Do you suffer from ‘gluteal amnesia’? Pilates can help 

Thanks to a lovely Fix Program regular, I had such a laugh reading this article about men over 40 losing their buttocks. Girls, don’t laugh - we tend to lose them too. Men’s tend to disappear around to the front to their bellies and we women seem to have them slide down the backs of our legs. 

http://www.afr.com/Page/Uuid/033a59e0-39fb-11e3-a334-c26c4e617206 

But is all seriousness, the buttock muscles are terribly important in supporting our pelvis and back, holding our hips in a good alignment in our pelvis and in providing us with the power to get up out of seats or to walk and run. Underactive and weakened gluts will result in a greater instability about the hip and pelvic regions. This can result in an increased load transferred to the lower back above and to the hamstring muscles below.

Some of us can feel that our hamstring muscles seem to become tighter as we get older. The hamstrings are a powerful and often over worked group of muscles running from your sit bones of your pelvis to the backs of your knee. If you once had quite flexible stretchy legs and hamstrings and now notice they are becoming tighter and stiffer, then perhaps your buttock muscles are weakened? Perhaps you are reliant on these hamstrings for more power and stability about the pelvis in your day than previously? Is there an imbalance about the muscles of your hip and leg?

Has your brain developed ‘gluteal amnesia’?

So how do you ‘find’ your buttocks again? The solution is often a simple one, but also quite a challenge for some brains! Often you need the kind and expert assistance with appropriate cues from your favourite physiotherapist to discover these muscles again. Here are my top 3 Pilates exercises to firstly find, awaken and then challenge your buttocks.

Step 1: Let’s find our buttock muscles again with ‘Virtual reality leg lifts’

Lie on your tummy with your knee bent to 90 degrees. Imagine your thigh is stuck to the mat and unable to lift off.

Gently lift your pelvic floor muscles and deepen your navel, becoming aware of the subtle tightening between your hip bones and lower belly coming off the mat. Try holding these muscles on while you breathe. Next, imagine you are lifting the foot of your bent leg towards the sky. But remember, you can’t as it is stuck to the mat.

Where do you notice the muscle activating? Is it in your buttock region or down the back of your leg?

If you feel that your buttock is not engaging, try placing your hand on the buttock and imagine very gently holding a piece of paper between your buttock cheeks. Feel it now?

So, try again. Lift your pelvic floor, gently deepen your navel, imagine the paper held gently between you cheeks and then an imaginary lift on your foot towards the sky. Any luck?

Practice, practice again- it is really a brain challenge! This is the hardest step – rewiring your brain to habitually activate your buttock. If all else fails, practice on the other side and see if you can activate your buttock on this side before returning to the other.

You really must master this before progressing to step 2.

Step 2: Awaken your buttocks with great squat technique and side stepping squats

We should all know how to squat safely but here’s a quick recap.

Standing with your feet hip width apart, find your pelvis neutral posture. Become aware of your pelvic floor muscles lifting and abdominals deepening as you lift through your waists gently. Fold your trunk over your hips as if you were aiming to sit onto a chair, your knees bending and your weight shifting into your heels. Remember your tall waist posture and unchanging spinal curves. AS you push up to a standing posture, push through your heels and be aware of your buttock muscles activating.

You can make this more challenging with your theraband tied around your knees, or with sidestepping squats across the room. Remember your sinking hips, folding trunk, tall waists and pushing up through your heels. When sidestepping, feel your leading leg doing most of the work.

Wake up those buttocks.

Step 3: Challenge your buttocks and build endurance with single leg squats, step-ups and jumps

So now you have found your buttocks and your brain knows what it’s like to use and feel them, you can really go for it. Single leg squats, with or without weights, lunges, step ups onto a step or parkbench. All of these will build endurance in your new found gluteals and give you a shapely derriere.

Remember the basics – good pelvic posture (‘neutral’ and no tipping sideways), tall waists, pelvic floor and deep abdominal engagement and pushing through your heels. Even a cupped hand over the buttock cheek will help to reinforce to your brain that you are activating well and feeling that lovely bulky butt!

Good luck rediscovering a shapely behind and giving your back, posture and tight leg muscles a lending hand too.

Are you one of those people who are insanely jealous of the deep sleepers that don’t even hear a thunder storm during the night? Or waking at 4.15am every morning? Or maybe you just have a little one relying on you for a cuddle or feed during the night? You are not alone! And your lack of sleep can significantly affect your health and well being.

