Pelvic Floor

Clinical Pilates at SPS Castlereagh Street

Clinical Pilates Classes Sydney CBD

Pilates at Castlereagh Street Sydney CBD

Pilates Classes at Castlereagh Street Sydney CBD

We are excited to announce that Clinical Pilates are now offered at our Castlereagh Street physiotherapy clinic! All of the pilates classes and private sessions will be lead by our experienced physiotherapist and Pilates clinician Talia, who will provide a personalised approach to your exercise regime – whatever your fitness or experience level may be.

We are offering a variety of Pilates Classes:

  • Pilates Mat classes: These are ideal for those who are new to pilates, returning to exercise from injury or would like to focus on the fundamentals of pilates and correct core activation. You will work through a variety of exercises on the mat using small equipment to challenge your posture and core control.
  • Pilates Equipment classes: For those of you who have Pilates experience or are wanting to be further challenged on the pilates equipment, these classes progress and challenge your core control with the use of the Reformer, Trapeze Table and small equipment such as swiss balls, foam rollers and hand weights. The class is run as a circuit providing a taste of each equipment in every class. Close supervision to posture and technique is maintained.
  • Pre-natal pilates classes: Our pre-natal pilates classes are suitable to join at any stage of your pregnancy if you have been cleared for exercise. These classes have an emphasis on exercise and education to give you confidence throughout your pregnancy and into labour. Activation of your pelvic floor and deep abdominals will be taught in functional positions, as you work through a variety of exercises using equipment such as the Reformer, Swiss Ball, Theraband and small weights to challenge your stability in different postures. As the class is led by a physiotherapist it is a great chance to manage any musculoskeletal aches or pains you might be experiencing such as treating low back pain.
  • Private (1:1) and Duet (2:1) sessions: These  classes allow for more individualised sessions to introduce the participants to both mat and equipment-based exercises. The fundamentals of pilates can be consolidated and a home exercise program can be developed. These sessions afford you the freedom to book whenever suits your schedule and can be a great way to enhance your current training regime, or get you back into exercise.

To ensure correct technique and to maximise benefits from each session, we have a maximum of four people per class. This allows close supervision and the power to tailor each class to the participants needs.

Clinical Pilates Classes Sydney CBD

Clinical Pilates Classes Sydney CBD

PILATES CLASSES TIMETABLE: Next term begins 26th June 2017

TIME MONDAY TUESDAY THURSDAY
7AM – 7:45AM Equipment
8AM – 8:45AM Mat
12:30PM – 1:15PM Pre-natal
6:45PM – 7:30PM Equipment

 Pilates Classes Pricing

  • Assessment: $136 (45 minutes)
  • Internal Assessment: $FOC (30 minutes)
  • Pilates Pack Private: $655 (45 mins) (Buy 5, get 1 free)

$535 (30 mins) (Buy 5, get 1 free)

  • Duet classes $86 (45 mins)
  • Duet class pack $430 (45mins) (Buy 5, get 1 free)
  • Small group class: $41/class ($328 – 8 week term)

$33/class ($528 -16 week term)

$45 casual class

Reception can be contacted on: 02 9264 4153 or Castlereagh@ssop.com.au for further information or to speak with Talia.

Clinical Pilates at Sydney Physiotherapy Solutions Chatswood

Pilates Classes Chatswood

Clinical Pilates has landed at Sydney Physiotherapy Solutions Chatswood

Pilates Classes Chatswood

Pilates Classes Chatswood

Do you suffer from persistent or recurrent low back or pelvic pain?

  • A 2016 study on back pain and Pilates exercise showed significant improvements in disability, pain, flexibility and balance in patients with low back pain.
  • Multiple studies have also shown altered muscle activation patterns around the low back to be related to acute, and/or persistent low back pain.
  • Pilates exercises teach you how to effectively activate the deep core muscles of your back, abdomen and pelvic floor. Thus, helping to manage the source of your low back pain.
  • We also use real-time ultrasound to assess the activation patterns of your deep core muscles. This allows us to directly assess muscles and provide visual feedback to you.

Our new Chatswood Pilates classes are run by our Physiotherapist and Pilates Clinician, Brittney Marlowe. Our Chatswood pilates classes cater for all experience levels from beginners to advanced.

You will need to have an initial Pilates assessment prior to beginning classes, so we can identify your individual status, your needs and requirements, and goals for the term.

Health  Fund rebates may apply.

Class timetable

Monday 7.30am – 8.15am

Tuesday 1pm – 1.45pm

Thursday 6.15pm – 7pm

 Pricing

Group class (max 4 people per class)

Casual class – $45/class

One term (10 pack of classes) – $40/class (buy 9 get one free)

Private session – $98

Initial consultation – no gap*

Reception can be contacted on: 02 9419 2553 or chatswood@ssop.com.au for further information or to speak with Brittney.

To find out more about our Chatswood Pilates classes contact Sydney Physio Solutions – your local Chatswood physio.

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.

Erectile Dysfunction

In order for men to have good penile health, for the tissue to stay healthy, men need to get erections.

