How to get back on track after injury: UFIT Clinic

An ACL rupture is one of the most dreaded injuries in sport – not only is it painful, the rehab process is long and difficult, and tests the determination of even the most committed patient.

But like with many other types of injury - it is not all doom and gloom... 

Thanks to advances in rehabilitation and improvements in surgical techniques, it's not the career-ending injury that sports people once feared. With proper guidance, patience, and a large dose of motivation, it is definitely possible to make a full and complete recovery.

Marie De Place is a perfect example of someone who overcame such a major setback, and is now stronger and fitter than ever. She had her first appointment at the UFIT Clinic in March 2016, after a skiing accident. A year later she has just done her first Olympic distance triathlon. Here she shares with us her road to recovery with senior physio Declan Halpin, and the ups and downs along the way.

Marie’s initial reaction wasn’t what you might expect:

“My first thought was ‘I'd better be skiing again soon as I just bought a nice brand new ski jacket yesterday’ (typical girl thinking I guess). My second thought was "Good news! I will not have to train for that stupid triathlon that my friends convinced me to join". My third thought was "Hey, I will finally experience going down a ski slope in a sleigh pushed by the rescue guys".

She really had no idea at that time that an ACL injury would lead to ten months of rehab before she would be able to ski again! Typical recovery from an ACL rupture can be anywhere between nine and twelve months, depending on the type of repair performed, the fitness of the patient, and how quickly their body responds to the treatment program. It is usually broken down into four phases:

1. Acute Phase - Where the focus is on reducing the pain and swelling and improving range of movement.

2. Activation Phase - Returning the knee to full range of movement, strengthening key muscles such as your hamstrings, developing knee stability with balance exercises, and introducing body weight exercises such as air squats, bear crawls and lunges.

3. Strengthening Phase -  Building strength back into the leg to make sure both sides are equally strong. This usually means picking up some weights and doing lots of squats, deadlifts, step-ups, and other lower limb exercises.

4. Power Phase - Your leg can’t just be strong – it needs to be fast and powerful as well! In this phase we get you to hop, jump, skip, and run (in a straight line). This is often when the patient feels like they are really making good progress!

5. Return to Play - The final part of the rehab process is the most fun. Lots of side to side movements, agility runs, ladder work, and jumping around on wobbly surfaces!

So how did Marie find the process?

“Long, for sure. I did not expect it to last for 10 months but, as you get back to an (almost) normal life after a couple of months, the remaining eight months were more like cherries on the cake. Boring? Sometimes, especially when ending up in the same gym every night or so. Thank god, the exercises are not always the same. Fun? Yes, some good laughs, when I was wondering whether "crab walk", "bear crawling" and other weird animals jumps or moves were real physio movements or just Declan making fun of me.” [Declan: A little bit of both Marie!]

However, she reports that you get a real sense of achievement as you slowly return to full function:

"Beyond that, there is the satisfaction to feel that you are getting better and better and you can again do stuff you couldn't the week before.”

It is not just up to the surgeon and the physio to get you better – it takes a lot of commitment and hard work from the patient themselves. As Marie says,

“Motivation and commitment are key to recovery. Fortunately, you have your physio by your side, to support you and relieve the pain when necessary. However, when it it comes to leaving the office and going to the (so boring) gym to do difficult or quite painful exercise, only you can make it work.”

Finding the right physio and physio clinic is key – after all, you are going to spend the majority of a year working together, seeing each other weekly throughout the time period! Marie felt she made the right choice: 

"At UFIT, Declan and the team have been supporting me along the recovery journey, giving me confidence I can do it, that I will recover and practice all the sports I like again. And this is not as easy as it sounds for sometimes I did not progress as fast as I expected, some other times I felt pain again and had to slow down or even go back to the previous month program. It would have been so discouraging without their support.”

Creating a supportive atmosphere is key, but Marie believes it is more than this, it also requires trust.

“I had a great experience at UFIT. Everyone, from the receptionist to the physio team is welcoming, positive and attentive to your needs. They are great professionals providing an efficient recovery plan, prescribing relevant exercises, executing targeted massage and treatment.
But they do much more: they build trust. The best technical skills are not worth much if you don't trust your physio and you don't trust yourself. When someone tells you "drop your crutches and walk to the end of the corridor", believe me, you need to trust that person to do it. Recovering from an injury is a challenge. As any challenge, it requires you to be confident that you can succeed.”

Marie’s recovery led her to committing and achieving an incredible goal:

“I have just run my first Olympic Distance triathlon. I was more motivated than ever. I trained intensively for the last 3 months, starting as soon as my recovery at UFIT ended. And believe me, I am nothing like an athlete! Yet, along my recovery journey, I learned how to strive for progress, endure long, sometimes boring exercise sessions and a reasonable amount of pain. A beneficial experience in many aspects.”

The process is definitely a two way street, and requires both the patient and the therapist to collaborate and work hard to get the best results. The UFIT Clinic Senior Physio, Declan Halpin enjoyed working with Marie,

“My job is easy when a patient like Marie comes in. From day one she was determined and motivated to succeed, and never backed down from a challenge, or said ‘No’ when I asked her for another rep or set. It is easy to see when patient’s aren’t sticking to their rehab program – their progress is slow, and they fall behind in their recovery. This was never the case with Marie, and you can see this from what she has achieved in less than a year after such a serious injury.”

Marie says there is nothing she would have changed in her rehab process, and has given the UFIT Clinic the best compliment that anyone can give – referring her friends and family to come and see the team.

I would like to recommend the UFIT physio team and especially Declan to whom I owe a lot, but be patient when trying to get an appointment as they are some of the most recommended physiotherapists across the Island (actually I am sending all my friends, husband and sons to UFIT).

Thank you Marie – congratulations on your recovery and your Triathlon, and hopefully see you soon (but not too soon)!!

