Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
We are often asked by patients which exercise approach is best for them, should it be a high intensity approach either through their own training or part of a group or lower pace longer workouts. The Shannon Clinic Melbourne Chiropractic and Sports Care is here to educate you on what the literature tells us about high intensity interval training (HIIT) and moderate continuous training (MCT) so you can determine what works best for you.
The Benefits of Exercise
There is a wealth of research available today showing the benefits of exercise on health resulting in a raft improvements including;
The current physical activity guidelines for good health recommend at a minimum 150 mins per week of moderate to vigorous exercise or 75 mins per week of vigorous exercise. The question then becomes what type of exercise is better, high intensity interval training (HIIT) or moderate continuous training (MCT)?
What is HIIT and MCT?
True HIIT is often a variation of what is known as a Wingate test where an individual is asked to go “all out” in a 30 second sprint and then has a 3 to 4 minute slow recovery before going all out again for 30 seconds. This is usually repeated 4 to 6 times. During the “all out” sprint the individual needs to keep their heart rate (HR) above 85% of their maximum. This entire workout might take 12 to 15 minutes to complete and is performed 2 to 3 times per week.
MCT involves an individual operating at a lower level of intensity around 60-70% of their maximum heart rate however, they need to continue to exercise for longer, usually around 60 to 90 minutes. An example of this would be to go for a steady ride on a push bike. Unlike HIIT, MCT needs to be undertaken 4 to 5 times per week.
Purely on face value there are pros and cons to both; HIIT although very time efficient can be very unpleasant for those who don’t like working at such high intensities. Whereas MCT is more comfortable in terms of the effort required however, it is more time consuming.
What Are the Benefits of HIIT and MCT?
Overall the consistent findings within the literature indicate HIIT is as good and probably superior to MCT in terms of improving cardiovascular fitness, especially V02max in a variety of cohorts including young athletes, adults, obese and diabetic individuals. For body composition, reduction in blood lipids (fats) and % of body fat, HIIT and MCT achieve similar results. In respect to weight loss, exercise is important however, diet is the key to long term sustainable weight loss. For long term glucose metabolism MCT appears superior to HIIT.
What Exercise is Right for You?
On the face of the findings it could be argued that MCT is as effective overall as HIIT, therefore we should all be training at moderate intensities for longer; however, time is a factor that is omitted in this argument. Similar health benefits can be achieved through HIIT to MCT in a fraction of the time. This means for athletes they can focus more on sports specific skills training, while for those who are busy or do not enjoy exercising can still gain meaningful health benefits without needing to dedicate hours a week exercising.
The important message to take away is that neither HIIT nor MCT are vastly superior to the other; both provide meaningful health benefits in terms of body composition, cardiovascular fitness, blood lipids, glucose metabolism. At the end of the day, it is about making sure you find an exercise approach that works for you which allows you to achieve at least 150 mins of moderate to vigorous exercise or 75 mins of vigorous exercise per week of to improve you overall health and life expectancy. This is something melbourne sports chiropractor Dr. Shannon advocates and discusses with all of his patients. It is also an area that alarmingly too many people fall well below this mark and often are not doing any exercise at all.
If you are interested in ways to improve your athletic performance we highly recommend having a read of our blog on NMN supplementation, as well as mental imagery. To book an appointment to see our melbourne city chiropractor or massage therapist you can below Our sports chiropractic clinic is located on Collins Street in the Melbourne CBD and is easily accessible by trams on Collins Street, Swanston Street, Bourke Street and Elizabeth Street, by train via Flinders Street Station and parking at Federation Square.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
Ketogenic diets or low carbohydrate diets routinely appear in the media with stories ranging from the negative health implications they can have including reduced bone health to the benefits they have on weight loss, diabetes and performance in elite athletes. With such conflicting information out there, Melbourne city chiropractor Dr. Shannon uses his knowledge and experience in addition to reviewing the literature to see what the truth is about ketogenic diets and performance.
What Is Keto?
For a diet to be considered ketogenic it needs to contain less than 50g of carbohydrates (CHO) per day, be high in fats 70-80%, with the remaining 15-25% coming from protein. For athletes, especially endurance athletes CHO’s are the preferred fuel source for enhancing performance therefore by restricting CHO intake it forces the body into ketosis. In a ketosis state, ketone bodies (fat molecules) are released from the liver, producing an alternative fuel source to CHO’s.
