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Groin Pain In Football

Groin Pain In Football

If you play one of the football codes (Soccer, AFL, Rugby League or Union), chances are you have already or may in the future experience some groin pain. One study of almost 700 sub-elite male football players reported 50% of players had experienced groin pain in the previous season (Thorborg et al. 2017). Groin pain is highly prevalent, accounting for up to 14% of all injuries sustained in football (Haroy et al. 2017). It is common for groin pain to start in preseason training, when there is a spike in load following the off-season. The athlete is coming off a low training base into a high intensity training environment in a bid to regain fitness. The groin structures may struggle to adapt adequately to the rapidly increasing physical demands.

The typical pattern will be a gradual onset of discomfort in the groin which initially doesn’t affect your ability to train or play. You may feel stiff and sore post training and often into the next morning. As the weeks progress, you may notice that this worsens, and pivoting and kicking becomes increasingly difficult. A common scenario is that the athlete stops or modifies training to preserve him/herself for the weekend game. However, this can eventually progress to a point of being sidelined altogether.

How is groin pain diagnosed?

Groin pain diagnosis can be difficult in athletes due the overlapping anatomy in the region. Groin pain can emanate from several closely related structures and is categorised into groin pain arising from these different structures:

  • Adductor related groin pain (groin/inner thigh muscles and tendons)
  • Iliopsoas related groin pain (hip flexor muscles and tendons)
  • Pubic related groin pain (pubic bone, joint and nearby structures)
  • Inguinal related groin pain (structures in the groin crease)
  • Hip related groin pain (from the hip joint)
Anatomical image of different areas of groin pain

A detailed musculoskeletal assessment from your sports physiotherapist or sports physician usually provides the diagnosis. In some cases, scans (ultrasound or MRI) may be used to help clarify the reason for your groin pain. Once your diagnosis is established, it is then important to understand what may have contributed to the cause. Typically, this can be broken into three categories: load, muscle strength and biomechanics (the way you move).

Load

Understanding the onset of groin pain is important for management. Fixture congestion or periods of high game demands will increase chronic overload to the groin region. This is often the case during preseason and towards finals when there are increasing number of games over short time frame. In addition, fluctuations in training patterns or game availability will influence injury risk. Ensuring consistent exposure to agility drills and sprinting in training or games will help reduce variations in loads. Working with your Physio to manage appropriate loads can help reduce overload and help you continue to play through groin pain.

It is rare complete rest will resolve athletic groin pain. Prolonged periods out of training and games will accelerate muscle weakening and reduce tolerance to physical strain across the hip, groin and pelvic region. Instead, modifying training loads to exclude components of training that are provocative (i.e., cutting, small-sided games, kicking) will allow you to maintain fitness and some resemblance of load whilst working on a rehabilitation program to address any strength deficits.

Muscle Strength

Assessment of hip muscle strength is vital for groin health. One Australian study showed that in A-League & EFL soccer players, increased hip abductor (glute) strength on the kicking leg and higher levels of overall hip abductor and adductor (groin) muscle strength were associated with a reduced likelihood of future injury (Bourne et al. 2020). Using muscle dynamometry, we can profile muscle strength and compare this to normative data available in professional athletes to understand testing benchmarks.

VALD, a leading sport science company demonstrated that the median adductor isometric strength score was 422N (43kg) in professional English and European footballers (over the 2020/21 season). In comparison, AFLW athletes on average, test just over 300N (30kg). Depending on your gender and sporting code, we can refer to research data to help understand how strong you need to be and use this to guide your rehab prescription.

Physiotherapist testing muscle strength for groin pain rehabilitation

Biomechanics

Agility (cutting, pivoting and acceleration) actions are often amongst the most provocative movements for groin pain. Recent research (King et al. 2018) has highlighted the important relationship between how people move their body when changing direction and the load they put on their groin region. Due to the high physical demands of acceleration, being able to control your body during these actions influences how much force is being directed to the groin. Typically, athletes with inefficient strategies change direction with a greater side lean of the trunk, plant their foot too wide and have inadequate control of movement around the hip joint.

The cutting strategy used by a player will be related to the strength and athletic qualities that athlete possesses. One example is of reduced trunk strength (i.e., reduced ability to resist movement with the abdominal and/or back muscles) leading to increased trunk lean over the planted foot. This means the groin muscles have to work harder to push off. Another example is inadequate calf strength and ability to produce fast, forceful movements, resulting in poor ability of the calf to absorb landing forces. These forces are once again transmitted to the groin. Video analysis of cutting technique is used to develop drills and rehab programs to improve efficiency and reduce re-injury risk.

Two soccer players changing direction_groin pain mechanism

Restoring plyometric ability (explosive jumping) and power are important pieces of the puzzle in restoring effective control of the trunk and pelvis during dynamic movements. Force plates are used to help assess this. Using jump testing, we can break down data about how high you are able to jump, how fast you take off, how much force you generate when leaving the ground and on landing, and your ability to effectively break or stop quickly. These metrics are then used to help ensure the most effective exercise selection and rehab programs.

Treatment of groin pain takes a step-by-step approach. Load management is the initial priority and reducing provocation to the area can help reduce symptoms immediately. Following this, developing muscle strength and resilience to improve the ability of your groin structures to cope with sporting loads is next. Lastly, training cutting technique can be helpful to further reduce stress in the groin region and often has the added benefit of improved performance.

This blog was written by one of our Physiotec Sports Physiotherapists, Kevin Doan

If you would like to book with one of our Sports physio's, Kevin, Dave, Eric or Tyler please call, email or book online below:

Phone: (07) 3342 4284

Email: [email protected]

 

Heels Dancing: Tips to look after your body

Heels Dancing: Tips to look after your body

Heels dancing has become increasingly popular from recreational dancers to professionals. Heels is not a style, culture or background in itself but is featured across many genres of dance with commercial heels being the most mainstream, influenced by artists in music videos, touring performances and award shows. Heels are commonly worn in other dance styles including vogueing, waacking, musical theatre, pole, salsa, or latin. However, heels can be worn in any style, even breaking or hip hop! This blog will focus on heels dancing for dancers currently or aiming towards commercial dancing.

It is important for dancers to understand the impact wearing and performing in heels can have on the body. When wearing heels, a person’s centre of mass is shifted forward causing a protruding head, increased arch in the lower back, increased pressure on the forefoot, plus an increased balance requirement due to the reduced base of support.1,2,3 Heels dancing can involve a lot of deep squat positions with weight on the toes rather than the heels. This can be challenging for the knees. It will also place the ankle in a more ‘open position,’ reducing stability and increasing the risk of ankle injury. 

This alteration in biomechanics explains why dancing in heels can be painful, despite Beyonce making it look so effortless. Whether you are a beginner heels dancer or heading towards performing professionally, we have some tips to help you train to become more comfortable dancing in heels and to look after your body.

