The best surface in the state

Perth Stadium opens this weekend! From all accounts, the surface will be state of the art. The turf was grown at Serpentine, mixed with 10% artificial grass for durability, cut 40mm thick and laid out under the sun (as well as under five 'grow lights' which will become more important in winter). Safe to say the surface will be the best in the state for elite sport.

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 But what's your best surface? While we might dream of playing at Perth Stadium, most of us will do our exercise on other surfaces. But that's not a bad thing, it all depends on what you're going for:

A challenge

If you want to push beyond your normal routine, mixing up your walk or run with a bit more resistance can help. This might involve knee deep water at the beach, hills, or following your friend who's that little bit fitter than you on their route! Running or walking on sand will challenge your strength as well as the small muscles which detect changes in your surface and contribute to your balance. 

Rehab

When first getting back into exercise after a stint on the sidelines with injury, it's always best to start with a surface that gives your body the most assistance. In the very early stage, depending on your injury, doing some walking or jogging in the pool might help to support your joints by decreasing the body weight going through them on each step. Moving up onto a flat, supportive surface like even grass or a treadmill generally is a good next step before pounding the hard pavement or challenging yourself on the more difficult surfaces like sand or hills. 

Performance

When training for peak performance, it's wise to be working yourself on a surface as similar to your playing surface as possible. If you're a footy player, this will mean grass. As a basketball player, you want to get used to changing directions and landing on the surface you'll be competing on. If you're a beach volleyball player... you get the picture. 

Physio

If you're worried that the surface you're training on is too easy, too difficult or contributing to an injury, your physio can assess you and then help you create a balanced program of exercise that will both challenge and protect you. And if you have ambitions to play at Perth Stadium, we'd love to help you get there! 

To make an appointment, call us on 9364 4073 or book online. 

How well do you know your neck?

There are seven bones in your neck. Each has its own role. Think of them like the parts of a movable, adaptable jigsaw. 

Some bones are so specialised that they get their own names. The bone closest to the skull is called the atlas (in Greek mythology, Atlas is the god who is commonly depicted as holding up the globe), the bone beneath it is called the axis, and then the names start getting a little less creative: C3, C4... C7. 

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This is one of the bones in your neck. The large triangular hole is there for a reason: it's a strong canal for your spinal cord to run through. The smaller holes on either side protect the arteries that transport the blood to the brain. 

The dozens of muscles around the neck get their cues from the brain via small nerves which run to the muscles and instruct them on when to tense up (all the time if you're stressed!) and when to relax (almost all the time if you're asleep). 

There's also a strong and complex network of ligaments and discs joining the bones of the neck into a sturdy, unified whole. So the jigsaw of the neck is not just the way the bones sit together, but the way the muscles, bones, nerves, discs, ligaments and blood flow all support each other to keep you thinking, moving and active. 

Think that's pretty amazing? So do we. Want to know more about your neck? Your physio's happy to tell you more. 

 

Welcome, Jacinta

We're excited to welcome the newest member of our physiotherapy team to LifeCare Applecross!

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Jacinta has 20 years of experience in the physiotherapy profession, graduating from Curtin University in 1997. She initially worked at Mercy Hospital, gaining valuable experience in orthopaedic surgical conditions and post-natal care. Since then Jacinta has predominantly worked in private practice, treating a wide range of musculoskeletal conditions. She has a particular interest in sporting injuries, and has worked as a team physiotherapist for East Fremantle Football Club, and the Perth Orioles Netball team. More recently, Jacinta has developed an interest in the management of pregnancy and post-natal conditions, including back and pelvic pain.

Jacinta is a qualified Clinical Pilates instructor, and strongly believes in the value of activity and exercise for maintaining health and fitness throughout all life stages, and assisting clients to achieve their optimal wellbeing.

Personal Interests

Jacinta is a keen (albeit slow!) recreational runner, and recently completed her first marathon. She also enjoys travelling overseas, and camping with her family.

Qualifications

BSc (Physiotherapy) (Hons)

Clinical Pilates Instructor

The whole LifeCare Applecross community is glad to have Jacinta's expertise at the practice. To make an appointment with Jacinta, call us on 9364 4073. 

Eddie's travel tips

Eddie's back at LifeCare Applecross after a stint abroad. He's got some travel tips for anyone who's looking to leave their pain at home and head off on their own adventure:  

Beijing - Great Friends for the Great Wall 

When undertaking any new strenuous exercise (eg. hiking the Great Wall of China through the Beijing heat) do choose a good group of friends who'll encourage you all the way and give you the moral support that you need. Don't go it alone! 

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Moscow - Learn from Ivan the Terrible  

There's some speculation that Ivan (1530-1584) was so Terrible, partly because he used mercury to ease his back pain. This quite literally went to his head. Don't use strategies to ease your pain which cause more problems than they solve. Do use healthy strategies like exercise, pacing and sleeping well.  

Tallinn - Sauna culture

When thinking about healthy ways to ease the aches and pains, there's nothing like a bit of warmth in your lungs and birch-branch whipping to relax down the muscles and get the blood flowing (at the very least the birch-branch whipping will distract you from your pain!). Do stay hydrated. When jumping into cold water after a sauna, don't go head first, the rapid cooling of your head could have nasty results.