The Sleep Health Foundation has found that more than 1.5 million Australian adults suffer from sleep disorders. If you are one of these you will know that a lack of sleep can have a major impact on your mood, concentration, memory and quality of life!

Here are some ways you can try and get a good night’s sleep:

Exercise. Disciplines like Pilates that get your body moving, strengthens your muscles and increases your endorphins the happy hormones. Exercise can also help reduce your stress.

Stretching and relaxation. Having a wind down routine prior to bedtime can help get you relaxed for sleep. This may include focusing on your breathing or setting aside time for meditation.

Write down what is on your mind before you start your wind down routine so you can forget about that email you forgot to send or the phone call you need to return.

Switch off your electronics 1 hour before bed time. These days it’s so easy to get caught up in work and social media at all hours of the day. Unfortunately this stimulates our mind and the light exposure reduces the levels of melatonin in your body which is the major hormone that controls your sleep and awake time. This can create a level of sleeplessness during the night.

Avoid heavy meals too close to bed time. Try to have your meal a few hours before bedtime.

Decrease the clutter in your bedroom and keep it clean and dark.

If you are having pain through the night especially in your neck or back, check the height of your pillow and try to keep your spine straight when sleeping. If this is significantly worrying you please go and see your Physiotherapist.

While you sleep your body goes through a cleansing process like a detox, rejuvenating your brain cells. This is especially important if you are in pain or going through prolonged stress. If you want to read more have a look at this article:

http://blog.naturaltherapyforall.com/2013/10/21/brain-undergoes-cleaning-process-whilst-asleep-study-finds/

Sleep Well.

During pregnancy, levels of the hormone relaxin drastically increase to help your soft tissues stretch, allowing plenty of room for your growing bub. However it can also have its downside – the joints in your pelvis can become excessively flexible, sometimes causing pain with movement. This pain is called Pelvic Girdle Pain (PGP), and 45% of all women will suffer from it with 25% continuing to experience it postpartum.

To understand what is going wrong and how we can help, let’s take a closer look at the pelvis. It has three joints that are affected by PGP.

The pubic symphysis.

This joint sits at the front of your pelvis, down low where the pubic bones are joined together with cartilage and ligaments. This joint transfers the load of the trunk from your tailbone to your hips and acts as a shock absorber while you’re walking.

The sacroiliac joints (SIJs)

Of which you have 2. They sit at the back of your pelvis, connecting your tailbone (sacrum) to the large curved pelvic bones (the iliums) with ligaments. These convert rotational forces generated by your lower limbs through your spine, stabilising you and also helping to absorb shocks.

During pregnancy, relaxin allows the ligaments of the pubic symphysis to stretch, letting the pelvic bones widen apart – a very important adaptation your body makes in preparation for delivery. However, this can cause pain on movements whenever your legs are wide apart such as when getting in and out of a car.

Relaxin also makes the SIJs more hypermobile, which can lead to a dull, aching pain near your tailbone (near the dimples) on one side or both. This may be particularly acute whenever your hips rotate and bear weight at the same time, such as when standing up from sitting, climbing stairs, or expended periods of walking. The pain may also feel like it is in your lower back, buttock, hip and thigh even though the SIJs are the real problem – we call this referred pain when it appears far from the true cause.

PGP is likely to worsen as the pregnancy progresses, but more than 70% of women whose symptoms started with their pregnancy are pain free by 2 months post delivery without the need of physiotherapy treatment. In the meantime, gentle core stability exercises such as those found in Pilates can help to stabilise your pelvic joints by increasing your postural muscle support – all helping to keep your bones in the right places! Exercises that gently engage the pelvic floor and deep abdominal muscles (as you have experienced in your Fix Program pregnancy classes) are particularly effective.

In the unfortunate (though fortunately rare) cases of severe PGP, hands-on physiotherapy treatment can offer relief and help correct the joints’ positions. One of our Fix physios can also test to see if using a pelvic stability belt might ease your pain. These are designed to offer compression during painful movements to the lax pelvic joints. We are also great at giving advice on movements to avoid, practice of movements to adopt and exercises to limit your painful movements.

So please don’t hesitate to let us know if you need further help with your PGP – there is a lot that physiotherapy can do to help you, like compression wear as seen below until you, your body and your bub are all settled.

Holding the ripe mango under your chin 

In your Pilates classes at The Fix Program, you will have heard us reminding you to keep a big juicy ripe mango gently tucked in between your chin and chest. This is another of the many visual cues we use to help you correct your neck and upper back posture, engaging the deep postural muscles that support an ideal alignment.

Why I do I need to think about a mango under my chin?

