Physical Activity, Exercise & Training

09/27/202102/25/2021 by Sami Karam

Physical Activity, Exercise, and Training are three very different things that are often confused as being the same thing. It’s important we understand the differences between those three when it comes to our purposes in the clinic and rehabilitation. Knowing the differences may mean you have a successful experience when dealing with health improvement.

History of physical activity, exercise and training

Our ancestors, even as little as 100 years ago, worked really hard physically. Outside of competitive athletic endeavours and warfare, there was no real need to have to think about adding any more stress to your body than what your daily life already asked of you. Both men and women were on average much more physically resilient, because their lives demanded it.

Today’s physical activity, exercise and training

Your life in 2020 whatever doesn’t physically demand much from you. So now you have to actually think about adding some physical stress to your life, so you don’t deteriorate into uselessness. Out of this necessity, came the need for physical stress that can be categorised into three distinct groups being physical activity, exercise, and training.

Disclaimer: This is for Educational Purposes Only

Let me take a quick intercession to inform you as to the nature of our advice. We are experienced, healthcare clinicians. We wish to share our experience with you on topics to do with your health. We may be a little colourful in doing so, but at the heart of what we do is in-the-trenches experience. Whilst we have achieved academic success and understand the evidence, we are not solely evidence-based. We are, however, EVIDENCE INFORMED.

We find that the evidence is usually 10-15years (at minimum) behind what we are seeing in the clinic. We see real people, with real problems, and we’ve made a great living out of offering real solutions.

If all you’re after is the researched evidence, you can find some on Google Scholar, or you can very easily look for more on Google. We want to give you real-life advice, most of which you may not find in the research.

There is no way that this document can replicate or replace expert assessment and guidance given by a qualified registered healthcare practitioner who has seen you personally. I am sure you’re aware that I have no knowledge of your personal medical history or how you take care of your body. If you require care from a qualified practitioner, you would be best served by seeing someone who can empathise with your situation and treat you accordingly.

I’m sure you understand that I disclaim any and all responsibility for anything you do as a result of reading this document. And by reading this article, you accept 100% responsibility for the actions of you or anyone under your care.

What is physical activity?

Physical Activity is the act of you surviving and being alive. When you get up in the morning and you brush your teeth, have a shower, go downstairs, have a cup of coffee, go to work, come home, have some dinner, go to the bathroom. You check your watch and you’ve done twelve thousand, maybe fifteen thousand steps. That’s great! That’s physical activity. That’s just you getting around for survival, we call that physical activity. It’s simple really and it’s the most basic form of movement. It takes very little thought and the minimum amount of effort on your part. But it also offers the minimum amount of return. That is not what we would classify as exercise.

What is exercise?

Exercise on the other hand is when you perform a set of movements or a workout for the sake of that workout on that particular day. The results of that workout lead to no specific place other than the physical stress and its consequences on that day. It’s generally random and is not programmed for any specific purpose other than performing that day’s exercise.

How you can exercise

You’ve burnt a few calories, you’ve jumped on the bike, and thrown the dumbbells around a little bit, but there’s no particular end goal or purpose. You’re just exercising. You’re moving around and you’re getting up a sweat. Now there are harder forms of exercise like maybe boot camp, or pump class, or F45 or CrossFit. These activities can be physically more demanding, but they’re random workouts none-the-less and therefore, EXERCISE! Now I can see all the CrossFitters going crazy,” oh I train bro.” NO! You don’t train, YOU EXERCISE! Your random workouts of the day are exercise. There are competitive cross-fitters who train for CrossFit competition, but they train to compete specifically in CrossFit events. They have specific things that they need to do that get them closer to their end goal for the CrossFit performance. And this brings me to my final point of what training is.

What is training?

Training is performing a workout that most efficiently brings you closer to a preconceived target or goal. This goal is usually quite specific and therefore requires specific programming of each workout. For example, if we set the goal of running a marathon, every time you perform a workout, it has to be done in the most efficient way to get you closer to the goal of you running the marathon. If you’re training to compete in a tennis tournament, your training each and every time you do it has to be done in the most efficient way to get you closer to that tennis performance.

If you’re just doing random sets of exercises you’re exercising, you’re not training! Now it’s important we understand the differences in the clinic with regards to injury, because we want you to have a training mindset, we want you to reach a specific goal with your rehabilitation, we program things for you so that every time you workout you get closer to that specific goal.

