Tanya Bowden

The Pains of Pregnancy

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Aaaaahhhh the joys of being pregnant! That mystical glow everyone tells you about! Those warm fuzzy feelings of joy and excitement as you feel your baby moving and growing…. A carefully selected and nutritionally balanced diet to supplement and nourish your tiny developing human… Your body has never felt better right?

Not necessarily!

As I approach my final weeks of pregnancy, I feel it is my duty as a Physiotherapist to talk you through some of the not so warm and fuzzy joys of pregnancy. The one’s that your Physiotherapist can help you out with to make your pregnancy experience more of a ‘glow’ and less of a ‘blow’……

  • Muscle Cramps: Now this was one that nobody warned me about! A new level of pain that I can only imagine occurs to prepare your body for the impending painful trauma of childbirth….. If you have been woken in the middle of the night to experience the terror of your calf muscles trying to tear themselves free of your shin bone, then you will understand! It is thought these are most likely caused by a combination of fatigue and the effects of pregnancy hormone. But don’t despair – a number of things can help! Staying hydrated and taking Magnesium tables are top of the list. But your Physiotherapist can help too. Your Physiotherapist can use a combination of stretches, massage and dry needling to help alleviate muscle tension. The following is a handy calf stretch that you can do before going to bed:
  • PF2
  • Pelvic Pain: As your little bundle grows you will find there is increasing pressure on your pelvis. Your body is also preparing for childbirth via the production of a hormone caused relaxin. This will cause your ligaments to increase their laxity and results in decreased stability around your pelvis. You may experience pain anywhere around you pelvis but in particular near the pubic symphysis or the sacro-iliac joint. Your Physiotherapist can assess your pelvis and make any adjustment if needed. They can also arrange a support belt if it is appropriate make you more stable and decrease the pain .
  • Lower Back pain: The increasing bump on your front can often lead to an increased lumbar lordosis (or curvature of your lower back). Not only does this affect the biomechanics of your spine, it will also tilt your pelvis forward and can lead to tightness of your hip flexor muscles. The increasing load and changing spinal curvature often leads to lower back pain and in some cases, sciatic nerve pain. Your Physio can give you some exercises and stretches to counter this and will have a range of different treatment techniques they can use to help manage your pain.
  • Exercise: Many pregnant women become quite anxious when it comes to exercise during pregnancy. In fact, there is a lot of evidence to support the many benefits of exercise during pregnancy for both you and your baby. The key is to do the right kind of exercise. The most important factor is exercise intensity. Particularly in your first trimester, your baby is unable to regulate body temperature which means you need to be careful of over heating. Heart rate monitoring is less accurate during pregnancy because of the changes in blood volume and blood pressure. The best measure is the talk test. As long as you can talk comfortably while exercising then you are unlikely to be over exerting yourself.
  • Cat Stretch
  • The other thing to be aware of is the type of exercise. Low impact exercise such as swimming and gentle exercise bike are great – particularly if you are suffering with pain. Walking is also fantastic if you are not too sore. Pre natal pilates is something your Physiotherapist can help you with to maintain spinal mobility and work on your core and pelvic floor muscle strength. Finally don’t forget to train your pelvic floor! 10 reps of 10 second holds daily is the recommended amount. If you are not sure about your technique then check with your Physiotherapist beforehand.

The Worst and Best Shoes

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We’ve all heard of the phrase ‘beauty is pain’, but could you shoes be destroying your feet?? The answer is Yes! Here are my 5 top shocking shoes……

  • The higher they are – the further you fall! Or roll….. Ankle sprains and nasty fractures often result from a lateral roll of the ankle when wearing heels. The heel height alone puts extra stress on the ball of the foot (see pic above) and shortens the achilles tendon. In fact, some women who have been wearing heels for a long period of time find it hard to get their heel to the ground when not wearing heels! Thats some serious foot fauxpas! The solution? Go low….. the lower the heel the more natural the foot position.
  • Beware the stiletto heel! Pinpoint heels a have a smaller the base of support and result in a greater chance of you wobbling around like a baby giraffe on stilts! What this means is that there is much more of a chance of tripping, rolling or slipping! The solution? Opt for a more chunky heel which will better distribute your weight.
  • The next type of dangerous shoe is the pointy toe heel! Not only do you have to deal with the effect of the heel – the triangle shape of it forces your forefoot into an unnatural position and can result in the development of unsightly bunions! (see pic above). The solution? Pick a heel with enough space for your forefoot – or at the very least one which goes triangle shaped after your toe line!
  • On the flip side of the stiletto you also need to watch out for the completely flat shoe. Those are the ones with zero arch support. This covers the ballet flats and the thongs (or flip flops for the British). The lack of support here makes your foot quite vulnerable to developing plantar fasciitis – a painful condition involving inflammation and sometimes tearing of the connective tissue underneath your arch. So if you opt for these type shoes – make sure you add some support (ie in the form of an orthotic or a thong with some built in arch support).
  • The final shoe I’ll ruin for you is the hard soled wedge! Although these offer a much nicer support base – the rigidity of the wedge can restrict normal movement of the foot. Try to choose a wedge with a little flexibility to counter this.

