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The 7 keystones to joint health: # 1 posture, alignment, technique

Does the way you move, your posture affect your joints?

The first keystone habit of healthy joints is movement quality, your posture, alignment and technique.

There is a principle in exercise physiology called Wolf’s Law…cool name eh, which states

“The body will adapt to the forces applied to it”

This means that the way we navigate our bodies in space will directly affect how our bodies adapt to that movement. So if you move poorly, with bad posture, poor joint alignment and exercise techniques chances are your body will not adapt favourably over time to those loads.

Movement quality matters

Also the load frequency, duration, and intensity matters

For example its been shown that for runners the best type of footwear isn’t the ones with the best shock absorbing, latex stretching, pronation controlling inner heels.

Its weather the shoe feels comfortable

Translation, the big shoe companies are making a lot of money selling stuff to runners that probably really don’t matter.

Shoe comfort and a well designed pregressive running program are the two best areas to pay attention to for all my running friends out there.

Let’s look at resistance training, lifting weights to create a change in the body tissues, including muscles, ligaments, tendons, cartilage, connective tissue and fascia. Each of these tissue types respond differently to exercises, and adapt at different rates. For example muscle change pretty fast, your biceps will start to pop in a few weeks of mirror curls. However the biceps tendons take about ten times longer to adapt, so we need to allow time for the biceps to catch up. This is often where plateaus come from, the body is waiting for other structures to adapt, get stronger before leveling up. This is a super intelligent system, because even though the muscle can handle more force, the tendon can’t, so the body essentially regulates how much you can do. When folks try to push past this, is where injuries can happen.

This also works in the reverse

If you are not using muscles, tendons, ligaments, cartlidge, if they are not being loaded, or used, then the body basically will use its precious resources elsewhere, (muscles is expensive to maintain metabolically), resulting in your muscles and joints getting weaker, smaller, and less resilient.

Or, you simply get weaker, and frail

Being weak and frail is a pretty big risk to injury. If you’ve been sedentary for many years, with poor posture, sitting on your but playing video games, watching netflix or cruisin you tube for 8 hours a day, your body will adapt to those poor positions

Bend over to pick a pen off the floor and your back goes out

Squat down to grab that bottle of milk from the bottom shelf at the supermarket and your knee goes pop

Reach over your shoulder to grab the seat belt and your neck jams up

Get up out of bed and it takes you 20 minutes to iron out the stiffness in your lower back

Elevator is out of action so you have to take the stairs, but have to stop half way to catch your breathe

These are all examples of the body adapting to your current movement habits. If you don’t have an exercise practice, then you are setting yourself up for some trouble. It may not happen quickly, but over time you will notice that you have to start to plan what used to be easy daily tasks

If i go for a walk, will my hips hurt the rest of the day

If I do too much lifting at work, will my back be OK for the weekend, don’t want to be laid up on the couch because I tweaked it again

I’d love to do that fun run with my daughter, but my dodgy knee won’t let me

Its when your joint pain stops you from doing things you really want to do that most folks seek out help. Pain is a big motivator, and it sucks to be in pain, especially if its been there for a long time.

So here’s the good news

The majority of joint pain problems respond really well to exercise

In fact, in a HUGE study on back pain last year the authors found that the  two best things someone can do for lower back pain was psychology and exercise

Mindest and movement

Exercise helps build great psychological habits, a powerful mindset drives great exercise habits. The two are so closely linked I could write a whole blog post on it..which I probably will

The key to using exercise to move well, develop awesome posture and reduce your joint pain is to work with a good coach who can teach you how to do it safely.

Now as an Exercise hysiologsit im certainly going to recommend working with one, heck we go to university for 4-5 years to learn how to assess, prescribe and coach exercise for folks just like you. However you could also start with a great yoga or pilates instructor, a personal trainer who appreciates movement quality, or our allied health partner in movement, physiotherapists.

The key is to find a Movement professional who has solid experience, understands your specific needs, and you feel you can work with.

Invest your time and money in hiring a great movement coach to help you. Consider the real value in being able to move pain free before you balk at the cost of an exercise coaching session. When you consider the cost of medication, specialists vists, potential orthopedic surgeries and procedures, time off work, versus the cost of a 3- 6 month exercise program, that once you complete, you will have that skill set of moving well for the rest of your life, is a cost that when put into perspective will seem like an absolute bargin.

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The 7 keystones to healthy joints #7: How joint health coaching can help you

The 7 Keystones to Healthy Joints

In this blog series I want to share with you my thoughts on how to address joint pain effectively based on my 20 years of clinical experience helping folks move better, reduce their pain, and live an active and healthy lifestyle.

I acknowledge I have a bit of a diverse background. Being an Exercise physiologist and Acupuncturist, so the filters i use combine both eastern and western health sciences and practices.

