The hip flexor muscles
Picturing the front hip muscles
Visual pictures can really help with locating the tricky and deep tissues in our body that we cannot see. This is especially so for our recent work in our Pilates classes on the front hip strength and stability.
“Imagine standing on eggshells and your thigh sinking back into your hip.”
This is the instruction to help you to activate the deep front hip muscle called ‘iliacus’. You can see this muscle in the image. Iliacus is a part of the hip flexor muscles – the ones that lift your leg up in front of you as with walking or lifting each leg to walk up stairs. Psoas major is another of these, and is the stronger of the 2.
Iliacus has a more important role and that is to hold the top of your leg bone or femur securely in the hip socket. Iliacus should do this as the bigger muscle ‘movers’ go about moving your leg about. It is one of the muscles giving that ball and socket joint a lovely tight fit.
By looking more at the iliacus muscle in this picture, you can almost imagine that as it contracts or shortens (as a muscle does when it activates), it will suck the leg bone up into the pelvis better.
And hence our postural cue above!
So when we do our squats, lunges, and mat work, picture your iliacus gently drawing your femur into your pelvis for a happier and healthier hip. And remember that sometimes we will not feel much happening at all, and quite often this is the goal.
Subtle, subtle! Less is more.
Lorimer’s Pain Quiz
Do you really know how pain works in your body?
So we have all been in pain from time to time or perhaps more frequently than we’d like. Does this make us an expert on pain? Lorimer Mosely has a post-doctorate in pain and was also a physio in days gone by. He has adapted a pain quiz to test us on our knowledge on all things nerves, brains and pain. Test yourself on this extract from his quiz. I’ve reworded some questions to make them easier to understand, but if you’d like the full quiz, let me know.
Answer true or false to these statements.
- Pain only occurs when you are injured.
- The intensity of pain matches the severity of the injury.
- Nerves in the periphery of your body (the limbs) can adapt by becoming more excitable.
- Chronic pain means the injury has not healed properly.
- The body tells the brain when it is in pain.
- The pain you feel is the same pain as your grandparents felt.
- In chronic pain, the brain becomes more sensitive to danger messages from your muscles and joints.
- The immune system has nothing to do with a pain experience.
- The brain decides when you will experience pain.
- Stress can make your nerves fire.
- Your internal pain control system is stronger than any drug taken.
- Chronic pain is more common in wealthier countries of the world.
Did you write down all of your answers? You can check the answers below.
Pain is an amazing thing and we are still unravelling its complexity in our bodies, brains, psychology and biology. Modern scanning has allowed for a real window into the brain and our understanding has grown in the past decade. So much so that this understanding has given us as health professionals the ability to educate our patients about the pain they are in. And on top of that, the research demonstrates that through knowing and understanding pain, pain can actually be diminished in individuals from this alone! Incredible.
If this interests you, there are a few amazing books about for suggested reading. Why not try Explain Pain ( Lorimer Mosely, David Butler) for a fresh view on the physiology of pain, or The Brain That Changes Itself (Norman Doidge) for wonderful tales about the brain’s ability to change, called neuroplasticity.
Know pain, no pain.
Quiz answers:
1.F 2.F 3.T 4.F 5.F 6.F 7.T 8.F 9.T 10.T 11.T 12.T
Women and World Continence Week
Bladder leakage, no matter how light, is not normal
Although embarrassing, bladder and bowel troubles are common, affecting 1 in 4 people in Australia. Although common, it is not normal to be suffering from these troubles. Pregnancy, the post natal period and menopause are the times we women may experience leaky bladders and other issues ‘down there’.
We need to start talking more openly about this topic - with family, girlfriends, doctors and women’s health physios. If you are at all worried, your GP or even your Fix physio would be a great place to start.
When researching for this blog post with my circle of friends and colleagues, I found an alarming trend. One I had not thought of working within the health industry, as to me, any troubles ‘down there’ would mean immediate attention and appropriate management. Perhaps obvious to me and other physios, but not to all those other women out there.
It seemed that if there were stories and admissions of leaking (or other pelvic floor issues) within a circle of girlfriends or mother groups, there seemed to be an acceptance that this was normal. On a positive note, it is wonderful to hear that at least the conversation had started, however, on a negative note, hearing that as a group, bladder troubles were considered a normal part of being a woman, is very disheartening.
