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.

Health and fitness advice on social media? Take it with a pinch of salt

 Did your mum ever tell you: “Don’t believe everything you read in the news”?

Did your mum ever tell you: “Don’t believe everything you read in the news”?

We turn on the TV or scroll through social media, and we are bombarded by a plethora of information – some reliable, some not. A recent study by Pew Research Center found that nearly half of the adult population in many countries today uses Facebook as a news source.

Having such ease of access to new information is great. You can discover a new fitness trend, or search for the latest workout or diet plan within minutes of scrolling through your social media feed. But sometimes it can backfire and get overwhelming if you don’t know how to filter through the sea of information.

Personally I can be quite gullible myself, and am regularly tricked into believing April Fools’ jokes. However, even there is a limit to my naiveté. One day whilst scrolling through my Instagram feed, I came upon a post that made me shout various profanities.

This particular post stated that “the position you sleep in is the likely cause of back and neck pain in most people”. It shows a person lying down with the spine specifically highlighted in red, creating the impression that there is pain or tissue damage in the spine. Then it shows the same person lying down with three different pillows wedged under his spine and neck to apparently “correct” his posture, claiming that the pain can be averted by purchasing those special pillows.

 Your spine and body is inherently strong and adaptable. Take images like these with a pinch of salt.

Your spine and body is inherently strong and adaptable. Take images like these with a pinch of salt.

The truth is that each one of us are unique and like to sleep in different positions. There is not one right or wrong position, or an ideal mattress or pillow type. Getting a well-rested night of sleep is more important than the position you sleep in. Posts like this could be very harmful for someone who is currently experiencing back or neck pain. This could cause apprehension and lead them to be unnecessarily stressed over the way they sleep.

Another example would be an image that shows a person bending forward, with an “explosion” emoticon right at their lower back indicating a disc bulge or other tissue damage. The post implies that your back is inherently weak, unstable, or easily damaged by a move as basic as bending forward – which is completely untrue. Social media posts like these are designed to be shocking and evoke strong emotions in order to get comments, likes, and shares.

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Like many things in life, matters related to health and fitness cannot simply be defined in black or white. As each of us are individually unique, we all move differently and have different needs and demands. To suggest that one thing is the cause of pain is simply absurd. Here are some other common misconceptions regarding health and fitness:

COMMON MISCONCEPTIONS

  • Running is bad for your knees.
  • Squatting is bad for your knees.
  • Deadlifts are bad for your back.
  • Resting is good for a bad back.
  • You shouldn’t exercise if you’ve got arthritis.

All of these above statements are false. Performing exercises incorrectly may cause you to develop pain. But when the issues are identified, and the exercises are modified or corrected, you strengthen your body as a result of exercising the right way. Instead of the above statements, the below ones are more applicable:

CORRECTED STATEMENTS

  • Recent evidence shows that running is not bad for your knees.
  • Squatting with correct technique is beneficial at building strength in your legs which alleviates the stress on your knees.
  • Deadlifts when performed correctly are beneficial in strengthening the lower back, making it less susceptible to lower back problems.
  • Movement is best for a bad back. Bed rest is likely to worsen back pain and increase recovery time.
  • Modified exercises that account for any physical limitations can help with weight loss, and strengthen the muscles around your joints, thus alleviating stress. Studies have shown that “the loss of 10 pounds of body weight can lead to a 40-pound reduction of pressure in the knee joints”.
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There is a lot of great information online, especially when it comes to health and fitness. However, you do have to be careful, as there are a few “snakes in the grass”. You should be judicious about where you are taking your information from.

If you have a heart condition, you would see a cardiologist and seek information from a credible source such as the Singapore Heart Foundation, rather than from an Instagram profile named '@HappyHeartDoc4000'. Likewise, when looking for information on fitness, health, and nutrition, make sure you are using reputable sources with credible qualifications.

5 things to note when getting information from social media sites:

  1. The number of page followers does not replace accredited qualifications.
  2. Any post with dietary, nutritional, or health claims should ideally have links to supporting research.
  3. Be wary of fear mongering – your bodies are strong and resilient.
  4. Always check the qualifications of whom you are taking information from.
  5. It is best to seek physiotherapy, personal training, and nutritional advice from a qualified professional that you can meet face-to-face.
     

WHEN SHOULD YOU SEEK PROFESSIONAL HELP?

There are no hard and fast rules when it comes to reaching out for professional medical or fitness advice. Typically, if your pain is worsening and things are not improving after a couple of weeks, it would be a good idea to contact your physiotherapist or doctor. If you are stuck for ideas and feel you need help, it is better to consult a professional than to suffer in pain alone.


ABOUT THE AUTHOR

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Kieran 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.

Kieran is also a certified sports massage therapist, dry needling therapist, and kettlebell instructor.

Pre-natal massage: the touch you need to relieve pregnancy-related aches

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Pregnancy is a magical and momentous experience.  It is also a significant time for every mums-to-be as you experience physical changes in your body to accommodate your new little addition. The amount of pressure pregnancy puts on your neck, lower back, ankles, and your pelvis can cause a great deal of discomfort. This is not unexpected, as your whole weight distribution is shifting, and your posture may need a little help to readjust. All you want is to feel a bit of relief from the cramps and body aches!

Pregnancy also increases blood flow in your body. You may feel warmer and perspire more easily. The numerous hormonal changes and the enormity of your impending life change can also – let’s be honest about it, play havoc with your emotions. Depression and anxiety are often overlooked, but the experience is very real and may be overwhelming.

At UFIT Clinic, aside from working with athletes, we also wholeheartedly support expectant mums in their journey through pregnancy. Our team of pre-natal trained specialists are trained in working with expectant mums to help ease the discomforts you often experience in pregnancy. Having a massage can provide expectant mums a much-needed relief from these physical and psychological symptoms associated with pregnancy.

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A pre-natal massage helps to improve your blood circulation, reduce swelling, and lower your blood pressure. It also helps you to you feel relaxed, lower your stress levels, and the very simple power of the right touch can be immensely soothing to your senses.

An experienced pre-natal therapist will make you feel comfortable, and work in a way that is safe for you and your baby. Trained pre-natal therapists are able to understand the baby’s position, and take into account the lymphatic system and blood circulation. Techniques are adjusted to suit your individual needs – a lighter stroke, more focus on hands and feet, and a gentle face massage to soothe away tension and headaches.

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The attention does not end when your baby is born. Post pregnancy, a post-natal massage can give your body and mind a much needed break from the responsibilities of looking after a newborn. You might even nod off, just a little bit, but we won’t tell.

Lastly, always make sure your therapist knows that you are pregnant, and that your gynaecologist gave you the medical clearance to proceed!


ABOUT THE AUTHOR

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Lynsey Keyes is a UK trained massage therapist and certified in both ITEC and BTEC level 4 Massage and Anatomy and Physiology. Having spent 15 years working in high-pressure marketing roles, Lynsey embraced her ultimate passion in bodywork and uses her experience to help people overcome the physical and mental stresses of modern life.

She is a passionate believer that massage should be a part of our everyday lives to support our bodies in whatever challenge we put upon them; whether you are a professional sports person, have a sore back from carrying your baby, or simply need to release some tension from a day in the office.

