3 reasons sleep is every athlete's best friend

photo source

Sleep is crucial to everyone who wants to be the best that they can be.

It is all the more important for athletes who need to be at their physical peak in order to perform at their very best. It can be tempting when you are training hard for an all-important competition to forgo your sleep in favour of extra training, but you really are not doing yourself any favours.

Read on to find out exactly why sleep is your best friend and why you should make it a priority, even if you are training hard.

1. It can help you make healthier dietary choices

When it comes to training, one of the most important factors is diet.

It is no good training hard to get your body into peak condition and then filling it with the wrong types of foods. When we don’t get enough sleep we can create an imbalance in the hormones that tell us when to eat and when to stop.

Ultimately, a lack of sleep can lead to surplus ghrelin, the hormone that tells you it’s time to eat and a reduction in leptin, the hormone that tells you that you are full. It’s easy to see therefore, how lack of sleep can lead to overeating.

Add to this the fact that not getting enough sleep makes you feel rubbish anyway, making it more difficult to make good dietary choices, and you can see how you might not be in a position to fuel your body in the best way.

2. Repair muscles quicker

Studies show that sleep releases a growth hormone that is responsible for helping to repair muscle damage. It also plays a part in building new muscle, burning fat and strengthening bones. These are all essential if you are to make sure that your body is in peak condition ready to compete in a big event. It is recommended that athletes aim to get around two hours of extra sleep per night, for this very reason.

To ensure you get this extra rest, you might need to consider setting up a sleep routine for yourself, to help you maximise the amount of sleep that you get. It’s all about creating the right atmosphere, to tell your body it is time for sleep.

Look at your routine, how comfortable your bed is and also the temperature in your room. The ideal temperature is around 16-23C (60-75F), so take a look at your thermostat and see if turning it down might help you.

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3. It can boost performance

Sleep deprivation affects glycogen and glucose production.

The body relies on these two substances to fuel itself and if you are not producing enough, it might be missing out on that extra fuel that it needs to get you through those difficult training sessions.

Not having enough glycogen and glucose in the system can also impair cognitive functioning, which could be detrimental when it comes to making sure you are on top of your game ready for the big event too.

Much success in sport comes from brain power and being able to logically work out your way to the top.

Don’t harm your chances by cutting back on your sleep.

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Chronic Pain - The Myths

Chronic pain is a significant global health burden and low back pain causes more disability than any other condition.

Interpreting pain

People with negative beliefs about their pain report higher levels of pain intensity and disability.

People with musculoskeletal pain often view their body as being a fragile or a vulnerable structure which is easy to (re)injure.

Here are some common misconceptions about pain:

Credit: World Confederation of Physical Therapy

Some facts about pain

Acute pain alarms us about potential tissue damage and typically comes on suddenly as a result of a specific incident.

Chronic pain serves no biologic purpose as it is not related to actual tissue damage, but more the threat of tissue damage.

Sensitive Alarms

To understand chronic pain more simply, think of a house with a security alarm set up.

After the house was burgled a few months ago, the owners decided to set the alarm’s sensitivity to high.

So every time the wind blew, it would blow a lot of leaves and debris around - setting off the alarm system. The owners woke up to the alarm and prepared for a ‘fight-flight’ situation. But each time the alarm went off, they didn’t find anything wrong.

After an injury, the body is biologically wired to act like a sensitive alarm system - magnifying small normal niggles.

This is a normal and healthy protective response.

For some people though, while the original injury can heal (normally taking no longer than 3-6 months), this protective response (highly sensitive alarm system) can remain in place indefinitely.

This can lead to overwhelming sense of anxiety and fear, that can turn into a downward spiral of inactivity, de-conditioning and eventually more pain.

Maybe the most important picture to understand if you’ve had pain lasting more than six months.

Pain that lasts more than six months is generally related to an overly sensitive nervous system rather than a specific issue in the tissues

(Picture credit: Explain Pain - Butler & Mosely)

Consulting with a Physio who is specialised to treat chronic pain can help you discover if you have a sensitive nervous system and get you back on the fast track to living life again.

Physiotherapists will help you understand how chronic pain works.

They will help you reduce the fear attached to pain and explore long-term strategies to build confidence through engaging in activities that you once enjoyed.

Exercise and building capacity

People who have suffered chronic pain often have reduced physical capacity, that has dropped over a period of months or years.

This keeps them in the ‘zone of stress’ where everyday tasks can seem over-whelming and tiring.

