Call 07 3102 3337

Call 07 3102 3337

reception@praxisphysio.com.au

Call 07 3102 3337
Book Online
Unilateral vs Bilateral Training: Part 1 – Your Comparative Guide

Unilateral vs Bilateral Training: Part 1 – Your Comparative Guide

by | May 19, 2023 | Gym and Strength, Hip, Knee, Lower Back, Return to Sport

We often get asked what are the benefits of one form of exercise versus another. Sometimes this is as simple as discussing the difference between cardio and weights. Today’s article focuses on the difference between a two types of gym based loading programs Bilateral vs Unilateral training. In Part 2, we delve more into some of what the evidence says regarding these modalities.

In general, strength training plays a pivotal role in athletic development, enhancing performance, preventing injuries, and promoting overall fitness. This is especially true for the injured population. As such, our Praxis physiotherapists will discuss with you how your rehabilitation plan will incorporate strength training.

When it comes to strength training though, two primary approaches are often employed: unilateral and bilateral training. Unilateral training focuses on exercises that isolate a single limb or side of the body, whereas bilateral training involves movements that engage both limbs simultaneously. This blog aims to contrast the benefits and drawbacks of unilateral and bilateral strength training methods, examining their impact on athletic performance and overall physical development.

Unilateral Strength Training

Unilateral strength training involves exercises that emphasize working one limb or side of the body independently. One of the significant advantages of unilateral training is its ability to identify and correct muscle imbalances. By targeting each limb separately, athletes can pinpoint weaknesses, imbalances, or asymmetries, and address them with specific exercises. Unilateral training also enhances proprioception and balance by requiring greater neuromuscular control. It activates stabilizer muscles and enhances coordination, which can lead to improved athletic performance and injury prevention.

Moreover, unilateral training allows for greater range of motion and flexibility development, as each limb can move freely without the restrictions imposed by bilateral movements. This can be particularly beneficial for athletes who need to improve mobility and functional strength in specific joints or muscle groups. Additionally, unilateral exercises offer sport-specific advantages by simulating movements that athletes encounter during competition, such as single-leg jumps in basketball, change of direction football or one-arm strokes in swimming.

However, unilateral training does have limitations. It generally requires more time and effort to complete a full-body workout due to the need to perform exercises separately for each limb. Additionally, unilateral exercises tend to involve lower weight loads, which may limit their potential for developing maximum strength.

Bilateral Strength Training

Bilateral strength training, on the other hand, focuses on exercises that engage both limbs simultaneously. One of the primary benefits of bilateral training is the ability to lift heavier weights. This can lead to significant gains in maximal strength and power, making it particularly advantageous for athletes involved in sports that require explosive movements, such as weightlifting or sprinting.

Mid Potion Achilles Tendinopathy Location

Bilateral exercises also promote increased overall muscle mass and hypertrophy due to the higher loading potential. By engaging multiple muscle groups simultaneously, bilateral training can provide a time-efficient method for achieving muscle growth and development. Additionally, the bilateral movements help improve intermuscular coordination, allowing athletes to transfer strength gains more effectively across various activities.

However, bilateral training may not address asymmetries or imbalances as effectively as unilateral training. In some cases, stronger limbs may compensate for weaker ones, perpetuating muscle imbalances and potentially increasing the risk of injury. Moreover, bilateral exercises may not fully translate to specific sport-related movements that often require unilateral actions.

In summary, both unilateral and bilateral strength training methods offer unique benefits and drawbacks for athletes. Unilateral training aids in identifying and correcting muscle imbalances, enhancing proprioception, and improving sport-specific movements. It is a valuable tool for injury prevention and rehabilitation. On the other hand, bilateral training allows athletes to lift heavier weights, develop overall muscle mass, and enhance intermuscular coordination. It is particularly effective for activities that demand explosive power. Ultimately, the choice between unilateral and bilateral training should be determined by an athlete’s specific needs, goals, and the demands of their respective sport. Further, an accurate assessment of any asymmetries that may be present helps to decide where to start. A well-rounded strength training program can incorporate elements of both methods to optimize performance and minimise the risk of injuries.

To read more about the specifics of athletic performance, read our Part 2 Blog.

