The Science behind Yoga (and other exercise programmes)
The Science behind Yoga (and other exercise programmes)
I recently shared an article about science and yoga. It was interesting as it focused on changes within the brain brought about through yoga practice. What I found most interesting was that these changes are brought about by the focusing of the mind rather than the performance or achievement of yoga poses. This means that the benefits can be gained by any mindful exercise programme which encourages you to focus on breath, link your mind to your body and gain relaxation.
Much of the benefit yoga is proven to provide is associated with the management of stress. The article claimed that 90% of all the illness we suffer is stress related. I haven’t been able to verify that figure but stress certainly has a big impact your health and your ability to recover.
Do you suffer any of these basic symptoms of stress:
- High resting heart rate.
- Repeated headaches.
- Stiffness in your neck and/or tight shoulders.
- Back pain.
- Periods of fast shallow breathing.
- Increased perspiration (e.g. sweaty palms)
- Repeated stomach upset, nausea and/or diarrhea.
Or any of these which are more likely to develop over a longer period: • You have high blood pressure • You suffer chronic neck, shoulder, or low back pain • You suffer reflux disease or IBS • You have low fertility, problems during pregnancy, or painful menstrual periods. • Your arthritis, asthma or other chronic conditions worsen • You have skin problems such as acne and psoriasis.
If any of these sound familiar then the regular practice Yoga, or a programme with the same benefits, could certainly help you to better health.
The main elements in Yoga that have been found to improve a person’s stress levels are: breath, movement, mindful attention and relaxation.
Breath is a particularly powerful tool and can be used to control the stress response of the body. By filling the lungs, taking fewer breaths, making them deeper and longer you control the breath and lower blood pressure and stress response. By focusing your mind on each breath, you regulate your thoughts, give yourself space and empty your brain. In research, focus on breathing has been shown to change the way in which the brain (prefrontal cortex) behaves. Particularly in reducing depression and changing behavior to be more positive. Neurotransmitters work more effectively and the interbrain links are improved giving a variety of benefits to the body.
By combining breath, movement, mindful attention and relaxation we can change how we feel and in time even change how our bodies behave.
In fact you can get all these benefits from most of our classes at the Studio.
· In IMF Pilates we spend time training our brains to consciously connect to different muscle groups and to identify and engage specific muscles we want to work. This connects the mind to the body in a practical way. By having to concentrate on each position the mind is forced to empty other thoughts. In this way you can achieve relaxation and stress relief through simple movement.
· In Yoga For Healthy Backs we use the power of breath and relaxation techniques to reduce specific back pain.
· In All Woman IMF Pilates we additionally focus on the relaxation of each part of the body. This helps you to connect more fully with your body and to enable complete relaxation. Brilliant for pregnant clients, particularly useful through labour, and menopausal women suffering from stress and anxiety.
· In Janey’s Yoga, using classic poses, she has an approach she calls ‘help yourself to find yourself’. She positions herself as a facilitator to help you find yourself rather than a teacher of Yoga, The article I mentioned earlier used the line ‘Use yoga to find out who you really are’, this is clearly aimed at the type of Yoga Janey practices.
The image of yoga, often shown by the media, and presented by Yogis themselves is of skinny flexible, capable people adopting difficult and complicated positions. In reality, the benefits can be obtained by almost anybody. If you are busy, stressed, unfit, overweight, inflexible, not used to exercise or not sure about joining a class, whatever your age, we can still help you. None of these are a valid excuse for doing nothing. Movement is vital if you are to improve any of the above conditions.
Come into your body and reconnect!
Are you still doing sit ups in the hope of achieving a strong core?
Sit ups are often performed as a core muscle exercise. However research continually shows that they are not effective at building core strength. Old habits die hard and in the fitness industry sit ups, crunches, roll ups, roll downs etc… have been around for as long as people have been exercising. But, this doesn’t mean that they are good or effective!
Core muscles are those which hold your body together, giving it strength by binding around your trunk. They support your spine and strengthening them can significantly reduce back pain. I would include in core muscles those around the shoulder girdle. They have a big impact on posture which, if poor, can cause the shoulders to slump forward and eventually result in pain. Recent research has also added new muscles as essential for core stability, known as gluteals. This complex muscle group lies across your butt and holds your pelvis stable.
So back to sit ups, what happens to your body during the exercise?
