Returning to running or higher intensity activity can be a daunting challenge for women who have had children three months ago, or even three years ago. At The Moving Body, our physiotherapists are trained in the specialty of Women’s Health and can help you achieve your goals of returning to walking, running or high impact activity. In this blog post, we give you more information about how and when to start your return to running program.

Are there any Guidelines for Returning to Running Postnatal?

In 2019, three renowned women’s health and running physiotherapists developed the first ever Return to Running Postnatal guidelines 1 . The guidelines were the first of its kind, and were developed to give healthcare professionals and postnatal women advice with regard to returning to higher impact exercise, like running, after pregnancy. The ‘take home’
message from the guidelines was that it is not a ‘one size fits all’ recovery, and that each return to running program varies depending on the individual. Furthermore, it highlighted the lack of research that has been carried out in this area. No studies to date, specific to the postnatal population have been carried out to evaluate return to running after pregnancy.

The Recommendations:

  • It is recommended that every woman undergo a postnatal assessment* with a qualified Women’s Health physiotherapist, regardless of method of delivery or whether or not they have had a perineal tear.
  • Women can benefit from an individualized assessment and guided pelvic floor rehabilitation for the prevention and management of pelvic organ prolapse, the management of urinary incontinence, and for improved sexual function.
  • Return to running is not advisable prior to three months postnatal or beyond if any symptoms of pelvic floor dysfunction are identified prior to, during or after attempting return to running.
  • Healthcare professionals should assess pelvic health, load impact management and strength testing in order to evaluate readiness to running postnatal.
  • Additional factors such as body weight, breastfeeding, sleep, fitness and psychological status should be considered prior to return to running postnatal.

Initial Post-Partum Stage – What CAN you do?

Below is a list of activities that you can do in the first six weeks postpartum. It is important to remember to listen to the body, starting slowly before gradually building up your tolerance and advancing exercises. If you are unsure of an exercise or how to progress, it is important to consult with a physiotherapist or a fitness professional trained in postnatal rehabilitation.

  • Gentle walking, building up to cross trainer, stationary bike or swimming.
  • Pelvic floor exercises.
  • Gentle abdominal exercises such as pelvic tilting or knee rolls (ensure tissue healing prior to starting abdominal exercises if after caesarean section)
  • Gentle resistance exercises such as squats without additional weights.

When is too soon to start running?

It is recommended that you go and get a pelvic health checkup prior to returning to running. As a rule of thumb, it is advisable not to run prior to three months postnatal or beyond this if experiencing any symptoms of pelvic floor dysfunction, however, if your pelvic health physiotherapist can help assess.

Contraindications to returning to running too early postnatal?

Running is considered a high impact activity and places a high demand on the body. During moderate running, the force going through the legs and pelvic floor is more than doubled, therefore, it is important to ensure the body is strong enough to tolerate this load. Returning to running too soon, before the body is ready, may lead to pelvic floor dysfunction and musculoskeletal injury. High impact exercise has been found to have an
almost three times increased risk of pelvic floor dysfunction 2 . Signs and symptoms to seek further medical advice include:

  • Urinary or faecal incontinence prior to or on commencement of running.
  • Heaviness or dragging in the vagina on commencement of running.
  • Musculoskeletal pain prior to or on commencement of running.
  • Decreased abdominal strength or function/ pendular abdomen – this may indicate diastasis recti abdominis (DRA).
  • Ongoing vaginal bleeding not related to menstrual cycle.
  • Anyone experiencing these symptoms should be evaluated by their women’s health
  • physiotherapist or GP prior to returning to running.

Anyone experiencing these symptoms should be evaluated by their women’s health physiotherapist or GP prior to returning to running.

Other Factors for Consideration Prior to Returning to Running:

