Rotator cuff injuries are a common cause of shoulder pain, with the elderly population having a higher percentage of rotator cuff injuries to the younger population due to reduced blood supply to the rotator cuff with age.
Non-surgical treatment is highly effective for rotator cuff injuries with a focus on increasing shoulder range of motion and strength to assist with increase in blood supply.
Some modifiable risk factors for rotator cuff tears include; posture, smoking and poor or insufficient diet.
Interestingly some of the non-modifiable risk factors include; age (with increasing age comes increased risk), hand dominance, gender, age and pathology of the other shoulder.
With consideration of the modifiable risk factors we should aim to strengthen and improve posture (reduce forward and internally rotated shoulders and forward head posture), quit smoking if you currently smoke and eat a diet that includes the following key components to support our tendons, while this list is not exhaustive, it provides an area of consideration;
 

• Collagen: Tendons and ligaments are largely made up by collagen, regular intake can help to nourish them and also assist in repair
• Vitamin C – Assists with rebuilding collagen
• Omega 3 fish oils – A natural anti-inflammatory which is important for wound healing and a proper immune response.
• Zinc – Important for tissue development and repair
• Glucosamine – Assists with increasing tendon to bone healing

​As we move into the hotter weather normally we focus more on our fluid intake, however we should be considerate of this all year round. Have you ever stopped to consider how much you should actually drink to keep your body hydrated?

Our bodies are made up of up to 60% water, with different organs and areas having higher or lower percentage of body water. Did you know all of the ways water helps us?

• A vital nutrient to the life of every cell, acts first as a building material.
• It regulates our internal body temperature by sweating and respiration
• The carbohydrates and proteins that our bodies use as food are metabolised and transported by water in the bloodstream;
• It assists in flushing waste mainly through urination
• acts as a shock absorber for brain, spinal cord, and fetus
• forms saliva
• lubricates joints

(USGS, 2018. The water in you. https://water.usgs.gov/edu/propertyyou.html) 

Males and females will have a different level of water, with males typically having a higher percentage of water, also people with high muscle density will have more body water, individuals with a higher fat mass will have a lower body water percentage. 

When you are looking to optimise your fluid intake I researched numerous articles and papers to identify the recommendation, whether it be by calculation per body weight or a general rule. The common theme was 2.7L for females and 3.7L for males from the National Academy of Medicine, with this number in mind consideration should be placed that water will be ingested from our food and some other beverages. 

A really simple test you can do is check the colour of your urine in the day. After you have had your first toilet trip in the morning from there after you are looking for a pale yellow to clear urine. Anything darker or smelly requires more fluid. 

Keep in mind also, if you are exercising you need to increase your intake also. If you had weighed yourself prior to exercise and then weigh again afterwards. What ever the change in weight is, times it by 1.5 to determine your replacement water intake.

Exercise associated muscle cramps (EAMC) can be quite debilitating during exercise, anyone who has had a cramp before either during exercise or not would agree they can be quite painful. Researchers 1 suggest that the cause is still unclear and has been postulated that it could be several factors combined in the right conditions which induce EAMC. These factors include;
 

1. Neuromuscular fatigue
2. Dehydration - Electrolyte Imbalance

 
Dehydration – electrolyte imbalance had its limitations due to the level of dehydration and electrolyte loss that caused one individual to cramp was not identical in other individuals. There was no cause and effect relationship from the levels of dehydration and electrolyte loss.
 
Neuromuscular fatigue when reviewed found that cramps were more likely to occur when the muscle placed into a shorten position - when you bend your leg and your hamstring cramps, the hamstring is in a shortened position. As the muscle fatigues the afferent nerves (the ones that send signals from your muscles to your central nervous system) also fatigue. It is unclear where the neuromuscular fatigue is occurring which could induce a cramp, the peripherally (in the muscle) or centrally. Furthermore, it is suggested that fatigue is essentially a continuum rather than an absolute point.
 
Treatment methods included; hydration, electrolyte replacement, carbohydrate replacement and stretching. Of all these methods, stretching gave significant relief where hydration, electrolyte replacement and carbohydrate replacement did not provide relief to cramps particularly as it can take up to 13 minutes for the ingested substances to be digested and moved into the blood stream.
 
So, what should one do about the cramps then? Let’s look at prevention, this is not a concrete solution due to research not finding absolute cause and effect relationships for EAMC however it can provide the best alternative to putting your head in the sand and hoping for the best.
 
