Swing into Spring!

Last week’s blog discussed overtraining in spring, but how about those people that don’t train at all and just go out there and start swinging a golf club at the first sign of spring. This is when injury can occur. Although sports like golf are considered low impact, golf injuries are increasing at an alarming rate. A golfers shoulder, forearm and back are the most common injury areas. So what should a golfer do before he goes out swinging?

A stretching program is definitely recommended which should be initiated in the pre-season and then continued as a pregame warm up. Golf-specific stretching exercises should address those areas that are necessary for proper mechanics and subsequently the most injured, such as the shoulders, forearm, and back. Strengthening the forearm will also prevent “golfer’s elbow”. The American Academy of Orthopedic Surgeons recommends simple exercises such as wrist curls and squeezing a tennis ball to prevent elbow injuries.

Another recommendation is Resistance Training. Building up the muscles that have been left dormant during those winter months will do wonders to prevent spring injuries that could keep you off the course all summer.

And what about aerobic endurance? The average golfer walks 3 miles during the course of an 18 hole game which is certainly nothing to sniffle at! So how does a golfer prepare aerobically. Try a one mile walk and then build slowly over the pre season months to ensure that you don’t over do it. Look at walking programs such as PARC’s Walk This Way which is specifically designed for adults wanting to start a walking program. Remember aerobic endurance in the form of walking or cycling also has been shown to reduce the recurrence of low back pain after injury.

Remember, before starting any form of exercise or training program check with your doctor first and may all your balls be birdies!!

Reference:
BRANDON, B. and P.Z. PFARCF. Training to prevent golf injury. Curr. Sports Med. Rep., Vol. 8, No. 3, pp. 142-146, 2009

To stretch or not to stretch – that is the question?

Who hasn’t begun a run, exercise session or volleyball game with a bit of static stretching? You see it everywhere – runners stretching their hamstrings while pushing against trees and stretching their Achilles tendon using street curbs, and then setting out for their run.

But is this really doing your muscles and energy systems any good for your pending athletic performance?

Once an essential part of the sporting warm up, many coaches are now suggesting that static stretches should be avoided just prior to warming up, competition or exercise. New research also doubts the effectiveness of static stretching in enhancing your performance or work out, with some strongly recommending against it.

Static stretching, the slow and constant movement of a muscle to a fixed end point, and held for up to +/-30 seconds, is designed to improve range of motion and enhance athletic performance. But research says that doing this before athletic practice or performance actually produces a decline in muscle performance and should not be done immediately before any activity whose performance depends largely upon achieving high amounts of force.

While there is value to static stretching, the real question is ‘when do you perform it?’ The best times are just after a low intensity activity designed to increase muscle temperature, or after your workout, or at a completely different time not associated with a high session of physical activity, in order to get its full benefits.

To learn more about static stretching prior to exercise, please review the following resources.

Small, Katie, McNaughton, Lars, and Matthews, Martyn, (2008) A Systematic Review into the Efficacy of Static Stretching as Part of a Warm-Up for the Prevention of Exercise-Related Injury. Research in Sports Medicine, 16(3), p213.

Warming Up

Flexibility Training

To stretch or not to stretch before competitive tennis?

Yoga Poses and Meditation for back pain

Yoga- the ancient physical, mental and spiritual discipline - has been found to be a great intervention for chronic back pain. And many high level athletes use yoga as a part of their training and recovery programs. The physical stretches are the most helpful part of the recovery but let us not forgot that the mental aspect of the discipline is quite beneficial to recovery as well.

By holding a pose in yoga, our muscles strengthen. If you can hold it for about a minute and start to feel a burn you are strengthening your muscle. Yoga is a workout that reduces stress, increases flexibility and coordination.

Studies have found that sixty to ninety percent of adults will suffer from back pains. Outside the athletics world, we put our back through so much lifting, heaving, twisting and shoving in every-day life. Some of the numerous causes of back pains include: poor posture, excess body weight, herniated disc and degenerative disks to name a few. With all that work our backs are doing it’s not surprising that with 20 small intricate joints building our vertebrae, our backs are taking a beating. Add to that any athletic endeavor and it is obvious that we need to be mindful of our back health.

Although yoga is ideal for back pain recovery, simple stretching activities also work to help relieve the pain. The focus on mindfulness is what makes yoga differ from simple stretching. It calms the body and gives peace of mind. A large emphasis in yoga is good posture, which help counter the initial causes of the back pain. Before stretching your way into recovery, try asking a healthcare professional what works best for you.

