pregnancy physio at a womens health sppointment pelvic health

Are you experiencing increased urinary frequency or urge?

Feeling the need to go to the toilet frequently is much more common than most people realise. This can be accompanied with or without urinary leakage. This leakage can be only a few drops and others may experience larger amounts to almost complete emptying of the bladder.   

What is increased urinary frequency?

As with many things in life, everyone is different. This also applies to normal urinary frequency (the amount of times you need to empty your bladder a day). For most people, the normal number of times is between 6-7 in a 24 hour period. However, between 4 – 10 times a day can also be normal if that person is healthy and happy with the number of times they visit the toilet. It can also depend on the amount of fluid you drink, what you drink or if you take certain types of medications.

What is increased urinary urge?

Urinary urgency occurs when the pressure in the bladder builds suddenly, and it becomes difficult to hold in the urine. This pressure can cause a strong and immediate sensation that you  need to urinate. Urinary urgency can occur regardless of whether the bladder is full or not. It can also make a person want to urinate more frequently than usual. 

What causes increased urinary frequency and urinary urge?  

There can be several reasons why you may experience this and one should always seek advice from the appropriate health care provider. Your GP is a good start however, sometimes a pelvic health physiotherapist may be able to assist further. 

Commonly urinary frequency and urinary urge are caused by a miscommunication between the brain and the bladder. When we don’t have any issues,  the bladder will fill up to an appropriate amount before telling the brain that it’s time to go to the toilet. With increased frequency and urge this pathway is disrupted. This can be caused by several factors and a good place to start finding the route problem is by filling in a bladder diary.  

How do I fill in a bladder diary?

A bladder diary is used to record how much liquid you drink, how often you need to urinate and how much urine you pass. It can be extremely helpful to understand your bladder habits.  When writing a bladder diary you should include the exact time for intake of both fluids and solids, the amount voided (urinary output) and the sensation of urge at the time. Any leakage should be included, ideally in detail ( quantity/ did you have to change your underwear/sanitary towels?). Remember: the more detailed the better. It can be useful to  complete the bladder diary over a minimum of 3 days, ideally both weekdays and weekends to get a good idea of what your “normal” is.  

I’ve completed my bladder diary – what now? 

Ideally you will now have seen a pelvic health physiotherapist to help guide you at this point. This is to see whether you are voiding appropriately or not and what the suggested plan of action may be to address the frequency issue, or if there are any other factors contributing to your symptoms.

Parts of the treatment can be bladder retraining. This is based on teaching the bladder to only tell the brain that it’s appropriate needing the toilet when there is an appropriate amount of fluid in the bladder.  The treatment may also include pelvic floor muscles strengthening  or relaxation.

How do I retrain the bladder for increased frequency?  

You may get asked to try to delay going to the toilet when treating increased frequency and urge. This can feel extremely overwhelming and lead to increased anxious behaviour for many. Feeling anxious and stressed can often make the problem worse. Therefore, when starting to retrain the bladder you can do this when in the comfort of your own home at first. 

 When you know you have recently been to the toilet and it’s not appropriate to go again so soon, try to delay but only aim for 5 minutes. If you set the bar low at a manageable level, this will help reduce the risk of feeling stressed and increase your symptoms. Trying to divert your thoughts is helpful. Find a small and easy task, such as emptying the dishwasher or checking your email. Try to relax as much as possible and breathe calmly. 

Now, if after 5 minutes you still feel the urge to go, allow yourself to go. You will gradually increase the time you are able to delay and you should focus on being as calm and collected as possible when you take yourself to the toilet.  

Having good control of your pelvic floor is also extremely helpful when treating increased urinary frequency and urge. You can read more about the pelvic floor here.

