Chevron Island Physio

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6 TOP TIPS TO SAVE YOUR SHOULDERS

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SHOULDER INJURIES:

 

Shoulder pain is one of the most common problems treated by physiotherapists and sports physicians, and is particularly common in those who participate in health and fitness-related activities.

 

There is nothing more frustrating than shoulder pain interrupting your daily activities, keeping you awake at night or putting you on the sidelines watching your team mates compete or train.

Here are a few tips that my help prevent shoulder pain from starting or getting worse.

 

TIP 1: REST

If you notice shoulder pain during certain activities such as throwing a ball, swimming or hanging out the washing, stop that activity for a period of time and find an alternative exercise such as riding a stationary bike or using the dryer or a low clothes horse. Doing so can give your shoulder some time to rest and heal, while maintaining your cardiovascular fitness and still being able to do the jobs that need to be done and the things you love. During this time of rest, you can use some ice and always add a few gentle stretches to ensure you don’t develop a stiff shoulder. Your physiotherapist can advise you on the best stretches for your particular problem.

 

TIP 2: CHANGE YOUR SLEEPING POSITION

We spend on average 8hours a night sleeping. It is fair to say, if you spend all night sleeping on your sore shoulder your recovery will be very slow. If you notice pain in your right shoulder, don’t sleep on your right side. Try sleeping on your back instead – you can prop your arm up on a pillow to add support. If sleeping on your back is too uncomfortable, try sleeping on your left side with a pillow in front of you for your right arm to rest over.

TIP 3: INCREASE THORACIC SPINE MOBILITY

I am yet to see a shoulder-related problem that cannot be at least partly eased by the introduction of exercises to increase the mobility of the thoracic spine. The thoracic spine plays a significant role in loading (or unloading as the case may be) the glenohumeral joint. I encourage all patients to include a number of specific thoracic spine mobility exercises at the beginning of their rehabilitation. It is clear to see that this reduced range of motion in the thoracic spine leads to massive stresses being placed on the glenohumeral joint during most overhead exercises.

TIP 4: LIMIT OVERHEAD EXERCISES

Many gym training programs  involve extensive overhead pressing movements. Intensive overhead movements are often overrated and can lead to shoulder problems. When you look more closely at the available range of motion in the typical military press, at the start of the movement the shoulders are already in 70 to 80 degrees of abduction, and, depending on the width of your grip, at the end of the pressing phase you may only be at 130 to 140 degrees. This equates to a movement of only 60 degrees at most. If you subscribe to the ‘time under tension’ philosophy for hypertrophy, then it stands to reason that this reduced range of motion will reduce available ‘tension time’ and, thus,reduce results. A better and more shoulder-friendly exercise is the closer grip barbell shoulder press, dumbbell shoulder press, or Arnold press, in which the movement begins lower down and follows a flexion/extension plane rather than the abduction/adduction plane. This allows a greater range of motion but also keeps the hands closer to the centre of the body and reduces shearing forces around the shoulder.

TIP 5: WARM UP BEFORE EXERCISE

Warm up before you work out. Exercising cold muscles is never a good idea. If you haven’t done a sport or exercise for a while, ease into it. Learn how to do exercises with correct technique and always listen to your body.

TIP 6: BEWARE OF SMALL MUSCLE OVERLOAD

It is easy for the stabilising muscles to be overloaded, especially by those who do hard gym training three to four times a week. These small rotator cuff muscles are easily fatigued if you do a routine such as chest on day one, shoulders on day two, and back on day three; even though it seems that you are only doing shoulder exercises on one day, the actual shoulder muscles are involved in all of these workouts.I recommend that more advanced trainers group the pressing movements into the same workout and never do shoulders as a stand-alone body part. The deltoid group as a whole will get plenty of training directly from a solid chest and back routine so they will rarely, if ever, require individual and intensive training. Be especially aware if you and your clients are involved in other shoulder-related activities such as tennis, swimming and surfing, as these activities will also drain your recovery powers and lead to overloading of the small stabilisers.

 

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.

 

 

 

 

 

Why every new mum should see a Women’s Health Physiotherapist

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Having a baby is one of life’s truly extraordinary experiences. At Chevron Island Physio we are so lucky to have been a part of many of our patients journeys into motherhood and have shared this exciting time with them.

When submerged in the fog of new motherhood, adding one more task to your list can seem overwhelming. However, if there is one appointment every mother should attend after childbirth, it is an assessment with a women’s health physiotherapist.