Contact SIRC for more information on yoga!

Reference from the SIRC Collection: 
(2012) Suffering from Low Back Pain? Maybe You Should Try Yoga. Tufts University health & Nutrition Letter, 29(12), 3.

Online Resource:
Shepley Caron (2012). Yoga for Sports Performance: Why Yoga is an Athlete’s “Secret Weapon”. Presented at the 2012 Coaches of Ontario Conference. Retrieved from the Internet March 29, 2012.

Holingshead, Sue. Yoga for Sports Performance. Retrieved from IDEA Health & Fitness Association website March 29, 2012.

Is Stretching Really Necessary?

Stretching is an activity that we all know is beneficial to us but it's often overlooked.  Stretching is necessary to a body in motion in order to help prevent injury and prepare the muscles for work. However, stretching is not a warm-up, in fact, stretching requires a warm-up.  Stretching when your body is not warmed up can cause tiny tears in your muscle and also make you more prone to injury.

Before you start we're going to cover a few guidelines for you to keep in mind:

• Stretch warm muscles, stretching cold muscles can cause injury
• Stretch slowly to minimize risk of injury
• Stretch often (once a week is not going to cut it)
• Stay relaxed
• Focus on the muscles that need the most attention, if you have a muscle that's tight try to stretch it 3-5 times a day until it starts to feel better

Things to avoid:

• Try not to bounce (ballistic stretching) while stretching, depending on your flexibility, it has the potential to cause problems
• Don't forget to hydrate, aim for at least two litres of water per day
• Don't overdo it, if it hurts dial it back a bit and ease into the stretch slowly
• You don't have to stretch out your entire body, your routine should reflect your personal needs

For maximum results, try to perform each stretch two or three times to ensure you get the most out of your routine. Try to make stretching a part of your exercise routine. It will help put you in the right frame of mind before exercise and help you relax afterwards.

References from the SIRC Collection

1. Blackburn K. Home stretches save back from pain: fitness tips by Kelly Blackburn. Golf Digest. January 2003;54(1):40.
2. Foster M. 13 Tips for Stretching Sanity. Massage & Bodywork. October 2005;20(5):58-59.
3. Golden A, Tierney N. Don't Forget to STRETCH. Volleyball. October 2011;22(8):24-27.
4. The Impact of Stretching on Sports-Injury Risk and Performance. Athletic Therapy Today. November 2006;11(6):66-69.
5. Stopka C. Increasing Student Flexibility--The Ultra- Stretch Way!. Palaestra. March 2009;24(4):31-35
6. Woods K, Bishop P, Jones E. Warm-Up and Stretching in the Prevention of Muscular Injury. Sports Medicine. September 2007;37(12):1089-1099.

Don't let age slow you down!

Many of you may not know that the International Council on Active Aging celebrates Active Aging Week, from September 23-29.  A lot people participate in this annual event, with this year's theme being many journeys, many destinations.  To celebrate this week, we are giving some tips for
healthy, active living, so you don't have to let age slow you down!

1. Determine your participation style - Do you prefer being with a running group/fitness class or do you like to fly solo?  Do you like indoor or outdoor fitness?  How much time can you dedicate to your fitness routine?

2. Warm-up - Before any exercise, your body needs time to adjust to the upcoming workout.  Be sure to take your time, rushing through your warm-up routine can increase your chance of an injury.

3.  Strength training - Don't be alarmed, you don't need to be a body builder to lift weights.  Starting with small weights and gradually working your way up will do wonders for an aging body.  Many studies have shown that strength training aids in maintaining muscular mass, benefits your joints and increases your metabolism. 

4. Take a Yoga, Pilates, or stretching class - These low impact classes are gaining in popularity with our aging population.  They are also a form of strength training and as an added benefit, help your balance which can reduce falls.  One class a week is good, but if you can add a daily stretching routine on top of it, you'll be doing your body a favour.

5. Eat a balanced diet - We hear this all the time, but it gets even more important as we age.  Try to get as many leafy greens, vegetables, nuts and fish as you can.  All are excellent sources of vitamins and minerals and will give you the energy you need to stay active.

6. Take your vitamins - If you can get enough vitamins through food, vitamin B12, vitamin C, vitamin E, vitamin D and omega 3's can all be taken as a supplement and are great additions to a balanced diet.

7. Get some sleep - Yes, exercise is important, but it's also essential to let your body recover.  Take a 15 - 20  minute nap each day; put your feet up, turn off the phone and let your body relax for a bit.