So when all is said and done…. most of the shoes that look amazing on the catwalk are not so amazing for your feet. As I said earlier… beauty is pain so choose your shoes wisely! Wearing these not very sensible but ever so sexy shoes will not do too much damage if worn in the short term. In saying that you need to be aware of long term use and day to day poor footwear choices! Your feet will thank you for it……

shoe fall

Top 5 Exercises for Golf – warm up for your best game!

Golf

There are plenty of great exercises you can do to build strength and flexibility specifically for golf. The exercises you do to warm up pre game are all about preparing your body to play and optimising your results!

This means warming up the right muscles, increasing your body temperature and practising the movement patterns required to bring out your best game. Ive picked the following 5 exercises as the ones that I think are most beneficial.

Before starting the exercise, warm your body up by having a 3-5 minute walk. Then:

1. Squats with golf club: Hold your club out in front of your body (hands shoulder width apart and club at shoulder height). Sit back into your squat as you lift your club up above shoulder level with both hands (stretching shoulders). Remember with your squat to keep the weight into your heels and your back in a nice neutral position (no bending or over arching through spine). This exercise with loosen up your shoulders as well getting some blood pumping into the leg and butt muscles.

Repeat x 10

2. Shoulder Mobilisation: If you have no shoulder problems, take the club in one hand (at the handle), and lift it up and over then behind the back (see pic). Your other hand then reaches behind the back to hold the club at the other end . Release with the top hand and take the club from behind the back and back around over the top. Continue to pass from one hand to the other (like a figure 8 movement). Repeat x 10.

province-flexibility-golf-shoulders

 

3. Leg swings: Now to think about loosening up those hip flexors. We know dynamic stretches are better pre game so get that leg a-swinging! Hold onto a fence or your club for support and then start with small leg swings back and forth. Increase your swing as the muscles loose up! Repeat swings x 10 per leg

4. Thoracic rotations: Next, place your club across your shoulders behind your neck (hands slightly wider than shoulders). Then bend the knees a little and lean slightly forward at the hips (similar to your swing position). From here, rotate from one side to the other – aim to get your club in front of your body with each turn. Repeat x 10 per side.

5. Practise swings: Go light with this. Spend about 2 mins practising your swing technique. This will get your body prepared for the movement and allow you to focus on your technique briefly pre game.

The you are good to go…. All set for the game of your life!

 

Is Your Smartphone giving you Text Neck

Preventing-Text-Neck_Dec-2014

Love your smartphone? Or do you find it a pain in the neck, literally?

What a pain in the neck these smart phones are becoming!! The past few years has seen a steady rise in the number of reported neck pain cases….. and smart phones are playing a significant role!

Text neck is a repetitive strain injury that’s becoming more common as more people hunch over smartphones. Aggravating muscle pain in the neck and shoulders, and sometimes lower back, is occurring even in teens and adolescents.

The posture adopted when looking down at your phone causes a change in force to your neck. The forces increases 6-fold as you take your neck from a neutral position (that is looking straight in front), to a flexed positioned of 60 degrees (that is a chin to chest position).

The end result is additional strain to the neck muscles. The pectorals and upper traps can become tight and sore, and opposing muscles such as the deep neck muscles and scapula muscles can become weak.

Smart phones are not going to go away, that’s one thing we can say for sure. However there are some exercises below to relieve the pain in our text neck.

1. Straighten up and improve your posture. Your ear should be in line with your shoulder – not in front.

2. Stretch out into extension and reverse your posture. Trying lying on your stomach and pushing up into a cobra stretch.

