Article was written by Heather Lowman-Riggs - Senior Physiotherapist

I bumped into a lady from home last weekend. ‘I’ve fractured my spine again’ she said ‘this time I just reached for the shampoo in the shower’.

I was shocked. This was a normal 62 year old nurse who had no major health issues, did a lot of charity work in Africa, ate a vegetarian diet and had recently lost a lot of weight in a health kick. A huge amount of weight, 8 stone over about a year to
be precise.

Blood tests revealed that she didn’t have cancer (another cause of calcium in the blood stream) but a DEXA scan showed osteoporosis (thinning of the bones www.nos.org.uk). Looking at her I thought about the normal osteoporosis risk factors
that physiotherapists watch out for: low body mass index, post menopausal, smoking, excess alcohol, prolonged steroid use, thyroid issues, being female, early hysterectomy, lack of calcium in the diet and lack of weight bearing exercise. She
was female and post menopausal but had started exercising as part of her weight loss programme and none of the other factors seemed to be applicable to her.

‘I do have a family history of osteoporosis’ she said and I have lost a LOT of weight
and don’t eat much fish or dairy.

I did a quick literature search to see what was out there on weight loss and osteoporosis and sure enough I found an old study of 30 post menopausal dieters some of whom were given calcium supplementation (McDonald 1998). Those who’s
diet was supplemented showed significantly less bone turnover. The authors therefore suggested a protective dose of 1500mg of calcium per day for post menopausal women trying to lose weight. More recently a review highlighted concerns around loss of bone density post gastric band surgery (Center and White 2013).

I also found literature which suggested that certain foods can be connected to slight pH changes which over a long period of time leach calcium from the bones (carnauba et al 2017). This reminded me of ketones an acidotic bi-product of fat
breakdown that came to fame during the Atkins-diet era. It is possible that the weight loss might have been associated with sustained increased in acid and therefore sped up the loss of bone density in a lady who already had a genetic predisposition.

I’m no dietitian so turned to Dr Google because I wondered what was normal in terms of standard adult calcium intake. About 700mg it seems according to an NHS website. On your plate that might look like a whole can of sardines (100g) or 100g block of cheddar cheese. Therefore, both would need to be consumed to satisfy the recommendations of the study on post menopausal dieters for 1500mg a day!!

This is hardly a systematic review of the literature, I haven’t even followed up on the advice around vitamin D! This is just a thought process started by a successful dieter’s misfortune. We put so much emphasis on weight loss for so many sorts of
health benefits and that remains unchanged. As a physio I will be keeping an eye out for those who come for treatment after dramatic weight loss but might have undiagnosed bone density issues. If I was a post-menopausal dieter I might consider
seeking some further advice on sensible bone protection measures.

Cauley, J., 2017. Osteoporosis:fracture epidemiology update 2016. Current opinion in Rheumatology. 29(2) 150-156.
Center, J. R., & White, C. P. (2013). Obesity: Bariatric surgery, weight loss and bone. Nature reviews. Endocrinology, 9(11), 630-632
McDonald, H., 1998. Nutrition bites. File it under every cloud has a silver lining’….osteoporosis.
Carnauba, R., Beatriz A., Paschoal V., and Hübscher, G., 2017 Diet-Induced Low-Grade Metabolic Acidosis and Clinical Outcomes: A Review.
Nutrients 2017, 9(6), 538
https://www.nhs.uk/conditions/vitamins-and- minerals/calcium/
National Osteoporosis Society www.nos.org.uk

Article was written by Heather Lowman-Riggs - Senior Physiotherapist

Wait for my blog on what happens when you ignore your own advice and get injured, I told Stuart last week. 

I had signed up for 'The Grizzly 2018' just 48 hours before it started, in the knowledge that I had only put on my running trainers twice so far in this year! 
I just didn't want to miss out for another year, because the Grizzly is a notorious, off road race, organised by the running club that I was part of a few years back in Devon. It has 3000 feet of ascent and takes in all the delights of East Devon's shingle beaches, cliff face stairways and waist deep bogs.

Nobody could have predicted however, the arctic winds and drifts of snow that would accompany this years Grizzly. The race organisers braved the wrath of the participants (who had trained) by cutting the distance from 20 miles to 10 miles. We were urged that safety was more important than times, we needed to look out for each other out there. So we did and it was great. 

