Approachable Fitness & Physical Therapy

Fitness Trends for 2016

As the New Year approaches we tend to look back and review the past year and also plan ahead to the next one.
2015 saw The Studio develop extra-small classes, enabling clients to enjoy individual tuition within a group format. This makes it affordable, effective and sociable.
I undertook further training to enhance my skills as a fitness professional and soft tissue therapist. My specialist training with an experienced osteopath this year was in the diagnosis, treatment and prevention of knee pain. A really useful area in which to have more knowledge. My soft tissue work training was in recognising and releasing the tightness which causes poor posture and gives back pain along with some new techniques to offer sport massage without pain.

So, what underlying trends can we expect to see in 2016? (ref ACSM)
1. Wearable Technology
Trackers, heart rate monitors etc… all helping increase activity levels by constant monitoring.
2. Body Weight Workouts
Taking fitness back to basics by using body weight instead of machines and free weights.
3. HIIT
High Intensity Interval Training used with many forms of fitness to improve performance and shorten the time spent exercising.
4. Strength Training
Both in the gym and in classes for general fitness as well as improved bone density.
5. Fitness Professionals with better training
Improved training leads to better results and more choice for the public in looking to improve their fitness.
6. Personal Training
Including group PT - extra small group exercise classes, perfect for affordable individual tuition
7. Functional Fitness
Fitness which helps activities of everyday life, essential for keeping active for longer.
8. Fitness for Older Adults
Older adults have specific requirements which are now recognised and will be better catered for.
9. Exercise for weight loss
Dieting alone cannot achieve sustainable weight loss and this trend backs the theory that exercise is an essential part of weight loss.
10. Yoga
Yoga has many forms and often includes ‘wellness’ which features lower down the list of fitness trends. I see these combined to offer an exercise based way to cope with the stress of today’s busy lifestyles.
Comments

Are you still doing sit ups in the hope of achieving a strong core?

Sit ups are often performed as a core muscle exercise. However research continually shows that they are not effective at building core strength. Old habits die hard and in the fitness industry sit ups, crunches, roll ups, roll downs etc… have been around for as long as people have been exercising. But, this doesn’t mean that they are good or effective!

Core muscles are those which hold your body together, giving it strength by binding around your trunk. They support your spine and strengthening them can significantly reduce back pain. I would include in core muscles those around the shoulder girdle. They have a big impact on posture which, if poor, can cause the shoulders to slump forward and eventually result in pain. Recent research has also added new muscles as essential for core stability, known as gluteals. This complex muscle group lies across your butt and holds your pelvis stable.

So back to sit ups, what happens to your body during the exercise?

Your shoulders round into a position very similar to that seen in the office chair slump, the slouched driving position or the collapse on the sofa rounding. In other words, good posture across the shoulder girdle is completely lost. When this was first performed I don’t suppose we were living a life of sitting and slouching so possibly the postural issues we see today were not as prevalent.

Your spine is curled forward. For some this may feel good and indeed be beneficial but for many the compressional force on the intervertebral discs will aggravate previous injuries such as herniations (slipped disc) or prolapsed discs. Measuring this compressional force is something we’ve only been able to do in recent years, and it is huge when performing a sit up. When I first taught these exercises the fitness industry was oblivious to these potential dangers.

Once you get almost half way up, your hip flexors become the main workers to stabilise and complete the movement, to bring you up to sitting. These are also shortened by a sedentary lifestyle and if not specifically stretched they pull the pelvis out of alignment causing back pain.

This brings us onto the new core muscles, the gluteals. Generally weak (despite years of tums and bums classes!) and difficult to activate, yet essential for good posture and a strong core. In those who perform lots of crunches the hip flexors, hamstrings and rectus femoris (thighs) tend to be strong but these muscles work in a vertical plane. In these people the gluteals are likely not to work at all, yet they provide all the essential diagonal support for the pelvis.

If you are looking for a strong core, the exercises you need are those which use the gluteals and the stabilizing abdominals, not the sit up muscles.

If you’re tempted to go for a ‘6 pack’, remember that it can only be achieved by over developing the muscles so they push out through the fascia, which is there to hold them together. For a female to develop a 6 pack, as well as the muscle development she also needs a BMI well below that recommended for good health.

For effective exercise advice look for an instructor with a good understanding of spinal load during exercise, preferably with a specific low back qualification and an interest in functional fitness and posture.
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Pain is not as simple as you might think!

Almost everyone will have felt pain at some time in their life. Here at the studio we see a lot of people suffering from pain, mainly associated with movement or a persistent ache. We can usually help to alleviate this either by reducing it or by offering techniques to manage it. What you may not realise is that there may not be a physical reason for the pain.

To get a better insight into what is going on when you hurt, we need to understand how you feel pain.

The ability to feel pain is very important to our wellbeing. It stops us doing things that are damaging to our bodies, and makes us rest to allow our bodies to recover from injury. So you really should not ignore pain, or simply "work through it".
Firstly you should make sure that there is not physical damage causing the pain.

The expected mechanism of pain starts with some physical damage which causes receptors within the nervous system to fire. This action creates minute electrical currents which are passed from nerve cell to nerve cell up to the pain perception center in the brain. It is here that these signals are actually converted into what we know as pain. All along this pathway it is possible for your body to mistakenly trigger, sometimes from a sort of nerve memory. Hence, for example, the site of an old injury can often be painful even though there is no damage or reason for that pain.

The brain itself is quite capable of "making up" pain. If you injure your ankle your brain will avoid movements that cause pain in the damaged area. This is good. However once the damage is repaired, the brain continues to avoid movements that were painful. The fear of pain can cause actual pain. The brain has to be retrained to understand that the pain is no longer there by specific repeated movement patterns.

Often in avoiding pain the body will stress another area and cause a pain there. It doesn't always make the right decisions as to the best way of helping your body.
We see this type of issue often at the studio. A client may have had a small injury to a back muscle lifting something heavy out of a car (shopping or a child are frequent culprits here). The body's defense mechanism leaps into action and activates a range of alternate muscle actions to protect the damaged area. Unfortunately this will usually cause a misalignment, or imbalance in the body, often resulting in the stressing of and possible damage to a whole set of different muscles ranging from shoulders to knees and ankles.

Clients come to us with a problem in their knee. However, when we have taken a holistic review of their gait and completed a range of movement tests we can see that the problem is not in fact in the knee at all, rather it is a bodily imbalance brought about by a completely different issue.

So, if you have pain, my advice is:
Firstly, check with your GP to rule out a structural or other cause which needs medical treatment.
Then, come to The Studio for a half hour one to one consultation so we can assess the best ongoing solution.
Alternately, or in addition, if you have access to a physio ask them for muscle testing and exercises.

Frequently the solution from me (or a physio) will be regular exercise combined with soft tissue treatment and exercises to include in your existing fitness regime or to do at home.

Don't put up with pain, call us, we may well be able to help.
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Back Pain Solutions - The latest research

As a practitioner in the field of back pain and a member of ‘Backcare’ the UK’s national back pain association I receive regular updates on current research and recommendations.  The most recent publication contained several interesting articles which I will summarise and share with you.

Orthopaedic surgeons speak out about what they see as the alarming trend in dangerous and unjustified back surgeries.

To quote George Ampat a consultant orthopaedic surgeon based at Royal Liverpool University Hospital ‘Unfortunately, there is a false belief that surgery or new technology can fix back pain.  This is far from the truth.’  He says that out of 100 patients who see a health professional for back pain 97/98% will get better without surgery through exercise and over the counter medication.

