Women’s Health and Insurance with UEX

During Pink October, or Breast Cancer Awareness month, we think about Women’s Health and how a specialist Women’s Health and Continence Physiotherapist can help with a wide range of conditions to bring more awareness to this sensitive but highly important field of health. Our health insurance partner, UEX, also shares if those physio sessions can be covered by a health insurance plan and how.

7 benefits of pre-natal Pilates

Pre-natal Pilates is a great exercise method that teaches a mother to deal with the physical changes through pregnancy, and get ready for childbirth. Here are the 7 ways of how pre-natal Pilates can benefit a mum-to be.

Have a RAD six pack? Not as cool as you may think!

Rectus abdominis diastasis (or otherwise known as abdominal separation) refers to the separation of the 6-pack muscles from the midline of the abdominal wall. This commonly happens during the later stages of pregnancy, and if left untreated may lead to post childbirth issues such as pelvic girdle instability, lower back and pelvic pain.

Is running bad for your knees?

Whether you are a seasoned marathon runner or a beginner jogger, time and time again you've probably heard this: RUNNING TOO MUCH IS BAD FOR YOUR KNEES.

As a Physiotherapist who runs frequently, I'd be a millionaire if I was given a dollar every time I was asked the question, “Will running damage my knees?" or being told, "You're a Physio, you should know that running damages your knees!"

The fastest woman in Singapore - the author holds the women's half marathon national record of 1hr 23min 14sec!

The fastest woman in Singapore - the author holds the women's half marathon national record of 1hr 23min 14sec!

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FACT: RUNNING IMPROVES YOUR JOINT HEALTH

A 2016 research done with more than 2500 Osteoarthritis Initiative participants shows that running has no correlation with knee damage. Another study also found that running decreases inflammatory markers correlated with knee pain and degeneration. The study discovered that the cyclical loading of the knee joint during running promotes healthy cartilage turnover in the knees. The bending and straightening of the knee, along with the loading and unloading of the knee during running, circulates the joint fluid and provides nourishment to the surrounding tissues.

(Disclaimer: Current studies on running and knee degeneration are limited to recreational runners with no existing knee issues. Research is inconclusive for runners with previous injury history. However, excessive long distance running can result in a situation where the knee is overwhelmed. When this happens, the knee joint is no longer able to counter the inflammation effectively, risking the potential for joint degeneration.)

So is it okay for you to run ten marathons one after another then? The answer is NO. If performed in the wrong manner, running can injure you, just like any other sport!


What are the 3 main causes for running injuries in Singapore?

1. LOADING ON AN IMBALANCED STRUCTURE

Running is a sport that involves symmetrical weight bearing. Ultimately our running speed is only as fast as our stronger leg can work. In my experience as a physiotherapist, identifying the areas of muscular strength and length imbalances appear to be the most straightforward way of pain reduction and injury prevention.

I can often get my patients to run without pain by simply identifying and tackling their weak and tight muscles. If the weaker leg begins to lag, the stronger leg starts to take on more responsibility in moving the body forward. Muscular strength imbalances put you at a risk of overworking the stronger leg. Otherwise, the weaker leg simply ends up working way beyond what it can manage. It is crucial to have symmetrical strength so that both your legs are working together to propel the body forwards.

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2. OVERLOADING

Overtraining – or overloading the capacity of your muscles is another common cause of running injuries. During a hard training session, your muscle fibres break down, and for that period, your body is temporarily weaker. At this stage, you must rest to allow your muscles to repair and heal, after which it is stronger.

A sudden increase in mileage or accumulation of high mileage without adequately resting can prevent the healing process of your muscles. Excessive loading can eventually exceed your muscles’ loading capacity. This is when injury occurs.
 

3. OVERLOADING ON AN IMBALANCED STRUCTURE

This is the most common cause of exercise related injuries in our modern-day society. Running is an efficient sport to raise our heart rates and burn calories, so it is no surprise that it is the go to exercise for the "weekend warriors". These people are generally inactive during the work week, and then come weekend, switch gears from zero to five and do a marathon-distance run.

These runners are essentially overloading onto an imbalanced muscular system – a result of accumulated sitting from Monday to Friday. Muscles can change its length tension if you stay in the same position over a period of time. Therefore, sitting for too long can lead to certain muscular imbalances such as tight hip flexors, weak glutes, weak abdominals, tight lower back muscles…just to name a few.

If you are a weekend warrior, you should consider incorporating a couple of short pre-habilitative exercises during the weekdays, to minimise the number of imbalances before you begin any heavy training regime on the weekends.


How can Physiotherapy help prevent overloading injuries?

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  • Ensure that your muscles have adequate loading capacity to take on your current training load.
  • Use different functional testing to make sure your muscles can tolerate and sustain loads relative to your training level.
  • By analysing your movement patterns – such as running hard on the treadmill, a Physio can gather clues as to whether your muscles have adequate capacity to load well at higher running speeds.
  • The Physio can then prescribe you with the right type of exercises to do to complement your training regime.

Remember not to bump up your running volume too fast and too soon. Happy running!


ABOUT THE AUTHOR

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Mok Ying Rong is a Physiotherapist at UFIT Clinic. With an intense passion in the musculoskeletal field, she utilises a holistic manual approach alongside an energetic desire to get people back to a pain-free status. Ying's niche is in analysing and treating issues related to the running biomechanics. 