8. Regular medical care - Seeing your doctor for regularly scheduled visits is important for everyone.  Even if you are an athlete, we are all prone to the everyday problems of aging.

Exercise is beneficial to everyone, including those with chronic pain or special mobility needs. Even moderate activity can improve your quality of life so get out there, get moving and above all, have some fun!

References from the SIRC Collection:

1. Dudney G. Run for your life! Aging is not the enemy of the runner as long as the running can be kept fresh. Marathon & Beyond. November 2004;8(6):64-68;70-72.
2. Holviala J, Kraemer W, Häkkinen K, et al. Effects of strength, endurance and combined training on muscle strength, walking speed and dynamic balance in aging men. European Journal Of Applied Physiology. April 2012;112(4):1335-1347.
3. Kruger J. Guidelines for physical activity: pointers for active-aging professionals. Journal On Active Aging. January 2010;9(1):34-39.
4. Phillips W, Alvar B. Developing strength in older adults: how much training is 'enough'?. Journal On Active Aging. March 2004;3(2):34-37.
5. Scott D. Beat the aging curve: 25 tips for healthy aging. Triathlete. April 2007;(276):188;190-191.
6. Strength training can relieve knee osteoarthritis. Research Review (International Council On Active Aging). January 28, 2009;9(4):4.

Stretching it out

Many people make the assumption that stretching and warming up are pretty much the same thing, when in fact they are quite different. Warming up is the preparation of your body for the demands of the physical activity you have planned, whereas stretching is focused on specific areas that are tight and require loosening.

While studies have shown mixed results on the effectiveness of stretching, possible benefits include:

• increased range of motion in the joints
• improved muscular coordination
• reduced level of muscle tension
• improves flexibility
• and enhanced circulation 

Stretching exercises should be performed for 5 - 10 mins and should concentrate on the muscles that feel tight. Be aware of your body - mild discomfort (tension and pull) is to be expected while holding a stretch but sharp pain is usually a signal that a person has pushed too far.

Static vs. Dynamic stretching

Dynamic stretching consists of functional based exercises which use sport specific movements to prepare the body for activity. Generally performed before a work out, they consist of controlled exercises that improve range of motion, loosen up your muscles and increase your heart rate. 

Static stretching is the slow and constant movement of a muscle to a fixed end point, and can be held for up to 30 seconds. Holding a muscle in an elongated, fixed position can hurt performance if done before a workout, so it's recommended that this type of stretching is most appropriate to perform as part of your cool down.

When is a good time to stretch?

Stretching your body should be done after your muscles are already sufficiently warmed up. Give yourself 15-20 minutes to work up a bit of sweat, then add in 5 - 10 minutes of stretching.

Evidence suggests that athletes can benefit from a regular stretching program if it executed properly and timed within a workout to reduce the risk of injury. Aside from the physical benefits, stretching can also provide a proper mindset and mental focus for the training ahead.

References from the SIRC Collection:

1. Graetzer D. Feel the heat: Get warm before taking the court. Handball. February 2012;62(1):36-37.
2. Legg J. THE ROLE OF STRETCHING IN WARMUP FOR PERFORMANCE, AND INJURY PREVENTION. Strength & Conditioning Coach. October 2007;15(3):7-10.
3. McHugh M, Cosgrave C. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scandinavian Journal Of Medicine & Science In Sports. April 2010;20(2):169-181.
4. Small K, McNaughton L, Matthews M. A Systematic Review into the Efficacy of Static Stretching as Part of a Warm-Up for the Prevention of Exercise-Related Injury. Research In Sports Medicine. July 2008;16(3):213-231.
5. Stone M, Ramsey M, Kinser A, O'Bryant H, Ayers C, Sands W. Stretching: Acute and Chronic? The Potential Consequences. Strength & Conditioning Journal (Allen Press). December 2006;28(6):66-74.
6. The Impact of Stretching on Sports-Injury Risk and Performance. Athletic Therapy Today. November 2006;11(6):66-69.
7. Woods K, Bishop P, Jones E. Warm-Up and Stretching in the Prevention of Muscular Injury. Sports Medicine. September 2007;37(12):1089-1099.

Hamstring Injuries - Identification and Prevention

Hamstring injuries can affect any athlete, at any time. You are more likely to get a hamstring strain if you perform sports that involve a lot of running and jumping or stopping and starting. Sprinting, hurdles, handball, football, baseball/softball, running and soccer are all good examples. The hamstring is formed from three muscles - the semitendinosus, semimembranosus and the biceps femoris - all of which perform the job of pulling the heel up toward the butt and control the decent.

