Baseball is a sport I have been involved in for many years, from club level through to national competition. Through my academic development, I have come to the conclusion that baseball in Australia remains relatively underdeveloped from a strength and conditioning (S&C) perspective, particularly given the increasing performance demands associated with pitch velocity, pitch volume, and spin rate. While many developing athletes utilise plyometric (plyo) balls and banded warm-ups prior to games, current research suggests that these methods, when implemented in isolation, may hinder performance or increase injury risk if not supported by a well-structured strength and mobility program (Reinold et al., 2018; Zhang et al., 2023).

Resistance training (RT) plays a critical role in both sport performance and overall musculoskeletal resilience. When prescribing RT for baseball athletes, it is essential to understand the mechanical loading patterns and physical demands of pitching. During the pitching motion, the elbow is exposed to forces of approximately 1090N shortly after ball release (Diffendaffer et al., 2023). Without sufficient torque capacity and surrounding muscular strength, this may place excessive stress on the UCL (ulnar collateral ligament) and GHJ (glenohumeral joint).

Shoulder ER (External Rotation) at 90d Shoulder Abduction and Pitch Cycle

(Diffendaffer et al., 2023)

   

(Diffendaffer et al., 2023)

   

From a performance standpoint, RT has demonstrated clear benefits. Upper body strength training alone has been shown to increase pitch velocity by approximately 1.69 mph compared to control groups (Lachowetz et al., 1998). In contrast, weighted ball programs, while effective for velocity development, appear to present a different risk profile. Reinold et al. (2018) reported an increase in pitch velocity of approximately 1 m/s (~2.2 mph); however, this was accompanied by a 24% injury rate within a small cohort over a short-term intervention period, including four elbow injuries.

Additionally, weighted ball programs have been associated with increases in PROM (Passive Range of Motion) for shoulder ER of approximately 4.3° (Reinold et al., 2018). This increase in ER may reflect reduced neuromuscular control and poor positioning efficiency during high-velocity throwing, particularly in athletes lacking sufficient strength and control through these ranges. Increased PROM in ER may heighten anterior loading of the GHJ and contribute to altered joint mechanics. Over time, this may result in compensatory adaptations, including posterior shoulder tightness and increased loading of the medial elbow (Melugin et al., 2021).

With respect to mobility, thoracic spine (T-spine) mobility appears to play a greater role in injury mitigation than direct pitch velocity increases (Skopal et al., 2024). Reduced thoracic rotation has been associated with increased elbow valgus stress and compensatory movement patterns during pitching (Okamura & Iida, 2025). Conversely, improving T-spine mobility may help in reducing these stresses by enhancing kinetic chain efficiency.

Practical interventions to address these factors include:

• Mobility: Open books, quadruped T-spine rotations, windmills
• Motor control: Anti-lateral flexion exercises (e.g., suitcase carries), rotational control drills
• Strength and power integration: Medicine ball rotational throws, hip–shoulder separation drills

Example Exercises (Diffendaffer et al., 2023).

These strategies provide a foundation for improving trunk mechanics, reducing compensatory patterns, and decreasing medial elbow stress during the pitching cycle.

In summary, there is no single “best” method for increasing pitch velocity. An effective approach requires a multifactorial strategy incorporating thoracic mobility, RT, plyometric-based interventions, and sport-specific resisted throwing. Practitioners should remain cautious of excessive increases in shoulder ER PROM, as this may contribute to joint instability and increased reliance on passive structures (Reinold et al., 2018). When appropriately integrated, these methods can enhance performance while minimising compensatory movement patterns, reducing medial elbow stress, and limiting overload of the GHJ.

Further research is required to better define optimal programming strategies that maximise performance outcomes while minimising injury risk in baseball athletes. However, an understanding of the key phases of pitch delivery allows practitioners to more effectively prescribe interventions targeting delivery inefficiencies (Zhang et al., 2023).

What is Menopause?

Menopause marks a time in a Woman’s life when she stops having monthly periods (Health Direct). It is the end of her reproductive stage of life, as the ovaries no longer have eggs to release and there is a natural decline in her reproductive hormones (Health Direct).

