Changes to Clinical Pilates

You may have heard through the media or directly through your private health insurer about the changes to your ability to claim a rebate for "Pilates Classes". These changes come into effect on April 1, 2019 as a result of the Federal Government's Private Health Insurance Reforms.

For us, the only thing that will change for us is your receipt. Our classes, although called Clinical Pilates have always been individually tailored group exercises, drawing from a variety of exercise domains. They have been specific to each individual, regularly re-assessed and progressed. This will not change and we believe, has been one of the things that has made our classes different to a "Pilates Class". First and foremost, our classes are Physiotherapy and always draw from a wide range of evidence-based domains. 

There is a great article on the Australian Physiotherapy Association website, explaining the changes in detail https://australian.physio/advocacy/phi-pilates-reform. Otherwise, just ask us next time you're in.

Many runners believe that wearing the wrong shoe type for the foot is a leading cause of running related injuries (1). This belief stems from traditional shoe prescription methods where running shoes are prescribed on the basis of matching shoe features to foot type e.g. motion controlled shoes to pronated feet. 

Unfortunately there is a lack of conclusive evidence to support such beliefs (2).

There are currently five high quality research studies, which demonstrate that traditional shoe prescription does not prevent running related injuries in groups of novice runners, female runners or in military training populations (3-7). However a recent study has challenged these findings. In a group of recreational runners who were prescribed either a motion control or neutral shoe and followed for six months, a motion control shoe provided some protection against injury in runners with a pronated foot type (8).

With such conflicting findings, further high quality research is required to determine the most effective shoe prescription system (9).  In the meantime runners should understand that while other shoe prescription paradigms e.g. minimalist or maximalist shoes, are often suggested, there is no conclusive evidence that any shoe, regardless of type, is effective at reducing risk of sustaining a running related injury. However, there are strategies with proven efficacy that can help to keep reduce your chance of injury (see below). 

Important points to consider when purchasing a new pair of runners:

• Ensure the runners you select fit well and are comfortable to run in (2).
• Avoid making rapid changes to the type of shoe you have become accustomed to running in. For example changing straight to a minimalist shoe from a heavier motion control shoe. Instead make a gradual transition over several months (10).
• When improved running performance is a priority, select a lighter shoe model (11).
• Consider rotating between two or more pairs of runners for training. This has been shown to have a small protective effect against injury (12).

To reduce your risk of sustaining a running related injury, consider implementing the following strategies into your training routine:

Careful management of training loads is important to reduce injury risk.13Avoid progressing your total running load (e.g. distance, time, or intensity) by more than 5-10% each week to ensure your body has time to adapt to the training stimulus, and the risk of tissue overload is minimised (13).  Wearable technology such as GPS monitors can assist in monitoring training loads.  However, research has not yet determined what is the most important training metric e.g., duration, intensity, etc., when it comes to reducing risk of running related injury.

Completing a strength training program consistently 2-3 times per week for longer than 6 weeks has also been shown to reduce risk of overuse injuries in running populations (14) and improve running performance (15). For further information on strength training for runners click hereto read a recent blog on this topic.

Ensuring you are getting enough sleep i.e. 7-9 hours or more each night, is also important. For instance, adequate sleep may reduce the risk of stress fractures in running populations. Getting more sleep has proven beneficial effects on performance and recovery (16-17).

It is important to remember that the information provided above, although evidence based, is general in nature. Runners should consult a health professional who has experience working with runners for advice on reducing injury risk specific to their individual circumstances.  

