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Why Mo Farahs training has a lot to do with recovery after stroke

Or... The seven secret 'esses' of training.

I hope you like the title, I think it sounds good. But in fact, there aren’t seven, they aren’t exactly secret, you don't need to be in training to benefit, and they don’t all begin with S. There are at least nine, so you may well ask why I would say seven in the first place.

In short, when I studied PE at college in the 1980s, we were taught about seven. It’s a work in progress that’s all.

So, whether you are training for the Tour de France or a local athletics club event, or you just want to exercise more for your health. Or whether you are recovering from a stroke and training for your first few steps, are struggling with a long-term condition, such as MS, or if you have had a hip or knee replacement, you can do any of these better by adding the variety that is discussed here. It'll be more fun and more effective - and it is still meant to be fun, even if you're lucky enough to get paid for it.

I have put some videos up on Facebook and the vlog section of my website about this, and in my opinion, they have good solid content. They might not be quite as entertaining as "Titanic". Certainly not as popular. More useful, maybe. Shorter, thankfully.

YouTube is an amazing resource so I make no apology for advising people to look there. It’s a bit tricky to separate the good from the bad, but on this subject, the good stuff will have references quoted. There will also be some fake news, but if you find it, comment in an appropriate way. I like funny cat videos too.

Stamina

So here goes, what can you say about stamina training? Surely there's not much to say, is there? You get on your bike, go for a run long and steady, get in the pool and plough up and down, don't you? Yes, you do, but if you leave it there then you have missed a trick. The great Canadian physiologist, John Douillard teaches a breathing technique that, in my humble opinion should be in everyone's' skill set.

He calls it Darth Vader breathing. Just copy and paste that phrase into YouTube and try to copy it... then try to gently exercise using it. First, make sure you can take your pulse while exercising at a pre-set and repeatable resistance (this is best done by walking or for cyclists on a turbo trainer/static bike).

This one is even more relevant who are reliant on a wheelchair, for example. Most of the people that I have worked with who have a neuro problem use breath-holding to compensate for the loss of movement or balance.

Learn and practice the Darth Vader exercise and then practice it while you get used to exercising and breathing in that way. Simple. What you will find, is that your heart needs to work a lot less for the same workload. A little bit of magic.

Nearly everyone does far too much stamina work in one go and not enough of the other types. If performance is of interest to you, whether you're a runner, cyclist or swimmer, then aim for more variety. For sports readers, most of us, the longest period of exercise is only needed once a fortnight. By that I mean bike rides over 40 miles, runs over 10 miles, swimming over a mile.

For the people I work with most, these types of activities are not on your radar at the moment, but the number one priority is to regain or improve basic walking.

If you are in the highest echelons of sport you can disregard those numbers, they are different for you. But most will still be overdoing the long slow stuff in one go. The magic happens when you hit a ratio of around 80:20. 80% of the time is on stamina work, or zone 2 if you prefer to do this by heart rate measurements. 20% is spent on other things.

And if you are in the group of people who are wheelchair reliant, there is a big lesson here - it’s about the volume required. I often say to someone when they first get a flicker of a movement returning, that that’s great, now do it 10,000 times. And 10,000 can sound like a lot, but that is the number of steps that a sedentary person takes in a week. A busy person, like a nurse, for example, can do that in less than a day.

So in one way, it’s a small number. But the volume of exercise is what produces today’s buzzword, neuroplasticity. Geoff Kidd, Nigel Lawes and Iris Musa were writing about this in the early 1990s, so it isn’t really a new subject, but when they first expanded their ideas to a neurology world where there was “no change in the nervous system after adulthood", they were poo-pooed.

Neuroplasticity

Neuroplasticity describes how the nervous system grows, develops, adapts and changes throughout the life cycle. It is responsible for what we call learning, developing a skill, or developing spasticity in a muscle.

Strength

Strengthening exercise needs to be quite specific to the sport. If you are a runner, then running against resistance, e.g. towing a car tyre, is often used. On a bike, ride up a hill in too high a gear. You don't need to use a massive resistance to get an increase in strength, but if you use a slightly lower resistance, you need to do it for longer. You still get more strength.

I do like body weight resistance work. If you want stronger legs, simply doing repetitive stand-up sit-down exercises will strengthen just about every muscle below your waist. All training programmes need to be progressive. For top athletes, this includes progressively harder work and intermittently easier. It’s not possible to continuously improve.

For a stroke survivor aiming to be better at standing up, one progression might be, to gradually place the weaker leg under more strain, by bringing the foot closer underneath. This kind of work needs personalising, so do seek advice.

Speed

On a bike, you need to make your legs go faster until you start to bounce in the saddle, repetitively in bursts. I do mine under a doorway and reach up to fix my hands on the lintel. Less bounce more speed. Runners will run down hills as well as up. Near my house, there is a lovely wood with a good path through it. There's a section of about 150 metres where the track goes downhill and then back up. Not too steep. Downhill, I can run faster than I ever can on the track, no surprise. The uphill slows me down nicely without going base over apex.

Olympic sprint winner Alan Wells was one of the first well-known athletes to really do a lot of arm work, particularly a boxing exercise with a speed bag. He was pretty good, yet has faced a lot of allegations about steroid use. I have no idea whether he was guilty or not, but the exercise would, in fact, be quite sufficient on its own. Controversial.