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Switzerland - New ways to get to work

If there's one place in the world that's as water-loving (and as expensive) as Perth, it's Switzerland. There are many picturesque cities on the convergence of lake and river. In Lucerne, when the river's flowing well, it's not uncommon for people to swim home from work. Do: water-proof-bag your laptop. Don't: let your imagination stop you from finding creative ways to get active.  

Above all, whether staying at home or hitting the road over the holiday season, keep active, stay relaxed and don't let pain get in your way. Let us know if we can help!

Swimmer's Shoulder

At this time of year, the clear, crisp waters of Cottesloe, Coogee and Dunsborough are at their most inviting. Most of us love to get down there as much as we can during the summer, many use the beaches as a great place to exercise. Some of the crazier ones are even planning to swim to Rottnest in February! But for a small portion of swimmers, a sore shoulder is the thing standing in the way of their enjoyment of WA's best water. 

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Swimmer's Shoulder

Swimmer's shoulder is an umbrella term for a variety of conditions which can develop as a result of repetitive shoulder movements. If you notice your shoulder gets sore the longer you swim, or are worried that there's a bit of discomfort hanging around, here are two ideas to help you out: 

Variety

Swimmer's Shoulder is generally a problem of repetition. It makes sense then that the simplest way to avoid this is with variety. Mix some backstroke or sidestroke in with your swimming routine to give a breather to the parts of the shoulder which are worked in freestyle. Make sure your breathing technique is one in which you rotate to both sides of your body so that one shoulder isn't working harder than the other to consistently lift your neck out of the water.

Assessment

Ensuring there's healthy variety to your swim is a good first step. But this isn't always possible (those training for a competition) and sometimes variety doesn't take you all the way to pain-free swimming, or perhaps not as soon as you'd like. If this is the case, a thorough swimming-oriented physio assessment can help to identify the underlying causes of the pain and then address them. Your physio will assess the shoulder joint, muscles, tendons and any signs of inflammation. They'll even look further afield to understand if any issues with the neck or the nerves are contributing. A quick check early after the onset of pain can often help to prevent a more difficult problem from developing and get you started on an individualised program of recovery. 

If you're hoping to make the most of the West Aussie summer and are worried that your shoulder is going to stand in your way, we're happy to help by chatting about the variety in your program or assessing your shoulder for underlying issues. Call us on 9364 4073 or drop in to 8 Riseley Street for an appointment.

Mother's Day - Remedial Massage Vouchers

Need the perfect gift for your Mother? 

Maybe your Mother-in-Law? Grandmother? There's a remedial massage to suit everyone here at LifeCare Applecross Physiotherapy. Our two friendly and experienced massage therapists, Rudu and Nicole, recognise the value of personal preferences for a well rounded, effective and memorable massage experience.

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What will this involve? 

Remedial Massage has a very broad scope. In fact, it's really an umbrella term which covers many different modalities. On one end of the spectrum, there are the deeper mechanical approaches such as Myofascial Release Technique, Deep Tissue Massage and Trigger Point Therapy. At the other end of the spectrum your therapist might incorporate some of the light and relaxing modalities such as Manual Lymphatic Drainage, Swedish Massage, Trager and even energy based modalities like Healing Touch, Pranic Healing and Reiki. Your consultation is the perfect opportunity for you and your therapist to determine which of these approaches will best suit your treatment plan. Many clients ask for a fusion of these deeper and lighter approaches. 

Some clients prefer to be in conversation with their therapist while others would rather be quiet and zone out during their session. Feel free to clarify this with your therapist if you feel the need as well! 

Why LifeCare Applecross?

One of the advantages of investing in a professional remedial massage is that your session will be initiated by a thorough consultation when your therapist will listen, communicate and reflect on the appropriate course of treatment. Careful consultation will maximise your treatment time and allow your therapist to zone in and tackle the relevant areas right off the bat.

Another advantage of Remedial Massage at Lifecare Applecross Physiotherapy is the fact that our massage therapists work in close collaboration with the other health care professionals on our team. It can be very reassuring to know that your therapist is kept ‘in the loop’ with assessments, findings and diagnoses made by their colleagues. Your session will also be adequately documented so that there is a reference of your treatment, allowing for the fine-tuning of your treatment goals.

Hopefully we shed some light on the subject, feel free to give us a call on 9364 4073 if you have any other queries. You can purchase individual massage vouchers or packs from our reception. Our two excellent therapists, Rudu, our male therapist and Nicole, our female therapist, both love what they do and look forward to showing you the value and efficacy of this wonderful therapy that works! Just ask any of their regulars!

contagious sport

As physios, we're passionate about keeping people active. By treating injuries and preparing people to prevent them, we like to think we do our bit to keep our community fit and healthy. But we also realise we're not the only ones in this game... Parents, coaches, friends and volunteers are all just as important as physios.