3. Hold your phone or device at eye level – even if just for short periods.

4. Give yourself a break and get off your phone! The world will not come crashing to a halt if you give yourself a break from your phone….

If pain persists be sure to see your Physio for treatment and further advice regarding specific exercises or contact the team at Sydney Physiotherapy Solutions to make an appointment at either of our Sydney CBD physio clinics or at our recently opened Chatswood Physiotherapy clinic.

Back Pain in the Workplace

Sitting at work all day can be a real pain in the b….. ack! Literally!!

Our bodies are not designed to stay in one position for long periods of time – we need movement to keep our joints and muscles happy and prevent the build up of lactic acid.

Sitting with poor posture for long periods of time is one of the biggest factors when looking at back pain in the workplace.

Here are a few simple things you can do to minimise back pain while working:

1. The most important thing is to move regularly! It doesn’t have to be a big break – small frequent breaks from sitting is more effective than 1 long break! Try to get up at least every 30 minutes – even if its to stand up and stretch for a few seconds before sitting back down.

2. Try to do some stretches throughout the day – there are lots of stretches you can do but the main thing is to try and reverse the posture that your body had been stuck in…. for example if you are sitting with your spine bent all day – try to extend or reverse your spine as a stretch (you can lie on the floor or just stand and extend).

Extension stretch

 

3. Check your chair or arrange to have an ergonomic assessment. An assessment will look at the position and support given from your chair, the position of your computer screen, mouse and keyboard, as well as the height and general layout of your work station.

If you have persistent pain or pain referring into your legs then be sure to check in with your Physio for a complete assessment.

Tips to stay motivated in winter

Winter is creeping closer and staying fit and healthy can become more of a challenge!! The dark, cold mornings and red sniffly noses can make those training goals just seem a little further out of reach…..

One way to stay a little motivated is to pick an exercise goal or event and then set a plan to keep you honest!

You may want to get involved in the Sydney Running festival and train to do a running event! There are plenty to choose from…. Here are a few pointers:

– Give yourself enough time to plan your training schedule. If you are already a runner – give yourself at least 8 weeks to prepare for your event. If you are new to running – allow yourself 12 weeks to work up to it.

– For longer events try to do 3 runs a week. That’s one longer run and 2 shorter runs. The shorter runs can include some speed work or interval training.

– Remember the 10% rule as a general guide – gradually increasing distances by no more than 10% each week.

– Remember the importance of cross training and strength work. Cross training is good in the prevention of overuse injuries and strength is so important for long distance running.

– Stay healthy! Eat well and stay hydrated. You are less likely to end up sick and out of action….

– Finally, don’t let niggles turn into injuries! See your Physio early for any problems and get a running assessment if your have poor running form or are new to the sport.

 

 

Shoulder Pain and Body Posture

Lets face it – shoulder pain and desk jobs go hand in hand! If you spend several hours a day working on a computer, you may unconsciously find yourself adopting poor postural habits such as hunching over your keyboard. This position is usually a sign that you have a tight chest and a weak upper back.

Over time, this type of bad body posture can contribute to you developing a rounded upper back, a condition called kyphosis, which can cause shoulder pain and upper back stiffness and pain.

upper crossed

In the Physio world we often see this ‘upper-crossed’ pattern of poor posture that you can see in the above picture.

So rather than getting ‘upper-tight’ (and uptight) about it – do some shoulder exercise to correct it! Stretches for the chest and upper trapezius in the upper back &  neck will allow your shoulders to come back and be better centred in the joint.

Add some strengthening work for the deep neck flexors and back muscles and…. voila!!!! Better posture and less shoulder pain.

If you do continue to suffer from shoulder pain contact one of our shoulder specialists who are part of the team at Sydney Physio Solutions.

The sling systems of the body and functional movements

The human body is truly an amazing machine! We are all aware that our bodies have muscles, nerves, fascia, bones etc….. These allow us to move, lift, produce force and get about our daily activities. But when we look a little more closely, we see that the body is a complex system consisting of many different chains. When we injure our self – we can often create a dysfunction or a weakness in a particular chain. This can then go on to create problems with the way we move or perform tasks.

