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Thinking about trying a Pilates based class or one to one session?  The Studio Norfolk offers a mix of techniques picking the most effective pilates exercises, combining them with bio mechanic muscle spasm releases and classic back pain exercises.  This gives a class which will increase mobility through the joints, strengthen the back and core muscles, improve balance and help you be ‘functionally fitter’. For more information do get in touch

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Osteoporosis – A simple guide

Osteoporosis: a simplified explanation

What is it?
Osteoporosis is a weakening of bones which can lead to an increased risk of fracture

Who is at risk?
You are at risk if you: are menopausal, have a family history, have broken a bone, are of slim build, if you endurance train, do not eat properly, smoke, are a heavy drinker, are underweight, are inactive.

Signs to look out for
Osteoporosis itself has no symptoms but a fall is more likely to result in a fracture.
As it progresses you will lose height, and develop a hunch as your thoracic spine curves.

What can you do about it?
Undertake specific exercise to strengthen muscle and improve bone strength
Practice falls prevention, train in balance
Make your diet healthy with moderate alcohol intake
Do not smoke.


Current guidelines for test results for the T score:
Normal: -1 to 1
Starting to weaken (normal for age): -1 to -2.5
Osteoporosis: below -2.5

Prescriptive Exercise

EXERCISE CORRECTLY Have you been to a physio recently? Or  have you seen an Osteopath? Do you have exercises to do at home? Are you doing them correctly and gaining maximum benefit?

Most people do not exercise correctly and so not get the full benefit I recently received some training from an experienced osteopath.  He suggested that many people given exercises by physios or osteopaths, don’t do them correctly.  They don’t exercise often enough or for long enough, and they use poor technique.  This results in a longer period of pain, more visits to specialists and often no answer at the end of it. The most effective way to exercise a specific muscle is with supervision by a professional who understands your condition and the exercise required to improve it.  Anne at the Studio is one of these professionals. This is where one to one sessions are ideal, allowing you the time with this specialist to talk through and practise the exercises you need to do on a daily or weekly basis.

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

Back Pain90% of back pain is described as ‘non specific’ as there is no specific cause and no medical treatment can be offered other than pain relief.   Exercise can help manage and considerably reduce levels of pain.

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

8 Reasons Why you should cut down on sugar

SUGAR – Why you should avoid it
This week sugar and the negative effect it has on our bodies has featured in several news articles so here are the facts that you need to bear in mind when reviewing your sugar intake:
Firstly, in really simple terms: Sugar can play havoc with your weight, hormones, energy, and give you tooth decay. Eating sugar offers you ’empty’ calories – i.e. no benefit and lots of potential for harm. Therefore you should be looking to reduce your sugar intake.
When you shop, look at the labels of everything you buy. Sugar can be found in a surprising array of foods. Be especially careful when buying breakfast cereal and processed food such as ready prepared meals, including soups or cooking sauces since these often contain unexpectedly high levels of sugar.

Run through the list of negative effects below to remind yourself of why you should be avoiding sugar:
1. Consuming sugar makes your blood sugar levels rise quickly. The pancreas is stimulated, it produces insulin to stabilise the blood sugar levels. Insulin is known to promote the storage of fat so more sugar = more insulin = more fat stored.
2. The high level of insulin production not only encourages the body to store fat, but is the main risk factor in diabetes.
3. H igh blood sugar levels damage artery walls, making it easier for cholesterol and fat to build up. This causes heart disease and high blood pressure.
4. A raised insulin level affects the immune system lowering resistance to disease.
5. Sugar puts stress on the kidneys and can interfere with absorption of some essential minerals. This can contribute to osteoporosis.
6. Sugar can cause free radical formation in the blood, this causes damage to each cell in your body. It speeds up the ageing process which you’ll see as wrinkles. Some studies have suggested that it also speeds the deterioration of brain cells and contributes to dementia.
7. Sugar can increase fermentation during the digestion process causing bloating.
8. Since insulin is a hormone it is an intrinsic part of the body’s hormonal balance. Abnormal variations in that balance are known to cause fatigue, depression, weight gain, fluid retention, and so on. 

For all these reasons cut down on sugar and enjoy better health

Knee Pain Exercises

Knee Pain Exercises:

Many people suffer from knee pain.  Sometimes it can be directly attributed to an injury maybe many years ago, sometimes it may be as a result of arthritis but some knee pain simply appears for no apparent reason.

There are many recommended exercises to strengthen the muscles which support the knees but I have found that many of these actually put stress onto the knee joint and can cause further pain.  While in a fit young athlete it may be a case of working through the pain I would suggest that if you feel ‘bad pain’ (as opposed to muscle working ‘good pain’) then it’s time to find another way to strengthen the muscle.