If you have suffered from an ACL or other injury, or have questions about your own recovery, please do not hesitate to contact the UFIT Clinic at +65 6532 2025, or find us at www.ufitclinic.com 

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:

 
pic 2.jpg

What is swimmer’s 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 hand paddles that are too large 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.

pic 3.jpg

Bad body rotation

pic 4.jpg

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 approximately 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 helped (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.

Too scared to jump on a trampoline with your kids? Not sure when to return to exercise after having your baby?

Maybe you should see a Women’s Health and Continence Physio!

What does a women’s health and continence (WH &C) physiotherapist do?

A WH & C Physio is a physiotherapist that has done additional study at University to specialise in the areas of continence and women’s health. They can treat every day aches and pains and sports injuries but are also able to treat conditions related to pregnancy and pelvic floor muscle dysfunction.

 What does an assessment with a women’s health and continence physiotherapist involve?

Initial assessments are usually between 45 minutes and an hour long. The physiotherapist will spend most of the first session asking questions to determine the source of your symptoms. If the pelvic floor muscles need to be examined, the initial and follow up assessments may involve the use of real-time ultrasound over the lower abdomen, to providing visual biofeedback during pelvic floor muscle training.

What conditions do women’s health and continence physiotherapists treat?

WH & C physiotherapists treat a diverse range of conditions related to pregnancy and the postnatal period as well as conditions related to pelvic floor muscle deficiency in men and women at any point in their lifespan, including: 

 1. Antenatal services

  • Management of musculoskeletal complaints such as back and pelvic pain, pubic symphysis disorder and carpal tunnel syndrome
  • Advice on exercise in pregnancy
  • Pelvic floor muscle assessments.

2. Postnatal services

  • Management of musculoskeletal conditions such as back and pelvic pain and
    de Quervain’s tenosynovitis
  • Assessment and management of abdominal separation
  • Pelvic floor muscle assessments
  • Advice on return to exercise
  • Treatment of blocked milk ducts
  • Treatment of perineal pain and swelling after delivery
  • Pelvic floor muscle rehabilitation after obstetric tears
  • Assessment of altered bladder sensation.

3. Other conditions treated by a women’s health and continence physiotherapist

  • Urinary incontinence
  • Faecal incontinence
  • Constipation
  • Pelvic organ prolapse
  • Painful intercourse
  • Vaginismus
  • Provoked vestibulodynia
  • Coccyx pain.

If you would like further information on the services or if you would like to book an appointment please contact UFIT clinic.


About the author

After spending the first part of her career juggling work, athletics and travel, Kelly decided to pursue her passion for Women’s Health and completed a Graduate Certificate in Continence and Women's Health at Curtin University. Upon completion of her course, Kelly worked for a specialist Women’s and Men’s Health and Continence Clinic where she gained further experience in the assessment and management of ante-natal and post-natal conditions, incontinence, post prostatectomy complications and pelvic pain disorders. Read more

Declan “Half-rep” Halpin with Kelly Latimer

A trip down memory lane for Kelly Latimer and her time spent with Declan, Head Physio at the UFIT Clinic so far. In Kelly's words...

I first saw Declan a couple of years ago after he reached out to me via social media. He had heard of an issue I was having that was initially diagnosed by another physio as a hamstring problem and said he would like to take a look at it. As my last physio was utterly useless, I agreed. A proper diagnosis and a few weeks of treatment later, I was back up and functioning like before, if not even better. His multi-pronged approach of manipulation, massage and strengthening exercises was exactly what I needed.

It was at that point I decided to start training with Declan too. We assessed my goals and he came up with routines for me that kept me safe and helped me reach new levels of fitness. We trained to prep my body for pregnancy, so that I could train through pregnancy. I’m happy to say that I’ve managed to escape a lot of pregnancy issues like trapped nerves in my back, back aches and excessive weight gain. I couldn’t have done it without Declan’s assistance and guidance.

I wouldn’t hesitate to recommend Declan’s services to anyone. He is brilliant. Open-minded and always eager to learn more to help his patients, he’s now increasingly harder to get hold of. However I also know that he has cultivated the creme de la creme of rehabilitation specialists in Singapore (and likely South East Asia) at the UFIT Clinic, so whoever you see will be sure to get you back on the road to recovery - providing you do your exercises.

Thank you, Declan. And thank you, UFIT.


For more information about the UFIT Clinic team and how they can help you find our more by visiting the website here www.ufitclinic.com

If you're looking for specific pre and post natal services please check out the latest with what's going on in our UFIT mama's corner.

The Benefits of At Home Physiotherapy by Health Comes to You

Health Comes to You is Singapore’s premium at home physiotherapy service. We offer a full range of physiotherapy interventions, provided to you by a team of specialist male and female therapists, both locally and internationally trained.

Our team includes;

  • Orthopaedic (after surgery) physiotherapists
  • Physiotherapist trained in treating pain and injury
  • Paediatric physiotherapists
  • Neurological physiotherapists
  • Osteoporosis and Parkinson's Disease physiotherapists

Why choose at home physio? Well, many people prefer at home physiotherapy because after just one session it is possible for your therapist to fully understand your needs as an individual (yes, every patient is different!) This is because performing physiotherapy in your home environment means that your therapist can witness your problems first hand.

