Common myths during pregnancy

There is so much noise when it comes to what you should and shouldn’t be doing to have a healthy and active pregnancy, that it can be hard to tell what’s true and what is a myth.

We’re here to bust some common myths for you, and offer some advice about what things youcan do to have a healthy and active pregnancy.

Myth 1: You need to keep your heart rate below 140bpm when exercising.

NOPE! You do not need to keep your heart rate below 140bpm when exercising. In fact, the Australian Government Pregnancy Exercise Guidelines actually recommend vigorous activity for 1.25-2.5 hours per week whilst pregnant.

What is vigorous activity? It is activity where you are unable to talk whilst completing it because you are huffing and puffing, such as jogging, cycling, or swimming at a decent pace.

A better method of monitoring yourself whilst exercising is using the Rating of Perceived Exertion scale (RPE). This is a scale from 1-10, where 1 is easy, and 10 is flat out and could only sustain for a couple of minutes. During pregnancy Exercise & Sports Science Australia (ESSA) recommend sticking to 6-7 RPE or less during pregnancy.

Myth 2: Pregnancy hormones like relaxin make the pelvis loose and unstable and that’s why we get pelvic girdle pain.

WRONG! The pelvis stays strong and stable during pregnancy. Besides, if relaxin makes our pelvic ligaments unstable, why do some women remain pain free during pregnancy?

The reason some women develop pelvic girdle pain during pregnancy is complex, and more to do with the pelvic area becoming more sensitive during pregnancy.

Because our body is protecting our baby, it becomes more sensitive to changes in the area such as tight lower back muscles, tight glutes, or weakness in muscles that can cause pain.

There is also a link between pelvic girdle pain and incontinence, and a link between pelvic girdle pain and stress at work (Pulsifer et. al, 2022).

It’s recommended to seek help early, ideally within the first 2 weeks of pelvic pain occurring, as research shows that if you do this then you have a higher likelihood of the pain completely resolving.

Myth 3: It’s normal to leak urine during or after pregnancy.

It is COMMON, not normal. The Continence Foundation of Australia (2024) estimates that 1 in 3 women who have a baby will wet themselves at some point in their lives, so this is an extremely common occurrence.

However, leaking is not normal and there is something you can do about it - pelvic floor exercises!

How to squeeze your pelvic floor muscles: squeeze the muscles around your anus as if you are holding in wind. Studies have shown that this cue is the most effective for the majority of people.

Try starting with 10 x 2-3 second holds completed three times a day, and slowly build up to 10 x 8-10 second holds three times a day.

If you’re not sure that you’re doing your pelvic floor exercises correctly, book in to see a women’s & pelvic health physiotherapist for an assessment.

References:

Continence Foundation of Australia (2024). Pregnancy, childbirth and incontinence. Retrieved from: https://www.continence.org.au/incontinence/who-it-affects/women/pregnancy-and-childbirth#:~:text=Many%20bladder%20and%20bowel%20problems,or%20do%20exercise%20(stress%20incontinence)

Department of Health and Ageing (2021). Physical activity and exercise during pregnancy. Retrieved from: https://www.health.gov.au/topics/physical-activity-and-exercise/pregnancy

Pulsifer, Jodie & Britnell, Susannah & Sim, Adrienne & Adaszynski, Jessica & Dufour, Sinéad. (2022). Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain. British Journal of Sports Medicine. 56. bjsports-2022.10.1136/bjsports-2022-105724.

Hip bursitis? How your physio can help!

Bursitis is part of a cluster of hip problems that are known as greater trochanteric pain syndrome (GTPS). This is the fancy name for pain on the outside of the hip, that usually involves the glute muscle tendons, and the hip bursa.

The bursa is a fluid-filled sack that sits underneath the glute muscle tendons, and helps them to glide smoothly over the bone on the side of the hip.

Bursitis is when the hip bursa becomes inflamed and swollen, causing pain to the outside of the hip.

How does GTPS occur?

GTPS usually occurs because the hip stabilising muscles (gluteals) have become weak, which causes a change in the hip tendon structure known as tendinopathy. Tendinopathy can be painful on its own, but often causes bursitis as it can cause compression and irritation of the bursa.

GTPS can also be triggered by hormonal changes such as menopause. Menopause causes the tendons in the hip to become more brittle or less flexible, and more prone to developing tendinopathy and bursitis.

Most of the time it is a combination of the two that causes the problem.

Treatment for GTPS

1. Reduce / modify aggravating activities: try to keep pain 3/10 or less to settle the tendon down.

2. Strengthen the glute muscles- start with isometrics (holds against resistance) and slowly increase to functional movements, such as sit to stand and squats.

3. Do not stretch- this will aggravate tendon pain. Instead use a spikey massage ball to loosen up your glute muscles, and a heat pack can help as well.

