Have you heard about how exercise and ADT should go together like sausages and bread? Research has shown exercise can help to reduce side effects of this treatment (without influencing the effectiveness of the drug). Prostate cancer, unfortunately, needs male hormones (androgens such as testosterone) to thrive, so one of the main types of drug therapy for this disease is androgen deprivation therapy (ADT). These medications aim to reduce or block the effect these hormones have. Whilst it can be an effective treatment, reducing the amount of testosterone in a man’s body does have a significant impact in the form of confronting side effects such as weight gain, loss of muscle mass and menopause-like symptoms. Here is a look at 6 different ways exercise can help you deal with treatment side effects:
1. Exercise and ADT: Improving body composition whilst on ADT
As a typical side of effect of ADT, men may notice an increase in abdominal fat and reduction of your muscle mass. However, did you know that exercise can lessen the change in your body composition? Research shows that if men complete 2-3 sessions of progressive resistance training per week, they will minimise the loss in muscle mass and strength. If men were taking ADT for a short time (3 months), a combination of moderate to high intensity aerobic and resistance training will help prevent changes in fat mass. However, if men are using ADT over a long period of time, they will have to also make changes with their diet to see changes in your fat mass.
2. ADT can impact your strength and endurance: Exercise can help!
ADT and the lack of testosterone can impact their day-to-day capacity/endurance and as such can affect their ability to do the fun things in life (playing with grandchildren, working in the shed, catching up with friends etc). The great news is exercise can help! Whilst it is not new that exercise can help keep everyone feeling fit and capable, the interesting thing is that the sooner men start/continue once ADT is commenced, the less ADT related capacity you stand to lose.
3. ADT can lead to excessive fatigue, but did you know exercise is one of the best treatments?
Due to the decline in androgen production (ie: testosterone) and other cancer-related issues, men may notice an increase in their fatigue levels. This may mean they do not feel as able or motivated to live life as they used to. Whilst it may be counterintuitive, research shows that progressive exercise (building up to 150mins per week) is arguably the BEST medical management strategy to reduce fatigue. That being said, it is important to learn how to regulate how much they do depending on how they feel. One day they may find the walk to the letterbox is moderately hard, whereas another day they may be able to complete a full 30 min moderate intensity brisk walk. Interestingly, the higher the fatigue levels, the greater the benefits from exercising.
4. Keeping the bones strong is really important when on ADT
Another side effect of ADT is a possible reduction in bone mineral density (and may even lead to osteoporosis and bone fractures). Preliminary research shows that at least 2 sessions of resistance training per week can mitigate losses in bone density. However, this exercise needs to be reasonably heavy and “impact” the bone – we want to challenge the bone enough to increase its density. We recommend that exercise is slowly progressed to this impact exercise so as not to increase the risk of injury.
5. Exercise can reduce your risk of other diseases whilst on ADT
Men are already dealing with a lot thanks to a prostate cancer diagnosis. SO it is important to note that due to the changes in hormone levels and a combination of other factors, there is an increased risk of developing other metabolic conditions such as type 2 diabetes, cardiovascular disease and high blood pressure in men on ADT. There is preliminary research showing positive changes in blood sugar, cholesterol and triglyceride levels. In other cancer populations, they have shown that exercise can provide a protective effect against the cardiometabolic diseases. So to reduce the burden, get on your bike!
6. Other side effects from ADT can be impacted by exercise
There are a few other benefits, which are fantastic for men on ADT! Did you know that new evidence suggests that exercise may help to preserve sexual activity and libido and lessen declines in sexual function? It may improve mood and reduce psychological distress, anxiety and depression. Finally, observational data suggests that is may even reduce the risk of dying from prostate cancer and even improve overall lifespan. If we could put all these benefits into a pill, would you take it?
The when, where and how of exercise for men undergoing ADT?
For many men, they are not exactly sure where to start, so here are a few ways:
You can visit an accredited exercise physiologist who specialises in treating those with cancer who can set you up with an individualized program. This will help give you the tools and knowledge to exercise and get the benefits from it.