No I didn't' get injured. 
In fact I realised that although I wasn't fast because I haven't been running up hills lately, I felt strong. Twice a week circuits and plenty of cycling meant that I could trust my legs on the icy downhills and was steady on the climbs. Time didn't matter. 

This made me think of our marathon runner clients, who are running out of time and getting left trailing behind in their training plans. I'm not saying don't train, that is obviously not a sensible thing to do, but sometimes life gets in the way and those runs are not keeping pace with your plan. Maybe you are starting to despair about niggles that are making your training runs into a chore, maybe time pressures mean you feel guilty for missing runs, so you are skipping the strength and conditioning or cross-training sessions, or maybe you are actually already in pain but are too scared to skip a run in case you get behind on your plan.

Put like that, it is obvious what I'm driving at. 
We can't expect our bodies to do something high impact and repetitive without the appropriate strength in our muscles, tolerance in our tendons and movement patterns that load our joints optimally, even when we are tired. Those strength and conditioning sessions should be designed to give you all of the above. Obviously there is no substitute for getting out there and running but please don't rely on quantity alone. Quality comes with strength, appropriate joint ranges and even balance. 

So now might be the time to book in for a Physiotherapy Assessment, so we can help you with your training plan, or even join a Pilates class.

2017 has been a fabulous year and we couldn't have done it without you, our amazing clients.

Christmas is upon us, and with it brings a short break for the all team at Sussex Physio Pilates.

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Saturday 23rd December - Monday 1st January 2018
We will be closed

We will return to normal opening hours on
Tuesday 2nd January 2018

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All the team are looking forward to 2018 and what it will bring. We will continue to build on our Workshops next year, so watch this space for Workshop dates in 2018.

Have a wonderful festive holiday and we hope to see you all in 2018!

Older People’s Day – FREE Falls Prevention Talk for Older People of Worthing.

Friday 29th September at 1.30pm

Sussex Physio Pilates, 22-24 South Street, Tarring. BN14 7LH

Within the talk we will discuss:

·         Causes of falls

·         Assessment using the – ‘Timed Up and Go’ test

·         Consequences of falls

·         How to get up from a fall

·         Ways of reducing the risk of a fall

·         Including exercise!

Senior Physiotherapists and Pilates teachers at Sussex Physio Pilates, Claire Yuill and Nicky Sykes, who both have private and NHS backgrounds, will be available before and after the talk to answer any questions on fall prevention, but also how Physiotherapy can help individuals in general.

Call us now to book your place - It's FREE - 01903 256 500

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Falls are not an inevitable part of ageing.

The video below, demonstrates the timed up and go test, which helps to assess whether a person is at an increased risk of falls.

This is one way to assess a person's falls risk, but it you're concerned about falling, it is recommended you seek a full and comprehensive falls assessment from a qualified healthcare professional, such as a Physiotherapist.

The timed up and go test from csp.org.uk on Vimeo.

If you would like to book an assessment for Falls Prevention or for any other joint or muscle issue you may have, please don't hesitate to contact us on: 01903 256 500

Runners focused Pilates workshop taught by:

NICKY SYKES - SENIOR PHYSIOTHERAPIST & PILATES INSTRUCTOR

Saturday 9th September 2017
9:30am - 11:00 am

Workshop Schedule:
Specific Pilates exercises for Runners
Posture for Runners
Injury Prevention
Handout of Exercises

Course Participation Requirements:
Pilates Experience Needed
Are you able to contract your Pilates Core?

1.5 Hour Workshop price is: £20.00
Only 3 places left

Not done Pilates before? 
Book a 1:1 Pilates Session Now!

Contact us now on 01903 256 500 to secure your place!

Stop what you’re doing, be aware of your breathing, how you’re feeling and just let go.
Most people forget to take time out for themselves and have a moment to breathe.
Today is dedicated to doing just that. RELAX!

Enjoy some of the Best Ways To Unwind This National Relaxation Day.

 

• Have an afternoon nap

 

• Go for an evening walk along the beach and catch the sunset

 

• Do some Pilates or meditation

 

• Take yourself off somewhere quiet to read a book. 

