Draft term break timetable is subject to change. This timetable will run for 2 weeks only in weeks commencing 11th and 18th April, 2016.

Classes are recommended and scheduled for

• intermediate and advanced Pilates

• pregnancy Pilates.

City to Surf in August…here I come!

Last month we talked about all of the posture tips for running to prevent injury and make your running style super efficient. Have any of you started to utilise at least 1 or 2 of the postural cues when running (or even walking)?

Here are a few more things to consider before you head out and start your training for the City to Surf or May SMH Half Marathon! (or to walk the dog each night).

• Treat for your feet.

The ultimate key to success is having the right running shoes! It is always a good idea to get your shoes chosen and fitted by a qualified professional. As physiotherapists, we work closely with podiatrists and therefore get the inside intel on the leading shoe brands. Currently Brooks, New balance and Mizuno are making top-notch running shoes.

However, there are various styles in each brand, for various terrains, for various foot types. Therefore getting your shoes fitted by someone with the ‘know how’ is a must!

• Run on the right surface

Running on the right surface can help you avoid those niggly injuries, and is especially important if you are new to running or if you are returning to running after a period of time off. The perfect terrain is level, not too soft nor too hard. Sand and grass can often be too soft, cement or road often too hard. The best by far is running on man-made dirt tracks, such as compressed gravel, stone aggregate or cinders tracks.

These ideal terrains may not be so easily on your door step, so try to mix up your surfaces to keep your body adapting and not loading up too much repetitively.

• Don’t over-stride

Research strongly supports increasing your cadence (number of strides per minute) and shortening your stride length. This has been shown to improve your efficiency and performance, and is associated with reduced injury rates. Therefore keep your strides short, and if you want to improve your pace increase the number of strides you take per minute, rather than lengthening your stride. It is said that a cadence that is ideal for everyone running is between 80-100 steps per minute. Get counting!

• Why not start with interval running

For both new runners and those returning to running, to ease your way back into things, why not start with interval running? Interval running is a fantastic way to return to running gradually and avoiding fatigue and overload related injuries. The following is an example of an interval running program:

Week 1

2min jog, 4 min fast walk x6

Week 2

4min jog, 4min fast walk x4

Week 3

6 min jog, 2min fast walk x4

Week4

10min jog, 2min fast walk x3

There are also plethoras of running apps that can be downloaded, often for free that can take you through a graded jogging program. I have had friends successfully work their way through the Couch25k app. This app talks you through a 9 week interval training program to have you running from nothing to 5ks in 9 weeks. You can even load up your own favourite motivating exercise music to listen to whilst being directed by the wonderful voice over.

• Do the ‘prehab’!

It is always a good idea to condition your body prior to return to running. This can be done by performing specific exercises that target the essential muscle groups. The muscles of the core and buttocks are vital to running, as they provide your legs with a stable and level base from which to move under. Here are some early stage core and buttock exercises to get you started:

• The Leg Roll In and Out. This exercise has you thinking about the stable pelvis and the deep set of muscles within the deep abdomen and pelvis. Applying this muscle ‘feeling and awareness’ when running will build resilience about the pelvic platform, hips and spine.

• Clam. This exercise builds strength, awareness and endurance in the lateral hip area and a muscles specifically called ‘gluteus medius’. This muscle controls the hip joint within the pelvis, and prevents the awkward side to side drop of the pelvis seen in some walkers/runners. Weakness in this muscle can cause lower back pain, hamstring and ITB injuries and knee pain.

• Lunges. This gets you up and on your feet, putting it all together. Running has you needing leg strength, hip control and pelvic control and lunges have you thinking about all of this. Take your time and work that lower body. Try fixed feet lunges and then progress to stepping lunges to make it even more dynamic and like running.

If you would like a personalized program or the above exercises progressed to higher level running specific exercises please contact your Fix Program physiotherapist.

Leg Roll Out and In.pdf (151.3KB)

The Clam Exercise finding deep bottom muscles.pdf (191.6KB)

Deep Lunges.pdf (118KB)

www.c25k.com

12 easy nutrition tips to ease endometriosis and pelvic pain

Last month, I wrote about how hands-on women’s health physiotherapy is effective for women who suffer from endometriosis. This month I cover some practical nutrition tips to manage the pain and symptoms associated with endometriosis. This is information I provide as a Women’s Health Nutrition Coach to my patients with endometriosis.