Your shoulders round into a position very similar to that seen in the office chair slump, the slouched driving position or the collapse on the sofa rounding. In other words, good posture across the shoulder girdle is completely lost. When this was first performed I don’t suppose we were living a life of sitting and slouching so possibly the postural issues we see today were not as prevalent.
Your spine is curled forward. For some this may feel good and indeed be beneficial but for many the compressional force on the intervertebral discs will aggravate previous injuries such as herniations (slipped disc) or prolapsed discs. Measuring this compressional force is something we’ve only been able to do in recent years, and it is huge when performing a sit up. When I first taught these exercises the fitness industry was oblivious to these potential dangers.
Once you get almost half way up, your hip flexors become the main workers to stabilise and complete the movement, to bring you up to sitting. These are also shortened by a sedentary lifestyle and if not specifically stretched they pull the pelvis out of alignment causing back pain.
This brings us onto the new core muscles, the gluteals. Generally weak (despite years of tums and bums classes!) and difficult to activate, yet essential for good posture and a strong core. In those who perform lots of crunches the hip flexors, hamstrings and rectus femoris (thighs) tend to be strong but these muscles work in a vertical plane. In these people the gluteals are likely not to work at all, yet they provide all the essential diagonal support for the pelvis.
If you are looking for a strong core, the exercises you need are those which use the gluteals and the stabilizing abdominals, not the sit up muscles.
If you’re tempted to go for a ‘6 pack’, remember that it can only be achieved by over developing the muscles so they push out through the fascia, which is there to hold them together. For a female to develop a 6 pack, as well as the muscle development she also needs a BMI well below that recommended for good health.
For effective exercise advice look for an instructor with a good understanding of spinal load during exercise, preferably with a specific low back qualification and an interest in functional fitness and posture.
Pain is not as simple as you might think!
Almost everyone will have felt pain at some time in their life. Here at the studio we see a lot of people suffering from pain, mainly associated with movement or a persistent ache. We can usually help to alleviate this either by reducing it or by offering techniques to manage it. What you may not realise is that there may not be a physical reason for the pain.
To get a better insight into what is going on when you hurt, we need to understand how you feel pain.
The ability to feel pain is very important to our wellbeing. It stops us doing things that are damaging to our bodies, and makes us rest to allow our bodies to recover from injury. So you really should not ignore pain, or simply "work through it".
Firstly you should make sure that there is not physical damage causing the pain.
The expected mechanism of pain starts with some physical damage which causes receptors within the nervous system to fire. This action creates minute electrical currents which are passed from nerve cell to nerve cell up to the pain perception center in the brain. It is here that these signals are actually converted into what we know as pain. All along this pathway it is possible for your body to mistakenly trigger, sometimes from a sort of nerve memory. Hence, for example, the site of an old injury can often be painful even though there is no damage or reason for that pain.
The brain itself is quite capable of "making up" pain. If you injure your ankle your brain will avoid movements that cause pain in the damaged area. This is good. However once the damage is repaired, the brain continues to avoid movements that were painful. The fear of pain can cause actual pain. The brain has to be retrained to understand that the pain is no longer there by specific repeated movement patterns.
Often in avoiding pain the body will stress another area and cause a pain there. It doesn't always make the right decisions as to the best way of helping your body.
We see this type of issue often at the studio. A client may have had a small injury to a back muscle lifting something heavy out of a car (shopping or a child are frequent culprits here). The body's defense mechanism leaps into action and activates a range of alternate muscle actions to protect the damaged area. Unfortunately this will usually cause a misalignment, or imbalance in the body, often resulting in the stressing of and possible damage to a whole set of different muscles ranging from shoulders to knees and ankles.
Clients come to us with a problem in their knee. However, when we have taken a holistic review of their gait and completed a range of movement tests we can see that the problem is not in fact in the knee at all, rather it is a bodily imbalance brought about by a completely different issue.
So, if you have pain, my advice is:
Firstly, check with your GP to rule out a structural or other cause which needs medical treatment.
Then, come to The Studio for a half hour one to one consultation so we can assess the best ongoing solution.
Alternately, or in addition, if you have access to a physio ask them for muscle testing and exercises.
Frequently the solution from me (or a physio) will be regular exercise combined with soft tissue treatment and exercises to include in your existing fitness regime or to do at home.
Don't put up with pain, call us, we may well be able to help.
Back Pain Solutions - The latest research
As a practitioner in the field of back pain and a member of ‘Backcare’ the UK’s national back pain association I receive regular updates on current research and recommendations. The most recent publication contained several interesting articles which I will summarise and share with you.
