Keeping hydrated, a guide.

We all know the importance of hydration during exercise, but do we really know how to measure it? As most people know, sweating leads to fluid and electrolyte loss. If we don’t replace the lost fluids or electrolytes we become dehydrated, leading to muscle fatigue, confusion, lack of coordination, inability to regulate heat and heat exhaustion.

It is important to know how to measure your water loss as it varies person to person, you can do this by weighing yourself before and after exercise and checking the colour of your urine. and ensure you are hydrated prior to exercise. The darker the colour the more dehydrated you are. The ACSM guidelines for dehydration and weight loss  are as follows:

Well hydrated: -1 to +1% (body weight (bw) change), Minimal dehydration: -1 to -3% (bw change), Significantly dehydrated: -3 to -5% (bw change), Severely dehydrated: -5% (bw change)

As stated above, prior to exercise you should check the colour of your urine and weigh yourself. If your urine is dark to very dark, be sure to hydrate as follows at least four hours prior to exercise: 16-20 fluid oz (450 - 570 ml) water or carbohydrate (5-8%) sports drink. Then 10-15 minutes prior to exercise take on 8-12 fluid oz (230-340 ml) of water.

During exercise for under 60 minutes you should take 3-8 fluid oz (85-230 ml) water. For over 60 minutes exercise you should ingest a carbohydrate/electrolyte sports drink 3-8 fluid oz (85-230 ml) every 15-20 minutes. DO NOT CONSUME more than 1 lt per hour of fluids!

When you have completed your exercise, be sure to weigh yourself to determine how much fluids you should ingest within 2 hours. ACSM guidelines suggest 20- 24 fluid oz (570-680ml) for every pound lost.

Be careful not to overhydrate as this can lead to a potentially lethal condition so do not ingest more than 1 litre per hour of fluids. If you suspect you have over-hydrated contact your GP to begin tests.

I hope this helps to keep you hydrated this spring and summer.

If you have any questions about sports injuries and rehabilitation, please contact me at sara@prestigesportinjury.co.uk

The easy answer isn't always the answer

So a wee while ago I read a blog post by Adam Meakins the Sports Physio about the devolving of self-efficacy. Basically we're becoming a society  of people who cannot take care of themselves and healthcare professionals who complicate the process.

Adam is 100% correct. And I felt I needed to write a post expanding upon this with my view.

We are humans and as humans we want to do things in the easiest way possible. We're always looking for the easy answer, the fastest results and what requires the least amount of effort. In one way this makes us very innovative, but on the opposite side of the coin it makes us very lazy. 

When it comes to sports injuries and rehab it is important that the client is on board with their own rehab. If they don't buy into it or aren't ready to help themselves then the whole process is a mute point. Many sports injuries require us as sports therapists or physios to use the biopsychosocial model, which in short means looking at the biology, psychology and social factors of the client. This means it's not just prescribing exercises to help a client, but the client needs help to reduce their stress and ensure their social circle and lifestyle doesn't impede the process. All this equals a lot of work from the client.

Because we're creatures who want the easy answer, most people will see many different professions before realising that most of them are not actually helping. Most seek those who perform manual therapy, which is the most passive of treatments, and means the least amount of work from the individual. However, passive usually doesn't work. So they see a variety of people and then get to a point where they realise they're tired of "treatments" and want to get better. Until a person is ready to make a change efforts to help using exercise and stress relief techniques are futile.

Reliance on passive treatments makes us, well, passive in our own health. Adam points as professionals we need to make sure we're not part of the problem and reassure our clients and not confuse or frighten them. Sometimes a client doesn't need a steroid shot or surgery or even complicated exercises, often simple is best. Obviously, we need to be aware of any red flags when assessing clients, so in the absence of red flags we can proceed as needed.

