Help! I have Tennis Elbow, What Should I Do?
Help! I have Tennis Elbow, What Should I Do?
It is tennis elbow season here on Waiheke Island. Tennis elbow pain is basically pain on the outside of the elbow.
The crazy thing is it is pretty rare to see it in a tennis player. Although tennis is going off on the island and shout out to coach Able for getting more people excited about tennis. At this time of the year when the garden is going crazy you are more likely to see it with line trimming, pulling weeds out or trimming the hedge.
Tennis elbow or if you want to get technical “lateral epicondylosis” is effectively a gripping issue. Shaking hands, picking things up, holding a jug, hitting a backhand and even opening a door can be painful when they are irritated. When they are very painful they even hurt at night especially when you straighten your arm.
So what causes it?
A muscle called extensor carpi radialis attaches to your wrist to provide stability when you grip something. The other end of the muscles attaches to your outside elbow and is the tendon.
When you are gripping repetitively with your wrist in an awkward position it overloads the tendon in the elbow. If it continues the tendon starts to fill with water and cells begin to become active. This reaction is extremely painful. The problem is if you keep doing this for long enough the tendon can begin to start degenerating. This starts to swell and make your arm sensitive to anything.
So how do you fix it?
The bad news is a 4 month recovery is considered awesome and a year recovery is considered average. The below protocol means it is more likely to be the quickest way out of the injury.
The solution involves a few parts
Reduce the load on the tendon
You need to understand what movements will normally flare it which is normally picking something up, wrist palm down with a straightish arm.
Turning your palm up to use more of your bicep helps reduce the load through the tendon. You can also use the optimal grip position which is a slight extension of your wrist.
Trying to use your other arm more for a few weeks is also helpful and understanding the ideal grip position when lifting something.
See the below picture and notice how the wrist is slightly extended to pick something up.
Restore function to your tendon
We here at our Oneroa Physio clinic use a very systematic process to rebuild the tendon and because tendons' bloody supply is average they are slow to heal BUT exercise is the fastest way to fixing the tendon unfortunately. Cortisone injections are old school and a bad idea. They reduce the quality of the tendon and you only get one of them. PRP blood injections are experimental so you’ll have to trust me on it.
Where most people go wrong is they do the same exercises every week. You need to lift heavier every couple of weeks to stimulate growth and reduce pain.
A big part of our job is to keep you accountable along the journey.
These are two of the exercises we prescribe early. When you contract your wrist gripping the band for 5 x 30 -45 seconds it has been shown to reduce pain. Try these two at home. Just remember they must be completely pain free!
Taping and braces
When they are really acute we have two tapings we like to use. One is quite “hard core” and looks like you’ve just had surgery and the other is lighter. Some people prefer one and some prefer the other. There is no right answer but one will work. I also encourage bracing to get out of the really painful stage.
Strengthen your upper body or stretch it.
There is a correlation between neck stiffness and pain, shoulder weakness or stiffness and weak tricep muscles. Our job is to find what that issue is, speed up the process with our hands or acupuncture needles then give you the right exercises to speed it up.
Fix any mechanical issues you may have with your body.
Believe it our not, due to old injuries, habits and muscle imbalances in our body, our elbow can be the victim of what isn’t working in the rest of the body. Sometimes we need to address this to fix the issue.
There are other sources of pain around the elbow such as the joint, the radial nerve and your neck. So if you’re having random pains like pins and needles or burning it is not tennis elbow.
If you’re reading this you aren’t alone. It is one of the most common injuries for people over 30. It is really common on islands where everything grows like crazy and in our local tradies who basically grip things all day long for a job.
If it’s not getting better and you’re starting to get frustrated with it book online here and we’ll get you a plan to get it sorted within 4 months and not a year!
Simple Summer Habits To Reset Your Health
Reset and Reconnect: Summer Health Tips for You
I don’t know about you, but the rumors of a long, hot summer sound well overdue! After last year’s never-ending rain, it felt like all my healthy habits took a hit. This year, though, with more sunlight and warmth ahead, it’s the perfect time for a bit of a factory reset—an opportunity to bring back those healthier habits.
Here are some easy ways to kick-start your healthy habits as we head into summer:
1. Start Your Day with Sunshine
Natural sunlight is more than just a mood booster—it sets your body’s circadian rhythm, making everything from digestion to sleep work better. Did you know that getting sunlight first thing in the morning can actually lead to a better night’s sleep? Plus, it improves your mood and sets the tone for your day.
Try this: set your alarm 20 minutes earlier and get outside for a walk or run. Lay out your workout clothes the night before to make it easier. Trust me, just those few moments of early morning light can make a world of difference.
Bonus: Spending time alone, without distractions like your phone, helps calm your nervous system. It gives you space to reflect, reset, and make decisions with a clearer mind.
2. Make the Most of Warmer Days—Move Your Body!
With the sunshine finally showing up (and the warmer weather following), now is the perfect time to introduce a new exercise habit. It doesn’t have to be complicated—whether it’s lifting weights, doing morning yoga, or joining one of our early Pilates classes (followed by a swim at the beach?).
We’re running a special offer to help you get started: five classes for just $50, or two private sessions for $100 where you’ll get a personalized program and learn how to use the equipment properly.
Or, why not set yourself a six-week challenge? It’s the ideal time frame to build a lasting habit. How about running 5 kilometers? Check out the awesome ‘Couch to 5km’ program here .
3. Dive Into New Goals
Did you know the Te Huruhi community pool is open to everyone? They set up lanes for laps and even have stroke correction and swim squads. Click HERE for more info. Set a goal to swim 1km (that’s 40 lengths!) without stopping. Or, if biking is more your thing, challenge yourself to ride to Orapiu and back. Summer is the perfect time to take on these challenges, with the extra daylight giving you more time to enjoy the outdoors.
4. Slow Down and Enjoy the Moment
We spend so much of the year rushing from one thing to the next. Long summer nights are an opportunity to slow down and regroup. Whether it’s a picnic at the beach with family, a slow dinner outdoors, or finally picking up that book you’ve been meaning to read, take time to savor the season.
These simple changes aren’t hard to add to your routine, but they could change your life for the better. I’d love to hear what you think—reply with a comment or drop by Connect Studio and let me know how you’re planning to make the most of your summer!
The Questions We Ask
With the evolution of science we now understand that both injury and pain are more complex than originally considered, and so treatment to heal requires a more holistic approach. Particularly if the discomfort from injury has hung around for more than a few weeks.
When someone has had pain for more than 3 months it is deemed chronic and we often ask questions such as:
How many hours do you sleep?
What’s your step count per day?
What do you think is going on?
What may be perceived as random questions to be asked are all highly relevant for solving pain problems, and to identify the unhelpful beliefs that may be getting in the way of your recovery.
We know if you sleep less than six hours per night pain is ramped up in your nervous system, so the sensation is actually worse.
We know if your step count has reduced considerably and suddenly, you are more likely to experience back pain (think working from home and lockdowns).
We know if your step count has reduced considerably and suddenly, you are more likely to experience back pain (think working from home and lockdowns).
We know that your subconscious beliefs, such as “my mum had a knee replacement at 50, so I probably need one”, or “it’s definitely arthritis because I'm 60”, need to be addressed and removed in order for you to begin your road to recovery.
We also know that starting your day with movement - such as your physio program, some stretches/ yoga, will lead to a better day in terms of movement quality and overall reduced pain.
We know from research and functional MRI studies of the brain that in the presence of pain, all sorts of areas you wouldn’t expect to light-up, such as past experiences, beliefs etc.
So addressing pain and injury is not about setting some exercises and on completion expecting you to be sweet.
It’s a combination of the right exercise program, sleeping well, managing your stress, removing unhelpful beliefs, having better sleep hygiene, increasing your step count and a bunch of other factors.
