creative ways to mimic and simulate daily tasks will not only significantly improve movement skills and function, but add much needed muscle improved flexibility for tight muscles that previously did not respond to stretching or releasing. Use of various learning tools such as video and external surface will also speed up the learning and enable you to complete tasks never before possible.
Nick Jack is owner of No Regrets Personal Training a Rehabilitation & Sports Training Studio located in Melbourne Australia. Having worked as a Trainer for over 10 years and has qualifications as a CHEK Exercise Coach, CHEK Golf Performance Specialist & Master Rehab Trainer and Twist Conditioning Sports Conditioning coach he specializes in working with rehabilitation and injury prevention programs. You can check out his website at www.noregretspt.com.au
References
Motor Learning & Performance by Richard A Schmidt
Bending The Aging Curve by Joseph Signorile
Anatomy Trains by Thomas Meyers
National Stroke Association
When you have a serious injury, such as breaking your arm, tearing your ACL ligament or even one as simple as banging your knee against a hard object, the limitations of functional capacity that these injuries have on your body can be quite debilitating
Arthritis is a very common health problem I see as a rehabilitation trainer every week and one that affects millions of people all over the world. It can be extremely painful and significantly change your lifestyle and overall health. Most people think of this as an “old person’s” condition but it can affect many younger people and cause serious damage to their body.
Training the “Core” is one of the most popular terms used in gyms these days, and is thrown around in the sporting world as essential for preventing injury. Unfortunately many people have very poor understanding of what this really means and how to do it correctly.