8.5 million people suffer painful joints

As a Personal Trainer (PT) and therapist I work mostly with clients who have some kind of injury. Talking with other PTs I have noticed that they have a growing number of clients who are training with an injury.

photo-11-09-2016-12-35-47 Clients who have seen a GP and have been sent away with pain killers decide to work through the injury. As pain killers are great at reducing pain they can make clients forget about an injury, which might lead to their condition worsening as they train. In the United Kingdom around 8.5 million people suffer painful joints*. During a year Accident and Emergency treat 380,000 sports injuries and 30% of GP appointments relate to musculoskeletal problems*. As the NHS is lacking the budget, staff and resources to cope with these problems, the responsibility for helping clients with injuries is often transferred on to PTs.

PTs can create bespoke programmes to help with injury recovery and prevention. PT’s have tools to improve balance, strength, mobility and the neuromuscular system.  With correct forms of action a PTs can help clients regain mobility of the joints. If our body is lacking in a range of motion it starts compensating and overloading tissues. A good example of this is lower back pain triggered by a limited range of motion in the hip.

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My clients mostly work with functional movements through the use of plyometric exercises and kettlebells. We can classify movement patterns as:

  • Lifting
  • Pushing
  • Pulling
  • Squatting
  • Rotating
  • Walking

Restoring mobility, agility, strength and balance in those patterns brings relief and reduction of pain.

A fully mobile, strong and agile body deals better with daily stresses, works more efficiently and is more resistant to injury, just like well-oiled and maintained machinery.

 

 

*Data taken from

Register of Exercise Professionals journal.

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About the author: Les Bubka is an experienced martial artist, personal trainer and therapist who specialises in posture, mobility and Karate.  Les works with a wide variety of clients including martial artists and athletes as well as those suffering with postural dysfunction or those who wish to improve their fitness and wellbeing.
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Training and the immune system

DSC_0379This week I would like to have a closer look at the relationship between training and health.  There is no doubt that engaging in regular physical activities improves our health.  Exercising increases the production of white blood cells, which are responsible for our immune response to infections.  In Poland we have a popular saying “sport to zdrowie”, in English “sport is health”; whilst this is true it is only true up to a certain point.  When we increase the duration and intensity of our workouts, our immune system actually gets weaker.

A good study that supports this is one done by Dr David Nieman who is a pioneer in the research area of exercise immunology at Appalachian State University.  The study I refer to examined marathon runners at the Los Angeles Marathon in 1987.  Dr Nieman himself took part in 58 marathons and noticed that when he ran around 144km a week he more often suffered from throat infections, however when he reduced this distance to below 100km the infections stopped.  In examining the impact of marathon training on health Dr Nieman and his team questioned a randomly selected group of 4926 participants of the Los Angeles Marathon.  The main interest of this study was history of infections before the marathon and health problems that occurred after the run.  The study showed that for a long distance runner the probability of getting an infection is nearly six times greater than people who run lesser distances.  Dr Nieman suggests that athletes that run more than 100km a week double their risk of infection.  It has been proven that this happens because training hard for long periods (over 1.5 hours) can weaken the immune system, with this affect lasting up to 24 hours.  This study was published in the Journal of Applied Sciences, 2007.

Kancho Joko Ninomiya summarised this nicely by saying “Don’t train hard, train smart”.  In this way it is recognised that a “good hard session” in the dojo or gym is not always beneficial to our health.  It is good sometimes to stop and think about our workout programmes to make sure that we are getting the best out of them.

Stretching

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For years I had done the traditional approach to stretching in martial arts training.  This consisted of a general warm up followed by static stretching, which then moved onto kicks, punches and whatever else was being taught in the session.   Using this approach I was not able to perform high kicks for over fifteen years.  I had always struggled with my suppleness and in looking for a solution to my problem lots of instructors told me that I just simply do not stretch enough.  As a result I did very long sessions of stretching followed by kicking.  However, I was not able to kick higher and over time I had increased pain in my muscles and joints.  The effect of this was that my ability to kick actually decreased as often after sessions I had developed micro injuries and pains in my muscles that were taking a long time to heal.  I had then been told by my doctor that my hips are in fact ‘closed’ and so I would never be able to kick high and so I dropped my strenuous stretching regime and went back to doing enough stretching to maintain mobility.