Bladder or bowel control issues can be treated, managed and even cured with the help of a pelvic floor physiotherapist. It will not get better on its own, and it needs specific pelvic floor exercises, and changes and improvements to your toilet habits
There is help at hand.
Here are some important facts
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Leaking is NOT a natural part of childbirth, ageing, or being a woman.
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Bladder or bowel control issues do NOT get better on their own.
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Incontinence CAN be treated, managed and even cured with the help of a pelvic floor physiotherapist.
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Many women lose control during pregnancy or after childbirth and that sets them up for a lifetime of issues, which can be worse after menopause.
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Sometimes the issue is not only muscle weakness. Prolapse, or sagging of the bladder, uterus or bowel could be the cause and a support device called a pessary can give immediate relief.
This all sound a little bleak, doesn’t it? It may, but don’t put up with it. Tell someone who cares and seek treatment. Heba and Tabitha are here at The Fix Program to help. You may not be aware, but they have had extensive post grad training in pelvic floor conditions unique to women.
Draft Pilates Timetable Term 2 2015
Late Cancellation Policy from March 2015
Cancellation Policy
At The Fix Program we aim to provide a professional service at a time that is most suitable to you. We also aim to have same day appointments available for urgent enquiries and all other appointments available within 1 week of your enquiry.
Unfortunately, we are experiencing a large number of last minute cancellations and clients not attending their allocated appointment times. This is having a major impact on our waiting list and can negatively affect treatment progress.
What we are doing about it
Reminder emails 24 hours prior to appointments are a proactive approach on our behalf. This gives our patients the time to contact us via email or phone to cancel and shift appointment times.
So that we can continue to provide a timely service, Fix is now implementing a CANCELLATION AND FAILURE TO ATTEND POLICY.
Effective from Monday 16th March 2015 the cancellation policy will apply if:
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You cancel your allocated appointment time with less than 24 hours notice; or
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You fail to attend your allocated appointment time.
Failing to attend or notify within the 24 hours will incur a fee of $50.00 (to be paid at your next appointment)
If we receive advance notice that you are unable to attend it will provide an opportunity to offer the appointment to other clients from our waiting list or those requiring emergency physiotherapy.
We would like to avoid having to apply a cancellation fee - your co-operation would be greatly appreciated.
Pilates and breath
Learn to breathe well and relax
There are many reasons why we should learn how to breathe well. Appropriate breath can help our bodies in many ways and its importance is somewhat overlooked. Breathing can bring about relaxation, reduce stress levels, decrease pain, increase feelings of good health and wellbeing.
So, what makes me stressed?
We’ve all heard the expression ‘fight or flight’. This is how the body has evolved to respond to any threatening situation. In times of stress the body uses a hormone called cortisol. Cortisol turns on processes we need for survival and switches off processes that are not needed for survival. This is great in an emergency, but if you are stressed all of the time, prolonged elevated cortisol levels have been found in blood streams. These chronically high levels are linked to depression, mood swings, memory changes, poor healing, pain, weight gain and immune problems.
On the flip side, when you’re relaxed and feeling good, your body produces ‘happy hormones’ such as opioids and serotonin.
How do I de-stress?
- For a start, try to stop worrying. Pilates, Yoga, relaxation, meditation and breathing techniques have also been proven to reduce the level of circulating stress hormones and increase your level of happy hormones.
- Try going for a walk, listening to relaxing music, or just clearing your mind for twenty minutes every day.
- Try to set aside ‘worry time’. Rather than worrying about things constantly (and keeping your cortisol levels elevated) make a specific time every week when you think about your worries. If a worry enters your head at another time, like when you’re trying to fall asleep, set it aside for your ‘worry time’.
- Try this relaxation technique when lying down or sitting comfortably. Close your eyes and focus on your deep breathing. Focus on the cool air as you breathe in through your nose and the warm air and you breathe out through your mouth. Focus on one body part at a time starting from your head all the way to your toes imagining all your muscles releasing and feeling heavy.
- Try to take time to practice mindfulness throughout your day. Even a minute here and there to become mindful of your breath, the comings and goings of your body sensations, tensions and your surroundings can help to de-clutter your brain and provide energy and calmness.
