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Physiotherapy

Make use of your physio or instructor

goals

How your physiotherapist or Pilates instructor can assist you to achieve your goal.

 

Movement is a skill

We often forget that movement is a skill and that we have ‘learned’ it. Along with internal focus, external feedback is an important component of how we learn. One of the primary roles of your physio or instructor is to provide feedback. Beyond the instruction of ‘what’ to do they can often provide valuable feedback on ‘how’ to do something. An experienced physio or instructor would have accumulated hundreds if not thousands of hours studying, teaching, practising and observing movement. Why not take advantage of it?

 

One instructor vs. a variety of instructors

As a general rule, we recommend finding somebody that you connect with and have some consistency initially. The benefit is it allows a relationship to develop. The instructor will get a better idea of your body, movement and tendencies. You will get a deeper understanding of their teaching style and process. This helps reduce confusion while learning the foundations.

Once you have established a foundation (focusing on the principles) go experience other instructors and be open to their different perspectives and experience their different styles. You may find another favourite!

Pilates Principles

 

Group versus private sessions

Group settings are more economical and provide some social interaction. Private sessions allow for individual attention throughout the entire session.

Through our experience, nothing works well for ‘everybody’. In a group setting, we instruct for what works for ‘most’ people. We will try to make corrections for the individual as much as possible but by the nature of the class environment, our attention has to be divided. If you are finding you need a bit more attention a private session is a great option.

 

Some great times to consider working one-on-one with your physio or Pilates instructor would be:

– Pain*
– New to Pilates
– Specific goals
– Performance & technique

* The presence of pain especially if increased during Pilates needs to be discussed with your physio or pilates instructor.

At The Body Refinery, our physiotherapists or Pilates instructors are here to ‘guide’ you and help with technique. It is important that you combine the external feedback with your internal experience to get the most out of your Pilates. The more you understand your body, the more likely you will be able to apply this knowledge to activities and goals beyond the Pilates setting.

 

Some key ways to make good use of your physio or Pilates instructor:

– Find an instructor you connect with and have some consistency initially
– Listen to their feedback and apply it to your inward experience
– Private or small group sessions are available if more individual attention is required
– If you have a question ask!


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Recurrent calf tightness

calf tightness

Calf tightness is a very common complaint in runners and is often a recurrent issue. After stretching the calves or releasing them with massage, a trigger ball or foam roller, they may still feel tight, which can be very frustrating. A common reason this occurs is when runners spend a large amount of time trying to release tight muscles, when this time may be better spent focusing on strengthening them.

It may be hard to believe, but tight calves are usually weak. Studies have found that a high level of strength, and associated endurance, in the gastrocnemius and soleus muscles will prevent recurrent tightness.

 

Some other factors that can contribute to recurrent calf tightness:

  • Running technique: low cadence (amount of steps per minute) can lead to over-striding, and a greater impact force onto the lower limbs on landing/foot strike. An ideal cadence is said to be about 180 beats per minute. Running at the correct cadence will lead to your foot landing closer to your body’s centre of gravity. The focus should be on faster, shorter steps.
  • Foot and ankle mobility and conditioning: decreased ankle and foot mobility and foot muscle strength will lead to poor push-off or forward propulsion, reduced shock absorption and greater impact loading. The calves will have to work harder to compensate for this.
  • Decreased strength in the hip muscles and core: it is important to evaluate any deficiencies in the rest of the kinetic chain that could increase the stress on your calf muscles when you run. Decreased strength in your gluteal muscles and hamstrings, which are necessary for hip extension and help propel you off the ground, will cause you to rely more on your calves for forward propulsion. Good core control and pelvic stability are important for efficient activation of the gluteal and other lower limb muscles.

Effective management of recurrent calf tightness must include exercises to address the above factors, and not just focus on stretching and releasing the calf muscles.

 

The physiotherapists at The Body Refinery will assess your gait and running technique (Runity), to help determine the cause of your recurrent calf tightness. They will then develop a comprehensive rehab program to address the underlying factors and optimise your function and performance. Book a session with Aga or Kristen by calling 07 3358 3915.

