Osteoporosis is one of the least-discussed, under-diagnosed and under-treated conditions in Australia, with nearly two-thirds of Australians over the age of 50 suffering from low bone mass. With an increase in the incidence of osteoporotic fractures over the past two decades, it could be an indication that there is a decrease in bone quality from generation to generation with a lack of physical activity thought to play a major role.
As bone is a dynamic tissue with the capacity to adapt to changing load requirements, exercise along with a good diet and adequate sunlight has been shown as a vital stimulus for the growth and maintenance of optimum bone strength throughout life. Recent research indicates that programmed physical activity as a standalone treatment is just as effective as anti-osteoporotic medications for maintaining, or improving bone mineral density, with a combination of exercise and medication having best long term outcomes.
Research, along with our long term anecdotal experience indicates that a variety of activities and exercises should be undertaken to promote increased bone mass whilst reducing fracture risk such as those suffered from falls. In addition, varied physical activity helps maintain exercise adherence whilst having beneficial effects on a person’s quality of life such as increased fitness, weight loss and reduced pain symptoms.
For clients with osteoporosis or osteopenia, we recommend performing daily weight bearing activities such as walking, running, hopping or jumping to increase impact loading and stimulate bone growth, and regular strength and resistance exercises to improve functionality and reduce pain levels. We also recommend including exercises that focus on correcting posture and improve balance to reduce falls risk.
Overall, a well-balanced program for osteoporotic clients should be one not only improves bone mass, strength and balance, but one that alleviates associated pain, improves ones psychological well-being and takes into consideration an individual’s personal interests, exercise preference and goals to maximise adherence and long-term program outcomes.
An example session for a person with low bone mass may include:
To find out more about how we may assist you with osteoporosis or reducing the risk of developing osteoporosis, please contact one of our team members today.
BY Tara Baker
Sometimes as a nutritionist, I forget the simplest of things. The basics. We know them, but do we know why the basics are important? Why do we need some foods over others? We presume we know, but do we realise how important they are to our body function? I’m talking about macronutrients. These are the nutrients that provide us calories or energy. Nutrients are the building blocks for growth, metabolism and for other body functions. The word MACRO means large, which means they are required in large amounts. These are carbohydrates, proteins and fats.
The amount of calories that each one provides is different. Carbohydrate provides four calories per gram. Protein supplies four calories per gram and fat provides nine calories per gram.
Besides these three, the only other substance that provides us with calories is alcohol, which provides seven calories per gram. Alcohol however, is not a macronutrient because we do not need it for survival.
So why do we need Carbohydrates?
Carbohydrates are the main source of fuel and easily used for energy. All the tissues and cells in our body can use glucose for energy. Carbohydrates are needed for the central nervous system, the kidneys, the brain, muscles and our heart to function properly. Carbohydrates can be stored in our muscles and liver and used later for energy. They are super important in maintaining good intestinal health and waste elimination. Found in foods like grains (including rice), potatoes, fruits, milk and yoghurt. Also in vegetables, beans, nuts and seeds.
Fibre refers to the certain types of carbohydrates that we can't digest. These carbohydrates pass through the intestinal tract and help to move waste out of the body. Diets that are low in fibre have been shown to cause problems such as constipation and haemorrhoids and increase the risk for certain types of cancers, such as colon cancer. Diets high in fibre however, have been shown to decrease the risk of heart disease and obesity and also help lower cholesterol. Foods high in fibre, which I call ‘sweepers’ include fruits, vegetables and wholegrains. I advise pear, kiwi fruit and carrot to almost everyone I see.
Why do we need protein?
Most people fall short of their protein requirement but it can be easily met by consuming a balanced diet. We need protein for;
: Growth (especially important for children, teens and pregnant women)
: Tissue repair
: Immune function
: Making essential hormones and enzymes
: Energy when carbohydrate isn't available
: Preserving lean muscle mass
: Strong hair and skin repair
Protein is found in meats, poultry, fish, meat substitutes, cheese, milk, nuts and legumes. When we eat these foods, our bodies break down the protein they contain into amino acids. Some amino acids are essential which means we need to get them from our diet and others are nonessential, meaning our body can make them…So clever.