There are many other reasons that make at home physiotherapy a great choice, here are some of them:

1. Convenience

-        To put it simply, we do all the travel so that you don’t have to! Many of us in Singapore work very long hours and are ‘time poor’, having physio at home will certainly help free up your day and reduce the need (and stress) of making additional arrangements e.g. childcare

-        If your mobility is currently an issue (for example after surgery), this removes the problem, and the expense of getting to a clinic for treatment

 

2. Flexible appointments

-        We appreciate that you may need to see a physiotherapy outside of normal working hours, this is why we offer evening and weekend appointments at no extra cost

3. Health Insurance compatible – offering the cashless method

-        The great news is that physiotherapy at home is fully claimable under insurance. In many circumstances you won’t need to pay a cent, as the company deals directly with your insurance of your behalf

4. Personalised service

-        Physiotherapy at home is highly personal and many of our patients feel more relaxed exploring pain or discussing medical complaints at home than they do behind a curtain or in a cubicle

-        Physiotherapy at home also means that you have the freedom to explore alternative treatment modalities with your physiotherapy, such as hydrotherapy (water based rehab), gym based rehab and Pilates

-        We provide equipment to be used during the session, and will assist you to source any additional equipment that you may need e.g. foam roller

Are you ready to start physio at home in Singapore? Contact us today to arrange an initial assessment with one of our specialist physios on +65 8358 2144 or email info@healthcomestoyou.com.

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. 

 

Great Quads, But Is It Any Good For Your Feet?

All high-impact workouts put strain on your feet and ankles, but Crossfit’s and Bootcamps mix of weights, jumps, and cardio can place additional types of pressure on your feet.

These types of stresses have led to misrepresentations in the media. CrossFit has a reputation of being dangerous, with stories of sprained ankles, plantar fasciitis or stress fractures, but these tend to be rare outcomes, and there’s no research based evidence that CrossFit is any more dangerous than other forms of intensive exercise. One study found that 70% of participants had been injured at some point which sounds like a lot, but researchers estimated the rate was three injuries per 1,000 hours trained.  That’s roughly the same as you’d expect to get from gymnastics, and far safer than contact sports like rugby.

Still, there are some aspects of CrossFit which make it risky.  The emphasis on high reps and heavy weights, mean you must have a good trainer.  Many trainers have only a weekend’s training in CrossFit methods, and no expertise in biomechanics, and they may be oblivious to small mistakes in technique which can lead to big problems in the long term.  The team mentality means CrossFitters encourage each other to push past the pain barrier; which is fantastic if you’re lacking motivation, but extremely dangerous if you’re on the brink of injuring yourself.

Many people have inherent imbalances, joint limitations or they may be harbouring niggling injuries which make exercise injuries more common. Niggling injuries are easier to overlook if they are in your feet or legs. For sports people it is very easy to ignore a recurring injury if it seems small, but as with most injuries the most serious often start years before as a niggle or an ache, with appropriate screening the more serious injuries can often be prevented.

Years of sedentary living and poor posture can lead to significant muscle weaknesses, leaving people much stronger on their dominant side.  Even people who are fairly active often have muscle weaknesses that leave them out of alignment: for example, if you always carry a heavy handbag on your right shoulder then it will leave you stronger on that side of your body.  It’s also very common also have one leg slightly longer than the other

In everyday life, you’re unlikely to notice that one of your legs is a little shorter or you are suffering from ankle instability.  But once you start doing intense WODs, lifting huge weights, or running long distances, the lopsided distribution of your body weight can lead to long-term problems with your ankles and knees.  Unless you drop a barbell on your foot, most injuries are caused by problems building up over time as the strain on your body exacerbates pre-existing issues. 

Eventually, though, building muscle strength through CrossFit will leave you less injury-prone, since stronger muscles are less likely to tear.  You just have to make sure you’re pushing your body safely.  Wearing well-fitted shoes is proven to reduce your risk of injuries from exercise, but since there’s such a variety of activities in a CrossFit class it can be hard to choose the right footwear. There is a large debate currently between the two most common shoes used in CrossFit, but we will broach this another time.  As with all new sports and activities, there are some ideas about health and fitness which are widespread but not really backed up by scientific evidence.  Eating paleo is one, doing multiple sets of Olympic lifts is another. There’s a widespread idea that the best shoe for CrossFit is one with a very flexible sole and zero drop – that is, a shoe that keeps your heel exactly level with your toes.

It is important to have a new shoe for each sporting activity, and with the variation of movements and activities in CrossFit, in theory, you’d need a different type of shoe for each activity – one for cardio, one for lifts, and one for jumps. Since everybody knows how to run or jump but most people have never done clean-and-jerks before starting CrossFit, it makes sense to focus on getting a good pair of weightlifting shoes. 

Weightlifting shoes are very different running shoes.  They usually have a slight wedge shape to them, because lifting the heel slightly reduces pressure on the spine while lifting and forces the quads to take more of the weight.  The raised heel also discourages you from lifting the ankle or rolling sideways into ‘duck feet.'  

Done correctly, with good form, weightlifting actually strengthens the bones in your feet and ankles, but done incorrectly it can cause nasty chronic injuries like collapsed arches.  Women should be especially careful to wear the right shoes for lifting weights.  A study found that men tended to get more ‘typical’ weightlifting injuries, like shoulder sprains or muscle tears in the arms, while women were more vulnerable to hurting their knees and ankles.

CrossFit is great for your cardiovascular fitness, it burns hundreds of calories a session, and all those squats will give you glutes that could crack a walnut. Just make sure that you’re taking good care of your feet and ankles, or you could end up ruining all your gains by getting injured. 


About the author

Tim has been working in Singapore for 6 years, he spent 2 years at Tan Tock Seng Hospital before moving to The Foot Practice. Tim recently joined the UFIT Clinic team to help support our CrossFit Tanjong Pagar and CrossFit Bukit Timah athletes.

He has previously worked at Addenbrookes Hospital in Cambridge (UK) whilst also working under several renowned Podiatric surgeons in London. Tim has worked in Southern India, Peru and China treating a whole range of different foot types.  

He specialises in non-surgical treatment of the foot and ankle, with special interest to sports injuries and paediatric foot care. With a specialist interest in the effect of custom made orthotics and the effect on foot health. 

Hey CrossFitters and Bootcampers! Kneesy does it with those tendons…

With a rise in CrossFit and Bootcamp participation it's not uncommon for the Clinic to treat a wide range of knee conditions. Owing to the dynamic nature of these activities the stress on the knee joint can predispose one to tendon related issues in the knee, of which Patella Tendinopathy is generally the most common.