If you’re in pain ask yourself - are there some beliefs that you hold which may not be helping? I’m happy for you to reply to this with ones you need help with.
Think - Is your sleep good and you’re doing the right things in the lead up to bed time? Are you moving enough, or could you start your day by doing your physio program? Let me know your thoughts - I'm genuinely interested in hearing them.
Unlock your flexibility
The feeling of being less flexible than you were isn’t great. Especially as it gets colder! Groaning as you pick something up off the floor. Sitting on the floor with your legs “crossed”, but really your knees are touching your ears! Remembering the glory days when you could easily do the splits.
Like everything in life, unfortunately getting your flexibility back takes work. But…. when it starts to become a habit and you start to notice the results it’s very rewarding.
A lot of people wouldn’t know, but strengthening muscles can improve your flexibility just as much as stretching. Evidence for the foam roller at this stage is non-existent in relation to flexibility.
The question is: if I was to try and get more flexible within six weeks, what would I do?
In a nutshell, I would have a strengthening program that focuses on as much range as possible with which I could control safely. Probably using the Pilates reformer a couple of times per week, combined with a stretching program at night.
A combination of the above would definitely see me improve in that time.
A 2023 study showed static stretching with five lots of 30 second holds, six days per week, for six weeks, increased flexibility significantly. Other studies have reported the same for calf and hamstring flexibility, for a total duration of 120 and 180 seconds respectively.
I’ll be honest, there is no way I would do six days per week. I would do four nights in front of the TV doing 4 x 30 second holds for each of the muscles I wanted to improve.
In a 2021 systematic review they looked at strength training to increase flexibility versus stretching. Interestingly the studies were actually showing that strength training improved flexibility more than stretching, but the difference was not significant enough. So both improved flexibility.
So if you are super keen on increasing your flexibility, do both. Aiming for full range of motion strengthening safely is the key. Using the Pilates reformer is amazing because you can keep your body well controlled, but get full range of motion out of your muscles with resistance. Think legs in straps. Amazing way to improve your flexibility. If you're interested in our Pilates classes you can find more HERE.
But I would also add stretching to really nail it
The final thing to note is that if you just focus on static stretching you may increase your flexibility, but a study in 2019 demonstrated that you are actually weaker in this new range so simply being more flexible isn’t that great, especially if you are more susceptible to injury!
So, to summarize, if I was super keen I would do Pilates three times per week; home strengthening one to two times per week; and four sessions per week of static stretching, for a minimum of 120 seconds (broken into sets of 30 seconds). If you are keen to give the above a good crack let me know how you go!
Urgency culture…and how to counteract it
It’s a thing. We live in a world that rewards immediacy. Whether that’s responding to txts and calls on demand and afterhours, or when it’s inconvenient! We check social media mindlessly for fear of missing out. We overextend ourselves in personal relationships and agree to unrealistic workloads!
This demand to be “on” both personally and professionally, all the time, can be exhausting and lead to stress and anxiety.
One of the best ways to counteract this is to engage in activities that remind you that there is NO RUSH such as intentional breathing, listening, movement, and touch (these are known as the “four practices of control”).
Pilates is the perfect practice! Going slow is encouraged, moving with your breath is key, and it’s an opportunity to put the phone on silent for an hour and focus solely on your body and mind.
We may get to the end of the day and think “I’m too tired for class” but often getting there is the hardest part, and engaging in this kind of exercise can leave you feeling energised and better afterwards.
Check out the link below for a great article on “Urgency Culture” by NatGeo.
https://www.nationalgeographic.com/science/article/urgency-culture-burnout?loggedin=true&rnd=1713916578235
Stop Sucking Your Tummy IN!
At Connect Studio a big part of what we do is getting you to chill out your grippy muscles, and strengthen the kind of “opposite” ones that are a bit weak. Why do we grip our muscles? It can be trying to suck your tummy to look “better”, it could be stress, past trauma or protecting an injury.
For example you might be a back gripper, meaning your back muscles are always hard/tight/on so we want to soften them and strengthen the opposite muscles of your core at the same time!
Doesn’t seem like too much of an ask but let me tell you about the revelation I’ve had about this since being pregnant! I like to grip through my tummy muscles which is always a big source of back pain for me, Nicks always telling me to take a chill pill hah! They are just constantly on, and I have to work on using very gentle core cues in my Pilates programme to get them to work as “nice abs” not trying to be Incredible Hulk abs.
Bracing my abs will be an accumulative result of things like overtraining my 6 pack as a young gymnast, some nervous system and stress related stuff - everyone has their places that they hold tension, but also just being your average woman that feels like she has to be slim! Especially as a Pilates instructor - yikes a chubby tummy is not part of the look. Maybe when you were younger your mum told you to suck your tummy in and stand up straight for photos? Or do you look at too much filtered, airbrushed content on social media where people have perfect flat stomachs? Or you’re just struggling to navigate a changing body as each decade seems to bring with it a new set of challenges around how we respond to exercise/food/stress/pregnancy etc. I know if I had a tighter fitting outfit on my stomach it would not be relaxed, I’d be subconsciously or even a bit consciously “holding it in”.
Roll on pregnancy and I just don’t give a shit! I can “eat for two” and my growing belly is an expectation not something to be worried about! I was a bit nervous about how my back would cope carrying a baby but so far it’s felt the best it’s felt in years! And it’s my theory and Nick agrees, that it’s because I’m not such a tummy gripper these days.
It will be interesting to see what happens postpartum. I’m sure I’ll be wanting to “get my body back” as any woman does, but I’ll do my best to do this in a conscious way and actually just love my body how it is at any given time because it would have just pulled off a pretty impressive stunt! And give it a break from “sucking it in” all the time.
How To improve Your Posture To Relieve Hip Pain
One of the most common causes of hip, pelvic and low back pain is butt gripping. Common traits of the infamous butt gripper are having to pull your undies out of your backside every time you stand up from a chair, being taught to do this in ballet and barre as a kid and being told by your mother to tuck your bottom in. Rafael Nadel is the king of butt gripping. Ever wonder why his knees aren’t great?
Butt gripping is the highly scientific term for tensing your backside all the time. Ballet dances are taught from an early age to “tuck your backside under”, yogi’s are taught to do it into some poses. Sometimes people don’t even know they are doing it. Some people do it on one side (normally the sore side) and some people do it on both sides.
Today we look at how we can reduce it and keep our back and hips happy and healthy.
How to sit to reduce hip pain and reduce butt gripping
When you sit down, it’s all about the strategy you use to sit. Fold from your hips thinking about the front of your hips staying soft and your sit bones going back and wide. Aim to sit right on the edge of the chair, place one hand on the edge of your hips under your sit bone and slowly pull one hip at a time all the way back into the back of the chair so you're in a good sitting position. This just takes the load off the front of your hip, gives your hips space so they aren’t compressed. It is a good habit for all of us to do when we sit down. You want to keep your chest up as well, so you're leaning back into the chair and it helps to put the weight through the entire part of your hip as opposed to overloading the front.
How to stand to break the butt gripping habit!
A lot of the time we see people coming in with hip or low back pain and they stand with their hips and pelvis all the way in front of their knees. So the first thing I want you to do is think about having two thirds of your weight in your heels, and about one third of the weight in your toes. It just helps to put your pelvis and hips over your feet and it allows the hips, the knees, and the feet to take the load of the body a little bit better as opposed to everything being through the hip when you're standing quite forward. So you can do this when you're brushing your teeth, making a cup of tea or coffee, or standing waiting for the bus. Just think about having two thirds of your weight in the heels and one third in the front of your foot.