There are many products on the market for the condition known as sciatica, most of which you will see advertised for a while before they disappear – usually because they don’t work.  Sciatica is usually caused by a collapse of the spinal discs pushing the intervertebral cushion out, a bit like squeezing jam out of a doughnut.  Fortunately, with time and stability work this will usually ease within a few weeks.  One research study in the US looked at the results of surgery and showed a benefit for up to 8 years after surgery.  In the same study, those who did not have surgery also continued to improve over the same period.  Another study looked at the return to work ratio of those having surgery v those not having surgery.  The result?  26% of those having surgery returned to work v 67% of those who didn’t.  In addition, there was a 40% increase in the use of painkillers in those who had surgery.

Exercise myth busted - Don't delay, be active:
Nick Sinfield, a chartered physiotherapist says that a common effect of pain is that you become fearful of movement or believe that a certain movement will damage something.  In fact you should be moving and doing physical activities that move the spine normally.  Moving with a rigidly protected back will prevent your recovery not help it.  By not bending and moving correctly strain is placed on already sensitive soft tissues.

In my opinion if your back is sensitive, painful or stiff you should choose your exercises carefully.  Pick those which will reduce stiffness with gentle controlled movement and minimum spinal load on the spinal structure.  This type of exercise will improve the function of the spine, enabling it to cope better with everyday life. The ligaments and muscles which support your back require strengthening and rest will only weaken these leading to more back pain.

Remember the proven benefits of exercise:

Increases blood flow to all muscles which helps the healing process

Reduced muscle spasm, especially with biomechanic based anti-spasm techniques

Increase in your confidence in your body’s ability to move

Reduction in anxiety which helps with soft tissue relaxation.

Improved body awareness enabling you to listen to your body better in the future therefore reducing the likelihood of a recurrence.


Surgeons Speak out - Surgery can't fix all:
David Hanscom an orthopaedic surgeon specialising in complex spinal surgery says that although there is no connection between disc degeneration and pain there are hundreds of thousands of spinal fusion operations being performed for back pain every year based on MRI scans showing disc degeneration.
He says that in the over 60's, disc degeneration is present in 100% of people - most of whom do not suffer from chronic back pain.  This is normal.  Disc degeneration is not a disease, it is a normal part of aging, like grey hair.  Add to this the research that looks at back surgery patients after 2yrs with only a third showing improvement and you can see that it is easy to end up in what he calls the 'failed back surgery syndrome' with crippling pain for ever.

So, why do so many people see surgery as the best solution?

Well, there seems to be a number of factors having an effect.  Firstly, the health industry is increasingly commercialized with huge sums of money to be made from drug development and spinal devices. So it’s no wonder that these are promoted.

Add to this the fact that exercise in the UK is still almost entirely unregulated so usually excluded from being prescribed on the NHS.

Also, the training required to be effective as a back specialist forms something of a barrier to many exercise professionals.  As a result only a small number of us are fully aware of all the techniques and therefore the best way to help people with back pain.

Finally, people will always tend to select the solution that requires them to do the least work.  Often the choice will look like a life time of exercise against an operation and a period of recovery followed by a pain free existence.  Unfortunately this view is being called into question more and more.

My opinion?

This situation is a great shame because exercise is a cost effective, less invasive and therefore risky, solution.  However the fix for all this is not easy and probably would involve some form of regulation for those exercise professionals who would like to provide the service for the NHS.  Also doctors and surgeons need to be aware of the success rates of the exercise alternative, and also be directing patients down this course.
You can see from this why I feel so strongly that exercise options should be thoroughly tried before progressing to surgery. 

If you have any questions on this just give me a call
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Risk v Benefit - Keeping your exercise programme safe


Risk v Benefit Keeping your exercise programme safe

 

There is much in the popular press about the benefits of exercise for both physical and mental health.  Many people are encouraged to take up exercise by their doctor or physiotherapist.  On the other hand, there are many articles about the risk of injury from exercise.  For example one study showed that over 60% of runners will pick up an injury in any one year, and another stated that 35% of women exercising on a regular basis will have a musculoskeletal injury.  

 

As a fitness professional and physical therapist I use a variety of techniques to ensure that my clients gain the benefit and do not suffer any injury:

 

I encourage clients to work at their own level, not keeping up or competing with each other.

I keep a close eye on the posture of each client as they exercise.  If there is a postural fault when a client walks in, they will probably keep that faulty position as they exercise.  This will be a habit that I am keen to discourage and correct with exercise.

When I spot a common postural imbalance within a group I will add exercises to help them correct it.  This could be drawing back rounded shoulders, lengthening the neck or stretching tight hamstrings to encourage better pelvic alignment.

At the beginning of each session I check how everyone is feeling and how long standing injuries are progressing.  I will include the best exercises to help each persons condition.  This could be reducing range of movement to encourage stabilization of a lax joint, work to strengthen a weak joint or stretches to help muscles tightened up by other sports such as running or cycling.

 
Using these methods I aim to help everyone to exercise and gain a benefit whilst not risking an injury.  Remember that your feedback is essential to ensuring a safe effective exercise programme so don’t keep quiet about any pain or discomfort as there is usually a way to manage it, and it is often a good indicator to the types of exercise you need.
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Yoga:- Religion? Life Style? Extreme Exercise, Relaxing Exercise? Just what is Yoga?



In fact it can be any of these things, and more besides.  For an understanding of Yoga it is necessary to look at the history and development of this ancient art.

 

Before we start I must point out that I am not a Hindu, neither do I teach nor practice any of the true forms of Yoga. I am not an expert in this field, but am offering a simplified insight into the many meanings of the statement I do Yoga. and what might be involved in a Yoga session.

 

In the beginning.


We can start with the Vedas.  These are the four collections forming the earliest body of Indian scripture, which codified the ideas and practices of Vedic religion and laid down the basis of classical Hinduism. They were probably composed between 1500 and 700 BC, and contain hymns, philosophy, and guidance on ritual.

 

It is the Vedas that are the common link between Hinduism and Yoga and which form their very foundations. Yoga is in fact one of the 6 main branches of Hindu philosophy.

The word Yoga means Union some say union with God, others union with self. This union can be perceived through a variety of methods including, but not limited to, control of the mind and senses, meditation and caring for the body through asanas, pranayam, cleansings, and detachment from worldly objects. Yoga directs us towards a righteous path of living; it is the remover of our identification with our physical body; and the aid to achieving moksha (liberation) in this lifetime.

 

So Yoga is religious and part of Hinduism?

Yes, but not necessarily!  Even from quite early in the development of Yoga and Hinduism it seems to me that Yoga could and did stand separately from Hinduism, as well as being an intrinsic part of it.  Yoga was originally a way of life but over time, it seems, a variety of elements from the whole have been extracted, each with specific benefits, and each called Yoga.  Confusing isnt it.

 

And now?

There are many forms of Yoga, some are named (e.g.  Hatha, Vinyasa, Kundalini, Ashtanga, Bikram, Iyengar, Anusara, Restorative, Jivamukti, to name but a few) whilst others are just Yoga.  Each focuses on a set of targets or beliefs drawn from the Yogic teachings.

 

What does this mean for me?


When you attend a Yoga class you might find you spend your time relaxing and meditating.  Or, you could find yourself attempting to achieve extreme positions.  The class might be constructed to be accessible for any age or ability, or the session could expect a high level of fitness, stamina, strength and flexibility.

There is no doubt that there can be huge benefits to be gained by the practice of Yoga however it is also clear that Yoga can also be physically detrimental.

When you consider the history of yoga you can see that it was not invented as a remedy for back pain or other injury. If this is your aim you need to seek form of exercise with a more physiological remedial basis.

 

How can I know what I am letting myself in for?


I would strongly advise that you contact the person running the sessions and ask them specifically what the aims of the class are, what their qualifications are, and make sure that their answers match up to your own targets and expectations.  In any case be extremely wary of any class that expects you to push past the pain.  Pain is the bodys protection mechanism and you should only be working through pain in closely controlled circumstances with specific goals.
Comments

I have arthritis, should I exercise?

