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The post Osgood-Schlatter Disease in Teens: What Causes it, and How to Fix it first appeared on Body in Common.

Shoulder Pain and How Clinical Pilates Can Help

mail@bodyincommon.com — Mon, 20 Apr 2020 11:28:54 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

Shoulder Impingement Pain and How Clinical Pilates Can Help

"Sok Ching is a Physiotherapist and Clinical Pilates Specialist at Body in Common in Bangsar, Malaysia. She takes us through the causes of Shoulder Impingement Pain, and shows us a clear path to fixing the issues.”

Don't Live with Shoulder Pain

Shoulder pain is a tough condition to live with. It restricts your quality of life, stops you from playing sport, or even just putting away the groceries. It’s often caused by irritation to the structures inside the shoulder joints. This leads to inflammation of the Tendons, Bursae (the fluid sac that lubricates the joint), or Capsules (the ligaments surround the joint).

Common causes of the pain include:

Overuse,
Repetitive motions,
Wear and tear,
Poor movement patterns,
Underlying muscle imbalances,
Or maybe having a past history of injuries to the surrounding areas.

To understand what’s causing your shoulder pain, we have to first develop a deeper understanding of the shoulder complex.

What Makes up the Shoulder?

“Warning: the next paragraph gets technical, but it really helps us to understand the causes!”

The Shoulder has lots of bones and joints…

The shoulder complex is made up of three bones: the Humerus (Upper Arm bone), Scapula (Shoulder Blade at the back), and Clavicle (Collar Bone at the front).

The shoulder joint is not a simple hinge: it can roll forward and back, as well as shift up and down in its socket. This allows a much greater range of movement for our arms.

These three bones connect to each other through different joints:

GH Joint (the shoulder ball and socket).
AC Joint (connects your collar bone to your shoulder blade above the shoulder ball)
ST Joint, (on the back: between your shoulder blade and your upper back)
SC Joint (on the front: connects your collar bone to your chest)

As you can see, the shoulder joint is very complex!

Surrounding these bones, the Shoulder joint has lots of muscles…

There are lots of muscles to move the arm in different directions. And as we mentioned earlier, the shoulder ball can also move up, down, forward, and back inside the joint to increase movement.

The main muscles that move the shoulder ball around are the Rotator Cuff Muscles.

These rotator cuff muscles extend from the top of the upper arm bone and attach to the Shoulder Blade. In order to make this work, the Rotator Cuff tendons have to pass through the joint itself (through the Subacromial space).

“Remember ‘Subacromial Space’ – it’s the key to your Shoulder Impingement!”

This Subacromial Space consists of a lubricating sac, known as Bursa, to allow smooth movements in the shoulder. If there’s any irritation or inflammation to the tendons and bursae, the space will shrink, which will cause sharp pain whenever you try to lift the shoulder.

What Causes Shoulder Impingement?

Let’s look into the possible factors that worsen the impingement:

Shoulder Impingement Cause 1 – Poor Posture

If you have shoulder pain, it’s best to look at posture first. Often posture will give hints about the cause of the pain, or might be the cause itself.

Some of the most common causes are having rounded shoulders and a Kyphotic trunk (an exaggerated curve in your upper back – a bit like a small forward ‘hunch’).

In the case of posture-related impingement, your shoulder ball is sitting in an unnatural position. This position constantly pushes and rubs on the structures around the shoulder ball. Over time, this puts stress on the Subacromial Space (the small hole in your shoulder joint, where the tendons run).

In particular, the shoulder ball tends to push up into the socket. This will worsen the condition as it compresses the space when you try to lift your arm up.

Shoulder Impingement Cause 2 – Having Tight Chest and Shoulder Muscles

Now that you know rounded shoulders have its effect on worsening the impingement, there are also some other factors to add.

With your shoulders slouched for a long time, it will encourage the tightening in the muscles of the chest. The front of your chest has two muscles: the Pectoralis Major and the Pectoralis Minor. You probably know them as the ‘Pecs’.

As these muscles tighten overtime, they start to shorten. This shortening then encourages your shoulders to round even more. It’s a cycle that repeats itself: As a muscle becomes tighter, it’s also under tension almost all the time. This will lead to it being overworked and painful.

Aside from the two Pectoralis (chest) muscles, the Upper Trapezius (the triangle muscles between your neck and shoulders) are very likely to be tight as well. The same cycle will happen here too, with the only difference being the position where the muscles pull the shoulders.

With very tight Upper Trapezius, the shoulders are always stiff and raised towards the ears. This forces the shoulder ball upwards, enclosing the Subacromial Space further.

This condition is commonly combined with the poor posture we talked about above. If it gets worse, it may also lead to neck stiffness and tension headaches.

Shoulder Impingement Cause 3 – Weak Shoulder Blade Muscles

There are a lot of muscles that surround the shoulder blades to allow movements. This is because there are so many different movements our shoulder blades and arms can do:

Elevation and Depression (raising and lowering the shoulders),
Retraction and Protraction (pulling the shoulder blades back, or letting them forward),
Upward and Downward Rotations (rolling the shoulders over or rolling them back).

When we sit slouched over, or walk with bad posture, our posture muscles get weak.

The posture muscles that are particularly essential to be strengthened are the Lower Trapezius (the muscles in the centre of your back below your shoulder blades). The Lower Trapezius pulls the shoulder blades down away from the ears.

The Rhomboids (muscles in between the shoulder blades), pull the shoulder blades backwards to keep them squeezed together. This prevents rounding of shoulders.

The final muscle is the Serratus Anterior. This muscle is difficult to explain, and even harder to look at in images. Essentially, it pulls your shoulder blades in towards your ribs, and stops them from ‘winging out’. This works with the other two sets of muscles to provide stabilization.

You may remember from cause number 1 that tight and high shoulders are a major cause of shoulder pain. Strengthening these three muscle groups helps to counter the tightness that is developed in the front of chest and top of the shoulders.

Imagine stretching out those tight muscles until they become loose. If there’s no muscle there to keep the muscles long and loose, the muscles will eventually return to their initial state and tighten up again. This makes strengthening these three back muscles extremely important in reducing shoulder pain.

Shoulder Impingement Cause 4 – Stiff Trunk

Another cause of Shoulder Impingement Pain can be because of a stiff upper back. This limits your range of movement in the spine. As your shoulder is connected to the upper back through the Shoulder Blades on the back and the collar bone on the front, any stiffness in the back can translate into stiffness in the shoulder as well.

Shoulder Impingement Cause 5 – Poor Rhythm Between the Shoulder Blade, the Collar Bone, and the Upper Arm.

Imagine we start with our arms by our side, and then raise them out sideways slowly in a big arc until they are above our heads.

This motion doesn’t simply happen in the ball and socket joint – if it did, we’d crush all of the nerves and fibres inside it!

To increase our shoulder’s range of motion, we actually rotate through four different joints (the GH, ST, SC, and AC Joints mentioned earlier). What makes this even more complex is that they all rotate in different amounts during different parts of the shoulder lift. This is called the Scapulohumeral Rhythm.

As the arm moves, if any single joint is stiff or gets the timing wrong, you won’t be able to properly raise your arm without pain (this is similar to how Frozen Shoulder works).

Over time, any stiffness or bad joint-timing will cause irritation and swelling to the to the structures inside.

Time for the Good News: How to Fix Your Shoulder Pain!

Now that you have an idea of what’s going on in the shoulder, it’s time to see what you can do to help your shoulders!

The good news is that there is already a very well-developed field that can help with Shoulder Pain. This field is called Clinical Pilates, and it’s an area that Physiotherapists can choose to Specialize in.

Clinical Pilates is all about creating personally-tailored exercise programmes that strengthen specific muscles, while lengthening and loosening others. The exercises are very specific and can work on very targeted areas.

Clinical pilates is always a good idea to cope with pains in the body as it incorporates low-impact workouts planned by a professional physiotherapist or practitioner, with or without equipment.

For Shoulder Impingement Pain, the things that you want to work on are:

Stretching and loosening the pecs and Upper Trapezius (triangle muscles over your shoulders)
Working on mobility of your stiff upper back (your Thoracic Spine)
Strengthening your Lower Trapezius, Rhomboids, and Serratus Anterior (The three muscle groups that move your shoulder blade).

Five Exercises to Help Shoulder Pain

Here are some of the exercises that you can kick start with to help your shoulders:

Exercise 1 – Wall Stretches for your Pectoralis Major

Why:

Your Pecs pull your shoulder ball forward in its socket. Loosen up your tight chest muscles so that your shoulders can sit further back in the shoulder socket.

How:

Stand in a doorway facing forward, with the side of your body next to the door frame. Raise your arm so that your upper arm is horizontal with your shoulders. Bend your elbow so that your forearm is pointing towards the ceiling.

Place your entire forearm and upper arm against the wall on one side of the doorway. If you’re unable to reach, just adjust your body angle a bit and work with what you can do.

From there, gently twist your upper body and head away from the wall to feel the stretch along your chest to your upper arm.

Don’t overdo it! This is Clinical stretching for pain-relief – not ballet. Gentle stretches are far more effective than aggressive stretching.

Stop when you feel a gentle pull in in your chest region. Hold for 30 seconds. Release and repeat twice.

Special Caution:

“When stretching, we want to feel it in the chest – not the shoulder ball. If your shoulder ball pushes forward, it’s possible to feel the stretch in the joint. This will not help your shoulder pain, and will actually destabilize your joint. Ease back, set your shoulder back in the joint, and try again.”

Exercise 2 – Wall Stretches for your Pectoralis Minor

Why:

Unlike the Pec Major, the pec minor Rotates the shoulder ball over in the joint. This muscle gets very tight if you have rounded shoulders. Stretch it out to get your shoulder joint back to centre.

How:

To stretch out the pectoralis minor, set yourself up exactly as per the previous stretch.

This time, however, we ward to raise the upper arm slightly above shoulder height so that your palm is higher than your head.

Now rotate your body gently away to feel a stretch. The stretch should now feel higher up in the pecs – just below your collar bone.

Exercise 3 – Low Kneeling Cat and Cow

Why:

If a stiff upper back is the cause of your shoulder pain, you can increase your spinal mobility by flexing your spine forwards, and then extending it backwards. This exercise helps you to get the motion in your upper back instead of your lower back.

How:

Kneel down on a mat or blanket, sitting on your heels.

Place your palms on the floor slightly forward to the knees with gentle pressure towards the ground.

Inhale first. As you exhale, start to sink the belly down towards the floor, gently arch the upper back up, look upwards. (This is the ‘cow’ pose)

Inhale. As you exhale, start to tuck the belly inwards, tuck everything in away from the floor, and round the upper back up, head looking down, look into the belly button. (Now you’re an angry cat!).

Repeat the whole cycle five times.

Caution:

“The purpose of this exercise is to get mobility in your upper spine. Take it slow and try to feel that movement in your upper body. It’s difficult for most people. If you rush this movement, you will only flex your lower back – the area that is already very mobile.”

Exercise 4 – Low Kneeling Trunk Twists

Why:

While the previous exercise focused on forward and backward flexion of your upper spine, you also need to rotate the upper spine to improve your mobility. Increasing upper spine mobility will reduce shoulder pain.

How:

Just as with the Cat Cow pose, sit in a kneeling position again, and then place your hands on the ground.

From here, take one hand and touch your palm to the back of your head.

Inhale first, and as you exhale, start to twist your upper body and slowly point your elbow towards the ceiling.

Open through the front of the chest. Inhale at the top, as you exhale, reverse the motion until your elbow is pointing towards the ground.

Repeat for five times. And then change sides.

Caution:

“When you’re pointing your elbow towards the ground, make sure that it’s your spine that’s rotating – not your arm! If you’re just rotating your arm, you’re doing the chicken dance, and not getting any shoulder pain relief.”

