Yoga is an ancient and complex practice, rooted in Indian philosophy, that originated several thousand years ago. Yoga began as a spiritual practice, as a way of reaching enlightenment, but in Western culture it has become popular as a way of promoting physical and mental well-being.
Although classical yoga also includes other elements, yoga as practiced in the West typically emphasizes physical postures (asanas), breathing techniques (pranayama), and meditation (dyana). Popular yoga styles such as hatha, iyengar, bikram, and vinyasa yoga focus on these elements. Several traditional yoga styles encourage daily practice with periodic days of rest, whereas others encourage individuals to develop schedules that fit their needs.
What do we know about the effectiveness of yoga?
- National survey results from 2012 show that many people who practice yoga believe that it improves their general well-being, and there is beginning to be evidence that it actually may help with certain aspects of wellness including stress management, positive aspects of mental health, promoting healthy eating and physical activity habits
- Yoga may help relieve low-back pain and neck pain
- There’s promising evidence that yoga may help people with some chronic diseases such as cancer, multiple sclerosis, and chronic obstructive pulmonary disease manage their symptoms and improve their quality of life
- Yoga may help people with diabetes control their blood sugar
- Growing evidence indicates that yoga may help women manage both physical and psychological symptoms of menopause
- Yoga may be helpful for anxiety or depressive symptoms associated with difficult life situations
- Yoga may help people to manage sleep problems
- Yoga may be helpful for people who are trying to quit smoking
- Yoga-based interventions may help overweight/obese people lose weight
What do we know about the safety of yoga?
Yoga is generally considered a safe form of physical activity when performed properly, under the guidance of a qualified instructor. Serious injuries are rare, however, as with other types of physical activity, injuries can occur. (One of our honours students, Zoe Toland, is currently working with one of our EPs, to investigate the most common forms of yoga injuries as reported by physiotherapists, yoga teachers and yoga practitioners – we’ll keep you updated with the results!).
The most important thing to remember, as with any exercise, is to listen to the feedback your body gives you and modify and adjust what you’re doing accordingly. We want to push ourselves, and whilst feeling some level of discomfort is okay (think muscle burn and high level of challenge), but pain is our bodies way of saying ‘probably best to not do this’.
People with certain health conditions, older adults, and pregnant women may need to avoid or modify some yoga poses and practices. These individuals should discuss their specific needs with their health care professional/yoga instructor and may be better suited to more clinical yoga classes.
What happens in a yoga class?
Sometimes the biggest thing that stops us from trying something new is not knowing what to expect and fearing we’ll be the awkward newbie! So let’s go through what you can expect from a yoga class (or at least ours!)
- Yoga mats and all the props you will need (a block, a strap, a bolster, a towel) are provided, but you can always bring your own if you would prefer!
- The teacher will introduce themselves and talk about what the focus of the class will be; this could be a range of things from a certain postural focus, or an attention focus, or it could be a focus on the pace of movement
- Classes start with slow, controlled, warm-up type movements and typically move into some more challenging series of movements; you can expect challenges that target strength, balance, range of motion, focus, stability, control and your attitude toward the practice
What you won’t get…
- Spiritual-talk. We’re not dissing the spiritual talk, but we prefer to focus on your physical and mental alignment in class
- Chanting. We get it, it feels a bit weird.
- Basically, anything that’s not evidence-based within the scientific literature, won’t be included in our classes (e.g., chakras, lifestyle choices)
How often should I practice yoga?
The recommended frequency and duration of yoga sessions varies depending on the condition being treated. In general, studies examining yoga have included weekly or twice weekly 60- to 90-minute classes. For some studies, classes are shorter, but there are more classes per week. So whilst the research evidence is inconclusive, we think that any form of exercise that is challenging strength through range of motion, and providing you with a form of mindfulness is a great addition to your weekly activities!
Our recommendation: as much or as little as suits your body’s needs and fits in with your weekly schedule.
iNform’s NEW Clinical Yoga Classes!
We are super excited to be launching clinical yoga classes at the end of May, at our new Malvern clinic! Classes will run on Thursday mornings and evenings, for a duration of 45 minutes and will be run by our Exercise Physiologist and Yoga Teacher: Jacinta Brinsley. Jacinta is also completing a PhD in the area of yoga and mental health/mental illness.
If you have any questions, want further information, or want to book in for a yoga class – fill out this form
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It would be rhetorical to say: that your body is special. And you would only want the best to be guiding you through your health and well-being safely. And yet, one can still be suggestible- picking up dodgy anecdotal tips from ‘that guy’ on the lat-pull-down machine.
I have personally experienced the exercise benefits, being safely loaded, and moving with confidence with one of my colleagues. Leaving my body and surrendering to an expert has given myself a deeper appreciation of the importance of finding an expert in human movement. I have always been on the other side to what I have been accustomed too- and as bias as it sounds: my colleagues here at iNform health really know how to manage and care for their clients.
