What makes your pain better/worse?


It is now well established in the literature that factors like poor sleep (Schuh-Hofer et al. 2013), negative expectations (Bingel et al. 2011; Kessner et al. 2014), worry, anxiety, depression (Ligthart et al. 2013; 2014), fear (Crombez et al. 2012) , stress (Chen et al. 2011; Fagundes et al. 2013; Scott et al. 2013) and negative beliefs about the injury (Wiech et al. 2008; Wertli et al. 2014) all have the capacity to amplify the danger messages. Therefore the brain is alerted to more “danger” than there actually is and the pain response may not reflect the degree of tissue injury.

- Running Physio.


How much sleep do you really need?

The National Sleep Foundation gathered a 18 person- multidisciplinary expert panel to evaluate scientific literature regarding sleep requirements for different age groups. The evaluation is published in the journal “Sleep Health” and nicely illustrated in the infographic below.

Of note, the conclude that individual sleep requirements should be considered, but that these (should) rarely deviate far from the normal range. If done so consistently, over time this will most likely compromise health and well-being.

Alongside the CF-idoms/nonsense-phrases that somehow became popular due to plain stupidity, the “you can sleep when you are old”- phrase should be disregarded and the person stating it publicly ridiculed. That is, of course, only if you are interested in optimising health, memory, mental and physical performance, recovery, lean body mass, pain reduction etc etc.*




* (Thomas et al., 2000; Alhola et al., 2007; Taheri et al., 2004; Knutson et al., 2007; Afflect et al., 1996; Kundermann et al., 2004; Moldofsky et al., 2001)

The “surprising” problem with calorie counting – part 2

As promised, here is part 2 of the nice little two-story infographic on calorie counting by Precision Nutrition.

Whereas the first one nicely illustrated 5 reasons as to why trying to count the calories that goes in is a waste of time, the one below shows why “calories out” also is close- to- impossible to determine somewhat precisely.

In short; you’re not your neighbour!



The “surprising” problem with calorie counting – part 1

Another nice infographic by Precision Nutrition.

In short, you should know that you have absolutely no idea about how many calories you are really absorbing; mainly because of individuality, imprecise calorie-descriptions and food preparation. That is good news! If anything, it´s an argument to save you the never-ending trouble of counting and weighing your food.

Part 2 is a nice read as well!


Neurocounseling – bridging the gap between brain and behavior

The following is a guest-post by Tim Wayne, sharing an interesting infographic from Bradley University. In the very least it should remind us of the importance of a choosing a good therapist.


In a nutshell, a counselor’s role is to help clients rewire themselves to avoid undesired behaviors while promoting positive ones. However, one emerging field of counseling takes the idea one step further. This field is called neurocounseling, and it is founded on the principle that our brains are always developing to help us retain and use information — a principle called neuroplasticity.

By using knowledge of how the brain works, counselors are now able to better help clients reshape their brains to produce new neurons and neural connections. By reshaping our brains through neurocounseling, counselors are exploring how these techniques can help those suffering from depression, addiction, and even brain injuries.

In the infographic below, created for Bradley University’s Online Counseling Programs, you can learn more about what neurocounseling is and how these techniques can be used to serve those with mental disorders and conditions.



How exposure to blue light affects your brain and body


I know this. You know this. Most people still act like it doesn’t matter. Most people are stupid.

Light-exposure can be good or bad depending on when it occurs. As mentioned in the post “electronic devices before sleep?” which highlights the results from Chang et al. 2014,  your nighttime Ipad/kindle-reading will have adverse effects on your sleep and health.


The infographic below sums it up pretty nicely: If you exposure yourself to (blue) light before bedtime, you´re going to have a bad time!



Importance of mind-muscle connection during progressive resistance training

… is the head-turning title of yet another really nice article in a series that seems never-ending. – I am sure Jimmy agrees.

Basically, the study by Calatayud et al. 2015 sought to evaluate wether focusing on specific muscles during the bench press exercise can selectively activate these. As the abstract below shows, the results are quite interesting.

In short, it seems that focusing on a specific muscle will increase the activity of this muscle, without decreasing the activity of other prime-movers. In contrast, when specifically focusing on the triceps muscle during benchpress and hereby increasing the activity, the activity of the pectoralis muscles were also increased at loads corresponding to 50% and 60% of 1RM.