Exercise 5 – Shoulder Retractions

Why:

How:

Sit sideways on a stool (no chair back) in front of a mirror for better view of your posture.

Look at the position of your shoulder joint as well as your collar bone. Are there a lot of wrinkles in your shirt at the front of the shoulder? If there are, your shoulders are hunched forward.

If your shoulders are rounded, you need to strengthen through your shoulder blades to bring the backwards and downwards.

Think of having a glass chopstick in between your shoulder blades behind you. Squeeze the glass chopstick so that it does not fall down to the floor. If you release, the chopstick will drop and break.

As you do this, focus on getting the squeeze in your between your shoulder blades (in the Rhomboids and Lower Trapezius).

Don’t forget to keep the shoulders down, away from the ears.

Hold the squeeze for 10 seconds, release slowly. And repeat for five repetitions.

Practice this whenever possible to start correcting your sitting posture.

Caution:

“Your shoulder position matters when you’re squeezing your shoulder blades. If you shrug your shoulders up near your ears, all of the squeeze goes through your Upper Trapezius (The triangle muscles between your neck and shoulders). Do you remember “Shoulder Impingement Cause 2”? That’s right! Tight Upper Trapezius! So doing this exercise correctly will help, while doing it incorrectly will actually worsen your shoulder pain.”

Shoulder Pain Relief. Where to Now?

Hopefully by this point, you can start to understand just how complex shoulder pain can be. If you’re serious about getting real Shoulder Pain Relief in the long term, then it’s time to come and see a professional Physiotherapist.

Specifically, you want to see a Physiotherapist who specializes in Chronic Pain relief, and has a Clinical Pilates Studio.

This type of Physiotherapist is very different from a Sports Physio. They deal exclusively with clients who have nagging shoulder, neck, and knee issues, and they have different equipment to suit these conditions.

No condition is too small to address. It’s common for clients to have pain and wait 5, 10, even 20 years before they finally say ‘enough is enough’. You can seek treatment today and solve your body issues quickly and effectively.

So please do book in to see a Physiotherapist to get the right diagnosis and programme for your shoulder pain relief.

“Body in Common is an Australian-Style Physiotherapy Studio in Bangsar, Malaysia. We provide Physiotherapy, Clinical Pilates, and Telehealth services in our studio. We Specialize in helping clients find relief from Chronic Pain.
Feel free to get in touch and look after yourself.”

See Our Home Exercises for Shoulder Pain

All Fit Fitness Sdn. Bhd.
Trading As
Body in Common

Get in Touch

Bangsar: 0173255699

Kota Damansara: 01117702502

The post Shoulder Pain and How Clinical Pilates Can Help first appeared on Body in Common.

Scoliosis Management in Children

mail@bodyincommon.com — Sat, 18 Apr 2020 08:37:40 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

Scoliosis Management in Children

“Hilda Teo is a registered Physiotherapist and Clinical Pilates Specialist at Body in Common. Her specialism is working with children, and she takes us through Scoliosis, and how Clinical Pilates can help.”

Our Spine is Important

Without our spine we wouldn’t be able to sit up, stand, walk or run.

The spine provides structural support for the head and body. But it does not stop there. The most important aspect of the spine is its ability to provide support while having a large range of flexible motion.

It also protects the spinal cord, nerve roots and many of the body’s internal organs. it’s one of the most complex parts of the human body, as it needs to fulfil so many different roles.

Needless to say, the spine is a lot more than just a few bones.

So given all this complexity, it’s very common for people to have spinal problems. For most of us, it’s just some back pain or lack of flexibility. For other people, it can be a significant change in the way the spine functions. Scoliosis is one of these changes.

What is Scoliosis?

The technical definition of Scoliosis is:

“A lateral spinal curvature of 10° or greater with vertebral rotation, assessed using the Cobb method.”

In much simpler terms, it’s a condition that causes the spine to curve sideways into a C-curve or S-shaped curve.

In more severe cases of Scoliosis, you can actually see that the person looks asymmetrical: it might look like one of their shoulders is higher than the other, or perhaps it looks like they’re leaning over sideways. In most mild cases, it’s very hard for other people to see the difference.

Scoliosis curves can occur at any part of the spine, but the most common regions are at the Thoracic (upper back) and Lumbar (lower back) regions.

Type of Scoliosis

Kids of any age and even infants can have Scoliosis. It can be classified as

Congenital (existing since birth),
Neuromuscular (As a result of Muscle or Brain issues),
or Idiopathic (a fancy medical word that means “We don’t know why”).

Approximately 85% of Scoliosis cases are Idiopathic. This means that the vast majority of Scoliosis sufferers don’t have any clear cause.

Idiopathic Scoliosis can be further classified by the age of onset:

Infantile (0-3 years),
Juvenile (4-10 years),
and Adolescent (11-18 years).

Adolescent Idiopathic Scoliosis accounts for approximately 90 % of cases of idiopathic Scoliosis in children, and especially affects children when they are growing the most.

This means that the majority of Scoliosis sufferers were not born with the condition, and have no clear cause apart from ‘growing up’ during their teen years.

What are the Symptoms of Scoliosis?

As mentioned earlier, the Spine is one of the most important and complex parts of the human body. As a result, when something is not right, a range of complexities can arise.

Scoliosis symptoms run the full spectrum, depending on the severity of the curve—from painless and subtle to debilitating with visible deformity, respiratory or cardiac problems. There is also an emotional and psychological element to more severe cases, as people around them can see the condition.

With all that mentioned, it’s clear that Scoliosis can significantly impact a child’s quality of life.

Visible Signs of Scoliosis:

When the spine is curved, there are often visible signs, such as:

Tilted, uneven shoulders, with one shoulder blade protruding more than the other,
Prominent ribs on one side,
Uneven waistline and one hip higher than the other.

With this poor body alignment, the muscles surrounding the spine will be imbalanced. The muscles on one side of the body can be weak and lengthened while the other side will be tight and taut.

Scoliosis can also cause uneven weight to be carried on the spinal discs (the soft cushions between each spinal segment). This can cause back pain or even worse, nerve root compression.

The good news is that most cases are not too extreme. However, as the spine is so important, all cases should do exercises to minimise the problem.

Scoliosis Can be Treated and Managed

There are two different stages of Scoliosis. While the body is still young and growing, it is possible to redirect that growth to minimise the extent of the Scoliosis.

Once the body is fully grown, it is nearly impossible to fully remove the unwanted curve.

As a result, realistic treatments focus on Reducing the Curve, not eliminating it altogether. Scoliosis is a life-long condition, but with the right programmes, it can be pain-free for most people, without the need for dangerous surgeries.

The Two Elements of Treatment

In extreme cases, children will often need specially-built braces to resist further growth in the wrong direction. There are special Scoliosis bracing specialists for these cases.

For most cases, a professionally-designed set of exercises can help to re-train the body to minimise the curvature. Did you know that exercise is one of the key treatments for a Scoliosis management plan?

This is where Clinical Pilates comes into picture. Clinical Pilates is a well-structured and specifically tailored exercise program designed by a certified Physiotherapist with Specialist Clinical Pilates training.

This Clinical Pilates programme is specifically designed for each person, depending on their type and location of Scoliosis. It can help to slow down the progress of the spinal curvature as well as strengthening your muscles and improving posture.

By strengthening various postural muscles, and relaxing others, the aim is to promote symmetry within the spine to regain trunk alignment. With improved function and strength, it can take some of the stress off the scoliotic spine and eventually living a pain-free life.

Before commencing Clinical Pilates, a thorough full body assessment is performed to evaluate the areas of weakness. From here, the Physiotherapist will create a programme of exercises that’s suitable for the child.

How Can Clinical Pilates Help Children with Scoliosis?

1 – Clinical Pilates helps to improve core strength and posture.

Clinical Pilates exercises are all about activating your core muscles which are all the deep abdominals, back muscles and muscles around the pelvis. These muscles are designed to protect the spine by creating a sturdy rod that limits excessive movement in any direction.

With a strong core, comes a strong body which allows your child to walk better, run faster, or even participate better in social activities outside of school.

2 – Clinical Pilates Increases functional movements and flexibility.

With stretching exercises and proper breathing techniques incorporated in Clinical Pilates, children will gain awareness of their own body targeting muscles that are often neglected. They will learn how to move their spine and limbs efficiently to their full functional level and to be able to self-correct their spine’s position during their daily activities.

Clinical Pilates elongates and strengthens muscles, improving muscle elasticity and joint mobility which will create a balanced musculature that can alleviate pain and reduce the potential for injury now and as they continue to grow into adulthood.

3 – It Improves their mental health and well-being

Clinical Pilates can guide kids to a stronger body and a more relaxed state of mind. The most obvious benefit is an improved range of motion, a more natural walk, and better ease in fitting in with society.

With a stronger body and better participation among their peers, it will definitely increase children’s self-esteem and confidence.

Types of Clinical Pilates Exercises for Scoliosis

If you think your child has Scoliosis, it’s a good idea to see a Paediatric Orthopaedic Surgeon to obtain an accurate diagnosis on the severity and type of the Scoliosis curve. The first step is getting an accurate diagnosis that includes the curve degree, its shape, and location.

Without an accurate diagnosis, it is difficult to design the best possible programme. Once your child has a clear diagnosis, it’s time to see a Physiotherapist with Clinical Pilates training.

The following exercises are some examples of Clinical Pilates used in the studio. The following three can be safely performed at home, however for proper results, you should see a specialist.

Exercise 1 – Mermaids

‘Mermaids’ is a really good Clinical Pilates exercise that works on the side of the body.

It’s a wonderful lateral flexion exercise (‘side bend’ exercise) that helps to open up and stretch out the tightness at the side body from the ribs to the pelvis. It can be used as a gentle warm-up exercise as well as a cool down after an exercise routine.

Exercise:

Sit on the floor with both your legs folded to the right side. Sit up tall as though there is a helium balloon pulling you from above your head.

Keeping your right hip glued to the ground, extend your right arm straight above your head and try to reach to the opposite side like creating a rainbow with your right arm.

To stretch your sides further, slowly move your left hand further away from your body.

Now using your abs, bring back the torso up and sit back up straight.

Repeat this movement for 2-3 times, then switch sides. You can do a double set on the tighter side of the body. Do these exercises slowly – they are not performed in the same manner as a gym workout.

Exercise 2 – Shoulder Bridge

Shoulder Bridge is a great exercise that encourages the articulation of the spine in a proper and functional manner, while strengthening your back and glute muscles (‘bum muscles’) at the same time.

It’s a core stabilisation exercise too as it engages your trunk and pelvic floor muscles.

Exercise:

Lie down on your back in a neutral position. With your knees bent, start tilting your pelvis.

Next, slowly lift your back, vertebrae by vertebrae to create a diagonal straight line, all the way from your knees to the shoulder. Make sure the knees are parallel and there is no tension on your upper body.

Hold this position for 5 seconds and then lower your spine vertebrae by vertebrae, starting from your chest to your pelvic slowly on to the mat again. Repeat this exercise for 10 to 15 repetitions.

Exercise 3 – Seated pelvic tilts

Seated pelvic tilts is another fantastic exercise for those who have Scoliosis.

It helps to activate the core and improves strength in the lower back muscles too. This subtle spinal movement often provides relief especially when there is back pain. As children spend most of their time sitting in classrooms, this exercise will benefit them a lot in terms of maintaining good sitting posture and endurance.

Exercise:

You can either do it on a chair or a gym ball to make it more challenging to the core. Always ensure that your hip level is higher than your knees in sitting.

Sitting up nice and tall with your feet shoulder-width apart, try to imagine your pelvis as a bowl of soup. This will be your starting position.

