“I left my heart rate monitor at home, and had one of my best rides”.

“I have put my Garmin in my back pocket and was surprised as to how well I had ridden, despite not having it”.

These comments seem to be more and more common among pedaling groups.
My firm belief, up until recently, has always been that heart rate is a vital part of exercise and improvement. That it is a great way to tell what sort of state one’s body is in. But these sorts of comments made me consider the alternative.

Finally enjoying your ride

Initially, if my heart rate was relatively low but I was cycling hard, I’d know medically that my body was not in a healthy state, yet I’d brush it off calmly to “I have just not recovered enough”. And if my heart rate was higher than normal, I’d use the same excuse. But medically, I know that neither a high or low heart rate can be justified by solely low recovery, and I certainly can’t use the same reasoning for two very different health scenarios.

When I was diagnosed with asthma (the proper kind) my reasoning behind constantly watching my heart rate was now to monitor what sort of strain my lungs were putting on my heart. If my heart rate was too high I’d reason that it was my asthmas fault but yet again if it was too low I would reason that my lungs were not supporting the heart muscle with sufficient oxygen… you get the point

Before you know it you are staring at a million screens whilst you ride: your watch on one hand, your gps on another, and you’re running a million different scenarios in your head as to why you feel so tired.. and the list goes on. Cyclists who are fueled by passion and competitiveness often become fantastic researchers who know all about exercise physiology.

But at some point we have to be real with ourselves and see that what’s exhausting us: is all the body monitoring and over analysing. Isn’t the whole point of riding: to escape our overactive minds!! Sure we’re not thinking of work or day-to-day issues but all that body monitoring is a bit like an over powering mother who messages you every two seconds to ask where you are.

I took my heart rate monitor off about eight months ago, before then, it was basically molded to my arm, actually probably had some mold on it from some dodgy river crossing (the spruit). To be perfectly honest, I have loved my rides ever since. And I’m finally reading my body correctly. If I feel tired; I’m probably tired. If I’my chest starts wheezing then I use my trusty little pump. I have taken all the gadgets off and finally listen to what my body wants.

I’m by no means advocating that you all lose your monitoring devices, if they make you happy and keep you calm, use them. But don’t forget to ride your bike (and look up!). Unless you’re going to be pro, or win The Tour de France, try and have some fun.

My amazing mom worries about everything from the rock that in her mind launches itself onto me… to me having a massive asthma attack and dying… to possibly all the snakes in the grass. She also doesn’t think that losing my heart monitoring devices was smart. But bottom line is when my heart rate was low, I did not stop riding. And when my heart rate was high, did I not stop riding. So what’s the point of having one unless you listen to it…?

These gadgets are super helpful to the racing guys that are improving daily and need to keep up their power wattage and training. Also the GPS is helpful if you’re on self-navigation. Also knowing what sort of mileage you have done and still have to do, helps knowing when to push a bit harder and when to hold back a bit.

I was becoming obsessed with these stats and forgot to actually enjoy myself. I was more focused on trying to better my cadence and fitness than just being present. So the minute I down-sized, got rid of my heart rate monitor (I kept my distance “thingy”) I finally started reading my body better and actually rode faster. Maybe it’s the “don’t set yourself up to fail” view but I really found my motivation improved when I left the gadgets behind. So perhaps give it a go?

If you are still unaware of who Professor Tim Noakes is, and more importantly, what he stands for, then you must be living the good life isolated from society, possibly with the Knysna forest hippies. So perhaps stop reading now… When the Banting diet was introduced to South Africans it had a dramatic snow ball effect and soon every South African became a dietitian overnight. It is for this exact reason that I’m not going to delve into the facts and flaws of Banting. Instead I’d like to introduce you to a new topic called ‘fasting and training’ vs ‘feeding then racing’.

What is intermittent fasting?

The basic concept behind The Fast Diet by Michael Mosley, MD, and Mimi Spencer is to eat normally for 5 days per week and eat very restricted calories on the other 2 days. That is not what this article is about either.

This article speaks to the positive effects associated with training without breakfast (kind of like fasting, since you haven’t eaten for close to 12 hours before exercise) vs the effects of training after having eaten breakfast.

But before I jump ahead, picture this, its winter…

Getting to the start of a ride, run or to the gym is said to be the most difficult part of training. I’m inclined to agree! Getting out of bed and putting on those cold socks can be an emotional ballet! And often the love we have for the sport does not prevail when it is zero degrees outside.
However, once you win the battle to get up and start your challenge, a few other elements start to play a vital role. Your diet. Particularly what you’ve had for breakfast. If you’re like me, you’ll have done everything by the book in order to avoid the infamous ‘BONK’, which is that emotional ballet, but on ice!