Why Athletes Choose a Keto Diet
The utlization of fats as fuel becomes one of the primary reasons endurance athletes are attracted to ketogenic diets. This attraction occurs because fats provide a better source of energy than carbohydrates and there is an abundance of fat stores compared to the limited glycogen (CHO) stores in the muscles. Other reasons athletes are attracted to ketogenic diets include, the feeling of enhanced recovery, improvements in body composition and reduced post exercise inflammation.
It is well documented that ketogenic and low CHO diets are beneficial for body composition changes, namely weight reduction through decreases in adipose (fat) tissue. This isn’t surprising considering fat oxidation (fats being burned for fuel) becomes the primary energy source in a ketogenic diet.
Keto Diets and Athletic Performance
In terms of athletic performance the evidence is less clear. Majority of the current studies looking at athletic performance and ketogenic diets routinely involve small sample sizes of elite athletes and over a short time frame (3-10 weeks). As a result, any findings from these studies need to be interpreted and considered with other available literature. With such a specific cohort (study population) transferability of the results to other non-elite athletes becomes difficult.
Exercise Capacity
In terms of endurance performance, there appears to be a reduction in performance during high intensity bouts above 70% of VO2Max when on a short term (3-10 week) ketogenic diet. The postulated causes include; fats require greater oxygen uptake and energy to be broken down compared to CHO, possible impaired glycogen metabolism at higher intensities. However, one study which looked at endurance athletes who were on ketogenic diets for longer than 6 month showed no changes in muscle glycogen stores.
Resistance Training
For resistance training and lean muscle mass it appears that ketogenic diets result in reduced body mass, with conflicting evidence on whether it impacts on lean muscle mass. Regardless, it doesn’t appear to negatively impact strength.
Bone Health
Bone health is an interesting area. An Australian study published early this year revealed that bone resorption (break down of bone) increased and bone formation (new bone formation) decreased in elite athletes (race walkers) while on a short term (3 – 3.5 week) ketogenic diet. This study received a lot of press because the implications are potentially serious; ketogenic diets leading to reduced bone mineral density and bone injuries in elite athletes. However, this study needs to be put into context. It looked at elite race walkers, predominantly males who were on short term ketogenic diets. This is a very specific subgroup of people. As the study rightly points out, further research is needed to understand these findings further before any definitive answer is known about ketogenic diets (short and long term) and bone health in elite athletes and in the general population.
The Wash Up
When it comes to athletic performance ketogenic diets improve fat oxidation and reduce body mass, which is important in endurance sports and weight-class based sports such as boxing, weight lifting, martial arts etc. They don’t negatively affect exercise capacity at submaximal workloads below 70% VO2Max but they do appear to reduce exercise capacity at high intensities. They may also reduce endurance capacity but this appears to be individual, with some athletes being affected and others not. At present, finding the right balance of lower CHO levels which are higher enough not to impact performance at higher intensities is the best approach to maximize athletic performance through a ketogenic diet. One final note, even though CHO intake levels are low, this does not mean an athlete will be running a negative energy balance; energy expenditure should always match energy intake.
As a Melbourne city sports chiropractor with a postgraduate diploma in sports and exercise medicine including nutrition and sports nutrition, Dr. Shannon utilizes diet and supplementation within his wholistic approach to rehabilitation. To book an appointment today with Melbourne city chiropractor Dr. Shannon or sports massage therapists Paula Pena click below. Our Melbourne CBD chiropractic clinic is centrally located on the corner of Collins Street and Swanston Street, opposite the Melbourne Town Hall in the Manchester Unity building.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
The Benefits of HIT/HIIT Training
Exercise and physical activity are extremely important for our overall health and wellbeing. With evidence showing physical activity improves; quality of life, sleep, cognition, physical function, insulin sensitivity, while reducing the risks of; clinical depression, dementia, a raft of cancers and chronic preventable diseases, as well as anxiety, blood pressure, weight gain and falls. You can read more about the benefits of physical activity in Melbourne city chiropractor Dr. Shannon’s article on Exercise Medicine.
The current recommendations for physical activity are for 150 minutess per week of moderate to vigorous exercise, this means exercising to an intensity where it is still possible to maintain a conversation but with difficulty. High intensity (with/without intervals) training is a great way of efficiently reaching that 150 minutes per week mark with a host of added benefits.
High Intensity Training (HIT) / High Intensity Interval Training (HIIT)
HIIT refers to exercise that occurs in frequent short burst or “sprints” of high intensity exercise, with recovery periods. The sprints can last from 30 seconds to 4 minutes, with recovery periods lasting anywhere from 1 to 4 minutes and repeated sprints of 2 to 6 cycles per session. For true HIIT to be achieved, heart rate (HR) needs to reach 85-90%+ of max HR during the sprint effort. This is the key difference with moderate continuous training (MCT) where HR will only reach 60-70% of max HR.