Inhale and start to engage your core. Exhale and tilt your pelvis which is the bowl of soup backward. Inhale as you tilt your pelvis forward to the starting position. Do 5 to 10 reps.

There are Many More Exercises:

These are just a few examples of Clinical Pilates exercises that can be done on a daily basis.

Regularly completing this routine can help relieve tension and other symptoms of Scoliosis, but if you’re looking for a more specialised exercise routine to prevent long-term progression of your condition, you should consult a Clinical Pilates instructor.

Going into Adulthood with Scoliosis: What to Expect?

Most people think of Scoliosis as a condition that affects only adolescents — not something adults struggle with. But every child with Scoliosis eventually becomes an adult, and the belief that curves don’t progress during adulthood is a myth.

As the joints degenerate and bone density reduces with age, the Scoliosis could worsen with a progression of 0.5 to 2 degrees a year. Some studies have shown that certain men and women who had Scoliosis in childhood may experience some difficulties with physical activity, social activities, body image and sexual activity.

In worst-case scenarios, Scoliosis could lead to conditions alongside Scoliosis down the line such as Degenerative Disc Disease, Spinal Stenosis, Spondylolisthesis, Osteoporosis and Arthritis.

Going into Adulthood with Scoliosis: What to Expect?

In worst-case scenarios, Scoliosis could lead to conditions alongside Scoliosis down the line such as Degenerative Disc Disease, Spinal Stenosis, Spondylolisthesis, Osteoporosis and Arthritis.

It’s Not All Doom and Gloom!

The good news is that if you start managing the problems today, you minimize the problems tomorrow.

Clinical Pilates has been clinically shown as an effective management tool for Scoliosis of any severity level. When doing a proper management plan, you can expect to reduce pain and muscle-stress, and you can live a high-quality life.

Don’t let the Scoliosis curve be ahead of you. Take charge, fix it and keep your spine healthy and moving!

All Fit Fitness Sdn. Bhd.
Trading As
Body in Common

Get in Touch

Bangsar: 0173255699

Kota Damansara: 01117702502

The post Scoliosis Management in Children first appeared on Body in Common.

How Your Body Changes During Pregnancy, and How Clinical Pilates Can Help

mail@bodyincommon.com — Thu, 16 Apr 2020 12:33:50 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

How Your Body Changes During Pregnancy, and How Clinical Pilates Can Help

“Are you currently pregnant and starting to think about your body after giving birth?
Or have you just given birth and have noticed changes in your body?
Do you feel like your tummy is bulging a lot even after delivery?
Do you want to get back to exercising, but don’t know where to start safely?”

All Bodies Change During Pregnancy

This article is dedicated to all the moms out there, either those who are preparing to be a new mom, or to those of you who are still new to all the sudden changes in the body after giving birth to your baby. This will be a great chance for you to get to know your body a little bit more.

After delivery, your body will face some changes, both physically, mentally, and emotionally. People often say that your body will never be the same anymore, but the good news is that by understanding the changes and doing the right things, you can mostly get back to your pre-baby self.

Body Change Number 1 -
The Mummy Tummy Bulge

After giving birth, it’s normal to have a bulging tummy.

You may feel a gap located right in the centre of your tummy muscles. This gap is called Diastasis Recti. You may have heard of this issue, but most women go into Childbirth without ever having heard about it. Then after birth, you suddenly get a surprise!

There are two common reactions to this. Either you ignore it, or you think that something has gone wrong with your body.

But don’t worry, this is a very common symptom of giving birth, with plenty of science to fix it.

What is Diastasis Recti?

Diastasis Recti is basically the separation of your Rectus Abdominis (your six-pack abs). This separation happens down the middle of your six-pack muscles (at the Linea Alba).

During pregnancy, your body naturally releases hormones to relax your muscles in preparation for childbirth. Unfortunately the side effect is that every muscle in your body relaxes – not just specific ones. All of your connective tissues also relax, leading to the separation of your six pack.

Our abdominal area consists of four main muscles:

Rectus Abdominis (Six-Pack)
Internal and External Obliques (To the sides of your six-pack)
Transverse Abdominis, which hides underneath all of the other muscles. (Remember this one!)

There are a few factors that may worsen Diastasis, but one of the major factors is having a weak Core.

Your Core is made up of your Transversus Abdominis, Pelvic Floor, and Multifidus, a deep muscle situated in your lower back. Your core supports your body in positionand also holds you together.

To relate this back to the mummy tummy (Diastasis), imagine wearing a pair of loose jeans without having a belt to keep them up. Without that belt, the jeans will remain loose until you tighten up the belt.

Here, the belt is your Core muscles (not your six pack!), and to get rid of the mummy tummy, you need to tighten all of these back up.

Be Careful When Doing Sit-Ups!

Unfortunately, the most common answer people have is to do lots of crunches and sit-ups, thinking that they’ll keep in shape. What this actually does is to overwork your Rectus Abdominis during pregnancy.

By doing lots of abdominal crunches, sit-ups, chest curls during this period of time will encourage the separation of your abs (at the Linea Alba), causing the gap to be bigger, longer, or deeper.

Moral of the story: be careful what exercises you do during pregnancy!

Change Number 2 - Postpartum Fatigue

After giving birth, You’ll notice that you get tired more often than before.

Studies have shown that fatigue is a common problem for mothers after they give birth. With more tasks to do and more things to take care of now, your body might be trying to do too much.

You might be getting insufficient sleep and nutrition, might have breastfeeding difficulties, and find getting back to normal is quite stressful. You may also notice you have less motivation during this stage.

Exercise is the Key to Getting Over Fatigue

While doing exercises or any physical activities, our body releases chemicals called Endorphins. These chemicals make us more energized and reduce our stress levels

As I mentioned earlier, not all exercises are suitable just after pregnancy. For example, focusing only on sit ups can make the Mummy Tummy worse. That’s definitely not what we want! You may also want to be careful doing too many stretching-style classes, as your body has already become quite slack and ‘relaxed’ during pregnancy.

Low-impact, balanced, strength workouts are a great choice. Pilates is one of the best options during this time.

Change Number 3 - Incontinence

This may not be as common (luckily!), but you may notice some urine leakage when you’re doing big movements, such as coughing or laughing. You might also notice that you have less control over your urge to go to the toilet. When you feel the urge, you have to go immediately. It’s also quite common to need to go to the toilet more frequently.

This is due to the Pelvic Floor getting weaker as the body prepares to give birth.

After delivery, a good recovery is important to prevent incontinence. This means that we need to rebuild our Pelvic Floor strength. These muscles not only act as a support to hold our urine in, but they also keep our organs in place, and play an important role in sexual function.

Re-training the Pelvic Floor muscles is one of the more difficult tasks. After giving birth, it’s hard to feel them properly, and often quite hard to control their motion. Seeing an exercise specialist will really help with this specific problem.

Change Number 4 - New Pains and Aches

As you’ll remember, during pregnancy our bodies pump themselves full of muscle relaxant hormones to make giving birth easier. This means that after pregnancy, our muscles are not the same as before. We’ve also been carrying a 3-4kg weight in front of our bodies for months!

Developing aches in the lower back, upper back, neck, and wrists is a very common postpartum problem.

In particular, your posture will be slightly different than before, which will be putting new strains on your spine and neck muscles. It’s quite common that some muscles will be tighter on one side, and weaker on another side.

While many women just accept this part of the process, when these pains and aches appear, it’s always a good idea to get them checked as soon as possible. This is because our muscles are highly adaptable, and will not always grow back into the optimal position and length without help. It may be something simple that you can actually work on and solve quickly.

How can Clinical Pilates Help Get Back into Shape After Giving Birth?

Clinical Pilates is very effective in building strength, improving body postures, enhancing body awareness, reducing body pains and injuries, as well as preventing falls.

Clinical Pilates is fundamentally different from fitness Pilates, as it’s run by registered professionals, such as Physiotherapists. The exercises we do in Clinical Pilates are targeted, and clinically-proven, science-backed movements (hence the name!).

The first step of any Clinical Pilates programme is to get yourself properly assessed by a Physiotherapist. They do a detailed assessment of your body, your goals, and issues, and at the same time understand where and how the problems arise. This allows us to design a programme specific to your body.

For instance, if you do have a Diastasis Recti, what we do after getting a proper assessment is to start getting some activation through your Transversus Abdominis.

Our first step is to make sure you’re getting the activation correctly, and also making sure you feel what you’re supposed to feel. This allows you to start safely working on the issues, instead of working on the wrong things.

For Further Information

If you have already given birth, We have a dedicated article discussing Diastasis Recti, and giving you some tips to start safely working on it at home.

It’s never too early or too late to talk to a professional about your body. Look after yourself, and best of luck with your pregnancy!

See Our Home Exercises for
Fixing the Mummy Tummy

All Fit Fitness Sdn. Bhd.
Trading As
Body in Common

Get in Touch

Bangsar: 0173255699

Kota Damansara: 01117702502

The post How Your Body Changes During Pregnancy, and How Clinical Pilates Can Help first appeared on Body in Common.

Understanding Cerebral Palsy and How Clinical Pilates Can Help

mail@bodyincommon.com — Tue, 14 Apr 2020 07:23:40 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

Understanding Cerebral Palsy and How Clinical Pilates Can Help

Hilda Teo is a Registered "Physiotherapist, working both in hospitals, as well as at Body in Common. She specializes in Paediatric Physiotherapy, and takes us through what Cerebral Palsy means for your child."

Common Signs of Cerebral Palsy

Does your baby’s head fall backward when you pick them up? Or perhaps their limbs are rather stiff when you’re handling them?

As they grow older, do they seem to be slower than their peers to reach milestones like rolling, sitting and crawling?

These may be the early signs of children with Cerebral Palsy.

What is Cerebral Palsy?

Cerebral Palsy (CP) is a neurological disorder caused by a brain injury or malformation that occurs while the child’s brain is under development.

This type of injury is ‘non-progressive’, meaning that it happened during one moment, and does not get worse over time. The injury (or malformation) may have been in the womb, during birth, or immediately after birth.

It’s a lifelong condition that affects the communication between the brain and the muscles, causing a permanent state of weakness, abnormal movements, and coordination issues.

CP occurs in 1-3 out of every 1000 babies born (about 0.15% to 0.3%) and is more likely to occur in babies who are born premature as well as babies of low birth weight.

To understand what’s happening in these children, we need to understand a bit more about how the brain works.

Anatomy of the Brain

As we all know, the brain is one of the largest and most complex organs in the human body. It’s running hundreds and thousands of simultaneous processes that range from managing temperature, to running other organs, to processing jokes. This complexity is both the brain’s strength and weakness, and a lot can go wrong.

The brain has several zones, including:

The Cerebrum
The Cerebral Cortex
The similarly named, Cerebellum
And the Brainstem.

The Cerebrum:

The Cerebrum is the largest part of the brain and makes up the right and left hemispheres. It’s the part of the brain responsible for processing sensory information, such as sight and sound; and it’s also responsible for planning motor activity, emotion, and memory.

The Cerebrum has a lot of functions!

The Cerebral Cortex:

Coating the surface of the Cerebrum and the Cerebellum is the Cerebral Cortex.

This is the wrinkly layer of tissues that is seen on the brain. It’s divided into four lobes of the brain: the frontal lobe, parietal lobe, occipital lobe, and temporal lobe, which are each responsible for processing different types of sensory information and are also involved in the synthesis of movements.

The Cerebellum:

The Cerebellum is located under the Cerebrum. It plays an important role in coordinating muscle movements, maintaining posture and balance. You can see that while the Cerebrum focused on the big picture, the Cerebellum keeps the muscles functioning correctly. Without your cerebellum, you would find it difficult to stand upright, keep your balance or even to move around.

