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Depression, Illness Perceptions and Exercise

Jun 10, 2021

Many people experience a decline in their mental health following an injury. Surveys have shown that approximately 20 to 50 percent of people with musculoskeletal conditions show signs of elevated depressive symptoms. Depression has been identified as a risk factor for poor recovery outcomes, longer claim times and increased work absence after a work-related musculoskeletal disorder.

We tend to develop an idea about our injury to make sense of it and adapt to the difficulties that it causes, known as an illness perception. Illness perceptions are emotional and cognitive representations that you have around your injury and are not only based on symptoms, but also the injury-related consequences, past experiences, and related anxiety. Studies have shown that negative illness perceptions and the injured worker expecting a slower recovery is associated with increased depressive symptoms, reduced adherence to treatments, poorer treatment outcomes and longer claim times. It is possible that recovery expectancies are the vehicle by which depression influences return to work results in those with musculoskeletal injuries. Individuals who were 100 percent certain that they would return to work within 6-months have been found to be 4 x more likely to return to work during that time. Therefore, positive illness perceptions are important and result in improved health outcomes, quality of life, function, and emotional status.

Exercise and physical activity can provide numerous benefits for not only musculoskeletal injuries, but for depressive symptoms as well. For individuals who participate in regular physical activity, even at lower levels, they are at decreased risk of experiencing symptoms of depression and are less likely to experience future depressive episodes. Further, regular exercise can assist in weight management, improving diabetes control and decrease the impact of cardiovascular disease, which often occurs in those with depression.

Treating professionals should talk to their clients about an exercise regime that suits their personal preferences and circumstances. An Accredited Exercise Physiologist has specialized training in the construction and delivery of exercise and lifestyle interventions for individuals with work and non-work related chronic and complex illnesses, including depression. Illness perceptions often present as a barrier to commencing and maintaining an exercise routine. Thus, it is vital that the exercise professional has an in-depth understanding of the client’s condition and comorbidities to best assist in the individuals exercise and recovery journey.

Tiffany Mullins B.Sc, M.Clin.Ex.Phys

Accredited Exercise Physiologist

 

References

Berk, M., Sarris, J., Coulson, C., & Jacka, F. (2013). Lifestyle management of unipolar depression.  Acta Psychiatrica Scandinavica127 , 38-54. https://doi.org/10.1111/acps.12124

Carriere, J., Thibault, P., & Sullivan, M. (2014). The Mediating Role of Recovery Expectancies on the Relation Between Depression and Return-to-Work.  Journal Of Occupational Rehabilitation25 (2), 348-356. https://doi.org/10.1007/s10926-014-9543-4

Exercise is Medicine. (2014).  Depression and exercise  [Factsheet]. Exercise is Medicine Australia 2014. Retrieved 17 May 2021, from www.exerciseismedicine.org.au.

Mammen, G., & Faulkner, G. (2013). Physical Activity and the Prevention of Depression.  American Journal Of Preventive Medicine45 (5), 649-657. https://doi.org/10.1016/j.amepre.2013.08.001

Stanton, R., Happell, B., & Reaburn, P. (2014). The mental health benefits of regular physical activity, and its role in preventing future depressive illness.  Nursing: Research And Reviews , 45. https://doi.org/10.2147/nrr.s41956

Ünal, Ö. (2019). The relationship of illness perceptions with demographic features, pain severity, functional capacity, disability, depression, and quality of life in patients with chronic low back pain.  Turkish Journal Of Physical Medicine And Rehabilitation65 (4), 301-308. https://doi.org/10.5606/tftrd.2019.3248

 