1. Beginners: Advice to ease your transition into heels dancing

  • Dancing in heels has many similarities to dancing in pointe shoes, it requires adequate training, body awareness and maturity. For a beginner it is important to take classes with similar foundation like jazz or ballet as this will help strengthen your ankles and other muscle groups used when wearing a heel. 
  • Kiira Harper when giving advice for heels dancing admits ‘no heels dancer is a safe dancer’ but there are precautions you can take to ensure you look after your body. When starting out, you may find you need to change into a flat shoe like runners or dance barefoot as your feet will not be used to wearing heels for a whole class. As you build your confidence training in heels, it’s important to practice in your heels such as when rehearsing for a performance so you are training your muscle memory and the correct muscles to work during the routine.
  • Learn from different heels dancing teachers to become versatile, each teacher will teach their own style. Some of the first pioneers to teach heels dancing are Aisha Francis, Danielle Polanco, Anthony Garza, Yanis Marshall, Kiira Harper, Brinn Nicole, and Michelle Jersey Maniscalco. Searching these choreographers on YouTube is a great way to get to know heels dancing and how it differs between choreographers teaching their own style.
  • Train with dance teachers who teach correct heels dancing technique. This can be difficult to decipher but look at their credentials and experience and perhaps reach out to your local dance community via Facebook groups or on Instagram as they can point you in the right direction.

2. SHOES: Carefully select your shoes for heels dancing

  • For younger dancers doing cabaret, theatrical, tap or other types of dance in heels, start with a low, block heel and gradually work your way up as you gain strength and control. For pre-professional and experienced dancers the following guide will help when selecting a shoe for Heels Dancing.
  • Type of shoe - Boot heels are best for beginners as they provide the most ankle support while building up strength in the ankles. Good supportive heels may also have a lace up at front, buckle above the ankle, or a side zipper. These aspects all keep the ankle secure but are still flexible enough to move in. If your heels have laces, ensure they are durable and not touching the floor when tied up as this is a huge tripping hazard, the safest option is to tuck them into your shoe.
  • Width of the front of the shoe and thickness of the sole are important for allowing you to spread out your toes and feel the floor for greater stability. Ensure you have enough room in the front of your shoe and choose thinner soles that allow you to feel the floor better.  You could choose an open-toe shoe or a closed-toe shoe, as long as the toes aren’t cramped together. If your toes are cramped, you will get less feedback about your weight placement on the floor and less control around the foot and ankle.
  • Pumps - A pump may be suitable for more advanced heels dancing, depending on the choreography. A pump is the hardest type of heel to dance in as they require adequate strength to hold the foot within the shoe and it provides the least ankle support. Mishay Petronelli, with credits including The Greatest Showman and Janet Jackson, recommends pumps for pre-professional or professional dancers taking heels training as this will help prepare for any heel a dancer may be given and required to wear during a gig.
  • Avoid platforms if possible - This type of heel has an inflexible platform at the forefoot which can vary in height depending on the shoe. This can increase the risk of ankle injury due increased instability (heels are already unstable!) and less capacity for the dancer to “feel the floor”. Unless you are required to dance in a platform shoe as part of your professional costuming, please avoid them. 
  • Customised shoes – at the end of the day, dancing in heels is going to hurt regardless of what you do, especially if you are at rehearsals or performances for hours on end. You will need to break in new shoes. Gradually increase the time you train in new shoes, it will also take time for your feet to get used to them. To prolong your comfort you can try to get your heels customised to your feet at a shoe maker, they can add extra padding to reduce the pressure on your forefoot, or add rubber soles on bottom so you have a good grip on any surface. An alternative option for grip is to scratch the shoes on concrete to give them more texture, this creates more friction on the shoes while you’re dancing, applying hairspray to the bottoms will assist also. As a last minute option if you are already at class, most dancers will drop a small puddle of water on the floor and dip the bottom of their shoe into it for extra hold.

3. Warm-up: The best exercises to get your body ready for heels dancing

  • Exercises to warm-up when heels dancing don’t differ greatly from those that are conducted in a pointe class. Your warm-up should be done without the heels on so you can work through your feet properly first.
  • Calf rises – aim to achieve 25 single leg calf rises. The principal physiotherapist of the Australian Ballet Sue Mayes has some pointers for the perfect calf rises based on her research in 2003 including: The speed of movement should be slow, take 1 second to rise up, and 1 second to lower down. Your foot should be parallel, with your knee neutral so it is not bent or hyperextended, move through your full pain free range of motion with optimal control, ensure your toes remain long and flat, aim for a smooth motion, movement should be vertical so avoid any rocking forwards, you should see the gastrocnemius muscle active throughout range, for good alignment ensure the mid tibia (shin bone) is aligned with the 2nd metatarsal (2nd toe).4
  • Foot intrinsics – try a long toe push with a light theraband, for this exercise you will place the band around one toe at a time and slowly lift the toe, then lower back to the floor (easiest to perform in sitting), you can also try piano toes where you lower one toe to the floor at a time from smallest to biggest, and for a challenge try lowering in order of the biggest to smallest toe.
  • Balance – stand with your feet together on demi pointe, slowly lower your body to a full knee bend with control then slowly rise back up, this will require engagement of your core to hold you steady. This exercise takes you into a deep squat on the toes a common position in heels choreography. As mentioned earlier this increases the load on the knees and requires very good strength and control. It should only be performed if the action is pain free. If you experience knee pain please seek advice from your physiotherapist.
  • Core – try a tabletop exercise, lying on your back with both legs in a tabletop position with 90 degrees flexion of hips and knees, slowly extend one leg straight at a time. It is important to activate your core as you need to hold it when balancing to keep your centre, especially during turns
  • Bridges – you will need your glute max to help push you up from kneeling to standing when dancing in heels rather than requiring your quads and hamstrings to do all the work, ensure your feet are close to the bottom, then push through your heels to lift the bottom up, you can also try this on one leg for increased difficulty.

4. Cool-down: Take time to recover properly with these tips so your body aches a little less the day after heels dancing

  • Calf stretching can assist in allowing the muscle to relax in a lengthened position again, after working hard in a shortened position while dancing in heels. Other alternatives to release tension include massage or using a foam roller.
  • Lower back – in heels dancing a lot of time is spent with the lower back in a forced arch so it is essential to open up the lower back in the opposite direction. Try a child’s pose stretch with a 30 second hold, a cat-cow stretch on your hands and knees for 10 repetitions, knee rocks side to side to rotate through the lumbar spine, knee hugs into chest for 30 seconds, and slow controlled roll downs from standing for 10 repetitions.
  • Drink lots of water and try to get a good night’s sleep after a heels class, in particular for those classes that go for 3 or more hours or for all day long rehearsals.

Due to the increased demand on the body while heels dancing, it is important to ensure you are incorporating these safe dance practices so you can enjoy all the fun heels dancing provides while looking after your body. Our dance physiotherapists Rhianna and Jo are available for dance assessments if you are wanting to improve your heels dancing technique or have been experiencing pain associated with your dancing.