The Brainstem:

The Brainstem acts as a relay center that connects the cerebrum and cerebellum to the spinal cord. This ‘tiny yet mighty’ part of the brain is in charge of all the functions your body needs to stay alive, like breathing, digesting food, regulating your heart rate and body temperature as well as coughing and swallowing.

Which Part of the Brain is Affected by Cerebral Palsy?

As the name implies, most cases of Cerebral Palsy affect the Cerebral Cortex.

This means that CP can permanently affect body movement and muscle coordination, making it the most common motor disability in childhood.

Now that We’re familiar with the major components of the brain, it will be easier to understand the different types of Cerebral Palsy and how it can affect your child.

Types of Cerebral Palsy

There are four main types of Cerebral Palsy, with each type creating abnormalities in different parts of the brain, and resulting in different symptoms.

1 – Spastic Cerebral Palsy

Spastic Cerebral Palsy is the most common type, and is caused by damage to the Motor Cortex of the brain.

In this type of CP, there is an abnormal increase in muscle tone which often results in difficulty controlling movements due to tight muscles and rigid joints.

Spastic CP contains three more catgeories:

1. Spastic Diplegia (‘di’ meaning two, ‘Plegia’ meaning paralysis). This usually affects both legs and sometimes the arms.
2. Spastic Quadriplegia (‘quad’ meaning four) that affects all four limbs.
3. Spastic Hemiplegia (‘hemi’ meaning half) that affects one side of the body, for example, the right arm and right leg or vice versa.

2 – Dyskinetic Cerebral Palsy

Dyskinetic can be roughly translated to: “Involuntary movements”.

This type of CP is characterized by slow and involuntary writhing or jerky movements of the limbs. Hyperactivity in the facial and tongue muscles also makes it difficult to eat and speak. It’s a particularly difficult type to live with as it has a big psychological and social impact as well.

This type of CP also includes Athetoid (Slow, writhing movements of the hands and fingers), Choreoathetoid (Shoulders, Hips, and Face), and Dystonic cerebral palsies (Repetitive Movements and Unnatural, fixed Postures).

3 – Ataxic Cerebral Palsy

Ataxic Cerebral Palsy is the least common type of CP. While other CP mostly occurs due to the Cerebral Cortex, this type occurs from damage to the Cerebellum.

This affects balance and depth perception. Children with ataxic Cerebral Palsy will often have poor coordination and walk with an unsteady gait. They have difficulty with quick or precise movements, such as writing or buttoning a shirt, or a hard time controlling voluntary movement such as reaching for a book.

4 – Mixed Cerebral Palsy

Mixed Cerebral Palsy is when a child has a mixture of 2 of the above types.

It’s usually a result of damage to many parts of the brain. The most common combination is Spastic CP (Tight Muscles and Joints/Paralysis) and Dyskinetic CP (Involuntary Movements).

Other Effects of Cerebral Palsy

Besides having movement and posture issues, children with Cerebral Palsy may also have problems such as cognitive impairment, seizures, impaired vision, hearing loss, speech disorders and malnutrition, depending on which parts of the brain have been injured.

You could say that in some cases, Cerebral Palsy is just one part of a larger injury.

It goes without saying that it can affect a child’s quality of life tremendously. As parents, you will probably have a myriad of questions and concerns, and worry what the future holds for your child.

But the good news is that early intervention can make a big difference!

On a brighter note, CP is not a progressive disease. This means that it does not get worse over time. In many instances, CP can improve with a variety of treatments and therapies. These treatments focus on minimizing deformities and maximizing your child’s capability at home and in the community.

Which Professionals Help Cerebral Palsy?

Once the diagnosis is made and the type of CP is determined, a team of health care professionals will work with you and your child to build an appropriate plan. This plan is focused on helping your child grow and develop to their full potential.

As CP is a neurological condition, this team of professionals will come from a range of disciplines, with each profession focusing on their particular specialty. This team usually comprises of your Doctor, your Physiotherapist, and often various other specialists such as Podiatrists (foot and shoe specialists).

Here at Body in Common, we are Physiotherapists, so our specialty is in working with movement, coordination, posture, muscle length, and the physical symptoms that make up CP.

Physiotherapy rehabilitation will usually commence as soon as the diagnosis is made as it’s the cornerstone of all CP treatments.

Strength and resistance training, along with stretching exercises can help in improving muscle strength, balance, and motor skills as well as to prevent contractures (muscles getting stuck in position).

Physiotherapists also work closing with Podiatrists (foot specialists) to provide ‘Gait training’. This training uses special orthotics (shoe modifications) to learn to walk more naturally and improve their movement.

What is Clinical Pilates?

Clinical Pilates is a specialist field of Physiotherapy. While traditional physiotherapy uses a lot of hands-on movements and treatments, Clinical Pilates is focused on creating highly targeted exercises to change individual muscles in a person’s body.

For example, one exercise may strengthen a muscle, while another may lengthen a muscle to provide batter symmetry and balance. These exercises, unlike normal gym workouts, are highly customised to each person, and are backed by Evidence-based studies.

Special Equipment is used, with a variety of tensions, angles, and customizations to suit each body. The other major benefit of Clinical Pilates is that it’s extremely low-impact. This makes it safe for damaged joints and unnatural muscles that could be hurt doing other exercises.

How Can Clinical Pilates Help Children with Cerebral Palsy?

Often combined with Traditional Physiotherapy, Clinical Pilates has recently shown major benefits in helping a new population – children with neuromuscular disorders like Cerebral Palsy.

Being a low impact exercise that focuses on strengthening the body and core for better trunk stability, it’s well suited for people with physical limitations as the exercises can be tailored to target each child’s issues and needs.

Children with Cerebral Palsy have difficulty balancing during specific muscle movements. For example: bending and straightening the knee. Oftentimes, they are unable to hold their bodies against gravity, as they lack the alignment and muscle strength to stay upright. This can make other exercises very difficult.

Working on a piece of equipment called the ‘Clinical Pilates Reformer’ allows children to perform the exercises while lying on their back. This is often a more comfortable position that allows these children to move with greater ease and control, and contributes to a positive movement experience, which is a good one to begin with. It also removes the difficulties of dealing with gravity, making for a more successful rehab session.

Reformer work is also an effective way to teach these children how to control their own movements: They receive resistance from the equipment and feel the contact with the foot bar or jump board, which provides a better sense of where their body is in space as they move through a variety of positions.

Besides that, Clinical Pilates can be a brilliant form of neuromuscular relearning programme that teaches a series of function-based controlled movement exercises. These can be very helpful in learning new movement patterns that make performing daily activities easier and more successful. For example: learning to lift your leg properly to climb the stairs or get off of a toilet seat.

Clinical Pilates can help to improve a CP child’s range of motion, flexibility, strength, balance, and posture. But that’s not all. There are also emotional and mental benefits.

For a child who struggles with pain and movement, the improvements that come with exercises can be empowering. It gives them a greater sense of control and achievement.

As a paediatric physiotherapist and Clinical Pilates instructor, there’s nothing more satisfying than seeing a child happy and being able to accomplish achievements be it big or small throughout their therapy session.

Going into Adulthood with Cerebral Palsy: What to expect?

The likely outcome for Cerebral Palsy depends on individual factors, but except in the most severe of cases, it’s possible for children to grow up to live a normal life.

They are able to go to school with their peers with and without the help of special education and assistance with communication, hearing or vision aids, and speech and language therapy. Most children with CP grow up to function as independent adults. Those with more severe disabilities may need lifelong care and supervision.

Most children with CP live well into adulthood. Unfortunately there’s also bad news: due to the stress and strain on a person’s body as it functions with impairment from day-to-day life, CP can lead to premature aging, painful and degenerative arthritis as well as fatigue.

Adults with CP may also have limited strength and restricted patterns of movement, which puts them at risk for overuse syndromes and nerve entrapments. Some may develop scoliosis after puberty or experience musculoskeletal pain that can be acute or chronic on their lower back and both lower limbs.

The reality is that dealing with the condition can be a life-long endeavor, and we’re here to help make that the best outcome possible.

My Child has Cerebral Palsy. Where to go?

The first step is to see your doctor. Get the right diagnosis, and understand exactly what type of Cerebral Palsy they have. After that, it’s time to get in touch with a Physiotherapist:

Who understands Cerebral Palsy
Who has experience working with Children
And who is trained in Clinical Pilates.

This combination of experience will lead to the best outcomes for your child, and will help get your and your child’s life on a good track.

“Body in Common is an Australian-style Physiotherapy and Clinical Pilates Studio in Bangsar, Malaysia. If you live in our area, we highly recommend Hilda Teo as your local professional. You can get in touch with us via online chat, and can book your first appointment on our website.”

All Fit Fitness Sdn. Bhd.
Trading As
Body in Common

Get in Touch

Bangsar: 0173255699

Kota Damansara: 01117702502

The post Understanding Cerebral Palsy and How Clinical Pilates Can Help first appeared on Body in Common.

Clinical Pilates for Scoliosis Management

mail@bodyincommon.com — Thu, 09 Apr 2020 08:13:41 +0000

The post Clinical Pilates for Scoliosis Management first appeared on Body in Common.

How can Clinical Pilates Help with Prenatal Preparation?

mail@bodyincommon.com — Thu, 09 Apr 2020 07:09:03 +0000

Keep Your Body Confidence during Pregnancy with Pre-Natal Pilates.

Want us to contact you about 1-on-1 Pre-Natal Pilates? Fill out the form, and we’ll get in touch!

How can Clinical Pilates Help with Prenatal Preparation?

"Looking after your Body in Just as important as looking after your baby. The key to getting your body back after childbirth is what you do while you're still pregnant."

Clinical Pilates for Prenatal Prep

Are you pregnant or planning to get pregnant? Congratulations! Having a baby is a huge milestone in everyone’s life. But as a modern mum, we bet you also want to keep your body functional, strong, and safe.

If you’re thinking about having a baby, it’s not too early to get started with priming your body for pregnancy. It’s a time of change in the body, with both positive and negative effects:

Your body naturally produces muscle relaxant to prepare for giving birth.
This makes your muscles and joints weaker.
Your tummy grows, and your six-pack muscles physically push to the sides to allow room for the baby.
As the baby grows, lying on your back gets more uncomfortable.
And a host of other changes.

This all leaves your body in a very different state to how it was before! Prenatal prep is all about helping those positives, while reducing the negatives, to get the most out of your pregnancy.

It’s also a chance to prepare for the postnatal phase:

Sore wrists and repetitive stress injuries from holding the baby all day.
Recovering from the ‘mummy tummy’ (Diastasis Recti).
Getting back to your pre-baby fitness levels.

So What Does Prenatal Preparation Involve?

Pregnancy is a time of excitement and anticipation for several parents. This period gives the time to clear your doubts and prepare yourself for the challenges of motherhood.

Today, many women begin that preparation even before conception.

Humans have been having babies since the dawn of time, and with modern medicine, things have never been easier. Although you can have a healthy baby without any pregnancy plans, having one will help ensure that you and your baby have the greatest chances of having good health after childbirth.

Prenatal preparation starts with your doctor, and generally involves a discussion about your nutrition, exercise regimen, counselling and the necessity of avoiding alcohol, certain foods, and certain medications.

With your doctor directing the overall plan, you will usually end up with other specialists who have more knowledge in their area. For example, we’re Physiotherapists, and we specialise in keeping the body physically fit, and in shape.

Should You Exercise?

Absolutely! Nobody wants to be a couch potato for 9 months. Your ancestors exercised during pregnancy (mostly because they didn’t have cars and the internet!), and it’s safe for you to exercise too.