Some Facts about arthritis:
  • About 70% of people over the age of 65 will have some level of arthritis and 1 in 5 of the whole population.  This equates to around 10 million people in the UK.
  • A number of people will have no symptoms and be oblivious to the fact that they have arthritis, but most people with it will suffer some symptoms, such as pain and stiffness, on a daily basis.
  • The most common type of arthritis is Osteoarthritis, followed by Rheumatoid (especially in women) and Gout (especially in men).
  • There are actually over 100 different diseases that can cause the problems characterised as arthritis.
  • There is no cure for arthritis.
 
What is arthritis?
Arthritis affects the joints of the body.  At least two bones meet to form a joint, but some joints have three and wrists and ankles have more. Each joint in the body is constructed in a slightly different way.  Most of the main joints have cartilage covering the bone ends and the whole joint is enclosed in a sort of bag called the joint capsule.  This bag holds synovial fluid which effectively lubricates the joint.
Arthritis develops when the cartilage has become worn, torn, or has been removed, often due to trauma.
The synovial fluid within the joint capsule becomes thicker or ‘stickier’ as we age and as a result doesn’t coat the cartilage as well.  This results in increased wear to the cartilage and the bone ends which become roughened.  The joint can no longer slide smoothly and pain results.  This is typical in osteoarthritis of the knees, shoulders and hips.
With Rheumatoid arthritis joints become swollen as the body attacks its own tissues.  There are many other forms of arthritis, such as spondylitis which is when inflammation around the spine causes pain.

What causes arthritis?
Arthritis has a variety of causes, most of which are not fully understood.  For example:
  • Trauma to a joint earlier in life frequently makes arthritis more likely.  A car accident, sporting injury, trip or fall can all cause damage to a joint, weakening it and making it susceptible to arthritis, sometimes not manifested until later life.
  • Cartilage has a poor blood supply which means that when damaged by twisting or tearing is doesn’t heal very well.  As a result, it was common for cartilage to be removed following trauma, although nowadays this is less frequently performed and exercise is used to manage the situation.
  • Carrying excess weight puts more strain on the joints increasing the amount of wear and tear.
  • There is a clear genetic link which can increase the risk factor for Rheumatoid arthritis which can be activated by trauma.
 
Exercising with arthritis.
Arthritis causes joints to be stiff, painful and to have a reduced range of movement.  Exercise can improve these symptoms but it needs to take account of the arthritis. I work to create an environment and exercises within which the joints can be moved freely and without pain and you feel able to exercise within you own capabilities.  In addition, exercise can encourage good posture, which is essential in keeping the spine straight and reducing the risk of kyphosis – rounding of the neck shoulders as well as potentially slowing the progress of degeneration.
 
Key points to remember:
  • Loosening joints, using movement which is pain free, is essential to encourage and keep the maximum mobility.  For example, in ball and socket joints, simply rotating the limb within the joint capsule can have a beneficial effect, by encouraging the synovial fluid to coat the whole joint and become less ‘sticky’.
  • Specific muscle strengthening work to support the damaged joints will help reduce pain on a daily basis.  This is especially beneficial for the hips, shoulders, knees and spine.
  • Do not push through the pain, look for a different way to loosen or strengthen the painful area.
  • Avoid overstretching and putting joints into positions out of their normal range.  For example, knees are a hinge joint, designed to bend in a forward and backward motion with limited rotational range.  Sitting with legs crossed will stress the joint and in time can cause wear and then damage.
  • Note which activities cause pain and look to find other ways of doing them.  Exercise can be designed to help you strengthen your body enabling you to do regular activities with less pain.

Finally:
Arthritis can be debilitating and has no cure, but exercise is one of the recommended treatments - don’t let arthritis be a reason to stop exercising.

 
Comments

Exercise - Benfits more than just your body!


When you think about ‘exercise’ you probably think about the benefit to your muscles and cardio vascular system, that it may hurt, you may ache afterwards but you’ll feel better for it and you’ll spend time with a group of likeminded people at your class or in the gym.  The first few statements relate to the physical benefits, but the latter are the extra benefits you may not have considered as being so important.

NHS Choices has this to say about exercise and mental wellbeing:

“It has long been known that regular exercise is good for our physical health. It can reduce the risk of cancer, heart disease and strokes. In recent years, studies have shown that regular physical activity also has benefits for our mental health. Exercise can help people with depression and prevent them becoming depressed in the first place. Dr Alan Cohen, a GP with a special interest in mental health, says that when people get depressed or anxious, they often feel they're not in control of their lives. "Exercise gives them back control of their bodies and this is often the first step to feeling in control of other events," he says.”
see : http://www.nhs.uk/conditions/stress-anxiety-depression/pages/exercise-for-depression.aspx for the full detail.

So, if you are feeling down, generally tired, depressed or lonely, why not try a regular exercise class?

If you’re not used to exercising particularly in a class, you may think of a number of reasons why exercise is not for you.  Often, these reasons are based on misunderstanding or misinformation.  I have listed a few common feelings here along with an explanation of what actually seems to happen.

I have never been sporty, so I don’t do physical activity.
In fact many of our class members are not sporty in the slightest, and they still find the classes are easy to do.

I always feel tired so class will simply exhaust me further.
Many exercises or movement in classes can be made easier or harder by the way you do them.  Simply do as much or as little as you feel you can.

Exercise has to hurt to be beneficial, I don’t want that.
The more recent thinking by exercise professionals is that “no pain, no gain” is not, in fact, true.  In reality we have seen plenty of people who have improved their fitness and personal wellbeing, through exercise, and have not felt any pain in the process.

When I get there everyone will know everyone else, consequently I will be left out and feel awkward.
Whilst some classes can be a bit insular, in our experience most class are actually very inclusive.  New people are joining all the time and are very soon embraced by the class camaraderie.  As an alternative why not take a friend with you?

I have tried yoga/pilates/circuits/whatever and I found it painful/just didn’t like it.
Actually, pretty well every class is different in one way or another.  The content is usually created by the person giving the class so there are as many different forms of pilates, yoga, circuits, boot camps, meditation, etc. as there are teachers.  It is worth trying a number of different classes until you find the ones that suit you.  Almost always there is at least one out there.

I have never done any exercise, there are so many different classes I don’t know where to start.
In this case, go for pilates or yoga.  Look for a class where the instructor tailors content to fit peoples’ ability. Talk to the instructor, or other class members to find out about other classes in your area that may suit you.  Then just go along and give it a go.  It is normally easy to have a trial at any class and move on until you find one you like. But it is always worth taking to the instructor about any aspect that you didn’t like because it may be that it could be change to suit you.

The fact of the matter is that almost everyone can benefit from joining a class.

If you continue to be inactive you are more likely to suffer from low mood, depression, tension, stress, anxiety and worry.

By taking more exercise you will feel better about yourself, be less depressed, less anxious, have improved sleep and better concentration, not only this, but you will improve your physically capabilities.  All great reasons to be more active, particularly the older you get.

Looking at the technical side of why we benefit mentally from being more active there is a combination of reasons, some of which are not fully understood.  The simplest factor is that exercise stimulates the release of mood enhancing chemicals, dopamine and serotonin. On top of that the social aspect of common goals and camaraderie have a positive effect, as does the realisation of achievement.  Also your support network can be extended, we have found that classes are very good at support and often bring together common experiences and solutions to life’s difficulties.

The key to gaining a benefit is in finding an exercise programme which suits you.

It needs to be enjoyable and an escape from the pressure of ever day life.

It may not be hard work and you should feel able to rest during the class when you feel that you’ve done enough.

There may be a strong social element with interaction with others in the group.  The companionship you feel from your fellow class mates can be as important as the actual exercise.