Why sitting for too long is hurting you

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Modern lifestyles are increasingly leading us towards a highly sedentary lifestyle. For many of us, our days are mostly spent in a seated position. We sit in the commute. We sit behind the desk at work. And to relax at home, we sit in front of the TV for a few hours at a stretch. Imagine the compounded effects of all that sitting!

We have all heard the phrase “Use it, or lose it.” It is repeated for a reason, because it is true! Those of you who exercises regularly know just how quickly you can lose your strength and fitness when you take just a week off regular training. Sitting doesn’t engage much of your muscles. All it does is to poorly load them, which lead to stresses, strains, pain, and loss of muscle mass.

It is well known that exercise produces the “happy hormones” endorphin. Simply moving more produces the same results too. When you are stationary for too long, guess what – your endorphins level drops too.

Now the really bad news: Just as exercise doesn’t counteract the effects of eating junk food, exercise also doesn’t counteract the effects of sitting! This means that although you are likely to reduce some of the negative effects by exercising regularly, it doesn’t mean you can sit the rest of the day because the negative effects of sitting increase in proportion to the amount of time you sit.

Not convinced yet? Here’s a list of some common side effects of sitting for an extended period of time, and how it can impact on your fitness training!


side effects of sitting for too long

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NECK TIGHTNESS
Looking in one direction (i.e. at the computer screen, the TV, or your mobile phone) for a prolonged period can reduce your range of movement. This can lead to tight muscles especially when turning your neck, and affect your performance in team sports, swimming, driving, and even sleeping. The constant “pain in the neck” or headache is a common ailment affecting many people in our society – the next time you are on the MRT, just look around to see how many people are looking down at their phones! Muscle tightness limits your body’s range of movement, and impact on your ability to generate maximum force in weights training.

SHOULDER PAIN AND/OR "CLICKING"
Rounding and pushing your shoulders forward as you type on your keyboard makes the muscles at the front of your body tighter, which worsens your slouching even more. Most people will get stiffness and pain on the outside of the shoulders, or around the shoulder blades as they are constantly being pulled forwards. Your shoulders eventually get weaker and go out of position. You know that feeling when you sleep awkwardly and wake up stiff? Well that is what you are doing to your body when sitting poorly.

ELBOW AND WRIST ACHES AND FATIGUE
In today’s modern age we are constantly engaged on our electronic and mobile devices. We are typing on the keyboard, scrolling social media on the phone, or playing games on the tablet. The wrists and elbows are being used more than ever in these limited positions that constantly engage the hand and wrist muscles. No wonder they are such a common area to have a repetitive strain injury!
 

3 simple ways to make a change

Now that we know how long hours of sitting poorly can affect us physically and mentally, what can be done instead?

  1. Stand up and move every 45 minutes. You know the feeling when you feel like wriggling in your chair, or perhaps lean your body to one side– that is your body telling you to GET UP! Don’t just shift in your chair, get up and stretch or go for a walk. If you are short on time, even just standing up and down again in your seat helps to give your body a quick reset. Set an alarm or reminder to get up from your seat regularly.
 Infographic:  WOLMED

Infographic: WOLMED

  1. Consider a standing desk. As companies are placing more importance on staff wellness, many are open to the idea of improving ergonomics. There are many types of standing desks available on the market that allows you to adjust the height of the desk with a touch of a button. You don’t have to work standing up all day, changing it up is the key.
     
  2. Make sure you are sitting properly. If a standing desk isn’t an option for now, use the following steps as a guide on how to sit properly:
    • Sit right to the back of your chair (ideally maintain a 2-inch gap between the edge of the seat and the back of your knees)
    • Raise your chair to an appropriate height so that when you are tucked in, you are able to use the keyboard with your elbows relaxed at a 90-degrees angle on the armrests. If your feet are dangling, deter the urge to sit forward to plant your feet on the floor. Because as soon as you sit forward, you lose the back support and will soon slouch. Instead, you can place a low box as a footrest below your feet to create the ideal 90-degrees bend at your knees.
    • Pull yourself close in to the desk. At this position, your chair’s armrests slip underneath the desk. If you are too far away, you will constantly be leaning your body forward in an unbalanced angle to use the keyboard.
    • Bring your monitor closer! Stop leaving a nice clear space in front of you that is rarely needed – bring your keyboard and monitor closer to you, so you don’t end up leaning your body and neck closer to the screen as you concentrate or become tired.
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If you spend a good part of your day seated behind a desk, and am experiencing constant aches and and muscle tightness, you might want to visit a physiotherapist to do an in-depth ergonomic assessment to find out if imbalances in your posture and balance are causing these issues.


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ABOUT THE AUTHOR

Lucie Lamprey is 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.

5 tips to bounce back quickly from DOMS

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Anyone and everyone who has exercised at one point or another in their life has experienced Delayed Onset Muscle Soreness, or DOMS for short. It’s that achey feeling you feel in your muscles 2-3 days post exercise, and it can often be quite painful – limiting your movement to a point where stairs seems like Everest, or you find yourself looking for a toilet with grab rails to help you into position!

Some people actively look for DOMS, and feel they haven’t worked hard enough unless they experience it. Other people, on the other hand, refuse to workout for the next week if they get any soreness after a workout. So who is right – is DOMS something to be afraid of or encouraged? And what is the best way to get over it so that we can get active again?

The science behind what exactly causes DOMS is not 100% clear, but most people agree that it is caused by micro-tears to the muscles, which leads to inflammation as they heal, causing the pain. What we know for certain is that DOMS arises in the first 24 hours post-exercise, and typically peaks 48 hours after exercise. It leads to a temporary decrease in force production for the first 48 hours post-exercise. What is clear is that lactic acid accumulation is not a component of this process, and should not be blamed for your DOMS. Eccentric training (lengthening the muscle with tension applied - for example the lowering phase of a bicep curl or on the way down in a squat) definitely leads to a lot more DOMS than fast, concentric weight training.  

So is it bad for you? In a word, no. However, it will limit your effectiveness in any subsequent exercise or sport sessions over the next two to three days, which will limit the amount of work you can get through. Importantly, it has been linked with an increased chance of injury within this 48 period, through its inhibition of certain muscles and reduction in range of movement - so try to avoid playing a football match the day after doing a heavy legs squatting session!

Recent research points to the ‘repair’ process your muscles are undergoing as the source of the pain. As your muscles are repairing themselves, they release a substance called bradykinin along with other enzymes to create growth, which causes blood vessels to enlarge and nerves to become more sensitive. The combination of the sensitized nerve endings and the increased fluid in the area lead to the pain and ‘stiffness’ felt within the muscles.

The good news is that this ‘pain’ you feel is a sign you are getting stronger, and you are getting some benefits from the training you are doing as the body goes through the damage-repair cycle. A word of caution – more DOMS does not necessarily mean you are working harder, it can just mean that you are not training very smartly, and have overloaded a particularly weak area.

 

So what can you do to reduce DOMS quickly to get back into the gym? Here are a few tips:

  1. Warm-up and cool down before and after your session. Having an effective warmup and cool down has been shown to reduce DOMS in untrained individuals versus individuals who received neither. Your warmup should include the areas of your body you are about to workout, and you should be at least breathless by the end of it. Cool down should involve stretching, and a lot of:

  2. Foam Rolling: If you don’t know what a foam roller is, find out. Buy one, and make it your friend. Foam rolling has consistently shown to be effective at improving range of movement in tight athletes the day after high intensity workouts, and reduce DOMS. The more recent research points to a neuro-physiological affect on your muscles (desensitization of the nerve endings in your muscles) as the mechanism behind foam rolling, which may be why it is effective on DOMS.