Exercise is an integral part of healthy pregnancies. Healthy pregnant women with an uncomplicated pregnancy, are usually advised to participate in at least 30 minutes of low to moderate exercise on most days of the week (1).

And of course, exercise offers a ton of benefits, for both you and your baby. Prenatal exercises can support your baby’s brain growth and development, help you stay in shape and ease pregnancy-related aches and pains.

The real question is: what types of exercise are safe?

But when it comes to pregnancy, there are several elements to keep in mind before beginning any form of exercise:

It’s crucial to avoid high-impact exercises that may pose risks to the baby.
As your baby grows, your centre of gravity also changes, and you’ll find that tasks that were easy before do become harder.
Lying on your back can be uncomfortable, and as the baby gets heavier, can even reduce your blood flow.
As your body gets more muscle relaxant, your joints can become unsafe, and stretching can actually become a bad thing.

What your body really needs is a low-impact exercise program such as Beginner Fitness Pilates or Clinical Pilates: exercises that are low-impact, focus on balance and coordination, and that don’t do excessive stretching.

Why Clinical Pilates for Prenatal Mums?

Today, Clinical Pilates is gaining popularity as a great form of exercise in prenatal preparation. It works on achieving muscle harmony through the strengthening of weak muscles and lengthening of tight, unbalanced muscles (2).

This gives you greater control over your body and increases strength and elasticity without damaging your joints. You can begin with Clinical Pilates at any stage of your pregnancy, even if you have never previously trained in this method.

The greatest benefit is that you can continue to do exercise from the first week of your pregnancy, right up until the last week, by slowly changing your personal programme as your body progresses.

Below are some of the reasons Clinical Pilates is a great choice for Prenatal Mums:

1 - Clinical Pilates Prevents Pain and Improves Your Posture and Body Awareness

Clinical pilates works on your core muscles that provide support and stability to your pelvis, spine and hips. Clinical pilates strengthens these muscle groups and helps you manage the increasing demands of your body weight. Moreover, it also helps you better control the pain during birth (3-5).

As your baby grows, you shall also observe changes in your posture. Often your shoulders become more rounded with your pelvis tilting more anteriorly, placing extra pressure on your lower back.

By becoming more aware of your posture we reduce any posture-related problems during pregnancy.

Working on maintaining good muscle awareness during pregnancy, helps your body bounce back faster and better after giving birth.

2 - Maintains Your Pelvic Floor Muscle Strength

The pelvic floor muscles are a broad sheet of muscles and tissue that starts from your pelvic bone in the front of the body and ends at the base of your spine. It’s the group that’s responsible for solving postnatal incontinence, but also so much more.

As you put on baby-weight, there is a lot of stress on the pelvic floor muscle causing them to become weak and overstretched.

Ideally, you want to increase the strength and activation of your Pelvic Floor, while still allowing it to be flexible and ready for birth.

Pelvic movements and exercises help you make your ligaments more flexible. This increases the diameter of the opening of the cervix and facilitates natural births with no need of unnecessary c-sections or instrumental deliveries (6-9).

3 - Enhances Functional Movement and Keeps You Flexible (But Not too flexible!)

Clinical pilates focuses on lengthening and stretching of areas that often become tight during the course of pregnancy.

While many women turn to yoga for prenatal exercise, they don’t realise that being too flexible puts your body at risk of additional injuries. During pregnancy, with all of the body’s extra muscle relaxant, you need to be twice as careful.

Good flexibility happens in the muscles themselves, while keeping the joints safe and well-supported. For every flexible point, there needs to be an equally strong point to keep everything safe and functions.

Areas such as the upper back, chest and legs can specifically benefit from low impact exercises by improving their mobility. This is more than just random stretching: it’s creating strength in the right places, and improving functional movement. Clinical Pilates uses a combination of strength and flexibility workouts to make your body feel light and relaxed (10).

4 - Clinical pilates keeps your weight in check, prepares you for labour and speeds up postnatal recovery

Through clinical pilates, we make sure that you do not gain too much weight during your pregnancy and thus reduce the possibility of gestational diabetes and high blood pressure (11).

As we particularly emphasize on relaxed breathing and deep embodiment, clinical pilates helps you prepare for labour and childbirth. It also helps you cope with several emotional ups and downs associated with pregnancy.

Moreover, regular pilates sessions make you feel stronger and energized throughout your pregnancy. This existing foundation of fitness helps you recover faster after the birth of your beautiful baby.

What are the Best Clinical Pilates Exercises for Pregnancy?

Take it slow, listen to your body, and talk to a professional. Here are some of the Clinical Pilates exercises that help with Prenatal preparation.

Exercise 1 - Swimming Pose

As you put on weight, your back suffers a lot as the baby bump grows. The swimming pilates exercise is an amazing move to work on your back extensor muscles.

Generally, pregnant women are recommended not to lie on their bellies. So to enjoy the benefits of the back extensor exercise we are going to show you a modified version of the swimming exercise.

Exercise:

This exercise is pretty simple. Get into a cat position, with your hands directly underneath your shoulders and knees directly below the hips.

Take a breath in, and with exhale bring the left arm and right leg as high as possible. Make sure your spine is in alignment.

Hold this position for a moment and then lower it back to the starting position.

Now repeat it with the opposite arms and legs up, making sure your spine is staying in a neutral position. While performing this exercise try to remain in a steady position with minimal to no rotation.

Why:

This exercise focuses on your back extensors. It strengthens them, particularly your back and also the support of the lower back with the abdominal wall.

Exercise 2 - Clams

You will need to keep your pelvis and hips strong to help your body support your growing baby. Clams help you strengthen your pelvic and hip muscles, which reduces and prevents the occurrence of pelvic girdle pain.

Exercise:

Begin the exercise by lying on one side, with your head resting on your arms and knees bent in a 90-degree angle in front of your hips. Keep your top hand on your hips or in front of you on the floor.

Stack your hips, one on top of the other with your ribs, waist, spine and pelvis in a neutral position.

In one sleek movement, keeping your fit together open the top knee without allowing your top hips to drop backwards. Once reached on the top, lower it back to the start position.

Repeat on the same side for 10 repetitions before switching to the other side.

As you gain strength in your hips, you can use a resistance band by placing it around your knee or you can also raise your ankles for a challenging variation of the exercise.

Why:

The clam is an ideal exercise to strengthen your pelvic and hip muscles.

Exercise 3 - Side planks

Side planks are an effective way of strengthening your core without increasing the risk of developing diastasis recti – the thing causing a bulge in the middle of your abdomen.

Side planks are safe to be performed in all trimester of pregnancy.

Exercise:

Lie on your left side while resting on your forearms and keeping your whole body in a straight line. Keep your elbow directly underneath your shoulder.

Gently contract your abdomen and lift your hips off the floor making sure your ribs, hips, knees and ankles are all aligned.

Hold this position for 30 seconds and then change to the other side.

As you progress in your pregnancy, you can first try bending only your bottom leg and keeping the top leg straight. Later, you may side plank with both your legs bent.

We love this exercise as it can be done in endless variations. If you feel strong and confident, try lifting your top leg while performing side planks.

Why:

Side planks strengthen your hips and abdominal muscles, especially the obliques. It also stabilizes your shoulders.

Exercise 4 - Dumbbell wrist extensors

As you move closer to your pregnancy date, it is better if we focus our attention towards muscles that will play an important role after birth.

Dumbbell wrist extensors are great for your forearms and wrists. It will build your wrist strength which will help you when the time comes to regularly lift your baby.

Exercise:

Seat in a chair and hold a dumbbell in your right hand. Make sure, to begin with a lighter one before gradually increasing the weights.

Now, lean your forearm onto a table or your thighs and keeping your palm down hang your wrist off the edge of the table or at the end of your knees.

Holding your forearm in place, slowly bend your wrist upward with lifting the dumbbell as high as you can. Now slowly lower it back to the starting position and repeat it for 10 more times before moving onto the left hand.

You can also train your flexors, by keeping your palm facing up and repeating the same movement. This will help you strengthen your forearms.

Why:

Dumbbell wrist extensors are excellent in enhancing your wrist and forearms strength and help you prevent any wrist-related injuries after birth.

Why Us?

Clinical pilates is excellent for preparing your body for labour and building strength and flexibility. Regular clinical pilates sessions will make you feel stronger and energetic.

The frequency and type of exercise we suggest will depend on your level of activity before pregnancy. Therefore before engaging with clinical pilates, we carry out an assessment to check your level of fitness.

We specialize in educating and preparing you to be mentally, physically and emotionally ready for the arrival of your baby. So do get in touch and we will make sure you’re all set for your growing ball of love.

Keep Your Body Confidence during Pregnancy with Pre-Natal Pilates.

Want us to contact you about 1-on-1 Pre-Natal Pilates? Fill out the form, and we’ll get in touch!

Once you're done with Prenatal, You can also get back in shape with Post-Natal Pilates

Backed by Evidence. References.

Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., … & Kriska, A. (1995). Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Jama, 273(5), 402-407.
Ochoteco M, Colella S. Método Pilates manual teórico-práctico. La Plata: Ediciones Al Margen; 2011.
Oktaviani, I. (2018). Pilates workouts can reduce pain in pregnant women. Complementary therapies in clinical practice, 31, 349-351.
Garriguet J, Ruiz J, Lacal JF, Gomáriz MJ, Rodríguez MI, Castellano D, et al. Analgesia epidural y resultados obstétricos. ClinInvest Ginecol Obstet. 2007; 34.
Borreguero M. La actividad física durante el embarazo y su influencia en el proceso de parto y en la recuperación posparto. REDUCA (Enfermería, Fisioterapia y Podología). 2012;4.
Currie S, Sinclair M, Murphy MH, Madden E, Dunwoody L, Liddle D. Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions. PLoSONE. 2013;8:e66385.
Pearce EE, Evenson KR, Downs DS, Steckler A. Strategies to promote physical activity during pregnancy. Am J Lifestyle Med. 2013;7:38—50.
Mata F, Chulvi I, Roig J, Heredia JR, Isidro F, Benítez Sillero JD, et al. Prescripción del ejercicio físico durante el embarazo. RAMD. 2010;3:68—79.
Gomes, C. S., Pedriali, F. R., Urbano, M. R., Moreira, E. H., Averbeck, M. A., & Almeida, S. H. M. (2018). The effects of Pilates method on pelvic floor muscle strength in patients with post‐prostatectomy urinary incontinence: A randomized clinical trial. Neurourology and urodynamics, 37(1), 346-353.
Torres-Luque G, Torres-Luque L, García Chacón S, Villaverde Gutiérrez C. Seguimiento de un programa de actividad física en el medio acuático para mujeres embarazadas. Kronos. Actividad física y salud. Madrid (Villaviciosa de Odón); 2012.
Márquez JJ, García V, Ardila R. Ejercicio y prevención de obesidad y diabetes mellitus gestacional. Rev Chil Obstet Ginecol. 2012;77:401—6.

All Fit Fitness Sdn. Bhd.
Trading As
Body in Common

Get in Touch

Bangsar: 0173255699

Kota Damansara: 01117702502

The post How can Clinical Pilates Help with Prenatal Preparation? first appeared on Body in Common.

Clinical Pilates for Arthritis Management

mail@bodyincommon.com — Thu, 09 Apr 2020 06:51:38 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

Clinical Pilates for Arthritis Management

"Living with Arthritis is a difficult part of life and affects both young and old people. For most cases, 'Motion is Lotion', and professionally designed Clinical Pilates can help by providing low-impact, and meaningful workouts aimed at Arthritis Management."

Arthritis Management using Clinical Pilates

Do you feel pain and stiffness in your body?

Do you have trouble moving around in your house?

Living with arthritis is horrible, which is why it’s so important to do everything you can do to improve your situation.

