Posts Tagged posture

Low Back Pain – Keeping A Neutral Spine Posture

A Neutral Spine Is Important For Your Recovery

Lower back or “lumbar” disc injuries are a common type of back injury we see here at Central Performance. Our dedicated team of physiotherapists do a fantastic job of reducing pain & restoring the range of motion that can be lost as a result of a disc injury. Extensive research consistently shows that exercise plays a vital role in recovering from an episode of low back pain, but we find that many clients are unsure about how to begin or restart an exercise program. Many are not confident about getting back to even light or moderate exercise, fearing that they may re-injure their back. So today our Exercise Physiologists share a tip on how to avoid re-injury whilst exercising following a low back disc injury:

Keep a neutral Spine

Many people who exercise with lower back pain do so whilst holding their spine in positions that can increase their pain. Increased muscle tension due to recent pain can change both your resting posture & your movement patterns. For example focusing too much on not bending your spine (remember the old saying of “keep your back straight and bend your knees”?) can mean that your spine stays locked into extension (a deeper hollow in your low back than normal). This increases compression through some spinal joints, and if this is maintained as you go back to the gym this can cause ongoing pain. Alternatively, having hamstrings that are too tight can cause too much flexion (bending forwards) in your low back as you bend down, potentially increasing pressure on your spinal discs and causing more pain. 

A golden rule of exercising as you recover from a lower back injury, particularly disc injuries, is to maintain a neutral spine! A neutral spine is the term used for the position of the spine when all three curves of the spine (cervical, thoracic and lumbar) are in proper alignment with each other. It’s the most comfortable, stable position for the spine to be in whilst performing any activity, and you should aim to keep you spine neutral as you get back to exercise. Neutral Spinal Posture

Keeping a neutral spine is very important whilst exercising, as it distributes your weight evenly throughout the discs and joints in your back, as well as cushioning impact and other forces present throughout exercise. This allows clients with low back disc injuries to progress to performing more complex exercises and movements, which enables them to recover from their injury quicker and get back to doing the things they love!

Initial supervision and instruction on how to achieve and maintain a neutral spinal posture is an important first step to getting back to exercise safely and early following an episode of back pain. Contact us for more information on how our exercise physiologists and physiotherapists can help you with this, and stay tuned for upcoming posts about how to progress your exercises to give you the fastest an most complete recovery possible. 

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Build A Strong Healthy Spine With Clinical Pilates

Clinical Pilates To Relieve Back & Neck Pain 

Up to 80% of people will have back pain at some stage in their lives, & 10% will experience significant disability as a result. It’s one of the most common things we see here at Central Performance, & our Clinical Pilates program is one of the main tools we use to strengthen your spine to keep you active & moving in to the future.

How is Clinical Pilates different to regular Pilates?

Clinical Pilates is an exercise system based around core/central stability, balance, posture, movement control & breathing. Each person with back or neck pain will have a different injury history, lifestyle factors (eg desk workers compared to retail assistants) & a wide variety of things that aggravate or ease the pain. It is for this reason that specific individualised programs are vital to target each person’s pattern of instability, weakness or tightness.

New research has found that “exercises that are distinctly targeted to a patient & their individual needs have a strong correlation with improved symptoms, both immediately after exercise & over a three month period.” This individualised program feature is one area where Clinical Pilates differs significantly from more generic group-based Pilates classes.

Another way Clinical Pilates is different from regular Pilates is that your program is based on a specific initial assessment that clarifies patterns of movement (flexion or extension) that aggravate & ease your pain plus boost or inhibit your muscle function. Left & right asymmetry is also assessed to clarify target areas for your program. You are also regularly re-assessed throughout your sessions to ensure that you are improving & building strength as expected. Click for more information on Clinical Pilates. 

Who Should Try Clinical Pilates? 

Clinical Pilates is ideal for you if you have, or have had, pain in your back, neck or pelvis. It can be especially effective if you have had several episodes of pain in the past.