Having experienced some pretty horrible joint pain myself, a chronic lower back problem sustained after a fall, and a Grade 3 medial Collateral Ligament tear and a meniscus “bucket” tear from a workout that went pair shaped I have fist hand experience in both acute and chronic joint pain

They both are not much fun

Last year my mum had a Total Hip replacement, a bone on bone hip that needed a new joint. We spent 12 months doing pre hab, and since he has bounced back after surgery, back in the garden doing what she loves.

Weekly in my studio I see mostly musculoskeletal pain clients, folks with arthritis, sports injuries, and back pain. I’ve been doing this for 20 years, and I’m still studying and learning about the body so  I cna help folks get out of pain.

Lets be honest, being in pain sucks, but the pain is there for a reason, its telling us there’s something not quite right, its the bodies intelligent way of protecting us.

The problem is often that we fail to cover all the bases on how to help the body heal. And this is what this blog series is really about. The 7 keystones of healthy joints is what i’ve observed really help folks get out of pain, move better, and get back into their life

What ive noticed is the reductionist model of Western medicine we tend to look at one aspect of a problem, however my Chinese medicine training has taught me that we need to look at the system as a whole, human biology is pretty darm complex, so we need to weave all the elements together to help the body heal.

Move away from symptom based treatment, to looking at addressing the fundamental cause of joint pain. I call this playing the long game, and outside of trauma “oh shit” injuries that cant be helped (falling out of a tree) the majority of chronic joint issues are closely linked to a person’s lifestyle, how the exercise, eat, sleep, think, and work.

To really get of pain we need to look at the whole picture

But before I dive down that rabbit hole, let’s get a little bit of context of just how big a problem joint pain is.

Below is some sobering statistics from Austalian Government reports

Here is my four point summary

  1. Joint problems are the 4th biggest health issue in australia
  2. As you get older they tend to get worse
  3. Exercise and Nutrition are really important to deal with joint problems
  4. It’s way cheaper to prevent them, than trying to fix them

Take a minute to read over some of the key elements from the Australain Govournment reports

  1. Musculoskeletal conditions are defined as conditions of the bones, muscles and their attachments, and include joint problems such as arthritis. Although there are more than 100 musculoskeletal conditions the most common are osteoarthritis, rheumatoid arthritis, osteoporosis and back pain
  1. Osteoarthritis is a degenerative joint condition affecting the weight-bearing joints such as the hips, knees and ankles as well as the hands and spine. In the initial stages pain occurs in the joints during and after activity but as the condition progresses pain may be experienced from minimal movement or during rest
  1. Rheumatoid arthritis is an auto-immune disease causing chronic inflammation of the joints. It most commonly affects the hand joints and can lead to deformities of the hands
  1. Osteoporosis is a condition whereby there is a progressive loss of bone density and decrease in the strength of the skeleton with a resultant risk of fracture
  1. Chronic back pain can be attributed to numerous causes including muscle strain or the displacement of an intervertebral disc
  1. In 2001, 32% (6 million) of the population reported having a disease of the musculoskeletal system and connective tissue as a long-term condition, where the condition lasted, or was expected to last, six months or more.
  2. Musculoskeletal conditions were the fourth leading contributor to total burden of disease in Australia, with back pain and problems, osteoarthritis and rheumatoid arthritis being the greatest contributors to the musculoskeletal burden.
  1. Musculoskeletal conditions are highly prevalent, affecting 30% (6.9 million) of all Australians in  2014–15, based on self-reported data. This includes 3.7 million people with back problems, 2.1 million people with osteoarthritis, 0.8 million people with osteoporosis and 0.4 million people  with rheumatoid arthritis
  1. In general, these conditions are more common in women than men, and more than half of those Australians with musculoskeletal conditions (61%) are of working age (25–64).
  1. Musculoskeletal conditions are a significant cause of disability and have a strong negative effect on a person’s quality of life, affecting the ability to participate in self-care, work, family and social activities. In 2015, 31% of people with disability reported having musculoskeletal conditions
  1. Data from the Bettering the Evaluation and Care of Health (BEACH) survey of general practitioners suggest that, in 2015–16, musculoskeletal conditions were managed at a rate of 18 per 100 encounters (Britt et al. 2016). Hypertension is the most frequently managed problem, managed at 75 in 1,000 general practice encounters in 2015–16 (Britt et al. 2016). In the same period, back complaints were managed at 31 in 1,000 general practice encounters and osteoarthritis was managed at 26 in 1,000 general practice encounters (Britt et al. 2016).
  1. With almost 7 million Australians having musculoskeletal conditions, resulting expenditure on health services is substantial. For example, in 2008–09, musculoskeletal conditions were the fourth largest overall contributor to direct health expenditure in Australia, accounting for 8.7% ($5,690 million) of total health-care expenditure after cardiovascular disease, oral health and mental disorders
  1. In 2011, the leading causes of burden due to musculoskeletal conditions were ‘other musculoskeletal conditions’ (35%) and back pain and problems (31%). The remaining burden was distributed across osteoarthritis (17%), rheumatoid arthritis (16%)
  2. Females experienced a higher proportion compared with males for osteoarthritis (66% females; 34% males), rheumatoid arthritis (64% females; 36% males) and ‘other musculoskeletal conditions’ (52% females; 48% males).
  1. There was no difference by sex for back pain and problems (50% males; 50% females).
  1. People aged 45 and over experienced the majority of the non-fatal burden for ‘other musculoskeletal conditions’—72% for those aged 45 and over compared with 28% for those  aged 44 and under.
  1. People aged 64 and under experienced the majority of the non-fatal burden for osteoarthritis (52%), rheumatoid arthritis (63%) and gout (58%) compared with people aged 65 and over (48%, 37%, and 42%, respectively).
  1. People aged 54 and under experienced the majority of the non-fatal burden for back pain and problems (60%) compared with those aged 55 and over (40%).
  1. overweight and obesity contributed to 10% of the total burden due to all musculoskeletal conditions, 45% of the burden of osteoarthritis, 39% for gout and 7.5% for back pain and problems
  1. occupational exposures and hazards contributed to 5.4% of the total burden due to all musculoskeletal conditions, and 17% of the burden due to back pain and problems
  1. A large proportion of the burden of osteoarthritis and gout was attributed to overweight and obesity, suggesting that a reduction in the prevalence of this risk factor may also reduce the level of burden associated with specific musculoskeletal conditions.

