Can exercise really be the best medicine?

We all know that regular exercise is good for you, but new research published in the British Medical Journal (BMJ) has found that in the case of some diseases, exercise can be more effective than certain medications.

Researchers looked at results from nearly 340,000 patients who had already suffered from heart disease and stroke to see how exercise compared to using prescribed drugs. In the case of stroke, physical activity was found to be more successful than some medication in preventing death. And exercise was found to be equally as effective as certain drugs for preventing people who had already suffered one heart attack from suffering another.

However, exercise was not universally found to be more effective. In the case of patients recovering from heart failure, a group of drugs known as diuretics were found to be better. Overall the study, which also examined patients at risk of developing diabetes, concluded that exercise was equally as effective as medication in preventing early death.

The researchers, from the London School of Economics, Harvard Pilgrim Healthcare Institute at the Harvard Medical School and Stanford University School of Medicine, published their findings in October 2013 after reviewing 305 randomized trials that compared the effects of taking pills and exercise. They acknowledge that there is less data examining the role of physical activity and have called for more studies to be carried out into the role of exercise in preventing early death.

Whilst the study may get patients thinking about the importance of exercise and get prescribing authorities to consider if savings could be made longer term, it is not a call to ditch the drugs altogether. Instead experts are recommending that both drugs and exercise need to work side by side, in combination with each other, for maximum benefit.

What sort of exercise brings these health benefits?

The studies reviewed looked at a variety of exercises, frequency and levels of intensity so no single advice can be given. However, the NHS recommends that adults aged from 19-64 years old should be moderately active (eg swimming, cycling, fast walking) for at least two and a half hours a week or have at least one hour and fifteen minutes a week of intense exercise, such as running or racket sports. Muscle strengthening exercises, such as sit-ups or exercises with weights, involving all major muscle groups should also be done twice or more a week.

Aside from the study, exercise has been found to improve a sense of wellbeing and boost energy. Other lifestyle choices, such as eating a healthy diet and stopping smoking, were not considered in this study but are also known to be important in preventing disease and aiding recovery.

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How Can Physiotherapy Help With Back Pain

Around 80% of us will experience some kind of back pain in our lives. It can vary from the odd twinge to debilitating pain lasting years, but in almost all cases taking it easy is not the solution. Keeping active is often the best remedy, although you need to ensure that what you are doing is appropriate and will not make the problem worse.

Can physiotherapy help back pain?

Doctors refer patients for physiotherapy (also called physical therapy or physio) as it helps to improve mobility and your body’s ability to heal itself following surgery, illness, respiratory problems and injury. This includes helping to reduce back pain and preventing it from recurring. Physiotherapists are trained healthcare professionals.

When should I consider physiotherapy for treating back pain?

Physio may help people manage back pain regardless of how long they have experienced symptoms before seeking treatment. However, 2012 research found that patients who saw a physiotherapist within two weeks of their initial consultation for low back pain were over 50% less likely to need further treatment, such as surgery or steroid injections, than those who waited 90 days.

What will my physiotherapist do?

Your physiotherapist will make an assessment to identify the reason for your back pain and produce recommendations tailored to you to ease the pain and treat the cause. This may include exercises and stretches, soft tissue mobilisation (such as massage), and electrotherapy. They will also advise you on improving posture, how to lift and carry heavy objects, changes to lifestyle and other ways you can take control of the situation to reduce pain and prevent a recurrence. Most physical therapy treatment programmes will be carried out over a number of weeks and you will be asked to do specific exercises in between appointments.

What else can I do?

You may not be able to prevent back pain completely, but there are steps you can take to reduce your risks of suffering back pain again and to reduce the impact back pain has on your life if it strikes again:

  • Try to maintain good posture, especially if you spend long periods of time sat at a desk or in a car;
  • Look after your back by keeping active – walking or swimming are both low impact exercises that can really help. Choose something you enjoy, as exercise needs to be regular;
  • Learn how to lift heavy object correctly, or use equipment to help you. Bend from your knees and hips keeping your back straight;
  • Listen to your body. If you’ve been sitting still for a long period of time and start to feel stiff try some simple stretches to keep your back flexible.

