Myth Busters Part 2 - Nutting out the Specifics!

Are you ready for The Pole Physio Myth Busting Part 2? Because we are ready to crack these myths WIDE open. In this blog we are going to nut out myths around the types of stretching, recovery and why we do not always need to rest after injuries. We are going to make you think about the requirements for imaging and why getting older does not always equate to more injuries. And we have a particular myth close to our hearts about healthcare professionals. But more on that one later!

Are you ready to bust some myth and continue to enhance your ‘Poletential’? Because it is time to get cracking… And speaking of cracking… (great Segway…)

Sometimes my joints crack – is this causing damage? Grandma always said cracking my knuckles will cause arthritis.

Absolutely not – our joints cracking, popping or making noises is normal (often referred to as cavitation or crepitus). Changes in joint pressure and tendons sliding (due to friction) are the most common reason why we hear noises. And there is NO evidence that indicates cracking joints leads to arthritis (Deweber, Olszewski & Ortolano 2011).

So how does the pressure change result in a noise? Let me get a little nerdy for you… Kawchuk et al (2015) was able to use real time imaging to investigate how the audible ‘crack’ occurs in our knuckles. The initial theory was that joint cracking was release of gas bubbles in a joint, however his research proved the opposite. When two opposing surfaces resist separation then rapidly separate – dissolved gases actually create a gas cavity – which is the noise we hear (and for all those nerds out there – this is called tribonucleation). This is why we have to wait a period of time before we crack our knuckles again – this gas bubble won’t let us.

Simply - in order to make a joint ‘crack’ we are moving it into end of range positions (to create resistance). So, if the research says it is not a problem - why do we always say ‘cracking joints is bad for you’?

Often because we heard it from our parents to stop us making that noise. A study in 2017 by Robertson et al. looked into individuals’ beliefs around noises in the knee. Those in the study reported that they felt hearing a noise indicated that something was happening to the area that was wrong and it was a sign of aging, therefore they needed to avoid or alter activities that caused the noise. And you know who influenced the thoughts the most? Friends, family AND health professionals! A simple statement can create so much influence on our thoughts – that’s why it is important that we challenge them.

Sometimes noise is not a good thing. If you hear or feel cracking, popping or noises that are associated with pain, swelling, sudden reduction in range of movement, or if you have had a recent injury and start to notice noises - that is a time to get it checked out by a qualitied health professional.

KEY TAKE AWAY: Joint noises are a normal part of our bodies movements and not all of them result in damage. If you are concerned – reach out to a health professional to check it out.

Ok I get it – but I need my back cracked to go back into place, because my hips are out of alignment…

Alas no – this is another myth that has been started by some health professionals to create recurring business and to explain how good we feel after we hear that sound.

When treatment involves hearing a cracking noise – your joints are not moving back into place or being adjusted, that is tribonucleation occurring (yes, I really wanted to use that word again.) Studies have shown movements that result in a ‘cracking’ noise do not change the orientation or structure of the joint (Kawchuk et al., 2015). The feeling of relief is your body responding to a technique intended on downregulating your nervous system, changing your pressure pain threshold resulting in a feeling of safety and relaxation (Lascurain-Aguirrebena, Newham & Critchley 2016; Oliveira et al., 2013).

Our spines and pelvis are very stable structures – so unless trauma is involved or you have severe connective tissue disorders – your hips or spine are not out of alignment.

KEY TAKE AWAY: Our spine and hips do not go out of alignment easily, nor do we need them cracked back into place! A bit like a massage, if a good back cracking feels good then go for it, if you are not a fan, then get your body moving in other ways.

Everyone says I need to have some recovery days – a few days rest on the couch is recovery, right?

Not quite.

The definition of recovery – according to the Oxford dictionary - means ‘returning to a normal state of health, mind or strength’. When we apply that to sport – recovery after training or competition is allowing athletes to return to their normal physiological and psychological state as rapidly as possible, to allow for participation at the next training session not to be compromised by muscle soreness or fatigue. Who automatically cringed as they recall the last class they went to feeling fatigued?

As health professionals we consider recovery in two ways – active or passive recovery. The simplest way to consider if recovery is active or passive –– does the activity involve gentle, non-strenuous movements or no movement at all?