SOURCE: The burden of musculoskeletal conditions in Australia: a detailed analysis of the Australian Burden of Disease Study 2011 we can see that joint problems are a big deal

Ok, so now we know the problem is legit, joint health effects a lot of people, and that means there’s a lot of folks suffering with pain.

Its my mission to help folks get out of pain, move well, and enjoy an active and healthy lifestyle. To do that actually requires a huge amount of skills, habits and actions, that need to be practiced, over a long period of time.

Simply taking pain medication of anti inflams won’t do it

Simply exercising more won’t do it

Simply taking the latest fad supplement won’t cut it

Where i see people going wrong is that they are trying to fix their joint problem with only 1 tool, when they really need a who tool kit

So I want to share with you my method of helping folks get out of joint pain using the 7 keystones of healthy joints

Its an integrated approach combining exercise science, nutrition, change psychology, controlling your environment, learning how to manage pain and inflammation, and restoring your digestive system health

Of course if you want to work with me to get out of pain you are welcome to reach out and inquire about how I can help you in person. It is also my hope that this blog series will give you some insight on how to help yourself, there may be just one or two pieces of your joint pain puzzle that you’ve been missing.

Take a few minutes to watch my first VLOG that outline the 7 keystones to joint health.

Either way, I’m here to help

Cheers

drew

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The 7 keystones to healthy joints #6: Does eating clean help your joint pain

Hell yes eating a good diet is vitally important to healthy joints, and here is why,

Your body is in a continual state of cellular upkeep, cleaning up the cell bits and pieces that are broken, used, or no longer needed (waste product), and replacing them with clean, happy cells ready to get to work.

The place you get the majority of your new cells is thought the food you eat, and the fluids you drink. As you digest your food your body slowly extracts the buildings blocks its needs to conduct repair and restoration.

Your joints need building blocks to repair, and grow stronger

If you are eating a poor diet, typical of the modern western diet which is highly processed, lots of sugar, high in inflammatory saturated fats like canola oil or margarine, and eat foods which contain lots of artificial flavours chemicals and additives then you will not be supplying good quality nourishing building blocks to the cells

You joints simply don’t have the tools they need to work well, and even though it won’t happen quickly, the joints will start to suffer.

Additionally if you are eating a typical standard western diet it’s going to be choc full of foods that seem alien to your digestive system, food that your body simply doesn’t have the chemical machinery to absorb, breakdown, and use in the body, when this happens the body reacts like the food is a foreign body, and mobilises a low grade inflammation response, trying to deal with thee foods in disguise that it can’t really do anything with.

The most common examples of this include gluten and diary, which contain proteins in them that most humans don’t have the right combination of enzymes to metabolize. The gastrointestinal problems therese food types can cause for folks are well documented. Simply reducing the intake of foods which you know cause a bad reaction can make all the difference in your body and joint health.

Now if you diet is consistently crap, then over time your bodies army of healthy bacteria, whose job it is to break down the food, to help you digest it, will start to weaken. This sets up a vicious cycle of poor digestive health, poor absorption of food. Once your ability to absorb nutrients is comprised, its harder for the body to maintain the general upkeep of cells, and they gradually begin to decline in robustness and health. Combine this increase in body weight, poor biomechanical loading, lack of exercise and all of a sudden your joints begin to hurt.