I'm sure some of my clients have left thinking "Well, that doesn't seem like much." But, I choose the best exercise for what we're trying to accomplish, not the most complicated and cool looking exercises. This may only be 4-5 exercises, maybe less, but less can be more. If a client sees the rehab as a burden that's going to take too much time, they won't do any of the exercises. Short and simple can be the best remedy. I'm not in the business of performing treatments that aren't necessary or try and make something simple sound complicated just to get more work. My clinic is a  no BS zone!

So, if you've been "treated" by a variety of professions and still aren't any better it might be time to seek the help of a professional who won't complicate the problem. If you are suffering from chronic pain there are physios out there who specialise in using the biopsychosocial model to help you help yourself.

If you have any questions about sports injuries or rehab please email me at sara@prestigesportinjury.co.uk

Don't forget to get your Zzzzzz for recovery

As athletes we often here about the importance of sleep for recovery. But what is recovery, and why is it so important?

For me, I feel that sleep is the most important part of recovery, and probably the one that most people ignore. Becoming deprived of sleep leads to an increase of cortisol, the stress hormone. People under stress often have higher levels of cortisol than those not under stress. A lack of sleep also decreases glycogen and carbohydrates, leaving your muscles lacking the energy stores required for exercise. Less sleep also means a higher likelihood of fatigue, low energy and poor focus. Which means a higher likelihood of injury. Sleep deprivation also effects the brains ability to repair memory, consolidate memory and release hormones such as testosterone.

So, what does sleep do for us? Sleep restores brain function and alertness, good for hard training sessions. It enhances muscle recovery through protein synthesis and human growth hormone release, important for body builders. Sleep also repairs damaged tissues, this can take from 24-36 hours post session.

Good sleep and recovery means a reduction in injury rates. Muscles that are tired and sleep deprived cannot protect tendons, ligaments and bones from injuries as well as recovered muscles.

There are 5 stages of sleep 1-4 are non-REM sleep and 5 is REM sleep. Both types are important and necessary. These 5 stages run in cycles thorough out the sleep period, lasting about 90 minutes.

So, what can you do to help improve your sleep?

Have a night time ritual. This means turning off and removing your phone from your bedroom. The blue light from electronics tricks the brain into thinking it is daylight, so be shot of it. Get to bed before midnight, this is the better time to begin sleep rather than after. Make sure your room is dark and cool, blackout curtains are helpful to keep unwanted light out. Buy a high-quality mattress that is comfortable for you. Before going to sleep you can meditate or partake in positive self-talk.

Have a morning ritual. Get up the same time each day, even weekends! Get sunlight as soon as possible. Wake up and open your curtains.

What can affect sleep. Poor nutrition can affect sleep, avoid processed, fatty and spicy food. Avoid alcohol and watch your caffeine intake in the afternoon.

It can be helpful to track your sleep to help determine if high or low intensity work outs should take place. If you are feeling sluggish or tired, postpone your hard workout for a light one such as walking, hiking or cycling.

If you feel signs of fatigue, be sure to take the time off to recovery. Fatigue can manifest as tiredness, cold-like symptoms, lack of balance and the feeling of heavy feet.

So, remember, when you build a training plan, be sure to build in recovery and sleep. IF you’re not sure how to make a training plan there are many coaches online or personal trainers who can help take that burden off your shoulders.

If you have any questions about sports injuries and rehabilitation, please contact me at sara@prestigesportinjury.co.uk

Being outdoors is just the bees knees.

I know these currently cold days might want to keep you indoors, but don’t forgo the outdoors altogether! Whether you run, cycle or just go out for a walk the benefits of being outdoors are numerous and ones that you won’t want to miss.

If you’re looking to boost your creativity get yourself outside. I often use my outdoor run to think about business decisions, blog posts and even what craft project I’m going to work on next. A fair few years ago Stanford University noted the increase in creativity of 60% while walking outside. Some of this clarity may come from the alone time your brain gets when outdoors. Even when you’re out with other people there will be moments of peace away from conversation. When we’re inside there are many distractions such as the TV, internet and chores! This time alone gives us the ability to increase our concentration on tasks when we return from the outdoors.