Many people will recognise the feelings of weakness or instability that often follow an episode of pain in the back, neck or pelvis. This happens because of our pain inhibition reflex – which is when our brain switches off our stabiliser muscles in response to pain signals. These muscles do not then automatically switch back to on to normal strength after the episode of pain passes, so we are left with a weak spot. This increases the risk of recurrent or continuing pain.
Research shows that there is an 80% risk of recurrence within one year after an episode of lower back pain. This risk can be reduced by 65% with a directionally-specific core re-training program such as Clinical Pilates, & the situation is similar for neck pain. Your Clinical Pilates program kick-starts your core stabiliser & other spinal muscles & builds their strength so you can confidently get back to doing the things that you love. 


Clinical Pilates at Central Performance

Your Clinical Pilates program starts off with four 1-on-1 sessions. This is known as our Quickstart Program & in these sessions you will be fully assessed, be guided through your personalised program, & get confident in correct form & technique when using Pilates equipment including the Reformer bed, Wunda chair & barrel.

Following your Quickstart program you may choose to join our small group classes (max of 4 people per class), or if you prefer you can continue with 1-on-1 sessions. Even in a group environment you will still be doing your own individualised program & be under the close supervision of our great instructors. 

Our Clinical Pilates program is achieving excellent results for our clients. The most common benefits reported include;

•  reduced pain in their back, neck & pelvis

•  increased confidence with exercise & daily activities like lifting, carrying & pushing

•  better & taller posture

All of our instructors are fully qualified & experienced physiotherapists with further certification in Clinical Pilates training. This gives you the confidence of knowing that your program is designed & supervised by highly skilled clinicians every step of the way.  


For More Information On Clinical Pilates Click Here.
 Or Click Here To Book Online 


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4 Quick Tests To See If Your Headache Is Coming From Your Neck

Woman With HeadacheHeadaches can really affect your lifestyle. You may find it hard to concentrate at work, & it can make you feel like not socialising so much because lots of noise or bright lights make it feel worse. Exercise is not very appealing & can make the pain worse, & many people become a bit short-tempered when they have a headache. You may also start to catch yourself taking regular painkillers as if it’s become a normal thing to do. If this sounds like you then there are 4 simple checks you can do yourself to see if your neck may be part of the problem.

Are neck-related headaches common?

Headache is the world’s most common pain disorder & affects 66% of the global population. Research shows that up to 22% of headaches are either partly or fully driven by problems in the neck. When the neck, which is officially called the cervical spine, is producing your headache it is called a cervicogenic headache. Studies also show that assessment & treatment by an appropriately trained physiotherapist is effective for treating these neck-related or cervicogenic headaches.

How can my problems in my neck give me a headache?

Several structures in the neck, primarily those in the upper neck or “sub occipital (C1-3)” region can produce cervicogenic headaches. They include the spinal joints (facet or zygapophyseal joints), muscles, & discs (especially the C2/3 disc). Restriction, tightness or inflammation in any of these areas can affect neural processing in an area called the trigeminocervical nucleus (TCN) & cause pain referral along the trigeminal nerve to the head & face area.

It is important to remember that many people with neck-related headaches do not have a history of neck trauma or even significant isolated neck pain. At Central Performance we treat a large number of headache sufferers & we find that mostly it is related to their posture, with no specific separate neck issues. Often people have tried regular painkillers, heat/cold or massage, but have only found temporary relief.

How can I tell if my headaches are coming from my neck?

Diagnosing different types of headache can be tricky because people may have more than one type of headache at any given time. However cervicogenic headaches do have some common patterns & features, so if you know what to look for you can quickly get an idea of whether your neck is likely to be part of your problems. Use these 4 simple tests to help you decide if you should get your neck checked out to see if it is causing some or all of your headaches.

Test 1: back-to-front radiation

Most cervicogenic headaches start from the back of the skull & then radiate forwards to the temples, cheek, forehead, eye or jaw area.

Test 2: the pain is worse on one side, & doesn’t swap sides

The pain is normally on one side or at least worse on one side, & rarely swaps sides.

Test 3: neck posture or position can increase or reduce the headache

Often gentle movement or stretching of the neck will at least temporarily ease the headache.  Sustained poor postures such as looking down at a screen, iPad or phone will usually increase the headache.

Test 4: upper neck pressure can increase or reduce the headache

Firm pressure around the upper neck & base of the skull can temporarily increase or relieve the headache.