As health professionals we recommend you have a balance of active and passive recovery. All athletes need to have balanced nutrition (if you are concerned make an appointment with a sports dietician as this is outside of our scope) and quality sleep (check out the sleep blog).

Ok I get it – I need some recovery time in my week that is not just sitting on the couch –BUT I need to attend more classes to improve and nail those nemesis tricks!

Here is where a lovely saying ‘less is more’ is appropriate. In burying this myth – we need to look at the types of pole training we are doing. Dr Joanne Nicholas’ PhD published in 2019 provides a wealth of information regarding what pole dancing involves. The key points relating to classes are:

• A 60-minute pole class can be classified as moderate-intensity exercise.

• Classes that focused on routine-based training have an increased energy output.

• Skill based classes equate to resistance (micro damage occurring to muscles to improve strength) and neuromuscular training (the body learning and remembering how to do tricks!)

So, what does that mean for you? When you think about the pole classes that you attend each week – are they either getting your heart rate up for an extended period, challenging the strength of your muscles or fatiguing your mind and body? An even easier way to think about how hard you are pushing your body when it comes to exercise:

• If you can talk and sing without puffing – low level

• If you can talk but not sing– moderate level

• If you cannot say more than a few words without needing a breath – intense level

When was the last time you were singing during a pole class?

Unless you’re an instructor, who sings out their chorey, then you probably can’t remember. So, pole is quite demanding on many facets of the body and recovery is really important!

As part of a longer-term recovery plan - we utilise a deload week every 8-12 weeks. This is where we still exercise but at a much lower intensity and allow for a process called super compensation to occur. This is where our body catches up on longstanding fatigue and recovers strength in a superhuman sort of way so we can be even more incredible the following few weeks. How cool is that? You can read more about that in our taking a break blog.

How about from a week-to-week basis? Wondering how much rest we need? It depends on the classes you attend and your base level of fitness, however for most people the rule of thumb is 24-48 hours (Dupuy et al., 2018). If you are training to failure (e.g., that last invert was an absolute fail) then your recovery will be slower during the 24-48 hours following training (Moran-Navarro et al., 2017).

So, what is the easiest way for you to identify when your body requires more recovery? Consider the time required between sessions so that in attending the next class you have reduced soreness and minimal fatigue. This will mean you have the ability to have a training session of higher quality – resulting in unlocking those nemesis tricks (Kellman et al., 2018).

KEY TAKE AWAY: Fatigue and overtraining are the most reported reasons for injuries at pole that YOU can modify…. (Szopa et al., 2022; Istoczak, Vital & De-seze, 2022). You do not need to attend more classes to improve – you need to allow time for your body to recover after! If you want even MORE information – check out our pole recovery blog or reasons why we get injured blog.

Oh no! I have injured myself – I need to stop all activities and get a scan to find out what is going on.

WOAH.. there is a lot here we need to unpack before we crack it. Starting with scans.

The majority of health professionals will not need to review a scan prior to seeing a patient. As part of our training, we are able to diagnose injuries and commence rehabilitation without scans if appropriate. Like all things however, there will be a time when a scan may be required, this can include (but not limited to) ruling out a fracture or other pathologies.

An important thing to remember with a scan, is that it is a snapshot of your body at a period of time, and a good clinician will be assessing to see if the scan results MATCH what you are reporting. Why is this important? Well, we know from research that a lot of scans will identify pathology that is not symptomatic or a problem for a patient – simple meaning – IMAGING DOES NOT CORRELATE TO PAIN.

A brilliant example of this I am going to take from a previous blog about scans that you can read here – this image shows for multiple areas of the body how many pathologies were identified on scans that individuals had NO SYMPTOMS for.

Hopefully you get the picture that scans are not always needed… So, let’s look at the other part of this myth - Do you have to stop all activities?

The majority of injuries, with appropriate alternatives and de-loading are able to be managed allowing you to continue training at pole or with other off the pole activities.

HOWEVER, there are some specific injuries and illnesses where it is best to completely stop all activities involving the injured area (fractures) or all of body movements (illnesses). This should be advised and discussed with you by an appropriate health care professional.