Hydration prior to exercise and as a daily focus, our bodies have approximately 60% of their content from water in adults which should be maintained for optimal function and towards prevention of EAMC and heat stress. Pre-hydration should commence a few hours prior to exercise to allow urine levels to return to normal and with the goal of commencing activity with normal plasma levels. Due to varying sweat rates during activity and individualized hydration program during activity is recommended. You can determine your sweat loss by weighing yourself before and at then end of exercise.  During exercise fluid ingestion is suggested to be sufficient to ensure no more than 2% body weight loss after exercise 2. Hydration post exercise looks at returning fluid loss and electrolytes during activity.
 
Exercise to delay neuromuscular fatigue should be incorporated into your training programs. These are a combination of strengthening the muscles you will be using during your chosen exercise. A combination of eccentric training and plyometrics can be beneficial to improving your bodies ability to withstand neuromuscular fatigue. Complimenting this with a balanced stretching program. These exercises should be undertaken in the correct volumes and at the right times of your strength program, therefore getting an individualized program that progresses you through volumes and frequencies that align with your current level of strength and ability is key.
 
References 
1. Miller, K. C., Stone, M. S., Huxel, K. C., & Edwards, J. E. (2010). Exercise-Associated Muscle Cramps: Causes, Treatment, and Prevention. Sports Health, 2(4), 279–283. http://doi.org/10.1177/1941738109357299 

2. Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. (2007). American College of Sports Medicine position stand. Exercise and fluid replacement. Medicine and Science in Sports and Exercise. 2007 Feb;39(2):377-90. 

I love time in my garden on a weekend, mostly as I enjoy the beauty it gives, the nice space for our family to enjoy and also digging, pruning etc are all tasks that either can take your days focus away and leave you solely focused on the task at hand or can provide some amazing thinking time. Last weekend it was the latter and I wanted to share my thoughts with you;
  A new job takes time to learn, sometimes we make mistakes or we need time to settle into a new routine. The key is we show up each day, mostly because we get paid or we will get fired if we don't. Consider your exercise plan, are you continually showing up? We cannot expect to develop a new routine or see progress unless we do. Your payment is good health, longevity and reaching the goals you set out to achieve.
This week and moving forwards, make sure you show up for yourself.

Joint's starting to feel the cooler weather, or maybe they ache even without it being cold? Dr Oz has some great tips for improving joint pain and I agree, this is something you should not have to put up with. Exercise strengthens the muscles that support the joints and draw the bones away from each other to maintain joint space. If you are unsure where to start with exercises, be sure to get in contact with me to have your exercise program written specific for your needs and current ability. The joint support recommended in this video you can get direct from me, this is a product I can't speak highly enough of. All client's who use this have found reductions in joint pain within a short period of time. Make sure you reach out via phone or email to talk about this product.

Working against gravity and maintaining good posture is essential to keep living and performing at your best. With so many of our tasks being in front of us our chest can get tight which then draws our shoulders forward and inward.

Grab your foam roller out and take a few minutes to lie down and stretch out your chest. If you don't have a foam roller you can use a rolled up towel or blanket, it won't be as effective but it will give more stretch than if you were lying straight on the floor. In need of a roller, I always stock the long 90cm rollers, give me a call and I can get one to you!

Enjoy for a few minutes with your arms in varying positions, relax breath and enjoy. Remember if you have any discomfort to get in touch with BODY FX Exercise Physiology Services.

The thoracic spine's main function is be the attachment of the ribs and to protect our heart and lungs. Reduced mobility in the thoracic spine can be from a number of reasons some of which can include; sitting with poor posture for long periods at a desk or while driving, breast feeding in awkward positions and having poor exercising techniques.

Reduced mobility in the thoracic spine can have a number of impacts on the body;

- Reduced ability to take deep breaths from your diaphragm
- Increased load on your neck which can lead to headaches or neck pain
- Increased risk of shoulder pain or injuries
- Increased risk of lower back pain or a flattening of the lumbar spine which in can tighten the hamstrings and put further pressure on the lower back.

This simple exercise can be done daily to assist in improving your mobility in the thoracic spine, if you have shoulder concerns or pain the option to bend your moving arm (the top arm) and move through the chest is available to you.

If there is any pain felt and you are unable to reduce the range to be pain free, discontinue the exercise and make sure you get in touch.

