Exercise helps boost learning - that's great!

But how easy is it to put this into your day....?

What's new?

Earlier this year (2016), research was published on how to boost learning. 

Excellent. 

I'm always interested to hear ways to help me, and everyone else, learn things (perhaps this is because I think it should be easier than it is). My own personal experience, is that I find I have to keep going back to the subject again and again before it really starts to sink in. 

The research compared three groups after forty minutes of a learning exercise. One group didn't exercise at all, the second exercised straight after the learning task and the third group exercised four hours after completing the learning task. The groups were then all tested to see how much they'd retained. The results are suggesting that exercising four hours after the learning task helped boost retention the most.

Let's look at the pros and cons..

Pros:

• Improves learning - The obvious plus side is the suggestion that exercise can help improve learning. As I said above - excellent! Anything that helps make things easier.

• Adds to other known benefits - Boosting learning can be added to the list of other known benefits of exercise, such as improving mood, increased energy, promoting better sleep and physical health. I do like to tick a lot of boxes with activities I'm doing, so if exercise helps me sleep better, improve my mood and mental and physical health, as well as helping me learn - then that's fab!

• Can be incorporated into education systems - Knowing that exercise can help with learning will benefit anyone in education. Perhaps useful to use while on study leave in preparation for taking exams, or even after learning new topics during short courses.

• Guilt-free time away from studies - My own personal study approach has been to lock myself away in a quiet room and to go over what it is I need to know. I tend to feel guilty if I Ieave the room, as I feel I should be still sat there until the new information has sunk in. If I had of known that exercising would help me with what I'm trying to learn then I'd be straight out the door and guilt-free, knowing that this will benefit me and my studies.

Cons

• How easy is it to fit into the day? - I suppose the obvious one for me is how practical is it to exercise four hours after learning something. For myself, in more recent years, the courses I've been on to increase my knowledge in different areas typically finish at five o'clock in the evening, sometimes as late at nine o'clock. I can't see me then going out four hours later to exercise (even if it would help me retain more information). If finishing earlier in the day then I can of course see that it would be easier to go out.

• Does the exercise have to be on a bike? - The form of exercise the investigators used was a bike for 30 minutes. Let's say the above point made about how difficult it may be to time exercise four hours after a learning exercise, is do-able. It may or may not be difficult to get hold of a bike in order to cycle for 30 minutes. Myself, I live in an area where I feel the roads are quite dangerous for someone on a bike, so would not want to cycle around here, and I don't have access to gym facilities (preferring the outdoors to exercise). If I had access to a gym, then some considerations would be how far away it is and how easy it is to get to. Ideally for me, running would be a better and more convenient form of exercise.

Much as I've noted the difficulties of timing exercise into someone's day, I do actually think that it's a great area to research. As I said above, anything that may help enhance learning and make things that little bit easier to remember information learned is great. As I typically find reading research articles, it always leads me to ask more questions. Such as:

• Does the exercise need to be cycling? For me running is preferential, but for others, it could be other activities such as swimming or a team-based exercise.
• Does it need to be 30 minutes of exercises or could it be less?
• How intense does the exercise need to be? High-intensity or gentle exercise?
• Is there any other time difference after learning that has similar effects? Logistically I would feel the closer to learning the exercise is, the easier it may be to fit into the day.
• Does the learning-based exercise the study use equate to any kind of learning or is it just specific to the exercise they used?

What's the way forwards?

As discussed above there are lots of questions that this research raises. Despite that, I'm a big believer in people trying things to see how it affects them. Unfortunately, in real life, there's no control that you can compare yourself to, to see if exercise has or hasn't helped improve learning.

With all the other benefits that exercise has to health, in my opinion, you can't go far wrong in taking a learning task and then scheduling in some form of exercise a few hours after you finish. In my mind, it wouldn't necessarily have to be cycling and perhaps doesn't have to be as long as four hours after the learning. As long as you enjoy what you're out doing.

Start small...