 

This blog was written by Physiotec Dance Physiotherapist, Rhianna Tunks

If you would like to book with one of our dance physio's, Rhianna or Jo, please call, email or book online below:

Phone: (07) 3342 4284

Email: [email protected]

 

References

  1. Chien HL, Lu TW and Liu MW. Effects of long-term wearing of high-heeled shoes on the control of the body’s center of mass motion in relation to the center of pressure during walking. Gait Posture 2014; 39: 1045–1050.
  2. Silva AM, de Siqueira GR, da Silva GA: Implications of high-heeled shoes on body posture of adolescents. Rev Paul Pediatr 2013; 31(2): 265–71
  3. Yung-Hui L and Wei-Hsien H. Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Appl Ergon 2005; 36: 355–362.
  4. Mulready R – How To Get Strong Calves. The Australian Ballet 2020. Retrieved from: https://australianballet.com.au/behind-ballet/how-to-get-strong-calves
Whole-Body Strength Training for Cyclists

Whole-Body Strength Training for Cyclists

As a cyclist, you’re constantly joking about only needing “legs and lungs”. The goal of a cyclist is to be as light as possible, with the highest amount of power to weight ratio coming from the legs, pushing into the pedals. That is why there are plenty of memes out there of cyclists with stick thin arms and torso, but with massive quads and hamstrings, and titles such as “Don’t miss leg day!”. Jokes aside, imbalances such as these can have a potentially detrimental effect on your long-term health. Strength training for cyclists is key for injury prevention and performance.

As cycling is a relatively low weight-bearing sport, it is beneficial for cyclists to engage in additional loaded strength training to address a variety of issues from bone density to muscular balance. Obviously, strength demands differ between cyclists – a road cyclist, track cyclist, mountain biker or BMX rider will all have very different needs, but the tips I share below can be used a general guideline, across all types of cycling.

 

 

Strength training for cyclists are a great addition to your training routine

Strength and conditioning programs should be kept as simple as possible. As often is the case, it is the simple stuff that works best and has stood the test of time.  The programs I recommend to a lot of my patients, typically contain the exercises below.

Sample workout
Compound Push (Knee Dominant) Back Squat/ Goblet Squat
Upper Body Push (Horizontal) Dumbbell Chest Press, Bench Press
Upper Body Pull (Horizontal) Bent over rows, Seated rows
Compound Pull Offset/Single Legged (Hip Dominant) Offset Romanian Deadlift, Offset Trap Bar Deadlift
Trunk Stability (Anti Rotation) Pallof Press, Plank + KB drags
*One of the Compound movements needs to be single legged or offset Work in 3 sets of 5-8 repetition with 2 RIR (Reps in Reserve)

By utilising a full body routine such as this, all the major components of the body will be covered, and even if a session is missed, you’ll know you are always covering the full body in each session. Optimally, you would want to engage this routine two times a week for adequate loading-for-strength benefits.

Compound movements are multi-joint movements which utilise multiple groups of muscles at the same time. Utilising a multi-joint movement under adequate weight helps to develop the ability to generate force through those joints. For a cyclist, the ability to generate better force in the hips and knees, coupled with bike specific training, may lead to an increase in power production.

I also added a note in the table to ensure one of the hip or knee dominant exercise needs to be either single legged or offset. Single leg/offset work is often underutilised, but is a very effective tool for stability. It also assists with restoring any imbalances you may have developed over the years, either through injuries or poor habits. I recommend that single-sided work be done towards the back end of the exercise session, as you would not often use as heavy weight. What’s more, doing single-sided work with a bit of fatigue from all the previous work sets will really challenge ones stability under appropriate weight.

The Importance of Upper Body Strength for Cyclists

For a cyclist, upper body work is not hugely important from a max strength or bulk point of view, however having good muscle tone in the upper body musculature is important for general well-being in everyday life. You don’t want to be “that” cyclist who is strong in the legs but weak with poor tone in the upper body, “that” cyclist who injures the neck or shoulder lifting a bag of groceries. Dependent on what field of cycling, some streams like track cycling and BMX may require a bit more upper body bulk and strength compared to road cycling and mountain biking.

Don’t forget to switch it up!

For a bit of variation in your workouts, you can alternate your sessions by switching the compound hip/knee dominant work around so you can focus the heavier work on the other compound exercises whilst offset/single leg work on the other. This will create a nice balance in loading for different movement patterns. I would try to do the heavy and double legged compound work at the start of the session and do the single leg or offset compound movements towards the mid or latter end of the session. Also for upper body work you can switch between horizontal movements like bench press and bent over rows with vertical upper body movements like overhead dumbbell press and lat pull down. See example in the table below.

Sample Variation
Compound Pull (Hip Dominant) Traditional deadlift, Trap-bar Deadlift
Upper Body Push (Vertical) Dumbbell Overhead Shoulder Press, Barbell overhead press
Upper Body Pull (Vertical) Lat Pull Down, Chin Ups
Compound Press Offset/Single legged (Knee Dominant) Bulgarian Split Squat, Lunges
Trunk Stability (Rotation) Woodchop, Medicine ball trunk rotations
*One of the Compound movements needs to be single legged or offset *Work in 3 sets of 5-8 repetition with 2 RIR (Reps in Reserve)

Hopefully what I have covered here about strength training for cyclists will be helpful as a starting point for a simple strength and conditioning program. As always, check in with your strength and conditioning focused allied health professional to determine if these recommendations are suitable for you.

The best advice I can give is, keep it simple and sustainable. The session need not be super long in duration – aim for 30-45 minutes to be done with your program. Over time, as you develop more experience and build up a repertoire of exercises you are familiar with, in each of the categories, you will be able to interchange exercises that are similar in each category to keep your work out fresh and engaging.

 

As with undertaking any new program or form of exercise, if you have any medical concerns, please check with your doctor. Or, should you need some tailored advice for strength training for cyclists – come see us here at PhysioTec.
Eric Huang is a qualified physiotherapist who specialises in cycling related pain and injuries. He has a passion for all things cycling, is a competitive cyclist himself, and runs his own cycling crew. Call 3342 4284 to book an appointment with Eric.

 

References:

Nicols JF, Palmer JE, Levy SS (2003) Low bone mineral density in highly trained male master cyclists. Osteoporos Int. 14:644-649

Rønnestad, B.R., Hansen, E.A. & Raastad, T. In-season strength maintenance training increases well-trained cyclists’ performance. European Journal of Applied Physiology. 110, 1269–1282 (2010)

Westcott, Wayne L. PhD. Resistance training is medicine: effects of strength training on health. Current Sports Medicine Reports: July/August 2012 – Volume 11 – Issue 4 – p 209-216

Louis, J., Hausswirth, C., Easthope, C. et al. Strength training improves cycling efficiency in master endurance athletes. European Journal of Applied Physiology. 112, 631–640 (2012). https://doi.org/10.1007/s00421-011-2013-1

 

Shall we dance? The health benefits of dancing at any age

Shall we dance? The health benefits of dancing at any age

Patients often ask me, “what is the best form of exercise?”. The answer I usually give is “The kind you enjoy”. My reasoning is, if you enjoy doing something then it is far more likely you will find the time to do it – an opinion supported by research1. So, if the gym isn’t your cup of tea, you don’t fancy a jog around the neighbourhood or it’s too cold for a swim – have you thought about dance as a form of exercise? Enjoyment is merely one reason to dance – once you hear about all the health benefits of dance, you’ll be shimmying back for more!

