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“Knee Pain, what to do?” – Readers Question

knee pain fixed

“I have osteoarthritis in my knee but am a fanatical athlete. Running I have to give up, but otherwise, I do everything from strength training to spinning, and daily cycling to lubricate the knee. Lunges are too stressful just like certain yoga exercises. Doctors advised me to do a procedure. But I am not ready for that yet,  although the pain comes back more regularly. I am 53 and my weight is fine. Do you have any more tips to improve my knee condition?”

– Caroline

 

Mark Chen, Physiotherapist:

A number of factors are important in the discomfort caused by osteoarthritis. Of course, the way of stressing the knee is very important and also the amount of rest that the joint gets to recover. Running is an activity that generates enormous impact on the knees. It is therefore not very surprising that you get a lot of problems with that particular choice of sport.

Strength training is indeed a good way to relieve the joint. You describe that lunges are too stressful, does the same apply to squats? If so, are you sure that the technique is correct? A large part of the load on the knees can be reduced by making these kinds of exercises more hip-dominant versus knee-dominant. If you use the hips more, the knees will taxed less. A good trainer can advise you and adjust if necessary.

Another option is so-called ‘open chain’ exercises. Thanks to machines, these exercises can train the muscles without having to carry the whole body weight. A disadvantage is that this way of moving often does not match how you use the knees in daily life (rising from a chair, climbing stairs). We call these exercises “non-functional” but that doesn’t mean they are not valuable.

Nutrition is also important. There is more and more research that shows that a balanced diet has a big effect on the discomfort that arthrosis brings with it. Consume a balanced diet and try to supplement with a multivitamin and possibly glucosamine. In the field of glucosamine, scientific studies are contradictory, but I have seen that a good quality glucosamine supplement can definitely add value.

A final option is an injection with Fermathron (hyaluronic acid). This is a kind of gel that can be injected and acts as a pad. It can both reduce pain and increase mobility and lasts for up to six months

If you’d like some extra help with your knee, make an appointment here!

I hope that helps,

 

Mark Chen

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#MindsetMonday: FOCUS (RSD VIDEO)

People are like

“I have panic attacks, I have anxiety attacks out of nowhere”
Here’s the reason why,
And it’s connected to discipline and willpower
your thoughts have become your MASTER
you have become your thought’s little B*tch
Isn’t that crazy if you think about it?
Our thoughts, out “human’s most powerful tool”
We are the only species on earth -probably-
that can create abstracts thoughts about future
about things that are not even tangible
and what do we do with those thoughts?
we become their little b*tch
The ability to maintain focus over an elongated timespan
is going to be one of the most sought-after abilities in the work and marketplace
You should be able to train your focus to maintain it for more than 15 seconds
Because that ability will enable you to do the things you need to do

 

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Starting with Fitness (In Phnom Penh)

“I would like to start working on my fitness. I am 58 years old and have stopped drinking (white wine) for a year and unfortunately gained weight. I smoke, my height is 1 meter 64 and now I’m at 78 kilograms. I always weighed around 70 kilograms. I have never done anything to work on my fitness in the last twenty years. I do not feel comfortable with that and I am now considering sports, but I would like some advice on this.

Of course, I can go to a Fitness gym but I feel a lot of resistance; a gym with often many young people who are focused on their muscles and hard music.

Ideally, I would like my muscles to become more supple and my posture and condition to improve. I notice that after walking for fifteen minutes I am already heaving, my posture is probably not good either, because I often get pain between my shoulder blades.

I hope you can give me some tips. Thanks in advance.”

– Joki

Mark Chen, physiotherapist

I would first off offer to adjust your vision with regard to a fitness gym. I understand very well that it can be overwhelming to enter a gym for the first time, but I think that once you feel at home, a lot of the prejudices will fade away.

I’ve also had that experience when I was 16 when I went to the gym for the first time.  There I was, with my ‘mini-weights’, standing there between the ‘big boys’. I remember it to be very uncomfortable and I felt judged. But soon, people started talked to me, I got tips and I started to feel more and more at ease. And of course, my fitness increased!

A few years later it was the other way around, and it was me that put new members at ease, as an instructor but also as a member. A beautiful thing, right? Fitness remains, in my opinion, one of the fastest and most effective ways to work on your health. And crossing that first speedbump may be difficult, but it is definitely worth it in the end. Don’t let limiting beliefs hold you back.

 

Personal trainer

If necessary, hiring a personal trainer is a good option. This will facilitate the entire process and create a tailor-made fitness program, where your postural problems can be tackled at the same time.

Yoga
In addition, there are plenty of other sports to be fit and flexible. For example, yoga is an option that immediately comes to mind. A wonderful form of exercise that is focused on all aspects of Fitness: stability, posture, and flexibility in the entire body.