Ying is also an avid sportswoman. She started off as a competitive swimmer before transiting towards triathlons, and finally establishing herself in the run scene. Her more memorable achievements include breaking the Singapore National Half-Marathon record in the 2016 Gyeongju Half Marathon, and representing the nation in the 2015 World Cross Country.

Ying's first hand sporting experiences allows her to relate better to people who are passionate about sports.

Age is just a number when it comes to fitness

Ever heard the expression: “Age is just a number.”?

When it comes to health and fitness, this expression is 100% true. A 40 or 50-year-old who trains regularly and looks after their nutrition will likely to be in a lot better shape than a 20-year-old living a sedate lifestyle and eating a diet of junk food and fizzy drinks. 

Don't let age define what you can, or cannot do.

Don't let age define what you can, or cannot do.

Take a look at the image below comparing the MRI scans of the quadriceps of 3 different individuals:

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The amazing thing is that these legs may even look quite similar on the outside, but notice the difference once we look into the scans!

As you can see, it is not the age that makes the difference, but the lifestyle. (Never let anyone tell you that you are too old to do something!) Those who maintain an active lifestyle and eat clean, nutritious food is more likely to be healthy, whereas those who are not as active will lose fitness and function more quickly as you age. Losing fitness and function is a huge issue for the elderly, as it will lead to a sharp decline in independence.

As we get older, the cells in our body don’t regenerate as fast or as well as they once did, which results in a longer recovery time. A hamstring strain in a teenager should heal faster than someone in their 40s (presuming they’ve done their rehab correctly). One reason for this physiologically is that elastin – the component that allows tissues to stretch – slows down in production considerably after 40.

As well as having less flexible tissues, lubricant in your joints (known as the synovial fluid) lessens, which reduces the shock-absorbing capacity, increasing the chances of developing Osteoarthritis. Unfortunately, there is no way of reversing the loss of synovial fluid production, it is simply part and parcel of the aging process.

One of the most common issues we see in the clinics is Knee Arthritis, and best way to treat this is to reduce the stress on your joints. This doesn’t mean sitting down all day. On the contrary, it means modifying the exercises you do, and correctly loading the joints by strengthening the surrounding muscles. By strengthening the muscles around your legs, they are capable of accepting a greater load, meaning that less force will go onto the knee.

The American College of Sports Medicine states that the population who benefit the most from exercise are post-menopausal women. Exercise helps to fight against Osteoporosis by reducing the breakdown of bone density, which many post-menopausal women tend to suffer from.

As with all things, prevention is better than cure. So it is essential that you maintain a strong foundation of fitness and health. Rather than playing catch up on your health trying to fight off the effects of an unhealthy lifestyle, it is better and easier to look after yourself throughout your life by maintaining a good level of fitness.

As a rule of thumb, the most important muscles to look after as you get older are your quadriceps at the front of your thighs. They are important to strengthen in order to reduce the risk of arthritic pain as you reach middle age, and for the elderly past their 60s - the strength to stand up and walk independently.

For the “weekend warriors” with desk-bound jobs (which applies to most readers), it is essential that you stretch and mobilise your back before every training. If you are not warming up properly prior to your workouts after sitting for prolonged periods, you will likely be too stiff and immobile, which can lead to compensations and injuries in the upper and lower back, hips, shoulders, and neck.

 

Here are some simple exercises you can do at home regularly to maintain your strength and mobility:

1. Foam rolling your upper and lower back.

1. Foam rolling your upper and lower back.

2. Leg-over rotations.

2. Leg-over rotations.

3. Open book upper back rotations with foam roller support.

3. Open book upper back rotations with foam roller support.

4. Wall squats - these can be done as holds in the bottom position.

4. Wall squats - these can be done as holds in the bottom position.

5. Straight leg raises (if wall squats are irritable on the knees).

5. Straight leg raises (if wall squats are irritable on the knees).

Aging (and the body aches and deterioration that comes with it) is a part of nature’s process that unfortunately cannot be reversed. However, staying fit and healthy is a choice that you can make. Keeping strong and mobile is the key to injury and illness prevention, allowing you to live your life to the fullest even as you get older!

For a customised and extensive assessment of your physical well-being and muscle health, book a consultation with a Physiotherapist.


About the Author

Kieran Sasiadek is a UK trained Physiotherapist with extensive clinical experience at UK’s NHS hospitals and clinics, as well as with professional football club Burnley FC. In Singapore, Kieran spent three years with Jurong Health Services working with the Intensive Care, General Medicine, Orthopaedics, and Sports Rehabilitation units. He also presented published research in that time. Subsequently, he was the Head of Physiotherapy at a private clinic before joining UFIT Clinic.

Kieran is an avid sportsman, active in rugby, touch rugby, soccer, Gaelic football, and basketball. His love of sports compliments his passion in treating sports injuries in amateur and professional athletes. His main ethos is to provide his clients with the independence to take control of their rehabilitation program, and enjoy the process of recovery.

How to arrive fresh and looking good after a long-haul flight

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Summer holidays are upon us! For many of us, that means it is the time of the year to visit friends and families across the globe, or jetting off on a plane to a well-deserved holiday destination.

As much as we love getting away, quite often a long flight can cause us aches and pains, and more than a little discomfort. The environment and conditions on the plane itself can cause some physiological changes in the body, and can get especially obvious on long-haul flights.

Below are some of the common symptoms you might experience, and some suggestions on what you can do to keep them at bay, and arrive at your holiday destination refreshed and ready to go!