One of the appealing features of HIIT programs are how time efficient they are, especially when compared to MCT. In addition to this, HIIT programs appear to result in similar or greater endurance performances and VO2max (a measure of fitness) when compared to MCT.
Cardiovascular protocols utilizing short intervals (30 seconds or less), for 5 minutes or less, performed 4 or fewer times per week will assist in developing VO2max in the general population. However, the greatest improvements come from longer sprint intervals (2 minutes or longer), higher volume (15 minutes or longer) over a longer duration (4-12 weeks). Resistance training HIT protocols are typically defined as more than 70-80% of a 1 repetition maximum, performed at a maximum of 1 set of 12 repetitions.
Finally, for anyone considering a HIIT program it is important to note that even though HIIT appears to be safe for most individuals, consulting a health/medical practitioner to determine if a HIIT program is safe for you is extremely important before you start any HIIT program.
To book an appointment with Melbourne city sports chiropractor Dr. Shannon or remedial massage therapist Paula Pena you can book below. You will find our Melbourne chiropractic clinic located on Collins Street in the Melbourne CBD opposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
Supplements Are Big Business!
Sports nutrition supplements, more formally known as nutritional erogogenic aids are part of a supplement industry that is currently booming, with sales in Australia skyrocketing to $1billion dollars per year. It is not hard to miss manufacturers bold advertising campaigns, their lists of powders, pills and liquids for pre workout right through to post workout and recovery, all there to help you “train harder” and achieve “mass gains”. If you do miss the advertising, you cannot miss the plethora of blogs and websites dedicated to sharing what the “best” performance supplements to take are.
As a Melbourne city chiropractor who has undertaken sports nutrition in his postgraduate sports and exercise medicine training, sports chiropractor Dr. Shannon breaks down what you need to know about sport supplementation.
Do Supplements Really Work?
Do these advertised supplements actually work? The simple answer is well summed up by Professor Ron Maughan who said “if it works, it is probably banned (by WADA). If it is not banned, it probably doesn’t work.” However, there are some exceptions that we will get to. For elite athletes subjected to drug testing, ergogenic supplements can be a challenging area. Studies show high rates of contamination among supplements with one study ranging from 12-58%, predominantly for prohormones and stimulants. There are also everyday health considerations for non athletes, do you want to be ingesting a supplement containing a banned substances?
How To Protect Yourself From Banned Supplements
Thankfully there are some tools out there to help athletes and individuals to navigate through the challenging world of ergogenic supplements. There are fantastic sites like informed-choice who independently test batches of supplements to determine if they contain banned substances. The Australian Institute of Sport (AIS) also have a sports supplement framework which is based around the best available evidence to determine the safety, efficacy and legality of different supplements.
Which Supplements Work And Which Are Banned?
Using the AIS framework it becomes clear which supplements have strong evidence to support their use and which don’t. Grade A supplements backed by strong evidence which aren’t banned include:
Caffeine
Beta-alanine
Bicarbonate
Beetroot juice (nitrates)
Creatine
Glycerol
Grade B supplements, those containing emerging evidence or deserve further research include:
Carnitine
Fish oil
Curcumin
Branched Chain Amino Acids (BCAA)
Tyrosine
Vitamin C and E
Grade D supplements, those that are on the banned WADA list include:
DMAA (stimulant)
DMBA (stimulant)
DHEA (prohormone/hormone booster)
Maca root powder (prohormone/hormone booster)
“Peptides”
Final Thoughts on Sports Supplements
Don’t be drawn in by the bold advertising nor the websites and forums. Have a thorough understanding of the risks and benefits of any supplements being considered. Consult an appropriately trained health professional to see if you actually need to be taking any supplements at all, it maybe a change in diet and training is all that is required.
There are ergogenic supplements out there that have good evidence to support there ability to enhance performance in endurance, sprint and power sports – you can find more information on how protein enhances performance here. However, there are also a great deal of supplements out there that have no evidence to support there use and may well even include banned substances, so make sure you know what you are putting into your body.