Orthopaedic surgeons speak out about what they see as the alarming trend in dangerous and unjustified back surgeries.
To quote George Ampat a consultant orthopaedic surgeon based at Royal Liverpool University Hospital ‘Unfortunately, there is a false belief that surgery or new technology can fix back pain. This is far from the truth.’ He says that out of 100 patients who see a health professional for back pain 97/98% will get better without surgery through exercise and over the counter medication.
There are many products on the market for the condition known as sciatica, most of which you will see advertised for a while before they disappear – usually because they don’t work. Sciatica is usually caused by a collapse of the spinal discs pushing the intervertebral cushion out, a bit like squeezing jam out of a doughnut. Fortunately, with time and stability work this will usually ease within a few weeks. One research study in the US looked at the results of surgery and showed a benefit for up to 8 years after surgery. In the same study, those who did not have surgery also continued to improve over the same period. Another study looked at the return to work ratio of those having surgery v those not having surgery. The result? 26% of those having surgery returned to work v 67% of those who didn’t. In addition, there was a 40% increase in the use of painkillers in those who had surgery.
Exercise myth busted - Don't delay, be active:
Nick Sinfield, a chartered physiotherapist says that a common effect of pain is that you become fearful of movement or believe that a certain movement will damage something. In fact you should be moving and doing physical activities that move the spine normally. Moving with a rigidly protected back will prevent your recovery not help it. By not bending and moving correctly strain is placed on already sensitive soft tissues.
In my opinion if your back is sensitive, painful or stiff you should choose your exercises carefully. Pick those which will reduce stiffness with gentle controlled movement and minimum spinal load on the spinal structure. This type of exercise will improve the function of the spine, enabling it to cope better with everyday life. The ligaments and muscles which support your back require strengthening and rest will only weaken these leading to more back pain.
Remember the proven benefits of exercise:
Increases blood flow to all muscles which helps the healing process
Reduced muscle spasm, especially with biomechanic based anti-spasm techniques
Increase in your confidence in your body’s ability to move
Reduction in anxiety which helps with soft tissue relaxation.
Improved body awareness enabling you to listen to your body better in the future therefore reducing the likelihood of a recurrence.
Surgeons Speak out - Surgery can't fix all:
David Hanscom an orthopaedic surgeon specialising in complex spinal surgery says that although there is no connection between disc degeneration and pain there are hundreds of thousands of spinal fusion operations being performed for back pain every year based on MRI scans showing disc degeneration.
He says that in the over 60's, disc degeneration is present in 100% of people - most of whom do not suffer from chronic back pain. This is normal. Disc degeneration is not a disease, it is a normal part of aging, like grey hair. Add to this the research that looks at back surgery patients after 2yrs with only a third showing improvement and you can see that it is easy to end up in what he calls the 'failed back surgery syndrome' with crippling pain for ever.
So, why do so many people see surgery as the best solution?
Well, there seems to be a number of factors having an effect. Firstly, the health industry is increasingly commercialized with huge sums of money to be made from drug development and spinal devices. So it’s no wonder that these are promoted.
Add to this the fact that exercise in the UK is still almost entirely unregulated so usually excluded from being prescribed on the NHS.
Also, the training required to be effective as a back specialist forms something of a barrier to many exercise professionals. As a result only a small number of us are fully aware of all the techniques and therefore the best way to help people with back pain.
Finally, people will always tend to select the solution that requires them to do the least work. Often the choice will look like a life time of exercise against an operation and a period of recovery followed by a pain free existence. Unfortunately this view is being called into question more and more.
This situation is a great shame because exercise is a cost effective, less invasive and therefore risky, solution. However the fix for all this is not easy and probably would involve some form of regulation for those exercise professionals who would like to provide the service for the NHS. Also doctors and surgeons need to be aware of the success rates of the exercise alternative, and also be directing patients down this course.
You can see from this why I feel so strongly that exercise options should be thoroughly tried before progressing to surgery.
If you have any questions on this just give me a call
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
Risk v Benefit - Keeping your exercise programme safe
Risk v Benefit – Keeping your exercise programme safe
There is much in the popular press about the benefits of exercise for both physical and mental health. Many people are encouraged to take up exercise by their doctor or physiotherapist. On the other hand, there are many articles about the risk of injury from exercise. For example one study showed that over 60% of runners will pick up an injury in any one year, and another stated that 35% of women exercising on a regular basis will have a musculoskeletal injury.