Using these 4 tests will help you quickly screen if your neck is likely to be contributing to your headaches. If these tests indicate that your neck is involved, seeing a physiotherapist who is trained & experienced in treating cervicogenic headaches is the best front-line management. At Central Performance our physio’s have all of the knowledge & experience required to help you. One of our Director’s, Chris Jackson, has a Master’s degree in Manipulative Physiotherapy which focusses heavily on spinal problems including upper neck pain & headaches, & has been treating cervicogenic patients for over 23 years.

How can physiotherapy help neck-related headaches?

There is extensive evidence showing that physiotherapy is effective in 3 key areas of management for these patients;

1. Accurate diagnosis & localisation of joint dysfunction

If you are unsure whether your headaches are coming from your neck we can assess you to confirm or rule out your neck as a cause of your problems. If we do not feel that your neck is the main cause of your problems we can discuss other possible causes, & can liaise with your GP if other investigation or management is required.Physiotherapy neck mobilisation

2. Manual therapy is effective for acute symptom relief

We can often bring patients fast relief from headache pain by using tailored hands-on treatment techniques including joint mobilisations, soft tissue releases, mobilisations-with-movement & trigger point releases. We also start to put you back in control of your symptoms by providing you with a home exercise program designed to re-inforce & build on the improvements made with hands-on treatment in the clinic. Another goal in the early stage is to allow you to significantly reduce or eliminate your medication use.

3. Clinical Pilates: Structured exercise to strengthen the spinal stabilisers & deep neck flexor muscles for effective long-term relief from headache symptoms

As your pain settles you get access to our great research-driven exercise programs for effective long-term symptom relief. Our Clinical Pilates program includes private & small-group sessions using individualised exercise programming specifically designed to strengthen the spinal stabiliser muscles. Restoring balance to your spinal mobility & stability systems is critical & effective in keeping you free of headaches into the future. Click for more info on Clinical Pilates or watch the video below.

Mixed Headaches

You may have headaches from different mechanisms at different times, & even different types of headaches occurring at the same time. Often one mechanism can set-off or aggravate another, so seeing a physiotherapist to effectively resolve the cervicogenic component of your headaches can provide significant relief even if some other mechanisms are involved as well.

Clinical Pilates Studio ClassThe key to effective headache treatment lies in the accurate diagnosis of what type of headache you have. We regularly get clients who have had headaches for years & have taken a significant amount of medication that may have been unnecessary because they never really considered their neck as a source of much of their pain. A skilled physiotherapist can effectively assess if your neck is involved, & give you effective & proven treatment to get you feeling better. When this is matched with a tailored spinal mobility & stability exercise program like our Clinical Pilates program you can realistically look forwards to a future without headaches, or at least with greatly reduced symptoms.

Lastly, please remember that whilst headaches are very largely due to relatively benign causes, if you are experiencing lots more severe or frequent headaches, or if they have come on or increased very suddenly, you should definitely get them checked out ASAP. Your GP can help you, or if you are screened by one of our physio’s & we think you need further investigation we can refer you on to see the best person for you.


For bookings or more information please call Central Performance on 9280 2322 to speak to one of our physios or contact us online.
We’re happy to discuss whether a physiotherapy assessment is the right choice for your headaches.

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Lower Back Pain in Golfers

Lower back pain is by far the most common complaint for golfers of all ages and ability levels. Data collected from the Titleist Performance Institute (TPI) show that 28.1% of all players have lower back pain after every round. The most common trend is for trail-sided back pain, ie. pain on the right side of the lower back for a right-handed golfer or left sided back pain for a left-handed golfer.

In actual fact the lower back is generally not the cause of the injury but is the area of the body that is overloaded the most and eventually suffers from the pain. Most of the time it is the fault of the body segments above or below the lower back that are dysfunctional. If the hips, upper back, shoulders or ankles do not move correctly it puts more pressure through the lower back than it is supposed to cope with and it subsequently breaks down. For example, if you are tight through your upper back or hips, the rotation required to bring you to the correct position at the top of your backswing is unable to occur in the upper back and hips. This forces your lower back to compensate and attempt to rotate further. Your back is then repeatedly loaded with more force than it can take, ultimately resulting in the facet joint injuries we see so commonly in golf. It may be an injury that comes on all of a sudden during a swing, or it can be a gradually stiffening/tightening of the back or soreness that is present after a round.

