The draft timetable may be subject to change. This is a 10 week term of classes, running from the week commencing Monday 25th April and ending week commencing 27th June, 2016.
Please note that there will be NO classes on Mondays 25th April and 13th June due to public holidays. Monday’s classes will therefore run as a shorter 8 week term. Payment will reflect this accordingly.
Classes available for
Stretch & Relax
Clearing the confusion around arthritis
As a physiotherapist, I am always explaining the differences between osteo and rheumatoid arthritis. There is a common misconception that they are the same disease, however, they are very different.
When reading through X-Ray or MRI reports together with my patients, this discussion about the differing arthritis conditions typically arises. These scan reports speak of ‘degenerative changes’, ‘bony spurring’, ‘osteophytes’, and ‘osteoarthrosis.’ These words all sound a little scary, don’t they? However, it is often said that if each person over 40 were scanned from head to toe, there would be these changes in every one of these people in at least one of their joints. It really is a natural part of aging and shouldn’t be viewed as a catastrophe!
Practitioners, doctors and those with these X-ray changes should really look to the associated symptoms felt at these affected joints (if there are even any?) before rushing to blaming these findings as the cause of pain and dysfunction. Often investigations such as scans like these can show the presence of ‘degenerative changes’ but without any associated pain or other symptom. Scans really should be read and used with caution for this very reason.
Let’s look in more depth at the main characteristics of osteoarthritis (OA) this month. In our next newsletter, we will explore rheumatoid arthritis (RA).
The 5 features of osteoarthritis.
OA is the most prevalent type of arthritis with a report from the Australian government from December 2015 reporting that self-reported OA is as high as 1 in 13 Australians. Of these, every 2 in 3 are female. It is not at all common in children and comes with ages over 40.
OA is also known as the ‘wear and tear’ arthritis or degenerative joint disease. It is mostly found in the fingers, thumb, big toe, lumbar spine, hips and knees. It is most painful and symptomatic in the hips and knees. When someone is off to have their knee and/or hip joint replaced, they are typically receiving new stainless steel or titanium joints to replace their old worn out ones from the degenerative process of OA. The before mentioned Australian government report states that there was a 32% rise in total knee replacements from 2004 to 2014.
OA is caused by the slow breakdown or erosion of the cartilage which lines our joints. This cartilage acts as a cushioning between the 2 bones making up a joint. The cartilage allows for the smooth sliding of one joint surface over the other as we move and can absorb impact and pressures like a shock absorber. If a joint is used too much or has excessive loading such as with some repetitive movements of sport or from carrying too much weight, the watery composure of the cartilage breaks down almost to the point of bone rubbing on bone. This stimulates the body to respond, changing the affected joint’s muscle and bone. This is where thickening of the soft tissue or the growth of bone spurs will occur.
Bone spurs- also called osteophytes- are the body’s clever response to the bone on bone abnormality of an affected arthritic joint. The exposed bone within the joint can become inflamed and this stimulates further bone to grow around the edges of the joint. It can be thought of as the body trying to increase the surface area of the joint to spread the pressures and stresses across a greater area. Unfortunately, some osteophytes can cause problems, but this is not a blanket norm. In some joints such as the small facet joints on the spine, bony spurring can restrict the space of a nerve canal, causing possible irritation of the nerve. Another problematic spurring of bone can be at the big toe. Generally bone spurs themselves are not problematic, but they are a signal of an underlying problem that often needs to be addressed. They can be documented to help assess the severity of a condition such as arthritis.
OA is characterised by stiffness and limited movement in the affected joint. Initially, pain is felt after activity and settles with rest. There may be some stiffness in the morning, but this is mild and lasts less than 30 minutes. As the OA worsens, the joint may become enlarged and tender due to bony spurring. Tis can affect pain free movement and alter the mechanics of good movement across the region, making everyday activities such as walking difficult.
How can exercise like Pilates assist with pain associated with osteoarthritis?