Here are three reasons why you should be exercising with an expert.
1. Your tissues need time to adapt to load.
Your tissues, all the way down to the extracellular matrix- are for ever adapting to stressors and making proteins. Prescribing appropriate load- will ensure ones tissues will safely adapt; which will add a host of benefits to ones neuromuscular system. Reduced risk of tendonopathies, appropriate motor learning and myonuclei growth (muscle hypertrophy). On the contrary, excessive loading that exceeds the capacity of the neuromuscular system can induce the contra effects to the aforementioned. Tendon pathology, disorganised motor learning due to inappropriate load and systemic inflammation (abnormal prostaglandin levels) due to poor tissue healing.
2. Assessing the capacity of the neuromuscular system before undertaking load is paramount- and if neglected, your ‘health professional’ is going in blind.
If there is a muscle inhibition due to de-conditioned tissues, or a previous pathology that was poorly rehabilitated, would you feel safe to be loaded? Or if you were unable to co-contract your gluteus maximums, or have adequate lumbo-pelvic control? And yet, you may still be subjected to axial loading in your first session…! A thorough musculoskeletal assessment can identify any red flags and give your health professional valuable subjective/objective information to prescribe appropriate exercise correctives. This will then ensure more complex movements are performed safely.
3. Co-care is so important in addressing the whole individual.
Here at iNform, our clients are closely monitored by a wonderful internal/external team of allied health professionals; ranging from: GP’s, physio’s, osteo’s, chiros, pod’s and psychologist (without exhausting). All working and communicating together for the greater good of your physical and mental health. Co-care leads to better clinical outcomes, a proper working diagnosis, and the right form of treatments that benefit you the individual.
So, next time you are wanting to move with confidence. Be interrogative with your research. Find an evidence based approach that doesn’t involve a lecture from ‘that guy’ wearing a weight belt with a skimpy muscle singlet (stereotyping much?).
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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!)
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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!
Your 30 minute session at iNform…
- Improve focus
- Improve cognitive function
- Decrease anxiety
- Decrease depressive symptoms
- Improve feelings of well-being
- Increases self-esteem
- Decreases risk of dementia
- Decrease markers of inflammation (particularly in people who are overweight)
- Decrease cholesterol
- Decrease blood pressure
- Improve insulin-swings for those with type 2 diabetes
- Improves insulin-sensitivity
- Boosts metabolic rate
- Reverse ageing factors in mitochondria and muscles
- Increases bone mineral density (and prevents bone loss)
- Increases muscle mass
- Improves movement control
- Reduces chronic lower back pain
- Reduces arthritic pain
- Reduces pain from fibromyalgia
And I guarantee I have left some benefits out.
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]
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Chemotherapy is prescribed to do a great number of things: to cure, aid other treatments, control the cancer, and help with symptom relief. It is a powerful tool, but as everyone knows, it brings with it a vast array of challenges, both during your cycles and after. But where does tailored exercise fit into this? Is it possible to stay active whilst undergoing chemo, and why on earth would you want to?
The plain and simple fact is that there is a growing body of evidence that shows tailored exercise during chemotherapy can reduce unwanted side effects, limit de-conditioning, AND now it is also being found to aid treatment. So, why are we not prescribing exercise like a drug? Why are we still not using it to its potential? Well, let’s talk about the benefits first…
1. Exercise creates a reduction in chemotherapy related neuropathy symptoms
Neuropathy is a relatively common side effect of chemotherapy. Essentially, it effects the hands and feet, creating symptoms like numbness, tingling and pain, cramping, difficulty handling small objects, and issues with gait and balance. Unpleasant! Multi-modal exercise, such as resistance exercises coupled with low to moderate intensity aerobic exercise like walking, creates significant reductions in both the severity and prevalence of neuropathic symptoms. Now that sounds to me like a pretty useful treatment!
2. Exercise reduces cancer related fatigue
Chemotherapy is associated with a crippling fatigue, known as cancer related fatigue. This can have a sudden onset and can impose a significant physical burden. It is also psychologically draining as it often means you are unable to do the things you love, and can impose a financial burden due to missed days as work. There are now hundreds of studies that show that exercise reduced fatigue levels. If you would like to know more, read my previous blog “Cancer related fatigue: Does exercise help or hinder?”
3. Exercise reduces de-conditioning
Research has shown that the loss of rapid muscle mass is accelerated 24-fold during chemotherapy in comparison to healthy people. It is no wonder people undergoing chemo feel fatigued when they lose so much muscle, so quickly. Luckily we have a treatment for that! Specific resistance training has shown to minimise this loss of strength. Completing targeted strength training means that carrying your children, doing the shopping, getting out of the car doesn’t become so fatiguing. That has to improve your quality of life.
