The merits of a great video

We all picture ourselves to look like as graceful and effortless as the most famous of marathoners. However, how often do our bubbles burst when we see a photo or a video at the fun-run finish line?

Running ( and walking for the non-runners) biomechanics play an important role in the development of injuries in active individuals. When pain and the physical examination findings are in agreement with abnormalities observed in a biomechanics running analysis, it serves as a great tool for intervention. What exercises, what running cues, what change in shoes may allow for this person to walk and run injury free? 

Here are a few common issues we see in runners that really set up a risk of the body breaking down, being less efficient and potentially becoming injured. Perhaps you see yourself doing one of more of these when you run? Or perhaps you don’t!

Why not have a friend film you and have it looked at by our physio team? A short 30 second video from the side and from the rear would be all you need, so grab your phone and shoot away!

Excessive pelvic drop. Image B shows the dropping or dumping of a pelvis.

• The cause? Weakness across the glutes and pelvis.
• The effect? Outer hip pain, knee pain, glut tendonopathy, lower back overloading

Rear foot instability. Image A shows a normal, B abnormal degree of heel pronation and instability.

• The cause? Poor shoe choice with inappropriate hind foot guidance and control, tight calf and stiff foot joints.
• The effect? Where do we start? Foot, knee, Achilles, hip, lower back issues.

Over-striding. Image A shows good hip-ankle alignment while B shows the ankle too far forward from center of gravity.

• The cause? Poor trunk posture being too upright, tight hip flexors, poor running technique and awareness
• The effect? Higher ground reaction forces and poorer energy absorption, resulting in overloading of foot, knee, hip and back. 

Knee angle at foot fall. Image A shows a very extended knee, when images B and C show the preferred land on a soft or slightly flexed knee.

• The cause? Over-striding, trunk too upright and poor running awareness
• The effect? Load impact forces are greater on the knee, potentially causing pain and stress fractures

Foot strike pattern. Forefoot vs midfoot vs hindfoot.

The jury is till out and research still continues into this well discussed topic among runners. It is believed by many that injury risk is less in the forefoot striker (image A) as it brakes and absorbs the ground reaction force force more efficiently.

So grab a friend a get filming. We would love to see and help your analysis and share exercise/tips and shoe advice, so contact us to make an appointment.

Reference: Souza, R.B, An eveidence based videotaped running biomechanical analysis (2016)

_You deserve to give your body time
_

by Carrie Seow, women’s health physio at The Fix Program Ryde

Did you know that it can take up to a year after giving birth for your body to regain its pre-baby strength, shape and tone?

We understand the pressure these days to want to return to your pre-baby body in a hurry. But please remember that giving birth to a baby is NO SMALL THING. Be kind to yourself as your body needs some time to recover. Changes that your body has gone through during pregnancy are very normal and usually temporary.

We see a lot of new mums wanting to get back into exercise as soon as possible after giving birth. Social media has much to blame for this as we see celebrity mums slipping back into their skinny leg jeans mear weeks after having their babies. This is not realistic for most and yest, places pressures on us all. 

As the body is still recovering, it’s important to return back to exercise safely to reduce the risk of injury or pelvic floor dysfunction. What you do as a new mum may have an impact on your pelvic health for life.

Here are a few things to consider when returning to exercise after giving birth:

• It’s not just about how you feel on the outside.

Your body - including your abdominal muscles, pelvic floor and pelvic organs - have been through a lot! Jumping back into exercise too early or pushing yourself too hard may be placing extra stress on an already stressed pelvic floor and increasing your risk of pelvic floor dysfunction. Running, impact, heavy loads lited in an inappropriate way can add to pelvic floor pressures and risk of injury.

• Did you know that pregnancy and labour take its toll on your pelvic floor?

It is thought that during pregnancy, the pressure that a baby places on the pelvic floor is equivalent to that of a 100kg man jumping on a trampoline. And that’s in pregnancy alone! Labour definitely adds to this pressure in many ways and the stress is further compounded if you have suffered a perineal tear, episiotomy, a long second stage of labour, or given birth to a baby weighing more than 4kg. 

Hormonal changes also add pressure to a pelvic floor that may not be strong enough to withstand the pressures of jumping, running, weights, squats or even coughing and laughing.

• Weak pelvic floor muscles may not only mean embarrassing leaks or passing wind when you don’t want to.

There is also a risk that the organs (bladder, uterus and bowel) in the pelvis can start sagging or dropping too low, also known as a pelvic organ prolapse.

• A caesarean is major abdominal surgery.

It can take some time for the abdominal muscles to recover. You need to give your body time and start gentle breathing, postural, abdominal and pelvic floor exercises.

