Top 5 Exercises To Keep Your Shoulder Healthy

In the shoulder, the higher the mobility, the lower the stability. However, this theory is not applied on a healthy shoulder. The shoulder is a complex joint that allows the arm moving in a circular motion, also, the joint has four muscles formed as a group called the rotator cuff muscles, which work in a balanced way to stabilise our shoulder.

The rotator cuff muscles
Let’s figure out the locations and the primary functions.

Refer to the diagram below, the rotator cuff muscles include the Supraspinatus (initiates the abduction), Infraspinatus (with the action of external rotation), Teres minor (helping the action of external rotation) and Subscapularis (with the action of internal rotation).

The rotator cuff muscles are important to us.
How can we protect it?
There are few tips to keep the shoulder healthy.

1. Keep a good posture
Chest open, engage core muscles by elongating the spine. Avoid ‘poking out the chin’ and ‘rounded shoulders’, so that the rotator cuff muscles work with proper biomechanics.

2. Avoid repetitive and heavy overhead activities
These are the predisposing factors to develop the rotator cuff tears or tendinopathy (previously known as tendinitis).

3. Regular exercises
Strengthening can prevent rotator cuff tendinopathy or impingement syndrome with age or degenerative changes.

4. Consultation
If you have any shoulder pain, stiffness or weakness, always seek the guidance of your physiotherapist. We can refer on if we think you need investigations or a medical consultation.

 

Top 5 Exercises for Healthy Shoulders

Here are some of the shoulder exercises which can train our shoulder stay strong and healthy. If any of these give you pain, see your physiotherapists for some easier exercises.

 

1. Wall Angels
Good to warm up your shoulder. Do it slowly and with control.

Start standing with shoulders and head touching the wall.
Draw the shoulder blade inward and downward.
Bend your elbow. Keep the forearm touching the wall.
Bring your arms up as high as you can get them, then return and repeat.

 

2 Scapular Retraction – putting arms in position ‘L’, ‘M’, ‘Y’, ‘T’
Improve the upper back and shoulder blade muscles strength. Too easy? Add some light weights!

Lie on your front with your forehead rested on a small towel.
Move your arms out to your sides then bend your UL in ‘L’, ‘M’, ‘Y’, or ‘T’
Keeping your chest and head in contact with the floor throughout, squeeze your shoulder blades together, and then arms off the floor.
Hold this position for 5 seconds. Relax and repeat.

 

3 Shoulder Elevation with Thera band
Shoulder elevation with shoulder stabilization.

Stand up straight facing a wall.
Loop a resistance band around both of your wrists.
Keeping this control with your shoulder blades, brings the arm up and down.

 

4 Gym Ball Wall Bounces

Raise the gym ball to shoulder height in one hand.
When ready, bounce the ball against the wall whilst keeping your elbow at shoulder height.

 

5 Arm Lift on Foam Roller
Arm strengthening exercise with cores muscle engagement.

Lie on top of a foam roller supporting head and buttock, draw shoulder blade inward and downward, flatten the lower back, feet on the floor.
Hold a pair of dumbbell and lift arms up and down.

Happy Feet, Happy Me!

 

Our feet are an extremely important part of our body. They provide us with important sensory information from our surroundings and provide essential strength and stability for the rest of the body to work from. If you have poor posture and strength in your feet, it could lead to pain and increase your risk of injury in both the feet and ankles, as well as further up in the knees and hips.

Over the last few decades, people are spending more and more time in supportive shoes and less time moving and working their foot and balance muscles. As a result, many people have stiff and weak feet with decreased balance.

So how do you turn these stiff weak feet into amazing ‘Happy Feet’?

Gradual exposure is key. Start with 5-20min a day of bare foot activity around the home or walking on grass. Build this up gradually over time. Be sure to incorporate a foot mobility and strength exercise program.

 

 

Try a couple of these foot exercises at home:

1. Big toe flexionWrap a piece of yellow or red TheraBand or a thick rubber band around your big toe.

  • Keeping the other 4 toes long and flat flex your big toe down towards the ground against the resistance band. Hold for 20 seconds and slowly release it again.
  • Try to work the big toe independently from the other toes.

