Thread: ITBS and squats

… Well you guys are obviously smarter than I am but there are two stretches I’ve found that seem to help. The two stretches are in the middle surrouned by the rest of what I do to recover from inattention, bad luck, or stubborness.
What I have found after having, golfer’s elbow, tennis elbow, screwed up shoulders to the point of not being able to turn the steering wheel without pain, sciatica and a screwed up mouse wrist is that no single modality works by itself. You pretty much need to throw the kitchen sink at it. Tendons are a goddamn pain to rehab.
Notice this is within the context of…
RICE and MEAT
Rest – If it hurts leave it, if it aches exercise carefully
Ice – 3 times a day and after massage, stretching and exercise.
Compression – Tensor bandages at night (it doesn’t take much compression to do the trick)
Elevation – leg up when convenient helps but it’s mostly a pain in the ass
Just RICE used to get me to no pain but it never got me strong.
MEAT
Mobility – Working the damn thing through it’s full range of motion DOES help. It was a key contributor to finally getting through my shoulder tendonitis.
In the case of my IT Bands I have such bad lower body flexibility that mobility work is essentially stretching.
I did a full range of stretching over the last couple of weeks.
back extension, flexion
groin,
quads
hamstrings
calves
… I can say for certain that better mobility in my shoulders has absolutely reduced my reinjury rate. (chronic slouch from a desk job and generally being a slouch). I am told the hockey kids often similar issues, shortening of tendons in shoulders from skating.
… I would guess that same will occur for the IT Bands IF posture issues are a causal factor (tight hips, tight piriformis, tight hams – and I have all of these)
The first stretch I found was the cure to my sciatica (tight piriformis pinching the nerve in my ass)

You can adjust this to emphasize the IT Band pretty effectively.
This is the second which is really a variation of the first

Exercise: Bill Starr’s Advice is exactly the thing and Mark has a sticky for injuries.
Analgesics: I tend to just Ice obsessively, I can eat ibuprophen by the handful and it just doesn’t do much for me.
Therapy: The foam roller isn’t bad for a day or two but the IT Band is just to deep and tough to get at with it. After a couple of minutes with the foam roller I pull out a 1 inch diameter stick I have from escrima and put some weight into it. With some elbow grease you can get a fairly decent massage with good piece of wood. After that I go to the A535 and thumbs and knuckles to dig in and rub the sore part with and against the grain. (followed by ice and a tensor bandage)
If I manage to get a good massage, I generally give it a day to heal because it usually feels a bit on the bruised side.
If I do ALL of these things then I feel better fairly rapidly although when my shoulders were completely buggered it took me the better part of 4 months to figure out how to heal them (I had tried to work through the pain for the better part of a year).

What Causes Knee Pain When Squatting, and How’s It Treated?

If you’ve experienced some trauma to your knee, make an appointment with your doctor to rule out fracture or other serious situations.

If you’re simply having some general pain when you squat, you may try treating your pain at home.

Change your activity

Look at how you’re moving throughout the day. You may need to change up your exercise or daily routine for some time while you’re experiencing pain.

Consider limiting or temporarily stopping activities that are causing you discomfort. If you don’t want to stop all physical activity, consider switching to cross-training that isn’t as tough on the joints.

Low-impact options include:

  • swimming
  • aqua aerobics
  • aqua jogging
  • cycling

R.I.C.E.

The R.I.C.E. method involves rest, ice, compression, and elevation:

  • Rest by stopping activities that make your knee hurt. You should also avoid everyday situations where you may need to put weight on your affected knee.
  • Ice by applying cold packs to your knee for 20 minutes at a time, several times throughout the day. You should never put ice directly on your skin, so cover your ice pack with a light towel or blanket.
  • Compress to prevent swelling. You can find elastic bandages at most drug stores. Resist the urge to wrap your knee too tightly. Light but snug tension is best. Be sure to leave a hole open over your kneecap.
  • Elevate your knee as often as you can. You can lie down and prop your knee up on pillows so it rests higher than your heart.

Heat

R.I.C.E. is a good method to follow if you believe your pain may be the result of sprains or strains. But applying heat to the knee may help if your pain is related to arthritis or stiffness in your joint.

Heat improves blood and oxygen flow to the area, but it can also increase swelling and inflammation.

You may use a store-bought heating pad for relief or make your own using everyday items like rice in a sock, or wet towels in a zip-top bag.

Medicate pain

Over-the-counter (OTC) medications may help ease your pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) are good choices because they help with both discomfort and inflammation. You may know these medications as ibuprofen (Advil, Motrin) and naproxen (Aleve).

There are other OTC pain-relief methods available, including creams and gels. Capsaicin, for example, is an alternative for people who can’t take NSAIDs. It’s a compound found in hot chili peppers and can be applied as often as 3 to 4 times a day for several weeks.

Consider massage

Massage with a licensed massage therapist can help ease tension in the muscles that surround your joints, giving you relief and helping to prevent future injury.

Sports massage may be best for injuries related to sports and overuse. The technique is similar to Swedish massage, but it focuses specifically on affected muscles.

Ask your doctor for recommendations for massage therapists in your area, and call your insurance company before your appointment to see if you have coverage.