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It's long been a trend in Australia that young people drop out of sport as they transition from childhood to adolescence and into adulthood. In truth, injuries are only one of the reasons why kids stop playing sport (there are many other significant barriers to participation such as lack of enjoyment, cost and time commitments). Looking at the picture of Australian health in this way, we recognise that it's the whole community that has a role in helping kids keep up the habit of exercise.  

One of the most easily addressed aspects of sport participation for young people is the enjoyment factor. For lots of kids, sport is a great way to enjoy time with friends, express themselves creatively and challenge themselves a little in the process. Junior sport is about fun, encouragement, inclusiveness and team work. By focusing on these aspects of junior sport, we all encourage kids to make healthy activities into future habits.

Recently, there have been some helpful reminders of this in the media. As we transition into a new season of winter sport for 2017, let's make sure we're all doing our bit to prepare our youngsters for active lives by thinking creatively about how to make sport fun, and in doing so, the most important results - a healthier community - will take care of themselves.

If your child is finding it difficult to do the activities they enjoy because of injury or if you need some help brainstorming ideas for making exercise beneficial and fun, call us on 9364 4073 or pop in for an appointment.  

The Worst Pain of the Year

A physio blog in January.... Oh no. You're probably expecting to be told to forget about all the good food that you had over Christmas and cast your mind bravely ahead to the exercise that you plan to do this year. In fact, the opposite is true. 

Think back to the best meal you had at Christmas. It might have been the turkey which went so well with the cranberry sauce or the cherries which were the deepest, richest red you've ever seen. It could have been the pudding that came just after you'd had enough time to digest the main meal or even the leftovers on Boxing Day that tasted so much better once all the fuss was over and you could finally put your feet up on the couch to watch the cricket.

In thinking back to your best meal, it's likely that your most intense memory doesn't just involve your memory of its taste alone, but also of the smells, the setting, the people you were with, the time of day, the drink in your hand. And that's not surprising given the fact that it's well known that all the sights, sounds and smells associated with food are part of the experience of eating. In fact they can make all the difference as to what type of flavour the food produces.

What does that possibly have to do with physio? 

The truth is, the same is true of pain. Your experience of pain is one that draws on all kinds of sensations that the body takes in. This includes what's going on in the injured body part, what's going on in the rest of the body as well as what's going on in the world around you. 

Okay, but still, what does that have to do with physio?

Your physio is able to help you to identify the different factors that may be contributing to your pain, including ones you might not have thought about much. Your physio is then able to help you to improve these factors. That's because your physio recognises that pain (like flavour) develops out of a variety of processes and so it will also be reduced by a variety of strategies and methods. 

This means that when you see a physio about your pain, you'll almost never just get one thing to solve the problem. You'll get multiple strategies which will all work together to help you to heal and to minimise your pain. 

So next time you eat a brilliant meal, think about all the things that are making it such an intensely enjoyable moment. And next time you're in pain, think about all the factors which are making it such an intensely painful moment. If you need help with reversing this pain or want to understand why it hurts so much, just give us a call on 9364 4073 and we'll be more than happy to help. 

#Onelegphysio

Don't think you spend much time balancing on one leg? Well, did you know that when you're walking, you're actually spending three-quarters of your time with just one leg in contact with the ground?

That's right, your ability to control your body on just one leg is pretty important. And when you add the challenge of talking on the phone, balancing a child on your hip or breaking into a jog, the skill of balance becomes even more important in avoiding injuries, falls and embarrassment. 

As physios, we spend a lot of time trying to train this skill. That's why as a profession, we're trying to raise awareness in our communities about the importance of balance. And what better way to know how your balance is than to test it? The average person can balance on one leg for 33.4 seconds. So right now, stop reading this post, stand up, get your stopwatch out and time yourself.

How did you go? 

If you're really good at balancing on one leg you're probably still reading this as you keep your balance. Too easy. Good on you. But the world record for one leg balance is 76 hours and 40 minutes so you still have a little way to go. 

You won't be surprised to learn though that you don't really need 76 hours of one leg balance. What you do need is balance sufficient to what your individual requirements are. If you're a casual walker, you need some decent balance to avoid injuries and falls (and the odd cyclist who might swing by). If you're a footy player or a netballer, you'll need some better balance to land on one leg, take off and change direction. 

A great way of getting a better feel for where your balance is at is to progress through the 'difficult dozen' at oneleg.physio. In trying these different challenges, you'll get a better understanding of all the factors that contribute to your balance (muscle strength, concentration, environment etc.) There are some pretty difficult ones there so make sure the exercises are safe for you, if in doubt just give us a call (see below). Once you find your limit and discover more about how your balance works, feel free to post your successes at #onelegphysio so others can be inspired to develop their balance skills, boost their sporting performance and decrease their risk of injury as well.   

For specific concerns about your balance and individualised exercises, speak to your physio by booking an appointment on 9364 4073. We have a whole range of strategies and exercises that can be really helpful in developing brilliant balance and would love to see everyone in our community that little bit more comfortable on one leg! 

A disc is not really a disc

It might surprise you to learn that a disc isn't really much like a compact disc (CD), a floppy disk, a frisbee or even a discus. In fact, the term disc is a little misleading because the strong, dynamic, malleable structures that bridge the gap between your vertebrae are not really like discs at all.