  • Body Weight: Being overweight increases the load through the pelvic floor, and women with a BMI > 30 are at higher risk of pelvic floor symptoms and musculoskeletal injury. Low impact exercise is advisable until BMI is within targeted range.
  • Fitness: Levels of fitness pre pregnancy, during pregnancy and birth experience and issues should be considered.
  • Psychological Status: Women should use other coping mechanisms as well as running for management of psychological issues like postnatal depression.
  • Diastasis Recti Abdominis (DRA): DRA may indicate reduce abdominal strength and control, which leads to a higher risk of musculoskeletal injury.
  • Breastfeeding: Breast feeding prolongs the presence of hormonally altered environment postnatal which can impact joint and ligament laxity. This, in turn may increase the risk of developing injury or dysfunction. It is also important to consider timing of runs around feeds, to ensure that breasts are not too full or likely to become uncomfortable.
  • Uterine Scar Healing: Ensure healing of scar and scar tissue mobilization prior to running to reduce pain and restriction.
  • Supportive Clothing: A good supportive (rather than compressive) sports bra can help reduce stress on the body during running. As shoe size can often change during pregnancy, ensure that your shoes are correctly fitted.
  • Sleep: Sleep is key for recovery both mentally and physically, and can often be impaired postnatally. Sleep deprivation has shown to have an increased risk of injury in athletes. It is important to optimize sleep routines as much as possible.
  • Running with a buggy: Involves increased energy expenditure and altered biomechanics. It is advisable to start running alone first before introducing the buggy

How can your women’s health physiotherapist help?

Your women’s health physiotherapist will carry out a detailed examination to determine your fitness for return to running, from doing a pelvic floor examination to checking for diastasis rectus abdominis. From there, we can formulate a treatment plan and advise you on how to prevent and manage any issues you might be experiencing and how best to begin your return to running.

The return to running process is an extremely different experience for everyone, and there is no one size fits all approach. Every postnatal woman should have the opportunity to have a consultation with a women’s health physiotherapist, and with guidance, you can ensure that you return to running at a time and pace that suits you, your body and your rehabilitation. Engaging in physical activity is well established to provide a variety of health benefits. However, for many women, issues developed during pregnancy or delivery such as pelvic floor dysfunction or musculoskeletal pain, act as a barrier to returning to an activity that they once enjoyed 3 . While these issues are common, they should not be considered normal, and if you are experiencing any of the symptoms mentioned in the article above, you should consult with your women’s health physiotherapist to begin your recovery.

Article written by Women’s Health Physiotherapist,

Mary Wrixon

What is a Painful Radiculopathy?

Low back pain is one of the most common musculoskeletal complaints encountered in a physiotherapist’s clinical practice. Painful lumbar radiculopathy is a type of back pain that is associated with symptoms of shooting or burning pain travelling down the leg, weakness and numbness. Previously it has been referred to as ‘Sciatica’. It has an incidence of 5-12% amongst the general population. Radicular lower back pain is a debilitating and frustrating condition; however, it can be managed together with your physiotherapist. 

The nerves in our body transport messages from the body to the brain, and from the brain back, to initiate and control movement and sensation. The nerves enter and exit via the spine and travel along the spinal chord. Painful radiculopathy occurs when there is impaired nerve insulation which disrupts the transporting of function from the nerves to the body parts. It can occur due to compression, damaging the nerve root which can cause loss of nerve function (leading to weakness or numbness), or due to a chemical irritation within the spine, leading to inflammation (causing pain). Radiculopathy can happen at any portion of the spine, but it is most commonly seen in the lower back (lumbar) region. 

Signs and symptoms of painful lumbar radiculopathy include back pain with unilateral leg pain. The leg pain can be dull, piercing, shooting, tingling or burning sensation radiating down as far as the knee or towards the ankle. It usually occurs in the area that the affected nerve supplies (dermatome). It can often be much worse that the lower back pain itself, and can occur both at rest and during activity.  Patients often report numbness or weakness in the leg and can sometimes present with an altered gait pattern, depending on the severity of symptoms.  

Why does Painful Radiculopathy Happen?

There are many reasons for the onset of this type of pain. Predisposing factors are obesity, smoking, heavy manual labour, extended periods of sitting e.g. while driving and job dissatisfaction. More acute factors that contribute to radicular low back pain (usually triggered by trauma of twisting or straining the back or wear and tear) include 

  • A disc bulge: where over 25% of the disc (cushioning between the vertebrae) extends beyond its normal margin impinging on surrounding structures including the nerve root.
  • A disc herniation: where under 25% of the disc herniates beyond its normal margins margin impinging on surrounding structures including the nerve root.
  • Spinal stenosis: narrowing of the joint spaces within the spine due to degenerative changes of the spine.
  • Spondylolisthesis: when one of the vertebrae slip forward onto the bone directly beneath.
  • Spinal tumours or infections. 

In cases under 50 years old, a herniated disc is the most frequent cause, while for those aged over 50 years old it can be caused by stenosis or degenerative changes in the spine. It is important to note, that often, people can have these findings on an MRI and experience no symptoms as well. 

