There are a lots of ways to keep your body moving while your back is fully supported

Back pain itself can be caused by a range of conditions. Mechanical causes are by far the most common and include disc issues, muscular spasm, and vertebral joint problems. They are often precipitated by poor biomechanics, such as those affected by years of bad posture and weak stabilising muscles. Back pain can also be caused by trauma, scoliosis, inflammatory arthritis, or pregnancy, just to name a few. There are some rare but quite serious causes and complications of back pain, so if you experience any of these, make sure you see your doctor early: numbness or tingling down your legs, numbness around your anus, severe pain that does not improve with rest, pain after a fall or injury, bladder or bowel trouble, weakness in one or both legs, fever, unintentional weight loss, or night pain.

In acute, non-specific low back pain, the most important thing is try and keep active and do normal activities as much as possible. Often in order to achieve this, you will need to get in control of your pain first. This might mean seeing your General Practitioner to get some help with pain relief, or it might mean using some simple pain medication from the pharmacy. The important thing is DO NOT REST IN BED for days on end. Gentle mobilisation is vital from the beginning. And if the pain is so bad you can’t move – see your doctor. When you do need to rest in those early days, do so for short periods of time and rest well. This means not sitting down for hours on end, but often lying down in a position that works for you with pillows to support your knees or side.

There is no evidence to support one particular exercise or activity to improve back pain, but we do know that gentle mobilisation is crucial to recovery. So go for a slow walk, do a couple of very gentle, low range stretches or try walking in water. Whatever you do, just keep it low intensity, and focus on simply moving. As your pain improves, and you start moving better, you can start building your activity up again, but don’t go overboard! This is not the time to be jumping straight back into your high intensity gym session. In general, exercise will not aggravate or worsen you injury or back pain. If you feel like your back pain is a little worse the next day, it might be a sign that you need to back off the intensity the next day or so, but it is highly unlikely you have extended the injury provided that you are starting low and going slow.

If you struggle to lie down there are always alternatives

There is little evidence to support any specific complementary treatments for acute back pain, although things like massage or osteopathy might help in the early days with pain and function. After that nothing is really any better than simple exercise. If there is something you want to try and you are sure it won’t do any harm, you can make your own choices. There is also little evidence for any radiological imaging in acute back pain, so if you see your GP and they don’t send you off for an X-ray, CT or MRI straight away, they are actually showing very appropriate management. If pain isn’t improving in the way we would expect it, or any of those ‘red flag’ symptoms listed above are present, we might consider early imaging, but more often than not, it’s not needed.

There are ways you can work on your core strength and still protect your back.

It is a great idea to work with someone once you are out of that really acute (first 72 hour period), to find out about any poor biomechanics and explore how you might be able to prevent any further episodes. Often this is best done with a physiotherapist, as they are well placed to do a full biomechanical assessment and then give you a specifically targeted program to manage any individual issues. From there you can get back in to exercise, but don’t overdo it! Time and again, I’ve seen people get straight back in to the gym, often lifting heavy weights, or trying to get straight back into HIIT or Metafit or boot-camps or step classes….your back is still vulnerable! And until you work out if there is something specific you need to work on (weak abdominal muscles, unilateral tight buttock muscles, poor posture etc), you are setting yourself up for re-injury. And just a little note – whilst ‘core’ is important to posture and back stabilisation, it is all about function. Doing a hundred crunches a day or holding plank for 2 minutes might give you a six-pack, or a nice rigid ‘rack’ but they aren’t going to give you a healthy, strong, flexible and functional core and they might just set you up for a back injury. Find a health provider or fitness instructor that understands how to help you do exercise safely with a focus on function, not just on looks. And remember, if you aren’t getting on top of your back pain in the way we would expect, see a health professional.

When we are younger there are lots of activities that can impact on anyone’s pelvic floor: constipation, chronic coughing, always holding your breath. Basically anytime you increase the pressure in your abdominal cavity by bearing down you can impact your pelvic floor. Certain sports also have an impact; trampolining, horse riding and gymnastics to name a few. Many of these sports create a very strong pelvic floor but it is constantly turned on. Any muscle that is over active is not a functional muscle, and with pelvic floor, non-functioning can lead to leaking urine.