KEY TAKE AWAY: You do not need to have a scan prior to seeking medical intervention for injuries AND you DO NOT have to stop exercising with the majority of injuries! And how do you know whether to stop or continue poling? Make an appointment to speak with a health professional such as one of our expert team members.

So, I had a scan, and now I am being told I need to have surgery. That will just fix my problem, right? No need for Physio before or after?

This myth we are actually going to tackle in a blog of its own later this year – there is just so much in this single sentence to talk about.

But to quickly nip this in the bud until the blog is released:

• A scan does not always dictate the requirement for surgery – it shows the pathology of an area at a point in time

• Physiotherapy is beneficial and a requirement for the majority of injuries, regardless of the requirement for surgical intervention. It is usually required both before (prehab) AND after surgery.

It is important to speak with your health professional about your specific injury and requirements – but keep an eye out for our blog on why we prehab for surgery.

Why can’t I just chill out in the splits to stretch? I just need to stretch more to improve my flexibility, and I am always told ANYONE can get the splits with enough training.

If anyone has recently completed our Flexibility 101 workshop – you know why hanging out in the splits does not anyways achieve those long lines! But for those who did not get a chance to check it out – here is a brief summary for you:

There are two main reasons why we stretch:

• Maintenance stretching – mostly passive – completed as part of cooldowns, staying in your ‘comfort zone’ and not stressing the area by moving into end of range positions

• Developmental stretching – the intention is to increase the length of the muscles and flexibility in a joint. This is done through active and passive stretching.

So, if we want to improve our flexibility, we can achieve this through focusing on development stretching. Why? Because in order to improve our flexibility there are four things that need to occur:

• Improve stretch tolerance to allow our nervous system to feel comfortable with our muscles and joints moving into end of range positions

• Improve viscoelasticity (muscle’s capacity to return to a resting state) - with the intention of that resting state having more movement than it has previously.

• Reduce stretch reflex through inhibition – the stretch reflex is the body’s protective response to an end of range movement.

• Create muscle hypertrophy – resulting in stronger muscles – allowing our body to control the movements into further ranges

(Folpp et al., 2006; Ben & Harvey, 2010; Chan et al., 2002; Taylor et al., 1990; Ryan et al., 2012; Freitas and Mil-Homens, 2015; Simpson et al., 2017; Panidi et al., 2021))

See how that is a mix of active and passive stretching? We do this specifically because an important goal with flexibility is to have as small a gap as possible between active and passive range of movement. Easiest way to test this? Stand up and without using your hands lift your leg as high as it will go and back down, then grab your ankle and gently lift as high as it will go (be cautious if you are cold doing this!). See the difference in ranges? That is the difference between active and passive flexibility of your front splits.

And how do you achieve this reduced gap? Research shows that all types of stretching can be effective, but we know to enable control into end of range positions we need to be strong.

And yes – with appropriate training most people can improve their flexibility - but be prepared – this can take many years. There will also be some people due to anatomical variations of the hip or other pathology that may not be able to significantly improve their flexibility.

And for those that have been told ‘you will get more injuries if you do not stretch after training’, there is no evidence to support this. What we do know is that it is more important to go through an appropriate cooldown to slowly lower your heartrate, move your body through its ranges of movement and listen to what your body needs.

Key Take Away: Chilling out in the splits whilst watching TV is a way to improve passive flexibility in the short term, but make sure you have active stretching in the mix as well! It can be a lot more technical as to why your splits are not improving (changes in collagen fibres in muscle post injury, neural restriction) and if you have concerns book in with your health professional to get it addressed. If you want to read more about – then check out our Active vs Passive flexibility blog

But I am old – even with the right recovery and doing the stretches properly I will have more injuries so I have to be careful.

Let me bust this myth wideeeee open for you. Have you read our blog on longevity at pole (click here!) ? Age does not always equate to injuries. Yes – as we age our body changes (thanks hormones) and we notice increased muscle and joint stiffness.

This is associated with age-related degeneration (a normal process of aging – like grey hairs), changes to collagen fibres in our body and overall muscle strength. As we age due to these changes, we can have an increased risk of injuries to our tendons (due to those collagen fibre changes), however in maintaining appropriate strength and continuing with appropriate loading – the likelihood of an injury can be reduced (Svensson et al., 2015).

