Thursday, 28 April 2016

What happens to muscles during endurance exercise?

If you are training for your next marathon, Ironman or ultra-marathon and are worried about the breakdown of muscle tissue then you should continue reading this. It will give you a rundown on what happens to your muscles during endurance exercise and how you can avoid the breakdown of those precious muscles while training.

While you are training for that upcoming endurance event you are obviously trying to increase stamina. This can, in turn, result in muscle mass loss. This is due to a number of reasons. One being that endurance exercise can breakdown carbohydrates and fats quickly. Your body then begins to breakdown its own muscles for an energy source. 

Training to prevent muscle loss

Many people may think that training for your particular event means just doing that particular exercise and slowly increasing your distance as you become fitter. This works if you are looking at developing stamina and cardiovascular fitness. However, this may result in a decreases to not only muscle size but also strength and power. To maintain muscle mass while endurance training it is ideal to complete a weight or resistance program as well.

It is important to look at the type of event you are competing in and what you are trying to achieve. Muscle bulk is generally heavier and requires more oxygen and blood flow, but will also provide more power in the vital moments of a race and could be the difference between first and second place. So an elite athlete may want more muscle than their competitors and will train accordingly. However, for most recreational endurance athletes 1-3 resistance training sessions per week is enough to prevent muscle loss. 

Nutrition to prevent muscle loss

Recent studies have found that ingesting protein before and/or during endurance exercise can prevent the muscle protein breakdown. This can also stimulate muscle protein synthesis and enhance skeletal muscles response to resistance training. Protein is both a trigger for activating muscle building pathways, as well as the main component muscle is made with. To ensure that muscle synthesis matches or exceeds breakdown, at least 1.2 to 1.7 grams of protein per kilogram of body weight should be eaten daily

When supplementing with protein it is important to do so within specific time frames. Having either a whole food source or protein supplement within the first 3 hours after exercises is the best time to achieve optimal results.

Whey protein is popular for pre and post-workout supplementation because it’s high in branch chain amino acids (BCAAs), which are most effective for preventing muscle breakdown as well as promoting muscle growth and recovery after exercise.


If you are thinking about entering an endurance event in 2016,please consider your training program and nutrition in order to prevent any muscle mass loss.  

Wednesday, 27 January 2016

New Years Resolutions are about creating better habits.

Did you make one? We did… It’s almost a month into 2016, are you starting to lose focus or worse have you fallen off the band wagon? A recent study of 1000 Australians, showed that 69% intended to set a New Year’s resolution. Why not, it’s such a great time to set such personal goals, with the start of a fresh new year. But staggeringly less than a quarter of these people will achieve their resolution goals. Here at Rebalance Myotherapy we have clients every year that achieve some amazing goals. This blog gives a little insight into how to help set your goals and also ultimately achieve them. 

A study at the UK University of Hertforshire found the key to keeping on track varies according to your gender. They found that if men set specific goals they were more likely to achieve their resolutions. For example instead of setting a broard goal of losing weight, men that had the goal to lose a certain number of kgs, were able to train and achieve this target. Makes sense really, giving your goals direction and having a target to head towards.

The same study showed that women who shared their resolutions with others had a greater chance of accomplishing their goals. Professor Richard Wiseman states 'women benefit from social support provided by friends and family’. I’ve always found sharing my goals is a great method, it has helped me stay on the path to achieving them. Also, when I’ve set goals I’ve found its best not to set yourself up for failure, rather to set goals that give you the sense of achievement. So instead of waking up New Year’s Day and unrealistically stating I will exercise every day in 2016, just commit to exercising 3 times a week and get yourself a different training buddy for each day. You will then have the social support off three workout buddy's which no matter your fitness level, it is one of the most beneficial and motivational things you can do. No one wants to be that workout buddy that pulls out of training sessions last minute, trust me this method has gotten me out of bed more times than I can count.