Where folks go wrong when trying to fix their joint issues is in addressing one thing only, so they may start exercises, but unless they address the pro inflammatory diet, the exercise could in fact accelerate tissue degeneration as there no building blocks to repair the cells and deal with the micro inflammation of exercise. Or they address the nutrition peice, but neglect sleep and exercise. Its really a 360 degree, all around lifestyle overhaul that needs to happen to really create healthy joints, and if you think that joint surgery will magically fix your issue with a new knee or hip, what you really are doing is just prolonging the fourth deterioration of the joint as most joint replacement have a shelf life of 6 -10 years.

When the body breaks down its own tissues for resources, it’s called catabolism, like when stored sugar, or glycogen is released into the bloodstream to make fuel available for cellular work. When the body stores metabolic resources, its called Anabolism, perhaps made famous by anabolic steroids, used to grow muscle.

If the rate of Catabolism (breaking down) is greater than the rate of Anabolism (storing / building) then tissues will gradually wear down, and this is the basic mechanism of osteoarthritis, where the cartilage that sits between joints, which acts as a cushion to absorb forces, and keep bony surfaces off each other, is worn away.

Eating a healthy diet, that is rich in amino acids / collagen (proteins), minerals and vitamins (fruit and vegetables) and healthy fats (avocado, coconut oil) will go a long way in helping your body supply the joints the metabolic resources it needs to build and repair tissues. Additionally  a diet which is predominantly focused on rebuilding digestive health, minimises pro inflammatory foods like saturated fats (canolla oil) and promotes tissue health will be well suited to reducing pain and inflammation in the joints.

The mindset that really helps is to think about joint health starting in your gut, what you eat can directly effect how your joints feel, and the healthier your digestive system, the more robust your skeletal system will be.

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The 7 keystones to healthy joints #5: Is inflammation causing your joint pain

Being in pain is not fun at all, and if you have had joint pain,particularly the type that’s been there longer than 6 weeks, it’s probably chronic. So the question is, what’s actually causing the pain and inflammation of the joint, and how do you fix it.

To better understand pain in relation to your joints it helps to appreciate the healing time frames of soft tissues structures, bones, ligaments, cartilage, tendons and muscles.

Muscles a couple of weeks

Bones a few months

Tendons and ligaments 10 -12 months

Cartilage 12 – 18 months

So a muscle injury will heal up pretty quick, a bit of physio, acupuncture and massage therapy and you’ll be good to go. Bones are pretty straight forward, a good 12 weeks generally sees a unification of the broken bones, and then allow another 18 months for the bone to fully harden.

Where it gets trickier is with the connective tissues structure of cartilage, tendons and ligaments. Generally these structures have poor blood supply and rely on passive movement to move nutrients into the cells to facialte repair. Its when the repair rate of the tissue is slower the wear that degenerative changes often start to occur. The muscles heal quickly, the rest takes a lot longer, and when folks don’t allow that naturally healing process occur is when issue really start to raise their heads.

Pain and inflammation are signals from you body that there is something not right with hat area of the body. How the body interports the pain is rather complex, with most processing occurring in the central nervous system, the brain. The brain number one job is to protect the body, so if it senses danger to the system, often triggered by firing of mechanoreceptors in the joints, and specialised nerves (nociception) in the muscles, tendons, fascia and ligaments.

What triggers these nerve fiber pain response has been the subject of intensive study, and what we are learning is that often the pain we experience, particular if longer than 6 weeks, don’t always add up to what’s anatomically, or structurally damaged.

For example we could get an MRI study of 10 peoples lower backs that all showed disc herniations of the same type and location. But each person would have a very different response to how it feels. Some may be in a pretty bad way, experiencing lots of pain, others may feel discomfort but nothing drastic, where others may not even have been aware there was a problem.

Pain is a unique experience to the individual, just because your friend had a dodgy knee from running, does not mean you will. There are simply too many variables to consider when working with pain.

Pain is often a protection mechanism, trying to avoid further injury to structures, which is why its very important to get the right advice, guidelines and structured exercise to teach the brain that its ok and safe to exercise, even if there ids still pain.

The brain is the ultimate learning machine, and if we can layer the appropriate stimuli the pain signals can be desensitized, meaning, movement that may have caused a pain response either no longer do, or are significantly reduced. Often folks with joint pain are afraid to move because either cause pain and they fear doing further damage. However as we know, decreasing physical activity will create inactivity loop which will weaken the joint, and thus increase forces going through it, further causing pain.

Inflammation is the reaction of the body to injury, or damage to tissues. If your joints are inflamed its either because it’s in the early stages of healing and repair, a totally normal process, or its chronic, and the body is responding to an unfavorable environment, this my be continually trigger pain receptors which makes the body thin kits still in the early phases of healing, or, as we are starting to understand inflammation is coming from somewhere in the system , and if manifesting in the joints as an autoimmune response.