The average age for menopause is 51 years old, with most Australian women experiencing it between the ages of 45-60 years old (Health Direct).

Menopause is reached when a woman has gone 12 consecutive months with no periods (Health Direct).

Stages of Menopause?

There are three stages of menopause (Exercise Right):

1. Perimenopause: This is the lead up to menopause where the woman’s menstrual cycle becomes erratic and irregular when hormones start to decline, on average it last 4-6 years. Side effects of menopause can start to present, such as hot flashes.

2. Menopause: This is the permanent end of menstruation and no periods for 12 months consecutive, caused by the cessation of hormone production that causes your menstrual period.

3. Post menopause: A point of time after menopause has occurred. Once the woman has entered this stage, she remains in this stage for the rest of her life.

A woman can also enter Early Onset Menopause which is when she experiences her final menstrual cycle before 45 years old and Premature Menopause is before the age of 40 years old. Menopause occurring early can be triggered by surgery, naturally occurring, or medication.

What are the Signs and Symptoms of Menopause?

Common symptoms of Menopause which are not limited to, include (Jean Hailes):

• Hot flashes and night sweats
• Impaired sleep
• Physical symptoms like irregular periods or sore breasts
• Emotional symptoms like lowered mood or forgetfulness
• Painful joints.

Long-term health risks of Menopause

A reduction in female hormones after menopause can lead to several increased health risks, like (Better Health):

• Osteoporosis which can weaken bones and increase the risk of fractures
• Heart diseases like high blood pressure, heart attack and stroke as it can lead to a build up of plaque in the arteries walls
• Urinary incontinence as lower hormone levels can weaken the urethra (tube through which urine leaves the body)
• Weight gain around your abdomen.

The good news is that these long-term health risks can be reduced by engaging in a well-structured exercise plan, which an Accredited Exercise Physiologist is specialised in designing.

Benefits of Exercising to Manage Menopause

Exercise can improve a Woman’s health long-term when entering menopause by (Exercise Right):

• Increasing bone mineral density, reducing the risk of Osteopenia and Osteoporosis
• Reducing the risk of factors of cardiovascular disease like decreasing blood pressure
• Improving pelvic floor health by increasing muscles that make up and surround the pelvic floor
• Maintaining a healthy weight range to reduce the risk of non-communicable diseases like diabetes.

Exercise can also help manage symptoms of menopause, like (Exercise Right):

• Improving mood through releasing the feel-good hormone endorphins
• Improving sleep quality by reducing disruptions and inducing deeper sleep
• Reducing joint pain by increasing the strength of the muscles surrounding the joint
• Reducing hot flashes by improving the control of the thermoregulatory system.

The Best form of Exercise for Menopause

Women who are entering or have entered Menopause should include the following forms of exercise in their routine (Exercise Right):

• Resistance training (e.g., squats, heel raises, glute bridges): In particular, weight-bearing strength exercises to increase bone mineral density, and strength exercises of muscles surrounding the pelvic floor to reduce the risk of incontinence and pelvic organ prolapse
• Aerobic training (e.g., walking, swimming): To increase cardiovascular fitness and increase energy expenditure to assist in maintaining body weight
• Balance training (e.g., single leg stance): To reduce the risk of falls, as changes in Women’s hormones are known to affect their inner ears which play a critical role in balance.

Safety Considerations Exercising during Menopause

Although women menopausal and post-menopausal are encouraged to engage in an active lifestyle, the following things should be considered when exercising to ensure their safety (Exercise Beyond Menopause):

• Avoid engaging in plyometric exercise (repetitive jumping and hoping) initially if they have been inactive for a significant period, as they are at a high risk of osteoporosis diagnosis and risk of a fracture
• Avoid performing sit-ups and crunches as these moves increase the stress on their spine which is more delicate due to menopause-related bone loss
• Avoid working out late at night if experiencing menopausal sleep disturbance, as intense exercise can elevate cortisol the stress hormone which can make falling asleep harder
• Take caution with performing Hot Yoga, as many menopausal women struggle with overheating.

