UFIT Clinic

7 benefits of pre-natal Pilates

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

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

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

Is running bad for your knees?

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

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

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

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

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FACT: RUNNING IMPROVES YOUR JOINT HEALTH

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

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

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


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

1. LOADING ON AN IMBALANCED STRUCTURE

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

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

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2. OVERLOADING

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

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

3. OVERLOADING ON AN IMBALANCED STRUCTURE

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

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

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


How can Physiotherapy help prevent overloading injuries?

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

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


ABOUT THE AUTHOR

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

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

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

Age is just a number when it comes to fitness

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

  1. Foam rolling your upper and lower back.

1. Foam rolling your upper and lower back.

  2. Leg-over rotations.

2. Leg-over rotations.

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

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

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

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

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

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

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

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


About the Author

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

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

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

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

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

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

 

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

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FOLLOW THESE TIPS FOR A COMFORTABLE JOURNEY

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


ABOUT THE AUTHOR

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

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

To stretch or not to stretch?

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Before a workout, that is.

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

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

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

WHAT ARE THE DIFFERENT TYPES OF STRETCHING?  

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

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

  Photo credit: Yuri Elkaim

Photo credit: Yuri Elkaim

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

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

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

1. Improved performance

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

2. Increased flexibility

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

3. Injury Prevention

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

4. Reduction of delayed onset muscle soreness (DOMS) 

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

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

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

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

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

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

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

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

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

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


ABOUT THE AUTHOR

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

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

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

5 COMMON CYCLING INJURIES AND HOW TO PREVENT THEM

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

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

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1. LOWER BACK PAIN

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

Correction:

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


2. NECK PAIN AND HEADACHES

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

Correction:

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

3. KNEE PAIN

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

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

Correction:

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

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

4. HAND AND WRIST PAIN

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

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

Correction:

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

5. MUSCLE STRAINS AND TEARS

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

Correction:

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

WHEN SHOULD YOU SEEK PROFESSIONAL HELP?

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

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

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

Happy biking!


ABOUT THE AUTHOR

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

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

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

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

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

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

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


TOP 9 HEALTH BENEFITS OF HORSE RIDING

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

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

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

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

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

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

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

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

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

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

 Horse-riding is suitable and beneficial for all ages.

Horse-riding is suitable and beneficial for all ages.

WHAT IS PREHAB?

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

HOW PREHAB CAN IMPROVE YOUR RIDING PERFORMANCE

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

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

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

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

 

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

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

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


ABOUT THE AUTHOR

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

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

Preventing common shoulder injuries in combat sports training

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

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

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

1. SHOULDER INSTABILITY

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

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

 

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

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

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

 

2. ROTATOR CUFF DYSFUNCTION

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

Symptoms:
Rotator cuff dysfunction may present as:

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

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

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

 

3. ABNORMAL MOVEMENT OF THE SHOULDER BLADE (SCAPULA)

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

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

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

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

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

 

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

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

Foam rolling of the shoulders, concentrating the following muscles:

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

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

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

 2. Lift the dumbbell by turning your arm upwards.

2. Lift the dumbbell by turning your arm upwards.


Shoulder forward flexion with isometric external rotation

 1. Hold a resistance band around your hands.

1. Hold a resistance band around your hands.

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

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

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

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


Scapular stability + rotator cuff activation

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

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

 2. Turn your forearms upward.

2. Turn your forearms upward.

 

PHYSIOTHERAPY CAN IMPROVE YOUR SHOULDER FUNCTION IN COMBAT SPORTS

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

During your physiotherapy session, your Physiotherapist can:

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

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

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


ABOUT THE AUTHORS

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

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

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

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

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


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.

Precious new life: Getting ready for the big day

Friends Jodie and Steph share their experience of how the UFIT Pre-Natal Program kept them in great mental and physical shape throughout their labour and into the delivery room. Each Saturday over 7 weeks they and other expecting mums were guided by UFIT specialists on everything relating to pre-natal fitness, nutrition, and meditation. Here is how it helped them.

What were your favourite parts of the program?

Steph: I liked the variety of sessions. I wouldn’t have taken myself to see a nutritionist or learnt how to meditate in pregnancy if it weren’t for the program. I didn’t appreciate or understand the importance of these areas and of some of the other topics covered until learning about them.