I truly believe obtaining goals is clearly linked to creating habits and studies have shown that on average it takes more than 2 months (66 days to be exact) before a new behavior becomes automatic. So with this knowledge make sure you set realistic timelines and understand achieving them will take time (science says so!). Interestingly researchers have also found that 'missing one opportunity to perform the new behavior did not materially affect the habit formation process'. In other words, don’t be so hard on yourself if every now and then you struggle to find time to work on your goals. Treat your goals as a work in progress sometimes you will be moving 100km/hr towards them, other times you will feel you are stagnant or even worse moving backwards. A good way to counteract this is take yourself back to the beginning, reread your goals and look at how far you’ve already come. It’s easy to lose sight of what you’ve already achieved when you’re too focused on that next allusive milestone.

So with 2016 already in full flight and one month already disappearing, there is no time like the present to revisit your goals.  Make sure they have direction and are specific to what you want to achieve. Set realistic time lines, share with a loved one and make yourself accountable. There is no better feeling then accomplishing a goal whether it’s a personal or work related.  Good luck and I hope this information helps you achieve your New Year’s resolution.  

Monica Canny

Thursday, 19 November 2015

Sitting is the new smoking!

Many of you may have recently seen articles with the headline “sitting is the new smoking.” As scary as it sounds it is very much the case for a lot of Australians who work at a desk in an office environment.

Recent studies have suggested that for every hour we spend sitting can cut up to 22 minutes from our lifespan and many of us can spend up to 80% of our working day seated. 

Australians as a population are eating more and moving less and this, in turn is increasing our risk of obesity, heart disease, diabetes, muscular pain, depression and even stroke. The World Health Organisation recognises physical inactivity as the fourth biggest killer in Australia, that’s ahead of obesity. I bet you’re thinking “but I exercise regularly”, “I stretch”, “I go to the gym”. In fact studies showed that on the days that people exercised they were actually 30% less active than they were on days when they didn’t exercise. The recommended amount of exercise of 30 minutes a day on at least five days a week is enough to benefit from, however if you spend most of your day sitting that 30 minutes will not be enough to counteract the negative effects on your body.

Not only does sitting for such long periods effect you general health and wellbeing if can also have a negative effect on your postural muscles. As we continue to sit at our desks the more fatigued our postural muscles can get, this results in slouching or slumping to try and become more comfortable. The slouched position puts added pressure on our lower back, lessens the activation of our core and can result in a weakening of our postural muscles in our neck and shoulders while the muscles in our chest become tight and our shoulders internally rotated. These changes in our posture can lead to many presentations of lower back pain, shoulder dysfunction, neck pain and even headaches. 

So, how do we counteract all these negative changes in our bodies? We don’t need to spend hours at the gym, or even start running marathons, we just need to move more. Whether that means setting an alert in your calendar to get up and walk around every half an hour or just moving the printer or bin away from your desk so that you have to get up more often, stand up during meetings or even have a walking meeting. Even when you’re at home, stand up and move during the ad breaks when watching TV, stand while talking on the phone, get a takeaway coffee and go for a walk instead of sitting in a coffee shop.

None of these suggestions are outrageous strategies that take huge changes to be made to your life, they are all little things that can be done by anyone. So if you or your co-workers are sitting for a large portion of your day it may be worthwhile implementing some of these into your office.

If you would like any more information or to arrange some Corporate Myotherapy for your workplace please visit our website or call 0418 709 904.




Tuesday, 22 September 2015

Tendinopathy: What is it? & How is it treated?


This time of year we have many patients coming to see us as part of their training for marathons, trail runs and many other events and sportsAs this training is putting an increased load on your muscles and tendons it is inevitable that we see a lot of people presenting to us with tendon pain.

Tendinopathy is an all-encompassing term that is used to describe several conditions affecting tendons and surrounding tissues in response to overuse. You may have heard of tendinitis, tendinosis or even tensosynovitis. These terms all can be grouped under the ‘Tendinopathy’ category. Although sounding quite overwhelming, they are fairly common and treatable if you follow the advice from your health professional. 

There are several ways to approach a tendinopathy. Usually it depends on the onset of the injury, how long you have had it for and how much tissue may be damaged. In most cases though, we will aim to get you pain free at rest within a few weeks. This may include treatment with us here at Rebalance Myotherapy along with some at home prescriptive exercises for you to do. We would also get you to refrain from any aggravating factors during this time

A recent Cochrane systematic review evaluated the effectiveness of different types of treatment applications ranging from Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen, physical therapy, corticosteroid injections, right through to surgery and stem cell treatment. 

