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FACT OR FICTION FRIDAY || I’m too old to lift weights!

FACT OR FICTION FRIDAY || I’m too old to lift weights!

by | Dec 13, 2019 | Gym and Strength, Osteoarthritis

Answer: FICTION 🙊 Progressive strength training in the elderly (>60 years) is efficient, even with higher intensities, to improve bone health, pack on muscle and retain function. And not surprisingly, side effects are rare! Strength training increases muscle strength by increasing muscle mass, and by improving the recruitment of motor units, and increasing their firing rate. This is no different between younger and older gym goers.
Mid Potion Achilles Tendinopathy Location

It all comes down to how you train! Training with higher loads generally provokes marginally larger gains in muscle size. Intensity corresponding above 85% of the individual maximum voluntary strength can also illicit improved rate of force development compared to 60-80%. This is imperative for reducing frailty as we age.

It is now recommended that healthy old people should train 3 or 4 times weekly for the best results; persons with poor performance at the outset can achieve improvement even with less frequent training.

So if you are using age as an excuse – STOP! Don’t let your age be a barrier to trying new things or feeling strong. We are here to help with supervised sessions, a great network of PTs as well as our clinical reformer pilates classes which are a great way to start (or return) to strength training!

To book for a clinical pilates 1:1 session or to chat with a physio about how strength training can help you, head to our booking page or give us a call on (07) 3102 3337

Team Praxis

PREVENT | PREPARE | PERFORM

References:

Mayer, F., Scharhag-Rosenberger, F., Carlsohn, A., Cassel, M., Müller, S., & Scharhag, J. (2011). The intensity and effects of strength training in the elderly. Deutsches Ärzteblatt International, 108(21), 359.

Lopez, P., Pinto, R. S., Radaelli, R., Rech, A., Grazioli, R., Izquierdo, M., & Cadore, E. L. (2018). Benefits of resistance training in physically frail elderly: a systematic review. Aging clinical and experimental research, 30(8), 889-899.

FACT OR FICTION FRIDAY || Knee Pain and Scans

FACT OR FICTION FRIDAY || Knee Pain and Scans

by | Dec 6, 2019 | Knee, Osteoarthritis, Pain

Answer: FICTION 🙊

“Osteoarthritis” is a common term that gets used by our patients as an explanation of their knee pain. But is this always the case 🤔?

🔍In a recent systematic review estimates of osteoarthritis feature prevalence on MRI among asymptomatic uninjured knees were up to 14% in adults < 40 years, and up to 43% in adults > 40 years!

Whilst features on MRI imaging such as cartilage defects, meniscal tears and osteophyte lesions can potentially play a role if you have pain, this should always be interpreted in the context of your clinical presentation by a health care professional as these changes can be normal in an asymptomatic population – just like grey hair as we age 👴👵!

If you have knee pain and have resigned yourself to a ‘life sentence’, come and have a chat to one of our physios to ensure you aren’t robbing yourself of a full functioning future 🕺🏃🏌️🏄🏋️🏊🚴🏂🎾! Call 07 3102 3337 or book online 

#kneeoa #praxisphysio #factorfictionfriday #preventprepareperform #kneepain #kneeosteoarthritis #mri #fullfunctionfuture

Reference:

Culvenor AG, Øiestad BE, Hart HF, et al Prevalence of knee osteoarthritis features on magnetic resonance imaging in asymptomatic uninjured adults: a systematic review and meta-analysis British Journal of Sports Medicine 2019;53:1268-1278.

Pilates: Mat vs Reformer Pilates (Part 2 of 3)

Pilates: Mat vs Reformer Pilates (Part 2 of 3)

by | Jun 21, 2019 | Reformer Pilates

In part one, we unearthed that pilates has a role to play in reducing the severity of chronic lower back pain. In part two, we tackle a common question from our patients and delve further into the research to see if there is a difference between mat and reformer pilates.

SUMMARY:

  • A reformer is a large piece of pilates equipment that utilises a spring mechanism to apply load in various positions and degrees of loading from gravity.
  • Both forms of exercise are better than the ‘wait and see’ or pharmacological approach with respect to chronic lower back pain
  • The use of reformers may provide a larger stimuli to the sensory system which facilitates proper performance due to better stabilisation
  • Pilates promotes the restoration of the function of muscles involved in lumbopelvic stabilisation, that is, transversus abdominis, multifidus, diaphragm and pelvic floor muscles (the “core”)
  • Reformer pilates provides more options for strengthening, ideal for those recovering from injury, pregnancy or surgery

 

As a general rule, the aim of pilates is to restore or sustain the motor control of the lumbar spine and proper body posture. Joseph Pilates (the founder of pilates) believed beginning exercise in the horizontal plane was important to relieve the stress and strain on the joints, and to align the body before adding additional gravitational forces while standing, sitting or kneeling.

Both mat and reformer are popular types of pilates which both focus on strengthening. Mat pilates, as its names suggests is a floor based method that tends to use bodyweight as the chief form of resistance.

Reformer, is the most popular equipment of Pilates. The design of Reformer utilises a spring mechanism that the person works to control while moving in various planes (Bulguroglu et al 2017). Reformer pilates allows more exercises compared to a mat and it provides the option of performing exercises numerous body positions – from your back, side, stomach and being seated — and also on your feet or knees.