As OA is a ‘wear and tear’ disease that is associated with aging, often is cannot be helped. However, its progression or severity can be altered with a few practices.
Exercise is a well documented management for those suffering from OA. This is a broad statement and to dissect it a little is time well spent. Here are some points to consider:
Confused?
So, for those of you with OA or any painful joint, you need to move, strengthen your muscles but without repetitive excessive loading on your sore joints.
There is still so much choice for you to keep up the exercise. Why not try:
Feel free to chat with our physio team if you need guidance and treatment for your painful joints.
Picture the cylinder that holds your spine and pelvis strong
We know that visualisation is an amazing learning tool. Picturing a concept or an idea can allow the brain to interpret or reinforce new ideas being learned. Seeing muscles and joints in the body can help you to understand the workings better. It may even have you feel the muscles working better if you can picture them activating. This can be very much so in the deep ‘core muscles’ of the lower trunk and pelvis.
This illustration above may assist you in getting your head around the muscles we are always talking about in your Fix Program classes. These muscles form a part of your body’s postural control system as you go about your day. The very same deep muscles that stop your bones from falling to bits and the cause of our many aches and pains!
In our Pilates classes, you will hear us repetitively saying:
“Breathe in deep and wide, and as you exhale, imagine gently lifting your pelvic floor ( feeling your’ pebble lift from the pond’) and become aware of the front hip bones drawing towards each other”
The ‘cylinder’ of lower trunk support
When looking at the picture above more carefully, and if using your imagination a little, you will see that the 4 sets of muscles make a cylinder-like shape. After looking at these muscles, try to picture a basic cylinder in your mind. Now place the diaphragm on top of your cylinder, the pelvic floor muscular sling on the bottom, and wrap the transverses abdominus ( deepest of the abs) around the rest. This cylinder fills the circumference of the lower half of your trunk, from the lower ribs to the base of the pelvis. Multifidis is another deep postural muscle that ‘laces up’ through the spinal vertebra and completes the picture.
Visualising this muscular cylinder can really help you to ‘find’ and activate your pelvic postural muscles better.
So, now that you can visualise your muscular cylinder, what comes next?
With the cylinder of muscles now pictured better in your brain, you may start to locate, contract and strengthen your ‘core’ even better than you thought. Why not try connecting your cylinder picture with the instructions you hear at class.
When looking at the diaphragm sitting at the top of cylinder under your lower rib cage, picture your diaphragm descending downward slightly into your cylinder as you breathe in ‘deep and wide.’ As you exhale the diaphragm moves upwards to its starting position.
When picturing the diaphragm ascending as you exhale, you may see now that this creates a vacuum within the cylinder. This region of less pressure makes it easy now for your pelvic floor at the bottom of your cylinder to lift. Do you now understand why we lift the pelvic floor as we exhale? The pelvic floor and diaphragm have a direct relationship with each other. As the diaphragm ascends, so does the pelvic floor. Likewise, as the diaphragm descends as you inhale, so does the pelvic floor. This is the natural pelvic floor-diaphragm rhythm.
The pelvic floor, transversus abdominus and diaphragm muscles are all interconnected through nerve and fascial (thin tissue between muscles and organs) networks. Muscles connected in this way will contract together and relax together. So, let’s now imagine the circular component of your cylinder.
While your diaphragm and pelvic floor ascend together on your exhale breath, the deep abdominal will slightly draw in, as if tightening a belt gently around the lower cylinder. This apparent tightening will be felt the full circumference of the cylinder in those very aware of their bodies, even around the sides of the waists and in towards the lower back. For others, the feeling will seem heightened at the front of the pelvis between the ‘hip bones’. The slight drawing in of the cylinder can almost have you believe these ‘hip bones’ are being gently pulled towards each other.