• Abdominal separation is often a dreaded term amongst mums but it is actually a natural and normal event during pregnancy.

There would be hardly any space for a baby to grow if the abdominal muscles did not separate at all. Management of abdominal muscle separation is important in the early months following birth. Adopting good postures, wearing appropriate support, breathing techniques and deep pelvic floor and abdominal coordination is the key to rebuilding your core.

• Leaking is not normal! 

It may be common but you don’t have to put up with it. If you suffer from urinary or faecal leakage, pelvic pain, vaginal heaviness or discomfort, bladder urgency or frequency, dragging back pain then please give us a call to chat about your body and pelvic floor.

We believe it is important for all women to get assessed prior to returning to exercise after delivering a baby, regardless of whether you had a caesarian or a vaginal birth. Women’s health physiotherapists can assess and guide you through your return to exercise, based on your body, your pregnancy and your labour outcomes. Remember – it is different for everyone.

Check out The Fix Program’s famous post natal checkup information. We recommend this from 6 weeks to 1 year post natally. This check will give you the confidence and the science of safe return to exercise. Our physio clinics also teach pelvic floor safe Mums&Bubs Pilates and functional training where you can bring bub along.

It is said that pregnancy is for 9 months, but post natal is forever. We new mums need to look after our bodies!

Draft ‘April term break 2019’. Timetable is subject to change.

These classes will run for 2 WEEKS in our Sydney CBD and Broadway clinics. Classes will commence from the week commencing Monday 15th April. Please note due to Easter and ANZAC holidays, classes are restricted to Tuesdays and Wednesdays only. 

Classes are recommended and scheduled for:

• Intermediate/advanced  mixed level Pilates for challenging and functional postural control. These classes are suitable for our existing Pilates clientele currently attending our beginners, intermediate or advanced classes in 2018.
• Pregnancy specific Pilates. These classes are suitable for our existing pregnancy Pilates clientele currently attending our classes, or have been assessed to be ready for these classes.

Draft ‘term 2 2019’ Pilates timetable is subject to change.

These classes will run for 10 WEEKS in our YORK STREET CBD clinic.

Classes will commence from Monday 29th April and end Friday 5th July 2019.

Monday classes will be a 9 week term due to the Labour Day public holiday in June .

Classes for this term at our York Street CBD clinic are recommended and scheduled for:

• Clinical Rehabiltation classes
• Beginners Pilates based classes
• Intermediate to advanced Pilates based classes
• Pregnancy specific Pilates
• Mums&Bubs post natal Pilates. Safe and fun with baby when you really want to be sure your exercise is safe as a new mum. 

Draft ‘term 2 2019’ Pilates timetable is subject to change.

We are super excited to offer classes for the first time ever at our new clinic this term.  These classes will run for 10 WEEKS in our RYDE clinic.We hope to soon offer more classes on other days of the week, but come and say hello on a Monday.

Classes will commence from Monday 29th April and end Friday 5th July 2019. Monday classes will be a 9 week term due to the Labour Day public holiday in June .

Classes for this term at our Ryde clinic are recommended and scheduled for:

• Intermediate to advanced Pilates based classes
• Pregnancy specific Pilates
• Mums&Bubs post natal Pilates. Safe and fun with baby when you really want to be sure your exercise is safe as a new mum. 

We are thrilled to announce a new clinic opening…just for women in Ryde

On March 25th 2019, we will be opening a brand new clinic at Ryde. We will be located within the beautiful Fernwood Fitness Women’s Gym.

Our passion for the wellness of women will shine on at this new clinic, bringing you all The Fix Program expertise and care. The expertise that has been changing the lives of women since 2005 when we opened our first CBD based clinic.

We will be there with:

• our physiotherapy services for you. Whether it’s your postural pain or a gym niggle, with our expert physio’s treating you, we’ve got you covered.
• our specialised women’s health physiotherapists, managing pelvic floor and physical problems unique to women. Incontinence, pelvic pain, sexual pain, pregnancy related issues, post natal rehabilitation, prolapse, and pessary prescription are our forte.
• our pregnancy physiotherapy services for the best for you and your baby. Helping you through pregnancy with safe and appropriate pregnancy Pilates classes and physiotherapy for pregnancy related pelvic girdle pain, back pain and other aches at this special time.
• our post natal physiotherapy services with Mums&Bubs Pilates classes, post natal pelvic floor and abdominal separation checks and advice before safely returning to your pre-baby exercise routines.

And this is just the start.

Where are we?

Within the Fernwood Ryde Womens Gym, 84 Belmore Rd, Ryde.

What do I do next if I wish to make an appointment?

Contact us. You don’t need a doctor’s referral to see our physiotherapists. We’ll be happy to chat about your needs, and for the month of April 2019, we are offering 50% off your first visit fees to celebrate our arrival at Ryde.