My favoured exercises for knee pain are those which strengthen the muscles which support the knee.  The quadriceps muscle running down the front of the thigh and the gluteal muscles across your butt which keep your pelvis stable and in that way help with the tracking of the knee.

A bio mechanic check will highlight weakness in these areas.  If you are cycling, running or thinking about raising the intensity or frequency of your exercise programme it would be worth getting this checked out.  Knee pain caused by muscle imbalance will often only become apparent when you increase an aspect of your training programme. If you are taking part in active sport you are likely to find that a programme of squats, lunges, and specific gluteal exercises will really help.

If you feel that your knee pain could be caused by arthritis or general joint degeneration it is worth a visit to your GP for them to assess whether you would benefit from a referral for more investigation.  Frequently in my experience clients are told by their GP to take painkillers or anti-inflammatory drugs and given no other options.  In these cases I have found the exercises described below can be hugely beneficial.

The exercises are simple and effective and put no strain on the joint.  The basic concept is of working the muscles which are each side of your knee in order to keep it more stable.  Strengthening the muscle which engages when moving from bent to straight ensures that you use muscle rather than putting stress on the joint when performing any movement involving your legs.  Strengthening the gluteal muscles I will look at in another article as they are also implicated in low back pain.

Moving your leg from bent to straight is a great and simple exercise as are straight leg lifts.  There are many variations but I particularly like the way these video clips describe and demonstrate the exercises as they are closest to the way in which I choose to teach it myself. 

The ‘knee dance’ leg lift I have had great success with and this is demonstrated and explained really well on this video clip

The classic bent to straight leg lift with support and straight leg lifts are also great for ongoing knee strength and they are explained and demonstrated well on this video clip

The exercises on the video clips are almost identical to those I teach in my classes and are explained well with close up views so if you’ve done these in my class you may find it beneficial to watch them and check your technique to get the best result from future classes.  If you don’t come to class and have any questions do get in touch and I will be happy to help.

As an additional note I would add that these are exercises that I have had success with when working with clients suffering knee pain as well as rehabilitating from knee surgery.  They are not necessarily suited to everyone and I would advise you to seek advice from a medical professional before starting an exercise programme.  If you have problems with your knee locking or giving way you should certainly seek advice.

Myofascial Release Technique

Myofascial Release Technique:
In October 2013 I completed a Diploma in Myofascial Release Technique (MRT)
It’s a technique not offered by many therapists but which is gaining a reputation for giving the benefit of sport massage with a much more gentle approach. 

What is fascia?
Fascia is the connective tissue which holds together our muscles and which link the bone and muscular structures of our bodies.  Fascia connects the pelvis to the shoulder, and the sole of the foot to the hamstrings and so on… 
Could it help you?
Do you have very tight muscle which is difficult to loosen during sport or holistic massage.  Do you have areas of your body which feel ‘solid’, possibly across your lower back, shoulders or the outside of your leg (ITB)? Do you feel your body needs ‘clicking’ back into place? Do you have pain from tight muscles?
If these symptoms sound familiar then MFR would be worth a try.  By releasing the fascia the underlying muscles can the be treated much more easily.  If the fascia is pulling on bony structures such as the pelvis or shoulder girdle the releasing it can allow the muscles to settle back to their correct position.

What should I expect from a treatment?

The treatment will start with a consultation to assess your condition, level of pain or discomfort.  This will be followed by Biomechanic based muscle testing and depending on your condition range of movement and nerve mobility tests.  For some clients the Myofascial Release Technique is all that is required to ‘free up’ the body and allow easier movement.  For other clients once the fascia has been released we can move onto work on the underlying muscles.

The Myofascial release treatment commences with gentle pressure from the therapists hands on tight fascial areas.  This warms the area and it will begin to ease or give a little.  As this eases, the therapist’s hands will move to cover a bigger area.  The fascia becomes more mobile and the underlying muscle can function with more efficiency. The main areas I work on are the shoulders, both front and back, upper and lower back, legs and feet, and back up to the neck area.  If you prefer to be clothed during the treatment this is possible although the treatment needs to be on bare skin so do wear a vest top and loose skirt (for ladies) or shorts (for men). Oil is not used during Myofascial Release.

If I move on to work on the underlying muscles this will be with oil or massage lotion.  Working on deeper layers after Myofascial Release tends to gives an effective result on the muscle without the need for heavy pressure.  To a large degree this takes away the painful nature of sport massage enabling you to relax.  This in turn helps the dysfunctional muscles return to normality more easily.

Following a Myofascial Release and Sport Massage treatment I would repeat the tests we started with to check for change. I often prescribe home exercises and apply ‘Kinesio Tape’ to continue the treatment.

Feedback
I have had great results with this so far.  Clients have reported low back pain relief, reduction in hip pain, and significant relief from plantar fasciitis.
I am a great believer in trying new techniques and trying different approaches to get the
optimum result.  If you’ve tried it please do give me feedback so I can develop my techniques further.