What are they like then? Well, it's a little hard to say (which is why people have used the imperfect term 'disc'). What we can say is that they are remarkably unique and resilient structures... Here are four facts to help you get to know them a little better. 

 

1) Discs are naturally robust structures. 

Just watch your favourite sporting event and you'll see what immense forces the spine can cope with. It's true that discs can sometimes be a source of pain and (frustratingly) sometimes after you don't think you've done much at all! But anatomically and structurally, discs are strong and amazingly adaptable structures. They are made up of two features: a gel-like centre (nucleus pulposus) wrapped in a series of strong fibrous rings (anulus fibrosis).   

2) Discs never 'slip'. 

Discs are firmly connected to the bones of your spine, so a disc will never 'slip out of place'. However, discs can bulge or herniate. When they do this, they sometimes irritate a nerve or release chemicals that do this. There are many important things your physio is able to do to help you with this (see point 4 below) but the treatment will never involve 'pushing a disc back into place' because they never 'slip' in the first place.  

3) Degenerated discs are the wrinkles of the spine.

A common cause of stress for people who have recently had a scan of their spine is all the 'degeneration' that they see on the report! Don't panic though, discs degenerate naturally. In fact, there are many findings on your scans which may be like wrinkles - signs of a bit of ageing but not necessarily causing you much of a problem at all. It's always best to discuss your scans with your physio or your doctor who can assess your spine and connect the picture with way your back is in flesh and bone. 

4) Disc pain is treatable.   

The body has a remarkable ability to restore the normal function of a disc after it has been irritated. This does sometimes take a little time, but your physio can help you to accelerate this process through treatment and advice. Depending on your particular case and guided by a thorough assessment by your physio, this might include exercises, positioning advice, taping, manual therapy, muscle retraining, referral to other services and a whole lot more. 

So if you think you might have an issue with a disc or are worried about what that might mean, get to know your discs a little better by booking in with your physio on 9364 4073. 

Paralympics

As physios, we're always inspired by people who push boundaries through hard work and determination. In just under a week, thousands of athletes will be displaying the athletic prowess that only dedication and hard work can achieve. Here's a bit more info to make it easier to switch on and follow the Paralympics:

When are the Paralympics? 

The Rio Paralympic Games run from the 7th to the 18th of September. 

Who is competing?

More than 4,000 athletes are taking part this year from 160 nations. Australia are sending 179 competitors to the games. 

Which sports are played?

There are 22 sports at this year's Paralympics including 2 new sports: para-canoe and para-triathlon. There are only two sports at the Paralympics that don't have an Olympic counterpart: boccia (like bocce) and goalball (an indoor-soccer-like game for visually impaired athletes using a bell-filled ball). Other sports include athletics, cycling and wheelchair basketball, rugby and tennis.

How do the classifications work?

Doctors, physios and other health professionals are involved in assessing and classifying athletes to ensure fair and equal competition. The class of competition is designated by letters and numbers. Usually, the higher the number, the higher the functional potential of athletes in that class. 

What's happening in Western Australia?

Perth has a very vibrant wheelchair sports association, running sports from wheelchair tennis and rugby to powerlifting, athletics and archery. To get involved, see wheelchairsportswa.org.au

 

Delayed Onset of Muscle Soreness

A few days after finishing the HBF Run for a Reason, you might be feeling a little worse for wear. The quads could be burning, the calves feeling tighter than they've ever felt before. You might be experiencing DOMS - Delayed Onset of Muscle Soreness. 

What is DOMS?

DOMS is muscle ache that usually peaks within 24-72 hours post exercise. When performing heavy exercise, the muscles fibres undergo microscopic damage. DOMS is related to the muscle repair process which occurs when the body is adapting to an unaccustomed load. This is particularly noticeable after performing eccentric exercise (which involves the muscles working while lengthening) such as jogging or walking down a hill. Some people think that DOMS is associated with lactic acid buildup however the best evidence suggests that it doesn't actually play a role.  

Have I done too much?

Moderate DOMS can actually be quite a normal response to increasing exercise intensity. So if you're a little stiff and sore following the HBF Run for a Reason, don't stress too much. What's even more encouraging is that DOMS seems to have a protective benefit: experiencing DOMS after an exercise session makes it less likely you'll experience it again soon. It's all part of the body's remarkable ability to increase its capacity in response to what you ask it to do. In saying that, significant muscle or joint pain during exercise is not a normal part of exercise and if there's a sharp sudden onset or swelling, it's best to stop and seek an assessment to rule out muscle strain or joint sprain. 

How Can I prevent it in the future? 

This is probably what you want to know! There are several ways to help prevent significant DOMS. One of the most commonsense strategies is to gradually build up exercise over time. A good steady progression of exercise intensity over a number of weeks will ensure that your increase in fitness and strength will come with minimal discomfort! A good warm-up and cool-down also makes sure the muscles are supple and flexible, decreasing the pain and stiffness that can result from intense exercise. If your DOMS is significant, it may be best to stick to lower intensity exercise (walking, gentle swimming or cycling) for a few days before getting back to full intensity workouts, ensuring your muscles are at full capacity and ready to cope with the load. If you're still struggling more than three or four days after exercise, come and see your physio and we'll get you back on track!