Choose your class stream for term 2 Pilates programs

As you should be aware and as we outlined in an earlier post in January, there are changes in private health fund rebates for alternative therapies, including Pilates. This decision and reform by the federal government in 2018 comes into effect 1 April 2019. This has meant changes to the way physio clinics across Australia deliver group exercise  to comply with the new rules.

 Luckily for physiotherapist however, we have been permitted (with intense lobbying late 2018) to continue to deliver classes of which Pilates may be a clinically appropriate exercise for an individual. (This sadly is not the case for Pilates studios across Australia, where services for classes or individual sessions taught by non-physios are no longer claimable).

However with this, there are changes to the way we physiotherapists deliver these classes to comply with the claiming process. This will effect your classes, so please consider your options. 

As physiotherapists, we are excited by these changes as we can see a better goal orientated and individualised approach to your rehabilitation in our new small format classes. Individualised exercise for individuals. Targetted for your actual weaknesses and with better outcomes.

Please think about what you are after in attending physio-instructed classes such as ours. With this in mind, please read the table below as we explain the 2 different class streams that we will now offer at The Fix Program.

What do we suggest you do now?

• Please talk with us more about your concerns and any questions regarding your attendance in classes going forward. Both our admin and physio staff will be able to assist you.
• Contact you private health fund regarding rebates, quoting our new fee schedule.
• Decide on which class will be right for you, taking into consideration what you are personally after from our classes, and also the rebates involved.
• If you are choosing to move to the clinical rehabilitation class stream, please arrange to book your 1 hour assessment. These must be done and your exercises set before the commencement of term 2 2019 on 15th April 2019.  This can be performed by any of our physio staff where they will assess your current goals and clinical picture, set and teach you your exercises and focuses for your classes and get you ready for the new clinical rehabilitation small format classes.

We understand this must be a lot to take in, as it has been for our clinic and all physio clinics around Australia. We are prepared for an adjustment period to get the new class system in place and ask and thank you for your patience during this time.

Sweeping changes across the private health funds for Pilates

For those of you in private health funds, you may be starting to receive letters from your providers outlining the recent decision made around natural therapies and other ancillary health services. As of 1 April 2019, these services including Pilates will no longer be funded for rebates.

But do not despair…

Those involved with our physiotherapy professional association (the A.P.A.) have been lobbying hard over the past months with Greg Hunt MP the Minister for Health, the health insurance ombudsman and with the fund providers themselves. They have had a minor victory, ensuring us that the health funds will continue to rebate exercise classes that are Pilates-based if prescribed and taught by a physio. Basically, as physiotherapists, we are permitted to choose Pilates-based exercise as the best course of management, among other treatment modalities, to treat particular injuries and movement dysfunctions.

However there will need to be a few changes made in clinics like ours to be ready for the 1 April changes. We are still waiting to be advised on these adaptations to the way we deliver, advertise and receipt your classes to be eligible for your rebates.

Stay tuned for this.

For those of you interested, here is the statement issued by the A.P.A. late last year:

 **All parties agree that physio is physio**

The APA has won a hard fought battle ensuring Pilates-informed exercises prescribed by physiotherapists as part of an individualised program will continue to receive rebates in one-on-one, group and class settings.

The Department of Health has just released its final clarification on the Rules governing its PHI (private health insurance) reforms and agreed with our position that the use of exercises drawn from Pilates are acceptable and within the scope of physiotherapy practice.

As previously advised and in keeping with the intention of the natural therapy reforms, Pilates-only sessions will no longer be funded as of 1 April next year. The reform of natural therapies was designed to eliminate rebates for non evidence-based therapies, and not intended to impact physiotherapy.

However, the review into natural therapies conducted by the government and announced last year, did not differentiate between Pilates-informed exercises prescribed by physiotherapists as part of a treatment program and Pilates offered by fitness instructors and in other contexts.

Therefore, we have been in long and hard negotiations to ensure that all parties agree physiotherapy is physiotherapy.

Draft ‘Summer school 2019’ Pilates timetable is subject to change.

These classes will run for 3 WEEKS in our BROADWAY clinic.

Classes will commence from the week of Monday 7th January and end Friday 25 January 2019.

Draft ‘Summer school 2019’ Pilates timetable is subject to change.

These classes will run for 3 WEEKS in our York St, Sydney CBD clinic.

Classes will commence from Monday 7th January and end Friday 25 January 2019.

Classes for this term are recommended and scheduled for:

• Intermediate/advanced level Pilates for challenging and functional postural control, available to those of you currently our clientele.
• Pregnancy specific Pilates
• Yoga by Tus. Thursday nights to end your day on a high!