What Athletes Should Know About IT Band Injuries

“Usually, hip weakness contributes to faulty movement patterns, and over time, that can cause the IT band to feel tight. Really the issue may be repetitive stress into a movement that’s less efficient. For example, a very common thing I see is the knee falling inward toward the other knee (think knock-knees) when someone is squatting, climbing or descending stairs, walking, or getting in and out of a chair. This puts a lot of stress on the IT band and can make it feel painful or tight. But again, it’s just a symptom of a problem elsewhere.”

“Generally, IT band problems are a symptom of dysfunction somewhere else.”

Dr. Keith Sparks of Kansas-based ICT Muscle & Joint Clinic agrees. He calls it “referral pain” that occurs from flawed hip movement.

The IT band is a thick band of connective tissue near your hips, and it runs along the outer part of your leg until attaching to the outside of your knee.

Since your IT band isn’t technically a muscle, it doesn’t contract, which means it won’t lengthen, stretch, or shorten. Instead, other muscles like your glutes, outer hips, and outer quads serve as a push-pull to the IT band; if those muscles become tight, it creates a tense or painful sensation.

Don’t stop working out while you rehab,

Your Other Muscles

“The IT band originates from the Tensor Fasciae Latae (TFL) muscle and the gluteus maximus, so these can be two sources refer pain down through the IT band,” says Patrick Suarez, a doctor of physical therapy in Arlington, Virginia.

“Making sure you are keeping this muscle not only mobile by stretching and rolling but strong, as well, will help reduce your chances of pain in the IT band. The IT band also ends at your tibia, just outside the knee, so proper joint mobility at not only the knee but the kneecap, can help. It is important to think about where the source of that pain or tightness might be coming from.”

Increased Activity

An increase in running mileage, or an extra-long intense workout, can cause pain and swelling associated with iliotibial band syndrome.

Usually, though, the culprit involves muscle imbalances, weakness, and a loss of flexibility in the hip flexors, hips abductors, internal rotators, and both gluteus maximus and medius.

Your IT band is intended to strengthen your knee, so when the surrounding or supporting muscles are tight, it forces your body to compensate—resulting in friction and compression on your knee area.

Check out these workout samples from Aaptiv. You’ll love them.

Can I fix a tight IT band?

“As with anything, relieving a tight IT band depends on what is causing the tightness,” says Vivian Eisenstadt, owner and chief physical therapist of Vivie Therapy in Los Angeles.

In her opinion, it’s usually related to one of two things: pelvis misalignment or foot pronation. The former happens when one side of your pelvis is rotated, which requires better hip alignment to make sure pelvis muscles function properly; the latter involves being “flat-footed,” which causes knees to buckle inward.

Going to a physical therapist or chiropractor can help with both, along with doing exercises to strengthen and support the arch of your foot.

Physical Therapist Lauren Lobert has a lot of experience in treating patients with IT band tightness and pain, based on her work as founder of APEX Physical Therapy. She sticks to four pieces of advice:

  1. Foam roll daily. “It hurts . . . a lot. Especially in the beginning. But, the more you do it, the less it hurts, I promise.”
  2. Strengthen your glutes. “You need a mix of gluteus maximus gluteus medius strengthening to ensure a more stable pelvis and fewer compensations. My favorite exercises requiring minimal equipment are single leg hip thrusts for gluteus maximus and side-lying extended range of motion hip abduction for gluteus medius.”
  3. Do single leg balance training. “Single leg balance training will help improve knee positioning and overall stability on even and uneven surfaces.”
  4. New footwear. “When all else fails, change your footwear or look into orthotics.”

Eisenstadt also recommends a number of methods to release tightness such as deep tissue massage and standing side stretches with crossed legs. Here’s one specific exercise, per Eisenstadt, that you can try at home:

Side-lying Adductor Straight Leg Raise

  • Start by laying on your side, with the leg closest to the floor out straight with your ankle flexed.
  • Keep the leg that is closer to the floor extended (straight following your torso, as if you want your leg to go behind you).
  • Bend your upper knee, cross your top leg over your bottom leg with top foot flat, perpendicular to your body (pointed away from you).
  • Keep your bottom leg extended at the hip, and raise it as much as possible towards the ceiling. Your leg doesn’t have to raise a lot; aim for tension on the inside of your moving thigh.
  • Repeat five sets of five and build up to three sets of ten.

Foam Roll

As mentioned above, using a foam roller is another popular way to address IT band pain, according to Suarez and Graff. “The most common way to relieve a tight IT band to use a foam roller along the outside of the thigh and roll your IT band, or perform stretching that includes bending pretty far to one side while trying to keep your leg grounded,” says Suarez.

“But, most people overlook where the IT band originates and where it ends, and these points can be critical to relieving discomfort and pain in the IT band.”

Graff suggests spending a little time with the foam roller on a specific, tender spot—even though that’s probably the last thing you want to do—and focus on taking deep breaths.

“Many times, when people just roll around , they’re tense because they’re holding themselves up, but they also hold their breath, which just feeds into the part of our nervous system that is contributing to that tension,” she notes.

Aaptiv has stretching programs that will help your IT band feel better. See a sample stretching class here.

Is a tight IT band preventable?

The best way to avoid a tight IT band is to continually strengthen your hips and glutes, stretch to keep muscles flexible and use a foam roller, when possible. Try to stay active versus sitting all day and be mindful of overexercising.