There are 3 aspects within a golf swing that have a strong relationship with lower back pain. The first is an S-posture at initial setup position. As you can see in the picture below on the left, the S-posture creates increased compression forces through the lower back due to the excessive lumbar lordosis (curve). This compression puts heavier load through our facet joints and with repetition this can result in an acute irritation of the facet joints or gradual degenerative changes through these joints.

Instead of the S-posture set-up, we ideally need a straighter line through the lumbar spine. This requires core stability to draw the spine out of the large curve and maintain a stable lower back position throughout the swing. If you have an S-posture, you can begin to correct this by practising basic motor pattern and core exercises, sometimes beginning in lying or kneeling positions, then progressing into more relevant standing golf positions.

The second major feature of the golf swing that correlates with lower back pain is the “Reverse Spine Angle”. At the top of the backswing the line between our head and centre of the pelvis should point away from the target. A “Reverse Spine Angle” is where this line of the spine is tilted towards the target. In this position the facet joints of our lower back are in an open position so as we move into the downswing and ball contact there is a rapid compression onto the facet joints as we close down onto them. People may develop a “Reverse Spine Angle” because of an inability to separate the movement of the upper body from the movement of the lower body, such as restricted rotation at the upper back or tightness through the latissimus dorsi muscle (the lats). It can also be caused by restriction in trail hip range of motion or weak gluteals and core muscles.

“Early Extension” is the third characteristic of the golf swing which can result in lower back pain. This is the movement of the hips and/or spine straightening up too early in the downswing. It can be seen on the second image below where the buttocks moves forwards away from the back line, when it should actually remain in contact as the hips rotate rather than straighten. “Early extension” again jams down and compresses onto the facet joints of the lower back. The physical causes for this can be reduced hip rotation of the lead hip, poor rotational mobility in the upper back, tightness/shortness in the lats, poor gluteal or core strength and overall a poor overhead deep squat movement.

As well as assessing the golf swing to determine if these swing characteristics are present, a golf assessment must also include a physical screen. TPI teach a Physical Screen consisting of 16 tests, ranging from hip range of motion, upper back rotational range, overhead squat patterns and even to wrist range of motion. All of these body segments need to be working together as a unit to achieve a successful, safe and reproducible golf swing.

TPI’s philosophy of the golf swing is this:
“We do not believe in one way to swing a club, rather in an infinite number of swing styles. But, we do believe there is one EFFICIENT way for every player to swing and it is based on what the player can physically do.”

At Central Performance we have two practitioners who are TPI Certified to assess the golf swing and perform your golfing physical screen.
Helen Hathaway – Physiotherapist
Danny James – Strength and Conditioning Coach
We are by no means golf coaches who are the experts at swing analysis, but would love to work with you and your golf coach (if you have one) to ensure that the mechanics of your body allow for the most efficient and safe swing for you.

Our physiotherapist, Helen, and strength and conditioning coach, Danny, run Golf Biomechanical Assessments consisting of a Physical Screen and a Golf Swing Analysis. They piece together the information gathered from these tests and establish a plan to help you get the most out of your body to improve your golf game. For some, the goal may be to get through a round of golf without feeling stiff in the back for two days following. This may mean manual treatment with Helen to improve joint range of motion and muscle length, as well as a program of corrective exercises to restore normal function. For others, it may be that they want to improve the power in their swing and could benefit from strength and power development with Danny. If you are having pain or discomfort with your golf, or feel that your game could be improved by improving your body’s mechanics, feel free to call and chat, or email

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Good Reads: July 28, 2016

Our Helen

One of our major goals at Central Performance is to motivate through education so that you will be better equipped with the resources necessary to improve your physical performance.

We hope to share with you information that is well researched, field-proven to get results,  easy to understand and ready to apply. If there is anything specific that you would like to know more about, please feel free to reach out to us on Facebook and Twitter or at the centre directly.

To begin, we’ve put together a quick list of some recent ‘good reads’ for you to peruse in case you missed them. Enjoy.

5 Mistakes That May Be Holding You Back
From Ewa Januszkiewicz, Neuroscientist and competetive powerlifter.

An Easy Drill to Enhance Thoracic Extension
Mike Reinold’s site is a wealth of rehabilitation-to-performance information. This post looks at techniques that enhance thoracic mobility.