 We always advise seeking help when experiencing these symptoms,  we know their common but also know that there’s much to be done about this. A specialist pelvic health physiotherapist is a good start. Don’t let your bladder dictate your day! Here at Physiofit we have some expertly trained pelvic health physiotherapists and if you would like to discuss any symptoms further please contact us on  01223 914140 or  e-mail us on  enquiries@vineryroadstudios.co.uk

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How to maintain spinal flexibility without straining your joints in pregnancy

Pregnancy puts a lot of strain on the joints and soft tissues of the body. Your weight increases as the baby grows,  your posture changes to allow for this to happen and prepare you for labour and there are major changes to your hormone levels. Exercise and stretching can have many benefits to overcome any aches that all these changes can bring about but there is also some danger of overstretching.

Am I more flexible during pregnancy?

In some ways yes. During pregnancy,  the levels of a hormone called relaxin increase. The function of relaxin is to loosen or relax the ligament of the pelvis and soften and widen the cervix in  preparation for birth. However it doesn’t just affect the ligaments of the pelvic but the ligaments in your entire body. Ligaments are tough fibrous structures that hold two bones together in our joints. When  we have increased relaxin, the ligaments allow our joints to move slightly further than they would if we were not pregnant.

Isn’t increased flexibility a good thing?

Good flexibility is a great thing however, the increased ability of your joints to move in pregnancy can allow you to overstretch in activities like yoga or sustained stretching routines. For this reason, stretching too enthusiastically can be harmful, as it may cause injury.

How can I avoid overstretching?

To avoid any potential problems, have a look at the tips below:

  • Warm up.  A gentle warm up before you begin is essential as stretching cold muscles can cause injury. The warm up may consist of a few minutes of walking, squats or knee raises making sure you are moving all the parts of your body you are going to stretch.
  • Pre-pregnancy level: During pregnancy you should not be aiming to improve your flexibility just maintaining it. Try not to go deeper into poses than you could before pregnancy and then you know you are working in a safe zone. If you are new to stretching then  gentle and slow should be the aim.
  • Don’t bounce. Bouncing while you’re stretching can result in a pulled muscle. Instead, focus on holding each stretch for 20 to 30 seconds, getting as far as feels comfortable and holding at that spot.
  • Listen to your body. If it feels uncomfortable then ease off on the stretch and limit yourself to a range of motion that feels good, never painful. Don’t overdo it. 

Strengthening exercises: Strengthening the abdominal and glute muscles can help manage the postural changes that occur, and when you are stronger you can hold your body back from moving into over stretched positions.

Are there any stretches I should avoid during pregnancy?

It’s safest to avoid stretches that involve deep backbends. In pregnancy our lower back and pelvic posture changes and moves more into an anterior tilt. This will naturally put more strain on your lower back. If you also stretch deeply into a back bent this can overload the joints and start to cause discomfort.

Also be sure to avoid lying flat on your back for extended periods of time after the first trimester.

Still not sure what movements are safe?

If you are still unsure what stretching exercises you should be doing why not book an appointment with one of our specialised physiotherapists who will be able to guide you through a safe exercises routine that aligns with your goals. We also offer on-line pre and post natal pilates classes which would be ideal for any pregnancy. If you would like to book an appointment or any further advice please do not hesitate to contact us on 01223914140 or email us on enquiries@vnineryroadstudios.co.uk

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Shin splints, stress fractures and shin pain - exercises, treatment and advice

Shin pain is quite a common sports injury and is more likely to occur if you have just taken up running, started running again after a break or if your sport involves jumping and landing frequently, basketball for example.

There are two areas which are generally affected; the muscles at the front of your shin (anterior compartment) or the shin bone itself (tibia). Distinguishing between these two areas is vital because they are different issues and require different treatment.

Muscular shin pain (Chronic Exertional Compartment Syndrome)

Chronic Exertional Compartment Syndrome (CECS) is the medical term for muscular shin pain caused by an increase in pressure which comes on while running.

If your shins become tight and sore roughly at the same point into a run, gradually increase as you keep running and then ease off quickly at the end, then your shin pain is likely to be muscular.

An increase in pressure in the anterior compartment can actually cause nerve compression, so pins and needles, skin numbness or muscle weakness can also be signs of this condition.