1. Saragiotto, B. T., Yamato, T. P., & Lopes, A. D. (2014). What do recreational runners think about risk factors for running injuries? A descriptive study of their beliefs and opinions. Journal of Orthopaedic & Sports Physical Therapy, 44(10), 733-738.
2. Nigg, B. M., Baltich, J., Hoerzer, S., & Enders, H. (2015). Running shoes and running injuries: mythbusting and a proposal for two new paradigms: ‘preferred movement path’ and ‘comfort filter’. British Journal of Sports Medicine 49(20), 1290-1294.
3. Nielsen, R. O., Buist, I., Parner, E. T., Nohr, E. A., Sørensen, H., Lind, M., & Rasmussen, S. (2014). Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. British Journal of Sports Medecine, 48(6), 440-447.
4. Ryan, M. B., Valiant, G. A., McDonald, K., & Taunton, J. E. (2011). The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial. British Journal of Sports Medicine, 45(9), 715-721.
5. Knapik, J. J., Trone, D. W., Swedler, D. I., Villasenor, A., Bullock, S. H., Schmied, E., ... & Jones, B. H. (2010). Injury reduction effectiveness of assigning running shoes based on plantar shape in Marine Corps basic training. The American journal of sports medicine, 38(9), 1759-1767.
6. Knapik, J. J., Swedler, D. I., Grier, T. L., Hauret, K. G., Bullock, S. H., Williams, K. W., ... & Jones, B. H. (2009). Injury reduction effectiveness of selecting running shoes based on plantar shape. The Journal of Strength & Conditioning Research, 23(3), 685-697.
7. Knapik, J. J., Brosch, L. C., Venuto, M., Swedler, D. I., Bullock, S. H., Gaines, L. S., ... & Jones, B. H. (2010). Effect on injuries of assigning shoes based on foot shape in air force basic training. American journal of preventive medicine, 38(1), S197-S211.
8. Malisoux, L., Chambon, N., Delattre, N., Gueguen, N., Urhausen, A., & Theisen, D. (2016). Injury risk in runners using standard or motion control shoes: a randomised controlled trial with participant and assessor blinding. British Journal of Sports Medicine, 50(8), 481-487.
9. Napier, C., & Willy, R. W. (2018). Logical fallacies in the running shoe debate: let the evidence guide prescription. British Journal of Sports Medicine, Online editorial, Doi: 10.1136/bjsports=2018-100117
10. Warne, J. P., & Gruber, A. H. (2017). Transitioning to minimal footwear: A systematic review of methods and future clinical recommendations. Sports medicine-open, 3(1), 33.
11. Fuller, J. T., Thewlis, D., Tsiros, M. D., Brown, N. A., & Buckley, J. D. (2017). Six-week transition to minimalist shoes improves running economy and time-trial performance. Journal of science and medicine in sport, 20(12), 1117-1122.
12. Malisoux, L., Urhausen, A., & Theisen, D. (2014). Impact of training characteristics on running-related injuries in recreational runners. British Journal of Sports Medicine, 48(7), 631-632.
13. Gabbett, T. J. (2016). The training—injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medcine, 50(5), 273-280.
14. Lauersen, J. B., Bertelsen, D. M., & Andersen, L. B. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48(11), 871-877.
15. Rønnestad, B. R., & Mujika, I. (2014). Optimizing strength training for running and cycling endurance performance: A review. Scandinavian journal of medicine & science in sports, 24(4), 603-612.
16. Finestone, A., & Milgrom, C. (2008). How stress fracture incidence was lowered in the israeli army: a 25-yr struggle. Medicine and Science in Sports and Exercise, 40(11 Suppl), S623-9.
17. Bonnar, D., Bartel, K., Kakoschke, N., & Lang, C. (2018). Sleep interventions designed to improve athletic performance and recovery: a systematic review of current approaches. Sports medicine, 48(3), 683-703.

Surfing is an amazing sport and activity. It not only has physical benefits but has been proven to have profound psychological benefits. It is thought to bring sense of calm and tranquillity to those who surf, even if its only a quick session before work.

On a recent trip to Costa Rica, my husband and I thought we would embrace the local way of life and learn to surf. Now we had played around with mate’s surfboards in the past but had never had lessons or been out consistently. Full of confidence and ideas of popping up and surfing barrels, we started our surfing safari....How hard could it be......

Surfing is a highly aerobic exercise, which also requires a lot of muscular endurance and strength of the upper body. We found this out the hard way, not being able to lift our arms up the next morning after our first lesson.

“It not only has physical benefits but has been proven to have profound psychological benefits.”

Over the next few days, we noticed a few niggles in our lower backs and stiffness in our necks but gee we felt amazing. On reflection and being lucky to have Physiotherapy knowledge, we started to incorporate some stretching into our daily surfing routine.

Due to the repetitive nature of surfing, particularly paddling, the upper body, neck and shoulders can be prone to injury. Maintaining flexibility with dynamic style stretches may help prevent these types of injuries from occurring.

If you have glorious plans like we did, to start surfing or are returning to the waves after the winter hibernation, here are some stretches and mobility exercises to help prevent  injury and combat those niggles.

“Maintain flexibility with dynamic style stretches may help prevent injury”

Of course, if you are returning from injury or not 100% sure if these are appropriate, please feel free to drop us a line or book an assessment with one of our Physiotherapists.

Remember don’t bounce these stretches and don’t push into pain, it should feel like a gentle stretch.