General Fitness

Four years after the birth of my second child I was eventually diagnosed with hypothyroidism and Hashimoto’s Disease. It was a long journey to get the diagnosis, as although I felt very unwell, I was regularly advised that there wasn’t anything wrong with me. So, I just presumed all my symptoms were related to being a busy mum who ran a business.

The symptoms I was experiencing were:

• Lethargy / Fatigue
• Weight gain and fluid retention
• Depression / Low mood
• Sleep disturbance
• Breathlessness
• Dry skin
• Poor concentration
• Muscle pain and weakness
• Decreased libido
• Menstrual changes

Other symptoms that people with Hashimoto’s Disease experience are:

• Increased sensitivity to cold
• Thinning of hair and eyebrows
• Constipation
• Enlarged thyroid (Goitre)
• Decreased fertility

 

Hashimoto’s Disease is now considered the most common Autoimmune diseases and affects the thyroid gland (Beynon, & Pinneri, 2016). It usually causes hypothyroid symptoms, however, it is possible for Hashimoto symptoms to swing between hypothyroidism and hyperthyroidism.

Hypothyroidism (underactive Thyroid) is more common in women than men, with estimates that 10 times more women than men are affected. Hypothyroidism is typically gradually progressive, with symptoms increasing as thyroid function deteriorates.

Hyperthyroidism, or overactive thyroid, occurs if the thyroid gland produces too much thyroid hormone, causing every function in the body to speed up.

For me, the medication made a huge difference, but being a physiotherapist, I wanted to know more about my condition and what else I could do – especially in the areas of exercise and movement.

Exercise has been shown to be effective in improving thyroid-stimulating hormone (TSH) levels. Studies have shown that medium-intensity aerobic exercise (classified as 70% of a person’s maximum heart rate) produced the best results for improving TSH.  However, if exercise is too intense, too lengthy or too frequent, there may not be enough time for the body to restore normal levels of thyroid hormones T3 and T4.

Correlation between physical activity and signs of autoimmune flare-ups varies from one person to another.

For me, the perfect exercise turned out to be Pilates – I could work hard enough to get the intensity I required to support and stimulate TSH levels, without producing the negative reactions associated with over-exercising.  The other addition I made to my exercise routine was to start training with an Exercise Physiologist for my weights training and cardiovascular workouts. My EP was able to monitor me and understood the pathophysiology of Hashimoto’s Disease (I highly recommend Natalie Soldatenko at The Body Refinery).

 

Ten years on, I am feeling the best I have ever felt – I feel like I am 20 again. My advice to women experiencing any of the symptoms listed earlier, is to get your thyroid tested, and if a thyroid issue is identified, see an endocrinologist and start to exercise appropriately by training with someone who has the training to properly understand autoimmune conditions.

 

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Written by Susan Cottrell, Physiotherapist and Director of The Body Refinery

What’s the difference between registered and unregistered NDIS service providers?

Why would a service provider choose not to be registered with the NDIA?

What does engaging an unregistered service provider mean for an NDIS participant?

 

The Body Refinery works with many NDIS clients but is an unregistered service provider. The National Disability Insurance Scheme encourages service providers to register, however, this process takes a considerable amount of time, money and effort on behalf of the service provider. For this reason, there are many service providers who choose not to register. This effectively labels them as ‘unregistered service providers’.

One of the benefits of opting to be Plan-Managed or Self-Managed over Agency-Managed (i.e. by the NDIA), is access to both registered and unregistered service providers.

The word ‘unregistered’ can make some people feel uneasy, however, the term is misunderstood, and as a result, some participants miss out on the opportunity to work with a vast number of professional service providers who can help them achieve their NDIS goals.

Put simply:

• a registered service provider is an entity that has registered its services and has been approved by the NDIA as a service provider.
• an unregistered service provider has not completed this approval process, though can still offer a valid service to participants.

One key difference is that only registered providers can claim their invoices directly with the National Disability Insurance Scheme, whereas an unregistered provider will send invoices to you or your Plan Manager for payment. Participants who use the services of unregistered providers will need to manually claim funds back from the NDIS through their NDIS portal, or you can engage a Plan Manager to do this for you.

It’s important to remember that just because a service provider chooses to remain unregistered with the NDIS doesn’t necessarily mean that you can’t use their services. Unregistered service providers can offer NDIS participants essential and highly-skilled services that can assist the participant in reaching their goals. These services are still covered by the NDIS, though you may need to pay a gap if the price of the services doesn’t fall within the NDIS price guide.

There is minimal risk in engaging an unregistered service provider, with many of these service providers using their skills and dedication to improve the lives of people living with a disability.