 

WHAT HAPPENS TO YOUR BODY ON A LONG-HAUL FLIGHT?

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FOLLOW THESE TIPS FOR A COMFORTABLE JOURNEY

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Experiencing discomfort from muscle stiffness or swelling after a long flight? Get professional help from UFIT Clinic's team of massage therapists!


ABOUT THE AUTHOR

Dipti Mistry is a UK trained Sports Therapist and an APPI-trained Pilates Instructor. She specialises in sports injuries, from assessment to full rehabilitation while incorporating the Pilates principles into her programs. She believes in the importance of encouraging energy-efficient movement patterns and postural/body awareness which reduces the risk of further injuries.

Through Pilates she has developed a deeper understanding of chronic over-use problems and postural/muscular imbalances that are often related to lower back pain, shoulder, and neck issues. As well as clinical practice, she has also worked alongside professional and amateur teams in football, field hockey, rugby, tennis, and athletics in London and Singapore.

To stretch or not to stretch?

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Before a workout, that is.

Research done over recent years has been hard on some traditional sports practices, with some approaches that have been ingrained in sports for many years now coming under close scrutiny. One such approach is the use of a 'warm up' prior to sport. As therapists and trainers, we hear many gym-goers, runners, and sports players guiltily confess, “I never warm up!” but the question is, do they need to and why?

Warming up prior to physical performance is believed to facilitate mental and physical readiness, prevent injuries, and improve performance. Static stretching – once strictly adhered to has since been thought to impair performance and have no impact on injury prevention. As such, static stretching has been replaced with dynamic stretching. But is it wise to cease static stretching altogether?

The body of research behind stretching is contradictory and often confusing. Let us first explore the different types of stretching before we talk about how and when to stretch.
 

WHAT ARE THE DIFFERENT TYPES OF STRETCHING?  

Static stretching involves holding a position near the end range of comfort for a prolonged period of time, feeling a stretch sensation in the muscle.  For example, this is what a static hamstring stretch could look like:

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Dynamic stretching involves moving a limb and muscle from one end of its range to the other in a slow and controlled manner. For example, a dynamic stretch for hamstrings would involve swinging the leg forwards and backwards: 

Photo credit: Yuri Elkaim

Photo credit: Yuri Elkaim

PNF stretching (proprioceptive neuromuscular facilitation) incorporates static stretching and isometric muscle contractions to increase range of motion. For example – during a lying down hamstring stretch, a partner’s hand or shoulder is used to push against for a few seconds, to contract the hamstring muscle. The muscle is then relaxed and the stretch pushed to their new limit of range of motion. This is usually repeated 3-4 times:

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WHY DO WE STRETCH AS PART OF A WARM-UP?

There are four main proposed benefits to stretching prior to sport or exercise:

1. Improved performance

Despite the high number of studies done on this subject, it is still difficult to say whether stretching helps performance. Some evidence shows that static stretching can briefly inhibit a muscle’s ability to generate power – this generally occurs when the stretch is held for longer than 60 seconds immediately before performance. However, in studies where stretches were held for less than 20 seconds 10 minutes before performance, it has been found that static stretching had no impact on performance. Some studies show that dynamic stretching can slightly improve performance when done immediately prior to the exercise. The negative effects of stretching before sport such as reduced power and speed shown in some research realistically will not be noticed by most of us and is only of importance to elite athletes at the top of their game. It also very much depends on what the sport is. For something like gymnastics or martial arts, the importance of stretching beforehand is perhaps more significant than for sprinters or weightlifters where speed and power is key.

2. Increased flexibility

It has been established that PNF, static and dynamic stretching can improve range of motion over a short duration. Over time, stretching enhances flexibility not by actually lengthening the muscle but by increasing the brain and body’s tolerance to that stretch by calming down the nervous system. It is proposed that by using a few stretches, whether static or dynamic, as part of a warm-up may cause short-term neural adaptations thereby resulting in an improved stretch tolerance. Again, the usefulness of this outcome depends on what you are about to do – is it an activity that requires deep, end range positions and full range of movement?

3. Injury Prevention

It is often thought that stretching prior to exercise can reduce the likelihood of getting injured however the evidence for this is pretty weak and inconclusive. Some evidence suggests that static stretching has no overall effect on complex or overuse injuries but there may be a benefit in reducing acute muscle injuries, especially with repetitive contractions such as with sprinting.

4. Reduction of delayed onset muscle soreness (DOMS) 

DOMS is muscle soreness that occurs between 24 and 48 hours after exercise and it usually occurs when someone is new to a particular exercise or has not performed it at a certain intensity previously. The effect of DOMS is often worse when the exercise involves eccentric muscle contraction (when a muscle contracts while lengthening or during the lowering phase of an exercise). While there is certainly no harm in stretching before or after exercise in relation to DOMS, it appears that there is little benefit to it with most studies showing very little or no difference in DOMs when stretching or not stretching. Any benefits may be most relevant for athletes who participate in high intensity exercise daily, and therefore need to recover quickly.

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The evidence does not seem too strong in favour of stretching as part of a warm-up. What should we do instead to prepare for exercise?