Arthritis literally means ‘joint inflammation’, coming from the Greek words “arthron” (joint) and “itis” (inflammation). This inflammation can cause pain and stiffness in the joints, making simple movements such as climbing stairs or buttoning your shirt, a very painful experience.

Although joint inflammation is more of a symptom rather than a diagnosis, the term arthritis is largely used for describing any kind of joint disorders.

So What is Arthritis?

In reality, arthritis is not a single disease but an informal way of describing a joint disease. It encompasses more than 100 different types of arthritis (1) and related conditions such as rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, gout, scleroderma, fibromyalgia, lupus, juvenile arthritis, and many more.

Simply put: Arthritis isn’t just for old people: it’s a condition that affects people of all ages and backgrounds.

Common symptoms include pain, swelling, stiffness and decrease in the range of motion. These symptoms may come and go or may progress and even get worse over time.

Arthritis is the leading cause of disability among the adult population in the US (2), which has resulted in more than 17% of hospitalization in 2011 (3). Arthritis affects more than one in four adults (4) with influencing people of all ages, races and gender.

As people don’t seek help until their symptoms become severe, it is difficult to estimate the true number of individuals living with arthritis. Estimates including only doctor-diagnosed arthritis, indicate that more than 54 million adults and around 300,000 children suffer from arthritis or some kind of rheumatic diseases.

I Think I Have Arthritis. Where do I Start?

The most important thing in arthritis is to get an accurate diagnosis of your joint pain. As you can imagine, with so many different joint conditions, it’s easy to make the wrong assumptions and think that nothing can be done!

Step 1 is to talk to your primary healthcare provider, get the right diagnosis, and then you know you’ll be getting the right solutions.

Maintaining a healthy weight and regular physical activity are two golden rules for successful arthritis management. Moreover, there are several things that can be done to preserve mobility, joint function and quality of life. Clinical Pilates is one such effective modality, that has been proven effective at reducing your reliance on drugs or surgery.

What is Clinical Pilates?

Clinical Pilates is highly recommended in arthritis management, as it is an ideal exercise which has a lower impact on your already painful joints.

This low impact exercise is named after the system’s creator: Joseph Pilates. The original Pilates system was developed before and after World War 2, working with bed-ridden patients, and incorporated its fair share of real science and also plenty of guesswork (like most systems of the time).

Having now existed for more than 70 years, there are now two very distinct types of Pilates: fitness Pilates, and Clinical Pilates. The Clinical system is unique in that it’s run by fully-trained Physiotherapists, who through Scientific studies, have removed a lot of that early guesswork, building up a reliable system that gets great results. What we have today is a great system with solid science behind it (as you will see from the references littered throughout our articles!).

Clinical Pilates focuses on core stability. It keeps your spine healthy and helps your body stay balanced. Most importantly, it’s extremely low-impact on the joints, with hundreds of targeted exercises to achieve very personalised outcomes.

This means that Clinical Pilates is great for arthritis patients who normally shy away from exercises, as they believe they can’t do them without making their pain worse. It’s gentle on the cartilage, ligaments, and other parts of your joints, while still maintaining a good result.

Is Clinical Pilates Good in Arthritis Management?

When it comes to arthritis, giving up and not moving is simply not an option. We have to live our lives to the fullest from the beginning to the very end. You can’t be on pain drugs for decades, and surgery has a very low success rate, and is usually a temporary fix. That leaves careful exercise, weight loss, and functional movement as the keys to successful arthritis management in the long-term.

One of my favourite Physio sayings is ‘Motion is Lotion”. It perfectly sums up what Clinical Pilates offers to arthritis sufferers. Simply put, you have to move a joint to stimulate blood flow, assist waste removal, and facilitate normal function.

But when it comes to arthritis, a “one size fits all approach” is not viable. Exercises need to gently move the joints, keep your supporting muscles strong, and keep your weight low to reduce stress on the joints. Here’s where Clinical Pilates’ tailored option comes in. With infinitely modifiable positions and resistances, each client gets a fully personalised programme that is suited to their needs.

1 - Clinical Pilates helps you strengthen your core

Arthritis patients often have weak core muscles due to muscle inactivity, degenerative spine changes and maybe, chronic pain.

Through a series of targeted movements, Clinical Pilates strengthens your core by training you to pull your abs in and up in alignment (5).

As you strengthen your core, your posture is improved which eases the pressure on your joints, especially your spine and hips.

2 - Increases strength and decreases associated pain

Clinical Pilates helps you increase strength levels by working on your lower body, abdominal and dorsal muscles (6).

By strengthening the muscle groups around a specific joint, you decrease the pain and risk of damaging the joint further (7). For example, if you have strong quads, you decrease the amount of pain in your knees, especially if the pain is because of inflammation under your knee caps.

3 - Improves your functional movement

Clinical Pilates focuses on proper arm, shoulder and neck movements. With a gain in strength and flexibility, you will be better equipped to handle pain episodes and in due course, you can decrease the risk of loss in mobility.

Every time you feel pain in your joints, you may not move that joint as much afterwards, to compensate for the resulting pain.

Clinical Pilates gently exercises the surrounding muscles and help you regain alignment, so that muscles function properly and you get back your whole range of motion.

4 - Enhances your awareness of body movements and decreases the fear of pain due to movement

As joints start to get more painful, most people start to ‘compensate’, by shifting their body weight and favouring joints that are less painful. Unfortunately, doing this causes a lot of trouble over time.

By working on your visual, vestibular and proprioceptive systems, Clinical Pilates helps you gain back the position and awareness of body movements (8), and most importantly, maintains proper body movement, protecting the joints that aren’t suffering pain as well.

As individuals with arthritis always experience some kind of pain, there are high chances of developing kinesiophobia, that is fear of pain due to movement.

By increasing the strength and endurance and improving your flexibility and balance parameters, Clinical Pilates also decreases the fear of pain due to movement (9,10) and helps you lead a pain-free life.

5 - Has a positive physical and also a positive social impact

We truly understand how any kind of relief is welcoming for people with arthritis. Clinical Pilates has demonstrated efficacy in reducing joint pain intensity and disability in arthritis patients (11).

By increasing strength in the supporting muscles and decreasing the number of pain episodes, Clinical Pilates can help to build new confidence, and get you back out there, living life. The smiles on our clients faces are a testament to the success of the system.

Our top 3 Clinical Pilates exercises for managing arthritis

In arthritis management, we focus on strengthening the muscles that cover and support your joints. By working on these muscle groups, you stabilize the joints and eventually reduce the pain associated with arthritis.

1 - Shoulder Bridge

Shoulder Bridge is a classic Pilates exercise. With our sedentary lifestyle, we tend to stress our body structures more, and with time we lose its functional capability.

Arthritis people with weakness in the spine, hips and knees can perform this movement to strengthen and improve its mobility.

Exercise:

Lie down in a neutral position. With your knees bent, start tilting your pelvis. This will help you close the gap between the mat and your lumbar spine.

Now lift your back, vertebrae by vertebrae until a diagonal line is created, all the way from your knees to the shoulder. Make sure the knees are parallel and are not wandering or shaky.

Hold this position for 5 seconds and then lower your spine vertebrae by vertebrae, slowly on to the mat again. Repeat this exercise for 10 to 15 repetitions.

Why:

Shoulder Bridge is an excellent workout to strengthen and stabilize your whole body. It strengthens the spine, glutes and hamstrings.

Moreover, it also vitalizes your hips and knees and promotes better body awareness, helping you stay relaxed.

2 - The Saw

The saw is another amazing exercise for improving spinal mobility. Over time, pain can make you resist several body movements involving your spine. This may affect its mobility and if left unchecked, may cause your spine to become rigid.

In this exercise, we train your abdominals, especially the obliques and help you stretch your spine. As we do the twist and flex action, a lot of stabilizing back muscles are activated while doing the consistent reach of arm motion.

Exercise:

Sit, and depending on your flexibility, keep the feet flexed. Make sure you’re sitting tall with your bones feeling evenly grounded. Outstretch your arms sideways, at a slight angle forward.

Now twist your spine to the left, starting with your centre and allowing your arms to follow along with your torso.

With activating your core, reach your right hand outside of your left foot. Also, rotate your head as if you are looking towards your back shoulder.

Return back to the start position and perform the same exercise with your left hand reaching out to your right foot.

Once you master the technique, try to perform this exercise at a more dynamic pace.

Why:

This is an excellent exercise for improving your spinal mobility. It further helps in stretching your back muscles and hamstrings.

3 - Wall sit

Wall sit exercise is generally done for improving knee stability. Although a very simple exercise, many people often get it wrong. You know you’re performing the exercise properly if you form a right angle at your knees with your heels on the ground and back flat against the wall.

Exercise:

Begin with your back against the wall and feet shoulder-width apart, keeping them about two feet from the wall.

Now in a sliding movement, engage your core muscles and slide your back down the wall until your thighs are parallel to the floor.

Make sure your knees are directly above your ankles and your back against the wall. Hold this position for 20-60 seconds and then slide back to the starting position.

Take a minute break and perform the exercise 3-5 times. Challenge yourself by increasing your hold time as you increase your strength.

Why:

Wall sit is an excellent exercise for building isometric strength and endurance in the glutes, quadriceps and calves. It also enhances knee stability.

Getting started with Pilates

Clinical Pilates is an amazing joint-friendly mind-body workout, which helps ease pressure on the joints. As with any exercise program, make sure you are doing it with proper form and technique.

The movements are so subtle that you won’t even realise if you are not performing the exercise correctly. Therefore, when you’re first starting out with Clinical Pilates, it is better to invest in a private session, as a single one on one session will help you get the most out of your subsequent group sessions.

So do get in touch to live a surgery-free and pain-free life.

See What Clinical Pilates is Like on our Youtube Channel

Backed by Evidence. References.

Centers for Disease Control and Prevention (CDC). Arthritis in General. Updated June 1, 2016.
Barbour KE, et al. Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation — United States, 2010–2012. MMWR. 2013;62(44): 869-873.
The Burden of Musculoskeletal Diseases in the United States (BMUS). Prevalence Societal, and Economic Cost, Third Edition. 2014.
Barbour KE, et al. Vial Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation – United States 2013-2015. MMWR 2017;66(9); 246-253.
Cruz-Díaz, D., Bergamin, M., Gobbo, S., Martínez-Amat, A., & Hita-Contreras, F. (2017). Comparative effects of 12 weeks of equipment based and mat Pilates in patients with Chronic Low Back Pain on pain, function and transversus abdominis activation. A randomized controlled trial. Complementary therapies in medicine, 33, 72-77.
LC De Oliveira, RG De Oliveira, DAA Pires Oliveira (2015) Effects of Pilates on muscle strength, postural balance and quality of life of older adults: A randomized, controlled, Clinical trial. J Phys Ther Sci 27(3): 871-876.
KHALILI, M., GOLPAYEGANI, M., & SHAHRJERDI, S. (2014). The effect of eight weeks Pilates training on pain and quality of life in men with Rheumatoid arthritis.
Kisacik, P., Oksuz, S., Arın, G., Akdogan, A., Dogan, O., Karabulut, E., & Unal, E. (2016). FRI0637-HPR The Effects of Clinical Pilates Exercises on Kinestesia and Position Sense in Patients with Osteoarthritis of The Knee.
Oksuz, S., Ünal, E., Dizmek, P., & Ozcan, D. A. (2014). AB1175-HPR The Effects of Clinical Pilates Exercises on Kinesophobia in Women with Osteoporosis. Annals of the Rheumatic Diseases, 73(Suppl 2), 1225-1226.
Oksuz, S., & Unal, E. (2017). The effect of the Clinical Pilates exercises on kinesiophobia and other symptoms related to osteoporosis: Randomised controlled trial. Complementary therapies in Clinical practice, 26, 68-72.
Mendonça, T. M., Terreri, M. T., Silva, C. H., Neto, M. B., Pinto, R. M., Natour, J., & Len, C. A. (2013). Effects of Pilates exercises on health-related quality of life in individuals with juvenile idiopathic arthritis. Archives of physical medicine and rehabilitation, 94(11), 2093-2102.