Jodie: I also liked the variety of topics and practical components covered in the course. I didn’t know what my limits were when exercising in pregnancy so it was good to go through that and things like proper technique when lifting and doing gym exercises with Holly.

Steph: Life is so busy. I would spend 5 days of the week carrying on as normal and working hard. It was nice to take the time out every weekend to focus on my pregnancy. It was a great way to connect with the baby and to meet other like-minded individuals in their pregnancies.

Was there anything you were surprised to learn?

Jodie: I found the talks on nutrition really interesting as I hadn’t realised there were certain foods that could prevent that feeling of nausea that comes with morning sickness.

Noa provided us with some great recipes that I continue to use.

Steph: I was surprised to learn what Women’s Health Physiotherapists do both during pregnancy to alleviate pelvic pain and immediately after delivery. It was good to know the service was there if we needed it.

Jodie, you’re a second-time mum – did you still find the UFIT Prenatal Program Beneficial?

Jodie: Yes! Firstly, it was a reminder of how the body changes in pregnancy and of the postpartum recovery. Secondly, I felt this program had a very different focus compared to the Antenatal classes that I attended in my first pregnancy. Other programs focus on the delivery, breastfeeding and how to care for your baby whereas this was more about the mother and how to maintain your health and fitness throughout your pregnancy.

Steph: The UFIT Program was unique in the sense it was very holistic – it was more about how to look after yourself which in turn will help your baby.

Have you kept in contact with the other participants from the course?

Steph: Yes, we see each other fairly often for walks.

Jodie: Most of the girls have posted a photo of their newborns on our Facebook group once they’ve had the baby which has been really nice.  

Would you recommend the UFIT Prenatal Program to others?

Jodie: Definitely. It is very different from other Antenatal courses out there and it was great that it incorporated both theory as well as practical sessions in areas such as yoga and meditation.

Steph: I have already recommended it to friends who have since participated in it and loved it! The information presented was relevant and concise and the presenters are all pre and postnatal experts – I wouldn’t have had access to this information and to these presenters if I hadn’t have signed up for the course.

The UFIT Pre-Natal program is a 7 week program by UFIT's pre-natal experts who will prepare you for a safe and comfortable pregnancy and delivery, and includes:

* weekly seminars from experts in nutrition, exercise science, physiotherapy and psychology

* weekly exercise classes by our physios, yoga teachers and trainers

* a pre-natal personal training session

* a pre-natal massage session

* a meditation session

* a pelvic floor muscle assessment 

* meeting others on the same journey as you. 

 

 

 

 

Swimmer’s shoulder: Preventing and treating injuries

Did you know?

  • The average high school swimmer performs 1 to 2 million strokes annually with each arm
  • Over 1/3 of top level swimmers experience shoulder pain that prevents them from normal training
  • 90% of complaints by swimmers that bring them to the doctor and/or osteopath/physiotherapist are related to shoulder problems.

Shoulder anatomy

The shoulder complex is designed to achieve the greatest range of motion (ROM) with the most degrees of freedom of any joint system in the body.

Your shoulder is a ball and socket joint, with a rim of cartilage that goes around the socket to make it deeper and more stable. Surrounding the joint is your joint capsule, a fibrous material, with thicker parts of the capsule forming ligaments.

A number of muscles, and the tendons from these muscles run around and over your joint. The muscles that have the most effect on your joint stability are called the rotator cuff. The ‘cuff’ is made up of 4 muscles which work together to help keep your shoulder centred in the socket:

 
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What is a swimmer shoulder?

Swimmer’s shoulder is an umbrella term covering a range of painful shoulder overuse injuries that occur in swimmers. Because there are various parts of your shoulder that can be injured from your swimming stroke, your pain can be anything from a local pain near the shoulder joint, to a spreading pain that travels up your shoulder and neck or down into your arm. Being an overuse injury, it is caused by repeated trauma rather than a specific incident.

Swimmer's shoulder has the following characteristics:

  1. Inflammation of the supraspinatus and biceps tendon within the subacromial space leading to a shoulder impingement syndrome.
  2. The onset of symptoms is often associated with altered posture, glenohumeral (shoulder) joint mobility, neuromuscular control, or muscle performance
  3. Training errors such as overtraining, overloading, and especially poor stroke technique may also contribute to this condition.

