High-Intensity Interval Training is all rage right now. I have come across stacks of tabloid articles and television programs recently espousing the virtues of HIIT training, and for good reason.
There is good evidence to show that training in short bursts of high intensity can yield all sorts of wonderful benefits towards our metabolic health, body composition and fitness markers. My colleague, Hunter Bennett, wrote a great article on this topic that you can read here. This has lead to the creation of Fitness Franchises and individual businesses that focus solely on the HIIT principle.
In my opinion, such businesses offer fitness training to the masses much in the same way that Fast Food Chains delivers nutrition. Cheaply, poorly, and with an unacceptable level of health risk to their patrons.
So what’s the problem, hater?
There are a few, but I will focus on the two major ones that I commonly see:
1) The lack of pre-exercise screening and assessment.
Before you start training at a fitness centre, the staff (who should be adequately qualified) are required to take you through the ‘Adult Pre-Exercise Screening Tool‘ so that the appropriate level of exercise can be prescribed for you based on any metabolic or physical risk factors you may have.
This is in your best interest as if you have a health concern, either diagnosed or undiagnosed you should ease your way gently into an exercise program. This process is a basic requirement for all accredited Fitness Businesses. If you have started training and you have not been adequately screened using this questionnaire I would be highly concerned about the people you have trusted with your health. They have let you down.
Following the metabolic screening questionnaire, we at iNform believe a thorough evaluation of Movement Competency should be completed, so that you can be prescribed exercises that you are able to complete safely and effectively.
Again, if you are thrust into a High Intensity Circuit class without anyone assessing you movement capabilities (and adjusting your exercise recommendations accordingly) then you have been put into a situation that carries an unacceptable level of injury risk.
2) Overly complex, diverse and advanced exercises.
The evidence to support the use of HIIT style training is derived from studies that generally use quite straight-forward forms of exercises- such as sprints on a stationary bike or rower. Or they use pretty simple resistance exercises such as squats, push-ups, bicep curls etc. Also the groups used in these studies tend to be quite homogeneous- males or females aged 18-23; type-2 diabetics; post-menopausal women etc etc.
So we have simple, yet vigorous exercises being prescribed to a group of ‘similar’ people (with unsuitable people being screened out in the participant selection process) to determine the effect of HIIT training over a period of time.
This does not sound like your average HIIT class- where you might find a 18y.o Netballer; a 48y.o. Accountant; a 32y.o. mother of a 9-month old baby, and god knows who else. Surely if you are putting together a session for a group as diverse is this, in the best interests of the participants you would be more conservative with your exercise selection than those conducting the studies are!
So what should you do?
This article probably comes across as discouraging towards group based HIIT classes. That wasn’t my intention. Rather than discouraging, I hope this article can help you make informed choices about who you trust to guide your exercise programming. If you are thinking of undertaking some HIIT training, here are some things to look out for:
- Do qualified staff screen you for metabolic risk and movement capability prior to entering you into a class. If the answer is no, DO NOT TRAIN THERE!
- Are the exercises require a lot of jumping, throwing, swinging etc. If the answer is yes, BE CAREFUL!
- Do your joints hurt during and/or after the exercise session? If so, THIS IS NOT WHAT WE WOULD CALL GOOD SORE!
- Did the staff conduct a thorough one-on-one evaluation of your metabolic health and movement capacity- then prescribe exercises that were appropriate to you level of fitness and capability with a view to gradually build intensity? If the answer is yes, THIS SOUNDS LIKE SOMEONE WORTHY OF YOUR TRUST!
About the Author
Operation Flinders Mountain Bike Challenge 2019
Throughout the 4 days of the Operation Flinders Mountain Bike Challenge a recurring theme in my thoughts was the relativity of time. From the moment we left the terminal at Adelaide Airport on the Friday morning until we arrived back there on Monday night, we were all completely off the grid. We had no phone or internet connection. Our only form of connection to the rest of the world was a CB Radio, used for location updates to the command centre (and in case of emergency).
It was amazing how slow time passed over those four days. Our days in Yankaninna Station were spent like this: Wake up in our swag; ensure the fire was started and maintained; eat breakfast; tidy up; get dressed to ride; ride from camp A to camp B; arrive at camp B; get changed; eat, drink and chat around the fire; go to sleep under stars; repeat. It was a beautifully simple existence.
Through the days as we rode through stunning terrain we could either quietly enjoy the natural beauty of our surrounds, or chat with our fellow riders. There was plenty of time for each. Most of the participants were strangers to one-another prior to the event. There were a few small groups, but most people only really knew 3 to 4 of the 15+ people that were there for the event. By the end of the fourth day we had united into a real team. We had gotten to know each other well through sharing intimate thoughts and feelings- when you have nothing to do but travel from point to point, then eat, drink and stay warm you have a lot of time to build relationships. And some of the conversations that I had with people who were strangers only a few days ago, I haven’t ever had with long-time friends or even family. When we first met at Adelaide Airport on the Friday there were polite handshakes to introduce ourselves. As we said goodbye on Monday night, there were hugs all round. It was a deeply satisfying trip. I felt relaxed, replenished, rejuvenated.
