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The thousands of UK patients that go through painful knee surgery may only be getting negligible benefits, a new study has discovered. As people get older the meniscus – the cartilage in the knee that acts as a shock absorber – thins out, making it more likely to tear. Researchers in Canada studies 811 procedures and the results were published in the Canadian medical Association Journal; they found that there was little evidence to show that surgery achieved better outcomes than not operating, or even performing a placebo operation. Other treatments like weight loss, anti-inflammatory drugs, exercise and physiotherapy should be used first, with surgery as a last resort only.
Top physics and personal trainers second this advice through experience. Following surgery the limb will never return to 100% effectiveness. Often, exercise (in particular muscle strengthening and prorioception work) can get the joint into as goo shape as a painful operation. Plus there is no lengthy recovery period where fitness, confidence and strength can decline further.
So before you go under the knife, call us! Remember, surgeons need to do surgery to stay in work and pay the bills!
By Adam Atkinson
Want to run faster? Many of us are have-a-go runners; some of us run competitively, or have at least done the odd 10k or half marathon for charity. But if we really wanted to step up and become great, what running tips could we get from double Olympic and European champion Mo Farah? How can we run faster?
Run3D, a company that analyses runners’ gait and is part of the University of Oxford, analysed footage of Mo Farrah running to see what we, the lesser mortal, could learn from his style. Factors from arm position to foot strike were looked at and Dr Jessica Leitch came up with 9 points that help to make him (and could help you become) a great runner and to run faster.
Foot strike: The traditional way of running (in the West) is with a heel strike first, and then rolling through the foot and pushing off on the toes. Farah, however, hits the ground with his mid-fiit first. This is known as mid-foot striking, and by adopting this style the impact or “braking” as the foot hits the ground is less, reducing forces through the knee and the hip. It also makes running more efficient and allows for a faster cadence.
Foot position: his foot lands only marginally in front of him, again reducing the impact and braking effect. This “falling forward” into the run means that momentum is carried forward, not vertically.
Hang time: the amount of time that the foot is in contact with the ground is known as “stance time”. The ground equals friction, much less so the air. Mo has a very short stance time – milliseconds – so less energy is lost with ground contact. He is flying!
Twist and wiggle: body movement is measured in three planes – up and down, side to side, and rotational. While running we want most of the movement to be forward, and too much movement in the other planes can waste energy. So when Mo runs, his hips stay relatively still with little side to side movement.
Relaxed style: relax the jaw, don’t hunch the shoulders, don’t clench the fists. A relaxed running style uses less energy and means that you will run more efficiently.
Trailing leg position: just after the foot leaves the ground, Mo flicks the heel up towards the bottom like a sprinter. The shortens the pivot of the leg and means that less effort is needed to get the leg back forward for the next stride.
Cadence: this is the rate at which the feet hit the ground. A high cadence will mean greater speed. Many of the points above allow Mo to run at a greater cadence, and go faster!
Arm position: As he runs, Farah keeps his hands high and the elbows very bent. This again reduces the length of the arm level and means that there is less energy required to get back to the starting position. This generates a more powerful arm drive.
Forward, not vertical: all of the points mentioned contribute to less vertical bouncing and more forward movement, so his leg energy goes forwards, not up and down.
Even you, the amateur runner can immediately try to use some of these techniques to go faster straight away! If you need more help with technique, getting fit, strength training for running or a training programme, then we can help with some one-on-one personal training sessions.
By Adam Atkinson
Summer fast approaches, many of us are starting to enter running events, from 5k charity runs, 10k races to one of the many half or full marathons on offer. The best training for running is of course running, but complimenting this with a strength training for running program will help you run faster, run longer, feel fitter and be more stable on your feet. It will also ensure that you stay injury free through your training.