What is it?:

Jumpers knee, or Patella Tendinopathy is a clinical diagnosis of pain and dysfunction in the patella tendon. It is generally caused by repetitive high impact activities (e.g box jumps) which can result in an overload of the tendon, resulting in pain. Over time and without adequate management of the knee, the pain can become persistent and chronic. It is one of the more common conditions we see at the UFIT Clinic.

What does it look like?:

It generally presents as a specific pain at the base of the knee cap (pictured). Usually you are able to pinpoint the area of pain with one fingertip. A localised swelling may be seen during the initial painful phase, and as the condition becomes more chronic, thickening of the tendon may be noted.

 

Who Gets It?:

Generally, it is found in relatively young adults between the age of 18 and 40. Athletes who are involved in high impact jumping and landing sports (volleyball, netball, basketball), activities which place a high load on the knees (Crossfit and bootcamps) and who play sport on hard artificial surfaces may be at risk for developing Patella Tendinopathy.

How do I Test if I have it?:

The condition manifests usually after a period where training and activity have been increased (such as pre-season training). Athletes tend to have pain on the knees which usually eases with a warm up, but returns at the end of the activity. It can be especially exacerbated by jumping activities (box-jumps). If you suspect yourself of having Patella Tendinopathy, a simple test called the Singe Leg Decline Squat is very useful in determining whether or not you have Patella Tendinopathy. (pictured)

I have Patella Tendinopathy, how do I fix it?:

Patella Tendinopathy has been characterised as being a difficult condition to shift. Previously, athletes were instructed to rest a painful tendon before returning to activity. In fact, resting a tendon actually reduces its load bearing capacity and will make the situation worse.

So, if I can't rest, I can still go 100%?

Not quite. It is important that the athlete avoids any activities which will increase their pain levels. For the initial painful stages, isometric exercises have been shown to be really useful in reducing pain levels sufficiently. A Spanish Squat (picture), held for 45s x 5 reps is effective in reducing pain levels immediately. Icing of a painful tendon may have an analgesic effect, as can offload taping to help with the pain in the short term.

Once the tendon has settled, it is vital that a steady progressive strength training be commenced to improve the load bearing capacity of the tendon. Any issues which may have predisposed you to developing Patella Tendinopathy can also be addressed under the eye of a qualified physiotherapist.

5 Tips for Patella Tendon Pain:

-    Don’t ignore it: continuing through the pain will result in your quads getting weaker and will increase the load on the painful area

-    Don’t aggravate it: if your tendon is painful its your bodies warning light blinking to tell you you've done too much too soon.

-    Don’t Rest It: Commencement of early, specific rehab exercises will accelerate your return to performance

-    Ditch the knee guards: Knee guards may actually cause more issues as they can compress   the patella tendon, causing more pain.

-   Load it Up: A strong tendon is a healthy tendon. Progressive strengthening will allow you to kick this painful condition to the kerb, and allow you to maximise your potential.

ABOUT THE AUTHOR

As a musculoskeletal physiotherapist, Paul Doohan at the UFIT Clinic has a extensive experience within professional sport (Football Association of Singapore), private physiotherapy and in the public hospital sector (Singapore General Hospital). Having experienced the profession in a number of settings, Paul has developed a keen insight into what is required to help people of all ages and athletic levels. 

10 Minutes to 10 more yards!

How much money do you spend every year on trying to improve your golf game?

$500 on that new M2 driver, $300 on those comfortable new performance FootJoys, not to mention the multiple lesson packages over the course of year. Although well fitted clubs and apparel are important, and of course the input from a professional is invaluable, you are missing out one of the most important facets of your golf game. You! Constant changing of equipment in order to improve your game can be compared to the Ferrari F1 team trying new colour schemes, new uniforms for the drivers, without doing anything to improve the car itself. Put simply, having a better body will have you playing better golf.

You cant go onto social media these days without seeing videos of Rory, DJ, Jordan and Jason working out with their trainers. Funny how I just mentioned the top 4 players in the world at the minute? More and more professionals are waking up to the improvements they can make in their game with small changes in their physical fitness. If it works for finely tuned athletes like the pros, it works 10 fold for us amateurs.

Our daily routines do not prepare us for the game of golf. Most of us spend Monday to Fridays seated at a desk, at a steering wheel, or on the couch, with maybe an hour or two at the gym if we’re lucky. This lifestyle does not prepare us at all for the physical requirements of the game of golf. If we don’t turn or rotate our bodies at any time throughout the week, Saturday mornings first tee shot becomes even more of a challenge. Not to mention the closing three holes where our bodies have thrown in the towel.

Coaches all the time tell us the importance of turning, rotating, posture, weight shift etc. However, it can by nigh on impossible to avoid these flaws if your body is too stiff, weak or off balance to cope with the demands of what the coach wants you to do. Thats why at the UFIT Clinic, we assess your body to establish your physical abilities to efficiently swing a golf club. By performing our Titleist Performance Institute screening with our Golf Physiotherapist, you will get a picture of where you are lacking physically and where you need to improve.

Ok, so you've showed me what I am struggling with, how are you going to help me? Physical improvements can occur at home, in the gym, at the range, wherever you can find time. Also, don’t think you have to find hours in your busy schedules to make improvements. As little as 10 minutes at home can help you hit longer and more accurate.

Common Example

A lot of golfers struggle with their shoulder turns into the back swing, causing a lot of us to standup in the swing which means we will be club path on the downswing will be affected. A simple circuit for improving your shoulder turn in less than 10 minutes can be seen below.

Performing a bow and arrow movement. Open the chest for ten repetitions. You should feel the stretch in your shoulder, chest and mid back.

Performing a bow and arrow movement. Open the chest for ten repetitions. You should feel the stretch in your shoulder, chest and mid back.