There are a few online programs that can guide you if you do not want to or do not have the resources to visit an exercise specialist. Check out online!
If you are comfortable exercising on your own, you can get straight into it. Much of the literature prescribes 2-3 resistance training exercise sessions per week plus building up to 150 minutes of moderate intensity aerobic exercise per week (but remember that you do not want to go to hard to quickly – building up is the best way!)
My Father-in-law absolutely loves wine. As long as it is a big, smooth Barossa Shiraz. I on the other hand like a bit of diversity- a cold, crisp Riesling on a hot summer’s day; a big brooding Cabernet on a cold wintry night; a Pinot, well, there are a lot of contexts where Pinot is appealing! It is much the same with running for me. Some people like to do the same 5km Park Run every week. Great! I however like to run in lot’s of different ways and contexts. So here are my top 5 types of run and where I enjoy doing them the most.
5: Flat Road Running
A long, straight, flat stretch of tarmac in front of me. Feet tapping away with the consistency of a metronome. Breathing in an easy rhythm- every 3rd foot strike. Mind clear, basically meditating. Km’s ticking away without really noticing. This is running relaxation.
Where I do it: The Riverland; Yorke Peninsula (Around Port Broughton or Ardrossan).
From a crouched starting point, then accelerating up to top speed. Driving the knees forward, ripping the elbows back. Completely releasing the brakes. I am sure it feels more impressive than it looks, but in my mind I am flying. The lungs start to bite which is the cue to take the foot off the the accelerator. My legs gradually wind down. I let myself recover, then go again.
Where I do it: Balhannah Footy Oval; Amy Gillett Bikeway
Yes I am serious, I love running uphill. As I approach the incline my mindset shifts. This hill will be like a big meal- just take your time with it and take it one mouthful at a time. I lean forward, focus on pulling my knees through, and get into a nice easy rhythm. I imagine the little engine that could; chug-chugging it’s way up the winding track. The revs are oscillating close to, but always under the red-line until the crest is spotted, then comes an acceleration. Relief as the gradient plateaus.
Where I do it: The (Old) South Eastern Freeway; ‘The Guts’ Track at Fox Creek.
I love narrow, rocky trails. If there is a steep drop-off on one side, excellent. Creek crossing, boulder hopping, ducking under low branches. It can be more like an obstacle course than a run. Agility and power are required to negotiate what the trails offers. One minute I am scampering up tight switch backs; next I am weaving down the other side like a slalom skier. This is an extreme sport!
Where I do it: Sturt Gorge; Morialta
1: Beach Running
This is running stripped (almost!) completely back. Barefoot, wearing just shorts and a hat. Along the shore line, the waves are the soundtrack. Always on a hot day. When the heat gets a bit much the hat gets chucked to one side and in the ocean I go. The first beach run of the summer results in blistered feet and sore calves- but both toughen up pretty quick. For me beach running is heaven.
Where I do it: Normanville to Carrickalinga; Aldinga Beach
I hope to see you out at one of my favourite spots!
What makes YOU exercise? (Other than your trainer)
We all know that exercise is good for us. Some of us exercise for particular reasons and to get certain benefits over others. Whilst some of us exercise with goals in mind like running a half marathon or just being able to pick up our grandkids. Or it might just be that this our time for ourselves each week. Whatever the reason you exercise, and whatever form of exercise you do, for whatever amount of time you do it for; I pat you on the back for the fact that you do it!
The World Health Organisation has released some fresh data last week showing almost one third (30.4%) of Australians aren’t getting enough exercise. Out of 168 countries, we ranked 97th for the % of population being sufficiently active. Which is scary considering physical inactivity is so highly associated with chronic health problems.
Just one type of exercise we do: Resistance Training (aka strength training or weight training)
This is what most clients at iNform typically spend the majority of their session doing. It can look like anything from body weighted strength, focusing on alignment and control, to lifting very heavy weights only a handful of times. The person that hasn’t broken a sweat all session, and the person that is drenched in sweat at the end of the session – have both engaged in strength training. It looks completely different for everyone. That’s the beautiful thing about strength training, it can be adapted and individualised just for you and your body’s specific needs.