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Written by Agnieszka Biniek

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What is Myotherapy

myotherapy

Myotherapy, or Musculoskeletal Therapy, is a method of hands-on exercise therapy to treat musculoskeletal pain and associated conditions such as:

  • Neck and shoulder pain or stiffness
  • Lower back pain and discomfort
  • Hip pain
  • Sports, stress, and work-related tightness.

 

What can I expect

Our Myotherapists have completed a Bachelor of Health Science (Myotherapy) and use varied evidence-based assessment and treatment techniques, which are tailored to each presenting condition. Our Myotherapists’ approach will typically involve an assessment, treatment and re-assessment format, where we will discuss a suggested treatment plan depending on your symptoms, as well as self-management education to ensure a successful outcome.

 

Assessment

Assessment will take a few minutes at the start of the appointment and involves a discussion – listening to your description; discussing your symptoms, as well as any injuries or surgeries that may contribute to them, and how you are affected by them. This will be followed by an assessment of how you are moving, to see where you may be restricted, experiencing discomfort, or lacking stability – this will often involve assessment of nearby joints, muscles and tissues also. Additionally, we will feel the texture and quality of the affected muscles or structures to gain a further understanding of what is causing the symptoms. Taking time to do a thorough, holistic assessment is integral for informing a quality, effective treatment.

 

myotherapy

Treatment

The aim of each myotherapy treatment is to reduce the severity and intensity of your symptoms, help you understand what is happening in your body and why these symptoms have occurred, and to get you feeling and moving better.

 

Our Myotherapists may use a variety of treatment techniques including:

  • deep tissue and pin and stretch massage
  • joint mobilisation
  • neural mobilisation such as flossing
  • trigger point therapy
  • dry needling
  • electro-stimulation dry needling
  • specific stretch techniques such as MET (Muscle Energy Technique) and PNF (Proprioceptive Neuromuscular Facilitation)
  • myofascial techniques, including cupping

 

Myotherapy can be helpful in filling the gap between remedial massage and physiotherapy. If you would like to book an appointment, please contact our friendly admin team on 07 3358 3915.

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Written by Sarah Holloway

Pilates for Neurological conditions

Neurological conditions

Neurological conditions such as Parkinson’s Disease, Multiple Sclerosis (MS), Stroke and Traumatic Brain Injury (TBI) disrupt normal neural system function and create significant challenges to movement and day to day functioning. Pilates provides an excellent environment to retrain movement and create new neural pathways.

Parkinson’s Disease and MS are both degenerative conditions, whereas stroke and traumatic brain injury occur due to an injury to the brain. For people with neurological conditions, there is a blockage in normal transmission of neural signals from the brain to the rest of the body. This can be due to the lack of a neurotransmitter (dopamine) as in Parkinson’s, problems with conduction of neural signals due to demyelination of neurons with MS or neural cell death which occurs in stroke and TBI.

Thankfully, the brain has the capacity to learn and build new neural pathways in a phenomenon called neuroplasticity. A nice way to think of it is when there is an accident on the freeway and you need to take a detour through the back streets to reach your destination. Blockages opposing normal movement may involve weakness, spasticity (heightened stretch reflex), rigidity and problems with coordination and motor planning. Treatment and exercise need to be targeted towards each symptom and in a specific order for new neural pathways to develop.

For those with neurological conditions, it is imperative to start treatment and exercise sooner rather than later. It is essential to improve function and strengthen weakened muscles to delay the progression of symptoms. Pilates provides an excellent form of exercise due to the supportive nature and the ability to challenge balance, coordination and strength.

parkinson's disease rehab Neurological conditions

How can The Body Refinery help you?

At The Body Refinery, we believe in commencing your rehabilitation as soon as a diagnosis is made. If you have Parkinson’s or MS and feel like your symptoms are very minimal and not yet giving you great difficulty, we encourage you to start your Pilates journey as early as possible to ensure you are able to keep doing what you love for as long as possible. For Stroke and TBI, the rehabilitation process does not stop once you leave hospital or outpatient rehab, it continues until you are either back to functioning at the pre-injury level or able to do the things you’d like.