Get your Deep Hip Muscles to Relax with this Exercise
This is a great position to help teach you to relax your deep hip muscles or “butt grippers”. This of space in the back of your hips or think of your backside muscles melting. From here rock forwards and back slowly.
So if you notice you are consistently pulling your underpants out when you stand up or you did a lot of ballet as a kid or your grand mother taught you to “tuck your butt in” to improve your posture then practice the above every day. The basic day to day things have a tremendous impact on your pain and hip health.
Mindfulness To Combat Injury Pain
I remember when I first graduated from Physio school and someone actually gave me a job and I could practice on real life patients. My mind was in constant panic mode, thinking about what i’m doing next, what did I just do? Can I even feel what’s wrong? Are they going to be worse? It was a constant state of fight or flight, or in my case FREEZE.
Ironically the biggest thing I've learnt in 23 years as a Physio is that the more present, or mindful I am, the better I am at my job. The more present I am the more I can feel what is wrong, what needs to happen and what we need to solve. In some ways it is a very therapeutic job where the less you think, the more you feel.
This led me down the path of mindfulness, breathwork and everything in between. Interestingly, along the way, I discovered that people in pain also respond incredibly well to mindfulness. Becoming more present and observing, rather than judging, calms your nervous system and reduces the noise coming out of the pain centers in your brain!
Our brains are constantly thinking. It could be a negative replay of something someone said to you the past week. It could be a previous negative work experience that you keep reliving over and over. It could be something you're worrying about in the future. It could be all of these things all at once! It’s like having your computer on and you have 36 tabs open all at once (guilty). Being mindful or present is simply shutting all the tabs and just looking at one. Your breath, your surroundings, what you’re feeling, or what you’re hearing. Focusing on one of these to help you be present in the moment. For such a simple concept it took me far too long to understand it.
My current understanding is that being present in the moment is focusing on what’s around you currently without judgment. Looking at the sky and not attaching to it whether it’s a lovely sunny day, or it’s raining and miserable.
“The present moment is all you ever have. There is never a time in your life when your life isn’t this moment”. Eckart Tolle
So how does this relate to pain, injury or improving sporting performance?
There are a few ways and a lot of research to show that mindfulness meditation, breathwork, or mindset work are incredibly powerful. Here are 3 quick reasons based on systematic reviews and randomized controlled trials
A study of 75 people with chronic pain, who did 4 sessions of 20 minutes of mindfulness meditation in a week, reduced their pain intensity by 27% and had reductions of pain unpleasantness by 44% when compared to just resting alone! On functional MRI’s of their brain, there was reduced activity in the pain centers of their brain.Also in chronic lower back pain, mindfulness was found to be twice as effective as painkillers in pain reduction!
Another cool study was that after 8 weeks of meditation, there was reduced activity in the amygdala of your brain. The area responsible for stress and anxiety (known to increase pain).
If you think about being injured or in pain, there can be unhelpful subconscious beliefs that can be adding to your pain. Common things can be “I thought I'd be better by now, but here I am still in pain”. “All i’m trying to do is get better, but the work cover case manager doesn’t believe me”. Finally my fave “i’m going to need a knee replacement, it’s definitely bone on bone”. These unhelpful thoughts are on a reflex loop. Going on - and on - and on, all day.
Mindfulness meditation, or breathwork, is like a factory reset of your phone. Getting you back into the calm relaxed state your body requires to heal and repair, and muting those lovely negative thoughts.
For athletes, being in the present moment or “flow state” is the name of the game. The less you're thinking, the better your performance. Mindfulness is like exercise. The stronger you can make your ‘mindfulness muscle’, the longer your attention span will be able to focus, the more you can get into the flow state where you play on instinct.
So how can I start being mindful? What’s out there? I googled it and gave up.
Personally I've found apps are the quickest and easiest way to get started. I have an annual subscription to Headspace, and it is worth every cent. There are multiple series on anxiety, stress, sleep, performance and everything in between. I regularly do the anxiety series. Each day it begins with a brief explanation of anxiety and then begins with a meditation, focusing on your breath or scanning your body. You get a free 30 day trial and that’s enough to see whether it’s for you.
Calm is another option, similar to Headspace. Great app and even has sleep stories by famous celebrities and athletes. I personally liked the LeBron James series.
If you want to go somewhere and learn. I’d recommend these people, based in Auckland, who do an 8 week course on reducing stress, anxiety and pain. Click HERE to check them out
You could also try two mindfulness exercises right now!
Breathing: through your nose and out through your nose x 3. Now breathe in for 4, hold for 6 seconds and out for 7 seconds x 10
2. Name 5 things you can see. Don’t label them as good or bad just name them. Name 5 things you can hear (close your eyes if you want). Name 5 things you can feel. Again no labels.
How does that make you feel? Calmer?
The cool thing is you can do these anywhere. At work if you’re wound up, with the kids when they are kicking off or on the drive home from work.
Give it a try. Commit to it for around 4 days per week, for at least for 3 weeks. It’s ok to be constantly thinking. I like to think of them as exercise reps between thoughts. Good luck and email me for any advice. I’m doing my trainers certification at the moment because it’s made such an impact on my life.
Try "Constructive Rest" to Switch Off Those Grippy Muscles
It’s funny when you’re the physio or Pilates instructor, people assume you’re pain free and actually show genuine surprise when you say you get back or neck pain! All of us crew at Connect would say we’re all human and have our own little niggles that need constant maintenance!
In saying that, I myself do get a bit frustrated sometimes when my back pain pops up occasionally. I spend my days trying to help people be pain free so why can’t I do it for myself? This question has taken me down a journey of self-enquiry and exploring other modalities.
Don’t get me wrong, regular Pilates practice keeps me reeeallly good most of the time! But in moments of stress I notice it creep into my neck or back.
You’ve probably heard us talking about gripping patterns…butt grippers, tummy grippers, back grippers, lat grippers, neck grippers, trap grippers! It’s simply referring to the body part that likes to over work and ends up staying braced or “on” most of the time. In Pilates we tailor your programme to encourage those muscles to switch off a little, and encourage the muscles around that area to do their jobs so the gripping one doesn’t have to do all the work!
Why does this happen though!? There can be any number of reasons, but stress and trauma are big players, which is why working on the physical body, although great, may not be enough to fully fix the issue.
Somatic work is an incredible tool, but what is it? Not nearly enough people even know what it is, and it’s definitely not readily available, however it’s time is now and I’m confident it will become more commonplace pretty quickly. It’s a nervous system based approach to dealing with stress/anxiety/trauma whereby we learn to regulate our nervous system and understand how to move our bodies out of their fight/flight/freeze response, which we can be in without even consciously being aware of it. The past few years have had an immense effect on peoples stress levels which is why this kind of work will be so important moving forward so that we can heal collectively.
A simple example in a Pilates situation is taking a moment to lie on the reformer, and before doing anything just do some deep breathing and get a sense of the reformer really holding your body, on every exhale allow the full weight of your body to simply be held. This is a much better place to start exercising from than getting on there and ripping straight in with tension in your shoulders, core being switched into beast mode, etc.
A somatic therapist I recently visited sent me to an article to help me with my Psoas muscle. This is a muscle in your core/hip flexor area which attaches to your leg and spine. I was telling her how frustrating it is that I have physio readily available to me, we needle my psoas, and I do specific exercises to keep everything happy, yet it always finds its way back to being tight, pulling me out of alignment and triggering the back and neck pain. She said the psoas is a deeply emotional muscle and a messenger for your central nervous system. In some spiritual philosophies it is seen as the residing place of your gut intuition, and is the “guardian of your soul”. Tension in this muscle is a massive contributor to a lot of back pain, leg pain, digestive problems, reproductive issues, and even breathing issues given it’s closeness to the diaphragm.