A quick look at the science

A basic look at what our bodies do when we exercise: When we exercise, our bodies use our reserves (these reserves can be fats, proteins or carbohydrates). Our bodies will convert these food sources into glycogen. Very basically, the muscles require glycogen to convert into ATP which is the energy we need in order to open the gates in the muscle to calcium which is where the contraction originates.
The quickest energy source without spiking your blood sugar is a complex, non-refined carbohydrate. Although you can run on fat, it takes longer for your body to convert it into the energy it needs to complete an exercise. Your body will need to sieve it through an extra system that uses more oxygen before it gives you the glycogen.
So Simply put, you will obtain the energy from fat and protein but at a much slower rate than the carbohydrate; which is immediate. As you can imagine, this process becomes even more important when you are in a race scenario, as you will need sustained energy throughout the race.

So what happens to us if we train before eating breakfast?

We have not eaten since dinner; let’s say at 8pm the previous evening. We therefore do not have an immediate supply of carbohydrate or fat. We have a limited reserve with little carbohydrates as most would have been digested and converted into storage fat. However, your body is resilient, strong and reliable, it does not shutdown, and it strives to survive. Your body starts to convert the stores into the energy that is required to complete your training. But here comes the question; why can you produce it fairly quickly when everyone has been saying the problem with Banting is that the energy release is too long?
This is where the research gets interesting. Your body puts itself into stress while running on empty. When you are stressed you will activate a system known as the sympathetic nervous system. This system has the ability to speed everything up, turns you into “stealth mode”! Your body releases hormones that in turn, activate enzymes that allow for faster fat conversion into energy. Your heart rate will increase as your metabolism increases and you are able to complete a good quality exercise session. This stress is not necessarily good for you overlong periods, and can play a harmful role on the adrenals and in turn, your kidneys. Simply put we are not designed to be in sympathetic nervous systems for long periods of time. i.e.: for 24 hours or weeks and weeks on end.

We’re not saying race on empty, in fact race on full, but according to some studies training on empty can be very beneficial (also don’t starve all day).

How it works

Complete 1- 2 hours of training after not eating for roughly 12- 14 hours, after which you should resume normal eating habits. By training on empty, you are decreasing your intensity and training your body to use its fat when it is “empty”. For an athlete this format of training can also assist with preventing “bonking” as your body will know what to use when it is empty because you have conditioned it in this regard. You will also loose body fat.
Studies have shown that no body mass was lost but body fat was converted into muscle. Athletes found that initially they battled without the ready-energy that breakfast provided and many tired quickly and got hungry. However, the trial found that athletes were running normally once routine had been established. Then when racing, athletes would eat normally, filling up with glycogen, improving their performance on race day dramatically. Conversely, the opposite result was found in athletes who consumed carbohydrates throughout the trial. The most significant difference in performance was discovered when analysing marathon runners. The athletes that had been training on empty for weeks prior to breakfast did not tire nor need as much food during the marathon when compared to other athletes. . We can conclude that this way of eating for results will not affect your short-distance exercise or short gym sessions. Although you may find you have less energy in the first ten kilometers it is the endurance events where this way of training can be very beneficial. In addition, you will be lighter having lost body fat.

To conclude

There will never be a generic winning formula that will work for everybody. Read as much as you can. Experiment with varying combinations and approaches, and formulate what best works for you, and what feels most natural. By eating more natural food sources, and avoiding refined foods, you will be rewarded time and again. Treat your body well and don’t over train! Do not take any diet to the extreme For example; do not starve yourself for lengthy periods (especially not when training). By doing so, you are putting your system under unwarranted stress. Be wise and do what works for you.

Point of interest: Simple carbohydrate vs. Complex carbohydrates

Carbohydrates are sugars that will come in two forms namely simple and complex. The main difference is how quickly each is digested and absorbed, this is fully dependant on its chemical structure. Simple carbohydrates are also known as simply sugar and will raise your blood sugar level quickly and then be digested so you will then be hungry again and tire. Sugars provide no nutrition except for energy. Left over energy will be converted into fat and stored.
Complex carbohydrates are formed when many sugars string together and it’s for this reason they take longer to break down and digest. Leaving you full for longer and also not spiking the sugar levels but gradually increasing them.
When you mix a carbohydrate with a refined starch or even simple carbohydrate (sugar) you get the no go foods namely: white bread, cakes, pastries, coke etc. When not processed a complex carbohydrate is known as whole grain foods.