You can also ice your IT band to reduce inflammation during an episode, or switch to low-impact activities and give your body a break. However, these suggestions don’t always lead to a complete fix, so, if your pain persists, you may also want to talk to your doctor about additional treatment.

“It’s very valuable to go in and see someone and have them look at the way you move to see if that could be why things are feeling tight,” says Graff. “Otherwise, using a foam roller may only give temporary relief, because you’re just addressing a symptom and not the root of the problem.”

Ready to get started with Aaptiv workouts? View some of our sample workouts and classes here.

When you first start your business, you’re truly a one-man-band.

After a few weeks you’re gonna be envying the guy in the street, because he only has to worry about drums, symbols, feet tapping and an accordion.

You on the other hand, have to worry about website building, landing pages, conversion, analytics, tracking, SEO, paid advertising, sales copy, graphics, support, launches and social media.

Suddenly you feel like you’ve been upgraded, you’re now a one-man (or woman) orchestra!

But panic not, there’s a simple solution…

Get someone else to do some of the work for you!

I know, I know, you don’t think that you can afford it at the moment, and you may well be right. You’re probably just taking a bit out, and here I am, some a-hole, suggesting that you give your money to someone else.

But here’s the thang…

When you get someone else to do the work, yes you’re handing over a chunk of your cash, and yes it hurts.

However, you then free up your time to focus on the important things… like getting more customers so that you can afford to pay the people you’re handing your work to.

Yup, that’s how you build up a team of staff from scratch.

It’s not rocket science, but you do have to be prepared to accept reduced revenue in order to do it.

If you don’t want to do that, then you’ll only ever be able to scale your business to a certain level, because you’ll only ever be able to do a certain amount of work.

Personally, taking the hit is a short-term issue, scaling your business gives you long-term revenue.

It’s a no-brainer!

Michael

How to turn your one man band business into a market leader

With high-profile tech entrepreneurs consistently making headlines across the media, it’s all too easy to allow your personal achievements to feel dwarfed. If you’re constantly on the lookout for the next awe-inspiring rags to riches tale, you’ll appreciate how those individuals can gain almost rockstar status in young entrepreneur circles – like a wannabe superstar, you can work hard to reach those dizzy heights with your own start-up, but this is akin to starting a band with the aim of becoming the next Rolling Stones.

Guiding your start-up through the varying stages of success is an exciting prospect; after all, the journey is the most thrilling part of being a business owner. Although we’ve been conditioned to believe that it’s all or nothing and success must be imminent, I’m going to discuss the more traditional model that is: starting small, building a solid brand and growing on that success to create a long term, reputable company.

Referring back to the music analogy, this amounts to starting out on the local scene, building a fanbase, sparking interest in the media and ultimately retaining full control of your brand.

Starting a new business inevitably comes with varying degrees of risk, but as a risk-averse personality type myself, there are certainly ways to minimise that risk whilst still maximising your growth. For me, that meant reducing my outgoings, working three jobs, picking up new skills and learning on the job. Here, Adam Mezzatesta of live music agency Bands for Hire, discusses some of his recommendations to turn your one man band business into a market leader.

1. Reinvest profits and minimise personal outgoings

When you first start a new company, you’re going to revel in every enquiry, every social media mention and hopefully, every sale. As those sales turn to profit, you’ll need to reinvest every penny in order to take your business to the next level, and that may mean some cutbacks in your personal life.

My early career began as an independent musician (aka unsigned, struggling musician) and so I was already adequately trained up in this area. With sidelines that included a function band and web design moonlighting, I was able to juggle all three until the time felt right to focus my efforts on what mattered most. If you’re lucky enough to have a sideline or skill that you can utilise in parallel with your business, then this may be the right step for you. Remember that right now we’re talking about playing it safe – not everyone was born to risk it all and go for glory.

By keeping outgoings to a minimum and drawing a small income elsewhere, you’ll be able to build a steady cash flow, giving you the confidence to invest in marketing and other areas to speed up growth.

2. Work smart

In the early stages of your business, you may find yourself working as a one man band, taking on everything from product development, branding and marketing to networking, accounting and website maintenance. That can certainly be overwhelming, but by incorporating quality systems into your day to day work life, you’ll take the pain out of the mundane and increase your productivity threefold. For me, working smart means spending more time on something initially that will inevitably save you time long term.

A key aspect of working smart is reducing unnecessary administration time. As the owner of a booking agency, one of the first things I had to overcome was how to avoid typing the same email replies over, and over again. After a little research I came across an app called TextExpander which has many features to severely cut down on your typing, including boilerplate email replies, shortcuts for today’s date, general typo corrections and abbreviations for words that you almost always type incorrectly or just can’t be bothered to type at all!

Years later we introduced a web-based system to manage our bookings but still to this day rely heavily on TextExpander to reduce our daily workload.

Online accounting

It can be tempting to manually take care of your accounts using spreadsheets and invoice templates, but while this may seem like the easy way to begin with, eventually it will drag you down and you’ll have no choice but to move over to a web based system. From April 2019 all VAT-registered companies are required to submit returns digitally, so you may as well get started straight away.

There are a number of well-known accounting software solutions out there; we use Sage which ties in nicely with our payroll and card payments but other popular options are Quickbooks, Clearbooks, Xero and KashFlow. Most will offer free trial periods, so it’s worth playing around to find which suits your requirements best – transitioning from one accounting system to another is something you’ll want to avoid in the future, with so many other aspects of the business taking priory.