All too often women do not become aware that Women’s health physios exist until they are experiencing pelvic floor issues like incontinence, pelvic organ prolapse or pelvic pain. Having an accurate and thorough examination early post-partum is critical for any woman recovering from pregnancy and delivery.

So what does a Women’s health physio actually do?

A Women’s health physiotherapist typically sees women who are dealing with:

  • Incontinence (urinary, faecal, and/or gas)
  • Pelvic organ prolapse (a condition where the pelvic organs have lost their support system)
  • Pelvic pain
  • Painful sex
  • Diastasis recti (abdominal separation)
  • Lower back, hip, sacrum or coccyx pain
  • Women who are looking to recover well from birth and may not yet be experiencing symptoms

Pregnancy and birth can be very stressful on a woman’s body. During pregnancy, the weight of a growing baby places pressure on the pelvic floor musculature and connective tissue. In addition to this, hormonal changes throughout pregnancy result in softening pelvic support to prepare for birth. These changes alone can lead to a pelvic floor that is more vulnerable to dysfunction.

During a vaginal birth, the pelvic floor has had to accommodate the exit of a baby. Frequently this can result in some degree of muscle tearing and nerve damage. In the case of a C-section, while the muscles of the abdominal wall are not incised, the fascia, nerves and skin are, which can contribute to symptoms postpartum.

An assessment with a women’s health physio empowers a woman to learn more about her body’s function and provides her with tools to recover efficiently and effectively so that she can return to the activities she loves in both daily life and fitness.

“Without an awareness of the function of one’s pelvic floor, it’s possible that a new mother will engage in activities that put her at greater risk of developing dysfunction, even if she isn’t currently experiencing symptoms.”

The 6-Week check-up your medical care provider performs is quite different to the assessment performed by a Women’s health physiotherapist

More often than not, women will attend a postpartum check up with their OB-GYN, midwife or GP at around 6 weeks postpartum. These women are commonly given the green light to return to exercise often without having their pelvic floor strength, coordination and overall function accurately evaluated.

This is where a women’s health physio fits in. We are the experts in assessing strength, function and coordination of a woman’s pelvic floor. After attending the six-week postpartum visit with a doctor or midwife, we strongly encourage women to schedule an appointment with a women’s health physio to receive a comprehensive evaluation of all structures most impacted by their pregnancy and birth experience.

5 reasons a woman will benefit from a postpartum assessment with a women’s health physio:

 

1.      Let’s alleviate symptoms and identify issues before they become bigger problems

While issues like incontinence, pain, and prolapse are common, they are not normal and shouldn’t be considered inevitable consequences of becoming a mother. Working with a women’s health physio can help to alleviate symptoms and treat the cause of dysfunction, meaning women do not have to put up with such bothersome symptoms!

A women’s health physio will provide a thorough assessment of the body with close attention to the abdominal wall, and the structures within the pelvis. After performing an external assessment that includes assessing for abdominal separation or diastasis recti, a women’s health physio can then perform an internal assessment.

They can then make recommendations on lifestyle factors (bowel and bladder habits, breath, alignment) that may be increasing one’s risk of developing pelvic floor dysfunction and will work to develop a plan to facilitate recovery from birth and a return to the mother’s chosen activities.

2.      Kegels are not always the most appropriate exercise for pelvic floor recovery

All too often, women are recommended to do kegel after kegel to strengthen their pelvic floor. While these exercises can be a helpful tool in the rehabilitation of one’s pelvic floor, when it comes to improving the function of a pelvic floor there is not a ‘one size fits all approach’. Some women will have a pelvic floor that is over-recruited or over-active which in turn will result in a weak and dysfunctional pelvic floor. These women will be made worse with kegels and will often be required to commence treatment using pelvic floor relaxation techniques. A women’s health physio can identify an over-recruitment issue and can help to facilitate relaxation and more appropriate function.

3.      A correctly functioning Pelvic Floor is essential to performance in exercise and activities of daily living

Many new mums will find that they end up leaking or experiencing pain or pressure if they try to rush back into levels of fitness that they did before giving birth. A women’s health physio will assess your individual function of your pelvic floor and provide recommendations on your return to exercise and activity rate.

The pelvic floor is the base of our core and works together with the diaphragm, the transversus abdominis, and multifidus, stabilizing the body from the inside out. Whether lifting a baby in a car seat, or a barbell at the gym, the pelvic floor responds to stabilise and provide support.