With your hand behind your head, open your chest by raising your elbow up towards the ceiling. The stretch should be felt in the chest and upper back. Perform 10-12 repetitions.

With your hand behind your head, open your chest by raising your elbow up towards the ceiling. The stretch should be felt in the chest and upper back. Perform 10-12 repetitions.

Using a foam roller between the shoulder blades, mobilise the upper back by extending over the foam roller. Hold for two deep breathes and relax. Repeat eight repetitions.

Using a foam roller between the shoulder blades, mobilise the upper back by extending over the foam roller. Hold for two deep breathes and relax. Repeat eight repetitions.

Perform this circuit for 10 minutes twice a day, and watch your clubhead speed, club path and plane and your finish improve before your eyes!

 

ABOUT THE AUTHOR

As a musculoskeletal physiotherapist, Paul has a extensive experience within professional sport (Football Association of Singapore), private physiotherapy and in the public hospital sector (Singapore General Hospital). Having experienced the profession in a number of settings, Paul has developed a keen insight into what is required to help people of all ages and athletic levels. 

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 perfectionism in sport good? Bad? or both?

Perfectionism has been placed under the researcher’s microscope in recent years to determine whether this complex personality trait has a positive or negative influence on performance and well-being.

Some of the most controversial examples of perfectionistic individuals can be found in the world of elite sport.

When Tiger Woods won his first Major at Augusta he was the longest off the tee by more than 30 yards. He was hitting wedges & 9 irons into the par 5’s and that is when talk of Tiger proofing Augusta started. He won by a record 12 strokes and immediately began the task of transforming his swing.

Nadal.jpeg

Move to the centre court at Wimbledon and you will see the cameras fixed on Rafael Nadal’s eccentric on-court routine. In front of the chair Nadal is sitting on during breaks you will always see two water bottles (one chilled, one not). Every time play changes ends the bottles are lined up so the labels face the baseline of the side he is playing. As they are repositioned he takes a sip from both without fail.

Critics and fans alike have questioned whether these obsessive behaviors are the result of perfectionism gone awry or the secret to success. Is perfectionism, good, bad, or both?

This is the question posed by many Sport Psychologists including myself. Recent research emphasizes perfectionism as a double-edged sword.

On the bright side, perfectionism has been labelled a hallmark of Olympic champions, characterised by extremely high personal standards and an insatiable appetite for success.

On the flip side, when that drive to succeed becomes an obsessive need to avoid failure, the darker side of perfectionism can rear its ugly head.

Research has shown that an adaptive form of perfectionism is indicated by high personal standards for performance, neatness and precision, and persistent hard work and effort in one’s achievement striving. In this form, a perfectionistic individual exemplifies very similar traits to the “high achiever.”

It appears that perfectionism becomes problematic when these seemingly motivational traits coexist with a tendency to be over-self-critical and extremely rigid in one’s performance pursuits such that anything less than perfect is viewed as failure.

The combination of these traits forms maladaptive perfectionism. Unlike those exhibiting maladaptive perfectionistic traits, positive perfectionists aim high but seem to be more accepting of their limitations and limitations in their environment.

So what does perfectionism look like in the real world? We live in a society that praises perfectionistic striving and demands high standards and precision, in order to stand out from the rest. Take a closer look at your own experiences and there’s no doubt you have found yourself tied up in the perfectionism paradox at one point or another.

For some of us, a healthy dose of perfectionism has fuelled our pain-staking efforts to put out a superior product on the job, or stay behind in training countless hours to refine a change in your technique or master a new skill.

Take a look at your habits outside of sport and inside the academic zone. I am certain that as an athlete and student with the desire to reach the top, you have found yourself doing anything you could in order to avoid writing that important mid-term paper.

Not because you hate writing, but because you must produce a perfect piece, and you perceive failure before you begin typing. Instead of starting the project you organize your inbox, clean your apartment, or perhaps even dust off your running shoes.

Many of us don’t realize that procrastination is a key indication of maladaptive perfectionism. When our intentions to deliver an excellent product is confused with a mistake-free product, we are left with doubts about our adequacy to get the job done, resulting in high levels of stress and ultimately, total avoidance of the task. Sound familiar?

So then, how does one maintain the perfectionist’s edge without crossing over to the dark side? What is the secret to finding a balance? For insight into preserving the bright side of your perfectionist nature, look no further than the media releases of the world’s best athletes.

In the ramp up to the London Olympics 2012, BBC news revealed the startling demise of swimming sensation Michael Phelps during his London Olympic campaign. After winning eight gold medals, in a week-long display of invincibility at the 2008 Games, expectations for the then 23 year old “Baltimore Bullet”, rose to nothing short of sheer perfection. Without the freedom to make mistakes, Phelps instinctual move was to avoid the pool at all costs, which he did successfully for almost 2 years from 2009-2010.

Reporters declared Phelps’ come back to Olympic form a by-product of his revived competitive drive. However, when you peel back the layers of Phelps’ perfectionistic nature the truth behind his recovery is in plain sight. The 27-year-old explained, “Everything I’ve done, I’ve been able to learn from – mistakes I’ve made in the pool, mistakes I’ve made out of the pool”.

Showing signs of freedom to be less precise and less self-punitive, Phelps tweeted a month before the Olympics, “My life, my choices, my mistakes, my lessons, not your business.” “Physically it’s been painful, but we’re taking steps in the right direction.” Adaptive perfectionists are people who derive a real sense of pleasure from the labours of a painstaking effort and who feel free to be less precise.

Through the ebbs and flows in the careers of some of the world’s best athletes, we can learn the art of harnessing an adaptive style of perfectionism. The following section provides tips for preventing the dark side of perfectionism and promoting a healthy competitive mind-set for competition and adaptive habits on the range and practice green.

TIPS FOR PREVENTING THE DARK SIDE OF PERFECTIONISM AND PROMOTING HEALTHY ACHIEVEMENT STRIVING IN YOUR TOUR READY ENDEAVOURS.