And there’s even more to the importance of breathing well
We also know that learning to make your diaphragm stronger by breathing well has many a physical effect. This is the breath we strive for at your Fix Program classes. These can include:
- A more efficient delivery of oxygen to your body. Using your diaphragm allows for greater volumes of air into all corners of your lungs.
- The physical mobilising and stretching effect of breathing into your lower lungs will improve movement of your ribs and the stiff thoracic or middle spine.
- The prevention of extra work and tension of the chest and neck muscles which are often inappropriately used for daily breath. Most of us know how tired these muscles typically are anyway. Why add to that with your breathing style?
- A stronger deep postural ‘corset’ for our spine and pelvis. The diaphragm has connections to many organs and muscles in the trunk via fascia and via this connectivity has a crucial role in stability and movement control in the region.
Yes, the diaphragm is a muscle that too can be strengthened! And a stronger diaphragm will lead to a stronger deep abdominal corset, pelvic floor and spinal alignment.
The challenge
Try to become more aware of your breath as you go about your busy lives. This can happen anywhere – at work, rest or play. Slow down the rate of your breath, relax your neck and shoulders and visualise the breath into your lower ribs. Imagine breathing widely and sense the expansion and movement in your trunk.
Slow your breath and the mind will follow. Healthy mind, healthy and strong body.
‘Core stability’ or ‘postural control’
To plank or not to plank?
It is a common claim that a strong core will enhance movement ability, such as for walking and running. ‘The Plank’ and similar ‘core’ exercises are therefore often prescribed to achieve this. But how appropriate are planks for our everyday movement requirements? Postural control sitting at your desk, turning, reaching, walking, swimming or running? Do we really sit, walk or run looking like a plank?
In effect, if we strengthen muscles in a particular way, they will be terrific and strong in that, but not necessarily with a cross over effect to other movements or requirements. This is called ‘training specificity.’ Muscles and movements needs to be precisely and specifically trained to optimise gains in strength and movement quality.
So what about muscles involved in ‘core stability’?
When we speak about ‘core stability’, stability suggests rigidity and no movement. However, don’t we really want to be able to bend and move through the spine and body? Think about your average day and the range of movements involved - turning, twisting, and bending, from popping on your socks to start the day, to twisting your head and trunk to reverse out of the driveway in your car.
In exercises like ‘the plank’, there is the need to brace and co-contract multiple muscle groups at one time. This is a model relying on stiffness. However, stiffness in our bodies does not necessarily result in better function. Walking and running activities are perfect examples of this where there needs to be free trunk rotation as the arms swing, and free rib expansion and movement for greater breath capacity.
Instead of ‘core stability’, a better term to use would be ‘postural control.’ This suggests that muscles need to be strong and efficient within movement, controlling you throughout. When we move, there is a whole team of muscles working. There are the little deep ones holding on at your joints, while the team of bigger ones move you. Even these bigger ones work to control the movement speed and precision. So to get these teams working like a well oiled machine, exercises should be practiced to mimic both the movement and postures involved.
At The Fix Program pilates classes, we work really hard at making sure we follow this theory of strengthening, exercise and movement. How do we do this?
- Have you noticed we spend a lot more time now strengthening your ‘postural control’ muscles in many varied postures – standing, sitting, stepping, twisting and lying?
- We teach you how to be more precise and aware about control (not rigidity) about the pelvis, the ribs, the neck and shoulder blades.
- We use visual cues such as ‘float through your postures’, ‘feel more fluid in your movement,’ becoming aware of breathing symmetrically through the rib bases. All of this is in contrast to bracing or rigidity in postures.
- We have introduced more Feldenkrais and Yoga type sequenced exercises where movement is free and awareness is paid to differences/asymmetries across our bodies.
There is nothing wrong with continuing to plank, so if you enjoy these, go for it. They do always feel like a brilliant challenge for the body. But do be aware of the need to exercise with movement also.
At the end of the day it’s more about beautiful movement, free and flowing.
Draft Pilates Timetable Term 1 2015
The real bird dogs
A silly name for a difficult Pilates move
Taking me several years to get the name right for this exercise, I really have struggled with the ‘Bird Dog’. You know the exercise. Lifting and stretching out your arm and opposing leg from your hands and knees. We assume the name comes from the hunting dog poses. The dogs that hunt birds?
Perhaps it is these little critters we are trying to be?
Then again …
All in the name for a good laugh. Check these ones out too.
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