If you're interested in taking this forwards then I'd suggest starting small to improve your chances of success. Perhaps take a subject that you'd like to brush up on and have a read through the topic on a day you know that you're going to the gym, run or play your chosen sport. The hardest part, as suggested above will be to check your progress.

Even if you don't manage to fully integrate the above suggestions into your lifestyle, I feel it's definitely worthwhile knowing about this kind evidence that's out there. Maybe in the future, when you come across a difficult subject, you can always head out the house/flat to do some exercises, knowing that rather than taking you away from your studies it may actually be helping!

Reference:
Van Dongen et. al. (2016) Physical Exercise Performed Four Hours after Learning Improves Memory Retention and Increase Hippocampal Pattern Similarity during Retrieval. Current Biology, 26(13), pp 1722-1727       

Upper body six-week challenge

Update on the upper body challenge...

I started a six-week challenge mid-April for upper body exercises and wrote about it here. I am pleased to say that I've now successfully completed the six weeks, although will come clean and admit that I did have a few odd days where I wasn't able to do the set of exercises (where does time go to some days?!)

At the end of the six weeks I now feel I'm sitting up straighter and my posture has improved in general. However, I also feel that as with most things, this is a work in progress - I would definitely benefit from a few more weeks of the exercises and perhaps make them slightly harder exercises. There are a few ways to measure posture, none of them great, but one of the simpler things to do is place your back against a wall and see if your head, shoulders and low back touch it. I found this article explains how to do this fairly well.

Which exercises were used?

Read on to find out..

Shoulder-W exercise

I discussed the shoulder-W exercise in my previous post. I definitely found this one the most difficult due to weak lower traps and overuse of my neck muscles. I found with time and repetitions I could move my arms more with less visual use of neck muscles. This one is definitely a work in progress as I believe I've had years of over-using neck muscles and have generally been quite weak in my shoulders.

Scapula (shoulder blade) setting

• Gently squeeze the shoulder blades together - keep this tension throughout
• Hold the theraband shoulder width apart, move hands away from each other so the band goes on tension - keep this tension throughout
• Action is to move the arms up to shoulder height and return to the start position

Reps = 3 x 10

Sounds easy? Try it and find out

When teaching this in the clinic setting I tend to find the shoulder blade squeeze eases off when the arms start to raise up. I also tend to find with the shoulder blade squeeze the shoulders will also raise up, which will put too much tension on those upper muscles.

As discussed above, I find when I perform the exercises that my neck muscles over-work as I lift my shoulders up, so another point to watch out for.

Below is a suggestion of what not to do...rounded shoulder and head forwards. Watch out for setting yourself up correctly - it's always better to do less repetitions of quality exercises rather than more repetitions in the wrong position.

Chest stretch with theraband

• Start with the theraband around your rib cage, holding both ends
• Gently squeeze the shoulder blades together - keep this tension throughout (are you noticing a theme with this?)
• Keeping the shoulder blade squeeze, straighten your arms and then bring them out wide. Return to the start position

Reps = 3 x 10

Shoulder external rotation with theraband or small hand weight

  

• Lay down with one arm hanging over the side of the bed/plinth, placing a rolled up towel under the upper part of the arm so it's well supported. Hold onto a small weight - I used 1kg
• Keep the upper arm still, move your hand up so the forearm is parallel to your body
• Return to the start position 

Reps = 3 x 10

Below is what the position would look like without a towel to rest the upper arm on - it causes the shoulder girdle to become too rounded.

Shoulder shrugs

• Lay down with your back resting on the bed, lifting your hips up to the ceiling
• Arms are pointing straight up to the ceiling, holding onto a light weight (I used 1kg)
• Keeping the elbow straight, move the whole arm up towards the ceiling (the shoulder of the side being moved will come away from the support)
• Return to the start position

Reps = 3 x 10 times

Thoracic extension with foam roller

• Lay down with the roller along your spine, arms out to the side
• You can feel a lovely shoulder stretch with this
• Stay there around 5 minutes

So there you have it, the exercises I've been doing for the past six weeks. As you can see I started off with very light weights, this was to ensure I was doing the correct technique and working on the smaller, endurance muscles. I'm giving myself a break from the challenge, but may return to the exercises later and increase the weights used.