The only way to get on top long term is to re-build your capacity, to create zone of relaxation, where you can easily handle the demands of everyday life.

A few tips:

1. Increase training or exercise loads gradually – our bodies don’t like surprises

2. Avoid changing too many training or exercise factors in one go

3. Participate in a program that focuses on whole body strength to ensure the body is tolerant to changes in exercise load

4. Pace yourself. Break bigger activities into smaller chunks.

Pain is normal - use this scale to guide your level of activity

Some people with chronic pain become overly sensitive at perceiving small normal niggles.

When you start to resume your activities., pain that is at a 0-5 level is considered ACCEPTABLE —> KEEP GOING.

Pain that increases to 5-10 means you are probably over-doing it and need to rest or modify your activity.

Pay attention to your pain during the activity as well as notice the 24 hour response e.g. the next day.

Need some help with getting you back to doing what you love?

If you think we are the right fit for you and you wish to get relief right away, use our simple online booking system to make an appointment.  If you would prefer to speak to us directly,  call us 1300 657 813

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Pain on Inside of Knee? Get To Know Your VMO

The Resilient Knee Project is an innovative solution for people with chronic knee pain that empowers individuals to self-manage their pain and most importantly, get them back to enjoy the physical and mental benefits of running.

Founded by Daniel O’Grady, dedicated professional with first hand experience of overcoming knee pain and running the NYC Marathon, the project aims to be a world leader in restoring people’s confidence in their knees and get back to doing what they love.

Is The Resilient Knee Program right for you?

Take the free quiz here

Get to your know your VMO

If you’ve ever had a nagging pain on the inside of your knee or a knee that seems to buckle or give way, there is a fair chance you’ve had some dysfunction in the VMO muscle.

VMO dysfunction is very common in runners, hikers, cyclists, athletes involved in jumping sports and after any knee injury.

In this short blog, we’ll find out more about how issues develop in the VMO and what you can do to help.

WHAT IS THE VMO MUSCLE?

VMO stands for Vastus Medialis Oblique and this is part of the quads, running along the inside of the thigh, with the bulk of the muscle sitting directly above the inside of the knee.

FUNCTION:

The role of the VMO is to assist with extending your knee and arguably the most responsible muscle for knee stability, as it helps control the alignment of the knee-cap.

When the VMO isn’t functionally optimally, the knee cap tends to shift slightly out of place during movements such as squats and lunges, causing pain and inflammation behind the knee-cap.

SYMPTOMS:

When the quads get overloaded (suddenly or over time), tightness in the muscle fibres (called trigger points) can refer a toothache-like pain deep in the knee joint (see Figure 1 below).

This pain from the overloaded VMO muscle can often be confused with joint pain such osteo-arthritis or a meniscus tear, as the location and type of pain are often similar.

Figure 1

The initial knee pain then may disappear after a few weeks, only to be replaced by a sudden weakness in the knee (a condition called “buckling knee”) that causes a person to unexpectedly fall while walking.

HOW THE VMO BECOMES OVERLOADED:

The VMO can be activated as a protective response to knee injury such as to the ligaments, meniscus or post-surgery.

The VMO is also commonly overloaded with repeated use in the following situations:

• suddenly increasing your volume of running or cycling (running places around 6 x body weight through the quads)

• a new (or sudden increase) in an exercise program involving repetitive squats, lunges, leg extensions or wall sits

• jumping sports e.g. basketball

• cycling - poor bike fit

• walking downhill or stairs

• being over-zealous in rehabbing the VMO - too much strengthening too soon

TREATMENT:

Physiotherapy assessment will involve a comprehensive movement assessment to determine the cause of your VMO issue.

“Short term treatment such as soft tissue massage and dry needling is very helpful, while long term building capacity in the quads, glutes and core is critical to prevent a relapse.

TRIGGER POINT DRY NEEDLING:

Tightness and contraction of the VMO responds very well to dry needling, which can de-activate the trigger points (knots in the muscle).

The benefit of dry needling is that it can reach the deep fibers of the muscle and lead to a quicker resolution of symptoms. 

Treatment of the VMO is generally very responsive to treatment, provided the contributing factors are addressed.