So what did I learn from this?
I think it is fair to say that most people in our society can relate to this feeling that time is accelerating. That days, weeks, months, even years are careering out of control. Where did the first half of 2019 go? Why is this? Why can 6 months disappear almost in the blink of an eye, yet four days seem like an eternity? Feeling like the to-do list is always longer than manageable and lengthening by two tasks for every one one that we tick-off feels futile and it makes sense that we would feel constantly under pressure. This kind of life is exhausting. At Yankaninna Station we had no choice than to completely disconnect from the rest of the world- but it seems like the pervasive feeling in our society is that we have no choice than to stay permanently connected at all other times. Do we though?
What can you do?
What would happen if you switched your phone off before dinner and didn’t switch it on again until the next morning after breakfast. What if you switched off wi-fi and data-roaming on Friday when you leave the office and used your phone just to make and receive calls and texts from your family and ‘real’ friends. If you were able to do this, what might this do to your perception of time, and pressure? If you couldn’t burn up time mindlessly scrolling through social media pages what might you notice about the world immediately around you? What conversations would you have with your people if your mind wasn’t frequently distracted by alerts from your phone?
No matter how busy you are, you have the ability to find a bit of sanctuary even just for 10 minutes a day by switching off the phone and quietly taking in your surrounds. You can choose to disconnect from the web and completely be with the people you are with. The world will keep turning, it might just seem like it turns a little slower.
About the Author
There is no shortage of people who want to discourage you from running. “It’s bad for your knees!” they knowingly proclaim. Worryingly, some of these people are Medical and Health Professionals. Aren’t we supposed to be encouraging Australians to be more active? So what’s with this?
Is there evidence to link running and knee injury?
Well yes and no. If you take a group of runners and monitor them over the course of a year, some will get injured- and the most likely part of the body that will sustain the injury is the knees. There are a few studies that have looked at this, and the numbers vary from study to study but the consistent themes are; running comes with injury risk; and the knee is the most likely spot you’ll feel it.
But does this justify the blanket rule that running is bad for your knees? If so, we would also have to conclude the golf is bad for your back, swimming is bad for your shoulders and cycling is bad for your neck. Should we also avoid these forms of physical activity?
Why do some runner’s knees get injured?
There is no single answer to this, and the reality is that injuries that develop over time generally do so because of the convergence of a number of factors. Here is a case study that can illustrate this point:
Steve is 45 and works long hours as a Chartered Accountant. He spends extended stretches of time at his computer, occasionally getting up to make another coffee. He often skips lunch, but when he can sneak out he usually grabs whatever is quick and easy from the Bakery across the road. After work he drops in to his local for a quick beer or two with a couple of mates, before getting home in time for dinner with the family. When the kids are off to bed, the feet are up and he spends more time than he should watching Netflix. His sleep is short and poor in quality as a result.
Steve sees his Doctor who informs him his blood pressure, blood glucose and waist circumference are all trending towards the red-zone, and that he needs to start doing some exercise immediately to turn things around. Steve heeds the warning, so early Saturday morning he laces up his ten year old sneakers he usually wears to mow the lawn, chucks on a t-shirt and shorts and gets out to his local Park-Run 5km. Steve starts out confidently but after about 500m starts to puff and pant. By 2km his knees and lower back are getting sore but he is a determined bugger, so he drags himself across the next 3km with a slow, loping stride. ‘This will only get easier’ he tells himself, and to his credit he repeats this torture for the next 3 weeks.
By Sunday after week 4, his knees are swollen, sore and hot to the touch. He sees his Doctor again the following day and fills him in. “Well you shouldn’t have started running, don’t you know running is bad for your knees?! You should walk, or maybe ride a bike instead”.
Was running the problem here? Or what is that Steve, although well-intentioned, just plunged himself into a task he was completely under-prepared for and hurt himself as a consequence?
Steve’s current lifestyle needs a dramatic overhaul- his overall health could benefit greatly from making some improvements to his diet, reducing his sedentary time, reducing his alcohol frequency and making sleep a greater priority.
Steve could get some advice on footwear by someone who knows what they are talking about. He could also invest some time and money speaking to an expert on how to build his body and his running form so that when he does run he has the strength and the technique to do so more efficiently.
This sounds like an awful lot. But the reality is that running is hard on your body but that is why it can impact our health in such profound, positive way. Our body adapts and evolves to physical stress if it is dosed out appropriately. It is worth making the health changes to equip your body to not only meet the demands of running, but to thrive on them.
Running is not inherently bad for your knees. Running does put your overall health under the microscope, and penalises you for what you neglect. Rather than discouraging people from running, we as Health Professionals should be encouraging our clients to audit and refine how they take care of themselves.
About the Author
The British Journal of Sports Medicine recently published a review of the evidence for Strength Training as a strategy to reduce injuries in Athletes- and the results are impressive! For those that tend to just read the first few lines of an article, take this away. If you are an athlete, or you coach athletes, strength training should be a priority in your programming if you want to reduce injury risk. For the rest of you, please read on.
