Virginia Sherriff

Pilates and Lower Back Pain

Pilates for Lower Back Pain

Core Stability Exercise vs General Exercise for Chronic Low Back Pain

It has been well documented that Lower Back Pain, (LBP), is one of the most frequently reported disabilities (affecting between 60% – 80% of adults), we face in the community. Unfortunately, 40% of those suffering with LBP will not fully recover within the first 3 months.

As Physios and Pilates Clinicians, we see this type of presentation everyday.  A common back pain trigger can be from a poor lifting technique.  At Sydney Physio Solutions, we are continuously striving to find the best way of helping to improve the experience and recovery in this population group.

A recent study, published earlier this year, found that people with Lower back pain who undertook exercises to activate and gain control of their deep spinal stabilisers, aka “The Core”, had better outcomes in the first few months of treatment than those who didn’t.

In a nutshell……

  • “Core exercises”, (learning specific & correct activation of your muscles supporting the spine and pelvis), provide a better outcome during the first 3 months of intervention compared to general exercise alone for people with LBP.1
  • People with Lower back Pain (LBP) display a decreased activation or delay in Transverse Abdominus (deep abs), and Multifidus (supporting spinal muscles). Thus core exercises consist of regaining the strength of these muscles through specific training. 1

At Sydney Physio Solutions, all of our Pilates Clinicians are physios, and thus have the ability not only to assess your core in real time via Ultrasound, but can also guide you personally on what exercises will help and how to progress these if you suffer from lower back pain. Using this technology, you can guarantee you are receiving the most up-to-date, effective and evidenced based approach to managing your pain.

Back Pain Exercises: Low Back Pain Relief & Hamstring Strength for Squats

Looking for Physio in Sydney CBD to treat your lower back pain – Sydney Physio Solutions have two centrally located clinics in Sydney CBD as well as a clinic in Chatswood.

Reference:

  1. Brian JC, Kenneth EG, Elizabeth RN, Lindsey EE. Core stability exercise Versus General exercise for Chronic lower back pain. Journal of athletic training 2017 Vol 52 (1) 71-72.

Couch Potato Syndrome

Admittedly, sometimes after a long day at work it is hard to resist the temptation to take the train home and fire up Netflix or the like for  ‘lock in’  & non-stop uninterrupted episodes of Game of Thrones, your favourite sport, or some version of reality TV.  What a way to escape and not have to think about – well, anything…

For many of us now, with access to mobiles, social media and on demand telly, this is becoming more and more common place.  We may not want to admit it, but Couch Potato is not just the hash brown left over form Sunday brunch, but in fact the way we end up through the week and weekends….it is certainly hard to resist when the episodes just keep coming.

Unfortunately, when we spend most the day sitting at the desk or in meetings  and then do the same at home, the body does not often get the level of physical activity it needs to function optimally.  The spine in particular is a machine that is built to move, and often this is where we feel the most aches and pains from sitting too long – especially sprawled over the couch with arms and legs in every direction!

When you sit on the couch – do try and keep your spine in relatively good line and maybe even get a little footrest to support yourself and throw a decent pillow behind your neck to support it – watch for excessive twisting or slumping of the body – then you can have your rest time without getting up in pain!

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Pilates in Sydney CBD

Sydney Physiotherapy Solutions has a dedicated Pilates Studio and expert, caring instructors who are all experienced physiotherapists.

We offer a wide variety of classes from beginner to advanced and have something for everyone. There are private and duet sessions, mat classes and classes utilising the pilates equipment such as the reformer and trapeze table. We also offer specialist classes for ante-natal clients, runners, cyclists and men’s health.

Clients are required to undergo a thorough assessment before commencing pilates with us & this allows the instructor to tailor exercises specifically for you.

Morton’s Neuroma

Pain in the foot?  Feel like there is a ball squashed up between your toes when there isn’t?  Tingling and/or numbness in the toes?  All these signs and symptoms may be linked to pressure building on the nerves of your feet, officially called a “Morton’s Neuroma”.  This is usually a build up of stress around the plantar nerve where it travels between the 3rd and 4th toe, and the tissue surrounding the nerve thickens and compresses the nerve -ouch!