As a fitness professional and physical therapist I use a variety of techniques to ensure that my clients gain the benefit and do not suffer any injury:
I encourage clients to work at their own level, not keeping up or competing with each other.
I keep a close eye on the posture of each client as they exercise. If there is a postural fault when a client walks in, they will probably keep that faulty position as they exercise. This will be a habit that I am keen to discourage and correct with exercise.
When I spot a common postural imbalance within a group I will add exercises to help them correct it. This could be drawing back rounded shoulders, lengthening the neck or stretching tight hamstrings to encourage better pelvic alignment.
At the beginning of each session I check how everyone is feeling and how long standing injuries are progressing. I will include the best exercises to help each person’s condition. This could be reducing range of movement to encourage stabilization of a lax joint, work to strengthen a weak joint or stretches to help muscles tightened up by other sports such as running or cycling.
Using these methods I aim to help everyone to exercise and gain a benefit whilst not risking an injury. Remember that your feedback is essential to ensuring a safe effective exercise programme so don’t keep quiet about any pain or discomfort as there is usually a way to manage it, and it is often a good indicator to the types of exercise you need.
I have arthritis, should I exercise?
Some Facts about arthritis:
What is arthritis?
- About 70% of people over the age of 65 will have some level of arthritis and 1 in 5 of the whole population. This equates to around 10 million people in the UK.
- A number of people will have no symptoms and be oblivious to the fact that they have arthritis, but most people with it will suffer some symptoms, such as pain and stiffness, on a daily basis.
- The most common type of arthritis is Osteoarthritis, followed by Rheumatoid (especially in women) and Gout (especially in men).
- There are actually over 100 different diseases that can cause the problems characterised as arthritis.
- There is no cure for arthritis.
Arthritis affects the joints of the body. At least two bones meet to form a joint, but some joints have three and wrists and ankles have more. Each joint in the body is constructed in a slightly different way. Most of the main joints have cartilage covering the bone ends and the whole joint is enclosed in a sort of bag called the joint capsule. This bag holds synovial fluid which effectively lubricates the joint.
Arthritis develops when the cartilage has become worn, torn, or has been removed, often due to trauma.
The synovial fluid within the joint capsule becomes thicker or ‘stickier’ as we age and as a result doesn’t coat the cartilage as well. This results in increased wear to the cartilage and the bone ends which become roughened. The joint can no longer slide smoothly and pain results. This is typical in osteoarthritis of the knees, shoulders and hips.
With Rheumatoid arthritis joints become swollen as the body attacks its own tissues. There are many other forms of arthritis, such as spondylitis which is when inflammation around the spine causes pain.What causes arthritis?
Arthritis has a variety of causes, most of which are not fully understood. For example:
Exercising with arthritis.
- Trauma to a joint earlier in life frequently makes arthritis more likely. A car accident, sporting injury, trip or fall can all cause damage to a joint, weakening it and making it susceptible to arthritis, sometimes not manifested until later life.
- Cartilage has a poor blood supply which means that when damaged by twisting or tearing is doesn’t heal very well. As a result, it was common for cartilage to be removed following trauma, although nowadays this is less frequently performed and exercise is used to manage the situation.
- Carrying excess weight puts more strain on the joints increasing the amount of wear and tear.
- There is a clear genetic link which can increase the risk factor for Rheumatoid arthritis which can be activated by trauma.
Arthritis causes joints to be stiff, painful and to have a reduced range of movement. Exercise can improve these symptoms but it needs to take account of the arthritis. I work to create an environment and exercises within which the joints can be moved freely and without pain and you feel able to exercise within you own capabilities. In addition, exercise can encourage good posture, which is essential in keeping the spine straight and reducing the risk of kyphosis – rounding of the neck shoulders as well as potentially slowing the progress of degeneration. Key points to remember:
- Loosening joints, using movement which is pain free, is essential to encourage and keep the maximum mobility. For example, in ball and socket joints, simply rotating the limb within the joint capsule can have a beneficial effect, by encouraging the synovial fluid to coat the whole joint and become less ‘sticky’.
- Specific muscle strengthening work to support the damaged joints will help reduce pain on a daily basis. This is especially beneficial for the hips, shoulders, knees and spine.
- Do not push through the pain, look for a different way to loosen or strengthen the painful area.
