Do you sit too much?

In the past few years there has been a big push for more standing desks in the workplace. More recently the same thing is being proposed for the classroom.

So what is all the fuss about? 

We spend far too much of our time sitting. We sit to eat breakfast and then sit in the car, sit at work, and sit on the way home, then sit on the couch until going to bed. In reality we were not designed to sit all day. We were designed to walk, run, squat and climb. It is not good to sit for this long – physically or psychologically.
Research shows that a sedentary lifestyle with too much sitting decreases energy expenditure and increases risk of Heart Disease, Diabetes, Metabolic Syndrome, Cancer, Back and neck pain and other orthopaedic problems.

So what can you do about it?

Firstly if you have a job where you sit for the majority of the day get up as often as possible to stretch and re-set your posture (every 20 minutes is ideal).

If you have the ability to use a stand-up desk these are a big advantage. Just be careful not to fall into any poor postures (don’t lock knees or hang off one hip!).
Another option is to kneel at your desk. This will mean that your hips are in a more natural position and only require minimal adjustment of your current workplace. Use a pillow under your knees and just start kneeling for short periods throughout the day and slowly increase it.

Simple Standing Posture Checklist   (Refer to picture)    ü     Weight through rear two thirds of heels   ü     Soft knees   ü     Pubic bone (front of pelvis) in a vertical line to sternum (chest bone)   ü     Widen collar bones gently   ü     Lengthen through back of neck

Simple Standing Posture Checklist (refer to picture)

  •        Weight through rear two thirds of heels
  •        Soft knees
  •         Pubic bone (front of pelvis) in a vertical line to sternum (chest bone)
  •          Widen collar bones gently
  •        Lengthen through back of neck


Tendon pain - What is it? What to do!

Tendon pain is very common and can be commonly misdiagnosed and accused of being other surrounding structures.

Tendons connect muscles to bones all over our body. They can become sore after sudden over loads (ie jogging on a slopping, soft beach or playing a hard game of tennis) or with regular endurance based activities (ie walking up and down stairs everyday at work or having to sustain arms at shoulder height as with hairdressing).

Tendons react and respond very differently to muscle. There are some very important points to adhere to when faced with tendon pain:

1. Don’t       stretch them          2. Only       ice them           3. Don’t       completely rest them

1. Don’t stretch them  

2. Only ice them   

3. Don’t completely rest them

If pain persists it is wise to see your local Physiotherapist for a strict return to activity tendon loading program.  

Do sit ups help a tummy bulge?

Not if you have a diastasis - a tummy ‘bulge’ could in fact be a diastasis!

Diastasis rectus abdominis is a separation of the rectus abdominis muscle, which is commonly known as the ‘six pack’ muscle. It occurs when there is excessive stretch to the linea alba (the middle line of connective tissue joining the muscles together), usually from too much intra-abdominal pressure. This condition affects 100% of women in their third trimester of pregnancy, but it can actually occur in anyone, even men!

There is actually some trending on social media currently with misinformed people attempting to get definition of this linea alba, coining the term “ab crack”!

The diastasis, or tummy gap, can be palpated and measured at different points along the abdomen. In some people it can easily be seen as a ‘doming’ or ‘tenting’ shape when you bend forward or move to get up from lying, especially noticeable when doing an abdominal sit-up. Diastasis can affect how well your abdominal muscles work as part of the “core” system, and can even lead to problems with the pelvic floor.

Reduce your Abd Crack!

Horizon physiotherapist Peri Ross has recently completed a specialist “Diastasis Detective” course which utilises a whole body approach of looking “north of the navel and south of the pubis” to treat diastasis.

 A big part of addressing diastasis is whole body alignment and posture. The Horizon Clinical Pilates program integrates these principles on an individual basis, specifically addressing any alignment or pressure issues which can affect tummy separation. You can learn how to move with optimal posturing, which is how your body is designed to move!    

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Is your posture giving you a headache?

The relationship of poor posture and neck and head pain is one of intimacy. Muscles that connect between the shoulder blades, the neck and base of the skull are responsible for how we hold our shoulders, good or bad!
Sitting slumped in a shoulder forward position at a computer all day can result in the shoulder blades being positioned forward and downward sloping. This puts these connecting muscles in a state of tension which intern restricts the natural movement of the neck joints and head movements.
Alternatively sitting stiff and upright whilst 'pinching' the shoulder blades together can also result in abnormally positioned shoulder blades which will affect the connecting muscles.
A postural assessment and necessary correction will help significantly in managing and solving, long term neck pain and headaches.

Knee pain in children

Knee pain is a common symptom of poor foot mechanics.  Obviously there are many causes of knee pain, but quite often foot mechanics are solely to blame for an incorrect knee position.  Commonly knee pain in children that occurs without injury strikes at the age of 13-14 years.  It affects more active children who are growing.

Looking at shoe choices for both school and sporting activities is imperative when teens complain of knee pain.  Often orthotic intervention is required in this critical growing age.
Kylie Gates, our resident podiatrist has over 20 years experience in treating children with knee pain. A through assessment of the walking pattern is required to determine the best form of treatment.