Rehabilitating your injuries

For our purposes when it comes to rehabilitating your injury in the clinic, physical activity is almost like asking us NOT to help you. You may as well resign yourself to the fact that you’re going to get hurt again because you’re not adapted to any added strain to your daily life.

How exercise can hurt your rehabilitation

For most people, exercise is where they’re at, and it’s better than sitting on your ass all day. The problem with exercise is the randomness of it. If random exercise is also performed at high intensity, it can lead to injury and inflammation because there is little control over the stress you place on the body. If you think that the workout of the day (WOD) or the F45 class is programmed with you specifically in mind, think again! That’s why most people don’t last more than three months without some form of injury.

How training helps you recover from injury

Training on the other hand is where we see the best results when it comes to rehabilitation. We can control the movement, the load, the frequency, and the intensity so that it is not only suited to you personally, but done the right way, it can not only help you heal, but make you stronger and more useful than your pre-injury self.

It’s really important you understand the differences between the three and not confuse them. It usually accounts for the difference between successful long-term resolution to injury, or frequent re-injury. Stay Strong!

If you feel that any of the information we’ve given you here resonates with you and you feel we are in a position to help, please BOOK ONLINE as we would welcome the opportunity. If you feel that we can help you in any other way, please reach out to us via our CONTACT PAGE.

Dr. Sami Karam, Osteopath

I’ve been a qualified Osteopath since 2004. I’ve been playing football ever since I could remember and I have a passion for it. I’ve played at the highest level in the NSW State League at both Youth and Senior levels, and have also been Head Physician at numerous State League Clubs. I’ve travelled internationally and consulted with Sports academies in Barcelona and Italy. I have a special interest in Strength and Conditioning for footballers, as I believe it gives them an edge in their physical competition. My passion involves bringing all of this knowledge into every single treatment that I provide for all athletes. If you feel that I can help you and want to reach out to me, contact me.

More about Osteopath Dr. Sami Karam

Show Me The Evidence

09/27/202102/15/2021 by Sami Karam

Most people seek out treatment to help with their pain and get on with their lives. Other people seek out treatment for similar reasons, except they also want to know the evidence and the science behind the treatments being offered to them. If you also want to know how we analyse evidence within our particular field of medicine, read on!

Evidence-based healthcare professionals

When it comes to looking at evidence within our particular field of healthcare, it can be a bit of a murky area. One practitioner is an evidence-based practitioner. This person is a champion of evidence-based medicine and will generally only allow approaches in their repertoire that have been researched and verified by academia.

Disclaimer: This is for Educational Purposes Only

Just medical research evidence?

This type of practitioner will look at the evidence and base their practise solely on the evidence, even at the sacrifice of approaches that have worked over many lifetimes. That means if there isn’t enough evidence to support what they’re doing, they just won’t do it! Now, this seems like a very ethical and scientific way of doing things. And we all keep getting told to “listen to the science.” I mean, nobody wants to be treated with snake oil and magic potions right?!

So on the surface, this seems like the legitimate approach, especially in healthcare. But when you start seeing the practical applications of evidence-based medicine, you will find it has more holes in it than swiss cheese.

Clinical trials and individual variables

The first one is that evidence takes a long time to curate, by the time somebody gets clinical trial set up, gets funding for even larger clinical trials, if they get funding at all, then gets those clinical trails peer-reviewed, then gets that published. It can take anywhere between five, ten sometimes even fifteen years. If we’re to wait for those evidence to come out we’d really be stuck behind the eightball and we wouldn’t be able to help as many people as we’d like.

Another problem that we have is that the research itself, the experiential design tries to eliminate the variables. The problem with that, is real-life people have variables, they have kids, they have jobs, they have job sites they need to go to, they have shopping bags they need to carry, they don’t sleep well, they have diabetes, they have cholesterol, we need to understand these variables in our individual patients. The problem with the research is it tries to eliminate these variables and doesn’t always give us the best results.

This type of medical research was set up with pharmaceuticals in mind, not a holistic approach to treatment. They test one pill against one condition, and eliminate the variables to try and be specific with their outcomes. This works well with pills, not so much with people!

