I’ve written this blog plenty of times in my head, and now, with my 7 month old baby asleep on my lap I thought I would give it a go.
In essence this is a case study on myself, and I’m fully aware that no two pregnancies are the same, but I do feel I learnt a few things along the way that I could share, that may just help someone else…
There is nothing quite like a new year’s resolution to get you starting something. That’s really the easy bit, the tough bit is keeping it up. You’re likely feeling fat and unfit after a festive season of excess, and whilst it is good to indulge ourselves now and again, let’s be honest if you carry on with that trajectory, you’re likely to have more than a few kilos by this time next year, you might even pick up a few illnesses and long term issues along the way too. Remember that low fitness kills more people than smoking, diabetes and obesity combined and that physical inactivity is associated with a higher risk for severe Covid19. If it’s not just your body you are worried about Google ‘Scholarly articles about the psychological benefits of exercise’ and you will find literally thousands of articles talking about combatting stress, decrease in suicidal thoughts, improved self-esteem, academic improvements in children, improved mood and quality of life etc etc. Exercise really is medicine.
This study aimed to look at injuries in rugby union over 2 seasons in both male and female amateur rugby players.
The most common injuries in men and women were concussion and ankle ligament sprains, and ACL injuries causing the most playing time lost.
THE REALLY INTERESTING BIT: 83% of non-contact injuries for women happened in the last quarter of the game…
Spinal stress fractures, Severe’s Disease, Osgood Schlatter’s Disease amongst other things are the scourge of every young cricketing team. With my background in academy cricket physio and national pathway cricket, I now find myself working in private practice based at a cricket ground and so still see a lot of young cricketers, and the stories really haven’t changed that much. School, club and county are all competing for time with the kids, and parents either feel pressured or are doing the pressurising of the kids to do all of the training and matches laid on by all of the entities. Coupled with the fact that children no longer play in seasons, a perfect storm begins to brew.
There is nothing quite like a new year’s resolution to get you starting something. That’s really the easy bit, the tough bit is keeping it up. You’re likely feeling fat and unfit after a festive season of excess, and whilst it is good to indulge ourselves now and again, let’s be honest if you carry on with that trajectory, you’re likely to have more than a few kilos by this time next year, you might even pick up a few illnesses and long term issues along the way too. Remember that low fitness kills more people than smoking, diabetes and obesity combined and that physical inactivity is associated with a higher risk for severe Covid19. If it’s not just your body you are worried about Google ‘Scholarly articles about the psychological benefits of exercise’ and you will find literally thousands of articles talking about combatting stress, decrease in suicidal thoughts, improved self-esteem, academic improvements in children, improved mood and quality of life etc etc. Exercise really is medicine.
I hope you have all been watching England thrashing South Africa over the last few weeks in the cricket (breaks my poor little South African heart!!). I was lucky enough to work full time in cricket for seven years (as Derbyshire County Cricket Club’s men’s physio and the BLACKCAPS (New Zealand’s International men’s team) physio, and since my time of being fully involved in one of my favourite sports, I am still fortunate enough to treat a lot of cricketers.
Every day I see people who love to do a specific sport.... running, cycling, swimming to their hearts content. And none of them want to do anything else, because they love their sport. And why wouldn't you?
The problem is that if you love Macaroni Cheese, and all you want to eat is Macaroni Cheese every day, the reality is if you don't eventually start eating some vegetables, you'll get scurvy!!!
Are you suffering from Pelvic Girdle Pain?……10 tips that will really help .
PGP can really take the fun out of pregnancy. However if you follow a few simple rules you can really take control again.
1. Do not stand on one leg. Now you’re probably thinking, well I don’t stand on one leg, but trust me you do, and much more than you think! For example, every time you put your knickers/socks/trousers/boots on etc you need to be sitting down. Moving something left on the floor by sliding it with one foot also constitutes standing on one leg……… Resist ladies!
2. Both legs need to go in the same direction at the same time (obviously walking is the exception to this!). So when you get out of the car, first slide the seat back as far as it will go and swing both legs out at the same time (sit on a plastic bag so you swivel easily). Turning over in bed is the same, keep both knees together so both legs roll over at the same time.
3. Avoid wearing heels. They tip all your extra weight forwards onto the front of your pelvis and that leads to a grumpy pelvis every time. Sorry, it’s just the way it is.
4. Take shorter steps and walk slower. Most of us love to walk at a fair ole pace but it’s unkind to a pelvis that is adapting to having an increased load. Learn the skill of walking slower to keep a painfree pelvis.
5. Limit stairs. As you can’t go upstairs without standing on one leg, stairs are the enemy to a woman with PGP. Plan, delegate, and limit as much as possible. Your pelvis will thank you at the end of the day.
6. Decrease the load you carry. The more weight your pelvis has to carry the more likely you are to get pain. As no one can help you carry the baby around, delegate some of the other stuff you lug from A to B.
7. Give up work earlier than you think. I know this is a controversial one but often that last month is more tiring than you can imagine and a long commute can often aggravate PGP. Maybe you can negotiate working from home one a day a week?
8. Bump lifts. This is when you lift the weight of the baby out of your pelvis by using your abdominals. It’s such a useful skill to employ when getting out of a chair, rolling over in bed or when you are just standing to relieve pain in your pelvis.
9. Pace yourself, regular rests to take the weight off your feet/pelvis are better than having a whole morning on your feet and then crashing in the afternoon.
10. Exercise. Keeping strong is always a good idea. The pelvis tends to love symmetrical exercises, including things like squats, making the sure the legs don’t go too wide. Breaststroke tends to aggravate PGP, so use a float between your legs and just do the arms so you can keep exercising.