So the two big causes of inflammation in joints is mechanical, or a auto immune response

Mechanical inflammation simply means that you keep creating micro injuries to the tissues and joint structures. This is either caused by the wrong type of rehab protocols, and exercises appropriate to your joint issue (too much, not enough, or poorly done), or, you keep doing something habitually that you may not be connecting to the joint problem. For example you may have a sore neck from working at a computer with the monitor setup at the wrong angle. The poor angle place you neck in an extended position for long periods of times which is triggering pain in your neck joints or muscle

Inflammation is very closely related to nutrition, with a lot of research highlighting the links between the gut biome and joint health which we will discuss in more detail int he next blog. Suffice to say, if your diet is rubbish, and you have joint pain, its going to be really hard to heal and repair simply because your body doesn’t have the right building blocks to repair tissues with. It would be like trying to put out a bush fire with a water pistol.

The key habit of healthy joints is to dig deeper into what is actually causing your pain, why is there, what is it that you are doing in your day to day life that is predisposing pain and inflammation in your body, in most instances there’s usually something that’s causing the pain

Working with an Exercise Physiologist can help you work out your pain triggers, and develop strategies on how to turn down those pain signals, decrease inflammation and start you on the path to join health and longevity.

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The 7 keystones to healthy joints #4: How does sleep effect your joints?

Sleep is where your joint heal, if your sleep is poor, the micro damage that’s done through the day doesn’t get a chance to be completed, gradual deterioration of the your tissues health can be linked to poor sleep.

In simple terms your body has two switches that hoover on in the background, always working at some level, the “on” switch, the sympathetic nervous system is related to getting shit done It is the fight  or flight system designed to make you alert, and ready for action. Adrenal cortisol and other stress hormones are active to help you move your body, do work, and basically get after it. Glucose is released to fuel muscle contraction, and, and the slower metabolic fuel pathways, such as fat metabolism, are put in the back of the que as they take longer to work. In this state you body is highly alert, active and stimulated.

The “off” switch is the parasympathetic nervous system, where it essentially reverses the action of the sympathetic nervous system. It facilitates digestion, restoration and regeneration of tissues, which can be down if you are sympathetically stimulated. The cells use this time to clean up, and tidy up, getting rid of any residual waste from the days activity, and replacing them with healthy metabolic machinery to prepare for the next days activity. Muscle protein synthesis and anabolism occurs at rest, meaning the muscles repair and grow whilst you sleep, and the same happens for cartilage in the joints, just a little slower as the blood supply is not as abundant in cartilage than in muscle. That’s ok because cartilage is generally a lot tough tissue, taking a lot more to break it down.

The important thing to understand if you are not getting good quality sleep consistently then your body is in a constant state of stress and repair, not being able to find a a homeostatic balance where tissue demands are met by good nutrition and recovery, including sleep.

Sleep is a critical habit of healthy joints, as they are able to recover from the stress of the day and come out the other side just that little bit stronger, robust and mobile, the goal for healthy joints.

The formula to getting good sleep is pretty simple, the application however can be tricky as they are all closely tied into daily habits

Good sleep = go to bed early = decrease blue light exposure + minimise stress + avoid stimulants + make sure your bedroom is dark and cool

So for someone who stays up late, on their computer, playing stimulating video games or watching TV shows, whilst drinking red bulls, coffee or alcohol, with light on in the room is probably not going to get a really restful sleep. Do that over weeks, months, and years and you are essentially training the body to operate in a stressed environment during the time it should be switching to rest, recovery and regeneration mode.

If you want to start working on creating healthy joints, then it absolutely pays to focus on good quality rest, recovery and sleep. Try not to fall into the grind and burn trap, where more work, harder workouts, long days are somehow going to make you superhuman, because what’s most likely to happen is you’ll just simply burn out from the stress.

Take some time to really listen to your body, set yourself up to have a brilliant day by have a good sleep


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The 7 keystones to healthy joints” #3 does your weight effect your joints

So the simple answer is yes, your weight will affect the health of your joints.

There are two ways that being overweight can lead to joint issues, being increased mechanical stress commonly seen in Osteoarthritis, and inflammatory markers we often see in cases like Rheumatoid arthritis. In fact reducing systemic inflammation is a keystone to healthy joints, which we will cover in more detail in our 5th blog.

So how does being overweight contribute to wear and tear of the joints?

Well , like all things in the body, the mechanisms are complex, and there is still a ton of research being done on the best ways to avoid joint wear and tear, but the general model for mechanical joints issues relates to

  1. Increase forces going through the joints
  2. Shifts in center of gravity
  3. Uneven loading through joints
  4. Decrease in physical activity as weight increases

So lets take a look at each of these

Increase forces  going through the joints

When walking for example, the force on your knees is equivalent to around one and a half times your body weight. So if a 90 kg person is going for a walk, there’s about 136kg of forces going through the knees, and that’s just on a flat, even surface at a comfortable pace.