Home treatment techniques for muscular shin pain include:

  1. Ice: make an ice massager and use this to massage in small circles along the muscle for 3 – 5 mins.
  2. Taping to support the muscles, provide gentle compression and relieve pain.
  3. Gentle foam rolling when this is comfortable.
  4. You don’t have to stop running entirely, just adjust the distance or pace to a comfortable level or try running on a treadmill until your symptoms settle.
  5. Compression socks help some people while running, so this is definitely worth a try.

Shin bone pain (shin splints and stress fractures) 

Bone pain at the bottom on the inside of your shin is commonly called Medial Tibial Stress Syndrome (MTSS). Shin pain which is worse on impact and not only increases during your run but persists afterwards, means that you are more likely to be experiencing bone, rather than muscular pain. You may also notice tenderness on the bone when you press directly onto the painful area.

If you suspect that your shin pain is coming from the bone, rather than muscle, then you must stop running. Continuing to push your shin bones can lead to a stress fracture, so it’s really important that you rest entirely for about 2 – 4 weeks to let the pain settle. If you actually have a stress fracture, this last for up to 6 weeks.

Ice packs and painkillers can help to relieve pain and you should not consider a ‘return to running programme’ until you can press on your shin bone without any pain at all and hop on the spot at least 20 times, without any pain.

Treatment and exercises for shin pain

I would strongly recommend a physical assessment to give you a proper diagnosis and also help you identify the underlying causes. Anything from weakness around your hips to training errors like sudden spikes in your distance or pace, inefficient running techniques, tight or weak calf muscles or always running on hard surfaces all have the potential to cause shin pain.

A physiotherapist might recommend a course of Shockwave Therapy to relieve pain and improve tissue healing in both muscular and bone pain and provide a programme of corrective exercises specific to your individual issues and movement patterns.

Our simple knee programme will help you start to build strength and control around your hips, knees and ankles in the early stages of rehab:

For more advice or information about shin pain, don’t hesitate to get in touch!

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What type of training is TRX and why is it recommended

Want to stop injuring your neck and shoulders while doing press-ups and pull-ups?

This may sound harsh but in many cases, one of the biggest causes of injury during these moves is a lack of upper body strength. Simply put, you may not be strong enough for what you are attempting to do.

So to avoid neck, shoulder and upper back issues, try building up your strength using a TRX weight suspension system. Most gyms now have them but you can also buy your own, fairly inexpensively and use it at home.

The TRX is a nylon adjustable strap ending in hand hoops that can be fixed to a wall or overhead beam or bar. If using at home, you can also attach it to a door frame (as per the manufacturer’s instructions).

Exercise 1: Incline press up on the TRX

Stand with your hands in the loops and then lean forward, putting some weight through your arms and keeping your shoulder blades back. Bend your elbows until your chest is in line with your hands. Push firmly through the handles until your elbows are straight again. Once your elbows are straight, press through your hands allowing your shoulder blades to slide apart, then pull them back together again and repeat.

The forward and backwards movement of the shoulder blades are very important, as this helps to create strength and control during transitions between movements.

Exercise 2: TRX rows

Our second exercise is exactly the same as the first but in reverse.

Hold on to the handles and this time lean backwards until your weight is supported by your arms and you are resting on your heels. Pull your shoulder blades backwards, then, keeping your body straight, pull yourself forward by bending your elbows until your chest is in line with your hands. Slowly lower yourself again, keeping your shoulder blades back. Once your arms are straight again, allow your shoulder blades to come forward. Then they pull them back together and start again.

Start with 3 sets of 10 reps progressing to 15. Once you are able to complete this number comfortably and with good control, make the exercise harder by lengthening the TRX to make the incline greater. The closer you are to the floor, with both moves, the harder the exercise.

If you have any questions at all, please don’t hesitate to contact us at our Cambridge clinic. 

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What should I do if I sprain my knee?

What is  a knee sprain?

A knee sprain is a stretching or tearing of the ligament in the knee joint. Ligaments are tough bands of tissue that connect two bones together in your joint. A knee sprain can occur when you injure or twist your knee awkwardly and may cause you to experience some pain, swelling and/or bruising in and around the knee initially following injury. The swelling may appear immediately or after some time. You may also have difficulty bending and straightening the knee and struggle with walking.