Dancing is great for fitness

Dance as exercise really is the allrounder when it comes to physical health benefits2. Studies show dance classes are as good for you, if not better, than other forms of structured exercise3. With so many types of dance available, you’re almost certain to find one you’ll enjoy. You can begin dancing at almost any age, so whether you’re 5 or 95, interested in ballet or belly-dancing, tap or tango, read on and see how dancing can help improve your health and wellness!

Cardiovascular improvement

Most of us know that physical activity and getting our heart pumping can help improve the function of our heart and lungs. The Australian government guidelines for exercise recommends adults participate in 2 ½ to 5 hours of moderate intensity physical activity (you can talk but not sing during the activity) or 1 ¼ to 2 ½ hour of vigorous activity (can’t say more than a few words without stopping for breath) each week4. A US intergenerational program showed both children and adults can reach their target heart rates through dance5. By incorporating ballet classes or line dancing lessons a couple of times a week and enjoying the petite allegro or Boot Scootin’ Boogie, you can gain the wonderful heart-pumping benefits that dancing can provide6.

Muscle strength and endurance

Ever admired the toned legs of a ballet dancer or the stamina of couples competing on dance tv shows? You too can enjoy strengthening your lower limbs and improve your endurance by attending regular dance classes.  Studies show that regardless of the type of dance, if you attend 3 hour-long classes a week, you’ll likely develop stronger legs and improved endurance in just 12 weeks7.

Balance and posture

Most everyday activity, such as walking, has us travelling in fairly straight lines without too much change in the level of our heads. Even when you’re at the gym – be it on a treadmill, stair climber or stationary bike – your movement is fairly limited. Dance on the other hand has us moving in all directions – forward, backward, sideways – often covering a lot of area. In addition to moving more in all directions, dancing often includes turns, jumps and sometimes even floor work.  When you’re performing that tango turn or jazz pirouette, you’ll be challenging your balance and dynamic postural control. This makes most forms of dancing ideal for improving our balance, and helping reduce the risk of falls, particularly as we age7,8,9.

Mobility and flexibility

We know that staying active and moving the joints is beneficial to joint health but there is some perception that dancing, particularly ballet, can lead to wear and tear on the hips.  This has not proven to be the case with an Australian study showing no difference in hip joint changes between professional ballet dancers and other athletes10. In fact, movement of the limbs during dance can help maintain flexibility, strengthen joint supporting muscles and keep the joints healthy9. Dance lessons have also been shown to help people with mobility issues, such as those with Parkinson’s disease. Recent research revealed regular dance classes improved the functional ability of people with Parkinson’s making it easier for them to move and get around11.

Dancing engages the brain and has “feel good” benefits

Not only do we see physical benefits in those who regularly participate in dance lessons, but dance can also give your brain a boost and improve your emotional wellbeing.

Memory and attention

If you’ve already attended a dance class, you’ll know how challenging remembering the combination of steps and movements can be. Perhaps you’ve also marvelled at more experienced classmates and their ability to pick up steps quickly or remember the choreography. Learning a dance sequence is like doing mental push-ups or a physical crossword for the brain, and the more you dance the better you’ll become. Challenging the brain to remember the steps and putting them all together in movement improves our “brain plasticity” and helps build our grey and white matter. In fact,  dancing improves our brains function much better than conventional exercise and can help stave off age-related mental impairments like poor memory and attention12.

Mental health and social connection

While those of us getting older will be especially keen on the mobility and memory benefits that dancing provides, there are also emotional benefits for people of all ages. Dancing can be a great way for adolescents (or people of any age) to deal with emotional distress.

A recent study found that teenage girls showed less nervousness, anxiety and and even reported less headaches and stomach aches while attending regular dance classes13.  Other studies have show similar benefits; A 12 week dance course lowered depression in a group of university students14 and a group of 60 – 82 year old’s reported improved social activities and networks through dance classes15. Regardless of dance style, people of all ages and cultural groups report a greater sense of happiness, social connectedness and life satisfaction through dance participation15.

Dance is great, whatever your age

Now that you know dancing can significantly improve balance, strength, endurance, mobility, memory and wellbeing, why not take a look to see what dance classes are available near you? Many dance schools offer classes for all ages including beginner classes for adults or those returning after a long hiatus. So grab a friend, sign up for a class and get moving!

(And if you’re isolating – there’s never been a better time to dance like nobody’s watching!)

Do you want to maximise the benefits you gain from dance, but not sure how to make the most of your dance moves?

Under the supervision of our experienced dance physios Jo and Rhianna, you will be professionally guided along the way, in a safe and effective manner.

Book Now
As with undertaking any new form of exercise, if you have any medical concerns, please check with your doctor. Or should you feel worried about a particular physical issue – unsure if you can boogie with a “bad knee” or practice ballet with a bunion – come see us here at PhysioTec. We’ll do a thorough assessment and provide you with some individualised exercises and advice in preparation to really enjoy and gain the most from your dance classes.

Joanne Manning is a qualified physiotherapist with a special interest in dance rehabilitation and injury prevention. Call 3342 4284 to book an appointment with Joanne.

 

References

1. Dishman, R. e. (2005). Enjoyment Mediates Effects of a School-Based Physical-Activity Intervention. Medicine & Science in Sports & Exercise, Volume 37 – Issue 3 – p 478-487 doi: 10.1249/01.MSS.0000155391.62733.A7.

2. Hwang PW, B. K. (2015). The Effectiveness of Dance Interventions to Improve Older Adults’ Health: A Systematic Literature Review. Alternative Therapies in Health and Medicine, 21(5):64-70.

3. Fong Yan, A. C. (2018). The Effectiveness of Dance Interventions on Physical Health Outcomes Compared to Other Forms of Physical Activity: A Systematic Review and Meta-Analysis. Sports Medicine, 48, 933–951.

4. Government, A. (2021, March 30). Factsheet: Adults 18-64. Retrieved from The Department of Health: https://www1.health.gov.au/internet/main/publishing.nsf/Content/fs-18-64 years

5. Schroeder K, R. S. (2017). Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.  Journal of Pediatric Nursing, 37:29-34.

6. Gronek P, W. D. (2020 ). A Review of Exercise as Medicine in Cardiovascular Disease: Pathology and Mechanism. Ageing and Disease , Mar 9;11(2):327-340.

7. Rodrigues-Krause J, K. M.-O. (2019 ). Dancing for Healthy Aging: Functional and Metabolic Perspectives. Alternative Therapies in Health and Medicine, Jan;25(1):44-63.