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How simple food swaps can make a big difference to your health

Did you know that by making a few small changes to your day-to-day diet can make a big difference to your risk of developing Type 2 diabetes?

By making some easy food swaps you can reduce the number of calories you eat by 500-600 kcal per day. These changes are ideal if you’re aiming to lose weight at a sensible amount of 1-2 lbs per week.

If you’re looking for some simple food swaps, check out the graphic below from Diabetes UK.

Ensuring you stick to these simple food swaps every day could help you to lose up to half a stone in just one month.

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Our guide to injury prevention in the cold weather

The onset of the Winter Olympics 2014 has got me thinking about this chilly season. Winter often brings with it poor travel conditions, freezing weather and the promise of winter sports for those of us who like to ski or snowboard. Last winter was a long one with icy and cold conditions lasting ‘til March. Often the cold weather can aggravate conditions such as arthritis as well as slippery conditions increasing the risk of injury. So here are a few of my top tips for minimising your risk of pain and injury:

  • Stay active – Try and keep moving as much as possible during the cold months to prevent that stiff feeling, particularly in your knees. Regular movement will help to lubricate and nourish your joints! If you’re heading out into the cold air for a jog, break a light sweat first then stretch to help maintain mobility and reduce the risk of injury. In times of cold weather aim to wear full length running leggings (with reflector strips if it’s dark!) for your run or cycle to keep your muscles warm and reduce the risk of injury.
  • Wrap up warm – A scarf and a woolly hat are winter essentials to prevent both neck and back pain, often caused by tensing in the chill. If you’re a seasonal sufferer of chilblains in your hands and feet, always have a pair of mittens to hand (they’re better at keeping your circulation flowing compared to gloves), and allow your feet to breathe when you leave the outside and enter a warm room.
  • Avoid slips and trips – I commonly see men and women with injuries caused by falling, during the cold winter months. Often, particularly for women, these injuries have been caused by wearing inappropriate footwear. Slips on icy surfaces can cause more serious accidents such as fractures and sprains.

For those of you with more adrenaline-fuelled plans in the pipeline this winter, here are some tips to bear in mind pre and post winter sports: Preparation

  • Hit the gym for strength and conditioning, such as squats and lunges, as well as interval training on the cross-trainer and step machine for a month in the lead up to toughen up your legs and core.
  • Good quality equipment is vital – if you’re a regular on the slopes, invest in your own boots to give you individual, fitted support. If you’re new, ensure your hired boots fit you comfortably. Don’t be shy if you feel the ones you have aren’t right – swap them if they’re causing you to blister or cramp.


  • If you have a vulnerable joint, buy an effective support to give it the structure it needs. For advice, see a physiotherapist or alternatively someone in the shop should be able to assist you.
  • Make sure you do an active warm up of a couple of warm ups runs. Start with some light exercises, before heading to more difficult slopes. Remember that cooling down is just as important as warming up.
  • Get to know the mountain, such as trees, rocks, and ice patches so they can be avoided. Stay on marked trails and be aware of slippery surfaces in the town.
  • If you’re tired take a break – you are most likely to injure yourself when you’re tired.
  • Wear a helmet! They may not be the greatest fashion accessory, but wearing a helmet could save you from a very serious injury. If you’re snowboarding make sure you also wear wrist and knee guards.
  • Should you be unlucky enough to return with a niggling pain or injury please do seek the advice of a physiotherapist. If you are unsure whether physiotherapy is the right course of action for you, why not visit our ‘Ask A Physio’ form? You can submit your question to our triage team for free advice within one working day.

About the author Simon Cabot has been a physiotherapist for almost 15 years and works onsite at the Nuffield Health Canary Wharf medical centre. He has a broad skill set including CBT, Sports rehab, and numerous manual therapy techniques.

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