- Avoid overstretching and putting joints into positions out of their normal range. For example, knees are a hinge joint, designed to bend in a forward and backward motion with limited rotational range. Sitting with legs crossed will stress the joint and in time can cause wear and then damage.
- Note which activities cause pain and look to find other ways of doing them. Exercise can be designed to help you strengthen your body enabling you to do regular activities with less pain.
Arthritis can be debilitating and has no cure, but exercise is one of the recommended treatments - don’t let arthritis be a reason to stop exercising.
Why do you need strong 'glutes'?
When new people join a class or come to me with back pain they are usually completely unaware of their glute muscles. The glutes are quite likely to be weak and tight, which sounds like an odd combination.
Strengthening the muscle and stretching it so it can function correctly is an essential part of keeping your body working effectively and without pain.
- Keeping correct alignment
Strong glutes can protect you from injury and reduce the impact of arthritic pain by providing support to the spine and pelvis. They also give correct alignment throughout the body helping to protect the knees from uneven wear, keep the feet lined up reducing problems with the achilles and plantar fascia.
- Support when walking or running or weight training
The glute muscles stabilise your pelvis while you run or walk. They help with hip extension and forward propulsion. If they fail to engage correctly the work falls to the hip flexors which are less able and become tight quickly. This puts stress onto the lumbar spine giving back pain. Strong glutes help give correct positioning when weight training, especially during squats, so your knees are protected. They also help with protecting your back when bending to pick up items from the floor or gardening.
- Injury prevention
If your glutes are not strong, your entire lower body alignment may become out of balance causing injuries such as achilles tendinitis, shin splints, knee pain and leading to tight ITB which runners are particularly susceptible to. When the glutes are not strong enough to do their job, other muscles not as well designed for the job take over. While in everyday life it is usually the back which suffers, in those who train at a higher level the muscle imbalance is more pronounced leading to increased risk of injury.
The glutes are one of the largest muscle groups in the body. If trained it can produce an enormous amount of power. By strengthening this muscle you will be able to move with less stress on your skeletal structure. This is of enormous benefit as bones become less strong with age and affected by degenerative conditions.
So, to keep active and move with ease - get your glutes working!
- Reduction in back pain
To simplify the effect strong glutes have on back pain visualise your spine. It runs from the back of your head to your pelvis (hip bones). Your pelvis sits like a t junction at the bottom of your spine. Below this are your glutes, providing support to everything above it – hips and spine. Once you move they are powering from behind you enabling you to move easily with less effort. The other muscle groups, abdominals, quads and hip flexors are at the front of your body and while they are essential for movement and stability they are not nearly so well placed to provide power as the glutes.
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.
Thinking about taking up Yoga?
THINKING ABOUT STARTING YOGA?
Before you do you should understand the potential benefits and dangers (yes dangers) of practising Yoga.
Yoga has been criticised for being potentially dangerous by causing injuries and aggravating existing conditions such as arthritis. Some authors of critical articles have themselves been injured in a Yoga class, others get their information 2nd hand by talking to participants in Yoga classes. Research can be difficult to verify as there have been no specific clinical trials so information is usually taken from surveys.
An extensive survey of yoga practitioners in Australia showed that about 20% had suffered some physical injury while practicing yoga. In the previous 12 months 4.6% of the respondents had suffered an injury producing prolonged pain or requiring medical treatment. Headstands, hand stands, shoulder stands, lotus and half lotus (seated cross-legged position), forward and backward bends, produced the greatest number of injuries. Respondents commonly took the blame for the injury on themselves, citing reasons such as ‘pushing it too far’ and not warming up, along with being too competitive. Read the source document here
The same article also asked the participants for the effect that Yoga had had on a range of over 500 specific medical conditions from which they suffered. The results were positive:
• Much better 53.3%
• Better 29.3%
• Little better 12.5%
• No change 4.5%
• Little worse 0.3%
• Worse 0.0%
• Much worse 0.4%
In my opinion there are many health benefits for both mind and body to be gained from taking up yoga. The relaxation element is good for sufferers of depression as well as in rehabilitation from cancer and the management of heart disease. The flow through a succession of poses can help with stress management and improved posture
Injuries seem to come from beginners pushing themselves beyond their ability and instructors with little training, or experience, who cannot evaluate each participant’s ability and offer alternative positions. Looking at the list of positions which incurred most injuries, head and shoulder stands should only be performed under close supervision by those working at an intermediate level. Lotus and half lotus positions place the knees in positions which will aggravate any existing damage to ligaments or cartilage whether originating from an injury or wear and tear. Forward and backward bends put load on the spine which can aggravate any degenerative conditions and potentially cause back pain rather than ease it.
