Sitting is the new smoking

You may have heard the phrase “Sitting is the new smoking”, along with “Movement is Medicine” or “Motion is Lotion”. It’s becoming more and more clear that the sedentary behavior that has become so ingrained in modern society isn’t good for us. A big part of what we do is help our clients find ways to spend less time sitting stationary to allow for faster recovery from injury or surgery.

We have known for a long time that gentle movement and physical activity is helpful for conditions like back pain and osteoarthritis. However, research has also shown that independent of physical activity, sedentary behavior has been associated with cardiovascular disease, diabetes and some cancers (1). This means that going to the gym doesn’t fully negate the effects of sitting at your desk all day. See if you can add some incidental activity into your workday; maybe you could pace the corridor whilst on the phone or do 5 squats every time you go to the printer.

A question that we are commonly asked is “what is the perfect posture?” The short answer is there is none.

A question we commonly hear is, “what’s the perfect posture”. The short answer is that there is none. Ultimately, our bodies are designed to move. The most expensive and individualised ergonomic chairs and desks won’t stop you from feeling uncomfortable if you stay in the same position for hours at a time. Pain and discomfort is often a result of the subconscious brain reminding you to stretch your muscles and lubricate your joints. Try thinking about pain as a helpful reminder that your body needs to do something different.

If you have an office job or drive long distances, try this stretch to break up periods of sitting.

1. de Rezende, L. F. M., Lopes, M. R., Rey-López, J. P., Matsudo, V. K. R., & do Carmo Luiz, O. (2014). Sedentary behavior and health outcomes: an overview of systematic reviews. PloS one, 9(8), e105620.

Hydrotherapy for MS: Debunking the Heat Sensitivity Barrier

The hydrotherapy pool has proven itself to be a great environment for improving fitness, increasing muscle strength, improved mobility and walking, reducing fatigue, improved well-being and quality of life for people suffering from multiple sclerosis.

What is heat sensitivity in MS?

Increased body temperature for a multiple sclerosis sufferer leads to slowing of nerve conduction and therefore an increased fatigue, weakness and temporary worsening of old or onset of new symptoms; usually resolving within 24 hours.

Will the warm pool contribute to heat sensitivity?

A common misconception amongst MS patients is that a hydrotherapy pool will be detrimental to their function as a result of heat sensitivity. However, water is a better conductor of heat than air, so heat can quickly be carried away for improved temperature regulation during more intense exercise in the pool- more so than on land. Studies have shown no adverse effects for people with MS in pools with a temperature of 25-35°c.

Tips for Managing Heat Sensitivity

• Exercise in a well-ventilated pool with a temperature of 25-35 degrees

• Stay well hydrated

• All exercise requires an adaptation period, so take regular short rest breaks

• Everyone’s body is different: Try exercising in a few different pools/ different temperatures within the prescribed range and find which one suits your body best.

What do I do if my symptoms get worse following exercise in the pool?

If symptoms are worse for any more than 2 hours after a pool session, then the session is likely too challenging. Speak to your Neurological physiotherapist about how to modify your program.

Some comorbidities can affect your safety in the water, so make sure to discuss an appropriate hydrotherapy plan with us before commencing.

I want to ride my bicycle!

Cycling builds and maintains cardiovascular strength and endurance, and can complement many rehabilitation programs. Cycling can be a safe and low-impact exercise when performed correctly.

Lower back pain can be commonly experienced by cyclists; this is largely as a result of poor cycling technique or poor bike set-up. If you experience discomfort in the lower back when you cycle there are a few things that you could consider:

Check your posture: The sustained flexion position of the lower back, that most are accustomed to while cycling, places a lot of strain through the soft tissues in and around the spine.  This can lead to pain or irritation in the low back, and may also be felt into the buttock or legs.

When cycling try to adapt a ‘neutral spine’ position, by making adjustments to the pelvis position into a more flat-back position, you should be able to feel a low-level muscle activity through the lower stomach muscles. This will also enable you to cycle with more efficiency, as engaging these postural-support muscles improves force transfer across the pelvis.

Start integrating the postural changes with short cycles only. Over time you will gradually increase the endurance of the postural muscles to more-easily sustain the neutral spine posture.

Get a professional bike-fit: To prevent unnecessary strain to the body, and to ride with efficiency see a local bike store for a comprehensive bike-fitting. It is important that your bike frame is the correct size, and bike fittings such as the handle-bar height, saddle height, and saddle angle are adjusted to your body dimensions.

Small alterations can impact how we use our muscles. For example; saddle angle directly effects the tilt of the pelvis; which correlates to the position of the joints of the lower back. All spinal joints are most happy in a mid-range posture; the easiest way to maintain this neutral spine posture is with a saddle angle that is level with the ground.

Use your gears: An ideal cadence during rehab to progress towards is above 70 RPM. A higher cadence (ie a low gear) such as this, will decrease muscle tension and allow blood flow to nourish working muscles. Moving down the gears as the incline increases will challenge the cardiovascular system more, but will avoid increased pressure through the soft tissues.

Cycling is a repetitive movement, so regular position changes to the front and back of the saddle, and to standing are encouraged to further avoid strain. 

At Bespoke Physiotherapy, a number of our clients use cycling as an integral part of their rehabilitation process. For some, even with appropriate bike-set up and correct use of gears cycling may not be appropriate. Weakness around the core, reduced flexibility and poor postural habits will have a large impact on discomfort and may need to be addressed prior. 

Clinical Pilates is a great form of exercise to help you prepare for your return to cycling after injury or surgery because of it's emphasis on improving core stability, postural awareness, strength, balance and flexibility. 

We'd love to hear from you if you're considering getting back on your bike! 

Remember that cycling may not be appropriate after surgery or some injuries.  If cycling is something that you would like to work towards please don't hesitate to chat to one of our Physios who can assist and advise in a return to cycling program.