Which class will suit you best – Pilates or Yoga?

Which class will suit you best, Yoga or Pilates?

There are many types of Yoga, from the relaxing Hatha to the dynamic Ashtanga so it is impossible to give a accurate comparison without attending each of the classes you are choosing between. For the purpose of this article I will, compare the basic principles which I follow in my classes of ‘I Move Freely Pilates’ and ‘Freestyle Fitness Yoga’.

It is important to look first at why you are considering taking up the exercise programme.  What do you hope to achieve from it? How would you describe your current physical condition and general health?

Getting back to exercise after a period of back pain?

Both Yoga and Pilates are often suggested to people with back pain and research has continually shows that both can help with it’s management. Exercise is often more effective than painkillers over a longer period and can help avoid the need for medical intervention. For most conditions, some activity is better than none so any exercise is likely to be beneficial.

If you have back pain the recommended exercises consist of gentle flexion and extension. This is best performed in an ‘unloaded’ position, usually lying on the floor initially to allow the muscles to flex and extend without the risk of spasm. So how is this movement treated in yoga and pilates classes?

Many yoga positions involve curling your spine, either from standing (as in rolling down towards your feet), from sitting rolling back to lie flat on the floor, or, from lying bringing your feet over your head. In all these positions there is some load or strain on the spine.

Although there are Pilates exercises which roll down I tend to leave these out of my classes as so many people find it aggravates theback pain.  I believe that it is possible to exercise the back avoiding unsupported spinal flexion.

When you recover from a period of back pain it is essential to train your core muscles to support your spine and pelvis. This can reduce the likelihood of a recurrence and prevent further damage. Pilates exercises focus on this area so they can be of enormous benefit to you.

Any exercise which is performed sitting on the floor will load the spine and this is aggravated by leaning forward. This is frequently seen in yoga but rarely in pilates. If you find it uncomfortable to sit on the floor with your feet out in front of you then Yoga is probably not for you.

Looking for an exercise class to keep you moving as you get older?

As the body ages it becomes increasingly important to keep it moving, encouraging joints to keep their range of movement, preventing stiffness and to recover from any surgery which you may have had on damaged joints.  The key to keeping good mobility in this instance is to encourage movement within the normal range.  Pilates is likely to include this in the warmup section of the class.  Yoga encourages a greater range of movement which may not be achieveable if you have joint damage caused by aging and could cause more pain.

Spinal twisting is an area where there is potential for spinal load which can lead to pain or damage. Several Yoga positions involve a twisted spine which for a healthy spine is unlikely to cause a problem. If your spine has any kind of degeneration trying to push yourself to achieve more movement can cause more damage. I am keen to encourage engagement of the supporting muscles to increase control through twisted positions. This is more likely to be achieved in a Pilates class where twisting is usually done on the floor and with abdominal engagement.

You are looking for increased flexibility?

If you are young, fit and healthy then Yoga is a great place to achieve greater flexibility.  Many yoga positions encourage increased range of movement through the joints as well as through muscle length.  Much of our flexibility is genetic but there is often room for improvement.  While Pilates will often include stretching it will be to maintain existing flexibility rather than with the aim of increasing flexibility.

Looking for increased strength?

Both Yoga and Pilates will improve strength although in different ways.  Pilates will work to increase abdominal strength to give the core area strength and stability.  It will also work to strengthen gluteus (butt) muscles which in conjuction with the abdominal work give great core stability.

Yoga will often assume that you have good core strength.  If you don’t have that core  strength then you may use incorrect muscles to perform the movements.   Yoga will improve upper body strength through positions which involve taking part of your body weight on your hands.  Lower body strength will be gained by standing positions and balances.

Looking for core strength?

For core strength I would recommend Pilates as the focus is so specific on the muscles which give you that strength.  While Yoga will give core strength you will get more benefit from a Yoga class if you already have some core strength. Yoga usually includes ‘the plank’ which is one of the most beneficial exercises using many core muscles as well as building strength. Perfect if you are already fairly fit but possibly to be aimed towards if you are a beginner.  In ‘I Move Freely’ Pilates we work towards the ‘plank’ lifts with graduated versions.

To conclude:

The benefits of yoga;

Strength, flexibility, core strength maintenance

Pilates:

Building of a strong core, back exercises and maintenance of joint mobility.

If you have any questions about this article do get in touch.

Remember that all classes vary so this is not intended as a comprehensive guide.

Kinesio Taping for Tendonitis

‘I have suffered from pain in my wrist and elbow for several years, probably as a result of many years playing club level badminton.  Recently my wrist hurt even more and specifically when I twisted my hand.  I didn’t know what I’d done to it but it felt different to the usual pain so asked Anne if she could help.  She suggested trying out Kinesio Tape.  I was sceptical but willing to try anything.  To my surprise, within a couple of days the pain had almost gone. I call it ‘magic tape’.

