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Should I plank during pregnancy? goPhysio Advice

Posted on 21st September 2016 by

There was a great question today over on twitter that I saw,

Should I keep doing planks now I’m pregnant?

Exercise during pregnancy is great. There are so many benefits, which we covered in a previous blog. But what’s important is that you do the right exercise for you and the stage of pregnancy you are at.

Planks probably aren’t the best type of exercise for you to do whilst pregnant. There are so many alternative exercises that are more suitable and appropriate that would still work the areas that a plank does. Many of these are Pilates based, working on deep abdominal and pelvic muscles but in a much gentler way. The trouble with a plank is that it’s a fairly intense exercise and puts a lot of strain through your abdominals.

This work your abdominals really hard (the point of the exercise!) but your abdominals are already undergoing so many physical changes that planking may put too much exertion through them. The problem with doing inappropriate exercises is that you put yourself at greater risk of developing issues such as Diastasis Recti or pelvic girdle pain.

The general rule of thumb with exercise in pregnancy is if you’re already taking part regularly in an exercise pre-pregnancy, then it’s usually safe to continue this during pregnancy. So, if planks are a regular part of your exercise routine and you already have excellent strength and control in these areas, then modifying this exercise as part of your routine is likely to be OK. Just bear in mind the bigger your bump gets, the more strain those muscle are under. Most importantly, listen to your body. Don’t do anything you don’t feel comfortable with and if in any doubt, seek advice from a suitably qualified professional.

The safest option is to join an exercise class that specifically focuses on pregnancy, under the guidance of a specially trained professional you can be rest assured that you are giving your changing body the best workout.

The Effects of Pregnancy on the Body

Posted on 19th July 2016 by

We all know the obvious changes that your body goes through during pregnancy, but there are some less know changes that occur, sometimes without you even realising!

Almost all the systems in the body will undergo changes to help prepare you for the arrival of your new baby:

Soft Tissue Changes

  • The hormone Relaxin starts to be produced 2 weeks after conception and peaks at 12 weeks. It continues to be produced throughout pregnancy and the effects can last up to 3-6 months after delivery.
  • Relaxed muscles and ligaments are at an increased risk of injury, with an increased possibility of sprains and strains.
  • Conditions such as Symphysis Pubic Dysfunction (SPD) and Pelvic Girdle Pain (PGP) are also more common due to the increased elasticity of the joints, muscles and ligaments.
  • Muscles undergo adaptive length changes, to accommodate your increasing bump – with Rectus Abdominis (your tummy muscles) increasing by up to 50cm in length.
  • Due to the increased length, muscles can develop a ‘stretch weakness’ – putting you at a higher risk of injury.

Postural Changes

  • Pregnancy postural changesAs your baby grows, it causes your centre of gravity to shift forwards. To compensate and keep you balanced, your spinal posture will change.
  • As the image here shows, your thoracic spine will become more kyphotic or rounded. This leads to an increased lordosis or curve in your lumbar spine. This causes increased tension in your paraspinal muscles and reduced activity & strength of the gluteal muscles.

Circulatory System

  • Blood volume will increase to prepare for any loss during delivery and your heart rate will increase by 20 beats per minute (BPM) in the first trimester and by up to 50 BPM in the third trimester.
  • Blood vessels will increase in diameter to accommodate the additional blood volume, leading to low blood pressure. Lying flat on your back and changing position too quickly may also cause dizziness and feeling light headed.

Fluid Retention

  • In early pregnancy, this will show as increased weight, but will come increasingly more noticeable throughout the pregnancy. Hands, feet, ankles and lower legs tend to be most affected by fluid retention.
  • Fluid retention in the hands and arms can cause compression of the median nerve, leading to carpal tunnel symptoms.
  • Swollen feet and ankles may restrict your mobility – calf raises, ankle mobility and support/compression stockings can help.

Digestive System

  • Relaxin, a hormone to relax your ligaments for labour, causes a reduction in smooth muscle activity. This can lead to issues such as reflux, indigestion and heartburn. It can also slow your digestive tract down, leading to constipation.
  • Eating little and often may help, as well as staying hydrated and eating a high fibre diet.

physical changes to body

How Can Exercise Help?

First Trimester

This trimester is important for development of your baby, so gentle exercise focusing on activating your pelvic floor and core abdominal muscles is key. If you start off with good habits and postures, it will help the whole way through your pregnancy. Often, women can suffer quite badly with morning sickness, tiredness and a lack of energy at this stage of their pregnancy. Gentle exercise may help to improve mood, aid with sleep and keep your joints & muscles flexible.

