Should I Exercise During Pregnancy?

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The British Journal of Sports Medicine have recently published a much needed update on exercise recommendations during pregnancy. Appropriate exercise during pregnancy has be shown to be associated with less complications as well as enhancing maternal physical and mental health.
The amount of exercise that is appropriate for you may depend on your previous level of fitness as well as any current or previous health issues. If you are having certain issues during pregnancy such as pre-eclampsia, then exercise may be limited. It is recommended that all pregnant women who aren’t currently meeting the new guidelines and don’t have any contraindications to exercise start to progressively move towards them. The updated exercise recommendations will be released next year.
If you would like to know what exercise you should be doing during pregnancy and what you should avoid, or if you want to start doing Clinical Pilates during your pregnancy come in and see one of our friendly and experienced physiotherapists. Genevieve has a special interest in Women’s and Men’s Health and can also assist with other pregnancy related issues.

What to do with a Sprained Ankle

As all of the Winter sports seasons have come to a close we are hearing the question “can I play on this sprained ankle?” The ankle sprain is the most common sporting injury accounting for up to 45% of all injuries. It also has recurrence rates of 73% and has a 59% possibility of long term disability. And yet it is an injury that is commonly brushed off and played through.

The first thing that you should do after even a minor ankle sprain is have it assessed by a physiotherapist or other relevant health professional. When rehabilitating your ankle it is important to optimise the strength, flexibility, balance and motor controlback to at least pre-injury levels. It is also usually a good idea to brace or strap your ankle when returning back to sport.

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The Miraculous Healing Disc

If you’ve ever had lower back pain and been diagnosed by a health care professional as having a disc related injury such as a disc bulge or protrusion, you’ve probably felt that sinking feeling in your gut and immediately started asking yourself questions like “will I have this for the rest of my life?” or “will I need to have surgery for this?”. We have long known that much like an ankle sprain or any other injury discs will heal themselves spontaneously. A recent meta-analysis showed that in the United Kingdom 82.94% of patients who had disc herniation spontaneously reabsorbed without surgery.

It's time that we stop being so fearful of lower back injuries and started realising how strong and stable our spines are.

If you’re having lower back pain and want to know the best course of action, book in to see one of our experienced and friendly physiotherapists.

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How do I treat persistent neck pain?

Neck pain is one of the most common symptoms leading sufferers to seek help from health practitioners, but what can be done for long term chronic neck pain?

Chronic or persistent neck pain is multi factorial so the short answer is that it depends on your particular presentation. Treatment for neck pain, like many other injuries, shouldn’t be a “one size fits all” approach. Once you have had a thorough assessment of all of the potential contributing factors to your neck pain treatment might consist of education, manual therapy, stretching and exercise. Research has shown that specific neck and shoulder exercises can improve neck pain, disability and strength after 1 year and 3 year follow-ups. So like many other injuries, having appropriate strength and control is important in the resolution of your symptoms. 

For more information about neck pain book in to talk with one of our friendly and experienced physiotherapists.

Neck Twists

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  • Slowly rotate neck all the way to one side
  • Hold for 3 seconds then slowly rotate all the way to the other side
  • Repeat 10 times to each side

Neck Rolls

  • Side flex your neck by bringing your right ear down towards your right shoulder•Slowly roll your neck around until your chin is towards your chest
  • Continue rolling until you left ear is towards your left shoulder
  • Roll back in the same fashion
  • Repeat 10 times to each side

Beating Tendon Pain

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Have you ever had tendon pain? These disorders can occur in many tendons around our body including the Achilles, knee, hip, shoulder and elbow (golfers or tennis elbow). They can be very painful and disabling, but how do we treat them?


WHAT DOESN’T WORK?
Anti-inflammatories may be beneficial in the early stages to settle pain and bursitis but long term use of anti-inflammatories including cortisone injection has very limited evidence. Because tendon pain, also known as tendinopathy is not an inflammatory process it is hard to justify use of anti-inflammatories and in fact repeated cortisone injections may weaken the integrity of the tendon.
Stretching used to be a common treatment for tendon pain but in actual fact may be counterproductive in the natural healing process of the tendon and may cause more pain.