  3. Manual therapy/Massage/Acupuncture: If your DOMS is particularly bad, speak to your friendly local physio about manual treatment and acupuncture to hasten your recovery. Both are effective.

  4. Active Recovery: Research has shown that lightly exercising the area the day after a heavy session can reduce the recovery time. For example, after a heavy squatting day, jump on a stationary bike the next day for a gentle 20minute cycle. Your legs will thank you!

  5. Nutrition and Hydration: Being well hydrated, and feeding your working muscles with good fuel should be the cornerstone of any workout program. Don’t waste your time in the gym if you are not paying attention to this outside of the gym. You will recover quicker, and you will make more progress if you do!

 

Final Word

It is unlikely you will avoid DOMS altogether when you start a new strength program. It is not something that you should be afraid of, or that should keep you away from the gym. However, pain does not need to be present in order for you to achieve progress in your conditioning. If anything, intentionally causing DOMS will only limit the amount of work that you can do in subsequent sessions, potentially slowing down your progress.

The ultimate goal of any training program is to find the optimal balance between work and recovery. The key to a great training program is to find that sweet spot where you are doing enough micro ‘damage’ to create a muscle adaptation, without crippling you for the next two days and making you miss your next session!

Recover well!


About the author

Declan is Clinic Director for the UFIT Clinic and a fully qualified, registered physiotherapist. He is passionate about helping his patients achieve their long term goals through identifying their weaknesses and imbalances, and developing a strategy to eradicate them. 

Find out more about Declan right here.

The benefits of Cupping in modern massage therapy

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As a Manual Physical Therapist, I am constantly thinking about how to use my body mechanics in the most productive way for the treatment of my clients. This is also to ensure I have longevity in a career I love, and that my body can withstand the often heavy workload that is placed upon it by a physically demanding job. This has driven me to constantly update my techniques and search for tools that alleviate pain and relieve muscle tension in the most effective way.

I’m normally not a sucker (pun intended!) for gimmicks, and have to admit to previously being a little skeptical about the clinical application of suction therapy, or “Cupping” as it is more commonly known. This in turn has driven me to understand the process, benefits, and see why it is quickly becoming a popular therapy method in Singapore, Asia and beyond. Here’s a basic outline of the therapy, and its application in modern massage treatments.


What is Cupping?

Cupping originated thousands of years ago, and is one of the oldest forms of manual therapy (I’m not going to take you through its history - the internet is your library if you’re interested!). By placing a glass or a plastic cup onto the skin, the therapist creates a vacuum in the cup which draws the skin, muscle, and fascia up into the cup. This vacuum can be created with either a hand suction pump or a burning cotton wool ball. The latter is becoming less common in modern therapy due to the relative lack of control on the suction.

In Western medicine, Cupping is used as a direct clinical application. The therapist notes an area of restriction and applies the suction directly onto it to affect change. This is different to traditional Eastern methods which rely on affecting change in the line of meridians or “Qi” throughout the body. Used in conjunction with other massage treatments, Cupping is a useful tool to add into the treatment mix as it provides a different sensation and effectiveness, and thereby improving the overall results.

Cupping is used in the treatment of many types of muscle tensions, including common ailments such as neck pain, shoulder pain, tight trapezius, lower back pain, spinal congestion, and plantar fasciitis.

 Source: WSJ

Source: WSJ


What does Cupping feels like?

Contrary to the commonly-held impression, the suction of the cups does not hurt. In fact, most people find the sensation very pleasant, a sort of a release. The cups can remain in position for several minutes, or the therapist can glide them over the skin similar to the movements of a massage. This negative pressure is the opposite to a deep tissue massage – a pulling versus a pushing effect.


The Benefits of Cupping

  • Relaxation: suction cups provide a negative pressure on the skin, muscles, and fascia. This is in contrast to the positive pressure of the deep tissue massage, and can be a very relaxing and soothing experience.
     
  • Promotes blood circulation speeds up muscle recovery. The negative pressure from the suction allows new blood to flow into that area of tissue with several benefits -
    1. Provides a feeling of relief from physical and emotional tensions
    2. Begins the healing and regeneration process - the exchange of blood allows the removal of toxins and dead cells
    3. Enhances circulation
    4. Warms the skin, and softens tissues to regain elasticity
    5. Reduces inflammation


Useful applications of Cupping in massage therapy

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1. Cupping increases the blood flow and warms the skin, which makes makes it easier for the therapist to get into the ‘knots' in your muscles.

2.  Once the cup is removed, the skin relays information to the therapist about the underlying tissue. A darker patch on skin would indicate an area of restriction or adhesion in the muscles. It can then help the therapist to pinpoint exactly where to massage.

3. As Cupping is a less strenuous (but no less effective) form of therapy, it helps the therapist to prolong their ability to treat clients at a high level for a longer duration.

4. Cupping is used as part of a bespoke suite of massage treatments to improve your body’s condition, which could include deep tissue, stretch therapy, “Gua Sha” (explanation for another time!), and a combination of different techniques depending on what is needed.


Does it leave unsightly dark circles on the skin?

A good therapist will explain the potential effect of Cupping on the skin prior to treatment to get your consent. It is likely that there may be a resulting reddening of the skin directly under the cup, the colour of which depends on the health of the underlying tissue. Healthy tissues do not leave a dark circle.

The technique I use is to slowly move the cup over the soft tissue as I would in a massage, rather than leave it in one spot which is more common in TCM (Traditional Chinese Medicine). This method is less likely to leave dark circles on the skin.

 The Cupping method used in UFIT's massage therapy is part of a comprehensive treatment plan, and is less likely to leave dark marks that look like most of them here!

The Cupping method used in UFIT's massage therapy is part of a comprehensive treatment plan, and is less likely to leave dark marks that look like most of them here!

 

While I wish there is a better name for it, I have had great feedback and results from my clients after using Cupping Therapy, and I am now fully converted to its application!


ABOUT THE AUTHOR

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Lynsey Keyes is a UK trained massage therapist and certified in both ITEC and BTEC level 4 Massage and Anatomy and Physiology. Having spent 15 years working in high-pressure marketing roles, Lynsey embraced her ultimate passion in bodywork and uses her experience to help people overcome the physical and mental stresses of modern life.

She is a passionate believer that massage should be a part of our everyday lives to support our bodies in whatever challenge we put upon them; whether you are a professional sports person, have a sore back from carrying your baby, or simply need to release some tension from a day in the office.

Here’s what to look out for when choosing the right running shoes

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All we need to run, is a good pair of shoes. There is a myriad of factors that may influence your choice of running shoes. Well-meaning friends may advise you to choose shoes based on their own personal preferences and experience, but what works for them may not apply to you. Given that everyone has a slightly different foot structure (and not to mention the exorbitant costs of shoes these days), it is key that you choose the most appropriate shoes for your feet.

Here are 4 essential factors you should consider when getting your next pair of running kicks.