A huge benefit of the outdoors in the decrease in stress when we’re out there. It has been noted by scientists that we, as a species, do not go outside enough. This could be contributing to our high stress lifestyles. By not taking time away from our household and work responsibilities we are impacting our mental health.  What better way of being in the present moment than walking, cycling or running outside? We don’t have to worry about the what if’s, what next or what has happened in our lives.

Self esteem can also be improved from just 5 minutes of outdoor exercise, being near a green space or near water can enhance this effect. The best activities for this is walking, running, cycling, horse back riding, fishing and gardening.

Going outdoors is also relatively low cost. For short in-town excursions to a local park all you need is a pair of walking shoes and proper outer wear for the weather. Many cities also have rental bike schemes if you want to try cycling without the commitment of purchasing a bike.

So, if you want to have improved mood, better self-esteem, less stress and better creativity get yourself outside and enjoy what nature has to offer us!

Mo' mobility, less problems

We’ve all been told that mobility training is good for us, but do we know why?

To start off mobility itself is the ability to control a joint in full range of motion. It is a consistent effort to increase the amount of range of motion in a joint through specialised strength training.

The first reason it is important is if you use the full range of motion from a joint you can execute more power and efficiency in your exercise. This is good news if you’re trying to increase reps or weight during training. It is also good if you’re a rugby player, football player or any other sport that requires explosive powerful movements.

The second reason is injury prevention. If you’re not using a joint in full range, there is the likelihood that you’re compensating both other muscles and joints for the lack of mobility. For instance, lack of mobility in the ankle can lead to stress to the knee, hips and lumbar. Similarly, if you don’t have full range of motion in the shoulder and your humerus is not in the optimal position in the glenoid labrum you can put your rotator cuff muscle at risk of injury.

Finally, mobility is a good way to warm up the joint prior to exercise or events. Warming up the joint is created by movement and the shifting and warming of synovial fluid in the joint. This also works out any restrictions from tight muscles from affecting your event.

The great news is that you don’t need that much time for mobility, 10-15 minutes a day is enough to start reaping its benefits. When you start doing it you may also notice where your weaknesses are in each joint and can make specific changes to your strength training routine to remedy it.

A good way to get started is to choose some full mobility exercises such as: overhead squats (with a lightweight pole or bar), a prayer stretch on a bench and knee-to-elbow bird dogs. There are examples of these on you tube from a variety of practitioners.

If you have any questions about strength, mobility and sports injuries please email me at sara@prestigesportinjry.co.uk

Is whole body cryotherapy worth the hype?

Short answer, Not really. I’ll explain further.

Cryotherapy is a method of recovery which is done by lowering the skin temperature of the body. Some of the most common modalities are ice packs, ice massages, gels and cooling creams. Recently whole-body cryotherapy (WBC) chambers have been introduced to high level foot ball and rugby teams. But is this new, and costly, method really the best way to enhance recovery through cryotherapy?

I hit the research hard. One of the first studies I found from Hausswirth, el al (2011) claims the benefits of WBC on highly trained runners. One large flaw in this study is that the other modalities involved were far-infrared (not a highly reliable modality) and basically sitting in a chair for ten minutes. These two “sham” modalities would, of course, show that WBC is a reliable way to recover after running.  It’s studies like this that make me angry. They manipulate the data by introducing two modalities they know won’t work to “prove” that WBC is reliable.

Other research I won’t even mention here were studies paid for and sponsored by companies that make WBC chambers. I don’t give research like this the time of day. Many involve manipulated data to sell a product to teams that can afford it.

A more recent study by Viera, et al (2015) studied the effect of WBC on a vertical jump after high intensity training by placing participants in a chamber at the suggested -110 degrees for 3 minutes and a control temperature of 21 degrees for the same time. In this study there was no significant difference between the WBC and control group. Thus, suggesting that some of the “benefits” of WBC are possibly due to the placebo effect. 

