Regular exercise is highly beneficial for people living with diabetes. Exercise can address many complications associated with Diabetes AND improve health, well being and physical function.

There are three main types of Diabetes Mellitus; Type 1, Type 2 and Gestational Diabetes.
1)Type 1 diabetes (IDDM) Is caused by an autoimmune condition in which the pancreas does not produce insulin in levels required to maintain optimal blood glucose levels. This  is usually diagnosed in childhood.

2) Type 2 diabetes  (NIDDM)  generally develops later in life, and accounts for around 90% of all diabetes cases.

3) Gestational diabetes refers to a condition of high levels of blood glucose when pregnant. This also increases a woman’s risk of developing type 2 diabetes later in life.

All three refer to a condition in which the body cannot adequately control the levels of glucose in the blood. Ongoing high levels of blood glucose increases the risk of many chronic conditions including cardiovascular disease.
Exercise, along with dietary intervention, is among the most potent therapy for the management and prevention of type two and gestational diabetes, and the management of type 1 diabetes.

Exercise will improve insulin sensitivity which results in improved glucose control. An Increase in muscle mass will allow for higher levels of glucose storage in the body and keeps the glucose out of the blood, reduces blood pressure, and aids with fat loss. 

The two main types of exercise to consider are aerobic and strength training.
Aerobic exercise -  build towards 210 minutes of moderate intensity exercise per week (walking, running, swimming, cycling etc).
This is higher than the normal recommendation of 150 minutes per week.  This higher volume of exercise has been shown to produce significant benefits for people with diabetic complications.

Strength training will increase muscle size and strength and  allows for increased glucose storage in the muscles. Higher muscle strength will also help to increase a person’s capacity to carry out activities of daily living, improve bone density and joint health.
Strength training – undertake at least 2x/week in order to achieve significant adaptations.
 
Different intensities of exercise will change the level of glucose in the blood. For example,

• Low level aerobic exercise will lower blood glucose levels
• High level exercise can release glucose .

This is an important factor to consider if an individual has poor glucose control.  It becomes especially important to measure blood glucose levels when exercising (often before, during and after) to ensure they are not risking  hypoglycaemia (low sugars).
When first diagnosed or starting to exercise, it is important that the diabetic person has the support of a team of health professionals to design and monitor the exercise program and monitor the use of medication as required.
In the long term, regular exercise will lead to a reduction in blood glucose levels, and allow for better glucose control in their day to day life.

For more information, or to book a consultation, please call 02 6352 3131.

Adam Brogan
Accredited Exercise Physiologist
M.Clin.Ex.Phys, B.Sp.&Ex.Sci, AEP, AES, ESSAM

The grasses are growing with the warm weather and rain we have been having, and lots of people are out making hay.
This means people are out on tractors, trucks and headers looking backwards, and often doing this one sided, causing neck pain.
So what can you do?
- Sit taller with good posture (no slouching)
- Try and change up the direction you are looking back so it’s not the same side all the time
- Do some gentle neck stretches (ear to shoulder)
- Get out of the tractor more often (try every hour or so) to move your body around

In true, slightly slow off the mark style, it’s taken me all month to get organised to write this newsletter highlighting October as Mental health month.

The people of Lithgow and the surrounding rural districts have had a lot of ongoing stresses over the past year and I think it’s actually fitting to be writing this today as it’s 1 year since the Gospers Mountain fire started – who would have thought that that one lightning strike in the middle of the scrub would cause so much destruction? Over 2.6 million acres of our beautiful native flora and fauna burnt, heartache and many tears to those who lost their homes and properties, and a huge amount of stress and anxiety to everyone who lived in our region. Many of us are involved in the RFS and so many people donated their time, money and supplies to keep all our crews going and safe.
 
The fires were a stressful time for everyone and coming off 3 years of drought it’s no wonder the people of our area were in a heightened state of anxiety and in many cases depression.
 
In early March I was seeing a lot of people with pain and injuries that occurred during the summer but had not had the capacity to be able to address it previously. Many people were quite upset and had not actually spoken to anyone about their experience during the fires and drought until they came in for a physio appointment. I feel privileged and honoured that people felt they could talk to us and were comfortable to be able to open up about what has been happening in their lives.
 
Then along came COVID…. This was another level…. An unknown, and everyone was watching the situation overseas and seeing all the terrible images on the TV. No wonder people were again becoming anxious when we started to get cases.  The messages we were receiving were confusing and the government and health districts were trying their best to give us the information, but they too were learning as they went.

There were so many uncertainties associated with COVID, none of us were sure of the health impacts, financial impacts and social impacts.
I know many people were really worried about all or at least some of these on themselves, their families and friends.


At Tablelands Physio we have been staying positive and available to our clients to help them through this time and not put anyone at any greater risk. We are truly grateful to all our clients who have been patient with our requests for masks, signing in, embracing the Telehealth options, scheduling dilemmas and incessant cleaning that has for the time being become out new norm.
 
Back to Mental health month….
 
I prefer to call it happiness month, but since I’ve missed most of October maybe we can flick it to November instead.
 