Thanks for reading!

Photos courtesy of E. Arshamian, Director and physio of Fortitude Physio

The new challenge - to improve posture

The New Challenge

Following on from the running challenge I set myself earlier this year, I've now set myself a six-week upper body challenge. I'm actually halfway through the six weeks, so I thought it was high time I write about it!

The exercises I've given myself are low intensity with the focus on correct set-up and positioning. There are eight in total but I wanted to talk about one in particular as I find it quite challenging and would be interested to hear other people's experience with it.

I am aiming to complete 30 repetitions of each of the eight exercises, once a day, for at least five days of the week if not more. I'll keep you updated with how I get along.

The shoulder W-exercise

The set-up (see photo below):

• Gently squeeze the shoulder blades together
• Chin tucked in
• Holding the theraband at hip height initially, move the hands out and away from each other so this increases the tension on the band

Once set-up - keep the tension between shoulder blades and with the theraband

Action:

• Raise and lower the arms to shoulder height.

Starting position - squeeze shoulder blades and pull theraband so there's tension there

Keep everything on tension and raise the arms up to shoulder height

Sounds easy? Try it and find out...and then let me know!

What not do to..

Below is a suggestion of what not to do...rounded shoulder and head forwards. Watch out for setting yourself up correctly, mirrors can help with this or have someone watch your set-up and give verbal feedback. Photos and videos using phones can be helpful too.

Poor position of shoulder and head too far forwards

When teaching this in the clinic setting I tend to find the shoulder blade squeeze eases off pretty much immediately when the arms start to raise up. This I find is one of the hard parts to the exercise, yet one of the reasons to continue doing the exercise. If the shoulder blade muscles switch off that easily it's telling us that they're weak and likely not doing the job they should do (keeping the shoulder blades together and so keeping us in a more upright position).

For myself, it wasn't the muscles not working around the shoulder blades that was an issue, I actually found I was using muscles that didn't need to work. The muscles at the front of my neck seemed to be overworking, quite a lot it seemed. Which means I'm activating my neck muscles to help me lift and lower my arms?!

I also found that my shoulders raised up (as if I was shrugging them) the higher my arms were raised. 

If I had carried on repeating the exercise, despite getting increased neck muscle and shoulder activation, I would be reinforcing a poor movement pattern and building on the neck and shoulder muscles (which I don't want). The reason for doing the exercise are to target the muscles in between and around the shoulder blades, to help improve my posture (which I do want)

So, what to do...?

The Solution:

It's always better to do fewer repetitions of quality exercises than lots of repetitions. Sometimes you may need to adapt the exercise to ensure you've kept the quality. 

Using the exercise above as an example, I adapted it by not raising my arms up too high and stopped moving when I noticed any increase in activity of my neck muscles or noticed my shoulders raising - standing in front of a mirror helped with this. Any alterations in muscle activity indicated that I was starting to compensate, which was my cue to stop and return to the start position. Performing the exercise in this way, I have progressed from hardly moving my arms at all to being able to raise them up to my shoulder height.

Images courtesy of E.Arshamian, Physiotherapist and owner/director of Fortitude Physiotherapy

Running challenge - update

Earlier this year...

I wrote about how I don't keep New Years resolutions and so don't make any. This year I'm trying something slightly different, which is to set goals within a shorter amount of time, six weeks to be precise. The idea being that it will make things more achievable. I talked about SMART (Specific, Measurable, Achievable, Realistic, Timely) goals. My goal was to:

Run 5km, averaging 5.15 minutes a kilometre.

Click here to read the full post.

Since setting the goal...

I'll be upfront and honest and admit that I wasn't very consistent with doing everything that I'd set out to do. For example, during week two and three I wasn't feeling well and only managed to complete one set of strength exercises.

I also found that at the beginning it felt like I had loads of time to complete everything in but as the deadline loomed closer there was a sense of urgency and feeling I had left things too late - a feeling I had experienced before.