Strength training for running – old school vs new school
Strength training for running traditionally focused on;
Bilateral moves (both feet on the ground at the same time),
Saggital plane exercise (forward and backward but not twisting movements)
Single body parts, not compound whole body movements
Muscle endurance, not strength
These traditional workouts did not really look at balance, strength or stability.
Strength training for running – the smart, modern way – should include integrated whole body movements, a focus on rotational exercises (we rotate when we run!) and an emphasis on stability in the foot as well as overall balance. This prevents energy leakage from unstable foot placement and lack of balance. We hardly ever do a 10k on a smooth surface, so stability, strength and blanche will really help transfer all your running skill into forward movement. Shorter workouts will also help make them more achievable, as well as getting nearly all the benefit of more sets. Try to include the strength training on days when you have a shorter run or are doing speed/interval work. This will shorten the overall time needed as well as having a great warm up included.
This strength training routine can be done by any level of runner, from advanced to beginner. If you want to make it more challenging then simply add some weight in the form of dumbbells, barbells or kettle bells. If you are a beginner then the exercises can be adapted to be slightly less challenging.
To save time you can superset each pair of exercises. For example do the first exercise, push ups, then go straight to the round the clock lunges. Once the pair is complete rest for 45 seconds and repeat the pair. Do 2-3 sets of 12-14 repetitions. It’s got to be hard going, so judge the weight accordingly!
1 – Push ups with a frog lift
2 – Round the clock lunges
3 – Split stance bent over row
4 - Woodchop with weight
5 – Russian twist
6 – Leg curl on a swiss ball
Other exercises to consider are lunges with a knee raise, walking lunges and some plyometric exercises like burpees and knee tuck jumps.
By Robert Adam Atkinson
Physical training suspended from a rope or strapping has recently become very popular and is now an accepted part of fitness training. Often taking its generic name from a specific brand of equipment, the TRX, suspending yourself from an unstable rope or strap during training can exaggerate the effects of gravity, presenting a unique challenge to the muscles and joints. But what are the origins of suspended movement training?
Three types of suspended movement training have been blended together to form the basis of the genre today. Its origins come from the ancient Incan empire, German gymnastics and also the US Navy seals.
Physical training using ropes is first referenced during the Incan Empire in the 15th and 16th centuries. This empire was spread over a very large area, from Chile and Argentina in the south to Ecuador and Colombia in the north. One of the most important parts of maintaining such a large empire was speedy and reliable communications. So the Inca used highly trained runners known as “Chasqui” or speed messengers. These messengers were taken into service for life, and needed to be very fit in all aspects. Cardio-vascular fitness was needed, but also strength, speed, agility and control, as the terrain varied vastly between jungles and rocky, high altitude mountains. The messenger routes through the Andes were dotted with relay stations, so that one messenger could take on a short part of the trail at great speed, passing it on to the next who would do the same. In this way as many as 240 miles could be covered in a single day. Even the roman empire at its height could only manage 100 miles a day. The Chasqui used ropes to help them through both the rocky and jungle terrain. So it made sense that their structured training included sessions using exercises suspended from ropes.
Gymnastics is also part of the history of SMT (suspended movement training). In 1842 German gymnastics coach Adolf Spiel developed swinging apparatus with triangular handles which he called “ringeschwebel”. These handles were then developed into circular rings. In the 1924 Paris olympics the rings were introduced as a new event and are still used today in the modern games. The gymnastic rings are an incredibly difficult skill to master; static holds, inverted hand stands, hanging holds with explosive swings and dismounts are part of the Modern event.
However the man who joined these elements into a functional training system for ordinary athletes (you and me) is generally considered to be Navy seal Randy Hetrick. During many foreign deployments access to traditional training environments and equipment was usually very restricted. In a quest to keep up his high levels of strength and fitness he developed parachute webbing with a metal carabiner to produce the first suspended movement prototype. In 2005 Hetrick set up a company and began the production and marketing of what we know today as the TRX. Since then several other systems have become available, all using strapping and metal or compound cleats with handles and straps.
