abdominals, back, Core stability, Feet, Gymn Dangers, Physiotherapy, Pilates, Shoulder

What is Core Stability?

Power and Strength are useless without Stability and Control

muscles

Big flashy muscles might be attractive but as any physio will tell you, they are next to useless without core stability.

Thankfully the health and fitness industry has now started to embrace the need for core stability, but still few people really understand the concept and what it means.

Essentially our bodies have hundreds of different muscles that all perform important tasks and the very conspicuous Abs, Glutes, Pecs, Delts and Biceps (amongst others) are there to provide strength but they are supported by a plethora of smaller, less conspicuous muscles that provide stability.

shock absorbersThese are generically referred to as the ‘Core Muscles’ and the best comparison we can think of is with automotive suspension systems.

If the ‘Strength’ muscles are the springs then the ‘Core’ muscles would be the shock absorbers.  They are usually less conspicuous, sometimes even hidden within the springs but without them your car would fall apart in no time.

The same goes for humans.  Good strength muscles alone won’t keep you running smoothly. Without good core stability you’ll be in for lube and servicing (physio) all too often and eventually you’ll be off to the scrap yard before your time!

inner_core_musclesWhen it comes to spinal stability, the most important muscles are the multifidus, pelvic floor and transversus abdominis. As shown in the image to the right, these muscles form a supportive cylinder around the spine. The transversus abdominis is like a corset around your abdomen and it sits deep underneath all the “six-pack” muscles.  It attaches the lower ribs, diaphragm and lumbar spine to the pelvis.

This ‘core’ stabilises the spine and allows the load of movement to be evenly distributed between all the intricate joints of the spine. Just like a car suspension system, it reduces the shock through the joints and thus reduces wear and tear which would, over time, lead to conditions such as arthritis or bulging discs.

personaltrainerDoing exercises like sit ups is useful to strengthen the big “six-pack” muscles, but doing this exercise without good core stability will lead to excessive load through the joints of the spine and can lead to injury of the spine.

So in that respect it is important to activate and strengthen the core before you start on a regime of strength building.

 

Muscles of the posterior shoulderAnother example is the shoulder. The “delts”, “lats”, “pecs” and “biceps” look fabulous but they are not the stabilisers of the shoulder.

Over training of these without attention to the deeper, core stabilisers of the shoulder can result in injury as a result of an increased load being put through the system without the appropriate “suspension”, so to speak.

See our blog on ‘Shoulder Stability’ for a series of simple exercises to build core shoulder stability.

Each area of the body  has a “core” component.

Feet have intrinsic muscles that operate in balancing.

Ankles rely on hip and foot stabilisers for control.

Knees similarly need good hips and feet to be protected.

and even Necks have a deep system of muscles that control movement.

In essence, the core muscles play a crucial a role in overall well being and strength. Without the stability and control provided by the deeper core muscles, the power and strength gained from training is useless!!

Stay tuned as our series of CORE STABILITY blogs will introduce the specifics of core training for different parts of the body and the common areas of overloading we see in fitness regimes!

Post by Catherine Stephens (B.App.Sc Physio) and Angus Tadman (B.App.Sc Physio Hons I)

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abdominals, Balance, Core stability, Daily Exercises, Physiotherapy, Shoulder, Stability

Swiss Ball for Stability – video-blog

Hello and welcome to our first video blog.

Its all about core stability, pelvic stability and balance – all three very important to maintaining a healthy balance within yourself.

Here’s Angus to demonstrate the exercise.

If you haven’t got a Swiss Ball at home then we highly recommend you get one – they are an extremely versatile aid to keeping yourself in-trim at home and to top it all they are great fun to use too.   We’ll have plenty more demonstrations of exercises you can do with a Swiss Ball soon.

We have them in stock in the shop so ask at reception. Here’s the page that lists all our supplies:- https://northernbeachesphysio.com/supplies/

We’re aiming to make a lot more video clips over the course of this year which will be hosted on our Northern Beaches Physio channel on YouTube.

Here’s a link:-  http://www.youtube.com/channel/UCNCRpch8eeN3bPCH4oaAPFQ

Stay tuned !

So, how are we doing?  Did Angus do well? (and no, channel seven, you can’t have him).  Do you like our blogs?  What would you like to see more of?  Use the ‘Reply’ field below to have your say, we’d love to hear from you.

Post by Catherine Stephens B. App Sc (Physio) MAPA.

Physiotherapy, Shoulder

Frozen Shoulder – a predictable mystery

Although the reasons for onset of Frozen Shoulder remain unclear to the medical profession, the physiological process and symptoms experienced are quite predictable.

Most patients present with a general stiffness, restricted movement and some associated pain in the shoulder that radiates down the upper arm.  In some cases the pain is slight and in others extreme.

Ultrasounds and MRIs can detect many subtle abnormalities of joints and surrounding muscle and tissue but Frozen Shoulder is largely diagnosed by the physician based on movement dysfunction and associated pain, especially when elongated timeframes are involved e.g. 6 months plus.

Frozen shoulder age chart

It might sound a bit hit and miss but Frozen Shoulder is quite common – in fact 2% of the population suffer it with the vast majority of patients in their 50s.  If you have diabetic issues then the chances of it developing are even greater.