Grading your foot type

Foot type

Ever had foot pain? ….persistent ankle swelling from an old injury? …..or even wear and tear of the joints in your ankles and feet?

Our recent in-service looked at the “FPI” Foot Posture Index.

This is a reputable assessment tool of the foot and ankle that can determine the position and potential mechanics of your feet and ankles.

We all know how important your feet are, and for patients who have experienced foot problems they will entirely relate to how frustrating and even debilitating these problems can be.

At Horizon Physiotherapy we aim to assist your foot problems with effective diagnosis, targeted exercises and support based taping or orthotics. We feel we have furthered our knowledge of how the ankle and the foot joints function.

There are 26 bones in each foot and the ankle joint itself provides specific mobility to transfer weight from your body through the various joints in the foot to ultimately propel you forward.

There are 12 muscles in your lower leg that cross the ankle into the foot, and control movements required to walk, run or jump. Smaller muscles and ligaments within the foot play a vital support role to these movements and further contribute to overall propulsion of your body.

The main aspect of foot mechanics is an “unlocking” mechanism when landing on your heel, followed by a “locking” mechanism (re-formation of the foot as a semi-rigid lever) when pushing off with your toes.

Understanding this mechanism including the muscles function allows us to effectively treat and diagnose patients with a goal of returning to sport, recreational activities and even pain free walking.

If you have any questions about foot pain, ankle movements (mechanics), types of treatment, exercises and/or equipment required (shoes and orthotics) feel free to contact us via the website or at the clinic.

Saddle Size - A pain in the butt!

A common issue with cyclists is perennial pain and/or numbness. The “Perineum” is the area in both male and females between the pubic bone and the coccyx. This area isnot designed for direct pressure and is protected as such by the Ischial Tuberosities – commonly known as the sit bones.

Saddle size

The perineal nerve arises from the pudendal nerve to supply the perineal area and the sexual organs. The pudendal artery also forms the perineal artery that supplies blood to the same area. Both these structures can be compressed and compromised with prolonged, direct pressure from a poorly fitted saddle.

Most cyclists don’t realise that saddles actually come in a range of sizes. I am often explaining to patients that saddles are like shoes – the most important thing is they fit, the gimmicks are secondary. Saddles commonly range from 130mm to 170mm and the essential measurement to determine which one is appropriate is your sit bone width.

How Wide Are My Sit Bones?

When I measure a clients sit bones and we determine they need a wider saddle, their first thought is – “oh, so I have a big butt”. Sit Bone width is the boney architecture of the pelvis, it bears no correlation with pelvic width or mass. I see large clients with narrow sit bones and skinny clients with wide sit bones, the important point is that they are weight bearing on the saddle. A poorly fitting seat that is too narrow will sit inside the sit bones. the edges of the seat rub up against the inside of the sit bones and cause painful saddle sores. The prolonged perineal pressure leads to perineal artery and nerve compression which results in numbness to perineal area and possible sexual dysfunction and urinary issues.

What Can I Expect With The Correct Width Saddle?

Well firstly comfort. You are now sitting on the widest part of the saddle, through your boney architecture. This enables the rider to connect to the saddle as a reference point and apply the greatest amount of power through the legs. We have all ridden behind cyclists that rock around their saddle as if they are sitting on a narrow tube or watched a poorly fitted time trialist perched on the end of their saddle rather than through the widest part of the saddle (which is a separate blog at a later date). In these the examples the body is defining its stable reference point for power at the shoulder girdle – resulting in neck and shoulder tightness. The saddle provides a significant mechanical advantage and as such not only needs to be the right width, it also needs to be set up correctly.

Saddle Position

Saddle position comes with good bike fit. You can have the right width saddle, but if you are too far forward, aft, high or low there will be a compromise. I often get people coming to see me with SMP saddles, saying they are disappointed that the seat didn’t work for them like it had for their mates. The SMP is a great saddle with a great size range (most important), a generous cut away, long rails (for adjustment) designed by an urologist. They do require specific set up, but once in the right place they are a fantastic saddle. Specialized have just brought out a new size range in the Romin range, which is also great – a reasonably priced saddle, good cut away, good rail length and light. There are other saddle companies that offer good saddles, but most are limited to smaller sizes – which isn’t a problem as long as it is your size.

There is an interesting historical note to saddles. In the 1980′s most bikes would come with a 150mm wide saddle. In the 1990′s most bikes would come with 140mm wide saddles. From the 2000′s most saddles on bikes bought off the floor in a bike shop are 130mm wide. In my experience (dealing with a sample size of over 5000 bike fits), the average male sit bone width is 140mm and the average female is 150mm (again these are my observations), why are saddles getting smaller? The answer here perhaps lies in marketing, a narrow saddle simply looks faster, sleak and less bulky. Coupled with the fact most Pro riders are small and fit 130mm saddles, this width saddle will be the standard that comes with your bike. I find it interesting when I hear cyclists say they love their Brooks or Rolls saddle (the Brooks “narrow” saddle is 150mm) as they are so comfortable compared to other saddles – they have simply found a saddle that fits their sit bone width.

Saddle width is often overlooked when purchasing a bike and in bike fit, getting it right will go a long way if you spend a long time in the saddle.


When you are comfortable, you are powerful.