All our physiotherapists at The Body Refinery undertake specific training in neurological conditions during their university study. Two of our physiotherapists Luiseach Walsh and Kristen Eales undertook further advanced Pilates training specifically for MS, Parkinson’s Disease and Stroke.

As with all conditions, no one case is the same and everyone presents with a different set of challenges and goals. We, therefore, recommend one on one sessions as well as diligence with a home exercise program set by your physiotherapist to alleviate symptoms and maintain progressions made in the studio. For more information on how The Body Refinery team can help you, please contact our reception team to book an appointment with one of our physiotherapists.

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Seeing a Women’s Health Physiotherapist after giving birth should be the norm

women’s health physiotherapist

In Australia, seeing a women’s health or pelvic floor physiotherapist isn’t a standard course of recovery. But it should be.  Most women will only see a women’s health physiotherapist if they have obvious symptoms, however, there are good reasons why all women should visit a women’s health physiotherapist at least once after giving birth.

A brief check-up with a midwife or obstetrician six weeks after giving birth isn’t sufficient for postpartum care. Generally, this type of check-up only involves a quick look at the uterus, a few quick questions on depression and how feeding is going.

Most women have some degree of pelvic floor or core muscle dysfunction after giving birth. A brief check-up typically doesn’t allow sufficient time to address all the questions surrounding any issues and the risks involved in not rehabilitating fully. Obstetricians and midwives’ main focus is on pregnancy, the birth and also recovery following the birth, however, they’re main focus doesn’t generally extend to the rehabilitation of the pelvic floor and core muscle control.

 

Childbirth and pregnancy place a huge strain on the body.  

In Pregnancy ligaments become lax, posture changes due to a shift in the centre of mass, and organs are pushed to the side by the rapidly growing uterus. Along with pregnancy, there is also the birth itself.  Regardless of the method of delivery, it involves a baby passing through a relatively small opening or layers of abdominal tissue. After the trauma that is often experienced during pregnancy and birth, returning the mother’s body to normal function and alignment is an important step.

Women place so much pressure on themselves to get back their “pre-baby body” that in many cases this goal is pursued at the expense of their own health, without any awareness of the damage they may be doing… and often under the guidance of a trainer that has no training in postnatal health. Just because a trainer has had a baby, or because a training session is called “mums and bubs” does not mean the trainer knows how to train a postnatal body. Make sure you research your trainer and ensure you have a postnatal check-up with a women’s health physiotherapy prior to exercising. An insufficient postnatal assessment followed by exercise under the guidance of an under-qualified trainer can be dangerous and has the potential to lead to long-term damage.

Your health is important, so make sure you do your research, let your health professional know of any issues you are experiencing, and don’t be afraid to ask your personal trainer, Pilates instructor or physiotherapist what qualifications or formal training they have in postnatal exercise.

Many postmenopausal women present to women’s health physiotherapist with a prolapse that has occurred because they didn’t sufficiently rehabilitate their pelvic floor and core after childbirth, or because they started running too soon after birth.  The body can remain in a postpartum state for around 30 years, so it’s not uncommon for a postmenopausal woman to experience a prolapse after picking up a grandchild or moving some furniture, because their bodies have not returned to full health after childbirth.

 

Postnatal symptoms that may be experienced include, but are not limited to:

  • pelvic pain
  • low back pain>
  • thoracic back pain
  • incontinence (urinary or faecal)
  • increased urinary frequency
  • pain during sex
  • pain sitting
  • pain walking
  • a sensation of heaviness
  • organ prolapse

 

Most of these symptoms are due to a breakdown in pelvic floor function and can be relatively easily treated. If you are postnatal, whether it has been 3 months or 40 years since you gave birth, book yourself in to see a women’s health physiotherapist or a pelvic floor physiotherapist – it could be the answer to any of the symptoms listed above, including the niggling back pain you have been putting up with for years.