What is the Treatment for Painful Radiculopathy?

Overall, the majority of cases of painful lumbar radiculopathy are not severe, and will resolve with time, and thus conservative management is the first line of treatment, however approximately 30% of cases will continue for a year or longer. Treatment is varied and includes a combination of physiotherapy and medical management. 

Contacting your local physiotherapy clinic can be the first step. After a detailed assessment with the physiotherapist, we can guide you towards a program of manual and exercise therapy that suits your personal needs and goals. There is much evidence to show that staying active with a structured routine of guided exercises is an effective form of management. In certain cases, we may refer you onward for further medical management. 

At The Moving Body, our physiotherapists are well equipped to manage your radicular lower back pain whether you are in the acute stages of pain, or if this has been an ongoing issue for months or years. We utilize a wide variety of treatment techniques including Pilates and modified resistance training to manage pain and optimize lumbo-pelvic strength. In severe cases, we may refer you onwards for an X-ray or MRI. We work hand in hand with GPs and orthopaedic consultants to ensure that you recover as soon as possible. While it is never too late to start, the sooner this issue is addressed, the better the outlook is. Contact us today to arrange your physiotherapy consultation. 

Picture the scene, you are at the start line, patiently waiting to run head first into the water along with 50 or more other people in your wave start or treading water desperately trying not to tire yourself out before you start the swim ahead.

Picture the scene, you are at the start line, patiently waiting to run head first into the water along with 50 or more other people in your wave start or treading water desperately trying not to tire yourself out before you start the swim ahead.

If you are lucky it is a wetsuit swim, the wetsuit giving you some welcomed buoyancy – unless of course you are a swimmer, one of those triathletes who swam before they could walk and just look so effortless as you flail your arms through the water to make it through the distance!

Personally, I was always grateful the swim was first, out of the way and then it was happy days on the bike!

It didn’t seem to matter what coaches told me about my freestyle technique, and I had a few coaches try to help (4 to be exact) – they all said similar things but none of them made enough sense to me and once i was face down, horizontal in the water I definitely had no idea!

What is it about being that way in water that totally threw my proprioception out of whack? As a Pilates trainer with pretty good body awareness and co-ordination, it was so frustrating to find myself unable to ‘keep my elbow high’, ‘press through the water’, ‘keep your fingers facing the bottom of the pool’ – I thought I was! The coaches saw otherwise.

And what about legs – what were they meant to do again? My triathlon coach (not swim coach) used the pull buoy in most of my training sessions – heaven on earth as far as I was concerned, now I can swim! As soon as my toy was taken away from me it was as if I had 2 separate body halves. Someone asked me to count once how many leg kicks I did per stroke – I tried to count for them, I tried – I failed. My body and mind became totally disconnected and I decided to ignore the request!

I was strong enough though to get myself through the swim of most races I did in the top three and I have Pilates to thank for that.

  I mainly used the Reformer to focus on my swim arms – as much as I could understand from what the coaches had said. I developed strong rotator cuff muscles, and kept myself open in the chest with GYROTONIC® method. My core strength helped to give me some lift in the water and not totally sink my legs. Planks on the Reformer definitely developed my streamlined torso so if I ever did manage to suss out the technique needed for swimming I had the internal stability and external strength for it! The Chair helped my spine stay subtle and rotate in a face down position, being able to move with control from one side to the other as if in the water. My leg kick wasn’t too bad on land – but again as soon as I hit the water and I had to coordinate I became dissociated from what my upper and lower body were doing! My legs were an issue as they are with most bikers and runners – they tended to drop in the water too much and create drag. With a strong core and glutes it helped to minimise the drag, but not as much as I needed to keep up with the lead girls.

Why did this not all come together in the water itself? Might be due to a near drowning when I was 9 leaving me a deep subconscious fear of relaxing as I swam – instead I tended to fight the water. So as calm and smooth and graceful as I might be on the Pilates equipment, it never held well enough together in the swim.

However, I never developed any swim injuries due to my total body stability and I used to swim 12km a week using hand paddles too – I developed strength to swim as opposed to form, not ideal but it worked better for me. Pilates and my knowledge of movement and the body and positioning kept me injury free.

I still swim – normally with a pull buoy and now I enjoy it more, very little focus on my 100m time, but I still have the coaches’ voices going round in my head in an attempt to help me become a swimmer.

