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Joint health and exercise

by Mark Adshead MCSP

Mark Adshead, Managing Director of Physio2go St. Albans continues his series for Life Magazines by joining forces with James McKeown and Steve Howard, personal trainers and exercise referral specialists at OA Health & Fitness in St Albans. Both James and Steve are experienced, fully qualified exercise professionals with years of experience advising clients from all walks of life. In this month’s edition they give words of encouragement to kick-start your get fit or keep fit routine. Mark shares some advice on avoiding injury and also provides professional guidance to consider as you work towards muscle and joint health following injury or elective joint surgery.

New Year brings a number of promises to oneself.... to get fit, stop smoking (does anyone still smoke??!!), lose weight, you know the drill!! Nothing is more discouraging than to start or re-start your fitness regime and land yourself with an avoidable strain or sprain. Just like any other project, a little bit of research and planning can go a long way towards achieving your personal goals.

Request a re-orientation to the equipment at your gym

New machines may have been added and old ones replaced. Remember, a resistance level of 5 may mean something completely different from one machine to another, so do not assume that the weighting of apparatus will be identical. There should always be a member of gym staff available to answer your questions about machinery and to demonstrate different training regimes. Your personal goals, such as weight loss, improved stamina, speed, and co-ordination will also play a part as to how different pieces of equipment are utilised in your regimen.

Set personal goals and time lines

These should be short term achievable goals such as increasing your cycling time on the static cycle from 10 minutes initially to 15 minutes, or increasing the resistance on the stepper from level 3 to level 4. Take advice from your trainer and you will find that after a few weeks you have doubled your exercise load in manageable increments. In addition to being a safer approach to resumed training, you will benefit from a greater sense of achievement. Your ultimate goal may be to lose weight, get fit for a skiing holiday with active friends, or be ready for summer tennis; the reality will require a step-wise approach to remain motivated and to avoid injury.

How to avoid injury

Many injuries are avoidable with a little forethought and trained supervision. Always ask the advice of your physiotherapist or trainer about stretching exercises. Not stretching correctly or devising your own stretches may cause injury. Stretching should be performed both before & after exercise. The stretches should be performed slowly & held for about 8-10 seconds prior to exercise, slightly longer after exercise. Any exercise session should start off with a gradual ‘warm up’ followed by gradually building up the intensity of the exercise so that the hardest exercise takes place in the middle of the session. The intensity of the exercises should slowly reduce to be followed by a ‘warm down‘ (similar time to thewarm up) slowly returning to your resting state.

When adequate hydration and nutrition is not available to your muscles, you are much more vulnerable to muscle strain injuries. It is also important for this reason (and all the other more obvious ones!) to schedule rest days as part of your exercise programme.

Some advice from the personal trainers

Steve & James have put together a list of some of the common misconceptions regarding exercise & healthy living. Some examples are as follows:

“No Pain - No Gain”

In order to improve fitness levels, we need to make our bodies work a little harder than we normally do, but this should be a gradual increase in effort & should not cause pain. As during exercise we are effectively overloading our muscles, a slight aching sensation, both during & after exercise is quite normal & is not a cause for concern. At no time during your exercise programme should you experience sharp pain. If this is the case, you should stop immediately & seek assistance. If the pain persists, you should seek medical advice.

“I need to do 30 minutes of continual aerobic exercise to gain any cardiovascular benefit”

Any amount of exercise is better that none, especially in the early stages of a fitness programme. Small bouts of moderate intensity physical exercise, like walking up the stairs or to the shops can easily be accommodated into most people’s daily routines. Even simple exercise like this can help improve fitness levels in people who would otherwise lead a sedentary lifestyle. If, however your ultimate goal is to reduce body fat levels, a cardiovascular work out of around 20-30 minutes should be your goal.

“Resistance training reduces flexibility”

Extensive research indicates that resistance training generally enhances flexibility. Care should however be taken to ensure that exercises on resistance based machines are being performed in the correct fashion to avoid excessive strain on joints & muscles. Additionally, exercises for opposing muscle groups should be performed (front of legs / back of legs, biceps / triceps). Regular exercise will improve the elasticity & therefore flexibility of muscles & tendons.

“To get fitter, I need to workout every day”

To enable us to get fitter, we need to increase our overall workload & put our body under a certain amount of stress. Be aware though that excessive exercising can have a similar effect to crash dieting, resulting in a lower metabolic rate & lower resistance to infections. The rest period between exercise is as important as the exercise itself. Always leave at least 24 hours between sessions.

Returning to the gym after injury or surgery

If you have had an injury or surgery, your return to full fitness will be gradual. If you have had joint surgery, you will have benefited from post-operative physiotherapy in hospital. Although you may have been given instructions to continue your exercise programme at home, this may prove challenging without with the safety of the hospital environment.

Physio2go provides a home-based physiotherapy service for patients in the critical 2-3 weeks following orthopaedic surgery. Once your mobility improves you will be able to continue your treatment at either your therapist’s clinic, or if appropriate ( with your surgeon’s approval ), continue your fitness programme under the supervision of a personal trainer at your gym. When you return to the gym after injury or surgery, follow the instructions of your doctor or physiotherapist. Provide your trainer with as much information as possible. If you have trained regularly before your injury or surgery you will benefit from ‘ muscle memory ‘, and although gradual, you should be able to make steady progress.

So with all these hints and tips behind you good luck ……and good health for 2007!