DRA is the acronym for diastasis of the rectus abdominal muscles, which is the separation that occurs during pregnancy to the abdominal muscles, to allow the baby to grow. This DRA occurs usually in the second and third trimester of pregnancy and can remain post pregnancy. It is suggested that post-natal DRA can lead to lower back pain and pelvic instability, and even develop urinary incontinence
The “acceptable” level of separation is less than 2 fingers at the level just below the belly button. You can check how much separation you have with this simple test:
1. Lay down on a hard surface with your knees bent and place a small cushion under your head.
2. Slide your fingers down towards your belly button and sink your fingers into your belly as you pass your belly button
3. As you pass below your belly button slowly sink 3 of your fingers into your tummy feeling your tummy muscles touch the side of your finger
4. Lift your head and bring your chin towards your chest to tighten the abdominals
5. Feel your abdominals squeeze your fingers, slowly remove each finger until you can feel your abdominals slightly pressing on the side of your fingers
6. Whatever fingers remain is approximately how many cm of separation you have
7. It is good to check the area just above and below your belly button too
The categorization of DRA is as follows:
· Normal < 2 fingers
· Mild DRA 2-3 fingers
· Moderate DRA 3-4 fingers
· Severe DRA > 4 fingers
Is there a way to manage this?
YES!!! The best ways to manage DRA during and post pregnancy involves movement education ie learning how to reconnect with your body and allow the deep muscles of your core to learn to work as a team once more. In more sever circumstances external supports may be useful and of course as a last resort surgery is an option.
While activity modifications can be useful in the short term and involve learning how to get in and out of deep chairs and bed, in the long term it is essential to relearn how too effectively and efficiently control and move your body. Exercises that help this learning journey include Pilates - for a more detailed outline of a Pilates journey post pregnancy please read our 'Exercise After Pregnancy' - these sessions will educate your on gentle core activation and pelvic floor exercises and ensure you are doing these exercises correctly!
External supports can help mimic the function of the abdominals, simple supports such as tubi grips and recovery shorts have been known to help.
It is always advised to seek our professional help when it comes to the management and education of DRA at BPS we have a variety of experienced women's health physio's who can help your with finding a solution that works for you, if you would like more information please don't hesitate to ask us a question here!
Feet ... do we ever really stop to think how amazing our feet are! They take us everywhere, carry us around day to day and yet more often than not we take them for granted. It's only when they start to protest and cause us pain that we seek help and advice ... and sometimes not even then!
Did you know there are 26 bones in the foot? That's a lot for the brain to control! The purpose of all these bones is to give us options when walking on a variety of different surfaces, these options allow us to adapt to the surfaces we stand on, that is if the bones, soft tissue structures and brain are all able to adapt. Unfortunately, years of 'abuse' often realists in our feet being less adaptable than we would like, stiffening up, poor arch control, poor tendon strength, bony compression - the lost goes on. Basically ... discomfort, it's our feet finally protesting and letting us know we are not treating them well!
So what does a foot want? What would keep our feet happy?
Generally feet like variety, they don't like to be stuck in the same shoe day in and day out. They like to use their mobility, their variability and their skill set, which means allowing them to walk on a variety of different terrain and in a variety of different footwear! They like to be stretched, strengthened, wobbled and moved in all which ways and at the end of the day they like to be rewarded with a pedicure (oh no wait ... that's just my feet, not a general rule of thumb!)
They like supportive (but not too supportive) footwear. They like the rest of the body to work with them, allowing loads from the ground to be transferred up the kinetic chain. They like to be kept strong yet supple, flexible yet controlled and dynamic yet steady!
SO how does one give one's feet all this? PILATES ... what better form of movement than Pilates to keep your 26 foot bones, and all their soft tissue attachments and neuromuscular connections moving well!
Want to know more ... ask one of our friendly Physiotherapists or Pilates instructor, they are a wealth of knowledge and would love to get you started on the road to you maintaining happy feet today!