When you’re sitting or standing for long periods, you might find your neck falling forward, your chin creeping out in front, your shoulders rounding forward, or even all three at once. Desk work and watching TV are when I notice this the most, when it sometimes even feels natural to relax my entire upper body and let it hang loose.

The truth, however, is that this slumping greatly increases the curve (technically the lordosis) of the cervical spine as the upper vertebrae slide forward over the ones below. The spaces between the vertebrae become more narrowed, leaving less room for your nerves to enter and leave the spinal column – this can exacerbate or even cause pain in the neck, head and even arms.

Also, forcing the outer muscles of your neck and shoulder to hold your head so far out increases their tightness and fatigue, causes pain and heachaches that are cervicogenic (which means ‘from the neck’). At the same time, your chest muscles become tight and shorten, your shoulder joints held forward and stiff, and the more you do it the harder it is not to!

So, how do I ‘hold my mango’?

To counteract this, we ask you to imagine that you’re very gently holding a big juicy mango between your chin and chest. Your head will gently be drawn back in line over your body, the back of your neck growing long and tall, and your chin slightly tucking down to gently hold your big mango to your chest. This restores the lordosis of your neck and upper back to its ideal state, optimally spacing out your vertebrae. It also relieves a lot of the weight of the head on your neck muscles – sitting atop your spine allows gravity to take over, relieving that familiar neck stiffness.

But most importantly this postural cue helps us to gently switch on the tiny, deep muscles near your spine in the neck called the deep neck flexors which, when activated properly, should work gently to support your neck in a tall, lengthened, ideal posture as you go about your day and practice your Pilates exercises.

Try to hold your mango very gently, so as not to squish its softness! This will keep your deep neck flexors doing the work and growing stronger, and help to avoid overuse and fatigue of the outer neck muscles.

So always remember your big juicy mango wherever you are, from sitting at work, on the sofa, carrying your shopping or your toddler. This will help you to stay properly aligned and supported to avoid postural neck pain and headaches.

Think of your ‘tall ribs’ and get twisting

This exercise at a good slow and controlled pace really gets those oblique abdominals and upper trunk muscles going. Remember that these muscles are needed every day for any movement involving a turn of the body. Add to that your great shoulder stability and pelvic control and this exercise is a challenge for the whole trunk. This version has you in sitting, but you could also try it in a static wall squat or deep lunge position.

The Starting Position:

The focus:

• Sit on a chair or Swiss ball in ‘active sitting’. Active sitting starts with legs hip width apart to your feet, a neutral pelvis posture, long waists and a lifted breastbone.

• With a partner or your theraband fixed at one end, hold your theraband with clasped hands out in front of your chest.

• Set your shoulder blades softly and widely into their ‘pockets’ in the upper back and melt the tension away from your neck and shoulders.

• Imagine you are on a skewer, turning with a beautifully tall and centred axis.

• Twist with long waists and tallness between all of your ribs each side of your trunk. Think of the rib rack and thick meat between each and every rib.

• Keep melting through your shoulders and neck and keep stable and neutral on your pelvis.

The Movement:

• Breathe in deep and wide to prepare. As you breathe out, gently lift your pelvic floor muscles and imagine your hip bones drawing together at the front as your navel deepens.
• As you next breathe in, turn your trunk against your theraband resistance, keeping your hands in front of your chest at all times.
• As you exhale, slowly return your trunk to the middle.
• Repeat to the same side 8-10 times, before changing your set up to turn to the opposite direction.

Tip:

Try this same movement with a partner as you squat against a wall to really challenge your legs and pelvis more so for that complete body workout.

The rack of ribs

Have you ever found yourself in a Pilates class wondering why we’re telling you to ‘think long through the waists’ or to ‘melt between the sit bones’? We can hear you thinking ‘What new impossible task will I be asked to do this week – wiggle my spine-toes?’ Explain The Pilates Cue is a new category of articles you’ll see popping up in Fix News over the coming months in which we will look a little closer at all those weird and wonderful verbal cues and uses of imagery we mention so often to aid us during our Fix Program classes.

So why do we love to use these cues at The Fix Program? We know from the research that motor learning and skill acquisition can be greatly improved by the use of visualization techniques. We layer multiple cues which, through practice, reinforce the laying down of new nerve pathways in the brain during exercise and postural practice. This way it will become a new habit for you, even outside the context of the studio.

Let’s get into unraveling our first cue, the ‘rack of ribs’ – which is certainly not an invitation to dinner! Our familiarity with their shape, however, makes it a useful visualization tool which can, through applying the right Pilates techniques, address problems in our posture.