One way to help release this muscle (and relax your entire body) is called constructive rest – which I’ve posted the link to the video below. You need 15 whole, uninterrupted minutes to do this (hard I know – but so worth it!!). Here’s a photo of my reluctant model (thanks Paddy) giving it a crack!
In simple terms, you lie on the floor with your knees bent, a pillow between your knees and a soft scarf or tie around your knees to hold them together so you don’t have to. You can choose to have your head on the ground or raised with a book or two depending on the shape of your neck/shoulders. You then lay there with your eyes closed and do nothing. Not even look at the telly or have a conversation as that will use muscles. It would be a good time to meditate or just rest and completely let go.
If you’re interested in my experience, I loved it and am totally going to try and do this once a week! I thought 15 minutes would be really hard but it actually went really fast. I lay on the floor behind a sunny window, and went in and out of consciousness. One interesting thing that came up was an urge to move my left leg, or feel like I had to hold it up, it was restless, and I had to fight with myself to just leave the leg alone which was really hard. I then went into a bit of semi consciousness and when I came to again I felt like my legs were completely weightless, almost like they weren’t there! It was a strange but really amazing feeling. I also felt a real letting go sensation in the right side of my tummy and my right shoulder which are the places I hold tension, and my pelvis felt more evenly weighted on the floor.
So go on try it – if nothing else it’s a good excuse to lock yourself away for 15 uninterrupted minutes of me time which with partners, kids, dogs, jobs, is a luxury in its own right!!
The more years we complete around the sun, the more experiences we have - both good and bad. Our bodies store information in our nervous systems based on these experiences and learned beliefs. This is why it’s so important to just allow yourself some TLC; rest and recovery is just as important as movement. Much like a beautiful classic car, it needs to be driven to stay functional but the WoF’s and services become much more frequent! But don’t they just get better and better with age!
Got Neck Pain That Won't Go? Try This
1/3 of neck pain after an injury can hang around for over a year. That’s quite a large stat!
Whether that is in the form of your neck catching every time you move, an ongoing ache that comes at the end of the day, or purely your neck feeling stiff and noisy when you wake up.
Research is beginning to come out on solutions for persistent neck pain.
The two key and MOST effective interventions are a combination of exercise and “hands on” Physio.
EXERCISE
This can be specific neck muscle retraining. Subtle exercises targeted at the smaller endurance muscles are option 1. We try and incorporate these early. Firstly because they can be done pain free even when your neck is very sore. It also builds from the inside out, meaning once the key stabilizing muscles are going their job well we can then focus on building neck strength in the bigger muscles. Doing this early means that within 6-8 weeks you are seriously reducing your chances of your neck pain persisting.
Another exercise option that has been studied is global postural muscle strength exercises. This focuses on posture globally, working larger postural muscles with bigger exercises affecting multiple muscle groups.
They did a study comparing the above interventions against each other relating to persistent neck pain. They both signifcantly improved neck pain however they couldn’t determine which was more effective. They concluded they were both effective.
Here at Connect Studio Physio and Pilates on Waiheke, we like to throw the whole kitchen sink at neck pain and combine both interventions.
Making sure the deep little muscles are working through the ranges you need, then introducing the bigger gross postural and strength exercises to build resilience in your neck.
We combine this with imagery cues to make sure we get the most specific contractions possible to enhance results.
The final exercise intervention that has been shown to reduce persistent neck pain is cardio. Most people that suffer from this find going for a 40 minute walk or run makes them feel considerably better.
If you do get neck pain with walking make sure you come in and get your gait assessed. It sounds like you are using your neck muscles to walk. When we film you walking, you will see for yourself why you are getting neck pain.
I wanted to go through a couple of basic exercises from each of the above exercise groups for you to try. I’ve added videos to make it easier for you to understand.
Exercise 1: Deep Neck Flexor Isometric Holds
This exercise wakes up the deep neck flexors of your neck. Their primary job is to hold the neck joints in a snug stable position and prepare your neck for movement. In pain they can be inhibited and the shallow overactive smuscles take over. These bigger muscles weren’t designed to stabilize your neck so get tight which leads to sore compressed painful joints and muscles.
The exercise is essentially doing a gentle nod or yes motion with your head, making sure you aren’t overusing the front neck muscles. It is subtle and you won’t feel much. Hold for 10 seconds and repeat 10 times.
Exercise 2: Deep neck flexor hold in neck flexion
This is a far more advanced version of the first exercise. It requires a lot more neck strength. Don’t try this without at least 1-2 weeks of the initial exercise. Watch the video for instructions
Exercise 3: This is a great postural exercise for necks. If you notice your head sticks forward relative to your shoulders, this one is for you. You should never feel pain. It should feel challenging but manageable. Ideally hold for a few seconds and build your endurance from there. Once you are doing 6-8 x 30 seconds you are doing well.
HANDS ON PHYSIO
In order to help restore balance to the neck we use “hands on” physio techniques. We then progress to adding hands on techniques through all the movements we do during the day. Why? because we don’t live lying face down on a treatment table.
Once the neck muscles begin to wake up we can start heading towards the exercises above. But quite often we will use “hands on” physio while you do the exercise initially. This helps you get the feeling of what your neck should be doing through out the exercise.
Why hold your neck in an optimal position? To see whether the exercise is going to make you better or worse. One exercise can be effective for someone but not for another person. Prescribing exercises that have the same positive effect on your neck as “hands on” physio is the name of the game. An art as well as a science. You could get 5 people next to each other and those same exercises could have 5 different effects. Put together 4 good exercises that target neck control with upper body, lower body, abdominal control and you start to really solve the problem of persistent neck pain.
So try the above exercises. See whether they work. It’s ok if they don’t. Your neck pain may not be caused by your neck! Just come in and let us help figure out your unique neck pain puzzle. If you do want some help now you can click HERE to book an appointment. Otherwise if you want a free 10 minute phone consult with our Physio team to see whether we can help click HERE
Knee Pain As You're Getting Older?
Not many people like clicking on these posts and admitting we are old but … doing these things really works.
Knee pain as we get older can present in a few ways
Pain the first few steps in the morning
Pain at night that aches after more exercise than normal
A giving way sensation or pain up and down stairs
Pain when you’ve been sitting or squatting for a while and go to stand
The most common thing people say to me when they come in is “it’s probably arthritis and i’ll have to live with it”
The most recent example I can think of was a legend of a guy in his 60’s who loved hiking. He walked every day around 6-7kms and 3 x per year would go on a 5 day hike or tramp you guys call it here in NZ.
6 weeks prior he had done a hike that was around 5 hours and had more steps than he had ever done. He also hadn’t been on a big walk for a year due to covid.
He came in and immediately went with the “it’s probably arthritis isn’t it?”
“I think i’ll just walk with poles from now on and just walk once per week”
Yet 7 weeks ago he had no knee pain. My reply was “that’s a pretty rapid aging process of your knee in 6 weeks don’t you think?’
I reassured him that he will not be retiring anytime soon from walking. We constructed an 8 week program with Physio, Pilates and strength work and he did a 3 day hike 10 weeks later. I also saw him walking last week and joked “where are your walking poles I thought you had arthritis?”
All jokes aside there is no relationship between arthritis and pain. You can have a pretty arthritic knee joint and no pain. You can also have a pretty healthy knee joint and have tremendous pain.
The key things you need to do are
Settle the pain quickly
Fix any mechanical issues
Change your walking or running stride length (if excessive)
Restore pre-injury function to your knee
Grow your muscles (8-12 weeks)
If you tick those 5 boxes then you generally have done your absolute best at getting your knee pain under control. The above is also backed by a load of evidence in the form of the GLAD knee program. A 3 month knee rehab protocol which we use.
So i’m going to show you one thing from each of the above categories to help head you in the right direction.