To help with the genesis of a training program or to chat about your training your goals, book in with one of our knowledgeable Praxis physiotherapists. We are here to help!

Until next time,

Praxis What You Preach

Treatment Strategies

Physiotherapy plays a pivotal role in the management of Achilles tendinopathy. Treatment strategies focus on reducing pain, promoting healing, and improving function. These will include calf strengthening exercises, stretching routines and activity modification as frontline options. Moreover, physiotherapists can guide patients in proper footwear selection, gait retraining, and implementing preventive measures to minimize the risk of reinjury.

Rehabilitation and Prevention

Rehabilitation programs are essential for individuals recovering from Achilles tendinopathy. Gradual progression of exercise intensity, functional training, and sport-specific drills enable patients to regain strength, flexibility, and proprioception while minimizing the risk of relapse. Educating patients on proper warm-up and cool-down routines, appropriate footwear selection, and regular monitoring of training loads can significantly contribute to preventing Achilles tendinopathy in the future. One of the common errors patients make is making rehabilitation too easy, or returning to sport too quickly. Again, physiotherapy play a pivotal role in ensuring you undertake a graduated return to loading as the application of mechanical stress to the Achilles tendon promotes tendon healing and remodeling.

Conclusion

Achilles tendinopathy requires a comprehensive approach for effective management. As physiotherapists, our knowledge and expertise are invaluable in helping you overcome this condition and return to their active lifestyles. To discuss your Achilles issues with us to get you back to what you love doing, book online with Praxis today.

Until next time, Praxis What Your Preach.

Team Praxis

Stress Fractures in Young Cricket Fast bowlers: A persistent challenge

Stress Fractures in Young Cricket Fast bowlers: A persistent challenge

by | May 16, 2023 | Lower Back, Return to Sport

Lumbar stress fractures are a common and persistent injury among cricket fast bowlers, particularly adolescents. The repetitive and high-intensity nature of the bowling action places tremendous stress on the lower back, leading to the development of stress fractures in the lumbar vertebrae. With several years of cricket physio experience, I’ll explore the causes, symptoms, treatment, and prevention strategies associated with these usually season ending injuries.

Causes and Symptoms:

The primary cause of lumbar stress fractures in fast bowlers is the high volumes of repeated hyperextension and rotation of the lower back during the bowling action. This repetitive motion places excessive strain on the bony structures of the spine (pars interarticularis), eventually leading to small cracks or fractures. Adolescent fast bowlers are of particular risk as this strut of bone has yet to fully develop (as with most of their surrounding musculature) and thus is more susceptible to overload. Symptoms of lumbar stress fractures may include lower back pain, stiffness, tenderness, and discomfort, particularly during bowling.

Treatment and Rehabilitation:

The management of lumbar stress fractures requires a comprehensive approach. Initially, rest and avoiding activities that exacerbate the pain are essential to allow the bone to heal. A period of complete rest from bowling, coupled with appropriate pain management is usually recommended. A structured rehabilitation program focusing on core stability, flexibility, and strengthening exercises on the lumbar spine, pelvis and lower limbs is crucial for a safe return to bowling. Once a players has reestablished the requisite physical attributes, a graduated bowling plan is established.

Prevention Strategies:

Prevention is key in mitigating the risk of lumbar stress fractures. Fast bowlers should maintain a balanced training regime that includes multi-joint strength training, flexibility exercises, and proper warm-up and cool-down routines. Regular monitoring of workload and ensuring adequate recovery time between bowling spells can also minimize the likelihood of injury. Of particular note, is avoiding back to back days of fast bowling in adolescent cricketers.

In summary, lumbar stress fractures pose a significant challenge to cricket fast bowlers, especially those in their teen years or as they transition to junior cricket to senior cricket. A diagnosis typically requires extensive time away from bowling and requires a targeted rehabilitation plan and a cautious return to the sport. By understanding the causes, recognizing the symptoms, and implementing effective prevention and strengthening strategies, bowlers can continue to bowl fast and trouble the batsmen down the other end!

If you wanting to minimise your risk of a stress fracture, or think you may have one, feel free to consult with one of our expert physiotherapists, well versed in the cricket literature.