Many swimmers have inherent ligamentous laxity and often will have multidirectional shoulder instability - essentially, more movement in the joint.

However, all swimmers develop muscle imbalances where the adductors and internal rotators of the arm over-develop (due to the nature of swimming). Unfortunately, this leaves a relative weakness of the external rotators and scapular stabilisers - simply because they don’t get used as much. Consequently, this muscle imbalance overuse and/or poor technique results in an anterior capsule laxity. These all culminate and allow the humeral head to move forward and up thereby, compromising the subacromial space (where the supraspinatus and biceps tendons run through) causing an irritation/impingement.

What goes wrong in swimmer’s shoulder?

The shoulder is a very mobile joint, and being so mobile, it needs to be well controlled by the muscles and ligaments that surround the joint. Over-training, fatigue, hypermobility, poor technique, weakness, tightness, previous shoulder injury or use of too large hand paddles can lead to your muscles and ligaments being overworked. If this goes on, injuries such as rotator cuff impingement and tendonitis, rotator cuff tears, bursitis, capsule and ligament damage, or cartilage damage can occur.

 

Prevention of swimmer’s shoulder

9 times out of 10, a poor stroke technique is causing shoulder pain in the first place in swimming. Correcting your technique is not actually that difficult, but you do need to know what to look out for and, just as importantly, work diligently to improve in these areas. Video analysis is a great tool for this because it really helps you identify what you personally need to work on.

 

The following 3 simple tips will ensure you avoid developing a shoulder injury from your swimming:

1. Body rotation

Developing a good, symmetrical body rotation through the development of an efficient bilateral breathing pattern is key to removing shoulder injury.

Swimming with a flat body in the water with limited rotation along the long axis of the spine causes the arms to swing around the side during the recovery phase.

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Bad body rotation

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Good body rotation

This swinging action results in large amounts of internal rotation at the shoulder joint which is the major source of impingement and rotator cuff issues. By using several key technique drills this can be easily addressed and fixed.

2. Hand placement into water

A hand pitch outwards with a thumb first entry into the water leads to excessive internal rotation which, from approx 3200 strokes per hour, can eventually lead to acute pain in the shoulder as an 'over‐use' injury. Instead of entering the thumb first, change your technique to enter with a flat hand, finger tip first

 

3. High elbow catch

Without the use of video analysis, many swimmers are unaware of how they pull through under the water. Typically swimmers will pull through with either a dropped elbow or with a very straight arm. Doing so loads the shoulder muscles excessively as the majority of the pull through phase is spent pushing down, rather than pressing back. Working to develop a ‘high elbow catch’ technique with enhanced swimming posture will really help you utilise the larger, more powerful muscle groups of your chest and upper back, rather than rely upon the shoulders.


Treatment for swimmer’s shoulder

Researchers have concluded that there are essentially 7 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence.

 

Phase 1: Pain relief & anti-inflammatory tips

As with most soft tissue injuries the initial treatment is RICE - Rest, Ice, Compression and Elevation.

In the early phase you’ll most likely be unable to fully lift your arm or sleep comfortably. You should stop doing the movement or activity that provoked the shoulder pain in the first place and avoid doing anything that causes pain in your shoulder.

You may need to wear a sling or have your shoulder taped to provide pain relief. In some cases it may mean that you need to sleep relatively upright or with pillow support.

Ice is a simple and effective modality to reduce your pain and swelling. Apply for 20-30 minutes every 2 to 4 hours during the initial phase, or when you notice that your injury is warm or hot.

Anti-inflammatory medication (if tolerated) and natural substances (eg arnica) may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.

As you improve, supportive taping will help to both support the injured soft tissue and reduce excessive swelling.

Your osteopath will utilise a range of pain relief techniques including joint mobilisations and massage to assist you during this painful phase.

 

Phase 2: Regain full Range Of Motion (ROM)

If you protect your injured rotator cuff structures appropriately the injured tissues will heal. Inflammed structures eg (tendonitis, bursitis) will settle when protected from additional damage.

Symptoms related to swimmers shoulder may take several weeks to improve. During this time it is important to create an environment that allows you to return to normal use quickly and prevent a recurrence.

It is important to lengthen and orientate your healing scar tissue via joint mobilisations, massage, shoulder muscle stretches and light active-assisted and active exercises.

Researchers have concluded that osteopathic treatment will improve your range of motion quicker and, in the long-term, improve your functional outcome.