Article written by Lisa Jones, Pilates Master Trainer and Triathlete

The more I cycled and the longer I stayed on the aero bars the tighter I found my back was getting– if I wasn’t careful I walked like a little old lady with a rounded upper back. The position is great for cycling, making us low and aerodynamic, but it’s not good for our posture or our internal organs, to be so squished up. Pilates gave my spine back its length – it unwound me, twisting me back into straightness and opening my body up again. This allowed me the flexibility to be on the aero bars for longer, by resetting my posture it was easier to be in that rounded position and lessened the strain on my shoulders and lower back and hips.

Pilates helped me to be a pain free cyclist, it taught me how to move, where to move from and when I started to feel niggles when I was cycling, I had the awareness in myself to change my pedaling action to not feel the niggle. The only pain I ever experienced was the pain of a race – or when I fell off!

“I’m a Pilates trainer” I thought, “surely I can balance!” It took me a few goes to understand how to get on them and stay on them – and stay on them for longer and longer without feeling tension in my back, hips and shoulders.

Whenever I was out cycling and especially on the bars, I started to think of the work I did in the Pilates studio – how my leg turned in its socket, how to set my shoulders to avoid neck tension and whether I did or didn’t need to use my core! Whenever I stood and accelerated, I realised how much I needed my core to hold me stable and provide power down to my feet.

Cycling – it looks easy; you sit on a saddle and you turn your legs around and the bike moves forward!

Try doing that for 180km if you are an IronMan triathlete or 100km for roadies (cyclists not triathletes…) – if your position on your bike isn’t quite right, and your biomechanics are slightly off, pretty soon you’ll experience some sort of discomfort, pain and possibly injury – not to mention saddle soreness!

Cycling from the outside looks like great exercise – and it is, but when you go to the extremes of the sport more ‘inside’ work is needed, enter Pilates.

Do you remember as a kid the first time you took the stabilisers off your bike? Your dad ran furiously next to you helping you balance for as long as possible and then YOU WERE ON YOUR OWN!!…The feeling was incredible, you could balance! As kids we have less fear – the excitement of being more grown up on the bike overtook all else. I remember when I got my first road bike as an adult, equipped with aero bars which I had never experienced before. Out I headed full of confidence – I went down onto the aerobars and promptly toppled off into the hedge – not a good start to my triathlon career!

When I then trained myself in the studio, I started adding in exercises and movements that tuned me in to how to move my hip joints and keep my pelvis still. When you are on the bike the last thing you want is your butt wiggling on or off the saddle – firstly it chaffs, secondly it is inefficient movement making you less streamlined and wasting energy and thirdly it leads to lower back tension/injury.

Pilates teaches you how to ‘disassociate’ the hip from the pelvis, how to let the leg move freely in its socket and how to transfer the power from your core in to the leg, the foot and thus the pedal. The more I focused in the studio, the more power I could generate on the bike and the more comfortable I was on my seat. Standing and climbing became easier as I learnt how to use the back of my legs to pull the pedal up while keeping my pedal horizontal – sparing me from tight calves (helpful in triathlons when you need your calves to run off the bike).

The more I cycled and the longer I stayed on the aero bars the tighter I found my back was getting– if I wasn’t careful I walked like a little old lady with a rounded upper back. The position is great for cycling, making us low and aerodynamic, but it’s not good for our posture or our internal organs, to be so squished up. Pilates gave my spine back its length – it unwound me, twisting me back into straightness and opening my body up again. This allowed me the flexibility to be on the aero bars for longer, by resetting my posture it was easier to be in that rounded position and lessened the strain on my shoulders and lower back and hips.

Pilates helped me to be a pain free cyclist, it taught me how to move, where to move from and when I started to feel niggles when I was cycling, I had the awareness in myself to change my pedaling action to not feel the niggle. The only pain I ever experienced was the pain of a race – or when I fell off!

Pilates Helps With:
• Core Stability: Keeping the pelvis still on the saddle whether sitting or standing.
• Hip/Glute Power: Transferring down the leg to pedal.
• Hamstring – Quad Balance: Important as we tend to pull up too much and overwork the front of the leg, using the back of the leg too (hamstring) means we keep the power through the whole pedal cycle.
• Flexible Ankles: The ability to keep the pedal flat throughout the pedal stroke requires flexibility in the foot and ankle, minimizing ‘ankling’ and keeping the power into the crank.
• Flexible Hips and Spine: To continue to provide power when on the aero bars and in a crunched in position.
• Flexible Upper Back: To alleviate shoulder tension wherever hands are on the bars (including on the drops).