Ensure that you choose an instructor who has experience and a class which works at your level. Watch out for exercises which may not be suitable for you (see injury section above) and listen to your body.
As an exercise professional I am keen to see everyone partake in some sort of exercise, it’s a question of finding what suits you and for many Yoga will be ideal. Give it a try, but carefully.
Have you been to a physio recently? Or have you seen an Osteopath?
Do you have exercises to do at home?
Are you doing them correctly and gaining maximum benefit?
Most people do not exercise correctly and so do not get the full benefit!
I recently received some training from an experienced osteopath. He suggested that many people given exercises, by physios or osteopaths, don't do them correctly. They don't exercise often enough or for long enough, and they use poor technique. This results in a longer period of pain, more visits to specialists and often no answer at the end of it.
The most effective way to exercise a specific muscle is with supervision by a professional, who understands your condition and the exercise required to improve it. Anne at the Studio is one of these professionals.
This is where one to one sessions are ideal, allowing you the time with this specialist to talk through and practise the exercises you need to do on a daily or weekly basis.
I have listed a few specific issues that would benefit from correct exercise.
Exercise can be hugely beneficial for arthritic joints provided it is carefully monitored. Mobility and strength work must be within your normal range of movement.
90% of back pain is described as 'non specific' as there is no specific cause and no medical treatment can be offered other than pain relief. Exercise can help manage and considerably reduce levels of pain.
Knee pain has a variety of causes including injury and degeneration. Exercise can strengthen the joint to give better stability for excellent long term results.
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Common causes of back pain
Why do so many people suffer low back pain?
Every client I see is different but there are recurrent themes that appear time and time again. One of these is the difficulty we have in understanding which muscles engage for which task, and which muscles are stronger and should be used to take on heavier tasks. Our bodies are very good at using the muscles that they perceive are strong rather than the muscles which should be strong. This means that muscle imbalances we have developed over many years are maintained as strong muscles get stronger while weaker ones are left weak.
Frequently clients with back pain have an incorrect pattern of muscle engagement. There is often poor activation in the gluteus (butt) area, the abdominals which provide support (transverse/internal obliques) and the multifidus (muscles linking into each vertebrae). The rectus abdominal (used in situps) and hamstrings are often over working. This pattern of muscle activation alters the loading through the spine, sacrum and pelvis, doesn’t give efficient support and, as a result, will often lead to back pain.
Once you understand how to engage and identify the correct muscles you can practice at home and, in time, see benefit from in day to day life. If the stabilising abdominals are taught to activate along with the gluteus and multifidus there is a good chance of giving the spine and pelvis the support it needs. This is harder than it may sound as the brain has to learn new patterns and retain the knowledge to use in everyday life.
The basic pattern of engagement is this:
Tighten or brace the abdominal area (transverse abdominal) without incurring any movement. Engage the muscles which run in a strip each side of the spine (multifidus), and engage the butt (gluteus) muscle without tilting the pelvis. Once achieved, release and re-engage. With repetition this encourages the brain to understand the pattern of activation which is required. It can be practiced standing, sitting or lying.
Initially every muscle in the body engages, especially the neck and shoulders, but the muscles you want to engage have still not appeared. It often helps to ‘prod’ the area where you want the muscle to engage. This would be on the pocket area of your trousers for gluteus, each side of your spine for multifidus and in a line between your hip and belly button for your abdominals. Once the correct muscles activate without affecting the whole body additional work can be added.
This will strengthen these muscles with the correct activation pattern which is essential for long term benefit. To achieve any of this without professional instruction is difficult.
Try a one to one, consultation session at The Studio to help you achieve the correct muscle activation pattern as well as performing other tests for muscle spasm and imbalance which may contribute to back pain. If you are in a different area do get in touch and I can locate a coach local to you.
Please be aware that the information in this article assumes that there is no disc damage, scoliosis, degeneration, arthritis or nerve pain. It is a general view of the cause of much back pain. Bear in mind that there are other considerations including the angle of tilt of the pelvis, as well as foot and knee positioning. Consult your GP before starting an exercise plan if you have any concerns about your health.