DEALING WITH FEAR OF FAILURE
Individuals with negative perfectionistic tendencies are driven by a fear of failure.
Confront your fear of failure and breakdown your irrational thinking: Ask yourself: “What is the worst thing that could happen if I didn’t do everything just perfectly?”

Sit down with your coach and discuss “worse case scenarios” and positive responses for the upcoming competition, looking at undesirable situations in the preparation phase, the warm-up before the round, and on-the course.

Planning positive responses to “worse case scenarios” can help you more readily accept the limitations in yourself and your environment and recognise that there is no such thing as perfect preparation, or a perfect round of golf for that matter.

It helps you to feel more in control and ready to adapt your actions and expectations in any situation.

Fear of Failure = Procrastination and Avoidance Behaviour:

Fear of failure often leads to procrastination in training and avoidance of effort in competition to protect against experiencing intense disappointment from not achieving an error free, perfect performance. This is the behaviour associated with the “ALL OR NOTHING” MINDSET OF A PERFECTIONIST.

To prevent this type of behaviour in your own training:

  • During your pre-competition phase of training, plan regular sessions that involve stepping outside of your comfort zone without a focus on the end result but instead on “how much you can learn” This will encourage intense effort without worrying about NOT performing “perfectly.”

Reinterpret the Meaning of Errors and Mistakes

  • Remember that mistakes are inevitable so there is no need to focus on “NOT” making errors. Instead, focus on what you want to see yourself doing well.
  • Recognise mistakes as opportunities to gain feedback to make improvements.

Learn to Let Go
Players with highly negative perfectionistic tendencies often engage in obsessive thoughts about their recent performance and ruminate over mistakes. Put in place rituals that help you step away and focus on other things in their daily life.

  • Debriefing sessions at the end of training or competition with very concise take home points can stop you from repeatedly playing your last golf round over in your mind and take away a clearer, constructive evaluation.
  • Create a “symbolic” physical space/area for stepping in and out of the training environment.

Misplaced Effort is Typical
Be careful not to over-generalise the importance of competition events. Misplaced effort can lead to greater disappointment.

Learn to distinguish between life essentials and non-essentials, priority events and events simply for experience/learning. Your annual plan should clearly specify priority events, events for preparatory purposes, and new events for experience and learning (even at the elite level).

This will promote an adaptive mind-set and allow you to better manage your expectations and energy.

Create Objective Goals for Training
Maladaptive perfectionists focus on avoiding errors and performing every shot/ skill/ set perfectly, therefore these golfers:

  • Have no specific goals for training other than error free performance.
  • Often overlook positive actions in their training or competition.
  • Lose confidence quickly from even average performances.

Keep a structured training diary that specifies:

  • Specific goals for every training session and measure effort 1 – 5 on certain tasks or sets.
  • 3 things you did well and 1 thing to improve.

Aim high but set your expectations at the level you have been performing at in practice. Maintain realistic goals based on real facts about your performance standards.

High personal standards in achievement striving that coexists with these important thoughts and actions around performance, has the potential to be a “perfectly positive disposition.”

About the Author

Dr Jay-Lee Nair PhD | Performance Psychologist at the 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.

Sitting Uncomfortably? You should be.

Everyone knows we need to exercise, right? If you don’t know this, I worry for you. But the question is – do you get enough exercise? This, of course, depends on what we consider enough exercise. The American Physical Activity Guidelines (2016) ask us to do 120 minutes to 150 minutes of moderate physical activity in a seven day week. 

Reflect for a second: Do you get this done? And more importantly, is this enough

Let’s think about it in an average American’s week – say, for example, the most famous American of them all: Homer Simpson. Homer Simpson gets up every day at 7am. He sits down and has his breakfast. He then sits in his car on the way to work, where he sits for 8 to 9 hours at a computer console. He then sits back in his car for another 30 minute drive home, before sitting down for his dinner with his family, and then sitting in front of the TV for the rest of the evening. Doesn’t sound great, does it? 

Well, how about if I told you that Homer does a 60-minute walk twice a week around his neighbourhood, would that improve your opinion of his sedentary lifestyle? Sure, it is better that he does these walks, but it doesn’t take away from the huge amount of sitting and non-activity that he partakes in daily, and weekly. Here-in lies the problem! 

In the modern day world, we partake in incidental daily activity less and less. Our most popular forms of entertainment - the TV, cinema, professional sports watching, and videogames - all involve us sitting down! We sit down at home for meals, we sit down when we commute to work, and we definitely sit down at work! In fact, the average American worker sits for 8 hours a day in their work place! 

However, all this doesn’t really matter, unless sitting is bad for you. Well, let me ask you another question – is smoking bad for you? Every educated person, from the age of eight upwards, knows that smoking is harmful for your health and should not be encouraged. Now, what if I told you that sitting is as bad for your health as smoking? Shocking, right? Unfortunately, we now know this to be true: 

 

  •      Statistically speaking, prolonged sitting (7 hours or more) every day is as likely to give you cardiovascular disease, as smoking 15-20 cigarettes a day is to give you cancer. 
  •       - American Cancer Society (2013) 


More worryingly, according to the American Cancer Society, the negative effects of prolonged sitting on your health “cannot be undone by intermittent bouts of exercise.” In the same way that you cannot smoke twenty cigarettes and then go for a one mile run ‘to clear your lungs’, you cannot sit for eight hours a day, and then do a 30 minute gym session to avoid the negative impact on your health. Starting to sit uncomfortably?