Sally Murray, Resident Women's Health Physio @ The Derbyshire Sporting Joint
Injury prevention in cycling
So you’ve all the gear and only a vague idea; you’ve started cycling, training hard for the Cycle Derby Sportive, and you’re loving it… then some injuries start creeping in and you start to think ‘I thought this cycling malarkey was meant to be good for me!!’
Well, it is! But there are a few handy hints and tips we have for you to make sure that you last a bit longer past the Spring Sportive! With clickable exercise gifs you really have no excuse!!!
Stability:
Definiton: The ability to maintain a state of stableness, the property of a body that causes it when disturbed from a condition of equilibrium or steady motion to develop forces or moments that restore the original condition.
There are two main points that require good stability in order to put less strain on the rest of your body: your pelvis (and core muscles) and your shoulders (and shoulder-blade muscles).
Lower body stability: Because cyclists spend all their time bent forward, I often find their glutes don’t work as well as they should. The glutes attached around the pelvis all do different jobs:
The big one at the back is the Gluteus Maximus (GMax), and it is in charge of extending your hip (moving your hip backwards).
Gluteus Medius (GMed) is a little bit further around the side of your pelvis and its main job is to help control the side to side movement of the pelvis and also control the direction in which your knees face. Your core (not your six pack muscles!) helps to keep your spine supported while still being mobile.
If GMax doesn’t work properly I often see people with lower back or hamstring issues resulting, as both areas try and pick up where GMax is lacking.
If GMed doesn’t work properly I tend to see people with back pain, groin pain, knee pain, and sometimes even ankle/ foot pain resulting.
Core stabilisers are made up of your diaphragm on top (no holding your breath!), transversus abdominis which wraps around you like a brace, multifidus which runs between each little bone of the spine and your pelvic floor, which is not only responsible for stopping you wet yourself (men and women!) but also adding to the stability of the whole system.
If your core doesn’t work efficiently I often see people with back or hip pain resulting
Training these areas: (Click on each exercise to watch a brief video!)
Gmax: Bridges ,single leg bridges , squats, deadlifts, single leg deadlifts, split squats, step-ups, lunges (All of these can be done with weights)
Gmed: Clams (can do with theraband), side leg lifts (can do with theraband), curtseys, sumo walks (with band)
Core: Ball work (Exercise 1, Exercise 2, Exercise 3, Exercise 4, Exercise 5, Exercise 6), planks, BOSU work (Exercise 1A&B, Exercise 2A&B)
Around the clock exercise (Great for core and pelvis).
Hamstring (can do with a straight leg too)
Upper body stability: Obviously the more stable your upper body is, the safer you are on the bike, but also the less the rest of you needs to compensate.
Your serratus anterior (SAnt) muscle helps to keep your shoulderblades under control and keep them flat against your chest wall. They are great stabilisers particularly when you’re weightbearing through your arms.
Your rotator cuff (the infraspinatus, supraspinatus, teres minor, subscapularis in the picture above!) helps control where your arm and your shoulder blade is.
The deltoid muscle is the big chunky one on the outside which is your power muscle around all the delicate structures of your shoulder. This needs to work hard when the going gets tough and the hill gets nasty and everything wants to give up!
Your trapezius (all of the parts of it) are in charge of your shoulderblade position in terms of going up/ down and in.
Your big pectoralis muscles on the front of your chest also help with the control of your arm and shoulderblade. This is a big meaty muscle and is also your champion when the going gets tough to help you control your upper body.
Training these areas:
SAnt: Push plus, weighted punches
Rotator Cuff: Cables/ Theraband exercises
Deltoids: Weights/ theraband
Traps: Wall angels (make sure your back is flat against the wall along with your forearms), pull downs (yes these work your lats too), shrugs
Pecs: Chest press (weights machine), press ups, planks, plank to press up
Good whole body exercises:
BOSU planks
BOSU mountain climber series: Exercise 1a and 1b, Exercise 2a and 2b
These are only just a suggestion for you, and by no means the Holy Grail, but I never met anyone who didn’t feel better being stronger, and it definitely will make a difference on the bike.
Best of luck with your cycling this year!
Kate
Lead Physio
The Derbyshire Sporting Joint
I’ve been a qualified physiotherapist for over ten years now and I have heard literally thousands of people during that time talk about their ‘really bad back pain’. And to be honest, I never really got it. Patients would complain of severe, unremitting back pain that was there constantly. There was always a little part of my brain that thought, there is no way that this person has pain 24 hours a day.
It was with much enthusiasm that many of my patients came in saying they had seen the BBC programme: Horizon: The Truth About exercise (http://www.bbc.co.uk/programmes/b01cywtq) in which most people who saw the programme gleaned that they only had to do 3 minutes of exercise, once a week and all would be well. In summary the guy did 3 minutes of High Intensity Training a week, and it changed his INSULIN SENSITIVITY. His aerobic capacity did not change as he is a ‘non-responder’ to exercise. That is all. What the programme did not claim was that 12 minutes of exercise a month gave you all the other benefits of exercise (and I’m talking 30 minutes of medium intensity exercise a day).
These benefits include:
I’ve pretty much heard all the sayings out there with regards to injury.. ‘if it came on it’s own, it’ll leave on it’s own’, ‘rest cures all’, ‘stretching fixes everything’. But imagine your car breaks down, you park it in the garage for 3 weeks, and then 3 weeks later expect to drive it, as normal as soon as you back it out of the driveway.., a solution to the problem? Doubtful!
I see a lot of patients every day with pain, and so often their story goes... I used to go to the gym regularly, but about 3 months ago I stopped’, or ‘I just don’t have time for exercise’, or ‘I hate going to the gym because it’s boring’. My point is though, that those people are in pain for a reason: they’re weak, they’re unfit, they’re often overweight and they probably haven’t taken a deep breath in MONTHS