Utilise messaging apps

You may have lighting fast thumbs, but nothing beats the efficiency of having everything in one place. Companies such as Clickatell offer a full solution which allows you to send and receive SMS text messages online without the hassle of using your phone. If that’s a step too far for your current needs, then it’s definitely worth making use of the current apps on the market such as the desktop version of Whatsapp, the web-based version of Facebook Messenger and Apple’s desktop-based Messages – something which has revolutionised my daily working life.

There are a whole host of ways to improve productivity, from Adobe Sign to get your contracts and agreements signed off with ease, to the Sign feature on Apple’s Preview app to numerous free and paid software solutions for anything and everything.

3. Retain control

Going it alone isn’t the right choice for everyone, many businesses simply need the investment in order to move forward with a healthy cash flow. If growth in the first year is slower than expected, you may feel the urge to look for funding to accelerate that growth. On the other hand, if you’re happy to go slow and steady and have confidence in your product, retaining full control can often be the smart way forward.

If your company was a new band, you wouldn’t necessarily sign up to X-Factor in order to build a long and lasting music career – it’s far more realistic and rewarding to put the hard work in yourself early on than put your future in someone else’s hands.

4. Focus on your marketing – it’s free

Marketing is an area where you’ll undoubtedly be spending a lot of time and money, but this doesn’t need to be the case in the first year or two. By spending time researching social media marketing techniques and working hard on your Search Engine Optimisation (SEO), you should be able to gain enough momentum to dip your feet into the market and pinch that small market share that will get your business up and running.

SEO is a wide and varied form of marketing, but it’s something that can be done without a budget if you put the hours into research and exert the required effort. By cutting down on marketing spend in areas where you excel, you’ll have more budget available elsewhere, giving you the edge over your competitors.

“Having some form of web design knowledge will be extremely useful in the long run”

5. Learn basic coding

Regardless of the type of business you’re running, having some form of web design knowledge will be extremely useful in the long run. The very basics such as HTML and CSS can all be learnt for free online and will give you a massive advantage when it comes to reducing your costs early on – it’s perfectly acceptable to get your hands dirty with a little DIY in the first few years of starting out. Some basic web design knowledge will allow you to tweak and update your website without relying on third party companies and that’s going to seriously cut down on your outgoings.

If you’re up for the challenge, popular web-based languages such as PHP and Javascript are also very handy to know, even if it’s just for hacking a WordPress plugin that doesn’t quite meet your exact requirements.

6. Create a bespoke system

As your company grows, you may find you need a more robust way to organise your business, at which point it could be time to ditch the combination of online and desktop apps you’re currently using and create a bespoke software solution that fulfils all your needs. Creating a bespoke system will be costly and can be built in stages but is an essential step in order to increase your productivity and reduce the time spent on wasteful administrative activities.

7. Excel at customer service

As a one man band business the buck ultimately stops with you. With your name on the door, there’s no one better equipped to provide exceptional customer service than yourself – something which larger companies sometimes struggle to compete with. By offering more time per customer you can offer exceptional customer service catered towards each individual. With such a crucial advantage, you’ll be in a prime position to syphon away your competitors’ clients and edge your way forward into the marketplace.

8. Employ your first member of staff…sooner rather than later

Many entrepreneurs never get to the point where they take on their first employee and so remain a one man band forever. My biggest mistake in business was waiting too long to employ my first member of full-time staff and when I finally took the plunge it turned out to be one of the best decisions I’ve ever made.

You may find yourself in a favourable position where the business is thriving and you’re paying yourself generously, but this can be a dangerous thing for the entrepreneur – while it’s nice to finally be enjoying some financial freedom, short term gains are not the end game. If you’re thinking big, it could be time to loosen the shackles of the safety net and delve into the ugly world of recruitment, payrolls and pensions.

Young entrepreneurs with a hunger for success may be more than willing to take a gamble on a new business, but for others, taking the big leap to become a business owner can come with risks that are just too great to bear. If you work smart, work hard and never lose sight of the end goal then hopefully you’ll find that slow and steady can win the race… eventually.

Rare Disease Database

The causes and underlying mechanisms that cause amniotic band syndrome are complex and controversial. Several different theories have been proposed to explain the complex mechanisms that underlie amniotic band syndrome. The two main theories are known as the extrinsic theory and the intrinsic theory. The extrinsic theory states that amniotic band syndrome occurs due to factors found outside of the fetus (externally); the intrinsic theory states that amniotic band syndrome occurs due to factors found within the fetus (internally).

MECHANISMS
Extrinsic Theory
The extrinsic theory for the development of amniotic band syndrome is that strands of tissue separate from the inner layer (amnion) of the amniotic sac. The amniotic sac is the thin membrane that completely surrounds an embryo or developing fetus (amniotic sac). The sac contains a liquid (amniotic fluid), which supports, cushions and protects a developing fetus. The amniotic sac is composed of two main layers – the outer layer is called the chorion and the inner layer is called the amnion.

