7 Myths About PCOS

7 Myths About PCOS

PCOS is a fairly common condition in women (1 in 10), however there are many misconceptions out there about it. Check out these 7 myths about PCOS…

 

Myth 1:

PCOS = infertility.

Having PCOS does not mean you are infertile. PCOS is a common cause of infertility due to  the hormonal imbalances in the body blocking ovulation. PCOS women are still able to fall pregnant, and may or may not need a little help from their doctor.

 

Myth 2:

You must have ovarian cysts if you have PCOS.

Wrong! The Rotterdam diagnostic criteria for PCOS requires 2 out of 3 of the following;

  1. Irregular menstrual cycles, AND
  2. Hyperandrogenism (excluding other causes), OR
  3. Polycystic Ovaries on an ultrasound*

*You do not need to have cysts on ovaries to have PCOS and cysts on the ovaries does not mean you have PCOS.

 

Myth 3:

You have to be overweight to have PCOS.

Incorrect! In fact about 20% or more women present as healthy or underweight and are categorised as having lean PCOS.

 

Myth 4:

There’s no cure for PCOS so there’s nothing you can do about it.

So soo wrong! It is true that there is no cure for PCOS, however, there are many ways to manage your PCOS and reduce your symptoms, including exercise, diet and supplements, some medications**, stress management and positive sleep behaviours. 

**This depends on the underlying driver of PCOS. See Finding Your Root Cause of PCOS.

 

Myth 5:

If you’re not trying to conceive there’s no need to worry about PCOS.

Unfortunately, PCOS can increase the risk of Type 2 Diabetes, high blood pressure, heart disease, and anxiety and depression. If you’ve been diagnosed with PCOS it is important to manage your condition to reduce your risk of developing other chronic health conditions.

 

Myth 6:

All symptoms of PCOS are the same for every woman.

Not true. There are many symptoms of PCOS and you won’t experience all of them, or even experience them to the same extent that another woman does.

(Symptoms can include: irregular periods, hair loss, unwanted hair growth, acne, bloating, weight gain, mood swings, irritability, fatigue, or even loss of libido.)

 

Myth 7:

There is a one size fits all way to manage PCOS.

As mentioned before, there are different drivers of PCOS, as well as differing symptoms, and most importantly… different outcome goals. Therefore managing PCOS will be different for each woman. If you’re looking to get pregnant your journey will look very different to if you’re looking to reduce your symptoms, or improve your health outcomes. 

This is why it is so important to work with YOUR body and tailor your management plan to YOUR goals. And if needed working with health professionals who understand you and what you’re going through.

 

And there you have it! 7 myths about PCOS busted!

So is running actually good for your knees?

So is running actually good for your knees?

Yes!

But I’ll start by hitting you with three facts.

  1. People who run have a lower incidence of knee osteoarthritis than people who don’t (Timmins et al, 2017; Alentorn-Geli, E. 2017).
  2. The knee is the most common site of injury in runners (Van Gent et al, 2007).
  3. The most common cause for running injury is training error (Damstead et al, 2018).

This is how I reconcile these facts in my head.

Running, when appropriately ‘dosed’ is a good thing for our knees (and muscles, tendons, bones, heart, lungs, brain, gut etc etc). However when the dose is too great either acutely or chronically the most likely point in our body to ‘fail’ is our knees. If this is the case, it is not running that is bad for the knees, it is bad coaching, or no coaching that is actually bad for our knees.

Let me reiterate point 1 in case you glossed over it. People who run are less likely to end up with OA than those who don’t. And it isn’t a small difference. Runners are about 3x less likely than non-runners to develop OA. Check my first reference if you don’t believe me.

For many reasons, running is something that you should do, but you should do it in a quantity and frequency that is appropriate for you.

An an Accredited Exercise Physiologist, it is my absolute bread and butter to assess and prescribe the right ‘dose’ of running for you right now, and help you build upon that at your speed.

Please don’t avoid running because you think it is bad for you. And don’t let poor coaching be the reason that it is.

 

About The Author

 

Alentorn-Geli, E., Samuelsson, K., Musahl, V., Green, C. L., Bhandari, M., & Karlsson, J. (2017). The association of recreational and competitive running with hip and knee osteoarthritis: a systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 47(6), 373-390.