Second Trimester

When you reach your second trimester, things will ease up – morning sickness will reduce and you will have more energy. Your body will now start to show physical signs of changing, with a bump becoming visible and you may find that your breasts are increasing in size – which may lead to tension and strain in the upper back. It is vital to keep exercising at this stage, continuing to strengthen your core and pelvic floor as your bump grows. Exercise will also help to reduce fluid retention, keep muscles stretched and make the most of your new found energy!

Third Trimester

Final stretch now! You may find that you feel tired and breathless now, with most women carrying an extra 12kg of weight. Continuing gentle exercise will help keep you moving and prepare you for delivery and the arrival of your new baby. Ensuring the core and pelvic floor muscles remain strengthened will help support your uterus and will also aid in your post natal recovery.

Pilates is a great way to stay active during your pregnancy. It is safe, low impact and helps to strengthen all the key core and pelvic floor muscles, along with strengthening your arms & legs to help prepare your body for carrying, lifting and holding your new arrival – plus the car seat, pushchair, nappy bag…!

Here at goPhysio, we run specialised Ante and Post Natal Pilates classes. These are run by one of our Physio’s Kim, who has undertaken specialist ante & post natal training to help make sure you exercise safely and effectively during and after your pregnancy.

You can look at our website for more information, or call our team on 023 8035 2217.

Diastasis Recti – Separation of tummy muscles

Posted on 28th June 2016 by

We see a large number of pregnant ladies and new Mum’s at goPhysio. Physiotherapist, Kim, is specially trained to treat common conditions that occur during the ante and post natal periods. One thing that we’re seeing a lot of at the moment, is ladies suffering with separated tummy muscles, more formally known as ‘Diastasis Recti’.

What is a Diastasis Recti?

A diastasis recti is a separation of the outer layer of your superficial abdominal muscles, which can often occur in pregnancy (although non-pregnant people can get it too). Sometimes it is called an abdominal separation or tummy muscle separation.

Diastasis Recti goPhysio

The linea alba is a line of connective tissue that normally joins the two halves of your Rectus Abdominis muscles together. It doesn’t have as much stretch as the muscles around it – this means that under increasing pressure (like a growing baby), it can come apart, resulting in a separation of the muscles.

Is it common?

Around two thirds of women will have a diastasis recti after pregnancy. It can also occur in the non-pregnant population – usually due to a significant trauma or change in internal or external abdominal pressure.

Women over the age of 35, have had multiple pregnancies, large babies or multiple births, such as twins/triplets, are all at an increased risk. Shorter women can also be more at risk as they don’t always have as much space in their abdomen to accommodate the growing baby as someone taller!

You may see your tummy muscles ‘dome’ as you try and sit forwards, you may actually feel a gap in your abdominal muscles or see a hollow. All of these can be signs of a separation in your tummy muscles.

Does it cause other problems?

It can do – a weak core can put additional strain on your back muscles and might lead to back pain or stiffness. A large diastasis can also cause your abdominal contents to push forwards as they don’t have the support of the muscles to hold them in place.

Can it be fixed?

Yes! But you need to be very careful in how you address this issue – crunches, sit ups and planks will only make the problem worse. You need to slowly heal the damaged connective tissue of the Linea Alba and not over work or strain the area, as this could cause further separation of the muscles. The weaker the connective tissue and the wider the gap, the longer it is likely to take to heal. In some instances surgery is required to repair there gap, although this is very rare. The key is doing the right things to address the separation and help it heal.

It’s important to see a qualified Physiotherapist who can advise you on the severity of your diastasis and exercises to start improving and strengthening the core muscles.

Why Is Rehabilitation Pilates different to other Pilates Classes?

Posted on 12th June 2016 by

Pilates classes are a big part of what we offer here at goPhysio in Chandlers Ford. However, the Pilates classes we run at goPhysio are a little different to others you may experience in the area. Our Pilates is in essence ‘Rehabilitation Pilates’.

Rehabilitation Pilates is different to a traditional class you may attend at the gym or local hall.

Physio Pilates Chandlers FordRehabilitation Pilates has been specifically developed for use by physiotherapists.  All of our instructors are both Charted Physiotherapists and are trained by the Australian Physiotherapy and Pilates Institute (APPI), which is the world leader in rehabilitation Pilates.

Rehabilitation Pilates exercises target the deep postural muscles of the tummy and spine to improve central ‘core stability’ & posture. They also help improve spinal mobility, increase flexibility of the key trunk and leg muscle groups and improve body and postural awareness. This type of Pilates is particularly suitable for you if you suffer with back or neck pain or have suffered a specific injury. It is also a great way of preventing injuries or preparing for sport.