FIX ANY MECHANICAL ISSUES
The most common one I see is over striding when you walk. What we typically do in the clinic is get people to walk outside and film it. We look at you walking from behind and the side. When we film from the side we look for over striding.
Over striding simply puts a lot more pressure on your knee than walking with a smaller stride.
Reducing your stride reduces the force through your knee. Imagine walking with less pressure through your knee for 8000 to 10000 steps per day!
The below video helps illustrate reducing your stride length
Restore pre injury function to the knee
We tend to restore function via exercises. Initially starting with isometric exercises where by we contract with good form for anywhere from 10-45 seconds depending on current strength levels or pain levels.
Try these two exercises which I like to start with. There should be no pain. If there is try reducing the depth of the movement or duration.
Isometric Bridge
Isometric Wall squat
Isometric Sumo Squat
Grow your muscles
Muscles get used to the same stimulus really quickly so if you do the same thing every week don’t expect to get better. You will initially but you will plateau.
You can grow the muscles by a couple of ways. Double to single leg exercise progressions. More reps. Less rest. More weight. It’s a science and an art to nail this.
We recommend you come in as everyone is unique and requires a different amount of force to grow your muscles.
So try the above. It really works. It will never replace a well designed Physio and rehab program. If you can dedicate 8 weeks to getting your knee under control email me at nick@connectstudio.co.nz with a brief description of your issues. I can recommend the right Physio for you to get back to what you love doing. If it sounds like I need to refer you on i’ll refer you to the right person who can help.
Cheers
Nick T
Connect Studio Waiheke
Why Do Sporty Kids Get Growing Pain?
Kids injuries are different to adult injuries. We regularly see kids here on Waiheke Island between the ages of 10-17. It’s really important to understand why our kids get sore and what can be done about it. I hope by reading this you understand the differences. When your child points at their Achilles it probably isn’t their achilles…..
Kids grow very differently compared to their friends. Did you know that in an under 13 sporting team there could be a variation of 3-5 biological years between the kids despite all being born within the same year!
Kids tend to grow feet first then legs then spine. So we generally see kids under 13 getting heel pain first which is called“severs disease” followed by front knee pain “osgoulds slatters disease” (13-14 years) then teenagers will then get spinal issues such as “pars defects” or “sheurmans disease”.
So what are all these “diseases”? They sound horrific but aren’t really.
The most common child to adolescent injuries revolve around the growth centres of their bones or growth plates. Kids bones don’t fully fuse until well into their teenage years. Where the area isn’t fused is called a growth centre. As bone grows during the child to adolescence phase fusion isn’t uniform or symmetrical. Parts of the bone can harden and others take a bit longer and remain soft. So the system around the growth plates isn’t balanced or stable. So as kids go through growth spurts their bones may grow but it doesn’t necessarily mean they are now harder and can handle the stress of jumping sports. Bones get long before they get strong so even though a kid has gone through a growth spurt their bones aren’t strong.
Interestingly girls bones don’t fully mature til around 18 and boys bones later at 21. Children and adolescents' long bone ends are 2-5 x weaker than adults.
As we grow we get this imbalance of soft areas of bone and hard areas of bone that aren’t happening equally. We get muscles and tendons that aren’t lengthening at the same rate as the bones are growing. These attach on the growth centres. When you play a lot of explosive sports such as soccer, gymnastics, tennis or rugby you can over load these growth centres. A combination of imbalance in the bone modelling system, tightness in the muscles and tendons with loads of sport and a lack of recovery leads to apophysitis.
It can vary from mild pain during a game on certain days to being barely able to walk. Symptoms can last up to 2 years and can really put kids off sport so it’s important to manage it well.
So what can be done?
I’ve found taking a holistic approach to the injury really helps
Some questions to ask yourself as a parent
Is your child getting enough sleep? Remember a lot of our recovery happens when we sleep. So if there is a lack of sleep this can influence bone remodelling . Think about screen use beofre bed. It delays good quality sleep. Think about teenagers. They tend to be night owls, gaming with their mates until bed which can be really late. Yet they are expected to be at school by 8.30.
Are you kids getting a good nutritional balance?
How much sport are they playing per week? One of the key aspects to treatment is working out their current weekly sporting diary. What days are the worst? What else are they doing that day? eg basket ball or touch rugby at lunch.
Also remember kids have PE at school.
It is really important to bring your kids in early when they have pain. Not only because we can manage them quickly but also to exclude other conditions that can masquerade as the above..
Particularly if there have been fevers, chills and a lot of night pain.
You also need guidance on how to strengthen the area. You also need to “wake up” the communication between the brain and the affected area.How many times have you seen your kids go through that phase of constantly hurting themselves. Walking into walls and tripping over. Rest alone in the presence of a lack of strength won’t help get them better.
So if you think your child is suffering from the above, bring them in. Just click the link HERE, fill in your details and bring them in. I’d also recommend bringing in a pair of shorts and their training shoes.
Reduce Your Winter Aches And Pains
Waking up early in the morning when it is pouring outside, it’s dark, you can hear the trees smashing against the side of the house, you know it’s freezing out there ….. It just doesn’t inspire you to leap out of bed and punch out 10000 steps.
People often complain of feeling sore and stiff during the winter months. Usually people come in and say “I can tell when the weather is about to change because my old injury/ osteoarthritis starts to hurt more”.
We also see a huge increase in ligament injuries during winter months from changing direction during sport, opposition player force or just slipping over in your driveway. Arguably these are less in summer.
So why do we tend to hurt more in winter? Why do old joint injuries suddenly turn into meteorologists? Why do we see more ligament injuries during winter? What can we do to minimise feeling like the tin man during the colder months?
Some of the common reasons we see an increase in the above are obvious but how many people action them regularly?
Reason 1: Our incidental exercise is greatly reduced
As a result of the wind, cold and slippery tracks our daily step count is reduced considerably. If it rains constantly it could be a week before you do any real incidental exercise.
This lack of mobility means stiffness, tight tissue and more compression on joints. If those joints are or have been injured in the past they can hurt more.
Reason 2: Change in atmospheric pressure
Change in weather conditions tends to make your joints and old injuries/ fractures hurt more. The change in air pressure causes joints to swell and the change in this pressure causes pain. Yes it’s actually a thing.
Reason 3: Sickness
It’s fair to say this year has been a bit of a stitch up with regards to everyone being sick. Especially those of us with kids: Being reintroduced to other humans again combined with covid version 6.0 has meant lots of nasty bugs around. The same inflammatory cells that are released when you are injured are released when you are sick. How many people felt every old injury they’ve ever had when they had covid?
Reason 4: Mood
Winter sucks unless you're mountain skiing. It can make you feel a little down. Constant rain, darkness, mud and dampness doesn't make you feel amazing. There is a direct correlation between your mood and pain. If you are stressed or down, your pain is magnified.
Changing the above can make a real difference to how your body feels during winter. Try some of the below and let me know how you go!
Increase that step count with adding a couple of light layers
Get out and increase your step count with a couple of light layers you can remove as it gets warmer. It’s unpleasant for 4 mins and then you’re good to go.
Start your day with movement
Do some yoga on an app or try a warm room yoga class, do your Physiotherapy program first thing in the morning (this should also mean less pain and discomfort throughout the day), try one of our morning Connect Studio Pilates Classes . How much better do you feel afterwards?
Your body is warm while everyone else is freezing. Nothing hurts and you feel good! This has to be the biggest secret weapon against feeling pain in winter.
Take a joint health supplement and fish oil.
Drink loads of water
We still sweat in winter! However we tend to swap water for more coffee and tea. Both tea and coffee are diuretics and make you pee more dehydrating you. Lack of hydration to your muscles and fascia in winter leads to muscle tightening which can lead to pain and injury. Keep up your water intake!
