Dr. Kyle: Building Stronger Bones

When discussing bone health, we often talk about proper nutrition. Adequate vitamin D and calcium intake are usually recommended to enhance bone mineral density (BMD). What is not discussed as often is the role of exercise and weight training for increasing bone strength. A holistic approach looking at what we put IN our body as well as what we DO with our body is the key for building stronger bones.

As we age our body experiences several physiological changes. Our hormone levels change, muscle mass declines, and bones become less dense. Low bone density, otherwise known as osteopenia, increases our risk of fracture. Although we can bounce back from a slip or fall in our early years, a hip fracture in older individuals can have detrimental effects on quality of life. The good news is, there are important steps you can take to prevent or slow down the decline of BMD.

Research has demonstrated that healthy individuals and patients with osteoporosis can improve BMD with high-moderate impact activities and resistance training. A few examples of high impact exercises include step classes, jogging, and jumping jacks. Resistance or weight training on the other hand can include elastic band, pully, and free-weight based exercises. To put it simply, the more force you transmit through the bone, the more the bone will remodel and grow! Clinical judgment is needed to determine the intensity of force that each patient can tolerate.

Recent studies have found that high-intensity resistance training and impact training improves BMD and physical function in postmenopausal women. Low-intensity and light-resistance exercise programs are not enough to stimulate bone remodelling and improve BMD. Heavy multi-joint compound exercises such as squats and deadlifts induce extensive muscle recruitment and transmit greater force through the bones. In particular, these exercises will apply force through the lumbar spine and femoral neck, making them stronger and more resilient to fracture. Proper form and supervision are crucial when performing any high intensity or heavy loading activities.

Talk to a primary health care provider about your BMD and if an exercise program for developing BMD is right for you. Not only will exercise strengthen your bones, but it will have profound impacts on many other systems of the body as well. As always, if you have any question do not hesitate to contact me at drkyle@forwardhealth.ca or visit my Instagram page @drkylearam!

Reference:

Sinaki M. Exercise for patients with established osteoporosis. InNon-Pharmacological Management of Osteoporosis 2017 (pp. 75-96). Springer, Cham.

Mounsey A, Jones A, Tybout C. Does a formal exercise program in postmenopausal women decrease osteoporosis and fracture risk?. Evidence-Based Practice. 2019 Apr 1;22(4):29-31.

Dr. Kyle: Why You Should Use The Sauna

Everyone enjoys a day at the spa for some much-needed relaxation, but did you know that time spent in the sauna may actually increase muscle gains?

Originating in Finland, this traditional passive heat therapy is becoming increasing popular world-wide. Saunas are often used for the treatment of musculoskeletal pain as well as headaches. Recent evidence has suggested benefits for high-blood pressure, neurocognitive diseases and pulmonary conditions.

Emerging studies have found a protective effect for cardiovascular disease with regular sauna use for both men and women. It turns out, the more you use the sauna the better. More time spent sweating it out, the more health benefits!

Need any more reasons to hop in the sauna?

Sauna use has also been associated with increased net protein synthesis. This is why amenities such as saunas and steam rooms have become more common place in gym and fitness facilities. After your workout may be the best time to jump in the sauna and here’s why:

1. Intense short-term heat exposure stimulates the production of heat shock proteins that reduce muscle degeneration cause by oxidative stress.
2. Produce Growth hormone for increased lean muscle mass.
3. Increased NO (nitric oxide) availability to promote blood flow and circulation.
4. Decrease inflammatory pathway activity and free radical production.
5. Improve insulin sensitivity, allowing your body to utilize glucose more efficiently.
6. Enhance the production of BDNF (brain derived neurotropic factor) which synthesizes new brain cells.

Essentially, saunas stimulate the bodies autonomic nervous system in order to maintain a constant core body temperature in extreme heat. Short durations of heat stress induces adaptive mechanisms similar to exercise and have profound physiological effects.

It has also been found to help with anxiety, depression and improve parasympathetic function! Who doesn’t want a little extra mental clarity in their life.