Generally prior to going in to the ‘main body’ of your training session or sport the goal is to prepare the body by raising body temperature, heart rate, respiration rate and blood flow. This could be achieved through spending a few minutes on an exercise bike, doing a few ‘laps around the field’ or it could be achieved through sports-specific dynamic range of motion exercises that are relevant to the sport. Static stretching is likely to cool the body down and while being generally specific to a muscle it is not often specific to the requirements of your sport. So if you can achieve the flexibility requirements for your sport through dynamic stretching, why not trade in static stretches for higher intensity drills that are specific to your sport. For those who do use stretches regularly before a sport or activity, there may be positive psychological benefits of a familiar routine and positive expectations in which case it will not be harmful to continue.

With no ‘one size fits all’ approach to warming up prior to exercise and some fairly wishy-washy evidence behind it, the most sensible thing to do is whatever feels right for your body in order to prepare it for whatever it is about to do. We cannot generalise that either static or dynamic stretches are more effective prior to performance, but instead must analyse the requirements of the specific sport as well as the individual. Including mobility work into a warm-up is a sensible idea, moving the body in ways that will help it in the exercise you are about to do. For example, if you are about to work on your squats in the gym, use a dynamic hip opener to get the hip joints moving before adding load. If you are about to run then doing some dynamic leg swings will help the legs prepare for the motion of hip flexion and extension. It’s about waking up the nervous system too, as well as the joints and soft tissues. Neuromuscular activation exercises are useful to help recruit those important muscles that you’ll be using in your session. For example, runners are often advised to do some crab walks, gluteal bridges or some single leg stability work to get their gluteal muscles firing; this will then help with their running technique and efficiency.

Here is a brief summary of a general approach to a warm-up that is adaptable to different sports and training environments:

1. HEART RATE RAISER 
Get blood pumping, increase HR, blow flow and respiratory rate. Encourages physical and mental readiness.

2. DYNAMIC MOBILITY
Move joints and soft tissues to prepare for the movement/training you are about to do. Calm down nervous system to cope with ‘end range’ or deeper positions if needed.

3. ACTIVATION
Wake up muscles needed to enhance technique and improve performance in the sport.

4. SPORT SPECIFIC DRILLS
Full physical and mental readiness, high intensity for optimal preparation.

As such, follow the recommendations, apply them to your sport but most importantly, listen to your body do what feels right for you!


ABOUT THE AUTHOR

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Lucy Warren is a Physiotherapist and Pilates specialist from the UK. She has a first-class honours degree in Physiotherapy from Cardiff University, and is also an APPI-trained matwork instructor. Lucy has extensive sports experience with professional and semi-professional teams and athletes, having provided pitch-side physiotherapy for multiple elite sport teams in the UK. She has also worked for the British Army for two years, assessing and treating infantry soldiers and helping them to rehabilitate to peak fitness. 

Lucy taught matwork Pilates for several years before making the transition across to Reformer Pilates. Lucy loves using the Reformer and other Pilates equipment with her clients in order to achieve their specific rehabilitation goals. She believes that it is an incredibly versatile tool which can lead to daily life improvements like better posture and more efficient movement, as well as relief from pain associated with physical imbalances.

In her own time Lucy is a keen netballer, skier, and loves to travel to new places.

5 COMMON CYCLING INJURIES AND HOW TO PREVENT THEM

Whether you’re in the saddle to commute, training to compete, or just for fun, cycling is an excellent exercise as well as a fantastic way to get around.

Being an Osteopath as well as an amateur cyclist myself, I know that cycling injuries do occur and often re-occur. In my experience, injuries are usually caused by overuse or poor riding form. The resulting pain and physical limitations can be particularly debilitating for cyclists, impeding performance or preventing you from continue to cycle altogether. Luckily, most injuries can be resolved fairly quickly with some simple bike set-up tweaks, and some manual therapy such as Osteopathy for persistent pain.
 

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1. LOWER BACK PAIN

This is largely caused by the sustained flexed forward position in cycling which can put excessive pressure through the joints and discs of your low back.

Correction:

  • Raise your handlebars to reduce the amount of flexion going through your lower back.
  • Daily stretches and exercises to improve hip and lumbar flexibility - an Osteopath or other manual therapist can advise on the best stretches for you.


2. NECK PAIN AND HEADACHES

Neck pain and headaches can also be due to a flexed forward cycling posture. This in turn causes your neck to over-extend, especially when you are looking up and around. Long periods of neck extension can lead to muscle tightness, joint pain, and associated headaches.

Correction:

  • Raise your handlebars to decrease the extension curve in your neck.
  • Alter your cycling position so you are sitting in a more upright position for short periods.
  • Do regular neck flexion and side-bending stretches to ease neck and shoulder tension – consult an Osteopath or other manual therapist on the best stretches for you.
     

3. KNEE PAIN

Knee pain is commonly caused by your saddle being too low, or your cleats not in an optimal position. A saddle that is too low means that your knee and leg never straighten out fully. This leads to shortened hamstrings, sustained tension on the knee cap, and weakening of the muscle controlling the last 10 degrees of knee extension (known as the vastus medialis). All of these can lead to knee problems such as patella mal-tracking, patellar tendonitis, and overuse injuries.

Many road cyclists use cleats to connect their shoes to the pedals. Whilst cleats improve performance, they can also result in persistent knee pain if they are not optimally positioned.

Correction:

  • Raise your saddle.
  • Optimise cleat position.
  • Cycle in a lower gear to decrease the amount of stress through your knee on each pedal stroke.
  • Consider getting a professional bike-fit done.
     
An optimally placed cleat position can help to prevent many cycling related pain.