INITIAL CONSULTATION (SINGLE AREA) $133.90
INITIAL CONSULTATION SENIOR PHYSIO (SINGLE AREA) $156.90
INITIAL CONSULTATION (MULTIPLE AREAS) $207.10
INITIAL CONSULTATION SENIOR PHYSIO (MULTIPLE AREAS) $235.35
PHYSIOTHERAPY FOLLOW UP (60 MINS) $133.90
PHYSIOTHERAPY FOLLOW UP SENIOR PHYSIO (60 MINS) $156.90
PHYSIOTHERAPY FOLLOW UP (45 MINS) $103.50
PHYSIOTHERAPY FOLLOW UP SENIOR PHYSIO (45 MINS) $121.30
PHYSIOTHERAPY FOLLOW UP (30 MINS) $73.22
PHYSIOTHERAPY FOLLOW UP SENIOR PHYSIO (30 MINS) $85.70
INITIAL APPOINTMENT $125.50
PILATES PRIVATE $125.50
PILATES SEMI PRIVATE (2PPL) $65.90
PILATES SEMI PRIVATE (BLOCK OF 5) $319.03
PILATES SEMI PRIVATE (BLOCK OF 10) $593.10
PILATES STUDIO (3PPL) $49.15
PILATES STUDIO (BLOCK OF 10) $442.45
60 MINUTES $125.50
45 MINUTES $94.15
30 MINUTES $62.75
PILATES CLASS $26.15
PILATES CLASS (BLOCK OF 5) $120.30
PILATES CLASS (BLOCK OF 10) $209.20
PILATES CLASS (BLOCK OF 20) $376.50
PILATES CLASS (BLOCK OF 50) $784.50
PILATES MONTHLY UNLIMITED $199.00
At BPS we know that when you bring a friend to class it's not only your friend that benefits, you do to!
Research shows that training with friends is not only more fun, but it also;
- increases your serotonin levels when compared with those who are training alone
- makes you more committed and therefore more likely to reach your goals
- improves your capacity for learning and retaining new information (which when it comes to Pilates is super helpful!)
So - to help you stay committed and reach your goals, every time you bring a new friend to class BPS will give you YOUR class on us.
Take control of your class and appointment bookings at BPS by using the MindBody App
Who here has been to the doctor complaining of joint pain, got sent for a scan that showed signs of arthritis, in which the doctor quickly blames it for your pain? It was once thought that the reason why our joints become sore and painful is because of arthritis, making the joints grind on each other as we move. It is true to a small extent, but it does not mean that we need to stop moving or use it as an excuse.
A lot of patients I speak to in the clinic always tells me the same story, “I have arthritis in my knees, so I can’t walk too far”, or “My back has arthritis that is why I can’t garden for too long”. This is by far not true at all. Having arthritis does not stop you from enjoying life, you telling yourself you “can’t” is what is stopping you from enjoying life.
But before we continue lets explain what arthritis is. Arthritis is a common term to describe joint pain due to changes in the joint itself. The most common form is called Osteoarthritis (OA) which affects the whole joint, from the cartilage, ligaments and to the bone itself. There is no cure for arthritis but there are many ways to manage it.
Often Doctors tend to diagnose OA via a system developed in the 1960’s which uses X-rays to determine the severity of OA, rather than symptoms the patient is presenting. However recent research has shown that there is not a strong relationship between what is found on film to the amount of pain and disability a patient experience, as once believed.
Not all is lost, however contrary to what simple logic tells us to do, we need to continue moving to get better. Since OA causes us to lose integrity within our joints, we need to then strengthen the structures that surround the joint to prevent unnecessary mechanical load through the joint. You can think of your muscles surrounding the joint are like shock absorbers. The stronger the muscles the better it is at absorbing the force so that you can protect your joints.
All of the current literature on all types of OA points to an active approach, by exercising and having a healthy lifestyle. We understand that sometimes being active and exercising can be painful but that does not mean we need to stop, it should not define us. What we need is to seek proper advice from movement specialists such as a physiotherapist or an exercise physiologist who knows how to modify exercises to make it more comfortable, and to progress it in a safe and enjoyable manner.
What about surgery you ask? Well recently in 2018 the British Medical Journal (BMJ) held an expert panel on the matter and concluded that they strongly discourage knee surgery and strongly support conservative treatment for degenerative knee conditions such as OA. “Patients and their health care providers must trade-off the marginal short-term benefit against the burden of the surgical procedure”. I understand that with this panel spoke about knee OA, but we can extend this for all joints in the body.
I guess the take home message here is think of arthritis like a speed bump, you approach it slowly, take your time to go over it. It does not stop you in your tracks.