Now add in an incline and the forces start to really ramp up, going up and down a flight of stairs can easily be two – three times bodyweight of force going through the knees. So if our 90 kg walker started to go up a flight of stairs we are looking, his knees will start o fell loads of 180 – 270 kg. If you squat down to tie your shoes or pick up an object off the floor then the forces are even greater up to five to six times body weight

These are considered to be fairly normal tasks, walking, climbing a set of stairs, and tying your shoes, however the more excess body weight you have the harder it gets to do, and the more forces are placed on the joints.

Now if exercise is structured and graded correctly to suit the individual’s unique body demands then exercise for folks who are overweight is highly recommended. However too much, or not enough of the right type of exercise can lead to excessive joint wear and tear, setting up common issues such as degenerative arthritis, meniscus tears, and joint pain.

Shift of center of gravity

Your center of gravity is the point where the mass of your body distributes evenly in the body, and for us bipedal humans, it usually sits just below the belly button. The center of gravity shifts as the body changes shape in space, for example if you squat down, your center of gravity lowers, if you lean out to one side, your center of gravity shift slightly tot he side you lean toward.

Now as folks increase in body weight, or lets call it what it is, they get fatter )increase adipose tissue storage) they tend to store the extra kilograms in region of the body. For men it tends to be more on the belly, for women hips and thighs. We don’t really have any control on where the body stores extra fat, it distributes evenly across the body to maintain balance. The issue becomes for those folks who are really starting to increase body weight, that the center of gravity starts to shift, generally anteriorly as the majority of stored fat goes on the belly hips and thighs. This extra loading creates an anterior rotation of the pelvis, which in turn changes the angles of the knee, hips and lower back joints, leading to a change in the load distribution through the joints

Uneven loading through joints

In essence the loading starts to become uneven through the skeletal system, and with the uneven loading we see structural changes occur in the muscles, bones, joints and ligaments. For example as the hips tilt more anteriorly it tends to create a medial  bend in the knee joint, which then loads up the meniscus unevenly. This uneven loading can produce changes in the cartlidge, which in a balanced system will favourably respond by growing more collagen fibres, and generally becoming a tougher tissue abel to handle the increasing loads. However, as we saw from above, increase weigh can really ramp up the forces, and with the increase forces distributed unevenly we start to set up a gradual wear and tear process.

Decrease in physical activity as weight increases

So as folks increase in body weight, and joint pain starts to become an issue exercise becomes increasing difficult. At first the stairs were just hard to get up, a little knee stiffness, and aching, with some huffy puffiness at the top as you catch your breath. Then you start to skip the stairs and take the elevator, because well its just a bit easier. Next week you try the stairs again and find it harder than before, so you just stop taking the stairs altogether and the elevator is your passive mode of transport up to the office.

You have effectively stopped doing one of the most important things you can do to prevent or help with your knee pain, exercise.

The right type of exercise is absolutely critical for joint health and longevity. Sure your can get away with poor form squats and deadlifts for a little while, but sooner or later those bad reps add up. We know for example that a disc herniation is rarely a traumatic, good to bad injury, but rather a gradual build up of wearing down the discs structural integrity, in some studies they suggest about 20,000+ repetitions before the discs start to wear…so those 100 situps a day seem like a good idea, but they could potentially be doing you long term harm, particularly if your program is not designed to promote systemic muscular balance, reduce loading forces,  and address uneven joint distribution.

We also know that joints love the right amount of loading, they respond very well to the correct amount of load, it promotes growth and healing of the joints and is a critical aspect of healthy joints. Additionally exercise is pretty darn handy if you want to lose weight, the benefits of relating metabolism with good diet, and an intelligent approach to exercise can literally save you years of pain and discomfort, and will save you a ton of money by avoiding surgeries, time of work, and countless visits to doctors, specialists and symptomatic treatments.

Ig you are overweight, and have joint pain and not sure where to start that’s ok, its can be pretty scary, and a little confusing on what’s the best thing to do. Thats where Exercise Physiology can help, as a specialist in exercise I can guide you through the step by step process of restoring your joints to optimal health, so you can go for a walk, take that flight of stairs, and do your shoes up without the fear of paying for it later.

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The 7 keystones to healthy joints” #2 should you exercise if you have joint pain

Last week I had a new client in studio who was concerned about her knees, she’d just come back from the doctor who told her recent MRI showed her knee was pretty much worn out, and she’d most likely need a knee replacement. The doc recommended she work with an Exercise Physiologist, but she was unsure;

“How can I exercise on my knee when its so sore.”

We sat down and had a bit of a chat about her knee pain. The buildup of her knee pain took a few years, after a fall at work where she tore some cartilage in her knee. She had pretty much accepted the fact that she was going to get a knee replacement, because dodgy knees are in her family.

She’d also stopped going to the gym because it hurt too much too squat, when i asked did she get any advice on it she admitted she thought it wouldn’t help, so left it.