There can be many reasons for men to develop erectile dysfunction but they can be largely broken down into 3 main categories.

Psychological erectile dysfunction.  Depression, anxiety and stress all have adverse effects on erectile function.  The solution?  clinical psychologists, sex therapists, even simple strategies like meditation and relaxation time.

Medical erectile dysfunction. Vascular issues, neurological issues (such as occurs following prostate surgery), hormonal issues…all of these complex factors have to be assessed and evaluated by an experienced GP or sexual health doctor.  Treatments of these issues can range from surgery and medications to counselling that patience and time should improve matters.

Physical dysfunction.  Erections occur when blood moves into the penis and is held there.  Pelvic floor muscles can act as both a pump to move blood in, and as a tourniquet to keep it in there.  Pelvic floor muscles can become weak as we age, which is one reason that erectile dysfunction becomes more prevalent as we get older.  But like all muscles that we have voluntary control over, we have the ability to target them specifically and then expose them to progressive training.  Thats where we mens health physios come into play.

RTUS led training of pelvic floor muscles has started to become the gold standard to show men how to isolate their muscles more effectively, and once you know where they are there are now gadgets like the private gym, a US based product (that has now got early scientific evidence behind it) to help men with pelvic floor muscle training.pg-complete-product-main  Lifting weights has never been so much fun!!!

Prostatectomy Training

Sydney Men's Health Physiotherapy

Sydney Men’s Health Physiotherapy

Incontinence and erectile dysfunction are unfortunately common issues following radical prostatectomy operations for men with prostate cancer.

New research highlights the need for men to focus on improving their awareness of which muscles they are targeting within the pelvic floor before developing strength.  This early motor control is often more readily learnt BEFORE surgery and the right muscles can be easily viewed working using real time ultrasound.

A good analogy is that just hitting a golf ball hard doesn’t always lead to a good outcome…better to work on the golf swing first….THEN you can develop strength.

For more information, contact the Men’s Health physiotherapists at Sydney Physiotherapy Solutions

Continence Foundation of Australia upcoming NSW State Conference

I am very honoured to have been asked to make a keynote speech at the NSW state conference for the Continence Foundation of Australia in May.  Click here to see the program.

I’ll be talking about the role Men’s Health Physiotherapy can play in managing men with pelvic pain.  This is a hugely under reported and under researched area within medicine.  I will be speaking to consultant urologists, doctors, continence nurses as well as CFA members (carers and sufferers too).

I have also been asked to present alongside Dr Vincent Tse, the current president of the CFA NSW, in presenting the current research and practical interventions I make with men with prostate cancer to improve their continence and erectile function following prostatectomy.

Going to be a busy day!!

Banner_-_NSW_Conference_15

 

Pelvis Problems

Pelvis Problems……you say Potato , I say …. Chronic Pelvic Pain Syndrome, Pudendal Neuralgia, Pelvic Dysfunction, Sacro Illiac Dysfunction.

The Pelvis is so misunderstood; we as a society have difficulty even finding a consensus on how to name problems with it. Here are a few names which really mean the same thing –

  • Chronic Pelvic Pain Syndrome
  • Pudendal Neuralgia
  • Pelvic Dysfunction
  • Sacro Illiac Dysfunction

When this confusion is combined with the difficulty some patients have talking about their very personal issues, we are left with poor communication between patients and medical practitioners and often lost and depressed patients.

Patients may see a range of doctors and specialists. In fact it is important that all medical explanations be investigated. Sometimes there is no convincing diagnosis. Sometimes a patient is correctly diagnosed and then sent to a physio/chiro/osteopath who does not treat the issue completely and the results are not good enough.

To treat this problem from a musculoskeletal view the practitioner must have an excellent understanding of the relationship between the thorax, lower back and the pelvis. If this relationship is not good the patient’s core loses the ability to stabilise, and two things can happen. One side of the Pelvis can rotate and irritate the Pudendal Nerve, which goes to the perineum, or the pelvic floor muscles try too hard to create core stability. If the pelvic floor muscles are overused they become tight, develop trigger points and cause pain and dysfunction.

These conditions, or should I say this condition, has symptoms which include:

  • Pain, tingling, numbness, burning and / or sharp stabs anywhere from the anus to the head of penis or labia.
  • The patient may have associated thigh, leg, buttock or back pain.
  • The patient may have urinary problems
  • Men may have pain with ejaculation, or delayed onset of pain post sex
  • The patient may have increased symptoms with sitting

It may be a mixture of these examples

Two highly experienced senior physiotherapists are now combining their knowledge to overcome this problem. Stuart Baptist is a men’s pelvic floor physiotherapist at the forefront of his field. I am a thorax, lower back and sacro-illiac joint physiotherapist who helps both men and women with pelvic problems.

If you are suffering, chances are you can be helped. Contact the front desk, 9252 5770  for an initial consultation.

 

Male Pelvic Floor

Can be broken down into 3 main zones

1. Anal region – this one is the easiest and most often used

ALL MEN KNOW HOW TO STOP  FROM BREAKING WIND IN PUBLIC PLACES – sometimes we just don’t bother making that choice!!