There are many problems other than research design. Who’s conducting the research? Do they have clinical experience? Where is the funding coming from? Who is reviewing the research? The system has many flaws. Fixing your criteria for treatment solely based on the current literature is like taking sex advice from a nun!

Evidence-informed practitioners

Another type of practitioner is the evidence-informed practitioner. This type of practitioner understands the evidence and looks at the evidence but siphons it through their own clinical experience and their education and comes up with the best reasoning for that particular person in front of them. Good practitioners, ones that get results, are evidence-informed. They can take a piece of literature and interpret it within the framework of the particular case they’re trying to solve.

In the fearsome age of the Covid-19 pandemic, all the experts (insert Hollywood celebrity here) keep insisting that we “listen to the science,” and “listen to the doctors!” And as we can plainly see, none of them can agree on anything. Even science can’t seem to agree with itself. But there are some great doctors out there that have a great understanding of treating viruses, medications, vaccines, and the big picture, because they are actually in the trenches treating people on a daily basis. They will have a better understanding than some academic sitting behind their desk looking at systematic reviews.

So in saying this, do we just throw research out the window? No, we need to understand the research, it has a place. Science is not exact. It’s not even about finding the truth. It’s just about being a little less wrong each time you try. And that’s how good research can have its place, by being a little less wrong each time.

What we do need to do is, we need to apply that research through our own clinical experience and then use that to create good clinical reasoning for the person in front of us. We treat an individual that is in front of us and we use the research to help us come to the best possible solution. Hope that helps, Stay Strong!

Dr. Sami Karam, Osteopath

More about Osteopath Dr. Sami Karam

Shoulder Pain Stopping You from Shooting Buckets?

04/23/202302/15/2021 by Sami Karam

The shoulder is an important joint in the body for basketball Shooting Guards (SG). Real Lakers fans and ballers remember when Kobe the ‘Black Mamba’ suffered from a shoulder injury which resulted in 9 months off from playing the sport. Now for any coach and fan, losing a player like Kobe is never a good sign for the club and the team. If you’re a shooting guard like Kobe, the team needs you most because of your offensive scoring abilities, so don’t allow your shoulder pain to stop you from scoring those buckets.

Rotator Cuff Injuries:

Some of the muscles and tendons that wrap around and protect the shoulder joint may become stressed during the late stages of a basketball shot just before the flick of the wrist takes place. Repetitive stress onto the rotator cuff tendon can, overtime, result in small micro-tearing.

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For the elite basketball athletes like the ‘Black Mamba’ and us average shooting guards (SG) this can throw off our game, affect scoring abilities, and have an impact on the offensive game.

Now, if you’re an SG your main focus should be on addressing 1) your shooting form and 2) implementing correct exercise strategies to help you from preventing and suffering from what Kobe had suffered.

If your pain persists past this, you need to seek professional help from someone that is just as passionate about balling as you are. They’ll understand your problem better and help get you back on the court.

Stretch & Strengthen to help prevent and reduce Shoulder Pain

Stretching/Mobility Drills for shoulders:

Pectoral stretches – to help open up the chest and prevent rounding through the front. Often basketball players are well developed through the chest due to the amount of shooting and chest passing that occurs which builds the front of the chest up.

Internal rotation shoulder stretch – focuses on stretching the internal rotator muscles that help with the shot execution. Refer to our blog post about sleeper stretch and how it helps shoulder pain.

Strength Training/Development Exercises for shoulders:

Here are some more exercises, stretches, and health tips.

We may not all be as good as Kobe, but we definitely don’t have to suffer as he did. Shoulder pain can (and does) affect many ballers. It is to be taken seriously and addressed because of the short term and long term effects it can have on the athletes shooting abilities. These tips can help you identify and correct problems that can lead to some serious pain. Happy Shooting!

Front Squat

Standing Face Pulls

Neutral Grip Dumbell Push Press

Dr. Sami Karam, Osteopath

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What Exactly Is An Osteopath

07/10/202102/03/2021 by Sami Karam

If you’re one of our patients, and you’ve asked me before, what exactly is an Osteopath? Today I’m going to answer that question for you. If you’re not one of our patients and you’d like to know what an Osteopath does, the rest of this article should clarify some misconceptions and inform you about the profession.