Unregistered NDIS providers are not audited for adherence to the requirements of the National Disability Insurance Scheme Commission, however, physiotherapists and other health professionals already adhere to the requirements of their own professional industry body, the standards expected by their employer/practice and generally pride themselves on providing excellent patient care.

 

The Body Refinery offers a range of services that are covered under the NDIS, and the relevant team members are experienced in writing the care plans required for the NDIS.  We have existing relationships with many Plan Management companies to ensure that participants receive the highest quality of care.

If you’d like to see how we can ensure you are living your fullest life with the benefits of the NDIS, call our friendly admin team, who can arrange for you to speak directly with one of our physiotherapists, osteopaths, or exercise physiologists.

NDIS – National Disability Insurance Scheme
NDIA – National Disability Insurance Agency

Cross and strength training for running can help make you a more robust, stronger and efficient runner, thus reducing your risk of injury, making running easier and potentially benefiting your race pace.

If you look at the biomechanics of running, not only is it an integrated, full-body activity, it is also a series of single-leg movements. Thus, we need to have an adequate amount of single-leg balance, strength and mobility at the ankle, knee and hip, along with the slings and systems involved with upper body and pelvis rotation, counter-rotation, supporting the weight of the upper body and absorption of energy.

Here are 12 simple exercises you can incorporate into your easy run or cross-training days. Once you’ve mastered these and you’re looking for more variations and progressions, contact us at The Body Refinery to book in for a refined runner session and get the most out of your training time!

The goal is to get to 1 minute per exercise, completed with good form. Complete the exercises in chronological order from 1 – 12 – this is one set. You’re aiming to build up to 3 sets over time.

Start out on the ground – here we will wake our brain and body up to each other, you will increase your muscle and body position awareness in these supported exercises, ready to increase the challenge and integrate more movements further along in this exercise sequence.

• Supine bridges – focusing on gluteus maximus and hamstrings with some pelvic control from abdominals, progress to adding a single leg march.

• Side leg raises – focusing on pelvic stability and gluteus medius – our main pelvic stability muscle. Add a bottom leg lift for more core and inner thigh challenge

• Single leg stretch – a little bit of ab love while you’re controlling hip extension and flexion

• Thoracic mobility + spine extensor strength – FR mobilisation & dart/scare crow

• Side plank – an amazing exercise working on neck, shoulder, oblique, side hip + inner thigh and ankle strength. Add a twist to increase the oblique challenge and a top leg lift to really fire up those hip stabilisers.

• Plank – another amazing exercise integrating neck, shoulder, abdominal and quad strength + toe mobility. Add alternating leg raises or shoulder taps or both

• Clamshell push up

Now let’s bring this party up off the ground and integrate.

• Full squat, hands against a wall – working on upper back mobility and hip mobility with leg and hip strengthening
• Walking lunges – focusses on building single leg glute and quad strengthening.

• Dragon squat – mobility and stability! Involving hip, ankle, toes.

• Discobolus – single-leg hip stability, balance and strength coming at you

• Double leg hopping on the spot w leg hike – lower leg tissue recoil + hip & knee mobility and strength

 

Want a super quick session? No problems, go from number 8 – 12.

If you are looking for further support and guidance or prefer the motivation of training in a group, The Body Refinery is here to help. Our team of dedicated movement professionals deliver over 160+ group fitness and Pilates classes and many more individual and group studio Pilates, exercise physiology and clinical rehab sessions per week, in addition to having specialised running programs on offer.

We have you covered! Contact The Body Refinery today to find out how we can help.

Your posture during screen time

Have you heard of the chin poke posture or forward head posture, or text neck? As their name suggests it is the position we find ourselves forming when we’re deep into a solid Netflix binge, IG scroll session or when we’ve been concentrating hard at work or study. It looks like chin poking out, and hunched shoulders, arms out in front on a keyboard or holding or devices.

No judgement friends, only care.

If this is you (let’s be honest, it’s all of us right?!) this blog is here to help.

Here are a few ways you can minimise getting a sore neck and shoulders, along with some remedies if you’ve already gone too hard with screen time and need some smoothing out.

 

Why does it hurt and what’s the problem with being in this posture?

 

So glad you asked.

Technically forward head posture means your skull is leaning forward a few to several centimetres in front of the midline of your body – your ears are not lining up with your shoulders. You can test this by standing against a wall: does your butt, upper back and back of the headline up nice and easily on the wall? If not…forward head posture.

Gravity plays a huge role in how the body changes from prolonged postures. In this case, because the head isn’t stacked nicely on top, the weight of your head increases load through your neck and upper back joints and tissues, for every couple of centimetres your head is forward, there is approximately an additional 4.5kg of weight placed through these areas, potentially leading to stiffness and dysfunction, including headaches and soreness in the neck and upper back.