Injuries more often than not occur due to accidents, overloading and the occasional silly thing we do (look I fell over running and hurt my shoulder… it happens..)

Key Take Away: Health professionals can never 100% guarantee that you will not sustain an injury – but we can modify some of the risk factors. The important thing for our mature polers is to continue to listen to your body and know what it needs.

Sweet! I am feeling inspired and have just googled some exercises to include as my ‘light gym’ during active recovery…

HANG on a tick…. Whilst we are pleased you are keen to crack on with other exercises, Googling exercises is not the best of ideas… You can find some ‘inspiration’, but heed with caution, as it is important to understand what the intention of the exercise is and what it is targeting (strength, neural compliance, proprioception).

As a poler, attending private lessons or classes to get off the pole exercises from instructors is a great way to build foundational exercises, or look at some reputable sources - Like our awesome Anatomy blogs! Our pole physio team have not only gone into depth around the anatomy and muscle requirement for each trick, but we also have exercises SPECIFIC to off the pole that can help you build strength and unlock your tricks.

An even better idea? Book an appointment with your health care professional to get a tailored progressive program. Bookings through The Pole Physio allow you to do this all online.

Ok I’ll book in – but all health care professionals are the same – it doesn’t matter who I see to ask the questions I have.

We know each country is different, however as The Pole Physio is an online platform with majority of our staff originating from Australia, we wanted to take the opportunity to provide you with additional information regarding our training and apply it to this myth. There is a SIGNIFICANT difference between a Physiotherapist who has their undergraduate degree (Bachelor), post graduate degree (Masters) and those who are a SPECIALIST Physiotherapist.

Undergraduate Physiotherapists (Bachelor or Doctor of Physiotherapy degree)

Undergraduate Physiotherapists in Australia have completed 4-6 years of study graduating with a Bachelor of Physiotherapy or a Doctor of Physiotherapy degree (different to a Doctorate – Australia likes to keep things interesting). These Physiotherapists can independently manage uncomplicated injuries and it is expected through experience as their careers progress, they are able to manage more complex presentations.

Post graduate Physiotherapists (Masters of Physiotherapy in a particular area).

Post graduate Physiotherapists have completed a Masters of Physiotherapy in their area of interest over 2-4 years (Sports and Exercise, Neurology, Musculoskeletal etc). These Physiotherapists can deliver effective management in most complex and critical patient presentations in their area of practice, and are often involved in mentoring/supervision, teaching and/or research.

Clinical Specialist Physiotherapists (As awarded by the College of Physiotherapists – recognised titled Dr)

A Specialist Physiotherapist as awarded by the College of Physiotherapists in Australia, through completion of a 2-year training program and passing specific exams. Specialist Physiotherapists can manage the most complex, difficult or critical client presentations in their area of practice, and can be recognised as a point of expert clinical review, opinion or referral.

IMPORTANT NOTE: The term clinical SPECIALIST should not be confused with those Physiotherapists specialising in a particular area (meaning they have a specific interest or have completed additional training in that area). The title Specialist is a protected term in Australia reserved for therapists who have gone through a formal specialisation process.

PhD (Dr) - Physiotherapists will often have the opportunity to pursue a career in research, and complete a thesis awarding them a PhD and the title Dr. These Physiotherapists may have continued to treat and manage patients’ injuries during this time.

KEY TAKE AWAY: Do your research and ask questions. There are many great Physiotherapists who have not completed any additional postgraduate studies (for various reasons) but there are also many Physiotherapists who don’t have the expertise and knowledge you require for successful rehabilitation.

WOW –

Mind blown right? When it comes down to the nuts and bolts of it all, whilst we cracked these myths wide open – you may still have questions. If anything we have mentioned in our blog is making you consider your recovery strategies or stretching techniques, or is having you consider how to manage your injury or feeling like you are plateauing – make an appointment via the online booking system to get on top of it.

And if you are hungry for more, Part 3 is underway so get your appetites ready! The tea is about to be spilt…

Until next time, train safe.

The Pole Physio

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References:

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