There are only two certainties in our life, and aging is one of them. There is no way to avoid it but there are ways to slow it down or delay some of the nasties that come with age. However, there is one miracle cure that can slow and prevent aging, and that is exercise. As we age there are a myriad of changes that occur to our body and mind some of them include:
Changes to our cardiovascular system:
As we age the most common thing to occur in our hearts is stiffening of our blood vessels, meaning your heart must work harder to pump blood. This means that you are at a higher risk of having a heart attack or high blood pressure.
Changes to our cognition
Contrary to popular belief dementia is part of healthy aging, however it can become an issue when its happens too early or too severely.
Changes to muscle mass
Sarcopenia is a condition which causes gradual muscle wastage as we age. It is something that we can not inherently avoid without actively seeking preventative measures.
Changes to our balance
As we age, we become more unsteady on our feet leading to an increased risk of falls.
Changes to bone mass
In women after menopause, the reduction in eostrogen leads to a drastic decline in bone mineral density; making the bone more brittle.
Yet all is not doom and gloom! You can delay or even prevent of all the above with regular exercise. According to the American College of Sports Medicine (ACSM) participating in 150-300minutes of easy to moderate exercise per week we can combat all of the above. Easy to moderate exercise includes briskly walking the dog, leaving the car at home and walking to public transport and joining a recreational sports team.
A recent study conducted by the University of Birmingham in 2018 looked at groups of elderly individuals who participated in regular physical activities and compared to their peers, they exhibited an immune system and cholesterol levels of a younger person.
To be honest, most of this is common knowledge, but to practice it in a practical and safe manner requires knowledge and expertise. If you have decided to embark on your fitness journey for the first time, or if you have started but keep getting injured, it is best to consult your movement specialist, whether it is a physiotherapist or an exercise physiologist.
Read our policy here
To help you stay on track for your goals we are introducing a more efficient class booking system at BPS Caringbah.
Summer is well and truly here and it is time for us to get moving. This means more chances of injury. So how do we protect ourselves?
It’s a common belief that a 5-10minute warm up protocol prior to an event will reduce our chances of having an injury. It has been drilled into our psyche since we were young and continues to this day. We often attribute to any injuries we sustained to “oh I was not warm enough”, or “yeah I should have stretched more”. However, this may not be the case, but before we dive into this topic lets talk about why we stretch in the first place.
Stretching has two distinct effect on our muscles, the first, influences the elasticity of the muscle and the second influences the excitability of the muscle. Looking at the elasticity component, a sustained slow passive stretch can increase the elasticity of the muscle, allowing greater range of motion within our joints. Regarding neural effects of stretching it has been shown to decrease motor neuron excitability, a fancy word term for muscles relaxation. The correct dose of stretching varies between muscle groups, but the general rule of thumb is either a 4x90s or a 5x60s stretch per muscle group, totalling 5 minutes to have an adequate effect.
On the flip side prolonged passive stretching can cause strength induced strength loss to a muscle, where after a bout of stretches the muscle becomes weaker. This induced strength loss is dependent on the type of stretch that is applied, with dynamic stretches.
Currently the research shows that stretching does not reduce the risk of injury, however in certain sports that require large ranges of motion such as ballet or gymnastics, a proper pre-game stretch routine is vital, so that you can reach those ranges. In practical every day activities such as running or going to the gym, activities that does not require large ranges, stretching seems to have little to no effect on injury prevention.
In saying that I am not against stretching, I am against pre-game stretches, I am all for routine stretches as part of your exercise routine to promote joint flexibility. Coming back to what I said earlier about the correct dose, 5 minutes of stretching is needed per muscle group to increase length. Doing a 5-10-minute routine prior to a game does not even come close to what is needed to have an effect.
So how do we protect ourselves?
Well here are a few easy tips to prevent yourself from getting injured this summer:
· Do not bite off more than you can chew
o If you have never ran a 10km fun run before, don’t do it.
· Train appropriately for your event
o Strengthen the muscles that is appropriate to your task.
· Do not play through pain
o Pain is your body telling you to slow down
· Wear the right gear
o This is a no brainer, wear appropriate fitted protective gear such as helmets, knee pads, etc.
· Increase flexibility
o Stretching exercises should be incorporated into a daily fitness plan, not a last ditch effort.
· Take breaks
o By having frequent rest period, you can drastically reduce the risk of injury. When you are tired you are not performing optimally leading to injuries.