What You Need to Know About Your Athletic Daughter
The good people at RYPT tackle some common myths about about female athletes and strength training.

The PERFECT Meal – What to Eat to Lose Fat & Build Muscle
An oldie but a goodie, Coach Nick Tumminello shares some general nutrition advice.


Danny James is the Head of Personal Training and Strength and Conditioning services at Central Physio and Performance Fitness located in Surry Hills, Sydney.

Danny James is the Head of Personal Training and Strength and Conditioning services at Central Physio and Performance Fitness, located in Surry Hills in the Sydney CBD area.


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Sit to Stand Desks

The Research Around Sit-to-Stand Desks

Sit to Stand DeskLately in the clinic we have been getting asked a lot about Sit-To-Stand desks. So, we’ve done the research & have here the guidelines for how these desks should be implemented in the work place or home office.

There has been a lot of hype in recent years stating that “sitting is the new smoking” which is beyond frightening when we consider the sedentary nature of so many occupations. There is definitely backing to this claim – the amount of time spent sitting has been conclusively linked to heart disease, Type 2 Diabetes, lung disease, depression, some cancers (bowel and breast) & obesity. These are the longer term, gradual effects of sitting. However, most of the issues we see here in the clinic are the musculoskeletal problems that arise – lower back pain, upper back pain, neck pain, headaches, rounding shoulders & poked neck postures, none of which feel good or look good! Other concerns are the effects that prolonged sitting can have on the metabolic system, the increase in mental fatigue & the impact on work productivity.

Surprisingly, research also shows that prolonged sitting, with absence of movement over a long period of time, has negative health effects regardless of the amount of physical activity you do at other times. We recommend 2 minutes of exercise every 20 minutes to lower glucose levels & reverse the negative effects of sitting. The exercise need not be high intensity; a walk around the office for 2 minutes will suffice. A good trick we often recommend to clients is to have a water glass or a very small water bottle on their desk within eyesight. Not only will this encourage good daily water intake, it also gives you a reason to get up from your desk to move regularly, whether it be to refill your glass or go to the bathroom!

Unfortunately there are downsides to standing for long periods of time too. These include lower back & knee, leg or foot pain, fatigue & cardiovascular problems which come about not only because of the static nature of standing, but also because of the poor postures adopted during that time standing. If you are standing for long periods, you may need extra interventions to assist, eg. shoe inserts, compression stockings & anti-fatigue mats.

After all that you may be thinking you’d be better off standing up, walking around the office, walking right out the door & never coming back! If only!

However, there is a good way to manage your time so you can sit AND stand to improve your musculoskeletal woes, energy levels and productivity, & reduce the negative medical effects on metabolic rate & blood sugar levels.

So the question arises…should I get a standing desk? Should I stand all the time? When I stand for too long, my back & legs get sore & tired…Am I standing incorrectly?

Sit & Stand deskOverall we are tending to recommend sit-to-stand desks to many of our clients, especially if they are suffering from neck or back pain that worsens with sitting. The main benefit is that they enable shifts between postures throughout the day.

The guidelines for sitting & standing times are under constant review as more research becomes available on the topic. Recent studies advocate for workers to aim to accumulate 2 hours a day of standing & walking during work hours, before eventually progressing to a total of 4 hours per day. To start out, we recommend standing for 15-20 minutes of each hour, to equate to 2 hours of the working day.

We also recommend:
– Breaks every 20-30 minutes
–    Task variety – in the type of work & the mental and postural demands
–    Frequent short walks, rather than infrequent longer breaks

Some workplaces & managers are concerned by the frequency of these mini-breaks. However, recent studies show a positive effect on reducing discomfort in all musculoskeletal areas, with no detrimental effect on worker productivity.

Many workplaces require a letter from a physiotherapist explaining the need for sit-to-stand desks or recommendations for regular breaks. We are more than happy to write this up if we feel either would benefit you.

Once getting a sit-stand desk it is vital to have it set up correctly to suit your body type & size, both in the standing position & sitting position. Many workplaces have someone who can perform ergonomic assessments to determine the ideal desk for your available space & assist in the setup once a desk is purchased. There are also occupational health or ergonomic physiotherapists that you can seek help from.