People who come along to our Pilates classes tend to fall into one of 5 categories:

  1. They’ve had an injury and have been seeing us for Physiotherapy. Once they are nearing recovery, they start with Pilates to both continue their recovery and help improve their physical ability to stop the injury coming back.
  2. They have been advised to start Pilates by another health care practitioner (e.g. Consultant or GP) and want to join a Physio led class to make sure they have the right support in the class and adequately experienced Instructor.
  3. They’ve suffered with back or neck pain (or other injuries) on and off for years and have heard Pilates is great to stop it re-occurring.
  4. They’ve been to another Pilates class elsewhere but felt that the class size was too big and they weren’t getting enough attention or support from the instructor. We even have people who’ve picked up an injury at other classes from doing Pilates incorrectly.
  5. They’ve just heard wonderful things about Pilates and want to experience the benefits too in a friendly, supportive environment!

As our instructors are also Physiotherapist, you have ‘on hand’ expertise ready to share their knowledge and advice at every class. They have such an extensive knowledge of the human body and also injury, so can tailor each class to the individual needs and make sure you really get the most out of it for you. The classes only ever have a maximum of 8 participants, so you are always under the watchful eye to make sure you’re doing the exercises correctly and be progressed when needed.

We also run 2 specialist Pilates classes for pregnant ladies and also new mums and their babies.

There is a real skill in getting the Pilates exercises right and this needs concentration, guidance and attention.

Take a look at our class timetable to see the classes we run at goPhysio.

Questions we’re often asked about our classes

How many people come to the Pilates classes? The numbers for each class are strictly limited to a maximum of 8. This is to ensure that we maintain a high quality class, with the instructor being able to give sufficient attention & support to each individual.

How do I book onto a Pilates class? If you want to join our classes you can give us a call at the clinic on 02380253317 or email us. We’ll help find the most suitable class for you, we’ll can chat through the booking process and organise payment for the class. Alternatively, If you are currently attending goPhysio, chat to your Physio or our Reception team, who can organise for you to attend a class.

How much do the classes cost? We normally run our courses in 8 week blocks. The cost of each 8 week course is £100.

Why do I need a 1-2-1 before I start Pilates? We do advocate that if you haven’t seen us at goPhysio before you have a 30 minute 1-to-1 pilates session, before joining a class. This will enable our Pilates Instructor to help you to get 110% out of your Pilates! This is norma;l procedure for anyone starting a Physio led Pilates course. These 1-2-1 appointments cost £35.

Pilates Classes Chandlers Ford

Pelvic Girdle Pain in Pregnancy

Posted on 23rd July 2015 by

Yesterday on BBC Radio 4’s Inside Health programme, there was a great overview of Pelvic Girdle Pain (PGP).

PGP is an umbrella term used to describe pain felt in the hip, back & pelvic area during pregnancy. It can affect 1 in 5 pregnancies, normally from the second trimester, but can start from very early on in pregnancy.

It used to be thought that it was caused by changes in the ligaments during pregnancy but latest research has found that this only plays a small part. It is thought now that the biomechanical changes that occur during pregnancy in your back and pelvis are the more likely cause.

PGP can be very mild or it can be seriously debilitating, interrupting sleep, causing problems walking, sitting and gong up and down stairs. It can have a major impact on your life and pregnancy. The early it is diagnosed and the earlier treatment is sought, the better.

Physiotherapy is key to helping Mums to be with PGP. A Physio will carry out a thorough assessment of your back and pelvis to find out exactly what is going on and where the problem is coming from. This will guide an appropriate treatment and management programme with the aim of easing the pain, stopping it worsening and helping you to cope and stay active. There are many treatments that a Physio can use. These include manual therapy, specific exercises and lots of advice.

The sooner you seek expert advice if you think you may be suffering with PGP the better.
At goPhysio, we also offer specialist Ante Natal Pilates Classes that are run by a Physio. This is a really pro-active way to help prevent PGP by optimising your physical health during pregnancy. If you’re suffering with PGP the exercises can offer much relief. Plus you’ve got on hand Physio for advice when you need it.

Once you’ve had your baby, the good news is that PGP often resolves quite quickly.

If you’d like further information about PGP, The Pelvic Partnership is a great online resource. There is also a very informative booklet available to download here.

To listen to the Radio 4 show in full, click on this link, the section on PGP starts at about 17 minutes in.

If you are suffering with PGP, book an appointment to see our specialist Physiotherapist, Kim, by calling us on 023 8025 3317.