An optimally placed cleat position can help to prevent many cycling related pain.

4. HAND AND WRIST PAIN

Leaning forwards during cycling puts a lot of tension through forearms and hands, which can be exacerbated by gripping the handlebars too tightly and not varying your hands position. This can lead to repetitive strain injury (RSI) with pain and tightness in the wrists, forearms and elbows.

Some cyclists also experience tingling and numbness into their hands and fingers, most commonly on the pinkie and ring fingers. This is caused by compression of the ulnar or median nerves due to the sustained wrist and hand position on the handlebars. It can be made worse from the bike vibration if you are cycling on rough terrain.

Correction:

  • Change your hand position on the handlebars regularly.
  • Ensure that your wrists are straight and not over-extended.
     

5. MUSCLE STRAINS AND TEARS

Hamstrings and calves are the most common muscle injuries amongst cyclists. This is because these muscle groups get particularly tight, making them more vulnerable to tears and tendon injuries.

Correction:

  • Warm up before a ride, and stretch afterwards to keep your muscles healthy and flexible. Using a foam roller after a ride for myofascial release can help with this too.
  • Check saddle height. A saddle that is too high can put a strain on the hamstring tendons.
  • Check cleat position as cleats too far forward may put a strain through the achilles tendon.
  • Pace your training program. Build up gradually to longer-distance cycling.
     

WHEN SHOULD YOU SEEK PROFESSIONAL HELP?

If you are experiencing the pain only when you are riding, then hopefully the above tips can help alleviate the issues. However, if the pain persists even when you are off the bike, you may need to get professional help.

An Osteopath will be able to provide relief by releasing restrictions, improving flexibility, and releasing muscle tensions. Osteopathy can also give you the best chance of staying pain-free by maintaining joint health, mobility, and muscle flexibility, as well as provide you with an individualised exercise advice.

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You may also want to consider getting a professional bike fitting done. This will ensure that no particular part of your body is under excessive strain, which should also help to improve performance.

Happy biking!


ABOUT THE AUTHOR

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Sebastien Bodet is a qualified Osteopath from France with a MSc in Osteopathy from Ecole d’Osteopathie Paris. He is also a certified Personal Trainer and Swimming Coach.

Sebastien is a former Olympic swimmer who represented France in the 2008 Beijing Olympic Games. He was a member of the University of Michigan Elite swimming team, and to this day remains an Olympic Sports Ambassador in France.

Sebastien's area of specialty is sports injuries, rehabilitation, and pain management. As a former professional athlete, he understands what it takes to maintain and rehabilitate the body for a high level of sporting performance. He takes a holistic approach to injury treatment, not limiting the treatment plan to only the pain area, but accounting for the entire body structure and lifestyle habits to create a fully customised treatment plan.

Sebastien's priority with every patient is to ensure safety and efficacy of their treatment plan. He is passionate about restoring body fitness and function to its optimum so that all of his patients can live life to the fullest potential.

Top 9 benefits of horse-riding (and prehab to improve riding performance)

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With increasing affordability and accessibility to horse-riding in Singapore, there is growing interest in horse-riding as a sport and hobby, and a rise in participation in local competitions such as the recent National Dressage Championships, and the National Jumping Championships.

For some people, hopping onto the back of a majestic horse that weighs many times our body weight may be a scary thought. Horse-riding requires not just physical skills, but also a good understanding of your mount. However, there are many health benefits associated with horse-riding – aside from getting a good physical workout, it can also be an incredibly healing experience. As an avid rider growing up, I want to share with you not just the obvious benefits, but also some of the more unknown ones.


TOP 9 HEALTH BENEFITS OF HORSE RIDING

1. BALANCE A necessary skill to be able to stay on the horse, especially if it turns quickly. It doesn’t mean that if you don’t typically have ‘good balance’ you can’t ride – you can hold the front of the saddle to begin with and as you improve you will be able to stay upright and balanced without holding on.

Balance Test: Many of us don’t realise how bad our balance is unless you have done any lower limb rehab. Try standing on one leg, close your eyes and balance for 30seconds. Too easy? Try balancing on tip-toes while staying super still. Not so easy? Balance is one of the easiest things to improve and quickly – we can show you how.

2. CARDIOVASCULAR SYSTEM BOOST Trotting and riding associated activities such as mucking out are considered a moderate exercise for the rider. The longer and faster you go, the higher the intensity and the more calories you burn.

3. COORDINATION Your arms and legs are your communication to the horse. There are certain arm positions and squeezes that you perform to indicate a command and often at the same time. Your body awareness will flourish.

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4. INTERNAL ORGANS STIMULATION This is the same when walking on foot, which is why it is one of the many reasons it is fantastic for sedentary or wheelchair bound people; it aids in liver function and digestion.

5. MOTOR FUNCTION The whole body has to work both independently and together to develop riding skills. As it is unlike most other sports your body can develop and improve new motor skills.

6. REFLEXES AND ALERTNESS As the horse moves, you must instantly and continuously react to it and be aware of any environmental considerations. We will keep you on your toes and develop your responses.

7. SELF-CONFIDENCE Responsibility, patience, overcoming fears, self-control and relationship building with the horse; an unbiased and non-judgemental partner that is only responsive to your intent and behaviour (which studies have found to be highly beneficial for those with ADHD, depression, anxiety and mental health disorders).

