Physio jargon……high and low threshold training!

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At the Physio Clinic Bristol, we are experts in assessing and treating movement dysfunctions, weather you have come in following a specific injury or you are committing to the TPM Active, Performance Matrix process.  We will provide a detailed analysis and retraining of your movement system.

Two terms come up a lot during the rehabilitation process HIGH threshold training and LOW threshold training so I thought it would be helpful for all you guys working on your movement health to have better understanding of the two terms.

Put simply with have two main types of muscle (or motor units as physio’s would say!). Slow low threshold muscles and fast high threshold muscles. During day-to-day function or when participating in sports your body will select and recruit the appropriate muscle unit depending on the task. There are however differences in how these different muscle units are switched on, the speed at which they switch on, the force they use and how quickly they fatigue.

The table below outlines these differences.

Function Slow motor units Fast motor units
Contraction speed Slow Fast
Contraction force Low High
Recruitment threshold (how easily are they switched on) Low threshold – easily activated High threshold – requires higher stimulus
Fatigability Fatigue resistant Fast fatiguing

Comerford and Mottram (2012)

Put into context, day-to-day tasks such as walking, postural control, cooking and cleaning predominantly recruit the low threshold units.  Activities that require speed, heavy force or high loads e.g. throwing, heavy lifting, running, jumping etc. predominantly recruit high threshold units.

Research demonstrates that pain is more likely to inhibit low threshold motor units, the body will often compensate for this disruption employing recruitment strategies that are normally used for high threshold tasks – this can lead to over working of muscles, strain on the musculoskeletal system and ultimately pain.

If you feel that you are constantly foam rolling tight muscles or that you get pain during day-to-day activities, then book it with one of the team at The Physio Clinic Bristol and get your movement system analysed. We will correctly identify with system is not working efficiently and get you on the road to recovery.

Although the low threshold training might seem slow, non-fatiguing with low force often establishing the correct recruitment of this strategy is vital for successful rehabilitation.

Birgitte Hoff

Birgitte Hoff

To Heat or Not To Heat?

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To heat or not to heat? Football-injury-300x200 (1)

Some questions answered on the dilemma on whether to apply heat or cold to an injury.

 

This is a question we come across often here at The Physio Clinic, so we are writing down a few guidelines to help in the dilemma… “should I use heat or ice?”

 

Hot and cold are the two most common pain-relief therapies for muscle and joint pain. They both are advantageous in that they are easy to apply and are inexpensive.

Which one you use depends on whether the pain is a new one (acute) or one that keeps re-occurring (cronic).

In general a new or acute injury will result in inflammation and possibly swelling (just think of a freshly sprained ankle!).  Application of ice in the form of an ice pack/bag of peas wrapped in a clean damp cloth will cause vasoconstriction or narrowing of the blood vessels and so decreasing blood flow to the area which reduces pain, muscle spasm and inflammation. Applying ice will not stop the inflammatory process as this is necessary to kick start the healing process but it can help to temporarily ease pain.

It is recommended that ice be applied every few hours for 24-48 hours after the injury. Ice should not be applied for more than 20 minutes and skin should be checked every 10 minutes to check for ice burns. As physio’s we always recommend that ice should be used in combination with rest, compression and elevation after an acute injury.

Heat in general is used on more ongoing aches and pains including those niggly cases of low back or neck pain. Heat does the opposite of cold in that it causes vasodilation or opening up of blood vessels. This in turn increases blood flow and supplies oxygen and nutrients to reduce pain in joints and relax sore muscles, ligaments and tendons. The warmth can also decrease muscle spasm and thereby increase joint range of motion. Again application time should be limited to a maximum of 20 minutes and skin should be checked every 10 minutes to prevent burning. In applying heat only a warm hot water bottle or heat pack wrapped in a clean cloth should be applied to prevent risk of burning.

With both hot and cold it is important not to apply either to open wounds, infected or broken skin. Areas of diminished sensation occurring with poor circulation or diabetes should also be avoided.

If you are in any doubt- seek professional advice.