Joseph Pilates said: “The health of our spine is directly proportionate to the age of our body. If your spine is inflexibly stiff at 30, you are old. If it is completely flexible at 60, you are young.”

What happens when we get old?
As we age, there are many changes to our bodies such as:

  • Degenerative conditions of the spine and joints
  • Spinal stiffness, Osteoarthritis, Osteoporosis
  • Knee pain and weakness
  • Weakening muscles
  • Loss of balance and proprioception
  • Slower metabolism

Regular exercise and physical activity could delay or reduce the risk of some diseases and disabilities that develop as people grow older.

In Pilates, we focus on strengthening the core- it’s designed to build core strength of the body through balancing, stretching and correct breathing techniques, which will help to protect the spine and reduce the risk of osteoporosis and back problems.

It’s also a safe exercise- it can be customised and modified for all types of body, fitness level, and any age groups.

There are many benefits to doing Pilates to help avoid the adverse effects of aging:

  • Improved posture
  • Increased balance and stability
  • Reduce chronic pain
  • Build bone density and strength.

It’s never too early to start strengthening your core.
Let’s stay active. Keep your body and spirit young.

Ways to Improve Your Posture

By understanding proper posture, you can learn about your own postural deviations and determine which corrective exercises will work best to improve your alignment. The easiest and most effective way to correct imbalances is to stretch the overactive, short muscles and to strengthen the underactive, weak muscles. With correct alignment and good posture, your muscles will work more efficiently. You can prevent pain and injury, look and feel better.

Pilates is a good form of exercise that can help with postural correction. You can get a postural assessment and work with your instructor to correct your muscle imbalances.

Posture can signal both the enduring characteristics of a person (character, temperament, etc.), and his or her current emotions and attitudes. So, if your health is not enough reason to improve your posture, then the way you look might be?!

The Physiotherapist from The Moving Body can assess your posture and check for imbalances. Contact us at The Moving Body if you feel that you need help with improving your posture or if your misaligned posture has already led to an injury.

All our Physiotherapists at The Moving Body are Pilates trained. Pilates is a good form of exercise that can help with postural correction. Our Pilates instructors can also do a postural assessment and work with you to correct your muscle imbalances. The physio’s and instructors work closely together and can refer you to each other in case they feel you are better off with the other discipline, to ensure the most optimal outcome for you!

Understanding Your Posture

Ideal Posture

Good posture, or ”neutral spine” is the proper alignment of the body. Deviations from neutral alignment are identified as excessive curvature or reduction in curvature. Ideal posture indicates proper alignment of the body’s segments such that the least amount of energy is required to maintain a desired position and a minimum amount of strain is placed upon the tissues of the body. It is ideal to maintain a neutral spine whether its sitting or standing!

A Common Postural Imbalance

Most postural deviations occur because the muscles that work to hold a joint in place are imbalanced – one muscle group will be too tight and the opposing muscle group is too weak. Muscles that are in a prolonged, or stretched position can’t function properly and lose strength. A muscle in a shortened position will decrease in length, since it is not being used causing muscle tightness.

For example, people with shoulders that hunch forward often have tight pectoral muscles that pull the shoulders forward and rotate them in towards the midline of the body. Pair tight pecs with weak back muscles and you have an imbalance that pulls the shoulder girdle away from its ideal position. When imbalances like these occur, for a prolonged period of time, overactive muscles compensate for underactive muscles, which causes tension, fatigue, discomfort and injuries.

The above described posture – the forward head posture is one of the most common postures these days. This posture leads to a typical imbalance of the upper postural muscles, described by Czech Physician Vladimir Janda as the upper cross syndrome.

This posture starts a domino effect; the head shifts forward, the centre of gravity shifts forward, the upper body shifts backward, and to compensate that, the pelvis tilts forward. The entire spine responds to the change of the head position. The load on the cervical spine increases from 5.4 kg to 19 kg!

Who should get a post-natal physiotherapy assessment? And when?

A postnatal assessment is recommended for all women following delivery. It can be carried out as early as six weeks after delivery to many, many years later. The time after giving birth can be hectic, and it is important to take the time to look after your own welfare and body as well as your baby’s.