Below are 10 great insights from The Chartered Society of Physiotherapy (CSP) about Back Pain.

1. Your back is stronger than you may think
   Most people worldwide will experience back pain during their lifetime. It can be disabling and worrying but it is very common and rarely dangerous. 

   The spine is a strong, stable structure and not easily damaged so in most instances it is a simple sprain or strain.
   In these cases – 98 per cent, according to research – people recover reasonably quickly, and many do so without treatment.
   Some people experience repeat episodes, which can be distressing, but again these are rarely dangerous.

2. You rarely need a scan and it can do more harm than good
   This is because seeing perfectly normal changes to their spine can cause people to avoid the activities they should be doing to get better, such as exercise and movement in general.

   In very rare cases, there may be something more serious or underlying that requires medical advice.

   A scan may help with your diagnosis and symptoms to be aware of are at the bottom of this page.

   However, these account for just two per cent of cases so if your physio or GP does not send you for one, you should take it as a good sign that there is nothing concerning going on.

3. Avoid bedrest, stay in work and gradually resume normal activities
   Scientific studies now indicate prolonged rest and avoidance of activity for people with low back pain actually leads to higher levels of pain, greater disability, poorer recovery and longer absence from work.

   In the first few days of a new episode of low back pain, avoiding aggravating activities may help to relive pain.

   However, staying as active as possible and returning to all usual activities gradually is actually important in aiding recovery – this includes staying in work where possible.

   While it is normal to move differently and more slowly in the first few days of having back pain, this altered movement can be unhealthy if continued in the long-term.

4. You should not fear bending or lifting
   Bending and lifting are often portrayed as causes of back pain and while an injury can occur if something is picked up in an awkward or unaccustomed way, it’s most likely to just be a sprain or strain.

   The important thing is to practice and get your body used to carrying different loads and weights in a way we find comfortable and efficient.

   We all run differently, and it’s perfectly normal for us to find our own technique for lifting.

5. Exercise and activity reduce and prevent back pain
   Exercise is shown to be very helpful for tackling back pain and is also the most effective strategy to prevent future episodes.

   Start slowly and build up both the amount and intensity of what you do and don’t worry if it’s sore to begin with – you won’t be damaging your back.

   No one type of exercise is proven to be more effective than others so just pick an exercise you enjoy, that you can afford to maintain in the long-term and that fits in with your daily schedule.

6. Painkillers will not speed up your recovery
   There is no strong evidence on the benefits of painkillers and they do not speed up recovery.

   They should only be used in conjunction with other measures, such as exercise, and even then just as a short-term option as they can bring side effects.

   Exercise, which is safer and cheaper, is considered the preferred option.

7. Surgery is rarely needed
   There are some uncommon back conditions where there is pressure on the nerves that supply the legs and the patient gets leg symptoms, such as pain, pins and needles or numbness.

   For these conditions, surgery can help the leg symptoms but it is important to understand that it is not always required.

   You also need to know that on average, the results for back surgery are no better in the medium and long term than non-surgical interventions, such as exercise.

   So a non-surgical option, which includes exercise and activity, should always come first.

8. Get good quality sleep
   The importance of sleep in tackling back pain has become increasingly clear in recent years.

   This is because it reduces stress and improves your overall feeling of wellbeing, making you less susceptible to the triggers of pain in the first instance and helping you to cope when it does occur.

   Aim for 7.5-8 hours a night and try to aim for a regular routine, as far as possible.

   It is also very important to know that there is no best position or type of mattress – whatever feels most comfortable for you is best.

9. You can have back pain without any damage or injury
   Many physical or psychological factors can cause back pain and often a combination of these are involved.

   Many factors can cause back pain and often a combination of these are involved.

   They could be

   - Physical factors, such as ‘protecting’ the back and avoiding movements, or a simple strain.
   - Psychological factors, including a fear of damage or not getting better, feeling down or being stressed.
   - More general health and lifestyle factors, like being tired and rundown, not getting enough good quality sleep, being overweight or not getting enough physical activity
   - Social triggers, such as difficult relationships at work or home, low job satisfaction or stressful life events, like a family death or illness.

   Crucially, it’s important to know that all pain is 100 per cent real and never ‘all in your head’, even when factors like stress or mood are involved.