In endometriosis and chronic pelvic pain conditions, there is often a repetitive inflammatory process occurring within the pelvis. Pain is often a cardinal symptom of inflammation and, without getting too technical, the presence of something called “cytokines” in the body suggests inflammation. Interestingly, research shows the presence of several inflammatory cytokines in women with endometriosis.

So, what do pain, inflammation and inflammatory cytokines have to do with endometriosis?

Well, understanding this process provides the basis for why an anti-inflammatory diet is important in managing this disease. Certain foods have been proven to reduce inflammation and these are recommended for women with endometriosis. Knowing this makes it easier to stick with dietary changes, because ultimately you are not just reducing your symptoms but also reducing the growth of the disease. So let’s get into the anti-inflammatory foods.

Some general anti-inflammatory foods that you can simply begin to incorporate into your diet and cooking include

• lime zest
• mushrooms (button, oyster, honey-brown, shiitake, enoki)
• sweet potato, onion (be careful with this if you have IBS and are sensitive to FODMAPs)
• Thai spices such as kyeng, dill, kaffir lime, chilli, teaw, sweet basil, pea eggplant
• other herbs and spices that are anti-inflammatory including curcumin (turmeric), ginger, cinnamon, cloves, oregano and sage.

Please bear in mind that every woman with endometriosis is different and a blanket diet cannot be given to every woman. A woman with endometriosis may have other concurrent conditions that would warrant other dietary modifications. This could include irritable bowel syndrome, interstitial cystitis, poly-cystic ovarian syndrome and pudendal neuralgia.

There are some general recommendations that are given for women with endometriosis. These suggestions can include

• ensuring you have clean protein, healthy fats and fibre at every meal

• going gluten-free. More and more research is showing significant improvements in women who stop eating gluten. Gluten ranks as one of the highest toxins for women with endometriosis. Simply going gluten-free without any other changes can be enough to reduce pain significantly.

  Some women can also be sensitive to other grains, but if not, you can enjoy brown rice, buckwheat, quinoa and teff as alternatives.

• limiting soy. Pelvic pain is found to be higher in women who regularly eat soy. If you need to have soy, its best to stick with low amounts of non-GMO, organic, fermented whole soy foods.

• limiting diary. A lot of women with endometriosis have developed sensitivities to dairy. This can be sensitivity to lactose, which is a sugar found in dairy, or sensitivity to casein, which is a protein found in dairy. Dairy can cause inflammation which can lead to pain.

  Simply substitute for non-dairy alternatives e.g. almond or other nut milk, rice milk, coconut milk, coconut yoghurt, coconut cream and coconut ice cream. Grass-fed butter is usually well-tolerated.

• limiting sugars. Processed and refined sugars wreak havoc on the gut. Switch to coconut sugar or pure maple syrup for sweeteners. If you have a chocolate addiction try Loving Earth brand of chocolate instead.

• limiting coffee and alcohol.

• enjoying increased high omega-3 fatty acids. Foods that are high in omega 3 are your powerhouses of anti-inflammatories. They can even be used as an alternative to pharmaceutical NSAIDs!

  For example, flaxseeds/linseeds, walnuts, brussel sprouts, cauliflower and fish such as sardines, salmon, tuna, blue mackerel, gemfish, shrimp

• increasing your vegetable intake. Have rainbow colourful vegetables at every meal, making sure you have lots of green leafy vegetables. Sulfur containing vegetables and cruciferous vegetables help with estrogen detoxification. This is found in broccoli, brussel sprouts, cauliflower, kale, leafy greens and cabbage.

• increasing your fibre intake. This is effective for estrogen detoxification. Simply add chia seeds or flaxseeds to your meals. Your goal here is 35-45g of fibre per day.

• increasing your antioxidants. Foods high in Vitamin C are very effective for reducing inflammation. These can include papaya, bell peppers, broccoli, brussel sprouts, strawberries, pineapple, oranges, kiwi fruit, cantaloupe and cauliflower.

• drinking lots of water and tea. English breakfast and green tea are anti-inflammatory teas.

• taking probiotics. Cycle between 3 different brands of quality probiotics every 3 days for optimal gut health.

So there you have it. Twelve tips to reduce the pain associated with endometriosis. You can start your journey to a healthier pain-free life by adopting these nutritional strategies.

If you would like more personalised nutrition coaching for endometriosis or pelvic pain, you can enquire with one of our women’s health physiotherapists at The Fix Program.