Additionally, lengthening and weakness occur to the ‘core’ muscles at the front of the neck, the postural muscles through the upper back, between the shoulder blades and at the back of the shoulders. While shortening and tightness affect other muscle, including at the base of your head and chest muscles. This can create dysfunction and discomfort in addition to reducing the strength and endurance to hold your head and upper back upright.

Further to this, other muscles can compensate for those that are weakened but can end up overactive, often becoming the cause of headaches and discomfort between the shoulder blades. Our ability to breathe properly and deeply is reduced, thus there can be reduced oxygen in our system and muscles – we can feel de-energised and achy around our fatigued postural muscles. The jaw alignment is not ideal in head forward posture, potentially leading to tightness and dysfunction. And upper body alignment in this posture can affect shoulder range and function.

 

How to avoid this

 

Take regular reset and movement breaks. If you can commit to this for a couple of weeks, you will increase your body awareness, improve postural strength, improve mobility and reduce tension. And you will be likely to continue this behaviour as it will become a habit.

Here are some stretch suggestions:

5-10 second Reset breaks regularly – do a quick body scan

• Sitting up from the sit bones, even pressure through both sides of your seat, spine upright in a neutral position- hopefully supported by a good chair, both feet on the ground, head sitting on top of shoulders. Shoulders relaxed, neck long and relaxed.
• Take a few deep, slow breaths in through the nose, down into the abdomen, expanding outwards into the lower ribs and up into the chest. Then slowly breathe out fully, pausing for a moment before the next breath.

Movement breaks

Mobility – Increase blood flow around the joints and tissues and improve the movement of the spine to make sitting upright easier.

 

In your seat:

• T-spine extension – Sitting up tall in your chair, extend back over the backrest, breathe in and exhale to return. Do several, they feel good!

• Mermaid – take your left hand out to the side, inhale, exhale as you curve your upper back in a C shape to open the ribs, reaching your arm overhead. Do at least 6 repetitions on each side.

• Bow and arrow – reaching arms in front, shoulder width and height reach one arm forward rotating your spine with it as you pull the other arm back like a bow and arrow, you’re aiming to rotate your upper body while keeping the hips square. Do at least 6 repetitions on each side.

• Shoulder rolls – get the blood flowing around your shoulder muscles by circling the shoulders forward 6 times and back 6 times.

Postural Strengthening

This will help you find a good posture with ease and have the endurance to maintain it. It will also allow to decrease the aching pain around your neck, shoulders and upper back.

• Cervical retractions – sitting up tall, draw the head back w a gentle chin tuck as if you were trying to get a double chin. Hold for a few seconds. You can progress this to standing against a wall and retracting your head to press the back of it against the wall for a few seconds. Or coming into 4 point kneeling and adopting the same retracted position through the head and neck and holding against gravity for several seconds before relaxing. Repeat 10 times

• Bruggers- sitting tall, take your arms in an A shape, Extend the arms back behind you, Rotate the crook of the elbow to face out, thumbs back and palms out. Squeeze in between the shoulder blades and hold for 30 sec to 1 min, 3-4 times, increasing a little more in time or sets as the weeks go on.

• Theraband rows – if you have a resistance band, tie it around something steady and about at navel level or higher. Hold the ends and pull the elbows back like you’re rowing. 15 – 20 reps.

• Dart – laying on the ground face down, arms along your side, extend your upper back, lifting your chest and upper ribs off the ground. Roll the shoulders back to open the chest, lift the arms off the ground and squeeze them up to the ceiling as you pull the shoulder blades together, hold for a few moments and lower. Repeat 5-6 times.

 

Stretching

Decrease tightness and tension in shortened muscles.

• Hip flexor stretch – Stand in a lunge position and as you drop your back knee toward the ground, tuck your bottom under and press the hips forward at the same time.

• Pectoralis major and minor stretch – Stand side on to a wall or door frame, place your forearm vertically on the wall or door frame with your elbow slightly above the shoulder, step forward with the body until you feel a stretch in your chest. Also in the door frame, slide your arm vertically up the wall until your elbow is higher than your head and walk forward until you get a comfortable, but deep stretch in the chest

• Upper cervical stretch – Tuck your chin in and tip your nose toward your chest, you can add some gentle assistance with your hand to deepen the stretch.

 

Further help is available at The Body Refinery

At The Body Refinery, we have a great team of movement and health professionals to help you further. Our physios are trained in headache assessment and treatment. You can book in for a massage to reduce tension and stiffness and restore muscle function and movement. And you can boost your strength, stability and mobility with our varied movement options – work out at home with our live virtual classes or your own membership to The Body Refinery Online. Come in for greater attention to your form and a tailored movement session with our Exercise Physiologist, Pilates Instructor or in a physio run clinical rehab session.