Saturday, December 9, 2017

Early Christmas Present From Oakley

Oakley Jawbreaker
Here's my early Christmas present from Oakley. A pair of Jawbreaker sunglasses. It does seem a little big as you can see from the picture above, but then it also means you get more protection.

Vented lenses means it won't fog up so easily. I really like the fact that peripheral vision is great too.

Many thanks to Joey from Oakley.

Here's another look
Please also see this post on the Jawbreaker.

Monday, November 27, 2017

Stretching Your Muscles? Or Stretching Your Brain?

Kids stretching before gong fu classes
We've written before that just one static stretch of 30 seconds can reduce your maximum strength. Hence, I've questioned whether it improves your sporting performance or help prevent exercise related injury.

Here's another interesting thought. Does stretching makes one more flexible because repeated stretching alters the mechanical properties of the muscles, tendons and joints you are stretching?

Or stretching causes you and your muscles to tolerate more tension when you stretch? You become more flexible or can reach further because your brain tells you that you can and not because you've altered the mechanical properties in the joint.

This was exactly what researchers were wanting to know when they pooled data from 26 studies that measured the mechanical properties of the joint, muscles and tendons after stretching programs of between three to eight weeks.

Participants in those 26 studies stretched at least twice a week, average total stretching time slightly less than 20 minutes each week.

I was surprised (and I'm sure you'll be too) when the results appear to support the second theory as only very small changes were seen in the mechanical properties measure. Participants did get more flexible and were willing to tolerate greater tensile forces while stretching.

Bear in mind that the stretching period was only eight weeks. The authors point out that weight training over similar duration show increase in neuromuscular strength gains but no change in size of the actual muscles. The same may be true for stretching, neural changes first followed by physical changes.

Some readers will undoubtedly say that don't worry about whether is the the physical muscle changing or neural changes. As long as flexibility improves.

As written earlier, we do not know for sure if stretching improves your sporting performance or helps prevent injuries, but the general consensus is that regular stretching may be beneficial in the long term.


Reference
Freitas SR, Mendes B et al (2017). Can Chronic Stretching Change The Muscle-tendon Mechanical Properties? A Review. Scan J Med Sci Sports. DOI: 10.1111/sms.12957

Monday, November 20, 2017

Strength Training Just As Important (If Not More) Than Aerobic Exercises

Lifting before running
After our two beautiful boys came along, my wife used to just run as there was not much time for any other exercise. She found big benefits from minimal running. It improved her mood and energy levels while also lowering her risk of heart disease and stroke.

After a few years of just running, she felt that her fitness level was stagnating and that she was losing strength. So earlier this year, (along with two friends), my wife has been doing twice weekly strength training sessions at the Holland Village F45  gym.

A recent study found strength training just as important (if not more than aerobic training) and can add years to your life. This is the largest study so far (over 80,000 adults) to compare mortality outcomes of different types of exercise people did.

Researchers found that strength training (both gym machines and body weight) decreased the risk of early death (23 percent) and cancer-related death (31 percent).

Earlier I wrote about how weight training can also help solve Singapore's diabetes problem as highlighted by our prime minister during the 2017 National Day Rally. This study lends more weight to my suggestions to help Singaporeans get healthier.

Moreover, the World Health Organization's (WHO) physical activity guidelines suggest 150 minutes of physical activities and two days of strength training every week.

Seems like my wife's twice weekly strength training sessions at the Holland Village F45 is spot on with WHO's guidelines.

For those intimidated by gyms, (be it costs or images of heavy weights), the researchers suggested that body weight exercises like sit-ups, push-ups, lunges and triceps dips done in your own home or local park can be just as beneficial.


Reference

Stamatakis E, Lee I, Bennie J et al (2017). Does Strength Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis Of Eleven Population Cohorts With All-cause, Cancer, and Cardiovascular Mortality Endpoints. Am J Epidemiology. kwx345. https://doi.org/10.1093/aje/kwx345.

Ting Jun having a go with Rachel's help

Friday, November 10, 2017

Like Father Like Daughter

With Mona
Earlier you've read about how I've treated 2 of Singapore's fastest men in our clinics previously. Well, today Mr C Kunalan's daughter Mona came to see me.