   Each of the factors can turn up the volume on your pain and gaining a greater understanding of when that can happen puts you in a stronger position to recognise them and learn how to turn down the dial again.

10. If it doesn’t clear up, seek help but don’t worry
    If your back pain does not clear up after 6 – 8 weeks, make an appointment to see your GP or physiotherapist

    Physiotherapists provide expert advice, guidance and treatment for back pain.

    This is to help reduce your chances of future episodes, while improving your overall health and wellbeing.

Symptoms to be aware of:

These symptoms are very rare but you should contact a doctor if you experience any of them:

• Difficulty passing urine or having the sensation to pass water that is not there
• Numbness/tingling in your genitals or buttocks area
• Loss of bladder or bowel control
• Impaired sexual function, such as loss of sensation during intercourse
• Loss of power in your legs
• Feeling unwell with your back pain, such as a fever or significant sweating that wakes you from sleep

Source: CSP

Download the CSP Back Pain Leaflet below...

As the joys of the Brighton Marathon and the Worthing Half Marathon become a distant memory, excitement over the upcoming London Marathon is growing. Many runners, however, will be nursing injuries from previous races and training.

Below we cover a few of the common running injuries and ways to help ease the pain:

Runners Knee: Also known as Anterior knee pain or Chondromalacia Patella, this describes pain and inflammation to the front of the knee, 'under' the knee cap. Common muscle imbalances around the knee and pelvis can cause the kneecap to be pulled out of the correct line of movement (mal-track). Running can encourage hamstring and ITB tightness which can pull the kneecap laterally. Worn trainers and overpronation can also be a cause. A physiotherapist can make an assessment to identify the cause of your anterior knee pain and the fastest route back to running.

Achilles Tendinitis:  The Achilles Tendon joins the 2 powerful calf muscles to the back of the heel bone. Inflammation of the Achilles Tendon can occur with changes to your running regime, such as increasing hill training or increasing your running speed. Tight calf muscles, tight hamstrings or excessive pronation of the feet (rolling inwards) can all be contributing factors. Rest, ice and anti-inflammatories can all help as initial treatments. Physiotherapy such as ultrasound and acupuncture can reduce inflammation. Stretching must be done gently, and it is wise to get your trainers checked, as these can also be a cause of the pain. 

Low Back Pain: There many causes of Low Back Pain, but muscular strain is often the culprit of a running injury to the back. Often there is an underlying problem such as muscle imbalances around the pelvis and 'core' eg. weak deep abdominals, tight hamstrings and back muscles. Rest, heat and gentle stretching exercise can all help. Physiotherapy can help diagnose and treat both acute and underlying problems.

For further information or to book and Assessment & Treatment, please call Sussex Physio Pilates on - 01903 256 500

Pilates Workshop for Runners

 

Runners focused Pilates workshop by:

Nicky Sykes - Physiotherapist & Pilates Instructor

Saturday 18th March 2017
9:30am - 11:00 am

Workshop Schedule:
Specific Pilates exercises for Runners
Posture for Runners
Injury Prevention
Handout of Exercises

Course Participation Requirements:
Pilates Experience Needed
Are you able to contract your Pilates Core?

1.5 Hour Workshop price is: £20.00
Only 3 places left

Not done Pilates before? 
Book a 1:1 Pilates Session Now!

Contact us now on 01903 256 500 to secure your place!

It was fantastic to be chosen for the latest issue of the 'Sussex Life Magazine'.

Hazel Sillver wrote a fabulous article on how to find a 'new lease of life in retirement' and has suggested 17 activities that are on offer in Sussex for the over 60s.

We are very proud to be part of Hazel's article and even more pleased that it was the first on the list and the only one from Worthing.

The article suggests a range of activities from Nordic Walking, Gardening, Dancing, Bridge, Cycling and Book clubs.

Hazel has captured what we offer the over 50s at Sussex Physio Pilates perfectly. She talks about how all of our Pilates teachers are Chartered Physiotherapists and that we have 4 Platinum Pilates classes across the week.

The Platinum Pilates classes are a friendly Physio-based Clinical Pilates class dedicated to the needs of the over 50s that focus on muscle tone, balance, osteoporosis prevention/management, posture and reducing aches & pains.