Attn: All coaches

How familiar is this story? Your junior sporting team starts the season with promise and ambition, winning matches for fun... By mid-season though, a few key injuries have weakened the team and caused that humiliating slide down the ladder. 

At least when it comes to knee injuries, the answer may well be here. 

This newsletter summarises five key ways to prevent knee injuries. Before putting them into practice, we'd recommend visiting knee.netball.com.au for excellent pictures, videos and guidelines related to the exercises we'll discuss. This site is a great resource not only for netballers but for all budding sports stars looking to prevent knee injuries.

Warm Up

Purpose: To prepare the body - legs, arms, heart and mind - for activity by raising the heart rate and increasing blood flow. Practicing footwork in controlled exercises paves the way for more unpredictable training and match scenarios. 
Examples: Jog forwards and backwards, bottom flicks forward and backwards, high knee march, side skipping.

Strength

Purpose: Strength training around the knee, ankle, hip and trunk develops a stable base for movement. The better the muscular system is equipped to control movement, the less stress the ligaments are placed under which prevents strains and ruptures. 
Examples: Squats, bridges, planking, side-planking.

Balance/Landing

Purpose: In order to get the best performance out of strong muscles, specific balance and landing training is essential. Absorbing the force of landing evenly throughout all the joints of the leg ensures no single joint is overloaded. A good landing technique is soft and involves: hips bent, knees bent, feet straight ahead, knees in line with feet and trunk stable. 
Examples: balancing on one leg and throwing the netball between partners/ handballing the footy, jumping and landing with good technique on both legs and then one leg, jumping forward/backwards/L/R and catching ball.

Agility

Purpose: Agility exercises practice dynamic movements which help to build a sense of control and power in match-like tasks. Building these exercises into training sessions helps to improve performance and prevent injuries. 
Examples: Decelerating shuffle, zig-zag running, side-to-side shuffling while passing/ handballing.

Physio

Did you know that physio can help with up to 80% of anterior knee pain? If you have any concerns about injury or vulnerability, an appointment with a physio will either put your mind at ease or give the player specific strategies which can help them to return to full training and match-play as quickly as possible. 

Our friendly physio's love working with local sporting clubs so if there's anything you think we can help you with, call us on 9364 4073, and we'd be happy to chat.

Your type of exercise

No matter what injury, age, body type, sport, job or attitude, there's an exercise option that's just right for you here at LifeCare Riseley Physio.

What type of exerciser are you?

THE RECOVERER

Exercise for you: Clinical Pilates
Run by: Pilates-trained physiotherapist

Suffering from pain, recovering from injury or trying to reach sporting excellence? An exercise program developed by a Pilates-trained physiotherapist helps you get back to doing all the things you love. After an initial assessment which reveals your strengths and weaknesses, your physio will help you to develop individual rehab goals.

Close supervision and feedback on body awareness, alignment, breathing, control, flowing movements and precision helps you move better and feel great. Your individual program can be designed to reinforce a set of home exercises so that you're not only making progress within each session, but between them as well.

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THE REFORMER

Exercise for you: Reformer class, mat class
Run by: Pilates instructor

For those who are keen on an individualised whole body workout that retrains posture, develops relaxation and improves control, our Pilates instruction classes are just the thing. Pilates-trained instructors will guide you through a refined series of exercises; they have hundreds to choose from! This is a good option for people who are not experiencing a specific pathology needing rehab but are looking to rebuild a balanced body. We find many people get hooked on exercise and enjoy keeping up their regular Pilates time with an instructor guiding them through a program that is forever adapting, just as you are.

THE EXPECTANT EXERCISER

Exercise for you: Pregnancy class
Run by: Women's health physiotherapist

These classes are for women at any stage of pregnancy, but ideally those in the second and third trimester. Keep coming until your due date (or beyond)!

The classes are run as a six week block, with one class per week. The classes involve an hour of Pilates-type exercise with a focus on stretching, toning, breathing, relaxation, posture and pelvic floor activation. This is done with the use of a mat, exercise ball, theraband and hand weights. Different options are available to ensure that all levels of fitness and Pilates experience are catered for!

THE WISE WALKER

Exercise for you: Osteo class
Run by: Physiotherapist

Our osteo class is designed for building strength, balance, flexibility and bone density. There are a wide range of exercises that are adjusted to your needs; all done to the backdrop of great conversations and plenty of laughter. Come and meet all the energetic exercisers!

THE FLEXIBLE BOUNDER

Exercise for you: Kids Pilates
Run by: Pilates-trained physiotherapist

Particularly helpful for kids with hypermobility, there's plenty of excitement to keep the entertainment factor high. Pilates comes alive as a series of therapeutic exercises are turned into muscle games that challenge balance, control and stability. This class is great at developing good patterns of movement from an early age, helping kids of all body types to enjoy exercise, prevent injury and promote development!