In most cases, you will also have developed short or long-term protective tightness of your joint capsule (usually posterior) and some compensatory muscles. These structures need to be stretched to allow normal movement.

Signs that you have full soft tissue extensibility include being able to move your shoulder through a full range of motion. In the early stage, this may need to be passively (by someone else) eg your osteopath. As you improve you will be able to do this under your own muscle power.

Phase 3: Restore scapular control

Your shoulder blade (scapular) is the base of your shoulder and arm movements.

Normal shoulder blade-shoulder movement - known as scapulo-humeral rhythm is required for a pain-free and powerful shoulder function. Alteration of this movement pattern results in impingement and subsequent injury.

Researchers have identified poor scapulo-humeral rhythm as a major cause of rotator cuff impingement. Any deficiencies will be an important component of your rehabilitation. Plus, they have identified scapular stabilisation exercises as a key ingredient for a successful rehabilitation.

Phase 4: Restore normal Neck-Scapulo-Thoracic-Shoulder function

It may be difficult to comprehend, but your neck and upper back (thoracic spine) are very important in the rehabilitation of shoulder pain and injury.

Neck or spine dysfunction can not only refer pain directly to your shoulder, but it can affect a nerve’s electrical energy, causing weakness and altered movement patterns.

Plus, painful spinal structures form poor posture or injury do not provide your shoulder or scapular muscles with a solid pain-free base to act upon.

In most cases, especially chronic shoulders, some treatment directed at your neck or upper back will be required to ease your pain, improve your shoulder movement and stop the pain or injury returning.

Phase 5: Restore rotator cuff strength

It may seem odd that you don’t attempt to restore the strength of your rotator cuff until a later stage in the rehabilitation. However, if a structure is injured we need to provide nature with an opportunity to undertake primary healing before we load the structures with anti-gravity and resistance exercises.

Having said that, researchers have discovered the importance of strengthening the rotator cuff muscles with a successful rehabilitation program. These exercises need to be progressed in both load and position to accommodate for which specific rotator cuff tendons are injured and whether or not you have a secondary condition such as bursitis.

 

Phase 6: Restore technique, speed, power & agility

Swimming requires repetitive arm actions, which place enormous forces on your body (contractile and non-contractile).

In order to prevent a recurrence as you return to swimming, your osteopath will guide you with exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance.

Depending on what your training or competitive program entails, a speed, agility, technique correction and power program will be customised to prepare you for swimming-specific training.

 

Phase 7: Return to swimming

Depending on the demands of your swimming season, you will require individual exercises and a progressed training regime to enable a safe and injury-free return to swimming. 

Your osteopath will discuss your goals, time frames and training schedules with you to optimise you for a complete return to swimming.

The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.


ABOUT THE AUTHOR

 

Sebastien 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.

UFIT CLINIC

A revolution in patient recovery and rehabilitation in Singapore –  Manual Therapists, Movement Specialists, Psychologists and Nutritionists working together to help you achieve your goals.

Singapore's only clinic that combines an international team of experts from multi-disciplinary backgrounds  to ensure that your health is always at the forefront. 

Book your consultation today at www.ufitclinic.com with one of our specialists.

Benefits of Prenatal Yoga – Alana Saphin-Polchleb

I have been practicing yoga for over 12 years and have slowly transitioned from a practice focused on dynamic, sweat inducing yoga to being able to understand and appreciate the benefits of slowing down the practice and the mind. When my husband and I found out we were pregnant with our first child in August last year, the benefits of this transition really came to fruition as prenatal yoga became more than just a “yoga class”, but also a place for relaxation, mindfulness and birth preparation. 

There are many benefits of practicing yoga while you are pregnant, here are just 5; 

1. Yoga develops strength, flexibility and stamina

Pregnancy and labour is most certainly a marathon not a sprint and as your baby grows inside your belly more energy and strength is required to help carry the extra weight. Yoga helps you strengthen your hips, back, arms and shoulders. A woman who is in the best possible shape for the challenge of labour and beyond, both mentally and physically, will also most likely recover faster after the bub has arrived. 


2. Promotes emotional well being, relaxation and stress management

Through deep breathing the nervous system goes into parasympathetic mode, which promotes relaxation. Learning how to control your breath during yoga can be challenging however; this awareness and control is not only an effective tool during pregnancy to help calm and reduce anxiety, it is also a technique to help with pain management, allowing you to focus and relax during labour. 