Putting it all together
This muscular cylinder is only the beginning of wonderful postural support for your pelvis, spine and body. These muscles work subtlely throughout your day, gently holding your spine and pelvis aligned. For maximum benefit, these muscles need to be trained ‘functionally.’ This means whilst doing other things such as moving, bending, lifting, twisting, walking, running, jumping and even sitting at your desk. There are other muscles all involved here too from upper back and shoulder muscles to spinal muscles, hip muscles and leg muscles, both deep and superficial layers.
So when involved in any of these activities above (which pretty much means all of the time when awake and conscious!), can you imagine your deep muscular cylinder at work? Sitting in there within your pelvis and lower trunk with the involved muscles on each surface all acting in a connected way?
Try it and you may be surprised at your postural alignment, endurance and movement freedom and efficiency.
Is there some truth to feeling moody on wet days?
With all of this rain about the past few days, I’ve personally started feeling a little low. Why is that? Is it the obvious that I just prefer sunshine? Is it that I should be on the beach and feel frustrated that I’m not? Perhaps I simply hate feeling cooped up at home? Or is there actually a physiological explanation for my feeling blue? This got me reading and researching the web on a morning where there was little else to do.
So apparently, day to day weather changes have very little effect on our moods. A 2008 study conducted by Jaap Denissen about the effects of weather on daily mood found that weather fluctuations accounted for very little variance in people’s day-to-day mood. This was a surprising discovery since there are so many observable changes in human behaviour associated with our changes in weather.
This research did show that there was an association between the amounts of sunlight and feeling fatigued. The less sunlight people were exposed to, the more they exhibited depression-like symptoms. The study concluded that in the winter season of the northern hemisphere, as days got shorter, people experienced more feelings of reported fatigue during the day, and also craved more carb-rich foods.
OK, so these past 3 days of wet weather in Sydney town are not really comparable to the northern winters of this study, but perhaps there’s something in there about darker, sunless rainy days?
Another cool study that I found was one from 2013 which looked at aggression and the climate. It found that the more it rained (especially in areas where high rainfall is not expected), the more aggressive people seemed to get. This was also true for higher temperatures. We apparently are all more placated when things are moderate and dry!
In my gloomy-mooded, wet weather internet trawl this morning, one final research paper which interested me and probably gives the best explanation (in my opinion) was a Dutch psychologist’s study of 2011. Klimstra, the author, stated that the impact of weather may really depend on your personality type! Sounds simple and plausible. He grouped his subjects into the 4 ‘weather personality’ types – summer lovers, summer haters, rain haters and those unaffected by weather.
Guess that makes me a ‘rain hater’! (If you’re interested, his definition of a rain hater was one who was “angrier and less happy on days with more precipitation. By comparison, more happy, but less angry, on days with more sunshine and higher temperatures.”)
Defines me perfectly, well today anyway!
The best way to beat low mood
It has been well documented that exercise can alleviate the symptoms of low mood and in low depressive disorders. We can make inferences from these well documented positive effects on our temporary low moods such as with the weather. Beats the opposite –feeling sorry and eating lots of the wrong foods! Haven’t we all been there?
The Beyond Blue initiative on depression states:
‘Keeping active can help a person stay physically fit and mentally healthy. Research shows that keeping active can:
• help lift mood
• help people get a good night’s sleep
• increase energy levels
• help block negative thoughts and/or distract people from daily worries
• help people feel less alone if they exercise or socialise with others
• increase well-being.’
So in all this rain, get to your gym, to your Fix class, or pop down a mat on the floor at home and exercise! Not only will it kill an hour or more, but it will distract you from that awful rain outside, increase your energy levels, and your feelings of happiness! Get those endorphins pumping.
And what the heck, why not take it to the next level and go out for a walk or run in the rain and pretend you’re 6 years old again!
Some of you may have seen this last week in the Sydney Morning Herald. This newspaper article highlights the effect on our bodies of sitting- scary stuff that effects not only our physical wellbeing, but also our physiological and overall mortality. I have found personally from working with injured workers, that there is a trend in newer offices to incorporate a communal standing work station or two for all to share and utilise throughout the day. This is a great idea and at least a step in the right direction to minimise the detrimental effects of our increasingly sedentary lifestyles.