Do a nightly stretch routine
If you are felling stiff finish the day with a nightly stretch routine. Do it watching netflix. It’s a great way to unwind especially combined with breath work. If your not sure where to start with breath work simply try box breathing: push into the stretch, breathe through your nose for 4 seconds, hold for 4 seconds, out for 4 seconds. Next round or next stretch.
Do your Physio program to wind down. Make sure your body is in better alignment and settled before you sleep. Particularly if you are susceptible to a little night pain .
Meditate or book a holiday!
So commit to a couple of the above. My fave is movement before starting anything else. Let me know how you go!
P.S if you want a Physio Rehab Program to keep your body feeling aligned and strong over winter click HERE
Hamstring Strains - The Key Things You Must Do And Not Do
If you have ever had a hamstring strain you definitely don’t forget about it anytime soon . Whether you were sprinting along at full pace for the ball or doing sprints at the park. It stops you immediately in your tracks. It’s like someone just kicked you in the back of the leg, you stop immediately and do that stiff legged urgent bathroom walk. Alternatively you just lie on your back holding your thigh because the pain and cramping are so bad. It can look pretty black and bruised sometimes and you just do not want to move your leg.
The hamstring has to do a lot when you sprint. It has to move your hip and knee at the same time because it crosses both joints. The most common point you get a hamstring strain is when you are swinging your leg through at full pace just before your foot strikes the ground (terminal swing). It’s at this point that the hamstring has to really decelerate the leg before it hits the ground while the hamstring is in a very stretched position.
Here is great example of a hamstring tearing in an AFL player to help understand the above position
I want to reassure you that the majority of hamstring strains return to sport within 3 to 4 weeks max. That is with the right rehab program and early quality management. It has a really high reinjury rate in the first 15 weeks of between 20 and 33% so it’s really important you complete the rehab program to a high level to condition the hamstring to sprinting.
People are surprised at how early we get you running (7-8 days). Sprinting drills 4 days. Riding a bike (3-4 days). Sprinting at 2 - 2.5 weeks in some form. What is really important is those first few days. Minimising the damage done. Reducing extra swelling. Trying to set up an environment where you can rehab quality healing hamstring tissue.
So what should you do if you have just strained your hamstring?
The first thing you should do is go home and rest. I’d put some compression bandage, k tape or compression tights on during the day and take them off when you sleep. This reduces the swelling and bleeding. The less swelling, the quicker you can start rehabbing.
DON’T take voltaren. It delays scar tissue when we really want to lay some scar tissue. This is arguably the most common mistake people make. If you are in a lot of pain I would recommend panadol or ice packs.
DON’T drink alcohol. Sometimes you want to feel like drowning your sorrows after this type of injury which usually happens when you’re in great form. But don’t …. it simply increases the bleeding and swelling.
Work from home if you can for the first two days and ideally just chill on the couch. There isn’t really any new tissue laid down until day 3 so trying to be a hero by limping to work a day after injuring yourself doesn’t do you or your hamstring any favours.
Try and elevate your leg above your heart on a couple of pillows for the first two days is also useful.
Early rehab phase
On your first visit to the clinic our goal is to really settle your pain, begin gently reloading the hamstring, gently strengthening your hamstring and give you some explosive vertical propulsion movements to maintain your power and figure out what we can do to maintain your cardio fitness.
It’s really important to book an appointment to see us or your local physio on day 3. If you can’t and have to wait a couple of days try the below exercises (don’t try on day 1 or 2).
Do the below exercises twice per day BUT they need to be pain free.
EXERCISE 1: ISOMETRIC BRIDGE 6-8 X 10 SECONDS. PROGRESS OUT UNTIL THE POINT JUST BEFORE PAIN.
ISOMETRIC HAMSTRING PROGRESSION
EXERCISE 3: BRIDGE WITH CORE SLIDERS AND SLIDING LUNGE
EXERCISE 3: SINGLE DEADLIFT AND REACH
People get worried when they start doing this at day 3 or 4. However when they can see it’s safe and pain free it can be a real confidence booster. The hamstring needs to be stretched out further with speed to bother it so these are safe exercises as long as done pain free.
If you have access to an exercise bike I would also start cycling. It should be pain free and you should be able to add a bit of resistance to get a proper work out to keep your fitness up.
So that’s a pretty good start to your hamstring strain rehab program. I consider it a “good” injury to get because your hamstring has a great blood supply and you can work around a 14-28 day return to sport most of the time. There are times where it can be slower. This generally indicates that you may have injured the central hamstring tendon. We would get an MRI to diagnose this if you weren’t back on the field post doing our sprint testing protocol.
So there you have it. Create the nice environment needed for both of us to get you on the field or training ASAP. Give us a call on 0293650004 or book online HERE to get your program started asap.
Thanks for reading :)
Nick T
Achillies Tendon Strains
Achilles tendon strains are frustrating especially during a lockdown when you’ve committed to getting fit, to get better at running, or you’re just loving the fact that we get these beautiful Waiheke Island bush trails to ourselves.
The achilles tendon is a really important spring that propels you forward. It is generally injured when you overload your spring Achilles spring.
Common overloading of your Achilles spring can include some of the following common examples
Running again because the gym is closed when you haven’t run for weeks or months
Adding some sprint training which you aren’t used to
Doing too much running without recovery days
For those of us that are a bit older it can be going for longer walks than normal. Initially they can be pretty sore for 14-21 days. Especially in the mornings. The pain is generally localised to the middle part of the Achilles tendon.
Please note if your pain is at the bottom of the back of the heel then that is a very different injury and requires different management. Sometimes without the right management they can drag on for weeks, months and years. Following the below advice will go a long way to avoiding the above statement.
So what happens if you overload your achilles spring with any variation of the above?
The first thing is to stop all spring-like activities until you have seen your local Waiheke Physio. I can’t emphasize this enough. You can drastically reduce your time out of spring like exercise if you stop all explosive exercise.
Consider taking nurofen. You need to check with your pharmacist but neurofen or ibuprofen can really settle your tendon down. Ibuprofen reduces the activity of your tendon cells thus reducing the pain in your tendon.
Do the below exercises 2 to 5 times per day. Recent research has found that doing isometric calf raises can really help settle your achilles tendon down. Isometric calf raises are basically calf raises without moving up or down. You have to do them at around the midpoint in the calf raise. If you raise up too high in the calf, it can actually make you worse. Watch the videos below for two good options to start with.
If you are unfit I'd start with 5 x 10 second holds with a minute rest between each set. If you are fairly fit and strong go for 30 to 45 second hold x 5 with a minute between each set.
Jump on a bike and maintain your fitness with the bike. You should be able to push yourself pretty hard on the bike as it is a non springform of exercise. Swimming or the cross trainer are other good options.
Please note if your achilles is sore with the above you need to come in as the chances are you actually have something else going on. Believe it or not there are around 7 things that can cause Achilles type pain and we have loads of tricks up our sleeves to help get them under control also. If you need some help with getting your Achilles pain under control no matter how long it has been there and you live on the Motu click HERE to book online or give us a call on 09 372 2343.
How Compassion Can Help Us Heal
Tautoko - waiho I te toipoto, kaua I te toiroa.
This is a beautiful Maori whakatauki, or proverb, which means let us keep close together, not far apart. But given we’ve been in Level 4 lockdown for the last five weeks, with at least another two weeks at Level 3, it’s been physically impossible for us to stay close together, which makes it hard to offer one another support. For many people this will be having major effects on their health and well being. We need to treat each other with kindness and compassion as the community opens up again; it is more powerful than you may think.
