Women’s Health Week – September 5-9

September 5-9 is Women’s Health week, so let’s celebrate Women, Exercise and Pregnancy

Clifton Hill Physiotherapy is teaming up with The Jean Hailles Foundation to promote women and their health during women’s health week.


Women are often told to exercise comfortably when they are pregnant. This is certainly true to a point; women should absolutely listen to their bodies, but the recommended guidelines are actually more precise than this. In fact, it is recommended that women do 30 mins of moderate intensity, safe exercise, most days a week.

Moderate exercise means you are breathing heavily, can hold a short conversation and are somewhat comfortable, but the exercise is becoming more challenging. 30 minutes does not have to be done all in one go either; you can break this up during the day. It is important to stay fit and healthy during your pregnancy for your baby’s health but also so that you are comfortable, remain active and give yourself the best chance for recovery.

Apart from the obvious postural and hormonal changes that the mother goes through, there are also significant changes to the heart, lungs, kidneys and gastrointestinal systems. One important change is that pregnant women produce a hormone called relaxin. Relaxin allows the ligaments in the body to stretch and this hormone is great because it allows your pelvis to adapt to the growing baby. Relaxin is in the bloodstream and therefore it is throughout the entire body, not just the pelvis. Consequently, your newfound flexibility may be counteracted by your muscles tightening and this will cause a different strain on your body.

The combination of all these changes means that the mother needs to be educated about how much and what type of exercise she should be doing. This is very important that the mother and baby stay safe, fit and healthy. These are some of the basic recommendations for pre and post-natal exercise:

First trimester: Correct pelvic floor exercises, proper technique for core exercises, fix any postural imbalances and continue exercising.

Second trimester: Correct pelvic floor exercises, no exercising on your back, no heavy lifting, no new exercise (except Pilates), prevent pelvic pain, maintain muscle strength, improve deep core strength.

Third trimester: Pelvic floor exercises, no exercising on your back or tummy, maintain fitness and strength.

Post-natal:  Whether you had a natural or caesarean delivery, the first 6 weeks is gentle. Enjoy being a mum and focus on walking, pelvic floor exercises and correct deep core exercises. It is best to get your tummy and pelvic floor muscles checked by a physio before returning to exercise. When your baby is 12 weeks old and you have been cleared by your health professional, you can slowly return to your normal exercise routine.

At Clifton Hill Physiotherapy, Pilates & Rehab we have expert Physiotherapists to safely guide your fitness and rehab through the ante natal to the post natal period, including pre-natal pilates and mums and bubs post-natal classes. Call 9486 1918 for more information.

To help celebrate Women’s Health week Clifton Hill Physiotherapy is hosting a FREE seminar to learn about the importance of exercise and pregnancy at our clinic, from 10am – 12pm, at 101-103 Queens Parade.

Spaces are strictly limited and RSVP by Tuesday 29 August is essential. If you’d like to attend email debbie@cliftonhillpilatesandrehab.com.au 

Seminar flyer information

Rosie Purdue

Women’s Health physiotherapist

Research update at Clifton Hill Physiotherapy

Exciting research update at Clifton Hill Physiotherapy, and your chance to help make a difference…Stroke

Many of you may already know that many of the physiotherapists from Clifton Hill Physiotherapy and Clifton Hill Pilates and Rehabilitation are involved in ongoing clinical research, in an effort to improve clinical services and health practises for everyone.

Traditionally, treatment for chronic pain has been associated with poor results. Recently, with a huge increase in scientific knowledge about chronic pain, things have started to change, with a big shift in services provided and increasing success of targeted treatment interventions.  However for people who experience stroke, the knowledge base surrounding chronic pain still has a long way to go.

Chronic pain persists in 40 to 60% of all people who experience stroke. 

Brendon Haslam, one of our physios with an interest in chronic pain and neurological conditions, has been researching chronic pain following stroke. His research is looking to identify what contributes to people with stroke developing chronic pain, and he is involved in numerous studies in the area.