Myofascial pain syndrome is often seen in clinical practice as a cause for pain. It is characterized as a dull ache to a burning pain that can cause referral of pain to other areas of the body (Travell and Simons, 1999). One method used to treat this, is by dry-needling therapy (DNT). DNT has proved to be effective in treatment of myofascial pain, but it has shown to cause post needling soreness. This soreness discourages many patients from receiving further dry-needling or treatment (Kamanli et al. 2005).

Ways to help alleviate this post-soreness have been mentioned such as heat, stretching, ultrasound and application of pressure (Fleckenstein et al. 2010). All these modalities are done after the needle has been removed. This then adds an extra modality to the treatment as well as increased treatment time; therefore these modalities are often skipped by practitioners (Hong, 1994). Another factor to look at is that many of these modalities have not been researched objectively for effectiveness on relieving the post-needling soreness (Kamanli et al. 2005).

Using a moxi cigar, placed on top of the acupuncture needle whilst inserted into the active trigger point is a way in which heat as a modality to treat post-needling soreness can be combined into the needling time. Doing this study would also objectively research if there are benefits to this added modality and its effectiveness on alleviating post-needling soreness.

The aim of the study is to investigate if heat conduction using a moxi cigar is an effective modality in alleviating post-needling soreness when treating myofascial pain syndrome with DNT.

The trial will be comprised of 90 participants divided randomly into three equal groups. Group A will receive DNT of active trigger point 1 of the trapezius muscle only. Group B will receive DNT of active trigger point 1 of the trapezius muscle, with the addition of the burning Moxi cigar to conduct heat through the acupuncture needle to the trigger point. Group C will receive DNT of active trigger point 1 of the trapezius muscle, followed by 5 minutes of ultrasound therapy over the acupoint.

Each participant will be treated once with readings being recorded before treatment as well as immediately after, then again after a seven minute break. They will be asked to come in 24 hours post treatment to obtain the last readings as well as to complete a pain diary prior to the last 24 hour measurement.

Subjective data will be in the form of a numerical pain scale questionnaire and a pain diary. Objective data will be CROM and algometer readings. Subjective data will be obtained prior to treatment, in the numerical pain scale questionaire and then again 24 hours after treatment. The pain diary will be a recording of pain at four time points (4hrs, 8hrs, 12 hrs and 24hrs) starting immediately after treatment. Objective data will be taken prior to treatment, immediately post treatment then again after a 7 minute interval post treatment. After 24 hours participants will need to return for a final pain scale questionnaire and for algometer and CROM readings.

Data collected by the researcher was analysed with the help of a statistician. After consultation with STATKON at the University of Johannesburg’s, Auckland park campus, it was concluded that results would be analysed using Shapiro-Wilk test for normality and Levene’s test for equal variances. For all objective data collected, normality and equal variances were present. This added to the group size lead to conclude that parametric testing would be used on objective data. The parametric tests used were: One way Anova and Post Hoc test. For subjective data normality and equal variances were not present and thus non-parametric testing was used on subjective data namely: Kruskal Wallis, Wilcoxon-signed rank and Mann-Whitney U test.

Based on these results clinically the study showed that dry needling with the addition of ultrasound or moxibustion, as a treatment for post-needling soreness did appear to have better results. The use of these two added modalities did ease post-needling soreness which for many patients is the reason they don’t wish to receive further dry-needling treatment. When using moxibustion the post-needling soreness is eased.  This added treatment can be used during the dry needling and does not require additional treatment time for the practitioner or for the patient. To conclude, the efficacy of using a moxibustion to alleviate post-needling soreness has been seen clinically. This treatment can be used with minimal addition treatment time and should be used in clinical practice.

The full research article can be downloaded from this link.

Abstract:

Abstract:

Comparing lower lumbar kinematics in cyclists with low back pain (flexion pattern) versus asymptomatic controls–field study using a wireless posture monitoring system.

Abstract:
Purpose: This study aims to compare the effects of Chiropractic manipulative therapy of the cervical spine in conjunction with SpiderTech therapy in the treatment of chronic neck pain with regards to pain, disability and cervical spine range of motion.