These chains that I am talking about are often referred to as slings. Physiotherapist Diane Lee identifies 4 main sling systems within the human body.

slings

The top picture is the posterior sling, the middle is the anterior sling and the bottom picture is the lateral sling. The posterior sling is an important one, as we use this sling to drive movement in walking and running. As you can see from the picture below, the glute max muscle works with the opposite lat dorsi muscle during the push off phase of walking or running. This combined contraction counters rotation and produces tension in the fascia joining the two muscles. This allows the system to work like a spring as it stores energy and also stabilises the sacroliliac joint (the back on the pelvis). It’s very clever!

running posterior sling

Sometimes people who have sustained injury to the hip, back or shoulder will need to retrain these muscles as a system in order to return to full function – particularly if they are keen to get back into running. This is just one of many examples of how the body works in this way. Pilates is a great way to retrain dysfunction within all sling systems to allow efficient movement and peak performance.

Getting pinned down by the silly season??

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Its that time of the year again and oh how much fun it is! One week to go and already I can feel the stress of the silly season building in my muscles and bulging over my belt……

I came across a few handy little tips to stay healthy and happy over the Christmas season that I really liked. Thought I’d share as Im sure Im not the only one who can get a little carried away at this time of the year…….

  1. Detox your system. We all know Christmas is not an ideal time to lose weight, so take care of yourself in the run up to the big day. By eating healthily and staying active beforehand, you will take on Christmas week feeling super energised!
  1. Plan ahead. Dinner invitation at 7pm? Buffet at the office party at 9pm? Have a light, healthy snack beforehand to banish cravings. Who can say no to Christmas treats when they are starving? Not many! By filling up beforehand you can limit the damage.
  1. Fit exercise into the holidays. I know it’s difficult, but even just 15 minutes of activity a few times a day will help to keep you feeling energised, and go some way towards burning off those mince pies! Tinned fruits make for great weights, and jumping jacks can be done in front of a Christmas movie!
  1. Water, water water. It will keep you feeling fuller for longer, hydrate your system and if you’re drinking alcohol too – water in between each drink will cause you to drink less of the hard stuff and combat tomorrow’s hangover!
  1. Learn about food substitutions. Eating healthily doesn’t mean you have to miss out – just make smart replacements. Choose fruit as a starter instead of pate; use lower fat custard in the trifle; or offer to bring a lower fat version of a dish that could be a diet disaster.
  1. Smaller portions. You can sample different dishes or desserts, but keeping the portions small keeps the calories lower. Plus, who doesn’t want to try 3 small plates of different dishes as opposed to one larger dish?
  1. Do things you enjoy. Christmas is a stressful time for everyone, no matter how organised you may be. Yet, it is a time to be spent with family, friends and merriment! So make time for the things you really love this Christmas.
  1. Do something for someone else. It is the time of giving, right? So why not offer to pick up a friend’s turkey, visit an elderly neighbour for a cup of tea or bake some Christmas treats for the office. Doing something nice for someone else will give you more satisfaction than any gift!

So enjoy the festive season everyone and take care of yourselves!

(tips from www.tescohealthandwellbeing.com)

Dysfunction of the Sacroiliac Joint – Back Pain

The SIJ is the joint between the sacrum (which is at the base of the spine) and the two halves of the pelvis. This joint allows for a very small amount of movement, which can become painful and unstable if the movement is not well controlled.

pelvis 1 pelvis 2

The SIJ is believed to be the cause of lower back pain in 15-38% of cases and provides attachment for approximately 30 muscles around the back and pelvis. Dysfunction occurs as a result of failure to transfer load effectively. The important muscles involved in the force closure of this joint includes our pelvic floor muscles, transversus abdominus and the glute max and obliques (which make up the posterior sling).

pelvis 3

 

The following are signs of SIJ dysfunction:

  • Pain maps: never above L5, may refer down leg
  • Patients may describe as sciatica
  • Pain is recurring, triggered by bending, lifting
  • Commonly idiopathic
  • Initial episodes may be caused by: pregnancy, trauma from fall or motor vehicle accident, hard braking, transverse force on pelvis
  • Worse when loaded, eg standing, walking
  • Possible changes in bladder habits

In order to manage SIJ pain, it is wise to avoid high load activities such as hopping, jumping and running. Soft tissue techniques such as massage, heat packs, stretching and dry needling can be very effective is releasing tight muscles and decreasing pain. During pregnancy, support belts can also be useful.

It is also a good idea to consult your Physiotherapist who can identify and treat contributing factors including specific muscle weakness, imbalances, leg length differences, postural factors and overall biomechanics and running technique.