Six Physio are leading independent physiotherapists & sports injury specialists, offering expert treatment in a range of services including Physiotherapy, Lower Back Pain, Sports Massage, Six Pilates, Sports Physiotherapy, Biomechanical Sports Assessments and Work Station Ergonomics.
Family can often be far away, so who is there to help when your Pregnancy test says ‘yes’. It transpires there is now an expert for everything.
From Hypnobirthing and having a Doula to guide you at home, through to antenatal classes and pregnancy massages the list is endless. Some ladies have a tendency for reflexology, some acupuncture, some would rather have a PT. Do what is right for you.
Every pregnancy is different – but one thing is consistent – after you’ve given birth your body is not the same as it was. This is where we come in, our Women’s Health specialists offer postnatal body checks to advise you on how to get your body back to where it was!
It’s back to reality after a weekend of Sporting fever…
But there is more to come:
Women’s Netball World Cup
Hopefully all this sport inspires you to keep active… but don’t go from zero to hero or you will pick up an injury!
At Six Physio we have 140+ team members who between them compete in a huge range of sports, but even if they’ve never tried your sport of choice, you can be sure the physios’ bio-mechanical knowledge will fix you: plus they’ll keep you smiling throughout and somehow make dull exercises more interesting! #rehabiskey
These classes are gaining popularity but few realise there can be health hazards ahead Sarah Bentley explains to The Mail Online how poor bike set up can cause knee and back pain. 12th June ’19
With SoulCycle opening its first UK studio in London’s Soho — this is a clear sign that the cult of spinning isn’t waning any time soon – they offer more than just an exercise, it’s a ‘philosophy’.
The spinning phenomenon is easily understood: the energy, the music, the ability to burn 500-700 calories in just 45 mins.
However, from a Physiotherapist’s point of view, Sarah explains:
‘At Six we see so many ‘spinjuries’ caused by poor cycling techniques and wrongly positioned saddles and handlebars.’
‘A poor bike set-up or incorrect technique can cause knee pain if the saddle is too low, or lower back pain if the handlebars are too far away and you’re slumping.’
‘You can also get numbness or tingling in your feet from having your shoes done up too tightly and even hyperextension in the neck from pushing your head forwards while looking up at the instructor, so we now offer biomechanical assessments and personalised advice about setting up your bike to fit you.’
That’s not to say she’s anti-spin, however. ‘It’s great cardiovascular exercise, as long as you’re combining it with other workouts for your core and all-round strength.’
Juliet Slade, Rehab Specialist at Mansion House gets to grips with this move:
Stop. Take a few out minutes to learn how to squat properly.
This essential move can help tone and strengthen specific muscles as long as it’s performed the right way.
Squats are dependent on movement quality. Predominantly poor squatters will move from their back rather than their pelvis – reducing their ability to use glutes and relying more so on lower back muscles and quads. This can be due to just poorly learned technique or biomechanical restrictions such as stiff upper backs.
There was probably a time not too long ago where in most households the only roller that existed was in the kitchen drawer!
But times have rolled on. So, in case you’ve never heard of one or are not sure how to use it, they are an amazing tool to aid your recovery after working out or competing.
Rehab and Pilates physio Juliet Slade of Six Physio in London knows all about the benefits of the foam roller – using one “boosts circulation to the tissues, facilitating smooth movement,” she explains.
And foam rolling helps your muscles before exercise too. Test before you buy though – the lighter the colour can mean the softer the roller, but, as Slade explains, “in most cases this isn’t correct – they just look pretty if they’re brighter.”
While some have ridges and knobs for applying varying amounts of pressure, others are smooth. Newbies, choose the smoother ones first. But don’t take it too easy, 7/10 on the discomfort scale is about right, you can upgrade later.
Remember, your goal is ‘myofascial release’ and the following methods will help you protect your fascia – the soft connective tissue just beneath your skin that connects your muscles, bones, nerves, organs and blood vessels – by stretching and it.
Sit on the floor and position the roller under the area you want to release, before slowly rolling your body weight back and forth across the roller.
You can target particularly painful areas but to begin with, move slowly and work from the centre of the body outwards, focusing on specific muscle groups rather than individual muscles.
Think: hamstrings, calves, quads, outer thigh, buttocks, chest and back to name a few.
Research in the Journal of Athletic Training found that 20 minutes of foam rolling immediately after exercise and every 24 hours thereafter helps to reduce stiffness after hard exercise and prolonged muscle soreness.