Choose a form of exercise that you can keep up on a regular basis.
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Thai Boxing - Personal Training with a difference


Make a difference to yourself today.

Are you in the Warwick area and looking for a different way to get and stay in shape?

Personal training will not only help you achieve your goals but is also a great alternative to a regular gym work out and run on the treadmill!

Singkhao Muay Thai Instructor Macauley Coyle is a competitive Muay Thai Fighter and athlete.

The training he will provide is varied and is planned to suit your individual needs and goals, whether you want to work on technique, become healthier, lose weight, improve your fitness or just learn something new.

So whatever you are aiming for, Macauley can help you reach your goals and achieve them faster than you would on your own.

Personal training sessions vary from person to person, areas that you may cover in a session include padwork, technical work, cardio and plyometrics. All equipment is provided and all you need to bring is lose fitting clothing, suitable for working out in. Nutritional advice is also available on request.

Comments

Why do you need strong 'glutes'?


When new people join a class or come to me with back pain they are usually completely unaware of their glute muscles.  The glutes are quite likely to be weak and tight, which sounds like an odd combination.

Strengthening the muscle and stretching it so it can function correctly is an essential part of keeping your body working effectively and without pain.

  • Keeping correct alignment
    Strong glutes can protect you from injury and reduce the impact of arthritic pain by providing support to the spine and pelvis.  They also give correct alignment throughout the body helping to protect the knees from uneven wear, keep the feet lined up reducing problems with the achilles and plantar fascia.

  • Support when walking or running or weight training
    The glute muscles stabilise your pelvis while you run or walk. They help with hip extension and forward propulsion. If they fail to engage correctly the work falls to the hip flexors which are less able and become tight quickly.  This puts stress onto the lumbar spine giving back pain.  Strong glutes help give correct positioning when weight training, especially during squats, so your knees are protected.  They also help with protecting your back when bending to pick up items from the floor or gardening.

  • Injury prevention
    If your glutes are not strong, your entire lower body alignment may become out of balance causing injuries such as achilles tendinitis, shin splints, knee pain and leading to tight ITB which runners are particularly susceptible to.  When the glutes are not strong enough to do their job, other muscles not as well designed for the job take over.  While in everyday life it is usually the back which suffers, in those who train at a higher level the muscle imbalance is more pronounced leading to increased risk of injury.

  • Strength
    The glutes are one of the largest muscle groups in the body.  If trained it can produce an enormous amount of power. By strengthening this muscle you will be able to move with less stress on your skeletal structure.  This is of enormous benefit as bones become less strong with age and affected by degenerative conditions.

  • Reduction in back pain
    To simplify the effect strong glutes have on back pain visualise your spine.  It runs from the back of your head to your pelvis (hip bones).  Your pelvis sits like a t junction at the bottom of your spine.  Below this are your glutes, providing support to everything above it – hips and spine.  Once you move they are powering from behind you enabling you to move easily with less effort.  The other muscle groups, abdominals, quads and hip flexors are at the front of your body and while they are essential for movement and stability they are not nearly so well placed to provide power as the glutes.

So, to keep active and move with ease - get your glutes working!
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Physical Therapists and Practitioners: which one is right for me?

There are a whole host of people out there offering a service to improve your physical being. Some have virtually no training, others have trained for years. Some provide a diagnosis, others just relieve stress. Some are very different, Pilates vs Indian head massage, while others are confusingly similar, osteopathy vs physiotherapy vs chiropractic. Some provide regular exercise, others are more remedial. So which one is right for you?

To look at it another way, for what should I go to each person? Or, what can I expect from each visit? Unfortunately, and possibly surprisingly there is not a straight forward answer to this (except possibly for GPs). Mainly because each therapy is practiced by an individual and your experience will vary greatly, even within a single discipline, depending on that individual’s experience, capabilities and beliefs. The best thing to do is book a consultation session so the practitioner can explain what services they offer, what you can expect to experience with them and a recommendation as to what would be best for you. Alternatively talk to someone who has been to a session and get a recommendation.

To help you choose which is right for you we can identify some basic information about each therapy.

1 Medically qualified and registered practitioners.
  • GP – For diagnosis and medical knowledge. Your GP is the first place to go for any diagnosis. If your GP cannot complete a diagnosis he will be able to send you to someone who can.
    Physiotherapy – For injury rehabilitation with medical knowledge. A physiotherapist will work generally on a specific site on your body. They may use manipulation techniques and suggest exercise programmes.
    Chiropractic – For diagnosis, medical knowledge, injury rehabilitation and chronic pain relief. According to the Collins English Dictionary this is a system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. They use manipulation and movements beyond your normal range. They tend to do this quickly, many people will recognise this as “clicking”.
    Osteopathy – For diagnosis, medical knowledge, injury rehabilitation and chronic pain relief. According to the Collins English Dictionary this is a system of healing based on the manipulation of bones or other parts of the body. This is a more holistic approach than chiropractic, but they also use movements beyond your normal range. They tend to do this slowly, manipulating and stretching the muscles and tendons.
Bear in mind that, with the exception of GPs, you might have a very similar treatment from any of the above therapies and differentiation can be quite difficult. They all undertake many years of training in their own discipline and are required to be registered to practice.

2. Exercise Methods:
  • Yoga – An ancient teaching from India. It is as much a way of life as an exercise class. There are many types. Some will include extreme positions and movements to improve strength and flexibility. Some include meditation, breathing, and relaxation techniques. Some will use flowing movements through a range of positions to achieve strength and flexibility. Try to talk to your yoga teacher prior to attending a class to establish whether the class will suit you. Generally you can expect a Yoga class to be physically challenging and involve a lot of stretches, balances and quiet reflection.
    Pilates – Invented in the early 20th century by Joseph Pilates. This concentrates on the development of the “core” musculature. Again there are a number of variations from the pure, following exactly the original moves and approach, to fitness based and hot Pilates. Generally you can expect a Pilates session to be full of small slow movements coupled with balance. The focus is on correct technique to ensure the engagement of the important “core” muscles of the body.
    Gym Training – A range of strength and cardio-vascular training equipment can be found in most gyms. Trained staff are on hand to explain the use of the equipment, and you would expect to have a personal programme to follow developed by one of the trainers. The staff are usually fitness experts but may not necessarily have any more specific training or expertise. Generally you can expect to be left to follow your own programme at your own pace in your own way.
    Exercise classes – There are a large range of general exercise classes from circuit training to spin, from British Military Fitness (BMF) to Zumba. They are normally quite large classes (8 to 30 and more) and can be very social. There is usually a large cardio element to these classes, some also include strength work. You can expect to work hard, work up a sweat, and gain stamina.
    Personal training – Otherwise known as one-to-one or consultancy. This category covers a wide range of services from specific sport training, through weight loss and life coaching, to back care and post-operative exercise. Some personal trainers are also qualified in massage techniques and a one-to-one session can help enormously to get the best out of classes such as yoga and Pilates. You can expect personal and tailored interaction but make sure you understand the qualifications of your trainer and that they match your goals. These one-to-one sessions are usually invaluable in helping people to meet their goals by selecting the best therapies and explaining the important techniques.
Once again it is a good idea to discover what qualifications and experience your trainer has, for any of these exercise therapies. Do remember that an inexperienced therapist can be just right for you, and an experienced, well qualified therapist may not suit your requirements. That situation is rare, it would be more normal for you to get a fuller, more effective and more enjoyable class from a more qualified and experienced instructor. In other words, to some extent, you will need to “suck it and see”. Just because you went to a Pilates class and it made your back hurt, that doesn’t mean that all Pilates classes would make your back hurt.