Common culprits for this stress may be shoes that are too tight across the width (therefore squashing the mid foot area) and or too high (which put more load through the toes). People with changes to the foot posture (e.g bunions/flat feet; hyper mobile feet) may be more predisposed to Morton’s neuroma.

So how do I manage this pain?

Sometimes the obvious answer is the best one…by simply offloading the stress and pressure to the toes you can change your pain – if possible, try wearing footwear that doesn’t force all the toes heavily together.  Failing that, certain types of orthotics (foot supports) can be trialled to support the arch and spread the toes – this can offload the building pressure.  Ultimately if these changes don’t improve your pain, a cortisone injection may be advised by your doctor.

Deep Neck Flexors

Deep Neck Flexors – The ‘core’ of the head and neck muscles…

Most of us have heard about our deep core muscles and how they support the spine – ‘pull in your core!” “this will build your core” and we seek out every way possible to train these guys…yet not often do we hear about the deep muscles of the head and neck, aka the deep neck flexors.

The role of the deep neck flexors is to keep the head in a neutral position relative to the neck, so that the head doesn’t drift forward and create stress on the muscles and joints around it – which is often what we see with neck pain and headaches as the load increases.

So ask yourself….

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So – if you happen to catch a side glimpse of yourself and see your head slowly drifting forward, it’s not all doom and gloom. Take a moment to have a look at the video below and start training the ‘core’ muscles of your neck – you will thank yourself for it!

 

Golfer’s Elbow

Golfer’s Elbow

Golfer’s Elbow, aka Medial Epicondylitis, is a niggly condition that affects not only the everyday golfer taking a swing, but those involved in racquet sports, (e.g tennis/squash), throwing, and activities that involve gripping (e.g driving). This may be due to repetitive stress or excessive loading which can build up around the tendons and muscles on the inside of the elbow and forearm.

For some people, you may not see this coming. Over time, what may begin as a low level irritation can soon turn into a pattern of pain and discomfort from the stressed structures, which can lead to pain with grip, weakness in grip and sensitivity to touch. If this is your dominant arm then this can be quite limiting in day to day activities.

med Epicondylitis

But alas! All is not lost! It may just be that your grip technique is off, and this in turn has put low level undue stress to the inside elbow. For example, a lot of amateur golfers can have poor swing mechanics at impact, which can lead to excessive load on the forearm muscles. Simple swing modifications may be all that you need to become pain free. For sports that require a lot of throwing (e.g Cricket or baseball), technique needs to address the power exerted from the ground up through the body. Rest from your aggravating activity, and icing around the elbow may be advised in the first instance to allow any inflammation to settle and structures affected to begin their repair process. A graded and progressive strength programme for the muscles of the shoulder, arm and forearm may also be required.

elbow

Core Stabilisers

“Pull in your core!”  “Use your core muscles!” “This one’s for your core”

Words and phrases you may have heard if you have ever been to a gym class, had a personal trainer or been to your physio for injury management….but what does that mean?  And what muscles comprise your “core?”

Core

Core

Your core stabilisers are made up up of 3 main muscles groups – your Transverse Abdominals (Deep Abs); your Pelvic Floor (a sling from your pubic bone to tail), and Multifidus, (small segmental muscles lining your spine).  Collectively these 3 groups support and stabilise your spine and pelvis to protect from excessive movement and loading.  Think of them like scaffolding supporting an important building – i.e you!

These muscles are not the glory makers like your thighs or glutes…they are slow burners working at a low level in the background, so when activated prior to movement they ensure your movement is smooth, steady and controlled.

Learning to fire these muscles correctly to help your posture, balance and stability takes practice.    If you are unsure on the correct technique, chat to your physio  – they can look at you on real time ultrasound and give you accurate, objective and real time feedback.

Shoulder Injuries in Tennis

Shoulder pain & tennis players seem to go together! With the ATP World Tennis circuit well underway, we can almost always guarantee at least 1 of the top 10 Men or Women players will suffer from a shoulder injury. Rafael Nadal, Andy Murray & Novak Djokovic have all had shoulder injuries in the last few years. This is not surprising when you take the age old issue of  training overuse and repetitive stress on the shoulder, and add to that the sheer power of serving up to 200kph on match day.

