Pelvic Floor Dysfunction - More common than you might think
HAVE A LOOK AT THE NEW PELVIC FLOOR WORK - IT
AFFECTS MORE PEOPLE THAN YOU MIGHT THINK
Pelvic Floor Dysfunction: What is it, why do you have it and how can you correct it?
To start with, new research in 2014 shows that 80% of women will have Pelvic Floor Dysfunction (PFD) at some point in their life and 30% will have stress incontinence. Men are also affected by PFD, frequently as a result of prostrate problems, although this is talked about much less.What is Pelvic Floor Dysfunction?
A dysfunctional muscle is one which will not contract nor release so it tends to be both tight and weak, and consequently, unable to function correctly.
The pelvic floor is the muscle group which forms the 'under carriage' of your trunk. It supports your internal organs, includes the "bathroom" muscles and adds support to the sacro-iliac joint. So it is essential that it functions correctly. If it is dysfunctional it will be tight, short and weak instead of being flexible, long and strong. Symptoms of PFD may include:
Abdominal separation following pregnancy
Back and Sacro-Iliac joint pain The contributors to PFD include:
Crunches and sit ups
Wearing high heels
Sitting for too long What is the solution?
New research has identified that the pelvic floor will not work effectively in isolation, it will function up to 75% better through a specific mix of muscle group activation rather than with the traditional 'kegels' exercises (controlled lifting of the pelvic floor in isolation).
In addition, all exercises should be performed with the pelvis in a neutral position, not in the pelvic tilt position.
The specific mix of muscle group activation is to work the Glute (butt) muscles in conjunction with inner, and outer, thigh muscles. This is the key combination for optimum pelvic floor engagement and improved support to the pelvis.The best exercises are:
Squats with correct alignment to strengthen yet lengthen the pelvic floor
Shoulder bridge with a small ball between your knees
Curtsey or split squats
Clam type exercise using fast and slow twitch pelvic floor activation
Check with an exercise professional to ensure that your technique is correct as this is essential to gain any PF benefit. The big benefit of this new approach is that by working this specific group of muscles, correctly, the pelvic floor will activate automatically.Exercises to avoid
Any exercise with a pelvic tilt as this shortens the pelvic floor muscle, encouraging dysfunction.
Crunches or sit ups, which increase the downward pressure on the pelvic floor.
High impact exercise.
Pilates exercises such as 'the 100'Would you like to know more?
Just contact Anne by phone or email to discuss your needs. The correct exercises and techniques are taught in 'I Move Freely' Pilates Classes at The Studio
Pilates, Yoga and back pain.
What is the difference between Pilates and Yoga, and why would you choose to take up one or the other?
Frequently either are recommended by physio’s or doctors for back pain and can be very beneficial under the right circumstances. Unfortunately both carry inherent risks, particularly for people with back issues, and Yoga tends to be less useful than Pilates in these circumstances.
Yoga was developed in India hundreds of years ago to address a whole range of human issues, from the physical to the psychological. It would normally include a significant spiritual aspect as well as extreme body positioning, providing a 'whole body' (holistic) teaching and healing.
More recently popular Bikram and Ashtanga developments of this teaching include a dynamic approach, which can be difficult for less able (normal) people to handle.
Many Yoga teachings, including the Bikram and Ashtanga methods, aim to stretch the body as far as possible and to target the maximum range of movement through each joint. While this may be considered beneficial for a person with no history of joint pain or injury, it is not recommended from a bio-mechanical view. One reputable source recommended that only the under 25’s should be allowed into this type of yoga class.
I feel it is not developed from a physiology base, and not all positions nor movements would be recommended by up to date research into human physiology.
There are Yoga classes that focus on the spiritual elements and relaxation. These can be perfect if you are looking for stress relief or a meditation like class. The spiritual element actually enables some people to really connect their mind and body and gain a tangible benefit from this.
Pilates is an exercise method developed by Joseph Pilates, an injured gymnast and body builder, in the 1920's. It was developed from exercises from all the programmes available at the time along with some innovation from Joseph P. This included Yoga and several fundamental Pilates exercises clearly come from this discipline. Joseph understood the need for “core strength” and this is the focus for most Pilates forms.
Whilst there are still trainers that teach “pure” Pilates (as Joseph would have done), other professionals have modified and developed the exercises ever since. There is no copyright on the word 'Pilates' so the content of classes can vary hugely.
Many of the Yoga movements are medically contra-indicated for the back (i.e. the risk of making matters worse, by doing the exercise, is greater than the likely benefit). Some of the Pilates movements are also contra-indicated for the back (mostly derived from Yoga movements).
For an example of a Yoga inspired Pilates exercise which can cause back pain we can take a bio-mechanical look at the ‘roll down’.
Yoga and Pilates both use the ‘roll down’, a movement from sitting to lying where the back curls round to allow vertebra by vertebra to reach the floor. The intention being to strengthen the abdominal muscles.
But what actually happens to your body when doing this?
The intervertebral disc space is opened which can aggravate or even cause bulging (herniation/slipped disc). A little like squeezing a jam donut until the jam pops out.