SELF-CARE TIPS:

• apply heat to the VMO muscle 10 minutes each day to increase blood flow and reduce tension

• if you’re a runner or hiker, avoid the hills (in the short-term)

• ensure your shoes are not overly worn

• when running - avoid over-striding, ensure proper warm up and cool down and take walking breaks frequently to avoid overloading the VMO

• avoid prolonged kneeling on the floor e.g. gardening, washing floors - use a low bench or stool to sit on instead

• foam roll the VMO daily for a few minutes (see below). It’s also a good idea to roll out the adductors which are also commonly tight
  

Foam Roller for the VMO:

Foam rolling the inner quad and adductor - fun times!

Let’s get you back to doing what you love…

If you’d like to get your knee on the fast track straight away, please use the button below to schedule an appointment:

Dan O'Grady is a results driven qualified Physiotherapist and member of the Australian Physiotherapy Association.  Dan has a special interest in treating knee pain.  He has been working in private practice for 15 years. He is passionate about helping people to move better, feel better and get back to doing what they love.

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Download the The Healthy Knees E-Book - now on special !!

The Obstacle Is The Way

This blog post was inspired by Ryan Holiday’s book, The Obstacle Is The Way, which describes how employing the philosophy of Stoicism can turn our ‘trials into triumphs’.

This book got me thinking about how we approach issues such as sporting injuries, chronic pain and loss of function that we see in the clinic.

Obstacles such as chronic pain are becoming more prevalent in Australia, with one in five adults reporting they suffer with moderate to severe pain everyday.

It is clear, as a rehab community, we are collectively not doing a great job at helping.

The longer I work as a physio, the more I see how the right mindset and beliefs are a key factor in recovery.

Reading more about the Stoic philosophy, I could see how my values as a health care practitioner aligned closely with with this approach.

The average person has about 50,000 thoughts per day, and for someone who is in chronic pain, you could imagine a large percentage of those thoughts could be centered around these three questions:

• what is going on?

• how is this going to get better?

• when is this going to get better?

When they experience injuries, it’s common for athlete’s (even weekend warriors) to feel anxious and depressed.

One study of 343 male college athletes found that 51 percent had some symptoms of depression after being injured.

Addressing beliefs and attitudes early on can provide the foundation to a successful return to full function.

Downward Spiral Of Injury

We know that a previous injury is the biggest risk factor for another injury.

And that means as a rehab community, we have some work to go in terms of educating and providing injured people a comprehensive rehabilitation program in order to prevent compensations and further issues.

Without inadequate rehab, a downward spiral of pain and injury can develop, eventually leading to burnout.

Stoicism - a little background

Getting back on topic!

Stoic philosophy was founded in Athens in the early 3rd century BC, and was practiced by the likes of Epictetus, Seneca and Marcus Aurelius.

Ryan Holiday writes specifically of being inspired by Marcus Aurelius, whose quote inspired the book:

“The impediment to action advances action.

What stands in the way becomes the way.”

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Marcus Aurelius, as well as being one of the most successful Roman Emperors, had his own private struggles with chronic pain in the chest and stomach.

His personal notes practicing Stoic philosophy, The Meditations, refers many times to psychological strategies for coping with pain and illness.

His physical resilience and endurance was remarkable, despite not having ideal physical health he was to become one of the most respected emperors in Roman history.

Mindset Shift

One of the biggest lessons taught by the Stoics was to re-conceptualise your obstacles from something to avoid to something to welcome, as a means of growing stronger and more resilient.

Obstacles give you important clues as to where you may have some ‘weak links’ and provides an opportunity to turn them into strengths.

Following a Stoic philosophy involves re-wiring your thinking, shifting from negative emotions such as from worry, anger and frustration to calmness, gratitude and hope.

To be clear, negative emotions can be healthy and natural.

But at some point, they become more of a hindrance to your forward progress.

With the right plan in place, and plenty of patience, grit and perseverance according to leading sports scientist Tim Gabbett, you can turn yourself into an unbreakable athlete. 

“It is a rough road that leads to the heights of greatness” - Seneca

Short Term Pain Coping Strategies

Of course if your only goal is to avoid pain, there are some strategies that can bring about some fast relief.

Using pain-relieving medication has it’s time and place.

But unfortunately we’ve seen the long term consequences of opioid medications (e.g. tramadol, oxycontin and codeine) that can sometimes lead to addiction and other serious side effects.

And we now know from the research that these drugs create a long-term increased pain sensitivity, making your pain levels greater than before you started taking them.

The other problem is once you come off the medications, you haven’t any had an opportunity to learn from your pain and injuries, so you essentially need to start all over again.

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Instead of relying on pain medications, here’s eight practical strategies, inspired by the Stoic Philosophers, over 2000 years ago, to help you overcome your pain and live the best life you possibly can:

1. Accept Pain And Injuries 100%

The Stoic philosophers were big on understanding the rhythms of nature.