8. Wallmann HW, G. C. (2008). The effect of a senior jazz dance class on static balance in healthy women over 50 years of age: a pilot study. Biological Research for Nursing, 10(3):257–266.

9. Joung HJ, L. Y. (2019). Effect of Creative Dance on Fitness, Functional Balance, and Mobility Control in the Elderly. Gerontology, 65(5):537-546.

10. Mayes S, F. A. (2016 ). Professional ballet dancers have a similar prevalence of articular cartilage defects compared to age- and sex-matched non-dancing athletes. Clinical Rheumatology, 35(12):3037-3043.

11. Carapellotti AM, S. R. ( 2020). The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis. PLoS One, 15(8):e0236820.

12. Rehfeld K, L. A. (2018 ). Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One, Jul 11;13(7).

13. Mansfield L, K. T. (2018). Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review. BMJ Open, 8:e020959.

14. Akandere M, D. B. (2011). The effect of dance over depression. Coll Antropol , 35:651–6.

15. Sheppard A, B. M. ( 2020). Promoting wellbeing and health through active participation in music and dance: a systematic review. International Journal of Qualitative Studies in Health and Well-being, 15(1):1732526.

Music is Physical – The importance of exercise for musicians

Music is Physical – The importance of exercise for musicians

As a musician, you are likely to spend much of your time practicing. But how much time do you devote to keeping fit? Everyone knows that exercise is good for a person’s health, however did you know that fitness and exercise for musicians can also improve your performance?

In this blog, we discuss being fit to play

Fitness and exercise improves performance

Fitness for PerformanceSports medicine and performance research has well established that being fitter and stronger is probably going to mean you perform better, get injured less and have a longer career. Sportswomen and men do not get fit from playing sport – they get fit to play sport.

Professional sports have millions of dollars invested in strength and conditioning programs, GPS tracking of on-field movements and intensity, injury surveillance, early management and strict recovery protocols. They even have a fully or partially employed team of doctors, physios, exercise physiologists, strength coaches, psychologists, massage therapists, nutritionists and specialists, all on speed dial!

In the performing arts sector, the dance world has embraced these concepts to some extent, but it’s really only in the past 10-15 years that we have seen dancers “cross training” using weights, modern physical conditioning science and recovery techniques. Professional companies measured the cost of injuries and then implemented more stringent balances between dance floor time and body (and mind) care time!1 Dancers are learning that you can’t just dance and expect to be fit to dance.

But what about training and exercise for musicians?

Musicians, generally, have not embraced these concepts. Unlike dance, a musician’s physical appearance has not historically been important to the final product of the artistic performance. Hence, the physicality of one’s body has not been in the forefront of musicians’ training.

Demands of instrumental musicThe physical demands of instrumental performance are often only considered when things start to hurt. A study from Germany2 indicated the average age of onset of pain related to playing, in professional orchestral musicians, was 35. This indicates a realm of physical performance that is low load, high repetition – pain creeps up on you and can ‘suddenly’ take over your career or passion. There are no high impact injuries nor torn muscles from sudden explosive force (like dance or sport), but research3 shows that over 80% of professional orchestral musicians in Australia have had pain related to playing, that has interfered with or stopped them playing. Most musicians rely on the “gig economy” – with no guaranteed income, worker’s compensation or income protection insurance. So realistically, pain and injury will hurt more than just their bodies.

Music is physical.

Yes, music can be expressive, creative, therapeutic and passionate but to create music on any instrument (even digitally) musicians need to use their body as well as their mind. Musicians of all levels and ages will benefit from:

  • being fitter and stronger
  • physically warming up before playing
  • eating to perform, and
  • having a recovery protocol for after playing

In short – condition, prepare, play, recover (CPPR).

Exercises musicians can do to increase fitness levels

It’s easiest to break down your physical condition into two areas – cardiovascular fitness and strength. The latest W.H.O exercise guidelines4 recommend a minimum of 150 minutes a week of moderate intensity exercise (most people can get that fast walking) and 2 additional strength training sessions involving major muscle groups. I suspect some reading this will not be achieving that minimum.

Get fit to play musicAny gains in fitness or strength are made by challenging your body to respond to a load just greater than it is used to – challenging but achievable. You have to start low and slow, and build up to your target. Musicians should understand this concept as no one starts playing with a concerto – one must first learn the scales.

General cardiovascular fitness is gained, depending on your physical ability, by activities like walking, running, swimming or boxing, but all should be approached carefully and built on gradually.

Likewise, to gain body strength, start slowly and build gradually. Simple bodyweight exercises like calf rises, squats, bridges, dips and push ups (start on the wall or a bench) are enough to get you going and improve your general strength. From there you can progress to resistance bands or weights and just see the difference it will make to your playing endurance –  reduced fatigue, less pain – and often, improved performance!

Balance exercises are a very interesting area and can be surprisingly beneficial, particularly in the older musician. The ability to transfer body weight either standing or sitting can be an important part of injury reduction and also performance enhancement.

Is a warmup necessary for musicians?

A general body warmup before playing will increase the local muscle temperature and many people comment how it mentally places them in a performance space as well. Simple arm circles, body twists and leg swings are an easy way to start a routine that of course will flow into warmup on your instrument.

Recovery strategies are rarely seen amongst the musicians I have worked with (until I work with them!) Hydration (water), nutrition, some simple stretches and mentally ‘winding down” are proven sports practices based on a large body of research. Sleep is a huge area of current research and in musicians is currently rarely measured nor discussed.

CPPR – condition, prepare, play, recover.

Most musicians just play – until they can’t. Embracing sports science principles can not only minimise pain or injury, but improve performance and prolong careers.

For more information on fitness and exercise for musicians, pain or injury management or other aspects of musicians’ physical demands, call 3342 4284 to book an appointment with David Peirce at PhysioTec.

 

References

1. The “Cost” of Injuries in a Professional Ballet Company.
Ruth Solomon,B.A., John Solomon,Ph.D., LyleJ. Micheli, M.D., and ErnestMcGray, Jr. Medical problems of performing artists Dec 1999

2. Frequency, severity and predictors of playing-related musculoskeletal pain in professional orchestral musicians in Germany Steinmetz et al January 2014

3. Musculoskeletal pain and injury in professional orchestral musicians in Australia.
Bronwen Ackermann 1, Tim Driscoll, Dianna T Kenny Medical problems of performing artists 2012

4. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med: first published as 10.1136/bjsports-2020-102955 on 25 November 2020.

How can we prevent dance injuries ?

How can we prevent dance injuries ?

One of the most common questions I get asked as a physiotherapist with a special interest in dance rehabilitation and injury prevention is, “How can we prevent dance injuries?”.

GOOD QUESTION!

It’s a very valid question considering:

  • the rate of injury in young and adolescent dancers is higher than that reported in young soccer players or gymnasts
  • the injury rate of dancers aged between 9 -18 years is even higher than that of professional ballet and contemporary dancers!4,7

Why do dance injuries occur?