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1. SHOE WIDTH
Standing in a neutral position with your shoes on and your toes spread apart, your foot should fit squarely within the foot bed of the shoe. If your toes feel cramped against the sides of the shoe, the shoe fit is too tight. Some shoe brands such as New Balance and Asics manufacture shoes that are available in wider than usual sizes, known as 2E (wide) and 4E (extra wide). Shoes in these sizes will provide you with roomier insoles for extra comfort.

2. SHOE LENGTH
Your feet will normally swell up slightly after a run or at the end of the day, so it is advisable to go shoe shopping in the evening to maximise your chances of getting the correct shoe size. The general rule of the thumb (literally) is that there should also be a thumb’s width of space between your longest toe (usually the first toe, or second for some) and the tip of the shoe.  When you run, sweat that is produced may cause your foot to move more than usual in your shoe. Having that little space between your toes and the tip of the shoe prevents any unnecessary abrasions to the foot.

3. FLEXIBILITY
The shoe should bend along the same line as your big toe when it bends at the ball of your foot. In other words, the bending point of the shoe should be close to the bending point of your toes. You can determine the bending point of the shoe by holding on to the heel of the shoe and press the front part of the shoe onto the ground. If the bending point of the shoe is too far forward or backward from the bending point of your toes, this may cause you pain along the arch or at the big toe.

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A lack of flexibility in the shoe can also lead to increased tightness in the calf muscles when you run, as the foot is unable to move freely. Having said that, a shoe which is too flexible may also cause a strain on the muscles and ligaments in the foot due to repeated over-stretching.

4. COMFORT
Current research findings are moving towards the notion that so long as a shoe feels good when worn, it should work. For most people, this is identified as the subjective feeling of having support under the arch. Some shoes retailer allow you to test out shoes on an in-store treadmill. Test run the shoes first - if the arch of your foot starts to feel tight and sore after a short while, it probably means that the shoe is providing too much support. Instead, change to a shoe with less stability and more cushioning, and try it out again on the treadmill.

The key is to find a pair of shoes that allows your feet to feel comfortable in while running. Ultimately, the correct shoe for you should complement your natural stride, rather than change the way you run.


 The author Mok Ying Rong has represented Singapore in multiple international run meets. 

The author Mok Ying Rong has represented Singapore in multiple international run meets. 

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If you are suffering from a pre-existing injury from running, or even if you just want to improve your running efficiency, this is where physiotherapy can help you. A trained physiotherapist can assess your gait, and check for any strength imbalances which could be the root cause of your issues. With an appropriate treatment and rehabilitation programme under the guidance of a physiotherapist, you will be equipped with the skills and knowledge to choose the correct footwear  and optimize your running gait.

Choosing your shoes, though, is only the prologue. Your running journey only really begins when you step your foot out of the door!


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ABOUT THE AUTHOR

Mok Ying Rong is a physiotherapist 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.

How to manage pain and stay injury-free

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It's so annoying to be injured. It stops you from doing what you want to do and brings a lot of discomfort with it. That niggling pain that bothers you every time you exercise, or the discomfort you have when sitting at your desk for hours on end. A lot of us will try to ignore the pain, hoping that it will go away with time or rest. Sometimes this works. You listened to your body telling you to take some time out to recover and HOORAY, you're back in the game. But sometimes this approach just won't kick it.

Understanding why you feel pain is the most important thing to do if you want to get rid of it effectively. One thing that's important to know is that PAINFUL doesn't necessarily mean HARMFUL. This doesn't mean to say that you should keep pushing yourself through the pain hoping it will just go away. What it means is that there may not be anything structurally damaged, but there is something happening biomechanically that your body just does not like. Injury can occur when there is altered stress on the body's tissues. The pain you feel in the body is your brain's way of telling you that something isn't right, like an early warning system.

How can we overcome pain? Rehabilitation is usually multi-faceted but to put it simply; we need to get the stiff bits moving and the bendy bits more stable.

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The thoracic spine is just one part of the body that we frequently see as being 'stiff' - this is likely to be due to the modern day lifestyle of sitting too much and spending too much time in poor postures. Doing regular thoracic mobility exercises and foam rolling the upper back will help to increase range and free your upper back up so that the lower back doesn't have to do all the work.

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Hips and ankles are two other common 'stiff bits', below are a few ideas of how to get them moving.

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Increasing stability and control in the relatively 'bendy' bits is equally important. This may involve increasing core and gluteal activation, strength and endurance of the deep postural muscles in order to create a strong and stable foundation from which to move. Combining the two approaches is a recipe for success, as long as you do your homework.

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This is just a little snapshot into what your rehabilitation may involve. So if you've got a niggling pain that just won't go away, or you think you could get a little more out of your training if only you could move a little better, book in a session with one of our physiotherapists for a full body check-up.  

For now though, consider these three steps to help you stay injury-free:

1. Progress gradually

Don’t ramp up your training too quickly, it’s just not worth it. Our bodies take time to change and adapt so be consistent and avoid loading spikes. For example, if you've had a week of rest from exercise, don’t expect to do more than you previously did, as large fluctuations increase the load on our joints and soft tissues. Follow the 10 percent rule: add mileage OR intensity by 10 percent or less a week, and do not increase both at the same time. Monitor yourself with a training App to show what you have done each week. Also remember overload can be brought about by a combination of lifestyle and training. If you have been overloaded at work, this will affect your training too.

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2. Recover well

Listen to your body. It needs time to recover, both mentally and physically. The micro trauma that occurs to the muscles and tendons stimulates further healing and growth, and this can only happen if they’re given a chance to rest and recover. If you start to feel a niggling pain, give yourself time to recover. Do not be afraid to adapt your training schedule to your needs. You won't lose fitness from taking one day off. Ensure your training programme includes recovery sessions - this can be swimming, pilates, yoga, or foam rolling sessions.

3. Strength and conditioning

We all have areas of weaknesses. An important component of any training plan is to make sure we have good flexibility, core stability, and strength. A dynamic strength and conditioning programme will target specific areas to help stabilise joints, promote postural balance, and improve muscle performance and efficiency. It helps the body tissues to become used to higher levels of loading, enabling them to deal with the increased demands of training and competing, therefore minimising the risk of injury. In essence - get the stiff bits moving and control the bendy bits!

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When you have an injury that just won't seem to go away, see a physiotherapist who can assess different predisposing factors such as your biomechanics, alignment, muscle strength, muscle length, and motion control. Get this – often the source of your pain may not be where you feel it. At UFIT Clinic we don't just prod and poke the bit that hurts in the hope that the pain will go away. Our physiotherapists are highly skilled in assessing body biomechanics in order to fully understand how your body moves and why certain activities or postures are causing you pain. Book an assessment with us to find out more!


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ABOUT THE AUTHOR

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.

Effective ways to relieve a Migraine

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If you suffer from terrible migraines, you are not alone. Migraine is the third most prevalent illness in the world affecting an incredible 1 billion people worldwide!

Migraine is a neurological condition that can be episodic or chronic. It usually starts with a severe throbbing in the neck or at the side of the head, a searing pain that can shoot straight up into your skull. Often it is accompanied by nausea, vomiting, dizziness, visual disturbances, tingling in the extremities, and hypersensitivity of the senses. Attacks can last between 4 to 72 hours.