After giving birth, a number of musculoskeletal imbalances can occur in a women’s body. These imbalances can cause pain and poor movement control which may lead to further physical problems in the future. They may not always be easily recognized in the beginning and so it is important to be assessed. A trained women’s health physiotherapist can assist in the diagnosis and treatment of post partum musculoskeletal and pelvic floor disorders.

Post Natal Physiotherapy assessment: What is Involved?

A one hour assessment with a specialist physiotherapist in which we carry out:

  • A tummy assessment to check for a ‘gap’ or diastasis rectus.
  • A pelvic floor examination (internal and external).
  • An assessment of any other physical problems experienced since pregnancy.
  • Prescription of a personalized post natal rehab program which incorporates the patient’s lifestyle and goals.
  • Education and advice regarding return to exercise.

What to look for in a post natal assessment?

  • Posture: New aches and pains in the neck, back and pelvis are extremely common post-natally. From feeding to lifting and bouncing your new baby, the body is often forced into awkward positions. Assessment of musculoskeletal range and strength can help us help you understand your symptoms and give you exercises to reduce your discomfort.
  • Pelvic floor assessment: Regardless of c-section or vaginal delivery, a post natal pelvic floor assessment is important post partum. Over 30% of women experience urinary incontinence in the months following delivery. An internal assessment of your pelvic floor contraction carried out by your specialized women’s health physiotherapist, will give you a greater understanding of how to best activate your pelvic floor. Furthermore, it can help us guide you on the best way to improve the strength of your pelvic floor.
  • Tummy assessment: A gap or a separation between the abdominal wall muscles is known as a diastasis recti abdominus (DRA). It occurs during pregnancy, when the abdominal muscles are stretched to accommodate your growing bump. A large DRA has been related to core instability and pelvic floor dysfunction. During your post natal assessment, we will assess your diastasis and advise you on how best to manage it. We can also assess your c-section scar and provide scar tissue release as required.
  • Breathing: Your bump during pregnancy impacts the diaphragmatic movement. Our diaphragm has an impact on the pelvic floor strength and control, and can affect your ability to return to exercise. Therefore, we assess your breathing pattern to optimally co-operate with your pelvic floor.
  • Wrist pain: De quervain’s syndrome (mothers thumb). Tendons of the wrist rubbing off surrounding structures causing inflammation, onset due to repetitive nature of motherhood in lifting and adjusting. Your women’s health physiotherapist can provide treatment to reduce the discomfort and exercises to increase the strength of the wrist to prevent worsening of the pain.
  • Breast feeding dysfunction: Mastitis is a condition where the milk ducts in the breast can become swollen and painful. It commonly affects women who are breast feeding. Treatment for this consists of a course of gentle massage and ultrasound therapy to help reduce the inflammation, and allow for a smoother breast feeding experience.

The Moving Body offers post- natal assessments by a trained physiotherapist.

Email us us to book your appointment now!

Written By Mary Wrixon, Physiotherapist

In the second part of a series of three articles, we will talk about how the concept of ”Preventive Physiotherapy” can be used to possibly prevent a slipped disc.

Slipped disc is the colloquial term for a herniated disc, or prolapsed disc. These can be traumatic in nature (due to accidents), or due to general wear and tear.

Intervertebral discs are found between the bones (vertebrae) of the spines. They function as shock absorbers, and maintain the space between vertebrae. It is important to maintain this intervertebral disc space in order to prevent compression of the nerves present here. Excessive pressure applied on any part of the disc will cause its gel—like contentsto ooze out. This gel may in turn apply pressure on the nerve root, resulting in pain along the course of this nerve.

There are two factors affecting the size of this space (and therefore, the amount of pressure on nerve roots):1. The health of the intervertebral disc
2. The balanced activation of the muscles supporting the spine

The concept of “Preventive Physiotherapy” will preserve the health of the disc by ensuring optimal activation of spinal stabilisers. Analysis of muscle strength, posture and lifestyle, can be used to identify the following:
1. Weaknesses in the muscular system supporting the spine
2. Incorrect movement patterns (which may place excessive force on the disc)
3. The cause of these weaknesses and incorrect movement patterns

Early intervention, in the form of specific exercises targeting the weak muscles and functional training, may prevent excessive force being placed on the disc. It is thus possible to prevent non-traumatic slipped discs.

Consult one of our Physiotherapists to maintain the health of your intervertebral discs.

Article written by Aparna Shah, Physiotherapist

Diastasis Recti is a fairly common condition during pregnancy and post-partum. Also known as abs separation, there is a widening of the gap between the left and right rectus abdominis muscle, at the mid line fascia.