One thing that is inevitable in a woman’s life is menopause. When we head into menopause our hormone levels change. Oestrogen is a female defining hormone, it gives us our breasts, periods, and our waisted shape (this is why our waist thickens after menopause) and it affects how muscles contract and heal. The change in oestrogen affects the pelvic floor in two ways:

1. Your pelvic floor does not contract or heal as well, and
2. Your pelvic floor can atrophy (waste) by up to 1% a year post menopause.

So with your pelvic floor getting thinner and not contracting as well you are leaving yourself open to leaking urine.  If you do not work it, you will loose it!

My biggest bit of advice on pelvic floor health is ‘prevention is better than cure.’ As much as this all sounds very grim there is a simple solution – look after your pelvic floor. Start doing pelvic floor exercises! It does not take much time, but it can have a huge impact on your future life as well as your current one. Did you know that some studies have suggested that pelvic floor muscle strength may be related to increased sensation and sexual satisfaction? So why ignore your pelvic floor? Take control and make it work for you.

For instructions on how to work your pelvic floor head over to WHEN (www.when.org.au) and download your free information sheet on how to preform pelvic floor exercises.

One of our pelvic floor workshops setup to go.

Hopefully you will be able to stay health and well this winter but just in case here are a few ways you can protect your pelvic floor:

1. Make sure you are doing regular pelvic floor work, even when you don’t have a cough! If you need a reminder about the best exercises to do  you might consider attending one of our monthly Pelvic Floor 101 workshops.
2. Support your pelvic floor through a cough. You can cross your legs and squeeze your inner thighs together to do this.

The stronger your pelvic floor is at the beginning of a cold the better it will be afterwards too!

First port of call is to stretch your glutes and hamstrings. If these muscles are tight it will pull on your lower back. These stretches are really easy to do at home and you don’t need any special equipment!
Even if you do not experience back pain these exercises are a great preventative measure.
If you don’t feel any relief from these stretches please see your general practitioner or allied health professional for further assessment!

Stretch 1

Sit up straight in your chair and place the foot of one leg over the knee of your other leg. Gently press down to get a stretch through your leg. Swap to the other leg and repeat

Stretch 2

Sit up straight in your chair and put one leg on an object slightly lower than your chair, a rubbish bin is ideal! You can lean forward into this for an extra stretch!

Recently we have had quite a few clients twisting ankles. We have done the normal rehab and they have returned to running only to twist their ankle again!

It made me think about some ballet exercises for strengthening feet and ankles I was given when I first trained by an amazing woman Margo Islop, who is a retired ballerina.
So far we have been using these exercises on runners, it’s great to be able to source different techniques from all sorts of fields then apply them to any client who will benefit from it. After we had success with this routine a few of our young dancers started asking about them, so we thought we would put the routine up on the blog so everyone could access it.

Jane’s daughter Lily loves to dance and is determined to build up enough strength to go “en pointe” one day. We thought she would be the perfect dancer to apply this to!

Here she is with a sequence of the foot and ankle strengthening exercises that can be performed anywhere with a theraband!

Lily looks amazing performing these exercises, they are great for dances but they are very diverse and can be used on runners, the elderly any client who needs to build foot and ankle strength.

Loop the band around your big toe. Flex the toe against the band. Then slowly extend the big toe, gently pulling backwards with the band.

Loop the band around the second and third toes, flex and extend the toes.

Loop the band around the fourth and fifth toes. Gently extend and flex the toes.

Place the band around the foot lengthwise, under and across the heels and toes. Flex and extend all toes against the band.

With the band still lengthwise around the foot gently rock your pelvis forward and lean towards your foot as you point the foot.

Huge thanks to our budding ballerina, Lily!

After researching this topic further I wish someone had explained to me the importance of looking after my feet during pregnancy. I know we have so many other body parts to concentrate on during pregnancy and generally we might get a foot rub from our partner if we are lucky. The main concern in most pregnancy are that our feet will swell and we will not fit into our shoes. This is a really common occurrence and we instantly revert to wearing the easiest thing to slip on our feet, Flip flops or thongs, dependant on where you grew up.

So I am here to tell you especially as its summer, don’t wear thongs unless they have some arch support!
There is limited research into this topic but the research that is available is well worth looking into.