According to this theory, amniotic band syndrome occurs when the inner layer (amnion) of the amniotic sac ruptures or tears, exposing the fetus to strands of fibrous tissue that may float freely in the amniotic fluid or remain partially attached to the amniotic sac. These bands of tissue can disrupt the normal development of a fetus. The bands of tissue can wrap around or entangle (constrict) the fingers, toes, arms, legs and other parts of the developing fetus as when a rubber band had been tightly wrapped around an arm or leg or another body part. The symptoms that occur due to amniotic bands depend on the specific part of the body affected by these strands of tissue and how tightly they have wrapped around a body part. If the amniotic bands are still partially attached to the amniotic sac, they may wrap around a fetal body part and tether (anchor) that body part to the amniotic sac. This can restrict movement and proper development of the affected fetus.

Intrinsic Theory
The intrinsic theory was proposed because some researchers noted that, while the above theory explains some cases of amniotic band syndrome, it is insufficient to explain all cases. The external theory fails to explain why there is an intact amniotic sac in some infants with amniotic band syndrome; why there are a high number of malformations affecting internal organs in some patients; and why some infants have defects of parts of the body not affected by amniotic (constriction) bands.

The intrinsic theory attributes the development of amniotic band syndrome to impaired blood flow (circulation) to specific parts of the developing fetus (vascular disruption or compromise). The exact, underlying cause(s) of impaired blood flow is unknown. In areas where the blood flow is poor, injury occurs to the blood vessel walls of the fetus. This leads to bleeding (hemorrhaging) and tissue loss in the affected areas, which in turn results in the varied symptoms associated with the disorder. The intrinsic theory attributes the presence of constriction bands as a secondary effect of the impaired blood flow and subsequent damage to the fetus. In a 1987 article in the journal, Teratology, Webster, et al. demonstrated this theory of vascular disruption with an intact amnion in animal models.

CAUSES
Damage to the amniotic sac has been implicated as a cause of amniotic band syndrome under the extrinsic theory. The exact reason that the amniotic sac tears or ruptures is not always known and researchers believe that in some cases it may happen as a random occurrence.

In some cases, specific environmental factors have been identified. In some infants, trauma to the abdominal area during pregnancy or blunt trauma to the placenta seemed to have caused the amniotic band syndrome.

A few infants have been affected after the performance of a diagnostic technique chorionic villus sampling (CVS), when performed early during pregnancy. The prenatal test was performed to detect certain problems in a fetus such as chromosomal abnormalities or certain genetic disorders. During the procedure, tissue is removed from the placenta and certain cells called chorionic villi are studied. One estimate of the risk for this occasional risk was 1 in 2,000 CVS procedures.

It has also been reported that intense uterine contractions caused by a drug known as misoprostol (a prostaglandin E1 analogue) has resulted in amniotic band syndrome. Misoprostol is approved by the Food and Drug Administration for the treatment of gastric ulcers. However, the drug has been used to induce abortion. If the pregnancy continues after the use of misoprostol at 6 to 8 weeks of pregnancy, the infant may have the amniotic band syndrome.

The exact cause of impaired fetal blood flow as suggested by the intrinsic theory is unknown. It has been noted, also, that the amniotic band syndrome occurs with greater frequency in first pregnancies, problem pregnancies or premature births. Young women and women of African descent also have higher rates of infants with amniotic band syndrome. Research is ongoing to determine why certain populations have a greater risk of developing the disorder than other populations.

Some recent genetic studies have begun to identify intrinsic, genetic factors that may predispose infants to the development of amniotic band syndrome (genetic predisposition). A genetic predisposition to developing a disorder means that a person carries a gene, or more likely gene(s), for the disorder, but that the disorder is not expressed unless it is triggered or activated under certain circumstances such as particular environmental factors (multifactorial inheritance).

For example, a genetic predisposition to vascular disruption may contribute to the development of amniotic band syndrome in some cases. Two medical journal articles (Hunter, et al. and Carmichael, et al.) have discussed the possibility that genetic factors influence the development of amniotic band syndrome in certain pregnancies.

Although genetic factors are believed to play a role in the development of infants with some cases of amniotic band syndrome, the risk of recurrence in a subsequent child is extremely low. Most cases of amniotic band syndrome occur sporadically. Current, ongoing research into the potential intrinsic factors associated with amniotic band syndrome should reveal more about the complex causes and development of the disorder.

Sleeping Hip Pain In Pregnancy

As your body changes with pregnancy, so does your posture. Your baby bump will gradually develop and slowly stretch out your abdominal muscles and bring your centre of gravity forward. To compensate for this your lower back will arch more and your lower back extensor muscles become more active to cope with the increased load, resulting in general lower back ache and sometimes pelvic pain. This change in posture and position during pregnancy may also affect the muscles around the pelvis, specifically your deeper stabilising gluteal muscles, reducing their ability to work, and this in itself can lead to pain along the sides of the hips and occasionally along the outside of the thigh.

Most pregnant women first start to notice this type of pain or discomfort in bed. Lying on their side may become increasingly uncomfortable with a sharp ache developing at the outside of the hip making it hard to lie on their side for too long. So, due to not being able to lie on the back for too long, sleep can be difficult. Some women resort to sleeping while sitting! With an ever increasing baby bump you may notice more of a “waddle” with your walk, with the hips swaying from side to side as you take a step. This happens as your body starts to rely more on the structural/passive stabilisers to hold you steady like your Ilio-tibial band (ITB) instead of your muscles.