3. Massage Therapy (soft tissue therapies).
  • Sports Massage – Despite its name this is not just for fit and active people. It is a deep massaging technique that focuses on areas of tight or knotted muscles and aims to release them by manipulation and the use of pressure. It can be quite painful, and often the massaged areas can be worse for a couple of days. Generally there is noticeable improvement after that. Having said that, very often it is not painful, and the improvement can be immediate. It is unlikely to be a relaxing experience although some people do find it so. Look for a sports massage if you have muscles that are knotted. Deep massage can encourage a healthy circulation before strenuous activity and a sports massage therapist can also provide post exercise or event massage.
    Myofascial Release – Your whole body is covered with the fascia. It is under the skin, but over the muscles. If you look at a joint of meat the fascia is the white fibrous covering. In the best circumstances the fascia is taut yet flexible. In most people it has areas where it is attached to muscles, or damaged, or affected by scar tissue and so on. It can be like having a large rubber band holding your body out of alignment. As a result you may have pain in a shoulder that is cause by tight fascia running down your leg. A Myofascial massage is different from any other soft tissue therapy and feels gentle. The aim is to free the fascia to allow the body to align itself correctly. Look for a fascial release massage to ease those aches and pains, or to correct a postural anomaly.
    Manual Lymphatic Drainage – Generally known as MLD. The body’s lymph system is just as important as the blood system, although not many people realise just how essential it is. Without lymph your blood would not get oxygen from the lungs, and your muscles would not get the oxygen from the blood. Not only that, but the body’s immune system would not work at all properly. It is lymph that is normally responsible for swelling at injury sites. Lymph is circulated around the body, but it doesn’t have pipes and a pump like blood, it relies on muscle movement and gravity to get around. There are specific sites around the body that process lymph, called lymph nodes. It is here that the lymph is processed to allow it to fulfil its many functions. The movement of lymph around the body can be adversely affected by inactivity, injury, illness and pressure. You should consider MLD if you have swelling, such as post joint replacement surgery, joint pain, or sinusitis. Since the lymph system is in the skin MLD is extremely gentle, but its effects can be immediate and dramatic.
    Swedish Massage – Probably the best known massage. There are a wide range of generic massage techniques, such as this, that have general positive effects, but are not targeted like the techniques covered so far. They range from light to deep massages, some involve slapping and or drumming actions, others are done with the feet. Swedish massage will stimulate the circulation and be both enjoyable and very relaxing.
    Hot Stone Massage – The use of pre-heated stones helps in many ways to increase the effect of massage. Hot stone massages are extremely relaxing. The heat from the stones encourages circulation and the muscles to relax. Using a hot stone to massage with has the effect of a deep massage without the need for so much pressure. Try one of these if you are stressed, or if you have any particularly stiff or knotted muscles.
    Indian Head Massage – Although it is called a head massage you will normally get a head, face, neck and shoulder massage. It is said to stimulate hair growth, but it is definitely a most relaxing massage. It can be done with the client in a sitting position, and fully clothed, so it is ideal for an office environment, or anywhere away from a massage couch. When I have given these types of massage it is quite normal for my client to fall asleep, such is the relaxing effect of the technique. It is very good at reliving the tension in the shoulders that results from sitting at a desk working a computer. Try one of these if you are stressed, have a stiff neck, have a head ache or just fancy a good old pampering.
Which massage may suit you is very difficult to identify, a particular massage for one person can be brilliant, the same massage for another person can be debilitating. Have a conversation with your chosen therapist about your own preferences and any medical conditions you may have. If you have a bad reaction after a massage it is worth letting the therapist know and going back for another try. Most qualified soft tissue therapists will have a range of techniques at their command and will be able to take an alternative approach to avoid any bad reactions.

4 Other specialist areas
  • Postural Assessment
    • Therapists with a postural assessment qualification will be able to identify any postural issues that may be causing pain, or imbalance. They will have a thorough knowledge of the musculature that is essential to correct stance. This is applicable to both exercise and massage therapists.
    Bio-Mechanics
    This area is a whole profession in its own right. Usually employed to gain the maximum performance from athletes and sports people, it has an application for everyone. A therapist with bio-mechanics training will be able to help anyone to a better understanding of their body and, generally, to identify an alternative approach to solving issues such as back pain, knee pain and the correction of running or walking style (gait).
    GP Referral
    This qualification enables exercise therapists to understand and make allowances for chronic conditions presented to GPs which would benefit from exercise. A therapist with this knowledge can support not just GPs, but any of the medical therapists (osteopaths, chiropractors and physiotherapists). Often this support can be in the form of specific exercise plans, but may also be particular massage techniques.
    Back Pain
    The causes of back pain are myriad. Sometimes there is a medically identifiable issue (e.g. herniated disc), but often there is no specific reason for the pain. Where this is the case therapists with specific training in dealing with back pain are able to help with targeted exercise plans, manipulations and massage.

In short, look at the qualifications of your chosen therapist and make sure that they meet your requirements.
Remember that you can get a good result from a newly qualified therapist, but if you have a recurrent problem to solve, look for qualifications, experience and evidence of on-going training, as research continues to improve the way we treat physical conditions.
Comments

Pilates, Yoga and back pain.

What is the difference between Pilates and Yoga, and why would you choose to take up one or the other?
Frequently either are recommended by physio’s or doctors for back pain and can be very beneficial under the right circumstances. Unfortunately both carry inherent risks, particularly for people with back issues, and Yoga tends to be less useful than Pilates in these circumstances.

Yoga
Yoga was developed in India hundreds of years ago to address a whole range of human issues, from the physical to the psychological. It would normally include a significant spiritual aspect as well as extreme body positioning, providing a 'whole body' (holistic) teaching and healing.
More recently popular Bikram and Ashtanga developments of this teaching include a dynamic approach, which can be difficult for less able (normal) people to handle.
Many Yoga teachings, including the Bikram and Ashtanga methods, aim to stretch the body as far as possible and to target the maximum range of movement through each joint. While this may be considered beneficial for a person with no history of joint pain or injury, it is not recommended from a bio-mechanical view. One reputable source recommended that only the under 25’s should be allowed into this type of yoga class.
I feel it is not developed from a physiology base, and not all positions nor movements would be recommended by up to date research into human physiology.
There are Yoga classes that focus on the spiritual elements and relaxation. These can be perfect if you are looking for stress relief or a meditation like class. The spiritual element actually enables some people to really connect their mind and body and gain a tangible benefit from this.

Pilates
Pilates is an exercise method developed by Joseph Pilates, an injured gymnast and body builder, in the 1920's. It was developed from exercises from all the programmes available at the time along with some innovation from Joseph P. This included Yoga and several fundamental Pilates exercises clearly come from this discipline. Joseph understood the need for “core strength” and this is the focus for most Pilates forms.
Whilst there are still trainers that teach “pure” Pilates (as Joseph would have done), other professionals have modified and developed the exercises ever since. There is no copyright on the word 'Pilates' so the content of classes can vary hugely.

Back Pain
Many of the Yoga movements are medically contra-indicated for the back (i.e. the risk of making matters worse, by doing the exercise, is greater than the likely benefit). Some of the Pilates movements are also contra-indicated for the back (mostly derived from Yoga movements).
For an example of a Yoga inspired Pilates exercise which can cause back pain we can take a bio-mechanical look at the ‘roll down’.
Yoga and Pilates both use the ‘roll down’, a movement from sitting to lying where the back curls round to allow vertebra by vertebra to reach the floor. The intention being to strengthen the abdominal muscles.
But what actually happens to your body when doing this?
The intervertebral disc space is opened which can aggravate or even cause bulging (herniation/slipped disc). A little like squeezing a jam donut until the jam pops out.
In fact not only the abdominal muscles but also the hip flexors, hold the body as it rolls down.
The shoulders curl forward shortening the pectoral muscle group and the mid trapezius lengthens.
For many people these muscles are either already tight (pectorals) or already long (mid trapezius) from daily repetitive movements such as computer work or driving. The hip flexors are frequently tight just from sitting down for too long.
It turns out that this exercise provides no real benefit but potentially compounds the postural issues that everyday life gives most of us. Worse still it can aggravate back pain and intervertebral disc issues, rather than helping.