Sit-to-stand desks  have occasionally been installed but not utilised effectively. This may be because they are physically difficult to adjust, the users do not like to stand, or the adjustment of the desk is difficult & therefore contributing to musculoskeletal injuries. It is therefore important to have the desk set up well for your body.

Key features for correct sitting postures: 
– feet flat on the ground or onto a footstool
– knees & hips at right angles
– support through the lower back, either from the chair itself, or from a lumbar cushion
– elbows set up at right angles – adjust the chair or desk height to achieve this

Key features for correct standing postures:
– even weight distribution through both legs
– avoid leaning into one hip
– have your weight spread evenly through heel & forefoot
– have your elbow/hand levels 90 degrees
– setup your screen so the top of the screen corresponds with eye height

Click here for a PDF of the IDEAL SITTING POSTURE. Feel free to pass this on to your colleagues!

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Research shows that Pilates can help treat & prevent low back pain


Build a strong core to treat & prevent low back pain

Research shows that a Pilates-based exercise program specifically targeting core stability is effective for preventing & managing low back pain.

Did you know that once you get back pain the chances of getting another episode of back pain in the next year is 80%? This is a scary statistic, but the good news is that you can more than halve this risk by completing a core stabilisation program.

One major reason behind such high recurrence rates for back pain is pain inhibition of the core stabiliser muscles. Basically, we all have a hard-wired reflex called the pain inhibition reflex that switches off our core stabiliser muscles during back pain. Importantly, research shows that these muscles do not automatically turn back on again once our back pain settles.

The fact that your core stabilisers stay switched off even when your pain has settled is critical because it means that even if your pain goes away you are left with a weak spot in your back. This weak spot is much more prone to re-injury, especially when your pain has gone so you think everything is back to normal & you get back into your normal activities & exercise. A classic example would be someone who just takes pain-killers or anti-inflammatories so they feel much better, then goes back to some exercise & then has a much bigger recurrence of pain. Of course getting rid of the pain as fast as possible is good, but you have to make sure your back gets fully strong again once your pain goes.

Another reason for the development of this weak spot is the disruption to the timingof our core muscles, i.e. the muscles don’t fire at the right time. Normally our core stabilisers fire before we begin moving to prepare our spines for taking load. However after an episode of back pain our stabilisers don’t fire until after we begin moving, which means that our spines are left unsupported for the initial part of movement. This puts our joints & discs under much more load & harmful shearing stresses than they are designed for because our core muscles are working reactively rather than proactively.

FOR MORE INFORMATION ON TREATING LOW BACK PAIN email Central Performance or call 9280 2322

So what exactly are the core muscles?

A lot of research now shows that re-training our core stabilisers is the most effective way to get rid of that weak spot. But what is “the core”?

Many people think of our core as being our stomach muscles – our abs (six pack) & our obliques. However, this is in fact incorrect. The “core” is a group of deeper muscles including our transversus abdominis, pelvic floor, diaphragm & multifidus. These lie behind our abdominals & obliques, & our multifidus actually extends along the entire length of our spines. Your core is critical for keeping your spine stable, strong, healthy & flexible.

To retrain your core the most important thing you need to do first is to learn how to switch your core on without using your other abdominals to compensate. This is very different to just doing normal abdominal exercises, & this is where many people get into trouble. When you’ve had back pain your core is switched off & your other abdominals become overactive to try & compensate. So if you just do normal abdominal exercises then most of the time you’re just using the wrong muscles & your core stays weak. You have to “wake up” your core first, get it firing, & then gradually integrate it back into higher-level exercises. Think of it like giving you a really stable base to support you as you get back to your normal activities & exercise.

How do I switch on my core?

One of the best cues for you to get the feeling of contracting your core stabilisers is by doing a pelvic floor contraction. Your pelvic floor muscles, as well as working as part of your core stabiliser system, also control your bladder & bowel. To switch them on imagine trying to stop your flow of urine half way through. If you put your fingertips just inside your pelvic bones at the front of your hips you should feel the muscles slightly contract & become firm. You may also notice your belly button draw down towards your spine. This is your transversus abdominus contracting.