When completing mobility, it’s important to remember that stretching isn’t going to be detrimental to the tissue. But for optimum benefits, always mobilise the tissue first and then stretch afterwards. For example, foam roll your calves, then stretch your calves, then move on to the next muscle group.

1. Foot release with a ball

• Place ball under foot and roll it back and forth applying pressure down
• Roll the ball slowly and applying pressure when a knot or trigger point is found
• Place heel on ground and the ball under the ball of your foot and swing foot side to side
• Place toes on ground and the ball under the heel and swing foot side to side

2. Calf release with a foam roller

• Sit down with legs straight and one leg on top of the foam roller
• Place the opposite leg over the top to add pressure
• Roll the leg from side to side – you may feel a flicking sensation which is okay
• Find multiple spots throughout the calf before changing sides

3. Standing calf stretch

• Place the ball of your foot against the wall and keep your leg straight
• Slowly push your hips forward whilst maintaining a straight knee position. Hold this position
• Then, keep foot in the same position and bend knee towards the wall. Hold this position before changing sides

4. Seated hamstring release with a ball

• Sit on a firm surface (preferably with feet off the ground) & sit tall
• Place a therapy ball into the back of your leg and relax the leg
• Move knee from left to right so that the hamstring flicks over the ball
• You can use your hands to push down on the leg to provide more pressure
• Then, extend your leg (don’t fully straighten)
• Find multiple spots throughout the hamstring and straighten the leg 10 times per spot

5. Supine hamstring stretch

• Lay on your back with your legs straight and place the strap around your foot
• Slowly lift one leg, keeping it as relaxed as possible – ensure you have a very slight bend in the knee
• If you notice your calves are being stretched more than your hamstring – point your toes to the roof

6. Quad release with a foam roller

• Lay on your front with the roller on the front of your thigh
• Roll slowly down to just above the knee (don’t cross the knee joint) and back up towards the hip
• If you feel a knot or trigger point (lumps) then stop over it and just hold that position for 10-30seconds then continue to roll
• Allow your feet to drag along the floor as your roll – this means that your legs are relaxed

7. ITB release with a foam roller

• Place the roller on the outside of your thigh (ITB) and lay on your forearm
• Roll slowly down to just above the knee (don’t cross the knee joint) and back up towards the hip
• If you feel a knot or trigger point (lumps) then stop over it and just hold that position for 10-30seconds then continue to roll

8. Hip flexor release with a ball

• Find the top of your hip bone and place the therapy ball just on the inside of this (should be approx. in line with your belly button)
• Lay on the ball and allow your body to relax into it

9. Kneeling quad stretch

• Kneel down so that your foot is placed on the edge of a bench or chair while your opposite knee is at 90deg out in front of you
• Squeeze glute to align pelvis for a greater stretch
• If this stretch is too intense, you can start with the back foot on the ground

10. Side lying glute release with a ball

• Lay on your side with top knee pointing to roof and other leg flat bent on the ground (as seen in picture)
• Place the therapy ball into the fleshy part of the glute and relax into the balls
• Slowly slide the bottom knee up and then straighten the leg 10 times per spot

11. Glute stretch (prone or supine)

• Laying on your back, put one foot on top of the opposite knee (as seen in step 1 of picture)
• Then place hands behind your bent knee and bring feet off the ground

According to Sports Medicine Australia, up to 70% of recreational and competitive runners experience overuse injuries annually.

• 42% of running injuries occur at the knee (most commonly ITB friction syndrome, patellofemoral pain syndrome, patella tendinopathy and meniscal injuries)
• 17% occur at the foot/ankle with plantar fasciitis being the most common in this category
• 13% occur in the lower leg, with the most common being shin splints
• 11% occur at the hip/pelvis

Most of these injuries are a result of training errors (such as increasing volume or intensity too quickly and/or inadequate recovery between sessions), poor running technique, low levels of strength or reduced range of motion.