So where do these findings come from? There have been a couple of big studies recently that have shed light on this ‘Sitting Disease.’ The first, in 2010, was published in the Journal of Epidemiology by Patel et al. They followed 123,000 Americans (male and female) for a period of 13 years, taking data on a whole host of subjects. Shockingly, they found that women that were sedentary for more than 6.5 hours a day, were 94% more likely to die of heart disease during the study, than those that sat for less than 3 hours. These effects were a little bit less pronounced in men, but still startling: 68% of men who sat for more than 6.5 hours a day would succumb to life ending cardiac disease than their more active counterparts. Possibly the most worrying part of these findings were that these risks were completely unrelated to how much exercise the subjects reported getting.

Another study, this time from the Brits, asked 4,560 adults to self-report their activity levels. Published in the British Journal of Sports Medicine by Chau et al. in 2013, they found that after controlling for sex, race, economic status, and activity level, prolonged sitting significantly increased a person’s risk for diabetes and heart disease. This increased risk was evident in those who sat for as little as four hours per day! 

So what exactly is it about sitting that is so bad for us? Basically, if you are sitting down right now, everything from your rib cage down has gone into ‘metabolic shutdown.’ Below your diaphragm, your muscles have stopped working. Therefore, while your heart continues working to pump the blood around your system, you are using far less blood glucose and triglycerides. Persistently high levels of these floating around your body will eventually guarantee you either heart or circulatory disease.  

Sitting uncomfortably now? Don’t worry, there are things we can do to stop the downward slide. 

The first, and most obvious solution, is to Stand Up while at work. Researchers at the University of Chester found that by standing up for three hours a day (5 days a week, at work), subjects heart rates were found to be 10 beats per minute faster than those sitting in the same time. This is an improvement of about 50 calories burned an hour, or 750 extra calories burned in your working week. Whilst this might sound like much – over the course of the year, this works out to the equivalent of running 10 marathons over the year!

If your office currently doesn’t support a standing work environment, talk to your management about it. In ten years time, it will seem archaic to have desks in a corporate environment which cannot be raised to allow office workers to stand up while working. Think of how quickly the corporate environment got rid of ‘smoking areas’ once the true cost of smoking was realised! Until then, take regular breaks from sitting, implement stand up meetings, or have a ‘walking lunch’ with colleagues. At the very least – no more sitting on the MRT! 

Good luck! Your body will thank you in the long term. 

 

About the author

Declan Halpin (written while standing – kind of)

 

Declan Halpin is a physiotherapist based in Singapore, at the UFIT Clinic. He has worked with the Singapore Rugby Union as both physiotherapist, as well as the Western Province Stormers in South Africa. He is a senior medical educator for World Rugby, and travels throughout Asia delivering courses on medical care in rugby. Recently, Declan was asked to step in for the New Zealand All Blacks as their physiotherapist at the HSBC 7s in Singapore. For more information on this topic, or help with injuries, please contact him at www.ufitclinic.com.sg or make an appointment through +65 6532 2025. 

So what does a Golf Physiotherapist actually do?

Are you an avid golfer looking to improve your game or need assistance with an injury? Find out why you might be in need of a Golf Physiotherapist to help say goodbye to those niggles and pains.

 

 

What is a ‘Golf Physiotherapist”?

Simply, a Golf Physiotherapist is a specialised in the assessment and management of injuries which are unique to golfers and the golf swing.
 

What’s different about a Golf Physiotherapist from a general Physiotherapist?

An in-depth knowledge and understanding of the game of golf! Golf as a sport poses a unique biomechanical load on the human body, and requires specific areas of flexibility and stability in order to play well and injury free.

Having trained with the Titleist Performance Institute (TPI), we utilise a system incorporating video analysis, golf specific movement screening and physiotherapy assessment techniques to identify any dysfunctions and potential causes of injury.

What does a golf Physiotherapist do?

We look at your golf swing, and we break down the golf swing to see how your body moves in each specific phase of the swing. Using this data, we can be specific on what is causing your issues and target the cause, not just the effect. After identifying these dysfunctions, targeted interventions using manual therapy, mobility work, flexibility training and strength training are implemented to getting you back to your optimal level of performance.

 

How will a Golf Physiotherapist help me?

By addressing your weakness in the gym and the clinic, you are then able to work on your strengths on the course and the range. At the UFIT Clinic, we work closely with your coach to ensure your body is capable of performing the best swing for you. If you are injured, a golf specific Physiotherapist will identify the part of your body where the dysfunction originates and work on improving both your short and long term health.

Paul Doohan talks Golf with Su Ann Heng

Paul Doohan talks Golf with Su Ann Heng

Do I have to be injured to see a Golf Physiotherapist?

No, anybody who wants to improve their golfing performance will benefit from seeing a golf physiotherapist! One of our major aims is injury prevention. If your back, neck, shoulder, wrist or elbow are giving niggling issues which are not yet stopping you playing, we can intervene to prevent a performance limiting problem from developing. Its much easier to prevent a problem than to fix a problem!

Who should see a Golf Physiotherapist?

If you are worried about any physical issue limiting your performance, if you have any pain during your golf swing, if you are finding the last 4 holes are a real struggle, or if you are looking at improving your performance and reducing your handicap, you will benefit massively from a consultation with our Golf Physiotherapist. You will be healthier, and your game will improve.

Golf specific therapists have been around for a few years on the PGA and USPGA tours, and are very popular in the United States.

Having this systematic approach to the golfers physical health and his/her swing allows a golf physiotherapist to provide the optimal care to the athlete.
 

About the 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

Paul Doohan is one of the UFIT Clinic's top Physiotherapists and specialises in Golf Physiotherapy. Possessing a certification with the Titleist Performance Institute, Paul specialises in the assessment and treatment of golfers, helping deliver effective results in injury management and prevention, as well as performance improvement.

Visit us today - www.ufitclinic.com

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.

Meditation Old School - New Cool…But what is it really? | UFIT Meditation Teacher

 While most of the thousands of meditation practices and meditative science are derived from very ancient traditions, the art of meditation has enjoyed somewhat of a revival in recent years.