Arguably the biggest advantage to foam rolling is how it benefits your posture – most of all your upper -middle back, which, as humans have become increasingly sedentary, has weakened.
“By increasing circulation using a roller, your muscles are prepped for a state of higher activity,” advises Slade, and as a result increasing the chances of better flexibility.
Improved blood flow, improving your immune system by releasing your fascia and decreased stress are further reasons to get a foam roller in your life.
‘When can I get back to netball?
Can i get back to touch rugby this month?
Am I OK to run this week?
These are very common questions that we get asked by new mums. With the benefits of sport and activity being so well documented – positive for physical health, mental health and an important social contact point for many people – it is always a great goal for us, as Physios, to help our patients to achieve. After having a baby, these goals are still within reach, however it is important to be aware that your body has been on a challenging journey and extra steps may be needed to return back to sport safely.
Everybody has a different goal, everybody has a different pregnancy and everybody has a different birth experience.
1/ Consider a pelvic floor muscle assessment by a specialist Women’s Health Physiotherapist.
Our pelvic floor muscles are a layer of muscles that support the pelvic organs and span the bottom of the pelvis. They act as a type of muscular trampoline from the tailbone (coccyx) at the back to the pubic bone(at the front), and from one sit bone to the other (side to side). After having a baby the pelvic floor is weak and injured in most women.
When performing high impact activities (ie running, jumping, skipping) the physical force of landing passes through the lower limb and pelvic floor as the foot strikes the ground. This ground reaction force is felt as the abdominal contents bear down on the pelvic floor, making it difficult for a weak pelvic floor and bladder not to let go. This added strain on the abdominal muscles and pelvic floor can be too much for the weak muscles to control and you can become symptomatic (ie leaking of urine, pelvic organ prolapse, back pain).
It is important to be able to perform a correct pelvic floor muscle contraction – regardless of how you have delivered your baby, and especially if you did not train these muscles before giving birth. A Women’s Health Physiotherapist will assess the pelvic floor strength and control, teach you how to perform a correct pelvic floor muscle contraction, and set a personalised strengthening programme for you.
2/ Core strength assessment.
During pregnancy, the abdominal muscles are stretched as the baby grows. This can sometimes lead to a stretching of the outer abdominal muscles – called Diastasis Rectus Abdominis. While this is common ( ⅔ of pregnant women will experience this), our core strength depends on good control and strength of these muscles around our abdomen and also our lower back and hips.
It is recommended that an assessment of these muscles – including the abdominal muscles – is completed by a Women’s Health Physio, prior to returning to higher impact activities. This is quite often done together with a Pelvic Floor Assessment at a 6 week post natal assessment.
3/ Functional assessment.
Returning to sport after a period of time off should always be preceded by a return to sport assessment. If you had taken six months off playing soccer due to a knee injury, you would get your strength, movement and control assessed by a Physiotherapist before returning to the pitch to reduce risk of further injury. The very same is valid for returning to sport in the postnatal period.
Quite often it may be close to a year between the pregnancy and postnatal period, before you are feeling able to returning to your sport – and so identifying areas that may put you at a risk of injury is key! Functional assessments look at your control and strength in various movements to ensure that your key muscle groups are prepared and strong enough to return to your particular sport/activity.
4/ Gradual load progression.
Return to running ( and so high impact activities/sports) is not advisable in the first 3 month post natal period, and beyond this if there are any symptoms of pelvic floor dysfunction ( as mentioned above).
We recommend that a low impact exercise routine is followed in the post natal period, with a return to impact exercises from 3- 6 months postnatally at the earliest. An example of a gradual load progression would involve starting initially with walking for cardiovascular exercise, then introduction of functional activities (ie squats, lunges).
The next progression would involve low impact exercises such as static cycling bike, swimming ( if wound healing is complete), power walking, and building on your functional strength programme. Remember, you need to be strong to run – and so consider building up your lower limb, core strength and general cardiovascular strength in alternative ways, until your body is ready to return to high impact activities.
Once you have gotten the green flag to get back to higher impact activities, consider the ‘couch to 5km’ app for a planned guided return to running and building up your running tolerance.
5/ Treat yourself to some new activewear!
Having addressed all the above steps, consider a well deserved mini shopping spree. Comfort is everything when exercising, so with that in mind, start with looking after your feet.
Often during pregnancy your feet can change shape – widening a little – or you may still be holding a little extra water. Check that your trainers/runners still fit comfortably and that they aren’t pinching anywhere.