If you are looking to improve your performance or just get the most out of your body, book an appointment today wtih Melbourne city chiropractor Dr. Shannon or remedial massage therapist Paula Pena at your Melbourne CBD chiropractic clinic on Collins Street, opposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
Runners are always looking for ways to improve whether it be through hydration, supplementation, diet, training and coaching. Although shoe type (minimally shod, shod etc) often get discussed in relation to injury rates and foot strike patterns, less attention is paid to the effect shoe weight has on running performance. In our Melbourne city sports chiropractic clinic many of our recreational runners run in shoes like ASICS Kayanos which weigh around the 300g mark. So what does this mean in terms of performance for those runners?
A research paper looked to quantify the effects heavier shoes had on running times. Blinded to the runners, the researchers placed lead weights into runners shoes (normal shoe weight, normal shoe weight +100gm and normal shoe weight +300gm) and then had them run on a treadmill and perform a 3km time trial. The data showed that the energy cost of the runner increased by 1% for ever extra 100gm of weight.
What Does This Mean?
This small study leads some support to the notion that if two runners with the same age, fitness, race pace and times line up against each other one wearing a 200g shoe and the other a 300g shoe. The runner in the 300g shoe will have to exert an extra 1% of their energy to cover exactly the same distance. This is likely to result in a slower finishing time.
It should be noted though, there is a lower threshold limit for shoe weight. Ie, having the lightest possible shoe doesn’t mean you will run the fastest. The cushioning of the shoe helps to absorb impact shock and therefore reduces energy expenditure. If you remove too much cushioning, energy expenditure will increase because that cushioning effect is greatly diminished.
If you are interested in more running related blogs we have a great selection, especially on running injuries. To make an appointment with Melbourne city chiropractor Dr. Shannon or sports massage therapist Paula Pena you can book below. You will find our Melbourne CBD chiropractic clinic on Collins Street, opposite the Melbourne Town Hall.
Shannon Clinic – Melbourne Chiropractic and Sports Care Blog
In January 2016, Melbourne city chiropractor Dr. Shannon published his first journal paper titled “Running Medicine: A Clinician’s Overview” which was published the the peer reviewed Chiropractic Journal of Australia. This paper would be the impetus for a series of journal papers Melbourne city sports chiropractor Dr. Shannon would go on to write which included papers co-authored by sports medicine physicians and orthopaedic surgeons on shoulder injuries, injuries in elite tennis players and sports concussion.
Below is a text copy of the paper with a link to the journal at the end.
INTRODUCTION
Running is associated with a variety of sports, but as a stand-alone activity its popularityhas exploded. Running is an efficient way to increase physical fitness and lose weight. As a result there has been a rise in charity fun runs and races [1, 2]. Today the number of recreational runners far exceeds competitive runners [3].
Like all physical activities there are injury risks associated with running, with injuries rates reported from 19-79% of participants per year [4]. Despite the great advancements in shoe technology and materials since the inception of the modern running shoe in the 1970s, running injury rates have remained largely unchanged [5].
Acute injuries in running are generally rare, with 80% of all injuries due to overuse. 37-56% of runners are expected to endure an overuse injury each year [1,6]. The most common injury sites in runners are the knee and Achilles tendon, which account for nearly 20% of all running injuries [6]. When expressed as a percentage of body part, the knee accounts for 25% of all injuries, followed by the lower leg (20%), the foot (16%), ankle (15%), upper leg (10%), hip/pelvis (7%) and the lower back (7%) [7].
The most prevalent injuries seen in runners are Achilles/calf injuries, iliotibial band injuries, meniscal injuries, patellofemoral pain syndrome, hamstring and quadriceps injuries [2]. Running injuries are associated with 2 consistent predictors, total miles run and previous injury [6].
With such high participation rates and high injury rates there is a strong probability that primary care physicians will see patients with a running-related injury. It is therefore important to understand the types of injuries runners have, the potential biomechanical and technique related-causes associated with running injuries and the different foot striking patterns runners adopt. This paper will provide an overview of the more common running injuries encountered in practice, the mechanical and technique deficiencies associated with running injuries and the different types of foot-striking patterns.
Discussion
Common Running Injuries Seen In Practice
There are scientists who believe we were born to run [9]. This was created out of a need to hunt for prey to survive and it is this belief that has driven the trend of barefoot running. When shoes are removed one can appreciate the anatomical complexities involved with running. This primarily involves the great toe, heel, ankle, knee, hip, pelvis and lower back. These are the areas which assist in absorbing the ground reaction forces associated with running, and higher ground reaction forces may be associated with a greater risk of injury [10,11].