So we spent some time talking about ways we can exercise safely, even when theres “dodgy worn out knee”. She was surprised to learn that exercises is really effective in helping folks manage joint pain, if it’s done in the right way.

The key to exercising when you have joint pain is to first understand the nature of the pain, whats actually causing the problem, it could be:

Mechanical – incorrect or poor movement quality, exercise technique, postural loading

Structural – there may me some anatomical uniqueness in your joint which can cause the spaces between the joints to be smaller, or create impingement

Traumatic – perhaps you were playing netball, landed awkwardly and twisted your knee

Inflammatory – you may have an autoimmune response like Rhamatoid Arthritis which cause joint pain

To find out what’s causing your pain try touching base with a Physiotherapist, Exercise Physiologist, Chiropractor, and Osteopath.

As a guideline I would recommend touching base with one of the four allied health professionals as they spend 4-6 years at university training to work specifically with musculoskeletal conditions.

Of course a visit to your doctor is always a great idea if you are unsure who to see.

Once you have a clear idea of what’s causing your joint pain we can then start to craft an exercise program that suits your specific needs. Everyone requires a slightly different approach due to the inherent individuality of the human experience.

I can see 10 clients who all have clinically similar knee pain, but each person will have an exercise program design for them, based on their exercise experience, pain levels, mobility, flexibility, strength, capacity to do the exercises and ability to practice at home or in the studio

Starting an exercise program when you are in pain can be pretty daunting, theres alot of fear wrapped up in thoughts of pain, and causing further problems. These are totally legitimate concerns, particularly when moving the wrong way can trigger pain.

For example, if we return to the client I mentioned at the beginning when we look at her ability to stand up out of a chair, whats we cal a sit to stand, she was having a lot of pain in standing. After spending some time on her technique we were able to make a big shift in the pain she was experiencing.

In terms of exercise coaching it was pretty simple technique adjustment, but if you didn’t know, you don’t know. Its often the case, simple correction can make HUGE changes in someone’s movement experience.

Once you are comfortable with exercise, understand what good pain should feel like (yep, its a thing) and what bad pain feels like (the yuk kind), and understand a little more about what pain is, why its there, and how it works then you’ll b e surprised at how much better you start to feel, simply because know you have more understanding, and that gives you control

A big shift when you are in pain is understanding that it need not control your life. For many thats a total game changer

Moving forward it all about layering the right exercise progressions, which may include little things like adding extra repetitions, sets or rest periods. We can also look at moving from exercises that are low intensity, easy to perform, to harder intensity , more complex to perform.

This may look like starting with a chair squat, moving to goblet squat, and eventually a KB rack squat with press

How we layer in the progression is the Art and science of exercise prescriptions, and take years of experience to understand the nuances of human behaviour, Movement in conjunction with what the current research recommends as a best practice.

Its a real blend of experience and structured movement therapy

Its a collaborative approach, coaching and instruction with lots of practice, repetition and feedback

Its a process, a systematic approach of rebuilding movement and tissue health

And it what i love to help people to do

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7 Reasons To Get Up

The Turkish Get is a mainstay in Kettlebell training, here’s 7 reasons wht you should it include it in your practice.

Movement Check In – Turkish Get Up

If you want a single exercise that ticks a lot of boxes the the Turkish Get Up is definitely one to check out

– mobilty 

– stability

– flexibility 

– strength

– control

The Turkish Get up in action

During a Turkish Get Up you will do these movements….all with a KB (im using a 24kg bk here)

– side lying roll into supine

– chest press to arm bar

– oblique sit up into sit pisition

– shoulder and elbow extension

– hip bridge

– single leg bridge

– kneeling windmill

– shoulder press/ arm bar

– lunge to stand

Then you do all that in reverse

Then you do all that on the other side

Pretty cool right

Now the Get Up can be used in lots of different ways

#1 as a warm up

Use the get up as a warm up drill with body weight or a light kb. It will prepare all your joints, core, breathing and mindset

#2 concentration drill

When you are working on a complex movement, or using a pretty heavy weight it really focuses the mind, anchors you in the now, and charges your concentration. If you have ever trued a get up with a heavy weight theres a bit of an ohh shit factor, because if it goes pair shaped it will end badly…so no room for fluffin’ around

#3 shoulder stability and Rotator Cuff / joint control

The TGU is brilliant at developing shoulder stability and control in two positions, overhead, and under body

The supporting arm is essentially in load bearing full extension

The overhead arm us in full load bearing extension

As you progress through the get up both shoulders are required to dynamically stabilise through all planes if motion, sagital, frontal and transverse making it brilliant to challenge and develop the rotator cuff and gleno-humeral stabilty /ROM

#4 core stability 

From the time you begin to the end your core is lit up like a christmas tree….all aspects of the core muscles are on point

From rolling, oblique sit up, anti rotation, spinal stabilisation and respiratory function. If your core is weak, youll find out pretty quickly 

Particularly challenging is the oblique sit up from the bottom position and the kneeling windmill, which both require strength and control rol to execute. Additionally they are both triplanar Movement so the neurological component is pretty key.