Method:

This study consisted of two groups of 15 participants between the ages of eighteen and forty, ensuring equal male to female and age ratios. The potential participants were examined and accepted according to the inclusion and exclusion criteria.  The method of treatment administered to each participant was determined by group allocation. Group 1 received chiropractic manipulative therapy to restriction(s) of the cervical spine, with the SpiderTech Neck Spider applied to the posterior aspect of the neck. Group received chiropractic manipulative therapy to restriction(s) of the cervical spine only.

Procedure:

Treatment consisted of 6 treatment sessions with an additional follow up consultation, with two consultations being performed per week interval. Subjective data and objective data was taken at the beginning of the first, fourth and seventh sessions. The subjective data collected was in the form of a Numerical Pain Rating Scale and a Vernon- Mior Neck Pain and Disability Index. Objective data consisted of cervical spine range of motion readings taken using a Cervical Range of Motion measuring instrument (CROM). Analysis of collected data was performed by a statistician. The Chiropractic manipulative techniques used were based on restrictions identified during motion palpation and were applied at the first six consultations, with the seventh consultation consisting of data gathering only.

Results:

Statistically significant changes were noted in group 1 and group 2 with reference to pain and disability, and in group 1 and group 2 with reference to cervical spine range of motion. Clinically significant improvements in group 1 and group 2 were noted over the duration of the study with reference to pain, disability and cervical spine range of motion. However, the combined treatment group (group 1) had a clinically greater effect than that of the manipulation only group.

Conclusion:

The results show that both Chiropractic manipulative therapy, as well as Chiropractic manipulation in conjunction with the SpiderTech Neck Spider are effective treatment protocols in decreasing pain and disability and increasing cervical spine range of motion in patients with chronic neck pain. However, neither treatment protocol proved to be preferential. When compared to Chiropractic manipulative therapy alone, SpiderTech therapy in conjunction with Chiropractic manipulative therapy has a clinically larger effect on neck pain, disability and range of motion of the cervical spine.

To view the full research paper, please follow this link.

Research by: Uria, Craig Jonathon

Back and neck pain is not something that is limited to the adult world. Children are little versions of a grown up and therefore anatomically are almost identical, yet they are still growing and developing and are in constant change. It is vital for their adult world to take their pain seriously and to really look into it before deciding it’s just the normal “growing pains”. The correct attention to chronic pain in children can allow them to develop into pain free adults who are far more in tune with their bodies and able to recognise when there is a problem and prevent it getting worse. It is not only vital for their physical development but it teaches them to take responsibility for their own health and to take charge when their bodies are sore, this will install a much healthier attitude towards their bodies (Dampier, D)

Here is some science for those of you who are still not convinced, According to a recent study that tracked the incidence of back and neck pain from childhood to adolescence, one in 10 children (age 9) suffer from neck pain and one in three suffer back pain. The percentages dip a bit at age 13, but then climb dramatically by age 15.

Here’s what the research shows:

That’s right: By age 15, nearly one in six adolescents report neck pain and nearly one in two report back pain. Now that’s a serious health issue requiring serious attention.

Back and neck pain affect people of all ages; that’s the bottom line. If your children haven’t seen a doctor of chiropractic yet, there’s no better time than now – regardless of whether they’re complaining of pain in the back, neck or elsewhere.

After all, preventing pain before it starts is the secret to lasting health and wellness. And don’t your children deserve that as much as you do?

That’s right: By age 15, nearly one in six adolescents report neck pain and nearly one in two report back pain. Now that’s a serious health issue requiring serious attention.

Back and neck pain affect people of all ages; that’s the bottom line. If your children haven’t seen a doctor of chiropractic yet, there’s no better time than now – regardless of whether they’re complaining of pain in the back, neck or elsewhere.

After all, preventing pain before it starts is the secret to lasting health and wellness. And don’t your children deserve that as much as you do.

Sourced from CASA: http://www.chiropractic.co.za/news/Kids-Need-Chiropractic,-Too/index.html

The first visit usually lasts about an hour. The chiropractor takes a complete health history, including information on past injuries and illnesses, current conditions and medications, lifestyle, diet, sleep habits, exercise, mental stresses, and use of alcohol, drugs, or tobacco.

During a physical exam, the chiropractor evaluates your spine and joints and may perform diagnostic tests, such as blood pressure, x-rays, MRIs, and other tests to make a diagnosis. Treatment usually starts on the first visit unless the chiropractor decides that special investigations into the condition need to be carried out before treatment.