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The post Clinical Pilates for Arthritis Management first appeared on Body in Common.

How can Clinical Pilates Reduce Falls in Old Age?

mail@bodyincommon.com — Thu, 09 Apr 2020 06:32:50 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

How can Clinical Pilates Reduce Falls in Old Age?

"Clinical Pilates and Physiotherapy isn't just about injuries. One of the most important things we can do is keep the body running as we get older."

Reducing Falls for the Elderly

“How do I keep my father from falling?”

“I’m worried about leaving my Grandmother alone with the stairs”

“I don’t want to use a walker. I want to go shopping by myself.”

These are thoughts that we’ll all have at some point in our lives. After all, falls are dangerous, and when older adults are involved, it can be the final push that stops them from doing what they love.

The Centre for Disease Control and Prevention reports that falls are a leading cause of injury and death in individuals 65 years of age and older. (1) As medicine gets better, we’re living longer, but our joints and muscles still wear out at the same pace! We need to start looking after ourselves!

This is backed up by our experience in the Physiotherapy world, which has shown that people who reduce their fall risk live longer, more independent, and happier lives. Conversely, when someone over 60 does break a bone, it can take months or even years to fully recover back to their previous quality of life. This means that it’s extremely important to reduce falls for the elderly before they happen.

Sorry: No amount of injections, massages, surgeries, or other ‘quick fixes’ are going to change this reality.

Although it’s impossible to completely avoid all falls for older people, we can take preventive measures to vastly improve their injury tolerance, balance, and responsiveness to make a big difference to Quality of Life.

International-Quality Physiotherapists teaching Clinical Pilates is the answer to your problem. It’s not a quick fix – it’s the one that works.

The Magnitude of such Deadly Falls - and My Own Personal Experience!

At 65, you're not elderly, but falls still hurt a lot!

According to the World Health Organization, it is estimated that approximately 28-35% of individuals aged 65 and above have a significant fall each year. As age increases, there is an increase in the fall rates, rising to 32-42% for people over 70 years. (3)

Imagine having a 30% chance of a significant fall every year!

It’s hard to believe it until it happens in your own family. At 65, my mother was strong, fit,and exercising every day. You could hardly call her elderly at all. Despite that, one unlucky staircase later, and she had to spend several months in a cast, followed up by 1 year of rehab physiotherapy – something that a younger person would have recovered from in a much shorter time.

It can happen to any of us, and we were lucky that her excellent fitness regimen before the fall meant that she was able to make a full recovery with Clinical Pilates after it happened. Needless to say, this personal experience made us all that much more focused on the issue!

What Factors Cause Older People to Fall?

Falls in older adults are multifactorial. This means that it’s not just one reason causing the issue, but many small factors adding up to a big difference. It’s not just weak knees, or bad balance – it’s many things, and this is why many other fitness programmes, surgerys, and injections fail – they only address one factor, and leave all of the other factors in place.

Weakness
Ageing balance system
Lack of flexibility
Lower Bone Density
Poorer eyesight and situational awareness
Slow reaction time.
Pain
Poor walking technique (Gait)
Many Others…

Everyone’s body is unique, and so everyone needs to be working on a slightly different programme to maximise their quality of life. We need to address every factor that we can, and we need to address them in harmony. Think: “Flexibility without Strength is just as dangerous as Strength without Flexibility.”

Here are some of the most common issues that we need to address with Clinical Pilates before a fall ever happens:

The first line of defense: Building strong primary leg muscles to support the knee and ankle joints. This makes us safer when we do hit a bad stair or bump in the road.
The second line of defense: Retraining the vestibular system (balance system) to keep it responsive and accurate. When we’re toddlers, we first have to learn to balance on two legs. It’s a skill that we had to learn and calibrate before we could walk. As we get older, our balance mechanisms start to deteriorate (the inner ear gets more viscous), and we need to recalibrate and train it to get it back to peak responsiveness.
The third line of defense: building a better range of motion (think ‘strong flexibility’ as opposed to ‘uncontrolled flexibility’). This better range of motion makes us more responsive if a slip or trip does happen.
The last line of defense: a stronger core, arms, and wrists so that if we do fall, we can absorb the impact and protect our vulnerable joints and bones.

And of course, reducing falls for the elderly is all about building confidence and acceptance in our society. It’s never embarrassing to work towards a fit, older self.

How does Clinical Pilates Specifically Help Reduce Fall Incidents in Older People?

Several experimental studies (4,5), analyses (6) and systematic review studies (7-9) have demonstrated the benefits of Clinical Pilates for falls prevention.

Clinical Pilates focuses on controlled and conscious movements to improve overall flexibility, muscle tone, fitness, posture and balance. These movements are based on 6 core principles: precision, breathing, concentration, control, centralization and fluidity.

Most importantly, Clinical Pilates is tailored to each person so they work on exactly what their body needs. This is the key in the system’s success.

We do Clinical Pilates using small equipment such as a mat, rollers, elastics and balls. We also use large Studio equipment such as the Cadillac (aka Trapeze Table), Reformer, Ladder Barrel, and Wunda Chair. This lets us do highly targeted exercises that you can’t do with other forms of fitness and physiotherapy.

1 - Clinical Pilates Increases the Level of Muscle Strength

Clinical pilates increases the strength of your lower limbs, abdominal and dorsal muscles (your back muscles). (10)

With aging, there is a corresponding decline in muscle mass and strength. Sarcopenia is a natural syndrome which is characterized by progressive loss of skeletal muscle mass. This natural loss of muscle mass occurs in the older population which further increases the probability of fall incidents.

Clinical pilates can help to fix these issues by building muscle mass and strength, without the risk of damaging joints (a common risk in yoga, jogging, cycling, or weight lifting). Using apparatus such as the Reformer, Trapeze Table and Combo chair, we challenge and strengthen your lower limbs, trunk flexors and extensors (your abs and core), eventually increasing your level of muscle strength.

This makes for a stronger body that is more resilient to falls, slips, and unexpected forces. It’s our first line of defense as we age.

2 - Clinical Pilates Increases your Level of Flexibility

We often associate flexibility workouts with warm-up and cool-down exercises. But when it comes to quality of life, we forget that flexibility is one of the important elements of our health. Clinical pilates stretches your whole body and helps you increase your level of flexibility in a safe and balanced way (remember: building flexibility without control just makes you weaker!). (11)

Clinical pilates utilizes dynamic stretches to safely increase your range of motion. A better range of motion, when combined with more muscle strength, helps you to react more quickly to slips and falls.

3 - Regulates Your Balance System

Loss of balance is one of the most common reasons for falls in elderly people. This is because as we age, the fluid in our inner ear starts to get more viscous, our eyesight gets worse, and our hearing is not as sharp. These elements all make up important parts of our vestibular system, and as they degrade, we become less-responsive to fast changes in balance.

If we just let ourselves degrade slowly over time, we will eventually have worse overall balance. But the good news is that just as you learned balance as a toddler, you can re-learn it as an adult and improve your responsiveness.

Using clinical pilates we stimulate both the static and dynamic balance systems, by working on your visual, vestibular and proprioceptive processes. (12,13) This is all about create new challenges for your balance system in a controlled environment, improving your response speed, and helping your brain to recalibrate with your inner ear and eyes.

The second part is rebuilding your static balance power. Your body’s balance largely depends on the deep muscles of the trunk i.e. the core muscles. The more activated the core muscles, the better an older adult can maintain his or her balance. Clinical pilates helps in activating the deep core muscles using conscious and controlled body movements.

4 - Clinical Pilates improves your Gait and Sway

Gait and balance dysfunction are prominent risk factors for falls in the older population. It is estimated that 20-40% of people aged over 65 are affected by gait disorders, with the stat increasing to 40-50% in adults over 85 years of age. (14) To put this in simple terms, as we age, we stop walking efficiently, and start to put unnecessary stress and wear on our joints!

Impaired gait is highly associated with an increase in stride or step variability, which is a hallmark predictor of falling. If we can walk more efficiently, we are less likely to slip or trip on an uneven surface.

Clinical Pilates helps in reducing falls for the elderly by improving balance and gait, where other modes of fitness fail to provide results. We do this through targeted exercises with a single, clear goal – improving your walking efficiency. Imagine going back to school to learn to walk! (Don’t worry, it’s not embarrassing – it’s surprisingly fun).

For example, Tandem walking, a simple but effective clinical pilates exercise can be used to improve gait parameters in older adults by working on stride-length and balance in a safe and effective environment. We also improve the strength of your gluteus medius muscles (the forgotten ‘side of your bum’ muscle), which can help to reduce hip sway.

5 - Reduces the Fear of Falls - Improving your Quality of Life!

At the end of the day, we’re specialist physios because we want you to get out there and live your life to the fullest. We get great joy out of seeing people leave our studio with a renewed sense of physical purpose, and more spring in their step.

Fear of falling is almost as bad as the fall itself. If you’re living in fear, you’re not doing all of the great things that you love to do. And if you’re not doing the things you love to do, your body gets weaker and increases your risk of falling.

As you can see above, Clinical pilates is an exceptional modality for improving specific strength and balance. It emphasizes the motor control of the pelvic floor and deep trunk muscles, i.e. the transversus abdominis and multifidus.

It is effective in bone formation in women with osteopenia (the first stage of weakening bones) (17-19), enhancing function and improving emotional and social well being (21-22) in the elderly population.

But most importantly, it improves confidence and gets you back out there enjoying your life, and that’s what really matters. (16)

3 Best Exercises for Reducing Falls in Older People

With so many proven benefits, we’re confident in reducing the number of falls in elderly individuals through Clinical Pilates exercises.

Nothing beats seeing a professional, and getting a safe, personalized, and targeted programme. But to get you started, here are three great ways to start improving your (or your parent’s) life.

1 - Shoulder Bridge

In older people, the stiffness in the spine increases with age, restricting free body movements. It seems like the whole upper body is rigid and not able to move freely. The shoulder bridge is the perfect exercise to keep the spine mobile, agile and ultimately young.

Exercise:

Lie down in a neutral position. With your knees bent, start tilting your pelvis. This will help you close the gap between the mat and your lumbar spine.

Now, lift your back, vertebrae by vertebrae until a diagonal line is created, all the way from your knees to the shoulder. Make sure the knees are parallel and are not wandering or shaky.

Hold this position for 5 seconds and then lower your spine vertebrae by vertebrae, slowly on to the mat again. Repeat this exercise for 10 to 15 repetitions.

Why:

Shoulder Bridge is an excellent exercise to individually work on your spine and increase its mobility. Moreover, by contracting your trunk muscles and lifting the pelvic floor, you also activate the core as well.

2 - Standing Side Kicks

As we age, we tend to lose muscle mass and strength. For balancing the body, it is important to maintain your lower body strength.

Your hips are the largest weight-bearing joints in your body. Therefore, they are also prone to a great amount of physical abuse. Standing side kicks are effective in regaining the lost strength of your lower body.

Exercise:

Before beginning with standing side kicks, properly warm your body for 5 to 10 minutes.

To begin with, stand on your feet, with feet hip-width apart. Place your hands on the hips and contract your glutes and abdominal muscles.

Now transfer your weight on your right leg and lift your left leg towards the side until you reach the edge of your flexibility. Hold this position for a count of two and slowly lower it back to the ground.