One of the better studies from Holmes & Willoughby (2016) looked at previous studies and compared WBC to cold water immersion on recovery and skin temperature. One of the claims of WBC is that the extremely cold temperature is more effective at lowering the skin temperature than other modalities. In this study participants used a WBC chamber at -110 to -120 degrees for 2-4 minutes and cold-water immersion at 8-14 degrees for 5-10 minutes. The results showed that using cold water immersion lowers the skin, muscle and core temperature more effectively than WBC. The study suggests that further high-level studies on WBC be performed to confirm their claims.

My personal opinion is that WBC is very expensive and some of the membership rates are well over £100 a month. Most people would not use the WBC more than once or twice a week, making it a very expensive means of recovery. Plus, it means coming home from your run or workout, getting in the car, driving to a centre, going in a chamber for 3 whole minutes then driving back home. A lot of effort when you can simply fill your tub with cool water once you get home and sit and chill in it. Studies are not conclusive of its claims, and with that kind of cost, you may be better off buying a gym membership or hiring a personal trainer.

However,  saying that, its definitely worth trying. I will admit though getting a snapshot of yourself in the mittens, slippers and headband in a chamber is pretty cool, but unless it works for you, it’s just a lot of money for cold air.

If you have any questions about sports therapy, sports injuries and cryotherapy please feel free to email me sara@prestigesportinjury.co.uk

Don't let Resolutions get you down

I’m not the biggest fan of New Year’s Resolutions. Most people make themselves ridiculous goals that they have no chance of keeping like never eating chocolate or to stop drinking alcohol entirely. It’s all too easy to get caught up in the Resolution Mayhem and not actually sit and think about what goals you would like to achieve in the next year.

I like to break my goals down into sections: professional, personal and running. Obviously, my professional goals include things I want to learn in the upcoming year, clinic ideas and marketing of the clinic. Personal goals include things I want to learn independently, books I want to read and travel goals. The running goals I keep separate as I see them as different challenges. It may be a desired distance, race or number of races I want to complete in the next year.

Breaking your goals down into sections is a good way to start without overwhelming yourself. Also, write them down or put them in a spread sheet, this is a good way to chart what you need to do to meet your goals. For instance, I try to read a specific number of journal articles in a year for my professional goals. So, I keep a list in my spreadsheet of which one I read and what knowledge I obtained from it. I also like to list my book list for personal goals and check them off once read, truthfully, I do the same with my race list for running.

Once you’ve sectioned off your goals, you can break them down further. For instance, if your goal is to lose weight first, decide how much you may need to lose (you should see your GP for an idea of your ideal weight, don’t just guess it as it may be too low). Once you know what you need to lose break it down by week or month. Then make your exercise plan, a personal trainer will be able to help you with this part as it is often difficult to decide what exercises to do when. Plus, we often choose not to put the things we really don’t like on the list. Once you have your exercise plan, think about your diet. What can you eat less of? What should you eat more of? If you’re a chocoholic like myself, it is hard to give it up, however, you can decide to eat less of it or eat dark chocolate in small doses. If you’re not sure of what you need to eat find a good nutritionist either in person or online and they can help you plan and determine what you need to eat based on your activity level and goals.

By putting your small goals into a checklist of the bigger goal you can see your results much easier. This may be in the form of a spreadsheet or an app on your phone. Either way it is important to track your progress and don’t be disheartened if you have a bad week occasionally, just get yourself back on track as soon as you can. This is especially important for anyone who has had a sports injury, nothing is worse than the setback, however if you get appropriate rehab and advice you can be back in a healthier state.

So, if you have already set your goals or if you’re not sure just remember to break them down and track them. If you have any questions about sports injuries or rehabilitation, please email me: sara@prestigesportinjury.co.uk