Physiotherapy Now

Jerusalem physiotherapy by Tamara May

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Taking your Pelvic Floor to the Next Level

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As mentioned on previous blogs the pelvic floor muscles help support your bladder bowel and uterus, which is why they are the muscles we strengthen and exercise when having incontinence problems. The pelvic floor muscle also help to make up the core muscles of one’s body. They are the foundations that help stabilise the pelvis, along with the deep muscles of the back and abdomen. This is why with prolapse one can experience back pain or abdomen pain. This is also the reason to integrate core stability exercises into your daily work out routine as well as your specific pelvic floor contraction exercises.
A good exercise to start with is lying down on your back with your knees bent in a sit up position (do not do sit- ups) and raise your bottom off the floor and hold for 2-3 seconds before lowering (not flopping) back to the ground.

When you have mastered that exercise it is time to start progressing your exercises. Only start progressing your exercises when you are ready. It is much better to do fewer exercises correctly and exercise the muscles you intend than to exercise lots and wobble all over the place because you are incorporating all other muscle groups that are not suppose to be working in order to perform the activity.
The next good exercise to do is still in the the sit up position, one leg at a time move forward 10 cm and bring back to starting position.

When you can do this easily raise one leg in the air so the hip is at 90 degrees and straighten the leg in the air and lower to the floor slowly, then switch legs and do the same.

Then move onto both hips at 90 degrees, lowering 1 leg to the floor and then switching.
The both hips at 90 degrees again and 1 at a time straightening the knee while lowering to the ground.

When you can do all these exercises without wobbling around while lying on your back still keeping both your legs straight raise and lower in a controlled manner.

If you are suffering from pelvic floor problems and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.

Aerobic Exercise During Preganancy

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As well as exercises to strengthen specific areas of the body, raising your heartbeat and working up a sweat is also very important during pregnancy and highly recommended. It will help strengthen your heart and lungs as well as maintain muscle tone. Now most sports are suitable if you are pregnant (for those of you that were already doing a sport), but what about the couch potatoes? I do not advise couch potatoes to start training for a marathon while pregnant but on the other hand I would not advise to continue being a couch potato all through your pregnancy, as long as there are no complications and you have not been advised to be on bed rest. I am therefore going to mention each sport specifically, as to what the correct advice should be, as it is important to pick a sport that you enjoy. 

Dance routines and aerobic exercise is safe to continue as normal if you are experienced, although you may want to tone down the intensity level and make sure you do not exert yourself to the point of exhaustion, which could deprive your body of oxygen. However if you are a beginner I would advise low impact dance or aerobics, or even water aerobics. 

Swimming and exercise in water is great. In water you weigh just a tenth of what you are out of the water. It is gentle on your joints but also allows you to boost your strength and flexibility. 

Gym machines such as step, rowing and treadmills are also great to use during pregnancy, including beginners. You can adjust speed, inclines and tensions to a level of comfort for you starting slowly if you are a beginner. Make sure you stretch beforehand and take it slowly. During the 3rd trimester it is best to avoid jumping and fast running and be very careful to avoid falling over.

Jogging for the experienced runner is also fine and during pregnancy you can stick to it but you may want to consider limiting your distances and sticking to a more level terrain (or use a treadmill). If you were not a runner before pregnancy I would suggest you stick to walking for now. Bear in mind that loose ligaments and joints during pregnancy can make running harder on the knees and also make you more prone to injury, so make sure you do not over do it. 

Kick boxing during pregnancy, now it takes a great deal of grace and speed, 2 things that are reduced during pregnancy. You may find you are not able to kick as high or move as quickly but if you are still comfortable getting exercise from kickboxing and you are not a novice it is fine to continue. Be careful to avoid movements that you have difficulty in doing or that cause you to strain, and remember not to over do it. 

Outdoor sports such as cycling, skating, hiking and skiing are not to be taken up as your new sport especially as they test your balance but again if you are experienced (except skiing) in this area and are comfortable to continue it is fine. However high altitudes, slippery conditions (skiing) and rock climbing are not advisable. Be careful about safety; don’t cycle in wet conditions, or windy and rocky paths and always wear a helmet. With skating as you get bigger your balance will become more challenging and then it is time to hang to your skates up for a while. Skiing is too dangerous as there is high risk of serious injuries, even if you are in the Olympics. 

Last but definitely not least I will mention walking, which is great for everyone anywhere and everywhere. Start slow and build up to a brisk walk.

With all this exercise don’t forget to drink, drink and drink some more, especially in the hot weather. 

If you are suffering from any pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you privately or through Leumit in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.

   

Sciatica: Don’t Let It Get On Your Nerves

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This condition is so named as it is caused by your sciatic nerve. The course the nerve takes runs from your lower back travelling down the back of your legs and branching out into your feet. This is also where the pain is felt, following the course of this nerve. The job of this nerve is to help you feel sensation and move the muscles in your legs. 
Although seemingly quite common during pregnancy – especially in the third trimester – it is not necessarily directly caused by anything to do with pregnancy, although it can be aggravated by your posture during pregnancy. You can also suffer from sciatica without being pregnant. 
Sciatica happens when there is inflammation or pressure from your back on the nerve, often caused by a slipped or injured disc. It can also be caused by the growing uterus putting pressure onto the nerve. When suffering from sciatica you will feel a burning shooting pain, quite often in just one of the legs. It can be constant or it can come and go. Although coupled with inflammation, it is important to remember that while pregnant you cannot take Ibuprofen, even at over-the-counter strength.    
Treatment can include exercises to strengthen your pelvic floor, stomach and back muscles.  You may also be advised to wear a support belt. Flat shoes are also an essential. In bed it is important to support your bump using pillows. Keeping mobile is also very important as well as a sufficient amount of rest and getting off your feet.  One can also use heat and ice on the painful area for 10 minutes at a time.  
It is also important to discuss with your physiotherapist different birthing positions for labour as you may be more limited due to your sciatica. Labouring in water is often preferred in this case as moving in water can feel easier. 
If you suffer from any type of back pain or leg pain during pregnancy and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.