Imagining the iconic meal of ribs, where each individual rib is parallel and separated by even gaps filled with delicious meat. These intercostal muscles (the ‘meat’) should be just as equal between parallel ribs in our own body, making the ribcage equally tall on both sides. For those of us who slouch to one side, we can imagine the result - a tightening of the intercostals muscle space between each rib can become smaller and less even – by thinking of the results on the dish. When the ribs close together like a folded accordion with a slight sideways twist, it is far from ideal in both the culinary and the physiotherapy sense. This poor rib posture can set up poor movement patterns and muscle activations in the trunk, can affect the neck and lower back, change nerve dynamics in the area and even interfere with our breathing.

Putting this into practice, imagine how we might reduce the space between our ribs when we valiantly attempt to ‘glide the shoulder blades down the back’ (a cue for another post perhaps?). When doing arm work and setting the shoulder blades, think of the blades gliding freely over the top of the rack of ribs without causing those ribs to lose their lovely parallel gaps and collapsing downward on one side. Another reason to ‘keep both sides of your trunk long’ (yet another cue)!

Why not try thinking of your rack of ribs next time you’re doing Scissor Arms on the mat or as you stretch into a Wall Twist? And then carry this visualization into functional activities as you carry your child or a heavy bag of groceries or when sitting long hours at your desk.

Then you can get back to dreaming wistfully of dinner.

By Tabitha Webb

To cycle, or run or walk – that is the question

http://well.blogs.nytimes.com/2013/08/29/ask-well-is-it-better-to-bike-or-run/

I recently came across this article in the New York Times, which briefly discusses the pros and cons of common exercise. I thought I would lay out some of the reasons for choosing or avoiding various forms of aerobic exercise. The three forms of exercise that were compared were walking (6kph), running (14kph), and cycling (28kph).

Firstly, there is weight management. Running is the winner here at 1,000 calories per hour, cycling is close at 850, and walking consumes only 360. Clearly the high-intensity workouts are best. Note also that you need to walk for nearly three times as long as you would run if you wanted to burn the same amount of calories.

In addition, running and cycling (as high-intensity workouts) cause lower blood levels of ghrelin, a hormone linked to hunger, so act as appetite suppressants as well. However these two more strenuous exercises compare very differently when considering impact – as cycling does not involve weight-bearing, injuries and muscle soreness are far less common among cyclists than runners. Walking is by far the least strenuous, of course!

The characteristic shared by all exercises is a positive effect on wellbeing – aerobic exercise leads to cardiovascular fitness, which is linked to lower risk of chronic diseases and an increased lifespan. Additional motivators for us at The Fix Program are that fit people experience less pain, have improved mental health and sleep better.

As with any form of exercise, combining them with a core stability, postural and stretching program (such as Pilates) can reduce risk of injury and improve performance by ensuring your body is working in optimal, stable balance as you train. There is no ‘best choice’ of exercise to pair with such a program and achieve all these benefits – any form, or even a variety, can be modified to best suit your preferences, safety and weight loss needs.

Author Tabitha Webb

In July’s version of ‘pain tales’ we looked into nerves and how they send messages to the brain (and back again). Nerves conduct messages from our muscles, skin and joints as electrical impulses to and from our brain. Even the brain itself is made up of trillions of nerves and connections, and then there are the nerves that supply to our vital organs.

So what can happen when all of this goes amiss? When nerves become hyper sensitive due to injury, pressure or in chronic pain?

We have all probably heard about brain plasticity. This ability for the brain to change, adapt, ‘be plastic’ in reaction to stimuli can also be demonstrated in the peripheral nervous system. This peripheral nervous system includes all nerves outside of the brain (or central nervous system).

Lets explore…

Nerves are able to conduct electrical impulses or messages via their conductivity. Positive and negative ions pass over the nerve ‘walls’, charging them until the point that an impulse fires along the nerve. This is called an ‘action potential’. Charged ions can rush into the nerve via sensors, also known as receptors or ‘ion channels’. These are made of protein and ‘listen out’ or measure different stimuli. They are specific and specialised for just that stimulus. For example, light receptors in your eyes, or sound wave sensors in your ears.

There are only 3 types of sensors in your nerves for your muscle, skin and bones – one to detect the stimulus of temperature, one for mechanical changes (such as stretching, vibration, pulling) and one for chemical changes (such as adrenaline, acids, endorphins).