For those who are reading this that are regulars at iNform, you will know better than anyone the effects that training with us has. Hopefully from brightening your mood and giving you a giggle, to helping increase your body awareness, getting you stronger and facilitating better movement throughout life’s activities. But for those who maybe don’t know all of the amazing benefits that strength training alone can have on your body; I have made a nerdy little list below. Please feel free to share this with your friends and family members who maybe aren’t quite convinced on exercise, there’s something in here for everyone!
How can you get all these benefits, plus more? (we didn’t even look at the benefits of aerobic exercise!)
If you would like to start getting more out of your resistance training sessions, or if you’re wanting to start resistance training but you have some niggles that bother you, I recommend getting in touch with one of our amazing movement specialists who can help find the right exercises for you!
If you would like more information on particular benefits and which study I sourced it from, feel free to email me at: [email protected]
Our list of the 3 best core exercises offer the perfect way to keep your spine health and your abdominal muscles strong and functioning well – no matter where you are!
Those of you who have had some previous ‘iNform experience’ would be fully aware that we tend to stray away from traditional abdominal exercises like crunches, for those movements that train the core in a more movement specific manner.
Now, first and foremost, a bit of a disclaimer – these traditional exercises are unquestionably anatomically correct.
With this I mean that they do indeed train the abdominal muscles – although they certainly don’t really train them in a manner that replicates how they work in the real world.
You see, the muscles of the trunk (AKA, your core) make up a seriously complex system that plays a multitude of roles which are dependent upon the scenario in which they are placed.
With this in mind, they act to stabilise the spine and pelvis during high force and high velocity movements, they transfer force from one limb to another (for example, from the hip to the arm during throwing movements), and can also initiate movement of the trunk itself.
Which should make it pretty obvious as to why traditional abdominal exercises really don’t do enough.
But don’t worry – we have got you covered.
The 3 great core exercises outlined in this article provide a simple way that you can train the muscles of the trunk in an effective and efficient manner. These can be performed at home, and offer a fantastic means of enhancing your ability to stabilise the spine and transfer force – ticking all of the boxes for us.
3 Best Core Exercises You Can Do at Home
So, onto our exercises.
The first cab off the rank is the deadbug.
Extremely simple in premise, this great exercise offers one of the most effective ways to improve core strength and improve spinal stability, while also enhancing the trunks ability to transfer force between the upper and lower limbs.
Moreover, it can be performed anywhere and at any time.
Start by lying on your back with your feet and hands in the air. Your knees should be bent to 90 degrees (you should ultimately look like a ‘dead bug’). In this position brace your abdominals and press your lower back flat into the ground.
Proceed to drive one leg out, while simultaneously lowering your opposite arm back. Extend both out as far as you can without your lower back raising off the floor. This movement should be slow and controlled.
Return to the starting position and repeat on the other side – this is one repetition.
We can thank well known coach Tony Gentilcore for the perfect demonstration
An oldie but a goodie!
When performed appropriately the side plank trains the muscles of the trunk and the hip in a manner that teaches proper spine and hip control. This means a healthier spine, and a stronger trunk – both of which are pretty important of you ask me!
Start lying on your side with your elbow directly under your shoulder. You should be able to form a straight line from the bottom of your feet to the top of your head.
Lift your hips and trunk off the ground, ensuring that they are held in a straight line and completely rigid.
Hold this position for 20-30 seconds, and then repeat on the other side.
Here is a perfect demonstration by super coach, Dean Somerset.
Our third and final option is a specific plank variation that aims to correct the unwanted postural deviations we see as the result of prolonged periods of sitting. I really like this plank variation for a couple of reasons.
Firstly, it is seriously brutal. As a result, you only need to do sets of 15-20 seconds to get a decent effect, and get your abdominal muscles working overtime.