How can I sprain my knee?

A knee sprain can occur when you injure or twist your knee awkwardly. They are common in athletes who engage in fast-paced sports, such as football, basketball or hockey. 

Most knee sprains occur as a result of:

  • Direct impact on the knee from an outside force ( such as a fall onto the knee or a kick)
  • A sudden stop or change in direction when moving at speed 
  • Over-straightening of the knee joint 

What should I  do if I sprain my knee?

If your knee injury is serious, that you are unable to weight bear or your knee is giving away when you put weight on it,  you should seek immediate medical attention. You may wish to go to A&E  or seek advice from a physiotherapist.

If your injury seems less severe (although this can still be painful and limit your mobility and function) follow the POLICE principles to help reduce your pain and help you to recover.

  • Protection. Protect your injury from further damage. You’ll need to rest for the first 48-72 hours following the injury. Depending on the injury, consider using some form of support or a splint.
  • Optimal Loading. Get active sooner rather than later. Start active mobilisation and flexibility exercises as soon as tolerated without excessive pain. the longer you  rest the more muscle waiting will occur and your overall recovery will take longer.
  • Ice. Apply a cold compress such as a bag of ice or frozen peas, wrapped in a towel onto the painful area. Do this for around 15-20 minutes every 2-3 hours for the first 48-72 hours following the injury. 
  • Compression. Compress the injured area with a simple elastic bandage to help control swelling. This bandage should be snug but not tight and also should be removed before going to sleep. 
  • Elevation. Elevate the injured area, while sitting or lying down, supported on a pillow, to help keep the swelling under control. Avoid prolonged periods with the leg not elevated.

Consider arranging medical review/referral to physiotherapy after 5–7 days, if symptoms are not improving as expected (for example if you are still experiencing difficulties in walking or weight-bearing) or if symptoms are getting worse (such as increased pain or swelling) the physiotherapist will be able to access your knee and  give you a detailed rehabilitation programme to  progress you back to your previous level of activity.

What exercises can I start doing?

Isometric quadriceps:

Sit with your leg out straight. Tighten your thigh muscles trying to straighten your leg as much as comfortable and hold for 30 seconds. Repeat 10 times.

Active Straight leg Raise (ASLR):

Sit with your legs out in front of you. Tighten your abdominals and your thigh( quad) muscles. Breathe out to lift your leg 5 cm  off the ground and hold it  with the knee straight. Count to 5 seconds and lower slowly. Repeat 10 times.


Active knee flexion ( bending) in supine and/or sitting:

Sit on a chair with your feet on the floor or sit with your legs out straight.

Actively bend your knee as much as possible. Use a towel to help slide your knee underneath if sitting on a chair.
Repeat 10 times.

If you think you may have sprained your knee and want to book an appointment with a specialised physiotherapy or have  any questions do not hesitate to contact us.

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Physiotherapy Cambridge, Physiotherapist Cambridge, Physio in Cambridge

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Chronic pain Physiotherapy treatment -Chronic Back pain - Cambridge Physiotherapy and Sports Injury Clinic

Easy desk stretches you can do at home or in the office

With so many of us having careers which allow us to work from home, working on the computer can sometimes give us even less reason to get up and move around, it’s not surprising that you might feel a bit chair-shaped by the end of the day.

Temporary workstation setups – at a kitchen table or using a laptop on the sofa – don’t help either, as you may not have the same supportive setup you would have in the office.

Your neck, upper back, shoulders and lower back are common places for aching and muscle tension to gradually accumulate. Feeling stiff and uncomfortable in these or any other area of your body can not only affect your concentration and productivity but may develop into a more significant pain problem if you ignore it. So getting into the habit of changing positions and moving frequently during your working day is absolutely vital and our quick and easy programme of desk stretches is designed to help you stay on the move at work, without even getting out of your chair.

While incorporating movement into your working day is the key, this can be difficult to achieve if you have deadlines, back-to-back online meetings a heavy workload, or even all three! So we recommend a simple strategy called ‘habit stacking’ to make new habits like your desk stretches more memorable and stick with you for the long term.