These lightweight and versatile fitness systems are also very useful as a travel kit for those looking to keep fit on the move.
They are quite unstable so a few lessons or sessions with a personal trainer are recommended to get the most out of this amazing system.
By Robert Adam Atkinson
HIIT (high intensity interval training) has had lots of press over the last 2 years, from the BBC Horizon programme “The truth about exercise” to the well publicised Andrew Marr incident. Many accredited studies have shown that HIIT will increase aerobic fitness (VO2 max) as well as providing all the health benefits of longer duration exercise. Its time efficiency and effectiveness have made it very popular; but what are the optimal number of intervals?
In the BBC Horizon programme, Dr Michael Moseley was tested doing a single 3 minute routine, containing several 30 second, maximal bursts. Some complete just one sustained, flat-out 3-4 minute burst, whereas others practice a more conventional training routine of more intervals – as many as 10, all close to maximum heart rate. Each interval is followed by periods of slower recovery.
Frequency of training also varies greatly. Some may train every day, others a few times a week with days off between exercise. Dr Mosley Was completing just two sessions a week.
Although scientific studies have proved that intense interval training can increase your aerobic fitness up to 10 times faster than moderate exercise, no studies had been done to determine the optimum amount of intervals. Until now. A study by Mcmaster University in Ontario tested 17 young men and women on different HIIT regimes. 10 of the 17 were asked to exercise on 2 separate days a week. On the first day they did a standard HIIT session of four 30 second intervals of excruciating effort alternated with one minute of recovery. On the other day they did a single, non-stop interval of around 4 minutes, after which they had used the exact amount of energy as in the first session. Blood samples were gathered after each session.
The remaining 7 volunteers did the non-stop, single four minute interval for 6 weeks, completing it 3 times a week. Again blood samples were taken.
Although there were gains for the single interval training group immediately after exercise, these did not translate into lasting improvements over the 6 week study. Only the group who were doing multiple intervals gained in the medium term.
In another study by the University of Science and Technology in Norway, volunteers were asked to perform 24 HIIT workouts over three or eight weeks. This meant that some of the subjects did sessions every day (sometimes twice on the same day), while others only exercised three times a week. At the end of the study, those exercising 3 times a week had improved aerobic fitness by 11%, while those who were at it daily showed no improvements; in fact some of them showed a small decline. Only after they stopped exercise did the daily group show signs of improvement, with aerobic capacity creeping up by 6% some 12 days after cessation of activity.
The conclusion of both of these studies is that the best gains come from more standard interval training. Several intervals interspersed with recovery are best. So try to do 60-90 seconds off full on swearing-inducing effort with 60 seconds of slow recovery. Repeat at least 4 times, but 8 is better. The less recovery you have the faster you will improve lactic tolerance. The longer recovery you have the more you will improve speed and power.
By Adam Atkinson
If you spend hours sitting down, then get up, says a new study. Sitting for long periods gives people larger derrieres researchers have found. A study by Tel Aviv University looked at fat cells in the body and found that those exposed to “sustained, chronic pressure”, like those forces exerted in long periods of sitting, experience accelerated growth of lipid droplets, molecules that carry fats.
That is to say, the fat cells expand, becoming 50% larger and gaining mass, leading to weight gain.
Sedentary lifestyles can lead to obesity through inactivity and over-eating, but this new study shows that sitting for too long can be even more harmful.
Every year, many of us decide to go dry for the month of January, not drinking alcohol to make up for the debauchery of the festive season. Some reports are sceptical about the benefits of this one month “fad”, so a ten of staff at the New Scientist magazine decided to go dry and study the results properly.
On October the 5th of last year, 14 members of the magazine’s staff (all of whom regarded themselves as “normal” drinkers) were given various tests and questionnaires to asses the state of their livers and overall health. For the next 5 weeks, 10 drank no alcohol, while the remaining four carried on as normal. They then returned to the laboratory to repeat the tests. For the four drinkers, there were no notable changes.