COMPARE THE PAIR

Not a great deal of research has been conducted on differentiating the two forms of pilates. What studies do exist tend poorly define what equipment was used or whether individual tailoring of the sessions occurred.

Luz et al compared the effectiveness of Pilates mat and equipment-based Pilates exercises (with the use of Reformer) in a group of 86 individuals with chronic lower back pain. The 6-week routine included individual, 1-hour sessions performed twice a week and supervised by a Pilates-experienced physical therapist. The outcome measures were: pain intensity, disability, global perceived effect, patient’s specific disability and fear of movement, known as kinesiophobia (Luz et al 2014). The assessment was recorded after 6-week intervention and 6 months. A significant difference was noted in both groups after a 6-week programme in all of the areas evaluated. After 6 months however, a significant difference was found in disability, specific disability and kinesiophobia in favour of equipment-based Pilates exercises (Luz et al 2014; Eilks et al 2019).

 

In the study by Cruz-Diaz et al, the influence of Pilates mat exercises and equipment-based Pilates exercises (with reformer) on pain, disability, kinesiophobia and activation of transversus abdominis (expressed as a change in muscle thickness and assessed by real-time ultrasound examination) was assessed. The trial involved 98 patients with chronic lower back pan (CLBP) allocated to three groups: Pilates mat exercises, Pilates apparatus or the control group. The programme was conducted in groups of four participants during 12 weeks with 50 min sessions (twice a week). The evaluation was carried out during intervention (6 weeks after baseline) and after 12 weeks. As with Luz et al, significant improvement were shown in both groups for all outcome measures after 6 and 12 weeks. However, in the comparison between groups, the superiority of equipment-based Pilates was noted (Cruz-Diaz et al 2017). In both studies, it was suggested that the finding may be an effect of the use of apparatus in exercises that provides larger stimuli to the sensory system, resulting in larger feedback, which facilitates proper performance due to better stabilisation (Eilks et al 2019). According to da Luz et al, this result may also be caused by a placebo effect inherent for the application of equipment. As noted earlier however, reformer pilates offers a larger scope of exercises to draw upon for those who are limited by pain, weakness or fear of movement. So there you have it. What little research there is suggests that any pilates is good for your rehabilitation or as a part of your ongoing strength program. However, it appears that reformer pilates is more effective, and allows a greater degree of variability of training. For more about what makes Praxis Pilates special, check out our website here. Join us for part 3 next week where we look at what the research suggests regarding the frequency of pilates. Is more actually better? Till next time – Praxis what you preach Prevent. Prepare. Perform

References:

  1. Eliks, M., Zgorzalewicz-Stachowiak, M., & Zeńczak-Praga, K. (2019). Application of Pilates-based exercises in the treatment of chronic non-specific low back pain: state of the art. Postgraduate medical journal, 95(1119), 41-45.
  2. da Luz Jr, M. A., Costa, L. O. P., Fuhro, F. F., Manzoni, A. C. T., Oliveira, N. T. B., & Cabral, C. M. N. (2014). Effectiveness of mat Pilates or equipment-based Pilates exercises in patients with chronic nonspecific low back pain: a randomized controlled trial. Physical therapy, 94(5), 623-631.
  3. Bulguroglu, I., Guclu-Gunduz, A., Yazici, G., Ozkul, C., Irkec, C., Nazliel, B., & Batur-Caglayan, H. Z. (2017). The effects of Mat Pilates and Reformer Pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation, 41(2), 413-422.
  4. Cruz-Díaz, D., Bergamin, M., Gobbo, S., Martínez-Amat, A., & Hita-Contreras, F. (2017). Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complementary therapies in medicine, 33, 72-77.
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.
Congratulations 30 Day Challengers

Congratulations 30 Day Challengers

by | Jul 20, 2018 | Uncategorized

Final measures have been taken. Numbers crunched and the results are in…

But first, a massive congratulations to all our 30 Day Challengers who recently completed a gruelling but rewarding 30 days of Reformer Pilates. Participants completed a suite of baseline strength measures (recording maximum repetitions) on the reformers and then underwent a structured program devised by our clinical Pilates guru’s Emma, Karen and Kylie. No two workouts were the same and challengers used their 20 classes over the 30 days to take giant strides in improving their pilates technique and strength.

We had an eager and wide range of participants from the sporting to the previously sedentary office worker. All participants have reported how strong they feel after only a month with further benefits felt in enhanced posture and energy levels.

During this challenge, our participant’s average improvement to their baseline testing was more than 80%! Special mentions to Dominique P, whose push ups went from 15 to 43 repetitions. Sandra L doubled her ab curl ups to record the highest measure of 120 reps and increased her scooter lunge a whopping 55 reps!

But there can only be one winner from each clinic. Our winners were *drumroll please* Michael B. from Club Coops Carseldine and Siobhan E. from the X-Centre in the Valley. Michael in particular blew the competition away with calf raises progressing from 38 to 105 reps, footwork (on all springs) from 40 to a mammoth 120 reps! Not to be outdone, Siobhan almost doubled her abdominal curls to 118 and added almost 40 reps to her Scooter lunge!

Michael and Siobhan each receive a FREE 5-Pack as a reward for effort and dedication during the colder months of the year! Great stuff!!

Congratulations again to all our participants and our winners Michael and Siobhan. Stay tuned for the next challenge date which we’ll have a few added surprises and bonuses included!

Yours in Health,

Praxis Pilates – Prevent. Prepare. Perform.