 

2. Trigger ball rolling of the plantar fascia

  • Using a firm ball roll your foot along the ball on the ground.
  • Try going along the length of your foot as well as side to side.
  • Pause on tight or tender sports for a longer release.

3. The perfect heel raise

  • Always hold onto the wall or a bench for this exercise, it is for strength not balance
  • With parallel feet slowly rise onto the ball of your foot.
  • Keep the middle of your shin bone or ankle joint directly above your 2nd toe. Be careful not to roll outwards.
  • Slowly lower the heels back down to the ground
  • Do not use momentum to help you raise your heel, you should not feel like you are rocking forwards and backwards on your heel.
  • Do as many repetitions as you can of a full height heel raise. Once you can do 20, try doing them on a single leg.

4. Balance

  • Challenge yourself daily with a balance exercise. Try feet together, one foot forwards one foot backwards, single leg.
  • Try balancing on a rolled up towel, a pillow, the edge of the gutter, a log fence at the park, let your imagination run wild!

These are a couple of my favourites that are included with many more exercises and fun movements in our ‘Happy Feet’ class. Come and give it a try!!

 

How to Safely Return to Exercise post COVID 19

One of the most challenging things people are finding when they are recovering from COVID-19 is managing fatigue. Fatigue, like breathlessness and lack of mental focus make up some of the symptoms post COVID that last mid to long term post infection. These symptoms can come and go over time and can impact our ability to complete activities of daily living, limit social interactions and limit the return to healthy lifestyle habits like exercise.

Most of us are aware that physical activity is important to maintain a healthy lifestyle and should be part of our daily routine. But how should we tackle this safely after being infected with COVID 19? 

But How Do I start??

If you were hospitilised due to COVID-19 symptoms OR had symptoms of myocardial injury such as chest pain, severe breathlessness, palpitations or syncope, you should be assessed by your doctor or medical specialist first.

If you had mild symptoms of COVID-19 it is advised to rest and recover for 10days from when symptoms started. When you have been symptom-free for 7 days and you are no longer requiring medications such as paracetamol, you may start your journey back into exercise. 

Here is your 4 phase guide. Aim to spend 1-2 weeks in phases 1 and 2, then a minimum of 1 week per phase for 3,4 and 5. 

**Please remember, STOP EXERCISING IMMEDIATELY AND CONTACT YOUR HEALTHCARE PROVIDER IF YOU experience chest pain or palpitations, unexpected breathlessness or signs of blood clots such as red,swollen calves.

Phase 1:  Extremely light intensity activity. Start gently back into body movements such as flexibility and breathing exercises, balance exercises and gentle walking. You should be able to hold a full conversation throughout the exercise.

Phase 2: Minimal to light exertion. Start increasing your movements but keep the intensity to a level you can still hold a conversation throughout. Activities might include household and light garden tasks, gentle walking, balance or yoga exercises, stretching and light strengthening activities. Once you can perform all your activities of normal daily living easily AND walk 500m on the flat without feeling fatigued or breathless, it’s time to progress to phase 3.

Phase 3: Moderate intensity aerobic and strength exercise. Start increasing the intensity of exercise from a gentle walk to brisk walking, cycling, jogging or swimming. It’s a great idea to start with 2x 5minute blocks of exercise and build these up. Try exercising at this intensity every 2nd day allowing recovery in between. When you can tolerate 30min of moderate exercise in a session progress to phase 4.

Phase 4: Moderate intensity aerobic and strength exercise. 30min sessions of building intensity. Allow for a rest day every 2 days where you should stretch, or roll and release tight muscles. Progress to phase 5 when fatigue levels are as pre-COVID levels.

Phase 5: Return of pre-COVID level of exercise. Hard to Very hard intensity exercise as you are able. Be sure to manage training load with moderate and low intensity exercise days as well as rest days in your training program to manage risk of overuse/overtraining injuries.

 

Citing article : Returning to Physical Activity after COVID-19. BMJ 2021;372:m4721

 

New GLA:D® Program for hip and/or knee osteoarthritis coming soon!