Your chance to help people who have had a stroke…

One of these studies is an online survey, looking to have as many people as possible participate. (EVEN IF YOU HAVEN’T HAD A STROKE). Any adult over 18 can join in. It involves answering a few questionnaires online and looking at your ability to recognise various pictures of hands and shoulders. Sounds simple doesn’t it, so why not give it a go? You can go straight to the survey by clicking on this link here  http://research.noigroup.com/?_p=stls

To get all the important information needed, it does take a little while, so if you have a spare 15 minutes (now or later), grab yourself a coffee and see what all the fuss is about. As well as having an interesting time in doing the recognition tasks (and we promise you will), you’ll also be doing your bit to help a group of people who are really doing it tough.

We’ve already had nearly 700 people (without stroke) participate, but we need over 1000!

Early results from the study so far have already been presented at a Stroke Conference in Canberra last year (Smart Strokes) and Brendon is due to present at next weeks’ Stroke Society of Australasia Conference in Queenstown, New Zealand. To show that this study is having a global impact, further findings are being presented at the American Society of Neuro Rehabilitation’s Conference in Baltimore in November. The National Stroke Foundation of Australia also recently invited Brendon to be a panel member in their podcast series on “Pain after stroke”, you can listen to that here https://enableme.org.au/Community/Podcasts/Pain  (it’s racing up the iTunes charts).

Thanks for reading this, and we hope you all take up the opportunity to participate!

If you have any queries, please feel free to contact Brendon directly at brendon.h@cliftonhillphysiotherapy.com.au




The importance of the post-natal recovery period

You got through the pregnancy, the birth and getting home!  Now what happens?

The post-natal recovery period is often referred to as the fourth trimester.  PostHowever, not surprisingly, new mums sometimes find it difficult to find the time to take care of themselves, and also, to understand what is normal during this recovery period.  It is often a challenging time full of change, both physically and emotionally.

A number of issues may arise during the post-natal period, many of which can be helped by consulting a specialist Women’s Health Physiotherapist.

Hormonal Changes:

During pregnancy a special hormone called Relaxin increases in the mother’s body.  The role of Relaxin is to act on ligaments and muscles in the body, particularly the abdomen, hips and pelvis, in order to increase the ability of these structures to stretch and accommodate a growing baby.  Whilst these hormone levels are highest during pregnancy, it is known that they may stay elevated for up to 5-6 months following the birth, and even longer if breastfeeding.  This means that during this period, the female body will still be experiencing physiological changes outside of their normal.  You can experience ongoing symptoms of back pain, pelvic girdle pain, abdominal muscle separation and pelvic floor laxity.  It is important to understand that post-natal recovery can continue beyond 6 months and it is vital that women are supported during this time.

 Pelvic floor function:

During pregnancy, the pelvic floor muscles must support the weight of a growing baby!  Naturally, as the baby gets bigger there is an increased load going through the pelvic floor muscles.  Not only this, but during the birthing process, the pelvic floor muscles are able to stretch more than ANY other muscle in the body to allow the birth to proceed!  Considering this, it is common to experience some pelvic floor dysfunction following giving birth, regardless of the method of delivery.  You may notice issues with your bladder or bowel (loss of urine, wind or faeces) or increased frequency and urgency to go to the toilet.  If you have had stitches, there may be some ongoing discomfort and you may experience some pain with returning to intercourse.  Although these symptoms are common, it is important to reinforce that there are treatment and management options available to improve these conditions.


Breastfeeding opens up a whole new world for many new mothers.  It is a new skill that requires time and energy to develop.  One of the common barriers to breastfeeding is Mastitis.  Mastitis is defined as inflammation or infection of the breast tissue that can result in breast pain, swelling, warmth and redness.  This can be very painful for mothers and can also contribute to poor feeding.  Mastitis is most common within the first six weeks following birth, however can occur at any time during the breastfeeding period.  Physiotherapy plays a large role in education and treatment strategies including therapeutic ultrasound for Mastitis.


If you are having any issues during the post-natal recovery period please feel free to contact Clifton Hill Physiotherapy and book an appointment with one of our specialised Women’s Health Physiotherapists who are here to support you during this time of change.


Ali Harding






Welcome Isabella Lees Trinca to Clifton Hill Physiotherapy

We are thrilled to welcome the lovely Issy, who joins our team this week. Issy

As well as being an experienced general Physiotherapist and Pilates instructor, Issy has special expertise in pelvic health – especially pelvic pain and bowels issues.