Secondly, it’s really hard to perform incorrectly. Once you get yourself in the proper position, if you ‘lose it’ you will feel it straight away. As a result, you can be sure that this exercises is doing exactly what its supposed to – which is building essentially building a strong and resilient human!
So, without further ado:
Start in a traditional plank position, with your elbows placed directly under your shoulders while you are up on your toes.
Shift your hips up so that they are slightly elevated, and squeeze your glutes as hard as you possibly can (imagine you are trying to crack a walnut…).
While in this position, actively ‘drag’ your elbows towards your knees (your elbows shouldn’t actually move, this should simply increase tension).
Hold this position with maximal tension for 15-20 seconds.
And another excellent demonstration provided by Dr John Rusin
Putting it all Together
So, doing these in a single (very short) session at home might look something like this.
Deadbug 20 reps either side
Side plank 20 seconds either side
RKC plank 20 seconds
Then rest for 1 minute and repeat the cycle 3-4 times, for a grand total of 10ish minutes.
Simple, and effective.
Take Home Message
I appreciate that you may not have the time available to get in a solid gym session every single day – but to say you don’t have the time to do anything is inexcusable. The program provided using the 3 core exercises outlined can be performed in as little as 10 minutes.
Not to mention it can be done literally anywhere, offers the perfect way to promote back health and enhance trunk strength, and allows your burn a little energy in the process.
I’m going to do something that I would never otherwise willingly do, and that is to plagiarize someone else’s work. But the article written by Josh Glancy in this weekend’s The Weekend Australian’s Inquirer is too good and on point to not make you aware of it. Josh’s article is based on an interview with Greg Lukianoff and Jonthan Haidt, who wrote “The Coddling of the American mind”. At iNform we have just instituted a No Snowflake Policy so this article resonates so strongly that I’m just going to pass on my summary of his words.
As a society we are starting to employ iGens, the generation made up of those born after 1995. they entered University around 2013, and the workforce as we speak. Now, of course this does not apply to every person, or perhaps even a majority of people, born in this period. But many factors in the last couple of decades have led to a coddled and over protected generation with a tendency for low resilience and ‘catastrophising’ what are otherwise bad and unwelcome events into disastrous ones.
Creating iNform’s No Snowflake Policy
What led the team at iNform to create the ‘No Snowflake Policy’ were a small number of members of this generation who came in with a tendency to think in binary terms; their arguments driven by emotions, by how things make them feel, rather than pointing to facts or rationality; and with little capacity to think beyond themselves and their circumstances and idealistic desires. We see the iNform ‘business’ as an elite athlete, a body at peak capacity; where every part of it is incredibly important, but only effective if it works as a part of the greater whole. Needless to say, snowflakes would not be a productive part of this organism!
As highlighted by Lukianoff and Haidt, this is not a political or ideological problem, but one of mental health; primarily due to over-protective parenting that fails to equip children to deal with confusion, adversity, and risk. And why? Maybe because increases in safety and technology are making our lives so comfortable that we now recoil from comfort! “safety has now taken on an almost religious quality” with the downside being children not feeling enough control over their lives.
We grow and develop as a consequence to adaptations to exposure. So with restricted exposure to risk and danger; fear or freedom; injury or adversity; these ‘young adults” first exposure to risk, adversity or pain is likely to be overly traumatic. The consequences to this can be severe, including anxiety, depression and even suicide (with rates for all these climbing over the last decade).
An over emphasis on academic achievement has also led to a decrease in ‘free play’ in children, which is when they get to learn the basic principles of team-work, compromise and conflict resolution… all in the sandpit or playground. For an example of how this is being tackled by Australian school’s, read the recent ABC article on the ‘Anti-cottonwool Schools‘.
Concerningly, we are also starting to see the outcomes of the snowflake effect in young adult’s capacity to deal with their first significant injury. As they have not had a chance to experience their body’s amazing capacity to heal and recuperate, this first sign of ‘something wrong’ is often catastrophised disproportionately. Luckily we have the skill set in-house and with our network of health professionals to get these clients back on track!