Now before I go on to tell you what an Osteopath actually is, let me take a few seconds and tell you what an Osteopath is NOT! If your doctor, your trainer, or another health professional has said to you, “an Osteopath is a combination of a Physiotherapist and a Chiropractor” they’re an idiot! Plain and simple. An Osteopath is a unique professional in the way that they think about the body. Their philosophy is what sets them apart from other allied health and medical professionals.

Disclaimer: This is for Educational Purposes Only

History of the Osteopath profession

Osteopathy was founded in the late 1800s by an American Physician and Surgeon, Dr. Andrew Taylor Still. He served in the Union Army as a surgeon during the American Civil War, during which, he lost three of his children to spinal meningitis. Frustrated that the mainstream orthodox medicine at the time was unable to save his children, he devoted the next 10yrs of his life in the pursuit of a better understanding of the body, disease, and health.

He went on to develop a philosophy for treating the human body as a whole system, looking at not only the elimination of disease but the constant search for health. Osteopathy grew and flourished in the USA, to the point of being a part of the mainstream medical model. The profession expanded its reach into Britain, Europe, Australia and now the far corners of the world.

About Osteopaths

Osteopathy uses Osteopathic Manipulative Technique (OMT) to treat various tissues that may contribute to the pain that comes with disease and dysfunction. OMT aims to improve movement. These techniques are varying and wide in nature and encompass the entire body, from muscles, bones, joints, blood vessels, nerves, internal organs and fascia.

Yet, it’s the philosophy of treatment, not the technique that defines what an Osteopath does. Osteopathy has shared many techniques that other professions claim as their own. Joint manipulation is the bread and butter, go to technique for Chiropractors. Yet Osteopaths were performing this for many decades before Chiropractic was even thought of.

Muscle Energy Technique (MET) is a common muscular release technique used by Osteopaths. Rebranded with a fancier name, Physiotherapists began using Proprioceptive Neuromuscular Facilitation or PNF as it’s commonly known by Physiotherapists once they found use and evidence for its application.

Fascia is the binding tissue that encapsulates and binds muscles, tendons, joints and organs together. It’s now in fashion with many Physiotherapists and Integrative doctors, yet it is found in the very earliest of Osteopathic literature. It is one of the first pieces of anatomy an Osteopath is taught about and a focus for the Osteopath for improving injury. The point is, techniques and anatomy and physiology are shared amongst the professions, albeit some do it better than others, but it is the philosophy and thought process of the Osteopath that sets them apart from the Physiotherapist or the Chiropractor or the Exercise Physiologist. It’s the philosophy in practice.

Osteopath philosophy

#1 The body is a holistic unit

The 1st principle that guides us, is that we believe the body is a holistic unit. We don’t like to isolate body parts. We don’t like to say, a muscle a bone a joint a nerve. We look at the injury within the whole system, and then we go and affect the system to help your injury.

#2 Structure and function are closely related

The 2nd principle that we follow, is that we believe that structure and function are closely related. We need to understand the mechanics of the actual movement problem that you have. We need to understand the way that the body moves, and the actual structure of the body and how it’s affected by movement, so that we can help you overcome that injury.

#3 Body’s ability to heal itself

The 3rd principle that we follow, is that we believe in the body’s ability to heal itself. So if we are able to overcome some of those obstacles, we move them out of the way so that the body can go and fix itself. We don’t fix anything, all we’re doing is that we’re helping you get better by moving some poor function out of the way so that the body’s own healing mechanism can be stimulated and come into play.

#4 Follow all the Osteopath principals

And the 4th principle, and this is an important one, is that if you don’t follow the first 3 principles, you’re not practising Osteopathy. You might be a Physiotherapist that says “well I use some of those techniques” or a Chiropractor that says “I do some of these things in my clinic.” That’s all well and good, and well done to those practitioners who have gone on to seek knowledge and improve their skill. But that would have been done out of their own volition and not because it was passed down to them through their education. It’s not part of their ingrained philosophy or their formal teachings.

In summary, An Osteopath is a registered health practitioner that looks at the body as a whole system, assess the mechanical structure and helps that mechanical structure heal itself by improving its movement. It’s a very effective system of treatment when it’s put into practice. One would hope that medicine heads in this patient-centric, holistic philosophy of improving health. Hope that clears up for you, Stay Strong!

Dr. Sami Karam, Osteopath

More about Osteopath Dr. Sami Karam

What is osteoarthritis?