But there is good news! Physiotherapy can help to release the tight structures around the sides of the hip and through the lower back with soft tissue massage, gentle stretching, joint mobilisation and even dry needling. We can also teach your some simple stretches for the lower back, like the cat stretch, so you can continue to mobilise your lower back. We will also teach you some basic stabilising exercises for the gluteals and pelvic floor muscles to make sure all the right muscles are holding your body steady throughout your pregnancy. You can also try changing your sleeping posture by putting a pillow behind your back so you are not directly on your side to avoid direct pressure down through the hip, or tryng a pillow positioned between the knees.

If you are getting back or hip pain and tight hips uduring pregnancy come and talk to one of our Physio’s at Bend + Mend in Sydney’s CBD to see what you can do to change it.

6 Hip Opening Stretches To Do During Pregnancy

6 Hip Opening Stretches To Do During Pregnancy

July 20, 2018 by Nina Spears

Stretching and exercise is so important during pregnancy. Why, you ask? Well, now that you’re carrying around extra weight and fluids, it can make you feel sore, tired and downright uncomfortable. Stretching during your pregnancy helps relieve your aching joints, reduce muscle tension, relieve lower back pain, increase flexibility, help you relax, and, BEST of all, better prepare you for childbirth. All of these hip opening stretches are things that you can benefit from when you’re preparing to give birth. What pregnant mama doesn’t want that?

It’s time to prepare your body for labor by incorporating specific hip stretches into your prenatal workout routine. Remember that the hormones released into your body during pregnancy loosen ligaments in your joints naturally. This is intended to aid childbirth, but it also leaves you more prone to injuries. Get your doctor’s approval before beginning any new exercise regimen during pregnancy. If you experience any discomfort in your hips, stop exercising. Do not stretch a sore muscle. If there’s any pain, talk to your doctor.

(Note: Obviously, I’m not expecting, but I wanted to take some photos to show you these stretches so you can perform them safely.)

Butterfly / Tailor Pose

This is a fantastic hip opening stretch for the inner thighs, hips, and groin. This pose not only helps widens your hips, it also helps ease aches in your lower back.

  1. While sitting on the ground, bring the soles of your shoes together, allowing your knees to point out to each side.
  2. Grasping your feet or ankles, draw both heels in as close to your body as is comfortable.
  3. Lean forward slightly and hold that position. Focus on taking big deep belly breaths.
  4. For an even deeper stretch, press your thighs down with your hands or elbows to bring your knees closer to the ground. Hold that pose and focus on the stretch and your breath.

Squats / Garland Pose

Squats help strengthen your thighs and open up your pelvis in preparation for childbirth. Ina May said, “squat 300 times a day, you’re going to give birth quickly.” If I were pregnant, that’d be enough motivation for me!

  1. Stand with feet facing forward or slightly outward, shoulder-width or slightly wider than hip-distance, apart.
  2. Slowly and fluidly bend your knees and lower your body, extending the arms out in front for balance if helpful.
  3. Balance your weight on the balls of your heels and pause.
  4. Breathe and slowly rise back up and then repeat the action.

Hip Flexor Stretch

The hip flexors are the muscles at the top of your thighs that allow you to lift your knees and bend at the waist.

  1. Kneel on your right knee and put your left foot in front of you so your leg forms a right angle.
  2. Put your left hand on your left thigh for balance and put your right hand on your right hip or also on your left thigh.
  3. Keeping your back straight, lean forward and shift your body weight to the forward leg. You will feel the stretch in the right thigh.
  4. Hold for 30 seconds, then switch legs and repeat.

Pigeon

With this pose, you can use a yoga strap or yoga brick to help you ease into this hip stretch until your flexibility increases.

  1. Sit on your mat with one leg extended behind you.
  2. Bend your front leg to 90 degrees and, if sitting on a mat, walk your foot to the inside edge of your mat.
  3. Inhale as you lay your knee down flat (at the opposite edge of the mat).
  4. Hold for a few minutes and repeat on the other side.

Figure 4

This stretch is an excellent way to release the hips and tight glutes! You’ll be amazed by how much easier you’re able to move — and deeper you can squat!

  1. Start lying on your back with knees bent, feet flat on the floor.
  2. Lift right leg and cross right ankle over the knee.
  3. Reach hands around left leg to meet under thigh (as shown).
  4. Draw the left thigh towards you while keeping your torso pressed against floor.
  5. Use your right elbow to gently press right knee away from you as you draw thigh in closer.
  6. Hold for 3-5 breaths, deepening the stretch with every exhale, then switch sides.

Seated Straddle

  1. Extend both legs out wide with your feet flexed.
  2. Press your pelvis and hamstrings into the floor to help straighten your spine.
  3. Stay in this position if this is enough of a stretch for the backs of your legs, or walk your hands out in front of you.

Remember, stretching during pregnancy helps protect your freedom of movement and prevent muscle injury. It’s important to keep your muscles and joints strong and flexible for an easier labor.

If you don’t stretch during your pregnancy:

  • You could reduce your joint range of motion.
  • You could make your muscles become short and tight, so that they function less efficiently.
  • It can lead to spinal misalignment, which can cause mild to severe back pain and can cause specific muscle groups to tighten. Over time, spinal misalignment can distort the shapes of major muscle groups.