Perhaps you will now think twice about those hours sat in front of the TV at the end of your work days.
http://www.smh.com.au/executive-style/management/beware-of-the-chair-20100303-pj4g.html
Thanks to Lou H for the link.
If you have been to a physio with an injury, you would have possibly heard that your ‘muscles are imbalanced’. This imbalance was probably explained to be the cause of the pain you were having- whether it be postural pain, muscular injuries such as a strain or tendonitis, or joint irritation.
So what does this actually mean?
Let’s start by looking at the reasons for pain.
Musculoskeletal pain (ie pain from muscles and joints) occurs in the presence of any nor or a combination of the following issues:
So, how does any of this start?
When you look at a child who is free of pain, and watch them move as they play or sit as they eat, and they have the most stunning poise and posture. They way they move is uninhibited and as it should be. Their posture is held with balance across all of the muscles that need to work to hold their little bodies up. They have not yet been affected by positions of sitting all day like we adults, or sedentary lifestyle or bad postural habits.
You could say that their muscles are ‘balanced.’
As we become accustomed to new ‘learned’ postures that are not ideal, muscles begin to work in altered ways. These slow insidious changes to our body become the new way we hold ourselves- the new habits. Some muscles will begin to work harder or have increased tone and others will become weaker.
You could say that muscles become ‘imbalanced’.
What is muscle tone?
Muscles have a normal state of tension, even at rest. The muscles continuously ‘buzz away’ with a message from the nerves that innervate them. So in reality, the resting state of a muscle still has low activation going on. This tone of muscles is necessary to protect them from sudden injury form stretching, or to help maintain normal posture and support around the joints of the body.
Putting it all together.
The tone of each muscle around each and every joint of the body needs to be balanced for the alignment and movement of the joint to be optimal. In poor posture, in injury, in compensated or adapted movements, this becomes out of whack. Some muscles become spasmed or tight (you could say in ‘high tone’ or ‘over-active’), while other muscles nearby become weak or not activated (you could say in ‘low tone’ or ‘under-active’).
This ‘imbalance’ and can pull a joint into poorer alignment and encourage further weaknesses, less support for the joint, altered movement, stresses, loads and pain.
You could imagine that the tightrope walker with the beautifully balanced pole is your painfree joint with the balance of muscles about all right. He remains centred, balanced, performing at his best.
In the same way, you could imagine the tightrope walker without the balanced pole, with too much pole length pulling him one way and not enough length from the other side to pull him back. This is the painful joint or posture with an imbalanced muscle system supporting it, all overloaded, stressed and painful.
You need your physio
This is where your physio can help you out. They can teach you about restoring the correct muscular balance and muscle tone around your painful joints and postures. You will need to learn to turn off those over active muscles and learn to find and strengthen your underactive ones. You can then achieve that perfect postural support, joint alignment and movement perfection.
The zipper front – the best visual cue for the lower belly I have heard!
Abdominal separation or Rectus Diastasis (RD) is a common and necessary part of carrying a baby and being a new mum. It affects 66% of women.
RD is the wonderful pregnant body’s way of getting your abdominal muscles around your growing belly by separating down the middle. This is not a complete separating away, but more a stretching of the thin tissue of connective tissue or fascia called the linea alba that gives our abdominal muscle that vertical line in the ‘six pack’. Picture those men’s fitness magazine cover boys – the dividing up of the abs into those ‘packs’. RD is necessary but if the separation of your belly muscle is too great (they say, greater than 3 fingers wide), there can be knock on effects to the region. These can include:
Back in January 2014, I wrote about 6 top tips in protecting abdominal separation. Recently I stumbled across the teachings and blog from a women’s health physio from the US named Julie Wiebe. I love this woman! She is a passionate physio doing amazing stuff assisting women about the world in ante natal, post natal and pelvic floor troubles.