The evidence found in these studies showed that topical or oral NSAIDs were affective within the short term (7-14 days)however there was no clear evidence that ongoing use of NSAIDs is effective in the treatment of tendinopathies. As this is usually a go-to for the general public, we recommend that this only be used in the first two weeks after the injury to control pain and swelling.

Physical therapy is used frequently in the treatment of tendinopathies. This is what you would see us for and can include modalities like dry needling, soft tissue mobilisation, prescriptive stretching and strengthening exercises. The main focus of the exercises we will give you is to eccentrically contract the muscle and tendon complex. These programs work particularly well for Achilles tendinopathy. Eccentric loading of a muscle is the process of contracting a muscle as it lengthens ie. Lowering your heel off a step slowly.

Corticosteroid injections are another common treatment for tendinopathy. Most of the findings with this treatment are positive pain relief in the short term, up to 6 weeks. However, long term effectiveness has not been proven. 

Surgery for tendinopathies is rare and can be performed as a last option usually after all non-operative measures have been taken.

Although they may take some time, most tendinopathies will heal with conservative treatment within 6-12 weeks.  

Hopefully this information has been helpful to you all out there who are training for upcoming events! Please feel free to contact the clinic on 0418 709 904 if you would like any more information or advice.

Thursday, 2 July 2015

I found a lump in my breast!

What a hectic start to the year most of us have had! Here at Rebalance Myotherapy we love hearing and sharing in many of our client’s achievements and pathways through life. This blog is a little different to our past ones, it’s written still with plenty of health advice and has a hidden message for everyone…

My year to date has been very life changing, I’ve been busy running Rebalance Myotherapy Clinic while also managing to get married, move house and take a short trip to Japan. What all of you would be unaware off is, quite recently I was surprised to discover a lump in my breast!

Now being a Myotherapist we do develop palpation skills that enable us to feel taught bands and trigger points within muscles. It’s what makes us good at our job and getting the desired results you personally require. I guess I have these skills to thank for discovering my lump. Over the years I have had numerous patients present with all sorts of lumps and bumps. Usually they turn out to be lipomas, which is a growth of fatty tissue that slowly develops just under the skin and are usually quite harmless. Whenever we find these abnormalities we always advise patients to seek their GP‘s opinion. When we treat you at Rebalance Myotherapy Clinic not only will we inform you of any lumps we find but also any changes we notice on moles, especially on your back and other hard to self-monitor areas.

On discovering my lump I was filled with a mixture of emotions. My head raced to every amazing woman I’ve known that has battled breast cancer or currently still is. Pulling myself together, I quickly reassured myself with these simple facts; I fall in the wrong age category and I also have no family history. I thought it would be highly unlikely for this lump to amount to much but with my newly wedded husband’s insistence I made a doctor’s appointment to be examined.

On examination there was a definite thickening and lump on my breast, the next step was a referral out for a mammogram and ultrasound. Easy I thought, go and have these scans done and then we can put all this worry behind us and enjoy our newly wedded bliss.

Arriving at the hospital I started to fret what are these scans going to show? For those that have never had a mammogram done before, let me paint a picture of my experience. I was escorted to a dark room which contained a machine that looks like something out of star wars. All sorts of buzzing and flashing lights greeted me as I walked out of the change room. The robe they gave me was quickly removed and I was instructed to place my breast on the machine’s bench.  You are then instructed to relax as they move the machine and you into the correct position to be scanned.  For me, I felt like I was in a very bad tango dance move with this machine! Once they are happy with your position, a piece of plastic slowly squashes your breast down until it reaches a size that feels smaller than a pancake! Now let me tell you relaxing in this position is very hard, as I thought my breast was going to explode at any moment.

The ultrasound is a walk in the park compared to the mammogram. The only thing I will say about this experience is that it is a long process and also be aware that you will have a front row to every measurement taken. You see where you get your breast ultra-sounded is the same examination room that pregnant women receive their scans too. So promptly right in front of you is a monitor that shows you everything! I’m sure these screens bring lots of women joy but in my case it was quite the opposite.