WHAT DOES WORK?
Exercise!! As usual exercise comes to the rescue. The most important thing you can do for your painful tendon is to use appropriate exercise. This might mean temporarily pausing irritable exercise and instead doing specific rehabilitation to improve the integrity and natural healing of the tendon. It may also be necessary to address biomechanical factors that are putting additional load or compressive load through the tendon.
For more information about tendons book in to talk with one of our friendly and experienced physiotherapists. 

Surgery or Exercise?

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About a million orthopaedic surgeries are performed each year in Australia and these numbers are continuing to rise. A recent study marked a significant increase in shoulder surgery in Western Australia including a 473% rise in public funded rotator cuff surgeries. These numbers are reflected similarly for other joint surgeries such as knee and hip replacements.
A recent news story on SBS Insight shined a light on this data and asked the question; how many of these surgeries are necessary? The evidence for surgery in many of these cases has little scientific evidence when compared with conservative treatments such as exercise. So when considering a surgical management do your research and talk to as many experts as possible before deciding if you can get just as good or better outcomes from options such as physiotherapy, exercise rehabilitation or Pilates. 

Three Simple Steps to Minimise Pain when Sitting at Work

1.       Get up and move!

The more often the better. This is the absolute best thing you can do to minimise your chances of getting pain from sitting.

Getting up and moving is the most important thing that you can do when you have been sitting down all day. We recommend getting up every 20 minutes while at work. This might be to do a quick stretch and then sit back down or to go for a walk down the hall to make a tea, as long as you are moving outside the posture that you sit in. Using a “stand up reminder” app on your phone can be a good way of ensuring that you get up more often.
Also consider how much you’re moving before and after work. If you sit in the car to and from work, then sit to eat dinner and sit on the couch watching TV then work isn’t your only problem. Get out and exercise! The health department recommends between 2.5 and 5 hours of moderate intensity exercise per week.
Remember your body needs movement. If you sit all day at work then your body needs it even more!

2.       Optimise your sitting posture

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You should be supported into good posture so that you can relax your back into your chair. Maintain the natural curves in your spine and avoid leaning on the desk.

 “The best posture is your next posture” is a saying going around the health community at the moment. It alludes to the fact that posture isn’t everything and the best thing you can do is move as much as possible. This is true but sitting with appropriate posture and support will minimise the stress on your muscles and joints thereby decreasing your risk of overuse pain.
The best position to be in is a position where you are leaning back and are supported by the back of the seat into a neutral position. If you sit up away from the back of the chair you will be unnecessarily using the muscles in your back which may cause them to fatigue. The back of the chair is there for a reason – use it!
It is also important to try to maintain your spines natural curves when you’re sitting so try to sit right into the back of your chair so you don’t slouch, sit up tall and try to avoid leaning on the desk.
For more information see one of our physiotherapists or get your workstation assessed and setup by your workplaces occupational safety and health employee.

3.       Reverse your posture

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Your body will natural crave this after sitting. You will feel like you need to stretch into the opposite position to what you have been sitting in. A good example of this after a long car trip you will naturally want to stand and stretch backwards into extension.  

When you have been sitting all day the muscles in the front of your hips and back of your thighs are in a shortened position so will start to feel tight. There can also be a tendency to slouch and therefor have your spine in a flexed posture. The opposite position of this is standing with hips and knees straight arching your spine backwards. The best stretching position for you might be different than this. If you have a tendency to roll your shoulders forwards you might want to stretch them backwards.

Stretch the muscles that feel like they need it and do it often! This is a great way to minimise the long term postural loading on muscles and joints.

If you get any pain from sitting or require more information, see one of our friendly physiotherapists.

What's Causing my Back Pain?

Did you know that only 5-10% of cases of low back pain are associated with a specific pathology. The remaining 90% of low back pain is a result of multiple contributing factors both mechanical and non-mechanical. We know many modifiable lifestyle or mechanical factors can load your lower back in a maladaptive manner. However, other non-mechanical factors including feeling anxious about your lower back pain can not only reinforce maladaptive movements but also impact your pain experience. If you are in a low mood or feeling stressed it can put you on high alert for any incoming signals and also impact how you interpret them. In other words, your mood can turn the volume up on your ‘pain channels’.

When treating low back pain it is important to provide you with the tools to create positive adaptation and pain coping strategies. There is no recipe to treating low back pain and your treating health professional should take into consideration all the factors which could be contributing to your symptoms.