Protein that comes from animal sources contain all the essential amino acids we need. Plant sources do not.
Why do we need fat?
Poor old fat has received a lot of backlash over its potential to gain weight, however some fat is essential for survival. We can't run our car without oil, just as we can’t function without fats.
Fat is found in meat, poultry, nuts, milk products, butter, oils, fish, seeds, coconut and avocado. Dietary guidelines say we need 20-30% of our calories from good fats. These help aid with;
: Normal growth and development
: Energy (fat is the most concentrated source of energy)
: Absorbing fat soluble vitamins like A,D,E,K and carotenoids
: Maintaining cell membranes
: Balancing and producing hormones and cholesterol
: Many digestive functions
: Reducing pain in joints
By replacing saturated and trans fat in your diet with unsaturated fat found in avocado, olive oil, nuts and seeds, you are reducing your chances of heart disease, dementia and many other illnesses.
Controversy has existed for a long time over whether strength training is beneficial or detrimental for endurance athletes including runners, cyclists, swimmers, triathletes or adventure racers. Recently though, there has been an abundance of research and information that supports endurance performance enhancement through strength training when applied correctly. In addition, research also confirms resistance training to be the best exercise intervention for injury prevention.
One of the main concerns often expressed by endurance athletes and their coaches towards performing strength training is that it will increase muscle bulk and therefore add unnecessary weight to their desired lean and light bodies. However, recent research across a range of endurance sports indicates that correct exercise prescription and manipulation of load, reps (the number of times you perform the specific exercise), sets (the number of cycles of reps that you complete), intensity (how hard you perform the exercise), rest interval duration (time period between performing the exercise, or subsequent exercise) and exercise selection can avoid muscle hypertrophy as well as minimising any self-perceived heaviness or fatigue sometimes reported during the days following strength training interventions.
Previously, the typical approach to strength training for endurance athletes was to perform high repetitions with short rest (eg. 20 reps with 30 seconds rest), or to perform a standard weight based training regime (eg. 8-12 reps with moderate rest). Conversely, best-practice current strength training guidelines found to enhance endurance sports performance advocate using high loads and low repetitions. In addition, it is recommended to perform the movement explosively during the concentric phase (when you’re working against the resistance) which together stimulate increased muscle power output through improved neuromuscular function (muscle signalling pathways and recruitment) whilst minimising muscle hypertrophy.
For swimming, dryland resistance based training interventions have been shown to improve stroke length and tethered swimming force production which are both linked to better swimming performance. In running, strength training has been shown to decrease middle and long distance time trial performances as well as improving running economy (reduced oxygen cost) through decreased ground contact time, increased musculotendinous stiffness, or more efficient running biomechanics. Similarly, for cyclists strength training improves technique, reduces the oxygen cost, enhances lactate-profile power and increases absolute peak power and average power output over varying distances (1 km – 45 km).
Although often overlooked, another key benefit of strength training is its preventative effect on sports injuries (including overuse injuries). In 2014, a large meta-analysis reviewing strength training, proprioceptive training, stretching, and multiple exposure (strength, stretc hing and/or proprioception) exercises on sports injury prevention found strength training alone to have the strongest positive effect. The study reported that strength training “reduced sports injuries to less than a third and overuse injuries could be almost halved” whilst “stretching proved no beneficial effect”. Before you remove stretching from your training regime, the study only looked at stretching's preventative effect on injury and does not take into account that stretching and mobility exercises may be necessary to achieve joint range of motion to achieve efficient movement patterns such as that during catch phase of freestyle swimming.
Therefore, is strength training safe and beneficial for endurance athletes? Yes!! However, the training program needs to be well designed, functional, and sport specific with a focus on correct movement patterns and technique. Together, these guidelines will ensure your strength training intervention will enhance your endurance sports performance and decrease your risk of developing sports related injuries.
Interested in joining our specific strength and conditioning classes? Click here to book online
In Part 1 of the series on Essential tips for international competition I covered everything you need to know regarding choosing your travel and accommodation, through to recommending you learn some of the local social etiquettes and laws at your race venue. In Part 2 here, I’ll provide you with some great tips on how to individualise your training specifically for your event to ensure you’re race-tuned and ready to perform at your peak.