Just like stormy weather, it would unwise and naive to believe you would never have a pain or flare-up in your body.

No one gets out of life without serious challenges along the way and no one is immune to experiencing pain.

However, the difference lies in how we perceive and respond to it.

A real life example world would be to consider how a sailing boat gets from point A to point B if there is a direct headwind blowing in their direction?

Would the sailor just give up and think it’s not worth the hassle?

The experienced sailor would no doubt accept that unfavourable winds are going to happen some of the time - that is a normal part of life, and they wouldn’t get overly emotional when it occurs.

For the sailor who is committed to reaching point B, the solution, is to change tack.

If the boat turns onto a 45 degree angle, then the sails are able to pick up the wind and use it to the boats advantage.

Progress is no doubt slow and frustrating, but it is still forward momentum and getting you closer towards your goal.

When the winds eventually turn favourably, you would have built up a decent reserve of resilience and capacity.

Bottom line: there is a season for pain and it is a normal and inevitable part of life.

Keep breathing, batten down the hatches if necessary.

The storm will pass.

2. Let Go Of Your Fight Against Pain

Following on from the first point, counter-intuitively, to overcome your pain, you must be at peace with your pain and fully accept it.

The struggle, the fight and the mental battle against your pain only ends up wasting precious energy and resources, that could otherwise be better spent.

Being trapped in a state of resistance and anxiety leads to your body into a fight or flight mode where your muscles are held in a constant state of tension.

This can lead to even more problems than your initial injury.

Common muscles that are involved in the fight / flight response are:

• neck / trapezius

• hip flexors

• lower back

• TMJ jaw

• shoulders

Once you can find acceptance, a significant burden is literally lifted from your shoulders.

With the guidance of a health care professional, it’s important to let go of your anxiety and find a place inside that is relaxed.

“Sometimes, your only way out of the pain is through the pain”

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3. Imagine The Worst Case Scenario

The Stoics proposed, rather than avoiding the pain, we must accept it and then confront it.

Once you are feeling more relaxed and in control of your emotions, Stoicism actually encourages you to imagine the worst case scenario in terms of your pain experience.

If you could courageously come to terms with the worst case scenario - and see how, while it would be difficult, you would definitely still be able to cope.

Practicing this exercise mindfully can help reduce the fear around pain, injury and loss of function, knowing that you will be able to manage, no matter how bad things get.

4. Good vs Bad?

Injuries can often be thought of as ‘bad’.

But are they really?

This reminds me a of a story about a farmer.

One day his horse runs away. And his neighbor comes over and says, to commiserate, “I’m so sorry about your horse.” And the farmer says “Who Knows What’s Good or Bad?”. The neighbor is confused because this is clearly terrible. The horse is the most valuable thing he owns.

But the horse comes back the next day and he brings with him 12 feral horses. The neighbor comes back over to celebrate, “Congratulations on your great fortune!” And the farmer replies again: “Who Knows What’s Good or Bad?”

And the next day the farmer’s son is taming one of the wild horses and he’s thrown and breaks his leg. The neighbor comes back over, “I’m so sorry about your son.” The farmer repeats: “Who Knows What’s Good or Bad?”

Sure enough, the next day the army comes through their village and is conscripting able-bodied young men to go and fight in war, but the son is spared because of his broken leg.

And this story can go on and on like that. Good. Bad. Who knows?

Be at peace with your path and have faith that everything happens for a reason.

There is no good or bad to the practicing Stoic, there is only perception.

5. Switch From Goal Oriented To Process Oriented

While you can learn the principles of Stoicism, the philosophy is actually one of action.

A Stoic needs to focus his attention on action in the present moment of time because neither the past nor the future can be changed.

Being process orientated, you start to focus on all of the small daily things you need to do that all add up to produce the end result.

Come back to the present moment.

That is where the power is to change your life for the better.

Take the focus off being pain-free and instead put your focus on the process.

What are the small daily tasks you need to do to become pain free?

“Luck is what happens when preparation meets opportunity.” ― Seneca

6. Understand Your Pain

“We are more often frightened than hurt; and we suffer more in imagination than in reality.” – Seneca

There is no doubt that ongoing pain that is unexplained can be frightening.

With the help of your Physio and Doctor, if you can understand that some degree of pain is a normal part of the healing process, you can relax in that knowledge.