Issy has completed postgraduate training in Pelvic Floor Physiotherapy and Musculoskeletal Conditions in Women at The University of Melbourne. Issy enjoys teaching physiotherapy students and regularly lectures postgraduate physiotherapy students in Women’s Health and specifically bowel health. She has extensive Pilates training and has taught clinical and fitness based Pilates classes. She has worked extensively in pre and postnatal care, oncology, orthopaedic and neurological rehabilitation and pain management clinics.

Issy has considerable experience with bowel conditions and enjoys being part of the multidisciplinary team in the gastroenterology department at St Vincent’s hospital with a special interest in treating chronic pain and pelvic floor conditions. She understands the sensitivity of pelvic symptoms and and is committed to providing the highest standard of treatment to enhance quality of life.

Also, Issy gets a new puppy this week called Ralph!

How to progress your Pilates workouts

Let’s have a peek into a daily Pilates session with Andrew Firth…


 Hmmm. Your gluteals don’t seem to be firing properly. That’s okay – we can work on that. Let’s just do a few activation exercises…

Okay, so you can activate your glutes now. Great. Now let’s intensify the stresses we place on them, so that your glutes develop some new strength and mobility.

What’s that? Our strength work is getting a bit too easy? Alright then, let’s start working your glutes without activating your lower back, or your quads for that matter. Let’s train your body how to do true hip extension. Let’s develop some skilled body mechanics.

 Great. Your glutes are strong, you can extend your hip joint correctly, and you’ve got your lumbopelvic area under control. Let’s work for muscle fatigue now. It’s time to crank up the resistance, the load, the repetitions, the sets. A couple of new exercises wouldn’t hurt either…

 Awesome. You’re a hip-extending dynamo. Your glutes are practically superhuman – a superb Level 8 out of a possible 10. But did you realise that your abdominals are lagging behind at Level 6? Let’s work your transversus abdominus a bit more now, and don’t forget your obliques! We need more chest lifting, more roll backs, more long stretches, and more long-lever positions. I’ll just incorporate those into your routine…

 You’re strong. Flexible. Energetic, and invigorated. Your abs and glutes are equal now; both are firing at a sky-high Level 9. But we haven’t talked about your shoulder girdle for a while. Let’s spread the love a little – First off, let’s talk about your thoracic spine…

Pilates is much, much more than a few isolated exercises to be learned once and quickly discarded. It is a system of movement, driven by goals and fuelled by education. Forget grunt for the sake of grunt; learn what you’re supposed to be doing, ensure that you’re doing it properly, and THEN grunt to your heart’s content!

Want to learn more about your best Pilates workouts? Drop in for one of my classes and we can talk!

Andrew Firth

Pilates Instructor at Clifton Hill Pilates and Rehab

Person-Centred Exercise

What does your exercise routine look like? Is it designed for you? Is it tailored to your individual needs? Who prescribed the exercises that you perform? Do you understand it? Are you doing it safely and effectively? Who is helping you to reach your goals? How do you remember each exercise? Who do you ask if you are not sure that you are doing it correctly? Are you actively involved in the design of your exercise routine?

Providing answers to these questions is essential if you are interested in achieving an optimal state of health. Too many people make the mistake of performing exercise that is not suited to them or that doesn’t account for their individuality. This leads to poor results!

A person-centred exercise routine is essential for success. Your routine should be based on your unique needs, your abilities, explained to you in a way that you understand, and enable you to choose the path of success.

Working in partnership with your trusted health professional such as an Exercise Physiologist, Physiotherapist and General Practitioner is one of the best ways to successfully engage in exercise. It becomes a team effort, with you at the centre of the plan. The health professionals communicate clearly with each other and yourself, share information, and build trust along the way. You feel supported and motivated to improve.

Common understandings should be developed between the client and the care giver. You need to understand your role in the routine, and ask questions about the exercises to ensure you are successful. The communication between yourself and the care giver should be honest and open, enabling any barriers to be understood, and modifications made to the routine if needed.

At Clifton Hill Physiotherapy and Clifton Hill Pilates and Rehab, our team will enable you to exercise safely and effectively by prescribing person centred exercise. The support and guidance will facilitate long term change and maximise your potential.

Feel free to contact our highly qualified and professional team to discuss your exercise routine. We look forward to continuing to provide best practice exercise advice to help you get the most out of your life! See you soon!