In fact not only the abdominal muscles but also the hip flexors, hold the body as it rolls down.
The shoulders curl forward shortening the pectoral muscle group and the mid trapezius lengthens.
For many people these muscles are either already tight (pectorals) or already long (mid trapezius) from daily repetitive movements such as computer work or driving. The hip flexors are frequently tight just from sitting down for too long.
It turns out that this exercise provides no real benefit but potentially compounds the postural issues that everyday life gives most of us. Worse still it can aggravate back pain and intervertebral disc issues, rather than helping.
My training as a back pain specialist made me question the validity of some of these exercises, particularly when clients have back problems (slipped or bulging vertebral discs, degeneration of facet joints or osteoporosis). My bio-mechanic training has encouraged me to question each exercise that I teach. What is the benefit? What is the risk? Why am I teaching it to this particular group? Is there a better way to gain the desired result? There should always be a clear answer to all these questions.
I have been teaching Pilates and Yoga, in various forms, for more than 20 years. Over the last 10 years I have developed “I move freely” Pilates as an exercise form that carries most of the Pilates benefits with few of the risks.
I Move Freely Pilates takes the principles of Pilates but integrates Bio Mechanic coaching techniques to offer an up to date way of keeping mobile, strong and with the optimum amount of flexibility. Mobility work is essential to keep the whole body moving easily. I feel that mobility and balance are key skills that deteriorate with age but which with work can be improved reducing the risk of stiff joints and falls in old age.
The strengthening work uses the body's ability to statically contract or 'engage' a muscle as well as using controlled lengthening and contracting of specific muscle groups. It works on the muscles of the abdomen, buttocks (glutes) and back, many of which you can't see (most people don’t even know they have them), but which should perform functional roles of support throughout daily life.
It is this functional supporting role that reduces back and other joint pain. Each exercise involves a very precise movement and often it is impossible for anyone else to 'see' how hard a person is working as the work is in 'engaging' a specific muscle. This often leads people to do the exercises at a level below that of which they are capable and so they don't achieve the full benefit but feel they are 'stretching out' rather than 'working'.
Performed correctly Pilates can achieve great core stability and it is as useful to elite sportsmen and women as it is to the general public.
This link (from my Norfolk Studio) explains more about stretching v working a muscle:
Most Yoga teachers have spent time in India studying and practicing so they are expert in their knowledge. Most Pilates instructors have studied the teachings of Joseph Pilates and have an in depth knowledge of the exercises and breathing techniques he espoused. However this does not make any of them experts in back pain management. They are unlikely to have had the training to working with particular conditions, such as arthritis, or liaising with physio’s as to the correct exercise programme for someone with a recently herniated (slipped) disc. For this you need a back pain specialist.
All forms of Pilates and Yoga can offer some people real benefits. To choose which would suit you best give some thought to what you hope to achieve and how your body will respond to the challenges of each class. Do try several before deciding which suits you and don’t be put off if your back aches after one class, try another – they are all different.
I also strongly recommend taking at least one consultation with a back pain trained exercise professional, since it is essential to know some basic information about how to perform Pilates exercises that is not usually covered in the class situation.
Is there an age when exercise becomes bad for you, risky or inappropriate?
At what age does it become bad, too risky or inappropriate for you to exercise?
In my opinion the answer is there is no age beyond which exercise should not be attempted!
I may be biased having worked in the world of exercise all my life and coming from an active family but my opinion is backed up by recent research and national recommendations.
The current government recommendation for those aged over 65, is
1. To be active daily
2. To accumulate 150mins weekly of ‘moderate intensity activity’ in bouts of at least 10mins at a time
3. To exercise twice weekly for strength, flexibility, balance and co-ordination
4. Minimise the amount of sedentary time. (sitting)
5. Some activity is better than none, and more provides greater health benefits
This might sound onerous, but in reality it can be achieved very easily.
Let’s look into these guidelines a bit deeper to see how easy it is to meet them and what the benefits are.
First we can consider why should we exercise at all?
• All muscle wastes away if it is not used: the motto use it or lose it really is true.
• Skills such as balance and co-ordination deteriorate with age. However they can be maintained and even improved with regular practise. This deterioration is the main case of older people falling so easily, so controlled exercise will reduce your risk of falling.
• Bone density also deteriorates with age meaning falls are more likely to result in fractures. Controlled exercise will improve bone density hence reducing the risk of fractures.
• Posture can deteriorate as we age for all sorts of reasons, most of which are correctable by specific targeted exercise: don’t become a stooping person!
• Your cardio-vascular system ages with you. We get higher blood pressure, less efficient blood flow around the body and much reduced oxygen uptake by the body, leaving us feeling less like exercise, when in fact we need more! See point 1.
• If you are suffering from arthritis, exercise is known to be beneficial, reduce levels of pain and improve mobility.
Second, what is moderate intensity activity (point 2 of the recommendations)?
Activity, here, can be defined as any movement that increases your heart rate from its normal resting rate. The measure of moderate intensity is different for every individual. It is not advisable to use any generic figures for this, the best approach would be to ask any appropriately qualified instructor.
