TRAINING FOR VOLUME AND INTENSITY

The Best Physiotherapists in Mohali, Pune, New Delhi, Gurgaon, Bhubaneswar, and Bangalore give you an understanding of Training for Volume and Intensity!

Whether you are working out just for physical fitness or as a professional athlete, you can reach a plateau very soon if you keep on doing the same activity repeatedly. After a point of time, the body adapts to the load being applied and stops showing improvements.

This is where the ‘overload principle’ comes into the picture. In simplest terms, the term overload principle means doing more with the body than what it is normally used to do. When it comes to exercise science, it can simply mean lifting more weight than the previous session or running a mile extra than the last run.

There can be multiple ways in which a body’s physical capacity can be overloaded. Of them, volume and intensity stand out as the most important ones.

VOLUME: volume is the total amount of weight lifted in a given session. It can be calculated by this simple equation:

sets x reps x weight

For example, 4 sets of 8 reps of barbell squats with 60 kg mean you have performed 32 reps for 60 kg each. Volume, in this case, would be 1920 kg.

To enhance performance, the volume needs to be altered carefully and gradually. Key points to be considered when working on volume are:

  1. A graded increase in the weight: this method can also be used interchangeably to increase the intensity. Keeping the number of reps the same, weight can be added on each rep to increase the resultant volume.
  2. Increasing the number of reps at the same weight: Keeping the weight constant, the number of reps can be increased per workout. For e.g.: depending on the goals, the no. of reps per set may be increased from 8 to 12 before attempting a weight increase.
  3. Increasing the number of sets: increasing a set per workout gradually at any one of the exercises can also be one of the methods to increase the total volume.

The reason why volume is one of the single most predictors of training outcomes is that it determines the duration for which the muscle is under tension. Known as TUT (time under tension), it increases the associated microtrauma of the muscle fibers, thus gradually increasing their fatigue threshold. This results in greater adaptations.

In terms of aerobic training, volume means the duration for which the activity was carried out. For eg; 30 minutes of running per session 2 days/week. In this case, the volume can be altered by changing the number of work out days or by modifying the duration of the activity.

INTENSITY: it is the amount of effort which is being put into the exercise. In terms of aerobic exercise, it can be represented as % of VO2 max, Rate of perceived exertion (RPE), % of maximum heart rate (HRmax), or % of Heart rate reserve (HRR).

In terms of resistance training, it is most commonly represented as a % of 1 repetition maximum (1 RM).

Activities such as walking or shooting are considered as low-intensity exercises. While 100-meter sprints, Olympic lifting, and Crossfit are considered as high-intensity activities because they require the individual to perform as per their maximal capacity.

Just like the volume, intensity can also be altered according to the goals to attain the desired results.

For aerobic training, activities at 70-80% of HRmax are considered as high intensity. Training in this zone increases the aerobic threshold thus improving the aerobic capacity.

Calculation of HRmax- 220-AGE. For e.g. if an individual of 30 years, the HRmax would be (220-30)= 190 beats/min. Now while prescribing a high intensity, any exercise which could reach 70-80% of HRmax ( 133-152 beats/min) could be used for training.

For resistance training, doing 6-12 reps at 67-85% of 1 RM causes muscular hypertrophy. raining for ≤6 reps at 85% of 1 RM improves muscular strength.1

In a nutshell, modifying these and certain other parameters result in improving performance. One thing that should be kept in mind when designing the exercise programs is that more is not always better. Sufficient rest supplemented with proper diet should be given to the body to recover before the next session.

Visit your nearest ABTP center to get individualized consultation with experts and help in periodizing your training programs for desired volume and intensity as per the sports conditioning requirements.

References:

The Best Physiotherapists in Mohali, Pune, New Delhi, Gurgaon, Bhubaneswar, and Bangalore give you an understanding of Hip Arthritis!