Juhi, Matt and Sandra recently undertook the GLA:D® – “Good Life with osteoArthritis: Denmark” course and are now certified GLA:D® physiotherapists. We will soon be launching our in-house GLA:D® Program – a 6 week program of education and exercise designed to help reduce the symptoms of hip and/or knee osteoarthritis. Over the 6 weeks patients will attend 2 education sessions and 12 supervised exercise sessions, each of about 60 minutes.

GLA:D® is an evidence-based approach shown to help people of all ages with mild, moderate and severe osteoarthritis by reducing pain, increasing mobility and enhancing quality of life. Often surgery such as joint replacement can be avoided and, if having a total knee joint or hip replacement, completing the GLA:D® program prior can lead to a quicker recovery.

The GLA:D® exercises can be personalised to each individual participant, continued at home and repeated as and when you feel you may benefit from them.

 

Click here to read more about our upcoming GLA:D® Program.

 

Click here to express your interest in our GLA:D® Program and we will contact you once it has launched. You can also call us on 3857 5815.

 

 

7 EXERCISES TO HELP A STIFF BACK

Does your back feel stiff? Read on to find out how you can improve your thoracic mobility…

Our daily habits make us very prone to stiffness in the thoracic spine, which often makes it hard to stretch, bend or flex your spine, and can lead to back pain and tension. We spend a great deal of time through the day in thoracic flexion (forward bending) e.g. when showering, sitting at a desk, looking at our phone, preparing food, eating, doing housework, etc. 

Unfortunately, our usual daily routines rarely require us to extend our thoracic spine so, unless we go out of our way to do otherwise, we are often stuck in a forward position. Over time this leads to a fixed flexion posture and can be hard to reverse. It becomes especially hard to reverse as we age and, if not addressed, often leads to a great deal of debilitation in later life. 

Poor thoracic mobility can also have flow-on affects into the neck, shoulders and lower back. With our thoracic spine in a flexed position, we are more likely to overload the neck muscles, impinge the shoulder joints and place more pressure on our lower back, especially when sitting through the day. Natural movement, combined with joint mobilising exercises for the thoracic spine can help offset poor habits and help us to improve overall posture and prevent movement restriction later in life.

The following exercises can almost all be done with no equipment, with a couple of exercises only requiring a foam roller and a broomstick.

1. Cobra pose

Start lying face down with toes pointed and hands on the floor underneath your shoulders. Push up through your arms and extend spine as far as you can, ensuring you also lift your head and look straight ahead. You can lock out your elbows if able, otherwise if this feels too extreme you can rest on your forearms. Hold this position for 10 seconds before returning to the starting position. The aim here is to get as much extension through the spine as possible. Repeat 5 times and remember to keep breathing as you stretch.

 

2. Archer stretch 

Lie on your side with your hips and knees bent to 90 degrees, keep your knees together as you arc your top arm up towards the ceiling and continue all the way around onto the floor. Hold for 10 seconds and repeat 5 times. The aim here is to get as much rotation through the spine as possible. Do the same lying on the other side. 

 

3. Child’s pose 

Get on your hands and knees, drop your bottom back onto your heels while keeping your palms firmly planted on the floor. Let your head drop between your arms and push your chest to the floor. Hold for 30 seconds and repeat 3 times. You can get a wider stretch by pushing your knees out to the sides so your legs form a V.

 

 

4. Cat cow stretch

Get on all-fours with your hands directly below your shoulders and knees directly below your hips. Alternate between arching and curling the spine. The aim here is to move your spine through its full range of motion in each direction. Repeat 10 times in each direction.

 

 

 

 

 

 

5. Roller Thoracic extension 

Lying down on a foam roller, with the roller sideways underneath your body, extend back over the roller as far as your feel comfortable. Roll up and down trying to extend the spinal segment above the roller as much as possible. If this feels too intense or uncomfortable you may want to work on the cobra stretch more until you gain more mobility. 

 

6. Thoracic rotation with stick 

Rest broomstick on shoulders and place hands on top of stick at each end. Rotate the spine to the side as far as possible, trying to point the stick to 12 o’clock if able, hold for 5 seconds. Repeat 10 times in each direction.