Pelvic Girdle Pain

Pelvic girdle pain (PGP) refers to pain felt at the back of the pelvis, on either side of the pelvis and/or over the joint at the front of the pelvis which is called the pubic symphysis. PGP is common during pregnancy and studies report more than half of all pregnant women experience some PGP. Fortunately, almost all of these women (90%) recover before their baby has turned one. It is important to know that pelvic girdle pain cannot harm your baby, but by reducing the symptoms you are more likely to remain active and comfortable during your pregnancy.


The cause of pelvic girdle pain is normally a combination of changes happening in your body as your baby grows. Your growing baby stretches your abdominal muscles and the position of the baby changes your centre of gravity. This can affect your balance and the way you stand and walk. The pelvis is actually made up of three bones; a left and right pelvic bone and the sacrum, which is the triangular shaped bone at the base of the spine. These three bones are held together like a jigsaw and the joints do not normally move.  When you are pregnant your body produces a hormone called relaxin. Relaxin loosens your ligaments so that the pelvis can widen to hold the growing baby and helps prepare your body for the birth. When the ligaments in the pelvis are looser, the muscles around the pelvis have to work extra hard in order to maintain good support for the pelvic joints.


The symptoms of PGP range from pain in the pelvis as mentioned above, but can also refer into the lower back, hips, groin, thighs and even sometimes knees. Often the pain is made worse by movement such as walking long distances, getting in and out of the car, climbing the stairs, rolling over in bed or during sexual intercourse. PGP can be mild or severe and can occur at any stage of the pregnancy, but it is more common in the second and third trimesters.


PGP can be treated at any stage of the pregnancy and the quicker you get help from your health professional, the more comfortable you will be. Your physiotherapist can help treat both the symptoms and the cause. Using ice to settle inflammation and resting the joints for a couple of days is a good place to start. Some ways you can help reduce PGP are standing with correct posture, sitting to get dressed, keeping your legs together when getting in and out of the car and lying with a pillow between your legs to sleep.

If your muscles are overworking, they probably need loosening and they will certainly need strengthening. Your physio can show you safe exercises to strengthen your core muscles including your pelvic floor, back and deep abdominals as well as your glute muscles. In some cases, if your muscles require extra support, then your physiotherapist can fit you with tubigrip (a bandage to give your tummy support), or a pelvic belt that provides firmer support to the pelvis. Very occasionally, if your symptoms are more severe and persistent, then your physio may recommend using crutches

Remember, PGP is not something you just have to ‘put up with’ until your baby is born. Early diagnosis and treatment relieves symptoms and our experienced Physiotherapists can help you continue with your normal everyday activities and be well for this exciting time in your life.

Please speak with us if you have any enquiries and remember our new Pelvic Smart Pre- Natal Pilates classes begin in April on Monday evenings and Saturday mornings (9486 1918).


Rosie Purdue


Rosie has particular interest in sports and women’s health having recently completed the APA Level One Continence and Pelvic Floor course’. Rosie also has extensive pilates experience and has continued her education with courses in APPI Pilates, pre and post-natal Pilates, the DMA method and high-level suspension training.


Slow and steady wins the race

“The Biggest Loser” – a TV show that reinforces the myth that exercising to near breaking point will help you. There’s a lot to learn from observing the participants Ex-Phys-img01flogging themselves to near breaking point. I commend them for trying to improve their wellbeing; it takes courage and perseverance to undertake such a change. They feel better from exercising and challenging themselves, they lose weight quickly and they gain self-belief.

But the show is a perfect example of why so many people fall short of their expectations when exercising. This model of exercise is unsustainable in the longer term and significantly increases the risk of injury, poor compliance, and poor results!

For most of us (elite athletes may be an exception, although they are not exempt) exercising at maximal or near maximal intensities in a boot camp style environment is an excellent way to injure yourself and will ultimately prevent you from achieving your wellbeing goals.

An exercise routine requires a few essential ingredients: it should be tailored to individual needs, coordinated and delivered by a team of health professionals (collaboration between an Exercise Physiologist and / or Physiotherapist and / or GP), be evidenced based, target specific outcomes (weight loss, rehabilitation, mental wellbeing, chronic disease, increased muscle tissue), be person centred, be clearly understood by its participants, and be designed to gradually overload the body. It is this ingredient, gradual overload, which is often neglected.