For all the latest session times and availabilities in our popular classes, or for an assessment with a physio to determine which one is best for you, call us on 9364 4073.

Your New Year's Resolution

It's February already - that time of year when your New Year's resolutions start to become challenging (if they weren't already)! If you're trying to achieve something new this year, whether it's exercise related or not, here are a few tips that will help you sustain the change.

SHARE IT!

Finding someone who'll go on that journey of change with you makes all the difference in actually getting there. With fitness especially, a reliable exercise partner helps with motivation, enjoyment and accountability. If someone else is aiming to get to the same point, you might even help a friend to meet their goals this year! Joining a club or group helps when it comes to committing to a goal. 

Here at LifeCare Riseley, we know how helpful exercise partners are. That's why we're running a special offer for you and your friends: Bring a friend to one of our reformer classes or mat classes during February, and you'll both have your first session for free! Ask our friendly receptionists for more details.

MAKE IT MEASURABLE

Vague goals like 'I want to exercise more' fail so easily partly because there's no way of knowing when you've succeeded. If a goal is clearly measurable, such as, 'I will run three times a week for half an hour' then you get that nice buzz of self-congratulation as you stretch at the end of your final run for the week. It's this feeling that keeps you coming back for more the following week.

FORGIVE YOURSELF

If you don't achieve your goal, don't waste time regretting it. And don't be too concerned with trying to make up for it by overdoing it the following week.

If you get any insight into what stopped you reaching your goal, harness that to hit your next target and keep pressing on. Above all, don't give up! Remember: once the new exercise habits become a routine, it does get easier!

TALK TO A PROFESSIONAL

Physio's are trained to help people to change. We spend a lot of our time encouraging people to think about changing habits or improving exercise. As you can imagine, it's much easier work for us when people are already trying to change and we just need to help them along! So if you've got a New Year's resolution that you're motivated by, we'd love to speak to you. If you're not sure what form of exercise will be best, what's realistic to expect or when to try and step up the intensity, if there's some nagging pain that's standing in between you and your resolution, we'll help you with all that and more! 

Make 2016 a memorable one by getting where you want to go. And remember that when it comes to achieving your New Year's resolution, where you're at this December has everything to do with what you do this February!

 

Festive Season Specials

What a great time of year: the days are long, the weather is perfect for heading down to the beach and Christmas is not far away. The trouble with so many good things happening is that the busyness is unavoidable. 

Let us know if we can help! Whether it's a massage to relieve the stress, an easy and unique gift idea or reassurance that your back pain won't wreck the Christmas celebrations, we're all keen to make this season a memorable one for the Applecross community. 

We're happy to help this Christmas with some special festive season offers that are valid all the way up to the 24th of December!

MASSAGE VOUCHER

With all that shopping, wrapping and cooking just around the corner, what better way to unwind than a massage? We offer vouchers for 1 hour and 1/2 hour massages or packs of massages to be used throughout the Christmas season and beyond. 

As a special Christmas gift, we'll provide a free massage stick (valued at $14) with every one hour massage voucher purchased!

PILATES PACK

Do your family or friends want to move better and stay fit? A Pilates Pack voucher could be the perfect way to get a new year resolution off to a good start. By starting a Pilates program, you'll be diving into an enjoyable and challenging series of exercises focused on balanced and controlled positioning, graceful movement and body awareness that could be useful on your Christmas function dance floor. 

This Christmas, every Pilates Pack purchased as a gift will include a free mat class (valued at $29.95). Pilates Packs start from $270.10 for 10 sessions. Call our friendly receptionists for more details.

STOCKING FILLER GIFT IDEAS

Always reaching for that pair of socks? Some grip socks for Pilates could be an option this year. A massage stick can release all of those tight, tender spots. Miracle Balls relax down the tension too by working alongside breathing and positioning; don't forget they come with a free class. A foam roller or a hot pack might not fit in a stocking but could come in handy for the year ahead as well.

FIT AND HEALTHY THIS SUMMER

Want to be able to join in that back yard Boxing Day test? Looking to swim down at the beach a few extra times next year? Driving a long distance and wondering how your back will cope? Your physio can help with getting your body right for whatever it is you're looking forward to over the Christmas break. By planning ahead, you'll give yourself the time to make the changes you'll need before the Christmas period. 

For more information on all the Christmas options or if you have any questions about how your summer can be healthier and happier, call our friendly receptionists on 9364 4073.

CHRISTMAS OPENING HOURS

  • Christmas Eve: Open until 5pm
  • Friday 25th Dec - Monday 28th Dec: Closed
  • Tuesday 29th Dec: Normal Hours
  • Wednesday 30th Dec: Normal Hours
  • Thursday 31st Dec: Open until 5pm
  • Friday 1st Dec: Closed
  • Saturday 2nd Jan onward: Normal Hours

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In other news: the Pericoach has arrived! Stay tuned for more info in our next newsletter.

What is the core and how do I use it?

Women's health physiotherapist Taryn Watson shares her insights on the importance of 'the core' for a healthy lifestyle.

Which muscles make up your ‘core’?