Whether you are working out just for physical fitness or as a professional athlete, you can reach a plateau very soon if you keep on doing the same activity repeatedly. After a point of time, the body adapts to the load being applied and stops showing improvements.

This is where the ‘overload principle’ comes into the picture. In simplest terms, the term overload principle means doing more with the body than what it is normally used to do. When it comes to exercise science, it can simply mean lifting more weight than the previous session or running a mile extra than the last run.

There can be multiple ways in which a body’s physical capacity can be overloaded. Of them, volume and intensity stand out as the most important ones.

VOLUME: volume is the total amount of weight lifted in a given session. It can be calculated by this simple equation:

sets x reps x weight

For example, 4 sets of 8 reps of barbell squats with 60 kg mean you have performed 32 reps for 60 kg each. Volume, in this case, would be 1920 kg.

To enhance performance, the volume needs to be altered carefully and gradually. Key points to be considered when working on volume are:

  1. A graded increase in the weight: this method can also be used interchangeably to increase the intensity. Keeping the number of reps the same, weight can be added on each rep to increase the resultant volume.
  2. Increasing the number of reps at the same weight: Keeping the weight constant, the number of reps can be increased per workout. For e.g.: depending on the goals, the no. of reps per set may be increased from 8 to 12 before attempting a weight increase.
  3. Increasing the number of sets: increasing a set per workout gradually at any one of the exercises can also be one of the methods to increase the total volume.

The reason why volume is one of the single most predictors of training outcomes is that it determines the duration for which the muscle is under tension. Known as TUT (time under tension), it increases the associated microtrauma of the muscle fibers, thus gradually increasing their fatigue threshold. This results in greater adaptations.

In terms of aerobic training, volume means the duration for which the activity was carried out. For eg; 30 minutes of running per session 2 days/week. In this case, the volume can be altered by changing the number of work out days or by modifying the duration of the activity.

INTENSITY: it is the amount of effort which is being put into the exercise. In terms of aerobic exercise, it can be represented as % of VO2 max, Rate of perceived exertion (RPE), % of maximum heart rate (HRmax), or % of Heart rate reserve (HRR).

In terms of resistance training, it is most commonly represented as a % of 1 repetition maximum (1 RM).

Activities such as walking or shooting are considered as low-intensity exercises. While 100-meter sprints, Olympic lifting, and Crossfit are considered as high-intensity activities because they require the individual to perform as per their maximal capacity.

Just like the volume, intensity can also be altered according to the goals to attain the desired results.

For aerobic training, activities at 70-80% of HRmax are considered as high intensity. Training in this zone increases the aerobic threshold thus improving the aerobic capacity.

Calculation of HRmax- 220-AGE. For e.g. if an individual of 30 years, the HRmax would be (220-30)= 190 beats/min. Now while prescribing a high intensity, any exercise which could reach 70-80% of HRmax ( 133-152 beats/min) could be used for training.

For resistance training, doing 6-12 reps at 67-85% of 1 RM causes muscular hypertrophy. raining for ≤6 reps at 85% of 1 RM improves muscular strength.1

In a nutshell, modifying these and certain other parameters result in improving performance. One thing that should be kept in mind when designing the exercise programs is that more is not always better. Sufficient rest supplemented with proper diet should be given to the body to recover before the next session.

Visit your nearest ABTP center to get individualized consultation with experts and help in periodizing your training programs for desired volume and intensity as per the sports conditioning requirements.

References:

  1. Essentials of strength training and conditioning, 4th edition. National strength and conditioning association.
  2. ACSM’s Guidelines for Exercise Testing and Prescription, 10th edition.

Hip Arthritis

The Best Physiotherapists in Pune, New Delhi, Gurgaon, Mohali, Bhubaneswar, and Bangalore give you an understanding on Hip Arthritis!