My first tip is to do some simple research on the event demands. This should include determining the course profile, terrain, expected weather conditions and what your predicted finish time might be.
Once you’ve analysed the course profile, if you notice it’s substantially different to what you’d commonly encounter in local races or training (eg. has longer or steeper ascents, is likely to leave you out on course far longer etc), it’s likely you’ll benefit from some key targeted training sessions in your lead up. For example, if the course includes some significant climbs, I recommend regularly including some simulated race efforts on a local ascent that has a similar gradient or length to what you’ll encounter in your race during your final 6-8 weeks of preparation. For cycling events, you might even be able to pre-ride the exact event course at a local virtual cycling studio.
For those competing off the beaten track, knowing the course terrain you’ll tackle will provide vital information towards ensuring you optimise your equipment selection including bike, tyre or shoe choice. Further, different terrains may require you to learn an additional skill set such as being able to rock-hop over obstacles on a mountain bike or having the lower limb strength to sustain a consistent pace during a sand run. For each of these scenarios, practice makes perfect so time on task is advised.
Although weather can be highly unpredictable and you won’t know until race day the exact conditions, you can usually determine if the weather is likely to be hot and humid, or perhaps cold and rainy due to seasonal averages as well as looking at the conditions of past events.
If the race is likely to be in held neutral conditions (eg. 20°C) this is less of a concern, but for those racing in places such as Hawaii or throughout Asia where the conditions are often intense with severe heat and humidity, acclimation training is advised. For hot and humid conditions, I recommend performing at least 10-14 days of specific heat acclimation training during the preceding 2-3 weeks to competition. This may be achieved simply through arriving at the race venue early, by attending a local sports performance centre offering heat acclimation services, or creating your own hotbox at home. A recommended method is to perform regular 45 – 60 min training sessions between 35-40°C and 60-80% humidity. As the heat and humidity will add significant intensity to the training sessions alone, these acclimation sessions can be performed at a relatively low intensity which will allow your body to physiologically adjust to the change in climate without over stressing the rest of your body.
On the other end of the spectrum, if the race is likely to be cold and/or wet, this is often far easier to prepare for from a physiologically standpoint and may only require the planning of correct race attire which might include the use of a wetsuit, arm warmers, gloves, gilet or jackets etc. However, if you’re event has specific equipment regulations (such as swimming the English channel where water temperature is often <16°C water and wetsuits are not permitted), applying a covering of petroleum jelly to any parts of the exposed body and aiming to increase your body fat percentage may also be required.
Stay tuned for the final part of the series where I’ll cover tips when packing your bags and how to minimise the stress placed on your body and immune system from long-haul flying.
I’m often asked what the difference between an Accredited Exercise Physiologist (AEP) and a personal trainer (PT) is. So to clear up a few misconceptions that both positions are one-and-the-same, I thought I’d put finger to key and note down seven of the key differences between the two qualifications and roles.
Starting off, a large difference between an AEP and PT is the level of education required to become accredited as either. For AEP accreditation, each practitioner is required to complete a minimum of 4 years of University study of an Exercise Science degree or similar. On the other hand, a PT can become accredited with as little as a short two week private training course. Yes, you read that correctly, your PT at your gym or running your local boot camp may have completed as little as two weeks of study to gain their Certificate III in fitness. Pretty scary I know!!!
2. Minimum experience
As part of exercise physiology accreditation, each exercise physiologist is required to demonstrate a minimum of 500 hours of supervised practical experience across a wide range of clientele. Compulsory subgroup populations trained with includes apparently healthy clientele, and those with cardiopulmonary, metabolic, musculoskeletal, neurological, or neuromuscular conditions. In addition, many AEPs are also experienced working with oncology and renal patients, or performing cardiac stress testing. On the contrary, PT applicants often perform less than 20 hours of practical experience and work only with apparently healthy clients.