It’s natural and normal to feel depressed at times, particularly and especially when, life throws you a curve ball. Whether it’s the ending of a relationship, a death in the family, the loss of a job, or even just adjusting to different circumstances. Depression is a mood state, just like happy, excited or sad. Across the spectrum of symptoms, there are distinctly different types of depression. From not being able to eat or sleep, to eating too much and feeling too fatigued to even get out of bed. If depression was a colour it would come in all shades, in all colours.
Exercise and Depression: Nature’s Anti-depressant
A recent meta-analysis found that engaging in physical activity could reduce your chances of developing depression by 17%. We also know that typically exercise has a large effect on reducing symptoms of depression, and this includes activities like resistance training, yoga, bouldering (rock climbing), cycling, swimming and running. A well known study done in 1999 at Duke University even concluded that exercise was as effective as medication in relieving symptoms of depression!
Luckily exercise and physical activity also comes in a full spectrum of colours, too. From walking to work in the morning, or going for a run in your lunch break, to signing up for a yoga class or going to a boxing session with a mate. There is a type of exercise for everyone, and every type of exercise can be adapted to the intensity which you like best! You can exercise alone, or with a friend, or with a bunch of strangers. You can exercise indoors or outdoors. You can literally make it whatever you want!
I say all of this because I think the words ‘exercise’ or ‘physical activity’ bring to mind images of stereotypical types of exercise, like being in a gym or being outside running, which can put a lot of people off straight away. A better term to use would be movement. And our bodies were made to move, our physiology and particularly our neurophysiology (our brain) NEEDS us to move in order for us to feel good. (If you want to read more about this, read my stress blog).
Working Out Depression
Are you sure exercise is going to make me feel better…? (Yep!)
Exercise releases endorphins (anti-stress hormones), 40 types of them to be exact. One of the effects these have is that they calm the brain and relieve muscle pain during strenuous exercise (hence why Superman can lift cars up!). Exercise also regulates all of the same neurotransmitters targeted by antidepressants.
For starters, it immediately elevates norepinephrine, waking up the brain and getting it going. As well as improving self-esteem, which is one component of depression. Exercise boosts dopamine, which improves mood and feelings of wellness, and jump-starts the attention system. Dopamine is important because it is all about driving motivation and attention, that’s why they say getting started is the hardest part!
Exercise also increases BDNF which protects neurons against cortisol in areas that control mood, including the hippocampus. It encourages neurons to connect and grow, and it vital for neuroplasticity and neurogenesis (keeping our brain young and adaptable)!
In addition to feeling good when you exercise, you feel good about yourself, and that has a positive effect that can’t be traced to a particular chemical or area in the brain. We know that norepinephrine and serotonin, which are both boosted with exercise, act on the limbic system (the amygdala, the hypothalamus and the hippocampus) which is responsible for things like how we perceive and regulate our emotions. Even small doses of exercises are effective at improving peoples quality of life and psychosocial functioning.
The best exercises for reducing/preventing depressive symptoms are:
A recent study suggests that exercising between 3 and 5 times a week for 30-60 minutes is associated with better mental health, and team sports, cycling, aerobic and gym exercise came in at the top for types of exercise associated with better mental health.
Resistance training has also shown to have a large impact on reducing depressive symptoms, particularly when supervised by a health professional and lasting shorter than 45 minutes. You can read more on this in James’ blogs here and here.
If you’ve been feeling down and you start to exercise and feel better, the sense that you’re going to be OK and that you can count on yourself shifts your entire attitude. The stability of the routine alone can dramatically improve mood. So next time you feel flat do the smart thing, the thing that future you will appreciate, and move your body (even if it’s just out of the house!). And if motivation or accountability is the issue, why not train with an Exercise Physiologist or another qualified health professional?
Exercise is not an instant cure, but if you move your body your mood basically won’t have a choice!
It’s important to keep expectations reasonable
Exercise outside, or in an environment that stimulates your senses
Exercise with somebody
Something is better than nothing!
Try to form an exercise routine – this adds to feelings of stability