Exercising During Pregnancy

Posted on 25th June 2014 by

Many women are nervous about exercising during pregnancy and stop all activities once they discover they are expecting.

Whilst high impact and contact sports aren’t advisable during this time, there are many forms of exercise that you can do.

The general advice is that if you’re already regular exercise when you get pregnant, you can keep up this form of exercise – but don’t take up anything new!

There are many benefits to exercising during pregnancy, including:

  • Maintained Cardio-Vascular fitness
  • Helping with a more positive pregnancy experience
  • May help prevent gestational diabetes
  • Preparation for labour
  • Improved circulation – reduces fluid retention
  • Assists in post natal recovery
  • Maintains muscle length and flexibility
  • Maintains healthy weight
  • Increased body awareness and control – reducing risk of injury
  • Increase levels of energy and feeling of well-being

One form of exercise which is great to take part in whilst you are pregnant is Pilates. Pilates provides a safe, low impact and fun way to maintain your fitness levels and keep active for almost everyone who is pregnant.

The benefits of Pilates during pregnancy include:

  • A safe, low impact form of exercise
  • Conditioning & toning of your pelvic floor muscles
  • Improved postural awareness and control
  • Improved spinal and pelvic stability
  • Maintains fitness levels throughout pregnancy
  • Prepares your body for new tasks (toning and strengthening your arms & legs ready for carrying your baby and all that extra equipment around!)
  • Relaxation
  • Reduces pain associated with pregnancy such as low back pain, SPD, pelvic girdle pain
  • Social opportunity – meet like minded, local mums to be!

The benefits of Pilates after you’ve had your baby include:

  • Assists with weight loss and toning
  • Increases fitness levels
  • Helps maintain bone density
  • Social opportunity – meet local new mums
  • Can help prevent post-natal depression
  • Speeds recovery from delivery
  • Builds muscle strength and tone

Check out more information about our NEW Ante Natal & Post Natal Pilates Classes at goPhysio in Chandlers Ford.

Ante Natal Pilates Chandlers Ford Post natal Pilates Chandlers Ford

How come my feet have grown after I’ve had a baby?

Posted on 19th March 2014 by

Why, after being a size 4 all of my adult life do I now have to buy size 5 shoes?!

All pregnant women expect to get bigger with pregnancy, but it’s not just your bump that can grow! Research has found that Relaxin, the hormone responsible for relaxing the joints, ligaments and muscles surrounding the pelvis and low back in preparation for child birth, will also act on other ligaments in the body.

A study at the University of Iowa found that on average during pregnancy, arch height decreased by between 1-5mm and foot length increased by 2-10mm, with these changes remaining at 19 weeks post-delivery.

During pregnancy, as your feet take the load of your increasing body weight (plus a growing bump), combined with gravity and the effects of Relaxin, can cause your feet to ‘grow’ in size, either in length or width. Many women find they will need to wear a larger shoe size during their pregnancy to accommodate their larger feet. This is often due to water retention and swelling in the feet and legs, causing them to look and feel bigger than they are!

Most women will find that once they have had their baby as the Relaxin levels in their body lower, their feet will return to their ‘normal’ pre-pregnancy size. However, in some cases there can be a permanent increase in shoe size. This can be due to a variety of factors – number of pregnancies, hyper-mobility (natural flexibility) of the foot and weight gain.

Foot archesThis permanent change in foot size is more common than we think! The permanent change is caused by the plantar ligaments that support the longitudinal arch of the foot becoming stretched and permanently lengthened. This in turn leads to flattened or collapsed arches, which can potentially lead to foot, ankle, knee and hip pain over time.

feet growth baby

The actress, Denise van Outen, mentioned after the birth of her daughter a few years ago, that her feet grew from a size five to six while she was pregnant, and have stayed that size since – she had to give away most of her designer shoes as they no longer fitted!

If you have noticed that your feet have permanently increased in size after you’ve had your baby, with your middle arch starting to flatten out, goPhysio could help. With our GaitScan system, we can assess your new foot position and if it would help you, provide you with a pair of custom made orthotics which will help support the arches of your foot and relieve the pressure on other structures higher up in your leg. In the future this will help prevent long-term adaptations being made by your body which can result in other problems, such as back, pelvic & hip pain. As a new Mum, with little time to rest, you’ll certainly be on your feet a lot more and this isn’t likely to change for many years to come. Looking after your body and being pro-active in preventing issues is key. If you’ve already noticed aches & pains, custom made orthotics will help reduce these.

If you have any questions about how we can help with foot pain during pregnancy, pop in to see us or give us a call!