Hip Back & Neck Pain

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.

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.

5 lesser known benefits of massage

OK, so we are mostly aware of the obvious reasons to get a massage; relaxation, stress relief, easing muscle soreness, injury prevention and management. All of these are fantastic and very well documented ways in which massage therapy could and should be a part of our lives on a regular basis.

But as more and more people are pushing their bodies to the extremes of their limits, (UltraRunning Magazine saw a jump of 10% in participation in 2013 on the previous year) and occasionally suffering a little for it, how else can one of the oldest manual therapies in the world play its part in preparing us for the long haul? UFIT Clinic massage therapist Lynsey Keynes shares the five lesser-known benefits:


Increased range of motion

Whether you’re engaged in five UFIT bootcamps a week and not stretching out properly (naughty naughty), or whether you're stuck under a laptop all week and suffering from carpal tunnel syndrome, your muscles are getting used and abused on a daily basis. Building regular massages into your routine can help soften, open up, stretch, release and allow extra, oxygenated blood to flow into those muscles and joints enabling you to reach and push further than before.


Balance improvement

Racket sports, driving, carrying kids on one side, generally just not being ambidextrous (who actually is?), all have an effect on the shortening of our muscles, and therefore tightening on one side. In a sporting environment, achieving good balance is key, and with a good massage to realign the posture, you could be well on your way to equilibrium.


Decrease migraine frequency

Exercise can be a migraine trigger (which presents a bit of a conundrum). Massage can help relieve muscle spasms, improve circulation, enhance sleep quality and increase serotonin, all of which can play a part in preventing not just tension headaches, but vascular headaches. Any migraine sufferer knows an attack can happen any time, so begin by pre-empting the threat and having a massage once a week to keep them at bay.


Boosts immunity

Having just one massage can boost your immunity. How? Massage interacts with the hormone system and decreases levels of cortisol, the stress hormone in the body. When you’re stressed, you probably notice you get more colds, sleep less well, just don’t feel 100%. Massage manages that cortisol away, and encourages the production of white blood cells, which defend your body against illness. So no more excuses not to get out for that run!


Eases symptoms of depression

Massage releases dopamine and serotonin, eases physical pain, calms the mind, decreases anxiety, soothes tense muscles and the sheer act of touch can simply be enough to lift your spirits. So use massage therapy alongside regular exercise, to help stabilise moods and tackle those challenges whether they be physical, emotional or mental.


About the author

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Lynsey 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 decided to embrace her ultimate passion in bodywork and use her experience to help people overcome the physical and mental stresses that modern life puts upon us.

She is a passionate believer that massage and sports 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.

Moving well again with Rolfing

Muscular pain, poor mobility, bad posture - there are many ways to treat these issues. Here is how Rolfing has helped hundreds of UFIT clients move freely and comfortably again. 

Rolfing is a hands-on therapy that takes a holistic, full body approach to let you move more easily and comfortably. Through manipulation of connective tissue, Rolfers improve postural alignment and structure over the long-term. Unlike massage, which often focuses on relaxation and relief of muscle discomfort, Rolfing focuses on improving body alignment and functioning.

Also known as structural integration, Rolfing has been used by many professional athletes to rehabilitate injuries, break up scar tissue, and increase range of motion to improve performance and avoid future injuries. Dancers and musicians often use it to increase comfort in their bodies while performing, as well as avoid repetitive stress injuries.

In the UFIT Clinic, Rolfing has helped clients needing postural corrections after weight loss or pregnancy, office workers with repetitive strain from sitting too long, and others with injuries or tightness from their training.

When you first visit Maria Hussain, UFIT's Rolfing specialist, she will get you to stand while she checks your posture and how your joints are positioned. While you may go to see her with a knee issue, she will quickly seek any imbalances in other parts of the body which may cause the knee pain - such as a lack of ankle mobility - and treat that first. 

Says Maria "Walking is the most functional exercise of the body yet often we don't walk correctly which can cause postural issues, joint immobility and pain as we place pressure on other parts of the body". 

ROLFING WORKS HOLISTICally BY TREATING CONNECTIVE TISSUE

Rolfing embraces a wide range of approaches including osteopathy, chiropractic medicine, yoga and the Alexander Technique. It manipulates the body’s Myofascial system - the connective tissue (fascia) - which is the biological fabric that holds us together and enables stability of muscles and bones while allowing movement, and is crucial in high performance and central in recovery from injury.

Says Maria: "My objective is to lengthen, stretch and soften affected tissue to improve posture and bring the body’s natural structure into proper balance, alignment and integration".

Injury, stress, exercise, and work related repetitive movements can cause fascia to lose its elasticity and become shorter, tighter and denser. Tightened fascia pulls our muscles and skeleton out of proper alignment which can cause pain, discomfort and fatigue. By fascial manipulation remarkable changes in posture and structure can be achieved.