Arthritis is inflammation of one or more of your joints. By far, the most common types of hip arthritis are osteoarthritis and rheumatoid arthritis, but there are more than 100 different forms of arthritis that can affect a variety of joints in your body; arthritis of the hip is a very common condition.
The hip is your body’s largest weight-bearing joint. This joint is also called a ball-and-socket joint. The ball is the upper end of the thighbone (femur), which fits into the socket (or acetabulum) at your pelvis.
Several muscles cross the hip joint and a strong capsule envelops the hip joint itself. Muscles are connected to bones that make up the hip joint by tendons, which are made from strong fibrous tissue, enabling motion of the joint.
Primary types of arthritis of the hip
Osteoarthritis: The most common form of arthritis in the hip. It is degenerative wear and tear type of arthritis where the cartilage in the hip joint gradually wears away. This causes bone rubbing on bone and can produce bone spurs. Osteoarthritis develops slowly, and the pain increases over time.
Rheumatoid arthritis: A chronic disease that attacks multiple joints throughout the body. It can affect the same joint on both sides of the body. The synovial membrane that lines the hip joint begins to swell, which results in pain and stiffness. Rheumatoid arthritis is an autoimmune disease which means the immune system attacks the body’s own tissues and damages the cartilage and ligaments while softening the bone.
Post-traumatic arthritis: A form of arthritis that develops after an injury to the hip. These injuries can cause instability and additional wear of the hip joint that over time can lead to arthritis.
Hip arthritis symptoms
Pain-often in the groin area, down the front of the thigh
Limp
Stiffness
Difficulties with activities, such as putting on shoes and socks, or getting in and out of the car
Physician examination
To determine whether you have arthritis in the hip your physician will ask you for a complete medical history, have you describe your symptoms and conduct a physical examination. An X-ray or MRI may be necessary to confirm the diagnosis and determine if there are other problems.
Hip arthritis treatment
There is no cure for arthritis in the hip or knee; however, there are a number of treatment options. Often, non-surgical treatment can allow a comfortable level of function before any surgical treatment is needed.
Nonsurgical treatment options include:
Activity minimization such as switching from high impact activity to low impact activity
Weight loss
Physical therapy
Assistive devices such as a cane or shoe inserts
Medications such as non-steroidal anti-inflammatories
Corticosteroid (cortisone) injections
If nonsurgical treatment options for hip and knee arthritis symptoms fail to provide pain relief, a total joint specialist may recommend joint replacement.
People with hip or knee osteoarthritis (OA) use oral pain medications more often than nondrug pain treatments, such as physical therapy, knee joint injections and topical creams, according to an analysis of three clinical trials. That’s in spite of guidelines that recommend trying nondrug treatments before medications.
The analysis, which appeared recently in Arthritis Care & Research, looked at trials conducted by researchers at Duke University, the Durham Veterans Affairs (VA) Health Care System, and the University of North Carolina at Chapel Hill, all in North Carolina. A total of nearly 1,200 patients ages 61 to 65 participated in the three studies. All participants had knee or hip OA, and most were overweight and treated by a primary care doctor. None got the minimum 150 minutes of physical activity a week recommended for good health.
Researchers found that 70 percent to 82 percent of the study participants took pills for pain, mainly nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, but sometimes other pain relievers such as acetaminophen (Tylenol) and opioids. The use of pain medications was more common among those with severe symptoms.
About 39 to 52 percent of the participants received physical therapy, half had corticosteroid or hyaluronic acid knee injections and 25 to 39 percent used topical pain creams.