3. Important birth muscles are toned

Prenatal yoga encourages deep toning of the pelvic floor, hip and transverse abdominal muscles.  Building and maintaining this muscle tone through out your pregnancy can not only alleviate muscle aches and pains throughout the 9 months but also facilitate a speedy postnatal recovery. 

4. Connection with your Bubba

A prenatal yoga practice at least once a week allows you to take some time out of your busy schedule to bond with your growing baby. Slowing down, breathing deeply and connecting with your baby as your pregnancy progresses allows you to focus on how your body responds differently to the changes that are happening week to week. 

5. Relief from common pregnancy complaints

A regular prenatal yoga practice can help to reduce or alleviate common pregnancy complaints such as easing heartburn, fluid retention and muscle cramps to name a few. By stretching and toning your muscles you can also help blood circulate through the body in a healthy way as well as alleviate back, neck and hip pain which is often caused by the increasing stress from the growing weight of the baby. 

You certainly don’t have to have been practicing yoga for 12 years to gain these benefits. If you have some experience in practicing yoga prior to your pregnancy, with your drs consent, you can commence prenatal practice. If you’ve had little to no yoga experience that’s also fine; following the all clear from your dr at 12 weeks. 

 

Runners: Your Missing Ingredient To Success!

Most runners run because they love running. They love getting out on the road or the track, they love the time to reset, to reflect, and they love the feeling of achievement after every run – from a competitive race to a slow jog around the park! But what if I told you that there was a way to make your running smoother and faster, to avoid running injuries,  and therefore to get more enjoyment out of it!

Running is essentially a series of one legged hops in a row. In order to improve this, you need to develop the strength and the stability of the movement. The best way to do this is to Squat.

   Air Squats

Air Squats

   Back Squats

Back Squats

There really is not a better exercise to focus on your core, hips, glutes, and leg strength. Any runner who does not squat is missing out on all the benefits this exercise brings in terms of strength and stability. It can also help to erase any muscle imbalances you have, where one side of your body is doing all the work! Start off just doing body weight squats, ensuring your knees are in line with your toes, and do not extend over your toes. If you can manage this, add a small weight like a medicine ball. Aim for a high volume of reps in order to mimic more closely the requirements of running! You will very soon start feeling the benefit in your muscles, and see the benefits in your running times!

Once you have mastered the squat you can progress to exercises on a single leg.

If you are unsure if you are doing it correctly, or if the squatting movement causes you pain, speak to a good sports trainer or physiotherapist about assessing the movement before you add weigh to it!

See your UFIT Clinic Physiotherapist to get you back to full health today!

Glutes: The Running Engine

Most runners run because they love running. They love getting out on the road or the track, they love the time to reset, to reflect, and they love the feeling of achievement after every run – from a competitive race to a slow jog around the park! But what if I told you that there was a way to make your running smoother and faster, to avoid running injuries, and therefore to get more enjoyment out of it? It’s simple: develop strength and power in your glutes! It’s free, it’s easy, and it will make a big long term difference to your health and happiness!

Running is essentially a series of one legged hops in a row. If your knee is not stable in this movement, you can cause injuries and also waste energy – very important over a long run! In order to improve this, you need to develop the strength and the stability of the movement by focusing on developing power in your glutes! See below for two exercises to introduce into your running program. Do these to become a stronger, faster runner today, and avoid injuries in your future!  

Hip Abduction:

  1. Lie on your side, with your foot in line with your hips, and both hips on top of each other.
  2. Slowly raise and lower your top leg up and down (see Photo 1), ensuring that you feel your glute muscle is activated.
  3. Repeat 20 times on on each leg, for 3 sets.

Single Leg Glute Bridge:

  1. Lie on your back with knees together, and one leg extended off the ground.
  2. Raise your bum up off the ground until there is a straight line from your knee to your hip to your shoulder. (See Photo 2).
  3. Repeat ten times on each leg, twice.

If you are unsure if you are doing it correctly, or if the movement causes you pain, speak to a good sports trainer or physiotherapist about assessing the movement! However, if you can add this in before every run you do, you will quickly find yourself running smoother, and avoiding any niggly injuries which might have been in your path!  
 