What does a migraine feel like?

I am lucky enough to never have to suffer from a migraine. And unless you have, you will never know exactly how debilitating, disorientating and downright vomit-inducing it can be. Descriptions such as these can give you an idea:

“Like a vice around my head, with stabbing behind my ears and pressure behind my eyes. Pull the shades, lie down, don’t move.”

“It’s like having your head compressed by a two-ton brick while someone hits your temple with a hammer at random intervals.”

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During an attack, you most likely do not want anyone to touch you or even come near you. You just want to take a prescribed painkiller, and ride it out in a dark room. Are you tired of this routine, and looking for a more effective pain-relief solution?

Relieve migraine with massage therapy

When you’re coming out of an attack, getting a massage can help to relieve the pain immensely. Massage has been proven to help reduce muscle spasms, improve circulation, relieve tension and vascular headache pain, and promote relaxation. In fact, a twice-weekly 30-minute massage has proven to be effective against migraine attacks in a study conducted over 5 weeks.

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Deep tissue massage can help to ease through any areas of muscle or fascia that have become tight and restricted as a result of the migraine pain. These are the spots that a well-trained and experience massage therapist will focus on:

1. Neck and Shoulders

The neck and shoulders are the most common areas of tension. Migraines can cause these areas to become tight and rigid, and as such would benefit from deep, slow strokes. Even by simply lifting the weight of the head for a few minutes, the muscles in the neck are given enormous relief.

2. Head and Skull

Tension is also often felt in the jaw and temples. A face massage should never be underestimated for the relaxation it can bring. The 43 muscles in the face can become extremely tense and contorted during an attack, and the numerous pressure points in the skull mean that a gentle ‘hair wash’ approach on the skull can feel like heaven.

3. Hands and Feet

As they are less directly related to areas where migraines are felt, massaging hands and feet can be an extremely effective and accessible area to treat when a sufferer is feeling unwell.

 

D.I.Y. Massage for Migraine Relief

If you are feeling the onset of a migraine, a D.I.Y. massage on these 4 pressure points will help to relieve the pressure in your head. Press a finger down firmly on each of these points for a few seconds, and release slowly:

2. Between your eyebrows

1. Base of your skull

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4. Between your big toe and second toe (at the top of your foot)

3. Between your thumb and index finger

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The right massage therapist will be able to work out the what, where, and how to massage in order to relieve your migraine symptoms. One person’s migraine symptoms might differ from another, so there is more than one prescribed pattern for treatment. I recommend having a massage soon after your attack has subsided, and also schedule regular inter-migraine massages to prevent further attacks. Don’t wait until the next horror!


About the author

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Lynsey Keyes is a UK trained massage therapist and certified in both ITEC and BTEC level 4 Massage and Anatomy and Physiology. Having spent 15 years working in high-pressure marketing roles, Lynsey embraced her ultimate passion in bodywork and uses her experience to help people overcome the physical and mental stresses of modern life.

She is a passionate believer that massage should be a part of our everyday lives to support our bodies in whatever challenge we put upon them; whether you are a professional sports person, have a sore back from carrying your baby, or simply need to release some tension from a day in the office.

Are you a “Weekend Warrior”? 8 tips to avoid common exercise injuries

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Let’s set the scene – it’s the weekend! It’s been a long week at work with lots of disruptions and sleepless nights. You had a couple of drinks the night before and had less than 6 hours of sleep. But no problem! You just want to get outdoors and smash an intense workout to get those positive endorphins running.

Warm up? That’s boring. Foam-roll? Nah, haven’t got time for that! Take an electrolyte drink? Hmm, I’m fresh out of my supply. But it’s okay, just get into it. What’s the worst that can happen, right?

Ten minutes into your run, you are starting to feel a little ‘niggle’ in the muscle. But it’s okay, just keep going. Two minutes later, you sprint round a bend…and BAM! A sharp pain in your ankle. Or you’re on your last heavy deadlift…and AGH! Your back!

These are what we at UFIT Clinic like to call the “weekend warrior” injuries – afflictions caused by poor preparation, fatigue, or overload.  Here’s the top 5 most commonly seen injuries at the clinic on a Monday morning, and the steps you can take to avoid them.

 UFIT Clinic's team of physiotherapy, osteopathy, and sports massage therapists.

UFIT Clinic's team of physiotherapy, osteopathy, and sports massage therapists.


1. Ankle sprain

This is usually caused by rolling the foot inwards during some form of impact. This inward motion can cause one or multiple ligament sprains of varying degrees, with a lot of swelling, bruising and surrounding tissue damage.

Estimated recovery time: 2 - 6 weeks

2. Hamstring strain

This occurs most frequently in sports with explosive movements such as sprinting, soccer, and weightlifting. We also see injuries due to gradual overload, usually in runners or cyclists. Pain, visible swelling and bruising usually behind or around the back of the knee is commonly experienced.

Estimated recovery time: 6 - 12 weeks

3. Shoulder tendon injuries

Your shoulder tendons are the end parts of the muscles that is attached to the bone, and these guys are very sensitive to load and compression. Shoulder tendon injuries can be caused by poor seating posture at work, or wrong technique during exercise, leading to inflammation, sharp pain and reduced range of motion.

Estimated recovery time: 6-12 weeks, and sometimes even up to 6 months

4. Sharp lower back pain

Sudden onset of lower back pain is a very frequent injury is one of the most common injuries we see every day in the clinic. Your spine is a very strong structure made up of lots of tissue including bones, joints, muscles, tendons, ligaments, nerves and fascia. When any one of these structures are injured due to incorrect posture, poor technique, or weight overload, you get lower back pain.

Estimated recovery time: Usually 6 weeks, unless something more serious is involved such as an intervertebral disc or nerve injury, which may take longer.

5. Tennis or golfer’s elbow

You don't need to play either sport to be afflicted with this condition. The most common cause of elbow pain is a weakness at the wrist, leading to an overloading of the forearm muscles and the elbow tendon. Incorrect shoulder and wrist movements in sports such as tennis, golf, and weightlifting can also cause elbow pain.

Estimated recovery time: 6-12 weeks depending on how aggravated the elbow tendon is


8 ways to stay injury-free

 

1. Build your training up slowly

 Don't rush through your workout, listen to your body and go at your own pace.

Don't rush through your workout, listen to your body and go at your own pace.

If you’ve just returned from a break, holiday or rest period, then you need to consider gradually increasing you training appropriately. For example, if you just started to train for a marathon after a long period of inactivity, don’t begin by running 5 days in a row.

2. Warm-up properly

 Take the time to warm up properly before any exercise.

Take the time to warm up properly before any exercise.

Before jumping straight into your workout, make sure you do a dynamic warm up where you actively move your muscles to wake up your nervous system. Even a 5 minutes warm up routine can drastically reduce the chances of an injury.

3. Follow an appropriate training program

 Join an exercise group led by a certified instructor to get the most out of your workout.

Join an exercise group led by a certified instructor to get the most out of your workout.

When training for a particular event or race, it’s a good idea to follow a training program or join an exercise group to help you stay on track of your progress.

4. Focus on correct technique

 Improve your running foam and performance with a  Running Gait Analysis  at UFIT Clinic.