And ‘Developing’ is the only way to describe it.  Frozen Shoulder mainly occurs from no obvious associated injury to the shoulder.  In fact it can just develop for no apparent reason, though it will often accompany a recent traumatic incident – though again not necessarily to the shoulder.  A patient presented recently who had had a car accident, suffering whiplash and three weeks later developed a frozen shoulder.

The Process:

What happens is that the body ‘believes’ the main shoulder joint is damaged and therefore triggers an inflammatory response in order to heal it.  This involves streams of white blood cells, platelets and fibroplasts being sent to the joint lining and surrounding joint capsule and ligaments which causes inflammation and subsequent shrinkage which in turn restricts movement.

Frozen Shoulder Capsule

Left: Normal capsule allows generous movement Right: Frozen capsule shrinkage restricts movement

This process is like a ‘domino effect’, once started it naturally continues with no known way of stopping it – even though there is no original injury that triggered it.

Domino effect

It is as if the immune system makes an error of judgement.  In fact it is a natural hormonal change that instigates this ‘Inflammatory Cascade’ in the first place, which is why it affects women in their early 50s and men in their late 50s who are experiencing natural hormonal life changes at this time.

Eventually, after many months (usually around 5-7 months) the ‘dominoes’ run out and the inflammatory cascade stops, at which point Myofibroplasts are then sent in to smooth out the scar tissue.  This is exactly what happens with external injuries where the initial ugly scar tissue will soften and decrease until it eventually all but disappears.

Frozen shoulder timeframe

Pain starts to decrease and mobility return, but this is often a very slow process taking up to two years (and sometimes more) to complete and cannot be hurried along.

Treatment:

The most common treatment that can be effective during this ‘post freeze’ time is a cortisone injection into the glenohumeral (shoulder) joint which reduces the inflammation making it less painful and debilitating to everyday activities for around 3-4 weeks.  The injection can be repeated if needed.

Cortisone effect chart

It is a popular treatment that has much success but doesn’t always have optimum effect and in some cases can be relatively ineffective.

There are other methods for severe cases including arthroscopic capsular release, which is a key-hole, day-surgery procedure.

Physiotherapy:

Shoulder treatmentPhysiotherapy may exacerbate the pain in the first few months following the onset of symptoms in the ‘freezing’ phase or the inflammatory phase. But in the ‘thawing’ phase when the inflammation has settled, then physiotherapy and stretch exercises will help accelerate recovery in range of motion.

Due to the restrictions on movement inflicted by the Frozen Shoulder, all the other muscles surrounding the shoulder area will weaken and ligaments shrink, so a gradual stretching and re-building of muscle tone will be required over at least 6 months, sometimes longer.

Your physiotherapist is best to advise on exercise and stretching regimes, while taking care not to impinge the recovering joint.

Arms Spread

Author: This is a shortened version of an in-depth article by Mark Haber, specialist orthopaedic surgeon, M.B. B.S.  F.R.A.C.S. (Ortho). All illustrations copyright Mark Haber.   See full length article here.

Mark Haber conducts consultations at Warringah Medical Centre, Dale Street, Brookvale on referral from your GP.

Improving Movement, Physiotherapy, Stability

5 exercises to keep your shoulder stable and healthy

The key to a healthy, pain free and strong shoulder is a stable scapula (or shoulder blade) which is the base from which all shoulder movement occurs. It is the bone where the “socket” of your shoulder is found and to which the “ball” of your upper arm (humerus) connects.

Losing scapula stability is often the first step toward developing painful injuries such as rotator cuff tears, subacromial bursitis and arthritis.

The following exercises are very effective for improving scapula stability and therefore improving shoulder function. Please keep in mind that you should never have pain during or after doing these exercises. If you do, please consult a physiotherapist before continuing.

scapulaScapula Clock#1.Scapula clock: Stand close to a wall with your elbow bent. Place your hand on a small ball on the wall just below shoulder height. Roll your shoulder blade back and down and hold it set in this position.

Make circles alternating from clockwise to counterclockwise with your hand on the ball while maintaining your shoulder set. Repeat 10 times each way.

Pull Downs#2. Pull downs: Using a cable or theratube secured above you.

Pull down with straight arms to the side of body and simultaneously draw your shoulder blades back and down to feel muscular squeeze in the middle part of your back just below the shoulder blades.

Repeat 10-20 times.

Wall Push Ups#3. Wall push ups: Place hands on wall below shoulder height and slightly wider than shoulder width.

Stand with feet together and away from wall so you are weight bearing through your arms and hands.

Do slow push ups on the wall being mindful to keep the shoulders back and down as you press toward wall.

As you press away from the wall roll the shoulder blades around the ribcage to arch the upper spine.  Repeat 10 times.

4 Point Kneeling#4. Four point kneeling: Assume four point kneeling position.

Take weight forward so your nose is in front of your fingertips. Bend elbows and take shoulders down away from your ears.

Keep shoulders back and down and maintain stability on one arm as you lift the other out in front.  Repeat on the other side and do 5-10 repetitions.

Ball Roll#5. Roll out on ball: Assume start position as pictured.

Ensure shoulders, hips and knees are aligned and support weight on hands.

Slowly roll the ball out in front of you, keeping your body aligned and extend the arms away from the body to allow the elbows and forearms to rest on the ball.

Maintain shoulder blades down and back. Repeat 10 times.

Post by Angus Tadman