The easiest position to feel this contraction is lying on your back with your knees bent up & feet on the floor. You need to make sure your breathing stays relaxed & regular during the contraction. You can put a hand on your ribs to make sure they continue to move in and out just like they do with relaxed regular breathing. Practice keeping this contraction going for 5 breaths in & out, then relax. Repeat this for 2 or 3 minutes at least daily (preferably twice a day) to get the hang of it.

What’s next?

Once you can switch on your core you need to build it’s strength & endurance. You also need to start getting it to co-ordinate properly with the other muscles around your body. This process is critical to your long-term success because you need your core to work effectively with all your other muscles during your every-day activities & exercise. If you sit at a desk for 8 hours a day your core needs to have the endurance to stay active for the whole 8 hours. If you go for a 30 minute run your core needs to be firing & working well with your hip & leg muscles the whole time.

Pilates is a great way to train your core. It can help you train the correct muscles with the correct timing to improve stability, mobility, strength & function. If you have recently had back pain you need to do a Pilates-based re-stabilisation program that is specifically targeted to people recovering from a pain episode to ensure that your fundamental core activation is solid before progressing to more general or higher-level exercises.

What’s the best program for you?

At Central Physio and Performance Fitness we have a great range of Pilates programs tailored to meet the needs of clients ranging from beginners to experienced Pilates devotees.

Core Control is specifically designed for people recovering from back or neck pain or for those who are new to Pilates. It is a gentle, closely-supervised program that gradually activates & strengthens your core. It’s perfect for you if you have had back pain & want to strengthen your spine but are unsure about how to become stronger without stirring up your pain.

Freedom Pilates is the next level of mat Pilates. It brings in more challenging exercises by increasing resistance, speed & complexity of movement. It is great for integrating core stability into more higher-level exercises & is ideal for you if you already have some Pilates experience.

Studio (Equipment) Pilates hugely expands your exercise options by using equipment including the Reformer, Wunda Chair & Barrel. We individually prescribe your exercise program so that it is perfectly matched to your ability & fitness goals. Individual & small group (max 3 people) sessions are available.

Our Pilates services are run by Helen Hathaway, our physiotherapist with formal DMA qualifications in Clinical Pilates. As well as being formally trained in the Pilates method  Helen also incorporates newer technology, equipment & research into her sessions. And because she is a registered physiotherapist you may be eligible for private health fund rebates – check with your fund.

References & research

1. Burton AK, McClune TD, Clarke RD, Main CJ. Long-term follow-up of patients with low back pain attending manipulative care: outcomes and predictors. Manual Therapy 2004; 9: 30-35
2. Richardson CA, Snidjers CJ, Hides JA, et al. The relation between the transversus abdominus muscles, sacroiliac joint mechanics, and lower back pain. Spine 2004; 27(4): 399-405
3. La Touche R, Escalante K, Linares M. Treating Non-Specific Lower Back Pain Through the Pilates Method. Journal of Bodywork and Movement Therapies 2008; 12(4): 364-370.

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Strength Training in Women & Exercising During Pregnancy

Strength Training for Women

Strength-training-womenThere are significant benefits for strength training in women, most of which far outweigh the benefits of cardio. Some of these benefits include:

  • Decreased risk of osteoporosis with enhanced bone remodelling to increase bone strength
  • Stronger connective tissues (ligaments, muscles and tendons) to increase joint stability and help prevent injury
  • Increased lean body mass and decreased body fat overall
  • Higher metabolic rate – compared to fat, muscle is metabolically active and increases the metabolic rate, fat oxidation and calorie consumption. This means that even at rest your body is going to burn more energy
  • Improved self esteem and confidence
  • Enhance mood and concentration levels

However many women are hesitant to to take up weight training for several reasons – fear they will end up bulky, are intimidated by the machines or testosterone-filled gyms or lack the knowledge to commence a structured safe program.

There are some significant differences between men and women physiologically which can have an impact on strength training. However it is interesting to note that when strength is calculated per cross-sectional area of muscle there are no significant gender differences. There are three significant hormones used in the body in order to create muscle growth. These include testosterone, growth hormone and insulin-like growth factor. Of these, testosterone is most closely related to promoting the protein synthesis necessary to repair muscle tissue after exercise. Women have 10-20 times lower levels of testosterone and testosterone receptors than men so rely more heavily on secretion of growth hormone from the pituitary gland to help mediate the changes in muscle. This means that for women recovery is often not as quick as for men who have higher levels testosterone in their body, at the ready for muscle repair.