Mobility is imperative for running recovery and performance and helps decrease risk of injury. It helps to decrease tissue tightness, decrease knots in the muscle, increase joint range of motion and increase blood flow to the tissue to aid in recovery. This ultimately enhances your running performance and reduces your risk of injury.

Let’s take a deep dive on the main muscles to mobilise for running and why!

Glutes
The gluteus maximus’ primary role is to create hip extension, while the glute medius acts to stabilise the leg each time it hits the ground. Tight glute muscles can pull on surrounding muscles such as the lower back and hamstrings, which in turn could lead to lower back pain, knee pain and piriformis syndrome.

Hip Flexors
The hip flexors complete the movement of hip flexion (surprising, I know), which is when you bring your knee up towards your chest. The hip flexors are often tight from being in seated positions all day, and this can inhibit the body’s ability to achieve full hip extension, which can ultimately prevent the powerful glute muscles from working properly. When these muscles are tight, it can also change our pelvis position and result in an increased arch in the lower back. This places excess length on the hamstrings, which may predispose you to increased risk of hamstring strain.

Quadriceps
The quadriceps primary role is to straighten the knee, however one of the quadricep muscles (the rectus femoris) also crosses the hip joint and acts as a hip flexor, so if this muscle is tight we can have the same issues as mentioned above.

Hamstrings
The hamstrings work to bend the knee so that the foot can be lifted off the ground, and works in partnership with the quads to control the straightening of the knee. As a result, tight hamstrings can reduce stride length in running if it is inhibiting adequate leg extension and may predispose you to risk of hamstring injury.

Calves
The calf muscles plantarflex the foot, pushing the front of the foot down and ultimately propelling the body forwards. If these muscles are tight, there is a reduction in dorsiflexion (which is movement of the toes pointing upwards) which can lead to increased pronation of the foot to compensate. Tighter calf muscles also don’t have the capacity to generate the same amount of power, decreasing running efficiency and performance.

Running is one of the most popular forms of physical activity, with an estimated 3 million Australians participating in either recreational or competitive running. It is a simple, cost-effective mode of physical activity that can be enjoyed by many and results in significant health benefits.

Benefits of running:

• Improves overall fitness
• Helps with weight loss
• Improves bone density and bone health
• Decreases blood pressure
• Improves cognitive function and decreases Alzheimer’s in later life
• Improves glucose and insulin control for diabetics and lowers risk of developing diabetes
• Improves mental health and self-esteem
• Improves sleep quality
• Increases life expectancy

 
Honestly, if running was a pill, I think everyone would be taking it.

Strength training is essential so that our muscles and joints can withstand the huge forces being placed on them during running. If there is weakness in the muscular and fascial systems, the body will find a way to compensate so that it can continue running. These compensations can lead to poor running mechanics, poor running efficiency and eventually injury.

There are three general experience levels to define runners: novice, intermediate and experienced. Strength training is important for all three runners, but the number of running sessions, strength sessions and recovery days will vary accordingly. Novice runners are those who are new to the sport (anything under 1-2 years) and have a lot of room for improvement. Intermediate runners have been in the sport for several years and is the category that most runners fall into. Experienced runners are individuals who have been in the sport for a considerable number of years and have or almost have reached their full genetic potential (think elite athletes).

Novice runners should aim for 2 strength sessions and 2-3 running sessions per week. Start slowly, listen to your body, and focus on your recovery (rest, hydration, nutrition, sleep and mobility). After the first 4 weeks of training, consider adding in an additional non-weight bearing cardio session such as cycling, swimming, elliptical or rowing. Over the next few months, you can gradually add in additional running sessions. However, it is imperative that you allow the body adequate recovery between sessions. During exercise (both running and strength training), the body undergoes a considerable amount of stress, resulting in microscopic tears and degradation to the tissues and changes in bone structure. During the recovery process, these microscopic tears in the muscle are repaired, collagen production in tendons increases and bone mineral density increases. Ultimately, these adaptations increase the load that the body can withstand. Without adequate recovery over time, the body is unable to make these adaptations, which can lead to overuse injuries such as stress fractures and tendinopathies.