This sense of urgency reminded me of exams taken in the past, where at the start of the course felt like I had loads of time to complete the work in and towards the end felt like there was not enough time in the day to complete all the work. I guess most people have had that feeling of cramming the night before an exam.

What I've learned from this experience is that it's better to do something small every day or every other day, that leads towards the bigger goal. Even though it doesn't feel much at the time, all the small things add up to the bigger thing and means that goal is easier to be achieved.

Running challenge

When I ran the 5km at the end of the six weeks, I didn't think that I would have improved that much. If you look below, I wrote down each time that I had completed a run or strength exercises. I was fairly consistent with the strength exercises, did a few hill runs, but very minimal normal runs. Having not run very much in total over the last six weeks, I thought this would then impact on my average time.

So I know you're dying to know how I did and yes, I'm very pleased to be able to say that I managed to achieve my goal and run 5kms within my target time and pace of 5.15min/km. In fact I even managed to go faster than I set out to be and ran a pace of...

5/11min/km! Yay

From attending a running lecture last year, I know that strength is as important when running as running technique is. Perhaps my own experience these last six weeks of doing more strength exercises and minimal running, yet have still managed to improve my running time, goes some way to support this point. It'll remain to be seen if I continue with this improved time!

For the future, I'm going to have the strength exercises and running ticking away in the background. I'd like to maintain the speed I've got for now and maybe in the future, I'll set myself another running challenge - whether that's to increase my speed further or whether that's to try something I've not done before like a half marathon..we'll see.

What's next?

Good question. I'll be setting my next challenge and sharing it on here with you, so watch this space...

Hamstring Stretch Enlightenment

The Story

I’ve been treating one of my patients with a hamstring injury. He’s been progressing well, but when I checked - he wasn't so good at doing the stretches I've assigned him. The other day I asked him to perform the stretch so I could have a look at the technique.

The Issues

1. He picked a surface to rest his leg on that was a little too high which made it difficult to get the foot up there. This then puts an already shortened and tight muscle on an extra stretch - and that's just to get to the start position. Unfortunately, this then has the issue of potentially aggravating the injury.
2. Due to the height of the leg, this left him a little off balance. As I have to be super safety conscious this could, of course, lead to a fall and so another injury, which we definitely don't want
3. Taking the above two points into consideration, he was then in an awkward position, off balance and so was not able to perform the correct technique that was initially taught.

The Solution/way to correct

After seeing how the stretches were being done, I was then able to correct the technique and thought I'd share the pointers on here.

Lowering the height that the leg to be stretched is resting on, makes it easier to get into position and also makes it easier to balance. As he wasn't in an awkward position he could then perform the correct technique.

Setting yourself up correctly..

• If using something to rest the foot on, make sure the height is at the level of your knee or lower when standing up straight
• Make sure the leg being stretched is straight
• Keep your hips and body facing forwards
• You're wanting to feel the stretch on the back of the thigh
• Keep the back straight throughout - if you feel back pain then stop and seek advice
• If the stretch becomes painful then stop
• Hold for at least 15 seconds

What to look out for...

• The hips may be rotating and not facing forwards - in these photos below the hips are rotating

• or the back is not kept straight 

• What you could do, to prevent the hips rotating and keep the back straight, is to lie on the  ground, hold the back of your thigh and then straighten your knee.
• Ideally, you want a small arch in your low back, rather than it flattening against the ground

Sometimes the technique of stretches just needs a tweak, so as a suggestion, get someone to have a look at your form to give you some feedback (if it's me then I can be very picky..!).

Images courtesy of E.Arshamian, owner/director of Fortitude Physiotherapy

Strength exercises for improving running

As discussed in my post last week, I've given myself a six-week challenge for improving my running. My aim is to run faster than I currently do.

I'm one week into it and so far so good. I committed to doing two strength sessions each week, along with either a run or hill sprints. Last week I also managed to include a swim into the mix.

The strength of an individual is important for running as well as running technique. Below are the exercises I have been doing. I've included a summary of each exercise. However, it's always best if you're going to try them yourself to get a trained professional to check your technique. Incorrect technique can cause all sorts of problems...