My training as a back pain specialist made me question the validity of some of these exercises, particularly when clients have back problems (slipped or bulging vertebral discs, degeneration of facet joints or osteoporosis). My bio-mechanic training has encouraged me to question each exercise that I teach. What is the benefit? What is the risk? Why am I teaching it to this particular group? Is there a better way to gain the desired result? There should always be a clear answer to all these questions.
I have been teaching Pilates and Yoga, in various forms, for more than 20 years. Over the last 10 years I have developed “I move freely” Pilates as an exercise form that carries most of the Pilates benefits with few of the risks.
I Move Freely Pilates takes the principles of Pilates but integrates Bio Mechanic coaching techniques to offer an up to date way of keeping mobile, strong and with the optimum amount of flexibility. Mobility work is essential to keep the whole body moving easily.  I feel that mobility and balance are key skills that deteriorate with age but which with work can be improved reducing the risk of stiff joints and falls in old age.
The strengthening work uses the body's ability to statically contract or 'engage' a muscle as well as using controlled lengthening and contracting of specific muscle groups. It works on the muscles of the abdomen, buttocks (glutes) and back, many of which you can't see (most people don’t even know they have them), but which should perform functional roles of support throughout daily life.
  It is this functional supporting role that reduces back and other joint pain. Each exercise involves a very precise movement and often it is impossible for anyone else to 'see' how hard a person is working as the work is in 'engaging' a specific muscle.  This often leads people to do the exercises at a level below that of which they are capable and so they don't achieve the full benefit but feel they are 'stretching out' rather than 'working'.
Performed correctly Pilates can achieve great core stability and it is as useful to elite sportsmen and women as it is to the general public. 
This link (from my Norfolk Studio) explains more about stretching v working a muscle:
http://thestudionorfolk.wordpress.com/2013/08/12/are-you-stretching-or-working-your-muscles/

To Conclude
Most Yoga teachers have spent time in India studying and practicing so they are expert in their knowledge. Most Pilates instructors have studied the teachings of Joseph Pilates and have an in depth knowledge of the exercises and breathing techniques he espoused. However this does not make any of them experts in back pain management. They are unlikely to have had the training to working with particular conditions, such as arthritis, or liaising with physio’s as to the correct exercise programme for someone with a recently herniated (slipped) disc. For this you need a back pain specialist.
All forms of Pilates and Yoga can offer some people real benefits. To choose which would suit you best give some thought to what you hope to achieve and how your body will respond to the challenges of each class. Do try several before deciding which suits you and don’t be put off if your back aches after one class, try another – they are all different.
I also strongly recommend taking at least one consultation with a back pain trained exercise professional, since it is essential to know some basic information about how to perform Pilates exercises that is not usually covered in the class situation.
Comments

Is there an age when exercise becomes bad for you, risky or inappropriate?

At what age does it become bad, too risky or inappropriate for you to exercise?

In my opinion the answer is there is no age beyond which exercise should not be attempted!
I may be biased having worked in the world of exercise all my life and coming from an active family but my opinion is backed up by recent research and national recommendations.

The current government recommendation for those aged over 65, is
1. To be active daily
2. To accumulate 150mins weekly of ‘moderate intensity activity’ in bouts of at least 10mins at a time
3. To exercise twice weekly for strength, flexibility, balance and co-ordination
4. Minimise the amount of sedentary time. (sitting)
5. Some activity is better than none, and more provides greater health benefits

This might sound onerous, but in reality it can be achieved very easily.

Let’s look into these guidelines a bit deeper to see how easy it is to meet them and what the benefits are.

First we can consider why should we exercise at all?
• All muscle wastes away if it is not used: the motto use it or lose it really is true.
• Skills such as balance and co-ordination deteriorate with age.  However they can be maintained and even improved with regular practise.  This deterioration is the main case of older people falling so easily, so controlled exercise will reduce your risk of falling.
• Bone density also deteriorates with age meaning falls are more likely to result in fractures.  Controlled exercise will improve bone density hence reducing the risk of fractures.
• Posture can deteriorate as we age for all sorts of reasons, most of which are correctable by specific targeted exercise: don’t become a stooping person!
• Your cardio-vascular system ages with you. We get higher blood pressure, less efficient blood flow around the body and much reduced oxygen uptake by the body, leaving us feeling less like exercise, when in fact we need more! See point 1.
• If you are suffering from arthritis, exercise is known to be beneficial, reduce levels of pain and improve mobility.

Second, what is moderate intensity activity (point 2 of the recommendations)?
Activity, here, can be defined as any movement that increases your heart rate from its normal resting rate. The measure of moderate intensity is different for every individual.  It is not advisable to use any generic figures for this, the best approach would be to ask any appropriately qualified instructor.

What activities could count as moderate intensity?
Walking is brilliant provided it is on a regular basis and is appropriately vigorous.  We can check whether you are being vigorous enough by testing your activity level in a SELECT class.  If you walk your dog daily it is quite possible that you already meet the guidelines for cardiovascular exercise.

Interestingly, golf is found to be of limited benefit.  It is not aerobic, it promotes misbalanced strength and flexibility in the body and research shows no bone density improvement.  This would not count.

Gardening is also classed as non-beneficial.  The bending, reaching and kneeling all puts stress on the body rather than strengthening it.

Swimming is similar to walking in that it can be great for cardio if it is done regularly and with appropriate vigour. However it doesn’t improve bone density or balance. And if you suffer any joint issues, breaststroke should be avoided.

Other exercises to consider that can be beneficial are, cycling, rowing or cross-training in the gym.

So what exercise is available to address point 3 of the recommendations?
Generally these exercises are specific routines that are performed in classes, in the gym, in a swimming pool or at home.  The important point here is to ask an appropriately qualified instructor for guidance on what would be the most beneficial forms for you, and also to teach you how to perform the movements without them being detrimental to you.

Pilates is probably the most suitable form of exercise as it is controlled and specific in its aims. It doesn’t encourage excessive movement, and primarily uses the body’s own weight for resistance. This means it is particularly accessible even for people to do at home.

I have developed a specific variant of Pilates designed to be particularly beneficial for people with injuries, aches and pains, bad backs and posture difficulties.  In “I Move Freely” Pilates classes I use biomechanic exercises to gain the maximum benefit in loosening stiff joints, backcare exercises to strengthen yet protect the spine as well as strengthening exercises for the muscles which give support to our skeletal structure.  Posture is addressed with work to open the shoulder girdle, thus preventing the shoulder rounding which can easily lead to ‘hunching’. Also, I avoid some traditional Pilates exercises (e.g. roll downs, the 100 or double leg lifts) which put pressure on the lower back, neck and pelvic muscles.  Provided you exercise correctly and regularly in class and continue to use the correct muscle engagements throughout the week when doing normal everyday activities you will be gaining strength and stability. 

What if you don’t feel able to take part in a class nor want to go to the gym?
SELECT is a small group class (max 4 people) I run specifically to cater for you.  Because the attendees are very limited the exercises can be completely tailored to your individual needs. 
For example, if you cannot get down to the floor, or you cannot stand for any period, we can provide chair based exercise, or we have exercise couches.  If you find it uncomfortable on normal exercise mats we can provide memory foam mats which protect any protruding, or painful parts from the hard floor.
As another example, If you have specific recommendations from your GP or physio, we are experienced at working with your practitioner to make sure the exercises are appropriate to your needs.
SELECT allows me to shape the class to each individual whatever their requirements.
Consequently, SELECT makes getting started easy, it is friendly, focussed to your needs, will address concerns you may have about your body as it ages and work towards keeping you independent and active – fit for life for all of your life.

