Tips For Healthy Cycling. By Nick Black, Physiotherapist

Cycling orchard lined roads, touring between vineyards, cruising the Kettle valley railway, flowing down trails at Smith creek, or eagerly awaiting completion of the Okanagan rail trail – cycling offers something for everyone in the beautiful Okanagan.
After an injury or surgery, my patients commonly ask “do you think I’m ready to get back on my bike?”. More often than not, the answer is “yes”. The bicycle is such a fantastic tool for rehabilitation and exercise, producing low impact forces on the body, while promoting lower limb range of motion and strength. However, whether your goal is rehabilitation, fitness, competing in the next triathlon, or just plain enjoyment, you should be aware of some common aches and pains that can stem from time on your bike.
Necks, backs and knees are the most common areas of complaint from cyclists. Sure, cycling is low impact but it can also require long periods of time in sustained postures. When a muscle is in a prolonged contraction its blood flow is limited, its pH level drops becoming more acidic, at which time the muscle will begin to fatigue and complain. Experiencing muscle fatigue and mild pain is a normal process of getting stronger, however only when balanced with adequate recovery time! Prolonged load beyond your tissues tolerance and inadequate recovery time are the primary reasons for injuries on the bike.
If you’re new to cycling or getting back on the bike after a long hiatus, I would encourage you to adhere to the following three principles. 1) Get your bike properly fitted to you. A well fitted bike creates an efficient posture, significantly reducing unwanted loading on your neck, back and knees. Your local bike store can guide you in this process. 2) Start low and build slow. Gradually increasing the load on your bodies tissues and allowing recovery after a ride will allow your tissues to adapt, becoming more tolerant to prolonged postures on the bike. 3) Develop your core strength. The concept of ‘core strength’ is an over promoted concept but when it comes to cycling, having strong gluts and lower back muscles will help to maintain an efficient posture for producing power through the legs and minimizing strain on your back in the process. Consider consulting a physiotherapist or exercise professional for a few core strengthening exercises that can be performed off the bike two to three times a week.
The benefits of cycling far outweigh any of the potential aches and pains mentioned above. Train smartly by adhering to the above principles and continue to experience the joys of cycling in the Okanagan. Maybe I’ll see you at this years Apple triathlon?
Nick Black is a registered Physiotherapist at Sun City Physiotherapy Winfield. He can be contacted at the new Winfield location by phone: 250-766-2544 or email:winfield@suncityphysiotherapy.com

Exercise after Pregnancy by Brenda Walsh, Physiotherapist

There are a few things a woman should take into consideration when resuming exercise after pregnancy: Pelvic floor strength and her abdominal muscles. Restoration and strengthening of the Pelvic Floor muscles is very important and should begin in the early days and continue weeks after delivery. Whether her delivery was vaginal or C-section, special attention needs to be paid to the post-partum woman’s abdominal wall. A widening of the gap between the two bands of the Rectus Abdominus muscle, known as Diastasis Recti, may not resolve spontaneously after pregnancy.

Pregnancy and childbirth puts a woman’s body through one of her life’s most strenuous events. Laxity in the ligaments, an increase abdominal girth, an exaggerated forward tilt of the pelvis can alter the center of gravity, affecting dynamic stability of the spine and pelvis. Combined with the load of carrying a new baby and breastfeeding, these added stresses to the spine can lead to postural fatigue and discomfort. Physiotherapists are experts at analyzing posture and alignment and can prescribe postural exercises and advice on body mechanics.

Kegel exercises are an important part of pre-natal health. The Pelvic Floor muscles (PFM) lie at the base of the pelvis, and run from behind the pubic bone to the tailbone. Differentiate a PFM contraction from the buttock muscles. To avoid increasing intra-abdominal pressure, don’t hold your breath and push. Instead, think of pulling the two side walls of the vagina toward midline, and lift up inside. Hold this contraction for 10 seconds, without holding your breath.
Immediately after a vaginal delivery, many women find it hard to feel a contraction in their pelvic floor muscles. It works much easier if “muscle memory” exists from previous practice.
If you’re having difficulty with this, an internal examination by a women’s health physiotherapist can determine the extent of the problem. Other concerns, such as uncomfortable scarring after an episiotomy, can also be addressed.

We have 3 layers of abdominal muscles. 100% of women have some degree of Diastasis Recti, or abdominal separation in their third trimester of pregnancy. At 8 weeks post-partum, if the gap is marked (greater than 2 fingers width), if untreated it will likely still be a problem after a year. Diastasis Recti can aggravate low back problems and result in a midline “doming” of the abdomen under load. The underlying cause is an abnormal increase in intra-abdominal pressure during exertion, not the pregnancy itself.

If you suspect you have a Diastasis, try to avoid activities that strain on the abdominal wall. This would include sit-ups, especially over a large ball, heavy lifting, yoga postures that include back bends, Pilates “100’s”. This is until you have learned to contract the inner Transversus Abdominus (TrA) muscle to support the wall.

Two thirds of women with Diastasis Recti have some level of Pelvic floor dysfunction. The Pelvic Floor muscles and TrA work synergistically to support the pelvic organs, especially during exertion. Good tone in these muscles helps to prevent and treat prolapse and stress incontinence, which can show up in mid-life.

Brenda Walsh is a registered physiotherapist and associate at Sun City’s Glenmore location. She can be contacted at glenmore@suncityphysiotherapy.com

Skiing and Snowboarding by Krista Smith, Physiotherapist

Ski and snowboard season is here!

I’m sure many of you skiers out there have already started to dust off your equipment, check the daily snow report and maybe even head to the mountain for some early season skiing.

We are fortunate in Kelowna to have so many great ski resorts nearby. Skiing and snowboarding are great ways to get some fresh air and exercise when it can be a challenge to stay active in Kelowna through the fall and winter. This is especially true lately when it has been so wet, cold and dark outside. Since most outdoor activities have wrapped up for the summer, I think that this is the perfect time of year to start conditioning your body in preparation for the upcoming ski season, if you are not already doing so. A good exercise program which addresses core and hip stability, balance, flexibility, muscle endurance and aerobic conditioning will go a long way to help improve your endurance and technique on the mountain to help you get the most out of your season.

If you are currently recovering from an injury or if you have just been sedentary for some time and are noticing a lack of strength, balance, range of motion or overall conditioning, it can be very useful to engage in a progressive rehabilitation exercise program prior to doing something more demanding on your body, like hitting the slopes for the day.

In the clinic, it is not uncommon to see overuse or traumatic injuries pop up as a result of unresolved muscle weakness, due to injury or sedentary behaviour, followed by more demanding or intense exercise. This excessive demand could come from lifting very heavy weights, running too fast or too far, attending an advanced exercise class or participating in a full day of winter activities. While the above examples may very well be a realistic long term goal, you may be putting your body at an increased risk of injury if you engage in an activity that your body is not adequately prepared for.

Exercise needs to be consistent and frequent, rather than all or none. Set a goal to exercise small amounts each day. An exercise program should include a combination of core stability, strengthening, stretching, balance training and aerobic conditioning.

If you are currently recovering from an injury or if you have been inactive for some time and are not sure where to begin, a physiotherapist can help get you on the right track, by developing a safe and effective individualized home exercise program based on your specific goals and current ability.

Krista Smith is a Registered Physiotherapist and associate at Sun City Physiotherapy’s downtown Kelowna clinic. She can be contacted at 250-861-8056 or email downtown@suncityphysiotherapy.com