It is also a sport that can be well adapted to the individual, making it accessible to everyone. I also suspect that the chance of having hard music and muscular men is a lot smaller.

Hiking
Last but not least, do not underestimate the effect of walking on your level of fitness. You indicate that you start heaving after fifteen minutes. Maybe it is an option to start walking fifteen minutes a day? If after a few days you might notice that you are no longer panting, you can, for example, extend it by five minutes every week. Before you know it you walk for half an hour without stopping. Once a start has been made and progress becomes more visible, the motivation to continue will automatically follow.

It is literally a matter of taking the first step. Good luck, and I hope you find a sport that suits you.

 

I hope that helps!

 

Mark

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Readers Question: “Spinning class bad for Knees?”

I have arthrosis in my knee and a little bit in the hips, can I still do spinning? I’ve been doing it for years.

– Din

Mark Chen, Physiotherapist

The advantage of spinning is that it is not a weight-bearing activity (except the standing parts, of course). That makes it a ‘safer’ option than, for example, running, where your knees and hips have to endure huge impact for miles. So if you look at it purely from a mechanical-stressn perspective, it should be no problem at all.

You indicate that you have been doing spinning for years. Could it be that the number of years and intensity have contributed to the current condition of the knee? Ultimately, it is, of course, a one-sided and repetitive form of sport. For example, do you clearly have more pain immediately after spinning, or the morning after? In that case, you should question how good spinning is for your body.

I am personally a fan of variety, not only because I like to do different things but also not to burden my body too much with one element. I also recommend this to the majority of my clients. Ask yourself the above questions and if spinning does indeed cause problems for you, then consider reducing or varying with a different sport.

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Podcasts worth watching : Joe Rogan & Firas Zahabi

#Joerogan #Firas #Zahabi #Podcast

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Injured? Here are the estimated recovery times

Muscle Sprain/ Tear:

Grade I: 0-2 Weeks
Grade II: 2-12 Weeks
Grade III: 3-24 Weeks

Ligament Sprain / Tear:

Grade I: 0-3 Days
Grade II: 3-24 Weeks
Grade III: 5-52 Weeks

Tendon:

Tendonitis: 3-7 Weeks
Tendinosis: 12-28 Weeks
Laceration: 5-28 Weeks

Bone Contusion/Fracture:

5-12 Weeks

Cartilage Irritation/Damage:

12-100 Weeks

Ligament Graft:

12-100 Weeks

 

All of these are depending on health and level of activity of the individual, alongside with illness beliefs, perception, nutrition, sleep and stress levels. Therefore these are to be used as a guideline and always is the help of a professional recommended for an efficient rehabilitation process.

Source: Dr. Caleb Burgess DPT, OCS, CSCS

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Do this before you start running

If you’ve read the previous articles on running, you now know that your bodies’ own shock absorbers are of crucial importance.

Whenever I work with clients that want to either get into or- improve their running performance, I test them on multiple abilities.
One of those is their ability to jump. or actually, to land. 

By practicing and optimizing your jumping mechanics, you create can learn how to use your ankles, knees, and hips to decelerate impact. It teaches the central nervous system how to make all the different muscles and joints to work together in an efficient way.

These are the conditions for a healthy jump and landing.

  • Knees track the first 2 toes during the jump and the landing
  • There is a smooth transition between ankle, knee and hip flexion during the land
  • There is a smooth transition between ankle, knee and hip extension during the jump
  • No noticeable impact may be heard during the landing “or Ninja-style landing”
  • Has to be performed barefoot

This is how to test it for yourself, though I strongly advise getting a set of trained eyes to accompany you for a good assessment.

  • Put your phone on camera mode and select the “Slow-Motion” option.
  • Make the jump at least three times while taking separate videos for it.
  • Rate the technique on the points above. Sound usually doesn’t transfer well to slow-mo videos so you’ll have to rate that yourself.

Here’s a video of my athletes doing box jumps in slow-mo, what do you think?

 

 

Gyms in Phnom Penh

 

 

If you’re looking for an option to get Fit and Healthy in Phnom Penh, I’ve listed a couple of options in different facilities with options for every budget.

Fully equipped gyms:

The Place

 

This is the most well-known Fitness center and has all the facilities you could need. Top of the line equipment, pool, steam, sauna and group classes. They have 2 locations (which does not mean you can go to both on the same membership for some strange reason).

Page: https://www.facebook.com/theplacefitnesscenter/

Pricing: 60$ and up

Rating: 5/10
Would recommend: No

Superfit

Comparable to the Place with lots of space, good equipment, and pool/steam/sauna. They also have a nice outdoor space with lots of material to throw/climb/jump. So if you’re looking into a more CrossFit or HITT approach, you can do that here. In front of the gym, there is a massive parking space (which is rare) and there’s also a great atmosphere which was an important factor for myself.
Prices range from around 40-60$ per month depending on the duration of membership and if they’re running a promotion, which is quite often.