# 5 integrated Functional Strength

To be able to start on the ground to a standing position with a heavy load held over head requires strength through the while kinetic chain

There is no isolated movement here

The body must work as an integrated unit, all the moving parts working to achieve a movement.

#6 its Daily living training

whats more Functional than practicing how to get up iff the floor. Every week i work with clients who have difficulty getting down, and or up off the floor. Its an ability filks take for granted, but since the event ion if the seated toilet we hardly squat or get close to the ground. If you dont train it, move it or work it, mist likely means you wont be very good at it.

Practice standing up and lying down….it is a fundamental human Movement everyone should be able to do

#7 its kinda fun

Not all training has to be serious, and the Turkish Get Up is a great way of making training fun. Just like you were a kid on the play ground, learn to explore your bodies movement with a playful curiosity 

The Turkish Get Up is a great exercise, with lots of ways to approach biulding it into your daily practice

For any tips or help biulding your  get up make sure to send me a message 

Cheers

Drew

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Two essential skills to practice in Yoga, Attention and Intention

For some Yoga is about getting a nice stretch and sweat, for others its a path to connect to something deeper. Each student has a unique path to follow, and beginning to craft a practice is often harder than it seems. For me Yoga and Tai Chi was how I recovered from Chronic Fatigue Syndrome back in 1999, a story for another  day. Today I wanted to share a bit of my 20 years or so practice and teaching with what I’ve found to be two essential mental skills to apply to your practice that has helped many of my students.

The power of Attention and Intention.

What I have observed is it’s often the practice, the act of what the student is actually doing that is most  challenging. The what am i meant to do, how should i breathe, whats do those sanskrit words mean, do you really want my hips to go there!

Yoga is a very deep and complex practice, an average 60 minute class may involve over 30 different postures, asana, or positions. It’s a lot of information for the beginner to take in and can quickly become overwhelming.

To help new and regular students find their practice i have found giving the space and permission to explore their practice is helpful, to do this we start with the  practice of paying attention. Paying attention can be rather difficult as the art of focus and concentration in a world of digital distractions is rather challenging, but it is well  worth exploring.

From The subtle nuances of shifting your weight evenly over the foot, to the linking sensation of lengthening and lifting the spine in an opening of a Sun Salutation, the skills learnt in asana begin with paying attention to what you are doing.

To pay attention to the teachers instruction

To pay attention to the thoughts and feelings that come up during practice

And to do so with a curiously playful mind.

Concentrating and paying attention is a skill that requires practice, and yoga is the perfect playground to develop your attention. Paying attention shifts the practice from outcome driven, trying to perfect the shape of a pose, to process focused, building the asana the step by step.

Once we can pay attention to the practice, we can then develop intention that allows you to craft and shape your practice.

It’s a shift from simply following, to now doing, to actively directing your practice, even within a busy studio class you can still follow the teachers sequencing and instructions, but inject your powerful intention to direct your practice. Or to put it another way, first think it, then do it. Visualise your self executing Triangle pose with your bodies full expression of alignment and breath. See yourself doing that pose, and plant the intention, the thought that will lead to action.

Intention cultivates purposeful practice.

Intention focuses the will, and directs the mind.. Focusing your will power and mind in downdog is very different from downdog where you are just hanging out stretching your calves..

Downdog with intention allows for the lengthening of the spine, the internal rotation of the elbow, the shoulder depression and retraction, fully extending the knees whilst dorsiflexing the ankle. Your intention in the breath allows each inhale to find space, each exhale to explore depth. Your attention is focused on the self talk, the feeling of the muscles, and the sensation of the asana as they happen, with a witnessing mind that is not judgement based.

You may know attention and intention as being mindful, and to be mindful requires the awareness (attention), and the action (intention). Once you learn to  direct you willpower and mental energy to execute the practice with full intention. It will transform your practice from simply stretching and relaxing, to a deeply integrated, functional and mindful practice, and allow you to find union.

For me yoga allows you to fully express who you are by connecting to your core being, and the practices on the mat are applicable in the real world outside the studio. For example in July I will be undertaking a crucible experience of Kokoro Camp, a 56 hours training event designed to challenge  your physical, mental and spiritual condition. To be successful in Kokoro will require continual application of attention and intention practices leading up too, and during the 56 hours continuous training that is kokoro.

What we practice on the mat, we take out into the real world.

cheers

drew

Drew is student and teacher of Human Movement, Practitioner of Chinese Medicine and an Exercise Physiologist with a Passion to teach people how craft their personal practice, recharge their energy and move pain free. You are likely to find Drew teaching the odd Qigong or yoga class, finding hidden bush trails to walk and has a quiet obsession with the computer game Civilization 6.You can find drew at www.moveep.com.