 

 

7. Thoracic side bends with stick 

Rest broomstick on shoulders and place hands on top of stick at each end. Bent to the side through the spine, trying to point the stick down towards the floor as far as possible, hold for 5 seconds. Repeat 10 times in each direction.

If you’re struggling with back pain, stiffness or just want to help your body grow stronger and healthier, call or book online to have an appointment with a member of our team today.

 

This post was written by Greg Holmes, Physiotherapist at Stafford Physiotherapy and Pilates. 

Returning to running after pregnancy

When is it safe to return to running after pregnancy? You ran before you got pregnant. You might have continued running during pregnancy. And now you’ve had the baby and you’re keen to get your joggers back on and hit the pavement once again. So when is it safe to do so?

There is a general lack of evidence-based research around returning to running in the postnatal period. Running is a high impact activity which places a significant load on the entire body, especially the pelvic floor muscles. The most recent guidelines* are from 2019 and suggest waiting a minimum 12 weeks after birth. The guidelines also suggest that women meet a series of criteria for adequate strength of the pelvic floor and lower body muscles before hitting the pavement again.

The first 12 weeks after birth is commonly referred to as the 4th trimester. There is still a large amount of relaxin in your body, which means the connective tissue, such as ligaments, is still more stretchy than normal. Your body is still recovering from birth during this period, especially if you had perineal tears, episiotomies, a caesarian section or any other complications. The pelvic floor muscles are weak after pregnancy and birth and you may have symptoms that indicate these muscles need strengthening.

Symptoms of pelvic floor weakness can include:

  • Incontinence – leaking, inability to control bladder and/or bowel
  • Heaviness in the vagina
  • Dragging sensation in the vagina and perineal region
  • Pelvic pain

There is strong evidence to support an individualised assessment and structured exercise program for pelvic floor rehabilitation in the management of these conditions. Sandra is qualified to undertake pelvic floor assessments and can refer you to a specialised pelvic floor physiotherapist if needed.

It is also important to be assessed by a physiotherapist if you had a rectus diastasis (abdominal muscle separation). Our physiotherapists can screen for this.

Low impact exercise such as walking is encouraged in the first 3 months (12 weeks) of the postnatal period. Following this a graded return to a running program should be implemented to build lower limb strength and gradually introduce loading again to the pelvic floor muscles.

Call us today to get started!

* Reference: Returning to Running Postnatal – guidelines for medial, health and fitness professionals managing this population. Tom Goom, Grainne Donnelly and Emma Brockwell. March 2019

 

If you’d like one of our physiotherapists to help you get running again post-pregnancy, please call or book online.

 

This post was written by Lucy Beumer, Sports and Exercise Physiotherapist and Clinical Pilates Instructor at Stafford Physiotherapy and Pilates. 

How to safely return to the gym post COVID

Now restrictions are easing and the gyms are back open, it’s really important that we transition our home workouts back into our gym routines safely, without overloading and injuring ourselves. It’s important that we restrain our excitement, for the moment, take an honest account of our loading in the past few months and plan before we return to lifting with heavier and regular weight again. Our strength will be reduced, so reduce your weight!

Warm up and cool down

Make sure you reintroduce a good 5-10 minute warm up before you commence your sessions. Try to target the area you will be training, if you are training an upper body resistance session for example, you should include some light weight or body weighted exercises targeting that area before loading up! It’s a good idea to have a dynamic stretch or use a foam roller if you have been static and sitting at work all day!

Cool downs are often neglected, however also very important now you are training again. Be sure to stretch after your sessions and grab the foam roller for a few minutes for your legs or upper back to reduce the extra tone that will build up in your muscles, just remember to wipe down after! #COVIDsafe.

Loading

If you haven’t been lifting during the past two months, your body loses strength far faster than you want to believe! Start conservative, reduce your weight to start and aim for higher reps.

Prioritise good movement patterns again first. It’s important to allow some time over the first few weeks for your stabilising muscles to remember how to lift again. If you load up too quickly these muscles can become tight leading to breakdown in movement patterns which can result in injury.

Contain your excitement; you can’t get back two months of minimal training in two weeks, so be patient! Aim for around 10-15% increase in load each week.