Rafael Nadal - service

Rafael Nadal – service

Records show that most commonly these players will suffer irritation to the soft tissue structures around the shoulder joint, which can lead to inflammation, shoulder pain, and the inability to play.

For the average Joe, (like me!), tennis shoulder injuries are more likely to occur from poor form (boo!), poor technique, or poor shoulder strength and stability (yikes!).  If in doubt, before dusting off the old racquet it may be worth having a quiet word with your local tennis instructor, or even your physio…..you will thank yourself for it!

Osteoporosis – how to look after dem bones…..

I am sure we have all heard of Osteoporosis, and I am sure one of the first things that springs to mind for most of us is, well, that is just happens to older women who mysteriously develop ‘frail and weak bones’.

Delving further into this, I was interested and slightly surprised to read  that in Australia, Osteoporosis affects more than 1 million of us, with one quarter of those being men.  It is also reported that another 6 million Aussis have low bone density (their bones are less strong) which can lead to bone disease and risk of fracture.

So what exactly is Osteoporosis?

Osteoporosis is a disease that leaves our bones more fragile and brittle and thus at risk of fracture and stress.  This occurs when the supply of certain minerals such as Calcium, is not met by the demand that bone needs to remain strong and healthy.

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What are the Risk Factors?

For women, a rapid drop in the hormone Oestrogen following menopause can lead to a subsequent drop in Calcium, and thus render them at higher risk for Osteoporotic change and more rapid loss of bone density (toughness).  Once this occurs, our bones are more at risk of fracture (breaking) with even a minor bump or fall.

In men, a drop in testosterone levels can have a similar effect on bony strength and toughness.

Family History, low calcium and Vitamin D levels, certain medical conditions, smoking and excessive alcohol intake and not doing much physical exercise can also be potential contributing factors.

Prevention

It is never too late to address any risk factors that you suspect may put you at risk of Osteoporosis – maintaining adequate levels of Calcium and Vitamin D will certainly help to improve your bone strength.  These can easily be tested for by your GP and managed from there.

Regular physical exercise is also great way of improving muscle mass and building strength in your bones.  Specific weight bearing exercise (on your feet, putting weight through your bones) and resistance (weight) training are really good ways of helping your bones and your body stay strong – and you don’t have to go to a gym or be Popeye to achieve this!

Going for a brisk walk, dancing; playing tennis/netball/basketball or even taking the stairs more often can help.

walk_edit

Reference:  http://www.osteoporosis.org.au/

 

Posture & Pilates – how do they relate???

As both a Physiotherapist & Pilates Clinician, I often hear the comment from my patients “I know I have bad posture’, which is followed swiftly by “how do I improve this?” so I thought I would just take a moment or two to cover a few of the basics, and how we integrate posture exercises in the Pilates Studio.

1.  Begin with your ‘Neutral Spine’ position

  • What is that?  Neutral spine is the term used to explain the correct alignment and posture for the spine, and it all begins around the lower back and pelvis
  • Why?  By setting the body into a neutral position, we immediately offload the discs, joints and muscles around the back, and set up a really good foundation for the rest of the body to move from.

Without correcting and setting your lower back into a neutral position, you may find this leads over time to injuries not only of the back, but also the hips, knees and feet.

  • But how?  I think the best way to explain (and practice this) is lying on your back with knees bent – then roll the pelvis so your spine flattens to the floor, roll forwards to create a big arch, and then find your middle ground between the 2 – this should align the ribs and the hip bones.

No matter what position you are in, weather this is sitting, standing or lying – you can always use this method to help find your neutral spine and set correct postural alignment, which is a fundamental aspect of any Pilates programme.

So how do good posture and Pilates link together?

Pilates exercises and teaching always begins with setting neutral spine and correct posture – crucial for offloading muscles and joints of the body and optimising efficient movement and breathing.

Understanding your own posture, and how you set your pelvis and spine should give you a good idea on what you need to work on, and what muscles may need stretching or strengthening, which is where your Pilates programme can certainly help.