Among many things (of which I am sure you will hear from me in fixnews letters to come), she had the most wonderfully simple analogy for the separated belly- the open fly or zipper.
She says:
I like to think of a diastasis (ie belly separation) that has resisted closure like an open zipper. An open fly affects more that just the zipper, it strains the button above, it messes with the fit of the pants, exposes things not supposed to be exposed.
What you do with the abdomen in a short prescribed exercise session a few times a day cannot beat 16-18 hours a day of standing, sitting and moving in lousy alignment that separates the midline all day. If your alignment keeps your fly open all day, then all your movements and daily exertions, like lifting little ones, will reinforce keeping it open. Same goes for fitness. The alignment you do fitness in is critical to approximating the abdomen and connective tissue to encourage closure.
What a perfect picture. If you stand, sit or exercise all day with bottom tucked under, hips pushed forward and slumped like the illustration below, your fly zipper will always gape open.
This will never allow for the connective tissue of the linea alba in your belly to come together, always being pulled apart like the open zip. Instead, stand tall with your waists gently lengthened and your ribs stacked beautifully over your neutral level pelvis. You could now picture that your fly will be drawn together, even if you did forget to do it up after that dash to the loo while managing your crying little one in the pram. Aim for this posture as much as you can, and your belly separation will be encouraged to come together. Even more, your diaphragm, your belly muscles, your pelvic floor and your spine will start to work more as it should, becoming stronger and more supportive.
Ab separation will never start to correct in that first year after baby if we are always in a poor posture for most of our days ( The ultimate goal that you want to achieve is a balanced well working system of deep belly, outer belly, pelvic floor, diaphragm and butt muscles). And as Julie has said, with all great intentions at working on this in your gym or Pilates classes, nothing works better than thinking of your posture and the closed zipper for best outcome. Easy.
So when standing, sitting, feeding, carry baby, pushing prams, at the gym ( after 4 months post baby girls!), cleaning the house, driving the car… remember your belly as the zipper!
Love it!
Why not check out Julie’s website and blog at
Heba wows her audience on speaking about the troubles with a tight pelvic floor
This summit held September in Melbourne is an annual gathering for all those interested in women’s health, fitness, and nutrition, in whatever capacity. It brings together world-renowned speakers and presenters from all areas of these industries, to inform and inspire.
Heba submitted a proposal with many to speak at The Platform, a program that the summit encourages to discover and nurture new presenters in the arena of women’s health. And amongst the incredible response, Heba was invited to speak about overactive (tight) pelvic floor muscles. She was one of only 4 winners to present. Knowing that this is her true passion, it did not surprise us that she was asked to speak.
You can watch this very presentation on youtube. It runs for 20 minutes or so and worth every minute. Heba speaks using such wonderful and simple examples. Things really make sense and to be honest, I bet all of us watching start to think that she could be speaking about bladder and pelvic floor habits of our own or our friends/mothers/wives.
Pelvic floor over- activity, tightness and spasm can be a very common problem with both men and women’s pelvic floor muscles. Perhaps some of these common signs of the tight pelvic floor could be you or someone you know?
If so, did you know that women’s health physiotherapists are at the forefront of being able to manage and treat these problems? Teaching how to ‘let go’ or ‘turn down’ the pelvic floor muscle tension is the goal here to allow for a more normal tension in this region and allowing for better sexual, bladder and bowel function. A variety of treatment techniques can be called upon, including any of:
Most women (and men) would put up with these types of problems. I guess it is because mostly we assume nothing can be done for this sort of pain. GPs are sometimes at a loss when all other urine tests, blood tests, swabs and scans have been done and appear normal.
Watch Heba’s speech and we hope that this can inspire you to speak openly with your friends and doctors about the problems seen with the tight pelvic floor.
Go Heba!
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