This article was by Lauresen, Andersen and Andersen (2018). Below is a summary:
- 6 studies were included, totaling 7738 participants aged between 12-40 y.o.
- The average intervention duration was 21.39 weeks.
- Average volume of training was 80 reps per week.
- Average intensity was 8.39 RM (these means the maximum number of repetitions that can be performed for a given exercise).
- Strength Training reduced sports injuries by 66% with a 95% confidence interval of 52% (combined results from 4 of the 6 studies).
- A 10% increase in strength training volume resulted in reduced injury risk of 4%.
- No injuries occurred as a result of the strength training throughout the interventions.
- Strength training was both safe and effective for adolescents as well as adult athletes.
Why? The Mechanisms
The authors can only speculate as to why strength training helped protect athletes from injury, but their proposed mechanisms to explain its effectiveness are:
- Preconditioning- effectively toughening up the muscles/tendons so they can deal with greater loads.
- Variation of loading across the body so that parts of the body that are not stressed by the sport take more of the load in the gym.
- Improved coordination and technique in the gym crossing over to movements in sports.
The authors concluded with the following recommendations for strength training, and I advise that if you choose to trust an Exercise Professional to help you or your athletes commence a strength training program that they can demonstrate an understanding and adherence to these principles.
- Commence with a familiarisation period so that the athletes can develop the confidence and capability to perform the exercises correctly.
- Ensure the athlete is supervised in the gym so that exercises can be completed well and loads are monitored accurately.
- Loads are individualised to the athletes capability and are altered appropriately over a training cycle.
- Exercises are varied across the year of training.
I would add in that it is also important that the strength training program is correctly synchronised with the training and competition schedules, so the Exercise Professional must be in regular communication with the athlete’s coach. For example, during an athletes off-season they can focus on improving function and technique; during pre-season switch to muscle building; and within season aim to build/maintain strength and power. The Exercise Physiologists at iNform have extensive experience managing the strength training programs of athletes across many sports. If you would like to speak to one of our EPs about the services we offer athletes, please contact us!
About the Author
Lauersen, J. B., Andersen, T. E., & Andersen, L. B. (2018). Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis. Br J Sports Med, bjsports-2018.
Recently the Journal of Sports Sciences published a Systematic Review detailing the factors associated with injury in Elite Junior Tennis players. It is important that coaches and parents of such athletes are aware of the findings (Oosterhoof et al, 2018).
Risk Factors for Lower Back Injury
Previous Lower Back Injury:
Previous injury is often a good predictor of future injury. Why? That is not clear, but one reason may be that rehabilitation of injuries is often not done to the level that it needs to. Rehab is often done adequately to get a player back on the court, but functional deficiencies can remain. This can predispose the athlete to recurrence, or to injury of another part of the body due to compensation. Elite Junior Tennis players should undertake their rehabilitation under the guidance of a Physiotherapist and Exercise Physiologist that are experienced in this field.
Training Loads > 6hrs p/wk:
Elite Junior Tennis players will be training and playing at least this amount. So how do we mitigate against this as a risk factor? For one, the athlete needs to have a good recovery repertoire and be diligent with it. A recovery program should be personalised for the athlete, but some common features of an athlete recovery plan are; adequate sleep; good diet, hydration and nutritional support (protein especially); massage; stretching and cold-water immersion. Secondly, Functional Resistance training can help build strength in muscles and tendons, mobility in joints, stability in movement, balance and spatial awareness. If your child, or an athlete under your guidance does not have a recovery plan, and/or is not undertaking a quality, personalised functional strength program I would speak to a qualified and experienced Exercise Physiologist to help them build one.
Risk Factor for Upper Extremity Injury
Fewer Years of Playing Experience
The authors do not specify what it meant by ‘fewer years of experience’ so we can only speculate. But generally speaking, when a young person starts at a new sport, their body is going to be exposed to forces that they may not be conditioned to deal with. I recommend that young people new to tennis undertake an overall movement capacity assessment, such as the ‘Movement Screen’ (Movement Screen ). This will identify any functional limitations that can be corrected through a functional strength training program. We use the Movement Screen with all of our young athletes at iNform.
Risk Factor for Lower Extremity Injury
Interestingly, in the studies included in the aforementioned review players that regularly stretched the muscles of the lower body had an increased risk of injury than those that didn’t. This is counterintuitive for most, as stretching is supposed to be good for us, right? Stretching can be useful for increasing the mobility of a restricted joint. However stretching can also acutely reduce our muscles responsiveness and power. So there are pros and cons to stretching for athletes. If an athlete is going to be prescribed stretches, they should be recommended only for areas that display movement restriction (and have shown a positive response to stretching) and should be timed so that performance is not impacted negatively. The Exercise Physiologists at iNform can easily identify whether a young tennis player would benefit from stretching, and recommend when is best to do it.
Whilst there are injury risks associated with playing Elite Level Tennis at the junior level, they can be mitigated by taking an intelligent and strategic approach to the young athletes programming. The Exercise Physiologists at iNform have extensive experience helping Elite Young Tennis players stay strong and healthy and on the court.
About the Author