It has been found that foot length and width can increase due to pregnancy and also that your foot arch can drop by up to 1cm!
This has been attributed to an altered gait pattern (the way you walk).

This can all be traced back to the fact we have an increase of weight when we are pregnant and also the change in our hormones. Our feet take a beating! The majority of change in feet seems to occur during our first pregnancy. There is a fantastic article: Pregnancy leads to lasting changes in foot structure ( 2013) where the researchers have suggested that the incidence of hip and knee issues are more common in older women who have had children, and they are suggesting this all relates to the fact our arches have dropped.

So when you are pregnant look after your feet!

Give them support, if you have to wear thongs there are whole heap of new thongs around with arch support. Do foot exercises to wake up those little muscles in your feet so your arches get a little extra support.

We use these hard yellow massage balls to wake up the feet. Try 10 to 20 presses on the ball of your foot, repeat on the arch and then the heel. Remember you arch is generally more sensitive so be gentle. We have our pregnant ladies sit down to do this work, just so we can ensure their pelvis does not shear with the movement. You can also substitute a franklin ball if you need something a bit softer.

Another exercise to try is scrunching your toes on a towel. Try to get the towel to move, focus on lifting your arches when preforming this exercise.

We are extremely lucky that our studio works like a community and everyone takes an interest in others wellbeing. One of our other amazing clients Liz who is a retired physio let us know about a new brace on the market for drop foot. We watched the video and were taken back by the amazing results!

The brace is called the Turbomed 3000 and you can view the video at http://turbomedorthotics.com/. Lee contacted the practitioner in charge of her braces in the past and they agreed that it could really work for her. So the week before she left for the mainland the brace arrived. It was amazing to watch Lee walk with the brace on, even with her improved strength and balance turning around was still an issue, but not with this brace on! It has just been the icing on the cake, the extra confidence in her walking is spectacular.

We will miss Lee terribly but we are very glad to see her starting her new life on the mainland with such great confidence. It has been a pleasure and honour to have been able to assist in Lee’s recovery.

In 2010, after being repeatedly prompted by my daughter (an Osteopath and Pilates Instructor in Melbourne), I started looking into Pilates. My Neurosurgeon’s secretary suggested I give 3 Degrees Pilates Studio a try which was then based in Sandy Bay.
And so began a six year relationship with Peta Titter – my Pilates instructor with a wealth of knowledge about trauma impacted bodies from her years of training and working as an Intensive Care and Emergency Nursing Sister. Peta made it her business to give me back my independence, my self confidence and some normality of life.

The first day was hard as I wobbled like a drunk into the studio and was thoroughly assessed by Peta. I had lost so much muscle tone and had practically no core strength. An exercise program was planned for me and we slowly started working on core issues. I saw Peta twice weekly and as time passed we both saw healthy progress with my damaged body.
All the braces were now gone, I was walking with the assistance of a walking cane, I was driving, even doing a few household chores. Slowly, my core strength improved, my muscles regained some definition and I began to feel like the woman I had once been.

Peta and her team adjusted my program as required. All the girls were caring and patient as sometimes there were setbacks which required a rethink regarding my exercises. I was also given back up exercises I could do at home.
It is now 2016. I walk really well, feel confident again, I’m independent and life is pretty good. I continue to do my Pilates religiously and have recently moved to the mainland requiring me to say an emotional goodbye to all the special team at 3 Degrees Pilates.

Every day I give thanks for the day I met Peta and her dedicated team and became part of the 3 Degrees family. Would I recommend Pilates and Peta to others with trauma impacted bodies? In a heartbeat! Even those that don’t have medical problems can only benefit from this mind and body strengthening modality we call Pilates”

I have Peta and her team to thank for working with me prior and post operation, which has meant a return to normal activities with a positive mind and strengthened body. I have found that Peta and her dedicated team of instructors bring their own unique skills to the studio whilst continuously demonstrating a genuine interest and care for their clients. The day I found 3 degrees Pilates was a indeed serendipitous!

The general recommendation is to elevate these types of wounds, and I have seen the difference in drainage around the area this creates.
BUT seeing elevation WITH gentle mobilization just blew me away! I know that it is really hard when people have falls and that they are sore and lose their confidence. The first reaction is to rest, but the difference this gentle exercise created is amazing and a great reason to make sure people keep moving.

Peta