Squats - 30 repetitions

Explanation:

• Feet hip width apart
• Feet facing forwards
• Toes relaxed throughout the whole of the exercise (toes can claw or dig into the ground at times, typically without the person knowing so keep your eye out for this one)
• Knees stay in alignment with toes (no knock knees)
• Hips stay level throughout

Split squats (that's what I call it) or also known as the Bulgarian squat - 30 repetitions on both legs

Explanation:

• Back leg resting on a raised surface
• Front foot facing forwards
• Toes relaxed
• As you lower, the front knee stays over the foot

Hip raises - 30 repetitions

Explanation:

• Lying on a flat surface with no pillow/towel support (as this can increase the stress felt on the neck)
• Feet hip width apart
• Lift hips up to the ceiling and then return to the start position
• Knees stay steady throughout (imagine you've got a drink resting on the knees which you don't want to spill)

Single leg bridge - 30 repetitions on both legs

Explanation:

• As with the hip raises but using just one leg

Side plank with clam - 30 repetitions on both  legs

Side plank position

Side plank if also performing the clam

The clam (without side-plank)

Explanation:

• Lay on the ground with your body in a straight line, knees bent and feet in-line with the body
• Leaning on your elbow, lift your body up so you're resting on the lower half of your leg and your elbow
• Keeping the feet together, raise you top knee up and then return to the start position (opening up like a clam)
• Throughout the clam movement, keep your hips still
• Throughout the exercise keep your chin tucked in

Crab walking with a theraband - 4m for one repetition, 10 repetitions in total

Theraband around knees (easier)

Theraband around ankles (harder)

Explanation:

• Keeping feet and knees together, tie the theraband around your legs either just above the knee or down around the ankles
• Move your legs so that they're hip width apart
• Bend your knees and keep them bent throughout the whole exercise
• Keep your knees over your toes at all times
• Sidestep to the right and left - keeping the knees bent and knees over the toes

Images courtesy of E.Arshamian, owner/director of Fortitude Physiotherapy

Making New Year's Resolutions

Happy New Year!

I hope your New Years celebrations were good. Have you made any New Years resolutions??

Most people that I know, know that as a rule, I don't make any resolutions. The number one reason for this is that I generally stick to them for a bit, but let go of them as the year progresses. So after a while, I decided not to make any.

This year was no different until I listened to a podcast recently about making goals.

What I found interesting about what was being said, is that there was nothing new in the advice given. The podcast was talking about SMART goals, which as Physios, we're taught to discuss and set with the people we see.  SMART stand for:

Specific

Measurable

Achievable/Attainable

Realistic

Timely

At times, I find this can be easier said than done.

As an example, if someone sprains their ankle, I would want them to have full-range of movement at the ankle, with strength and balance improved within six weeks. If they want to get back to their sport, I'd want them to be doing sport-specific exercises in week four to five, with the aim of getting them back to the sport after week six.

While listening to the podcast, I realised that despite having this knowledge of setting goals, I don't tend to apply this outside of my work life.

I thought I'd give it a go this year, so rather than making one big new year's resolution, I'll start with making a short-term goal of six-weeks.  I can then keep making short-term goals throughout the year and so will be more likely to stick to them and achieve them.  I also thought if I share them on here, then I'll be more likely to do to them!

Here goes - I would like to be able to run faster than I do. However, this is very non-specific and too general a statement. So, on a 5km run, I would average 5.30min/km or longer (depending on my legs). I would like to average 5.15min/km or less on a 5km run.

This goal is now specific to an average time on a 5km run, measurable (time and distance), should be achievable and realistic. I've given myself six weeks to achieve this goal, which will take me to the end of February.

In order to improve my running time, I'm going to commit to two strength sessions a week working primarily on my glutes strength and one running session a week working on either hill sprints and/or distance. I'll post later the exercises I've given myself.

I'll check in here in the next few weeks to let you know my progress. I'm planning on running in the Park Run at the end of February so I can get an official time. No pressure!

How about you - have you set any resolutions that you've stuck with or any short-term goals? I'd love to hear what personal challenges have been set for people.