Other benefits of doing hip opening stretches during pregnancy are:

  • It helps bring oxygenated blood into your muscles, to give you more energy and help flush out toxins and lactic acid, so you’ll experience less muscle soreness.
  • If done properly with deep breathing, stretching also helps bring more oxygen to your baby to help him/her grow.
  • It helps keep you loose, calm and relaxed.
  • It keeps you flexible.
  • Stretching before and after exercise prevents injury and sore muscles
  • It helps to relieve physical and mental tension.
  • It helps to lengthen your muscles to permanently enhance your flexibility.
  • Stretching regularly helps to lubricate your joints so that they move smoothly and without pain.
  • Stretching regularly gives you a greater freedom of movement.
  • It helps counterbalance the biochemical effects that pregnancy can have on your body.
  • It can also help you cope with the psychological and emotional stress of pregnancy.
  • It not only helps you prepare for the birth of your child, but can help you get into the habit of taking time out for yourself to rest and rejuvenate before the demands of parenting become overwhelming, so that once your baby arrives you’ll remember that you need to take care of yourself in order to be able to take care of him.

The list goes on and on! So stretch those hips and pelvis, ladies! You won’t regret it.

Low back and pelvic pain is common during pregnancy.

What can do to help myself – Low back and pelvic girdle pain

A variety of factors can contribute to the occurrence of low back and pelvic girdle pain in pregnancy. Weight gain causing a strain on joints and a change in your posture, previous back or lower limb pain, fatigue, home or work activities resulting in repetitive lifting and bending and descent of the baby into the pelvic cavity in the last four weeks of pregnancy can all add strain on the joints of the pelvis and spine. This may cause pain in the low back and groin and may radiate to the hips, down the legs, into the abdomen or ribs at bra strap level. Initially you may find difficulty with working, turning over in bed, standing on one leg, driving and household tasks. You will find that the longer you do something such as walking the more pain you get and when you are tired at the end of the day it is generally worse.

Ways to ease back and pelvic pain

  • Avoid activities which cause pain and accept help from friends and family with household tasks
  • Avoid repetitive lifting or bending. If it is related to your work ask your employed for a work place assessment
  • Change positions frequently for example try not to sit for more than 30 minutes at a time
  • Maintain a good posture and achieve a balance of exercise and rest
  • Avoid constipation by eating a balanced diet and drinking regular fluids
  • Use an ice pack for ten minutes over the painful area. Repeat regularly. If you cannot tolerate this, warm baths or heat packs will help with muscle relaxation, massage can help.
  • Medication as recommended by your GP or midwife

See below for general advice about different activities and postures as well as other musculoskeletal conditions that can occur during pregnancy.

Standing Posture

Stand with your feet hip width apart facing forward. Check your weight is balanced between each foot with your knees straight but not locked. Relax your shoulders down, gently drawing the shoulder blades down and towards each other. Stretch the back of your neck by thinking of lifting the crown of your head towards the ceiling. Holding this posture, gently lift the pelvic floor, drawing your belly button to your spine (as if tightening your belt one notch tighter than usual). Try to maintain this tension when working in standing and avoid stooping when doing activities such as washing up. If you work in standing it may be useful to lean against a wall, bend your knees and gently tilt your pelvis backwards so your spine flattens to the wall.

Walking

It is important to take regular walks to maintain your fitness. If you have a lot of pain when walking, avoid uneven surfaces such as cobbles and the beach. Try to maintain the upright posture developed in standing, think about “walking tall”, maintaining gentle tension in your pelvic floor and abdominal muscles (belly button to spine) to hold your hips level. Walking up hill requires a stronger contraction through the abdominal muscles to maintain the best possible posture. Don’t allow yourself to “waddle” side to side. When your heel contacts the ground gently squeeze your buttock muscles to help you stay tall.

Bending and Stretching

When picking up objects or doing housework such as loading the washing machine bend the hips and knees not the spine. If you contract the abdominal and pelvic floor muscles as you are bending or reaching this supports the back. Take care not to over stretch and avoid squatting.

Carrying

Everything should be held centrally, close to the body or split the load so it can be managed equally left and right for example use two smaller shopping bags or a rucksack. Ensure you avoid carrying heavy handbags, the vacuum or toddlers. If you have to lift get as close as possible to the load to be lifted e.g. toddler, washing basket, Moses basket, vacuum, buggy and use the strong muscles of the legs to push up with whilst keeping the back straight and drawing in the abdominal and pelvic floor muscles.

Sitting posture

Sit with your feet hip width apart, facing forward and heels positioned under knees. Try to position the hips at a right angle, with weight equal between left and right sit bones. Using a small rolled towel at waist height supports the natural curve of your lower back. Your shoulders should be relaxed with shoulder blades gently pulling back and down towards each other. Stretch the back of your neck by thinking of lifting the crown of your head towards the ceiling and drawing the chin back. Whilst holding this posture, lift the pelvic floor and gently draw belly button to spine. Ensure you sit on seats that give you support; you may need to use cushions to support your spine when relaxing. Avoid sitting on low chairs, with the legs crossed or tucked up sideways on the sofa. Sitting in these positions can make your pain worse.

Getting out of a chair

Shuffle your weight to the front of the chair then lean to bring your nose over your toes before pushing up with the legs to stand. Avoid twisting whilst standing up, especially if holding any type of load.