After a few months of lighter stretching I realised that I was actually able to kick higher and more freely.  On discovering this I started to analyse my body’s response to different forms of stretching such as dynamic, static, forced, isometric etc.  From my studies came the clear view that for my body structure, the traditional methods of stretching were not suitable.  Having changed my programme of stretching for a few years I can now freely kick higher than my own head height.  My closed hips do not allow me to kick perfectly, but at least I know that there are other ways to improve my flexibility.  Now I do five sessions of stretching a week and no longer suffer with muscle or joint pains.

Most of the martial arts training sessions that I have seen/experienced run with the same traditional model: aerobic warm up, stretching, technical then cool down.  In my opinion an aspect of this cycle that is incorrect is when instructors use static stretching techniques directly after the aerobic warm up, which I believe should be used only as cool down exercises.  By doing these static stretches we stretch our muscles to their maximum, which causes micro tears.  This then limits our muscles’ abilities to perform rapid contractions, but we then move onto dynamic techniques such as kicks.  Consequently performing static stretching first can actually have a detrimental effect on our performance.  As our muscles already have micro tears at this point, performing repetitive rapid contractions can cause further damage on overstretched muscles.  Our trainee might not feel this damage, but with time it can accumulate and result in injury.

Our muscles respond to the micro damages in our muscle fibre by creating scarring.  This scarring makes our muscles less flexible, which is why some people experience muscle tightness after intensive training and the process of stretching the muscles has to be repeated again to counteract the tightness.

In my experience it is much more efficient to use dynamic stretching as part of a warm up prior to training as this prepares our muscles to perform dynamic contractions without overstretching our muscles first.  Doing dynamic instead of static stretching also helps to maintain our aerobic effort and so our body does not cool down prior to executing techniques.

For beginners we can also achieve suppleness quicker by stretching only one side of the body (unilateral) at a time.  This is because when we stretch both sides of the body (bilateral) (e.g. both legs) at the same time, our nervous system responds quicker to protect our muscles from overstretching and so limits our progression.  Stretching only one side at a time allows us to stretch further, but is also more representative of fighting where we only kick with one leg at a time (usually!).

All of my students are now training this way and we can all see the beneficial results, especially for those people who have been struggling with their kicks, who now love to kick to the head!  As a bonus we also have not had any muscle injuries.  Static stretching in our club is done only as a cool down but is used on every session.

Combining these two methods of dynamic and static stretching in this order produces better results than the more traditional setup.  It is also the recommended method of stretching by experts.

I am aware that there are other methods of stretching that are effective for others as we are all different, but on the basis of my body responses over nearly 20 years, I can recommend this method as it is certainly beneficial to me and my student s.

Thanks for reading.

Injury Prevention

Injury Prevention

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During classes the instructor/sensei is obliged to create a safe environment for members of the club. Most of us think that wearing protective gear is all that is required – we put on our head gear, gloves, shin pads and we feel safe. This is true to some extent, but safety is much more. As teachers we have to explain to students the importance of body mechanics and anatomy. Knowledge of how our bodies are designed and how they work is a key element of healthy training. For example, knowing the structure of the elbow and its mechanics will prevent over extending it when punching. Similarly, when kicking it is better to not use the full motion of the knee dynamically as our muscles do not have time to react to prevent over extension, in this case our hips should be used to help extend our range of movement. These few examples of anatomical knowledge illustrate how this is important to promoting the safe practice of techniques by students.

 

An additional safety measure is ensuring that training is conducted in a controlled environment.  To provide this as instructors we have a responsibility to pay attention to how students behave.  For instance, observing their fighting manners, their egos and their approach to wearing safety equipment. If we notice that one of our fighters behaves dangerously when sparring or is rude it is up to the instructor to intervene and correct the student, as if no intervention is made this may result in injury.

 

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Another danger at the dojo/gym is a person performing an exercise or drill without guidance and preparation. An example of this would be students being introduced to high throws without prior training of break falls.  This is very dangerous and has in some unfortunate cases resulted in the death of the student being thrown.

 

On YouTube it is easy to find footage of completely unprepared people fighting and being beaten badly. I believe it is an instructor’s responsibility to adequately prepare students to fight. For example I believe that it is irresponsible for an instructor to teach students light contact sparring when the instructor then sends them for full contact fights – these students will be ill prepared for the experience and are likely to get injured and/or shocked. Consequently when joining a dojo/club, I think it is always best to make sure that you check the qualifications of the instructor along with their insurance and consider whether the methods and equipment that they use during their sessions is as safe as reasonably practicable.

 

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Thanks for your time 🙂