Dry needling – No need for needle phobia

dry needling

Dry needling helps with managing musculoskeletal pain, functional movement and postural complaints. Myofascial pain is probably the most common condition physiotherapists see worldwide. It affects ups to 10% of the adult population and can account for acute and chronic pain complaints. Commonly myofascial pain results in trigger points, which are typically recognized by palpable nodules in taut bands of tissue. The perpetuating factors of myofascial pain syndromes are low-level musculature contraction, unaccustomed eccentric contraction, muscle overloads, and muscle fatigue.

These factors can be caused by, but not limited to:

  • mechanical dysfunctions such as forward head postures
  • joint hypermobility
  • ergonomic stressors
  • poor body mechanics
  • Scoliosis.

 

What is Myofascial?

As far back as the 16th century, myofascial pain syndromes have been recognised as causing sensory, motor and autonomic symptoms and dysfunctions. However, it wasn’t until the 1900’s that it was discovered that the origin of myofascial pain was the trigger points and that the stimulation of the trigger point referred pain. Initially, injection of an analgesic medication into the trigger points produced a decrease in a patient’s symptoms, pain, and the sensitivity to touch of the trigger points. Further research discovered that the actual insertion and stimulation of the muscle with a dry needle produced pain relief without the need for medication. Thus, the development of trigger point dry needling began.

Myofascial trigger point dry needling has no similarities with traditional acupuncture except for the tool being used during the process. Traditionally, acupuncture is based upon Chinese medicine that seeks to regulate flow and stability of energy through subcutaneous placements of needles. Acupuncture points are points mainly along the paths of energy flow (or meridians). In contrast, trigger point dry needles are inserted into specific musculature, targeting tight muscles, and based on neuromuscular and biomechanical principles.

 

The Dry Needling technique

Studies have found that inserting a dry needle into a trigger point is a very effective way to release trigger points. The theory behind the dry needling technique comes from Dr Chan Gunn, who contributed to the development of dry needling and introduced the term intramuscular stimulation (IMS), in which he described that myofascial pain syndromes are a result of radiculopathy or peripheral neuropathy, causing a disordered function of the peripheral nerve.

This concept is referred to as the radiculopathy model and is based on the Cannon and Rosenblueth’s law of denervation, which states that free flow of nerve impulses maintains innervated function and integrity of structures. When any neural flow is disrupted, all the structures that are innervated by that nerve, such as skeletal muscle, smooth muscle, spinal neurons, sympathetic ganglia, and sweat glands, are affected and can become atrophic, highly irritable, and hypersensitive. The trigger point model describes myofascial trigger points consisting of taut musculature bands due to the excessive release of acetylcholine. Myofascial trigger points are classified as active or latent.

Active myofascial trigger points can cause local and referred pain, or other parasthesias, whereas latent myofascial trigger points may not produce pain without being stimulated. Active myofascial trigger points typically refer pain to a particular site, and these sites are not restricted to a single segmental or peripheral nerve distribution. Clinically, myofascial trigger points can cause motor dysfunction or muscle weakness as a result of motor inhibition, restricted motion, and muscular stiffness. Furthermore, sensory dysfunctions may be noted through localized tenderness, referral of pain to specific areas, hyperalgesia, and/or allodynia.

 

What treatment can you get from dry needling?

The goal of dry needling is to produce a twitch response (short contraction) of the muscle being needled. The twitch of the muscle is the desired response; however, benefits can occur even without a twitch of the muscle. The simple insertion of the needle into the taut bands can interrupt the pathogenic process and produce mechanical changes in the tissue. The insertion of a needle into the trigger point can produce a deep ache or cramping pressure that lasts only briefly. Reproduction of pain and referral of symptoms may also occur, and soreness may last up to 24–48 hours. Improvements in functional range of motion, decrease in complaints of pain, and ease of mobility may be seen after treatment.

Trigger point dry needling is a relatively new technique in physiotherapy. Internationally, Australia, Belgium, Canada, Chile, Denmark, Ireland, The Netherlands, New Zealand, Norway, South Africa, Spain, Sweden, and Switzerland have recognized trigger point dry needling to be within the scope of practice for a physical therapist.