With the recent popularity of Pilates, the term ‘the core’ has become widely spread. When taken in the true sense of the term, it should involve activation of the pelvic floor muscles (PFM) and the deep abdominal muscles such as the transverse abdominus (TA).

Despite popular belief, your six pack muscle (more correctly termed the Rectus Abdominis or RA) is not your core. Neither are the two layers of obliques underneath this. They are 'power' muscles, and help to move your trunk, and while very important, they do not have a supportive function like the PF and TA. In fact, while the PF and TA muscles have an upward, inward motion when contracting correctly, the RA and obliques create a downward and often outward force in the abdomen.

Why is the ‘core’ so important?

The upward and inward action of the ‘core’ is very important in gynaecological and urological health. We know from research that this action of the PF, which is assisted by the TA, prevents the pelvic organs from descending (known as pelvic organ prolapse), prevents our bladder and bowel from leaking (called incontinence) and helps to support the lower part of the spine and the pelvis. 

Recent research on women has shown that it is possible to manage (or even better to prevent) incontinence and prolapse by exercising the ‘core’ muscles regularly, if done under the guidance of a Women's Health and Continence Physiotherapist (Hagen et al 2014, Neumann et al 2005).

How do you exercise your ‘core’?

The main way to exercise these muscles is to do regular pelvic floor exercises (or 'Kegels'), which involves a squeeze and a lift around the back passage, front passage and the vagina. This should not be visible from the outside, except for maybe a subtle indraw of the lower abdomen as the TA muscles come in to assist the PF. Ideally you should be doing a few sets of these a day, but there is no 'recipe'. A Women's Health & Continence Physiotherapist can give you an individualised program depending on what you can do after they check with an abdominal ultrasound, or in some cases a vaginal or rectal examination.

These exercises can be done in any position - standing, sitting, lying down - and the physiotherapist can show you how to incorporate this into your other workouts. Pilates-type exercises can complement the basic PF exercises, and this is where 'Core training' comes into play.

In reality, unfortunately, what is advertised as ‘core training’ exercises in many gym programs are double straight leg raises and heavy medicine ball work that actually cause an over-recruitment of the superficial ‘power’ abdominal muscles and completely override the more subtle, deeper muscles. When a Women’s Health & Continence Physiotherapist assesses the pelvic floor, the bearing down and bulging into the pelvic floor during these exercises is often evident. Externally this can also be obvious, with abdominal doming and breath holding occurring. Sit ups, double leg raises and planks may eventually have their place in a safe work out - but they are definitely NOT the starting point for Core Training.

What can go wrong if ‘core training’ is done incorrectly?

People often only realize that these exercises have been inappropriate when something goes wrong. This may be in the form of a musculoskeletal issue such as a lumbar disc injury, in the form of an abdominal issue such as an umbilical hernia, or in the form of a urological/gynaecological issue such as a vaginal prolapse or urinary incontinence. All of these are essentially caused by the same issue – repetitive high intra-abdominal pressure that exceeds what can be matched by the deep supporting muscles such as the pelvic floor.

So in summary – question what you are told in a gym class is a 'Core' exercise. Is it really, or are you just recruiting your upper abdominal muscles and pushing everything outwards? Do you want abdominal muscles that draw inwards and are flat, or abdominal muscles that push outwards? And more importantly, do you want your insides to be pushed downwards into your pelvic floor during a work out (like the chicken in the picture)? Probably not.

Seek help from a Women's Health and Continence Physiotherapist if you wish to learn more about how to correctly exercise your core. Taryn Watson and Robyn Hickmott both provide expert Women's Health and Continence Physiotherapy services here at LifeCare Riseley.

References: 

Hagen et al (2014), Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicenter randomized controlled trial, The Lancet, 383 (796-806).

Neumann PG, K. Grant, R. Gill, V (2005) Physiotherapy for female stress urinary incontinence: a multicentre observational study. Australian and New Zealand Journal of Obstetrics and Gynaecology;45(226-232)

Robust Inspiration

The American writer William Faulkner said, "I only write when inspiration strikes. Fortunately it strikes at nine o'clock every morning." With both writing and exercise it's healthy to want motivation but unwise to wait around for it to appear out of thin air. Here are three common barriers to exercise and some hints that will help you say, "I only exercise when I'm motivated. Fortunately, I'm motivated every day."

TIME

Our busy lifestyles can push exercise to the fringes of our schedules. The mornings are short and cold. The evenings are when the kids do their exercise. In a busy week, making the most of short blocks of time can be crucial.

Building exercise into your daily routine can keep you active. Taking the stairs instead of the lift, going for a stroll in your lunch break, cycling rather than driving to work, walking on the treadmill while you're watching TV might not take as much time out of the day as you think.

Another good idea for the busy worker is to commit to a schedule. Joining a sporting team or gym class locks you in to a regular pattern of exercise that's more difficult to squeeze out of your calendar than that occasional run.

ENJOYMENT

Not enjoying exercise can also stand in the way of an active lifestyle. This, too, is a problem that can be overcome. The number of ways to get active is really only limited by your imagination. It's okay not to like swimming, running, or organised sport. Have you tried yoga, surfing, gardening, dancing, unicycling, or rock-climbing?