Now because I had a front row seat to the ultrasound I knew my results would indicate something. When you physically see the radiologist measuring and pausing on masses within your breast tissue, it would have been a little na├»ve of me to think my scans would come back ‘all clear’. I think a wise decision for the hospitals to make would be to turn these monitors off when scanning breasts. My results indicated two lesions that most likely represent fibroadenomas with a suggested guided biopsy to confirm these findings. It’s quite common for these tests to discover other lumps you weren’t aware of, that is the beauty about getting them done you get the full picture. So now I had two lumps but this soon would change to three as the doctor discovered a third during the biopsy.

Fibroadenomas are not cancerous but can sometimes be hard to distinguish from cancer, hence requiring a biopsy. Researches are unsure what causes them and they are quite common especially in women aged 15 to 25. Up to 1 in 6 (15%) of women have a fibroadenoma at some time in their life. They can be also known as a ‘breast mouse’ as they are quite firm and rubbery, and when pushed on they can appear to move away under your fingers. A specialist doctor decides if it’s safe to leave them alone or if surgical removal is the better option but most fibroadenomas are left alone and do not require treatment.

Once again, compared to a mammogram, a breast biopsy is relatively easy to get through. Don’t get me wrong, it’s more than a tickle and you do take a while to recover but the pain and tenderness is manageable. I found out this week my biopsy results confirmed the initial indications that my lumps are fibroadenomas. All the worry and uncertainty I had surrounding these lumps was definitely worth going through to hear those results. I am lucky! I am lucky I found the lumps and lucky to have these results. The reason I have chosen to write a clinic blog about this experience is to raise awareness that if you find something abnormal or something is starting to show signs of change get it checked out. We live in a world where there are some pretty amazing medical tests and treatments available and early intervention can sometimes be the key.

We are very health conscious here at Rebalance Myotherapy Clinic and we want our patients to be proactive about their health. So after reading this blog I hope a few of you are sitting there groping your boobs or even booking that doctors appointment to get that mole checked out that you’ve been meaning to. 

Warmest Regards
Monica Canny
Rebalance Myotherapy Clinic

Monday, 8 June 2015

Your Questions Answered About Trigger Points

When you are at Rebalance Myotherapy clinic you may hear Monica and myself constantly talking about Myofascial Trigger Points or Trigger Point Therapy and you are lying there thinking, "What on earth are they talking about!" Here I am going to give you quick overview of what we mean.
What is a myofascial trigger point?
A myofascial trigger point is a spot found in skeletal muscle where a palpable nodule can be felt that has an increased irritability and is also known as a “knot”. They are usually found within a taut band of muscle fibres and can elicit pain both locally and referred if compressed or stimulated.
There are two main types of trigger points categorised as either active or latent. An active trigger point typically will be symptomatic at rest as well as when it is stimulated. Trigger points can prevent full lengthening of the muscle, they can also produce referred pain and even a local twitch response when stimulated.
A latent trigger point is asymptomatic and will not cause pain when the muscle is at ease. However, when a latent trigger point is stimulated it can cause all the symptoms of an active trigger point.

What causes myofascial trigger points?
The causes of myofascial trigger point can be very widespread, from general overuse to poor nutrition or even stress. These factors are very hard to isolate and often go hand in hand. Frequently we see people with muscle imbalances and poor posture which can lead to chronic myofascial trigger points developing. Our goal is to treat the immediate pain of the trigger point while also addressing the underlying factor/s causing them to occur.

How does trigger point therapy work?
The aim of trigger point therapy is to remove and alleviate the pain associated with trigger points. We do this by using a range of techniques both hands on and with the use of dry needling. All the techniques we use are designed to increase blood flow to the area of the trigger point and in turn allow the muscle fibers to receive the nutrition they require to release and relax.

How can you (the patient) assist the trigger point therapy you receive from Rebalance Myotherapy?
After having a treatment with us, you will be asked to do some extra work on the area at home. This may include using a heat pack, self-massage, foam roller, spikey ball or even some good old fashioned stretching.  These are all things you can do to assist your recovery after your treatment and may help in the prevention of new trigger points forming.
If you have any questions or would like any more information on any musculoskeletal conditions please don’t hesitate to contact us at the clinic, 0418709904

 Rebalance Myotherapy Clinic 

Monday, 1 December 2014

How I became another knee statistic….