First, let’s take a look at why dance injuries happen.

The reason for young dancers reporting more injuries than their counterparts in other sports is partly due to growth spurts in this age group, coupled with the high physical demands of dance. There are also numerous other factors that have been identified as risks for injury. Some are intrinsic – related to the individual such as growth, hormones or previous injuries1 – and others are extrinsic or external, such as environmental factors like dance floors, equipment or training load.2 Research on both intrinsic and extrinsic risk factors, and their relationship to dance injuries is a growing area of research and hence, more information will continue to emerge.

There does seem to be a growing consensus that the majority of dance injuries in ballet dancers is due to overuse3,6,9. Dancers are familiar with the repetitive nature of dance training – having to repeat a move over and over again in order to learn and perfect a new skill or piece of choreography. This can prove somewhat tricky to manage among aspiring young dancers. In addition to this, the rigors of dance can increase at particular times of the year4, and we certainly see more injured dancers here in clinic around exam and performance periods.

What are the most common injuries for dancers?

In young dancers of ballet, tap, jazz, hip hop, contemporary, ballroom and Irish dancing, it may be no surprise that the lower limb (leg) is most commonly injured. This includes the knee, ankle and foot – with rate of occurrence in that order – followed by the hip and spine. Ligaments tend to be the most commonly injured soft tissue, with muscles and tendons making up about 30% of injuries, while bone injuries make up around 20% of all injuries.5

Acute versus chronic dance injuries

Traumatic injuries are usually referred to as acute injuries, while injuries relating to overuse are often longer lasting or slowly developing injuries, referred to as chronic injuries. Research has shown that the majority of injuries sustained by young ballet dancers are of the ‘overuse’ type, with more than three quarters of all injuries falling into this category.6 With overuse-type injuries, the dancer is usually unable to pinpoint exactly what caused the injury and often reports pain increasing over time. Tendinopathy and bone stress reaction/stress fractures are examples of this type of injury, typically caused by repetitive stress and/or overloading.  Other causes of chronic injuries can be structural or genetic in nature, such as hyperextended knees usually seen in the hypermobile population.

Acute injuries are usually a result of an “accident”. Examples of an acute injury are a slip on the floor or landing poorly from a jump, resulting in a muscle strain or ankle sprain.

So, what can we do to help prevent dance injuries?

Accidents do happen, however the majority of dance injuries can be prevented, and there are ways of reducing a dancer’s risk of injury.15 Some of the ways we can help reduce the risk of dance injuries are:

Dance Screenings or Dance Profiles

Dance screenings have long been performed by qualified physiotherapists to identify areas of weakness or concern, with the aim being to prevent dance injuries. Pre-pointe assessments or pre-pointe profiling (a term we prefer) is a good example. Although there is not a great consensus as to what elements and tests can accurately predict who is more likely to be injured, it is highly beneficial in identifying possible risk factors and facilitating improvements in strength and technique.

Screening dancers should not be limited to girls wishing to progress onto pointe. Research shows male dancers sustain dance injuries at the same rate as females, and as they mature, male dancers require higher levels of dance strength and flexibility. It is therefore a logical course of action that, during the important period of growth and adolescence, young men undertake a dance profile to identify any potential injury risks and develop appropriate and individualised training goals.

A good time of year to undertake a screening is during the school holidays. During this period, the student usually has more time to address any strength or flexibility deficits that may have been identified by the physiotherapist. They can use the extra time over the holidays to focus on these areas and begin the year a step ahead.

Check out the dance environment for potential injury risks

Acute injuries are sometimes a result of an environmental factor, and are therefore preventable. For example, purpose-built dance floors are an extremely important factor for keeping a dancer safe. Checking the floors for spills or items that may cause injury is another way of preventing accidents. Wearing properly fitting clothing and professionally fitted shoes appropriate to the style of dance can also help prevent environment-related injuries.

Always warm up before dancing

It is vital that dancers warm up before class, rehearsal or performance – skipping a warm up can lead to injury. The goal of a warm up is to raise the heartrate, warm up the muscles and mobilise the joints. This should be a gradual process conducted in phases. First a light sweat should be achieved by raising the heartrate and getting the big muscles working, for example, jogging, skipping or lunges. Then, dynamic stretches should be done.

It’s important, especially for young dancers, to understand that static stretches should not be done in early warm up. Static stretches should instead be left for the end of class, during cool-down.

Keep your body Dance-Fit with an individualized dance conditioning and exercise program

Individualized conditioning programs have been shown to reduce the rate of injury in professional dancers.7 These types of programs are created using information obtained during the dance profile, and takes into consideration the dancer’s history and previous injuries. Historically, supplementary strength and conditioning programs were avoided by ballet dancers,  who were concerned that this type of training would result in reduced flexibility or a non-aesthetic physique. There is, however, little evidence supporting this theory, and this opinion has now mostly been replaced by integrating elements from sports research showing the benefit of such programs8 with a dance-specific approach. Physiotherapists, especially those with extensive dance knowledge, are perfectly placed to guide  young dancers in their supplemental training.

Get enough rest and monitor your loading to help prevent dance injuries 

Finally, and of great importance to young dancers, is rest and load management. Since research shows ‘overuse’ as the main cause of injury in young dancers, monitoring their loading is of paramount importance.9-10 Young athletes who train in the same sport for more hours per week than their age (in years), were shown to have 70 percent more overuse injuries13. Furthermore, a 2014 study showed that young athletes who had less than 8 hours of sleep each night were more likely to sustain injuries than those who slept 8 hours or more.14

So, a short answer to the question of how to prevent dance injuries is….

Ensure the young dancer has a healthy dance schedule, has been screened for deficits and potential injury risks, and has an individualised conditioning program.

The dancer, as well as their family, dance teachers and health professionals, all need to work together to help the young dancer remain as injury-free and healthy as possible!

Have you experienced a dance injury?

Do you want to know how to stay safe whilst dancing and prevent injuries from occurring?

Under the supervision of our experienced dance physios Rhianna and Jo, you will be professionally guided along the way, in a safe and effective manner.

Book Now

 

For more information about PhysioTec’s Dance Physiotherapy services, including dance screenings and pre-point profiling, injury rehabilitiation or dance-specific strength and conditioning, click here or call 3342 4284 to book an appointment with Rhianna or Jo.