Wall Street, Fortune 500 and ASX 200 chief executives, along with popular celebrities and big hitters in the scientific community are "coming out" as avid meditators. The annual ‘Mindfulness Summit’ is supported and attended by top end CEO’s and political leaders.

Times Magazine recently featured a cover story on “The Mindfulness Revolution”, an account of the extent to which mindfulness meditation has re-entered modern life and the National Institutes of Health in the US predicts that by 2017 there may be more than 27 million American adults with a recent meditation experience.

ufit-meditation

Yet despite all the wonderful buzz, renewed interest and excellent research available there are still some firmly held misconceptions about what meditation and mindfulness actually are.

I find it useful when I start my courses or workshops to explain what meditation is not first. Once the preconceived ideas and misconceptions have been dispelled, then the student is in a much better position to explore meditation fully.

So here are the top misconceptions that I come across regularly:

Meditation is not a woo woo hippy activity for the few.

Meditation and mindfulness practices are used extensively in the medical and psychological arena for treatment of chronic pain, anxiety, depression and addiction. More recently and more widely it is also used in trauma and cardiac wards with amazing regenerative results, and therapeutically in palliative care and nursing homes.

Meditation has been a critical enabler in underprivileged schools around the world. It is a common practice in law enforcement in some progressive countries like Canada and is a key element of training in the professional sports arena. Canadian Police meditating before they start their shifts.

There is a plethora of empirical evidence, studies and research now that had followed and measured the different applications of meditation and the affects regular practice yields.

Meditation is not a religion… although most spiritual frameworks involve some form of meditation as part of the process of prayer, ritual or ceremony. The changes in brain activity and activation of the enteric nervous system enable feelings of deep connection, slipping out of time, acute awareness and bliss, which many people equate to a spiritual experience. 

Meditation is not about denying you body. Your body is integral to the process, however certain meditation techniques allow you to temporarily lose your association with the body in deep states.

Meditation is not clearing the mind of all thought… if you try this you soon realise that you’re on a hiding to nothing. The mind is thought. What it is about is drawing-in the dissipated mind and calm the mind/body system. It is not simply about relaxation. In fact the hallmark of meditation is that you are acutely alert, monitoring and observing your inner environment throughout your practice.

So what is meditation…really?

When posture, breath and mental point of focus are combine effectively brainwave activity and the central nervous system become coherent and synchronised. This alters the state of consciousness to that of a witness of your internal environment – the still steady observer behind the breath and the body and the feelings. When we dwell in this state often some amazing things start to happen in our mind/body systems…we regenerate physically, we have a greater sense of wellbeing, greater empathy and connectedness.

The physical changes that start to take place with regular practice, interestingly all combine to enable deeper and deeper meditation. It’s a natural virtuous cycle, that is, the more you meditate the more your system becomes enabled to meditate.

Meditation is the technique through which mindfulness is nurtured and sustained.

So what is mindfulness then?

Mindfulness is the ability to experience day-to-day life from this viewpoint of the witness. It implies “an attitude of curiosity, openness and acceptance of, rather than reactivity to, whatever is happening. Non-reactivity doesn’t mean not responding, it just means that we don’t feel so compelled to react especially without choice and discernment.” (Meditation Association of Australia)

There are thousands of meditation practices from all around the world and many different traditions, and they generally fall into one of five categories.

  •  Concentration Meditation
  • Mindfulness Meditation
  • Reflective Meditation
  • Creative Meditation
  • Heart-Centered Meditation

All of them require presence, attention and intention and at the outset when you are learning you always start with building your ability to concentrate the mind and bring it into presence. This is key and it is absolutely possible to strengthen the power of your mind to be present and to concentrate, by regularly doing it, just like exercising the body!

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; Physiotherapy, Structural Integration, Massage Therapy, Meditation, Performance Psychology, Nutrition and Podiatry & Foot Care.

About the Author

Dani Van De Velde | Meditation Teacher, UFIT Clinic
Book an appointment with Dani Van De Velde at the Singapore UFIT Clinic to learn how The Meditation Teacher can work with you individually or your company.

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!

ufit-clinic-running-physiotherapy

 

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. 

 

Understanding the Healing Power of Rolfing - Structural Integration.

Rolfing or Structural Integration is a system of soft tissue manipulation and movement education that organises the body in gravity in order to achieve balance. 

Rolfing was created by Dr. Ida Rolf who received her PH.D in biochemistry in 1920, she then furthered her knowledge through scientific work in organic chemistry.

In creating Rolfing, Dr Rolf, applied her knowledge of science to seek answers for health and wellbeing and embraced a wide range of approaches including  Osteopathy, Chiropractic medicine , Yoga and the Alexander Technique.

Bringing together a variety of disciplines Dr Rolf discovered that she could achieve remarkable changes in posture and structure by manipulating the body’s Myofascial system, she believed that everything is connected. Eventually she named her work StructuralIntegration.

Structural Integration is a type of bodywork that focuses on the connective tissue or fascia of the body. Fascia is the biological fabric that holds us together, essential to the dance between stability and movement , and crucial in high performance and central in recovery from injury.

Fascia is designed to be elastic and move freely with muscles and bones. Injury, stress, 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.

Structural Integration at UFIT Clinic works to lengthen, stretch and soften this tissue to improve posture and bring the body’s natural structure into proper balance, alignment and integration.

Structural integration is beneficial for all types of people, Some  patients come to ease chronic back, neck and joint pain and others come hoping to improve their athletic performance or to keep in top condition to prevent or quickly recover from injuries

In general a body that is more aligned and balanced in gravity moves with more ease, fluidity, efficiency and grace.  An aligned and balanced body can improve breathing and increase energy, boost self-confidence and relieve physical and mental stress.

 

About the Author – 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/

The sessions are practiced at UFIT Clinic, 6 Raffles Quay and to find out more about Maria Hussain and her work with Structural Integration and Fascia Muscle.

All our blogs are written in conjunction with our sister site ufit.com.sg