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Dance Injury Prevention & Conditioning

Dance may appear graceful and effortless, however achieving this actually requires a high degree of athleticism and long hours of dedicated training.  Dancers therefore need to be athletes as well as artists.  Dancers are therefore vulnerable to injury, just as athletes in other sports are prone to sports injuries.  The types of injury dancers sustain will depend on many factors, especially the style of dance (ballet, jazz, contemporary, tap, acrobatics, ballroom, Irish, hip-hop, and many more); the number of hours spent training or performing; and the specific choreography they are rehearsing. For example if a ballet dancer is doing hours of pointe work each day (ie. on the tips of their toes in pointe shoes), they will be more prone to foot and ankle problems.  If a theatrical dancer is performing repeated layout kicks or arabesques (repetitive low back extension), they may be more prone to low back pain or injury.  These factors (called “extrinsic factors” as they are ‘outside’ the individual) are not so easy to control, as they depend largely on the needs of the school or company the dancer belongs to, and their examination, rehearsal and production processes. 

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However there are also a large number of “intrinsic factors” (within the individual), more of which are in the dancer’s control. These include:

  •  Structural factors, or the dancer’s anatomy or alignment. Eg. Lordosis, kyphosis, scoliosis (spinal curvatures); genu varum/valgum (bow-legs or knock-knees), femoral and acetabular version (anatomy of the hip joints) and many more.
  • Joint mobility & soft tissue flexibility.  This will affect the dancer’s “facility” with turn-out, splits, arabesque, etc.
  • Muscle strength, endurance & neuromuscular control. These affect the dancer’s “biomechanics” (control of alignment), joint stability, posture, “lines” of movement, and their overall performance qualities.
  • Cardiovascular fitness (“anaerobic” and “aerobic”).  This will affect their stamina, in terms of performance ability as well as coping with long hours of training.
  • Psychology, or mind-set. This obviously affects many aspects of a dancer’s life, including their attitude towards performance, dedication to training, and their ability to cope with injuries or other set-backs.

Most of these issues can be helped by programmes targeted at each dancer’s strengths and weaknesses.  Weaknesses can be identified through a comprehensive dance physiotherapy assessment. They can then be addressed with specific exercises, ranging from home exercises with no or minimal equipment, through to Pilates studio sessions, fitness training and cross-training.  Although we can’t change our anatomy (our body’s structure), most other posture, flexibility and control issues can be corrected (or at least improved) by an individualised physiotherapy “conditioning” programme. 

Physio-Dance becomes a regular part of the dancer’s warm-up and conditioning routine.  This will go a long way towards coping with the high demands of dance training, competition and performance. It can prevent injuries from occurring in the first place; or, if an injury does occur, can ensure recovery is as quick and effective as possible. 

Sitting Posture at School/Home

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Studies have shown that a large proportion of adolescents will sit with poor posture. Sitting for long periods of time in poor postures will increase the stress on your back neck and shoulders and can lead to pain. It is important to optimise these postures at a young age so that they don’t continue into adulthood.

An optimal posture while sitting should have your spine in a “neutral” position which is a position where it maintains its natural curves. This is why a chair with lumbar support is important to maintain the natural inward curve of your lower back.

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Your shoulders should be relaxed and not rolled forward with your elbows at your sides. Your cheekbones should then sit naturally above your collar bones. 

For those students who are studying at home on computers it is important to setup your home workstation properly. Using laptops or tablets should only be for short periods of time unless you are using a separate keyboard and raising the screen to an ideal height.

The other way to minimise the effect of sitting is to get up from your chair as often as possible and stretch.

 

 

These two stretches can be helpful when you are spending extended times sitting throughout the day.

  Doorway Pectoral Stretch   1.             Stand in the doorway with arms on the sides of the door frame  2.             Push the trunk forward stretching through the chest and fronts of the shoulders  3.             Be mindful of not letting your ribs flare  4.             If you are tighter on one side focus on just that arm to allow for more postural symmetry

Doorway Pectoral Stretch

  1. Stand in the doorway with arms on the sides of the door frame
  2. Push the trunk forward stretching through the chest and fronts of the shoulders
  3. Be mindful of not letting your ribs flare
  4. If you are tighter on one side focus on just that arm to allow for more postural symmetry
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Trunk Rotations

  1. Sit up in your chair, rotating around to the side
  2. Pull around on the back of the chair to get a deeper stretch
  3. Hold for one breath then slowly repeat to the opposite side
  4. Repeat 5 times to each side