You might just learn a new skill and meet people in the process. In fact, deciding to do something with friends might be the way to make a walk (almost) as enjoyable as catching up for coffee. You can always walk to your favourite café.

INJURY

The fear of injury sometimes prevents people from being active. Just as there are thousands of different kinds of exercise to fit everyone's interests, there are also many types of exercise to match everyone's physical capacity. If you're worried you might be stirring something up, you can always check with your physio to get the all-clear and brainstorm ideas that will fit with your body, your interests and your busy schedule.

Your knees might not let you do everything you used to be able to do, but they will definitely let you do something every day, and ultimately thank you for it.

Those dreaded three letters: ACL

When Chris Judd told his three year old son that he wouldn't be able to play football anymore because of his ACL injury, his son said, "I think you should play soccer." If only recovery from injury was that simple! In fact, the knee is one of the most complex joints in the body, and the ACL is pivotal to its function.

Judd

 

ANATOMY

There are four main ligaments that control the position of the knee. The Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) form a cross inside the joint, with the Medial Colateral (MCL) and Lateral Colateral (LCL) ligaments running down either side of the knee.

The ACL's main role is to prevent the knee joint from rotating and sliding when athletes are required to turn on the spot, jump and land.

Because of subtle differences in male and female anatomy, women are slightly more likely to experience ACL injuries than men.

Knee ligaments

INJURY

Chris Judd's injury was typical of the way ACLs are torn: he landed on a reasonably straight knee that was also rotated and bent to the side.

When an ACL is ruptured, the athlete often hears a pop or a crack followed by intense swelling and pain. Injuries to the ACL can also be associated with other injuries to the knee, including the meniscus and the MCL.

As signs and symptoms vary from person to person, it's important to have an assessment of the knee as soon as possible after injury, ideally before excessive swelling has entered the joint.

Initial treatment involves controlling swelling around the knee. This means icing the knee for twenty minutes every two hours, resting, elevating the leg and using compression bandage. Your physio can assess the extent of the damage and guide you through these strategies.

PHYSIO

Following ACL rupture, surgical reconstruction of the ligament is a common procedure used to return full stability to the joint. Many factors impact on the decision regarding surgery. These include your goals, other damage done to the knee, degree of instability, age and the ability to take time off work. The surgeon will often take part of the tendon from your hamstrings and use it to replace your torn ACL.

With a detailed assessment and exercise program, your physio can help you prevent ACL injuries in the first place. The better your muscles are at adapting to different positions, the less likely the knee will be placed under extreme stress. The exercises that develop these muscles are not just focussed on strength, but on the ability of your muscles to stabilise the knee (see our previous newsletter on proprioception).

After injury, regardless of whether you decide on surgical or non-surgical management, physiotherapy plays an important role in rehabilitating the knee. Your physio will guide you through protecting the joint, getting it moving, stabilising the leg and knowing when you're ready for different activities. They'll get you on the path to meeting your goals as quickly as possible - whether that's football, soccer, or just playing with your kids.

Where is your ankle?

When you're running on the beach, how does your ankle adapt to a bumpy patch of sand?
You reach your arm behind you in the car; what is it that allows you to know where your hand is?
How do you shuffle your hips from an awkward position to a comfortable one?
 

beach running

PROPRIOCEPTION

The answer is proprioception. It's your body's ability to know when your joints are moving and where they are moving to. It relies on the input of special nerve endings in your muscles that detect changes in pressure and length around the joint.

When your joint changes position, these nerve endings tell the brain what's going on. The brain can then activate the muscles needed to either keep the joint moving or change the direction towards another position.

You use proprioception whenever you're performing a task that requires balance or accuracy... more or less constantly!

INJURY

Most of the time, proprioception happens subconsciously. However, after injury, this process can be disrupted. In some cases, this increases your chance of re-injury because the body cannot respond as well to its surroundings as it did in the past.

For example, if your body cannot detect that your ankle is rolling outward, it will not be able to fire the muscles necessary for preventing excessive movement, and so risks spraining the joint.

Pilates edited.jpg

TRAINING

The good news is that your proprioception can improve with training. It's a distinct skill from strength and flexibility and needs to be specifically targeted after injury.

Progressive balance exercises can have a profound impact on joint stability. Pilates, with its emphasis on form and control, also helps to train your body to know where it is in space.

Sometimes, your physio might encourage you to use a mirror to begin with so that you can see what position your body is in. Eventually, once your proprioception is full, your joints will be able to detect this position themselves and self-correct without the need for visual cues. This is vital for preventing injury.

POSTURE

In order for your body to maintain a good position, it needs to know what that good position feels like. Postures that aggravate pain can often result from a lack of body awareness. Proprioception retraining is an important tool for developing the body's ability to find and hold a comfortable position throughout the day.

So whether you're running on the beach or sitting in your chair at work, good proprioception allows for controlled, pain-free movement.

You might have heard it said, "If you can't measure it, you can't manage it." That's true for the body's joints: your ability to detect the position of your joints is essential for your ability to manage the way they move.