If you are unsure of your technique, book in a few sessions with one of our physiotherapists, or an exercise physiologist at the gym, for guidance around movement patterns. This can be much more cost effective than future dealings with an orthopaedic surgeon.

Rest

Rest is very important for any training, particularly if you are changing the loading (weight, frequency or type of training). Your body needs time to adapt and change. You most likely will experience some serious DOMS (delayed onset muscle soreness) during the first few weeks returning to gym. Listen to your body, it’s ok to experience these DOMS however, if you are feeling pain greater than 2 days post exercise, you should reign it in!

Space out your sessions, make sure you give the worked muscle group a solid 1-2 days recovery before loading up again. If you are training whole body workouts, have rest days between sessions, take time on these days to focus on cardio, stretching, trigger pointing and foam rolling.

It’s important to allow this rest for your muscles to recover and continue to build strength without being overloaded. It might be worthwhile booking in a few regular remedial massages in the next few months.

The biggest risk to injury is this period of load change and building up again. Listen to your body and make sure you follow up with your physio early if you are experiencing altered movement patterns and developing niggles greater than just DOMS. If you can extinguish these niggles early, it’s likely you can continue training and avoid any further time out of the gym.

 

If you’d like one of our physiotherapists to help your injury-free return to the gym, please call or book online.

 

This post was written by Mitch Esdale, Physiotherapist at Stafford Physiotherapy and Pilates. 

Everyday Exercise – Part One: Socks

With people spending much more time at home, social sports cancelled and gyms closed, we thought we would help you still get your exercise in, with a bunch of exercises you can do at home using simple items you’re almost guaranteed to have around the house! Introducing our Everyday Exercise series!

Part one: Socks

Gym closed? Can’t get hold of weights for a workout because everyone sold out weeks ago? Never fear, you can get a pretty solid workout with just a pair of socks on your polished wood floor or tiles. Check out these 12 exercises to get your body working! You can follow the video, and there are written descriptions below to assist.

1. Mountain Climbers

In a long plank position, slide your knees towards your chest, alternating legs.

2. Knee Tuck

In a long plank position, slide both knees together towards your chest and back out.

3. Cross Mountain Climber

From a long plank position, slide one knee in towards your opposite shoulder, alternating legs.

4. Plank Jack

In a long plank position slide your legs out and in again with straight legs.

5. Pike

From a long plank position, keep your legs straight and slide them in towards your hands, lifting your hips up towards the ceiling.

6. Arm Slides

On your hands and knees or plank position, alternately slide one arm forwards as far as you can. Let your chest drop but keep your support elbow straight. Lift your chest again pushing your support arm into the floor as you return.

7. Arm Circles

On your hands and knees or plank position, alternately slide one arm forwards as far as you can, letting your chest drop but keep your support elbow straight. Then circle the hand out to the side before returning to the middle as you lift your chest again pushing your support arm into the floor.

8. Thread the Needle

On your hands and knees or plank position, slide one arm underneath the other reaching through to the other side letting your upper body twist.

9.Hamstring Slideouts

On your back, knees bent up and feet on the floor. Lift your hips up into a bridge then slide both feet out as straight as you can get while keeping your hips lifted off the ground. Lower your hips to bring your meet back to start again.

10. Scooter

Standing with your weight on one leg in a mini squat, slide the other foot back keeping the stance knee pointing straight forward and your hips square.

11. Curtesy Lunge

Slide one leg across behind the other while lunging with the front leg. Alternate sides.

12. Side Lunge

Stand with your weight on one leg in a mini squat. Repetitively slide the other out to the side and back in again. Keep the stance knee pointing straight ahead.

 

If you’d like a personalised home exercise program, please call or book online to see one of our physiotherapists.

 

This post was written by Allyson Flanagan, Physiotherapist and Clinical Pilates Instructor at Stafford Physiotherapy and Pilates. 

Home exercise equipment + programs

Do you want to exercise at home and need some equipment? We have full (long) rollers, short rollers, exercise balls, chi balls, sliders, exercise resistance bands (plus handles if needed), hand stress balls and exercise DVDs. We sell these!