8. SEROTONIN PRODUCTION Doubling up on this mood-enhancing hormone by exercising and spending time with animals.

9. SENSORY INTEGRATION STIMULATION Riding well means ‘feeling’ your way with the horse, which is unlike most sports which is sight reliant (you can’t play the easiest version of racquet, team or ball sports if you can’t see the ball), but you can ride with very limited vision.
 

Horse-riding is suitable and beneficial for all ages.

Horse-riding is suitable and beneficial for all ages.

WHAT IS PREHAB?

 “Prehab” is a proactive approach to building strength and stability, and improving mobility, balance, and joint functions to decrease the potential for injuries. Prehab is extremely beneficial when you are considering getting back to any sport after a break.

HOW PREHAB CAN IMPROVE YOUR RIDING PERFORMANCE

RIDING FOR STRENGTH TRAINING
Horse riding is an isometric exercise, where specific muscles are targeted to stay in a certain position without contracting the muscle. One of the best features of this sport is that whether you’re trying to or not, you DO engage all the right muscles. Over time as they improve in strength, so will the transfer of this strength to other positions such as standing or sitting, and other forms of exercise.

Walking and trotting (like a light jog) are the two most common speeds that you will be doing as a beginner in horse riding. To try to understand the number of muscles involved, imagine trying to balance and coordinate your movements with the horse as you squat up and down continuously. Your quads, hamstrings, glutes, and adductors will certainly be sore the next day! Any old ankle, knee, or hip injury that has not been fully rehabilitated may start to rear its ugly head as you will rely more on your better side, and the imbalance will only become greater.

While riding, your arms are either pulling the reins or held statically in a raised position. This can create beautifully sculpted shoulders – provided you don’t have chronically tight shoulders from sitting at the desk all day. Your Physiotherapist can teach you how to open them up and get your shoulder blades stronger, so that you can hold them correctly and much more comfortably, and not exacerbate any niggling shoulder problems.

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DEVELOP STRONG CORE MUSCLES
If you are looking for a core of steel, then look no further! Your core muscles are in overdrive to balance and stabilise your upper body on an unpredictable and ever-changing base of support; slouching or over extending the back will affect your ability to stay on the horse as it turns one way, you need to counterbalance with those obliques. Your centre of gravity and body weight are constantly shifting, but you must remain as central on the saddle as you can, or you might cause yourself or even the horse to go off balance. The core is the foundation of our body, and if it isn’t working optimally, then how can we expect it to provide the base for our limbs?

 

A strong pelvic floor is critical in horse riding. If you’re unsure that your pelvic floor muscles are strong enough to tolerate this type of exercise, then you must get assessed before you try horse riding. (Come in to see UFIT’s Women’s Health Physiotherapists Kelly McGinnity or Lucie Lamprey)

Horse riding is a wonderful hobby for both adults and children looking for a new and extremely fulfilling experience. It fosters a wide range of skills that many of us would get huge benefits from but a certain level of body awareness and improvements would be ideal to maximise these benefits.

Physiotherapy can identify areas of weakness, potential problems, and imbalances in the body, and create a customised sport-specific prehab plan to achieve your goals. The aim is not to be “perfect”, but prevention is better (and less painful) than cure. Speak to a Physiotherapist and take the first steps to create the foundations for a long, injury-free, and healthy hobby.


ABOUT THE AUTHOR

Lucie Lamprey is a Senior Physiotherapist at UFIT Clinic. She has a B.Sc. (Hons) in Physiotherapy from the University of Southampton, as well as a Masters of Manual Therapy from The University of Western Australia. Lucie has worked with a wide range of clients, including people who are new to exercise, those with pre-existing medical conditions, to recreational and competitive elite athletes.

Lucie specialises in sports injury rehabilitation and injury prevention, with a focus on the spine, pelvis, and lower limbs. She is a certified Clinical Exercise Specialist from the American College of Sports Medicine (ACSM), with extensive exercise knowledge to develop exercise programs for athletes with comorbidities. Other areas of expertise include managing acute or chronic pre and post-natal conditions, incontinence and pelvic organ prolapse, and dry-needling for musculoskeletal conditions.

Preventing common shoulder injuries in combat sports training

The rise in mainstream popularity of combat sports in recent years has seen more people taking up the sport as a way to keep fit. Be it boxing, muay thai, jiu-jitsu, or mixed martial arts (MMA), combat sports are great for stress-relieving, as well as offer a cardio-intensive full-body workout.

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While this development is exciting and highly promising, there is a growing concern over the increase in numbers of combat sport-related injuries we see in the clinic, particularly in the shoulders. This can greatly impact on your training and performance in the sport, and if not treated in time, develop into a more serious chronic condition.

Here are the top 3 most commonly seen combat sport-related shoulder injuries:
 

1. SHOULDER INSTABILITY

The gleno-humeral joint of the shoulder is a ball-and-socket joint, in which the spherical humeral head (ball) is ideally centered in the glenoid cavity of the scapula (socket).

Symptoms:
Feeling “loose” in your shoulder, as though the shoulder is going to pop out of place with certain movements.

 

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Causes:
Shoulder instability may be due to one or more of the following contributing factors:

  • Structurally shallow glenoid cavity
  • Looseness of the ligaments from previous dislocations or misalignments
  • Generalized joint hypermobility
  • Decreased activity of surrounding stabilizing muscles

Prognosis:
We’ve seen our fair share of shoulder dislocations while fighters are trading punches, or getting caught in a clinch. A dislocated shoulder can put you out of training and fighting for months. Left untreated, shoulder instability may result in recurrent misalignments and dislocations, causing fighters to lose precious training time and confidence in their punching, clinching, or grappling abilities.