About UFIT Clinic

We are a collection of professionals from a range of different disciplines, working together to provide a multi-disciplinary approach to the treatment of our clients. 

Whilst all being experts in our own fields, we are humble enough to listen and learn, and work with each other to provide the best care for our patients. Staff professional development and further education is one of our guiding principals, and one which we are deeply committed to. Our services include; PhysiotherapyStructural IntegrationMassage TherapyMeditationPerformance PsychologyNutrition and Podiatry & Foot Care.

See your UFIT Clinic Physiotherapist to get you back to full health today!

Why should an experienced coach bring a sport psychologist into the picture?

“I know sport psychology” said the coach, the trainer, and everyone in between. We all have knowledge, experience, and thus opinions about people and what helps them to perform.

There’s no doubt that a top coach intricately understands the psychology of their sport. There are cases when an experienced coach has a stronger knowledge of the sport than the sport psychologist.  Most coaches have worked with an athlete for several years and feel they know them better than a sport psychologist ever could.

 Image taken from  businessinsider 's online page

Image taken from businessinsider's online page

So why wouldn’t you bypass the sport psychologist and take the mental skills training with your athletes into your own hands?

Here is my rationale for why working collaboratively with a sport psychologist can lead to great outcomes for you and your athletes, even if the above scenarios are true for you.

Knowing Thy Self

While getting to know an athlete and building rapport is important, a good sport psychologist is primarily concerned with helping the athlete get to know themselves.  This knowledge will form the foundation for knowing when to use certain mental skills, in their own way, in key moments.

Mentoring vs. Awareness Building

Coaches use knowledge and expertise to advise, mentor, and encourage certain habits.  This approach is perfect for facilitating the adoption of sport specific behaviours, but what about innate perceptions, personality, or motivation in an athlete that may be blocking high performance.

I hear coaches say, “I’ve repeatedly talked about this, but nothing is changing.  I just think they don’t want to change or maybe they are just not capable.”

Sometimes change requires the athlete to work from the inside out in a way that advice alone can’t initiate.  In this case, a self-awareness building approach is required.  Contrary to popular belief, sport psychologists are not advisers, we are awareness builders.  We are trained in techniques to facilitate this process in the athlete themselves, allowing a deeper self understanding of their emotions, thoughts, and actions and independently learning how the sport environment influences these things in positive and negative ways.

In this sense, the sport psychologist can be the change agent that opens the door for coaches to elevate an athletes performance to the next level.

Knowledge vs. Adaptation

There is a distinction between understanding sport psychology concepts in the general sense and creating interventions designed to accommodate the idiosyncrasies of each and every individual.  A good sport psychologist is trained to adapt a singular concept introduced in sport psychology theories and to prescribe strategies for an athlete that best suits their needs, strengths, and limitations from a psychological stand point.

Psychologist First, Passion for Sport Second

A sport psychologist is a licensed psychologist first.  We are trained at the highest level to understand and develop interventions for suboptimal human behaviours and to promote the integration of high performing behaviours. Secondly, we are passionate about sport, understand the demands of sport, and the important role the coach plays in developing an athlete’s potential.

I’ve had the most success in achieving performance gains when working collaboratively with a coach on the mental change process in an athlete.  For example, when you can combine the awareness of a golfer’s emotional and mental response, with information from the coach about their technical defaults under pressure or focus lapses, you have a recipe for shaping a powerful intervention from all angles.  A sport psychologist will incorporate an experienced coaches knowledge of the sport and the athlete.

If coaches are serious about taking their athletes to the next level or developing the full potential of the person, it’s definitely worth considering the alliance with a sport psychologist.

About the Author

Book an appointment with Dr Jay-Lee Nair at the Singapore UFIT Clinic to learn how a Mental Notes psychologist can work with you.

ABOUT UFIT CLINIC

We are a collection of professionals from a range of different disciplines, working together to provide a multi-disciplinary approach to the treatment of our clients. 

Whilst all being experts in our own fields, we are humble enough to listen and learn, and work with each other to provide the best care for our patients. Staff professional development and further education is one of our guiding principals, and one which we are deeply committed to. Our services include; PhysiotherapyStructural IntegrationMassage TherapyMeditationPerformance PsychologyNutrition and Podiatry & Foot Care.