Until next time,

Praxis What You Preach

About the author. Stephen is an experience Cricket Physiotherapist having spent 15 years working in elite and semi-elite cricket. He was fortunate enough to have Dr Marc Portus as his mentor early on in his career. Dr Portus is an authority on stress fractures in fast bowlers having completed his PhD in the area and helped shape modern day workload parameters. Stephen’s particular area of interest is in the high performance pathways (U16-U20’s) cricket where stress fractures are often first experienced. To read more about Stephen or book, click here

Fact or Fiction Friday – Lower back Pain and MRI’s

Fact or Fiction Friday – Lower back Pain and MRI’s

by | Nov 8, 2022 | Lower Back, Pain

I need to get an MRI to help with the management of my lower back pain

Answer – FICTION

In a recent narrative review, Wang and colleagues (2018) concluded that MRI imaging in the early stages of lower back pain can have detrimental effects including more pain, less improvement, higher risk of surgery and worse overall health status. In fact, one study reported that patients that received an MRI within the first month had an 8x greater risk for surgery and 5x more medical costs!

If you do NOT present with severe neurological deficits, signs of a serious or specific underlying condition or have persistent pain >6 weeks which is unresponsive to conservative treatment then there likely isn’t a need for further investigation!

To get help with your long standing back pain or even that acute flare up, give us a call on (07) 3102 3337 or book online  so we can sort you out.

#praxiswhatyoupreach #praxisphysio #factorfictionfriday #physioeducation #preventprepareperform #pain #backpain #lowerbackpain #MRI #patienteducation

Wang Y, et al. Informed appropriate imaging for low back pain management: A narrative review. Journal of Orthopaedic Translation. 2018.

Lower Back Pain

Lower Back Pain

by | Dec 3, 2019 | Lower Back, Pain

Sharp catch of pain? Ongoing aches? Trouble getting out of bed or with long car rides? Stiff and sore when you are bending over to pick things up? Referred pain into you legs?

If you’ve experienced any of these symptoms recently you are not alone. Lower back pain is a common ailment affecting people of all ages and lifestyles with up to 80% of us experiencing various symptoms in our lifetime. Lower back pain can be caused by various factors such as poor posture, muscle strain, joint pain or underlying medical conditions.

Back pain is complex. These aches and pains are usually a sign that your spine are not tolerating loads well and are more sensitive than usual. Symptoms could arise from a subtle change in muscle balance and biomechanics, altered postures, novel or increases in training intensity or even your thoughts arounds the fragility of your spine. Physiotherapy offers effective solutions for managing and alleviating lower back pain by assessing the root cause of the pain, educating you on what is happening and develop personalised treatment plans. We also employ techniques like manual therapy, exercises, and stretches to strengthen you, improve flexibility, return you to activity and desensitise the painful area. Physiotherapy also includes education on proper body mechanics and ergonomics to prevent future episodes in activities such as lifting, sports or activitities of daily living.

Mid Potion Achilles Tendinopathy Location

Whatever the cause, our highly trained Praxis physiotherapists have expertise in this area and will help identify the problem and work with you so that you will feel empowered to fix the problem. At Praxis Physio, this is our point of difference. We promise to take the time to fix you using a range of modalities including advice, hands on manual therapies, reformer pilates and of course strength and conditioning programming.

No need to accept back pain as ‘normal’ call us now on (07) 3102 3337 or book online to have one of our physios get you back on track before your pain becomes any worse.

Team Praxis,

PREVENT | PREPARE | PERFORM

Pilates: Reforming our back pain rehabilitation (Part 1 of 3)

Pilates: Reforming our back pain rehabilitation (Part 1 of 3)

by | Jun 3, 2019 | Lower Back, Pain, Reformer Pilates

With our 30 day pilates challenge starting today, we thought we would take a look at why we love pilates so much for our patients, and what some of the benefits are. Part 1 looks at how pilates affect those with chronic lower back pain. Part 2 looks at the difference between mat and reformer pilates and part 3 looks at how often is required to see the benefit of pilates.