Improve your running foam and performance with a Running Gait Analysis at UFIT Clinic.

If you are new to an exercise, it is advisable to consult a coach, or a physiotherapist to learn the correct technique, proper form, and movement pattern in order to avoid injury.

5. Self-maintenance

 A sports massage session after a workout can work wonders on those knots.

A sports massage session after a workout can work wonders on those knots.

Don’t like foam-rolling and stretching? Then we would highly recommend you to book yourself in for regularly massages or body work sessions with a physiotherapist to keep all the muscles limber and the joints mobile so that you can continue to exercise injury-free.

6. Stay hydrated

 Make sure you drink enough water, especially when you're working out under the sun.

Make sure you drink enough water, especially when you're working out under the sun.

Our muscles, fascia and connective tissue are mostly made up of water, so when the body is dehydrated we are at a higher risk of sustaining a soft tissue injury. Making sure that you drink between 3-4 litres of fluids daily, and take a electrolyte supplements to combat what we lose through sweat, especially if you love exercising outdoors. A simple tip is to have a glass of water before bed, one glass in the morning, and continue to sip water or electrolytes throughout the your exercise.

7. Get adequate sleep

 Put your phone away from your bedside - the blue light from mobile devices can affect your ability to get enough sleep.

Put your phone away from your bedside - the blue light from mobile devices can affect your ability to get enough sleep.

Research has shown that inadequate sleep can leave you susceptible to increased exercise injuries. So having a late night on Friday ahead of a rugby match on a Saturday morning might not be the best plan. Plan your social and exercise calendar in advance to ensure you are getting at least 7-8 hours of sleep a night.

8. If you are experiencing pain, stop!

 Learn to tell the difference between a muscle ache and pain from overexertion.

Learn to tell the difference between a muscle ache and pain from overexertion.

Mild muscle aches during a hard workout session is to be expected. But if you are experiencing a different type of pain that you’ve never felt before, then stop immediately. Do not push through pain, as doing so might complicate and add on to the original injury. If in doubt, consult you physiotherapist. They can help to assess, diagnose and treat the injury appropriately.

Practice these 8 tips to stay injury-free and become an “everyday warrior”!


About the author

Máire is a senior physiotherapist at UFIT Clinic specializing in sports injuries and rehabilitation. She has a Masters in Physiotherapy in Queen Margaret University, Edinburgh, and has worked with a number of amateur and professional sports teams, including the Irish national basketball team.

Máire is also an avid runner and competes regularly in Singapore, often placing on the podium. As an APPI (Australian Physiotherapy and Pilates institute) and Balanced Body trained pilates instructor, Máire uses the principles of pilates clinically when treating runners as well as in her own recovery, and believes that it has contributed to her injury-free running career.

 

QUALIFICATIONS 

  • BSc (Hons) Athletic Therapy and Training (Dublin, Irl)
  • Sc Physiotherapy (Edinburgh, UK)
  • Kinesio® Tape Application Certified
  • Australian Physiotherapy & Pilates Institute Mat Certified
  • Balanced Body Reformer and Equipment based Pilates Trained
  • OMT Dry Needling Practitioner 

Frozen shoulder – How to let it go

A chilly explanation

So what exactly is frozen shoulder? Current research suggests it is characterized by a change in the joint capsule and certain ligaments within the shoulder causing them to lose their elasticity and become very stiff hence the term ‘frozen’. The pain may be a result of the inflammatory process and the chemicals released while this is happening. But it could also be attributed to a host of other causes.

  (Source: MMG, Inc. 1996)

(Source: MMG, Inc. 1996)

Diagnosis - the cold facts

  • Did the pain came on gradually in the shoulder or upper arm with no significant trauma?
  • Is the range of movement reduced - notably into flexion (straight up in front) and external rotation (with the elbow bent at the side, rotating outwards) even with someone assisting you with those movements?
  • Are you unable to lie on the side of your affected shoulder?
  • Did the pain run in a pattern from “pain-predominant” - where it is more painful than stiff, to "stiffness-predominant” where it is more stiff than painful?
  • Have you had an X-ray that cleared the pain of other possible diagnoses?
 UFIT Senior Physiotherapist Daniel working on restoring shoulder mobility with a client.

UFIT Senior Physiotherapist Daniel working on restoring shoulder mobility with a client.

Frozen shoulder is technically a diagnosis of elimination. If you are showing the signs and symptoms, our investigation must eliminate all other likely reasons for the frozen shoulder diagnosis to be accurate. For example, Elsa is experiencing terrible shoulder pain, and is unable to lift up her arm, rotate it out to the side, or lie on it.  But after getting an X-ray, she discovered that the pain is actually caused by a joint fracture and rotator cuff tear, with the same symptoms of a frozen shoulder.

Osteoarthritis, joint fractures, rotator cuff tears, and shoulder dislocations all produce similar signs and symptoms. So if you suspect your shoulder pain might be due to a frozen shoulder, make sure you see your doctor to rule out other possible causes.

Don’t be a snowflake, get expert advice

If you suspect you have frozen shoulder, get down to see your doctor or a physiotherapist and get it checked out. It is uncommon to require a surgical intervention, as studies have shown that conservative measures such as a graded exercise program produce the best results. However, there may be other things the doctor can recommend to ease the pain.

If you've already been diagnosed with a frozen shoulder, the best advice would be to see a physiotherapist, who will recommend an individualized rehabilitation program to guide you through the stages of your condition.

 Don't self diagnose - see an expert if you are experiencing pain!

Don't self diagnose - see an expert if you are experiencing pain!

In the meantime don’t freeze, do something about it

Learn how to manage the pain. Pain is a very complicated and multi-faceted phenomenon. Understanding how and why we feel pain will help you to deal with it.

Modify your activities. This can be as simple as switching the hand you use to reach for the seat-belt. List down all the activities that causes discomfort to your shoulder, and try to think of different ways you can modify the activity. This will save you  from a world of discomfort.

Get more pillows for the bed. If it is uncomfortable to sleep at night, prop your upper back and arm up with pillows so that you can get a better quality of rest.

Exercise. Gentle exercises such as "hanging shoulder rolls" and the "pendulum arm swing" can help to relieve the discomfort, and is also a good way to kickstart your journey to regain full range of movement.

Be patient, and pace yourself. If you try to rush and overdo the rehabilitative work, it may negatively affect your condition tomorrow. So be conscious of your abilities to avoid aggravating the pain.

About the author

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Daniel Arthur is a Senior Physiotherapist from the UK currently working at UFIT Clinic in One North. He brings over 8 years of experience working with the UK National Health Service, private health clinics and premiership sports clubs.

Instagram – Thefightingphysio

 

Beat lower back pain: an expert opinion

Lower back pain is common. Over 80% of us will suffer from it. Unfortunately, there is a long-held view that lower back pain is usually caused by something mechanical, and can only be resolved with surgery. In most cases this is not true. There are many things that you can do on your own to alleviate the pain, without having to go under the knife. Our body is a remarkable instrument that is capable of recovering on its own, given sufficient time.

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Physiotherapy and rehabilitation can help you manage and recover from lower back pain, through a mixture of mobility and strengthening exercises.