 

2. ROTATOR CUFF DYSFUNCTION

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The rotator cuff is a group of muscles in the shoulder that primarily moves the shoulder into internal and external rotation, and also functions to improve the stability of the shoulder joint.

Symptoms:
Rotator cuff dysfunction may present as:

  • Rotator cuff weakness
  • Rotator cuff tendon inflammation
  • Rotator cuff tear

Causes:
In the absence of acute trauma, rotator cuff dysfunction in combat sport athletes often begin as relative weakness of the external rotators in comparison to the internal rotators, which are often in a shortened resting position as a result of a typically-hunched fight stance. Over time, the external rotators become strained in an elongated position, as they counter the force of the internal rotators.

Prognosis:
With repetitive straining over time, the tendons of the rotator cuff undergo degeneration with wear and overuse. Overtime, rotator cuff weakness and inflammation may eventually lead to a tear. Rotator cuff tears are often painful and debilitating, leaving fighters unable to train and compete for several months.
Rotator cuff tears have been known to heal poorly. The majority of rotator cuff tears often go on to become larger tears or full-thickness tears if untreated over time. Hence, it is important to seek treatment early to maximize healing and minimize further injury.

 

3. ABNORMAL MOVEMENT OF THE SHOULDER BLADE (SCAPULA)

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The scapula is an important consideration in the shoulder joint. Since the glenoid cavity (as mentioned above, it’s where the ball-shaped end of the humerus) is part of the scapula, its position in motion is crucial in housing the humeral head to maintain smooth and efficient movement of the shoulder.

Symptoms:
Scapular dyskinesia is a collective term referring to dysfunctional motions of the scapula during shoulder movement. It often presents with increased bony prominence of the scapula.

Causes:
This often occurs due to a lack of control and variations in interaction between some of these muscles:

  • Trapezius – a major muscle covering most of the upper back and the posterior of the neck
  • Levator scapulae – at the back and side of the neck
  • Serratus anterior – fan-shaped muscle along the ribs underneath the armpit

Prognosis:
While scapular dyskinesia itself is rarely the source of pain, it may be present in shoulder injuries or any muscular imbalance in the shoulders, making it worth an assessment for any contributions to structural and functional errors in the shoulder.

 

PHYSIO-RECOMMENDED WARM UP/”PRE-HAB” EXERCISES

To minimize the risk of shoulder injuries during training, here are some simple “pre-hab” exercises to warm-up and prepare our shoulders for a training session:

Foam rolling of the shoulders, concentrating the following muscles:

  • Subscapularis
  • Latissimus dorsi
  • Posterior capsule
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Shoulder internal and external rotation

1. Holding a dumbbell in one hand, rest you elbow on your knee, with your arm pointed downwards.

1. Holding a dumbbell in one hand, rest you elbow on your knee, with your arm pointed downwards.

2. Lift the dumbbell by turning your arm upwards.

2. Lift the dumbbell by turning your arm upwards.


Shoulder forward flexion with isometric external rotation

1. Hold a resistance band around your hands.

1. Hold a resistance band around your hands.

2. Stretch the resistance band by bringing your hands in-line with your shoulders.

2. Stretch the resistance band by bringing your hands in-line with your shoulders.

3. Raise both arms in front of you while keeping the the resistance band stretched.

3. Raise both arms in front of you while keeping the the resistance band stretched.


Scapular stability + rotator cuff activation

1. Pull a resistance band towards your chest with your elbows bent at the side.

1. Pull a resistance band towards your chest with your elbows bent at the side.

2. Turn your forearms upward.

2. Turn your forearms upward.

 

PHYSIOTHERAPY CAN IMPROVE YOUR SHOULDER FUNCTION IN COMBAT SPORTS

The above exercises serve as a general guideline to athletes looking for warm-up ideas for a healthy shoulder. Should you experience shoulder instability or pain during your martial arts training, or have been diagnosed with a rotator cuff injury, you might want to consider visiting a Physiotherapist.

During your physiotherapy session, your Physiotherapist can:

  • Assess for shoulder instability, possible rotator cuff injury, or any other shoulder injuries
  • Assess biomechanics, including the movement of your scapula, and identify biomechanical errors in your movement
  • Treat soft tissue limitations
  • Prescribe a rehabilitation program to improve shoulder stability, scapular motion, rotator cuff strength, and overall shoulder function

Your rehabilitation plan may often consist of a program that progressively loads the shoulder, with an emphasis on motor control and dynamic stability through movement. The aim is to get you back to training with greater confidence and reduced injury risk.
 

Do you participant in combat sports training regularly? We can help you in your training performance and recovery!


ABOUT THE AUTHORS

Daniel Arthur and Nada Khalid are Physiotherapists at the UFIT Clinic. Between them, they share a great passion and plenty of experience in combat sports training, which provide them with the understanding of prevention and treatment methods for combat sport-related injuries.

Daniel holds black belts in Taekwondo and American freestyle kickboxing. He is a Bronze medalist at the ICO World Championships in Italy, where he represented England. He is also an experienced kickboxing trainer, having taught the sport since he was 16.