Patients are typically asked to lie on a specially designed table, where the chiropractor does the spinal manipulations. The most common is manual manipulation, where the chiropractor moves a joint to the end of its range, then applies a low force thrust. The chiropractor may also use other treatments, including massage and heat and ice therapies. You should not feel any pain from the manipulation. Some people have minor aches, stiffness, and tiredness for a few days after the manipulation while their body adjusts to the new alignment.

Chiropractic is a health care professional that will focus on disorders that arise due to this misalignment of the joints of the” body.

These misalignments are known by chiropractors as ‘subluxations’. A simple way to look at it, is by having a look at a chain, if all the links are lined up correctly the chain is at it optimum strength and able to function correctly, if we have a kink in the chain, this functionality is lost and often the chain then has a weakened spot.

There is a large difference between the human body and a chain though. The human body has an innate intelligence and it is able to pick up these “kinks”, and it immediately tries to correct the “kinks” so that our functionality is not lost. These “kinks” can be precipitated by many factors such as acute traumatic injury, incorrect prolonged sitting and incorrect posture just to name a few.

In the bodies correction it uses muscles and tissue to pull at the “kinks” and sometimes cause muscles to be overworked and go into hypertonic state (spasm) it is then that we become aware of a problem, once we are able to feel pain. As chiropractors we use our education in physiology and anatomy along with biomechanics to find these “kinks” in the chain, we then deliver an ‘adjustment’ to the joint into the correct biomechanical position in order to restore movement and relieve symptoms thereby reducing pain.

What does a Chiropractor treat?

• Spinal pain
• Joint pain- from head to toe
• Headaches and dizziness
• Jaw pain
• Sporting injuries
• Work and stress related injuries
• Sciatica
• Back pain related to pregnancy
• And many many more….

How many sessions will I need

This is a question asked by majority of patients and simply: it is dependent on the condition that you present with. The initial session will be there to establish what the disorder is and if it is a chiropractic case or if referral is required. The chiropractor will then discuss with the patient what sort of treatment plan will be followed. Most treatment plans are three sessions after initial consult and then a subjective as well as objective reassessment of the patient’s condition and pain. This will determine if the treatment is having an effect on the condition or if the patient needs to seek other treatment that the chiropractor will be able to advise on and refer. Chiropractors have an extensive knowledge in diagnostics but remain doctors of chiropractic and should use their professional knowledge when determining if a patient needs to be referred on to a specialist in another field of expertise.

What happens during a visit to a chiropractor?

The first visit usually lasts about an hour. The chiropractor takes a complete health history, including information on past injuries and illnesses, current conditions and medications, lifestyle, diet, sleep habits, exercise, mental stresses, and use of alcohol, drugs, or tobacco. During a physical exam, the chiropractor evaluates your spine and joints and may perform diagnostic tests, such as blood pressure, x-rays, MRIs, and other tests to make a diagnosis. Treatment usually starts on the first visit unless the chiropractor decides that special investigations into the condition need to be carried out before treatment. Patients are typically asked to lie on a specially designed table, where the chiropractor does the spinal manipulations. The most common is manual manipulation, where the chiropractor moves a joint to the end of its range, then applies a low force thrust. The chiropractor may also use other treatments, including massage and heat and ice therapies. You should not feel any pain from the manipulation. Some people have minor aches, stiffness, and tiredness for a few days after the manipulation while their body adjusts to the new alignment.

The Follow up treatment

The follow-up treatment will be approximately 20-30 minutes long and will begin with a discussion on your response to the treatment plan. All the basic paper work would have been done on your first visit.

This will once again be followed by the appropriate treatment specific to you as an individual and your condition, we are all designed differently and live our lives and experiences very differently. Therefore no two patients respond the same way and no two patients are treated in the same way after all we are not robots.

A number of follow-up consultations may be required to achieve the required recovery goals including a reduction in pain and inflammation, improvement in functionality and quality of life however this will be dependent on the nature of your condition and your response to the treatment plan.

How much will this cost me?

Current rates for chiropractic consultation for 2014 are as follows

Adults:

First consultation R380.

Follow ups R350.
Children under the age of 14:

First consultation R350.

Follow ups R300.

Please note that this is a cash based practice and you will be require to pay via cash, or card. American express and Diners are also accepted along with Visa and MasterCard credit or debit cards.

Our rates are based on Discovery Medical Scheme healthcare provider rates. And you just need to submit your invoice into your medical aid for re-imbursement.