References

  1. Kenny SJ, Whittaker JL, Emery CA. Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review. Br J Sports Med. 2016;50(16):997–1003.
  2. Russell JA. Preventing dance injuries: current perspectives. Open Access J Sports Med. 2013;4:199–210.
  3. Leanderson C, Leanderson J, Wykman A, Strender LE, Johansson SE, Sundquist K. Musculoskeletal injuries in young ballet dancers. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1531–5.
  4. Prevention of Injuries in the Young Dancer (Contemporary Pediatric and Adolescent Sports Medicine). Springer International Publishing. Kindle Edition.
  5. Fuller M, Moyle GM, Hunt AP, Minett GM. Injuries during transition periods across the year in pre-professional and professional ballet and contemporary dancers: a systematic review and meta-analysis. Phys Ther Sport. 2020 Apr 3;44:14-23.
  6. Shah S, Weiss DS, Burchette RJ. Injuries in professional modern dancers: incidence, risk factors, and management. J Dance Med Sci. 2012;16(1):17–25.
  7. Steinberg N, Aujla I, Zeev A, Redding E. Injuries among talented young dancers: findings from the U.K. Centres for advanced Training. Int J Sports Med. 2014;35(3):238–44.
  8. Faigenbaum AD, Kraemer WJ, Blimkie CJ, Jeffreys I, Micheli LJ, Nitka M, et al. Youth resistance training: updated position statement paper from the national strength and conditioning association. J Strength Cond Res. 2009;23(5 Suppl):S60–79.
  9. Prevention of Injuries in the Young Dancer (Contemporary Pediatric and Adolescent Sports Medicine). Springer International Publishing. Kindle Edition.
  10. Allen N, Nevill AM, Brooks JH, Koutedakis Y, Wyon MA. The effect of a comprehensive injury audit program on injury incidence in ballet: a 3-year prospective study. Clin J Sport Med. 2013;23(5):373–8.
  11. Ekegren CL, Quested R, Brodrick A. Injuries in pre-professional ballet dancers: incidence, characteristics and consequences. J Sci Med sport. 2014;17(3):271–5.
Pregnancy, pelvic pain & safely returning to running

Pregnancy, pelvic pain & safely returning to running

Pregnancy is an exciting and special time but it can also come with a lot of questions. Whilst Google gives us access to a wonderful world of information, it can lead to more questions and sometimes concerns. This article will discuss the effect of pregnancy on the mother in terms of pelvic pain and the pelvic floor and returning to running after pregnancy, backed up by evidence and research. It is important to remember that not any one pregnancy is exactly the same!

Pelvic Pain & Exercise during Pregnancy

Based on various studies, approximately 50% of women experience low back pain or pelvic girdle pain (pubic, buttock, tailbone, pelvic floor regions) during pregnancy and 25% continue to have this pain 12 months after delivery (Davenport MH, et. al., 2019).

A panel of experts looked at 32 studies, which included a total of 52,297 women without absolute or relative contraindications to exercise (Davenport MH, et. al., 2019). For the absolute and relative contraindications, please click here. From this, it was found that physical activity during pregnancy decreased the severity of low back, pelvic and lumbopelvic pain. (Davenport MH, et. al., 2019). This is both during the pregnancy and in the early postpartum period. The exercise components of these studies included yoga, aerobic exercise, general muscle strengthening and a combination of resistance and aerobic training (Davenport MH, et. al., 2019).

Another study by Owe et. Al (2016) looked at 39, 184 pregnant women who had not previously given birth. This study found that exercising up to five times weekly prior to pregnancy was protective against pelvic girdle pain and also those women who reported participating in high impact exercises prior to pregnancy had the lowest risk of pelvic girdle pain during pregnancy. (Owe KM, et. al, 2016).

The most current guidelines state that an accumulation of 150 minutes of moderate intensity exercise each week is recommended in order to achieve the health benefits and reduce risks of pregnancy complications (Mottola MF, et al., 2018).

Pregnancy & the Pelvic Floor

In relation to the pelvic floor, the main recommendation part of the most current guidelines state that pelvic floor muscle training is associated with a reduction in prenatal and postnatal urinary incontinence (Mottola MF, et al., 2018). These exercises can be performed daily HOWEVER, it is crucial that women seek instruction from a trained health professional (such as a women’s health physiotherapist) to ensure proper technique in order to obtain the best outcomes/benefits from performing these exercises. This is especially the case for women who have never trained these muscles.

Returning to Running after Pregnancy
More recently (March 2019), three highly experienced physiotherapists – Tom Goom, Gráinne Donnelly & Emma Brockwell combined their areas of expertise to release a paper on returning to running postnatal and the guidelines for this population. The main findings that were included in the paper were that women in the post-natal period benefit from an individualised assessment and guided pelvic floor rehabilitation in order to prevent and manage pelvic organ prolapse (bladder, bowel or uterus descending into the vagina) (Hagen, S et al., 2014), manage urinary continence (Bø, 2003) (Dumoulin, C et al., 2018) (Price, N et al., 2010) and improve sexual function.

Based on expert opinion only, the following suggestions were made:

• Return to running is NOT recommended at all prior to 3 months post-natal OR beyond this time point if any symptoms of pelvic floor dysfunction are identified before or after attempting return to running
• Pelvic health, load impact management and strength testing should be assessed in order to establish if a patient is ready to return to running in the post-natal period
• Additional factors that should be considered in the postnatal evaluation are weight, fitness, breathing, psychological wellbeing/status, abdominal separation, breast support and feeding, running with a buggy and relative energy deficiency in sport (RED-S)

How we can help you at Physiotec:

It is imperative to see your physiotherapist before commencing physical activity, especially if planning a pregnancy, already pregnant or in the post-natal period.

Here at Physiotec, your women’s health physiotherapist can:
1. assess your pelvic floor muscles to ensure you are using them correctly
2. assess and address other areas of concern such as low back pain or pelvic pain
3. advise you on the safest exercises during pregnancy as well as into the post-natal period
4. perform a physical assessment to determine whether you are ready to return to running or other exercise after pregnancy 
5. perform a running assessment to ensure that your technique places minimal loads on your pelvic floor and joints following pregnancy

You might also like to join one of our Pilates classes to stay strong or build strength and control before, during or after your pregnancy.

 

Are you currently pregnant?

Do you have pain in your pelvic region?

Would you like to return to running safely?

Our physiotherapists can provide you with a thorough assessment, and provide you with appropriate recommendation on how to approach your pelvic pain, or return to running safely.

Bibliography

Bø, K. (2003). Is there still a place for physiotherapy in the treatment of female incontinence? EAU , 145-153.
Davenport MH, et. al. (2019). Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. British Journal of Sports Medicine, 53, 90-98.
Dumoulin, C., Cacciari, L. and Hay-Smith, EC. (2018). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews(10).
Hagen, S., Stark, D., Glazener, C., Dickson, S., Barry, S., Elders, A., Frawley, H, Galea, MP, Logan, J., McDonald, A., McPherson G., Moore KH, Norrie, J., Walker, A., Wilson, D. (2014). Individualised pelvic floor muscle training in women with pelvic organ prolapse: a multicenter randomised controlled trial. 282(9919), 796-806.
Mottola MF, et al. (2018). 2019 Canadian guideline for physical activity throughout pregnancy. British Journal of Sports Medicine, 52, 1339-1346.
Owe KM, et. al. (2016). Exercise level before pregnancy and engaging in high-impact sports reduce the risk of pelvic girdle pain: a population-based cohort study of 39 184 women. British Journal of Sports Medicine, 50, 817-822.
Price, N., Dawood, R. and Jackson SR. (2010). Pelvic floor exercise for urinary incontinence: A systematic literature review. Maturitas, 67(4), 309-315.