Clinically, The Body Refinery physiotherapists have found dry needling to be very effective in managing pain in both acute and chronic patients. Our Physiotherapists have also found dry needling to be highly effective in clients with movement and postural complaints. It is a quick easy way to release muscle trigger points prior to therapeutic exercises and the release is maintained well by exercise.

 

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Book an appointment with a Physiotherapist today on 07 3358 3915 or at info@thebodyrefinery.com.au

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Neck pain and Pilates: the benefits and effects on posture

Neck Pain

Neck pain is a relatively common complaint. It affects up to 70% of individuals in their lifetime. International statistics show that around 10-15% of the population has neck pain at any given time. No age group or occupation appears immune and neck pain is second only to low back pain in annual workers compensation costs in Australia. Neck pain tends to be a persistent and recurrent disorder and up to 60% of persons can expect some degree of ongoing pain for many years after their first episode. The pain intensity can range from mild to severe.

Many treatments for neck pain have been found to be ineffective for relieving acute neck pain but Pilates combined with Physiotherapy has been found to be one of the most effective treatments for acute neck pain.

 

There are several principles that underlie the Pilates  approach to neck pain:

 

  • Clinical Pilates commences early in the 
rehabilitation process, usually within the patient’s initial 
presentation
  • Pilates should not provoke neck pain
  • Pilates exercises are designed to address the specific changes 
identified in the muscle system and in sensorimotor function
  • Muscles are trained specifically and within a functional and task-specific context
  • Repetition is essential in the learning process to establish or re-establish appropriate movement and muscle control
  • Patients must understand the rationale underpinning the various components and phases of the exercise approach. Their contribution to, and compliance with, the Pilates program is critical to the learning process.

These principles are derived from the evidence of the rapidity of onset of changes in sensorimotor function, the changes in muscle activity in response to pain, the specific changes in the muscles’ properties in association with neck pain, as well as the evidence for specificity in exercise to address the often complex and various impairments that may be present in a patient’s presenting disorder.

 

Neck pain

 

The exercise program described is a staged program, which progresses through three basic phases

 

Stage 1:The first phase of the exercise program, as indicated, aims to activate and train the deep cervical and axioscapular muscles with precise exercises and to integrate their actions into their functional supporting role in an upright posture. Low-load endurance exercises are introduced to train the deep muscles in line with their functional supporting role. Stage 1 focuses on motor learning and specificity of exercise to address the impaired muscle function in those with neck pain.

Stage 2:The exercise program in stage 2 continues to have a focus on motor learning but also begins to add load in both the formal and functional exercises of this stage.

Stage 3: This phase focuses on strength and endurance training. This phase should be approached with some caution from both muscle control and symptom perspectives.

 

How we can help

 

An appropriate well-constructed exercise program is mandatory in the rehabilitation of patients with cervical disorders to assist optimal recovery as well as attempt to intervene into the transition to recurrent or chronic pain.

Clinical Pilates addresses all 3 stages of the rehabilitation exercises. Pilates principles focus on posture and body awareness so clients are able to go from rehab phase into maintenance using the same exercises.

The Body Refinery, offers physiotherapist who are highly trained in manual therapy as well as clinical Pilates making the environment ideal to manage clients with acute and chronic neck pain and whiplash related disorders.

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Book an appointment with a Physiotherapist today on 07 3358 3915 or at info@thebodyrefinery.com.au.

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What is your rehabilitation goal?

rehabilitation health

When rehabilitating from an injury, it is important to have a rehabilitation goal.

In our experience having a specific goal to work towards makes the rehabilitation, or performance, process more effective. It helps define a target for both the patient and therapist to work towards. A more specific destination, allows for a more direct path to be taken to reach it.

Along the “pain to performance pathway”, there will be moments where the relevance of a necessary treatment or exercise may not be obvious to the client. As physiotherapists and Pilates instructors, we find that understanding the client’s goal allows us to explain the rationale behind the treatment direction. Having a common understanding and open dialogue ensures that everyone is on the same page, and working towards the same goal. This results in faster rehabilitation, and a more satisfying experience for both parties.

 

What do you really want?

Goals are also important for establishing the level of ability that needs to be achieved. For example, the amount of rehabilitation following an ankle sprain will differ depending on whether the goal is daily incidental walking or competitive beach volleyball.