Is Parental Pressure Always Harmful? | UFIT Performance Psychology

How much pressure is too much? Our Performance Psychologist at the UFIT Clinic delves into how far is too far. 

Tackle this head on and find ways in which you can home your pressure into a positive environment in which your child grows and prospers from.

The formula for Performance is defined as: Performance = Potential – Interference.

One of the greatest personal dilemmas that interferes with optimal performance and negates an athlete’s true potential in their sport is performance anxiety.

Last year, performance anxiety was the number one reason athletes and their parents visited my office.  This form of anxiety occurs when the athlete perceives the sport challenge as a threat and is a significant predictor of dropout in young athletes, increases the risk of injury, and is also associated with depressive episodes.  Whilst the factors that contribute to this dilemma are complex, it is the real or perceived experience of pressure that nearly always leads to this form of anxiety.

Many parents and coaches ask me if there are things they can change in their communication with their child when they learn their child is suffering performance anxiety.  Questions I frequently hear are:

“Am I placing too much pressure on my son/daughter some how?”
“Should I reduce my expectations?”
“Will it help if I back off?”

While asking such questions, it’s not uncommon for parents to express worry that their child will become lazy or complacent if they do “back off”.

What is being questioned here is the ‘intensity of involvement.'

The intensity of your involvement in your child’s sporting endeavours can actually have a positive or negative effect on your child’s sport experience depending on the nature or the content of the pressure.  Given the research results, we might naturally expect that parental pressure will have a uniformly negative effect on children’s sport experience.  However, recent research suggests this is not the case, and it is actually the focus or content of the pressure rather than its intensity that is at the heart of the issue.

The key question all parents should ask is, “what is your child being pressured to do?”

Being pressured to give maximum effort and demonstrate self-improvement may have different consequences than being pressured to outperform others, because the outcomes in question differ in degree of controllability.   When a parent is focused on self-oriented outcomes this has the effect of enhancing the athlete’s feeling of control over their performance and creates less evaluation apprehension.  This focus establishes a ‘mastery climate’ where effort, enjoyment, and learning skills is emphasised, and mistakes are viewed as opportunities to grow.  On the flip side, a ‘performance climate’ is built when parents base the criterion for success around the comparison to others, praising winning even when effort is lacking, and mistakes are viewed as unacceptable.  While the intensity level of parental pressure within these two climates might be similar, there are two vastly different forms of pressure being established and likely with it, very different effects.

Daniel O’Rourke and colleagues at the University of Washington argue that parental pressure is like a double-edged sword.  These researchers studied anxiety levels over the course of a season in 300 US youth swimmers ranging in age from 9 to 14 years.  The study found that anxiety significantly increased from the start to the end of the season in those athletes who perceived parental pressure to be high and with a ‘performance focus’.  While that’s not surprising, what is more interesting is that the study also found that athletes with the lowest levels of anxiety throughout the season perceived parental pressure to be high in intensity but with a ‘mastery climate’ focus.  The message here is that high parental pressure is not always harmful, particularly when the focus of your engagement in your child’s sporting activities directs their focus and motivation to the process of their performance.

Set the tone for performance expectations based on the demonstration of adaptive behavior such as responding well to unpredictable events including bad weather or court conditions and bouncing back from errors with positive body language and emotional control.  Focus on helping your child develop excellent pre-shot or pre-race routines that lead to professional habits and actions.   After all, there is absolutely no point in expecting a certain score or time, or ranking from your child because they have done it once before, especially when they have not established a level of discipline, conduct, or self-awareness in their sport that propels them to achieve such results consistently.

When intense focus is placed on the process of their performance, even at a young age, they learn to respect the game and learn what sport is truly all about.

ABOUT UFIT CLINIC

We are a collection of professionals from a range of different disciplines, working together to provide a multi-disciplinary approach to the treatment of our clients. 

Whilst all being experts in our own fields, we are humble enough to listen and learn, and work with each other to provide the best care for our patients. Staff professional development and further education is one of our guiding principals, and one which we are deeply committed to. Our services include; PhysiotherapyStructural IntegrationMassage TherapyMeditationPerformance PsychologyNutrition and Podiatry & Foot Care.

About the Author

Dr Jay-Lee Nair PhD | Psychologist UFIT Clinic
Book an appointment with Dr Jay-Lee at the Singapore UFIT Clinic to learn how a Mental Notes psychologist can work with you.