Help! It’s not getting better!

If you need additional support, see one of our friendly physiotherapists for a thorough assessment and treatment plan for individualised management.

Back pain: Simple and effective exercises

Introduction: Back pain is a common ailment that affects millions of people worldwide. Whether it's due to poor posture, muscle strain, or underlying conditions, finding relief from back pain is a top priority for many. While medication and rest can provide temporary relief, incorporating physiotherapy exercises into your routine can help strengthen your back muscles, improve flexibility, and alleviate discomfort in the long term. In this blog post, we'll explore the five best exercises recommended by physiotherapists to combat back pain effectively.

1. Cat-Cow Stretch:

• Start on your hands and knees, with your wrists aligned under your shoulders and your knees under your hips.

• Inhale as you arch your back, lifting your chest and tailbone towards the ceiling (Cow Pose).

• Exhale as you round your spine, tucking your chin to your chest and drawing your belly button towards your spine (Cat Pose).

• Repeat this sequence, flowing smoothly between the two poses for 8-10 repetitions. This exercise helps improve spinal flexibility and relieves tension in the back muscles.

2. Bridge Exercise:

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.

• Engage your core muscles as you lift your hips towards the ceiling, creating a straight line from your shoulders to your knees.

• Hold this position for 5-10 seconds, then slowly lower your hips back down to the starting position.

• Aim for 8-10 repetitions. The bridge exercise strengthens the muscles in your lower back, buttocks, and hamstrings, which can help stabilize the spine and reduce back pain.

3. Bird-Dog Exercise:

• Begin on your hands and knees, with your wrists aligned under your shoulders and your knees under your hips.

• Extend your right arm forward and your left leg back, keeping your spine in a neutral position.

• Hold this position for a few seconds, then return to the starting position and switch sides, extending your left arm forward and your right leg back.

• Repeat this alternating movement for 8-10 repetitions on each side. The bird-dog exercise improves core strength and stability, which are essential for maintaining proper posture and preventing back pain.

4. Child's Pose:

• Start on your hands and knees, then sit back on your heels with your knees slightly apart.

• Lower your chest towards the floor, reaching your arms out in front of you and resting your forehead on the ground.

• Hold this position for 20-30 seconds, focusing on deep breathing and relaxing the muscles in your back.

• Child's pose gently stretches the muscles in the back, hips, and thighs, providing relief from tension and promoting relaxation.

5. Pelvic Tilt Exercise:

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.

• Engage your abdominal muscles as you flatten your lower back against the floor, tilting your pelvis upwards.

• Hold this position for a few seconds, then release and allow your lower back to arch slightly away from the floor.

• Repeat this movement for 8-10 repetitions. The pelvic tilt exercise helps improve pelvic alignment and strengthen the deep abdominal muscles, which can reduce strain on the lower back.

Conclusion: Incorporating these five physiotherapy exercises into your daily routine can significantly improve back pain symptoms and prevent future discomfort. However, it's essential to consult with a physiotherapist or healthcare professional before starting any new exercise program, especially if you have underlying medical conditions or injuries. Remember to listen to your body and stop any exercise that causes pain or discomfort. With consistency and proper technique, you can strengthen your back muscles, improve flexibility, and enjoy a life free from back pain.

Carpal Bone Fractures: Incidence and the major culprit (Scaphoid)

The carpal bones are a group of eight small bones in your hand. These include

• Scaphoid (Most common 40-70% in literature)

• Lunate (0/5% - 1% rare due to protected position in proximal carpal row)

• Capitate (rare due to its protect position in the middle of the carpus)

• Trapezium (4-5% of fractures)

• Trapezoid (0.5-1%)

• Triquetrum (2nd most common 4-18% in literature)

• Hamate (2% of all fractures (Hook of hamate often a golf club versus ground)

• Pisiform (<1% off all carpal fractures)

Scaphoid Fractures

The most common type of carpal bone fracture is a scaphoid fracture most likely because it is the easiest to identify on a plain x-ray in comparison to other bones. Having said that it can often not seen (known as an occult fracture) then an MRI or CT scan is recommended. Due to the blood supply which passes the bone and has a branch that reverts back the bone is at risk of death (avascular necrosis) or non union (not healing) therefore it is pertinent not to miss this injury.

Treatment in the acute stages is often splinting and review x-ray in 2 weeks is suspicious of a scaphoid fracture. Hand physiotherapist can make a splint to immobilise the wrist and this often includes the thumb. Once confirmed immobilisation can be from 6-12 weeks. With a injury like this it is recommended to work with your physio and sports physician (Sports doctor) to best guide the appropriate treatment pathway if conservative management is not appropriate.

Hulsopple et al (2017) Treatment of acute carpal bone fractures. Current Sports Medicine Reports