It’s important to realise that whatever pain you experience should be related to a certain physiological process.

For example:

Ankle sprain —> inflammation around the ligament, you can expect some soreness for 4-6 weeks

Lower Back pain —> occasional flare-ups, especially if sitting too long. Disc injury takes around 3 months to heal

Tendon degeneration —> worst in the morning and with sudden changes in training volume, hills or speed work

Knee - patello-femoral syndrome —> (pain in front of the knee cap) take on average 3 months to get better and pain relates to irritation behind the knee cap and gets worse with squats, kneeling and stairs

Nerve related irritation or damage —> could be many months or years of altered sensation in the affected area

Muscle pain —> the most common source of musculo-skeletal pain - lack of oxygen to the muscle from poor posture, excess muscle tightness or injury.

Chronic pain (more than 6 months) —> relates to increased sensitivity in the nervous system which magnifies minor tissue problems. It may come down to the fact, that we all have wear and tear and issues in our body, for whatever reason, the body and nervous system has decided to heavily focus on that particular area.

If there is ongoing pain and you are not sure why, then you may need to talk to your health care provider in more detail.

7. Develop A Growth Mindset

Stoic philosophy has a lot in common with the Growth Mindset approach, developed by Carol Dweck.

According to this approach, the most important word in the dictionary is ‘yet’.

Re-frame your challenges…

“I haven’t completed the marathon…yet”

“I haven’t felt strong and pain-free in my lower back…yet”

“I’m not sure what it feels like to walk without pain…yet”

8. Train Your Mind To Endure Pain And Discomfort

It takes practice to exhibit self-control with our perceptions of life’s obstacles.

You can practice - the next time your stub your toe or get a paper cut.

Pause for a moment and see if you can absorb the sensation of discomfort - without reacting to it.

One of the great things about exercise is that it is a form of discipline where you willingly put yourself in a position of discomfort for a period of time, with the hope that you will come out the other side better off physically or more importantly mentally afterwards.

As you practice pushing yourself to the threshold, you will build a reserve of willpower to draw from as necessary, creating a “Inner Citadel” of strength and resilience.

For me personally, that is one of the reasons I enjoy the process of running so much.

Every time I go for a run, I know I will confront the pain of a body wanting to stop.

To achieve any sort of reasonable time, you need to learn to listen to your bodies pain, but constantly re-directing your attention and keep pushing to achieve your goal.

“Faced with pain, you will discover the power of endurance” - Epictetus

Conclusion

Pain and injuries are never easy.

But with the right attitude, they can be an valuable internal guide to making you better and stronger than before.

What seem like insurmountable obstacles become once in a lifetime opportunities.

If you’d like to find out more about Stoic philosophy, I’d highly recommend you check out the book, The Obstacle Is The Way.

Now it’s over to you,

What’s the biggest obstacle you’ve faced? What benefits were you able to derive from it?

I’d love to hear your thoughts in the comments section below.

Increasing Motivation For Exercise

Completing a personalised exercise program is a critical part of getting the best outcome from your Physiotherapy treatment program.

At your Initial Assessment, we perform a thorough movement screening, and thoughtfully design a program to help you re-build your foundation and address the underlying root cause of your symptoms.

Ideally, you’ll find the exercises fun, interesting, challenging (and possibly even enjoyable).

The best results will involve us collaborating together to add / modify the exercises as we go.

With your feedback, we'll be able to fine-tune them so you are getting the most positive impact and making real progress towards your goal.

Realistically, it's natural to have trouble finding the motivation or time to get the exercises done (especially as you start to feel better), so here's:

3 tips to help improve your exercise adherence:

1. Keep in mind your purpose and your 'why'

Think about the types of activities that you want to be able to do again, pain-free.

Tell yourself, every set of exercises you do are getting you one step closer to reaching your goal.

'The journey of a thousand miles begins with one step'.

2. Set aside a regular time and place to do the exercises

Perhaps you could tie the exercises onto an already established daily routine such as after brushing your teeth, or straight after a walk/run).

Using the in-built reminder in the app can also really help.

3. Aim for 'progress not perfection'

We don't expect you to be 100% compliant with these exercises every day, (but we'll be incredibly impressed if you do!).

We've heard every excuse in the book about why you couldn't complete your exercises, so no need to aim for perfection, we all have days where other priorities must take precedence.

But remember that your health is important.

'Those who think they have no time for exercise will sooner or later have to find time for illness'.

Please let us know if you have any questions or concerns to help make your journey a good one.

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