If you have been experiencing intense lower back pain regularly, manual therapy and soft tissue release can help to reduce pain and facilitate movement. It will not be an easy journey. There will be sweat (lots of it), there may be tears (I can’t promise they won't be mine!), and there will likely be setbacks. These are normal, recovery is usually not linear and pain is not predictable. But at the end of that journey, you can be satisfied that you have earned your recovery. Not only that, you will become fitter, stronger,  and better equipped with practical and effective knowledge to avert pain in future.

An MRI scan is not always necessary

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An MRI scan is useful if you are planning a surgery, as it gives the doctor a good overview of your anatomy. It is also useful if you are displaying certain neurological symptoms, such as progressive leg weakness or a loss of bowel control. Your doctor and physiotherapist will screen for these conditions, which may indicate certain pathologies. In the absence of these, your MRI is just a very expensive “selfie”. It gives little to no value in helping the doctor come up with a treatment plan, or predict how you will respond to conservative treatment.

A good physiotherapist will base your treatment on your symptoms, thoughts, feelings, response to movement, and tests results. There are also numerous studies comparing the MRI results of people who have back pain, with those who doesn't have pain. In both groups, there is a remarkable similarity in the number of people with disc bulges and other degeneration symptoms. If these conditions are present in people who are not experiencing back pain, maybe they are not the main issues that are causing the pain.

Tips for Beating the Pain

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  • Stay active. People who remain active recover more quickly. It can be as simple as including a 20-minute walk each morning and evening.
  • Change postures regularly. Your back becomes sensitised by prolonged stationary posture & awkward movements - your best posture is your next posture.
  • Do regular spine-strengthening exercises. Don’t be afraid of any particular movements, even if they don't feel comfortable right now.
  • Practice, practice, practice. The exercises may leave you feeling sore at first, but you will get better with regular practice.
  • Be patient. Sometimes the pain can get worse for no reason at all. Be proactive and optimistic about treating it, but don’t blame yourself for making it worse.
  • Stay optimistic. The more you worry about your pain, the worse it might become - your brain acts like an amplifier.
  • Make sure you are getting a good night's sleep. This might mean making adjustments to the pillows you use, or your sleep posture.
  • Get strong. Strong supporting muscles can help to alleviate back pain, and also provide a whole host of other benefits.
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About the author

Kyle Wild completed his physiotherapy training in Leeds, UK and worked briefly in the NHS before combining roles between private practice and sport. He has extensive experience in contact sports, from initial injury management to post-injury rehabilitation . His passions lie in preparing people to perform within their chosen sports, with an emphasis on performance throughout the rehab process. You have to prepare your body for the stress and strains of what you enjoy doing, especially if you don't want to end up in the clinic because of it!

Overtraining Your Kids: Too Much, Too Soon?

Over the years, school sports in Singapore are becoming more and more challenging and demanding. No longer just a social event, the competitions are now extremely competitive. Either this is because schools are putting more focus on competitive sports as a way of raising their profile, or parents are seduced by the notion of nurturing the next Olympic champion, the reality is that school kids in Singapore are training harder than ever, for longer, more intense sessions. 

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Overtraining is an issue for two reasons:

1) Burnout:

Paediatric burnout, or ‘overtraining syndrome’ is more than just being tired. It is the body's physiological and psychological response to chronic stress. This can happen when excessive demand is placed on the young athletes – either in volume (too many sessions in a week) or intensity (too much pressure to perform).

What are the signs of burnout from overtraining?

  • Fatigue: Does your child wakes up in the morning and still complains about being tired? Or do their teachers comment about them being sleepy at school?

  • Low self-esteem: Is your kid suddenly telling you that they are ‘not good’ at a particular sport, or want to drop out of the competition because it's not fun anymore?

  • Low immune system: Has your child been falling sick easily and frequently?

  • Irritability: Has your once-happy child suddenly become withdrawn and snappy with you and his coaches? This is a natural response to chronic stress.

  • Depression: In extreme cases, athletic burnout can trigger bouts of depression in kids as young as 12 if they are pressured by high expectations to perform.

2) Overuse Injuries:

At the UFIT Clinic here in Singapore, we are seeing more and more ‘overuse injuries’ in young kids. What are we referring to? Inflammation of tendons and ligaments, issues such as Osgood-Schlatters, or Sever’s syndrome, and even stress fractures in developing bones. These are most commonly seen in young athletes who participate in two or more sports. Coaches are usually aware of not overworking their athletes. However, when your child goes from session to session, and coach to coach, the cumulative effect of all that physical work can lead to a burnout, constant muscle fatigue, or worse, forcing your child to sit out of the sport due to injuries.

The Good News? Both Burnout and Overuse Injuries are entirely preventable!

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Review your child's weekly schedule for sports training, including all school-based activities (PE classes, etc). You might be surprised by the amount of time your child spends on physical activities! Ask your child if they are happy with the amount of physical training they are participating in - do they feel pressured to train? You can also consider speaking to your child’s coaches if you feel that their training schedule is too demanding. Show them your child’s physical activity schedule – they might also be surprised!

We recommend that your child should have at least one full day of rest in a week, and no more than two days a week with two scheduled training sessions. This will certainly prevent the possibility of burnout and overuse injuries. With your child happier and more relaxed, that will actually lead to better sporting performance!

About the Author

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Declan has always maintained a strong interest in sports, and has previously worked as an Academy Physiotherapist for Crystal Palace Football Club (a professional football club in London, England), He was also the Rehabilitation Coach for the Western Province Stormers Academy (a professional rugby club in Cape Town, South Africa). Within Asia, he consults for the Indonesian Athletics Association as a Performance coach and physiotherapist for their Olympic athletes and Elite Development Squad.

How to get rid of Plantar Fasciitis, the foot of all evil

Plantar Fasciitis is often a dreaded foot disease - but with persistent and consistent treatment it can be overcome! Mok Ying Rong - UFIT Clinic physiotherapist,  Nike Sponsored elite athlete, Singapore’s Half-Marathon record holder and winner of the 2017 Great Eastern Womens' Half Marathon - shares her advice on overcoming Plantar Fasciitis right here ... 

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What is plantar fasciitis?

It is a clinical condition characterised by sharp pain in the middle of the heel and along the arch area. Pain is often worse with the initial few steps after prolonged inactivity such as the first step you take in the morning. Pain gets better with some movement but increases with further loading. Pain is often worse at the end of the day.

Who gets it?

Athletes who engage in repetitive weight-bearing sports such as distance running, basketball. Weekend warriors who engage in a sudden increase in sports coming from a level of sedentary desk work throughout the week. There is also some evidence linking ageing with plantar fasciitis. People with occupations requiring prolonged standing and walking.

What contributes to the development of plantar fasciitis?

Intrinsic and extrinsic factors both play a contributing role. Intrinsic factors include arch height, hypomobility of the ankle, tight calf muscles etc. Extrinsic factors consist of factors such as inappropriate footwear, uneven ground surfaces, increased in weight-bearing activities, sudden increased in mileage and increased Body Mass Index. Alteration of ankle-foot biomechanics resulting from previous injuries and soft tissue or joint limitation can contribute to the development of PF. For example, tight calves can limit the mobility of the ankle which can subsequently result in excessive compensatory pronation, leading to a strain at the plantar fascia.

How does physiotherapy help plantar fasciitis?