Rachel Flynn, who visited Maria for treatment after a car accident shares her experience:

"At my first appointment I was hunched over and my entire body was in a state of shock. I wasn't aware of how I was carrying myself. Maria’s knowledge of the effect of a road traffic accident on the body has been key to my recovery. She explained what was going on with the myofascial tissue, which helped me gain confidence to start moving normally again. I'm exercising again and Maria continues to assist me by identifying movements I need to get my normal gait back and minimise pain. Aside from that, Maria is such a helpful person and has been a great support on getting me the best results in recovery".

An aligned and balanced body can ease strain patterns in the entire system and improve breathing and increase energy, boost self-confidence and relieve physical and mental stress. Rolfing has also been shown to reduce spinal curvature in people with lordosis (sway back), and enhance neurological functioning.

WHO IS ROLFING FOR?

Rolfing is beneficial for everyone - for pain management, to enhance athletic performance, to facilitate injury rehabilitation and anyone who just wants to move better and feel more co-ordinated and aligned in their body.

ABOUT MARIA HUSSAIN

I’ve been been practicing bodywork for more than 10 years and I’m a qualified Structural Integration practitioner, studying with Tom Myers the author of Anatomy Trains and the founder of KMI Structural Integration, Meyers is an advanced Rolfer with more than 40 years’ experience. For more information on Rolfing visit www.anatomytrains.com/at/kmi/experience/

Maria is based at the UFIT Clinic, at both 6 Raffles Quay and one-north. 

 

 

 

Runners: Your Hips Don't Lie!

Are you a regular runner finding yourself with tedious pains after your runs?

Running, is known for high impact and stress it puts on your bones, muscles and connective tissue around the hip when taking part in this repetitive. It doesn’t matter what age you are, hip pain can occur in all runners. While it may start off mild, hip pain can become much more severe as time goes on if it is not treated properly. Therefore, it is important to take the proper precautions, reduce your training if you're experiencing running-related hip pain.

At the UFIT Clinic, one of the biggest groups of patients we see for injuries are competitive and social runners. Runners, more than most, have a single-minded devotion to their sport – heading out in rain or shine here in Singapore. Unfortunately, this devotion often leads to them “running through the pain” when they feel a niggle in their knees, or ankles. Eventually, this kind of attitude will lead to you ending up in physiotherapy with one of our therapists – and while we’re always happy to see you at the UFIT Clinic, we think you would probably prefer to be still out there jogging!

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So how do you avoid this fate? It all starts with your hips!

When you think about it, running is really just a series of single leg hops, over and over again. If you do not have sufficient strength and stability in your pelvis and hips, this is going to make this single leg hop action unsteady and not very powerful. If this is the case, it will make you both less efficient as a runner, and also more likely to injure yourself – bad news for any runner, social or competitive!

Why?

First, let’s discuss performance: running is about moving from point A to Point B in a straight line, as quickly as possible. Any deviation from this straight line in your body is a waste of energy – you are bleeding power. If your hip and pelvis aren’t stable, this leads to a ‘rolling gait’, and your knees pointing inwards instead of straight ahead – a loss of straight line power. Over the course of a long run, these incremental losses will add up to quite a big waste of your stored energy levels, leaving you with a less impressive run-time than anticipated.

The second issue is injuries. Without hip and pelvic stability, your knees and ankles will roll inwards with every step. Eventually, this will lead to overuse stress on the cartilage on one side of the knee, or your patellar tendon, resulting in a painful chronic injury, making running painful, leading to many physiotherapy appointments, and potentially leading to surgery.  

So how do I know if I have pelvic instability?

You can test yourself very simply.

1.     Single Leg Hop Test: One easy way is to hop up and down in front of a mirror, watching your knee. Does your knee stay in line with your toes, or rotate inwards? Does your upper body stay straight and stable?

2.     Wobble Lunge Test: If you have access to a wobble board, place it out in front of you about three feet away. Then, with a dowel across your shoulders (a broomstick will do), lunge forward, placing your lead foot on the wobble board. Again, are you able to keep your knees in line with your toes? Can you keep a strong, stable body position, or do you collapse to one side?

If your answer to either of these questions is ‘No’– I suggest you talk to a good personal trainer at UFIT, or a physiotherapist at the UFIT Clinic, before you commit to a regular running schedule. They should be able to assess your running and prescribe you some hip strengthening and pelvic stability exercises to ensure that you remain injury free, and also become a stronger, faster runner.

Do it for your running times, and do it for your knees!

If this sounds like you, come and see one of our Physiotherapists today – www.ufitclinic.com

About the Author

Declan Halpin has always maintained a strong sporting interest, and has previously worked as an Academy Physiotherapist for Crystal Palace Football Club (a professional football club in London, England), and as a Rehabilitation Coach for the Western Province Stormers Academy (a professional rugby club from Cape Town, South Africa). Declan is our Senior Physiotherapist at the UFIT Clinic heading up 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.