Rating: 7.5/10
Would recommend: Yes

 

Crossfit Gyms:

Amatak

This is the first Crossfit gym in Cambodia and they recently moved to a new location in Russian market. They have a strong focus on community-based fitness and offer group classes like crossfit and bootcamp. All the coaches are certified teachers and are driven to give you a great experience. Prices are 80-130$ depending on the type of membership. They also have a kitchen that focuses on healthy meals.

Page: https://www.facebook.com/pg/AmatakFitness/

Rating: 8/10
Would recommend: Yes

 

 

Yiqi Crossfit

In Chinese, YiQi, pronounced yee-chee, means togetherness. The CrossFit YiQi logo personifies the uniqueness of our fitness center with our mascot, the Yi qi–half-bird, half-dinosaur discovered in China. The mascot is rendered in Khmer art style to symbolize the arrival of the world-renowned CrossFit Fitness onto the Cambodian scene. The black color represents the high-intensity workouts of CrossFit, while in contrast, the lime green gives a fresh, healthy feel to the atmosphere of our CrossFit YiQi center. Our motto, “Leave No One Behind”, embodies our most important principle: the spirit of fellowship one will feel immediately upon joining the community.

 

Page: https://www.facebook.com/crossfityiqi/
Pricing: 80$ and up
Rating: 8.5/10
Would recommend: Yes

Basic (local) Gyms

Fit zone

 

Very basic, but has everything you need, if you know what to do. Friendly people and open from early morning until late. No aircon.

Page: https://www.facebook.com/fitzonelap
Pricing : 3000 Riel (0.75 cents) per time
Rating : 9/10
Would recommend: yes

 

S-Fitness

Very comparable to Fit-zone and mostly a matter of personal preference

Page: https://www.facebook.com/sfitnesspage/
Pricing: 3000 Riel (0.75 cents)
Rating: 8/10
Would recommend: Yes

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Why you can’t trust Science

 

 

 

 

I’ve been getting pulled into many discussions regarding health, exercise and nutrition lately and the trend is clear:

Everything needs to be SCIENCE BASED.

This is a good thing, or at the very least, the idea is good.

It’s good to want to support your thoughts and findings with some kind of testing to see if what you’ve seen or done is replicable or that it was just a combination of circumstances.

There are, however, some issues to the current use and limitations of science that I have problems with and I think they’re worth a share so that you are aware of it the next time you read the sentence “Scientific research shows”

1# Cherry Picking

Take an interesting topic on nutrition and it won’t take you long to find 100+ different scientific studies on it. It’s very common for people to pick a scientific study that fits their argument and use that as “proof”. If you don’t have the knowledge, or time, for that matter, to take a good look at what that article actually says, it’s an understandable result to accept that as truth.

You’ll also want to ask yourself the question: who is benefitting from this bit of research? It has happened more than once that scientific studies have been over/underplayed to favor the financer of the study.

 

#2 Science has been wrong more times than it’s been right

Take this example of cholesterol and the drastic dangers of it on your cardiovascular system. It’s a funny explaining video on how Science was wrong on it many times. It’s not that scientific studies are badly done necessarily, there are many other factors in play.
We could have been asking the wrong questions, doing the wrong tests, or didn’t quite have the right instruments to do proper testing -and who says we do now? –

 

#3 Human Errors

Science may sound bulletproof, but it’s still executed by humans. And we make mistakes.  When we have problems that can’t be explained easily we tend to blame stress for pretty much everything but stress is never factored in when it comes to scientific research. Not for the scientists, and not for the participants. But we do make mistakes. Constantly. We make them when remembering facts, with what we are supposed to write down, and sometimes, well, it helps to get paid $50.000 to say something that goes against everything you know is true

#4 Research is not Research

Anecdotal evidence, expert opinions, cross sectional studies, they’re often presented as evidence but the actual value of them in terms of the hierarchy of scientific studies is not very high. There’s a pretty serious change that there are another couple of studies of the same level of reliability that prove the conclusions of yours, wrong. And otherwise, there will probably be one very soon.

 

 

#5 Research can be slow to catch on

 

Sometimes we practice certain principles that are based on scientific research for years, only to find out that it was the wrong approach all along. I touched on that with my 2nd point but here’s another great example on how we’ve overplayed the importance of calories in weight loss. It’s still the most practiced approach (and it does have value) but the point is that only now we are finding that it’s most likely hormones that play a crucial part in weight loss, and not just energy balance. This video is a long one but has very valuable information that might change the way you think about weight loss.

 

As always, I’d love your thoughts about these things. Because I need any insights I can get 🙂

 

Mark