Last week I listened to a podcast – The Healing Power of Compassion with Dr Julian Abel, a recently retired palliative care consultant, and co-leader of the Frome Project. The Frome Project aimed to end loneliness and improve health in the small English town by building community connection and providing compassionate alternatives to medical intervention. One GP Dr Helen Kingston was instrumental. When she started working in a large practice she wanted to find a way to make sure care was coordinated, there was a good exchange of information between practice members, and at the same time (realising that a doctor’s role is more than just drug intervention) wanted to find a way for people to feel supported by their community. She employed someone to start a community development programme from within the medical centre; this created a way of connecting community resource to what happens in the medical practice. It was extremely effective! Emergency hospital admissions dropped by 30%, along with improved quality of life scores, health outcomes, and costs. People even started moving there because it simply became such a friendly town. Given we live in a small community, we have a big opportunity to implement similar initiatives to Waiheke in order to improve the health and wellbeing of our people!
So what does “compassionate alternatives to medical intervention” actually mean? They aren’t asking people to stop taking their meds, rather saying that medical treatment when combined with compassion and positive social relationships dwarves the effectiveness of medical treatment alone. When we think about what is most important in life, positive human interaction and relationships are extremely high up on the list, and compassion is a basis for these relationships to exist. Compassion and kindness contributes to an increase in Oxytocin hormone, also known as the “love drug” because it gives you that warm fuzzy feeling, as well as boosting endorphins – yes it actually changes our biochemistry!! This helps to lower stress and anxiety, decreases ones sensation of pain, and therefore has a profound impact on health and longevity. Arguably the traditional medical world focusses too much on objective parameters such as blood tests, and not enough on subjective ones such as joy and reasons for living, so what they were doing in Frome found a way to merge the two, with great success.
To give you an example, a woman named Cathy was diagnosed with a very severe form of acute Rheumatoid Arthritis, and was wheelchair bound within just 3 weeks. She was a businesswoman with a dog and two kids, but didn’t know a lot of people around her very well. This illness devastated her, and she turned to her doctor to get a sense of hope that this wouldn’t be her life from now on. Aside from treating her medically, the doctor referred her to a “health connector”- someone who is trained in motivational interviewing but not a health professional. The health connector recommended she be around people going through a similar thing so she knows she’s not stuck. She attended a self-management group at the medical centre, went to pain management sessions, exercise sessions, and eventually into the community where she was connected to an incredible wealth of people. Cathy went from someone being relatively isolated and focused to being someone deeply engaged in the community, she made friends for life, and was comforted knowing that they were there for her and vice versa. Her life was transformed, not only did she regain her health (large improvement in pain and mobility), she regained her happiness also. The combination of the medical treatment and the support network transformed her life, and gave her a reason for living. You could look at her illness as a blessing in disguise as it made her realise what was important to her and what made her happy.
Oxygen: The New Anti Aging Drug
Oxygen has become the new wonder drug. The simple art of breathing has taken the crown of sleeping. Just like the coconut did to kale and goji berries.
Something we do subconsciously and automatically has now been broken down into a bunch of different systems and made to be complex. It can be overwhelming on which one to pick. To be honest they are all great. I’d probably just start with something simple which we will go over later. Like running 5kms instead of a marathon the first time you try.
A patient of mine came in just before the lockdown. She felt the key issue to her back pain was her weak core. So we got the ultrasound out to see if her core was “weak”. Her pelvic floor wasn’t moving and the right side of her deep tummy muscles was flat-lining.
What was more obvious was she was using her neck muscles to breathe, breathing rapidly and shallowly. I asked if she was asthmatic. She said she was a kid and had developed anxiety of not being able to breathe ever since.
We did a couple of mindful breathing exercises to change her breathing mechanics and then all of a sudden her “weak core” was now functioning perfectly. It wasn’t her weak core that was the issue, it was her breath. Just like getting strong or fit this stuff takes both patience and time but being aware of it is a huge step in the right direction.
So what’s the big deal with the breath anyway?
The breath is kind of like the on-off stress button. Stress is actually good for you in small doses. It’s how we evolve, become more robust, and more resilient. It’s also a bit anti-aging as well. Think of the Infrared sauna, cold baths, High-intensity exercise, and intermittent fasting as a couple of options of “good stress”.
Bad stress is different. It’s when the stress button is left on for a while. Like an IV drip of constant stress. Not helpful. Think pandemics, work stress that lasts for weeks not hours. Thinking of grinding your teeth in your sleep.
Changing your breath from those shallow rapid breaths to slower, deeper nasal breaths to your diaphragm or tummy is the quickest way out of that state and into the parasympathetic calm zone. The zone where we repair and do the good stuff our body needs.
Interesting facts about mouth shallow breathing: it can increase oral cavities by 60% and increase your susceptibility to viruses by being a mouth breather when you sleep.
So what do I do Wim Hoff, Butyeko? I’m confused?
You can try Wim Hoff if you want. He has an app HERE
However, if you have been an asthmatic, suffer from breathing anxiety, or just don’t like the idea of hyperventilation try this
Step 1: Lye on your back with one hand on your chest and one hand on your tummy. Close your eyes and focus more breath on your tummy than your chest. Breathe in and out through your nose.
Step 2: Make the breathing patterns 3 seconds in and 3 seconds out x 10 breaths.
Step 3: Now make them 5 seconds in and 5 seconds out x 10 breaths
Step 4: Add a 5-second breath-hold between 5 in and 5 out
Step 5: Pat yourself on the back. That will do. Still feel as stressed? Probably not.
Step 6: Don’t beat yourself up if you don’t do it perfectly the first week. Also don’t overthink it or panic. You’ve survived this long breathing the way you have. Be patient. It takes weeks not days to get it better and you’re going to get events like a pandemic where you still get overwhelmed.
It’s a great tool to get that stress button off. You can do this exercise driving, you can do it walking and at your desk. You can even do it on a ski chair lift if you have a massive fear of heights like myself.
You know what….it could even strengthen your “weak core”.
Here are a few breathing exercises:
Breathing The New Anti Aging Drug
Breathing Drill 2
Immediate Stress Relief Breathing Exercise
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Do You Really Need A Knee Replacement If You Have Osteoarthritis Of The Knee?
Do You Really Need A Knee Replacement If You Have Osteoarthritis Of The Knee?
I saw a guy the other day 5 years after I originally met him for his annual warrant of fitness. In his 60’s, an old rugby player who had had a couple of decent injuries to his knee and also fell off the roof.
He’d seen a knee surgeon who gave him the old line “i’ll see you in 3 years for a knee replacement” because he had knee osteoarthritis.
What kind of answer is that? Really? In 2021?
He had been favouring his knee for 2 years since seeing the surgeon. Which ironically had caused his other knee to blow up, combined with the opposite foot and back. His thought process was the less I weight bear on it the longer it will last. Making him look like the leaning tower of pizza.
DO YOU REALLY NEED A KNEE REPLACEMENT BECAUSE YOU HAVE KNEE OR HIP OSTEOARTHRITIS?
Not always! In Fact a lot of the time you can live quite comfortably with knee or hip osteoarthritis. It’s been the 4th anniversary of the “oracle” surgeon predicting his knee would need to be replaced.
We had a good laugh about it and he had forgotten which knee was the one to be replaced.
SO WHAT IS OSTEOARTHRITIS ACTUALLY?
It is a random joint disease that often begins with no real rhyme or reason. Did you know that Osteoarthritis is more common than high blood pressure and diabetes in people over the age of 65?
Osteoarthritis (OA) is a condition that affects joints. In a healthy joint, a layer of cartilage covers the ends of the bones. Cartilage is your shock absorber. It protects the ends of the bone, makes the bones of the joint play nicely and allows your joints to move smooth.