Three years ago I experienced what it’s like to rupture an ACL (anterior cruciate ligament) and my left knee required a full reconstruction as a result of a netball injury. The rehabilitation back to playing was a long, drawn out and frustrating process. But after 12 months off I managed to get back to playing the sport I loved so much. I had a full season virtually pain free and was over the moon! I was ready to continue playing for as long as I could. However, fate wouldn’t allow that… The risk of injuring either the same or opposite ACL within the first 2 years post-surgery is 6 times greater for people with a knee reconstruction (Source: American Orthopaedic Society of Sports Medicine) and its even higher for women compared to men. Unfortunately this year I became part of this statistic and the timing was devastating, on and off the court!

Another netball match would lead me into becoming another statistic and being utterly devastated. It was the second last round of the 2014 home and away season and it was just like any other game day, except maybe a bit sunnier which is surprising for Ballarat! It was early in the 3rd quarter and I dodged and twisted on my right leg, much like I had done millions of times before, there was a very loud “pop” and the feeling of pain was instant. I let out a scream and landed on the court grabbing my knee knowing exactly what had happened and the memories of my past knee reconstruction came flooding back. The pain was extreme for the next few minutes, but after calming down, I thought maybe it wasn’t so bad… Oh how I was wrong! Off to hospital I went for an x-ray and the results came back normal. But due to still being unable to weight bear on my right leg I was given a referral for an MRI (magnetic resonance imaging). This scan would be able to show how much damage I had actually done to the ligaments. Frustratingly, there was a wait of 2 days for the MRI.

In the mean time I had to make a phone call that I was dreading. Two weeks earlier I had started my new job here at Rebalance Myotherapy and was loving every minute of it. But I knew with this injury that working would be impossible for at least a week and if not longer. The thought of losing my job had crossed my mind briefly, I called Monica with the unexpected bad news. After making sure I was ok, we arranged that I would have the week off. There was no pressure to return before I was fully fit so the results from the MRI would determine the date I would return to work.

Due to my minimal swelling and lack of pain on viewing my MRI results I was in complete shock. It showed I had a fully ruptured right ACL, a grade 3 tear in the MCL (medial collateral ligament), a torn lateral meniscus (cartilage inside my knee), the bone was compressed in the femur and a torn popliteus muscle behind my knee. I was absolutely devastated!

The next step was to contact my surgeon and arrange for my second knee reconstruction. His advice was to wear a hinged knee brace locked between 30-90 degrees of knee flexion. Doing this allows the MCL to partially heal prior to having surgery. With this brace I was able to start moderately weight bearing through the leg again. Feeling still relatively pain free (this can occur with complete ruptures due to all of the nerve fibres being torn), I managed the swelling with ice and NSAIDs. By the end of the first week I was fully weight bearing and also walking reasonably normally which enabled me to return to work. I was happy to be back that’s for sure!

Eight weeks after the original injury I returned to the surgeon for a review and hopefully book a date to have surgery. The advice given was that I was able to go without the brace and will be having my surgery in early 2015. Until then my job is to “prehab” the whole leg, which involves building up the strength I have lost in my calves, quads and hamstrings. There is also the tough decision on what type of graft would suit me. My options are either a hamstring graft, where they take part of my hamstring tendons, sew them together and insert that where my ACL was or have the artificial LARS implant. Both have pros and cons and neither are completely fool proof. You just need to look at the AFL footballer Daniel Menzal who at 23 years old has already had four reconstructions including both the LARS and hamstring grafts. He will be making his comeback with Geelong Cats in 2015. What a long road to recover he has experienced.

At this stage unfortunately I won’t be looking to play netball again. Which is really sad, to retire at a ripe old age of 25. My focus right now is on my strength training and looking forward to finally having the reconstruction. With a bit of luck, in 2015, I will be able to regain full strength and range with my knee, with the long term goal of even completing my first ever fun run.