 If you are unsure in any way about attending a class or what exercise is suitable for you, please arrange to pop in for an informal chat and see how easy it is to incorporate exercise into your life.
Comments

Thinking about taking up Yoga?


THINKING ABOUT STARTING YOGA?

Before you do you should understand the potential benefits and dangers (yes dangers) of practising Yoga.

Yoga has been criticised for being potentially dangerous by causing injuries and aggravating existing conditions such as arthritis.  Some authors of critical articles have themselves been injured in a Yoga class, others get their information 2nd hand by talking to participants in Yoga classes. Research can be difficult to verify as there have been no specific clinical trials so information is usually taken from surveys.

An extensive survey of yoga practitioners in Australia showed that about 20% had suffered some physical injury while practicing yoga. In the previous 12 months 4.6% of the respondents had suffered an injury producing prolonged pain or requiring medical treatment. Headstands, hand stands, shoulder stands, lotus and half lotus (seated cross-legged position), forward and backward bends, produced the greatest number of injuries. Respondents commonly took the blame for the injury on themselves, citing reasons such as ‘pushing it too far’ and not warming up, along with being too competitive. Read the source document here

The same article also asked the participants for the effect that Yoga had had on a range of over 500 specific medical conditions from which they suffered.  The results were positive:

• Much better 53.3%
• Better 29.3%
• Little better 12.5%
• No change 4.5%
• Little worse 0.3%
• Worse 0.0%
• Much worse 0.4%

In my opinion there are many health benefits for both mind and body to be gained from taking up yoga.  The relaxation element is good for sufferers of depression as well as in rehabilitation from cancer and the management of heart disease.  The flow through a succession of poses can help with stress management and improved posture

Injuries seem to come from beginners pushing themselves beyond their ability and instructors with little training, or experience, who cannot evaluate each participant’s ability and offer alternative positions.  Looking at the list of positions which incurred most injuries, head and shoulder stands should only be performed under close supervision by those working at an intermediate level.  Lotus and half lotus positions place the knees in positions which will aggravate any existing damage to ligaments or cartilage whether originating from an injury or wear and tear. Forward and backward bends put load on the spine which can aggravate any degenerative conditions and potentially cause back pain rather than ease it.

Ensure that you choose an instructor who has experience and a class which works at your level.  Watch out for exercises which may not be suitable for you (see injury section above) and listen to your body.

As an exercise professional I am keen to see everyone partake in some sort of exercise, it’s a question of finding what suits you and for many Yoga will be ideal.  Give it a try, but carefully.
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HIIT Pilates - The best of both worlds?

The latest fitness trend to be big in the UK is HIIT - High Intensity Interval Training.  Everyone is doing it, teaching it, and apparently loving it.  Last week I saw HIIT Pilates classes using Pilates equipment to gain the high intensity workouts.  My reaction to that was simply WHY?  Pilates and HIIT are two different regimes with different aims.  I don’t believe they mix at all.Pilates is a fabulous fitness programme which tones specific areas, encourages the correct muscle engagement, uses breath, focus and concentration to achieve great posture, alignment and muscle balance.
Pilates can be practised as rehabilitation post-surgery or as an exercise programme to help with arthritis or other chronic conditions.
Pilates concentrates on small, slow, controlled movements to train the body to engage the correct muscles for everyday movement and strengthen them where they are weak.
Pilates is suitable for almost everybody.
Pilates is NOT intended to be an aerobic work-out.  It will not improve your stamina nor enable you to lift heavy weights
HIIT on the other hand is targeted to improve your stamina and dynamic fitness, a completely different aim.

So, is HIIT something you should be doing as well?
That depends on the benefit you are seeking to gain and how much effort you are prepared and able to put in to achieve it.
If you are healthy, enjoy pushing yourself to meet new physical challenges and are looking to increase strength and cardiovascular capacity it could definitely help you.  If you are an athlete or sportsman looking to improve your performance then HIIT could be a beneficial part of your program, as could a bio-mechanics program and regular Pilates classes.
On the other hand, remember that it is high intensity exercise. If you have any medical history which precludes pushing your heart rate up this is not for you.  If you have joint pain or disease it could aggravate it.  If you do not use correct technique it is easy to pick up injuries.  And finally remember that it’s not the only exercise programme which delivers results, a gentler progressive programme may suit you better.
Don’t follow the latest trend because it is promoted in the glossy magazines with celebrity endorsements, choose a programme that gives you the benefits you are looking for.

HIIT Pilates is ‘HIIT’ using Pilates equipment.  It is not Pilates in any shape or form. Don’t be confused.
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Exercise Prescription

EXERCISE CORRECTLY

Have you been to a physio recently? Or  have you seen an Osteopath?
Do you have exercises to do at home?
Are you doing them correctly and gaining maximum benefit?
Most people do not exercise correctly and so do not get the full benefit!

I recently received some training from an experienced osteopath.  He suggested that many people given exercises, by physios or osteopaths, don't do them correctly.  They don't exercise often enough or for long enough, and they use poor technique.  This results in a longer period of pain, more visits to specialists and often no answer at the end of it.

The most effective way to exercise a specific muscle is with supervision by a professional, who understands your condition and the exercise required to improve it.  Anne at the Studio is one of these professionals.
This is where one to one sessions are ideal, allowing you the time with this specialist to talk through and practise the exercises you need to do on a daily or weekly basis.

I have listed a few specific issues that would benefit from correct exercise.

Arthritis
Exercise can be hugely beneficial for arthritic joints provided it is carefully monitored.  Mobility and strength work must be within your normal range of movement. 

Back Pain
90% of back pain is described as 'non specific' as there is no specific cause and no medical treatment can be offered other than pain relief.   Exercise can help manage and considerably reduce levels of pain.

Knee Pain
Knee pain has a variety of causes including injury and degeneration.  Exercise can strengthen the joint to give better stability for excellent long term results. 
Comments

Exercise v Manual Work

Exercise or Manual Work?

Strenuous occupational physical activity in midlife increases the risk of mobility limitation in old age, whereas leisure-time physical activity decreases the risk. This is found in a study which followed up 5,200 public sector employees for 28 years. The study was conducted at the Gerontology Research Center in Finland and the Finnish Institute of Occupational Health.

Heavy physical labour is often repetitive, wears the body and lasts for several hours a day. On the contrast, leisure-time physical activity is designed to improve fitness and provide recreation and a typical exercise session lasts for one or two hours. Even though both are based on muscle activity and result in energy expenditure, their long-term consequences are different.

The functional ability in old age is a result of processes which may have started already in midlife - some of them have supported the health of the person while others may have been detrimental to the health. The current research results suggest that a marked decline in mobility occurs only in the last years of life.


The results were published in The Journal of the American Geriatrics Society. The research was funded by the Academy of Finland.
This study highlights the effect of our daily work on our physical health. I see many clients (especially those in nursing) with low back pain from degenerative conditions which have been caused by lifting during their working life. I would expect that we will see many more problems with the thoracic spine from the next generation to reach retirement as so many people spend their work life bent over a computer screen or sitting in the car.

Exercise to correct the muscular imbalances created by work positions will be increasingly important to prevent pain later in life. I would suggest that if you have limited time it is more beneficial to work on achieving good posture through muscular support rather than doing exercises just to ‘be fit’.
Comments

The New Pelvic Floor Work

PELVIC FLOOR DYSFUNCTION (PFD) - IT AFFECTS MORE PEOPLE THAN YOU MIGHT THINK

PFD what is it, do you have it and how can you correct it?
We now know that 80% of women will have Pelvic Floor Dysfunction (PFD) at some point in their life.
A dysfunctional muscle is one which will not contract nor release so it tends to be both tight and weak, and consequently, unable to function correctly.
The pelvic floor is the muscle which forms the 'under carriage' of your trunk so it is essential that it functions correctly for adequate core support.
If it is dysfunctional it will be tight , short and weak instead of being flexible, long and strong.