22 Mar, 2024
Does your spine look like the picture on the left or does it look more like the one on the right? As Exercise Physiologists, we often see all sorts of presentations of the spine and in this blog, we will be covering a condition known as ‘lordosis’. More specifically, we will be focusing on the lower or ‘lumbar’ aspect of the spine, which is where we see this condition commonly. What is Lordosis? Normally, the spine is naturally curved forward a little bit which helps with shock absorption and supports optimum posture but in lordosis there is an inward exaggeration of the spinal curve which can be felt on the outside as a deep dip in the lower back. Who does it affect? Simply put, anyone of any age group can develop lordosis and it is most seen in people who are pregnant, as a hereditary condition in children and adults with obesity or reduced bone density are at a higher risk of development of this condition. What is the cause? A common cause for lordosis includes poor posture as a result of weak core muscles and muscular imbalances which can be attributed to the modern-day lifestyle where we are sitting more than ever. Other causes include conditions such as osteoporosis, spondylolisthesis, kyphosis and as previously mentioned, obesity. What are the symptoms? An obvious symptom of lordosis is lower back pain. As you can see in the photos above, there is a higher risk of complication involving entrapment of a nerve when there is excessive spinal curvature leading to increased compression of the spinal vertebrae. Although sometimes lordosis can be asymptomatic and a person can go about their daily lives without too much of an issue, in more serious cases, those affected can potentially experience lumbar radiculopathy or sciatica, where there is compression of the exiting lumbar nerve roots and lead to symptoms which can be described as burning, tingling, radiating pain, paraesthesia and numbness in one or more uncommonly, both legs. How is it treated by an Exercise Physiologist? As they say, prevention is better than cure and to reduce the risk of potential future development of lordosis, maintenance of a healthy weight and engaging in core-strengthening exercises will assist with reducing the pressure placed on the spine as well as maintaining proper posture. However, if you are somebody who is already experiencing back pain as a result of lordosis, it is never too late to engage in physical therapy to improve pain-free range of movement, flexibility and mobility of the spine. Posture can also be improved significantly with strengthening of the appropriate musculature in the trunk, hips and lower limbs and addressing compensatory patterns that may have developed over time. For example, when a person spends a significant amount of time in a seated position, the muscles in the lower or lumbar aspect of the back can become excessively tight from trying to support and stabilise the spine. Additionally, muscle groups such as the hamstrings, glutes and abdominals become weak and inhibited, contributing to poor biomechanics. Physical therapy has been proven to be highly effective by taking a conservative approach to manage symptoms and improve function. With adherence to an appropriate rehabilitation programme an injured worker will have a higher chance of returning to work as well as a return to normal activities. Chris Chen Workers Compensation Specialist ‑ Innovation Team Leader (AEP, ESSAM) Exercise Rehabilitation Services ‑ WA
08 Mar, 2024
Rhythm is one of the most important elements of music across all its forms. Rhythm gives structure to music. It assists tone, it influences tempo and can control cadence, just for a quick snapshot. What I’ve found over my time playing music as hobby, is that rhythm is ever important and ever consistent. It’s something we can create, maintain, tweak, and develop but ultimately it remains consistent in providing structure. It’s also something we all have in our day-to-day life and in relation to our overall health, a rhythm can provide a positive impact on our overall health and wellbeing. So, you’re probably wondering where I’m going with this and how does it relate to exercise or health? Over time, or maybe just through personal growth and more awareness I have found that there are certain structures or constants that are frequent in my day and when performed consistently over a period time, provide the opportunity for me to perform at the best I can be and have a positive impact on my health and wellbeing. That being said, when these structures aren’t followed through or forgotten, it can then create the opposite effect; whereby we may feel stress, fatigue, unmotivated and not on the right track. For me I have found that I have a general rhythm that I try to maintain, the hard part is consistency (which is the challenge for most things!). Think of this another way. It could be your routine, your non-negotiable’s, the one-percenter’s, your daily habits or even just the beat of your day. Things that you do daily, that create structure, consistency, and the mainstay standards you have for yourself that help you be the best version of yourself. For some it can involve a variety of things and as you’re reading this, I am sure you are already thinking about some of these items. Okay, what are these constants? They can be as specific as you like or as general as possible, they could incorporate activity and exercise (I hope so!) or involve silence and stillness. It could include reading, journalling, meditation, the way you sleep or eat, the rules, restrictions, or freedoms you have put in place. There is no right or wrong way. If it works for you and you can be consistent, then ultimately this is your rhythm and as such your guide to maintaining your health! Coming into a new year, dealing with significant change, or working through a new challenge, there’s always a chance you can be thrown a curveball and then get stuck trying to work through it, whereby there are usually sacrifices made with our day-to-day rhythm, which then impact our health and wellbeing in a negative manner. It’s important in these moments to reflect to our rhythm or routine (whatever name you have for it) and make sure we don’t make those sacrifices, and we strive to maintain our peak health and well-being. Afiq Jackson Workers Compensation Specialist ‑ Team Leader North West (AEP, ESSAM)
01 Mar, 2024
Hey guys, Mike Andrews here. I am the Business Development Manager at Absolute Balance, a role I have filled for just over 18 months. This exciting role has allowed me to learn an immense amount about myself and the team that makes up our business. The team of exercise physiologists, the corporate team, and injury prevention, have phenomenal positive outcomes and back to work results, proving their elite level of work. The team is changing lives on the daily, however I often notice how they overlook their own impact, and just shrug it off as “just doing my job”. I agree, they are doing their job, but the impact and effect is way more than that and there is importance in knowing your impact. Now this is where I come in, and I love my role, without a doubt, I consider it an absolute privilege. I spend quality face to face time with our team, assisting and coaching them on their mindset around their impact of “just doing my job”. As a result of my role and my interaction with the team believe “BDM” should stand for Building & Developing Mindset. Each team member has a different approach to their work, comes from a different mindset, background, and has their own strengths, and or weakness, an aspect which makes the time spent with them so rewarding. Everyone will find their sweet spot with their mindset at different stages which is great! With that being said, the real goal for the business is combining the individual strengths into a highly functioning team. In my view, the simpler and more straight forward the goals/attributes the better. I’ve stated three that I believe will result in a highly functioning team, which are: 1. Clear vision. 2. Clear roles for each team member. 3. Celebrating the process. As important as each attribute is, I believe the last one outweighs the rest. When you combine the energy and passion our team have with an improved mindset, each day will be more rewarding and enjoyable. My role is to help assist the team members to use their attributes and strengths to find their sweet spot or ultimate mindset. That’s why I believe my role is so enjoyable and ultimately should stand for Building & Developing Mindset. Michael Andrews Business Development Manager 
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