Physical Activity & Pregnancy

Physical Activity & Pregnancy

Physical Activity & Pregnancy

The Facts, the Figures & the False Conceptions

If you are pregnant or planning a pregnancy and you are unsure about the current guidelines for physical activity and what is safe, this is a must read! An excellent team of experts have appraised over 27,000 manuscripts and abstracts (Davies G & Artal R., 2019) in order to bring us the most up to date information and guidelines on physical activity during pregnancy.

THE FACTS:

Physical activity during pregnancy:

  • DOES NOT increase the risks of structural or functional birth defects which stem from in the womb (Davenport MH, et al., 2019)
  • Has a significant effect on reducing the severity of low back pain, pelvic girdle pain and lumbopelvic pain. (Davenport MH, et al., 2019)
  • Decreases the chances of using instruments during delivery (Davenport MH, et al., 2019)
  • Reduces the chances of depression during pregnancy as well as the severity of symptoms. Unfortunately, this does not apply to the post-natal period. (Davenport MH, et al., 2018)
  • Reduces the risk of excessive weight gain during pregnancy as well as weight retention postpartum. (Ruchat S, et al., 2018)
  • Results in a small increase in the mother’s body temperature which is safe for the baby. (Davenport MH, et al, 2019)
  • Effectively reduces the risk of developing gestational diabetes mellitus, gestational hypertension and pre-eclampsia. (Davenport MH, et al., 2018)
  • Reduces the odds of having abnormally large babies (Davenport MH, et al., 2018)

Additionally…

  • There is no association between physical activity during pregnancy and increased risk of miscarriage or perinatal mortality (stillbirth or deaths in the first week of life) (Davenport MH, et al., 2019)
  • There is not enough evidence to inform us if lying on our back to exercise is safe or if it should be avoided altogether during pregnancy (Mottola MF, et al., 2019)
  • There was no association found between exercise during pregnancy and complications with the newborn baby or harmful childhood outcomes (Davenport MH, et al., 2018)

THE FIGURES & RECOMMENDATIONS

(Mottola MF, et al., 2018)

  • An accumulation of 150 minutes of moderate intensity exercise each week is recommended in order to achieve the health benefits and reduce risks of pregnancy complications
  • Exercise over a minimum of 3 days per week, however daily exercise is encouraged
  • Variety is key in order to achieve greater benefits
  • Pelvic floor muscle training can be performed daily in order to reduce risk of urinary incontinence
  • Exercising flat on the back should be modified if the pregnant women is experiencing light headedness, nausea or feeling unwell
  • TAKE HOME MESSAGE: All women WITHOUT contraindications should be participating in physical activity during pregnancy

THE FALSE CONCEPTIONS

  • Exercise will harm the baby. The evidence has shown that there are no increased risks of miscarriage or a small baby when undertaking physical activity during pregnancy
  • Heart rate should be below 140 beats per minute. This is an outdated guideline from the 80s and there was no evidence to even support this guideline, it was based on expert opinion.
  • Exercise needs to be at a gym or with group fitness. Lots of studies that were looked at were walking programmes. Additionally, moderate intensity physical activity can include gardening, mowing the lawns and some household chores.

Other considerations for physical activity & pregnancy

There are other considerations specific to the mother during pregnancy and physical activity. These include, but are not limited to, the pelvic floor and risk of overload/prolapse as well as pelvic pain. If you are planning a pregnancy/already pregnant and have a history of pelvic pain or pelvic floor concerns, it is important to see your physiotherapist before commencing physical activity. Here at Physiotec, your women’s health physiotherapist can assess your pelvic floor muscles to ensure you are using them correctly, assess and address other areas of concern such as low back pain or pelvic pain and advise you on the safest exercises during pregnancy as well as into the post-natal period. You might also like to join one of our Pilates classes to stay strong or build strength and control before, during or after your pregnancy.

Download more information on Physical Activity during Pregnancy here

Try Torpedo Perturbation Training at PhysioTec

Try Torpedo Perturbation Training at PhysioTec

Perturbation Training

See one of our Physiotec staff, Colm Coakley, demonstrating some perturbation training using the CorMax Torpedo. Half filled with water, the Torpedo becomes an unstable load which your muscles need to figure out how to control. Consequently, it provides a great dynamic stability challenge! Also, due to the ever-changing stimulus, it keeps the nervous system guessing.  This requires the system to continually change the way muscles are stimulated to respond.

In response to pain, or sometimes due to excessive training in very rigid unvarying patterns eg like regularly holding a rigid plank for 2+minutes, the nervous system can begin to recruit muscles in very confined, ‘primitive’ patterns. This can lead to a loss of normal efficiency and load sharing-load sparing in muscle recruitment patterns. As a result, this can also potentially contribute to pain, injury and a loss of athletic performance. At Physiotec, we are always exploring and embracing strategies that can help our patients get the best out of their bodies and their lives. Come & join one of our highly qualified physio’s in an innovative and challenging workout.

6 Tips To Bulletproof Your Running This Summer

6 Tips To Bulletproof Your Running This Summer

It’s spring time and for many it’s a sign to start getting fit for summer. For those who had been hibernating during winter it is worth taking note of these following tips to bulletproof yourself for the months of running ahead.

 

  1. Remember you are exposing your body to increase stresses and strains that it may not be accustomed to. Many runners experience injury in their first 8 weeks by doing too much, too fast, too soon. Increase running volume by no more than 10% every 2 weeks.
  2. If you are taking up running for the first time, allow 48 hours between runs during the first four weeks. You can do other lower impact exercise on alternate days such as cycling, swimming and strength training.
  3. Break up your first few runs into run/walk intervals. For example 1 minute run/1 minute walk for 20-30 minutes. 
  4. Run with a shorter step and higher cadence. Pick the foot up as you swing the leg through and land with a verticals shin and bent knee joint in the front of the hip. Run tall with an upright posture. As you improve in fitness and strength your running technique will feel easier.
  5. Strength Training/Pilates will help your running performance and reduce the risk of injury. Runners need strong hips, trunk muscles and ankles to move well, maintain good posture and prevent injury. Two-three #strength training sessions is recommended per week focusing on whole body ground based exercises such as squats, lunges, deadlifts and step ups. Good movement and technique must be trained before adding resistance.
  6. Make sure you have the appropriate equipment/footwear. Nothing more likely to cause injury/discomfort than this. Find the runner that is most comfortable for you or a brand you trust and have used previously in the past with good results.

 

If you have pain running and you’re unsure about why, STOP! Go see your GP or Physiotherapist, find out why you have a problem and then deal with it. Many running related pains are easily dealt with, but some, if left untreated, can become chronic problems.

Enjoy your running! Every session you do doesn’t have to be better than the last one. Schedule easy runs for yourself where you don’t worry about pace and just enjoy a nice easy trot!