What activities could count as moderate intensity?
Walking is brilliant provided it is on a regular basis and is appropriately vigorous. We can check whether you are being vigorous enough by testing your activity level in a SELECT class. If you walk your dog daily it is quite possible that you already meet the guidelines for cardiovascular exercise.
Interestingly, golf is found to be of limited benefit. It is not aerobic, it promotes misbalanced strength and flexibility in the body and research shows no bone density improvement. This would not count.
Gardening is also classed as non-beneficial. The bending, reaching and kneeling all puts stress on the body rather than strengthening it.
Swimming is similar to walking in that it can be great for cardio if it is done regularly and with appropriate vigour. However it doesn’t improve bone density or balance. And if you suffer any joint issues, breaststroke should be avoided.
Other exercises to consider that can be beneficial are, cycling, rowing or cross-training in the gym.
So what exercise is available to address point 3 of the recommendations?
Generally these exercises are specific routines that are performed in classes, in the gym, in a swimming pool or at home. The important point here is to ask an appropriately qualified instructor for guidance on what would be the most beneficial forms for you, and also to teach you how to perform the movements without them being detrimental to you.
Pilates is probably the most suitable form of exercise as it is controlled and specific in its aims. It doesn’t encourage excessive movement, and primarily uses the body’s own weight for resistance. This means it is particularly accessible even for people to do at home.
I have developed a specific variant of Pilates designed to be particularly beneficial for people with injuries, aches and pains, bad backs and posture difficulties. In “I Move Freely” Pilates classes I use biomechanic exercises to gain the maximum benefit in loosening stiff joints, backcare exercises to strengthen yet protect the spine as well as strengthening exercises for the muscles which give support to our skeletal structure. Posture is addressed with work to open the shoulder girdle, thus preventing the shoulder rounding which can easily lead to ‘hunching’. Also, I avoid some traditional Pilates exercises (e.g. roll downs, the 100 or double leg lifts) which put pressure on the lower back, neck and pelvic muscles. Provided you exercise correctly and regularly in class and continue to use the correct muscle engagements throughout the week when doing normal everyday activities you will be gaining strength and stability.
What if you don’t feel able to take part in a class nor want to go to the gym?
SELECT is a small group class (max 4 people) I run specifically to cater for you. Because the attendees are very limited the exercises can be completely tailored to your individual needs.
For example, if you cannot get down to the floor, or you cannot stand for any period, we can provide chair based exercise, or we have exercise couches. If you find it uncomfortable on normal exercise mats we can provide memory foam mats which protect any protruding, or painful parts from the hard floor.
As another example, If you have specific recommendations from your GP or physio, we are experienced at working with your practitioner to make sure the exercises are appropriate to your needs.
SELECT allows me to shape the class to each individual whatever their requirements.
Consequently, SELECT makes getting started easy, it is friendly, focussed to your needs, will address concerns you may have about your body as it ages and work towards keeping you independent and active – fit for life for all of your life.
If you are unsure in any way about attending a class or what exercise is suitable for you, please arrange to pop in for an informal chat and see how easy it is to incorporate exercise into your life.
HIIT Pilates - The best of both worlds?
The latest fitness trend to be big in the UK is HIIT - High Intensity Interval Training. Everyone is doing it, teaching it, and apparently loving it. Last week I saw HIIT Pilates classes using Pilates equipment to gain the high intensity workouts. My reaction to that was simply WHY? Pilates and HIIT are two different regimes with different aims. I don’t believe they mix at all.Pilates is a fabulous fitness programme which tones specific areas, encourages the correct muscle engagement, uses breath, focus and concentration to achieve great posture, alignment and muscle balance.
Pilates can be practised as rehabilitation post-surgery or as an exercise programme to help with arthritis or other chronic conditions.
Pilates concentrates on small, slow, controlled movements to train the body to engage the correct muscles for everyday movement and strengthen them where they are weak.
Pilates is suitable for almost everybody.
Pilates is NOT intended to be an aerobic work-out. It will not improve your stamina nor enable you to lift heavy weights
HIIT on the other hand is targeted to improve your stamina and dynamic fitness, a completely different aim.
So, is HIIT something you should be doing as well?
That depends on the benefit you are seeking to gain and how much effort you are prepared and able to put in to achieve it.
If you are healthy, enjoy pushing yourself to meet new physical challenges and are looking to increase strength and cardiovascular capacity it could definitely help you. If you are an athlete or sportsman looking to improve your performance then HIIT could be a beneficial part of your program, as could a bio-mechanics program and regular Pilates classes.
On the other hand, remember that it is high intensity exercise. If you have any medical history which precludes pushing your heart rate up this is not for you. If you have joint pain or disease it could aggravate it. If you do not use correct technique it is easy to pick up injuries. And finally remember that it’s not the only exercise programme which delivers results, a gentler progressive programme may suit you better.
Don’t follow the latest trend because it is promoted in the glossy magazines with celebrity endorsements, choose a programme that gives you the benefits you are looking for.
HIIT Pilates is ‘HIIT’ using Pilates equipment. It is not Pilates in any shape or form. Don’t be confused.