I've known Mona since our school days. She used to dominate all the sprints in the National Schools Track and Field events held at the old National Stadium.

I remember when she was running in the "B" division (17 years old and under) as a 15 year old, she clocked 12.2 seconds to break the previous record and be the fastest school girl outright. Much faster even than the all the girls running in the "A" division (20 years and under).

It wasn't a surprise when she went on to don national colors and even won medals at the SEA Games.

As you can see from the picture, Mona is still in very good shape. Other than running, she still does strength training regularly to maintain her speed. Like father, like daughter.

See the resemblance?



Wednesday, November 1, 2017

Arches And Legs

Gotta be in slippers for "Arches and Legs" right?
It has been a big learning week for us. Aized and Rachel went for their Anatomy Trains course last Friday to Sunday. And Ting Jun, Reggie and I went for the next part on the "Arches and Legs" for the past three days.

Some of it has been revision of earlier concepts, while incorporating more in depth details as well.

Here are some pictures from our past 3 days at the course.

Feet and arches
Let me have a look too
Ting Jun deep in thought

When it comes to learning and making ourselves better physios, we make sure we do not cut any corners. As a team, we've spent lots of time going for courses, discussing difficult cases and sharing what we've learnt with each other to improve ourselves.

Majority of our patients are by "word of mouth" referrals. A patient comes and sees us in our clinic, they get better really quickly and they then refer their families and friends to our clinic.

So please come and see us in our clinics and we'll do our best to help you.

Looking forward to using what we've learnt at work tomorrow. Yes, back to work tomorrow.

Wednesday, October 25, 2017

Older Men And Calf/ Hamstring Injuries

Both the calf and hamstrings
After last week's post, I was just talking to Rachel and she mentioned to me this past week she's seen a few cases of patients tearing the calf muscles too. All happened to be male patients on the older side of 40 years old.

I thought of my own patients with calf muscle strains/ tears and realized that they too tended to be the older male patients too.

I was pleasantly surprised that Rachel's and my observation was spot on. A recently published article in the British Journal of Sports Medicine investigated over a thousand articles on the risk factors of calf muscle strains. Ten articles satisfied their inclusion criteria of which more than 5000 athletes in football, rugby union, Australian rules football, basketball and triathlon were involved.

As you get older, your aging athletic body has a few things going against you. You have a higher incidence of disc degeneration and the potential of L5 nerve root compression as mentioned in last week's post.

Older athletes lose some muscle power output and rate of force production. (Trust me on this, I have definitely experienced this).

Moreover, as the athlete gets older, your testosterone levels and production start to decline and this may limit your muscles' rate of recovery, which can lead to accumulative fatigue.

The most predictive risk factors were down to age and previous injury of calf strain. Having previous hamstring or groin strain was also a contributing factor. A possible proposed mechanism for this is a change in the change in the muscle architecture following a muscle strain.

When your muscle heals after a previous injury, the damaged muscle is usually replaced by a fibrotic scar tissue. It is often common to get future damage in the areas adjacent to this scarring.

Another factor that may play a role is due to a change in the length and shape of your damaged calf muscle. Shorter muscle fascicle length has been noted as a risk factor for repeat hamstring strains too.

We can't help you when it comes to your age and previous injuries to the calf and/ or hamstrings. But what we can do along with treating you is to ensure you have a sound rehabilitation process with some definite focus on eccentric exercises.

Here's a tip for those who you who haven't seen us in our clinics. Do your eccentric training at the end of the day when you have no training scheduled or only light training the next day. This minimizes the risk of DOMs or delayed onset of muscle soreness.


Reference

Green B and Pizzari T (2017). Calf Muscle Strain Injuries In Sport: A Systematic Review Of Risk Factors For Injury. BJSM. 51: 1189-1194.

Sunday, October 22, 2017

SS Turns 8!


Our clinic celebrated our 8th anniversary yesterday. A big thank you to all our families, staff, friends and patients for all your support all this while. We wouldn't have done it without all of you.

Our goal has remained the same all this while. To make our patients better quicker. "As long as we're happy and enjoy treating our patients, it's not really work."

Here's to many more years to come!