Sleeping

Avoid sleeping flat on your back after week sixteen of your pregnancy. When lying in bed lie on your side with one or two pillows under the top leg to keep it parallel to the ceiling. If one side of your pelvis is more painful than the other, lie with that side uppermost. If you wake in pain get up and walk around the house until the pain eases. When lying down a small pillow under your bump can give support also. When turning over in bed, bend your knees up towards your hips, keep them together. Turn your head in the direction you want to move and reach your arms over in the same direction. Keep the knees pressed together and roll onto the opposite side. Don’t sit up from flat before you roll as you may notice your tummy “doming”. When getting out of bed, roll onto side, lower legs over side at same time as pushing up with your arms. Keep your legs bent to aid in the motion of getting up. It is important to contract the abdominal and pelvic floor muscles firmly throughout any rolling or twisting movements.

Relaxation

Practicing relaxation during your pregnancy will help you to rest more effectively and comfortably. Often when we are tired and have discomfort we can feel tension. Tension causes an increase in blood pressure, heart rate, and rate of breathing which can lead to feelings of panic and loss of control. Using relaxation can help reduce, or prevent, tension from building up and can be used during labour may be able to cope better with the pain and feel more in control.

Exercise to help low back and pelvic pain

You can use a combined exercise of the pelvic floor, abdominal and back muscles together which can help ease back and pelvic pain. In standing, lean against a wall with your feet slightly away from the wall and your knees slightly bent. Gently pull in your lower pelvic floor and abdominal muscles and flatten your back against the wall. Hold the contraction for ten seconds and aim to repeat ten times at least three times a day or if you are experiencing back pain.

Diastasis Rectus Abdominis

The abdominal muscle has three layers. The rectus abdominis muscle is the layer under the skin which meets in the midline at the linea Alba, which is a fibrous band running from the bottom of the breastbone to the top of the pelvis. This muscle works strongly when coughing and lifting. The obliques are deeper abdominal muscles which allow you to twist and rotate at the waist. Underneath these muscles is the transversus abdominis which acts as a corset stabilising the spine during movement and controlling posture.

Diastasis is more noticeable in the later stages of pregnancy. You may notice that as you get out of the bath or as you sit up from lying that your tummy “domes” and when you are walking you want to support the tummy. During pregnancy the muscles and the linea alba stretch, thin and lengthen over your growing baby, causing weakness and poor control of movement. With a severe diastasis (up to 20 cm) the back is at greater risk of strain therefore appropriate exercises from your physiotherapist is important. A small diastasis (3cm) often gets better by itself.

Ways to minimise a diastasis

It is important to avoid heavy lifting or sitting up from lying incorrectly, as this may cause bulging and widening of the muscles. If you have a toddler you must take great care to avoid carrying them on your hip, lifting them and putting them in the car or bath as all these activities can overstretch the abdominal muscles and cause pelvic pain. Avoid high impact exercises such as aerobics; zumba and boot camps also sit ups and advanced abdominal exercises unless instructed. If you find your diastasis bulges during coughing, sneezing and opening your bowels Use your hand to support your abdominal muscles.

Abdominal exercises to help diastasis

To exercise the abdominal muscles lie on your side with your knees bent placing your hand on the lower part of your tummy under your bump. As you breathe out, gently draw in your lower tummy away from your hand towards your back. Hold for a count of ten continuing to breathe in and out as normal and then relax. Repeat this exercise ten times, three times as day. As you progress you can practice this exercise in sitting or standing. Try to use this muscle during any activity requiring effort, for example vacuuming, shopping or getting up from a chair.

Antenatal Carpal Tunnel Syndrome

During the later stages of pregnancy you may notice that you are retaining fluid and that you have swollen hands and ankles. A fibrous band across the wrist protects blood vessels, nerves and muscles as they pass into the hand. The area beneath this band is called the carpal tunnel. Swelling under this band causes compression of the nerve and blood vessels, which supply the muscles, and skin. This gives symptoms that may include:

  • Swelling
  • Tingling or pins and needles affecting the thumb, palm, and fingers of one or both hands
  • Numbness
  • Night pain
  • Hands may be hot and sweaty and mottled in appearance
  • Difficulty holding/gripping objects
  • Pain/swelling in the forearms.

Please note if the swelling becomes severe, affects your face or gives you headaches you must contact your midwife immediately.

Ways to help the symptoms

  • Remove all rings, watches and tight clothing which may restrict circulation.
  • When resting keep your hands elevated on pillows and clench/ release your fists several times to improve the circulation.
  • If your hands are particularly swollen use an ice pack or plunge your hands in to a bowl of iced water for up to ten minutes
  • Use resting splints at night to keep your hands in a good position. These can be provided by your physiotherapist. If you have pain in only one hand, avoid sleeping on that side.
  • At work avoid taking weight through your hands and keeping your wrists bent for long periods. Keep your wrists in a neutral position when using computers or working on a cashiers till. You can use your splints throughout the day to support your wrist.

Ribflare

This is the name given to discomfort over your lower ribs that is caused by your growing baby lifting your ribs up and out from their normal position. Try not to sit for long periods especially in the car and avoid sitting on low chairs. Stand without leaning backwards trying to keep your abdominals in a shortened position. Stretching exercises will help especially if you gently contract your abdominal muscles, try lifting your arm on the painful side to the ceiling then bend sideways away from the ache. Sleeping on the unaffected side with your arm stretched forwards on a pillow.

It band pain when squatting

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