Habit stacking is a simple method which can help you break up your working day by pairing your new ‘stretching’ habit with an existing workplace habit to help you remember and to help the new habit stick. It’s a really effective way of making long-term healthy changes to your working day and also in your general life.

Optimising your workplace setup at home or in the office will also help you feel more comfortable and there are several very useful resources here.

Finally, building strength and fitness as part of your lifestyle will reduce both the physical and mental stress associated with sedentary work. A well-balanced programme of cardiovascular exercises, like walking or cycling, combined with strength and conditioning training is ideal.

Don’t hesitate to get in touch if you need a more individualised programme of workplace stretches or more advice on habit stacking.

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How to prevent an injury at the gym

Whether you are new to the gym or starting back after a break due to injury, illness or pandemic restrictions, ensuring that you do not get injured is essential so you can fully enjoy your gym experience.

Often when you are going to the gym for the first time in a while,  you are excited and want to do everything at once, however, this can increase your risk of injury.

How to get started in the gym?

While some injuries are unavoidable accidents, there are always steps you can take to help protect yourself as much as possible.

  • Warm up properly: A warm-up raises the temperature of the involved muscles and promotes flexibility and mobility. Riding a stationary bike, jogging, swimming, stair climbing or high repetitions of very lightweight exercises are recommended forms of warm-up. This will ensure that your body is  ready for the more strenuous workout
  • Avoid just repeating the same motion over and over again.   If you continuously train or exercise the same muscles in the same way you will increase your chances of getting an overuse injury. To help prevent overuse injuries, vary your workouts.  Train different groups of muscles if strength training, use different equipment, and don’t always just run for your cardio workout, try the static bike or rowing machine. This will help keep you more balanced,  spread the strain across your body and make your workouts more exciting,
  • Good form for your exercise. If you are new to the gym or want to try a new exercise or piece of equipment, learning the right way to use it can help prevent injury. Often you get a free session with one of the personal trainers in a gym so take advantage of this to learn the proper way to do an exercise. Here at Physiofit, we offer 1:1 strength and conditioning sessions with a physio who is also strength and condition trained therefore they will be able to give you the best advice and teach you how to use any gym equipment you are interested in to help reduce injury chances.
  • Resting in between workouts. Exercising too often without adequate time for the body to recover can negatively impact your body’s overall level of strength and conditioning. Overtraining drains your energy which, in turn, slows or negatively impacts your progress.  Your body will become depleted and weakened,  which will increase your likelihood of an injury. The solution is to cut back to three to four sessions per week if you are always doing the same type of exercise and keep session length to no more than an hour.

  • Do not push your body too hard or too quickly: This is extremely important if you are starting a new type of exercise or returning after a period of rest. It’s essential to slowly increase your intensity levels ( even if it seems too easy at first) so your body can adapt and strengthen slowly. Listen to your body. You can expect sore muscles after your workout. But you should never feel pain when exercising. If you feel pain, stop right away.
  • Avoid doing exercise that is too strenuous for your level of fitness. Using too much weight in an exercise will increase injury potential. What’s too much? If you can’t control weight on its downward, loading motion or if you have to jerk or heave a weight in order to lift it. An out-of-control barbell or dumbbell can have a mind of its own and obeys the laws of gravity therefore you may find yourself on the floor with the weight.
  • Using proper equipment. In the gym, the main equipment you will need is your footwear. The type you need will depend on the exercises you intend on doing, for example, if you are going to run on the treadmill you will need proper running trainers, if you are lifting weights a weightlifting shoe will be more appropriate.

Further support  before you start at the gym

Here at Physiofit, we can offer you 1:1 strength and conditioning sessions with a physiotherapist, where we can teach you how to lift weights and use gym equipment in a safe and structured way. We can tailor a gym program specific to your needs. We also offer running biomechanical assessments, looking at the way you move and identifying areas that may need improvement to keep you injury-free. if you have any questions regarding our services please do not hesitate to contact us.

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