Without adequate rehabilitation post-birth, the body may be susceptible to injury and pain, with the pelvic floor being particularly vulnerable.

4.        Having a C-section does not mean your pelvic floor is in the clear

All too often I hear that having a C-section removes the risk of pelvic floor dysfunction and often leads women to believe that working with a women’s health physio is only necessary for women who have given birth vaginally. Women who birth by C-section, however, are still susceptible to pelvic floor dysfunction, pain, and diastasis recti and can benefit just as much from seeing a women’s health physio as those women birthing vaginally. There are many other factors other than the birth that can influence the function of the pelvic floor including the pregnancy, fitness and daily life activities, constipation, and genetic predisposition.

5.      Working with a women’s health physio gives you added support in your journey into motherhood

As soon as a woman gives birth their focus (and those around them) shifts to caring about their new baby. This frequently puts them at the bottom of the priority list when it comes to care. Prioritising the new mother’s physical and emotional wellness is just as important as celebrating her new baby. Emphasizing recovery and function postpartum has so many benefits for both mum and bub.

We are lucky enough to have two Women’s Health Physios at Chevron Island Physio who can help you. Contact us on 5504 7000 to find out more information.

Alison Jeffrey

(Physiotherapist/Pilates instructor/Women’s Health Special Interest).

References

  1. Bump, R., Hurt, W., Fantl, J., Wyman, J. (1991). Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction. American Journal of Obstetrics and Gynecology, 165(2), 327-329. https://www.ncbi.nlm.nih.gov/pubmed/1872333

TAKE SALLY HOME WITH YOU!

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ARE YOU STIFF AND SORE?

DID YOU KNOW THAT WE OFFER MAINTENANCE AND WELLBEING PROGRAMS THAT CAN BE DONE IN THE COMFORT OF YOUR OWN HOME FOR AS LITTLE AS $20?

Our Physiotherapist Sally Buratowski has 23 years’ experience and has treated a wide range of patients from 1-104 years of age. We live in an ageing population, and many of us may live to be over 100 years old which means that we may need to keep working until we’re 75 or 80! Specific DAILY exercises should be included into everyone’s routine to help combat this.

To aid people with these exercises, Sally has developed a range of whole body maintenance and wellbeing programs for each area of the body which include specific exercises to improve balance, mobility, flexibility, stability and strength. She has also developed a program for over 50s, over 60s, children with growing pains, scoliosis and middle back pain and people with chest conditions such as asthma and pneumonia.

Purchase your DVD or USB here

See a preview of Sally’s over 60’s DVD here.

Staying Injury Free in the New Year

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HOW CAN I STAY
INJURY FREE?
BY HEEDING A FEW TRAINING DO’S AND DON’TS YOU CAN SIGNIFICANTLY REDUCE YOUR RISK OF SUSTAINING A WORKOUT-RELATED INJURY.

Many new participants to exercise are worried about the risk of injury. However, in real terms the benefits of exercise greatly outweigh any possible risk associated with maintaining an active and
healthy lifestyle. That being said, there are some common injuries that we do see among the exercising population and you will be happy to know that these injuries can often be prevented, simply by following these tips and training strategies.

Common Injury 1: Anterior knee pain
Some physiotherapy and sports medicine clinics spend nearly 50 per cent of their time treating people who suffer from pain in and around the front of their knee. The cause of this pain can be due to conditions such as patellofemoral pain syndrome, patella tendinopathy or iliotibial band friction
syndrome. Avoid anterior knee pain by:Increasing your level of activity gradually. Do not increase volume or intensity of exercise by more than 10 per cent each week.Avoiding excessive incline running. This increases rotational forces around the knee and puts greater strain on the joint. Keeping your knee in line with your second toe (the one next to the big toe) during most lunging and squatting activities. This helps
reduce pressure on the patellofemoral joint. Making sure you have good shoes. The 10-year-old pair of sneakers that you found in the cupboard will probably not provide adequate support during exercise.

Common Injury 2: Shoulder Pain
Many exercising individuals are at risk of shoulder pain when they start a new exercise program; and the risk of pain in this area more then doubles if you have had a shoulder injury in the past. Common problems that affect the shoulders of active people include rotator cuff tendinopathy, impingement syndromes, acromioclavicular joint strain and referred pain from the cervical spine.