The symptoms of PFD may include:
Abdominal separation following pregnancy
Occasional stress incontinence
Pelvic discomfort
Back and Sacro-Iliac joint pain

The contributors to PFD include:
Pregnancy
Over doing sit ups
Poor posture
Wearing high heels
Sitting for too long 

What is the solution?
Exercise with the pelvis in a neutral position.
Ensure Sacro Iliac joint stability by strengthening surrounding muscle groups
Strengthen Glute (butt) muscles in conjunction with inner and outer thigh muscles
Squat with correct alignment to strengthen yet lengthen the pelvic floor

Exercises to avoid:
Any exercise with a pelvic tilt as this shortens the pelvic floor muscle encouraging dysfunction
Sit ups which increase the downward pressure on the pelvic floor
High impact exercise
Pilates exercises such as 'the 100'


Would you like to know more?
Just contact Anne by phone or email to discuss your needs.
The correct exercises and techniques are taught in 'I Move Freely' Pilates Classes at The Studio
For more specific advice book a one to one session or a place at one of our new 
"SELECT" classes.
Comments

The Studio News 02/01/14

  • This weeks newsletter with up to date availability for classes and massage. Information about Myofascial Release Technique, a subtle yet effective treatment for tightness in muscles and fascia which causes pain. Plus, Manual lymphatic drainage to help with swelling and boost your immune system. Help with making and keeping new years resolutions and easy tips to follow to help keep healthy through the winter.
  • Read the full newsletter...
Comments

Exercise for all ages and conditions

This article was written for the REPS blog to encourage other fitness instructors to consider moving into this specialist area but is may be useful for anyone who would like to get fitter but is unsure where to start. I am happy to meet anybody keen to start an exercise programme on an informal basis to chat over the best way to get started, I am also happy to advise other exercise professionals on working in this area.

REPs member
Anne Mercer shares her story on how she has succeeded on a prosperous career in the fitness industry.
I have been a full time fitness instructor for just over 30 years now. I started in aerobics, moved through ‘Bums, Legs and Tums’, callanetics and even line dancing to an altogether more interesting and rewarding area of fitness best described as "Exercise for all ages and conditions".

I struggle to find a name to cover all that I do but I think that this pretty much does it. It’s a rewarding area requiring experience and specialist knowledge. I never simply go through the motions of a class. There is no standard class format. Every movement is thought through to consider what it does in terms of the potential benefit as well as the potential risk. This specific approach enables almost anyone to take part in my class. Some may need to lie on a massage couch rather than the floor, the class size is very small and I have a selection of pillows for added support and cushioning.

I base my class on the focus, control and concentration of Pilates. Clients learn to control every movement their body makes and to be aware of exactly which muscle is causing the movement or stabilising the body while it moves. Added to this I use the fundamental back care exercises as recommended by Williams and McKenzie. I consider the spinal load through each movement. I never teach roll downs, sit ups and rarely use seated positions.   The recommended range of movement required by life is my goal with clients aiming for this, not the extreme range some exercise regimes use.

Bio Mechanic principles of pelvic stability and nerve mobility play a large part in ensuring mobilisation and the prevention of dysfunctional muscle tissue. I work on the abdominal stability muscles along with the gluteals, teaching the principle that our muscles provide the scaffolding to our bone structure. Balance is another important area with simple exercises to improve balance and to reduce the risk of falling in the future.

To complete this I work on postural muscles of the upper body to ward off the hunched neck position so often seen in the older generation.

Some of my clients have back pain, joint replacements, degenerative conditions of the spine, or are recovering from mild strokes. Most simply have the general aches and pains that accompany getting older. They need a class which supports them in their quest to keep fitter and keep active as they age. Many classes (including those that I have taught) are aiming at an altogether higher level of fitness which my clients would feel intimidating and at which they would probably be unable to do many of the exercises. Even clients at perimenopausal age have muscular aches that appear from nowhere and affect their ability to exercise.

Added into this mix are many men who have sustained sporting injuries in their youth (rugby/football/tennis etc...) which then return as early joint degeneration or suspected arthritis by the time they are in their mid 40’s.

Over recent years I have seen huge progression in my clients which I find incredibly satisfying. They show a great tenacity in sticking with the exercises and the results are well worth it. They have smaller waists – no mean feat in post menopausal women, balance (for men and women) so good they could be garden statues and they all stand upright within a few months.

To teach this age group you need to specialise into the Low Back, 50+ and GP referral qualification, and then read as much as you can about the effect of ageing on the body. I have found that a sport massage qualification is invaluable to allow me to be ‘hands on’ in certain situations. Talk to people with these conditions, work on a one-to-one basis with them to see what they can do and how exercise can help them.

If you’d like more information on my techniques do get in touch. I am passionate about enabling this sector of the population to be able to take part in group exercise and happy to help anyone move into this area.

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Common causes of back pain

Why do so many people suffer low back pain?

Every client I see is different but there are recurrent themes that appear time and time again. One of these is the difficulty we have in understanding which muscles engage for which task, and which muscles are stronger and should be used to take on heavier tasks. Our bodies are very good at using the muscles that they perceive are strong rather than the muscles which should be strong. This means that muscle imbalances we have developed over many years are maintained as strong muscles get stronger while weaker ones are left weak.

Frequently clients with back pain have an incorrect pattern of muscle engagement. There is often poor activation in the gluteus (butt) area, the abdominals which provide support (transverse/internal obliques) and the multifidus (muscles linking into each vertebrae). The rectus abdominal (used in situps) and hamstrings are often over working. This pattern of muscle activation alters the loading through the spine, sacrum and pelvis, doesn’t give efficient support and, as a result, will often lead to back pain.

Once you understand how to engage and identify the correct muscles you can practice at home and, in time, see benefit from in day to day life. If the stabilising abdominals are taught to activate along with the gluteus and multifidus there is a good chance of giving the spine and pelvis the support it needs. This is harder than it may sound as the brain has to learn new patterns and retain the knowledge to use in everyday life.

The basic pattern of engagement is this:
Tighten or brace the abdominal area (transverse abdominal) without incurring any movement. Engage the muscles which run in a strip each side of the spine (multifidus), and engage the butt (gluteus) muscle without tilting the pelvis. Once achieved, release and re-engage. With repetition this encourages the brain to understand the pattern of activation which is required. It can be practiced standing, sitting or lying.
Initially every muscle in the body engages, especially the neck and shoulders, but the muscles you want to engage have still not appeared. It often helps to ‘prod’ the area where you want the muscle to engage. This would be on the pocket area of your trousers for gluteus, each side of your spine for multifidus and in a line between your hip and belly button for your abdominals. Once the correct muscles activate without affecting the whole body additional work can be added.

This will strengthen these muscles with the correct activation pattern which is essential for long term benefit. To achieve any of this without professional instruction is difficult.

Try a one to one, consultation session at The Studio to help you achieve the correct muscle activation pattern as well as performing other tests for muscle spasm and imbalance which may contribute to back pain. If you are in a different area do get in touch and I can locate a coach local to you.

Please be aware that the information in this article assumes that there is no disc damage, scoliosis, degeneration, arthritis or nerve pain. It is a general view of the cause of much back pain. Bear in mind that there are other considerations including the angle of tilt of the pelvis, as well as foot and knee positioning. Consult your GP before starting an exercise plan if you have any concerns about your health.
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