Note that this effect seems to “wear off” when playing around with higher loads (80% of 1RM), so it´s something that could, and should, be used for your training sessions focusing on power.



Altogether 18 resistance-trained men participated. Subjects were familiarized with the procedure and performed one-maximum repetition (1RM) test during the first session. In the second session, 3 different bench press conditions were performed with intensities of 20, 40, 50, 60 and 80 % of the pre-determined 1RM: regular bench press, and bench press focusing on selectively using the pectoralis major and triceps brachii, respectively. Surface electromyography (EMG) signals were recorded for the triceps brachii and pectoralis major muscles. Subsequently, peak EMG of the filtered signals were normalized to maximum maximorum EMG of each muscle.


In both muscles, focusing on using the respective muscles increased muscle activity at relative loads between 20 and 60 %, but not at 80 % of 1RM. Overall, a threshold between 60 and 80 % rather than a linear decrease in selective activation with increasing intensity appeared to exist. The increased activity did not occur at the expense of decreased activity of the other muscle, e.g. when focusing on activating the triceps muscle the activity of the pectoralis muscle did not decrease. On the contrary, focusing on using the triceps muscle also increased pectoralis EMG at 50 and 60 % of 1RM.


Resistance-trained individuals can increase triceps brachii or pectarilis major muscle activity during the bench press when focusing on using the specific muscle at intensities up to 60 % of 1RM. A threshold between 60 and 80 % appeared to exist.






8 things to little sleep does to your body

We all know this. Sleep matters, but for one reason or another it´s always the one factor people tend to pay the least attention to. The diet is strictly vegan/paleo/whatever and the training is scheduled down to the very minute and superset, but sleep and basic sleep hygiene is rarely prioritized nearly as high.

It´s stupid and you know it. Some would argue that makes you stupid.

Here is another reminder:


Image credit: Business Insider

Electromyographic comparison of elastic resistance versus machine exercise for high-intensity strength training in chronic stroke patients


Another really nice study was just published in “Archives of Physical Medicine and Rehabilitation”. The study from Vinstrup et al. 2015 examines differences in muscle activation during knee flexion- and extension with two different training modalities; conventional machine training and Theraband elastic tubing.

Physiotherapists working with chronic stroke patients should use this knowledge to apply best practices of rehabilitation following stroke. More on this topic will follow.




To investigate whether elastic resistance training can induce comparable levels of muscle activity as conventional machine training in chronic stroke patients.


Comparative study


Outpatient rehabilitation facility


18 stroke patients with hemiparesis (mean age 57 (SD: 8) years).


Patients performed 3 consecutive reps at 10 repetition maximum (RM) of unilateral knee extension- and flexion, using elastic resistance and conventional training machines.

Main outcome measure

Surface electromyography (EMG) was measured in vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF) and semitendinosus (ST), and normalized to the maximal EMG (nEMG) of the non-paretic leg.


In the paretic leg, agonist muscle activity ranged from 18-24% nEMG during knee flexion and 32-40% nEMG during knee extension. For the latter, VL nEMG was higher during machine exercise compared with elastic resistance (40% [95% CI 33 – 47] vs 32% [95% CI 25 – 39], P=0.003). In the non-paretic leg, agonist muscle activity ranged from 54-61% during knee flexion and 52-68% during knee extension (n.s.). For knee flexion, ST nEMG was higher (61% [95% CI 50 – 71] vs 54% [95% CI 44 – 64], P=0.016), and for knee extension VM nEMG was higher (68% [95% CI 60 – 76] vs 56% [95% CI 48 – 64], P<0.001) during machine exercise compared with elastic resistance. By contrast, antagonist co-activation was significantly higher during knee flexion with elastic resistance compared with the machine. Lastly, there were no differences in perceived exertion between exercise modalities.


Machine training appears to induce slightly higher levels of muscle activity in some of the investigated muscles compared to elastic resistance during lower-limb strength training in chronic stroke patients. The higher level of co-activation during knee flexions with elastic tubing suggests that elastic resistance exercises are more difficult to perform. This is likely due to a higher level of movement instability.