Daniel holds black belts in Taekwondo and American freestyle kickboxing. He is a Bronze medalist at the ICO World Championships in Italy, where he represented England. He is also an experienced kickboxing trainer, having taught the sport since he was 16.

As an active muay thai fighter, Nada trains up to 6 days a week. She has won multiple national-level Muay Thai fights, and most recently fought and won her professional debut in Thailand by a technical knockout.

As an active muay thai fighter, Nada trains up to 6 days a week. She has won multiple national-level Muay Thai fights, and most recently fought and won her professional debut in Thailand by a technical knockout.


Reduce chronic back pain and increase flexibility with Pilates

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Do you spend long days in the office behind your desk? Do you find your body getting increasingly stiff, fidgety, or uncomfortable as the day progresses? The cause could be due to a weak core stability – the foundation of your body.


HIGH-RISE AND BODY-WISE

Think of your body like one of the skyscrapers in CBD. Your deep core muscles are like the foundations, beams and pillars which hold it upright. Should this internal scaffolding become weak or damaged, your body becomes an unstable structure, ready to break at any time. High-rise buildings of course have many supportive structures internally, externally and underground to allow for error (thank goodness) so that they can withstand the elements.

Having strong abs - or core muscles provide a foundation for your body's stability.

Having strong abs - or core muscles provide a foundation for your body's stability.

Our bodies are somewhat clever in that we too, have a back-up system. We have muscles that are ready to help out should our main structural system fail. However, these muscles simply aren't designed for this role of anti-gravity and postural support, so when they get tired and tight, this is where injury occurs.

Sitting at a desk all day causes our internal scaffolding to become ineffective, and our deep core in turn becomes weak and under-active. Aside from a weak core, we often find that our upper back and hips can become stiff. Our joints produce lubrication through movement. With long periods of immobility, the production of the fluid that oils our joints slows.


KEEP THINGS TICKING

Studies into lower back pain have proven that the muscles that support the trunk and pelvis become weak through a process called pain inhibition, i.e. a painful area becomes a weak area as the adjacent muscles just don't want to work. Seeing a Physio can help to put you on the right path through an assessment of your posture and functional movements, and subsequently a specific treatment plan to help target those weak or stiff bits.

A physiotherapist can help to assess and correct your posture and functional movements.

A physiotherapist can help to assess and correct your posture and functional movements.

General exercise and maintaining an active lifestyle will help to keep things ticking over. Or working with a personal trainer to have some specific guidance with your training can really help to build general or specific strength and endurance, depending on your individual goals.


BUILD THAT 'POWERHOUSE'

One form of exercise that is perhaps a little more targeted towards the core and our 'internal scaffolding' is Pilates. Pilates aids the activation and development of the deep core muscles, which are crucial for pain-free daily function, optimal performance during sports, and injury prevention. Through its extensive repertoire and targeting of very specific muscle groups, Pilates will make you 'feel' muscles you never knew you had, and also increase your body awareness significantly. So when you start to notice that your posture is off alignment and causing unnecessary stress on your body, you can correct and reposition yourself.

Pilates reformer The reformer helps to correct body imbalances by increasing awareness of core and gluteal activation. 

Pilates reformer The reformer helps to correct body imbalances by increasing awareness of core and gluteal activation. 

Pilates also helps to improve flexibility by encouraging you to counter-balance those positions that you find yourself stuck in for long periods of time – such as rounding forward over your keyboard, or slumping towards your computer screen.

Pilates can be done on a mat or with a specialist equipment, the most popular of the equipment being the reformer. Pilates is best taught by a qualified physiotherapist, or someone who has extensive experience within a rehabilitation setting. This allows them to scrutinise your every move to ensure you're doing the movements perfectly, thus eliminating the room for error to achieve the best results.

Activation and strengthening of core muscles helps to protect the spine and prepare the body for movement, thereby preventing injury.

Activation and strengthening of core muscles helps to protect the spine and prepare the body for movement, thereby preventing injury.

Regular activation and strengthening of these crucial deep core muscles with Pilates is important, whether you're experiencing physical pain or not. We all know that having an effective core or 'powerhouse' muscles is a recipe for success. The general rule is that after six weeks of twice-weekly Pilates sessions, your body will start to FEEL different, aside from looking more toned. And the best part about Pilates - ANYONE can do it!

The newest UFIT Clinic outlet at Orchard Central offers small group Physio-led Pilates Reformer classes. While there are other Pilates Reformer classes in Singapore, this will be the only class that offers an individually tailored program led by a physiotherapist who will pick from an extensive repertoire of exercises to best achieve your specific goals.


About the author

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Lucy Warren is a Physiotherapist and Pilates specialist from the UK. She has a first-class honours degree in Physiotherapy from Cardiff University, and is also an APPI-trained matwork instructor. Lucy has extensive sports experience with professional and semi-professional teams and athletes, having provided pitch-side physiotherapy for multiple elite sport teams in the UK. She has also worked for the British Army for two years, assessing and treating infantry soldiers and helping them to rehabilitate to peak fitness. 

Lucy taught matwork Pilates for several years before making the transition across to Reformer Pilates. Lucy loves using the Reformer and other Pilates equipment with her clients in order to achieve their specific rehabilitation goals. She believes that it is an incredibly versatile tool which can lead to daily life improvements like better posture and more efficient movement, as well as relief from pain associated with physical imbalances.

In her own time Lucy is a keen netballer, skier, and loves to travel to new places.