Sutherland physio

STRENGTH TRAINING FOR DECREASING INJURY RISK - FLOW KNOWS

Craig from Flow Physio Co Sutherland talks to us about a recent study that looked at the effects of strength training on injury risk. Read on for more.



Strength training programs as a whole reduced the likelihood of injury by 66% (Lauersen et al 2018)

A recent meta-analysis of 6 studies with a combined total of 7739 participants aged from 12-40 published in the BJSM looked at strengthening intervention on injury risk.

It was found that strength training programs as a whole reduced the likelihood of injury by 66% with 95% certainty!

It was also found that the longer programs provided the most favourable results.

The programs had an average of 8 months with zero adverse effects reported.

Strength training appears to have a direct preventative effect for injuries of the hamstrings, ACL and anterior knee pain.

Take Home Messages:

  • This study obviously indicates the benefits of implementing a strengthening program for all athletes and weekend warriors regardless of age or sport

  • Consistency over time provides the greatest benefits

  • Strength training is safe

  • Appropriate dosage and progression is important

Reference: Lauersen JB, Andersen TE, Andersen LB. Strength training as superior, dose-dependent and safe prevention of acute and overuse sports injuries: a systematic review, qualitative analysis and meta-analysis Br J Sports Med 2018;52:1557-1563.

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What is an over-active pelvic floor? Women's Health Wednesday

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This week charlotte, our women's health physio in sutherland, explains AN OVER-ACTIVE PELVIC FLOOR?

Like any muscle in the body it is important that the pelvic floor can both contract and relax.

If you think of your bicep muscle this needs to be able to contract to pick something up and relax to put something down. Imagine if the bicep was contracted all day long, it would be really hard to use your arm functionally and your bicep muscle would not work efficiently. Especially when strength is needed, the pelvic floor is the same.

Some women have pelvic floor muscles which have difficulty relaxing and remain constantly contracted. This however does NOT mean they are strong, imagine how tired they would be when you need them! 

OVER-ACTIVE ≠ STRONG

 

What are the symptoms of an over-active pelvic floor?

Symptoms will vary from person to person, but often include:

  • Pain with sex

  • Pain with using tampons

  • Pain with pap-smears

  • Pelvic or back pain

  • Difficulty emptying bladder or bowel (constipation)

  • Incontinence

  • Increased sensation of needing to urinate

 

Who is at risk of an over-active pelvic floor? 

People who tend to have a higher risk for an over-active pelvic floor include:

  • People with an overactive bladder, this is due to always needing to squeeze their pelvic floor to minimise leaking

  • Strong athletic women with strong outer core muscles

  • People with anxiety

  • Sedentary work/life style (poor posture can shorten the pelvic floor muscles)

  • Mouth/chest breathers

 

What is the treatment for an over-active pelvic floor?

Our initial treatment will always look at the way you breathe!

If you imagine your core and trunk muscles as a box, your pelvic floor is the base of your core with your transverse abdominus being the walls and your diaphragm muscle (breathing muscle) being the ceiling.

It is really important that all aspects of your core are working efficiently. If you are always breathing through your mouth, with a chest pattern of breathing the pelvic floor does not have a chance to relax.

Diaphragmatic breathing or “belly” breathing is essential as this allows the pelvic floor to descend and relax. 

 

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Can I still do pilates with an over-active pelvic floor?

Yes! However more focus should be on the strength of your muscles (not including your pelvic floor initially) therefore you should not actively contract your pelvic floor during initial pilates sessions. 

As symptoms decrease, we start to add in a graded strengthening program for you pelvic floor

WOMEN'S HEALTH PHYSIO - SAFELY RETURNING TO EXERCISE AFTER PREGNANCY

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Although a lot of women are keen to get back their pre baby routine it is really important to make this return as safe as possible.  

Whether you have had a caesarian or vaginal delivery we recommend you starting your pelvic floor exercises along with light walking as soon as you feel comfortable.

6 week check with your Women's Health Physio

At 6 weeks you will have a follow up appointment with your Obstetrician or GP, after this we recommend having a 6 week check up with a Women's Health Physiotherapist who will check the integrity of your pelvic floor. This is to make sure you can get a contraction, as some women's pelvic floor can be inhibited after birth and they can struggle to contact their pelvic floor muscles. It will also involve assessing the position of your pelvic organs to make sure there is no prolapse, checking for a abdominal separation and deep core contraction. Following this we will be able to safely prescribe a postnatal exercise program for you to begin. 

What about returning to running or high intensity exercise?

Although every woman’s body recovers differently, we still recommend waiting a minimum of 12 weeks, as well as having no incontinence issues, no pain or no prolapse symptoms before participating in any outer abdominal exercises such as sit ups or any high intensity core work that increases your intra abdominal pressure. This intra abdominal pressures directly puts strain on your pelvic floor.

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Running is another hight impact exercise that places strain through these muscles and we recommend before beginning to run that your have your pelvic floor assessed and pass a pelvic floor stress test.

The Pelvic Floor - Women's Health Physio Sutherland

How much do you know about your pelvic floor?

Recent studies have shown that 20% of women asked to contract their pelvic floor are actually contracting the wrong muscles.

Your Pelvic floor is a group of muscles and fascia which run from the front to the back of your pelvis. These muscles provide support to the bladder, uterus and bowel. 

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These muscles need to be able to cope with the growing of your uterus (and baby) during pregnancy. They also need to be able to stretch significantly during labour to allow for the birth of your baby.

Postnatally, the pelvic floor muscles need to be strong enough to be able to return to normal function of supporting your organs in daily activities and with time, strong enough to return to more strenuous activities such has running.  

Need to talk to someone about your pelvic floor? 

 

ACL INJURY - RETURNING TO SPORT WITHOUT SURGERY

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A subset of people who suffer an ACL rupture can successfully return to sport without surgery.

We refer to them as copers or responders.

How do we identify them and have a successful return to sport?

  1. Screen for suitability - this isn't for everyone
  2. Systematically rehab - progression is key
  3. Test against objective criteria with minimum standards