8 Guidelines for Strength Training During Pregnancy

The benefits of light to moderate-intensity weight training have been shown to be beneficial during pregnancy, however there is a lot of anxiety and uncertainty regarding moderate to higher levels of weight. Lucie Lamprey, our Women’s Health Specialist and Senior Physiotherapist at UFIT Clinic Raffles Quay, shares some guidelines for moderate-high intensity strength training during pregnancy.

Stand Up and Make a Difference

Stand Up and Make a Difference

The UFIT team comprising Dave Lee (Physiotherapist at UFIT Clinic Orchard) and Simon Porter (Head of UFIT Performance) have worked closely with the team at Visa Singapore to perform desk assessment demonstrations and provided education on correct sitting posture and desk set-ups to stay pain free.

Here are the exercises and stretches that work best performed at the desk. A handful of these exercises you can do at home or at the gym to help bulletproof your back, neck and hips against being seated all day.

Discovering What Lies Beyond Your Limits

Dave Lee, Physiotherapist at UFIT Clinic Orchard and triathlete, gives us insight into the world of triathlon competitions and some common injuries and issues that may occur. If you are participating in the Metasprint Series Singapore Bike-Run Duathlon on 10 March 2019, Dave’s knowledge of injuries that affect endurance athletes, especially cyclists, can help you gain better understanding and nip any issues in the bud before problems arise.

Common Musculoskeletal Conditions in Children

Being active in sports, UFIT Clinic Orchard’s Senior Physiotherapist and competitive Muay Thai fighter Nada Khalid listens to her body and is aware of any issues that might arise. She would be able to take the necessary actions and precautions as needed. That being said, this will not always be the case when it comes to children who are active in sports.

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.