It is well known that the brain has a fight or flight mode. When there are stresses our body and brain go into overdrive to manage the situation, more adrenaline and cortisol is released, and we are often able to cope with quite stressful situations.

Unfortunately, if the stress goes on for a long period of time, we are unable to maintain this heightened level of stress and this causes adverse effects to our physical and mental health.
We get a fatigue and are at risk of developing higher levels of depression and anxiety.
 
As a Physio, I am managing people with pain all day every day and we know as health professionals that if people are in a level of heightened anxiety, depression or have sleep deprivation, their pain levels are increased and their capacity to cope is diminished.  
 
We also know that by trying to manage our stress and anxieties, often by exercise, mindfulness activities, talking to friends or professionals, we can also have a positive impact on managing pain and our mental health. We are fortunate as allied health professionals that we can help you manage your symptoms and have time to listen.

A few tips that I have been trying to undertake this “happiness” month:

• Exercise most days - I either a walk/run, ride a horse or if the weather is wet I often do a quick session of the 7 minute exercise program – (some exercise is always better than none)

 

• Monitor your number of steps- I try and make sure I do a minimum of 10000/day- but start with looking at what you are currently doing and increase this every week by 10-15%

 

• Eat healthier- minimise process foods, reduce added sugar and aim for 5 serves of veggies a day.

 

• Undertake a mindfulness session- these can be quick in the middle of the day or a something to help you sleep- the “smiling mind” app is a good one to start with.

 

• Do more fun things- catch up friends, get out and about in nature, spend quality time with family, laugh!

It is important that you look after your mental wellbeing and happiness- it will help you, manage that annoying injury, allow you to cope with whatever life throws at you and allow you to live a more fulfilled life.
 
If you are worried or not coping we are always about to help as we can, or point you in the right direction. I’ve added a questionnaire to fill out if you would like to see how you are tracking (you’re the only person to get the results). And I’ll include some links if you need more information.

https://www.beyondblue.org.au/the-facts/anxiety-and-depression-checklist-k10
 
https://www.health.nsw.gov.au/mentalhealth/pages/mental-health-line.aspx
this will put you in touch with the local mental health team if you are worried about yourself or a someone else.
 
https://coronavirus.beyondblue.org.au/?utm_campaign=hp_banner
 
We are always here to support and help you achieve your health goals, get you back doing the things you enjoy and reduce your pain. Check our Facebook or Insta page or ask to join our VIP Facebook group for all our up to date news, tips and advice.
 
 
Stay well, healthy and happy.
 

I am treating a large number of people at the moment that have come to us after putting up with headaches for years. So how do you know if you need physio or migraine medication?
 It’s tricky as many people have migraines that have some component from the neck, and some have neck headaches that mimic migraines.

An easy way to start thinking about it is to ask:

• Do I have pain in my neck at the same time as my headache?
  
• Is the headache on 1 side (but not always is this the case)?
  
• Is it worse after certain positions either at work or maybe sitting at the laptop at home?
  
• Am I getting pain into my eye?
  
• Is it worse after sleeping?
  

Not always will these mean that it is from your neck (cervicogenic) but it’s a good place to start.

Many of my clients are coalminers that have problems when looking up for long periods of the shift or sitting on an IMCO, looking one way or another whilst driving. (I still haven’t worked out why the seat can’t spin around). Or, when they go home they sit on the lounge with their head turned slightly one way for an extended period of time - (NB check your TV set up or don’t sit for long or preferably both). Lack of sleep, exercise and a poor diet can also contribute to ongoing pain.

So what can you do about it?

• Take note of when and where you get the pain, time of day, severity etc. (a headache diary is helpful here.
  
• Change position regularly: If you’ve been looking up take a break and do a different job, get out of the IMCO and stretch, get out of your chair and move.
  
• Exercise daily: I know that you might walk miles underground at times, but you also sit in that crib room and on the transport in and out. The fitter and stronger you are, the less back and neck pain you will have.  
  
• For the gym crew out there: look at your form and position of your head when doing weights. You’d be surprised what changing your head position can do to headaches
  
• Undertake some neck stretches: Nothing crazy like twisting your head around with your hands to get the clunk, just look both ways and ear down to each side for starters
  
• Get a good sleep in, especially for those on night shift
  

If your headaches and neck pain continue and you’ve tried those simple tricks, a physiotherapy assessment can determine if it is from your neck. It’s a quick and simple way to screen your headaches. If we are worried about anything, we will send you back to your Dr for scanning/medication.

Approximately 80-90% of people with headaches originating from their neck will get relief from physio. So, don’t put up with it any longer.

Your partner will be happy and so will your head.

With the exciting news of gyms reopening this weekend, it is more important than ever to remember to ease back into exercise post-coronavirus. It is advised when returning to gym programs, to take 30 percent off your weights for the first few sessions, before adding 10 percent each week thereafter.

It is also important to remember to stretch, warm up, and cool down (especially in these winter months). Look after your form, check your posture, and if you are having problems, pop in to the practice to have a chat to one of our Physios or EP, or have a chat to a local PT.

Let’s go and support our local gyms who have been doing it tough these last few months.