But for those who had gone dry, the effects were significant. Their levels of liver fat (an indicator of possible future liver damage) had fallen by an average of 15%. Their blood glucose levels (connected to the onset of diabetes) had taken a huge plunge by 23%, from 5.1 to 4.3 mmols per litre. The normal range is 3.9-5.6.
They also lost weight. This is without a specific effort to do so, and they lost an average of 1.5kg. Their blood cholesterol (an early indicator for heart disease) had also dropped by 5% from 4.6 to 4.4mmol. 5.2 or below is considered healthy.
The dry group also reported have better concentration levels as well as sleeping more soundly, rating their sleep as improved by 10%.
Kevin Moore, a consultant in liver sciences for University College London declared that he was amazed by the results.
“What you have is a pretty average group of people who would not consider themselves heavy drinkers, yet stopping drinking for a month alters liver fat, cholesterol and blood sugar, and helped them to lose weight”. “If someone had a product that did that they would be raking it in”.
Many runners or even novices just focus on running and building a high milage when training for a marathon. Added milage may be good for building endurance, but it may also lead to imbalance and injuries. The high impact in running puts large stresses on the joints and connective tissue. If the muscles cannot take this load then injuries will happen.
Simultaneously running starts to break down muscle tissue over time. So keeping and even increasing muscle while doing your training is essential for a successful marathon. Core training will also ensure that all the effort you are making with your legs is translated into forward momentum. A soft unfit core will absorb this energy and slow you down. Strength training should fit into your running schedule, not the other way around. Marathon training will include some shorter faster runs, these are ideal as a warm up for your strength training.
Add in an extra day for strength and stretching, and you will be in great shape for the big day.
Phase 1 (week 1-4) of marathon strength training should focus on form and slow tempo in the exercises. No weights should be needed (except for some pulling movements) and higher repetitions are best, so 15-20 reps with low recovery of around 30 seconds. Single leg exercises are also good at this stage to begin establishing a balance. A good circuit would be spider-man push ups, single leg squat onto a bench, bent over row, rotating lunge into shoulder press, Russian twist, plank. 2-5 sets.
Phase 2 (weeks 5-8) of marathon strength training needs to go a little heavier by adding weights. Barbells and similar bilateral exercises are good at this stage. Repetitions come down to 8-10 with slightly longer recovery of 1:30min. A good routine is barbell bench press, deadlift, barbell bent over row, barbell jerk, barbell straight legged deadlift. 6-10 sets
Phase 3 (weeks 9-12) goes more explosive as you build power. Sets drop for less volume. Jumping squats, fast push ups and inverted rows are the order of the day. Reps stay low and recovery is high. 2-4 sets. Suggest fast push ups, burpees, inverted row, snowboarder squats, jack knifes, plank.
Phase 4 (weeks 12-16) focuses on tapering. Back to phase 1 exercises (basics with balance) but now add in more stretching, foam roller work, massage and even swimming.
So another year has gone by and leaves us to reflect on 2013 fitness tips. This past year science and research fine-tuned and expanded what we know about physical activity and how it effects our brains, heart, joints and even our DNA before we have been born. We learned that our lifespans can be greatly increased with exercise, particularly if we go reasonably hard and fast.
This year we were both encouraged – fitness can happen in 7 minutes a day – and depressed (especially if we thought that barefoot running could improve our form and prevent injury). It was at times validating (why cool downs are not really necessary), enlightening (why gentle exercise does not quash our appetite’s as much as we thought), boring (boredom with food can be a great appetite suppressant) and down right strange (chewing gum helps focus the brain).