We also have home exercise packs available:

  1. Chi ball + exercise band + sliding disc – $30
  2. Short roller + Chi ball + exercise band + sliding disc – $50
  3. Long roller + Chi ball + exercise band + sliding disc – $75

The sliding disc is used to slide your foot along a carpeted or hard surface.

The chi ball adds an extra challenge or assistance to your exercise.

If you would like us to drop them off (and live near our practice at Stafford), we can do that for free.

We already have some information on great exercises on our facebook page (and our VIP facebook page for patients), the blog on our website and our instagram. There will be much more to come soon to help you keep exercising.

If you would like an exercise program to suit your personal requirements (particularly if you have a previous or current injury, chronic pain or a particular need), we will be starting online consultations (Telehealth) in the next few weeks. We can incorporate equipment you may already have at home, or help you choose which equipment to buy.

We are happy to have a short chat to you on the phone if you have any questions. Allyson Flanagan is also doing home visits for those well people who have to stay home.

INTERESTING FACT: In 1918 a terrible epidemic (Spanish Influenza) broke out worldwide, killing millions of people. Joseph Pilates (the founder of Pilates), who was German, was confined to an internment camp in England during the second world war. There were tens of thousands of deaths in England and the camps were particularly hard hit. Joseph Pilates had begun devising strengthening exercises with controlled breathing and mindful movement with equipment using springs to rehabilitate the incarcerated and bedridden with wartime diseases. None of the followers of Joseph Pilates’ exercises got the Spanish Flu!

Staying healthy and active despite the cold and coronavirus!

In the past couple of weeks, amidst the continued development of COVID-19 as well as a cooler change in weather as winter approaches, a lot of us have had our usual work, exercise and social routines disrupted. First and foremost, we must adhere to current health guidelines and take all personal hygiene measures possible. BUT, you can still stay healthy and active, whether from home or within your local community.

Check your workspace set up

If working from home (or still in the office) – make sure you maintain good postural habits. Assess your computer set up, if using a laptop make sure it is at an appropriate height for your eye level, use a lower keyboard or mouse if you are able to. Change your posture often, stand every 30-60 minutes, do some big shoulder rolls, chest and neck stretches and sit to stands. Take a look at this blog post for more tips on workspace ergonomics.

Look at ways to incorporating exercise at home

Even though it’s no longer possible to go to the gym, there are plenty of exercises you can do with minimal equipment at home. Try 3 sets of 10 – body weight mini squats, lunges, sit to stands and calf raises for your lower body. Try a 3 x 10-30 second plank or side planks (you can do these on your knees and forearms). If you have some TheraBand do some low rowing, shoulder rotation, and glute bridges with this around your thighs. Check out this blog post for some TheraBand-specific exercises. Some gentle stretching and/or foam rolling is a great addition as well. We sell a variety of exercise equipment, so feel free to contact us for advice on which equipment and exercises would be suitable for you.

Keep moving

If you are able to walk or jog and are feeling well, enjoy the vitamin D benefits of some sunshine, get some fresh air, raise your heart rate a little and keep your joints and muscles moving. If you’re confined to home, walking laps around the yard or hallway, gardening and stationary bike are other ideas.

Fuel your body

It can be tempting to raid the pantry a little too frequently when you’re home, but it’s best to keep your nutritional intake as healthy as you can – do the simple things – drink water often and eat a variety of fruit and vegetables.

Keep up your usual exercise levels and habits

If you are feeling well, come in and participate in your clinical exercise classes with us. At this stage we are running all of our usual class times so, if you’re working from home, it may be the perfect opportunity to squeeze in an extra class, or try one of our 30-minute reformer classes for something new. You can read here about the measures we’re taking to keep the practice safe for both our patients and our team.

Address any injuries or niggles

Although some upcoming fun runs, social sport and competitions have sadly been postponed, why not utilise this time to your advantage and come and see our physiotherapists to address any areas of concern. It may be the perfect time to get started with some treatment and a personal exercise program for home.

 

Please call or book online to see one of our physiotherapists.

 

This post was written by Megan Esdale, Physiotherapist and Clinical Pilates Instructor at Stafford Physiotherapy and Pilates.