Damsted, C., Glad, S., Nielsen, R. O., Sørensen, H., & Malisoux, L. (2018). Is there evidence for an association between changes in training load and running-related injuries? A systematic review. International journal of sports physical therapy, 13(6), 931.

Timmins, K. A., Leech, R. D., Batt, M. E., & Edwards, K. L. (2017). Running and knee osteoarthritis: a systematic review and meta-analysis. The American journal of sports medicine, 45(6), 1447-1457.

Van Gent, R. N., Siem, D., van Middelkoop, M., Van Os, A. G., Bierma-Zeinstra, S. M. A., & Koes, B. W. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. British journal of sports medicine, 41(8), 469-480.

 

 

Pain The iNform Way

Pain The iNform Way

Although pain is advantageous for protection and survival. Persistent pain carries no real biological purpose – yet is sadly highly prevalent in the population. I’m not going to dwell on epidemiology. I want to tie in nicely the importance of clinician collaboration as an excellent prophylaxis for acute (and persistent) pain, whilst also discussing a Cochrane review on the lack of evidence of NSAIDs (nonsteroidal antiinflammatory drugs) for the acute management of low back pain.

 

What are Cochrane reviews?

Cochrane reviews are excellent resources for clinicians (and the general public) to access high quality evidence with iNformed recommendations. Cochrane reviews (or collaborations) involve clinicians/researchers who have excellent experience and knowledge in a specific field. They gather all the relevant research papers on the topic of research (low back back and NSAIDs in this case). They extract all the relevant papers that meet a specific criteria  and make recommendations based on the overall evidence.

The reason why I spent a good paragraph on the aforementioned is that the Cochrane library can be accessed by anyone! Therefore, anyone can seek and critically evaluate a medication (like a NSAID) for example. You can also look at the evidence (for the acute use of low back pain) and come to an evidence based conclusion. As a clinician, providing evidence based care is important for your health and well-being. We call this evidence based care the Science-Practitioner model.

 

Ok! I’ll provide you a quick synopsis of the paper.

 

Van Der Gagg and colleagues found: When using a qualitative (self reported) scale for reports in pain reduction, the authors found no statistically meaningful benefits for the use of an NSAID in acute low back pain. A previous Cochrane review in 2014 by the same group came to the same conclusions for the analgesic paracetamol for acute low back pain. These are important implications, as medication may be one’s first choice approach to decrease symptoms. However, with what’s been written and known empirically, what is the best approach to improve symptoms of acute low back pain?

 

The current evidence suggests that empirical pain education along with graded specific exercise correctives are the current gold standard for the management of acute low back pain. Pain education allows the individual who has pain to better understand it, whilst the clinician being thorough in their examination providing reassurance, and safety to move. We clinicians call this the biopsychosocial model. As the schematic below shows, this is an intricate interplay between tissue, one’s thoughts and feelings, and the environment (potential threats and safety’s).

My premise in this blog is to not overwhelm you with information. More so that there’s evidence out there for you to access. Along with clinicians whose duty of care is to iNform you on the aforementioned publications, and devise an appropriate treatment plan to improve your symptoms. The team at Move For Better Health can guide you safely through your acute pain, whilst collaborating together (Physio, Exercise Physiology, Psychology, Podiatry, Nutrition/Dietetics) in our disciplines with great communication and decades of combined experience.

 

About The Author

Why You Should Concentrate On Your Breath

Why You Should Concentrate On Your Breath

Stop! Now check you are breathing… or, are you holding onto your breath?

Breathing, which I’ll define as diaphragmatic breathing is incredibly important for many areas such as the management of blood pressure, reducing muscle tone and most noteworthy (and a collaborative of the two aforementioned), activating your parasympathetic nervous system. Now you all know that I’m a huge neuro-nerd! However, for the practicality of this blog I will only touch the surface of the parasympathetic and sympathetic nervous system.

So what is your parasympathetic and sympathetic nervous system?

Crash course in endocrinology!