Grades of strain: 

1. Grade One - Little pain occurs and the athlete may not be aware of injury until the cool down. Usually these strains clear up within a week to ten days.
2. Grade Two - These strains will take more time to heal and usually will prevent the athlete from training. Symptoms are swelling, pain, and limping; a rehabilitation program is recommended.
3. Grade Three - Severe injury involving a tear to half or all of the muscle. Athlete will experience pain, swelling and an inability to walk. This type of strain usually takes months of rehabilitation.

Possible causes of hamstring injury:

• Over-training or fatigue
• New running shoes or a change of training surface
• Previous injury
• Poor technique or lack of specific range of mobility
• Incorrect or no warm-up/stretch

Injury prevention:

• Warm up sufficiently and then perform stretches to targeted muscle groups. Stretching during the cool down may also help.
• Include strength training that is aimed at preventing hamstring injuries. This includes making the hamstrings resistant to fatigue, strengthening the hamstrings, increasing the eccentric strength of the muscles and addressing any deficiencies between the limbs.
• Avoid over-training and dramatic increases in training intensity or duration

Work performed on the playing field, track or weight room can all be used to improve an athlete's performance by making him/her faster and stronger. A good prevention method involves preparing an effective training program that will use this work to prevent potentially avoidable injuries, specifically to the hamstring.

References from the SIRC Collection:

1. Bell L, Cianca J, Erickson R. What Underlies My Hamstring Pain?. Running & Fitnews. November 2007;25(6):11-12.
2. Cissik J. Hamstring Injuries And The Sprinter. Track Coach. Fall2012 2012;(201):6405-6407.
3. Hamilton B. Hamstring muscle strain injuries: what can we learn from history?. British Journal Of Sports Medicine. October 2012;46(12):900-903.
4. Opar D, Williams M, Shield A. Hamstring Strain Injuries: Factors that Lead to Injury and Re-Injury. Sports Medicine. March 2012;42(3):209-226.
5. Robertson K, Molloy L. Hamstring Muscle Strains. Modern Athlete & Coach. April 2007;45(2):10-14.
6. Rosania J. TRAINING HAMSTRING REHAB EXERCISES. Swimming World. November 2007;48(11):26-27.
7. Snyder B. Hamstring Strains: Prevention and Treatment. Handball. February 2012;62(1):61.
8. Thames C. Low Back Pain and Hamstring Stretching: CAN STRETCHING EVER BE A BAD THING?. Hughston Health Alert. Winter2010 2010;22(1):5.
9. Understanding Running Injuries. IDEA Fitness Journal. February 2007;4(2):103.

Identification et prévention des blessures aux ischiojambiers

Aucun athlète n’est à l’abri d’une blessure aux ischiojambiers.* Le risque d’élongation des ischiojambiers est plus élevé si on pratique une activité comportant de la course, des sauts, des arrêts et des départs. Le sprint, les haies, le handball, le football, le baseball/softball, la course et le soccer sont de bons exemples. Les ischiojambiers comprennent trois muscles* : le semi-tendineux, le semi-membraneux et le biceps fémoral. La contraction de ces trois muscles a pour effet de lever le talon vers la fesse et d’en contrôler le retour.

Sévérité de l’élongation*

1. Premier degré : La douleur est légère et l’athlète peut ne pas sentir la blessure jusqu’à ce que le retour au calme soit effectué. Généralement, cette blessure se guérit en moins de sept à dix jours.  
2. Deuxième degré : La blessure prend plus de temps à guérir et empêche l’athlète de s’entraîner. Les symptômes sont : œdème, douleur et claudication. Un programme de réadaptation est de mise.  
3. Troisième degré : La gravité est telle que la moitié ou le muscle en entier présente une lésion. Les symptômes sont : douleur, œdème et incapacité de marcher. Ce genre de blessure exige généralement des mois de réadaptation. 