Women also have higher levels of stored fat than men (mostly for childbirth purposes) which means that less of the female’s bodyweight is made up with muscle so they have a decreased capacity to apply force during training. Alongside this, men have higher concentrations of type II muscle fibres which are more responsive to strength training, and women have higher levels of type I muscle fibres related to aerobic efficiency.

Exercise During Pregnancy

Exercise should continue to be encouraged in a safe way during pregnancy. There are significant benefits to exercising during this time:

  • easier delivery
  • better adaptation to pregnancy
  • weight and mood management
  • healthier baby
  • less pregnancy pain
  • improved strength and balance
  • quicker recovery post part
  • assist in insulin sensitivity – to help in avoiding gestational diabetes
  • assist in heat regulation

Interesting Physiological Changes During Pregnancy

Feelings of weakness and lack of energy – relaxation of the muscles of the blood vessels results in increased volume of the cardiovascular system (heart, arteries, veins and capillaries) causing a temporary vascular under-filling which accounts for feelings of weakness and lack of energy

Increased heart rate

Due to an increase in body weight there is an increase in strain on the cardiovascular system. This results in an increase in resting heart rate. It is then important that when exercising it is no longer a safe and valid measure to monitor heart rate changes – instead you need to use a difficulty level scale such as the Rate of Perceived Exertion scale.

Quickly becoming short of breath

The respiratory system (lungs) become more efficient at getting rid of carbon dioxide from the baby and from the mother. This means that oxygen consumption increases. The breathing rate can increase by up to 45%. Exercise and toning of muscles ensures that oxygen uptake is improved because of more optimally functioning muscles. In addition, it is important to facilitate horizontal diaphragmatic breathing because pregnant women have limited vertical breathing space because of the growth of the uterus/stomach.

Body temperature

During early pregnancy (first 12 weeks) the baby’s central nervous system (brain and spinal cord) is forming and even a 1% increase in body temperature may have adverse affects on the baby’s development. It is therefore important to modify exercise accordingly – women are recommended to avoid hot yoga, high intensity exercise in hot weather and hot hydrotherapy pools for exercise.

Increased joint laxity

Relaxin and elastin are hormones that effect the connective tissues of the body (the ligaments, cartilage and tendons) and the levels of these hormones soar during pregnancy. This reduces the structural stability of the joints, especially surrounding the pelvis. Considering the loosening of the connective tissues, it is vital that muscles are at optimal length in order to contract properly to stabilise the joints. It is common to experience musculoskeletal pain in the pelvis/lower back/pubic symphysis during pregnancy. Targeted exercises can assist in reducing and correcting these injuries.

If you have any questions regarding exercising during your pregnancy, or preparing your body for carrying a baby, please don’t hesitate to contact our strength and conditioning coaches or our physiotherapists. We’re here to help!

Head Strength and Conditioning Coach – Danny James

Having both personal trainer and strength and conditioning qualifications allows Danny to effectively work with people of all ability levels. He has guided many women through training programs before, during and after their pregnancy and loves helping keep women as active, strong and pain-free as possible through this time.

Qualifications include:

  • Certified Personal Trainer registered with Fitness Australia
  • Certified Strength and Conditioning Coach with the Australian Strength and Conditioning Association
  • Licensed State Weightlifting/Sports Power Coach with the Australian Weightlifting Federation
  • Accredited Sports Trainer with Sports Medicine Australia
  • Certified Functional Movement Screen Exercise Professional Level 2
  • Accredited Australian Sports Commission Coach
  • Member of the National Strength and Conditioning Association

Strength and conditioning coach – Matt Loudoun

Matt’s passion is to help people reach their goals both physically and mentally in a fun, safe and supportive environment.

He is a qualified personal trainer and strength and conditioning coach and is currently undertaking a 12 month S&C internship under Keegan Smith (NRL performance coach) and completing Precision Nutrition Level 1 Coaching Certification.

Danny and Matt both believe that a good coach employs an integrated model using the best current knowledge from all areas of exercise prescription to help clients achieve their goals.



Call us on 9280 2322 or email us if you have any questions or would like to book in with one of our strength and conditioning coaches.

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