Do it for 15 repetitions before moving onto your right leg. If you are finding it difficult to balance on one leg, hold onto a chair or a wall for stability.

Why:

With standing sidekicks, you work on the muscles that support the hips, which includes the glutes, quadriceps, abductors, adductors, iliopsoas, and hamstrings.

By performing this exercise you keep these lower body muscles strong and healthy and provide additional stability to the hips.

3 - Tandem walking

Impaired gait patterns are highly associated with the risk of falls in the elderly population. Tandem walking is an excellent exercise to improve spatial coordination and leg strength in older people.

Exercise:

Stand up straight with your abdominal muscles contracted and your chin tucked in.

Now place your one foot in front of the other in such a way that the heel of the forward foot touches the toes of the rear foot.

In the same manner, move forward as if you are walking on a tightrope. Walk for about 10 feet. Repeat it five times with performing the exercise once or twice a day.

Make sure the flooring is firm without any obstructions.

Why:

Tandem walking is the best exercise for maintaining body balance that can be performed anywhere. It improves your coordination and also strengthens your core and lower body muscles.

Join us in the movement for reducing falls in old age

Clinical Pilates is an outstanding tool for reducing falls for the elderly. Start in your 40’s or 50’s if you can, but it’s never too late to get moving.

If you are suffering from any chronic health conditions, do consult your healthcare provider (and us) before beginning any exercise program.

An of course, do join us to learn the power of Clinical Pilates and we’ll show you the best exercises for your body.

See Some Examples on our Youtube Channel

Backed by Evidence. References.

Falls are leading cause of injury and death in older Americans. (2016, September 22). Retrieved from https://www.cdc.gov/media/releases/2016/p0922-older-adult-falls.html
United Nations (UN) (2004). World Population Prospects: The 2004 Revision. New York, USA.
Falls Prevention in Older Age. (2015, October 3). Retrieved from https://www.who.int/ageing/projects/falls_prevention_older_age/en/
L Donath, R Roth, C Hurlimann, L Zahner, O Faude (2016) Pilates vs. Balance Training in Healthy Community- Dwelling Seniors: A 3-arm, Randomized Controlled. Int J Sports Med 37(3): 202-210.
J Bertoli, GM Biduski, C De la Rocha Freitas (2017) Six weeks of Mat Pilates training are enough to improve functional capacity in elderly women. J Bodyw Mov Ther 21(4): 1003-1008.
GC Miyamoto, LOP Costa, CMN Cabral (2013) Efficacy of the Pilates method for pain and disability in patients with chronic nonspecific low back pain: A systematic review with meta-analysis. Braz J Phys Ther 17(6): 517-532.
WHO-World Health Organization (2007) Global Report on Falls Prevention in Older Age. Community Health (Bristol) 53.
IFO Barros, MB Pereira, TH Weiller, ETR Anversa (2015) Internações hospitalares por quedas em idosos brasileiros e os custos correspondentes no âmbito do Sistema Único de Saúde. Rev Kairós Gerontol 18(4): 63-80.
PB Engers, AJ Rombaldi, EG Portella, MC da Silva (2016) Efeitos da prática do método Pilates em idosos: Uma revisão sistemática. Rev Bras Reumatol 56(4): 352-365.
LC De Oliveira, RG De Oliveira, DAA Pires Oliveira (2015) Effects of Pilates on muscle strength, postural balance and quality of life of older adults: A randomized, controlled, clinical trial. J Phys Ther Sci 27(3): 871-876.
S De Azevedo, J Simas, Z Machado, V Jonck (2014) The effect of Pilates method on elderly flexibility. Fisioter em Mov 27(2): 181-188.
IPC Coriolano, VR Pérez, MM Nascimento, HJ Appell (2012) The Pilates Method to Improve Body Balance in the Elderly. Arch Exerc Heal Dis 3(3): 188-193.
MS Tomruk, MZ Uz, B Kara, E Idiman (2016) Effects of Pilates exercises on sensory interaction, postural control and fatigue in patients with multiple sclerosis. Mult Scler Relat Disord 7: 70-73.
RW Pata, K Lord, J Lamb (2014) The effect of Pilates based exercise on mobility, postural stability, and balance in order to decrease fall risk in older adults. J Bodyw Mov Ther 18(3): 361-367.
M.E. Tinetti, D. Richman, L. Powell, Falls efficacy as a measure of fear of falling,J. Gerontol. 45 (1990) 239–243.
D Cruz Díaz, A Martínez Amat, MJ Torre Cruz, RA Casuso, N Mendoza, et al. (2015) Effects of a six-week Pilates intervention on balance and fear of falling in women aged over 65 with chronic low-back pain: A randomized controlled trial. Maturitas 82(4): 371-376.
Betz, S., 2005. Modifying Pilates for clients with osteoporosis. IDEA Fit. J. 46e55.https://www.ideafit.com/fitness-library/modifying-pilates-for-clients-with-osteoporosis.
Kim, C.S., Kim, J.Y., Kim, H.J., 2014. The effects of a single bout pilates exercise onmRNA expression of bone metabolic cytokines in osteopenia women. J. Exerc.Nutr. Biochem. 18 (1), 69e78.
Sinaki, M., Mikkelsen, B.A., 1984. Postmenpausal spinal osteoporosis: flexion versus extension exercises. Arch. Phys. Med. Rehabil. 65 (10), 593e596.
de Siqueira Rodrigues, B.G., Cader, S.A., Torres, O.B., de Oliveira, E.M., Dantas, E.H., 2010. Pilates method in personal autonomy, static balance and quality of life ofelderly females. J. Bodyw. Mov. Ther. 14 (2), 195e202.
Mokhtari, M., Nezakatalhossaini, M., Esfarjani, F., 2013. The effect of 12-week Pilates exercises on depression and balance associated with falling in the elderly.Procediae Soc. Behav. Sci. 70, 1714e1723.
Roh, S.Y., 2016. The effect of 12-week Pilates exercises on wellness in the elderly. J. Exerc. Rehabil. 12 (2), 119e123.

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Common Causes of Back Pain

mail@bodyincommon.com — Tue, 07 Apr 2020 06:40:42 +0000

COVID 19 Update: Physiotherapy Open. Group Fitness Now Doing Online Live Classes

Common Causes of
Back Pain

Is Back Pain making it harder to get a good nights’ sleep?

Or maybe spending quality time with family is getting difficult?

Is Back Pain making it harder to get a good nights’ sleep?

Or maybe spending quality time with family is getting difficult?

Most people will experience back pain at some point in their life. What do you do when it comes calling?

See a Chiro?

Go for Massage?

Traditional Medicine?

… or just some painkillers?

Doctors are quick to tell their patients that there’s nothing to be done about back pain.

“Just take some pain killers, drink plenty of water, and live with it…”

That advice just isn’t good enough!

There are a multitude of short-term fixes for back pain. Unfortunately that’s all they are: short-term fixes. If you want life-long relief, you need to look further than the symptoms and find the underlying source of the pain.

This is where Australian-Certified APPI Clinical Pilates comes in. Drawing from a long scientific background, It is a methodology that keeps you mobile and happy long into your life.

Clinical Pilates is a set of exercises that focus on posture, balance, core stability, strength, and flexibility. It is suitable for Men and Women, and Pilates students range for 5 years old to 105 years old!

So what are some of the most common causes of back pain? How do we really treat it?

#1 Desk Jobs.
Sitting causing Lower Back Pain.

It should come as no surprise that the human body did not evolve to be very good at sitting in front a computer. Our DNA is built to run, jump, crawl, swim, and so much more. Unfortunately, when we sit at a desk all day, we start to weaken our underlying muscles structures.

Our transversus abdominus (a deep hidden abdominal group – not your six pack!)
Multifidus (spine supporters)
Gluteals (we’ve all heard of the big “Gluteus Maximus”, but there are also the medius and minimus)

When these muscles weaken, our spine starts to pull out of alignment. This is exacerbated when our big primary muscles start to overcompensate. What you end up with is focus sore spots – usually along the spine at either the lower or the upper portion.

When we fix these underlying weaknesses, (as well as train better sitting posture), the underlying cause can be removed.

#2 - Weight Gain Putting Stress on your Back

Heavily linked to #1 above, a lack of physical activity or an excess amount of weight can start the slow slope towards weakening your supporting muscles.

If you want to truly fix back pain for the long term, a few sessions a week of light exercise is a great way to get back on track.

If one or two of these sessions is Clinical Pilates exercises, then you’ll be back on track even sooner. If the cause is just general lack of physical activity, then after a few sessions, you might be well suited to try Group Fitness Pilates Instead.

#3 - Old Injuries Causing Compensating Back Pain.

If you’ve sustained injuries in the past, it’s quite possible that you never truly recovered. We’re not just talking about back injuries here: a knee injury, or even hand injury could equally start the body favoring one side, and start the slow spiral to muscle imbalance and weakness.

My Husband was a classic case of #3, having received several back injuries over his life: Everything looked normal to the untrained eye, but up-close he had a slight limp that caused spinal movement to come out of alignment, and he always favored a side for lifting heavy objects. The result: back pain every morning from lying in bed, and a reliance on daily paracetamol.

These cases are much more tricky to assess, as the signs are often much more subtle than someone who is obviously weakened or has poor posture. A properly trained physiotherapist has a number of tests that allow for assessment, and from there, it is a process of re-balancing muscle groups and removing tension on overactive muscles.

In time, most back pain clients in this category can receive significant relief and reduce their need for painkillers.

#4 - Poor Flexibility Leading to Lumbar Spine Pain.

Are you having trouble tying your shoes? Is picking up something from the floor a task to be dreaded? How about sitting on the floor with your legs straight?

A common cause of back pain can actually be found in the muscles just below – the Gluteals and Hamstrings (aka the ‘bum muscles’). If these muscles are particularly tight, your body can search for the extra flex somewhere else – in your lower back. As a result, instead of your Hamstrings and Gluteals elongating to allow for proper movement, your lower spine curves and goes under significant stress.

In time, this compensation becomes dependence, and the hamstrings no longer have the ability to do their original job without the lower back stepping in. This is particularly common among people who lift heavy weights and avoid flexibility classes. We call these people ‘Vikings’, and they are represented in our logo by the Gorilla.

Relief can often be found through a mix of:

Micro-fascial releases (deep tissue massage that focuses on breaking down the muscle’s outer sack to improve flexibility and mobility).
Dynamic Pilates Stretching
Strengthening of the supporting muscles (the small ones that gym weights do not address).

#5 - Post Natal Injury or Weakening of the Core.

Another very common cause of back pain (but only for women) is from post-natal stress of injury. Delivering a baby does significant damage to a woman’s body, including the separating of their abdominal muscles, groin and leg strains, and 9 months of muscle-relaxing hormones.

The result is that your back may often weaken significantly after delivering a baby, and does not always fully recover on its own (this is especially true for women who have diastasis – abdominal separation). Special care needs to be taken in these cases, as the wrong workout can exacerbate the problems.

Clinical Pilates has a special set of exercises for dealing with these particular issues, and target the ‘deep muscles’ that sit below the large primary movers (such as the ‘six pack’). Most patients find Clinical Pilates to be particularly successful in the long term.

#6 - All of the Above!

You are unique, and your circumstances are most likely a combination of the above, and maybe the myriad of other possibilities that we don’t have the space to write about.

As Australian-trained Physiotherapists and Clinical Pilates Specialists, we are your trusted professional for assessing, planning, and achieving your personal goals. Please: don’t just read about it, come in and see us in Bangsar.

Natalie Tan – Body in Common

Bachelor of Physiotherapy – University of Melbourne

APPI-Certified Pilates Instructor – Matwork

APPI-Certified Pilates Instructor – Machine

Dry-Needling Training

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