04/23/202301/22/2021 by Sami Karam

Osteoarthritis is a disease that causes the breakdown of the cartilage in joints. Commonly referred to as Arthritis. Cartilage is the joint’s cushion. It covers the ends of bones and allows free movement. If it becomes rough, frays, or wears away, it causes bones to grind against each other. As a result, the joint becomes irritated and inflamed. Sometimes the irritation causes abnormal bone growths, called spurs, which increases swelling. The disease normally affects the feet, knees, lower back, hips, and fingers. Usually, only one or maybe a few joints are affected at one time.

Osteoarthritis is 3 times more common in women than in men. It is usually more bothersome after the age of 60. By age 60, most people have some osteoarthritis, although it may be too mild to cause symptoms.

How does it occur?

Osteoarthritis is caused by excessive wear on joints and possibly by inflammation within cartilage. Obesity, bad posture, old injuries, and overuse can all cause extra wear on joints. Heredity also appears to play a role.

What are osteoarthritis symptoms?

The symptoms of osteoarthritis include:

mild to severe pain in a joint, especially after overuse or long periods of inactivity, such as sitting for a long time
creaking or grating sound in the joint
swelling, stiffness, limited movement of the joint
weakness in muscles around the sore joint from lack of use
deformity of the joint

How is it diagnosed?

Our practitioners will review your medical history and examine you. X-rays may be used in the diagnosis but are not always necessary. Understanding your lifestyle will be key in determining how much wear and tear you are placing on your joints.

How is osteoarthritis treated?

The aim of treatment is to keep the joint working by reducing strain on the joint and by relieving pain, stiffness, and swelling.

Arthritis is the body’s attempt at immobilising an injured area. So we place emphasis on first making sure the other joints involved in a painful movement are working really well.

We always look at the areas above and below the painful segment and then we focus on the whole system regaining movement.

Manual therapy provides relief from pain and muscle spasms and maintains joint range of motion. Regular gentle exercise is very important for controlling osteoarthritis.

Exercise and movements should then emphasise strength as their main outcome as strength is what will really protect the affected joint from abnormal loading.

Sometimes severely damaged hips and knees may be surgically replaced.

How long will the effects of osteoarthritis last?

Unfortunately, osteoarthritis is a lifetime disease that can worsen over time. Avoiding repeated injury to your joints can help, but damaged cartilage cannot repair itself. We cannot reverse this process, but we have a great track record of managing it really well.

How can I take care of myself?

Although no one yet knows how to prevent osteoarthritis, you can help prevent symptoms by following these guidelines:

Keep your joints in good working order. Stay fit. Exercise and move to get strong
Daily moderate exercise is much better for your joints than occasional strenuous exercise. Walk a little each day to a level you can tolerate that does not produce pain
Be sure to wear comfortable, well-cushioned walking shoes. Otherwise, you can exercise while sitting down or go swimming
The water in heated swimming pools can help support your weight while you exercise, and the warmth helps improve joint movement
Protect your joints by doing warm-up exercises before strenuous activity
Keep your body healthy by eating a healthy diet low in inflammatory foods.
Maintain a healthy weight range

History of physical activity, exercise and training

Today’s physical activity, exercise and training

What is physical activity?

What is exercise?

How you can exercise

What is training?

Rehabilitating your injuries

How exercise can hurt your rehabilitation

How training helps you recover from injury

Dr. Sami Karam, Osteopath

Evidence-based healthcare professionals

Just medical research evidence?

Clinical trials and individual variables

Evidence-informed practitioners

Dr. Sami Karam, Osteopath

Rotator Cuff Injuries:

Stretch & Strengthen to help prevent and reduce Shoulder Pain

Stretching/Mobility Drills for shoulders:

Strength Training/Development Exercises for shoulders:

Dr. Sami Karam, Osteopath

History of the Osteopath profession

About Osteopaths

Osteopath philosophy

#1 The body is a holistic unit

#2 Structure and function are closely related

#3 Body’s ability to heal itself

#4 Follow all the Osteopath principals

Dr. Sami Karam, Osteopath

How does it occur?

What are osteoarthritis symptoms?

How is it diagnosed?

How is osteoarthritis treated?

How long will the effects of osteoarthritis last?

How can I take care of myself?

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