Therefore, our advice for each category of runner is as follows:

Novice

Runners should always complete training sessions on non-consecutive days (e.g., don’t run two days in a row or complete gym sessions two days in a row). You can alternate between running and strength training each day, or these can be completed on the same day. However, if both strength and running is being performed on the same day, complete your running session prior to your strength session, and allow at least 3-4 hours between the two.

Intermediate

Runners can run on consecutive days but be strategic on the types of running sessions being completed. For example, two high intensity running sessions shouldn’t be completed back-to-back. Instead, think high intensity, shorter duration running followed by a longer duration, lower intensity run the following day. As always, make sure you recover well after each session to maximise the quality of following sessions.

Experienced

Runners tend to run twice per day and usually have one complete rest day per week. This type of training is for advanced runners only, who have gradually built up their tissue tolerance over years and years of training. There will almost always be a qualified coach prescribing their training sessions to reduce risk of injury and maximise performance.

Stay tuned for an upcoming blog post on the best strength exercises to complete for running.

For more assistance with your running programming and strength program please call the studio to book an appointment with Kelsie (AES) 9762 0976.

Mobility = Mobilise

Mobilise = To Prepare and organise so that you are Capable of movement

Human tissue (muscles, fascia, ligaments and tendons) has a fantastic ability to adapt to any stress or stimulus placed upon it. Whether this is prolonged sitting, walking, inactivity or lifting weights.

Mobility refers to using an object to promote a positive change in human tissues (muscular, ligaments, tendons and fascia). There are a number of ways to perform mobility in order to promote this positive

• Self-massage – using a tennis ball, lacrosse ball, massage ball etc
• Rolling – Foam roller, battle star & rolling pins
• Stretching – body weight or power bands
• Distraction – power bands

Why is it so important?

Typically, mobility is used to reduce muscular tension; it’s commonly performed prior to exercise as part of the “warm up” but mobility should not simply be limited to part of the warm up routine for exercise. The vast benefits include:

• Recover tissue – increase blood flow
• Prepare for performance or activity
• Assists in reducing knots and trigger points
• Reduces pain associated with muscular tightness
• Increase joint range of motion
• Enhancing proprioception

Mobility can and should be performed by all individuals regardless of age, injuries, illness or training history – it simply needs to be specifically designed for your individual needs.

Written by Bridget Pledge, Osteopath

Osteopathy is founded on 4 main beliefs –
1. The body is a unit
2. Structure and function are inter-related
3. Our body is capable of self-healing, protection and regulation mechanisms
4. Treatment always considers the first 3 beliefs

With this in mind it is not surprising that Osteopaths are able to help a range of conditions, including pregnancy.

During pregnancy the female body is constantly changing to accommodate the growth and development of their baby. These structural changes can influence the function of the musculoskeletal, hormonal and cardiovascular systems of the body (principle number 2 – would you look at that!)
The most common structural changes Osteopaths see are –
• Lower back pain
• SIJ and pelvic pain
• Carpal tunnel syndrome
• Posture related back pain

These structural alterations are commonly associated with the hormonal changes occurring within women’s body during pregnancy. Increased levels of progesterone and relaxin (two very important hormones throughout pregnancy) lead to an increase in the laxity of ligaments in the female body. This means that a woman’s body becomes stretchier to allow the baby to have enough room to grow and thrive over the 9 months and prepare mum’s body for birth!

Osteopathic treatment can assist with enabling women to adapt and maintain the constant changes occurring in their body, allowing them to have reduced levels of pain and discomfort and feel their best throughout the pregnancy (principle number 3!)
By assisting women with osteopathic treatment for pain, discomfort or structural dysfunction throughout pregnancy, osteopaths are able to help women maintain the changes occurring and reduce the overall impact of this on their body’s functional ability (principle number 1!)

If you’re pregnant and are experiencing any of the following Osteopathy may assist to maintain your bodies optimal function, to reduce pain and optimise your labour experience
• Lower back pain
• Pain rolling over in bed
• Pain walking upstairs
• Pain and stiffness in your upper back or shoulders
• Headaches and neck pain
• Numbness, tingling or shooting pain in your arms or legs

If you have any questions about how Osteopathy with the team at Strong & Stable may assist you during your pregnancy, or after, please call us on 9763 0976.