American College of Rheumatology guidelines recommend nondrug therapies, including exercise and weight loss, as first-line treatments for OA. These can not only relieve pain and disability but also help delay further joint damage. Oral analgesics, including full-dose acetaminophen and prescription NSAIDs, can be used if the use of intermittent over-the-counter medications hasn’t relieved symptoms, but they can’t stop disease progression and can cause side effects, including stomach, bleeding, ulcers, high blood pressure and heart or kidney problems – all more common in older adults.
Most studies have found no evidence to support using opioids for chronic pain, and the Centers for Disease Control and Prevention (CDC) and many rheumatologists recommend against it. But nearly 30 percent of patients in the Durham VA Health System took opioids for arthritis. The study didn’t look at past medical histories, so it’s not known if patients using medications had tried and failed other treatments. Still, while the proportion of patients using NSAIDs from each of the three studies is fairly similar and in line with the findings of earlier studies, the proportion of VA patients taking opioids for arthritis pain (almost 30 percent) is more than twice as high as the percentage used by participants in the other two studies (between 10 and 13 percent), says lead author Lauren Abbate, MD, a researcher with the VA Eastern Colorado Healthcare System in Denver and an emergency medicine specialist at the University of Colorado School of Medicine in Aurora.
Doctors speculate that veterans may have more severe arthritis pain or other injuries, or can’t take NSAIDs due to other health problems, such as kidney disease. But she also notes that earlier reports found high rates of opioid use for chronic pain among veterans, which eventually led the U.S. Department of Veterans Affairs to establish guidelines to reduce the use of opioids for chronic pain. Race, sex, and socioeconomic status seemed to play some role in the types of treatments patients received. For example, women and non-whites were more likely than white men to have physical therapy or use topical creams. But in general, Dr. Abbate concludes that there’s a gap between existing guidelines and how OA is treated in the real world and that nondrug therapies for OA aren’t used nearly as much as they should be. She thinks closing that gap will lead to better care for all patients with arthritis.
The clinical guidelines from the American Academy of Orthopedic Surgeons recommend nondrug treatments along with medications, says Geoffrey Westrich, MD, an orthopedic surgeon, and director of research of Adult Reconstruction and Joint Replacement Service at Hospital for Special Surgery in New York City. Those guidelines, similar to the ACR’s, recommend that patients with symptomatic knee arthritis “participate in strengthening their muscles, low-impact aerobic exercises, and physical activity consistent with national guidelines (a minimum of 150 minutes a week),” says Dr. Westrich, who was not involved in the study.
He adds that, although NSAIDs are also recommended for arthritis patients who can tolerate them, “physical therapy or a home exercise program with muscle strengthening may also help patients manage their pain, increase activity and potentially improve their quality of life.”
For patients with severe arthritis whose pain is not helped by conservative measures, he says, “joint replacement surgery may be the best option for permanent pain relief.”
This injury may be present due to instability of scapular muscle; it is also due to asymmetric force transfer from chest to the arm, which can cause over or under activity of shoulder result in abnormal stress in the arm.
AT ABTP, we identify this issue and treat it precisely with the help of a postural bench we can find out where we are getting asymmetry in the body in terms of force transfer & it can be trained to be providing symmetry.it can be treated with the help of care therapy. It works at the ionic level, also it has a super low frequency which is lower than laser therapy, which is very safe to use even in the presence of a metal implant, it causes an exchange of ion which reduces the recovery time. Isokinetic will help to find the correct ratio of quads and hams muscle, which is very important for the optimal use of joints. We can also find the control and strength of core muscle which is very important for optimal use of hip joint and any pelvic movement; core muscle can be trained to provide stability and balance to the body to reduce any unnecessary wear and tear to joints.

