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.

Mastitis:

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

Physiotherapist

 

 

 

 

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…

Pilates_2

 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.

Cause

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.

Symptoms

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.

Treatment

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

Physiotherapist

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

Physiotherapist

Chief Physiotherapist Fitzroy Reds Football Club

Maintain a routine and enjoy the festive season

At this time of the year life can get really busy! It’s easy to be distracted by the pressures that come with the festive season and year’s end. Our priorities can shift from maintaining our “normal, healthy” routines to avoiding exercise and eating and drinking too much.

This can result in a few kilos being added, a loss of lean muscle mass, our aches and pains return or worsen, and we are left feeling exhausted as we enter the new year. Sound familiar?

One of the best ways to maintain our health and wellbeing during the festive season is to engage in a moderate exercise routine. Whilst enjoying the pleasures that eating and drinking bring exercising in moderation is the key. Moderate exercise such as swimming, walking, body weight resistance training, stretching, and floor exercises enable us to return to our normal routines in good shape and feeling great!

It’s important to focus on the bigger picture. Don’t stress if you over indulge on one or two occasions. Last time I checked there are 52 weeks in a year, so a few days here and there of no exercise and eating too much won’t actually change your overall health.

Enjoying a break from structured and intense exercise can be really beneficial to assist with recovery and preparation for the next phase of your routine. Use the festive season to focus on your weaknesses, such as improving your posture, resting muscle groups that have been overused at work, or doing your rehab specific exercises prescribed by your health professional.

Our minds and bodies enjoy a routine, so it’s important to continue to exercise during the festive season. Maintaining an exercise routine enables you to recover more quickly from any excesses, reduces your risk of injury and prepares your mind and body for the new year.

Speak with our experienced and qualified staff and we’ll set you up with an exercise routine that’s individualised, that’s portable (you can do it on holiday), and that enables you to maintain your health and enjoy the festive season!

Mike Fitzsimon 

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

Working out – it’s about YOU!

Exercise programs can be found online, in magazines, by watching TV shows, listening to the radio, getting tips from your friends or work colleagues, fitness enthusiasts, “fitness gurus”, etc.…. there are hundreds of “helpful” tips and advice available to us that are beneficial to everybody. Right? Actually, this is where many people with good intentions to improve their wellbeing get it very wrong.

Starting or changing an exercise routine without seeking advice and guidance from an experienced and qualified health professional will expose you to many problems, including poor technique, excessive loading, poor exercise choice, performing too many exercises, poor time management, setting unrealistic goals, all of which may lead to injury and/or a failure to reach your potential.

The most important exercise tip is that your exercise program needs to be about YOU. Yes, an individualised exercise prescription is the most important aspect of any training, rehabilitation, weight loss, strength or lifestyle modification program. Only a qualified health professional, trained and accredited to prescribe exercise should be giving you guidance and support to help with your journey towards better health.

An individualised exercise prescription by an Accredited Exercise Physiologist or Physiotherapist enables you to safely and effectively work towards achieving your goals whilst avoiding the pitfalls of injury and poor compliance. Collaboration between these health professionals enables your exercise program to be coordinated and delivered in a safe and effective manner, and most importantly will be tailored towards your individual needs.

Understanding how your body and mind will potentially react to an exercise routine is essential for longer term success. With education, patience, and great technique you can achieve your desired state of health and wellbeing.

So next time you need to set up a new routine or have an injury concern, speak to our staff about an individualised exercise program that focuses on YOUR NEEDS. We’ll get you started on a wonderful journey towards achieving your ultimate goal!

 

Mike Fitzsimon 

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