(ACTUAL MUSCLE NAME – LEVATOR ANI)

 2. Testicular region – The feeling you get when you’re walking into the surf on a cold winter’s morning and a big wave comes through and you don’t want your testicles to become submerged … You suck your nuts to your guts….You’re not stopping yourself from breaking wind here, just retracting the undercarriage vertically upwards.

(ACTUAL MUSCLE NAME – STRIATED URETHRAL SPHINCTER)

3. Penile region – A sensation like you are trying to shorten your penis…pulling the head of the penis back into the shaft.  (Possibly the one manouvre that NO MAN TRIES TO DO – who wants a shorter willy?)

(ACTUAL MUSCLE NAME – BULBOCAVERNOSUS)

So…Now you know the basics

Here’s a couple more facts:

We stop urinating voluntarily by contracting from the penile and testicular regions – these two muscles act in opposing directions around the urethra (wee tube) causing an increase in urethral closure pressure (the tube kinks).
If you try really hard to lift any one of your pelvic floor muscles on their own then the anal muscle (levator ani) works hardest of all – which interestingly has the least effect on increasing urethral closure pressure

THEREFORE…

Before you develop strength in the pelvic floor it makes sense to identify which muscle you want to train more accurately, prior to pushing really hard.  (you have to have a good golf swing before you start to swing hard at the ball!!)

How do I use this information?

1.  Target the pelvic floor muscles ACCURATELY – don’t flog them senseless from the get go…. Start gently and slowly try to get a sense as to how these muscles feel subtly different from each other.  Harder faster contractions are ALWAYS less accurate than slow gentle contractions.  If you’re not sure, get feedback on your performance with a transperineal real time ultrasound scan.  Men’s health physios can help you with this.

RTUS

Real Time Ultrasound

2. Give yourself time…it took a while for you to learn the ‘feel’ of driving a car…Don’t be impatient and expect to get things perfectly right first time.  Practice is ALWAYS needed to improve performance – as is good feedback

Once you have mastered the art of locating the pelvic floor muscles then you can start to develop the strength of the muscles moving forwards.

ALSO

You can’t do ANY ‘other’ exercises to make yourself better at locating the pelvic floor muscles…the same way that the ONLY way you get better at driving a car is to get in the car and drive it! You wont get better if you lift more weights or ride a bike!

Sorry for the bad news guys.

 

 

 

Clinical Pilates and lower limb injuries

In 2013, Perrott et al published a study in the Physical Therapy Reviews looked at the correlation between poor proximal control (pelvic & core strength) and lower limb muscle strains. They found that poor core strength can be related to various deficits including; reduced core tone/activation, trunk control, pelvic imbalances, poor balance in general and reduced hip flexibility. When the ‘core’ isn’t working well, forces are transferred differently into the leg and can therefore affect how muscles react to the ground as we push off to run, jump, leap etc.  Overall, this increases the likelihood of the body to compensate and puts more strain on the lower body – i.e we become less efficient with our movements.

The researchers did a meta-analysis of 6 studies that looked at exercise interventions that strengthened the core, combined with other interventions or training and that also reported on the incidence of lower limb muscle sprains. The results showed that lumbopelvic exercises (core exercises) could reduce the incidence of lower limb muscle sprains. Exercise interventions such as Clinical Pilates that look at stability, neuromuscular retraining and agility training are the most effective in achieving this goal.

IMG_1843

Until now the importance of core/proximal control on reducing lower limb injuries has been a theory with little high-level evidence to support it. This study helps give backing to the idea that injuries can be the result of an insufficiency elsewhere in the body.  Ideally, a core strength regime should be incorporated into any exercise regime to optimize energy efficiency and reduce the risk of lower body muscle strains  – if you have a history of such injuries, it can be prudent & beneficial to complement your training regime with a Clinical Pilates regime – this would take into account your history of injury and any specific goals for training – this makes your core regime specific for your needs.

(Perrott M, Pizzari T, Cook J Lumbopelvic exercise reduces lower limb muscle sprain in recreational athletes. Phys Ther Rev 18:1 2013 pg 24-33)

 

Pelvic Floor Muscles – getting the most out of Clinical Pilates

Because the Pelvic Floor muscles are not ones we can see contracting it can be a real battle to know how, let alone if, they are engaged.  This is a hard one to correct, and I think the most common mistake people have is that rather than recruiting theirPelvic Floor they will instead squeeze their Glutes (Buttocks) as if their life depends on it, and end up with overactivity of the Gluteal muscles.

The  result of this can mean that you end up with constant tension in your backside, and unfortunately you’re no closer to strengthening your Pelvic Floor Muscles than when you began.  As your pelvic floor muscles attach to the pubic bone, the tailbone and the two sitting bones the contraction is more of a drawing inwards and upwards between the legs, as if you are trying to stop yourself from passing fluid or wind.

As with training any muscle, the pelvic floor muscles also need to relax between contractions, so do give yourself some recovery time as well.

Please contact SSOP to find out more about our Clinical Pilates Classes in Sydney CBD.

Virginia Sherriff June 23rd, 2014

Pelvic Floor muscles