OSTEOPOROSIS

The Best Physiotherapists in Bangalore, New Delhi, Gurgaon, Mohali, Bhubaneswar, and Pune give you an understanding on Osteoporosis!

Osteoporosis is a progressive, systemic, skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissues with a consequent increase in bone fragility and susceptibility to fracture. It simply means “porous bones.” i.e., bones that are porous, or less dense, are more likely to break whereas Osteopenia refers to bone loss and is not as severe as in osteoporosis.

The most common fractures that occur in individuals with osteoporosis are hip, wrist, and vertebral fractures.

The types and causes of osteoporosis include:

a)Primary osteoporosis – caused by a disruption in the normal cycle of bone turnover (e.g., Postmenopausal osteoporosis – type I, senile osteoporosis (type II) and idiopathic osteoporosis )

b)Secondary osteoporosis – occurs when bone loss is a consequence of diseases such as Cushing’s disease, hyperthyroidism, and prolonged treatment with corticosteroids.

Studies have shown that bone loss starts from the age of 30–40 years in both men and women.

Although osteoporosis is thought of primarily as a disease of women, prevalence rates in men can be as high as 15%.

While women experience a marked increase in bone loss during perimenopause and post-menopause, in men, a small longitudinal bone loss is observed throughout life.

Epidemiology:

Worldwide, it is estimated that 1 in 3 women above the age of 50 will experience osteoporotic fractures, as well as 1 in 5 men.

In 2013, sources estimate that 50 million people in India are either osteoporotic (T-score lower than-2.5) or have low bone mass (T-score between-1.0 and-2.5).

Also, studies indicate that osteoporosis and osteopenia or low bone mass may occur at a relatively younger age in the Indian population.

Even though these estimates suggest that the prevalence of osteoporosis in males is lower than in women, mortality in males post-hip fracture is high. Further, in older men, the risk of hip fracture or vertebral fracture is 30% higher than in women of the same age.

In a study conducted in Pune (2018), it was found that osteoporosis prevalence of 3.5% in premenopausal women at the Lumbar Spine. Postmenopausal women who were <5 YSM (years since menopause) showed osteoporosis prevalence of 18.4%, while postmenopausal women who were more than 5 YSM showed a higher prevalence of 37%.

Assessment at ABTP:

•Physical Examination – History, Flexibility and muscle strength will be evaluated

•Walker View – Gait Analysis & VO2 max

•Functional Line – Movement screening of Shoulder elevation & abduction, Trunk side bends, and squats in certain clients.

•Postural Bench – Vertebral load distribution between the upper, mid, and low back and also between the right & left sides.

•Prokin – Static Stability – compared Bipedal and Dynamic stability – Balance on both feet.

Expected Recovery Period :

a)Breathing Pattern – 4 weeks

b)Posture – 2 to 3 months

c)Balance & fall prevention: min 6 months &

d) bone density: after 6 weeks

Aspects of Training to assist recovery: Walking twice a week for 30 minutes (can be broken into smaller periods e.g. three ten-minute blocks)

Further Objectives to prevent relapse :

1. Exercise regularly. It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. 

2. Ask their doctor or pharmacist to review their medicines for Calcium & Vitamin D supplements

3. Have their eyes checked by an eye doctor at least once a year and update their eyeglasses to maximize their vision.

4. Make their homes safer by reducing tripping hazards, adding grab bars inside and outside the tub or shower and next to the toilet, adding railings on both sides of stairways, and improving the lighting in their homes.

Fractures in Sports

The Olympic motto,”Citius, Altius, Fortius.” is Latin for “Swifter, Higher, Stronger”. Currently, our athletes have become more ambitious and aim to reach higher and higher, as a result of which they tend to train more vigorously, where there are a lot of instances that injuries occur. Fractures are one such injury where improper management and lack of good rehabilitation can lead to prolonged absenteeism from the Sport.

By definition, a fracture is the breaking of a bone. Fractures mainly occur in athletes of contact sports like football and rugby.

Upper limb fractures comprise of three quarter of all sports-related fractures, with the five most common types being finger phalanx, distal radius, metacarpal, clavicle and scaphoid. Lower limb fractures comprise one quarter of all sports-related fractures, with the five most common types being ankle, metatarsal, toe phalanx, tibial shaft and fibula.

Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. Depending on the type and site of fracture, the recovery and rehabilitation will differ.

Stress fractures are one of the most common types of fracture in sports population. 0.7-20 % sports medicine and clinic injuries are contributed by stress fractures. It is a partial or a complete fracture due to repeated low intensity stress on a bone. Track-and-field athletes have the highest incidence of stress fractures compared with other athletes.

In order to identify if an injury could be a fracture, look for swelling, redness or pain. Do not ignore any pain or aches.