 

Your parasympathetic nervous system is what’s known as your ‘rest and digest’ system. A relaxation system let’s say. Your sympathetic nervous system is your ‘fight, flee and freeze’ system. And although a neat sounding alliteration. The sympathetic nervous system should only be called for during short bursts of stress (such as physical activity, complex problem solving). However, when called upon more-so and on a regular basis the sympathetic nervous system can have a downstream effect in compromising the immune system (sickness), all the way down to-your genome (RNA damage).

So you can see that being more parasympathetic over sympathetic is important! And what is an excellent prophylaxis for the parasympathetic nervous system? Diaphragmatic breathing! That’s right! I don’t have to go all spiritual on you’ll here. Just your breath!

Let’s get practical!

1. Sit in a comfortable chair, or lie supine (on your back).

2. Make sure you’re not distracted!

3. Rest your hands gently on-to the side of your ribs.

4. Inhale for a count of two seconds through the nose by breathing into your hands (notice how your ribs expand).

5. Hold the end of the two second inhale for a further two seconds (deliberate breath-hold)

6. Exhale through the mouth for the count of four. (You should notice that your ribs draw back inwards somewhat.

7. Repeat five more times.

8. Note how you feel?

Fingers crossed you’re feeling perhaps a sense of ease? Slightly calm and relaxed? A bit more mental clarity? Even a wry smile?

So there you go peeps! I didn’t use the word meditation once (this time). I simply guided you through how to breath diaphragmatically, inducing a parasympathetic response. A neat tool to use throughout ones day! Recommended when there’s an accumulation of unease.

About The Author

*Disclaimer: if you are prone to orthostatic hypotension, or vertigo (BPPV). Please be mindful when standing or arising from a lying position following diaphragmatic breathing. Or consult with your GP or EP if you need-so.

 

 

 

7 Surprising Benefits of Exercise for Menopause

7 Surprising Benefits of Exercise for Menopause

Menopause. 

 

Every single woman on the planet will experience it during their 45 – 55’s. If you asked two different women, they’d tell you two different versions of what menopause was like. That’s because although the symptoms are common, not everyone experiences menopause in the same way….

 

Symptoms of Menopause

 

Not to worry though, there is something you can do to help manage your symptoms and help you through this change in your life.

 

The 7 Benefits of Exercise for Menopause!

 

Exercise has been shown to provide several health benefits whilst you are going through menopause. Exercise can…

 

1. Help Manage Symptoms! (Woohoo!)

 

Exercise can actually help to manage and reduce some of the symptoms of menopause such as; aches and pains, loss of libido, and fatigue. Increasing physical activity will result in a positive cycle of feeling better, which will increase motivation to exercise, making you feel better, and so on. You’ll end up feeling better on the inside and out!

 

2. Boost your Mood!

 

Women going through menopause commonly struggle with mood changes, anxiety, depression, and stress due to the hormonal changes within their bodies. However, exercise can increase positive mood and also protect against anxiety and depression.

 

Happy

 
3. Prevent Weight Gain!

 

Due to changes in hormone levels during menopause women may find they gain weight more easily than before (especially around the belly). Exercise and healthy eating is a great way to reduce weight and prevent any extra kilo’s creeping on.

 

4. Reduce Risk of Cardiovascular Disease!

 

Oestrogen plays a protective mechanism against cardiovascular disease. During menopause, oestrogen is reduced which increases the risk of cardiovascular disease. Incorporating exercise into your daily routine can strengthen your heart and reduce risk of heart disease

 

5. Reduce Risk of Osteoporosis!

 

Oestrogen also plays an important role in maintaining bone density. The reduced oestrogen production during menopause can lead to decreased bone density, and thus increase the risk of osteoporosis. Exercise can strengthen bones and muscles, and improve balance reducing the risk of fractures due to falls.

 

Bone Health

 

6. Reduce Risk of Diabetes!

 

Changes in hormone levels during menopause can also affect the way your body reacts to insulin, potentially leading to diabetes. Exercise helps the body respond to insulin and remove excess blood sugars reducing the risk of developing diabetes.

 

7. Help Maintain Physical Function!

 

As our bodies age they start to decline in physical function (loss of muscle, loss of bone, decrease in balance, etc). Exercise is the perfect way to keep up your function and ability to continue to live the life you love. (And run around after your energetic little grandchildren!)