For neurologically-injured people, speed is even more critical. I see so many who have some movement (in the legs mainly) and that movement is almost always slow, but you must have the speed to get a leg to act as a shock absorber and to control forward flow in walking. So you must train for speed. You can do this simply by using resistance bands (big elastic strips) to assist a movement (most of you are only using it to resist the movement you are trying to train). Yes, you have to work on strength, but you must do some speed work too. Swimmers, swim downhill too. Seriously.

Skill

The last exercise was also a skill one. As is pedalling a bike with one leg, runners do some work on the form; arm form, striding, bounding and hill reps, too.

For neuro-peoples, this means balance training. Most of the exercises given to this group will test balance but not re-teach it. See my youtube videos for ideas if you like.

Surge

Also known as plyometrics, it's practising accelerations, from medium to nearly flat out and with a little too much resistance for comfort! For competitive athletes, and if it won't upset the neighbours or destroy your house, practice standing broad jumps (a bunny hop, if you like) up the stairs. With practice, you should be able to jump the height of your inside leg. Maybe more. Consider wearing shin pads, especially if you are not used to doing this kind of thing.

If you have had a stroke, and just recovering some basic abilities, surge training might mean simply standing up from a chair, but a bit quicker. Make sure you have the right support or supervision to keep safe, of course. And the classic, but for so many, nigh on impossible, doing a tiny version of a bunny hop. Get help to start trying this.

Stretch

Probably the most contentious of all the topics. Coaches, physios, and therapists have been arguing over this one since whenever. My own belief, after listening to the arguments for 40 years, is that it is important and counts as a training session. Which means that you need to recover after it. Meaning not to be done immediately prior to a different category of training or a race. You can do some light stretching before training or racing exercise, but don't work at it like you are trying to increase your baseline range of movement. Too late for that just before the competition.

Broadly speaking, stretch is achieved by loading a muscle as it gets longer, also known as eccentric muscle work. So to stretch your hamstring muscles in the backs of the thighs, you could simply try to touch your toes. It needs to be done at the correct speed, with correct hold, so some coaching here would be good. There is some really well-researched and referenced work published on video on Youtube about this. Have a look.

Sychology (sic)

Well, it sounds like an S. Motivating the highest performers is not a job for a short article like this. For the rest of us, it's about keeping it fresh and fun. So lots of variety is one way. With friends or without, indoors or outdoors, circuit or gym training. Maybe group classes, for example, spinning. Ride a bike, run, swim, just play a game.

There is interesting research showing the dramatic jump in the pace that people can tolerate in competition. So practising competitions may in itself provide some of the boost needed to sharpen your performances, if performance is indeed your goal. But not too often, and please find out about recovery after this. An incorrect recovery strategy will probably lead to injury or deteriorating performance.

Sustenance

The eighth secret is sustenance or food. I personally recommend only eating things that you can recognise what plant it came from, so cook in water, steam or bake. Using oil adds calories you can't use easily and removes too much water from the food itself. Meat is not necessary to live on, so if you eat it, do so sparingly. Anything from the dairy is not necessary. Humans are the only species to take milk from another species and consume as adults. It isn't food and isn't necessarily a good source of calcium either. There is plenty of calcium in it, but that doesn’t mean that the body can absorb it. Western society, in particular, is facing an epidemic of osteoporosis and is consuming dairy like it's going out of fashion.

In short, the probable mechanism of this, for those eating larger quantities of animal-based foods, will use their calcium stores from bone, as a buffer to maintain the pH (balance of acid/alkaline) of their blood. If this is indeed the case, you may well wonder how children ever build strong bones in the first place. Good question. The answer will be pretty complicated and certainly beyond me to explain fully, but likely due to the very powerful effects of hormones etc. during growth. My point is that it needs looking into, and not by people funded by the dairy industry.

Sleep

Sleep is a marvellous thing. I saved the best ‘til last and if you are a parent, you don't need this pointing out. Sleep is great if you and if other people (especially the little ones) are doing it. If you are not a parent, learn to treasure it. Many of us treat sleep like an inconvenience (well, I was young once too). Actually, sleep is an amazing resource for a keen competitor.

During sleep, the whole hormone balance in your body changes, improving repair and response to training. Tour De France legends, Team Sky know stuff. They even used to take their own mattresses to hotels to maximise the benefits of sleep.

I can't recommend it personally but I have to note that some of my own best performances have been after a really rubbish night's sleep. Work that out if you can.

To conclude, I am glad to be of the opinion that there is still a little bit of magic to be figured out about how humans tick. More research needed then.

Therapy Directory is not responsible for the articles published by members. The views expressed are those of the member who wrote the article.

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Newton Abbot, Devon, TQ12

Written by Andy Mackellar

Newton Abbot, Devon, TQ12

I'm a physiotherapist working in Devon, helping mostly people with Stroke, Head Injury, Parkinson's Disease and Severe trauma. I do love sports medicine but mainly have worked at it in a voluntary capacity, right up to the level of working at Commonwealth Games.
I enjoy sharing and learning experiences with all kinds of people.

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