Beyond improving the communication between the therapist and patient, goal-setting provides something else that can be of even greater importance along the “pain to performance pathway”: intrapersonal benefits. Defining a goal and attaching meaning to that goal can be a powerful motivator. A meaningful goal can help motivate you to persist through the tough periods when the drive to continue is low.

 

Do you know SMART?

A common strategy for goal-setting involves the use of the SMART goal method. Using this method can be very helpful when setting a rehabilitation goal.

SMART goals are:

  • Specific
  • Measurable
  • Attainable
  • Relevant
  • Time-frame Oriented

(Note- the above can vary slightly)

 

The Body Refinery’s physiotherapists and Pilates instructors can be very helpful in assisting you to define a goal. However, to receive the full benefits from the rehabilitation process, it is important to remember that you need to be working toward your own goal.

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Start your journey at The Body Refinery by booking your initial appointment today on 07 3358 3915 or at info@thebodyrefinery.com.au.

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Physiotherapy tips for Fall Prevention

Neurological conditions fall prevention

Falls in older people is a common problem that can have devastating consequences for individuals and their support networks. Physiotherapists play a crucial role in the prevention of falls in older people. There is high-level evidence that appropriately prescribed exercise interventions can prevent falls.

As we age, our bodies lose muscle and bone strength. These are two of the many reasons our balance begins to decrease with age.

 

If you’ve had a fall in the past six months, your chances of falling may be increased. There are many factors that can increase the risks of falling. These include:

 

Home hazards

  • Poor footwear such as loose slippers or shoes that don’t fit properly
  • Indoor hazards such as internal steps, rugs on the floor, slippery tiles in the bathroom, inadequate lighting between the bed and the bathroom/toilet at night
  • Hazards in the garden and outside areas of the house such as outside steps which don’t have handrails or are slippery, and uneven footpaths

Sensory and balance problems

  • Muscle weakness
  • Low vision or blindness
  • Poor balance
  • Reduced sensation

Medicines

 

Chronic diseases

  • Stroke
  • Incontinence
  • Parkinson’s disease
  • Low vision or blindness
  • Dementia
  • Delirium
  • Hypotension (low blood pressure)
  • Diabetes
  • Arthritis
  • Anxiety
  • Depression
  • Osteoporosis

 

fall prevention

 

Best ways to prevent a fall

 

1. Understand your fall history

If you’ve experienced a fall in the past, then you’re at a higher risk of falling again. Knowing you’re at risk of falling helps you set strategies to help minimise the likeliness of falling in the future. Recognise risk situations and take necessary steps to avoid them.

2. Exercise on a regular basis

Balance and leg strength are very crucial to avoiding falls. Try exercises that will improve your balance and strengthen your bones. Weight-bearing exercises help improve coordination, cognition, posture, balance, joint flexibility and reaction time.
Weight-bearing exercises don’t mean lifting weights. They are any exercises that keep you standing, like walking. Go for walks in the evening to strengthen weak hips and legs.

3. Check your medications

Medications with various side effects, such as lightheadedness, dizziness, and confusion, can increase your fall risk. Talk with your doctor about your medications to know if they cause any of these side effects and take necessary steps to prevent falls after taking such medication.

4. Test your vision

When was your last eye exam? If you have any troubles with your eyesight, then have your eyes checked. People with blurry vision and weak eyesight are at higher risk of falling.

5. Reorganise your home environment

Reduce the clutter in your home or office to avoid stumbling. Add grab bars in areas where there are high risks of falling, like in the bathroom or stairways.

Final verdict

Understanding the fall risks helps you minimise the risks and helps to avoid falls.

 

men pilates

 

Falls can be fatal and should not be taken lightly. If you do fall, make sure you visit a doctor or physiotherapist and be examined, even if there are no visible injuries. Death from falls is usually not caused by the fall, but the associated problem.

Physiotherapy helps you maintain your independence with the implementation of individual, class and home exercise programs for balance, strength and falls prevention. By undergoing a falls assessment, your physiotherapist can build an appropriate strength and balance programme to reduce your risk of falls.