 

Awesome right?! You don’t have to just deal with this change you’re going through… There is something YOU can do to help yourself through it! 

 

General Exercise Guidelines 

150 mins of moderate exercise a week (or 30 mins a day over 5 days)

OR

75 mins of vigorous activity a week

AND

2-3x strength training days a week (non-consecutive days)

 

About the Author

RunStrong: Load Management

RunStrong: Load Management

If you watch almost any form of professional sport you may have heard the term ‘Load Management’ in recent years. Often the conversations on this topic are led by cranky former athletes tut-tutting that ‘back in my day we didn’t have load management, we just played!’

Yes, the term Load Management has been popularised in recent years. This is not because the athletes of today are soft compared with their predecessors. This is because those charged with preparing athletes to be at their best when they need to perform are now armed with a vast and growing body of evidence that supports Load Management. 

And the evidence supporting Load Management is not confined to team sport athletes, or elites in individual sports. Published research shows that recreational, even novice runners should be considering how they are managing their training loads.

Show me the evidence!!

  • A Systematic Review by Drew and Finch (2016) that included 35 studies found that across many sports, training loads were predictive of both injury and illness. 

 

  • A Systematic Review by Damsted er al (2018) found that runners were more likely to develop an injury if they; suddenly altered the velocity, distance and/or frequency of their running; increased their average weekly running by >30% versus <10%; and/or they had a sudden spike in their training volume the week before the injury occurred. 

 

  • In a Systematic Review and Meta-analysis by Videbaek et al (2015) (13 articles included)  that looked at injury incidence per 1000hrs of running, novice runners were likely to experience more-than-double the amount of injuries per 1000hrs as recreational runners.

 

  • A Systematic review by van Gent et al (2007) found that the most common site of injury in the runners in the included studies was the knee, but that training plans that gradually increased loads were protective against knee injuries.

 

I have provided the complete citations for each of these Review Articles for those that want to dig deeper into the evidence. I warn you though that this search is an absolute rabbit warren- like I said earlier, there is a vast and growing body of evidence on this topic! 

Evidence is important in health. In this particular area though, the evidence is just reinforcing what common sense should already be telling us.

Stress > Recover > Adapt > Repeat

Running is a form of physical stress. When we allow adequate recovery our body gradually adapts to deal with this stress. 

A well-structured training plan is really a balancing act between imparting a ‘dose’ of physical stress, then encouraging recovery strategies to enhance the adaptation process. Stress > Recover > Adapt. We repeat this cycle over a given period of time so that you can be as well prepared as possible for the event you are training for.  

The evidence tells us that if we try to rush this process, if we build load too quickly and impart too much stress at any time point we can tip this balance and create injury. And if not injury, we can end up just becoming run-down and sick which can be terribly frustrating if you have an event looming on the calendar.  

Load Management and Goal Setting

If you are training for a specific event do you have enough time between now and then to build load gradually? 

Actually, I’ll be more precise than that. From your current training load, can you build upon that total load by no more than 10% per week up to when (if) you plan to taper?

Does your time-frame include some rest weeks and additional weeks for unforeseen circumstances? 

If you can confidently answer YES! to those questions I don’t need to wish you good luck, as you are probably managing yourself impeccably. 

If you cannot answer yes, then I recommend you seek something more reliable than luck. I suggest finding a good coach, experienced in Load Management for runners.  

 

About The Author

Damsted, C., Glad, S., Nielsen, R. O., Sørensen, H., & Malisoux, L. (2018). Is there evidence for an association between changes in training load and running-related injuries? A systematic review. International journal of sports physical therapy, 13(6), 931.

Drew, M. K., & Finch, C. F. (2016). The relationship between training load and injury, illness and soreness: a systematic and literature review. Sports medicine, 46(6), 861-883.

Van Gent, R. N., Siem, D., van Middelkoop, M., Van Os, A. G., Bierma-Zeinstra, S. M. A., & Koes, B. W. (2007). Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. British journal of sports medicine, 41(8), 469-480.

Videbæk, S., Bueno, A. M., Nielsen, R. O., & Rasmussen, S. (2015). Incidence of running-related injuries per 1000 h of running in different types of runners: a systematic review and meta-analysis. Sports medicine, 45(7), 1017-1026.