Does your sports bra still fit, and is it supportive enough? If you are still breastfeeding, or have recently stopped, a supportive sports bra that fits correctly is important for any impact sports. It helps with reducing upper back and neck pain, and also supporting your breasts to be comfortable with higher impact activities.
Having some help to get you back to doing what you enjoy safely is important, and having some guidance tailored to you and your sport is essential.
Physiotherapists with specialist training in Women’s Health are well placed to give you that individual guidance.
Is a heavy bag bad for your spine or are you just carrying it the wrong way, asks @Petabee The Times 28th May 2019
We hear all these comments:
if your tote is too heavy it can affect your gait, don’t carry a holdall in the crook of your arm… But are they right?
Peta Bee admits hers is stuffed with everything from sunglasses, keys, newspapers, water, various items the kids have given to her to carry that have never found their way out… and this doesn’t include her phone, phone charger, bike lock & gym kit!
A recent survey of 1,000 women by Aspinal of London has revealed that UK women typically carry 17 items with them daily. Peta Bee used Aspinal’s online handbag calculator (yes, there really is such a thing), and her bag clocks in at 4.5kg, add gym kit and it can be an extra 1.8kg, making it more like the weight of a three-month-old baby!
But experts now think it is not a bag’s weight that’s problematic as much as how (and how often) we carry it…. provided you are strong enough to carry it, even the heaviest handbag will do no harm. Our very own Matt Todman shares his supported view:
“The relationship between carrying a large, heavy bag and it causing pain is now considered mythical rather than real and there are plenty of clinical studies support this.”
When it comes to the best type of bag for your back, there are no clear rules. “Anything which is symmetrical is generally better if you have existing back ache, because it prevents you from becoming lopsided due to the weight of the bag being distributed on one side of the body only,” Todman says. “If your back hurts then using a backpack over both shoulders and used with a hip belt fastening will help to direct the load through the hips and not towards the painful bit of your back.”
To be honest everything seems logical when you think about it:
“The nearer you keep a bag to the centre of your mass, the more control you have of it…If you want to improve your strength, resilience and endurance and reduce your risk of problems, carrying different bags containing little and often at the start and slowly increasing the weight is the best way forward. That’s what we would call a perfect loading strategy.”
Find one that feels comfortable and don’t feel guilty about using it.
Diastasis Rectus Abdominus (DRA or RAD) refers to excessive prolonged widening of the mid-line abdominal connective tissue, called the linea alba.
Everyone, including women who have not had a baby, have some degree of separation of the linea alba. This is a normal anatomical feature of the body, that becomes further affected by the necessary stretching of the abdominal tissues during pregnancy.
Risk factors for DRA are thought to include multiple pregnancies, heavy or poor lifting techniques (e.g breath hold) genetic predisposition, chronic straining (including coughing, vomiting and constipation), and excessive abdominal loading with exercise.
When we assess DRA, we are looking not only at the width, but also the depth of the separation.
A women’s health physiotherapist is the perfect person to assess and create a management plan regarding diastasis.
Everyone’s tummy is different and thus a unique treatment plan is required for each Mummy.
FAILURE TO LUNCH How skipping breaks at work can lead to bad posture, an unhealthy diet and sleepless nights – 17th April for The Sun
Claire Dunwell speaks to experts about damage you could be doing – and how to make the most of your lunch break.
When was the last time you took your full lunch hour at work?
It seems we are a nation of desk-hunching, on-the-go eaters. Just three per cent of us take an hour-long break, with 52 per cent grabbing no more than ten minutes. A fifth blame their workload and 12 per cent say they are worried about leaving their desk. But skipping these breaks can have negative impacts on our health.
Without getting up from your desk for a lunch break, and moving about, we sit in the same position for long periods – which is bad for posture.
Julia Barber, consultant at Six Physio, says: “Our bodies are designed to move but many of us are employed in sedentary occupations.
“Research suggests active breaks with postural changes may be effective in reducing pain and discomfort as well as preventing our backs and muscles from tightening up in the first place.
“Try setting an alert on your phone to prompt you to get up.”
FIX IT:Motion is lotion for the joints and just small breaks in the day can improve how your body and brain feel, come clocking-off time.
Get up and do a circle of the office every hour and go for a walk on your lunch break.
Other factors include: Sleep, Bones, Fitness, Happiness, Diet
If you are on a journey to complete your first triathlon… congratulations and stick with it. If you are a seasoned ‘pro’ then well done for the commitment.