This client feedback was particularly interesting as it was a difficult case to treat.  As mentioned in his feedback this client had suffered from joint pain in his wrist elbow and shoulders previously.  The pre-existing pain was likely to be arthritis and a result of general ‘wear and tear’.  The wrist pain was accompanied by swelling and the pain was in a very specific location and occurred on specific movement.  This would indicate tendonitis which can be helped by Kinesio Taping.

Kinesio Tape can be used for a variety of injuries:

It can provide support for weak or injured muscles without affecting the normal range of motion. This works well for elbow and knee injuries.

It can activate muscles that have been weakened after injury, surgery or weakened by degenerative muscle wasting.

It can inhibit muscles that are tight, fatigued or overused, allowing them to relax and recover faster.  This is particularly successful for the lower back.

It can  correct postural imbalances.  I use this most successfully on the shoulder areas.

It can be used to create a negative pressure areas of inflammation, encouraging lymphatic drainage to relieve swelling and improve circulation to speed healing.  This can also help following surgery.

For this particular client I wanted to both provide stability to support the wrist, encourage the flexor muscles to relax and reduce the swelling. I used a technique of ‘I strip’ with 10% stretch over the joint area with a four fingered fan with no stretch, pictured below on the return visit 3 days later.

KTape wrist

The tape stayed on well and by on the return visit the client was pain free and I was pleased with this result.

Much of the success of Kinesio Taping is dependent on the accuracy of application.  It must be placed in exactly the correct place on the muscle requiring treatment, the tension must be accurate and the tape activated.  I have found that practise is crucial to getting the most consistent results and the more I use tape the better the results become.  While most of my experience has been with the lower back and shoulders this case showed that the same principle applied to another area also gives a successful result.

For more information on Kinesio Taping contact me or look at http://www.kinesiotaping.co.uk/

Post Mastectomy Exercise

‘Following a mastectomy for breast cancer I was given a series of post operative exercises to ensure I regained my arm and shoulder movement. The exerises were helpful but two of them I found particularly difficult to do. I was really struggling and becoming quite dispondent. I returned to my Pilates session two weeks after my operation and Anne came up with great alternative exercises. My arm and shoulder movement continues to improve and I have never looked back.’

I received this feedback from a client recently and it made me wonder how many other people are in a similar situation.
As a physical therapist I have an excellent knowledge of the muscular structure of the body and how it moves. My advice comes from experience I have gained working with clients, assessing what movement they need to regain and how best to achieve it. The results I have seen have been brilliant and I would like to share the most sucessful exercises with other readers. I am not a medical expert so If you are unsure about trying out new exercises do check with your specialist first.

WHY EXERCISE IS IMPORTANT
Exercises following breast surgery are essential for the following reasons:
Increasing your range of movement which will be reduced following surgery.
Reducing arm and shoulder stiffness which can lead to aches and pain as well as postural imbalance.
Reducing the risk of lymphoedema by encouraging the lymphatic system to work properly.

You will be given advice regarding starting your exercise programme following surgery and it is important to follow the guidelines you are given. This is likely to involve a small amount of exercise 3 or 4 times a day. Muscles will waste if they are not used, this will cause weakness and stiffness. Surgery often reduces the range of movement and the only way to regain this is stretching exercises.

MY RECOMMENDATIONS

Shoulder shrugs and lifts: Gently lift and lower each shoulder, circle each shoulder back feeling for maximum movement on each movement.

The Mouse: Lie on the floor on your side with the operated side uppermost. Put the top hand (elbow bent) on the floor in front of you, ‘creep’ the hand along the floor towards your head, and eventually past your head. Return to start position and repeat x 10. This can replace the ‘walking up the wall’ exercise.

The Shoulder stretch: Kneel on the floor with your hands on the floor in front of you. Move your weight forwards onto your hands and walk them away a few inches in front of you. Leaving your hands where they are gently ease your weight back to your knees, then move forward again. Repeat x 10.

The Hand Skate: From the same kneeling position put your hands as wide as you can. Gently move your weight from side to side. This will stretch the area also stretched by the ‘side-on to the wall walk’. Repeat x 10

FURTHER INFO
If you are planning to try out any of these exercises do get in touch with me if there are any parts you don’t understand, or if you sucessfully complete these exercises and would like progressions. Do check with your physio if you have continued stiffness or pain.

 UPDATE…

The client I worked with on the exercises in this article is now almost five months post op. She has continued with her weekly exercise sessions throughout chemotherapy treatment and although tired comments that the exercise has helped her to feel better.  With the exercise and a couple of sport massages she has achieved full range of movement from her arm and shoulder.  This is an amazing result and I am incredibly proud of her achievement.