Changes detected by these 3 types of sensors will create the influx of ions to create a message that rushes along your nerve pathway to your brain, or back again. You may remember from previous discussions that these messages are NOT pain messages. Pain is the construct from the brain after weighing up all the information that the nerves have delivered for that time and that place.

The most amazing thing about these sensors is that their life is short- only living for a few days. They are always being replaced by new sensors and the type of sensor may change depending on what your brain decides is needed for your best survival. The brain does this by producing sensors proportionate to the stimuli around.

So, for example, if your posture is poor and you have rounded shoulders when you sit all day, the mechanical sensor numbers will be higher than the temperature or chemical ones in the nerves of this area of our body. This is because of the constant pulling loads on the nerves about your neck and upper back through your rounded shoulder and chin poked out. This makes for a very over sensitive area in your body, detecting lots of mechanical changes and forces and producing a higher rate of impulses from these nerves to the brain. Your brain may choose to ignore these, but will be more likely to feel more pain. And this makes for a tired painful neck and upper back. Sound familiar?

So back to ‘plasticity’ (and the good news if you suffer from pain)! The same can happen in reverse. The number of a particular sensor type in a nerve will reduce if the stimulus is less. And a return to a relatively balanced and stable number of each receptor type in all of your nerves. Using the same example of poor posture and rounded shoulders in our neck pain sufferers, better your posture –‘mangoes under the chin’, ‘long tall neck’, ‘lifted breastbones’ – move more, be stronger. This will decrease the mechanical pulling on your nerves up there, reduce the mechanical sensors about and therefore the number of impulses to your brain. The result – less pain!

So remember that nerve sensors are dying and being replaced every few days. Pain and sensitivity is always changing and that the pain you are in now is not fixed.

Pilates, Yoga and Feldenkrais can really capitalise on the practice of mindfulness

Mindfulness is originally a Buddhist term and is used a lot in clinical psychology for reducing stress, anxiety and depression. It is all about being in the present moment and allowing your thoughts, feelings and sensations to just be, without judgement. It is about being aware of the you without evaluation. 

Exercise disciplines such as Pilates, Yoga and Feldenkrais can really capitalise on the practice of mindfulness to enhance practice and results. Making contact with what is as you move, breathe or relax can better help you learn the movement, improve your strength, mobility and reduce pain levels. 

Mindful movement can be done through becoming aware of how you move. This can be done in the most simplest of ways, including:

Visualising the movement with closed eyes as you move

Visual representations and cues for your movement

Focusing on the sensations associated with the movement, such as muscles contracting or shortening, lengthening, stretching, or bones feeling heavy

Focusing on symmetry of movement across your body

Smooth and controlled movement

Mindfulness in movement allows for improved motor learning, or skill acquisition. By definition, human learning is any permanent change in behaviour, knowledge, skill or ability that cannot be ascribed to development or inherited growths. Motor learning is the process of learning a movement – from acquisition to practice. It requires the brain to ‘write’ motor programs amongst your nerve pathways using information about the movement, knowledge and experience. This includes the correct muscles to be used, the correct nerve pathways talking to the muscles, movement sequencing, timing and automation. To be more aware of your movement, you can ‘write’ your motor programs better to develop new movement habits and for them occur automatically. This is just like the preparatory activation of the deep pelvic stabilising muscles before your body moves to protect the spine and pelvis. Through thoughtful practice, your deep muscles can do just this! 

Pain management for those with all sorts of pain associated with movement or postures benefit hugely from thoughtful movement. Pain is ‘wired up’ in the brain as ‘pain movies” (as we’ve spoken about several times in our ‘Pain Tales’ posts). We know that subjective feelings about movement and pain can ‘fire off’ the pain experience in someone with persistent pain. Remembering that particular movements have always been painful, have caused pain before, evaluating movement experiences as ‘good’, ‘bad’ or fear that movement or exercise will make the pain worse – this can all get in the way of beating the pain cycle. By minimising these subjective describing words and judgements when exercising mindfully, it is often possible to move through the pain. This can establish new nerve pathways, movements that are no longer as threatening, less pain with activity and a potential breaking down of the pain cycle. 

At The Fix Program, as physiotherapists, we truly believe and place a huge emphasis on mindful movement. Within our classes, we use a mix of strategies to bring you ‘into the moment’ with your exercise, to forget what’s going on outside the studio, become more aware of your own movement patterns and to make change. And we see wonderful results in doing this.

Why not try practicing mindfulness in everything you do? From your exercise routines, to your work and home life. Live in the moment without judgemental thoughts getting in the way.