Diastasis Recti reduces the functional strength of the abdominal wall and can aggravate lower back pain and cause pelvic instability.

Risk factors:

  • Separation in a previous pregnancy can significantly increase the probability and severity of the condition in subsequent pregnancies.
  • Women with multiple pregnancies and multiple birth pregnancy.
  • Petite women.

A simple self-test for Diastasis Recti:

  • Lie on your back with your knees bent, and the soles of your feet on the floor.
  • Roll your upper body off the floor into a “crunch”.
  • Check for a gap/separation at your mid line.

Things to avoid when you have this condition:

  • Avoid any movement or exercise that places strain on the mid line, like full sit-ups,crunches, oblique curls, reverse
  • curls, and full roll-ups and planks.
  • Avoid heavy lifting.
  • Abstain from backbends and other spinal flexion movements.

If you think you suffer from diastasis recti, please contact us at so we can work with you on a treatment plan.

Non-specific lower back pain can be troublesome and is more prevalent than you think. It effects over 80% of the adult Singaporean population at some time in their lives (Sing Health) and up to 60% of people in their adult life worldwide (WHO). It is one of the leading problems resulting in unemployment and disability when chronic. However there are a few changes that can be made to our lifestyle to relieve some of the causes of back pain.

1. Knowing when to Seek Help
Knowing the severity of your symptoms can help to identity the kind of health professional to engage as a first point of contact. In the acute stage (24-72 hours) pain can be intense, especially if the cause was due to trauma or a disc related injury. Seeking the advice of a medical professional is essential if you experience all or some of the following symptoms:

  • Pain that can keep you up at night
  • Severe pain which limits your daily functions
  • A loss of bladder and or bowel control
  • A significant reduction of strength/ power in the legs or back
  • Severe numbness

Please consult a doctor as these are often suggestive of a more serious underlying problem.

For back pain of a less serious nature, there is light at the end of the tunnel! Here at the Moving Body our experienced Pilates instructors and or Pilates trained Physiotherapists are at hand to help relieve that pain! But here are a few other changes that you could make for a healthy and happy back.

2. Posture
How many times have you found yourself slumped at your desk or sofa, or standing more on one leg than the other? Adverse postures can have a significant effect on your joints. Incorrect sitting or standing postures can contribute towards compression of the lower back. Over a period of time a poor posture can result in secondary muscle changes such as lengthening of the gluteal muscles and shortening/lengthening of the lower back muscles. Simple changes such as a chair that allows for support of the natural curve of your spine can help to reduce additional stress in the lower back. Alternatively using a lumbar role or towel can make a world of a difference to giving your back the support that it needs.

3. Core Control
Although the jury is not conclusive on the literature surrounding the science behind lower back pain and core stability, it is still a very important component of back strength. The core is made up for 4 key muscles, which align the spine and form a corset and hammock like structure that supports the spine and torso. These stabilizing muscles lie deep to the bigger muscles or the prime movers, to keep the spine stable and reduce excessive or potentially damaging movement. Not sure where your core muscles lie or how to activate them? Pilates is a great way to gain awareness and build up your core strength, and for those with a longer history of back pain a physiotherapist can help to work with you to regain function.

4. Muscle Balance
Short and tight muscles can be a source of pain. We all know what it feels like to have developed areas of tension, which may be rather uncomfortable to release via massage. The muscles in the lower back can be prone to tightness, especially the muscles on either side of the lower back called the quadratus lumborum and the parapinals , which are common sites for trigger points and referred pain patterns. Stretching or manual release can help to relieve this tension.

5. Keep it Moving!
Pain can be the start of a downward spiral for inactivity, which in turn can be a source of pain, so it is important to break this cycle. If you are having any of the more serious symptoms above then gentle exercises should be prescribed and monitored by a healthcare professional, as it is still important to strengthen the surrounding areas. If you imagine the muscles in the back of your body as a chain, and one part of the chain has a problem it is likely to affect the other muscles in the chain; this is why conditioning is important to maintain overall health. Exercises such as swimming or walking through water can be extremely beneficial as the water will give resistance to movement, strengthen several large muscle groups whilst weight bearing is reduced by up to 60%. Keeping active is also a great way to keep your weight controlled another factor that will increase the stress on the joints!

Article written by Rebecca Taylor, Physiotherapist