Strength and balance retraining is the most long-term, effective fall prevention measure that has cardiovascular, metabolic, and self-confidence benefits in addition to greater stability. Research has shown that falls can be prevented by retraining your balance and improving your muscular strength, endurance and flexibility.

Gentle strengthening, mobility and balance exercises with our Physiotherapists at The Body Refinery, will help you maintain your independence and confidence.
It is never too late to work on your muscle strength and improve your balance. If you or a member of your family are concerned about falls and/or balance, we would love to assist you.

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Book an appointment with a Physiotherapist today by calling 07 3358 3915 or visit info@thebodyrefinery.com.au

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Pilates and Low Back Pain

Pilates low back pain

Chronic Low Back Pain (LBP) is a condition that affects more than 50% of the population, with  70% of the population believed to experience an episode of LBP within their lives. Research shows that 60-80% of these patients will experience another episode of back pain within 1 year of an episode. With such a high prevalence, LBP is the second most common reason for absenteeism and for seeking medical consultation.

Through research, we now understand that after an initial onset of LBP there is a dramatic weakness, accompanied by an incorrect firing pattern in the key spinal stabiliser muscles, including the core muscles & multifidus. Importantly, without specific retraining, these muscles do not spontaneously recover. Despite the lack of pain, this ongoing weakness means the spine is not receiving sufficient support to prevent ongoing shearing forces across the disc and joints, which can result in chronic or recurrent LBP.

A common misunderstanding is that the strengthening of the superficial abdominal muscles is directly related to the deep core stabilising system. Many patients have heard of the need to perform abdominal exercises post LBP, and so begin strengthening exercises for the rectus abdominis and for the internal/external obliques. However, these strengthening exercises are not very effective in preventing LBP, compared to specific stabilising exercises involving the transversus abdominis & multifidus muscles.

 

Work on your core system

Studies have found that strengthening superficial muscles, despite not being stabilising muscles, does help to decrease pain and improve function after an episode of low back pain. However, the results were not as significant as those achieved by performing specific stabilising exercises of the core system. Core strengthening resulted in a 90% improvement in both reported pain and functional disability when using the McGill Questionnaire. The significant improvements with specific core training are explained by the fact that the two primary muscles, which are inhibited by LBP are re-activated to function correctly. As the multifidus has been found to atrophy after LBP, without specific training this muscle does not revert back to its pre-injury state, and therefore does not provide the stability required.

Patients who focus solely on exercising the larger superficial muscles still show improvements in pain and function. With a moderate contraction of the rectus abdominis and obliques, there is still an increase in intra-abdominal pressure which helps to alleviate compression forces on the disc. However, despite significant improvements in the strength of the superficial muscles, studies show that there was no change in activation of the deep core stabilising muscles. The increase in intra-abdominal pressure is a secondary stabilisation system and does not provide the micro segmental stabilisation that is delivered by the core stabilisers.

low back pain

Strengthening the superficial abdominal muscles certainly has its role in recovery from chronic LBP, however, it is necessary to first target the primary muscles that provide spinal segmental stability prior to global strengthening. Even without the superficial muscles, activation of the transversus abdominis and multifidus alone results in better outcomes for LBP patients. With correct management and guidance, patients with LBP who reactivate their core system in combination with their global stabilising muscles have a far better chance of preventing future episodes.

 

Pilates for LBP

This research clearly demonstrates the significant benefits to LBP patients that the addition of a targeted exercise program, such as Pilates, can have in retraining the deep spinal stabilisers. Pilates is designed to seamlessly progress patients into functional strengthening so that the spine is supported during everyday activities.

Can’t make it to our studio? Physiotherapist, Aga, has developed a 4-week Low Back Pain Online program in order for you to exercise everyday at home, at your own rhythm. More info on https://www.thebodyrefineryonline.com/low-back-pain-program

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Book an appointment with a Physiotherapist today by calling 07 3358 3915 or visit info@thebodyrefinery.com.au.

Can’t make it to the studio? Take your physiotherapist and Pilates Instructor with you with our 4-week online Low Back Pain program.

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