However the lesson they emerged gain and again was they intensity in exercise matters. The 7 minute workout as popularised by the New York Times was one of the most popular topics for the whole year, especially for those wanting to get their exercise over and done with quickly. The time commitment may seem small, but for the session to work the effort must be vigorous. To gain all the health benefits from this HIIT (high intensity interval training) you need to work at 90% of maximum heart rate and be very, very breathless and sweaty. But on top of getting fitter and healthier, HIIT also suppresses the appetite more than traditional aerobic based exercise.
The research on HIIT also undermined the common excuse not to get any exercise – “I don’t have the time”. Again, the emphasis must be on intensity and not the short duration.
Intensity winning over duration was also proved in a small study where out of shape volunteers ran on a treadmill at high speed for just 4 minutes three times a week. They increased their VO2 max (maximum oxygen uptake) by about 10% (in ten weeks) while improving blood sugar control and blood pressure.
We also learned in 2013 how pervasive the effects of exercise are. In another experiment, rodents that ran on wheels for several weeks responded far better to stressful situations than their non-exercising counterparts.
But one of the most interesting studies of 2013 showed how exercise can effect the very fabric of our being. In experiments, scientists found that exercise reshapes the genes within human cells. By changing how atoms attach to parts of our DNA the behaviour of the gene changes. Researchers found that in some cases, six months of moderate exercise remodelled genes related to the risk for diabetes and heart disease. Foe those of us wanting a slightly faster result, another study found that just a single session of cycling altered the genes in the muscle cells of the volunteers.
These studies are an important and inspirational remainder of the robust effect exercise can have on the human body, even at the level of our DNA.
And my favourite piece of fitness news in 2013? The blerch, via Frances Lindsay; thanks girl, keep running!Of course, any exercise can be substituted for running.
Some simple and well known exercises can be all you need to see if you are fit for your age. Or not!
1 – Push up test.
How many push-ups can you do continuously until failure? For men this is a full push up with the shoulders, knees and hips in a straight line. The tempo should be slow – 2 seconds down and two seconds up; you should go to a depth where your elbows are at 90 degrees. For women the same applies but do them from the knee. A poor score in this test means that you have low upper body strength and suffer from sarcopenia; this is the natural muscle wastage that happens to us all with ageing.
Scores: Women – aged 30-39 – 13 or above is good. Below 13 is poor. Women 40-49 – 11 reps is good, below 11 poor. Women 50-59 – 7 or above is good, below 7 is poor. Women 60-69 5 or above is good, less than 5 is poor.
Scores men: 30-39: 17 or above is good, less than 17 is poor. 40-49: 13 or above is good, less than 13 poor. 50-59: 10 or above is good, less is poor. 60-69: 8 or above is good, less than 8 is poor.
2 – Stand up sit down test.This is a simple yet one of the most functional moves there is. Using only one hand, from a cross legged position, how many times can you get up and sit down in 2 minutes? Regardless of sex, if you are under 40 you should be able to do 15. According to a Brazilian study of 2,000 people and published in the European Journal of Cardiovascular Prevention, this simple test is a strong predictor of how long you are likely to live. Those who had to use both hands or who needed to get up on both knees were 6 times more likely to die prematurely.
3 – What is your running speed? A simple but perhaps painful test. How fast can you run 1 mile? Running speed in midlife has been closely linked to the likelihood of heart disease.
1) a man is his fifties who can run a mile in 8 minutes or fewer (9 min for a woman) had a 10% lifetime risk of heart problems.
2) a man who could run a 9 minute mile (10 min 30s for a woman) had a 20% risk
3) a man who could only do a mile in more than 10 minutes (12 minutes for females) had a 30% risk.
The study concluded that the exercise that you do in your 40s has a large bearing on your health in your 80s.
3 – How far can you walk in 6 minutes?
Studies show that not only is this test an indicator of cardiovascular health, but it is also a guide to how well you will stave off aches and pains like a bad back in later life. Distances to aim for are: men and women under 60: 650-900m. men aged 60-64: 600m (women 500m). Men aged 65-69: 515m (women 460m). Men aged 70-74: 500m (women 440m).