Written by Mia Anton

Preseason is starting to wind up for many local and AFL clubs as the season is quickly approaching and the AFLW is hitting the finals of it’s biggest season yet, but what injuries should we be looking out for? And what can we do to prevent them?
It feels like every week we see another Anterior Cruciate Ligament (ACL) rupture in the AFLW, yet it is rarely seen in the AFL. Why is that?

After seeing two season ending knee injuries before round two, and many more since, I thought it was the perfect time to explain why it happens and how we can work to build a stronger base to reduce the chances of it occurring.

At the end of the 2018 AFLW season, the AFL released their inaugural AFLW Injury Report. Their studies showed that after the first two seasons, the top two injuries were ruptured ACLs and concussions. Other reports have indicated that women can be anywhere between two to eight times more likely than men to rupture an ACL. After hearing these facts, I thought I would outline some of the key risk factors, and what we can do to reduce our risk of injury.

What are the risk factors:

• Q-angle: this is a term used to describe the angle between the quadriceps tendon and the patella tendon. This angle is formed by drawing a line from the Anterior Superior Iliac Spine (ASIS – anterior bony prominent on the hip bone) down to the centre of the patella (kneecap), and a second line running from the tibial tubercle (most prominent bony surface of the shin, just below the kneecap) through the centre of the patella, then calculating the angle between these two lines.
  • Although the normal Q-angle is variable, the normal Q-angle for men is approximately 14 degrees; whereas for women it is approximately 17 degrees.
  • The wider pelvis and increased Q-angle in females is linked to the higher number of knee injuries, in particula
    r ACL injuries, in women due to the decreased knee stability, decreased shock absorption properties in the knee.

   

• Footy boots: almost all football boots on the market are designed for the male athlete. This means that they don’t take into consideration the anatomical differences between males and females. There are four main differences in women’s feet when compared to men’s are:
  • A narrower heel cup (where the shoe grips the heel)
  • A wider forefoot
  • Different arch heights and lengths
  • Wider hips (increased Q-angle; resulting in women weight-bearing through their feet differently to men).

• Hormonal changes in women: during their menstrual cycle, the level of oestrogen in women fluctuates. An increase in oestrogen levels can see a reduction in tendon and ligament stiffness, which is required during childbirth, but can also leave women more susceptible to injuries to their tendons and ligaments. Early data suggests that women suffer more soft tissue injuries than men

• Apprehension in contact sports: from a young age, boys are encouraged to be physical and partake in contact sports, whereas for many years girls were encouraged to play non-contact sports. This has led to a greater level of apprehension in girls when it comes to tackling or entering into contests. The hesitation and lack of understanding or knowledge when entering into a contest can result in improper technique being used, which typically tends to result in injury.

What should you do to decrease your risk:

• Boots: if you wear footy boots with low support (such as Nike, Adidas boots) orthotics can be a good addition to provide the feet with the required support levels. Alternatively, boots such as Asics provide the foot with a bit more support, and may provide the extra support your feet need, without the extra expense of orthotics. X-Blades is also another option for people who require more support from their boots; they are currently the only football boot manufacturers in Australia who make boots for women. The boots have been made to fit women’s feet and provide support to help stabilise movements and assist with the impact your body takes. More information on these boots can be found on their website https://xblades.com.au/

• Exercise Physiology: seeing an exercise physiologist to get an assessment done and a personalised program written to help strengthen any weaknesses that may be present.

• Osteopathy: booking in with your osteopath to get an assessment done is one of the best things you can do for your body. The holistic approach taken by osteopaths in their diagnosis and treatment looks at the way in which the structure and function of your body are reciprocally interrelated. Without knowing it, you may have compensatory patterns present that are leaving you more susceptible to injuries. Osteopaths can also help with any of those recurring niggles that you might feel, and help to reduce the chances of you sustaining a season ending injury.