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Your physiotherapist will help to manage and reduce your symptoms by utilising a variety of techniques according to your specific needs. Techniques include joint mobilisation, soft tissue releases, gait and footwear analysis. If you engage in sports such as distance running, your physiotherapist may also discuss with you on appropriate progressing of training loads. The physio will also assess for other factors that can put you at risk of symptom recurrence. Throughout the whole process, you will also need to play a part by doing the exercises that your physiotherapist will teach you.

If necessary, you will be prescribed orthotics and night splints. Orthotics can help to minimise excessive pronation which causes additional strain to the plantar fascia. Wearing a night splint at night allows the fascia to be placed in a more optimal and relaxed position.

Running and plantar fasciitis

Plantar fasciitis can be very persisting which gets increasingly difficult to treat the longer it is present. The best way to go about it is to prevent it. Try running on soft surfaces, increase your running mileage by no more than 10% per week, perform regular stretches for your calves after each run and wear the proper shoes for your foot type and gait.

Here are 3 activities to try out :

1. Assess the flexibility of your big toe

Can your big toe be raised up to an angle of 50 degrees when your knee is positioned above your foot (as in the diagram)? The flexibility of the big toe allows the ‘windlass mechanism’ to occur. This windlass mechanism is the winding of the plantar fascia to elevate the medial longitudinal arch. Without this mechanism, the foot loses its stability and the foot’s stability muscles cannot function well. The plantar fascia is then subjected to great amounts of strain.

2.    Stretch your calves

Here are two variations of calf stretches. For both variations, you can alternate between doing it with a straight knee and a bent knee. The former focuses on stretching of the gastrocnemius while the latter focuses on the soleus (the deeper of the two calf muscles).

a. Wall stretches

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b. Hang off an edge

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c. Self-mobilisation of the plantar fascia

With one hand, pull the toes of the foot back to place the fascia on a stretch. With the other hand, massage the fascia by applying gentle but firm pressure across the fascia along the arch. Do this for 5-10minutes, 2 times a day.

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About The Author

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Ying is a physiotherapist 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 started off her career as a physiotherapist in the private sector. During her period here, she found her niche in analysing and treating issues related to the running biomechanics. 

Ying is also an avid sportswoman. Ying started off as a competitive swimmer before transiting towards triathlons and finally establishing herself in the running domain. 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.

QUALIFICATIONS

  • BsC Physiotherapy (Queen Margaret University)
  • Dip Physiotherapy (Nanyang Polytechnic)
  • National Coaching Accreditation Programme (NCAP) theory level 1

Five reasons why you need an Osteopath

Hear it from Sebastien Bodet, Osteopath at the UFIT Clinic.  As a fully qualified Osteopath and former Olympic swimmer (he competed in the 2008 Beijing Olympic Games in the 4x200m freestyle relay and represented France for eight years in international competitions), Seb understands the personal needs and requirements of returning to training, competition and full function following an injury.

Osteopathy is a form of manual healthcare which recognises the important link between the structure of the body and the way it functions. Osteopaths focus on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a holistic unit.

And what does Osteopathy do?

1.     It cures pain

The most obvious benefit is the ability of Osteopaths to treat pain in a way that considers you as a person and your body as a whole. Osteopathic treatment can be used to effectively reduce and cure pain that you experience in a number of different areas of your body. You might walk into your Osteopathic clinic with a sore back and skip back out!

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Osteopathy can:

-       Remove the underlying cause of pain

-       Reduce pain and stiffness in muscles and joints

-       Increase the range of motions in the joints

-       Treat spinal problems from poor posture or spinal disk injuries

-       Relieve chronic pain through non-invasive treatment

-       Decrease the stress on the joints

-       Reduce tension in the body

-       Relieve tension headaches and migraine headaches.

2.     Reduces discomfort from chronic illness

Another obvious benefit of osteopathic treatment will be seen if you suffer from a chronic illness (such as asthma, arthritis, irritable bowel syndrome etc). Your Osteopath will be able to treat you in a way that alleviates your symptoms (even if they are unable to cure the disease itself).

This is a massive benefit if your illness causes you to have numerous symptoms that prevent you from carrying out your hobbies or reduce your quality of life.

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3.     Injury prevention

If you have just recovered from an injury or acute condition then Osteopathy can be used to reduce the likelihood of your problem reoccurring. For example, if you have just recovered from a period of knee pain, your Osteopath will be able to work to strengthen the structures that support your knee and retain the mobility in your joints. This will prevent you from injuring your knee in a similar way.

If you've never had an injury, but have a hobby or lifestyle that puts you at risk, then Osteopathic treatment could benefit you by preventing an injury. A common example of this is if you drive for long periods of time then your Osteopath will be able to treat your body in a way that prevents you from developing pain in your back (which is a common complaint of people who drive for their living).

Osteopathy can:

-       Reduce scars and adhesions

-       Treat trauma resulting from accidents (Sport injuries, Motor vehicle injuries)

-       Encourage the body to heal itself.

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4.     Pregnancy

During pregnancy your body undergoes a great amount of change and development to accommodate a growing fetus. The postural changes and increase in weight are obvious, but other changes may be more subtle like the effects of hormonal softening of ligaments and the position of the growing baby. A combination of these things can put additional pressure on your joints and muscles of your spine and pelvis.

The most common complaints that Osteopaths csn help with during pregnancy are:

-       Lower back pain

-       Sciatica

-       Pelvic girdle pain

-       Shortness of breath

-       Neck, shoulder and upper back pain

-       Insomnia

-       Swelling

-       High blood pressure

-       Fatigue.

5.     Relaxation

Osteopathic treatment will bring you added benefits as it will give you time just to think about yourself and your body. You will probably find your consultations extremely relaxing and Osteopathy is known to reduce your stress levels by increasing the efficiency of your bodies systems (such as your blood flow, nerve supply and immune system).

Osteopathy can:

-       Increase circulation

-       Reduce blood pressure.


About the author

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Sebastien Bodet is a qualified Osteopath from France and graduated with a MSc in Osteopathy from Ecole d’Osteopathie Paris. Prior to this, he obtained a BSc in Sport & Exercise Science from the University of Rouen. He is also a certified Personal Trainer and Swimming Coach.

Before relocating to Singapore, Sebastien worked as a Sports and Health Manager for a luxury Parisian spa and launched his own Osteopathy clinic in 2014.

Sebastien has a strong sports background. He is a former Olympic swimmer who competed in the 2008 Beijing Olympic Games in the 4x200m freestyle relay and represented France from 2001 to 2009 in major international competitions. He was a member of the University of Michigan Elite swimming team and to this day remains an Olympic Sports Ambassador in France.

Our first official UFIT play-date!

The UFIT Pre-Natal program has successfully helped 26 mothers-to-be prepare their bodies and minds for pregnancy. This means we've had 26 beautiful baby ‘graduates’ (no twins yet)!

Fostering a fun and supportive community is one of the most important aspects of the UFIT Pre-natal Program, and recently we had our first annual Pre-natal Graduation BBQ for all the new mums to get together to talk, share experiences, and offer advice, as well as the first ever UFIT play-date! We love seeing these new "first" friendships develop and these beautiful babies developing and growing. 

It was a highly successful day, which we are looking forward to repeating again.

Click on the photos here to see our slideshow :