The main and most important cause of fractures in sports is poor training practice, improper flexibility due to lack of stretching, lack of warm up, or trauma.

Physiotherapy plays an important role in getting the athlete fully fit again. Fracture treatment in sports population will differ from general population in that time is crucial to the rehabilitation process, and expectations of High Performance Sport is a challenge to bring an athlete into immediately.

To help an athlete to return to sport, the treatment involves holistic rehabilitation which includes, core strengthening, balance training, wound healing, pain relief, gait training and functional training.

How to avoid injuries or fractures?

Proper training and stay conditioned.

Hydrate yourself well.

Recovery- take proper rest to recover from a heavy workout session.

Do not forget to warm up and stretch.

Use proper gear or safety equipment during your play.

We at ABTP with our Physiotherapists in Mohali, Pune, Bangalore, New Delhi & Gurgaon, and Bhubaneswar, help athletes to get back to their sport through rehabilitation, along with faster fracture and wound healing. With the help of state of the art machines like CARE therapy, it is very easy to help the fracture heal and fix. We also work on Balance which is very important to gain after any injury, through Static Prokin. In lower limb fractures, we often see issues with walking, or gaining back to sport which might also involve running. With our Walker View and its 3D camera and analysis, we can help the athlete to gain the confidence to perform better. Our ultimate aim is to make the Athlete moving well again!

References:

  • The epidemiology of acute sports-related fractures in adults,Injury, 2008. Court-Brown CM, Wood AM, Aitken S.
  • Sports fractures-T. A. DeCoster, M. A. Stevens, and J. P. Albright
  • Sports-related fractures in South East Scotland: an analysis of 990 fractures. J OrthopSurg (Hong Kong) 2014. Aitken SA, Watson BS, Wood AM, Court-Brown CM
  • Fractures in sport: Optimising their management and outcome-Greg AJ Robertson and Alexander M Wood.
  • Stress Fractures in Athletes-Fredericson, Michael MD

Maintaining Good Posture

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We all know that maintaining correct posture is important to avoid pain and for leading a healthy life. Poor posture is formed due to bad habits which develop over a long period of time. Good posture is the correct alignment of our body which is supported by tension in the various muscles group.

Normally we do not consciously maintain normal posture. Instead, certain muscles do it for us, and we don’t even have to think about it. Several muscle groups, including the hamstrings and large back muscles, are critically important in maintaining good posture. While the ligaments help to hold the skeleton together, these postural muscles, when functioning properly, prevent the forces of gravity from pushing us over forward. Postural muscles also maintain our posture and balance during movement. 

Why is good posture essential?

Good posture helps us to walk, sit, lie and stand properly with the help of various muscles. It helps to reduce the strain on various body structures.

  • It helps in reducing strain on ligaments which keeps the bone structure together.
  • It also helps prevent certain posture related pathologies such as back pain, neck pain, knee pain and so on.
  • It allows the muscles to use less energy and in turn, prevents fatigue.
  • It helps prevent muscle strain and over use disorders.

Result of poor posture:

Poor posture can result in many problems:

  • It can cause excessive strain on postural muscles.
  • It can lead to tightness in the muscles which may cause deformities.
  • Poor posture results in back and neck pain.
  • Attaining poor posture for a long period of time can weaken the bone and laxity of the ligament.

How can I maintain Good Posture?

Yes, you can definitely maintain good posture by exercising regularly. Postural muscles such as hamstring, quadriceps and calf helps in maintaining a correct posture. Maintaining flexibility and strength in these muscles would help to attain correct posture. Moreover, frequent postural breaks is necessary.

Physical Self Awareness is integral to managing Good Posture. As you have a better understanding of your own body, automatically one becomes more aware of how to maintain such Posture. At ABTP, for example, this is done through Technology that gives you a data-driven Analysis of your physical parameters, and the Physiotherapists can suggest routines that help improve posture.