SUMMARY:

  • Back pain is extremely common, multifactorial, and often reoccurs
  • Strengthening interventions appear better for long term suffers of lower back pain
  • Pilates has been shown to improve muscular strength and endurance of key pelvic and postural musculature associated with lower back pain
  • Specifically, pilates promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles
  • As little as 2 sessions per week for 6 weeks has been shown to see improvements in pain and function for those with longstanding lower back pain, even after stopping pilates

Chronic low back pain (CLBP) is one of the commonest musculoskeletal problems in modern society (Anderson 1999) and is a highly prevalent in both the sporting and general public. CLBP is experienced by 70%–80% of adults at some time in their lives (Crombez et al 1999) and as such, the costs associated with LBP and related disability are enormous, causing a major economic burden for patients, governments and health insurance companies (Dagenais 2008).

Lower back pain has been one of the most extensively studied musculoskeletal conditions as a result of the prevalence and debilitation nature. Its management comprises a range of different intervention strategies including surgery, drug therapy and non-medical intervention like rehabilitation (Paolucci et al 2018). Within Physiotherapy, exercise therapy is probably the most commonly used intervention for the treatment of patients with chronic non-specific LBP due to its plausible biological rationale and low cost.

Whilst general conditioning programs to train strength and endurance of the spine musculature have been shown to reduce pain intensity and disability (Rainville et al 2004), the popularity of pilates (both mat and reformer) has helped provide an accessible and supervised form of therapeutic exercise.

EVIDENCE FOR PILATES

The Pilates method, using functional exercises aims to improve muscular strength and endurance. Specifically, the pilates method have promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles. Using the principles of progressive overload, your body adapts to the incremental loading week after week and consequently results important postural control improvement. In 2009, Curnow and colleagues showed that the Pilates method improves load transfer through the pelvis, something that intuitively helps those with CLBP.

However, a systematic review (Patti et al 2015) reported evidence that Pilates method-based exercises are more effective than no treatment or minimal physical exercise interventions in the management of chronic nonspecific LBP. Further, they pointed out that the effects of the Pilates method are only proven for patients with chronic nonspecific LBP in the short term.

A recent study by Natour and colleagues (2015) showed that the group of participants that were practicing Pilates method resulted statistically better compared with the a non exercising group who only used inflammatory medication. Those who were in the pilates group used less pain medication at 45, 90 (conclusion of the Pilates method), and 180 days, 90 days after the conclusion of the exercise program.

In conclusion, Pilates as an exercise choice is more effective than minimal physical exercise or drug based interventions in reducing pain and disability in the short-term period. There is agreement that exercise “helps” in the treatment of chronic pain, but it is still not clear exactly which factors or particular kind of exercises may be responsible of such improvements (Natour et al 2015; Patti et al 2015). Praxis Physiotherapy has always been a strong proponent of movement and loading early in rehabilitation (more on this in later blogs!).

In the next instalment, we discuss the difference between mat and reformer pilates and perhaps find some more answers regarding which exercise regime reigns supreme!

Check out all our other reformer pilates services on our website

Until next time,

Prevent. Prepare. Perform.

References:

  1. Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999;354(91789178):581–585.
  2. Crombez G, Vlaeyen JW, Heuts PH, Lysens R, Crombez G. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1-2):329–339.
  3. Dagenais DC, Caro J, Haldeman S. A systematic review of low back pain cost of illness studies in the United States and internationally. The Spine Journal 2008;8(1):8‐20.
  4. Paolucci, T., Attanasi, C., Cecchini, W., Marazzi, A., Capobianco, S. V., & Santilli, V. (2019). Chronic low back pain and postural rehabilitation exercise: a literature review. Journal of pain research, 12, 95.
  5. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J. 2004;4:106-115
  6. Patti, A., Bianco, A., Paoli, A., Messina, G., Montalto, M. A., Bellafiore, M., … & Palma, A. (2015). Effects of Pilates exercise programs in people with chronic low back pain: a systematic review. Medicine, 94(4).
  7. Curnow, D., Cobbin, D., Wyndham, J., & Choy, S. B. (2009). Altered motor control, posture and the Pilates method of exercise prescription. Journal of bodywork and movement therapies, 13(1), 104-111.
  8. Natour, J., Cazotti, L. D. A., Ribeiro, L. H., Baptista, A. S., & Jones, A. (2015). Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clinical rehabilitation, 29(1), 59-68.