Causes possibles des lésions des ischiojambiers 

• Surentraînement* ou fatigue 
• Nouvelles chaussures de course ou modification de la surface d’entraînement 
• Blessure antérieure 
• Piètre technique* ou manque d’amplitude articulaire spécifique 
• Absence ou insuffisance d’échauffement/étirement 

Prévention des blessures

• S’échauffer suffisamment* puis effectuer des exercices d’étirement des groupes musculaires ciblés. Effectuer des exercices d’étirement durant la phase de retour au calme s’avère aussi facilitateur. 
• Intégrer un programme d’entraînement à la force* visant la prévention des blessures aux ischiojambiers pour améliorer la résistance à la fatigue, accroître la capacité miométrique et pliométrique de contraction des ischiojambiers et corriger le déséquilibre intersegmentaire. 
• Éviter le surentraînement et l’augmentation drastique de l’intensité et de la durée des séances d’entraînement.

Les exercices réalisés sur le terrain de jeu, la piste et dans la salle de musculation s’avèrent tous utiles à l’amélioration de la performance de l’athlète en le rendant plus vite et plus fort. Une bonne méthode de prévention* consiste à préparer un programme d’entraînement* efficace incluant des exercices de prévention des blessures, particulièrement aux ischiojambiers.

* Seulement disponible en anglais

Références de la collection de SIRC:

1. Bell L, Cianca J, Erickson R. What Underlies My Hamstring Pain?. Running & Fitnews. November 2007;25(6):11-12.
2. Cissik J. Hamstring Injuries And The Sprinter. Track Coach. Fall2012 2012;(201):6405-6407.
3. Hamilton B. Hamstring muscle strain injuries: what can we learn from history?. British Journal Of Sports Medicine. October 2012;46(12):900-903.
4. Opar D, Williams M, Shield A. Hamstring Strain Injuries: Factors that Lead to Injury and Re-Injury. Sports Medicine. March 2012;42(3):209-226.
5. Robertson K, Molloy L. Hamstring Muscle Strains. Modern Athlete & Coach. April 2007;45(2):10-14.
6. Rosania J. TRAINING HAMSTRING REHAB EXERCISES. Swimming World. November 2007;48(11):26-27.
7. Snyder B. Hamstring Strains: Prevention and Treatment. Handball. February 2012;62(1):61.
8. Thames C. Low Back Pain and Hamstring Stretching: CAN STRETCHING EVER BE A BAD THING?. Hughston Health Alert. Winter2010 2010;22(1):5.
9. Understanding Running Injuries. IDEA Fitness Journal. February 2007;4(2):103.

Yoga and low back pain

Low back pain is one of the most common reasons for work absenteeism and the second most common complaint at doctor visits. It is generally caused by one of the following: repetitive incorrect lifting technique, degenerative or structural changes in the vertabrae, excessive sitting or standing, bending, twisting or falls. There is good news for low back pain sufferers, as there is a growing body of research that shows that yoga can be an effective treatment for people with chronic back problems.

What does yoga do for the body?

• Strengthen and stretches the muscles
• Provides stress relief
• Increases flexibility
• Improved coordination
• Good for overall health and fitness

While yoga may be good for overall back function, depending on the individual and the severity of the problem, it's important to note that yoga may not always alleviate the pain. Yoga classes were shown to be more beneficial than self care exercises or home videos. Performing yoga poses at home without the supervision of an instructor may prove to be a risky business if the poses are not done correctly.

Recent studies have shown that yoga combined with stretching can be a good, safe option for people who are willing to try physical activity to relieve moderate low back pain. Classes should be designed with a beginner in mind and taught by instructors that are able to modify postures for individual needs and or limitations. Before starting a new fitness regimen or class, please remember to contact your doctor or physiotherapist first to minimize risk of injury.

References from the SIRC Collection:

1. Archer S. YOGA HELPS MANAGE LOW-BACK PAIN. IDEA Fitness Journal. March 2012;9(3):69.
2. DeAvilla N. In the Classroom: Adapting Class for Students with Low Back Pain. Yoga Therapy In Practice. September 2005;1(1):7-9.
3. DAWSON-COOK S. STEERING CLEAR FROM A REAL PAIN IN THE BACK. American Fitness. May 2013;31(3):48-50.
4. Girdwain J, Mcgee K. Fix It with Fitness. Health (Time Inc.). May 2013;27(4):47.
5. HOWE D. Oh, My Aching Back. American Fitness. January 2011;29(1):54-55.
6. LARGEST U.S. STUDY SHOWS YOGA EASES BACK PAIN. American Fitness. March 2012;30(2):10.
7. Selfridge N. Yay Yoga! More Evidence for Helping Low Back Pain. Alternative Medicine Alert. March 2012;15(3):33-34.
8. Suffering from Low Back Pain? Maybe You Should Try Yoga. Tufts University Health & Nutrition Letter. February 2012;29(12):3.