Running injuries can be linked to overuse, higher ground reaction forces, previous injuries, orthotic inserts, and biomechanical and technique deficiencies [1,6,10,11]. These may result in complaints such as tendinopathies, tendon and muscle strains and tears, stress reactions and fractures [2,12,13]. Table 1 shows some of the more common running injuries seen in clinical practice.
Since 80% of running injuries are associated with overuse, it is important to establish the potential cause(s) of the injury, with many injuries being multifactorial [14-16]. Stress reactions and fractures are related to higher ground reaction forces, which are often associated with running kinematics. Mileage, improper footwear, training surfaces and poor musculoskeletal conditioning are associated with tendinopathies and strains.
Common Clinically Seen Biomechanical Deficiencies
Biomechanical and technique deficiencies have been identified as potential risk factors for running injuries [13,17,18]. One of the most common running injury, patellofemoral pain syndrome, which accounts for 17% of running injuries [19], has been linked to several different biomechanical factors, including reduced muscle strength and altered mechanical loading, lower limb kinematics and muscle activation patterns during running [20].
Table 1. Common running injuries
Lower limb kinematic studies tend to investigate the hip angle (flexion, adduction, drop, internal rotation), knee angle (flexion) and ankle angle (flexion, eversion, inversion) [21]. These joints are most prevalent in absorbing ground reaction forces and as a result, deficiencies here will lead to injury. Tables 2 and 3 show some of the deficiencies runners may have.
Table 2. Biomechanical deficiencies [22-24]
Since running injuries are multifactorial, treatment should focus on addressing all of the deficiencies involved with the injury. This may include rehabilitation and strengthening, changes in training habits, correcting technique errors and/or footwear, changes in step rate and alterations to foot strike [2,6,27].
Striking Patterns
Striking patterns refers to how a runner hits the ground with their foot. Runners can be a rearfoot striker (RFS), a midfoot striker (MFS) or a forefoot striker (FFS). RFS strikers account for 75% of all runners in traditional shoes, MFS 24% and FFS 1% [28]. RFS and FFS strikers exhibit differing load absorbing behaviors of the lower limb which can potentially lead to injuries or can potentially be used to help prevent injuries [26,28]. MFS impact loads sit in between RFS and FFS [28].
RFS have been shown to exhibit higher vertical impact peaks and load rates which have been associated with tibial shock,stress fractures, plantar fasciitis and patellofemoral pain [11,29,30]. RFS are also associated with increased loading of the muscles in the anterior compartment as a result of the dorsiflexed ankle. This may then lead to hypertrophy and increased pressures in the anterior compartment, and ultimately to exertional compartment syndrome [31].
Table 3. Technique deficiencies [25-27]
To combat the injury risks associated with RFS, a FFS pattern has been suggested as a way of reducing running-related injuries [26]. FFS has been shown to reduce patellofemoral contact force and patellofemoral stress [26]. There is also limited evidence to suggest that during the braking phase of the gait cycle, there is lower eccentric quadriceps work compared to RFS, potentially resulting in lower knee loading [32]. However, FFS results in greater plantar flexion of the ankle and this causes higher plantarflexion movement and Achilles strain, compared to RFS, which may increase the risks of foot and ankle injuries [25,33,34].
Step rate change (the number of steps per minute), has been associated with lower ground reaction forces and has been suggested as a possible avenue to help reduce the risk of running injuries. Forefoot running is closely associated with barefoot running and evidence suggests barefoot runners have reduced rates of loading compared to RFS in shod shoes, as well as a shorter stride length, which also has a load reducing effect [28]. Increasing the step rate by 5-10% helps to reduce bounce, lower extremity stiffness and moves the striking foot under the body. Reducing energy absorbed by the hip, knee and ankle and reducing the energy in the patellofemoral joint; however, it may increase the impact loading of the tibia if the rate is greater than 164 steps per minute [27].
CONCLUSION
Due to the high participation and injury rates seen in runners it is important for primary care physicians to be aware of the more common running injuries, the deficiencies that potentially contributed to the injury and how foot strike pattern may contribute to injuries but may also be beneficial in treating running injuries. When working with runners a multifactorial approach is required to improve lower limb strength, correct any malalignments and reduce ground reaction forces through strategies like changes to training habits, strengthening programs and changes to step rates and foot striking.
If you are struggling with a running related injury or keep breaking down with injuries, make an appointment to see Melbourne city chiropractor Dr. Shannon today. Additionally, for those looking for sports massage to help flush their legs during training, our Melbourne remedial massage therapist Paula Pena is available. Our Melbourne CBD chiropractic clinic is located on Collins Street, opposite the Melbourne Town Hall.
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