Triathlons are a great way to keep your body fitting fit in a multitude of ways; from having the capacity to cover long distances on your bike, to being slick and effortless in the water. They are also a launch-pad to aim for longer and bigger events and boost your interest to become an Iron man or women.
The human body is capable of some amazing feats of endurance and this isn’t just reserved for elite level athletes! Just people with the determination and drive to aim for the next big step or achievement. With enough fuel, training and mental grit you’ll be able to just keep motoring on and on. So, if growth and development make up who you are, if you’re wondering where to set the next limits and get your next kick then this information will be right up your street.
Break up the disciplines to boost your training…
Training all three disciplines takes time and establishing a good routine is vital. A good way to mark your progress, add distance into your training and get miles under your belt prior is to enter some single discipline events. The running season starts two months prior to the Tri season, giving ample opportunity to pick up some distance events before your Tri calendar is looming.
Check out the bottom of this article for some of our favourite single discipline distance events!
Listen to your body…
Regardless of the discipline, your body is the greatest guide of how your training is going. Remember it takes time to build muscle (4 weeks), but longer for your bones, ligaments and tendons to adapt (3 months). If you think of muscles as the fast winger on a rugby pitch, you give them the ball and they’ll sprint away with it; well bones and tendons are the slower front row, who despite having the ball, will make their way slowly across the pitch, getting there eventually but with hurdles along the way.
With this in mind training plans need to encompass gradual increases of load over time (hint… over three months) so all your tissue can adapt and get more resilient. Without forgetting the importance of factoring in rest periods and sleep, so that tissue doesn’t get too fatigued and fail. Sleep has been proven to be the best thing for recovery, so clocking 8 hours regularly will help keep you fresh and performing well.
Heavy weightlifting sessions, running sprints or long endurance cycles need recovery time afterwards. Over training syndrome is the most common cause of injuries us Physios see, and they start to happen if the training level is too high for too long, past the point at which the body can cope. Take note, the injury will only manifest 3-6 weeks after an over training error has occurred!
Physical AND mental elements…
Besides the more serious injuries such as bone stress fractures and muscle strains, that will cease your training immediately, other symptoms of over-training can flag up in physical and mental forms:
Excess fatigue, increased/decreased heart rate, weight loss, awaking un-refreshed or feeling overly heavy, sore and stiff muscles and strength losses. It can also manifest as depression, loss of motivation or appetite, insomnia, irritability, restlessness, decreased mental concentration and anxiety.
These are all things to watch out for, even if you’ve been doing events for years does not exempt you from injury. To avoid these pitfalls, I recommend that you follow a training plan that builds your fitness over time and keep a training log. Also, be realistic, if your normal level of activity amounted to sitting on the sofa and walking to the training station for your commute, then exercising five times from week one would put you at risk of some of the physical and mental symptoms above and increase your risk of injury!
An easy way to keep track is to measure physiologic markers, such as body weight, morning urine colour, morning heart rate, and maximal heart rate. Keeping an eye on overall training times and seeing if distances and time to complete specific runs or cycles are feeling harder or more taxing. Regular testing of a 10k run or cycle allow you to see if your training is paying off and improving your fitness levels or if there is nothing left in the tank showing your need to factor in more rest periods. Psychological markers such as happiness and wellness scales can also be key to your readiness.
Slow and steady wins the race…
Bearing all this in mind then it’s clear that taking your time training and preparing prior to your event is key for success. The body and it’s tissues take time to adapt, but can achieve amazing things when put to it, most of the time the body can exceed more than we give it credit for!
Examples of the level you could strive towards and achieve look no further than the UK’s Fell running champion and winner of the 268 mile Montane spine race, Jasmin Paris. She clocked a pace just above the average walking pace, albeit for 83 hours with only 7 hours sleep, and she arrived 15 hours ahead of all other competitors to the finish line.
Likewise, Courtney Dewalter won a 238 mile running race in 57 hours, 10 hours faster than second place. Plus Mark Beaumont cycled around the world in 79 days, at an average of 15 MPH, 16 hours a day for 240 miles per day!
There are plenty of real life heroes out there leading the way for people to aim bigger, better, harder and further… so, after finishing your next challenge, why not set your sights on something to compliment your triathlons. This could be the pinnacle of all triathlons, an Iron man, or a single discipline event.
Here are some of our top single discipline events…