Post Natal / Mums and Bubs Pilates Sutherland

MUMS & BUBS PILATES | Monday & Thursday, 11:15am at Flow Physio Co Sutherland

Postnatal Pilates usually begins 6 weeks after the birth of your child.

Prior to commencing classes, we offer a 6 week postpartum check where we thoroughly examine the integrity of your pelvic floor and transverse abdominus (deep core muscle). We will also check for a Diastasis Recti (abdominal separation), wound check if you have had a Caesarean and a general assessment to ensure you are safe to return to exercise.

Following the 6 week check we recommend joining the Mums and Bubs Pilates class. This class has a maximum capacity of 2 people which allows room for you to bring your baby and allows the Physiotherapist to monitor you more closely. 

This session will be 50 minutes.

FLOW KNOWS - Hamstring Injuries

This week we have seen Newcastle Knights rookie sensation, Kalyn Ponga ruled out of State of Origin 3 with a reported grade 1 lateral hamstring strain suffered against Canterbury over the weekend.

Backing up from a huge performance in Origin 2, Ponga sustained a somewhat innocuous injury early in the first half against the Bulldogs. 

When do hamstring injuries occur?

Hamstring muscle injuries are a common injury in sports that involve high-speed running and kicking. 

The biomechanics of hamstring injury

During maximal sprinting, the hamstrings work to decelerate the swinging shin bone and control the straightening of the knee. They then work as the foot hits the ground to help extend the hip.

Most hamstring injuries occur at the end of the swing phase when sprinting.

As was reported this week with Kalyn Ponga's injury - we usually see these injuries occur at the muscle-tendon junction of the outside hamstring muscle (biceps femoris).

Kalyn Ponga made 10x his season average for tackles per game in State of Origin 2

Some interesting stats out of Ponga's Origin performance came in his tackles made. Playing in the front-line, Ponga made a total of 29 tackles, approximately 43% of his total tackles made in 24 appearances for the Knights this year (68 tackles). 

How much has this spike in workload contributed to Ponga's hamstring injury? I would love more data, however what we have seen from his Origin performance is a spike in acute workloads comparative to his chronic workloads at fullback.

Acute workload increases >1.5x = increased injury risk

We know from the work done by Tim Gabbett that acute workload spikes that exceed 1.5x chronic workloads (preceding 3-6 weeks) leads to an increased soft tissue injury risk in the following weeks. 

Unfortunately, in Kalyn Ponga’s case, we have seen him sustain a grade 1 lateral hamstring strain and will likely miss 3-4 weeks of football, including State of Origin 3  

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

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.

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.

Pelvic Organ Prolapse - Women’s Health Physio

Pelvic Organ Prolapse

Did you know? 

One in two women who have had a baby will experience prolapse at some stage in their life, that’s why it is so important to have an understanding of what it is and the symptoms experienced with prolapse.

What is pelvic organ prolapse? 

Pelvic organ prolapse is when one or more of the pelvic organs (bladder, uterus and bowel) slip down into the vagina causing a bulge or a heavy dragging feeling. Prolapse happens due to damage of the support structures of the pelvic floor including muscles, fascia or ligaments.

What are the symptoms?

Symptoms of prolapse include:

• Sensation or heaviness/dragging/buldge in the vagina

• Incomplete emptying of your bladder/bowels

• Discomfort in the lower abdomen

• Recurrent urinary tract infections

• Sexual discomfort

• Incontinence

 

Prevention and management strategies

The good news is there is lots that can be done to prevent or manage prolapse. The pelvic floor acts as a sling supporting the pelvic organs, therefore pelvic floor strength training is one of the treatment options that can prevent or help alleviate symptoms of prolapse. 

FLOW KNOWS - Syndesmosis injury - High ankle sprains

This week, Flow Knows dives into high ankle sprains or syndesmosis injuries.

There has been media coverage this week around Dylan Napa and his race against the clock to prove his fitness for Origin 2 on Sunday night.

The tibiofibular syndesmosis consists of the ligaments and interosseous membrane that maintain the joint at the bottom of the shin bone, above the ankle joint (high ankle).

The syndesmosis plays an important role in dynamic ankle function and is often injured in a planted, rotating foot/ankle. We tend to see this in contact sports like rugby league where the foot is planted as the player gets tackled.

As the knee goes over the foot, the tibia and fibula separate to accomodate the ankle joint. With intact ligaments and membrane this is controlled and limited. In the case of an injury to these ligaments, this separation can cause pain and dysfunction with ankle movements and weight-bearing.

When a suspected high ankle sprain presents we send you off for x-rays to determine if there is any widening of the distal tibiofibular joint and if referral to an orthopaedic surgeon is required.

If there is no widening, treatment consists of a strength, mobility and proprioception program to restore full function.

Severe injuries usually present with concomitant injuries like fractures and if there is a widening of the joint on weight-bearing x-rays, a surgical review is required.