As we get a bit older, cartilage breaks down and becomes thinner. It happens in our 30’s and 40’s and is a normal age related process. As cartilage breaks down it leaves the ends of the bones unprotected, and the joint loses its ability to move as smooth.
In OA as the cartilage becomes softer, it fibrillates in the areas of maximum weight bearing. You can also get bony spurs into the joint. This can lead to swelling, aching, weird noises and stiffness. s.
AM I AT RISK?
If you have had a serious joint injury such as rupturing your ACL in your knee or tearing the meniscus you have a 50% more likely chance of developing OsteoArthritis as you get older.
If you expose your joint to too much load: think of Rafael Nadel training 5 hours per day or NBA basketballers training for hours on hard courts every day with minimal recovery you can also be more susceptible to OA.
If you put on an extra few kgs your joints are forced to take more load which is a risk factor for OA.
Being a couch potato or desk workaholic doesn’t help your joints. Cartilage needs movement to keep the joint healthy. Too much sitting on your backside stops the load required to activate cells to repair cartilage and nourish your joints.
Some things we just can’t change like time!
That was all rather depressing. However THE GOOD NEWS IS STUDIES HAVE SHOWN THERE IS NO RELATIONSHIP BETWEEN WHAT YOUR KNEE LOOKS LIKE ON AN X RAY AND PAIN!
Did you know they did a study and radiologists couldn’t tell from the images who had back pain and who didn’t. Quite often you can have a lot of arthritis and be in no pain. Quite often you could have none and be in a lot of pain. People wrongly call knee osteoarthritis "wear and tear" and state that my joints are “worn out”. This is not the case at all and it is dangerous terminology because it assumes if you keep moving you will wear them out more. You NEED movement to help!!!! Read on to find out why movement is absolutely crucial to feeling better.
HOW CAN I HELP MYSELF?
NEUROMUSCULAR STRENGTH EXERCISES
It has now been shown that neuromuscular strength exercises (What we do as Physiotherapists) and physical activity can reduce risk of developing OA and improve your cartilage quality.
How do neuromuscular exercises help? Stronger muscles help to stabilize the joint. Training your muscles to work in the right order also keeps the joints in a happier healthier position leading to less compression and other forces that overload the cartilage.
Strength training grows our muscles. The stronger they are the less force goes through your joints.
LOSE JUST A LITTLE BIT OF WEIGHT
Losing 1 kg can reduce the load through your joint by 3 to 5 times. Imagine what would happen if you lost 5kg! See a dietician to create a plan to reduce weight.
Or check out this science backed app called NOOM. Chaz and I are hooked on it.
EXERCISE
Exercise or simply increasing your physical activity can be as simple as walking slightly more than you had the week before or cycling for 20 minutes. Moderate exercise e.g. 30 mins per day has been shown to be very beneficial to your cartilage.
Exercise also releases endorphins which is our body's natural pain killer.
Exercise increases your muscles efficiency and strength. This helps create less force through the joint.
In knee osteoarthritis the old “move it or lose it” is very apt.
So move regularly, exercise, look after your weight and consider strength training to keep your muscles strong and healthy.
If you are struggling with your joints at the moment feel free to reach out. We are more than happy to answer any questions. Just email us at hello@connectstudio.co.nz
If you are struggling with your knee joints at the moment, live on Waiheke Island and need a Waiheke Physio read below
THE 8 WEEK BULLETPROOF YOUR KNEE PROGRAM
We created this program based on the GLAD hip and knee osteoarthritis study used on over 10000 people suffering from OA of the knee. The results were amazing just as they have been with us. During the Bulletproof Your Knee Program you will include neuromuscular exercises that target stabilizing the knee joint, relieve pain and build trust on your affected side. Loading the joint the best possible way.
From our work and that from the GLAD program participants experience significantly less pain, have improved physical function and a better quality of life. People also took fewer pain killers.
You can book online HERE. Make sure to write in the notes that you want the 8 week knee program.
Nick
The Legit Benefits Of Infrared Sauna Use As Proven In Scientific Studies
When the idea of having an infrared sauna was floated by Chaz I initially thought “great, another wellness gimmick” because “wellness is so hot right now”.
I’m a sceptic and had this drummed in at university that everything must be evidence based.
The throw away line I heard was “it releases toxins” and I thought yip that’s what sweat does… go for a run…
However, some pretty switched on scientists started harping on about the benefits of sauna so I thought I’d do some research. Can sitting on your backside in a hot room listening to Spotify, Netflix or the Calm app really be good for you???
Interestingly a lot of the research comes out of Finland. I know it’s cold there, but they really do have a thing for saunas. The studies they do are pretty big but the results are actually incredible. Here are some of the findings in case you were tempted to indulge yourself but need a reason to actually pursue it.
People that use saunas 2-3 x per week are 22% less likely to die from a sudden cardiac event e.g. a heart attack or stroke
Regular users (4 x per week) are 63% less likely to experience a sudden cardiac event. Yes that’s right 63%
Using a sauna 2 x per week led to 22% less chance of developing high blood pressure (sauna use stops hardening of the arteries)
Using a sauna 4 x per week led to a 46% less chance of developing high blood pressure. So for a non drug intervention I reckon that is pretty significant
Reduces chronic inflammation markers in your blood reducing chronic inflammation
Using the sauna 4 x per week led to a 65% reduction in risk of developing Alzheimers disease
Reduced depression in healthy patients using 2 sessions per week
When I started to read these benefits I couldn’t get in the sauna fast enough. Thinking of the long term gain if I could reduce any of the above, I’m all in.
On a personal note the things I’ve noticed the most since using the sauna 3 x per week are
I’m a lot more relaxed in both mind and body
The days I use the sauna I sleep like a baby!
A post swim sauna is epic. One of our clients times his sauna use with full tide. Genius!
So if you are interested in trying our sauna we have an intro offer of 3 sessions for $70 as well as a number of options including concession passes and memberships on our website
https://www.connectstudio.co.nz/book-now
Cheers, and see you soon!
Nick
How to Offset the Effects of Sitting to Improve Posture and Reduce Pain
Sitting! One of the biggest contributors to our generation of people suffering from bad posture and back pain! In Western society, everything has been engineered to have us sitting with our hips at 90⁰ - chairs, toilets, cars, etc which leads to our hips being so used to that position that they become stiff and the muscles around them shorten, creating a vice-like effect. We therefore lose mobility into other hip positions and consequently the surrounding muscles can’t do their jobs properly either. This is why we often hear of health practitioners telling us things like our “glutes aren’t firing” or we are “quad dominant”. So how do we offset the effects of sitting? Hopefully this blog can give you some simple tips to reverse the damage!
One useful tip is to evaluate the amount of sitting you do during the day, and aiming to offset this at the end of each day. Be honest with yourself and take into account driving, working, sitting on the couch watching a movie, eating, etc. From there, for every hour of sitting (hips in a bent up/flexed position), aim to do one minute of work on hip extension (i.e. stretching the front of the hips and strengthening the hip extensors such as Glutes and Hamstrings).
Other than offsetting the sitting, working on hip extension is hugely beneficial for everyday life. These muscles are responsible for having good gait and ensuring we are walking and running efficiently. They play a big part in getting up off chairs, out of cars, off the floor, and so when they are a little sleepy our body compensates and uses other muscles which can often lead to some of the common back and hip pain we see. As humans we really only have about 15-20degrees of hip extension (how far you can take your straight leg behind your hips keeping your pelvis and lower back still), however if we don’t have the ability to do that, every time we take a step we find the movement somewhere else such as hinging at the lower back, which puts it under unnecessary load. The hip joint is the biggest joint in the body so we need to make sure it’s working well so that all the other little joints in our knees, feet, spine etc, don’t have to compensate and overwork! Take a look at the video for ideas on hip mobility and hip extensor strength, and remember movement is medicine!