We sit for a large percentage of our day, releasing your hip flexors is key for standing straight, moving freely (run or walk better) and also assisting in reductions in back pain.

Give this simple stretch a try and then let me know how you found it with a comment below.

Are you stiff in the morning in your lower back on waking, suffer lower back pain through the day. Here are two simple exercises to assist in releasing your back. Always work within pain free range and if you are concerned or unsure about them please contact Shannon from BODY FX Exercise Physiology for assistance.

Post me a comment and let me know how you found the exercises!!

1. Tell me about your job as a podiatrist, what does it involve?
Podiatry is the medical science that deals with the feet and lower limbs. It is primarily divided into three groups the first is general foot care which involves nails, skin, corns and calluses, warts etc.

The second is wound care which involves the treatment of ulcers and wounds in the lower limbs, offloading these wounds and managing the care of the area as part of a health care team and finally there is bio mechanics which studies the way in which bones, muscles tendons, ligaments and joints interact with each other.

Within each of these categorised there is also Sports Medicine, Gerentology, Pediatrics etc. We do basic surgery under local anaesthesia in the clinic, generally on toes and toe nails and occasionally deal with trauma to feet. We also take out our fair share of splinters! So basically... I'm a health practitioner of the lower limb. 
 
2. How would someone know if they need to see a podiatrist?
Anyone with pain or discomfort in the lower limbs can see a podiatrist. From ingrown toe nails to heel pain, knee pain to corns and calluses and everything in between, we can treat and look after you. So I suppose if you have a pair of feet, you will need to see us at some stage!
 
3. Can orthotics go in any shoe?
Not any shoe.... Thongs and open backed sandals are a big ask but most shoes...yes. I have had Qantas stewardesses who have to wear high heels put them in their shoes for work and may other place them into small court shoes. Modern orthotics, using state of the art technology are very slim line and can be accommodated into most shoes.  Those who prefer sandals, shoe manufacturers like Birkenstock and Merrel have thongs or sandals with built in arch support and are great for summer. Of course we can also easily fit them into runner, hiking boots, RMs Fashion boots, etc etc!

4. What's your view on light weight running shoes?
That depends on your definition of a light weight running shoe! Every car needs a different type of tyre. You don't put an all terrain 4WD tyre on a Toyota corolla.... It is just not done, is dangerous and can lead to an accident. Similarly, there are feet that will do well in a light weight shoe and there are feet that need more structure. A marathon runner's definition for a short run is different from those of us who jog once or twice a week.

The foot, the activity and the shoe have to be married together to achieve the outcome. It is always best to buy shoes from a reputable shop with staff trained to fit shoes properly to the foot in need. 
 
5. What should you look for in a shoe for kids while their foot is growing and considering different ages, i.e. pre-school, infants (K-2) primary etc?
We are the only species on the planet (besides horses) that wear shoes. Nature has designed our feet to function without footwear at all. The environment which we have built and created is the reason that footwear has become necessary. Given this fact, I tend to be a big advocate of minimal footwear in toddler and pre-school ages. If the environment is a safe one the child's feet and muscles should be allowed to develop without the support of a shoe. After all nature has been doing this for a lot longer then we have!

School brings with it new challenges. The environment tends to be more structured and so the shoe also needs to become more structured. A good set of school shoes is essential to this. Many parents bring their kids in with $30 school shoes from Target or Big W with problems that could have been avoided with a more appropriate shoe. There is no shoe your child will spend more time in this year than the school shoe so I recommend brands like Ascent, Clarks and Startrite as the go to brands for structure and comfort.

My kids are always fitted to Ascents which I find wear very well and the kids report are very comfortable. If they don't need to be in a "school shoe" then there are plenty of black runners on the market from Asics, Mizuno, Brooks etc .  I always use two tests when buying new shoes. The first test I put the tow of the show in one palm and the heel in my other palm and I compress the shoe horizontally. The only place the shoe should bend is in the forefoot at the toe joint. In the next test, I hold the shoe with the sole of the heel in my palm and my fingers extending forward. I then press the heel. The heel should not collapse if the show is a steady and stable shoe. If parents use these two tests when they buys kids shoes and they pass then generally it is a decent shoe. 

6. Any other great advice?
The only other piece of advice i would add is that a running shoe should never ever see its 1st Birthday regardless of how much wear it gets. When you buy it, lift up the foot bed, and write the date in black Artline. You shouldn't still be in them when that date comes round again!