For any questions or comments please email me at drkyle@forwardhealth.ca and be sure to follow my Instagram and Facebook page @drkylearam.

References:

Hussain, J., & Cohen, M. (2018). Clinical Effects of Regular Dry Sauna Bathing: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 1857413. doi:10.1155/2018/1857413

Laukkanen, T., Kunutsor, S. K., Khan, H., Willeit, P., Zaccardi, F., & Laukkanen, J. A. (2018). Sauna bathing is associated with reduced cardiovascular mortality and improves risk prediction in men and women: a prospective cohort study. BMC medicine, 16(1), 219. doi:10.1186/s12916-018-1198-0

Dr. Kyle: Sport Injury Rehabilitation

 

There are many factors to consider before clearing an athlete to return to sport. Time since injury, improvements in range of motion and increases in joint stability are all good metrics to evaluate before giving an athlete the green light.

Many rehabilitation programs focus primarily on enhancing maximal muscle strength. Current research suggests that Rate of Force Development (RFD) may actually be a better predictive factor in determining whether an athlete is ready for sport.

Common athletic maneuvers such as pivoting, jumping and stop-and-starts require rapid stabilization of the joints in the lower limb. This requires almost instantaneous muscle activation to prevent joint displacement and avoid re-injury. Factors such as neural activation, fiber composition and muscle contractile properties influence RFD and the body’s ability to absorb load on the joint. Therefore, it may not matter how strong the muscle is, but rather how fast the muscle can fire.

So how might this change rehabilitation programs?

Most physical rehabilitation protocols help build strength but fail to include an explosive component. Because athletic demands are often variable and unpredictable, it is important for the muscles to be able to react to any situation. Incorporating explosive plyometric exercises and a variation of sport specific drills will improve RFD and prevent future injury.

Take home points for sport-injury rehab:

• Allow sufficient time to for healing process to occur
• Recover full range of motion and flexibility
• Progressively overload the muscle to build strength
• Explosive training to enhance ability of muscle to generate force rapidly.
• Incorporate plyometric and sport specific drills to complement athletic demands.

As always, the best way to stay in the game is to avoid injury in the first place. So don’t wait for the pain to start before implementing an effective strength AND conditioning program.

If you or someone you know is suffering from a sport injury, call and book an appointment today for a complete musculoskeletal assessment!

 

Reference:
Buckthorpe, M., & Roi, G. S. (2018). The time has come to incorporate a greater focus on rate of force development training in the sports injury rehabilitation process. Muscles, ligaments and tendons journal, 7(3), 435-441. doi:10.11138/mltj/2017.7.3.435

Concussion Management: What you need to know.

What is a concussion?

A concussion is a traumatic brain injury that causes a temporary disturbance in brain cells. A concussion is sustained when there is a sudden acceleration or deceleration of the brain inside the skull. The most common cause of a concussion is a direct impact to the head. A significant hit elsewhere in the body can transmit force to the head and neck and creates a whiplash effect. This type of impact can also result in a concussion.

Signs and Symptoms

• Nausea/Vomiting
• Headaches
• Dizziness
• Loss of Consciousness
• Sensitivity to light/noise
• Visual disturbance
• Neck pain
• Irritability/Mood changes
• And many more!

How are they treated?

When a concussion is suspected, the individual should be removed from play or activity. An immediate referral to a licensed health care professional with training in concussion management is crucial for early diagnosis and treatment. Once an assessment has been completed there are certain protocols that should be followed to ensure proper recovery. These concussion treatment guidelines may include:

• Relative cognitive and physical rest for first 24-48 hours
• Gradual return to normal daily activities
• Progressive exercise therapy
• Manual therapy of the neck
• Diet and nutritional recommendations
• Vestibular rehabilitation

Recovery

Roughly two weeks after a concussion is sustained, the brains energy levels return to normal. In this time span it is important to rest and prevent a second impact from occurring. This is especially important in younger athletes who may be eager to return to play. Signs and symptoms should continue to be monitored by a licensed health care practitioner.

 

For more information or questions about concussion management please contact drkyle@forwardhealth.ca.