If you have any further questions, or are interested in making your body as Strong and Stable as it can be leading into the upcoming footy season, call us on 03 9762 0976 and book in for an Osteopathy or Exercise Physiology session.

To book an appointment with Mia Anton please follow the link below:

https://strong-stable-pty-ltd.cliniko.com/bookings?practitioner_id=102199

Everybody meet Rob.

Rob was diagnosed with Prostate Cancer in early 2018, at 69 years old. I first met Rob in February 2018 when he attended for an Exercise Physiology assessment to commence an exercise program to accompany his treatment, as advised by his oncologist, Dr Cooray. Rob’s treatment plan involves both hormone replacement therapy and chemotherapy, which both have several physical effects on the body (including fatigue, nausea, reduction in bone density, and more), and can be mentally challenging to get through.

Since February, Rob has completed 4 out of 6 rounds of chemotherapy. Rob has 3 weeks of chemotherapy and then one week off, so his energy levels, fatigue and nausea vary throughout this time. However, despite how he is feeling and with a bit less hair, Rob is a regular face in the gym, attending 2-4 times per week to complete a program consisting of both strength and aerobic exercises. Rob completes his exercises independently, however, under the guidance of Exercise Physiologists, his program is changed regularly, and altered depending on how he is feeling on the day. While Rob will admit he has missed a day or two here or there, he feels that his exercise program has contributed greatly to how he feels both physically and mentally, and always feels better after leaving.

Having been a keen marathon runner back in his golden days, Rob has always loved exercise and appreciates all the benefits it provides. But after his diagnosis, Rob says one of the best parts of being able to exercise is the control it allows him to have on his own health. In Rob’s own words: “in a world where you have a life threatening disease, and are constantly being told what to do and where to go and what time to be there and what treatment you’re having, I am in control of my exercise, and that is empowering”.

It is an absolute pleasure looking after Rob in the gym, who is always keen for a chat and a joke or up for a challenge. Keep up the great work Rob, you are a superstar and an inspiration to all of us!

Axillary web syndrome (also known as cording) can occur in the days, weeks or in some cases months following a mastectomy, axillary surgery or clearance. It is believed to be caused by the trauma to the connective tissue that encases the blood vessels, lymph vessels, nerves and muscles in the axillary (armpit).
This trauma creates tension which clients often describe cording as a ‘tight band running down from the armpit into the inner arm’ and is often identified when moving the arm overhead where a visible cord/band can be seen

How can an Exercise Physiologist help

An Exercise Physiologist can assist in the development of a suitable mobility exercise program designed to resolve and treat the cording. An initial assessment is conducted to gather all relevant information regarding your treatment and recovery and a mobility-based home exercise program is prescribed and demonstrated. For best results the programs are best to be performed daily and regular reviews with your EP are encouraged to monitor progress and gradually increase your exercise.

Treatment methods for cording

There are a number of different methods used to treat cording, depending on the severity of the cording a client may require one or all of the following treatments;

• • Mobility exercises to improve the tissue health in the axillary (armpit), thoracic (upper back), pectorals (chest), biceps, triceps and forearm, a few examples are shown below
  • Massage
  • Laser treatment from a lymphoedema practitioner

Fortunately for most clients with a few sessions of exercise, massage and laser if required, their cording resolves, however it is recommended that all clients with a history of cording continue to regularly practice their mobility exercises to prevent any further issues in the future.

How can an Exercise Physiologist help

An Exercise Physiologist can assist in the development of a suitable mobility exercise program designed to resolve and treat your cording. At the completing of your initial appointment you will have been instructed on how to complete your individually tailored exercise program and be asked to completed in an intensive block of daily exercises for a prescribed period of time, e.g. 2 weeks. Following this you will be asked to attend for a review to check the progress and increase your exercise program as able.
If you are interested in further information on how Exercise Physiology at Strong & Stable can help you please call us on 9762 0976.

References
1. https://www.cancercouncil.com.au/breast-cancer/after-cancer-treatment/cording/
2. http://www.breastcancer.org/treatment/side_effects/aws