Although PT courses cover foundation studies in exercise science, design and instructing, I’m sure you can imagine the depth each subject would cover considering they have six subjects to complete in their short two week course. On the other hand, the education component AEP qualification is far more in-depth and requires at least a 6 month full-time equivalent University study load in the following subjects:
4. Ensuring correct exercise prescription
Although I haven’t coined the terms ‘exercise prescription’ or ‘exercise is medicine’ myself, to many they are both relatively new terms. See, AEPs are trained to use exercise to improve health outcomes similar to how a doctor is trained to prescribe a pill. As part of their training, AEPs are taught how and why an exercise works, not just the muscles an exercise works. For example, an AEP is trained to identify how your reduced hip flexors range of movement are affecting your pelvic position which alters the gluteal muscles moment-arm and causes a functional weakness and instability of the hip which can contribute to your back, hip, knee or ankle pain. Following this, the AEP also knows what the best exercises are to address these imbalances and correct them. Further, not only are AEPs knowledgeable in exercise prescription for joint or muscle related conditions, they are also skilled with the knowledge of how to safely implement an exercise therapy intervention and improve health outcomes in someone with a history of cardiac complications, diabetes, high blood pressure, or weight management problems and know how the medications the client are on may affect, or be affected by exercise.
On the other side, PTs generally use a narrow approach rather than a holistic one due to their lack of training and knowledge. This might include a view where a leg extension exercise just works the quadriceps muscles, rather than looking at how excessive strengthening of the quadriceps without sufficient posterior chain strengthening may lead to muscle imbalances that can cause irreversible knee damage. In addition, PTs have very little, to zero training in the interaction between client medication and exercise.
5. Motivation and encouragement
As AEPs are required to study a psychology component in their studies, their approach to client motivation is generally based on evidence, rather than just industry habits. For example, most AEPs aim to intrinsically motivate their client as research shows that for long-term program adherence and best health outcomes, intrinsic motivation works best. This may include educating the client on how exercise and lifestyle modification can help to improve their health, level of energy, or general wellbeing. On the other hand, the PT often uses extrinsic motivation such as the use of shouting at you which might work in the short term, but isn’t generally advised for long-term program adherence or enjoyment. And for those who do prefer being shouted at, I’m sure if you ask you AEP, they’ll happily oblige ;)
6. Clientele qualified and insured to work with
While personal trainers are only qualified and insured to train with persons considered to be low risk (i.e. apparently healthy populations), AEPs are qualified and trained to deliver exercise therapy for all categories of clientele including elite athletes or those classified as high risk. Moderate-high risk clients that only AEPs should train can include males ≥45yrs or females ≥55yrs, those with a BMI ≥30kg/m2, a history of cardiac complications, the elderly, diabetics or asthmatics.
7. Private health fund rebates and Medicare referral eligibility
Unlike PTs who are only recognised as fitness professionals, AEPs are recognised allied-health workers (other allied-health workers include physiotherapists, chiropractors, Dietitians, podiatrists, and occupational therapists). This means clients seeing an AEP under GP referral, workcover, Department of Veteran Affairs (DVA), diabetes services, or Aboriginal health services may be entitled to receive Medicare health rebates or bulked-billed services. In addition, 30 of the leading Australian private health insurers now pay a benefit for services provided by an AEP. As many AEPs are additionally registered as fitness professionals, any private health fund rebate available for PT services are also claimable with your AEP.
So in summary, hopefully you can see there’s a very large difference between an AEP and PT. This is not only in terms of their education, experience, or training, but also with the wide range of clientele that AEPs are able to safely work with from elite athletes, to the chronically ill, frail or elderly. So next time you’re thinking about whether to see an AEP or PT, think about whether you’d put your life in the hands of someone with only two weeks of study to service your car brakes, or someone with the highest industry qualification. I know who I’d put my health and trust in!!
As a sport scientist, coach advisor and professional triathlete, I’m often asked what's the best way to prepare for international competition. In this three part series I’ll cover everything you need to know from planning your trip, preparing your mind and body for your key competition, and lastly, ensuring you arrive at your destination feeling fresh, healthy and ready to perform at your best.
With busy race schedules, injuries/illness, work and other life commitments, it’s not always easy planning too far in advance for some racers. However, where ever possible try to plan as far ahead as possible and arrange your trip accordingly. Things to take into consideration when planning your trip should include:
Brodie Gardner has a Masters in Exercise Physiology, Honours in Sports Science and competes as a professional triathlete. He has a long history working with elite athletes and has provided consultation services to numerous Australian sporting associations.