4. Exercise reduce risk of cardiovascular disease
Due to the direct toxic effects of anti-cancer therapies as well de-conditioning, people undergoing chemotherapy have a risk of developing cardiovascular diseases such as heart failure, stroke, and coronary heart disease. A study in 2016 found that post-diagnosis exposure to exercise was associated with substantial reductions in newly diagnosed cardiovascular diseases or cardiovascular related death. That is massive!
5. Improved completion rates of treatment
Now, oncologists provide treatment doses based on what they think will create the best chance on achieving the treatment goal. However, completion can depend on how well you can withstand the treatment and it’s side effects. So, given that exercise therapy can reduce general pain levels, cancer related fatigue, and neuropathy it makes sense that it allows more people to fully complete treatment. This can give you the best chance of survival!
6. Exercise reduces risk of death
If you exercise when diagnosed with cancer, you will reduce your chance of dying. I know that is a massive statement, but a review of 71 studies in 2015 found that exercise was linked to reduced mortality in breast, colorectal, and prostate cancers (those were the only cancers these studies focused on). In one of those studies they found mortality reduced by 24%, 32%, 39% and 40% when individuals participated in low, moderate, vigorous and very vigorous activities respectively. What they essentially found was that there was a dose response relationship with exercise and mortality. Therefore, some exercise is definitely better than none and more is better than less. It depends on personal side effects of your chemotherapy treatment.
7. There are always caveats to exercising whilst undergoing chemotherapy
It is important to be aware of the caveats to exercising while undergoing chemotherapy. Exercise must be tailored to the current functional status and capacity of each individual patient and then must be progressed and regressed based treatment cycles. Overstretching areas around catheters should be avoided. Stoma’s should be cleaned before and after sessions and if you are feeling feverish. It is also important to monitor acute changes in your pain levels, gastrointestinal disorders (nausea, vomiting diarrhoea etc), changes in heart rate, and blood pressure and breathing rates.
As we mentioned, exercise prescription must tailored to the current functional status and capacity of each individual patient. Typically you can exercise directly after each chemotherapy dose but usually once side effects really hit, intensities will need to be modified. For the same reported feelings of exertion, your exercise may change from being able to jog around the block, to being able to walk to the mailbox. Then, as you progress through your cycle, your intensity can increase. Just remember, exercise may sometimes feel like the last thing you want to do, but just like any good medicine, it will help when prescribed appropriately!
If you have any questions regarding how and when you can use exercise, please feel free to contact Holly on 8431 2111.
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Can we use Strength Training for depression?
Any keen gym goer would have heard of the film “Pumping Iron” – and the subsequent revolution of Bodybuilding. Besides from being built like Hercules and having a positive-B sample, Strength Training has a lot of wonderful benefits for men and women. But what about Strength Training for depression?
Well, a recent meta-analysis published in the journal: JAMA Psychiatry may have just eluded some neat findings for Strength Training as an adjunct for reducing depression. The meta-analysis included: 33 clinical trials, with 1,877 participants. Gordon and colleagues found: “resistance exercise training was associated with a significant reduction in depressive symptoms.”
Promising news. However, there are limitations to consider… “total volume of resistance exercise training, health status and strength improvements were not associated with an antidepressant effect”.
So what could be some potential hypothesis that are contributing to the antidepressant effects experienced by the participants?
Filling in the gaps for using Strength Training for depression
First and foremost – we are born to move! When are ancestors became bipedal – moving to find food, water and shelter was essential.
And what happens when there is an unexpected reward? Dopamine is released, which causes a surge (reward dependent) of this wonderful catecholamine increasing the likelihood that the behaviour will be repeated – such as moving to find more resources, or more dumbbells!
Secondly, Strength Training has noteworthy benefits in the release of particular growth hormones and hypertrophic increases in muscle tissue. It would be plausible that an increase in testosterone, along with bigger muscles, would most definitely increase motor behaviour (going to the gym), along with libido (I will leave you with your own imagination). Which would equate to more energy being utilized, while also affecting higher cognitive regions in the frontal lobe improving: attention, motivation and reduced impulsiveness. The same areas of the brain that are inhibited by depression!
Lastly, although are ancestors missed out on dubstep, listening to music whilst exercising greatly activates many brain regions, along with an endogenous release of natural opioids that increase euphoria. I can see Hippocrates prescribing dubstep for his melancholic patients…
So hopefully I’ve filled in some missing gaps in the aforementioned meta-analysis that would be difficult to quantify.
Key take home points when using Strength Training for depression:
- Work with an accredited Exercise Physiologist/Scientist – to move with confidence. While also being guided about specific exercise prescription for your current goals, or medical condition.
- Make a sweet as music-playlist to increase baseline mood when Strength Training. Creating your own playlist will likely increase adherence to Strength Training along with enjoyment and motivation.
- Lastly, always consult your GP – if you are currently inactive, and wanting to increase your physical activity levels. The team at iNform can assist you from there onwards.
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