Avoid shoulder pain by:
Including some specific strengthening exercises for the small rotator cuff muscles (your physiotherapist or personal trainer can show you some of these). Making sure you can always ‘see your hands’ when doing weight training exercises such as shoulder presses and pulldowns. Making sure you allow rest days for your shoulders (i.e., do NOT do a heavy chest workout on day one, return for a massive back and shoulders session on day two and then swim 5km on day three.) For those smaller shoulder stabilisers you need to allow suitable rest days to recover from intensive training sessions. Ensuring you have adequate body roll, if you are keen on swimming. Always get a swim coach to check your technique before increasing your distances too rapidly.

Common Injury 3:Low Back Pain
While it is true that some exercising people experience low back pain as a result of exercise, most medical research confirms that exercise is actually one of the best preventative measures you can take, to reduce the risk of lower back pain. However, the people who do end up with back pain may be suffering from conditions such as lumbar disc degeneration, facet joint strain, sacroiliac joint dysfunction or simple lumbar muscle strain and spasm.

Avoid lumbar spine pain by:
Ensuring the joints in your spine are stretched and moved through a full range of motion every day. This may involve simple ‘knee to chest’ stretches and ‘ back extensions’ on your tummy.Moving around as much as you can during work hours, and when you arrive at the gym take five to ten minutes every time, to rotate, flex and extend your spine prior to commencing your exercise routine. Getting your trainer or physiotherapist to show you a range of core stability exercises that will strengthen the muscles that control your lower back. This will also minimise your risk of injury.

Low back pain, shoulder pain and anterior knee pain are all common injuries that can
be avoided this summer.

IN SUMMARY
While many people are concerned about the risks involved in exercise, the truth is that typical fitness centre activities such as weight training, group fitness classes and cardiovascular equipment training have a much lower injury risk than the majority
of team and individual sports. In fact, it is thought that the removal of the‘competitive’ aspect is one of the major reasons for this.Take heed of the suggestions made above, make sure that you consult your local physiotherapist or sports physician about any pain or problem before it affects your training program, ask your personal
trainer to check your exercise technique regularly and, above all, get out there and enjoy being physical!

Interestingly, many low back injuries happen between exercises, rather than during the actual lift, so be extra careful when lifting dumbbells from the floor, or while twisting to place weighted plates on machines.

How to write goals for 2018

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January is all about New Year’s resolutions and what you can do to get what you want out of life, love, career etc. Although we should be focusing on them all year round it’s a good chance to start fresh and think about what it is you want. Many resolutions that are made set us up for failure as they are not clear or achievable. It’s also helpful to have it written down and placed in a spot that is visible to you to keep you on track (fridge, beside your bed etc). Often by February our New Year Goals have already fallen by the way side!

I found these questions quite interesting and thought provoking. A good place to start anyway!

Career & Business Goals for 2018

What would you like to achieve in your career?
What type of roles do you want to be doing in your career?
What would you like to achieve in your business life?

Financial Goals for 2018

How much money do you want to earn in the next 12 months?
How much do you want to save or invest?
Which debts do you want to clear in the next 12 months?
What personal financial circumstances do you want to change?

Community Goals for 2018

What would you like to contribute to your community?
What would like to do for your friends in the next 12 months?
What activities would you like to be a part of, in your community?

Family Goals for 2018

What would you like to achieve as a family in the next 12 months?
What would you like to do for your family?
What type of person are you going to become for your family?

Health & Fitness Goals for 2018

How fit and healthy would you like to be in the next 12 months?
What is your fitness goal for this year?
What are some of the fitness activities you would like to pursue?
What eating or drinking habits would you like to change?
What foods would you like to include more of in your diet and why?
What foods would you like to decrease in your diet?
For a One Week Clean-tox Eating Program (created by a Nutritionist) click here

Personal Development Goals for 2018

What activities are you going to do in the next 12 months to develop your skills, knowledge and attitude?
What courses are you going to do to improve yourself?
What do you want to do to become a better person?

Adventure Goals for 2018

What type of holiday would you like to take?
What type of adventure activity would you like to do?

Lifestyle Goals for 2018

What are you going to do just for you?
What rewards are you going to give you or your family?
What revitalises you, gives you energy and recharges your batteries?
What can you do to keep a positive mindset?
2 for 1 Yoga Deal available throughout January 2018 – Bring a friend and only pay $11 each! Check out the timetable here

Answer as many or as little of these questions as you like but I found them quite useful to get me thinking about what I want from a variety of different areas of life. If you have any tips I would love to hear them!

Kasey Boorman
(Nutritionist)

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