Gradual overload is the consistent and steady increase in exercise load and volume over a mid to long term period that can be as little as 2 weeks and as much as 10 years. There are many examples of people “getting it wrong” when overloading. It is one of the most difficult ingredients of any exercise routine to get right, as it requires an understanding of our unique individual physiology. If we maintain a consistent routine at moderately graduated loads, then we increase our chances of success significantly!

Where do we start? Who do we ask for advice? How do we determine an appropriate training load? What exercises are the best to do? How will our exercise routine deliver results safely and effectively?

Engaging the services of a health professional who specialises in Exercise Prescription is the best way to ensure your progress will be gradual, consistent, safe and ultimately effective. Moving correctly, learning good technique, activating the key muscles that promote stability and control, before gradually increasing loads to build endurance and strength is the safest and most effective approach. Learning good movement patterns and unlearning faulty movements enable you to gradually overload the body safely and effectively.

Have a chat to one of our team so that we can enable you to discover that when it comes to exercise routines, “slow and steady wins the race”!

Are you listening to your body?

Our physiology is extremely efficient at letting us know how we feel. Fatigue, soreness, tightness, anxiety and stress tell us our physiology is not as it should be. It’s ok to experience these feelings from time to time, but learning strategies to manage and minimise their negative effects is essential to living a healthy and happy life.

An evidence based exercise routine is one of the best ways to enhance our physiology and our wellbeing! Exercise that focuses on our individual needs, prescribed by an experienced and highly qualified Exercise Physiologist, in collaboration with your physiotherapist and GP, is one of the safest and most effective methods of understanding your physiology and improving your life!

Your exercise routine should enable you to listen to your body. Learning how to perform correct movements that minimise injury and maximise outcomes is essential. Identifying potential injuries and understanding the causes of existing ailments will give you the confidence to undertake your own training. Starting or changing your exercise routine should be done with the support of your health professional who will guide you on your journey.

So listen to your body! If you don’t like what you hear, consult one of our friendly and highly experienced staff to help you learn skills and strategies that enable you to exercise safely and effectively.

Mike Fitzsimon 

(Bachelor Applied Science (Physical Education) / Graduate Diploma Sport & Recreation Management)

Anterior Cruciate Ligament Injuries and Gender

With the establishment of the AFL Women’s competition next year there has been a large increase in women who are eager to participate in our national code of football. This is a great initiative to promote physical activity and its associated health benefits, but also a brilliant medium to experience the fun and friendship of team sports.

However, as a sport adapts and evolves we often see a change in injury incidence. This is not something new, and professionals are consistently reviewing their training and rehabilitation methods to meet the most current demands of sport and physical activity.

For example, many would be familiar with the substitute rule that was implemented (and then excluded) from the AFL between 2011 and 2015. Injury prevalence was altered as a result of these changed playing characteristics, and hence training regimes were aimed to reduce these new injury risks.

With the pre-season underway for the AFL Women’s competition, we have unfortunately already seen some stars go down with ACL injuries, including Kiara Bowers (Fremantle) and Kendra Heil (Collingwood). Women are known to have an increased risk of knee injury compared with men who participate in the same sport, and professionals are harnessing this knowledge by utilising targeted interventions during their preseason programs.

There are thought to be a number of external risk factors (aspects we CAN change) for ACL injury. BMI (body mass index), jumping and landing mechanics, muscular imbalances, fatigue and many more are thought to contribute to overall ACL injury risk.

A structured and appropriately progressive pre-season program of strength and conditioning is essential to modify potential ACL injury risk. Such a program should include jumping and landing practice, change of direction training and appropriate practice of each of the specific demands associated with the athlete’s chosen sport. Athletes with certain previous injuries or other physiological findings may benefit from a more targeted pre-season approach under the guidance of a physiotherapist or sports and exercise professional.

It is essential to remember that while risk of injury is associated with all sports, the health and wellbeing benefits of being fit, active and social within a group of like-minded people is invaluable. There are many ways to optimise your ability to stay injury free including specific training and home exercises, diet plans and adequate rest.

All the best for the pre-season and best of luck to any new Australian Rules Footballers in 2017. As always, your physiotherapist is more than happy to assist you if you have any specific questions about pre-season training.


Bill Williams


Chief Physiotherapist Fitzroy Reds Football Club